Machine learning applications in cardiac computed tomography: a composite systematic review

Artificial intelligence and machine learning (ML) models are rapidly being applied to the analysis of cardiac computed tomography (CT). We sought to provide an overview of the contemporary advances brought about by the combination of ML and cardiac CT. Six searches were performed in Medline, Embase, and the Cochrane Library up to November 2021 for (i) CT-fractional flow reserve (CT-FFR), (ii) atrial fibrillation (AF), (iii) aortic stenosis, (iv) plaque characterization, (v) fat quantification, and (vi) coronary artery calcium score. We included 57 studies pertaining to the aforementioned topics. Non-invasive CT-FFR can accurately be estimated using ML algorithms and has the potential to reduce the requirement for invasive angiography. Coronary artery calcification and non-calcified coronary lesions can now be automatically and accurately calculated. Epicardial adipose tissue can also be automatically, accurately, and rapidly quantified. Effective ML algorithms have been developed to streamline and optimize the safety of aortic annular measurements to facilitate pre-transcatheter aortic valve replacement valve selection. Within electrophysiology, the left atrium (LA) can be segmented and resultant LA volumes have contributed to accurate predictions of post-ablation recurrence of AF. In this review, we discuss the latest studies and evolving techniques of ML and cardiac CT

Evaluation of cancer outcome assessment using MRI: A review of deep-learning methods

Accurate evaluation of tumor response to treatment is critical to allow personalized treatment regimens according to the predicted response and to support clinical trials investigating new therapeutic agents by providing them with an accurate response indicator. Recent advances in medical imaging, computer hardware, and machine-learning algorithms have resulted in the increased use of these tools in the field of medicine as a whole and specifically in cancer imaging for detection and characterization of malignant lesions, prognosis, and assessment of treatment response. Among the currently available imaging techniques, magnetic resonance imaging (MRI) plays an important role in the evaluation of treatment assessment of many cancers, given its superior soft-tissue contrast and its ability to allow multiplanar imaging and functional evaluation. In recent years, deep learning (DL) has become an active area of research, paving the way for computer-assisted clinical and radiological decision support. DL can uncover associations between imaging features that cannot be visually identified by the naked eye and pertinent clinical outcomes. The aim of this review is to highlight the use of DL in the evaluation of tumor response assessed on MRI. In this review, we will first provide an overview of common DL architectures used in medical imaging research in general. Then, we will review the studies to date that have applied DL to magnetic resonance imaging for the task of treatment response assessment. Finally, we will discuss the challenges and opportunities of using DL within the clinical workflow

Fully Automatic Whole-Volume Tumor Segmentation in Cervical Cancer

Uterine cervical cancer (CC) is the most common gynecologic malignancy worldwide. Whole-volume radiomic profiling from pelvic MRI may yield prognostic markers for tailoring treatment in CC. However, radiomic profiling relies on manual tumor segmentation which is unfeasible in the clinic. We present a fully automatic method for the 3D segmentation of primary CC lesions using state-of-the-art deep learning (DL) techniques. In 131 CC patients, the primary tumor was manually segmented on T2-weighted MRI by two radiologists (R1, R2). Patients were separated into a train/validation (n = 105) and a test- (n = 26) cohort. The segmentation performance of the DL algorithm compared with R1/R2 was assessed with Dice coefficients (DSCs) and Hausdorff distances (HDs) in the test cohort. The trained DL network retrieved whole-volume tumor segmentations yielding median DSCs of 0.60 and 0.58 for DL compared with R1 (DL-R1) and R2 (DL-R2), respectively, whereas DSC for R1-R2 was 0.78. Agreement for primary tumor volumes was excellent between raters (R1-R2: intraclass correlation coefficient (ICC) = 0.93), but lower for the DL algorithm and the raters (DL-R1: ICC = 0.43; DL-R2: ICC = 0.44). The developed DL algorithm enables the automated estimation of tumor size and primary CC tumor segmentation. However, segmentation agreement between raters is better than that between DL algorithm and raters.publishedVersio

Integrating radiomics into holomics for personalised oncology: from algorithms to bedside.

Radiomics, artificial intelligence, and deep learning figure amongst recent buzzwords in current medical imaging research and technological development. Analysis of medical big data in assessment and follow-up of personalised treatments has also become a major research topic in the area of precision medicine. In this review, current research trends in radiomics are analysed, from handcrafted radiomics feature extraction and statistical analysis to deep learning. Radiomics algorithms now include genomics and immunomics data to improve patient stratification and prediction of treatment response. Several applications have already shown conclusive results demonstrating the potential of including other "omics" data to existing imaging features. We also discuss further challenges of data harmonisation and management infrastructure to shed a light on the much-needed integration of radiomics and all other "omics" into clinical workflows. In particular, we point to the emerging paradigm shift in the implementation of big data infrastructures to facilitate databanks growth, data extraction and the development of expert software tools. Secured access, sharing, and integration of all health data, called "holomics", will accelerate the revolution of personalised medicine and oncology as well as expand the role of imaging specialists

Artificial Intelligence, Mathematical Modeling and Magnetic Resonance Imaging for Precision Medicine in Neurology and Neuroradiology

La tesi affronta la possibilità di utilizzare metodi matematici, tecniche di simulazione, teorie fisiche riadattate e algoritmi di intelligenza artificiale per soddisfare le esigenze cliniche in neuroradiologia e neurologia al fine di descrivere e prevedere i patterns e l’evoluzione temporale di una malattia, nonché di supportare il processo decisionale clinico. La tesi è suddivisa in tre parti. La prima parte riguarda lo sviluppo di un workflow radiomico combinato con algoritmi di Machine Learning al fine di prevedere parametri che favoriscono la descrizione quantitativa dei cambiamenti anatomici e del coinvolgimento muscolare nei disordini neuromuscolari, con particolare attenzione alla distrofia facioscapolo-omerale. Il workflow proposto si basa su sequenze di risonanza magnetica convenzionali disponibili nella maggior parte dei centri neuromuscolari e, dunque, può essere utilizzato come strumento non invasivo per monitorare anche i più piccoli cambiamenti nei disturbi neuromuscolari oltre che per la valutazione della progressione della malattia nel tempo. La seconda parte riguarda l’utilizzo di un modello cinetico per descrivere la crescita tumorale basato sugli strumenti della meccanica statistica per sistemi multi-agente e che tiene in considerazione gli effetti delle incertezze cliniche legate alla variabilità della progressione tumorale nei diversi pazienti. L'azione dei protocolli terapeutici è modellata come controllo che agisce a livello microscopico modificando la natura della distribuzione risultante. Viene mostrato come lo scenario controllato permetta di smorzare le incertezze associate alla variabilità della dinamica tumorale. Inoltre, sono stati introdotti metodi di simulazione numerica basati sulla formulazione stochastic Galerkin del modello cinetico sviluppato. La terza parte si riferisce ad un progetto ancora in corso che tenta di descrivere una porzione di cervello attraverso la teoria quantistica dei campi e di simularne il comportamento attraverso l'implementazione di una rete neurale con una funzione di attivazione costruita ad hoc e che simula la funzione di risposta del modello biologico neuronale. E’ stato ottenuto che, nelle condizioni studiate, l'attività della porzione di cervello può essere descritta fino a O(6), i.e, considerando l’interazione fino a sei campi, come un processo gaussiano. Il framework quantistico definito può essere esteso anche al caso di un processo non gaussiano, ovvero al caso di una teoria di campo quantistico interagente utilizzando l’approccio della teoria wilsoniana di campo efficace.The thesis addresses the possibility of using mathematical methods, simulation techniques, repurposed physical theories and artificial intelligence algorithms to fulfill clinical needs in neuroradiology and neurology. The aim is to describe and to predict disease patterns and its evolution over time as well as to support clinical decision-making processes. The thesis is divided into three parts. Part 1 is related to the development of a Radiomic workflow combined with Machine Learning algorithms in order to predict parameters that quantify muscular anatomical involvement in neuromuscular diseases, with special focus on Facioscapulohumeral dystrophy. The proposed workflow relies on conventional Magnetic Resonance Imaging sequences available in most neuromuscular centers and it can be used as a non-invasive tool to monitor even fine change in neuromuscular disorders and to evaluate longitudinal diseases’ progression over time. Part 2 is about the description of a kinetic model for tumor growth by means of classical tools of statistical mechanics for many-agent systems also taking into account the effects of clinical uncertainties related to patients’ variability in tumor progression. The action of therapeutic protocols is modeled as feedback control at the microscopic level. The controlled scenario allows the dumping of uncertainties associated with the variability in tumors’ dynamics. Suitable numerical methods, based on Stochastic Galerkin formulation of the derived kinetic model, are introduced. Part 3 refers to a still-on going project that attempts to describe a brain portion through a quantum field theory and to simulate its behavior through the implementation of a neural network with an ad-hoc activation function mimicking the biological neuron model response function. Under considered conditions, the brain portion activity can be expressed up to O(6), i.e., up to six fields interaction, as a Gaussian Process. The defined quantum field framework may also be extended to the case of a Non-Gaussian Process behavior, or rather to an interacting quantum field theory in a Wilsonian Effective Field theory approach