Development, multi-institutional external validation, and algorithmic audit of an artificial intelligence-based Side-specific Extra-Prostatic Extension Risk Assessment tool (SEPERA) for patients undergoing radical prostatectomy: a retrospective cohort study.

Journal: The Lancet. Digital health
Published Date:

Abstract

BACKGROUND: Accurate prediction of side-specific extraprostatic extension (ssEPE) is essential for performing nerve-sparing surgery to mitigate treatment-related side-effects such as impotence and incontinence in patients with localised prostate cancer. Artificial intelligence (AI) might provide robust and personalised ssEPE predictions to better inform nerve-sparing strategy during radical prostatectomy. We aimed to develop, externally validate, and perform an algorithmic audit of an AI-based Side-specific Extra-Prostatic Extension Risk Assessment tool (SEPERA).

Authors

  • Jethro C C Kwong
    Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
  • Adree Khondker
    Division of Urology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
  • Eric Meng
    Faculty of Medicine, Queen's University, Kingston, ON, Canada.
  • Nicholas Taylor
    Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
  • Cynthia Kuk
    Division of Urology, Department of Surgery, Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada.
  • Nathan Perlis
    Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Girish S Kulkarni
    Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Temerty Centre for AI Research and Education in Medicine, University of Toronto, Toronto, ON, Canada.
  • Robert J Hamilton
    Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, Toronto, ON, Canada. Electronic address: rob.hamilton@uhn.ca.
  • Neil E Fleshner
    Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Antonio Finelli
    Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Theodorus H van der Kwast
    Laboratory Medicine Program, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
  • Amna Ali
    Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
  • Munir Jamal
    Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Frank Papanikolaou
    Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Thomas Short
    Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • John R Srigley
    Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
  • Valentin Colinet
    Division of Urology, Department of Surgery, Jules Bordet Institute, Brussels, Belgium.
  • Alexandre Peltier
    Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
  • Romain Diamand
    Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
  • Yolene Lefebvre
    Department of Medical Imagery, Jules Bordet Institute, Brussels, Belgium.
  • Qusay Mandoorah
    Division of Urology, Department of Surgery, L'Institut Mutualiste Montsouris, Paris, France.
  • Rafael Sanchez-Salas
    Department of Urology, Institut Mutualiste Montsouris, Paris, France.
  • Petr Macek
    Institut Mutualiste Montsouris, Paris, France.
  • Xavier Cathelineau
    Department of Urology, Institut Mutualiste Montsouris, Paris, France.
  • Martin Eklund
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Electronic address: martin.eklund@ki.se.
  • Alistair E W Johnson
  • Andrew Feifer
    Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada; Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
  • Alexandre R Zlotta
    Division of Urology, Department of Surgery, Sinai Health System, University of Toronto, Toronto, ON, Canada; Surgical Oncology, Urology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. Electronic address: alexandre.zlotta@sinaihealth.ca.