Multicenter Multireader Evaluation of an Artificial Intelligence-Based Attention Mapping System for the Detection of Prostate Cancer With Multiparametric MRI.

Journal: AJR. American journal of roentgenology
PMID: 32755355

Abstract

The purpose of this study was to evaluate in a multicenter dataset the performance of an artificial intelligence (AI) detection system with attention mapping compared with multiparametric MRI (mpMRI) interpretation in the detection of prostate cancer. MRI examinations from five institutions were included in this study and were evaluated by nine readers. In the first round, readers evaluated mpMRI studies using the Prostate Imaging Reporting and Data System version 2. After 4 weeks, images were again presented to readers along with the AI-based detection system output. Readers accepted or rejected lesions within four AI-generated attention map boxes. Additional lesions outside of boxes were excluded from detection and categorization. The performances of readers using the mpMRI-only and AI-assisted approaches were compared. The study population included 152 case patients and 84 control patients with 274 pathologically proven cancer lesions. The lesion-based AUC was 74.9% for MRI and 77.5% for AI with no significant difference ( = 0.095). The sensitivity for overall detection of cancer lesions was higher for AI than for mpMRI but did not reach statistical significance (57.4% vs 53.6%, = 0.073). However, for transition zone lesions, sensitivity was higher for AI than for MRI (61.8% vs 50.8%, = 0.001). Reading time was longer for AI than for MRI (4.66 vs 4.03 minutes, < 0.001). There was moderate interreader agreement for AI and MRI with no significant difference (58.7% vs 58.5%, = 0.966). Overall sensitivity was only minimally improved by use of the AI system. Significant improvement was achieved, however, in the detection of transition zone lesions with use of the AI system at the cost of a mean of 40 seconds of additional reading time.

Authors

  • Sherif Mehralivand
    Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
  • Stephanie A Harmon
    Clinical Research Directorate, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, Maryland, USA.
  • Joanna H Shih
    Division of Cancer Treatment and Diagnosis: Biometric Research Program, National Cancer Institute, National Institutes of Health, Rockville, MD.
  • Clayton P Smith
    Molecular Imaging Program, National Cancer Institute, National Institutes of Health, 10 Center Dr, MSC 1182, Bldg 10, Rm B3B85, Bethesda, MD 20892-1088.
  • Nathan Lay
    Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Clinical Image Processing Service, Radiology and Imaging Sciences Department, National Institutes of Health Clinical Center, Bethesda, MD 20892-1182, USA.
  • Burak Argun
    Department of Urology, Acibadem University, Istanbul, Turkey.
  • Sandra Bednarova
    Department of Radiology, University of Udine, Udine, Italy.
  • Ronaldo Hueb Baroni
    Diagnostic Imaging Department, Albert Einstein Hospital, Sao Paolo, Brazil.
  • Abdullah Erdem Canda
    School of Medicine, Yildirim Beyazit University, Ankara Ataturk Research & Training Hospital, Ankara, Turkey. Electronic address: erdemcanda@yahoo.com.
  • Karabekir Ercan
    Department of Radiology, Ankara City Hospital, Ankara, Turkey.
  • Rossano Girometti
    Department of Radiology, University of Udine, Udine, Italy.
  • Ercan Karaarslan
    Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, Department of Radiology, İstanbul, Türkiye.
  • Ali Riza Kural
    Acibadem University School of Medicine, Istanbul, Turkey.
  • Andrei S Purysko
    Department of Radiology, Cleveland Clinic, Cleveland, OH.
  • Soroush Rais-Bahrami
    University of Alabama at Birmingham, Department of Urology, Birmingham, Alabama.
  • Victor Martins Tonso
    Diagnostic Imaging Department, Albert Einstein Hospital, Sao Paolo, Brazil.
  • Cristina Magi-Galluzzi
    Department of Pathology, Cleveland Clinic, Cleveland, OH.
  • Jennifer B Gordetsky
    Department of Pathology, University of Alabama at Birmingham, Birmingham, AL.
  • Ricardo Silvestre E Silva Macarenco
    Pathology Department, Albert Einstein Hospital, Sao Paolo, Brazil.
  • Maria J Merino
    Center for Interventional Oncology, National Cancer Institute & Clinical Center, National Institutes of Health, Bethesda, MD, USA.
  • Berrak Gumuskaya
    Department of Pathology, Ankara Yildirim Beyazit University, School of Medicine, Ankara, Turkey.
  • Yesim Saglican
    Department of Pathology, Acibadem University, Istanbul, Turkey.
  • Stefano Sioletic
    Department of Pathology, University of Udine, Udine, Italy.
  • Anne Y Warren
    Department of Pathology, University of Cambridge, Cambridge, UK.
  • Tristan Barrett
    Department of Radiology, University of Cambridge, Cambridge, UK.
  • Leonardo Bittencourt
    Department of Radiology, Federal Fluminense University, Rio de Janeiro, Brazil.
  • Mehmet Coskun
    Department of Radiology, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey.
  • Chris Knauss
    Department of Radiology, Walter Reed Medical Center, Bethesda, MD.
  • Yan Mee Law
    Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
  • Ashkan A Malayeri
    Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD.
  • Daniel J Margolis
    Weill Cornell Imaging, Cornell University, New York, NY.
  • Jamie Marko
    Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD.
  • Derya Yakar
    Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: d.yakar@umcg.nl.
  • Bradford J Wood
    Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Peter A Pinto
    Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Peter L Choyke
    Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Ronald M Summers
    National Institutes of Health, Clinical Center, Radiology and Imaging Sciences, 10 Center Drive, Bethesda, MD 20892, USA.
  • Baris Turkbey
    Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.

Keywords

External Resources

Popular Topics
Recent Journals