A system that automatically evaluates bone scans produces a measure that is prognostic for overall survival (OS) in patients with metastatic prostate cancer, investigators are reporting.
The automated bone scan index (BSI) produced by the artificial intelligence–based system provides prognostic discrimination beyond other established risk markers, investigators reported in.
The automated BSI also provides significantly greater discriminative ability compared with the current standard, which is manual assessment by counting metastatic lesion numbers, according to Andrew J. Armstrong, MD, of Duke University, Durham, N.C. and his coauthors.
“Incorporating the aBSI into clinical practice to supplement nuclear medicine reports may permit a more objective analysis of bone scan changes over time and their clinical relevance to patient care,” Dr. Armstrong and colleagues said.
The BSI represents tumor burden as a percentage of total skeletal weight. The system used in this study automates BSI methods by using artificial neural networks to detect metastatic hot spots and classify them as malignant or benign.
The automated system was evaluated in a preplanned secondary analysis of a randomized clinical trial of imiquimod in men with chemotherapy-naive metastatic castration-resistant prostate cancer. Evaluable bone scans were available for 721 out of 1,245 total enrollees from 241 sites in 37 countries.
In the secondary analysis, investigators found that baseline aBSI was significantly associated with OS. Risk of death increased by 20% for every doubling of the aBSI score (hazard ratio, 1.20; 95% confidence interval, 1.14-1.26; P less than .001).