Patient Selection

Patients who underwent radical prostatectomy at Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology between January 2016 and December 2019 were retrospectively enrolled in this study. This retrospective study was approved by the institutional review board (IRB) of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Because our study belonged to a retrospective study, patient consent to review their medical records were not required by the IRB. And all patient information was strictly confidential and our procedures were carried out according to the Declaration of Helsinki. Inclusion criteria: (1) prostate TRUS and bp-MRI performed for all patients before surgery; (2) standard systematic (12-core) TRUS-guided biopsy prior to surgery performed for all patients; (3) final pathological results of each patient involved detailed description of EPE, SVI, and Gleason grade group. Exclusion criteria: (1) neoadjuvant therapy prior to TRUS and MRI examination; (2) patients with incomplete clinical data; (3) unsatisfactory quality of MRI images. A bp-MRI was performed on all men using a 3 Tesla MRI scanner (MAGNETOM Skyra; Siemens, Medical Solutions, Erlangen, Germany). The bp-MRI findings were re‑reported and scored by the same dedicated radiologist on a five-point scale using modified (no contrast-enhanced imaging) Prostate Imaging Reporting and Data System (PI-RADS) version 2 criteria.¹⁶ TRUS‑guided biopsy was performed using a 2102 BK Ultrasound system (BK Medical A/S, Herlev, Denmark). This study finally enrolled 222 patients.