{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T23:21:45Z","timestamp":1788477705960,"version":"build-2803163510"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"1179","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"The Shanxi Provincial Key Research and Development","award":["2024SF-YBXM-417"],"award-info":[{"award-number":["2024SF-YBXM-417"]}]},{"name":"The Xi\u2019an Science and Technology Program Project for Medical Research","award":["25YXYJYB00095"],"award-info":[{"award-number":["25YXYJYB00095"]}]},{"name":"The Youth Project of the Scientific Research Fund of the Second Affiliated Hospital of Xi\u2019an Jiaotong University","award":["YJ[QN]202313"],"award-info":[{"award-number":["YJ[QN]202313"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the value of combining zonal origin with intravoxel incoherent motion (IVIM) parameters in predicting the International Society of Urological Pathology (ISUP) risk groups of prostate cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The retrospective study enrolled 351 prostate cancer patients who underwent mpMRI including IVIM. Patients were stratified into low-risk and high-risk group according to ISUP grades, and divided into peripheral zone (PZ) and transition zone (TZ) cancer group according to zonal origins of lesions. Clinicopathological characteristics and IVIM-derived parameters between groups were compared. Logistic regression was performed to identify variables associated with ISUP high-risk group. The predictive accuracy of the variables for ISUP risk groups was evaluated using receiver operating characteristic (ROC) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PZ cancers exhibited higher proportion of pathological stage \u2265pT3 (P\u2009=\u2009.0184) and ISUP grade 3-5 (P\u2009&amp;lt;\u2009.0001), and demonstrated lower Dmean, ADCmin, and ADCmean (P\u2009=\u2009.0209, P\u2009=\u2009.0160, P\u2009=\u2009.0302) than TZ cancers. There was significant differences in zonal origin, Dmean, ADCmin, and ADCmean between the 2 ISUP risk groups (P\u2009&amp;lt; .0001, P &amp;lt; .0001, P\u2009=\u2009.0024, P\u2009=\u2009.0017). Zonal origin, prostate-specific antigen (PSA), Dmean, and ADCmin were identified as independent predictors of ISUP high-risk disease. The comprehensive model combining zonal origin, PSA, Dmean, and ADCmin demonstrated superior predictive performance (AUC\u2009=\u20090.956, 95% CI: 0.930-0.981) with a sensitivity of 90.63% and a specificity of 76.04%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The combined diagnostic model demonstrates high efficiency for predicting the ISUP risk group preoperatively for prostate cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>The multiparameter predictive model including anatomical zones offers a non-invasive and effective tool for preoperative risk stratification for prostate cancer, thereby improving decision-making precision, and reducing unnecessary invasive procedures.<\/jats:p>\n                  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