Transition-zone PSA-density calculated from MRI deep learning prostate zonal segmentation model for prediction of clinically significant prostate cancer.

Purpose: To develop a deep learning (DL) zonal segmentation model of prostate MR from T2-weighted images and evaluate TZ-PSAD for prediction of the presence of csPCa (Gleason score of 7 or higher) compared to PSAD. Methods: 1020 patients with a prostate MRI were randomly selected to develop a DL zon...

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Published in:Abdominal Radiology Vol. 49; no. 10; pp. 3722 - 3735
Main Authors: Kuanar, Shiba, Cai, Jason, Nakai, Hirotsugu, Nagayama, Hiroki, Takahashi, Hiroaki, LeGout, Jordan, Kawashima, Akira, Froemming, Adam, Mynderse, Lance, Dora, Chandler, Humphreys, Mitchell, Klug, Jason, Korfiatis, Panagiotis, Erickson, Bradley, Takahashi, Naoki
Format: Journal Article
Published: Springer Nature Oct2024
Online Access:View this record in EBSCOhost
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      dt: Oct2024
      vid: 49
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00261-024-04301-z
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        atl: Transition-zone PSA-density calculated from MRI deep learning prostate zonal segmentation model for prediction of clinically significant prostate cancer.
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          Kuanar, Shiba
          Cai, Jason
          Nakai, Hirotsugu
          Nagayama, Hiroki
          Takahashi, Hiroaki
          LeGout, Jordan
          Kawashima, Akira
          Froemming, Adam
          Mynderse, Lance
          Dora, Chandler
          Humphreys, Mitchell
          Klug, Jason
          Korfiatis, Panagiotis
          Erickson, Bradley
          Takahashi, Naoki
        affil: https://ror.org/02qp3tb03 Department of Radiology, Mayo Clinic, 55905, Rochester, MN, USA
      sug:
      ab: Purpose: To develop a deep learning (DL) zonal segmentation model of prostate MR from T2-weighted images and evaluate TZ-PSAD for prediction of the presence of csPCa (Gleason score of 7 or higher) compared to PSAD. Methods: 1020 patients with a prostate MRI were randomly selected to develop a DL zonal segmentation model. Test dataset included 20 cases in which 2 radiologists manually segmented both the peripheral zone (PZ) and TZ. Pair-wise Dice index was calculated for each zone. For the prediction of csPCa using PSAD and TZ-PSAD, we used 3461 consecutive MRI exams performed in patients without a history of prostate cancer, with pathological confirmation and available PSA values, but not used in the development of the segmentation model as internal test set and 1460 MRI exams from PI-CAI challenge as external test set. PSAD and TZ-PSAD were calculated from the segmentation model output. The area under the receiver operating curve (AUC) was compared between PSAD and TZ-PSAD using univariate and multivariate analysis (adjusts age) with the DeLong test. Results: Dice scores of the model against two radiologists were 0.87/0.87 and 0.74/0.72 for TZ and PZ, while those between the two radiologists were 0.88 for TZ and 0.75 for PZ. For the prediction of csPCa, the AUCs of TZPSAD were significantly higher than those of PSAD in both internal test set (univariate analysis, 0.75 vs. 0.73, p < 0.001; multivariate analysis, 0.80 vs. 0.78, p < 0.001) and external test set (univariate analysis, 0.76 vs. 0.74, p < 0.001; multivariate analysis, 0.77 vs. 0.75, p < 0.001 in external test set). Conclusion: DL model-derived zonal segmentation facilitates the practical measurement of TZ-PSAD and shows it to be a slightly better predictor of csPCa compared to the conventional PSAD. Use of TZ-PSAD may increase the sensitivity of detecting csPCa by 2–5% for a commonly used specificity level.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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