Nai Ying-Hwey, Cheong Dennis Lai Hong, Roy Sharmili, Kok Trina, Stephenson Mary C, Schaefferkoetter Josh, Totman John J, Conti Maurizio, Eriksson Lars, Robins Edward G, Wang Ziting, Chua Wynne Yuru, Ang Bertrand Wei Leng, Singha Arvind Kumar, Thamboo Thomas Paulraj, Chiong Edmund, Reilhac Anthonin
Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Magn Reson Imaging. 2023 Jul;100:64-72. doi: 10.1016/j.mri.2023.03.009. Epub 2023 Mar 16.
The classification of prostate cancer (PCa) lesions using Prostate Imaging Reporting and Data System (PI-RADS) suffers from poor inter-reader agreement. This study compared quantitative parameters or radiomic features from multiparametric magnetic resonance imaging (mpMRI) or positron emission tomography (PET), as inputs into machine learning (ML) to predict the Gleason scores (GS) of detected lesions for improved PCa lesion classification.
20 biopsy-confirmed PCa subjects underwent imaging before radical prostatectomy. A pathologist assigned GS from tumour tissue. Two radiologists and one nuclear medicine physician delineated the lesions on the mpMR and PET images, yielding 45 lesion inputs. Seven quantitative parameters were extracted from the lesions, namely T2-weighted (T2w) image intensity, apparent diffusion coefficient (ADC), transfer constant (K), efflux rate constant (K), and extracellular volume ratio (V) from mpMR images, and SUV and SUV from PET images. Eight radiomic features were selected out of 109 radiomic features from T2w, ADC and PET images. Quantitative parameters or radiomic features, with risk factors of age, prostate-specific antigen (PSA), PSA density and volume, of 45 different lesion inputs were input in different combinations into four ML models - Decision Tree (DT), Support Vector Machine (SVM), k-Nearest-Neighbour (kNN), Ensembles model (EM).
SUV yielded the highest accuracy in discriminating detected lesions. Among the 4 ML models, kNN yielded the highest accuracies of 0.929 using either quantitative parameters or radiomic features with risk factors as input.
ML models' performance is dependent on the input combinations and risk factors further improve ML classification accuracy.
使用前列腺影像报告和数据系统(PI-RADS)对前列腺癌(PCa)病变进行分类时,不同阅片者之间的一致性较差。本研究比较了多参数磁共振成像(mpMRI)或正电子发射断层扫描(PET)的定量参数或放射组学特征,将其作为机器学习(ML)的输入,以预测检测到的病变的 Gleason 评分(GS),从而改善 PCa 病变分类。
20 名经活检证实的 PCa 患者在根治性前列腺切除术前行影像学检查。一名病理学家根据肿瘤组织确定 GS。两名放射科医生和一名核医学医生在 mpMR 和 PET 图像上勾勒病变,得到 45 个病变输入。从病变中提取七个定量参数,即 mpMR 图像中的 T2 加权(T2w)图像强度、表观扩散系数(ADC)、转移常数(K)、流出率常数(K)和细胞外体积比(V),以及 PET 图像中的 SUV 和 SUV。从 T2w、ADC 和 PET 图像的 109 个放射组学特征中选择了八个放射组学特征。将 45 个不同病变输入的定量参数或放射组学特征与年龄、前列腺特异性抗原(PSA)、PSA 密度和体积等危险因素以不同组合输入四个 ML 模型——决策树(DT)、支持向量机(SVM)、k 近邻(kNN)、集成模型(EM)。
SUV 在鉴别检测到的病变方面准确性最高。在这四个 ML 模型中,kNN 使用定量参数或带有危险因素的放射组学特征作为输入时,准确率最高,为 0.929。
ML 模型的性能取决于输入组合,危险因素可进一步提高 ML 分类的准确性。