Imaging Genomics and Multiomics: A Guide for Beginners Starting Radiomics-Based Research.

Radiomics uses advanced mathematical analysis of pixel-level information from radiologic images to extract existing information in traditional imaging algorithms. It is intended to find imaging biomarkers related to the genomics of tumors or disease patterns that improve medical care by advanced detection of tumor response patterns in tumors and to assess prognosis. Radiomics expands the paradigm of medical imaging to help with diagnosis, management of diseases and prognostication, leveraging image features by extracting information that can be used as imaging biomarkers to predict prognosis and response to treatment. Radiogenomics is an emerging area in radiomics that investigates the association between imaging characteristics and gene expression profiles. There are an increasing number of research publications using different radiomics approaches without a clear consensus on which method works best. We aim to describe the workflow of radiomics along with a guide of what to expect when starting a radiomics-based research project.

Early pulmonary complications related to cancer treatment in children.

In this review, we summarize early pulmonary complications related to cancer therapy in children and highlight characteristic findings on imaging that should be familiar to a radiologist reviewing imaging from pediatric cancer patients.

Late pulmonary complications related to cancer treatment in children.

As the number of childhood cancer survivors increases, a heightened awareness and recognition of therapy-related late effects is becoming more important. Pulmonary complications are the third leading cause of late mortality in cancer survivors. Diagnosis of these complications on chest imaging helps facilitate prompt treatment to mitigate adverse outcomes. In this review, we summarize the imaging of late pulmonary complications of cancer therapy in children and highlight characteristic findings that should be recognized by radiologists.

Skeletal muscle mass as a marker to predict outcomes in children and young adults with cancer.

PURPOSE: Nutrition is an important outcome predictor in oncology patients including treatment response, physical disability, quality of life, and overall survival. Sarcopenia (loss of skeletal muscle mass and function) is a demonstrated marker of nutritional status in adults, but data are more limited in children. The purpose of this study was to evaluate whether total psoas muscle area (tPMA) measured at the time of cancer diagnosis predicts overall survival (OS), disease free survival (DFS), or number of days neutropenic. METHODS: A retrospective study was performed. tPMA was measured at the L3 and L4 mid-lumbar vertebral body level by a single reviewer on cross-sectional imaging studies performed within 2 weeks of primary oncologic diagnosis for all oncology patients who received their primary therapy at Cincinnati Children's Hospital between 1/1/2000 and 12/31/2013. Spearman's correlation was used to assess the association between tPMA and OS, DFS, days neutropenic, and adjusted days neutropenic. Subanalysis was performed assessing the relationship of tumor type and age at diagnosis with each parameter. RESULTS: 164 patients (median age 9.9 years; 89 M/75 F) were included in the study. Days neutropenic and normalized days neutropenic were significantly but weakly negatively correlated with tPMA at L3 (r = - 0.24, p < 0.002 and r = - 0.18, p < 0.05 respectively) and L4 (r = - 0.25, p < 0.002; and and r = - 0.19, p < 0.02 respectively). At subanalysis, the correlation between anthropometric features and normalized days neutropenic was only seen with brain tumors. There was no statistically significant relationship between sarcopenia at diagnosis and DFS or OS overall or in subanalysis. CONCLUSION: There is a weak inverse relationship between days neutropenic and psoas muscle bulk in pediatric and young adult oncology patients suggesting a relationship between nutritional status and cell recovery. Measures of sarcopenia, however, did not correlate with DFS or OS.

Multispecialty Enterprise Imaging Workgroup Consensus on Interactive Multimedia Reporting Current State and Road to the Future: HIMSS-SIIM Collaborative White Paper.

Diagnostic and evidential static image, video clip, and sound multimedia are captured during routine clinical care in cardiology, dermatology, ophthalmology, pathology, physiatry, radiation oncology, radiology, endoscopic procedural specialties, and other medical disciplines. Providers typically describe the multimedia findings in contemporaneous electronic health record clinical notes or associate a textual interpretative report. Visual communication aids commonly used to connect, synthesize, and supplement multimedia and descriptive text outside medicine remain technically challenging to integrate into patient care. Such beneficial interactive elements may include hyperlinks between text, multimedia elements, alphanumeric and geometric annotations, tables, graphs, timelines, diagrams, anatomic maps, and hyperlinks to external educational references that patients or provider consumers may find valuable. This HIMSS-SIIM Enterprise Imaging Community workgroup white paper outlines the current and desired clinical future state of interactive multimedia reporting (IMR). The workgroup adopted a consensus definition of IMR as "interactive medical documentation that combines clinical images, videos, sound, imaging metadata, and/or image annotations with text, typographic emphases, tables, graphs, event timelines, anatomic maps, hyperlinks, and/or educational resources to optimize communication between medical professionals, and between medical professionals and their patients." This white paper also serves as a precursor for future efforts toward solving technical issues impeding routine interactive multimedia report creation and ingestion into electronic health records.