PURPOSE: Several studies reported the possibility of predicting genetic abnormalities in non–small-cell lung cancer by deep learning (DL). However, there are no data of predicting ALK gene rearrangement ( ALKr) using DL. We evaluated the ALKr predictability using the DL platform. MATERIALS AND METHODS: We selected 66 ALKr-positive cases and 142 ALKr-negative cases, which were diagnosed by ALKr immunohistochemical staining in our institution from January 2009 to March 2019. We generated virtual slide of 300 slides (150 ALKr-positive slides and 150 ALKr-negative slides) using NanoZoomer. HALO-AI was used to analyze the whole-slide imaging data, and the DenseNet network was used to build the learning model. Of the 300 slides, we randomly assigned 172 slides to the training cohort and 128 slides to the test cohort to ensure no duplication of cases. In four resolutions (16.0/4.0/1.0/0.25 μm/pix), ALKr prediction models were built in the training cohort and ALKr prediction performance was evaluated in the test cohort. We evaluated the diagnostic probability of ALKr by receiver operating characteristic analysis in each ALKr probability threshold (50%, 60%, 70%, 80%, 90%, and 95%). We expected the area under the curve to be 0.64-0.85 in the model of a previous study. Furthermore, in the test cohort data, an expert pathologist also evaluated the presence of ALKr by hematoxylin and eosin staining on whole-slide imaging. RESULTS: The maximum area under the curve was 0.73 (50% threshold: 95% CI, 0.65 to 0.82) in the resolution of 1.0 μm/pix. In this resolution, with an ALKr probability of 50% threshold, the sensitivity and specificity were 73% and 73%, respectively. The expert pathologist's sensitivity and specificity in the same test cohort were 13% and 94%. CONCLUSION: The ALKr prediction by DL was feasible. Further study should be addressed to improve accuracy of ALKr prediction.

A global navigation satellite system (GNSS) buoy system for early tsunami warnings has been developed for more than 20 years. The first GNSS buoy system using a real-time kinematic algorithm (RTK) was implemented in the Nationwide Ocean Wave information network for Ports and HArbourS (NOWPHAS) wave monitoring system in Japan in 2008. The records of NOWPHAS were used to update the tsunami alert by the Japan Meteorological Agency (JMA), owing to the tsunami generated by the 2011 Tohoku-oki earthquake (Mw9.0). However, considering that the distance limit is less than 20 km for the RTK algorithm, a new system was designed by introducing a new positioning algorithm and satellite data transmission to place the buoy much farther from the coast. A new technique for the continuous monitoring of ocean-bottom crustal movements was also implemented in the new system. The new buoy system can be used for weather forecasting and ionospheric monitoring as well.

Although pulmonary emphysema is a component of chronic obstructive pulmonary disease, the prognostic significance of the quantitative severity of emphysema in patients with primary lung cancer is unclear. This study aimed to identify the association between the quantitative severity of emphysema detected by the low-attenuation area on computed tomography and the prognostic outcome of early non-small-cell lung cancer. A consecutive series of 1062 patients who underwent lobectomy for clinical stage I and II non-small-cell lung cancer were enrolled in this study. The clinicopathological features and long-term outcomes of patients with primary lung cancer in emphysema were investigated. The extent of emphysema in the lobe where the tumour was present was measured by preoperative computed tomography as a percentage of the low-attenuation area (LAA%). LAA% ≥ 1.0% was detected in 145 (13.7%) patients. LAA% was associated with pleural invasion (P < 0.0001), vascular invasion (P < 0.0001) and a larger tumour size (P = 0.001). The overall survival and recurrence-free survival in patients with LAA% ≥ 1.0% and with LAA% < 1.0% at 5 years were 78.6% and 92.1% (P < 0.0001) and 68.7% and 85.2% (P < 0.0001), respectively. According to the Cox proportional hazards model, LAA% was an independent prognostic factor for overall survival and recurrence-free survival (P = 0.0004 and P = 0.003, respectively). The quantitative severity of pulmonary emphysema was found to be associated with poor prognosis and clinicopathological aggression in early non-small-cell lung cancer.

To estimate the probability of pregnancy in infertile women with endometriosis, two series of multivariate analyses were performed in Tohoku University Hospital. In the first series, from 1993 to 1997, 103 patients participated. The Cox proportional hazard regression model revealed a hazard ratio of 2.43 in patients with high ovarian adhesion scores. Bilateral ovarian adhesion was an important variable in anatomical factors, probably second only to bilateral tubal adhesion. In the next series, from 1998 to 1999, 23 patients were included, and the preoperative serum concentrations of cytokines, interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α were analyzed. Only TNF-α was selected with a forward stepwise analysis after forcing age and infertile duration. In the logistic regression model, the serum TNF-α level had a significant and negative impact on the likelihood of pregnancy.

Background: A methodology to assess the immune microenvironment (IME) of non‐small cell lung cancer (NSCLC) has not been established, and the prognostic impact of IME factors is not yet clear. Aims: This study aimed to assess the IME factors and evaluate their prognostic values. Methods and Results: We assessed CD8 ⁺ tumor‐infiltrating lymphocyte (TIL) density, forkhead box protein P3 ⁺ (Foxp3 ⁺ ) TIL density, and programmed death receptor ligand‐1 (PD‐L1) tumor proportion score (TPS) using a machine‐learning algorithm in whole‐slide imaging (WSI). We dichotomized patients according to TIL density or TPS and compared their clinical outcomes. Between September 2014 and September 2015, 165 patients with NSCLC were enrolled in the study. We assessed IME factors in the epithelium, stroma, and their combination. An improvement in disease‐free survival (DFS) was observed in the high CD8 ⁺ TIL density group in the epithelium, stroma, and the combination of both. Moreover, the group with high PD‐L1 TPS in the epithelium showed better DFS than that with low PD‐L1 TPS. In the multivariate analysis, the CD8 ⁺ TIL density in the combination of epithelium and stroma and PD‐L1 TPS in the epithelium were independent prognostic factors (hazard ratio [HR] = 0.43; 95% confidence interval [CI] = 0.26–0.72; p = .001, HR = 0.49; 95% CI = 0.30–0.81; p = .005, respectively). Conclusion: Our approach demonstrated that the IME factors are related to survival in patients with NSCLC. The quantitative assessment of IME factors enables to discriminate patients with high risk of recurrence, who can be the candidates for adjuvant therapy. Assessing the CD8 ⁺ TIL density in the combination of epithelium and stroma might be more useful than their individual assessment because it is a simple and time‐saving analysis of TILs in WSI.