CT Radiomics Adds No Benefit Over Volume Dynamics for Early Lesion Response in Metastatic Melanoma on Immunotherapy

CT radiomics offered no improvement over volume dynamics for predicting early lesion response in metastatic melanoma on immunotherapy, with both models achieving similar AUCs internally (0.86 vs 0.84) and externally (0.68).

• Radiomics model internal AUC 0.86 [95% CI 0.81-0.90] vs volume model 0.84 [0.78-0.88]; external AUC both 0.68, with no significant difference (equivalence margin ±0.05).
• Organ-specific analyses showed no significant improvement from adding radiomics for any lesion site.
• The external validation cohort included only 12 progression events, limiting generalizability; larger studies are required.

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