Size of pelvic bone metastasis as a significant prognostic factor for metastatic prostate cancer patients



To investigate the potential prognostic value of image analysis of pelvic bone metastasis in newly diagnosed prostate cancer patients.


Data from 69 patients with both bone scintigraphy and pelvic CT images were selected for this analysis. Open source software (3D Slicer version 4.8.1.) was used for image analysis. Metastatic pelvic bone lesions were manually contoured, and radiomic features were extracted. As risk factors for overall survival (OS) and cause-specific survival (CSS), 105 radiomic features and clinical risk factors including age, initial prostate-specific antigen, Gleason score, TNM stage, lactate dehydrogenase (LDH), hemoglobin (Hb), alkaline phosphatase, extent of disease, visceral metastases, and radiotherapy were assessed by uni- and multivariate analyses.


Median follow-up was 41 months (range 0–157 months). Five-year overall survival and cause-specific survival rate were 37.9% and 43.5%, respectively. After multivariate analysis, LDH, Hb, and “maximum 2D diameter” defined as maximum tumor size in the axial plane were detected as risk factors for OS. Gleason sum, LDH, and maximum 2D diameter were detected as risk factors for CSS.


Maximum 2D diameter was detected as a significant prognostic factor for metastatic prostate cancer patients.

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Fig. 1

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available.



Overall survival


Cause-specific survival


Lactate dehydrogenase




Extent of disease


Alkaline phosphatase


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Author information




TH and HI drafted the manuscript. TH, KT, HT, SK, TK, MH, YW, and HI participated in the design of the study. TH and HI performed the statistical analysis. MI and TH supervised the study. TH, KT, HT, SK, TK, MH, YW, and HI collected medical information about this study.

Corresponding author

Correspondence to Hiromichi Ishiyama.

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The authors declare that they have no conflict of interest.

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This study was approved by the institutional review board of Kitasato University School of Medicine (B17-245). No consent was required as this study used anonymized registry data.

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Hayakawa, T., Tabata, K., Tsumura, H. et al. Size of pelvic bone metastasis as a significant prognostic factor for metastatic prostate cancer patients. Jpn J Radiol (2020).

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  • Prostate cancer
  • Radiomics
  • Bone metastasis
  • Computed tomography
  • Pelvis