» Articles » PMID: 39881076

3D-AttenNet Model Can Predict Clinically Significant Prostate Cancer in PI-RADS Category 3 Patients: a Retrospective Multicenter Study

Overview
Publisher Springer
Date 2025 Jan 29
PMID 39881076
Authors
Affiliations
Soon will be listed here.
Abstract

Purposes: The presence of clinically significant prostate cancer (csPCa) is equivocal for patients with prostate imaging reporting and data system (PI-RADS) category 3. We aim to develop deep learning models for re-stratify risks in PI-RADS category 3 patients.

Methods: This retrospective study included a bi-parametric MRI of 1567 consecutive male patients from six centers (Centers 1-6) between Jan 2015 and Dec 2020. Deep learning models with double channel attention modules based on MRI (AttenNet) for predicting PCa and csPCa were constructed separately. Each model was first pretrained using 1144 PI-RADS 1-2 and 4-5 images and then retrained using 238 PI-RADS 3 images from three training centers (centers 1-3), and tested using 185 PI-RADS 3 images from the other three testing centers (centers 4-6).

Results: Our AttenNet models achieved excellent prediction performances in testing cohort of center 4-6 with the area under the receiver operating characteristic curves (AUC) of 0.795 (95% CI: [0.700, 0.891]), 0.963 (95% CI: [0.915, 1]) and 0.922 (95% CI: [0.810, 1]) in predicting PCa, and the corresponding AUCs were 0.827 (95% CI: [0.703, 0.952]) and 0.926 (95% CI: [0.846, 1]) in predicting csPCa in testing cohort of center 4 and center 5. In particular, 71.1% to 92.2% of non-csPCa patients were identified by our model in three testing cohorts, who can spare from invasive biopsy or RP procedure.

Conclusions: Our model offers a noninvasive screening clinical tool to re-stratify risks in PI-RADS 3 patients, thereby reducing unnecessary invasive biopsies and improving the effectiveness of biopsies.

Critical Relevance Statement: The deep learning model with MRI can help to screen out csPCa in PI-RADS category 3.

Key Points: AttenNet models included channel attention and soft attention modules. 71.1-92.2% of non-csPCa patients were identified by the AttenNet model. The AttenNet models can be a screen clinical tool to re-stratify risks in PI-RADS 3 patients.

References
1.
Netzer N, Weisser C, Schelb P, Wang X, Qin X, Gortz M . Fully Automatic Deep Learning in Bi-institutional Prostate Magnetic Resonance Imaging: Effects of Cohort Size and Heterogeneity. Invest Radiol. 2021; 56(12):799-808. DOI: 10.1097/RLI.0000000000000791. View

2.
Ahmed H, El-Shater Bosaily A, Brown L, Gabe R, Kaplan R, Parmar M . Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017; 389(10071):815-822. DOI: 10.1016/S0140-6736(16)32401-1. View

3.
Ahdoot M, Wilbur A, Reese S, Lebastchi A, Mehralivand S, Gomella P . MRI-Targeted, Systematic, and Combined Biopsy for Prostate Cancer Diagnosis. N Engl J Med. 2020; 382(10):917-928. PMC: 7323919. DOI: 10.1056/NEJMoa1910038. View

4.
Lim C, Abreu-Gomez J, Thornhill R, James N, Al Kindi A, Lim A . Utility of machine learning of apparent diffusion coefficient (ADC) and T2-weighted (T2W) radiomic features in PI-RADS version 2.1 category 3 lesions to predict prostate cancer diagnosis. Abdom Radiol (NY). 2021; 46(12):5647-5658. DOI: 10.1007/s00261-021-03235-0. View

5.
Hiremath A, Shiradkar R, Fu P, Mahran A, Rastinehad A, Tewari A . An integrated nomogram combining deep learning, Prostate Imaging-Reporting and Data System (PI-RADS) scoring, and clinical variables for identification of clinically significant prostate cancer on biparametric MRI: a retrospective multicentre study. Lancet Digit Health. 2021; 3(7):e445-e454. PMC: 8261599. DOI: 10.1016/S2589-7500(21)00082-0. View