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Yin X, Wang K, Wang L, Yang Z, Zhang Y, Wu P, Zhao C, Zhang J. Algorithms for classification of sequences and segmentation of prostate gland: an external validation study. Abdom Radiol (NY) 2024; 49:1275-1287. [PMID: 38436698 DOI: 10.1007/s00261-024-04241-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES The aim of the study was to externally validate two AI models for the classification of prostate mpMRI sequences and segmentation of the prostate gland on T2WI. MATERIALS AND METHODS MpMRI data from 719 patients were retrospectively collected from two hospitals, utilizing nine MR scanners from four different vendors, over the period from February 2018 to May 2022. Med3D deep learning pretrained architecture was used to perform image classification,UNet-3D was used to segment the prostate gland. The images were classified into one of nine image types by the mode. The segmentation model was validated using T2WI images. The accuracy of the segmentation was evaluated by measuring the DSC, VS,AHD.Finally,efficacy of the models was compared for different MR field strengths and sequences. RESULTS 20,551 image groups were obtained from 719 MR studies. The classification model accuracy is 99%, with a kappa of 0.932. The precision, recall, and F1 values for the nine image types had statistically significant differences, respectively (all P < 0.001). The accuracy for scanners 1.436 T, 1.5 T, and 3.0 T was 87%, 86%, and 98%, respectively (P < 0.001). For segmentation model, the median DSC was 0.942 to 0.955, the median VS was 0.974 to 0.982, and the median AHD was 5.55 to 6.49 mm,respectively.These values also had statistically significant differences for the three different magnetic field strengths (all P < 0.001). CONCLUSION The AI models for mpMRI image classification and prostate segmentation demonstrated good performance during external validation, which could enhance efficiency in prostate volume measurement and cancer detection with mpMRI. CLINICAL RELEVANCE STATEMENT These models can greatly improve the work efficiency in cancer detection, measurement of prostate volume and guided biopsies.
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Affiliation(s)
- Xuemei Yin
- Department of Medical Imaging, First Hospital of Qinhuangdao, 066000, Qinhuangdao City, Hebei Province, China
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China
| | - Kexin Wang
- School of Basic Medical Sciences, Capital Medical University, 100052, Beijing, China
| | - Liang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China
| | - Yaofeng Zhang
- Beijing Smart Tree Medical Technology Co. Ltd, 100011, Beijing, China
| | - Pengsheng Wu
- Beijing Smart Tree Medical Technology Co. Ltd, 100011, Beijing, China
| | - Chenglin Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China.
| | - Jun Zhang
- Department of Medical Imaging, First Hospital of Qinhuangdao, 066000, Qinhuangdao City, Hebei Province, China.
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Boschheidgen M, Albers P, Schlemmer HP, Hellms S, Bonekamp D, Sauter A, Hadaschik B, Krilaviciute A, Radtke JP, Seibold P, Lakes J, Arsov C, Gschwend JE, Herkommer K, Makowski M, Kuczyk MA, Wacker F, Harke N, Debus J, Körber SA, Benner A, Kristiansen G, Giesel FL, Antoch G, Kaaks R, Becker N, Schimmöller L. Multiparametric Magnetic Resonance Imaging in Prostate Cancer Screening at the Age of 45 Years: Results from the First Screening Round of the PROBASE Trial. Eur Urol 2024; 85:105-111. [PMID: 37863727 DOI: 10.1016/j.eururo.2023.09.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/05/2023] [Accepted: 09/28/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) has been suggested as a tool for guiding biopsy recommendations in prostate cancer (PC) screening. OBJECTIVE To determine the performance of multiparametric MRI (mpMRI) in young men at age 45 yr who participated in a PC screening trial (PROBASE) on the basis of baseline prostate-specific antigen (PSA). DESIGN, SETTING, AND PARTICIPANTS Participants with confirmed PSA ≥3 ng/ml were offered mpMRI followed by MRI/transrectal ultrasound fusion biopsy (FBx) with targeted and systematic cores. mpMRI scans from the first screening round for men randomised to an immediate PSA test in PROBASE were evaluated by local readers and then by two reference radiologists (experience >10 000 prostate MRI examinations) blinded to the histopathology. The PROBASE trial is registered as ISRCTN37591328 OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The local and reference Prostate Imaging-Data and Reporting System (PI-RADS) scores were compared, and the sensitivity, negative predictive value (NPV), and accuracy were calculated for both readings for different cutoffs (PI-RADS 3 vs 4). RESULTS AND LIMITATIONS Of 186 participants, 114 underwent mpMRI and FBx. PC was detected in 47 (41%), of whom 33 (29%) had clinically significant PC (csPC; International Society of Urological Pathology grade group ≥2). Interobserver reliability between local and reference PI-RADS scores was moderate (k = 0.41). At a cutoff of PI-RADS 4, reference reading showed better performance for csPC detection (sensitivity 79%, NPV 91%, accuracy of 85%) than local reading (sensitivity 55%, NPV 80%, accuracy 68%). Reference reading did not miss any PC cases for a cutoff of PI-RADS <3. If PI-RADS ≥4 were to be used as a biopsy cutoff, mpMRI would reduce negative biopsies by 68% and avoid detection of nonsignificant PC in 71% of cases. CONCLUSIONS Prostate MRI in a young screening population is difficult to read. The MRI accuracy of for csPC detection is highly dependent on reader experience, and double reading might be advisable. More data are needed before MRI is included in PC screening for men at age 45 yr. PATIENT SUMMARY Measurement of prostate specific antigen (PSA) is an effective screening test for early detection of prostate cancer (PC) and can reduce PC-specific deaths, but it can also lead to unnecessary biopsies and treatment. Magnetic resonance imaging (MRI) after a positive PSA test has been proposed as a way to reduce the number of biopsies, with biopsy only recommended for men with suspicious MRI findings. Our results indicate that MRI accuracy is moderate for men aged 45 years but can be increased by a second reading of the images by expert radiologists. For broad application of MRI in routine screening, double reading may be advisable.
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Affiliation(s)
- Matthias Boschheidgen
- Dusseldorf University, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - Peter Albers
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany; Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Susanne Hellms
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - David Bonekamp
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (dktk), University Hospital Essen, Essen, Germany
| | - Agne Krilaviciute
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan Philipp Radtke
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany
| | - Petra Seibold
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jale Lakes
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany
| | - Christian Arsov
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany; Department of Urology and Paediatric Urology, Elisabeth-Krankenhaus Rheydt, Städtische Kliniken Mönchengladbach GmbH, Mönchengladbach, Germany
| | - Jürgen E Gschwend
- Department of Urology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Marcus Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Markus A Kuczyk
- Department of Urology, Medical University Hannover, Hannover, Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Nina Harke
- Department of Urology, Medical University Hannover, Hannover, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Ruprecht Karls University, Heidelberg, Germany
| | - Stefan A Körber
- Department of Radiation Oncology, Heidelberg University Hospital, Ruprecht Karls University, Heidelberg, Germany
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Frederik L Giesel
- University Dusseldorf, Medical Faculty, Department of Nuclear Medicine, D-40225 Dusseldorf, Germany
| | - Gerald Antoch
- Dusseldorf University, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany; Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Düsseldorf (CIO ABCD), Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nikolaus Becker
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lars Schimmöller
- Dusseldorf University, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany; Department of Diagnostic, Interventional Radiology and Nuclear Medicine, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Herne, Germany.
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Nicoletti G, Mazzetti S, Maimone G, Cignini V, Cuocolo R, Faletti R, Gatti M, Imbriaco M, Longo N, Ponsiglione A, Russo F, Serafini A, Stanzione A, Regge D, Giannini V. Development and Validation of an Explainable Radiomics Model to Predict High-Aggressive Prostate Cancer: A Multicenter Radiomics Study Based on Biparametric MRI. Cancers (Basel) 2024; 16:203. [PMID: 38201630 PMCID: PMC10778513 DOI: 10.3390/cancers16010203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/19/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
In the last years, several studies demonstrated that low-aggressive (Grade Group (GG) ≤ 2) and high-aggressive (GG ≥ 3) prostate cancers (PCas) have different prognoses and mortality. Therefore, the aim of this study was to develop and externally validate a radiomic model to noninvasively classify low-aggressive and high-aggressive PCas based on biparametric magnetic resonance imaging (bpMRI). To this end, 283 patients were retrospectively enrolled from four centers. Features were extracted from apparent diffusion coefficient (ADC) maps and T2-weighted (T2w) sequences. A cross-validation (CV) strategy was adopted to assess the robustness of several classifiers using two out of the four centers. Then, the best classifier was externally validated using the other two centers. An explanation for the final radiomics signature was provided through Shapley additive explanation (SHAP) values and partial dependence plots (PDP). The best combination was a naïve Bayes classifier trained with ten features that reached promising results, i.e., an area under the receiver operating characteristic (ROC) curve (AUC) of 0.75 and 0.73 in the construction and external validation set, respectively. The findings of our work suggest that our radiomics model could help distinguish between low- and high-aggressive PCa. This noninvasive approach, if further validated and integrated into a clinical decision support system able to automatically detect PCa, could help clinicians managing men with suspicion of PCa.
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Affiliation(s)
- Giulia Nicoletti
- Department of Electronics and Telecommunications, Polytechnic of Turin, Corso Duca degli Abruzzi, 24, 10129 Turin, Italy;
- Department of Surgical Sciences, University of Turin, Corso Dogliotti, 14, 10126 Turin, Italy; (V.C.); (R.F.); (A.S.)
| | - Simone Mazzetti
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale, 142—KM 3.95, 10060 Candiolo, Italy; (S.M.); (G.M.); (F.R.); (D.R.)
| | - Giovanni Maimone
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale, 142—KM 3.95, 10060 Candiolo, Italy; (S.M.); (G.M.); (F.R.); (D.R.)
| | - Valentina Cignini
- Department of Surgical Sciences, University of Turin, Corso Dogliotti, 14, 10126 Turin, Italy; (V.C.); (R.F.); (A.S.)
| | - Renato Cuocolo
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081 Baronissi, Italy;
| | - Riccardo Faletti
- Department of Surgical Sciences, University of Turin, Corso Dogliotti, 14, 10126 Turin, Italy; (V.C.); (R.F.); (A.S.)
| | - Marco Gatti
- Department of Surgical Sciences, University of Turin, Corso Dogliotti, 14, 10126 Turin, Italy; (V.C.); (R.F.); (A.S.)
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Via Pansini, 5, 80131 Naples, Italy; (M.I.); (A.P.)
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Via Pansini, 5, 80131 Naples, Italy;
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Via Pansini, 5, 80131 Naples, Italy; (M.I.); (A.P.)
| | - Filippo Russo
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale, 142—KM 3.95, 10060 Candiolo, Italy; (S.M.); (G.M.); (F.R.); (D.R.)
| | - Alessandro Serafini
- Department of Surgical Sciences, University of Turin, Corso Dogliotti, 14, 10126 Turin, Italy; (V.C.); (R.F.); (A.S.)
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Via Pansini, 5, 80131 Naples, Italy; (M.I.); (A.P.)
| | - Daniele Regge
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale, 142—KM 3.95, 10060 Candiolo, Italy; (S.M.); (G.M.); (F.R.); (D.R.)
- Department of Translational Research, Via Risorgimento, 36, University of Pisa, 56126 Pisa, Italy
| | - Valentina Giannini
- Department of Surgical Sciences, University of Turin, Corso Dogliotti, 14, 10126 Turin, Italy; (V.C.); (R.F.); (A.S.)
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale, 142—KM 3.95, 10060 Candiolo, Italy; (S.M.); (G.M.); (F.R.); (D.R.)
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Tang J, Zheng X, Wang X, Mao Q, Xie L, Wang R. Computer-aided detection of prostate cancer in early stages using multi-parameter MRI: A promising approach for early diagnosis. Technol Health Care 2024; 32:125-133. [PMID: 38759043 PMCID: PMC11191472 DOI: 10.3233/thc-248011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
BACKGROUND Transrectal ultrasound-guided prostate biopsy is the gold standard diagnostic test for prostate cancer, but it is an invasive examination of non-targeted puncture and has a high false-negative rate. OBJECTIVE In this study, we aimed to develop a computer-assisted prostate cancer diagnosis method based on multiparametric MRI (mpMRI) images. METHODS We retrospectively collected 106 patients who underwent radical prostatectomy after diagnosis with prostate biopsy. mpMRI images, including T2 weighted imaging (T2WI), diffusion weighted imaging (DWI), and dynamic-contrast enhanced (DCE), and were accordingly analyzed. We extracted the region of interest (ROI) about the tumor and benign area on the three sequential MRI axial images at the same level. The ROI data of 433 mpMRI images were obtained, of which 202 were benign and 231 were malignant. Of those, 50 benign and 50 malignant images were used for training, and the 333 images were used for verification. Five main feature groups, including histogram, GLCM, GLGCM, wavelet-based multi-fractional Brownian motion features and Minkowski function features, were extracted from the mpMRI images. The selected characteristic parameters were analyzed by MATLAB software, and three analysis methods with higher accuracy were selected. RESULTS Through prostate cancer identification based on mpMRI images, we found that the system uses 58 texture features and 3 classification algorithms, including Support Vector Machine (SVM), K-nearest Neighbor (KNN), and Ensemble Learning (EL), performed well. In the T2WI-based classification results, the SVM achieved the optimal accuracy and AUC values of 64.3% and 0.67. In the DCE-based classification results, the SVM achieved the optimal accuracy and AUC values of 72.2% and 0.77. In the DWI-based classification results, the ensemble learning achieved optimal accuracy as well as AUC values of 75.1% and 0.82. In the classification results based on all data combinations, the SVM achieved the optimal accuracy and AUC values of 66.4% and 0.73. CONCLUSION The proposed computer-aided diagnosis system provides a good assessment of the diagnosis of the prostate cancer, which may reduce the burden of radiologists and improve the early diagnosis of prostate cancer.
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Affiliation(s)
- Jianer Tang
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
- Department of Urology, First Affiliated Hospital of Huzhou Teachers College, Huzhou, Zhejiang, China
| | - Xiangyi Zheng
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiao Wang
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
| | - Qiqi Mao
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
| | - Liping Xie
- Department of Urology, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, China
| | - Rongjiang Wang
- Department of Urology, First Affiliated Hospital of Huzhou Teachers College, Huzhou, Zhejiang, China
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Gelikman DG, Rais-Bahrami S, Pinto PA, Turkbey B. AI-powered radiomics: revolutionizing detection of urologic malignancies. Curr Opin Urol 2024; 34:1-7. [PMID: 37909882 PMCID: PMC10842165 DOI: 10.1097/mou.0000000000001144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
PURPOSE OF REVIEW This review aims to highlight the integration of artificial intelligence-powered radiomics in urologic oncology, focusing on the diagnostic and prognostic advancements in the realm of managing prostate, kidney, and bladder cancers. RECENT FINDINGS As artificial intelligence continues to shape the medical imaging landscape, its integration into the field of urologic oncology has led to impressive results. For prostate cancer diagnostics, machine learning has shown promise in refining clinically-significant lesion detection, with some success in deciphering ambiguous lesions on multiparametric MRI. For kidney cancer, radiomics has emerged as a valuable tool for better distinguishing between benign and malignant renal masses and predicting tumor behavior from CT or MRI scans. Meanwhile, in the arena of bladder cancer, there is a burgeoning emphasis on prediction of muscle invasive cancer and forecasting disease trajectory. However, many studies showing promise in these areas face challenges due to limited sample sizes and the need for broader external validation. SUMMARY Radiomics integrated with artificial intelligence offers a pioneering approach to urologic oncology, ushering in an era of enhanced diagnostic precision and reduced invasiveness, guiding patient-tailored treatment plans. Researchers must embrace broader, multicentered endeavors to harness the full potential of this field.
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Affiliation(s)
- David G Gelikman
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Soroush Rais-Bahrami
- Department of Urology, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
- Department of Radiology, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Peter A Pinto
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Baris Turkbey
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Chatterjee A, Gallan A, Fan X, Medved M, Akurati P, Bourne RM, Antic T, Karczmar GS, Oto A. Prostate Cancers Invisible on Multiparametric MRI: Pathologic Features in Correlation with Whole-Mount Prostatectomy. Cancers (Basel) 2023; 15:5825. [PMID: 38136370 PMCID: PMC10742185 DOI: 10.3390/cancers15245825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
We investigated why some prostate cancers (PCas) are not identified on multiparametric MRI (mpMRI) by using ground truth reference from whole-mount prostatectomy specimens. A total of 61 patients with biopsy-confirmed PCa underwent 3T mpMRI followed by prostatectomy. Lesions visible on MRI prospectively or retrospectively identified after correlating with histology were considered "identified cancers" (ICs). Lesions that could not be identified on mpMRI were considered "unidentified cancers" (UCs). Pathologists marked the Gleason score, stage, size, and density of the cancer glands and performed quantitative histology to calculate the tissue composition. Out of 115 cancers, 19 were unidentified on MRI. The UCs were significantly smaller and had lower Gleason scores and clinical stage lesions compared with the ICs. The UCs had significantly (p < 0.05) higher ADC (1.34 ± 0.38 vs. 1.02 ± 0.30 μm2/ms) and T2 (117.0 ± 31.1 vs. 97.1 ± 25.1 ms) compared with the ICs. The density of the cancer glands was significantly (p = 0.04) lower in the UCs. The percentage of the Gleason 4 component in Gleason 3 + 4 lesions was nominally (p = 0.15) higher in the ICs (20 ± 12%) compared with the UCs (15 ± 8%). The UCs had a significantly lower epithelium (32.9 ± 21.5 vs. 47.6 ± 13.1%, p = 0.034) and higher lumen volume (20.4 ± 10.0 vs. 13.3 ± 4.1%, p = 0.021) compared with the ICs. Independent from size and Gleason score, the tissue composition differences, specifically, the higher lumen and lower epithelium in UCs, can explain why some of the prostate cancers cannot be identified on mpMRI.
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Affiliation(s)
- Aritrick Chatterjee
- Department of Radiology, University of Chicago, Chicago, IL 60637, USA; (X.F.); (M.M.); (G.S.K.); (A.O.)
- Sanford J. Grossman Center of Excellence in Prostate Imaging and Image Guided Therapy, University of Chicago, Chicago, IL 60637, USA
| | - Alexander Gallan
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Xiaobing Fan
- Department of Radiology, University of Chicago, Chicago, IL 60637, USA; (X.F.); (M.M.); (G.S.K.); (A.O.)
- Sanford J. Grossman Center of Excellence in Prostate Imaging and Image Guided Therapy, University of Chicago, Chicago, IL 60637, USA
| | - Milica Medved
- Department of Radiology, University of Chicago, Chicago, IL 60637, USA; (X.F.); (M.M.); (G.S.K.); (A.O.)
- Sanford J. Grossman Center of Excellence in Prostate Imaging and Image Guided Therapy, University of Chicago, Chicago, IL 60637, USA
| | | | - Roger M. Bourne
- Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Tatjana Antic
- Department of Pathology, University of Chicago, Chicago, IL 60637, USA;
| | - Gregory S. Karczmar
- Department of Radiology, University of Chicago, Chicago, IL 60637, USA; (X.F.); (M.M.); (G.S.K.); (A.O.)
- Sanford J. Grossman Center of Excellence in Prostate Imaging and Image Guided Therapy, University of Chicago, Chicago, IL 60637, USA
| | - Aytekin Oto
- Department of Radiology, University of Chicago, Chicago, IL 60637, USA; (X.F.); (M.M.); (G.S.K.); (A.O.)
- Sanford J. Grossman Center of Excellence in Prostate Imaging and Image Guided Therapy, University of Chicago, Chicago, IL 60637, USA
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7
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Patel K, Huang S, Rashid A, Varghese B, Gholamrezanezhad A. A Narrative Review of the Use of Artificial Intelligence in Breast, Lung, and Prostate Cancer. Life (Basel) 2023; 13:2011. [PMID: 37895393 PMCID: PMC10608739 DOI: 10.3390/life13102011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/30/2023] [Accepted: 09/30/2023] [Indexed: 10/29/2023] Open
Abstract
Artificial intelligence (AI) has been an important topic within radiology. Currently, AI is used clinically to assist with the detection of lesions through detection systems. However, a number of recent studies have demonstrated the increased value of neural networks in radiology. With an increasing number of screening requirements for cancers, this review aims to study the accuracy of the numerous AI models used in the detection and diagnosis of breast, lung, and prostate cancers. This study summarizes pertinent findings from reviewed articles and provides analysis on the relevancy to clinical radiology. This study found that whereas AI is showing continual improvement in radiology, AI alone does not surpass the effectiveness of a radiologist. Additionally, it was found that there are multiple variations on how AI should be integrated with a radiologist's workflow.
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Affiliation(s)
- Kishan Patel
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA (A.G.)
| | - Sherry Huang
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
| | - Arnav Rashid
- Department of Biological Sciences, Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Bino Varghese
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA (A.G.)
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA (A.G.)
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Mervak BM, Fried JG, Wasnik AP. A Review of the Clinical Applications of Artificial Intelligence in Abdominal Imaging. Diagnostics (Basel) 2023; 13:2889. [PMID: 37761253 PMCID: PMC10529018 DOI: 10.3390/diagnostics13182889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/23/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Artificial intelligence (AI) has been a topic of substantial interest for radiologists in recent years. Although many of the first clinical applications were in the neuro, cardiothoracic, and breast imaging subspecialties, the number of investigated and real-world applications of body imaging has been increasing, with more than 30 FDA-approved algorithms now available for applications in the abdomen and pelvis. In this manuscript, we explore some of the fundamentals of artificial intelligence and machine learning, review major functions that AI algorithms may perform, introduce current and potential future applications of AI in abdominal imaging, provide a basic understanding of the pathways by which AI algorithms can receive FDA approval, and explore some of the challenges with the implementation of AI in clinical practice.
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Affiliation(s)
| | | | - Ashish P. Wasnik
- Department of Radiology, University of Michigan—Michigan Medicine, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA; (B.M.M.); (J.G.F.)
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Chaddad A, Tan G, Liang X, Hassan L, Rathore S, Desrosiers C, Katib Y, Niazi T. Advancements in MRI-Based Radiomics and Artificial Intelligence for Prostate Cancer: A Comprehensive Review and Future Prospects. Cancers (Basel) 2023; 15:3839. [PMID: 37568655 PMCID: PMC10416937 DOI: 10.3390/cancers15153839] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
The use of multiparametric magnetic resonance imaging (mpMRI) has become a common technique used in guiding biopsy and developing treatment plans for prostate lesions. While this technique is effective, non-invasive methods such as radiomics have gained popularity for extracting imaging features to develop predictive models for clinical tasks. The aim is to minimize invasive processes for improved management of prostate cancer (PCa). This study reviews recent research progress in MRI-based radiomics for PCa, including the radiomics pipeline and potential factors affecting personalized diagnosis. The integration of artificial intelligence (AI) with medical imaging is also discussed, in line with the development trend of radiogenomics and multi-omics. The survey highlights the need for more data from multiple institutions to avoid bias and generalize the predictive model. The AI-based radiomics model is considered a promising clinical tool with good prospects for application.
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Affiliation(s)
- Ahmad Chaddad
- School of Artificial Intelligence, Guilin Universiy of Electronic Technology, Guilin 541004, China
- The Laboratory for Imagery, Vision and Artificial Intelligence, École de Technologie Supérieure (ETS), Montreal, QC H3C 1K3, Canada
| | - Guina Tan
- School of Artificial Intelligence, Guilin Universiy of Electronic Technology, Guilin 541004, China
| | - Xiaojuan Liang
- School of Artificial Intelligence, Guilin Universiy of Electronic Technology, Guilin 541004, China
| | - Lama Hassan
- School of Artificial Intelligence, Guilin Universiy of Electronic Technology, Guilin 541004, China
| | | | - Christian Desrosiers
- The Laboratory for Imagery, Vision and Artificial Intelligence, École de Technologie Supérieure (ETS), Montreal, QC H3C 1K3, Canada
| | - Yousef Katib
- Department of Radiology, Taibah University, Al Madinah 42361, Saudi Arabia
| | - Tamim Niazi
- Lady Davis Institute for Medical Research, McGill University, Montreal, QC H3T 1E2, Canada
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Panic J, Defeudis A, Balestra G, Giannini V, Rosati S. Normalization Strategies in Multi-Center Radiomics Abdominal MRI: Systematic Review and Meta-Analyses. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2023; 4:67-76. [PMID: 37283773 PMCID: PMC10241248 DOI: 10.1109/ojemb.2023.3271455] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/18/2023] [Accepted: 04/25/2023] [Indexed: 06/08/2023] Open
Abstract
Goal: Artificial intelligence applied to medical image analysis has been extensively used to develop non-invasive diagnostic and prognostic signatures. However, these imaging biomarkers should be largely validated on multi-center datasets to prove their robustness before they can be introduced into clinical practice. The main challenge is represented by the great and unavoidable image variability which is usually addressed using different pre-processing techniques including spatial, intensity and feature normalization. The purpose of this study is to systematically summarize normalization methods and to evaluate their correlation with the radiomics model performances through meta-analyses. This review is carried out according to the PRISMA statement: 4777 papers were collected, but only 74 were included. Two meta-analyses were carried out according to two clinical aims: characterization and prediction of response. Findings of this review demonstrated that there are some commonly used normalization approaches, but not a commonly agreed pipeline that can allow to improve performance and to bridge the gap between bench and bedside.
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Affiliation(s)
- Jovana Panic
- Department of Surgical Science, and Polytechnic of Turin, Department of Electronics and TelecommunicationsUniversity of Turin10129TurinItaly
| | - Arianna Defeudis
- Department of Surgical ScienceUniversity of Turin10129TurinItaly
- Candiolo Cancer InstituteFPO-IRCCS10060CandioloItaly
| | - Gabriella Balestra
- Department of Electronics and TelecommunicationsPolytechnic of Turin10129TurinItaly
| | - Valentina Giannini
- Department of Surgical ScienceUniversity of Turin10129TurinItaly
- Candiolo Cancer InstituteFPO-IRCCS10060CandioloItaly
| | - Samanta Rosati
- Department of Electronics and TelecommunicationsPolytechnic of Turin10129TurinItaly
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Gibala S, Obuchowicz R, Lasek J, Schneider Z, Piorkowski A, Pociask E, Nurzynska K. Textural Features of MR Images Correlate with an Increased Risk of Clinically Significant Cancer in Patients with High PSA Levels. J Clin Med 2023; 12:jcm12082836. [PMID: 37109173 PMCID: PMC10146387 DOI: 10.3390/jcm12082836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Prostate cancer, which is associated with gland biology and also with environmental risks, is a serious clinical problem in the male population worldwide. Important progress has been made in the diagnostic and clinical setups designed for the detection of prostate cancer, with a multiparametric magnetic resonance diagnostic process based on the PIRADS protocol playing a key role. This method relies on image evaluation by an imaging specialist. The medical community has expressed its desire for image analysis techniques that can detect important image features that may indicate cancer risk. METHODS Anonymized scans of 41 patients with laboratory diagnosed PSA levels who were routinely scanned for prostate cancer were used. The peripheral and central zones of the prostate were depicted manually with demarcation of suspected tumor foci under medical supervision. More than 7000 textural features in the marked regions were calculated using MaZda software. Then, these 7000 features were used to perform region parameterization. Statistical analyses were performed to find correlations with PSA-level-based diagnosis that might be used to distinguish suspected (different) lesions. Further multiparametrical analysis using MIL-SVM machine learning was used to obtain greater accuracy. RESULTS Multiparametric classification using MIL-SVM allowed us to reach 92% accuracy. CONCLUSIONS There is an important correlation between the textural parameters of MRI prostate images made using the PIRADS MR protocol with PSA levels > 4 mg/mL. The correlations found express dependence between image features with high cancer markers and hence the cancer risk.
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Affiliation(s)
- Sebastian Gibala
- Urology Department, Ultragen Medical Center, 31-572 Krakow, Poland
| | - Rafal Obuchowicz
- Department of Diagnostic Imaging, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Julia Lasek
- Faculty of Geology, Geophysics and Environmental Protection, AGH University of Science and Technology, 30-059 Krakow, Poland
| | - Zofia Schneider
- Faculty of Geology, Geophysics and Environmental Protection, AGH University of Science and Technology, 30-059 Krakow, Poland
| | - Adam Piorkowski
- Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland
| | - Elżbieta Pociask
- Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland
| | - Karolina Nurzynska
- Department of Algorithmics and Software, Silesian University of Technology, 44-100 Gliwice, Poland
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12
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Zhou J, Cao W, Wang L, Pan Z, Fu Y. Application of artificial intelligence in the diagnosis and prognostic prediction of ovarian cancer. Comput Biol Med 2022; 146:105608. [PMID: 35584585 DOI: 10.1016/j.compbiomed.2022.105608] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 11/03/2022]
Abstract
In recent years, the wide application of artificial intelligence (AI) has dramatically improved the work efficiency of clinicians and reduced their workload. This review provides a glance at the latest advances in AI-assisted diagnosis and prognostic prediction of ovarian cancer (OC). We performed an advanced search in PubMed and IEEE/IET Electronic Library, and included 39 articles in this review. A comprehensive and objective criterion was built to assess the reliability and quality of all studies from four aspects: the size of datasets for model development, research design, the division of training sets and test sets, and the type of quantitative performance indicators. This review analyzed the construction of AI models, including data pre-processing methods, feature selection techniques, AI classifiers, or algorithms. Additionally, we compared the performance of these models built on different datasets, which may support researchers for further iteration and development of AI. Finally, we discussed the challenges and future directions for AI application in medicine.
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Affiliation(s)
- Jingyang Zhou
- Queen Mary School, Medical Department, Nanchang University, Nanchang, 330031, Jiangxi Province, PR China
| | - Weiwei Cao
- Queen Mary School, Medical Department, Nanchang University, Nanchang, 330031, Jiangxi Province, PR China
| | - Lan Wang
- Queen Mary School, Medical Department, Nanchang University, Nanchang, 330031, Jiangxi Province, PR China
| | - Zezheng Pan
- Faculty of Basic Medical Science, Nanchang University, Nanchang, 330006, Jiangxi Province, PR China
| | - Ying Fu
- The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, PR China.
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More than Meets the Eye: Using Textural Analysis and Artificial Intelligence as Decision Support Tools in Prostate Cancer Diagnosis—A Systematic Review. J Pers Med 2022; 12:jpm12060983. [PMID: 35743766 PMCID: PMC9225075 DOI: 10.3390/jpm12060983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022] Open
Abstract
(1) Introduction: Multiparametric magnetic resonance imaging (mpMRI) is the main imagistic tool employed to assess patients suspected of harboring prostate cancer (PCa), setting the indication for targeted prostate biopsy. However, both mpMRI and targeted prostate biopsy are operator dependent. The past decade has been marked by the emerging domain of radiomics and artificial intelligence (AI), with extended application in medical diagnosis and treatment processes. (2) Aim: To present the current state of the art regarding decision support tools based on texture analysis and AI for the prediction of aggressiveness and biopsy assistance. (3) Materials and Methods: We performed literature research using PubMed MeSH, Scopus and WoS (Web of Science) databases and screened the retrieved papers using PRISMA principles. Articles that addressed PCa diagnosis and staging assisted by texture analysis and AI algorithms were included. (4) Results: 359 papers were retrieved using the keywords “prostate cancer”, “MRI”, “radiomics”, “textural analysis”, “artificial intelligence”, “computer assisted diagnosis”, out of which 35 were included in the final review. In total, 24 articles were presenting PCa diagnosis and prediction of aggressiveness, 7 addressed extracapsular extension assessment and 4 tackled computer-assisted targeted prostate biopsies. (5) Conclusions: The fusion of radiomics and AI has the potential of becoming an everyday tool in the process of diagnosis and staging of the prostate malignancies.
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