Quality Reporting of Radiomics Analysis in Mild Cognitive Impairment and Alzheimer's Disease: A Roadmap for Moving Forward

• Published in: Korean journal of radiology Vol. 21; no. 12; pp. 1345 - 1354
• Main Authors: Won, So Yeon, Park, Yae Won, Park, Mina, Ahn, Sung Soo, Kim, Jinna, Lee, Seung-Koo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.12.2020; 대한영상의학회
• Subjects: Aged; Alzheimer Disease - diagnosis; Alzheimer Disease - diagnostic imaging; Alzheimer's disease; Biomarkers; Brain research; Cognitive ability; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - diagnostic imaging; Databases, Factual; Datasets; Dementia; Hippocampus - anatomy & histology; Hippocampus - diagnostic imaging; Humans; Medical imaging; Neuroimaging; Neuroimaging - methods; Neuroimaging and Head & Neck; Oncology; Quality standards; 방사선과학; Radiomics, Radiomics quality score; Mild cognitive impairment; Alzheimer's disease; Dementia
• DOI: 10.3348/kjr.2020.0715
• ISSN: 1229-6929; 2005-8330

To evaluate radiomics analysis in studies on mild cognitive impairment (MCI) and Alzheimer's disease (AD) using a radiomics quality score (RQS) system to establish a roadmap for further improvement in clinical use. PubMed MEDLINE and EMBASE were searched using the terms 'cognitive impairment' or 'Alzheimer' or 'dementia' and 'radiomic' or 'texture' or 'radiogenomic' for articles published until March 2020. From 258 articles, 26 relevant original research articles were selected. Two neuroradiologists assessed the quality of the methodology according to the RQS. Adherence rates for the following six key domains were evaluated: image protocol and reproducibility, feature reduction and validation, biologic/clinical utility, performance index, high level of evidence, and open science. The hippocampus was the most frequently analyzed (46.2%) anatomical structure. Of the 26 studies, 16 (61.5%) used an open source database (14 from Alzheimer's Disease Neuroimaging Initiative and 2 from Open Access Series of Imaging Studies). The mean RQS was 3.6 out of 36 (9.9%), and the basic adherence rate was 27.6%. Only one study (3.8%) performed external validation. The adherence rate was relatively high for reporting the imaging protocol (96.2%), multiple segmentation (76.9%), discrimination statistics (69.2%), and open science and data (65.4%) but low for conducting test-retest analysis (7.7%) and biologic correlation (3.8%). None of the studies stated potential clinical utility, conducted a phantom study, performed cut-off analysis or calibration statistics, was a prospective study, or conducted cost-effectiveness analysis, resulting in a low level of evidence. The quality of radiomics reporting in MCI and AD studies is suboptimal. Validation is necessary using external dataset, and improvements need to be made to feature reproducibility, feature selection, clinical utility, model performance index, and pursuits of a higher level of evidence.