Development and Validation of a Radiomics Nomogram for Predicting Clinically Significant Prostate Cancer in PI-RADS 3 Lesions
Open Access
- 26 January 2022
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Oncology
- Vol. 11, 825429
- https://doi.org/10.3389/fonc.2021.825429
Abstract
Purpose: To develop and validate a radiomics nomogram for the prediction of clinically significant prostate cancer (CsPCa) in Prostate Imaging-Reporting and Data System (PI-RADS) category 3 lesions. Methods: We retrospectively enrolled 306 patients within PI-RADS 3 lesion from January 2015 to July 2020 in institution 1; the enrolled patients were randomly divided into the training group (n = 199) and test group (n = 107). Radiomics features were extracted from T2-weighted imaging (T2WI), apparent diffusion coefficient (ADC) imaging, and dynamic contrast-enhanced (DCE) imaging. Synthetic minority oversampling technique (SMOTE) was used to address the class imbalance. The ANOVA and least absolute shrinkage and selection operator (LASSO) regression model were used for feature selection and radiomics signature building. Then, a radiomics score (Rad-score) was acquired. Combined with serum prostate-specific antigen density (PSAD) level, a multivariate logistic regression analysis was used to construct a radiomics nomogram. Receiver operating characteristic (ROC) curve analysis was used to evaluate radiomics signature and nomogram. The radiomics nomogram calibration and clinical usefulness were estimated through calibration curve and decision curve analysis (DCA). External validation was assessed, and the independent validation cohort contained 65 patients within PI-RADS 3 lesion from January 2020 to July 2021 in institution 2. Results: A total of 75 (24.5%) and 16 (24.6%) patients had CsPCa in institution 1 and 2, respectively. The radiomics signature with SMOTE augmentation method had a higher area under the ROC curve (AUC) [0.840 (95% CI, 0.776–0.904)] than that without SMOTE method [0.730 (95% CI, 0.624–0.836), p = 0.08] in the test group and significantly increased in the external validation group [0.834 (95% CI, 0.709–0.959) vs. 0.718 (95% CI, 0.562–0.874), p = 0.017]. The radiomics nomogram showed good discrimination and calibration, with an AUC of 0.939 (95% CI, 0.913–0.965), 0.884 (95% CI, 0.831–0.937), and 0.907 (95% CI, 0.814–1) in the training, test, and external validation groups, respectively. The DCA demonstrated the clinical usefulness of radiomics nomogram. Conclusion: The radiomics nomogram that incorporates the MRI-based radiomics signature and PSAD can be conveniently used to individually predict CsPCa in patients within PI-RADS 3 lesion.Funding Information
- Natural Science Foundation of Shandong Province
This publication has 31 references indexed in Scilit:
- Texture analysis of 3D dose distributions for predictive modelling of toxicity rates in radiotherapyRadiotherapy and Oncology, 2018
- A Radiomics Nomogram for the Preoperative Prediction of Lymph Node Metastasis in Bladder CancerClinical Cancer Research, 2017
- Computational Radiomics System to Decode the Radiographic PhenotypeCancer Research, 2017
- Radiomics: the bridge between medical imaging and personalized medicineNature Reviews Clinical Oncology, 2017
- Development and Validation of a Radiomics Nomogram for Preoperative Prediction of Lymph Node Metastasis in Colorectal CancerJournal of Clinical Oncology, 2016
- Radiomics: Images Are More than Pictures, They Are DataRadiology, 2016
- Automatic classification of prostate cancer Gleason scores from multiparametric magnetic resonance imagesProceedings of the National Academy of Sciences of the United States of America, 2015
- PI-RADS Prostate Imaging – Reporting and Data System: 2015, Version 2European Urology, 2015
- Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approachNature Communications, 2014
- ESUR prostate MR guidelines 2012European Radiology, 2012