AI deployment on GBM diagnosis: a novel approach to analyze histopathological images using image feature-based analysis

Background: Glioblastoma (GBM) is one of the most common malignant primary brain tumors, which accounts for 60–70% of all gliomas. Conventional diagnosis and the decision of post-operation treatment plan for glioblastoma is mainly based on the feature-based qualitative analysis of hematoxylin and eosin-stained (H&amp;E) histopathological slides by both an experienced medical technologist and a pathologist. The recent development of digital whole slide scanners makes AI-based histopathological image analysis feasible and helps to diagnose cancer by accurately counting cell types and/or quantitative analysis. However, the technology available for digital slide image analysis is still very limited. This study aimed to build an image feature-based computer model using histopathology whole slide images to differentiate patients with glioblastoma (GBM) from healthy control (HC). Method: Two independent cohorts of patients were used. The first cohort was composed of 262 GBM patients of the Cancer Genome Atlas Glioblastoma Multiform Collection (TCGA-GBM) dataset from the cancer imaging archive (TCIA) database. The second cohort was composed of 60 GBM patients collected from a local hospital. Also, a group of 60 participants with no known brain disease were collected. All the H&amp;E slides were collected. Thirty-three image features (22 GLCM and 11 GLRLM) were retrieved from the tumor volume delineated by medical technologist on H&amp;E slides. Five machine-learning algorithms including decision-tree (DT), extreme-boost (EB), support vector machine (SVM), random forest (RF), and linear model (LM) were used to build five models using the image features extracted from the first cohort of patients. Models built were deployed using the selected key image features for GBM diagnosis from the second cohort (local patients) as model testing, to identify and verify key image features for GBM diagnosis. Results: All five machine learning algorithms demonstrated excellent performance in GBM diagnosis and achieved an overall accuracy of 100% in the training and validation stage. A total of 12 GLCM and 3 GLRLM image features were identified and they showed a significant difference between the normal and the GBM image. However, only the SVM model maintained its excellent performance in the deployment of the models using the independent local cohort, with an accuracy of 93.5%, sensitivity of 86.95%, and specificity of 99.73%. Conclusion: In this study, we have identified 12 GLCM and 3 GLRLM image features which can aid the GBM diagnosis. Among the five models built, the SVM model proposed in this study demonstrated excellent accuracy with very good sensitivity and specificity. It could potentially be used for GBM diagnosis and future clinical application.</p

Integrating demographics and imaging features for various stages of dementia classification: feed forward neural network multi-class approach

Background: MRI magnetization-prepared rapid acquisition (MPRAGE) is an easily available imaging modality for dementia diagnosis. Previous studies suggested that volumetric analysis plays a crucial role in various stages of dementia classification. In this study, volumetry, radiomics and demographics were integrated as inputs to develop an artificial intelligence model for various stages, including Alzheimer’s disease (AD), mild cognitive decline (MCI) and cognitive normal (CN) dementia classifications. Method: The Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset was separated into training and testing groups, and the Open Access Series of Imaging Studies (OASIS) dataset was used as the second testing group. The MRI MPRAGE image was reoriented via statistical parametric mapping (SPM12). Freesurfer was employed for brain segmentation, and 45 regional brain volumes were retrieved. The 3D Slicer software was employed for 107 radiomics feature extractions from within the whole brain. Data on patient demographics were collected from the datasets. The feed-forward neural network (FFNN) and the other most common artificial intelligence algorithms, including support vector machine (SVM), ensemble classifier (EC) and decision tree (DT), were used to build the models using various features. Results: The integration of brain regional volumes, radiomics and patient demographics attained the highest overall accuracy at 76.57% and 73.14% in ADNI and OASIS testing, respectively. The subclass accuracies in MCI, AD and CN were 78.29%, 89.71% and 85.14%, respectively, in ADNI testing, as well as 74.86%, 88% and 83.43% in OASIS testing. Balanced sensitivity and specificity were obtained for all subclass classifications in MCI, AD and CN. Conclusion: The FFNN yielded good overall accuracy for MCI, AD and CN categorization, with balanced subclass accuracy, sensitivity and specificity. The proposed FFNN model is simple, and it may support the triage of patients for further confirmation of the diagnosis.</p

MO3-4 Radiotherapy technique recommendation based on radiomics for non-small cell lung cancer (NSCLC) patients

BackgroundLung cancer is the most common cancer in Hong Kong, with 85% of lung cancers are non-small cell lung cancer (NSCLC). Radiation therapy is the mainstream treatment strategy with intensity-modulated radiotherapy (IMRT) technique and stereotactic body radiotherapy (SBRT) technique. With the advancement of artificial intelligence (AI) technologies, different new machine learning systems have emerged with higher computing power for more complicated data analysis.Method488 NSCLC patients who received radiotherapy in Prince of Wales hospital were included in this study. 107 radiomics were retrieved with planned target volume (PTV) from CT images using Slicer (V.4.11.20210226) with the PyRadiomics extension. Random Forest from R was used to build the prognosis prediction model. Patients from 2014-17 was used as training and validation data with 70:30 ratio. Patients from 2018-19 was used as testing data. The performance of random forest model and whether radiotherapy technique with better prognosis can be recommended was assessed using Receiver Operating Characteristic Curve (ROC), with sensitivity (Se), specificity (Sp), accuracy (A) and area under the curve (AUC).ResultThe performance of the random forest model was good, with Se 85%, Sp 38%, A 61.6% and AUC 72%. The ability to recommend a radiotherapy technique with better prognosis was similar, with Se 85%, Sp 42%, A 62.75% and AUC 72%. The size zone non-uniformity, dependence non-uniformity and busyness played important roles in prognostic predication and technique recommendation.ConclusionThe random forest model based on radiomics was good for radiotherapy technique recommendation. Further investigation can be performed using radiomics from multiple image modalities, genomic data and more treatment options can be recommended

Association between polarity of first episode and solar insolation in bipolar I disorder

Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth. Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer. The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001). Increased awareness and research into circadian dysfunction throughout the course of BD is warranted. [Abstract copyright: Copyright © 2022 Elsevier Inc. All rights reserved.