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...
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| Format: | Article |
| Language: | English |
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BMC
2025-08-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-025-00927-4 |
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| 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 |
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