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Neural Networks in Urologic Oncology
Published in Raouf N.G. Naguib, Gajanan V. Sherbet, Artificial Neural Networks in Cancer Diagnosis, Prognosis, and Patient Management, 2001
In 1998, Tewari et al. published an economically minded paper proposing the use of ANNs to increase the accuracy of clinical staging of CaP in patients with clinically organ confined disease [15]. This study used a probabilistic neural network with a genetic adaptive algorithm to find individual and overall smoothing factors and a dataset of 1200 patients. The inputs for this model were race, DRE finding, size of tumour on ultrasound, PSA, biopsy Gleason score, and biopsy staging information (number of positive biopsies, bilateral cancer, and perineural invasion). Outputs were margin status, seminal vesicle involvement, and lymph node metastasis. The accuracy and area under the receiver operating characteristics (ROC) curve were 76.7% and 0.7940, 73.2% and 0.804, 72.6% and 0.768 for margins, seminal vesicle and lymph nodes, respectively. Of note, the negative predictive values were 92%, 100%, and 98% for margins, seminal vesicle, and lymph nodes, respectively. As the authors point out, such high negative predictive values may make such a model an important screening tool avoiding further costly staging procedures.
Breast Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Thermography can visualize three basic signs of BrCA: (1) venous proliferation, (2) lymphatic inflammation, and (3) skin arteriolar vasodilation from local NO production (Figure 9.5). What follows is a description of the appearance of these three processes. (Note: perineural invasion by malignant cells may also affect breast thermographic appearance, but this has not been adequately studied.39) Although the areas of the breast involved and thermal signs generated will vary from case to case, the underlying pathological mechanisms remain the same. By combining these three signs with anatomical considerations, the presence and rough location of the underlying disease may be determined.
Colonic stents for malignant bowel obstruction: current status and future prospects
Published in Expert Review of Medical Devices, 2019
Vittorio Maria Ormando, Rossella Palma, Alessandro Fugazza, Alessandro Repici
Even though the short-term results of SEMS placement as BTS have been well established stent indication in curative setting has been suggested with caution due to uncertainty about its impact on long-term oncological outcomes [66–68]. This uncertainty mostly originates from concerns about tumor mass manipulation during stent placement, guidewire damage/perforations, stent deployment radial force and risk of occult/silent perforations at the proximal and distal ends of the stent, which may translate in tumor cell dissemination locally, but also in the blood stream. In 2007, Maruthachalam et al. [69] have showed an increase of cytokeratin 20mRNA expression (a marker for circulating tumor cells) in peripheral blood of patients undergoing SEMS placement. Subsequently, two more studies reported a higher rate of perineural and node malignant invasion after SEMS placement as compared with emergency surgery [70]. The long-term impact and clinical relevance of these pathological findings are, however, still not completely clear. A recent multicenter study in patients with stage III colon cancer have found no significant association between the presence of circulating tumor cells and reduced long-term survival, although these findings might not be extrapolated to SEMS for obstructing cancers [71]. Another recent study focusing on the risk of perineural invasion in relation to colorectal stenting was not able to demonstrate any possible association with tumor recurrence [72].