Internal validation of THINKERS-PA for outcome prediction after pituitary adenoma radiosurgery
Authors' conclusion
THINKERS-PA provides an internally validated framework for individualized prediction of tumor, endocrine, and treatment-related outcomes after GKRS.
Study context
- Population
- Patients with pituitary adenomas treated with Gamma Knife radiosurgery (GKRS)
- Participants
- 125 patients
- Comparison
- Functioning vs Nonfunctioning
- Functioningn = 72
- Nonfunctioningn = 53
- Outcome
- Tumor progression, biochemical remission in functioning adenomas, and new hypopituitarism (discrete-time survival heads)
Methodological detailsretrospective, mixture-of-experts neural network, repeated nested 5-fold cross-validation
- Retrospective
- Mixture-of-experts neural network
- Repeated nested 5-fold cross-validation
Performance
As reported in the abstract
THINKERS-PA prediction performance (out-of-fold)
- Mean time-dependent AUC, progression
- 0.82
- Mean time-dependent AUC, biochemical remission
- 0.84
- Mean time-dependent AUC, hypopituitarism
- 0.81
- Integrated Brier score, progression
- 0.083
- Integrated Brier score, biochemical remission
- 0.143
- Integrated Brier score, hypopituitarism
- 0.119
- Calibration slope, progression
- 0.89
- Calibration slope, biochemical remission
- 0.91
- Calibration slope, hypopituitarism
- 0.87
- Censoring-aware mean absolute error, progression
- 10.7 months
- Censoring-aware mean absolute error, biochemical remission
- 8.6 months
- Censoring-aware mean absolute error, hypopituitarism
- 9.8 months
Secondary outcomes
Observed outcome rates
- Tumor progression
- 14.4%
- Biochemical remission in functioning adenomas
- 59.7%
- New hypopituitarism in patients at risk
- 25.0%
Dose-sweeping estimates within ± 1 Gy of delivered dose
- Patients with dose-sweeping estimate within ± 1 Gy of delivered dose
- 71%
Original publication
Internal validation of THINKERS-PA for outcome prediction after pituitary adenoma radiosurgery. Pituitary. Published 3 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →