Development and validation of a visual nomogram for predicting clinically significant prostate cancer in negative mpMRI using 68Ga-PSMA PET/CT

Abstract Multi-parametric magnetic resonance imaging (mpMRI) is a valuable medical technology for detecting clinically significant prostate cancer (csPCa). The diagnostic accuracy of mpMRI for csPCa in negative mpMRI (PI-RADS 1–2) remains suboptimal, underscoring the need for improvements for csPCa....

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Main Authors: Wei Hu, ShiKuan Guo, XiangLiang Meng, FuLi Wang, ShuaiJun Ma, Chao Zhang, JingYi Wang, Lei Yuan, LongLong Zhang, YuMing Jing, Jian Chen, HaoZhong Hou, Yang Wang, KeYing Zhang, Yu Li, Fei Kang, DongHui Han, HongQian Guo, JingLiang Zhang, Jing Ren, WeiJun Qin
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-12312-z
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author Wei Hu
ShiKuan Guo
XiangLiang Meng
FuLi Wang
ShuaiJun Ma
Chao Zhang
JingYi Wang
Lei Yuan
LongLong Zhang
YuMing Jing
Jian Chen
HaoZhong Hou
Yang Wang
KeYing Zhang
Yu Li
Fei Kang
DongHui Han
HongQian Guo
JingLiang Zhang
Jing Ren
WeiJun Qin
author_facet Wei Hu
ShiKuan Guo
XiangLiang Meng
FuLi Wang
ShuaiJun Ma
Chao Zhang
JingYi Wang
Lei Yuan
LongLong Zhang
YuMing Jing
Jian Chen
HaoZhong Hou
Yang Wang
KeYing Zhang
Yu Li
Fei Kang
DongHui Han
HongQian Guo
JingLiang Zhang
Jing Ren
WeiJun Qin
author_sort Wei Hu
collection DOAJ
description Abstract Multi-parametric magnetic resonance imaging (mpMRI) is a valuable medical technology for detecting clinically significant prostate cancer (csPCa). The diagnostic accuracy of mpMRI for csPCa in negative mpMRI (PI-RADS 1–2) remains suboptimal, underscoring the need for improvements for csPCa. This study aimed to build a visual predictive nomogram for early detection of csPCa in negative mpMRI. We retrospectively reviewed 303 men from our institution who simultaneously underwent 68Ga-PSMA-11 PET/CT and mpMRI before a biopsy between March 2020 and July 2022 and 130 men from the outside institution (Nanjing Drum Tower Hospital) as external validation between September 2021 and June 2022. The enrolled patients in our institution were randomly divided into the training set (n = 212) and the internal validation set (n = 91). Multivariate logistic regression was performed to identify independent predictors and establish a nomogram using SUVmax of 68Ga-PSMA-11 PET/CT and prostatic specific antigen density (PSAD) to predict the occurrence of csPCa in negative mpMRI. Multivariate logistic regression demonstrated that SUVmax (odds ratio [OR] 5.296, 95% confidence interval [CI] 1.691–23.972), and PSAD (OR 4.867, 95%CI 2.389–10.901) were independent predictors for csPCa in negative mpMRI. The area under the curve (AUC) of the nomogram was 0.819 (95%CI 0.729–0.890). Additionally, both the decision curve analysis (DCA) curve and the net reclassification improvement (NRI) showed significant improvements for csPCa in our model. External validation validated the reliability of the prediction nomogram. The visual interactive web risk calculator PI-RADS/SUVmax/PSAD model (PSP Model, www.cspca.online ) based on the nomogram allows us to assess the risk of having csPCa. The nomogram based on preoperative examination was developed to predict csPCa in negative mpMRI and help reduce unnecessary biopsies. The visual PSP Model is an effective and accurate tool for urologists to use in the early prediction and timely management of csPCa.
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spelling doaj-art-0cf82da7108e4dc79c0aaf07a7e585242025-08-20T03:04:30ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-12312-zDevelopment and validation of a visual nomogram for predicting clinically significant prostate cancer in negative mpMRI using 68Ga-PSMA PET/CTWei Hu0ShiKuan Guo1XiangLiang Meng2FuLi Wang3ShuaiJun Ma4Chao Zhang5JingYi Wang6Lei Yuan7LongLong Zhang8YuMing Jing9Jian Chen10HaoZhong Hou11Yang Wang12KeYing Zhang13Yu Li14Fei Kang15DongHui Han16HongQian Guo17JingLiang Zhang18Jing Ren19WeiJun Qin20Department of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, No.988th Hospital of Joint Logistic Support Force of PLADepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Nuclear Medicine, Xijing Hospital, Fourth Military Medical UniversityRadiology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Northwest University First HospitalDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityRadiology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Nuclear Medicine, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Institute of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityRadiology, Xijing Hospital, Fourth Military Medical UniversityDepartment of Urology, Xijing Hospital, Fourth Military Medical UniversityAbstract Multi-parametric magnetic resonance imaging (mpMRI) is a valuable medical technology for detecting clinically significant prostate cancer (csPCa). The diagnostic accuracy of mpMRI for csPCa in negative mpMRI (PI-RADS 1–2) remains suboptimal, underscoring the need for improvements for csPCa. This study aimed to build a visual predictive nomogram for early detection of csPCa in negative mpMRI. We retrospectively reviewed 303 men from our institution who simultaneously underwent 68Ga-PSMA-11 PET/CT and mpMRI before a biopsy between March 2020 and July 2022 and 130 men from the outside institution (Nanjing Drum Tower Hospital) as external validation between September 2021 and June 2022. The enrolled patients in our institution were randomly divided into the training set (n = 212) and the internal validation set (n = 91). Multivariate logistic regression was performed to identify independent predictors and establish a nomogram using SUVmax of 68Ga-PSMA-11 PET/CT and prostatic specific antigen density (PSAD) to predict the occurrence of csPCa in negative mpMRI. Multivariate logistic regression demonstrated that SUVmax (odds ratio [OR] 5.296, 95% confidence interval [CI] 1.691–23.972), and PSAD (OR 4.867, 95%CI 2.389–10.901) were independent predictors for csPCa in negative mpMRI. The area under the curve (AUC) of the nomogram was 0.819 (95%CI 0.729–0.890). Additionally, both the decision curve analysis (DCA) curve and the net reclassification improvement (NRI) showed significant improvements for csPCa in our model. External validation validated the reliability of the prediction nomogram. The visual interactive web risk calculator PI-RADS/SUVmax/PSAD model (PSP Model, www.cspca.online ) based on the nomogram allows us to assess the risk of having csPCa. The nomogram based on preoperative examination was developed to predict csPCa in negative mpMRI and help reduce unnecessary biopsies. The visual PSP Model is an effective and accurate tool for urologists to use in the early prediction and timely management of csPCa.https://doi.org/10.1038/s41598-025-12312-zProstate cancer68Ga-PSMA PET/CTMpMRINomogramDiagnosis
spellingShingle Wei Hu
ShiKuan Guo
XiangLiang Meng
FuLi Wang
ShuaiJun Ma
Chao Zhang
JingYi Wang
Lei Yuan
LongLong Zhang
YuMing Jing
Jian Chen
HaoZhong Hou
Yang Wang
KeYing Zhang
Yu Li
Fei Kang
DongHui Han
HongQian Guo
JingLiang Zhang
Jing Ren
WeiJun Qin
Development and validation of a visual nomogram for predicting clinically significant prostate cancer in negative mpMRI using 68Ga-PSMA PET/CT
Scientific Reports
Prostate cancer
68Ga-PSMA PET/CT
MpMRI
Nomogram
Diagnosis
title Development and validation of a visual nomogram for predicting clinically significant prostate cancer in negative mpMRI using 68Ga-PSMA PET/CT
title_full Development and validation of a visual nomogram for predicting clinically significant prostate cancer in negative mpMRI using 68Ga-PSMA PET/CT
title_fullStr Development and validation of a visual nomogram for predicting clinically significant prostate cancer in negative mpMRI using 68Ga-PSMA PET/CT
title_full_unstemmed Development and validation of a visual nomogram for predicting clinically significant prostate cancer in negative mpMRI using 68Ga-PSMA PET/CT
title_short Development and validation of a visual nomogram for predicting clinically significant prostate cancer in negative mpMRI using 68Ga-PSMA PET/CT
title_sort development and validation of a visual nomogram for predicting clinically significant prostate cancer in negative mpmri using 68ga psma pet ct
topic Prostate cancer
68Ga-PSMA PET/CT
MpMRI
Nomogram
Diagnosis
url https://doi.org/10.1038/s41598-025-12312-z
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