Image-Based Biomarkers in Magnetic Resonance-Guided Radiotherapy (MRgRT)

Radiomics involves identifying biomarkers from routine medical images. This research field is particularly relevant in the case of image-guided radiotherapy treatments, and more specifically in the case of MRI-guided radiotherapy (MRgRT), where images are acquired daily, enabling delta-radiomic strategies to be implemented from a vast amount of imaging data. After outlining the implementation of a radiomic workflow in the context of MRgRT, this chapter reviews the literature published on this subject with a special focus on delta radiomics. The chapter concludes with a discussion of prospects, in particular the need for multicenter randomized clinical trials to validate the proposed dose escalation strategies and its implication in the integration of biomarkers from other omics sciences (proteomics, genomics, metabolomics) that is ultimately essential for effective personalization of patient-specific treatment.