Image Guided Radiotherapy (IGRT) and Delta (Δ) Radiomics-An Urgent Alliance for the Front Line of the War against Head and Neck Cancers.
Camil Ciprian MireșteanRoxana Irina IancuDragoș Petru Teodor IancuPublished in: Diagnostics (Basel, Switzerland) (2023)
The identification of a biomarker that is response predictive could offer a solution for the stratification of the treatment of head and neck cancers (HNC) in the context of high recurrence rates, especially those associated with loco-regional failure. Delta (Δ) radiomics, a concept based on the variation of parameters extracted from medical imaging using artificial intelligence (AI) algorithms, demonstrates its potential as a predictive biomarker of treatment response in HNC. The concept of image-guided radiotherapy (IGRT), including computer tomography simulation (CT) and position control imaging with cone-beam-computed tomography (CBCT), now offers new perspectives for radiomics applied in radiotherapy. The use of Δ features of texture, shape, and size, both from the primary tumor and from the tumor-involved lymph nodes, demonstrates the best predictive accuracy. If, in the case of treatment response, promising Δ radiomics results could be obtained, even after 24 h from the start of treatment, for radiation-induced xerostomia, the evaluation of Δ radiomics in the middle of treatment could be recommended. The fused models (clinical and Δ radiomics) seem to offer benefits, both in comparison to the clinical model and to the radiomic model. The selection of patients who benefit from induction chemotherapy is underestimated in Δ radiomic studies and may be an unexplored territory with major potential. The advantage offered by "in house" simulation CT and CBCT favors the rapid implementation of Δ radiomics studies in radiotherapy departments. Positron emission tomography (PET)-CT Δ radiomics could guide the new concepts of dose escalation on radio-resistant sub-volumes based on radiobiological criteria, but also guide the "next level" of HNC adaptive radiotherapy (ART).
Keyphrases
- radiation induced
- contrast enhanced
- positron emission tomography
- lymph node metastasis
- artificial intelligence
- pet ct
- computed tomography
- early stage
- locally advanced
- radiation therapy
- machine learning
- cone beam computed tomography
- magnetic resonance imaging
- lymph node
- deep learning
- healthcare
- image quality
- high resolution
- magnetic resonance
- primary care
- big data
- dual energy
- young adults
- combination therapy
- risk assessment
- quality improvement
- neoadjuvant chemotherapy
- human health
- pet imaging
- quantum dots
- open label
- case control