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A Comparative Study of Deep Learning Dose Prediction Models for Cervical Cancer Volumetric Modulated Arc Therapy 宫颈癌容积调制弧治疗的深度学习剂量预测模型比较研究
IF 2.8 4区 医学 Q3 ONCOLOGY Pub Date : 2024-04-08 DOI: 10.1177/15330338241242654
Zhe Wu, Mujun Liu, Ya Pang, Lihua Deng, Yi Yang, Yi Wu
Purpose: Deep learning (DL) is widely used in dose prediction for radiation oncology, multiple DL techniques comparison is often lacking in the literature. To compare the performance of 4 state-of-the-art DL models in predicting the voxel-level dose distribution for cervical cancer volumetric modulated arc therapy (VMAT). Methods and Materials: A total of 261 patients’ plans for cervical cancer were retrieved in this retrospective study. A three-channel feature map, consisting of a planning target volume (PTV) mask, organs at risk (OARs) mask, and CT image was fed into the three-dimensional (3D) U-Net and its 3 variants models. The data set was randomly divided into 80% as training-validation and 20% as testing set, respectively. The model performance was evaluated on the 52 testing patients by comparing the generated dose distributions against the clinical approved ground truth (GT) using mean absolute error (MAE), dose map difference (GT-predicted), clinical dosimetric indices, and dice similarity coefficients (DSC). Results: The 3D U-Net and its 3 variants DL models exhibited promising performance with a maximum MAE within the PTV 0.83% ± 0.67% in the UNETR model. The maximum MAE among the OARs is the left femoral head, which reached 6.95% ± 6.55%. For the body, the maximum MAE was observed in UNETR, which is 1.19 ± 0.86%, and the minimum MAE was 0.94 ± 0.85% for 3D U-Net. The average error of the Dmean difference for different OARs is within 2.5 Gy. The average error of V40 difference for the bladder and rectum is about 5%. The mean DSC under different isodose volumes was above 90%. Conclusions: DL models can predict the voxel-level dose distribution accurately for cervical cancer VMAT treatment plans. All models demonstrated almost analogous performance for voxel-wise dose prediction maps. Considering all voxels within the body, 3D U-Net showed the best performance. The state-of-the-art DL models are of great significance for further clinical applications of cervical cancer VMAT.
目的:深度学习(DL)被广泛应用于放射肿瘤学的剂量预测,但文献中往往缺乏多种深度学习技术的比较。目的:比较 4 种最先进的深度学习模型在预测宫颈癌容积调制弧治疗(VMAT)的体素级剂量分布方面的性能。方法和材料:这项回顾性研究共检索了 261 例宫颈癌患者的计划。由计划靶体积(PTV)掩膜、危险器官(OARs)掩膜和 CT 图像组成的三通道特征图被输入到三维(3D)U-Net 及其 3 个变体模型中。数据集被随机分为 80% 作为训练验证集,20% 作为测试集。通过使用平均绝对误差(MAE)、剂量图差异(GT-预测)、临床剂量学指数和骰子相似系数(DSC),将生成的剂量分布与临床批准的地面实况(GT)进行比较,对 52 名测试患者的模型性能进行评估。结果:3D U-Net 及其 3 个变体 DL 模型表现出良好的性能,UNETR 模型在 PTV 内的最大 MAE 为 0.83% ± 0.67%。在 OAR 中,左股骨头的 MAE 最大,达到 6.95% ± 6.55%。在身体方面,UNETR 的 MAE 最大,为 1.19 ± 0.86%,而 3D U-Net 的 MAE 最小,为 0.94 ± 0.85%。不同 OAR 的 Dmean 差值平均误差在 2.5 Gy 以内。膀胱和直肠的 V40 差值平均误差约为 5%。不同等剂量体积下的平均 DSC 均高于 90%。结论DL 模型可以准确预测宫颈癌 VMAT 治疗计划的体素级剂量分布。所有模型在体素剂量预测图方面的表现几乎相似。考虑到体内的所有体素,3D U-Net 显示出最佳性能。最先进的 DL 模型对宫颈癌 VMAT 的进一步临床应用具有重要意义。
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引用次数: 0
Endometrial Cancer Detection by DNA Methylation Analysis in Cervical Papanicolaou Brush Samples 通过宫颈巴氏涂片刷样本中的 DNA 甲基化分析检测子宫内膜癌
IF 2.8 4区 医学 Q3 ONCOLOGY Pub Date : 2024-04-08 DOI: 10.1177/15330338241242637
San-feng Wang, Chong-yang Du, Mi Li, Bin Wen, Qing-jun Shen, Fang Ma, Liang Zhang, Hua Deng
Background: Endometrial cancer (EC) is the leading gynecological cancer worldwide, yet current EC screening approaches are not satisfying. The purpose of this retrospective study was to evaluate the feasibility and capability of DNA methylation analysis in cervical Papanicolaou (Pap) brush samples for EC detection. Methods: We used quantitative methylation-sensitive PCR (qMS-PCR) to determine the methylation status of candidate genes in EC tissue samples, as well as cervical Pap brushes. The ability of RASSF1A and HIST1H4F to serve as diagnostic markers for EC was then examined in cervical Pap brush samples from women with endometrial lesions of varying degrees of severity. Results: Methylated RASSF1A and HIST1H4F were found in EC tissues. Further, methylation of the two genes was also observed in cervical Pap smear samples from EC patients. Methylation levels of RASSF1A and HIST1H4F increased as endometrial lesions progressed, and cervical Pap brush samples from women affected by EC exhibited significantly higher levels of methylated RASSF1A and HIST1H4F compared to noncancerous controls ( P < .001). Receiver operating characteristic (ROC) curves and area under the curve (AUC) analyses revealed RASSF1A and HIST1H4F methylation with a combined AUC of 0.938 and 0.951 for EC/pre-EC detection in cervical Pap brush samples, respectively. Conclusion: These findings demonstrate that DNA methylation analysis in cervical Pap brush samples may be helpful for EC detection, broadening the scope of the commonly used cytological screening. Our proof-of-concept study provides new insights into the field of clinical EC diagnosis.
背景:子宫内膜癌(EC)是全球最主要的妇科癌症,但目前的EC筛查方法并不令人满意。这项回顾性研究的目的是评估宫颈巴氏涂片样本中的 DNA 甲基化分析用于检测子宫内膜癌的可行性和能力。方法:我们使用甲基化敏感定量 PCR(qMS-PCR)来确定宫颈癌组织样本和宫颈巴氏涂片刷样本中候选基因的甲基化状态。然后在患有不同严重程度子宫内膜病变的妇女的宫颈巴氏涂片样本中检测了 RASSF1A 和 HIST1H4F 作为宫颈癌诊断标记物的能力。结果显示在EC组织中发现了甲基化的RASSF1A和HIST1H4F。此外,在宫颈癌患者的宫颈涂片样本中也观察到了这两个基因的甲基化。RASSF1A和HIST1H4F的甲基化水平随着子宫内膜病变的进展而增加,与非癌变对照组相比,宫颈癌患者的宫颈涂片样本中RASSF1A和HIST1H4F的甲基化水平明显更高(P <.001)。接收者操作特征(ROC)曲线和曲线下面积(AUC)分析显示,在宫颈涂片样本中检测EC/EC前,RASSF1A和HIST1H4F甲基化的综合AUC分别为0.938和0.951。结论这些研究结果表明,宫颈涂片刷状样本中的DNA甲基化分析有助于检测EC,从而扩大了常用细胞学筛查的范围。我们的概念验证研究为临床EC诊断领域提供了新的见解。
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引用次数: 0
Blind Spots in Development of Nanomedicines 纳米药物开发中的盲点
IF 2.8 4区 医学 Q3 ONCOLOGY Pub Date : 2024-04-03 DOI: 10.1177/15330338241245342
Bhagyashree V. Salvi, Maithali Kantak, Kalyani Kharangate, Francesco Trotta, Timothy Maher, Pravin Shende
The field of nanomedicine demonstrates immense advantages and noteworthy expansion compared to conventional drug delivery systems like tablet, capsules, etc. Despite the innumerable advantages, it holds certain shortcomings in the form of blind spots that need to be assessed before the successful clinical translation. This perspective highlights the foremost blind spots in nanomedicine and emphasizes the challenges faced before the entry into the market, including the need for provision of safety and efficacy data by the regulatory agencies like FDA. The significant revolution of nanomedicine in the human life, particularly in patient well-being, necessitates to identify the blind spots and overcome them for effective management and treatment of ailments.
与片剂、胶囊等传统给药系统相比,纳米医学领域具有巨大的优势和显著的扩展性。尽管优势众多,但它也存在一些不足,即在成功临床转化之前需要评估的盲点。本视角突出了纳米医学的主要盲点,并强调了进入市场前所面临的挑战,包括需要美国食品及药物管理局等监管机构提供安全性和有效性数据。纳米医学在人类生活中,尤其是在患者福祉方面的重大变革需要找出盲点并加以克服,以有效管理和治疗疾病。
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引用次数: 0
Combined OLA1 and CLEC3B Gene Is a Prognostic Signature for Hepatocellular Carcinoma and Impact Tumor Progression OLA1 和 CLEC3B 基因的组合是肝细胞癌的预后特征并影响肿瘤进展
IF 2.8 4区 医学 Q3 ONCOLOGY Pub Date : 2024-04-02 DOI: 10.1177/15330338241241935
Zhoufeng Chen, Liuwei Zeng, Zhuoyan Chen, Jun Xu, Xiangting Zhang, Huiya Ying, Yuan Zeng, Fujun Yu
Hepatocellular carcinoma (HCC), partly because of its complexity and high heterogeneity, has a poor prognosis and an extremely high mortality rate. In this study, mRNA sequencing expression profiles and relevant clinical data of HCC patients were gathered from different public databases. Kaplan–Meier survival curves as well as ROC curves validated that OLA1|CLEC3B was an independent predictor with better predictive capability of HCC prognosis compared to OLA1 and CLEC3B separately. Further, the cell transfection experiment verified that knockdown of OLA1 inhibited cell proliferation, facilitated apoptosis, and improved sensitivity of HCC cells to gemcitabine. In this study, the prognostic model of HCC composed of OLA1/CLEC3B genes was constructed and verified, and the prediction ability was favorable. A higher level of OLA1 along with a lower level of CEC3B is a sign of poor prognosis in HCC. We revealed a novel gene pair OLA1|CLEC3B overexpressed in HCC patients, which may serve as a promising independent predictor of HCC survival and an approach for innovative diagnostic and therapeutic strategies.
肝细胞癌(HCC)由于其复杂性和高度异质性,预后较差,死亡率极高。本研究从不同的公共数据库中收集了 HCC 患者的 mRNA 测序表达谱和相关临床数据。Kaplan-Meier生存曲线和ROC曲线验证了OLA1|CLEC3B是一个独立的预测因子,与分别预测OLA1和CLEC3B相比,其对HCC预后的预测能力更强。此外,细胞转染实验验证了敲除 OLA1 可抑制细胞增殖,促进细胞凋亡,提高 HCC 细胞对吉西他滨的敏感性。本研究构建并验证了由 OLA1/CLEC3B 基因组成的 HCC 预后模型,其预测能力良好。OLA1水平较高而CEC3B水平较低是HCC预后不良的标志。我们揭示了一种新型基因对 OLA1|CLEC3B 在 HCC 患者中的过表达,这可能是预测 HCC 患者生存率的一种有希望的独立指标,也是创新诊断和治疗策略的一种方法。
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引用次数: 0
Constructing a Classification Model for Cervical Cancer Tumor Tissue and Normal Tissue Based on CT Radiomics. 基于CT放射组学构建宫颈癌肿瘤组织和正常组织的分类模型
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-01-01 DOI: 10.1177/15330338241298554
Jinghong Pei, Jing Yu, Ping Ge, Liman Bao, Haowen Pang, Huaiwen Zhang

This study aimed to develop an automated classification framework for distinguishing between cervical cancer tumor and normal uterine tissue, leveraging CT images for radiomics feature extraction. We retrospectively analyzed CT images from 117 cervical cancer patients. To distinguish between cancerous and healthy tissue, we segmented gross tumor volume and normal uterine tissue as distinct regions of interest (ROIs) using manual segmentation techniques. Key radiomic parameters were extracted from these ROIs. To bolster model's predictive capability, the data was stratified into train data (70%) and validation data (30%). During feature selection phase, we applied Least Absolute Shrinkage and Selection Operator regression algorithm to identify most relevant features. Subsequently, we built classification models using five state-of-the-art machine learning algorithms: Support Vector Machine (SVM), Random Forest (RF), K-Nearest Neighbors (KNN), Extreme Gradient Boosting (XGBoost), and Decision Tree (DT). Ultimately, the performance of each model was evaluated. Through stringent feature selection process, we identified 18 pivotal radiomic features for classification of cervical cancer and normal uterine tissue. When applied to test data, all five models achieved excellent performance, with area under the curve (AUC) values ranging from 0.8866 to 0.9190 (SVM: 0.9144, RF: 0.9078, KNN: 0.9051, DT: 0.8866, XGBoost: 0.9190), all surpassing threshold of 0.8. In terms of test data, all five models had high sensitivity; accuracy of SVM, RF, and XGBoost models was comparable; and specificity of five models was similar. XGBoost model outperformed the others in terms of diagnostic accuracy, achieving an AUC of 0.8737 (95% CI: 0.8198-0.9277) for train data and 0.9190 (95% CI: 0.8525-0.9854) for test data. Our findings underscore the potential of CT radiomics combined with machine learning algorithms for accurately classifying cervical cancer tumors and normal uterine tissue with high recognition capabilities. This approach holds significant promise for clinical diagnostics.

本研究旨在开发一种自动分类框架,利用 CT 图像进行放射组学特征提取,以区分宫颈癌肿瘤和正常子宫组织。我们对 117 名宫颈癌患者的 CT 图像进行了回顾性分析。为了区分癌组织和健康组织,我们使用手动分割技术将肿瘤总体积和正常子宫组织分割为不同的感兴趣区(ROI)。从这些 ROI 提取关键的放射学参数。为了增强模型的预测能力,我们将数据分为训练数据(70%)和验证数据(30%)。在特征选择阶段,我们采用最小绝对收缩和选择操作器回归算法来识别最相关的特征。随后,我们使用五种最先进的机器学习算法建立了分类模型:支持向量机(SVM)、随机森林(RF)、K-近邻(KNN)、极梯度提升(XGBoost)和决策树(DT)。最终,我们对每个模型的性能进行了评估。通过严格的特征选择过程,我们确定了用于宫颈癌和正常子宫组织分类的 18 个关键放射学特征。在应用于测试数据时,五个模型都取得了优异的表现,曲线下面积(AUC)值从 0.8866 到 0.9190 不等(SVM:0.9144;RF:0.9078;KNN:0.9051;DT:0.8866;XGBoost:0.9190),均超过了 0.8 的阈值。在测试数据方面,所有五个模型都具有较高的灵敏度;SVM、RF 和 XGBoost 模型的准确度相当;五个模型的特异性相似。XGBoost 模型的诊断准确性优于其他模型,训练数据的 AUC 为 0.8737(95% CI:0.8198-0.9277),测试数据的 AUC 为 0.9190(95% CI:0.8525-0.9854)。我们的研究结果凸显了 CT 放射组学与机器学习算法相结合的潜力,可准确地对宫颈癌肿瘤和正常子宫组织进行分类,并具有很高的识别能力。这种方法在临床诊断中大有可为。
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引用次数: 0
Erratum to "Integrating Therapeutic Ultrasound With Nanosized Drug Delivery Systems in the Battle Against Cancer". 将治疗性超声波与纳米药物输送系统集成用于抗癌》的勘误。
IF 2.8 4区 医学 Q3 ONCOLOGY Pub Date : 2024-01-01 DOI: 10.1177/15330338231223384
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引用次数: 0
Decanoylcarnitine Inhibits Triple-Negative Breast Cancer Progression via Mmp9 in an Intermittent Fasting Obesity Mouse. 癸酰肉碱通过 Mmp9 抑制间歇性禁食肥胖小鼠的三阴性乳腺癌进展
IF 2.8 4区 医学 Q3 ONCOLOGY Pub Date : 2024-01-01 DOI: 10.1177/15330338241233443
Yifan Tang, Shuai Chen, Saijun Wang, Ke Xu, Kun Zhang, Dongmei Wang, Ninghan Feng

Purpose: Treatment of triple-negative breast cancer (TNBC) remains challenging. Intermittent fasting (IF) has emerged as a promising approach to improve metabolic health of various metabolic disorders. Clinical studies indicate IF is essential for TNBC progression. However, the molecular mechanisms underlying metabolic remodeling in regulating IF and TNBC progression are still unclear. Methods: In this study, we utilized a robust mouse model of TNBC and exposed subjects to a high-fat diet (HFD) with IF to explore its impact on the metabolic reprogramming linked to cancer progression. To identify crucial serum metabolites and signaling events, we utilized targeted metabolomics and RNA sequencing (RNA-seq). Furthermore, we conducted immunoblotting, real-time quantitative polymerase chain reaction (RT-qPCR), cell migration assays, lentivirus-mediated Mmp9 overexpression, and Mmp9 inhibitor experiments to elucidate the role of decanoylcarnitine/Mmp9 in TNBC cell migration. Results: Our observations indicate that IF exerts notable inhibitory effects on both the proliferation and cancer metastasis. Utilizing targeted metabolomics and RNA-seq, we initially identified pivotal serum metabolites and signaling events in the progression of TNBC. Among the 349 serum metabolites identified, decanoylcarnitine was picked out to inhibit TNBC cell proliferation and migration. RNA-seq analysis of TNBC cells treated with decanoylcarnitine revealed its suppressive effects on extracellular matrix-related protein components, with a notable reduction observed in Mmp9. Further investigations confirmed that decanoylcarnitine could inhibit Mmp9 expression in TNBC cells, primary tumors, lung, and liver metastasis tissues. Mmp9 overexpression abolished the inhibitory effect of decanoylcarnitine on cell migration. Conclusion: This study pioneers the exploration of IF intervention and the role of decanoylcarnitine/Mmp9 in the progression of TNBC in obese mice, enhancing our comprehension of the potential roles of various dietary patterns in the process of cancer treatment.

目的:三阴性乳腺癌(TNBC)的治疗仍然具有挑战性。间歇性禁食(IF)已成为改善各种代谢紊乱的代谢健康的一种有前途的方法。临床研究表明,间歇性禁食对 TNBC 的进展至关重要。然而,调节 IF 和 TNBC 进展的代谢重塑的分子机制仍不清楚。研究方法在本研究中,我们利用了一种强健的 TNBC 小鼠模型,并让受试者暴露于含有 IF 的高脂饮食 (HFD),以探索其对与癌症进展相关的代谢重塑的影响。为了确定关键的血清代谢物和信号转导事件,我们采用了靶向代谢组学和 RNA 测序(RNA-seq)技术。此外,我们还进行了免疫印迹、实时定量聚合酶链反应(RT-qPCR)、细胞迁移试验、慢病毒介导的 Mmp9 过表达和 Mmp9 抑制剂实验,以阐明癸酰肉碱/Mmp9 在 TNBC 细胞迁移中的作用。结果:我们的观察结果表明,IF对细胞增殖和癌细胞转移都有显著的抑制作用。利用靶向代谢组学和 RNA-seq 技术,我们初步确定了 TNBC 进展过程中的关键血清代谢物和信号转导事件。在确定的 349 种血清代谢物中,我们发现癸酰肉碱能抑制 TNBC 细胞的增殖和迁移。用癸酰肉碱处理TNBC细胞的RNA-seq分析显示,癸酰肉碱对细胞外基质相关蛋白成分有抑制作用,其中Mmp9的含量明显减少。进一步研究证实,癸酰肉碱可抑制Mmp9在TNBC细胞、原发肿瘤、肺部和肝转移组织中的表达。Mmp9的过表达可消除癸酰肉碱对细胞迁移的抑制作用。结论这项研究开创性地探索了中和食物干预和癸酰肉碱/Mmp9在肥胖小鼠TNBC进展过程中的作用,加深了我们对各种饮食模式在癌症治疗过程中的潜在作用的理解。
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引用次数: 0
HCC-Check: A Novel Diagnostic Tool for Early Detection of Hepatocellular Carcinoma Based on Cytokeratin-1 and Epithelial Membrane Antigen: A Cross-Sectional Study. HCC-Check:基于细胞角蛋白-1 和上皮细胞膜抗原的肝细胞癌早期诊断新工具:一项横断面研究。
IF 2.8 4区 医学 Q3 ONCOLOGY Pub Date : 2024-01-01 DOI: 10.1177/15330338241234790
Kareem A Attallah, Mohamed S Albannan, Khaled Farid, Sherine M Rizk, Nevine Fathy

Background: Hepatocellular carcinoma is frequently diagnosed in advanced stages, leading to a poorer prognosis. Therefore, early diagnosis and identification of biomarkers may significantly improve outcomes. Methods: This cross-sectional study enrolled 486 participants distributed among 3 groups: F1 to F3 = 184, F4 = 183, and hepatocellular carcinoma = 119. Liver fibrosis staging was performed using FibroScan, while imaging features were used for hepatocellular carcinoma detection. Epithelial membrane antigen and cytokeratin-1 levels in serum were quantified through Western blot and ELISA, respectively. Results: Patients diagnosed with hepatocellular carcinoma exhibited significantly elevated levels of epithelial membrane antigen and cytokeratin-1 compared to non-hepatocellular carcinoma patients, with a highly significant statistical difference (P < .0001). Epithelial membrane antigen demonstrated diagnostic performance with an area under the curve of 0.75, a sensitivity of 69.0%, and a specificity of 68.5%. Cytokeratin-1 for the identification of hepatocellular carcinoma showed a sensitivity of 79.0% and a specificity of 81.4%, resulting in an area under the curve of 0.87. The developed HCC-Check, which incorporates epithelial membrane antigen, cytokeratin-1, albumin, and alpha-fetoprotein, displayed a higher area under the curve of 0.95 to identify hepatocellular carcinoma, with a sensitivity of 89.8% and a specificity of 83.9%. Notably, HCC-Check values exceeding 2.57 substantially increased the likelihood of hepatocellular carcinoma, with an estimated odds ratio of 50.65, indicating a higher susceptibility to hepatocellular carcinoma development than those with lower values. The HCC-Check diagnostic test exhibited high precision in identifying patients with hepatocellular carcinoma, particularly those with small tumor sizes (<5 cm) and a single nodule, as reflected in area under the curve values of 0.92 and 0.85, respectively. HCC-Check was then applied to the validation study to test its accuracy and reproducibility, showing superior area under the curves for identifying different stages of hepatocellular carcinoma. These outcomes underscore the effectiveness of the test in the early detection of hepatocellular carcinoma. Conclusion: The HCC-Check test presents a highly accurate diagnostic method for detecting hepatocellular carcinoma in its early stages.

背景:肝细胞癌通常在晚期才被诊断出来,预后较差。因此,早期诊断和确定生物标志物可显著改善预后。研究方法这项横断面研究共招募了 486 名参与者,分为 3 组:F1至F3=184人,F4=183人,肝细胞癌=119人。肝纤维化分期采用 FibroScan,肝细胞癌检测采用成像特征。血清中的上皮膜抗原和细胞角蛋白-1水平分别通过Western印迹和ELISA法进行量化。结果与非肝细胞癌患者相比,确诊为肝细胞癌的患者上皮膜抗原和细胞角蛋白-1的水平明显升高,且统计学差异非常显著(P 结论:HCC-Check检测方法是一种非常有效的肝细胞癌检测方法:HCC-Check 检验是一种高度准确的诊断方法,可用于检测早期肝细胞癌。
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引用次数: 0
The Value of Topological Radiomics Analysis in Predicting Malignant Risk of Pulmonary Ground-Glass Nodules: A Multi-Center Study. 拓扑放射组学分析在预测肺磨玻璃结节恶性风险中的价值:一项多中心研究
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-01-01 DOI: 10.1177/15330338241287089
Miaoyu Wang, Yuanhui Wei, Minghui Zhu, Hang Yu, Chaomin Guo, Zhigong Chen, Wenjia Shi, Jiabo Ren, Wei Zhao, Zhen Yang, Liang-An Chen

Background: Early detection and accurate differentiation of malignant ground-glass nodules (GGNs) in lung CT scans are crucial for the effective treatment of lung adenocarcinoma. However, existing imaging diagnostic methods often struggle to distinguish between benign and malignant GGNs in the early stages. This study aims to predict the malignancy risk of GGNs observed in lung CT scans by applying two radiomics methods: topological data analysis and texture analysis.

Methods: A retrospective analysis was conducted on 3223 patients from two centers between January 2018 and June2023. The dataset was divided into training, testing, and validation sets to ensure robust model development and validation. We developed topological features applied to GGNs using radiomics analysis based on homology. This innovative approach emphasizes the integration of topological information, capturing complex geometric and spatial relationships within GGNs. By combining machine learning and deep learning algorithms, we established a predictive model that integrates clinical parameters, previous radiomics features, and topological radiomics features.

Results: Incorporating topological radiomics into our model significantly enhanced the ability to distinguish between benign and malignant GGNs. The topological radiomics model achieved areas under the curve (AUC) of 0.85 and 0.862 in two independent validation sets, outperforming previous radiomics models. Furthermore, this model demonstrated higher sensitivity compared to models based solely on clinical parameters, with sensitivities of 80.7% in validation set 1 and 82.3% in validation set 2. The most comprehensive model, which combined clinical parameters, previous radiomics features, and topological radiomics features, achieved the highest AUC value of 0.879 across all datasets.

Conclusion: This study validates the potential of topological radiomics in improving the predictive performance for distinguishing between benign and malignant GGNs. By integrating topological features with previous radiomics and clinical parameters, our comprehensive model provides a more accurate and reliable basis for developing treatment strategies for patients with GGNs.

背景:肺部 CT 扫描中恶性磨玻璃结节(GGN)的早期发现和准确鉴别对于有效治疗肺腺癌至关重要。然而,现有的成像诊断方法往往难以在早期阶段区分良性和恶性地玻璃结节。本研究旨在通过拓扑数据分析和纹理分析这两种放射组学方法,预测肺部CT扫描中观察到的GGN的恶性风险:在2018年1月至2023年6月期间,对两个中心的3223名患者进行了回顾性分析。数据集被分为训练集、测试集和验证集,以确保模型开发和验证的稳健性。我们利用基于同源性的放射组学分析,开发了适用于 GGN 的拓扑特征。这种创新方法强调整合拓扑信息,捕捉 GGN 内复杂的几何和空间关系。通过结合机器学习和深度学习算法,我们建立了一个预测模型,该模型整合了临床参数、以往的放射组学特征和拓扑放射组学特征:结果:将拓扑放射组学纳入我们的模型大大提高了区分良性和恶性GGN的能力。在两个独立验证集中,拓扑放射组学模型的曲线下面积(AUC)分别达到了0.85和0.862,优于之前的放射组学模型。此外,与仅基于临床参数的模型相比,该模型的灵敏度更高,在验证集 1 中的灵敏度为 80.7%,在验证集 2 中的灵敏度为 82.3%。最全面的模型结合了临床参数、先前的放射组学特征和拓扑放射组学特征,在所有数据集中获得了最高的AUC值0.879:本研究验证了拓扑放射组学在提高区分良性和恶性 GGN 的预测性能方面的潜力。通过将拓扑特征与先前的放射组学和临床参数相结合,我们的综合模型为制定 GGN 患者的治疗策略提供了更准确、更可靠的依据。
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引用次数: 0
Assessing the Impact of a 1.5 T Transverse Magnetic Field in Radiotherapy for Esophageal Cancer Patients. 评估 1.5 T 横向磁场对食道癌患者放疗的影响
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-01-01 DOI: 10.1177/15330338241227291
Yukun Li, Baosheng Li, Jian Zhu, Yong Yin, Zhenjiang Li

Purpose: Magnetic resonance (MR)-guided radiotherapy enables visualization of static anatomy, capturing tumor motion, and extracting quantitative image features for treatment verification and outcome monitoring. However, magnetic fields in online MR imaging (MRI) require efforts to ensure accurate dose measurements. This study aimed to assess the dosimetric impact of a 1.5 T magnetic field in esophageal cancer radiotherapy using MR-linac, exploring treatment adaptation potential and personalized medicine benefits. Methods: A prospective cohort study enrolled 100 esophageal squamous cell carcinoma patients undergoing 4DCT and 3DCT scans before radiotherapy. The heart was contoured on 3DCT, 4DCT end expiration (EE), and 4DCT end inhalation (EI) images by the same radiation oncologist. Reference RT plans were designed on 3DCT, with adjustments for different phases generating 5 plan types per patient. Variations in dose-volume parameters for organs at risk and the target area among different plans were compared using Monaco 5.40.04. Results: Slight dose distortions at air-tissue interfaces were observed in the magnetic field's presence. Dose at air-tissue interfaces (chest wall and heart wall) was slightly higher in some patients (3.0% tissue increased by 4.3 Gy on average) compared to nonmagnetic conditions. Average clinical target volume coverage V100 dropped from 99% to 95% compared to reference plans (planEI and planEE). Dose-volume histogram variation between the original plan and reference plans was within 2.3%. Superior-inferior (SI) direction displacement was significantly larger than lateral and anterior-posterior directions (P < .05). Conclusion: Significant SI direction shift in lower esophageal cancerous regions during RT indicates the magnetic field's dosimetric impact, including the electron return effect at tissue-air boundaries. Changes in OAR dose could serve as valuable indicators of organ impairment and target dose alterations, especially for cardiac tissue when using the 1.5 T linac method. Reoptimizing the plan with the magnetic field enhances the feasibility of achieving a clinically acceptable treatment plan for esophageal cancer patients.

目的:磁共振(MR)引导的放射治疗可实现静态解剖的可视化,捕捉肿瘤运动,并提取定量图像特征用于治疗验证和结果监测。然而,在线磁共振成像(MRI)中的磁场需要努力确保准确的剂量测量。本研究旨在利用 MR-linac 评估 1.5 T 磁场在食管癌放疗中的剂量学影响,探索治疗适应性潜力和个性化医疗优势。研究方法一项前瞻性队列研究招募了100名食管鳞状细胞癌患者,他们在放疗前接受了4DCT和3DCT扫描。由同一位放射肿瘤专家在三维CT、四维CT呼气末(EE)和四维CT吸气末(EI)图像上绘制心脏轮廓。在 3DCT 上设计参考 RT 计划,并根据不同阶段进行调整,为每位患者生成 5 种计划类型。使用 Monaco 5.40.04 比较了不同计划中危险器官和靶区的剂量-体积参数变化。结果:在磁场存在的情况下,观察到空气-组织界面有轻微的剂量失真。与无磁条件相比,一些患者的空气-组织界面(胸壁和心壁)剂量略高(3.0%的组织平均增加 4.3 Gy)。与参考计划(planEI 和 planEE)相比,平均临床靶体积覆盖率 V100 从 99% 降至 95%。原始计划与参考计划之间的剂量-体积直方图差异在 2.3% 以内。上-下(SI)方向的位移明显大于侧向和前-后方向(P 结论:上-下(SI)方向的位移明显大于侧向和前-后方向:下食管癌区在 RT 过程中出现明显的 SI 方向移动表明磁场对剂量学产生了影响,包括组织-空气边界的电子回流效应。OAR剂量的变化可作为器官损伤和靶剂量改变的重要指标,尤其是在使用1.5 T线性加速器时对心脏组织的影响。利用磁场重新优化计划可提高食管癌患者获得临床可接受治疗计划的可行性。
{"title":"Assessing the Impact of a 1.5 T Transverse Magnetic Field in Radiotherapy for Esophageal Cancer Patients.","authors":"Yukun Li, Baosheng Li, Jian Zhu, Yong Yin, Zhenjiang Li","doi":"10.1177/15330338241227291","DOIUrl":"10.1177/15330338241227291","url":null,"abstract":"<p><p><b>Purpose:</b> Magnetic resonance (MR)-guided radiotherapy enables visualization of static anatomy, capturing tumor motion, and extracting quantitative image features for treatment verification and outcome monitoring. However, magnetic fields in online MR imaging (MRI) require efforts to ensure accurate dose measurements. This study aimed to assess the dosimetric impact of a 1.5 T magnetic field in esophageal cancer radiotherapy using MR-linac, exploring treatment adaptation potential and personalized medicine benefits. <b>Methods:</b> A prospective cohort study enrolled 100 esophageal squamous cell carcinoma patients undergoing 4DCT and 3DCT scans before radiotherapy. The heart was contoured on 3DCT, 4DCT end expiration (EE), and 4DCT end inhalation (EI) images by the same radiation oncologist. Reference RT plans were designed on 3DCT, with adjustments for different phases generating 5 plan types per patient. Variations in dose-volume parameters for organs at risk and the target area among different plans were compared using Monaco 5.40.04. <b>Results:</b> Slight dose distortions at air-tissue interfaces were observed in the magnetic field's presence. Dose at air-tissue interfaces (chest wall and heart wall) was slightly higher in some patients (3.0% tissue increased by 4.3 Gy on average) compared to nonmagnetic conditions. Average clinical target volume coverage V100 dropped from 99% to 95% compared to reference plans (planEI and planEE). Dose-volume histogram variation between the original plan and reference plans was within 2.3%. Superior-inferior (SI) direction displacement was significantly larger than lateral and anterior-posterior directions (<i>P</i> < .05). <b>Conclusion:</b> Significant SI direction shift in lower esophageal cancerous regions during RT indicates the magnetic field's dosimetric impact, including the electron return effect at tissue-air boundaries. Changes in OAR dose could serve as valuable indicators of organ impairment and target dose alterations, especially for cardiac tissue when using the 1.5 T linac method. Reoptimizing the plan with the magnetic field enhances the feasibility of achieving a clinically acceptable treatment plan for esophageal cancer patients.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"23 ","pages":"15330338241227291"},"PeriodicalIF":2.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10807384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Technology in Cancer Research & Treatment
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