Karaciğer Görüntülemesinde Radyomiks: Tanı, Prognoz ve Tedavi Yanıtı Değerlendirme
Synopsis
Radiomics is the approach of extracting quantitative phenotypic features that cannot be directly assessed by the human eye from routine medical images and relating these features to clinical outcomes such as diagnosis, prognosis and treatment response. The liver is a particularly attractive organ for radiomics owing to the rich phenotypic information provided by multiparametric MRI, multiphase CT and hepatocyte-specific contrast agents. The current literature shows meaningful signals in staging liver fibrosis, portal hypertension, characterization of hepatocellular carcinoma, prediction of microvascular invasion and recurrence, biological risk stratification of intrahepatic cholangiocarcinoma, treatment response in colorectal liver metastases, and prediction of locoregional/systemic treatment outcomes. However, high discrimination performance is not synonymous with clinical utility. Differences in imaging protocol, scanner, reconstruction, segmentation, preprocessing and feature design can substantially affect feature reproducibility, while small retrospective cohorts, high dimensionality, data leakage and insufficient external validation lead to optimistic performance estimates. Future studies therefore need IBSI-compliant feature extraction, prospective multicenter design, external validation, calibration, decision-curve analysis and demonstration of added value over existing clinical biomarkers. The most likely clinical future of radiomics is to become a measurable and verifiable component of multimodal artificial-intelligence systems integrating clinical, laboratory, pathology, genomic and longitudinal imaging data, rather than a standalone “imaging signature.”
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