{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:11Z","timestamp":1787027771008,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["PI23\/03010"],"award-info":[{"award-number":["PI23\/03010"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"award":["PI23\/03010"],"award-info":[{"award-number":["PI23\/03010"]}],"id":[{"id":"https:\/\/ror.org\/00ca2c886","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objectives: To externally validate the Barcelona Predictive Models (BCN-PM 1 and 2) for detecting csPCa in an Ibero-American population. BCN-PM 1 was designed to reduce magnetic resonance imaging (MRI) use, whereas BCN-PM 2 aims to decrease unnecessary prostate biopsies. Methods: This prospective, multicenter study included 661 men with suspected PCa recruited in 2025 across three Ibero-American centers. All participants underwent MRI followed by targeted biopsies of lesions with the Prostate Imaging\u2013Reporting and Data System (PI-RADS) \u2265 3, along with systematic biopsy. When PI-RADS lesions were &lt;3, only systematic biopsies were performed. CsPCa was defined as International Society of Urological Pathology Grade Group \u2265 2. BCN-PM 1 incorporates age (years), family history of PCa (no vs. yes), prior negative prostate biopsy (no vs. yes), digital rectal examination (DRE: normal vs. suspicious), and prostate volume-derived estimation by DRE (small, median, or large). BCN-PM 2 includes age, family history of PCa, prior negative prostate biopsy, prostate volume measured by MRI (mL), and PI-RADS score (1\u20135). Results: The rate of csPCa detection was 53.7%. Both models demonstrated good calibration with strong agreement between predicted probabilities and observed csPCa rates. BCN-PM 1 closely followed the reference line, with minor deviations at higher predicted probabilities, whereas BCN-PM 2 showed modest departures at the extremes of risk. The area under the curve was 0.740 (95% CI 0.702\u20130.777) for BCN-PM 1 and 0.803 (95% CI 0.769\u20130.836) for BCN-PM 2 (p &lt; 0.001). Decision curve analysis demonstrated a net benefit for both models compared with strategies of biopsy in all or no men. BCN-PM 2 showed greater net benefit than BCN-PM 1. At 95% sensitivity, BCN-PM 1 reduced MRI requests by 10.6%, while BCN-PM 2 avoided 19.4% of unnecessary biopsies. The sequential use of BCN-PM 1 and 2 resulted in a 10.6% reduction in MRI exams and a 23.1% reduction in biopsies, at the cost of missing 8.4% of csPCa cases. The performance of the biopsy improved from 53.7% to 64.0% (p &lt; 0.001). Conclusions: BCN-PM1 and BCN-PM 2 were successfully validated in an Ibero-American population.<\/jats:p>","DOI":"10.3390\/cancers18111810","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:19:42Z","timestamp":1780316382000},"page":"1810","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["External Validation and Clinical Impact of the Barcelona Predictive Models for Detecting Significant Prostate Cancer in Prostate Biopsies in an Ibero-American Population"],"prefix":"10.3390","volume":"18","author":[{"given":"Nahuel","family":"Paesano","sequence":"first","affiliation":[{"name":"Department of Urology, ROC Clinic and HM Hospitals, 28050 Madrid, Spain"},{"name":"Uro-Radiology Unit, Clinica Creu Blanca, 08034 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Camean","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximiliano","family":"Ringa","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Alem\u00e1n, Buenos Aires 1424, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0332-9138","authenticated-orcid":false,"given":"Maximiliano","family":"L\u00f3pez-Silva","sequence":"additional","affiliation":[{"name":"Centro Argentino de Urolog\u00eda, Buenos Aires 1114, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Koren","sequence":"additional","affiliation":[{"name":"Centro de Estudios M\u00e9dicos e Investigaci\u00f3n Cl\u00ednica, Buenos Aires 1431, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1s Eduardo","family":"Olmedo","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Cl\u00ednico Universidad de Chile, Independencia, Santiago 8380456, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3517-7810","authenticated-orcid":false,"given":"Joaqu\u00edn Ignacio","family":"Gurovich","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Cl\u00ednico Universidad de Chile, Independencia, Santiago 8380456, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar Iv\u00e1n","family":"Bravo-Castro","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Central Militar, Mexico 11200, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Violeta","family":"Catal\u00e1","sequence":"additional","affiliation":[{"name":"Uro-Radiology Unit, Clinica Creu Blanca, 08034 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Contreras","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Alem\u00e1n, Buenos Aires 1424, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3363-1452","authenticated-orcid":false,"given":"Juan","family":"Justo-Quintas","sequence":"additional","affiliation":[{"name":"Department of Urology, ROC Clinic and HM Hospitals, 28050 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Miguel","family":"P\u00e9rez-Ruiz","sequence":"additional","affiliation":[{"name":"Department of Urology, ROC Clinic and HM Hospitals, 28050 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Garc\u00eda-Barreras","sequence":"additional","affiliation":[{"name":"Department of Urology, ROC Clinic and HM Hospitals, 28050 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berta","family":"Mir\u00f3","sequence":"additional","affiliation":[{"name":"Bioinformatics and Statistical Unit, Vall d\u2019Hebron Research Institute, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Regis","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Universitario Vall d\u2019Hebron, 08035 Barcelona, Spain"},{"name":"Research Group in Urology, Vall d\u2019Hebron Research Institute, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"M\u00e9ndez","sequence":"additional","affiliation":[{"name":"Research Group in Urology, Vall d\u2019Hebron Research Institute, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Trilla","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Universitario Vall d\u2019Hebron, 08035 Barcelona, Spain"},{"name":"Research Group in Urology, Vall d\u2019Hebron Research Institute, 08035 Barcelona, Spain"},{"name":"Department of Surgery, Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2168-323X","authenticated-orcid":false,"given":"Juan","family":"Morote","sequence":"additional","affiliation":[{"name":"Research Group in Urology, Vall d\u2019Hebron Research Institute, 08035 Barcelona, Spain"},{"name":"Department of Surgery, Universitat Aut\u00f2noma de Barcelona, 08193 Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 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