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Rickard M, Fernandez N, Blais AS, Shalabi A, Amirabadi A, Traubici J, Lee W, Gleason J, Brzezinski J, Lorenzo AJ. Volumetric assessment of unaffected parenchyma and Wilms' tumours: analysis of response to chemotherapy and surgery using a semi-automated segmentation algorithm in children with renal neoplasms. BJU Int 2020; 125:695-701. [PMID: 32012416 DOI: 10.1111/bju.15026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To present our proof of concept with semi-automatic image recognition/segmentation technology for calculation of tumour/parenchyma volume. METHODS We reviewed Wilms' tumours (WTs) between 2000 and 2018, capturing computed tomography images at baseline, after neoadjuvant chemotherapy (NaC) and postoperatively. Images were uploaded into MATLAB-3-D volumetric image processing software. The program was trained by two clinicians who supervised the demarcation of tumour and parenchyma, followed by automatic recognition and delineation of tumour margins on serial imaging, and differentiation from uninvolved renal parenchyma. Volume was automatically calculated for both. RESULTS During the study period, 98 patients were identified. Of these, based on image quality and availability, 32 (38 affected moieties) were selected. Most patients (65%) were girls, diagnosed at age 50 ± 37 months of age. NaC was employed in 64% of patients. Surgical management included 27 radical and 11 partial nephrectomies. Automated volume assessment demonstrated objective response to NaC for unilateral and bilateral tumours (68 ± 20% and 53 ± 39%, respectively), as well as preservation on uninvolved parenchyma with partial nephrectomy (70 ± 46 cm3 at presentation to 57 ± 41 cm3 post-surgery). CONCLUSION Volumetric analysis is feasible and allows objective assessment of tumour and parenchyma volume in response to chemotherapy and surgery. Our data show changes after therapy that may be otherwise difficult to quantify. Use of such technology may improve surgical planning and quantification of response to treatment, as well as serving as a tool to predict renal reserve and long-term changes in renal function.
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Affiliation(s)
- Mandy Rickard
- Division of Urology, Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Nicolas Fernandez
- Division of Urology, Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, ON, Canada.,Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogota, Colombia.,Department of Urology, Fundacion Santa Fe de Bogota, Universidad de los Andes, Bogota, Colombia
| | - Anne-Sophie Blais
- Division of Urology, Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, ON, Canada.,Division of Urology, Centre Hospitalier Universitaire de Quebec, Quebec City, QC, Canada
| | - Ahmed Shalabi
- Department of Physics and Astronomy, University of Waterloo, Waterloo, ON, Canada
| | - Afsaneh Amirabadi
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada
| | - Jeffrey Traubici
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada
| | - Wayne Lee
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada
| | - Joseph Gleason
- Department of Urology, University of Tennessee Health Science Center, Memphis, TN, USA.,Division of Paediatric Urology, LeBonheur Children's Hospital, Memphis, TN, USA.,Department of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Jack Brzezinski
- Division of Haematology and Oncology, Department of Paediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Armando J Lorenzo
- Division of Urology, Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, ON, Canada
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Sakkalis V, Sfakianakis S, Tzamali E, Marias K, Stamatakos G, Misichroni F, Ouzounoglou E, Kolokotroni E, Dionysiou D, Johnson D, McKeever S, Graf N. Web-based workflow planning platform supporting the design and execution of complex multiscale cancer models. IEEE J Biomed Health Inform 2015; 18:824-31. [PMID: 24808225 DOI: 10.1109/jbhi.2013.2297167] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Significant Virtual Physiological Human efforts and projects have been concerned with cancer modeling, especially in the European Commission Seventh Framework research program, with the ambitious goal to approach personalized cancer simulation based on patient-specific data and thereby optimize therapy decisions in the clinical setting. However, building realistic in silico predictive models targeting the clinical practice requires interactive, synergetic approaches to integrate the currently fragmented efforts emanating from the systems biology and computational oncology communities all around the globe. To further this goal, we propose an intelligent graphical workflow planning system that exploits the multiscale and modular nature of cancer and allows building complex cancer models by intuitively linking/interchanging highly specialized models. The system adopts and extends current standardization efforts, key tools, and infrastructure in view of building a pool of reliable and reproducible models capable of improving current therapies and demonstrating the potential for clinical translation of these technologies.
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5
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Stamatakos G, Dionysiou D, Lunzer A, Belleman R, Kolokotroni E, Georgiadi E, Erdt M, Pukacki J, Rueping S, Giatili S, d'Onofrio A, Sfakianakis S, Marias K, Desmedt C, Tsiknakis M, Graf N. The Technologically Integrated Oncosimulator: Combining Multiscale Cancer Modeling With Information Technology in the In Silico Oncology Context. IEEE J Biomed Health Inform 2014; 18:840-54. [DOI: 10.1109/jbhi.2013.2284276] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Georgios Stamatakos
- Institute of Communication and Computer Systems, National Technical University of Athens, In Silico Oncology Group, 9 Iroon Polytechniou, Zografos, Greece
| | - Dimitra Dionysiou
- Oncology Group, Institute of Communication and Computer Systems, National Technical University of Athens, GR , Greece
| | | | | | - Eleni Kolokotroni
- Oncology Group, Institute of Communication and Computer Systems, National Technical University of Athens, GR , Greece
| | - Eleni Georgiadi
- Oncology Group, Institute of Communication and Computer Systems, National Technical University of Athens, GR , Greece
| | | | - Juliusz Pukacki
- Poznan Supercomputing and Networking Center (PSNC), Poznan, Poland
| | - Stefan Rueping
- Fraunhofer IAIS, Schloss Birlinghoven, St. Augustin, Germany
| | - Stavroula Giatili
- Oncology Group, Institute of Communication and Computer Systems, National Technical University of Athens, GR , Greece
| | | | | | - Kostas Marias
- Foundation for Research and Technology Hellas, Heraklion, Greece
| | | | - Manolis Tsiknakis
- Department of Informatics Engineering, TEI Crete and the Computational Medicine Laboratory, Institute of Computer Science, FORTH , Heraklion, Greece
| | - Norbert Graf
- University Hospital of the Saarland, Pediatric Haematology and Oncology, Homburg, Germany
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8
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Marias K, Dionysiou D, Sakkalis V, Graf N, Bohle RM, Coveney PV, Wan S, Folarin A, Büchler P, Reyes M, Clapworthy G, Liu E, Sabczynski J, Bily T, Roniotis A, Tsiknakis M, Kolokotroni E, Giatili S, Veith C, Messe E, Stenzhorn H, Kim YJ, Zasada S, Haidar AN, May C, Bauer S, Wang T, Zhao Y, Karasek M, Grewer R, Franz A, Stamatakos G. Clinically driven design of multi-scale cancer models: the ContraCancrum project paradigm. Interface Focus 2011; 1:450-61. [PMID: 22670213 PMCID: PMC3262443 DOI: 10.1098/rsfs.2010.0037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 03/07/2011] [Indexed: 12/13/2022] Open
Abstract
The challenge of modelling cancer presents a major opportunity to improve our ability to reduce mortality from malignant neoplasms, improve treatments and meet the demands associated with the individualization of care needs. This is the central motivation behind the ContraCancrum project. By developing integrated multi-scale cancer models, ContraCancrum is expected to contribute to the advancement of in silico oncology through the optimization of cancer treatment in the patient-individualized context by simulating the response to various therapeutic regimens. The aim of the present paper is to describe a novel paradigm for designing clinically driven multi-scale cancer modelling by bringing together basic science and information technology modules. In addition, the integration of the multi-scale tumour modelling components has led to novel concepts of personalized clinical decision support in the context of predictive oncology, as is also discussed in the paper. Since clinical adaptation is an inelastic prerequisite, a long-term clinical adaptation procedure of the models has been initiated for two tumour types, namely non-small cell lung cancer and glioblastoma multiforme; its current status is briefly summarized.
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Affiliation(s)
- K. Marias
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - D. Dionysiou
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
| | - V. Sakkalis
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - N. Graf
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - R. M. Bohle
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - P. V. Coveney
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - S. Wan
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - A. Folarin
- Cancer Research Institute, University College London, 72 Huntley Street, London WC1E 6BT, UK
| | - P. Büchler
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - M. Reyes
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - G. Clapworthy
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - E. Liu
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - J. Sabczynski
- Philips Technologie GmbH, Innovative Technologies, Hamburg, Germany
| | - T. Bily
- Faculty of Mathematics and Physics, Department of Applied Mathematics, Charles University in Prague, Prague, Czech Republic
| | - A. Roniotis
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - M. Tsiknakis
- Institute of Computer Science at FORTH, Heraklion, Greece
| | - E. Kolokotroni
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
| | - S. Giatili
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
| | - C. Veith
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - E. Messe
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - H. Stenzhorn
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - Yoo-Jin Kim
- Departments of Paediatric Oncology and Haematology, Pathology, Genetics, Universität des Saarlandes, Homburg, Germany
| | - S. Zasada
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - A. N. Haidar
- Centre for Computational Science, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - C. May
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - S. Bauer
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - T. Wang
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - Y. Zhao
- Department of Computer Science & Technology, University of Bedfordshire, Luton, UK
| | - M. Karasek
- Faculty of Mathematics and Physics, Department of Applied Mathematics, Charles University in Prague, Prague, Czech Republic
| | - R. Grewer
- Philips Technologie GmbH, Innovative Technologies, Hamburg, Germany
| | - A. Franz
- Philips Technologie GmbH, Innovative Technologies, Hamburg, Germany
| | - G. Stamatakos
- In Silico Oncology Group, Institute of Communications and Computer Systems, National Technical University of Athens, Athens, Greece
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