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Averbuch I, Tschernichovsky R, Yust-Katz S, Rotem O, Limon D, Kurman N, Icht O, Reinhorn D, Moskovitz M, Hanovich E, Benouaich-Amiel A, Siegal T, Zer A, Gal O. Converging survival trends in non-small cell lung cancer patients with and without brain metastasis receiving state-of-the-art treatment. J Neurooncol 2024; 166:461-469. [PMID: 38324192 PMCID: PMC10876498 DOI: 10.1007/s11060-024-04562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Historically, patients with brain metastasis (BM) have been excluded from clinical trials investigating treatments for non-small cell lung cancer (NSCLC) due to their unfavorable prognosis. Advanced treatments have increased survival prospects for NSCLC patients with BM. This study evaluated the life expectancy of NSCLC patients with and without BM in the context of contemporary treatments. METHODS Outcome data were collected for patients with advanced NSCLC attending a tertiary medical center between 2015 and 2020. Patients were stratified according to BM status and compared for overall survival (OS) using log-rank and Cox regression analyses. RESULTS The cohort included 360 patients with NSCLC of whom 134 (37.2%) had BM. Most (95%) of cases of BM developed within the first two years: 63% at diagnosis, 18% during the first year, 14% during the second year. There was no significant difference in OS between patients without BM and those with BM (median 23.7 vs. 22.3 months, HR = 0.97, p = 0.82); patients with BM and a targetable or non-targetable mutation (40.2 vs. 31.4 months, HR = 0.93, p = 0.84, and 20.7 vs. 19.87 months, HR = 0.95, p = 0.75, respectively); and patients with symptomatic BM (23.7 vs. 19.8 months, HR = 0.95, p = 0.78). Treatment for BM (95% of patients) consisted of stereotactic radiosurgery or tyrosine kinase inhibitors, with corresponding intracranial control rates of 90% and 86%. CONCLUSION The results imply that the presence of BM has no impact on the prognosis of NSCLC. The practice of excluding NSCLC patients with BM from clinical trials warrants reconsideration.
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Affiliation(s)
- Itamar Averbuch
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel.
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
| | - Roi Tschernichovsky
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Shlomit Yust-Katz
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
- Neuro-Oncology Unit, Davidoff Cancer Center at Rabin Medical Center, Petach Tikva, 4941492, Israel
| | - Ofer Rotem
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Dror Limon
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Noga Kurman
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Oded Icht
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Daniel Reinhorn
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Mor Moskovitz
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Ekaterina Hanovich
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Alexandra Benouaich-Amiel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
- Neuro-Oncology Unit, Davidoff Cancer Center at Rabin Medical Center, Petach Tikva, 4941492, Israel
| | - Tali Siegal
- Neuro-Oncology Unit, Davidoff Cancer Center at Rabin Medical Center, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Alona Zer
- Fishman Oncology Institute, Rambam Health Care Campus, Haifa, Israel
| | - Omer Gal
- Davidoff Cancer Center, Rabin Medical Center- Beilinson Hospital, 39 Jabotinsky St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
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Valente J, António J, Mora C, Jardim S. Developments in Image Processing Using Deep Learning and Reinforcement Learning. J Imaging 2023; 9:207. [PMID: 37888314 PMCID: PMC10607786 DOI: 10.3390/jimaging9100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/24/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
The growth in the volume of data generated, consumed, and stored, which is estimated to exceed 180 zettabytes in 2025, represents a major challenge both for organizations and for society in general. In addition to being larger, datasets are increasingly complex, bringing new theoretical and computational challenges. Alongside this evolution, data science tools have exploded in popularity over the past two decades due to their myriad of applications when dealing with complex data, their high accuracy, flexible customization, and excellent adaptability. When it comes to images, data analysis presents additional challenges because as the quality of an image increases, which is desirable, so does the volume of data to be processed. Although classic machine learning (ML) techniques are still widely used in different research fields and industries, there has been great interest from the scientific community in the development of new artificial intelligence (AI) techniques. The resurgence of neural networks has boosted remarkable advances in areas such as the understanding and processing of images. In this study, we conducted a comprehensive survey regarding advances in AI design and the optimization solutions proposed to deal with image processing challenges. Despite the good results that have been achieved, there are still many challenges to face in this field of study. In this work, we discuss the main and more recent improvements, applications, and developments when targeting image processing applications, and we propose future research directions in this field of constant and fast evolution.
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Affiliation(s)
- Jorge Valente
- Techframe-Information Systems, SA, 2785-338 São Domingos de Rana, Portugal; (J.V.); (J.A.)
| | - João António
- Techframe-Information Systems, SA, 2785-338 São Domingos de Rana, Portugal; (J.V.); (J.A.)
| | - Carlos Mora
- Smart Cities Research Center, Polytechnic Institute of Tomar, 2300-313 Tomar, Portugal;
| | - Sandra Jardim
- Smart Cities Research Center, Polytechnic Institute of Tomar, 2300-313 Tomar, Portugal;
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Mahajan A, B G, Wadhwa S, Agarwal U, Baid U, Talbar S, Janu AK, Patil V, Noronha V, Mummudi N, Tibdewal A, Agarwal JP, Yadav S, Kumar Kaushal R, Puranik A, Purandare N, Prabhash K. Deep learning based automated epidermal growth factor receptor and anaplastic lymphoma kinase status prediction of brain metastasis in non-small cell lung cancer. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2023; 4:657-668. [PMID: 37745691 PMCID: PMC10511818 DOI: 10.37349/etat.2023.00158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/13/2023] [Indexed: 09/26/2023] Open
Abstract
Aim The aim of this study was to investigate the feasibility of developing a deep learning (DL) algorithm for classifying brain metastases from non-small cell lung cancer (NSCLC) into epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement groups and to compare the accuracy with classification based on semantic features on imaging. Methods Data set of 117 patients was analysed from 2014 to 2018 out of which 33 patients were EGFR positive, 43 patients were ALK positive and 41 patients were negative for either mutation. Convolutional neural network (CNN) architecture efficient net was used to study the accuracy of classification using T1 weighted (T1W) magnetic resonance imaging (MRI) sequence, T2 weighted (T2W) MRI sequence, T1W post contrast (T1post) MRI sequence, fluid attenuated inversion recovery (FLAIR) MRI sequences. The dataset was divided into 80% training and 20% testing. The associations between mutation status and semantic features, specifically sex, smoking history, EGFR mutation and ALK rearrangement status, extracranial metastasis, performance status and imaging variables of brain metastasis were analysed using descriptive analysis [chi-square test (χ2)], univariate and multivariate logistic regression analysis assuming 95% confidence interval (CI). Results In this study of 117 patients, the analysis by semantic method showed 79.2% of the patients belonged to ALK positive were non-smokers as compared to double negative groups (P = 0.03). There was a 10-fold increase in ALK positivity as compared to EGFR positivity in ring enhancing lesions patients (P = 0.015) and there was also a 6.4-fold increase in ALK positivity as compared to double negative groups in meningeal involvement patients (P = 0.004). Using CNN Efficient Net DL model, the study achieved 76% accuracy in classifying ALK rearrangement and EGFR mutations without manual segmentation of metastatic lesions. Analysis of the manually segmented dataset resulted in improved accuracy of 89% through this model. Conclusions Both semantic features and DL model showed comparable accuracy in classifying EGFR mutation and ALK rearrangement. Both methods can be clinically used to predict mutation status while biopsy or genetic testing is undertaken.
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Affiliation(s)
- Abhishek Mahajan
- Clatterbridge Centre for Oncology NHS Foundation Trust, L7 8YA Liverpool, UK
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Gurukrishna B
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Shweta Wadhwa
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Ujjwal Agarwal
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Ujjwal Baid
- Department of Electronics and Telecommunication Engineering, SGGS Institute of Engineering and Technology, Nanded 431606, Maharashtra, India
| | - Sanjay Talbar
- Department of Electronics and Telecommunication Engineering, SGGS Institute of Engineering and Technology, Nanded 431606, Maharashtra, India
| | - Amit Kumar Janu
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Vijay Patil
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Naveen Mummudi
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Anil Tibdewal
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - JP Agarwal
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Subash Yadav
- Department of Pathology, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Rajiv Kumar Kaushal
- Department of Pathology, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Ameya Puranik
- Department of Nuclear Medicine, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Nilendu Purandare
- Department of Nuclear Medicine, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India
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