This blog explores the evolving role of radiomics in enhancing prognostic imaging for osteosarcoma. Osteosarcoma is a highly aggressive and heterogeneous bone malignancy. Conventional imaging typically relies on qualitative assessments of tumor size, margins, and visible metastases. Traditional methods can be limited in capturing the subtle heterogeneity critical for accurate prognosis.
Radiomics is an emerging tool in medical imaging that provides a data-driven approach by extracting quantitative features from standard scans. These features include shape, texture, and intensity.
A recent multicenter study by Su et al. (2024), highlighted in this blog’s presentation, demonstrates that combining radiomic features from both inside the tumor (intratumoral) and the surrounding tissue (peritumoral) significantly improves survival prediction models in osteosarcoma.
However, key challenges remain, including:
The need for standardized workflows
Broader clinical validation
Interdisciplinary training
With continued advancements in artificial intelligence and imaging platforms, radiomics holds substantial potential to transform osteosarcoma prognosis and support more personalized musculoskeletal oncology care.
References- Greenwood AC, Arora RD, Shaikh H. Osteosarcoma (Osteogenic Sarcoma) [Updated 2024 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563177
- Sadykova LR, Ntekim AI, Muyangwa-Semenova M, Rutland CS, Jeyapalan JN, Blatt N, Rizvanov AA. Epidemiology and risk factors of osteosarcoma. Cancer Invest. 2020;38(5):259–269.
- Smith MA, Seibel NL, Altekruse SF, Ries LA, Melbert DL, O’Leary M, Smith FO, Reaman GH. Outcomes for children and adolescents with cancer: challenges for the twenty-first century. J Clin Oncol. 2010;28(15):2625–2634.
- Chiesa AM, Spinnato P, Miceli M, Facchini G. Radiologic Assessment of Osteosarcoma Lung Metastases: State of the Art and Recent Advances. Cells. 2021;10:553. doi:10.3390/cells10030553.
- Wu Y, Xu L, Yang P, et al. Survival Prediction in High-grade Osteosarcoma Using Radiomics of Diagnostic Computed Tomography. EBioMedicine. 2018;34:27–34. doi:10.1016/j.ebiom.2018.07.006.
- Crombé A, Simonetti M, Longhi A, Hauger O, Fadli D, Spinnato P. Imaging of Osteosarcoma: Presenting Findings, Metastatic Patterns, and Features Related to Prognosis. J Clin Med. 2024;13:5710. https://doi.org/10.3390/jcm13195710
- Cè M, Cellina M, Ueanukul T, et al. Multimodal Imaging of Osteosarcoma: From First Diagnosis to Radiomics. Cancers (Basel). 2025;17(4):599. doi:10.3390/cancers17040599
- Gillies RJ, Anderson AR, Gatenby RA, Morse DL. The biology underlying molecular imaging in oncology: From genome to anatome and back again. Clin Radiol. 2010;65:517–521.
- Lambin P, Leijenaar RTH, Deist TM, et al. Radiomics: The bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol. 2017;14:749–762.
- Goyal N, Kalra M, Soni A, Baweja P, Ghonghe NP. Multi-modality imaging approach to bone tumors – State-of-the-art. J Clin Orthop Trauma. 2019;10(4):687–701. doi:10.1016/j.jcot.2019.05.022
- Su Q, Wang N, Wang B, et al. CT-based intratumoral and peritumoral radiomics for predicting prognosis in osteosarcoma: A multicenter study. Eur J Radiol. 2024;172:111350. doi:10.1016/j.ejrad.2024.111350
