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Intelligence artificielle pour la caractérisation du cancer de la prostate par agressivité en IRM multiparamétrique

Abstract : Prostate cancer (PCa) is the most frequently diagnosed cancer in men in more than half the countries in the world and the fifth leading cause of cancer death among men in 2020. Diagnosis of PCa includes multiparametric magnetic resonance imaging acquisition (mp-MRI) - which combines T2 weighted (T2-w), diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) sequences - prior to any biopsy. The joint analysis of these multimodal images is time demanding and challenging, especially when individual MR sequences yield conflicting findings. In addition, the sensitivity of MRI is low for less aggressive cancers and inter-reader reproducibility remains moderate at best. Moreover, visual analysis does not currently allow to determine the cancer aggressiveness, characterized by the Gleason score (GS). This is why computer-aided diagnosis (CAD) systems based on statistical learning models have been proposed in recent years, to assist radiologists in their diagnostic task, but the vast majority of these models focus on the binary detection of clinically significant (CS) lesions. The objective of this thesis is to develop a CAD system to detect and segment PCa on mp-MRI images but also to characterize their aggressiveness, by predicting the associated GS. In a first part, we present a supervised CAD system to segment PCa by aggressiveness from T2-w and ADC maps. This end-to-end multi-class neural network jointly segments the prostate gland and cancer lesions with GS group grading. The model was trained and validated with a 5-fold cross-validation on a heterogeneous series of 219 MRI exams acquired on three different scanners prior prostatectomy. Regarding the automatic GS group grading, Cohen’s quadratic weighted kappa coefficient (κ) is 0.418 ± 0.138, which is the best reported lesion-wise kappa for GS segmentation to our knowledge. The model has also encouraging generalization capacities on the PROSTATEx-2 public dataset. In a second part, we focus on a weakly supervised model that allows the inclusion of partly annotated data, where the lesions are identified by points only, for a consequent saving of time and the inclusion of biopsy-based databases. Regarding the automatic GS group grading on our private dataset, we show that we can approach performance achieved with the baseline fully supervised model while considering 6% of annotated voxels only for training. In the last part, we study the contribution of DCE MRI, a sequence often omitted as input to deep models, for the detection and characterization of PCa. We evaluate several ways to encode the perfusion from the DCE MRI information in a U-Net like architecture. Parametric maps derived from DCE MR exams are shown to positively impact segmentation and grading performance of PCa lesions.
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Submitted on : Tuesday, September 27, 2022 - 3:47:24 PM
Last modification on : Thursday, October 27, 2022 - 3:12:39 PM


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  • HAL Id : tel-03789679, version 1


Audrey Duran. Intelligence artificielle pour la caractérisation du cancer de la prostate par agressivité en IRM multiparamétrique. Traitement du signal et de l'image [eess.SP]. Université de Lyon, 2022. Français. ⟨NNT : 2022LYSEI008⟩. ⟨tel-03789679⟩



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