title: Role of transrectal ultrasonography in the prediction of prostate cancer: artificial neural network analysis.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the diagnostic performance of an artificial neural network (ANN) model with and without transrectal ultrasonographic (TRUS) data.
  
  
  METHODS
  Six hundred eighty-four consecutive patients who had undergone TRUS-guided prostate biopsy from May 2003 to January 2005 were enrolled. We constructed 2 ANN models. One (ANN_1) incorporated patient age, digital rectal examination findings, prostate-specific antigen (PSA) level, PSA density, transitional zone volume, and PSA density in the transitional zone as input data, whereas the other (ANN_2) was constructed with the above and TRUS findings as input data. The performances of these 2 ANN models according to PSA levels (group A, 0-4 ng/mL; group B, 4-10 ng/mL; and group C, >10 ng/mL) were evaluated using receiver operating characteristic analysis.
  
  
  RESULTS
  Of the 684 patients who underwent prostate biopsy, 214 (31.3%) were confirmed to have prostate cancer; of 137 patients with positive digital rectal examination results, 60 (43.8%) were confirmed to have prostate cancer; and of 131 patients with positive TRUS findings, 93 (71%) were confirmed to have prostate cancer. In groups A, B, and C, the AUCs for ANN_1 were 0.738, 0.753, and 0.774, respectively; the AUCs for ANN_2 were 0.859, 0.797, and 0.894. In all groups, ANN_2 showed better accuracy than ANN_1 (P < .05).
  
  
  CONCLUSIONS
  According to receiver operating characteristic analysis, ANN with TRUS findings was found to be more accurate than ANN without. We conclude that TRUS findings should be included as an input data component in ANN models used to diagnose prostate cancer.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Chongno-gu, Seoul, Korea.
authors.forename: Hak Jong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Kwang Gi
authors.initials: KG
authors.lastname: Kim
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Hwang
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Jung
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Hong
authors.forename: Seung Hyup
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D016571:Neural Networks, Computer; D011237:Predictive Value of Tests; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D012007:Rectum; D014463:Ultrasonography / Q000379:methods