Single-center versus multi-center biparametric MRI radiomics approach for clinically significant peripheral zone prostate cancer

J. Bleker, D. Yakar, B. van Noort, D. Rouw, I. de Jong, R. Dierckx, T. Kwee and H. Huisman

Insights into Imaging 2021;12(1).

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To investigate a previously developed radiomics-based biparametric magnetic resonance imaging (bpMRI) approach for discrimination of clinically significant peripheral zone prostate cancer (PZ csPCa) using multi-center, multi-vendor (McMv) and single-center, single-vendor (ScSv) datasets.


This study's starting point was a previously developed ScSv algorithm for PZ csPCa whose performance was demonstrated in a single-center dataset. A McMv dataset was collected, and 262 PZ PCa lesions (9 centers, 2 vendors) were selected to identically develop a multi-center algorithm. The single-center algorithm was then applied to the multi-center dataset (single-multi-validation), and the McMv algorithm was applied to both the multi-center dataset (multi-multi-validation) and the previously used single-center dataset (multi-single-validation). The areas under the curve (AUCs) of the validations were compared using bootstrapping.


Previously the single-single validation achieved an AUC of 0.82 (95% CI 0.71-0.92), a significant performance reduction of 27.2% compared to the single-multi-validation AUC of 0.59 (95% CI 0.51-0.68). The new multi-center model achieved a multi-multi-validation AUC of 0.75 (95% CI 0.64-0.84). Compared to the multi-single-validation AUC of 0.66 (95% CI 0.56-0.75), the performance did not decrease significantly (p value: 0.114). Bootstrapped comparison showed similar single-center performances and a significantly different multi-center performance (p values: 0.03, 0.012).


A single-center trained radiomics-based bpMRI model does not generalize to multi-center data. Multi-center trained radiomics-based bpMRI models do generalize, have equal single-center performance and perform better on multi-center data.