Lung cancer is a significant cause of mortality worldwide, emphasizing the importance of early detection for improved survival rates. In this study, we propose a machine learning (ML) tool trained on data from the PLCO Cancer Screening Trial and validated on the NLST to estimate the likelihood of lung cancer occurrence within five years. The study utilized two datasets, the PLCO (n=55,161) and NLST (n=48,595), consisting of comprehensive information on risk factors, clinical measurements, and outcomes related to lung cancer. Data preprocessing involved removing patients who were not current or former smokers and those who had died of causes unrelated to lung cancer. Additionally, a focus was placed on mitigating bias caused by censored data. Feature selection, hyper-parameter optimization, and model calibration were performed using XGBoost, an ensemble learning algorithm that combines gradient boosting and decision trees. The ML model was trained on the pre-processed PLCO dataset and tested on the NLST dataset. The model incorporated features such as age, gender, smoking history, medical diagnoses, and family history of lung cancer. The model was well-calibrated (Brier score=0.044). ROC-AUC was 82% on the PLCO dataset and 70% on the NLST dataset. PR-AUC was 29% and 11% respectively. When compared to the USPSTF guidelines for lung cancer screening, our model provided the same recall with a precision of 13.1% vs. 9.3% on the PLCO dataset and 3.2% vs. 3.1% on the NLST dataset. The developed ML tool provides a freely available web application for estimating the likelihood of developing lung cancer within five years. By utilizing risk factors and clinical data, individuals can assess their risk and make informed decisions regarding lung cancer screening. This research contributes to the efforts in early detection and prevention strategies, aiming to reduce lung cancer-related mortality rates.
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Endometrial cancer is one of the most common tumors in the female reproductive system and is the third most common gynecological malignancy that causes death after ovarian and cervical cancer. Early diagnosis can significantly improve the 5-year survival rate of patients. With the development of artificial intelligence, computer-assisted diagnosis plays an increasingly important role in improving the accuracy and objectivity of diagnosis, as well as reducing the workload of doctors. However, the absence of publicly available endometrial cancer image datasets restricts the application of computer-assisted diagnostic techniques.In this paper, a publicly available Endometrial Cancer PET/CT Image Dataset for Evaluation of Semantic Segmentation and Detection of Hypermetabolic Regions (ECPC-IDS) are published. Specifically, the segmentation section includes PET and CT images, with a total of 7159 images in multiple formats. In order to prove the effectiveness of segmentation methods on ECPC-IDS, five classical deep learning semantic segmentation methods are selected to test the image segmentation task. The object detection section also includes PET and CT images, with a total of 3579 images and XML files with annotation information. Six deep learning methods are selected for experiments on the detection task.This study conduct extensive experiments using deep learning-based semantic segmentation and object detection methods to demonstrate the differences between various methods on ECPC-IDS. As far as we know, this is the first publicly available dataset of endometrial cancer with a large number of multiple images, including a large amount of information required for image and target detection. ECPC-IDS can aid researchers in exploring new algorithms to enhance computer-assisted technology, benefiting both clinical doctors and patients greatly.
Wide heterogeneity exists in cancer patients' survival, ranging from a few months to several decades. To accurately predict clinical outcomes, it is vital to build an accurate predictive model that relates patients' molecular profiles with patients' survival. With complex relationships between survival and high-dimensional molecular predictors, it is challenging to conduct non-parametric modeling and irrelevant predictors removing simultaneously. In this paper, we build a kernel Cox proportional hazards semi-parametric model and propose a novel regularized garrotized kernel machine (RegGKM) method to fit the model. We use the kernel machine method to describe the complex relationship between survival and predictors, while automatically removing irrelevant parametric and non-parametric predictors through a LASSO penalty. An efficient high-dimensional algorithm is developed for the proposed method. Comparison with other competing methods in simulation shows that the proposed method always has better predictive accuracy. We apply this method to analyze a multiple myeloma dataset and predict patients' death burden based on their gene expressions. Our results can help classify patients into groups with different death risks, facilitating treatment for better clinical outcomes.
This paper is concerned with adaptive mesh refinement strategies for the spatial discretization of parabolic problems with dynamic boundary conditions. This includes the characterization of inf-sup stable discretization schemes for a stationary model problem as a preliminary step. Based on an alternative formulation of the system as a partial differential-algebraic equation, we introduce a posteriori error estimators which allow local refinements as well as a special treatment of the boundary. We prove reliability and efficiency of the estimators and illustrate their performance in several numerical experiments.
Artificial neural networks are prone to being fooled by carefully perturbed inputs which cause an egregious misclassification. These \textit{adversarial} attacks have been the focus of extensive research. Likewise, there has been an abundance of research in ways to detect and defend against them. We introduce a novel approach of detection and interpretation of adversarial attacks from a graph perspective. For an input image, we compute an associated sparse graph using the layer-wise relevance propagation algorithm \cite{bach15}. Specifically, we only keep edges of the neural network with the highest relevance values. Three quantities are then computed from the graph which are then compared against those computed from the training set. The result of the comparison is a classification of the image as benign or adversarial. To make the comparison, two classification methods are introduced: 1) an explicit formula based on Wasserstein distance applied to the degree of node and 2) a logistic regression. Both classification methods produce strong results which lead us to believe that a graph-based interpretation of adversarial attacks is valuable.
An assurance calculation is a Bayesian alternative to a power calculation. One may be performed to aid the planning of a clinical trial, specifically setting the sample size or to support decisions about whether or not to perform a study. Immuno-oncology (IO) is a rapidly evolving area in the development of anticancer drugs. A common phenomenon that arises from IO trials is one of delayed treatment effects, that is, there is a delay in the separation of the survival curves. To calculate assurance for a trial in which a delayed treatment effect is likely to be present, uncertainty about key parameters needs to be considered. If uncertainty is not considered, then the number of patients recruited may not be enough to ensure we have adequate statistical power to detect a clinically relevant treatment effect. We present a new elicitation technique for when a delayed treatment effect is likely to be present and show how to compute assurance using these elicited prior distributions. We provide an example to illustrate how this could be used in practice. Open-source software is provided for implementing our methods. Our methodology makes the benefits of assurance methods available for the planning of IO trials (and others where a delayed treatment expect is likely to occur).
In the field of semi-supervised medical image segmentation, the shortage of labeled data is the fundamental problem. How to effectively learn image features from unlabeled images to improve segmentation accuracy is the main research direction in this field. Traditional self-training methods can partially solve the problem of insufficient labeled data by generating pseudo labels for iterative training. However, noise generated due to the model's uncertainty during training directly affects the segmentation results. Therefore, we added sample-level and pixel-level uncertainty to stabilize the training process based on the self-training framework. Specifically, we saved several moments of the model during pre-training, and used the difference between their predictions on unlabeled samples as the sample-level uncertainty estimate for that sample. Then, we gradually add unlabeled samples from easy to hard during training. At the same time, we added a decoder with different upsampling methods to the segmentation network and used the difference between the outputs of the two decoders as pixel-level uncertainty. In short, we selectively retrained unlabeled samples and assigned pixel-level uncertainty to pseudo labels to optimize the self-training process. We compared the segmentation results of our model with five semi-supervised approaches on the public 2017 ACDC dataset and 2018 Prostate dataset. Our proposed method achieves better segmentation performance on both datasets under the same settings, demonstrating its effectiveness, robustness, and potential transferability to other medical image segmentation tasks. Keywords: Medical image segmentation, semi-supervised learning, self-training, uncertainty estimation
Ultra-high dimensional confounder selection algorithms comparison with application to radiomics data
Radiomics is an emerging area of medical imaging data analysis particularly for cancer. It involves the conversion of digital medical images into mineable ultra-high dimensional data. Machine learning algorithms are widely used in radiomics data analysis to develop powerful decision support model to improve precision in diagnosis, assessment of prognosis and prediction of therapy response. However, machine learning algorithms for causal inference have not been previously employed in radiomics analysis. In this paper, we evaluate the value of machine learning algorithms for causal inference in radiomics. We select three recent competitive variable selection algorithms for causal inference: outcome-adaptive lasso (OAL), generalized outcome-adaptive lasso (GOAL) and causal ball screening (CBS). We used a sure independence screening procedure to propose an extension of GOAL and OAL for ultra-high dimensional data, SIS + GOAL and SIS + OAL. We compared SIS + GOAL, SIS + OAL and CBS using simulation study and two radiomics datasets in cancer, osteosarcoma and gliosarcoma. The two radiomics studies and the simulation study identified SIS + GOAL as the optimal variable selection algorithm.
Biclustering is widely used in different kinds of fields including gene information analysis, text mining, and recommendation system by effectively discovering the local correlation between samples and features. However, many biclustering algorithms will collapse when facing heavy-tailed data. In this paper, we propose a robust version of convex biclustering algorithm with Huber loss. Yet, the newly introduced robustification parameter brings an extra burden to selecting the optimal parameters. Therefore, we propose a tuning-free method for automatically selecting the optimal robustification parameter with high efficiency. The simulation study demonstrates the more fabulous performance of our proposed method than traditional biclustering methods when encountering heavy-tailed noise. A real-life biomedical application is also presented. The R package RcvxBiclustr is available at //github.com/YifanChen3/RcvxBiclustr.
The detection of Alzheimer's disease (AD) from spontaneous speech has attracted increasing attention while the sparsity of training data remains an important issue. This paper handles the issue by knowledge transfer, specifically from both speech-generic and depression-specific knowledge. The paper first studies sequential knowledge transfer from generic foundation models pretrained on large amounts of speech and text data. A block-wise analysis is performed for AD diagnosis based on the representations extracted from different intermediate blocks of different foundation models. Apart from the knowledge from speech-generic representations, this paper also proposes to simultaneously transfer the knowledge from a speech depression detection task based on the high comorbidity rates of depression and AD. A parallel knowledge transfer framework is studied that jointly learns the information shared between these two tasks. Experimental results show that the proposed method improves AD and depression detection, and produces a state-of-the-art F1 score of 0.928 for AD diagnosis on the commonly used ADReSSo dataset.
Breast cancer remains a global challenge, causing over 1 million deaths globally in 2018. To achieve earlier breast cancer detection, screening x-ray mammography is recommended by health organizations worldwide and has been estimated to decrease breast cancer mortality by 20-40%. Nevertheless, significant false positive and false negative rates, as well as high interpretation costs, leave opportunities for improving quality and access. To address these limitations, there has been much recent interest in applying deep learning to mammography; however, obtaining large amounts of annotated data poses a challenge for training deep learning models for this purpose, as does ensuring generalization beyond the populations represented in the training dataset. Here, we present an annotation-efficient deep learning approach that 1) achieves state-of-the-art performance in mammogram classification, 2) successfully extends to digital breast tomosynthesis (DBT; "3D mammography"), 3) detects cancers in clinically-negative prior mammograms of cancer patients, 4) generalizes well to a population with low screening rates, and 5) outperforms five-out-of-five full-time breast imaging specialists by improving absolute sensitivity by an average of 14%. Our results demonstrate promise towards software that can improve the accuracy of and access to screening mammography worldwide.
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