Exhibit Hall | Forum 5
Purpose: To investigate a graph attention network (GAT) based approach combining both radiomics and clinical data for improved and interpretable prediction of lymph node invasion (LNI) in high-grade prostate cancers (PCa).
Methods: Experiments were conducted using an IRB approved in-house dataset of 170 high-grade PCa (Gleason≥8) each with FDG-PET/CT images acquired prior to prostatectomy for staging purposes. A total of 101 and 94 radiomic markers were extracted from the CT and PET images respectively and ordered by Gini importance. The population graph was built using the k-nearest neighbor graph construction method with a mutual information weighted similarity metric. To ensure learning of a graph with interpretable connections, the features used for graph construction were the clinical features merged with the most important radiomic shape-based CT feature and first-order intensity-based PET feature. As for the node features, we combined clinical data and the top 10% of radiomic markers. The performance of the GAT model was compared to a random forest classifier (RFC) and a support vector machine (SVM). The models were optimized using a stratified nested 5-fold cross-validation with 140 patients and evaluated on a holdout-set of 30 patients. Adjustments for class imbalance were applied during modeling.
Results: On the validation sets, the models reached {AUC=0.68±0.09, bACC=0.65±0.07}, {AUC=0.61±0.05, bACC=0.61±0.06} and {AUC=0.68±0.07, bACC=0.68±0.07} for the GAT, RFC and SVM models respectively. On the holdout-set, the models reached {AUC=0.765, bACC=0.705}, {AUC=0.66, bACC=0.66} and {AUC=0.725, bACC=0.725}. Although SVM achieved better balanced accuracy than GAT, the predictions made by the latter have the advantage of being interpretable through the graph-attention mechanism, which aims to assign greater importance to neighbors of the same class.
Conclusion: Our results suggest that combining imaging and non-imaging information in an intuitive graph-based approach improves the interpretability of LNI predictions in high-grade PCa while maintaining good performance compared to other models.
Funding Support, Disclosures, and Conflict of Interest: Natural Sciences and Engineering Research Council of Canada (NSERC), Fonds de Recherche du Quebec - Nature et technologies (FRQNT)