Borys Katarzyna, Lodde Georg, Livingstone Elisabeth, Weishaupt Carsten, Römer Christian, Künnemann Marc-David, Helfen Anne, Zimmer Lisa, Galetzka Wolfgang, Haubold Johannes, Friedrich Christoph M, Umutlu Lale, Heindel Walter, Schadendorf Dirk, Hosch René, Nensa Felix
Institute for Artificial Intelligence in Medicine, University Hospital Essen, Girardetstraße 2, 245131, Essen, Germany.
Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
J Transl Med. 2025 May 12;23(1):532. doi: 10.1186/s12967-025-06507-1.
BACKGROUND: Accurate assessment of expected survival in melanoma patients is crucial for treatment decisions. This study explores deep learning-based body composition analysis to predict overall survival (OS) using baseline Computed Tomography (CT) scans and identify fully volumetric, prognostic body composition features. METHODS: A deep learning network segmented baseline abdomen and thorax CTs from a cohort of 495 patients. The Sarcopenia Index (SI), Myosteatosis Fat Index (MFI), and Visceral Fat Index (VFI) were derived and statistically assessed for prognosticating OS. External validation was performed with 428 patients. RESULTS: SI was significantly associated with OS on both CT regions: abdomen (P ≤ 0.0001, HR: 0.36) and thorax (P ≤ 0.0001, HR: 0.27), with lower SI associated with prolonged survival. MFI was also associated with OS on abdomen (P ≤ 0.0001, HR: 1.16) and thorax CTs (P ≤ 0.0001, HR: 1.08), where higher MFI was linked to worse outcomes. Lastly, VFI was associated with OS on abdomen CTs (P ≤ 0.001, HR: 1.90), with higher VFI linked to poor outcomes. External validation replicated these results. CONCLUSIONS: SI, MFI, and VFI showed substantial potential as prognostic factors for OS in malignant melanoma patients. This approach leveraged existing CT scans without additional procedural or financial burdens, highlighting the seamless integration of DL-based body composition analysis into standard oncologic staging routines.
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