iPCa-Net: A CNN-based framework for predicting incidental prostate cancer using multiparametric MRI

Incidental prostate cancer (iPCa) is an early stage of clinically significant prostate cancer (csPCa) and is typically asymptomatic, making it difficult to detect in clinical practice. The objective of this study is to predict iPCa by analyzing prostatic MRIs using deep convolutional neural network (CNN). While CNN-based models in medical image analysis have made significant advancements, the iPCa prediction task presents two challenging problems: subtler differences in MRIs that are imperceptible to human eyes and a lower incidence rate, resulting in a more pronounced sample imbalance compared to routine cancer prediction. To address these two challenges, we propose a new CNN-based framework called iPCa-Net, which is designed to jointly optimize two tasks: prostate transition zone segmentation and iPCa prediction. To evaluate the performance of our model, we construct a prostatic MRI dataset comprising 9536 prostate MRI slices from 448 patients diagnosed with benign prostatic hyperplasia (BPH) at our institution. In our study, the incidence rate of iPCa is 5.13% (23 out of 448) . We compare our model with eight state-of-the-art methods for segmentation task and nine established methods for prediction task respectively using our dataset, and experimental results demonstrate the superior performance of our model. Specifically, in the prostate transition zone segmentation task, our iPCa-Net outperforms the top-performing method by 1.23% with respect to mIoU. In the iPCa prediction task, our iPCa-Net surpasses the top-performing method by 2.06% with respect to F1 score. In conclusion, our iPCa-Net demonstrates superior performance in the early identification of iPCa patients compared to state-ofthe-art methods. This advancement holds great significance for appropriate disease management and is highly beneficial for patients.