{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T18:44:18Z","timestamp":1792349058689,"version":"4.4.0"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The detection of prostate cancer requires histological confirmation in biopsy core. Currently, number of unnecessary prostate biopsies are being performed in the United States. This is due to the absence of appropriate biopsy decision\u2010making protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To develop and validate a 4K score\/multiparametric magnetic resonance imaging (mpMRI)\u2010based nomogram to predict prostate cancer (PCa), clinically significant prostate cancer (csPCa), and unfavorable prostate cancer (uPCa).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Retrospective, single\u2010center study evaluating a cohort of 574 men with 4K score test &gt;7% or suspicious digital rectal examination (DRE) or Prostate Imaging Reporting and Data System (PI\u2010RADS) scores 3, 4, or 5 on mpMRI that underwent systematic and\/or mpMRI\/ultrasound fusion\u2013targeted prostate biopsy between 2016 and 2020. External cohort included 622 men. csPCa and uPCa were defined as Gleason score \u22653\u2009+\u20094 and \u22654\u2009+\u20093 on biopsy, respectively. Multivariable logistic regression analysis was performed to build nomogram for predicting PCa, csPCa, and uPCa. Validation was performed by plotting the area under the curve (AUC) and comparing nomogram\u2010predicted probabilities with actual rates of PCa, csPCa, and uPCa probabilities in the external cohort.<\/jats:p><jats:p>4K score, a PI\u2010RADS \u22654, prostate volume and prior negative biopsy were significant predictors of PCa, csPCa, and uPCa. AUCs were 0.84, 0.88, and 0.86 for the prediction of PCa, csPCa, and uPCa, respectively. The predicted and actual rates of PCa, csPCa, and uPCa showed agreement across all percentage probability ranges in the validation cohort. Using the prediction model at threshold of 30, 30% of overall biopsies, 41% of benign biopsies, and 19% of diagnosed indolent PCa could be avoided, while missing 9% of csPCa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This novel nomogram would reduce unnecessary prostate biopsies and decrease detection of clinically insignificant PCa.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1357","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T13:54:05Z","timestamp":1614866045000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["A <scp>4K<\/scp> score\/<scp>MRI<\/scp>\u2010based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancer"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8027-6661","authenticated-orcid":false,"given":"Vinayak 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology Icahn School of Medicine at Mount Sinai Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Radiology Icahn School of Medicine at Mount Sinai Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Kenneth","family":"Haines","sequence":"additional","affiliation":[{"name":"Department of Pathology Icahn School of Medicine at Mount Sinai Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanoj","family":"Punnen","sequence":"additional","affiliation":[{"name":"Department of Urology University of Miami, Miller School of Medicine  Miami Florida 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