Performance of a Region of Interest–based Algorithm in Diagnosing International Society of Urological Pathology Grade Group ≥2 Prostate Cancer on the MRI-FIRST Database—CAD-FIRST Study

The overall performance of the tested computer-aided diagnosis (CADx) system was similar to that of the Prostate Imaging Reporting and Data System version 2 score assigned prospectively at the time of biopsy. The CADx predefined diagnostic thresholds, which provided 90% sensitivity in the training dataset, yielded sensitivity of 86% (95% confidence interval: 76–94) and specificity of 64% (95% confidence interval: 55–74) in the test dataset. The CADx score could help stratify the risk of clinically significant prostate cancer in patients with positive magnetic resonance imaging and negative prostate-specific antigen density.