Radiomic assessment of oesophageal adenocarcinoma: a critical review of 18F-FDG PET/CT, PET/MRI and CT.

OBJECTIVES: Radiomic models present an avenue to improve oesophageal adenocarcinoma assessment through quantitative medical image analysis. However, model selection is complicated by the abundance of available predictors and the uncertainty of their relevance and reproducibility. This analysis reviews recent research to facilitate precedent-based model selection for prospective validation studies. METHODS: This analysis reviews research on 18F-FDG PET/CT, PET/MRI and CT radiomics in oesophageal adenocarcinoma between 2016 and 2021. Model design, testing and reporting are evaluated according to the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) score and Radiomics Quality Score (RQS). Key results and limitations are analysed to identify opportunities for future research in the area. RESULTS: Radiomic models of stage and therapeutic response demonstrated discriminative capacity, though clinical applications require greater sensitivity. Although radiomic models predict survival within institutions, generalisability is limited. Few radiomic features have been recommended independently by multiple studies. CONCLUSIONS: Future research must prioritise prospective validation of previously proposed models to further clinical translation.

Sparse Regression in Cancer Genomics: Comparing Variable Selection and Predictions in Real World Data.

BACKGROUND: Evaluation of gene interaction models in cancer genomics is challenging, as the true distribution is uncertain. Previous analyses have benchmarked models using synthetic data or databases of experimentally verified interactions - approaches which are susceptible to misrepresentation and incompleteness, respectively. The objectives of this analysis are to (1) provide a real-world data-driven approach for comparing performance of genomic model inference algorithms, (2) compare the performance of LASSO, elastic net, best-subset selection, L 0 L 1 penalisation and L 0 L 2 penalisation in real genomic data and (3) compare algorithmic preselection according to performance in our benchmark datasets to algorithmic selection by internal cross-validation. METHODS: Five large ( n 4000 ) genomic datasets were extracted from Gene Expression Omnibus. 'Gold-standard' regression models were trained on subspaces of these datasets ( n 4000 , p = 500 ). Penalised regression models were trained on small samples from these subspaces ( n ∈ { 25 , 75 , 150 } , p = 500 ) and validated against the gold-standard models. Variable selection performance and out-of-sample prediction were assessed. Penalty 'preselection' according to test performance in the other 4 datasets was compared to selection internal cross-validation error minimisation. RESULTS: L 1 L 2 -penalisation achieved the highest cosine similarity between estimated coefficients and those of gold-standard models. L 0 L 2 -penalised models explained the greatest proportion of variance in test responses, though performance was unreliable in low signal:noise conditions. L 0 L 2 also attained the highest overall median variable selection F1 score. Penalty preselection significantly outperformed selection by internal cross-validation in each of 3 examined metrics. CONCLUSIONS: This analysis explores a novel approach for comparisons of model selection approaches in real genomic data from 5 cancers. Our benchmarking datasets have been made publicly available for use in future research. Our findings support the use of L 0 L 2 penalisation for structural selection and L 1 L 2 penalisation for coefficient recovery in genomic data. Evaluation of learning algorithms according to observed test performance in external genomic datasets yields valuable insights into actual test performance, providing a data-driven complement to internal cross-validation in genomic regression tasks.

Systematic review of research design and reporting of imaging studies applying convolutional neural networks for radiological cancer diagnosis.

OBJECTIVES: To perform a systematic review of design and reporting of imaging studies applying convolutional neural network models for radiological cancer diagnosis. METHODS: A comprehensive search of PUBMED, EMBASE, MEDLINE and SCOPUS was performed for published studies applying convolutional neural network models to radiological cancer diagnosis from January 1, 2016, to August 1, 2020. Two independent reviewers measured compliance with the Checklist for Artificial Intelligence in Medical Imaging (CLAIM). Compliance was defined as the proportion of applicable CLAIM items satisfied. RESULTS: One hundred eighty-six of 655 screened studies were included. Many studies did not meet the criteria for current design and reporting guidelines. Twenty-seven percent of studies documented eligibility criteria for their data (50/186, 95% CI 21-34%), 31% reported demographics for their study population (58/186, 95% CI 25-39%) and 49% of studies assessed model performance on test data partitions (91/186, 95% CI 42-57%). Median CLAIM compliance was 0.40 (IQR 0.33-0.49). Compliance correlated positively with publication year (ρ = 0.15, p = .04) and journal H-index (ρ = 0.27, p < .001). Clinical journals demonstrated higher mean compliance than technical journals (0.44 vs. 0.37, p < .001). CONCLUSIONS: Our findings highlight opportunities for improved design and reporting of convolutional neural network research for radiological cancer diagnosis. KEY POINTS: • Imaging studies applying convolutional neural networks (CNNs) for cancer diagnosis frequently omit key clinical information including eligibility criteria and population demographics. • Fewer than half of imaging studies assessed model performance on explicitly unobserved test data partitions. • Design and reporting standards have improved in CNN research for radiological cancer diagnosis, though many opportunities remain for further progress.