Senologie - Zeitschrift für Mammadiagnostik und -therapie 2021; 18(03): 273-284
DOI: 10.1055/a-1557-1062
Wissenschaftliche Arbeit

Bilder sind Daten: Eine Perspektive der Brustbildgebung auf ein zeitgenössisches Paradigma

Images Are Data: A Breast Imaging Perspective on a Contemporary Paradigm
Matthias Dietzel
1   Abteilung für Radiologie, Universitätsklinikum Erlangen, Deutschland
,
Paola Clauser
2   Abteilung für Biomedizinische Bildgebung und bildgeführte Therapie, Abteilung für molekulare und geschlechtsspezifische Bildgebung, Medizinische Universität Wien, Wien, Österreich
,
Panagiotis Kapetas
2   Abteilung für Biomedizinische Bildgebung und bildgeführte Therapie, Abteilung für molekulare und geschlechtsspezifische Bildgebung, Medizinische Universität Wien, Wien, Österreich
,
Rüdiger Schulz-Wendtland
1   Abteilung für Radiologie, Universitätsklinikum Erlangen, Deutschland
,
Pascal Andreas Thomas Baltzer
2   Abteilung für Biomedizinische Bildgebung und bildgeführte Therapie, Abteilung für molekulare und geschlechtsspezifische Bildgebung, Medizinische Universität Wien, Wien, Österreich
› Author Affiliations

Zusammenfassung

Hintergrund Radiologische Untersuchungen nicht nur als bloße Bilder, sondern als Datenquelle zu betrachten, ist zum modernen Paradigma der diagnostischen Bildgebung geworden. Dieser Perspektivwechsel hat sich besonders in der Brustbildgebung durchgesetzt, ermöglicht er doch, aus der Informatik abgeleitete Verfahren anzuwenden, innovative klinische Anwendungen zu realisieren und bereits etablierte Methoden zu verfeinern. In diesem Zusammenhang sind die Begriffe „bildgebender Biomarker“, „Radiomics“ und „künstliche Intelligenz“ von zentraler Bedeutung. Diese Methoden versprechen nichtinvasive, kostengünstige (z. B. im Vergleich zu Multigen-Arrays), workflow-freundliche (automatisiert, nur eine Untersuchung, sofortige Ergebnisse) und klinisch relevante Informationen.

Methoden und Ergebnisse Dieser Artikel wurde als narratives Review zu dem besagten Paradigma im Bereich der Brustbildgebung konzipiert. Der Schwerpunkt liegt auf den Schlüsselkonzepten und wichtigen Schlagworten. Für alle Bereiche der Brustbildgebung werden beispielhafte Studien diskutiert.

Schlussfolgerung Die Interpretation von radiologischen Untersuchungen als Datenquelle verspricht eine Optimierung der Behandlung von Brustkrebspatientinnen im Zeitalter der Präzisionsmedizin, weil damit die Diagnose verfeinert und eine individualisierte Behandlung erreicht werden könnte.

Kernaussagen:

  • In der konventionellen Brustbildgebung werden Untersuchungen anhand von visuell erkennbaren Mustern interpretiert.

  • Das Radiomics-Paradigma behandelt radiologische Brustuntersuchungen hingegen als abstrakte Datenquelle, in der Informationen zu finden sind, die über visuell erkennbare Muster hinausgehen.

  • Derartige radiomische Signaturen können als bildgebende Biomarker angesehen werden, da sie diagnostische, prädiktive und prognostische Informationen liefern.

  • Derartige bildgebende Biomarker können im Zeitalter der Präzisionsmedizin zur Individualisierung der Brustkrebsbehandlung eingesetzt werden.

  • In diesem narrativen Übersichtsartikel stellen wir das Radiomics-Paradigma auf dem Gebiet der Brustkrebsbildgebung anhand von exemplarischen Literaturbeispielen dar.

Abstract

Background Considering radiological examinations not as mere images, but as a source of data, has become the key paradigm in the diagnostic imaging field. This change of perspective is particularly popular in breast imaging. It allows breast radiologists to apply algorithms derived from computer science, to realize innovative clinical applications, and to refine already established methods. In this context, the terminology “imaging biomarker”, “radiomics”, and “artificial intelligence” are of pivotal importance. These methods promise noninvasive, low-cost (e. g., in comparison to multigene arrays), and workflow-friendly (automated, only one examination, instantaneous results, etc.) delivery of clinically relevant information.

Methods and Results This paper is designed as a narrative review on the previously mentioned paradigm. The focus is on key concepts in breast imaging and important buzzwords are explained. For all areas of breast imaging, exemplary studies and potential clinical use cases are discussed.

Conclusion Considering radiological examination as a source of data may optimize patient management by guiding individualized breast cancer diagnosis and oncologic treatment in the age of precision medicine.

Key Points:

  • In conventional breast imaging, examinations are interpreted based on patterns perceivable by visual inspection.

  • The radiomics paradigm treats breast images as a source of data, containing information beyond what is visible to our eyes.

  • This results in radiomic signatures that may be considered as imaging biomarkers, as they provide diagnostic, predictive, and prognostic information.

  • Radiomics derived imaging biomarkers may be used to individualize breast cancer treatment in the era of precision medicine.

  • The concept and key research of radiomics in the field of breast imaging will be discussed in this narrative review.



Publication History

Article published online:
30 September 2021

© 2021. Thieme. All rights reserved.

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