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Two T<jats:sub>2<\/jats:sub>\u2010weighted and three diffusion\u2010weighted imaging (DWI) acquisitions: 1) b\u2010values 0, 100, 200, 300, 500 s\/mm<jats:sup>2<\/jats:sup>; 2) b\u2010values 0,1500 s\/mm<jats:sup>2<\/jats:sup>; 3) b\u2010values 0, 2000 s\/mm<jats:sup>2<\/jats:sup>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>IMPROD bpMRI examinations were qualitatively (IMPROD bpMRI Likert score) and quantitatively (DWI\u2010based Gleason grade score) prospectively reported. Men with IMPROD bpMRI Likert 3\u20135 had two targeted biopsies followed by 12\u2010core systematic biopsies (SB); those with IMPROD bpMRI Likert 1\u20132 had only SB. Additionally, 2\u2010core from normal\u2010appearing prostate areas were obtained for the mRNA expression of ACSM1, AMACR, CACNA1D, DLX1, PCA3, PLA2G7, RHOU, SPINK1, SPON2, TMPRSS2\u2010ERG, and TDRD1 measured by quantitative reverse\u2010transcription polymerase chain reaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Univariate and multivariate analysis using regularized least\u2010squares, feature selection and tournament leave\u2010pair\u2010out cross\u2010validation (TLPOCV), as well as 10 random splits of the data in training\u2010testing sets, were used to evaluate the mRNA, clinical and IMPROD bpMRI parameters in detecting clinically significant prostate cancer (SPCa) defined as Gleason score\u2009\u2265\u20093\u2009+\u20094. The evaluation metric was the area under the curve (AUC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>IMPROD bpMRI Likert demonstrated the highest TLPOCV AUC of 0.92. The tested clinical variables had AUC 0.56\u20130.73, while the mRNA and additional IMPROD bpMRI parameters had AUC 0.50\u20130.67 and 0.65\u20130.89 respectively. The combination of clinical and mRNA biomarkers produced TLPOCV AUC of 0.87, the highest TLPOCV performance without including IMPROD bpMRI Likert.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>The qualitative IMPROD bpMRI Likert score demonstrated the highest accuracy for SPCa detection compared with the tested clinical variables and mRNA biomarkers.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold>1<\/jats:p><jats:p><jats:bold>Technical Efficacy Stage:<\/jats:bold>2<\/jats:p><jats:p>J. Magn. Reson. Imaging 2020;51:1540\u20131553.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26945","type":"journal-article","created":{"date-parts":[[2019,10,7]],"date-time":"2019-10-07T04:47:58Z","timestamp":1570423678000},"page":"1540-1553","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prostate Cancer Risk Stratification in Men With a Clinical Suspicion of Prostate Cancer Using a Unique Biparametric MRI and Expression of 11 Genes in Apparently Benign Tissue: Evaluation Using Machine\u2010Learning Techniques"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9744-9204","authenticated-orcid":false,"given":"Ileana","family":"Montoya Perez","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology University of Turku Turku Finland"},{"name":"Department of Future Technologies University of Turku Turku Finland"},{"name":"Medical Imaging Centre of Southwest Finland Turku 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