Multimodal imaging deep learning model for predicting extraprostatic extension in prostate cancer using MpMRI and 18 F-PSMA-PET/CT

Abstract Objective This study aimed to construct a multimodal imaging deep learning (DL) model integrating mpMRI and 18F-PSMA-PET/CT for the prediction of extraprostatic extension (EPE) in prostate cancer, and to assess its effectiveness in enhancing the diagnostic accuracy of radiologists. Methods...

Full description

Saved in:
Bibliographic Details
Main Authors: Fei Yao, Heng Lin, Ying-Nan Xue, Yuan-Di Zhuang, Shu-Ying Bian, Ya-Yun Zhang, Yun-Jun Yang, Ke-Hua Pan
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Cancer Imaging
Subjects:
Online Access:https://doi.org/10.1186/s40644-025-00927-4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849225994336993280
author Fei Yao
Heng Lin
Ying-Nan Xue
Yuan-Di Zhuang
Shu-Ying Bian
Ya-Yun Zhang
Yun-Jun Yang
Ke-Hua Pan
author_facet Fei Yao
Heng Lin
Ying-Nan Xue
Yuan-Di Zhuang
Shu-Ying Bian
Ya-Yun Zhang
Yun-Jun Yang
Ke-Hua Pan
author_sort Fei Yao
collection DOAJ
description Abstract Objective This study aimed to construct a multimodal imaging deep learning (DL) model integrating mpMRI and 18F-PSMA-PET/CT for the prediction of extraprostatic extension (EPE) in prostate cancer, and to assess its effectiveness in enhancing the diagnostic accuracy of radiologists. Methods Clinical and imaging data were retrospectively collected from patients with pathologically confirmed prostate cancer (PCa) who underwent radical prostatectomy (RP). Data were collected from a primary institution (Center 1, n = 197) between January 2019 and June 2022 and an external institution (Center 2, n = 36) between July 2021 and November 2022. A multimodal DL model incorporating mpMRI and 18F-PSMA-PET/CT was developed to support radiologists in assessing EPE using the EPE-grade scoring system. The predictive performance of the DL model was compared with that of single-modality models, as well as with radiologist assessments with and without model assistance. Clinical net benefit of the model was also assessed. Results For patients in Center 1, the area under the curve (AUC) for predicting EPE was 0.76 (0.72–0.80), 0.77 (0.70–0.82), and 0.82 (0.78–0.87) for the mpMRI-based DL model, PET/CT-based DL model, and the combined mpMRI + PET/CT multimodal DL model, respectively. In the external test set (Center 2), the AUCs for these models were 0.75 (0.60–0.88), 0.77 (0.72–0.88), and 0.81 (0.63–0.97), respectively. The multimodal DL model demonstrated superior predictive accuracy compared to single-modality models in both internal and external validations. The deep learning-assisted EPE-grade scoring model significantly improved AUC and sensitivity compared to radiologist EPE-grade scoring alone (P < 0.05), with a modest reduction in specificity. Additionally, the deep learning-assisted scoring model provided greater clinical net benefit than the radiologist EPE-grade score used by radiologists alone. Conclusion The multimodal imaging deep learning model, integrating mpMRI and 18 F-PSMA PET/CT, demonstrates promising predictive performance for EPE in prostate cancer and enhances the accuracy of radiologists in EPE assessment. The model holds potential as a supportive tool for more individualized and precise therapeutic decision-making.
format Article
id doaj-art-7b970dff54a8400cb78e7eb784bfacac
institution Kabale University
issn 1470-7330
language English
publishDate 2025-08-01
publisher BMC
record_format Article
series Cancer Imaging
spelling doaj-art-7b970dff54a8400cb78e7eb784bfacac2025-08-24T11:48:21ZengBMCCancer Imaging1470-73302025-08-0125111010.1186/s40644-025-00927-4Multimodal imaging deep learning model for predicting extraprostatic extension in prostate cancer using MpMRI and 18 F-PSMA-PET/CTFei Yao0Heng Lin1Ying-Nan Xue2Yuan-Di Zhuang3Shu-Ying Bian4Ya-Yun Zhang5Yun-Jun Yang6Ke-Hua Pan7Department of Radiology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Wenzhou Medical UniversityAbstract Objective This study aimed to construct a multimodal imaging deep learning (DL) model integrating mpMRI and 18F-PSMA-PET/CT for the prediction of extraprostatic extension (EPE) in prostate cancer, and to assess its effectiveness in enhancing the diagnostic accuracy of radiologists. Methods Clinical and imaging data were retrospectively collected from patients with pathologically confirmed prostate cancer (PCa) who underwent radical prostatectomy (RP). Data were collected from a primary institution (Center 1, n = 197) between January 2019 and June 2022 and an external institution (Center 2, n = 36) between July 2021 and November 2022. A multimodal DL model incorporating mpMRI and 18F-PSMA-PET/CT was developed to support radiologists in assessing EPE using the EPE-grade scoring system. The predictive performance of the DL model was compared with that of single-modality models, as well as with radiologist assessments with and without model assistance. Clinical net benefit of the model was also assessed. Results For patients in Center 1, the area under the curve (AUC) for predicting EPE was 0.76 (0.72–0.80), 0.77 (0.70–0.82), and 0.82 (0.78–0.87) for the mpMRI-based DL model, PET/CT-based DL model, and the combined mpMRI + PET/CT multimodal DL model, respectively. In the external test set (Center 2), the AUCs for these models were 0.75 (0.60–0.88), 0.77 (0.72–0.88), and 0.81 (0.63–0.97), respectively. The multimodal DL model demonstrated superior predictive accuracy compared to single-modality models in both internal and external validations. The deep learning-assisted EPE-grade scoring model significantly improved AUC and sensitivity compared to radiologist EPE-grade scoring alone (P < 0.05), with a modest reduction in specificity. Additionally, the deep learning-assisted scoring model provided greater clinical net benefit than the radiologist EPE-grade score used by radiologists alone. Conclusion The multimodal imaging deep learning model, integrating mpMRI and 18 F-PSMA PET/CT, demonstrates promising predictive performance for EPE in prostate cancer and enhances the accuracy of radiologists in EPE assessment. The model holds potential as a supportive tool for more individualized and precise therapeutic decision-making.https://doi.org/10.1186/s40644-025-00927-4Deep learningExtraprostatic extensionMagnetic resonance imagingMultimodal imagingPositron emission tomographyProstate cancer
spellingShingle Fei Yao
Heng Lin
Ying-Nan Xue
Yuan-Di Zhuang
Shu-Ying Bian
Ya-Yun Zhang
Yun-Jun Yang
Ke-Hua Pan
Multimodal imaging deep learning model for predicting extraprostatic extension in prostate cancer using MpMRI and 18 F-PSMA-PET/CT
Cancer Imaging
Deep learning
Extraprostatic extension
Magnetic resonance imaging
Multimodal imaging
Positron emission tomography
Prostate cancer
title Multimodal imaging deep learning model for predicting extraprostatic extension in prostate cancer using MpMRI and 18 F-PSMA-PET/CT
title_full Multimodal imaging deep learning model for predicting extraprostatic extension in prostate cancer using MpMRI and 18 F-PSMA-PET/CT
title_fullStr Multimodal imaging deep learning model for predicting extraprostatic extension in prostate cancer using MpMRI and 18 F-PSMA-PET/CT
title_full_unstemmed Multimodal imaging deep learning model for predicting extraprostatic extension in prostate cancer using MpMRI and 18 F-PSMA-PET/CT
title_short Multimodal imaging deep learning model for predicting extraprostatic extension in prostate cancer using MpMRI and 18 F-PSMA-PET/CT
title_sort multimodal imaging deep learning model for predicting extraprostatic extension in prostate cancer using mpmri and 18 f psma pet ct
topic Deep learning
Extraprostatic extension
Magnetic resonance imaging
Multimodal imaging
Positron emission tomography
Prostate cancer
url https://doi.org/10.1186/s40644-025-00927-4
work_keys_str_mv AT feiyao multimodalimagingdeeplearningmodelforpredictingextraprostaticextensioninprostatecancerusingmpmriand18fpsmapetct
AT henglin multimodalimagingdeeplearningmodelforpredictingextraprostaticextensioninprostatecancerusingmpmriand18fpsmapetct
AT yingnanxue multimodalimagingdeeplearningmodelforpredictingextraprostaticextensioninprostatecancerusingmpmriand18fpsmapetct
AT yuandizhuang multimodalimagingdeeplearningmodelforpredictingextraprostaticextensioninprostatecancerusingmpmriand18fpsmapetct
AT shuyingbian multimodalimagingdeeplearningmodelforpredictingextraprostaticextensioninprostatecancerusingmpmriand18fpsmapetct
AT yayunzhang multimodalimagingdeeplearningmodelforpredictingextraprostaticextensioninprostatecancerusingmpmriand18fpsmapetct
AT yunjunyang multimodalimagingdeeplearningmodelforpredictingextraprostaticextensioninprostatecancerusingmpmriand18fpsmapetct
AT kehuapan multimodalimagingdeeplearningmodelforpredictingextraprostaticextensioninprostatecancerusingmpmriand18fpsmapetct