Synthetic MRI T1/T2 and ADC combination yields higher AUC than PI-RADS v2.1 for zone-specific prostate cancer detection

In 141 prostate MRI lesions, a model combining synthetic MRI T1, T2, and ADC showed AUC 0.947 in the peripheral zone and 0.961 in the transition zone, vs PI-RADS v2.1 AUC 0.799 and 0.803 (P=0.002, P=0.013).

• ADC alone had AUC 0.881 in the peripheral zone and 0.878 in the transition zone.
• The T1+T2+ADC model significantly outperformed PI-RADS; adding prostate-specific antigen density did not yield further significant improvement (P=0.329 and P=0.700).
• Quantitative measurements showed good-to-excellent inter-reader reproducibility.

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