Advancements of Artificial Intelligence in Liver-Associated Diseases and Surgery

Untargeted Lipidomic Biomarkers for Liver Cancer Diagnosis: A Tree-Based Machine Learning Model Enhanced by Explainable Artificial Intelligence

Background and Objectives: Liver cancer ranks among the leading causes of cancer-related mortality, necessitating the development of novel diagnostic methods. Deregulated lipid metabolism, a hallmark of hepatocarcinogenesis, offers compelling prospects for biomarker identification. This study aims to employ explainable artificial intelligence (XAI) to identify lipidomic biomarkers for liver cancer and to develop a robust predictive model for early diagnosis. Materials and Methods: This study included 219 patients diagnosed with liver cancer and 219 healthy controls. Serum samples underwent untargeted lipidomic analysis with LC-QTOF-MS. Lipidomic data underwent univariate and multivariate analyses, including fold change (FC), t-tests, PLS-DA, and Elastic Network feature selection, to identify significant biomarker candidate lipids. Machine learning models (AdaBoost, Random Forest, Gradient Boosting) were developed and evaluated utilizing these biomarkers to differentiate liver cancer. The AUC metric was employed to identify the optimal predictive model, whereas SHAP was utilized to achieve interpretability of the model's predictive decisions. Results: Notable alterations in lipid profiles were observed: decreased sphingomyelins (SM d39:2, SM d41:2) and increased fatty acids (FA 14:1, FA 22:2) and phosphatidylcholines (PC 34:1, PC 32:1). AdaBoost exhibited a superior classification performance, achieving an AUC of 0.875. SHAP identified PC 40:4 as the most efficacious lipid for model predictions. The SM d41:2 and SM d36:3 lipids were specifically associated with an increased risk of low-onset cancer and elevated levels of the PC 40:4 lipid. Conclusions: This study demonstrates that untargeted lipidomics, in conjunction with explainable artificial intelligence (XAI) and machine learning, may effectively identify biomarkers for the early detection of liver cancer. The results suggest that alterations in lipid metabolism are crucial to the progression of liver cancer and provide valuable insights for incorporating lipidomics into precision oncology.

Exploitation of Bio-Inspired Classifiers for Performance Enhancement in Liver Cirrhosis Detection from Ultrasonic Images

In the current scenario, liver abnormalities are one of the most serious public health concerns. Cirrhosis of the liver is one of the foremost causes of demise from liver diseases. To accurately predict the status of liver cirrhosis, physicians frequently use automated computer-aided approaches. In this paper, through clustering techniques like fuzzy c-means (FCM), possibilistic fuzzy c-means (PFCM), and possibilistic c means (PCM) and sample entropy features are extracted from normal and cirrhotic liver ultrasonic images. The extracted features are classified as normal and cirrhotic through the Gaussian mixture model (GMM), Softmax discriminant classifier (SDC), harmonic search algorithm (HSA), SVM (linear), SVM (RBF), SVM (polynomial), artificial algae optimization (AAO), and hybrid classifier artificial algae optimization (AAO) with Gaussian mixture mode (GMM). The classifiers' performances are compared based on accuracy, F1 Score, MCC, F measure, error rate, and Jaccard metric (JM). The hybrid classifier AAO-GMM, with the PFCM feature, outperforms the other classifiers and attained an accuracy of 99.03% with an MCC of 0.90.

A Machine Learning Framework for Diagnosing and Predicting the Severity of Coronary Artery Disease

BACKGROUND

Although machine learning (ML)-based prediction of coronary artery disease (CAD) has gained increasing attention, assessment of the severity of suspected CAD in symptomatic patients remains challenging.

METHODS

The training set for this study consisted of 284 retrospective participants, while the test set included 116 prospectively enrolled participants from whom we collected 53 baseline variables and coronary angiography results. The data was pre-processed with outlier processing and One-Hot coding. In the first stage, we constructed a ML model that used baseline information to predict the presence of CAD with a dichotomous model. In the second stage, baseline information was used to construct ML regression models for predicting the severity of CAD. The non-CAD population was included, and two different scores were used as output variables. Finally, statistical analysis and SHAP plot visualization methods were employed to explore the relationship between baseline information and CAD.

RESULTS

The study included 269 CAD patients and 131 healthy controls. The eXtreme Gradient Boosting (XGBoost) model exhibited the best performance amongst the different models for predicting CAD, with an area under the receiver operating characteristic curve of 0.728 (95% CI 0.623-0.824). The main correlates were left ventricular ejection fraction, homocysteine, and hemoglobin (p < 0.001). The XGBoost model performed best for predicting the SYNTAX score, with the main correlates being brain natriuretic peptide (BNP), left ventricular ejection fraction, and glycated hemoglobin (p < 0.001). The main relevant features in the model predictive for the GENSINI score were BNP, high density lipoprotein, and homocysteine (p < 0.001).

CONCLUSIONS

This data-driven approach provides a foundation for the risk stratification and severity assessment of CAD.

CLINICAL TRIAL REGISTRATION

The study was registered in www.clinicaltrials.gov protocol registration system (number NCT05018715).

Application of Artificial Intelligence Methods for Imaging of Spinal Metastasis

Spinal metastasis is the most common malignant disease of the spine. Recently, major advances in machine learning and artificial intelligence technology have led to their increased use in oncological imaging. The purpose of this study is to review and summarise the present evidence for artificial intelligence applications in the detection, classification and management of spinal metastasis, along with their potential integration into clinical practice. A systematic, detailed search of the main electronic medical databases was undertaken in concordance with the PRISMA guidelines. A total of 30 articles were retrieved from the database and reviewed. Key findings of current AI applications were compiled and summarised. The main clinical applications of AI techniques include image processing, diagnosis, decision support, treatment assistance and prognostic outcomes. In the realm of spinal oncology, artificial intelligence technologies have achieved relatively good performance and hold immense potential to aid clinicians, including enhancing work efficiency and reducing adverse events. Further research is required to validate the clinical performance of the AI tools and facilitate their integration into routine clinical practice.