European Urology Oncology Multi-institutional Clinical Tool for Predicting High-risk Lesions on 3Tesla Multiparametric Prostate Magnetic Resonance Imaging  Matthew Truong, Janet E. Baack Kukreja, Soroush Rais-Bahrami, Nimrod S. Barashi, Bokai Wang, Zachary Nuffer, Ji Hae Park, Khoa Lam, Thomas P. Frye, Jeffrey W. Nix, John V. Thomas, Changyong Feng, Brian F. Chapin, John W. Davis, Gary Hollenberg, Aytekin Oto, Scott E. Eggener, Jean V. Joseph, Eric Weinberg, Edward M. Messing  European Urology Oncology  DOI: 10.1016/j.euo.2018.08.008 Copyright © 2018 European Association of Urology Terms and Conditions

Fig. 1 Development and validation of the BiRCH models. Statistical methods included logistic regression analysis (LRA) and support vector machine (SVM), a machine learning technique. mpMRI=multiparametric magnetic resonance imaging; PCa=prostate cancer. European Urology Oncology DOI: (10.1016/j.euo.2018.08.008) Copyright © 2018 European Association of Urology Terms and Conditions

Fig. 2 Calibration and decision curve analysis. (A) Calibration curves for BiRCH LRA 1&2 and BiRCH LRA 3. The diagonal solid line represents ideal predictions. The dotted line represents actual predictions. (B) Decision analysis curves for BiRCH LRA 1&2 and BiRCH LRA 3 PCa compared with PSA. The gray line is the benefit of performing mpMRI on all patients, and the horizontal line is the benefit of performing mpMRI on none. A high standardized net benefit across a wide range of probabilities was observed when applied to patients within indications 1 and 2. A net benefit was observed only at high probabilities within indication 3, and thus the BiRCH models are not clinically useful for active surveillance patients. LRA=logistic regression analysis; mpMRI=multiparametric magnetic resonance imaging; PCa=prostate cancer; PSA=prostate-specific antigen. European Urology Oncology DOI: (10.1016/j.euo.2018.08.008) Copyright © 2018 European Association of Urology Terms and Conditions

Fig. 3 Web-based BiRCH machine learning tool (http://birch.azurewebsites.net/). CY=computed tomography; MRI=magnetic resonance imaging; PIRADS=Prostate Imaging Reporting and Data System; PSA=prostate-specific antigen; SVM=support vector machine. European Urology Oncology DOI: (10.1016/j.euo.2018.08.008) Copyright © 2018 European Association of Urology Terms and Conditions