Predicting clinically significant prostate cancer from quantitative image features including compressed sensing radial MRI of prostate perfusion using machine learning: comparison with PI-RADS v2 assessment scores

BACKGROUND: To investigate if supervised machine learning (ML) classifiers would be able to predict clinically significant cancer (sPC) from a set of quantitative image-features and to compare these results with established PI-RADS v2 assessment scores. METHODS: We retrospectively included 201, histopathologically-proven, peripheral zone (PZ) prostate cancer lesions. Gleason scores ≤3+3 were considered as clinically insignificant (inPC) and Gleason scores ≥3+4 as sPC and were encoded in a binary fashion, serving as ground-truth. MRI was performed at 3T with high spatiotemporal resolution DCE using Golden-angle RAdial SParse (GRASP) MRI. Perfusion maps (Ktrans, Kep, Ve), apparent diffusion coefficient (ADC), and absolute T2-signal intensities (SI) were determined in all lesions and served as input parameters for four supervised ML models: Gradient Boosting Machines (GBM), Neural Networks (NNet), Random Forest (RF) and Support Vector Machines (SVM). ML results and PI-RADS scores were compared with the ground-truth. Next ROC-curves and AUC values were calculated. RESULTS: All ML models outperformed PI-RADS v2 assessment scores in the prediction of sPC (RF, GBM, NNet and SVM vs. PI-RADS: AUC 0.899, 0.864, 0.884 and 0.874 vs. 0.595, all P