fe1fba7ebb0f85049f3286a16a2ed0e1 cancers-18-02541.pdf 133ec969f5b0eabd3c35bcf680456cbc6b0eb780 cancers-18-02541.pdf a3588fd9dbdcfe1bf8141cf2081bb287312bb9eeb4e88830bf988fe2d4b71eb2 cancers-18-02541.pdf Title: Comparative Validation and Performance of the Barcelona- and ERSPC-MRI Predictive Model in an Ibero-American Population of Men Suspected of Having Prostate Cancer Subject: Background: External validation of predictive models is needed in new populations after their implementation. Objective: We aimed to validate and compare the performance of the BCN-MRI PM and ERSPC-MRI PM in an Ibero-American population. Methods: We conducted a retrospective analysis of 540 men with suspected PCa who underwent MRI and prostate biopsy in 2025. Individual csPCa risk estimates were calculated using the online calculators for the BCN-MRI PM and ERSPC-MRI PM. The reference standard outcome was the rate of avoided biopsies. Calibration, discrimination of csPCa, net benefit, and clinical utility were analyzed with R software. Results: All participants underwent MRI and prostate biopsy. The median age was 66 years (95% CI 61–71). The overall csPCa detection rate was 55.7%. The BCN-MRI PM demonstrated good calibration, with close agreement between predicted and observed csPCa probabilities, whereas the ERSPC-MRI PM underestimated risk in the intermediate-probability range. Discrimination for csPCa was significantly better with the BCN-MRI PM (AUC, 0.807; 95% CI 0.771–0.843) than with the ERSPC-MRI PM (AUC, 0.764; 95% CI 0.724–0.803; p < 0.001). Decision curve analysis showed a greater net benefit for the BCN-MRI PM than for the ERSPC-MRI PM and the strategy of biopsying all men. Clinical utility curves demonstrated a more favorable balance between avoided biopsies and missed csPCa cases across threshold probabilities. At a sensitivity of 95%, the BCN-MRI PM achieved a specificity of 38.9% (95% CI, 32.5–45.1%) compared with 30.1% (95% CI, 24.6–35.7%) for the ERSPC-MRI PM, avoiding 21.5% and 16.3% of biopsies, respectively (p = 0.043). The performance of both models was also evaluated according to PI-RADS category and participating center. Conclusions: In this Ibero-American cohort, the BCN-MRI PM demonstrated superior calibration and overall clinical performance compared with the ERSPC-MRI PM. Keywords: clinically significant prostate cancer; predictive model; magnetic resonance imaging Author: Nahuel Paesano, Violeta Catalá, Juan Camean, Tomás Eduardo Olmedo, Joaquín Ignacio Gurovich, Maximiliano Ringa, Berta Miró, Lucas Regis, Olga Mendez, Enrique Trilla and Juan Morote Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Fri Aug 7 11:55:26 2026 CEST ModDate: Fri Aug 7 11:58:59 2026 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 19 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3082285 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- DRIBUA+URWPalladioL-Bold Type 1 Custom yes yes yes 127 0 AYJDGP+URWPalladioL-Roma Type 1 Custom yes yes yes 128 0 IMAEHO+VnURWPalladioL Type 1 Custom yes yes yes 129 0 VVWZWV+URWPalladioL-Ital Type 1 Custom yes yes yes 130 0 PDTLUH+CMSY10 Type 1 Builtin yes yes yes 180 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 274 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-09-30 03:56:44 CEST RepresentationInformation: cancers-18-02541.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-09-29 14:48:04 CEST Size: 3082285 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 579 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Design, Setting, and Participants Item: Title: PCa Suspicion and Diagnostic Approach for csPCa Item: Title: Data Variables Item: Title: Assessment of Individual csPCa Risk Using the BCN-MRI PM and ERSPC-MRI PM Item: Title: Statistical Analysis Item: Title: Results Children: Item: Title: Characteristics of the Study Population Item: Title: Analysis and Correlation of csPCa Probabilities Calculated by the BCN-MRI PM and ERSPC-MRI PM Item: Title: Analysis of Heterogeneity Between Participant Centers Item: Title: Calibration of BCN-MRI PM and ERSPC-MRI PM Item: Title: Discrimination of csPCa from the BCN-MRI PM and ERSPC-MRI PM Item: Title: Net Benefit of BCN-MRI PM and ERSPC-MRI PM Item: Title: Clinical Utility of BCN-MRI PM and ERSPC-MRI PM Item: Title: Performance and Clinical Utility of the BCN-MRI PM and ERSPC-MRI PM According to PI-RADS Categories Item: Title: Clinical Utility of the BCN-MRI PM and ERSPC-MRI PM According to Participant Centers Item: Title: Discussion Item: Title: Conclusions Item: Title: References Info: Title: Comparative Validation and Performance of the Barcelona- and ERSPC-MRI Predictive Model in an Ibero-American Population of Men Suspected of Having Prostate Cancer Author: Nahuel Paesano, Violeta Catalá, Juan Camean, Tomás Eduardo Olmedo, Joaquín Ignacio Gurovich, Maximiliano Ringa, Berta Miró, Lucas Regis, Olga Mendez, Enrique Trilla and Juan Morote Subject: Background: External validation of predictive models is needed in new populations after their implementation. Objective: We aimed to validate and compare the performance of the BCN-MRI PM and ERSPC-MRI PM in an Ibero-American population. Methods: We conducted a retrospective analysis of 540 men with suspected PCa who underwent MRI and prostate biopsy in 2025. Individual csPCa risk estimates were calculated using the online calculators for the BCN-MRI PM and ERSPC-MRI PM. The reference standard outcome was the rate of avoided biopsies. Calibration, discrimination of csPCa, net benefit, and clinical utility were analyzed with R software. Results: All participants underwent MRI and prostate biopsy. The median age was 66 years (95% CI 61–71). The overall csPCa detection rate was 55.7%. The BCN-MRI PM demonstrated good calibration, with close agreement between predicted and observed csPCa probabilities, whereas the ERSPC-MRI PM underestimated risk in the intermediate-probability range. Discrimination for csPCa was significantly better with the BCN-MRI PM (AUC, 0.807; 95% CI 0.771–0.843) than with the ERSPC-MRI PM (AUC, 0.764; 95% CI 0.724–0.803; p < 0.001). Decision curve analysis showed a greater net benefit for the BCN-MRI PM than for the ERSPC-MRI PM and the strategy of biopsying all men. Clinical utility curves demonstrated a more favorable balance between avoided biopsies and missed csPCa cases across threshold probabilities. At a sensitivity of 95%, the BCN-MRI PM achieved a specificity of 38.9% (95% CI, 32.5–45.1%) compared with 30.1% (95% CI, 24.6–35.7%) for the ERSPC-MRI PM, avoiding 21.5% and 16.3% of biopsies, respectively (p = 0.043). The performance of both models was also evaluated according to PI-RADS category and participating center. Conclusions: In this Ibero-American cohort, the BCN-MRI PM demonstrated superior calibration and overall clinical performance compared with the ERSPC-MRI PM. 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