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The development of mathematical observers for optimization in breast imaging
Authors: ---
ISBN: 9789461653086 Year: 2020 Publisher: Leuven Leuven University Press

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Breast cancer screening in women aims to reduce cancer mortality rate by means of early detection and treatment. The screening is typically performed using a two-dimensional (2D) full-field digital mammography (FFDM) system, where the breast structure is captured in a single 2D projection. However the representation of three-dimensional (3D) breast tissue in 2D images causes a major drawback of this technique: normal tissue could mask a malignancy or overlapping normal tissue could appear suspicious. To reduce this drawback the digital breast tomosynthesis (DBT) technique was introduced. In DBT, series of projections are acquired over a narrow angular range around the breast. These projections are then reconstructed into a pseudo-3D volume, which allows for cross-sectional visualization of the breast and partly solves the tissue overlapping found in 2D FFDM.The major radiological breast cancer signs are low contrast large objects (masses) and tiny high-contrast objects (microcalcifications) in a background of sometimes very complicated breast tissue patterns in the 2D mammogram or the DBT reconstructed volume. Breast cancer detection is a challenging task for both the imaging system and the radiologist. For DBT and FFDM the diagnostic information is inversely correlated with the X-ray radiation exposure needed for the medical examination. Therefore high image quality is aimed for at a mean glandular dose to the women that is as low as reasonably achievable. In order to fulfill this requirement the mammography system performance is regularly evaluated in terms of image quality and dose. In order to balance between diagnostic information and X-ray exposure risk, research studies are conducted to optimize the X-ray systems. The standard means of image quality evaluation for these purposes typically involve a test object with critical targets and human observer reading studies. While these studies are the gold standard, they usually require a substantial amount of time, especially if there are many parameters involved, and might turn out as a bottleneck for certain optimization studies. This thesis focuses on the development of an automated method for image quality evaluation using model observers to replace human observers for quality assurance and optimization in breast imaging.The statistical model observers and specifically the channelized Hotelling observer (CHO) are mathematical operations based on the statistical properties of the pixel values in the images. A possible application, after specific adjustments of the algorithms, is related to the estimation of X-ray system performance in terms of detectability of certain lesions in images. A recently developed 3D structured phantom in our research group showed that it can be successfully used to evaluate image quality on different DBT and FFDM systems under different scanning conditions using human observers. We hypothesized that the phantom evaluation can be achieved using a tuned CHO algorithm that predicts the human observer scores. This would allow for quicker and more reliable observer performance estimations.The first step was to study and evaluate the effect of all different components contributing to the CHO performance estimation for low contrast lesions representing non-spiculated masses. The successfully developed CHO model had high correlation with the human observers using a Siemens DBT system. The CHO was further applied to other DBT vendors, which showed poor correlation with human results. In order to achieve good generalization to a wider range of DBT systems, the channel mechanism was improved to select the same frequency range regardless of the reconstruction pixel size of the different DBT systems and the first comparative studies with the CHO on all commercially available systems was performed. The next step focused on the small high-contrast objects, namely calcification clusters. With these targets, largely differing from mass lesions, a more innovative CHO approach was required. The calcification clusters in the phantom consist of 5 calcification particles forming the target. A two-layer CHO algorithm was developed for the cluster detection in DBT and FFDM. First and for the Siemens DBT system, the particle locations were found by scanning areas around the expected locations, and this was followed by a classification step, where the separate particle test statistics were combined into a single cluster test statistics. Exactly the same algorithm was also tested for different DBT vendors and showed good correlation without a requirement for additional tuning. With a CHO validated to work in different scanning conditions and for multiple DBT vendors, the CHO was tested on different 3D structured DBT test images. The virtual clinical trial image dataset obtained from the OPTIMAM simulation framework consisted of 2D FFDM images and DBT images with simulated mass lesions. The already developed CHO algorithm was redesigned to work also on the 2D images and the CHO observer performance for the DBT systems was further improved by introducing a volumetric CHO. This update of the CHO, required to make the CHO work on these different backgrounds showed that the previously developed algorithm did not generalize well enough. We hypothesized then that the channelization algorithm (feature extraction algorithm) for mass-like lesions can be improved using deep learning. Thus two deep learning model observers were developed in parallel to the standard CHO. Both deep learning methods were trained on 4-AFC examples from humans. This resulted in better generalization across a wider range of DBT vendors and conditions.In summary, this thesis investigated the feasibility of a channelized Hotelling observer to estimate the human observer reading results of image quality evaluation tasks. Two distinct practical tools emerged from the work summarized in this PhD project: a deep learning CHO for mass-like lesion detection and a two-layer CHO for calcification cluster detection. It is our hope that these tools will be used routinely by medical physicists and researchers for image quality evaluation studies. The software is fully prepared for use by many users and a specific teaching course has been developed. We hope that it may help to give DBT the role it deserves in the breast cancer screening, and ultimately bring mortality down.


Book
Perspectives in Mammary Gland Development and Breast Cancer Research
Authors: --- --- ---
Year: 2020 Publisher: Frontiers Media SA

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This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact


Book
Perspectives in Mammary Gland Development and Breast Cancer Research
Authors: --- --- ---
Year: 2020 Publisher: Frontiers Media SA

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Abstract

This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact


Book
Latest Advances in Glycoengineering
Authors: ---
Year: 2020 Publisher: Frontiers Media SA

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This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact


Book
Latest Advances in Glycoengineering
Authors: ---
Year: 2020 Publisher: Frontiers Media SA

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Abstract

This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact


Book
Perspectives in Mammary Gland Development and Breast Cancer Research
Authors: --- --- ---
Year: 2020 Publisher: Frontiers Media SA

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Abstract

This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact


Book
Latest Advances in Glycoengineering
Authors: ---
Year: 2020 Publisher: Frontiers Media SA

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Abstract

This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact


Book
Treatment Strategies and Survival Outcomes in Breast Cancer
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ISBN: 3039287591 3039287583 Year: 2020 Publisher: MDPI - Multidisciplinary Digital Publishing Institute

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Treatment strategies for breast cancer are wide-ranging and often based on a multi-modality approach, depending on the stage and biology of the tumour and the acceptance and tolerance of the patient. They may include surgery, radiotherapy, and systemic therapy (endocrine therapy, chemotherapy, and targeted therapy). Advances in technologies such as oncoplastic surgery, radiation planning and delivery, and genomics, and the development of novel systemic therapy agents alongside their evaluation in ongoing clinical trials continue to strive for improvements in outcomes. In this Special Issue, we publish a collection of studies looking at all forms of therapeutic strategies for early and advanced breast cancer, focusing on their outcomes, notably survival.

Keywords

relative survival --- young women --- cancer treatment --- n/a --- fulvestrant --- lapatinib --- tumor biology --- antihormone therapy --- mastectomy --- aromatase inhibitors --- chemotherapy --- serum biomarker --- cyclin E --- anthracycline resistance --- zero-inflated Poisson regression model --- lymph-node ratio --- CHEK2 --- comparative effectiveness --- breast-conserving therapy --- taxane sensitivity --- liquid biopsy --- HER2 c-erbB2 --- colorectal cancer --- infiltrating breast cancer --- survival --- exercise characteristics --- lactate dehydrogenase --- biomarker --- breast cancer survivors --- BRCA --- disease-free survival --- PIK3CA --- metastatic breast cancer --- cell-free DNA --- invasive breast cancer --- radiotherapy --- Metformin --- social well-being --- gene expression --- contralateral breast cancer --- basal-like breast cancer --- LMK-235 --- Src kinase --- HER2/neu --- LKB1 --- Older women --- LDH --- mutation carriers --- stage IV --- mammography screening --- NCDB --- cMet --- SEER --- pertuzumab --- physical function --- outcome --- ribociclib --- older patients --- geriatric oncology --- metastatic --- overdiagnosis --- next-generation sequencing --- abemaciclib --- Endocrine therapy --- monitoring metastatic breast cancer --- breast cancer --- circulating tumor cells --- Breast Cancer --- PALB2 --- histone deacetylase --- prognosis --- physical activity --- trastuzumab --- ductal carcinoma in situ --- contralateral prophylactic mastectomy --- ERCC1 --- family history --- T-DM1 --- ATM --- advanced breast cancer --- incidence --- palbociclib --- HDAC5 inhibitors --- APOBEC3B


Book
NCD Care Continuum and Opportunities for Action within Health Reform in Ukraine
Authors: --- --- --- ---
Year: 2020 Publisher: Washington, D.C. : The World Bank,

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Ukraine is amid a comprehensive health sector reform to transform the current unaffordable and inefficient system into a modern, more efficient, and affordable one. The country's health system is not addressing non-communicable diseases (NCD) and chronic conditions effectively, and NCD-related health outcomes compare relatively poorly to countries with a similar level of health financing. The paper analyzed the continuum of care for four conditions (hypertension, diabetes, breast, and cervical cancer) using the cascade framework as an analytical tool and programmatic data from two regions of Ukraine (Lviv and Poltava). It draws on global evidence of good and cost-efficient practices and includes the findings from guided discussions with Ukrainian health care planners, administrators, and providers. The analysis found significant gaps in detection, treatment monitoring, and treatment adherence in hypertension care (the largest breakpoints were blood pressure monitoring and achieving treatment targets) and similarly in diabetes care (underdiagnosis, inappropriate or incomplete treatment monitoring, sub-optimal treatment success). In breast cancer care, there was inadequate screening coverage among eligible women, post-screening losses, and a lack of documentation regarding treatment outcomes. In cervical cancer care, the screening intervals for covered women were short, creating inefficiencies, while many women were not screened despite program eligibility, and there was also a lack of long-term monitoring of women who had undergone treatment. The authors discuss the methodological approach of analyzing routine medical records and cancer registry data and triangulating data across multiple data sources. Important lessons and policy implications include the need to revise sequence of services, focus on follow up and retention in care, develop systems for managing risk factors, and strengthen the monitoring and data recording of NCD cases. Improved NCD care would save lives, reduce disability, save resources in health care, and reduce the impact of NCDs on individuals and society.


Book
New Aspects of Cancer Stem Cell Biology : Implications for Innovative Therapies
Authors: ---
Year: 2020 Publisher: Basel, Switzerland MDPI - Multidisciplinary Digital Publishing Institute

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The cancer stem cell (CSC) paradigm represents one of the most prominent breakthroughs of the last decades in tumor biology. CSCs are that subpopulation within a tumor that can survive conventional therapies and as a consequence are able to fuel tumor recurrence. Nevertheless, the biological characteristics of CSCs and even their existence, remain the main topic among tumor biologists debates. The difficulty in achieving a better definition of CSC biology may actually be explained by the plasticity of such a cell subpopulation. Indeed, the emerging view is that CSCs represent a dynamic “state” of tumor cells that can acquire stemness-related properties under specific circumstances, rather than referring to a well-defined group of cells. Regardless of their origin, it is clear that designing novel antitumor treatments based on the eradication of CSCs will only be possible upon unraveling the biological mechanisms that underlie their pathogenic role in tumor progression and therapy resistance. The Special Issue on “New aspects of cancer stem cell biology: implications for innovative therapies” aims at highlighting recent insights into CSC features that can make them an attractive target for novel therapeutic strategies.

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