Systematic Review on the Association of Radiomics with Tumor Biological Endpoints

SIMPLE SUMMARY: In this systematic review, we aim to highlight existing literature devoted to the study of an association between medical imaging radiomics and cancer biological endpoints. The use of radiomics as an ancillary tool in cancer treatment would allow for a non-invasive, inexpensive, three-dimensional characterization of the tumor phenotype, contributing to the delivery of precision medicine. Nonetheless, its clinical application remains a challenge, as extensive, multi-center validation studies of radiomic features connection with tumor biology are required. In this review, we performed a search in PubMed database for peer-reviewed studies which evaluate the association between radiomic features and the following set of clinically relevant tumor markers: anaplastic lymphoma kinase (ALK), v-raf murine sarcoma viral oncogene homolog B1 (BRAF), epidermal growth factor (EGFR), human epidermal growth factor receptor 2 (HER-2), isocitrate dehydrogenase (IDH), antigen Ki-67, kirsten rat sarcoma viral oncogene homolog (KRAS), programmed cell death ligand 1 (PD-L1), tumor protein p53 (TP-53) and vascular endothelial growth factor (VEGF). ABSTRACT: Radiomics supposes an alternative non-invasive tumor characterization tool, which has experienced increased interest with the advent of more powerful computers and more sophisticated machine learning algorithms. Nonetheless, the incorporation of radiomics in cancer clinical-decision support systems still necessitates a thorough analysis of its relationship with tumor biology. Herein, we present a systematic review focusing on the clinical evidence of radiomics as a surrogate method for tumor molecular profile characterization. An extensive literature review was conducted in PubMed, including papers on radiomics and a selected set of clinically relevant and commonly used tumor molecular markers. We summarized our findings based on different cancer entities, additionally evaluating the effect of different modalities for the prediction of biomarkers at each tumor site. Results suggest the existence of an association between the studied biomarkers and radiomics from different modalities and different tumor sites, even though a larger number of multi-center studies are required to further validate the reported outcomes.