ABSTRACT
RATIONALE AND OBJECTIVES: The aim of this study was to explore the use of texture features generated from liver computed tomographic (CT) datasets as potential image-based indicators of patient response to radioembolization (RE) with yttrium-90 ((90)Y) resin microspheres, an emerging locoregional therapy for advanced-stage liver cancer. MATERIALS AND METHODS: Overall posttherapy survival and percent change in serologic tumor marker at 3 months posttherapy represent the primary clinical outcomes in this study. Thirty advanced-stage liver cancer cases (primary and metastatic) treated with RE over a 3-year period were included. Texture signatures for tumor regions, which were delineated to reveal boundaries with normal regions, were computed from pretreatment contrast-enhanced liver CT studies and evaluated for their ability to classify patient serologic response and survival. RESULTS: A series of systematic leave-one-out cross-validation studies using soft-margin support vector machine (SVM) classifiers showed hepatic tumor texton and local binary pattern (LBP) signatures both achieve high accuracy (96%) in discriminating subjects in terms of their serologic response. The image-based indicators were also accurate in classifying subjects by survival status (80% and 93% accuracy for texton and LBP signatures, respectively). CONCLUSIONS: Hepatic texture signatures generated from tumor regions on pretreatment triphasic CT studies were highly accurate in differentiating among subjects in terms of serologic response and survival. These image-based computational markers show promise as potential predictive tools in candidate evaluation for locoregional therapy such as RE.
Subject(s)
Algorithms , Image Interpretation, Computer-Assisted/methods , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/radiotherapy , Pattern Recognition, Automated/methods , Tomography, X-Ray Computed/methods , Yttrium Radioisotopes/therapeutic use , Aged , Aged, 80 and over , Artificial Intelligence , Female , Humans , Image Enhancement/methods , Male , Middle Aged , Radiopharmaceuticals/therapeutic use , Reproducibility of Results , Sensitivity and Specificity , Treatment OutcomeABSTRACT
OBJECTIVE: To ascertain the relationship between the initial and unprocessed sperm parameters and pregnancy rates in SOIUI, for Asian couples with male factor infertility. DESIGN: Retrospective study. SETTING: A large government tertiary-care women's hospital with 15,000 deliveries per year. POPULATION: One thousand four hundred and seventy nine couples undergoing 2846 cycles of SOIUI. METHODS: All couples enrolled in the SOIUI programme were analysed, comparing initial sperm parameters and the post-processed total motile sperm, against pregnancy rates per cycle. MAIN OUTCOME MEASURES: Pregnancy rates in relation to initial sperm parameters and post-processed total motile sperm. RESULTS: Ninety-three percent of the couples had male factor infertility. The average normal forms for these men was 14.7%. Overall pregnancy rate was 12.1% per completed SOIUI cycle. We found a significant drop in pregnancy rates if the percentage of motile sperms in the unprocessed sperm sample fell below 30%. We also found that insemination of at least 1 million motile sperm resulted in a significant increase in pregnancy rates. CONCLUSIONS: We recommend SOIUI as an effective treatment of suitable couples with male infertility, before embarking on IVF. However, if the initial percentage of motile sperm fell below 30%, or if after processing, the total motile sperm count was fewer than 1 million, these couples should consider in vitro fertilisation.
