Translating radiomics into clinical practice: A step-by-step guide to study design and evaluation

Radiomics, the high-throughput extraction of quantitative features from medical images, holds immense potential to advance precision medicine. Despite its growing popularity in research, radiomics sees few cases of successful translation into clinical practice, attributable in part to the technical complexity of its workflow; clinicians lacking formal computational training might find it daunting to conduct or evaluate radiomics studies. This practical guide aims to address this by providing a step-by-step approach to plan or appraise a radiomics study, for clinicians or others new to the field. Emphasis is placed on critical aspects such as data preprocessing, feature reproducibility, bias minimisation, and model validation, the areas frequently overlooked in early stage works. By equipping readers with accessible, pragmatic advice, this guide seeks to broaden access to radiomics, facilitating high-quality study design, and accelerating its integration into patient care.