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Di Fiore R, Drago-Ferrante R, Suleiman S, Veronese N, Pegreffi F, Calleja-Agius J. Sarcopenia in gynaecological cancers. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024:108403. [PMID: 38760237 DOI: 10.1016/j.ejso.2024.108403] [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: 01/08/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024]
Abstract
Gynaecological cancers (GCs) comprise a group of cancers that originate in the female reproductive organs. Each GC is unique, with different signs and symptoms, risk factors and therapeutic strategies. Worldwide, the majority of GCs are still associated with high mortality rates, especially ovarian, due to difficulty in early detection. Despite numerous studies on the underlying pathophysiology, research in the field of GCs poses unique scientific and technological challenges. These challenges require a concerted multi- and inter-disciplinary effort by the clinical, scientific and research communities to accelerate the advancement of prognostic, diagnostic, and therapeutic approaches. Sarcopenia is a multifactorial disease which leads to the systemic loss of skeletal muscle mass and function. It can be caused by malignancies, as well as due to malnutrition, physical inactivity, ageing and neuromuscular, inflammatory, and/or endocrine diseases. Anorexia and systemic inflammation can shift the metabolic balance of patients with cancer cachexia towards catabolism of skeletal muscle, and hence sarcopenia. Therefore, sarcopenia is considered as an indicator of poor general health status, as well as the possible indicator of advanced cancer. There is a growing body of evidence showing the prognostic significance of sarcopenia in various cancers, including GCs. This review will outline the clinical importance of sarcopenia in patients with GCs.
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Affiliation(s)
- Riccardo Di Fiore
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta; Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA, 19122, USA.
| | - Rosa Drago-Ferrante
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta; BioDNA Laboratories, Malta Life Sciences Park, SGN 3000, San Gwann, Malta.
| | - Sherif Suleiman
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta.
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, 90128, Palermo, Italy.
| | - Francesco Pegreffi
- Department of Medicine and Surgery, Kore University of Enna, 94100, Enna, Italy.
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080, Msida, Malta.
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Butt SR, Soulat A, Lal PM, Fakhor H, Patel SK, Ali MB, Arwani S, Mohan A, Majumder K, Kumar V, Tejwaney U, Kumar S. Impact of artificial intelligence on the diagnosis, treatment and prognosis of endometrial cancer. Ann Med Surg (Lond) 2024; 86:1531-1539. [PMID: 38463097 PMCID: PMC10923372 DOI: 10.1097/ms9.0000000000001733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
Endometrial cancer is one of the most prevalent tumours in females and holds an 83% survival rate within 5 years of diagnosis. Hypoestrogenism is a major risk factor for the development of endometrial carcinoma (EC) therefore two major types are derived, type 1 being oestrogen-dependent and type 2 being oestrogen independent. Surgery, chemotherapeutic drugs, and radiation therapy are only a few of the treatment options for EC. Treatment of gynaecologic malignancies greatly depends on diagnosis or prognostic prediction. Diagnostic imaging data and clinical course prediction are the two core pillars of artificial intelligence (AI) applications. One of the most popular imaging techniques for spotting preoperative endometrial cancer is MRI, although this technique can only produce qualitative data. When used to classify patients, AI improves the effectiveness of visual feature extraction. In general, AI has the potential to enhance the precision and effectiveness of endometrial cancer diagnosis and therapy. This review aims to highlight the current status of applications of AI in endometrial cancer and provide a comprehensive understanding of how recent advancements in AI have assisted clinicians in making better diagnosis and improving prognosis of endometrial cancer. Still, additional study is required to comprehend its strengths and limits fully.
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Affiliation(s)
| | | | | | | | | | | | | | - Anmol Mohan
- Karachi Medical and Dental College, Karachi, Pakistan
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Kim M, Lee SM, Son IT, Park T, Oh BY. Prognostic Value of Artificial Intelligence-Driven, Computed Tomography-Based, Volumetric Assessment of the Volume and Density of Muscle in Patients With Colon Cancer. Korean J Radiol 2023; 24:849-859. [PMID: 37634640 PMCID: PMC10462901 DOI: 10.3348/kjr.2023.0109] [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: 11/01/2022] [Revised: 05/03/2023] [Accepted: 06/28/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE The prognostic value of the volume and density of skeletal muscles in the abdominal waist of patients with colon cancer remains unclear. This study aimed to investigate the association between the automated computed tomography (CT)-based volume and density of the muscle in the abdominal waist and survival outcomes in patients with colon cancer. MATERIALS AND METHODS We retrospectively evaluated 474 patients with colon cancer who underwent surgery with curative intent between January 2010 and October 2017. Volumetric skeletal muscle index and muscular density were measured at the abdominal waist using artificial intelligence (AI)-based volumetric segmentation of body composition on preoperative pre-contrast CT images. Patients were grouped based on their skeletal muscle index (sarcopenia vs. not) and muscular density (myosteatosis vs. not) values and combinations (normal, sarcopenia alone, myosteatosis alone, and combined sarcopenia and myosteatosis). Postsurgical disease-free survival (DFS) and overall survival (OS) were analyzed using univariable and multivariable analyses, including multivariable Cox proportional hazard regression. RESULTS Univariable analysis showed that DFS and OS were significantly worse for the sarcopenia group than for the non-sarcopenia group (P = 0.044 and P = 0.003, respectively, by log-rank test) and for the myosteatosis group than for the non-myosteatosis group (P < 0.001 by log-rank test for all). In the multivariable analysis, the myosteatotic muscle type was associated with worse DFS (adjusted hazard ratio [aHR], 1.89 [95% confidence interval, 1.25-2.86]; P = 0.003) and OS (aHR, 1.90 [95% confidence interval, 1.84-3.04]; P = 0.008) than the normal muscle type. The combined muscle type showed worse OS than the normal muscle type (aHR, 1.95 [95% confidence interval, 1.08-3.54]; P = 0.027). CONCLUSION Preoperative volumetric sarcopenia and myosteatosis, automatically assessed from pre-contrast CT scans using AI-based software, adversely affect survival outcomes in patients with colon cancer.
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Affiliation(s)
- Minsung Kim
- Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Sang Min Lee
- Department of Radiology, CHA University Gangnam Medical Center, Seoul, Republic of Korea
| | - Il Tae Son
- Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Taeyong Park
- Medical Artificial Intelligence Center, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Bo Young Oh
- Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
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Borrelli A, Pecoraro M, Del Giudice F, Cristofani L, Messina E, Dehghanpour A, Landini N, Roberto M, Perotti S, Muscaritoli M, Santini D, Catalano C, Panebianco V. Standardization of Body Composition Status in Patients with Advanced Urothelial Tumors: The Role of a CT-Based AI-Powered Software for the Assessment of Sarcopenia and Patient Outcome Correlation. Cancers (Basel) 2023; 15:cancers15112968. [PMID: 37296930 DOI: 10.3390/cancers15112968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Sarcopenia is a well know prognostic factor in oncology, influencing patients' quality of life and survival. We aimed to investigate the role of sarcopenia, assessed by a Computed Tomography (CT)-based artificial intelligence (AI)-powered-software, as a predictor of objective clinical benefit in advanced urothelial tumors and its correlations with oncological outcomes. METHODS We retrospectively searched patients with advanced urothelial tumors, treated with systemic platinum-based chemotherapy and an available total body CT, performed before and after therapy. An AI-powered software was applied to CT to obtain the Skeletal Muscle Index (SMI-L3), derived from the area of the psoas, long spine, and abdominal muscles, at the level of L3 on CT axial images. Logistic and Cox-regression modeling was implemented to explore the association of sarcopenic status and anthropometric features to the clinical benefit rate and survival endpoints. RESULTS 97 patients were included, 66 with bladder cancer and 31 with upper-tract urothelial carcinoma. Clinical benefit outcomes showed a linear positive association with all the observed body composition variables variations. The chances of not experiencing disease progression were positively associated with ∆_SMI-L3, ∆_psoas, and ∆_long spine muscle when they ranged from ~10-20% up to ~45-55%. Greater survival chances were matched by patients achieving a wider ∆_SMI-L3, ∆_abdominal and ∆_long spine muscle. CONCLUSIONS A CT-based AI-powered software body composition and sarcopenia analysis provide prognostic assessments for objective clinical benefits and oncological outcomes.
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Affiliation(s)
- Antonella Borrelli
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Martina Pecoraro
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Leonardo Cristofani
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Emanuele Messina
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Ailin Dehghanpour
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Nicholas Landini
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Michela Roberto
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Stefano Perotti
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Daniele Santini
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy
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Schmeusser BN, Ali AA, Fintelmann FJ, Garcia JM, Williams GR, Master VA, Psutka SP. Imaging Techniques to Determine Degree of Sarcopenia and Systemic Inflammation in Advanced Renal Cell Carcinoma. Curr Urol Rep 2023:10.1007/s11934-023-01157-6. [PMID: 37036632 DOI: 10.1007/s11934-023-01157-6] [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] [Accepted: 03/12/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an up-to-date understanding regarding the literature on sarcopenia and inflammation as prognostic factors in the context of renal cell carcinoma (RCC). RECENT FINDINGS Sarcopenia is increasingly recognized as a prognostic factor in RCC. Emerging literature suggests monitoring quantity of muscle on successive imaging and examining muscle density may be additionally informative. Inflammation has prognostic ability in RCC and is also considered a key contributor to development and progression of both RCC and sarcopenia. Recent studies suggest these two prognostic factors together may provide additional prognostic ability when used in combination. Ongoing developments include quality control regarding sarcopenia research and imaging, improving understanding of muscle loss mechanisms, and enhancing clinical incorporation of sarcopenia via improving imaging analysis practicality (i.e., artificial intelligence) and feasible biomarkers. Sarcopenia and systemic inflammation are complementary prognostic factors for adverse outcomes in patients with RCC. Further study on high-quality sarcopenia assessment standardization and expedited sarcopenia assessment is desired for eventual routine clinical incorporation of these prognostic factors.
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Affiliation(s)
- Benjamin N Schmeusser
- Department of Urology, Emory University School of Medicine, 1365 Clifton Road NE, Building B, Suite 1400, Atlanta, GA, 30322, USA
| | - Adil A Ali
- Department of Urology, Emory University School of Medicine, 1365 Clifton Road NE, Building B, Suite 1400, Atlanta, GA, 30322, USA
| | | | - Jose M Garcia
- Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Medicine, Division of Gerontology & Geriatric Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Grant R Williams
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Alabama, USA
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Viraj A Master
- Department of Urology, Emory University School of Medicine, 1365 Clifton Road NE, Building B, Suite 1400, Atlanta, GA, 30322, USA.
- Winship Cancer Institute, Emory University, Atlanta, GA, USA.
| | - Sarah P Psutka
- Department of Urology, University of Washington, 1959 NE Pacific Stree, Box 356510, Seattle, WA, 98195, USA.
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, USA.
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Santhanam P, Nath T, Peng C, Bai H, Zhang H, Ahima RS, Chellappa R. Artificial intelligence and body composition. Diabetes Metab Syndr 2023; 17:102732. [PMID: 36867973 DOI: 10.1016/j.dsx.2023.102732] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
AIMS Although obesity is associated with chronic disease, a large section of the population with high BMI does not have an increased risk of metabolic disease. Increased visceral adiposity and sarcopenia are also risk factors for metabolic disease in people with normal BMI. Artificial Intelligence (AI) techniques can help assess and analyze body composition parameters for predicting cardiometabolic health. The purpose of the study was to systematically explore literature involving AI techniques for body composition assessment and observe general trends. METHODS We searched the following databases: Embase, Web of Science, and PubMed. There was a total of 354 search results. After removing duplicates, irrelevant studies, and reviews(a total of 303), 51 studies were included in the systematic review. RESULTS AI techniques have been studied for body composition analysis in the context of diabetes mellitus, hypertension, cancer and many specialized diseases. Imaging techniques employed for AI methods include CT (Computerized Tomography), MRI (Magnetic Resonance Imaging), ultrasonography, plethysmography, and EKG(Electrocardiogram). Automatic segmentation of body composition by deep learning with convolutional networks has helped determine and quantify muscle mass. Limitations include heterogeneity of study populations, inherent bias in sampling, and lack of generalizability. Different bias mitigation strategies should be evaluated to address these problems and improve the applicability of AI to body composition analysis. CONCLUSIONS AI assisted measurement of body composition might assist in improved cardiovascular risk stratification when applied in the appropriate clinical context.
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Affiliation(s)
- Prasanna Santhanam
- Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Tanmay Nath
- Department Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Cheng Peng
- Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Harrison Bai
- Department of Radiology and Radiology Sciences, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Helen Zhang
- The Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Rexford S Ahima
- Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Rama Chellappa
- Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, 21287, USA; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
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Cerdá-Alberich L, Solana J, Mallol P, Ribas G, García-Junco M, Alberich-Bayarri A, Marti-Bonmati L. MAIC-10 brief quality checklist for publications using artificial intelligence and medical images. Insights Imaging 2023; 14:11. [PMID: 36645542 PMCID: PMC9842808 DOI: 10.1186/s13244-022-01355-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/20/2022] [Indexed: 01/17/2023] Open
Abstract
The use of artificial intelligence (AI) with medical images to solve clinical problems is becoming increasingly common, and the development of new AI solutions is leading to more studies and publications using this computational technology. As a novel research area, the use of common standards to aid AI developers and reviewers as quality control criteria will improve the peer review process. Although some guidelines do exist, their heterogeneity and extension advocate that more explicit and simple schemes should be applied on the publication practice. Based on a review of existing AI guidelines, a proposal which collects, unifies, and simplifies the most relevant criteria was developed. The MAIC-10 (Must AI Criteria-10) checklist with 10 items was implemented as a guide to design studies and evaluate publications related to AI in the field of medical imaging. Articles published in Insights into Imaging in 2021 were selected to calculate their corresponding MAIC-10 quality score. The mean score was found to be 5.6 ± 1.6, with critical items present in most articles, such as "Clinical need", "Data annotation", "Robustness", and "Transparency" present in more than 80% of papers, while improvements in other areas were identified. MAIC-10 was also observed to achieve the highest intra-observer reproducibility when compared to other existing checklists, with an overall reduction in terms of checklist length and complexity. In summary, MAIC-10 represents a short and simple quality assessment tool which is objective, robust and widely applicable to AI studies in medical imaging.
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Affiliation(s)
- Leonor Cerdá-Alberich
- grid.84393.350000 0001 0360 9602Clinical Medical Imaging Area and Biomedical Imaging Research Group (GIBI230-PREBI), Hospital Universitario y Politécnico La Fe – Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Jimena Solana
- grid.84393.350000 0001 0360 9602Clinical Medical Imaging Area and Biomedical Imaging Research Group (GIBI230-PREBI), Hospital Universitario y Politécnico La Fe – Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Pedro Mallol
- grid.84393.350000 0001 0360 9602Clinical Medical Imaging Area and Biomedical Imaging Research Group (GIBI230-PREBI), Hospital Universitario y Politécnico La Fe – Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Gloria Ribas
- grid.84393.350000 0001 0360 9602Clinical Medical Imaging Area and Biomedical Imaging Research Group (GIBI230-PREBI), Hospital Universitario y Politécnico La Fe – Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Miguel García-Junco
- grid.84393.350000 0001 0360 9602Clinical Medical Imaging Area and Biomedical Imaging Research Group (GIBI230-PREBI), Hospital Universitario y Politécnico La Fe – Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Angel Alberich-Bayarri
- grid.84393.350000 0001 0360 9602Clinical Medical Imaging Area and Biomedical Imaging Research Group (GIBI230-PREBI), Hospital Universitario y Politécnico La Fe – Instituto de Investigación Sanitaria La Fe, Valencia, Spain ,Quantitative Imaging Biomarkers in Medicine, Quibim SL, Valencia, Spain
| | - Luis Marti-Bonmati
- grid.84393.350000 0001 0360 9602Clinical Medical Imaging Area and Biomedical Imaging Research Group (GIBI230-PREBI), Hospital Universitario y Politécnico La Fe – Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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