Publications by authors named "Alberto Traverso"

Introduction: Local recurrence and distant metastasis remain a concern in advanced rectal cancer, with up to 10% and 20%-30% of patients suffering local and distal progression, respectively. Radiomics refers to a novel technology that extracts and analyses quantitative imaging features from images, which can be subsequently used to develop and test clinical models predictive of outcomes. We aim to develop and test an MRI-based radiomics nomogram predictive of disease recurrence in patients with T4 rectal cancer.

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Background: Artificial intelligence (AI) models are emerging as promising tools to identify predictive features among data coming from health records. Their application in clinical routine is still challenging, due to technical limits and to explainability issues in this specific setting. Response to standard first-line immunotherapy (ICI) in metastatic Non-Small-Cell Lung Cancer (NSCLC) is an interesting population for machine learning (ML), since up to 30% of patients do not benefit.

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Background: Atrial fibrillation (AF) is an important side effect of thoracic Radiotherapy (RT), which may impair quality of life and survival. This study aimed to develop a prediction model for new-onset AF in patients with Non-Small Cell Lung Cancer (NSCLC) receiving RT alone or as a part of their multi-modal treatment.

Patients And Methods: Patients with stage I-IV NSCLC treated with curative-intent conventional photon RT were included.

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Background:  Multicenter precision oncology real-world evidence requires a substantial long-term investment by hospitals to prepare their data and align on common Clinical Research processes and medical definitions. Our team has developed a self-assessment framework to support hospitals and hospital networks to measure their digital maturity and better plan and coordinate those investments. From that framework, we developed PRISM for Cancer Outcomes: PR: agmatic I: nstitutional S: urvey and benchM: arking.

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Background: The status of axillary lymph nodes (ALN) plays a critical role in the management of patients with breast cancer. It is an urgent demand to develop highly accurate, non-invasive methods for predicting ALN status.

Purpose: To evaluate the efficacy of ultrasound radiofrequency (URF) time-series parameters, in combination with clinical data, in predicting ALN metastasis in patients with breast cancer.

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Article Synopsis
  • - The study aimed to develop an AI model using Multi-Task Learning (MTL) to predict important clinical factors for cervical cancer, such as stage, histology, grade, and lymph node metastasis (LNM) before surgery.
  • - Researchers used a total of 281 cervical cancer cases across training and validation periods, employing an Artificial Neural Network (ANN) to achieve high prediction accuracy rates, notably 95% for histology and 86% for grade, while significantly reducing prediction time compared to traditional methods.
  • - Findings indicated that the AI model outperformed Single-Task Learning approaches in accuracy and efficiency, suggesting it could be a valuable tool for preoperative assessments in cervical cancer management.
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Objective: To develop a model combining clinical and radiomics features from CT scans for a preoperative noninvasive evaluation of Huvos grading of neoadjuvant chemotherapy in patients with HOS.

Methods: 183 patients from center A and 42 from center B were categorized into training and validation sets. Features derived from radiomics were obtained from unenhanced CT scans.

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Background: Deterioration of neurocognitive function in adult patients with a primary brain tumor is the most concerning side effect of radiotherapy. This study aimed to develop and evaluate normal-tissue complication probability (NTCP) models using clinical and dose-volume measures for 6-month, 1-year, and 2-year Neurocognitive Decline (ND) postradiotherapy.

Methods: A total of 219 patients with a primary brain tumor treated with radical photon and/or proton radiotherapy (RT) between 2019 and 2022 were included.

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Background: As artificial intelligence (AI) becomes increasingly prevalent in the medical field, the effectiveness of AI-generated medical reports in disease diagnosis remains to be evaluated. ChatGPT is a large language model developed by open AI with a notable capacity for text abstraction and comprehension. This study aimed to explore the capabilities, limitations, and potential of Generative Pre-trained Transformer (GPT)-4 in analyzing thyroid cancer ultrasound reports, providing diagnoses, and recommending treatment plans.

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Objectives: Radiation therapy for lung cancer requires a gross tumour volume (GTV) to be carefully outlined by a skilled radiation oncologist (RO) to accurately pinpoint high radiation dose to a malignant mass while simultaneously minimizing radiation damage to adjacent normal tissues. This is manually intensive and tedious however, it is feasible to train a deep learning (DL) neural network that could assist ROs to delineate the GTV. However, DL trained on large openly accessible data sets might not perform well when applied to a superficially similar task but in a different clinical setting.

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Objectives: Stereotactic body radiotherapy (SBRT) is a treatment option for patients with early-stage non-small cell lung cancer (NSCLC) who are unfit for surgery. Some patients may experience distant metastasis. This study aimed to develop and validate a radiomics model for predicting distant metastasis in patients with early-stage NSCLC treated with SBRT.

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Purpose: To propose a new quality scoring tool, METhodological RadiomICs Score (METRICS), to assess and improve research quality of radiomics studies.

Methods: We conducted an online modified Delphi study with a group of international experts. It was performed in three consecutive stages: Stage#1, item preparation; Stage#2, panel discussion among EuSoMII Auditing Group members to identify the items to be voted; and Stage#3, four rounds of the modified Delphi exercise by panelists to determine the items eligible for the METRICS and their weights.

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Radiomics objectively quantifies image information through numerical metrics known as features. In this study, we investigated the stability of magnetic resonance imaging (MRI)-based radiomics features in rectal cancer using both anatomical MRI and quantitative MRI (qMRI), when different methods to define the tumor volume were used. Second, we evaluated the prognostic value of stable features associated to 5-year progression-free survival (PFS) and overall survival (OS).

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Article Synopsis
  • - Ureteral injuries during gynecological laparoscopic surgery are common, but a new deep learning model aids real-time detection of the ureter, decreasing the risk of such injuries.
  • - The model was trained on over 3,000 frames from surgical videos, achieving an impressive Dice score of 0.86 and processing images rapidly for real-time application.
  • - Validation by 55 surgeons indicated that the model's accuracy is on par with human performance, making it a promising tool for reducing ureteral injuries in surgery.
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This review article visits the current state of artificial intelligence (AI) in radiotherapy clinical practice. We will discuss how AI has a place in the modern radiotherapy workflow at the level of automatic segmentation and planning, two applications which have seen real-work implementation. A special emphasis will be placed on the role AI can play in online adaptive radiotherapy, such as performed at MR-linacs, where online plan adaptation is a procedure which could benefit from automation to reduce on-couch time for patients.

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Cancer is a fatal disease and the second most cause of death worldwide. Treatment of cancer is a complex process and requires a multi-modality-based approach. Cancer detection and treatment starts with screening/diagnosis and continues till the patient is alive.

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Artificial intelligence has been introduced to clinical practice, especially radiology and radiation oncology, from image segmentation, diagnosis, treatment planning and prognosis. It is not only crucial to have an accurate artificial intelligence model, but also to understand the internal logic and gain the trust of the experts. This review is intended to provide some insights into core concepts of the interpretability, the state-of-the-art methods for understanding the machine learning models, the evaluation of these methods, identifying some challenges and limits of them, and gives some examples of medical applications.

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Purpose: To identify clinical risk factors, including gross tumor volume (GTV) and radiomics features, for developing brain metastases (BM) in patients with radically treated stage III non-small cell lung cancer (NSCLC).

Methods: Clinical data and planning CT scans for thoracic radiotherapy were retrieved from patients with radically treated stage III NSCLC. Radiomics features were extracted from the GTV, primary lung tumor (GTVp), and involved lymph nodes (GTVn), separately.

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Introduction: Immunotherapy-induced pneumonitis (IIP) is a serious side-effect which requires accurate diagnosis and management with high-dose corticosteroids. The differential diagnosis between IIP and other types of pneumonitis (OTP) remains challenging due to similar radiological patterns. This study was aimed to develop a prediction model to differentiate IIP from OTP in patients with stage IV non-small cell lung cancer (NSCLC) who developed pneumonitis during immunotherapy.

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Purpose: To develop a deep learning model that combines CT and radiation dose (RD) images to predict the occurrence of radiation pneumonitis (RP) in lung cancer patients who received radical (chemo)radiotherapy.

Methods: CT, RD images and clinical parameters were obtained from 314 retrospectively-collected patients (training set) and 35 prospectively-collected patients (test-set-1) who were diagnosed with lung cancer and received radical radiotherapy in the dose range of 50 Gy and 70 Gy. Another 194 (60 Gy group, test-set-2) and 158 (74 Gy group, test-set-3) patients from the clinical trial RTOG 0617 were used for external validation.

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Research exploring CycleGAN-based synthetic image generation has recently accelerated in the medical community due to its ability to leverage unpaired images effectively. However, a commonly established drawback of the CycleGAN, the introduction of artifacts in generated images, makes it unreliable for medical imaging use cases. In an attempt to address this, we explore the effect of structure losses on the CycleGAN and propose a generalized frequency-based loss that aims at preserving the content in the frequency domain.

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