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Le Gall A, Hoang-Thi TN, Porcher R, Dunogué B, Berezné A, Guillevin L, Le Guern V, Cohen P, Chaigne B, London J, Groh M, Paule R, Chassagnon G, Vakalopoulou M, Dinh-Xuan AT, Revel MP, Mouthon L, Régent A. Prognostic value of automated assessment of interstitial lung disease on CT in systemic sclerosis. Rheumatology (Oxford) 2024; 63:103-110. [PMID: 37074923 DOI: 10.1093/rheumatology/kead164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/10/2023] [Accepted: 03/27/2023] [Indexed: 04/20/2023] Open
Abstract
OBJECTIVE Stratifying the risk of death in SSc-related interstitial lung disease (SSc-ILD) is a challenging issue. The extent of lung fibrosis on high-resolution CT (HRCT) is often assessed by a visual semiquantitative method that lacks reliability. We aimed to assess the potential prognostic value of a deep-learning-based algorithm enabling automated quantification of ILD on HRCT in patients with SSc. METHODS We correlated the extent of ILD with the occurrence of death during follow-up, and evaluated the additional value of ILD extent in predicting death based on a prognostic model including well-known risk factors in SSc. RESULTS We included 318 patients with SSc, among whom 196 had ILD; the median follow-up was 94 months (interquartile range 73-111). The mortality rate was 1.6% at 2 years and 26.3% at 10 years. For each 1% increase in the baseline ILD extent (up to 30% of the lung), the risk of death at 10 years was increased by 4% (hazard ratio 1.04, 95% CI 1.01, 1.07, P = 0.004). We constructed a risk prediction model that showed good discrimination for 10-year mortality (c index 0.789). Adding the automated quantification of ILD significantly improved the model for 10-year survival prediction (P = 0.007). Its discrimination was only marginally improved, but it improved prediction of 2-year mortality (difference in time-dependent area under the curve 0.043, 95% CI 0.002, 0.084, P = 0.040). CONCLUSION The deep-learning-based, computer-aided quantification of ILD extent on HRCT provides an effective tool for risk stratification in SSc. It might help identify patients at short-term risk of death.
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Affiliation(s)
- Aëlle Le Gall
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
| | | | - Raphaël Porcher
- Université de Paris, Paris, France
- Service d'Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France
| | - Bertrand Dunogué
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
| | - Alice Berezné
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
| | - Loïc Guillevin
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
- Université de Paris, Paris, France
| | - Véronique Le Guern
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
| | - Pascal Cohen
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
| | - Benjamin Chaigne
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
- Université de Paris, Paris, France
| | - Jonathan London
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
| | - Matthieu Groh
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
| | - Romain Paule
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
| | - Guillaume Chassagnon
- Service de Radiologie, APHP-CUP, Hôpital Cochin, Paris, France
- Université de Paris, Paris, France
| | - Maria Vakalopoulou
- Centre de Vision Numérique, École Centrale Supelec, Gif-sur-Yvette, France
| | - Anh-Tuan Dinh-Xuan
- Service de Physiologie et Explorations Fonctionnelles, Hôpital Cochin, AP-HP, Paris, France
| | - Marie Pierre Revel
- Service de Radiologie, APHP-CUP, Hôpital Cochin, Paris, France
- Université de Paris, Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
- Université de Paris, Paris, France
| | - Alexis Régent
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'ile de France, APHP-CUP, Hôpital Cochin, Paris, France
- Université de Paris, Paris, France
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Mosele F, Deluche E, Lusque A, Le Bescond L, Filleron T, Pradat Y, Ducoulombier A, Pistilli B, Bachelot T, Viret F, Levy C, Signolle N, Alfaro A, Tran DTN, Garberis IJ, Talbot H, Christodoulidis S, Vakalopoulou M, Droin N, Stourm A, Kobayashi M, Kakegawa T, Lacroix L, Saulnier P, Job B, Deloger M, Jimenez M, Mahier C, Baris V, Laplante P, Kannouche P, Marty V, Lacroix-Triki M, Diéras V, André F. Trastuzumab deruxtecan in metastatic breast cancer with variable HER2 expression: the phase 2 DAISY trial. Nat Med 2023; 29:2110-2120. [PMID: 37488289 PMCID: PMC10427426 DOI: 10.1038/s41591-023-02478-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
The mechanisms of action of and resistance to trastuzumab deruxtecan (T-DXd), an anti-HER2-drug conjugate for breast cancer treatment, remain unclear. The phase 2 DAISY trial evaluated the efficacy of T-DXd in patients with HER2-overexpressing (n = 72, cohort 1), HER2-low (n = 74, cohort 2) and HER2 non-expressing (n = 40, cohort 3) metastatic breast cancer. In the full analysis set population (n = 177), the confirmed objective response rate (primary endpoint) was 70.6% (95% confidence interval (CI) 58.3-81) in cohort 1, 37.5% (95% CI 26.4-49.7) in cohort 2 and 29.7% (95% CI 15.9-47) in cohort 3. The primary endpoint was met in cohorts 1 and 2. Secondary endpoints included safety. No new safety signals were observed. During treatment, HER2-expressing tumors (n = 4) presented strong T-DXd staining. Conversely, HER2 immunohistochemistry 0 samples (n = 3) presented no or very few T-DXd staining (Pearson correlation coefficient r = 0.75, P = 0.053). Among patients with HER2 immunohistochemistry 0 metastatic breast cancer, 5 of 14 (35.7%, 95% CI 12.8-64.9) with ERBB2 expression below the median presented a confirmed objective response as compared to 3 of 10 (30%, 95% CI 6.7-65.2) with ERBB2 expression above the median. Although HER2 expression is a determinant of T-DXd efficacy, our study suggests that additional mechanisms may also be involved. (ClinicalTrials.gov identifier NCT04132960 .).
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Affiliation(s)
- Fernanda Mosele
- INSERM U981, Gustave Roussy, Villejuif, France
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Elise Deluche
- Department of Medical Oncology, CHU Dupuytren, Limoges, France
| | - Amelie Lusque
- Department of Biostatistics, Institut Claudius-Regaud, IUCT Oncopole, Toulouse, France
| | - Loïc Le Bescond
- INSERM U981, Gustave Roussy, Villejuif, France
- CVN Lab, CentraleSupélec,Université Paris-Saclay, Gif-Sur-Yvette, France
- OPIS, Inria, CentraleSupélec, Université Paris-Saclay, Gif-Sur-Yvette, France
| | - Thomas Filleron
- Department of Biostatistics, Institut Claudius-Regaud, IUCT Oncopole, Toulouse, France
| | - Yoann Pradat
- MICS Lab, CentraleSupélec, Université Paris-Saclay, Gif-Sur-Yvette, France
| | | | - Barbara Pistilli
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Thomas Bachelot
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Frederic Viret
- Department of Medical Oncology, Centre Paoli Calmettes, Marseille, France
| | - Christelle Levy
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - Nicolas Signolle
- AMMICa Platform, INSERM US23, CNRS UAR 3655, AMMICa, Villejuif, France
| | - Alexia Alfaro
- Imaging and Cytometry Platform, Gustave Roussy, UAR 23/3655, Université Paris-Saclay, Villejuif, France
| | | | | | - Hugues Talbot
- CVN Lab, CentraleSupélec,Université Paris-Saclay, Gif-Sur-Yvette, France
- OPIS, Inria, CentraleSupélec, Université Paris-Saclay, Gif-Sur-Yvette, France
| | | | - Maria Vakalopoulou
- OPIS, Inria, CentraleSupélec, Université Paris-Saclay, Gif-Sur-Yvette, France
- MICS Lab, CentraleSupélec, Université Paris-Saclay, Gif-Sur-Yvette, France
| | - Nathalie Droin
- AMMICa Platform, INSERM US23, CNRS UAR 3655, AMMICa, Villejuif, France
| | - Aurelie Stourm
- AMMICa Platform, INSERM US23, CNRS UAR 3655, AMMICa, Villejuif, France
| | - Maki Kobayashi
- Translational Research Department, Daiichi Sankyo RD Novare, Tokyo, Japan
| | - Tomoya Kakegawa
- Translational Research Department, Daiichi Sankyo RD Novare, Tokyo, Japan
| | - Ludovic Lacroix
- AMMICa Platform, INSERM US23, CNRS UAR 3655, AMMICa, Villejuif, France
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif, France
| | - Patrick Saulnier
- AMMICa Platform, INSERM US23, CNRS UAR 3655, AMMICa, Villejuif, France
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif, France
| | - Bastien Job
- AMMICa Platform, INSERM US23, CNRS UAR 3655, AMMICa, Villejuif, France
| | - Marc Deloger
- AMMICa Platform, INSERM US23, CNRS UAR 3655, AMMICa, Villejuif, France
| | | | | | - Vianney Baris
- UMR9019, CNRS, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Pierre Laplante
- UMR9019, CNRS, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Patricia Kannouche
- UMR9019, CNRS, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Virginie Marty
- AMMICa Platform, INSERM US23, CNRS UAR 3655, AMMICa, Villejuif, France
| | | | - Veronique Diéras
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Fabrice André
- INSERM U981, Gustave Roussy, Villejuif, France.
- Department of Medical Oncology, Gustave Roussy, Villejuif, France.
- Faculty of Medicine, Université Paris-Saclay, Kremlin Bicêtre, France.
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Chounta S, Allodji R, Vakalopoulou M, Bentriou M, Do DT, De Vathaire F, Diallo I, Fresneau B, Charrier T, Zossou V, Christodoulidis S, Lemler S, Letort Le Chevalier V. Dosiomics-Based Prediction of Radiation-Induced Valvulopathy after Childhood Cancer. Cancers (Basel) 2023; 15:3107. [PMID: 37370717 DOI: 10.3390/cancers15123107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/16/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Valvular Heart Disease (VHD) is a known late complication of radiotherapy for childhood cancer (CC), and identifying high-risk survivors correctly remains a challenge. This paper focuses on the distribution of the radiation dose absorbed by heart tissues. We propose that a dosiomics signature could provide insight into the spatial characteristics of the heart dose associated with a VHD, beyond the already-established risk induced by high doses. We analyzed data from the 7670 survivors of the French Childhood Cancer Survivors' Study (FCCSS), 3902 of whom were treated with radiotherapy. In all, 63 (1.6%) survivors that had been treated with radiotherapy experienced a VHD, and 57 of them had heterogeneous heart doses. From the heart-dose distribution of each survivor, we extracted 93 first-order and spatial dosiomics features. We trained random forest algorithms adapted for imbalanced classification and evaluated their predictive performance compared to the performance of standard mean heart dose (MHD)-based models. Sensitivity analyses were also conducted for sub-populations of survivors with spatially heterogeneous heart doses. Our results suggest that MHD and dosiomics-based models performed equally well globally in our cohort and that, when considering the sub-population having received a spatially heterogeneous dose distribution, the predictive capability of the models is significantly improved by the use of the dosiomics features. If these findings are further validated, the dosiomics signature may be incorporated into machine learning algorithms for radiation-induced VHD risk assessment and, in turn, into the personalized refinement of follow-up guidelines.
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Affiliation(s)
- Stefania Chounta
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, F-91190 Gif-sur-Yvette, France
| | - Rodrigue Allodji
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
- Polytechnic School of Abomey-Calavi (EPAC), University of Abomey-Calavi, 01, Cotonou P.O. Box 2009, Benin
| | - Maria Vakalopoulou
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, F-91190 Gif-sur-Yvette, France
| | - Mahmoud Bentriou
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, F-91190 Gif-sur-Yvette, France
| | - Duyen Thi Do
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
| | - Florent De Vathaire
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
| | - Ibrahima Diallo
- Department of Radiation Oncology, Gustave Roussy, F-94800 Villejuif, France
- Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, F-94800 Villejuif, France
| | - Brice Fresneau
- Gustave Roussy, Université Paris-Saclay, Department of Pediatric Oncology, F-94805 Villejuif, France
| | - Thibaud Charrier
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
- Institut Curie, PSL Research University, INSERM, U900, F-92210 Saint Cloud, France
| | - Vincent Zossou
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- INSERM, CESP, Cancer and Radiation Team, F-94805 Villejuif, France
- Gustave Roussy, Department of Clinical Research, Cancer and Radiation Team, F-94805 Villejuif, France
- Polytechnic School of Abomey-Calavi (EPAC), University of Abomey-Calavi, 01, Cotonou P.O. Box 2009, Benin
- Institut de Formation et de Recherche en Informatique, (IFRI-UAC), Cotonou P.O. Box 2009, Benin
| | - Stergios Christodoulidis
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, F-91190 Gif-sur-Yvette, France
| | - Sarah Lemler
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, F-91190 Gif-sur-Yvette, France
| | - Veronique Letort Le Chevalier
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, F-91190 Gif-sur-Yvette, France
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Hering A, Hansen L, Mok TCW, Chung ACS, Siebert H, Hager S, Lange A, Kuckertz S, Heldmann S, Shao W, Vesal S, Rusu M, Sonn G, Estienne T, Vakalopoulou M, Han L, Huang Y, Yap PT, Brudfors M, Balbastre Y, Joutard S, Modat M, Lifshitz G, Raviv D, Lv J, Li Q, Jaouen V, Visvikis D, Fourcade C, Rubeaux M, Pan W, Xu Z, Jian B, De Benetti F, Wodzinski M, Gunnarsson N, Sjolund J, Grzech D, Qiu H, Li Z, Thorley A, Duan J, Grosbrohmer C, Hoopes A, Reinertsen I, Xiao Y, Landman B, Huo Y, Murphy K, Lessmann N, van Ginneken B, Dalca AV, Heinrich MP. Learn2Reg: Comprehensive Multi-Task Medical Image Registration Challenge, Dataset and Evaluation in the Era of Deep Learning. IEEE Trans Med Imaging 2023; 42:697-712. [PMID: 36264729 DOI: 10.1109/tmi.2022.3213983] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Image registration is a fundamental medical image analysis task, and a wide variety of approaches have been proposed. However, only a few studies have comprehensively compared medical image registration approaches on a wide range of clinically relevant tasks. This limits the development of registration methods, the adoption of research advances into practice, and a fair benchmark across competing approaches. The Learn2Reg challenge addresses these limitations by providing a multi-task medical image registration data set for comprehensive characterisation of deformable registration algorithms. A continuous evaluation will be possible at https://learn2reg.grand-challenge.org. Learn2Reg covers a wide range of anatomies (brain, abdomen, and thorax), modalities (ultrasound, CT, MR), availability of annotations, as well as intra- and inter-patient registration evaluation. We established an easily accessible framework for training and validation of 3D registration methods, which enabled the compilation of results of over 65 individual method submissions from more than 20 unique teams. We used a complementary set of metrics, including robustness, accuracy, plausibility, and runtime, enabling unique insight into the current state-of-the-art of medical image registration. This paper describes datasets, tasks, evaluation methods and results of the challenge, as well as results of further analysis of transferability to new datasets, the importance of label supervision, and resulting bias. While no single approach worked best across all tasks, many methodological aspects could be identified that push the performance of medical image registration to new state-of-the-art performance. Furthermore, we demystified the common belief that conventional registration methods have to be much slower than deep-learning-based methods.
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Battistella E, Vakalopoulou M, Sun R, Estienne T, Lerousseau M, Nikolaev S, Andres EA, Carre A, Niyoteka S, Robert C, Paragios N, Deutsch E. COMBING: Clustering in Oncology for Mathematical and Biological Identification of Novel Gene Signatures. IEEE/ACM Trans Comput Biol Bioinform 2022; 19:3317-3331. [PMID: 34714749 DOI: 10.1109/tcbb.2021.3123910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Precision medicine is a paradigm shift in healthcare relying heavily on genomics data. However, the complexity of biological interactions, the large number of genes as well as the lack of comparisons on the analysis of data, remain a tremendous bottleneck regarding clinical adoption. In this paper, we introduce a novel, automatic and unsupervised framework to discover low-dimensional gene biomarkers. Our method is based on the LP-Stability algorithm, a high dimensional center-based unsupervised clustering algorithm. It offers modularity as concerns metric functions and scalability, while being able to automatically determine the best number of clusters. Our evaluation includes both mathematical and biological criteria to define a quantitative metric. The recovered signature is applied to a variety of biological tasks, including screening of biological pathways and functions, and characterization relevance on tumor types and subtypes. Quantitative comparisons among different distance metrics, commonly used clustering methods and a referential gene signature used in the literature, confirm state of the art performance of our approach. In particular, our signature, based on 27 genes, reports at least 30 times better mathematical significance (average Dunn's Index) and 25% better biological significance (average Enrichment in Protein-Protein Interaction) than those produced by other referential clustering methods. Finally, our signature reports promising results on distinguishing immune inflammatory and immune desert tumors, while reporting a high balanced accuracy of 92% on tumor types classification and averaged balanced accuracy of 68% on tumor subtypes classification, which represents, respectively 7% and 9% higher performance compared to the referential signature.
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Chassagnon G, Campredon A, Vakalopoulou M, Burgel PR. Diversity of approaches in artificial intelligence: an opportunity for discoveries in thoracic imaging. Eur Respir J 2022; 60:13993003.00022-2022. [PMID: 35086838 DOI: 10.1183/13993003.00022-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Guillaume Chassagnon
- Radiology department, Hôpital Cochin, AP-HP.Centre Université de Paris, Paris, France.,Université de Paris, Paris, France
| | - Alienor Campredon
- Radiology department, Hôpital Cochin, AP-HP.Centre Université de Paris, Paris, France.,Université de Paris, Paris, France
| | - Maria Vakalopoulou
- OPIS - OPtimisation Imagerie et Santé; Inria Saclay, Palaiseau, France.,MICS - Mathématiques et Informatique pour la Complexité et les Systèmes; CentraleSupelec, Gif-sur-Yvette, France
| | - Pierre-Régis Burgel
- Université de Paris, Paris, France .,Respiratory Medicine and Cystic Fibrosis National Reference Center; Cochin Hospital; Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France.,ERN-Lung CF network
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7
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Campredon A, Battistella E, Martin C, Durieu I, Mely L, Marguet C, Belleguic C, Murris-Espin M, Chiron R, Fanton A, Bui S, Reynaud-Gaubert M, Reix P, Hoang-Thi TN, Vakalopoulou M, Revel MP, Da Silva J, Burgel PR, Chassagnon G. Using chest CT scan and unsupervised machine learning for predicting and evaluating response to lumacaftor-ivacaftor in people with cystic fibrosis. Eur Respir J 2021:2101344. [PMID: 34795038 DOI: 10.1183/13993003.01344-2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/12/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Lumacaftor-ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) modulator known to improve clinical status in people with cystic fibrosis (CF). This study aimed to assess lung structural changes after one year of lumacaftor-ivacaftor treatment, and to use unsupervised machine learning to identify morphological phenotypes of lung disease that are associated with response to lumacaftor-ivacaftor. METHODS Adolescents and adults with CF from the French multicenter real-world prospective observational study evaluating the first year of treatment with lumacaftor-ivacaftor were included if they had pretherapeutic and follow-up chest computed tomography (CT)-scans available. CT scans were visually scored using a modified Bhalla score. A k-mean clustering method was performed based on 120 radiomics features extracted from unenhanced pretherapeutic chest CT scans. RESULTS A total of 283 patients were included. The Bhalla score significantly decreased after 1 year of lumacaftor-ivacaftor (-1.40±1.53 points compared with pretherapeutic CT; p<0.001). This finding was related to a significant decrease in mucus plugging (-0.35±0.62 points; p<0.001), bronchial wall thickening (-0.24±0.52 points; p<0.001) and parenchymal consolidations (-0.23±0.51 points; p<0.001). Cluster analysis identified 3 morphological clusters. Patients from cluster C were more likely to experience an increase in percent predicted forced expiratory volume in 1 sec (ppFEV1) ≥5 under lumacaftor-ivacaftor than those in the other clusters (54% of responders versus 32% and 33%; p=0.01). CONCLUSION One year treatment with lumacaftor-ivacaftor was associated with a significant visual improvement of bronchial disease on chest CT. Radiomics features on pretherapeutic CT scan may help in predicting lung function response under lumacaftor-ivacaftor.
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Affiliation(s)
- Alienor Campredon
- Radiology department, Hôpital Cochin, AP-HP.Centre Université de Paris, Paris, France
- Université de Paris, Paris, France
| | - Enzo Battistella
- OPIS - OPtimisation Imagerie et Santé; Inria Saclay, Palaiseau, France
- MICS - Mathématiques et Informatique pour la Complexité et les Systèmes, Gif-sur-Yvette, France
| | - Clémence Martin
- Université de Paris, Paris, France
- Respiratory Medicine and Cystic Fibrosis National Reference Center; Cochin Hospital; Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF network
| | - Isabelle Durieu
- ERN-Lung CF network
- Centre de référence Adulte de la Mucoviscidose, Service de médecine interne, Hospices civils de Lyon, Pierre Bénite, France
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Laurent Mely
- Hôpital Renée Sabran, Cystic Fibrosis Center, Giens, France
| | - Christophe Marguet
- Pediatric Respiratory Disease and Cystic Fibrosis Center, Hospital, UNIROUEN, Inserm EA 2656, Rouen University Hospital, Normandie Univ, Rouen, France
| | - Chantal Belleguic
- Centre de Ressources et de Compétences de la Mucoviscidose Adulte, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Marlène Murris-Espin
- Cystic Fibrosis Center, Service de Pneumologie, Pôle des Voies Respiratoires, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Raphaël Chiron
- Cystic Fibrosis Center, Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Annlyse Fanton
- Department of Pulmonary Medicine, Cystic Fibrosis Resource and Competence Centre for Adults, Dijon University Hospital, France
| | - Stéphanie Bui
- Pediatric Respiratory Disease and Cystic Fibrosis Center and CIC 1401, CHU de Bordeaux, Bordeaux, France
| | - Martine Reynaud-Gaubert
- Department of Respiratory Medicine and Lung Transplantation, Aix Marseille Univ, APHM, Hôpital Nord, Marseille, France
| | - Philippe Reix
- UMR 5558 CNRS, Equipe EMET, Université Claude Bernard Lyon 1, Lyon, France
- Cystic Fibrosis Center, Hospices Civils de Lyon, Lyon, France
| | - Trieu-Nghi Hoang-Thi
- Radiology department, Hôpital Cochin, AP-HP.Centre Université de Paris, Paris, France
| | - Maria Vakalopoulou
- OPIS - OPtimisation Imagerie et Santé; Inria Saclay, Palaiseau, France
- MICS - Mathématiques et Informatique pour la Complexité et les Systèmes, Gif-sur-Yvette, France
| | - Marie-Pierre Revel
- Radiology department, Hôpital Cochin, AP-HP.Centre Université de Paris, Paris, France
- Université de Paris, Paris, France
| | - Jennifer Da Silva
- Respiratory Medicine and Cystic Fibrosis National Reference Center; Cochin Hospital; Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
- URC-CIC Paris Descartes Necker Cochin, AP-HP, Hôpital Cochin, Paris, France
| | - Pierre-Régis Burgel
- Université de Paris, Paris, France
- Respiratory Medicine and Cystic Fibrosis National Reference Center; Cochin Hospital; Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
- ERN-Lung CF network
| | - Guillaume Chassagnon
- Radiology department, Hôpital Cochin, AP-HP.Centre Université de Paris, Paris, France
- Université de Paris, Paris, France
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Hoang-Thi TN, Vakalopoulou M, Christodoulidis S, Paragios N, Revel MP, Chassagnon G. Deep learning for lung disease segmentation on CT: Which reconstruction kernel should be used? Diagn Interv Imaging 2021; 102:691-695. [PMID: 34686464 DOI: 10.1016/j.diii.2021.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE The purpose of this study was to determine whether a single reconstruction kernel or both high and low frequency kernels should be used for training deep learning models for the segmentation of diffuse lung disease on chest computed tomography (CT). MATERIALS AND METHODS Two annotated datasets of COVID-19 pneumonia (323,960 slices) and interstitial lung disease (ILD) (4,284 slices) were used. Annotated CT images were used to train a U-Net architecture to segment disease. All CT slices were reconstructed using both a lung kernel (LK) and a mediastinal kernel (MK). Three different trainings, resulting in three different models were compared for each disease: training on LK only, MK only or LK+MK images. Dice similarity scores (DSC) were compared using the Wilcoxon signed-rank test. RESULTS Models only trained on LK images performed better on LK images than on MK images (median DSC = 0.62 [interquartile range (IQR): 0.54, 0.69] vs. 0.60 [IQR: 0.50, 0.70], P < 0.001 for COVID-19 and median DSC = 0.62 [IQR: 0.56, 0.69] vs. 0.50 [IQR 0.43, 0.57], P < 0.001 for ILD). Similarly, models only trained on MK images performed better on MK images (median DSC = 0.62 [IQR: 0.53, 0.68] vs. 0.54 [IQR: 0.47, 0.63], P < 0.001 for COVID-19 and 0.69 [IQR: 0.61, 0.73] vs. 0.63 [IQR: 0.53, 0.70], P < 0.001 for ILD). Models trained on both kernels performed better or similarly than those trained on only one kernel. For COVID-19, median DSC was 0.67 (IQR: =0.59, 0.73) when applied on LK images and 0.67 (IQR: 0.60, 0.74) when applied on MK images (P < 0.001 for both). For ILD, median DSC was 0.69 (IQR: 0.63, 0.73) when applied on LK images (P = 0.006) and 0.68 (IQR: 0.62, 0.72) when applied on MK images (P > 0.99). CONCLUSION Reconstruction kernels impact the performance of deep learning-based models for lung disease segmentation. Training on both LK and MK images improves the performance.
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Affiliation(s)
- Trieu-Nghi Hoang-Thi
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Department of Radiology, Hôpital Cochin, AP-HP.centre, 75014 Paris, France
| | - Maria Vakalopoulou
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, 3 91190 Gif-sur-Yvette, France
| | - Stergios Christodoulidis
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, 3 91190 Gif-sur-Yvette, France
| | - Nikos Paragios
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, 3 91190 Gif-sur-Yvette, France; TheraPanacea, 75014 Paris, France
| | - Marie-Pierre Revel
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Department of Radiology, Hôpital Cochin, AP-HP.centre, 75014 Paris, France
| | - Guillaume Chassagnon
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Department of Radiology, Hôpital Cochin, AP-HP.centre, 75014 Paris, France.
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9
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Martinot S, Bus N, Vakalopoulou M, Robert C, Deutsch E, Paragios N. OC-0308 Fast Monte-Carlo dose simulation with recurrent deep learning. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06855-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Sahasrabudhe M, Sujobert P, Zacharaki EI, Maurin E, Grange B, Jallades L, Paragios N, Vakalopoulou M. Deep Multi-Instance Learning Using Multi-Modal Data for Diagnosis of Lymphocytosis. IEEE J Biomed Health Inform 2021; 25:2125-2136. [PMID: 33206611 DOI: 10.1109/jbhi.2020.3038889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We investigate the use of recent advances in deep learning and propose an end-to-end trainable multi-instance convolutional neural network within a mixture-of-experts formulation that combines information from two types of data-images and clinical attributes-for the diagnosis of lymphocytosis. The convolutional network learns to extract meaningful features from images of blood cells using an embedding level approach and aggregates them. Moreover, the mixture-of-experts model combines information from these images as well as clinical attributes to form an end-to-end trainable pipeline for diagnosis of lymphocytosis. Our results demonstrate that even the convolutional network by itself is able to discover meaningful associations between the images and the diagnosis, indicating the presence of important unexploited information in the images. The mixture-of-experts formulation is shown to be more robust while maintaining performance via. a repeatability study to assess the effect of variability in data acquisition on the predictions. The proposed methods are compared with different methods from literature based both on conventional handcrafted features and machine learning, and on recent deep learning models based on attention mechanisms. Our method reports a balanced accuracy of [Formula: see text] and outperfroms the handcrafted feature-based and attention-based approaches as well that of biologists which scored [Formula: see text], [Formula: see text] and [Formula: see text] respectively. These results give insights on the potentials of the applicability of the proposed method in clinical practice. Our code and datasets can be found at https://github.com/msahasrabudhe/lymphoMIL.
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11
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Batistella E, Paré L, Sahasrabudhe M, Pascual T, Vakalopoulou M, Villagrasa P, Deutsch E, Chic N, Villacampa G, Nuciforo P, Cortes J, Llombart-Cussac A, Paragios N, Prat A. Abstract PS5-13: Holistic artificial intelligence-driven predictor in HER2-positive (HER2+) early breast cancer (BC) treated with neoadjuvant lapatinib and trastuzumab without chemotherapy: A correlative analysis from SOLTI-1114 PAMELA. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps5-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Positive partial response was observed in patients with primary HER2+ early BC with dual HER2 blockade that were not treated with chemotherapy. In this context and beyond, the low (partial) response rate of chemotherapy-free treatment strategies creates the necessity for patient stratification prior to treatment selection. Here, we tackle the challenging task of evaluating the ability of clinical, gene expression and histopathology data to predict response following dual HER2 blockade without chemotherapy. Our aim is through artificial intelligence to automatically decipher the complementarity of clinical, genomic and histopathology data through an evidence-driven approach towards a low dimensional holistic signature that determines outcomes and could be subsequently used as a clinical biomarker for treatment patient inclusion. Methods: PAMELA (Lancet Oncology 2017) was a prospective study in HER2+ BC designed to evaluate the ability of the PAM50 HER2-enriched intrinsic subtype to predict pCR following 18-weeks of neoadjuvant lapatinib and trastuzumab (and hormonal therapy if hormone receptor-positive [HR+]). Clinical-pathological variables (15) were included such as tumor cellularity, tumor-infiltrating lymphocytes (TILs), the expression of BC-related genes/signatures (567) along with histopathological data from pre-treatment samples. Imaging information was obtained from H/E slides, through an unsupervised deep learning approach using an attention network. The semantic segmentation was used to derive at the patch level image and shape characteristics resulted on a pathomics-derived feature vector of (300) variables. An integrative approach that harnessed clinical, genomics and pathomics data into a unified prediction framework was used. Patients were divided into a training set 80% and a testing set 20% with proportions of pCR and non-pCR corresponding to the ones observed. A 100-fold Cross-validation (CV) was performed on the training. Linear and non-linear robust feature selection were used to recover a low dimensional holistic signature along with an ensemble learning approach to select the top 5 machine learning/artificial intelligence methods for prognosis. Results: From the high dimensional feature (882) space, a low dimensional holistic signature of 8 predictive variables was automatically retrieved through. The signature consisted of 4 genomics variables (expression levels of ERBB2, ESR1, Luminal A signature and Risk of Relapse score), 2 clinical-pathological variables (histologic grade and ER-status) and 2 imaging variables (mean Short Run Low Gray Level Emphasis of the gray level run length matrix and the mean absolute deviation). To ensure the robustness and generalizability of the results, we present results averaged over 100 splits into training and test. On all cases the same holistic signature was uses and the same prediction methods/principles. The proposed AI-driven prognosis mechanism reached 75% balanced accuracy, 69% precision, 65% sensitivity, 86% specificity and 0.84 AUC demonstrating the relevance of the approach. It was observed a successful classification of 86% for the non-pCR and 65% for the pCR cases. Ablation studies were performed to determine the relevance of the different categories of variables. Genomics variables were the most informative since their removal led to the highest decrease of the metrics (11% in average). Conclusion: The proposed method has great potentials for an effective and clinically meaningful implementation of pre-selecting patients that will not achieve a pCR after neoadjuvant dual HER2 blockade. Besides, the generality of the method used here makes it transposable to any type of cancer or therapy.
Citation Format: Enzo Batistella, Laia Paré, Mihir Sahasrabudhe, Tomás Pascual, Maria Vakalopoulou, Patricia Villagrasa, Eric Deutsch, Núria Chic, Guillermo Villacampa, Paolo Nuciforo, Javier Cortes, Antonio Llombart-Cussac, Nikos Paragios, Aleix Prat. Holistic artificial intelligence-driven predictor in HER2-positive (HER2+) early breast cancer (BC) treated with neoadjuvant lapatinib and trastuzumab without chemotherapy: A correlative analysis from SOLTI-1114 PAMELA [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS5-13.
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Affiliation(s)
| | - Laia Paré
- 2SOLTI Breast Cancer Research Group, Barcelona, Spain
| | | | - Tomás Pascual
- 2SOLTI Breast Cancer Research Group, Barcelona, Spain
| | | | | | - Eric Deutsch
- 4Université Paris-Saclay, Institut Gustave Roussy, Paris, France
| | | | - Guillermo Villacampa
- 6Oncology Data Science Group, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | | | - Javier Cortes
- 8IOB Institute of Oncology, Quiron Group, Barcelona, Spain
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Sun R, Sundahl N, Hecht M, Putz F, Lancia A, Rouyar A, Milic M, Carré A, Battistella E, Alvarez Andres E, Niyoteka S, Romano E, Louvel G, Durand-Labrunie J, Bockel S, Bahleda R, Robert C, Boutros C, Vakalopoulou M, Paragios N, Frey B, Soria JC, Massard C, Ferté C, Fietkau R, Ost P, Gaipl U, Deutsch E. Radiomics to predict outcomes and abscopal response of patients with cancer treated with immunotherapy combined with radiotherapy using a validated signature of CD8 cells. J Immunother Cancer 2020; 8:jitc-2020-001429. [PMID: 33188037 PMCID: PMC7668366 DOI: 10.1136/jitc-2020-001429] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Combining radiotherapy (RT) with immuno-oncology (IO) therapy (IORT) may enhance IO-induced antitumor response. Quantitative imaging biomarkers can be used to provide prognosis, predict tumor response in a non-invasive fashion and improve patient selection for IORT. A biologically inspired CD8 T-cells-associated radiomics signature has been developed on previous cohorts. We evaluated here whether this CD8 radiomic signature is associated with lesion response, whether it may help to assess disease spatial heterogeneity for predicting outcomes of patients treated with IORT. We also evaluated differences between irradiated and non-irradiated lesions. METHODS Clinical data from patients with advanced solid tumors in six independent clinical studies of IORT were investigated. Immunotherapy consisted of 4 different drugs (antiprogrammed death-ligand 1 or anticytotoxic T-lymphocyte-associated protein 4 in monotherapy). Most patients received stereotactic RT to one lesion. Irradiated and non-irradiated lesions were delineated from baseline and the first evaluation CT scans. Radiomic features were extracted from contrast-enhanced CT images and the CD8 radiomics signature was applied. A responding lesion was defined by a decrease in lesion size of at least 30%. Dispersion metrices of the radiomics signature were estimated to evaluate the impact of tumor heterogeneity in patient's response. RESULTS A total of 94 patients involving multiple lesions (100 irradiated and 189 non-irradiated lesions) were considered for a statistical interpretation. Lesions with high CD8 radiomics score at baseline were associated with significantly higher tumor response (area under the receiving operating characteristic curve (AUC)=0.63, p=0.0020). Entropy of the radiomics scores distribution on all lesions was shown to be associated with progression-free survival (HR=1.67, p=0.040), out-of-field abscopal response (AUC=0.70, p=0.014) and overall survival (HR=2.08, p=0.023), which remained significant in a multivariate analysis including clinical and biological variables. CONCLUSIONS These results enhance the predictive value of the biologically inspired CD8 radiomics score and suggests that tumor heterogeneity should be systematically considered in patients treated with IORT. This CD8 radiomics signature may help select patients who are most likely to benefit from IORT.
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Affiliation(s)
- Roger Sun
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Île-de-France, France.,Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France.,Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, Île-de-France, France
| | - Nora Sundahl
- Department of Radiation Oncology, University Hospital Ghent, Gent, Oost-Vlaanderen, Belgium
| | - Markus Hecht
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Florian Putz
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Andrea Lancia
- Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Lombardia, Italy
| | - Angela Rouyar
- Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France
| | - Marina Milic
- Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France
| | - Alexandre Carré
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Île-de-France, France.,Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France
| | - Enzo Battistella
- Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France
| | - Emilie Alvarez Andres
- Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France.,TheraPanacea, Paris, France
| | - Stéphane Niyoteka
- Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France
| | - Edouard Romano
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Île-de-France, France
| | - Guillaume Louvel
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Île-de-France, France
| | | | - Sophie Bockel
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Île-de-France, France.,Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France.,Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, Île-de-France, France
| | - Rastilav Bahleda
- Drug Development Department, Gustave Roussy, Villejuif, Île-de-France, France
| | - Charlotte Robert
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Île-de-France, France.,Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France
| | - Celine Boutros
- Departement of Medicine, Gustave Roussy, Villejuif, Île-de-France, France
| | | | - Nikos Paragios
- TheraPanacea, Paris, France.,CentraleSupélec, Gif-sur-Yvette, Île-de-France, France
| | - Benjamin Frey
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jean-Charles Soria
- Departement of Medicine, Gustave Roussy, Villejuif, Île-de-France, France
| | - Christophe Massard
- Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, Île-de-France, France.,Drug Development Department, Gustave Roussy, Villejuif, Île-de-France, France
| | - Charles Ferté
- Departement of Medicine, Gustave Roussy, Villejuif, Île-de-France, France
| | - Rainer Fietkau
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Piet Ost
- Department of Radiation Oncology, University Hospital Ghent, Gent, Oost-Vlaanderen, Belgium
| | - Udo Gaipl
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Eric Deutsch
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Île-de-France, France .,Institut Gustave Roussy, Inserm, Radiothérapie Moléculaire et Innovation Thérapeutique, Paris-Saclay University, Villejuif, Île-de-France, France.,Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, Île-de-France, France
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Alvarez Andres E, Fidon L, Vakalopoulou M, Lerousseau M, Carré A, Sun R, Beaudre A, Deutsch E, Paragios N, Robert C. PO-1702: Optimizing the generation of brain pseudo-CT from MRI based on a highly efficient 3D neural network. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01720-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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14
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Sun R, Sundahl N, Hecht M, Putz F, Lancia A, Milic M, Carré A, Lerousseau M, Theo E, Battistella E, Andres EA, Louvel G, Durand-Labrunie J, Bockel S, Bahleda R, Robert C, Boutros C, Vakalopoulou M, Paragios N, Frey B, Massard C, Fietkau R, Ost P, Gaipl U, Deutsch E. PD-0425: Radiomics for selection of patients treated with immuno-radiotherapy: pooled analysis from 6 studies. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00447-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chassagnon G, Vakalopoulou M, Régent A, Sahasrabudhe M, Marini R, Hoang-Thi TN, Dinh-Xuan AT, Dunogué B, Mouthon L, Paragios N, Revel MP. Elastic Registration-driven Deep Learning for Longitudinal Assessment of Systemic Sclerosis Interstitial Lung Disease at CT. Radiology 2020; 298:189-198. [PMID: 33078999 DOI: 10.1148/radiol.2020200319] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Longitudinal follow-up of interstitial lung diseases (ILDs) at CT mainly relies on the evaluation of the extent of ILD, without accounting for lung shrinkage. Purpose To develop a deep learning-based method to depict worsening of ILD based on lung shrinkage detection from elastic registration of chest CT scans in patients with systemic sclerosis (SSc). Materials and Methods Patients with SSc evaluated between January 2009 and October 2017 who had undergone at least two unenhanced supine CT scans of the chest and pulmonary function tests (PFTs) performed within 3 months were retrospectively included. Morphologic changes on CT scans were visually assessed by two observers and categorized as showing improvement, stability, or worsening of ILD. Elastic registration between baseline and follow-up CT images was performed to obtain deformation maps of the whole lung. Jacobian determinants calculated from the deformation maps were given as input to a deep learning-based classifier to depict morphologic and functional worsening. For this purpose, the set was randomly split into training, validation, and test sets. Correlations between mean Jacobian values and changes in PFT measurements were evaluated with the Spearman correlation. Results A total of 212 patients (median age, 53 years; interquartile range, 45-62 years; 177 women) were included as follows: 138 for the training set (65%), 34 for the validation set (16%), and 40 for the test set (21%). Jacobian maps demonstrated lung parenchyma shrinkage of the posterior lung bases in patients found to have worsened ILD at visual assessment. The classifier detected morphologic and functional worsening with an accuracy of 80% (32 of 40 patients; 95% confidence interval [CI]: 64%, 91%) and 83% (33 of 40 patients; 95% CI: 67%, 93%), respectively. Jacobian values correlated with changes in forced vital capacity (R = -0.38; 95% CI: -0.25, -0.49; P < .001) and diffusing capacity for carbon monoxide (R = -0.42; 95% CI: -0.27, -0.54; P < .001). Conclusion Elastic registration of CT scans combined with a deep learning classifier aided in the diagnosis of morphologic and functional worsening of interstitial lung disease in patients with systemic sclerosis. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Verschakelen in this issue.
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Affiliation(s)
- Guillaume Chassagnon
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Maria Vakalopoulou
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Alexis Régent
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Mihir Sahasrabudhe
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Rafael Marini
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Trieu-Nghi Hoang-Thi
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Anh-Tuan Dinh-Xuan
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Bertrand Dunogué
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Luc Mouthon
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Nikos Paragios
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
| | - Marie-Pierre Revel
- From the Department of Radiology (G.C., T.N.H.T., M.P.R.), Department of Internal Medicine, Reference Center for Rare Systemic Autoimmune Diseases of Île de France (A.R., B.D., L.M.), and Department of Physiology (A.T.D.X.), Hôpital Cochin, AP-HP Centre, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, École CentraleSupélec, Png-sur-Yvette, France (G.C., M.V., M.S., N.P.); and TheraPanacea, Paris, France (R.M., N.P.)
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16
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Chassagnon G, Vakalopoulou M, Régent A, Zacharaki EI, Aviram G, Martin C, Marini R, Bus N, Jerjir N, Mekinian A, Hua-Huy T, Monnier-Cholley L, Benmostefa N, Mouthon L, Dinh-Xuan AT, Paragios N, Revel MP. Deep Learning-based Approach for Automated Assessment of Interstitial Lung Disease in Systemic Sclerosis on CT Images. Radiol Artif Intell 2020; 2:e190006. [PMID: 33937829 DOI: 10.1148/ryai.2020190006] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/19/2020] [Accepted: 03/31/2020] [Indexed: 12/23/2022]
Abstract
Purpose To develop a deep learning algorithm for the automatic assessment of the extent of systemic sclerosis (SSc)-related interstitial lung disease (ILD) on chest CT images. Materials and Methods This retrospective study included 208 patients with SSc (median age, 57 years; 167 women) evaluated between January 2009 and October 2017. A multicomponent deep neural network (AtlasNet) was trained on 6888 fully annotated CT images (80% for training and 20% for validation) from 17 patients with no, mild, or severe lung disease. The model was tested on a dataset of 400 images from another 20 patients, independently partially annotated by three radiologist readers. The ILD contours from the three readers and the deep learning neural network were compared by using the Dice similarity coefficient (DSC). The correlation between disease extent obtained from the deep learning algorithm and that obtained by using pulmonary function tests (PFTs) was then evaluated in the remaining 171 patients and in an external validation dataset of 31 patients based on the analysis of all slices of the chest CT scan. The Spearman rank correlation coefficient (ρ) was calculated to evaluate the correlation between disease extent and PFT results. Results The median DSCs between the readers and the deep learning ILD contours ranged from 0.74 to 0.75, whereas the median DSCs between contours from radiologists ranged from 0.68 to 0.71. The disease extent obtained from the algorithm, by analyzing the whole CT scan, correlated with the diffusion lung capacity for carbon monoxide, total lung capacity, and forced vital capacity (ρ = -0.76, -0.70, and -0.62, respectively; P < .001 for all) in the dataset for the correlation with PFT results. The disease extents correlated with diffusion lung capacity for carbon monoxide, total lung capacity, and forced vital capacity were ρ = -0.65, -0.70, and -0.57, respectively, in the external validation dataset (P < .001 for all). Conclusion The developed algorithm performed similarly to radiologists for disease-extent contouring, which correlated with pulmonary function to assess CT images from patients with SSc-related ILD.Supplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
- Guillaume Chassagnon
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Maria Vakalopoulou
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Alexis Régent
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Evangelia I Zacharaki
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Galit Aviram
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Charlotte Martin
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Rafael Marini
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Norbert Bus
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Naïm Jerjir
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Arsène Mekinian
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Thông Hua-Huy
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Laurence Monnier-Cholley
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Nouria Benmostefa
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Luc Mouthon
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Anh-Tuan Dinh-Xuan
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Nikos Paragios
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Marie-Pierre Revel
- Departments of Radiology (G.C., N.J., M.P.R.) and Physiology (T.H.H., A.T.D.X.), Hôpital Cochin, and Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin (A.R., N. Benmostefa, L.M.), Assistance Publique-Hôpitaux de Paris, Université de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France; Center for Visual Computing, Ecole CentraleSupelec, Gif-sur-Yvette, France (G.C., M.V., E.I.Z., C.M., N.P.); Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (G.A.); TheraPanacea, Paris, France (R.M., N. Bus, N.P.); and Departments of Internal Medicine and Inflammatory Disorders (A.M.) and Radiology (L.M.C.), Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
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17
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Estienne T, Lerousseau M, Vakalopoulou M, Alvarez Andres E, Battistella E, Carré A, Chandra S, Christodoulidis S, Sahasrabudhe M, Sun R, Robert C, Talbot H, Paragios N, Deutsch E. Deep Learning-Based Concurrent Brain Registration and Tumor Segmentation. Front Comput Neurosci 2020; 14:17. [PMID: 32265680 PMCID: PMC7100603 DOI: 10.3389/fncom.2020.00017] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 02/11/2020] [Indexed: 01/30/2023] Open
Abstract
Image registration and segmentation are the two most studied problems in medical image analysis. Deep learning algorithms have recently gained a lot of attention due to their success and state-of-the-art results in variety of problems and communities. In this paper, we propose a novel, efficient, and multi-task algorithm that addresses the problems of image registration and brain tumor segmentation jointly. Our method exploits the dependencies between these tasks through a natural coupling of their interdependencies during inference. In particular, the similarity constraints are relaxed within the tumor regions using an efficient and relatively simple formulation. We evaluated the performance of our formulation both quantitatively and qualitatively for registration and segmentation problems on two publicly available datasets (BraTS 2018 and OASIS 3), reporting competitive results with other recent state-of-the-art methods. Moreover, our proposed framework reports significant amelioration (p < 0.005) for the registration performance inside the tumor locations, providing a generic method that does not need any predefined conditions (e.g., absence of abnormalities) about the volumes to be registered. Our implementation is publicly available online at https://github.com/TheoEst/joint_registration_tumor_segmentation.
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Affiliation(s)
- Théo Estienne
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Molecular Radiotherapy and Innovative Therapeutics, Villejuif, France
- Gustave Roussy Cancer Campus, Department of Radiation Oncology, Villejuif, France
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, Gif-sur-Yvette, France
| | - Marvin Lerousseau
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Molecular Radiotherapy and Innovative Therapeutics, Villejuif, France
- Gustave Roussy Cancer Campus, Department of Radiation Oncology, Villejuif, France
- Université Paris-Saclay, CentraleSupélec, Inria, Centre de Vision Numérique, Gif-sur-Yvette, France
| | - Maria Vakalopoulou
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, Gif-sur-Yvette, France
- Université Paris-Saclay, CentraleSupélec, Inria, Centre de Vision Numérique, Gif-sur-Yvette, France
| | - Emilie Alvarez Andres
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Molecular Radiotherapy and Innovative Therapeutics, Villejuif, France
- Gustave Roussy Cancer Campus, Department of Radiation Oncology, Villejuif, France
| | - Enzo Battistella
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Molecular Radiotherapy and Innovative Therapeutics, Villejuif, France
- Gustave Roussy Cancer Campus, Department of Radiation Oncology, Villejuif, France
- Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systèmes, Gif-sur-Yvette, France
| | - Alexandre Carré
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Molecular Radiotherapy and Innovative Therapeutics, Villejuif, France
- Gustave Roussy Cancer Campus, Department of Radiation Oncology, Villejuif, France
| | - Siddhartha Chandra
- Université Paris-Saclay, CentraleSupélec, Inria, Centre de Vision Numérique, Gif-sur-Yvette, France
| | - Stergios Christodoulidis
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Predictive Biomarkers and Novel Therapeutic Strategies in Oncology, Villejuif, France
| | - Mihir Sahasrabudhe
- Université Paris-Saclay, CentraleSupélec, Inria, Centre de Vision Numérique, Gif-sur-Yvette, France
| | - Roger Sun
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Molecular Radiotherapy and Innovative Therapeutics, Villejuif, France
- Gustave Roussy Cancer Campus, Department of Radiation Oncology, Villejuif, France
- Université Paris-Saclay, CentraleSupélec, Inria, Centre de Vision Numérique, Gif-sur-Yvette, France
| | - Charlotte Robert
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Molecular Radiotherapy and Innovative Therapeutics, Villejuif, France
- Gustave Roussy Cancer Campus, Department of Radiation Oncology, Villejuif, France
| | - Hugues Talbot
- Université Paris-Saclay, CentraleSupélec, Inria, Centre de Vision Numérique, Gif-sur-Yvette, France
| | - Nikos Paragios
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Eric Deutsch
- Gustave Roussy-CentraleSupélec-TheraPanacea Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Molecular Radiotherapy and Innovative Therapeutics, Villejuif, France
- Gustave Roussy Cancer Campus, Department of Radiation Oncology, Villejuif, France
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Chassagnon G, Vakalopoulou M, Paragios N, Revel MP. Artificial intelligence applications for thoracic imaging. Eur J Radiol 2019; 123:108774. [PMID: 31841881 DOI: 10.1016/j.ejrad.2019.108774] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/13/2019] [Accepted: 11/21/2019] [Indexed: 02/06/2023]
Abstract
Artificial intelligence is a hot topic in medical imaging. The development of deep learning methods and in particular the use of convolutional neural networks (CNNs), have led to substantial performance gain over the classic machine learning techniques. Multiple usages are currently being evaluated, especially for thoracic imaging, such as such as lung nodule evaluation, tuberculosis or pneumonia detection or quantification of diffuse lung diseases. Chest radiography is a near perfect domain for the development of deep learning algorithms for automatic interpretation, requiring large annotated datasets, in view of the high number of procedures and increasing data availability. Current algorithms are able to detect up to 14 common anomalies, when present as isolated findings. Chest computed tomography is another major field of application for artificial intelligence, especially in the perspective of large scale lung cancer screening. It is important for radiologists to apprehend, contribute actively and lead this new era of radiology powered by artificial intelligence. Such a perspective requires understanding new terms and concepts associated with machine learning. The objective of this paper is to provide useful definitions for understanding the methods used and their possibilities, and report current and future developments for thoracic imaging. Prospective validation of AI tools will be required before reaching routine clinical implementation.
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Affiliation(s)
- Guillaume Chassagnon
- Radiology Department, Groupe Hospitalier Cochin Broca Hôtel-Dieu - Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France; Laboratoire Mathématiques et Informatique pour la Complexité et les Systèmes, Ecole CentraleSupelec, 3 Rue Joliot Curie, 91190 Gif-sur-Yvette, France; Center for Visual Computing, Ecole CentraleSupelec, 3 Rue Joliot Curie, 91190, Gif-sur-Yvette, France
| | - Maria Vakalopoulou
- Laboratoire Mathématiques et Informatique pour la Complexité et les Systèmes, Ecole CentraleSupelec, 3 Rue Joliot Curie, 91190 Gif-sur-Yvette, France; Center for Visual Computing, Ecole CentraleSupelec, 3 Rue Joliot Curie, 91190, Gif-sur-Yvette, France
| | - Nikos Paragios
- Laboratoire Mathématiques et Informatique pour la Complexité et les Systèmes, Ecole CentraleSupelec, 3 Rue Joliot Curie, 91190 Gif-sur-Yvette, France; TheraPanacea, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France; Center for Visual Computing, Ecole CentraleSupelec, 3 Rue Joliot Curie, 91190, Gif-sur-Yvette, France
| | - Marie-Pierre Revel
- Radiology Department, Groupe Hospitalier Cochin Broca Hôtel-Dieu - Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France; Center for Visual Computing, Ecole CentraleSupelec, 3 Rue Joliot Curie, 91190, Gif-sur-Yvette, France.
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Alvarez Andres E, Fidon L, Vakalopoulou M, Noël G, Beaudre A, Niyoteka S, Benzazon N, Lefkopoulos D, Deutsch E, Paragios N, Robert C. 44 Assessing the impact of key preprocessing concepts on the pseudo CT generation. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Sun R, Lancia A, Sundahl N, Milic M, Carre A, Lerousseau M, Estienne T, Battistella E, Klausner G, Bahleda R, Alvarez-Andres E, Robert C, Boutros C, Vakalopoulou M, Paragios N, Ost P, Massard C, Deutsch E. Evaluation of a radiomic signature of CD8 cells in patients treated with immunotherapy-radiotherapy in three clinical trials. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Alvarez Andres E, Fidon L, Vakalopoulou M, Noël G, Niyoteka S, Benzazon N, Deutsch E, Paragios N, Robert C. PO-1002 Pseudo Computed Tomography generation using 3D deep learning – Application to brain radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31422-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sun R, Limkin EJ, Vakalopoulou M, Dercle L, Champiat S, Han SR, Verlingue L, Brandao D, Lancia A, Ammari S, Hollebecque A, Scoazec JY, Marabelle A, Massard C, Soria JC, Robert C, Paragios N, Deutsch E, Ferté C. A radiomics approach to assess tumour-infiltrating CD8 cells and response to anti-PD-1 or anti-PD-L1 immunotherapy: an imaging biomarker, retrospective multicohort study. Lancet Oncol 2018; 19:1180-1191. [PMID: 30120041 DOI: 10.1016/s1470-2045(18)30413-3] [Citation(s) in RCA: 698] [Impact Index Per Article: 116.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/18/2018] [Accepted: 05/23/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Because responses of patients with cancer to immunotherapy can vary in success, innovative predictors of response to treatment are urgently needed to improve treatment outcomes. We aimed to develop and independently validate a radiomics-based biomarker of tumour-infiltrating CD8 cells in patients included in phase 1 trials of anti-programmed cell death protein (PD)-1 or anti-programmed cell death ligand 1 (PD-L1) monotherapy. We also aimed to evaluate the association between the biomarker, and tumour immune phenotype and clinical outcomes of these patients. METHODS In this retrospective multicohort study, we used four independent cohorts of patients with advanced solid tumours to develop and validate a radiomic signature predictive of immunotherapy response by combining contrast-enhanced CT images and RNA-seq genomic data from tumour biopsies to assess CD8 cell tumour infiltration. To develop the radiomic signature of CD8 cells, we used the CT images and RNA sequencing data of 135 patients with advanced solid malignant tumours who had been enrolled into the MOSCATO trial between May 1, 2012, and March 31, 2016, in France (training set). The genomic data, which are based on the CD8B gene, were used to estimate the abundance of CD8 cells in the samples and data were then aligned with the images to generate the radiomic signatures. The concordance of the radiomic signature (primary endpoint) was validated in a Cancer Genome Atlas [TGCA] database dataset including 119 patients who had available baseline preoperative imaging data and corresponding transcriptomic data on June 30, 2017. From 84 input variables used for the machine-learning method (78 radiomic features, five location variables, and one technical variable), a radiomics-based predictor of the CD8 cell expression signature was built by use of machine learning (elastic-net regularised regression method). Two other independent cohorts of patients with advanced solid tumours were used to evaluate this predictor. The immune phenotype internal cohort (n=100), were randomly selected from the Gustave Roussy Cancer Campus database of patient medical records based on previously described, extreme tumour-immune phenotypes: immune-inflamed (with dense CD8 cell infiltration) or immune-desert (with low CD8 cell infiltration), irrespective of treatment delivered; these data were used to analyse the correlation of the immune phenotype with this biomarker. Finally, the immunotherapy-treated dataset (n=137) of patients recruited from Dec 1, 2011, to Jan 31, 2014, at the Gustave Roussy Cancer Campus, who had been treated with anti-PD-1 and anti-PD-L1 monotherapy in phase 1 trials, was used to assess the predictive value of this biomarker in terms of clinical outcome. FINDINGS We developed a radiomic signature for CD8 cells that included eight variables, which was validated with the gene expression signature of CD8 cells in the TCGA dataset (area under the curve [AUC]=0·67; 95% CI 0·57-0·77; p=0·0019). In the cohort with assumed immune phenotypes, the signature was also able to discriminate inflamed tumours from immune-desert tumours (0·76; 0·66-0·86; p<0·0001). In patients treated with anti-PD-1 and PD-L1, a high baseline radiomic score (relative to the median) was associated with a higher proportion of patients who achieved an objective response at 3 months (vs those with progressive disease or stable disease; p=0·049) and a higher proportion of patients who had an objective response (vs those with progressive disease or stable disease; p=0·025) or stable disease (vs those with progressive disease; p=0·013) at 6 months. A high baseline radiomic score was also associated with improved overall survival in univariate (median overall survival 24·3 months in the high radiomic score group, 95% CI 18·63-42·1; vs 11·5 months in the low radiomic score group, 7·98-15·6; hazard ratio 0·58, 95% CI 0·39-0·87; p=0·0081) and multivariate analyses (0·52, 0·35-0·79; p=0·0022). INTERPRETATION The radiomic signature of CD8 cells was validated in three independent cohorts. This imaging predictor provided a promising way to predict the immune phenotype of tumours and to infer clinical outcomes for patients with cancer who had been treated with anti-PD-1 and PD-L1. Our imaging biomarker could be useful in estimating CD8 cell count and predicting clinical outcomes of patients treated with immunotherapy, when validated by further prospective randomised trials. FUNDING Fondation pour la Recherche Médicale, and SIRIC-SOCRATE 2.0, French Society of Radiation Oncology.
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Affiliation(s)
- Roger Sun
- Gustave Roussy-CentraleSupélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Radiomics Team, Molecular Radiotherapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Elaine Johanna Limkin
- Gustave Roussy-CentraleSupélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Radiomics Team, Molecular Radiotherapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Maria Vakalopoulou
- Gustave Roussy-CentraleSupélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Centre for Visual Computing, University of Paris-Saclay, Gif-sur-Yvette, France
| | - Laurent Dercle
- Immunology of Tumours and Immunotherapy INSERM U1015, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France; Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stéphane Champiat
- Department of Drug Development, Gustave Roussy Cancer Campus, Villejuif, France
| | - Shan Rong Han
- Department of Pathology, North Franche-Comté Hospital, Trevenans, France
| | - Loïc Verlingue
- Department of Drug Development, Gustave Roussy Cancer Campus, Villejuif, France
| | - David Brandao
- Haematology and Pathology INSERM U1170, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France
| | - Andrea Lancia
- Gustave Roussy-CentraleSupélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Radiomics Team, Molecular Radiotherapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France; Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology, and Radiotherapy, Tor Vergata General Hospital, Rome, Italy
| | - Samy Ammari
- Department of Radiology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Antoine Hollebecque
- Department of Drug Development, Gustave Roussy Cancer Campus, Villejuif, France
| | - Jean-Yves Scoazec
- Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France; Faculty of Medicine, Paris-Sud University, Kremlin-Bicêtre, France
| | - Aurélien Marabelle
- Department of Drug Development, Gustave Roussy Cancer Campus, Villejuif, France
| | - Christophe Massard
- Department of Drug Development, Gustave Roussy Cancer Campus, Villejuif, France
| | - Jean-Charles Soria
- Department of Drug Development, Gustave Roussy Cancer Campus, Villejuif, France; Faculty of Medicine, Paris-Sud University, Kremlin-Bicêtre, France
| | - Charlotte Robert
- Gustave Roussy-CentraleSupélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Radiomics Team, Molecular Radiotherapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France; Medical Physics Unit, Gustave Roussy Cancer Campus, Villejuif, France; Faculty of Medicine, Paris-Sud University, Kremlin-Bicêtre, France
| | - Nikos Paragios
- Gustave Roussy-CentraleSupélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Centre for Visual Computing, University of Paris-Saclay, Gif-sur-Yvette, France
| | - Eric Deutsch
- Gustave Roussy-CentraleSupélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Radiomics Team, Molecular Radiotherapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Department of Drug Development, Gustave Roussy Cancer Campus, Villejuif, France; Faculty of Medicine, Paris-Sud University, Kremlin-Bicêtre, France.
| | - Charles Ferté
- Gustave Roussy-CentraleSupélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Radiomics Team, Molecular Radiotherapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France; Department of Drug Development, Gustave Roussy Cancer Campus, Villejuif, France
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Savadjiev P, Chong J, Dohan A, Vakalopoulou M, Reinhold C, Paragios N, Gallix B. Demystification of AI-driven medical image interpretation: past, present and future. Eur Radiol 2018; 29:1616-1624. [PMID: 30105410 DOI: 10.1007/s00330-018-5674-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/05/2018] [Accepted: 07/17/2018] [Indexed: 12/22/2022]
Abstract
The recent explosion of 'big data' has ushered in a new era of artificial intelligence (AI) algorithms in every sphere of technological activity, including medicine, and in particular radiology. However, the recent success of AI in certain flagship applications has, to some extent, masked decades-long advances in computational technology development for medical image analysis. In this article, we provide an overview of the history of AI methods for radiological image analysis in order to provide a context for the latest developments. We review the functioning, strengths and limitations of more classical methods as well as of the more recent deep learning techniques. We discuss the unique characteristics of medical data and medical science that set medicine apart from other technological domains in order to highlight not only the potential of AI in radiology but also the very real and often overlooked constraints that may limit the applicability of certain AI methods. Finally, we provide a comprehensive perspective on the potential impact of AI on radiology and on how to evaluate it not only from a technical point of view but also from a clinical one, so that patients can ultimately benefit from it. KEY POINTS: • Artificial intelligence (AI) research in medical imaging has a long history • The functioning, strengths and limitations of more classical AI methods is reviewed, together with that of more recent deep learning methods. • A perspective is provided on the potential impact of AI on radiology and on its evaluation from both technical and clinical points of view.
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Affiliation(s)
- Peter Savadjiev
- Department of Diagnostic Radiology, McGill University, Montreal, QC, Canada
| | - Jaron Chong
- Department of Diagnostic Radiology, McGill University, Montreal, QC, Canada.,Department of Diagnostic Radiology, McGill University Health Centre, Montreal, QC, Canada
| | - Anthony Dohan
- Department of Diagnostic Radiology, McGill University, Montreal, QC, Canada.,Department of Diagnostic Radiology, McGill University Health Centre, Montreal, QC, Canada.,Department of Body & Interventional Imaging, Hôpital Lariboisière-AP-HP, Université Diderot-Paris 7 and INSERM U965, 75475, Paris Cedex 10, France
| | - Maria Vakalopoulou
- Ecole CentraleSupelec, 91190, Gif-sur-Yvette, France.,Inria Saclay/Ile-de-France, 91120, Palaiseau, France
| | - Caroline Reinhold
- Department of Diagnostic Radiology, McGill University, Montreal, QC, Canada.,Department of Diagnostic Radiology, McGill University Health Centre, Montreal, QC, Canada
| | - Nikos Paragios
- Ecole CentraleSupelec, 91190, Gif-sur-Yvette, France.,TheraPanacea, 75014, Paris, France
| | - Benoit Gallix
- Department of Diagnostic Radiology, McGill University, Montreal, QC, Canada. .,Department of Diagnostic Radiology, McGill University Health Centre, Montreal, QC, Canada.
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Sun R, Limkin EJ, Vakalopoulou M, Dercle L, Champiat S, Han SR, Verlingue L, Brandao D, Ammari S, Mahjoubi L, Hollebecque A, Scoazec JY, Marabelle A, Massard C, Soria JC, Robert C, Paragios N, Deutsch E, Ferte C. Medical image computing to assess tumor infiltrating CD8 T cells, tumor immune phenotype and response to anti-PD-1/PD-L1 immunotherapy in prospective phase 1 trials. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.3016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Roger Sun
- Gustave Roussy Cancer Campus, Radiation oncology department,, Villejuif, France
| | | | - Maria Vakalopoulou
- Center for Visual Computing - CentraleSupelec - INRIA - University Paris-Saclay, Gif-Sur-Yvette, France
| | - Laurent Dercle
- Department of Radiology, Columbia University Medical Center, New York, NY
| | - Stephane Champiat
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - Shan Rong Han
- Hôpital Nord Franche - Comté, Pathology department, Trevenans, France
| | | | - David Brandao
- INSERM U1170, Gustave Roussy Cancer Campus, Villejuif, France
| | - Samy Ammari
- Gustave Roussy Cancer Campus, Villejuif, France
| | | | | | - Jean-Yves Scoazec
- Department of Biopathology, Gustave Roussy Cancer Campus, Villejuif, France
| | | | | | | | | | - Nikos Paragios
- Center for Visual Computing - CentraleSupelec - INRIA - University Paris-Saclay, Gif-Sur-Yvette, France
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Papadomanolaki M, Vakalopoulou M, Zagoruyko S, Karantzalos K. BENCHMARKING DEEP LEARNING FRAMEWORKS FOR THE CLASSIFICATION OF VERY HIGH RESOLUTION SATELLITE MULTISPECTRAL DATA. ACTA ACUST UNITED AC 2016. [DOI: 10.5194/isprsannals-iii-7-83-2016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In this paper we evaluated deep-learning frameworks based on Convolutional Neural Networks for the accurate classification of multispectral remote sensing data. Certain state-of-the-art models have been tested on the publicly available SAT-4 and SAT-6 high resolution satellite multispectral datasets. In particular, the performed benchmark included the <i>AlexNet</i>, <i>AlexNet-small</i> and <i>VGG</i> models which had been trained and applied to both datasets exploiting all the available spectral information. Deep Belief Networks, Autoencoders and other semi-supervised frameworks have been, also, compared. The high level features that were calculated from the tested models managed to classify the different land cover classes with significantly high accuracy rates <i>i.e.</i>, above 99.9%. The experimental results demonstrate the great potentials of advanced deep-learning frameworks for the supervised classification of high resolution multispectral remote sensing data.
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