Routine follow-up visits and radiographic imaging are required for outcome evaluation and
tumor recurrence monitoring. Yet more personalized surveillance is required in order to
sufficiently address the nature of heterogeneity in nonsmall cell lung cancer and possible
recurrences upon completion of treatment. Radiomics, an emerging noninvasive technology
using medical imaging analysis and data mining methodology, has been adopted to the area
of cancer diagnostics in recent years. Its potential application in response assessment
for cancer treatment has also drawn considerable attention. Radiomics seeks to extract a
large amount of valuable information from patients’ medical images (both pretreatment and
follow-up images) and quantitatively correlate image features with diagnostic and
therapeutic outcomes. Radiomics relies on computers to identify and analyze vast amounts
of quantitative image features that were previously overlooked, unmanageable, or failed to
be identified (and recorded) by human eyes. The research area has been focusing on the
predictive accuracy of pretreatment features for outcome and response and the early
discovery of signs of tumor response, recurrence, distant metastasis, radiation-induced
lung injury, death, and other outcomes, respectively. This review summarized the
application of radiomics in response assessments in radiotherapy and chemotherapy for
non-small cell lung cancer, including image acquisition/reconstruction, region of interest
definition/segmentation, feature extraction, and feature selection and classification. The
literature search for references of this article includes PubMed peer-reviewed
publications over the last 10 years on the topics of radiomics, textural features,
radiotherapy, chemotherapy, lung cancer, and response assessment. Summary tables of
radiomics in response assessment and treatment outcome prediction in radiation oncology
have been developed based on the comprehensive review of the literature.