Radiomics to the Rescue

Excerpt

In this issue of Annals of Surgical Oncology, Xie et al.¹ present a compelling use of radiomics for the diagnosis of lymph node metastasis among patients with esophageal cancer in their manuscript “Prediction of Individual Lymph Node Metastatic Status in Esophageal Squamous Cell Carcinoma Using Routine CT Imaging: Comparison of Size-Based Measurements and Radiomics-Based Models”. This manuscript is compelling for several reasons. First, this is a large study of consecutively enrolled esophageal squamous cell cancer patients that challenges existing definitions of enlarged lymph nodes based on size criteria. The existing criterion for abnormal lymph node size has been established at 1 cm, but Xie et al. suggest that a value of 6.9 mm has improved discrimination of metastasis. This finding is similar to other studies, which have rejected the convention of a 1-cm normal.² Secondly, this manuscript challenges the very foundation of size-based criteria for detection of lymph node metastasis in this population. Their radiomics-based models showed excellent discriminatory ability with optimal results for the 2D model, which showed receiver operating characteristic curve AUC values of 0·841–0·891, accuracy of 84.2–94.7%, sensitivity of 65.7–83.3%, and specificity of 84.4–96.7%. …