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Liu H, Huang J, Li Q, Guan X, Tseng M. A deep convolutional neural network for the automatic segmentation of glioblastoma brain tumor: Joint spatial pyramid module and attention mechanism network. Artif Intell Med 2024; 148:102776. [PMID: 38325925 DOI: 10.1016/j.artmed.2024.102776] [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: 12/20/2023] [Accepted: 01/14/2024] [Indexed: 02/09/2024]
Abstract
This study proposes a deep convolutional neural network for the automatic segmentation of glioblastoma brain tumors, aiming sat replacing the manual segmentation method that is both time-consuming and labor-intensive. There are many challenges for automatic segmentation to finely segment sub-regions from multi-sequence magnetic resonance images because of the complexity and variability of glioblastomas, such as the loss of boundary information, misclassified regions, and subregion size. To overcome these challenges, this study introduces a spatial pyramid module and attention mechanism to the automatic segmentation algorithm, which focuses on multi-scale spatial details and context information. The proposed method has been tested in the public benchmarks BraTS 2018, BraTS 2019, BraTS 2020 and BraTS 2021 datasets. The Dice score on the enhanced tumor, whole tumor, and tumor core were respectively 79.90 %, 89.63 %, and 85.89 % on the BraTS 2018 dataset, respectively 77.14 %, 89.58 %, and 83.33 % on the BraTS 2019 dataset, and respectively 77.80 %, 90.04 %, and 83.18 % on the BraTS 2020 dataset, and respectively 83.48 %, 90.70 %, and 88.94 % on the BraTS 2021 dataset offering performance on par with that of state-of-the-art methods with only 1.90 M parameters. In addition, our approach significantly reduced the requirements for experimental equipment, and the average time taken to segment one case was only 1.48 s; these two benefits rendered the proposed network intensely competitive for clinical practice.
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Affiliation(s)
- Hengxin Liu
- School of Microelectronics, Tianjin University, Tianjin, China
| | - Jingteng Huang
- School of Microelectronics, Tianjin University, Tianjin, China
| | - Qiang Li
- School of Microelectronics, Tianjin University, Tianjin, China
| | - Xin Guan
- School of Microelectronics, Tianjin University, Tianjin, China.
| | - Minglang Tseng
- Institute of Innovation and Circular Economy, Asia University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan; UKM-Graduate School of Business, Universiti Kebangsaan Malaysia, 43000 Bangi, Selangor, Malaysia; Department of Industrial Engineering, Khon Kaen University, 40002, Thailand.
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Bravo-Vázquez LA, Méndez-García A, Rodríguez AL, Sahare P, Pathak S, Banerjee A, Duttaroy AK, Paul S. Applications of nanotechnologies for miRNA-based cancer therapeutics: current advances and future perspectives. Front Bioeng Biotechnol 2023; 11:1208547. [PMID: 37576994 PMCID: PMC10416113 DOI: 10.3389/fbioe.2023.1208547] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023] Open
Abstract
MicroRNAs (miRNAs) are short (18-25 nt), non-coding, widely conserved RNA molecules responsible for regulating gene expression via sequence-specific post-transcriptional mechanisms. Since the human miRNA transcriptome regulates the expression of a number of tumor suppressors and oncogenes, its dysregulation is associated with the clinical onset of different types of cancer. Despite the fact that numerous therapeutic approaches have been designed in recent years to treat cancer, the complexity of the disease manifested by each patient has prevented the development of a highly effective disease management strategy. However, over the past decade, artificial miRNAs (i.e., anti-miRNAs and miRNA mimics) have shown promising results against various cancer types; nevertheless, their targeted delivery could be challenging. Notably, numerous reports have shown that nanotechnology-based delivery of miRNAs can greatly contribute to hindering cancer initiation and development processes, representing an innovative disease-modifying strategy against cancer. Hence, in this review, we evaluate recently developed nanotechnology-based miRNA drug delivery systems for cancer therapeutics and discuss the potential challenges and future directions, such as the promising use of plant-made nanoparticles, phytochemical-mediated modulation of miRNAs, and nanozymes.
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Affiliation(s)
| | | | - Alma L. Rodríguez
- Tecnologico de Monterrey, School of Engineering and Sciences, Querétaro, México
| | - Padmavati Sahare
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, México
| | - Surajit Pathak
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Chennai, India
| | - Antara Banerjee
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Chennai, India
| | - Asim K. Duttaroy
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sujay Paul
- Tecnologico de Monterrey, School of Engineering and Sciences, Querétaro, México
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Deep Learning Classifies Low- and High-Grade Glioma Patients with High Accuracy, Sensitivity, and Specificity Based on Their Brain White Matter Networks Derived from Diffusion Tensor Imaging. Diagnostics (Basel) 2022; 12:diagnostics12123216. [PMID: 36553224 PMCID: PMC9777902 DOI: 10.3390/diagnostics12123216] [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: 10/27/2022] [Revised: 12/04/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Classifying low-grade glioma (LGG) patients from high-grade glioma (HGG) is one of the most challenging tasks in planning treatment strategies for brain tumor patients. Previous studies derived several handcrafted features based on the tumor's texture and volume from magnetic resonance images (MRI) to classify LGG and HGG patients. The accuracy of classification was moderate. We aimed to classify LGG from HGG with high accuracy using the brain white matter (WM) network connectivity matrix constructed using diffusion tensor tractography. We obtained diffusion tensor images (DTI) of 44 LGG and 48 HGG patients using routine clinical imaging. Fiber tractography and brain parcellation were performed for each patient to obtain the fractional anisotropy, axial diffusivity, radial diffusivity, and mean diffusivity weighted connectivity matrices. We used a deep convolutional neural network (DNN) for classification and the gradient class activation map (GRAD-CAM) technique to identify the neural connectivity features focused on by the DNN. DNN could classify both LGG and HGG with 98% accuracy. The sensitivity and specificity values were above 0.98. GRAD-CAM analysis revealed a distinct WM network pattern between LGG and HGG patients in the frontal, temporal, and parietal lobes. Our results demonstrate that glioma affects the WM network in LGG and HGG patients differently.
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Battalapalli D, Rao BVVSNP, Yogeeswari P, Kesavadas C, Rajagopalan V. An optimal brain tumor segmentation algorithm for clinical MRI dataset with low resolution and non-contiguous slices. BMC Med Imaging 2022; 22:89. [PMID: 35568820 PMCID: PMC9107172 DOI: 10.1186/s12880-022-00812-7] [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: 12/06/2021] [Accepted: 04/20/2022] [Indexed: 11/27/2022] Open
Abstract
Background Segmenting brain tumor and its constituent regions from magnetic resonance images (MRI) is important for planning diagnosis and treatment. In clinical routine often an experienced radiologist delineates the tumor regions using multimodal MRI. But this manual segmentation is prone to poor reproducibility and is time consuming. Also, routine clinical scans are usually of low resolution. To overcome these limitations an automated and precise segmentation algorithm based on computer vision is needed. Methods We investigated the performance of three widely used segmentation methods namely region growing, fuzzy C means and deep neural networks (deepmedic). We evaluated these algorithms on the BRATS 2018 dataset by choosing randomly 48 patients data (high grade, n = 24 and low grade, n = 24) and on our routine clinical MRI brain tumor dataset (high grade, n = 15 and low grade, n = 28). We measured their performance using dice similarity coefficient, Hausdorff distance and volume measures. Results Region growing method performed very poorly when compared to fuzzy C means (fcm) and deepmedic network. Dice similarity coefficient scores for FCM and deepmedic algorithms were close to each other for BRATS and clinical dataset. The accuracy was below 70% for both these methods in general. Conclusion Even though the deepmedic network showed very high accuracy in BRATS challenge for brain tumor segmentation, it has to be custom trained for the low resolution routine clinical scans. It also requires large training data to be used as a stand-alone algorithm for clinical applications. Nevertheless deepmedic may be a better algorithm for brain tumor segmentation when compared to region growing or FCM.
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Affiliation(s)
- Dheerendranath Battalapalli
- Department of Electrical and Electronics Engineering, Birla Institute of Technology and Science Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - B V V S N Prabhakar Rao
- Department of Electrical and Electronics Engineering, Birla Institute of Technology and Science Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - P Yogeeswari
- Department of Pharmacy, Birla Institute of Technology and Science Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - C Kesavadas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, 695011, India
| | - Venkateswaran Rajagopalan
- Department of Electrical and Electronics Engineering, Birla Institute of Technology and Science Pilani, Hyderabad Campus, Hyderabad, 500078, India.
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Rammohan N, Ho A, Saxena M, Bajaj A, Kruser TJ, Horbinski C, Korutz A, Tate M, Sachdev S. Tumor-associated alterations in white matter connectivity have prognostic significance in MGMT-unmethylated glioblastoma. J Neurooncol 2022; 158:331-339. [PMID: 35525907 DOI: 10.1007/s11060-022-04018-3] [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: 03/22/2022] [Accepted: 04/16/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE We investigated the prognostic significance of tumor-associated white matter (TA-WM) tracts in glioblastoma (GBM) using magnetic resonance-diffusion tensor imaging (MR-DTI). We hypothesized that (1) TA-WM tracts harbor microscopic disease not targeted through surgery or radiotherapy (RT), and (2) the greater the extent of TA-WM involvement, the worse the survival outcomes. METHODS We studied a retrospective cohort of 76 GBM patients. TA-WM tracts were identified by MR-DTI fractional anisotropy (FA) maps. For each patient, 22 TA-WM tracts were analyzed and each tract was graded 1-3 based on FA. A TA-WM score (TA-WMS) was computed based on number of involved tracts and corresponding FA grade of involvement. Kaplan-Meier statistics were utilized to determine survival outcomes, log-rank test was used to compare survival between groups, and Cox regression was utilized to determine prognostic variables. RESULTS For the MGMT-unmethylated cohort, there was a decrease in OS for increasing TA-WMS (median OS 16.5 months for TA-WMS 0-4; 13.6 months for TA-WMS 5-8; 7.3 months for TA-WMS > 9; p = 0.0002). This trend was not observed in the MGMT-methylated cohort. For MGMT-unmethylated patients with TA-WMS > 6 and involvement of tracts passing through brainstem or contralateral hemisphere, median OS was 8.3 months versus median OS 14.1 months with TA-WMS > 6 but not involving aforementioned critical tracts (p = 0.003 log-rank test). For MGMT-unmethylated patients, TA-WMS was predictive of overall survival in multivariate analysis (HR = 1.14, 95% CI 1.03-1.27, p = 0.012) while age, gender, and largest tumor dimension were non-significant. CONCLUSION Increased TA-WMS and involvement of critical tracts are associated with decreased overall survival in MGMT-unmethylated GBM.
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Affiliation(s)
- Nikhil Rammohan
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 1820, Chicago, IL, 60611, USA
| | - Alexander Ho
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 1820, Chicago, IL, 60611, USA
| | - Mohit Saxena
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Amishi Bajaj
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 1820, Chicago, IL, 60611, USA
| | - Tim J Kruser
- Turville Bay Radiation Oncology Center, SSM Health Dean Medical Group, Madison, WI, USA
| | - Craig Horbinski
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alexander Korutz
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew Tate
- Department of Neurologic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sean Sachdev
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Ste 1820, Chicago, IL, 60611, USA.
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Bhalodiya JM, Lim Choi Keung SN, Arvanitis TN. Magnetic resonance image-based brain tumour segmentation methods: A systematic review. Digit Health 2022; 8:20552076221074122. [PMID: 35340900 PMCID: PMC8943308 DOI: 10.1177/20552076221074122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/20/2021] [Accepted: 12/27/2021] [Indexed: 01/10/2023] Open
Abstract
Background Image segmentation is an essential step in the analysis and subsequent characterisation of brain tumours through magnetic resonance imaging. In the literature, segmentation methods are empowered by open-access magnetic resonance imaging datasets, such as the brain tumour segmentation dataset. Moreover, with the increased use of artificial intelligence methods in medical imaging, access to larger data repositories has become vital in method development. Purpose To determine what automated brain tumour segmentation techniques can medical imaging specialists and clinicians use to identify tumour components, compared to manual segmentation. Methods We conducted a systematic review of 572 brain tumour segmentation studies during 2015-2020. We reviewed segmentation techniques using T1-weighted, T2-weighted, gadolinium-enhanced T1-weighted, fluid-attenuated inversion recovery, diffusion-weighted and perfusion-weighted magnetic resonance imaging sequences. Moreover, we assessed physics or mathematics-based methods, deep learning methods, and software-based or semi-automatic methods, as applied to magnetic resonance imaging techniques. Particularly, we synthesised each method as per the utilised magnetic resonance imaging sequences, study population, technical approach (such as deep learning) and performance score measures (such as Dice score). Statistical tests We compared median Dice score in segmenting the whole tumour, tumour core and enhanced tumour. Results We found that T1-weighted, gadolinium-enhanced T1-weighted, T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging are used the most in various segmentation algorithms. However, there is limited use of perfusion-weighted and diffusion-weighted magnetic resonance imaging. Moreover, we found that the U-Net deep learning technology is cited the most, and has high accuracy (Dice score 0.9) for magnetic resonance imaging-based brain tumour segmentation. Conclusion U-Net is a promising deep learning technology for magnetic resonance imaging-based brain tumour segmentation. The community should be encouraged to contribute open-access datasets so training, testing and validation of deep learning algorithms can be improved, particularly for diffusion- and perfusion-weighted magnetic resonance imaging, where there are limited datasets available.
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Affiliation(s)
- Jayendra M Bhalodiya
- Institute of Digital Healthcare, Warwick Manufacturing Group, The University of Warwick, UK
| | - Sarah N Lim Choi Keung
- Institute of Digital Healthcare, Warwick Manufacturing Group, The University of Warwick, UK
| | - Theodoros N Arvanitis
- Institute of Digital Healthcare, Warwick Manufacturing Group, The University of Warwick, UK
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RMS-UNet: Residual multi-scale UNet for liver and lesion segmentation. Artif Intell Med 2022; 124:102231. [DOI: 10.1016/j.artmed.2021.102231] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/12/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022]
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Jia Q, Shu H. BiTr-Unet: a CNN-Transformer Combined Network for MRI Brain Tumor Segmentation. BRAINLESION : GLIOMA, MULTIPLE SCLEROSIS, STROKE AND TRAUMATIC BRAIN INJURIES. BRAINLES (WORKSHOP) 2021; 2021:3-14. [PMID: 36005929 PMCID: PMC9396958 DOI: 10.1007/978-3-031-09002-8_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Convolutional neural networks (CNNs) have achieved remarkable success in automatically segmenting organs or lesions on 3D medical images. Recently, vision transformer networks have exhibited exceptional performance in 2D image classification tasks. Compared with CNNs, transformer networks have an appealing advantage of extracting long-range features due to their self-attention algorithm. Therefore, we propose a CNN-Transformer combined model, called BiTr-Unet, with specific modifications for brain tumor segmentation on multi-modal MRI scans. Our BiTr-Unet achieves good performance on the BraTS2021 validation dataset with median Dice score 0.9335, 0.9304 and 0.8899, and median Hausdor_ distance 2.8284, 2.2361 and 1.4142 for the whole tumor, tumor core, and enhancing tumor, respectively. On the BraTS2021 testing dataset, the corresponding results are 0.9257, 0.9350 and 0.8874 for Dice score, and 3, 2.2361 and 1.4142 for Hausdorff distance. The code is publicly available at https://github.com/JustaTinyDot/BiTr-Unet.
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Affiliation(s)
- Qiran Jia
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY 10003, USA
| | - Hai Shu
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY 10003, USA
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Lyu C, Shu H. A Two-Stage Cascade Model with Variational Autoencoders and Attention Gates for MRI Brain Tumor Segmentation. BRAINLESION : GLIOMA, MULTIPLE SCLEROSIS, STROKE AND TRAUMATIC BRAIN INJURIES. BRAINLES (WORKSHOP) 2020; 2020:435-447. [PMID: 36037049 DOI: 10.1007/978-3-030-72084-1_39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Automatic MRI brain tumor segmentation is of vital importance for the disease diagnosis, monitoring, and treatment planning. In this paper, we propose a two-stage encoder-decoder based model for brain tumor subregional segmentation. Variational autoencoder regularization is utilized in both stages to prevent the overfitting issue. The second-stage network adopts attention gates and is trained additionally using an expanded dataset formed by the first-stage outputs. On the BraTS 2020 validation dataset, the proposed method achieves the mean Dice score of 0.9041, 0.8350, and 0.7958, and Hausdorff distance (95%) of 4.953 , 6.299, 23.608 for the whole tumor, tumor core, and enhancing tumor, respectively. The corresponding results on the BraTS 2020 testing dataset are 0.8729, 0.8357, and 0.8205 for Dice score, and 11.4288, 19.9690, and 15.6711 for Hausdorff distance. The code is publicly available at https://github.com/shu-hai/two-stage-VAE-Attention-gate-BraTS2020.
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Affiliation(s)
- Chenggang Lyu
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY 10003, USA
| | - Hai Shu
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY 10003, USA
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