{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T02:56:08Z","timestamp":1791687368890,"version":"4.3.4"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T00:00:00Z","timestamp":1773446400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Key R&D Projects of Hainan Province","award":["ZDYF2021SHFZ243"],"award-info":[{"award-number":["ZDYF2021SHFZ243"]}]},{"name":"Hainan Province Health Science and Technology Innovation Joint Project","award":["WSJK2024MS196"],"award-info":[{"award-number":["WSJK2024MS196"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Periprostatic adipose tissue (PPAT) fibrosis is a histological feature potentially linked to prostate cancer (PCa) aggressiveness, though its role is not fully understood. This study investigates the correlation between PPAT fibrosis and PCa aggressiveness and develops a radiomics model based on PPAT MRI features for non-invasive prediction. Methods: This retrospective study included 51 patients who underwent radical prostatectomy. PPAT samples were collected, stained with Sirius Red and quantitatively evaluated for fibrosis using 12 indices via 3D reconstruction with Imaris software. Patients were stratified by cancer aggressiveness based on Grade Groups. Radiomic features were extracted from T1-weighted MRIs of the PPAT. An XGBoost model was developed to predict aggressiveness using these features. Results: Significant correlations were found between multiple PPAT fibrosis indices and PCa aggressiveness (p &lt; 0.05), with more aggressive tumors showing increased fiber complexity. PPAT fibrosis was also significantly associated with primary tumor location in the peripheral zone (p &lt; 0.05). Conversely, PPAT volume showed no significant correlation with aggressiveness (p = 0.616). The radiomics model based on PPAT features achieved an AUC of 0.86 in predicting cancer aggressiveness. Conclusions: PPAT fibrosis is a promising marker of PCa aggressiveness, superior to PPAT volume. The significant link with tumor location provides new insights into the tumor microenvironment (TME). MRI-based radiomics of PPAT offers a potential non-invasive method for assessing fibrosis and aggressiveness, aiding in early diagnosis and personalized treatment.<\/jats:p>","DOI":"10.3390\/cancers18060949","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T14:30:32Z","timestamp":1773671432000},"page":"949","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fibrosis of Periprostatic Adipose Tissue: A Potential Marker of Prostate Cancer Aggressiveness"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3194-5416","authenticated-orcid":false,"given":"Yiling","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Radiology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyue","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"College of Computer Science and Cyberspace Security, Hainan University, Haikou 570228, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiming","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Urology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxing","family":"Huang","sequence":"additional","affiliation":[{"name":"College of Information and Communication Engineering, Hainan University, Haikou 570208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,14]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. 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