{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:29Z","timestamp":1787014349024,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the generalizability of a computer\u2010aided diagnosis (CADx) system based on the apparent diffusion coefficient (ADC) and wash\u2010in rate, and trained on a French population to diagnose International Society of Urological Pathology \u2265\u20092 prostate cancer on multiparametric MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty\u2010eight consecutive patients who underwent radical prostatectomy at a single Japanese institution were retrospectively included. Pre\u2010prostatectomy MRIs were reviewed by an experienced radiologist who assigned to suspicious lesions a Prostate Imaging\u2010Reporting and Data System version 2.1 (PI\u2010RADSv2.1) score and delineated them. The CADx score was computed from these regions\u2010of\u2010interest. Using prostatectomy whole\u2010mounts as reference, the CADx and PI\u2010RADSv2.1 scores were compared at the lesion level using areas under the receiver operating characteristic curves (AUC), and sensitivities and specificities obtained with predefined thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In PZ, AUCs were 80% (95% confidence interval [95% CI]: 71\u201390) for the CADx score and 80% (95% CI: 71\u201389;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.886) for the PI\u2010RADSv2.1score; in TZ, AUCs were 79% (95% CI: 66\u201390) for the CADx score and 93% (95% CI: 82\u201396;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.051) for the PI\u2010RADSv2.1 score. The CADx diagnostic thresholds that provided sensitivities of 86%\u201391% and specificities of 64%\u201375% in French test cohorts yielded sensitivities of 60% (95% CI: 38\u201383) in PZ and 42% (95% CI: 20\u201371) in TZ, with specificities of 95% (95% CI: 86\u2013100) and 92% (95% CI: 73\u2013100), respectively. This shift may be attributed to higher ADC values and lower dynamic contrast\u2010enhanced temporal resolution in the test cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The CADx obtained good overall results in this external cohort. However, predefined diagnostic thresholds provided lower sensitivities and higher specificities than expected.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70161","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T08:25:29Z","timestamp":1751876729000},"page":"1440-1448","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["External Validation on a Japanese Cohort of a Computer\u2010Aided Diagnosis System Aimed at Characterizing\n                    <scp>ISUP<\/scp>\n                    \u2265\u20092 Prostate Cancers at Multiparametric\n                    <scp>MRI<\/scp>"],"prefix":"10.1111","volume":"32","author":[{"given":"Raphael","family":"Escande","sequence":"first","affiliation":[{"name":"Department of Radiology H\u00f4pital Edouard Herriot, Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan","family":"Jaouen","sequence":"additional","affiliation":[{"name":"LabTau INSERM U1032  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Gonindard\u2010Melodelima","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Grenoble Alpes Laboratoire D'\u00e9cologie Alpine  Grenoble France"},{"name":"CNRS  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Crouzet","sequence":"additional","affiliation":[{"name":"LabTau INSERM U1032  Lyon France"},{"name":"Department of Urology H\u00f4pital Edouard Herriot, Hospices Civils de Lyon  Lyon France"},{"name":"Universit\u00e9 Lyon 1  Lyon France"},{"name":"Facult\u00e9 de m\u00e9decine Lyon\u2010Est  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Urology Tokai University Hachioji Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9mi","family":"Souchon","sequence":"additional","affiliation":[{"name":"LabTau INSERM U1032  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0030-478X","authenticated-orcid":false,"given":"Olivier","family":"Rouvi\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Radiology H\u00f4pital Edouard Herriot, Hospices Civils de Lyon  Lyon France"},{"name":"LabTau INSERM U1032  Lyon France"},{"name":"Universit\u00e9 Lyon 1  Lyon France"},{"name":"Facult\u00e9 de m\u00e9decine Lyon\u2010Est  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6673-9316","authenticated-orcid":false,"given":"Sunao","family":"Shoji","sequence":"additional","affiliation":[{"name":"Department of Urology Tokai University School of Medicine  Isehara Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-019-0212-4"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.7578"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.03.027"},{"key":"e_1_2_10_5_1","first-page":"9","article-title":"Prostate Cancer: Diagnosis and Management","volume":"124","author":"NICE Guidance \u2010 Prostate Cancer: Diagnosis and Management: (c) NICE","year":"2019","journal-title":"BJU International"},{"key":"e_1_2_10_6_1","article-title":"Prostate MRI, With or Without MRI\u2010Targeted Biopsy, and Systematic Biopsy for Detecting Prostate Cancer","volume":"4","author":"Drost F.\u2010J. 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