oDigital pathology biomarkers for guiding radiotherapy-based treatment concepts in prostate cancer − a systematic review and expert consensus

Publikation: Beitrag in FachzeitschriftÜbersichtsartikel (Review)BeigetragenBegutachtung

Beitragende

  • Constantinos Zamboglou - , German Medical Institute (Autor:in)
  • William De Doncker - , German Medical Institute (Autor:in)
  • Andreas Thomas Christoforou - , German Medical Institute (Autor:in)
  • Stefano Arcangeli - , Università degli Studi di Milano Bicocca (Autor:in)
  • Alejandro Berlin - , Princess Margaret Cancer Centre , University of Toronto (Autor:in)
  • Pierre Blanchard - , Institut Gustave Roussy (Autor:in)
  • Glenn Bauman - , Western University (Autor:in)
  • Riccardo Campi - , Azienda Ospedaliera Universitaria (AOU) Careggi (Autor:in)
  • Elena Castro - , Hospital Universitario 12 de Octubre (Autor:in)
  • Ananya Choudhury - , University of Manchester (Autor:in)
  • Alan Dal Pra - , University of Miami Miller School of Medicine (Autor:in)
  • Cédric Draulans - , KU Leuven, AZ Sint-Maarten (Autor:in)
  • Neil Desai - , University of Miami Miller School of Medicine (Autor:in)
  • Konstantinos Ferentinos - , German Medical Institute (Autor:in)
  • Giulio Francolini - , Azienda Ospedaliera Universitaria (AOU) Careggi (Autor:in)
  • Silke Gillessen - , Ente Ospedaliero Cantonale (EOC), Università della Svizzera italiana (Autor:in)
  • Anca Ligia Grosu - , Universitätsklinikum Freiburg, Deutsches Krebsforschungszentrum (DKFZ), Albert-Ludwigs-Universität Freiburg (Autor:in)
  • Juan Gómez Rivas - , Hospital Clinico Universitario San Carlos (Autor:in)
  • Tobias Hoelscher - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • George Hruby - , Royal North Shore Hospital, University of Sydney (Autor:in)
  • Barbara Alicja Jereczek-Fossa - , Università degli Studi di Milano, IRCCS Istituto Europeo di Oncologia - Milano (Autor:in)
  • Sophia Kamran - , Harvard University (Autor:in)
  • Veeru Kasivisvanathan - , University College London, University College London Hospitals NHS Foundation Trust, Alan Turing Institute (Autor:in)
  • Amar U. Kishan - , University of California at Los Angeles (Autor:in)
  • Valentinos Kounnis - , Churchill Hospital (Autor:in)
  • Andrew Loblaw - , University of Toronto (Autor:in)
  • Jarad Martin - , GenesisCare, Newcastle (Autor:in)
  • Federico Mastroleo - , Università degli Studi di Milano, IRCCS Istituto Europeo di Oncologia - Milano, Mayo Clinic Rochester, MN (Autor:in)
  • Axel S. Merseburger - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Marcin Miszczyk - , Medizinische Universität Wien, WSB University (Autor:in)
  • Osama Mohamad - , University of Texas MD Anderson Cancer Center (Autor:in)
  • Piet Ost - , Iridium Network (Autor:in)
  • Athanasios Papatsoris - , National and Kapodistrian University of Athens (Autor:in)
  • Jan C. Peeken - , Technische Universität München, German Society for Radiation Oncology (DEGRO), Deutsches Konsortium für Translationale Krebsforschung (DKTK) - München, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (Autor:in)
  • Francesco Sanguedolce - , Autonomous University of Barcelona (Autor:in)
  • Paul Sargos - , Centre Georges-François Leclerc, Amethyst Radiotherapy (Autor:in)
  • Nina Schmidt-Hegemann - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Tyler M. Seibert - , University of California at San Diego (Autor:in)
  • Mohamed Shelan - , Universität Bern (Autor:in)
  • Shankar Siva - , University of Melbourne, Peter Maccallum Cancer Centre (Autor:in)
  • Timo F.W. Soeterik - , Santeon, St. Antonius Ziekenhuis (Autor:in)
  • Daniel E. Spratt - , Case Western Reserve University (Autor:in)
  • Arnulf Stenzl - , Eberhard Karls Universität Tübingen (Autor:in)
  • Iosif Strouthos - , European University Cyprus (Autor:in)
  • Philip Sutera - , University of Rochester Medical Center (Autor:in)
  • Stephane Supiot - , Ico Centre René GAUDUCHEAU, Université de Nantes (Autor:in)
  • Derya Tilki - , Stanford University, Universität Hamburg (Autor:in)
  • Phuoc T. Tran - , University of Maryland, Baltimore (Autor:in)
  • Alison C. Tree - , Royal Marsden NHS Foundation Trust (Autor:in)
  • Jonathan Tward - , University of Utah (Autor:in)
  • Yüksel Ürün - , Ankara University (Autor:in)
  • Neha Vapiwala - , University of Pennsylvania (Autor:in)
  • Mark R. Waddle - , Mayo Clinic Rochester, MN (Autor:in)
  • Eric Wegener - , GenesisCare, Newcastle (Autor:in)
  • Thomas Zilli - , Università della Svizzera italiana, Ente Ospedaliero Cantonale (EOC), Hôpitaux universitaires de Genève (Autor:in)
  • Vedang Murthy - , Homi Bhabha National Institute (Autor:in)
  • Alexander Henry Thieme - , Stanford University (Autor:in)
  • Simon Spohn - , Deutsches Krebsforschungszentrum (DKFZ), Universitätsklinikum Freiburg (Autor:in)

Abstract

Current risk-stratification systems for prostate cancer (PCa) do not sufficiently reflect the disease heterogeneity, and digital pathology (DP) combined with artificial intelligence (AI) tools (DP-AI) may offer a solution to this challenge. The aim of this work is to summarize the role of DP-AI for PCa patients treated with radiotherapy (RT), and to point out future areas of research. We conducted (1) a systematic review on the evidence of DP-AI for patients treated with RT and (2) a survey of experts using a modified Delphi method, addressing the current role of DP-AI in clinical and research practice to identify relevant fields of future development. Eleven studies investigated DP-AI in PCa RT, with most using the multimodal AI (MMAI) classifier and four ongoing studies are currently prospectively testing the DP-AI performance. DP-AI showed strong prognostic and predictive performance for endpoints like distant metastasis free survival and overall survival, outperforming traditional risk models and assisting treatment decisions such as androgen deprivation therapy (ADT) duration. Fifty-one and 35 experts responded to round 1 and round 2 of the survey respectively. Questions with ≥75 % agreement were considered relevant and included in the qualitative analysis. Survey results confirmed growing adoption of DP scanners, although regional differences in re-imbursement mechanisms and availability persist, with experts endorsing DP-AI's potential across localized, postoperative, and metastatic settings, though further prospective validation is needed. DP-AI tools show strong prognostic and predictive potential in various PCa by guiding patient stratification and optimising ADT duration in primary RT. Prospective studies and validation in cohorts using modern diagnostic and treatment methods are needed before broad clinical adoption.

Details

OriginalspracheEnglisch
Aufsatznummer111039
FachzeitschriftRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Jahrgang210
PublikationsstatusVeröffentlicht - Sept. 2025
Peer-Review-StatusJa

Externe IDs

Scopus 105010263448

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Androgen deprivation therapy, Artificial intelligence, Biomarkers, Digital pathology, Personalized medicine, Prostate cancer, Radiotherapy, Risk stratification, Treatment selection