From the Department of Diagnostic Imaging (C.H., A.W.P.M., Z.J.) and Warren Alpert Medical School (A.L.), Brown University, Providence, RI; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (I.I., J.C.); Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (G.N.); and Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21205 (H.X.B.).
Radiology. 2023 Nov;309(2):e222891. doi: 10.1148/radiol.222891.
Interventional oncology is a rapidly growing field with advances in minimally invasive image-guided local-regional treatments for hepatocellular carcinoma (HCC), including transarterial chemoembolization, transarterial radioembolization, and thermal ablation. However, current standardized clinical staging systems for HCC are limited in their ability to optimize patient selection for treatment as they rely primarily on serum markers and radiologist-defined imaging features. Given the variation in treatment responses, an updated scoring system that includes multidimensional aspects of the disease, including quantitative imaging features, serum markers, and functional biomarkers, is needed to optimally triage patients. With the vast amounts of numerical medical record data and imaging features, researchers have turned to image-based methods, such as radiomics and artificial intelligence (AI), to automatically extract and process multidimensional data from images. The synthesis of these data can provide clinically relevant results to guide personalized treatment plans and optimize resource utilization. Machine learning (ML) is a branch of AI in which a model learns from training data and makes effective predictions by teaching itself. This review article outlines the basics of ML and provides a comprehensive overview of its potential value in the prediction of treatment response in patients with HCC after minimally invasive image-guided therapy.
介入肿瘤学是一个快速发展的领域,微创影像引导局部区域治疗肝细胞癌 (HCC) 的技术不断进步,包括经动脉化疗栓塞术、经动脉放射性栓塞术和热消融术。然而,目前 HCC 的标准化临床分期系统在优化治疗患者选择方面的能力有限,因为它们主要依赖于血清标志物和放射科医生定义的影像学特征。鉴于治疗反应的差异,需要一种更新的评分系统,该系统包括疾病的多维方面,包括定量影像学特征、血清标志物和功能生物标志物,以最佳地对患者进行分类。由于大量的数值医疗记录数据和影像学特征,研究人员转向基于图像的方法,如放射组学和人工智能 (AI),以自动从图像中提取和处理多维数据。这些数据的综合可以提供临床相关的结果,以指导个性化的治疗计划并优化资源利用。机器学习 (ML) 是人工智能的一个分支,其中模型通过自我教学从训练数据中学习并做出有效的预测。这篇综述文章概述了 ML 的基础知识,并全面概述了其在预测微创影像引导治疗后 HCC 患者治疗反应中的潜在价值。
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