Artificial intelligence is proving to be a valuable tool in the fight against prostate cancer, with new research demonstrating its ability to identify aggressive tumors and predict treatment outcomes more accurately than traditional methods.
Researchers at Brigham and Women's Hospital and UCLA have developed AI systems that can precisely measure prostate tumor volume from MRI scans, offering clinicians crucial information about cancer aggressiveness and potential treatment response.
AI Successfully Identifies Aggressive Prostate Tumors
A team led by Dr. David Yang, a radiation oncologist at Brigham and Women's Hospital, trained an AI model using MRI images from 732 prostate cancer patients. The system successfully identified and outlined approximately 85% of high-risk prostate tumors.
"AI-determined tumor volume has the potential to advance precision medicine for patients with prostate cancer by improving our ability to understand the aggressiveness of a patient's cancer and therefore recommend the most optimal treatment," said Dr. Yang.
The study, published in the journal Radiology, found that larger tumors identified by the AI were significantly more likely to recur or metastasize after treatment. This correlation held true for patients treated with both surgery and radiation therapy.
"The AI measurement itself can tell us something additional in terms of patient outcomes," explained Dr. Martin King, senior researcher and radiation oncologist at Brigham and Women's. "For patients, this can really tell them something about what are the chances of cure, and the likelihood that their cancer will reoccur or metastasize in the future."
Tumor Volume Predicts Treatment Success
In a parallel study conducted at UCLA and published in BJUI Compass, researchers evaluated an FDA-approved AI tool called Unfold AI, developed in collaboration with Avenda Health. The system analyzes data from MRI scans and biopsies to create detailed three-dimensional maps of prostate tumors.
The UCLA team studied 204 men with prostate cancer who underwent partial gland cryoablation, a minimally invasive procedure targeting localized tumors. They found that tumor volume was the strongest predictor of treatment success, with an area under the curve (AUC) of 0.73.
"By using AI to measure the size of a man's prostate tumor more precisely, we can better predict who is likely to be cured with focal therapies like partial gland cryoablation," said Dr. Wayne Brisbane, assistant professor of urology at UCLA and first author of the study.
The research established 1.5 cubic centimeters as an optimal threshold for tumor volume, balancing sensitivity (55.8%) and specificity (85.7%). Patients with tumors smaller than this threshold had significantly better outcomes following focal cryoablation.
Clinical Applications and Future Directions
Both AI systems offer several potential clinical benefits. They could help radiation oncologists pinpoint tumors for more targeted treatment, potentially reducing side effects while maintaining efficacy. The technology also provides faster assessment of cancer aggressiveness compared to current methods, which can take two weeks or longer.
Dr. Leonard Marks, professor of urology at UCLA, emphasized the significance of these findings: "Using AI to predict tumor volume and shape gives a clearer picture and could help choose better candidates for focal cryotherapy."
The UCLA study suggested that using a tumor volume threshold smaller than 1.5cc as a criterion for partial gland ablation could potentially prevent 72% of treatment failures, highlighting the clinical value of AI-derived measurements.
While these results are promising, researchers acknowledge the need for further validation. "We want to validate our findings, using other institutions and patient cohorts with different disease characteristics, to make sure that this approach is generalizable to all patients," Dr. Yang noted.
Experts plan to evaluate these AI tools in larger, multicenter trials to confirm their effectiveness across diverse patient populations. If successful, this technology could significantly improve treatment selection and outcomes for the thousands of men diagnosed with prostate cancer each year.
As AI continues to evolve in oncology applications, these studies represent important steps toward more personalized and effective prostate cancer care, potentially sparing patients from unnecessary treatments while ensuring those with aggressive disease receive appropriate intervention.
