Radiomic biomarkers for head and neck squamous cell carcinoma
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REVIEW ARTICLE
Radiomic biomarkers for head and neck squamous cell carcinoma Stephanie Tanadini-Lang1 · Panagiotis Balermpas1 · Matthias Guckenberger1 · Matea Pavic1 · Oliver Riesterer2 · Diem Vuong1 · Marta Bogowicz1 Received: 1 April 2020 / Accepted: 13 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Tumor heterogeneity is a well-known prognostic factor in head and neck squamous cell carcinoma (HNSCC). A major limitation of tissue- and blood-derived tumor markers is the lack of spatial resolution to image tumor heterogeneity. Tissue markers derived from tumor biopsies usually represent only a small tumor subregion at a single timepoint and are therefore often not representative of the tumors’ biology or the biological alterations during and after treatment. Similarly, liquid biopsies give an overall picture of the tumors’ secreted factors but completely lack any spatial resolution. Radiomics has the potential to give complete three-dimensional information about the tumor. We conducted a comprehensive literature search to assess the correlation of radiomics to tumor biology and treatment outcome in HNSCC and to assess current limitations of the radiomic biomarkers. In total, 25 studies that explored the ability of radiomics to predict tumor biology and phenotype in HNSCC and 28 studies that explored radiomics to predict post-treatment events were identified. Out of these 53 studies, only three failed to show a significant correlation. The major technical challenges are currently artifacts due to metal implants, non-standardized contrast injection, and delineation uncertainties. All studies to date were retrospective and none of the above-mentioned radiomics signatures have been validated in an independent cohort using an independent software implementation, which shows that transferability due to the numerous technical challenges is currently a major limitation. However, radiomics is a very young field and these studies hopefully pave the way for clinical implementation of radiomics for HNSCC in the future.
Keywords Prognostic biomarkers · Quantitative image analysis · Computed tomography · Positron emission tomography · Magnetic resonance imaging
Introduction The term squamous cell carcinoma of the head and neck (HNSCC) represents a highly heterogeneous group of malignancies, arising mainly from the oral cavity, pharynx, and larynx. They contribute 4–6% of all cancer cases, with a globally rising incidence over the last decades [1, 2]. Outcome is still unsatisfactory, not exceeding 60% overall survival, especially for advanced stages [3]. The heterogeneity of this disease group regarding organ and tissue of origin, etiology, molecular and mutational landscape [4], and the emergence of personalized cancer medicine [5] has Stephanie Tanadini-Lang
[email protected] 1
Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistraße 100, 8091 Zurich, Switzerland
2
Centre for Radiation Oncology KSA-KSB, Canton Hospital Aarau, Aarau, Swi
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