Fritz Benjamin, Yi Paul H, Kijowski Richard, Fritz Jan
University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore.
New York University Grossman School of Medicine.
Invest Radiol. 2023 Jan 1;58(1):3-13. doi: 10.1097/RLI.0000000000000907. Epub 2022 Sep 1.
Radiomics and machine learning-based methods offer exciting opportunities for improving diagnostic performance and efficiency in musculoskeletal radiology for various tasks, including acute injuries, chronic conditions, spinal abnormalities, and neoplasms. While early radiomics-based methods were often limited to a smaller number of higher-order image feature extractions, applying machine learning-based analytic models, multifactorial correlations, and classifiers now permits big data processing and testing thousands of features to identify relevant markers. A growing number of novel deep learning-based methods describe magnetic resonance imaging- and computed tomography-based algorithms for diagnosing anterior cruciate ligament tears, meniscus tears, articular cartilage defects, rotator cuff tears, fractures, metastatic skeletal disease, and soft tissue tumors. Initial radiomics and deep learning techniques have focused on binary detection tasks, such as determining the presence or absence of a single abnormality and differentiation of benign versus malignant. Newer-generation algorithms aim to include practically relevant multiclass characterization of detected abnormalities, such as typing and malignancy grading of neoplasms. So-called delta-radiomics assess tumor features before and after treatment, with temporal changes of radiomics features serving as surrogate markers for tumor responses to treatment. New approaches also predict treatment success rates, surgical resection completeness, and recurrence risk. Practice-relevant goals for the next generation of algorithms include diagnostic whole-organ and advanced classification capabilities. Important research objectives to fill current knowledge gaps include well-designed research studies to understand how diagnostic performances and suggested efficiency gains of isolated research settings translate into routine daily clinical practice. This article summarizes current radiomics- and machine learning-based magnetic resonance imaging and computed tomography approaches for musculoskeletal disease detection and offers a perspective on future goals and objectives.
基于放射组学和机器学习的方法为提高肌肉骨骼放射学在各种任务中的诊断性能和效率提供了令人兴奋的机会,这些任务包括急性损伤、慢性病、脊柱异常和肿瘤。早期基于放射组学的方法通常局限于较少数量的高阶图像特征提取,而现在应用基于机器学习的分析模型、多因素相关性和分类器能够进行大数据处理,并测试数千个特征以识别相关标志物。越来越多基于新型深度学习的方法描述了用于诊断前交叉韧带撕裂、半月板撕裂、关节软骨缺损、肩袖撕裂、骨折、转移性骨病和软组织肿瘤的基于磁共振成像和计算机断层扫描的算法。最初的放射组学和深度学习技术专注于二元检测任务,例如确定单一异常的存在与否以及区分良性与恶性。新一代算法旨在包括对检测到的异常进行实际相关的多类别表征,例如肿瘤的分型和恶性分级。所谓的增量放射组学评估治疗前后的肿瘤特征,放射组学特征的时间变化作为肿瘤对治疗反应的替代标志物。新方法还可预测治疗成功率、手术切除完整性和复发风险。下一代算法与实践相关的目标包括全器官诊断和高级分类能力。填补当前知识空白的重要研究目标包括精心设计的研究,以了解孤立研究环境中的诊断性能和建议的效率提升如何转化为日常临床实践。本文总结了当前基于放射组学和机器学习的用于肌肉骨骼疾病检测的磁共振成像和计算机断层扫描方法,并对未来目标和目的提出了展望。