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Miao S, Yu F, Sheng R, Zhang X, Li Y, Qi Y, Lu S, Ji P, Fan J, Zhang X, Xu T, Wang Z, Liu Y, Yang G. Radiomics of pericoronary adipose tissue on computed tomography angiography predicts coronary heart disease in patients with type 2 diabetes mellitus. BMC Cardiovasc Disord 2024; 24:300. [PMID: 38867152 PMCID: PMC11167783 DOI: 10.1186/s12872-024-03970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/04/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Diabetes is a common chronic metabolic disease. The progression of the disease promotes vascular inflammation and the formation of atherosclerosis, leading to cardiovascular disease. The coronary artery perivascular adipose tissue attenuation index based on CCTA is a new noninvasive imaging biomarker that reflects the spatial changes in perivascular adipose tissue attenuation in CCTA images and the inflammation around the coronary arteries. In this study, a radiomics approach is proposed to extract a large number of image features from CCTA in a high-throughput manner and combined with clinical diagnostic data to explore the predictive ability of vascular perivascular adipose imaging data based on CCTA for coronary heart disease in diabetic patients. METHODS R language was used for statistical analysis to screen the variables with significant differences. A presegmentation model was used for CCTA vessel segmentation, and the pericoronary adipose region was screened out. PyRadiomics was used to calculate the radiomics features of pericoronary adipose tissue, and SVM, DT and RF were used to model and analyze the clinical data and radiomics data. Model performance was evaluated using indicators such as PPV, FPR, AAC, and ROC. RESULTS The results indicate that there are significant differences in age, blood pressure, and some biochemical indicators between diabetes patients with and without coronary heart disease. Among 1037 calculated radiomic parameters, 18.3% showed significant differences in imaging omics features. Three modeling methods were used to analyze different combinations of clinical information, internal vascular radiomics information and pericoronary vascular fat radiomics information. The results showed that the dataset of full data had the highest ACC values under different machine learning models. The support vector machine method showed the best specificity, sensitivity, and accuracy for this dataset. CONCLUSIONS In this study, the clinical data and pericoronary radiomics data of CCTA were fused to predict the occurrence of coronary heart disease in diabetic patients. This provides information for the early detection of coronary heart disease in patients with diabetes and allows for timely intervention and treatment.
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Affiliation(s)
- Shumei Miao
- School of Computer Science and Engineering, Southeast University, Sipailou 2, Nanjing, 210096, Jiangsu, China
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Feihong Yu
- Department of Ultrasonic Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rongrong Sheng
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiaoliang Zhang
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yong Li
- Department of Cardiovascular Medicine Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yaolei Qi
- School of Computer Science and Engineering, Southeast University, Sipailou 2, Nanjing, 210096, Jiangsu, China
| | - Shan Lu
- Department of Nutritional Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Pei Ji
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiyue Fan
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Zhang
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tingyu Xu
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhongmin Wang
- Department of Information, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yun Liu
- Department of Geriatrics endocrinology, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Rd 300, Nanjing, 210096, Jiangsu, China.
| | - Guanyu Yang
- School of Computer Science and Engineering, Southeast University, Sipailou 2, Nanjing, 210096, Jiangsu, China.
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Varghese BA, Cen SY, Jensen K, Levy J, Andersen HK, Schulz A, Lei X, Duddalwar VA, Goodenough DJ. Technical and clinical considerations of a physical liver phantom for CT radiomics analysis. J Appl Clin Med Phys 2024; 25:e14309. [PMID: 38386922 PMCID: PMC11005983 DOI: 10.1002/acm2.14309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 01/17/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE This study identifies key characteristics to help build a physical liver computed tomography (CT) phantom for radiomics harmonization; particularly, the higher-order texture metrics. MATERIALS AND METHODS CT scans of a radiomics phantom comprising of 18 novel 3D printed inserts with varying size, shape, and material combinations were acquired on a 64-slice CT scanner (Brilliance 64, Philips Healthcare). The images were acquired at 120 kV, 250 mAs, CTDIvol of 16.36 mGy, 2 mm slice thickness, and iterative noise-reduction reconstruction (iDose, Philips Healthcare, Andover, MA). Radiomics analysis was performed using the Cancer Imaging Phenomics Toolkit (CaPTk), following automated segmentation of 3D regions of interest (ROI) of the 18 inserts. The findings were compared to three additional ROI obtained of an anthropomorphic liver phantom, a patient liver CT scan, and a water phantom, at comparable imaging settings. Percentage difference in radiomic metrics values between phantom and tissue was used to assess the biological equivalency and <10% was used to claim equivalent. RESULTS The HU for all 18 ROI from the phantom ranged from -30 to 120 which is within clinically observed HU range of the liver, showing that our phantom material (T3-6B) is representative of biological CT tissue densities (liver) with >50% radiomic features having <10% difference from liver tissue. Based on the assessment of the Neighborhood Gray Tone Difference Matrix (NGTDM) metrics it is evident that the water phantom ROI show extreme values compared to the ROIs from the phantom. This result may further reinforce the difference between a structureless quantity such as water HU values and tissue HU values found in liver. CONCLUSION The 3-D printed patterns of the constructed radiomics phantom cover a wide span of liver tissue textures seen in CT images. Using our results, texture metrics can be selectively harmonized to establish clinically relevant and reliable radiomics panels.
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Affiliation(s)
- Bino Abel Varghese
- Department of RadiologyKeck Medical CenterUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Steven Yong Cen
- Department of RadiologyKeck Medical CenterUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Kristin Jensen
- Department of Physics and Computational RadiologyOslo University HospitalOsloNorway
| | | | | | - Anselm Schulz
- Department of Radiology and Nuclear MedicineOslo University HospitalOsloNorway
| | - Xiaomeng Lei
- Department of RadiologyKeck Medical CenterUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Vinay Anant Duddalwar
- Department of RadiologyKeck Medical CenterUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
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Huynh LM, Hwang Y, Taylor O, Baine MJ. The Use of MRI-Derived Radiomic Models in Prostate Cancer Risk Stratification: A Critical Review of Contemporary Literature. Diagnostics (Basel) 2023; 13:diagnostics13061128. [PMID: 36980436 PMCID: PMC10047271 DOI: 10.3390/diagnostics13061128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
The development of precise medical imaging has facilitated the establishment of radiomics, a computer-based method of quantitatively analyzing subvisual imaging characteristics. The present review summarizes the current literature on the use of diagnostic magnetic resonance imaging (MRI)-derived radiomics in prostate cancer (PCa) risk stratification. A stepwise literature search of publications from 2017 to 2022 was performed. Of 218 articles on MRI-derived prostate radiomics, 33 (15.1%) generated models for PCa risk stratification. Prediction of Gleason score (GS), adverse pathology, postsurgical recurrence, and postradiation failure were the primary endpoints in 15 (45.5%), 11 (33.3%), 4 (12.1%), and 3 (9.1%) studies. In predicting GS and adverse pathology, radiomic models differentiated well, with receiver operator characteristic area under the curve (ROC-AUC) values of 0.50–0.92 and 0.60–0.92, respectively. For studies predicting post-treatment recurrence or failure, ROC-AUC for radiomic models ranged from 0.73 to 0.99 in postsurgical and radiation cohorts. Finally, of the 33 studies, 7 (21.2%) included external validation. Overall, most investigations showed good to excellent prediction of GS and adverse pathology with MRI-derived radiomic features. Direct prediction of treatment outcomes, however, is an ongoing investigation. As these studies mature and reach potential for clinical integration, concerted effort to validate these radiomic models must be undertaken.
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Affiliation(s)
- Linda My Huynh
- Department of Radiation Oncology, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, 987521 Nebraska Medical Center, Omaha, NE 68198-7521, USA
- Department of Urology, University of California, Orange, CA 92868, USA
| | - Yeagyeong Hwang
- Department of Urology, University of California, Orange, CA 92868, USA
| | - Olivia Taylor
- Department of Radiation Oncology, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, 987521 Nebraska Medical Center, Omaha, NE 68198-7521, USA
| | - Michael J. Baine
- Department of Radiation Oncology, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, 987521 Nebraska Medical Center, Omaha, NE 68198-7521, USA
- Correspondence:
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Li G, Zhang X, Song X, Duan L, Wang G, Xiao Q, Li J, Liang L, Bai L, Bai S. Machine learning for predicting accuracy of lung and liver tumor motion tracking using radiomic features. Quant Imaging Med Surg 2023; 13:1605-1618. [PMID: 36915317 PMCID: PMC10006135 DOI: 10.21037/qims-22-621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 12/02/2022] [Indexed: 01/11/2023]
Abstract
Background Internal tumor motion is commonly predicted using external respiratory signals. However, the internal/external correlation is complex and patient-specific. The purpose of this study was to develop various models based on the radiomic features of computed tomography (CT) images to predict the accuracy of tumor motion tracking using external surrogates and to find accurate and reliable tracking algorithms. Methods Images obtained from a total of 108 and 71 patients pathologically diagnosed with lung and liver cancers, respectively, were examined. Real-time position monitoring motion was fitted to tumor motion, and samples with fitting errors greater than 2 mm were considered positive. Radiomic features were extracted from internal target volumes of average intensity projections, and cross-validation least absolute shrinkage and selection operator (LassoCV) was used to conduct feature selection. Based on the radiomic features, a total of 26 separate models (13 for the lung and 13 for the liver) were trained and tested. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were used to assess performance. Relative standard deviation was used to assess stability. Results Thirty-three and 22 radiomic features were selected for the lung and liver, respectively. For the lung, the AUC varied from 0.848 (decision tree) to 0.941 [support vector classifier (SVC), logistic regression]; sensitivity varied from 0.723 (extreme gradient boosting) to 0.848 [linear support vector classifier (linearSVC)]; specificity varied from 0.834 (gaussian naive bayes) to 0.936 [multilayer perceptron (MLP), wide and deep (W&D)]; and MLP and W&D had better performance and stability than the median. For the liver, the AUC varied from 0.677 [light gradient boosting machine (Light)] to 0.892 (logistic regression); sensitivity varied from 0.717 (W&D) to 0.862 (MLP); specificity varied from 0.566 (Light) to 0.829 (linearSVC); and logistic regression, MLP, and SVC had better performance and stability than the median. Conclusions Respiratory-sensitive radiomic features extracted from CT images of lung and liver tumors were proved to contain sufficient information to establish an external/internal motion relationship. We developed a rapid and accurate method based on radiomics to classify the accuracy of monitoring a patient's external surface for lung and liver tumor tracking. Several machine learning algorithms-in particular, MLP-demonstrated excellent classification performance and stability.
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Affiliation(s)
- Guangjun Li
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangyu Zhang
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Xinyu Song
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Lian Duan
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Guangyu Wang
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Xiao
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Lan Liang
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Long Bai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Sen Bai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Zhang X, Song X, Li G, Duan L, Wang G, Dai G, Song Y, Li J, Bai S. Machine Learning Radiomics Model for External and Internal Respiratory Motion Correlation Prediction in Lung Tumor. Technol Cancer Res Treat 2022; 21:15330338221143224. [PMID: 36476136 PMCID: PMC9742719 DOI: 10.1177/15330338221143224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives: The complexity and specificity of lung tumor motion render it necessary to determine the external and internal correlation individually before applying indirect tumor tracking. However, the correlation cannot be determined from patient respiratory and tumor clinical characteristics before treatment. The purpose of this study is to present a machine learning model for an external/internal correlation prediction that is based on computed tomography (CT) radiomic features. Methods: 4-dimensional computed tomography (4DCT) images of 67 patients were collected retrospectively, and the external/internal correlation of lung tumor was calculated based on Spearman's rank correlation coefficient. Radiomic features were extracted from average intensity projection and the light gradient boosting machine (LightGBM)-based cross-validation (the recursive elimination method) was used for feature selection. The LightGBM framework forecasting models with classification thresholds 0.7, 0.8, and 0.9 are established using stratified 5-fold cross-validation. Model performance was assessed using receiver operating characteristics, sensitivity, and specificity. Results: There were 16, 18, and 13 features selected for models 0.7, 0.8, and 0.9, respectively. Texture features are of great importance in external/internal correlation prediction compared to other features in all models. The sensitivities of the predictions in models 0.7, 0.8, and 0.9 were 0.800 ± 0.126, 0.829 ± 0.140, and 0.864 ± 0.086, respectively. The specificities were 0.771 ± 0.114, 0.936 ± 0.0581, and 0.839 ± 0.101, whereas the area under the curve (AUC) was 0.837, 0.946, and 0.877, respectively. Conclusions: Our findings indicate that radiomics is an effective tool for respiratory motion correlation prediction, which can extract tumor motion characteristics. We proposed a machine learning framework for correlation prediction in the motion management strategy for lung tumor patients.
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Affiliation(s)
- Xiangyu Zhang
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xinyu Song
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China,Department of Radiation Oncology, Cancer Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guangjun Li
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lian Duan
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Guangyu Wang
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Guyu Dai
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Song
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Sen Bai
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China,Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China,Sen Bai, MS, Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Guangjun Li, MS, Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
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Feng H, Wang H, Xu L, Ren Y, Ni Q, Yang Z, Ma S, Deng Q, Chen X, Xia B, Kuang Y, Li X. Prediction of radiation-induced acute skin toxicity in breast cancer patients using data encapsulation screening and dose-gradient-based multi-region radiomics technique: A multicenter study. Front Oncol 2022; 12:1017435. [PMID: 36439515 PMCID: PMC9686850 DOI: 10.3389/fonc.2022.1017435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
Purpose Radiation-induced dermatitis is one of the most common side effects for breast cancer patients treated with radiation therapy (RT). Acute complications can have a considerable impact on tumor control and quality of life for breast cancer patients. In this study, we aimed to develop a novel quantitative high-accuracy machine learning tool for prediction of radiation-induced dermatitis (grade ≥ 2) (RD 2+) before RT by using data encapsulation screening and multi-region dose-gradient-based radiomics techniques, based on the pre-treatment planning computed tomography (CT) images, clinical and dosimetric information of breast cancer patients. Methods and Materials 214 patients with breast cancer who underwent RT between 2018 and 2021 were retrospectively collected from 3 cancer centers in China. The CT images, as well as the clinical and dosimetric information of patients were retrieved from the medical records. 3 PTV dose related ROIs, including irradiation volume covered by 100%, 105%, and 108% of prescribed dose, combined with 3 skin dose-related ROIs, including irradiation volume covered by 20-Gy, 30-Gy, 40-Gy isodose lines within skin, were contoured for radiomics feature extraction. A total of 4280 radiomics features were extracted from all 6 ROIs. Meanwhile, 29 clinical and dosimetric characteristics were included in the data analysis. A data encapsulation screening algorithm was applied for data cleaning. Multiple-variable logistic regression and 5-fold-cross-validation gradient boosting decision tree (GBDT) were employed for modeling training and validation, which was evaluated by using receiver operating characteristic analysis. Results The best predictors for symptomatic RD 2+ were the combination of 20 radiomics features, 8 clinical and dosimetric variables, achieving an area under the curve (AUC) of 0.998 [95% CI: 0.996-1.0] and an AUC of 0.911 [95% CI: 0.838-0.983] in the training and validation dataset, respectively, in the 5-fold-cross-validation GBDT model. Meanwhile, the top 12 most important characteristics as well as their corresponding importance measures for RD 2+ prediction in the GBDT machine learning process were identified and calculated. Conclusions A novel multi-region dose-gradient-based GBDT machine learning framework with a random forest based data encapsulation screening method integrated can achieve a high-accuracy prediction of acute RD 2+ in breast cancer patients.
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Affiliation(s)
- Huichun Feng
- Medical Imaging and Translational Medicine Laboratory, Hangzhou Cancer Center, Hangzhou, China
- Patient follow-up center, Hangzhou Cancer Hospital, Hangzhou, China
| | - Hui Wang
- Medical Imaging and Translational Medicine Laboratory, Hangzhou Cancer Center, Hangzhou, China
- Department of Radiotherapy, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lixia Xu
- Medical Imaging and Translational Medicine Laboratory, Hangzhou Cancer Center, Hangzhou, China
- Department of Radiotherapy, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yao Ren
- Medical Imaging and Translational Medicine Laboratory, Hangzhou Cancer Center, Hangzhou, China
- Department of Radiotherapy, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qianxi Ni
- Department of Radiology, Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Zhen Yang
- Department of Radiotherapy, Xiangya Hospital Central South University, Changsha, China
| | - Shenglin Ma
- Medical Imaging and Translational Medicine Laboratory, Hangzhou Cancer Center, Hangzhou, China
- Medical Oncology, Xiaoshan Hospital Affiliated to Hangzhou Normal University, Hangzhou, China
| | - Qinghua Deng
- Medical Imaging and Translational Medicine Laboratory, Hangzhou Cancer Center, Hangzhou, China
- Patient follow-up center, Hangzhou Cancer Hospital, Hangzhou, China
| | - Xueqin Chen
- Medical Imaging and Translational Medicine Laboratory, Hangzhou Cancer Center, Hangzhou, China
- Patient follow-up center, Hangzhou Cancer Hospital, Hangzhou, China
| | - Bing Xia
- Medical Imaging and Translational Medicine Laboratory, Hangzhou Cancer Center, Hangzhou, China
- Patient follow-up center, Hangzhou Cancer Hospital, Hangzhou, China
| | - Yu Kuang
- Medical Physics Program, University of Nevada, Las Vegas, NV, United States
- *Correspondence: Xiadong Li, ; Yu Kuang,
| | - Xiadong Li
- Medical Imaging and Translational Medicine Laboratory, Hangzhou Cancer Center, Hangzhou, China
- Department of Radiotherapy, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Xiadong Li, ; Yu Kuang,
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Teo PT, Bajaj A, Randall J, Lou B, Shah J, Gopalakrishnan M, Kamen A, Abazeed ME. Deterministic small-scale undulations of image-based risk predictions from the deep learning of lung tumors in motion. Med Phys 2022; 49:7347-7356. [PMID: 35962958 PMCID: PMC10115400 DOI: 10.1002/mp.15869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Deep learning (DL) models that use medical images to predict clinical outcomes are poised for clinical translation. For tumors that reside in organs that move, however, the impact of motion (i.e., degenerated object appearance or blur) on DL model accuracy remains unclear. We examine the impact of tumor motion on an image-based DL framework that predicts local failure risk after lung stereotactic body radiotherapy (SBRT). METHODS We input pre-therapy free breathing (FB) computed tomography (CT) images from 849 patients treated with lung SBRT into a multitask deep neural network to generate an image fingerprint signature (or DL score) that predicts time-to-event local failure outcomes. The network includes a convolutional neural network encoder for extracting imaging features and building a task-specific fingerprint, a decoder for estimating handcrafted radiomic features, and a task-specific network for generating image signature for radiotherapy outcome prediction. The impact of tumor motion on the DL scores was then examined for a holdout set of 468 images from 39 patients comprising: (1) FB CT, (2) four-dimensional (4D) CT, and (3) maximum-intensity projection (MIP) images. Tumor motion was estimated using a 3D vector of the maximum distance traveled, and its association with DL score variance was assessed by linear regression. FINDINGS The variance and amplitude in 4D CT image-derived DL scores were associated with tumor motion (R2 = 0.48 and 0.46, respectively). Specifically, DL score variance was deterministic and represented by sinusoidal undulations in phase with the respiratory cycle. DL scores, but not tumor volumes, peaked near end-exhalation. The mean of the scores derived from 4D CT images and the score obtained from FB CT images were highly associated (Pearson r = 0.99). MIP-derived DL scores were significantly higher than 4D- or FB-derived risk scores (p < 0.0001). INTERPRETATION An image-based DL risk score derived from a series of 4D CT images varies in a deterministic, sinusoidal trajectory in a phase with the respiratory cycle. These results indicate that DL models of tumors in motion can be robust to fluctuations in object appearance due to movement and can guide standardization processes in the clinical translation of DL models for patients with lung cancer.
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Affiliation(s)
- P Troy Teo
- Department of Radiation Oncology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Amishi Bajaj
- Department of Radiation Oncology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - James Randall
- Department of Radiation Oncology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bin Lou
- Digital Technology and Innovation Division, Siemens Healthineers, Princeton, New Jersey, USA
| | - Jainil Shah
- Diagnostic Imaging Computed Tomography, Siemens Healthineers, Malvern, Pennsylvania, USA
| | - Mahesh Gopalakrishnan
- Department of Radiation Oncology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ali Kamen
- Digital Technology and Innovation Division, Siemens Healthineers, Princeton, New Jersey, USA
| | - Mohamed E Abazeed
- Department of Radiation Oncology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA
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Radiomic and Volumetric Measurements as Clinical Trial Endpoints—A Comprehensive Review. Cancers (Basel) 2022; 14:cancers14205076. [PMID: 36291865 PMCID: PMC9599928 DOI: 10.3390/cancers14205076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary The extraction of quantitative data from standard-of-care imaging modalities offers opportunities to improve the relevance and salience of imaging biomarkers used in drug development. This review aims to identify the challenges and opportunities for discovering new imaging-based biomarkers based on radiomic and volumetric assessment in the single-site solid tumor sites: breast cancer, rectal cancer, lung cancer and glioblastoma. Developing approaches to harmonize three essential areas: segmentation, validation and data sharing may expedite regulatory approval and adoption of novel cancer imaging biomarkers. Abstract Clinical trials for oncology drug development have long relied on surrogate outcome biomarkers that assess changes in tumor burden to accelerate drug registration (i.e., Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) criteria). Drug-induced reduction in tumor size represents an imperfect surrogate marker for drug activity and yet a radiologically determined objective response rate is a widely used endpoint for Phase 2 trials. With the addition of therapies targeting complex biological systems such as immune system and DNA damage repair pathways, incorporation of integrative response and outcome biomarkers may add more predictive value. We performed a review of the relevant literature in four representative tumor types (breast cancer, rectal cancer, lung cancer and glioblastoma) to assess the preparedness of volumetric and radiomics metrics as clinical trial endpoints. We identified three key areas—segmentation, validation and data sharing strategies—where concerted efforts are required to enable progress of volumetric- and radiomics-based clinical trial endpoints for wider clinical implementation.
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Song R, Cui Y, Ren J, Zhang J, Yang Z, Li D, Li Z, Yang X. CT-based radiomics analysis in the prediction of response to neoadjuvant chemotherapy in locally advanced gastric cancer: A dual-center study. Radiother Oncol 2022; 171:155-163. [DOI: 10.1016/j.radonc.2022.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/26/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
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Yang M, Cao Q, Xu Z, Ge Y, Li S, Yan F, Yang W. Development and Validation of a Machine Learning-Based Radiomics Model on Cardiac Computed Tomography of Epicardial Adipose Tissue in Predicting Characteristics and Recurrence of Atrial Fibrillation. Front Cardiovasc Med 2022; 9:813085. [PMID: 35310976 PMCID: PMC8927627 DOI: 10.3389/fcvm.2022.813085] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose This study aimed to evaluate the feasibility of differentiating the atrial fibrillation (AF) subtype and preliminary explore the prognostic value of AF recurrence after ablation using radiomics models based on epicardial adipose tissue around the left atrium (LA-EAT) of cardiac CT images. Method The cardiac CT images of 314 patients were collected wherein 251 and 63 cases were randomly enrolled in the training and validation cohorts, respectively. Mutual information and the random forest algorithm were used to screen for the radiomic features and construct the radiomics signature. Radiomics models reflecting the features of LA-EAT were built to differentiate the AF subtype, and the multivariable logistic regression model was adopted to integrate the radiomics signature and volume information. The same methodology and algorithm were applied to the radiomic features to explore the ability for predicting AF recurrence. Results The predictive model constructed by integrating the radiomic features and volume information using a radiomics nomogram showed the best ability in differentiating AF subtype in the training [AUC, 0.915; 95% confidence interval (CI), 0.880–0.951] and validation (AUC, 0.853; 95% CI, 0.755–0.951) cohorts. The radiomic features have shown convincible predictive ability of AF recurrence in both training (AUC, 0.808; 95% CI, 0.750–0.866) and validation (AUC, 0.793; 95% CI, 0.654–0.931) cohorts. Conclusions The LA-EAT radiomic signatures are a promising tool in the differentiation of AF subtype and prediction of AF recurrence, which may have clinical implications in the early diagnosis of AF subtype and disease management.
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Affiliation(s)
- Min Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiqi Cao
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhihan Xu
- Siemens Healthineers Computed Tomography (CT) Collaboration, Shanghai, China
| | - Yingqian Ge
- Siemens Healthineers Computed Tomography (CT) Collaboration, Shanghai, China
| | - Shujiao Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjie Yang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Wenjie Yang
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11
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Adachi T, Nagasawa R, Nakamura M, Kakino R, Mizowaki T. Vulnerabilities of radiomic features to respiratory motion on four-dimensional computed tomography-based average intensity projection images: A phantom study. J Appl Clin Med Phys 2022; 23:e13498. [PMID: 35088515 PMCID: PMC8906211 DOI: 10.1002/acm2.13498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 05/11/2021] [Accepted: 09/11/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To evaluate the influence of respiratory motion on the robustness of radiomic features on four-dimensional computed tomography (4DCT)-based average intensity projection (AIP) images by employing an anthropomorphic chest phantom. METHODS Three spherical objects (φ30 mm), namely, acrylic (100 Hounsfield unit [HU], homogeneous), rubber (-140 HU, homogeneous), and cork (-630 HU, heterogeneous), were moved with motion amplitudes of 0, 1, 2.5, 4, 6, 8, and 10 mm in the phantom, and 4DCT scans were repeated at four different locations. Thereafter, the AIP images were generated considering the average of the 10 respiratory phases of the 4DCT images. Further, the targets were manually delineated on the AIP images in the lung window setting. A total of 851 radiomic features, including 107 unfiltered features and 744 wavelet filter-based features, were extracted from the region of interest for each material. The feature robustness among the different target motion amplitude (ε) was evaluated by normalizing the feature variability of the target motion relative to the variability of data from 573 patients with early-stage non-small cell lung cancer. The features with absolute ε values ≤0.5 were considered highly robust to target motions. RESULTS The percentage of robust unfiltered and wavelet filter-based features with a motion amplitude of 1 mm was greater than 83.2% and 93.4%, respectively; however, the percentage decreased by more than 24.3% and 17.6%, respectively, for motion amplitudes greater than 2.5 mm. The movement of cork had a small effect on the feature robustness compared to that of acrylic and rubber, regardless of the target motion amplitudes. CONCLUSIONS Our phantom study demonstrated that target motion amplitudes ≤1 mm led to the robustness of radiomic features on the 4DCT-based AIP images of thoracic regions. The frequency components and directions of the wavelet filters may be essential factors in 4DCT-based radiomic analysis.
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Affiliation(s)
- Takanori Adachi
- Division of Medical Physics, Department of Information Technology and Medical Engineering, Human Health Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan.,Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan
| | - Ryoko Nagasawa
- Division of Medical Physics, Department of Information Technology and Medical Engineering, Human Health Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan
| | - Mitsuhiro Nakamura
- Division of Medical Physics, Department of Information Technology and Medical Engineering, Human Health Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan.,Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan
| | - Ryo Kakino
- Division of Medical Physics, Department of Information Technology and Medical Engineering, Human Health Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan.,Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Sakyo-ku, Japan
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12
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Radiomics for Predicting Lung Cancer Outcomes Following Radiotherapy: A Systematic Review. Clin Oncol (R Coll Radiol) 2021; 34:e107-e122. [PMID: 34763965 DOI: 10.1016/j.clon.2021.10.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/24/2021] [Accepted: 10/14/2021] [Indexed: 12/13/2022]
Abstract
Lung cancer's radiomic phenotype may potentially inform clinical decision-making with respect to radical radiotherapy. At present there are no validated biomarkers available for the individualisation of radical radiotherapy in lung cancer and the mortality rate of this disease remains the highest of all other solid tumours. MEDLINE was searched using the terms 'radiomics' and 'lung cancer' according to the Preferred Reporting Items for Systematic Reviews and Met-Analyses (PRISMA) guidance. Radiomics studies were defined as those manuscripts describing the extraction and analysis of at least 10 quantifiable imaging features. Only those studies assessing disease control, survival or toxicity outcomes for patients with lung cancer following radical radiotherapy ± chemotherapy were included. Study titles and abstracts were reviewed by two independent reviewers. The Radiomics Quality Score was applied to the full text of included papers. Of 244 returned results, 44 studies met the eligibility criteria for inclusion. End points frequently reported were local (17%), regional (17%) and distant control (31%), overall survival (79%) and pulmonary toxicity (4%). Imaging features strongly associated with clinical outcomes include texture features belonging to the subclasses Gray level run length matrix, Gray level co-occurrence matrix and kurtosis. The median cohort size for model development was 100 (15-645); in the 11 studies with external validation in a separate independent population, the median cohort size was 84 (21-295). The median number of imaging features extracted was 184 (10-6538). The median Radiomics Quality Score was 11% (0-47). Patient-reported outcomes were not incorporated within any studies identified. No studies externally validated a radiomics signature in a registered prospective study. Imaging-derived indices attained through radiomic analyses could equip thoracic oncologists with biomarkers for treatment response, patterns of failure, normal tissue toxicity and survival in lung cancer. Based on routine scans, their non-invasive nature and cost-effectiveness are major advantages over conventional pathological assessment. Improved tools are required for the appraisal of radiomics studies, as significant barriers to clinical implementation remain, such as standardisation of input scan data, quality of reporting and external validation of signatures in randomised, interventional clinical trials.
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13
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On dose cube pixel spacing pre-processing for features extraction stability in dosiomic studies. Phys Med 2021; 90:108-114. [PMID: 34600351 DOI: 10.1016/j.ejmp.2021.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 09/06/2021] [Accepted: 09/17/2021] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Dosiomics allows to parameterize regions of interest (ROIs) and to produce quantitative dose features encoding the spatial and statistical distribution of radiotherapy dose. The stability of dosiomics features extraction on dose cube pixel spacing variation has been investigated in this study. MATERIAL AND METHODS Based on 17 clinical delivered dose distributions (Pn), dataset has been generated considering all the possible combinations of four dose grid resolutions and two calculation algorithms. Each dose voxel cube has been post-processed considering 4 different dose cube pixel spacing values: 1x1x1, 2x2x2, 3x3x3 mm3 and the one equal to the planning CT. Dosiomics features extraction has been performed from four different ROIs. The stability of each extracted dosiomic feature has been analyzed in terms of coefficient of variation (CV) intraclass correlation coefficient (ICC). RESULTS The highest CV mean values were observed for PTV ROI and for the grey level size zone matrix features family. On the other hand, the lowest CV mean values have been found for RING ROI for the grey level co-occurrence matrix features family. P3 showed the highest percentage of CV >1 (1.14%) followed by P15 (0.41%), P1 (0.29%) and P13 (0.19%). ICC analysis leads to identify features with an ICC >0.95 that could be considered stable to use in dosiomic studies when different dose cube pixel spacing are considered, especially the features in common among the seventeen plans. CONCLUSION Considering the observed variability, dosiomic studies should always provide a report not only on grid resolution and algorithm dose calculation, but also on dose cube pixel spacing.
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14
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Shur JD, Doran SJ, Kumar S, Ap Dafydd D, Downey K, O'Connor JPB, Papanikolaou N, Messiou C, Koh DM, Orton MR. Radiomics in Oncology: A Practical Guide. Radiographics 2021; 41:1717-1732. [PMID: 34597235 PMCID: PMC8501897 DOI: 10.1148/rg.2021210037] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Radiomics refers to the extraction of mineable data from medical imaging
and has been applied within oncology to improve diagnosis,
prognostication, and clinical decision support, with the goal of
delivering precision medicine. The authors provide a practical approach
for successfully implementing a radiomic workflow from planning and
conceptualization through manuscript writing. Applications in oncology
typically are either classification tasks that involve computing the
probability of a sample belonging to a category, such as benign versus
malignant, or prediction of clinical events with a time-to-event
analysis, such as overall survival. The radiomic workflow is
multidisciplinary, involving radiologists and data and imaging
scientists, and follows a stepwise process involving tumor segmentation,
image preprocessing, feature extraction, model development, and
validation. Images are curated and processed before segmentation, which
can be performed on tumors, tumor subregions, or peritumoral zones.
Extracted features typically describe the distribution of signal
intensities and spatial relationship of pixels within a region of
interest. To improve model performance and reduce overfitting, redundant
and nonreproducible features are removed. Validation is essential to
estimate model performance in new data and can be performed iteratively
on samples of the dataset (cross-validation) or on a separate hold-out
dataset by using internal or external data. A variety of noncommercial
and commercial radiomic software applications can be used. Guidelines
and artificial intelligence checklists are useful when planning and
writing up radiomic studies. Although interest in the field continues to
grow, radiologists should be familiar with potential pitfalls to ensure
that meaningful conclusions can be drawn. Online supplemental material is available for this
article. Published under a CC BY 4.0 license.
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Affiliation(s)
- Joshua D Shur
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Simon J Doran
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Santosh Kumar
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Derfel Ap Dafydd
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Kate Downey
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - James P B O'Connor
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Nikolaos Papanikolaou
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Christina Messiou
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Dow-Mu Koh
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Matthew R Orton
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
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15
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Wong J, Baine M, Wisnoskie S, Bennion N, Zheng D, Yu L, Dalal V, Hollingsworth MA, Lin C, Zheng D. Effects of interobserver and interdisciplinary segmentation variabilities on CT-based radiomics for pancreatic cancer. Sci Rep 2021; 11:16328. [PMID: 34381070 PMCID: PMC8357939 DOI: 10.1038/s41598-021-95152-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/16/2021] [Indexed: 02/06/2023] Open
Abstract
Radiomics is a method to mine large numbers of quantitative imaging features and develop predictive models. It has shown exciting promise for improved cancer decision support from early detection to personalized precision treatment, and therefore offers a desirable new direction for pancreatic cancer where the mortality remains high despite the current care and intense research. For radiomics, interobserver segmentation variability and its effect on radiomic feature stability is a crucial consideration. While investigations have been reported for high-contrast cancer sites such as lung cancer, no studies to date have investigated it on CT-based radiomics for pancreatic cancer. With three radiation oncology observers and three radiology observers independently contouring on the contrast CT of 21 pancreatic cancer patients, we conducted the first interobserver segmentation variability study on CT-based radiomics for pancreatic cancer. Moreover, our novel investigation assessed whether there exists an interdisciplinary difference between the two disciplines. For each patient, a consensus tumor volume was generated using the simultaneous truth and performance level expectation algorithm, using the dice similarity coefficient (DSC) to assess each observer's delineation against the consensus volume. Radiation oncology observers showed a higher average DSC of 0.81 ± 0.06 than the radiology observers at 0.69 ± 0.16 (p = 0.002). On a panel of 1277 radiomic features, the intraclass correlation coefficients (ICC) was calculated for all observers and those of each discipline. Large variations of ICCs were observed for different radiomic features, but ICCs were generally higher for the radiation oncology group than for the radiology group. Applying a threshold of ICC > 0.75 for considering a feature as stable, 448 features (35%) were found stable for the radiation oncology group and 214 features (16%) were stable from the radiology group. Among them, 205 features were found stable for both groups. Our results provide information for interobserver segmentation variability and its effect on CT-based radiomics for pancreatic cancer. An interesting interdisciplinary variability found in this study also introduces new considerations for the deployment of radiomics models.
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Affiliation(s)
- Jeffrey Wong
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael Baine
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sarah Wisnoskie
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Nathan Bennion
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Dechun Zheng
- Department of Radiology, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Lei Yu
- Department of Radiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Vipin Dalal
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael A Hollingsworth
- Eppley Institute for Research in Cancer, University of Nebraska Medical Center, Omaha, NE, USA
| | - Chi Lin
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Dandan Zheng
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA.
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16
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Xu H, Lv W, Zhang H, Ma J, Zhao P, Lu L. Evaluation and optimization of radiomics features stability to respiratory motion in 18 F-FDG 3D PET imaging. Med Phys 2021; 48:5165-5178. [PMID: 34085282 DOI: 10.1002/mp.15022] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/18/2021] [Accepted: 05/25/2021] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To evaluate the impact of respiratory motion on radiomics features in 18 F-fluoro-2-deoxy-D-glucose three dimensional positron emission tomography (18 F-FDG 3D PET) imaging and optimize feature stability by combining preprocessing configurations and aggregation strategies. METHODS An in-house developed respiratory motion phantom was imaged in 3D PET scanner under nine respiratory patterns including one reference pattern. In total, 487 radiomics features were extracted for each respiratory pattern. Feature stability to respiratory motion was first evaluated by metrics of coefficient of variation (COV) and relative difference (RD) in a fixed preprocessing configuration. Further, one-way ANOVA and trend analysis were performed to evaluate the impact of preprocessing configuration (voxel size, discretization scheme) and aggregation strategy on feature stability. Finally, an optimization framework was proposed by selected feature-specific configurations with minimum COV value, and the diagnostic performance was validated in stable versus unstable features and fixed versus optimal features by a set of 46 patients with lung disease. RESULTS PET radiomics features were sensitive to respiratory motion, only 79/487 (16%) features were identified to be very stable in the fixed configuration. Preprocessing configuration and aggregation strategy had an impact on feature stability. For different voxel size, bin number, bin size and aggregation strategy, 188/487 (39%), 70/487 (15%), 148/487 (30%), and 38/95 (29%) features appeared significant changes in feature stability. The optimized configuration had the potential to improve feature stability compared to fixed configuration, with the COV decreased from 22% ±24% to 16% ±20%. Regarding the diagnostic performance, the stable and optimal configuration features outperformed the unstable and fixed configuration features, respectively (AUC 0.88, 0.87 vs. 0.83, 0.85). CONCLUSIONS Respiratory motion shows considerable impact on feature stability in 3D PET imaging, while optimizing preprocessing configuration may improve feature stability and diagnostic performance.
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Affiliation(s)
- Hui Xu
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
| | - Wenbing Lv
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
| | - Hongyan Zhang
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
| | - Jianhua Ma
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
| | - Peng Zhao
- National Innovation Center for Advanced Medical Devices, Shenzheng, China
| | - Lijun Lu
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
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17
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Davey A, van Herk M, Faivre-Finn C, Brown S, McWilliam A. Optimising use of 4D-CT phase information for radiomics analysis in lung cancer patients treated with stereotactic body radiotherapy. Phys Med Biol 2021; 66. [PMID: 33882470 PMCID: PMC8144744 DOI: 10.1088/1361-6560/abfa34] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/21/2021] [Indexed: 11/11/2022]
Abstract
Purpose. 4D-CT is routine imaging for lung cancer patients treated with stereotactic body radiotherapy. No studies have investigated optimal 4D phase selection for radiomics. We aim to determine how phase data should be used to identify prognostic biomarkers for distant failure, and test whether stability assessment is required. A phase selection approach will be developed to aid studies with different 4D protocols and account for patient differences. Methods. 186 features were extracted from the tumour and peritumour on all phases for 258 patients. Feature values were selected from phase features using four methods: (A) mean across phases, (B) median across phases, (C) 50% phase, and (D) the most stable phase (closest in value to two neighbours), coined personalised selection. Four levels of stability assessment were also analysed, with inclusion of: (1) all features, (2) stable features across all phases, (3) stable features across phase and neighbour phases, and (4) features averaged over neighbour phases. Clinical-radiomics models were built for twelve combinations of feature type and assessment method. Model performance was assessed by concordance index (c-index) and fraction of new information from radiomic features. Results. The most stable phase spanned the whole range but was most often near exhale. All radiomic signatures provided new information for distant failure prediction. The personalised model had the highest c-index (0.77), and 58% of new information was provided by radiomic features when no stability assessment was performed. Conclusion. The most stable phase varies per-patient and selecting this improves model performance compared to standard methods. We advise the single most stable phase should be determined by minimising feature differences to neighbour phases. Stability assessment over all phases decreases performance by excessively removing features. Instead, averaging of neighbour phases should be used when stability is of concern. The models suggest that higher peritumoural intensity predicts distant failure.
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Affiliation(s)
- Angela Davey
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Marcel van Herk
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Corinne Faivre-Finn
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom.,Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Sean Brown
- Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom.,Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Alan McWilliam
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.,Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, United Kingdom
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18
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Reiazi R, Abbas E, Famiyeh P, Rezaie A, Kwan JYY, Patel T, Bratman SV, Tadic T, Liu FF, Haibe-Kains B. The impact of the variation of imaging parameters on the robustness of Computed Tomography radiomic features: A review. Comput Biol Med 2021; 133:104400. [PMID: 33930766 DOI: 10.1016/j.compbiomed.2021.104400] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/23/2021] [Accepted: 04/11/2021] [Indexed: 12/13/2022]
Abstract
The field of radiomics is at the forefront of personalized medicine. However, there is concern that high variation in imaging parameters will impact robustness of radiomic features and subsequently the performance of the predictive models built upon them. Therefore, our review aims to evaluate the impact of imaging parameters on the robustness of radiomic features. We also provide insights into the validity and discrepancy of different methodologies applied to investigate the robustness of radiomic features. We selected 47 papers based on our predefined inclusion criteria and grouped these papers by the imaging parameter under investigation: (i) scanner parameters, (ii) acquisition parameters and (iii) reconstruction parameters. Our review highlighted that most of the imaging parameters are disruptive parameters, and shape along with First order statistics were reported as the most robust radiomic features against variation in imaging parameters. This review identified inconsistencies related to the methodology of the reviewed studies such as the metrics used for robustness, the feature extraction techniques, the reporting style, and their outcome inclusion. We hope this review will aid the scientific community in conducting research in a way that is more reproducible and avoids the pitfalls of previous analyses.
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Affiliation(s)
- Reza Reiazi
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Engy Abbas
- Joint Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Petra Famiyeh
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Aria Rezaie
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jennifer Y Y Kwan
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Tirth Patel
- Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Scott V Bratman
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Tony Tadic
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Fei-Fei Liu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin Haibe-Kains
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada; Department of Computer Science, University of Toronto, Toronto, Ontario, Canada; Vector Institute, Toronto, Ontario, Canada.
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19
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Zhao B. Understanding Sources of Variation to Improve the Reproducibility of Radiomics. Front Oncol 2021; 11:633176. [PMID: 33854969 PMCID: PMC8039446 DOI: 10.3389/fonc.2021.633176] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/01/2021] [Indexed: 12/12/2022] Open
Abstract
Radiomics is the method of choice for investigating the association between cancer imaging phenotype, cancer genotype and clinical outcome prediction in the era of precision medicine. The fast dispersal of this new methodology has benefited from the existing advances of the core technologies involved in radiomics workflow: image acquisition, tumor segmentation, feature extraction and machine learning. However, despite the rapidly increasing body of publications, there is no real clinical use of a developed radiomics signature so far. Reasons are multifaceted. One of the major challenges is the lack of reproducibility and generalizability of the reported radiomics signatures (features and models). Sources of variation exist in each step of the workflow; some are controllable or can be controlled to certain degrees, while others are uncontrollable or even unknown. Insufficient transparency in reporting radiomics studies further prevents translation of the developed radiomics signatures from the bench to the bedside. This review article first addresses sources of variation, which is illustrated using demonstrative examples. Then, it reviews a number of published studies and progresses made to date in the investigation and improvement of feature reproducibility and model performance. Lastly, it discusses potential strategies and practical considerations to reduce feature variability and improve the quality of radiomics study. This review focuses on CT image acquisition, tumor segmentation, quantitative feature extraction, and the disease of lung cancer.
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Affiliation(s)
- Binsheng Zhao
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States
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20
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Varghese BA, Hwang D, Cen SY, Lei X, Levy J, Desai B, Goodenough DJ, Duddalwar VA. Identification of robust and reproducible CT-texture metrics using a customized 3D-printed texture phantom. J Appl Clin Med Phys 2021; 22:98-107. [PMID: 33434374 PMCID: PMC7882093 DOI: 10.1002/acm2.13162] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the robustness and reproducibility of computed tomography-based texture analysis (CTTA) metrics extracted from CT images of a customized texture phantom built for assessing the association of texture metrics to three-dimensional (3D) printed progressively increasing textural heterogeneity. MATERIALS AND METHODS A custom-built 3D-printed texture phantom comprising of six texture patterns was used to evaluate the robustness and reproducibility of a radiomics panel under a variety of routine abdominal imaging protocols. The phantom was scanned on four CT scanners (Philips, Canon, GE, and Siemens) to assess reproducibility. The robustness assessment was conducted by imaging the texture phantom across different CT imaging parameters such as slice thickness, field of view (FOV), tube voltage, and tube current for each scanner. The texture panel comprised of 387 features belonging to 15 subgroups of texture extraction methods (e.g., Gray-level Co-occurrence Matrix: GLCM). Twelve unique image settings were tested on all the four scanners (e.g., FOV125). Interclass correlation two-way mixed with absolute agreement (ICC3) was used to assess the robustness and reproducibility of radiomic features. Linear regression was used to test the association between change in radiomic features and increased texture heterogeneity. Results were summarized in heat maps. RESULTS A total of 5612 (23.2%) of 24 090 features showed excellent robustness and reproducibility (ICC ≥ 0.9). Intensity, GLCM 3D, and gray-level run length matrix (GLRLM) 3D features showed best performance. Among imaging variables, changes in slice thickness affected all metrics more intensely compared to other imaging variables in reducing the ICC3. From the analysis of linear trend effect of the CTTA metrics, the top three metrics with high linear correlations across all scanners and scanning settings were from the GLRLM 2D/3D and discrete cosine transform (DCT) texture family. CONCLUSION The choice of scanner and imaging protocols affect texture metrics. Furthermore, not all CTTA metrics have a linear association with linearly varying texture patterns.
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Affiliation(s)
- Bino A. Varghese
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Darryl Hwang
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Steven Y. Cen
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Xiaomeng Lei
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | | | - Bhushan Desai
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | | | - Vinay A. Duddalwar
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
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21
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Kothari G, Korte J, Lehrer EJ, Zaorsky NG, Lazarakis S, Kron T, Hardcastle N, Siva S. A systematic review and meta-analysis of the prognostic value of radiomics based models in non-small cell lung cancer treated with curative radiotherapy. Radiother Oncol 2020; 155:188-203. [PMID: 33096167 DOI: 10.1016/j.radonc.2020.10.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Radiomics allows extraction of quantifiable features from imaging. This study performs a systematic review and meta-analysis of the performance of radiomics based prognostic models in non-small cell lung cancer (NSCLC). MATERIALS AND METHODS A literature review was performed following PRISMA guidelines. Medline, EMBASE and Cochrane databases were searched for articles investigating radiomics features predictive of overall survival (OS) in NSCLC treated with curative intent radiotherapy. A random-effects meta-analysis of Harrell's Concordance Index (C-index) was performed on the performance of radiomics models. RESULTS Of the 2746 articles retrieved, 40 studies of 55 datasets and 6223 patients were eligible for inclusion in the systematic review. There was significant heterogeneity in the methodology for feature selection and model development. Twelve datasets reported the C-index of radiomics based models in predicting OS and were included in the meta-analysis. The C-index random effects estimate was 0.57 (95% CI 0.53-0.62). There was significant heterogeneity (I2 = 70.3%). CONCLUSIONS Based on this review, radiomics based models for lung cancer have to date demonstrated modest prognostic capabilities. Future research should consider using standardised radiomics features, robust feature selection and model development, and deep learning techniques, absolving the need for pre-defined features, to improve imaging-based models.
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Affiliation(s)
- Gargi Kothari
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - James Korte
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Biomedical Engineering, School of Engineering, University of Melbourne, Melbourne, Australia
| | - Eric J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Nicholas G Zaorsky
- Department of Radiation Oncology, Penn State Cancer Institute, Hershey, USA; Department of Public Health Sciences, Penn State College of Medicine, Hershey, USA
| | - Smaro Lazarakis
- Health Sciences Library, Peter MacCallum Cancer Centre, Parkville, Australia
| | - Tomas Kron
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | - Nicholas Hardcastle
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia
| | - Shankar Siva
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia
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22
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Alis D, Yergin M, Asmakutlu O, Topel C, Karaarslan E. The influence of cardiac motion on radiomics features: radiomics features of non-enhanced CMR cine images greatly vary through the cardiac cycle. Eur Radiol 2020; 31:2706-2715. [PMID: 33051731 DOI: 10.1007/s00330-020-07370-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/02/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The cardiac cycle might impair the reproducibility of radiomics features of cardiac magnetic resonance (CMR) cine images, yet this issue has not been addressed in the previous research. We aim to evaluate whether radiomics features of CMR cine images vary during the cardiac cycle and investigate the reproducibility of radiomics features of CMR cine images. METHODS This retrospective study enrolled 59 healthy adults who underwent CMR examination. Two observers segmented the myocardium on a 4D stack of three consecutive mid-ventricular short-axis cine images covering the cardiac cycle. A total of 352 radiomics features were extracted. The coefficient of variation and intraclass correlation coefficient were used to assess the feature variability through the cycle and inter-observer reproducibility, respectively. RESULTS Approximately 55% of radiomics features showed large variability through the cardiac cycle. The original features showed more variability than the Laplacian of Gaussian-filtered features (73.8% vs. 48%). The features of 4D stack cine images had a higher proportion of reproducible features (92.0%, 87.7%, and 76.1%) compared with the end-diastolic (77.8%, 62.2%, and 41.7%) and the end-systolic images (81.5%, 74.1%, and 58.8%) for intraclass correlation cut-off values of 30.80, > 0.85, and > 0.90, respectively. CONCLUSIONS Radiomics features of CMR cine images greatly vary during the cardiac cycle. The radiomics features of 4D stack of cine images are more robust compared with end-diastolic and end-systolic cine images in terms of reproducibility. The impact of the cardiac cycle on the reproducibility of the features should be considered when employing CMR cine images radiomics. KEY POINTS • There is limited evidence on the impact of cardiac motion on radiomics features of CMR cine images and the reproducibility of the radiomics features of CMR cine images. • Radiomics features of non-enhanced CMR cine images greatly vary during the cardiac cycle, and the number of "reproducible" features shows significant variations according to the cardiac phases. • The impact of cardiac cycle on the reproducibility of the radiomics features should be considered when employing CMR cine images radiomics.
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Affiliation(s)
- Deniz Alis
- Department of Radiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.
| | - Mert Yergin
- Department of Software Engineering and Applied Sciences, Bahcesehir University, Istanbul, Turkey
| | - Ozan Asmakutlu
- Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Halkali, Istanbul, Turkey
| | - Cagdas Topel
- Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Halkali, Istanbul, Turkey
| | - Ercan Karaarslan
- Department of Radiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
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23
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Lee G, Park H, Bak SH, Lee HY. Radiomics in Lung Cancer from Basic to Advanced: Current Status and Future Directions. Korean J Radiol 2020; 21:159-171. [PMID: 31997591 PMCID: PMC6992443 DOI: 10.3348/kjr.2019.0630] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 10/24/2019] [Indexed: 12/14/2022] Open
Abstract
Ideally, radiomics features and radiomics signatures can be used as imaging biomarkers for diagnosis, staging, prognosis, and prediction of tumor response. Thus, the number of published radiomics studies is increasing exponentially, leading to a myriad of new radiomics-based evidence for lung cancer. Consequently, it is challenging for radiologists to keep up with the development of radiomics features and their clinical applications. In this article, we review the basics to advanced radiomics in lung cancer to guide young researchers who are eager to start exploring radiomics investigations. In addition, we also include technical issues of radiomics, because knowledge of the technical aspects of radiomics supports a well-informed interpretation of the use of radiomics in lung cancer.
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Affiliation(s)
- Geewon Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Radiology and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Hyunjin Park
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, Korea.,Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea
| | - So Hyeon Bak
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Radiology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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24
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Stability of dosomics features extraction on grid resolution and algorithm for radiotherapy dose calculation. Phys Med 2020; 77:30-35. [DOI: 10.1016/j.ejmp.2020.07.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/29/2020] [Accepted: 07/16/2020] [Indexed: 12/16/2022] Open
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25
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Shape and texture-based radiomics signature on CT effectively discriminates benign from malignant renal masses. Eur Radiol 2020; 31:1011-1021. [PMID: 32803417 DOI: 10.1007/s00330-020-07158-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/15/2020] [Accepted: 08/05/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Using a radiomics framework to quantitatively analyze tumor shape and texture features in three dimensions, we tested its ability to objectively and robustly distinguish between benign and malignant renal masses. We assessed the relative contributions of shape and texture metrics separately and together in the prediction model. MATERIALS AND METHODS Computed tomography (CT) images of 735 patients with 539 malignant and 196 benign masses were segmented in this retrospective study. Thirty-three shape and 760 texture metrics were calculated per tumor. Tumor classification models using shape, texture, and both metrics were built using random forest and AdaBoost with tenfold cross-validation. Sensitivity analyses on five sub-cohorts with respect to the acquisition phase were conducted. Additional sensitivity analyses after multiple imputation were also conducted. Model performance was assessed using AUC. RESULTS Random forest classifier showed shape metrics featuring within the top 10% performing metrics regardless of phase, attaining the highest variable importance in the corticomedullary phase. Convex hull perimeter ratio is a consistently high-performing shape feature. Shape metrics alone achieved an AUC ranging 0.64-0.68 across multiple classifiers, compared with 0.67-0.75 and 0.68-0.75 achieved by texture-only and combined models, respectively. CONCLUSION Shape metrics alone attain high prediction performance and high variable importance in the combined model, while being independent of the acquisition phase (unlike texture). Shape analysis therefore should not be overlooked in its potential to distinguish benign from malignant tumors, and future radiomics platforms powered by machine learning should harness both shape and texture metrics. KEY POINTS • Current radiomics research is heavily weighted towards texture analysis, but quantitative shape metrics should not be ignored in their potential to distinguish benign from malignant renal tumors. • Shape metrics alone can attain high prediction performance and demonstrate high variable importance in the combined shape and texture radiomics model. • Any future radiomics platform powered by machine learning should harness both shape and texture metrics, especially since tumor shape (unlike texture) is independent of the acquisition phase and more robust from the imaging variations.
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26
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van Timmeren JE, Cester D, Tanadini-Lang S, Alkadhi H, Baessler B. Radiomics in medical imaging-"how-to" guide and critical reflection. Insights Imaging 2020; 11:91. [PMID: 32785796 PMCID: PMC7423816 DOI: 10.1186/s13244-020-00887-2] [Citation(s) in RCA: 726] [Impact Index Per Article: 145.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023] Open
Abstract
Radiomics is a quantitative approach to medical imaging, which aims at enhancing the existing data available to clinicians by means of advanced mathematical analysis. Through mathematical extraction of the spatial distribution of signal intensities and pixel interrelationships, radiomics quantifies textural information by using analysis methods from the field of artificial intelligence. Various studies from different fields in imaging have been published so far, highlighting the potential of radiomics to enhance clinical decision-making. However, the field faces several important challenges, which are mainly caused by the various technical factors influencing the extracted radiomic features.The aim of the present review is twofold: first, we present the typical workflow of a radiomics analysis and deliver a practical "how-to" guide for a typical radiomics analysis. Second, we discuss the current limitations of radiomics, suggest potential improvements, and summarize relevant literature on the subject.
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Affiliation(s)
- Janita E van Timmeren
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Davide Cester
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Stephanie Tanadini-Lang
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Hatem Alkadhi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Bettina Baessler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
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27
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Fornacon-Wood I, Faivre-Finn C, O'Connor JPB, Price GJ. Radiomics as a personalized medicine tool in lung cancer: Separating the hope from the hype. Lung Cancer 2020; 146:197-208. [PMID: 32563015 PMCID: PMC7383235 DOI: 10.1016/j.lungcan.2020.05.028] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/18/2020] [Accepted: 05/23/2020] [Indexed: 12/24/2022]
Abstract
Radiomics has become a popular image analysis method in the last few years. Its key hypothesis is that medical images harbor biological, prognostic and predictive information that is not revealed upon visual inspection. In contrast to previous work with a priori defined imaging biomarkers, radiomics instead calculates image features at scale and uses statistical methods to identify those most strongly associated to outcome. This builds on years of research into computer aided diagnosis and pattern recognition. While the potential of radiomics to aid personalized medicine is widely recognized, several technical limitations exist which hinder biomarker translation. Aspects of the radiomic workflow lack repeatability or reproducibility under particular circumstances, which is a key requirement for the translation of imaging biomarkers into clinical practice. One of the most commonly studied uses of radiomics is for personalized medicine applications in Non-Small Cell Lung Cancer (NSCLC). In this review, we summarize reported methodological limitations in CT based radiomic analyses together with suggested solutions. We then evaluate the current NSCLC radiomics literature to assess the risk associated with accepting the published conclusions with respect to these limitations. We review different complementary scoring systems and initiatives that can be used to critically appraise data from radiomics studies. Wider awareness should improve the quality of ongoing and future radiomics studies and advance their potential as clinically relevant biomarkers for personalized medicine in patients with NSCLC.
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Affiliation(s)
| | - Corinne Faivre-Finn
- Division of Cancer Sciences, University of Manchester, Manchester, UK; Department of Radiation Oncology, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - James P B O'Connor
- Division of Cancer Sciences, University of Manchester, Manchester, UK; Department of Radiology, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - Gareth J Price
- Division of Cancer Sciences, University of Manchester, Manchester, UK
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28
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Avanzo M, Stancanello J, Pirrone G, Sartor G. Radiomics and deep learning in lung cancer. Strahlenther Onkol 2020; 196:879-887. [PMID: 32367456 DOI: 10.1007/s00066-020-01625-9] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/15/2020] [Indexed: 02/07/2023]
Abstract
Lung malignancies have been extensively characterized through radiomics and deep learning. By providing a three-dimensional characterization of the lesion, models based on radiomic features from computed tomography (CT) and positron-emission tomography (PET) have been developed to detect nodules, distinguish malignant from benign lesions, characterize their histology, stage, and genotype. Deep learning models have been applied to automatically segment organs at risk in lung cancer radiotherapy, stratify patients according to the risk for local and distant recurrence, and identify patients candidate for molecular targeted therapy and immunotherapy. Moreover, radiomics has also been applied successfully to predict side effects such as radiation- and immunotherapy-induced pneumonitis and differentiate lung injury from recurrence. Radiomics could also untap the potential for further use of the cone beam CT acquired for treatment image guidance, four-dimensional CT, and dose-volume data from radiotherapy treatment plans. Radiomics is expected to increasingly affect the clinical practice of treatment of lung tumors, optimizing the end-to-end diagnosis-treatment-follow-up chain. The main goal of this article is to provide an update on the current status of lung cancer radiomics.
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Affiliation(s)
- Michele Avanzo
- Department of Medical Physics, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via F. Gallini 2, 33081, Aviano, PN, Italy.
| | | | - Giovanni Pirrone
- Department of Medical Physics, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Giovanna Sartor
- Department of Medical Physics, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via F. Gallini 2, 33081, Aviano, PN, Italy
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29
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Papanikolaou N, Matos C, Koh DM. How to develop a meaningful radiomic signature for clinical use in oncologic patients. Cancer Imaging 2020; 20:33. [PMID: 32357923 PMCID: PMC7195800 DOI: 10.1186/s40644-020-00311-4] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/15/2020] [Indexed: 01/08/2023] Open
Abstract
During the last decade, there is an increasing usage of quantitative methods in Radiology in an effort to reduce the diagnostic variability associated with a subjective manner of radiological interpretation. Combined approaches where visual assessment made by the radiologist is augmented by quantitative imaging biomarkers are gaining attention. Advances in machine learning resulted in the rise of radiomics that is a new methodology referring to the extraction of quantitative information from medical images. Radiomics are based on the development of computational models, referred to as “Radiomic Signatures”, trying to address either unmet clinical needs, mostly in the field of oncologic imaging, or to compare radiomics performance with that of radiologists. However, to explore this new technology, initial publications did not consider best practices in the field of machine learning resulting in publications with questionable clinical value. In this paper, our effort was concentrated on how to avoid methodological mistakes and consider critical issues in the workflow of the development of clinically meaningful radiomic signatures.
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Affiliation(s)
- Nikolaos Papanikolaou
- Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Av. Brasília, Doca de Pedrouços, 1400-038, Lisbon, Portugal.
| | - Celso Matos
- Department of Radiology, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Dow Mu Koh
- Department of Radiology, Royal Marsden Hospital, Sutton, UK
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30
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Morton N, Sykes J, Barber J, Hofmann C, Keall P, O’Brien R. Reducing 4D CT imaging artifacts at the source: first experimental results from the respiratory adaptive computed tomography (REACT) system. ACTA ACUST UNITED AC 2020; 65:075012. [DOI: 10.1088/1361-6560/ab7abe] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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