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Wang Z, Li F, Cai J, Xue Z, Du K, Tao Y, Zhang H, Zhou Y, Fan H, Wang Z. Identification of lesion bioactivity in hepatic cystic echinococcosis using a transformer-based fusion model. J Infect 2025; 90:106455. [PMID: 40049526 DOI: 10.1016/j.jinf.2025.106455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Accepted: 02/26/2025] [Indexed: 04/12/2025]
Abstract
BACKGROUND Differentiating whether hepatic cystic echinococcosis (HCE) lesions exhibit biological activity is essential for developing effective treatment plans. This study evaluates the performance of a Transformer-based fusion model in assessing HCE lesion activity. METHODS This study analyzed CT images and clinical variables from 700 HCE patients across three hospitals from 2018 to 2023. Univariate and multivariate logistic regression analyses were conducted for the selection of clinical variables to construct a clinical model. Radiomics features were extracted from CT images using Pyradiomics to develop a radiomics model. Additionally, a 2D deep learning model and a 3D deep learning model were trained using the CT images. The fusion model was constructed using feature-level fusion, decision-level fusion, and a Transformer network architecture, allowing for the analysis of the discriminative ability and correlation among radiomics features, 2D deep learning features, and 3D deep learning features, while comparing the classification performance of the three multimodal fusion models. RESULTS In comparison to radiomics and 2D deep learning features, the 3D deep learning features exhibited superior discriminative ability in identifying the biological activity of HCE lesions. The Transformer-based fusion model demonstrated the highest performance in both the internal validation set and the external validation set, achieving AUC values of 0.997 (0.992-1.000) and 0.944 (0.911-0.977), respectively, thereby outperforming both the feature-level and decision-level fusion models, and enabling precise differentiation of HCE lesion biological activity. CONCLUSION The Transformer multimodal fusion model integrates clinical features, radiomics features, and both 2D and 3D deep learning features, facilitating accurate differentiation of the biological activity of HCE lesions and exhibiting significant potential for clinical application.
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Affiliation(s)
| | - Fuyuan Li
- Qinghai University, Xining, Qinghai, China
| | - Junjie Cai
- Qinghai University, Xining, Qinghai, China
| | | | - Kaihao Du
- Qinghai University, Xining, Qinghai, China
| | | | - Hanxi Zhang
- Department of Hepatobiliary and Pancreatic Surgery, Qinghai University Affiliated Hospital, Xining, Qinghai, China
| | - Ying Zhou
- Department of Hepatobiliary and Pancreatic Surgery, Qinghai University Affiliated Hospital, Xining, Qinghai, China
| | - Haining Fan
- Department of Hepatobiliary and Pancreatic Surgery, Qinghai University Affiliated Hospital, Xining, Qinghai, China
| | - Zhan Wang
- Department of Medical Engineering and Translational Applications, Qinghai University Affiliated Hospital, Xining, Qinghai, China.
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Nijiati M, Tuerdi M, Damola M, Yimit Y, Yang J, Abulaiti A, Mutailifu A, Aihait D, Wang Y, Zou X. A deep learning radiomics model based on CT images for predicting the biological activity of hepatic cystic echinococcosis. Front Physiol 2024; 15:1426468. [PMID: 39175611 PMCID: PMC11338923 DOI: 10.3389/fphys.2024.1426468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 07/15/2024] [Indexed: 08/24/2024] Open
Abstract
Introduction: Hepatic cystic echinococcosis (HCE) is a widely seen parasitic infection. Biological activity is crucial for treatment planning. This work aims to explore the potential applications of a deep learning radiomics (DLR) model, based on CT images, in predicting the biological activity grading of hepatic cystic echinococcosis. Methods: A retrospective analysis of 160 patients with hepatic echinococcosis was performed (127 and 33 in training and validation sets). Volume of interests (VOIs) were drawn, and radiomics features and deep neural network features were extracted. Feature selection was performed on the training set, and radiomics score (Rad Score) and deep learning score (Deep Score) were calculated. Seven diagnostics models (based on logistic regression algorithm) for the biological activity grading were constructed using the selected radiomics features and two deep model features respectively. All models were evaluated using the receiver operating characteristic curve, and the area under the curve (AUC) was calculated. A nomogram was constructed using the combined model, and its calibration, discriminatory ability, and clinical utility were assessed. Results: 12, 6 and 10 optimal radiomics features, deep learning features were selected from two deep learning network (DLN) features, respectively. For biological activity grading of hepatic cystic echinococcosis, the combined model demonstrated strong diagnostic performance, with an AUC value of 0.888 (95% CI: 0.837-0.936) in the training set and 0.876 (0.761-0.964) in the validation set. The clinical decision analysis curve indicated promising results, while the calibration curve revealed that the nomogram's prediction result was highly compatible with the actual result. Conclusion: The DLR model can be used for predicting the biological activity grading of hepatic echinococcosis.
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Affiliation(s)
- Mayidili Nijiati
- Department of Radiology, The Fourth Affiliated Hospital of Xinjiang Medical UniversityÜrümqi, Xinjiang, China
- Department Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, Kashi, China
| | - Mireayi Tuerdi
- Department of Infectious Diseases, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | - Maihemitijiang Damola
- Department of Radiology, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | - Yasen Yimit
- Department Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, Kashi, China
- Department of Radiology, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | - Jing Yang
- Huiying Medical Imaging Technology, The Fourth Affiliated Hospital of Xinjiang Medical University, Beijing, China
| | - Adilijiang Abulaiti
- Department of Radiology, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | | | - Diliaremu Aihait
- Department of Radiology, The First People’s Hospital of Kashi Prefecture, Kashi, China
| | - Yunling Wang
- Department of Imaging Center, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Xiaoguang Zou
- Department Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, Kashi, China
- Clinical Medical Research Center, The First People’s Hospital of Kashi Prefecture, Kashi, China
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Özdemir S, Çomaklı S, Küçükler S, Aksungur N, Altundaş N, Kara S, Korkut E, Aydın Ş, Bağcı B, Çulha MH, Öztürk G. Integrative analysis of serum-derived exosomal lncRNA profiles of alveolar echinococcosis patients. Gene 2024; 892:147884. [PMID: 37813208 DOI: 10.1016/j.gene.2023.147884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/25/2023] [Accepted: 10/06/2023] [Indexed: 10/11/2023]
Abstract
Alveolar echinococcosis is a severe zoonotic disease caused by the pseudotumoral intrahepatic development of the larval stage of the tapeworm Echinococcus multilocularis. The diagnosis of alveolar echinococcosis is hard since it has features of liver cancer. LncRNAs are among the non-coding RNAs that have received the most attention in recent biomarker studies. Here, we aimed to identify the serum-derived exosomal lncRNAs associated with alveolar echinococcosis in humans with RNA-seq. After RNA isolation from exosomes, we performed RNA-seq to determine the lncRNAs. We found 8 target genes in the cis direction and a total of 6468 gene targets for lncRNAs were identified in the trans direction. Totally 621 mRNA transcripts were found as differentially expressed between the controls and patients. 278 of them were up-regulated and 343 were down-regulated. Moreover, 234 lncRNAs were found as differentially expressed between the controls and patients. 58 of them were up-regulated, and 176 of them were down-regulated. The top five biological pathways regulated by identified lncRNAs were detected in this study. As a result, it is thought that these results will contribute to lncRNA-based biomarker studies that can be used in the early diagnosis of alveolar echinococcosis in humans.
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Affiliation(s)
- Selçuk Özdemir
- Atatürk University, Faculty of Veterinary Medicine, Department of Genetics, Erzurum, Turkey; German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany.
| | - Selim Çomaklı
- Atatürk University, Faculty of Veterinary Medicine, Department of Pathology, Erzurum, Turkey
| | - Sefa Küçükler
- Atatürk University, Faculty of Veterinary Medicine, Department of Biochemistry, Erzurum, Turkey
| | - Nurhak Aksungur
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Necip Altundaş
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Salih Kara
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Ercan Korkut
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Şeyma Aydın
- Atatürk University, Faculty of Veterinary Medicine, Department of Genetics, Erzurum, Turkey
| | - Betül Bağcı
- Atatürk University, Faculty of Veterinary Medicine, Department of Genetics, Erzurum, Turkey
| | - Muhammed Hüdai Çulha
- Selçuk University, Faculty of Veterinary Medicine, Department of Genetics, Konya, Turkey
| | - Gürkan Öztürk
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
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Özdemir S, Aksungur N, Altundaş N, Kara S, Korkut E, Özkaraca M, Sefa Mendil A, Öztürk G. Genome-wide profiling of the expression of serum derived exosomal circRNAs in patients with hepatic alveolar echinococcosis. Gene 2022; 814:146161. [PMID: 34995736 DOI: 10.1016/j.gene.2021.146161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/30/2021] [Accepted: 12/06/2021] [Indexed: 01/22/2023]
Abstract
The patients with hepatic alveolar echinococcosis is poorly detected due to invasive and slow growth. Thus, early diagnosis of hepatic alveolar echinococcosis is so important for patients. Circular RNAs are crucial types of the non-coding RNA. Recent studies have provided serum-derived exosomal circRNAs as potential biomarkers for detection of various diseases. The clinical importance of exosomal circRNAs in hepatic alveolar echinococcosis have never been explored before. Here, we investigated the serum-derived exosomal circRNAs in the diagnosis of hepatic alveolar echinococcosis. Firstly, High-throughput Sequencing was performed using 9 hepatic alveolar echinococcosis and 9 control samples to detect hepatic alveolar echinococcosis related circRNAs. Afterwards, bioinformatic analyzes were performed to identify differentially expressed circRNAs and pathway analyzes were performed. Finally, validation of the determined circRNAs was performed using RT-PCR. The sequencing data indicated that 59 differentially expressed circRNAs; 31 up-regulated and 28 down-regulated circRNA in hepatic alveolar echinococcosis patients. The top 5 up-regulated and down-regulated circRNAs were selected for validation by RT-qPCR assay. As a result of the verification, circRNAs that were significantly up- and down-regulated showed an expression profile consistent with the results obtained. Importantly, our findings suggested that identified exosomal circRNAs could be a potential biomarker for the detection of hepatic alveolar echinococcosis serum and may help to understand the pathogenesis of hepatic alveolar echinococcosis.
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Affiliation(s)
- Selçuk Özdemir
- Atatürk University, Faculty of Veterinary Medicine, Department of Genetics, Erzurum, Turkey; Heinrich Heine University, Faculty of Medicine, Department of Gastroenterology, Hepatology and Infection, Düsseldorf, Germany.
| | - Nurhak Aksungur
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Necip Altundaş
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Salih Kara
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Ercan Korkut
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Mustafa Özkaraca
- Sivas Cumhuriyet University, Faculty of Veterinary Medicine, Department of Pathology, Sivas, Turkey
| | - Ali Sefa Mendil
- Erciyes University, Faculty of Veterinary Medicine, Department of Pathology, Kayseri, Turkey
| | - Gürkan Öztürk
- Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
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