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Quantifying Smooth Muscles Regional Organization in the Rat Bladder Using Immunohistochemistry, Multiphoton Microscopy and Machine Learning 利用免疫组化、多光子显微镜和机器学习量化大鼠膀胱平滑肌的区域组织结构
Pub Date : 2024-05-08 DOI: arxiv-2405.04790
Alireza Asadbeygi, Yasutaka Tobe, Naoki Yoshimura, Sean D. Stocker, Simon Watkins, Paul Watton, Anne M. Robertson
The smooth muscle bundles (SMBs) in the bladder act as contractile elementswhich enable the bladder to void effectively. In contrast to skeletal muscles,these bundles are not highly aligned, rather they are oriented moreheterogeneously throughout the bladder wall. In this work, for the first time,this regional orientation of the SMBs is quantified across the whole bladder,without the need for optical clearing or cryosectioning. Immunohistochemistrystaining was utilized to visualize smooth muscle cell actin in multiphotonmicroscopy (MPM) images of bladder smooth muscle bundles (SMBs). Featurevectors for each pixel were generated using a range of filters, includingGaussian blur, Gaussian gradient magnitude, Laplacian of Gaussian, Hessianeigenvalues, structure tensor eigenvalues, Gabor, and Sobel gradients. A RandomForest classifier was subsequently trained to automate the segmentation of SMBsin the MPM images. Finally, the orientation of SMBs in each bladder region wasquantified using the CT-FIRE package. This information is essential forbiomechanical models of the bladder that include contractile elements.
膀胱中的平滑肌束(SMB)是膀胱有效排尿的收缩元件。与骨骼肌不同的是,这些肌束并非高度排列整齐,而是在整个膀胱壁上均匀分布。在这项研究中,首次对整个膀胱的 SMB 的区域定向进行了量化,而无需进行光学清除或冷冻切片。免疫组化染色被用来观察多光子显微镜(MPM)图像中膀胱平滑肌束(SMB)的平滑肌细胞肌动蛋白。利用一系列滤波器生成了每个像素的特征向量,包括高斯模糊、高斯梯度幅度、高斯拉普拉斯、Hessianeigenvalues、结构张量特征值、Gabor 和 Sobel 梯度。随后对随机森林分类器进行了训练,以自动分割 MPM 图像中的 SMB。最后,使用 CT-FIRE 软件包量化了每个膀胱区域中 SMB 的方向。这些信息对于包含收缩元件的膀胱生物力学模型至关重要。
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引用次数: 0
A Step Test to Evaluate the Susceptibility to Severe High-Altitude Illness in Field Conditions 在野外条件下评估严重高海拔疾病易感性的步骤测试
Pub Date : 2024-05-03 DOI: arxiv-2405.01896
Eric HermandURePSSS, H&P, Léo LesaintH&P, Laura DenisH&P, Jean-Paul RichaletINSEP, François LhuissierH&P
A laboratory-based hypoxic exercise test, performed on a cycle ergometer, canbe used to predict susceptibility to severe high-altitude illness (SHAI)through the calculation of a clinicophysiological SHAI score. Our objective wasto design a field-condition test and compare its derived SHAI score and variousphysiological parameters, such as peripheral oxygen saturation (SpO2), andcardiac and ventilatory responses to hypoxia during exercise (HCRe and HVRe,respectively), to the laboratory test. A group of 43 healthy subjects (15females and 28 males), with no prior experience at high altitude, performed ahypoxic cycle ergometer test (simulated altitude of 4,800 m) and step tests (20cm high step) at 3,000, 4,000, and 4,800 m simulated altitudes. According totested altitudes, differences were observed in O2 desaturation, heart rate, andminute ventilation (p < 0.001), whereas the computed HCRe and HVRe were notdifferent (p = 0.075 and p = 0.203, respectively). From the linearrelationships between the step test and SHAI scores, we defined a risk zone,allowing us to evaluate the risk of developing SHAI and take adequatepreventive measures in field conditions, from the calculated step test scorefor the given altitude. The predictive value of this new field test remains tobe validated in real high-altitude conditions.
在自行车测力计上进行的实验室缺氧运动测试可通过计算临床生理学 SHAI 分数来预测对严重高海拔疾病(SHAI)的易感性。我们的目的是设计一种现场条件测试,并将其得出的 SHAI 评分和各种生理参数(如外周血氧饱和度(SpO2)、运动时心脏和呼吸对缺氧的反应(分别为 HCRe 和 HVRe))与实验室测试进行比较。一组 43 名没有高海拔经验的健康受试者(15 名女性和 28 名男性)分别在模拟海拔 3,000 米、4,000 米和 4,800 米处进行了缺氧循环测力计测试(模拟海拔 4,800 米)和台阶测试(20 厘米高台阶)。根据测试海拔高度,观察到氧气饱和度、心率和分钟通气量存在差异(p < 0.001),而计算得出的 HCRe 和 HVRe 没有差异(分别为 p = 0.075 和 p = 0.203)。根据台阶试验和 SHAI 分数之间的线性关系,我们定义了一个风险区,从而可以根据计算出的特定海拔高度的台阶试验分数,评估罹患 SHAI 的风险,并在野外条件下采取适当的预防措施。这种新的野外测试的预测价值还有待在真实的高海拔条件下进行验证。
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引用次数: 0
SCIMAP: A Python Toolkit for Integrated Spatial Analysis of Multiplexed Imaging Data SCIMAP:用于多路复用成像数据综合空间分析的 Python 工具包
Pub Date : 2024-05-03 DOI: arxiv-2405.02076
Ajit J. Nirmal, Peter K. Sorger
Multiplexed imaging data are revolutionizing our understanding of thecomposition and organization of tissues and tumors. A critical aspect of suchtissue profiling is quantifying the spatial relationship relationships amongcells at different scales from the interaction of neighboring cells torecurrent communities of cells of multiple types. This often involvesstatistical analysis of 10^7 or more cells in which up to 100 biomolecules(commonly proteins) have been measured. While software tools currently cater tothe analysis of spatial transcriptomics data, there remains a need for toolkitsexplicitly tailored to the complexities of multiplexed imaging data includingthe need to seamlessly integrate image visualization with data analysis andexploration. We introduce SCIMAP, a Python package specifically crafted toaddress these challenges. With SCIMAP, users can efficiently preprocess,analyze, and visualize large datasets, facilitating the exploration of spatialrelationships and their statistical significance. SCIMAP's modular designenables the integration of new algorithms, enhancing its capabilities forspatial analysis.
多重成像数据正在彻底改变我们对组织和肿瘤的构成和组织的认识。这种组织图谱分析的一个重要方面是量化不同尺度细胞之间的空间关系,从相邻细胞的相互作用到多种类型细胞的经常性群落。这通常需要对多达 100 种生物大分子(通常是蛋白质)的 10^7 或更多细胞进行统计分析。虽然目前的软件工具可以满足空间转录组学数据分析的需要,但仍然需要专门针对多路复用成像数据的复杂性量身定制的工具包,包括将图像可视化与数据分析和探索无缝集成的需要。我们介绍了 SCIMAP,这是一个专为应对这些挑战而设计的 Python 软件包。有了 SCIMAP,用户可以高效地预处理、分析和可视化大型数据集,促进对空间关系及其统计意义的探索。SCIMAP 的模块化设计可以集成新的算法,从而增强其空间分析能力。
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引用次数: 0
Fluid-structure interaction simulations for the prediction of fractional flow reserve in pediatric patients with anomalous aortic origin of a coronary artery 流体-结构相互作用模拟用于预测冠状动脉主动脉起源异常的儿科患者的部分血流储备量
Pub Date : 2024-05-02 DOI: arxiv-2405.01703
Charles Puelz, Craig G. Rusin, Dan Lior, Shagun Sachdeva, Tam T. Doan, Lindsay F. Eilers, Dana Reaves-O'Neal, Silvana Molossi
Computer simulations of blood flow in patients with anomalous aortic originof a coronary artery (AAOCA) have the promise to provide insight into thiscomplex disease. They provide an in-silico experimental platform to explorepossible mechanisms of myocardial ischemia, a potentially deadly complicationfor patients with this defect. This paper focuses on the question of modelcalibration for fluid-structure interaction models of pediatric AAOCA patients.Imaging and cardiac catheterization data provide partial information for modelconstruction and calibration. However, parameters for downstream boundaryconditions needed for these models are difficult to estimate. Further,important model predictions, like fractional flow reserve (FFR), are sensitiveto these parameters. We describe an approach to calibrate downstream boundarycondition parameters to clinical measurements of resting FFR. The calibratedmodels are then used to predict FFR at stress, an invasively measured quantitythat can be used in the clinical evaluation of these patients. We findreasonable agreement between the model predicted and clinically measured FFR atstress, indicating the credibility of this modeling framework for predictinghemodynamics of pediatric AAOCA patients. This approach could lead to importantclinical applications since it may serve as a tool for risk stratifyingchildren with AAOCA.
对冠状动脉主动脉起源异常(AAOCA)患者的血流进行计算机模拟,有望让人们深入了解这种复杂的疾病。计算机模拟为探索心肌缺血的可能机制提供了一个实验室内实验平台,而心肌缺血是冠状动脉异常患者的一种潜在致命并发症。成像和心导管检查数据为模型构建和校准提供了部分信息。然而,这些模型所需的下游边界条件参数很难估算。此外,重要的模型预测,如分数血流储备(FFR),对这些参数非常敏感。我们介绍了一种根据静息 FFR 的临床测量结果校准下游边界条件参数的方法。校准后的模型可用于预测压力下的 FFR,这是一种无创测量的数据,可用于这些患者的临床评估。我们发现模型预测值与临床测量值在压力下的 FFR 之间存在合理的一致性,这表明该建模框架在预测儿科 AAOCA 患者血液动力学方面具有可信度。这种方法可以作为对 AAOCA 儿童进行风险分层的工具,因此在临床上有重要的应用前景。
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引用次数: 0
Image segmentation of treated and untreated tumor spheroids by Fully Convolutional Networks 利用全卷积网络对已处理和未处理的肿瘤球体进行图像分割
Pub Date : 2024-05-02 DOI: arxiv-2405.01105
Matthias Streller, Soňa Michlíková, Willy Ciecior, Katharina Lönnecke, Leoni A. Kunz-Schughart, Steffen Lange, Anja Voss-Böhme
Multicellular tumor spheroids (MCTS) are advanced cell culture systems forassessing the impact of combinatorial radio(chemo)therapy. They exhibittherapeutically relevant in-vivo-like characteristics from 3D cell-cell andcell-matrix interactions to radial pathophysiological gradients related toproliferative activity and nutrient/oxygen supply, altering cellularradioresponse. State-of-the-art assays quantify long-term curative endpointsbased on collected brightfield image time series from large treated spheroidpopulations per irradiation dose and treatment arm. Here, spheroid controlprobabilities are documented analogous to in-vivo tumor control probabilitiesbased on Kaplan-Meier curves. This analyses require laborious spheroidsegmentation of up to 100.000 images per treatment arm to extract relevantstructural information from the images, e.g., diameter, area, volume andcircularity. While several image analysis algorithms are available for spheroidsegmentation, they all focus on compact MCTS with clearly distinguishable outerrim throughout growth. However, treated MCTS may partly be detached anddestroyed and are usually obscured by dead cell debris. We successfully traintwo Fully Convolutional Networks, UNet and HRNet, and optimize theirhyperparameters to develop an automatic segmentation for both untreated andtreated MCTS. We systematically validate the automatic segmentation on larger,independent data sets of spheroids derived from two human head-and-neck cancercell lines. We find an excellent overlap between manual and automaticsegmentation for most images, quantified by Jaccard indices at around 90%. Forimages with smaller overlap of the segmentations, we demonstrate that thiserror is comparable to the variations across segmentations from differentbiological experts, suggesting that these images represent biologically unclearor ambiguous cases.
多细胞肿瘤球(MCTS)是一种先进的细胞培养系统,可用于评估组合放射(化疗)疗法的影响。从三维细胞-细胞和细胞-基质相互作用到与增殖活性和营养/氧气供应相关的径向病理生理梯度,它们都表现出与治疗相关的活体特征,从而改变细胞的放射反应。最先进的检测方法是根据每个辐照剂量和治疗臂从大量接受治疗的球状细胞群中收集的明场图像时间序列来量化长期治疗终点。在这里,根据 Kaplan-Meier 曲线记录的球形体控制概率类似于体内肿瘤控制概率。这种分析需要对每个治疗臂多达 100,000 张图像进行费力的球面分割,以便从图像中提取相关的结构信息,如直径、面积、体积和圆度。虽然有几种图像分析算法可用于球面分割,但它们都侧重于在整个生长过程中具有清晰可辨外缘的紧凑型 MCTS。然而,经过处理的 MCTS 可能会部分脱落和破坏,通常会被死细胞碎片遮挡。我们成功地训练了两个全卷积网络(UNet 和 HRNet),并优化了它们的参数,从而开发出了未处理和已处理 MCTS 的自动分割技术。我们在来自两个人类头颈癌细胞系的更大的独立球体数据集上对自动分割进行了系统验证。我们发现大多数图像的手动和自动分割都有很好的重合度,根据 Jaccard 指数量化,重合度约为 90%。对于分割重叠度较小的图像,我们证明这一误差与不同生物学专家的分割差异相当,这表明这些图像代表了生物学上不明确或模糊的病例。
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引用次数: 0
The Highly Durable Antibacterial Gel-like Coatings for Textiles 用于纺织品的高耐久性抗菌凝胶状涂层
Pub Date : 2024-05-01 DOI: arxiv-2405.00530
Seyedali Mirmohammadsadeghi, Davis Juhas, Mikhail Parker, Kristina Peranidze, Dwight Austin Van Horn, Aayushi Sharma, Dhruvi Patel, Tatyana A. Sysoeva, Vladislav Klepov, Vladimir Reukov
Hospital-acquired infections are considered a priority for public healthsystems, which poses a significant burden for society. High-touch surfaces ofhealthcare centers, including textiles, provide a suitable environment forpathogenic bacteria to grow, necessitating incorporating effectiveantibacterial agents into textiles. This paper introduces a highly durableantibacterial gel-like solution, Silver Shell finish, which containschitosan-bound silver chloride microparticles. The study investigates thecoating's environmental impact, health risks, and durability during repeatedwashing. The structure of the Silver Shell finish was studied usingTransmission Electron Microscopy (TEM) and Energy-Dispersive X-ray Spectroscopy(EDX). TEM images showed a core-shell structure, with chitosan forming aprotective shell around groupings of silver micro-particles. Field EmissionScanning Electron Microscopy (FESEM) demonstrated the uniform deposition ofSilver Shell on the surface of fabrics. AATCC Test Method 100 was employed toquantitatively analyze the antibacterial properties of fabrics coated withsilver microparticles. Two types of bacteria, Staphylococcus aureus (S. aureus)and Escherichia coli (E. coli) were used in this study. The antibacterialresults showed that after 75 wash cycles, a 100% reduction for both S. aureusand E. coli in the coated samples using crosslinking agents was observed. Thecoated samples without a crosslinking agent exhibited a 99.88% and 99.81%reduction for S. aureus and E. coli after 50 washing cycles. AATCC-147 wasperformed to investigate the coated samples' leaching properties and thecrosslinking agent's effect against S. aureus and E. coli. All coated samplesdemonstrated remarkable antibacterial efficacy even after 75 wash cycles.
医院获得性感染被认为是公共卫生系统的首要问题,给社会造成了沉重负担。医疗保健中心的高接触表面(包括纺织品)为病原菌的生长提供了适宜的环境,因此有必要在纺织品中加入有效的抗菌剂。本文介绍了一种高度耐用的抗菌凝胶状溶液--银壳整理剂,它含有壳聚糖结合氯化银微粒。研究调查了该涂层对环境的影响、健康风险以及反复洗涤时的耐久性。研究人员使用透射电子显微镜(TEM)和能量色散 X 射线光谱仪(EDX)对银壳表面涂层的结构进行了研究。TEM 图像显示了一种核壳结构,壳聚糖在银微颗粒群周围形成了保护壳。场发射扫描电子显微镜(FESEM)显示银壳均匀地沉积在织物表面。AATCC 测试方法 100 被用来定量分析涂有银微颗粒的织物的抗菌性能。本研究使用了金黄色葡萄球菌(S. aureus)和大肠杆菌(E. coli)两种细菌。抗菌结果表明,经过 75 个洗涤周期后,使用交联剂的涂层样品中的金黄色葡萄球菌和大肠杆菌均减少了 100%。未使用交联剂的涂层样品在 50 次洗涤后,金黄色葡萄球菌和大肠杆菌的减少率分别为 99.88% 和 99.81%。对 AATCC-147 进行了测试,以研究涂层样品的浸出特性以及交联剂对金黄色葡萄球菌和大肠杆菌的作用。即使经过 75 次洗涤,所有涂层样品都表现出了显著的抗菌效果。
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引用次数: 0
Anti-pig Antibodies in Swine Veterinarian Serum: Implications for Clinical Xenotransplantation 猪兽医血清中的抗猪抗体:对临床异种移植的影响
Pub Date : 2024-04-23 DOI: arxiv-2404.14658
Guerard Byrne, Christopher McGregor
Recent clinical xenotransplantation and human decedent studies demonstratethat clinical hyperacute rejection of genetically engineered porcine organs canbe reliably avoided but that antibody mediated rejection continues to limitgraft survival. We previously identified porcine glycans and proteins which areimmunogenic after cardiac xenotransplantation in nonhuman primates, but theclinical immune response to antigens present in glycan depleted triple knockout(TKO) donor pigs is poorly understood. In this study we use fluorescencebarcoded HEK cells and HEK cell lines expressing porcine glycans (Gal and SDa)or proteins (CD9, CD46, CD59, PROCR and ANXA2) to screen antibody reactivity inhuman serum from 160 swine veterinarians, a serum source with potentialoccupational immune challenge from porcine tissues and pathogens. High levelsof anti-Gal IgM were present in all samples and lower levels of anti-SDa IgMwere present in 41% of samples. IgM binding to porcine proteins, primarily CD9and CD46, previously identified as immunogenic in pig to non-human primatecardiac xenograft recipients, was detected in 28 of the 160 swine veterinariansamples. These results suggest that barcoded HEK cell lines expressing porcineprotein antigens can be useful for screening human patient serum. Acomprehensive analysis of sera from clinical xenotransplant recipients todefine a panel of commonly immunogenic porcine antigens will likely benecessary to establish an array of porcine non-Gal antigens for effectivemonitoring of patient immune responses and allow earlier therapies to reverseantibody mediated rejection.
最近的临床异种移植和人类死者研究表明,基因工程猪器官的临床超急性排斥反应可以可靠地避免,但抗体介导的排斥反应继续限制移植物的存活。我们以前曾鉴定出在非人灵长类动物心脏异种移植后具有免疫原性的猪聚糖和蛋白质,但对存在于聚糖耗尽的三重基因敲除(TKO)供体猪中的抗原的临床免疫反应却知之甚少。在这项研究中,我们使用表达猪聚糖(Gal 和 SDa)或蛋白质(CD9、CD46、CD59、PROCR 和 ANXA2)的荧光编码 HEK 细胞和 HEK 细胞系来筛选来自 160 名猪兽医的人类血清中的抗体反应性。所有样本中都存在高水平的抗 Gal IgM,41% 的样本中存在较低水平的抗 SDa IgM。在 160 份猪兽医样本中,有 28 份样本检测到了与猪蛋白(主要是 CD9 和 CD46)结合的 IgM。这些结果表明,表达猪蛋白抗原的条形码 HEK 细胞系可用于筛选人类患者血清。对临床异种移植受者的血清进行全面分析,以确定猪抗原的常见免疫原性,很可能是建立猪非gal抗原阵列的必要条件,从而有效监测患者的免疫反应,及早采取治疗措施以逆转抗体介导的排斥反应。
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引用次数: 0
Adaptive integration of history variables in constrained mixture models for organ-scale growth and remodeling 器官尺度生长和重塑受限混合模型中历史变量的自适应整合
Pub Date : 2024-04-15 DOI: arxiv-2404.09706
Amadeus M. Gebauer, Martin R. Pfaller, Jason M. Szafron, Wolfgang A. Wall
In the last decades, many computational models have been developed to predictsoft tissue growth and remodeling (G&R). The constrained mixture theorydescribes fundamental mechanobiological processes in soft tissue G&R and hasbeen widely adopted in cardiovascular models of G&R. However, even after twodecades of work, large organ-scale models are rare, mainly due to highcomputational costs (model evaluation and memory consumption), especially inlong-range simulations. We propose two strategies to adaptively integratehistory variables in constrained mixture models to enable large organ-scalesimulations of G&R. Both strategies exploit that the influence of depositedtissue on the current mixture decreases over time through degradation. Onestrategy is independent of external loading, allowing the estimation of thecomputational resources ahead of the simulation. The other adapts the historysnapshots based on the local mechanobiological environment so that theadditional integration errors can be controlled and kept negligibly small, evenin G&R scenarios with severe perturbations. We analyze the adaptivelyintegrated constrained mixture model on a tissue patch for a parameter studyand show the performance under different G&R scenarios. To confirm thatadaptive strategies enable large organ-scale examples, we show simulations ofdifferent hypertension conditions with a real-world example of a biventricularheart discretized with a finite element mesh. In our example, adaptiveintegrations sped up simulations by a factor of three and reduced memoryrequirements to one-sixth. The reduction of the computational costs gets evenmore pronounced for simulations over longer periods. Adaptive integration ofthe history variables allows studying more finely resolved models and longerG&R periods while computational costs are drastically reduced and largelyconstant in time.
过去几十年来,人们开发了许多计算模型来预测软组织的生长和重塑(G&R)。约束混合物理论描述了软组织生长与重塑的基本机械生物学过程,并已被广泛应用于心血管的生长与重塑模型。然而,即使经过二十年的努力,大型器官尺度模型仍然很少见,主要原因是计算成本高(模型评估和内存消耗),特别是在长程模拟中。我们提出了两种策略,在约束混合模型中自适应性地整合历史变量,以实现大器官尺度的 G&R 模拟。这两种策略都利用了沉积组织对当前混合物的影响会随着时间的推移而降低的特性。一种策略独立于外部负载,允许在模拟之前对计算资源进行估计。另一种策略则根据当地的机械生物学环境调整历史快照,从而控制额外的积分误差,即使在具有严重扰动的 G&R 情景中,也能保持微小到可以忽略不计的积分误差。我们分析了组织斑块上的自适应积分约束混合物模型,以进行参数研究,并展示了不同 G&R 情景下的性能。为了证实自适应策略能够实现大器官尺度的示例,我们展示了用有限元网格离散化的双心室心脏的真实世界示例对不同高血压条件的模拟。在我们的例子中,自适应积分将模拟速度提高了三倍,内存需求减少到六分之一。在较长时间的模拟中,计算成本的降低更为明显。对历史变量进行自适应积分,可以研究分辨率更高的模型和更长的 G&R 周期,同时计算成本大幅降低,并且在时间上基本保持不变。
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引用次数: 0
Primary liver cancer classification from routine tumour biopsy using weakly supervised deep learning 利用弱监督深度学习对常规肿瘤活检进行原发性肝癌分类
Pub Date : 2024-04-07 DOI: arxiv-2404.04983
Aurélie Beaufrère, Nora Ouzir, Paul Emile Zafar, Astrid Laurent-Bellue, Miguel Albuquerque, Gwladys Lubuela, Jules Grégory, Catherine Guettier, Kévin Mondet, Jean-Christophe Pesquet, Valérie Paradis
The diagnosis of primary liver cancers (PLCs) can be challenging, especiallyon biopsies and for combined hepatocellular-cholangiocarcinoma (cHCC-CCA). Weautomatically classified PLCs on routine-stained biopsies using a weaklysupervised learning method. Weak tumour/non-tumour annotations served as labelsfor training a Resnet18 neural network, and the network's last convolutionallayer was used to extract new tumour tile features. Without knowledge of theprecise labels of the malignancies, we then applied an unsupervised clusteringalgorithm. Our model identified specific features of hepatocellular carcinoma(HCC) and intrahepatic cholangiocarcinoma (iCCA). Despite no specific featuresof cHCC-CCA being recognized, the identification of HCC and iCCA tiles within aslide could facilitate the diagnosis of primary liver cancers, particularlycHCC-CCA. Method and results: 166 PLC biopsies were divided into training, internal andexternal validation sets: 90, 29 and 47 samples. Two liver pathologistsreviewed each whole-slide hematein eosin saffron (HES)-stained image (WSI).After annotating the tumour/non-tumour areas, 256x256 pixel tiles wereextracted from the WSIs and used to train a ResNet18. The network was used toextract new tile features. An unsupervised clustering algorithm was thenapplied to the new tile features. In a two-cluster model, Clusters 0 and 1contained mainly HCC and iCCA histological features. The diagnostic agreementbetween the pathological diagnosis and the model predictions in the internaland external validation sets was 100% (11/11) and 96% (25/26) for HCC and 78%(7/9) and 87% (13/15) for iCCA, respectively. For cHCC-CCA, we observed ahighly variable proportion of tiles from each cluster (Cluster 0: 5-97%;Cluster 1: 2-94%).
原发性肝癌(PLC)的诊断具有挑战性,尤其是活组织检查和肝细胞胆管癌(cHCC-CCA)的诊断。我们采用弱监督学习方法,对常规染色活检样本上的原发性肝癌进行了分类。弱肿瘤/非肿瘤注释作为训练 Resnet18 神经网络的标签,网络的最后一个卷积层用于提取新的肿瘤瓦片特征。在不知道恶性肿瘤精确标签的情况下,我们采用了无监督聚类算法。我们的模型识别出了肝细胞癌(HCC)和肝内胆管癌(iCCA)的特定特征。尽管没有识别出 cHCC-CCA 的具体特征,但识别出滑动片中的 HCC 和 iCCA 瓦片有助于诊断原发性肝癌,尤其是 cHCC-CCA。方法和结果:将 166 份 PLC 活检样本分为训练集、内部集和外部验证集:分别为 90、29 和 47 份样本。两名肝脏病理学家对每张整张血红素藏红花(HES)染色图像(WSI)进行了审查。在标注肿瘤/非肿瘤区域后,从 WSI 中提取了 256x256 像素瓦片,用于训练 ResNet18。该网络用于提取新的瓦片特征。然后将无监督聚类算法应用于新的瓦片特征。在双簇模型中,簇 0 和簇 1 主要包含 HCC 和 iCCA 组织学特征。在内部和外部验证集中,病理诊断与模型预测的诊断一致性分别为:HCC 100%(11/11)和 96%(25/26),iCCA 78%(7/9)和 87%(13/15)。对于 cHCC-CCA,我们观察到每个群组的瓦片比例差异很大(群组 0:5-97%;群组 1:2-94%)。
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引用次数: 0
Autonomous Artificial Intelligence Agents for Clinical Decision Making in Oncology 用于肿瘤学临床决策的自主人工智能代理
Pub Date : 2024-04-06 DOI: arxiv-2404.04667
Dyke Ferber, Omar S. M. El Nahhas, Georg Wölflein, Isabella C. Wiest, Jan Clusmann, Marie-Elisabeth Leßman, Sebastian Foersch, Jacqueline Lammert, Maximilian Tschochohei, Dirk Jäger, Manuel Salto-Tellez, Nikolaus Schultz, Daniel Truhn, Jakob Nikolas Kather
Multimodal artificial intelligence (AI) systems have the potential to enhanceclinical decision-making by interpreting various types of medical data.However, the effectiveness of these models across all medical fields isuncertain. Each discipline presents unique challenges that need to be addressedfor optimal performance. This complexity is further increased when attemptingto integrate different fields into a single model. Here, we introduce analternative approach to multimodal medical AI that utilizes the generalistcapabilities of a large language model (LLM) as a central reasoning engine.This engine autonomously coordinates and deploys a set of specialized medicalAI tools. These tools include text, radiology and histopathology imageinterpretation, genomic data processing, web searches, and document retrievalfrom medical guidelines. We validate our system across a series of clinicaloncology scenarios that closely resemble typical patient care workflows. Weshow that the system has a high capability in employing appropriate tools(97%), drawing correct conclusions (93.6%), and providing complete (94%), andhelpful (89.2%) recommendations for individual patient cases while consistentlyreferencing relevant literature (82.5%) upon instruction. This work providesevidence that LLMs can effectively plan and execute domain-specific models toretrieve or synthesize new information when used as autonomous agents. Thisenables them to function as specialist, patient-tailored clinical assistants.It also simplifies regulatory compliance by allowing each component tool to beindividually validated and approved. We believe, that our work can serve as aproof-of-concept for more advanced LLM-agents in the medical domain.
多模态人工智能(AI)系统有可能通过解释各种类型的医疗数据来增强临床决策能力。然而,这些模型在所有医疗领域的有效性尚不确定。每个学科都面临着独特的挑战,需要应对这些挑战才能获得最佳性能。当试图将不同领域整合到一个模型中时,这种复杂性就会进一步增加。在这里,我们介绍了多模态医疗人工智能的替代方法,该方法利用大型语言模型(LLM)的通用能力作为中心推理引擎。这些工具包括文本、放射学和组织病理学图像解读、基因组数据处理、网络搜索以及医疗指南中的文档检索。我们在一系列临床肿瘤学场景中验证了我们的系统,这些场景与典型的病人护理工作流程非常相似。结果表明,该系统在使用适当工具(97%)、得出正确结论(93.6%)、为单个患者病例提供完整(94%)和有用(89.2%)的建议,以及根据指令持续参考相关文献(82.5%)方面具有很高的能力。这项工作提供了证据,证明 LLMs 在作为自主代理使用时,能够有效地规划和执行特定领域的模型,以检索或综合新信息。它还简化了监管合规性,允许每个组件工具单独进行验证和批准。我们相信,我们的工作可以为医疗领域更先进的 LLM 代理提供概念验证。
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arXiv - QuanBio - Tissues and Organs
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