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Sufyan M, Shokat Z, Ashfaq UA. Artificial intelligence in cancer diagnosis and therapy: Current status and future perspective. Comput Biol Med 2023; 165:107356. [PMID: 37688994 DOI: 10.1016/j.compbiomed.2023.107356] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/21/2023] [Accepted: 08/12/2023] [Indexed: 09/11/2023]
Abstract
Artificial intelligence (AI) in healthcare plays a pivotal role in combating many fatal diseases, such as skin, breast, and lung cancer. AI is an advanced form of technology that uses mathematical-based algorithmic principles similar to those of the human mind for cognizing complex challenges of the healthcare unit. Cancer is a lethal disease with many etiologies, including numerous genetic and epigenetic mutations. Cancer being a multifactorial disease is difficult to be diagnosed at an early stage. Therefore, genetic variations and other leading factors could be identified in due time through AI and machine learning (ML). AI is the synergetic approach for mining the drug targets, their mechanism of action, and drug-organism interaction from massive raw data. This synergetic approach is also facing several challenges in data mining but computational algorithms from different scientific communities for multi-target drug discovery are highly helpful to overcome the bottlenecks in AI for drug-target discovery. AI and ML could be the epicenter in the medical world for the diagnosis, treatment, and evaluation of almost any disease in the near future. In this comprehensive review, we explore the immense potential of AI and ML when integrated with the biological sciences, specifically in the context of cancer research. Our goal is to illuminate the many ways in which AI and ML are being applied to the study of cancer, from diagnosis to individualized treatment. We highlight the prospective role of AI in supporting oncologists and other medical professionals in making informed decisions and improving patient outcomes by examining the intersection of AI and cancer control. Although AI-based medical therapies show great potential, many challenges must be overcome before they can be implemented in clinical practice. We critically assess the current hurdles and provide insights into the future directions of AI-driven approaches, aiming to pave the way for enhanced cancer interventions and improved patient care.
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Affiliation(s)
- Muhammad Sufyan
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Pakistan.
| | - Zeeshan Shokat
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Pakistan.
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Pakistan.
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2
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Schena CA, Laterza V, De Sio D, Quero G, Fiorillo C, Gunawardena G, Strippoli A, Tondolo V, de'Angelis N, Alfieri S, Rosa F. The Role of Staging Laparoscopy for Gastric Cancer Patients: Current Evidence and Future Perspectives. Cancers (Basel) 2023; 15:3425. [PMID: 37444535 DOI: 10.3390/cancers15133425] [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: 05/13/2023] [Revised: 06/18/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
A significant proportion of patients diagnosed with gastric cancer is discovered with peritoneal metastases at laparotomy. Despite the continuous improvement in the performance of radiological imaging, the preoperative recognition of such an advanced disease is still challenging during the diagnostic work-up, since the sensitivity of CT scans to peritoneal carcinomatosis is not always adequate. Staging laparoscopy offers the chance to significantly increase the rate of promptly diagnosed peritoneal metastases, thus reducing the number of unnecessary laparotomies and modifying the initial treatment strategy of gastric cancer. The aim of this review was to provide a comprehensive summary of the current literature regarding the role of staging laparoscopy in the management of gastric cancer. Indications, techniques, accuracy, advantages, and limitations of staging laparoscopy and peritoneal cytology were discussed. Furthermore, a focus on current evidence regarding the application of artificial intelligence and image-guided surgery in staging laparoscopy was included in order to provide a picture of the future perspectives of this technique and its integration with modern tools in the preoperative management of gastric cancer.
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Affiliation(s)
- Carlo Alberto Schena
- Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France
| | - Vito Laterza
- Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Davide De Sio
- Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Giuseppe Quero
- Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Digestive Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Claudio Fiorillo
- Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Gayani Gunawardena
- Department of Digestive Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonia Strippoli
- Medical Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Vincenzo Tondolo
- Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Nicola de'Angelis
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France
| | - Sergio Alfieri
- Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Digestive Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Fausto Rosa
- Department of Digestive Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Emergency and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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3
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Bektaş M, Burchell GL, Bonjer HJ, van der Peet DL. Machine learning applications in upper gastrointestinal cancer surgery: a systematic review. Surg Endosc 2023; 37:75-89. [PMID: 35953684 PMCID: PMC9839827 DOI: 10.1007/s00464-022-09516-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Machine learning (ML) has seen an increase in application, and is an important element of a digital evolution. The role of ML within upper gastrointestinal surgery for malignancies has not been evaluated properly in the literature. Therefore, this systematic review aims to provide a comprehensive overview of ML applications within upper gastrointestinal surgery for malignancies. METHODS A systematic search was performed in PubMed, EMBASE, Cochrane, and Web of Science. Studies were only included when they described machine learning in upper gastrointestinal surgery for malignancies. The Cochrane risk-of-bias tool was used to determine the methodological quality of studies. The accuracy and area under the curve were evaluated, representing the predictive performances of ML models. RESULTS From a total of 1821 articles, 27 studies met the inclusion criteria. Most studies received a moderate risk-of-bias score. The majority of these studies focused on neural networks (n = 9), multiple machine learning (n = 8), and random forests (n = 3). Remaining studies involved radiomics (n = 3), support vector machines (n = 3), and decision trees (n = 1). Purposes of ML included predominantly prediction of metastasis, detection of risk factors, prediction of survival, and prediction of postoperative complications. Other purposes were predictions of TNM staging, chemotherapy response, tumor resectability, and optimal therapy. CONCLUSIONS Machine Learning algorithms seem to contribute to the prediction of postoperative complications and the course of disease after upper gastrointestinal surgery for malignancies. However, due to the retrospective character of ML studies, these results require trials or prospective studies to validate this application of ML.
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Affiliation(s)
- Mustafa Bektaş
- Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
| | - George L. Burchell
- Medical Library, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - H. Jaap Bonjer
- Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Donald L. van der Peet
- Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
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4
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Robustness of Radiomics in Pre-Surgical Computer Tomography of Non-Small-Cell Lung Cancer. J Pers Med 2022; 13:jpm13010083. [PMID: 36675744 PMCID: PMC9864775 DOI: 10.3390/jpm13010083] [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: 11/22/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
Background: Radiomic features are increasingly used in CT of NSCLC. However, their robustness with respect to segmentation variability has not yet been demonstrated. The aim of this study was to assess radiomic features agreement across three kinds of segmentation. Methods: We retrospectively included 48 patients suffering from NSCLC who underwent pre-surgery CT. Two expert radiologists in consensus manually delineated three 3D-ROIs on each patient. To assess robustness for each feature, the intra-class correlation coefficient (ICC) across segmentations was evaluated. The ‘sensitivity’ of ICC upon some parameters affecting features computation (such as bin-width for first-order features and pixel-distances for second-order features) was also evaluated. Moreover, an assessment with respect to interpolator and isotropic resolution was also performed. Results: Our results indicate that ‘shape’ features tend to have excellent agreement (ICC > 0.9) across segmentations; moreover, they have approximately zero sensitivity to other parameters. ‘First-order’ features are in general sensitive to parameters variation; however, a few of them showed excellent agreement and low sensitivity (below 0.1) with respect to bin-width and pixel-distance. Similarly, a few second-order features showed excellent agreement and low sensitivity. Conclusions: Our results suggest that a limited number of radiomic features can achieve a high level of reproducibility in CT of NSCLC.
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Khalid MU, Laplante S, Madani A. Machines with vision for intraoperative guidance during gastrointestinal cancer surgery. Front Med (Lausanne) 2022; 9:1025382. [PMID: 36250078 PMCID: PMC9561352 DOI: 10.3389/fmed.2022.1025382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Muhammad Uzair Khalid
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- *Correspondence: Muhammad Uzair Khalid
| | - Simon Laplante
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Surgical Artificial Intelligence Research Academy, University Health Network, Toronto, ON, Canada
| | - Amin Madani
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Surgical Artificial Intelligence Research Academy, University Health Network, Toronto, ON, Canada
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Chen Q, Zhang L, Liu S, You J, Chen L, Jin Z, Zhang S, Zhang B. Radiomics in precision medicine for gastric cancer: opportunities and challenges. Eur Radiol 2022; 32:5852-5868. [PMID: 35316364 DOI: 10.1007/s00330-022-08704-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/20/2022] [Accepted: 02/28/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Radiomic features derived from routine medical images show great potential for personalized medicine in gastric cancer (GC). We aimed to evaluate the current status and quality of radiomic research as well as its potential for identifying biomarkers to predict therapy response and prognosis in patients with GC. METHODS We performed a systematic search of the PubMed and Embase databases for articles published from inception through July 10, 2021. The phase classification criteria for image mining studies and the radiomics quality scoring (RQS) tool were applied to evaluate scientific and reporting quality. RESULTS Twenty-five studies consisting of 10,432 patients were included. 96% of studies extracted radiomic features from CT images. Association between radiomic signature and therapy response was evaluated in seven (28%) studies; association with survival was evaluated in 17 (68%) studies; one (4%) study analyzed both. All results of the included studies showed significant associations. Based on the phase classification criteria for image mining studies, 18 (72%) studies were classified as phase II, with two, four, and one studies as discovery science, phase 0 and phase I, respectively. The median RQS score for the radiomic studies was 44.4% (range, 0 to 55.6%). There was extensive heterogeneity in the study population, tumor stage, treatment protocol, and radiomic workflow amongst the studies. CONCLUSIONS Although radiomic research in GC is highly heterogeneous and of relatively low quality, it holds promise for predicting therapy response and prognosis. Efforts towards standardization and collaboration are needed to utilize radiomics for clinical application. KEY POINTS • Radiomics application of gastric cancer is increasingly being reported, particularly in predicting therapy response and survival. • Although radiomics research in gastric cancer is highly heterogeneous and relatively low quality, it holds promise for predicting clinical outcomes. • Standardized imaging protocols and radiomic workflow are needed to facilitate radiomics into clinical use.
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Affiliation(s)
- Qiuying Chen
- Department of Radiology, the First Affiliated Hospital, Jinan University, No.613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China.,Graduate College, Jinan University, Guangzhou, Guangdong, China
| | - Lu Zhang
- Department of Radiology, the First Affiliated Hospital, Jinan University, No.613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China.,Graduate College, Jinan University, Guangzhou, Guangdong, China
| | - Shuyi Liu
- Department of Radiology, the First Affiliated Hospital, Jinan University, No.613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China.,Graduate College, Jinan University, Guangzhou, Guangdong, China
| | - Jingjing You
- Department of Radiology, the First Affiliated Hospital, Jinan University, No.613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China.,Graduate College, Jinan University, Guangzhou, Guangdong, China
| | - Luyan Chen
- Department of Radiology, the First Affiliated Hospital, Jinan University, No.613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China.,Graduate College, Jinan University, Guangzhou, Guangdong, China
| | - Zhe Jin
- Department of Radiology, the First Affiliated Hospital, Jinan University, No.613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China.,Graduate College, Jinan University, Guangzhou, Guangdong, China
| | - Shuixing Zhang
- Department of Radiology, the First Affiliated Hospital, Jinan University, No.613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China. .,Graduate College, Jinan University, Guangzhou, Guangdong, China.
| | - Bin Zhang
- Department of Radiology, the First Affiliated Hospital, Jinan University, No.613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China. .,Graduate College, Jinan University, Guangzhou, Guangdong, China.
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Radiomics as a New Frontier of Imaging for Cancer Prognosis: A Narrative Review. Diagnostics (Basel) 2021; 11:diagnostics11101796. [PMID: 34679494 PMCID: PMC8534713 DOI: 10.3390/diagnostics11101796] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 12/12/2022] Open
Abstract
The evaluation of the efficacy of different therapies is of paramount importance for the patients and the clinicians in oncology, and it is usually possible by performing imaging investigations that are interpreted, taking in consideration different response evaluation criteria. In the last decade, texture analysis (TA) has been developed in order to help the radiologist to quantify and identify parameters related to tumor heterogeneity, which cannot be appreciated by the naked eye, that can be correlated with different endpoints, including cancer prognosis. The aim of this work is to analyze the impact of texture in the prediction of response and in prognosis stratification in oncology, taking into consideration different pathologies (lung cancer, breast cancer, gastric cancer, hepatic cancer, rectal cancer). Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. This paper contains a narrative report and a critical discussion of radiomics approaches related to cancer prognosis in different fields of diseases.
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8
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Liu S, Xu M, Qiao X, Ji C, Li L, Zhou Z. Prediction of serosal invasion in gastric cancer: development and validation of multivariate models integrating preoperative clinicopathological features and radiographic findings based on late arterial phase CT images. BMC Cancer 2021; 21:1038. [PMID: 34530755 PMCID: PMC8447770 DOI: 10.1186/s12885-021-08672-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To develop and validate multivariate models integrating endoscopic biopsy, tumor markers, and CT findings based on late arterial phase (LAP) to predict serosal invasion in gastric cancer (GC). METHODS The preoperative differentiation degree, tumor markers, CT morphological characteristics, and CT value-related and texture parameters of 154 patients with GC were analyzed retrospectively. Multivariate models based on regression analysis and machine learning algorithms were performed to improve the diagnostic efficacy. RESULTS The differentiation degree, carbohydrate antigen (CA) 199, CA724, CA242, and multiple CT findings based on LAP differed significantly between T1-3 and T4 GCs in the primary cohort (all P < 0.05). Multivariate models based on regression analysis and random forest achieved AUCs of 0.849 and 0.865 in the primary cohort, respectively. CONCLUSION We developed and validated multivariate models integrating endoscopic biopsy, tumor markers, CT morphological characteristics, and CT value-related and texture parameters to predict serosal invasion in GCs and achieved favorable performance.
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Affiliation(s)
- Song Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing City, 210008, Jiangsu Province, China
| | - Mengying Xu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing City, 210008, Jiangsu Province, China
| | - Xiangmei Qiao
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing City, 210008, Jiangsu Province, China
| | - Changfeng Ji
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing City, 210008, Jiangsu Province, China
| | - Lin Li
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing City, 210008, Jiangsu Province, China.
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Yang H, Hu B. Early gastrointestinal cancer: The application of artificial intelligence. Artif Intell Gastrointest Endosc 2021; 2:185-197. [DOI: 10.37126/aige.v2.i4.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/25/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
Early gastrointestinal (GI) cancer has been the core of clinical endoscopic work. Its early detection and treatment are tightly associated with patients’ prognoses. As a novel technology, artificial intelligence has been improved and applied in the field of endoscopy. Studies on detection, diagnosis, risk, and prognosis evaluation of diseases in the GI tract have been in development, including precancerous lesions, adenoma, early GI cancers, and advanced GI cancers. In this review, research on esophagus, stomach, and colon was concluded, and associated with the process from precancerous lesions to early GI cancer, such as from Barrett’s esophagus to early esophageal cancer, from dysplasia to early gastric cancer, and from adenoma to early colonic cancer. A status quo of research on early GI cancers and artificial intelligence was provided.
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Affiliation(s)
- Hang Yang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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10
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Qin Y, Deng Y, Jiang H, Hu N, Song B. Artificial Intelligence in the Imaging of Gastric Cancer: Current Applications and Future Direction. Front Oncol 2021; 11:631686. [PMID: 34367946 PMCID: PMC8335156 DOI: 10.3389/fonc.2021.631686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 07/07/2021] [Indexed: 02/05/2023] Open
Abstract
Gastric cancer (GC) is one of the most common cancers and one of the leading causes of cancer-related death worldwide. Precise diagnosis and evaluation of GC, especially using noninvasive methods, are fundamental to optimal therapeutic decision-making. Despite the recent rapid advancements in technology, pretreatment diagnostic accuracy varies between modalities, and correlations between imaging and histological features are far from perfect. Artificial intelligence (AI) techniques, particularly hand-crafted radiomics and deep learning, have offered hope in addressing these issues. AI has been used widely in GC research, because of its ability to convert medical images into minable data and to detect invisible textures. In this article, we systematically reviewed the methodological processes (data acquisition, lesion segmentation, feature extraction, feature selection, and model construction) involved in AI. We also summarized the current clinical applications of AI in GC research, which include characterization, differential diagnosis, treatment response monitoring, and prognosis prediction. Challenges and opportunities in AI-based GC research are highlighted for consideration in future studies.
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Affiliation(s)
- Yun Qin
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yiqi Deng
- Department of Laboratory Medicine, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Hanyu Jiang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Na Hu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Huang J, Yao H, Li Y, Dong M, Han C, He L, Huang X, Xia T, Yi Z, Wang H, Zhang Y, He J, Liang C, Liu Z. Development and validation of a CT-based radiomics nomogram for preoperative prediction of tumor histologic grade in gastric adenocarcinoma. Chin J Cancer Res 2021; 33:69-78. [PMID: 33707930 PMCID: PMC7941693 DOI: 10.21147/j.issn.1000-9604.2021.01.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/22/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To develop and validate a radiomics nomogram for preoperative prediction of tumor histologic grade in gastric adenocarcinoma (GA). METHODS This retrospective study enrolled 592 patients with clinicopathologically confirmed GA (low-grade: n=154; high-grade: n=438) from January 2008 to March 2018 who were divided into training (n=450) and validation (n=142) sets according to the time of computed tomography (CT) examination. Radiomic features were extracted from the portal venous phase CT images. The Mann-Whitney U test and the least absolute shrinkage and selection operator (LASSO) regression model were used for feature selection, data dimension reduction and radiomics signature construction. Multivariable logistic regression analysis was applied to develop the prediction model. The radiomics signature and independent clinicopathologic risk factors were incorporated and presented as a radiomics nomogram. The performance of the nomogram was assessed with respect to its calibration and discrimination. RESULTS A radiomics signature containing 12 selected features was significantly associated with the histologic grade of GA (P<0.001 for both training and validation sets). A nomogram including the radiomics signature and tumor location as predictors was developed. The model showed both good calibration and good discrimination, in which C-index in the training set, 0.752 [95% confidence interval (95% CI): 0.701-0.803]; C-index in the validation set, 0.793 (95% CI: 0.711-0.874). CONCLUSIONS This study developed a radiomics nomogram that incorporates tumor location and radiomics signatures, which can be useful in facilitating preoperative individualized prediction of histologic grade of GA.
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Affiliation(s)
- Jia Huang
- Graduate College, Shantou University Medical College, Shantou 515041, China
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Huasheng Yao
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- School of Automation Science and Engineering, South China University of Technology, Guangzhou 510006, China
| | - Yexing Li
- Graduate College, Shantou University Medical College, Shantou 515041, China
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Mengyi Dong
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Graduate College, Southern Medical University, Guangzhou 510515, China
| | - Chu Han
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Lan He
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Xiaomei Huang
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Graduate College, Southern Medical University, Guangzhou 510515, China
| | - Ting Xia
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Zongjian Yi
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou 510006, China
| | - Huihui Wang
- Graduate College, Shantou University Medical College, Shantou 515041, China
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Yuan Zhang
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Graduate College, Southern Medical University, Guangzhou 510515, China
| | - Jian He
- Graduate College, Shantou University Medical College, Shantou 515041, China
- Department of Interventional Radiology, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Changhong Liang
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Zaiyi Liu
- Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
- Zaiyi Liu, PhD. Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
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12
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Kudou M, Kosuga T, Otsuji E. Artificial intelligence in gastrointestinal cancer: Recent advances and future perspectives. Artif Intell Gastroenterol 2020; 1:71-85. [DOI: 10.35712/aig.v1.i4.71] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/28/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
Artificial intelligence (AI) using machine or deep learning algorithms is attracting increasing attention because of its more accurate image recognition ability and prediction performance than human-aid analyses. The application of AI models to gastrointestinal (GI) clinical oncology has been investigated for the past decade. AI has the capacity to automatically detect and diagnose GI tumors with similar diagnostic accuracy to expert clinicians. AI may also predict malignant potential, such as tumor histology, metastasis, patient survival, resistance to cancer treatments and the molecular biology of tumors, through image analyses of radiological or pathological imaging data using complex deep learning models beyond human cognition. The introduction of AI-assisted diagnostic systems into clinical settings is expected in the near future. However, limitations associated with the evaluation of GI tumors by AI models have yet to be resolved. Recent studies on AI-assisted diagnostic models of gastric and colorectal cancers in the endoscopic, pathological, and radiological fields were herein reviewed. The limitations and future perspectives for the application of AI systems in clinical settings have also been discussed. With the establishment of a multidisciplinary team containing AI experts in each medical institution and prospective studies, AI-assisted medical systems will become a promising tool for GI cancer.
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Affiliation(s)
- Michihiro Kudou
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Department of Surgery, Kyoto Okamoto Memorial Hospital, Kyoto 613-0034, Japan
| | - Toshiyuki Kosuga
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Department of Surgery, Saiseikai Shiga Hospital, Ritto 520-3046, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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Ma B, Guo Y, Hu W, Yuan F, Zhu Z, Yu Y, Zou H. Artificial Intelligence-Based Multiclass Classification of Benign or Malignant Mucosal Lesions of the Stomach. Front Pharmacol 2020; 11:572372. [PMID: 33132910 PMCID: PMC7562716 DOI: 10.3389/fphar.2020.572372] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/08/2020] [Indexed: 12/23/2022] Open
Abstract
Gastric cancer (GC) is one of the leading causes of cancer-related death worldwide. It takes some time from chronic gastritis to develop in GC. Early detection of GC will help patients obtain timely treatment. Understanding disease evolution is crucial for the prevention and treatment of GC. Here, we present a convolutional neural network (CNN)-based system to detect abnormalities in the gastric mucosa. We identified normal mucosa, chronic gastritis, and intestinal-type GC: this is the most common route of gastric carcinogenesis. We integrated digitalizing histopathology of whole-slide images (WSIs), stain normalization, a deep CNN, and a random forest classifier. The staining variability of WSIs was reduced significantly through stain normalization, and saved the cost and time of preparing new slides. Stain normalization improved the effect of the CNN model. The accuracy rate at the patch-level reached 98.4%, and 94.5% for discriminating normal → chronic gastritis → GC. The accuracy rate at the WSIs-level for discriminating normal tissue and cancerous tissue reached 96.0%, which is a state-of-the-art result. Survival analyses indicated that the features extracted from the CNN exerted a significant impact on predicting the survival of cancer patients. Our CNN model disclosed significant potential for adjuvant diagnosis of gastric diseases, especially GC, and usefulness for predicting the prognosis.
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Affiliation(s)
- Bowei Ma
- Center for Intelligent Medical Imaging & Health, Research Institute of Tsinghua University in Shenzhen, Shenzhen, China.,Tsimage Medical Technology, Yantian Modern Industry Service Center, Shenzhen, China
| | - Yucheng Guo
- Center for Intelligent Medical Imaging & Health, Research Institute of Tsinghua University in Shenzhen, Shenzhen, China.,Tsimage Medical Technology, Yantian Modern Industry Service Center, Shenzhen, China
| | - Weian Hu
- Tsimage Medical Technology, Yantian Modern Industry Service Center, Shenzhen, China
| | - Fei Yuan
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenggang Zhu
- Department of General Surgery, Ruijin Hospital, Shanghai Institute of Digestive Surgery, Shanghai Key Lab for Gastric Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingyan Yu
- Department of General Surgery, Ruijin Hospital, Shanghai Institute of Digestive Surgery, Shanghai Key Lab for Gastric Neoplasms, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Zou
- Center for Intelligent Medical Imaging & Health, Research Institute of Tsinghua University in Shenzhen, Shenzhen, China.,Tsimage Medical Technology, Yantian Modern Industry Service Center, Shenzhen, China
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14
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Liang G, Fan W, Luo H, Zhu X. The emerging roles of artificial intelligence in cancer drug development and precision therapy. Biomed Pharmacother 2020; 128:110255. [DOI: 10.1016/j.biopha.2020.110255] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/22/2020] [Accepted: 05/10/2020] [Indexed: 12/12/2022] Open
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Global updates in the treatment of gastric cancer: a systematic review. Part 2: perioperative management, multimodal therapies, new technologies, standardization of the surgical treatment and educational aspects. Updates Surg 2020; 72:355-378. [PMID: 32306277 DOI: 10.1007/s13304-020-00771-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 04/11/2020] [Indexed: 12/24/2022]
Abstract
Gastric cancer is the fifth malignancy and the third cause of cancer death worldwide, according to the global cancer statistics presented in 2018. Its definition and staging have been revised in the eight edition of the AJCC/TNM classification, which took effect in 2018. Novel molecular classifications for GC have been recently established and the process of translating these classifications into clinical practice is ongoing. The cornerstone of GC treatment is surgical, in a context of multimodal therapy. Surgical treatment is being standardized, and is evolving according to new anatomical concepts and to the recent technological developments. This is leading to a massive improvement in the use of mini-invasive techniques. Mini-invasive techniques aim to be equivalent to open surgery from an oncologic point of view, with better short-term outcomes. The persecution of better short-term outcomes also includes the optimization of the perioperative management, which is being implemented on large scale according to the enhanced recovery after surgery principles. In the era of precision medicine, multimodal treatment is also evolving. The long-time-awaited results of many trials investigating the role for preoperative and postoperative management have been published, changing the clinical practice. Novel investigations focused both on traditional chemotherapeutic regimens and targeted therapies are currently ongoing. Modern platforms increase the possibility for further standardization of the different treatments, promote the use of big data and open new possibilities for surgical learning. This systematic review in two parts assesses all the current updates in GC treatment.
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