Radiomics Models Predict Ablative Radiotherapy Response in Oligometastatic Disease

Oligometastatic disease is increasingly recognized as a distinct intermediate state of cancer between localized and widespread metastatic forms (17). Stereotactic ablative radiotherapy has emerged as a standard intervention for these patients, with prospective data indicating improvements in both progression-free and overall survival (8, 13). However, the clinical presentation of this disease is highly heterogeneous, encompassing de novo, oligoprogressive, and induced states that may respond differently to local therapy (1, 2). While conventional prognostic factors such as tumor diameter and primary histology provide some guidance, they often lack the precision needed to predict the biological response of individual lesions to high-dose radiation (8, 12). A new systematic analysis now evaluates whether advanced computational analysis of imaging data can bridge this gap in clinical decision-making.