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Magnetic Resonance Imaging is increasing in importance in prostate cancer diagnosis due to the high accuracy and quality of the examination procedure. However, this process requires a time-consuming analysis of the results. Currently, machine vision is widely used in many areas. It enables automation and support in radiological studies. Successful detection of primary prostate tumors depends on the effective segmentation of the prostate itself. At times, a CT scan may be performed; alternatively, MRI may be the selected option. The data always reach a bottleneck stage. This paper presents the effective training of deep learning models to segment the prostate based on onefold and multimodal medical images. This approach supports the computer-aided diagnosis (CAD) system for radiologists as the first step in cancer exams. A comparison of two approaches designed for prostate segmentation is described. The first combines YOLOv4, the object detection neural network, and U-Net for a semantic segmentation based on onefold modality MRI images. The second presents the same method trained on multimodal images—a CT and MRI mixed dataset. The learning process was carried out in a cloud environment using GPU cards. The experiments are based on data from 120 patients who have undergone MRI and CT examinations. Several metrics evaluated the trained models. In the prostate semantic segmentation process, better results were achieved by mixed MRI with CT datasets. The best model achieved the value of 0.9685 for the Sørensen–Dice coefficient for the threshold value of 0.6. [ABSTRACT FROM AUTHOR]

Prostate gland segmentation is the primary step to estimate gland volume, which aids in the prostate disease management. In this study, we present a 2D-3D convolutional neural network (CNN) ensemble that automatically segments the whole prostate gland along with the peripheral zone (PZ) (PPZ-SegNet) using a T2-weighted sequence (T2W) of Magnetic Resonance Imaging (MRI). The study used 4 different public data sets organized as Train #1 and Test #1 (independently derived from the same cohort), Test #2, Test #3 and Test #4. The prostate gland and the peripheral zone (PZ) anatomy were manually delineated with consensus read by a radiologist, except for Test #4 cohorts that had pre-marked glandular anatomy. A Bayesian hyperparameter optimization method was applied to construct the network model (PPZ-SegNet) with a training cohort (Train #1, n = 150) using a five-fold cross validation. The model evaluation was performed on an independent cohort of 283 T2W MRI prostate cases (Test #1 to #4) without any additional tuning. The data cohorts were derived from The Cancer Imaging Archives (TCIA): PROSTATEx Challenge, Prostatectomy, Repeatability studies and PROMISE12-Challenge. The segmentation performance was evaluated by computing the Dice similarity coefficient and Hausdorff distance between the estimated-deep-network identified regions and the radiologist-drawn annotations. The deep network architecture was able to segment the prostate gland anatomy with an average Dice score of 0.86 in Test #1 (n = 192), 0.79 in Test #2 (n = 26), 0.81 in Test #3 (n = 15), and 0.62 in Test #4 (n = 50). We also found the Dice coefficient improved with larger prostate volumes in 3 of the 4 test cohorts. The variation of the Dice scores from different cohorts of test images suggests the necessity of more diverse models that are inclusive of dependencies such as the gland sizes and others, which will enable us to develop a universal network for prostate and PZ segmentation. Our training and evaluation code can be accessed through the link: https://github.com/ mariabaldeon/PPZ-SegNet.git. [ABSTRACT FROM AUTHOR]

Abstract The diagnosis of early prostate cancer depends on the accurate segmentation of prostate regions in magnetic resonance imaging (MRI). However, this segmentation task is challenging due to the particularities of prostate MR images themselves and the limitations of existing methods. To address these issues, we propose a U-shaped encoder-decoder network MM-UNet based on Mamba and CNN for prostate segmentation in MR images. Specifically, we first proposed an adaptive feature fusion module based on channel attention guidance to achieve effective fusion between adjacent hierarchical features and suppress the interference of background noise. Secondly, we propose a global context-aware module based on Mamba, which has strong long-range modeling capabilities and linear complexity, to capture global context information in images. Finally, we propose a multi-scale anisotropic convolution module based on the principle of parallel multi-scale anisotropic convolution blocks and 3D convolution decomposition. Experimental results on two public prostate MR image segmentation datasets demonstrate that the proposed method outperforms competing models in terms of prostate segmentation performance and achieves state-of-the-art performance. In future work, we intend to enhance the model's robustness and extend its applicability to additional medical image segmentation tasks.

Abstract Purpose objective(s) Manual contouring of the prostate region in planning computed tomography (CT) images is a challenging task due to factors such as low contrast in soft tissues, inter- and intra-observer variability, and variations in organ size and shape. Consequently, the use of automated contouring methods can offer significant advantages. In this study, we aimed to investigate automated male pelvic multi-organ contouring in multi-center planning CT images using a hybrid convolutional neural network-vision transformer (CNN-ViT) that combines convolutional and ViT techniques. Materials/methods We used retrospective data from 104 localized prostate cancer patients, with delineations of the clinical target volume (CTV) and critical organs at risk (OAR) for external beam radiotherapy. We introduced a novel attention-based fusion module that merges detailed features extracted through convolution with the global features obtained through the ViT. Results The average dice similarity coefficients (DSCs) achieved by VGG16-UNet-ViT for the prostate, bladder, rectum, right femoral head (RFH), and left femoral head (LFH) were 91.75%, 95.32%, 87.00%, 96.30%, and 96.34%, respectively. Experiments conducted on multi-center planning CT images indicate that combining the ViT structure with the CNN network resulted in superior performance for all organs compared to pure CNN and transformer architectures. Furthermore, the proposed method achieves more precise contours compared to state-of-the-art techniques. Conclusion Results demonstrate that integrating ViT into CNN architectures significantly improves segmentation performance. These results show promise as a reliable and efficient tool to facilitate prostate radiotherapy treatment planning.

Purpose objective(s): Manual contouring of the prostate region in planning computed tomography (CT) images is a challenging task due to factors such as low contrast in soft tissues, inter- and intra-observer variability, and variations in organ size and shape. Consequently, the use of automated contouring methods can offer significant advantages. In this study, we aimed to investigate automated male pelvic multi-organ contouring in multi-center planning CT images using a hybrid convolutional neural network-vision transformer (CNN-ViT) that combines convolutional and ViT techniques. Materials/methods: We used retrospective data from 104 localized prostate cancer patients, with delineations of the clinical target volume (CTV) and critical organs at risk (OAR) for external beam radiotherapy. We introduced a novel attention-based fusion module that merges detailed features extracted through convolution with the global features obtained through the ViT. Results: The average dice similarity coefficients (DSCs) achieved by VGG16-UNet-ViT for the prostate, bladder, rectum, right femoral head (RFH), and left femoral head (LFH) were 91.75%, 95.32%, 87.00%, 96.30%, and 96.34%, respectively. Experiments conducted on multi-center planning CT images indicate that combining the ViT structure with the CNN network resulted in superior performance for all organs compared to pure CNN and transformer architectures. Furthermore, the proposed method achieves more precise contours compared to state-of-the-art techniques. Conclusion: Results demonstrate that integrating ViT into CNN architectures significantly improves segmentation performance. These results show promise as a reliable and efficient tool to facilitate prostate radiotherapy treatment planning. [ABSTRACT FROM AUTHOR]

Magnetic Resonance Imaging is increasing in importance in prostate cancer diagnosis due to the high accuracy and quality of the examination procedure. However, this process requires a time-consuming analysis of the results. Currently, machine vision is widely used in many areas. It enables automation and support in radiological studies. Successful detection of primary prostate tumors depends on the effective segmentation of the prostate itself. At times, a CT scan may be performed; alternatively, MRI may be the selected option. The data always reach a bottleneck stage. This paper presents the effective training of deep learning models to segment the prostate based on onefold and multimodal medical images. This approach supports the computer-aided diagnosis (CAD) system for radiologists as the first step in cancer exams. A comparison of two approaches designed for prostate segmentation is described. The first combines YOLOv4, the object detection neural network, and U-Net for a semantic segmentation based on onefold modality MRI images. The second presents the same method trained on multimodal images—a CT and MRI mixed dataset. The learning process was carried out in a cloud environment using GPU cards. The experiments are based on data from 120 patients who have undergone MRI and CT examinations. Several metrics evaluated the trained models. In the prostate semantic segmentation process, better results were achieved by mixed MRI with CT datasets. The best model achieved the value of 0.9685 for the Sørensen–Dice coefficient for the threshold value of 0.6.

The precise and automatic segmentation of prostatemagnetic resonance imaging (MRI) images is vital for assisting doctors in diagnosing prostate diseases. In recent years, many advanced methods have been applied to prostate segmentation, but due to the variability caused by prostate diseases, automatic segmentation of the prostate presents significant challenges. In this paper, we propose an attention-guided multi-scale feature fusion network (AGMSFNet) to segment prostateMRI images. We propose an attention mechanism for extracting multi-scale features, and introduce a 3D transformer module to enhance global feature representation by adding it during the transition phase from encoder to decoder. In the decoder stage, a feature fusion module is proposed to obtain global context information. We evaluate our model on MRI images of the prostate acquired from a local hospital. The relative volume difference (RVD) and dice similarity coefficient (DSC) between the results of automatic prostate segmentation and ground truth were 1.21% and 93.68%, respectively. To quantitatively evaluate prostate volume on MRI, which is of significant clinical significance, we propose a unique AGMSF-Net. The essential performance evaluation and validation experiments have demonstrated the effectiveness of our method in automatic prostate segmentation. [ABSTRACT FROM AUTHOR]

Accurate and robust prostate segmentation in transrectal ultrasound (TRUS) images is of great interest for ultrasound-guided brachytherapy for prostate cancer. However, the current practice of manual segmentation is difficult, time-consuming, and prone to errors. To overcome these challenges, we developed an accurate prostate segmentation framework (A-ProSeg) for TRUS images. The proposed segmentation method includes three innovation steps: (1) acquiring the sequence of vertices by using an improved polygonal segment-based method with a small number of radiologist-defined seed points as prior points; (2) establishing an optimal machine learning-based method by using the improved evolutionary neural network; and (3) obtaining smooth contours of the prostate region of interest using the optimized machine learning-based method. The proposed method was evaluated on 266 patients who underwent prostate cancer brachytherapy. The proposed method achieved a high performance against the ground truth with a Dice similarity coefficient of 96.2% ± 2.4%, a Jaccard similarity coefficient of 94.4% ± 3.3%, and an accuracy of 95.7% ± 2.7%; these values are all higher than those obtained using state-of-the-art methods. A sensitivity evaluation on different noise levels demonstrated that our method achieved high robustness against changes in image quality. Meanwhile, an ablation study was performed, and the significance of all the key components of the proposed method was demonstrated. [ABSTRACT FROM AUTHOR]

Whole-prostate gland (WPG) segmentation plays a significant role in prostate volume measurement, treatment, and biopsy planning. This study evaluated a previously developed automatic WPG segmentation, deep attentive neural network (DANN), on a large, continuous patient cohort to test its feasibility in a clinical setting. With IRB approval and HIPAA compliance, the study cohort included 3,698 3T MRI scans acquired between 2016 and 2020. In total, 335 MRI scans were used to train the model, and 3,210 and 100 were used to conduct the qualitative and quantitative evaluation of the model. In addition, the DANN-enabled prostate volume estimation was evaluated by using 50 MRI scans in comparison with manual prostate volume estimation. For qualitative evaluation, visual grading was used to evaluate the performance of WPG segmentation by two abdominal radiologists, and DANN demonstrated either acceptable or excellent performance in over 96% of the testing cohort on the WPG or each prostate sub-portion (apex, midgland, or base). Two radiologists reached a substantial agreement on WPG and midgland segmentation (κ = 0.75 and 0.63) and moderate agreement on apex and base segmentation (κ = 0.56 and 0.60). For quantitative evaluation, DANN demonstrated a dice similarity coefficient of 0.93 ± 0.02, significantly higher than other baseline methods, such as DeepLab v3+ and UNet (both p values < 0.05). For the volume measurement, 96% of the evaluation cohort achieved differences between the DANN-enabled and manual volume measurement within 95% limits of agreement. In conclusion, the study showed that the DANN achieved sufficient and consistent WPG segmentation on a large, continuous study cohort, demonstrating its great potential to serve as a tool to measure prostate volume.

Prostate cancer is one of the most commonly diagnosed non-cutaneous malignant tumors and the sixth major cause of cancer-related death generally found in men globally. Automatic segmentation of prostate regions has a wide range of applications in prostate cancer diagnosis and treatment. It is challenging to extract powerful spatial features for precise prostate segmentation methods due to the wide variation in prostate size, shape, and histopathologic heterogeneity among patients. Most of the existing CNN-based architectures often produce unsatisfactory results and inaccurate boundaries in prostate segmentation, which are caused by inadequate discriminative feature maps and the limited amount of spatial information. To address these issues, we propose a novel deep learning technique called Multi-Stage FCN architecture for 2D prostate segmentation that captures more precise spatial information and accurate prostate boundaries. In addition, a new prostate ultrasound image dataset known as CCH-TRUSPS was collected from Chongqing University Cancer Hospital, including prostate ultrasound images of various prostate cancer architectures. We evaluate our method on the CCH-TRUSPS dataset and the publicly available Multi-site T2-weighted MRI dataset using five commonly used metrics for medical image analysis. When compared to other CNN-based methods on the CCH-TRUSPS test set, our Multi-Stage FCN achieves the highest and best binary accuracy of 99.15%, the DSC score of 94.90%, the IoU score of 89.80%, the precision of 94.67%, and the recall of 96.49%. The statistical and visual results demonstrate that our approach outperforms previous CNN-based techniques in all ramifications and can be used for the clinical diagnosis of prostate cancer. [ABSTRACT FROM AUTHOR]

Background: Multiparametric magnetic resonance imaging (mp‐MRI) is introduced and established as a noninvasive alternative for prostate cancer (PCa) detection and characterization. Purpose: To develop and evaluate a mutually communicated deep learning segmentation and classification network (MC‐DSCN) based on mp‐MRI for prostate segmentation and PCa diagnosis. Methods: The proposed MC‐DSCN can transfer mutual information between segmentation and classification components and facilitate each other in a bootstrapping way. For classification task, the MC‐DSCN can transfer the masks produced by the coarse segmentation component to the classification component to exclude irrelevant regions and facilitate classification. For segmentation task, this model can transfer the high‐quality localization information learned by the classification component to the fine segmentation component to mitigate the impact of inaccurate localization on segmentation results. Consecutive MRI exams of patients were retrospectively collected from two medical centers (referred to as center A and B). Two experienced radiologists segmented the prostate regions, and the ground truth of the classification refers to the prostate biopsy results. MC‐DSCN was designed, trained, and validated using different combinations of distinct MRI sequences as input (e.g., T2‐weighted and apparent diffusion coefficient) and the effect of different architectures on the network's performance was tested and discussed. Data from center A were used for training, validation, and internal testing, while another center's data were used for external testing. The statistical analysis is performed to evaluate the performance of the MC‐DSCN. The DeLong test and paired t‐test were used to assess the performance of classification and segmentation, respectively. Results: In total, 134 patients were included. The proposed MC‐DSCN outperforms the networks that were designed solely for segmentation or classification. Regarding the segmentation task, the classification localization information helped to improve the IOU in center A: from 84.5% to 87.8% (p < 0.01) and in center B: from 83.8% to 87.1% (p < 0.01), while the area under curve (AUC) of PCa classification was improved in center A: from 0.946 to 0.991 (p < 0.02) and in center B: from 0.926 to 0.955 (p < 0.01) as a result of the additional information provided by the prostate segmentation. Conclusion: The proposed architecture could effectively transfer mutual information between segmentation and classification components and facilitate each other in a bootstrapping way, thus outperforming the networks designed to perform only one task. [ABSTRACT FROM AUTHOR]

Segmentation of the prostate gland from magnetic resonance images is rapidly becoming a standard of care in prostate cancer radiotherapy treatment planning. Automating this process has the potential to improve accuracy and efficiency. However, the performance and accuracy of deep learning models varies depending on the design and optimal tuning of the hyper-parameters. In this study, we examine the effect of loss functions on the performance of deep-learning-based prostate segmentation models. A U-Net model for prostate segmentation using T2-weighted images from a local dataset was trained and performance compared when using nine different loss functions, including: Binary Cross-Entropy (BCE), Intersection over Union (IoU), Dice, BCE and Dice (BCE + Dice), weighted BCE and Dice (W (BCE + Dice)), Focal, Tversky, Focal Tversky, and Surface loss functions. Model outputs were compared using several metrics on a five-fold cross-validation set. Ranking of model performance was found to be dependent on the metric used to measure performance, but in general, W (BCE + Dice) and Focal Tversky performed well for all metrics (whole gland Dice similarity coefficient (DSC): 0.71 and 0.74; 95HD: 6.66 and 7.42; Ravid 0.05 and 0.18, respectively) and Surface loss generally ranked lowest (DSC: 0.40; 95HD: 13.64; Ravid −0.09). When comparing the performance of the models for the mid-gland, apex, and base parts of the prostate gland, the models' performance was lower for the apex and base compared to the mid-gland. In conclusion, we have demonstrated that the performance of a deep learning model for prostate segmentation can be affected by choice of loss function. For prostate segmentation, it would appear that compound loss functions generally outperform singles loss functions such as Surface loss. [ABSTRACT FROM AUTHOR]

Simple Summary: Prostate cancer represents a highly prevalent form of cancer worldwide, with timely detection and treatment being crucial for achieving a high survival rate. Manual segmentation, which is the process of manually identifying different anatomical structures or tissues within an image, is the most prevalent detection method. However, it is a time-consuming and subjective task constrained by the radiologists' expertise, which underpins the demand for automated segmentation methods. In this study, we conduct a comprehensive and rigorous comparison of multiple prevalent deep learning-based automatic segmentation models for the prostate gland and both peripheral and transition zones, using multi-parametric MRI data. Prostate cancer is one of the most common forms of cancer globally, affecting roughly one in every eight men according to the American Cancer Society. Although the survival rate for prostate cancer is significantly high given the very high incidence rate, there is an urgent need to improve and develop new clinical aid systems to help detect and treat prostate cancer in a timely manner. In this retrospective study, our contributions are twofold: First, we perform a comparative unified study of different commonly used segmentation models for prostate gland and zone (peripheral and transition) segmentation. Second, we present and evaluate an additional research question regarding the effectiveness of using an object detector as a pre-processing step to aid in the segmentation process. We perform a thorough evaluation of the deep learning models on two public datasets, where one is used for cross-validation and the other as an external test set. Overall, the results reveal that the choice of model is relatively inconsequential, as the majority produce non-significantly different scores, apart from nnU-Net which consistently outperforms others, and that the models trained on data cropped by the object detector often generalize better, despite performing worse during cross-validation. [ABSTRACT FROM AUTHOR]

Purpose: Automatic segmentation of prostate magnetic resonance (MR) images is crucial for the diagnosis, evaluation, and prognosis of prostate diseases (including prostate cancer). In recent years, the mainstream segmentation method for the prostate has been converted to convolutional neural networks. However, owing to the complexity of the tissue structure in MR images and the limitations of existing methods in spatial context modeling, the segmentation performance should be improved further. Methods: In this study, we proposed a novel 3D pyramid pool Unet that benefits from the pyramid pooling structure embedded in the skip connection (SC) and the deep supervision (DS) in the up-sampling of the 3D Unet. The parallel SC of the conventional 3D Unet network causes low-resolution information to be sent to the feature map repeatedly, resulting in blurred image features. To overcome the shortcomings of the conventional 3D Unet, we merge each decoder layer with the feature map of the same scale as the encoder and the smaller scale feature map of the pyramid pooling encoder. This SC combines the low-level details and high-level semantics at two different levels of feature maps. In addition, pyramid pooling performs multifaceted feature extraction on each image behind the convolutional layer, and DS learns hierarchical representations from comprehensive aggregated feature maps, which can improve the accuracy of the task. Results: Experiments on 3D prostate MR images of 78 patients demonstrated that our results were highly correlated with expert manual segmentation. The average relative volume difference and Dice similarity coefficient of the prostate volume area were 2.32% and 91.03%, respectively. Conclusion: Quantitative experiments demonstrate that, compared with other methods, the results of our method are highly consistent with the expert manual segmentation. [ABSTRACT FROM AUTHOR]

Clinically oriented deep learning algorithms, combined with large-scale medical datasets, have significantly promoted computer-aided diagnosis. To address increasing ethical and privacy issues, Federated Learning (FL) adopts a distributed paradigm to collaboratively train models, rather than collecting samples from multiple institutions for centralized training. Despite intensive research on FL, two major challenges are still existing when applying FL in the real-world medical scenarios, including the performance degradation (i.e., retrogress) after each communication and the intractable class imbalance. Thus, in this paper, we propose a novel personalized FL framework to tackle these two problems. For the retrogress problem, we first devise a Progressive Fourier Aggregation (PFA) at the server side to gradually integrate parameters of client models in the frequency domain. Then, at the client side, we design a Deputy-Enhanced Transfer (DET) to smoothly transfer global knowledge to the personalized local model. For the class imbalance problem, we propose the Conjoint Prototype-Aligned (CPA) loss to facilitate the balanced optimization of the FL framework. Considering the inaccessibility of private local data to other participants in FL, the CPA loss calculates the global conjoint objective based on global imbalance, and then adjusts the client-side local training through the prototype-aligned refinement to eliminate the imbalance gap with such a balanced goal. Extensive experiments are performed on real-world dermoscopic and prostate MRI FL datasets. The experimental results demonstrate the advantages of our FL framework in real-world medical scenarios, by outperforming state-of-the-art FL methods with a large margin. The source code is available at https://github.com/CityU-AIM-Group/PRR-Imbalance https://github.com/CityU-AIM-Group/PRR-Imbalance. [ABSTRACT FROM AUTHOR]

Prostate gland segmentation is the primary step to estimate gland volume, which aids in the prostate disease management. In this study, we present a 2D-3D convolutional neural network (CNN) ensemble that automatically segments the whole prostate gland along with the peripheral zone (PZ) (PPZ-SegNet) using a T2-weighted sequence (T2W) of Magnetic Resonance Imaging (MRI). The study used 4 different public data sets organized as Train #1 and Test #1 (independently derived from the same cohort), Test #2, Test #3 and Test #4. The prostate gland and the peripheral zone (PZ) anatomy were manually delineated with consensus read by a radiologist, except for Test #4 cohorts that had pre-marked glandular anatomy. A Bayesian hyperparameter optimization method was applied to construct the network model (PPZ-SegNet) with a training cohort (Train #1, n = 150) using a five-fold cross validation. The model evaluation was performed on an independent cohort of 283 T2W MRI prostate cases (Test #1 to #4) without any additional tuning. The data cohorts were derived from The Cancer Imaging Archives (TCIA): PROSTATEx Challenge, Prostatectomy, Repeatability studies and PROMISE12-Challenge. The segmentation performance was evaluated by computing the Dice similarity coefficient and Hausdorff distance between the estimated-deep-network identified regions and the radiologist-drawn annotations. The deep network architecture was able to segment the prostate gland anatomy with an average Dice score of 0.86 in Test #1 (n = 192), 0.79 in Test #2 (n = 26), 0.81 in Test #3 (n = 15), and 0.62 in Test #4 (n = 50). We also found the Dice coefficient improved with larger prostate volumes in 3 of the 4 test cohorts. The variation of the Dice scores from different cohorts of test images suggests the necessity of more diverse models that are inclusive of dependencies such as the gland sizes and others, which will enable us to develop a universal network for prostate and PZ segmentation. Our training and evaluation code can be accessed through the link: https://github.com/mariabaldeon/PPZ-SegNet.git.

One of the most prevalent forms of tumor found in males all over the world is prostate cancer. The main risk factors are age and family history. Magnetic Resonance Imaging (MRI) is highly recommended for detecting and localizing prostate cancer. It is very important for precise segmentation of the prostate region in MRI scans to improve the treatment possibilities and the chance of patient survival with prostate cancer. Manually segmenting the prostate region is a daunting task and often time-consuming because of the variation in shapes of prostates among patients, poor delineation of the boundary, and the use of different MRI modes. In this paper, we propose an automatic segmentation model for the prostate regions in MRI scans based on Unet and Xception net. To boost the performance of model, local residual connections are added in the decoder stage of the Unet. The empirical results are compared to different Unet based models with different preprocessing methods to assess the effectiveness of the proposed model. The experimentations are performed to support the fact that the proposed model performs better than other methods taken under study. [ABSTRACT FROM AUTHOR]

Accurate delineation of the prostate in MR images is an essential step for treatment planning and volume estimation of the organ. Prostate segmentation is a challenging task due to its variable size and shape. Moreover, neighboring tissues have a low-contrast with the prostate. We propose a robust and precise automatic algorithm to define the prostate's boundaries in MR images in this paper. First, we find the prostate's ROI by a deep neural network and decrease the input image's size. Next, a dynamic multi-atlas-based approach obtains the initial segmentation of the prostate. A watershed algorithm improves the initial segmentation at the next stage. Finally, an SSM algorithm keeps the result in the domain of allowable prostate shapes. The quantitative evaluation of 74 prostate volumes demonstrated that the proposed method yields a mean Dice coefficient of 0. 8 3 ± 0. 0 5. In comparison with recent researches, our algorithm is robust against shape and size variations. [ABSTRACT FROM AUTHOR]

Early and rapid diagnosis of prostate cancer, the horsehead disease among men, has become increasingly important. Nowadays, many methods are used in the early diagnosis of prostate cancer. Compared to other imaging methods, magnetic resonance imaging (MRI) based on prostate gland imaging is preferred because angular imaging (axial, sagittal, and coronal) provides precise information. But diagnosing the disease from these MR images is time-consuming. For example, imaging differences between MR devices for prostate segmentation and inhomogeneous and inconsistent prostate appearance are significant challenges. Because of these segmentation difficulties, manual segmentation of prostate images is challenging. In recent years, computer-aided intelligent architectures (deep learning-based architecture) have been used to overcome the manual segmentation of prostate images. These architectures can now perform manual prostate segmentation in seconds that used to take days thanks to their end-to-end automatic deep convolutional neural networks (DCNN). Inspired by the studies mentioned above, this study proposes a novel DCNN approach for prostate segmentation by combining ResUnet 2D with residual blocks and Edge Attention Vnet 3D architectures. In addition, the weighted foal Twersky loss function, which was proposed for the first time, significantly increased the architecture's performance. Evaluation experiments were performed on the MICCAI 2012 Prostate Segmentation Challenge Dataset (PROMISE12) and the NCI-ISBI 2013(NCI_ISBI-13) Prostate Segmentation Challenge Dataset. As a result of the tests performed, Dice scores of 91.92 and 91.15% in the whole prostate volume were obtained in the Promise 12 and NCI_ISBI 13 datasets, respectively. Comparative analyses show that the advantages and robustness of our method are superior to the state-of-the-art approaches. [ABSTRACT FROM AUTHOR]

Purpose: Prostate segmentation of 3D TRUS images is a prerequisite for several diagnostic and therapeutic applications. Unfortunately, this difficult task suffers from high intra and interobserver variability, even for experienced urologists/radiologists. This is why automatic segmentation algorithms could have a significant clinical added‐value. Methods: This paper introduces a new deep segmentation architecture consisting of two main phases: view‐specific segmentations of 2D slices and their fusion. The segmentation phase is based on three segmentation networks trained in parallel on specific slice viewing directions: axial, coronal, and sagittal. The proposed fusion network is then fed with the output of the segmentation networks and trained to produce three confidence maps. These maps correspond to the local trust granted by the fusion network to each view‐specific segmentation network. Finally, for a given slice, the segmentation is computed by combining these confidence maps with their corresponding segmentations. The 3D segmentation of the prostate is obtained by restacking all the segmented slices to form a volume. Results: This approach was evaluated on a database of 100 patients with several combinations of network architectures (for both the segmentation phase and the fusion phase) to show the flexibility and reliability of the framework. The proposed approach was also compared to STAPLE, to the majority voting strategy, and to a direct 3D approach tested on the same database. The new method outperforms these three approaches on all evaluation criteria. Finally, the results of the multi‐eXpert fusion (MXF) framework compare favorably with other state‐of‐the‐art methods, while these methods typically work on smaller databases. Conclusions: We proposed a novel MXF framework to segment 3D TRUS images of the prostate. The main feature of this approach is the fusion of expert network results at the pixel level using computed confidence maps. Experiments conducted on a clinical database have shown the robustness and flexibility of this approach and its superiority over state‐of‐the‐art approaches. Finally, the MXF framework demonstrated its ability to capture and preserve the underlying gland structures, particularly in the base and apex regions. [ABSTRACT FROM AUTHOR]

In prostate cancer, fusion biopsy, which couples magnetic resonance imaging (MRI) with transrectal ultrasound (TRUS), poses the basis for targeted biopsy by allowing the comparison of information coming from both imaging modalities at the same time. Compared with the standard clinical procedure, it provides a less invasive option for the patients and increases the likelihood of sampling cancerous tissue regions for the subsequent pathology analyses. As a prerequisite to image fusion, segmentation must be achieved from both MRI and TRUS domains. The automatic contour delineation of the prostate gland from TRUS images is a challenging task due to several factors including unclear boundaries, speckle noise, and the variety of prostate anatomical shapes. Automatic methodologies, such as those based on deep learning, require a huge quantity of training data to achieve satisfactory results. In this paper, the authors propose a novel optimization formulation to find the best superellipse, a deformable model that can accurately represent the prostate shape. The advantage of the proposed approach is that it does not require extensive annotations, and can be used independently of the specific transducer employed during prostate biopsies. Moreover, in order to show the clinical applicability of the method, this study also presents a module for the automatic segmentation of the prostate gland from MRI, exploiting the nnU-Net framework. Lastly, segmented contours from both imaging domains are fused with a customized registration algorithm in order to create a tool that can help the physician to perform a targeted prostate biopsy by interacting with the graphical user interface. [ABSTRACT FROM AUTHOR]

Nowadays, many different methods are used in diagnosing prostate cancer. Among these methods, MRI-based imaging methods provide more precise information than other methods by obtaining the prostate's image from different angles (axial, sagittal, coronal). However, manually segmenting these images is very time-consuming and laborious. Besides, another challenge is the inhomogeneous and inconsistent appearance around the prostate borders, which is essential for cancer diagnosis. Nowadays, scientists are working intensively on deep learning-based techniques to identify prostate boundaries more efficiently and with high accuracy. In this study, a dynamic fusion architecture is proposed. For the fusion model, the Unet + Resnet3D and Unet + Resnet2D models were fused. Evaluation experiments were performed on the MICCAI 2012 Prostate Segmentation Challenge Dataset (PROMISE12) and the NCI-ISBI 2013(NCI_ISBI-13) Prostate Segmentation Challenge Dataset. Comparative analyzes show that the advantages and robustness of our method are superior to state-of-the-art approaches. [ABSTRACT FROM AUTHOR]

Prostate segmentation in transrectal ultrasound (TRUS) image is an essential prerequisite for many prostate-related clinical procedures, which, however, is also a long-standing problem due to the challenges caused by the low image quality and shadow artifacts. In this paper, we propose a Shadow-consistent Semi-supervised Learning (SCO-SSL) method with two novel mechanisms, namely shadow augmentation (Shadow-AUG) and shadow dropout (Shadow-DROP), to tackle this challenging problem. Specifically, Shadow-AUG enriches training samples by adding simulated shadow artifacts to the images to make the network robust to the shadow patterns. Shadow-DROP enforces the segmentation network to infer the prostate boundary using the neighboring shadow-free pixels. Extensive experiments are conducted on two large clinical datasets (a public dataset containing 1,761 TRUS volumes and an in-house dataset containing 662 TRUS volumes). In the fully-supervised setting, a vanilla U-Net equipped with our Shadow-AUG&Shadow-DROP outperforms the state-of-the-arts with statistical significance. In the semi-supervised setting, even with only 20% labeled training data, our SCO-SSL method still achieves highly competitive performance, suggesting great clinical value in relieving the labor of data annotation. Source code is released at https://github.com/DIAL-RPI/SCO-SSL. [ABSTRACT FROM AUTHOR]

Segmentation of the prostate gland from magnetic resonance images is rapidly becoming a standard of care in prostate cancer radiotherapy treatment planning. Automating this process has the potential to improve accuracy and efficiency. However, the performance and accuracy of deep learning models varies depending on the design and optimal tuning of the hyper-parameters. In this study, we examine the effect of loss functions on the performance of deep-learning-based prostate segmentation models. A U-Net model for prostate segmentation using T2-weighted images from a local dataset was trained and performance compared when using nine different loss functions, including: Binary Cross-Entropy (BCE), Intersection over Union (IoU), Dice, BCE and Dice (BCE + Dice), weighted BCE and Dice (W (BCE + Dice)), Focal, Tversky, Focal Tversky, and Surface loss functions. Model outputs were compared using several metrics on a five-fold cross-validation set. Ranking of model performance was found to be dependent on the metric used to measure performance, but in general, W (BCE + Dice) and Focal Tversky performed well for all metrics (whole gland Dice similarity coefficient (DSC): 0.71 and 0.74; 95HD: 6.66 and 7.42; Ravid 0.05 and 0.18, respectively) and Surface loss generally ranked lowest (DSC: 0.40; 95HD: 13.64; Ravid −0.09). When comparing the performance of the models for the mid-gland, apex, and base parts of the prostate gland, the models’ performance was lower for the apex and base compared to the mid-gland. In conclusion, we have demonstrated that the performance of a deep learning model for prostate segmentation can be affected by choice of loss function. For prostate segmentation, it would appear that compound loss functions generally outperform singles loss functions such as Surface loss.

Prostate cancer is the most common cancer in men after lung cancer. Generally, the segmentation of the prostate is the preprocessing work for the diagnosis of prostate cancer. Aiming at the variety of prostate and the similarity of visual characteristics between prostates and their surroundings, this paper proposes a new prostate segmentation network based on MR images, denoted as ProSegNet. ProSegNet consists of two parts: encoder and decoder. To improve the feature extraction capability of the encoder, we use dense blocks as the feature extraction unit, and at the same time introduce a cross-stage partial (CSP) structure to reduce the amount of calculation. In the design of the decoder structure, we integrated the spatial attention mechanism and the channel attention mechanism to enable it to focus on the important features while ignoring the invalid features. In addition, to segment the prostate more accurately, we add a prostate contour segmentation branch to the output of the segmentation network to learn the contour features of the prostate. Finally, to alleviate the problem of small intensity difference between the prostate and surrounding tissues, we designed a truncated intensity stretching image enhancement method. The performance of ProSegNet has been experimentally verified in the Promise12 and ProstateX datasets. On the Promise12 dataset, the dice similarity coefficient (DSC) and hausdorff (Haus) distance are 0.908 and 9.87 respectively. On the ProstateX dataset, the DSC and Haus reach the results of 0.892 and 10.45, respectively. Experimental results show that the ProSegNet can obtain a competitive performance.

Prostate cancer is a malignant tumor that occurs in the male prostate. Prostate cancer lesions have the characteristics of small size and blurry outline, which is a challenge to design a robust prostate cancer detection method. At present, clinical diagnosis of prostate cancer is mainly based on magnetic resonance (MR) imaging. However, it is difficult to obtain prostate cancer data, and the data with true values is also very limited, which further increases the difficulty of prostate cancer detection methods based on MR images. To solve these problems, this paper designs a new method of prostate cancer detection based on MR images, which is recorded as ProCDet. The method consists of three modules: registration of prostate MR images, segmentation of prostate, and segmentation of prostate cancer lesions. First, the registration between different sequences of MR images is performed to find the spatial relationship between the different sequences. Then, the designed prostate segmentation network based on the attention mechanism is used to segment the prostate to remove the interference of background information. Finally, a 3D prostate cancer lesion segmentation network based on Focal Tversky Loss is applied to determine the specific location of prostate cancer. Moreover, in order to take full advantage of unlabeled prostate data, this paper designs a self-supervised learning method to improve the accuracy of prostate cancer detection. The proposed ProCDet has been experimentally verified on the ProstateX dataset. When the average number of false-positive lesions per patient is 0.6275, the true-positive rate is 91.82%. Experimental results show that the ProCDet can obtain competitive detection performance.

Whole-prostate gland (WPG) segmentation plays a significant role in prostate volume measurement, treatment, and biopsy planning. This study evaluated a previously developed automatic WPG segmentation, deep attentive neural network (DANN), on a large, continuous patient cohort to test its feasibility in a clinical setting. With IRB approval and HIPAA compliance, the study cohort included 3,698 3T MRI scans acquired between 2016 and 2020. In total, 335 MRI scans were used to train the model, and 3,210 and 100 were used to conduct the qualitative and quantitative evaluation of the model. In addition, the DANN-enabled prostate volume estimation was evaluated by using 50 MRI scans in comparison with manual prostate volume estimation. For qualitative evaluation, visual grading was used to evaluate the performance of WPG segmentation by two abdominal radiologists, and DANN demonstrated either acceptable or excellent performance in over 96% of the testing cohort on the WPG or each prostate sub-portion (apex, midgland, or base). Two radiologists reached a substantial agreement on WPG and midgland segmentation (κ = 0.75 and 0.63) and moderate agreement on apex and base segmentation (κ = 0.56 and 0.60). For quantitative evaluation, DANN demonstrated a dice similarity coefficient of 0.93 ± 0.02, significantly higher than other baseline methods, such as DeepLab v3+ and UNet (both p values < 0.05). For the volume measurement, 96% of the evaluation cohort achieved differences between the DANN-enabled and manual volume measurement within 95% limits of agreement. In conclusion, the study showed that the DANN achieved sufficient and consistent WPG segmentation on a large, continuous study cohort, demonstrating its great potential to serve as a tool to measure prostate volume.

Purpose To investigate the accuracy and robustness of prostate segmentation using deep learning across various training data sizes, MRI vendors, prostate zones, and testing methods relative to fellowship-trained diagnostic radiologists. Materials and Methods In this systematic review, Embase, PubMed, Scopus, and Web of Science databases were queried for English-language articles using keywords and related terms for prostate MRI segmentation and deep learning algorithms dated to July 31, 2022. A total of 691 articles from the search query were collected and subsequently filtered to 48 on the basis of predefined inclusion and exclusion criteria. Multiple characteristics were extracted from selected studies, such as deep learning algorithm performance, MRI vendor, and training dataset features. The primary outcome was comparison of mean Dice similarity coefficient (DSC) for prostate segmentation for deep learning algorithms versus diagnostic radiologists. Results Forty-eight studies were included. Most published deep learning algorithms for whole prostate gland segmentation (39 of 42 [93%]) had a DSC at or above expert level (DSC ≥ 0.86). The mean DSC was 0.79 ± 0.06 (SD) for peripheral zone, 0.87 ± 0.05 for transition zone, and 0.90 ± 0.04 for whole prostate gland segmentation. For selected studies that used one major MRI vendor, the mean DSCs of each were as follows: General Electric (three of 48 studies), 0.92 ± 0.03; Philips (four of 48 studies), 0.92 ± 0.02; and Siemens (six of 48 studies), 0.91 ± 0.03. Conclusion Deep learning algorithms for prostate MRI segmentation demonstrated accuracy similar to that of expert radiologists despite varying parameters; therefore, future research should shift toward evaluating segmentation robustness and patient outcomes across diverse clinical settings. Keywords: MRI, Genital/Reproductive, Prostate Segmentation, Deep Learning Systematic review registration link: osf.io/nxaev © RSNA, 2024.

Background: The segmentation of prostates from transrectal ultrasound (TRUS) images is a critical step in the diagnosis and treatment of prostate cancer. Nevertheless, the manual segmentation performed by physicians is a time-consuming and laborious task. To address this challenge, there is a pressing need to develop computerized algorithms capable of autonomously segmenting prostates from TRUS images, which sets a direction and form for future development. However, automatic prostate segmentation in TRUS images has always been a challenging problem since prostates in TRUS images have ambiguous boundaries and inhomogeneous intensity distribution. Although many prostate segmentation methods have been proposed, they still need to be improved due to the lack of sensibility to edge information. Consequently, the objective of this study is to devise a highly effective prostate segmentation method that overcomes these limitations and achieves accurate segmentation of prostates in TRUS images., Methods: A three-dimensional (3D) edge-aware attention generative adversarial network (3D EAGAN)-based prostate segmentation method is proposed in this paper, which consists of an edge-aware segmentation network (EASNet) that performs the prostate segmentation and a discriminator network that distinguishes predicted prostates from real prostates. The proposed EASNet is composed of an encoder-decoder-based U-Net backbone network, a detail compensation module (DCM), four 3D spatial and channel attention modules (3D SCAM), an edge enhancement module (EEM), and a global feature extractor (GFE). The DCM is proposed to compensate for the loss of detailed information caused by the down-sampling process of the encoder. The features of the DCM are selectively enhanced by the 3D spatial and channel attention module. Furthermore, an EEM is proposed to guide shallow layers in the EASNet to focus on contour and edge information in prostates. Finally, features from shallow layers and hierarchical features from the decoder module are fused through the GFE to predict the segmentation prostates., Results: The proposed method is evaluated on our TRUS image dataset and the open-source µRegPro dataset. Specifically, experimental results on two datasets show that the proposed method significantly improved the average segmentation Dice score from 85.33% to 90.06%, Jaccard score from 76.09% to 84.11%, Hausdorff distance (HD) score from 8.59 to 4.58 mm, Precision score from 86.48% to 90.58%, and Recall score from 84.79% to 89.24%., Conclusions: A novel 3D EAGAN-based prostate segmentation method is proposed. The proposed method consists of an EASNet and a discriminator network. Experimental results demonstrate that the proposed method has achieved satisfactory results on 3D TRUS image segmentation for prostates., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1698/rc). The authors have no conflicts of interest to declare., (2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Segmenting prostate from magnetic resonance imaging (MRI) is a critical procedure in prostate cancer staging and treatment planning. Considering the nature of labeled data scarcity for medical images, semi-supervised learning (SSL) becomes an appealing solution since it can simultaneously exploit limited labeled data and a large amount of unlabeled data. However, SSL relies on the assumption that the unlabeled images are abundant, which may not be satisfied when the local institute has limited image collection capabilities. An intuitive solution is to seek support from other centers to enrich the unlabeled image pool. However, this further introduces data heterogeneity, which can impede SSL that works under identical data distribution with certain model assumptions. Aiming at this under-explored yet valuable scenario, in this work, we propose a separated collaborative learning (SCL) framework for semi-supervised prostate segmentation with multi-site unlabeled MRI data. Specifically, on top of the teacher-student framework, SCL exploits multi-site unlabeled data by: (i) Local learning, which advocates local distribution fitting, including the pseudo label learning that reinforces confirmation of low-entropy easy regions and the cyclic propagated real label learning that leverages class prototypes to regularize the distribution of intra-class features; (ii) External multi-site learning, which aims to robustly mine informative clues from external data, mainly including the local-support category mutual dependence learning, which takes the spirit that mutual information can effectively measure the amount of information shared by two variables even from different domains, and the stability learning under strong adversarial perturbations to enhance robustness to heterogeneity. Extensive experiments on prostate MRI data from six different clinical centers show that our method can effectively generalize SSL on multi-site unlabeled data and significantly outperform other semi-supervised segmentation methods. Besides, we validate the extensibility of our method on the multi-class cardiac MRI segmentation task with data from four different clinical centers. • We present a new and practical scenario of multi-site semi-supervised learning (MS-SSL), which allows the enrichment of the unlabeled pool with heterogeneous unlabeled data from multiple arbitrary sites and support the semi-supervised learning in local centers. • We propose a new separated collaborative learning (SCL) framework, including local learning and external multi-site learning, for this under-explored scenario. • We propose a novel local-support category mutual dependence learning scheme, which advocates mutual information-based distribution-insensitive relationship modeling on region-of-interests, for effective collaboration between local labeled data and heterogeneous external unlabeled data to support local learning. • Our method is extensively evaluated on public prostate MRI datasets from six different institutes with varying scanning protocols and patient demographics. The experimental results demonstrate the superiority of our approach. • We also validated the extensibility of our method on the multi-class cardiac MRI segmentation task with data from four different clinical centers. [ABSTRACT FROM AUTHOR]

• Segmentation model on multi-b-value DWI images. • Test-time integration included. • Prediction uncertainty estimating and analyzing up. Accurate auto-segmentation on diffusion-weighted imaging (DWI) remains a challenge. A 3D convolutional neural network (CNN) model using DWI was developed to automatically segment the prostate gland and estimate uncertainty in precision treatment planning. A total of 303 patients who uncervent multi-b-value DWI were retrospectively recruited and divided into training and testing groups based on the examination time. Radiologists labeled the prostate region on DWI images of b = 800 sec/mm2. A 3D U-shaped CNN was trained on multi-b-value DWI images (multi-b-value model) and evaluated using the Dice similarity coefficient (DSC), the Hausdorff distance (HD), and the average surface distance (ASD). Segmentation results were compared to a single-b-value model and registration result from T2-weighted images. The study estimated and analyzed the combination of epistemic and aleatoric uncertainty. The DSC, HD, and ASD of our final prediction were 0.928 ± 0.036, 5.472 ± 4.008 mm, and 0.575 ± 0.508 mm. The proposed multi-b-value model achieved a higher DSC on DWI images with all b-values when comparing with the single-b-value model, and superior to the registration result on most of the b-values. The uncertainty helps to effectively filter out prediction errors and indicates that the model is more confident in the middle of the prostate gland, followed by the base and apex of the prostate gland. The complementary information provided by the multi-b-value DWI images helps to improve both the performance of prostate segmentation, while also providing an estimation of the uncertainty associated with the segmentation prediction, which is clinically useful. [ABSTRACT FROM AUTHOR]

Automatic and accurate segmentation of the prostate is still a challenging task due to intensity inhomogeneity and complicated deformation of MR images. To tackle these problems with multi-atlas segmentation, in this paper, we propose a new metric for image registration and new descriptor for label fusion. First, to reduce the amount of edges in entropic graph, a modified α-mutual information (α-MI) based on fast minimal spanning tree (MST) is implemented for deformable registration. Second, localized α-MI allowing for the spatial information is proposed with the stochastic gradient optimization, and the feature space is encoded by a sparse auto-encoder. Finally, a multi-scale descriptor utilizing local self-similarity is integrated into the patch-based label fusion to obtain final segmentation. Experiments were performed on two subsets of totally 46 T2-weighted prostate MR images from 46 patients. Compared to α-MI based on k-nearest neighbor graph, the registration time of α-MI based on fast MST can be reduced by almost half. The median Dice overlap of registration using localized α-MI on one subset is shown to improve significantly from 0.725 to 0.764 (p = 1.14 × 10-5), compared to using α-MI without the spatial information. The median Dice overlap of prostate segmentation using the proposed method on 20 testing images of another subset is 0.871, and the median Hausdorff distance is 8.013 mm, which demonstrate a comparable accuracy to state-of-the-art methods.

In prostate cancer, fusion biopsy, which couples magnetic resonance imaging (MRI) with transrectal ultrasound (TRUS), poses the basis for targeted biopsy by allowing the comparison of information coming from both imaging modalities at the same time. Compared with the standard clinical procedure, it provides a less invasive option for the patients and increases the likelihood of sampling cancerous tissue regions for the subsequent pathology analyses. As a prerequisite to image fusion, segmentation must be achieved from both MRI and TRUS domains. The automatic contour delineation of the prostate gland from TRUS images is a challenging task due to several factors including unclear boundaries, speckle noise, and the variety of prostate anatomical shapes. Automatic methodologies, such as those based on deep learning, require a huge quantity of training data to achieve satisfactory results. In this paper, the authors propose a novel optimization formulation to find the best superellipse, a deformable model that can accurately represent the prostate shape. The advantage of the proposed approach is that it does not require extensive annotations, and can be used independently of the specific transducer employed during prostate biopsies. Moreover, in order to show the clinical applicability of the method, this study also presents a module for the automatic segmentation of the prostate gland from MRI, exploiting the nnU-Net framework. Lastly, segmented contours from both imaging domains are fused with a customized registration algorithm in order to create a tool that can help the physician to perform a targeted prostate biopsy by interacting with the graphical user interface.

Featured Application: The proposed model has the potential of having a significant impact on current prostate procedures, undercutting, and even eliminating, the need of manual segmentations through improvements in terms of robustness, generalizability and output resolution. Prostate segmentations are required for an ever-increasing number of medical applications, such as image-based lesion detection, fusion-guided biopsy and focal therapies. However, obtaining accurate segmentations is laborious, requires expertise and, even then, the inter-observer variability remains high. In this paper, a robust, accurate and generalizable model for Magnetic Resonance (MR) and three-dimensional (3D) Ultrasound (US) prostate image segmentation is proposed. It uses a densenet-resnet-based Convolutional Neural Network (CNN) combined with techniques such as deep supervision, checkpoint ensembling and Neural Resolution Enhancement. The MR prostate segmentation model was trained with five challenging and heterogeneous MR prostate datasets (and two US datasets), with segmentations from many different experts with varying segmentation criteria. The model achieves a consistently strong performance in all datasets independently (mean Dice Similarity Coefficient -DSC- above 0.91 for all datasets except for one), outperforming the inter-expert variability significantly in MR (mean DSC of 0.9099 vs. 0.8794). When evaluated on the publicly available Promise12 challenge dataset, it attains a similar performance to the best entries. In summary, the model has the potential of having a significant impact on current prostate procedures, undercutting, and even eliminating, the need of manual segmentations through improvements in terms of robustness, generalizability and output resolution. [ABSTRACT FROM AUTHOR]

Despite being one of the most prevalent forms of cancer, prostate cancer (PCa) shows a significantly high survival rate, provided there is timely detection and treatment. Computational methods can help make this detection process considerably faster and more robust. However, some modern machine-learning approaches require accurate segmentation of the prostate gland and the index lesion. Since performing manual segmentations is a very time-consuming task, and highly prone to inter-observer variability, there is a need to develop robust semi-automatic segmentation models. In this work, we leverage the large and highly diverse ProstateNet dataset, which includes 638 whole gland and 461 lesion segmentation masks, from 3 different scanner manufacturers provided by 14 institutions, in addition to other 3 independent public datasets, to train accurate and robust segmentation models for the whole prostate gland, zones and lesions. We show that models trained on large amounts of diverse data are better at generalizing to data from other institutions and obtained with other manufacturers, outperforming models trained on single-institution single-manufacturer datasets in all segmentation tasks. Furthermore, we show that lesion segmentation models trained on ProstateNet can be reliably used as lesion detection models., Competing Interests: Declaration of competing interest None Declared, (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)