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.

Highlights

  • Prostate cancer is the second most common cancer in men worldwide

  • The matrix was a table with two rows and two columns that reported the number of multiparametric magnetic resonance imaging (mp-MRI) Radiomics and Prostate Cancer false positives, false negatives, true positives (TP), and true negatives (TN)

  • A radiomics approach can consistently extract higher dimensional image features intrinsic to shape and texture, which are highly correlated with intratumor heterogeneity

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Summary

Introduction

Prostate cancer is the second most common cancer in men worldwide. There has been a rapid increase in the incidence of prostate cancer in China, with an average annual growth rate of 12.07% [1]. A common treatment option for localized prostate cancer includes endocrine therapy combined with radiation therapy. Biochemical recurrence (BCR) occurs in a significant number of patients after radiotherapy, with the 5– 8-years biochemical relapse-free survival rates being 65–85% in patients treated with intensity-modulated radiotherapy (IMRT) and image-guided radiation therapy (IGRT) [2]. Pretreatment identification of BCR in patients with localized prostate cancer can be useful to predict prognosis and guide treatment decisions. To identify multiparametric magnetic resonance imaging (mp-MRI)-based radiomics features as prognostic factors in patients with localized prostate cancer after radiotherapy

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