RESUMEN
BACKGROUND AND PURPOSE: In comparison to conventional medical imaging diagnostic modalities, the aim of this overview article is to analyze the accuracy of the application of Artificial Intelligence (AI) techniques in the identification and diagnosis of malignant tumors in adult patients. DATA SOURCES: The acronym PIRDs was used and a comprehensive literature search was conducted on PubMed, Cochrane, Scopus, Web of Science, LILACS, Embase, Scielo, EBSCOhost, and grey literature through Proquest, Google Scholar, and JSTOR for systematic reviews of AI as a diagnostic model and/or detection tool for any cancer type in adult patients, compared to the traditional diagnostic radiographic imaging model. There were no limits on publishing status, publication time, or language. For study selection and risk of bias evaluation, pairs of reviewers worked separately. RESULTS: In total, 382 records were retrieved in the databases, 364 after removing duplicates, 32 satisfied the full-text reading criterion, and 09 papers were considered for qualitative synthesis. Although there was heterogeneity in terms of methodological aspects, patient differences, and techniques used, the studies found that several AI approaches are promising in terms of specificity, sensitivity, and diagnostic accuracy in the detection and diagnosis of malignant tumors. When compared to other machine learning algorithms, the Super Vector Machine method performed better in cancer detection and diagnosis. Computer-assisted detection (CAD) has shown promising in terms of aiding cancer detection, when compared to the traditional method of diagnosis. CONCLUSIONS: The detection and diagnosis of malignant tumors with the help of AI seems to be feasible and accurate with the use of different technologies, such as CAD systems, deep and machine learning algorithms and radiomic analysis when compared with the traditional model, although these technologies are not capable of to replace the professional radiologist in the analysis of medical images. Although there are limitations regarding the generalization for all types of cancer, these AI tools might aid professionals, serving as an auxiliary and teaching tool, especially for less trained professionals. Therefore, further longitudinal studies with a longer follow-up duration are required for a better understanding of the clinical application of these artificial intelligence systems. TRIAL REGISTRATION: Systematic review registration. Prospero registration number: CRD42022307403.
Asunto(s)
Inteligencia Artificial , Neoplasias , Adulto , Humanos , Algoritmos , Hidrolasas , Aprendizaje Automático , Neoplasias/diagnóstico por imagen , Revisiones Sistemáticas como AsuntoRESUMEN
OBJECTIVE: To define which are and how the radiomics features of jawbone pathologies are extracted for diagnosis, predicting prognosis and therapeutic response. METHODS: A comprehensive literature search was conducted using eight databases and gray literature. Two independent observers rated these articles according to exclusion and inclusion criteria. 23 papers were included to assess the radiomics features related to jawbone pathologies. Included studies were evaluated by using JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. RESULTS: Agnostic features were mined from periapical, dental panoramic radiographs, cone beam CT, CT and MRI images of six different jawbone alterations. The most frequent features mined were texture-, shape- and intensity-based features. Only 13 studies described the machine learning step, and the best results were obtained with Support Vector Machine and random forest classifier. For osteoporosis diagnosis and classification, filtering, shape-based and Tamura texture features showed the best performance. For temporomandibular joint pathology, gray-level co-occurrence matrix (GLCM), gray level run length matrix (GLRLM), Gray Level Size Zone Matrix (GLSZM), first-order statistics analysis and shape-based analysis showed the best results. Considering odontogenic and non-odontogenic cysts and tumors, contourlet and SPHARM features, first-order statistical features, GLRLM, GLCM had better indexes. For odontogenic cysts and granulomas, first-order statistical analysis showed better classification results. CONCLUSIONS: GLCM was the most frequent feature, followed by first-order statistics, and GLRLM features. No study reported predicting response, prognosis or therapeutic response, but instead diseases diagnosis or classification. Although the lack of standardization in the radiomics workflow of the included studies, texture analysis showed potential to contribute to radiologists' reports, decreasing the subjectivity and leading to personalized healthcare.
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Quistes , Imagen por Resonancia Magnética , Humanos , Estudios Transversales , Tomografía Computarizada de Haz Cónico , Maxilares/diagnóstico por imagenRESUMEN
OBJECTIVES: This systematic review aimed to analyze the use of telehealth in monitoring patients with head and neck cancer regarding the application used, user adherence to technology, user satisfaction, and user quality of life. MATERIALS AND METHODS: A search strategy was developed using the PICO acronym and the terms "Head and Neck Cancer," "Telehealth," "Mobile Application," and "Supportive Care." A broad literature search was performed on PubMed, Cochrane Library, Scopus, Web of Science, Lilacs, and Embase databases and on grey literature through Open Grey, Google Scholar, and Jstor, for studies comparing the monitoring of head and neck cancer patients with telehealth apps to the monitoring performed in a traditional way at health units. No study design, publication status, publication time, or language restrictions were applied. Pairs of reviewers worked independently for study selection and risk of bias assessment. The protocol was registered in PROSPERO and the PRISMA checklist used for reporting the review. RESULTS: We found 393 references in the databases, 325 after duplicate removal; 19 met the criteria for full-text reading; 08 studies were included for qualitative synthesis. Although there was heterogeneity regarding the technology used, the studies included showed that remote monitoring and/or self-management of symptoms through mobile applications was feasible for most patients, with satisfactory degrees of acceptability, satisfaction, usability, and adherence. The health-related quality of life improved with the use of remote technologies for telehealth, associated with low to moderate self-efficacy, higher personal control, and higher knowledge of health with clinically acceptable levels of accuracy compared to traditional clinical evaluation. Even when the data presented were not statistically significant, patients reported improvement in health-related quality of life after the intervention. CONCLUSIONS: Telehealth monitoring through the use of remote technologies presents itself as an alternative way of educating and supporting patients during the treatment of Head and Neck Cancer (HNC). There is the need for a more user-friendly interface, adequate user experience assessment, and the concrete applicability of telehealth technologies for monitoring patients with HNC in order to legitimize the cost-effectiveness of developing long-term multicenter longitudinal studies term.
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Neoplasias de Cabeza y Cuello , Telemedicina , Estudios de Factibilidad , Neoplasias de Cabeza y Cuello/terapia , Humanos , Estudios Multicéntricos como Asunto , Satisfacción del Paciente , Satisfacción Personal , Calidad de Vida , TecnologíaRESUMEN
With the social isolation resulting from the coronavirus pandemic, the residency in Oral and Maxillofacial Surgery of the Federal District Public Health System adapted to maintain the attendance and course schedule. Theoretical classes migrated to online and there was an abrupt change in practical activities, such as the reduction in elective care and newbiosafetyprotocols. The objective of this research was to understand the impact of the pandemic on the residency, including the analysis of perception and the level of satisfaction of the participants regarding online classes and practical activities, analysis of the number and type of surgeries performed in 2020 and residents'attitudes aimedfor professional career, through Likerttypequestionnaires. Only half of the tutors and less than half of the residentswere motivated to use the virtual teaching environment. In addition, the number of surgerieswasreduced by more than 40%. In addition, half of the residents responded that they do not feel capableto resolve unexpected events related to their training and that they are not confident in making decisions regarding theirprofessional career. COVID-19 will continue to have a greater impact on surgical practice, so hospitals should develop a detailed contingency plan, including for pandemics and schools should permanently incorporate options of complementary remote activitiesin their curriculum (AU).
Com o isolamento social decorrente da pandemia de coronavírus, a residência em Cirurgia Buco-Maxilo-Facialda Secretaria de Saúde do Distrito Federalse adaptou para manter o atendimento e o cronograma do curso. Aulas teóricas migraram para onlinee houve abrupta mudança das atividades práticas, como a diminuição do atendimento eletivo e novos protocolos de biossegurança. O objetivo dessa pesquisa foi entender o impacto da pandemia no ensino na residência, incluindo a análise de percepção e do nível de satisfação dos participantes quanto às aulas onlinee atividades práticas, análise do número e tipo de cirurgias realizadas em 2020 e atitudes dos residentes voltadas para carreira profissional, por meio de questionários do tipo Likert. Apenas metade dos preceptores e menos da metade dos residentes estavam motivados a usar o ambiente virtual de ensino. O número de cirurgias foi reduzido em mais de 40%. Além disso, metade dos residentes respondeu que não se sente capaz de resolver eventos inesperados relacionados à sua formação e que não está segura em tomar decisões relativas à sua carreira profissional. A COVID-19 continuará a ter maior impacto na prática cirúrgica, por isso, hospitais devem desenvolver um plano de contingência detalhado, inclusive para o caso de futuras pandemias e escolas devem incorporar opções de atividades remotas complementares permanentemente em seu currículo (AU).
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Humanos , Masculino , Femenino , Percepción Social , Cirugía Bucal , Educación en Odontología/métodos , Redes Sociales en Línea , COVID-19/transmisión , Internado y Residencia , Brasil/epidemiología , Encuestas y Cuestionarios/estadística & datos numéricos , Contención de Riesgos Biológicos/métodos , Internado y ResidenciaRESUMEN
OBJECTIVES: This integrative review aimed to assess the benefits of the use of teledentistry for patients undergoing treatment of oral and head and neck cancer during the COVID-19 pandemic. MATERIALS AND METHODS: We searched in PubMed, Cochrane, Scopus, Web of Science, Lilacs, Embase, Open Grey, Google Scholar, and Jstor databases for studies referring to the management, control, and assistance, through teledentistry, to patients with oral and head and neck cancer during the COVID-19 pandemic. RESULTS: We found 356 references in the databases, 209 after duplicates removal, 23 met criteria for full-text reading, and 11 studies were included for qualitative synthesis, in four categories: virtual visits, use of remote technology, patient's satisfaction, multidisciplinary approach in teledentistry. We found that 78% of patients currently preferred teledentistry; 92% of patients would recommend the use of video consultation to other patients. The continuity of dental care, the reduction of patient visits to the hospital, the reduction of the risk of infection with the coronavirus, and limitation of face-to-face consultations to protect health professionals are benefits that reinforce the use of teledentistry by health institutions. Two studies showed patients' satisfaction with the use of teledentistry in monitoring cancer patients and showed an improvement in quality of life. CONCLUSIONS: The teledentistry, as a remote technology for monitoring patients with oral and head and neck cancer, is well accepted by patients in preliminary studies. Although these studies pointed out some benefits of using remote technologies for the care of cancer patients, further robust scientific evidence is still needed in this regard.
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COVID-19 , Neoplasias de la Boca , Telemedicina , Humanos , Neoplasias de la Boca/epidemiología , Neoplasias de la Boca/terapia , Pandemias , Calidad de Vida , SARS-CoV-2RESUMEN
Define-se e-learning como qualquer tipo de situação educacional em que o conteúdo é disponibilizado eletronicamente via Internet quando e onde as pessoas precisam. Usando as possibilidades que o ambiente virtual oferece para o ensino, foi elaborado um e-módulo na Plataforma Moodle. O objetivo desse estudo foi verificar o acesso, desempenho e aceitação de estudantes de graduação em Odontologia frente à utilização do e-módulo nas atividades online da Disciplina de Diagnóstico Bucal na Universidade de Brasília. Avaliações de conteúdo (pré e pós-teste), pré-teste de expectativa e pós-teste de satisfação foram elaborados para avaliar o conteúdo e a aceitação do emódulo entre os participantes. Dos 25 participantes iniciais, dois concluíram o e-módulo, 11 começaram e não concluíram, nove não acessaram a Plataforma e três não aceitaram responder o pósteste de satisfação. Pré e pós-teste de conteúdo não apresentaram dados significativos. O pós-teste de satisfação mostrou que dos estudantes que não acessaram o e-módulo, ou acessaram e não concluíram, 80% alegaram "não ter tempo para acessar a Plataforma" e 15% afirmaram não participar, ou não concluir o e-módulo "porque este não trazia acréscimo de crédito ou nota". Em conclusão, apesar de os estudantes serem positivos em relação ao uso de novas metodologias, a participação foi muito baixa. Já o desempenho foi similar àquele das aulas presenciais. Vários fatores influenciam a atitude dos estudantes no e-módulo, incluindo o ganho de recompensas e a forma pedagógica dos conteúdos. Assim, persiste ao professor o papel motivacional e mediador entre aprendizado e mundo virtual (AU).
E-learning can be defined as any type of educational situation in which the content is available electronically via Internet when and where people need it. Using the possibilities that virtual environment provides for education, was developed an e-module in the Moodle Platform. The aim of this study was to verify the access, performance, and acceptance of undergraduate dentistry students to use the e-module in the online activities of Oral Diagnosis Discipline at the University of Brasilia. Evaluations of content (pre and post-test), pre-test of expectation and post-test of satisfaction were designed to evaluate the content and acceptance of e-module among participants. Of the 25 initial participants, 2 completed the e-module, 11 started and did not complete, 9 did not access the platform and three did not accept to answer the post-test of satisfaction. Pre and post-test of content showed no significant data. The post-test of satisfaction showed that the students who have not accessed the e-module, or accessed and did not complete, 80% said they "did not have time to access the Platform" and 15% said they did not participate or did not complete the e-module "because it would not improve GPA or course credit number". In conclusion, although students were positive regarding the use of new methodologies, the participation was very low. The performance was similar to presential classes. Several factors influence the attitude of the students in the emodule, including rewards gain and the pedagogical form of the contents. Thus, it is up to the teacher the motivational and mediating role between learning and the virtual world (AU).
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Humanos , Masculino , Femenino , Estudiantes de Odontología , Diagnóstico Bucal , Educación en Odontología , Escolaridad , Radiografía Dental/métodos , Encuestas y Cuestionarios , Aprendizaje Basado en Problemas/métodos , Tecnología Educacional/métodos , Educación a Distancia/métodosRESUMEN
Social media can be defined as Internet-based applications that allow the widespread creation and exchange of user-generated content. The ease with which social media can be accessed through numerous mobile devices encourages medical educators to use social media to share content with students outside the classroom. The aim of this study was to introduce WhatsApp as a teaching tool in an Oral Radiology course. The secondary objective was to assess students' attitudes towards the use of this innovative tool in teaching of dentistry. In the first semester of 2016, 30 second-year undergraduate dental students at the University of Brasília were provided with weekly quizzes via a WhatsApp discussion group. The quizzes consisted of a tomographic or radiographic image from a real clinical case and a multiple-choice question. At the end of the semester students' attitudes were assessed using a satisfaction questionnaire. The results showed that students had a positive attitude towards the use of WhatsApp and considered it had helped them to learn about Oral Radiology. In conclusion, this technology can improve the way material is taught, since educators are prepared to develop better learning environments and students are concerned about the potential use of the social media in education (AU).
Mídias sociais podem ser definidas como um grupo de aplicativos baseados em Internet que permitem a criação e troca de conteúdos gerados pelo usuário de forma bastante expandida. A facilidade de as mídias sociais serem acessadas em dispositivos móveis encoraja educadores da área de saúde a compartilhar nessas mídias conteúdos que vão além da sala de aula. O objetivo desse estudo foi introduzir a mídia social WhatsApp como uma ferramenta de ensino no curso de Radiologia Oral. Como segundo objetivo, as atitudes dos estudantes ao utilizar essa nova ferramenta durante a graduação em Odontologia foram avaliadas. No primeiro semestre de 2016, quizzes semanais foram disponibilizados em um grupo de discussão no WhatsApp, criado com 30 alunos do segundo ano de Odontologia da Universidade de Brasília. Os quizzes eram compostos por uma imagem radiográfica ou tomográfica de um caso clínico real e uma questão de múltipla escolha. Ao final do semestre, avaliou-se o comportamento dos estudantes por um questionário de satisfação. O estudo mostrou que os alunos têm atitude positiva em relação ao uso do WhatsApp e o consideraram útil para auxiliar o aprendizado de Radiologia Oral. Em conclusão, essa tecnologia é capaz de aprimorar a forma como os conteúdos são ensinados, desde que os educadores estejam preparados para desenvolver melhores ambientes de aprendizado e os estudantes estejam conscientes sobre o potencial uso das mídias sociais para educação (AU).
Asunto(s)
Humanos , Masculino , Femenino , Educación en Odontología , Red Social , Medios de Comunicación Sociales , Estudiantes de Odontología , Radiografía Dental/métodos , Epidemiología Descriptiva , Encuestas y Cuestionarios , Tecnología Educacional/métodosRESUMEN
The purpose of this study is to introduce a visualization and interaction tool of Augmented Reality in mobile devices using three-dimensional (3D) volumetric images from patients' real tomographic acquisition, and to describe the steps for preparing the models for such 3D visualizations. Augmented Reality was built correlating tomographic images and open-source software, in a sequence of (1) image acquired, that consists of multi-planar images that can be visualized as 3D renderings and are the basis for constructing polygonal surfaces of specific anatomic structures of interest, (2) creation of volumetric models, in which 3D volumetric model can be saved and exported as a 3D polygonal mesh in .stl file format, (3) model simplification, which must be done in order to simplify the matrix of polygonal surfaces, and reduce models' megabytes, and (4) create the augmented reality project. Once these procedures are performed, the augmented reality project can be saved and visualized in mobile devices. The volumetric model from a computed tomography acquisition is available in any mobile device screen, superimposed on a marker. This approach facilitates the visualization of the model, giving the precise location of structures and abnormalities, as supernumerary teeth, bone fractures and asymmetries. Also, the model is saved for future and multiple visualization. Augmented reality application is a new perspective in dentistry although it is in an early phase. It can be created by integrating multiple technologies and has a great potential to support learning and teaching, and improve how 3D models from medical images are seen (AU).
O objetivo desse trabalho é introduzir uma ferramenta de visualização e interação baseada em realidade aumentada (RA) em dispositivos móveis utilizando imagens volumétricas em três dimensões (3D) a partir de aquisições tomográficas reais de pacientes, e descrever os passos para o preparo dos modelos para tais visualizações tridimensionais. A RA foi construída correlacionando imagens tomográficas e programas de computador livres, na seguinte sequência: (1) imagem adquirida, que consiste em imagens mutiplanares que podem ser visualizadas como renderizações 3D e são a base para a construção de superfícies poligonais de estruturas anatômicas específicas de interesse, (2) criação dos modelos volumétricos, passo no qual o modelo 3D pode ser salvo e exportado como uma malha poligonal 3D em formato de arquivo .stl, (3)simplificação do modelo, que deve ser executada com a finalidade de simplificar a matriz de superfícies poligonais e consequentemente reduzir os megabytes do modelo, e (4) criação do projeto de realidade aumentada. Essa abordagem facilita a visualização do modelo tomográfico, dando a localização precisa de estruturas e anormalidades, como dentes supranumerários, fraturas ósseas e assimetrias. Além disso, o referido modelo pode ser salvo para múltiplias visualizações futuras. A aplicação da realidade aumentada é uma nova perspectiva em Odontologia apesar de estar em fase inicial. Pode ser criada integrando múltiplas tecnologias e apresenta grande potencial para auxiliar o ensino e a aprendizagem, e para melhorar a forma como modelos 3D originados de imagens médicas são visualizados (AU).