Detection of Prostate Cancer Using Biparametric Prostate MRI, Radiomics, and Kallikreins: A Retrospective Multicenter Study of Men With a Clinical Suspicion of Prostate Cancer.

Autor: Montoya Perez I; Department of Diagnostic Radiology, University of Turku, Turku, Finland.; Department of Computing, University of Turku, Turku, Finland.; Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland., Merisaari H; Department of Diagnostic Radiology, University of Turku, Turku, Finland.; Department of Computing, University of Turku, Turku, Finland.; Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland., Jambor I; Department of Diagnostic Radiology, University of Turku, Turku, Finland.; Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland.; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA., Ettala O; Department of Urology, University of Turku, Turku University Hospital, Turku, Finland., Taimen P; Institute of Biomedicine, Department of Pathology, University of Turku, Turku University Hospital, Turku, Finland., Knaapila J; Department of Urology, University of Turku, Turku University Hospital, Turku, Finland., Kekki H; Department of Biotechnology, University of Turku, Turku, Finland., Khan FL; Department of Biotechnology, University of Turku, Turku, Finland., Syrjälä E; Department of Computing, University of Turku, Turku, Finland., Steiner A; Department of Diagnostic Radiology, University of Turku, Turku, Finland.; Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland., Syvänen KT; Department of Urology, University of Turku, Turku University Hospital, Turku, Finland., Verho J; Department of Diagnostic Radiology, University of Turku, Turku, Finland.; Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland., Seppänen M; Department of Surgery, Satakunta Central Hospital, Pori, Finland., Rannikko A; Department of Urology, Helsinki University, Helsinki University Hospital, Helsinki, Finland., Riikonen J; Department of Urology, Tampere University Hospital, University of Tampere, Tampere, Finland., Mirtti T; Department of Pathology, University of Helsinki, Helsinki, Finland., Lamminen T; Department of Urology, University of Turku, Turku University Hospital, Turku, Finland., Saunavaara J; Department of Medical Physics, Turku University Hospital, Turku, Finland., Falagario U; Department of Urology, University of Foggia, Foggia, Italy., Martini A; Department of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy., Pahikkala T; Department of Computing, University of Turku, Turku, Finland., Pettersson K; Department of Biotechnology, University of Turku, Turku, Finland., Boström PJ; Department of Urology, University of Turku, Turku University Hospital, Turku, Finland., Aronen HJ; Department of Diagnostic Radiology, University of Turku, Turku, Finland.; Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland.
Jazyk: angličtina
Zdroj: Journal of magnetic resonance imaging : JMRI [J Magn Reson Imaging] 2022 Feb; Vol. 55 (2), pp. 465-477. Date of Electronic Publication: 2021 Jul 05.
DOI: 10.1002/jmri.27811
Abstrakt: Background: Accurate detection of clinically significant prostate cancer (csPCa), Gleason Grade Group ≥ 2, remains a challenge. Prostate MRI radiomics and blood kallikreins have been proposed as tools to improve the performance of biparametric MRI (bpMRI).
Purpose: To develop and validate radiomics and kallikrein models for the detection of csPCa.
Study Type: Retrospective.
Population: A total of 543 men with a clinical suspicion of csPCa, 411 (76%, 411/543) had kallikreins available and 360 (88%, 360/411) did not take 5-alpha-reductase inhibitors. Two data splits into training, validation (split 1: single center, n = 72; split 2: random 50% of pooled datasets from all four centers), and testing (split 1: 4 centers, n = 288; split 2: remaining 50%) were evaluated.
Field Strength/sequence: A 3 T/1.5 T, TSE T2-weighted imaging, 3x SE DWI.
Assessment: In total, 20,363 radiomic features calculated from manually delineated whole gland (WG) and bpMRI suspicion lesion masks were evaluated in addition to clinical parameters, prostate-specific antigen, four kallikreins, MRI-based qualitative (PI-RADSv2.1/IMPROD bpMRI Likert) scores.
Statistical Tests: For the detection of csPCa, area under receiver operating curve (AUC) was calculated using the DeLong's method. A multivariate analysis was conducted to determine the predictive power of combining variables. The values of P-value < 0.05 were considered significant.
Results: The highest prediction performance was achieved by IMPROD bpMRI Likert and PI-RADSv2.1 score with AUC = 0.85 and 0.85 in split 1, 0.85 and 0.83 in split 2, respectively. bpMRI WG and/or kallikreins demonstrated AUCs ranging from 0.62 to 0.73 in split 1 and from 0.68 to 0.76 in split 2. AUC of bpMRI lesion-derived radiomics model was not statistically different to IMPROD bpMRI Likert score (split 1: AUC = 0.83, P-value = 0.306; split 2: AUC = 0.83, P-value = 0.488).
Data Conclusion: The use of radiomics and kallikreins failed to outperform PI-RADSv2.1/IMPROD bpMRI Likert and their combination did not lead to further performance gains.
Level of Evidence: 1 TECHNICAL EFFICACY: Stage 2.
(© 2021 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC. on behalf of International Society for Magnetic Resonance in Medicine.)
Databáze: MEDLINE
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