Pathology test uses AI to predict prostate cancer progression following surgery

Oct. 3, 2018

A pathology test that applies artificial intelligence (AI) to characterize tissue samples can accurately predict clinically significant prostate cancer disease progression following surgery, according to a study conducted at the Icahn School of Medicine at Mount Sinai and published in Nature Prostate Cancer and Prostatic Diseases. The Precise MD post-op test automates the Gleason score (a grading system that has been used since the 1960s to establish the prognosis for a prostate cancer) through the application of an algorithm that integrates image analysis with protein biomarkers. Precise MD is a pathology platform that uses artificial intelligence and complex algorithms to translate data into clinical knowledge.

According to the American Cancer Society, prostate cancer is the second leading cause of cancer death in American men, behind lung cancer. Surgery is a treatment option that generally yields a good prognosis, but 25% to 30% of men who have surgery will have a recurrence. Accurate risk stratification post-surgery is essential to identifying patients at intermediate to high risk for clinically significant disease progression. Those patients could benefit from more attentive monitoring and possibly additional therapy, such as radiation or chemotherapy.

Researchers at the Center for Computational and Systems Pathology at Mount Sinai used AI-guided machine learning techniques to analyze cancer tissue samples from 590 patients who underwent a radical prostatectomy, an operation to remove the prostate gland and the tissues surrounding it. The Precise MD platform relies on microscopy with multispectral immunofluorescence to analyze cancer tissue architecture and biomarkers, enabling pathologists to see what the human eye cannot. Its analysis uses mathematical features to define tumor aggressiveness.

The Precise MD post-op test predicted significant disease progression with a greater degree of accuracy as compared with models that incorporated only clinical features such as the traditional Gleason score, or a Prostate-Specific Antigen (PSA) test; PSA is a substance produced by the prostate gland and elevated levels may indicate prostate cancer. Importantly, the Precise Post-op test reclassified 58% of intermediate risk patients as low risk and 42% as high risk for significant disease progression. Men identified as high risk by the Precise Post-op test may be appropriate candidates for additional monitoring and treatments, including chemotherapy and radiation.

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