Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Br J Radiol. 2021 Nov 1;94(1127):20210285. doi: 10.1259/bjr.20210285. Epub 2021 Jul 8.
The journey from early drawings of Thomas Hodgkin's patients to deep learning with radiomics in lymphoma has taken nearly 200 years, and in many ways, it parallels the journey of medicine. By tracing the history of imaging in clinical lymphoma practice, we can better understand the motivations for current imaging practices. The earliest imaging modalities of the 2D era each had varied, site-dependent sensitivity, and the improved accuracy of imaging studies allowed new diagnostic and therapeutic techniques. First, we review the initial imaging technologies that were applied to understand lymphoma spread and achieve practical guidance for the earliest lymphoma treatments. Next, in the 3D era, we describe how anatomical imaging advances replaced and complemented conventional modalities. Afterward, we discuss how the PET era scans were used to understand response of tumors to treatment and risk stratification. Finally, we discuss the emergence of radiomics as a promising area of research in personalized medicine. We are now able to identify involved lymph nodes and body sites both before and after treatment to offer patients improved treatment outcomes. As imaging methods continue to improve sensitivity, we will be able to use personalized medicine approaches to give targeted and highly focused therapies at even earlier time points, and ideally, we can obtain long-term disease control and cures for lymphomas.
从托马斯·霍奇金(Thomas Hodgkin)患者的早期绘图到淋巴瘤的放射组学深度学习,历经了近 200 年,在许多方面,这与医学的发展历程相似。通过追踪临床淋巴瘤实践中的影像学发展历程,我们可以更好地理解当前影像学实践的动机。2D 时代的最早成像方式在每个部位的敏感性都各不相同,而影像学研究的准确性提高则为新的诊断和治疗技术提供了可能。首先,我们回顾了最初应用于了解淋巴瘤扩散并为最早的淋巴瘤治疗提供实际指导的成像技术。接下来,在 3D 时代,我们描述了解剖成像技术的进步如何取代和补充了传统方式。之后,我们讨论了 PET 时代的扫描如何用于了解肿瘤对治疗的反应和风险分层。最后,我们讨论了放射组学作为个性化医学研究中一个有前途的领域的出现。我们现在能够在治疗前后识别出受累的淋巴结和身体部位,为患者提供更好的治疗效果。随着成像方法的敏感性不断提高,我们将能够更早地使用个性化医学方法为患者提供靶向和高度集中的治疗,理想情况下,我们可以获得长期的疾病控制和淋巴瘤的治愈。