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Wahid KA, Kaffey ZY, Farris DP, Humbert-Vidan L, Moreno AC, Rasmussen M, Ren J, Naser MA, Netherton TJ, Korreman S, Balakrishnan G, Fuller CD, Fuentes D, Dohopolski MJ. Artificial Intelligence Uncertainty Quantification in Radiotherapy Applications - A Scoping Review. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.13.24307226. [PMID: 38798581 PMCID: PMC11118597 DOI: 10.1101/2024.05.13.24307226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Background/purpose The use of artificial intelligence (AI) in radiotherapy (RT) is expanding rapidly. However, there exists a notable lack of clinician trust in AI models, underscoring the need for effective uncertainty quantification (UQ) methods. The purpose of this study was to scope existing literature related to UQ in RT, identify areas of improvement, and determine future directions. Methods We followed the PRISMA-ScR scoping review reporting guidelines. We utilized the population (human cancer patients), concept (utilization of AI UQ), context (radiotherapy applications) framework to structure our search and screening process. We conducted a systematic search spanning seven databases, supplemented by manual curation, up to January 2024. Our search yielded a total of 8980 articles for initial review. Manuscript screening and data extraction was performed in Covidence. Data extraction categories included general study characteristics, RT characteristics, AI characteristics, and UQ characteristics. Results We identified 56 articles published from 2015-2024. 10 domains of RT applications were represented; most studies evaluated auto-contouring (50%), followed by image-synthesis (13%), and multiple applications simultaneously (11%). 12 disease sites were represented, with head and neck cancer being the most common disease site independent of application space (32%). Imaging data was used in 91% of studies, while only 13% incorporated RT dose information. Most studies focused on failure detection as the main application of UQ (60%), with Monte Carlo dropout being the most commonly implemented UQ method (32%) followed by ensembling (16%). 55% of studies did not share code or datasets. Conclusion Our review revealed a lack of diversity in UQ for RT applications beyond auto-contouring. Moreover, there was a clear need to study additional UQ methods, such as conformal prediction. Our results may incentivize the development of guidelines for reporting and implementation of UQ in RT.
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Affiliation(s)
- Kareem A. Wahid
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Zaphanlene Y. Kaffey
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - David P. Farris
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Laia Humbert-Vidan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Amy C. Moreno
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Jintao Ren
- Department of Oncology, Aarhus University Hospital, Denmark
| | - Mohamed A. Naser
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Tucker J. Netherton
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stine Korreman
- Department of Oncology, Aarhus University Hospital, Denmark
| | | | - Clifton D. Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - David Fuentes
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael J. Dohopolski
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Niraula D, Cuneo KC, Dinov ID, Gonzalez BD, Jamaluddin JB, Jin JJ, Luo Y, Matuszak MM, Ten Haken RK, Bryant AK, Dilling TJ, Dykstra MP, Frakes JM, Liveringhouse CL, Miller SR, Mills MN, Palm RF, Regan SN, Rishi A, Torres-Roca JF, Yu HHM, El Naqa I. Intricacies of Human-AI Interaction in Dynamic Decision-Making for Precision Oncology: A Case Study in Response-Adaptive Radiotherapy. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.27.24306434. [PMID: 38746238 PMCID: PMC11092730 DOI: 10.1101/2024.04.27.24306434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background Adaptive treatment strategies that can dynamically react to individual cancer progression can provide effective personalized care. Longitudinal multi-omics information, paired with an artificially intelligent clinical decision support system (AI-CDSS) can assist clinicians in determining optimal therapeutic options and treatment adaptations. However, AI-CDSS is not perfectly accurate, as such, clinicians' over/under reliance on AI may lead to unintended consequences, ultimately failing to develop optimal strategies. To investigate such collaborative decision-making process, we conducted a Human-AI interaction case study on response-adaptive radiotherapy (RT). Methods We designed and conducted a two-phase study for two disease sites and two treatment modalities-adaptive RT for non-small cell lung cancer (NSCLC) and adaptive stereotactic body RT for hepatocellular carcinoma (HCC)-in which clinicians were asked to consider mid-treatment modification of the dose per fraction for a number of retrospective cancer patients without AI-support (Unassisted Phase) and with AI-assistance (AI-assisted Phase). The AI-CDSS graphically presented trade-offs in tumor control and the likelihood of toxicity to organs at risk, provided an optimal recommendation, and associated model uncertainties. In addition, we asked for clinicians' decision confidence level and trust level in individual AI recommendations and encouraged them to provide written remarks. We enrolled 13 evaluators (radiation oncology physicians and residents) from two medical institutions located in two different states, out of which, 4 evaluators volunteered in both NSCLC and HCC studies, resulting in a total of 17 completed evaluations (9 NSCLC, and 8 HCC). To limit the evaluation time to under an hour, we selected 8 treated patients for NSCLC and 9 for HCC, resulting in a total of 144 sets of evaluations (72 from NSCLC and 72 from HCC). Evaluation for each patient consisted of 8 required inputs and 2 optional remarks, resulting in up to a total of 1440 data points. Results AI-assistance did not homogeneously influence all experts and clinical decisions. From NSCLC cohort, 41 (57%) decisions and from HCC cohort, 34 (47%) decisions were adjusted after AI assistance. Two evaluations (12%) from the NSCLC cohort had zero decision adjustments, while the remaining 15 (88%) evaluations resulted in at least two decision adjustments. Decision adjustment level positively correlated with dissimilarity in decision-making with AI [NSCLC: ρ = 0.53 ( p < 0.001); HCC: ρ = 0.60 ( p < 0.001)] indicating that evaluators adjusted their decision closer towards AI recommendation. Agreement with AI-recommendation positively correlated with AI Trust Level [NSCLC: ρ = 0.59 ( p < 0.001); HCC: ρ = 0.7 ( p < 0.001)] indicating that evaluators followed AI's recommendation if they agreed with that recommendation. The correlation between decision confidence changes and decision adjustment level showed an opposite trend [NSCLC: ρ = -0.24 ( p = 0.045), HCC: ρ = 0.28 ( p = 0.017)] reflecting the difference in behavior due to underlying differences in disease type and treatment modality. Decision confidence positively correlated with the closeness of decisions to the standard of care (NSCLC: 2 Gy/fx; HCC: 10 Gy/fx) indicating that evaluators were generally more confident in prescribing dose fractionations more similar to those used in standard clinical practice. Inter-evaluator agreement increased with AI-assistance indicating that AI-assistance can decrease inter-physician variability. The majority of decisions were adjusted to achieve higher tumor control in NSCLC and lower normal tissue complications in HCC. Analysis of evaluators' remarks indicated concerns for organs at risk and RT outcome estimates as important decision-making factors. Conclusions Human-AI interaction depends on the complex interrelationship between expert's prior knowledge and preferences, patient's state, disease site, treatment modality, model transparency, and AI's learned behavior and biases. The collaborative decision-making process can be summarized as follows: (i) some clinicians may not believe in an AI system, completely disregarding its recommendation, (ii) some clinicians may believe in the AI system but will critically analyze its recommendations on a case-by-case basis; (iii) when a clinician finds that the AI recommendation indicates the possibility for better outcomes they will adjust their decisions accordingly; and (iv) When a clinician finds that the AI recommendation indicate a worse possible outcome they will disregard it and seek their own alternative approach.
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Wei L, Niraula D, Gates EDH, Fu J, Luo Y, Nyflot MJ, Bowen SR, El Naqa IM, Cui S. Artificial intelligence (AI) and machine learning (ML) in precision oncology: a review on enhancing discoverability through multiomics integration. Br J Radiol 2023; 96:20230211. [PMID: 37660402 PMCID: PMC10546458 DOI: 10.1259/bjr.20230211] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 09/05/2023] Open
Abstract
Multiomics data including imaging radiomics and various types of molecular biomarkers have been increasingly investigated for better diagnosis and therapy in the era of precision oncology. Artificial intelligence (AI) including machine learning (ML) and deep learning (DL) techniques combined with the exponential growth of multiomics data may have great potential to revolutionize cancer subtyping, risk stratification, prognostication, prediction and clinical decision-making. In this article, we first present different categories of multiomics data and their roles in diagnosis and therapy. Second, AI-based data fusion methods and modeling methods as well as different validation schemes are illustrated. Third, the applications and examples of multiomics research in oncology are demonstrated. Finally, the challenges regarding the heterogeneity data set, availability of omics data, and validation of the research are discussed. The transition of multiomics research to real clinics still requires consistent efforts in standardizing omics data collection and analysis, building computational infrastructure for data sharing and storing, developing advanced methods to improve data fusion and interpretability, and ultimately, conducting large-scale prospective clinical trials to fill the gap between study findings and clinical benefits.
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Affiliation(s)
- Lise Wei
- Department of Radiation Oncology, University of Michigan, Michigan, United States
| | - Dipesh Niraula
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, United States
| | - Evan D. H. Gates
- Department of Radiation Oncology, University of Washington, Washington, United States
| | - Jie Fu
- Department of Radiation Oncology, Stanford University, Stanford, California, United States
| | - Yi Luo
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, United States
| | - Matthew J. Nyflot
- Department of Radiation Oncology, University of Washington, Washington, United States
| | - Stephen R. Bowen
- Department of Radiation Oncology, University of Washington, Washington, United States
| | - Issam M El Naqa
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, United States
| | - Sunan Cui
- Department of Radiation Oncology, University of Washington, Washington, United States
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Cui S, Traverso A, Niraula D, Zou J, Luo Y, Owen D, El Naqa I, Wei L. Interpretable artificial intelligence in radiology and radiation oncology. Br J Radiol 2023; 96:20230142. [PMID: 37493248 PMCID: PMC10546466 DOI: 10.1259/bjr.20230142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 07/27/2023] Open
Abstract
Artificial intelligence has been introduced to clinical practice, especially radiology and radiation oncology, from image segmentation, diagnosis, treatment planning and prognosis. It is not only crucial to have an accurate artificial intelligence model, but also to understand the internal logic and gain the trust of the experts. This review is intended to provide some insights into core concepts of the interpretability, the state-of-the-art methods for understanding the machine learning models, the evaluation of these methods, identifying some challenges and limits of them, and gives some examples of medical applications.
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Affiliation(s)
- Sunan Cui
- Department of Radiation Oncology, University of Washington, Seattle, WA, United States
| | - Alberto Traverso
- Department of Radiotherapy, Maastro Clinic, Maastricht, Netherlands
| | - Dipesh Niraula
- Department of Machine Learning, Moffitt Cancer Center, FL, United States
| | - Jiaren Zou
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Yi Luo
- Department of Machine Learning, Moffitt Cancer Center, FL, United States
| | - Dawn Owen
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States
| | - Issam El Naqa
- Department of Machine Learning, Moffitt Cancer Center, FL, United States
| | - Lise Wei
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
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Drabiak K, Kyzer S, Nemov V, El Naqa I. AI and machine learning ethics, law, diversity, and global impact. Br J Radiol 2023; 96:20220934. [PMID: 37191072 PMCID: PMC10546451 DOI: 10.1259/bjr.20220934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/20/2023] [Accepted: 03/29/2023] [Indexed: 05/17/2023] Open
Abstract
Artificial intelligence (AI) and its machine learning (ML) algorithms are offering new promise for personalized biomedicine and more cost-effective healthcare with impressive technical capability to mimic human cognitive capabilities. However, widespread application of this promising technology has been limited in the medical domain and expectations have been tampered by ethical challenges and concerns regarding patient privacy, legal responsibility, trustworthiness, and fairness. To balance technical innovation with ethical applications of AI/ML, developers must demonstrate the AI functions as intended and adopt strategies to minimize the risks for failure or bias. This review describes the new ethical challenges created by AI/ML for clinical care and identifies specific considerations for its practice in medicine. We provide an overview of regulatory and legal issues applicable in Europe and the United States, a description of technical aspects to consider, and present recommendations for trustworthy AI/ML that promote transparency, minimize risks of bias or error, and protect the patient well-being.
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Affiliation(s)
- Katherine Drabiak
- Colleges of Public Health and Medicine, University of South Florida, Tampa, FL, USA
| | - Skylar Kyzer
- Colleges of Public Health and Medicine, University of South Florida, Tampa, FL, USA
| | - Valerie Nemov
- Colleges of Public Health and Medicine, University of South Florida, Tampa, FL, USA
| | - Issam El Naqa
- Department of Machine Learning, Moffitt Cancer Center, Tampa, FL, USA
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Magnini M, Ciatto G, Cantürk F, Aydoğan R, Omicini A. Symbolic knowledge extraction for explainable nutritional recommenders. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 235:107536. [PMID: 37060685 DOI: 10.1016/j.cmpb.2023.107536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/22/2023] [Accepted: 04/04/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND AND OBJECTIVE This paper focuses on nutritional recommendation systems (RS), i.e. AI-powered automatic systems providing users with suggestions about what to eat to pursue their weight/body shape goals. A trade-off among (potentially) conflictual requirements must be taken into account when designing these kinds of systems, there including: (i) adherence to experts' prescriptions, (ii) adherence to users' tastes and preferences, (iii) explainability of the whole recommendation process. Accordingly, in this paper we propose a novel approach to the engineering of nutritional RS, combining machine learning and symbolic knowledge extraction to profile users-hence harmonising the aforementioned requirements. MethodsOur contribution focuses on the data processing workflow. Stemming from neural networks (NN) trained to predict user preferences, we use CART Breiman et al.(1984) to extract symbolic rules in Prolog Körner et al.(2022) form, and we combine them with expert prescriptions brought in similar form. We can then query the resulting symbolic knowledge base via logic solvers, to draw explainable recommendations. ResultsExperiments are performed involving a publicly available dataset of 45,723 recipes, plus 12 synthetic datasets about as many imaginary users, and 6 experts' prescriptions. Fully-connected 4-layered NN are trained on those datasets, reaching ∼86% test-set accuracy, on average. Extracted rules, in turn, have ∼80% fidelity w.r.t. those NN. The resulting recommendation system has a test-set precision of ∼74%. The symbolic approach makes it possible to devise how the system draws recommendations. ConclusionsThanks to our approach, intelligent agents may learn users' preferences from data, convert them into symbolic form, and extend them with experts' goal-directed prescriptions. The resulting recommendations are then simultaneously acceptable for the end user and adequate under a nutritional perspective, while the whole process of recommendation generation is made explainable.
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Affiliation(s)
- Matteo Magnini
- Department of Computer Science and Engineering (DISI), Alma Mater Studiorum - Università di Bologna, via dell'Università 50, Cesena (FC), 47522, Italy.
| | - Giovanni Ciatto
- Department of Computer Science and Engineering (DISI), Alma Mater Studiorum - Università di Bologna, via dell'Università 50, Cesena (FC), 47522, Italy.
| | - Furkan Cantürk
- Department of Computer Science, Özyeğin University, Nisantepe Mah. Orman Sok. No:34-36 Alemdağ, Çekmeköy, Istanbul 34794, Türkiye.
| | - Reyhan Aydoğan
- Department of Computer Science, Özyeğin University, Nisantepe Mah. Orman Sok. No:34-36 Alemdağ, Çekmeköy, Istanbul 34794, Türkiye; Interactive Intelligence, Delft University of Technology, Mekelweg 4, Delft 2628 CD, the Netherlands.
| | - Andrea Omicini
- Department of Computer Science and Engineering (DISI), Alma Mater Studiorum - Università di Bologna, via dell'Università 50, Cesena (FC), 47522, Italy.
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Niraula D, Sun W, Jin J, Dinov ID, Cuneo K, Jamaluddin J, Matuszak MM, Luo Y, Lawrence TS, Jolly S, Ten Haken RK, El Naqa I. A clinical decision support system for AI-assisted decision-making in response-adaptive radiotherapy (ARCliDS). Sci Rep 2023; 13:5279. [PMID: 37002296 PMCID: PMC10066294 DOI: 10.1038/s41598-023-32032-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
Involvement of many variables, uncertainty in treatment response, and inter-patient heterogeneity challenge objective decision-making in dynamic treatment regime (DTR) in oncology. Advanced machine learning analytics in conjunction with information-rich dense multi-omics data have the ability to overcome such challenges. We have developed a comprehensive artificial intelligence (AI)-based optimal decision-making framework for assisting oncologists in DTR. In this work, we demonstrate the proposed framework to Knowledge Based Response-Adaptive Radiotherapy (KBR-ART) applications by developing an interactive software tool entitled Adaptive Radiotherapy Clinical Decision Support (ARCliDS). ARCliDS is composed of two main components: Artifcial RT Environment (ARTE) and Optimal Decision Maker (ODM). ARTE is designed as a Markov decision process and modeled via supervised learning. Given a patient's pre- and during-treatment information, ARTE can estimate treatment outcomes for a selected daily dosage value (radiation fraction size). ODM is formulated using reinforcement learning and is trained on ARTE. ODM can recommend optimal daily dosage adjustments to maximize the tumor local control probability and minimize the side effects. Graph Neural Networks (GNN) are applied to exploit the inter-feature relationships for improved modeling performance and a novel double GNN architecture is designed to avoid nonphysical treatment response. Datasets of size 117 and 292 were available from two clinical trials on adaptive RT in non-small cell lung cancer (NSCLC) patients and adaptive stereotactic body RT (SBRT) in hepatocellular carcinoma (HCC) patients, respectively. For training and validation, dense data with 297 features were available for 67 NSCLC patients and 110 features for 71 HCC patients. To increase the sample size for ODM training, we applied Generative Adversarial Networks to generate 10,000 synthetic patients. The ODM was trained on the synthetic patients and validated on the original dataset. We found that, Double GNN architecture was able to correct the nonphysical dose-response trend and improve ARCliDS recommendation. The average root mean squared difference (RMSD) between ARCliDS recommendation and reported clinical decisions using double GNNs were 0.61 [0.03] Gy/frac (mean [sem]) for adaptive RT in NSCLC patients and 2.96 [0.42] Gy/frac for adaptive SBRT HCC compared to the single GNN's RMSDs of 0.97 [0.12] Gy/frac and 4.75 [0.16] Gy/frac, respectively. Overall, For NSCLC and HCC, ARCliDS with double GNNs was able to reproduce 36% and 50% of the good clinical decisions (local control and no side effects) and improve 74% and 30% of the bad clinical decisions, respectively. In conclusion, ARCliDS is the first web-based software dedicated to assist KBR-ART with multi-omics data. ARCliDS can learn from the reported clinical decisions and facilitate AI-assisted clinical decision-making for improving the outcomes in DTR.
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Affiliation(s)
- Dipesh Niraula
- Department of Machine Learning, Moffitt Cancer Center, Tampa, FL, 33612, USA.
| | - Wenbo Sun
- University of Michigan Transport Research Institute, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jionghua Jin
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Ivo D Dinov
- Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Kyle Cuneo
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jamalina Jamaluddin
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Martha M Matuszak
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Yi Luo
- Department of Machine Learning, Moffitt Cancer Center, Tampa, FL, 33612, USA
| | - Theodore S Lawrence
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Shruti Jolly
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Randall K Ten Haken
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Issam El Naqa
- Department of Machine Learning, Moffitt Cancer Center, Tampa, FL, 33612, USA
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Zhang J, Zhu H, Wang J, Chen Y, Li Y, Chen X, Chen M, Cai Z, Liu W. Machine learning in non-small cell lung cancer radiotherapy: A bibliometric analysis. Front Oncol 2023; 13:1082423. [PMID: 37025583 PMCID: PMC10072228 DOI: 10.3389/fonc.2023.1082423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/20/2023] [Indexed: 03/19/2023] Open
Abstract
BackgroundMachine learning is now well-developed in non-small cell lung cancer (NSCLC) radiotherapy. But the research trend and hotspots are still unclear. To investigate the progress in machine learning in radiotherapy NSCLC, we performed a bibliometric analysis of associated research and discuss the current research hotspots and potential hot areas in the future.MethodsThe involved researches were obtained from the Web of Science Core Collection database (WoSCC). We used R-studio software, the Bibliometrix package and VOSviewer (Version 1.6.18) software to perform bibliometric analysis.ResultsWe found 197 publications about machine learning in radiotherapy for NSCLC in the WoSCC, and the journal Medical Physics contributed the most articles. The University of Texas MD Anderson Cancer Center was the most frequent publishing institution, and the United States contributed most of the publications. In our bibliometric analysis, “radiomics” was the most frequent keyword, and we found that machine learning is mainly applied to analyze medical images in the radiotherapy of NSCLC.ResultsThe research we identified about machine learning in NSCLC radiotherapy was mainly related to the radiotherapy planning of NSCLC and the prediction of treatment effects and adverse events in NSCLC patients who were under radiotherapy. Our research has added new insights into machine learning in NSCLC radiotherapy and could help researchers better identify hot research areas in the future.
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Affiliation(s)
- Jiaming Zhang
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Huijun Zhu
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jue Wang
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yulu Chen
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yihe Li
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xinyu Chen
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Menghua Chen
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhengwen Cai
- Department of Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Correspondence: Zhengwen Cai, ; Wenqi Liu,
| | - Wenqi Liu
- Department of Radiation Oncology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Correspondence: Zhengwen Cai, ; Wenqi Liu,
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Niraula D, Cui S, Pakela J, Wei L, Luo Y, Ten Haken RK, El Naqa I. Current status and future developments in predicting outcomes in radiation oncology. Br J Radiol 2022; 95:20220239. [PMID: 35867841 PMCID: PMC9793488 DOI: 10.1259/bjr.20220239] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Advancements in data-driven technologies and the inclusion of information-rich multiomics features have significantly improved the performance of outcomes modeling in radiation oncology. For this current trend to be sustainable, challenges related to robust data modeling such as small sample size, low size to feature ratio, noisy data, as well as issues related to algorithmic modeling such as complexity, uncertainty, and interpretability, need to be mitigated if not resolved. Emerging computational technologies and new paradigms such as federated learning, human-in-the-loop, quantum computing, and novel interpretability methods show great potential in overcoming these challenges and bridging the gap towards precision outcome modeling in radiotherapy. Examples of these promising technologies will be presented and their potential role in improving outcome modeling will be discussed.
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Affiliation(s)
- Dipesh Niraula
- Department of Machine Learning, H Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Sunan Cui
- Department of Radiation Oncology, Stanford Medicine, Stanford University, Stanford, USA
| | - Julia Pakela
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Lise Wei
- Department of Radiation Oncology, University of Michigan, Ann Arbor, USA
| | - Yi Luo
- Department of Machine Learning, H Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | | | - Issam El Naqa
- Department of Machine Learning, H Lee Moffitt Cancer Center and Research Institute, Tampa, USA
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