Multimodal Imaging and Digital Pathology for Prostate Cancer Prediction

This prospective and retrospective multicenter observational study enrolls patients with suspected prostate cancer who receive standardized preoperative multiparametric magnetic resonance imaging, transrectal ultrasound examination, followed by prostate biopsy or radical prostatectomy. Complete clinical data including age, BMI, prostate specific antigen indicators, PI-RADS v2.1 scores, Gleason score and ISUP grading are collected from all eligible participants. Biomechanically constrained non-rigid spatial registration technique is applied to achieve precise alignment between preoperative multimodal images and postoperative digital pathological whole slide images using high-quality multicenter datasets. A transformer-based multimodal deep learning fusion model is developed to analyze correlations between macroscopic imaging features and microscopic pathological heterogeneity, thereby establishing an interpretable artificial intelligence framework for clinically significant prostate cancer prediction. Comprehensive model validation is conducted via internal cross-validation, external multicenter independent verification and international public datasets. Decision curve analysis and clinical impact curve are applied to assess clinical applicability. The model serves as an intelligent auxiliary tool to refine biopsy strategies, avoid redundant puncture and excessive treatment, and facilitate early precise diagnosis and risk stratification of prostate cancer.