Integrating MRI Delta-radiomics and Transcriptomics to Assess Neoadjuvant Radiotherapy plus Targeted Therapy in Soft Tissue Sarcoma

Motivation: The complexity and heterogeneity of soft tissue sarcomas (STS) create challenges in personalized treatment, underscoring the need for tools that can reveal tumor characteristics and their biological implications. Goal(s): To evaluate the ability of MRI-based Delta-radiomics in classifying STS patients and explore its association with transcriptomic changes and immune microenvironment characteristics. Approach: Prospective phase II trial with 84 STS patients, utilizing MRI for radiomic feature extraction and transcriptomic analysis to correlate gene expression with treatment response. Results: Delta-radiomics stratified patients into distinct clusters, revealing significant correlations with gene expression profiles and immune response patterns, highlighting a comprehensive approach to treatment stratification in STS. Impact: The integration of radiomics and transcriptomics in this study has revolutionized the understanding of STS, providing a non-invasive approach to uncover the genetic basis of disease. This fusion offers a comprehensive view of disease mechanisms, which can enhance personalized treatment.