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      Multiparametric ultrasomics of significant liver fibrosis: A machine learning-based analysis

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          Abstract

          Objective

          To assess significant liver fibrosis by multiparametric ultrasomics data using machine learning.

          Materials and Methods

          This prospective study consisted of 144 patients with chronic hepatitis B. Ultrasomics—high-throughput quantitative data from ultrasound imaging of liver fibrosis—were generated using conventional radiomics, original radiofrequency (ORF) and contrast-enhanced micro-flow (CEMF) features. Three categories of features were explored using pairwise correlation and hierarchical clustering. Features were selected using diagnostic tests for fibrosis, activity and steatosis stage, with the histopathological results as the reference. The fibrosis staging performance of ultrasomics models with combinations of the selected features was evaluated with machine-learning algorithms by calculating the area under the receiver-operator characteristic curve (AUC).

          Results

          ORF and CEMF features had better predictive power than conventional radiomics for liver fibrosis stage (both p < 0.01). CEMF features exhibited the highest diagnostic value for activity stage (both p < 0.05), and ORF had the best diagnostic value for steatosis stage (both p < 0.01). The machine-learning classifiers of adaptive boosting, random forest and support vector machine were found to be optimal algorithms with better (all mean AUCs = 0.85) and more stable performance (coefficient of variation = 0.01–0.02) for fibrosis staging than decision tree, logistic regression and neural network (mean AUC = 0.61–0.72, CV = 0.07–0.08). The multiparametric ultrasomics model achieved much better performance (mean AUC values of 0.78–0.85) than the features from a single modality in discriminating significant fibrosis (≥ F2).

          Conclusion

          Machine-learning-based analysis of multiparametric ultrasomics can help improve the discrimination of significant fibrosis compared with mono or dual modalities.

          Key Points

          • Multiparametric ultrasomics has achieved much better performance in the discrimination of significant fibrosis (≥ F2) than the single modality of conventional radiomics, original radiofrequency and contrast-enhanced micro-flow.

          • Adaptive boosting, random forest and support vector machine are the optimal algorithms for machine learning.

          Electronic supplementary material

          The online version of this article (10.1007/s00330-018-5680-z) contains supplementary material, which is available to authorized users.

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          Most cited references26

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          Development and Validation of a Radiomics Nomogram for Preoperative Prediction of Lymph Node Metastasis in Colorectal Cancer.

          To develop and validate a radiomics nomogram for preoperative prediction of lymph node (LN) metastasis in patients with colorectal cancer (CRC).
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            Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study.

            Real-time shear wave elastography (SWE) is a novel, noninvasive method to assess liver fibrosis by measuring liver stiffness. This single-center study was conducted to assess the accuracy of SWE in patients with chronic hepatitis C (CHC), in comparison with transient elastography (TE), by using liver biopsy (LB) as the reference standard. Consecutive patients with CHC scheduled for LB by referring physicians were studied. One hundred and twenty-one patients met inclusion criteria. On the same day, real-time SWE using the ultrasound (US) system, Aixplorer (SuperSonic Imagine S.A., Aix-en-Provence, France), TE using FibroScan (Echosens, Paris, France), and US-assisted LB were consecutively performed. Fibrosis was staged according to the METAVIR scoring system. Analyses of receiver operating characteristic (ROC) curve were performed to calculate optimal area under the ROC curve (AUROC) for F0-F1 versus F2-F4, F0- F2 versus F3-F4, and F0-F3 versus F4 for both real-time SWE and TE. Liver stiffness values increased in parallel with degree of liver fibrosis, both with SWE and TE. AUROCs were 0.92 (95% confidence interval [CI]: 0.85-0.96) for SWE and 0.84 (95% CI: 0.76-0.90) for TE (P = 0.002), 0.98 (95% CI: 0.94-1.00) for SWE and 0.96 (95% CI: 0.90-0.99) for TE (P = 0.14), and 0.98 (95% CI: 0.93-1.00) for SWE and 0.96 (95% CI: 0.91-0.99) for TE (P = 0.48), when comparing F0-F1 versus F2- F4, F0- F2 versus F3-F4, and F0 -F3 versus F4, respectively. The results of this study show that real-time SWE is more accurate than TE in assessing significant fibrosis (≥ F2). With respect to TE, SWE has the advantage of imaging liver stiffness in real time while guided by a B-mode image. Thus, the region of measurement can be guided with both anatomical and tissue stiffness information. Copyright © 2012 American Association for the Study of Liver Diseases.
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              Can Quantitative CT Texture Analysis be Used to Differentiate Fat-poor Renal Angiomyolipoma from Renal Cell Carcinoma on Unenhanced CT Images?

              To determine the accuracy of texture analysis to differentiate fat-poor angiomyolipoma (fp-AML) from renal cell carcinoma (RCC) on unenhanced computed tomography (CT) images.
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                Author and article information

                Contributors
                chenlda@mail.sysu.edu.cn
                wangw73@mail.sysu.edu.cn
                Journal
                Eur Radiol
                Eur Radiol
                European Radiology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0938-7994
                1432-1084
                3 September 2018
                3 September 2018
                2019
                : 29
                : 3
                : 1496-1506
                Affiliations
                [1 ]GRID grid.412615.5, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, , The First Affiliated Hospital of Sun Yat-Sen University, ; 58 Zhongshan Road 2, Guangzhou, 510080 People’s Republic of China
                [2 ]GRID grid.488525.6, Department of Medical Ultrasonics, , The Sixth Affiliated Hospital of Sun Yat-sen University (Guangdong Gastrointestinal Hospital), ; Guangzhou, China
                [3 ]Research Center of GE Healthcare, Shanghai, China
                [4 ]ISNI 0000 0001 2360 039X, GRID grid.12981.33, Zhongshan School of Medicine, , Sun Yat-sen University, ; Guangzhou, China
                [5 ]GRID grid.412615.5, Department of Hepatobiliary Surgery, , The First Affiliated Hospital of Sun Yat-Sen University, ; Guangzhou, China
                Author information
                http://orcid.org/0000-0002-9485-583X
                Article
                5680
                10.1007/s00330-018-5680-z
                6510867
                30178143
                6c8ee880-5129-4bfd-a75c-d4eaec3fdc18
                © The Author(s) 2018

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 24 March 2018
                : 5 July 2018
                : 24 July 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81471672
                Award ID: 81701701
                Award ID: 81701719
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100009330, Medical Science and Technology Foundation of Guangdong Province;
                Award ID: 2016A030310143
                Award ID: 2016A020215042
                Award ID: 2015A030310144
                Award Recipient :
                Categories
                Ultrasound
                Custom metadata
                © European Society of Radiology 2019

                Radiology & Imaging
                ultrasonography,liver fibrosis,machine learning,decision support techniques,data mining

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