Medical imaging articles within Nature Reviews Clinical Oncology

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  • News & Views |

    A recent study reported the development and validation of the Liver Artificial Intelligence Diagnosis System (LiAIDS), a fully automated system that integrates deep learning for the diagnosis of liver lesions on the basis of contrast-enhanced CT scans and clinical information. This tool improved diagnostic precision, surpassed the accuracy of junior radiologists (and equalled that of senior radiologists) and streamlined patient triage. These advances underscore the potential of artificial intelligence to enhance hepatology care, although challenges to widespread clinical implementation remain.

    • Jeong Min Lee
    •  & Jae Seok Bae

  • Review Article |

    Despite a considerable increase in research output over the past decades, the translation of radiomic research into clinically useful tests has been limited. In this Review, the authors provide 16 key criteria to guide the clinical translation of radiomics with the hope of accelerating the use of this technology to improve patient outcomes.

    • Erich P. Huang
    • , James P. B. O’Connor
    •  & Lalitha K. Shankar

  • Perspective |

    The possible uses of artificial intelligence (AI) in radiation oncology are diverse and wide ranging. Herein, the authors discuss the potential applications of AI at each step of the radiation oncology workflow, which might improve the efficiency and overall quality of radiation therapy for patients with cancer. The authors also describe the associated challenges and provide their perspective on how AI platforms might change the roles of radiation oncology medical professionals.

    • Elizabeth Huynh
    • , Ahmed Hosny
    •  & Raymond H. Mak

  • Review Article |

    Photodynamic and photothermal therapies hold promise in the local treatment of cancer although, arguably, their full potential has not yet been achieved. Herein, the authors review the current clinical progress of these phototherapies and discuss the bioengineering approaches that are being explored to overcome challenges and thereby improve such treatments.

    • Xingshu Li
    • , Jonathan F. Lovell
    •  & Xiaoyuan Chen

  • Perspective |

    Integrating molecular nuclear imaging in clinical research has great potential to improve anticancer therapy, particularly through the development of imaging biomarkers. Herein, the multistage process of developing novel molecular imaging biomarkers is discussed, highlighting both the challenges that have restricted the use of molecular imaging in clinical oncology research and future opportunities in this area.

    • Elisabeth G. E. de Vries
    • , Laura Kist de Ruijter
    •  & Sjoukje F. Oosting

  • Review Article |

    Surgery remains the mainstay of treatment for patients with gliomas, independent of tumour grade, and maximal resection of the tumour is essential for long-term disease control. Herein, the authors discuss the current evidence on associations between the extent of glioma resection and clinical outcomes. They also describe the state-of-the-art surgical oncology approaches aimed at maximizing the extent of tumour resection while minimizing patient morbidity.

    • Nader Sanai
    •  & Mitchel S. Berger

  • Review Article |

    Radiomics is the high-throughput mining of quantitative image features from standard-of-care medical imaging to enable data to be extracted and applied within clinical-decision support systems. The process of radiomics is described and its pitfalls, challenges, opportunities, and capacity to improve clinical decision making. The radiomics field requires standardized evaluation of scientific findings and their clinical relevance. This review provides guidance for investigations to meet this urgent need in the field of radiomics.

    • Philippe Lambin
    • , Ralph T.H. Leijenaar
    •  & Sean Walsh

  • Review Article |

    After curative treatment, 30% of patients with stage I–III and up to 65% of patients with stage IV colorectal cancer (CRC) develop recurrent disease. Thus, surveillance for disease recurrence is clearly needed in these patients, but controversy surrounds the optimal follow-up approaches. Herein, the current evidence relating to surveillance strategies for patients with CRC is comprehensively reviewed, and the future development of patient-centred programmes is discussed.

    • Eric P. van der Stok
    • , Manon C. W. Spaander
    •  & Ernst J. Kuipers

  • Review Article |

    Many of the molecular pathways that are aberrant in brain tumours result in reprogramming of metabolism, which creates opportunities forin vivometabolic imaging to improve diagnosis, patient stratification, and disease monitoring. Herein, the molecular basis and strategies for non-invasive metabolic imaging of brain tumours are reviewed.

    • Michelle M. Kim
    • , Abhijit Parolia
    •  & Sriram Venneti

  • News & Views |

    Annual thoracic CT screening is currently recommended for individuals deemed to be at high risk of developing lung cancer; however, Patz and co-workers now raise the very important question of choosing the optimal interval between screening exams, in order to balance the potential benefits and harms associated with each round of CT. Herein, we present important considerations for determining such intervals.

    • David Yankelevitz
    •  & Claudia Henschke

  • News & Views |

    The recently updated breast cancer screening guidelines from the American Cancer Society are less aggressive than previous versions and clearer about overdiagnosis. However, a lack of attention was placed on the differences in effect estimates between trials at high and low risk of bias, and the authors failed to quantify the most serious harm.

    • Karsten Juhl Jørgensen
    •  & Peter C. Gøtzsche

  • News & Views |

    The results of three recent studies demand that more attention be placed on defining the most-appropriate approach to population-based breast-cancer screening, in particular regarding the potential harms of increasing overdiagnosis. Two of these studies report that more-sensitive detection of breast neoplasms is possible by 3D tomography and by MRI, but the third paper raises the question of whether this increased sensitivity is desirable.

    • Steven Narod

  • Review Article |

    The use of traditional Euclidean geometry can present challenges for analysis of image characteristics, particular those of extremely complex biological structures, obtained by medical and scientific imaging modalities. Fractal geometry is a potentially complementary mathematical approach that enables efficient estimation of geometrical complexity, and the irregularity of shapes and patterns. This Review introduces the concept of fractals and fractal geometry, and describes how analysis of fractal (non-integer) dimension and associated measurements, such as lacunarity (texture), can be performed and applied to the analysis of cancer. The authors discuss how fractal analysis might provide information on many diverse biological structures relevant to the natural history of lung cancer, which might prove useful for the diagnosis and management of this disease.

    • Frances E. Lennon
    • , Gianguido C. Cianci
    •  & Ravi Salgia

  • Review Article |

    PET has evolved from a purely diagnostic imaging technique to a multifunctional modality that can provide diverse information of relevance to oncological management. This modality might offer the potential to improve patient care and outcomes by enabling better disease characterization, treatment-response monitoring, and follow-up assessment. Herein, the authors discuss the data supporting the use of PET in personalizing the clinical management of patients with locally advanced and metastatic non-small-cell lung cancer.

    • Willem Grootjans
    • , Lioe-Fee de Geus-Oei
    •  & Johan Bussink

  • Opinion |

    Recent advances in multimodality imaging in cancer have involved the integration of multiple quantitative, functional measurements that provide a more-comprehensive characterization of tumours. In this Review, Yankeelov and colleagues discuss how, although some of these approaches still need some adjusting, they can already be applied informatively in clinical trials of cancer therapeutics using existing tools.

    • Thomas E. Yankeelov
    • , Richard G. Abramson
    •  & C. Chad Quarles

  • Review Article |

    Antiangiogenic therapies are cytostatic rather than cytotoxic and, therefore, do not simply decrease tumour sizes. Thus, traditional assessment of radiographic response according to MRI-based tumour-volume criteria can no longer be considered adequate. Instead, vessel-calibre MRI has emerged as a potential alternative—providing insight into vessel type and oxygenation status, and opening possibilities for clinical trial design and monitoring therapeutic response and outcomes.

    • Kyrre E. Emblem
    • , Christian T. Farrar
    •  & Rakesh K. Jain

  • Review Article |

    The combination of conventional anatomical MRI and functional magnet resonance sequences–known as multiparametric MRI (mp-MRI) is emerging as an accurate tool for identifying clinically relevant tumours. This Review discusses the role of mp-MRI in the detection, staging, and treatment planning of prostate cancer.

    • Linda M. Johnson
    • , Baris Turkbey
    •  & Peter L. Choyke

  • News & Views |

    Two randomized controlled trials conducted within the SIGGAR study have reported efficacy results. In patients with symptoms of colorectal cancer, CT colonography should replace barium enema and is a good alternative to colonoscopy.

    • Jaap Stoker

  • Perspectives |

    PET or SPECT, is that the question? Single-photon emission computed tomography (SPECT) and positron emission tomography (PET) are both tomographic techniques that enable 3D-localization of the tumour and can be combined with CT for hybrid imaging; but is one better that the other? In oncology imaging nothing is black or white, and Rod Hicks and Michael Hofman provide us with an in-depth analysis of the advantages and disadvantages of each technique.

    • Rodney J. Hicks
    •  & Michael S. Hofman

  • Review Article |

    Are there any methods beyond MRI for brain tumours imaging? This Review by Andrew C. Peet and colleagues discusses the additional information that can be obtained by using functional imaging methods—such as diffusion imaging, perfusion imaging and magnetic resonance spectroscopy—and the challenges in determining the best way to incorporate these techniques into routine clinical practice.

    • Andrew C. Peet
    • , Theodoros N. Arvanitis
    •  & Adam D. Waldman

  • Perspectives |

    Treatment of prostate cancer using high-intensity focused ultrasound (HIFU) focal therapy could be a reliable treatment option but, are we ready for it? This Perspectives article assesses whether our current methods for cancer diagnosis, tissue targeting, and treatment follow up are accurate enough to allow the design of HIFU focal therapy protocols.

    • Olivier Rouvière
    • , Albert Gelet
    •  & Jean-Yves Chapelon

  • News & Views |

    Patients undergoing removal of adenoma have a 53% reduction in colorectal cancer-related death. However, to translate these results into a screening programme, participation rates should also be taken into account. The results of a large, first screening round of once-only colonoscopy demonstrated a low participation rate compared with biennial faecal immunochemical test.

    • Evelien Dekker

  • Review Article |

    Should dynamic contrast-enhanced (DCE)-MRI be used in the assessment of drug-development of antivascular agents? In this Review, O'connor et al. discuss whether data from DCE-MRI are reliable and reproducible biomarkers of drug efficacy, and whether they assist in dose selection and drug scheduling in the design of early clinical trials.

    • James P. B. O'Connor
    • , Alan Jackson
    •  & Gordon C. Jayson

  • Review Article |

    Although breast density is a powerful factor for predicting the risk of developing breast cancer, unfortunately current methods of measuring mammographic density are not entirely satisfactory. This Review analyzes the different factors affecting breast density and how to consider them so that the accuracy of individual risk assessments can be improved.

    • Valentina Assi
    • , Jane Warwick
    •  & Stephen W. Duffy

  • Review Article |

    The ability to follow the distribution and migration of biologically active cells in living organisms is crucial for the development of cell-based therapies. In this Review, Kircher et al. describe the imaging principles underlying currently available cell-tracking methods and highlight recent examples of their application in animal models and patients.

    • Moritz F. Kircher
    • , Sanjiv S. Gambhir
    •  & Jan Grimm

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