Radiomics in pancreatic neuroendocrine tumors: methodological issues and clinical significance

Bezzi, Carolina; Mapelli, Paola; Presotto, Luca; Neri, Ilaria; Scifo, Paola; Savi, Annarita; Bettinardi, Valentino; Partelli, Stefano; Gianolli, Luigi; Falconi, Massimo

doi:10.1007/s00259-021-05338-8

Cited by 41 publications

(24 citation statements)

References 51 publications

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“…Several reviews have summarized the use of radiomics in multiple pancreatic diseases from pancreatic cystic lesions to pancreatic tumors [ 15 – 22 ]. A comprehensive review reported that most of the pancreatic radiomics studies investigated focal pancreatic lesions, but only four studies discussed the pancreatitis [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our results implied that the level of evidence supporting clinical application and the overall study quality were suboptimal in pancreatitis radiomics research, requiring significant improvement. Several reviews have summarized the use of radiomics in multiple pancreatic diseases from pancreatic cystic lesions to pancreatic tumors [15][16][17][18][19][20][21][22]. A comprehensive review reported that most of the pancreatic radiomics studies investigated focal pancreatic lesions, but only four studies discussed the pancreatitis [12].…”

Section: Discussionmentioning

confidence: 99%

“…However, only 5.6% of pancreatic radiomics studies investigated the role of radiomics in acute pancreatitis [18]. Most radiomics studies on chronic, mass-forming, or autoimmune pancreatitis were aimed to differentiate these inflammatory conditions from malignancy lesions [19][20][21][22]. Implanting radiomics in acute pancreatitis could provide predictive information to identify patients with worse prognosis and therefore promote personalized medical treatment.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of radiomics in pancreatitis: applying the evidence level rating tool for promoting clinical transferability

Zhong

Xing

et al. 2022

Insights Imaging

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Background Multiple tools have been applied to radiomics evaluation, while evidence rating tools for this field are still lacking. This study aims to assess the quality of pancreatitis radiomics research and test the feasibility of the evidence level rating tool. Results Thirty studies were included after a systematic search of pancreatitis radiomics studies until February 28, 2022, via five databases. Twenty-four studies employed radiomics for diagnostic purposes. The mean ± standard deviation of the adherence rate was 38.3 ± 13.3%, 61.3 ± 11.9%, and 37.1 ± 27.2% for the Radiomics Quality Score (RQS), the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) checklist, and the Image Biomarker Standardization Initiative (IBSI) guideline for preprocessing steps, respectively. The median (range) of RQS was 7.0 (− 3.0 to 18.0). The risk of bias and application concerns were mainly related to the index test according to the modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The meta-analysis on differential diagnosis of autoimmune pancreatitis versus pancreatic cancer by CT and mass-forming pancreatitis versus pancreatic cancer by MRI showed diagnostic odds ratios (95% confidence intervals) of, respectively, 189.63 (79.65–451.48) and 135.70 (36.17–509.13), both rated as weak evidence mainly due to the insufficient sample size. Conclusions More research on prognosis of acute pancreatitis is encouraged. The current pancreatitis radiomics studies have insufficient quality and share common scientific disadvantages. The evidence level rating is feasible and necessary for bringing the field of radiomics from preclinical research area to clinical stage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A systematic review of radiomics in pancreatitis: applying the evidence level rating tool for promoting clinical transferability

Zhong

Xing

et al. 2022

Insights Imaging

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“…Kurtosis on coarse filtered images and skewness and entropy on PET-TA were significantly related to survival outcomes. There is increasing interest in imaging of heterogeneity and radiomics-based texture analysis (20)(21)(22)(23)(24)(25). Most of these studies focus predominantly on the PET-TA in NET demonstrating prognostic potential or treatment-related changes, where in one study (20) entropy significantly predicted outcome.…”

Section: Discussionmentioning

confidence: 99%

Radiomics-Based Texture Analysis of 68Ga-DOTATATE Positron Emission Tomography and Computed Tomography Images as a Prognostic Biomarker in Adults With Neuroendocrine Cancers Treated With 177Lu-DOTATATE

et al. 2021

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PurposeNeuroendocrine tumors (NET) are rare cancers with variable behavior. A better understanding of prognosis would aid individualized management. The aim of this hypothesis-generating pilot study was to investigate the prognostic potential of tumor heterogeneity and tracer avidity in NET using texture analysis (TA) of 68Ga-DOTATATE positron emission tomography (PET) and non-enhanced computed tomography (CT) performed at baseline in patients treated with 177Lu-DOTATATE. It aims to justify a larger-scale study to evaluate its clinical value.MethodsThe pretherapy 68Ga-DOTATATE PET-CT scans of 44 patients with metastatic NET (carcinoid, pancreatic, thyroid, head and neck, catecholamine-secreting, and unknown primary NET) treated with 177Lu-DOTATATE were analyzed retrospectively using commercially available texture analysis research software. Image filtration extracted and enhanced objects of different sizes (fine, medium, coarse), then quantified heterogeneity by statistical and histogram-based parameters (mean intensity, standard deviation, entropy, mean of positive pixels, skewness, and kurtosis). Regions of interest were manually drawn around up to five of the most 68Ga-DOTATATE avid lesions for each patient. 68Gallium uptake on PET was quantified as SUVmax and SUVmean. Associations between imaging and clinical markers with progression-free (PFS) and overall survival (OS) were assessed using univariate Kaplan-Meier analysis. Independence of the significant univariate markers of survival was tested using multivariate Cox regression analysis.ResultsMeasures of heterogeneity (higher kurtosis, higher entropy, and lower skewness) on coarse-texture scale CT and unfiltered PET images predicted shorter PFS (CT coarse kurtosis: p=0.05, PET entropy: p=0.01, PET skewness: p=0.03) and shorter OS (CT coarse kurtosis: p=0.05, PET entropy: p=0.01, PET skewness p=0.02). Conventional PET parameters such as SUVmax and SUVmean showed trends towards predicting outcome but were not statistically significant. Multivariate analysis identified that CT-TA (coarse kurtosis: HR=2.57, 95% CI=1.22–5.38, p=0.013) independently predicted PFS, and PET-TA (unfiltered skewness: HR=9.05, 95% CI=1.19–68.91, p=0.033) independently predicted OS.ConclusionThese preliminary data generate a hypothesis that radiomic analysis of neuroendocrine cancer on 68Ga-DOTATATE PET-CT may be of prognostic value and a valuable addition to the assessment of patients.

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“…Существует множество исследований по текстурному анализу, но в большинстве имеет место значительная статистическая диспропорция ввиду большого числа вариантов признаков в небольшой популяции. Это порождает значительную долю ложных результатов (так называемое "проклятие размерности"), поэтому следует выпол нять перекрестную проверку признаков и (или) проводить исследования на больших попу ляциях [11,36].…”

Section: проблемы внедренияunclassified

Radiomics in liver and pancreatic disorders: a review

et al. 2022

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A study of the international literature on texture analysis was performed, and the reported data was compared to the findings of radiomics studies performed by the specialists of our institute. The relevant papers were searched using a combination of the following search terms: “radiomics”, “radiology”, “texture analysis”, “perspectives”, and “clinical implementation”. The search was limited to papers published in English within the last 5 years, which essentially focused on liver and pancreas disorders. Due to the publication of new data on a fairly daily basis, the topic has not lost its relevance. The vast majority of authors confirm that radiomics can be efficiently used during diagnosis, treatment planning, and patient monitoring. However, consensus on the implementation of radiomics has not been reached yet, thereby delaying its introduction into clinical practice. The data collected in our institution reports that the clinical application of texture analysis methods may be very promising.

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Radiomics in pancreatic neuroendocrine tumors: methodological issues and clinical significance

Cited by 41 publications

References 51 publications

A systematic review of radiomics in pancreatitis: applying the evidence level rating tool for promoting clinical transferability

A systematic review of radiomics in pancreatitis: applying the evidence level rating tool for promoting clinical transferability

Radiomics-Based Texture Analysis of 68Ga-DOTATATE Positron Emission Tomography and Computed Tomography Images as a Prognostic Biomarker in Adults With Neuroendocrine Cancers Treated With 177Lu-DOTATATE

Radiomics in liver and pancreatic disorders: a review

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