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Peer-Reviewed Publication
Cancers (Basel)2026;18(12)June 18, 2026Journal Article

A Multimodal Artificial Intelligence Model to Guide Use of Whole-Pelvic Radiation Therapy in Patients with Localized Prostate Cancer: Exploratory Analysis of RTOG 9413.

Mutlay Sayan1, Huei-Chung Huang2, Erin L Stewart2, Timothy N Showalter2,3, Adam P Dicker4, George Daniel Grass5, Elizabeth M Gore6, Andrew Michael McDonald7, J Daniel Pennington8,9, Mark A Hallman10, Igor J Barani11, I-Chow Hsu5, Michael Rooney12, Stephanie L Pugh13, Paul L Nguyen1, Phuoc T Tran12, Mack Roach Iii14
1Mass General Brigham and Dana-Farber Cancer Institute, Boston, MA 02115, USA.
2Artera, Los Altos, CA 94022, USA.
3UVA Comprehensive Cancer Center, Charlottesville, VA 22908, USA.
4Thomas Jefferson University, Philadelphia, PA 19107, USA.
5H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.
6Clement J Zablock VAMC and the Medical College of Wisconsin, Milwaukee, WI 53295, USA.
7University of Alabama at Birmingham, Birmingham, AL 35294, USA.
8Southeast Clinical Oncology Research Consortium NCORP, Winston Salem, NC 27103, USA.
9Virginia Urology, Richmond, VA 23235, USA.
10Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
11St. Joseph's Hospital & Medical Center, Phoenix, AZ 85013, USA.
12The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
13NRG Oncology Statistics and Data Management Center, Philadelphia, PA 19103, USA.
14UCSF Medical Center-Mount Zion, San Francisco, CA 94115, USA.
PubMed PMC DOI PDF

Abstract

Background/Objectives: This study explored whether a multimodal artificial intelligence (MMAI) model integrating digitized histopathology and clinical features can identify prostate cancer patients who may benefit from neoadjuvant hormonal therapy (NHT) and whole-pelvic radiotherapy (WPRT). Methods: This secondary analysis of NRG/RTOG 9413 included NHT-treated patients with digitized biopsy slides…

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