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Internally validated calibration curves showed that the predicted risk of CSPCa was closer to the actual probability when the threshold was 60%. Decision curves showed that a better net benefit was achieved when the model was used to guide clinical practice. More cases of PCa and CSPCa were seen in the peripheral zone than in the transitional zone among patients with PI-RADS v2, score 3. The positive predictive value for a positive ADC ( 900 μm /s) for the detection of CSPCa and PCa improved with an increasing prostate-specific a