A concurrent, deep learning-based computer-aided detection system for prostate multiparametric MRI: a performance study involving experienced and less-experienced radiologists.

To evaluate the effect of a deep learning-based computer-aided diagnosis (DL-CAD) system on experienced and less-experienced radiologists in reading prostate mpMRI.

In this retrospective, multi-reader multi-case study, a consecutive set of 184 patients examined between 01/2018 and 08/2019 were enrolled. Ground truth was combined targeted and 12-core systematic transrectal ultrasound-guided biopsy. Four radiologists, two experienced and two less-experienced, evaluated each case twice, once without (DL-CAD-) and once assisted by DL-CAD (DL-CAD+). ROC analysis, sensitivities, specificities, PPV and NPV were calculated to compare the diagnostic accuracy for the diagnosis of prostate cancer (PCa) between the two groups (DL-CAD- vs. DL-CAD+). Spearman's correlation coefficients were evaluated to assess the relationship between PI-RADS category and Gleason score (GS). Also, the median reading times were compared for the two reading groups.

In total, 172 patients were included in the final analysis. With DL-CAD assistance, the overall AUC of the less-experienced radiologists increased significantly from 0.66 to 0.80 (p = 0.001; cutoff ISUP GG ≥ 1) and from 0.68 to 0.80 (p = 0.002; cutoff ISUP GG ≥ 2). Experienced radiologists showed an AUC increase from 0.81 to 0.86 (p = 0.146; cutoff ISUP GG ≥ 1) and from 0.81 to 0.84 (p = 0.433; cutoff ISUP GG ≥ 2). Furthermore, the correlation between PI-RADS category and GS improved significantly in the DL-CAD + group (0.45 vs. 0.57; p = 0.03), while the median reading time was reduced from 157 to 150 s (p = 0.023).

DL-CAD assistance increased the mean detection performance, with the most significant benefit for the less-experienced radiologist; with the help of DL-CAD less-experienced radiologists reached performances comparable to that of experienced radiologists.

• DL-CAD used as a concurrent reading aid helps radiologists to distinguish between benign and cancerous lesions in prostate MRI. • With the help of DL-CAD, less-experienced radiologists may achieve detection performances comparable to that of experienced radiologists. • DL-CAD assistance increases the correlation between PI-RADS category and cancer grade.

European radiology. 2022 Jul 28 [Epub ahead of print]

Sandra Labus, Martin M Altmann, Henkjan Huisman, Angela Tong, Tobias Penzkofer, Moon Hyung Choi, Ivan Shabunin, David J Winkel, Pengyi Xing, Dieter H Szolar, Steven M Shea, Robert Grimm, Heinrich von Busch, Ali Kamen, Thomas Herold, Clemens Baumann

Department of Radiology, Helios Klinikum Berlin-Buch, Schwanebecker Ch 50, 13125, Berlin, Germany. ., Department of Radiology, Helios Klinikum Berlin-Buch, Schwanebecker Ch 50, 13125, Berlin, Germany., Radboud University Medical Center, Nijmegen, The Netherlands., Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA., Charité-Universitätsmedizin Berlin, Berlin, Germany., Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea., Patero Clinic, Moscow, Russia., Department of Radiology, University Hospital of Basel, Basel, Switzerland., Department of Radiology, Changhai Hospital, Shanghai, China., Diagnostikum Graz Süd-West, Graz, Austria., Loyola University Medical Center, Maywood, IL, USA., Diagnostic Imaging, Siemens Healthcare, Erlangen, Germany., Digital Technology and Innovation, Siemens Healthineers, Princeton, NJ, USA.

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