Advancing Pediatric Sarcomas through Radiomics: A Systematic Review and Prospective Assessment Using Radiomics Quality Score (RQS) and Methodological Radiomics Score (METRICS)
Gayane Aghakhanyan,
Tommaso Filidei,
Maria Febi,
Salvatore C. Fanni,
Andrea Marciano,
Roberto Francischello,
Francesca Pia Caputo,
Lorenzo Tumminello,
Dania Cioni,
Emanuele Neri,
Duccio Volterrani
Affiliations
Gayane Aghakhanyan
Department of Translational Research and of New Surgical and Medical Technology, University of Pisa, 56126 Pisa, Italy
Tommaso Filidei
Department of Translational Research and of New Surgical and Medical Technology, University of Pisa, 56126 Pisa, Italy
Maria Febi
Department of Translational Research and of New Surgical and Medical Technology, Academic Radiology, University of Pisa, 56126 Pisa, Italy
Salvatore C. Fanni
Department of Translational Research and of New Surgical and Medical Technology, Academic Radiology, University of Pisa, 56126 Pisa, Italy
Andrea Marciano
Department of Translational Research and of New Surgical and Medical Technology, University of Pisa, 56126 Pisa, Italy
Roberto Francischello
Department of Translational Research and of New Surgical and Medical Technology, Academic Radiology, University of Pisa, 56126 Pisa, Italy
Francesca Pia Caputo
Department of Translational Research and of New Surgical and Medical Technology, Academic Radiology, University of Pisa, 56126 Pisa, Italy
Lorenzo Tumminello
Department of Translational Research and of New Surgical and Medical Technology, Academic Radiology, University of Pisa, 56126 Pisa, Italy
Dania Cioni
Department of Translational Research and of New Surgical and Medical Technology, Academic Radiology, University of Pisa, 56126 Pisa, Italy
Emanuele Neri
Department of Translational Research and of New Surgical and Medical Technology, Academic Radiology, University of Pisa, 56126 Pisa, Italy
Duccio Volterrani
Department of Translational Research and of New Surgical and Medical Technology, University of Pisa, 56126 Pisa, Italy
Pediatric sarcomas, rare malignancies of mesenchymal origin, pose diagnostic and therapeutic challenges. In this review, we explore the role of radiomics in reshaping our understanding of pediatric sarcomas, emphasizing methodological considerations and applications such as diagnostics and predictive modeling. A systematic review conducted up to November 2023 identified 72 papers on radiomics analysis in pediatric sarcoma from PubMed/MEDLINE, Web of Knowledge, and Scopus. Following inclusion and exclusion criteria, 10 reports were included in this review. The studies, predominantly retrospective, focus on Ewing sarcoma and osteosarcoma, utilizing diverse imaging modalities, including CT, MRI, PET/CT, and PET/MRI. Manual segmentation is common, with a median of 35 features extracted. Radiomics Quality Score (RQS) and Methodological Radiomics Score (METRICS) assessments reveal a consistent emphasis on non-radiomic features, validation criteria, and improved methodological rigor in recent publications. Diagnostic applications dominate, with innovative studies exploring prognostic and treatment response aspects. Challenges include feature heterogeneity and sample size variations. The evolving landscape underscores the need for standardized methodologies. Despite challenges, the diagnostic and predictive potential of radiomics in pediatric oncology is evident, paving the way for precision medicine advancements.
