Current applications and challenges of radiomics in urothelial cancer

New discoveries and technologies have begun to change paradigms of urothelial cancer therapy in recent years. One of the novel techniques which emerged in the imaging community is radiomics, which refers to the high-throughput extraction of quantitative image features from medical images. Radiomics, being noninvasive and easy to perform, has shown great potential in oncology by providing valuable information about tumor type, aggressiveness, progression, response to treatment and prognosis and enabling us to gain insights into the true utility of personalized medicine in the management of cancer in the near future. With rapid development in this area, radiomics has already been applied in urothelial cancer to predict pathological grade, clinical stage, lymph node metastasis and treatment response demonstrating promising results. In this review, we highlight advances in clinical applications of radiomics in urothelial cancer, discuss about the challenges and implications of radiomics for radiologists and suggest the future directions that we could move toward in order to fully realize the potentials of radiomics to improve personalized management of patients with urothelial cancer.