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Artificial intelligence in hepatFIGopancreaticobiliary surgery: a systematic review 人工智能在肝胆胰手术中的应用综述
Pub Date : 2022-01-01 DOI: 10.20517/ais.2022.20
M. Bektaş, B. Zonderhuis, H. Marquering, Jaime Costa Pereira, G. Burchell, D. L. van der Peet
Aim: The aim of this systematic review was to provide an overview of Machine Learning applications within hepatopancreaticobiliary surgery. The secondary aim was to evaluate the predictive performances of applied Machine Learning models. Methods: A systematic search was conducted in PubMed, EMBASE, Cochrane, and Web of Science. Studies were only eligible for inclusion when they described Machine Learning in hepatopancreaticobiliary surgery. The Cochrane and PROBAST risk of bias tools were used to evaluate the quality of studies and included Machine Learning models. Results: Out of 1821 articles, 52 studies have met the inclusion criteria. The majority of Machine Learning models were developed to predict the course of disease, and postoperative complications. The course of disease has been predicted with accuracies up to 99%, and postoperative complications with accuracies up to 89%. Most studies had a retrospective study design, in which external validation was absent for Machine Learning models. Conclusion: Machine learning models have shown promising accuracies in the prediction of short-term and long-term surgical outcomes after hepatopancreaticobiliary surgery. External validation of Machine Learning models is required to facilitate the clinical introduction of Machine Learning.
目的:本系统综述的目的是概述机器学习在肝胆胰手术中的应用。第二个目的是评估应用机器学习模型的预测性能。方法:系统检索PubMed、EMBASE、Cochrane和Web of Science。研究只有在描述肝胆胰手术中的机器学习时才有资格纳入。使用Cochrane和PROBAST偏倚风险工具评估研究质量,并纳入机器学习模型。结果:1821篇文献中,52篇符合纳入标准。大多数机器学习模型的开发是为了预测疾病的进程和术后并发症。预测病程的准确率高达99%,预测术后并发症的准确率高达89%。大多数研究采用回顾性研究设计,其中缺乏对机器学习模型的外部验证。结论:机器学习模型在预测肝胆胰手术后短期和长期手术结果方面显示出有希望的准确性。为了促进机器学习的临床应用,需要对机器学习模型进行外部验证。
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引用次数: 1
Artificial intelligence for decision support in surgical oncology - a systematic review 人工智能在外科肿瘤学决策支持中的应用综述
Pub Date : 2022-01-01 DOI: 10.20517/ais.2022.21
M. Wagner, A. Schulze, Michael Haselbeck-Köbler, P. Probst, Johanna M. Brandenburg, E. Kalkum, A. Majlesara, A. Ramouz, R. Klotz, Felix Nickel, K. März, S. Bodenstedt, M. Dugas, L. Maier-Hein, A. Mehrabi, S. Speidel, M. Büchler, B. Müller-Stich
Aim: We systematically review current clinical applications of artificial intelligence (AI) that use machine learning (ML) methods for decision support in surgical oncology with an emphasis on clinical translation. Methods: MEDLINE, Web of Science, and CENTRAL were searched on 19 January 2021 for a combination of AI and ML-related terms, decision support, and surgical procedures for abdominal malignancies. Data extraction included study characteristics, description of algorithms and their respective purpose, and description of key steps for scientific validation and clinical translation. Results: Out of 8302 articles, 107 studies were included for full-text analysis. Most of the studies were conducted in a retrospective setting (n = 105, 98%), with 45 studies (42%) using data from multiple centers. The most common tumor entities were colorectal cancer (n = 35, 33%), liver cancer (n = 21, 20%), and gastric cancer (n = 17, 16%). The most common prediction task was survival (n = 36, 34%), with artificial neural networks being the most common class of ML algorithms (n = 52, 49%). Key reporting and validation steps included, among others, a complete listing of patient features (n = 95, 89%), training of multiple algorithms (n = 73, 68%), external validation (n = 13, 12%), prospective validation (n = 2, 2%), robustness in terms of cross-validation or resampling (n = 89, 83%), treatment recommendations by ML algorithms (n = 9, 8%), and development of an interface (n = 12, 11%). Conclusion: ML for decision support in surgical oncology is receiving increasing attention with promising results, but robust and prospective clinical validation is mostly lacking. Furthermore, the integration of ML into AI applications is necessary to foster clinical translation.
目的:我们系统地回顾了目前人工智能(AI)的临床应用,这些应用使用机器学习(ML)方法在外科肿瘤学中进行决策支持,重点是临床翻译。方法:于2021年1月19日在MEDLINE、Web of Science和CENTRAL检索人工智能和机器学习相关的术语、决策支持和腹部恶性肿瘤的外科手术。数据提取包括研究特征、算法描述及其各自目的、科学验证和临床转化关键步骤的描述。结果:在8302篇文章中,107篇研究纳入全文分析。大多数研究是回顾性研究(n = 105,98 %),其中45项研究(42%)使用来自多个中心的数据。最常见的肿瘤实体是结直肠癌(n = 35, 33%)、肝癌(n = 21, 20%)和胃癌(n = 17, 16%)。最常见的预测任务是生存(n = 36,34%),人工神经网络是最常见的ML算法(n = 52,49%)。关键的报告和验证步骤包括,除其他外,患者特征的完整列表(n = 95,89%),多种算法的训练(n = 73,68%),外部验证(n = 13,12%),前瞻性验证(n = 2,2%),交叉验证或重新采样方面的稳健性(n = 89,83%), ML算法的治疗建议(n = 9,8%),以及界面的开发(n = 12,11%)。结论:机器学习在外科肿瘤学决策支持中的应用越来越受到关注,其结果令人鼓舞,但缺乏强有力的前瞻性临床验证。此外,将机器学习整合到人工智能应用程序中对于促进临床翻译是必要的。
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引用次数: 6
A nationwide survey on the perceptions of general surgeons on artificial intelligence 一项关于普通外科医生对人工智能看法的全国性调查
Pub Date : 2022-01-01 DOI: 10.20517/ais.2021.10
F. Voskens, J. Abbing, A. T. Ruys, J. Ruurda, I. Broeders
Aim: Artificial intelligence (AI) has the potential to improve perioperative diagnosis and decision making. Despite promising study results, the majority of AI platforms in surgery currently remain in the research setting. Understanding the current knowledge and general attitude of surgeons toward AI applications in their surgical practice is essential and can contribute to the future development and uptake of AI in surgery. Methods: In March 2021, a web-based survey was conducted among members of the Dutch Association of Surgery. The survey measured opinions on the existing knowledge, expectations, and concerns on AI among surgical residents and surgeons. Results: A total of 313 respondents completed the survey. Overall, 85% of the respondents agreed that AI could be of value in the surgical field and 61% expected AI to improve their diagnostic ability. The outpatient clinic (35.8%) and operating room (39.6%) were stated as area of interest for the use of AI. Statistically, surgeons working in an academic hospital were more likely to be aware of the possibilities of AI (P = 0.01). The surgeons in this survey were not worried about job replacement, however they raised the greatest concerns on accountability issues (50.5%), loss of autonomy (46.6%), and risk of bias (43.5%). Conclusion: This survey demonstrates that the majority of the surgeons show a positive and open attitude towards AI. Although various ethical issues and concerns arise, the expectations regarding the implementation of future surgical AI applications are high.
目的:人工智能(AI)具有改善围手术期诊断和决策的潜力。尽管有很好的研究结果,但大多数手术人工智能平台目前仍处于研究阶段。了解外科医生在手术实践中对人工智能应用的现有知识和普遍态度至关重要,有助于未来人工智能在手术中的发展和吸收。方法:2021年3月,在荷兰外科协会成员中进行了一项基于网络的调查。该调查衡量了外科住院医师和外科医生对人工智能的现有知识、期望和担忧的意见。结果:共有313名受访者完成了调查。总体而言,85%的受访者认为人工智能在外科领域可能有价值,61%的受访者希望人工智能能提高他们的诊断能力。门诊(35.8%)和手术室(39.6%)被认为是人工智能应用的兴趣领域。统计上,在学术医院工作的外科医生更有可能意识到人工智能的可能性(P = 0.01)。本次调查的外科医生并不担心工作被取代,但他们最担心的是问责问题(50.5%)、自主权丧失(46.6%)和偏见风险(43.5%)。结论:本调查显示,大多数外科医生对人工智能持积极开放的态度。尽管出现了各种伦理问题和担忧,但人们对未来手术人工智能应用的实施抱有很高的期望。
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引用次数: 5
Computer vision and machine learning for medical image analysis: recent advances, challenges, and way forward 医学图像分析的计算机视觉和机器学习:最新进展、挑战和前进方向
Pub Date : 2022-01-01 DOI: 10.20517/ais.2021.15
Eyad Elyan, Pattaramon Vuttipittayamongkol, Pamela Johnston, Kyle Martin, Kyle McPherson, C. Moreno-García, Chrisina Jayne, Md. Mostafa Kamal Sarker
The recent development in the areas of deep learning and deep convolutional neural networks has significantly progressed and advanced the field of computer vision (CV) and image analysis and understanding. Complex tasks such as classifying and segmenting medical images and localising and recognising objects of interest have become much less challenging. This progress has the potential of accelerating research and deployment of multitudes of medical applications that utilise CV. However, in reality, there are limited practical examples being physically deployed into front-line health facilities. In this paper, we examine the current state of the art in CV as applied to the medical domain. We discuss the main challenges in CV and intelligent data-driven medical applications and suggest future directions to accelerate research, development, and deployment of CV applications in health practices. First, we critically review existing literature in the CV domain that addresses complex vision tasks, including: medical image classification; shape and object recognition from images; and medical segmentation. Second, we present an in-depth discussion of the various challenges that are considered barriers to accelerating research, development, and deployment of intelligent CV methods in real-life medical applications and hospitals. Finally, we conclude by discussing future directions.
深度学习和深度卷积神经网络领域的最新发展显著地推动了计算机视觉(CV)和图像分析与理解领域的发展。复杂的任务,如分类和分割医学图像,定位和识别感兴趣的对象,已经变得不那么具有挑战性了。这一进展有可能加速利用CV的众多医学应用的研究和部署。然而,在现实中,实际部署到一线卫生设施的实例有限。在本文中,我们研究了应用于医学领域的CV技术的现状。我们讨论了CV和智能数据驱动医疗应用中的主要挑战,并提出了加快CV应用在卫生实践中的研究、开发和部署的未来方向。首先,我们批判性地回顾了CV领域解决复杂视觉任务的现有文献,包括:医学图像分类;从图像中识别形状和物体;还有医疗细分。其次,我们深入讨论了各种挑战,这些挑战被认为是加速智能CV方法在现实医疗应用和医院中的研究、开发和部署的障碍。最后,我们讨论了未来的发展方向。
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引用次数: 30
Artificial intelligence HPB surgery - current problems, future solutions? 人工智能HPB手术——当前的问题,未来的解决方案?
Pub Date : 2022-01-01 DOI: 10.20517/ais.2022.26
D. A. O’Reilly, H. Pitt
NO
没有
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引用次数: 1
Training in robotic pancreatic surgery 机器人胰腺手术的培训
Pub Date : 2022-01-01 DOI: 10.20517/ais.2022.28
Sam Body, M. Kawka, T. Gall, Andrew A. Gumbs, Henry A. Pitt
The aim of this narrative review is to discuss current training for the robotic approach to pancreatic surgery and the potential use of machine learning to progress robotic surgical training. A literature search using PubMed and MEDLINE was conducted to investigate training programmes in robotic pancreatic surgery and advances in the use of artificial intelligence for training. The use of virtual reality can assist novice robotic surgeons in learning basic surgical skills. The use of automated video analytics can also improve surgical education to enable self-directed learning both within and outside the operating room. The emerging role and novel applications of machine learning in robotic surgery could shape future training by aiding the autonomous recognition of anatomical structures in the surgical field, instrument tracking and providing feedback on surgical competence. Training should be standardised to ensure the attainment of assessment benchmarks and include virtual simulation basic training in addition to procedural-specific training. Standardised procedural techniques should be used to improve patient safety, theatre efficiency and the continuation of robotic practice.
这篇叙述性综述的目的是讨论目前胰腺手术机器人方法的培训以及机器学习在机器人手术培训方面的潜在应用。使用PubMed和MEDLINE进行文献检索,以调查机器人胰腺手术的培训计划和使用人工智能进行培训的进展。使用虚拟现实可以帮助新手机器人外科医生学习基本的手术技能。使用自动视频分析还可以改善外科教育,使手术室内外的自主学习成为可能。机器学习在机器人手术中的新兴作用和新应用可以通过帮助手术领域的解剖结构自主识别,器械跟踪和提供手术能力反馈来塑造未来的培训。培训应标准化,以确保达到评估基准,除具体程序培训外,还应包括虚拟模拟基本培训。应该使用标准化的程序技术来提高患者安全、手术室效率和机器人实践的延续。
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引用次数: 0
The use of pre-trained deep learning models for the photographic assessment of donor livers for transplantation 使用预先训练的深度学习模型对供肝移植进行摄影评估
Pub Date : 2022-01-01 DOI: 10.20517/ais.2022.06
H. Ugail, Aliyu Abubakar, Ali Elmahmudi, Colin Wilson, Brian Thomson
Aim: Hepatic steatosis is a recognised major risk factor for primary graft failure in liver transplantation. In general, the global fat burden is measured by the surgeon using a visual assessment. However, this can be augmented by a histological assessment, although there is often inter-observer variation in this regard as well. In many situations the assessment of the liver relies heavily on the experience of the observer and more experienced surgeons will accept organs that more junior surgeons feel are unsuitable for transplantation. Often surgeons will err on the side of caution and not accept a liver for fear of exposing recipients to excessive risk of death. Methods: In this study, we present the use of deep learning for the non-invasive evaluation of donor liver organs. Transfer learning, using deep learning models such as the Visual Geometry Group (VGG) Face, VGG16, Residual Neural Network 50 (ResNet50), Dense Convolutional Network 121 (DenseNet121) and MobileNet are utilised for effective pattern extraction from partial and whole liver. Classification algorithms such as Support Vector Machines, k-Nearest Neighbour, Logistic Regression, Decision Tree and Linear Discriminant Analysis are then used for the final classification to identify between acceptable or non-acceptable donor liver organs. Results: The proposed method is distinct in that we make use of image information both from partial and whole liver. We show that common pre-trained deep learning models can be used to quantify the donor liver steatosis with an accuracy of over 92%. Conclusion: Machine learning algorithms offer the tantalising prospect of standardising the assessment and the possibility of using more donor organs for transplantation.
目的:肝脂肪变性是公认的肝移植失败的主要危险因素。一般来说,总体脂肪负担是由外科医生通过视觉评估来测量的。然而,这可以通过组织学评估来增强,尽管在这方面也经常存在观察者之间的差异。在许多情况下,对肝脏的评估很大程度上依赖于观察者的经验,经验丰富的外科医生会接受更多初级外科医生认为不适合移植的器官。外科医生往往会过于谨慎而不接受肝脏移植,因为他们害怕接受者面临过高的死亡风险。方法:在本研究中,我们提出使用深度学习对供体肝脏器官进行无创评估。迁移学习,使用深度学习模型,如视觉几何组(VGG)面部,VGG16,残余神经网络50 (ResNet50),密集卷积网络121 (DenseNet121)和MobileNet,用于从部分和整个肝脏中有效提取模式。然后使用支持向量机、k近邻、逻辑回归、决策树和线性判别分析等分类算法进行最终分类,以识别可接受或不可接受的供体肝脏器官。结果:该方法的独特之处在于我们同时利用了部分肝脏和全肝的图像信息。我们表明,常见的预训练深度学习模型可用于量化供体肝脏脂肪变性,准确率超过92%。结论:机器学习算法提供了标准化评估和使用更多供体器官进行移植的可能性的诱人前景。
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引用次数: 4
Artificial intelligence in hepatopancreaticobiliary surgery - promises and perils 人工智能在肝胆胰手术中的应用——希望与危险
Pub Date : 2022-01-01 DOI: 10.20517/ais.2022.32
Christina Boutros, Vivek Singh, L. Ocuin, J. Marks, Daniel A. Hashimoto
Research and development in artificial intelligence (AI) has been experiencing a resurgence over the past decade. The rapid growth and evolution of AI approaches can leave one feeling overwhelmed and confused about how these technologies will impact hepatopancreaticobiliary (HPB) surgery, the obstacles to its clinical translation, and the role that HPB surgeons can play in accelerating AI’s development and ultimate clinical impact. This review outlines some of the basic terminology and current approaches in surgical AI, obstacles to further development and translation of AI, and how HPB surgeons can influence its future in surgery.
人工智能(AI)的研究和开发在过去十年中经历了复苏。人工智能方法的快速发展和演变可能会让人感到不知所措和困惑,这些技术将如何影响肝胰胆(HPB)手术,其临床转化的障碍,以及HPB外科医生在加速人工智能发展和最终临床影响方面可以发挥的作用。本文概述了手术人工智能的一些基本术语和当前方法,人工智能进一步发展和翻译的障碍,以及HPB外科医生如何影响其在手术中的未来。
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引用次数: 0
Why Artificial Intelligence Surgery (AIS) is better than current Robotic-Assisted Surgery (RAS) 为什么人工智能手术(AIS)比机器人辅助手术(RAS)更好?
Pub Date : 2022-01-01 DOI: 10.20517/ais.2022.41
ANDREW GUMBS, B. Gayet
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引用次数: 2
Automatic tissue segmentation of hyperspectral images in liver and head neck surgeries using machine learning 肝脏和头颈部手术中使用机器学习的高光谱图像自动组织分割
Pub Date : 2021-08-31 DOI: 10.20517/ais.2021.05
Fernando Cervantes-Sanchez, M. Maktabi, H. Köhler, R. Sucher, N. Rayes, J. Aviña-Cervantes, I. Cruz-Aceves, C. Chalopin
{"title":"Automatic tissue segmentation of hyperspectral images in liver and head neck surgeries using machine learning","authors":"Fernando Cervantes-Sanchez, M. Maktabi, H. Köhler, R. Sucher, N. Rayes, J. Aviña-Cervantes, I. Cruz-Aceves, C. Chalopin","doi":"10.20517/ais.2021.05","DOIUrl":"https://doi.org/10.20517/ais.2021.05","url":null,"abstract":"","PeriodicalId":72305,"journal":{"name":"Artificial intelligence surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42660199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
期刊
Artificial intelligence surgery
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