In past issues of The Imaging Wire, we’ve discussed some of the challenges to prostate cancer screening that have limited its wider adoption. But researchers continue to develop new tools for prostate imaging – particularly with MRI – that could flip the script.
Three new studies were published in just the last week focusing on prostate MRI, two involving AI image analysis.
In a new study in The Lancet Oncology, researchers presented results from AI algorithms developed for the Prostate Imaging—Cancer Artificial Intelligence (PI-CAI) Challenge.
- PI-CAI pitted teams from around the world in a competition to develop the best prostate AI algorithms, with results presented at recent RSNA and ECR conferences.
Researchers measured the ensemble performance of top-performing PI-CAI algorithms for detecting clinically significant prostate cancer against 62 radiologists who used the PI-RADS system in a population of 400 cases, finding that AI …
- Had performance superior to radiologists (AUROC=0.91 vs. 0.86)
- Generated 50% fewer false-positive results
- Detected 20% fewer low-grade cases
Broader use of prostate AI could reduce inter-reader variability and need for experienced radiologists to diagnose prostate cancer.
In the next study, in the Journal of Urology, researchers tested Avenda Health’s Unfold AI cancer mapping algorithm to measure the extent of tumors by analyzing their margins on MRI scans, finding that compared to physicians, AI …
- Had higher accuracy for defining tumor margins compared to two manual methods (85% vs. 67% and 76%)
- Reduced underestimations of cancer extent with a significantly higher negative margin rate (73% vs. 1.6%)
AI wasn’t used in the final study, but this one could be the most important of the three due to its potential economic impact on prostate MRI.
- Canadian researchers in Radiology tested a biparametric prostate MRI protocol that avoids the use of gadolinium contrast against multiparametric contrast-based MRI for guiding prostate biopsy.
They compared the protocols in 1.5k patients with prostate lesions undergoing biopsy, finding…
- No statistically significant difference in PPV between bpMRI and mpMRI for all prostate cancer (55% vs. 56%, p=0.61)
- No difference for clinically significant prostate cancer (34% vs. 34%, p=0.97).
They concluded that bpMRI offers lower costs and could improve access to prostate MRI by making the scans easier to perform.
The Takeaway
The advances in AI and MRI protocols shown in the new studies could easily be applied to prostate cancer screening, making it more economical, accessible, and clinically effective.
