Biopsy and imaging data were collected from clinical research reports, including per-patient overall Gleason score and maximum cancer core length (MCCL) on TPM, presenting PSA, prostate volume, and Likert scores, location, volume, and radiological features of individual MRI lesions. Overall Gleason score was defined as the predominant pattern across the entire prostate and constituted the final pathological score. In total, 235 participants were stratified into four mutually exclusive cancer definition groups according to their per-patient TPM summaries (previously recorded by an experienced uropathologist): (1) no cancer, (2) insignificant cancer, (3) secondary/definition 2 significant cancer (Gleason ≥3 + 4 of any length and/or MCCL ≥ 4 mm of any grade), and (4) primary/definition 1 significant cancer (Gleason score ≥4 + 3 of any length and/or MCCL ≥ 6 mm of any grade). Once stratified, men with at least one MRI lesion (Likert score 3–5) were identified for further analyses. For the remainder of this paper, the terms “TPM cancer burden”, “TPM cancer group”, and “TPM group” will be used interchangeably and will refer to TPM grouping according to the four disease definitions described.

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