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Schwarz L, Sobania D, Rothlauf F. On relevant features for the recurrence prediction of urothelial carcinoma of the bladder. Int J Med Inform 2024; 186:105414. [PMID: 38531255 DOI: 10.1016/j.ijmedinf.2024.105414] [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: 12/06/2023] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Urothelial bladder cancer (UBC) is characterized by a high recurrence rate, which is predicted by scoring systems. However, recent studies show the superiority of Machine Learning (ML) models. Nevertheless, these ML approaches are rarely used in medical practice because most of them are black-box models, that cannot adequately explain how a prediction is made. OBJECTIVE We investigate the global feature importance of different ML models. By providing information on the most relevant features, we can facilitate the use of ML in everyday medical practice. DESIGN, SETTING, AND PARTICIPANTS The data is provided by the cancer registry Rhineland-Palatinate gGmbH, Germany. It consists of numerical and categorical features of 1,944 patients with UBC. We retrospectively predict 2-year recurrence through ML models using Support Vector Machine, Gradient Boosting, and Artificial Neural Network. We then determine the global feature importance using performance-based Permutation Feature Importance (PFI) and variance-based Feature Importance Ranking Measure (FIRM). RESULTS We show reliable recurrence prediction of UBC with 82.02% to 83.89% F1-Score, 83.95% to 84.49% Precision, and an overall performance of 69.20% to 70.82% AUC on testing data, depending on the model. Gradient Boosting performs best among all black-box models with an average F1-Score (83.89%), AUC (70.82%), and Precision (83.95%). Furthermore, we show consistency across PFI and FIRM by identifying the same features as relevant across the different models. These features are exclusively therapeutic measures and are consistent with findings from both medical research and clinical trials. CONCLUSIONS We confirm the superiority of ML black-box models in predicting UBC recurrence compared to more traditional logistic regression. In addition, we present an approach that increases the explanatory power of black-box models by identifying the underlying influence of input features, thus facilitating the use of ML in clinical practice and therefore providing improved recurrence prediction through the application of black-box models.
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Affiliation(s)
- Louisa Schwarz
- Cancer Registry Rhineland-Palatinate, Mainz, Germany; Johannes Gutenberg University, Mainz, Germany.
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Qiao J, Wang G, Yang Z, Luo X, Chen J, Li K, Liu P. A hybrid particle swarm optimization algorithm for solving engineering problem. Sci Rep 2024; 14:8357. [PMID: 38594511 DOI: 10.1038/s41598-024-59034-2] [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: 01/11/2024] [Accepted: 04/05/2024] [Indexed: 04/11/2024] Open
Abstract
To overcome the disadvantages of premature convergence and easy trapping into local optimum solutions, this paper proposes an improved particle swarm optimization algorithm (named NDWPSO algorithm) based on multiple hybrid strategies. Firstly, the elite opposition-based learning method is utilized to initialize the particle position matrix. Secondly, the dynamic inertial weight parameters are given to improve the global search speed in the early iterative phase. Thirdly, a new local optimal jump-out strategy is proposed to overcome the "premature" problem. Finally, the algorithm applies the spiral shrinkage search strategy from the whale optimization algorithm (WOA) and the Differential Evolution (DE) mutation strategy in the later iteration to accelerate the convergence speed. The NDWPSO is further compared with other 8 well-known nature-inspired algorithms (3 PSO variants and 5 other intelligent algorithms) on 23 benchmark test functions and three practical engineering problems. Simulation results prove that the NDWPSO algorithm obtains better results for all 49 sets of data than the other 3 PSO variants. Compared with 5 other intelligent algorithms, the NDWPSO obtains 69.2%, 84.6%, and 84.6% of the best results for the benchmark function (f 1 - f 13 ) with 3 kinds of dimensional spaces (Dim = 30,50,100) and 80% of the best optimal solutions for 10 fixed-multimodal benchmark functions. Also, the best design solutions are obtained by NDWPSO for all 3 classical practical engineering problems.
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Affiliation(s)
- Jinwei Qiao
- School of Mechanical and Automotive Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
- Shandong Institute of Mechanical Design and Research, Jinan, 250353, China
| | - Guangyuan Wang
- School of Mechanical and Automotive Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
- Shandong Institute of Mechanical Design and Research, Jinan, 250353, China
| | - Zhi Yang
- School of Mechanical and Automotive Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China.
- Shandong Institute of Mechanical Design and Research, Jinan, 250353, China.
| | - Xiaochuan Luo
- School of Information Science and Engineering, Northeastern University, Shenyang, 110819, China
| | - Jun Chen
- School of Mechanical and Automotive Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
- Shandong Institute of Mechanical Design and Research, Jinan, 250353, China
| | - Kan Li
- Fushun Supervision Inspection Institute for Special Equipment, Fushun, 113000, China
| | - Pengbo Liu
- School of Mechanical and Automotive Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
- Shandong Institute of Mechanical Design and Research, Jinan, 250353, China
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3
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Maleki Varnosfaderani S, Forouzanfar M. The Role of AI in Hospitals and Clinics: Transforming Healthcare in the 21st Century. Bioengineering (Basel) 2024; 11:337. [PMID: 38671759 PMCID: PMC11047988 DOI: 10.3390/bioengineering11040337] [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: 02/28/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
As healthcare systems around the world face challenges such as escalating costs, limited access, and growing demand for personalized care, artificial intelligence (AI) is emerging as a key force for transformation. This review is motivated by the urgent need to harness AI's potential to mitigate these issues and aims to critically assess AI's integration in different healthcare domains. We explore how AI empowers clinical decision-making, optimizes hospital operation and management, refines medical image analysis, and revolutionizes patient care and monitoring through AI-powered wearables. Through several case studies, we review how AI has transformed specific healthcare domains and discuss the remaining challenges and possible solutions. Additionally, we will discuss methodologies for assessing AI healthcare solutions, ethical challenges of AI deployment, and the importance of data privacy and bias mitigation for responsible technology use. By presenting a critical assessment of AI's transformative potential, this review equips researchers with a deeper understanding of AI's current and future impact on healthcare. It encourages an interdisciplinary dialogue between researchers, clinicians, and technologists to navigate the complexities of AI implementation, fostering the development of AI-driven solutions that prioritize ethical standards, equity, and a patient-centered approach.
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Affiliation(s)
| | - Mohamad Forouzanfar
- Département de Génie des Systèmes, École de Technologie Supérieure (ÉTS), Université du Québec, Montréal, QC H3C 1K3, Canada
- Centre de Recherche de L’institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W5, Canada
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Cacciamani GE, Chen A, Gill IS, Hung AJ. Artificial intelligence and urology: ethical considerations for urologists and patients. Nat Rev Urol 2024; 21:50-59. [PMID: 37524914 DOI: 10.1038/s41585-023-00796-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 08/02/2023]
Abstract
The use of artificial intelligence (AI) in medicine and in urology specifically has increased over the past few years, during which time it has enabled optimization of patient workflow, increased diagnostic accuracy and enhanced computer analysis of radiological and pathological images. However, before further use of AI is undertaken, possible ethical issues need to be evaluated to improve understanding of this technology and to protect patients and providers. Possible ethical issues that require consideration when applying AI in clinical practice include patient safety, cybersecurity, transparency and interpretability of the data, inclusivity and equity, fostering responsibility and accountability, and the preservation of providers' decision-making and autonomy. Ethical principles for the application of AI to health care and in urology are proposed to guide urologists, patients and regulators to improve use of AI technologies and guide policy-making.
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Affiliation(s)
- Giovanni E Cacciamani
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- AI Center at USC Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA.
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Andrew Chen
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- AI Center at USC Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Inderbir S Gill
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- AI Center at USC Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Andrew J Hung
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- AI Center at USC Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
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Kim K, Byun YJ, Zheng CM, Moon S, Jo SJ, Kang HW, Kim WT, Choi YH, Moon SK, Kim WJ, Piao XM, Yun SJ. COL6A1 expression as a potential prognostic biomarker for risk stratification of T1 high grade bladder cancer: Unveiling the aggressive nature of a distinct non-muscle invasive subtype. Investig Clin Urol 2024; 65:94-103. [PMID: 38197756 PMCID: PMC10789541 DOI: 10.4111/icu.20230227] [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: 07/14/2023] [Revised: 08/23/2023] [Accepted: 10/05/2023] [Indexed: 01/11/2024] Open
Abstract
PURPOSE T1 high grade (T1HG) bladder cancer (BC) is a type of non-muscle invasive BC (NMIBC) that is recognized as an aggressive subtype with a heightened propensity for progression. Current risk stratification methods for NMIBC rely on clinicopathological indicators; however, these approaches do not adequately capture the aggressive nature of T1HG BC. Thus, new, more accurate biomarkers for T1HG risk stratification are needed. Here, we enrolled three different patient cohorts and investigated expression of collagen type VI alpha 1 (COL6A1), a key component of the extracellular matrix, at different stages and grades of BC, with a specific focus on T1HG BC. MATERIALS AND METHODS Samples from 298 BC patients were subjected to RNA sequencing and real-time polymerase chain reaction. RESULTS We found that T1HG BC and muscle invasive BC (MIBC) exhibited comparable expression of COL6A1, which was significantly higher than that by other NMIBC subtypes. In particular, T1HG patients who later progressed to MIBC had considerably higher expression of COL6A1 than Ta, T1 low grade patients, and patients that did not progress, highlighting the aggressive nature and higher risk of progression associated with T1HG BC. Moreover, Cox and Kaplan-Meier survival analyses revealed a significant association between elevated expression of COL6A1 and poor progression-free survival of T1HG BC patients (multivariate Cox hazard ratio, 16.812; 95% confidence interval, 3.283-86.095; p=0.001 and p=0.0002 [log-rank test]). CONCLUSIONS These findings suggest that COL6A1 may be a promising biomarker for risk stratification of T1HG BC, offering valuable insight into disease prognosis and guidance of personalized treatment decisions.
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Affiliation(s)
- Kyeong Kim
- Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
| | - Young Joon Byun
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Chuang-Ming Zheng
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sungmin Moon
- Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
- Department of Convergence of Medical Science, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Soo Jeong Jo
- Department of Convergence of Medical Science, Chungbuk National University College of Medicine, Cheongju, Korea
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Ho Won Kang
- Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Won Tae Kim
- Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Yung Hyun Choi
- Department of Biochemistry, College of Oriental Medicine, Dong-Eui University, Busan, Korea
| | - Sung-Kwon Moon
- Department of Food Science and Technology, Chung-Ang University, Ansung, Korea
| | | | - Xuan-Mei Piao
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea.
| | - Seok Joong Yun
- Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea.
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Bazarkin A, Morozov A, Androsov A, Fajkovic H, Rivas JG, Singla N, Koroleva S, Teoh JYC, Zvyagin AV, Shariat SF, Somani B, Enikeev D. Assessment of Prostate and Bladder Cancer Genomic Biomarkers Using Artificial Intelligence: a Systematic Review. Curr Urol Rep 2024; 25:19-35. [PMID: 38099997 DOI: 10.1007/s11934-023-01193-2] [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] [Accepted: 12/01/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE OF REVIEW The aim of the systematic review is to assess AI's capabilities in the genetics of prostate cancer (PCa) and bladder cancer (BCa) to evaluate target groups for such analysis as well as to assess its prospects in daily practice. RECENT FINDINGS In total, our analysis included 27 articles: 10 articles have reported on PCa and 17 on BCa, respectively. The AI algorithms added clinical value and demonstrated promising results in several fields, including cancer detection, assessment of cancer development risk, risk stratification in terms of survival and relapse, and prediction of response to a specific therapy. Besides clinical applications, genetic analysis aided by the AI shed light on the basic urologic cancer biology. We believe, our results of the AI application to the analysis of PCa, BCa data sets will help to identify new targets for urological cancer therapy. The integration of AI in genomic research for screening and clinical applications will evolve with time to help personalizing chemotherapy, prediction of survival and relapse, aid treatment strategies such as reducing frequency of diagnostic cystoscopies, and clinical decision support, e.g., by predicting immunotherapy response. These factors will ultimately lead to personalized and precision medicine thereby improving patient outcomes.
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Affiliation(s)
- Andrey Bazarkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Andrey Morozov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Alexander Androsov
- Department of Pediatric Surgery, Division of Pediatric Urology and Andrology, Sechenov University, Moscow, Russia
| | - Harun Fajkovic
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
| | - Juan Gomez Rivas
- Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain
| | - Nirmish Singla
- School of Medicine, Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Svetlana Koroleva
- Clinical Institute for Children Health Named After N.F. Filatov, Sechenov University, Moscow, Russia
| | - Jeremy Yuen-Chun Teoh
- Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Andrei V Zvyagin
- Institute of Molecular Theranostics, Sechenov University, Moscow, Russia
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences, 117997, Moscow, Russia
| | - Shahrokh François Shariat
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Bhaskar Somani
- Department of Urology, University Hospital Southampton, Southampton, United Kingdom
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
- Division of Urology, Rabin Medical Center, Petah Tikva, Israel.
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Froń A, Semianiuk A, Lazuk U, Ptaszkowski K, Siennicka A, Lemiński A, Krajewski W, Szydełko T, Małkiewicz B. Artificial Intelligence in Urooncology: What We Have and What We Expect. Cancers (Basel) 2023; 15:4282. [PMID: 37686558 PMCID: PMC10486651 DOI: 10.3390/cancers15174282] [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: 07/17/2023] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION Artificial intelligence is transforming healthcare by driving innovation, automation, and optimization across various fields of medicine. The aim of this study was to determine whether artificial intelligence (AI) techniques can be used in the diagnosis, treatment planning, and monitoring of urological cancers. METHODOLOGY We conducted a thorough search for original and review articles published until 31 May 2022 in the PUBMED/Scopus database. Our search included several terms related to AI and urooncology. Articles were selected with the consensus of all authors. RESULTS Several types of AI can be used in the medical field. The most common forms of AI are machine learning (ML), deep learning (DL), neural networks (NNs), natural language processing (NLP) systems, and computer vision. AI can improve various domains related to the management of urologic cancers, such as imaging, grading, and nodal staging. AI can also help identify appropriate diagnoses, treatment options, and even biomarkers. In the majority of these instances, AI is as accurate as or sometimes even superior to medical doctors. CONCLUSIONS AI techniques have the potential to revolutionize the diagnosis, treatment, and monitoring of urologic cancers. The use of AI in urooncology care is expected to increase in the future, leading to improved patient outcomes and better overall management of these tumors.
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Affiliation(s)
- Anita Froń
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.S.); (U.L.); (W.K.); (T.S.)
| | - Alina Semianiuk
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.S.); (U.L.); (W.K.); (T.S.)
| | - Uladzimir Lazuk
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.S.); (U.L.); (W.K.); (T.S.)
| | - Kuba Ptaszkowski
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Agnieszka Siennicka
- Department of Physiology and Pathophysiology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Artur Lemiński
- Department of Urology and Urological Oncology, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.S.); (U.L.); (W.K.); (T.S.)
| | - Tomasz Szydełko
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.S.); (U.L.); (W.K.); (T.S.)
| | - Bartosz Małkiewicz
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.S.); (U.L.); (W.K.); (T.S.)
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Predicting Recurrence of Non-Muscle-Invasive Bladder Cancer: Current Techniques and Future Trends. Cancers (Basel) 2022; 14:cancers14205019. [PMID: 36291803 PMCID: PMC9599984 DOI: 10.3390/cancers14205019] [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: 08/25/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 11/17/2022] Open
Abstract
Bladder cancer (BC) is the 10th most common cancer globally and has a high mortality rate if not detected early and treated promptly. Non-muscle-invasive BC (NMIBC) is a subclassification of BC associated with high rates of recurrence and progression. Current tools for predicting recurrence and progression on NMIBC use scoring systems based on clinical and histopathological markers. These exclude other potentially useful biomarkers which could provide a more accurate personalized risk assessment. Future trends are likely to use artificial intelligence (AI) to enhance the prediction of recurrence in patients with NMIBC and decrease the use of standard clinical protocols such as cystoscopy and cytology. Here, we provide a comprehensive survey of the most recent studies from the last decade (N = 70 studies), focused on the prediction of patient outcomes in NMIBC, particularly recurrence, using biomarkers such as radiomics, histopathology, clinical, and genomics. The value of individual and combined biomarkers is discussed in detail with the goal of identifying future trends that will lead to the personalized management of NMIBC.
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Zhang Y, Hua S, Jiang Q, Xie Z, Wu L, Wang X, Shi F, Dong S, Jiang J. Identification of Feature Genes of a Novel Neural Network Model for Bladder Cancer. Front Genet 2022; 13:912171. [PMID: 35719407 PMCID: PMC9198295 DOI: 10.3389/fgene.2022.912171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The combination of deep learning methods and oncogenomics can provide an effective diagnostic method for malignant tumors; thus, we attempted to construct a reliable artificial neural network model as a novel diagnostic tool for Bladder cancer (BLCA). Methods: Three expression profiling datasets (GSE61615, GSE65635, and GSE100926) were downloaded from the Gene Expression Omnibus (GEO) database. GSE61615 and GSE65635 were taken as the train group, while GSE100926 was set as the test group. Differentially expressed genes (DEGs) were filtered out based on the logFC and FDR values. We also performed Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses to explore the biological functions of the DEGs. Consequently, we utilized a random forest algorithm to identify feature genes and further constructed a neural network model. The test group was given the same procedures to validate the reliability of the model. We also explored immune cells' infiltration degree and correlation coefficients through the CiberSort algorithm and corrplot R package. The qRT-PCR assay was implemented to examine the expression level of the feature genes in vitro. Results: A total of 265 DEGs were filtered out and significantly enriched in muscle system processes, collagen-containing and focal adhesion signaling pathways. Based on the random forest algorithm, we selected 14 feature genes to construct the neural network model. The area under the curve (AUC) of the training group was 0.950 (95% CI: 0.850-1.000), and the AUC of the test group was 0.667 (95% CI: 0.333-1.000). Besides, we observed significant differences in the content of immune infiltrating cells and the expression levels of the feature genes. Conclusion: After repeated verification, our neural network model had clinical feasibility to identify bladder cancer patients and provided a potential target to improve the management of BLCA.
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Affiliation(s)
- Yongqing Zhang
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shan Hua
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiheng Jiang
- Department of Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiwen Xie
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Wu
- Department of Urology, Shanghai General Hospital, Nanjing Medical University School of Medicine, Shanghai, China
| | - Xinjie Wang
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Shi
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengli Dong
- Nursing Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juntao Jiang
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Dlamini Z, Skepu A, Kim N, Mkhabele M, Khanyile R, Molefi T, Mbatha S, Setlai B, Mulaudzi T, Mabongo M, Bida M, Kgoebane-Maseko M, Mathabe K, Lockhat Z, Kgokolo M, Chauke-Malinga N, Ramagaga S, Hull R. AI and precision oncology in clinical cancer genomics: From prevention to targeted cancer therapies-an outcomes based patient care. INFORMATICS IN MEDICINE UNLOCKED 2022. [DOI: 10.1016/j.imu.2022.100965] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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11
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İnce O, Yıldız H, Kisbet T, Ertürk ŞM, Önder H. Classification of retinoblastoma-1 gene mutation with machine learning-based models in bladder cancer. Heliyon 2022; 8:e09311. [PMID: 35520623 PMCID: PMC9061624 DOI: 10.1016/j.heliyon.2022.e09311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/19/2022] [Accepted: 04/20/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose This study aims to evaluate the potential of machine learning algorithms built with radiomics features from computed tomography urography (CTU) images that classify RB1 gene mutation status in bladder cancer. Method The study enrolled CTU images of 18 patients with and 54 without RB1 mutation from a public database. Image and data preprocessing were performed after data augmentation. Feature selection steps were consisted of filter and wrapper methods. Pearson’s correlation analysis was the filter, and a wrapper-based sequential feature selection algorithm was the wrapper. Models with XGBoost, Random Forest (RF), and k-Nearest Neighbors (kNN) algorithms were developed. Performance metrics of the models were calculated. Models’ performances were compared by using Friedman’s test. Results 8 features were selected from 851 total extracted features. Accuracy, sensitivity, specificity, precision, recall, F1 measure and AUC were 84%, 80%, 88%, 86%, 80%, 0.83 and 0.84, for XGBoost; 72%, 80%, 65%, 67%, 80%, 0.73 and 0.72 for RF; 66%, 53%, 76%, 67%, 53%, 0.60 and 0.65 for kNN, respectively. XGBoost model had outperformed kNN model in Friedman’s test (p = 0.006). Conclusions Machine learning algorithms with radiomics features from CTU images show promising results in classifying bladder cancer by RB1 mutation status non-invasively.
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Affiliation(s)
- Okan İnce
- Health Sciences University Prof. Dr. Cemil Tascioglu City Hospital, Department of Radiology, Turkey
- Corresponding author.
| | - Hülya Yıldız
- Health Sciences University Prof. Dr. Cemil Tascioglu City Hospital, Department of Radiology, Turkey
| | - Tanju Kisbet
- Health Sciences University Prof. Dr. Cemil Tascioglu City Hospital, Department of Radiology, Turkey
| | - Şükrü Mehmet Ertürk
- Istanbul University Istanbul Medical Faculty, Department of Radiology, Turkey
| | - Hakan Önder
- Health Sciences University Prof. Dr. Cemil Tascioglu City Hospital, Department of Radiology, Turkey
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12
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Pasha N, Turner NC. Understanding and overcoming tumor heterogeneity in metastatic breast cancer treatment. NATURE CANCER 2022; 2:680-692. [PMID: 35121946 DOI: 10.1038/s43018-021-00229-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 06/02/2021] [Indexed: 12/28/2022]
Abstract
Rational development of targeted therapies has revolutionized metastatic breast cancer outcomes, although resistance to treatment remains a major challenge. Advances in molecular profiling and imaging technologies have provided evidence for the impact of clonal diversity in cancer treatment resistance, through the outgrowth of resistant clones. In this Review, we focus on the genomic processes that drive tumoral heterogeneity and the mechanisms of resistance underlying metastatic breast cancer treatment and discuss implications for future treatment strategies.
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Affiliation(s)
- Nida Pasha
- Breast Cancer Now Toby Robins Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
| | - Nicholas C Turner
- Breast Cancer Now Toby Robins Breast Cancer Research Centre, The Institute of Cancer Research, London, UK. .,Ralph Lauren Centre for Breast Cancer Research and Breast Unit, Royal Marsden Hospital, London, UK.
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13
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Zhao X, Fang Y, Liu L, Xu M, Li Q. A covariance-based Moth-flame optimization algorithm with Cauchy mutation for solving numerical optimization problems. Appl Soft Comput 2022. [DOI: 10.1016/j.asoc.2022.108538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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14
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Qin P, Hu H, Yang Z. The improved grasshopper optimization algorithm and its applications. Sci Rep 2021; 11:23733. [PMID: 34887483 PMCID: PMC8660903 DOI: 10.1038/s41598-021-03049-6] [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: 10/11/2021] [Accepted: 11/26/2021] [Indexed: 11/09/2022] Open
Abstract
Grasshopper optimization algorithm (GOA) proposed in 2017 mimics the behavior of grasshopper swarms in nature for solving optimization problems. In the basic GOA, the influence of the gravity force on the updated position of every grasshopper is not considered, which possibly causes GOA to have the slower convergence speed. Based on this, the improved GOA (IGOA) is obtained by the two updated ways of the position of every grasshopper in this paper. One is that the gravity force is introduced into the updated position of every grasshopper in the basic GOA. And the other is that the velocity is introduced into the updated position of every grasshopper and the new position are obtained from the sum of the current position and the velocity. Then every grasshopper adopts its suitable way of the updated position on the basis of the probability. Finally, IGOA is firstly performed on the 23 classical benchmark functions and then is combined with BP neural network to establish the predicted model IGOA-BPNN by optimizing the parameters of BP neural network for predicting the closing prices of the Shanghai Stock Exchange Index and the air quality index (AQI) of Taiyuan, Shanxi Province. The experimental results show that IGOA is superior to the compared algorithms in term of the average values and the predicted model IGOA-BPNN has the minimal predicted errors. Therefore, the proposed IGOA is an effective and efficient algorithm for optimization.
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Affiliation(s)
- Peng Qin
- School of Electrical and Control Engineering, North University of China, Taiyuan, 030051, Shanxi, China. .,Shanxi Key Laboratory of Information Detection and Processing, Taiyuan, 030051, Shanxi, China.
| | - Hongping Hu
- School of Science, North University of China, Taiyuan, 030051, Shanxi, China
| | - Zhengmin Yang
- School of Science, North University of China, Taiyuan, 030051, Shanxi, China
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15
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Brodie A, Dai N, Teoh JYC, Decaestecker K, Dasgupta P, Vasdev N. Artificial intelligence in urological oncology: An update and future applications. Urol Oncol 2021; 39:379-399. [PMID: 34024704 DOI: 10.1016/j.urolonc.2021.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 12/20/2020] [Accepted: 03/21/2021] [Indexed: 01/16/2023]
Abstract
There continues to be rapid developments and research in the field of Artificial Intelligence (AI) in Urological Oncology worldwide. In this review we discuss the basics of AI, application of AI per tumour group (Renal, Prostate and Bladder Cancer) and application of AI in Robotic Urological Surgery. We also discuss future applications of AI being developed with the benefits to patients with Urological Oncology.
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Affiliation(s)
- Andrew Brodie
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Nick Dai
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Prokar Dasgupta
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Nikhil Vasdev
- Hertfordshire and Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, United Kingdom; School of Medicine and Life Sciences, University of Hertfordshire, Hatfield, United Kingdom.
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16
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Artificial Intelligence and Its Impact on Urological Diseases and Management: A Comprehensive Review of the Literature. J Clin Med 2021; 10:jcm10091864. [PMID: 33925767 PMCID: PMC8123407 DOI: 10.3390/jcm10091864] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/04/2021] [Accepted: 04/08/2021] [Indexed: 12/22/2022] Open
Abstract
Recent advances in artificial intelligence (AI) have certainly had a significant impact on the healthcare industry. In urology, AI has been widely adopted to deal with numerous disorders, irrespective of their severity, extending from conditions such as benign prostate hyperplasia to critical illnesses such as urothelial and prostate cancer. In this article, we aim to discuss how algorithms and techniques of artificial intelligence are equipped in the field of urology to detect, treat, and estimate the outcomes of urological diseases. Furthermore, we explain the advantages that come from using AI over any existing traditional methods.
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17
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Gandi C, Vaccarella L, Bientinesi R, Racioppi M, Pierconti F, Sacco E. Bladder cancer in the time of machine learning: Intelligent tools for diagnosis and management. Urologia 2021; 88:94-102. [PMID: 33402061 DOI: 10.1177/0391560320987169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Machine learning (ML) is the subfield of artificial intelligence (AI), born from the marriage between statistics and computer science, with the unique purpose of building prediction algorithms able to improve their performances by automatically learning from massive data sets. The availability of ever-growing computational power and highly evolved pattern recognition software has led to the spread of ML-based systems able to perform complex tasks in bioinformatics, medical imaging, and diagnostics. These intelligent tools could be the answer to the unmet need for non-invasive and patient-tailored instruments for the diagnosis and management of bladder cancer (BC), which are still based on old technologies and unchanged nomograms. We reviewed the most significant evidence on ML in the diagnosis, prognosis, and management of bladder cancer, to find out if these intelligent technologies are ready to be introduced into the daily clinical practice of the urologist.
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Affiliation(s)
- Carlo Gandi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Vaccarella
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Bientinesi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Racioppi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Pierconti
- Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emilio Sacco
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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18
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Shah M, Naik N, Somani BK, Hameed BMZ. Artificial intelligence (AI) in urology-Current use and future directions: An iTRUE study. Turk J Urol 2020; 46:S27-S39. [PMID: 32479253 PMCID: PMC7731952 DOI: 10.5152/tud.2020.20117] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/12/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Artificial intelligence (AI) is used in various urological conditions such as urolithiasis, pediatric urology, urogynecology, benign prostate hyperplasia (BPH), renal transplant, and uro-oncology. The various models of AI and its application in urology subspecialties are reviewed and discussed. MATERIAL AND METHODS Search strategy was adapted to identify and review the literature pertaining to the application of AI in urology using the keywords "urology," "artificial intelligence," "machine learning," "deep learning," "artificial neural networks," "computer vision," and "natural language processing" were included and categorized. Review articles, editorial comments, and non-urologic studies were excluded. RESULTS The article reviewed 47 articles that reported characteristics and implementation of AI in urological cancer. In all cases with benign conditions, artificial intelligence was used to predict outcomes of the surgical procedure. In urolithiasis, it was used to predict stone composition, whereas in pediatric urology and BPH, it was applied to predict the severity of condition. In cases with malignant conditions, it was applied to predict the treatment response, survival, prognosis, and recurrence on the basis of the genomic and biomarker studies. These results were also found to be statistically better than routine approaches. Application of radiomics in classification and nuclear grading of renal masses, cystoscopic diagnosis of bladder cancers, predicting Gleason score, and magnetic resonance imaging with computer-assisted diagnosis for prostate cancers are few applications of AI that have been studied extensively. CONCLUSIONS In the near future, we will see a shift in the clinical paradigm as AI applications will find their place in the guidelines and revolutionize the decision-making process.
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Affiliation(s)
- Milap Shah
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
- i-TRUE: International Training and Research in Uro-oncology and Endourology, Manipal, Karnataka, India
| | - Nithesh Naik
- i-TRUE: International Training and Research in Uro-oncology and Endourology, Manipal, Karnataka, India
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Bhaskar K. Somani
- i-TRUE: International Training and Research in Uro-oncology and Endourology, Manipal, Karnataka, India
- Department of Urological Surgery, University Hospital Southampton NHS Trust, Southampton, UK
| | - BM Zeeshan Hameed
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
- i-TRUE: International Training and Research in Uro-oncology and Endourology, Manipal, Karnataka, India
- KMC Innovation Centre, Manipal Academy of Higher Education, Manipal, Karnataka, India
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19
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The world is only ten years old: The dawn of artificial intelligence in urologic oncology. Urol Oncol 2020; 38:646-649. [DOI: 10.1016/j.urolonc.2020.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/17/2022]
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20
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Network modeling of patients' biomolecular profiles for clinical phenotype/outcome prediction. Sci Rep 2020; 10:3612. [PMID: 32107391 PMCID: PMC7046773 DOI: 10.1038/s41598-020-60235-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 11/05/2019] [Indexed: 12/15/2022] Open
Abstract
Methods for phenotype and outcome prediction are largely based on inductive supervised models that use selected biomarkers to make predictions, without explicitly considering the functional relationships between individuals. We introduce a novel network-based approach named Patient-Net (P-Net) in which biomolecular profiles of patients are modeled in a graph-structured space that represents gene expression relationships between patients. Then a kernel-based semi-supervised transductive algorithm is applied to the graph to explore the overall topology of the graph and to predict the phenotype/clinical outcome of patients. Experimental tests involving several publicly available datasets of patients afflicted with pancreatic, breast, colon and colorectal cancer show that our proposed method is competitive with state-of-the-art supervised and semi-supervised predictive systems. Importantly, P-Net also provides interpretable models that can be easily visualized to gain clues about the relationships between patients, and to formulate hypotheses about their stratification.
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21
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Suarez-Ibarrola R, Hein S, Reis G, Gratzke C, Miernik A. Current and future applications of machine and deep learning in urology: a review of the literature on urolithiasis, renal cell carcinoma, and bladder and prostate cancer. World J Urol 2019; 38:2329-2347. [PMID: 31691082 DOI: 10.1007/s00345-019-03000-5] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/25/2019] [Indexed: 01/15/2023] Open
Abstract
PURPOSE The purpose of the study was to provide a comprehensive review of recent machine learning (ML) and deep learning (DL) applications in urological practice. Numerous studies have reported their use in the medical care of various urological disorders; however, no critical analysis has been made to date. METHODS A detailed search of original articles was performed using the PubMed MEDLINE database to identify recent English literature relevant to ML and DL applications in the fields of urolithiasis, renal cell carcinoma (RCC), bladder cancer (BCa), and prostate cancer (PCa). RESULTS In total, 43 articles were included addressing these four subfields. The most common ML and DL application in urolithiasis is in the prediction of endourologic surgical outcomes. The main area of research involving ML and DL in RCC concerns the differentiation between benign and malignant small renal masses, Fuhrman nuclear grade prediction, and gene expression-based molecular signatures. BCa studies employ radiomics and texture feature analysis for the distinction between low- and high-grade tumors, address accurate image-based cytology, and use algorithms to predict treatment response, tumor recurrence, and patient survival. PCa studies aim at developing algorithms for Gleason score prediction, MRI computer-aided diagnosis, and surgical outcomes and biochemical recurrence prediction. Studies consistently found the superiority of these methods over traditional statistical methods. CONCLUSIONS The continuous incorporation of clinical data, further ML and DL algorithm retraining, and generalizability of models will augment the prediction accuracy and enhance individualized medicine.
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Affiliation(s)
- Rodrigo Suarez-Ibarrola
- Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Simon Hein
- Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Gerd Reis
- Department Augmented Vision, German Research Center for Artificial Intelligence, Kaiserslautern, Germany
| | - Christian Gratzke
- Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Arkadiusz Miernik
- Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Hugstetter Str. 55, 79106, Freiburg, Germany
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22
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Chen J, Remulla D, Nguyen JH, Dua A, Liu Y, Dasgupta P, Hung AJ. Current status of artificial intelligence applications in urology and their potential to influence clinical practice. BJU Int 2019; 124:567-577. [PMID: 31219658 DOI: 10.1111/bju.14852] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the applications of artificial intelligence (AI) in diagnosis, treatment and outcome predictionin urologic diseases and evaluate its advantages over traditional models and methods. MATERIALS AND METHODS A literature search was performed after PROSPERO registration (CRD42018103701) and in compliance with Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) methods. Articles between 1994 and 2018 using the search terms "urology", "artificial intelligence", "machine learning" were included and categorized by the application of AI in urology. Review articles, editorial comments, articles with no full-text access, and nonurologic studies were excluded. RESULTS Initial search yielded 231 articles, but after excluding duplicates and following full-text review and examination of article references, only 111 articles were included in the final analysis. AI applications in urology include: utilizing radiomic imaging or ultrasonic echo data to improve or automate cancer detection or outcome prediction, utilizing digitized tissue specimen images to automate detection of cancer on pathology slides, and combining patient clinical data, biomarkers, or gene expression to assist disease diagnosis or outcome prediction. Some studies employed AI to plan brachytherapy and radiation treatments while others used video based or robotic automated performance metrics to objectively evaluate surgical skill. Compared to conventional statistical analysis, 71.8% of studies concluded that AI is superior in diagnosis and outcome prediction. CONCLUSION AI has been widely adopted in urology. Compared to conventional statistics AI approaches are more accurate in prediction and more explorative for analyzing large data cohorts. With an increasing library of patient data accessible to clinicians, AI may help facilitate evidence-based and individualized patient care.
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Affiliation(s)
- Jian Chen
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
| | - Daphne Remulla
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
| | - Jessica H Nguyen
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
| | - Aastha Dua
- Computer Science Department, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Yan Liu
- Computer Science Department, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Prokar Dasgupta
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Andrew J Hung
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation & Education, University of Southern California Institute of Urology, Los Angeles, CA, USA
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23
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Xu J, Yang P, Xue S, Sharma B, Sanchez-Martin M, Wang F, Beaty KA, Dehan E, Parikh B. Translating cancer genomics into precision medicine with artificial intelligence: applications, challenges and future perspectives. Hum Genet 2019; 138:109-124. [PMID: 30671672 PMCID: PMC6373233 DOI: 10.1007/s00439-019-01970-5] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/02/2019] [Indexed: 02/07/2023]
Abstract
In the field of cancer genomics, the broad availability of genetic information offered by next-generation sequencing technologies and rapid growth in biomedical publication has led to the advent of the big-data era. Integration of artificial intelligence (AI) approaches such as machine learning, deep learning, and natural language processing (NLP) to tackle the challenges of scalability and high dimensionality of data and to transform big data into clinically actionable knowledge is expanding and becoming the foundation of precision medicine. In this paper, we review the current status and future directions of AI application in cancer genomics within the context of workflows to integrate genomic analysis for precision cancer care. The existing solutions of AI and their limitations in cancer genetic testing and diagnostics such as variant calling and interpretation are critically analyzed. Publicly available tools or algorithms for key NLP technologies in the literature mining for evidence-based clinical recommendations are reviewed and compared. In addition, the present paper highlights the challenges to AI adoption in digital healthcare with regard to data requirements, algorithmic transparency, reproducibility, and real-world assessment, and discusses the importance of preparing patients and physicians for modern digitized healthcare. We believe that AI will remain the main driver to healthcare transformation toward precision medicine, yet the unprecedented challenges posed should be addressed to ensure safety and beneficial impact to healthcare.
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Affiliation(s)
- Jia Xu
- IBM Watson Health, Cambridge, MA, USA.
| | | | - Shang Xue
- IBM Watson Health, Cambridge, MA, USA
| | | | | | - Fang Wang
- IBM Watson Health, Cambridge, MA, USA
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24
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Fernandes MNDF, Esteves RB, Teixeira CAB, Gherardi-Donato ECDS. The present and the future of Nursing in the Brave New World. Rev Esc Enferm USP 2018; 52:e03356. [PMID: 30043931 DOI: 10.1590/s1980-220x2017031603356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 02/27/2018] [Indexed: 11/21/2022] Open
Abstract
The "Brave New World" envisioned a society dominated by scientific and technological progress that went as far as to subjugate and dehumanize human beings. The future foreseen in this literary work is not far from what we are currently experiencing. Thus, considering that Nursing is affected and challenged in the midst of these technological transformations, this article aims to discuss the present and future of Nursing in a society that is undergoing constant technological transformations. In the midst of a whole technological apparatus in which fundamental procedures begin to be carried out by machines, Nursing needs to begin reflecting on what would be the best posture or its differential in a world with strong technological tendencies. Future transformations are still uncertain, nonetheless they will drastically change the way individuals relate to one another and to health services. Even in the midst of these uncertainties arising from present and future technological and scientific advances, the nature of Nursing which is essentially based on human interactions, can guarantee a place of prominence for this profession in society.
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Affiliation(s)
- Maria Neyrian de Fátima Fernandes
- Universidade Federal do Maranhão, Coordenação de Enfermagem, Imperatriz, MA, Brasil.,Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação em Enfermagem Psiquiátrica e Ciências Humanas, Ribeirão Preto, SP, Brasil
| | - Rafael Braga Esteves
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação em Enfermagem Psiquiátrica e Ciências Humanas, Ribeirão Preto, SP, Brasil
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26
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Abstract
Clinical outcomes for patients with bladder cancer have largely remained unchanged over the last three decades despite improvements in surgical techniques, perioperative therapies, and postoperative management. Current management still heavily relies on pathologic staging that does not always reflect an individual patient's risk. The genesis and progression of bladder cancer is now increasingly recognized as being a result of alterations in several pathways that affect the cell cycle, apoptosis, cellular signaling, gene regulation, immune modulation, angiogenesis, and tumor cell invasion. Multiplexed assessment of biomarkers associated with alterations in these pathways offers novel insights into tumor behavior while identifying panels that are capable of reproducibly predicting patient outcomes. Future management of bladder cancer will likely incorporate such prognostic molecular models for risk stratification and treatment personalization.
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Affiliation(s)
- Anirban P Mitra
- Institute of Urology, Keck School of Medicine of the University of Southern California, 1441 Eastlake Avenue, Suite 7416, MC 9178, Los Angeles, CA, 90033, USA.
| | - Siamak Daneshmand
- Institute of Urology, Keck School of Medicine of the University of Southern California, 1441 Eastlake Avenue, Suite 7416, MC 9178, Los Angeles, CA, 90033, USA
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27
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Lopez D, Montoya D, Ambrose M, Lam L, Briscoe L, Adams C, Modlin RL, Pellegrini M. SaVanT: a web-based tool for the sample-level visualization of molecular signatures in gene expression profiles. BMC Genomics 2017; 18:824. [PMID: 29070035 PMCID: PMC5657101 DOI: 10.1186/s12864-017-4167-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/05/2017] [Indexed: 02/07/2023] Open
Abstract
Background Molecular signatures are collections of genes characteristic of a particular cell type, tissue, disease, or perturbation. Signatures can also be used to interpret expression profiles generated from heterogeneous samples. Large collections of gene signatures have been previously developed and catalogued in the MSigDB database. In addition, several consortia and large-scale projects have systematically profiled broad collections of purified primary cells, molecular perturbations of cell types, and tissues from specific diseases, and the specificity and breadth of these datasets can be leveraged to create additional molecular signatures. However, to date there are few tools that allow the visualization of individual signatures across large numbers of expression profiles. Signature visualization of individual samples allows, for example, the identification of patient subcategories a priori on the basis of well-defined molecular signatures. Result Here, we generate and compile 10,985 signatures (636 newly-generated and 10,349 previously available from MSigDB) and provide a web-based Signature Visualization Tool (SaVanT; http://newpathways.mcdb.ucla.edu/savant), to visualize these signatures in user-generated expression data. We show that using SaVanT, immune activation signatures can distinguish patients with different types of acute infections (influenza A and bacterial pneumonia). Furthermore, SaVanT is able to identify the prominent signatures within each patient group, and identify the primary cell types underlying different leukemias (acute myeloid and acute lymphoblastic) and skin disorders. Conclusions The development of SaVanT facilitates large-scale analysis of gene expression profiles on a patient-level basis to identify patient subphenotypes, or potential therapeutic target pathways. Electronic supplementary material The online version of this article (10.1186/s12864-017-4167-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David Lopez
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA, 90095, USA
| | - Dennis Montoya
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA, 90095, USA
| | - Michael Ambrose
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA, 90095, USA
| | - Larry Lam
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA, 90095, USA
| | - Leah Briscoe
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA, 90095, USA
| | - Claire Adams
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA, 90095, USA
| | - Robert L Modlin
- Division of Dermatology, David Geffen School of Medicine, University of California, Los Angeles, CA, 90095, USA.,Department of Microbiology, Immunology and Molecular Genetics, University of California, Los Angeles, CA, 90095, USA
| | - Matteo Pellegrini
- Department of Molecular, Cell, and Developmental Biology, University of California, Los Angeles, CA, 90095, USA.
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28
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Amini E. Re: The Timing of Radical Cystectomy for bacillus Calmette-Guérin Failure: Comparison of Outcomes and Risk Factors for Prognosis: C. R. Haas, L. J. Barlow, G. M. Badalato, G. J. DeCastro, M. C. Benson and J. M. McKiernan J Urol 2016;195:1704-1709. J Urol 2016; 196:1589. [PMID: 27479524 DOI: 10.1016/j.juro.2016.06.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Erfan Amini
- Department of Urology, Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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lncRNA Up-Regulated in Nonmuscle Invasive Bladder Cancer Facilitates Tumor Growth and Acts as a Negative Prognostic Factor of Recurrence. J Urol 2016; 196:1270-8. [PMID: 27267320 DOI: 10.1016/j.juro.2016.05.107] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 10/21/2022]
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Yun SJ, Kim SK, Kim WJ. How do we manage high-grade T1 bladder cancer? Conservative or aggressive therapy? Investig Clin Urol 2016; 57 Suppl 1:S44-51. [PMID: 27326407 PMCID: PMC4910762 DOI: 10.4111/icu.2016.57.s1.s44] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 05/06/2016] [Indexed: 11/24/2022] Open
Abstract
High-grade T1 bladder cancer has a poor prognosis due to a higher incidence of recurrence and progression than other nonmuscle invasive bladder cancer; thus patients with high-grade T1 have to be carefully monitored and managed. If patients are diagnosed with high-grade T1 at initial transurethral resection (TUR), a second TUR is strongly recommended regardless of whether muscle layer is present in the specimen because of the possibility of understating due to incomplete resection. Since high-grade T1 disease shows diverse clinical courses, individual approaches are recommended for treatment. In cases with low risk of progression, cystectomy could represent overtreatment and deteriorate quality of life irreversibly, while, in those with high risk, bacillus Calmette-Guérin (BCG) therapy may worsen survival by delaying definitive therapy. Therefore, a strategy for predicting prognosis based on the risk of progression is needed for managing high-grade T1 disease. Molecular risk classifiers predicting the risk of progression and response to BCG may help identify the optimal management of high-grade T1 disease for each individual.
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Affiliation(s)
- Seok Joong Yun
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Seon-Kyu Kim
- Medical Genomics Research Center, Research Institute of Bioscience and Biotechnology, Daejeon, Korea.; Korean Bioinformation Center, Research Institute of Bioscience and Biotechnology, Daejeon, Korea
| | - Wun-Jae Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
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