Evidence map›Paper›PMID 39924390›Full record

ArticleEuropean urology oncology2026

Comparative Performance of Machine Learning Models in Reducing Unnecessary Targeted Prostate Biopsies.

Fuyao Chen, Roxana Esmaili, Ghazal Khajir, Tal Zeevi, Moritz Gross, Michael Leapman, Preston Sprenkle, Amy C Justice, Sandeep Arora, Jeffrey C Weinreb and 8 more

Abstract readComparative StudyMulticenter Study
In one paragraph

Article in European urology oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Fuyao ChenDepartment of Biomedical Engineering, Yale University New Haven CT USA; Medical Scientist Training Program, Yale School of Medicine New Haven CT USA.
Roxana EsmailiDepartment of Radiology and Biomedical Imaging, Yale University New Haven CT USA; Charité Center for Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin Berlin Germany.
Ghazal KhajirDepartment of Urology, Yale University New Haven CT USA.
Tal ZeeviDepartment of Biomedical Engineering, Yale University New Haven CT USA.
Moritz GrossDepartment of Radiology and Biomedical Imaging, Yale University New Haven CT USA; Charité Center for Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin Berlin Germany.
Michael LeapmanDepartment of Urology, Yale University New Haven CT USA.
Preston SprenkleDepartment of Urology, Yale University New Haven CT USA.
Amy C JusticeVA Connecticut Healthcare West Haven CT USA; Department of Internal Medicine, Yale University New Haven CT USA.
Sandeep AroraDepartment of Radiology and Biomedical Imaging, Yale University New Haven CT USA.
Jeffrey C WeinrebDepartment of Radiology and Biomedical Imaging, Yale University New Haven CT USA.
Michael SpektorDepartment of Radiology and Biomedical Imaging, Yale University New Haven CT USA.
Steffan HuberDepartment of Radiology and Biomedical Imaging, Yale University New Haven CT USA.
Peter A HumphreyDepartment of Pathology, Yale University New Haven CT USA.
Angelique LeviDepartment of Pathology, Yale University New Haven CT USA.
Lawrence H StaibDepartment of Biomedical Engineering, Yale University New Haven CT USA; Department of Radiology and Biomedical Imaging, Yale University New Haven CT USA; Department of Electrical Engineering, Yale University New Haven CT USA.
Rajesh VenkataramanEigen Health, Grass Valley CA USA.
Darryl T MartinDepartment of Urology, Yale University New Haven CT USA.
John A OnofreyDepartment of Biomedical Engineering, Yale University New Haven CT USA; Department of Radiology and Biomedical Imaging, Yale University New Haven CT USA; Department of Urology, Yale University New Haven CT USA. Electronic address: john.onofrey@yale.edu.

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007205 · NIGMS · YALE UNIVERSITY · PI KAZMIERCZAK, BARBARA I · 1985 to 2019
$42.9M
Image Analysis Tools for mpMRI Prostate Cancer Diagnosis Using PI-RADSR42CA224888 · NCI · EIGEN HEALTH SERVICES LLC · PI ONOFREY, JOHN AARON · 2020 to 2021
$1.5M
NCI NIH HHS R42 CA224888NIGMS NIH HHS T32 GM007205
6 · The paper itself

Abstract

BACKGROUND AND

objectiveConventional core needle biopsy for prostate cancer diagnosis can lead to diagnostic uncertainty and complications, prompting exploration of alternative risk assessment approaches that use clinical and imaging features. Our aim was to evaluate the effectiveness of machine learning (ML) models in reducing unnecessary biopsies.

methodsWe conducted a retrospective analysis of data for 1884 patients across two academic centers who underwent prostate magnetic resonance imaging and biopsy between 2016 and 2020 or 2004 and 2011. Twelve ML models were assessed for prediction of clinically significant prostate cancer (csPCa; Gleason grade group ≥2) using combinations of clinical features, including patient age, prostate-specific antigen level and density, Prostate Imaging-Reporting and Data System/Likert score, lesion volume, and gland volume. The models were trained and validated using a tenfold split for intrasite, intersite, and combined-site data sets. Model effectiveness was evaluated using the area under the receiver operating characteristic curve and decision curve analysis. KEY FINDINGS AND LIMITATIONS: The best-performing ML model would reduce the number of biopsies by 13.07% at a false-negative rate of 1.91%. Performance was consistent across sites, although the study is limited by the small number of centers and the absence of specific clinical data. CONCLUSIONS AND CLINICAL IMPLICATIONS: ML-enhanced clinical models provide an effective and generalizable approach for prediction of csPCa using standard clinical data. These models allow personalized risk assessment and follow-up, support clinical decision-making, and improve workflow efficiency. PATIENT SUMMARY: Models that are enhanced by machine learning can predict the severity of prostate cancer and help doctors in tailoring treatments for individual patients. This approach can simplify health care decisions and improve clinical efficiency.

Indexed as

Machine LearningProstateProstatic NeoplasmsUnnecessary ProceduresAgedBiopsy, Large-Core NeedleHumansImage-Guided BiopsyMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesMachine learningMultiparametric magnetic resonance imagingProstate cancerProstate Imaging-Reporting and Data SystemProstate-specific antigen densityUnnecessary biopsies

Identifiers

PMID39924390
PMCPMC12332026

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.