Beyond Correlation: An Ultra-Large Physics-Driven Vascularized Tumor Model to Bridge Feature Formation with Underlying Biology

Radiomics provides an appealing, non-invasive approach to probing tumor biology for potential diagnostic and prognostic applications. However, its clinical adoption is limited by challenges in interpretability, which in turn compromise its robustness. To uncover the underlying causation, we developed an ultra-large-scale (ULS) computational model that simulates heterogeneous, vascularized tumor growth under physical constraints to a scale that can be visualized in medical images. Our study revealed the pivotal role of tumor proliferation rate in driving necrosis and tissue heterogeneity and the dominant impact of oxygen consumption rate on vascularization level. Analysis of the resultant tumor Radiomics shows a causal relationship between tumor biophysical parameters and imaging features. Specifically, differences in proliferation and oxygen consumption rates result in distinct changes in radiomic image features, identifying suitable imaging modalities and quantitative imaging metrics for studying these biophysical parameters. This work thus reverse-engineers the building blocks of Radiomics as a means to understand their respective biological underpinnings.