arXiv:2410.23084eess.IVcs.CV2024-10被引 4

AI辅助医生定位前列腺癌,提升诊断准确率

AI-assisted prostate cancer detection and localisation on biparametric MR by classifying radiologist-positives

  • 以放射科医生标记的阳性病例为训练目标,优化AI模型
  • 在公开数据集上,敏感度80%时特异性从36.3%提升至44.1%
  • 适合希望减少过度活检、降低筛查成本的临床场景

当前前列腺癌的磁共振诊断依赖放射科医生判读,而现有AI方法多独立于医生进行癌症检测。本文提出一种新策略:训练深度学习模型,对放射科医生标记的患者或病灶(即放射科阳性)进行分类,而非覆盖所有患者。构建了一个单体素级分类模型,采用简单百分比阈值判断病灶、巴兹尔分区及患者层面的阳性结果。基于来自UCLA和UCL PROMIS研究的两个临床数据集(分别包含超过800例和500例经组织病理学标注的MR图像),实验表明该策略能有效提升整体诊断准确率。在不同临床显著性定义下,该方法在公开的UCLA数据集上,于保持80.0%敏感度的前提下,将特异性从仅靠放射科医生的36.3%提升至44.1%。该成果具有实际临床价值,可用于减少不必要的活检、降低癌症筛查成本以及量化治疗风险。

原文摘要 · Abstract (English)

Prostate cancer diagnosis through MR imaging have currently relied on radiologists' interpretation, whilst modern AI-based methods have been developed to detect clinically significant cancers independent of radiologists. In this study, we propose to develop deep learning models that improve the overall cancer diagnostic accuracy, by classifying radiologist-identified patients or lesions (i.e. radiologist-positives), as opposed to the existing models that are trained to discriminate over all patients. We develop a single voxel-level classification model, with a simple percentage threshold to determine positive cases, at levels of lesions, Barzell-zones and patients. Based on the presented experiments from two clinical data sets, consisting of histopathology-labelled MR images from more than 800 and 500 patients in the respective UCLA and UCL PROMIS studies, we show that the proposed strategy can improve the diagnostic accuracy, by augmenting the radiologist reading of the MR imaging. Among varying definition of clinical significance, the proposed strategy, for example, achieved a specificity of 44.1% (with AI assistance) from 36.3% (by radiologists alone), at a controlled sensitivity of 80.0% on the publicly available UCLA data set. This provides measurable clinical values in a range of applications such as reducing unnecessary biopsies, lowering cost in cancer screening and quantifying risk in therapies.

前列腺癌AI辅助影像诊断放射科

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