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    oDigital pathology biomarkers for guiding radiotherapy-based treatment concepts in prostate cancer - a systematic review and expert consensus.
        
        Radiother. Oncol. 210:111039 (2025)
    
    
    
				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.
			
			
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        Publikationstyp
        Artikel: Journalartikel
    
 
    
        Dokumenttyp
        Wissenschaftlicher Artikel
    
 
     
    
    
        Schlagwörter
        Androgen Deprivation Therapy ; Artificial Intelligence ; Biomarkers ; Digital Pathology ; Personalized Medicine ; Prostate Cancer ; Radiotherapy ; Risk Stratification ; Treatment Selection; Artificial-intelligence; Trial; Validation; Therapy
    
 
     
    
    
        Sprache
        englisch
    
 
    
        Veröffentlichungsjahr
        2025
    
 
     
    
        HGF-Berichtsjahr
        2025
    
 
    
    
        ISSN (print) / ISBN
        0167-8140
    
 
    
        e-ISSN
        1879-0887
    
 
     
     
     
	     
	 
	 
    
        Zeitschrift
        Radiotherapy and Oncology
    
 
		
    
        Quellenangaben
        
	    Band: 210,  
	    
	    
	    Artikelnummer: 111039 
	    
	
    
 
  
         
        
            Verlag
            Elsevier
        
 
        
            Verlagsort
            Elsevier House, Brookvale Plaza, East Park Shannon, Co, Clare, 00000, Ireland
        
 
	
         
         
         
         
         
	
         
         
         
    
         
         
         
         
         
         
         
    
        Begutachtungsstatus
        Peer reviewed
    
 
    
        Institut(e)
        Institute of Radiation Medicine (IRM)
    
 
    
        POF Topic(s)
        30203 - Molecular Targets and Therapies
    
 
    
        Forschungsfeld(er)
        Radiation Sciences
    
 
    
        PSP-Element(e)
        G-501300-001
    
 
    
        Förderungen
        Cypriot research and Innovation Foundation as part of the EU framework of the Cohesion Policy Programme "THALIA 2021-2027"
    
 
     	
    
    
        WOS ID
        001545464100001
    
    
        WOS ID
        001543500700001
    
    
        Scopus ID
        105010263448
    
    
        PubMed ID
        40645505
    
    
        Erfassungsdatum
        2025-07-21