Performance optimization of differential evolution with slime mould algorithm for multilevel breast cancer image segmentation.

Breast cancer is one of the most dangerous diseases for women's health, and it is imperative to provide the necessary diagnostic assistance for it. The medical image processing technology is one of the most critical of all complementary diagnostic technologies. Image segmentation is the core step of image processing, where multilevel image segmentation is considered one of the most efficient and straightforward methods. Many multilevel image segmentation methods based on evolutionary and population-based methods have been proposed in recent years, but many have the fatal weakness of poor convergence accuracy and the tendency to fall into local optimum. Therefore, to overcome these weaknesses, this paper proposes a modified differential evolution (MDE) algorithm with a vision based on the slime mould foraging behavior, where the recently proposed slime mould algorithm (SMA) inspires it. Besides, to obtain high-quality breast cancer image segmentation results, this paper also develops an excellent MDE-based multilevel image segmentation model, the core of which is based on non-local means 2D histogram and 2D Kapur's entropy. To effectively validate the performance of the proposed method, a comparison experiment between MDE and its similar algorithms was first carried out on IEEE CEC 2014. Then, an initial validation of the MDE-based multilevel image segmentation model was performed by utilizing a reference image set. Finally, the MDE-based multilevel image segmentation model was compared with peers using breast invasive ductal carcinoma images. A series of experimental results have proved that MDE is an evolutionary algorithm with high convergence accuracy and the ability to jump out of the local optimum, as well as effectively demonstrated that the developed model is a high-quality segmentation method that can provide practical support for further research of breast invasive ductal carcinoma pathological image processing.

First Report of Severe Autoimmune Hemolytic Anemia During Eltrombopag Therapy in Waldenström Macroglobulinemia-Associated Thrombocytopenia.

Autoimmune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA) can be observed in Waldenström macroglobulinemia (WM). The autoimmune disorders are primarily mediated by autoimmune monoclonal gammopathy, but drug-induced hemolysis should also be considered. Herein, we presented the case of a 63-year-old female WM patient complicated with ITP, who was admitted to our department with a complaint of abdominal pain. After first half of bortezomib/dexamethasone/rituximab (BRD) chemotherapy, her platelet level recovered, but subsequently decreased to extremely low level (around 1-2×109/L), and the patient suffered from platelet transfusion refractoriness. During the management of refractory thrombocytopenia, the patient developed severe hemolytic anemia, and further tests confirmed warm AIHA. FcγRIIα polymorphism test showed that the patient had FcγRIIα-131RH, which implied that the AIHA may not be WM-related. Given the effects of ibrutinib in controlling WM, secondary AITP and AIHA, ibrutinib single treatment was started, which quickly corrected the thrombocytopenia within five days, but not hemolysis. With a relatively safe platelet level, eltrombopag was stopped, and the hemolysis relieved three days after eltrombopag withdrawal. This is the first report on eltrombopag-induced AIHA in the management of WM-associated ITP.