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1.
Life (Basel) ; 13(12)2023 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-38137941

RESUMEN

This study explores the integration of Wide Field Optical Coherence Tomography (WF-OCT) with an AI-driven clinical decision support system, with the goal of enhancing productivity and decision making in breast cancer surgery margin assessment. A computationally efficient convolutional neural network (CNN)-based binary classifier is developed using 585 WF-OCT margin scans from 151 subjects. The CNN model swiftly identifies suspicious areas within margins with an on-device inference time of approximately 10 ms for a 420 × 2400 image. In independent testing on 155 pathology-confirmed margins, including 31 positive margins from 29 patients, the classifier achieved an AUROC of 0.976, a sensitivity of 0.93, and a specificity of 0.98. At the margin level, the deep learning model accurately identified 96.8% of pathology-positive margins. These results highlight the clinical viability of AI-enhanced margin visualization using WF-OCT in breast cancer surgery and its potential to decrease reoperation rates due to residual tumors.

2.
Am J Clin Pathol ; 156(1): 117-128, 2021 06 17.
Artículo en Inglés | MEDLINE | ID: mdl-33527136

RESUMEN

OBJECTIVES: This study aimed to develop and validate a deep learning algorithm to screen digitized acid fast-stained (AFS) slides for mycobacteria within tissue sections. METHODS: A total of 441 whole-slide images (WSIs) of AFS tissue material were used to develop a deep learning algorithm. Regions of interest with possible acid-fast bacilli (AFBs) were displayed in a web-based gallery format alongside corresponding WSIs for pathologist review. Artificial intelligence (AI)-assisted analysis of another 138 AFS slides was compared to manual light microscopy and WSI evaluation without AI support. RESULTS: Algorithm performance showed an area under the curve of 0.960 at the image patch level. More AI-assisted reviews identified AFBs than manual microscopy or WSI examination (P < .001). Sensitivity, negative predictive value, and accuracy were highest for AI-assisted reviews. AI-assisted reviews also had the highest rate of matching the original sign-out diagnosis, were less time-consuming, and were much easier for pathologists to perform (P < .001). CONCLUSIONS: This study reports the successful development and clinical validation of an AI-based digital pathology system to screen for AFBs in anatomic pathology material. AI assistance proved to be more sensitive and accurate, took pathologists less time to screen cases, and was easier to use than either manual microscopy or viewing WSIs.


Asunto(s)
Aprendizaje Profundo , Interpretación de Imagen Asistida por Computador/métodos , Infecciones por Mycobacterium/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium , Patología Clínica/métodos
3.
Pathol Oncol Res ; 17(1): 91-101, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20571940

RESUMEN

Non muscle invasive bladder cancers recur frequently and identification of biomarkers for predicting recurrence are necessary. The present study evaluated the individual and synergistic effects of tumor suppressor (p53/p21waf1) and angiogenesis [vascular endothelial growth factor (VEGF)/endoglin (CD105)] markers. The study included 90 cases of non muscle invasive bladder cancer. Cell spots were stained with primary antibodies and Flourescein isothiocyanate (FITC). Slides were observed under confocal laser scanning microscope for protein expression. The association between the markers individually and synergistically with recurrence were assessed by a χ2 and Fisher's Exact test. Survival analysis was performed to predict recurrence and test for significant difference in recurrence free survival probability. Recurrence [overall:39(43.3%) and low grade(LG):26(54.2%)] was significant with p53 and VEGF expression and the profiles p53/VEGF, p53/CD105, VEGF/CD105, p53/p21/CD105, p53/VEGF/CD105 and all four were significantly associated with recurrence in both groups. In the multivariable model the [HR(95%CI),p: overall and LG] profiles p21/VEGF [2.195(1.052-4.582),0.036; 3.425(1.332-8.811),0.011], VEGF/CD105[2.624(1.274-5.403),0.009 and 3.380(1.348-8.472),0.009], p53/p21/CD105 [2.000(0.993-4.027),0.052 and 2.539(1.047-6.157),0.039], p53/VEGF/CD105 [2.360(1.148-4.849),0.020 and 2.738(1.104-6.788),0.030], p21/VEGF/CD105 [2.611(1.189-5.731),0.017 and 3.946(1.530-10.182),0.005] and all four [2.382(1.021-5.556),0.045 and 3.572(1.287-9.911),0.014] significantly predicted the recurrence along with significant log rank. In the pTa subset (n = 33) the profiles p53/p21, p53/CD105, p21/VEGF, VEGF/CD105, p53/VEGF/CD105, p53/p21/CD105 and p21/VEGF/CD105, significantly predicted hazard for recurrence. The present study emphasizes an underlying association between tumor suppressor (p21waf1) and angiogenesis (VEGF/CD105) biomarkers. In addition combination profiles appeared to indicate an aggressive nature with high propensity for recurrence in LG and pTa tumours.


Asunto(s)
Biomarcadores de Tumor/análisis , Carcinoma de Células Transicionales/patología , Recurrencia Local de Neoplasia/patología , Neovascularización Patológica/patología , Neoplasias de la Vejiga Urinaria/patología , Adolescente , Adulto , Anciano , Antígenos CD/análisis , Antígenos CD/biosíntesis , Carcinoma de Células Transicionales/metabolismo , Carcinoma de Células Transicionales/mortalidad , Inhibidor p21 de las Quinasas Dependientes de la Ciclina/análisis , Inhibidor p21 de las Quinasas Dependientes de la Ciclina/biosíntesis , Endoglina , Femenino , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Masculino , Microscopía Confocal , Persona de Mediana Edad , Recurrencia Local de Neoplasia/mortalidad , Estadificación de Neoplasias , Neovascularización Patológica/metabolismo , Pronóstico , Receptores de Superficie Celular/análisis , Receptores de Superficie Celular/biosíntesis , Proteína p53 Supresora de Tumor/análisis , Proteína p53 Supresora de Tumor/biosíntesis , Neoplasias de la Vejiga Urinaria/metabolismo , Neoplasias de la Vejiga Urinaria/mortalidad , Factor A de Crecimiento Endotelial Vascular/análisis , Factor A de Crecimiento Endotelial Vascular/biosíntesis , Adulto Joven
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