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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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Lebret T, Paoletti X, Pignot G, Roumiguié M, Colombel M, Savareux L, Verhoest G, Guy L, Rigaud J, De Vergie S, Poinas G, Droupy S, Kleinclauss F, Courtade-Saïdi M, Piaton E, Radulescu C, Rioux-Leclercq N, Kandel-Aznar C, Renaudin K, Cochand-Priollet B, Allory Y, Nivet S, Rouprêt M. Artificial intelligence to improve cytology performance in urothelial carcinoma diagnosis: results from validation phase of the French, multicenter, prospective VISIOCYT1 trial. World J Urol 2023; 41:2381-2388. [PMID: 37480491 PMCID: PMC10465399 DOI: 10.1007/s00345-023-04519-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/01/2023] [Indexed: 07/24/2023] Open
Abstract
PURPOSE Cytology and cystoscopy, the current gold standard for diagnosing urothelial carcinomas, have limits: cytology has high interobserver variability with moderate or not optimal sensitivity (particularly for low-grade tumors); while cystoscopy is expensive, invasive, and operator dependent. The VISIOCYT1 study assessed the benefit of VisioCyt® for diagnosing urothelial carcinoma. METHODS VISIOCYT1 was a French prospective clinical trial conducted in 14 centers. The trial enrolled adults undergoing endoscopy for suspected bladder cancer or to explore the lower urinary tract. Participants were allocated either Group 1: with bladder cancer, i.e., with positive cystoscopy or with negative cystoscopy but positive cytology, or Group 2: without bladder cancer. Before cystoscopy and histopathology, slides were prepared for cytology and the VisioCyt® test from urine samples. The diagnostic performance of VisioCyt® was assessed using sensitivity (primary objective, 70% lower-bound threshold) and specificity (75% lower-bound threshold). Sensitivity was also assessed by tumor grade and T-staging. VisioCyt® and cytology performance were evaluated relative to the histopathological assessments. RESULTS Between October 2017 and December 2019, 391 participants (170 in Group 1 and 149 in Group 2) were enrolled. VisioCyt®'s sensitivity was 80.9% (95% CI 73.9-86.4%) and specificity was 61.8% (95% CI 53.4-69.5%). In high-grade tumors, the sensitivity was 93.7% (95% CI 86.0-97.3%) and in low-grade tumors 66.7% (95% CI 55.2-76.5%). Sensitivity by T-staging, compared to the overall sensitivity, was higher in high-grade tumors and lower in low-grade tumors. CONCLUSION VisioCyt® is a promising diagnostic tool for urothelial cancers with improved sensitivities for high-grade tumors and notably for low-grade tumors.
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Affiliation(s)
| | - Xavier Paoletti
- Institut Curie, Saint Cloud, France
- Université Versailles Saint-Quentin, Université Paris-Saclay, Saint Cloud, France
| | | | - Mathieu Roumiguié
- Urology Department, Centre Hospitalier Universitaire (CHU) Rangueil, IUCT Oncopole, Toulouse, France
| | - Marc Colombel
- Urology Department, Hôpital Edouard Herriot, Lyon, France
| | - Laurent Savareux
- Urology Auvergne Centre, Clinique de la Chataigneraie, Beaumont, France
| | | | - Laurent Guy
- Urology Department of Urology, CHU Gabriel Montpied, Clermont-Ferrand, France
| | | | | | - Grégoire Poinas
- Urology Department, Clinique Beausoleil, Montpellier, France
| | | | | | | | - Eric Piaton
- Centre de Pathologie Est, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Bron, France
| | - Camelia Radulescu
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Foch, Suresnes, France
| | | | | | - Karine Renaudin
- Department of Pathology, CHU Hôtel Dieu, Nantes, France
- Centre de Recherche en Transplantation et en Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France
| | | | - Yves Allory
- Department of Pathology, Institut Curie, Saint-Cloud, France
- Institut Curie, PSL Research University, CNRS, UMR144, Equipe Labellisée Ligue Contre le Cancer, Paris, France
| | | | - Morgan Rouprêt
- Urology Department, GRC n°5, Predictive ONCO-URO, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France
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Nittas V, Daniore P, Landers C, Gille F, Amann J, Hubbs S, Puhan MA, Vayena E, Blasimme A. Beyond high hopes: A scoping review of the 2019-2021 scientific discourse on machine learning in medical imaging. PLOS DIGITAL HEALTH 2023; 2:e0000189. [PMID: 36812620 PMCID: PMC9931290 DOI: 10.1371/journal.pdig.0000189] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 01/02/2023] [Indexed: 02/04/2023]
Abstract
Machine learning has become a key driver of the digital health revolution. That comes with a fair share of high hopes and hype. We conducted a scoping review on machine learning in medical imaging, providing a comprehensive outlook of the field's potential, limitations, and future directions. Most reported strengths and promises included: improved (a) analytic power, (b) efficiency (c) decision making, and (d) equity. Most reported challenges included: (a) structural barriers and imaging heterogeneity, (b) scarcity of well-annotated, representative and interconnected imaging datasets (c) validity and performance limitations, including bias and equity issues, and (d) the still missing clinical integration. The boundaries between strengths and challenges, with cross-cutting ethical and regulatory implications, remain blurred. The literature emphasizes explainability and trustworthiness, with a largely missing discussion about the specific technical and regulatory challenges surrounding these concepts. Future trends are expected to shift towards multi-source models, combining imaging with an array of other data, in a more open access, and explainable manner.
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Affiliation(s)
- Vasileios Nittas
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich), Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, Faculty of Medicine, Faculty of Science, University of Zurich, Zurich, Switzerland
| | - Paola Daniore
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Switzerland
| | - Constantin Landers
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich), Zurich, Switzerland
| | - Felix Gille
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Switzerland
| | - Julia Amann
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich), Zurich, Switzerland
| | - Shannon Hubbs
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich), Zurich, Switzerland
| | - Milo Alan Puhan
- Epidemiology, Biostatistics and Prevention Institute, Faculty of Medicine, Faculty of Science, University of Zurich, Zurich, Switzerland
| | - Effy Vayena
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich), Zurich, Switzerland
| | - Alessandro Blasimme
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich), Zurich, Switzerland
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