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Ankolekar A, Boie S, Abdollahyan M, Gadaleta E, Hasheminasab SA, Yang G, Beauville C, Dikaios N, Kastis GA, Bussmann M, Chelala C, Khalid S, Kruger H, Lambin P, Papanastasiou G, OPTIMA Consortium. Advancing breast, lung and prostate cancer research with federated learning. A systematic review. NPJ Digit Med 2025; 8:314. [PMID: 40425787 PMCID: PMC12117161 DOI: 10.1038/s41746-025-01591-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 03/26/2025] [Indexed: 05/29/2025] Open
Abstract
Federated learning (FL) is advancing cancer research by enabling privacy-preserving collaborative training of machine learning (ML) models on diverse, multi-centre data. This systematic review synthesises current knowledge on state-of-the-art FL in oncology, focusing on breast, lung, and prostate cancer. Unlike previous surveys, we critically evaluate FL's real-world implementation and impact, demonstrating its effectiveness in enhancing ML generalisability and performance in clinical settings. Our analysis reveals that FL outperformed centralised ML in 15 out of 25 studies, spanning diverse models and clinical applications, including multi-modal integration for precision medicine. Despite challenges identified in reproducibility and standardisation, FL demonstrates substantial potential for advancing cancer research. We propose future research focus on addressing these limitations and investigating advanced FL methods to fully harness data diversity and realise the transformative power of cutting-edge FL in cancer care.
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Affiliation(s)
- Anshu Ankolekar
- Department of Precision Medicine, GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
| | | | - Maryam Abdollahyan
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Emanuela Gadaleta
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Seyed Alireza Hasheminasab
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Guang Yang
- Bioengineering Department and Imperial-X, Imperial College London, London, UK
| | | | | | | | | | - Claude Chelala
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Sara Khalid
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Philippe Lambin
- Department of Precision Medicine, GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands
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2
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Tordjman M, Bolger I, Yuce M, Restrepo F, Liu Z, Dercle L, McGale J, Meribout AL, Liu MM, Beddok A, Lee HC, Rohren S, Yu R, Mei X, Taouli B. Large Language Models in Cancer Imaging: Applications and Future Perspectives. J Clin Med 2025; 14:3285. [PMID: 40429281 PMCID: PMC12112367 DOI: 10.3390/jcm14103285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2025] [Revised: 04/10/2025] [Accepted: 05/06/2025] [Indexed: 05/29/2025] Open
Abstract
Recently, there has been tremendous interest on the use of large language models (LLMs) in radiology. LLMs have been employed for various applications in cancer imaging, including improving reporting speed and accuracy via generation of standardized reports, automating the classification and staging of abnormal findings in reports, incorporating appropriate guidelines, and calculating individualized risk scores. Another use of LLMs is their ability to improve patient comprehension of imaging reports with simplification of the medical terms and possible translations to multiple languages. Additional future applications of LLMs include multidisciplinary tumor board standardizations, aiding patient management, and preventing and predicting adverse events (contrast allergies, MRI contraindications) and cancer imaging research. However, limitations such as hallucinations and variable performances could present obstacles to widespread clinical implementation. Herein, we present a review of the current and future applications of LLMs in cancer imaging, as well as pitfalls and limitations.
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Affiliation(s)
- Mickael Tordjman
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Ian Bolger
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Murat Yuce
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Francisco Restrepo
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Zelong Liu
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Laurent Dercle
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Jeremy McGale
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Anis L. Meribout
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Mira M. Liu
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Arnaud Beddok
- Department of Radiation Oncology, Institut Godinot, 51454 Reims, France
- Faculty of Medicine, Université de Reims Champagne-Ardenne, CRESTIC, 51100 Reims, France
- Yale PET Center, Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Hao-Chih Lee
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Scott Rohren
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Ryan Yu
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Xueyan Mei
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
| | - Bachir Taouli
- Biomedical Engineering & Imaging Institute, Mount Sinai Health System, New York, NY 10029, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, NY 10029, USA
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3
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Bhanbhro J, Nisticò S, Palopoli L. Issues in federated learning: some experiments and preliminary results. Sci Rep 2024; 14:29881. [PMID: 39623121 PMCID: PMC11612434 DOI: 10.1038/s41598-024-81732-0] [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: 07/29/2024] [Accepted: 11/28/2024] [Indexed: 12/06/2024] Open
Abstract
The growing need for data privacy and security in machine learning has led to exploring novel approaches like federated learning (FL) that allow collaborative training on distributed datasets, offering a decentralized alternative to traditional data collection methods. A prime benefit of FL is its emphasis on privacy, enabling data to stay on local devices by moving models instead of data. Despite its pioneering nature, FL faces issues such as diversity in data types, model complexity, privacy concerns, and the need for efficient resource distribution. This paper illustrates an empirical analysis of these challenges within specially designed scenarios, each aimed at studying a specific problem. In particular, differently from existing literature, we isolate the issues that can arise in an FL framework to observe their nature without the interference of external factors.
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Di Stefano V, D’Angelo M, Monaco F, Vignapiano A, Martiadis V, Barone E, Fornaro M, Steardo L, Solmi M, Manchia M, Steardo L. Decoding Schizophrenia: How AI-Enhanced fMRI Unlocks New Pathways for Precision Psychiatry. Brain Sci 2024; 14:1196. [PMID: 39766395 PMCID: PMC11674252 DOI: 10.3390/brainsci14121196] [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: 10/23/2024] [Revised: 11/24/2024] [Accepted: 11/25/2024] [Indexed: 01/11/2025] Open
Abstract
Schizophrenia, a highly complex psychiatric disorder, presents significant challenges in diagnosis and treatment due to its multifaceted neurobiological underpinnings. Recent advancements in functional magnetic resonance imaging (fMRI) and artificial intelligence (AI) have revolutionized the understanding and management of this condition. This manuscript explores how the integration of these technologies has unveiled key insights into schizophrenia's structural and functional neural anomalies. fMRI research highlights disruptions in crucial brain regions like the prefrontal cortex and hippocampus, alongside impaired connectivity within networks such as the default mode network (DMN). These alterations correlate with the cognitive deficits and emotional dysregulation characteristic of schizophrenia. AI techniques, including machine learning (ML) and deep learning (DL), have enhanced the detection and analysis of these complex patterns, surpassing traditional methods in precision. Algorithms such as support vector machines (SVMs) and Vision Transformers (ViTs) have proven particularly effective in identifying biomarkers and aiding early diagnosis. Despite these advancements, challenges such as variability in methodologies and the disorder's heterogeneity persist, necessitating large-scale, collaborative studies for clinical translation. Moreover, ethical considerations surrounding data integrity, algorithmic transparency, and patient individuality must guide AI's integration into psychiatry. Looking ahead, AI-augmented fMRI holds promise for tailoring personalized interventions, addressing unique neural dysfunctions, and improving therapeutic outcomes for individuals with schizophrenia. This convergence of neuroimaging and computational innovation heralds a transformative era in precision psychiatry.
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Affiliation(s)
- Valeria Di Stefano
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (V.D.S.); (L.S.J.)
| | - Martina D’Angelo
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (V.D.S.); (L.S.J.)
| | - Francesco Monaco
- Department of Mental Health, Azienda Sanitaria Locale Salerno, 84125 Salerno, Italy; (F.M.); (A.V.)
- European Biomedical Research Institute of Salerno (EBRIS), 84125 Salerno, Italy
| | - Annarita Vignapiano
- Department of Mental Health, Azienda Sanitaria Locale Salerno, 84125 Salerno, Italy; (F.M.); (A.V.)
- European Biomedical Research Institute of Salerno (EBRIS), 84125 Salerno, Italy
| | - Vassilis Martiadis
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Napoli 1 Centro, 80145 Naples, Italy;
| | - Eugenia Barone
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Michele Fornaro
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy;
| | - Luca Steardo
- Department of Clinical Psychology, University Giustino Fortunato, 82100 Benevento, Italy;
- Department of Physiology and Pharmacology “Vittorio Erspamer”, SAPIENZA University of Rome, 00185 Rome, Italy
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin, 10117 Berlin, Germany
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy;
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09123 Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Luca Steardo
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (V.D.S.); (L.S.J.)
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Hagestedt I, Hales I, Boernert E, Roth HR, Hoeh MA, Röhm R, Dobson E, Prieto JT. Toward a tipping point in federated learning in healthcare and life sciences. PATTERNS (NEW YORK, N.Y.) 2024; 5:101077. [PMID: 39568469 PMCID: PMC11573894 DOI: 10.1016/j.patter.2024.101077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2024]
Abstract
We discuss the real-world application of federated learning (FL) in the healthcare and life sciences industry, noting a tipping point in its adoption beyond academia. Sharing our experiences with multi-hospital and multi-pharma collaborations, we highlight the importance of involving key stakeholders to develop production-grade FL solutions that are fully compliant with stringent privacy and security standards.
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Bahloul MA, Jabeen S, Benoumhani S, Alsaleh HA, Belkhatir Z, Al‐Wabil A. Advancements in synthetic CT generation from MRI: A review of techniques, and trends in radiation therapy planning. J Appl Clin Med Phys 2024; 25:e14499. [PMID: 39325781 PMCID: PMC11539972 DOI: 10.1002/acm2.14499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/27/2024] [Accepted: 07/26/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) and Computed tomography (CT) are crucial imaging techniques in both diagnostic imaging and radiation therapy. MRI provides excellent soft tissue contrast but lacks the direct electron density data needed to calculate dosage. CT, on the other hand, remains the gold standard due to its accurate electron density information in radiation therapy planning (RTP) but it exposes patients to ionizing radiation. Synthetic CT (sCT) generation from MRI has been a focused study field in the last few years due to cost effectiveness as well as for the objective of minimizing side-effects of using more than one imaging modality for treatment simulation. It offers significant time and cost efficiencies, bypassing the complexities of co-registration, and potentially improving treatment accuracy by minimizing registration-related errors. In an effort to navigate the quickly developing field of precision medicine, this paper investigates recent advancements in sCT generation techniques, particularly those using machine learning (ML) and deep learning (DL). The review highlights the potential of these techniques to improve the efficiency and accuracy of sCT generation for use in RTP by improving patient care and reducing healthcare costs. The intricate web of sCT generation techniques is scrutinized critically, with clinical implications and technical underpinnings for enhanced patient care revealed. PURPOSE This review aims to provide an overview of the most recent advancements in sCT generation from MRI with a particular focus of its use within RTP, emphasizing on techniques, performance evaluation, clinical applications, future research trends and open challenges in the field. METHODS A thorough search strategy was employed to conduct a systematic literature review across major scientific databases. Focusing on the past decade's advancements, this review critically examines emerging approaches introduced from 2013 to 2023 for generating sCT from MRI, providing a comprehensive analysis of their methodologies, ultimately fostering further advancement in the field. This study highlighted significant contributions, identified challenges, and provided an overview of successes within RTP. Classifying the identified approaches, contrasting their advantages and disadvantages, and identifying broad trends were all part of the review's synthesis process. RESULTS The review identifies various sCT generation approaches, consisting atlas-based, segmentation-based, multi-modal fusion, hybrid approaches, ML and DL-based techniques. These approaches are evaluated for image quality, dosimetric accuracy, and clinical acceptability. They are used for MRI-only radiation treatment, adaptive radiotherapy, and MR/PET attenuation correction. The review also highlights the diversity of methodologies for sCT generation, each with its own advantages and limitations. Emerging trends incorporate the integration of advanced imaging modalities including various MRI sequences like Dixon sequences, T1-weighted (T1W), T2-weighted (T2W), as well as hybrid approaches for enhanced accuracy. CONCLUSIONS The study examines MRI-based sCT generation, to minimize negative effects of acquiring both modalities. The study reviews 2013-2023 studies on MRI to sCT generation methods, aiming to revolutionize RTP by reducing use of ionizing radiation and improving patient outcomes. The review provides insights for researchers and practitioners, emphasizing the need for standardized validation procedures and collaborative efforts to refine methods and address limitations. It anticipates the continued evolution of techniques to improve the precision of sCT in RTP.
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Affiliation(s)
- Mohamed A. Bahloul
- College of EngineeringAlfaisal UniversityRiyadhSaudi Arabia
- Translational Biomedical Engineering Research Lab, College of EngineeringAlfaisal UniversityRiyadhSaudi Arabia
| | - Saima Jabeen
- College of EngineeringAlfaisal UniversityRiyadhSaudi Arabia
- Translational Biomedical Engineering Research Lab, College of EngineeringAlfaisal UniversityRiyadhSaudi Arabia
- AI Research Center, College of EngineeringAlfaisal UniversityRiyadhSaudi Arabia
| | - Sara Benoumhani
- College of EngineeringAlfaisal UniversityRiyadhSaudi Arabia
- AI Research Center, College of EngineeringAlfaisal UniversityRiyadhSaudi Arabia
| | | | - Zehor Belkhatir
- School of Electronics and Computer ScienceUniversity of SouthamptonSouthamptonUK
| | - Areej Al‐Wabil
- College of EngineeringAlfaisal UniversityRiyadhSaudi Arabia
- AI Research Center, College of EngineeringAlfaisal UniversityRiyadhSaudi Arabia
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