A Framework for Prostate Cancer Diagnosis: Can AI improve Clinical Workflows? | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Framework for Prostate Cancer Diagnosis: Can AI improve Clinical Workflows? Markus Bauer, Lennart Schneider, Adam Gurwin, Marit Bernhardt, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7529946/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Prostate cancer (PCa) is the second most common cancer in men worldwide, presenting significant challenges in both diagnosis and treatment. To determine the most effective therapy for each patient, accurate staging and grading of the cancer are essential, but often difficult due to the complexities involved in both staging and grading. Staging prostate cancer involves assessing its extent within the prostate and its spread to other parts of the body. This requires precise imaging and interpretation of scans, such as magnetic resonance imaging (MRI), and can be challenging due to the prostate lesions’ small size, often resulting in missed lesions. Grading evaluates how much cancer cells differ from normal cells, typically using the Gleason scoring system, where pathologists examine tissue samples under a microscope. This process is challenging because it heavily depends on the pathologist’s expertise, leading to variability and inconsistent results. To address these challenges, we employ recent advances in deep learning, specifically self-supervised learning (SSL), and transformer-architectures to develop an open-source AI framework aimed at enhancing the staging and grading process. Our framework is also equipped with a module interface that allows for integrating individual image analysis use cases. To demonstrate the potential of our framework, we simulate actual clinical trials to test the AI system under realistic conditions. Our AI system has demonstrated the capability to accurately identify cancerous lesions in the majority of MRI and histopathology cases. Moreover, it can grade a substantial number of cases, including identifying various subtypes of prostate cancer, and assists in routine tasks. The results of our studies indicate that AI may indeed enhance the accuracy of staging and grading in prostate cancer diagnosis and has the potential to make diagnostic practice more efficient and reproducible. Artificial Intelligence and Machine Learning Artificial Intelligence Vision Transformer Self-Supervised Learn- ing Digital Pathology Prostate Carcinoma Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7529946","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":509876715,"identity":"5171e423-b8a9-41fb-b46f-0eb04417262f","order_by":0,"name":"Markus Bauer","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAu0lEQVRIiWNgGAWjYBACAzBZIcHA3sDYQIqWMxIMPAdI0sLYxgDUQqzDzNnPGD6unGeRx8N+uIHh455awlose3KMDc9ukyjm4UlsYJzx7DgRDjuQYybZuE0icT9DYgMzz4FjRGg5/8b8Z+McicQe/ofEarmRY8bY2ADUIgG2pYYIv8x4VizZcAyk5WHDwRkHDhDWYs6fvPFjQ00d0GHpDx98OFBHWAsKAFpxmEQtQECqLaNgFIyCUTASAACAHDypfcWggwAAAABJRU5ErkJggg==","orcid":"","institution":"ScaDS.AI (University of Leipzig)","correspondingAuthor":true,"prefix":"","firstName":"Markus","middleName":"","lastName":"Bauer","suffix":""},{"id":509876716,"identity":"fc6bcc6d-cf88-4beb-9c94-4e487a739d47","order_by":1,"name":"Lennart Schneider","email":"","orcid":"","institution":"Institute of Pathology, University Hospital Bonn, Germany","correspondingAuthor":false,"prefix":"","firstName":"Lennart","middleName":"","lastName":"Schneider","suffix":""},{"id":509876717,"identity":"ba18e4f6-04d3-4e86-9d3d-a96b91d11543","order_by":2,"name":"Adam Gurwin","email":"","orcid":"","institution":"Wroclaw Medical University, Wroclaw, Poland","correspondingAuthor":false,"prefix":"","firstName":"Adam","middleName":"","lastName":"Gurwin","suffix":""},{"id":509876718,"identity":"2535e6e9-4d34-4fca-87fc-91a9f03f5d66","order_by":3,"name":"Marit Bernhardt","email":"","orcid":"","institution":"Institute of Pathology, University Hospital Bonn, Germany","correspondingAuthor":false,"prefix":"","firstName":"Marit","middleName":"","lastName":"Bernhardt","suffix":""},{"id":509876719,"identity":"73663ff2-7b29-4214-9aa3-8aceab907ce6","order_by":4,"name":"Christoph Augenstein","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Christoph","middleName":"","lastName":"Augenstein","suffix":""},{"id":509876720,"identity":"95df3c6a-f5db-4ed9-a174-f5c65a103996","order_by":5,"name":"Glen Kristiansen","email":"","orcid":"","institution":"Institute of Pathology, University Hospital Bonn, Germany","correspondingAuthor":false,"prefix":"","firstName":"Glen","middleName":"","lastName":"Kristiansen","suffix":""},{"id":509876721,"identity":"67405f08-c30f-4927-8703-8afe1034b620","order_by":6,"name":"Bogdan Franczyk","email":"","orcid":"","institution":"University of Leipzig and Wroclaw University of Economics","correspondingAuthor":false,"prefix":"","firstName":"Bogdan","middleName":"","lastName":"Franczyk","suffix":""},{"id":509876722,"identity":"dca4c424-2ca8-47c7-b48d-a06e4d4ffe9a","order_by":7,"name":"Bartosz Małkiewicz","email":"","orcid":"","institution":"Wroclaw Medical University, Wroclaw, Poland","correspondingAuthor":false,"prefix":"","firstName":"Bartosz","middleName":"","lastName":"Małkiewicz","suffix":""}],"badges":[],"createdAt":"2025-09-03 19:46:31","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7529946/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7529946/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90568738,"identity":"f08efc07-d777-4814-9524-b4cb89bbdda0","added_by":"auto","created_at":"2025-09-04 08:00:55","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3682206,"visible":true,"origin":"","legend":"","description":"","filename":"ICEIS24post5.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7529946/v1_covered_49ccec24-594d-4e20-993e-4bec9707f610.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eA Framework for Prostate Cancer Diagnosis: Can AI improve Clinical Workflows?\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Leipzig University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"
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