Machine learning classifiers can predict Gleason pattern 4 prostate cancer with greater accuracy than experienced radiologists.

Autor: Antonelli M; Centre for Medical Image Computing, University College London, London, UK.; School of Biomedical Engineering and Imaging Science, King's College London, London, UK., Johnston EW; Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK., Dikaios N; Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK., Cheung KK; Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK., Sidhu HS; Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK., Appayya MB; Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK., Giganti F; Department of Radiology, University College London Hospital, London, UK.; Division of Surgery and Interventional Science, University College London, London, UK., Simmons LAM; Division of Surgery and Interventional Science, University College London, London, UK., Freeman A; Department of Pathology, University College London Hospital, London, UK., Allen C; Department of Radiology, University College London Hospital, London, UK., Ahmed HU; Division of Surgery and Interventional Science, University College London, London, UK., Atkinson D; Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK., Ourselin S; School of Biomedical Engineering and Imaging Science, King's College London, London, UK., Punwani S; Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK. shonit.punwani@gmail.com.; Department of Radiology, University College London Hospital, London, UK. shonit.punwani@gmail.com.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2019 Sep; Vol. 29 (9), pp. 4754-4764. Date of Electronic Publication: 2019 Jun 11.
DOI: 10.1007/s00330-019-06244-2
Abstrakt: Objective: The purpose of this study was: To test whether machine learning classifiers for transition zone (TZ) and peripheral zone (PZ) can correctly classify prostate tumors into those with/without a Gleason 4 component, and to compare the performance of the best performing classifiers against the opinion of three board-certified radiologists.
Methods: A retrospective analysis of prospectively acquired data was performed at a single center between 2012 and 2015. Inclusion criteria were (i) 3-T mp-MRI compliant with international guidelines, (ii) Likert ≥ 3/5 lesion, (iii) transperineal template ± targeted index lesion biopsy confirming cancer ≥ Gleason 3 + 3. Index lesions from 164 men were analyzed (119 PZ, 45 TZ). Quantitative MRI and clinical features were used and zone-specific machine learning classifiers were constructed. Models were validated using a fivefold cross-validation and a temporally separated patient cohort. Classifier performance was compared against the opinion of three board-certified radiologists.
Results: The best PZ classifier trained with prostate-specific antigen density, apparent diffusion coefficient (ADC), and maximum enhancement (ME) on DCE-MRI obtained a ROC area under the curve (AUC) of 0.83 following fivefold cross-validation. Diagnostic sensitivity at 50% threshold of specificity was higher for the best PZ model (0.93) when compared with the mean sensitivity of the three radiologists (0.72). The best TZ model used ADC and ME to obtain an AUC of 0.75 following fivefold cross-validation. This achieved higher diagnostic sensitivity at 50% threshold of specificity (0.88) than the mean sensitivity of the three radiologists (0.82).
Conclusions: Machine learning classifiers predict Gleason pattern 4 in prostate tumors better than radiologists.
Key Points: • Predictive models developed from quantitative multiparametric magnetic resonance imaging regarding the characterization of prostate cancer grade should be zone-specific. • Classifiers trained differently for peripheral and transition zone can predict a Gleason 4 component with a higher performance than the subjective opinion of experienced radiologists. • Classifiers would be particularly useful in the context of active surveillance, whereby decisions regarding whether to biopsy are necessitated.
Databáze: MEDLINE
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