Progress of magnetic resonance imaging radiomics in preoperative lymph node diagnosis of esophageal cancer

Abstract

Esophageal cancer, also referred to as esophagus cancer, is a prevalent disease in the cardiothoracic field and is a leading cause of cancer-related mortality in China. Accurately determining the status of lymph nodes is crucial for developing treatment plans, defining the scope of intraoperative lymph node dissection, and ascertaining the prognosis of patients with esophageal cancer. Recent advances in diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging (MRI) have improved the effectiveness of MRI for assessing lymph node involvement, making it a beneficial tool for guiding personalized treatment plans for patients with esophageal cancer in a clinical setting. Radiomics is a recently developed imaging technique that transforms radiological image data from regions of interest into high-dimensional feature data that can be analyzed. The features, such as shape, texture, and waveform, are associated with the cancer phenotype and tumor microenvironment. When these features correlate with the clinical disease outcomes, they form the basis for specific and reliable clinical evidence. This study aimed to review the potential clinical applications of MRI-based radiomics in studying the lymph nodes affected by esophageal cancer. The combination of MRI and radiomics is a powerful tool for diagnosing and treating esophageal cancer, enabling a more personalized and effectual approach.

Keywords: Esophageal cancer, Diffusion-weighted imaging, Dynamic contrast-enhanced imaging, Radiomics, Lymph nodes

Core Tip: Precise TNM staging is crucial for developing effective treatment plans for esophageal cancer. Establishing whether esophageal cancer has lymph node metastasis before surgery remains a significant clinical challenge. However, with the continuous advancement of radiomics, high-quality clinical decision support systems have emerged, enabling more accurate determination of preoperative lymph node status in esophageal cancer. This breakthrough may lead to formulating treatment plans that adhere to individualized medical guidelines.