Prognostic Value of AI-Assisted Lesion Tracking on End-of-Treatment PSMA PET in mCRPC Patients Treated with ¹⁷⁷ Lu-PSMA: A Retrospective, Single-Center Study

This study aimed to explore the prognostic value of the artificial intelligence-assisted lesion tracking applied to prostate-specific membrane antigen (PSMA) PET in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with PSMA radiopharmaceutical therapy. <b>Methods:</b> TRAQinform IQ was applied to baseline and end-of-treatment ⁶⁸Ga-PSMA-11 PET scans from 20 patients with mCRPC treated with ¹⁷⁷Lu-PSMA-617. Lesion response parameters and the TRAQinform Profile score-designed for early treatment response assessment-were generated. Survival analyses were performed. <b>Results:</b> A higher percentage of "new" lesions was associated with a shorter overall survival (OS) (hazard ratio, 1.03; <i>P</i> = 0.002), whereas a higher percentage of "disappeared" lesions was linked to improved OS (hazard ratio, 0.98; <i>P</i> = 0.028). Patients with a TRAQinform Profile score of 2.7 or greater had a shorter OS than those with a score of less than 2.7 (10.9 mo vs. 44.3 mo; <i>P</i> = 0.027). <b>Conclusion:</b> Artificial intelligence-assisted lesion-tracking analysis of PSMA PET is prognostic for OS in patients with mCRPC undergoing PSMA radiopharmaceutical therapy.