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Ma T, Wang H, Ye Z. Artificial intelligence applications in computed tomography in gastric cancer: a narrative review. Transl Cancer Res 2023; 12:2379-2392. [PMID: 37859746 PMCID: PMC10583011 DOI: 10.21037/tcr-23-201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/01/2023] [Indexed: 10/21/2023]
Abstract
Background and Objective Artificial intelligence (AI) is a revolutionary technique which is deeply impacting and reshaping clinical practice in oncology. This review aims to summarize the current status of the clinical application of AI-based computed tomography (CT) for gastric cancer (GC), focusing on diagnosis, genetic status detection and risk prediction of metastasis, prognosis and treatment efficacy. The challenges and prospects for future research will also be discussed. Methods We searched the PubMed/MEDLINE database to identify clinical studies published between 1990 and November 2022 that investigated AI applications in CT in GC. The major findings of the verified studies were summarized. Key Content and Findings AI applications in CT images have attracted considerable attention in various fields such as diagnosis, prediction of metastasis risk, survival, and treatment response. These emerging techniques have shown a high potential to outperform clinicians in diagnostic accuracy and time-saving. Conclusions AI-powered tools showed great potential to increase diagnostic accuracy and reduce radiologists' workload. However, the goal of AI is not to replace human ability but to help oncologists make decisions in their practice. Therefore, radiologists should play a predominant role in AI applications and decide the best ways to integrate these complementary techniques within clinical practice.
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Affiliation(s)
- Tingting Ma
- Department of Radiology, Tianjin Cancer Hospital Airport Hospital, Tianjin, China
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- The Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Hua Wang
- Department of Radiology, Tianjin Cancer Hospital Airport Hospital, Tianjin, China
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- The Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- The Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
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Jiang T, Zhao Z, Liu X, Shen C, Mu M, Cai Z, Zhang B. Methodological quality of radiomic-based prognostic studies in gastric cancer: a cross-sectional study. Front Oncol 2023; 13:1161237. [PMID: 37731636 PMCID: PMC10507631 DOI: 10.3389/fonc.2023.1161237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
Background Machine learning radiomics models are increasingly being used to predict gastric cancer prognoses. However, the methodological quality of these models has not been evaluated. Therefore, this study aimed to evaluate the methodological quality of radiomics studies in predicting the prognosis of gastric cancer, summarize their methodological characteristics and performance. Methods The PubMed and Embase databases were searched for radiomics studies used to predict the prognosis of gastric cancer published in last 5 years. The characteristics of the studies and the performance of the models were extracted from the eligible full texts. The methodological quality, reporting completeness and risk of bias of the included studies were evaluated using the RQS, TRIPOD and PROBAST. The discrimination ability scores of the models were also compared. Results Out of 283 identified records, 22 studies met the inclusion criteria. The study endpoints included survival time, treatment response, and recurrence, with reported discriminations ranging between 0.610 and 0.878 in the validation dataset. The mean overall RQS value was 15.32 ± 3.20 (range: 9 to 21). The mean adhered items of the 35 item of TRIPOD checklist was 20.45 ± 1.83. The PROBAST showed all included studies were at high risk of bias. Conclusion The current methodological quality of gastric cancer radiomics studies is insufficient. Large and reasonable sample, prospective, multicenter and rigorously designed studies are required to improve the quality of radiomics models for gastric cancer prediction. Study registration This protocol was prospectively registered in the Open Science Framework Registry (https://osf.io/ja52b).
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Affiliation(s)
- Tianxiang Jiang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhou Zhao
- Department of Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, China
| | - Xueting Liu
- Department of Medical Discipline Construction, West China Hospital, Sichuan University, Chengdu, China
| | - Chaoyong Shen
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Mingchun Mu
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaolun Cai
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Zhang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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Hu ZW, Liang P, Li ZL, Yong LL, Lu H, Wang R, Gao JB. Preoperative prediction of vessel invasion in locally advanced gastric cancer based on computed tomography radiomics and machine learning. Oncol Lett 2023; 26:293. [PMID: 37274479 PMCID: PMC10236253 DOI: 10.3892/ol.2023.13879] [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: 10/24/2022] [Accepted: 04/20/2023] [Indexed: 06/06/2023] Open
Abstract
Vessel invasion (VI) is an important factor affecting the prognosis of gastric cancer (GC), and the accurate determination of preoperative VI for locally advanced GC is of great clinical significance. Traditional methods for the evaluation of VI require postoperative pathological examination. Noninvasive preoperative evaluation of VI is therefore crucial to determine the best treatment strategy. To determine the value of preoperative prediction of gastric VI based on portal venous phase computed tomography (CT) radiomic features and machine-learning models, a retrospective analysis of 296 patients with locally advanced GC confirmed through pathological examination was performed. They were divided into two groups, VI+ (n=213) and VI- (n=83), based on pathological results. Using pyradiomics to extract two-dimensional radiomic features of the portal venous stage of locally advanced GC, data were divided into training (n=207) and validation sets (n=89), with a ratio of 7:3, and three feature selection methods were cascaded and merged. Finally, least absolute shrinkage and selection operator (LASSO) regression was used for feature screening to obtain the optimal feature subset. Four current representative machine-learning algorithms were used to construct the prediction model, the receiver operating characteristic curve was constructed to evaluate the predictive performance of the model, and the area under the curve (AUC), accuracy, sensitivity, and specificity were calculated. The differentiation degree, and the Lauren's and CA199 classifications were independent risk factors for locally advanced GC VI. Pyradiomics extracted 864 quantitative features of portal vein images of locally advanced GC. After filtering out low variance features using R, 236 features remained. Next, 18 features were screened using the LASSO algorithm. Extreme gradient boosting (XGBoost), logistic regression, Gaussian naive Bayes, and support vector machine models were constructed based on the 18 best features screened out of the portal venous CT images of advanced GC and three independent risk factors of GC VI in clinical features predicted the training set AUC values of 0.914, 0.897, 0.880, and 0.814, respectively. The predicted validation set AUC values were 0.870, 0.877, 0.859, and 0.773, respectively. The DeLong test results indicated no statistically significant difference in AUC values between the XGBoost and logistic regression models in the training and validation sets. The four machine-learning models showed high predictive performance. The logistic regression model had the highest AUC value in the validation set (0.877), and the accuracy and F1 score were 77 and 87.6%, respectively. CT radiomic features and machine-learning models based on the portal venous phase can be used as a noninvasive imaging method for the preoperative prediction of VI in locally advanced GC. The logistic regression model exhibited the highest diagnostic performance.
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Affiliation(s)
- Zhi-Wei Hu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Pan Liang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Zhi-Li Li
- Department of Radiology, Henan Provincial People's Hospital Medical Imaging Center, Zhengzhou, Henan 450003, P.R. China
| | - Liu-Liang Yong
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Hao Lu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Rui Wang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Jian-Bo Gao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
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Enhanced CT-based radiomics predicts pathological complete response after neoadjuvant chemotherapy for advanced adenocarcinoma of the esophagogastric junction: a two-center study. Insights Imaging 2022; 13:134. [PMID: 35976518 PMCID: PMC9385906 DOI: 10.1186/s13244-022-01273-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/20/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose This study aimed to develop and validate CT-based models to predict pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) for advanced adenocarcinoma of the esophagogastric junction (AEG). Methods Pre-NAC clinical and imaging data of AEG patients who underwent surgical resection after preoperative-NAC at two centers were retrospectively collected from November 2014 to September 2020. The dataset included training (n = 60) and external validation groups (n = 32). Three models, including CT-based radiomics, clinical and radiomics–clinical combined models, were established to differentiate pCR (tumor regression grade (TRG) = grade 0) and nonpCR (TRG = grade 1–3) patients. For the radiomics model, tumor-region-based radiomics features in the arterial and venous phases were extracted and selected. The naïve Bayes classifier was used to establish arterial- and venous-phase radiomics models. The selected candidate clinical factors were used to establish a clinical model, which was further incorporated into the radiomics–clinical combined model. ROC analysis, calibration and decision curves were used to assess the model performance. Results For the radiomics model, the AUC values obtained using the venous data were higher than those obtained using the arterial data (training: 0.751 vs. 0.736; validation: 0.768 vs. 0.750). Borrmann typing, tumor thickness and degree of differentiation were utilized to establish the clinical model (AUC-training: 0.753; AUC-validation: 0.848). The combination of arterial- and venous-phase radiomics and clinical factors further improved the discriminatory performance of the model (AUC-training: 0.838; AUC-validation: 0.902). The decision curve reflects the higher net benefit of the combined model. Conclusion The combination of CT imaging and clinical factors pre-NAC for advanced AEG could help stratify potential responsiveness to NAC. Supplementary Information The online version contains supplementary material available at 10.1186/s13244-022-01273-w.
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Mirón Mombiela R, Arildskov AR, Bruun FJ, Hasselbalch LH, Holst KB, Rasmussen SH, Borrás C. What Genetics Can Do for Oncological Imaging: A Systematic Review of the Genetic Validation Data Used in Radiomics Studies. Int J Mol Sci 2022; 23:6504. [PMID: 35742947 PMCID: PMC9224495 DOI: 10.3390/ijms23126504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Radiogenomics is motivated by the concept that biomedical images contain information that reflects underlying pathophysiology. This review focused on papers that used genetics to validate their radiomics models and outcomes and assess their contribution to this emerging field. (2) Methods: All original research with the words radiomics and genomics in English and performed in humans up to 31 January 2022, were identified on Medline and Embase. The quality of the studies was assessed with Radiomic Quality Score (RQS) and the Cochrane recommendation for diagnostic accuracy study Quality Assessment 2. (3) Results: 45 studies were included in our systematic review, and more than 50% were published in the last two years. The studies had a mean RQS of 12, and the studied tumors were very diverse. Up to 83% investigated the prognosis as the main outcome, with the rest focusing on response to treatment and risk assessment. Most applied either transcriptomics (54%) and/or genetics (35%) for genetic validation. (4) Conclusions: There is enough evidence to state that new science has emerged, focusing on establishing an association between radiological features and genomic/molecular expression to explain underlying disease mechanisms and enhance prognostic, risk assessment, and treatment response radiomics models in cancer patients.
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Affiliation(s)
- Rebeca Mirón Mombiela
- Radiology Derpartment, Herlev og Gentofte Hospital, Borgmester Ib Juuls Vej 17, Opgang 4, 4.Etage, E2, 2730 Herlev, Denmark; (A.R.A.); (F.J.B.); (L.H.H.); (K.B.H.); (S.H.R.)
| | - Anne Rix Arildskov
- Radiology Derpartment, Herlev og Gentofte Hospital, Borgmester Ib Juuls Vej 17, Opgang 4, 4.Etage, E2, 2730 Herlev, Denmark; (A.R.A.); (F.J.B.); (L.H.H.); (K.B.H.); (S.H.R.)
| | - Frederik Jager Bruun
- Radiology Derpartment, Herlev og Gentofte Hospital, Borgmester Ib Juuls Vej 17, Opgang 4, 4.Etage, E2, 2730 Herlev, Denmark; (A.R.A.); (F.J.B.); (L.H.H.); (K.B.H.); (S.H.R.)
| | - Lotte Harries Hasselbalch
- Radiology Derpartment, Herlev og Gentofte Hospital, Borgmester Ib Juuls Vej 17, Opgang 4, 4.Etage, E2, 2730 Herlev, Denmark; (A.R.A.); (F.J.B.); (L.H.H.); (K.B.H.); (S.H.R.)
| | - Kristine Bærentz Holst
- Radiology Derpartment, Herlev og Gentofte Hospital, Borgmester Ib Juuls Vej 17, Opgang 4, 4.Etage, E2, 2730 Herlev, Denmark; (A.R.A.); (F.J.B.); (L.H.H.); (K.B.H.); (S.H.R.)
| | - Sine Hvid Rasmussen
- Radiology Derpartment, Herlev og Gentofte Hospital, Borgmester Ib Juuls Vej 17, Opgang 4, 4.Etage, E2, 2730 Herlev, Denmark; (A.R.A.); (F.J.B.); (L.H.H.); (K.B.H.); (S.H.R.)
| | - Consuelo Borrás
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
- CIBERFES, Institute of Health Research-INCLIVA, 46010 Valencia, Spain
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