1
|
Campello CA, Castanha EB, Vilardo M, Staziaki PV, Francisco MZ, Mohajer B, Watte G, Moraes FY, Hochhegger B, Altmayer S. Machine learning for malignant versus benign focal liver lesions on US and CEUS: a meta-analysis. Abdom Radiol (NY) 2023; 48:3114-3126. [PMID: 37365266 DOI: 10.1007/s00261-023-03984-0] [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: 03/10/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES To perform a meta-analysis of the diagnostic performance of learning (ML) algorithms (conventional and deep learning algorithms) for the classification of malignant versus benign focal liver lesions (FLLs) on US and CEUS. METHODS Available databases were searched for relevant published studies through September 2022. Studies met eligibility criteria if they evaluate the diagnostic performance of ML for the classification of malignant and benign focal liver lesions on US and CEUS. The pooled per-lesion sensitivities and specificities for each modality with 95% confidence intervals were calculated. RESULTS A total of 8 studies on US, 11 on CEUS, and 1 study evaluating both methods met the inclusion criteria with a total of 34,245 FLLs evaluated. The pooled sensitivity and specificity of ML for the malignancy classification of FLLs were 81.7% (95% CI, 77.2-85.4%) and 84.8% (95% CI, 76.0-90.8%) for US, compared to 87.1% (95% CI, 81.8-91.0%) and 87.0% (95% CI, 83.1-90.1%) for CEUS. In the subgroup analysis of studies that evaluated deep learning algorithms, the sensitivity and specificity of CEUS (n = 4) increased to 92.4% (95% CI, 88.5-95.0%) and 88.2% (95% CI, 81.1-92.9%). CONCLUSIONS The diagnostic performance of ML algorithms for the malignant classification of FLLs was high for both US and CEUS with overall similar sensitivity and specificity. The similar performance of US may be related to the higher prevalence of DL models in that group.
Collapse
Affiliation(s)
- Carlos Alberto Campello
- School of Medicine, Universidade Federal do Mato Grosso, 2367 Quarenta e Nove St, Cuiabá, Brazil
| | - Everton Bruno Castanha
- School of Medicine, Universidade Federal de Pelotas, 538 Prof. Dr. Araújo St. Pelotas, Pelotas, Brazil
| | - Marina Vilardo
- School of Medicine, Universidade Catolica de Brasilia, QS 07, Brasília, Brazil
| | - Pedro V Staziaki
- Department of Radiology, University of Vermont Medical Center, 111 Colchester Ave, Burlington, USA
| | - Martina Zaguini Francisco
- Department of Radiology, Universidade Federal de Ciencias da Saude de Porto Alegre, 245 Sarmento Leite St, Porto Alegre, Brazil
| | - Bahram Mohajer
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, USA
| | - Guilherme Watte
- Department of Radiology, Universidade Federal de Ciencias da Saude de Porto Alegre, 245 Sarmento Leite St, Porto Alegre, Brazil
| | - Fabio Ynoe Moraes
- Department of Oncology, Queen's University, 76 Stuart St, Kingston, Canada
| | - Bruno Hochhegger
- Department of Radiology, University of Florida, 1600 SW Archer Rd, Gainesville, USA
| | - Stephan Altmayer
- Department of Radiology, Stanford University, 300 Pasteur Drive, Suite H1330, Stanford, USA.
| |
Collapse
|
2
|
Rakotozafindrabe ALR, Razafindrazoto CI, Laingonirina DHH, Ralideramanambina TB, Ralaizanaka BM, Maherison S, Rakotomalala JA, Randriamifidy NH, Rasolonjatovo AS, Rabenjanahary TH, Razafimahefa SH, Ramanampamonjy RM. Demographic, clinical and aetiological characteristics of patients with hepatocellular carcinoma followed between 2012 and 2017 at University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar. Ecancermedicalscience 2022; 16:1466. [PMID: 36819823 PMCID: PMC9934877 DOI: 10.3332/ecancer.2022.1466] [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: 03/27/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose The aim of this study was to describe the demographic, clinical and aetiological characteristics of hepatocellular carcinoma (HCC) in a Malagasy population sample in view to defining an appropriate control program. Methods This was a retrospective, descriptive study conducted in the Gastroenterology Department, Joseph Raseta Befelatanana University Hospital, Antananarivo, over a period of 6 years (January 2012 to December 2017). Results A total of 42 patients were selected, 29 of whom were men (69.05%) and 13 women (30.95%) (sex ratio: 2.2). The mean age was 56.6 years with extremes of 21 and 82 years. Subjects aged 60-69 years were most affected (35.71%). Abdominal pain was the main revealing symptom (38.10%). The main aetiological factors were: hepatitis B virus (HBV) (42.86%), hepatitis C virus (19.05%) and chronic alcoholism (23.81%). All patients were cirrhotic, of which 23 patients (54.76%) had Child-Pugh B class and 15 (35.71%) Child-Pugh C. Twenty-six patients (61.90%) had α-foetoprotein level plus 500 ng/mL. Six patients (14.29%) had portal thrombosis at diagnosis. Twenty patients (47.62%) had advanced HCC (Barcelona Clinic Liver Cancer C (BCLC C)) and 21 (50%) had end-stage HCC (BCLC D). Management was palliative in 41/42 patients. The in-hospital death rate was 23.81%. Conclusion HCC are diagnosed at advanced stage in this study. The prognosis is poor for most patients. HBV infection is the main risk factor. An effort should be made for early diagnosis and prevention.
Collapse
Affiliation(s)
| | | | | | | | - Behoavy Mahafaly Ralaizanaka
- Department of Hepato-Gastroenterology, University Hospital Andrainjato, BP1487 Ambatoharanana, Fianarantsoa 301, Madagascar
| | - Sonny Maherison
- Department of Gastroenterology, University Hospital Joseph Raseta Befelatanana, Antananarivo 101, Madagascar
| | | | | | | | | | - Soloniaina Hélio Razafimahefa
- Department of Hepato-Gastroenterology, University Hospital Andrainjato, BP1487 Ambatoharanana, Fianarantsoa 301, Madagascar
| | | |
Collapse
|
3
|
Dadoun H, Rousseau AL, de Kerviler E, Correas JM, Tissier AM, Joujou F, Bodard S, Khezzane K, de Margerie-Mellon C, Delingette H, Ayache N. Deep Learning for the Detection, Localization, and Characterization of Focal Liver Lesions on Abdominal US Images. Radiol Artif Intell 2022; 4:e210110. [PMID: 35652113 DOI: 10.1148/ryai.210110] [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: 04/23/2021] [Revised: 02/08/2022] [Accepted: 02/16/2022] [Indexed: 12/24/2022]
Abstract
Purpose To train and assess the performance of a deep learning-based network designed to detect, localize, and characterize focal liver lesions (FLLs) in the liver parenchyma on abdominal US images. Materials and Methods In this retrospective, multicenter, institutional review board-approved study, two object detectors, Faster region-based convolutional neural network (Faster R-CNN) and Detection Transformer (DETR), were fine-tuned on a dataset of 1026 patients (n = 2551 B-mode abdominal US images obtained between 2014 and 2018). Performance of the networks was analyzed on a test set of 48 additional patients (n = 155 B-mode abdominal US images obtained in 2019) and compared with the performance of three caregivers (one nonexpert and two experts) blinded to the clinical history. The sign test was used to compare accuracy, specificity, sensitivity, and positive predictive value among all raters. Results DETR achieved a specificity of 90% (95% CI: 75, 100) and a sensitivity of 97% (95% CI: 97, 97) for the detection of FLLs. The performance of DETR met or exceeded that of the three caregivers for this task. DETR correctly localized 80% of the lesions, and it achieved a specificity of 81% (95% CI: 67, 91) and a sensitivity of 82% (95% CI: 62, 100) for FLL characterization (benign vs malignant) among lesions localized by all raters. The performance of DETR met or exceeded that of two experts and Faster R-CNN for these tasks. Conclusion DETR demonstrated high specificity for detection, localization, and characterization of FLLs on abdominal US images. Supplemental material is available for this article. RSNA, 2022Keywords: Computer-aided Diagnosis (CAD), Ultrasound, Abdomen/GI, Liver, Tissue Characterization, Supervised Learning, Transfer Learning, Convolutional Neural Network (CNN).
Collapse
Affiliation(s)
- Hind Dadoun
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Anne-Laure Rousseau
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Eric de Kerviler
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Jean-Michel Correas
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Anne-Marie Tissier
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Fanny Joujou
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Sylvain Bodard
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Kemel Khezzane
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Constance de Margerie-Mellon
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Hervé Delingette
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Nicholas Ayache
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| |
Collapse
|
5
|
Pouëdras J, Izar F, Muscari F, Parent L, Breibach F, Péron JM, Otal P, Suc B, Rives M, Modesto A. [Stereotactic hypofractionated radiation therapy as a bridge to transplantation for hepatocellular carcinoma: Case report of a complete pathological response and review of the literature]. Cancer Radiother 2018; 22:797-801. [PMID: 30523795 DOI: 10.1016/j.canrad.2018.04.001] [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: 02/13/2018] [Revised: 04/09/2018] [Accepted: 04/17/2018] [Indexed: 11/30/2022]
Abstract
Patients with hepatocellular carcinoma who are on liver transplant waiting list usually require local treatment to limit any risk of tumour growth. Historically percutaneous radiofrequency ablation or transarterial chemoembolization represented the major therapeutic alternatives. Depending on the size, or the topography of the lesion these two techniques may not be feasible. Radiation therapy under stereotactic conditions has recently emerged in the management of localized hepatocellular carcinoma as an alternative to the focused therapies performed to date. We herein report the case of a 43-year-old patient harbouring a complete histological response on explant after liver stereotactic irradiation and discuss its role in the management of hepatocellular carcinoma before liver transplantation.
Collapse
Affiliation(s)
- J Pouëdras
- Département d'oncoradiothérapie, institut Claudius-Regaud, institut universitaire du cancer de Toulouse- Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - F Izar
- Département d'oncoradiothérapie, institut Claudius-Regaud, institut universitaire du cancer de Toulouse- Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - F Muscari
- Département de chirurgie digestive, hôpital Rangueil, CHU de Toulouse, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France
| | - L Parent
- Département de physique médicale, institut Claudius-Regaud, institut universitaire du cancer de Toulouse- Oncopole, 1 avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - F Breibach
- Département d'anatomie-pathologie, CHU de Toulouse, institut universitaire du cancer de Toulouse- Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - J-M Péron
- Département d'hépato-gastroentérologie, hôpital Purpan, CHU de Toulouse, 1, place Dr-Baylac, TSA 40031, Toulouse cedex 9, France
| | - P Otal
- Département d'imagerie médicale, hôpital Rangueil, CHU de Toulouse, 1, avenue Jean Poulhès, TSA 50032, 31059 Toulouse cedex 9, France
| | - B Suc
- Département de chirurgie digestive, hôpital Rangueil, CHU de Toulouse, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France
| | - M Rives
- Département d'oncoradiothérapie, institut Claudius-Regaud, institut universitaire du cancer de Toulouse- Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - A Modesto
- Département d'oncoradiothérapie, institut Claudius-Regaud, institut universitaire du cancer de Toulouse- Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
| |
Collapse
|