Better Prostate MRI with AI

A homegrown AI algorithm was able to detect clinically significant prostate cancer on MRI scans with the same accuracy as experienced radiologists. In a new study in Radiology, researchers say the algorithm could improve radiologists’ ability to detect prostate cancer on MRI, with fewer false positives.

In past issues of The Imaging Wire, we’ve discussed the need to improve on existing tools like PSA tests to make prostate cancer screening more precise with fewer false positives and less need for patient work-up.

  • Adding MRI to prostate screening protocols is a step forward, but MRI is an expensive technology that requires experienced radiologists to interpret.

Could AI help? In the new study, researchers tested a deep learning algorithm developed at the Mayo Clinic to detect clinically significant prostate cancer on multiparametric (mpMRI) scans.

  • In an interesting wrinkle, the Mayo algorithm does not indicate tumor location, so a second algorithm – called Grad-CAM – was employed to localize tumors.

The Mayo algorithm was trained on a population of 5k patients with a cancer prevalence similar to a screening population, then tested in an external test set of 204 patients, finding …

  • No statistically significant difference in performance between the Mayo algorithm and radiologists based on AUC (0.86 vs. 0.84, p=0.68)
  • The highest AUC was with the combination of AI and radiologists (0.89, p<0.001)
  • The Grad-CAM algorithm was accurate in localizing 56 of 58 true-positive exams

An editorial noted that the study employed the Mayo algorithm on multiparametric MRI exams.

  • Prostate cancer imaging is moving from mpMRI toward biparametric MRI (bpMRI) due to its faster scan times and lack of contrast, and if validated on bpMRI, AI’s impact could be even more dramatic.

The Takeaway
The current study illustrates the exciting developments underway to make prostate imaging more accurate and easier to perform. They also support the technology evolution that could one day make prostate cancer screening a more widely accepted test.

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