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Main Authors: Rouwendaal, Gideon N. L., Boeke, Daniël, Cox, Inge L., van der Poel, Henk G., Haan, Margriet C. van Dijk-de, Beets-Tan, Regina G. H., Boellaard, Thierry N., Silva, Wilson
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2508.03461
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author Rouwendaal, Gideon N. L.
Boeke, Daniël
Cox, Inge L.
van der Poel, Henk G.
Haan, Margriet C. van Dijk-de
Beets-Tan, Regina G. H.
Boellaard, Thierry N.
Silva, Wilson
author_facet Rouwendaal, Gideon N. L.
Boeke, Daniël
Cox, Inge L.
van der Poel, Henk G.
Haan, Margriet C. van Dijk-de
Beets-Tan, Regina G. H.
Boellaard, Thierry N.
Silva, Wilson
contents Accurate preoperative prediction of erectile dysfunction (ED) is important for counseling patients undergoing radical prostatectomy. While clinical features are established predictors, the added value of preoperative MRI remains underexplored. We investigate whether MRI provides additional predictive value for ED at 12 months post-surgery, evaluating four modeling strategies: (1) a clinical-only baseline, representing current state-of-the-art; (2) classical models using handcrafted anatomical features derived from MRI; (3) deep learning models trained directly on MRI slices; and (4) multimodal fusion of imaging and clinical inputs. Imaging-based models (maximum AUC 0.569) slightly outperformed handcrafted anatomical approaches (AUC 0.554) but fell short of the clinical baseline (AUC 0.663). Fusion models offered marginal gains (AUC 0.586) but did not exceed clinical-only performance. SHAP analysis confirmed that clinical features contributed most to predictive performance. Saliency maps from the best-performing imaging model suggested a predominant focus on anatomically plausible regions, such as the prostate and neurovascular bundles. While MRI-based models did not improve predictive performance over clinical features, our findings suggest that they try to capture patterns in relevant anatomical structures and may complement clinical predictors in future multimodal approaches.
format Preprint
id arxiv_https___arxiv_org_abs_2508_03461
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Evaluating the Predictive Value of Preoperative MRI for Erectile Dysfunction Following Radical Prostatectomy
Rouwendaal, Gideon N. L.
Boeke, Daniël
Cox, Inge L.
van der Poel, Henk G.
Haan, Margriet C. van Dijk-de
Beets-Tan, Regina G. H.
Boellaard, Thierry N.
Silva, Wilson
Image and Video Processing
Computer Vision and Pattern Recognition
Accurate preoperative prediction of erectile dysfunction (ED) is important for counseling patients undergoing radical prostatectomy. While clinical features are established predictors, the added value of preoperative MRI remains underexplored. We investigate whether MRI provides additional predictive value for ED at 12 months post-surgery, evaluating four modeling strategies: (1) a clinical-only baseline, representing current state-of-the-art; (2) classical models using handcrafted anatomical features derived from MRI; (3) deep learning models trained directly on MRI slices; and (4) multimodal fusion of imaging and clinical inputs. Imaging-based models (maximum AUC 0.569) slightly outperformed handcrafted anatomical approaches (AUC 0.554) but fell short of the clinical baseline (AUC 0.663). Fusion models offered marginal gains (AUC 0.586) but did not exceed clinical-only performance. SHAP analysis confirmed that clinical features contributed most to predictive performance. Saliency maps from the best-performing imaging model suggested a predominant focus on anatomically plausible regions, such as the prostate and neurovascular bundles. While MRI-based models did not improve predictive performance over clinical features, our findings suggest that they try to capture patterns in relevant anatomical structures and may complement clinical predictors in future multimodal approaches.
title Evaluating the Predictive Value of Preoperative MRI for Erectile Dysfunction Following Radical Prostatectomy
topic Image and Video Processing
Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2508.03461