An increasing array of tools is being developed using artificial intelligence (AI) and machine learning (ML) for cancer imaging. The development of an optimal tool requires multidisciplinary engagement to ensure that the appropriate use case is met, as well as to undertake robust development and testing prior to its adoption into healthcare systems. This multidisciplinary review highlights key developments in the field. We discuss the challenges and opportunities of AI and ML in cancer imaging; considerations for the development of algorithms into tools that can be widely used and disseminated; and the development of the ecosystem needed to promote growth of AI and ML in cancer imaging. 

https://www.nature.com/articles/s43856-022-00199-0.pdf

Artificial intelligence and machine learning in cancer imaging

Radiomics is the method of choice for investigating the association between cancer imaging phenotype, cancer genotype and clinical outcome prediction in the era of precision medicine. The fast dispersal of this new methodology has benefited from the existing advances of the core technologies involved in radiomics workflow: image acquisition, tumor segmentation, feature extraction and machine learning. However, despite the rapidly increasing body of publications, there is no real clinical use of a developed radiomics signature so far. Reasons are multifaceted. One of the major challenges is the lack of reproducibility and generalizability of the reported radiomics signatures (features and models). Sources of variation exist in each step of the workflow; some are controllable or can be controlled to certain degrees, while others are uncontrollable or even unknown. Insufficient transparency in reporting radiomics studies further prevents translation of the developed radiomics signatures from the bench to the bedside. This review article first addresses sources of variation, which is illustrated using demonstrative examples. Then, it reviews a number of published studies and progresses made to date in the investigation and improvement of feature reproducibility and model performance. Lastly, it discusses potential strategies and practical considerations to reduce feature variability and improve the quality of radiomics study. This review focuses on CT image acquisition, tumor segmentation, quantitative feature extraction, and the disease of lung cancer.

/pdf/understanding-sources-of-variation-to-improve-the-p9344pi3vf.pdf

Understanding Sources of Variation to Improve the Reproducibility of Radiomics.

Abstract Purpose The purpose of this guideline is to provide comprehensive information on best practices for robust radiomics analyses for both hand-crafted and deep learning-based approaches. Methods In a cooperative effort between the EANM and SNMMI, we agreed upon current best practices and recommendations for relevant aspects of radiomics analyses, including study design, quality assurance, data collection, impact of acquisition and reconstruction, detection and segmentation, feature standardization and implementation, as well as appropriate modelling schemes, model evaluation, and interpretation. We also offer an outlook for future perspectives. Conclusion Radiomics is a very quickly evolving field of research. The present guideline focused on established findings as well as recommendations based on the state of the art. Though this guideline recognizes both hand-crafted and deep learning-based radiomics approaches, it primarily focuses on the former as this field is more mature. This guideline will be updated once more studies and results have contributed to improved consensus regarding the application of deep learning methods for radiomics. Although methodological recommendations in the present document are valid for most medical image modalities, we focus here on nuclear medicine, and specific recommendations when necessary are made for PET/CT, PET/MR, and quantitative SPECT. 

/pdf/joint-eanm-snmmi-guideline-on-radiomics-in-nuclear-medicine-3dy8j8sm.pdf

Joint EANM/SNMMI guideline on radiomics in nuclear medicine

Lung cancer ranks second in new cancer cases and first in cancer-related deaths worldwide. Precision medicine is working on altering treatment approaches and improving outcomes in this patient population. Radiological images are a powerful non-invasive tool in the screening and diagnosis of early-stage lung cancer, treatment strategy support, prognosis assessment, and follow-up for advanced-stage lung cancer. Recently, radiological features have evolved from solely semantic to include (handcrafted and deep) radiomic features. Radiomics entails the extraction and analysis of quantitative features from medical images using mathematical and machine learning methods to explore possible ties with biology and clinical outcomes. Here, we outline the latest applications of both structural and functional radiomics in detection, diagnosis, and prediction of pathology, gene mutation, treatment strategy, follow-up, treatment response evaluation, and prognosis in the field of lung cancer. The major drawbacks of radiomics are the lack of large datasets with high-quality data, standardization of methodology, the black-box nature of deep learning, and reproducibility. The prerequisite for the clinical implementation of radiomics is that these limitations are addressed. Future directions include a safer and more efficient model-training mode, merge multi-modality images, and combined multi-discipline or multi-omics to form “Medomics.”

/pdf/structural-and-functional-radiomics-for-lung-cancer-3qzdjmybyw.pdf

Structural and functional radiomics for lung cancer.

Impact of feature harmonization on radiogenomics analysis: Prediction of EGFR and KRAS mutations from non-small cell lung cancer PET/CT images

Radiomic features are being increasingly studied for clinical applications. We aimed to assess the agreement among radiomic features when computed by several groups by using different software packages under very tightly controlled conditions, which included standardized feature definitions and common image data sets. Ten sites (9 from the NCI's Quantitative Imaging Network] positron emission tomography-computed tomography working group plus one site from outside that group) participated in this project. Nine common quantitative imaging features were selected for comparison including features that describe morphology, intensity, shape, and texture. The common image data sets were: three 3D digital reference objects (DROs) and 10 patient image scans from the Lung Image Database Consortium data set using a specific lesion in each scan. Each object (DRO or lesion) was accompanied by an already-defined volume of interest, from which the features were calculated. Feature values for each object (DRO or lesion) were reported. The coefficient of variation (CV), expressed as a percentage, was calculated across software packages for each feature on each object. Thirteen sets of results were obtained for the DROs and patient data sets. Five of the 9 features showed excellent agreement with CV < 1%; 1 feature had moderate agreement (CV < 10%), and 3 features had larger variations (CV ≥ 10%) even after attempts at harmonization of feature calculations. This work highlights the value of feature definition standardization as well as the need to further clarify definitions for some features.

/pdf/standardization-in-quantitative-imaging-a-multicenter-1rxypw7esc.pdf

Standardization in Quantitative Imaging: A Multicenter Comparison of Radiomic Features from Different Software Packages on Digital Reference Objects and Patient Data Sets

Recent studies on the web ecosystem have been raising alarms on the increasing geodifferences in access to Internet content and services due to Internet censorship and geoblocking. However, geodifferences in the mobile app ecosystem have received limited attention, even though apps are central to how mobile users communicate and consume Internet content. We present the ﬁrst large-scale measurement study of geodifferences in the mobile app ecosystem. We design a semi-automatic, parallel measurement testbed that we use to collect 5,684 popular apps from Google Play in 26 countries. In all, we collected 117,233 apk ﬁles and 112,607 privacy policies for those apps. Our results show high amounts of geoblocking with 3,672 apps geoblocked in at least one of our countries. While our data corroborates anecdotal evidence of takedowns due to government requests, unlike common perception, we ﬁnd that blocking by developers is signiﬁcantly higher than takedowns in all our countries, and has the most inﬂuence on geoblocking in the mobile app ecosystem. We also ﬁnd instances of developers releasing different app versions to different countries, some with weaker security settings or privacy disclosures that expose users to higher security and privacy risks. We provide recommendations for app market proprietors to address the issues discovered.

A Large-scale Investigation into Geodifferences in Mobile Apps

Russia’s invasion of Ukraine in February 2022 was followed by sanctions and restrictions: by Russia against its citizens, by Russia against the world, and by foreign actors against Russia. Reports suggested a torrent of increased censorship, geoblocking, and network events affecting Internet freedom. This paper is an investigation into the network changes that occurred in the weeks following this escalation of hostilities. It is the result of a rapid mobilization of researchers and activists, examining the problem from multiple perspectives. We develop GeoInspector, and conduct measurements to identify different types of geoblocking, and synthesize data from nine independent data sources to understand and describe various network changes. Immediately after the invasion, more than 45% of Russian government domains tested blocked access from countries other than Russia and Kazakhstan; conversely, 444 foreign websites, including news and educational domains, geoblocked Russian users. We find significant increases in Russian censorship, especially of news and social media. We find evidence of the use of BGP withdrawals to implement restrictions, and we quantify the use of a new domestic certificate authority. Finally, we analyze data from circumvention tools, and investigate their usage and blocking. We hope that our findings showing the rapidly shifting landscape of Internet splintering serves as a cautionary tale, and encourages research and efforts to protect Internet freedom.

Network Responses to Russia’s Invasion of Ukraine in 2022: A Cautionary Tale for Internet Freedom

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Papers

Standardization in Quantitative Imaging: A Multicenter Comparison of Radiomic Features from Different Software Packages on Digital Reference Objects and Patient Data Sets

A Large-scale Investigation into Geodifferences in Mobile Apps

Network Responses to Russia’s Invasion of Ukraine in 2022: A Cautionary Tale for Internet Freedom