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• Clinical Article •
Influence of rectal susceptibility artifacts on diagnosis of prostate cancer based on biparametric magnetic resonance imaging
WANG Zheng  HU Lei  LU Peng  LIU Song  FU Chengzhi  YU Song  YU Chengxin 

Cite this article as WANG Z, HU L, LU P, et al. Influence of rectal susceptibility artifacts on diagnosis of prostate cancer based on biparametric magnetic resonance imaging[J]. Chin J Magn Reson Imaging, 2024, 15(5): 134-140, 147. DOI:10.12015/issn.1674-8034.2024.05.021.


[Abstract] Objective To explore the impact of rectal susceptibility artifacts on the subjective evaluation and deep learning-based computer aided diagnosis (DL-CAD) in MRI-based prostate cancer diagnosis.Materials and Methods A retrospective analysis was conducted on 685 patients who underwent biparametric magnetic resonance imaging (bpMRI). All patients have confirmed pathological results via either biopsy or surgical resection. Three groups of radiologists (Reader 1-6) with varying years of experience independently reviewed suspicious lesions on prostate MRI according to the Prostate Imaging Reporting and Data System (PI-RADS) version 2.1. The other two readers scored whether there were rectal artifacts on MRI and the degree of artifacts. A DL-CAD model based on prostate MRI was constructed to evaluate the impact of rectal artifacts on the deep learning-based diagnostic model. The weighted Kappa coefficient was used for the consistency test of rectal artifact assessment. Differences in PI-RADS scores and rectal artifact scores among radiologists with different years of experience were compared using the chi-square test. The diagnostic differences among readers were compared using the multi-reader multi-case receiver operating characteristic curve (MRMC-ROC). The area under the curve (AUC) was used to evaluate the diagnostic performance of DL-CAD. The DeLong test was used to compare the differences in AUC values. A significance level of P<0.05 was considered statistically significant.Results This study included a total of 685 patients, comprising 199 cases of prostate cancer and 486 cases of benign lesions. In subjective evaluation, the AUC for junior Reader 1 was 0.772 without artifacts and 0.644 with artifacts, a statistically significant difference (P=0.023), while the AUC for junior Reader 2 was 0.809 without artifacts and 0.682 with artifacts, a statistically significant difference (P=0.007). The difference was not statistically significant (P>0.05) between the diagnostic performance of the middle and senior readers. Regarding the assessment of different degrees of rectal artifacts, there were no statistically significant differences in the diagnostic performance AUC among all readers (0.071≤P<0.973). Based on subjective scoring criteria, the other two readers rated the rectal artifact with a consistency of 0.851. In rectal artifact subgroup analysis, the AUC in the area without artifacts was higher than that in the area with artifacts in peripheral zone (Reader 1: 0.754 vs. 0.532; Reader 2: 0.771 vs. 0.580), and these differences were statistically significant (P<0.05). However, no statistically significant differences were observed in the remaining subgroups (P>0.05). In deep learning, the AUC without artifacts was 0.794 and the AUC with artifacts 0.538 for DL-CAD, and the difference was statistically significant(P<0.05). The AUC with mild artifacts were 0.546, the AUC with moderate artifacts were 0.590, and the AUC with severe artifacts were 0.481, and there was no significant difference in the diagnostic performance of DL-CAD (P>0.05).Conclusions Rectal susceptibility artifacts have significant negative effects on subjective visual assessment and DL-CAD assessment. There are differences in the impact of rectal artifacts on subjective visual assessment and DL-CAD assessment.
[Keywords] rectal susceptibility artifacts；prostate cancer；magnetic resonance imaging；prostate imaging report and data system；deep learning

WANG Zheng1, 2   HU Lei3   LU Peng1, 2   LIU Song1, 2   FU Chengzhi1, 2   YU Song1, 2   YU Chengxin1, 2*  

1 The first Clinical Medical College of three Gorges University, Yichang 443000, China

2 Department of Radiology, Yichang Central people's Hospital, Yichang 443000, China

3 Department of Radiology, Guangdong Provincial People's Hospital, Guangzhou 519041, China

Corresponding author: YU C X, E-mail: ycyucx@163.com

Conflicts of interest   None.

Received  2023-12-21
Accepted  2024-04-17
DOI: 10.12015/issn.1674-8034.2024.05.021
Cite this article as WANG Z, HU L, LU P, et al. Influence of rectal susceptibility artifacts on diagnosis of prostate cancer based on biparametric magnetic resonance imaging[J]. Chin J Magn Reson Imaging, 2024, 15(5): 134-140, 147. DOI:10.12015/issn.1674-8034.2024.05.021.

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