An evaluation of machine learning techniques to predict the outcome of children treated for Hodgkin-Lymphoma on the AHOD0031 trial: A report from the Children's Oncology Group

In this manuscript we analyze a data set containing information on children with Hodgkin Lymphoma (HL) enrolled on a clinical trial. Treatments received and survival status were collected together with other covariates such as demographics and clinical measurements. Our main task is to explore the potential of machine learning (ML) algorithms in a survival analysis context in order to improve over the Cox Proportional Hazard (CoxPH) model. We discuss the weaknesses of the CoxPH model we would like to improve upon and then we introduce multiple algorithms, from well-established ones to state-of-the-art models, that solve these issues. We then compare every model according to the concordance index and the brier score. Finally, we produce a series of recommendations, based on our experience, for practitioners that would like to benefit from the recent advances in artificial intelligence

Search Patterns and Absorptive Capacity: A Comparison of Low- and High-Technology Firms from Thirteen European Countries

Searching for externally available knowledge has been characterised as a vital part of the innovation process. Previous research has, however, almost exclusively focused on hightechnology environments, largely ignoring the substantial low- and medium-technology sectors of modern economies. We argue that low- and high-technology firms differ in their search patterns and that these moderate the relationship between innovation inputs and outputs. Based on a sample of 4,500 firms from 13 European countries we find that search patterns in low-technology industries focus on market knowledge while they are built around differences in technology sourcing activities for high-technology industries. --Absorptive capacity,search strategies,low-,medium- and high-technology sectors,open innovation

Incorporating Deep Learning Techniques into Outcome Modeling in Non-Small Cell Lung Cancer Patients after Radiation Therapy

Radiation therapy (radiotherapy) together with surgery, chemotherapy, and immunotherapy are common modalities in cancer treatment. In radiotherapy, patients are given high doses of ionizing radiation which is aimed at killing cancer cells and shrinking tumors. Conventional radiotherapy usually gives a standard prescription to all the patients, however, as patients are likely to have heterogeneous responses to the treatment due to multiple prognostic factors, personalization of radiotherapy treatment is desirable. Outcome models can serve as clinical decision-making support tools in the personalized treatment, helping evaluate patients’ treatment options before the treatment or during fractionated treatment. It can further provide insights into designing of new clinical protocols. In the outcome modeling, two indices including tumor control probability (TCP) and normal tissue complication probability (NTCP) are usually investigated. Current outcome models, e.g., analytical models and data-driven models, either fail to take into account complex interactions between physical and biological variables or require complicated feature selection procedures. Therefore, in our studies, deep learning (DL) techniques are incorporated into outcome modeling for prediction of local control (LC), which is TCP in our case, and radiation pneumonitis (RP), which is NTCP in our case, in non-small-cell lung cancer (NSCLC) patients after radiotherapy. These techniques can improve the prediction performance of outcomes and simplify model development procedures. Additionally, longitudinal data association, actuarial prediction, and multi-endpoints prediction are considered in our models. These were carried out in 3 consecutive studies. In the first study, a composite architecture consisting of variational auto-encoder (VAE) and multi-layer perceptron (MLP) was investigated and applied to RP prediction. The architecture enabled the simultaneous dimensionality reduction and prediction. The novel VAE-MLP joint architecture with area under receiver operative characteristics (ROC) curve (AUC) [95% CIs] 0.781 [0.737-0.808] outperformed a strategy which involves separate VAEs and classifiers (AUC 0.624 [ 0.577-0.658]). In the second study, composite architectures consisted of 1D convolutional layer/ locally-connected layer and MLP that took into account longitudinal associations were applied to predict LC. Composite architectures convolutional neural network (CNN)-MLP that can model both longitudinal and non-longitudinal data yielded an AUC 0.832 [ 0.807-0.841]. While plain MLP only yielded an AUC 0.785 [CI: 0.752-0.792] in LC control prediction. In the third study, rather than binary classification, time-to-event information was also incorporated for actuarial prediction. DL architectures ADNN-DVH which consider dosimetric information, ADNN-com which further combined biological and imaging data, and ADNN-com-joint which realized multi-endpoints prediction were investigated. Analytical models were also conducted for comparison purposes. Among all the models, ADNN-com-joint performed the best, yielding c-indexes of 0.705 [0.676-0.734] for RP2, 0.740 [0.714-0.765] for LC and an AU-FROC 0.720 [0.671-0.801] for joint prediction. The performance of proposed models was also tested on a cohort of newly-treated patients and multi-institutional RTOG0617 datasets. These studies taken together indicate that DL techniques can be utilized to improve the performance of outcome models and potentially provide guidance to physicians during decision making. Specifically, a VAE-MLP joint architectures can realize simultaneous dimensionality reduction and prediction, boosting the performance of conventional outcome models. A 1D CNN-MLP joint architecture can utilize temporal-associated variables generated during the span of radiotherapy. A DL model ADNN-com-joint can realize multi-endpoint prediction, which allows considering competing risk factors. All of those contribute to a step toward enabling outcome models as real clinical decision support tools.PHDApplied PhysicsUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/162923/1/sunan_1.pd

Medical Image Analytics (Radiomics) with Machine/Deeping Learning for Outcome Modeling in Radiation Oncology

Image-based quantitative analysis (radiomics) has gained great attention recently. Radiomics possesses promising potentials to be applied in the clinical practice of radiotherapy and to provide personalized healthcare for cancer patients. However, there are several challenges along the way that this thesis will attempt to address. Specifically, this thesis focuses on the investigation of repeatability and reproducibility of radiomics features, the development of new machine/deep learning models, and combining these for robust outcomes modeling and their applications in radiotherapy. Radiomics features suffer from robustness issues when applied to outcome modeling problems, especially in head and neck computed tomography (CT) images. These images tend to contain streak artifacts due to patients’ dental implants. To investigate the influence of artifacts for radiomics modeling performance, we firstly developed an automatic artifact detection algorithm using gradient-based hand-crafted features. Then, comparing the radiomics models trained on ‘clean’ and ‘contaminated’ datasets. The second project focused on using hand-crafted radiomics features and conventional machine learning methods for the prediction of overall response and progression-free survival for Y90 treated liver cancer patients. By identifying robust features and embedding prior knowledge in the engineered radiomics features and using bootstrapped LASSO to select robust features, we trained imaging and dose based models for the desired clinical endpoints, highlighting the complementary nature of this information in Y90 outcomes prediction. Combining hand-crafted and machine learnt features can take advantage of both expert domain knowledge and advanced data-driven approaches (e.g., deep learning). Thus, we proposed a new variational autoencoder network framework that modeled radiomics features, clinical factors, and raw CT images for the prediction of intrahepatic recurrence-free and overall survival for hepatocellular carcinoma (HCC) patients in this third project. The proposed approach was compared with widely used Cox proportional hazard model for survival analysis. Our proposed methods achieved significant improvement in terms of the prediction using the c-index metric highlighting the value of advanced modeling techniques in learning from limited and heterogeneous information in actuarial prediction of outcomes. Advances in stereotactic radiation therapy (SBRT) has led to excellent local tumor control with limited toxicities for HCC patients, but intrahepatic recurrence still remains prevalent. As an extension of the third project, we not only hope to predict the time to intrahepatic recurrence, but also the location where the tumor might recur. This will be clinically beneficial for better intervention and optimizing decision making during the process of radiotherapy treatment planning. To address this challenging task, firstly, we proposed an unsupervised registration neural network to register atlas CT to patient simulation CT and obtain the liver’s Couinaud segments for the entire patient cohort. Secondly, a new attention convolutional neural network has been applied to utilize multimodality images (CT, MR and 3D dose distribution) for the prediction of high-risk segments. The results showed much improved efficiency for obtaining segments compared with conventional registration methods and the prediction performance showed promising accuracy for anticipating the recurrence location as well. Overall, this thesis contributed new methods and techniques to improve the utilization of radiomics for personalized radiotherapy. These contributions included new algorithm for detecting artifacts, a joint model of dose with image heterogeneity, combining hand-crafted features with machine learnt features for actuarial radiomics modeling, and a novel approach for predicting location of treatment failure.PHDApplied PhysicsUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/163092/1/liswei_1.pd

Joint and individual analysis of breast cancer histologic images and genomic covariates

A key challenge in modern data analysis is understanding connections between complex and differing modalities of data. For example, two of the main approaches to the study of breast cancer are histopathology (analyzing visual characteristics of tumors) and genetics. While histopathology is the gold standard for diagnostics and there have been many recent breakthroughs in genetics, there is little overlap between these two fields. We aim to bridge this gap by developing methods based on Angle-based Joint and Individual Variation Explained (AJIVE) to directly explore similarities and differences between these two modalities. Our approach exploits Convolutional Neural Networks (CNNs) as a powerful, automatic method for image feature extraction to address some of the challenges presented by statistical analysis of histopathology image data. CNNs raise issues of interpretability that we address by developing novel methods to explore visual modes of variation captured by statistical algorithms (e.g. PCA or AJIVE) applied to CNN features. Our results provide many interpretable connections and contrasts between histopathology and genetics