Session Item

Radiomics can provide quantitative features from medical imaging that can be correlated to clinical endpoints. The challenges relevant to the robustness of radiomics features have been analyzed by many researchers, as it seems to be influenced by acquisition and reconstruction protocols, as well as by the segmentation of the region of interest (ROI). Prostate cancer represents a difficult playground for this technique, due to the discrepancies in the identification of the cancer lesion and the various acquisition protocols. The aim of this study is to investigate the role of radiomics in prostate cancer detection and the correlation with Gleason score. 

A homogeneous cohort of patients with a PSA rise that underwent multiparametric MRI imaging of the prostate before the biopsy was tested in this study. All the patients' images were acquired with the same MRI scanner, with a standardized protocol. The identification and segmentation of an MRI suspicious cancer lesion were done by two double-blinded Radiologists with great experience in prostate cancer (>10 years). After the segmentation, texture features were extracted with LifeX software. All the patients underwent random prostate biopsy procedures and the presence of prostate cancer, as well as the Gleason, was retrospectively collected. Texture features were then tested with intraclass coefficient correlation (ICC) analysis to analyze the reliability of the segmentation. The reliable features were then correlated with the presence of prostate cancer and with the Gleason score with Chi-Square analysis, with Bonferroni correction for multiple comparisons. 

Forty-four consecutive patients were included in the present analysis. In 26 patients (59,1%) the prostate biopsy confirmed the presence of prostate cancer, which was scored as Gleason 6 in 6 patients (13,6%), Gleason 3+4 in 8 patients (18,2), and Gleason 4+3 in 12 patients (27.3%). Chi-square analysis showed that only GLCM-Contrast^DWI400 and GLCM-dissimilarity^DWI400 were significantly correlated with both the presence of prostate cancer (respectively p:0,007 and p:0,012) and the Gleason score (respectively p:0,012 and p:0,024). 

Despite issues of reproducibility, correlations with prostate cancer detection and Gleason score are still promising although we remark the need to further study the potential of MRI radiomics in prostate cancer in a clinical setting.