Image-based clinical decision support for transrectal ultrasound in the diagnosis of prostate cancer: comparison of multiple logistic regression, artificial neural network, and support vector machine

• Published in: European radiology 2010-06, Vol.20 (6), p.1476-1484
• Main Authors: Lee, Hak Jong, Hwang, Sung Il, Han, Seok-min, Park, Seong Ho, Kim, Seung Hyup, Cho, Jeong Yeon, Seong, Chang Gyu, Choe, Gheeyoung
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Artificial Intelligence; Decision Support Systems, Clinical; Decision Support Techniques; Diagnostic Radiology; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging; Internal Medicine; Interventional Radiology; Logistic Models; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Pattern Recognition, Automated - methods; Prostatic Neoplasms - diagnostic imaging; Radiology; Rectum - diagnostic imaging; Regression Analysis; Reproducibility of Results; Sensitivity and Specificity; Ultrasonography - methods; Ultrasound; Urogenital
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-009-1686-x

Purpose We developed a multiple logistic regression model, an artificial neural network (ANN), and a support vector machine (SVM) model to predict the outcome of a prostate biopsy, and compared the accuracies of each model. Method One thousand and seventy-seven consecutive patients who had undergone transrectal ultrasound (TRUS)-guided prostate biopsy were enrolled in the study. Clinical decision models were constructed from the input data of age, digital rectal examination findings, prostate-specific antigen (PSA), PSA density (PSAD), PSAD in transitional zone, and TRUS findings. The patients were divided into the training and test groups in a randomized fashion. Areas under the receiver operating characteristic (ROC) curve (AUC, Az) were calculated to summarize the overall performance of each decision model for the task of prostate cancer prediction. Results The Az values of the ROC curves for the use of multiple logistic regression analysis, ANN, and the SVM were 0.768, 0.778, and 0.847, respectively. Pairwise comparison of the ROC curves determined that the performance of the SVM was superior to that of the ANN or the multiple logistic regression model. Conclusion Image-based clinical decision support models allow patients to be informed of the actual probability of having a prostate cancer.