Abstract: This paper presents a patient-sensitive simulation strategy capable of using the most efficient way the high-performance computational resources. The proposed strategy directly involves three different players: Computational Mechanics Scientists (CMS), Image Processing Scientists and Cardiologists, each one mastering its own expertise area within the project. This paper describes the general integrative scheme but focusing on the CMS side presents a massively parallel implementation of computational electrophysiology applied to cardiac tissue simulation. The paper covers different angles of the computational problem: equations, numerical issues, the algorithm and parallel implementation. The proposed methodology is illustrated with numerical simulations testing all the different possibilities, ranging from small domains up to very large ones. A key issue is the almost ideal scalability not only for large and complex problems but also for medium-size meshes. The explicit formulation is particularly well suited for solving this highly transient problems, with very short time-scale.

Abstract: Outlier detection is essential for optimal performance of machine learning methods and statistical predictive models. Their detection is especially determinant in small sample size unbalanced problems, since in such settings outliers become highly influential and significantly bias models. This particular experimental settings are usual in medical applications, like diagnosis of rare pathologies, outcome of experimental personalized treatments or pandemic emergencies. In contrast to population-based methods, neighborhood based local approaches compute an outlier score from the neighbors of each sample, are simple flexible methods that have the potential to perform well in small sample size unbalanced problems. A main concern of local approaches is the impact that the computation of each sample neighborhood has on the method performance. Most approaches use a distance in the feature space to define a single neighborhood that requires careful selection of several parameters, like the number of neighbors.
This work presents a local approach based on a local measure of the heterogeneity of sample labels in the feature space considered as a topological manifold. Topology is computed using the communities of a weighted graph codifying mutual nearest neighbors in the feature space. This way, we provide with a set of multiple neighborhoods able to describe the structure of complex spaces without parameter fine tuning. The extensive experiments on real-world and synthetic data sets show that our approach outperforms, both, local and global strategies in multi and single view settings.

Abstract: Plaque analysis in IVUS planes needs accurate intima and adventitia models. Large variety in adventitia descriptors difficulties its detection and motivates using a classification strategy for selecting points on the structure. Whatever the set of descriptors used, the selection stage suffers from fake responses due to noise and uncompleted true curves. In order to smooth background noise while strengthening responses, we apply a restricted anisotropic filter that homogenizes grey levels along the image significant structures. Candidate points are extracted by means of a simple semi supervised adaptive classification of the filtered image response to edge and calcium detectors. The final model is obtained by interpolating the former line segments with an anisotropic contour closing technique based on functional extension principles.

Abstract: Background Reliable predictive imaging markers of response to immune checkpoint inhibitors are needed. Purpose To develop and validate a pretreatment CT-based radiomics signature to predict response to immune checkpoint inhibitors in advanced solid tumors. Materials and Methods In this retrospective study, a radiomics signature was developed in patients with advanced solid tumors (including breast, cervix, gastrointestinal) treated with anti-programmed cell death-1 or programmed cell death ligand-1 monotherapy from August 2012 to May 2018 (cohort 1). This was tested in patients with bladder and lung cancer (cohorts 2 and 3). Radiomics variables were extracted from all metastases delineated at pretreatment CT and selected by using an elastic-net model. A regression model combined radiomics and clinical variables with response as the end point. Biologic validation of the radiomics score with RNA profiling of cytotoxic cells (cohort 4) was assessed with Mann-Whitney analysis. Results The radiomics signature was developed in 85 patients (cohort 1: mean age, 58 years ± 13 [standard deviation]; 43 men) and tested on 46 patients (cohort 2: mean age, 70 years ± 12; 37 men) and 47 patients (cohort 3: mean age, 64 years ± 11; 40 men). Biologic validation was performed in a further cohort of 20 patients (cohort 4: mean age, 60 years ± 13; 14 men). The radiomics signature was associated with clinical response to immune checkpoint inhibitors (area under the curve [AUC], 0.70; 95% CI: 0.64, 0.77; P < .001). In cohorts 2 and 3, the AUC was 0.67 (95% CI: 0.58, 0.76) and 0.67 (95% CI: 0.56, 0.77; P < .001), respectively. A radiomics-clinical signature (including baseline albumin level and lymphocyte count) improved on radiomics-only performance (AUC, 0.74 [95% CI: 0.63, 0.84; P < .001]; Akaike information criterion, 107.00 and 109.90, respectively). Conclusion A pretreatment CT-based radiomics signature is associated with response to immune checkpoint inhibitors, likely reflecting the tumor immunophenotype. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Summers in this issue.