Radiomics-augmented lesion characterization on prostate multiparametric magnetic resonance imaging: first-order features and ratio metrics may improve diagnostic performance in prostate cancer.
4 affiliations
- 1Institute for Radiology, Caritas Hospital St. Josef, Regensburg, Germany.
- 2Department of Urology, Caritas Hospital St. Josef, University of Regensburg, Regensburg, Germany.
- 3Institute for Radiology, University Hospital Regensburg, Regensburg, Germany.
- 4Institute for Pathology, University of Regensburg, Regensburg, Germany.
Abstract
Multiparametric magnetic resonance imaging (mpMRI) is increasingly recognized as an important diagnostic modality in the evaluation of prostate cancer. This analysis sought to investigate whether simple, ratio-normalized quantitative magnetic resonance imaging (MRI) biomarkers obtained from routine mpMRI of the prostate provide incremental diagnostic value beyond the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) for the detection of clinically significant prostate cancer (csPCa). In this retrospective single-center study, 129 men underwent pre-biopsy 3-Tesla mpMRI followed by MRI/ultrasound fusion-guided biopsy. Quantitative first-order imaging features representing the three principal imaging domains underlying PI-RADS were derived from T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) imaging and normalized to intra-patient reference tissue. The analyses were performed on a lesion-specific basis and stratified by anatomical zone. Zone-specific logistic regression models were constructed to assess the incremental diagnostic value of quantitative biomarkers beyond PI-RADS v2.1. In the peripheral zone (PZ; 99 lesions), PI-RADS alone exhibited moderate discrimination for csPCa [area under the curve (AUC) =0.723]. An integrative model combining PI-RADS with prostate-specific antigen density (PSAD) and quantitative MRI-derived ratios from DWI, T2WI, and DCE significantly improved discrimination [AUC =0.901, 95% confidence interval (CI): 0.839-0.964]. After bootstrap-based optimism correction, the AUC decreased to 0.879. In the transition zone (TZ; 30 lesions), univariable analyses revealed no consistent differences in quantitative parameters between clinically significant and non-clinically significant lesions. PI-RADS alone yielded an AUC of 0.670, while ratio-based quantitative parameters did not provide meaningful incremental diagnostic value beyond PI-RADS v2.1. Simple, ratio-normalized quantitative MRI parameters integrated with PI-RADS and PSAD showed potential incremental value for detecting csPCa in the PZ. Conversely, these parameters demonstrated no statistically significant incremental diagnostic value beyond PI-RADS in the TZ in this limited cohort. These findings support a zone-aware, pragmatic approach to the quantitative augmentation of PI-RADS using routinely available MRI metrics.
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BibTeX
@article{niessen2026radiomicsaugmented,
title = {{Radiomics-augmented lesion characterization on prostate multiparametric magnetic resonance imaging: first-order features and ratio metrics may improve diagnostic performance in prostate cancer.}},
author = {Christoph Niessen and Maximilian Haas and Maximilian Burger and Simon Udo Engelmann and Christoph Eckl and Elena Vogel and Marco Julius Schnabel and Christian Stroszczynski and Florian Weber and Sarah Lena Haas and Roman Mayr and Christoph Pickl},
journal = {Quantitative imaging in medicine and surgery},
year = {2026},
month = oct,
doi = {10.21037/qims-2026-1006},
url = {https://europepmc.org/article/MED/42997770},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Radiomics-augmented lesion characterization on prostate multiparametric magnetic resonance imaging: first-order features and ratio metrics may improve diagnostic performance in prostate cancer.
AU - Christoph Niessen
AU - Maximilian Haas
AU - Maximilian Burger
AU - Simon Udo Engelmann
AU - Christoph Eckl
AU - Elena Vogel
AU - Marco Julius Schnabel
AU - Christian Stroszczynski
AU - Florian Weber
AU - Sarah Lena Haas
AU - Roman Mayr
AU - Christoph Pickl
PY - 2026
DA - 2026/10/16
JO - Quantitative imaging in medicine and surgery
DO - 10.21037/qims-2026-1006
UR - https://europepmc.org/article/MED/42997770
AB - Multiparametric magnetic resonance imaging (mpMRI) is increasingly recognized as an important diagnostic modality in the evaluation of prostate cancer. This analysis sought to investigate whether simple, ratio-normalized quantitative magnetic resonance imaging (MRI) biomarkers obtained from routine mpMRI of the prostate provide incremental diagnostic value beyond the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) for the detection of clinically significant prostate cancer (csPCa). In this retrospective single-center study, 129 men underwent pre-biopsy 3-Tesla mpMRI followed by MRI/ultrasound fusion-guided biopsy. Quantitative first-order imaging features representing the three principal imaging domains underlying PI-RADS were derived from T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) imaging and normalized to intra-patient reference tissue. The analyses were performed on a lesion-specific basis and stratified by anatomical zone. Zone-specific logistic regression models were constructed to assess the incremental diagnostic value of quantitative biomarkers beyond PI-RADS v2.1. In the peripheral zone (PZ; 99 lesions), PI-RADS alone exhibited moderate discrimination for csPCa [area under the curve (AUC) =0.723]. An integrative model combining PI-RADS with prostate-specific antigen density (PSAD) and quantitative MRI-derived ratios from DWI, T2WI, and DCE significantly improved discrimination [AUC =0.901, 95% confidence interval (CI): 0.839-0.964]. After bootstrap-based optimism correction, the AUC decreased to 0.879. In the transition zone (TZ; 30 lesions), univariable analyses revealed no consistent differences in quantitative parameters between clinically significant and non-clinically significant lesions. PI-RADS alone yielded an AUC of 0.670, while ratio-based quantitative parameters did not provide meaningful incremental diagnostic value beyond PI-RADS v2.1. Simple, ratio-normalized quantitative MRI parameters integrated with PI-RADS and PSAD showed potential incremental value for detecting csPCa in the PZ. Conversely, these parameters demonstrated no statistically significant incremental diagnostic value beyond PI-RADS in the TZ in this limited cohort. These findings support a zone-aware, pragmatic approach to the quantitative augmentation of PI-RADS using routinely available MRI metrics.
SN - 2223-4292
SN - 2223-4306
ER -