Radiomics applications in the modern management of esophageal squamous cell carcinoma

Esophageal cancer ranks among the most lethal malignancies globally, with China accounting for more than half of worldwide esophageal squamous cell carcinoma (ESCC) cases. Late-stage diagnosis frequently precludes surgical intervention, contributing to poor outcomes. While precise clinical assessment is essential for treatment planning, therapeutic responses and prognosis exhibit substantial inter-patient heterogeneity, underscoring the urgent need for reliable biomarkers to enhance prognostic accuracy and guide personalized therapeutic strategies. Radiomics, an emerging field that extracts high-dimensional features from medical images, provides non-invasive approaches to improve diagnostic accuracy, predict survival, monitor adverse events, detect recurrence, and optimize treatment strategies. Radiomics has shown promising potential in the modern management of ESCC. Here, we review the critical contributions of radiomics to ESCC research and clinical practice, examining its workflow, applications, strengths, and limitations. Radiomics represents a compelling frontier with substantial potential to advance precision medicine for ESCC patients.