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Machine-Learning-Based Tool to Predict Target Prostate Biopsy Outcomes: An Internal Validation Study.

Enrico Checcucci1, Samanta Rosati2, Sabrina De Cillis3

  • 1Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy.

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|July 14, 2023
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Summary
This summary is machine-generated.

This study introduces a personalized predictive model using machine learning to identify prostate cancer (PCa) before biopsy. The fuzzy logic + support vector machine model accurately predicts PCa, potentially avoiding unnecessary procedures.

Keywords:
artificial intelligencemachine learningprostate biopsyprostate cancer

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Area of Science:

  • Urology
  • Medical Imaging
  • Machine Learning

Background:

  • Prostate cancer (PCa) diagnosis often involves invasive procedures like fusion biopsy (FB).
  • Accurate pre-biopsy risk stratification is crucial for patient management and resource optimization.

Purpose of the Study:

  • To develop and validate a personalized predictive model (PPM) using machine learning (ML) for identifying patients with suspected prostate cancer (PCa) after multiparametric MRI (mpMRI).
  • To assess the performance of a fuzzy inference system (FIS) combined with support vector machine (SVM) against other ML methods and standard diagnostic tools.

Main Methods:

  • Utilized a dataset of 1448 patients for training and 181 for validation, all undergoing mpMRI and FB.
  • Developed and compared four ML methods: FIS, SVM, k-nearest neighbors (KNN), and self-organizing maps (SOMs).
  • Evaluated a fuzzy logic (FL) + SVM system against logistic regression (LR) and standard diagnostic tools, focusing on metrics like AUC, NPV, specificity, sensitivity, and accuracy.

Main Results:

  • The FIS + SVM model showed performance comparable to LR in AUC but superior to other tools.
  • On the training set, FIS + SVM achieved the highest NPV (78.5%) and specificity (92.1% vs. 83% for LR).
  • In the validation set, FIS + SVM outperformed other methods with an NPV of 60.7%, sensitivity of 90.8%, and accuracy of 69.1%.

Conclusions:

  • A validated personalized predictive model (PPM) using FIS + SVM was successfully developed to predict PCa probability before FB.
  • This tool can help avoid unnecessary biopsies in approximately 15% of cases.
  • The model offers a promising approach for improving the diagnostic pathway for suspected prostate cancer.