Quality of Multicenter Studies Using MRI Radiomics for Diagnosing Clinically Significant Prostate Cancer: A Systematic Review

Background: Reproducibility and generalization are major challenges for clinically significant prostate cancer modeling using MRI radiomics. Multicenter data seem indispensable to deal with these challenges, but the quality of such studies is currently unknown. The aim of this study was to systematically review the quality of multicenter studies on MRI radiomics for diagnosing clinically significant PCa. Methods: This systematic review followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Multicenter studies investigating the value of MRI radiomics for the diagnosis of clinically significant prostate cancer were included. Quality was assessed using the checklist for artificial intelligence in medical imaging (CLAIM) and the radiomics quality score (RQS). CLAIM consisted of 42 equally important items referencing different elements of good practice AI in medical imaging. RQS consisted of 36 points awarded over 16 items related to good practice radiomics. Final CLAIM and RQS scores were percentage-based, allowing for a total quality score consisting of the average of CLAIM and RQS. Results: Four studies were included. The average total CLAIM score was 74.6% and the average RQS was 52.8%. The corresponding average total quality score (CLAIM + RQS) was 63.7%. Conclusions: A very small number of multicenter radiomics PCa classification studies have been performed with the existing studies being of bad or average quality. Good multicenter studies might increase by encouraging preferably prospective data sharing and paying extra care to documentation in regards to reproducibility and clinical utility.