CT Re-Simulation Based Delta-Radiomics – New Perspectives Beyond Adaptive Radiotherapy (ART)

Delta-radiomics, the variation of radiomics features during cancer treatment can be used as an early biomarker to predict the response to chemotherapy and radiation therapy. Re-simulation of computer tomography (CT), the step routinely used in adaptive radiotherapy (ART) can provide standardized images for the evaluation of radiomics features during radiotherapy. Thus, the early anticipation of the treatment result can help the clinician in personalizing the treatment by intensifying or de-escalating it. Other applications of delta-radiomics in radiotherapy could be the identification of cases that will require ART and the prediction of the risk of toxicity from the first irradiation fractions. By standardizing both the use of the same image acquisition and processing platform and evaluating delta variation without the need to report the baseline value of radio-mechanical parameters, this method could be implemented as a standard in clinical trials.