Characterization of prostate MRI focal lesions by combining human reading, artificial intelligence and prostate-specific antigen density: A multi-reader study

PURPOSE: The purpose of this study was to compare, across readers with varying experience, the characterisation of prostate MRI lesions as grade group (GG) ≥ 2 cancer, by using the PI-RADS version 2.1 (PI-RADSv2.1) score alone and by combining prostate specific antigen density (PSAd), the PI-RADSv2.1 score and the output of a radiomics-based algorithm (Q-CAD). MATERIALS AND METHODS: . RESULTS: strategy provided the highest net benefit for risk thresholds >12%-16%. Using lesions' delineations by Expert 2 yielded similar results. CONCLUSION: The combined strategies significantly increased specificity, at the cost of slightly reducing sensitivity for GG ≥ 2 cancers.