MRI is changing how prostate cancer is detected, diagnosed, and followed up. But even a technology as powerful as MRI could use a little help, as evidenced by a new study in Radiology showing that a commercially available AI algorithm could help radiologists diagnose clinically significant prostate cancer.
Workup of suspicious prostate lesions is being reshaped by MRI in meaningful ways.
- For example, MRI-guided biopsy is replacing systemic prostate biopsy without guidance, especially for patients with low to intermediate risk of prostate cancer.
But prostate MRI isn’t perfect – yet. Radiologist performance can vary due to differences in experience, as well as variations in MRI acquisitions, tumor location, and cancer prevalence. Could AI help even out these variations?
- To find out, researchers from South Korea tested Siemens Healthineers’ syngo.via MR Prostate algorithm in 205 patients suspected of prostate cancer who were scheduled for biopsy based on clinical information (including previous MRI scans).
The AI algorithm’s performance was compared to that of experienced radiologists, and researchers also estimated its impact on radiologist interpretation if used as a reading aid, finding that for clinically significant prostate cancer…
- AI had lower sensitivity versus radiologists (80% vs. 93%).
- But higher positive predictive value (58% vs. 48%).
- Adding AI to radiologists’ interpretation more than doubled specificity (44% vs. 21%).
- There were no cancer cases among lesions rated by both the algorithm and radiologists as not likely to be cancer (PI-RADS 1 or 2).
AI’s higher PPV indicates that it could help reduce unnecessary prostate biopsies, while also detecting clinically significant cancer that might have been missed by radiologists.
The Takeaway
The new findings echo previous studies that demonstrate the value of AI for MRI of prostate cancer, but differ in that they investigate a commercially available algorithm – indicating that tools for better prostate MRI are becoming accessible to radiologists.
