{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:17:45Z","timestamp":1780399065362,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82302244"],"award-info":[{"award-number":["82302244"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2024M763537"],"award-info":[{"award-number":["2024M763537"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Several studies have suggested that biopsy\u2010free radical prostatectomy reduces burdens for selected prostate cancer (PCa) patients pre\u2010screened by clinical indicators and PSMA\u2010PET\/CT. However, the absence of pre\u2010operative pathology precludes high\u2010risk PCa (HRPCa) identification, crucial for determining the need for extended pelvic lymph node dissection (ePLND). We evaluated whether combining pre\u2010operative clinical indicators and \u00b9\u2078F\u2010PSMA\u20101007 PET\/CT could non\u2010invasively stratify HRPCa risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective diagnostic study included a development cohort of 93 patients from USTC center, as well as two external validation cohorts: one cohort of 83 patients from XYH Hospital and another cohort of 117 patients from XJH Hospital. All enrolled patients met the USTC model value\u2009\u2265\u20090.6 criteria (assessed using a nomogram composed of PSAD and PI\u2010RADS grade) and obtained definitive pathological results within 4 weeks after \u00b9\u2078F\u2010PSMA\u20101007 PET\/CT examination. Patients were stratified as HRPCa (D'Amico criteria: tPSA&gt;\u200920\u2009ng\/mL, GS\u2009\u2265\u20098, or \u2265\u2009cT2c) or non\u2010high\u2010risk (NHR). Maximum standardized uptake value (SUVmax) and target\u2010to\u2010background ratios (TBRs) of PSMA\u2010PET\/CT were quantified. Diagnostic performance for HRPCa was evaluated using ROC analysis. Multivariate logistic regression analysis identified independent predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the development cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200993), SUVmax (AUC\u2009=\u20090.807) and tPSA (AUC\u2009=\u20090.777) demonstrated good discriminatory performance for identifying HRPCa (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The dual\u2010threshold criterion (SUVmax&gt;\u200920.9 and tPSA&gt;\u200915.09\u2009ng\/mL) achieved a consistently high PPV (up to 100% in the development cohort and &gt;\u200991% in external validation) and specificity, significantly outperforming single parameters (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In two external validation cohorts, similar diagnostic performance was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A dual\u2010threshold non\u2010invasive strategy is established for predicting HRPCa in biopsy\u2010free radical prostatectomy candidates pre\u2010screened by the USTC model, while its applicability to unscreened or low to intermediate\u2010risk populations remains unproven.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70145","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:10:23Z","timestamp":1772957423000},"page":"784-791","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Dual\u2010Threshold Strategy Enables Reliable Biopsy\u2010Free Diagnosis of High\u2010Risk Prostate Cancer"],"prefix":"10.1002","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0746-7997","authenticated-orcid":false,"given":"Yong","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Urology Centre for Leading Medicine and Advanced Technologies of IHM,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui China"},{"name":"Wannan Medical College Wuhu Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6716-1958","authenticated-orcid":false,"given":"Zhiqiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology Chinese PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2132-3621","authenticated-orcid":false,"given":"Jingliang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology Xijing Hospital Fourth Military Medical University Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangcheng","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Urology Xiangya Hospital Central South University Changsha Hunan China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology Centre for Leading Medicine and Advanced Technologies of IHM,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui China"},{"name":"Bengbu Medical University Bengbu Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6172-9896","authenticated-orcid":false,"given":"Yachao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology Chinese PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Urology Centre for Leading Medicine and Advanced Technologies of IHM,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui China"},{"name":"Bengbu Medical University Bengbu Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Urology Centre for Leading Medicine and Advanced Technologies of IHM,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Urology Centre for Leading Medicine and Advanced Technologies of IHM,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Urology Centre for Leading Medicine and Advanced Technologies of IHM,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoxi","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Urology Chinese PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Urology Centre for Leading Medicine and Advanced Technologies of IHM,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui China"},{"name":"Wannan Medical College Wuhu Anhui China"},{"name":"Department of Urology Anhui Provincial Cancer Hospital Hefei Anhui 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