Background and objectives:The incidence of symptomatic radiation pneumonitis(RP)and its relationship with dose-volume histogram(DVH)parameters in non-small cell lung cancer(NSCLC)patients receiving epidermal growth fa...Background and objectives:The incidence of symptomatic radiation pneumonitis(RP)and its relationship with dose-volume histogram(DVH)parameters in non-small cell lung cancer(NSCLC)patients receiving epidermal growth factor receptortyrosine kinase inhibitors(EGFR-TKIs)and concurrent once-daily thoracic radiotherapy(TRT)remain unclear.We aim to analyze the values of clinical factors and dose-volume histogram(DVH)parameters to predict the risk for symptomatic RP in these patients.Methods:Between 2011 and 2019,we retrospectively analyzed and identified 85 patients who had received EGFR-TKIs and oncedaily TRT simultaneously(EGFR-TKIs group)and 129 patients who had received concurrent chemoradiotherapy(CCRT group).The symptomatic RP was recorded according to the Common Terminology Criteria for Adverse Event(CTCAE)criteria(grade 2 or above).Statistical analyses were performed using SPSS 26.0.Results:In total,the incidences of symptomatic(grade≥2)and severe RP(grade≥3)were 43.5%(37/85)and 16.5%(14/85)in EGFR-TKIs group vs 27.1%(35/129)and 10.1%(13/129)in CCRT group respectively.After 1:1 ratio between EGFR-TKIs group and CCRT group was matched by propensity score matching,chi-square test suggested that the incidence of symptomatic RP in the MATCHED EGFR-TKIs group was higher than that in the matched CCRT group(χ^(2)=4.469,P=0.035).In EGFRTKIs group,univariate and multivariate analyses indicated that the percentage of ipsilateral lung volume receiving≥30 Gy(ilV_(30))[odds ratio(OR):1.163,95%CI:1.036-1.306,P=0.011]and the percentage of total lung volume receiving≥20 Gy(tlV_(20))(OR:1.171,95%CI:1.031-1.330,P=0.015),with chronic obstructive pulmonary disease(COPD)or not(OR:0.158,95%CI:0.041-0.600,P=0.007),were independent predictors of symptomatic RP.Compared to patients with lower iIV_(30)/tlV_(20)values(ilV_(30)and tlV_(20)<cut-off point values)and without COPD,patients with higher ilV_(30)/tlV_(20)values(ilV_(30)and tlV_(20)>cut-off point values)and COPD had a significantly higher risk for developing symptomatic RP,with a hazard ratio(HR)of 1.350(95%CI:1.190-1.531,P<0.001).Conclusion:Patients receiving both EGFR-TKIs and once-daily TRT were more likely to develop symptomatic RP than patients receiving concurrent chemoradiotherapy.The ilV_(30),tlV_(20),and comorbidity of COPD may predict the risk of symptomatic RP among NSCLC patients receiving EGFR-TKIs and conventionally fractionated TRT concurrently.展开更多
In single photon emission computed tomography-based three-dimensional radiotherapy(SPECT-B-3DCRT), im-ages of Tc-99 m galactosyl human serum albumin(GSA), which bind to receptors on functional liver cells, are merged ...In single photon emission computed tomography-based three-dimensional radiotherapy(SPECT-B-3DCRT), im-ages of Tc-99 m galactosyl human serum albumin(GSA), which bind to receptors on functional liver cells, are merged with the computed tomography simulation im-ages. Functional liver is defined as the area of normal liver where GSA accumulation exceeds that of hepato-cellular carcinoma(HCC). In cirrhotic patients with a gigantic, proton-beam-untreatable HCC of ≥ 14 cm in diameter, the use of SPECT-B-3DCRT in combination with transcatheter arterial chemoembolization achieved a 2-year local tumor control rate of 78.6% and a 2-year survival rate of 33.3%. SPECT-B-3DCRT was applied to HCC to preserve as much functional liver as possible. Sixty-four patients with HCC, including 30 with Child B liver cirrhosis, received SPECT-B-3DCRT and none ex-perienced fatal radiation-induced liver disease(RILD). The Child-Pugh score deteriorated by 1 or 2 in > 20% of functional liver volume that was irradiated with ≥ 20 Gy. The deterioration in the Child-Pugh score decreased when the radiation plan was designed to irradiate ≤ 20% of the functional liver volume in patients givendoses of ≥ 20 Gy(FLV20Gy). Therefore, FLV20 Gy ≤ 20% may represent a safety index to prevent RILD during 3DCRT for HCC. To supplement FLV20 Gy as a qualitative index, we propose a quantitative indicator, F 20 Gy, which was calculated as F 20 Gy = 100% ×(the GSA count in the area irradiated with ≥ 20 Gy)/(the GSA count in the whole liver).展开更多
BACKGROUND Although surgery remains the primary treatment for gastric cancer(GC),the identification of effective alternative treatments for individuals for whom surgery is unsuitable holds significance.HER2 overexpres...BACKGROUND Although surgery remains the primary treatment for gastric cancer(GC),the identification of effective alternative treatments for individuals for whom surgery is unsuitable holds significance.HER2 overexpression occurs in approximately 15%-20%of advanced GC cases,directly affecting treatment-related decisions.Spectral-computed tomography(sCT)enables the quantification of material compositions,and sCT iodine concentration parameters have been demonstrated to be useful for the diagnosis of GC and prediction of its invasion depth,angioge-nesis,and response to systemic chemotherapy.No existing report describes the prediction of GC HER2 status through histogram analysis based on sCT iodine maps(IMs).AIM To investigate whether whole-volume histogram analysis of sCT IMs enables the prediction of the GC HER2 status.METHODS This study was performed with data from 101 patients with pathologically confirmed GC who underwent preoperative sCT examinations.Nineteen parameters were extracted via sCT IM histogram analysis:The minimum,maximum,mean,standard deviation,variance,coefficient of variation,skewness,kurtosis,entropy,percentiles(1st,5th,10th,25th,50th,75th,90th,95th,and 99th),and lesion volume.Spearman correlations of the parameters with the HER2 status and clinicopathological parameters were assessed.Receiver operating characteristic curves were used to evaluate the parameters’diagnostic performance.RESULTS Values for the histogram parameters of the maximum,mean,standard deviation,variance,entropy,and percentiles were significantly lower in the HER2+group than in the HER2–group(all P<0.05).The GC differentiation and Lauren classification correlated significantly with the HER2 status of tumor tissue(P=0.001 and 0.023,respectively).The 99th percentile had the largest area under the curve for GC HER2 status identification(0.740),with 76.2%,sensitivity,65.0%specificity,and 67.3%accuracy.All sCT IM histogram parameters correlated positively with the GC HER2 status(r=0.237-0.337,P=0.001-0.017).CONCLUSION Whole-lesion histogram parameters derived from sCT IM analysis,and especially the 99th percentile,can serve as imaging biomarkers of HER2 overexpression in GC.展开更多
Image classification and unsupervised image segmentation can be achieved using the Gaussian mixture model.Although the Gaussian mixture model enhances the flexibility of image segmentation,it does not reflect spatial ...Image classification and unsupervised image segmentation can be achieved using the Gaussian mixture model.Although the Gaussian mixture model enhances the flexibility of image segmentation,it does not reflect spatial information and is sensitive to the segmentation parameter.In this study,we first present an efficient algorithm that incorporates spatial information into the Gaussian mixture model(GMM)without parameter estimation.The proposed model highlights the residual region with considerable information and constructs color saliency.Second,we incorporate the content-based color saliency as spatial information in the Gaussian mixture model.The segmentation is performed by clustering each pixel into an appropriate component according to the expectation maximization and maximum criteria.Finally,the random color histogram assigns a unique color to each cluster and creates an attractive color by default for segmentation.A random color histogram serves as an effective tool for data visualization and is instrumental in the creation of generative art,facilitating both analytical and aesthetic objectives.For experiments,we have used the Berkeley segmentation dataset BSDS-500 and Microsoft Research in Cambridge dataset.In the study,the proposed model showcases notable advancements in unsupervised image segmentation,with probabilistic rand index(PRI)values reaching 0.80,BDE scores as low as 12.25 and 12.02,compactness variations at 0.59 and 0.7,and variation of information(VI)reduced to 2.0 and 1.49 for the BSDS-500 and MSRC datasets,respectively,outperforming current leading-edge methods and yielding more precise segmentations.展开更多
Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we inves...Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-dose- rate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach. Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer. Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied. With a median of 5 (range, 4-7) implanted needles for each patient, the median dose of brachytherapy alone delivered to 90% of the target volume (D90 ) was 45 (range, 33-54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range, 20-36) Gyα/β10 for intermediate-risk clinical target volume (IR-CTV). The percentage of the CTV covered by the prescribed dose (V100 ) of HR-CTV with brachytherapy alone was 81.9%-99.2% (median, 96.7%). With an additional dose of external beam radiotherapy (EBRT), the median D90 was 94 (range, 83-104) Gyα/β10 for HR-CTV and 77 (range, 70 -87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100 ) was 75 (range, 66-84) Gyα/β10 for HR-CTV and 65 (range, 57-73) Gyα/β10 for IR-CTV. The minimum dose to the most irradiated 2 cc volume (D2cc ) was 73-96 (median, 83) Gyα/β3 for the bladder, 64-98 (median, 73) Gyα/β3 for the rectum, and 52-69 (median, 61) Gyα/β3 for the sigmoid colon. After a median follow-up of 15 months (range, 3 -24 months), two patients experienced local failure, and 1 showed internal iliac nodal metastasis. Despite the relatively small number of needles used, CT-guided HDRISBT for cervical cancer showed favorable DVH parameters and clinical outcome.展开更多
This study aimed to investigate the dose-volume effects of γ-ray stereotactic body radiotherapy (SBRT) on clinical outcomes of patients with huge-size (≥10 cm) unresectable hepatocellular carcinoma (HCC). A total of...This study aimed to investigate the dose-volume effects of γ-ray stereotactic body radiotherapy (SBRT) on clinical outcomes of patients with huge-size (≥10 cm) unresectable hepatocellular carcinoma (HCC). A total of 59 patients with huge-size unresectable HCC were treated with SBRT following TACE between May 2006 and Dec. 2009. The analyzed parameters included fractional dose, marginal dose, maximal dose, and mean dose that the target received, as well as percentages of tumor volume encompassed by 60% (P<sub>60</sub>), 70% (P<sub>70</sub>), and 80% (P<sub>80</sub>) of isodose curves in entire tumor. The clinical outcomes included objective response rate (ORR), disease-free survival (DFS), overall survival (OS), and adverse event (AE). During median follow-up of 18.4 months, 81.4% of ORR (8.5% CR and 72.9% PR) was achieved, higher than 28.9% of ORR recently reported for TACE alone. 1- and 3-year DFS rates were 31.1% and 2.6% with median DFS of 8.7 months;1-, 3-, and 5-year OS rates were 46.5%, 13.7%, and 2.9%, with median OS of 11.8 months. P<sub>70</sub> was the only factor significantly correlating to DFS (P = 0.009) and OS (P = 0.01). Neither severe radiation-related liver disease nor > grade 3 AE was observed. In conclusion, SBRT was a safe and effective option for treatment of huge-size unresectable HCC. P<sub>70</sub> represented a parameter for predicting DFS and OS, and high dose-volume (e.g., P<sub>70</sub>) might be required to achieve improved clinical outcomes of patients with this type of HCC.展开更多
Prescriptions for radiation therapy are given in terms of dose-volume constraints (DVCs). Solving the fluence map optimization (FMO) problem while satisfying DVCs often requires a tedious trial-and-error for selecting...Prescriptions for radiation therapy are given in terms of dose-volume constraints (DVCs). Solving the fluence map optimization (FMO) problem while satisfying DVCs often requires a tedious trial-and-error for selecting appropriate dose control parameters on various organs. In this paper, we propose an iterative approach to satisfy DVCs using a multi-objective linear programming (LP) model for solving beamlet intensities. This algorithm, starting from arbitrary initial parameter values, gradually updates the values through an iterative solution process toward optimal solution. This method finds appropriate parameter values through the trade-off between OAR sparing and target coverage to improve the solution. We compared the plan quality and the satisfaction of the DVCs by the proposed algorithm with two nonlinear approaches: a nonlinear FMO model solved by using the L-BFGS algorithm and another approach solved by a commercial treatment planning system (Eclipse 8.9). We retrospectively selected from our institutional database five patients with lung cancer and one patient with prostate cancer for this study. Numerical results show that our approach successfully improved target coverage to meet the DVCs, while trying to keep corresponding OAR DVCs satisfied. The LBFGS algorithm for solving the nonlinear FMO model successfully satisfied the DVCs in three out of five test cases. However, there is no recourse in the nonlinear FMO model for correcting unsatisfied DVCs other than manually changing some parameter values through trial and error to derive a solution that more closely meets the DVC requirements. The LP-based heuristic algorithm outperformed the current treatment planning system in terms of DVC satisfaction. A major strength of the LP-based heuristic approach is that it is not sensitive to the starting condition.展开更多
Background: Amniotic fluid turbidity increases with fetal lung maturation due to vernix and lung surfactant micelles suspended in the amniotic fluid. This study focused on this phenomenon and evaluated the presence or...Background: Amniotic fluid turbidity increases with fetal lung maturation due to vernix and lung surfactant micelles suspended in the amniotic fluid. This study focused on this phenomenon and evaluated the presence or absence of respiratory distress syndrome (RDS)/transient tachypnea of the newborn (TTN) by quantitatively assessing the brightness of the amniotic fluid turbidity using a noninvasive ultrasound histogram measurement function. Methods: We included cases of singleton pregnancies managed at the Niigata University Medical and Dental Hospital between November 2020 and March 2022. Histograms of amniotic fluid turbidity were measured at the center of the amniotic fluid depth, avoiding the fetus, placenta, and umbilical cord, with the gain setting set to 0, and the average value was obtained after three measurements. Histograms of fetal urine in the bladder were measured similarly. The value obtained by subtracting the fetal bladder brightness value from the amniotic brightness value based on histogram measurements was used as the final amniotic fluid brightness value. Results: We included 118 cases (16 of RDS/TTN and 102 of control). The gestational age of delivery weeks was correlated with amniotic fluid brightness (Spearman’s rank correlation coefficient was 0.344;p = 0.00014). Amniotic fluid brightness values were significantly lower in the RDS/TTN group than in the control group (RDS/TTN: 16.2 ± 13.5, control: 26.3 ± 16.3;p = 0.020). The optimal cutoff value of amniotic fluid brightness to predict RDS/TTN was 20.3. For predicting RDS/TTN, the sensitivity, specificity, positive predictive value, and negative predictive value were 91.7%, 69.6%, 26.2%, and 94.1%, respectively. Conclusions: The quantitative value of the amniotic fluid brightness by histogram measurements may provide an easy and objective index for evaluating the presence or absence of RDS/TTN.展开更多
An abnormality that develops in white blood cells is called leukemia.The diagnosis of leukemia is made possible by microscopic investigation of the smear in the periphery.Prior training is necessary to complete the mo...An abnormality that develops in white blood cells is called leukemia.The diagnosis of leukemia is made possible by microscopic investigation of the smear in the periphery.Prior training is necessary to complete the morphological examination of the blood smear for leukemia diagnosis.This paper proposes a Histogram Threshold Segmentation Classifier(HTsC)for a decision support system.The proposed HTsC is evaluated based on the color and brightness variation in the dataset of blood smear images.Arithmetic operations are used to crop the nucleus based on automated approximation.White Blood Cell(WBC)segmentation is calculated using the active contour model to determine the contrast between image regions using the color transfer approach.Through entropy-adaptive mask generation,WBCs accurately detect the circularity region for identification of the nucleus.The proposed HTsC addressed the cytoplasm region based on variations in size and shape concerning addition and rotation operations.Variation in WBC imaging characteristics depends on the cytoplasmic and nuclear regions.The computation of the variation between image features in the cytoplasm and nuclei regions of the WBCs is used to classify blood smear images.The classification of the blood smear is performed with conventional machine-learning techniques integrated with the features of the deep-learning regression classifier.The designed HTsC classifier comprises the binary classifier with the classification of the lymphocytes,monocytes,neutrophils,eosinophils,and abnormalities in the WBCs.The proposed HTsC identifies the abnormal activity in the WBC,considering the color and shape features.It exhibits a higher classification accuracy value of 99.6%when combined with the other classifiers.The comparative analysis expressed that the proposed HTsC model exhibits an overall accuracy value of 98%,which is approximately 3%–12%higher than the conventional technique.展开更多
Tuberculosis(TB)is a severe infection that mostly affects the lungs and kills millions of people’s lives every year.Tuberculosis can be diagnosed using chest X-rays(CXR)and data-driven deep learning(DL)approaches.Bec...Tuberculosis(TB)is a severe infection that mostly affects the lungs and kills millions of people’s lives every year.Tuberculosis can be diagnosed using chest X-rays(CXR)and data-driven deep learning(DL)approaches.Because of its better automated feature extraction capability,convolutional neural net-works(CNNs)trained on natural images are particularly effective in image cate-gorization.A combination of 3001 normal and 3001 TB CXR images was gathered for this study from different accessible public datasets.Ten different deep CNNs(Resnet50,Resnet101,Resnet152,InceptionV3,VGG16,VGG19,DenseNet121,DenseNet169,DenseNet201,MobileNet)are trained and tested for identifying TB and normal cases.This study presents a deep CNN approach based on histogram matched CXR images that does not require object segmenta-tion of interest,and this coupled methodology of histogram matching with the CXRs improves the accuracy and detection performance of CNN models for TB detection.Furthermore,this research contains two separate experiments that used CXR images with and without histogram matching to classify TB and non-TB CXRs using deep CNNs.It was able to accurately detect TB from CXR images using pre-processing,data augmentation,and deep CNN models.Without histogram matching the best accuracy,sensitivity,specificity,precision and F1-score in the detection of TB using CXR images among ten models are 99.25%,99.48%,99.52%,99.48%and 99.22%respectively.With histogram matching the best accuracy,sensitivity,specificity,precision and F1-score are 99.58%,99.82%,99.67%,99.65%and 99.56%respectively.The proposed meth-odology,which has cutting-edge performance,will be useful in computer-assisted TB diagnosis and aids in minimizing irregularities in TB detection in developing countries.展开更多
文摘Background and objectives:The incidence of symptomatic radiation pneumonitis(RP)and its relationship with dose-volume histogram(DVH)parameters in non-small cell lung cancer(NSCLC)patients receiving epidermal growth factor receptortyrosine kinase inhibitors(EGFR-TKIs)and concurrent once-daily thoracic radiotherapy(TRT)remain unclear.We aim to analyze the values of clinical factors and dose-volume histogram(DVH)parameters to predict the risk for symptomatic RP in these patients.Methods:Between 2011 and 2019,we retrospectively analyzed and identified 85 patients who had received EGFR-TKIs and oncedaily TRT simultaneously(EGFR-TKIs group)and 129 patients who had received concurrent chemoradiotherapy(CCRT group).The symptomatic RP was recorded according to the Common Terminology Criteria for Adverse Event(CTCAE)criteria(grade 2 or above).Statistical analyses were performed using SPSS 26.0.Results:In total,the incidences of symptomatic(grade≥2)and severe RP(grade≥3)were 43.5%(37/85)and 16.5%(14/85)in EGFR-TKIs group vs 27.1%(35/129)and 10.1%(13/129)in CCRT group respectively.After 1:1 ratio between EGFR-TKIs group and CCRT group was matched by propensity score matching,chi-square test suggested that the incidence of symptomatic RP in the MATCHED EGFR-TKIs group was higher than that in the matched CCRT group(χ^(2)=4.469,P=0.035).In EGFRTKIs group,univariate and multivariate analyses indicated that the percentage of ipsilateral lung volume receiving≥30 Gy(ilV_(30))[odds ratio(OR):1.163,95%CI:1.036-1.306,P=0.011]and the percentage of total lung volume receiving≥20 Gy(tlV_(20))(OR:1.171,95%CI:1.031-1.330,P=0.015),with chronic obstructive pulmonary disease(COPD)or not(OR:0.158,95%CI:0.041-0.600,P=0.007),were independent predictors of symptomatic RP.Compared to patients with lower iIV_(30)/tlV_(20)values(ilV_(30)and tlV_(20)<cut-off point values)and without COPD,patients with higher ilV_(30)/tlV_(20)values(ilV_(30)and tlV_(20)>cut-off point values)and COPD had a significantly higher risk for developing symptomatic RP,with a hazard ratio(HR)of 1.350(95%CI:1.190-1.531,P<0.001).Conclusion:Patients receiving both EGFR-TKIs and once-daily TRT were more likely to develop symptomatic RP than patients receiving concurrent chemoradiotherapy.The ilV_(30),tlV_(20),and comorbidity of COPD may predict the risk of symptomatic RP among NSCLC patients receiving EGFR-TKIs and conventionally fractionated TRT concurrently.
文摘In single photon emission computed tomography-based three-dimensional radiotherapy(SPECT-B-3DCRT), im-ages of Tc-99 m galactosyl human serum albumin(GSA), which bind to receptors on functional liver cells, are merged with the computed tomography simulation im-ages. Functional liver is defined as the area of normal liver where GSA accumulation exceeds that of hepato-cellular carcinoma(HCC). In cirrhotic patients with a gigantic, proton-beam-untreatable HCC of ≥ 14 cm in diameter, the use of SPECT-B-3DCRT in combination with transcatheter arterial chemoembolization achieved a 2-year local tumor control rate of 78.6% and a 2-year survival rate of 33.3%. SPECT-B-3DCRT was applied to HCC to preserve as much functional liver as possible. Sixty-four patients with HCC, including 30 with Child B liver cirrhosis, received SPECT-B-3DCRT and none ex-perienced fatal radiation-induced liver disease(RILD). The Child-Pugh score deteriorated by 1 or 2 in > 20% of functional liver volume that was irradiated with ≥ 20 Gy. The deterioration in the Child-Pugh score decreased when the radiation plan was designed to irradiate ≤ 20% of the functional liver volume in patients givendoses of ≥ 20 Gy(FLV20Gy). Therefore, FLV20 Gy ≤ 20% may represent a safety index to prevent RILD during 3DCRT for HCC. To supplement FLV20 Gy as a qualitative index, we propose a quantitative indicator, F 20 Gy, which was calculated as F 20 Gy = 100% ×(the GSA count in the area irradiated with ≥ 20 Gy)/(the GSA count in the whole liver).
基金Supported by Science and Technology Program of Fujian Province,No.2021J01430Joint Funds for the Innovation of Science and Technology of Fujian Province,No.2021Y9229.
文摘BACKGROUND Although surgery remains the primary treatment for gastric cancer(GC),the identification of effective alternative treatments for individuals for whom surgery is unsuitable holds significance.HER2 overexpression occurs in approximately 15%-20%of advanced GC cases,directly affecting treatment-related decisions.Spectral-computed tomography(sCT)enables the quantification of material compositions,and sCT iodine concentration parameters have been demonstrated to be useful for the diagnosis of GC and prediction of its invasion depth,angioge-nesis,and response to systemic chemotherapy.No existing report describes the prediction of GC HER2 status through histogram analysis based on sCT iodine maps(IMs).AIM To investigate whether whole-volume histogram analysis of sCT IMs enables the prediction of the GC HER2 status.METHODS This study was performed with data from 101 patients with pathologically confirmed GC who underwent preoperative sCT examinations.Nineteen parameters were extracted via sCT IM histogram analysis:The minimum,maximum,mean,standard deviation,variance,coefficient of variation,skewness,kurtosis,entropy,percentiles(1st,5th,10th,25th,50th,75th,90th,95th,and 99th),and lesion volume.Spearman correlations of the parameters with the HER2 status and clinicopathological parameters were assessed.Receiver operating characteristic curves were used to evaluate the parameters’diagnostic performance.RESULTS Values for the histogram parameters of the maximum,mean,standard deviation,variance,entropy,and percentiles were significantly lower in the HER2+group than in the HER2–group(all P<0.05).The GC differentiation and Lauren classification correlated significantly with the HER2 status of tumor tissue(P=0.001 and 0.023,respectively).The 99th percentile had the largest area under the curve for GC HER2 status identification(0.740),with 76.2%,sensitivity,65.0%specificity,and 67.3%accuracy.All sCT IM histogram parameters correlated positively with the GC HER2 status(r=0.237-0.337,P=0.001-0.017).CONCLUSION Whole-lesion histogram parameters derived from sCT IM analysis,and especially the 99th percentile,can serve as imaging biomarkers of HER2 overexpression in GC.
基金supported by the MOE(Ministry of Education of China)Project of Humanities and Social Sciences(23YJAZH169)the Hubei Provincial Department of Education Outstanding Youth Scientific Innovation Team Support Foundation(T2020017)Henan Foreign Experts Project No.HNGD2023027.
文摘Image classification and unsupervised image segmentation can be achieved using the Gaussian mixture model.Although the Gaussian mixture model enhances the flexibility of image segmentation,it does not reflect spatial information and is sensitive to the segmentation parameter.In this study,we first present an efficient algorithm that incorporates spatial information into the Gaussian mixture model(GMM)without parameter estimation.The proposed model highlights the residual region with considerable information and constructs color saliency.Second,we incorporate the content-based color saliency as spatial information in the Gaussian mixture model.The segmentation is performed by clustering each pixel into an appropriate component according to the expectation maximization and maximum criteria.Finally,the random color histogram assigns a unique color to each cluster and creates an attractive color by default for segmentation.A random color histogram serves as an effective tool for data visualization and is instrumental in the creation of generative art,facilitating both analytical and aesthetic objectives.For experiments,we have used the Berkeley segmentation dataset BSDS-500 and Microsoft Research in Cambridge dataset.In the study,the proposed model showcases notable advancements in unsupervised image segmentation,with probabilistic rand index(PRI)values reaching 0.80,BDE scores as low as 12.25 and 12.02,compactness variations at 0.59 and 0.7,and variation of information(VI)reduced to 2.0 and 1.49 for the BSDS-500 and MSRC datasets,respectively,outperforming current leading-edge methods and yielding more precise segmentations.
文摘Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-dose- rate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach. Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer. Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied. With a median of 5 (range, 4-7) implanted needles for each patient, the median dose of brachytherapy alone delivered to 90% of the target volume (D90 ) was 45 (range, 33-54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range, 20-36) Gyα/β10 for intermediate-risk clinical target volume (IR-CTV). The percentage of the CTV covered by the prescribed dose (V100 ) of HR-CTV with brachytherapy alone was 81.9%-99.2% (median, 96.7%). With an additional dose of external beam radiotherapy (EBRT), the median D90 was 94 (range, 83-104) Gyα/β10 for HR-CTV and 77 (range, 70 -87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100 ) was 75 (range, 66-84) Gyα/β10 for HR-CTV and 65 (range, 57-73) Gyα/β10 for IR-CTV. The minimum dose to the most irradiated 2 cc volume (D2cc ) was 73-96 (median, 83) Gyα/β3 for the bladder, 64-98 (median, 73) Gyα/β3 for the rectum, and 52-69 (median, 61) Gyα/β3 for the sigmoid colon. After a median follow-up of 15 months (range, 3 -24 months), two patients experienced local failure, and 1 showed internal iliac nodal metastasis. Despite the relatively small number of needles used, CT-guided HDRISBT for cervical cancer showed favorable DVH parameters and clinical outcome.
文摘This study aimed to investigate the dose-volume effects of γ-ray stereotactic body radiotherapy (SBRT) on clinical outcomes of patients with huge-size (≥10 cm) unresectable hepatocellular carcinoma (HCC). A total of 59 patients with huge-size unresectable HCC were treated with SBRT following TACE between May 2006 and Dec. 2009. The analyzed parameters included fractional dose, marginal dose, maximal dose, and mean dose that the target received, as well as percentages of tumor volume encompassed by 60% (P<sub>60</sub>), 70% (P<sub>70</sub>), and 80% (P<sub>80</sub>) of isodose curves in entire tumor. The clinical outcomes included objective response rate (ORR), disease-free survival (DFS), overall survival (OS), and adverse event (AE). During median follow-up of 18.4 months, 81.4% of ORR (8.5% CR and 72.9% PR) was achieved, higher than 28.9% of ORR recently reported for TACE alone. 1- and 3-year DFS rates were 31.1% and 2.6% with median DFS of 8.7 months;1-, 3-, and 5-year OS rates were 46.5%, 13.7%, and 2.9%, with median OS of 11.8 months. P<sub>70</sub> was the only factor significantly correlating to DFS (P = 0.009) and OS (P = 0.01). Neither severe radiation-related liver disease nor > grade 3 AE was observed. In conclusion, SBRT was a safe and effective option for treatment of huge-size unresectable HCC. P<sub>70</sub> represented a parameter for predicting DFS and OS, and high dose-volume (e.g., P<sub>70</sub>) might be required to achieve improved clinical outcomes of patients with this type of HCC.
文摘Prescriptions for radiation therapy are given in terms of dose-volume constraints (DVCs). Solving the fluence map optimization (FMO) problem while satisfying DVCs often requires a tedious trial-and-error for selecting appropriate dose control parameters on various organs. In this paper, we propose an iterative approach to satisfy DVCs using a multi-objective linear programming (LP) model for solving beamlet intensities. This algorithm, starting from arbitrary initial parameter values, gradually updates the values through an iterative solution process toward optimal solution. This method finds appropriate parameter values through the trade-off between OAR sparing and target coverage to improve the solution. We compared the plan quality and the satisfaction of the DVCs by the proposed algorithm with two nonlinear approaches: a nonlinear FMO model solved by using the L-BFGS algorithm and another approach solved by a commercial treatment planning system (Eclipse 8.9). We retrospectively selected from our institutional database five patients with lung cancer and one patient with prostate cancer for this study. Numerical results show that our approach successfully improved target coverage to meet the DVCs, while trying to keep corresponding OAR DVCs satisfied. The LBFGS algorithm for solving the nonlinear FMO model successfully satisfied the DVCs in three out of five test cases. However, there is no recourse in the nonlinear FMO model for correcting unsatisfied DVCs other than manually changing some parameter values through trial and error to derive a solution that more closely meets the DVC requirements. The LP-based heuristic algorithm outperformed the current treatment planning system in terms of DVC satisfaction. A major strength of the LP-based heuristic approach is that it is not sensitive to the starting condition.
文摘Background: Amniotic fluid turbidity increases with fetal lung maturation due to vernix and lung surfactant micelles suspended in the amniotic fluid. This study focused on this phenomenon and evaluated the presence or absence of respiratory distress syndrome (RDS)/transient tachypnea of the newborn (TTN) by quantitatively assessing the brightness of the amniotic fluid turbidity using a noninvasive ultrasound histogram measurement function. Methods: We included cases of singleton pregnancies managed at the Niigata University Medical and Dental Hospital between November 2020 and March 2022. Histograms of amniotic fluid turbidity were measured at the center of the amniotic fluid depth, avoiding the fetus, placenta, and umbilical cord, with the gain setting set to 0, and the average value was obtained after three measurements. Histograms of fetal urine in the bladder were measured similarly. The value obtained by subtracting the fetal bladder brightness value from the amniotic brightness value based on histogram measurements was used as the final amniotic fluid brightness value. Results: We included 118 cases (16 of RDS/TTN and 102 of control). The gestational age of delivery weeks was correlated with amniotic fluid brightness (Spearman’s rank correlation coefficient was 0.344;p = 0.00014). Amniotic fluid brightness values were significantly lower in the RDS/TTN group than in the control group (RDS/TTN: 16.2 ± 13.5, control: 26.3 ± 16.3;p = 0.020). The optimal cutoff value of amniotic fluid brightness to predict RDS/TTN was 20.3. For predicting RDS/TTN, the sensitivity, specificity, positive predictive value, and negative predictive value were 91.7%, 69.6%, 26.2%, and 94.1%, respectively. Conclusions: The quantitative value of the amniotic fluid brightness by histogram measurements may provide an easy and objective index for evaluating the presence or absence of RDS/TTN.
基金This research is funded by the Deanship of Scientific Research at Umm Al-Qura University,Grant Code:22UQU4281768DSR01.
文摘An abnormality that develops in white blood cells is called leukemia.The diagnosis of leukemia is made possible by microscopic investigation of the smear in the periphery.Prior training is necessary to complete the morphological examination of the blood smear for leukemia diagnosis.This paper proposes a Histogram Threshold Segmentation Classifier(HTsC)for a decision support system.The proposed HTsC is evaluated based on the color and brightness variation in the dataset of blood smear images.Arithmetic operations are used to crop the nucleus based on automated approximation.White Blood Cell(WBC)segmentation is calculated using the active contour model to determine the contrast between image regions using the color transfer approach.Through entropy-adaptive mask generation,WBCs accurately detect the circularity region for identification of the nucleus.The proposed HTsC addressed the cytoplasm region based on variations in size and shape concerning addition and rotation operations.Variation in WBC imaging characteristics depends on the cytoplasmic and nuclear regions.The computation of the variation between image features in the cytoplasm and nuclei regions of the WBCs is used to classify blood smear images.The classification of the blood smear is performed with conventional machine-learning techniques integrated with the features of the deep-learning regression classifier.The designed HTsC classifier comprises the binary classifier with the classification of the lymphocytes,monocytes,neutrophils,eosinophils,and abnormalities in the WBCs.The proposed HTsC identifies the abnormal activity in the WBC,considering the color and shape features.It exhibits a higher classification accuracy value of 99.6%when combined with the other classifiers.The comparative analysis expressed that the proposed HTsC model exhibits an overall accuracy value of 98%,which is approximately 3%–12%higher than the conventional technique.
文摘Tuberculosis(TB)is a severe infection that mostly affects the lungs and kills millions of people’s lives every year.Tuberculosis can be diagnosed using chest X-rays(CXR)and data-driven deep learning(DL)approaches.Because of its better automated feature extraction capability,convolutional neural net-works(CNNs)trained on natural images are particularly effective in image cate-gorization.A combination of 3001 normal and 3001 TB CXR images was gathered for this study from different accessible public datasets.Ten different deep CNNs(Resnet50,Resnet101,Resnet152,InceptionV3,VGG16,VGG19,DenseNet121,DenseNet169,DenseNet201,MobileNet)are trained and tested for identifying TB and normal cases.This study presents a deep CNN approach based on histogram matched CXR images that does not require object segmenta-tion of interest,and this coupled methodology of histogram matching with the CXRs improves the accuracy and detection performance of CNN models for TB detection.Furthermore,this research contains two separate experiments that used CXR images with and without histogram matching to classify TB and non-TB CXRs using deep CNNs.It was able to accurately detect TB from CXR images using pre-processing,data augmentation,and deep CNN models.Without histogram matching the best accuracy,sensitivity,specificity,precision and F1-score in the detection of TB using CXR images among ten models are 99.25%,99.48%,99.52%,99.48%and 99.22%respectively.With histogram matching the best accuracy,sensitivity,specificity,precision and F1-score are 99.58%,99.82%,99.67%,99.65%and 99.56%respectively.The proposed meth-odology,which has cutting-edge performance,will be useful in computer-assisted TB diagnosis and aids in minimizing irregularities in TB detection in developing countries.