Development of a Radiomic-Based Model Predicting Lymph Node Involvement in Prostate Cancer Patients

Vincent Bourbonne; Vincent Jaouen; Truong An Nguyen; Valentin Tissot; Laurent Doucet; Mathieu Hatt; Dimitris Visvikis; Olivier Pradier; Antoine Valéri; Georges Fournier; Ulrike Schick

doi:10.3390/cancers13225672

Development of a Radiomic-Based Model Predicting Lymph Node Involvement in Prostate Cancer Patients

Cancers (Basel). 2021 Nov 12;13(22):5672. doi: 10.3390/cancers13225672.

Authors

Vincent Bourbonne^{1

2}, Vincent Jaouen^{2

3}, Truong An Nguyen^{2

4}, Valentin Tissot⁵, Laurent Doucet⁶, Mathieu Hatt², Dimitris Visvikis², Olivier Pradier^{1

2}, Antoine Valéri^{2

4}, Georges Fournier^{2

4}, Ulrike Schick^{1

2}

Affiliations

¹ Radiation Oncology Department, University Hospital, 29200 Brest, France.
² LaTIM, UMR 1101, INSERM, University Brest, 29200 Brest, France.
³ IMT Atlantique, 29200 Brest, France.
⁴ Urology Department, University Hospital, 29200 Brest, France.
⁵ Radiology Department, University Hospital, 29200 Brest, France.
⁶ Pathology Department, University Hospital, 29200 Brest, France.

Abstract

Significant advances in lymph node involvement (LNI) risk modeling in prostate cancer (PCa) have been achieved with the addition of visual interpretation of magnetic resonance imaging (MRI) data, but it is likely that quantitative analysis could further improve prediction models. In this study, we aimed to develop and internally validate a novel LNI risk prediction model based on radiomic features extracted from preoperative multimodal MRI. All patients who underwent a preoperative MRI and radical prostatectomy with extensive lymph node dissection were retrospectively included in a single institution. Patients were randomly divided into the training (60%) and testing (40%) sets. Radiomic features were extracted from the index tumor volumes, delineated on the apparent diffusion coefficient corrected map and the T2 sequences. A ComBat harmonization method was applied to account for inter-site heterogeneity. A prediction model was trained using a neural network approach (Multilayer Perceptron Network, SPSS v24.0©) combining clinical, radiomic and all features. It was then evaluated on the testing set and compared to the current available models using the Receiver Operative Characteristics and the C-Index. Two hundred and eighty patients were included, with a median age of 65.2 y (45.3-79.6), a mean PSA level of 9.5 ng/mL (1.04-63.0) and 79.6% of ISUP ≥ 2 tumors. LNI occurred in 51 patients (18.2%), with a median number of extracted nodes of 15 (10-19). In the testing set, with their respective cutoffs applied, the Partin, Roach, Yale, MSKCC, Briganti 2012 and 2017 models resulted in a C-Index of 0.71, 0.66, 0.55, 0.67, 0.65 and 0.73, respectively, while our proposed combined model resulted in a C-Index of 0.89 in the testing set. Radiomic features extracted from the preoperative MRI scans and combined with clinical features through a neural network seem to provide added predictive performance compared to state of the art models regarding LNI risk prediction in PCa.

Keywords: MRI; lymph node involvement; prediction; prostate cancer; radiomics.