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Schooler GR, Infante JC, Acord M, Alazraki A, Chavhan GB, Davis JC, Khanna G, Morani AC, Morin CE, Nguyen HN, Rees MA, Shaikh R, Srinivasan A, Squires JH, Tang E, Thacker PG, Towbin AJ. Imaging of pediatric liver tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer 2023; 70 Suppl 4:e29965. [PMID: 36102690 PMCID: PMC10641897 DOI: 10.1002/pbc.29965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/16/2022] [Indexed: 11/11/2022]
Abstract
Primary hepatic malignancies are relatively rare in the pediatric population, accounting for approximately 1%-2% of all pediatric tumors. Hepatoblastoma and hepatocellular carcinoma are the most common primary liver malignancies in children under the age of 5 years and over the age of 10 years, respectively. This paper provides consensus-based imaging recommendations for evaluation of patients with primary hepatic malignancies at diagnosis and follow-up during and after therapy.
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Affiliation(s)
- Gary R. Schooler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Juan C. Infante
- Department of Radiology, Nemours Children’s Health, Orlando, FL
| | - Michael Acord
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Adina Alazraki
- Department of Radiology and Imaging Sciences, Emory University, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Govind B. Chavhan
- Department of Diagnostic Imaging, Hospital for Sick Children and Department of Medical Imaging, University of Toronto, ON Canada
| | | | - Geetika Khanna
- Department of Radiology and Imaging Sciences, Emory University, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Ajaykumar C. Morani
- Singleton Department of Radiology, Texas Children’s Hospital and Department of Radiology, Baylor College of Medicine, Houston, TX
| | - Cara E. Morin
- Department of Radiology, Cincinnati Children’s Hospital, Cincinnati, OH
| | - HaiThuy N. Nguyen
- Singleton Department of Radiology, Texas Children’s Hospital and Department of Radiology, Baylor College of Medicine, Houston, TX
| | - Mitchell A. Rees
- Department of Radiology, Nationwide Children’s Hospital, Columbus, OH
| | - Raja Shaikh
- Department of Radiology, Boston Children’s Hospital, Boston, MA
| | - Abhay Srinivasan
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Judy H. Squires
- Department of Radiology, University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | - Elizabeth Tang
- Department of Radiology, Seattle Children’s Hospital, Seattle, WA
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Hakoda H, Kiritani S, Kokudo T, Yoshimura K, Iwano T, Tanimoto M, Ishizawa T, Arita J, Akamatsu N, Kaneko J, Takeda S, Hasegawa K. Probe electrospray ionization mass spectrometry-based rapid diagnosis of liver tumors. J Gastroenterol Hepatol 2022; 37:2182-2188. [PMID: 35945170 DOI: 10.1111/jgh.15976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM Prompt differential diagnosis of liver tumors is clinically important and sometimes difficult. A new diagnostic device that combines probe electrospray ionization-mass spectrometry (PESI-MS) and machine learning may help provide the differential diagnosis of liver tumors. METHODS We evaluated the diagnostic accuracy of this new PESI-MS device using tissues obtained and stored from previous surgically resected specimens. The following cancer tissues (with collection dates): hepatocellular carcinoma (HCC, 2016-2019), intrahepatic cholangiocellular carcinoma (ICC, 2014-2019), and colorectal liver metastasis (CRLM, 2014-2019) from patients who underwent hepatic resection were considered for use in this study. Non-cancerous liver tissues (NL) taken from CRLM cases were also incorporated into the analysis. Each mass spectrum provided by PESI-MS was tested using support vector machine, a type of machine learning, to evaluate the discriminatory ability of the device. RESULTS In this study, we used samples from 91 of 139 patients with HCC, all 24 ICC samples, and 103 of 202 CRLM samples; 80 NL from CRLM cases were also used. Each mass spectrum was obtained by PESI-MS in a few minutes and was evaluated by machine learning. The sensitivity, specificity, and diagnostic accuracy of the PESI-MS device for discriminating HCC, ICC, and CRLM from among a mix of all three tumors and from NL were 98.9%, 98.1%, and 98.3%; 87.5%, 93.1%, and 92.6%; and 99.0%, 97.9%, and 98.3%, respectively. CONCLUSION This study demonstrated that PESI-MS and machine learning could discriminate liver tumors accurately and rapidly.
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Affiliation(s)
- Hiroyuki Hakoda
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sho Kiritani
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kokudo
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Yoshimura
- Department of Anatomy and Cell Biology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
| | - Tomohiko Iwano
- Department of Anatomy and Cell Biology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
| | - Meguri Tanimoto
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeaki Ishizawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junichi Arita
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhisa Akamatsu
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junichi Kaneko
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sen Takeda
- Department of Anatomy and Cell Biology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan.,Department of Anatomy, Teikyo University School of Medicine, Tokyo, Japan
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Fan PL, Chu J, Wang Q, Wang C. The clinical value of dual-energy computed tomography and diffusion-weighted imaging in the context of liver cancer: A narrative review. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:862-868. [PMID: 35338779 DOI: 10.1002/jcu.23197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/22/2022] [Accepted: 03/12/2022] [Indexed: 06/14/2023]
Abstract
The dual-energy computed tomography (DECT) and diffusion-weighted magnetic resonance imaging (DWI-MRI) are used to diagnose liver cancer. The clinical value of these two examination methods needs to be further summarized. We collected and summarized relevant literature published from 2011 to 2021. The diagnostic performance of DECT was assessed between conventional computed tomography and DWI-MRI. DWI-MRI had a 69% sensitivity for detecting small hepatocellular carcinoma (HCC) lesions and a 60% diagnostic specificity for differentiating between types of HCC lesions. DECT had a sensitivity to small liver lesions (<1 cm) of 69%, and the diagnostic specificity for HCC and metastasis was about 60%. DWI was more sensitive (90.3% vs. 74.9%) and accurate (91.9% vs. 76.9%) in diagnosing HCC compared with conventional MRI sequencing. With the aid of contrast media, DWI-MRI had 90.0% specificity for detecting small HCCs (smaller than 1 cm). Furthermore, DWI-MRI not only provided physicians with valuable diagnostic information but also delivered histological grading information, with 78% accuracy for all benign lesions and 71% for solid lesions. DECT had relatively high sensitivity and required a lower contrast medium dose. With standardized quantitative parameters, it can be an extremely useful tool for HCC surveillance. DWI-MRI is the preferred imaging process as it produces high-contrast images for supporting an early diagnosis (high sensitivity and specificity) and provides histological information using non-ionizing radiation.
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Affiliation(s)
- Pei-Lin Fan
- Discipline of Diagnostic Radiography, University of Sydney, Sydney, Australia
| | - Jun Chu
- Discipline of Diagnostic Radiography, University of Sydney, Sydney, Australia
| | - Qing Wang
- Discipline of Diagnostic Radiography, University of Sydney, Sydney, Australia
| | - Chen Wang
- Discipline of Diagnostic Radiography, University of Sydney, Sydney, Australia
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Dong SY, Yang YT, Wang WT, Zhu S, Sun W, Zeng MS, Rao SX. Hepatobiliary phase images of gadoxetic acid-enhanced MRI may improve accuracy of predicting the size of hepatocellular carcinoma at pathology. Acta Radiol 2022; 63:734-742. [PMID: 33969700 DOI: 10.1177/02841851211014194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has been widely used in clinical practice. However, scientific evidence is lacking for recommending a particular sequence for measuring tumor size. PURPOSE To retrospectively compare the size of hepatocellular carcinoma (HCC) measured on different gadoxetic acid-enhanced MRI sequences using pathology as a reference. MATERIAL AND METHODS A total of 217 patients with single HCC who underwent gadoxetic acid-enhanced MRI before surgery were included. The size of the HCC was measured by two abdominal radiologists independently on the following sequences: T1-weighted; T2-weighted; b-500 diffusion-weighted imaging (DWI); and arterial, portal venous, transitional, and hepatobiliary phases. Tumor size measured on MRI was compared with pathological size by using Pearson correlation coefficient, independent-sample t test, and Bland-Altman plot. Agreement between two readers was evaluated with intraclass correlation coefficient (ICC). RESULTS Correlation between the MR images and pathology was high for both readers (0.899-0.955). Absolute error between MRI and pathologic assessment was lowest on hepatobiliary phase images for both readers (reader 1, 2.8±4.2 mm; reader 2, 3.2±3.4 mm) and highest on arterial phase images for reader 1 (4.9±4.4 mm) and DWI phase images for reader 2 (5.1±4.9 mm). Absolute errors were significantly different for hepatobiliary phase compared with other sequences for both readers (reader 1, P≤0.012; reader 2, P≤0.037). Inter-reader agreements for all sequence measurements were strong (0.971-0.997). CONCLUSION The performance of gadoxetic acid-enhanced MRI sequences varied with HCC size, and the hepatobiliary phase may be optimal among these sequences.
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Affiliation(s)
- San-Yuan Dong
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, PR China
| | - Yu-Tao Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, PR China
| | - Wen-Tao Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, PR China
| | - Shuo Zhu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, PR China
| | - Wei Sun
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, PR China
| | - Meng-Su Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, PR China
| | - Sheng-Xiang Rao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, PR China
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Mohammadi A, Bartholmae W, Woisetschläger M. Comparison of multiphase data from CT perfusion vs clinical 4-phase CT scans with respect to image quality, lesion detection, and LI-RADS classification in HCC patients. Heliyon 2022; 8:e08757. [PMID: 35146150 PMCID: PMC8819526 DOI: 10.1016/j.heliyon.2022.e08757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 11/16/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose The aim of this study was to assess the image quality and diagnostic performance of reconstructed arterial (A) and portal venous (PV) phases in computed tomography perfusion (CTP) scans compared to the corresponding phases in standard 4-phase CT and to assess the utility for LI-RADS classification using CTP and 4-phase 4CT. Methods A total of 26 scans with each method (CTP and 4-phase CT) from 19 hepatocellular carcinoma patients were analyzed and compared. Arterial and PV phases reconstructed by advanced modeled iterative reconstruction at strength 4 (ADMIRE 4) from raw CTP data were compared with image sets from arterial and PV phases of 4-phase CT (ADMIRE 3) in the same patient with respect to image quality. Results Quantitative image analysis showed that reconstructed CTP datasets were equivalent to 4-phase CT image sets. Qualitative image analysis revealed similar lesion detection rates with the 2 methods for patients with an abdominal diameter ≤36 cm and body weight <90 kg, but lower detection rates with CTP for patients with an abdominal diameter >37 cm. There was no difference in Liver Imaging Reporting and Data System (LI-RADS) classifications between the 2 methods. Conclusion Reconstructed CTP images can potentially replace 4-phase CT images in patients weighing <90 kg and with a body diameter <37 cm, as the 2 methods are comparable in terms of quantitative image quality and ability to detect and classify lesions based on LI-RADS criteria. Reconstructed A- and PV-CTP images have comparable image quality to 4-phase CT. Reconstructed A- and PV-CTP images can be used for LI-RADS classification of HCC. A-/PV-CTP has the potential to reliably detect lesions in patients weighing <90 kg with body diameter ≤36 cm.
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Affiliation(s)
- A Mohammadi
- Department of Radiology, Department of Medical and Health Sciences, Linköping, Sweden
| | - W Bartholmae
- Department of Radiology, Department of Medical and Health Sciences, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - M Woisetschläger
- Department of Radiology, Department of Medical and Health Sciences, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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Osman MF, Shawali IH, Metwally LIA, Kamel AH, Ibrahim MES. CT perfusion for response evaluation after interventional ablation of hepatocellular carcinoma: a prospective study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00660-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Computed tomography (CT) perfusion was found to be useful in assessing treatment response in a variety of cancers through the evaluation in the arterial perfusion changes. We investigated the performance of CT perfusion parameters for assessment of hepatocellular carcinoma (HCC) response to radiofrequency ablation (RFA) and trans-arterial chemoembolization (TACE). We conducted a prospective diagnostic test accuracy study that recruited 70 HCC patients who were scheduled to undergo TACE or RFA. For each dynamic CT scan acquisition, four single perfusion CT image maps were generated, including functional maps of blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS).
Results
In TACE-treated lesions, the BV achieved a sensitivity and specific of 100% and 83.3%, at a cutoff level of ≤ 122 ml/min/100 gm, for responders. Likewise, at a cutoff level of > 10 s, transit time had a sensitivity of 90.5% and specificity of 100%. At a cutoff level of ≤ 14 ml/min/100 gm, the PS had a sensitivity of 100% and specificity of 83.33% for responders. In RFA-treated lesions, at a cutoff level of ≤ 170 ml/min/100 gm and ≤ 11 ml/100 gm, the BF and BV had a sensitivity of 100% and specificity 100%, respectively, for responders. At a cutoff level of ≤ 11 ml/min/100 gm, PS had a sensitivity 77.27% and specificity 80%.
Conclusions
The present study confirms the feasibility of CT perfusion for assessment of response to TACE and RFA among patients with HCC.
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Hara Y, Yamamura K, Matsumura K, Oda E, Akahoshi S, Yuki H, Tomiguchi J, Motohara T, Miyamoto H, Komohara Y, Beppu T. Laparoscopic Surgery for a Patient With Multiple Liver Metastases of Unknown Origin Concomitant With Gallbladder Tumor. In Vivo 2021; 35:2963-2968. [PMID: 34410995 DOI: 10.21873/invivo.12590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The liver is the digestive organ where metastatic adenocarcinoma of unknown primary site is most often observed. CASE REPORT A 74-year-old man was diagnosed with a growing gallbladder tumor and multiple liver tumors limited to the left lateral sector. Liver tumors were suggested to be primary or secondary adenocarcinoma with no relation to the gallbladder tumor. Also for diagnostic purposes, laparoscopic full-thickness resection of the gallbladder, laparoscopic lateral sectionectomy and lymph node sampling were performed. The final histopathological diagnosis was hyperplastic polyp of the gallbladder and metastatic poorly differentiated adenocarcinoma of the liver. Liver tumors were suspected to originate from the stomach, duodenum, or small intestine; however, the primary sites could not be identified. The patient has been closely followed up without any chemotherapy 3 months after surgery. CONCLUSION Laparoscopic surgery can be strongly recommended for patients with multiple liver tumors of unknown origin concomitant with a gallbladder tumor.
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Affiliation(s)
- Yoshihiro Hara
- Department of Surgery, Yamaga City Medical Center, Kumamoto, Japan
| | - Kensuke Yamamura
- Department of Surgery, Yamaga City Medical Center, Kumamoto, Japan
| | - Kazuki Matsumura
- Department of Surgery, Yamaga City Medical Center, Kumamoto, Japan
| | - Eri Oda
- Department of Surgery, Yamaga City Medical Center, Kumamoto, Japan
| | | | - Hideaki Yuki
- Department of Radiology, Yamaga City Medical Center, Kumamoto, Japan
| | - Jun Tomiguchi
- Department of Gastroenterology, Yamaga City Medical Center, Kumamoto, Japan
| | - Toshihiko Motohara
- Department of Gastroenterology, Yamaga City Medical Center, Kumamoto, Japan
| | - Hideaki Miyamoto
- Department of Medical Oncology, Yamaga City Medical Center, Kumamoto, Japan
| | - Yoshihiko Komohara
- Department of Cell Pathology, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan
| | - Toru Beppu
- Department of Surgery, Yamaga City Medical Center, Kumamoto, Japan;
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Nakamura Y, Higaki T, Honda Y, Tatsugami F, Tani C, Fukumoto W, Narita K, Kondo S, Akagi M, Awai K. Advanced CT techniques for assessing hepatocellular carcinoma. Radiol Med 2021; 126:925-935. [PMID: 33954894 DOI: 10.1007/s11547-021-01366-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023]
Abstract
Hepatocellular carcinoma (HCC) is the sixth-most common cancer in the world, and hepatic dynamic CT studies are routinely performed for its evaluation. Ongoing studies are examining advanced imaging techniques that may yield better findings than are obtained with conventional hepatic dynamic CT scanning. Dual-energy CT-, perfusion CT-, and artificial intelligence-based methods can be used for the precise characterization of liver tumors, the quantification of treatment responses, and for predicting the overall survival rate of patients. In this review, the advantages and disadvantages of conventional hepatic dynamic CT imaging are reviewed and the general principles of dual-energy- and perfusion CT, and the clinical applications and limitations of these technologies are discussed with respect to HCC. Finally, we address the utility of artificial intelligence-based methods for diagnosing HCC.
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Affiliation(s)
- Yuko Nakamura
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Toru Higaki
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yukiko Honda
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Fuminari Tatsugami
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Chihiro Tani
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Wataru Fukumoto
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Keigo Narita
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Shota Kondo
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Motonori Akagi
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kazuo Awai
- Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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Nishida N, Kudo M. Artificial Intelligence in Medical Imaging and Its Application in Sonography for the Management of Liver Tumor. Front Oncol 2020; 10:594580. [PMID: 33409151 PMCID: PMC7779763 DOI: 10.3389/fonc.2020.594580] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/16/2020] [Indexed: 12/15/2022] Open
Abstract
Recent advancement in artificial intelligence (AI) facilitate the development of AI-powered medical imaging including ultrasonography (US). However, overlooking or misdiagnosis of malignant lesions may result in serious consequences; the introduction of AI to the imaging modalities may be an ideal solution to prevent human error. For the development of AI for medical imaging, it is necessary to understand the characteristics of modalities on the context of task setting, required data sets, suitable AI algorism, and expected performance with clinical impact. Regarding the AI-aided US diagnosis, several attempts have been made to construct an image database and develop an AI-aided diagnosis system in the field of oncology. Regarding the diagnosis of liver tumors using US images, 4- or 5-class classifications, including the discrimination of hepatocellular carcinoma (HCC), metastatic tumors, hemangiomas, liver cysts, and focal nodular hyperplasia, have been reported using AI. Combination of radiomic approach with AI is also becoming a powerful tool for predicting the outcome in patients with HCC after treatment, indicating the potential of AI for applying personalized medical care. However, US images show high heterogeneity because of differences in conditions during the examination, and a variety of imaging parameters may affect the quality of images; such conditions may hamper the development of US-based AI. In this review, we summarized the development of AI in medical images with challenges to task setting, data curation, and focus on the application of AI for the managements of liver tumor, especially for US diagnosis.
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Affiliation(s)
- Naoshi Nishida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
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