Integrating multimodal clinical data with a large model for prostate cancer diagnosis
Accurate prostate cancer (PCa) diagnosis remains difficult because of tumor heterogeneity and the challenge of integrating multimodal clinical information. We developed Prost-LM, a multimodal large language model that jointly embeds MRI-derived features, numerical PSA values, and free-text clinical reports into a unified semantic space to enable deep cross-modal reasoning. Trained and validated on a large multi-center cohort of 3940 patients, Prost-LM achieved strong diagnostic performance, with an internal validation AUC of 0.954 for distinguishing PCa from benign conditions, outperforming MRI-only models (AUC = 0.868, P < 0.001). For detecting clinically significant PCa (Gleason score ≥ 7), Prost-LM reached an AUC of 0.955. Additionally, the model provides interpretable diagnostic decisions to support clinical verification. These results suggest Prost-LM can improve automated PCa diagnosis and support precision oncology through multimodal AI.
Authors
- Fubo Wang (ORCID: https://orcid.org/0000-0002-2209-9932)
- Zhengdong Zhou
- Lingfeng Wu
- C Wang
- Guijian Pang
- Jiangnan Xu (ORCID: https://orcid.org/0000-0002-8957-948X)
- Ziwei Wang (ORCID: https://orcid.org/0000-0002-3237-1522)
- Xi Zhang (ORCID: https://orcid.org/0000-0002-4638-3997)
- Yue Wang (ORCID: https://orcid.org/0000-0003-0098-5359)
- He He (ORCID: https://orcid.org/0000-0002-1513-3987)
- Minglun Li
- Wangjian Wu
- Shukai Zhao
- Guangtao Zhai
- Yuan Tian
- Shaojie Yin
- Zhankui Jia
- Bin Xu
- Xuedong Wei
- Xu Gao
Institutions
- Guangxi Medical University (CN)
- Second Military Medical University (CN)
- Shanghai Jiao Tong University (CN)
- Nantong University (CN)
- Soochow University (CN)
- Jiaxing University (CN)
- Shanghai Ninth People's Hospital (CN)
- Beijing Academy of Artificial Intelligence (CN)
- Changhai Hospital (CN)
- Klinikum Lüneburg (DE)
- Yancheng First People's Hospital (CN)
- First Affiliated Hospital of GuangXi Medical University (CN)
- First Affiliated Hospital of Soochow University (CN)
- First Affiliated Hospital of Zhengzhou University (CN)
- Shanghai Artificial Intelligence Laboratory (CN)
Publication Details
- Journal
- npj Digital Medicine
- Published
- 2026-04-25
- DOI
- https://doi.org/10.1038/s41746-026-02670-x
- Primary Topic
- Prostate Cancer Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Natural Science Foundation of China
- Chinesisch-Deutsche Zentrum für Wissenschaftsförderung
- Guangxi Medical University