Future artificial intelligence tools and perspectives in medicine.

PURPOSE OF REVIEW: Artificial intelligence has become popular in medical applications, specifically as a clinical support tool for computer-aided diagnosis. These tools are typically employed on medical data (i.e., image, molecular data, clinical variables, etc.) and used the statistical and machine-learning methods to measure the model performance. In this review, we summarized and discussed the most recent radiomic pipeline used for clinical analysis. RECENT FINDINGS: Currently, limited management of cancers benefits from artificial intelligence, mostly related to a computer-aided diagnosis that avoids a biopsy analysis that presents additional risks and costs. Most artificial intelligence tools are based on imaging features, known as radiomic analysis that can be refined into predictive models in noninvasively acquired imaging data. This review explores the progress of artificial intelligence-based radiomic tools for clinical applications with a brief description of necessary technical steps. Explaining new radiomic approaches based on deep-learning techniques will explain how the new radiomic models (deep radiomic analysis) can benefit from deep convolutional neural networks and be applied on limited data sets. SUMMARY: To consider the radiomic algorithms, further investigations are recommended to involve deep learning in radiomic models with additional validation steps on various cancer types.

Hippocampus and amygdala radiomic biomarkers for the study of autism spectrum disorder.

BACKGROUND: Emerging evidence suggests the presence of neuroanatomical abnormalities in subjects with autism spectrum disorder (ASD). Identifying anatomical correlates could thus prove useful for the automated diagnosis of ASD. Radiomic analyses based on MRI texture features have shown a great potential for characterizing differences occurring from tissue heterogeneity, and for identifying abnormalities related to these differences. However, only a limited number of studies have investigated the link between image texture and ASD. This paper proposes the study of texture features based on grey level co-occurrence matrix (GLCM) as a means for characterizing differences between ASD and development control (DC) subjects. Our study uses 64 T1-weighted MRI scans acquired from two groups of subjects: 28 typical age range subjects 4-15 years old (14 ASD and 14 DC, age-matched), and 36 non-typical age range subjects 10-24 years old (20 ASD and 16 DC). GLCM matrices are computed from manually labeled hippocampus and amygdala regions, and then encoded as texture features by applying 11 standard Haralick quantifier functions. Significance tests are performed to identify texture differences between ASD and DC subjects. An analysis using SVM and random forest classifiers is then carried out to find the most discriminative features, and use these features for classifying ASD from DC subjects. RESULTS: Preliminary results show that all 11 features derived from the hippocampus (typical and non-typical age) and 4 features extracted from the amygdala (non-typical age) have significantly different distributions in ASD subjects compared to DC subjects, with a significance of p < 0.05 following Holm-Bonferroni correction. Features derived from hippocampal regions also demonstrate high discriminative power for differentiating between ASD and DC subjects, with classifier accuracy of 67.85%, sensitivity of 62.50%, specificity of 71.42%, and the area under the ROC curve (AUC) of 76.80% for age-matched subjects with typical age range. CONCLUSIONS: Results demonstrate the potential of hippocampal texture features as a biomarker for the diagnosis and characterization of ASD.

Resistance to ursolic acid-induced apoptosis through involvement of melanogenesis and COX-2/PGE2 pathways in human M4Beu melanoma cancer cells.

Melanoma is one of the most aggressive forms of cancer with a continuously growing incidence worldwide and is usually resistant to chemotherapy agents, which is due in part to a strong resistance to apoptosis. Previously, we had showed that B16-F0 murine melanoma cells undergoing apoptosis are able to delay their own death induced by ursolic acid (UA), a natural pentacyclic triterpenoid compound. We had demonstrated that tyrosinase and TRP-1 up-regulation in apoptotic cells and the subsequent production of melanin were implicated in an apoptosis resistance mechanism. Several resistance mechanisms to apoptosis have been characterized in melanoma such as hyperactivation of DNA repair mechanisms, drug efflux systems, and reinforcement of survival signals (PI3K/Akt, NF-κB and Raf/MAPK pathways). Otherwise, other mechanisms of apoptosis resistance involving different proteins, such as cyclooxygenase-2 (COX-2), have been described in many cancer types. By using a strategy of specific inhibition of each ways, we suggested that there was an interaction between melanogenesis and COX-2/PGE2 pathway. This was characterized by analyzing the COX-2 expression and activity, the expression of tyrosinase and melanin production. Furthermore, we showed that anti-proliferative and proapoptotic effects of UA were mediated through modulation of multiple signaling pathways including Akt and ERK-1/2 proteins. Our study not only uncovers underlying molecular mechanisms of UA action in human melanoma cancer cells but also suggest its great potential as an adjuvant in treatment and cancer prevention.

Resistance to 3-HTMC-Induced Apoptosis Through Activation of PI3K/Akt, MEK/ERK, and p38/COX-2/PGE2 Pathways in Human HT-29 and HCT116 Colorectal Cancer Cells.

Increasing incidence and mortality of colorectal cancer brings the necessity to uncover new possibilities in its prevention and treatment. Chalcones have been identified as interesting compounds having chemopreventive and antitumor properties. In this study, we investigated the effects of the synthetic chalcone derivative 3-hydroxy-3',4,4',5'-tetra-methoxy-chalcone (3-HTMC) on proliferation, cell cycle distribution, apoptosis, and its mechanism of action in human colorectal HT-29 (COX-2 sufficient) and HCT116 (COX-2 deficient) cancer cells. We showed that 3-HTMC decreased cell viability in a dose-dependent manner with a more potent antiproliferative effect on HCT116 than HT-29 cells. Flow cytometric analysis revealed G2 /M cell cycle accumulation in HT-29 cells and significant G2 /M arrest in HCT116 cells with a subsequent apoptosis shown by appearance of Sub-G1 peak. We demonstrated that 3-HTMC treatment on both cell lines induced apoptotic process associated with overexpression of death receptor DR5, activation of caspase-8 and -3, PARP cleavage, and DNA fragmentation. In addition, 3-HTMC induced activation of PI3K/Akt and MEK/ERK principal survival pathways which delay 3-HTMC-induced apoptosis in both cell lines. Furthermore, COX-2 overexpression in HT-29 cells contributes to apoptosis resistance which explains the difference of sensitivity between HT-29 and HCT116 cells to 3-HTMC treatment. Even if resistance mechanisms to apoptosis reduced chalcone antitumoral potential, our results suggest that 3-HTMC may be considered as an interesting compound for colorectal cancer therapy or chemoprevention. J. Cell. Biochem. 117: 2875-2885, 2016. © 2016 Wiley Periodicals, Inc.

Deep Survival Analysis With Clinical Variables for COVID-19.

OBJECTIVE: Millions of people have been affected by coronavirus disease 2019 (COVID-19), which has caused millions of deaths around the world. Artificial intelligence (AI) plays an increasing role in all areas of patient care, including prognostics. This paper proposes a novel predictive model based on one dimensional convolutional neural networks (1D CNN) to use clinical variables in predicting the survival outcome of COVID-19 patients. METHODS AND PROCEDURES: We have considered two scenarios for survival analysis, 1) uni-variate analysis using the Log-rank test and Kaplan-Meier estimator and 2) combining all clinical variables ([Formula: see text]=44) for predicting the short-term from long-term survival. We considered the random forest (RF) model as a baseline model, comparing to our proposed 1D CNN in predicting survival groups. RESULTS: Our experiments using the univariate analysis show that nine clinical variables are significantly associated with the survival outcome with corrected p < 0.05. Our approach of 1D CNN shows a significant improvement in performance metrics compared to the RF and the state-of-the-art techniques (i.e., 1D CNN) in predicting the survival group of patients with COVID-19. CONCLUSION: Our model has been tested using clinical variables, where the performance is found promising. The 1D CNN model could be a useful tool for detecting the risk of mortality and developing treatment plans in a timely manner. CLINICAL IMPACT: The findings indicate that using both Heparin and Exnox for treatment is typically the most useful factor in predicting a patient's chances of survival from COVID-19. Moreover, our predictive model shows that the combination of AI and clinical data can be applied to point-of-care services through fast-learning healthcare systems.

Advancements in MRI-Based Radiomics and Artificial Intelligence for Prostate Cancer: A Comprehensive Review and Future Prospects.

The use of multiparametric magnetic resonance imaging (mpMRI) has become a common technique used in guiding biopsy and developing treatment plans for prostate lesions. While this technique is effective, non-invasive methods such as radiomics have gained popularity for extracting imaging features to develop predictive models for clinical tasks. The aim is to minimize invasive processes for improved management of prostate cancer (PCa). This study reviews recent research progress in MRI-based radiomics for PCa, including the radiomics pipeline and potential factors affecting personalized diagnosis. The integration of artificial intelligence (AI) with medical imaging is also discussed, in line with the development trend of radiogenomics and multi-omics. The survey highlights the need for more data from multiple institutions to avoid bias and generalize the predictive model. The AI-based radiomics model is considered a promising clinical tool with good prospects for application.

Deep Radiomic Analysis for Predicting Coronavirus Disease 2019 in Computerized Tomography and X-Ray Images.

This article proposes to encode the distribution of features learned from a convolutional neural network (CNN) using a Gaussian mixture model (GMM). These parametric features, called GMM-CNN, are derived from chest computed tomography (CT) and X-ray scans of patients with coronavirus disease 2019 (COVID-19). We use the proposed GMM-CNN features as input to a robust classifier based on random forests (RFs) to differentiate between COVID-19 and other pneumonia cases. Our experiments assess the advantage of GMM-CNN features compared with standard CNN classification on test images. Using an RF classifier (80% samples for training; 20% samples for testing), GMM-CNN features encoded with two mixture components provided a significantly better performance than standard CNN classification ( ). Specifically, our method achieved an accuracy in the range of 96.00%-96.70% and an area under the receiver operator characteristic (ROC) curve in the range of 99.29%-99.45%, with the best performance obtained by combining GMM-CNN features from both CT and X-ray images. Our results suggest that the proposed GMM-CNN features could improve the prediction of COVID-19 in chest CT and X-ray scans.

Deep CNN models for predicting COVID-19 in CT and x-ray images.

Purpose: Coronavirus disease 2019 (COVID-19) is a new infection that has spread worldwide and with no automatic model to reliably detect its presence from images. We aim to investigate the potential of deep transfer learning to predict COVID-19 infection using chest computed tomography (CT) and x-ray images. Approach: Regions of interest (ROI) corresponding to ground-glass opacities (GGO), consolidations, and pleural effusions were labeled in 100 axial lung CT images from 60 COVID-19-infected subjects. These segmented regions were then employed as an additional input to six deep convolutional neural network (CNN) architectures (AlexNet, DenseNet, GoogleNet, NASNet-Mobile, ResNet18, and DarkNet), pretrained on natural images, to differentiate between COVID-19 and normal CT images. We also explored the model's ability to classify x-ray images as COVID-19, non-COVID-19 pneumonia, or normal. Performance on test images was measured with global accuracy and area under the receiver operating characteristic curve (AUC). Results: When using raw CT images as input to the tested models, the highest accuracy of 82% and AUC of 88.16% is achieved. Incorporating the three ROIs as an additional model inputs further boosts performance to an accuracy of 82.30% and an AUC of 90.10% (DarkNet). For x-ray images, we obtained an outstanding AUC of 97% for classifying COVID-19 versus normal versus other. Combing chest CT and x-ray images, DarkNet architecture achieves the highest accuracy of 99.09% and AUC of 99.89% in classifying COVID-19 from non-COVID-19. Our results confirm the ability of deep CNNs with transfer learning to predict COVID-19 in both chest CT and x-ray images. Conclusions: The proposed method could help radiologists increase the accuracy of their diagnosis and increase efficiency in COVID-19 management.

Magnetic Resonance Imaging Based Radiomic Models of Prostate Cancer: A Narrative Review.

The management of prostate cancer (PCa) is dependent on biomarkers of biological aggression. This includes an invasive biopsy to facilitate a histopathological assessment of the tumor's grade. This review explores the technical processes of applying magnetic resonance imaging based radiomic models to the evaluation of PCa. By exploring how a deep radiomics approach further optimizes the prediction of a PCa's grade group, it will be clear how this integration of artificial intelligence mitigates existing major technological challenges faced by a traditional radiomic model: image acquisition, small data sets, image processing, labeling/segmentation, informative features, predicting molecular features and incorporating predictive models. Other potential impacts of artificial intelligence on the personalized treatment of PCa will also be discussed. The role of deep radiomics analysis-a deep texture analysis, which extracts features from convolutional neural networks layers, will be highlighted. Existing clinical work and upcoming clinical trials will be reviewed, directing investigators to pertinent future directions in the field. For future progress to result in clinical translation, the field will likely require multi-institutional collaboration in producing prospectively populated and expertly labeled imaging libraries.

A quantitative study of shape descriptors from glioblastoma multiforme phenotypes for predicting survival outcome.

OBJECTIVE: Predicting the survival outcome of patients with glioblastoma multiforme (GBM) is of key importance to clinicians for selecting the optimal course of treatment. The goal of this study was to evaluate the usefulness of geometric shape features, extracted from MR images, as a potential non-invasive way to characterize GBM tumours and predict the overall survival times of patients with GBM. METHODS: The data of 40 patients with GBM were obtained from the Cancer Genome Atlas and Cancer Imaging Archive. The T1 weighted post-contrast and fluid-attenuated inversion-recovery volumes of patients were co-registered and segmented into delineate regions corresponding to three GBM phenotypes: necrosis, active tumour and oedema/invasion. A set of two-dimensional shape features were then extracted slicewise from each phenotype region and combined over slices to describe the three-dimensional shape of these phenotypes. Thereafter, a Kruskal-Wallis test was employed to identify shape features with significantly different distributions across phenotypes. Moreover, a Kaplan-Meier analysis was performed to find features strongly associated with GBM survival. Finally, a multivariate analysis based on the random forest model was used for predicting the survival group of patients with GBM. RESULTS: Our analysis using the Kruskal-Wallis test showed that all but one shape feature had statistically significant differences across phenotypes, with p-value < 0.05, following Holm-Bonferroni correction, justifying the analysis of GBM tumour shapes on a per-phenotype basis. Furthermore, the survival analysis based on the Kaplan-Meier estimator identified three features derived from necrotic regions (i.e. Eccentricity, Extent and Solidity) that were significantly correlated with overall survival (corrected p-value < 0.05; hazard ratios between 1.68 and 1.87). In the multivariate analysis, features from necrotic regions gave the highest accuracy in predicting the survival group of patients, with a mean area under the receiver-operating characteristic curve (AUC) of 63.85%. Combining the features of all three phenotypes increased the mean AUC to 66.99%, suggesting that shape features from different phenotypes can be used in a synergic manner to predict GBM survival. CONCLUSION: Results show that shape features, in particular those extracted from necrotic regions, can be used effectively to characterize GBM tumours and predict the overall survival of patients with GBM. Advances in knowledge: Simple volumetric features have been largely used to characterize the different phenotypes of a GBM tumour (i.e. active tumour, oedema and necrosis). This study extends previous work by considering a wide range of shape features, extracted in different phenotypes, for the prediction of survival in patients with GBM.

Multi Texture Analysis of Colorectal Cancer Continuum Using Multispectral Imagery.

PURPOSE: This paper proposes to characterize the continuum of colorectal cancer (CRC) using multiple texture features extracted from multispectral optical microscopy images. Three types of pathological tissues (PT) are considered: benign hyperplasia, intraepithelial neoplasia and carcinoma. MATERIALS AND METHODS: In the proposed approach, the region of interest containing PT is first extracted from multispectral images using active contour segmentation. This region is then encoded using texture features based on the Laplacian-of-Gaussian (LoG) filter, discrete wavelets (DW) and gray level co-occurrence matrices (GLCM). To assess the significance of textural differences between PT types, a statistical analysis based on the Kruskal-Wallis test is performed. The usefulness of texture features is then evaluated quantitatively in terms of their ability to predict PT types using various classifier models. RESULTS: Preliminary results show significant texture differences between PT types, for all texture features (p-value < 0.01). Individually, GLCM texture features outperform LoG and DW features in terms of PT type prediction. However, a higher performance can be achieved by combining all texture features, resulting in a mean classification accuracy of 98.92%, sensitivity of 98.12%, and specificity of 99.67%. CONCLUSIONS: These results demonstrate the efficiency and effectiveness of combining multiple texture features for characterizing the continuum of CRC and discriminating between pathological tissues in multispectral images.