Assessment of Radiomic Features of Metabolism in Advanced Prostate Cancer using Hyperpolarized 13C MRI with Whole Abdominopelvic Coverage

Motivation: Hyperpolarized (HP) 13C-pyruvate MRI can address limitations of PSMA-PET for monitoring therapy and evaluating treatment-emergent, lethal subtypes of prostate cancer. Goal(s): To establish and characterize a novel radiomics framework of tumor metabolism in advanced prostate cancer based on whole abdominopelvic HP MRI. Approach: We extracted 316 metabolic features from 16 patients. Following feature selection and classification, their prognostic values were evaluated using uni- and multivariate survival analyses. Results: Metabolic feature kPL,median (pyruvate-to-lactate conversion rate) significantly predicted both progression-free (p<0.01) and overall (p<0.05) survivals with longer median PFS (11.2 vs 0.5 months) and OS (NR vs 18.4 months) in the lower- vs higher-kPL subgroups. Impact: A novel radiomics framework based on whole abdominopelvic hyperpolarized 13C-pyruvate MRI extracted and evaluated 316 metabolic features of advanced prostate cancer. Selected features significantly predicted clinical outcome measures (PFS and OS), strongly supporting further investigation of their prognostic values.