Martijn P. A. Starmans

Dr. Martijn P. A. Starmans

Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
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Research Focus & Metrics

Academic Career Length

9Years (2018-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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20 November 2019 in British Journal of Surgery
Verified
Journal Article
Open access
MVMelissa Vos
Melissa Vos
MSMartijn P. A. Starmans
Martijn P. A. Starmans
MTM J M Timbergen
M J M Timbergen
SVS R van der Voort
S R van der Voort
GPG A Padmos
G A Padmos
JVJ J Visser
J J Visser
Background: Well differentiated liposarcoma (WDLPS) can be difficult to distinguish from lipoma. Currently, this distinction is made by testing for MDM2 amplification, which requires a biopsy. The aim of this study was to develop a noninvasive method to predict MDM2 amplification status using radiomics features derived from MRI. Methods: Patients with an MDM2-negative lipoma or MDM2-positive WDLPS and a pretreatment T1-weighted MRI scan who were referred to Erasmus MC between 2009 and 2018 were included. When available, other MRI sequences were included in the radiomics analysis. Features describing intensity, shape and texture were extracted from the tumour region. Classification was performed using various machine learning approaches. Evaluation was performed through a 100 times random-split cross-validation. The performance of the models was compared with the performance of three expert radiologists. Results: The data set included 116 tumours (58 patients with lipoma, 58 with WDLPS) and originated from 41 different MRI scanners, resulting in wide heterogeneity in imaging hardware and acquisition protocols. The radiomics model based on T1 imaging features alone resulted in a mean area under the curve (AUC) of 0·83, sensitivity of 0·68 and specificity of 0·84. Adding the T2-weighted imaging features in an explorative analysis improved the model to a mean AUC of 0·89, sensitivity of 0·74 and specificity of 0·88. The three radiologists scored an AUC of 0·74 and 0·72 and 0·61 respectively; a sensitivity of 0·74, 0·91 and 0·64; and a specificity of 0·55, 0·36 and 0·59. Conclusion: Radiomics is a promising, non-invasive method for differentiating between WDLPS and lipoma, outperforming the scores of the radiologists. Further optimization and validation is needed before introduction into clinical practice.

22 February 2021 in Diagnostics
Verified
Journal Article
Open access
PDF file
JCJose Castillo
Jose Castillo
MSMartijn P. A. Starmans
Martijn P. A. Starmans
MAMuhammad Arif
Muhammad Arif
WNWiro J. Niessen
Wiro J. Niessen
SKStefan Klein
Stefan Klein
JVJifke Veenland
Jifke Veenland
Radiomics applied in MRI has shown promising results in classifying prostate cancer lesions. However, many papers describe single-center studies without external validation. The issues of using radiomics models on unseen data have not yet been sufficiently addressed. The aim of this study is to evaluate the generalizability of radiomics models for prostate cancer classification and to compare the performance of these models to the performance of radiologists. Multiparametric MRI, photographs and histology of radical prostatectomy specimens, and pathology reports of 107 patients were obtained from three healthcare centers in the Netherlands. By spatially correlating the MRI with histology, 204 lesions were identified. For each lesion, radiomics features were extracted from the MRI data. Radiomics models for discriminating high-grade (Gleason score ≥ 7) versus low-grade lesions were automatically generated using open-source machine learning software. The performance was tested both in a single-center setting through cross-validation and in a multi-center setting using the two unseen datasets as external validation. For comparison with clinical practice, a multi-center classifier was tested and compared with the Prostate Imaging Reporting and Data System version 2 (PIRADS v2) scoring performed by two expert radiologists. The three single-center models obtained a mean AUC of 0.75, which decreased to 0.54 when the model was applied to the external data, the radiologists obtained a mean AUC of 0.46. In the multi-center setting, the radiomics model obtained a mean AUC of 0.75 while the radiologists obtained a mean AUC of 0.47 on the same subset. While radiomics models have a decent performance when tested on data from the same center(s), they may show a significant drop in performance when applied to external data. On a multi-center dataset our radiomics model outperformed the radiologists, and thus, may represent a more accurate alternative for malignancy prediction.

21 December 2021 in Cancers
Verified
Journal Article
Open access
PDF file
JCJose Castillo
Jose Castillo
MAMuhammad Arif
Muhammad Arif
MSMartijn P. A. Starmans
Martijn P. A. Starmans
WNWiro J. Niessen
Wiro J. Niessen
CBChris H. Bangma
Chris H. Bangma
JVJifke Veenland
Jifke Veenland
The computer-aided analysis of prostate multiparametric MRI (mpMRI) could improve significant-prostate-cancer (PCa) detection. Various deep-learning- and radiomics-based methods for significant-PCa segmentation or classification have been reported in the literature. To be able to assess the generalizability of the performance of these methods, using various external data sets is crucial. While both deep-learning and radiomics approaches have been compared based on the same data set of one center, the comparison of the performances of both approaches on various data sets from different centers and different scanners is lacking. The goal of this study was to compare the performance of a deep-learning model with the performance of a radiomics model for the significant-PCa diagnosis of the cohorts of various patients. We included the data from two consecutive patient cohorts from our own center (n = 371 patients), and two external sets of which one was a publicly available patient cohort (n = 195 patients) and the other contained data from patients from two hospitals (n = 79 patients). Using multiparametric MRI (mpMRI), the radiologist tumor delineations and pathology reports were collected for all patients. During training, one of our patient cohorts (n = 271 patients) was used for both the deep-learning- and radiomics-model development, and the three remaining cohorts (n = 374 patients) were kept as unseen test sets. The performances of the models were assessed in terms of their area under the receiver-operating-characteristic curve (AUC). Whereas the internal cross-validation showed a higher AUC for the deep-learning approach, the radiomics model obtained AUCs of 0.88, 0.91 and 0.65 on the independent test sets compared to AUCs of 0.70, 0.73 and 0.44 for the deep-learning model. Our radiomics model that was based on delineated regions resulted in a more accurate tool for significant-PCa classification in the three unseen test sets when compared to a fully automated deep-learning model.

10 January 2019 in Medical Physics
Verified
Journal Article
Open access
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PKPetros Kalendralis
Petros Kalendralis
ATAlberto Traverso
Alberto Traverso
ZSZhenwei Shi
Zhenwei Shi
IZIvan Zhovannik
Ivan Zhovannik
RMRené Monshouwer
René Monshouwer
LWLeonard Wee
Leonard Wee
Purpose: The aim of this paper is to describe a public, open‐access, computed tomography (CT) phantom image set acquired at three centers and collected especially for radiomics reproducibility research. The dataset is useful to test radiomic features reproducibility with respect to various parameters, such as acquisition settings, scanners, and reconstruction algorithms.Acquisition and validation methods: Three phantoms were scanned in three independent institutions. Images of the following phantoms were acquired: Catphan 700 and COPDGene Phantom II (Phantom Laboratory, Greenwich, NY, USA), and the Triple modality 3D Abdominal Phantom (CIRS, Norfolk, VA, USA). Data were collected at three Dutch medical centers: MAASTRO Clinic (Maastricht, NL), Radboud University Medical Center (Nijmegen, NL), and University Medical Center Groningen (Groningen, NL) with scanners from two different manufacturers Siemens Healthcare and Philips Healthcare. The following acquisition parameter were varied in the phantom scans: slice thickness, reconstruction kernels, and tube current.Data format and usage notes: We made the dataset publically available on the Dutch instance of “Extensible Neuroimaging Archive Toolkit‐XNAT” (https://xnat.bmia.nl). The dataset is freely available and reusable with attribution (Creative Commons 3.0 license).Potential applications: Our goal was to provide a findable, open‐access, annotated, and reusable CT phantom dataset for radiomics reproducibility studies. Reproducibility testing and harmonization are fundamental requirements for wide generalizability of radiomics‐based clinical prediction models. It is highly desirable to include only reproducible features into models, to be more assured of external validity across hitherto unseen contexts. In this view, phantom data from different centers represent a valuable source of information to exclude CT radiomic features that may already be unstable with respect to simplified structures and tightly controlled scan settings. The intended extension of our shared dataset is to include other modalities and phantoms with more realistic lesion simulations.

1 January 2020
Verified
Book Chapter
Closed access
MSMartijn P. A. Starmans
Martijn P. A. Starmans
SVSebastian R. van der Voort
Sebastian R. van der Voort
JTJose M. Castillo Tovar
Jose M. Castillo Tovar
JVJifke F. Veenland
Jifke F. Veenland
SKStefan Klein
Stefan Klein
WNWiro J. Niessen
Wiro J. Niessen

17 September 2021 in Clinical & Experimental Metastasis
Verified
Journal Article
Open access
PDF file
MSMartijn P. A. Starmans
Martijn P. A. Starmans
FBFlorian E. Buisman
Florian E. Buisman
MRMichel Renckens
Michel Renckens
FWFrançois E. J. A. Willemssen
François E. J. A. Willemssen
SVSebastian R. van der Voort
Sebastian R. van der Voort
SKStefan Klein
Stefan Klein
Histopathological growth patterns (HGPs) are independent prognosticators for colorectal liver metastases (CRLM). Currently, HGPs are determined postoperatively. In this study, we evaluated radiomics for preoperative prediction of HGPs on computed tomography (CT), and its robustness to segmentation and acquisition variations. Patients with pure HGPs [i.e. 100% desmoplastic (dHGP) or 100% replacement (rHGP)] and a CT-scan who were surgically treated at the Erasmus MC between 2003–2015 were included retrospectively. Each lesion was segmented by three clinicians and a convolutional neural network (CNN). A prediction model was created using 564 radiomics features and a combination of machine learning approaches by training on the clinician’s and testing on the unseen CNN segmentations. The intra-class correlation coefficient (ICC) was used to select features robust to segmentation variations; ComBat was used to harmonize for acquisition variations. Evaluation was performed through a 100 × random-split cross-validation. The study included 93 CRLM in 76 patients (48% dHGP; 52% rHGP). Despite substantial differences between the segmentations of the three clinicians and the CNN, the radiomics model had a mean area under the curve of 0.69. ICC-based feature selection or ComBat yielded no improvement. Concluding, the combination of a CNN for segmentation and radiomics for classification has potential for automatically distinguishing dHGPs from rHGP, and is robust to segmentation and acquisition variations. Pending further optimization, including extension to mixed HGPs, our model may serve as a preoperative addition to postoperative HGP assessment, enabling further exploitation of HGPs as a biomarker.