Quality over quantity: biopsy-anchored CT radiogenomics models outperform all-lesion training in a multi-tumour cohort despite a smaller sample size - Summary - MDSpire

Quality over quantity: biopsy-anchored CT radiogenomics models outperform all-lesion training in a multi-tumour cohort despite a smaller sample size

  • By

  • Diana Ivonne Rodríguez Sánchez

  • Julian Middelkoop

  • Thera Vanneste

  • Olga Maxouri

  • Stephan Ursprung

  • Sajjad Rostami

  • Nino Bogveradze

  • Kalina Chupetlovska

  • Francesca Castagnoli

  • Federica Landolfi

  • Eun Kyoung Hong

  • Andrea Delli Pizzi

  • Nicolo Gennaro

  • Warissara Jutidamrongphan

  • Liliana Petrychenko

  • Petur Snaebjornsson

  • Zuhir Bodalal

  • Regina Beets-Tan

  • May 16, 2026

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Objective:

To evaluate whether restricting model training to biopsy-confirmed lesions improves external generalizability, which is crucial for addressing lesion-level molecular heterogeneity in EGFR-driven tumors.

Key Findings:
  • Biopsy-based training models outperformed all-lesion models in terms of external generalizability, indicating a potential shift in clinical practice.
  • Lesion-level label fidelity significantly improved reproducibility and interpretability of radiogenomic signatures, enhancing their clinical applicability.
  • The study highlights the importance of accounting for intra- and inter-tumoral heterogeneity in precision oncology, suggesting a need for refined diagnostic approaches.
Interpretation:

The findings suggest that using biopsy-confirmed lesions for training radiogenomic models enhances their reliability and applicability in clinical settings, effectively addressing the challenge of molecular heterogeneity in tumors and improving treatment strategies.

Limitations:
  • The study was retrospective, which may introduce biases that could affect the generalizability of the results.
  • Sample size for certain analyses was reduced when focusing on biopsy-confirmed lesions, potentially limiting the robustness of findings.
Conclusion:

Restricting training to biopsy-confirmed lesions leads to more robust radiogenomic models, supporting their use as a complement to traditional tissue testing in precision oncology.

Original Source(s)

Quality over quantity: biopsy-anchored CT radiogenomics models outperform all-lesion training in a multi-tumour cohort despite a smaller sample size

  • by Diana Ivonne Rodríguez Sánchez, Julian Middelkoop, Thera Vanneste, Olga Maxouri, Stephan Ursprung, Sajjad Rostami, Nino Bogveradze, Kalina Chupetlovska, Francesca Castagnoli, Federica Landolfi, Eun Kyoung Hong, Andrea Delli Pizzi, Nicolo Gennaro, Warissara Jutidamrongphan, Liliana Petrychenko, Petur Snaebjornsson, Zuhir Bodalal, Regina Beets-Tan

  • May 16, 2026

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