Direct Evaluation of Treatment Response in Brain Metastatic Disease with Deep Neuroevolution.

Cancer centers have an urgent and unmet clinical and research need for AI that can guide patient management. A core component of advancing cancer treatment research is assessing response to therapy. Doing so by hand, for example, as per RECIST or RANO criteria, is tedious and time-consuming, and can...

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Publicado en:Journal of Digital Imaging Vol. 36; no. 2; pp. 536 - 547
Autores principales: Stember, Joseph N, Young, Robert J, Shalu, Hrithwik
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Apr2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2023
      vid: 36
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10278-022-00725-5
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        atl: Direct Evaluation of Treatment Response in Brain Metastatic Disease with Deep Neuroevolution.
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          Stember, Joseph N
          Young, Robert J
          Shalu, Hrithwik
        affil: Memorial Sloan Kettering Cancer Center, 1275 York Avenue, 10065, NY, NY, USA
      sug:
        subj:
          Brain Neoplasms Therapy
          Neoplasm Metastasis Therapy
          Treatment Outcomes Evaluation
          Image Processing, Computer Assisted
          Artificial Intelligence Utilization
          Human
          Deep Learning
          Disease Progression Diagnosis
          Disease Remission Diagnosis
          Neural Networks (Computer)
          Magnetic Resonance Imaging
          Oncogenes
          Mutation
          Validity
          Funding Source
      ab: Cancer centers have an urgent and unmet clinical and research need for AI that can guide patient management. A core component of advancing cancer treatment research is assessing response to therapy. Doing so by hand, for example, as per RECIST or RANO criteria, is tedious and time-consuming, and can miss important tumor response information. Most notably, the prevalent response criteria often exclude lesions, the non-target lesions, altogether. We wish to assess change in a holistic fashion that includes all lesions, obtaining simple, informative, and automated assessments of tumor progression or regression. Because genetic sub-types of cancer can be fairly specific and patient enrollment in therapy trials is often limited in number and accrual rate, we wish to make response assessments with small training sets. Deep neuroevolution (DNE) is a novel radiology artificial intelligence (AI) optimization approach that performs well on small training sets. Here, we use a DNE parameter search to optimize a convolutional neural network (CNN) that predicts progression versus regression of metastatic brain disease. We analyzed 50 pairs of MRI contrast-enhanced images as our training set. Half of these pairs, separated in time, qualified as disease progression, while the other 25 image pairs constituted regression. We trained the parameters of a CNN via "mutations" that consisted of random CNN weight adjustments and evaluated mutation "fitness" as summed training set accuracy. We then incorporated the best mutations into the next generation's CNN, repeating this process for approximately 50,000 generations. We applied the CNNs to our training set, as well as a separate testing set with the same class balance of 25 progression and 25 regression cases. DNE achieved monotonic convergence to 100% training set accuracy. DNE also converged monotonically to 100% testing set accuracy. We have thus shown that DNE can accurately classify brain metastatic disease progression versus regression. Future work will extend the input from 2D image slices to full 3D volumes, and include the category of "no change." We believe that an approach such as ours can ultimately provide a useful and informative complement to RANO/RECIST assessment and volumetric AI analysis.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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