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Mayfield JD, Ataya D, Abdalah M, Stringfield O, Bui MM, Raghunand N, Niell B, El Naqa I. Presurgical Upgrade Prediction of DCIS to Invasive Ductal Carcinoma Using Time-dependent Deep Learning Models with DCE MRI. Radiol Artif Intell 2024; 6:e230348. [PMID: 38900042 DOI: 10.1148/ryai.230348] [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] [Indexed: 06/21/2024]
Abstract
Purpose To determine whether time-dependent deep learning models can outperform single time point models in predicting preoperative upgrade of ductal carcinoma in situ (DCIS) to invasive malignancy at dynamic contrast-enhanced (DCE) breast MRI without a lesion segmentation prerequisite. Materials and Methods In this exploratory study, 154 cases of biopsy-proven DCIS (25 upgraded at surgery and 129 not upgraded) were selected consecutively from a retrospective cohort of preoperative DCE MRI in women with a mean age of 59 years at time of diagnosis from 2012 to 2022. Binary classification was implemented with convolutional neural network (CNN)-long short-term memory (LSTM) architectures benchmarked against traditional CNNs without manual segmentation of the lesions. Combinatorial performance analysis of ResNet50 versus VGG16-based models was performed with each contrast phase. Binary classification area under the receiver operating characteristic curve (AUC) was reported. Results VGG16-based models consistently provided better holdout test AUCs than did ResNet50 in CNN and CNN-LSTM studies (multiphase test AUC, 0.67 vs 0.59, respectively, for CNN models [P = .04] and 0.73 vs 0.62 for CNN-LSTM models [P = .008]). The time-dependent model (CNN-LSTM) provided a better multiphase test AUC over single time point (CNN) models (0.73 vs 0.67; P = .04). Conclusion Compared with single time point architectures, sequential deep learning algorithms using preoperative DCE MRI improved prediction of DCIS lesions upgraded to invasive malignancy without the need for lesion segmentation. Keywords: MRI, Dynamic Contrast-enhanced, Breast, Convolutional Neural Network (CNN) Supplemental material is available for this article. © RSNA, 2024.
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MESH Headings
- Humans
- Female
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Deep Learning
- Middle Aged
- Magnetic Resonance Imaging/methods
- Retrospective Studies
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Contrast Media
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Aged
- Adult
- Predictive Value of Tests
- Image Interpretation, Computer-Assisted/methods
- Breast/diagnostic imaging
- Breast/pathology
- Breast/surgery
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Affiliation(s)
- John D Mayfield
- From the Departments of Radiology (J.D.M.), Oncologic Sciences (D.A., M.M.B., N.R., B.N.), and Medical Engineering (J.D.M.), University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612; and Department of Diagnostic Imaging and Interventional Radiology (D.A., B.N.), Department of Pathology (M.M.B.), Department of Cancer Physiology (N.R.), Quantitative Imaging CORE (M.A., O.S., I.E.N.), and Department of Machine Learning (M.M.B., I.E.N.), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Dana Ataya
- From the Departments of Radiology (J.D.M.), Oncologic Sciences (D.A., M.M.B., N.R., B.N.), and Medical Engineering (J.D.M.), University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612; and Department of Diagnostic Imaging and Interventional Radiology (D.A., B.N.), Department of Pathology (M.M.B.), Department of Cancer Physiology (N.R.), Quantitative Imaging CORE (M.A., O.S., I.E.N.), and Department of Machine Learning (M.M.B., I.E.N.), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Mahmoud Abdalah
- From the Departments of Radiology (J.D.M.), Oncologic Sciences (D.A., M.M.B., N.R., B.N.), and Medical Engineering (J.D.M.), University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612; and Department of Diagnostic Imaging and Interventional Radiology (D.A., B.N.), Department of Pathology (M.M.B.), Department of Cancer Physiology (N.R.), Quantitative Imaging CORE (M.A., O.S., I.E.N.), and Department of Machine Learning (M.M.B., I.E.N.), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Olya Stringfield
- From the Departments of Radiology (J.D.M.), Oncologic Sciences (D.A., M.M.B., N.R., B.N.), and Medical Engineering (J.D.M.), University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612; and Department of Diagnostic Imaging and Interventional Radiology (D.A., B.N.), Department of Pathology (M.M.B.), Department of Cancer Physiology (N.R.), Quantitative Imaging CORE (M.A., O.S., I.E.N.), and Department of Machine Learning (M.M.B., I.E.N.), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Marilyn M Bui
- From the Departments of Radiology (J.D.M.), Oncologic Sciences (D.A., M.M.B., N.R., B.N.), and Medical Engineering (J.D.M.), University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612; and Department of Diagnostic Imaging and Interventional Radiology (D.A., B.N.), Department of Pathology (M.M.B.), Department of Cancer Physiology (N.R.), Quantitative Imaging CORE (M.A., O.S., I.E.N.), and Department of Machine Learning (M.M.B., I.E.N.), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Natarajan Raghunand
- From the Departments of Radiology (J.D.M.), Oncologic Sciences (D.A., M.M.B., N.R., B.N.), and Medical Engineering (J.D.M.), University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612; and Department of Diagnostic Imaging and Interventional Radiology (D.A., B.N.), Department of Pathology (M.M.B.), Department of Cancer Physiology (N.R.), Quantitative Imaging CORE (M.A., O.S., I.E.N.), and Department of Machine Learning (M.M.B., I.E.N.), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Bethany Niell
- From the Departments of Radiology (J.D.M.), Oncologic Sciences (D.A., M.M.B., N.R., B.N.), and Medical Engineering (J.D.M.), University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612; and Department of Diagnostic Imaging and Interventional Radiology (D.A., B.N.), Department of Pathology (M.M.B.), Department of Cancer Physiology (N.R.), Quantitative Imaging CORE (M.A., O.S., I.E.N.), and Department of Machine Learning (M.M.B., I.E.N.), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
| | - Issam El Naqa
- From the Departments of Radiology (J.D.M.), Oncologic Sciences (D.A., M.M.B., N.R., B.N.), and Medical Engineering (J.D.M.), University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612; and Department of Diagnostic Imaging and Interventional Radiology (D.A., B.N.), Department of Pathology (M.M.B.), Department of Cancer Physiology (N.R.), Quantitative Imaging CORE (M.A., O.S., I.E.N.), and Department of Machine Learning (M.M.B., I.E.N.), H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla
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2
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Radhabai PR, Kvn K, Shanmugam A, Imoize AL. An effective no-reference image quality index prediction with a hybrid Artificial Intelligence approach for denoised MRI images. BMC Med Imaging 2024; 24:208. [PMID: 39134983 PMCID: PMC11318287 DOI: 10.1186/s12880-024-01387-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 08/01/2024] [Indexed: 08/16/2024] Open
Abstract
As the quantity and significance of digital pictures in the medical industry continue to increase, Image Quality Assessment (IQA) has recently become a prevalent subject in the research community. Due to the wide range of distortions that Magnetic Resonance Images (MRI) can experience and the wide variety of information they contain, No-Reference Image Quality Assessment (NR-IQA) has always been a challenging study issue. In an attempt to address this issue, a novel hybrid Artificial Intelligence (AI) is proposed to analyze NR-IQ in massive MRI data. First, the features from the denoised MRI images are extracted using the gray level run length matrix (GLRLM) and EfficientNet B7 algorithm. Next, the Multi-Objective Reptile Search Algorithm (MRSA) was proposed for optimal feature vector selection. Then, the Self-evolving Deep Belief Fuzzy Neural network (SDBFN) algorithm was proposed for the effective NR-IQ analysis. The implementation of this research is executed using MATLAB software. The simulation results are compared with the various conventional methods in terms of correlation coefficient (PLCC), Root Mean Square Error (RMSE), Spearman Rank Order Correlation Coefficient (SROCC) and Kendall Rank Order Correlation Coefficient (KROCC), and Mean Absolute Error (MAE). In addition, our proposed approach yielded a quality number approximately we achieved significant 20% improvement than existing methods, with the PLCC parameter showing a notable increase compared to current techniques. Moreover, the RMSE number decreased by 12% when compared to existing methods. Graphical representations indicated mean MAE values of 0.02 for MRI knee dataset, 0.09 for MRI brain dataset, and 0.098 for MRI breast dataset, showcasing significantly lower MAE values compared to the baseline models.
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Affiliation(s)
| | - Kavitha Kvn
- Department of Communication Engineering, School of Electronics Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Ashok Shanmugam
- Department of Electronics and Communication Engineering, Vel Tech Multi Tech Dr. Rangarajan Dr. Sakunthala Engineering College, Chennai, Tamil Nadu, India
| | - Agbotiname Lucky Imoize
- Department of Electrical and Electronics Engineering, Faculty of Engineering, University of Lagos, Akoka, Lagos, 100213, Nigeria.
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3
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He Y, Duan S, Wang W, Yang H, Pan S, Cheng W, Xia L, Qi X. Integrative radiomics clustering analysis to decipher breast cancer heterogeneity and prognostic indicators through multiparametric MRI. NPJ Breast Cancer 2024; 10:72. [PMID: 39112498 PMCID: PMC11306571 DOI: 10.1038/s41523-024-00678-8] [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: 12/22/2023] [Accepted: 07/19/2024] [Indexed: 08/10/2024] Open
Abstract
Breast cancer diagnosis and treatment have been revolutionized by multiparametric Magnetic Resonance Imaging (mpMRI), encompassing T2-weighted imaging (T2WI), Diffusion-weighted imaging (DWI), and Dynamic Contrast-Enhanced MRI (DCE-MRI). We conducted a retrospective analysis of mpMRI data from 194 breast cancer patients (September 2019 to October 2023). Using 'pyradiomics' for radiomics feature extraction and MOVICS for unsupervised clustering. Interestingly, we identified two distinct patient clusters associated with significant differences in molecular subtypes, particularly in Luminal A subtype distribution (p = 0.03), estrogen receptor (ER) (p = 0.01), progesterone receptor (PR) (p = 0.04), mean tumor size (p < 0.01), lymph node metastasis (LNM) (p = 0.01), and edema (p < 0.01). Our study emphasizes mpMRI's potential in breast cancer by using radiomics-based cluster analysis to categorize tumors, uncovering heterogeneity, and aiding in personalized treatment strategies.
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Affiliation(s)
- Yongsheng He
- Department of Radiology, Ma'anshan People's Hospital, Ma'anshan, Anhui, 243000, China
| | - Shaofeng Duan
- Department of Radiology, Ma'anshan People's Hospital, Ma'anshan, Anhui, 243000, China
| | - Wuling Wang
- Department of Radiology, Ma'anshan People's Hospital, Ma'anshan, Anhui, 243000, China
| | - Hongkai Yang
- Department of Radiology, Ma'anshan People's Hospital, Ma'anshan, Anhui, 243000, China
| | - Shuya Pan
- Department of Radiology, Ma'anshan People's Hospital, Ma'anshan, Anhui, 243000, China
| | - Weiqun Cheng
- Ma'anshan Clinical College, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Liang Xia
- Department of Radiology, Sir Run Run Hospital affiliated to Nanjing Medical University, Nanjing, Jiangsu, 211000, China
| | - Xuan Qi
- Department of Radiology, Ma'anshan People's Hospital, Ma'anshan, Anhui, 243000, China.
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4
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Liu Y, Jia X, Zhao J, Peng Y, Yao X, Hu X, Cui J, Chen H, Chen X, Wu J, Hong N, Wang S, Wang Y. A Machine Learning-Based Unenhanced Radiomics Approach to Distinguishing Between Benign and Malignant Breast Lesions Using T2-Weighted and Diffusion-Weighted MRI. J Magn Reson Imaging 2024; 60:600-612. [PMID: 37933890 DOI: 10.1002/jmri.29111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/17/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Breast MRI has been recommended as supplemental screening tool to mammography and breast ultrasound of breast cancer by international guidelines, but its long examination time and use of contrast material remains concerning. PURPOSE To develop an unenhanced radiomics model with using non-gadolinium based sequences for detecting breast cancer based on T2-weighted (T2W) and diffusion-weighted (DW) MRI. STUDY TYPE Retrospective analysis followed by retrospective and prospective cohorts study. POPULATION 1760 patients: Of these, 1293 for model construction (n = 775 for training and 518 for validation). The remaining patients for model testing in internal retrospective (n = 167), internal prospective (n = 188), and external retrospective (n = 112) cohorts. FIELD STRENGTH/SEQUENCE 3.0T MR scanners from two institution. T2WI, DWI, and first contrast-enhanced T1-weighted sequence. ASSESSMENT AUCs in distinguishing breast cancer were compared between combined model with gadolinium agent sequence and unenhanced model. Subsequently, the AUCs in testing cohorts of unenhanced model was compared with two radiologists' diagnosis for this research. Finally, patient subgroup analysis in testing cohorts was performed based on clinical subgroups and different types of malignancies. STATISTICAL TESTS Mann-Whitney U test, Kruskal-Wallis H test, chi-square test, weighted kappa test, and DeLong's test. RESULTS The unenhanced radiomics model performed best under Gaussian process (GP) classifiers (AUC: training, 0.893; validation, 0.848) compared to support vector machine (SVM) and logistic, showing favorable prediction in testing cohorts (AUCs, 0.818-0.840). The AUCs for the unenhanced radiomics model were not statistically different in five cohorts from those of the combined radiomics model (P, 0.317-0.816), as well as the two radiologists (P, 0.181-0.918). The unenhanced radiomics model was least successful in identifying ductal carcinoma in situ, whereas did not show statistical significance in other subgroups. DATA CONCLUSION An unenhanced radiomics model based on T2WI and DWI has comparable diagnostic accuracy to the combined model using the gadolinium agent. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yulu Liu
- Department of Radiology, Peking University People's Hospital, Beijing, China
| | - Xiaoxuan Jia
- Department of Radiology, Peking University People's Hospital, Beijing, China
| | - Jiaqi Zhao
- Department of Radiology, Jiangmen Central Hospital, Jiangmen, China
| | - Yuan Peng
- Department of Breast Surgery, Peking University People's Hospital, Beijing, China
| | - Xun Yao
- Department of Radiology, Peking University People's Hospital, Beijing, China
| | - Xuege Hu
- Department of Breast Surgery, Peking University People's Hospital, Beijing, China
| | - Jingjing Cui
- Department of Research and Development, United Imaging Intelligence (Beijing) Co., Ltd., Beijing, China
| | - Haoquan Chen
- Department of Radiology, Peking University People's Hospital, Beijing, China
| | - Xiufeng Chen
- Department of General Surgery, Beijing Aerospace General Hospital, Beijing, China
| | - Jing Wu
- Department of Radiology, Peking University People's Hospital, Beijing, China
| | - Nan Hong
- Department of Radiology, Peking University People's Hospital, Beijing, China
| | - Shu Wang
- Department of Breast Surgery, Peking University People's Hospital, Beijing, China
| | - Yi Wang
- Department of Radiology, Peking University People's Hospital, Beijing, China
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5
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Wang P, Wang H, Nie P, Dang Y, Liu R, Qu M, Wang J, Mu G, Jia T, Shang L, Zhu K, Feng J, Chen B. Enabling AI-Generated Content for Gadolinium-Free Contrast-Enhanced Breast Magnetic Resonance Imaging. J Magn Reson Imaging 2024. [PMID: 39052258 DOI: 10.1002/jmri.29528] [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: 04/01/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND There is increasing interest in utilizing AI-generated content for gadolinium-free contrast-enhanced breast MRI. PURPOSE To develop a generative model for gadolinium-free contrast-enhanced breast MRI and evaluate the diagnostic utility of the generated scans. STUDY TYPE Retrospective. POPULATION Two hundred seventy-six women with 304 breast MRI examinations (49 ± 13 years, 243/61 for training/testing). FIELD STRENGTH/SEQUENCE ZOOMit diffusion-weighted imaging (DWI), T1-weighted volumetric interpolated breath-hold examination (T1W VIBE), and axial T2 3D SPACE at 3.0 T. ASSESSMENT A generative model was developed to generate contrast-enhanced scans using precontrast T1W VIBE and DWI images. The generated and real images were quantitatively compared using the structural similarity index (SSIM), mean absolute error (MAE), and Dice similarity coefficient. Three radiologists with 8, 5, and 5 years of experience independently rated the image quality and lesion visibility on AI-generated and real images within various subgroups using a five-point scale. Four breast radiologists, with 8, 8, 5, and 5 years of experience, independently and blindly interpreted four reading protocols: unenhanced MRI protocol alone and combined with AI-generated scans, abbreviated MRI protocol, and full-MRI protocol. STATISTICAL ANALYSIS Results were assessed using t-tests and McNemar tests. Using pathology diagnosis as reference standard, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each reading protocol. A P value <0.05 was considered significant. RESULTS In the test set, the generated images showed similarity to the real images (SSIM: 0.935 ± 0.047 [SD], MAE: 0.015 ± 0.012 [SD], and Dice coefficient: 0.726 ± 0.177 [SD]). No significant difference in lesion visibility was observed between real and AI-generated scans of the mass, non-mass, and benign lesion subgroups. Adding AI-generated scans to the unenhanced MRI protocol slightly improved breast cancer detection (sensitivity: 92.86% vs. 85.71%, NPV: 76.92% vs. 70.00%); achieved non-inferior diagnostic utility compared to the AB-MRI protocol and full-protocol (sensitivity: 92.86%, 95.24%; NPV: 75.00%, 81.82%). DATA CONCLUSION AI-generated gadolinium-free contrast-enhanced breast MRI has potential to improve the sensitivity of unenhanced MRI in detecting breast cancer. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Pingping Wang
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
- Department of Information Science & Technology, Northwest University, Xi'an, China
| | - Hongyu Wang
- Department of School of Computer Science & Technology, Xi'an University of Posts and Telecommunications, Xi'an, China
| | - Pin Nie
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
| | - Yanli Dang
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
| | - Rumei Liu
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
| | - Mingzhu Qu
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
| | - Jiawei Wang
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
| | - Gengming Mu
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
| | - Tianju Jia
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
| | - Lei Shang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, Xi'an, China
| | - Kaiguo Zhu
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
| | - Jun Feng
- Department of Information Science & Technology, Northwest University, Xi'an, China
| | - Baoying Chen
- Department of Xi'an International Medical Center Hospital, Northwest University, Xi'an, China
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Fabijan A, Zawadzka-Fabijan A, Fabijan R, Zakrzewski K, Nowosławska E, Polis B. Assessing the Accuracy of Artificial Intelligence Models in Scoliosis Classification and Suggested Therapeutic Approaches. J Clin Med 2024; 13:4013. [PMID: 39064053 PMCID: PMC11278075 DOI: 10.3390/jcm13144013] [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: 06/07/2024] [Revised: 06/30/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Open-source artificial intelligence models (OSAIMs) are increasingly being applied in various fields, including IT and medicine, offering promising solutions for diagnostic and therapeutic interventions. In response to the growing interest in AI for clinical diagnostics, we evaluated several OSAIMs-such as ChatGPT 4, Microsoft Copilot, Gemini, PopAi, You Chat, Claude, and the specialized PMC-LLaMA 13B-assessing their abilities to classify scoliosis severity and recommend treatments based on radiological descriptions from AP radiographs. Methods: Our study employed a two-stage methodology, where descriptions of single-curve scoliosis were analyzed by AI models following their evaluation by two independent neurosurgeons. Statistical analysis involved the Shapiro-Wilk test for normality, with non-normal distributions described using medians and interquartile ranges. Inter-rater reliability was assessed using Fleiss' kappa, and performance metrics, like accuracy, sensitivity, specificity, and F1 scores, were used to evaluate the AI systems' classification accuracy. Results: The analysis indicated that although some AI systems, like ChatGPT 4, Copilot, and PopAi, accurately reflected the recommended Cobb angle ranges for disease severity and treatment, others, such as Gemini and Claude, required further calibration. Particularly, PMC-LLaMA 13B expanded the classification range for moderate scoliosis, potentially influencing clinical decisions and delaying interventions. Conclusions: These findings highlight the need for the continuous refinement of AI models to enhance their clinical applicability.
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Affiliation(s)
- Artur Fabijan
- Department of Neurosurgery, Polish-Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Poland; (K.Z.); (E.N.); (B.P.)
| | - Agnieszka Zawadzka-Fabijan
- Department of Rehabilitation Medicine, Faculty of Health Sciences, Medical University of Lodz, 90-419 Lodz, Poland;
| | | | - Krzysztof Zakrzewski
- Department of Neurosurgery, Polish-Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Poland; (K.Z.); (E.N.); (B.P.)
| | - Emilia Nowosławska
- Department of Neurosurgery, Polish-Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Poland; (K.Z.); (E.N.); (B.P.)
| | - Bartosz Polis
- Department of Neurosurgery, Polish-Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Poland; (K.Z.); (E.N.); (B.P.)
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Ye Y, Xia L, Yang S, Luo Y, Tang Z, Li Y, Han L, Xie H, Ren Y, Na N. Deep learning-enabled classification of kidney allograft rejection on whole slide histopathologic images. Front Immunol 2024; 15:1438247. [PMID: 39034991 PMCID: PMC11257957 DOI: 10.3389/fimmu.2024.1438247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 06/21/2024] [Indexed: 07/23/2024] Open
Abstract
Background Diagnosis of kidney transplant rejection currently relies on manual histopathological assessment, which is subjective and susceptible to inter-observer variability, leading to limited reproducibility. We aim to develop a deep learning system for automated assessment of whole-slide images (WSIs) from kidney allograft biopsies to enable detection and subtyping of rejection and to predict the prognosis of rejection. Method We collected H&E-stained WSIs of kidney allograft biopsies at 400x magnification from January 2015 to September 2023 at two hospitals. These biopsy specimens were classified as T cell-mediated rejection, antibody-mediated rejection, and other lesions based on the consensus reached by two experienced transplant pathologists. To achieve feature extraction, feature aggregation, and global classification, we employed multi-instance learning and common convolution neural networks (CNNs). The performance of the developed models was evaluated using various metrics, including confusion matrix, receiver operating characteristic curves, the area under the curve (AUC), classification map, heat map, and pathologist-machine confrontations. Results In total, 906 WSIs from 302 kidney allograft biopsies were included for analysis. The model based on multi-instance learning enables detection and subtyping of rejection, named renal rejection artificial intelligence model (RRAIM), with the overall 3-category AUC of 0.798 in the independent test set, which is superior to that of three transplant pathologists under nearly routine assessment conditions. Moreover, the prognosis models accurately predicted graft loss within 1 year following rejection and treatment response for rejection, achieving AUC of 0.936 and 0.756, respectively. Conclusion We first developed deep-learning models utilizing multi-instance learning for the detection and subtyping of rejection and prediction of rejection prognosis in kidney allograft biopsies. These models performed well and may be useful in assisting the pathological diagnosis.
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Affiliation(s)
- Yongrong Ye
- Department of Kidney Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liubing Xia
- Department of Kidney Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shicong Yang
- Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - You Luo
- Department of Kidney Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zuofu Tang
- Department of Kidney Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuanqing Li
- School of Automation Science and Engineering, South China University of Technology, Guangzhou, China
- Research Center for Brain-Computer Interface, Pazhou Lab, Guangzhou, China
| | - Lanqing Han
- Center for Artificial Intelligence in Medicine, Research Institute of Tsinghua, Pearl River Delta, Guangzhou, China
| | - Hanbin Xie
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yong Ren
- Scientific Research Project Department, Guangdong Artificial Intelligence and Digital Economy Laboratory (Guangzhou), Pazhou Lab, Guangzhou, China
- Shensi lab, Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China (UESTC), Shenzhen, China
- The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Ning Na
- Department of Kidney Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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8
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Seely JM, Domonkos V, Verma R. Auditing Abbreviated Breast MR Imaging: Clinical Considerations and Implications. Radiol Clin North Am 2024; 62:687-701. [PMID: 38777543 DOI: 10.1016/j.rcl.2023.12.010] [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] [Indexed: 05/25/2024]
Abstract
Abbreviated breast MR (AB-MR) imaging is a relatively new breast imaging tool, which maintains diagnostic accuracy while reducing image times compared with full-protocol breast MR (FP-MR) imaging. Breast imaging audits involve calculating individual and organizational metrics, which can be compared with established benchmarks, providing a standard against which performance can be measured. Unlike FP-MR imaging, there are no established benchmarks for AB-MR imaging but studies demonstrate comparable performance for cancer detection rate, positive predictive value 3, sensitivity, and specificity with T2. We review the basics of performing an audit, including strategies to implement if benchmarks are not being met.
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Affiliation(s)
- Jean M Seely
- Department of Radiology, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada.
| | - Victoria Domonkos
- Department of Radiology, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada
| | - Raman Verma
- Department of Radiology, The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada. https://twitter.com/RamanVermaMD
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9
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Yi M, Lin Y, Lin Z, Xu Z, Li L, Huang R, Huang W, Wang N, Zuo Y, Li N, Ni D, Zhang Y, Li Y. Biopsy or Follow-up: AI Improves the Clinical Strategy of US BI-RADS 4A Breast Nodules Using a Convolutional Neural Network. Clin Breast Cancer 2024; 24:e319-e332.e2. [PMID: 38494415 DOI: 10.1016/j.clbc.2024.02.003] [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: 08/15/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To develop predictive nomograms based on clinical and ultrasound features and to improve the clinical strategy for US BI-RADS 4A lesions. METHODS Patients with US BI-RADS 4A lesions from 3 hospitals between January 2016 and June 2020 were retrospectively included. Clinical and ultrasound features were extracted to establish nomograms CE (based on clinical experience) and DL (based on deep-learning algorithm). The performances of nomograms were evaluated by receiver operator characteristic curves, calibration curves and decision curves. Diagnostic performances with DL of radiologists were analyzed. RESULTS 1616 patients from 2 hospitals were randomly divided into training and internal validation cohorts at a ratio of 7:3. Hundred patients from another hospital made up external validation cohort. DL achieved more optimized AUCs than CE (internal validation: 0.916 vs. 0.863, P < .01; external validation: 0.884 vs. 0.776, P = .05). The sensitivities of DL were higher than CE (internal validation: 81.03% vs. 72.41%, P = .044; external validation: 93.75% vs. 81.25%, P = .4795) without losing specificity (internal validation: 84.91% vs. 86.47%, P = .353; external validation: 69.14% vs. 71.60%, P = .789). Decision curves indicated DL adds more clinical net benefit. With DL's assistance, both radiologists achieved higher AUCs (0.712 vs. 0.801; 0.547 vs. 0.800), improved specificities (70.93% vs. 74.42%, P < .001; 59.3% vs. 81.4%, P = .004), and decreased unnecessary biopsy rates by 6.7% and 24%. CONCLUSION DL was developed to discriminate US BI-RADS 4A lesions with a higher diagnostic power and more clinical net benefit than CE. Using DL may guide clinicians to make precise clinical decisions and avoid overtreatment of benign lesions.
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Affiliation(s)
- Mei Yi
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yue Lin
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zehui Lin
- Medical Ultrasound Image Computing (MUSIC) Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Ziting Xu
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lian Li
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ruobing Huang
- Medical Ultrasound Image Computing (MUSIC) Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Weijun Huang
- Department of Ultrasound, The First People's Hospital of Foshan, Foshan, China
| | - Nannan Wang
- Department of Ultrasound, The First People's Hospital of Foshan, Foshan, China
| | - Yanling Zuo
- Department of Ultrasound Imaging, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Nuo Li
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Dong Ni
- Medical Ultrasound Image Computing (MUSIC) Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yanyan Zhang
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - Yingjia Li
- Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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10
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Payne MM, Mali I, Shrestha TB, Basel MT, Timmerman S, Pyle M, Sebek J, Prakash P, Bossmann SH. T 1-mapping characterization of two tumor types. BIOPHYSICAL REPORTS 2024; 4:100157. [PMID: 38795740 PMCID: PMC11229382 DOI: 10.1016/j.bpr.2024.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/25/2024] [Accepted: 05/14/2024] [Indexed: 05/28/2024]
Abstract
T1 mapping is a quantitative method to characterize tissues with magnetic resonance imaging in a quick and efficient manner. It utilizes the relaxation rate of protons to depict the underlying structures within the imaging frame. While T1-mapping techniques are used with some frequency in areas such as cardiac imaging, their application for understanding malignancies and identifying tumor structures has yet to be thoroughly investigated. Utilizing a saturation recovery method to acquire T1 maps for two different tumor models has revealed that longitudinal relaxation mapping is sensitive enough to distinguish between normal and malignant tissue. This is seen even with decreased signal/noise ratios using small voxel sizes to obtain high-resolution images. In both tumor models, it was revealed that relaxation mapping recorded significantly different relaxation values between regions encapsulating the tumor, muscle, kidney, or spleen, as well as between the cell lines themselves. This indicates a potential future application of relaxation mapping as a method to fingerprint various stages of tumor development and may prove a useful measure to identify micro-metastases.
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Affiliation(s)
- Macy Marie Payne
- Department of Cancer Biology, University of Kansas Medical Center, Kansas City, Kansas
| | - Ivina Mali
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Tej B Shrestha
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Matthew T Basel
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Sarah Timmerman
- College of Veterinary Medicine, Kansas State University, Manhattan, Kansas
| | - Marla Pyle
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Jan Sebek
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas
| | - Punit Prakash
- Department of Electrical and Computer Engineering, Kansas State University, Manhattan, Kansas
| | - Stefan H Bossmann
- Department of Cancer Biology, University of Kansas Medical Center, Kansas City, Kansas.
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11
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Huang Y, Wang X, Cao Y, Li M, Li L, Chen H, Tang S, Lan X, Jiang F, Zhang J. Multiparametric MRI model to predict molecular subtypes of breast cancer using Shapley additive explanations interpretability analysis. Diagn Interv Imaging 2024; 105:191-205. [PMID: 38272773 DOI: 10.1016/j.diii.2024.01.004] [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: 11/10/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
PURPOSE The purpose of this study was to assess the predictive performance of multiparametric magnetic resonance imaging (MRI) for molecular subtypes and interpret features using SHapley Additive exPlanations (SHAP) analysis. MATERIAL AND METHODS Patients with breast cancer who underwent pre-treatment MRI (including ultrafast dynamic contrast-enhanced MRI, magnetic resonance spectroscopy, diffusion kurtosis imaging and intravoxel incoherent motion) were recruited between February 2019 and January 2022. Thirteen semantic and thirteen multiparametric features were collected and the key features were selected to develop machine-learning models for predicting molecular subtypes of breast cancers (luminal A, luminal B, triple-negative and HER2-enriched) by using stepwise logistic regression. Semantic model and multiparametric model were built and compared based on five machine-learning classifiers. Model decision-making was interpreted using SHAP analysis. RESULTS A total of 188 women (mean age, 53 ± 11 [standard deviation] years; age range: 25-75 years) were enrolled and further divided into training cohort (131 women) and validation cohort (57 women). XGBoost demonstrated good predictive performance among five machine-learning classifiers. Within the validation cohort, the areas under the receiver operating characteristic curves (AUCs) for the semantic models ranged from 0.693 (95% confidence interval [CI]: 0.478-0.839) for HER2-enriched subtype to 0.764 (95% CI: 0.681-0.908) for luminal A subtype, inferior to multiparametric models that yielded AUCs ranging from 0.771 (95% CI: 0.630-0.888) for HER2-enriched subtype to 0.857 (95% CI: 0.717-0.957) for triple-negative subtype. The AUCs between the semantic and the multiparametric models did not show significant differences (P range: 0.217-0.640). SHAP analysis revealed that lower iAUC, higher kurtosis, lower D*, and lower kurtosis were distinctive features for luminal A, luminal B, triple-negative breast cancer, and HER2-enriched subtypes, respectively. CONCLUSION Multiparametric MRI is superior to semantic models to effectively predict the molecular subtypes of breast cancer.
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Affiliation(s)
- Yao Huang
- School of Medicine, Chongqing University, Chongqing, 400030, China; Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China
| | - Xiaoxia Wang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China
| | - Ying Cao
- School of Medicine, Chongqing University, Chongqing, 400030, China; Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China
| | - Mengfei Li
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China
| | - Lan Li
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China
| | - Huifang Chen
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China
| | - Sun Tang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China
| | - Xiaosong Lan
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China
| | - Fujie Jiang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), 400030, Chongqing, China.
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12
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Lo Gullo R, Brunekreef J, Marcus E, Han LK, Eskreis-Winkler S, Thakur SB, Mann R, Groot Lipman K, Teuwen J, Pinker K. AI Applications to Breast MRI: Today and Tomorrow. J Magn Reson Imaging 2024. [PMID: 38581127 DOI: 10.1002/jmri.29358] [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: 12/06/2023] [Revised: 03/07/2024] [Accepted: 03/09/2024] [Indexed: 04/08/2024] Open
Abstract
In breast imaging, there is an unrelenting increase in the demand for breast imaging services, partly explained by continuous expanding imaging indications in breast diagnosis and treatment. As the human workforce providing these services is not growing at the same rate, the implementation of artificial intelligence (AI) in breast imaging has gained significant momentum to maximize workflow efficiency and increase productivity while concurrently improving diagnostic accuracy and patient outcomes. Thus far, the implementation of AI in breast imaging is at the most advanced stage with mammography and digital breast tomosynthesis techniques, followed by ultrasound, whereas the implementation of AI in breast magnetic resonance imaging (MRI) is not moving along as rapidly due to the complexity of MRI examinations and fewer available dataset. Nevertheless, there is persisting interest in AI-enhanced breast MRI applications, even as the use of and indications of breast MRI continue to expand. This review presents an overview of the basic concepts of AI imaging analysis and subsequently reviews the use cases for AI-enhanced MRI interpretation, that is, breast MRI triaging and lesion detection, lesion classification, prediction of treatment response, risk assessment, and image quality. Finally, it provides an outlook on the barriers and facilitators for the adoption of AI in breast MRI. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 6.
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Affiliation(s)
- Roberto Lo Gullo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Joren Brunekreef
- AI for Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Eric Marcus
- AI for Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Lynn K Han
- Weill Cornell Medical College, New York-Presbyterian Hospital, New York City, New York, USA
| | - Sarah Eskreis-Winkler
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Sunitha B Thakur
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Ritse Mann
- AI for Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Kevin Groot Lipman
- AI for Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jonas Teuwen
- AI for Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Katja Pinker
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
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13
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Dai C, Xiong H, He R, Zhu C, Li P, Guo M, Gou J, Mei M, Kong D, Li Q, Wee ATS, Fang X, Kong J, Liu Y, Wei D. Electro-Optical Multiclassification Platform for Minimizing Occasional Inaccuracy in Point-of-Care Biomarker Detection. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2312540. [PMID: 38288781 DOI: 10.1002/adma.202312540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/13/2024] [Indexed: 02/06/2024]
Abstract
On-site diagnostic tests that accurately identify disease biomarkers lay the foundation for self-healthcare applications. However, these tests routinely rely on single-mode signals and suffer from insufficient accuracy, especially for multiplexed point-of-care tests (POCTs) within a few minutes. Here, this work develops a dual-mode multiclassification diagnostic platform that integrates an electrochemiluminescence sensor and a field-effect transistor sensor in a microfluidic chip. The microfluidic channel guides the testing samples to flow across electro-optical sensor units, which produce dual-mode readouts by detecting infectious biomarkers of tuberculosis (TB), human rhinovirus (HRV), and group B streptococcus (GBS). Then, machine-learning classifiers generate three-dimensional (3D) hyperplanes to diagnose different diseases. Dual-mode readouts derived from distinct mechanisms enhance the anti-interference ability physically, and machine-learning-aided diagnosis in high-dimensional space reduces the occasional inaccuracy mathematically. Clinical validation studies with 501 unprocessed samples indicate that the platform has an accuracy approaching 99%, higher than the 77%-93% accuracy of rapid point-of-care testing technologies at 100% statistical power (>150 clinical tests). Moreover, the diagnosis time is 5 min without a trade-off of accuracy. This work solves the occasional inaccuracy issue of rapid on-site diagnosis, endowing POCT systems with the same accuracy as laboratory tests and holding unique prospects for complicated scenes of personalized healthcare.
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Affiliation(s)
- Changhao Dai
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200433, China
- Laboratory of Molecular Materials and Devices, Fudan University, Shanghai, 200433, China
| | - Huiwen Xiong
- Department of Chemistry, Fudan University, Shanghai, 200433, China
| | - Rui He
- School of Nuclear Science and Technology, Lanzhou University, Lanzhou, 73000, China
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, 730000, China
| | - Chenxin Zhu
- Institute of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Pintao Li
- Department of Chemistry, Fudan University, Shanghai, 200433, China
| | - Mingquan Guo
- Department of Laboratory Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China
| | - Jian Gou
- Department of Physics, National University of Singapore, Singapore, 117542, Singapore
| | - Miaomiao Mei
- Yizheng Hospital of Traditional Chinese Medicine, Yangzhou, 211400, China
| | - Derong Kong
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200433, China
- Laboratory of Molecular Materials and Devices, Fudan University, Shanghai, 200433, China
| | - Qiang Li
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, 730000, China
| | - Andrew Thye Shen Wee
- Department of Physics, National University of Singapore, Singapore, 117542, Singapore
| | - Xueen Fang
- Department of Chemistry, Fudan University, Shanghai, 200433, China
| | - Jilie Kong
- Department of Chemistry, Fudan University, Shanghai, 200433, China
| | - Yunqi Liu
- Laboratory of Molecular Materials and Devices, Fudan University, Shanghai, 200433, China
| | - Dacheng Wei
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, 200433, China
- Laboratory of Molecular Materials and Devices, Fudan University, Shanghai, 200433, China
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14
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Lee S, Park JS, Woo H, Yoo YK, Lee D, Chung S, Yoon DS, Lee KB, Lee JH. Rapid deep learning-assisted predictive diagnostics for point-of-care testing. Nat Commun 2024; 15:1695. [PMID: 38402240 PMCID: PMC10894262 DOI: 10.1038/s41467-024-46069-2] [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: 09/19/2023] [Accepted: 02/12/2024] [Indexed: 02/26/2024] Open
Abstract
Prominent techniques such as real-time polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA), and rapid kits are currently being explored to both enhance sensitivity and reduce assay time for diagnostic tests. Existing commercial molecular methods typically take several hours, while immunoassays can range from several hours to tens of minutes. Rapid diagnostics are crucial in Point-of-Care Testing (POCT). We propose an approach that integrates a time-series deep learning architecture and AI-based verification, for the enhanced result analysis of lateral flow assays. This approach is applicable to both infectious diseases and non-infectious biomarkers. In blind tests using clinical samples, our method achieved diagnostic times as short as 2 minutes, exceeding the accuracy of human analysis at 15 minutes. Furthermore, our technique significantly reduces assay time to just 1-2 minutes in the POCT setting. This advancement has the potential to greatly enhance POCT diagnostics, enabling both healthcare professionals and non-experts to make rapid, accurate decisions.
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Affiliation(s)
- Seungmin Lee
- Department of Electrical Engineering, Kwangwoon University, 20 Kwangwoon-ro, Nowon, Seoul, 01897, Republic of Korea
- School of Biomedical Engineering, Korea University, 145 Anam-ro, Seongbuk, Seoul, 02841, Republic of Korea
| | - Jeong Soo Park
- Department of Electrical Engineering, Kwangwoon University, 20 Kwangwoon-ro, Nowon, Seoul, 01897, Republic of Korea
- School of Mechanical Engineering, Korea University, 145 Anam-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Hyowon Woo
- Department of Electrical Engineering, Kwangwoon University, 20 Kwangwoon-ro, Nowon, Seoul, 01897, Republic of Korea
| | - Yong Kyoung Yoo
- Department of Electronic Engineering, Catholic Kwandong University, 24, Beomil-ro 579 beon-gil, Gangneung-si, Gangwon-do, 25601, Republic of Korea
| | - Dongho Lee
- CALTH Inc., Changeop-ro 54, Seongnam, Gyeonggi, 13449, Republic of Korea
| | - Seok Chung
- School of Mechanical Engineering, Korea University, 145 Anam-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea
| | - Dae Sung Yoon
- School of Biomedical Engineering, Korea University, 145 Anam-ro, Seongbuk, Seoul, 02841, Republic of Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, 02841, Republic of Korea
- Astrion Inc, Seoul, 02841, Republic of Korea
| | - Ki-Baek Lee
- Department of Electrical Engineering, Kwangwoon University, 20 Kwangwoon-ro, Nowon, Seoul, 01897, Republic of Korea
| | - Jeong Hoon Lee
- Department of Electrical Engineering, Kwangwoon University, 20 Kwangwoon-ro, Nowon, Seoul, 01897, Republic of Korea.
- CALTH Inc., Changeop-ro 54, Seongnam, Gyeonggi, 13449, Republic of Korea.
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15
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Wang Z, Li B, Yu H, Zhang Z, Ran M, Xia W, Yang Z, Lu J, Chen H, Zhou J, Shan H, Zhang Y. Promoting fast MR imaging pipeline by full-stack AI. iScience 2024; 27:108608. [PMID: 38174317 PMCID: PMC10762466 DOI: 10.1016/j.isci.2023.108608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/17/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
Magnetic resonance imaging (MRI) is a widely used imaging modality in clinics for medical disease diagnosis, staging, and follow-up. Deep learning has been extensively used to accelerate k-space data acquisition, enhance MR image reconstruction, and automate tissue segmentation. However, these three tasks are usually treated as independent tasks and optimized for evaluation by radiologists, thus ignoring the strong dependencies among them; this may be suboptimal for downstream intelligent processing. Here, we present a novel paradigm, full-stack learning (FSL), which can simultaneously solve these three tasks by considering the overall imaging process and leverage the strong dependence among them to further improve each task, significantly boosting the efficiency and efficacy of practical MRI workflows. Experimental results obtained on multiple open MR datasets validate the superiority of FSL over existing state-of-the-art methods on each task. FSL has great potential to optimize the practical workflow of MRI for medical diagnosis and radiotherapy.
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Affiliation(s)
- Zhiwen Wang
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Bowen Li
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Hui Yu
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Zhongzhou Zhang
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Maosong Ran
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Wenjun Xia
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Ziyuan Yang
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Jingfeng Lu
- School of Cyber Science and Engineering, Sichuan University, Chengdu, Sichuan, China
| | - Hu Chen
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Jiliu Zhou
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Hongming Shan
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Yi Zhang
- School of Cyber Science and Engineering, Sichuan University, Chengdu, Sichuan, China
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16
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Oyelade ON, Irunokhai EA, Wang H. A twin convolutional neural network with hybrid binary optimizer for multimodal breast cancer digital image classification. Sci Rep 2024; 14:692. [PMID: 38184742 PMCID: PMC10771515 DOI: 10.1038/s41598-024-51329-8] [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: 10/14/2023] [Accepted: 01/03/2024] [Indexed: 01/08/2024] Open
Abstract
There is a wide application of deep learning technique to unimodal medical image analysis with significant classification accuracy performance observed. However, real-world diagnosis of some chronic diseases such as breast cancer often require multimodal data streams with different modalities of visual and textual content. Mammography, magnetic resonance imaging (MRI) and image-guided breast biopsy represent a few of multimodal visual streams considered by physicians in isolating cases of breast cancer. Unfortunately, most studies applying deep learning techniques to solving classification problems in digital breast images have often narrowed their study to unimodal samples. This is understood considering the challenging nature of multimodal image abnormality classification where the fusion of high dimension heterogeneous features learned needs to be projected into a common representation space. This paper presents a novel deep learning approach combining a dual/twin convolutional neural network (TwinCNN) framework to address the challenge of breast cancer image classification from multi-modalities. First, modality-based feature learning was achieved by extracting both low and high levels features using the networks embedded with TwinCNN. Secondly, to address the notorious problem of high dimensionality associated with the extracted features, binary optimization method is adapted to effectively eliminate non-discriminant features in the search space. Furthermore, a novel method for feature fusion is applied to computationally leverage the ground-truth and predicted labels for each sample to enable multimodality classification. To evaluate the proposed method, digital mammography images and digital histopathology breast biopsy samples from benchmark datasets namely MIAS and BreakHis respectively. Experimental results obtained showed that the classification accuracy and area under the curve (AUC) for the single modalities yielded 0.755 and 0.861871 for histology, and 0.791 and 0.638 for mammography. Furthermore, the study investigated classification accuracy resulting from the fused feature method, and the result obtained showed that 0.977, 0.913, and 0.667 for histology, mammography, and multimodality respectively. The findings from the study confirmed that multimodal image classification based on combination of image features and predicted label improves performance. In addition, the contribution of the study shows that feature dimensionality reduction based on binary optimizer supports the elimination of non-discriminant features capable of bottle-necking the classifier.
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Affiliation(s)
- Olaide N Oyelade
- School of Electronics, Electrical Engineering and Computer Science, Queen's University Belfast, Belfast, BT9 SBN, UK.
| | | | - Hui Wang
- School of Electronics, Electrical Engineering and Computer Science, Queen's University Belfast, Belfast, BT9 SBN, UK
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17
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Chae A, Yao MS, Sagreiya H, Goldberg AD, Chatterjee N, MacLean MT, Duda J, Elahi A, Borthakur A, Ritchie MD, Rader D, Kahn CE, Witschey WR, Gee JC. Strategies for Implementing Machine Learning Algorithms in the Clinical Practice of Radiology. Radiology 2024; 310:e223170. [PMID: 38259208 PMCID: PMC10831483 DOI: 10.1148/radiol.223170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 01/24/2024]
Abstract
Despite recent advancements in machine learning (ML) applications in health care, there have been few benefits and improvements to clinical medicine in the hospital setting. To facilitate clinical adaptation of methods in ML, this review proposes a standardized framework for the step-by-step implementation of artificial intelligence into the clinical practice of radiology that focuses on three key components: problem identification, stakeholder alignment, and pipeline integration. A review of the recent literature and empirical evidence in radiologic imaging applications justifies this approach and offers a discussion on structuring implementation efforts to help other hospital practices leverage ML to improve patient care. Clinical trial registration no. 04242667 © RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
| | | | - Hersh Sagreiya
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Ari D. Goldberg
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Neil Chatterjee
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Matthew T. MacLean
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Jeffrey Duda
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Ameena Elahi
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Arijitt Borthakur
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Marylyn D. Ritchie
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Daniel Rader
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
| | - Charles E. Kahn
- From the Departments of Bioengineering (M.S.Y.), Radiology (H.S.,
N.C., M.T.M., J.D., A.B., C.E.K., W.R.W., J.C.G.), Genetics (M.D.R.), and
Medicine (D.R.), Perelman School of Medicine (A.C., M.S.Y., H.S., A.B., C.E.K.,
W.R.W., J.C.G.), University of Pennsylvania, 3400 Civic Center Blvd,
Philadelphia, PA 19104; Department of Radiology, Loyola University Medical
Center, Maywood, Ill (A.D.G.); Department of Information Services, University of
Pennsylvania, Philadelphia, Pa (A.E.); and Leonard Davis Institute of Health
Economics, University of Pennsylvania, Philadelphia, Pa (A.B.)
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18
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Wang H, Bothe TL, Deng C, Lv S, Khedkar PH, Kovacs R, Patzak A, Wu L. Comparison of Prognostic Models for Functional Outcome in Aneurysmal Subarachnoid Hemorrhage Based on Machine Learning. World Neurosurg 2023; 180:e686-e699. [PMID: 37821029 DOI: 10.1016/j.wneu.2023.10.008] [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: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Controversy exists regarding the superiority of the performance of prognostic tools based on advanced machine learning (ML) algorithms for patients with aneurysmal subarachnoid hemorrhage (aSAH). However, it is unclear whether ML prognostic models will benefit patients due to the lack of a comprehensive assessment. We aimed to develop and evaluate ML models for predicting unfavorable functional outcomes for aSAH patients and identify the model with the greatest performance. METHODS In this retrospective study, a dataset of 955 patients with aSAH was used to construct and validate prognostic models for functional outcomes assessed using the modified Rankin scale during a follow-up period of 3-6 months. Clinical scores and clinical and radiological features on admission and secondary complications were used to construct models based on 5 ML algorithms (i.e., logistic regression [LR], k-nearest neighbor, extreme gradient boosting, random forest, and artificial neural network). For evaluation among the models, the area under the receiver operating characteristic curve, area under the precision-recall curve, calibration curve, and decision curve analysis were used. RESULTS Composite models had significantly higher area under the receiver operating characteristic curves than did simple models in predicting unfavorable functional outcomes. Compared with other composite models (random forest and extreme gradient boosting) with good calibration, LR had the highest area under the precision-recall score and showed the greatest benefit in decision curve analysis. CONCLUSIONS Of the 5 studied ML models, the conventional LR model outperformed the advanced algorithms in predicting the prognosis and could be a useful tool for health care professionals.
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Affiliation(s)
- Han Wang
- Institute of Translational Physiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu, Berlin, Germany; Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Tomas L Bothe
- Institute of Translational Physiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu, Berlin, Germany
| | - Chulei Deng
- Department of Neurosurgery, Jinling Hospital, Nanjing, China
| | - Shengyin Lv
- Department of Neurology, Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Pratik H Khedkar
- Institute of Translational Physiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu, Berlin, Germany
| | - Richard Kovacs
- Institute of Neurophysiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu, Berlin, Germany
| | - Andreas Patzak
- Institute of Translational Physiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu, Berlin, Germany
| | - Lingyun Wu
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
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19
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Li JW, Sheng DL, Chen JG, You C, Liu S, Xu HX, Chang C. Artificial intelligence in breast imaging: potentials and challenges. Phys Med Biol 2023; 68:23TR01. [PMID: 37722385 DOI: 10.1088/1361-6560/acfade] [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: 01/15/2023] [Accepted: 09/18/2023] [Indexed: 09/20/2023]
Abstract
Breast cancer, which is the most common type of malignant tumor among humans, is a leading cause of death in females. Standard treatment strategies, including neoadjuvant chemotherapy, surgery, postoperative chemotherapy, targeted therapy, endocrine therapy, and radiotherapy, are tailored for individual patients. Such personalized therapies have tremendously reduced the threat of breast cancer in females. Furthermore, early imaging screening plays an important role in reducing the treatment cycle and improving breast cancer prognosis. The recent innovative revolution in artificial intelligence (AI) has aided radiologists in the early and accurate diagnosis of breast cancer. In this review, we introduce the necessity of incorporating AI into breast imaging and the applications of AI in mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography/computed tomography based on published articles since 1994. Moreover, the challenges of AI in breast imaging are discussed.
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Affiliation(s)
- Jia-Wei Li
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Dan-Li Sheng
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Jian-Gang Chen
- Shanghai Key Laboratory of Multidimensional Information Processing, School of Communication & Electronic Engineering, East China Normal University, People's Republic of China
| | - Chao You
- Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China
| | - Shuai Liu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China
| | - Hui-Xiong Xu
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, People's Republic of China
| | - Cai Chang
- Department of Medical Ultrasound, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
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20
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Yan S, Li J, Wu W. Artificial intelligence in breast cancer: application and future perspectives. J Cancer Res Clin Oncol 2023; 149:16179-16190. [PMID: 37656245 DOI: 10.1007/s00432-023-05337-2] [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: 06/26/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
Breast cancer is one of the most common cancers and is one of the leading causes of cancer-related deaths in women worldwide. Early diagnosis and treatment are the key for a favorable prognosis. The application of artificial intelligence technology in the medical field is increasingly extensive, including image analysis, automated diagnosis, intelligent pharmaceutical system, personalized treatment and so on. AI-based breast cancer imaging, pathology and adjuvant therapy technology cannot only reduce the workload of clinicians, but also continuously improve the accuracy and sensitivity of breast cancer diagnosis and treatment. This paper reviews the application of AI in breast cancer, as well as looks ahead and poses challenges to the future development of AI for breast cancer detection and therapeutic, so as to provide ideas for future research.
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Affiliation(s)
- Shuixin Yan
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315000, Zhejiang, China
| | - Jiadi Li
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315000, Zhejiang, China
| | - Weizhu Wu
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315000, Zhejiang, China.
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21
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Reig B, Kim E, Chhor CM, Moy L, Lewin AA, Heacock L. Problem-solving Breast MRI. Radiographics 2023; 43:e230026. [PMID: 37733618 DOI: 10.1148/rg.230026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Breast MRI has high sensitivity and negative predictive value, making it well suited to problem solving when other imaging modalities or physical examinations yield results that are inconclusive for the presence of breast cancer. Indications for problem-solving MRI include equivocal or uncertain imaging findings at mammography and/or US; suspicious nipple discharge or skin changes suspected to represent an abnormality when conventional imaging results are negative for cancer; lesions categorized as Breast Imaging Reporting and Data System 4, which are not amenable to biopsy; and discordant radiologic-pathologic findings after biopsy. MRI should not precede or replace careful diagnostic workup with mammography and US and should not be used when a biopsy can be safely performed. The role of MRI in characterizing calcifications is controversial, and management of calcifications should depend on their mammographic appearance because ductal carcinoma in situ may not appear enhancing on MR images. In addition, ductal carcinoma in situ detected solely with MRI is not associated with a higher likelihood of an upgrade to invasive cancer compared with ductal carcinoma in situ detected with other modalities. MRI for triage of high-risk lesions is a subject of ongoing investigation, with a possible future role for MRI in decreasing excisional biopsies. The accuracy of MRI is likely to increase with the use of advanced techniques such as deep learning, which will likely expand the indications for problem-solving MRI. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Beatriu Reig
- From the Department of Radiology, NYU Langone Health, 660 1st Ave, New York, NY 10016
| | - Eric Kim
- From the Department of Radiology, NYU Langone Health, 660 1st Ave, New York, NY 10016
| | - Chloe M Chhor
- From the Department of Radiology, NYU Langone Health, 660 1st Ave, New York, NY 10016
| | - Linda Moy
- From the Department of Radiology, NYU Langone Health, 660 1st Ave, New York, NY 10016
| | - Alana A Lewin
- From the Department of Radiology, NYU Langone Health, 660 1st Ave, New York, NY 10016
| | - Laura Heacock
- From the Department of Radiology, NYU Langone Health, 660 1st Ave, New York, NY 10016
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22
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Chen Y, Hua Z, Lin F, Zheng T, Zhou H, Zhang S, Gao J, Wang Z, Shao H, Li W, Liu F, Wang S, Zhang Y, Zhao F, Liu H, Xie H, Ma H, Zhang H, Mao N. Detection and classification of breast lesions using multiple information on contrast-enhanced mammography by a multiprocess deep-learning system: A multicenter study. Chin J Cancer Res 2023; 35:408-423. [PMID: 37691895 PMCID: PMC10485921 DOI: 10.21147/j.issn.1000-9604.2023.04.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/18/2023] [Indexed: 09/12/2023] Open
Abstract
Objective Accurate detection and classification of breast lesions in early stage is crucial to timely formulate effective treatments for patients. We aim to develop a fully automatic system to detect and classify breast lesions using multiple contrast-enhanced mammography (CEM) images. Methods In this study, a total of 1,903 females who underwent CEM examination from three hospitals were enrolled as the training set, internal testing set, pooled external testing set and prospective testing set. Here we developed a CEM-based multiprocess detection and classification system (MDCS) to perform the task of detection and classification of breast lesions. In this system, we introduced an innovative auxiliary feature fusion (AFF) algorithm that could intelligently incorporates multiple types of information from CEM images. The average free-response receiver operating characteristic score (AFROC-Score) was presented to validate system's detection performance, and the performance of classification was evaluated by area under the receiver operating characteristic curve (AUC). Furthermore, we assessed the diagnostic value of MDCS through visual analysis of disputed cases, comparing its performance and efficiency with that of radiologists and exploring whether it could augment radiologists' performance. Results On the pooled external and prospective testing sets, MDCS always maintained a high standalone performance, with AFROC-Scores of 0.953 and 0.963 for detection task, and AUCs for classification were 0.909 [95% confidence interval (95% CI): 0.822-0.996] and 0.912 (95% CI: 0.840-0.985), respectively. It also achieved higher sensitivity than all senior radiologists and higher specificity than all junior radiologists on pooled external and prospective testing sets. Moreover, MDCS performed superior diagnostic efficiency with an average reading time of 5 seconds, compared to the radiologists' average reading time of 3.2 min. The average performance of all radiologists was also improved to varying degrees with MDCS assistance. Conclusions MDCS demonstrated excellent performance in the detection and classification of breast lesions, and greatly enhanced the overall performance of radiologists.
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Affiliation(s)
- Yuqian Chen
- School of Information and Electronic Engineering, Shandong Technology and Business University, Yantai 264005, China
| | - Zhen Hua
- School of Information and Electronic Engineering, Shandong Technology and Business University, Yantai 264005, China
| | - Fan Lin
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Tiantian Zheng
- School of Medical Imaging, Binzhou Medical University, Yantai 264003, China
| | - Heng Zhou
- School of Information and Electronic Engineering, Shandong Technology and Business University, Yantai 264005, China
| | - Shijie Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Jing Gao
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Zhongyi Wang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Huafei Shao
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Wenjuan Li
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Fengjie Liu
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Simin Wang
- Department of Radiology, Fudan University Cancer Center, Shanghai 200433; China
| | - Yan Zhang
- Department of Radiology, Guangdong Maternal and Child Health Hospital, Guangzhou 510010, China
| | - Feng Zhao
- School of Computer Science and Technology, Shandong Technology and Business University, Yantai 264005, China
| | - Hao Liu
- Yizhun Medical AI Co. Ltd., Beijing 100080, China
| | - Haizhu Xie
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Heng Ma
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Haicheng Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
- Big Data and Artificial Intelligence Laboratory, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
- Big Data and Artificial Intelligence Laboratory, Yantai Yuhuangding Hospital, Affiliated Hospital of Qingdao University, Yantai 264000, China
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23
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Hagiwara A, Fujita S, Kurokawa R, Andica C, Kamagata K, Aoki S. Multiparametric MRI: From Simultaneous Rapid Acquisition Methods and Analysis Techniques Using Scoring, Machine Learning, Radiomics, and Deep Learning to the Generation of Novel Metrics. Invest Radiol 2023; 58:548-560. [PMID: 36822661 PMCID: PMC10332659 DOI: 10.1097/rli.0000000000000962] [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: 12/01/2022] [Revised: 01/10/2023] [Indexed: 02/25/2023]
Abstract
ABSTRACT With the recent advancements in rapid imaging methods, higher numbers of contrasts and quantitative parameters can be acquired in less and less time. Some acquisition models simultaneously obtain multiparametric images and quantitative maps to reduce scan times and avoid potential issues associated with the registration of different images. Multiparametric magnetic resonance imaging (MRI) has the potential to provide complementary information on a target lesion and thus overcome the limitations of individual techniques. In this review, we introduce methods to acquire multiparametric MRI data in a clinically feasible scan time with a particular focus on simultaneous acquisition techniques, and we discuss how multiparametric MRI data can be analyzed as a whole rather than each parameter separately. Such data analysis approaches include clinical scoring systems, machine learning, radiomics, and deep learning. Other techniques combine multiple images to create new quantitative maps associated with meaningful aspects of human biology. They include the magnetic resonance g-ratio, the inner to the outer diameter of a nerve fiber, and the aerobic glycolytic index, which captures the metabolic status of tumor tissues.
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Affiliation(s)
- Akifumi Hagiwara
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shohei Fujita
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Kurokawa
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Christina Andica
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Koji Kamagata
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- From theDepartment of Radiology, Juntendo University School of Medicine, Tokyo, Japan
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24
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The Systematic Review of Artificial Intelligence Applications in Breast Cancer Diagnosis. Diagnostics (Basel) 2022; 13:diagnostics13010045. [PMID: 36611337 PMCID: PMC9818874 DOI: 10.3390/diagnostics13010045] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022] Open
Abstract
Several studies have demonstrated the value of artificial intelligence (AI) applications in breast cancer diagnosis. The systematic review of AI applications in breast cancer diagnosis includes several studies that compare breast cancer diagnosis and AI. However, they lack systematization, and each study appears to be conducted uniquely. The purpose and contributions of this study are to offer elaborative knowledge on the applications of AI in the diagnosis of breast cancer through citation analysis in order to categorize the main area of specialization that attracts the attention of the academic community, as well as thematic issue analysis to identify the species being researched in each category. In this study, a total number of 17,900 studies addressing breast cancer and AI published between 2012 and 2022 were obtained from these databases: IEEE, Embase: Excerpta Medica Database Guide-Ovid, PubMed, Springer, Web of Science, and Google Scholar. We applied inclusion and exclusion criteria to the search; 36 studies were identified. The vast majority of AI applications used classification models for the prediction of breast cancer. Howbeit, accuracy (99%) has the highest number of performance metrics, followed by specificity (98%) and area under the curve (0.95). Additionally, the Convolutional Neural Network (CNN) was the best model of choice in several studies. This study shows that the quantity and caliber of studies that use AI applications in breast cancer diagnosis will continue to rise annually. As a result, AI-based applications are viewed as a supplement to doctors' clinical reasoning, with the ultimate goal of providing quality healthcare that is both affordable and accessible to everyone worldwide.
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25
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Li X, Cui J, Song J, Jia M, Zou Z, Ding G, Zheng Y. Contextual Features and Information Bottleneck-Based Multi-Input Network for Breast Cancer Classification from Contrast-Enhanced Spectral Mammography. Diagnostics (Basel) 2022; 12:diagnostics12123133. [PMID: 36553140 PMCID: PMC9777091 DOI: 10.3390/diagnostics12123133] [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: 10/31/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
In computer-aided diagnosis methods for breast cancer, deep learning has been shown to be an effective method to distinguish whether lesions are present in tissues. However, traditional methods only classify masses as benign or malignant, according to their presence or absence, without considering the contextual features between them and their adjacent tissues. Furthermore, for contrast-enhanced spectral mammography, the existing studies have only performed feature extraction on a single image per breast. In this paper, we propose a multi-input deep learning network for automatic breast cancer classification. Specifically, we simultaneously input four images of each breast with different feature information into the network. Then, we processed the feature maps in both horizontal and vertical directions, preserving the pixel-level contextual information within the neighborhood of the tumor during the pooling operation. Furthermore, we designed a novel loss function according to the information bottleneck theory to optimize our multi-input network and ensure that the common information in the multiple input images could be fully utilized. Our experiments on 488 images (256 benign and 232 malignant images) from 122 patients show that the method's accuracy, precision, sensitivity, specificity, and f1-score values are 0.8806, 0.8803, 0.8810, 0.8801, and 0.8806, respectively. The qualitative, quantitative, and ablation experiment results show that our method significantly improves the accuracy of breast cancer classification and reduces the false positive rate of diagnosis. It can reduce misdiagnosis rates and unnecessary biopsies, helping doctors determine accurate clinical diagnoses of breast cancer from multiple CESM images.
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Affiliation(s)
- Xinmeng Li
- School of Information Science and Engineering, Shandong Normal University, Jinan 250358, China
| | - Jia Cui
- School of Information Science and Engineering, Shandong Normal University, Jinan 250358, China
- Correspondence:
| | - Jingqi Song
- School of Information Science and Engineering, Shandong Normal University, Jinan 250358, China
| | - Mingyu Jia
- School of Information Science and Engineering, Shandong Normal University, Jinan 250358, China
| | - Zhenxing Zou
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai 264001, China
| | - Guocheng Ding
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai 264001, China
| | - Yuanjie Zheng
- School of Information Science and Engineering, Shandong Normal University, Jinan 250358, China
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