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Qi L, Li X, Yang Y, Zhao M, Lin A, Ma L. Accuracy of machine learning in the preoperative identification of ovarian borderline tumors: a meta-analysis. Clin Radiol 2024; 79:501-514. [PMID: 38670918 DOI: 10.1016/j.crad.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/07/2024] [Accepted: 02/22/2024] [Indexed: 04/28/2024]
Abstract
AIM The objective of this study is to explore the diagnostic value of machine learning (ML) in borderline ovarian tumors through meta-analysis. METHODS Pubmed, Embase, Web of Science, and Cochrane Library databases were comprehensively retrieved from database inception untill February 16, 2023. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was adopted to evaluate the risk of bias in the original studies. Sub-group analyses of ML were conducted according to clinical features and radiomics features. We separately discussed the discriminative value of ML for borderline vs benign and borderline vs malignant tumors. RESULTS Eighteen studies involving 12,778 subjects were included in our analysis. The modeling variables mainly consisted of radiomics features (n=13) and a small number of clinical features (n=5). When distinguishing between borderline and benign tumors, the ML model based on radiomic features achieved a c-index of 0.782 (95% CI: 0.732-0.831), sensitivity of 0.75 (95% CI: 0.67-0.82), and specificity of 0.75 (95% CI: 0.67-0.81) in the validation set. When distinguishing between borderline and malignant tumors, the ML model based on radiomic features achieved a c-index of 0.916 (95% CI: 0.891-0.940), sensitivity of 0.86 (95% CI: 0.78-0.91), and specificity of 0.88 (95% CI: 0.82-0.92) in the validation set. In addition, we analyzed the discriminatory ability of radiologists and found that their sensitivity was 0.26 (95% CI: 0.12-0.46) and specificity was 0.94 (95% CI: 0.90-0.97). CONCLUSIONS ML has tremendous potential in the preoperative diagnosis and differentiation of borderline ovarian tumors and may be more accurate than radiologists in diagnosing and differentiating borderline ovarian tumors.
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Affiliation(s)
- L Qi
- Department of Gynecology and Obstetrics, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China
| | - X Li
- Department of Pathology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China
| | - Y Yang
- Emergency Department, HongQi Hospital Affiliated to MuDanJiang Medical University, MuDanJiang City, Heilongjiang Province, China
| | - M Zhao
- Department of Gynecology and Obstetrics, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China
| | - A Lin
- Department of Gynecology and Obstetrics, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China.
| | - L Ma
- Center for Laboratory Diagnosis, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai City, Shandong Province, China.
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2
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Wei M, Zhang Y, Ding C, Jia J, Xu H, Dai Y, Feng G, Qin C, Bai G, Chen S, Wang H. Associating Peritoneal Metastasis With T2-Weighted MRI Images in Epithelial Ovarian Cancer Using Deep Learning and Radiomics: A Multicenter Study. J Magn Reson Imaging 2024; 59:122-131. [PMID: 37134000 DOI: 10.1002/jmri.28761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND The preoperative diagnosis of peritoneal metastasis (PM) in epithelial ovarian cancer (EOC) is challenging and can impact clinical decision-making. PURPOSE To investigate the performance of T2 -weighted (T2W) MRI-based deep learning (DL) and radiomics methods for PM evaluation in EOC patients. STUDY TYPE Retrospective. POPULATION Four hundred seventy-nine patients from five centers, including one training set (N = 297 [mean, 54.87 years]), one internal validation set (N = 75 [mean, 56.67 years]), and two external validation sets (N = 53 [mean, 55.58 years] and N = 54 [mean, 58.22 years]). FIELD STRENGTH/SEQUENCE 1.5 or 3 T/fat-suppression T2W fast or turbo spin-echo sequence. ASSESSMENT ResNet-50 was used as the architecture of DL. The largest orthogonal slices of the tumor area, radiomics features, and clinical characteristics were used to construct the DL, radiomics, and clinical models, respectively. The three models were combined using decision-level fusion to create an ensemble model. Diagnostic performances of radiologists and radiology residents with and without model assistance were evaluated. STATISTICAL TESTS Receiver operating characteristic analysis was used to assess the performances of models. The McNemar test was used to compare sensitivity and specificity. A two-tailed P < 0.05 was considered significant. RESULTS The ensemble model had the best AUCs, outperforming the DL model (0.844 vs. 0.743, internal validation set; 0.859 vs. 0.737, external validation set I) and clinical model (0.872 vs. 0.730, external validation set II). After model assistance, all readers had significantly improved sensitivity, especially for those with less experience (junior radiologist1, from 0.639 to 0.820; junior radiologist2, from 0.689 to 0.803; resident1, from 0.623 to 0.803; resident2, from 0.541 to 0.738). One resident also had significantly improved specificity (from 0.633 to 0.789). DATA CONCLUSIONS T2W MRI-based DL and radiomics approaches have the potential to preoperatively predict PM in EOC patients and assist in clinical decision-making. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Mingxiang Wei
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yu Zhang
- Department of Radiology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Cong Ding
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Jianye Jia
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Haimin Xu
- Department of Radiology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Yao Dai
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Guannan Feng
- Department of Gynecology, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Cai Qin
- Department of Radiology, Tumor Hospital Affiliated to Nantong University, Nantong, Jiangsu, China
| | - Genji Bai
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Shuangqing Chen
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Hong Wang
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
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Alhalabi OT, Sahm F, Unterberg AW, Jakobs M. The molecular diagnostic yield of frame-based stereotactic biopsies in the age of precision neuro-oncology: a cross-sectional study. Acta Neurochir (Wien) 2023; 165:2479-2487. [PMID: 37553446 PMCID: PMC10477138 DOI: 10.1007/s00701-023-05742-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE With the increasing role of molecular genetics in the diagnostics of intracranial tumors, delivering sufficient representative tissue for such analyses is of paramount importance. This study explored the rate of successful diagnosis after frame-based stereotactic biopsies of intracranial lesions. METHODS Consecutive patients undergoing frame-based stereotactic biopsies in 2020 and 2021 were included in this retrospective analysis. Cases were classified into three groups: conclusive, diagnosis with missing molecular genetics (MG) data, and inconclusive neuropathological diagnosis. RESULTS Of 145 patients, a conclusive diagnosis was possible in n = 137 cases (94.5%). For 3 cases (2.0%), diagnosis was established with missing MG data. In 5 cases (3.5%), an inconclusive (tumor) diagnosis was met. Diagnoses comprised mainly WHO 4 glioblastomas (n = 73, 56%), CNS lymphomas (n = 23, 16%), inflammatory diseases (n = 14, 10%), and metastases (n = 5, 3%). Methylomics were applied in 49% (n = 44) of tumor cases (panel sequencing in n = 28, 30% of tumors). The average number of specimens used for MG diagnostics was 5, while the average number of specimens provided was 15. In a univariate analysis, insufficient DNA was associated with an inconclusive diagnosis or a diagnosis with missing MG data (p < 0.001). Analyses of planned and implemented trajectories of cases with diagnosis with missing MG data or inconclusive diagnosis (n = 8) revealed that regions of interest were reached in almost all cases (n = 7). CONCLUSION Although stereotactic frame-based biopsies deliver a limited amount of tissue, they bear high histopathological and molecular genetic diagnostic yields. Given the proven surgical precision of the planned biopsy trajectories, optimizing surveyed lesion regions could help improve the rate of conclusive diagnoses.
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Affiliation(s)
- Obada T Alhalabi
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69121, Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas W Unterberg
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69121, Heidelberg, Germany
| | - Martin Jakobs
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69121, Heidelberg, Germany.
- Division of Stereotactic Neurosurgery, Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
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Jiang D, Liao J, Zhao C, Zhao X, Lin R, Yang J, Li Z, Zhou Y, Zhu Y, Liang D, Hu Z, Wang H. Recognizing Pediatric Tuberous Sclerosis Complex Based on Multi-Contrast MRI and Deep Weighted Fusion Network. Bioengineering (Basel) 2023; 10:870. [PMID: 37508897 PMCID: PMC10375986 DOI: 10.3390/bioengineering10070870] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/24/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Multi-contrast magnetic resonance imaging (MRI) is wildly applied to identify tuberous sclerosis complex (TSC) children in a clinic. In this work, a deep convolutional neural network with multi-contrast MRI is proposed to diagnose pediatric TSC. Firstly, by combining T2W and FLAIR images, a new synthesis modality named FLAIR3 was created to enhance the contrast between TSC lesions and normal brain tissues. After that, a deep weighted fusion network (DWF-net) using a late fusion strategy is proposed to diagnose TSC children. In experiments, a total of 680 children were enrolled, including 331 healthy children and 349 TSC children. The experimental results indicate that FLAIR3 successfully enhances the visibility of TSC lesions and improves the classification performance. Additionally, the proposed DWF-net delivers a superior classification performance compared to previous methods, achieving an AUC of 0.998 and an accuracy of 0.985. The proposed method has the potential to be a reliable computer-aided diagnostic tool for assisting radiologists in diagnosing TSC children.
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Affiliation(s)
- Dian Jiang
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China;
| | - Jianxiang Liao
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen 518000, China; (J.L.); (X.Z.)
| | - Cailei Zhao
- Department of Radiology, Shenzhen Children’s Hospital, Shenzhen 518000, China;
| | - Xia Zhao
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen 518000, China; (J.L.); (X.Z.)
| | - Rongbo Lin
- Department of Emergency, Shenzhen Children’s Hospital, Shenzhen 518000, China;
| | - Jun Yang
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China;
| | - Zhichen Li
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China;
| | - Yihang Zhou
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- Research Department, Hong Kong Sanatorium & Hospital, Hong Kong 999077, China
| | - Yanjie Zhu
- University of Chinese Academy of Sciences, Beijing 100049, China;
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China
| | - Dong Liang
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China;
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China
| | - Zhanqi Hu
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen 518000, China; (J.L.); (X.Z.)
| | - Haifeng Wang
- University of Chinese Academy of Sciences, Beijing 100049, China;
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China
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Gao Y, Dai Y, Liu F, Chen W, Shi L. An anatomy-aware framework for automatic segmentation of parotid tumor from multimodal MRI. Comput Biol Med 2023; 161:107000. [PMID: 37201442 DOI: 10.1016/j.compbiomed.2023.107000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/10/2023] [Accepted: 05/02/2023] [Indexed: 05/20/2023]
Abstract
Magnetic Resonance Imaging (MRI) plays an important role in diagnosing the parotid tumor, where accurate segmentation of tumors is highly desired for determining appropriate treatment plans and avoiding unnecessary surgery. However, the task remains nontrivial and challenging due to ambiguous boundaries and various sizes of the tumor, as well as the presence of a large number of anatomical structures around the parotid gland that are similar to the tumor. To overcome these problems, we propose a novel anatomy-aware framework for automatic segmentation of parotid tumors from multimodal MRI. First, a Transformer-based multimodal fusion network PT-Net is proposed in this paper. The encoder of PT-Net extracts and fuses contextual information from three modalities of MRI from coarse to fine, to obtain cross-modality and multi-scale tumor information. The decoder stacks the feature maps of different modalities and calibrates the multimodal information using the channel attention mechanism. Second, considering that the segmentation model is prone to be disturbed by similar anatomical structures and make wrong predictions, we design anatomy-aware loss. By calculating the distance between the activation regions of the prediction segmentation and the ground truth, our loss function forces the model to distinguish similar anatomical structures with the tumor and make correct predictions. Extensive experiments with MRI scans of the parotid tumor showed that our PT-Net achieved higher segmentation accuracy than existing networks. The anatomy-aware loss outperformed state-of-the-art loss functions for parotid tumor segmentation. Our framework can potentially improve the quality of preoperative diagnosis and surgery planning of parotid tumors.
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Affiliation(s)
- Yifan Gao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China; School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Yin Dai
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China; Engineering Center on Medical Imaging and Intelligent Analysis, Ministry Education, Northeastern University, Shenyang, 110169, China.
| | - Fayu Liu
- Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, Shenyang, 110002, China
| | - Weibing Chen
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China; Engineering Center on Medical Imaging and Intelligent Analysis, Ministry Education, Northeastern University, Shenyang, 110169, China
| | - Lifu Shi
- Liaoning Jiayin Medical Technology Co., LTD, Shenyang, 110170, China
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Koch AH, Jeelof LS, Muntinga CLP, Gootzen TA, van de Kruis NMA, Nederend J, Boers T, van der Sommen F, Piek JMJ. Analysis of computer-aided diagnostics in the preoperative diagnosis of ovarian cancer: a systematic review. Insights Imaging 2023; 14:34. [PMID: 36790570 PMCID: PMC9931983 DOI: 10.1186/s13244-022-01345-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/05/2022] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVES Different noninvasive imaging methods to predict the chance of malignancy of ovarian tumors are available. However, their predictive value is limited due to subjectivity of the reviewer. Therefore, more objective prediction models are needed. Computer-aided diagnostics (CAD) could be such a model, since it lacks bias that comes with currently used models. In this study, we evaluated the available data on CAD in predicting the chance of malignancy of ovarian tumors. METHODS We searched for all published studies investigating diagnostic accuracy of CAD based on ultrasound, CT and MRI in pre-surgical patients with an ovarian tumor compared to reference standards. RESULTS In thirty-one included studies, extracted features from three different imaging techniques were used in different mathematical models. All studies assessed CAD based on machine learning on ultrasound, CT scan and MRI scan images. Per imaging method, subsequently ultrasound, CT and MRI, sensitivities ranged from 40.3 to 100%; 84.6-100% and 66.7-100% and specificities ranged from 76.3-100%; 69-100% and 77.8-100%. Results could not be pooled, due to broad heterogeneity. Although the majority of studies report high performances, they are at considerable risk of overfitting due to the absence of an independent test set. CONCLUSION Based on this literature review, different CAD for ultrasound, CT scans and MRI scans seem promising to aid physicians in assessing ovarian tumors through their objective and potentially cost-effective character. However, performance should be evaluated per imaging technique. Prospective and larger datasets with external validation are desired to make their results generalizable.
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Affiliation(s)
- Anna H. Koch
- grid.413532.20000 0004 0398 8384Department of Gynaecology and Obstetrics and Catharina Cancer Institute, Catharina Hospital, 5623 EJ Eindhoven, Noord-Brabant, The Netherlands
| | - Lara S. Jeelof
- grid.413532.20000 0004 0398 8384Department of Gynaecology and Obstetrics and Catharina Cancer Institute, Catharina Hospital, 5623 EJ Eindhoven, Noord-Brabant, The Netherlands
| | - Caroline L. P. Muntinga
- grid.413532.20000 0004 0398 8384Department of Gynaecology and Obstetrics and Catharina Cancer Institute, Catharina Hospital, 5623 EJ Eindhoven, Noord-Brabant, The Netherlands
| | - T. A. Gootzen
- grid.413532.20000 0004 0398 8384Department of Gynaecology and Obstetrics and Catharina Cancer Institute, Catharina Hospital, 5623 EJ Eindhoven, Noord-Brabant, The Netherlands
| | - Nienke M. A. van de Kruis
- grid.413532.20000 0004 0398 8384Department of Gynaecology and Obstetrics and Catharina Cancer Institute, Catharina Hospital, 5623 EJ Eindhoven, Noord-Brabant, The Netherlands
| | - Joost Nederend
- grid.413532.20000 0004 0398 8384Department of Radiology, Catharina Hospital, 5623 EJ Eindhoven, Noord-Brabant, The Netherlands
| | - Tim Boers
- grid.6852.90000 0004 0398 8763Department of Electrical Engineering, VCA Group, University of Technology Eindhoven, 5600 MB Eindhoven, Noord-Brabant The Netherlands
| | - Fons van der Sommen
- grid.6852.90000 0004 0398 8763Department of Electrical Engineering, VCA Group, University of Technology Eindhoven, 5600 MB Eindhoven, Noord-Brabant The Netherlands
| | - Jurgen M. J. Piek
- grid.413532.20000 0004 0398 8384Department of Gynaecology and Obstetrics and Catharina Cancer Institute, Catharina Hospital, 5623 EJ Eindhoven, Noord-Brabant, The Netherlands
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Xu HL, Gong TT, Liu FH, Chen HY, Xiao Q, Hou Y, Huang Y, Sun HZ, Shi Y, Gao S, Lou Y, Chang Q, Zhao YH, Gao QL, Wu QJ. Artificial intelligence performance in image-based ovarian cancer identification: A systematic review and meta-analysis. EClinicalMedicine 2022; 53:101662. [PMID: 36147628 PMCID: PMC9486055 DOI: 10.1016/j.eclinm.2022.101662] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Accurate identification of ovarian cancer (OC) is of paramount importance in clinical treatment success. Artificial intelligence (AI) is a potentially reliable assistant for the medical imaging recognition. We systematically review articles on the diagnostic performance of AI in OC from medical imaging for the first time. METHODS The Medline, Embase, IEEE, PubMed, Web of Science, and the Cochrane library databases were searched for related studies published until August 1, 2022. Inclusion criteria were studies that developed or used AI algorithms in the diagnosis of OC from medical images. The binary diagnostic accuracy data were extracted to derive the outcomes of interest: sensitivity (SE), specificity (SP), and Area Under the Curve (AUC). The study was registered with the PROSPERO, CRD42022324611. FINDINGS Thirty-four eligible studies were identified, of which twenty-eight studies were included in the meta-analysis with a pooled SE of 88% (95%CI: 85-90%), SP of 85% (82-88%), and AUC of 0.93 (0.91-0.95). Analysis for different algorithms revealed a pooled SE of 89% (85-92%) and SP of 88% (82-92%) for machine learning; and a pooled SE of 88% (84-91%) and SP of 84% (80-87%) for deep learning. Acceptable diagnostic performance was demonstrated in subgroup analyses stratified by imaging modalities (Ultrasound, Magnetic Resonance Imaging, or Computed Tomography), sample size (≤300 or >300), AI algorithms versus clinicians, year of publication (before or after 2020), geographical distribution (Asia or non Asia), and the different risk of bias levels (≥3 domain low risk or < 3 domain low risk). INTERPRETATION AI algorithms exhibited favorable performance for the diagnosis of OC through medical imaging. More rigorous reporting standards that address specific challenges of AI research could improve future studies. FUNDING This work was supported by the Natural Science Foundation of China (No. 82073647 to Q-JW and No. 82103914 to T-TG), LiaoNing Revitalization Talents Program (No. XLYC1907102 to Q-JW), and 345 Talent Project of Shengjing Hospital of China Medical University (No. M0268 to Q-JW and No. M0952 to T-TG).
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Key Words
- AI, Artificial intelligence
- AUC, Area Under the Curve
- Artificial intelligence
- CT, Computed Tomography
- DL, Deep learning
- ML, Machine learning
- MRI, Magnetic Resonance Imaging
- Medical imaging
- Meta-analysis
- OC, Ovarian cancer
- Ovarian cancer
- SE, Sensitivity
- SP, Specificity
- US, Ultrasound
- XAI, Explainable artificial intelligence
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Affiliation(s)
- He-Li Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hong-Yu Chen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qian Xiao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ying Huang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hong-Zan Sun
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu Shi
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yan Lou
- Department of Intelligent Medicine, China Medical University, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing-Lei Gao
- National Clinical Research Center for Obstetrics and Gynecology, Cancer Biology Research Centre (Key Laboratory of the Ministry of Education) and Department of Gynecology and Obstetrics, Tongji Hospital, Wuhan, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Corresponding author at: Department of Clinical Epidemiology, Department of Obstetrics and Gynecology, Clinical Research Center, Shengjing Hospital of China Medical University, Address: No. 36, San Hao Street, Shenyang, Liaoning 110004, PR China.
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Wang S, Jiang T, Hu X, Hu H, Zhou X, Wei Y, Mao X, Zhao Z. Can the combination of DWI and T2WI radiomics improve the diagnostic efficiency of cervical squamous cell carcinoma? Magn Reson Imaging 2022; 92:197-202. [PMID: 35842193 DOI: 10.1016/j.mri.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/27/2022] [Accepted: 07/11/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND To investigate the value of MRI multi-sequence imaging model in differentiation of cervical squamous cell carcinoma (CSCC). METHODS A total of 104 CSCC patients confirmed with pathology were retrospectively enrolled. All patients underwent conventional MRI examination before treatment. The lesions were segmented using ITK-SNAP software manually and radiomics features were extracted by Artificial Intelligence Kit (AK) software. 396 tumor texture features were obtained and then the mRMR and Lasso algorithms were used to reduce the feature dimension. Three models including T2WI model, DWI model and Joint model (combined TWI and DWI) were constructed in training group and evaluated in validation group. and the receiver operator characteristics and calibration curve were used to evaluate the model performance. RESULTS The Joint model and T2WI model both showed a better diagnostic efficacy than single DWI model in differentiation of CSCC in training group (Joint model: AUC = 0.841; T2WI model: AUC = 0.804; DWI model: AUC = 0.732) and validation group (Joint model: AUC = 0.822; T2WI model: AUC = 0.791; DWI model: AUC = 0.724). But there was no statistical difference between Joint model and T2WI model by Delong test(P > 0.05). CONCLUSIONS The study suggested that the conventional T2WI sequence may be more suitable for prognosis evaluation of CSCC, which can provide a potential tool to facilitate the differential diagnosis of low-differentiation and high-differentiation CSCC.
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Affiliation(s)
- Subo Wang
- Department of Radiology, Shaoxing Hospital of Trational medicine, Shaoxing 312000, Zhejiang Province, China.
| | - Tingchong Jiang
- Department of Radiology, Shaoxing Hospital of Trational medicine, Shaoxing 312000, Zhejiang Province, China
| | - Xi Hu
- Department of Radiology, Sir Run Run Shaw Hospital Affiliated to Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Hongjie Hu
- Department of Radiology, Sir Run Run Shaw Hospital Affiliated to Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Xiaoxuan Zhou
- Department of Radiology, Sir Run Run Shaw Hospital Affiliated to Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | | | - Xiaoming Mao
- Department of Radiology, Shaoxing Hospital of Trational medicine, Shaoxing 312000, Zhejiang Province, China.
| | - Zhenhua Zhao
- Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, China.
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Wei M, Zhang Y, Bai G, Ding C, Xu H, Dai Y, Chen S, Wang H. T2-weighted MRI-based radiomics for discriminating between benign and borderline epithelial ovarian tumors: a multicenter study. Insights Imaging 2022; 13:130. [PMID: 35943620 PMCID: PMC9363551 DOI: 10.1186/s13244-022-01264-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background Preoperative differentiation between benign and borderline epithelial ovarian tumors (EOTs) is challenging and can significantly impact clinical decision making. The purpose was to investigate whether radiomics based on T2-weighted MRI can discriminate between benign and borderline EOTs preoperatively. Methods A total of 417 patients (309, 78, and 30 samples in the training and internal and external validation sets) with pathologically proven benign and borderline EOTs were included in this multicenter study. In total, 1130 radiomics features were extracted from manually delineated tumor volumes of interest on images. The following three different models were constructed and evaluated: radiomics features only (radiomics model); clinical and radiological characteristics only (clinic-radiological model); and a combination of them all (combined model). The diagnostic performances of models were assessed using receiver operating characteristic (ROC) analysis, and area under the ROC curves (AUCs) were compared using the DeLong test. Results The best machine learning algorithm to distinguish borderline from benign EOTs was the logistic regression. The combined model achieved the best performance in discriminating between benign and borderline EOTs, with an AUC of 0.86 ± 0.07. The radiomics model showed a moderate AUC of 0.82 ± 0.07, outperforming the clinic-radiological model (AUC of 0.79 ± 0.06). In the external validation set, the combined model performed significantly better than the clinic-radiological model (AUCs of 0.86 vs. 0.63, p = 0.021 [DeLong test]). Conclusions Radiomics, based on T2-weighted MRI, can provide critical diagnostic information for discriminating between benign and borderline EOTs, thus having the potential to aid personalized treatment options. Supplementary Information The online version contains supplementary material available at 10.1186/s13244-022-01264-x.
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Affiliation(s)
- Mingxiang Wei
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China.,Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yu Zhang
- Department of Radiology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Genji Bai
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Cong Ding
- Department of Radiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Haimin Xu
- Department of Radiology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Yao Dai
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Shuangqing Chen
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China. .,Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
| | - Hong Wang
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China. .,Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
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Clinical Analysis of 137 Cases of Ovarian Tumors in Pregnancy. JOURNAL OF ONCOLOGY 2022; 2022:1907322. [PMID: 35664560 PMCID: PMC9159870 DOI: 10.1155/2022/1907322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022]
Abstract
Ovarian tumors do not really typically occur in association with pregnant; however, once they do, the treatment is critical. It is important to note that around 6% of ovarian tumors in pregnancies are cancerous. The problems induced by ovarian tumors in pregnancy particularly necessitate rapid medical intervention and are much more frequent than cancer. Medication choices and survival of ovary tumor patients could be influenced by varied diagnoses of ovarian masses. So, we present an upgraded logistic regression (ULR) approach in this paper. Initially, the collection of 137 patient datasets was employed in screening test to identify the ovarian tumor as benign-tumor and malignant-tumor by using contrast-enhanced ultrasonography (CEU) method. Then, the screening test images are preprocessed using wavelet transform (WT) approach. The preprocessed data are extracted by using local binary pattern (LBP) and laws' texture energy (LTE) techniques. Finally, the clinical analysis of the ovarian tumor can be obtained by the proposed ULR approach. The performances were examined and compared with existing approaches to achieve the proposed approach with greatest correctness. The findings are depicted by utilizing the MATLAB tool.
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11
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Loukas C, L Kelekis N. Editorial for "MRI-Based Multiple Instance Convolutional Neural Network (MICNN) for Increased Accuracy in the Differentiation of Borderline and Malignant Epithelial Ovarian Tumors". J Magn Reson Imaging 2021; 56:182-183. [PMID: 34851547 DOI: 10.1002/jmri.28014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Constantinos Loukas
- Laboratory of Medical Physics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos L Kelekis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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