Radiomics Beyond the Hype: A Critical Evaluation Toward Oncologic Clinical Use

“Just Accepted” papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. Radiomics is a promising and fast-developing field within oncology that involves the mining of quantitative highdimensional data from medical images. Radiomics has the potential to transform cancer management, whereby radiomics data can be used to aid early tumor characterization, prognosis, risk stratification, treatment planning, treatment response assessment, and surveillance, etc. Nevertheless, certain challenges have delayed the clinical adoption and acceptability of radiomics in routine clinical practice. The objectives of this report are: (a) to provide a perspective on the translational potential and potential impact of radiomics in oncology; (b) to explore frequent challenges and mistakes in its derivation, encompassing study design, technical requirements, standardization, model reproducibility, transparency, data sharing, privacy concerns, quality control, as well as the complexity of multistep processes resulting in less radiologist-friendly interfaces; (c) to discuss strategies to overcome these challenges and mistakes; and (d) to propose measures to increase the clinical use and acceptability of radiomics, taking into account the different perspectives of patients, health care workers, and health care systems. ©RSNA, 2024