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Wednesday, August 17, 2022

Radiomics, a key tool in the medicine of the future @diariofarma

DailyPharma | 07.18.2022 – 12:53

Radiography, ultrasound or magnetic resonance imaging are some of the diagnostic techniques that allow to obtain internal images of a person and thus detect the presence of diseases, their extent and degree of involvement, and thus the best approach. able to establish therapeutic However, despite advances in the resolution of medical images, there is still information relevant to clinical decision making that is not visible to the observer.

Radiomics is an omics science that extracts, through computational algorithms, quantitative parameters in medical images to detect and measure features that are not appreciated by direct observation, called “radiomic features”, with the aim of associating them with specific physiological states. can be done.

In this sense, the Roche Institute Foundation has published the Anticipatory Report: Radiomics prepared by the Observatory of Trends in Future Medicine. In the words of the Vice President of the Roche Institute Foundation, Federico Plaza, “Computer advancements and the current widespread digital development have made it possible to generate information through radiomics, thus contributing medical imaging to the development of Personalized Precision Medicine (PPM). “.

Thanks to its ability to analyze large amounts of data, radiomics is a highly relevant source of information with a view to deepening our knowledge of the biological and functional diversity of tissues, the diversity of pathological phenomena and the near development of diseases. . This is explained by the coordinator of the report and director of the Medical Imaging Clinical Area of ​​the Hospital Universitario y Politécnico La Fe, Luis Martí-Bonmatí: “When we study a pancreatic tumor with a CT scan, in addition to radiologists, its size and While reporting resiliency, radiomics studies on these images will tell us more precisely whether the patient is amenable to surgery and whether he or she is going to develop a short-term recurrence or metastasis over the next three months.

This type of information is inaccessible to the radiologist’s eye, which is why, as experts point out, the combination of classic radiological readings with this new “hidden” radiomics information gives us information to predict what is going to happen. gives. occurs with the patient, contributing to greater accuracy and individualization of patient management and the design of the most appropriate therapeutic approach.

It is presented as an auxiliary tool in omics science research and clinical practice. According to the report’s coordinator, it offers many applications in areas such as oncology, rheumatological or neurodegenerative diseases. “For example, through images of the liver and tumors we can know whether hepatic metastases are going to develop in the short term. Thus, it allows to see very subtle changes in the image that are related to premetastatic niches.” , it can detect changes even before lesions are macroscopically apparent for radiologists, and it greatly changes the staging of patients”.

In addition, as Marti-Bonmati explains, “it also allows us to analyze the diversity of lesions. When we look at lesions, radiologists are very good at knowing their size, shape and structure, but We don’t recognize that they contain clusters of cells that have very different aggressive characteristics.”

Radiomics offers the opportunity to obtain greater amounts of information from medical images, contributing to the development of applications for the diagnosis and prediction of risk of events, aiding in decision-making and monitoring of treatment, or even that through the identification of different phenotypes in complementary diagnosis (fellow diagnosis) patients and their stratification against treatment. “Before the drug is administered, an image of the patient must be obtained to guarantee that the drug has the expected effect, that it will be effective. Radiomics serves as a complementary and essential diagnostic tool”, he comments. Huh.

Radiomics is useful in optimizing clinical research because it can be used, for example, to detect methodological biases in the re-analysis of images from clinical trials, such as incorrect patient selection; or used as a predictive tool for clinical events such as the presence of metastases A posterior. Similarly, the physician specifies that it can provide more reliable information than information obtained from other procedures, such as a biopsy, in which the study sample is very small and does not always represent the entire tissue or lesion. “When it comes to selecting the best candidates for administration of a targeted or very specific drug, biopsy may not be sufficient because it only samples a portion of the tumor or because there are metastatic tumors where the extent of metastasis is no longer similar. The expression does not occur in the tumor. Primary,” he explains.

Despite much of its potential being developed, this omics science is at an exploratory and evidence-generating stage, requiring its translation into clinical practice to address challenges of a different nature. These include great variability in generalization procedures and analysis of radiomics characteristics, a lack of knowledge about the clinical potential of radiomics as a tool for healthcare practice, as well as limited access to medical image banks and derived data. Is. Security and data protection reasons. However, Marti-Bonmati points out that the main challenge is matching the images. “We want them to be comparable, so that we can extract metrics that don’t depend on what device we acquired them from,” he says.

Consuelo Martín de Dios, managing director of the Roche Institute Foundation, recalls that with the development of new computational techniques that allow radiomics to obtain information, “a disruptive advance in medicine has been achieved. Radiomics aims at the state of diseases.” , presence or prognosis and can be used to select patients who are candidates for treatment and provide them with better therapeutic options in an individualized manner.

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