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Radiological semantics discriminate clinically significant grade prostate cancer

BACKGROUND: Identification of imaging traits to discriminate clinically significant prostate cancer is challenging due to the multi focal nature of the disease. The difficulty in obtaining a consensus by the Prostate Imaging and Data Systems (PI-RADS) scores coupled with disagreements in interpretin...

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Autores principales: Li, Qian, Lu, Hong, Choi, Jung, Gage, Kenneth, Feuerlein, Sebastian, Pow-Sang, Julio M., Gillies, Robert, Balagurunathan, Yoganand
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889697/
https://www.ncbi.nlm.nih.gov/pubmed/31796094
http://dx.doi.org/10.1186/s40644-019-0272-y
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author Li, Qian
Lu, Hong
Choi, Jung
Gage, Kenneth
Feuerlein, Sebastian
Pow-Sang, Julio M.
Gillies, Robert
Balagurunathan, Yoganand
author_facet Li, Qian
Lu, Hong
Choi, Jung
Gage, Kenneth
Feuerlein, Sebastian
Pow-Sang, Julio M.
Gillies, Robert
Balagurunathan, Yoganand
author_sort Li, Qian
collection PubMed
description BACKGROUND: Identification of imaging traits to discriminate clinically significant prostate cancer is challenging due to the multi focal nature of the disease. The difficulty in obtaining a consensus by the Prostate Imaging and Data Systems (PI-RADS) scores coupled with disagreements in interpreting multi-parametric Magnetic Resonance Imaging (mpMRI) has resulted in increased variability in reporting findings and evaluating the utility of this imaging modality in detecting clinically significant prostate cancer. This study assess the ability of radiological traits (semantics) observed on multi-parametric Magnetic Resonance images (mpMRI) to discriminate clinically significant prostate cancer. METHODS: We obtained multi-parametric MRI studies from 103 prostate cancer patients with 167 targeted biopsies from a single institution. The study was approved by our Institutional Review Board (IRB) for retrospective analysis. The biopsy location had been identified and marked by a clinical radiologist for targeted biopsy based on initial study interpretation. Using the target locations, two study radiologists independently re-evaluated the scans and scored 16 semantic traits on a point scale (up to 5 levels) based on mpMRI images. The semantic traits describe size, shape, and border characteristics of the prostate lesion, as well as presence of disease around lymph nodes (lymphadenopathy). We built a linear classifier model on these semantic traits and related to pathological outcome to identify clinically significant tumors (Gleason Score ≥ 7). The discriminatory ability of the predictors was tested using cross validation method randomly repeated and ensemble values were reported. We then compared the performance of semantic predictors with the PI-RADS predictors. RESULTS: We found several semantic features individually discriminated high grade Gleason score (ADC-intensity, Homogeneity, early-enhancement, T2-intensity and extraprostatic extention), these univariate predictors had an average area under the receiver operator characteristics (AUROC) ranging from 0.54 to 0.68. Multivariable semantic predictors with three features (ADC-intensity; T2-intensity, enhancement homogenicity) had an average AUROC of 0.7 [0.43, 0.94]. The PI-RADS based predictor had average AUROC of 0.6 [0.47, 0.75]. CONCLUSION: We find semantics traits are related to pathological findings with relatively higher reproducibility between radiologists. Multivariable predictors formed on these traits shows higher discriminatory ability compared to PI-RADS scores.
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spelling pubmed-68896972019-12-11 Radiological semantics discriminate clinically significant grade prostate cancer Li, Qian Lu, Hong Choi, Jung Gage, Kenneth Feuerlein, Sebastian Pow-Sang, Julio M. Gillies, Robert Balagurunathan, Yoganand Cancer Imaging Research Article BACKGROUND: Identification of imaging traits to discriminate clinically significant prostate cancer is challenging due to the multi focal nature of the disease. The difficulty in obtaining a consensus by the Prostate Imaging and Data Systems (PI-RADS) scores coupled with disagreements in interpreting multi-parametric Magnetic Resonance Imaging (mpMRI) has resulted in increased variability in reporting findings and evaluating the utility of this imaging modality in detecting clinically significant prostate cancer. This study assess the ability of radiological traits (semantics) observed on multi-parametric Magnetic Resonance images (mpMRI) to discriminate clinically significant prostate cancer. METHODS: We obtained multi-parametric MRI studies from 103 prostate cancer patients with 167 targeted biopsies from a single institution. The study was approved by our Institutional Review Board (IRB) for retrospective analysis. The biopsy location had been identified and marked by a clinical radiologist for targeted biopsy based on initial study interpretation. Using the target locations, two study radiologists independently re-evaluated the scans and scored 16 semantic traits on a point scale (up to 5 levels) based on mpMRI images. The semantic traits describe size, shape, and border characteristics of the prostate lesion, as well as presence of disease around lymph nodes (lymphadenopathy). We built a linear classifier model on these semantic traits and related to pathological outcome to identify clinically significant tumors (Gleason Score ≥ 7). The discriminatory ability of the predictors was tested using cross validation method randomly repeated and ensemble values were reported. We then compared the performance of semantic predictors with the PI-RADS predictors. RESULTS: We found several semantic features individually discriminated high grade Gleason score (ADC-intensity, Homogeneity, early-enhancement, T2-intensity and extraprostatic extention), these univariate predictors had an average area under the receiver operator characteristics (AUROC) ranging from 0.54 to 0.68. Multivariable semantic predictors with three features (ADC-intensity; T2-intensity, enhancement homogenicity) had an average AUROC of 0.7 [0.43, 0.94]. The PI-RADS based predictor had average AUROC of 0.6 [0.47, 0.75]. CONCLUSION: We find semantics traits are related to pathological findings with relatively higher reproducibility between radiologists. Multivariable predictors formed on these traits shows higher discriminatory ability compared to PI-RADS scores. BioMed Central 2019-12-03 /pmc/articles/PMC6889697/ /pubmed/31796094 http://dx.doi.org/10.1186/s40644-019-0272-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Li, Qian
Lu, Hong
Choi, Jung
Gage, Kenneth
Feuerlein, Sebastian
Pow-Sang, Julio M.
Gillies, Robert
Balagurunathan, Yoganand
Radiological semantics discriminate clinically significant grade prostate cancer
title Radiological semantics discriminate clinically significant grade prostate cancer
title_full Radiological semantics discriminate clinically significant grade prostate cancer
title_fullStr Radiological semantics discriminate clinically significant grade prostate cancer
title_full_unstemmed Radiological semantics discriminate clinically significant grade prostate cancer
title_short Radiological semantics discriminate clinically significant grade prostate cancer
title_sort radiological semantics discriminate clinically significant grade prostate cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889697/
https://www.ncbi.nlm.nih.gov/pubmed/31796094
http://dx.doi.org/10.1186/s40644-019-0272-y
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