Accurate Prostate Cancer Detection and Segmentation on Biparametric MRI using Non-local Mask R-CNN with Histopathological Ground Truth

Purpose: We aimed to develop deep machine learning (DL) models to improve the detection and segmentation of intraprostatic lesions (IL) on bp-MRI by using whole amount prostatectomy specimen-based delineations. We also aimed to investigate whether transfer learning and self-training would improve results with small amount labelled data. Methods: 158 patients had suspicious lesions delineated on MRI based on bp-MRI, 64 patients had ILs delineated on MRI based on whole mount prostatectomy specimen sections, 40 patients were unlabelled. A non-local Mask R-CNN was proposed to improve the segmentation accuracy. Transfer learning was investigated by fine-tuning a model trained using MRI-based delineations with prostatectomy-based delineations. Two label selection strategies were investigated in self-training. The performance of models was evaluated by 3D detection rate, dice similarity coefficient (DSC), 95 percentile Hausdrauff (95 HD, mm) and true positive ratio (TPR). Results: With prostatectomy-based delineations, the non-local Mask R-CNN with fine-tuning and self-training significantly improved all evaluation metrics. For the model with the highest detection rate and DSC, 80.5% (33/41) of lesions in all Gleason Grade Groups (GGG) were detected with DSC of 0.548[0.165], 95 HD of 5.72[3.17] and TPR of 0.613[0.193]. Among them, 94.7% (18/19) of lesions with GGG > 2 were detected with DSC of 0.604[0.135], 95 HD of 6.26[3.44] and TPR of 0.580[0.190]. Conclusion: DL models can achieve high prostate cancer detection and segmentation accuracy on bp-MRI based on annotations from histologic images. To further improve the performance, more data with annotations of both MRI and whole amount prostatectomy specimens are required.