{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:28:26Z","timestamp":1791430106420,"version":"4.3.3"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"publisher","award":["12975"],"award-info":[{"award-number":["12975"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol Exp"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Accurate exclusion of cribriform growth (GP4Crib+), an adverse histologic feature in prostate cancer, remains a challenge in selecting intermediate-risk patients for active surveillance (AS). This study evaluates whether an MRI-based radiomics model predicting GP4Crib+ can support AS inclusion decisions under the assumption that intermediate-risk men without GP4Crib+ could be safely managed with AS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This single-center retrospective study was approved by the institutional review board (IRBd21-108) and included men with Cambridge Prognostic Group (CPG) -1, CPG-2, or CPG-3 (Gleason grade (GG) 2) prostate cancer who underwent MRI and radical prostatectomy. In this cohort, a previously trained radiomics model was applied across the whole prostate to generate voxel-wise GP4Crib+ probability maps, to ultimately identify men with GP4Crib. This model was tested in two scenarios: (1) CPG-1+2, and (2) CPG-1+2+3(GG2) patients on biopsy. The reference scenario was CPG-1 men to AS (guideline recommendations).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 127 patients (median age 66 years, interquartile range 47\u201278). Standalone radiomics performance was moderate (area under the receiver operating characteristic curve (AUROC): 0.68 overall; 0.60 for CPG-2; and 0.70 for CPG-3(GG2)). At a 0.60 probability threshold, the model reduced overtreatment by 9% in CPG-1\u2009+\u20092 men (with 1% increase in undertreatment). In CPG-1+2+3(GG2) men, the model reduced overtreatment by 8%, maintaining low undertreatment (3%). Most false negatives involved smaller than 1.5-mm cribriform foci.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our MRI-based GP4Crib+ radiomics model is able to support AS decisions in men with CPG-1+2+3(GG2). Despite modest standalone diagnostic performance, its integration into the clinical work-up may help safely expand AS selection to intermediate-risk men, ultimately reducing overtreatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance statement<\/jats:title>\n                    <jats:p>MRI-based radiomics may support noninvasive exclusion of cribriform growth to guide active surveillance eligibility in intermediate-risk prostate cancer, enabling safer management decisions and reducing unnecessary treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Prostate cancer cribriform growth is difficult to detect but crucial for treatment decisions.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>MRI radiomics helps exclude cribriform growth in intermediate-risk prostate cancer patients.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Radiomics-informed decisions reduced overtreatment under structured AS scenarios.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s41747-026-00728-9","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T09:33:48Z","timestamp":1778664828000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["MRI radiomics predicting cribriform growth informs active surveillance decision in intermediate-risk prostate cancer"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8845-1794","authenticated-orcid":false,"given":"Mar","family":"Fernandez Salamanca","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Sim\u00f5es","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgorzata","family":"Der\u0119gowska-Cylke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Pais Pooch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim J.","family":"van Leeuwen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk G.","family":"van der Poel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos A. 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The studies were conducted in accordance with the local legislation and institutional requirements.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The ethics committee\/institutional review board waived the requirement of written informed consent for participation from the participants or the participants\u2019 legal guardians\/next of kin because, pursuant to national legislation prior to 25 May 2018 (Opt-out), and General hospital informed consent was considered.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"67"}}