Machine learning based on radiomics features combing B-mode transrectal ultrasound and contrast-enhanced ultrasound to improve peripheral zone prostate cancer detection.

purposeTo construct machine learning models based on radiomics features combing conventional transrectal ultrasound (B-mode) and contrast-enhanced ultrasound (CEUS) to improve prostate cancer (PCa) detection in peripheral zone (PZ).

methodsA prospective study of 166 men (72 benign, 94 malignant lesions) with targeted biopsy-confirmed pathology who underwent B-mode and CEUS examinations was performed. Risk factors, including age, serum total prostate-specific antigen (tPSA), free PSA (fPSA), f/t PSA, prostate volume and prostate-specific antigen density (PSAD), were collected. Time-intensity curves were obtained using SonoLiver software for all lesions in regions of interest. Four parameters were collected as risk factors: the maximum intensity (IMAX), rise time (RT), time to peak (TTP), and mean transit time (MTT). Radiomics features were extracted from the target lesions from B-mode and CEUS imaging. Multivariable logistic regression analysis was used to construct the model.

resultsA total of 3306 features were extracted from seven categories. Finally, 32 features were screened out from radiomics models. Five models were developed to predict PCa: the B-mode radiomics model (B model), CEUS radiomics model (CEUS model), B-CEUS combined radiomics model (B-CEUS model), risk factors model, and risk factors-radiomics combined model (combined model). Age, PSAD, tPSA, and RT were significant independent predictors in discriminating benign and malignant PZ lesions (P < 0.05). The risk factors model combing these four predictors showed better discrimination in the validation cohort (area under the curve [AUC], 0.84) than the radiomics images (AUC, 0.79 on B model; AUC, 0.78 on CEUS model; AUC, 0.83 on B-CEUS model), and the combined model (AUC: 0.89) achieved the greatest predictive efficacy.

conclusionThe prediction model including B-mode and CEUS radiomics signatures and risk factors represents a promising diagnostic tool for PCa detection in PZ, which may contribute to clinical decision-making.