Prediction of Response to Neoadjuvant Chemoradiotherapy by MRI-Based Machine Learning Texture Analysis in Rectal Cancer Patients

Introduction Neoadjuvant chemoradiotherapy (nCRT) followed by surgical resection is the standard treatment for locally advanced rectal cancer (LARC). Radiomics can be used as noninvasive biomarker for prediction of response to therapy. The main aim of this study was to evaluate the association of MRI texture features of LARC with nCRT response and the effect of Laplacian of Gaussian (LoG) filter and feature selection algorithm in prediction process improvement. Methods All patients underwent MRI with a 3T clinical scanner, 1 week before nCRT. For each patient, intensity, shape, and texture-based features were derived from MRI images with LoG filter using the IBEX software and without preprocessing. We identified responder from a non-responder group using 9 machine learning classifiers. Then, the effect of preprocessing LoG filters with 0.5, 1 and 1.5 value on these classification algorithms' performance was investigated. Eventually, classification algorithm's results were compared in different feature selection methods. Result Sixty-seven patients with LARC were included in the study. Patients' nCRT responses included 11 patients with Grade 0, 19 with Grade 1, 26 with Grade 2, and 11 with Grade 3 according to AJCC/CAP pathologic grading. In MR Images which were not preprocessed, the best performance was for Ada boost classifier (AUC = 74.8) with T2W MR Images. In T1W MR Images, the best performance was for aba boost classifier (AUC = 78.1) with a sigma = 1 preprocessing LoG filter. In T2W MR Images, the best performance was for naive Bayesian network classifier (AUC = 85.1) with a sigma = 0.5 preprocessing LoG filter. Also, performance of machine learning models with CfsSubsetEval (CF SUB E) feature selection algorithm was better than others. Conclusion Machine learning can be used as a response predictor model in LARC patients, but its performance should be improved. A preprocessing LoG filter can improve the machine learning methods performance and at the end, the effect of feature selection algorithm on model's performance is clear. Keywords:MRI; Rectal cancer; Radiomics; Machine learnin

Prediction of Response to Neoadjuvant Chemoradiotherapy by MRI-Based Machine Learning Texture Analysis in Rectal Cancer Patients

Introduction: Neoadjuvant chemoradiotherapy (nCRT) followed by surgical resection is the standard treatment for locally advanced rectal cancer (LARC). Radiomics can be used as noninvasive biomarker for prediction of response to therapy. The main aim of this study was to evaluate the association of MRI texture features of LARC with nCRT response and the effect of Laplacian of Gaussian (LoG) filter and feature selection algorithm in prediction process improvement. Methods: All patients underwent MRI with a 3T clinical scanner, 1 week before nCRT. For each patient, intensity, shape, and texture-based features were derived from MRI images with LoG filter using the IBEX software and without preprocessing. We identified responder from a non-responder group using 9 machine learning classifiers. Then, the effect of preprocessing LoG filters with 0.5, 1 and 1.5 value on these classification algorithms’ performance was investigated. Eventually, classification algorithm’s results were compared in different feature selection methods. Result: Sixty-seven patients with LARC were included in the study. Patients’ nCRT responses included 11 patients with Grade 0, 19 with Grade 1, 26 with Grade 2, and 11 with Grade 3 according to AJCC/CAP pathologic grading. In MR Images which were not preprocessed, the best performance was for Ada boost classifier (AUC = 74.8) with T2W MR Images. In T1W MR Images, the best performance was for aba boost classifier (AUC = 78.1) with a σ = 1 preprocessing LoG filter. In T2W MR Images, the best performance was for naive Bayesian network classifier (AUC = 85.1) with a σ = 0.5 preprocessing LoG filter. Also, performance of machine learning models with CfsSubsetEval (CF SUB E) feature selection algorithm was better than others. Conclusion: Machine learning can be used as a response predictor model in LARC patients, but its performance should be improved. A preprocessing LoG filter can improve the machine learning methods performance and at the end, the effect of feature selection algorithm on model’s performance is clear. KEYWORDS: MRI; Machine learning; Radiomics; Rectal cance

Adipose tissue-derived mesenchymal stem cells for breast tissue regeneration

YesWith an escalating incidence of breast cancer cases all over the world and the deleterious psychological impact that mastectomy has on patients along with several limitations of the currently applied modalities, it's plausible to seek unconventional approaches to encounter such a burgeoning issue. Breast tissue engineering may allow that chance via providing more personalized solutions which are able to regenerate, mimicking natural tissues also facing the witnessed limitations. This review is dedicated to explore the utilization of adipose tissue-derived mesenchymal stem cells for breast tissue regeneration among postmastectomy cases focusing on biomaterials and cellular aspects in terms of harvesting, isolation, differentiation and new tissue formation as well as scaffolds types, properties, material–host interaction and an in vitro breast tissue modeling

ISBS 2018 AUCKLAND CONFERENCE SPORTS TECHNOLOGY SHOWCASE PROGRAMME

The coordinators Amber Taylor (AUT Ventures), Rosanne Ellis (AUT Research and Innovation Office), and Ryan Archibald (ATEED) have selected companies with new products to be explored by biomechanists. We hope you gain ideas for your research and learn how to commercialise your products at this showcase. ISBS 2018 Auckland Conference Industry Partner Tekscan are supporting the lunch during the showcase. Dr Jono Neville, Shelley Diewald, and Farhan Tinwala will be showcasing AUT Strain Gauge. AUT Strain gauge allows for a valid and reliable assessment of the strength of an entire class or team in a relatively short amount of time. Steve Leftly and Farshid Sarmast will be showcasing Myovolt which is a breakthrough muscle massage system that you wear. It delivers vibration therapy to any part of the body, it\u27s easy to use, lightweight and has benefits backed by clinical research. Parn Jones, Eric Helms and Wilson Huang will be showcasing Avice which is a wearable device that gives you real-time actionable feedback during weight training. It measures changes in muscle performance to inform you how close to muscular failure you are. Xiaoyou Lin and Bandt Li are showcasing Pressure Mat which is a new resistive-sensing contact mat for detecting the pseudo force, of sports activities such as running, jumping, stepping. Holly Sutich and Bradley Phagan will be showcasing Beta-Energy which is a healthier natural energy drink. It provides sustainable energy so you don’t get the crash that you do from a normal energy drink. Arien Hielkema and Yasir Al-Hilali will showcase MyBio Motion which is a smart wearable knee sleeve. It provides support for rehabilitation from post-operative or knee trauma, and prevention from a knee injury. Daniel Thomson and Emily Coates will showcase Circuband which has successfully paired Virtual Reality with Resistance Training to make fitness more engaging and stimulating for both athletes and the public. Colin Anderson will demonstrate Physio Wear

سَحج امعا (زخم روده)، مروری بر علل، علائم و درمان آن در طب سنّتی ایرانی

One of the most common diseases that modern medicine still has not found complete cure for various types of that is intestinal ulcer, including inflammatory bowel disease. Iranian traditional medicine (ITM) has different mechanisms and is effective in the treatment of many diseases. Therefore, in this study we reviewed the causes, diagnosis and treatment of this disease in ITM. For this purpose valid and available traditional medicine books were reviewed. In ITM intestinal ulcers were known as Sahj and ghorhe. Main Causes include abnormal humor (bile, phlegm and melancholy) passing through the intestines, dry stool, eating and drinking physic drugs and toxins. For treatment, production and passing of abnormal humors should be avoided and should help to wound healing using herbs contain mucilage. For the treatment of upper intestinal tract, oral medications and for lower intestine enema are used. According to Efficacy of Iranian medicine in treatment of different diseases for hundreds of years it seems that with more researches can arrive to good result for prevention and treatment of many diseases like intestinal ulcers.یکی از بیماری‏های شایع امروزی که هنوز در طب کلاسیک درمان اساسی برای انواع آن شناخته نشده، زخم‏های روده‏ای و بیماری‏های التهابی روده است. از آنجایی که مکتاب‏های طب ایرانی راهکارهای متفاوت و مؤثری در درمان بیماری‌ها دارد، در این مطالعه مروری، به بررسی علل ایجاد، روش‏های تشخیصی و درمان این بیماری‏ در این مکتاب‏های پرداختیم. به این منظور، کتاب‏های طبی معتبر و در دسترس بررسی شدند. زخم‏های روده‏ای تحت عنوان سحج و قرحه امعا شناخته شده و موارد گوناگونی مانند ریزش اخلاط غیر طبیعی(صفرا، بلغم و سودا)، عبور مدفوع خشک، خوردن داروهای مسهل و خوردن مواد سمی از علل آن هستند. برای درمان، باید جلوی تولید و ریزش اخلاط غیر طبیعی را گرفت و با استفاده از داروهای گیاهی لعاب‏دار به بهبود زخم‏ها کمک کرد. برای درمان روده‏های فوقانی از داروهای خوراکی و روده‏های تحتانی از داروها به شکل حقنه (enema) استفاده می‏شود.‌ با توجه به کارآیی صدها ساله طب ایرانی در درمان بیماری‏های گوناگون به نظر می‏رسد با تحقیقات بیشتر بتوان به پیش‏گیری و درمان بیماری‏هایی مانند زخم روده‏ها کمک قابل توجهی کرد

Delivered dose to scrotum in rectal cancer radiotherapy by thermoluminescence dosimetry comparing to dose calculated by planning software

Background: Colorectal carcinoma is a common malignancy, in treatment of which pelvic radiotherapy plays an important role. But this may lead to azospermia. We designed a study to determine the delivered dose to the testis with thermoluminescence dosimetry (TLD) and compare it to the dose calculated by the Three-dimensional planning software. Methods: We measured the testicular doses by TLD; the TLDs were fixed to the scrotum in six points anteriorly and posteriorly in two random fractions of the radiation course. All patients received a 50-50.4 Gy radiation dose to the pelvis in a prone position with standard fractionation and 3-dimensional planning, through three or four fields. The average dose of the TLD measurements was compared to the average of 6 relevant point doses calculated by the planning software. Results: In 33 patients with a mean age of 56 years, the mean testis dose of radiation measured by TLD was 3.77 Gy, equal to 7.5% of the total prescribed dose. The mean of point doses calculated by the 3-dimensional planning software was 4.11 Gy, equal to 8.1% of the total prescribed dose. A significant relationship was seen between the position of the inferior edge of the fields and the mean testis dose (P= 0.04). Also body mass index (BMI) was inversely related with the testicular dose (P= 0.049). Conclusion: In this study, the mean testis dose of radiation was 3.77 Gy, similar to the dose calculated by the planning software (4.11 Gy). This dose could be significantly harmful for spermatogenesis, though low doses of scattered radiation to the testis in fractionated radiotherapy might be followed with better recovery. Based on above findings, careful attention to testicular dose in radiotherapy of rectal cancer for the males desiring continued fertility seems to be required

Assessment of Dose Delivery to Supraclavicular and Axillary Lymph Nodes in Adjuvant Breast Cancer Radiotherapy, with or without Posterior Axillary Boost in Relation to BMI

Background: The axillary and supraclavicular nodal volume treatment results in improvement of local control and survival after breast conserving surgery (BCS) or modified radical mastectomy (MRM). Studies on the depth of these nodes have questioned the consistent use of standard fields for all patients. This study was done to assess the dose delivery to these lymph nodes with conventional treatment techniques according to body mass index (BMI). Methods: Twenty six patients with breast cancer undergoing breast surgery were included and computed tomography (CT) simulation was done. Their axillary and supraclavicular nodal volumes were contoured for planning target volume (PTV). Supraclavicular and posterior axillary fields were generated for each patient with digital reconstruction radiography (DRR) technique. Then the dose distribution of the two conventional methods - anterior-posterior field (AP), and anterior field with posterior boost (AP+PA boost) - for total dose of 5000 cGy, was examined with radiotherapy dose plan program. An AP planned field suitable for PTV, was designed and compared to AP+PA boost. The diameter of axilla was measured at the center of AP field in CT scan. Data were analyzed in relationship to BMI. Results: PTV coverage and excessively irradiating normal tissues (hot points), proved to have significant differences in each method (p < 0.001 to 0.01). Axillary and supraclavicular LNs were in 1.6 to 10 and 0.5 to 6.3 cm depth, respectively. Depth of the prescribed dose, which was gained from planned field, had a significant statistical association with BMI (p < 0.05). Conclusions: Current standard fields are not appropriate for all patients, because of poor coverage of PTV. To sum up, 3D CT planning is strongly recommended for patients with high BMI

Chemoradiation in Nasopharyngeal Carcinoma: A 6-Year Experience in Tehran Cancer Institute

To determine the addition of value of neoadjuvant, concurrent and adjuvant chemotherapy to radiation in the treatment of nasopharyngeal carcinoma with regard to the overall survival (OS) and disease free survival (DFS) within a six year period in Tehran cancer institute. Files of all patients with nasopharyngeal carcinoma treated by radiotherapy with or without concurrent chemotherapy in a curative setting in Tehran cancer institute during the period of 1999-2005 were retrospectively reviewed.. A total of 103 patients with nasopharyngeal carcinoma had been treated during the study period with radiotherapy or chemoradiotherapy in our institute. There were 29 (28.2%) females and 74 (71.8%) males. The median age at the time of radiotherapy was 47 years old (range 9-75 years). The patients were followed 2 to 76 months with a median follow-up of 14 months. Time of first recurrence after treatment was 3-44 months with a median of 10 months.. Survival in 2 groups of patients treated with radiotherapy alone or chemoradiation did not have a significant difference (P>0.1). Two-year survival in patients treated with or without adjuvant chemotherapy and had local recurrence after treatment did not have significant difference (P>0.1). Two-year survival in patients with or without local recurrence after treatment did not have significant difference (P>0.1). A beneficial affect or a survival benefit of adjuvant/neoadjuvant chemotherapy and concurrent chemoradiation was not observed in Iranian patients

Morbidity and Mortality Following Short Course Preoperative Radiotherapy in Rectal Carcinoma

The aim of this study was to evaluate the morbidity and mortality in patients with operable stage II and III rectal cancers within one or two months after surgery, who has been treated pre-operatively with short course radiotherapy. Twenty-eight patients with rectal adenocarcinoma, consecutively referred to the Cancer Institute of Imam Khomeini Hospital from March 2009 to March 2010, were selected for the study after staging by endorectal ultrasound and CT of abdomen, pelvis, and chest; and if they had inclusion criteria for short course schedule, they were treated with radiotherapy alone at 2500 cGy for 5 sessions, and then they were referred to the surgical service for operation one week later. They were visited there by a surgeon unaware of the research who completed a questionnaire about pre-operative, operative, and post-operative complications. Of 28 patients, 25 patients underwent either APR or LAR surgery with TME. One patient developed transient anal pain grade I and one patient had dysuria grade I; they were improved in subsequent follow-up. Short course schedule can be performed carefully in patients with staged rectal cancer without concerning about serious complications. This shorter treatment schedule is cost-effective and would be more convenient for patients due to fewer trips to the hospital and the main treatment, i.e. operating the patient, will be done with the shortest time the following diagnosis

Gastrointestinal Tumor Board: An Evolving Experience in Tehran Cancer Institute

Gastrointestinal (GI) cancers are a significant source of morbidity and mortality in Iran, with stomach adenocarcinoma as the most common cancer in men and the second common cancer in women. Also, some parts of Northern Iran have one of the highest incidences of esophageal cancer in the world. Multi-disciplinary organ-based joint clinics and tumor boards are a well-recognized necessity for modern treatment of cancer and are routinely utilized in developed countries, especially in major academic centres. But this concept is relatively new in developing countries, where cancer treatment centres are burdened by huge loads of patients and have to cope with a suboptimum availability of resources and facilities. Cancer Institute of Tehran University of Medical Sciences is the oldest and the only comprehensive cancer treatment centre in Iran, with a long tradition of a general tumor board for all cancers. But with the requirements of modern oncology, there has been a very welcome attention to sub-specialized organ-based tumor boards and joint clinics here in the past few years. Considering this, we started a multi-disciplinary tumor board for GI cancers in our institute in early 2010 as the first such endeavor here. We hereby review this 2-year evolving experience. The process of establishment of a GI tumor board, participations from different oncology disciplines and related specialties, the cancers presented and discussed in the 2 years of this tumor board, the general intents of treatment for the decisions made and the development of interest in this tumor board among the Tehran oncology community will be reviewed. The GI tumor board of Tehran Cancer Institute started its work in January 2010, with routine weekly sessions. A core group of 2 physicians from each surgical, radiation and medical oncology departments plus one gastroenterologist, GI pathologist and radiologist was formed, but participation from all interested physicians was encouraged. An electronic database was kept from the beginning. The number of patients presented in the tumor board increased from 4 in January 2010 to 16 in December 2011. Most patients were presented by radiation oncology department (38%) and then surgical (36%) and medical oncology (20%) departments. Physicians’ participation also grew from an average of 8 each session to 12 in the same months, with a number of cancer specialists taking part from other university hospitals in Tehran. A total number of 225 patients were presented with a treatment decision made in this 2-year period. The majority of cases were colorectal (32%), stomach (23%), and esophageal (17%) cancers. The number of pancreatic (7%) and hepatobiliary (6%) cancers were much smaller. Most decisions were for a primary treatment (surgery or radiochemotherapy) and then a neoadjuvant approach. Tehran Cancer Institute's GI tumor board is one of the first multi-disciplinary organ-based tumor boards in Iran, and as such has made a successful start, establishing itself as a recognized body for clinical decisions and consultations in GI oncology. This experience is growing and evolving, with newer presentation and discussion formats and adapted guidelines for treatment of GI cancers in Iran sought