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2016 ; 7
(47
): 78140-78151
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An imaging-based approach predicts clinical outcomes in prostate cancer through a
novel support vector machine classification
#MMPMID27542201
Zhang YD
; Wang J
; Wu CJ
; Bao ML
; Li H
; Wang XN
; Tao J
; Shi HB
Oncotarget
2016[Nov]; 7
(47
): 78140-78151
PMID27542201
show ga
Preoperatively predict the probability of Prostate cancer (PCa) biochemical
recurrence (BCR) is of definite clinical relevance. The purpose of this study was
to develop an imaging-based approach in the prediction of 3-years BCR through a
novel support vector machine (SVM) classification. We collected clinicopathologic
and MR imaging datasets in 205 patients pathologically confirmed PCa after
radical prostatectomy. Univariable and multivariable analyses were used to assess
the association between MR findings and 3-years BCR, and modeled the imaging
variables and follow-up data to predict 3-year PCa BCR using SVM analysis. The
performance of SVM was compared with conventional Logistic regression (LR) and
D'Amico risk stratification scheme by area under the receiver operating
characteristic curve (Az) analysis. We found that SVM had significantly higher Az
(0.959 vs. 0.886; p = 0.007), sensitivity (93.3% vs. 83.3%; p = 0.025),
specificity (91.7% vs. 77.2%; p = 0.009) and accuracy (92.2% vs. 79.0%; p =
0.006) than LR analysis. Performance of popularized D'Amico scheme was
effectively improved by adding MRI-derived variables (Az: 0.970 vs. 0.859, p <
0.001; sensitivity: 91.7% vs. 86.7%, p = 0.031; specificity: 94.5% vs. 78.6%, p =
0.001; and accuracy: 93.7% vs. 81.0%, p = 0.007). Additionally, beside
pathological Gleason score (hazard ratio [HR] = 1.560, p = 0.008), surgical-T3b
(HR = 4.525, p < 0.001) and positive surgical margin (HR = 1.314, p = 0.007),
apparent diffusion coefficient (HR = 0.149, p = 0.035) was the only independent
imaging predictor of time to PSA failure. Therefore, We concluded that
imaging-based approach using SVM was superior to LR analysis in predicting PCa
outcome. Adding MR variables improved the performance of D'Amico scheme.