OBJECTIVE. The purpose of this study was to evaluate in a multicenter dataset the performance of an artificial intelligence (AI) detection system with attention mapping compared with multiparametric MRI (mpMRI) interpretation in the detection of prostate cancer. MATERIALS AND METHODS. MRI examinations from five institutions were included in this study and were evaluated by nine readers. In the first round, readers evaluated mpMRI studies using the Prostate Imaging Reporting and Data System version 2. After 4 weeks, images were again presented to readers along with the AI-based detection system output. Readers accepted or rejected lesions within four AI-generated attention map boxes. Additional lesions outside of boxes were excluded from detection and categorization. The performances of readers using the mpMRI-only and AI-assisted approaches were compared. RESULTS. The study population included 152 case patients and 84 control patients with 274 pathologically proven cancer lesions. The lesion-based AUC was 74.9% for MRI and 77.5% for AI with no significant difference (p = 0.095). The sensitivity for overall detection of cancer lesions was higher for AI than for mpMRI but did not reach statistical significance (57.4% vs 53.6%, p = 0.073). However, for transition zone lesions, sensitivity was higher for AI than for MRI (61.8% vs 50.8%, p = 0.001). Reading time was longer for AI than for MRI (4.66 vs 4.03 minutes, p < 0.001). There was moderate interreader agreement for AI and MRI with no significant difference (58.7% vs 58.5%, p = 0.966). CONCLUSION. Overall sensitivity was only minimally improved by use of the AI system. Significant improvement was achieved, however, in the detection of transition zone lesions with use of the AI system at the cost of a mean of 40 seconds of additional reading time.
AJR. American journal of roentgenology. 2020 Aug 05 [Epub ahead of print]
Sherif Mehralivand, Stephanie A Harmon, Joanna H Shih, Clayton P Smith, Nathan Lay, Burak Argun, Sandra Bednarova, Ronaldo Hueb Baroni, Abdullah Erdem Canda, Karabekir Ercan, Rossano Girometti, Ercan Karaarslan, Ali Riza Kural, Andrei S Pursyko, Soroush Rais-Bahrami, Victor Martins Tonso, Cristina Magi-Galluzzi, Jennifer B Gordetsky, Ricardo Silvestre E Silva Macarenco, Maria J Merino, Berrak Gumuskaya, Yesim Saglican, Stefano Sioletic, Anne Y Warren, Tristan Barrett, Leonardo Bittencourt, Mehmet Coskun, Chris Knauss, Yan Mee Law, Ashkan A Malayeri, Daniel J Margolis, Jamie Marko, Derya Yakar, Bradford J Wood, Peter A Pinto, Peter L Choyke, Ronald M Summers, Baris Turkbey
Department of Urology and Pediatric Urology, University Medical Center, Mainz, Germany., Clinical Research Directorate, Leidos Biomedical Research, Inc., Frederick, MD., Division of Cancer Treatment and Diagnosis: Biometric Research Program, National Cancer Institute, National Institutes of Health, Rockville, MD., Molecular Imaging Program, National Cancer Institute, National Institutes of Health, 10 Center Dr, MSC 1182, Bldg 10, Rm B3B85, Bethesda, MD 20892-1088., Department of Urology, Acibadem University, Istanbul, Turkey., Department of Radiology, University of Udine, Udine, Italy., Diagnostic Imaging Department, Albert Einstein Hospital, Sao Paolo, Brazil., Department of Urology, Koç University, School of Medicine, Istanbul, Turkey., Department of Radiology, Ankara City Hospital, Ankara, Turkey., Department of Radiology, Acibadem University, Istanbul, Turkey., Department of Radiology, Cleveland Clinic, Cleveland, OH., Department of Urology, University of Alabama at Birmingham, Birmingham, AL., Department of Pathology, Cleveland Clinic, Cleveland, OH., Department of Pathology, University of Alabama at Birmingham, Birmingham, AL., Pathology Department, Albert Einstein Hospital, Sao Paolo, Brazil., Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD., Department of Pathology, Ankara Yildirim Beyazit University, School of Medicine, Ankara, Turkey., Department of Pathology, Acibadem University, Istanbul, Turkey., Department of Pathology, University of Udine, Udine, Italy., Department of Pathology, University of Cambridge, Cambridge, UK., Department of Radiology, University of Cambridge, Cambridge, UK., Department of Radiology, Federal Fluminense University, Rio de Janeiro, Brazil., Department of Radiology, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey., Department of Radiology, Walter Reed Medical Center, Bethesda, MD., Department of Radiology, Singapore General Hospital, Singapore., Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD., Weill Cornell Imaging, Cornell University, New York, NY., Department of Radiology, Medical Imaging Centre, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Center for Interventional Oncology, National Cancer Institute and Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD., Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD., National Institutes of Health Clinical Center, Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, Bethesda, MD.