Biochemical recurrence prediction after radiotherapy for prostate cancer with T2w magnetic resonance imaging radiomic features

Catarina Dinis Fernandes, Cuong V. Dinh, Iris Walraven, Stijn W. Heijmink, Milena Smolic, Joost J.M. van Griethuysen, Rita Simões, Are Losnegård, Henk G. van der Poel, Floris J. Pos, Uulke A. van der Heide

Research output: Contribution to journalArticleAcademicpeer-review

27 Citations (Scopus)


Background and purpose: High-risk prostate cancer patients are frequently treated with external-beam radiotherapy (EBRT). Of all patients receiving EBRT, 15–35% will experience biochemical recurrence (BCR) within five years. Magnetic resonance imaging (MRI) is commonly acquired as part of the diagnostic procedure and imaging-derived features have shown promise in tumour characterisation and biochemical recurrence prediction. We investigated the value of imaging features extracted from pre-treatment T2w anatomical MRI to predict five year biochemical recurrence in high-risk patients treated with EBRT. Materials and methods: In a cohort of 120 high-risk patients, imaging features were extracted from the whole-prostate and a margin surrounding it. Intensity, shape and textural features were extracted from the original and filtered T2w-MRI scans. The minimum-redundancy maximum-relevance algorithm was used for feature selection. Random forest and logistic regression classifiers were used in our experiments. The performance of a logistic regression model using the patient's clinical features was also investigated. To assess the prediction accuracy we used stratified 10-fold cross validation and receiver operating characteristic analysis, quantified by the area under the curve (AUC). Results: A logistic regression model built using whole-prostate imaging features obtained an AUC of 0.63 in the prediction of BCR, outperforming a model solely based on clinical variables (AUC = 0.51). Combining imaging and clinical features did not outperform the accuracy of imaging alone. Conclusions: These results illustrate the potential of imaging features alone to distinguish patients with an increased risk of recurrence, even in a clinically homogeneous cohort.

Original languageEnglish
Pages (from-to)9-15
Number of pages7
JournalPhysics and Imaging in Radiation Oncology
Publication statusPublished - Jul 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 The Authors

Copyright 2019 Elsevier B.V., All rights reserved.


  • External beam radiotherapy
  • Prostate cancer
  • Radiomics
  • T2-weighted MRI


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