The prediction of tumor in the TNM staging (tumor, node, and metastasis) stage of colon cancer using the most influential histopathology parameters and to predict the five years disease-free survival (DFS) period using machine learning (ML) in clinical research have been studied here. From the colorectal cancer (CRC) registry of Chang Gung Memorial Hospital, Linkou, Taiwan, 4021 patients were selected for the analysis. Various ML algorithms were applied for the tumor stage prediction of the colon cancer by considering the Tumor Aggression Score (TAS) as a prognostic factor. Performances of different ML algorithms were evaluated using five-fold cross-validation, which is an effective way of the model validation. The accuracy achieved by the algorithms taking both cases of standard TNM staging and TNM staging with the Tumor Aggression Score was determined. It was observed that the Random Forest model achieved an F-measure of 0.89, when the Tumor Aggression Score was considered as an attribute along with the standard attributes normally used for the TNM stage prediction. We also found that the Random Forest algorithm outperformed all other algorithms, with an accuracy of approximately 84% and an area under the curve (AUC) of 0.82 ± 0.10 for predicting the five years DFS.

Colorectal cancer is one of the leading causes of cancer-related death worldwide. The early diagnosis of colon cancer not only reduces mortality but also reduces the burden related to the treatment strategies such as chemotherapy and/or radiotherapy. However, when the microscopic examination of the suspected colon tissue sample is carried out, it becomes a tedious and time-consuming job for the pathologists to find the abnormality in the tissue. In addition, there may be interobserver variability that might lead to conflict in the final diagnosis. As a result, there is a crucial need of developing an intelligent automated method that can learn from the patterns themselves and assist the pathologist in making a faster, accurate, and consistent decision for determining the normal and abnormal region in the colorectal tissues. Moreover, the intelligent method should be able to localize the abnormal region in the whole slide image (WSI), which will make it easier for the pathologists to focus on only the region of interest making the task of tissue examination faster and lesser time-consuming. As a result, artificial intelligence (AI)-based classification and localization models are proposed for determining and localizing the abnormal regions in WSI. The proposed models achieved F-score of 0.97, area under curve (AUC) 0.97 with pretrained Inception-v3 model, and F-score of 0.99 and AUC 0.99 with customized Inception-ResNet-v2 Type 5 (IR-v2 Type 5) model.

Total Kidney Volume (TKV) is essential for analyzing the progressive loss of renal function in Autosomal Dominant Polycystic Kidney Disease (ADPKD). Conventionally, to measure TKV from medical images, a radiologist needs to localize and segment the kidneys by defining and delineating the kidney’s boundary slice by slice. However, kidney localization is a time-consuming and challenging task considering the unstructured medical images from big data such as Contrast-enhanced Computed Tomography (CCT). This study aimed to design an automatic localization model of ADPKD using Artificial Intelligence. A robust detection model using CCT images, image preprocessing, and Single Shot Detector (SSD) Inception V2 Deep Learning (DL) model is designed here. The model is trained and evaluated with 110 CCT images that comprise 10,078 slices. The experimental results showed that our derived detection model outperformed other DL detectors in terms of Average Precision (AP) and mean Average Precision (mAP). We achieved mAP = 94% for image-wise testing and mAP = 82% for subject-wise testing, when threshold on Intersection over Union (IoU) = 0.5. This study proves that our derived automatic detection model can assist radiologist in locating and classifying the ADPKD kidneys precisely and rapidly in order to improve the segmentation task and TKV calculation.

Abdominal computed tomography (CT) is a frequently used imaging modality for evaluating gastrointestinal diseases. The detection of colorectal cancer is often realized using CT before a more invasive colonoscopy. When a CT exam is performed for indications other than colorectal evaluation, the tortuous structure of the long, tubular colon makes it difficult to analyze the colon carefully and thoroughly. In addition, the sensitivity of CT in detecting colorectal cancer is greatly dependent on the size of the tumor. Missed incidental colon cancers using CT are an emerging problem for clinicians and radiologists; consequently, the automatic localization of lesions in the CT images of unprepared bowels is needed. Therefore, this study used artificial intelligence (AI) to localize colorectal cancer in CT images. We enrolled 190 colorectal cancer patients to obtain 1558 tumor slices annotated by radiologists and colorectal surgeons. The tumor sites were double-confirmed via colonoscopy or other related examinations, including physical examination or image study, and the final tumor sites were obtained from the operation records if available. The localization and training models used were RetinaNet, YOLOv3, and YOLOv8. We achieved an F1 score of 0.97 (±0.002), a mAP of 0.984 when performing slice-wise testing, 0.83 (±0.29) sensitivity, 0.97 (±0.01) specificity, and 0.96 (±0.01) accuracy when performing patient-wise testing using our derived model YOLOv8 with hyperparameter tuning.

Background: Total Kidney Volume (TKV) is widely used globally to predict the progressive loss of renal function in patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD). Typically, TKV is calculated using Computed Tomography (CT) images by manually locating, delineating, and segmenting the ADPKD kidneys. However, manual localization and segmentation are tedious, time-consuming tasks and are prone to human error. Specifically, there is a lack of studies that focus on CT modality variation. Methods: In contrast, our work develops a step-by-step framework, which robustly handles both Non-enhanced Computed Tomography (NCCT) and Contrast-enhanced Computed Tomography (CCT) images, ensuring balanced sample utilization and consistent performance across modalities. To achieve this, Artificial Intelligence (AI)-enabled localization and segmentation models are proposed for estimating TKV, which is designed to work robustly on both NCCT and Contrast-Computed Tomography (CCT) images. These AI-based models incorporate various image preprocessing techniques, including dilation and global thresholding, combined with Deep Learning (DL) approaches such as the adapted Single Shot Detector (SSD), Inception V2, and DeepLab V3+. Results: The experimental results demonstrate that the proposed AI-based models outperform other DL architectures, achieving a mean Average Precision (mAP) of $95\%$ for automatic localization, a mean Intersection over Union (mIoU) of $92\%$ for segmentation, and a mean $R^2$ score of $97\%$ for TKV estimation. Conclusions: These results clearly indicate that the proposed AI-based models can robustly localize and segment ADPKD kidneys and estimate TKV using both NCCT and CCT images.