Abstract

Purpose: Use of quantitative imaging features and encoding the intra-tumoral heterogeneity from multi-parametric magnetic resonance imaging (mpMRI) for the prediction of Gleason score is gaining attention as a non-invasive biomarker for prostate cancer (PCa). This study tested the hypothesis that radiomic features, extracted from mpMRI, could predict the Gleason score pattern of patients with PCa.Methods: This analysis included T2-weighted (T2-WI) and apparent diffusion coefficient (ADC, computed from diffusion-weighted imaging) scans of 99 PCa patients from The Cancer Imaging Archive (TCIA). A total of 41 radiomic features were calculated from a local tumor sub-volume (i.e., regions of interest) that is determined by a centroid coordinate of PCa volume, grouped based on their Gleason score patterns. Kruskal-Wallis and Spearman's rank correlation tests were used to identify features related to Gleason score groups. Random forest (RF) classifier model was used to predict Gleason score groups and identify the most important signature among the 41 radiomic features.Results: Gleason score groups could be discriminated based on zone size percentage, large zone size emphasis and zone size non-uniformity values (p < 0.05). These features also showed a significant correlation between radiomic features and Gleason score groups with a correlation value of −0.35, 0.32, 0.42 for the large zone size emphasis, zone size non-uniformity and zone size percentage, respectively (corrected p < 0.05). RF classifier model achieved an average of the area under the curves of the receiver operating characteristic (ROC) of 83.40, 72.71, and 77.35% to predict Gleason score groups (G1) = 6; 6 < (G2) < (3 + 4) and (G3) ≥ 4 + 3, respectively.Conclusion: Our results suggest that the radiomic features can be used as a non-invasive biomarker to predict the Gleason score of the PCa patients.

Highlights

  • Prostate cancer (PCa) is one of the most prevalent male malignancies in the developed countries and 1/6th of the men in the USA are expected to be diagnosed with this disease in their lifetime [1]

  • We reclassified the patients based on their Gleason Grade Group (GGG) into three groups to better represent clinical management: Group 1 (G1), 30 patients, Gleason score 6; Group 2 (G2), 39 patients, Gleason score 3 + 4; and Group 3 (G3), 30 patients, Gleason primary pattern of 4 or higher (4 + 3, 8, 9 or 10)

  • After extracting 41 radiomic features from MR images of each PCa patient, we applied univariate analysis using the Kruskal-Wallis significance test to determine if any individual radiomic feature was statistically significant to compare between the Gleason score (GS) groups

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Summary

Introduction

Prostate cancer (PCa) is one of the most prevalent male malignancies in the developed countries and 1/6th of the men in the USA are expected to be diagnosed with this disease in their lifetime [1]. Patients with localized PCa are classified into three risk groups (low, intermediate, and high risk) based on their prostate-specific Antigen (PSA) level, Gleason score and clinical stage. Gleason Score Related Radiomic Features (i.e., TNM) [2]. For men with low-risk prostate cancer, active surveillance as opposed to immediate treatment has become a widely accepted treatment approach [3, 4]. A study of 17,943 patients with low-risk PCa who were treated with radical prostatectomy (RP) revealed that upgrading and upstaging occurred in 45% of these men [5]. The deferral of RP for more than 12 months has been associated with a 1.7-fold increased risk of non-organ confined disease after surgery [5]

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