Abstract
OBJECTIVES: There is a growing need to develop user-friendly, bladder-specific image analysis tools that can produce reliable artificial intelligence (AI)-quantitative imaging biomarkers (QIBs) derived from multiparametric (mp)MRI data for clinical applications. To address it, we developed an AI-powered BLADdEr multiparametric MRI Analysis for Clinical Application (AI-BLADE, current release v1.0) toolbox designed for extracting mpMRI-derived quantitative metrics. METHODS: AI-BLADE is an advanced tool for bladder-specific mpMRI data analysis with 2 core functionalities: (1) Deep Feature Analysis (MRI-DFA toolkit) and (2) Data-Driven Model-Based Analysis (MRI-MBA toolkit). AI-BLADE offers customizable options and serves as a one-stop shop solution for bladder cancer (BCa) clinical applications. The models within DFA and MBA were tested separately on 2 patient cohorts. DFA was used to classify BCa histology subtypes (n = 104) with T2-weighted images, while MBA was used to interrogate tumour physiology by deriving mpMRI QIBs, including apparent diffusion coefficient (ADC), and volume transfer constant (K(trans)) obtained from 34 BCa patients. RESULTS: Out of the 17 AI models tested, the VGG19 model with a decision tree classifier and no feature selection for the fully connected layer 7 achieved the highest area under the curve of the receiver operating characteristic of 0.79 in classifying BCa histology subtypes, demonstrating the strongest performance. The mean ADC and K(trans) values were 1.22 × 10(-3) (mm(2)/s) and 0.27 (min(-1)), respectively, reflecting underlying tumour physiology. CONCLUSION: The AI-BLADE (v1.0), a flexible and user-friendly software toolbox for analysing mpMRI data, shows strong potential for application in BCa oncology, offering capabilities that can enhance diagnostic accuracy and support improved patient outcomes. ADVANCES IN KNOWLEDGE: This is the first study to design, develop, and implement a novel bladder-specific AI toolbox for analysing mpMRI data. AI-BLADE enables an advanced image analysis workflow, facilitating AI-QIB-based clinical decision-making for patients with BCa.