Integrated 68Ga-PSMA PET/MRI models improve prostate cancer diagnosis and ISUP stratification, especially in the low-PSA cohort

BACKGROUND: Ga-PSMA PET/MRI-derived parameters in prostate cancer and their significance in risk stratification. METHODS: were recorded. Diagnostic performance of PET and MRI parameters was compared using ROC analysis. Two logistic regression model sets were constructed: one for improved diagnosis performance in the low-PSA subgroup (PSA < 20 ng/mL) and one for International Society of Urological Pathology (ISUP) Grade Group (GG) stratification (GG 1-2 vs. GG 3-5). Model performance was assessed via LOOCV, 1,000 bootstrap resamples, and decision curve analysis. RESULTS: model reached a LOOCV AUC of 0.906. DCA validated the clinical utility of the optimal models. CONCLUSIONS: and PLR-improves diagnosis, potentially enables non-invasive ISUP Grade Group stratification, and may facilitate personalized management. TRIAL REGISTRATION: NCT03756077. Registered 27 November 2018-Retrospectively registered, https://clinicaltrials.gov/show/NCT03756077.