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

Objectives 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. Methods 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. Results 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). Conclusions 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.

Automated summary

The study evaluated the effect of a deep learning-based computer-aided diagnosis system on experienced and less-experienced radiologists in reading prostate mpMRI. Results showed that DL-CAD assistance increased diagnostic accuracy for both groups of radiologists, with the most significant benefit observed in less-experienced radiologists, enabling them to achieve performances comparable to that of experienced radiologists.