Bisphosphonates Reduce Fracture Risk in Prostate Cancer Patients on Androgen Deprivation Therapy, suggests study
Researchers have found in a large randomized trial that men with metastatic prostate cancer receiving androgen deprivation therapy (ADT) had a significantly lower risk of fractures when treated with a bisphosphonate alongside standard of care (SOC). The study was published in the Annals of Oncology journal by C. Jones and colleagues.
The PanEcho model was trained on transthoracic echocardiographic (TTE) data from routine practice at Yale New Haven Health System (YNHHS) between January 2016 and June 2022. The training data set consisted of 1.2 million echocardiographic videos across 32,265 TTE studies of 24,405 patients. Internal validation was performed using a temporally distinct YNHHS cohort between July to December 2022. Further, the model was externally validated on four different health care cohorts and made publicly available for wider assessment.
Training was performed using a multitask deep learning framework that could process both diagnostic classification and echocardiographic parameter estimation concurrently.
The performance of PanEcho was to be assessed using two main measures:
Area Under the Receiver Operating Characteristic Curve (AUC): For diagnostic condition classification
Mean Absolute Error (MAE): For echocardiographic parameter estimation
These AI-derived results were compared to cardiologists' interpretations obtained from standard clinical practice.
Key Findings
Diagnostic Accuracy:
PanEcho performed 18 tasks of diagnostic classification with a median AUC of 0.91 (interquartile range [IQR]: 0.88–0.93) in internal validation.
Parameter Estimation:
For 21 measurements of echocardiography, the median normalized mean absolute error was 0.13 (IQR: 0.10–0.18).
Left ventricular ejection fraction (LVEF): Estimated with mean absolute error of 4.2% (internal) and 4.5% (external).
Moderate or greater left ventricular systolic dysfunction detection: AUC of 0.98 (internal) and 0.99 (external).
Right ventricular systolic dysfunction: AUC of 0.93 (internal) and 0.94 (external).
Severe aortic stenosis: AUC of 0.98 (internal) and 1.00 (external).
Performance in Limited Protocols:
Abbreviated TTE cohort: 15 diagnosis tasks, median AUC of 0.91 (IQR: 0.87–0.94)
Emergency department point-of-care cohort: 14 diagnosis tasks, median AUC of 0.85 (IQR: 0.77–0.87).
The study showed the reliability of the AI model PanEcho in reading broad echocardiographic parameters and diagnostic labels for high accuracy with diverse clinical settings. These findings establish the feasibility of integrating PanEcho into standard cardiovascular imaging workflow particularly as an assistant to help streamline and standardize echocardiogram reporting.
Reference:
Jones, C., Dutey-Magni, P., Murphy, L. R., Murray, M. L., Brown, J. E., McCloskey, E., Brown, M., Amos, C. L., Gilbert, D. C., Jones, R. J., Cross, W., Matheson, D., Millman, R., Parmar, M. K. B., Attard, G., Sydes, M. R., Brown, L. C., James, N. D., Clarke, N. W., Sachdeva, A., … STAMPEDE Trial Investigators (2025). Fracture-related hospitalisations in newly diagnosed high-risk localised or metastatic hormone-sensitive prostate cancer: secondary analysis of the STAMPEDE phase 3 trials of docetaxel and zoledronic acid using healthcare systems data. Annals of oncology : official journal of the European Society for Medical Oncology, S0923-7534(25)00854-3. Advance online publication. https://doi.org/10.1016/j.annonc.2025.07.005
