Can MRI of the Prostate Combined With a Radiomics Evaluation Determine the Invasive Capacity of a Tumour

Prostate biopsies are the gold standard assessment of how prostate cancer is diagnosed and how low risk prostate cancers are surveilled. The investigators have produced a machine-learning based algorithm which uses MRI characteristics (radiomic features or textures) to predict the results of a prostate biopsy. The field has numerous concerns that such radiomic based predictions will not be reproducible, as there as so many subtle changes between MRI scans of different patients.

The interventions are the use of the MRT and the use of a second MRI of the prostate (MRI-P).

Two primary outcomes will be investigated. First, the existing radiomics predictive model, labeled as the MRI-P based Radiomics Tool (MRT) will predict the Grade Group (GG) and compare it to the gold standard, pathologist's evaluation of the Grade Group (GG). Second, the stability of the predicted GG between two shortly spaced MRI-Ps will be compared.

Patients with a detectable prostate nodule on MRI-P which localizes to a biopsy confirmed prostate cancer will be approached for enrollment. If enrolled, participants will attend for a subsequent MRI-P in a brief time frame relative to the acquisition of the first MRI-P. Attempts will be made to obtain participants that allow for even distribution among all GGs.

Inclusion criteria

An appropriate diagnostic MRI-P, defined as:

• Being performed on 3T MRI at the Halifax Infirmary Building
• Taken place within 5 weeks of study enrolment
• Having a detectable nodule which anatomically localizes to prostate cancer (PCa) identified in diagnostic biopsy specimen
• Acquired T1+contrast, T2, and attenuated diffusion coefficient (ADC) series axial images of the prostate

An appropriate diagnostic biopsy, defined as:

• Taken place within 2 months of the participant's MRI-P 1
• Taken place within 3 months of participant's study enrolment
• Reports diagnosis of PCa
• Reports a systematic assessment of the biopsy, assessing at least 12 cores
• Reports at least on core involved with PCa and this core must anatomically localise to a nodule seen on MRI-P 1

Exclusion criteria

• Past prostatic interventions which would influence the prostate's structure
• Alterations to physiological testosterone levels
• Inability to position one's self in a reproducible fashion for an MRI-P
• Patient factors reported to produce significant artifact on MRI-P 1