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Leming MJ, Bron EE, Bruffaerts R, Ou Y, Iglesias JE, Gollub RL, Im H. Challenges of implementing computer-aided diagnostic models for neuroimages in a clinical setting. NPJ Digit Med 2023; 6:129. [PMID: 37443276 DOI: 10.1038/s41746-023-00868-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Advances in artificial intelligence have cultivated a strong interest in developing and validating the clinical utilities of computer-aided diagnostic models. Machine learning for diagnostic neuroimaging has often been applied to detect psychological and neurological disorders, typically on small-scale datasets or data collected in a research setting. With the collection and collation of an ever-growing number of public datasets that researchers can freely access, much work has been done in adapting machine learning models to classify these neuroimages by diseases such as Alzheimer's, ADHD, autism, bipolar disorder, and so on. These studies often come with the promise of being implemented clinically, but despite intense interest in this topic in the laboratory, limited progress has been made in clinical implementation. In this review, we analyze challenges specific to the clinical implementation of diagnostic AI models for neuroimaging data, looking at the differences between laboratory and clinical settings, the inherent limitations of diagnostic AI, and the different incentives and skill sets between research institutions, technology companies, and hospitals. These complexities need to be recognized in the translation of diagnostic AI for neuroimaging from the laboratory to the clinic.
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Affiliation(s)
- Matthew J Leming
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA.
- Massachusetts Alzheimer's Disease Research Center, Charlestown, MA, USA.
| | - Esther E Bron
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Rose Bruffaerts
- Computational Neurology, Experimental Neurobiology Unit (ENU), Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Yangming Ou
- Boston Children's Hospital, 300 Longwood Ave, Boston, MA, USA
| | - Juan Eugenio Iglesias
- Center for Medical Image Computing, University College London, London, UK
- Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, USA
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Randy L Gollub
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hyungsoon Im
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA.
- Massachusetts Alzheimer's Disease Research Center, Charlestown, MA, USA.
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
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Bao R, Song Y, Bates SV, Weiss RJ, Foster AN, Cobos CJ, Sotardi S, Zhang Y, Gollub RL, Grant PE, Ou Y. BOston Neonatal Brain Injury Dataset for Hypoxic Ischemic Encephalopathy (BONBID-HIE): Part I. MRI and Manual Lesion Annotation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.30.546841. [PMID: 37461570 PMCID: PMC10350009 DOI: 10.1101/2023.06.30.546841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Hypoxic ischemic encephalopathy (HIE) is a brain injury that occurs in 1 ~ 5/1000 term neonates. Accurate identification and segmentation of HIE-related lesions in neonatal brain magnetic resonance images (MRIs) is the first step toward predicting prognosis, identifying high-risk patients, and evaluating treatment effects. It will lead to a more accurate estimation of prognosis, a better understanding of neurological symptoms, and a timely prediction of response to therapy. We release the first public dataset containing neonatal brain diffusion MRI and expert annotation of lesions from 133 patients diagnosed with HIE. HIE-related lesions in brain MRI are often diffuse (i.e., multi-focal), and small (over half the patients in our data having lesions occupying <1% of brain volume). Segmentation for HIE MRI data is remarkably different from, and arguably more challenging than, other segmentation tasks such as brain tumors with focal and relatively large lesions. We hope that this dataset can help fuel the development of MRI lesion segmentation methods for HIE and small diffuse lesions in general.
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Affiliation(s)
- Rina Bao
- Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | | | | | - Anna N. Foster
- Boston Children’s Hospital, Boston, MA, USA
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Yue Zhang
- Boston Children’s Hospital, Boston, MA, USA
| | - Randy L. Gollub
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - P. Ellen Grant
- Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Yangming Ou
- Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Kaspar M, Liman L, Morbach C, Dietrich G, Seidlmayer LK, Puppe F, Störk S. Querying a Clinical Data Warehouse for Combinations of Clinical and Imaging Data. J Digit Imaging 2023; 36:715-724. [PMID: 36417023 PMCID: PMC10039164 DOI: 10.1007/s10278-022-00727-3] [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: 02/22/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 11/24/2022] Open
Abstract
This study aims to show the feasibility and benefit of single queries in a research data warehouse combining data from a hospital's clinical and imaging systems. We used a comprehensive integration of a production picture archiving and communication system (PACS) with a clinical data warehouse (CDW) for research to create a system that allows data from both domains to be queried jointly with a single query. To achieve this, we mapped the DICOM information model to the extended entity-attribute-value (EAV) data model of a CDW, which allows data linkage and query constraints on multiple levels: the patient, the encounter, a document, and a group level. Accordingly, we have integrated DICOM metadata directly into CDW and linked it to existing clinical data. We included data collected in 2016 and 2017 from the Department of Internal Medicine in this analysis for two query inquiries from researchers targeting research about a disease and in radiology. We obtained quantitative information about the current availability of combinations of clinical and imaging data using a single multilevel query compiled for each query inquiry. We compared these multilevel query results to results that linked data at a single level, resulting in a quantitative representation of results that was up to 112% and 573% higher. An EAV data model can be extended to store data from clinical systems and PACS on multiple levels to enable combined querying with a single query to quickly display actual frequency data.
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Affiliation(s)
- Mathias Kaspar
- Department of Health Services Research, Carl Von Ossietzky University of Oldenburg, Campus Haarentor, V4/1/129, Ammerländer Heerstraße 140, 26129, Oldenburg, Germany.
- Comprehensive Heart Failure Center and Department of Internal Medicine I, University and University Hospital Würzburg, Würzburg, Germany.
| | - Leon Liman
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | - Caroline Morbach
- Comprehensive Heart Failure Center and Department of Internal Medicine I, University and University Hospital Würzburg, Würzburg, Germany
| | - Georg Dietrich
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | | | - Frank Puppe
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center and Department of Internal Medicine I, University and University Hospital Würzburg, Würzburg, Germany
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Valtchinov VI, Murphy SN, Lacson R, Ikonomov N, Zhai BK, Andriole K, Rousseau J, Hanson D, Kohane IS, Khorasani R. Analytics to monitor local impact of the Protecting Access to Medicare Act's imaging clinical decision support requirements. J Am Med Inform Assoc 2022; 29:1870-1878. [PMID: 35932187 PMCID: PMC9552289 DOI: 10.1093/jamia/ocac132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/19/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aimed is to: (1) extend the Integrating the Biology and the Bedside (i2b2) data and application models to include medical imaging appropriate use criteria, enabling it to serve as a platform to monitor local impact of the Protecting Access to Medicare Act's (PAMA) imaging clinical decision support (CDS) requirements, and (2) validate the i2b2 extension using data from the Medicare Imaging Demonstration (MID) CDS implementation. MATERIALS AND METHODS This study provided a reference implementation and assessed its validity and reliability using data from the MID, the federal government's predecessor to PAMA's imaging CDS program. The Star Schema was extended to describe the interactions of imaging ordering providers with the CDS. New ontologies were added to enable mapping medical imaging appropriateness data to i2b2 schema. z-Ratio for testing the significance of the difference between 2 independent proportions was utilized. RESULTS The reference implementation used 26 327 orders for imaging examinations which were persisted to the modified i2b2 schema. As an illustration of the analytical capabilities of the Web Client, we report that 331/1192 or 28.1% of imaging orders were deemed appropriate by the CDS system at the end of the intervention period (September 2013), an increase from 162/1223 or 13.2% for the first month of the baseline period, December 2011 (P = .0212), consistent with previous studies. CONCLUSIONS The i2b2 platform can be extended to monitor local impact of PAMA's appropriateness of imaging ordering CDS requirements.
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Affiliation(s)
- Vladimir I Valtchinov
- Center for Evidence-Based Imaging, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Shawn N Murphy
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- i2b2 tranSMART Foundation, Wakefield, Massachusetts, USA
| | - Ronilda Lacson
- Center for Evidence-Based Imaging, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nikolay Ikonomov
- Institute of Mathematics and Informatics, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Bingxue K Zhai
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Katherine Andriole
- Center for Evidence-Based Imaging, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Justin Rousseau
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Dick Hanson
- Center for Evidence-Based Imaging, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Isaac S Kohane
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
- i2b2 tranSMART Foundation, Wakefield, Massachusetts, USA
| | - Ramin Khorasani
- Center for Evidence-Based Imaging, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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5
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Safaei AA, Habibi-Asl S. Multidimensional indexing technique for medical images retrieval. INTELL DATA ANAL 2021. [DOI: 10.3233/ida-205495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Retrieving required medical images from a huge amount of images is one of the most widely used features in medical information systems, including medical imaging search engines. For example, diagnostic decision making has traditionally been accompanied by patient data (image or non-image) and previous medical experiences from similar cases. Indexing as part of search engines (or retrieval system), increases the speed of a search. The goal of this study, is to provide an effective and efficient indexing technique for medical images search engines. In this paper, in order to archive this goal, a multidimensional indexing technique for medical images is designed using the normalization technique that is used to reduce redundancy in relational database design. Data structure of the proposed multidimensional index and also different required operations are designed to create and handle such a multidimensional index. Time complexity of each operation is analyzed and also average memory space required to store any medical image (along with its related metadata) is calculated as the space complexity analysis of the proposed indexing technique. The results show that the proposed indexing technique has a good performance in terms of memory usage, as well as execution time for the usual operations. Moreover, and may be more important, the proposed indexing techniques improves the precision and recall of the information retrieval system (i.e., search engine) which uses this technique for indexing medical images. Besides, a user of such search engine can retrieve medical images which s/he has specified its attributes is some different aspects (dimensions), e.g., tissue, image modality and format, sickness and trauma, etc. So, the proposed multidimensional indexing techniques can improve effectiveness of a medical image information retrieval system (in terms of precision and recall), while having a proper efficiency (in terms of execution time and memory usage), and can improve the information retrieval process for healthcare search engines.
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Safaei A. Text-based multi-dimensional medical images retrieval according to the features-usage correlation. Med Biol Eng Comput 2021; 59:1993-2017. [PMID: 34415513 PMCID: PMC8378118 DOI: 10.1007/s11517-021-02392-0] [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: 07/07/2020] [Accepted: 06/13/2021] [Indexed: 12/19/2022]
Abstract
Emerging medical imaging applications in healthcare, the number and volume of medical images is growing dramatically. Information needs of users in such circumstances, either for clinical or research activities, make the role of powerful medical image search engines more significant. In this paper, a text-based multi-dimensional medical image indexing technique is proposed in which correlation of the features-usages (according to the user's queries) is considered to provide an off-the content indexing while taking users' interestingness into account. Assuming that each medical image has some extracted features (e.g., based on the DICOM standard), correlations of the features are discovered by performing data mining techniques (i.e., quantitative association pattern discovery), on the history of users' queries as a data set. Then, based on the pairwise correlation of the features of medical images (a.k.a. Affinity), set of the all features is fragmented into subsets (using method like the vertical fragmentation of the tables in distribution of relational DBs). After that, each of these subsets of the features turn into a hierarchy of the features (by applying a hierarchical clustering algorithm on that subset), subsequently all of these distinct hierarchies together make a multi-dimensional structure of the features of medical images, which is in fact the proposed text-based (feature-based) multi-dimensional index structure. Constructing and using such text-based multi-dimensional index structure via its specific required operations, medical image retrieval process would be improved in the underlying medical image search engine. Generally, an indexing technique is to provide a logical representation of documents in order to optimize the retrieval process. The proposed indexing technique is designed such that can improve retrieval of medical images in a medical image search engine in terms of its effectiveness and efficiency. Considering correlation of the features of the image would semantically improve precision (effectiveness) of the retrieval process, while traversing them through the hierarchy in one dimension would try to optimize (i.e., minimize) the resources to have a better efficiency. The proposed text-based multi-dimensional indexing technique is implemented using the open source search engine Lucene, and compared with the built-in indexing technique available in the Lucene search engine, and also with the Terrier platform (available for the benchmarking of information retrieval systems) and other the most related indexing techniques. Evaluation results of memory usage and time complexity analysis, beside the experimental evaluations efficiency and effectiveness measures show that the proposed multi-dimensional indexing technique significantly improves both efficiency and effectiveness for a medical image search engine.
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Affiliation(s)
- AliAsghar Safaei
- Department of Medical Informatics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Zhang J, Lai PMR, Can A, Mukundan S, Castro VM, Dligach D, Finan S, Gainer VS, Shadick NA, Savova G, Murphy SN, Cai T, Weiss ST, Du R. Tobacco use and age are associated with different morphologic features of anterior communicating artery aneurysms. Sci Rep 2021; 11:4791. [PMID: 33637879 PMCID: PMC7910488 DOI: 10.1038/s41598-021-84315-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 02/09/2021] [Indexed: 11/24/2022] Open
Abstract
We present a cohort of patients with anterior communicating artery (ACoA) aneurysms to investigate morphological characteristics and clinical factors associated with rupture of the aneurysms. 505 patients with ACoA aneurysms were identified at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016, with available CT angiography (CTA). Three-dimensional (3D) reconstructions were performed to evaluate aneurysmal morphologic features, including location, projection, irregularity, the presence of daughter dome, height, height/width ratio, and relationships between surrounding vessels. Patient risk factors assessed included patient age, sex, tobacco use, alcohol use, and family history of aneurysms and aneurysmal subarachnoid hemorrhage. Logistic regression was used to build a predictive ACoA score for rupture. Morphologic features associated with ruptured ACoA aneurysms were the presence of a daughter dome (OR 21.4, 95% CI 10.6-43.1), smaller neck diameter (OR 0.55, 95% CI 0.42-0.71), larger aspect ratio (OR 3.57, 95% CI 2.05-6.24), larger flow angle (OR 1.03, 95% CI 1.02-1.05), and smaller ipsilateral A2-ACoA angle (OR 0.98, 95% CI 0.97-1.00). Tobacco use was predominantly associated with morphological factors intrinsic to the aneurysm that were associated with rupture while younger age was also associated with morphologic features extrinsic to the aneurysm that were associated with rupture. The ACoA score had good predictive capacity for rupture with AUC = 0.92 using the 0.632 bootstrap cross-validation for correction of overfitting bias. Ruptured ACoA aneurysms were associated with morphological features that are simple to assess using a simple scoring system. Tobacco use and younger age were predominantly associated with intrinsic and extrinsic morphological features characteristic of rupture, respectively.
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Affiliation(s)
- Jian Zhang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Pui Man Rosalind Lai
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Anil Can
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | - Victor M Castro
- Research Information Systems and Computing, Massachusetts General Brigham, Boston, MA, USA
| | - Dmitriy Dligach
- Boston Children's Hospital Informatics Program, Boston, MA, USA
- Department of Computer Science, Loyola University, Chicago, IL, USA
| | - Sean Finan
- Boston Children's Hospital Informatics Program, Boston, MA, USA
| | - Vivian S Gainer
- Research Information Systems and Computing, Massachusetts General Brigham, Boston, MA, USA
| | - Nancy A Shadick
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA
| | - Guergana Savova
- Boston Children's Hospital Informatics Program, Boston, MA, USA
| | - Shawn N Murphy
- Research Information Systems and Computing, Massachusetts General Brigham, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Tianxi Cai
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Scott T Weiss
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Rose Du
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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Age and morphology of posterior communicating artery aneurysms. Sci Rep 2020; 10:11545. [PMID: 32665589 PMCID: PMC7360743 DOI: 10.1038/s41598-020-68276-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/25/2020] [Indexed: 12/16/2022] Open
Abstract
Risk of intracranial aneurysm rupture could be affected by geometric features of intracranial aneurysms and the surrounding vasculature in a location specific manner. Our goal is to investigate the morphological characteristics associated with ruptured posterior communicating artery (PCoA) aneurysms, as well as patient factors associated with the morphological parameters.
Three-dimensional morphological parameters in 409 patients with 432 PCoA aneurysms diagnosed at the Brigham and Women’s Hospital and Massachusetts General Hospital between 1990 and 2016 who had available CT angiography (CTA) or digital subtraction angiography (DSA) were evaluated. Morphological parameters examined included aneurysm wall irregularity, presence of a daughter dome, presence of hypoplastic or aplastic A1 arteries and hypoplastic or fetal PCoA, perpendicular height, width, neck diameter, aspect and size ratio, height/width ratio, and diameters and angles of surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine the association of morphological parameters with rupture of PCoA aneurysms. Additional analyses were performed to determine the association of patient factors with the morphological parameters. Irregular, multilobed PCoA aneurysms with larger height/width ratios and larger flow angles were associated with ruptured PCoA aneurysms, whereas perpendicular height was inversely associated with rupture in a multivariable model. Older age was associated with lower aspect ratio, with a trend towards lower height/width ratio and smaller flow angle, features that are associated with a lower rupture risk. Morphological parameters are easy to assess and could help in risk stratification in patients with unruptured PCoA aneurysms. PCoA aneurysms diagnosed at older age have morphological features associated with lower risk.
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Kaspar M, Liman L, Ertl M, Fette G, Seidlmayer LK, Schreiber L, Puppe F, Störk S. Unlocking the PACS DICOM Domain for its Use in Clinical Research Data Warehouses. J Digit Imaging 2020; 33:1016-1025. [PMID: 32314069 PMCID: PMC7522145 DOI: 10.1007/s10278-020-00334-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Clinical Data Warehouses (DWHs) are used to provide researchers with simplified access to pseudonymized and homogenized clinical routine data from multiple primary systems. Experience with the integration of imaging and metadata from picture archiving and communication systems (PACS), however, is rare. Our goal was therefore to analyze the viability of integrating a production PACS with a research DWH to enable DWH queries combining clinical and medical imaging metadata and to enable the DWH to display and download images ad hoc. We developed an application interface that enables to query the production PACS of a large hospital from a clinical research DWH containing pseudonymized data. We evaluated the performance of bulk extracting metadata from the PACS to the DWH and the performance of retrieving images ad hoc from the PACS for display and download within the DWH. We integrated the system into the query interface of our DWH and used it successfully in four use cases. The bulk extraction of imaging metadata required a median (quartiles) time of 0.09 (0.03–2.25) to 12.52 (4.11–37.30) seconds for a median (quartiles) number of 10 (3–29) to 103 (8–693) images per patient, depending on the extraction approach. The ad hoc image retrieval from the PACS required a median (quartiles) of 2.57 (2.57–2.79) seconds per image for the download, but 5.55 (4.91–6.06) seconds to display the first and 40.77 (38.60–41.63) seconds to display all images using the pure web-based viewer. A full integration of a production PACS with a research DWH is viable and enables various use cases in research. While the extraction of basic metadata from all images can be done with reasonable effort, the extraction of all metadata seems to be more appropriate for subgroups.
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Affiliation(s)
- Mathias Kaspar
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany.
- Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany.
| | - Leon Liman
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | - Maximilian Ertl
- Service Center Medical Informatics, Würzburg University Hospital, Würzburg, Germany
| | - Georg Fette
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany
| | - Lea Katharina Seidlmayer
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany
| | - Laura Schreiber
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany
| | - Frank Puppe
- Chair of Computer Science VI, University of Würzburg, Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center and Department of Internal Medicine I, Würzburg University Hospital, Würzburg, Germany
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10
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Zhang J, Can A, Mukundan S, Steigner M, Castro VM, Dligach D, Finan S, Yu S, Gainer V, Shadick NA, Savova G, Murphy S, Cai T, Wang Z, Weiss ST, Du R. Morphological Variables Associated With Ruptured Middle Cerebral Artery Aneurysms. Neurosurgery 2020; 85:75-83. [PMID: 29850834 DOI: 10.1093/neuros/nyy213] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/27/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Geometric factors of intracranial aneurysms and surrounding vasculature could affect the risk of aneurysm rupture. However, large-scale assessments of morphological parameters correlated with intracranial aneurysm rupture in a location-specific manner are scarce. OBJECTIVE To investigate the morphological characteristics associated with ruptured middle cerebral artery (MCA) aneurysms. METHODS Five hundred sixty-one patients with 638 MCA aneurysms diagnosed between 1990 and 2016 who had available computed tomography angiography (CTA) were included in this study. CTAs were evaluated using the Vitrea Advanced Visualization software for 3-dimensional (3D) reconstruction. Morphological parameters examined in each model included aneurysm projection, wall irregularity, presence of a daughter dome, presence of hypoplastic or aplastic A1 arteries and hypoplastic or fetal posterior communicating arteries (PCoA), aneurysm height and width, neck diameter, bottleneck factor, aspect and size ratio, height/width ratio, and diameters and angles of surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine the association of morphological characteristics with rupture of MCA aneurysms. Logistic regression was used to build a predictive MCA score. RESULTS Greater bottleneck and size ratio, and irregular, multilobed, temporally projecting MCA aneurysms are associated with higher rupture risk, whereas higher M1/M2 ratio, larger width, and the presence of an ipsilateral or bilateral hypoplastic PCoA were inversely associated with rupture. The MCA score had good predictive capacity with area under the receiver operating curve = 0.88. CONCLUSION These practical morphological parameters specific to MCA aneurysms are easy to assess when examining 3D reconstructions of unruptured aneurysms and could aid in risk evaluation in these patients.
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Affiliation(s)
- Jian Zhang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Jiangsu Province, China
| | - Anil Can
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Srinivasan Mukundan
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Michael Steigner
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Victor M Castro
- Research Information Systems and Computing, Partners Healthcare, Boston, Massachusetts
| | - Dmitriy Dligach
- Department of Computer Science, Loyola University, Chicago, Illinois
| | - Sean Finan
- Boston Children's Hospital Informatics Program, Boston, Massachusetts
| | - Sheng Yu
- Center for Statistical Science, Tsinghua University, Beijing, China
| | - Vivian Gainer
- Research Information Systems and Computing, Partners Healthcare, Boston, Massachusetts
| | - Nancy A Shadick
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts
| | - Guergana Savova
- Boston Children's Hospital Informatics Program, Boston, Massachusetts
| | - Shawn Murphy
- Research Information Systems and Computing, Partners Healthcare, Boston, Massachusetts.,Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Tianxi Cai
- Biostatistics, Harvard School of Public Health, Boston, Massachusetts
| | - Zhong Wang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Jiangsu Province, China
| | - Scott T Weiss
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Rose Du
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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11
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Weiss RJ, Bates SV, Song Y, Zhang Y, Herzberg EM, Chen YC, Gong M, Chien I, Zhang L, Murphy SN, Gollub RL, Grant PE, Ou Y. Mining multi-site clinical data to develop machine learning MRI biomarkers: application to neonatal hypoxic ischemic encephalopathy. J Transl Med 2019; 17:385. [PMID: 31752923 PMCID: PMC6873573 DOI: 10.1186/s12967-019-2119-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/31/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Secondary and retrospective use of hospital-hosted clinical data provides a time- and cost-efficient alternative to prospective clinical trials for biomarker development. This study aims to create a retrospective clinical dataset of Magnetic Resonance Images (MRI) and clinical records of neonatal hypoxic ischemic encephalopathy (HIE), from which clinically-relevant analytic algorithms can be developed for MRI-based HIE lesion detection and outcome prediction. METHODS This retrospective study will use clinical registries and big data informatics tools to build a multi-site dataset that contains structural and diffusion MRI, clinical information including hospital course, short-term outcomes (during infancy), and long-term outcomes (~ 2 years of age) for at least 300 patients from multiple hospitals. DISCUSSION Within machine learning frameworks, we will test whether the quantified deviation from our recently-developed normative brain atlases can detect abnormal regions and predict outcomes for individual patients as accurately as, or even more accurately, than human experts. Trial Registration Not applicable. This study protocol mines existing clinical data thus does not meet the ICMJE definition of a clinical trial that requires registration.
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Affiliation(s)
- Rebecca J Weiss
- Division of Newborn Medicine, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Sara V Bates
- Division of Newborn Medicine, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Ya'nan Song
- Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Boston Children's Hospital, Harvard Medical School, 401 Park Drive, Landmark Center 7022, Boston, MA, 02115, USA
| | - Yue Zhang
- Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Boston Children's Hospital, Harvard Medical School, 401 Park Drive, Landmark Center 7022, Boston, MA, 02115, USA
| | - Emily M Herzberg
- Division of Newborn Medicine, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Yih-Chieh Chen
- Division of Newborn Medicine, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Maryann Gong
- Computer Science & Artificial Intelligence Lab (CSAIL), Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Isabel Chien
- Computer Science & Artificial Intelligence Lab (CSAIL), Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Lily Zhang
- Computer Science & Artificial Intelligence Lab (CSAIL), Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Shawn N Murphy
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Randy L Gollub
- Department of Psychiatry and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - P Ellen Grant
- Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Boston Children's Hospital, Harvard Medical School, 401 Park Drive, Landmark Center 7022, Boston, MA, 02115, USA.
- Neuroradiology Division, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
| | - Yangming Ou
- Fetal Neonatal Neuroimaging and Developmental Science Center (FNNDSC), Boston Children's Hospital, Harvard Medical School, 401 Park Drive, Landmark Center 7022, Boston, MA, 02115, USA.
- Neuroradiology Division, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
- Computational Health Informatics Program (CHIP), Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
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12
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Eryilmaz H, Dowling KF, Huntington FC, Rodriguez-Thompson A, Soare TW, Beard LM, Lee H, Blossom JC, Gollub RL, Susser E, Gur RC, Calkins ME, Gur RE, Satterthwaite TD, Roffman JL. Association of Prenatal Exposure to Population-Wide Folic Acid Fortification With Altered Cerebral Cortex Maturation in Youths. JAMA Psychiatry 2018; 75:918-928. [PMID: 29971329 PMCID: PMC6142921 DOI: 10.1001/jamapsychiatry.2018.1381] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Presently, 81 countries mandate the fortification of grain products with folic acid to lessen the risk of neural tube defects in the developing fetus. Epidemiologic data on severe mental illness suggest potentially broader effects of prenatal folate exposure on postnatal brain development, but this link remains unsubstantiated by biological evidence. OBJECTIVE To evaluate associations among fetal folic acid exposure, cortical maturation, and psychiatric risk in youths. DESIGN, SETTING, AND PARTICIPANTS A retrospective, observational clinical cohort study was conducted at Massachusetts General Hospital (MGH) among 292 youths 8 to 18 years of age born between January 1993 and December 2001 (inclusive of folic acid fortification rollout ±3.5 years) with normative results of clinical magnetic resonance imaging, divided into 3 age-matched groups based on birthdate and related level of prenatal folic acid fortification exposure (none, partial, or full). Magnetic resonance imaging was performed between January 2005 and March 2015. Two independent, observational, community-based cohorts (Philadelphia Neurodevelopmental Cohort [PNC] and National Institutes of Health Magnetic Resonance Imaging Study of Normal Brain Development [NIH]) comprising 1078 youths 8 to 18 years of age born throughout (PNC, 1992-2003) or before (NIH, 1983-1995) the rollout of folic acid fortification were studied for replication, clinical extension, and specificity. Statistical analysis was conducted from 2015 to 2018. EXPOSURES United States-mandated grain product fortification with folic acid, introduced in late 1996 and fully in effect by mid-1997. MAIN OUTCOMES AND MEASURES Differences in cortical thickness among nonexposed, partially exposed, and fully exposed youths (MGH) and underlying associations between age and cortical thickness (all cohorts). Analysis of the PNC cohort also examined the association of age-cortical thickness slopes with the odds of psychotic symptoms. RESULTS The MGH cohort (139 girls and 153 boys; mean [SD] age, 13.3 [2.3] years) demonstrated exposure-associated cortical thickness increases in bilateral frontal and temporal regions (9.9% to 11.6%; corrected P < .001 to P = .03) and emergence of quadratic (delayed) age-associated thinning in temporal and parietal regions (β = -11.1 to -13.9; corrected P = .002). The contemporaneous PNC cohort (417 girls and 444 boys; mean [SD] age, 13.5 [2.7] years) also exhibited exposure-associated delays of cortical thinning (β = -1.59 to -1.73; corrected P < .001 to P = .02), located in similar regions and with similar durations of delay as in the MGH cohort. Flatter thinning profiles in frontal, temporal, and parietal regions were associated with lower odds of psychosis spectrum symptoms in the PNC cohort (odds ratio, 0.37-0.59; corrected P < .05). All identified regions displayed earlier thinning in the nonexposed NIH cohort (118 girls and 99 boys; mean [SD] age, 13.3 [2.6] years). CONCLUSIONS AND RELEVANCE The results of this study suggest an association between gestational exposure to fortification of grain products with folic acid and altered cortical development and, in turn, with reduction in the risk of psychosis in youths.
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Affiliation(s)
- Hamdi Eryilmaz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown
| | - Kevin F. Dowling
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown
| | - Franklin C. Huntington
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown
| | | | - Thomas W. Soare
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown
| | - Lauren M. Beard
- Penn–Children’s Hospital of Philadelphia Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Hang Lee
- Massachusetts General Hospital Biostatistics Center, Harvard Medical School, Boston
| | - Jeffrey C. Blossom
- Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts
| | - Randy L. Gollub
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown
| | - Ezra Susser
- Department of Epidemiology, Columbia University, New York, New York,Department of Psychiatry, Columbia University, New York, New York,New York State Psychiatric Institute, New York, New York
| | - Ruben C. Gur
- Penn–Children’s Hospital of Philadelphia Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Monica E. Calkins
- Penn–Children’s Hospital of Philadelphia Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Raquel E. Gur
- Penn–Children’s Hospital of Philadelphia Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Theodore D. Satterthwaite
- Penn–Children’s Hospital of Philadelphia Lifespan Brain Institute, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Joshua L. Roffman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown
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13
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Zapletal E, Bibault JE, Giraud P, Burgun A. Integrating Multimodal Radiation Therapy Data into i2b2. Appl Clin Inform 2018; 9:377-390. [PMID: 29847842 PMCID: PMC5976493 DOI: 10.1055/s-0038-1651497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background
Clinical data warehouses are now widely used to foster clinical and translational research and the Informatics for Integrating Biology and the Bedside (i2b2) platform has become a de facto standard for storing clinical data in many projects. However, to design predictive models and assist in personalized treatment planning in cancer or radiation oncology, all available patient data need to be integrated into i2b2, including radiation therapy data that are currently not addressed in many existing i2b2 sites.
Objective
To use radiation therapy data in projects related to rectal cancer patients, we assessed the feasibility of integrating radiation oncology data into the i2b2 platform.
Methods
The Georges Pompidou European Hospital, a hospital from the Assistance Publique – Hôpitaux de Paris group, has developed an i2b2-based clinical data warehouse of various structured and unstructured clinical data for research since 2008. To store and reuse various radiation therapy data—dose details, activities scheduling, and dose-volume histogram (DVH) curves—in this repository, we first extracted raw data by using some reverse engineering techniques and a vendor's application programming interface. Then, we implemented a hybrid storage approach by combining the standard i2b2 “Entity-Attribute-Value” storage mechanism with a “JavaScript Object Notation (JSON) document-based” storage mechanism without modifying the i2b2 core tables. Validation was performed using (1) the Business Objects framework for replicating vendor's application screens showing dose details and activities scheduling data and (2) the R software for displaying the DVH curves.
Results
We developed a pipeline to integrate the radiation therapy data into the Georges Pompidou European Hospital i2b2 instance and evaluated it on a cohort of 262 patients. We were able to use the radiation therapy data on a preliminary use case by fetching the DVH curve data from the clinical data warehouse and displaying them in a R chart.
Conclusion
By adding radiation therapy data into the clinical data warehouse, we were able to analyze radiation therapy response in cancer patients and we have leveraged the i2b2 platform to store radiation therapy data, including detailed information such as the DVH to create new ontology-based modules that provides research investigators with a wider spectrum of clinical data.
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Affiliation(s)
- Eric Zapletal
- Department of Medical Informatics, Biostatistics, and Public Health, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes Faculty of Medicine, Paris, France
| | - Jean-Emmanuel Bibault
- Department of Radiation Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes Faculty of Medicine, Paris, France.,INSERM UMR 1138 Eq22, Cordeliers Research Centre, Paris Descartes University, Paris, France
| | - Philippe Giraud
- Department of Radiation Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes Faculty of Medicine, Paris, France
| | - Anita Burgun
- Department of Medical Informatics, Biostatistics, and Public Health, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes Faculty of Medicine, Paris, France.,INSERM UMR 1138 Eq22, Cordeliers Research Centre, Paris Descartes University, Paris, France
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14
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Johnson SB. Clinical Research Informatics: Supporting the Research Study Lifecycle. Yearb Med Inform 2017; 26:193-200. [PMID: 29063565 PMCID: PMC6239240 DOI: 10.15265/iy-2017-022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Indexed: 12/27/2022] Open
Abstract
Objectives: The primary goal of this review is to summarize significant developments in the field of Clinical Research Informatics (CRI) over the years 2015-2016. The secondary goal is to contribute to a deeper understanding of CRI as a field, through the development of a strategy for searching and classifying CRI publications. Methods: A search strategy was developed to query the PubMed database, using medical subject headings to both select and exclude articles, and filtering publications by date and other characteristics. A manual review classified publications using stages in the "research study lifecycle", with key stages that include study definition, participant enrollment, data management, data analysis, and results dissemination. Results: The search strategy generated 510 publications. The manual classification identified 125 publications as relevant to CRI, which were classified into seven different stages of the research lifecycle, and one additional class that pertained to multiple stages, referring to general infrastructure or standards. Important cross-cutting themes included new applications of electronic media (Internet, social media, mobile devices), standardization of data and procedures, and increased automation through the use of data mining and big data methods. Conclusions: The review revealed increased interest and support for CRI in large-scale projects across institutions, regionally, nationally, and internationally. A search strategy based on medical subject headings can find many relevant papers, but a large number of non-relevant papers need to be detected using text words which pertain to closely related fields such as computational statistics and clinical informatics. The research lifecycle was useful as a classification scheme by highlighting the relevance to the users of clinical research informatics solutions.
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Affiliation(s)
- S. B. Johnson
- Healthcare Policy and Research, Weill Cornell Medicine, New York, USA
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15
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Ou Y, Zöllei L, Retzepi K, Castro V, Bates SV, Pieper S, Andriole KP, Murphy SN, Gollub RL, Grant PE. Using clinically acquired MRI to construct age-specific ADC atlases: Quantifying spatiotemporal ADC changes from birth to 6-year old. Hum Brain Mapp 2017; 38:3052-3068. [PMID: 28371107 PMCID: PMC5426959 DOI: 10.1002/hbm.23573] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/03/2017] [Accepted: 03/07/2017] [Indexed: 12/19/2022] Open
Abstract
Diffusion imaging is critical for detecting acute brain injury. However, normal apparent diffusion coefficient (ADC) maps change rapidly in early childhood, making abnormality detection difficult. In this article, we explored clinical PACS and electronic healthcare records (EHR) to create age-specific ADC atlases for clinical radiology reference. Using the EHR and three rounds of multiexpert reviews, we found ADC maps from 201 children 0-6 years of age scanned between 2006 and 2013 who had brain MRIs with no reported abnormalities and normal clinical evaluations 2+ years later. These images were grouped in 10 age bins, densely sampling the first 1 year of life (5 bins, including neonates and 4 quarters) and representing the 1-6 year age range (an age bin per year). Unbiased group-wise registration was used to construct ADC atlases for 10 age bins. We used the atlases to quantify (a) cross-sectional normative ADC variations; (b) spatiotemporal heterogeneous ADC changes; and (c) spatiotemporal heterogeneous volumetric changes. The quantified age-specific whole-brain and region-wise ADC values were compared to those from age-matched individual subjects in our study and in multiple existing independent studies. The significance of this study is that we have shown that clinically acquired images can be used to construct normative age-specific atlases. These first of their kind age-specific normative ADC atlases quantitatively characterize changes of myelination-related water diffusion in the first 6 years of life. The quantified voxel-wise spatiotemporal ADC variations provide standard references to assist radiologists toward more objective interpretation of abnormalities in clinical images. Our atlases are available at https://www.nitrc.org/projects/mgh_adcatlases. Hum Brain Mapp 38:3052-3068, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Yangming Ou
- Psychiatric Neuroimaging, Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Laboratory for Computational NeuroimagingAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Quantitative Tumor Imaging at Martinos, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Fetal‐Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical SchoolBostonMassachusetts
| | - Lilla Zöllei
- Laboratory for Computational NeuroimagingAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
| | - Kallirroi Retzepi
- Psychiatric Neuroimaging, Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Laboratory for Computational NeuroimagingAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
| | - Victor Castro
- Research Computing, Partners Healthcare, 1 Constitution CenterCharlestownMassachusetts
- Laboratory of Computer ScienceMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusetts
| | - Sara V. Bates
- Division of Newborn Medicine, Department of PediatricsMassachusetts General Hospital for Children, Harvard Medical SchoolBostonMassachusetts
| | | | - Katherine P. Andriole
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusetts
| | - Shawn N. Murphy
- Research Computing, Partners Healthcare, 1 Constitution CenterCharlestownMassachusetts
- Laboratory of Computer ScienceMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusetts
| | - Randy L. Gollub
- Psychiatric Neuroimaging, Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
- Laboratory for Computational NeuroimagingAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusetts
| | - Patricia Ellen Grant
- Fetal‐Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical SchoolBostonMassachusetts
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16
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Zhang B, Chang K, Ramkissoon S, Tanguturi S, Bi WL, Reardon DA, Ligon KL, Alexander BM, Wen PY, Huang RY. Multimodal MRI features predict isocitrate dehydrogenase genotype in high-grade gliomas. Neuro Oncol 2017; 19:109-117. [PMID: 27353503 PMCID: PMC5193019 DOI: 10.1093/neuonc/now121] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND High-grade gliomas with mutations in the isocitrate dehydrogenase (IDH) gene family confer longer overall survival relative to their IDH-wild-type counterparts. Accurate determination of the IDH genotype preoperatively may have both prognostic and diagnostic value. The current study used a machine-learning algorithm to generate a model predictive of IDH genotype in high-grade gliomas based on clinical variables and multimodal features extracted from conventional MRI. METHODS Preoperative MRIs were obtained for 120 patients with primary grades III (n = 35) and IV (n = 85) glioma in this retrospective study. IDH genotype was confirmed for grade III (32/35, 91%) and IV (22/85, 26%) tumors by immunohistochemistry, spectrometry-based mutation genotyping (OncoMap), or multiplex exome sequencing (OncoPanel). IDH1 and IDH2 mutations were mutually exclusive, and all mutated tumors were collapsed into one IDH-mutated cohort. Cases were randomly assigned to either the training (n = 90) or validation cohort (n = 30). A total of 2970 imaging features were extracted from pre- and postcontrast T1-weighted, T2-weighted, and apparent diffusion coefficient map. Using a random forest algorithm, nonredundant features were integrated with clinical data to generate a model predictive of IDH genotype. RESULTS Our model achieved accuracies of 86% (area under the curve [AUC] = 0.8830) in the training cohort and 89% (AUC = 0.9231) in the validation cohort. Features with the highest predictive value included patient age as well as parametric intensity, texture, and shape features. CONCLUSION Using a machine-learning algorithm, we achieved accurate prediction of IDH genotype in high-grade gliomas with preoperative clinical and MRI features.
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Affiliation(s)
- Biqi Zhang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
| | - Ken Chang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
| | - Shakti Ramkissoon
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
| | - Shyam Tanguturi
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
| | - Wenya Linda Bi
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
| | - David A Reardon
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
| | - Keith L Ligon
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
| | - Brian M Alexander
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
| | - Patrick Y Wen
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (B.Z., K.C., R.Y.H.); Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Harvard Medical School, Boston, Massachusetts (S.R., K.L.L.); Department of Pathology, Boston Children's Hospital, Boston, Massachusetts (S.R., K.L.L.); Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts(S.R., D.A.R., K.L.L., P.Y.W.); Harvard Radiation Oncology Program, Boston, Massachusetts (S.T.); Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts (W.L.B.); Center of Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.); Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (B.M.A.)
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17
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Chang K, Zhang B, Guo X, Zong M, Rahman R, Sanchez D, Winder N, Reardon DA, Zhao B, Wen PY, Huang RY. Multimodal imaging patterns predict survival in recurrent glioblastoma patients treated with bevacizumab. Neuro Oncol 2016; 18:1680-1687. [PMID: 27257279 DOI: 10.1093/neuonc/now086] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 03/30/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Bevacizumab is a humanized antibody against vascular endothelial growth factor approved for treatment of recurrent glioblastoma. There is a need to discover imaging biomarkers that can aid in the selection of patients who will likely derive the most survival benefit from bevacizumab. METHODS The aim of the study was to examine if pre- and posttherapy multimodal MRI features could predict progression-free survival and overall survival (OS) for patients with recurrent glioblastoma treated with bevacizumab. The patient population included 84 patients in a training cohort and 42 patients in a testing cohort, separated based on pretherapy imaging date. Tumor volumes of interest were segmented from contrast-enhanced T1-weighted and fluid attenuated inversion recovery images and were used to derive volumetric, shape, texture, parametric, and histogram features. A total of 2293 pretherapy and 9811 posttherapy features were used to generate the model. RESULTS Using standard radiographic assessment criteria, the hazard ratio for predicting OS was 3.38 (P < .001). The hazard ratios for pre- and posttherapy features predicting OS were 5.10 (P < .001) and 3.64 (P < .005) for the training and testing cohorts, respectively. CONCLUSION With the use of machine learning techniques to analyze imaging features derived from pre- and posttherapy multimodal MRI, we were able to develop a predictive model for patient OS that could potentially assist clinical decision making.
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Affiliation(s)
- Ken Chang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - Biqi Zhang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - Xiaotao Guo
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - Min Zong
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - Rifaquat Rahman
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - David Sanchez
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - Nicolette Winder
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - David A Reardon
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - Binsheng Zhao
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - Patrick Y Wen
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts (K.C., B.Z., R.R., D.S., N.W., R.Y.H.); Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, New York (X.G., M.Z., B.Z.); Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts (D.A.R., P.Y.W.)
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18
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Ou Y, Gollub RL, Retzepi K, Reynolds N, Pienaar R, Pieper S, Murphy SN, Grant PE, Zöllei L. Brain extraction in pediatric ADC maps, toward characterizing neuro-development in multi-platform and multi-institution clinical images. Neuroimage 2015; 122:246-61. [PMID: 26260429 PMCID: PMC4966541 DOI: 10.1016/j.neuroimage.2015.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 07/29/2015] [Accepted: 08/03/2015] [Indexed: 01/18/2023] Open
Abstract
Apparent Diffusion Coefficient (ADC) maps can be used to characterize myelination and to detect abnormalities in the developing brain. However, given the normal variation in regional ADC with myelination, detection of abnormalities is difficult when based on visual assessment. Quantitative and automated analysis of pediatric ADC maps is thus desired but requires accurate brain extraction as the first step. Currently, most existing brain extraction methods are optimized for structural T1-weighted MR images of fully myelinated brains. Due to differences in age and image contrast, these approaches do not translate well to pediatric ADC maps. To address this problem, we present a multi-atlas brain extraction framework that has 1) specificity: designed and optimized specifically for pediatric ADC maps; 2) generality: applicable to multi-platform and multi-institution data, and to subjects at various neuro-developmental stages across the first 6 years of life; 3) accuracy: highly accurate compared to expert annotations; and 4) consistency: consistently accurate regardless of sources of data and ages of subjects. We show how we achieve these goals, via optimizing major components in a multi-atlas brain extraction framework, and via developing and evaluating new criteria for its atlas ranking component. Moreover, we demonstrate that these goals can be achieved with a fixed set of atlases and a fixed set of parameters, which opens doors for our optimized framework to be used in large-scale and multi-institution neuro-developmental and clinical studies. In a pilot study, we use this framework in a dataset containing scanner-generated ADC maps from 308 pediatric patients collected during the course of routine clinical care. Our framework leads to successful quantifications of the changes in whole-brain volumes and mean ADC values across the first 6 years of life.
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Affiliation(s)
- Yangming Ou
- Psychiatric Neuroimaging, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 120 2nd Ave, Charlestown, MA 02129, USA; Laboratory for Computational Neuroimaging, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th St, Charlestown, MA 02129, USA.
| | - Randy L Gollub
- Psychiatric Neuroimaging, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 120 2nd Ave, Charlestown, MA 02129, USA; Laboratory for Computational Neuroimaging, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th St, Charlestown, MA 02129, USA
| | - Kallirroi Retzepi
- Psychiatric Neuroimaging, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 120 2nd Ave, Charlestown, MA 02129, USA; Laboratory for Computational Neuroimaging, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th St, Charlestown, MA 02129, USA
| | - Nathaniel Reynolds
- Psychiatric Neuroimaging, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 120 2nd Ave, Charlestown, MA 02129, USA; Laboratory for Computational Neuroimaging, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th St, Charlestown, MA 02129, USA
| | - Rudolph Pienaar
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Children's Hospital Boston, Harvard Medical School, 1 Autumn St, Boston, MA 02115, USA
| | - Steve Pieper
- Isomics, Inc., 55 Kirkland St, Cambridge, MA 02138, USA
| | - Shawn N Murphy
- Research Computing, Partners HealthCare, 1 Constitution Center, Charlestown, MA 02129, USA; Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114, USA
| | - P Ellen Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Children's Hospital Boston, Harvard Medical School, 1 Autumn St, Boston, MA 02115, USA
| | - Lilla Zöllei
- Laboratory for Computational Neuroimaging, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th St, Charlestown, MA 02129, USA
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19
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Aronson SJ, Rehm HL. Building the foundation for genomics in precision medicine. Nature 2015; 526:336-42. [PMID: 26469044 PMCID: PMC5669797 DOI: 10.1038/nature15816] [Citation(s) in RCA: 266] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 08/11/2015] [Indexed: 01/04/2023]
Abstract
Precision medicine has the potential to profoundly improve the practice of medicine. However, the advances required will take time to implement. Genetics is already being used to direct clinical decision-making and its contribution is likely to increase. To accelerate these advances, fundamental changes are needed in the infrastructure and mechanisms for data collection, storage and sharing. This will create a continuously learning health-care system with seamless cycling between clinical care and research. Patients must be educated about the benefits of sharing data. The building blocks for such a system are already forming and they will accelerate the adoption of precision medicine.
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Affiliation(s)
- Samuel J Aronson
- Partners HealthCare Personalized Medicine, Boston, Massachusetts 02115, USA
- Partners HealthCare Research Information Services and Computing, Charlestown, Massachusetts 02129, USA
| | - Heidi L Rehm
- Partners HealthCare Personalized Medicine, Boston, Massachusetts 02115, USA
- Department of Pathology, Brigham &Women's Hospital, Boston, Massachusetts 02115, USA
- Harvard Medical School, Boston, Massachusetts 02115, USA
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
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20
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Daniel C, Choquet R. Information Technology for Clinical, Translational and Comparative Effectiveness Research. Findings from the Yearbook 2015 Section on Clinical Research Informatics. Yearb Med Inform 2015; 10:178-82. [PMID: 26293866 DOI: 10.15265/iy-2015-030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To summarize excellent current research in the field of Bioinformatics and Translational Informatics with application in the health domain and clinical care. METHOD We provide a synopsis of the articles selected for the IMIA Yearbook 2015, from which we attempt to derive a synthetic overview of current and future activities in the field. As last year, a first step of selection was performed by querying MEDLINE with a list of MeSH descriptors completed by a list of terms adapted to the section. Each section editor has evaluated separately the set of 1,594 articles and the evaluation results were merged for retaining 15 articles for peer-review. RESULTS The selection and evaluation process of this Yearbook's section on Bioinformatics and Translational Informatics yielded four excellent articles regarding data management and genome medicine that are mainly tool-based papers. In the first article, the authors present PPISURV a tool for uncovering the role of specific genes in cancer survival outcome. The second article describes the classifier PredictSNP which combines six performing tools for predicting disease-related mutations. In the third article, by presenting a high-coverage map of the human proteome using high resolution mass spectrometry, the authors highlight the need for using mass spectrometry to complement genome annotation. The fourth article is also related to patient survival and decision support. The authors present datamining methods of large-scale datasets of past transplants. The objective is to identify chances of survival. CONCLUSIONS The current research activities still attest the continuous convergence of Bioinformatics and Medical Informatics, with a focus this year on dedicated tools and methods to advance clinical care. Indeed, there is a need for powerful tools for managing and interpreting complex, large-scale genomic and biological datasets, but also a need for user-friendly tools developed for the clinicians in their daily practice. All the recent research and development efforts contribute to the challenge of impacting clinically the obtained results towards a personalized medicine.
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Affiliation(s)
- C Daniel
- Christel Daniel, MD, PhD, INSERM UMRS 1142, CCS Patient - Assistance Publique - Hôpitaux de Paris, 05 rue Santerre - 75 012 PARIS, France, Tel: +33 1 48 04 20 29, E-mail:
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