biostudies-literatureZou YXiaogan City Natural Science Program Project93-105https://www.ebi.ac.uk/biostudies/studies/S-EPMC11909710biostudies-literatureUnknown72(1)<h4>Introduction</h4>Accurate identification and grading of clinically significant prostate cancer (csPCa, Gleason Score ≥ 7) without invasive procedures remains a significant clinical challenge. This study aims to develop and evaluate a two-stage model designed for precise Gleason grading. The model initially uses radiomics-based multiparametric MRI to identify csPCa and then refines the Gleason grading by integrating clinical indicators and radiomics features.<h4>Methods</h4>We retrospectively analysed 399 patients with PI-RADS ≥ 3 lesions, categorising them into non-significant prostate cancer (nsPCa, 263 cases) and csPCa (136 cases, subdivided by GGs). Regions of interest (ROIs) for the prostate and lesions were manually delineated on T2-weighted and apparent diffusion coefficient (ADCJournal of medical radiation sciencesA two-stage model for precise identification and Gleason grading of clinically significant prostate cancer: a hybrid approach.PMC11909710XGKJ2024010035Liu XZou YXie YZhang YCui JChen LTian RWang XJiao CKang ZMa FfalseA two-stage model for precise identification and Gleason grading of clinically significant prostate cancer: a hybrid approach.<h4>Introduction</h4>Accurate identification and grading of clinically significant prostate cancer (csPCa, Gleason Score ≥ 7) without invasive procedures remains a significant clinical challenge. This study aims to develop and evaluate a two-stage model designed for precise Gleason grading. The model initially uses radiomics-based multiparametric MRI to identify csPCa and then refines the Gleason grading by integrating clinical indicators and radiomics features.<h4>Methods</h4>We retrospectively analysed 399 patients with PI-RADS ≥ 3 lesions, categorising them into non-significant prostate cancer (nsPCa, 263 cases) and csPCa (136 cases, subdivided by GGs). Regions of interest (ROIs) for the prostate and lesions were manually delineated on T2-weighted and apparent diffusion coefficient (ADC2025-01-01T00:00:00Z2025 Mar2025-04-20T00:11:30.558Z2025-04-20T00:11:30.558ZS-EPMC119097103969895710.1002/jmrs.841