Recognition of Postoperative Cystography Features by Artificial Intelligence to Predict Recovery from Postprostatectomy Urinary Incontinence: A Rapid and Easy Way to Predict Functional Outcome

I. Hung Shao, Hung Cheng Kan, Hung Yi Chen, Ying Hsu Chang, Liang Kang Huang, Yuan Cheng Chu, Po Hung Lin, Kai Jie Yu, Cheng Keng Chuang, See Tong Pang, Chun Te Wu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

2 Scopus citations

Abstract

Purpose: Post-operative cystography has been used to predict the recovery of postprostatectomy urinary incontinence (PPI) in patients with localized prostate cancer. This study aimed to validate the predictive value of cystography for PPI and utilize a deep learning model to identify favorable and unfavorable features. Methods: Medical records and cystography images of patients who underwent robotic-assisted radical prostatectomy for localized prostate cancer were retrospectively reviewed. Specific cystography features, including anastomosis leakage, a downward bladder neck (BN), and the bladder neck angle, were analyzed for the prediction of PPI recovery. Favorable and unfavorable patterns were categorized based on the three cystography features. The deep learning model used for transfer learning was ResNet 50 and weights were trained on ImageNet. We used 5-fold cross-validation to reduce bias. After each fold, we used a test set to confirm the model’s performance. Result: A total of 170 consecutive patients were included; 31.2% experienced immediate urinary continence after surgery, while 93.5% achieved a pad-free status and 6.5% were still incontinent in the 24 weeks after surgery. We divided patients into a fast recovery group (≤4 weeks) and a slow recovery group (>4 weeks). Compared with the slow recovery group, the fast recovery group had a significantly lower anastomosis leakage rate, less of a downward bladder neck, and a larger bladder neck angle. Test data used to evaluate the model’s performance demonstrated an average 5-fold accuracy, sensitivity, and specificity of 93.75%, 87.5%, and 100%, respectively. Conclusions: Postoperative cystography features can predict PPI recovery in patients with localized prostate cancer. A deep-learning model can facilitate the identification process. Further validation and exploration are required for the future development of artificial intelligence (AI) in this field.

Original languageEnglish
Article number126
JournalJournal of Personalized Medicine
Volume13
Issue number1
DOIs
StatePublished - 08 01 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

  • artificial intelligence
  • cystography
  • deep learning
  • postprostatectomy incontinence
  • radical prostatectomy
  • urinary incontinence

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