Radiologic exposomics: imaging the environmental imprint on cancer for precision oncology

Area of Science:

• Environmental Health
• Medical Imaging
• Oncology

Background:

• Environmental exposures (pollutants, metals, urban stressors) are linked to cancer development and progression.
• Understanding the in vivo biological effects of these exposures remains challenging.
• Quantitative medical imaging offers a potential solution to characterize these effects.

Purpose of the Study:

• To review the rationale for integrating geospatial exposure assessment with imaging biomarkers (radiomics) from CT and MRI.
• To explore how radiologic features can reflect long-term environmental stress impacts like oxidative damage, inflammation, and immune dysregulation.
• To summarize epidemiologic evidence and propose a workflow for harmonizing exposomic and radiomic data.

Main Methods:

• Review of existing literature on environmental exposures, cancer, and medical imaging.
• Discussion of radiomics as a tool to analyze tissue-level patterns.
• Presentation of a methodological workflow for data integration, including exposure assignment, imaging standardization, and feature extraction.
• Consideration of confounding factors, data governance, and equity.

Main Results:

• Radiologic features may serve as intermediate phenotypes of the exposome, reflecting biological processes influenced by environmental stressors.
• Integration of imaging and exposure data is plausible across major cancer types.
• The proposed workflow addresses challenges in harmonizing high-dimensional exposomic and radiomic data.

Conclusions:

• Medical imaging, particularly radiomics, can bridge the gap in understanding the in vivo biological effects of environmental exposures on cancer.
• This approach can expand the role of radiology in precision oncology.
• New hypotheses can be generated regarding how environmental conditions influence cancer biology.