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Development and Validation of an AI-Assisted Predictive Model Integrating R2* Mapping and Clinical Indicators for

Xin Li1, Yonggui Shi1, Jing Fang1

  • 1Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Cancer Medicine
|February 18, 2026
PubMed
Summary
This summary is machine-generated.

This study developed an AI nomogram using MRI data to accurately detect clinically significant prostate cancer (csPCa). The tool integrates AI-assisted S-PI-RADS v2.1 and R2* mapping for improved noninvasive prediction.

Keywords:
R2* mappingartificial intelligencebiparameternomogramprostate cancerprostate imaging reporting and data system

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Area of Science:

  • Radiology
  • Oncology
  • Artificial Intelligence

Background:

  • Limited evidence on AI-assisted Simplified Prostate Imaging Reporting and Data System version 2.1 (S-PI-RADS v2.1) combined with quantitative MRI for clinically significant prostate cancer (csPCa) detection.
  • Need for improved diagnostic tools for csPCa.

Purpose of the Study:

  • To develop and validate a nomogram for csPCa prediction.
  • Incorporate AI-assisted S-PI-RADS v2.1 (biparametric MRI) and R2* mapping into the nomogram.

Main Methods:

  • Prospective study of 345 patients (115 csPCa, 230 non-csPCa).
  • Analysis of clinical (age, BMI, PSA) and imaging (PV, S-PI-RADS, R2*) parameters.
  • Logistic regression for predictor identification, nomogram development (R software, DynNom), and validation (1000 bootstrap iterations).

Main Results:

  • Independent csPCa predictors: BMI, PSA ≥ 10 ng/mL, PV, S-PI-RADS 4-5, and R2* (all p < 0.05).
  • Full model (BMI+PSA+PV+S-PI-RADS+R2*) showed superior discrimination (AUC=0.915) vs. baseline (AUC=0.891).
  • Achieved 85.2% sensitivity and 80.9% specificity; robust internal validation (C-index=0.884).

Conclusions:

  • AI-enhanced nomogram accurately predicts csPCa noninvasively using clinical and multiparametric MRI data.
  • R2* significantly improved prediction performance.
  • Tool facilitates personalized clinical decision-making for prostate cancer.