Prediction of prostate cancer recurrence after radiotherapy using a fused machine learning approach: utilizing radiomics from pretreatment T2W MRI images with clinical and pathological information

Abstract Background. ThePlease provide an email address for the corresponding author. risk of biochemical recurrence (BCR) after radiotherapy for localized prostate cancer (PCa) varies widely within standard risk groups. There's a need for low-cost tools to more robustly predict recurrence and personalize therapy. Radiomic features from pretreatment MRI show potential as noninvasive biomarkers for BCR prediction. Previous research has not fully combined radiomics with clinical and pathological data in predicting BCR of PCa patients after radiotherapy. Purpose. This study aims to predict 5-year BCR using radiomics from pretreatment T2W MRI and clinical-pathological data in PCa patients treated with radiation therapy, and to develop a unified model compatible with 1.5T and 3T MRI scanners. Methods. 150 T2W scans and clinical parameters were preprocessed. 120 cases were used for training and validation, and 30 for testing. Four distinct machine learning models were developed: Model 1 used radiomics, Model 2 used clinical and pathological data, Model 3 combined these via late fusion. Model 4 integrated radiomic and clinical-pathological data via early fusion . Results. Model 1 achieved an AUC of 0.73, while Model 2 had an AUC of 0.64 for predicting outcomes in 30 new test cases. Model 3, using late fusion, had an AUC of 0.69. Early fusion models showed promise: Model 4 reached an AUC of 0.84 highlighting the effectiveness of early fusion model. Conclusions. This study is the first to use fusion technique for predicting BCR in PCa patients following radiotherapy, using pre-treatment T2W MRI images and clinical-pathological data. Our methodology improves predictive accuracy by fusing radiomics with clinical-pathological information, even with a small dataset, and introduces the first unified model for both 1.5T and 3T MRI images.