Abstract
Predicting biochemical recurrence of prostate cancer is imperative for initiating early treatment, which can improve the outcome of cancer treatment. However, because of inter- and intrareader variability in interpretation of F-18 fluciclovine positron emission tomography/computed tomography (PET/CT), it is difficult to reliably discern between necrotic tissue owing to radiation therapy and tumor tissue. Our goal is to develop a computational methodology using Haralick texture analysis that can be used as an adjunct tool to improve and standardize the interpretation of F-18 fluciclovine PET/CT to identify biochemical recurrence of prostate cancer. Four main textural features were chosen by variable selection procedure using least absolute shrinkage and selection operator logistic regression and bootstrapping, and then included as predictors in subsequent logistic ridge regression model for prediction (n = 28). Age at prostatectomy, prostate-specific antigen (PSA) level before the PET/CT imaging, and number of days between the prostate-specific antigen measurement and PET/CT imaging were also included in the prediction model. The overfitting-corrected area under the curve and Brier score of the proposed model were 0.94 (95% CI: 0.81, 1.00) and 0.12 (95% CI: 0.03, 0.23), respectively. Compared with a model with textural features (TI model) and that with only clinical information (CI model), the proposed model achieved 2% and 32% increase in AUC and 8% and 48% reduction in Brier score, respectively. Combining Haralick textural features based on the PET/CT imaging data with clinical information shows a high potential of enhanced prediction of the biochemical recurrence of prostate cancer.
Highlights
Prostate cancer (PCa) is the second leading cause of death by cancer among the male population in the United States
The goal of this study is to develop a computational methodology using Haralick texture analysis that can be used as an adjunct tool to improve and standardize the interpretation of F-18 fluciclovine positron emission tomography/computed tomography (PET/CT) to identify biochemical recurrence (BCR) of PCa, for inexperienced nuclear physicians and radiologists
82% of study participants had prostate-specific antigen (PSA) serum level
Summary
Prostate cancer (PCa) is the second leading cause of death by cancer among the male population in the United States. Biochemical recurrence (BCR) of PCa occurs in 27%–53% of patients and is typically detected by the rise in prostate-specific antigen (PSA) serum levels. One-third of the population experiencing recurrence develops metastasis within 8 years and multiple anatomical scans may be required to evaluate potential metastasis. Anatomical scans may be unable to detect tumors when their size is
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