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      Exploring Applications of Radiomics in Magnetic Resonance Imaging of Head and Neck Cancer: A Systematic Review

      systematic-review

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          Abstract

          Background

          Radiomics has been widely investigated for non-invasive acquisition of quantitative textural information from anatomic structures. While the vast majority of radiomic analysis is performed on images obtained from computed tomography, magnetic resonance imaging (MRI)-based radiomics has generated increased attention. In head and neck cancer (HNC), however, attempts to perform consistent investigations are sparse, and it is unclear whether the resulting textural features can be reproduced. To address this unmet need, we systematically reviewed the quality of existing MRI radiomics research in HNC.

          Methods

          Literature search was conducted in accordance with guidelines established by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Electronic databases were examined from January 1990 through November 2017 for common radiomic keywords. Eligible completed studies were then scored using a standardized checklist that we developed from Enhancing the Quality and Transparency of Health Research guidelines for reporting machine-learning predictive model specifications and results in biomedical research, defined by Luo et al. ( 1). Descriptive statistics of checklist scores were populated, and a subgroup analysis of methodology items alone was conducted in comparison to overall scores.

          Results

          Sixteen completed studies and four ongoing trials were selected for inclusion. Of the completed studies, the nasopharynx was the most common site of study (37.5%). MRI modalities varied with only four of the completed studies (25%) extracting radiomic features from a single sequence. Study sample sizes ranged between 13 and 118 patients (median of 40), and final radiomic signatures ranged from 2 to 279 features. Analyzed endpoints included either segmentation or histopathological classification parameters (44%) or prognostic and predictive biomarkers (56%). Liu et al. ( 2) addressed the highest number of our checklist items (total score: 48), and a subgroup analysis of methodology checklist items alone did not demonstrate any difference in scoring trends between studies [Spearman’s ρ = 0.94 ( p < 0.0001)].

          Conclusion

          Although MRI radiomic applications demonstrate predictive potential in analyzing diverse HNC outcomes, methodological variances preclude accurate and collective interpretation of data.

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          Most cited references38

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          Measuring Computed Tomography Scanner Variability of Radiomics Features.

          The purpose of this study was to determine the significance of interscanner variability in CT image radiomics studies.
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            Quantitative MRI radiomics in the prediction of molecular classifications of breast cancer subtypes in the TCGA/TCIA data set

            Using quantitative radiomics, we demonstrate that computer-extracted magnetic resonance (MR) image-based tumor phenotypes can be predictive of the molecular classification of invasive breast cancers. Radiomics analysis was performed on 91 MRIs of biopsy-proven invasive breast cancers from National Cancer Institute’s multi-institutional TCGA/TCIA. Immunohistochemistry molecular classification was performed including estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and for 84 cases, the molecular subtype (normal-like, luminal A, luminal B, HER2-enriched, and basal-like). Computerized quantitative image analysis included: three-dimensional lesion segmentation, phenotype extraction, and leave-one-case-out cross validation involving stepwise feature selection and linear discriminant analysis. The performance of the classifier model for molecular subtyping was evaluated using receiver operating characteristic analysis. The computer-extracted tumor phenotypes were able to distinguish between molecular prognostic indicators; area under the ROC curve values of 0.89, 0.69, 0.65, and 0.67 in the tasks of distinguishing between ER+ versus ER−, PR+ versus PR−, HER2+ versus HER2−, and triple-negative versus others, respectively. Statistically significant associations between tumor phenotypes and receptor status were observed. More aggressive cancers are likely to be larger in size with more heterogeneity in their contrast enhancement. Even after controlling for tumor size, a statistically significant trend was observed within each size group (P = 0.04 for lesions ≤ 2 cm; P = 0.02 for lesions >2 to ≤5 cm) as with the entire data set (P-value = 0.006) for the relationship between enhancement texture (entropy) and molecular subtypes (normal-like, luminal A, luminal B, HER2-enriched, basal-like). In conclusion, computer-extracted image phenotypes show promise for high-throughput discrimination of breast cancer subtypes and may yield a quantitative predictive signature for advancing precision medicine.
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              Computed Tomography Radiomics Predicts HPV Status and Local Tumor Control After Definitive Radiochemotherapy in Head and Neck Squamous Cell Carcinoma.

              This study aimed to predict local tumor control (LC) after radiochemotherapy of head and neck squamous cell carcinoma (HNSCC) and human papillomavirus (HPV) status using computed tomography (CT) radiomics.
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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                14 May 2018
                2018
                : 8
                : 131
                Affiliations
                [1] 1Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, United States
                [2] 2College of Medicine, The University of Tennessee Health Science Center , Memphis, TN, United States
                [3] 3Baylor College of Medicine , Houston, TX, United States
                [4] 4Department of Oncology and Hemato-Oncology, University of Milan , Milan, Italy
                [5] 5Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria , Alexandria, Egypt
                [6] 6Graduate School of Biomedical Sciences, The University of Texas Health Science Center , Houston, TX, United States
                [7] 7Hunan Cancer Hospital, Department of Head and Neck Radiation Oncology , Changsha, China
                Author notes

                Edited by: Issam El Naqa, University of Michigan, United States

                Reviewed by: Marc van Hoof, Maastricht University Medical Centre (MUMC), Netherlands; Pavankumar Tandra, University of Nebraska Medical Center, United States

                *Correspondence: Clifton D. Fuller, cdfuller@ 123456mdanderson.org

                Specialty section: This article was submitted to Radiation Oncology, a section of the journal Frontiers in Oncology

                Article
                10.3389/fonc.2018.00131
                5960677
                29868465
                ba950bb8-9367-4b64-aa50-a98c9e8dfa6b
                Copyright © 2018 Jethanandani, Lin, Volpe, Elhalawani, Mohamed, Yang and Fuller.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 31 January 2018
                : 10 April 2018
                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 75, Pages: 21, Words: 11605
                Categories
                Oncology
                Systematic Review

                Oncology & Radiotherapy
                radiomics,magnetic resonance imaging,mri,texture analysis,head and neck,radiation oncology

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