Large-Scale Radiomics Analysis for Prostate Cancer Detection Harnessing Machine and Deep Learning Models

Prostate cancer (PCa) is the second most common cancer in men, making early detection crucial for effective treatment. This study explores the efficacy of machine learning (ML) and deep learning (DL) models in detecting PCa lesions using radiomics features derived from multiparametric MRI data. Leveraging a dataset of 7621 retrospective and 2132 prospective cases from 12 clinical centers across Europe, we compared the performance of various ML (LASSO, Random Forest, SVM, XGBoost) and DL models (CNN, MLP, Transformer, CNN&MLP). Radiomic features were extracted and refined through a robust feature selection process. Models' performance was evaluated through nested cross-validation (CV) and externally. The CNN&MLP model achieved the highest ROC AUC (0.86) and PR AUC (0.90) in CV, while LASSO showed consistent generalization in external validation. Our findings indicate that DL models excel in high-dimensional data analysis but face challenges in generalizing to external datasets, highlighting the importance of external validation for clinical applicability.