Radiomics of Periprostatic Fat and Tumor Lesion Based on MRI Predicts the Pathological Upgrading of Prostate Cancer from Biopsy to Radical Prostatectomy

Affiliations

¹ Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 35005, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.).
² Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 35005, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China (X-Y.X., N.X.).
³ Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 35005, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China (X-Y.X., N.X.). Electronic address: drxun@fjmu.edu.cn.

PMID: 39730248
DOI: 10.1016/j.acra.2024.11.043

Radiomics of Periprostatic Fat and Tumor Lesion Based on MRI Predicts the Pathological Upgrading of Prostate Cancer from Biopsy to Radical Prostatectomy

Wen-Qi Liu et al. Acad Radiol. 2025 Aug.

. 2025 Aug;32(8):4607-4620.

doi: 10.1016/j.acra.2024.11.043. Epub 2024 Dec 27.

Authors

Affiliations

¹ Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 35005, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.).
² Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 35005, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China (X-Y.X., N.X.).
³ Department of Urology, Urology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou 35005, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Department of Urology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China (W-Q.L., Y.W., Z-B.K., B.L., X-H.W., X-Y.H., Z-J.C., J-Y.C., S-H.C., Y-T.X., F.L., D-N.C., Q-S.Z., X-Y.X., N.X.); Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China (X-Y.X., N.X.). Electronic address: drxun@fjmu.edu.cn.

PMID: 39730248
DOI: 10.1016/j.acra.2024.11.043

Abstract

Rationale and objectives: To assess the predictive value of MRI-based radiomics of periprostatic fat (PPF) and tumor lesions for predicting Gleason score (GS) upgrading from biopsy to radical prostatectomy (RP) in prostate cancer (PCa).

Methods: A total of 314 patients with pathologically confirmed prostate cancer (PCa) after radical prostatectomy (RP) were included in the study. The patients were randomly assigned to the training cohort (n = 157) and the validating cohort (n = 157) in a 1:1 ratio. All had pre-surgery MRI followed by transrectal ultrasound-guided prostate biopsy. Radiological features were extracted from T2-weighted imaging (T2WI) and apparent diffusion coefficient (ADC) sequences for PPF and tumors. Univariate and multivariate logistic regression identified independent clinical risk factors, and a combined model was established by integrating radiomic features of PPF and PCa. Model performance was assessed using receiver operating characteristic (ROC) curves, calibration, and decision curve analysis.

Results: The combined model, incorporating radiomic features of PPF, PCa, and clinical data, predicted GS upgrading from biopsy to RP excellently (AUC=0.925, 95%CI0.872-0.979) in the training cohort. The Hosmer-Lemeshow test confirmed model fit (χ² = 9.316, P = 0.316). The nomogram was validated in the validating cohort; it showed good accuracy (AUC= 0.937, 95% CI, 0.891-0.983) and was well calibrated (χ² = 12.871, P = 0.116). Decision curve analysis indicated good clinical utility of the radiomic nomogram.

Conclusion: The combined model incorporating PPF, PCa, and clinical data showed excellent performance in predicting GS upgrading from biopsy to RP in PCa patients. This offers a novel and reliable noninvasive tool for GS upgrading risk stratification.

Keywords: Gleason score (GS); Pathological upgrading; Periprostatic fat (PPF); Radiomics.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Radiomics of Periprostatic Fat and Tumor Lesion Based on MRI Predicts the Pathological Upgrading of Prostate Cancer from Biopsy to Radical Prostatectomy

Affiliations

Radiomics of Periprostatic Fat and Tumor Lesion Based on MRI Predicts the Pathological Upgrading of Prostate Cancer from Biopsy to Radical Prostatectomy

Authors

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Abstract

Conflict of interest statement

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