Z-SSMNet: Zonal-aware Self-supervised Mesh Network for Prostate Cancer Detection and Diagnosis with Bi-parametric MRI

Bi-parametric magnetic resonance imaging (bpMRI) has become a pivotal modality in the detection and diagnosis of clinically significant prostate cancer (csPCa). Developing AI-based systems to identify csPCa using bpMRI can transform PCa management by improving efficiency and cost-effectiveness. However, current state-of-the-art methods using convolutional neural networks (CNNs) are limited in learning in-plane and three-dimensional spatial information from anisotropic images. Their performances also depend on the availability of large, diverse, and well-annotated bpMRI datasets. We propose a Zonal-aware Self-supervised Mesh Network (Z-SSMNet) that adaptively integrates multi-dimensional (2D/2.5D/3D) convolutions to learn dense intra-slice information and sparse inter-slice information of the anisotropic bpMRI in a balanced manner. A self-supervised learning (SSL) technique is proposed to pre-train our network using large-scale unlabeled data to learn the appearance, texture, and structure semantics of bpMRI. It aims to capture both intra-slice and inter-slice information during the pre-training stage. Furthermore, we constrained our network to focus on the zonal anatomical regions to further improve the detection and diagnosis capability of csPCa. We conducted extensive experiments on the PI-CAI dataset comprising 10000+ multi-center and multi-scanner data. Our Z-SSMNet excelled in both lesion-level detection (AP score of 0.633) and patient-level diagnosis (AUROC score of 0.881), securing the top position in the Open Development Phase of the PI-CAI challenge and maintained strong performance, achieving an AP score of 0.690 and an AUROC score of 0.909, and securing the second-place ranking in the Closed Testing Phase.