Development of PSMA-PET-guided CT-based radiomic signature to predict biochemical recurrence after salvage radiotherapy
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
Abstract
Purpose: To develop a CT-based radiomic signature to predict biochemical recurrence (BCR) in prostate cancer patients after sRT guided by positron-emission tomography targeting prostate-specific membrane antigen (PSMA-PET). Material and methods: Consecutive patients, who underwent 68Ga-PSMA11-PET/CT-guided sRT from three high-volume centers in Germany, were included in this retrospective multicenter study. Patients had PET-positive local recurrences and were treated with intensity-modulated sRT. Radiomic features were extracted from volumes of interests on CT guided by focal PSMA-PET uptakes. After preprocessing, clinical, radiomics, and combined clinical-radiomic models were developed combining different feature reduction techniques and Cox proportional hazard models within a nested cross validation approach. Results: Among 99 patients, median interval until BCR was the radiomic models outperformed clinical models and combined clinical-radiomic models for prediction of BCR with a C-index of 0.71 compared to 0.53 and 0.63 in the test sets, respectively. In contrast to the other models, the radiomic model achieved significantly improved patient stratification in Kaplan-Meier analysis. The radiomic and clinical-radiomic model achieved a significantly better time-dependent net reclassification improvement index (0.392 and 0.762, respectively) compared to the clinical model. Decision curve analysis demonstrated a clinical net benefit for both models. Mean intensity was the most predictive radiomic feature. Conclusion: This is the first study to develop a PSMA-PET-guided CT-based radiomic model to predict BCR after sRT. The radiomic models outperformed clinical models and might contribute to guide personalized treatment decisions.
Details
Original language | English |
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Pages (from-to) | 2537-2547 |
Number of pages | 11 |
Journal | European journal of nuclear medicine and molecular imaging |
Volume | 50 (2023) |
Issue number | 8 |
Publication status | Published - 16 Mar 2023 |
Peer-reviewed | Yes |
External IDs
PubMed | 36929180 |
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ORCID | /0000-0002-7017-3738/work/146646026 |
Keywords
Sustainable Development Goals
ASJC Scopus subject areas
Keywords
- Outcome prediction, Personalization, Prostate cancer, PSMA-PET/CT, Radiomics, Salvage radiotherapy, Neoplasm Recurrence, Local/diagnostic imaging, Humans, Male, Prostatic Neoplasms/diagnostic imaging, Gallium Radioisotopes, Prostatectomy, Positron Emission Tomography Computed Tomography/methods, Gallium Isotopes