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Radiomics: the process and the challenges
Open accessAbstract
"Radiomics" refers to the extraction and analysis of large amounts of advanced quantitative imaging features with high throughput from medical images obtained with computed tomography, positron emission tomography or magnetic resonance imaging. Importantly, these data are designed to be extracted from standard-of-care images, leading to a very large potential subject pool. Radiomics data are in a mineable form that can be used to build descriptive and predictive models relating image features to phenotypes or gene-protein signatures. The core hypothesis of radiomics is that these models, which can include biological or medical data, can provide valuable diagnostic, prognostic or predictive information. The radiomics enterprise can be divided into distinct processes, each with its own challenges that need to be overcome: (a) image acquisition and reconstruction, (b) image segmentation and rendering, (c) feature extraction and feature qualification and (d) databases and data sharing for eventual (e) ad hoc informatics analyses. Each of these individual processes poses unique challenges. For example, optimum protocols for image acquisition and reconstruction have to be identified and harmonized. Also, segmentations have to be robust and involve minimal operator input. Features have to be generated that robustly reflect the complexity of the individual volumes, but cannot be overly complex or redundant. Furthermore, informatics databases that allow incorporation of image features and image annotations, along with medical and genetic data, have to be generated. Finally, the statistical approaches to analyze these data have to be optimized, as radiomics is not a mature field of study. Each of these processes will be discussed in turn, as well as some of their unique challenges and proposed approaches to solve them. The focus of this article will be on images of non-small-cell lung cancer.
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“The first such study used 182 texture features in combination with 22 semantic features to describe CT images of lung cancer (24).”
From Radiomics: Images Are More than Pictures, They Are Data (2016) · cites this paper as [24]
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Self-citationRadiomic Features Are Associated With EGFR Mutation Status in Lung Adenocarcinomas
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“…segmentation of the tumor region has shown advantages in image-based tumor phenotyping over traditionally used clinical measures such as largest anterior-posterior, transverse, and inferior-superior tumor dimensions on a subjectively-chosen slice (Kumar et al., 2012; Gillies et al., 2016).”
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Self-citationGray-level invariant Haralick texture features
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Assessing robustness of radiomic features by image perturbation
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“4 All intensity values outside range r are replaced by the nearest valid intensity: I j = 8 >> < >> : r 1; I j<r 1 r 2; I >r I j; otherwise (b) Intensities are then mapped to the [0;1] range by a simple transformation: I j;s= I j r 1 r 2 r 1 3. The number of supervoxels is estimated so that on ave…”
BackgroundMethodInfluentialHe, L., Huang, Y., Ma, Z., Liang, C., Liang, C., & Liu, Z. (2016) · Scientific Reports · doi:10.1038/srep34921 · Cited by 253
Image-Based Cardiac Diagnosis With Machine Learning: A Review
Martín-Isla, C., Campello, V. M., Izquierdo, C., Raisi‐Estabragh, Z., Baeßler, B., Petersen, S. E., & Lekadir, K. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.00001 · Cited by 250
“Introduced in 2012 (11, 12), the radiomics paradigm was, for a long time, mostly exploited in oncology (13).”
BackgroundRadiomic machine-learning classifiers for prognostic biomarkers of advanced nasopharyngeal carcinoma
Zhang, B., He, X. J., Ouyang, F., Gu, D., Dong, Y., Zhang, L., Mo, X., Huang, W., Tian, J., & Zhang, S. (2017) · Cancer Letters · doi:10.1016/j.canlet.2017.06.004 · Cited by 246
Deep learning and radiomics in precision medicine
Parekh, V. S., & Jacobs, M. A. (2019) · Expert Review of Precision Medicine and Drug Development · doi:10.1080/23808993.2019.1585805 · Cited by 255
“In radiology, Radiomics are textural mathematical constructs that capture the spatial appearance of the tissue of interest (shape and texture) on different types of images using texture [10–13 , 50– 53].”
BackgroundMethodTexture Analysis of Imaging: What Radiologists Need to Know
Varghese, B. A., Cen, S., Hwang, D., & Duddalwar, V. A. (2019) · American Journal of Roentgenology · doi:10.2214/ajr.18.20624 · Cited by 253
“, their value remains the same when repeated multiple times on a single scanner]) need to be identified [42, 43] (Fig.”
BackgroundPark, H., Lim, Y., Ko, E. S., Cho, H.-H., Lee, J. E., Han, B., Ko, E. Y., Choi, J. S., & Park, K. W. (2018) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-17-3783 · Cited by 243
“Other pathologic diagnoses in the 17 patients were as follows:mucinous carcinoma (7), medullary carcinoma (2), invasive micropapillary carcinoma (3), tubular carcinoma (1), invasive apocrine carcinoma (3), and adenoid cystic carcinoma (1).”
BackgroundVolumetric CT-based segmentation of NSCLC using 3D-Slicer
Velazquez, E. R., Parmar, C., Jermoumi, M., Mak, R. H., van Baardwijk, A. A. W., Fennessy, F. M., Lewis, J. H., Ruysscher, D. D., Kikinis, R., Lambin, P., et al. (2013) · Scientific Reports · doi:10.1038/srep03529 · Cited by 240
Self-citationRepeatability of Multiparametric Prostate MRI Radiomics Features
Schwier, M., van Griethuysen, J. J. M., Vangel, M. G., Pieper, S., Peled, S., Tempany, C. M., Aerts, H. J. W. L., Kikinis, R., Fennessy, F. M., & Fedorov, A. (2019) · Scientific Reports · doi:10.1038/s41598-019-45766-z · Cited by 232
“Since there is no systematic difference between the first and second scans, we model both between-subject and within-subject sources of variability as independent random effects and ICC(1,1) is therefore appropriate.”
MethodSelf-citationCriteria for the translation of radiomics into clinically useful tests
Huang, E. P., O’Connor, J. P. B., McShane, L. M., Giger, M. L., Lambin, P., Kinahan, P. E., Siegel, E. L., & Shankar, L. K. (2022) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-022-00707-0 · Cited by 246
Self-citationVirtual clinical trials in medical imaging: a review
Abadi, E., Segars, W. P., Tsui, B. M. W., Kinahan, P. E., Bottenus, N. B., Frangi, A. F., Maidment, A. D. A., Lo, J. Y.-C., & Samei, E. (2020) · Journal of medical imaging · doi:10.1117/1.jmi.7.4.042805 · Cited by 230
“267 – 269.”
Bibault, J., Giraud, P., Housset, M., Durdux, C., Taı̈eb, J., Berger, A., Coriat, R., Chaussade, S., Dousset, B. E., Nordlinger, B., et al. (2018) · Scientific Reports · doi:10.1038/s41598-018-30657-6 · Cited by 229
Quantitative imaging of cancer in the postgenomic era: Radio(geno)mics, deep learning, and habitats
Napel, S. A., Mu, W., Jardim‐Perassi, B. V., Aerts, H. J. W. L., & Gillies, R. J. (2018) · Cancer · doi:10.1002/cncr.31630 · Cited by 232
Self-citationThe crucial role of multiomic approach in cancer research and clinically relevant outcomes
Lu, M., & Zhan, X. (2018) · The EPMA Journal · doi:10.1007/s13167-018-0128-8 · Cited by 235
“This type of information is crucial for the diagnosis of tumors, but it does not accurately reflect the morphological and behavioral complexities of a tumor, with limited benefits in the judgment of treatment sensitivity and prognosis [255].”
BackgroundPapadimitroulas, P., Brocki, L., Christopher Chung, N., Marchadour, W., Vermet, F., Gaubert, L., Eleftheriadis, V., Plachouris, D., Visvikis, D., Kagadis, G. C., et al. (2021) · Physica Medica · doi:10.1016/j.ejmp.2021.03.009 · Cited by 226
“Shape features [19]: provide quantitative description of geometric properties of the ROIs/VOIs, such as surface area, total volume, diameter, sphericity or surface-to-volume ratio.”
BackgroundCunliffe, A. R., Armato, S. G., Castillo, R., Pham, N., Guerrero, T. M., & Al‐Hallaq, H. (2015) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2014.11.030 · Cited by 225
“0-10 Gy 503 (165-776) 532 (300-936) 10-30 Gy 162 (17-398) 118 (22-294) 30 Gy 49 (1-154) 27 (0-90)”
Feng, Z., Rong, P., Cao, P., Zhou, Q. S., Zhu, W., Yan, Z., Liu, Q., & Wang, W. (2017) · European Radiology · doi:10.1007/s00330-017-5118-z · Cited by 230
Kim, J. Y., Park, J. E., Jo, Y., Shim, W. H., Nam, S. J., Kim, J. H., Yoo, R., Choi, S. H., & Kim, H. S. (2018) · Neuro-Oncology · doi:10.1093/neuonc/noy133 · Cited by 222
Sun, W., Zheng, B., & Qian, W. (2017) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2017.04.006 · Cited by 227
Leijenaar, R. T. H., Carvalho, S., Hoebers, F. J. P., Aerts, H. J. W. L., van Elmpt, W., Huang, S. H., Chan, H. B., Waldron, J. N., O’Sullivan, B., & Lambin, P. (2015) · Acta Oncologica · doi:10.3109/0284186x.2015.1061214 · Cited by 216
Self-citationIntegrative methods for analyzing big data in precision medicine
Gligorijević, V., Malod‐Dognin, N., & Pržulj, N. (2015) · PROTEOMICS · doi:10.1002/pmic.201500396 · Cited by 226
“Even medical imaging, which was traditionally manually investigated, is now a subject of high-throughput capturing [14, 15].”
BackgroundCT-based radiomic analysis of stereotactic body radiation therapy patients with lung cancer
Huynh, E., Coroller, T. P., Narayan, V., Agrawal, V., Hou, Y., Romano, J., Franco, I. “., Mak, R. H., & Aerts, H. J. W. L. (2016) · Radiotherapy and Oncology · doi:10.1016/j.radonc.2016.05.024 · Cited by 215
Self-citationVoxel size and gray level normalization of CT radiomic features in lung cancer
Shafiq-ul-Hassan, M., Latifi, K., Zhang, G. G., Ullah, G., Gillies, R. J., & Moros, E. G. (2018) · Scientific Reports · doi:10.1038/s41598-018-28895-9 · Cited by 215
Self-citationRadiomics and radiogenomics in gliomas: a contemporary update
Singh, G., Manjila, S. V., Sakla, N. M., True, A., Wardeh, A. H., Beig, N. G., Vaysberg, A., Matthews, J., Prasanna, P., & Spektor, V. (2021) · British Journal of Cancer · doi:10.1038/s41416-021-01387-w · Cited by 226
Defining a Radiomic Response Phenotype: A Pilot Study using targeted therapy in NSCLC
Aerts, H. J. W. L., Großmann, P., Tan, Y., Oxnard, G. R., Rizvi, N. A., Schwartz, L. H., & Zhao, B. (2016) · Scientific Reports · doi:10.1038/srep33860 · Cited by 213
Self-citationZhu, X., Dong, D., Chen, Z., Fang, M., Zhang, L., Song, J., Yu, D., Zang, Y., Liu, Z., Shi, J., et al. (2018) · European Radiology · doi:10.1007/s00330-017-5221-1 · Cited by 211
Mali, S. A., Ibrahim, A., Woodruff, H. C., Andrearczyk, V., Müller, H., Primakov, S. P., Salahuddin, Z., Chatterjee, A., & Lambin, P. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11090842 · Cited by 228
“The radiomic hypothesis postulates that the quantitative study of medical image data can provide complementary knowledge in a quick and reproducible manner to support clinicians in their decision-making process, assisted by automated or semi-automated software [5,6].”
BackgroundSelf-citationBladder Cancer Treatment Response Assessment in CT using Radiomics with Deep-Learning
Kenny, H., Hadjiiski, L. M., Chan, H., Weizer, A. Z., Alva, A. S., Cohan, R. H., Caoili, E. M., Paramagul, C., & Samala, R. K. (2017) · Scientific Reports · doi:10.1038/s41598-017-09315-w · Cited by 208
Vial, A., Stirling, D. A., Field, M., Ros, M., Ritz, C. H., Carolan, M., Holloway, L. C., & Miller, A. (2018) · Translational Cancer Research · doi:10.21037/tcr.2018.05.02 · Cited by 207
“It has been found that texture features are the one of the most important imaging features for the field of radiomics (1-5, Kumar et al. (36) describe that there are a vast number of extractible radiomic features for each patient analysed, hence the quantity of features needs to be reduced to avoid…”
BackgroundInfluentialShiri, I., Rahmim, A., Ghafarian, P., Geramifar, P., Abdollahi, H., & Bitarafan‐Rajabi, A. (2017) · European Radiology · doi:10.1007/s00330-017-4859-z · Cited by 205
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Neisius, U., El-Rewaidy, H., Nakamori, S., Rodriguez, J., Manning, W. J., & Nezafat, R. (2019) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2018.11.024 · Cited by 196
“The use of quantitative mapping data compared with qualitative CMR improved standardization and reflection of physical tissue properties (37).”
Zhang, Y., Zhang, X., Cheng, Y., Li, B., Teng, X.-Z., Zhang, J., Lam, S., Zhou, T., Ma, Z., Sheng, J., et al. (2023) · Military Medical Research · doi:10.1186/s40779-023-00458-8 · Cited by 212
“The reproducibility of segmentation may be more important than its Acc, as was noted by Kumar et al. [188].”
BackgroundFeng, S., Jia, Y., Liao, B., Huang, B., Zhou, Q., Li, X., Wei, K., Chen, L., Li, B., Wang, W., et al. (2019) · European Radiology · doi:10.1007/s00330-018-5935-8 · Cited by 199
Radiomics and Artificial Intelligence for Biomarker and Prediction Model Development in Oncology
Forghani, R., Savadjiev, P., Chatterjee, A., Muthukrishnan, N., Reinhold, C., & Forghani, B. (2019) · Computational and Structural Biotechnology Journal · doi:10.1016/j.csbj.2019.07.001 · Cited by 206
“The fi rst published occurrence of the term radiomics dates back to 2012 [27,28].”
BackgroundChu, L. C., Park, S., Kawamoto, S., Fouladi, D. F., Shayesteh, S., Zinreich, E. S., Graves, J. S., Horton, K. M., Hruban, R. H., Yuille, A. L., et al. (2019) · American Journal of Roentgenology · doi:10.2214/ajr.18.20901 · Cited by 193
Where Is the Artificial Intelligence Applied in Dentistry? Systematic Review and Literature Analysis
Thurzo, A., Urbanová, W., Novák, B., Czakó, L., Siebert, T., Stano, P., Mareková, S., Fountoulaki, G., Kosnáčová, H., & Varga, I. (2022) · Healthcare · doi:10.3390/healthcare10071269 · Cited by 221
Genomic and immune heterogeneity are associated with differential responses to therapy in melanoma
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“16 The concept of textural analysis was first introduced in 1973 by Haralick and colleagues.”
Test–Retest Data for Radiomics Feature Stability Analysis: Generalizable or Study-Specific?
van Timmeren, J. E., Leijenaar, R. T. H., van Elmpt, W., Wang, J., Zhang, Z., Dekker, A. L. A. J., & Lambin, P. (2016) · Tomography · doi:10.18383/j.tom.2016.00208 · Cited by 191
“We investigated the test–retest stability on both data sets of a total of 542 radiomic features, divided into the following 4 groups: (1) Tumor intensity (n 15), (2) shape (n 11), (3) texture (n 44), and (4) wavelet (n 472).”
MethodSelf-citationAssessing the accuracy of a deep learning method to risk stratify indeterminate pulmonary nodules
Massion, P. P., Antic, S., Ather, S., Arteta, C., Brabec, J., Chen, H., Declerck, J., Dufek, D., Hickes, W., Kadir, T., et al. (2020) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201903-0505oc · Cited by 190
How to develop a meaningful radiomic signature for clinical use in oncologic patients
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Metadata
- Authors
- Kumar, V., Gu, Y., Basu, S., Berglund, A., Eschrich, S. A., Schabath, M. B., Forster, K., Aerts, H. J. W. L., Dekker, A., Fenstermacher, D., Goldgof, D. B., Hall, L. O., Lambin, P., Balagurunathan, Y., Gatenby, R. A., & Gillies, R. J.
- Affiliations
- Moffitt Cancer Center (US)
- University of South Florida (US)
- Harvard University (US)
- Maastricht University Medical Centre (NL)
- Corresponding author
- Gillies, Robert J.
- ORCID
- Venue
- Magnetic Resonance Imaging
- Publisher
- Elsevier BV
- Published
- 2012-11
- Volume
- 30
- Issue
- 9
- Pages
- 1234-1248
- ISSN
- 0730-725X (ISSN-L)
- PMC
- PMC3563280
- OpenAlex
- W2097475056
- Cited by
- 2,258
- References
- 104
- Citations by year
- 2026: 106 · 2025: 189 · 2024: 224 · 2023: 236 · 2022: 277 · 2021: 290 · 2020: 253 · 2019: 209 · 2018: 190 · 2017: 127 · 2016: 86 · 2015: 43 · 2014: 16 · 2013: 6 · 2012: 3
- FWCI
- 16.42
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Magnetic Resonance Imaging (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Radiological Society of North America
- National Cancer Institute (U01CA143062, P30CA076292)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Image Retrieval and Classification Techniques
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- radiomics, quantitative imaging features, image segmentation, feature extraction, data sharing, non-small cell lung cancer, computed tomography, positron emission tomography, prediction model
- MeSH terms
- Algorithms, Carcinoma, Non-Small-Cell Lung, Humans, Image Processing, Computer-Assisted, Lung Neoplasms, Magnetic Resonance Imaging, Medical Informatics, Pattern Recognition, Automated, Risk Factors, Software, Tomography, X-Ray Computed, Reproducibility of Results, Multivariate Analysis, Radiation Oncology, Phantoms, Imaging, Positron-Emission Tomography
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