RESUMEN
BACKGROUND: A fair amount of microcalcifications sent for biopsy are false positives. The study investigates whether quantitative radiomic features extracted from digital breast tomosynthesis (DBT) can be an additional and useful tool to discriminate between benign and malignant BI-RADS category 4 microcalcification. METHODS: This retrospective study included 252 female patients with BI-RADS category 4 microcalcifications. The patients were divided into two groups according to micro-histopathology: 126 patients with benign lesions and 126 patients with certain or possible malignancies. A total of 91 radiomic features were extracted for each patient, and the 12 most representative features were selected by using the agglomerative hierarchical clustering method. The binary classification task of the two groups was carried out by using four different machine-learning algorithms (i.e., linear support vector machine (SVM), radial basis function (RBF) SVM, logistic regression (LR), and random forest (RF)). Accuracy, sensitivity, sensibility, and the area under the curve (AUC) were calculated for each of them. RESULTS: The best performance was achieved using the RF classifier (AUC = 0.59, 95% confidence interval 0.57-0.60; sensitivity = 0.56, 95% CI 0.54-0.58; specificity = 0.61, 95% CI 0.59-0.63; accuracy = 0.58, 95% CI 0.57-0.59). CONCLUSIONS: DBT-based radiomic analysis seems to have only limited potential in discriminating benign from malignant microcalcifications.
RESUMEN
Our purpose is to evaluate the performance of magnetic resonance (MR) radiomics analysis for differentiating between malignant and benign parotid neoplasms and, among the latter, between pleomorphic adenomas and Warthin tumors. We retrospectively evaluated 75 T2-weighted images of parotid gland lesions, of which 61 were benign tumors (32 pleomorphic adenomas, 23 Warthin tumors and 6 oncocytomas) and 14 were malignant tumors. A receiver operating characteristics (ROC) curve analysis was performed to find the threshold values for the most discriminative features and determine their sensitivity, specificity and area under the ROC curve (AUROC). The most discriminative features were used to train a support vector machine classifier. The best classification performance was obtained by comparing a pleomorphic adenoma with a Warthin tumor (yielding sensitivity, specificity and a diagnostic accuracy as high as 0.8695, 0.9062 and 0.8909, respectively) and a pleomorphic adenoma with malignant tumors (sensitivity, specificity and a diagnostic accuracy of 0.6666, 0.8709 and 0.8043, respectively). Radiomics analysis of parotid tumors on conventional T2-weighted MR images allows the discrimination of pleomorphic adenomas from Warthin tumors and malignant tumors with a high sensitivity, specificity and diagnostic accuracy.
RESUMEN
Immunotherapy with checkpoint inhibitors (ICIs) is becoming standard of practice for an increasing number of cancer types. ICIs enhance T-cell action against the cancer cells. By unbalancing the immune system ICIs may cause dysimmune toxicities, a series of disorders broadly defined immune-related adverse events (irAEs). IrAEs may affect any organ or apparatus and most frequently involve skin, colon, endocrine organs, liver, and lungs. Early identification and appropriate treatment of irAEs can improve patient outcome. The paper aims at reviewing mechanisms of the occurrence of irAEs, the importance of a proper diagnosis and the main pillars of therapy. To provide effective guidance to the comprehension of major irAEs imaging findings will be reviewed.
