Beyond the Tumor: Recurrence-Prone Radiomics for Prognostication in Negative PSMA PET/CT scans of Prostate Cancer

Fereshteh Yousefirizi; Sara Harsini; Mobin Mohebi; Ian Alberts; Tahir Yusufaly; Monica Luo; Hamid Abdollahi; Elmira Yazdani; Soheila Mirabedin; Maziar Sabouri; Parham Geramifar; Peyman Sheikhzadeh; Patrick Martineau; Don Wilson; Francois Benard; Carlos Uribe; Arman Rahmim

arXiv · 2603.19368

Beyond the Tumor: Recurrence-Prone Radiomics for Prognostication in Negative PSMA PET/CT scans of Prostate Cancer

Fereshteh Yousefirizi·Sara Harsini·Mobin Mohebi·Ian Alberts·Tahir Yusufaly·Monica Luo·Hamid Abdollahi·Elmira Yazdani·Soheila Mirabedin·Maziar Sabouri·Parham Geramifar·Peyman Sheikhzadeh·Patrick Martineau·Don Wilson·Francois Benard·Carlos Uribe·Arman Rahmim

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Abstract

In patients with biochemical recurrence of prostate cancer and negative PSMA PET/CT, radiomics features extracted from recurrence-prone organs can predict clinical progression and progression-free survival. In a cohort of 132 patients, combining PET/CT radiomics with clinical variables significantly improved prognostic performance (C-index 0.74 vs. 0.65). Model performance was influenced by reader diagnostic certainty and remained robust on external validation. These findings suggest that radiomics from visually negative scans capture subclinical disease and provide added value for risk stratification.

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Fereshteh Yousefirizi, Sara Harsini, Mobin Mohebi, Ian Alberts, Tahir Yusufaly, Monica Luo, Hamid Abdollahi, Elmira Yazdani, Soheila Mirabedin, Maziar Sabouri, Parham Geramifar, Peyman Sheikhzadeh, Patrick Martineau, Don Wilson, Francois Benard, Carlos Uribe, Arman Rahmim. 2026-03-19. Beyond the Tumor: Recurrence-Prone Radiomics for Prognostication in Negative PSMA PET/CT scans of Prostate Cancer. https://arxiv.org/abs/2603.19368

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