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Development and Validation of a Non-Invasive AI Diagnostic Model for Prostate Cancer Using Multiparametric MRI and PSMA PET/CT

14 septembre 2026 mis à jour par: Xiangya Hospital of Central South University

A Retrospective, Multicenter Study to Develop and Validate a Non-Invasive Artificial Intelligence Diagnostic Model for Prostate Cancer Using Multiparametric MRI and PSMA PET/CT, With Pathologically Confirmed Diagnosis as the Reference Standard

Prostate cancer is one of the most common malignancies in men. Currently, due to the limited diagnostic accuracy of existing imaging tests, there is a risk of missed diagnosis or unnecessary prostate biopsy. This study aims to develop and validate a non-invasive artificial intelligence (AI) diagnostic model using two advanced imaging techniques: multiparametric MRI (mpMRI) and PSMA PET/CT. By integrating information from both imaging modalities, the AI model is expected to improve the diagnostic accuracy of prostate cancer, reduce unnecessary biopsies, and assist physicians in making better clinical decisions. This is a retrospective, multicenter study that plans to collect imaging and pathology data from approximately 1,000 to 1,500 patients across six major hospitals in China. The diagnostic performance of the model will be evaluated, including its ability to identify clinically significant prostate cancer and its value in assisting diagnosis in patients with PSA levels in the gray zone (4-20 ng/mL).

Aperçu de l'étude

Statut

Inscription sur invitation

Les conditions

Description détaillée

Study Design:

This is a retrospective and prospective, multicenter, case-control study. The study aims to develop and validate a non-invasive artificial intelligence (AI) diagnostic model for prostate cancer by integrating multiparametric MRI (mpMRI) and PSMA PET/CT imaging.

Participants:

Patients who underwent mpMRI, PSMA PET/CT, and prostate biopsy or radical prostatectomy at participating centers will be retrospectively enrolled. Eligible participants include pathologically confirmed prostate cancer patients (cases) and benign prostatic hyperplasia (BPH) patients (controls). Inclusion criteria include age ≥18 years, ECOG performance status 0-2, life expectancy >6 months, and availability of complete clinical data (PSA, Gleason score, PI-RADS, SUVmax, prostate volume, etc.). Exclusion criteria include prior prostate cancer treatment (endocrine therapy or radiotherapy), previous prostate surgery (e.g., TURP), severe renal insufficiency, other malignancies. Informed consent is waived for retrospective patients, while signed informed consent is required for prospective patients.

Sample Size:

Approximately 1,000 to 1,500 participants will be enrolled from six hospitals in China: Xiangya Hospital of Central South University, Qilu Hospital of Shandong University, Chinese PLA General Hospital, The First Affiliated Hospital of Guangzhou Medical University, Beijing Hospital and Renji Hospital, Shanghai Jiao Tong University School of Medicine.

AI Model Development:

The AI model will be developed using deep learning and radiomics techniques. mpMRI sequences (including T2-weighted, DWI/ADC, and DCE) and PSMA PET/CT images will be preprocessed, coregistered, and fused. The model will be trained to distinguish clinically significant prostate cancer (csPCa) from non-csPCa or benign conditions. The reference standard is histopathology from prostate biopsy or radical prostatectomy.

Outcome Measures:

Primary outcome measures include the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of the AI model for csPCa detection. Secondary outcome measures include positive predictive value (PPV), negative predictive value (NPV), overall accuracy, decision curve analysis (DCA) net benefit, diagnostic performance in the PSA gray zone (4-20 ng/mL) subgroup, and the proportion of patients who could avoid biopsy at 100% specificity threshold.

Statistical Analysis:

Model performance will be evaluated using internal cross-validation and external validation on data from different centers. Calibration curves and decision curve analysis will be used to assess clinical utility. Subgroup analyses will be performed for PSA gray zone patients and different Gleason grade groups.

Type d'étude

Observationnel

Inscription (Estimé)

1500

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Chine
    • Beijing Municipality
      • Beijing, Beijing Municipality, Chine, 100853
        • Chinese PLA General Hospital
      • Beijing, Beijing Municipality, Chine, 100730
        • Beijing Hospital
    • Guangdong
      • Guangzhou, Guangdong, Chine, 510120
        • The First Affiliated Hospital of Guangzhou Medical University
    • Shandong
      • Jinan, Shandong, Chine, 250012
        • Qilu Hospital of Shandong University
    • Shanghai Municipality
      • Shanghai, Shanghai Municipality, Chine, 200127
        • Renji Hospital, Shanghai Jiao Tong University School of Medicine
  • États-Unis
    • California
      • Los Angeles, California, États-Unis, 90095
        • David Geffen School of Medicine University of California, Los Angeles(UCLA)

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

This study will enroll patients who underwent mpMRI, PSMA PET/CT, and prostate biopsy or radical prostatectomy at six major hospitals in China: Xiangya Hospital of Central South University, Qilu Hospital of Shandong University, Chinese PLA General Hospital, The First Affiliated Hospital of Guangzhou Medical University, Beijing Hospital and Renji Hospital, Shanghai Jiao Tong University School of Medicine. The study population includes two groups: patients with pathologically confirmed prostate cancer (cases) and patients with pathologically confirmed benign prostatic hyperplasia (BPH, controls). All participants are male, aged 18 years or older, with no prior prostate cancer treatment (endocrine therapy or radiotherapy) or prostate surgery. Patients with severe renal insufficiency or other malignancies are excluded. A total of approximately 1,000 to 1,500 participants will be enrolled retrospectively from the participating centers.

La description

Inclusion Criteria:

  1. Age ≥ 18 years.
  2. ECOG performance status 0-2.
  3. Life expectancy > 6 months.
  4. Underwent mpMRI and PSMA PET/CT before systemic treatment or radical prostatectomy, with original DICOM data available for export.
  5. Has pathological diagnosis from prostate biopsy or radical prostatectomy as the gold standard.
  6. Complete clinical data available, including pre-treatment PSA (tPSA, fPSA), TNM stage, Gleason score, PI-RADS score, SUVmax, prostate volume (from MRI/PSMA PET), age, and BMI.
  7. Informed consent for data use for research purposes according to each center's ethics requirements.

Exclusion Criteria:

  1. History of other malignant tumors
  2. Previous prostate surgery (e.g., TURP)
  3. Prior endocrine therapy or radiotherapy
  4. Severe renal insufficiency
  5. Major organ dysfunction or life expectancy < 1 year

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Cohortes et interventions

Groupe / Cohorte
Groupe du cancer de la prostate
Non-cancer (BPH) Control

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Area Under the Curve (AUC) of the AI Model for Detecting Clinically Significant Prostate Cancer
Délai: At histopathological diagnosis by prostate biopsy or radical prostatectomy
The AUC (Area Under the Receiver Operating Characteristic Curve) will be calculated to evaluate the overall diagnostic performance of the AI model in distinguishing clinically significant prostate cancer (csPCa) from non-csPCa or benign conditions. The gold standard is histopathology from prostate biopsy or radical prostatectomy.
At histopathological diagnosis by prostate biopsy or radical prostatectomy
Specificity of the AI Model for Detecting Clinically Significant Prostate Cancer
Délai: At histopathological diagnosis by prostate biopsy or radical prostatectomy
Specificity (true negative rate) will be calculated to evaluate the model's ability to correctly identify patients without clinically significant prostate cancer. High specificity is a primary goal to reduce unnecessary prostate biopsies.
At histopathological diagnosis by prostate biopsy or radical prostatectomy
Sensitivity of the AI Model for Detecting Clinically Significant Prostate Cancer
Délai: At histopathological diagnosis by prostate biopsy or radical prostatectomy
Sensitivity (true positive rate) will be calculated to evaluate the model's ability to correctly identify patients with clinically significant prostate cancer.
At histopathological diagnosis by prostate biopsy or radical prostatectomy

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Overall Diagnostic Accuracy
Délai: At histopathological diagnosis by prostate biopsy or radical prostatectomy
Overall accuracy (proportion of true results among all cases) will be calculated for the AI model in detecting clinically significant prostate cancer.
At histopathological diagnosis by prostate biopsy or radical prostatectomy
Net Benefit of the AI Model for Detecting Clinically Significant Prostate Cancer
Délai: At histopathological diagnosis by prostate biopsy or radical prostatectomy
Net benefit will be calculated across a range of threshold probabilities to evaluate the clinical utility of the AI model for detecting clinically significant prostate cancer, using histopathological diagnosis from prostate biopsy or radical prostatectomy as the reference standard. Results will be compared with default strategies of biopsying all patients or no patients.
At histopathological diagnosis by prostate biopsy or radical prostatectomy
Proportion of Patients Who Could Avoid Biopsy at 100% Specificity Threshold
Délai: At histopathological diagnosis by prostate biopsy or radical prostatectomy
At a specificity of 100% (no false positives), the proportion of patients who would be correctly identified as non-csPCa and thus could safely avoid prostate biopsy will be calculated. Sensitivity at this threshold will also be reported.
At histopathological diagnosis by prostate biopsy or radical prostatectomy
AUC in PSA Gray Zone (4-20 ng/mL)
Délai: At histopathological diagnosis by prostate biopsy or radical prostatectomy
The area under the receiver operating characteristic curve (AUC) of the AI model will be evaluated in patients with PSA levels between 4 and 20 ng/mL to assess discrimination between clinically significant prostate cancer and non-clinically significant or benign disease, using histopathological diagnosis as the reference standard.
At histopathological diagnosis by prostate biopsy or radical prostatectomy
Specificity in PSA Gray Zone (4-20 ng/mL)
Délai: At histopathological diagnosis (prostate biopsy or radical prostatectomy)
Specificity of the AI model will be evaluated in patients with PSA levels between 4 and 20 ng/mL using histopathological diagnosis as the reference standard.
At histopathological diagnosis (prostate biopsy or radical prostatectomy)

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
Sensitivity in PSA Gray Zone (4-20 ng/mL)
Délai: At histopathological diagnosis (prostate biopsy or radical prostatectomy)
Sensitivity of the AI model will be evaluated in patients with PSA levels between 4 and 20 ng/mL, using histopathological diagnosis as the reference standard.
At histopathological diagnosis (prostate biopsy or radical prostatectomy)

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Xiangya Hospital of Central South University

Collaborateurs

Chinese PLA General Hospital
RenJi Hospital
Qilu Hospital of Shandong University
The First Affiliated Hospital of Guangzhou Medical University

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

13 janvier 2026

Achèvement primaire (Estimé)

30 septembre 2026

Achèvement de l'étude (Estimé)

31 décembre 2026

Dates d'inscription aux études

Première soumission

16 juin 2026

Première soumission répondant aux critères de contrôle qualité

1 juillet 2026

Première publication (Réel)

8 juillet 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

15 septembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

14 septembre 2026

Dernière vérification

1 mai 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • 2026010083_2

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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