Artificial Intelligence and Machine Learning in Prostate Cancer Patient Management-Current Trends and Future Perspectives

Artificial intelligence (AI) is the field of computer science that aims to build smart devices performing tasks that currently require human intelligence. Through machine learning (ML), the deep learning (DL) model is teaching computers to learn by example, something that human beings are doing naturally. AI is revolutionizing healthcare. Digital pathology is becoming highly assisted by AI to help researchers in analyzing larger data sets and providing faster and more accurate diagnoses of prostate cancer lesions. When applied to diagnostic imaging, AI has shown excellent accuracy in the detection of prostate lesions as well as in the prediction of patient outcomes in terms of survival and treatment response. The enormous quantity of data coming from the prostate tumor genome requires fast, reliable and accurate computing power provided by machine learning algorithms. Radiotherapy is an essential part of the treatment of prostate cancer and it is often difficult to predict its toxicity for the patients. Artificial intelligence could have a future potential role in predicting how a patient will react to the therapy side effects. These technologies could provide doctors with better insights on how to plan radiotherapy treatment. The extension of the capabilities of surgical robots for more autonomous tasks will allow them to use information from the surgical field, recognize issues and implement the proper actions without the need for human intervention

Automatic segmentation of regions of interest in vaginal brachytherapy

Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2023-2024. Tutor: Aida Niñerola ; Director: Adrià CasamitjanaThe postoperative endometrial carcinoma treatment often includes radiotherapy (external radiotherapy and/or vaginal brachytherapy) to prevent the reappearance of the tumour. This project aims to improve the efficiency of the vaginal brachytherapy treatment by developing an automatic segmentation algorithm capable of delineating both the clinical target volume and the organs at risk, reducing the time required by experts to exert such task. In this project, we develop an AI-based framework that uses a V-Net architecture at its core. To train and evaluate the model, we use retrospective CT images and corresponding manual delineations from patients treated in Hospital Clinic. The creation of the algorithm was achieved successfully, resulting in a completely functional creator of automatic segmentations. About its performance, the results were found satisfactory in the cases of the vagina, the rectum and the bladder, having acceptable discrepancies in the dosimetry output. On the other hand, the bowel and the sigma models would require further improvements since the segmentations obtained didn’t match the ground truth. Overall, the project represents a step forward in the application of artificial intelligence algorithms to radiotherapy related processes

The application of a deep convolution neural network for the automated delineation of the target and organs at risk in High Dose Rate Cervical Brachytherapy.

Medical Imaging and Clinical Oncology: Medical Physic

Segmentation of the Prostatic Gland and the Intraprostatic Lesions on Multiparametic Magnetic Resonance Imaging Using Mask Region-Based Convolutional Neural Networks

Purpose: Accurate delineation of the prostate gland and intraprostatic lesions (ILs) is essential for prostate cancer dose-escalated radiation therapy. The aim of this study was to develop a sophisticated deep neural network approach to magnetic resonance image analysis that will help IL detection and delineation for clinicians. Methods and Materials: We trained and evaluated mask region-based convolutional neural networks to perform the prostate gland and IL segmentation. There were 2 cohorts in this study: 78 public patients (cohort 1) and 42 private patients from our institution (cohort 2). Prostate gland segmentation was performed using T2-weighted images (T2WIs), although IL segmentation was performed using T2WIs and coregistered apparent diffusion coefficient maps with prostate patches cropped out. The IL segmentation model was extended to select 5 highly suspicious volumetric lesions within the entire prostate. Results: The mask region-based convolutional neural networks model was able to segment the prostate with dice similarity coefficient (DSC) of 0.88 ± 0.04, 0.86 ± 0.04, and 0.82 ± 0.05; sensitivity (Sens.) of 0.93, 0.95, and 0.95; and specificity (Spec.) of 0.98, 0.85, and 0.90. However, ILs were segmented with DSC of 0.62 ± 0.17, 0.59 ± 0.14, and 0.38 ± 0.19; Sens. of 0.55 ± 0.30, 0.63 ± 0.28, and 0.22 ± 0.24; and Spec. of 0.974 ± 0.010, 0.964 ± 0.015, and 0.972 ± 0.015 in public validation/public testing/private testing patients when trained with patients from cohort 1 only. When trained with patients from both cohorts, the values were as follows: DSC of 0.64 ± 0.11, 0.56 ± 0.15, and 0.46 ± 0.15; Sens. of 0.57 ± 0.23, 0.50 ± 0.28, and 0.33 ± 0.17; and Spec. of 0.980 ± 0.009, 0.969 ± 0.016, and 0.977 ± 0.013. Conclusions: Our research framework is able to perform as an end-to-end system that automatically segmented the prostate gland and identified and delineated highly suspicious ILs within the entire prostate. Therefore, this system demonstrated the potential for assisting the clinicians in tumor delineation

Reducing Tumour Volume Uncertainty for the Benefit of Radiation Therapy Cancer Patients

The efficacy of radiotherapy is dependent on its precision and accuracy. Increasingly conformal, modulated radiation fields can be reproducibly delivered to small, complex volumes within the human body. However, treatment is not without uncertainty. This thesis focuses on limitations in radiotherapy accuracy due to uncertainty in delineation of the volume requiring treatment