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

Objectives 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. Methods 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. Results 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). Conclusions 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.