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An artificial intelligence algorithm characterizes the deterioration of body composition from systemic therapy for patients with advanced prostate cancer

Skeletal muscle is a major determinant of functional status. The impact of advanced prostate cancer (aPC) systemic therapies on body composition is unknown. We identified aPC patients with serial PET-CTs receiving androgen deprivation therapy (ADT), androgen receptor pathway inhibitors (ARPI), chemotherapy, and/or Lutetium-177. An artificial intelligence algorithm quantified body composition changes from PET-CT images. Linear mixed effects models examined body composition changes over time by treatment type. The…

By the Truvace desk2 min read1 sourcePeer-reviewedTRV-2026-1416· cite & verify
An artificial intelligence algorithm characterizes the deterioration of body composition from systemic therapy for patients with advanced prostate cancer
The histology and histochemistry of man [electronic resource] : a treatise on the elements of composition and structure of the human body by Frey, Heinrich, 1822-1890 Barker, Arthur Edward James, 1850-1916 St. Thomas's Hospital. Medical School Library former owner King's College London. Public domain

In brief

Researchers used an artificial intelligence algorithm to measure body composition on PET-CT scans from patients with advanced prostate cancer. The dataset covered 2,342 scans from 468 patients who received androgen deprivation therapy, androgen receptor pathway inhibitors, chemotherapy, and/or Lutetium-177.

Skeletal muscle is a major determinant of functional status, yet the effect of these treatments on body composition had been unknown. Because the scans are already part of care for many of these patients, automated analysis could help flag those at risk of muscle wasting, though the abstract reports only associations in imaging data rather than patient functional outcomes.

Main points

  1. The analysis covered 2,342 PET-CT scans from 468 patients with advanced prostate cancer.
  2. Androgen deprivation therapy was associated with a 9% reduction in muscle density (-1.91 Hounsfield units).
  3. Androgen receptor pathway inhibitors were associated with an additional 6% reduction (-1.4 Hounsfield units).
  4. Lutetium-177 was associated with a subsequent 6% reduction (-1.3 Hounsfield units).

The gain

An automated PET-CT algorithm can measure body composition changes in advanced prostate cancer patients and identify those on systemic therapy who are at risk for muscle wasting.

The rundown

The study identified patients with serial PET-CT imaging who received androgen deprivation therapy, androgen receptor pathway inhibitors, chemotherapy, and/or Lutetium-177. The AI algorithm quantified body composition changes from these images, and linear mixed effects models assessed changes over time by treatment type.

On multivariable analysis, muscle density fell progressively across later stages of systemic therapy: 9% with androgen deprivation therapy, an additional 6% with androgen receptor pathway inhibitors, and a subsequent 6% with Lutetium-177. The authors describe this as a large longitudinal analysis of body composition in this population.

The authors conclude the findings support using an automated PET-CT algorithm to identify patients on systemic therapy at risk for muscle wasting.

Sources

  1. Peer-reviewedJNCI: Journal of the National Cancer Institute2026-10-01

The debate