{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:48:05Z","timestamp":1788536885859,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T00:00:00Z","timestamp":1659484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016803","name":"Natural Science Foundation of Suzhou City","doi-asserted-by":"publisher","award":["SLJ201906"],"award-info":[{"award-number":["SLJ201906"]}],"id":[{"id":"10.13039\/100016803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop and externally validate a novel nomogram in biopsy\u2010na\u00efve patients with prostate\u2010specific antigen (PSA) &lt;10\u00a0ng\/ml and PI\u2010RADS v2.1\u00a0=\u00a03 lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By Slicer\u20103D Software, the volume of all lesions was divided into two subgroups (PI\u2010RADS v2.1\u00a0=\u00a03a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate\u2010specific antigen density, digital rectal examination, PI\u2010RADS v2.1\u00a0=\u00a03 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, &lt;750\u2009mm<jats:sup>2<\/jats:sup>\/s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Until now, this is the first nomogram that predicts PCa and csPCa in biopsy\u2010na\u00efve patients with PSA &lt;10\u00a0ng\/ml and PI\u2010RADS v2.1\u00a0=\u00a03 lesions. Furthermore, PI\u2010RADS v2.1\u00a0=\u00a03 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so\u2010called \u201cdouble gray zone\u201d patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5100","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T10:09:46Z","timestamp":1659521386000},"page":"2560-2571","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Development and external validation of a novel nomogram to predict prostate cancer in biopsy\u2010na\u00efve patients with <scp>PSA<\/scp> &lt;10\u00a0ng\/ml and <scp>PI\u2010RADS<\/scp> v2.1\u00a0=\u00a03 lesions"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-9348","authenticated-orcid":false,"given":"Can","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8040-6267","authenticated-orcid":false,"given":"Jiale","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Urology The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine  Kunshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8957-948X","authenticated-orcid":false,"given":"Jiangnan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21590"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-016-1939-7"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11091822"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.02.033"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.09.074"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2019.06.014"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11481.x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000365697"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.03.002"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2565-3"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13649"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.5152\/tud.2017.01058"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.08.077"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.12.052"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.08.052"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.24985"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-17-0339"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.12.062"},{"key":"e_1_2_12_20_1","unstructured":"EAU Guidelines Office A The Netherlands.EAU guidelines 2022. 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