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Comparison of Predictive Performance of Three Lymph Node Staging Systems in Colorectal Signet Ring Cell Carcinoma Based on Machine Learning Model
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CT Radiomics Models Did Not Outperform Experts in Predicting [68Ga]Ga-PSMA-PET Positivity in Prostate Cancer Lymph

Thula Cannon Walter-Rittel1, Boris Gorodetski1, Alexander Hartenstein2

  • 1Department of Radiology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.

Current Oncology (Toronto, Ont.)
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PubMed
Summary
This summary is machine-generated.

Radiomic features from CT scans show potential for predicting prostate cancer lymph node metastasis when [68Ga]Ga-PSMA-PET/CT is unavailable. A simple CT density threshold of >27 HU effectively identified PSMA-positive lymph nodes.

Keywords:
computed tomography (CT)diagnostic imaginglymph node metastasisprostate cancerradiomics

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Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • [68Ga]Ga-PSMA-PET/CT is valuable for prostate cancer (PCa) staging but faces limitations in cost and availability.
  • This study explores using contrast-enhanced (CE) CT radiomics to predict PSMA-positive lymph nodes (LNs) as a surrogate for metastasis.

Purpose of the Study:

  • To evaluate the efficacy of radiomic features from CE-CT in predicting PSMA-positive LNs in PCa patients.
  • To compare the performance of radiomic models against expert uroradiologist assessments.

Main Methods:

  • Retrospective analysis of 447 PCa patients with 2537 segmented LNs.
  • Extraction and selection of radiomic features from CE-CT images.
  • Comparison of radiomic model performance with uroradiologist ratings on 417 LNs.

Main Results:

  • Radiomic models achieved 0.77-0.85 accuracy and 0.85-0.91 sensitivity.
  • Expert radiologists demonstrated higher accuracy (0.95) and specificity (0.97-0.98).
  • A CT density threshold >27 HU predicted PSMA-positive LNs with 0.79 accuracy and 0.87 sensitivity.

Conclusions:

  • Radiomic models did not surpass expert uroradiologists in predicting PSMA-positive LNs.
  • CT density >27 HU emerged as a predictive parameter for PSMA-positive LNs.
  • In resource-limited settings, CT-based radiomics may aid LN assessment for PCa staging.