Evaluating texture-based prostate cancer classification on multi-parametric magnetic resonance imaging and prostate specific membrane antigen positron emission tomography

In-vivo imaging of the prostate has shown to be useful for prostate cancer (PCa) localization especially during biopsy procedures. Multi-parametric MRI (mp-MRI) is gaining rapid popularity amongst clinicians but is complex and difficult to interpret by even expert radiologists. Prostate specific membrane antigen positron emission tomography (PSMA PET) is emerging as a new tool for PCa detection and has shown promising results towards lesion identification. Both imaging procedures suffer from intra- and inter- observer variability in PCa detection. Computer-aided diagnosis (CAD) systems have been developed as a solution to mitigate observer variability and have shown to boost diagnostic accuracy. There are currently no studies published that assessed the benefit of incorporating PSMA PET imaging and mp-MRI into a CAD system for PCa detection. We compared the accuracy of CAD models trained and tested on features from mp-MRI+PSMA PET, mp-MRI and PSMA PET by training on 1-10 features chosen from three feature selection methods for 10 different classifiers for each of the three experiments. We found that models trained on mp-MRI provided lower overall error and greater specificity, and models trained on mp-MRI+PSMA PET and PSMA PET provided greater sensitivity to lesions in the central gland, which is a known area of difficulty for mp-MRI. Further validation using a larger dataset is required to prove the added benefit of PSMA PET imaging as a second modality to PCa CAD systems. Once fully validated, these results will demonstrate the added benefit of incorporating PSMA PET imaging into CAD models towards PCa detection.