基于CT或PET/CT的生境成像应用进展：一项系统综述。
完整摘要 · 中文译文
背景：生境成像（HI）能够识别肿瘤异质性并刻画肿瘤微环境。尽管基于MRI的HI已较为成熟，但其在CT或PET/CT上的应用仍处于初期阶段，且探索不足。 目的：本系统综述分析了基于CT或PET/CT的HI在肿瘤诊断与治疗中的最新进展，评估其临床实用性与局限性。 方法：系统检索了PubMed、Embase、Web of Science和Cochrane Library中的文献。采用影像组学质量评分（RQS）评估研究质量。 结果：共纳入21项研究，涉及7363例患者。各研究提取的影像组学特征数量从41个到12,838个不等。癌症类型包括肺癌（47.6%）、头颈部癌（14.3%）、肾癌（14.3%）、胃肠道癌（9.5%）、卵巢癌（9.5%）和肝癌（4.8%）。所有纳入研究均为回顾性设计。平均RQS为15.71 ± 3.06。常见局限性包括缺乏扫描仪模拟研究、前瞻性验证、成本效益分析以及数据/代码共享。此外，各研究在图像采集、分割方法和生境定义方面存在显著异质性。 结论：基于CT或PET/CT的HI在评估治疗反应、预测预后以及揭示肿瘤病理和分子特征方面显示出初步潜力。然而，当前证据质量低至中等，存在偏倚风险，且方法学异质性较大。总体而言， 证据体系仍处于相对早期阶段。需要前瞻性研究来验证HI作为临床生物标志物。
完整摘要 · 英文原文
BACKGROUND: Habitat imaging (HI) enables the identification of tumor heterogeneity and characterization of the tumor microenvironment. Although HI based on MRI is well-established, its implementation using CT or PET/CT remains nascent and underexplored. OBJECTIVE: This systematic review analyzes recent advances in HI based on CT or PET/CT for tumor diagnosis and treatment, evaluating its clinical utility and limitations. METHODS: Literatures were systematically searched in PubMed, Embase, Web of Science, and Cochrane Library. Study quality was assessed using the radiomics quality score (RQS). RESULTS: A total of 21 studies comprising 7363 patients were included. The number of radiomic features extracted ranged from 41 to 12,838 across studies. Cancer types included lung (47.6%), head and neck (14.3%), renal (14.3%), gastrointestinal (9.5%), ovarian (9.5%), and liver (4.8%). All included studies were retrospective in design. The mean RQS was 15.71 ± 3.06. Common limitations included the absence of scanner simulation studies, prospective validation, cost-effectiveness analyses, and data/code sharing. Furthermore, substantial heterogeneity was observed across studies in terms of image acquisition, segmentation methods, and habitat definitions. CONCLUSION: HI based on CT or PET/CT demonstrates preliminary potential in evaluating treatment response, predicting prognosis, and revealing tumor pathological and molecular characteristics. However, the current evidence is of low-to-moderate quality with a risk of bias, and considerable methodological heterogeneity exists. The overall body of evidence remains at a relatively early stage. Prospective studies are needed to validate HI as a clinical biomarker.