Mask Enhanced Deeply Supervised Prostate Cancer Detection on B-mode Micro-Ultrasound

Prostate cancer is a leading cause of cancer-related deaths among men. The recent development of high frequency, micro-ultrasound imaging offers improved resolution compared to conventional ultrasound and potentially a better ability to differentiate clinically significant cancer from normal tissue. However, the features of prostate cancer remain subtle, with ambiguous borders with normal tissue and large variations in appearance, making it challenging for both machine learning and humans to localize it on micro-ultrasound images. We propose a novel Mask Enhanced Deeply-supervised Micro-US network, termed MedMusNet, to automatically and more accurately segment prostate cancer to be used as potential targets for biopsy procedures. MedMusNet leverages predicted masks of prostate cancer to enforce the learned features layer-wisely within the network, reducing the influence of noise and improving overall consistency across frames. MedMusNet successfully detected 76% of clinically significant cancer with a Dice Similarity Coefficient of 0.365, significantly outperforming the baseline Swin-M2F in specificity and accuracy (Wilcoxon test, Bonferroni correction, p-value<0.05). While the lesion-level and patient-level analyses showed improved performance compared to human experts and different baseline, the improvements did not reach statistical significance, likely on account of the small cohort. We have presented a novel approach to automatically detect and segment clinically significant prostate cancer on B-mode micro-ultrasound images. Our MedMusNet model outperformed other models, surpassing even human experts. These preliminary results suggest the potential for aiding urologists in prostate cancer diagnosis via biopsy and treatment decision-making.