Assessing invasiveness of subsolid lung adenocarcinomas with combined attenuation and geometric feature models

The aim of this study was to develop and test multiclass predictive models for assessing the invasiveness of individual lung adenocarcinomas presenting as subsolid nodules on computed tomography (CT). 227 lung adenocarcinomas were included: 31 atypical adenomatous hyperplasia and adenocarcinomas in situ (class H1), 64 minimally invasive adenocarcinomas (class H2) and 132 invasive adenocarcinomas (class H3). Nodules were segmented, and geometric and CT attenuation features including functional principal component analysis features (FPC1 and FPC2) were extracted. After a feature selection step, two predictive models were built with ordinal regression: Model 1 based on volume (log) (logarithm of the nodule volume) and FPC1, and Model 2 based on volume (log) and Q.875 (CT attenuation value at the 87.5% percentile). Using the 200-repeats Monte-Carlo cross-validation method, these models provided a multiclass classification of invasiveness with discriminative power AUCs of 0.83 to 0.87 and predicted the class probabilities with less than a 10% average error. The predictive modelling approach adopted in this paper provides a detailed insight on how the value of the main predictors contribute to the probability of nodule invasiveness and underlines the role of nodule CT attenuation features in the nodule invasiveness classification

Radiogenomics in non-small-cell lung cancer

Ο μη μικροκυτταρικός καρκίνος του πνεύμονα είναι ο πιο συχνά συναντώμενος υποτύπος καρκίνου του πνεύμονα, ο οποίος αποτελείται από ένα φάσμα υποτύπων. Το NSCLC είναι ένας θανατηφόρος, ετερογενής συμπαγής όγκος με μια εκτεταμένη σειρά μοριακών χαρακτηριστικών. Η πάθηση έχει γίνει ένα αξιοσημείωτο παράδειγμα ιατρικής ακριβείας καθώς το ενδιαφέρον για το θέμα συνεχίζει να επεκτείνεται. Ο απώτερος στόχος της τρέχουσας έρευνας είναι να χρησιμοποιήσει συγκεκριμένα γονίδια ως βιοδείκτες για την πρόγνωση, την έγκαιρη διάγνωση και την εξατομικευμένη θεραπεία, τα οποία διευκολύνονται από τη χρήση εξελισσόμενων τεχνικών αλληλούχισης επόμενης γενιάς που επιτρέπουν την ταυτόχρονη ανίχνευση μεγάλου αριθμού γενετικές ανωμαλίες. Γνωστές μεταλλάξεις ενός αριθμού γονιδίων, όπως τα EGFR, ALK και KRAS, επηρεάζουν ήδη τις αποφάσεις θεραπείας και νέα βασικά γονίδια και μοριακές υπογραφές διερευνώνται για την προγνωστική τους αξία καθώς και για την πιθανή συμβολή τους στην ανοσοθεραπεία και τη θεραπεία της υποτροπής στην αντίσταση στις υπάρχουσες θεραπείες. Οι τύποι δειγμάτων που χρησιμοποιούνται για μελέτες NGS, όπως αναρροφήσεις με λεπτή βελόνα, ιστός ενσωματωμένος σε παραφίνη σταθεροποιημένος με φορμαλίνη και DNA χωρίς κύτταρα, έχουν ο καθένας τα δικά του πλεονεκτήματα και μειονεκτήματα που πρέπει να ληφθούν υπόψηNon-small cell lung cancer is the most often encountered subtype of lung cancer, which consists of a spectrum of subtypes. NSCLC is a lethal, heterogeneous solid tumor with an extensive array of molecular features. The condition has become a notable example of precision medicine as interest in the topic continues to expand. The ultimate goal of the current research is to use specific genes as biomarkers for its prognosis, timely diagnosis, and personalized therapy, all of which are facilitated by the use of evolving next-generation sequencing techniques that permit the simultaneous detection of a large number of genetic abnormalities. Known mutations of a number of genes, such as EGFR, ALK, and KRAS, already influence treatment decisions, and new key genes and molecular signatures are being investigated for their prognostic value as well as their potential contribution to immunotherapy and the treatment of recurrence due to resistance to existing therapies. The sample types utilized for NGS studies, such as fine-needle aspirates, formalin-fixed paraffin-embedded tissue, and cell-free DNA, each have their own advantages and disadvantages that must be taken into accoun

Deep learning in medical imaging and radiation therapy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146980/1/mp13264_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146980/2/mp13264.pd

Radiologic evaluation of breast disorders related to tuberculosis amongst women in Durban, KwaZulu-Natal, South Africa.

Doctor of Philosophy in Clinical Medicine, University of KwaZulu-Natal, Durban, 2016.Women in KwaZulu-Natal Province, South Africa, are at high risk of developing breast tuberculosis (BTB) due to the increased incidence of HIV. However, there is a general lack of knowledge regarding the various diseases that can affect the breast. This is compounded by lack of the national breast screening program. As a result, many patients with breast cancer (BCA) and BTB are initially misdiagnosed by clinicians. It was evident from the study that much still has to be done in educating the public and healthcare workers about breast diseases. This project endeavoured to compare the effectiveness of various radiological technologies to identify breast problems. The study consisted of three phases all based at Ethekwini Municipality tertiary referral hospitals. The first phase aimed to determine the prevalence of the BTB using retrospective data over a period of 13 years. The same data further provided information of the clinical and radiological manifestations of BTB. This study concluded that while BTB is not common, it shares the clinical and radiology features with BCA, and is difficult to diagnose with current pathology methods. The second phase was done prospectively by recruiting patients who were newly diagnosed with BTB. The aim was to evaluate the use of modern imaging techniques to further describe the radiology patterns of BTB and to determine the radiological parameters that may be used in disease monitoring. The results provided insight into disease extent, and showed that it is usually more severe than perceived with current diagnostic methods. The third phase was performed using retrospective image analysis of patients who had BCA and BTB by using modern radiology techniques. The purpose was to identify the salient features that can differentiate BTB from the BCA. Several radiology parameters were identified as possible biomarkers for differentiation between the two conditions. The knowledge of their respective features would aid in the timeous diagnosis of both conditions, particularly in cases where the pathology results are inconclusive for various reasons. Overall the study highlights the lack of evidence based information on BTB. Recommendations and conclusions are provided in the last chapter

Artificial Intelligence in Image-Based Screening, Diagnostics, and Clinical Care of Cardiopulmonary Diseases

Cardiothoracic and pulmonary diseases are a significant cause of mortality and morbidity worldwide. The COVID-19 pandemic has highlighted the lack of access to clinical care, the overburdened medical system, and the potential of artificial intelligence (AI) in improving medicine. There are a variety of diseases affecting the cardiopulmonary system including lung cancers, heart disease, tuberculosis (TB), etc., in addition to COVID-19-related diseases. Screening, diagnosis, and management of cardiopulmonary diseases has become difficult owing to the limited availability of diagnostic tools and experts, particularly in resource-limited regions. Early screening, accurate diagnosis and staging of these diseases could play a crucial role in treatment and care, and potentially aid in reducing mortality. Radiographic imaging methods such as computed tomography (CT), chest X-rays (CXRs), and echo ultrasound (US) are widely used in screening and diagnosis. Research on using image-based AI and machine learning (ML) methods can help in rapid assessment, serve as surrogates for expert assessment, and reduce variability in human performance. In this Special Issue, “Artificial Intelligence in Image-Based Screening, Diagnostics, and Clinical Care of Cardiopulmonary Diseases”, we have highlighted exemplary primary research studies and literature reviews focusing on novel AI/ML methods and their application in image-based screening, diagnosis, and clinical management of cardiopulmonary diseases. We hope that these articles will help establish the advancements in AI