Cogito

The field of radiomic biomarkers seems to be maturing with higher levels of evidence being generated through validation in randomized trials. However, these biomarkers, currently, are inductive - based on a retrospective training set, we hope the signature/model extrapolates to a new patient. It only takes one black swan (aka an unknown unknown) for the model to crash and burn. This is particularly a huge problem with deep learning approaches and I am therefore more bullish on hand-crafted radiomics. Within radiomics, I believe shape features are much more interpretable than texture features. I see the way forward as radiomic biomarkers being incorporated in the standard biomarker discovery process in earlier phases of trials. This will largely be a collaborative effort between pharmas and small/medium companies with expertise in the AI/radiomic side. However, the key point is that while prospective validation may be convincing, it might not provide sufficient immunity to black swans. ...