Model to distinguishing transition zone cancers from benign prostatic hyperplasia on multi-parametric prostate MRI.
It is difficult to diagnose transition zone (TZ) cancer. With the performance of quantitative image analysis in multi-parametric MRI. With the development of logistic regression analysis, a prediction tool was made that can help to diagnose TZ cancer more accurately.

Standardized T2 weighted imaging and mean apparent diffusion coefficients (ADC) were independent factors for diagnosing TZ-cancer. 

The performance of this model was higher than PIRADSv2. 
Research authors: Yuji Iyama, Takeshi Nakaura, Kazuhiro Katahira, Ayumi Iyama, Yasunori Nagayama, Seitaro Oda, Daisuke Utsunomiya, Yasuyuki Yamashita
Details Formula Study characteristics Files & References
Model author
Model ID
Revision date
MeSH terms
  • Radiology
  • Urology
  • Magnetic Resonance Imaging
  • Prostatic Neoplasms
  • Model type
    Logistic regression (Calculation)
    No Formula defined yet
    Condition Formula

    Additional information

    Between November 2014 and March 2016, 210 consecutive patients underwent radical prostatectomy (RP). Inclusion criteria for this retrospective study were: (1) the patient had undergone RP no more than 1 month after MRI, (2) the availability of preoperative MRI scans at our institution, (3) a prostatectomy specimen included clinically significant TZ cancer (Gleason score (GS) >6) >10 mm, and (4) a prostatectomy specimen included a BPH nodule >10 mm.

    Ten patients without MRIs (n = 4) or outside preoperative MRI only (n = 6) were excluded. Of the 200 cases, 81 patients were included because the histopathology showed TZ cancer and BPH. Four patients were excluded due to the small size of the TZ cancer (diameter <10 mm). Six patients were excluded due to the small area of the BPH (diameter <10 mm; n = 2). Seven patients were excluded due to the clinically insignificant TZ cancer [GS ≤6]. Four patients were excluded due to poor MRI quality. These exclusions were made by the radiologist most experienced with prostate MRI in our department (K.K., 20 years’ experience) referring to the histopathological results and the MRI images. Finally, 60 patients were enrolled in this study

    Study Population

    Total population size: 60
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Continuous characteristics

    Name Mean SD Unit
    Age 70 5.5 years
    Body weight 62.5 4.8 kg
    PSA 10.4 25 ng/ml

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Gleason Sum Gleason score 7 46
    Gleason score 8 8
    Gleason score 9 6

    Related files

    Probability of transition zone (TZ) cancer is:

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    Notes are only visible in the result download and will not be saved by Evidencio

    Probability of transition zone (TZ) cancer is:

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    Outcome stratification

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    Conditional information

    Result interpretation

    Calculated probability of cancer can support decision making regarding disease management by clinicians. 

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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