Rakesh Shiradkar1, Soumya Ghose1, Ivan Jambor2,3, Pekka Taimen4,5, Otto Ettala6, Andrei S Purysko7, Anant Madabhushi1. 1. Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA. 2. Department of Diagnostic Radiology, University of Turku, Finland. 3. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 4. Institute of Biomedicine, University of Turku, Turku, Finland. 5. Department of Pathology, Turku University Hospital, Turku, Finland. 6. Department of Urology, Turku University Hospital, Turku, Finland. 7. Section of Abdominal Imaging and Nuclear Radiology Department, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Abstract
BACKGROUND: Radiomics or computer-extracted texture features derived from MRI have been shown to help quantitatively characterize prostate cancer (PCa). Radiomics have not been explored depth in the context of predicting biochemical recurrence (BCR) of PCa. PURPOSE: To identify a set of radiomic features derived from pretreatment biparametric MRI (bpMRI) that may be predictive of PCa BCR. STUDY TYPE: Retrospective. SUBJECTS: In all, 120 PCa patients from two institutions, I1 and I2 , partitioned into training set D1 (N = 70) from I1 and independent validation set D2 (N = 50) from I2 . All patients were followed for ≥3 years. SEQUENCE: 3T, T2 -weighted (T2 WI) and apparent diffusion coefficient (ADC) maps derived from diffusion-weighted sequences. ASSESSMENT: PCa regions of interest (ROIs) on T2 WI were annotated by two experienced radiologists. Radiomic features from bpMRI (T2 WI and ADC maps) were extracted from the ROIs. A machine-learning classifier (CBCR ) was trained with the best discriminating set of radiomic features to predict BCR (pBCR ). STATISTICAL TESTS: Wilcoxon rank-sum tests with P < 0.05 were considered statistically significant. Differences in BCR-free survival at 3 years using pBCR was assessed using the Kaplan-Meier method and compared with Gleason Score (GS), PSA, and PIRADS-v2. RESULTS: Distribution statistics of co-occurrence of local anisotropic gradient orientation (CoLlAGe) and Haralick features from T2 WI and ADC were associated with BCR (P < 0.05) on D1 . CBCR predictions resulted in a mean AUC = 0.84 on D1 and AUC = 0.73 on D2 . A significant difference in BCR-free survival between the predicted classes (BCR + and BCR-) was observed (P = 0.02) on D2 compared to those obtained from GS (P = 0.8), PSA (P = 0.93) and PIRADS-v2 (P = 0.23). DATA CONCLUSION: Radiomic features from pretreatment bpMRI can be predictive of PCa BCR after therapy and may help identify men who would benefit from adjuvant therapy. LEVEL OF EVIDENCE: 4 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;48:1626-1636.
BACKGROUND: Radiomics or computer-extracted texture features derived from MRI have been shown to help quantitatively characterize prostate cancer (PCa). Radiomics have not been explored depth in the context of predicting biochemical recurrence (BCR) of PCa. PURPOSE: To identify a set of radiomic features derived from pretreatment biparametric MRI (bpMRI) that may be predictive of PCaBCR. STUDY TYPE: Retrospective. SUBJECTS: In all, 120 PCapatients from two institutions, I1 and I2 , partitioned into training set D1 (N = 70) from I1 and independent validation set D2 (N = 50) from I2 . All patients were followed for ≥3 years. SEQUENCE: 3T, T2 -weighted (T2 WI) and apparent diffusion coefficient (ADC) maps derived from diffusion-weighted sequences. ASSESSMENT: PCa regions of interest (ROIs) on T2 WI were annotated by two experienced radiologists. Radiomic features from bpMRI (T2 WI and ADC maps) were extracted from the ROIs. A machine-learning classifier (CBCR ) was trained with the best discriminating set of radiomic features to predict BCR (pBCR ). STATISTICAL TESTS: Wilcoxon rank-sum tests with P < 0.05 were considered statistically significant. Differences in BCR-free survival at 3 years using pBCR was assessed using the Kaplan-Meier method and compared with Gleason Score (GS), PSA, and PIRADS-v2. RESULTS: Distribution statistics of co-occurrence of local anisotropic gradient orientation (CoLlAGe) and Haralick features from T2 WI and ADC were associated with BCR (P < 0.05) on D1 . CBCR predictions resulted in a mean AUC = 0.84 on D1 and AUC = 0.73 on D2 . A significant difference in BCR-free survival between the predicted classes (BCR + and BCR-) was observed (P = 0.02) on D2 compared to those obtained from GS (P = 0.8), PSA (P = 0.93) and PIRADS-v2 (P = 0.23). DATA CONCLUSION: Radiomic features from pretreatment bpMRI can be predictive of PCaBCR after therapy and may help identify men who would benefit from adjuvant therapy. LEVEL OF EVIDENCE: 4 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;48:1626-1636.
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