Abstract: Any image filtering operator designed for automatic shape restoration should satisfy robustness (whatever the nature and degree of noise is) as well as non-trivial smooth asymptotic behavior. Moreover, a stopping criterion should be determined by characteristics of the evolved image rather than dependent on the number of iterations. Among the several PDE based techniques, curvature flows appear to be highly reliable for strongly noisy images compared to image diffusion processes.
In the present paper, we introduce a regularized curvature flow (RCF) that admits non-trivial steady states. It is based on a measure of the local curve smoothness that takes into account regularity of the curve curvature and serves as stopping term in the mean curvature flow. We prove that this measure decreases over the orbits of RCF, which endows the method with a natural stop criterion in terms of the magnitude of this measure. Further, in its discrete version it produces steady states consisting of piece-wise regular curves. Numerical experiments made on synthetic shapes corrupted with different kinds of noise show the abilities and limitations of each of the current geometric flows and the benefits of RCF. Finally, we present results on real images that illustrate the usefulness of the present approach in practical applications.

Abstract: Background Reliable predictive imaging markers of response to immune checkpoint inhibitors are needed. Purpose To develop and validate a pretreatment CT-based radiomics signature to predict response to immune checkpoint inhibitors in advanced solid tumors. Materials and Methods In this retrospective study, a radiomics signature was developed in patients with advanced solid tumors (including breast, cervix, gastrointestinal) treated with anti-programmed cell death-1 or programmed cell death ligand-1 monotherapy from August 2012 to May 2018 (cohort 1). This was tested in patients with bladder and lung cancer (cohorts 2 and 3). Radiomics variables were extracted from all metastases delineated at pretreatment CT and selected by using an elastic-net model. A regression model combined radiomics and clinical variables with response as the end point. Biologic validation of the radiomics score with RNA profiling of cytotoxic cells (cohort 4) was assessed with Mann-Whitney analysis. Results The radiomics signature was developed in 85 patients (cohort 1: mean age, 58 years ± 13 [standard deviation]; 43 men) and tested on 46 patients (cohort 2: mean age, 70 years ± 12; 37 men) and 47 patients (cohort 3: mean age, 64 years ± 11; 40 men). Biologic validation was performed in a further cohort of 20 patients (cohort 4: mean age, 60 years ± 13; 14 men). The radiomics signature was associated with clinical response to immune checkpoint inhibitors (area under the curve [AUC], 0.70; 95% CI: 0.64, 0.77; P < .001). In cohorts 2 and 3, the AUC was 0.67 (95% CI: 0.58, 0.76) and 0.67 (95% CI: 0.56, 0.77; P < .001), respectively. A radiomics-clinical signature (including baseline albumin level and lymphocyte count) improved on radiomics-only performance (AUC, 0.74 [95% CI: 0.63, 0.84; P < .001]; Akaike information criterion, 107.00 and 109.90, respectively). Conclusion A pretreatment CT-based radiomics signature is associated with response to immune checkpoint inhibitors, likely reflecting the tumor immunophenotype. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Summers in this issue.