Abstract

Prostate cancer (PCa) is the second most diagnosed cancer in men. Patients with PCa often develop metastases, with more than 80% of this metastases occurring in bone. The most common imaging technique used for screening, diagnosis and follow-up of disease evolution is bone scintigraphy, due to its high sensitivity and widespread availability at nuclear medicine facilities. To date, the assessment of bone scans relies solely on the interpretation of an expert physician who visually assesses the scan. Besides this being a time consuming task, it is also subjective, as there is no absolute criteria neither to identify bone metastases neither to quantify them by a straightforward and universally accepted procedure. In this paper, a new algorithm for the false positives reduction of automatically detected hotspots in bone scintigraphy images is proposed. The motivation relies in the difficulty of building a fully annotated database. In this way, our algorithm is a semisupervised method that works in an iterative way. The ultimate goal is to provide the physician with a fast, precise and reliable tool to quantify bone scans and evaluate disease progression and response to treatment. The algorithm is tested in a set of bone scans manually labeled according to the patient’s medical record. The achieved classification sensitivity, specificity and false negative rate were 63%, 58% and 37%, respectively. Comparison with other state-of-the-art classification algorithms shows superiority of the proposed method.

Highlights

  • According to the World Health Organization, prostate cancer (PCa) is the second most commonly diagnosed cancer in men, accounting for more than 1.4 million new cases and more than 375,000 deaths worldwide in 2020

  • Patients with advanced prostate cancer often develop metastases, which are caused by primary tumor cells that escape from the prostate gland and spread through the lymphatic system or the bloodstream to other areas of the body

  • There is no cure for metastatic prostate cancer, but it can often still be treated to slow down its growth

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Summary

Introduction

According to the World Health Organization, prostate cancer (PCa) is the second most commonly diagnosed cancer in men, accounting for more than 1.4 million new cases and more than 375,000 deaths worldwide in 2020. Patients with advanced prostate cancer often develop metastases, which are caused by primary tumor cells that escape from the prostate gland and spread through the lymphatic system or the bloodstream to other areas of the body. The most frequent site for metastatic growth of prostate cancer is the bone, and almost all patients with advanced prostate cancer show histological skeletal involvement, being estimated that 84% to 90% of patients with metastatic disease had bone metastases [1,2,3]. Even though the bone metastases are seldom the cause of death, they are the leading cause of morbidity and a major challenge in the management of patients, leading to a diminished quality of life. A precise detection and up-take quantification of bone metastases is essential to provide the physicians the accurate staging they require to choose the appropriate treatment for an individual patient, to monitor the evolution of the disease and to evaluate the treatment efficiency

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