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Kocak B, Akinci D'Antonoli T, Mercaldo N, Alberich-Bayarri A, Baessler B, Ambrosini I, Andreychenko AE, Bakas S, Beets-Tan RGH, Bressem K, Buvat I, Cannella R, Cappellini LA, Cavallo AU, Chepelev LL, Chu LCH, Demircioglu A, deSouza NM, Dietzel M, Fanni SC, Fedorov A, Fournier LS, Giannini V, Girometti R, Groot Lipman KBW, Kalarakis G, Kelly BS, Klontzas ME, Koh DM, Kotter E, Lee HY, Maas M, Marti-Bonmati L, Müller H, Obuchowski N, Orlhac F, Papanikolaou N, Petrash E, Pfaehler E, Pinto Dos Santos D, Ponsiglione A, Sabater S, Sardanelli F, Seeböck P, Sijtsema NM, Stanzione A, Traverso A, Ugga L, Vallières M, van Dijk LV, van Griethuysen JJM, van Hamersvelt RW, van Ooijen P, Vernuccio F, Wang A, Williams S, Witowski J, Zhang Z, Zwanenburg A, Cuocolo R. METhodological RadiomICs Score (METRICS): a quality scoring tool for radiomics research endorsed by EuSoMII. Insights Imaging 2024; 15:8. [PMID: 38228979 DOI: 10.1186/s13244-023-01572-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/20/2023] [Indexed: 01/18/2024] Open
Abstract
PURPOSE To propose a new quality scoring tool, METhodological RadiomICs Score (METRICS), to assess and improve research quality of radiomics studies. METHODS We conducted an online modified Delphi study with a group of international experts. It was performed in three consecutive stages: Stage#1, item preparation; Stage#2, panel discussion among EuSoMII Auditing Group members to identify the items to be voted; and Stage#3, four rounds of the modified Delphi exercise by panelists to determine the items eligible for the METRICS and their weights. The consensus threshold was 75%. Based on the median ranks derived from expert panel opinion and their rank-sum based conversion to importance scores, the category and item weights were calculated. RESULT In total, 59 panelists from 19 countries participated in selection and ranking of the items and categories. Final METRICS tool included 30 items within 9 categories. According to their weights, the categories were in descending order of importance: study design, imaging data, image processing and feature extraction, metrics and comparison, testing, feature processing, preparation for modeling, segmentation, and open science. A web application and a repository were developed to streamline the calculation of the METRICS score and to collect feedback from the radiomics community. CONCLUSION In this work, we developed a scoring tool for assessing the methodological quality of the radiomics research, with a large international panel and a modified Delphi protocol. With its conditional format to cover methodological variations, it provides a well-constructed framework for the key methodological concepts to assess the quality of radiomic research papers. CRITICAL RELEVANCE STATEMENT A quality assessment tool, METhodological RadiomICs Score (METRICS), is made available by a large group of international domain experts, with transparent methodology, aiming at evaluating and improving research quality in radiomics and machine learning. KEY POINTS • A methodological scoring tool, METRICS, was developed for assessing the quality of radiomics research, with a large international expert panel and a modified Delphi protocol. • The proposed scoring tool presents expert opinion-based importance weights of categories and items with a transparent methodology for the first time. • METRICS accounts for varying use cases, from handcrafted radiomics to entirely deep learning-based pipelines. • A web application has been developed to help with the calculation of the METRICS score ( https://metricsscore.github.io/metrics/METRICS.html ) and a repository created to collect feedback from the radiomics community ( https://github.com/metricsscore/metrics ).
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Affiliation(s)
- Burak Kocak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Tugba Akinci D'Antonoli
- Institute of Radiology and Nuclear Medicine, Cantonal Hospital Baselland, Liestal, Switzerland.
| | - Nathaniel Mercaldo
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Bettina Baessler
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Ilaria Ambrosini
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Anna E Andreychenko
- Laboratory for Digital Public Health Technologies, ITMO University, St. Petersburg, Russian Federation
| | - Spyridon Bakas
- Division of Computational Pathology, Department of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
- Center for Federated Learning in Precision Medicine, Indiana University, Indianapolis, IN, USA
| | - Regina G H Beets-Tan
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Keno Bressem
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Irene Buvat
- Institut Curie, Inserm, PSL University, Laboratory of Translational Imaging in Oncology, Orsay, France
| | - Roberto Cannella
- Section of Radiology - Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | | | - Armando Ugo Cavallo
- Division of Radiology, Istituto Dermopatico dell'Immacolata (IDI) IRCCS, Rome, Italy
| | - Leonid L Chepelev
- Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada
| | - Linda Chi Hang Chu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Aydin Demircioglu
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital , Essen, Germany
| | - Nandita M deSouza
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
- Department of Imaging, The Royal Marsden National Health Service (NHS) Foundation Trust, London, UK
| | - Matthias Dietzel
- Department of Radiology, University Hospital Erlangen, Erlangen, Germany
| | | | - Andrey Fedorov
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Laure S Fournier
- Department of Radiology, Université Paris Cité, AP-HP, Hôpital Européen Georges Pompidou, PARCC UMRS 970, INSERM, Paris, France
| | | | - Rossano Girometti
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital S. Maria della Misericordia, Udine, Italy
| | - Kevin B W Groot Lipman
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Georgios Kalarakis
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Division of Radiology, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Medical School, University of Crete, Heraklion, Greece
| | - Brendan S Kelly
- Department of Radiology, St Vincent's University Hospital, Dublin, Ireland
- Insight Centre for Data Analytics, UCD, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Michail E Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
- Computational Biomedicine Laboratory, Institute of Computer Science, FORTH, Heraklion, Crete, Greece
| | - Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital, Sutton, UK
| | - Elmar Kotter
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Mario Maas
- Department of Radiology & Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Luis Marti-Bonmati
- Medical Imaging Department and Biomedical Imaging Research Group, Hospital Universitario y Politécnico La Fe and Health Research Institute, Valencia, Spain
| | - Henning Müller
- University of Applied Sciences of Western Switzerland (HES-SO Valais), Sierra, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva (UniGe), Geneva, Switzerland
| | - Nancy Obuchowski
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Fanny Orlhac
- Institut Curie, Inserm, PSL University, Laboratory of Translational Imaging in Oncology, Orsay, France
| | - Nikolaos Papanikolaou
- Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
- Department of Radiology, Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - Ekaterina Petrash
- Radiology department, Research Institute of Pediatric Oncology and Hematology n. a. L.A. Durnov, National Medical Research Center of Oncology n. a. N.N. Blokhin Ministry of Health of Russian Federation, Moscow, Russia
- Medical Department IRA-Labs, Moscow, Russia
| | - Elisabeth Pfaehler
- Institute for advanced simulation (IAS-8): Machine learning and data analytics, Forschungszentrum Jülich, Jülich, Germany
| | - Daniel Pinto Dos Santos
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
- Institute for Diagnostic and Interventional Radiology, Goethe-University Frankfurt Am Main, Frankfurt, Germany
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Sebastià Sabater
- Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Philipp Seeböck
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Nanna M Sijtsema
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Alberto Traverso
- Department of Radiotherapy, Maastro Clinic, Maastricht, the Netherlands
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
| | - Lisanne V van Dijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Robbert W van Hamersvelt
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Peter van Ooijen
- Department of Radiotherapy, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Federica Vernuccio
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnosis (Bi.N.D), University of Palermo, Palermo, 90127, Italy
| | - Alan Wang
- Centre for Medical Imaging & Centre for Brain Research, Faculty of Medical and Health Sciences, Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Stuart Williams
- Department of Radiology, Norfolk & Norwich University Hospital, Colney Lane, Norwich, Norfolk, UK
| | - Jan Witowski
- Department of Radiology, New York University Grossman School of Medicine, New York, USA
| | - Zhongyi Zhang
- School of Information and Communication Technology, Griffith University, Nathan, Brisbane, Australia
| | - Alex Zwanenburg
- National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Dresden, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Renato Cuocolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
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Geka G, Kanioura A, Kochylas I, Likodimos V, Gardelis S, Dimitriou A, Papanikolaou N, Chatzantonaki K, Charvalos E, Economou A, Kakabakos S, Petrou P. Cancer Marker Immunosensing through Surface-Enhanced Photoluminescence on Nanostructured Silver Substrates. Nanomaterials (Basel) 2023; 13:3099. [PMID: 38132997 PMCID: PMC10745687 DOI: 10.3390/nano13243099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
Nanostructured noble metal surfaces enhance the photoluminescence emitted by fluorescent molecules, permitting the development of highly sensitive fluorescence immunoassays. To this end, surfaces with silicon nanowires decorated with silver nanoparticles in the form of dendrites or aggregates were evaluated as substrates for the immunochemical detection of two ovarian cancer indicators, carbohydrate antigen 125 (CA125) and human epididymis protein 4 (HE4). The substrates were prepared by metal-enhanced chemical etching of silicon wafers to create, in one step, silicon nanowires and silver nanoparticles on top of them. For both analytes, non-competitive immunoassays were developed using pairs of highly specific monoclonal antibodies, one for analyte capture on the substrate and the other for detection. In order to facilitate the identification of the immunocomplexes through a reaction with streptavidin labeled with Rhodamine Red-X, the detection antibodies were biotinylated. An in-house-developed optical set-up was used for photoluminescence signal measurements after assay completion. The detection limits achieved were 2.5 U/mL and 3.12 pM for CA125 and HE4, respectively, with linear dynamic ranges extending up to 500 U/mL for CA125 and up to 500 pM for HE4, covering the concentration ranges of both healthy and ovarian cancer patients. Thus, the proposed method could be implemented for the early diagnosis and/or prognosis and monitoring of ovarian cancer.
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Affiliation(s)
- Georgia Geka
- Immunoassays/Immunosensors Lab, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (G.G.); (A.K.); (S.K.)
- Department of Chemistry, National and Kapodistrian, University of Athens, University Campus, 15771 Athens, Greece;
| | - Anastasia Kanioura
- Immunoassays/Immunosensors Lab, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (G.G.); (A.K.); (S.K.)
| | - Ioannis Kochylas
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, University Campus, 15784 Athens, Greece; (I.K.); (V.L.); (S.G.)
| | - Vlassis Likodimos
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, University Campus, 15784 Athens, Greece; (I.K.); (V.L.); (S.G.)
| | - Spiros Gardelis
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, University Campus, 15784 Athens, Greece; (I.K.); (V.L.); (S.G.)
| | - Anastasios Dimitriou
- Institute of Nanoscience & Nanotechnology, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (A.D.); (N.P.)
| | - Nikolaos Papanikolaou
- Institute of Nanoscience & Nanotechnology, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (A.D.); (N.P.)
| | - Kalliopi Chatzantonaki
- Molecular Diagnosis Department, INVITROLABS S.A., 12251 Peristeri, Greece; (K.C.); (E.C.)
| | - Ekaterina Charvalos
- Molecular Diagnosis Department, INVITROLABS S.A., 12251 Peristeri, Greece; (K.C.); (E.C.)
| | - Anastasios Economou
- Department of Chemistry, National and Kapodistrian, University of Athens, University Campus, 15771 Athens, Greece;
| | - Sotirios Kakabakos
- Immunoassays/Immunosensors Lab, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (G.G.); (A.K.); (S.K.)
| | - Panagiota Petrou
- Immunoassays/Immunosensors Lab, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (G.G.); (A.K.); (S.K.)
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Geka G, Kanioura A, Likodimos V, Gardelis S, Papanikolaou N, Kakabakos S, Petrou P. SERS Immunosensors for Cancer Markers Detection. Materials (Basel) 2023; 16:3733. [PMID: 37241360 PMCID: PMC10221005 DOI: 10.3390/ma16103733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023]
Abstract
Early diagnosis and monitoring are essential for the effective treatment and survival of patients with different types of malignancy. To this end, the accurate and sensitive determination of substances in human biological fluids related to cancer diagnosis and/or prognosis, i.e., cancer biomarkers, is of ultimate importance. Advancements in the field of immunodetection and nanomaterials have enabled the application of new transduction approaches for the sensitive detection of single or multiple cancer biomarkers in biological fluids. Immunosensors based on surface-enhanced Raman spectroscopy (SERS) are examples where the special properties of nanostructured materials and immunoreagents are combined to develop analytical tools that hold promise for point-of-care applications. In this frame, the subject of this review article is to present the advancements made so far regarding the immunochemical determination of cancer biomarkers by SERS. Thus, after a short introduction about the principles of both immunoassays and SERS, an extended presentation of up-to-date works regarding both single and multi-analyte determination of cancer biomarkers is presented. Finally, future perspectives on the field of SERS immunosensors for cancer markers detection are briefly discussed.
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Affiliation(s)
- Georgia Geka
- Immunoassays/Immunosensors Lab, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (G.G.); (A.K.); (S.K.)
| | - Anastasia Kanioura
- Immunoassays/Immunosensors Lab, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (G.G.); (A.K.); (S.K.)
| | - Vlassis Likodimos
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, University Campus, 15784 Athens, Greece; (V.L.); (S.G.)
| | - Spiros Gardelis
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, University Campus, 15784 Athens, Greece; (V.L.); (S.G.)
| | - Nikolaos Papanikolaou
- Institute of Nanoscience & Nanotechnology, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece;
| | - Sotirios Kakabakos
- Immunoassays/Immunosensors Lab, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (G.G.); (A.K.); (S.K.)
| | - Panagiota Petrou
- Immunoassays/Immunosensors Lab, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece; (G.G.); (A.K.); (S.K.)
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Pozzi Mucelli RM, Moro CF, Del Chiaro M, Valente R, Blomqvist L, Papanikolaou N, Löhr JM, Kartalis N. Publisher Correction: Branch-duct intraductal papillary mucinous neoplasm (IPMN): Are cyst volumetry and other novel imaging features able to improve malignancy prediction compared to well-established resection criteria? Eur Radiol 2023; 33:3005-3006. [PMID: 36513880 PMCID: PMC10017635 DOI: 10.1007/s00330-022-09309-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Raffaella M Pozzi Mucelli
- Department of Radiology Huddinge, Karolinska University Hospital, O-huset 42, 14186, Stockholm, Sweden. .,Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186, Stockholm, Sweden.
| | - Carlos Fernández Moro
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden.,Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobels Allé 8, 141 52, Stockholm, Sweden
| | - Marco Del Chiaro
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, 12631 E 17th Ave #6117, Aurora, CO, 80045, USA
| | - Roberto Valente
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186, Stockholm, Sweden.,Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, 12631 E 17th Ave #6117, Aurora, CO, 80045, USA.,Department of Surgical and Perioperative Sciences, Umeå University, Daniel Naezéns väg, 907 37, Umeå, Sweden
| | - Lennart Blomqvist
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Solnavägen 1, 17177, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, L1:00, 17176, Stockholm, Sweden
| | - Nikolaos Papanikolaou
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186, Stockholm, Sweden.,Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Av. Brasília, Doca de Pedrouços, 1400-038, Lisbon, Portugal.,Department of Radiology, Royal Marsden Hospital and The Institute of Cancer Research, London, SM2 5NG, UK.,Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013, Heraklion, Greece
| | - Johannes-Matthias Löhr
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186, Stockholm, Sweden.,Department of Upper Abdominal Diseases, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Hälsovägen, 13, 141 57, Stockholm, Huddinge, Sweden
| | - Nikolaos Kartalis
- Department of Radiology Huddinge, Karolinska University Hospital, O-huset 42, 14186, Stockholm, Sweden.,Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186, Stockholm, Sweden
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Kanioura A, Geka G, Kochylas I, Likodimos V, Gardelis S, Dimitriou A, Papanikolaou N, Kakabakos S, Petrou P. SERS Determination of Oxidative Stress Markers in Saliva Using Substrates with Silver Nanoparticle-Decorated Silicon Nanowires. Biosensors (Basel) 2023; 13:273. [PMID: 36832039 PMCID: PMC9953924 DOI: 10.3390/bios13020273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Glutathione and malondialdehyde are two compounds commonly used to evaluate the oxidative stress status of an organism. Although their determination is usually performed in blood serum, saliva is gaining ground as the biological fluid of choice for oxidative stress determination at the point of need. For this purpose, surface-enhanced Raman spectroscopy (SERS), which is a highly sensitive method for the detection of biomolecules, could offer additional advantages regarding the analysis of biological fluids at the point of need. In this work, silicon nanowires decorated with silver nanoparticles made by metal-assisted chemical etching were evaluated as substrates for the SERS determination of glutathione and malondialdehyde in water and saliva. In particular, glutathione was determined by monitoring the reduction in the Raman signal obtained from substrates modified with crystal violet upon incubation with aqueous glutathione solutions. On the other hand, malondialdehyde was detected after a reaction with thiobarbituric acid to produce a derivative with a strong Raman signal. The detection limits achieved after optimization of several assay parameters were 50 and 3.2 nM for aqueous solutions of glutathione and malondialdehyde, respectively. In artificial saliva, however, the detection limits were 2.0 and 0.32 μM for glutathione and malondialdehyde, respectively, which are, nonetheless, adequate for the determination of these two markers in saliva.
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Affiliation(s)
- Anastasia Kanioura
- Immunoassays/Immunosensors Laboratory, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece
| | - Georgia Geka
- Immunoassays/Immunosensors Laboratory, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece
| | - Ioannis Kochylas
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, University Campus, 15784 Athens, Greece
| | - Vlassis Likodimos
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, University Campus, 15784 Athens, Greece
| | - Spiros Gardelis
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, University Campus, 15784 Athens, Greece
| | - Anastasios Dimitriou
- Institute of Nanoscience & Nanotechnology, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece
| | - Nikolaos Papanikolaou
- Institute of Nanoscience & Nanotechnology, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece
| | - Sotirios Kakabakos
- Immunoassays/Immunosensors Laboratory, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece
| | - Panagiota Petrou
- Immunoassays/Immunosensors Laboratory, Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, NCSR “Demokritos”, 15341 Aghia Paraskevi, Greece
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Kochylas I, Dimitriou A, Apostolaki MA, Skoulikidou MC, Likodimos V, Gardelis S, Papanikolaou N. Enhanced Photoluminescence of R6G Dyes from Metal Decorated Silicon Nanowires Fabricated through Metal Assisted Chemical Etching. Materials (Basel) 2023; 16:ma16041386. [PMID: 36837016 PMCID: PMC9963757 DOI: 10.3390/ma16041386] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 05/17/2023]
Abstract
In this study, we developed active substrates consisting of Ag-decorated silicon nanowires on a Si substrate using a single-step Metal Assisted Chemical Etching (MACE) process, and evaluated their performance in the identification of low concentrations of Rhodamine 6G using surface-enhanced photoluminescence spectroscopy. Different structures with Ag-aggregates as well as Ag-dendrites were fabricated and studied depending on the etching parameters. Moreover, the addition of Au nanoparticles by simple drop-casting on the MACE-treated surfaces can enhance the photoluminescence significantly, and the structures have shown a Limit of Detection of Rhodamine 6G down to 10-12 M for the case of the Ag-dendrites enriched with Au nanoparticles.
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Affiliation(s)
- Ioannis Kochylas
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece
| | - Anastasios Dimitriou
- Institute of Nanoscience and Nanotechnology, NCSR “Demokritos”, Aghia Paraskevi, 15310 Athens, Greece
| | - Maria-Athina Apostolaki
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece
| | | | - Vlassios Likodimos
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece
| | - Spiros Gardelis
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece
| | - Nikolaos Papanikolaou
- Institute of Nanoscience and Nanotechnology, NCSR “Demokritos”, Aghia Paraskevi, 15310 Athens, Greece
- Correspondence:
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7
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Fanourakis G, Kyrodimos E, Papanikolaou V, Chrysovergis A, Kafiri G, Papanikolaou N, Verykokakis M, Tosios K, Vastardis H. APOBEC3B Is Co-Expressed with PKCα/NF-κB in Oral and Oropharyngeal Squamous Cell Carcinomas. Diagnostics (Basel) 2023; 13:diagnostics13030569. [PMID: 36766673 PMCID: PMC9914863 DOI: 10.3390/diagnostics13030569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
The enzymatic activity of APOBEC3B (A3B) has been implicated as a prime source of mutagenesis in head and neck squamous cell carcinoma (HNSCC). The expression of Protein Kinase C α (PKCα) and Nuclear Factor-κΒ p65 (NF-κΒ p65) has been linked to the activation of the classical and the non-canonical NF-κB signaling pathways, respectively, both of which have been shown to lead to the upregulation of A3B. Accordingly, the aim of the present study was to evaluate the expression of PKCα, NF-κΒ p65 and A3B in non-HPV related oral and oropharyngeal squamous cell carcinomas (SCC), by means of immunohistochemistry and in silico methods. PKCα was expressed in 29/36 (80%) cases of oral and oropharyngeal SCCs, with 25 (69%) cases showing a PKCα+/A3B+ phenotype and only 6/36 (17%) cases showing a PKCα-/A3B+ phenotype. Εxpression of NF-κB p65 was seen in 33/35 (94%) cases of oral and oropharyngeal SCCs, with 30/35 (86%) cases showing an NF-κB p65+/A3B+ phenotype and only 2/35 (6%) cases showing an NF-κB p65-/A3B+ phenotype. In addition, mRNA expression analysis, using the UALCAN database, revealed strong expression of all three genes. These findings indicate that the expression of A3B is associated with PKCα/NF-κB p65 expression and suggest a potential role for the PKC/NF-κB signaling pathway in the development of oral and oropharyngeal cancer.
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Affiliation(s)
- Galinos Fanourakis
- Department of Oral Biology, School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., 11527 Athens, Greece
- Correspondence:
| | - Efthymios Kyrodimos
- 1st ENT Department, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 114 Vasilissis Sophias Ave., 11527 Athens, Greece
| | - Vasileios Papanikolaou
- 1st ENT Department, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 114 Vasilissis Sophias Ave., 11527 Athens, Greece
| | - Aristeidis Chrysovergis
- 1st ENT Department, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 114 Vasilissis Sophias Ave., 11527 Athens, Greece
| | - Georgia Kafiri
- Department of Pathology, Hippokration Hospital, 114 Vasilissis Sophias Ave., 11527 Athens, Greece
| | - Nikolaos Papanikolaou
- EnzyQuest PC, Science and Technology Park of Crete, 100 Nikolaou Plastira Str., Vassilika Vouton, 70013 Heraklion, Greece
| | - Mihalis Verykokakis
- Institute for Fundamental Biomedical Research, BSRC Alexander Fleming, 34 Fleming Str., 16672 Vari, Greece
| | - Konstantinos Tosios
- Department of Oral Pathology, Medicine and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., 11527 Athens, Greece
| | - Heleni Vastardis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., 11527 Athens, Greece
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Dimitriadis A, Trivizakis E, Papanikolaou N, Tsiknakis M, Marias K. Enhancing cancer differentiation with synthetic MRI examinations via generative models: a systematic review. Insights Imaging 2022; 13:188. [PMID: 36503979 PMCID: PMC9742072 DOI: 10.1186/s13244-022-01315-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/24/2022] [Indexed: 12/14/2022] Open
Abstract
Contemporary deep learning-based decision systems are well-known for requiring high-volume datasets in order to produce generalized, reliable, and high-performing models. However, the collection of such datasets is challenging, requiring time-consuming processes involving also expert clinicians with limited time. In addition, data collection often raises ethical and legal issues and depends on costly and invasive procedures. Deep generative models such as generative adversarial networks and variational autoencoders can capture the underlying distribution of the examined data, allowing them to create new and unique instances of samples. This study aims to shed light on generative data augmentation techniques and corresponding best practices. Through in-depth investigation, we underline the limitations and potential methodology pitfalls from critical standpoint and aim to promote open science research by identifying publicly available open-source repositories and datasets.
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Affiliation(s)
- Avtantil Dimitriadis
- grid.4834.b0000 0004 0635 685XComputational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece ,grid.419879.a0000 0004 0393 8299Department of Electrical and Computer Engineering, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Eleftherios Trivizakis
- grid.4834.b0000 0004 0635 685XComputational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece ,grid.8127.c0000 0004 0576 3437Medical School, University of Crete, 71003 Heraklion, Greece
| | - Nikolaos Papanikolaou
- grid.4834.b0000 0004 0635 685XComputational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece ,grid.421010.60000 0004 0453 9636Computational Clinical Imaging Group, Centre of the Unknown, Champalimaud Foundation, 1400-038 Lisbon, Portugal ,grid.18886.3fThe Royal Marsden NHS Foundation Trust, THe Institute of Cancer Research, London, UK
| | - Manolis Tsiknakis
- grid.4834.b0000 0004 0635 685XComputational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece ,grid.419879.a0000 0004 0393 8299Department of Electrical and Computer Engineering, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Kostas Marias
- grid.4834.b0000 0004 0635 685XComputational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece ,grid.419879.a0000 0004 0393 8299Department of Electrical and Computer Engineering, Hellenic Mediterranean University, 71410 Heraklion, Greece
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Stasinou D, Psarras M, Zoros E, Stroubinis T, Papanikolaou N, Platoni K, Pappas E. ASSESSMENT OF SURFACE GUIDED RADIOTHERAPY SYSTEM FOR UTILIZATION IN SRS TREATMENTS USING A TG-302 COMPLIANT ANTHROPOMORPHIC HEAD PHANTOM. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)03041-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Stasinou D, Platoni K, Papanikolaou N, Zoros E, Kalaitzakis G, Zourari K, Pappas E. Overall Accuracy of Single-Isocenter Multiple Metastases SRS Treatments over Time: Comparison of Two Commercially Available Methods. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Buatti J, Stathakis S, Kirby N, Li R, de Oliveira M, Kabat C, Papanikolaou N, Paragios N. Dose Predictions for Head and Neck Cancers Using Hybrid Structure Sets Containing Manual and Automated Contours. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Papanikolaou N, Coulden A, Parker N, Lee S, Kelly C, Anderson R, Rees A, Cox J, Dhillo W, Meeran K, Al-Memar M, Karavitaki N, Jayasena C. P-698 Pituitary functioning gonadotroph adenomas (FGA)-induced ovarian hyperstimulation syndrome (OHSS): results from tertiary neuroendocrine centres in the UK. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
There are no published series of OHSS due to FGA. What FGA features should clinicians look for during OHSS, and what treatments are effective?
Summary answer
FGA tumour size is always >10mm. Other pituitary hormones may be deficient. Surgical resection of FGA is an effective treatment for OHSS.
What is known already
Pituitary adenomas affect 1:1000 adults and are classified as functioning or non-functioning. Non-functioning pituitary adenomas do not secrete hormones, but most commonly stain histologically gonadotroph cells. Functional pituitary adenomas secrete hormones such as prolactin causing prolactinoma. However, it is rare for a pituitary tumour to cause clinical features of excessive gonadotrophins (functioning gonadotroph adenoma; FGA).
Single case reports, but no case series, have been published on the presentation of FGA-induced OHSS in women.
Surgical excision of adenomas has been reported to cause remission of symptoms, though systematic data are lacking owing to rarity of these tumours.
Study design, size, duration
National case series from tertiary neuroendocrine units in England, Wales and Scotland.
Participants/materials, setting, methods
Eight high-volume pituitary endocrine tertiary units within England, Wales and Scotland audited their records for any cases of FGA-induced OHSS; only seven patients have been identified to date. In all cases, there had been no recent exposure to assisted reproductive technologies (ART) or drugs known to induce OHSS including gonadotrophins or selective oestrogen receptor modulators (SERMS).
Main results and the role of chance
Seven cases of FGA were identified with mean age 31.6 years (range 16-48) at diagnosis. Two-of-seven women presented acutely unwell with abdominal pain, distention and palpable mass requiring oophorectomy for ovarian torsion/ruptured ovarian cyst. The remaining five women presented with abdominal pain (n = 2), thyrotoxicosis (n = 1), menstrual irregularities/galactorrhoea (n = 1) and visual disturbances (n = 1). All women experienced intermittent pelvic pain during medical attendance. Pelvic ultrasound demonstrated enlarged multiseptated ovaries (volume ranging 27-442cm3). Ascites was noted in one woman. Six women had visual field defects due to optic chiasm compression on formal assessment. Median FSH was 26.10 u/L (8.3-33), but LH was <2.5 u/L in all cases. Estradiol (E2) far exceeded the reference range in 5/7 women (2990 to > 18000pmol/L);E2 was at the upper limit of normal in the remaining 2/7 women (960-1450pmol/L). Hyperprolactinaemia, hyperthyroidism and other pituitary hormones deficiency were noted in 6/7, 1/7 and 4/7 women respectively. All FGAs were macroadenomas with diameters ranging 16-48mm. Two patients were administered a somatostatin analogue prior to surgery, but FSH, E2 and tumour size did not change. Transsphenoidal surgery was performed in 6/7 women, and always improved symptomatic and biochemical features of OHSS; however, residual FGA tumour was present post-operatively in all cases studied.
Limitations, reasons for caution
It is possible that some ‘non-functioning’ gonadotroph adenomas cause subclinical problems including menstrual irregularity and mild OHSS which were never diagnosed.
We have insufficient data to determine the prognosis for future pregnancy after FGA-induced OHSS.
This study utilised historical case-notes, so some data is missing.
Wider implications of the findings
The ‘spontaneous’ presentation of OHSS may be confusing for clinicians. We report that FGA is an important cause of spontaneous OHSS which has well-defined biochemical and radiological characteristics, which may be treated effectively in the short-to-medium with pituitary surgery. Results of this study may provide greater awareness of FGA-induced OHSS.
Trial registration number
N/A
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Affiliation(s)
- N Papanikolaou
- Imperial College London, Metabolism-Digestion and Reproduction , London, United Kingdom
| | - A Coulden
- University hospitals Birmingham NHS Foundation Trust , Endocrinology, Birmingham, United Kingdom
| | - N Parker
- Imperial College Healthcare NHS Trust, Obstetrics and Gynaecology , London, United Kingdom
| | - S Lee
- Royal Infirmary of Edinburgh , Endocrinology, Edinburgh, United Kingdom
| | - C Kelly
- NHS Forth Valley , Endocrinology, Larbert, United Kingdom
| | - R Anderson
- University of Edinburgh, Obstetrics and Gynaecology- Center for Reproductive health , Edinburgh, United Kingdom
| | - A Rees
- Cardiff University- School of Medicine , Endocrinology, Cardiff, United Kingdom
| | - J Cox
- Imperial College Healthcare NHS Trust , Endocrinology, London, United Kingdom
| | - W Dhillo
- Imperial College London, Metabolism- Digestion and Reproduction , London, United Kingdom
| | - K Meeran
- Imperial College Healthcare NHS Trust , Endocrinology, London, United Kingdom
| | - M Al-Memar
- Imperial College Healthcare NHS Trust, Obstetrics and Gynaecology , London, United Kingdom
| | - N Karavitaki
- University hospitals Birmingham NHS Foundation Trust , Endocrinology, Birmingham, United Kingdom
| | - C Jayasena
- Imperial College London, Metabolism-Digestion and Reproduction , London, United Kingdom
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Koutoulidis V, Terpos E, Papanikolaou N, Fontara S, Seimenis I, Gavriatopoulou M, Ntanasis-Stathopoulos I, Bourgioti C, Santinha J, Moreira JM, Kastritis E, Dimopoulos MA, Moulopoulos LA. Comparison of MRI Features of Fat Fraction and ADC for Early Treatment Response Assessment in Participants with Multiple Myeloma. Radiology 2022; 304:137-144. [PMID: 35380497 DOI: 10.1148/radiol.211388] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background An imaging-based predictor of response could provide prognostic information early during treatment course in patients with multiple myeloma (MM). Purpose To investigate if very early changes in bone marrow relative fat fraction (rFF) and apparent diffusion coefficient (ADC) histogram metrics, occurring after one cycle of induction therapy in participants with newly diagnosed MM, could help predict overall best response status. Materials and Methods This prospective study included participants with MM who were enrolled between August 2014 and December 2017. Histogram metrics were extracted from ADC and rFF maps from MRI examinations performed before treatment and after the first treatment cycle. Participants were categorized into the very good partial response (VGPR) or better group and the less than VGPR group per the International Myeloma Working Group response criteria. ADC and rFF map metrics for predicting treatment response were compared using the Wilcoxon rank test, and the false discovery rate (FDR) was used to correct for multiple comparisons. Results A total of 23 participants (mean age, 65 years ± 11 [SD]; 13 men) were evaluated. There was no evidence of a difference in ADC metrics between the two responder groups after correcting for multiple comparisons. The rFF histogram changes between pretreatment MRI and MRI after the first treatment cycle (ΔrFF) that provided significant differences between the VGPR or better and less than VGPR groups were as follows: ΔrFF_10th Percentile (median, 0.5 [95% CI: 0, 1] vs -2.5 [95% CI: -5.1, 0.1], respectively), ΔrFF_90th Percentile (median, 2 [95% CI: 1, 6.8] vs -0.5 [95% CI: -1, 0]), ΔrFF_Mean (median, 3.4 [95% CI: 0.3, 7.6] vs -1.1 [95% CI: -1.8, -0.7]), and ΔrFF_Root Mean Squared (median, 3.2 [95% CI: 0.3, 6.1] vs -0.7 [95% CI: -1.3, -0.4]) (FDR-adjusted P = .03 for all), and the latter two also presented mean group increases in the VGPR or better group that were above the upper 95% CI limit for repeatability. Conclusion Very early changes in bone marrow relative fat fraction histogram metrics, calculated from MRI examination at baseline and after only one cycle of induction therapy, may help to predict very good partial response or better in participants with newly diagnosed multiple myeloma. © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Vassilis Koutoulidis
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Evangelos Terpos
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Nikolaos Papanikolaou
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Sophia Fontara
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Ioannis Seimenis
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Maria Gavriatopoulou
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Ioannis Ntanasis-Stathopoulos
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Charis Bourgioti
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - João Santinha
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - José Maria Moreira
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Efstathios Kastritis
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Meletios A Dimopoulos
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
| | - Lia A Moulopoulos
- From the 1st Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, 76 Vas. Sophias Ave, 11528 Athens, Greece (V.K., S.F., C.B., L.A.M.); Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece (E.T., M.G., I.N.S., E.K., M.A.D.); Computational Clinical Imaging Group, Center for the Unknown, Champalimaud Foundation, Lisbon, Portugal (N.P., J.S., J.M.M.); and Department of Medical Physics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece (I.S.)
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Anagnostopoulos AK, Gaitanis A, Gkiozos I, Athanasiadis EI, Chatziioannou SN, Syrigos KN, Thanos D, Chatziioannou AN, Papanikolaou N. Radiomics/Radiogenomics in Lung Cancer: Basic Principles and Initial Clinical Results. Cancers (Basel) 2022; 14:cancers14071657. [PMID: 35406429 PMCID: PMC8997041 DOI: 10.3390/cancers14071657] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Radiogenomics is a promising new approach in cancer assessment, providing an evaluation of the molecular basis of imaging phenotypes after establishing associations between radiological features and molecular features at the genomic–transcriptomic–proteomic level. This review focuses on describing key aspects of radiogenomics while discussing limitations of translatability to the clinic and possible solutions to these challenges, providing the clinician with an up-to-date handbook on how to use this new tool. Abstract Lung cancer is the leading cause of cancer-related deaths worldwide, and elucidation of its complicated pathobiology has been traditionally targeted by studies incorporating genomic as well other high-throughput approaches. Recently, a collection of methods used for cancer imaging, supplemented by quantitative aspects leading towards imaging biomarker assessment termed “radiomics”, has introduced a novel dimension in cancer research. Integration of genomics and radiomics approaches, where identifying the biological basis of imaging phenotypes is feasible due to the establishment of associations between molecular features at the genomic–transcriptomic–proteomic level and radiological features, has recently emerged termed radiogenomics. This review article aims to briefly describe the main aspects of radiogenomics, while discussing its basic limitations related to lung cancer clinical applications for clinicians, researchers and patients.
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Affiliation(s)
- Athanasios K. Anagnostopoulos
- Division of Biotechnology, Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens (BRFAA), 11525 Athens, Greece
- Correspondence:
| | - Anastasios Gaitanis
- Clinical and Translational Research, Center of Experimental Surgery, Biomedical Research Foundation of the Academy of Athens (BRFAA), 11527 Athens, Greece;
| | - Ioannis Gkiozos
- Third Department of Internal Medicine, “Sotiria” Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.G.); (K.N.S.)
| | - Emmanouil I. Athanasiadis
- Greek Genome Centre, Biomedical Research Foundation of the Academy of Athens (BRFAA), 11527 Athens, Greece; (E.I.A.); (D.T.)
| | - Sofia N. Chatziioannou
- Nuclear Medicine Division, Biomedical Research Foundation of the Academy of Athens (BRFAA), 11527 Athens, Greece;
| | - Konstantinos N. Syrigos
- Third Department of Internal Medicine, “Sotiria” Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.G.); (K.N.S.)
| | - Dimitris Thanos
- Greek Genome Centre, Biomedical Research Foundation of the Academy of Athens (BRFAA), 11527 Athens, Greece; (E.I.A.); (D.T.)
| | - Achilles N. Chatziioannou
- First Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Nikolaos Papanikolaou
- Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, 1400-038 Lisbon, Portugal;
- Machine Learning Group, The Royal Marsden, London SM2 5MG, UK
- The Institute of Cancer Research, London SM2 5MG, UK
- Karolinska Institutet, 14186 Stockholm, Sweden
- Institute of Computer Science, FORTH, 70013 Heraklion, Greece
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15
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Pozzi Mucelli RM, Moro CF, Del Chiaro M, Valente R, Blomqvist L, Papanikolaou N, Löhr JM, Kartalis N. Branch-duct intraductal papillary mucinous neoplasm (IPMN): Are cyst volumetry and other novel imaging features able to improve malignancy prediction compared to well-established resection criteria? Eur Radiol 2022; 32:5144-5155. [PMID: 35275259 PMCID: PMC9279268 DOI: 10.1007/s00330-022-08650-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/02/2022] [Accepted: 02/11/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Current guidelines base the management of intraductal papillary mucinous neoplasms (IPMN) on several well-established resection criteria (RC), including cyst size. However, malignancy may occur in small cysts. Since branch-duct (BD) IPMN are not perfect spheres, volumetric and morphologic analysis might better correlate with mucin production and grade of dysplasia. Nonetheless, their role in malignancy (high-grade dysplasia/invasive cancer) prediction has been poorly investigated. Previous studies evaluating RC also included patients with solid-mass-forming pancreatic cancer (PC), which may affect the RC yield. This study aimed to assess the role of volume, morphology, and other well-established RC in malignancy prediction in patients with BD- and mixed-type IPMN after excluding solid masses. METHODS Retrospective ethical review-board-approved study of 106 patients (2008-2019) with histopathological diagnosis of BD- and mixed-type IPMN (without solid masses) and preoperative MRI available. Standard imaging and clinical features were collected, and the novel imaging features cyst-volume and elongation value [EV = 1 - (width/length)] calculated on T2-weighted images. Logistic regression analysis was performed. Statistical significance set at two-tails, p < 0.05. RESULTS Neither volume (odds ratio (OR) = 1.01, 95% CI: 0.99-1.02, p = 0.12) nor EV (OR = 0.38, 95% CI: 0.02-5.93, p = 0.49) was associated with malignancy. Contrast-enhancing mural nodules (MN), main pancreatic duct (MPD) ≥ 5 mm, and elevated carbohydrate antigen (CA) 19-9 serum levels (> 37 μmol/L) were associated with malignancy (MN OR: 4.32, 95% CI: 1.18-15.76, p = 0.02; MPD ≥ 5 mm OR: 4.2, 95% CI: 1.34-13.1, p = 0.01; CA19-9 OR: 6.72; 95% CI: 1.89 - 23.89, p = 0.003). CONCLUSIONS Volume and elongation value cannot predict malignancy in BD- and/or mixed-type IPMN. Mural nodules, MPD ≥ 5 mm and elevated CA19-9 serum levels are associated with higher malignancy risk even after the exclusion of solid masses. KEY POINTS • Novel and well-established resection criteria for IPMN have been evaluated after excluding solid masses. • BD-IPMN volume and elongation value cannot predict malignancy. • Main pancreatic duct ≥ 5 mm, mural nodules, and elevated carbohydrate antigen 19-9 levels are associated with malignancy.
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Affiliation(s)
- Raffaella M. Pozzi Mucelli
- Department of Radiology Huddinge, Karolinska University Hospital, O-huset 42, 14186 Stockholm, Sweden ,Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186 Stockholm, Sweden
| | - Carlos Fernández Moro
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden ,Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Alfred Nobels Allé 8, 141 52 Stockholm, Sweden
| | - Marco Del Chiaro
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, 12631 E 17th Ave #6117, Aurora, CO 80045 USA
| | - Roberto Valente
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186 Stockholm, Sweden ,Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, 12631 E 17th Ave #6117, Aurora, CO 80045 USA ,Department of Surgical and Perioperative Sciences, Umeå University, Daniel Naezéns väg, 907 37 Umeå, Sweden
| | - Lennart Blomqvist
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Solnavägen 1, 17177 Stockholm, Sweden ,Department of Molecular Medicine and Surgery, Karolinska Institutet, L1:00, 17176 Stockholm, Sweden
| | - Nikolaos Papanikolaou
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186 Stockholm, Sweden ,Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Av. Brasília, Doca de Pedrouços, 1400-038 Lisbon, Portugal ,Department of Radiology, Royal Marsden Hospital and The Institute of Cancer Research, London, SM2 5NG UK ,Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
| | - Johannes-Matthias Löhr
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186 Stockholm, Sweden ,Department of Upper Abdominal Diseases, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Hälsovägen, 13, 141 57 Huddinge, Stockholm, Sweden
| | - Nikolaos Kartalis
- Department of Radiology Huddinge, Karolinska University Hospital, O-huset 42, 14186 Stockholm, Sweden ,Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, O-huset 42, 14186 Stockholm, Sweden
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16
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Shur JD, Doran SJ, Kumar S, Ap Dafydd D, Downey K, O'Connor JPB, Papanikolaou N, Messiou C, Koh DM, Orton MR. Radiomics in Oncology: A Practical Guide. Radiographics 2021; 41:1717-1732. [PMID: 34597235 PMCID: PMC8501897 DOI: 10.1148/rg.2021210037] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Radiomics refers to the extraction of mineable data from medical imaging
and has been applied within oncology to improve diagnosis,
prognostication, and clinical decision support, with the goal of
delivering precision medicine. The authors provide a practical approach
for successfully implementing a radiomic workflow from planning and
conceptualization through manuscript writing. Applications in oncology
typically are either classification tasks that involve computing the
probability of a sample belonging to a category, such as benign versus
malignant, or prediction of clinical events with a time-to-event
analysis, such as overall survival. The radiomic workflow is
multidisciplinary, involving radiologists and data and imaging
scientists, and follows a stepwise process involving tumor segmentation,
image preprocessing, feature extraction, model development, and
validation. Images are curated and processed before segmentation, which
can be performed on tumors, tumor subregions, or peritumoral zones.
Extracted features typically describe the distribution of signal
intensities and spatial relationship of pixels within a region of
interest. To improve model performance and reduce overfitting, redundant
and nonreproducible features are removed. Validation is essential to
estimate model performance in new data and can be performed iteratively
on samples of the dataset (cross-validation) or on a separate hold-out
dataset by using internal or external data. A variety of noncommercial
and commercial radiomic software applications can be used. Guidelines
and artificial intelligence checklists are useful when planning and
writing up radiomic studies. Although interest in the field continues to
grow, radiologists should be familiar with potential pitfalls to ensure
that meaningful conclusions can be drawn. Online supplemental material is available for this
article. Published under a CC BY 4.0 license.
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Affiliation(s)
- Joshua D Shur
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Simon J Doran
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Santosh Kumar
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Derfel Ap Dafydd
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Kate Downey
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - James P B O'Connor
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Nikolaos Papanikolaou
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Christina Messiou
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Dow-Mu Koh
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
| | - Matthew R Orton
- From the Department of Radiology, Royal Marsden Hospital NHS Foundation Trust, Sutton, England (J.D.S., D.a.D., K.D., N. P., C.M., D.M.K.); Institute of Cancer Research, 15 Cotswold Road, Sutton SM2 5NG, England (S.J.D., S.K., J.P.B.O., N. P., C.M., D.M.K., M.R.O.); and Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Lisbon, Portugal (N.P.)
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Santinha J, Matos C, Figueiredo M, Papanikolaou N. Improving performance and generalizability in radiogenomics: a pilot study for prediction of IDH1/2 mutation status in gliomas with multicentric data. J Med Imaging (Bellingham) 2021; 8:031905. [PMID: 33937440 PMCID: PMC8082292 DOI: 10.1117/1.jmi.8.3.031905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 04/13/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose: Radiogenomics offers a potential virtual and noninvasive biopsy. However, radiogenomics models often suffer from generalizability issues, which cause a performance degradation on unseen data. In MRI, differences in the sequence parameters, manufacturers, and scanners make this generalizability issue worse. Such image acquisition information may be used to define different environments and select robust and invariant radiomic features associated with the clinical outcome that should be included in radiomics/radiogenomics models. Approach: We assessed 77 low-grade gliomas and glioblastomas multiform patients publicly available in TCGA and TCIA. Radiomics features were extracted from multiparametric MRI images (T1-weighted, contrast-enhanced T1-weighted, T2-weighted, and fluid-attenuated inversion recovery) and different regions-of-interest (enhancing tumor, nonenhancing tumor/necrosis, and edema). A method developed to find variables that are part of causal structures was used for feature selection and compared with an embedded feature selection approach commonly used in radiomics/radiogenomics studies, across two different scenarios: (1) leaving data from a center as an independent held-out test set and tuning the model with the data from the remaining centers and (2) use stratified partitioning to obtain the training and the held-out test sets. Results: In scenario (1), the performance of the proposed methodology and the traditional embedded method was AUC: 0.75 [0.25; 1.00] versus 0.83 [0.50; 1.00], Sens.: 0.67 [0.20; 0.93] versus 0.67 [0.20; 0.93], Spec.: 0.75 [0.30; 0.95] versus 0.75 [0.30; 0.95], and MCC: 0.42 [0.19; 0.68] versus 0.42 [0.19; 0.68] for center 1 as the held-out test set. The performance of both methods for center 2 as the held-out test set was AUC: 0.64 [0.36; 0.91] versus 0.55 [0.27; 0.82], Sens.: 0.00 [0.00; 0.73] versus 0.00 [0.00; 0.73], Spec.: 0.82 [0.52; 0.94] versus 0.91 [0.62; 0.98], and MCC: - 0.13 [ - 0.38 ; - 0.04 ] versus - 0.09 [ - 0.38 ; - 0.02 ] , whereas for center 3 was AUC: 0.80 [0.62; 0.95] versus 0.89 [0.56; 0.96], Sens.: 0.86 [0.48; 0.97] versus 0.86 [0.48; 0.97], Spec.: 0.72 [0.54; 0.85] versus 0.79 [0.61; 0.90], and MCC: 0.47 [0.41; 0.53] versus 0.55 [0.48; 0.60]. For center 4, the performance of both methods was AUC: 0.77 [0.51; 1.00] versus 0.75 [0.47; 0.97], Sens.: 0.53 [0.30; 0.75] versus 0.00 [0.00; 0.15], Spec.: 0.71 [0.35; 0.91] versus 0.86 [0.48; 0.97], and MCC: 0.23 [0.16; 0.31] versus. - 0.32 [ - 0.46 ; - 0.20 ] . In scenario (2), the performance of these methods was AUC: 0.89 [0.71; 1.00] versus 0.79 [0.58; 0.94], Sens.: 0.86 [0.80; 0.92] versus 0.43 [0.15; 0.74], Spec.: 0.87 [0.62; 0.96] versus 0.87 [0.62; 0.96], and MCC: 0.70 [0.60; 0.77] versus 0.33 [0.24; 0.42]. Conclusions: This proof-of-concept study demonstrated good performance by the proposed feature selection method in the majority of the studied scenarios, as it promotes robustness of features included in the models and the models' generalizability by making used imaging data of different scanners or with sequence parameters.
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Affiliation(s)
- João Santinha
- Clinical Computational Imaging Group, Champalimaud Research, Champalimaud Foundation, Lisboa, Portugal.,Universidade de Lisboa, Instituto de Telecomunicações, Instituto Superior Técnico, Lisboa, Portugal
| | - Celso Matos
- Champalimaud Clinical Center, Radiology Department, Champalimaud Foundation, Lisboa, Portugal
| | - Mário Figueiredo
- Universidade de Lisboa, Instituto de Telecomunicações, Instituto Superior Técnico, Lisboa, Portugal
| | - Nikolaos Papanikolaou
- Clinical Computational Imaging Group, Champalimaud Research, Champalimaud Foundation, Lisboa, Portugal
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18
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Verde ASC, Santinha J, Carrasquinha E, Loucao N, Gaivao A, Fonseca J, Matos C, Papanikolaou N. Diffusion tensor-based fiber tracking of the male urethral sphincter complex in patients undergoing radical prostatectomy: a feasibility study. Insights Imaging 2020; 11:126. [PMID: 33245443 PMCID: PMC7695769 DOI: 10.1186/s13244-020-00927-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/13/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives To study the diffusion tensor-based fiber tracking feasibility to access the male urethral sphincter complex of patients with prostate cancer undergoing Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RARP).
Methods Twenty-eight patients (median age of 64.5 years old) underwent 3 T multiparametric-MRI of the prostate, including an additional echo-planar diffusion tensor imaging (DTI) sequence, using 15 diffusion-encoding directions and a b value = 600 s/mm2. Acquisition parameters, together with patient motion and eddy currents corrections, were evaluated. The proximal and distal sphincters, and membranous urethra were reconstructed using the deterministic fiber assignment by continuous tracking (FACT) algorithm, optimizing fiber tracking parameters. Tract length and density, fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) were computed. Regional differences between structures were accessed by ANOVA, or nonparametric Kruskal–Wallis test, and post-hoc tests were employed, respectively, TukeyHSD or Dunn’s. Results The structures of the male urethral sphincter complex were clearly depicted by fiber tractography using optimized acquisition and fiber tracking parameters. The use of eddy currents and subject motion corrections did not yield statistically significant differences on the reported DTI metrics. Regional differences were found between all structures studied among patients, suggesting a quantitative differentiation on the structures based on DTI metrics. Conclusions The current study demonstrates the technical feasibility of the proposed methodology, to study in a preoperative setting the male urethral sphincter complex of prostate cancer patients candidates for surgical treatment. These findings may play a role on a more accurate prediction of the RS-RARP post-surgical urinary continence recovery rate.
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Affiliation(s)
- Ana S C Verde
- Head of Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal
| | - Joao Santinha
- Head of Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal
| | - Eunice Carrasquinha
- Head of Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal
| | | | - Ana Gaivao
- Radiology Department, Champalimaud Foundation, Lisbon, Portugal
| | - Jorge Fonseca
- Urology Unit, Champalimaud Foundation, Lisbon, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Universidade Do Porto, Porto, Portugal
| | - Celso Matos
- Radiology Department, Champalimaud Foundation, Lisbon, Portugal
| | - Nikolaos Papanikolaou
- Head of Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal.
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19
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Trivizakis E, Tsiknakis N, Vassalou EE, Papadakis GZ, Spandidos DA, Sarigiannis D, Tsatsakis A, Papanikolaou N, Karantanas AH, Marias K. Advancing COVID-19 differentiation with a robust preprocessing and integration of multi-institutional open-repository computer tomography datasets for deep learning analysis. Exp Ther Med 2020; 20:78. [PMID: 32968435 PMCID: PMC7500043 DOI: 10.3892/etm.2020.9210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022] Open
Abstract
The coronavirus pandemic and its unprecedented consequences globally has spurred the interest of the artificial intelligence research community. A plethora of published studies have investigated the role of imaging such as chest X-rays and computer tomography in coronavirus disease 2019 (COVID-19) automated diagnosis. Οpen repositories of medical imaging data can play a significant role by promoting cooperation among institutes in a world-wide scale. However, they may induce limitations related to variable data quality and intrinsic differences due to the wide variety of scanner vendors and imaging parameters. In this study, a state-of-the-art custom U-Net model is presented with a dice similarity coefficient performance of 99.6% along with a transfer learning VGG-19 based model for COVID-19 versus pneumonia differentiation exhibiting an area under curve of 96.1%. The above was significantly improved over the baseline model trained with no segmentation in selected tomographic slices of the same dataset. The presented study highlights the importance of a robust preprocessing protocol for image analysis within a heterogeneous imaging dataset and assesses the potential diagnostic value of the presented COVID-19 model by comparing its performance to the state of the art.
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Affiliation(s)
- Eleftherios Trivizakis
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Department of Radiology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Nikos Tsiknakis
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
| | - Evangelia E. Vassalou
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece
- Department of Radiology, Sitia District Hospital, 72300 Lasithi, Greece
| | - Georgios Z. Papadakis
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Department of Radiology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Dimosthenis Sarigiannis
- HERACLES Research Center on the Exposome and Health, Centre for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki, 57001 Thermi, Greece
- University School for Advanced Studies IUSS, I-27100 Pavia, Italy
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Nikolaos Papanikolaou
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, 1400-038 Lisbon, Portugal
| | - Apostolos H. Karantanas
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Department of Radiology, Medical School, University of Crete, 71003 Heraklion, Greece
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece
| | - Kostas Marias
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Department of Electrical and Computer Engineering, Hellenic Mediterranean University, 71410 Heraklion, Greece
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Saenz D, Bry V, Zourari K, Zoros E, Pappas E, Rasmussen K, Papanikolaou N. PO-1641: Role of surface imaging for verification of mono-isocentric multi-focal stereotactic radiosurgery. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01659-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Mpatzaka T, Papageorgiou G, Papanikolaou N, Valamontes E, Ganetsos T, Goustouridis D, Raptis I, Zisis G. In-situ characterization of the development step of high-resolution e-beam resists. Micro and Nano Engineering 2020. [DOI: 10.1016/j.mne.2020.100070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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Tobaly D, Santinha J, Sartoris R, Dioguardi Burgio M, Matos C, Cros J, Couvelard A, Rebours V, Sauvanet A, Ronot M, Papanikolaou N, Vilgrain V. CT-Based Radiomics Analysis to Predict Malignancy in Patients with Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas. Cancers (Basel) 2020; 12:cancers12113089. [PMID: 33114028 PMCID: PMC7690711 DOI: 10.3390/cancers12113089] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/17/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023] Open
Abstract
To assess the performance of CT-based radiomics analysis in differentiating benign from malignant intraductal papillary mucinous neoplasms of the pancreas (IPMN), preoperative scans of 408 resected patients with IPMN were retrospectively analyzed. IPMNs were classified as benign (low-grade dysplasia, n = 181), or malignant (high grade, n = 128, and invasive, n = 99). Clinicobiological data were reported. Patients were divided into a training cohort (TC) of 296 patients and an external validation cohort (EVC) of 112 patients. After semi-automatic tumor segmentation, PyRadiomics was used to extract radiomics features. A multivariate model was developed using a logistic regression approach. In the training cohort, 85/107 radiomics features were significantly different between patients with benign and malignant IPMNs. Unsupervised clustering analysis revealed four distinct clusters of patients with similar radiomics features patterns with malignancy as the most significant association. The multivariate model differentiated benign from malignant tumors in TC with an area under the ROC curve (AUC) of 0.84, sensitivity (Se) of 0.82, specificity (Spe) of 0.74, and in EVC with an AUC of 0.71, Se of 0.69, Spe of 0.57. This large study confirms the high diagnostic performance of preoperative CT-based radiomics analysis to differentiate between benign from malignant IPMNs.
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Affiliation(s)
- David Tobaly
- Service De Radiologie, Assistance Publique-Hôpitaux De Paris, APHP. Nord, Hôpital Beaujon, 92110 Clichy, France; (R.S.); (M.D.B.); (M.R.)
- Correspondence: (D.T.); (V.V.)
| | - Joao Santinha
- Computational Clinical Imaging Group, Champalimaud Research, Champalimaud Foundation, Avenida Brasília, 1400-038 Lisbon, Portugal;
- Instituto de Telecomunicações, Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
| | - Riccardo Sartoris
- Service De Radiologie, Assistance Publique-Hôpitaux De Paris, APHP. Nord, Hôpital Beaujon, 92110 Clichy, France; (R.S.); (M.D.B.); (M.R.)
- Centre De Recherche De L’inflammation (Cri), Inserm U1149, Université De Paris, 75018 Paris, France
| | - Marco Dioguardi Burgio
- Service De Radiologie, Assistance Publique-Hôpitaux De Paris, APHP. Nord, Hôpital Beaujon, 92110 Clichy, France; (R.S.); (M.D.B.); (M.R.)
- Centre De Recherche De L’inflammation (Cri), Inserm U1149, Université De Paris, 75018 Paris, France
| | - Celso Matos
- Radiology Department, Champalimaud Foundation, Avenida Brasília, 1400-038 Lisbon, Portugal;
- Champalimaud Research, Champalimaud Foundation, Avenida Brasília, 1400-038 Lisbon, Portugal
| | - Jérôme Cros
- Service D’Anatomopathologie, Assistance Publique-Hôpitaux De Paris, APHP.Nord, Hôpital Beaujon, 92110 Clichy, France;
| | - Anne Couvelard
- Service D’Anatomopathologie, Assistance Publique-Hôpitaux De Paris, APHP.Nord, Hôpital Bichat, 75018 Paris, France;
| | - Vinciane Rebours
- Service De Pancréatologie, Assistance Publique-Hôpitaux De Paris, APHP.Nord, Hôpital Beaujon, 92110 Clichy, France;
| | - Alain Sauvanet
- Service De Chirurgie HPB, Assistance Publique-Hôpitaux De Paris, APHP.Nord, Hôpital Beaujon, 92110 Clichy, France;
| | - Maxime Ronot
- Service De Radiologie, Assistance Publique-Hôpitaux De Paris, APHP. Nord, Hôpital Beaujon, 92110 Clichy, France; (R.S.); (M.D.B.); (M.R.)
- Centre De Recherche De L’inflammation (Cri), Inserm U1149, Université De Paris, 75018 Paris, France
| | - Nikolaos Papanikolaou
- Computational Clinical Imaging Group, Champalimaud Research, Champalimaud Foundation, 1400-038 Lisbon, Portugal;
| | - Valérie Vilgrain
- Service De Radiologie, Assistance Publique-Hôpitaux De Paris, APHP. Nord, Hôpital Beaujon, 92110 Clichy, France; (R.S.); (M.D.B.); (M.R.)
- Centre De Recherche De L’inflammation (Cri), Inserm U1149, Université De Paris, 75018 Paris, France
- Correspondence: (D.T.); (V.V.)
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Bianchini L, Santinha J, Loução N, Figueiredo M, Botta F, Origgi D, Cremonesi M, Cassano E, Papanikolaou N, Lascialfari A. A multicenter study on radiomic features from T 2 -weighted images of a customized MR pelvic phantom setting the basis for robust radiomic models in clinics. Magn Reson Med 2020; 85:1713-1726. [PMID: 32970859 DOI: 10.1002/mrm.28521] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate the repeatability and reproducibility of radiomic features extracted from MR images and provide a workflow to identify robust features. METHODS T2 -weighted images of a pelvic phantom were acquired on three scanners of two manufacturers and two magnetic field strengths. The repeatability and reproducibility of features were assessed by the intraclass correlation coefficient and the concordance correlation coefficient, respectively, and by the within-subject coefficient of variation, considering repeated acquisitions with and without phantom repositioning, and with different scanner and acquisition parameters. The features showing intraclass correlation coefficient or concordance correlation coefficient >0.9 were selected, and their dependence on shape information (Spearman's ρ > 0.8) analyzed. They were classified for their ability to distinguish textures, after shuffling voxel intensities of images. RESULTS From 944 two-dimensional features, 79.9% to 96.4% showed excellent repeatability in fixed position across all scanners. A much lower range (11.2% to 85.4%) was obtained after phantom repositioning. Three-dimensional extraction did not improve repeatability performance. Excellent reproducibility between scanners was observed in 4.6% to 15.6% of the features, at fixed imaging parameters. In addition, 82.4% to 94.9% of the features showed excellent agreement when extracted from images acquired with echo times 5 ms apart, but decreased with increasing echo-time intervals, and 90.7% of the features exhibited excellent reproducibility for changes in pulse repetition time. Of nonshape features, 2.0% was identified as providing only shape information. CONCLUSION We showed that radiomic features are affected by MRI protocols and propose a general workflow to identify repeatable, reproducible, and informative radiomic features to ensure robustness of clinical studies.
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Affiliation(s)
- Linda Bianchini
- Department of Physics, Università degli Studi di Milano and INSTM RU, Milan, Italy
| | - João Santinha
- Computational Clinical Imaging Group, Center for the Unknown (CCU), Champalimaud Foundation, Lisbon, Portugal.,Instituto de Telecomunicações, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
| | | | - Mário Figueiredo
- Instituto de Telecomunicações, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
| | - Francesca Botta
- Medical Physics Unit, IEO, European Institute of Oncology IRCSS, Milan, Italy
| | - Daniela Origgi
- Medical Physics Unit, IEO, European Institute of Oncology IRCSS, Milan, Italy
| | - Marta Cremonesi
- Radiation Research Unit, IEO, European Institute of Oncology IRCSS, Milan, Italy
| | - Enrico Cassano
- Breast Imaging Division, IEO, European Institute of Oncology IRCSS, Milan, Italy
| | - Nikolaos Papanikolaou
- Computational Clinical Imaging Group, Center for the Unknown (CCU), Champalimaud Foundation, Lisbon, Portugal
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Cruz M, Ferreira AA, Papanikolaou N, Banerjee R, Alves FC. New boundaries of liver imaging: from morphology to function. Eur J Intern Med 2020; 79:12-22. [PMID: 32571581 DOI: 10.1016/j.ejim.2020.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/20/2020] [Accepted: 06/04/2020] [Indexed: 12/12/2022]
Abstract
From an invisible organ to one of the most explored non-invasively, the liver is, today, one of the cornerstones for current cross-sectional imaging techniques and minimally invasive procedures. After the achievements of US, CT and, most recently, MRI in providing highly accurate morphological and structural information about the organ, a significant scientific development has gained momentum for the last decades, coupling morphology to liver function and contributing far most to what we know today as precision medicine. In fact, dedicated tailor-made investigations are now possible in order to detect and, most of all, quantify physiopathological processes with unprecedented certitude. It is the intention of this review to provide a better insight to the reader of several functional imaging techniques applied to liver imaging. Contrast enhanced imaging, diffusion weighted imaging, elastography, spectral computed tomography and fat and iron assessment techniques are commonly performed clinically. Diffusion kurtosis imaging, magnetic resonance spectroscopy, T1 relaxometry and radiomics remain largely limited to advanced clinical research. Each of them has its own value and place on the diagnostic armamentarium and provide unique qualitative and quantitative information regarding the pathophysiology of diseases, contributing at a large scale to model therapeutic decisions and patient follow-up. Therefore, state-of-the-art liver imaging acts today as a non-invasive surrogate biomarker of many focal and diffuse liver diseases.
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Affiliation(s)
- Manuel Cruz
- Department of Radiology, Faculty of Medicine, University Hospital Coimbra and CIBIT/ICNAS research center, University of Coimbra, Coimbra, Portugal.
| | - Ana Aguiar Ferreira
- Department of Radiology, Faculty of Medicine, University Hospital Coimbra and CIBIT/ICNAS research center, University of Coimbra, Coimbra, Portugal
| | - Nikolaos Papanikolaou
- Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
| | - Rajarshi Banerjee
- Department of Acute Medicine, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Filipe Caseiro Alves
- Department of Radiology, Faculty of Medicine, University Hospital Coimbra and CIBIT/ICNAS research center, University of Coimbra, Coimbra, Portugal
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25
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Tsiknakis N, Trivizakis E, Vassalou EE, Papadakis GZ, Spandidos DA, Tsatsakis A, Sánchez-García J, López-González R, Papanikolaou N, Karantanas AH, Marias K. Interpretable artificial intelligence framework for COVID-19 screening on chest X-rays. Exp Ther Med 2020; 20:727-735. [PMID: 32742318 PMCID: PMC7388253 DOI: 10.3892/etm.2020.8797] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/27/2020] [Indexed: 02/07/2023] Open
Abstract
COVID-19 has led to an unprecedented healthcare crisis with millions of infected people across the globe often pushing infrastructures, healthcare workers and entire economies beyond their limits. The scarcity of testing kits, even in developed countries, has led to extensive research efforts towards alternative solutions with high sensitivity. Chest radiological imaging paired with artificial intelligence (AI) can offer significant advantages in diagnosis of novel coronavirus infected patients. To this end, transfer learning techniques are used for overcoming the limitations emanating from the lack of relevant big datasets, enabling specialized models to converge on limited data, as in the case of X-rays of COVID-19 patients. In this study, we present an interpretable AI framework assessed by expert radiologists on the basis on how well the attention maps focus on the diagnostically-relevant image regions. The proposed transfer learning methodology achieves an overall area under the curve of 1 for a binary classification problem across a 5-fold training/testing dataset.
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Affiliation(s)
- Nikos Tsiknakis
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
| | - Eleftherios Trivizakis
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Department of Radiology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Evangelia E. Vassalou
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece
- Department of Radiology, District Hospital, 72300 Lasithi, Greece
| | - Georgios Z. Papadakis
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Department of Radiology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | | | | | - Nikolaos Papanikolaou
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Computational Clinical Imaging Group, Centre for the Unknown, Champalimaud Foundation, 1400-038 Lisbon, Portugal
| | - Apostolos H. Karantanas
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Department of Radiology, Medical School, University of Crete, 71003 Heraklion, Greece
- Department of Medical Imaging, University Hospital of Heraklion, 71110 Heraklion, Greece
| | - Kostas Marias
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
- Department of Electrical and Computer Engineering, Hellenic Mediterranean University, 71410 Heraklion, Greece
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26
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Bui B, McConnell K, Obeidat M, Saenz D, Papanikolaou N, Shim EY, Kirby N. DNA dosimeter measurements of beam profile using a novel simultaneous processing technique. Appl Radiat Isot 2020; 165:109316. [PMID: 32745918 DOI: 10.1016/j.apradiso.2020.109316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/03/2020] [Accepted: 06/27/2020] [Indexed: 11/25/2022]
Abstract
A DNA dosimeter (DNAd) was previously developed that uses double-strand breaks (DSB) to measure dose. This dosimeter has been tested to measure dose in scenarios where transient-charged particle equilibrium (TCPE) has been established. The probability of double strand break (PDSBo), which is the ratio of broken double-stranded DNA (dsDNA) to the initial unbroken dsDNA in the dosimeter, was used to quantify DSBs and related to dose. The goal of this work is to produce a new technique to process and analyze the DNAd and quantify DNA-DSBs. This technique included simultaneously processing multiple DNAds and also establishing a new form to the probability of double strand break (PDSBn), which was then used to test the DNAd in a non-TCPE condition by taking beam penumbra measurements. The technique utilized a 384-well plate, and the measurements were made at the edge of a 10 × 10 cm field and compared to film measurements. During these penumbra measurements, while observing the positional differences in the higher gradient region at 4.1 and 4.55 cm from the center of the radiation field, the distance to agreement of PDSBo to film were 0.38 cm and 0.26 cm while the distance to agreement of PDSBn to film were 0.11 cm and 0.06 cm, respectively. Finally, the developed new separation technique reduced the time needed for the analysis of 25 samples from 200 min to 30 min.
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Affiliation(s)
- B Bui
- Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - K McConnell
- Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - M Obeidat
- Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - D Saenz
- Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - N Papanikolaou
- Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - E Y Shim
- Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - N Kirby
- Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
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27
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Trivizakis E, Papadakis GZ, Souglakos I, Papanikolaou N, Koumakis L, Spandidos DA, Tsatsakis A, Karantanas AH, Marias K. Artificial intelligence radiogenomics for advancing precision and effectiveness in oncologic care (Review). Int J Oncol 2020; 57:43-53. [PMID: 32467997 PMCID: PMC7252460 DOI: 10.3892/ijo.2020.5063] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/05/2020] [Indexed: 12/11/2022] Open
Abstract
The new era of artificial intelligence (AI) has introduced revolutionary data-driven analysis paradigms that have led to significant advancements in information processing techniques in the context of clinical decision-support systems. These advances have created unprecedented momentum in computational medical imaging applications and have given rise to new precision medicine research areas. Radiogenomics is a novel research field focusing on establishing associations between radiological features and genomic or molecular expression in order to shed light on the underlying disease mechanisms and enhance diagnostic procedures towards personalized medicine. The aim of the current review was to elucidate recent advances in radiogenomics research, focusing on deep learning with emphasis on radiology and oncology applications. The main deep learning radiogenomics architectures, together with the clinical questions addressed, and the achieved genetic or molecular correlations are presented, while a performance comparison of the proposed methodologies is conducted. Finally, current limitations, potentially understudied topics and future research directions are discussed.
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Affiliation(s)
- Eleftherios Trivizakis
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
| | - Georgios Z Papadakis
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
| | - Ioannis Souglakos
- Laboratory of Translational Oncology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Nikolaos Papanikolaou
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
| | - Lefteris Koumakis
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Aristidis Tsatsakis
- Laboratory of Forensic Sciences and Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Apostolos H Karantanas
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
| | - Kostas Marias
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), 70013 Heraklion, Greece
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28
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Papanikolaou N, Matos C, Koh DM. How to develop a meaningful radiomic signature for clinical use in oncologic patients. Cancer Imaging 2020; 20:33. [PMID: 32357923 PMCID: PMC7195800 DOI: 10.1186/s40644-020-00311-4] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/15/2020] [Indexed: 01/08/2023] Open
Abstract
During the last decade, there is an increasing usage of quantitative methods in Radiology in an effort to reduce the diagnostic variability associated with a subjective manner of radiological interpretation. Combined approaches where visual assessment made by the radiologist is augmented by quantitative imaging biomarkers are gaining attention. Advances in machine learning resulted in the rise of radiomics that is a new methodology referring to the extraction of quantitative information from medical images. Radiomics are based on the development of computational models, referred to as “Radiomic Signatures”, trying to address either unmet clinical needs, mostly in the field of oncologic imaging, or to compare radiomics performance with that of radiologists. However, to explore this new technology, initial publications did not consider best practices in the field of machine learning resulting in publications with questionable clinical value. In this paper, our effort was concentrated on how to avoid methodological mistakes and consider critical issues in the workflow of the development of clinically meaningful radiomic signatures.
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Affiliation(s)
- Nikolaos Papanikolaou
- Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Av. Brasília, Doca de Pedrouços, 1400-038, Lisbon, Portugal.
| | - Celso Matos
- Department of Radiology, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Dow Mu Koh
- Department of Radiology, Royal Marsden Hospital, Sutton, UK
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29
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Theodosiou T, Papanikolaou N, Savvaki M, Bonetto G, Maxouri S, Fakoureli E, Eliopoulos AG, Tavernarakis N, Amoutzias GD, Pavlopoulos GA, Aivaliotis M, Nikoletopoulou V, Tzamarias D, Karagogeos D, Iliopoulos I. UniProt-Related Documents (UniReD): assisting wet lab biologists in their quest on finding novel counterparts in a protein network. NAR Genom Bioinform 2020; 2:lqaa005. [PMID: 33575553 PMCID: PMC7671407 DOI: 10.1093/nargab/lqaa005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/20/2020] [Accepted: 01/31/2020] [Indexed: 02/04/2023] Open
Abstract
The in-depth study of protein–protein interactions (PPIs) is of key importance for understanding how cells operate. Therefore, in the past few years, many experimental as well as computational approaches have been developed for the identification and discovery of such interactions. Here, we present UniReD, a user-friendly, computational prediction tool which analyses biomedical literature in order to extract known protein associations and suggest undocumented ones. As a proof of concept, we demonstrate its usefulness by experimentally validating six predicted interactions and by benchmarking it against public databases of experimentally validated PPIs succeeding a high coverage. We believe that UniReD can become an important and intuitive resource for experimental biologists in their quest for finding novel associations within a protein network and a useful tool to complement experimental approaches (e.g. mass spectrometry) by producing sorted lists of candidate proteins for further experimental validation. UniReD is available at http://bioinformatics.med.uoc.gr/unired/
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Affiliation(s)
- Theodosios Theodosiou
- University of Crete, School of Medicine, Department of Basic Sciences, Heraklion 71003, Crete, Greece
| | - Nikolaos Papanikolaou
- University of Crete, School of Medicine, Department of Basic Sciences, Heraklion 71003, Crete, Greece
| | - Maria Savvaki
- University of Crete, School of Medicine, Department of Basic Sciences, Heraklion 71003, Crete, Greece.,Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Nikolaou Plastira 100, 70013 Heraklion, Crete, Greece
| | - Giulia Bonetto
- University of Crete, School of Medicine, Department of Basic Sciences, Heraklion 71003, Crete, Greece
| | - Stella Maxouri
- University of Crete, School of Medicine, Department of Basic Sciences, Heraklion 71003, Crete, Greece.,Medical School of Patras University, Laboratory of General Biology, Asklipiou 1, 26500 Rio Patras, Greece
| | - Eirini Fakoureli
- University of Crete, School of Medicine, Department of Basic Sciences, Heraklion 71003, Crete, Greece
| | - Aristides G Eliopoulos
- Department of Biology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece
| | - Nektarios Tavernarakis
- University of Crete, School of Medicine, Department of Basic Sciences, Heraklion 71003, Crete, Greece.,Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Nikolaou Plastira 100, 70013 Heraklion, Crete, Greece
| | - Grigoris D Amoutzias
- Bioinformatics Laboratory, Department of Biochemistry and Biotechnology, University of Thessaly, Larisa 41500, Greece
| | - Georgios A Pavlopoulos
- Institute for Fundamental Biomedical Research, BSRC "Alexander Fleming", 34 Fleming Street, 16672 Vari, Greece
| | - Michalis Aivaliotis
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Nikolaou Plastira 100, 70013 Heraklion, Crete, Greece.,Laboratory of Biological Chemistry, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, GR-54124, Thessaloniki, Greece.,Functional Proteomics and Systems Biology (FunPATh), Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Balkan Center, Thessaloniki, 10th km Thessaloniki-Thermi Rd, P.O.Box 8318, GR 57001, Greece
| | - Vasiliki Nikoletopoulou
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Nikolaou Plastira 100, 70013 Heraklion, Crete, Greece
| | - Dimitris Tzamarias
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Nikolaou Plastira 100, 70013 Heraklion, Crete, Greece
| | - Domna Karagogeos
- University of Crete, School of Medicine, Department of Basic Sciences, Heraklion 71003, Crete, Greece.,Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Nikolaou Plastira 100, 70013 Heraklion, Crete, Greece
| | - Ioannis Iliopoulos
- University of Crete, School of Medicine, Department of Basic Sciences, Heraklion 71003, Crete, Greece
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30
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Almeida SD, Santinha J, Oliveira FPM, Ip J, Lisitskaya M, Lourenço J, Uysal A, Matos C, João C, Papanikolaou N. Quantification of tumor burden in multiple myeloma by atlas-based semi-automatic segmentation of WB-DWI. Cancer Imaging 2020; 20:6. [PMID: 31931880 PMCID: PMC6958755 DOI: 10.1186/s40644-020-0286-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 01/06/2020] [Indexed: 12/31/2022] Open
Abstract
Background Whole-body diffusion weighted imaging (WB-DWI) has proven value to detect multiple myeloma (MM) lesions. However, the large volume of imaging data and the presence of numerous lesions makes the reading process challenging. The aim of the current study was to develop a semi-automatic lesion segmentation algorithm for WB-DWI images in MM patients and to evaluate this smart-algorithm (SA) performance by comparing it to the manual segmentations performed by radiologists. Methods An atlas-based segmentation was developed to remove the high-signal intensity normal tissues on WB-DWI and to restrict the lesion area to the skeleton. Then, an outlier threshold-based segmentation was applied to WB-DWI images, and the segmented area’s signal intensity was compared to the average signal intensity of a low-fat muscle on T1-weighted images. This method was validated in 22 whole-body DWI images of patients diagnosed with MM. Dice similarity coefficient (DSC), sensitivity and positive predictive value (PPV) were computed to evaluate the SA performance against the gold standard (GS) and to compare with the radiologists. A non-parametric Wilcoxon test was also performed. Apparent diffusion coefficient (ADC) histogram metrics and lesion volume were extracted for the GS segmentation and for the correctly identified lesions by SA and their correlation was assessed. Results The mean inter-radiologists DSC was 0.323 ± 0.268. The SA vs GS achieved a DSC of 0.274 ± 0.227, sensitivity of 0.764 ± 0.276 and PPV 0.217 ± 0.207. Its distribution was not significantly different from the mean DSC of inter-radiologist segmentation (p = 0.108, Wilcoxon test). ADC and lesion volume intraclass correlation coefficient (ICC) of the GS and of the correctly identified lesions by the SA was 0.996 for the median and 0.894 for the lesion volume (p < 0.001). The duration of the lesion volume segmentation by the SA was, on average, 10.22 ± 0.86 min, per patient. Conclusions The SA provides equally reproducible segmentation results when compared to the manual segmentation of radiologists. Thus, the proposed method offers robust and efficient segmentation of MM lesions on WB-DWI. This method may aid accurate assessment of tumor burden and therefore provide insights to treatment response assessment.
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Affiliation(s)
- Sílvia D Almeida
- Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Av. Brasília, Doca de Pedrouços, 1400-038, Lisbon, Portugal
| | - João Santinha
- Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Av. Brasília, Doca de Pedrouços, 1400-038, Lisbon, Portugal
| | - Francisco P M Oliveira
- Radiopharmacology, Champalimaud Centre for the Unknown, Av. Brasília, 1400-038, Lisbon, Portugal
| | - Joana Ip
- Radiology Department, Champalimaud Centre for the Unknown, Av. Brasília, 1400-038, Lisbon, Portugal
| | - Maria Lisitskaya
- Radiology Department, Champalimaud Centre for the Unknown, Av. Brasília, 1400-038, Lisbon, Portugal
| | - João Lourenço
- Radiology Department, Champalimaud Centre for the Unknown, Av. Brasília, 1400-038, Lisbon, Portugal
| | - Aycan Uysal
- Radiology Department, Champalimaud Centre for the Unknown, Av. Brasília, 1400-038, Lisbon, Portugal
| | - Celso Matos
- Radiology Department, Champalimaud Centre for the Unknown, Av. Brasília, 1400-038, Lisbon, Portugal
| | - Cristina João
- Hematology Department, Champalimaud Centre for the Unknown, Av. Brasília, 1400-038, Lisbon, Portugal.,Immunology Department, Nova Medical School, Nova University of Lisbon, 1169-056, Lisbon, Portugal
| | - Nikolaos Papanikolaou
- Computational Clinical Imaging Group, Champalimaud Foundation, Centre for the Unknown, Av. Brasília, Doca de Pedrouços, 1400-038, Lisbon, Portugal.
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Pelosi G, Sabella G, Cannone M, Balladore E, Papanikolaou N, Incarbone M, Zompatori M, Harari S, Bedini AV. Parietal Pleura-Based Malignant Perivascular Epithelioid Cell Neoplasm Protruding Into Serous Cavity: A Hitherto Unrecognized Occurrence. J Thorac Oncol 2019; 15:462-466. [PMID: 31812753 DOI: 10.1016/j.jtho.2019.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 09/20/2019] [Accepted: 11/22/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Giuseppe Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Interhospital Pathology Division, IRCCS MultiMedica, Milan, Italy.
| | - Giovanna Sabella
- Interhospital Pathology Division, IRCCS MultiMedica, Milan, Italy
| | - Maria Cannone
- Interhospital Pathology Division, IRCCS MultiMedica, Milan, Italy
| | | | | | | | - Maurizio Zompatori
- Department of Radiology, San Giuseppe Hospital, IRCCS MultiMedica, Milan, Italy
| | - Sergio Harari
- Department of Medical Sciences and Division of Pneumology, San Giuseppe Hospital, IRCCS MultiMedica, Milan, Italy
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Pelosi G, Nesa F, Taietti D, Servillo SP, Papanikolaou N, Zompatori M, Meroni A, Harari S, Incarbone M. Spread of hyperplastic pulmonary neuroendocrine cells into air spaces (S.H.I.P.M.E.N.T.S): A proof for artifact. Lung Cancer 2019; 137:43-47. [DOI: 10.1016/j.lungcan.2019.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 08/31/2019] [Accepted: 09/11/2019] [Indexed: 11/15/2022]
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Harari S, Cereda F, Pane F, Cavazza A, Papanikolaou N, Pelosi G, Scarioni M, Uslenghi E, Zompatori M, Caminati A. Lung Cryobiopsy for the Diagnosis of Interstitial Lung Diseases: A Series Contribution to a Debated Procedure. ACTA ACUST UNITED AC 2019; 55:medicina55090606. [PMID: 31546869 PMCID: PMC6780159 DOI: 10.3390/medicina55090606] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/12/2019] [Accepted: 09/16/2019] [Indexed: 12/31/2022]
Abstract
Introduction: Transbronchial cryobiopsy is an alternative to surgical biopsy for the diagnosis of fibrosing interstitial lung diseases, although the role of this relatively new method is rather controversial. Aim of this study is to evaluate the diagnostic performance and the safety of transbronchial cryobiopsy in patients with fibrosing interstitial lung disease. Materials and methods: The population in this study included patients with interstitial lung diseases who underwent cryobiopsy from May 2015 to May 2018 at the Division of Pneumology of San Giuseppe Hospital in Milan and who were retrospectively studied. All cryobiopsy procedures were performed under fluoroscopic guidance using a flexible video bronchoscope and an endobronchial blocking system in the operating room with patients under general anaesthesia. The diagnostic performance and safety of the procedure were assessed. The main complications evaluated were endobronchial bleeding and pneumothorax. All cases were studied with a multidisciplinary approach, before and after cryobiopsy. Results: Seventy-three patients were admitted to this study. A specific diagnosis was reached in 64 cases, with a diagnostic sensitivity of 88%; 5 cases (7%) were considered inadequate, 4 cases (5%) were found to be non-diagnostic. Only one major bleeding event occurred (1.4%), while 14 patients (19%) experienced mild/moderate bleeding events while undergoing bronchoscopy; 8 cases of pneumothorax (10.9%) were reported, of which 2 (2.7%) required surgical drainage. Conclusions: When performed under safe conditions and in an experienced center, cryobiopsy is a procedure with limited complications having a high diagnostic yield in fibrotic interstitial lung disease.
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Affiliation(s)
- Sergio Harari
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe-MultiMedica IRCCS, via San Vittore 12, 20123 Milan, Italy.
- U.O. di Medicina Generale, Ospedale San Giuseppe-MultiMedica IRCCS, Via San Vittore, 12, 20123 Milan, Italy.
| | - Francesca Cereda
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe-MultiMedica IRCCS, via San Vittore 12, 20123 Milan, Italy.
| | - Federico Pane
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe-MultiMedica IRCCS, via San Vittore 12, 20123 Milan, Italy.
| | - Alberto Cavazza
- U.O. di Anatomia Patologica Azienda USL/IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
| | - Nikolaos Papanikolaou
- Servizio Interaziendale di Anatomia Patologica, Polo Scientifico e Tecnologico, IRCCS MultiMedica, Via Gaudenzio Fantoli 16/15, 20138 Milan, Italy.
| | - Giuseppe Pelosi
- Servizio Interaziendale di Anatomia Patologica, Polo Scientifico e Tecnologico, IRCCS MultiMedica, Via Gaudenzio Fantoli 16/15, 20138 Milan, Italy.
- Dipartimento di Oncologia ed Onco-ematologia, Università degli Studi di Milano, 20122 Milan, Italy.
| | - Monica Scarioni
- U.O. di Anestesia e Rianimazione, Ospedale San Giuseppe-MultiMedica IRCCS, Via San Vittore, 12, 20123 Milan, Italy.
| | - Elisabetta Uslenghi
- Dipartimento di Diagnostica per Immagini e U.O. di Radiologia MultiMedica IRCCS, 20123 Milan, Italy.
| | - Maurizio Zompatori
- Dipartimento di Diagnostica per Immagini e U.O. di Radiologia MultiMedica IRCCS, 20123 Milan, Italy.
- Dipartimento Universitario DIMES, Università di Bologna, 40126 Bologna, Italy.
| | - Antonella Caminati
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe-MultiMedica IRCCS, via San Vittore 12, 20123 Milan, Italy.
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Obeidat M, McConnell K, Bui B, Stathakis S, Rasmussen K, Papanikolaou N, Shim EY, Kirby N. Optimizing the response, precision, and cost of a DNA double-strand break dosimeter. Phys Med Biol 2019; 64:10NT02. [PMID: 31026853 DOI: 10.1088/1361-6560/ab1ce8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We developed a dosimeter that measures biological damage following delivery of therapeutic beams in the form of double-strand breaks (DSBs) to DNA. The dosimeter contains DNA strands that are labeled on one end with biotin and on the other with fluorescein and attached to magnetic microbeads. Following irradiation, a magnet is used to separate broken from unbroken DNA strands. Then, fluorescence is utilized to measure the relative amount of broken DNA and determine the probability for DSB. The long-term goal for this research is to evaluate whether this type of biologically based dosimeter holds any advantages over the conventional techniques. The purpose of this work was to optimize the dosimeter fabrication and usage to enable higher precision for the long-term research goal. More specifically, the goal was to optimize the DNA dosimeter using three metrics: the response, precision, and cost per dosimeter. Six aspects of the dosimeter fabrication and usage were varied and evaluated for their effect on the metrics: (1) the type of magnetic microbeads, (2) the microbead to DNA mass ratio at attachment, (3) the type of suspension buffer used during irradiation, (4) the concentration of the DNA dosimeter during irradiation, (5) the time waited between fabrication and irradiation of the dosimeter, and (6) the time waited between irradiation and read out of the response. In brief, the best results were achieved with the dosimeter when attaching 4.2 µg of DNA with 1 mg of MyOne T1 microbeads and by suspending the microbead-connected DNA strands with 200 µl of phosphate-buffered saline for irradiation. Also, better results were achieved when waiting a day after fabrication before irradiating the dosimeter and also waiting an hour after irradiation to measure the response. This manuscript is meant to serve as guide for others who would like to replicate this DNA dose measurement technique.
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Affiliation(s)
- M Obeidat
- Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, United States of America
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Makris DN, Pappas EP, Zoros E, Papanikolaou N, Saenz DL, Kalaitzakis G, Zourari K, Efstathopoulos E, Maris TG, Pappas E. Characterization of a novel 3D printed patient specific phantom for quality assurance in cranial stereotactic radiosurgery applications. Phys Med Biol 2019; 64:105009. [PMID: 30965289 DOI: 10.1088/1361-6560/ab1758] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In single-isocenter stereotactic radiosurgery/radiotherapy (SRS/SRT) intracranial applications, multiple targets are being treated concurrently, often involving non-coplanar arcs, small photon beams and steep dose gradients. In search for more rigorous quality assurance protocols, this work presents and evaluates a novel methodology for patient-specific pre-treatment plan verification, utilizing 3D printing technology. In a patient's planning CT scan, the external contour and bone structures were segmented and 3D-printed using high-density bone-mimicking material. The resulting head phantom was filled with water while a film dosimetry insert was incorporated. Patient and phantom CT image series were fused and inspected for anatomical coherence. HUs and corresponding densities were compared in several anatomical regions within the head. Furthermore, the level of patient-to-phantom dosimetric equivalence was evaluated both computationally and experimentally. A single-isocenter multi-focal SRS treatment plan was prepared, while dose distributions were calculated on both CT image series, using identical calculation parameters. Phantom- and patient-derived dose distributions were compared in terms of isolines, DVHs, dose-volume metrics and 3D gamma index (GI) analysis. The phantom was treated as if the real patient and film measurements were compared against the patient-derived calculated dose distribution. Visual inspection of the fused CT images suggests excellent geometric similarity between phantom and patient, also confirmed using similarity indices. HUs and densities agreed within one standard deviation except for the skin (modeled as 'bone') and sinuses (water-filled). GI comparison between the calculated distributions resulted in passing rates better than 97% (1%/1 mm). DVHs and dose-volume metrics were also in satisfying agreement. In addition to serving as a feasibility proof-of-concept, experimental absolute film dosimetry verified the computational study results. GI passing rates were above 90%. Results of this work suggest that employing the presented methodology, patient-equivalent phantoms (except for the skin and sinuses areas) can be produced, enabling literally patient-specific pre-treatment plan verification in intracranial applications.
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Affiliation(s)
- D N Makris
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
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Ginieri-Coccossis M, Triantafillou E, Papanikolaou N, Baker R, Antoniou C, Skevington SM, Christodoulou GN. Quality of life and depression in chronic sexually transmitted infections in UK and Greece: The use of WHOQOL-HIV/STI BREF. Psychiatriki 2019; 29:209-219. [PMID: 30605425 DOI: 10.22365/jpsych.2018.293.209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This is a comparative study aiming to investigate quality of life (QoL) and depression in individuals diagnosed either with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), or genital warts (GW) and genital herpes (GH), in two healthcare settings, in the United Kingdom (UK) or in Greece (Gr). Using a matched-pairs design, two equalized patient samples with sexually transmitted infections (STI) were recruited: from UK (n=43) and from Greece (n=43). QoL was assessed with WHOQOL-HIV BREF for HIV patients and WHOQOL-STI BREF -a newly adapted instrument- for genital warts and genital herpes patients. Depressive symptomatology was measured by the Centre for Epidemiological Studies- Depression Scale (CES-D) along with sociodemographic data. Results indicate that in both country- healthcare settings, a high percentage of individuals diagnosed with any type of STI, reported considerable depressive symptomatology: 35.7% for UK and 41.5% for Greek participants respectively. Regarding QoL, participants in the Greek healthcare settings reported significantly lower scores in the environment domain, and even lower scores were reported by the GW/GH group, in comparison to HIV. Specifically, these groups indicated significantly lower values in the following WHOQOL-BREF environment facets: (i) physical safety and security, (ii) participation in and opportunities for recreation/leisure activities, (iii) home environment, (iv) accessibility and quality in health and social care, and (v) transport facilities. Regarding correlation of QoL and depression, regression analysis provided significant evidence for depression having a differential effect on WHOQOL-BREF QoL domains. Evidence of increased depressive symptomatology in both STI patient- cohorts may shed light into unmet healthcare needs that should be addressed by healthcare providers in UK and Greece respectively. Furthermore, all types of Greek STI participants reported lower QoL, particularly the GW/GH group, indicating important unmet QoL needs in the environment domain, such as health and social care accessibility and quality, or environmental and social resources, all lowering everyday QoL. The present findings may provide guidelines for tailored mental health interventions alleviating depressive symptomatology in STI patients. Provision of targeted-interventions at healthcare and social-environmental levels will contribute to QoL/ health improvement in STI patients.
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Affiliation(s)
- M Ginieri-Coccossis
- 1st Department of Psychiatry, University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - E Triantafillou
- 1st Department of Psychiatry, University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - N Papanikolaou
- 1st Department of Psychiatry, University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - R Baker
- Department of Medicine and Social Care Education, Leicester Medical School, UK
| | - C Antoniou
- 1st Dermatologic Clinic, Medical School, University of Athens, Hospital "A. Syggrou", Athens, Greece
| | - S M Skevington
- Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, UK
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Tsakogiannis A, Manousaki T, Lagnel J, Papanikolaou N, Papandroulakis N, Mylonas CC, Tsigenopoulos CS. The Gene Toolkit Implicated in Functional Sex in Sparidae Hermaphrodites: Inferences From Comparative Transcriptomics. Front Genet 2019; 9:749. [PMID: 30713551 PMCID: PMC6345689 DOI: 10.3389/fgene.2018.00749] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/31/2018] [Indexed: 12/24/2022] Open
Abstract
Sex-biased gene expression is the mode through which sex dimorphism arises from a nearly identical genome, especially in organisms without genetic sex determination. Teleost fishes show great variations in the way the sex phenotype forms. Among them, Sparidae, that might be considered as a model family displays a remarkable diversity of reproductive modes. In this study, we sequenced and analyzed the sex-biased transcriptome in gonads and brain (the tissues with the most profound role in sexual development and reproduction) of two sparids with different reproductive modes: the gonochoristic common dentex, Dentex dentex, and the protandrous hermaphrodite gilthead seabream, Sparus aurata. Through comparative analysis with other protogynous and rudimentary protandrous sparid transcriptomes already available, we put forward common male and female-specific genes and pathways that are probably implicated in sex-maintenance in this fish family. Our results contribute to the understanding of the complex processes behind the establishment of the functional sex, especially in hermaphrodite species and set the groundwork for future experiments by providing a gene toolkit that can improve efforts to control phenotypic sex in finfish in the ever-increasingly important field of aquaculture.
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Affiliation(s)
- Alexandros Tsakogiannis
- Hellenic Centre for Marine Research, Institute of Marine Biology, Biotechnology and Aquaculture, Heraklion, Greece
- Department of Biology, University of Crete, Heraklion, Greece
| | - Tereza Manousaki
- Hellenic Centre for Marine Research, Institute of Marine Biology, Biotechnology and Aquaculture, Heraklion, Greece
| | - Jacques Lagnel
- Hellenic Centre for Marine Research, Institute of Marine Biology, Biotechnology and Aquaculture, Heraklion, Greece
| | | | - Nikos Papandroulakis
- Hellenic Centre for Marine Research, Institute of Marine Biology, Biotechnology and Aquaculture, Heraklion, Greece
| | - Constantinos C. Mylonas
- Hellenic Centre for Marine Research, Institute of Marine Biology, Biotechnology and Aquaculture, Heraklion, Greece
| | - Costas S. Tsigenopoulos
- Hellenic Centre for Marine Research, Institute of Marine Biology, Biotechnology and Aquaculture, Heraklion, Greece
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Galvan E, Parenica H, Saenz D, Shi Z, Ha C, Rasmussen K, Kirby N, Papanikolaou N, Stathakis S. Retrospective Assessment of the Plan of the Day Approach in the Management of Prostate Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brito Delgado A, Rasmussen K, Shi Z, Pesqueira TM, Kauweloa K, Cohen D, Eng T, Kirby N, Saenz D, Stathakis S, Papanikolaou N, Gutierrez A. The Analytical Hierarchy Process (AHP) to Score Plan Quality of Intact Prostate Treatment Plans. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Saenz D, Rasmussen K, Pappas E, Kirby N, Stathakis S, Shi Z, Papanikolaou N. QA for SBRT of Spine Lesions: Introducing a Novel 3D Gel Dosimeter for Spatial and Dosimetric End-to-End Testing. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pelosi G, Papotti M, Righi L, Rossi G, Ferrero S, Bosari S, Calabrese F, Kern I, Maisonneuve P, Sonzogni A, Albini A, Harari S, Barbieri F, Capelletto E, Catino AM, Cavone D, De Palma A, Fusco N, Lunardi F, Maiorano E, Marzullo A, Novello S, Papanikolaou N, Pasello G, Pennella A, Pezzuto F, Punzi A, Prisciandaro E, Rea F, Rosso L, Scattone A, Serio G. Pathologic Grading of Malignant Pleural Mesothelioma: An Evidence-Based Proposal. J Thorac Oncol 2018; 13:1750-1761. [PMID: 30249391 DOI: 10.1016/j.jtho.2018.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 06/23/2018] [Accepted: 07/02/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION A pathologic grading system (PGS) for malignant pleural mesothelioma (MPM) is warranted to better identify different risk categories of patients, plan therapeutic options, and activate clinical trials. METHODS A series of 940 patients with MPM (328 in a training set and 612 in a validation set) that was diagnosed between October 1980 and June 2015 at the participant institutions was retrospectively assembled. A PGS was constructed by attributing to each histologic parameter, independent at multivariate analysis with excellent reproducibility (κ > 0.75), different scores based on the increase in corresponding hazard ratios. The relevant PGS score thus ranged from 0 to 8 points for individual patients with MPM. CONCLUSIONS The PGS was constructed by taking into consideration the histological subtyping of MPM (epithelioid/biphasic = 0 points; sarcomatoid = 2 points), necrosis (absent = 0 points versus present = 1 point), mitotic count per 1 mm2 (cutoffs as follows: 1-2 = 0 points, 3-5 = 1 point, 6-9 = 2 points, or ≥10 = 4 points), and Ki-67 labeling index based on 2000 cells (<30% = 0 points versus ≥30 = 1 point), all of which are independent factors in both patient sets after adjustment for stage and age at diagnosis. No heterogeneity was seen across the validation centers (p = 0.19). Epithelioid/biphasic MPM patterning and biopsy versus resection did not affect survival, whereas the PGS outperformed mitotic count and Ki-67 LI in both the training (area under the curve receiver operating characteristic = 0.76) and validation sets (area under the curve receiver operating characteristic = 0.73) (p < 0.01). Patient survival progressively deteriorated from a score of 0 (median times of 26.3 and 26.9 months) to a score 1 to 3 (median times of 12.8 and 14.4 months) and a score of 4 to 8 (median times of 3.7 and 7.7 months) in both sets of patients, with the hazard ratio for a 1-point increase in score being 1.46 (95% confidence interval: 1.36-1.56) in the training set and 1.28 (95% confidence interval: 1.22-1.34) in the validation set (after adjustment for age and [when available] tumor stage). The PGS was effective even in subgroup analysis (epithelioid, biphasic, and sarcomatoid tumors). DISCUSSION A simple and reproducible multiparametric PGS effectively predicted survival in patients with MPM.
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Affiliation(s)
- Giuseppe Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Inter-Hospital Pathology Division, Science and Technology Park, Institute for Research and Treatment Multimedica - IRCCS, Milan, Italy.
| | - Mauro Papotti
- Department of Oncology, University of Turin, and Pathology Unit Molinette Hospital, City of Health and Science, Turin, Italy
| | - Luisella Righi
- Department of Oncology, University of Turin, and Pathology Unit San Luigi Hospital, Orbassano, Turin, Italy
| | - Giulio Rossi
- Division of Anatomic Pathology, Regional Hospital Umberto Parini, Aosta, Italy
| | - Stefano Ferrero
- Division of Anatomic Pathology, Foundation for Research and Treatment - IRCCS Ca' Granda Major Hospital Polyclinic, Milan, and, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Silvano Bosari
- Division of Anatomic Pathology, Foundation for Research and Treatment - IRCCS Ca' Granda Major Hospital Polyclinic, Milan, and Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Fiorella Calabrese
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Izidor Kern
- Department of Cytology and Pathology, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology - IRCCS, Milan, Italy
| | - Angelica Sonzogni
- Department of Pathology and Laboratory Medicine, Foundation for Research and Treatment- IRCCS National Cancer Institute, Milan, Italy
| | - Adriana Albini
- Laboratory of Vascular Biology and Angiogenesis, Science and Technology Park, Institute for Research and Treatment (IRCCS) MultiMedica, Milan, Italy, and Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Sergio Harari
- Department of Medical Sciences and Division of Pneumology, San Giuseppe Hospital, Institute for Research and Treatment - IRCCS MultiMedica, Milan, Italy
| | - Fausto Barbieri
- Oncology Unit, University Hospital Azienda Policlinico of Modena, Modena, Italy
| | - Enrica Capelletto
- Department of Oncology, University of Turin, Thoracic Oncology Unit San Luigi Hospital, Orbassano, Turin, Italy
| | - Anna Maria Catino
- Medical Thoracic Oncology, Cancer Institute "Giovanni Paolo II", Bari, Italy
| | - Domenica Cavone
- National Mesothelioma Registry-Apulia Region, Regional Operational Center Cor Apulia, Occupational Health Division Bernardino Ramazzini, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Angela De Palma
- Section of Thoracic Surgery, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
| | - Nicola Fusco
- Division of Anatomic Pathology, Foundation for Research and Treatment - IRCCS Ca' Granda Major Hospital Polyclinic, Milan, and, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Francesca Lunardi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Eugenio Maiorano
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
| | - Andrea Marzullo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, Thoracic Oncology Unit San Luigi Hospital, Orbassano, Turin, Italy
| | - Nikolaos Papanikolaou
- Inter-Hospital Pathology Division, Science and Technology Park, Institute for Research and Treatment Multimedica - IRCCS, Milan, Italy
| | - Giulia Pasello
- Medical Oncology 2, Department of Medical and Experimental Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Antonio Pennella
- Department of Surgery and Pathology, University of Foggia Medical School, Foggia, Italy
| | - Federica Pezzuto
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Alessandra Punzi
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
| | - Elena Prisciandaro
- Section of Thoracic Surgery, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
| | - Federico Rea
- Thoracic Surgery Unit, Department of Cardiothoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Lorenzo Rosso
- Division of Thoracic Surgery, Foundation for Research and Treatment - IRCCS Ca' Granda Major Hospital Polyclinic, Milan and Department of Health Sciences, University of Milan, Milan, Italy
| | - Anna Scattone
- Section of Pathology, Cancer Institute "Giovanni Paolo II," Bari, Italy
| | - Gabriella Serio
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari Aldo Moro, Bari, Italy
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Manikis GC, Marias K, Lambregts DMJ, Nikiforaki K, van Heeswijk MM, Bakers FCH, Beets-Tan RGH, Papanikolaou N. Correction: Diffusion weighted imaging in patients with rectal cancer: Comparison between Gaussian and non-Gaussian models. PLoS One 2018; 13:e0196262. [PMID: 29664935 PMCID: PMC5903604 DOI: 10.1371/journal.pone.0196262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0184197.].
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Tuazon B, Narayanasamy G, Papanikolaou N, Kirby N, Mavroidis P, Stathakis S. Evaluation and comparison of second-check monitor unit calculation software with Pinnacle 3 treatment planning system. Phys Med 2018; 45:186-191. [PMID: 29472085 DOI: 10.1016/j.ejmp.2017.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to evaluate and compare the accuracy of dose calculations in second check softwares (Diamond, IMSure, MuCheck, and RadCalc) against the Phillips Pinnacle3 treatment planning system. Eighteen previously treated patients' treatment planning files consisting of a total of 204 beams were exported from the Pinnacle3 TPS to each of the four second check software. Of these beams, 145 of the beams used were IMRT plans while 59 were VMAT arcs. The values were represented as a percent difference between primary and secondary calculations and used for statistical analysis. Box plots, Pearson Correlation, and Bland-Altman analysis were performed in MedCalc. The mean percent difference in calculated dose for Diamond, IMSure, MuCheck, and RadCalc from Pinnacle3 were -0.67%, 0.31%, 1.51% and -0.36%, respectively. The corresponding variances were calculated to be 0.07%, 0.13%, 0.08%, and 0.03%; and the largest percent differences were -7.9%, 9.70%, 9.39%, and 5.45%. The dose differences of each of the second check software in this study can vary considerably and VMAT plans have larger differences than IMRT. Among the four second check softwares, RadCalc values has shown a high agreement on average with low variation, and had the smallest percent range from Pinnacle3 values. The closest in average percent difference from the Pinnacle3data was the IMSure software, but suffered from significantly larger variance and percent range. The values reported by Diamond and MuCheck had significantly high percent differences with TPS values.
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Affiliation(s)
- B Tuazon
- Department of Radiology, University of Texas Health San Antonio, San Antonio 78229, USA; Cancer Therapy and Research Center, 7979 Wurzbach Rd, 78229 San Antonio, USA
| | - G Narayanasamy
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - N Papanikolaou
- Department of Radiology, University of Texas Health San Antonio, San Antonio 78229, USA; Cancer Therapy and Research Center, 7979 Wurzbach Rd, 78229 San Antonio, USA
| | - N Kirby
- Department of Radiology, University of Texas Health San Antonio, San Antonio 78229, USA; Cancer Therapy and Research Center, 7979 Wurzbach Rd, 78229 San Antonio, USA
| | - P Mavroidis
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC 27514, USA
| | - S Stathakis
- Department of Radiology, University of Texas Health San Antonio, San Antonio 78229, USA; Cancer Therapy and Research Center, 7979 Wurzbach Rd, 78229 San Antonio, USA.
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Pelosi G, Papanikolaou N. Book Review—Diagnostic pathology: thoracic, 2nd edition. Virchows Arch 2017. [DOI: 10.1007/s00428-017-2266-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pelosi G, Sonzogni A, Harari S, Albini A, Bresaola E, Marchiò C, Massa F, Righi L, Gatti G, Papanikolaou N, Vijayvergia N, Calabrese F, Papotti M. Classification of pulmonary neuroendocrine tumors: new insights. Transl Lung Cancer Res 2017; 6:513-529. [PMID: 29114468 PMCID: PMC5653522 DOI: 10.21037/tlcr.2017.09.04] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/12/2017] [Indexed: 12/11/2022]
Abstract
Neuroendocrine tumors of the lung (Lu-NETs) embrace a heterogeneous family of neoplasms classified into four histological variants, namely typical carcinoid (TC), atypical carcinoid (AC), large cell neuroendocrine carcinoma (LCNEC) and small cell lung carcinoma (SCLC). Defining criteria on resection specimens include mitotic count in 2 mm2 and the presence or absence of necrosis, alongside a constellation of cytological and histological traits including cell size and shape, nuclear features and overall architecture. Clinically, TC are low-grade malignant tumors, AC intermediate-grade malignant tumors and SCLC/LCNEC high-grade malignant full-blown carcinomas with no significant differences in survival between them. Homologous tumors arise in the thymus that occasionally have some difficulties in differentiating from the lung counterparts when presented with large unresectable or metastatic lesions. Immunohistochemistry (IHC) helps refine NE diagnosis at various anatomical sites, particularly on small-sized tissue material, in which only TC and small cell carcinoma categories can be recognized easily on hematoxylin & eosin stain, while AC and LCNEC can only be suggested on such material. The Ki-67 labeling index effectively separates carcinoids from small cell carcinoma and may prove useful for the clinical management of a metastatic disease to help the therapeutic decision-making process. Although carcinoids and high-grade neuroendocrine carcinomas in the lung and elsewhere make up separate tumor categories on molecular grounds, emerging data supports the concept of secondary high-grade NETs arising in the preexisting carcinoids, whose clinical and biological relevance will have to be placed into the proper context for the optimal management of these patients. In this review, we will discuss the selected, recent literature with a focus on current issues regarding Lu-NET nosology, i.e., classification, derivation and tumor evolution.
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Affiliation(s)
- Giuseppe Pelosi
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Inter-hospital Pathology Division, Science & Technology Park, IRCCS MultiMedica Group, Milan, Italy
| | - Angelica Sonzogni
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Sergio Harari
- Department of Medical Sciences and Division of Pneumology, San Giuseppe Hospital, Science & Technology Park, IRCCS MultiMedica Group, Milan, Italy
| | - Adriana Albini
- Laboratory of Vascular Biology and Angiogenesis, Science & Technology Park, IRCCS MultiMedica Group, Milan, Italy
| | - Enrica Bresaola
- Department of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy
| | - Caterina Marchiò
- Department of Medical Sciences, University of Turin, and Pathology Division, AOU Città della Salute e della Scienza, Turin, Italy
| | - Federica Massa
- Department of Oncology, University of Turin, and Pathology Division, AOU Città della Salute e della Scienza, Turin, Italy
| | - Luisella Righi
- Department of Oncology, University of Turin, Pathology Division, San Luigi Hospital, University of Turin, Turin, Italy
| | - Gaia Gatti
- Department of Oncology, University of Turin, Pathology Division, San Luigi Hospital, University of Turin, Turin, Italy
| | - Nikolaos Papanikolaou
- Inter-hospital Pathology Division, Science & Technology Park, IRCCS MultiMedica Group, Milan, Italy
| | - Namrata Vijayvergia
- Department of Hematology and Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Fiorella Calabrese
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, and Pathology Division, AOU Città della Salute e della Scienza, Turin, Italy
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Manikis GC, Marias K, Lambregts DMJ, Nikiforaki K, van Heeswijk MM, Bakers FCH, Beets-Tan RGH, Papanikolaou N. Diffusion weighted imaging in patients with rectal cancer: Comparison between Gaussian and non-Gaussian models. PLoS One 2017; 12:e0184197. [PMID: 28863161 PMCID: PMC5593499 DOI: 10.1371/journal.pone.0184197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/15/2017] [Indexed: 01/22/2023] Open
Abstract
Purpose The purpose of this study was to compare the performance of four diffusion models, including mono and bi-exponential both Gaussian and non-Gaussian models, in diffusion weighted imaging of rectal cancer. Material and methods Nineteen patients with rectal adenocarcinoma underwent MRI examination of the rectum before chemoradiation therapy including a 7 b-value diffusion sequence (0, 25, 50, 100, 500, 1000 and 2000 s/mm2) at a 1.5T scanner. Four different diffusion models including mono- and bi-exponential Gaussian (MG and BG) and non-Gaussian (MNG and BNG) were applied on whole tumor volumes of interest. Two different statistical criteria were recruited to assess their fitting performance, including the adjusted-R2 and Root Mean Square Error (RMSE). To decide which model better characterizes rectal cancer, model selection was relied on Akaike Information Criteria (AIC) and F-ratio. Results All candidate models achieved a good fitting performance with the two most complex models, the BG and the BNG, exhibiting the best fitting performance. However, both criteria for model selection indicated that the MG model performed better than any other model. In particular, using AIC Weights and F-ratio, the pixel-based analysis demonstrated that tumor areas better described by the simplest MG model in an average area of 53% and 33%, respectively. Non-Gaussian behavior was illustrated in an average area of 37% according to the F-ratio, and 7% using AIC Weights. However, the distributions of the pixels best fitted by each of the four models suggest that MG failed to perform better than any other model in all patients, and the overall tumor area. Conclusion No single diffusion model evaluated herein could accurately describe rectal tumours. These findings probably can be explained on the basis of increased tumour heterogeneity, where areas with high vascularity could be fitted better with bi-exponential models, and areas with necrosis would mostly follow mono-exponential behavior.
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Affiliation(s)
- Georgios C. Manikis
- Foundation for Research and Technology - Hellas (FORTH), Institute of Computer Science, Computational Biomedicine Lab, Heraklion, Greece
| | - Kostas Marias
- Foundation for Research and Technology - Hellas (FORTH), Institute of Computer Science, Computational Biomedicine Lab, Heraklion, Greece
| | | | - Katerina Nikiforaki
- Foundation for Research and Technology - Hellas (FORTH), Institute of Computer Science, Computational Biomedicine Lab, Heraklion, Greece
| | - Miriam M. van Heeswijk
- Department of Radiology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
- GROW School for Oncology and Developmental Biology – Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Radiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Frans C. H. Bakers
- GROW School for Oncology and Developmental Biology – Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Regina G. H. Beets-Tan
- Department of Radiology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
- GROW School for Oncology and Developmental Biology – Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Nikolaos Papanikolaou
- Clinical Computational Imaging Group, Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
- * E-mail: ,
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Kokkinos V, Kallifatidis A, Kapsalaki EZ, Papanikolaou N, Garganis K. Thin isotropic FLAIR MR images at 1.5T increase the yield of focal cortical dysplasia transmantle sign detection in frontal lobe epilepsy. Epilepsy Res 2017; 132:1-7. [DOI: 10.1016/j.eplepsyres.2017.02.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/20/2017] [Accepted: 02/27/2017] [Indexed: 10/20/2022]
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Komisopoulos G, Buckey C, Stathakis S, Mavroeidi M, Swanson G, Baltas D, Papanikolaou N, Mavroidis P. EP-1559: Optimizing the risks for deterministic effects and secondary malignancies in bladder and rectum. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31994-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dijkhoff RAP, Maas M, Martens MH, Papanikolaou N, Lambregts DMJ, Beets GL, Beets-Tan RGH. Correlation between quantitative and semiquantitative parameters in DCE-MRI with a blood pool agent in rectal cancer: can semiquantitative parameters be used as a surrogate for quantitative parameters? Abdom Radiol (NY) 2017; 42:1342-1349. [PMID: 28050622 DOI: 10.1007/s00261-016-1024-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE The aim of this study was to assess correlation between quantitative and semiquantitative parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in rectal cancer patients, both in a primary staging and restaging setting. MATERIALS AND METHODS Nineteen patients were included with DCE-MRI before and/or after neoadjuvant therapy. DCE-MRI was performed with gadofosveset trisodium (Ablavar®, Lantheus Medical Imaging, North Billerica, Massachusetts, USA). Regions of interest were placed in the tumor and quantitative parameters were extracted with Olea Sphere 2.2 software permeability module using the extended Tofts model. Semiquantitative parameters were calculated on a pixel-by-pixel basis. Spearman rank correlation tests were used for assessment of correlation between parameters. A p value ≤0.05 was considered statistically significant. RESULTS Strong positive correlations were found between mean peak enhancement and mean K trans: 0.79 (all patients, p<0.0001), 0.83 (primary staging, p = 0.003), and 0.81 (restaging, p = 0.054). Mean wash-in correlated significantly with mean V p and K ep (0.79 and 0.58, respectively, p<0.0001 and p = 0.009) in all patients. Mean wash-in showed a significant correlation with mean K ep (0.67, p = 0.033) in the primary staging group. On the restaging MRI, mean wash-in only strongly correlated with mean V p (0.81, p = 0.054). CONCLUSION This study shows a strong correlation between quantitative and semiquantitative parameters in DCE-MRI for rectal cancer. Peak enhancement correlates strongly with K trans and wash-in showed strong correlation with V p and K ep. These parameters have been reported to predict tumor aggressiveness and response in rectal cancer. Therefore, semiquantitative analyses might be a surrogate for quantitative analyses.
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Affiliation(s)
- Rebecca A P Dijkhoff
- Department of Radiology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Monique Maas
- Department of Radiology, The Netherlands Cancer Institute, P.O. Box 90203, 1066 CX, Amsterdam, The Netherlands.
| | - Milou H Martens
- Department of Surgery, Zuyderland Medical Centre, P.O. Box 5500, 6130 MB, Sittard, The Netherlands
| | - Nikolaos Papanikolaou
- Division for Medical Imaging and Technology, Institute for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Doenja M J Lambregts
- Department of Radiology, The Netherlands Cancer Institute, P.O. Box 90203, 1066 CX, Amsterdam, The Netherlands
| | - Geerard L Beets
- Department of Surgery, The Netherlands Cancer Institute, P.O. Box 90203, 1066 CX, Amsterdam, The Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, The Netherlands Cancer Institute, P.O. Box 90203, 1066 CX, Amsterdam, The Netherlands
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Pappas E, Kantemiris I, Boursianis T, Landry G, Dedes G, Maris T, Lahanas V, Hillbrand M, Parodi K, Papanikolaou N. OC-0454: End-to-end QA methodology for proton range verification based on 3D-polymer gel MRI dosimetry. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30896-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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