Purpose: To validate a novel consensus method, called target-in-target, combining human analysis of mpMRI with automated CAD system analysis, with the aim to increasing the prostate cancer detection rate of targeted biopsies. Methods: A cohort of 420 patients was enrolled and 253 patients were rolled out, due to exclusion criteria. 167 patients, underwent diagnostic 3T MpMRI. Two expert radiologists evaluated the exams adopting PI-RADSv2 and CAD system. When a CAD target overlapped with a radiologic one, we performed the biopsy in the overlapping area which we defined as target-in-target. Targeted TRUS-MRI fusion biopsy was performed in 63 patients with a total of 212 targets. The MRI data of all targets were quantitatively analyzed, and diagnostic findings were compared to pathologist’s biopsy reports. Results: CAD system diagnostic performance exhibited sensitivity and specificity scores of 55.2% and 74.1% [AUC = 0.63 (0.54 ÷ 0.71)] , respectively. Human readers achieved an AUC value, in ROC analysis, of 0.71 (0.63 ÷ 0.79). The target-in-target method provided a detection rate per targeted biopsy core of 81.8 % vs. a detection rate per targeted biopsy core of 68.6 % for pure PI-RADS based on target definitions. The higher per-core detection rate of the target-in-target approach was achieved irrespective of the presence of technical flaws and artifacts. Conclusions: A novel consensus method combining human reader evaluation with automated CAD system analysis of mpMRI to define prostate biopsy targets was shown to improve the detection rate per biopsy core of TRUS-MRI fusion biopsies. Results suggest that the combination of CAD system analysis and human reader evaluation is a winning strategy to improve targeted biopsy efficiency.

Improvement of prostate cancer detection combining a computer-aided diagnostic system with TRUS-MRI targeted biopsy / Campa, R.; Del Monte, M.; Barchetti, G.; Pecoraro, M.; Salvo, V.; Ceravolo, I.; Indino, E. L.; Ciardi, A.; Catalano, C.; Panebianco, V.. - In: ABDOMINAL RADIOLOGY. - ISSN 2366-004X. - 44:1(2019), pp. 264-271. [10.1007/s00261-018-1712-z]

Improvement of prostate cancer detection combining a computer-aided diagnostic system with TRUS-MRI targeted biopsy

Campa R.
Primo
;
Del Monte M.
Secondo
;
Barchetti G.;Pecoraro M.;Salvo V.;Ceravolo I.;Indino E. L.;Ciardi A.;Catalano C.
Penultimo
;
Panebianco V.
Ultimo
2019

Abstract

Purpose: To validate a novel consensus method, called target-in-target, combining human analysis of mpMRI with automated CAD system analysis, with the aim to increasing the prostate cancer detection rate of targeted biopsies. Methods: A cohort of 420 patients was enrolled and 253 patients were rolled out, due to exclusion criteria. 167 patients, underwent diagnostic 3T MpMRI. Two expert radiologists evaluated the exams adopting PI-RADSv2 and CAD system. When a CAD target overlapped with a radiologic one, we performed the biopsy in the overlapping area which we defined as target-in-target. Targeted TRUS-MRI fusion biopsy was performed in 63 patients with a total of 212 targets. The MRI data of all targets were quantitatively analyzed, and diagnostic findings were compared to pathologist’s biopsy reports. Results: CAD system diagnostic performance exhibited sensitivity and specificity scores of 55.2% and 74.1% [AUC = 0.63 (0.54 ÷ 0.71)] , respectively. Human readers achieved an AUC value, in ROC analysis, of 0.71 (0.63 ÷ 0.79). The target-in-target method provided a detection rate per targeted biopsy core of 81.8 % vs. a detection rate per targeted biopsy core of 68.6 % for pure PI-RADS based on target definitions. The higher per-core detection rate of the target-in-target approach was achieved irrespective of the presence of technical flaws and artifacts. Conclusions: A novel consensus method combining human reader evaluation with automated CAD system analysis of mpMRI to define prostate biopsy targets was shown to improve the detection rate per biopsy core of TRUS-MRI fusion biopsies. Results suggest that the combination of CAD system analysis and human reader evaluation is a winning strategy to improve targeted biopsy efficiency.
computer-aided diagnosis; interventional radiology; multiparametric MRI; prostate biopsy; prostate cancer; TRUS/MRI fusion biopsy
01 Pubblicazione su rivista::01a Articolo in rivista
Improvement of prostate cancer detection combining a computer-aided diagnostic system with TRUS-MRI targeted biopsy / Campa, R.; Del Monte, M.; Barchetti, G.; Pecoraro, M.; Salvo, V.; Ceravolo, I.; Indino, E. L.; Ciardi, A.; Catalano, C.; Panebianco, V.. - In: ABDOMINAL RADIOLOGY. - ISSN 2366-004X. - 44:1(2019), pp. 264-271. [10.1007/s00261-018-1712-z]
File allegati a questo prodotto
File Dimensione Formato  
Campa_Improvement_2019.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 913.45 kB
Formato Adobe PDF
913.45 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1291640
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 10
  • ???jsp.display-item.citation.isi??? 8
social impact