![]() ![]() The apparent diffusion was obtained from diffusion-weighted imaging (DWI), which was acquired using a 2-dimensional echo planar imaging sequence with multiple bvalue acquisitions (0, 100 s mm − 2, 800 s mm − 2, 1000 s mm − 2, and 1500 s mm − 2), with diffusion-sensitizing gradients applied along the x-, y-, and z-axes. The prostate and seminal vesicles were imaged using transverse T1weighted turbo spinecho (TSE) images, as well as the transverse, coronal and sagittal T2weighted TSE images(T2WI). The signal was received via an 18channel body and standard spine array coils. We utilized a 3T MR scanner (MAGNETOM Skyra, Siemens Healthineers, Erlangen, Germany) to acquire images from all patients. Of these, 717 patients from June 2016 to August 2020 were enrolled in the training set, and 239 patients from August 2020 to August 2021 were enrolled in the validation set. Then all of them underwent transperineal PB (TP-PB). MRI-based triaging was performed as described by Donato et al. Of these patients, 63 had previously received treatment, 101 had a prostate-specific antigen (PSA) level above 100 ng ml − 1, 36 were unable to undergo MRI examinations, and 956 received a mpMRI examination. In this retrospective cohort study, a total of 1156 male patients presented for PB at The First Affiliated Hospital of Soochow University (Suzhou, China) from June 2016 to August 2021. Consequently, a novel csPCa prediction system is being developed to improve diagnostic performance and avoid unnecessary biopsies. The current focus is on identifying patients with clinically significant PCa (csPCa) as early as possible, rather than identifying all PCa. Currently, mpMRI is recommended prior to the first PB to improve diagnostic accuracy. The PIRADS ranges from 1 (clinically significant cancer is highly unlikely to present) to 5 (clinically significant cancer is highly likely to present). In 2015, the American College of Radiologists, the European Society of Urogenital Radiology (EUSR) and the AdMeTech Foundation developed the Prostate Imaging Reporting and Data System (PIRADS) version 2, which was later upgraded to 2.1. In recent years, multiparameter magnetic resonance imaging (mpMRI) has been increasingly used for diagnosis. Diagnosis of PCa relies on prostate biopsy (PB). The incidence of prostate cancer (PCa) has risen dramatically in recent years, making it the second most common male cancer worldwide, affecting approximately 375,000 men per year. score contains data that is easy to obtain and is worthy of clinical replication. score (including PIRADS(P), aPSADPZ(Z) and age(A)) can increase the detection rate of csPCa, which may decrease the risk of misdiagnosis and reduce the number of unnecessary biopsies. The validation set provided better validation of the model. score was in good agreement with the actual number of patients with csPCa in the high-risk threshold. In addition, the number of patients with csPCa predicted by P.Z.A. The nomogram displayed excellent net benefit and better overall calibration for predicting the occurrence of csPCa. External validation of the model using the validation set was also performed. score were evaluated by decision curve analysis and clinical impact curves. The nomogram was established, and discrimination abilities of the new nomogram were verified with a calibration curve and area under the ROC curve (AUC). Age, prostate-specific antigen (PSA), free/total PSA (f/tPSA), PSA density (PSAD), peripheral zone volume ratio (PZ-ratio), and adjusted PSAD of PZ (aPSADPZ) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The demographic and clinical characteristics of 956 patients were recorded. score for clinically significant prostate cancer (csPCa). ![]() This study aims to establish and validate a new diagnosis model called P.Z.A.
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