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Baldassi B, Poladyan H, Shahi A, Maa-Hacquoil H, Rapley M, Komarov B, Stiles J, Freitas V, Waterston M, Aseyev O, Reznik A, Bubon O. Image quality evaluation for a clinical organ-targeted PET camera. Front Oncol 2024; 14:1268991. [PMID: 38590664 PMCID: PMC10999605 DOI: 10.3389/fonc.2024.1268991] [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: 07/28/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction A newly developed clinical organ-targeted Positron Emission Tomography (PET) system (also known as Radialis PET) is tested with a set of standardized and custom tests previously used to evaluate the performance of Positron Emission Mammography (PEM) systems. Methods Imaging characteristics impacting standardized uptake value (SUV) and detectability of small lesions, namely spatial resolution, linearity, uniformity, and recovery coefficients, are evaluated. Results In-plane spatial resolution was measured as 2.3 mm ± 0.1 mm, spatial accuracy was 0.1 mm, and uniformity measured with flood field and NEMA NU-4 phantom was 11.7% and 8.3% respectively. Selected clinical images are provided as reference to the imaging capabilities under different clinical conditions such as reduced activity of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (18F-FDG) and time-delayed acquisitions. SUV measurements were performed for selected clinical acquisitions to demonstrate a capability for quantitative image assessment of different types of cancer including for invasive lobular carcinoma with comparatively low metabolic activity. Quantitative imaging performance assessment with phantoms demonstrates improved contrast recovery and spill-over ratio for this PET technology when compared to other commercial organ-dedicated PET systems with similar spatial resolution. Recovery coefficients were measured to be 0.21 for the 1 mm hot rod and up to 0.89 for the 5 mm hot rod of NEMA NU-4 Image Quality phantom. Discussion Demonstrated ability to accurately reconstruct activity in tumors as small as 5 mm suggests that the Radialis PET technology may be well suited for emerging clinical applications such as image guided assessment of response to neoadjuvant systemic treatment (NST) in lesions smaller than 2 cm. Also, our results suggest that, while spatial resolution greatly influences the partial volume effect which degrades contrast recovery, optimized count rate performance and image reconstruction workflow may improve recovery coefficients for systems with comparable spatial resolution. We emphasize that recovery coefficient should be considered as a primary performance metric when a PET system is used for accurate lesion size or radiotracer uptake assessments.
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Affiliation(s)
- Brandon Baldassi
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
| | | | - Anirudh Shahi
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
| | | | - Madeline Rapley
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
| | | | - Justin Stiles
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
| | - Vivianne Freitas
- Department of Medical Imaging, University Health Network, Sinai Health System, Women’s College Hospital, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | | | - Olexiy Aseyev
- Department of Medical Oncology, Thunder Bay Regional Health Sciences Center, Thunder Bay, ON, Canada
| | - Alla Reznik
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
- Radialis Inc., Thunder Bay, ON, Canada
| | - Oleksandr Bubon
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
- Radialis Inc., Thunder Bay, ON, Canada
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON, Canada
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Xu X, Zhao W, Liu C, Gao Y, Chen D, Wu M, Li C, Wang X, Song X, Yu J, Liu Z, Yu Z. The residual cancer burden index as a valid prognostic indicator in breast cancer after neoadjuvant chemotherapy. BMC Cancer 2024; 24:13. [PMID: 38166846 PMCID: PMC10762907 DOI: 10.1186/s12885-023-11719-z] [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: 07/18/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE The residual cancer burden index (RCB) was proposed as a response evaluation criterion in breast cancer patients treated with Neoadjuvant Chemotherapy (NAC). This study evaluated the relevance of RCB with replase-free survival (RFS). METHODS The clinical data of 254 breast cancer patients who received NAC between 2016 and 2020 were retrospectively collected. The relationship between clinicopathologic factors and RFS was evaluated using Cox proportional hazards regression models. RFS estimates were determined by Kaplan-Meier(K-M) analysis and compared using the log-rank test. Multivariate logistic regression analysis was used to evaluate the risk factors associated with RCB. Receiver operating characteristic (ROC) curves showed the potential of the RCB and MP grading systems as biomarkers for RFS. RESULTS At a median follow-up of 52 months, 59 patients(23.23%) developed relapse. Multivariate Cox regression showed that older age (P = 0.022), high Pathologic T stage after NAC (P = 0.023) and a high RCB score(P = 0.003) were risk factors for relapse. The outcomes of the multivariate logistic analysis indicated that RCB 0 (pathologic complete response [pCR]) was associated with HER2-positive patients (P = 0.002) and triple-negative breast cancer (TNBC) patients (P = 0.013). In addition, the RCB and MP scoring systems served as prognostic markers for patients who received NAC, and their area under curves (AUCs) were 0.691 and 0.342, respectively. CONCLUSION These data suggest that RCB can be equally applied to predict RFS in Chinese patients with NAC. The application of RCB may help guide the selection of treatment strategies.
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Affiliation(s)
- Xin Xu
- Tianjin Medical University Cancer Institute & Hospital,National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300000, China
- Departments of Oncology, The Second Affiliated Hospital of Shandong First Medical University, Shandong Province, Tai'an, 271000, China
| | - Wei Zhao
- Affiliated Hospital of Jining Medical University, Jining, 272060, China
| | - Cuicui Liu
- Liaocheng People's Hospital, Liaocheng, China
| | - Yongsheng Gao
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People's Republic of China
| | - Dawei Chen
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People's Republic of China
| | - Meng Wu
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People's Republic of China
| | - Chao Li
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People's Republic of China
| | - Xinzhao Wang
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People's Republic of China
| | - Xiang Song
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People's Republic of China
| | - Jinming Yu
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People's Republic of China
| | - Zhaoyun Liu
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People's Republic of China.
| | - Zhiyong Yu
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People's Republic of China.
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Dubey S, Tiwari G, Singh S, Goldberg S, Pinsky E. Using machine learning for healthcare treatment planning. Front Artif Intell 2023; 6:1124182. [PMID: 37181733 PMCID: PMC10167842 DOI: 10.3389/frai.2023.1124182] [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: 12/14/2022] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
We present a methodology for using machine learning for planning treatments. As a case study, we apply the proposed methodology to Breast Cancer. Most of the application of Machine Learning to breast cancer has been on diagnosis and early detection. By contrast, our paper focuses on applying Machine Learning to suggest treatment plans for patients with different disease severity. While the need for surgery and even its type is often obvious to a patient, the need for chemotherapy and radiation therapy is not as obvious to the patient. With this in mind, the following treatment plans were considered in this study: chemotherapy, radiation, chemotherapy with radiation, and none of these options (only surgery). We use real data from more than 10,000 patients over 6 years that includes detailed cancer information, treatment plans, and survival statistics. Using this data set, we construct Machine Learning classifiers to suggest treatment plans. Our emphasis in this effort is not only on suggesting the treatment plan but on explaining and defending a particular treatment choice to the patient.
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Affiliation(s)
- Snigdha Dubey
- Department of Computer Science, Metropolitan College, Boston University, Boston, MA, United States
| | - Gaurav Tiwari
- Department of Computer Science, Metropolitan College, Boston University, Boston, MA, United States
| | - Sneha Singh
- Department of Computer Science, Metropolitan College, Boston University, Boston, MA, United States
| | - Saveli Goldberg
- Department of Radiation Oncology Mass General Hospital, Boston, MA, United States
| | - Eugene Pinsky
- Department of Computer Science, Metropolitan College, Boston University, Boston, MA, United States
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