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External Validation of an MRI-Derived Radiomics Model to Predict Biochemical Recurrence after Surgery for High-Risk Prostate Cancer.

ABSTRACT: Adjuvant radiotherapy after prostatectomy was recently challenged by early salvage radiotherapy, which highlighted the need for biomarkers to improve risk stratification. Therefore, we developed an MRI ADC map-derived radiomics model to predict biochemical recurrence (BCR) and BCR-free survival (bRFS) after surgery. Our goal in this work was to externally validate this radiomics-based prediction model. EXPERIMENTAL DESIGN:A total of 195 patients with a high recurrence risk of prostate cancer (pT3-4 and/or R1 and/or Gleason's score > 7) were retrospectively included in two institutions. Patients with postoperative PSA (Prostate Specific Antigen) > 0.04 ng/mL or lymph node involvement were excluded. Radiomics features were extracted from T2 and ADC delineated tumors. A total of 107 patients from Institution 1 were used to retrain the previously published model. The retrained model was then applied to 88 patients from Institution 2 for external validation. BCR predictions were evaluated using AUC (Area Under the Curve), accuracy, and bRFS using Kaplan-Meier curves. RESULTS:With a median follow-up of 46.3 months, 52/195 patients experienced BCR. In the retraining cohort, the clinical prediction model (combining the number of risk factors and postoperative PSA) demonstrated moderate predictive power (accuracy of 63%). The radiomics model (ADC-based SZEGLSZM) predicted BCR with an accuracy of 78% and allowed for significant stratification of patients for bRFS (p < 0.0001). In Institution 2, this radiomics model remained predictive of BCR (accuracy of 0.76%) contrary to the clinical model (accuracy of 0.56%). CONCLUSIONS:The recently developed MRI ADC map-based radiomics model was validated in terms of its predictive accuracy of BCR and bRFS after prostatectomy in an external cohort.

SUBMITTER: Bourbonne V

PROVIDER: S-EPMC7226108 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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External Validation of an MRI-Derived Radiomics Model to Predict Biochemical Recurrence after Surgery for High-Risk Prostate Cancer.

Bourbonne Vincent V Fournier Georges G Vallières Martin M Lucia François F Doucet Laurent L Tissot Valentin V Cuvelier Gilles G Hue Stephane S Le Penn Du Henri H Perdriel Luc L Bertrand Nicolas N Staroz Frederic F Visvikis Dimitris D Pradier Olivier O Hatt Mathieu M Schick Ulrike U

Cancers 20200328 4

Adjuvant radiotherapy after prostatectomy was recently challenged by early salvage radiotherapy, which highlighted the need for biomarkers to improve risk stratification. Therefore, we developed an MRI ADC map-derived radiomics model to predict biochemical recurrence (BCR) and BCR-free survival (bRFS) after surgery. Our goal in this work was to externally validate this radiomics-based prediction model.<h4>Experimental design</h4>A total of 195 patients with a high recurrence risk of prostate can ...[more]

PMID: 32231077

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Project description: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.

Dataset Information

External Validation of an MRI-Derived Radiomics Model to Predict Biochemical Recurrence after Surgery for High-Risk Prostate Cancer.

Publications

External Validation of an MRI-Derived Radiomics Model to Predict Biochemical Recurrence after Surgery for High-Risk Prostate Cancer.

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