Machine Learning-Based Models for Prediction of Toxicity Outcomes in Radiotherapy

In order to limit radiotherapy (RT)-related side effects, effective toxicity prediction and assessment schemes are essential. In recent years, the growing interest toward artificial intelligence and machine learning (ML) within the science community has led to the implementation of innovative tools in RT. Several researchers have demonstrated the high performance of ML-based models in predicting toxicity, but the application of these approaches in clinics is still lagging, partly due to their low interpretability. Therefore, an overview of contemporary research is needed in order to familiarize practitioners with common methods and strategies. Here, we present a review of ML-based models for predicting and classifying RT-induced complications from both a methodological and a clinical standpoint, focusing on the type of features considered, the ML methods used, and the main results achieved. Our work overviews published research in multiple cancer sites, including brain, breast, esophagus, gynecological, head and neck, liver, lung, and prostate cancers. The aim is to define the current state of the art and main achievements within the field for both researchers and clinicians

Stage-Specific Predictive Models for Cancer Survivability

Survivability of cancer strongly depends on the stage of cancer. In most previous works, machine learning survivability prediction models for a particular cancer, were trained and evaluated together on all stages of the cancer. In this work, we trained and evaluated survivability prediction models for five major cancers, together on all stages and separately for every stage. We named these models joint and stage-specific models respectively. The obtained results for the cancers which we investigated reveal that, the best model to predict the survivability of the cancer for one specific stage is the model which is specifically built for that stage. Additionally, we saw that for every stage of cancer, the most important features to predict survivability, differed from other stages. By evaluating the models separately on different stages we found that their performance differed on different stages. We also found that evaluating the models together on all stages, as was done in past, is misleading because it overestimates performance

Performance/outcomes data and physician process challenges for practical big data efforts in radiation oncology

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146290/1/mp13136.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146290/2/mp13136_am.pd

An Interpretable Stroke Prediction Model using Rules and Bayesian Analysis

We aim to produce predictive models that are not only accurate, but are also interpretable to human experts. Our models are decision lists, which consist of a series of if...then... statements (for example, if high blood pressure, then stroke) that discretize a high-dimensional, multivariate feature space into a series of simple, readily inter- pretable decision statements. We introduce a generative model called the Bayesian List Machine which yields a posterior distribution over possible decision lists. It employs a novel prior structure to encourage sparsity. Our experiments show that the Bayesian List Machine has predictive accuracy on par with the current top algorithms for prediction in machine learning. Our method is motivated by recent developments in personalized medicine, and can be used to produce highly accurate and interpretable medical scoring systems. We demonstrate this by producing an alternative to the CHADS2 score, actively used in clinical practice for estimating the risk of stroke in patients that have atrial brillation. Our model is as interpretable as CHADS2, but more accurate

Cancer Outcome Prediction with Multiform Medical Data using Deep Learning

This thesis illustrated the work done for my PhD project, which aims to develop personalised cancer outcome prediction models using various types of medical data. A predictive modelling workflow that can analyse data with different forms and generate comprehensive outcome prediction was designed and implemented on a variety of datasets. The model development was accompanied by applying deep learning techniques for multivariate survival analysis, medical image analysis and sequential data processing. The modelling workflow was applied to three different tasks: 1. Deep learning models were developed for estimating the progression probability of patients with colorectal cancer after resection and after different lines of chemotherapy, which got significantly better predictive performance than the Cox regression models. Besides, CT-based models were developed for predicting the tumour local response after chemotherapy of patients with lung metastasis, which got an AUC of 0. 769 on disease progression detection and 0.794 on treatment response classification. 2. Deep learning models were developed for predicting the survival state of patients with non-small cell lung cancer after radiotherapy using CT scans, dose distribution and disease and treatment variables. The eventual model obtained by ensemble voting got an AUC of 0.678, which is significantly higher than the score achieved by the radiomics model (0.633). 3. Deep-learning-aided approaches were used for estimating the progression risk for patients with solitary fibrous tumours using digital pathology slides. The deep learning architecture was able to optimise the WHO risk assessment model using automatically identified levels of mitotic activity. Compared to manual counting given by pathologists, deep-learning-aided mitosis counting can re-grade the patients whose risks were underestimated. The applications proved that the predictive models based on hybrid neural networks were able to analyse multiform medical data for generating data-based cancer outcome prediction. The results can be used for realising personalised treatment planning, evaluating treatment quality, and aiding clinical decision-making

DEVELOPING NOVEL COMPUTER-AIDED DETECTION AND DIAGNOSIS SYSTEMS OF MEDICAL IMAGES

Reading medical images to detect and diagnose diseases is often difficult and has large inter-reader variability. To address this issue, developing computer-aided detection and diagnosis (CAD) schemes or systems of medical images has attracted broad research interest in the last several decades. Despite great effort and significant progress in previous studies, only limited CAD schemes have been used in clinical practice. Thus, developing new CAD schemes is still a hot research topic in medical imaging informatics field. In this dissertation, I investigate the feasibility of developing several new innovative CAD schemes for different application purposes. First, to predict breast tumor response to neoadjuvant chemotherapy and reduce unnecessary aggressive surgery, I developed two CAD schemes of breast magnetic resonance imaging (MRI) to generate quantitative image markers based on quantitative analysis of global kinetic features. Using the image marker computed from breast MRI acquired pre-chemotherapy, CAD scheme enables to predict radiographic complete response (CR) of breast tumors to neoadjuvant chemotherapy, while using the imaging marker based on the fusion of kinetic and texture features extracted from breast MRI performed after neoadjuvant chemotherapy, CAD scheme can better predict the pathologic complete response (pCR) of the patients. Second, to more accurately predict prognosis of stroke patients, quantifying brain hemorrhage and ventricular cerebrospinal fluid depicting on brain CT images can play an important role. For this purpose, I developed a new interactive CAD tool to segment hemorrhage regions and extract radiological imaging marker to quantitatively determine the severity of aneurysmal subarachnoid hemorrhage at presentation and correlate the estimation with various homeostatic/metabolic derangements and predict clinical outcome. Third, to improve the efficiency of primary antibody screening processes in new cancer drug development, I developed a CAD scheme to automatically identify the non-negative tissue slides, which indicate reactive antibodies in digital pathology images. Last, to improve operation efficiency and reliability of storing digital pathology image data, I developed a CAD scheme using optical character recognition algorithm to automatically extract metadata from tissue slide label images and reduce manual entry for slide tracking and archiving in the tissue pathology laboratories. In summary, in these studies, we developed and tested several innovative approaches to identify quantitative imaging markers with high discriminatory power. In all CAD schemes, the graphic user interface-based visual aid tools were also developed and implemented. Study results demonstrated feasibility of applying CAD technology to several new application fields, which has potential to assist radiologists, oncologists and pathologists improving accuracy and consistency in disease diagnosis and prognosis assessment of using medical image

Data Science in Healthcare

Data science is an interdisciplinary field that applies numerous techniques, such as machine learning, neural networks, and deep learning, to create value based on extracting knowledge and insights from available data. Advances in data science have a significant impact on healthcare. While advances in the sharing of medical information result in better and earlier diagnoses as well as more patient-tailored treatments, information management is also affected by trends such as increased patient centricity (with shared decision making), self-care (e.g., using wearables), and integrated care delivery. The delivery of health services is being revolutionized through the sharing and integration of health data across organizational boundaries. Via data science, researchers can deliver new approaches to merge, analyze, and process complex data and gain more actionable insights, understanding, and knowledge at the individual and population levels. This Special Issue focuses on how data science is used in healthcare (e.g., through predictive modeling) and on related topics, such as data sharing and data management

Bayesian networks for disease diagnosis: What are they, who has used them and how?

A Bayesian network (BN) is a probabilistic graph based on Bayes' theorem, used to show dependencies or cause-and-effect relationships between variables. They are widely applied in diagnostic processes since they allow the incorporation of medical knowledge to the model while expressing uncertainty in terms of probability. This systematic review presents the state of the art in the applications of BNs in medicine in general and in the diagnosis and prognosis of diseases in particular. Indexed articles from the last 40 years were included. The studies generally used the typical measures of diagnostic and prognostic accuracy: sensitivity, specificity, accuracy, precision, and the area under the ROC curve. Overall, we found that disease diagnosis and prognosis based on BNs can be successfully used to model complex medical problems that require reasoning under conditions of uncertainty.Comment: 22 pages, 5 figures, 1 table, Student PhD first pape