{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T16:37:49Z","timestamp":1770223069970,"version":"3.49.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aimed to evaluate the positive predictive value (PPV) of the Prostate Imaging Reporting and Data System (PI-RADS) combined with single related indicators in diagnosing prostate cancer (PCa) across different prostate zones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with complete clinical data who underwent prostate magnetic resonance imaging from January 2019 to October 2024 were retrospectively analyzed. PI-RADS was used for diagnosis, zoning, and grading, with 533 cases scoring \u22653. PPVs for PCa across different prostate zones were calculated by combining age, prostate-specific antigen (PSA), PSA density (PSAd), and prostate volume. Differences between non-PCa and PCa groups were compared using independent sample\n                      <jats:italic>t<\/jats:italic>\n                      - and rank-sum tests. Diagnostic efficacy was assessed using area under the curve (AUC) values for receiver operating characteristic curves. Univariate logistic regression analysis was used to identify factors associated with malignant pathology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The PPV for PI-RADS scores 3\u20135 was 20.6% (33\/160), 61.1% (159\/260), and 80.5% (91\/113), respectively. PPVs for PCa across peripheral, transitional, and multi-zones were 78.6% (96\/122), 35.2% (114\/323), and 82.9% (73\/88), respectively. Age, PSA, PSAd, and prostate volume significantly differed between the non-PCa and PCa groups, with AUC values of 0.629, 0.709, 0.809, and 0.703, respectively, and were significantly associated with malignant pathology (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001, univariate logistic regression analysis).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Combining the PI-RADS with other clinical indicators effectively enhanced its initially low PPV for transitional zone lesions, particularly when the PSAd was \u22650.15 ng\/mL\n                      <jats:sup>2<\/jats:sup>\n                      or the PSA was &amp;gt;10 ng\/mL.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1661267","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:34:39Z","timestamp":1770183279000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Positive predictive value of the prostate imaging reporting and data system combined with single related indicators in prostate cancer across different prostate zones"],"prefix":"10.3389","volume":"16","author":[{"given":"XiaFeng","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)","place":["Hangzhou, China"]},{"name":"Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LuYao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)","place":["Hangzhou, China"]},{"name":"Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ShiWei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)","place":["Hangzhou, China"]},{"name":"Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JianLiang","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)","place":["Hangzhou, China"]},{"name":"Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.03.027","article-title":"EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate Cancer-2024 update. Part I: Screening, diagnosis, and local treatment with curative intent","volume":"86","author":"Cornford","year":"2024","journal-title":"Eur Urol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-020-02431-8","article-title":"Prostate MRI: staging and decision-making","volume":"45","author":"Magnetta","year":"2020","journal-title":"Abdom Radiol (NY)"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-021-00320-9","article-title":"Use of multiparametric magnetic resonance imaging (mpMRI) in active surveillance for low-risk prostate cancer: A scoping review on the benefits and harm of mpMRI in different biopsy scenarios","volume":"24","author":"Chiam","year":"2021","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2174\/1573405618666211217101542","article-title":"Current MRI methods for the assessment of pathologic prostate: A brief review for clinicians","volume":"18","author":"Salazar-Ruiz","year":"2022","journal-title":"Curr Med Imaging"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s10334-022-01019-1","article-title":"PI-RADS: Multiparametric MRI in prostate cancer","volume":"35","author":"O\u2019Shea","year":"2022","journal-title":"Magma"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13020446","article-title":"Application of advanced imaging to prostate cancer diagnosis and management: A narrative review of current practice and unanswered questions","volume":"13","author":"McKone","year":"2024","journal-title":"J Clin Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e223128","DOI":"10.1148\/radiol.223128","article-title":"PI-RADS: where next","volume":"307","author":"Turkbey","year":"2023","journal-title":"Radiology"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-018-1751-5","article-title":"Assessment of PI-RADS v2 categories \u2265\u20093 for diagnosis of clinically significant prostate cancer","volume":"44","author":"Patel","year":"2019","journal-title":"Abdom Radiol (NY)"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s10334-022-01012-8","article-title":"MR fingerprinting of the prostate","volume":"35","author":"Lo","year":"2022","journal-title":"Magma"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2020.08.007","article-title":"Screening for prostate cancer","volume":"104","author":"Carlsson","year":"2020","journal-title":"Med Clin North Am"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-022-00638-6","article-title":"Serum PSA-based early detection of prostate cancer in Europe and globally: Past, present and future","volume":"19","author":"Van Poppel","year":"2022","journal-title":"Nat Rev Urol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J Clin"},{"key":"B13","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1002\/jmri.28505","article-title":"Patients with \u201cgray zone\u201d PSA levels: Application of prostate MRI and MRS in the diagnosis of prostate cancer","volume":"57","author":"Li","year":"2023","journal-title":"J Magn Reson Imaging"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e2330611","DOI":"10.2214\/AJR.23.30611","article-title":"PI-RADS upgrading rules: Impact on prostate cancer detection and biopsy avoidance of MRI-directed diagnostic pathways","volume":"222","author":"de Oliveira Correia","year":"2024","journal-title":"AJR Am J Roentgenol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1068893","article-title":"Development of a novel nomogram for predicting clinically significant prostate cancer with the prostate health index and multiparametric MRI","volume":"12","author":"Mo","year":"2022","journal-title":"Front Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2019182946","article-title":"PI-RADS steering committee: The PI-RADS multiparametric MRI and MRI-directed biopsy pathway","volume":"292","author":"Padhani","year":"2019","journal-title":"Radiology"},{"key":"B17","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1148\/radiol.2020190646","article-title":"Variability of the positive predictive value of PI-RADS for prostate MRI across 26 centers: Experience of the Society of Abdominal Radiology prostate cancer disease-focused panel","volume":"296","author":"Westphalen","year":"2020","journal-title":"Radiology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.eururo.2015.08.052","article-title":"PI-RADS prostate imaging \u2013 Reporting and data system: 2015, version 2","volume":"69","author":"Weinreb","year":"2016","journal-title":"Eur Urol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.02.033","article-title":"Prostate imaging reporting and data system version 2.1: 2019 update of prostate imaging reporting and data system version 2","volume":"76","author":"Turkbey","year":"2019","journal-title":"Eur Urol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.4102\/sajr.v25i1.2062","article-title":"PI-RADS v2.1: What has changed and how to report","volume":"25","author":"Scott","year":"2021","journal-title":"SA J Radiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"395","DOI":"10.2214\/AJR.20.24370","article-title":"Prospective PI-RADS v2.1 atypical benign prostatic hyperplasia nodules with marked restricted diffusion: Detection of clinically significant prostate cancer on multiparametric MRI","volume":"217","author":"Costa","year":"2021","journal-title":"AJR Am J Roentgenol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24757","article-title":"Consistent predictive ability of prostate-specific antigen density prediction model for clinically significant prostate cancer across age strata","volume":"84","author":"Malshy","year":"2024","journal-title":"Prostate"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e24700","DOI":"10.1002\/jcla.24700","article-title":"The influence of prostate volume on clinical parameters in prostate cancer screening","volume":"36","author":"Shan","year":"2022","journal-title":"J Clin Lab Anal"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24078","article-title":"Association between PSA density and pathologically significant prostate cancer: The impact of prostate volume","volume":"80","author":"Omri","year":"2020","journal-title":"Prostate"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.232635","article-title":"Fully automated deep learning model to detect clinically significant prostate cancer at MRI","volume":"312","author":"Cai","year":"2024","journal-title":"Radiology"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1661267\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:34:40Z","timestamp":1770183280000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1661267\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":25,"alternative-id":["10.3389\/fonc.2026.1661267"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1661267","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,4]]},"article-number":"1661267"}}