Artificial Intelligence (AI) for Automated Cancer Detection on Prostate MRI: Opportunities and Ongoing Challenges, From the AJR Special Series on AI Applications

Prostate MRI utilization has increased greatly in the past decade, serving primarily to direct targeted prostate biopsies. However, prostate MRI interpretation remains prone to consideration interreader variation. Artificial intelligence (AI) has the potential to standardize the detection of lesions on MRI that are suspicious for prostate cancer (PCa). This review explores the current status of AI for the automated detection of PCa by MRI. Recent literature providing promising results for AI models for PCa detection by MRI is highlighted. Numerous limitations of the existing literature are also described, including biases in model validation, heterogeneity in reporting of performance metrics, and lack of sufficient evidence of clinical translation. Challenges related to AI ethics and data governance are also discussed. An outlook is provided for AI in lesion detection by prostate MRI in the coming years, emphasizing current research needs. Future investigations, incorporating large-scale diverse multi-institutional training and testing datasets, are anticipated to enable the development of more robust AI models for PCa detection by MRI, though prospective clinical trials will ultimately be required to establish benefit of AI in patient management.