Imaging Analytics using Artificial Intelligence in Oncology: A Comprehensive Review.

The present era has seen a surge in artificial intelligence-related research in oncology, mainly using deep learning, because of powerful computer hardware, improved algorithms and the availability of large amounts of data from open-source domains and the use of transfer learning. Here we discuss the multifaceted role of deep learning in cancer care, ranging from risk stratification, the screening and diagnosis of cancer, to the prediction of genomic mutations, treatment response and survival outcome prediction, through the use of convolutional neural networks. Another role of artificial intelligence is in the generation of automated radiology reports, which is a boon in high-volume centres to minimise report turnaround time. Although a validated and deployable deep-learning model for clinical use is still in its infancy, there is ongoing research to overcome the barriers for its universal implementation and we also delve into this aspect. We also briefly describe the role of radiomics in oncoimaging. Artificial intelligence can provide answers pertaining to cancer management at baseline imaging, saving cost and time. Imaging biobanks, which are repositories of anonymised images, are also briefly described. We also discuss the commercialisation and ethical issues pertaining to artificial intelligence. The latest generation generalist artificial intelligence model is also briefly described at the end of the article. We believe this article will not only enrich knowledge, but also promote research acumen in the minds of readers to take oncoimaging to another level using artificial intelligence and also work towards clinical translation of such research.

Imaging of brain metastasis in non-small-cell lung cancer: indications, protocols, diagnosis, post-therapy imaging, and implications regarding management.

Increased survival (due to the use of targeted therapies based on genomic profiling) has resulted in the increased incidence of brain metastasis during the course of disease, and thus, made it essential to have proper imaging guidelines in place for brain metastasis from non-small-cell lung cancer (NSCLC). Brain parenchymal metastases can have varied imaging appearances, and it is pertinent to be aware of the various molecular risk factors for brain metastasis from NSCLC along with their suggestive imaging appearances, so as to identify them early. Leptomeningeal metastasis requires additional imaging of the spine and an early cerebrospinal fluid (CSF) analysis. Differentiation of post-therapy change from recurrence on imaging has a bearing on the management, hence the need for its awareness. This article will provide in-depth literature review of the epidemiology, aetiopathogenesis, screening, detection, diagnosis, post-therapy imaging, and implications regarding the management of brain metastasis from NSCLC. In addition, we will also briefly highlight the role of artificial intelligence (AI) in brain metastasis screening.

A study of bone mineral density in diabetes mellitus in eastern India.

To measure bone mineral density in diabetic patients at the time of clinical diagnosis of diabetes mellitus and to find out correlation, if any, with microvascular complication of diabetes mellitus and glycosylated haemoglobin, a study was conducted at Medical College and Hospital, Kolkata among 138 cases of diabetes and 212 controls. All patients were screened for ophthalmoscopy, routine blood and urine examinations. Bone ultrasound attenuation study of the calcaneus was performed in all cases. The bone ultrasound attenuation result was compared to a mean normal population result and expressed as Z score and T score. The age of diabetic patients varied from 11 years to 70 years. Of 138 diabetics, 32 (23.18%) had type 1 diabetes and rest type 2 diabetes. Forty-two diabetic patients had retinopathy, 42 nephropathy and 48 had neuropathy. Glycosylated haemoglobin was above 7% in 124 patients. The broadband ultrasound attenuation of type 1 diabetics ranged from 38 to 95 dB/MHz and in type 2 it was 35 to 104 dB/MHz. There was no statistically significant correlation between neuropathy, nephropathy, retinopathy and bone mineral density status. It was also found no correlation between glycosylated haemoglobin values and ultrasound attenuation.

Vitiligo associated with cutaneous amyloidosis.

Vitiligo is known to be associated with a variety of dermatoses and systemic diseases. We describe a case of vitiligo developing in a patient having cutaneous amyloidosis. To our knowledge this is the first report of its kind in the literature.

The immunization programme in Bangladesh: impressive gains in coverage, but gaps remain.

The paper reviews the achievements in tetanus immunization coverage and child immunization in Bangladesh. It uses data from the 1993-94 Bangladesh Demographic and Health Survey to identify and examine the programmatic and non-programmatic factors that influence the coverage of tetanus (TT) immunization during pregnancy, and full immunization among children 12-23 months old in rural Bangladesh. The purpose of this analysis is to identify the areas that need further programme attention. The logistic regression results show that the coverage of TT immunization was significantly associated with proximity to outreach clinics and the presence of a health worker in the community. Home visits by health/family planning fieldworkers and the proximity to outreach clinics had larger influences on TT coverage of poorer households compared to those better-off. The effect of distance to static clinics varied by regions. Among children, full immunization coverage (coverage of all of BCG, DPT1, DPT2, DPT3, Polio1 Polio2, Polio3) was significantly associated with distance to outreach clinics, the greater the distance to the clinics, the less the likelihood of immunization.

PIP: The authors review the achievements in tetanus immunization coverage and child immunization in Bangladesh, using data from the 1993-94 Bangladesh Demographic and Health Survey to identify and examine the programmatic and nonprogrammatic factors which influence the coverage of tetanus immunization (TT) during pregnancy, and full immunization among children aged 12-23 months old in rural Bangladesh. The research was conducted to identify which areas need additional program attention. According to logistic regression analysis, the coverage of TT immunization was significantly associated with proximity to outreach clinics and the presence of a health worker in the community. Home visits by health and family planning field workers, and the proximity to outreach clinics had more influence upon the TT coverage of poorer households than they did upon those which were more affluent. The effect of distance to static clinics varied by regions. Among children, full immunization coverage was significantly associated with distance to outreach clinics, with greater distance to the clinics reducing the likelihood of immunization.

Cutaneous Manifestations of Chronic Renal Failure.

Cutaneous manifestations of chronic renal failure (CRF) were studied in 20 cases. Generalised pruritus was observed in 8 patients, ichthyotic skin changes of varying degree in 18 patients and hyperpigmentation of sun-exposed skin in 7 patients. Scaling, pallor and hair loss correlated strongly with the severity of CRF. Skin biopsy performed in 5 cases revealed mild hyperkeratosis, reduction of prickle cell layer and flattening of rate ridges. No significant dermal changes were detected.

Tumor associated macrophage mediated lysis of autologous tumor cells.

Lysis of autologous tumor cells (ATC) mediated by the tumor associated macrophages (TAM) was studied by 4 h 51Cr-release assay at different days of growth of a transplantable ascites tumor, S-180, inoculated in adult male Swiss mice. The ATC were coated with serum of tumor bearing mice. On day 3 after tumor inoculation the TAM mediated a remarkable lysis of the tumor serum coated ATC. With advancement of tumor growth the cytolysis by TAM decreased gradually to the basal level at day 10 and totally abrogated at day 12. Also the binding of the tumor serum coated ATC by TAM varied at different days of tumor growth. At early phases of tumor growth high lytic activity of the TAM was correlated with augmented target binding. The observed lysis may be considered as antibody dependent cell mediated cytotoxicity (ADCC) extended by the TAM, since presence of specific tumor antibodies were demonstrated in the tumor serum used for coating ATC. No significant lysis was recorded when the ATC was coated with normal serum or used as such for direct lysis by the TAM. In vitro treatment of the TAM with suitable doses of Levamisole and Polyionosinic-polycyticyclic acid further augmented the TAM mediated high level of ADCC at day 3 with no change in its binding of ATC. The immunopotentiators enhanced both ADCC and target binding ability of the functionally depressed TAM at day 10.

Phagocytic activity of the tumor associated macrophages in relation to tumor growth: modulation with levamisole.

The phagocytic activity of the tumor associate macrophages isolated at different days of the growth of a murine transplantable ascites tumor was assessed by measuring the engulfment of Na2 51CrO4 labeled antibody coated sheep erythrocytes. Binding of the targets by the macrophages was also assessed. It was observed that, excepting the day 3, till day 7 of tumor growth the phagocytic activity of the tumor associated macrophages was very high as compared to that of resident macrophages of normal mice. Augmented target binding by the macrophages was recorded till day 7. Levamisole was observed to augment phagocytosis and target binding by the macrophages but a differential requirement as regard to the dose of Levamisole was noted for modulation of phagocytosis and target binding by the tumor associated macrophages at early and advanced stages of the tumor growth.

Quantification of thermal sensory perception in leprosy (a preliminary report).

An instrument called 'Thermosense' was designed and developed for quantitative assessment of thermal sensory perception. Preliminary testing on 20 healthy adult males showed that 39 degrees C was perceived as hot in 19 individuals on the forearm and arm. The perception on the finger tips was less than forearms. In 5 cases of leprosy (BT 4, TT 1) testing showed detectable difference in thermal perception within the lesion, in the skin, in the vicinity of the lesion and the uninvolved skin.

Inoculation leprosy subsequent to dog bite. A case report.

Development of leprosy lesion at the site of inoculation or injury is described by many workers off and on. An interesting case of indeterminate leprosy developing at the site of dog bite is being reported.