Abstract

ObjectivesTo investigate a previously developed radiomics-based biparametric magnetic resonance imaging (bpMRI) approach for discrimination of clinically significant peripheral zone prostate cancer (PZ csPCa) using multi-center, multi-vendor (McMv) and single-center, single-vendor (ScSv) datasets.MethodsThis study’s starting point was a previously developed ScSv algorithm for PZ csPCa whose performance was demonstrated in a single-center dataset. A McMv dataset was collected, and 262 PZ PCa lesions (9 centers, 2 vendors) were selected to identically develop a multi-center algorithm. The single-center algorithm was then applied to the multi-center dataset (single–multi-validation), and the McMv algorithm was applied to both the multi-center dataset (multi–multi-validation) and the previously used single-center dataset (multi–single-validation). The areas under the curve (AUCs) of the validations were compared using bootstrapping.ResultsPreviously the single–single validation achieved an AUC of 0.82 (95% CI 0.71–0.92), a significant performance reduction of 27.2% compared to the single–multi-validation AUC of 0.59 (95% CI 0.51–0.68). The new multi-center model achieved a multi–multi-validation AUC of 0.75 (95% CI 0.64–0.84). Compared to the multi–single-validation AUC of 0.66 (95% CI 0.56–0.75), the performance did not decrease significantly (p value: 0.114). Bootstrapped comparison showed similar single-center performances and a significantly different multi-center performance (p values: 0.03, 0.012).ConclusionsA single-center trained radiomics-based bpMRI model does not generalize to multi-center data. Multi-center trained radiomics-based bpMRI models do generalize, have equal single-center performance and perform better on multi-center data.

Highlights

  • In 2020, prostate cancer (PCa) is expected to be the most common cancer with the second highest mortality rate among western males [1]

  • Many recent efforts to improve diagnostic performance for csPCa have used some form of artificial intelligence (AI) [5]

  • A total of 236 lesions were scanned in either Hospital A or Hospital B, while the remaining 99 lesions were scanned in seven smaller regional medical centers

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Summary

Introduction

In 2020, prostate cancer (PCa) is expected to be the most common cancer with the second highest mortality rate among western males [1]. Multiparametric magnetic resonance imaging (mpMRI) has led to an increase in diagnostic performance for clinically significant (CS) PCa [2]. Many recent efforts to improve diagnostic performance for csPCa have used some form of artificial intelligence (AI) [5]. Among these studies, there is a lack of proper external validation [6]. Steps have been taken to standardize features [9], no studies have investigated what occurs during an external multi-center, multi-vendor (McMv) validation of a ScSv model

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