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Artesani A, Bruno A, Gelardi F, Chiti A. Empowering PET: harnessing deep learning for improved clinical insight. Eur Radiol Exp 2024; 8:17. [PMID: 38321340 PMCID: PMC10847083 DOI: 10.1186/s41747-023-00413-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/20/2023] [Indexed: 02/08/2024] Open
Abstract
This review aims to take a journey into the transformative impact of artificial intelligence (AI) on positron emission tomography (PET) imaging. To this scope, a broad overview of AI applications in the field of nuclear medicine and a thorough exploration of deep learning (DL) implementations in cancer diagnosis and therapy through PET imaging will be presented. We firstly describe the behind-the-scenes use of AI for image generation, including acquisition (event positioning, noise reduction though time-of-flight estimation and scatter correction), reconstruction (data-driven and model-driven approaches), restoration (supervised and unsupervised methods), and motion correction. Thereafter, we outline the integration of AI into clinical practice through the applications to segmentation, detection and classification, quantification, treatment planning, dosimetry, and radiomics/radiogenomics combined to tumour biological characteristics. Thus, this review seeks to showcase the overarching transformation of the field, ultimately leading to tangible improvements in patient treatment and response assessment. Finally, limitations and ethical considerations of the AI application to PET imaging and future directions of multimodal data mining in this discipline will be briefly discussed, including pressing challenges to the adoption of AI in molecular imaging such as the access to and interoperability of huge amount of data as well as the "black-box" problem, contributing to the ongoing dialogue on the transformative potential of AI in nuclear medicine.Relevance statementAI is rapidly revolutionising the world of medicine, including the fields of radiology and nuclear medicine. In the near future, AI will be used to support healthcare professionals. These advances will lead to improvements in diagnosis, in the assessment of response to treatment, in clinical decision making and in patient management.Key points• Applying AI has the potential to enhance the entire PET imaging pipeline.• AI may support several clinical tasks in both PET diagnosis and prognosis.• Interpreting the relationships between imaging and multiomics data will heavily rely on AI.
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Affiliation(s)
- Alessia Artesani
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele, 20090, Italy
| | - Alessandro Bruno
- Department of Business, Law, Economics and Consumer Behaviour "Carlo A. Ricciardi", IULM Libera Università Di Lingue E Comunicazione, Via P. Filargo 38, Milan, 20143, Italy
| | - Fabrizia Gelardi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan, Pieve Emanuele, 20090, Italy.
- Vita-Salute San Raffaele University, Via Olgettina 58, Milan, 20132, Italy.
| | - Arturo Chiti
- Vita-Salute San Raffaele University, Via Olgettina 58, Milan, 20132, Italy
- Department of Nuclear Medicine, IRCCS Ospedale San Raffaele, Via Olgettina 60, Milan, 20132, Italy
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Jimenez-Mesa C, Arco JE, Martinez-Murcia FJ, Suckling J, Ramirez J, Gorriz JM. Applications of machine learning and deep learning in SPECT and PET imaging: General overview, challenges and future prospects. Pharmacol Res 2023; 197:106984. [PMID: 37940064 DOI: 10.1016/j.phrs.2023.106984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/04/2023] [Accepted: 11/04/2023] [Indexed: 11/10/2023]
Abstract
The integration of positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging techniques with machine learning (ML) algorithms, including deep learning (DL) models, is a promising approach. This integration enhances the precision and efficiency of current diagnostic and treatment strategies while offering invaluable insights into disease mechanisms. In this comprehensive review, we delve into the transformative impact of ML and DL in this domain. Firstly, a brief analysis is provided of how these algorithms have evolved and which are the most widely applied in this domain. Their different potential applications in nuclear imaging are then discussed, such as optimization of image adquisition or reconstruction, biomarkers identification, multimodal fusion and the development of diagnostic, prognostic, and disease progression evaluation systems. This is because they are able to analyse complex patterns and relationships within imaging data, as well as extracting quantitative and objective measures. Furthermore, we discuss the challenges in implementation, such as data standardization and limited sample sizes, and explore the clinical opportunities and future horizons, including data augmentation and explainable AI. Together, these factors are propelling the continuous advancement of more robust, transparent, and reliable systems.
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Affiliation(s)
- Carmen Jimenez-Mesa
- Department of Signal Theory, Networking and Communications, University of Granada, 18010, Spain
| | - Juan E Arco
- Department of Signal Theory, Networking and Communications, University of Granada, 18010, Spain; Department of Communications Engineering, University of Malaga, 29010, Spain
| | | | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge CB21TN, UK
| | - Javier Ramirez
- Department of Signal Theory, Networking and Communications, University of Granada, 18010, Spain
| | - Juan Manuel Gorriz
- Department of Signal Theory, Networking and Communications, University of Granada, 18010, Spain; Department of Psychiatry, University of Cambridge, Cambridge CB21TN, UK.
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Filippi L, Frantellizzi V, Vincentis GD, Schillaci O, Evangelista L. Clinical Applications of TSPO PET for Glioma Imaging: Current Evidence and Future Perspective-A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13101813. [PMID: 37238297 DOI: 10.3390/diagnostics13101813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Our aim was to provide a comprehensive overview of the existing literature concerning the clinical applications of positron emission computed tomography (PET) with radiopharmaceuticals targeting the translocator protein (TSPO) in gliomas. A literature search for studies about TSPO PET in the last 10 years (from 2013 to February 2023) was carried out on PubMed, Scopus, and Web of Science using the following keywords: "PET" AND "Gliomas" AND "TSPO". The Critical Appraisal Skills Program checklist for diagnostic test studies was used for testing the quality of selected papers. Ten articles were selected, encompassing 314 glioma patients submitted to PET/CT (9/10) or PET/MRI (1/10) with TSPO ligands. Among the various available TSPO tracers, the most frequently used was the third-generation ligand, [18F]-GE-180. TSPO PET results were useful to identify anaplastic transformation in gliomas and for the prognostic stratification of patients bearing homogeneous genetic alterations. When compared to amino-acid PET, TSPO PET with [18F]-GE-180 presented superior image quality and provided larger and only partially overlapping PET-based volumes. Although biased by some issues (i.e., small sample size, most of the studies coming from the same country), preliminary applications of TSPO PET were encouraging. Further studies are needed to define implications in clinical practice and shape the role of TSPO PET for patients' selection for potential TSPO-targeted molecular therapies.
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Affiliation(s)
- Luca Filippi
- Nuclear Medicine Unit, "Santa Maria Goretti" Hospital, Via Antonio Canova, 04100 Latina, Italy
| | - Viviana Frantellizzi
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00185 Rome, Italy
| | - Giuseppe De Vincentis
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza, University of Rome, 00185 Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Laura Evangelista
- Nuclear Medicine Unit, Department of Medicine (DIMED), University of Padua, Via Giustiniani, 35128 Padua, Italy
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Rana A, Dumka A, Singh R, Panda MK, Priyadarshi N. A Computerized Analysis with Machine Learning Techniques for the Diagnosis of Parkinson's Disease: Past Studies and Future Perspectives. Diagnostics (Basel) 2022; 12:2708. [PMID: 36359550 PMCID: PMC9689408 DOI: 10.3390/diagnostics12112708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 08/03/2023] Open
Abstract
According to the World Health Organization (WHO), Parkinson's disease (PD) is a neurodegenerative disease of the brain that causes motor symptoms including slower movement, rigidity, tremor, and imbalance in addition to other problems like Alzheimer's disease (AD), psychiatric problems, insomnia, anxiety, and sensory abnormalities. Techniques including artificial intelligence (AI), machine learning (ML), and deep learning (DL) have been established for the classification of PD and normal controls (NC) with similar therapeutic appearances in order to address these problems and improve the diagnostic procedure for PD. In this article, we examine a literature survey of research articles published up to September 2022 in order to present an in-depth analysis of the use of datasets, various modalities, experimental setups, and architectures that have been applied in the diagnosis of subjective disease. This analysis includes a total of 217 research publications with a list of the various datasets, methodologies, and features. These findings suggest that ML/DL methods and novel biomarkers hold promising results for application in medical decision-making, leading to a more methodical and thorough detection of PD. Finally, we highlight the challenges and provide appropriate recommendations on selecting approaches that might be used for subgrouping and connection analysis with structural magnetic resonance imaging (sMRI), DaTSCAN, and single-photon emission computerized tomography (SPECT) data for future Parkinson's research.
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Affiliation(s)
- Arti Rana
- Computer Science & Engineering, Veer Madho Singh Bhandari Uttarakhand Technical University, Dehradun 248007, Uttarakhand, India
| | - Ankur Dumka
- Department of Computer Science and Engineering, Women Institute of Technology, Dehradun 248007, Uttarakhand, India
- Department of Computer Science & Engineering, Graphic Era Deemed to be University, Dehradun 248001, Uttarakhand, India
| | - Rajesh Singh
- Division of Research and Innovation, Uttaranchal Institute of Technology, Uttaranchal University, Dehradun 248007, Uttarakhand, India
- Department of Project Management, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
| | - Manoj Kumar Panda
- Department of Electrical Engineering, G.B. Pant Institute of Engineering and Technology, Pauri 246194, Uttarakhand, India
| | - Neeraj Priyadarshi
- Department of Electrical Engineering, JIS College of Engineering, Kolkata 741235, West Bengal, India
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Differential Diagnosis of Alzheimer Disease vs. Mild Cognitive Impairment Based on Left Temporal Lateral Lobe Hypomethabolism on 18F-FDG PET/CT and Automated Classifiers. Diagnostics (Basel) 2022; 12:diagnostics12102425. [PMID: 36292114 PMCID: PMC9601187 DOI: 10.3390/diagnostics12102425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/22/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose: We evaluate the ability of Artificial Intelligence with automatic classification methods applied to semi-quantitative data from brain 18F-FDG PET/CT to improve the differential diagnosis between Alzheimer Disease (AD) and Mild Cognitive Impairment (MCI). Procedures: We retrospectively analyzed a total of 150 consecutive patients who underwent diagnostic evaluation for suspected AD (n = 67) or MCI (n = 83). All patients received brain 18F-FDG PET/CT according to the international guidelines, and images were analyzed both Qualitatively (QL) and Quantitatively (QN), the latter by a fully automated post-processing software that produced a z score metabolic map of 25 anatomically different cortical regions. A subset of n = 122 cases with a confirmed diagnosis of AD (n = 53) or MDI (n = 69) by 18–24-month clinical follow-up was finally included in the study. Univariate analysis and three automated classification models (classification tree –ClT-, ridge classifier –RC- and linear Support Vector Machine –lSVM-) were considered to estimate the ability of the z scores to discriminate between AD and MCI cases in. Results: The univariate analysis returned 14 areas where the z scores were significantly different between AD and MCI groups, and the classification accuracy ranged between 74.59% and 76.23%, with ClT and RC providing the best results. The best classification strategy consisted of one single split with a cut-off value of ≈ −2.0 on the z score from temporal lateral left area: cases below this threshold were classified as AD and those above the threshold as MCI. Conclusions: Our findings confirm the usefulness of brain 18F-FDG PET/CT QL and QN analyses in differentiating AD from MCI. Moreover, the combined use of automated classifications models can improve the diagnostic process since its use allows identification of a specific hypometabolic area involved in AD cases in respect to MCI. This data improves the traditional 18F-FDG PET/CT image interpretation and the diagnostic assessment of cognitive disorders.
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Filippi L, Bianconi F, Schillaci O, Spanu A, Palumbo B. The Role and Potential of 18F-FDG PET/CT in Malignant Melanoma: Prognostication, Monitoring Response to Targeted and Immunotherapy, and Radiomics. Diagnostics (Basel) 2022; 12:929. [PMID: 35453977 PMCID: PMC9028862 DOI: 10.3390/diagnostics12040929] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 12/17/2022] Open
Abstract
Novel therapeutic approaches, consisting of immune check-point inhibitors (ICIs) and molecularly targeted therapy, have thoroughly changed the clinical management of malignant melanoma (MM), the most frequent and deadly skin cancer. Since only 30-40% of MM patients respond to ICIs, imaging biomarkers suitable for the pre-therapeutic stratification and response assessment are warmly welcome. In this scenario, positron emission computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) has been successfully utilized for advanced MM staging and therapy response evaluation. Furthermore, several PET-derived parameters (SUVmax, MTV, TLG) were particularly impactful for the prognostic evaluation of patients submitted to targeted and immunotherapy. In this review, we performed a web-based and desktop research on the clinical applications of 18F-FDG PET/CT in MM, with a particular emphasis on the various metabolic criteria developed for interpreting PET/CT scan in patients undergoing immunotherapy or targeted therapy or a combination of both. Furthermore, the emerging role of radiomics, a quantitative approach to medical imaging applying analysis methodology derived by the field of artificial intelligence, was examined in the peculiar context, putting a particular emphasis on the potential of this discipline to support clinicians in the delicate process of building patient-tailored pathways of care.
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Affiliation(s)
- Luca Filippi
- Nuclear Medicine Unit, “Santa Maria Goretti” Hospital, Via Antonio Canova, 04100 Latina, Italy
| | - Francesco Bianconi
- Department of Engineering, Università Degli Studi di Perugia, Via Goffredo Duranti 93, 06135 Perugia, Italy;
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy;
- IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Angela Spanu
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy;
| | - Barbara Palumbo
- Section of Nuclear Medicine and Health Physics, Department of Medicine and Surgery, Università Degli Studi di Perugia, Piazza Lucio Severi 1, 06132 Perugia, Italy;
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Palumbo B, Bianconi F, Palumbo I. Solitary pulmonary nodule: Is positron emission tomography/computed tomography radiomics a valid diagnostic approach? Lung India 2021; 38:405-407. [PMID: 34472516 PMCID: PMC8509171 DOI: 10.4103/lungindia.lungindia_266_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Barbara Palumbo
- Department of Medicine and Surgery, Section of Nuclear Medicine and Health Physics, University of Perugia, Perugia, Italy
| | | | - Isabella Palumbo
- Department of Medicine and Surgery, Section of Radiotherapy, University of Perugia, Perugia, Italy
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