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      Predicting Breast Cancer Events in Ductal Carcinoma In Situ (DCIS) Using Generative Adversarial Network Augmented Deep Learning Model

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          Abstract

          Standard clinicopathological parameters (age, growth pattern, tumor size, margin status, and grade) have been shown to have limited value in predicting recurrence in ductal carcinoma in situ (DCIS) patients. Early and accurate recurrence prediction would facilitate a more aggressive treatment policy for high-risk patients (mastectomy or adjuvant radiation therapy), and simultaneously reduce over-treatment of low-risk patients. Generative adversarial networks (GAN) are a class of DL models in which two adversarial neural networks, generator and discriminator, compete with each other to generate high quality images. In this work, we have developed a deep learning (DL) classification network that predicts breast cancer events (BCEs) in DCIS patients using hematoxylin and eosin (H & E) images. The DL classification model was trained on 67 patients using image patches from the actual DCIS cores and GAN generated image patches to predict breast cancer events (BCEs). The hold-out validation dataset (n = 66) had an AUC of 0.82. Bayesian analysis further confirmed the independence of the model from classical clinicopathological parameters. DL models of H & E images may be used as a risk stratification strategy for DCIS patients to personalize therapy.

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          Inception-v4, Inception-ResNet and the Impact of Residual Connections on Learning

          Very deep convolutional networks have been central to the largest advances in image recognition performance in recent years. One example is the Inception architecture that has been shown to achieve very good performance at relatively low computational cost. Recently, the introduction of residual connections in conjunction with a more traditional architecture has yielded state-of-the-art performance in the 2015 ILSVRC challenge; its performance was similar to the latest generation Inception-v3 network. This raises the question: Are there any benefits to combining Inception architectures with residual connections? Here we give clear empirical evidence that training with residual connections accelerates the training of Inception networks significantly. There is also some evidence of residual Inception networks outperforming similarly expensive Inception networks without residual connections by a thin margin. We also present several new streamlined architectures for both residual and non-residual Inception networks. These variations improve the single-frame recognition performance on the ILSVRC 2012 classification task significantly. We further demonstrate how proper activation scaling stabilizes the training of very wide residual Inception networks. With an ensemble of three residual and one Inception-v4 networks, we achieve 3.08% top-5 error on the test set of the ImageNet classification (CLS) challenge.
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            Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer

            The recurrence score based on the 21-gene breast cancer assay predicts chemotherapy benefit if it is high and a low risk of recurrence in the absence of chemotherapy if it is low; however, there is uncertainty about the benefit of chemotherapy for most patients, who have a midrange score.
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              Artificial intelligence in digital pathology — new tools for diagnosis and precision oncology

              In the past decade, advances in precision oncology have resulted in an increased demand for predictive assays that enable the selection and stratification of patients for treatment. The enormous divergence of signalling and transcriptional networks mediating the crosstalk between cancer, stromal and immune cells complicates the development of functionally relevant biomarkers based on a single gene or protein. However, the result of these complex processes can be uniquely captured in the morphometric features of stained tissue specimens. The possibility of digitizing whole-slide images of tissue has led to the advent of artificial intelligence (AI) and machine learning tools in digital pathology, which enable mining of subvisual morphometric phenotypes and might, ultimately, improve patient management. In this Perspective, we critically evaluate various Al-based computational approaches for digital pathology, focusing on deep neural networks and ‘hand-crafted’ feature-based methodologies. We aim to provide a broad framework for incorporating AI and machine learning tools into clinical oncology, with an emphasis on biomarker development. We discuss some of the challenges relating to the use of AI, including the need for well-curated validation datasets, regulatory approval and fair reimbursement strategies. Finally, we present potential future opportunities for precision oncology.
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                Author and article information

                Contributors
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                Journal
                CANCCT
                Cancers
                Cancers
                MDPI AG
                2072-6694
                April 2023
                March 23 2023
                : 15
                : 7
                : 1922
                Article
                10.3390/cancers15071922
                a5d04c4b-0233-44b1-ac20-baec5929eeb3
                © 2023

                https://creativecommons.org/licenses/by/4.0/

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