Construction of a Preoperative Radiologic-Risk Signature for Predicting the Pathologic Status of Prostate Cancer at Radical Prostatectomy

OBJECTIVE. We developed a radiologic-risk signature (RRS) that serves as a surrogate for the pathologic status of prostate cancer (PCA) and investigated its ability to predict disease-free survival. MATERIALS AND METHODS. This study included 631 patients with localized PCA who underwent prostatic multiparametric MRI before prostatectomy. Images from 426 training datasets were structurally interpreted and correlated to a postoperative Memorial Sloan Kettering Cancer Center (MSKCC) score by a stepwise partial least-squares regression analysis. The developed RRS, compared with a preoperative Kattan nomogram, was validated in a cohort of 205 patients with 3-year follow-up data after prostatectomy in terms of calibration, discrimination, and clinical usefulness. Statistical tests were performed by AUC analysis, Kaplan-Meier test, and decision curve analysis. RESULTS. The RRS, which consists of 12 preoperative variables, faithfully represented postoperative MSKCC score in 426 training (r = 0.75; p < 0.001) and ...