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.

Abstract: Corners and junctions are landmarks characterized by the lack of differentiability in the unit tangent to the image level curve. Detectors based on differential operators are not, by their own definition, the best posed as they require a higher degree of differentiability to yield a reliable response. We argue that a corner detector should be based on the degree of continuity of the tangent vector to the image level sets, work on the image domain and need no assumptions on neither the image local structure nor the particular geometry of the corner/junction. An operator measuring the degree of differentiability of the projection matrix on the image gradient fulfills the above requirements. Because using smoothing kernels leads to corner misplacement, we suggest an alternative fake response remover based on the receptive field inhibition of spurious details. The combination of both orientation discontinuity detection and noise inhibition produce our inhibition orientation energy (IOE) landmark locator.

Abstract: We describe a general framework for the recognition of distorted images of lineal shapes, which relies on three items: a model to represent lineal shapes and their deformations, a model for the generation of distorted binary images and the combination of both models in a common probabilistic framework, where the generation of deformations is related to an internal energy, and the generation of binary images to an external energy. Then, recognition consists in the minimization of a global energy function, performed by using the EM algorithm. This general framework has been applied to the recognition of hand-drawn lineal symbols in graphic documents.