Z-SSMNet: A Zonal-aware Self-Supervised Mesh Network for Prostate Cancer Detection and Diagnosis in bpMRI

Prostate cancer (PCa) is one of the most prevalent cancers in men and many people around the world die from clinically significant PCa (csPCa). Early diagnosis of csPCa in bi-parametric MRI (bpMRI), which is non-invasive, cost-effective, and more efficient compared to multiparametric MRI (mpMRI), can contribute to precision care for PCa. The rapid rise in artificial intelligence (AI) algorithms are enabling unprecedented improvements in providing decision support systems that can aid in csPCa diagnosis and understanding. However, existing state of the art AI algorithms which are based on deep learning technology are often limited to 2D images that fails to capture inter-slice correlations in 3D volumetric images. The use of 3D convolutional neural networks (CNNs) partly overcomes this limitation, but it does not adapt to the anisotropy of images, resulting in sub-optimal semantic representation and poor generalization. Furthermore, due to the limitation of the amount of labelled data of bpMRI and the difficulty of labelling, existing CNNs are built on relatively small datasets, leading to a poor performance. To address the limitations identified above, we propose a new Zonal-aware Self-supervised Mesh Network (Z-SSMNet) that adaptatively fuses multiple 2D, 2.5D and 3D CNNs to effectively balance representation for sparse inter-slice information and dense intra-slice information in bpMRI. A self-supervised learning (SSL) technique is further introduced to pre-train our network using unlabelled data to learn the generalizable image features. Furthermore, we constrained our network to understand the zonal specific domain knowledge to improve the diagnosis precision of csPCa. Experiments on the PI-CAI Challenge dataset demonstrate our proposed method achieves better performance for csPCa detection and diagnosis in bpMRI.