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Radiomics of Multiparametric MRI to Predict Biochemical Recurrence of Localized Prostate Cancer After Radiation Therapy.

ABSTRACT: Background: To identify multiparametric magnetic resonance imaging (mp-MRI)-based radiomics features as prognostic factors in patients with localized prostate cancer after radiotherapy. Methods:From 2011 to 2016, a total of 91 consecutive patients with T1-4N0M0 prostate cancer were identified and divided into two cohorts for an adaptive boosting (Adaboost) model (training cohort: n = 73; test cohort: n = 18). All patients were treated with neoadjuvant endocrine therapy followed by radiotherapy. The optimal feature set, identified through an Inception-Resnet v2 network, consisted of a combination of T1, T2, and diffusion-weighted imaging (DWI) MR series. Through a Wilcoxon sign rank test, a total of 45 distinct signatures were extracted from 1,536 radiomics features and used in our Adaboost model. Results:Among 91 patients, 29 (32%) were classified as biochemical recurrence (BCR) and 62 (68%) as non-BCR. Once trained, the model demonstrated a predictive classification accuracy of 50.0 and 86.1% respectively for BCR and non-BCR groups on our test samples. The overall classification accuracy of the test cohort was 74.1%. The highest classification accuracy was 77.8% between three-fold cross-validation. The areas under the curve (AUC) of receiver operating characteristic curve (ROC) indices for the training and test cohorts were 0.99 and 0.73, respectively. Conclusion:The potential of multiparametric MRI-based radiomics to predict the BCR of localized prostate cancer patients was demonstrated in this manuscript. This analysis provided additional prognostic factors based on routine MR images and holds the potential to contribute to precision medicine and inform treatment management.

SUBMITTER: Zhong QZ

PROVIDER: S-EPMC7235325 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Radiomics of Multiparametric MRI to Predict Biochemical Recurrence of Localized Prostate Cancer After Radiation Therapy.

Zhong Qiu-Zi QZ Long Liu-Hua LH Liu An A Li Chun-Mei CM Xiu Xia X Hou Xiu-Yu XY Wu Qin-Hong QH Gao Hong H Xu Yong-Gang YG Zhao Ting T Wang Dan D Lin Hai-Lei HL Sha Xiang-Yan XY Wang Wei-Hu WH Chen Min M Li Gao-Feng GF

Frontiers in oncology 20200512

Background: To identify multiparametric magnetic resonance imaging (mp-MRI)-based radiomics features as prognostic factors in patients with localized prostate cancer after radiotherapy. Methods:From 2011 to 2016, a total of 91 consecutive patients with T1-4N0M0 prostate cancer were identified and divided into two cohorts for an adaptive boosting (Adaboost) model (training cohort: n = 73; test cohort: n = 18). All patients were treated with neoadjuvant endocrine therap ...[more]

PMID: 32477949

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Project description:ObjectiveTo identify which patient with prostate cancer (PCa) could safely avoid extended pelvic lymph node dissection (ePLND) by predicting lymph node invasion (LNI), via a radiomics-based machine learning approach.MethodsAn integrative radiomics model (IRM) was proposed to predict LNI, confirmed by the histopathologic examination, integrating radiomics features, extracted from prostatic index lesion regions on MRI images, and clinical features via SVM. The study cohort comprised 244 PCa patients with MRI and followed by radical prostatectomy (RP) and ePLND within 6 months between 2010 and 2019. The proposed IRM was trained in training/validation set and evaluated in an internal independent testing set. The model's performance was measured by area under the curve (AUC), sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). AUCs were compared via Delong test with 95% confidence interval (CI), and the rest measurements were compared via chi-squared test or Fisher's exact test.ResultsOverall, 17 (10.6%) and 14 (16.7%) patients with LNI were included in training/validation set and testing set, respectively. Shape and first-order radiomics features showed usefulness in building the IRM. The proposed IRM achieved an AUC of 0.915 (95% CI: 0.846-0.984) in the testing set, superior to pre-existing nomograms whose AUCs were from 0.698 to 0.724 (p < 0.05).ConclusionThe proposed IRM could be potentially feasible to predict the risk of having LNI for patients with PCa. With the improved predictability, it could be utilized to assess which patients with PCa could safely avoid ePLND, thus reduce the number of unnecessary ePLND.Key points• The combination of MRI-based radiomics features with clinical information improved the prediction of lymph node invasion, compared with the model using only radiomics features or clinical features. • With improved prediction performance on predicting lymph node invasion, the number of extended pelvic lymph node dissection (ePLND) could be reduced by the proposed integrative radiomics model (IRM), compared with the existing nomograms.

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

Radiomics of Multiparametric MRI to Predict Biochemical Recurrence of Localized Prostate Cancer After Radiation Therapy.

Publications

Radiomics of Multiparametric MRI to Predict Biochemical Recurrence of Localized Prostate Cancer After Radiation Therapy.

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