ProstNFound+: A Prospective Study using Medical Foundation Models for Prostate Cancer Detection

Paul F. R. Wilson; Mohamed Harmanani; Minh Nguyen Nhat To; Amoon Jamzad; Tarek Elghareb; Zhuoxin Guo; Adam Kinnaird; Brian Wodlinger; Purang Abolmaesumi; Parvin Mousavi

arXiv · 2510.26703

ProstNFound+: A Prospective Study using Medical Foundation Models for Prostate Cancer Detection

Paul F. R. Wilson·Mohamed Harmanani·Minh Nguyen Nhat To·Amoon Jamzad·Tarek Elghareb·Zhuoxin Guo·Adam Kinnaird·Brian Wodlinger·Purang Abolmaesumi·Parvin Mousavi

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Abstract

Purpose: Medical foundation models (FMs) offer a path to build high-performance diagnostic systems. However, their application to prostate cancer (PCa) detection from micro-ultrasound (μUS) remains untested in clinical settings. We present ProstNFound+, an adaptation of FMs for PCa detection from μUS, along with its first prospective validation. Methods: ProstNFound+ incorporates a medical FM, adapter tuning, and a custom prompt encoder that embeds PCa-specific clinical biomarkers. The model generates a cancer heatmap and a risk score for clinically significant PCa. Following training on multi-center retrospective data, the model is prospectively evaluated on data acquired five years later from a new clinical site. Model predictions are benchmarked against standard clinical scoring protocols (PRI-MUS and PI-RADS). Results: ProstNFound+ shows strong generalization to the prospective data, with no performance degradation compared to retrospective evaluation. It aligns closely with clinical scores and produces interpretable heatmaps consistent with biopsy-confirmed lesions. Conclusion: The results highlight its potential for clinical deployment, offering a scalable and interpretable alternative to expert-driven protocols.

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Paul F. R. Wilson, Mohamed Harmanani, Minh Nguyen Nhat To, Amoon Jamzad, Tarek Elghareb, Zhuoxin Guo, Adam Kinnaird, Brian Wodlinger, Purang Abolmaesumi, Parvin Mousavi. 2025-10-30. ProstNFound+: A Prospective Study using Medical Foundation Models for Prostate Cancer Detection. https://arxiv.org/abs/2510.26703

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