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      Using 2-dimensional hand photographs to predict postoperative biochemical remission in acromegaly patients: a transfer learning approach

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          Abstract

          Background

          The primary treatment goals in acromegaly patients are complete surgical removal of underlying pituitary tumors and biochemical remission. One of the challenges in developing countries is the difficulty in monitoring postoperative biochemical levels in acromegaly patients, particularly those who live in remote areas or regions with limited medical resources.

          Methods

          In an attempt to overcome the abovementioned challenges, we conducted a retrospective study and established a mobile and low-cost method to predict biochemical remission in acromegaly patients after surgery, the efficacy of which was assessed retrospectively using the China Acromegaly Patient Association (CAPA) database. A total of 368 surgical patients from the CAPA database were successfully followed up to obtain their hand photographs. Demographics, baseline clinical characteristics, pituitary tumor features, and treatment details were collated. Postoperative outcome, defined as biochemical remission at the last follow-up timepoint, was assessed. Transfer learning with a new mobile tailored neurocomputing architecture, MobileNetv2, was used to explore the identical features that could be used as predictors of long-term biochemical remission after surgery.

          Results

          As expected, the MobileNetv2-based transfer learning algorithm was shown to predict biochemical remission with statistical accuracies of 0.96 and 0.76 in the training cohort (n=803) and validation cohort (n=200), respectively, and the loss function value was 0.82.

          Conclusions

          Our findings demonstrate the potential of the MobileNetv2-based transfer learning algorithm in predicting biochemical remission for postoperative patients who are at home or live far away from a pituitary or neuroendocrinological treatment center.

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          Most cited references43

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          A Threshold Selection Method from Gray-Level Histograms

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            Medical progress: Acromegaly.

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              A Consensus Statement on acromegaly therapeutic outcomes

              The 11th Acromegaly Consensus Conference in April 2017 was convened to update recommendations on therapeutic outcomes for patients with acromegaly. Consensus guidelines on the medical management of acromegaly were last published in 2014; since then, new pharmacological agents have been developed and new approaches to treatment sequencing have been considered. Thirty-seven experts in the management of patients with acromegaly reviewed the current literature and assessed changes in drug approvals, clinical practice standards and clinical opinion. They considered current treatment outcome goals with a focus on the impact of current and emerging somatostatin receptor ligands, growth hormone receptor antagonists and dopamine agonists on biochemical, clinical, tumour mass and surgical outcomes. The participants discussed factors that would determine pharmacological choices as well as the proposed place of each agent in the guidelines. We present consensus recommendations highlighting how acromegaly management could be optimized in clinical practice.
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                Author and article information

                Journal
                Quant Imaging Med Surg
                Quant Imaging Med Surg
                QIMS
                Quantitative Imaging in Medicine and Surgery
                AME Publishing Company
                2223-4292
                2223-4306
                06 April 2023
                01 June 2023
                : 13
                : 6
                : 3747-3759
                Affiliations
                [1 ]deptCenter for Pituitary Tumor Surgery, Department of Neurosurgery, The First Affiliated Hospital , Sun Yat-sen University , Guangzhou, China;
                [2 ]deptDepartment of Histology and Embryology, Zhongshan School of Medicine , Sun Yat-sen University , Guangzhou, China
                Author notes

                Contributions: (I) Conception and design: M Wang, H Wang, Y Zhu, W Chen; (II) Administrative support: S Yao, W Chen; (III) Provision of study materials or patients: M Wang, C Duan, J Chen, S Zhang; (IV) Collection and assembly of data: J Chen, Z Wang, B Hu, Z Mao; (V) Data analysis and interpretation: M Wang, C Duan, S Yao; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

                [#]

                These authors contributed equally to this work.

                Correspondence to: Haijun Wang. Center for Pituitary Tumor Surgery, Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China. Email: wanghaij@ 123456mail.sysu.edu.cn ; Yonghong Zhu. Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China. Email: zhuyongh@ 123456mail.sysu.edu.cn ; Wenli Chen. Center for Pituitary Tumor Surgery, Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China. Email: chenwenli@ 123456mail.sysu.edu.cn .
                [^]

                ORCID: 0000-0003-2458-6192.

                Article
                qims-13-06-3747
                10.21037/qims-22-1101
                10240016
                4b5fb289-670f-4d8e-a649-805b4dea582e
                2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.

                Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

                History
                : 11 October 2022
                : 27 March 2023
                Categories
                Original Article

                acromegaly,transfer learning,mobilenetv2,biochemical remission

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