Imaging of Precision Therapy for Lung Cancer: Current State of the Art

Abstract

Advances in characterization of molecular and genomic abnormalities specific to lung cancer have made precision therapy the current standard of care for lung cancer treatment. This article will provide a cutting-edge review of imaging of lung cancer in the current era of precision medicine. The focus of the article includes (a) an update on the recent advances in precision therapy for non-small cell lung cancer and their implications on imaging; (b) molecular and genomic biomarkers and pitfalls of image interpretations for lung cancer precision therapy; and (c) review of the current approaches and future directions of precision imaging for lung cancer, emphasizing emerging observations in longitudinal tumor kinetics, radiomics, and molecular and functional imaging. The article is designed to help radiologists to remain up to date in the rapidly evolving world of lung cancer therapy and serve as key members of multidisciplinary teams caring for these patients.

Radiomics nomogram: A noninvasive tool for preoperative evaluation of the invasiveness of pulmonary adenocarcinomas manifesting as ground-glass nodules

“…A review by Park et al. [38] showed that radiomics has been widely used to identify the specific driver mutational status of non-small cell lung cancer, predictors of treatment response and prognosis, and the immune phenotype of tumors. Radiomics can extract high-throughput quantitative features, which are not easily recognized visually, to reflect a tumor's heterogeneity.…”

Chest CT Diagnosis and Clinical Management of Drug-related Pneumonitis in Patients Receiving Molecular Targeting Agents and Immune Checkpoint Inhibitors: A Position Paper from the Fleischner Society

“…The reports on pneumonitis among patients with NSCLC receiving EGFR-targeted TKIs, or EGFR-TKIs, included acute fatal events (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Moreover, the recent introduction of novel molecular targeting agents such as third-generation EGFR-TKIs, newer anaplastic lymphoma kinase inhibitors, BRAF inhibitors, antibody-drug conjugates, and use of ICI combination regimens has brought new challenges to DRP (24). Despite many reports on this topic, there is limited published guidance on the evaluation and treatment of patients with DRP secondary to treatment with ICIs.…”

Radiomics nomogram for the prediction of 2019 novel coronavirus pneumonia caused by SARS-CoV-2

“…Furthermore, a maximum lesion range > 10 cm was associated with a 2.43-fold risk of COVID-19 pneumonia, compared with a maximum lesion range ≤ 5 cm, and There is much interest in the use of radiomics for assessing radiological image data. Radiomics has been widely used in the assessment of pulmonary nodules or masses, especially lung cancer [30,31]. However, there are few studies on predicting COVID-19 pneumonia using CT radiomics [15][16][17].…”