Karaciğer Görüntülemesinde Radyomiks: Tanı, Prognoz ve Tedavi Yanıtı Değerlendirme
Özet
Radyomiks, rutin tıbbi görüntülerden insan gözüyle doğrudan değerlendirilemeyen nicel fenotipik özelliklerin çıkarılması ve bu özelliklerin tanı, prognoz ve tedavi yanıtı gibi klinik sonlanımlarla ilişkilendirilmesi yaklaşımıdır. Karaciğer, multiparametrik MRI, çok fazlı CT ve hepatosit-spesifik kontrast ajanların sağladığı zengin fenotipik bilgi nedeniyle radyomiks açısından özellikle çekici bir organdır. Güncel literatür; karaciğer fibrozisinin evrelenmesi, portal hipertansiyon, hepatoselüler karsinomun karakterizasyonu, mikrovasküler invazyon ve nüks tahmini, intrahepatik kolanjiyokarsinomun biyolojik risk sınıflaması, kolorektal karaciğer metastazlarında tedavi yanıtı ve lokorejyonel/sistemik tedavi sonuçlarının öngörülmesinde anlamlı sinyaller göstermektedir. Bununla birlikte yüksek ayırt etme performansı, klinik yararla eş anlamlı değildir. Görüntüleme protokolü, cihaz, rekonstrüksiyon, segmentasyon, ön işleme ve özellik tasarımı farklılıkları özelliklerin tekrarlanabilirliğini önemli ölçüde etkileyebilir. Küçük retrospektif kohortlar, yüksek boyutluluk, veri sızıntısı ve yetersiz dış doğrulama da performansın iyimser tahmin edilmesine yol açmaktadır. Bu nedenle gelecekteki çalışmaların IBSI uyumlu özellik çıkarımı, prospektif çok merkezli tasarım, dış doğrulama, kalibrasyon, karar eğrisi analizi ve mevcut klinik biyobelirteçlerin üzerine ek değer gösterilmesini içermesi gerekmektedir.
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