A Multimodal Knowledge-Based Deep Learning Approach for MGMT Promoter Methylation Identification

Glioblastoma Multiforme (GBM) is considered one of the most aggressive malignant tumors, characterized by a tremendously low survival rate. Despite alkylating chemotherapy being typically adopted to fight this tumor, it is known that O(6)-methylguanine-DNA methyltransferase (MGMT) enzyme repair abilities can antagonize the cytotoxic effects of alkylating agents, strongly limiting tumor cell destruction. However, it has been observed that MGMT promoter regions may be subject to methylation, a biological process preventing MGMT enzymes from removing the alkyl agents. As a consequence, the presence of the methylation process in GBM patients can be considered a predictive biomarker of response to therapy and a prognosis factor. Unfortunately, identifying signs of methylation is a non-trivial matter, often requiring expensive, time-consuming, and invasive procedures. In this work, we propose to face MGMT promoter methylation identification analyzing Magnetic Resonance Imaging (MRI) data using a Deep Learning (DL) based approach. In particular, we propose a Convolutional Neural Network (CNN) operating on suspicious regions on the FLAIR series, pre-selected through an unsupervised Knowledge-Based filter leveraging both FLAIR and T1-weighted series. The experiments, run on two different publicly available datasets, show that the proposed approach can obtain results comparable to (and in some cases better than) the considered competitor approach while consisting of less than 0.29% of its parameters. Finally, we perform an eXplainable AI (XAI) analysis to take a little step further toward the clinical usability of a DL-based approach for MGMT promoter detection in brain MRI

Fingerprint Presentation Attacks: Tackling the Ongoing Arms Race in Biometric Authentication

The widespread use of Automated Fingerprint Identification Systems (AFIS) in consumer electronics opens for the development of advanced presentation attacks, i.e. procedures designed to bypass an AFIS using a forged fingerprint. As a consequence, AFIS are often equipped with a fingerprint presentation attack detection (FPAD) module, to recognize live fingerprints from fake replicas, in order to both minimize the risk of unauthorized access and avoid pointless computations. The ongoing arms race between attackers and detector designers demands a comprehensive understanding of both the defender’s and attacker’s perspectives to develop robust and efficient FPAD systems. This paper proposes a dual-perspective approach to FPAD, which encompasses the presentation of a new technique for carrying out presentation attacks starting from perturbed samples with adversarial techniques and the presentation of a new detection technique based on an adversarial data augmentation strategy. In this case, attack and defence are based on the same assumptions demonstrating that this dual research approach can be exploited to enhance the overall security of fingerprint recognition systems against spoofing attacks

CNN-Based Approaches with Different Tumor Bounding Options for Lymph Node Status Prediction in Breast DCE-MRI

Background: The axillary lymph node status (ALNS) is one of the most important prognostic factors in breast cancer (BC) patients, and it is currently evaluated by invasive procedures. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), highlights the physiological and morphological characteristics of primary tumor tissue. Deep learning approaches (DL), such as convolutional neural networks (CNNs), are able to autonomously learn the set of features directly from images for a specific task. Materials and Methods: A total of 155 malignant BC lesions evaluated via DCE-MRI were included in the study. For each patient’s clinical data, the tumor histological and MRI characteristics and axillary lymph node status (ALNS) were assessed. LNS was considered to be the final label and dichotomized (LN+ (27 patients) vs. LN− (128 patients)). Based on the concept that peritumoral tissue contains valuable information about tumor aggressiveness, in this work, we analyze the contributions of six different tumor bounding options to predict the LNS using a CNN. These bounding boxes include a single fixed-size box (SFB), a single variable-size box (SVB), a single isotropic-size box (SIB), a single lesion variable-size box (SLVB), a single lesion isotropic-size box (SLIB), and a two-dimensional slice (2DS) option. According to the characteristics of the volumes considered as inputs, three different CNNs were investigated: the SFB-NET (for the SFB), the VB-NET (for the SVB, SIB, SLVB, and SLIB), and the 2DS-NET (for the 2DS). All the experiments were run in 10-fold cross-validation. The performance of each CNN was evaluated in terms of accuracy, sensitivity, specificity, the area under the ROC curve (AUC), and Cohen’s kappa coefficient (K). Results: The best accuracy and AUC are obtained by the 2DS-NET (78.63% and 77.86%, respectively). The 2DS-NET also showed the highest specificity, whilst the highest sensibility was attained by the VB-NET based on the SVB and SIB as bounding options. Conclusion: We have demonstrated that a selective inclusion of the DCE-MRI’s peritumoral tissue increases accuracy in the lymph node status prediction in BC patients using CNNs as a DL approach

Leveraging Artificial Intelligence to Fight (Cyber)Bullying for Human Well-being: The BullyBuster Project

Bullying and cyberbullying are phenomena which, due to their growing diffusion, have become a real social emergency. In this context, artificial intelligence can be a powerful weapon to identify episodes of violence and fight bullying both in the virtual and in the real world. Through machine learning, it is possible to detect the language patterns used by bullies and their victims and develop rules to detect cyberbullying content automatically. The BullyBuster project merges the know-how of four interdisciplinary research groups to develop a framework useful for maintaining psycho-physical well-being in educational contexts

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Cross-modality calibration in multi-input network for axillary lymph node metastasis evaluation

The use of deep neural networks (DNNs) in medical images has enabled the development of solutions characterized by the need of leveraging information coming from multiple sources, raising the Multimodal Deep Learning. DNNs are known for their ability to provide hierarchical and high-level representations of input data. This capability has led to the introduction of methods performing data fusion at an intermediate level, preserving the distinctiveness of the heterogeneous sources in modality-specific paths, while learning the way to define an effective combination in a shared representation. However, modeling the intricate relationships between different data remains an open issue. In this paper, we aim to improve the integration of data coming from multiple sources. We introduce between layers belonging to different modality-specific paths a Transfer Module (TM) able to perform the cross-modality calibration of the extracted features, reducing the effects of the less discriminative ones. As case of study, we focus on the axillary lymph nodes metastasis evaluation in malignant breast cancer, a crucial prognostic factor, affecting patient’s survival. We propose a Multi-Input Single-Output 3D Convolutional Neural Network (CNN) that considers both images acquired with multiparametric Magnetic Resonance and clinical information. In particular, we assess the proposed methodology using four architectures, namely BasicNet and three ResNet variants, showing the improvement of the performance obtained by including the TM in the network configuration. Our results achieve up to 90% and 87% of accuracy and Area under ROC curve, respectively when the ResNet10 is considered, surpassing various fusion strategies proposed in the literature.

Evaluating Tumour Bounding Options for Deep Learning-based Axillary Lymph Node Metastasis Prediction in Breast Cancer

The involvement of axillary lymph node metastasis in breast cancer is one of the most important independent prognostic factors. While the metastasis of lymph node depends on primary tumour intrinsic behaviour, morphology and angioinvasivity, the involvement of the peritumoral tissue by the neoplastic cells also provides useful information for the potential tumour aggressiveness. The lymph node status is currently evaluated by histological invasive procedures with possible complications, asking for introducing safer approaches. Among different imaging techniques, the Dynamic Contrast Enhanced-Magnetic Resonance Imaging (DCE-MRI) highlights physiological and morphological characteristics, reflecting breast lesions behaviour and aggressiveness. In the recent years, deep learning (DL) approaches, such as Convolutional Neural Networks, gained increasing popularity for biomedical image processing. Thanks to their ability to autonomously learn from images the set of features for the specific task to solve, they allow finding non-invasive alternatives to the standard procedures used up to now. This paper aims to evaluate the applicability of DL approaches for the axillary lymph node metastasis prediction, considering primary tumour DCE-MRI sequence. Differently from other work in the literature, we include a detailed analysis of healthy tissue influence in lymph node tumour spread through the evaluation of different tumour bounding options. Promising results are reported on a dataset of 153 patients with 155 malignant lesions