To evaluate the feasibility of utilizing artificial intelligence (AI)-predicted biparametric MRI (bpMRI) image features for predicting the aggressiveness of prostate cancer (PCa).
A total of 878 PCa patients from 4 hospitals were retrospectively collected, all of whom had pathological results after radical prostatectomy (RP). A pre-trained AI algorithm was used to select suspected PCa lesions and extract lesion features for model development. The study evaluated five prediction methods, including (1) A clinical-imaging model of clinical features and image features of suspected PCa lesions selected by AI algorithm, (2) the PIRADS category, (3) a conventional radiomics model, (4) a deep-learning bases radiomics model, and (5) biopsy pathology.
In the externally validated dataset, the deep learning-based radiomics model showed the highest area under the curve (AUC 0.700 to 0.791). It exceeded the clinical-imaging model (AUC 0.597 to 0.718), conventional radiomic model (AUC 0.566 to 0.632), PIRADS score (AUC 0.554 to 0.613), and biopsy pathology (AUC 0.537 to 0.578). The AUC predicted by the model did not show a statistically significant difference among the three externally verified hospitals (p > 0.05).
Deep-learning radiomics models utilizing AI-extracted image features from bpMRI images can potentially be used to predict PCa aggressiveness, demonstrating a generalized ability for external validation.
Predicting the aggressiveness of prostate cancer (PCa) is important for formulating the best treatment plan for patients. The radiomic model based on deep learning is expected to provide an objective and non-invasive method for evaluating the aggressiveness of PCa.
Predicting the aggressiveness of PCa is important for patients to obtain the best treatment options. The deep learning-based radiomics model can predict the aggressiveness of PCa with high accuracy. The model has good universality when tested on multiple external datasets.
Insights into imaging. 2025 Jan 15*** epublish ***
Kexin Wang, Ning Luo, Zhaonan Sun, Xiangpeng Zhao, Lilan She, Zhangli Xing, Yuntian Chen, Chunlei He, Pengsheng Wu, Xiangpeng Wang, ZiXuan Kong
School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China., Department of Radiology, the Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, China., Department of Radiology, Peking University First Hospital, Beijing, 100034, China., Department of Radiology, Fujian Medical University Union Hospital, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian Province, China., Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China., Beijing Smart Tree Medical Technology Co. Ltd., No. 97, Changping Road, Shahe Town, Changping District, Beijing, 102200, China., Department of Radiology, the Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, China. .