Challenges in clinical translation of cardiac magnetic resonance imaging radiomics in non-ischemic cardiomyopathy: a narrative review

Background and Objective: Radiomics is an emerging technology that facilitates the quantitative analysis of multi-modal cardiac magnetic resonance imaging (MRI). This study aims to introduce a standardized workflow for applying radiomics to non-ischemic cardiomyopathies, enabling clinicians to comprehensively understand and implement this technology in clinical practice. Methods: A computerized literature search (up to August 1, 2024) was conducted using PubMed to identify relevant studies on the roles and workflows of radiomics in non-ischemic cardiomyopathy. Expert discussions were also held to ensure the accuracy and relevance of the findings. Only English-language publications were reviewed. Key Content and Findings: The paper details the essential processes of radiomics, including feature extraction, feature engineering, model construction, and data analysis. It emphasizes the role of MRI in assessing cardiac structure and function and demonstrates how MRI-based radiomics can aid in diagnosing and differentiating non-ischemic cardiomyopathies such as hypertrophic cardiomyopathy, dilated cardiomyopathy, and myocarditis. The study also investigates various cardiac MRI sequences to enhance the clinical application of radiomics. Conclusions: The standardized radiomics workflow presented in this study aims to assist clinicians in effectively utilizing MRI-based radiomics for the diagnosis and management of non-ischemic cardiomyopathies, thereby improving clinical decision-making.