Department of Radiology, HT Médica, San Juan de Dios Hospital, 14960, Córdoba, Spain.
Department of Radiology, HT Médica, San Juan de Dios Hospital, Av. del Brillante, 106, 14012, Córdoba, Spain.
Abdom Radiol (NY). 2024 Jan;49(1):322-340. doi: 10.1007/s00261-023-04071-0. Epub 2023 Oct 27.
Radiomics allows the extraction of quantitative imaging features from clinical magnetic resonance imaging (MRI) and computerized tomography (CT) studies. The advantages of radiomics have primarily been exploited in oncological applications, including better characterization and staging of oncological lesions and prediction of patient outcomes and treatment response. The potential introduction of radiomics in the clinical setting requires the establishment of a standardized radiomics pipeline and a quality assurance program. Radiomics and texture analysis of the liver have improved the differentiation of hypervascular lesions such as adenomas, focal nodular hyperplasia, and hepatocellular carcinoma (HCC) during the arterial phase, and in the pretreatment determination of HCC prognostic factors (e.g., tumor grade, microvascular invasion, Ki-67 proliferation index). Radiomics of pancreatic CT and MR images has enhanced pancreatic ductal adenocarcinoma detection and its differentiation from pancreatic neuroendocrine tumors, mass-forming chronic pancreatitis, or autoimmune pancreatitis. Radiomics can further help to better characterize incidental pancreatic cystic lesions, accurately discriminating benign from malignant intrapancreatic mucinous neoplasms. Nonetheless, despite their encouraging results and exciting potential, these tools have yet to be implemented in the clinical setting. This non-systematic review will describe the essential steps in the implementation of the radiomics and feature extraction workflow from liver and pancreas CT and MRI studies for their potential clinical application. A succinct overview of reported radiomics applications in the liver and pancreas and the challenges and limitations of their implementation in the clinical setting is also discussed, concluding with a brief exploration of the future perspectives of radiomics in the gastroenterology field.
放射组学允许从临床磁共振成像（MRI）和计算机断层扫描（CT）研究中提取定量成像特征。放射组学的优势主要在肿瘤学应用中得到了利用，包括更好地对肿瘤病变进行特征描述和分期，以及预测患者的结局和治疗反应。放射组学在临床环境中的引入需要建立标准化的放射组学工作流程和质量保证计划。
肝脏的放射组学和纹理分析提高了在动脉期区分富血管性病变的能力，如腺瘤、局灶性结节性增生和肝细胞癌（HCC），并在 HCC 预后因素的预处理评估中（如肿瘤分级、微血管侵犯、Ki-67 增殖指数）。胰腺 CT 和 MRI 图像的放射组学增强了对胰腺导管腺癌的检测及其与胰腺神经内分泌肿瘤、肿块型慢性胰腺炎或自身免疫性胰腺炎的鉴别。放射组学还可以帮助更好地描述偶然发现的胰腺囊性病变，准确区分良性和恶性胰内黏液性肿瘤。
尽管这些工具的结果令人鼓舞，具有令人兴奋的潜力，但它们尚未在临床环境中实施。本非系统性综述将描述从肝脏和胰腺 CT 和 MRI 研究中实施放射组学和特征提取工作流程的基本步骤，以评估其在临床中的潜在应用。还简要概述了肝脏和胰腺中放射组学应用的报道以及将其在临床环境中实施的挑战和局限性，并简要探讨了放射组学在胃肠病学领域的未来前景。
