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Huang H, Huang Y, Kaggie JD, Cai Q, Yang P, Wei J, Wang L, Guo Y, Lu H, Wang H, Xu X. Multiparametric MRI-Based Deep Learning Radiomics Model for Assessing 5-Year Recurrence Risk in Non-Muscle Invasive Bladder Cancer. J Magn Reson Imaging 2024. [PMID: 39167019 DOI: 10.1002/jmri.29574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 08/03/2024] [Accepted: 08/06/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Accurately assessing 5-year recurrence rates is crucial for managing non-muscle-invasive bladder carcinoma (NMIBC). However, the European Organization for Research and Treatment of Cancer (EORTC) model exhibits poor performance. PURPOSE To investigate whether integrating multiparametric MRI (mp-MRI) with clinical factors improves NMIBC 5-year recurrence risk assessment. STUDY TYPE Retrospective. POPULATION One hundred ninety-one patients (median age, 65 years; age range, 54-73 years; 27 females) underwent mp-MRI between 2011 and 2017, and received ≥5-year follow-ups. They were divided into a training cohort (N = 115) and validation/testing cohorts (N = 38 in each). Recurrence rates were 23.5% (27/115) in the training cohort and 23.7% (9/38) in both validation and testing cohorts. FIELD STRENGTH/SEQUENCE 3-T, fast spin echo T2-weighted imaging (T2WI), single-shot echo planar diffusion-weighted imaging (DWI), and volumetric spoiled gradient echo dynamic contrast-enhanced (DCE) sequences. ASSESSMENT Radiomics and deep learning (DL) features were extracted from the combined region of interest (cROI) including intratumoral and peritumoral areas on mp-MRI. Four models were developed, including clinical, cROI-based radiomics, DL, and clinical-radiomics-DL (CRDL) models. STATISTICAL TESTS Student's t-tests, DeLong's tests with Bonferroni correction, receiver operating characteristics with the area under the curves (AUCs), Cox proportional hazard analyses, Kaplan-Meier plots, SHapley Additive ExPlanations (SHAP) values, and Akaike information criterion for clinical usefulness. A P-value <0.05 was considered statistically significant. RESULTS The cROI-based CRDL model showed superior performance (AUC 0.909; 95% CI: 0.792-0.985) compared to other models in the testing cohort for assessing 5-year recurrence in NMIBC. It achieved the highest Harrell's concordance index (0.804; 95% CI: 0.749-0.859) for estimating recurrence-free survival. SHAP analysis further highlighted the substantial role (22%) of the radiomics features in NMIBC recurrence assessment. DATA CONCLUSION Integrating cROI-based radiomics and DL features from preoperative mp-MRI with clinical factors could improve 5-year recurrence risk assessment in NMIBC. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Haolin Huang
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
- School of Biomedical Engineering & State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai, China
| | - Yiping Huang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Qian Cai
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Peng Yang
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jie Wei
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Lijuan Wang
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
- School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yan Guo
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Hongbing Lu
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Huanjun Wang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Xiaopan Xu
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
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He C, Xu H, Yuan E, Ye L, Chen Y, Yao J, Song B. The accuracy and quality of image-based artificial intelligence for muscle-invasive bladder cancer prediction. Insights Imaging 2024; 15:185. [PMID: 39090234 PMCID: PMC11294512 DOI: 10.1186/s13244-024-01780-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/10/2024] [Indexed: 08/04/2024] Open
Abstract
PURPOSE To evaluate the diagnostic performance of image-based artificial intelligence (AI) studies in predicting muscle-invasive bladder cancer (MIBC). (2) To assess the reporting quality and methodological quality of these studies by Checklist for Artificial Intelligence in Medical Imaging (CLAIM), Radiomics Quality Score (RQS), and Prediction model Risk of Bias Assessment Tool (PROBAST). MATERIALS AND METHODS We searched Medline, Embase, Web of Science, and The Cochrane Library databases up to October 30, 2023. The eligible studies were evaluated using CLAIM, RQS, and PROBAST. Pooled sensitivity, specificity, and the diagnostic performances of these models for MIBC were also calculated. RESULTS Twenty-one studies containing 4256 patients were included, of which 17 studies were employed for the quantitative statistical analysis. The CLAIM study adherence rate ranged from 52.5% to 75%, with a median of 64.1%. The RQS points of each study ranged from 2.78% to 50% points, with a median of 30.56% points. All models were rated as high overall ROB. The pooled area under the curve was 0.85 (95% confidence interval (CI) 0.81-0.88) for computed tomography, 0.92 (95% CI 0.89-0.94) for MRI, 0.89 (95% CI 0.86-0.92) for radiomics and 0.91 (95% CI 0.88-0.93) for deep learning, respectively. CONCLUSION Although AI-powered muscle-invasive bladder cancer-predictive models showed promising performance in the meta-analysis, the reporting quality and the methodological quality were generally low, with a high risk of bias. CRITICAL RELEVANCE STATEMENT Artificial intelligence might improve the management of patients with bladder cancer. Multiple models for muscle-invasive bladder cancer prediction were developed. Quality assessment is needed to promote clinical application. KEY POINTS Image-based artificial intelligence models could aid in the identification of muscle-invasive bladder cancer. Current studies had low reporting quality, low methodological quality, and a high risk of bias. Future studies could focus on larger sample sizes and more transparent reporting of pathological evaluation, model explanation, and failure and sensitivity analyses.
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Affiliation(s)
- Chunlei He
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Department of Radiology, Sanya People's Hospital, Sanya, Hainan, 572000, China
| | - Hui Xu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Enyu Yuan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Lei Ye
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yuntian Chen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jin Yao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
- Department of Radiology, Sanya People's Hospital, Sanya, Hainan, 572000, China.
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Li S, Fan Z, Guo J, Li D, Chen Z, Zhang X, Wang Y, Li Y, Yang G, Wang X. Compressed sensing 3D T2WI radiomics model: improving diagnostic performance in muscle invasion of bladder cancer. BMC Med Imaging 2024; 24:148. [PMID: 38886638 PMCID: PMC11181529 DOI: 10.1186/s12880-024-01318-0] [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: 02/20/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Preoperative discrimination between non-muscle-invasive bladder cancer (NMIBC) and the muscle invasive bladder cancer (MIBC) is a determinant of management. The purpose of this research is to employ radiomics to evaluate the diagnostic value in determining muscle invasiveness of compressed sensing (CS) accelerated 3D T2-weighted-SPACE sequence with high resolution and short acquisition time. METHODS This prospective study involved 108 participants who underwent preoperative 3D-CS-T2-weighted-SPACE, 3D-T2-weighted-SPACE and T2-weighted sequences. The cohort was divided into training and validation cohorts in a 7:3 ratio. In the training cohort, a Rad-score was constructed based on radiomic features selected by intraclass correlation coefficients, pearson correlation coefficient and least absolute shrinkage and selection operator . Multivariate logistic regression was used to develop a nomogram combined radiomics and clinical indices. In the validation cohort, the performances of the models were evaluated by ROC, calibration, and decision curves. RESULTS In the validation cohort, the area under ROC curve of 3D-CS-T2-weighted-SPACE, 3D-T2-weighted-SPACE and T2-weighted models were 0.87(95% confidence interval (CI):0.73-1.00), 0.79(95%CI:0.63-0.96) and 0.77(95%CI:0.60-0.93), respectively. The differences in signal-to-noise ratio and contrast-to-noise ratio between 3D-CS-T2-weighted-SPACE and 3D-T2-weighted-SPACE sequences were not statistically significant(p > 0.05). While the clinical model composed of three clinical indices was 0.74(95%CI:0.55-0.94) and the radiomics-clinical nomogram model was 0.88(95%CI:0.75-1.00). The calibration curves confirmed high goodness of fit, and the decision curve also showed that the radiomics model and combined nomogram model yielded higher net benefits than the clinical model. CONCLUSION The radiomics model based on compressed sensing 3D T2WI sequence, which was acquired within a shorter acquisition time, showed superior diagnostic efficacy in muscle invasion of bladder cancer. Additionally, the nomogram model could enhance the diagnostic performance.
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Affiliation(s)
- Shuo Li
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Zhichang Fan
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Junting Guo
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Ding Li
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Zeke Chen
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Xiaoyue Zhang
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Yongfang Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Yan Li
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Guoqiang Yang
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Xiaochun Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China.
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Ye Y, Luo Z, Qiu Z, Cao K, Huang B, Deng L, Zhang W, Liu G, Zou Y, Zhang J, Li J. Radiomics Prediction of Muscle Invasion in Bladder Cancer Using Semi-Automatic Lesion Segmentation of MRI Compared with Manual Segmentation. Bioengineering (Basel) 2023; 10:1355. [PMID: 38135946 PMCID: PMC10740947 DOI: 10.3390/bioengineering10121355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/10/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Conventional radiomics analysis requires the manual segmentation of lesions, which is time-consuming and subjective. This study aimed to assess the feasibility of predicting muscle invasion in bladder cancer (BCa) with radiomics using a semi-automatic lesion segmentation method on T2-weighted images. Cases of non-muscle-invasive BCa (NMIBC) and muscle-invasive BCa (MIBC) were pathologically identified in a training cohort and in internal and external validation cohorts. For bladder tumor segmentation, a deep learning-based semi-automatic model was constructed, while manual segmentation was performed by a radiologist. Semi-automatic and manual segmentation results were respectively used in radiomics analyses to distinguish NMIBC from MIBC. An equivalence test was used to compare the models' performance. The mean Dice similarity coefficients of the semi-automatic segmentation method were 0.836 and 0.801 in the internal and external validation cohorts, respectively. The area under the receiver operating characteristic curve (AUC) were 1.00 (0.991) and 0.892 (0.894) for the semi-automated model (manual) on the internal and external validation cohort, respectively (both p < 0.05). The average total processing time for semi-automatic segmentation was significantly shorter than that for manual segmentation (35 s vs. 92 s, p < 0.001). The BCa radiomics model based on semi-automatic segmentation method had a similar diagnostic performance as that of manual segmentation, while being less time-consuming and requiring fewer manual interventions.
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Affiliation(s)
- Yaojiang Ye
- Department of Radiology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan 523059, China; (Y.Y.); (L.D.); (Y.Z.)
| | - Zixin Luo
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China; (Z.L.); (Z.Q.); (K.C.); (B.H.)
| | - Zhengxuan Qiu
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China; (Z.L.); (Z.Q.); (K.C.); (B.H.)
| | - Kangyang Cao
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China; (Z.L.); (Z.Q.); (K.C.); (B.H.)
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China; (Z.L.); (Z.Q.); (K.C.); (B.H.)
| | - Lei Deng
- Department of Radiology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan 523059, China; (Y.Y.); (L.D.); (Y.Z.)
| | - Weijing Zhang
- Imaging Department, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;
| | - Guoqing Liu
- College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China;
| | - Yujian Zou
- Department of Radiology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan 523059, China; (Y.Y.); (L.D.); (Y.Z.)
| | - Jian Zhang
- Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen 518060, China
| | - Jianpeng Li
- Department of Radiology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan 523059, China; (Y.Y.); (L.D.); (Y.Z.)
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Zhang Y, Xu Z, Wu S, Zhu T, Hong X, Chi Z, Malla R, Jiang J, Huang Y, Xu Q, Wang Z, Zhang Y. Construction of 3D and 2D contrast-enhanced CT radiomics for prediction of CGB3 expression level and clinical prognosis in bladder cancer. Heliyon 2023; 9:e20335. [PMID: 37809854 PMCID: PMC10560067 DOI: 10.1016/j.heliyon.2023.e20335] [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: 06/01/2023] [Revised: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023] Open
Abstract
Objective The purpose of this study was to construct a 3D and 2D contrast-enhanced computed tomography (CECT) radiomics model to predict CGB3 levels and assess its prognostic abilities in bladder cancer (Bca) patients. Methods Transcriptome data and CECT images of Bca patients were downloaded from The Cancer Imaging Archive (TCIA) and The Cancer Genome Atlas (TCGA) database. Clinical data of 43 cases from TCGA and TCIA were used for radiomics model evaluation. The Volume of interest (VOI) (3D) and region of interest (ROI) (2D) radiomics features were extracted. For the construction of predicting radiomics models, least absolute shrinkage and selection operator regression were used, and the filtered radiomics features were fitted using the logistic regression algorithm (LR). The model's effectiveness was measured using 10-fold cross-validation and the area under the receiver operating characteristic curve (AUC of ROC). Result CGB3 was a differential expressed prognosis-related gene and involved in the immune response process of plasma cells and T cell gamma delta. The high levels of CGB3 are a risk element for overall survival (OS). The AUCs of VOI and ROI radiomics models in the training set were 0.841 and 0.776, while in the validation set were 0.815 and 0.754, respectively. The Delong test revealed that the AUCs of the two models were not statistically different, and both models had good predictive performance. Conclusion The CGB3 expression level is an important prognosis factor for Bca patients. Both 3D and 2D CECT radiomics are effective in predicting CGB3 expression levels.
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Affiliation(s)
- Yuanfeng Zhang
- Department of Urology, Shantou Central Hospital, Shantou, PR China
- Department of Urology, Lanzhou University Second Hospital, Key Laboratory of Urological Disease of Gansu Province, Clinical Center of Gansu Province for Nephron-Urology, Lanzhou, PR China
| | - Zhuangyong Xu
- Department of Radiology,Shantou Central Hospital, Shantou, PR China
| | - Shaoxu Wu
- Department of Urology, Sun Yat-sen Memorial Hospital, Guangzhou, PR China
| | - Tianxiang Zhu
- Department of Cardiothoracic Surgery, Shantou Central Hospital, Shantou, PR China
| | - Xuwei Hong
- Department of Urology, Shantou Central Hospital, Shantou, PR China
| | - Zepai Chi
- Department of Urology, Shantou Central Hospital, Shantou, PR China
| | - Rujan Malla
- Department of Radiology, Nepal Medical Collage Teaching Hospital, Kathmandu, Nepal
| | - Jingqi Jiang
- Department of Urology, Lanzhou University Second Hospital, Key Laboratory of Urological Disease of Gansu Province, Clinical Center of Gansu Province for Nephron-Urology, Lanzhou, PR China
| | - Yi Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Guangzhou, PR China
| | - Qingchun Xu
- Department of Urology, Shantou Central Hospital, Shantou, PR China
| | - Zhiping Wang
- Department of Urology, Lanzhou University Second Hospital, Key Laboratory of Urological Disease of Gansu Province, Clinical Center of Gansu Province for Nephron-Urology, Lanzhou, PR China
| | - Yonghai Zhang
- Department of Urology, Shantou Central Hospital, Shantou, PR China
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Boca B, Caraiani C, Telecan T, Pintican R, Lebovici A, Andras I, Crisan N, Pavel A, Diosan L, Balint Z, Lupsor-Platon M, Buruian MM. MRI-Based Radiomics in Bladder Cancer: A Systematic Review and Radiomics Quality Score Assessment. Diagnostics (Basel) 2023; 13:2300. [PMID: 37443692 DOI: 10.3390/diagnostics13132300] [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: 05/22/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
(1): Background: With the recent introduction of vesical imaging reporting and data system (VI-RADS), magnetic resonance imaging (MRI) has become the main imaging method used for the preoperative local staging of bladder cancer (BCa). However, the VI-RADS score is subject to interobserver variability and cannot provide information about tumor cellularity. These limitations may be overcome by using a quantitative approach, such as the new emerging domain of radiomics. (2) Aim: To systematically review published studies on the use of MRI-based radiomics in bladder cancer. (3) Materials and Methods: We performed literature research using the PubMed MEDLINE, Scopus, and Web of Science databases using PRISMA principles. A total of 1092 papers that addressed the use of radiomics for BC staging, grading, and treatment response were retrieved using the keywords "bladder cancer", "magnetic resonance imaging", "radiomics", and "textural analysis". (4) Results: 26 papers met the eligibility criteria and were included in the final review. The principal applications of radiomics were preoperative tumor staging (n = 13), preoperative prediction of tumor grade or molecular correlates (n = 9), and prediction of prognosis/response to neoadjuvant therapy (n = 4). Most of the developed radiomics models included second-order features mainly derived from filtered images. These models were validated in 16 studies. The average radiomics quality score was 11.7, ranging between 8.33% and 52.77%. (5) Conclusions: MRI-based radiomics holds promise as a quantitative imaging biomarker of BCa characterization and prognosis. However, there is still need for improving the standardization of image preprocessing, feature extraction, and external validation before applying radiomics models in the clinical setting.
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Affiliation(s)
- Bianca Boca
- Department of Radiology, "George Emil Palade", University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania
- Department of Medical Imaging and Nuclear Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
| | - Cosmin Caraiani
- Department of Medical Imaging and Nuclear Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
| | - Teodora Telecan
- Department of Urology, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- Department of Urology, Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
| | - Roxana Pintican
- Department of Radiology, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
| | - Andrei Lebovici
- Department of Radiology, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
| | - Iulia Andras
- Department of Urology, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- Department of Urology, Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
| | - Nicolae Crisan
- Department of Urology, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- Department of Urology, Clinical Municipal Hospital, 400139 Cluj-Napoca, Romania
| | - Alexandru Pavel
- Department of Radiology, "George Emil Palade", University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania
| | - Laura Diosan
- Department of Computer Science, Faculty of Mathematics and Computer Science, "Babes-Bolyai" University, 400157 Cluj-Napoca, Romania
| | - Zoltan Balint
- Department of Biomedical Physics, Faculty of Physics, "Babes-Bolyai" University, 400084 Cluj-Napoca, Romania
| | - Monica Lupsor-Platon
- Department of Medical Imaging and Nuclear Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- Department of Radiology, Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", 400162 Cluj-Napoca, Romania
| | - Mircea Marian Buruian
- Department of Radiology, "George Emil Palade", University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania
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Li J, Qiu Z, Cao K, Deng L, Zhang W, Xie C, Yang S, Yue P, Zhong J, Lyu J, Huang X, Zhang K, Zou Y, Huang B. Predicting muscle invasion in bladder cancer based on MRI: A comparison of radiomics, and single-task and multi-task deep learning. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 233:107466. [PMID: 36907040 DOI: 10.1016/j.cmpb.2023.107466] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/09/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Radiomics and deep learning are two popular technologies used to develop computer-aided detection and diagnosis schemes for analysing medical images. This study aimed to compare the effectiveness of radiomics, single-task deep learning (DL) and multi-task DL methods in predicting muscle-invasive bladder cancer (MIBC) status based on T2-weighted imaging (T2WI). METHODS A total of 121 tumours (93 for training, from Centre 1; 28 for testing, from Centre 2) were included. MIBC was confirmed with pathological examination. A radiomics model, a single-task model, and a multi-task model based on T2WI were constructed in the training cohort with five-fold cross-validation, and validation was conducted in the external test cohort. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of each model. DeLong's test and a permutation test were used to compare the performance of the models. RESULTS The area under the ROC curve (AUC) values of the radiomics, single-task and multi-task models in the training cohort were: 0.920, 0.933 and 0.932, respectively; and were 0.844, 0.884 and 0.932, respectively, in the test cohort. The multi-task model achieved better performance in the test cohort than did the other models. No statistically significant differences in AUC values and Kappa coefficients were observed between pairwise models, in either the training or test cohorts. According to the Grad-CAM feature visualization results, the multi-task model focused more on the diseased tissue area in some samples of the test cohort compared with the single-task model. CONCLUSIONS The T2WI-based radiomics, single-task, and multi-task models all exhibited good diagnostic performance in preoperatively predicting MIBC, in which the multi-task model had the best diagnostic performance. Compared with the radiomics method, our multi-task DL method had the advantage of saving time and effort. Compared with the single-task DL method, our multi-task DL method had the advantage of being more lesion-focused and more reliable for clinical reference.
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Affiliation(s)
- Jianpeng Li
- Department of Radiology, Affiliated Dongguan Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong, China
| | - Zhengxuan Qiu
- Medical AI Lab, School of Biomedical Engineering, Health Science Centre, Shenzhen University, Shenzhen, China
| | - Kangyang Cao
- Medical AI Lab, School of Biomedical Engineering, Health Science Centre, Shenzhen University, Shenzhen, China
| | - Lei Deng
- Department of Radiology, Affiliated Dongguan Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong, China
| | - Weijing Zhang
- Imaging Department, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Chuanmiao Xie
- Imaging Department, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Shuiqing Yang
- Department of Radiology, Affiliated Dongguan Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong, China
| | - Peiyan Yue
- Medical AI Lab, School of Biomedical Engineering, Health Science Centre, Shenzhen University, Shenzhen, China
| | - Jian Zhong
- Medical AI Lab, School of Biomedical Engineering, Health Science Centre, Shenzhen University, Shenzhen, China
| | - Jiegeng Lyu
- Medical AI Lab, School of Biomedical Engineering, Health Science Centre, Shenzhen University, Shenzhen, China
| | - Xiang Huang
- Department of Radiology, Affiliated Dongguan Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong, China
| | - Kunlin Zhang
- Department of Radiology, Affiliated Dongguan Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong, China
| | - Yujian Zou
- Department of Radiology, Affiliated Dongguan Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, Guangdong, China.
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Health Science Centre, Shenzhen University, Shenzhen, China.
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Sarkar S, Min K, Ikram W, Tatton RW, Riaz IB, Silva AC, Bryce AH, Moore C, Ho TH, Sonpavde G, Abdul-Muhsin HM, Singh P, Wu T. Performing Automatic Identification and Staging of Urothelial Carcinoma in Bladder Cancer Patients Using a Hybrid Deep-Machine Learning Approach. Cancers (Basel) 2023; 15:cancers15061673. [PMID: 36980557 PMCID: PMC10046500 DOI: 10.3390/cancers15061673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Accurate clinical staging of bladder cancer aids in optimizing the process of clinical decision-making, thereby tailoring the effective treatment and management of patients. While several radiomics approaches have been developed to facilitate the process of clinical diagnosis and staging of bladder cancer using grayscale computed tomography (CT) scans, the performances of these models have been low, with little validation and no clear consensus on specific imaging signatures. We propose a hybrid framework comprising pre-trained deep neural networks for feature extraction, in combination with statistical machine learning techniques for classification, which is capable of performing the following classification tasks: (1) bladder cancer tissue vs. normal tissue, (2) muscle-invasive bladder cancer (MIBC) vs. non-muscle-invasive bladder cancer (NMIBC), and (3) post-treatment changes (PTC) vs. MIBC.
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Affiliation(s)
- Suryadipto Sarkar
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
- Correspondence:
| | - Kong Min
- Department of Radiology, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Waleed Ikram
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Ryan W. Tatton
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Irbaz B. Riaz
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Alvin C. Silva
- Department of Radiology, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Alan H. Bryce
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Cassandra Moore
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Thai H. Ho
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Guru Sonpavde
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | | | - Parminder Singh
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ 85054, USA
| | - Teresa Wu
- ASU-Mayo Center for Innovative Imaging, School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ 85281, USA
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9
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Liu Y, Xu X, Wang H, Liu Y, Wang Y, Dong Q, Li Z, Guo Y, Lu H. The Additional Value of Tri-parametric MRI in Identifying Muscle-invasive Status in Bladder Cancer. Acad Radiol 2023; 30:64-76. [PMID: 35676179 DOI: 10.1016/j.acra.2022.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/06/2022] [Accepted: 04/15/2022] [Indexed: 12/24/2022]
Abstract
RATIONALE AND OBJECTIVES Identification of muscle-invasive status (MIS) of bladder cancer (BCa) is critical for treatment decisions. The Vesical Imaging-Reporting and Data System (VI-RADS) has been widely used in preoperatively predicting MIS using tri-parametric MR imaging including T2-weighted (T2W), diffusion-weighted (DW), and dynamic contrast-enhanced (DCE) sequences. While the diagnostic values of radiomics features from bi-parametric MRI such as T2W + DW to identification of MIS have been reported, whether the tri-parametric MRI could provide additional diagnostic value to the radiomics prediction task, and how to integrate DCE features into the radiomics model, which is the objectives of this study, remain unknown. MATERIALS AND METHODS Patients with postoperatively confirmed BCa lesions (150 in non-muscle-invasive BCa and 56 in muscle-invasive BCa groups) were retrospectively included. Their T2W, DW with apparent diffusion coefficient (ADC) maps, and DCE sequences were acquired using a 3.0T MR system. Regions of interest were manually depicted and VI-RADS scores were assessed by three radiologists. Three predictive models were developed by the radiomics features extracted from sequence combinations of T2W + DW (Model one), T2W + DCE (Model two), and T2W + DW + DCE (Model three), respectively, using the least absolute shrinkage and selection operator. The performance of each model was quantitatively assessed on both the training (n = 165) and testing (n = 41) cohorts. Then a 10 times five-fold cross validation was conducted to assess the overall performance. RESULTS Three models achieved area under the curve of 0.888, 0.869, and 0.901 in the cross validation, respectively. The tri-parametric model performed significantly superior than the two bi-parametric models and VI-RADS. The analysis of feature coefficients derived from least absolute shrinkage and selection operator algorithm showed features from the tri-parametric MRI are effective in MIS discrimination. CONCLUSION The tri-parametric MRI provides additional value to the radiomics-based identification of MIS.
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Affiliation(s)
- Yan Liu
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, SN 710032, China; Shaanxi Provincial Key Laboratory of Bioelectromagnetic Detection and Intelligent Perception, Xi'an, SN 710032, China
| | - Xiaopan Xu
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, SN 710032, China; Shaanxi Provincial Key Laboratory of Bioelectromagnetic Detection and Intelligent Perception, Xi'an, SN 710032, China
| | - Huanjun Wang
- Department of Radiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, GD 510080, China
| | - Yang Liu
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, SN 710032, China; Shaanxi Provincial Key Laboratory of Bioelectromagnetic Detection and Intelligent Perception, Xi'an, SN 710032, China
| | - Yang Wang
- Department of Radiology, the First Affiliated Hospital, Air Force Medical University, Xi'an, SN 710032, China
| | - Qi Dong
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, SN 710032, China; Shaanxi Provincial Key Laboratory of Bioelectromagnetic Detection and Intelligent Perception, Xi'an, SN 710032, China
| | - Ziqi Li
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, SN 710032, China; Shaanxi Provincial Key Laboratory of Bioelectromagnetic Detection and Intelligent Perception, Xi'an, SN 710032, China
| | - Yan Guo
- Department of Radiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, GD 510080, China
| | - Hongbing Lu
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, SN 710032, China; Shaanxi Provincial Key Laboratory of Bioelectromagnetic Detection and Intelligent Perception, Xi'an, SN 710032, China.
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Zhang L, Li X, Yang L, Tang Y, Guo J, Li D, Li S, Li Y, Wang L, Lei Y, Qiao H, Yang G, Wang X. Multi‐Sequence and Multi‐Regional
MRI
‐Based Radiomics Nomogram for the Preoperative Assessment of Muscle Invasion in Bladder Cancer. J Magn Reson Imaging 2022. [DOI: 10.1002/jmri.28498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Lu Zhang
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Xiaoyang Li
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Li Yang
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Ying Tang
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Junting Guo
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Ding Li
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Shuo Li
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Yan Li
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Le Wang
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Ying Lei
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Hong Qiao
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Guoqiang Yang
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Xiaochun Wang
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
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Radiomics Nomogram Based on High-b-Value Diffusion-Weighted Imaging for Distinguishing the Grade of Bladder Cancer. Life (Basel) 2022; 12:life12101510. [DOI: 10.3390/life12101510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/03/2022] [Accepted: 09/23/2022] [Indexed: 12/24/2022] Open
Abstract
Background: The aim was to evaluate the feasibility of radiomics features based on diffusion-weighted imaging (DWI) at high b-values for grading bladder cancer and to compare the possible advantages of high-b-value DWI over the standard b-value DWI. Methods: Seventy-four participants with bladder cancer were included in this study. DWI sequences using a 3 T MRI with b-values of 1000, 1700, and 3000 s/mm2 were acquired, and the corresponding ADC maps were generated, followed with feature extraction. Patients were randomly divided into training and testing cohorts with a ratio of 8:2. The radiomics features acquired from the ADC1000, ADC1700, and ADC3000 maps were compared between low- and high-grade bladder cancers by using the Wilcox analysis, and only the radiomics features with significant differences were selected. The least absolute shrinkage and selection operator method and a logistic regression were performed for the feature selection and establishing the radiomics model. A receiver operating characteristic (ROC) analysis was conducted to assess the diagnostic performance of the radiomics models. Results: In the training cohorts, the AUCs of the ADC1000, ADC1700, and ADC3000 model for discriminating between low- from high-grade bladder cancer were 0.901, 0.920, and 0.901, respectively. In the testing cohorts, the AUCs of ADC1000, ADC1700, and ADC3000 were 0.582, 0.745, and 0.745, respectively. Conclusions: The radiomics features extracted from the ADC1700 maps could improve the diagnostic accuracy over those extracted from the conventional ADC1000 maps.
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12
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Huang X, Wang X, Lan X, Deng J, Lei Y, Lin F. The role of radiomics with machine learning in the prediction of muscle-invasive bladder cancer: A mini review. Front Oncol 2022; 12:990176. [PMID: 36059618 PMCID: PMC9428259 DOI: 10.3389/fonc.2022.990176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Bladder cancer is a common malignant tumor in the urinary system. Depending on whether bladder cancer invades muscle tissue, it is classified into non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). It is crucial to accurately diagnose the muscle invasion of bladder cancer for its clinical management. Although imaging modalities such as CT and multiparametric MRI play an important role in this regard, radiomics has shown great potential with the development and innovation of precision medicine. It features outstanding advantages such as non-invasive and high efficiency, and takes on important significance in tumor assessment and laor liberation. In this article, we provide an overview of radiomics in the prediction of muscle-invasive bladder cancer and reflect on its future trends and challenges.
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Affiliation(s)
- Xiaodan Huang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiangyu Wang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xinxin Lan
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Jinhuan Deng
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yi Lei
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Fan Lin
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
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13
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Predictive Value of CT-Based Radiomics in Distinguishing Renal Angiomyolipomas with Minimal Fat from Other Renal Tumors. DISEASE MARKERS 2022; 2022:9108129. [PMID: 35669501 PMCID: PMC9167090 DOI: 10.1155/2022/9108129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/03/2022] [Indexed: 01/05/2023]
Abstract
Objectives This study is aimed at determining whether CT-based radiomics models can help differentiate renal angiomyolipomas with minimal fat (AMLmf) from other solid renal tumors. Methods This retrospective study included 58 patients with a postoperative pathologically confirmed AMLmf (observation group) and 140 patients with other common renal tumors (control group). Non-contrast-enhanced CT and contrast-enhanced CT data were evaluated. Radiomics features were extracted from manually delineated volume of interest (VOIs). The least absolute shrinkage and selection operator (LASSO) regression was used for feature screening. Five classifiers, including logistic regression, multilayer perceptron (MLP), support vector machine (SVM), k-nearest neighbor (KNN), and logistic regression (LR), were used, with leave-out validation (128 training, 60 testing). The diagnostic performance of the classifier was evaluated and compared by receiver operating characteristic curve (ROC) analysis. Results Among the 1029 extracted features, prediction models of AMLmf were composed, by 2, 10, 4, and 9 selected features for precontrast phase (PCP), corticomedullary phase (CMP), nephrographic phase (NP), and excretory phase (EP), respectively. Models of CMP and NP achieved adequate performance after using MLP classifier, with prediction accuracy of 0.767 (AUC 0.85, sensitivity 0.76, and specificity 0.78) and 0.783 (AUC 0.83, sensitivity 0.79, and specificity 0.78), respectively. MLP model of features selected from the combination of the all features had the best diagnostic performance (accuracy 0.8500, sensitivity 0.8095, specificity 0.9444, and AUC 0.9193). Conclusions Radiomics features may help to distinguish benign AMLmf from common malignant kidney masses, which may contribute to the selection of interventions for renal tumors.
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Tang X, Huang H, Du P, Wang L, Yin H, Xu X. Intratumoral and peritumoral CT-based radiomics strategy reveals distinct subtypes of non-small-cell lung cancer. J Cancer Res Clin Oncol 2022; 148:2247-2260. [DOI: 10.1007/s00432-022-04015-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/04/2022] [Indexed: 12/24/2022]
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15
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Cui Y, Sun Z, Liu X, Zhang X, Wang X. CT-based radiomics for the preoperative prediction of the muscle-invasive status of bladder cancer and comparison to radiologists' assessment. Clin Radiol 2022; 77:e473-e482. [DOI: 10.1016/j.crad.2022.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 02/25/2022] [Indexed: 12/13/2022]
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16
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Li Z, Feng N, Pu H, Dong Q, Liu Y, Liu Y, Xu X. PIxel-Level Segmentation of Bladder Tumors on MR Images Using a Random Forest Classifier. Technol Cancer Res Treat 2022; 21:15330338221086395. [PMID: 35296195 PMCID: PMC9123929 DOI: 10.1177/15330338221086395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: Regional bladder wall thickening on noninvasive magnetic
resonance (MR) images is an important sign of developing urinary bladder cancer
(BCa), and precise segmentation of the tumor mass is an essential step toward
noninvasive identification of the pathological stage and grade, which is of
critical importance for the clinical management of patients with BCa.
Methods: In this paper, we proposed a new method based on the
high-throughput pixel-level features and a random forest (RF) classifier for the
BCa segmentation. First, regions of interest (ROIs) including tumor and wall
ROIs were used in the training set for feature extraction and segmentation model
development. Then, candidate regions containing both bladder tumor and its
neighboring wall tissue in the testing set were segmented. Results:
Experimental results were evaluated on a retrospective database containing 56
patients postoperatively confirmed with BCa from the affiliated hospital. The
Dice similarity coefficient (DSC) and average symmetric surface distance (ASSD)
of the tumor regions were adopted to quantitatively assess the overall
performance of this approach. The results showed that the mean DSC was 0.906
(95% confidential interval [CI]: 0.852-0.959), and the mean ASSD was 1.190 mm
(95% CI: 1.727-2.449), which were higher than those of the state-of-the-art
methods for tumor region separation. Conclusion: The proposed
Pixel-level BCa segmentation method can achieve good performance for the
accurate segmentation of BCa lesion on MR images.
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Affiliation(s)
- Ziqi Li
- School of Biomedical Engineering, 12644Air Force Medical University, Xi'an, PR China
| | - Na Feng
- Basic Medical Science Academy, 12644Air Force Medical University, Xi'an, PR China
| | - Huangsheng Pu
- College of Advanced Interdisciplinary Studies, 58294National University of Defense Technology, Changsha, PR China
| | - Qi Dong
- School of Biomedical Engineering, 12644Air Force Medical University, Xi'an, PR China
| | - Yan Liu
- School of Biomedical Engineering, 12644Air Force Medical University, Xi'an, PR China
| | - Yang Liu
- School of Biomedical Engineering, 12644Air Force Medical University, Xi'an, PR China
| | - Xiaopan Xu
- School of Biomedical Engineering, 12644Air Force Medical University, Xi'an, PR China
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Moitra D, Mandal RK. Classification of malignant tumors by a non-sequential recurrent ensemble of deep neural network model. MULTIMEDIA TOOLS AND APPLICATIONS 2022; 81:10279-10297. [PMID: 35194379 PMCID: PMC8852869 DOI: 10.1007/s11042-022-12229-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/12/2021] [Accepted: 01/14/2022] [Indexed: 05/04/2023]
Abstract
Many significant efforts have so far been made to classify malignant tumors by using various machine learning methods. Most of the studies have considered a particular tumor genre categorized according to its originating organ. This has enriched the domain-specific knowledge of malignant tumor prediction, we are devoid of an efficient model that may predict the stages of tumors irrespective of their origin. Thus, there is ample opportunity to study if a heterogeneous collection of tumor images can be classified according to their respective stages. The present research work has prepared a heterogeneous tumor dataset comprising eight different datasets from The Cancer Imaging Archives and classified them according to their respective stages, as suggested by the American Joint Committee on Cancer. The proposed model has been used for classifying 717 subjects comprising different imaging modalities and varied Tumor-Node-Metastasis stages. A new non-sequential deep hybrid model ensemble has been developed by exploiting branched and re-injected layers, followed by bidirectional recurrent layers to classify tumor images. Results have been compared with standard sequential deep learning models and notable recent studies. The training and validation accuracy along with the ROC-AUC scores have been found satisfactory over the existing models. No model or method in the literature could ever classify such a diversified mix of tumor images with such high accuracy. The proposed model may help radiologists by acting as an auxiliary decision support system and speed up the tumor diagnosis process.
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18
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Wang XH, Xu X, Ao Z, Duan J, Han X, Tang X, Fu YF, Wu XS, Wang X, Zhu L, Zeng W, Guo S. Elaboration of a Radiomics Strategy for the Prediction of the Re-positive Cases in the Discharged Patients With COVID-19. Front Med (Lausanne) 2021; 8:730441. [PMID: 34604267 PMCID: PMC8481365 DOI: 10.3389/fmed.2021.730441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/11/2021] [Indexed: 12/31/2022] Open
Abstract
Objective: A considerable part of COVID-19 patients were found to be re-positive in the SARS-CoV-2 RT-PCR test after discharge. Early prediction of re-positive COVID-19 cases is of critical importance in determining the isolation period and developing clinical protocols. Materials and Methods: Ninety-one patients discharged from Wanzhou Three Gorges Central Hospital, Chongqing, China, from February 10, 2020 to March 3, 2020 were administered nasopharyngeal swab SARS-CoV-2 tests within 12-14 days, and 50 eligible patients (32 male and 18 female) with completed data were enrolled. Average age was 48 ± 11.5 years. All patients underwent non-enhanced chest CT on admission. A total of 568 radiomics features were extracted from the CT images, and 17 clinical factors were collected based on the medical record. Student's t-test and support vector machine-based recursive feature elimination (SVM-RFE) method were used to determine an optimal subset of features for the discriminative model development. Results: After Student's t-test, 62 radiomics features showed significant inter-group differences (p < 0.05) between the re-positive and negative cases, and none of the clinical features showed significant differences. These significant features were further selected by SVM-RFE algorithm, and a more compact feature subset containing only two radiomics features was finally determined, achieving the best predictive performance with the accuracy and area under the curve of 72.6% and 0.773 for the identification of the re-positive case. Conclusion: The proposed radiomics method has preliminarily shown potential in identifying the re-positive cases among the recovered COVID-19 patients after discharge. More strategies are to be integrated into the current pipeline to improve its precision, and a larger database with multi-clinical enrollment is required to extensively verify its performance.
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Affiliation(s)
- Xiao-Hui Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaopan Xu
- School of Biomedical Engineering, Air Force Medical University, Xi'an, China
| | - Zhi Ao
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Duan
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoli Han
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xing Tang
- Department of Radiology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Yu-Fei Fu
- Department of Radiology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Xu-Sha Wu
- Department of Radiology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Xue Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linxiao Zhu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenbing Zeng
- Department of Radiology, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Shuliang Guo
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Wang X, Cheng B, Roberts N, Wang S, Luo Y, Tian F, Yue S. Shared and distinct brain fMRI response during performance of working memory tasks in adult patients with schizophrenia and major depressive disorder. Hum Brain Mapp 2021; 42:5458-5476. [PMID: 34431584 PMCID: PMC8519858 DOI: 10.1002/hbm.25618] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 02/05/2023] Open
Abstract
Working memory (WM) impairments are common features of psychiatric disorders. A systematic meta-analysis was performed to determine common and disorder-specific brain fMRI response during performance of WM tasks in patients with SZ and patients with MDD relative to healthy controls (HC). Thirty-four published fMRI studies of WM in patients with SZ and 18 published fMRI studies of WM in patients with MDD, including relevant HC, were included in the meta-analysis. In both SZ and MDD there was common stronger fMRI response in right medial prefrontal cortex (MPFC) and bilateral anterior cingulate cortex (ACC), which are part of the default mode network (DMN). The effects were of greater magnitude in SZ than MDD, especially in prefrontal-temporal-cingulate-striatal-cerebellar regions. In addition, a disorder-specific weaker fMRI response was observed in right middle frontal gyrus (MFG) in MDD, relative to HC. For both SZ and MDD a significant correlation was observed between the severity of clinical symptoms and lateralized fMRI response relative to HC. These findings indicate that there may be common and distinct anomalies in brain function underlying deficits in WM in SZ and MDD, which may serve as a potential functional neuroimaging-based diagnostic biomarker with value in supporting clinical diagnosis, measuring illness severity and assessing the efficacy of treatments for SZ and MDD at the brain level.
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Affiliation(s)
- Xiuli Wang
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Neil Roberts
- Edinburgh Imaging Facility, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Song Wang
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ya Luo
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Suping Yue
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu, China
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20
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Xu X, Wang H, Guo Y, Zhang X, Li B, Du P, Liu Y, Lu H. Study Progress of Noninvasive Imaging and Radiomics for Decoding the Phenotypes and Recurrence Risk of Bladder Cancer. Front Oncol 2021; 11:704039. [PMID: 34336691 PMCID: PMC8321511 DOI: 10.3389/fonc.2021.704039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/30/2021] [Indexed: 12/24/2022] Open
Abstract
Urinary bladder cancer (BCa) is a highly prevalent disease among aged males. Precise diagnosis of tumor phenotypes and recurrence risk is of vital importance in the clinical management of BCa. Although imaging modalities such as CT and multiparametric MRI have played an essential role in the noninvasive diagnosis and prognosis of BCa, radiomics has also shown great potential in the precise diagnosis of BCa and preoperative prediction of the recurrence risk. Radiomics-empowered image interpretation can amplify the differences in tumor heterogeneity between different phenotypes, i.e., high-grade vs. low-grade, early-stage vs. advanced-stage, and nonmuscle-invasive vs. muscle-invasive. With a multimodal radiomics strategy, the recurrence risk of BCa can be preoperatively predicted, providing critical information for the clinical decision making. We thus reviewed the rapid progress in the field of medical imaging empowered by the radiomics for decoding the phenotype and recurrence risk of BCa during the past 20 years, summarizing the entire pipeline of the radiomics strategy for the definition of BCa phenotype and recurrence risk including region of interest definition, radiomics feature extraction, tumor phenotype prediction and recurrence risk stratification. We particularly focus on current pitfalls, challenges and opportunities to promote massive clinical applications of radiomics pipeline in the near future.
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Affiliation(s)
- Xiaopan Xu
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
| | - Huanjun Wang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yan Guo
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xi Zhang
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
| | - Baojuan Li
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
| | - Peng Du
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
| | - Yang Liu
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
| | - Hongbing Lu
- School of Biomedical Engineering, Air Force Medical University, Xi’an, China
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21
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Zhou Q, Zhang Z, Ang X, Zhang H, Ouyang J. A nomogram combined with radiomics features, albuminuria, and metabolic syndrome to predict the risk of myometrial invasion of bladder cancer. Transl Cancer Res 2021; 10:3177-3191. [PMID: 35116625 PMCID: PMC8797668 DOI: 10.21037/tcr-21-426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/25/2021] [Indexed: 01/03/2023]
Abstract
Background To establish a preoperative prediction model of myometrial invasion of bladder cancer (BC) based on the radiomics characteristics of multi-parameter thin-slice enhanced computed tomography (CT) imaging. Methods Data from 100 patients with BC were analyzed retrospectively. The patients were divided into two groups: muscular invasive BC and non-muscular invasive BC. The tumor region was segmented from enhanced CT images (arterial- and venous-phase calibration maps) of all patients using Slicer-3D software. We extracted 1,223 texture features from tumor image data based on the shape and gray-level co-occurrence matrix, gray size region matrix, gray run-length matrix, adjacent gray difference matrix, and gray correlation matrix. The patients were randomly divided into a training group (n=70) and a verification group (n=30) in a 7:3 ratio. Interclass correlation coefficients >0.75, least absolute shrinkage, and selection operator regression were used for feature selection. The prediction model was established by combining Rad-score, independent clinical factors, and support vector machine (SVM), and a radiomics nomogram was constructed. The nomogram was tested using the consistency index, calibration curve, time-dependent receiver operating characteristic curve, and clinical decision curve to predict the myometrial invasion of the bladder preoperatively. Results Six radiomics features that were significantly related to myometrial invasion of BC were selected to construct a predictive model. The area under the curve (AUC) values of training group and verification group based on SVM were 0.898 (95% CI: 0.820–0.976) and 0.702 (95% CI: 0.495–0.909), respectively. Single factor and multiple factor analysis showed that albuminuria (95% CI: 0.243–2.206, P=0.0014) and metabolic syndrome (95% CI: 0.850–2.935, P<0.001) were independent influencing factors of BC myometrial invasion. Clinical factors and 11 radiomics features were used to construct a comprehensive model for predicting the pathological grade of BC (radiomics + clinical). After a comprehensive comparison, we found that the overall effectiveness of the model (radiomics + clinical) was the highest (AUC =0.8457). Conclusions Based on the multi-parameter thin-layer enhanced CT radiomics feature can be used as a potential independent predictor of BC myometrial invasion, the model based on parameters can initially quantitatively characterize the risk of myometrial invasion, and has excellent potential for predicting myometrial invasion of BC.
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Affiliation(s)
- Qi Zhou
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhiyu Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaojie Ang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Haoyang Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jun Ouyang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
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22
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Kozikowski M, Suarez-Ibarrola R, Osiecki R, Bilski K, Gratzke C, Shariat SF, Miernik A, Dobruch J. Role of Radiomics in the Prediction of Muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis. Eur Urol Focus 2021; 8:728-738. [PMID: 34099417 DOI: 10.1016/j.euf.2021.05.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/03/2021] [Accepted: 05/18/2021] [Indexed: 01/06/2023]
Abstract
CONTEXT Radiomics is a field of science that aims to develop improved methods of medical image analysis by extracting a large number of quantitative features. New data have emerged on the successful application of radiomics and machine-learning techniques to the prediction of muscle-invasive bladder cancer (MIBC). OBJECTIVE To systematically review the diagnostic performance of radiomic techniques in predicting MIBC. EVIDENCE ACQUISITION The literature search for relevant studies up to July 2020 was performed in the PubMed and EMBASE databases by two independent reviewers. The meta-analysis was inducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Inclusion criteria comprised studies that evaluated the diagnostic accuracy of radiomic models in predicting MIBC and used pathological examination as the reference standard. For bias assessment, Quality Assessment of Diagnostic Accuracy Studies-2 and Radiomic Quality Score were used. Weighted summary proportions were used to calculate pooled sensitivity and specificity. A linear mixed model was implemented to calculate the hierarchical summary receiver-operating characteristic (HSROC). Meta-regression analyses were performed to explore heterogeneity. EVIDENCE SYNTHESIS Eight studies with a total of 860 patients were included. The summary estimates for sensitivity and specificity in predicting MIBC were 82% (95% confidence interval [CI]: 77-86%) and 81% (95% CI: 76-85%), respectively. The area under HSROC was 0.88. There were no relevant heterogeneity in diagnostic accuracy measures (I2 = 33% and 41% for sensitivity and specificity, respectively), which was confirmed by a subsequent meta-regression analysis. CONCLUSIONS Radiomics shows high diagnostic performance in predicting MIBC. Despite differences in approaches, radiomic models were relatively homogeneous in their diagnostic accuracy. With further improvements, radiomics has the potential to become a useful adjunct in clinical management of bladder cancer. PATIENT SUMMARY Rapidly evolving imaging analysis methods using artificial intelligence algorithms, called radiomics, show high diagnostic performance in predicting muscle-invasive bladder cancer.
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Affiliation(s)
- Mieszko Kozikowski
- Urology Clinic, Centre of Postgraduate Medical Education, Department of Urology, Professor Witold Orlowski Independent Public Hospital, Warsaw, Poland.
| | - Rodrigo Suarez-Ibarrola
- Department of Urology, Faculty of Medicine, University of Freiburg Medical Centre, Freiburg, Germany
| | - Rafał Osiecki
- Urology Clinic, Centre of Postgraduate Medical Education, Department of Urology, Professor Witold Orlowski Independent Public Hospital, Warsaw, Poland
| | - Konrad Bilski
- Urology Clinic, Centre of Postgraduate Medical Education, Department of Urology, Professor Witold Orlowski Independent Public Hospital, Warsaw, Poland
| | - Christian Gratzke
- Department of Urology, Faculty of Medicine, University of Freiburg Medical Centre, Freiburg, Germany
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Arkadiusz Miernik
- Department of Urology, Faculty of Medicine, University of Freiburg Medical Centre, Freiburg, Germany
| | - Jakub Dobruch
- Urology Clinic, Centre of Postgraduate Medical Education, Department of Urology, Professor Witold Orlowski Independent Public Hospital, Warsaw, Poland
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23
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He L, Liu Z, Liu C, Gao Z, Ren Q, Lei L, Ren J. Radiomics Based on Lumbar Spine Magnetic Resonance Imaging to Detect Osteoporosis. Acad Radiol 2021; 28:e165-e171. [PMID: 32386949 DOI: 10.1016/j.acra.2020.03.046] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 12/19/2022]
Abstract
RATIONALE AND OBJECTIVES Signal intensity of the lumbar spine in magnetic resonance imaging (MRI) correlates to bone mineral density (BMD). This study aims to explore a lumbar spine magnetic resonance imaging based on the radiomics model for detecting osteoporosis. MATERIALS AND METHODS A total of 109 patients, who underwent both dual-energy X-ray absorptiometry (DEXA) and MRI of the lumbar spine, were recruited. Among these patients, 38 patients were normal, 32 patients had osteopenia, and 39 patients had osteoporosis, according to the DEXA results. A total of 396 × 2 radiomic features were extracted from the T1WI and T2WI images of the segmentation images in the lumbar magnetic resonance imaging. The correlated radiomic features were selected to establish the radiomic classification model. Then, the classification models (based on T1WI, T2WI, and T1WI+T2WI) of normal vs. osteopenia, normal vs. osteoporosis, and osteopenia vs. osteoporosis were established. The performance of the classification models was evaluated through the estimated area under the receiver operating characteristic curve. RESULTS The area under the receiver operating characteristic curves based on T1WI, T2WI, and T1WI+T2WI were 0.772, 0.772, and 0.810, respectively, for the models of normal vs. osteopenia, 0.724, 0.682, and 0.797, respectively, for the models of normal vs. osteoporosis, and 0.730, 0.734, and 0.769, respectively, for the models of osteopenia vs. osteoporosis. CONCLUSION Radiomic models established based on lumbar spine MRI can be used to detect osteoporosis.
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24
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Ge R, Cai H, Yuan X, Qin F, Huang Y, Wang P, Lyu L. MD-UNET: Multi-input dilated U-shape neural network for segmentation of bladder cancer. Comput Biol Chem 2021; 93:107510. [PMID: 34044203 DOI: 10.1016/j.compbiolchem.2021.107510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
Accurate segmentation of the tumour area is crucial for the treatment and prognosis of patients with bladder cancer. However, the complex information from the MRI image poses an important challenge for us to accurately segment the lesion, for example, the high distinction among people, size of bladder variation and noise interference. Based on the above issues, we propose an MD-Unet network structure, which uses multi-scale images as the input of the network, and combines max-pooling with dilated convolution to increase the receptive field of the convolutional network. The results show that the proposed network can obtain higher precision than the existing models for the bladder cancer dataset. The MD-Unet can achieve state-of-art performance compared with other methods.
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Affiliation(s)
- Ruiquan Ge
- School of Computer Science and Technology, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Huihuang Cai
- School of Computer Science and Technology, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Xin Yuan
- School of Computer Science and Technology, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Feiwei Qin
- School of Computer Science and Technology, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Yan Huang
- School of Computer Science and Technology, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Pu Wang
- Computer School, Hubei University of Arts and Science, Xiangyang, 441053, China.
| | - Lei Lyu
- School of Information Science and Engineering, Shandong Normal University, Jinan, 250014, China.
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25
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Razik A, Das CJ, Sharma R, Malla S, Sharma S, Seth A, Srivastava DN. Utility of first order MRI-Texture analysis parameters in the prediction of histologic grade and muscle invasion in urinary bladder cancer: a preliminary study. Br J Radiol 2021; 94:20201114. [PMID: 33882245 DOI: 10.1259/bjr.20201114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To explore the utility of first-order MRI-texture analysis (TA) parameters in predicting histologic grade and muscle invasion in urinary bladder cancer (UBC). METHODS After ethical clearance, 40 patients with UBC, who were imaged on a 3.0-Tesla scanner, were retrospectively included. Using the TexRADTM platform, two readers placed freehand ROI on the sections demonstrating the largest dimension of the tumor, evaluating only one tumor per patient. Interobserver reproducibility was assessed using the intraclass correlation coefficient (ICC). Mann-Whitney U test and ROC curve analysis were used to identify statistical significance and select parameters with high class separation capacity (AUC >0.8), respectively. Pearson's test was used to identify redundancy in the results. RESULTS All texture parameters showed excellent ICC. The best parameters in differentiating high and low-grade tumors were mean/ mean of positive pixels (MPP) at SSF 0 (AUC: 0.897) and kurtosis at SSF 5 (AUC: 0.828) on the ADC images. In differentiating muscle invasive from non-muscle invasive tumors, mean/ MPP at SSF 0 on the ADC images showed AUC >0.8; however, this finding resulted from the confounding effect of high-grade histology on the ADC values of muscle invasive tumors. CONCLUSION MRI-TA generated few parameters which were reproducible and useful in predicting histologic grade. No independent parameters predicted muscle invasion. ADVANCES IN KNOWLEDGE There is lacuna in the literature concerning the role of MRI-TA in the prediction of histologic grade and muscle invasion in UBC. Our study generated a few first-order parameters which were useful in predicting high-grade histology.
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Affiliation(s)
- Abdul Razik
- Departments of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Chandan J Das
- Departments of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Raju Sharma
- Departments of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Sundeep Malla
- Departments of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Sanjay Sharma
- Departments of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Amlesh Seth
- Departments of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Deep Narayan Srivastava
- Departments of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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26
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Hammouda K, Khalifa F, Soliman A, Ghazal M, El-Ghar MA, Badawy MA, Darwish HE, Khelifi A, El-Baz A. A multiparametric MRI-based CAD system for accurate diagnosis of bladder cancer staging. Comput Med Imaging Graph 2021; 90:101911. [PMID: 33848756 DOI: 10.1016/j.compmedimag.2021.101911] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/20/2021] [Accepted: 03/26/2021] [Indexed: 12/21/2022]
Abstract
Appropriate treatment of bladder cancer (BC) is widely based on accurate and early BC staging. In this paper, a multiparametric computer-aided diagnostic (MP-CAD) system is developed to differentiate between BC staging, especially T1 and T2 stages, using T2-weighted (T2W) magnetic resonance imaging (MRI) and diffusion-weighted (DW) MRI. Our framework starts with the segmentation of the bladder wall (BW) and localization of the whole BC volume (Vt) and its extent inside the wall (Vw). Our segmentation framework is based on a fully connected convolution neural network (CNN) and utilized an adaptive shape model followed by estimating a set of functional, texture, and morphological features. The functional features are derived from the cumulative distribution function (CDF) of the apparent diffusion coefficient. Texture features are radiomic features estimated from T2W-MRI, and morphological features are used to describe the tumors' geometric. Due to the significant texture difference between the wall and bladder lumen cells, Vt is parcelled into a set of nested equidistance surfaces (i.e., iso-surfaces). Finally, features are estimated for individual iso-surfaces, which are then augmented and used to train and test machine learning (ML) classifier based on neural networks. The system has been evaluated using 42 data sets, and a leave-one-subject-out approach is employed. The overall accuracy, sensitivity, specificity, and area under the receiver operating characteristics (ROC) curve (AUC) are 95.24%, 95.24%, 95.24%, and 0.9864, respectively. The advantage of fusion multiparametric iso-features is highlighted by comparing the diagnostic accuracy of individual MRI modality, which is confirmed by the ROC analysis. Moreover, the accuracy of our pipeline is compared against other statistical ML classifiers (i.e., random forest (RF) and support vector machine (SVM)). Our CAD system is also compared with other techniques (e.g., end-to-end convolution neural networks (i.e., ResNet50).
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Affiliation(s)
- K Hammouda
- Bioengineering Department, University of Louisville, Louisville, KY, USA
| | - F Khalifa
- Bioengineering Department, University of Louisville, Louisville, KY, USA
| | - A Soliman
- Bioengineering Department, University of Louisville, Louisville, KY, USA
| | - M Ghazal
- Electrical and Computer Engineering Department, Abu Dhabi University, UAE
| | - M Abou El-Ghar
- Radiology Department, Urology and Nephrology Center, Mansoura University, Egypt
| | - M A Badawy
- Radiology Department, Urology and Nephrology Center, Mansoura University, Egypt
| | - H E Darwish
- Mathematics Department, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - A Khelifi
- Computer Science and Information Technology Department, Abu Dhabi University, UAE
| | - A El-Baz
- Bioengineering Department, University of Louisville, Louisville, KY, USA.
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27
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Yang Y, Zou X, Wang Y, Ma X. Application of deep learning as a noninvasive tool to differentiate muscle-invasive bladder cancer and non-muscle-invasive bladder cancer with CT. Eur J Radiol 2021; 139:109666. [PMID: 33798819 DOI: 10.1016/j.ejrad.2021.109666] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 02/22/2021] [Accepted: 03/13/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To construct a deep-learning convolution neural network (DL-CNN) system for the differentiation of muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC) on contrast-enhanced computed tomography (CT) images in patients with bladder cancer. MATERIALS AND METHODS A total of 1200 cross-sectional CT images were obtained from 369 patients with bladder cancer receiving radical cystectomy from January 2015 to June 2018, including 249 non-muscle-invasive bladder cancer (NMIBC) series and 120 muscle-invasive bladder cancer (MIBC) series. All eligible images were distributed randomly into the training, validation, and testing cohorts with ratios of 70 %, 15 %, and 15 %, respectively. We developed one small DL-CNN containing four convolutional and max pooling layers and eight DL-CNNs with pretrained bases from the ImageNet dataset to differentiate NMIBC from MIBC. The intermediate activations were applied on the test dataset to visualize how successive DL-CNN layers transform their input. RESULTS The area under the receiver operating characteristic curve (AUROC) of the validation and testing datasets for the small DL-CNN was 0.946 and 0.998, respectively. The AUROCs of eight deep learning algorithms with pretrained bases ranged from 0.762 to 0.997 in the testing dataset. The VGG16 model had the largest AUROC of 0.997 among the eight algorithms with a sensitivity and specificity of 0.889 and 0.989. The independent features encoded by the small DL-CNN filters were displayed as assemblies of individual channels. CONCLUSION Based on contrast-enhanced CT images, our DL-CNN system could successfully classify NMIBC and MIBC with favorable AUROC in patients with bladder cancer. The application of our system in early stage might assist the pathological examination for the improvement of diagnostic accuracy.
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Affiliation(s)
- Yuhan Yang
- West China School of Medicine, Sichuan University, No.17 People's South Road, Chengdu, 610041, Sichuan, China.
| | - Xiuhe Zou
- West China Hospital, Sichuan University, Guoxue Road 37, Chengdu, 610041, China.
| | - Yixi Wang
- West China School of Medicine, Sichuan University, No.17 People's South Road, Chengdu, 610041, Sichuan, China.
| | - Xuelei Ma
- Department of Biotherapy and Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Guoxue Road 37, Chengdu, 610041, China.
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28
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Liu Y, Zheng H, Xu X, Zhang X, Du P, Liang J, Lu H. The invasion depth measurement of bladder cancer using T2-weighted magnetic resonance imaging. Biomed Eng Online 2020; 19:92. [PMID: 33287834 PMCID: PMC7720543 DOI: 10.1186/s12938-020-00834-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/19/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Invasion depth is an important index for staging and clinical treatment strategy of bladder cancer (BCa). The aim of this study was to investigate the feasibility of segmenting the BCa region from bladder wall region on MRI, and quantitatively measuring the invasion depth of the tumor mass in bladder lumen for further clinical decision-making. This retrospective study involved 20 eligible patients with postoperatively pathologically confirmed BCa. It was conducted in the following steps: (1) a total of 1159 features were extracted from each voxel of both the certain cancerous and wall tissues with the T2-weighted (T2W) MRI data; (2) the support vector machine (SVM)-based recursive feature elimination (RFE) method was implemented to first select an optimal feature subset, and then develop the classification model for the precise separation of the cancerous regions; (3) after excluding the cancerous region from the bladder wall, the three-dimensional bladder wall thickness (BWT) was calculated using Laplacian method, and the invasion depth of BCa was eventually defined by the subtraction of the mean BWT excluding the cancerous region and the minimum BWT of the cancerous region. RESULTS The segmented results showed a promising accuracy, with the mean Dice similarity coefficient of 0.921. The "soft boundary" defined by the voxels with the probabilities between 0.1 and 0.9 could demonstrate the overlapped region of cancerous and wall tissues. The invasion depth calculated from proposed segmentation method was compared with that from manual segmentation, with a mean difference of 0.277 mm. CONCLUSION The proposed strategy could accurately segment the BCa region, and, as the first attempt, realize the quantitative measurement of BCa invasion depth.
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Affiliation(s)
- Yang Liu
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, PR China
| | - Haojie Zheng
- School of Life Sciences and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi, 710126, PR China
| | - Xiaopan Xu
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, PR China
| | - Xi Zhang
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, PR China
| | - Peng Du
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, PR China
| | - Jimin Liang
- School of Life Sciences and Technology, Xidian University, 266 Xinglong Section of Xifeng Road, Xi'an, Shaanxi, 710126, PR China.
| | - Hongbing Lu
- School of Biomedical Engineering, Air Force Medical University, No. 169 Changle West Road, Xi'an, Shaanxi, 710032, PR China.
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29
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Wang D, Huang X, Bai L, Zhang X, Wei J, Zhou J. Differential diagnosis of chromophobe renal cell carcinoma and papillary renal cell carcinoma with dual-energy spectral computed tomography. Acta Radiol 2020; 61:1562-1569. [PMID: 32088966 DOI: 10.1177/0284185120903447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Computed tomography (CT) image features of chromophobe renal cell carcinoma (ChRCC) and papillary renal cell carcinoma (PRCC) are, occasionally, sometimes difficult to identify. However, spectral CT might provide quantitative parameters to differentiate them. PURPOSE To differentiate between ChRCC and PRCC with quantitative parameters using spectral CT. MATERIAL AND METHODS Forty cases of RCC confirmed with pathological tests were analyzed retrospectively (27 cases of PRCC and 13 cases of ChRCC). All patients underwent non-enhanced CT and dual-phase contrast-enhanced CT scans. For each lesion, the CT value of monochromatic images as well as iodine and water concentrations were measured, and the slope of spectrum curve was calculated. Data were analyzed using Student's t-test. Sensitivity and specificity of the quantitative parameters were analyzed using the receiver operating characteristic (ROC) curve. RESULTS During the cortex phase (CP) and parenchyma phase (PP), the CT value and slope of spectrum curve of ChRCC were higher than those of PRCC, and significant differences were observed at low energy levels (40-70 keV). Normalized iodine concentration of ChRCC and that of PRCC was significantly different during CP and PP (P < 0.05). The water (iodine) concentrations of ChRCC and PRCC in CP and PP were not statistically different (P > 0.05). All the ROCs for parameters were above the reference line. CONCLUSION Spectral CT may help increase the diagnostic accuracy of differentiating PRCC from ChRCC using a quantitative analysis.
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Affiliation(s)
- Dan Wang
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Xiaoyu Huang
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Liangcai Bai
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Xueling Zhang
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Jinyan Wei
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
| | - Junlin Zhou
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, PR China
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30
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Li ZY, Wang XD, Li M, Liu XJ, Ye Z, Song B, Yuan F, Yuan Y, Xia CC, Zhang X, Li Q. Multi-modal radiomics model to predict treatment response to neoadjuvant chemotherapy for locally advanced rectal cancer. World J Gastroenterol 2020; 26:2388-2402. [PMID: 32476800 PMCID: PMC7243642 DOI: 10.3748/wjg.v26.i19.2388] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/27/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neoadjuvant chemotherapy is currently recommended as preoperative treatment for locally advanced rectal cancer (LARC); however, evaluation of treatment response to neoadjuvant chemotherapy is still challenging.
AIM To create a multi-modal radiomics model to assess therapeutic response after neoadjuvant chemotherapy for LARC.
METHODS This retrospective study consecutively included 118 patients with LARC who underwent both computed tomography (CT) and magnetic resonance imaging (MRI) before neoadjuvant chemotherapy between October 2016 and June 2019. Histopathological findings were used as the reference standard for pathological response. Patients were randomly divided into a training set (n = 70) and a validation set (n = 48). The performance of different models based on CT and MRI, including apparent diffusion coefficient (ADC), dynamic contrast enhanced T1 images (DCE-T1), high resolution T2-weighted imaging (HR-T2WI), and imaging features, was assessed by using the receiver operating characteristic curve analysis. This was demonstrated as area under the curve (AUC) and accuracy (ACC). Calibration plots with Hosmer-Lemeshow tests were used to investigate the agreement and performance characteristics of the nomogram.
RESULTS Eighty out of 118 patients (68%) achieved a pathological response. For an individual radiomics model, HR-T2WI performed better (AUC = 0.859, ACC = 0.896) than CT (AUC = 0.766, ACC = 0.792), DCE-T1 (AUC = 0.812, ACC = 0.854), and ADC (AUC = 0.828, ACC = 0.833) in the validation set. The imaging performance for extramural venous invasion detection was relatively low in both the training (AUC = 0.73, ACC = 0.714) and validation (AUC = 0.578, ACC = 0.583) sets. The multi-modal radiomics model reached an AUC of 0.925 and ACC of 0.886 in the training set, and an AUC of 0.93 and ACC of 0.875 in the validation set. For the clinical radiomics nomogram, good agreement was found between the nomogram prediction and actual observation.
CONCLUSION A multi-modal nomogram using traditional imaging features and radiomics of preoperative CT and MRI adds accuracy to the prediction of treatment outcome, and thus contributes to the personalized selection of neoadjuvant chemotherapy for LARC.
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Affiliation(s)
- Zheng-Yan Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiao-Dong Wang
- Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Mou Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xi-Jiao Liu
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Zheng Ye
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bin Song
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Fang Yuan
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yuan Yuan
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chun-Chao Xia
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xin Zhang
- Life Science, PDx, IPM team, GE Healthcare, Shanghai 210000, China
| | - Qian Li
- Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
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Multi-modal radiomics model to predict treatment response to neoadjuvant chemotherapy for locally advanced rectal cancer. World J Gastroenterol 2020. [DOI: 10.3748/wjg.v26.i19.2387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
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Elaboration of a multisequence MRI-based radiomics signature for the preoperative prediction of the muscle-invasive status of bladder cancer: a double-center study. Eur Radiol 2020; 30:4816-4827. [PMID: 32318846 DOI: 10.1007/s00330-020-06796-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/19/2019] [Accepted: 03/06/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To develop a multisequence MRI-based radiomics signature for the preoperative prediction of the muscle-invasive status of bladder cancer (BCa). METHODS This retrospective study involved 106 eligible patients from two independent clinical centers. All patients underwent a preoperative 3.0 T MRI scan with T2-weighted image (T2WI) and multi-b-value diffusion-weighted image (DWI) sequences. In total, 1404 radiomics features were extracted from the largest region of the reported tumor locations on the T2WI, DWI, and corresponding apparent diffusion coefficient map (ADC) of each patient. A radiomics signature, namely the Radscore, was then generated using the recursive feature elimination approach and a logistic regression algorithm in a training cohort (n = 64). Its performance was then validated in an independent validation cohort (n = 42). The primary imaging and clinical factors in conjunction with the Radscore were used to determine whether the performance could be further improved. RESULTS The Radscore, generated by 36 selected radiomics features, demonstrated a favorable ability to predict muscle-invasive BCa status in both the training (AUC 0.880) and validation (AUC 0.813) cohorts. Subsequently, integrating the two independent predictors (including the Radscore and MRI-determined tumor stalk) into a nomogram exhibited more favorable discriminatory performance, with the AUC improved to 0.924 and 0.877 in both cohorts, respectively. CONCLUSIONS The proposed multisequence MRI-based radiomics signature alone could be an effective tool for quantitative prediction of muscle-invasive status of BCa. Integrating the Radscore with MRI-determined tumor stalk could further improve the discriminatory power, realizing more accurate prediction of nonmuscle-invasive and muscle-invasive BCa. KEY POINTS • DWI is superior to T2WI sequence in reflecting the heterogeneous differences between NMIBC and MIBC, and multisequence MRI helps in the preoperative prediction of muscle-invasive status of BCa. • Co-occurrence (CM), run-length matrix (RLM), and gray-level size zone matrix (GLSZM) features were the favorable feature categories for the prediction of muscle-invasive status of BCa. • The Radscore (proposed multisequence MRI-based radiomics signature) helps predict preoperatively muscle invasion. Combination with the MRI-determined tumor stalk further improves prediction.
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Caglic I, Panebianco V, Vargas HA, Bura V, Woo S, Pecoraro M, Cipollari S, Sala E, Barrett T. MRI of Bladder Cancer: Local and Nodal Staging. J Magn Reson Imaging 2020; 52:649-667. [PMID: 32112505 DOI: 10.1002/jmri.27090] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 12/24/2022] Open
Abstract
Accurate staging of bladder cancer (BC) is critical, with local tumor staging directly influencing management decisions and affecting prognosis. However, clinical staging based on clinical examination, including cystoscopy and transurethral resection of bladder tumor (TURBT), often understages patients compared to final pathology at radical cystectomy and lymph node (LN) dissection, mainly due to underestimation of the depth of local invasion and the presence of LN metastasis. MRI has now become established as the modality of choice for the local staging of BC and can be additionally utilized for the assessment of regional LN involvement and tumor spread to the pelvic bones and upper urinary tract (UUT). The recent development of the Vesical Imaging-Reporting and Data System (VI-RADS) recommendations has led to further improvements in bladder MRI, enabling standardization of image acquisition and reporting. Multiparametric magnetic resonance imaging (mpMRI) incorporating morphological and functional imaging has been proven to further improve the accuracy of primary and recurrent tumor detection and local staging, and has shown promise in predicting tumor aggressiveness and monitoring response to therapy. These sequences can also be utilized to perform radiomics, which has shown encouraging initial results in predicting BC grade and local stage. In this article, the current state of evidence supporting MRI in local, regional, and distant staging in patients with BC is reviewed. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2 J. Magn. Reson. Imaging 2020;52:649-667.
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Affiliation(s)
- Iztok Caglic
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Valeria Panebianco
- Department of Radiological, Oncological and Anatomo-pathological sciences, "Sapienza University", Rome, Italy
| | - Hebert A Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Vlad Bura
- Department of Radiology, County Clinical Emergency Hospital, Cluj-Napoca, Romania
| | - Sungmin Woo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Martina Pecoraro
- Department of Radiological, Oncological and Anatomo-pathological sciences, "Sapienza University", Rome, Italy
| | - Stefano Cipollari
- Department of Radiological, Oncological and Anatomo-pathological sciences, "Sapienza University", Rome, Italy
| | - Evis Sala
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
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Tang X, Xu X, Han Z, Bai G, Wang H, Liu Y, Du P, Liang Z, Zhang J, Lu H, Yin H. Elaboration of a multimodal MRI-based radiomics signature for the preoperative prediction of the histological subtype in patients with non-small-cell lung cancer. Biomed Eng Online 2020; 19:5. [PMID: 31964407 PMCID: PMC6975040 DOI: 10.1186/s12938-019-0744-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Non-invasive discrimination between lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) subtypes of non-small-cell lung cancer (NSCLC) could be very beneficial to the patients unfit for the invasive diagnostic procedures. The aim of this study was to investigate the feasibility of utilizing the multimodal magnetic resonance imaging (MRI) radiomics and clinical features in classifying NSCLC. This retrospective study involved 148 eligible patients with postoperative pathologically confirmed NSCLC. The study was conducted in three steps: (1) feature extraction was performed using the online freely available package with the multimodal MRI data; (2) feature selection was performed using the Student's t test and support vector machine (SVM)-based recursive feature elimination method with the training cohort (n = 100), and the performance of these selected features was evaluated using both the training and the validation cohorts (n = 48) with a non-linear SVM classifier; (3) a Radscore model was then generated using logistic regression algorithm; (4) Integrating the Radscore with the semantic clinical features, a radiomics-clinical nomogram was developed, and its overall performance was evaluated with both cohorts. RESULTS Thirteen optimal features achieved favorable discrimination performance with both cohorts, with area under the curve (AUC) of 0.819 and 0.824, respectively. The radiomics-clinical nomogram integrating the Radscore with the independent clinical predictors exhibited more favorable discriminative power, with AUC improved to 0.901 and 0.872 in both cohorts, respectively. The Hosmer-Lemeshow test and decision curve analysis results furtherly showed good predictive precision and clinical usefulness of the nomogram. CONCLUSION Non-invasive histological subtype stratification of NSCLC can be done favorably using multimodal MRI radiomics features. Integrating the radiomics features with the clinical features could further improve the performance of the histological subtype stratification in patients with NSCLC.
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Affiliation(s)
- Xing Tang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Xiaopan Xu
- School of Biomedical Engineering, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Zhiping Han
- Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Guoyan Bai
- Department of Clinical Laboratory, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China
| | - Hong Wang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Yang Liu
- School of Biomedical Engineering, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Peng Du
- School of Biomedical Engineering, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Zhengrong Liang
- Departments of Radiology, School of Computer Science and Biomedical Engineering, State University of New York, Stony Brook, NY, USA
| | - Jian Zhang
- Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China.
| | - Hongbing Lu
- School of Biomedical Engineering, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China.
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, Shaanxi, People's Republic of China.
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Ge L, Chen Y, Yan C, Zhao P, Zhang P, A R, Liu J. Study Progress of Radiomics With Machine Learning for Precision Medicine in Bladder Cancer Management. Front Oncol 2019; 9:1296. [PMID: 31850202 PMCID: PMC6892826 DOI: 10.3389/fonc.2019.01296] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/08/2019] [Indexed: 02/05/2023] Open
Abstract
Bladder cancer is a fatal cancer that happens in the genitourinary tract with quite high morbidity and mortality annually. The high level of recurrence rate ranging from 50 to 80% makes bladder cancer one of the most challenging and costly diseases to manage. Faced with various problems in existing methods, a recently emerging concept for the measurement of imaging biomarkers and extraction of quantitative features called "radiomics" shows great potential in the application of detection, grading, and follow-up management of bladder cancer. Furthermore, machine-learning (ML) algorithms on the basis of "big data" are fueling the powers of radiomics for bladder cancer monitoring in the era of precision medicine. Currently, the usefulness of the novel combination of radiomics and ML has been demonstrated by a large number of successful cases. It possesses outstanding strengths including non-invasiveness, low cost, and high efficiency, which may serve as a revolution to tumor assessment and emancipate workforce. However, for the extensive clinical application in the future, more efforts should be made to break down the limitations caused by technology deficiencies, inherent problems during the process of radiomic analysis, as well as the quality of present studies.
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Affiliation(s)
- Lingling Ge
- West China Hospital, Sichuan University, Chengdu, China
| | - Yuntian Chen
- Radiological Department, West China Hospital, Sichuan University, Chengdu, China
| | - Chunyi Yan
- West China Hospital, Sichuan University, Chengdu, China
| | - Pan Zhao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Peng Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Runa A
- Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu, China
| | - Jiaming Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
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Xu S, Yao Q, Liu G, Jin D, Chen H, Xu J, Li Z, Wu G. Combining DWI radiomics features with transurethral resection promotes the differentiation between muscle-invasive bladder cancer and non-muscle-invasive bladder cancer. Eur Radiol 2019; 30:1804-1812. [DOI: 10.1007/s00330-019-06484-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/19/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022]
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An Accurate Method to Distinguish Between Stationary Human and Dog targets Under Through-Wall Condition Using UWB Radar. REMOTE SENSING 2019. [DOI: 10.3390/rs11212571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research work on distinguishing humans from animals can help provide priority orders and optimize the distribution of resources in earthquake- or mining-related rescue missions. However, the existing solutions are few and their stability and accuracy of classification are less. This study proposes an accurate method for distinguishing stationary human targets from dog targets under through-wall condition based on ultra-wideband (UWB) radar. Eight humans and five beagles were used to collect 130 samples of through-wall signals using the UWB radar. Twelve corresponding features belonging to four categories were combined using the support vector machine (SVM) method. A recursive feature elimination (RFE) method determined an optimal feature subset from the twelve features to overcome overfitting and poor generalization. The results after ten-fold cross-validation showed that the area under the receiver operator characteristic (ROC) curve can reach 0.9993, which indicates that the two subjects can be distinguished under through-wall condition. The study also compared the ability of the proposed features of four categories when used independently in a classifier. Comparison results indicated that wavelet entropy-corresponding features among them have the best performance. The method and results are envisioned to be applied in various practical situations, such as post-disaster searching, hostage rescues, and intelligent homecare.
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Zheng J, Kong J, Wu S, Li Y, Cai J, Yu H, Xie W, Qin H, Wu Z, Huang J, Lin T. Development of a noninvasive tool to preoperatively evaluate the muscular invasiveness of bladder cancer using a radiomics approach. Cancer 2019; 125:4388-4398. [PMID: 31469418 DOI: 10.1002/cncr.32490] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/09/2019] [Accepted: 08/02/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Bladder cancer (BCa) can be divided into muscle-invasive BCa (MIBC) and non-muscle-invasive BCa (NMIBC). Whether the tumor infiltrates the detrusor muscle is a critical determinant of disease management in patients with BCa. However, the current preoperative diagnostic accuracy of muscular invasiveness is less than satisfactory. The authors report a radiomic-clinical nomogram for the individualized preoperative differentiation of MIBC from NMIBC. METHODS In total, 2602 radiomics features were extracted from whole bladder tumors and the basal part of the lesions on T2-weighted magnetic resonance imaging. Then, a radiomics signature was constructed using the least absolute shrinkage and selection operator algorithm in the training set (n = 130). Furthermore, a radiomic-clinical nomogram was developed incorporating the radiomics signature and selected clinical predictors based on a multivariable logistic regression analysis. The performance of the nomogram (discrimination, calibration, and clinical usefulness) was assessed and validated in an independent validation set (n = 69). RESULTS The radiomics signature, consisting of 23 selected features, showed good discrimination in the training and validation sets (area under the curve [AUC], 0.913 and 0.874, respectively). Incorporating the radiomics signature and magnetic resonance imaging-determined tumor size, the radiomic-clinical nomogram showed favorable calibration and discrimination in the training set with an AUC of 0.922, which was confirmed in the validation set (AUC, 0.876). Decision curve analysis and net reclassification improvement and integrated discrimination improvement indices (net reclassification improvement, 0.338, integrated discrimination improvement, 0.385) demonstrated the clinical usefulness of the nomogram. CONCLUSIONS The proposed noninvasive radiomic-clinical nomogram can increase the accuracy of preoperatively discriminating MIBC from NMIBC, which may aid in clinical decision making and improve patient prognosis.
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Affiliation(s)
- Junjiong Zheng
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jianqiu Kong
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Shaoxu Wu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yong Li
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jinhua Cai
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Hao Yu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Weibin Xie
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Haide Qin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Zhuo Wu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jian Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Tianxin Lin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.,State Key Laboratory of Oncology in South China, Guangzhou, People's Republic of China
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Use of Quantitative T2-Weighted and Apparent Diffusion Coefficient Texture Features of Bladder Cancer and Extravesical Fat for Local Tumor Staging After Transurethral Resection. AJR Am J Roentgenol 2019; 212:1060-1069. [PMID: 30860885 DOI: 10.2214/ajr.18.20718] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE. The purpose of this study was to determine whether quantitative T2-weighted imaging and apparent diffusion coefficient (ADC) texture features of bladder cancer and extravesical fat are predictive of muscle invasive bladder cancer (category ≥ T2) and extravesical (category ≥ T3) disease after transurethral resection of a bladder tumor (TURBT). MATERIALS AND METHODS. In this retrospective study, 36 patients (27 men, nine women; mean age, 71 years) were identified who underwent post-TURBT MRI followed by cystectomy without intervening treatment from August 2011 through October 2016. Texture features of bladder cancer and extravesical fat adjacent to the tumor on T2-weighted and ADC images were extracted and compared between category ≤ T2 versus ≥ T3 and category T1 versus ≥ T2 tumors by means of Kruskal-Wallis or Mann-Whitney U test. Multivariate logistic regression analysis was performed, and ROC curves were calculated. RESULTS. Twenty-six of the 36 (72%) tumors were ≥ T2, and 53% (19/36) were ≥ T3. In multivariate analysis, bladder cancer entropy on T2-weighted images (p = 0.006; odds ratio [OR], 4.56; 95% CI, 1.49-20.41; AUC, 0.85) and ADC maps (p = 0.019; OR, 2.24; 95% CI, 1.13-5.31; AUC, 0.80) and extravesical fat entropy on T2-weighted images (p = 0.005; OR, 17.50; 95% CI, 3.01-200.80; AUC, 0.84) and ADC maps (p = 0.002; OR, 6.54; 95% CI, 1.90-32.40; AUC, 0.82) remained greater for ≥ T3 than for ≤ T2 tumors. In multivariate analysis, bladder cancer entropy on ADC maps (p = 0.027; OR, 2.11; 95% CI, 1.08-5.03; AUC, 0.76) and extravesical fat entropy on T2-weighted images (p = 0.010; OR, 5.33; 95% CI, 1.25-3.79; AUC, 0.78) and ADC maps (p = 0.029; OR, 3.80; 95% CI, 1.25-16.97; AUC, 0.74) remained greater for category ≥ T2 compared with category T1 tumors. CONCLUSION. Greater entropy of primary bladder cancers and extravesicular fat was observed in category ≥ T3 than in category ≤ T2 and in category ≥ T2 than in category T1 tumors. MRI texture analysis can help with local bladder cancer staging in patients who have undergone TURBT and may serve as a biomarker for higher local category bladder cancers.
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Xu X, Wang H, Du P, Zhang F, Li S, Zhang Z, Yuan J, Liang Z, Zhang X, Guo Y, Liu Y, Lu H. A predictive nomogram for individualized recurrence stratification of bladder cancer using multiparametric MRI and clinical risk factors. J Magn Reson Imaging 2019; 50:1893-1904. [PMID: 30980695 DOI: 10.1002/jmri.26749] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/02/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Preoperative prediction of bladder cancer (BCa) recurrence risk is critical for individualized clinical management of BCa patients. PURPOSE To develop and validate a nomogram based on radiomics and clinical predictors for personalized prediction of the first 2 years (TFTY) recurrence risk. STUDY TYPE Retrospective. POPULATION Preoperative MRI datasets of 71 BCa patients (34 recurrent) were collected, and divided into training (n = 50) and validation cohorts (n = 21). FIELD STRENGTH/SEQUENCE 3.0T MRI/T2 -weighted (T2 W), multi-b-value diffusion-weighted (DW), and dynamic contrast-enhanced (DCE) sequences. ASSESSMENT Radiomics features were extracted from the T2 W, DW, apparent diffusion coefficient, and DCE images. A Rad_Score model was constructed using the support vector machine-based recursive feature elimination approach and a logistic regression model. Combined with the important clinical factors, including age, gender, grade, and muscle-invasive status (MIS) of the archived lesion, tumor size and number, surgery, and image signs like stalk and submucosal linear enhancement, a radiomics-clinical nomogram was developed, and its performance was evaluated in the training and the validation cohorts. The potential clinical usefulness was analyzed by the decision curve. STATISTICAL TESTS Univariate and multivariate analyses were performed to explore the independent predictors for BCa recurrence prediction. RESULTS Of the 1872 features, the 32 with the highest area under the curve (AUC) of receiver operating characteristic were selected for the Rad_Score calculation. The nomogram developed by two independent predictors, MIS and Rad_Score, showed good performance in the training (accuracy 88%, AUC 0.915, P << 0.01) and validation cohorts (accuracy 80.95%, AUC 0.838, P = 0.009). The decision curve exhibited when the risk threshold was larger than 0.3, more benefit was observed by using the radiomics-clinical nomogram than using the radiomics or clinical model alone. DATA CONCLUSION The proposed radiomics-clinical nomogram has potential in the preoperative prediction of TFTY BCa recurrence. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:1893-1904.
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Affiliation(s)
- Xiaopan Xu
- School of Biomedical Engineering, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, PR China
| | - Huanjun Wang
- Department of Radiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Peng Du
- School of Biomedical Engineering, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, PR China
| | - Fan Zhang
- Department of Radiology, Eastern Hospital of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, PR China
| | - Shurong Li
- Department of Radiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Zhongwei Zhang
- Department of Radiology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Jing Yuan
- Mathematics and Statistics School, Xidian University, Xi'an, Shaanxi, PR China
| | - Zhengrong Liang
- Departments of Radiology, School of Computer Science and Biomedical Engineering, State University of New York, Stony Brook, New York, USA
| | - Xi Zhang
- School of Biomedical Engineering, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, PR China
| | - Yan Guo
- Department of Radiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Yang Liu
- School of Biomedical Engineering, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, PR China
| | - Hongbing Lu
- School of Biomedical Engineering, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, PR China
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Computed tomography-based texture analysis of bladder cancer: differentiating urothelial carcinoma from micropapillary carcinoma. Abdom Radiol (NY) 2019; 44:201-208. [PMID: 30022220 DOI: 10.1007/s00261-018-1694-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE The purpose of the study is to determine the feasibility of using computed tomography-based texture analysis (CTTA) in differentiating between urothelial carcinomas (UC) of the bladder from micropapillary carcinomas (MPC) of the bladder. METHODS Regions of interests (ROIs) of computerized tomography (CT) images of 33 MPCs and 33 UCs were manually segmented and saved. Custom MATLAB code was used to extract voxel information corresponding to the ROI. The segmented tumors were input to a pre-existing radiomics platform with a CTTA panel. A total of 58 texture metrics were extracted using four different texture extraction techniques and statistically analyzed using a Wilcoxon rank-sum test to determine the differences between UCs and MPCs. RESULTS Of the 58 texture metrics extracted using the gray level co-occurrence matrix (GLCM) and gray level difference matrix (GLDM), 28 texture metrics were statistically significant (p < 0.05) for differences in tumor textures and 27 texture metrics were statistically significant (p < 0.05) for peritumoral fat textures. The remaining nine metrics extracted using histogram and fast Fourier transform analyses did not show significant differences between the textures of the tumors and their peritumoral fat. CONCLUSIONS CTTA shows that MPC have a more heterogeneous texture compared to UC. As visual discrimination of MPC from UC from clinical CT scans are difficult, results from this study suggest that tumor heterogeneity extracted using GLCM and GLDM may be a good imaging aid in segregating MPC from UC. This tool can aid clinicians in further sub-classifying bladder cancers on routine imaging, a process which has potential to alter treatment and patient care.
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Dolz J, Xu X, Rony J, Yuan J, Liu Y, Granger E, Desrosiers C, Zhang X, Ben Ayed I, Lu H. Multiregion segmentation of bladder cancer structures in MRI with progressive dilated convolutional networks. Med Phys 2018; 45:5482-5493. [DOI: 10.1002/mp.13240] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 12/15/2022] Open
Affiliation(s)
- Jose Dolz
- Laboratory for Imagery, Vision and Artificial Intelligence (LIVIA) École de technologie supérieure Montréal QCH3C 1K3Canada
| | - Xiaopan Xu
- School of Biomedical Engineering Fourth Military Medical University Xi’an Shaanxi710032China
| | - Jérôme Rony
- Laboratory for Imagery, Vision and Artificial Intelligence (LIVIA) École de technologie supérieure Montréal QCH3C 1K3Canada
| | - Jing Yuan
- School of Mathematics and Statistics Xidian University Xi’an 710071China
| | - Yang Liu
- School of Biomedical Engineering Fourth Military Medical University Xi’an Shaanxi710032China
| | - Eric Granger
- Laboratory for Imagery, Vision and Artificial Intelligence (LIVIA) École de technologie supérieure Montréal QCH3C 1K3Canada
| | - Christian Desrosiers
- Laboratory for Imagery, Vision and Artificial Intelligence (LIVIA) École de technologie supérieure Montréal QCH3C 1K3Canada
| | - Xi Zhang
- School of Biomedical Engineering Fourth Military Medical University Xi’an Shaanxi710032China
| | - Ismail Ben Ayed
- Laboratory for Imagery, Vision and Artificial Intelligence (LIVIA) École de technologie supérieure Montréal QCH3C 1K3Canada
| | - Hongbing Lu
- School of Biomedical Engineering Fourth Military Medical University Xi’an Shaanxi710032China
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Xu X, Zhang X, Tian Q, Wang H, Cui LB, Li S, Tang X, Li B, Dolz J, Ayed IB, Liang Z, Yuan J, Du P, Lu H, Liu Y. Quantitative Identification of Nonmuscle-Invasive and Muscle-Invasive Bladder Carcinomas: A Multiparametric MRI Radiomics Analysis. J Magn Reson Imaging 2018; 49:1489-1498. [PMID: 30252978 DOI: 10.1002/jmri.26327] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preoperative discrimination between nonmuscle-invasive bladder carcinomas (NMIBC) and the muscle-invasive ones (MIBC) is very crucial in the management of patients with bladder cancer (BC). PURPOSE To evaluate the discriminative performance of multiparametric MRI radiomics features for precise differentiation of NMIBC from MIBC, preoperatively. STUDY TYPE Retrospective, radiomics. POPULATION Fifty-four patients with postoperative pathologically proven BC lesions (24 in NMIBC and 30 in MIBC groups) were included. FIELD STRENGTH/SEQUENCE 3.0T MRI/T2 -weighted (T2 W) and multi-b-value diffusion-weighted (DW) sequences. ASSESSMENT A total of 1104 radiomics features were extracted from carcinomatous regions of interest on T2 W and DW images, and the apparent diffusion coefficient maps. Support vector machine with recursive feature elimination (SVM-RFE) and synthetic minority oversampling technique (SMOTE) were used to construct an optimal discriminative model, and its performance was evaluated and compared with that of using visual diagnoses by experts. STATISTICAL TESTS Chi-square test and Student's t-test were applied on clinical characteristics to analyze the significant differences between patient groups. RESULTS Of the 1104 features, an optimal subset involving 19 features was selected from T2 W and DW sequences, which outperformed the other two subsets selected from T2 W or DW sequence in muscle invasion discrimination. The best performance for the differentiation task was achieved by the SVM-RFE+SMOTE classifier, with averaged sensitivity, specificity, accuracy, and area under the curve of receiver operating characteristic of 92.60%, 100%, 96.30%, and 0.9857, respectively, which outperformed the diagnostic accuracy by experts. DATA CONCLUSION The proposed radiomics approach has potential for the accurate differentiation of muscle invasion in BC, preoperatively. The optimal feature subset selected from multiparametric MR images demonstrated better performance in identifying muscle invasiveness when compared with that from T2 W sequence or DW sequence only. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1489-1498.
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Affiliation(s)
- Xiaopan Xu
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Xi Zhang
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Qiang Tian
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Huanjun Wang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, PR China
| | - Long-Biao Cui
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, PR China.,School of Medical Psychology, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Shurong Li
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, PR China
| | - Xing Tang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Baojuan Li
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Jose Dolz
- LIVIA Laboratory, École de technologie supérieure (ETS), Montreal, QC, Canada
| | - Ismail Ben Ayed
- LIVIA Laboratory, École de technologie supérieure (ETS), Montreal, QC, Canada
| | - Zhengrong Liang
- Department of Radiology, School of Computer Science and Biomedical Engineering, State University of New York, Stony Brook, New York, USA
| | - Jing Yuan
- Mathematics and Statistics School Xidian University, Xi'an, Shaanxi, PR China
| | - Peng Du
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Hongbing Lu
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Yang Liu
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, PR China
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44
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van der Pol CB, Chung A, Lim C, Gandhi N, Tu W, McInnes MD, Schieda N. Update on multiparametric MRI of urinary bladder cancer. J Magn Reson Imaging 2018; 48:882-896. [DOI: 10.1002/jmri.26294] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Christian B. van der Pol
- Department of Radiology, Juravinski Hospital and Cancer Centre, HHS; McMaster University; Hamilton ON Canada
| | - Andrew Chung
- Department of Radiology, Beth Israel Deaconess Medical Center; Harvard Medical School; Boston Massachusetts USA
| | - Christopher Lim
- Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital; Harvard Medical School; Boston Massachusetts USA
| | - Niket Gandhi
- Department of Radiology, The Ottawa Hospital; University of Ottawa; Ottawa ON Canada
| | - Wendy Tu
- Department of Radiology, The Ottawa Hospital; University of Ottawa; Ottawa ON Canada
| | - Matthew D.F. McInnes
- Department of Radiology, The Ottawa Hospital; University of Ottawa; Ottawa ON Canada
| | - Nicola Schieda
- Department of Radiology, The Ottawa Hospital; University of Ottawa; Ottawa ON Canada
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45
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Feng Z, Rong P, Cao P, Zhou Q, Zhu W, Yan Z, Liu Q, Wang W. Machine learning-based quantitative texture analysis of CT images of small renal masses: Differentiation of angiomyolipoma without visible fat from renal cell carcinoma. Eur Radiol 2017; 28:1625-1633. [PMID: 29134348 DOI: 10.1007/s00330-017-5118-z] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 09/23/2017] [Accepted: 10/03/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the diagnostic performance of machine-learning based quantitative texture analysis of CT images to differentiate small (≤ 4 cm) angiomyolipoma without visible fat (AMLwvf) from renal cell carcinoma (RCC). METHODS This single-institutional retrospective study included 58 patients with pathologically proven small renal mass (17 in AMLwvf and 41 in RCC groups). Texture features were extracted from the largest possible tumorous regions of interest (ROIs) by manual segmentation in preoperative three-phase CT images. Interobserver reliability and the Mann-Whitney U test were applied to select features preliminarily. Then support vector machine with recursive feature elimination (SVM-RFE) and synthetic minority oversampling technique (SMOTE) were adopted to establish discriminative classifiers, and the performance of classifiers was assessed. RESULTS Of the 42 extracted features, 16 candidate features showed significant intergroup differences (P < 0.05) and had good interobserver agreement. An optimal feature subset including 11 features was further selected by the SVM-RFE method. The SVM-RFE+SMOTE classifier achieved the best performance in discriminating between small AMLwvf and RCC, with the highest accuracy, sensitivity, specificity and AUC of 93.9 %, 87.8 %, 100 % and 0.955, respectively. CONCLUSION Machine learning analysis of CT texture features can facilitate the accurate differentiation of small AMLwvf from RCC. KEY POINTS • Although conventional CT is useful for diagnosis of SRMs, it has limitations. • Machine-learning based CT texture analysis facilitate differentiation of small AMLwvf from RCC. • The highest accuracy of SVM-RFE+SMOTE classifier reached 93.9 %. • Texture analysis combined with machine-learning methods might spare unnecessary surgery for AMLwvf.
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Affiliation(s)
- Zhichao Feng
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China
| | - Pengfei Rong
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China
| | - Peng Cao
- GE Healthcare, Shanghai, 210000, China
| | - Qingyu Zhou
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China
| | - Wenwei Zhu
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China
| | - Zhimin Yan
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China
| | - Qianyun Liu
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China
| | - Wei Wang
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.
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Liu Y, Xu X, Yin L, Zhang X, Li L, Lu H. Relationship between Glioblastoma Heterogeneity and Survival Time: An MR Imaging Texture Analysis. AJNR Am J Neuroradiol 2017; 38:1695-1701. [PMID: 28663266 DOI: 10.3174/ajnr.a5279] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 04/25/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND PURPOSE The heterogeneity of glioblastoma contributes to the poor and variant prognosis. The aim of this retrospective study was to assess the glioblastoma heterogeneity with MR imaging textures and to evaluate its impact on survival time. MATERIALS AND METHODS A total of 133 patients with primary glioblastoma who underwent postcontrast T1-weighted imaging (acquired before treatment) and whose data were filed with the survival times were selected from the Cancer Genome Atlas. On the basis of overall survival, the patients were divided into 2 groups: long-term (≥12 months, n = 67) and short-term (<12 months, n = 66) survival. To measure heterogeneity, we extracted 3 types of textures, co-occurrence matrix, run-length matrix, and histogram, reflecting local, regional, and global spatial variations, respectively. Then the support vector machine classification was used to determine how different texture types perform in differentiating the 2 groups, both alone and in combination. Finally, a recursive feature-elimination method was used to find an optimal feature subset with the best differentiation performance. RESULTS When used alone, the co-occurrence matrix performed best, while all the features combined obtained the best survival stratification. According to feature selection and ranking, 43 top-ranked features were selected as the optimal subset. Among them, the top 10 features included 7 run-length matrix and 3 co-occurrence matrix features, in which all 6 regional run-length matrix features emphasizing high gray-levels ranked in the top 7. CONCLUSIONS The results suggest that local and regional heterogeneity may play an important role in the survival stratification of patients with glioblastoma.
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Affiliation(s)
- Y Liu
- From the School of Biomedical Engineering (Y.L., X.P.X., L.L.Y., X.Z., H.B.L.), Fourth Military Medical University, Xi'an, Shaanxi, China
| | - X Xu
- From the School of Biomedical Engineering (Y.L., X.P.X., L.L.Y., X.Z., H.B.L.), Fourth Military Medical University, Xi'an, Shaanxi, China
| | - L Yin
- From the School of Biomedical Engineering (Y.L., X.P.X., L.L.Y., X.Z., H.B.L.), Fourth Military Medical University, Xi'an, Shaanxi, China
| | - X Zhang
- From the School of Biomedical Engineering (Y.L., X.P.X., L.L.Y., X.Z., H.B.L.), Fourth Military Medical University, Xi'an, Shaanxi, China
| | - L Li
- From the School of Biomedical Engineering (Y.L., X.P.X., L.L.Y., X.Z., H.B.L.), Fourth Military Medical University, Xi'an, Shaanxi, China
| | - H Lu
- Department of Engineering Science and Physics (L.H.L.), City University of New York at College of Staten Island, Staten Island, New York.
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