Abstract
This study aims to investigate the diagnostic value of integrating multi-parametric magnetic resonance imaging (mpMRI) radiomic features with tumor abnormal protein (TAP) and clinical characteristics for diagnosing prostate cancer. A cohort of 109 patients who underwent both mpMRI and TAP assessments prior to prostate biopsy were enrolled. Radiomic features were meticulously extracted from T2-weighted imaging (T2WI) and the apparent diffusion coefficient (ADC) maps. Feature selection was performed using t-tests and the Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by model construction using the random forest algorithm. To further enhance the model's accuracy and predictive performance, this study incorporated clinical factors including age, serum prostate-specific antigen (PSA) levels, and prostate volume. By integrating these clinical indicators with radiomic features, a more comprehensive and precise predictive model was developed. Finally, the model's performance was quantified by calculating accuracy, sensitivity, specificity, precision, recall, F1 score, and the area under the curve (AUC). From mpMRI sequences of T2WI, dADC(b = 100/1000 s/mm(2)), and dADC(b = 100/2000 s/mm(2)), 8, 10, and 13 radiomic features were identified as significantly correlated with prostate cancer, respectively. Random forest models constructed based on these three sets of radiomic features achieved AUCs of 0.83, 0.86, and 0.87, respectively. When integrating all three sets of data to formulate a random forest model, an AUC of 0.84 was obtained. Additionally, a random forest model constructed on TAP and clinical characteristics achieved an AUC of 0.85. Notably, combining mpMRI radiomic features with TAP and clinical characteristics, or integrating dADC (b = 100/2000 s/mm²) sequence with TAP and clinical characteristics to construct random forest models, improved the AUCs to 0.91 and 0.92, respectively. The proposed model, which integrates radiomic features, TAP and clinical characteristics using machine learning, demonstrated high predictive efficiency in diagnosing prostate cancer.