State of the Art in Artificial Intelligence and Radiomics in Hepatocellular Carcinoma

The most common liver malignancy is hepatocellular carcinoma (HCC), which is also associated with high mortality. Often HCC develops in a chronic liver disease setting, and early diagnosis as well as accurate screening of high-risk patients is crucial for appropriate and effective management of these patients. While imaging characteristics of HCC are well-defined in the diagnostic phase, challenging cases still occur, and current prognostic and predictive models are limited in their accuracy. Radiomics and machine learning (ML) offer new tools to address these issues and may lead to scientific breakthroughs with the potential to impact clinical practice and improve patient outcomes. In this review, we will present an overview of these technologies in the setting of HCC imaging across different modalities and a range of applications. These include lesion segmentation, diagnosis, prognostic modeling and prediction of treatment response. Finally, limitations preventing clinical application of radiomics and ML at the present time are discussed, together with necessary future developments to bring the field forward and outside of a purely academic endeavor

Quantitative magnetic resonance imaging for focal liver lesions: Bridging the gap between research and clinical practice

Magnetic resonance imaging (MRI) is highly important for the detection, characterization, and follow-up of focal liver lesions. Several quantitative MRI-based methods have been proposed in addition to qualitative imaging interpretation to improve the diagnostic work-up and prognostics in patients with focal liver lesions. This includes DWI with apparent diffusion coefficient measurements, intravoxel incoherent motion, perfusion imaging, MR elastography, and radiomics. Multiple research studies have reported promising results with quantitative MRI methods in various clinical settings. Nevertheless, applications in everyday clinical practice are limited. This review describes the basic principles of quantitative MRI-based techniques and discusses the main current applications and limitations for the assessment of focal liver lesions

APPLICATION OF FUZZY-MLP MODEL TO ULTRASONIC LIVER IMAGE CLASSIFICATION

In this paper, we propose the application of fuzzy-MLP in theclassification of ultrasonic liver images. The four sets of ultrasonic liverimages used in the experiment are: normal, liver cysts, alcoholic cirrhosisand carcinoma.To deal with the sample images efficiently, we extract textural features fromthe Pathology Bearing Regions (PBRs) of the ultrasound liver images. Theselected features for the classification are entropy, energy and maximumprobability-based texture features extracted using gray level co-occurrencematrix second-order statistics. The fuzzy-MLP model is constructed for theselected features classify various categories of ultrasonic liver images.The efficacy of Fuzzy-MLP model and conventional artificial neural network(ANN) has been compared on the basis of the same feature vector. A testwith 82 training data and 110 test data for all the four classes shows 92.73%classification accuracy for the proposed fuzzy-MLP model. It is comparedwith the 81.82% counterpart provided by conventional ANN method

Computed tomography texture-based radiomics analysis in gallbladder cancer: initial experience

Aim of the study: To investigate computed tomography (CT) texture parameters in suspected gallbladder cancer (GBC) and assess its utility in predicting histopathological grade and overall survival. Material and methods: This retrospective pilot study included consecutive patients with clinically suspected GBC. CT images, clinical, and histological or cytological data were retrieved from the database. CT images were reviewed by two radiologists. A single axial CT section in the portal venous phase was selected for texture analysis. Radiomic feature extraction was done using commercially available research software. Results: Thirty-eight patients (31 females, mean age 53.1 years) were included. Malignancy was confirmed in 29 patients in histopathology or cytology analysis, and the rest had no features of malignancy. Exophytic gallbladder mass with associated gallbladder wall thickening was present in 22 (58%) patients. Lymph nodal, liver, and omental metastases were present in 10, 1, and 3 patients, respectively. The mean overall survival was 9.7 months. There were significant differences in mean and kurtosis at medium texture scales to differentiate moderately differentiated and poorly differentiated adenocarcinoma (p < 0.05). The only texture parameter that was significantly associated with survival was kurtosis (p = 0.020) at medium texture scales. In multivariate analysis, factors found to be significantly associated with length of overall survival were mean number of positive pixels (p = 0.02), skewness (p = -0.046), kurtosis (0.018), and standard deviation (p = 0.045). Conclusions: Our preliminary results highlight the potential utility of CT texture-based radiomics analysis in patients with GBC. Medium texture scale parameters including both mean and kurtosis, or kurtosis alone, may help predict the histological grade and survival, respectively

PCA-SVM based CAD System for Focal Liver Lesions using B-Mode Ultrasound Images

The contribution made by texture of regions inside and outside of the lesions in classification of focal liver lesions (FLLs) is investigated in the present work. In order to design an efficient computer-aided diagnostic (CAD) system for FLLs, a representative database consisting of images with (1) typical and atypical cases of cyst, hemangioma (HEM) and metastatic carcinoma (MET) lesions, (2) small as well as large hepatocellular carcinoma (HCC) lesions and (3) normal (NOR) liver tissue is used. Texture features are computed from regions inside and outside of the lesions. Feature set consisting of 208 texture features, (i.e. 104 texture features and 104 texture ratio features) is subjected to principal component analysis (PCA) for finding the optimal number of principal components to train a support vector machine (SVM) classifier for the classification task. The proposed PCA-SVM based CAD system yielded classification accuracy of 87.2% with the individual class accuracy of 85%, 96%, 90%, 87.5% and 82.2% for NOR, Cyst, HEM, HCC and MET cases respectively. The accuracy for typical, atypical, small HCC and large HCC cases is 87.5%, 86.8%, 88.8%, and 87% respectively. The promising results indicate usefulness of the CAD system for assisting radiologists in diagnosis of FLLs.Defence Science Journal, 2013, 63(5), pp.478-486, DOI:http://dx.doi.org/10.14429/dsj.63.395

Automated Assessment of T2-Weighted MRI to Differentiate Malignant and Benign Primary Solid Liver Lesions in Noncirrhotic Livers Using Radiomics

Rationale and Objectives: Distinguishing malignant from benign liver lesions based on magnetic resonance imaging (MRI) is an important but often challenging task, especially in noncirrhotic livers. We developed and externally validated a radiomics model to quantitatively assess T2-weighted MRI to distinguish the most common malignant and benign primary solid liver lesions in noncirrhotic livers. Materials and Methods: Data sets were retrospectively collected from three tertiary referral centers (A, B, and C) between 2002 and 2018. Patients with malignant (hepatocellular carcinoma and intrahepatic cholangiocarcinoma) and benign (hepatocellular adenoma and focal nodular hyperplasia) lesions were included. A radiomics model based on T2-weighted MRI was developed in data set A using a combination of machine learning approaches. The model was internally evaluated on data set A through cross-validation, externally validated on data sets B and C, and compared to visual scoring of two experienced abdominal radiologists on data set C. Results: The overall data set included 486 patients (A: 187, B: 98, and C: 201). The radiomics model had a mean area under the curve (AUC) of 0.78 upon internal validation on data set A and a similar AUC in external validation (B: 0.74 and C: 0.76). In data set C, the two radiologists showed moderate agreement (Cohen's κ: 0.61) and achieved AUCs of 0.86 and 0.82. Conclusion: Our T2-weighted MRI radiomics model shows potential for distinguishing malignant from benign primary solid liver lesions. External validation indicated that the model is generalizable despite substantial MRI acquisition protocol differences. Pending further optimization and generalization, this model may aid radiologists in improving the diagnostic workup of patients with liver lesions.</p

Technical advancements and protocol optimization of diffusion-weighted imaging (DWI) in liver

An area of rapid advancement in abdominal MRI is diffusion-weighted imaging (DWI). By measuring diffusion properties of water molecules, DWI is capable of non-invasively probing tissue properties and physiology at cellular and macromolecular level. The integration of DWI as part of abdominal MRI exam allows better lesion characterization and therefore more accurate initial diagnosis and treatment monitoring. One of the most technical challenging, but also most useful abdominal DWI applications is in liver and therefore requires special attention and careful optimization. In this article, the latest technical developments of DWI and its liver applications are reviewed with the explanations of the technical principles, recommendations of the imaging parameters, and examples of clinical applications. More advanced DWI techniques, including Intra-Voxel Incoherent Motion (IVIM) diffusion imaging, anomalous diffusion imaging, and Diffusion Kurtosis Imaging (DKI) are discussed