International evaluation of an AI system for breast cancer screening

McKinney, S. M., et al. |2020| International evaluation of an AI system for breast cancer screening| Nature| 577|(7788)| P. 89-94.

An international team of researchers including experts from Imperial College London trained and tested an artificial intelligence (AI) system screening using a simulation of the double-reading process that is used in the UK.  29000 mammography images were used to demonstrate that the AI system was able to correctly identify cancers from the images with a similar degree of accuracy to expert radiologists, and holds the potential to assist clinical staff in practice. 

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The authors of the paper found that the computer algorithm (AI system) maintained non-inferior performance and reduced the workload of the second reader by 88%. This robust assessment of the AI system paves the way for clinical trials to improve the accuracy and efficiency of breast cancer screening (Source: Imperial College London). 

Full press release from Imperial College London Artificial intelligence could help to spot breast cancer

Screening mammography aims to identify breast cancer at earlier stages of the disease, when treatment can be more successful1. Despite the existence of screening programmes worldwide, the interpretation of mammograms is affected by high rates of false positives and false negatives2. Here we present an artificial intelligence (AI) system that is capable of surpassing human experts in breast cancer prediction. To assess its performance in the clinical setting, we curated a large representative dataset from the UK and a large enriched dataset from the USA. We show an absolute reduction of 5.7%and 1.2% (USA and UK) in false positives and 9.4% and 2.7% in false negatives. We provide evidence of the ability of the system to generalize from the UK to the USA. In an independent study of six radiologists, the AI system outperformed all of the human readers: the area under the receiver operating characteristic curve (AUC-ROC) for the AI system was greater than the AUC-ROC for the average radiologist by an absolute margin of 11.5%. We ran a simulation in which the AI system participated in the double-reading process that is used in the UK, and found that the AI system maintained non-inferior performance and reduced the workload of the second reader by 88%. This robust assessment of the AI system paves the way for clinical trials to improve the accuracy and efficiency of breast cancer screening.

Paper: International evaluation of an AI system for breast cancer screening

In the news:

BBC |  AI ‘outperforms’ doctors diagnosing breast cancer

BMJ |  AI system outperforms radiologists in first reading of breast cancer screening, study claims

 

[NICE Technology Appraisal Guidance] Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation

NICE | April 2019 | Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation Technology appraisal guidance [TA578]

Evidence-based recommendations on durvalumab (Imfinzi) for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation in adults.

More evidence on durvalumab is being collected, until September 2021. After this NICE will decide whether or not to recommend it for use on the NHS and update the guidance. It will be available through the Cancer Drugs Fund until then.

Full details from NICE 

Redesigning cancer screening technology

University of Leeds | April 2019 | Redesigning cancer screening technology

Engineers at the University of Leeds have developed a prototype that could reduce the cost of manufacturing an endoscope from £800000 to £40. The team’s prototype is redesigned to make the endoscope cheaper to make, it is more intuitive to operate. It also does not need sterilising between patients as in this model- a narrow silicone tube and a tiny capsule housing the camera – a part of the device can be disposed after each endoscopy. 

Their innovation also has the potential to revolutionise cancer screening in low-to-middle income countries where the cost of equipment makes screening prohibitively expensive.

Project leader Pietro Valdastri, Professor of Robotics and Autonomous Systems at Leeds, said the international consortium of engineers had had totally redesigned the endoscope which had remained largely unchanged for the last 60-plus years.

The next stage for the research team is to trial the effectiveness of the low-cost device against conventional endoscopes (Source: University of Leeds)

Read the press release in full from the University of Leeds

 

Advances in Cancer Treatment

Parliamentary Office of Science and Technology | April 2019 | Advances in Cancer Treatment

The latest POSTnote from the Parliamentary Office of Science and Technology gives an overview of recent advances in cancer treatment, the potential benefits and risks, and considers the opportunities and challenges to using new technologies in the NHS.

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Image source: researchbriefings.parliament.uk

Overview

  • New cancer treatment technologies have shown promising results in clinical trials, particularly for difficult-to-treat cancers.
  • Significant progress has been made in cancer immunotherapies for specific cancers and patient populations. Research into the use of these therapies for other cancers and patients is ongoing.
  • Advances in radiotherapy include improved imaging and precision, proton beam therapy and molecular radiotherapy, all of which have also shown positive clinical results.
  • Combination therapies, which combine different types of immunotherapy, or drug and radiotherapies, are a priority for current and future research.
  • New therapies require specialised knowledge and resources; stakeholders agree that they should be delivered as part of a comprehensive multidisciplinary care package.

POSTnote Advances in Cancer Treatment

Patients in Yorkshire will benefit from the only MRI-PET scanner in Yorkshire, thanks to University of Sheffield fundraising campaign

University of Sheffield | December 2018 | Patients in Yorkshire set to benefit from revolutionary medical imaging thanks to £2 million fundraising appeal

A campaign launched by the University of Sheffield in 2017 has raised £2million to make possible a revolutionary scanner in Yorkshire.  During the last 18 months, staff, current  students, alumni and members of the public and local business community, and friends of the University have supported the Sheffield Scanner campaign.

The high-tech scanner will provide unprecedented views of inside the human body by combining the power of both MRI and PET images in a single scan. It will help leading scientists and medics tackle some of the most devastating diseases facing millions of people including dementia, cancer, multiple sclerosis, Parkinson’s and motor neurone disease (MND).

The facility will also bring more clinical trials to the region, giving patients in Yorkshire access to ground-breaking new innovative treatments that are being developed. The scanner will be the only MRI-PET scanner in Yorkshire, the new Sheffield Scanner Facility will be attached to the Royal Hallamshire Hospital.

Dame Pam Shaw, Vice-President and Head of the Faculty of Medicine, Dentistry and Health at the University of Sheffield, and Director of the Sheffield NIHR Biomedical Research Centre for Translational Neuroscience, said:

“The combination of these two imaging techniques – MRI and PET – in one machine will let us detect extremely small abnormalities very accurately. We are hoping, and expecting, this will allow us to diagnose medical conditions much earlier. We will also be able to monitor how new innovative treatments are working much more nimbly than we have in the past.

Professor Koen Lamberts, President and Vice-Chancellor of the University of Sheffield, said: “The success of this fundraising campaign is a fantastic achievement and marks the beginning of an exciting journey for the University, the Sheffield city region and beyond. I am extremely proud that Sheffield will now be home to one of only eight MRI-PET scanners in the UK.” (Source: University of Sheffield)

Social media boost for breast screening

More women attend for breast screening thanks to success of digital inclusion project | NHS Digital

An NHS project using social media to improve health by boosting digital inclusion has led to a 13 per cent increase in first time attendances for breast screening in Stoke-on-Trent over four years.

The local initiative saw information about screening posted on Facebook community groups, which empowered and enabled women to make appointments by reducing their anxiety around breast examinations. It also allowed them to communicate quickly and easily with health practitioners to ask questions about the screening process.

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Through this project, the North Midlands Breast Screening Service promoted their Facebook page on local community groups which their target group – women aged over 50 – regularly visited.

The screening team posted information such as patients explaining about how the screening process works and how it has affected them, and videos showing the rooms where it takes place. Posts were designed to encourage women to share them and so spread the message about the benefits and importance of screening.

The service’s Facebook page also answered questions in the group and by direct messaging, enabling women to book appointments more easily.

Full detail: More women attend for breast screening thanks to success of digital inclusion project | NHS Digital

See also: Social media could help raise breast screening take-up | OnMedica

New device accurately identifies cancer in seconds

Handheld device can identify cancerous tissue in 10 seconds, with 96% accuracy. | story via ScienceDaily

A team of scientists at The University of Texas has invented a handheld device that quickly and accurately identifies cancerous tissue during surgery, delivering results in about 10 seconds. The MasSpec Pen is a handheld instrument that gives surgeons precise diagnostic information about what tissue to cut or preserve, helping improve treatment and reduce the chances of cancer recurrence.

In tests on tissues removed from 253 human cancer patients, the MasSpec Pen took about 10 seconds to provide a diagnosis and was more than 96 percent accurate. The technology was also able to detect cancer in marginal regions between normal and cancer tissues that presented mixed cellular composition. The team expects to start testing this new technology during oncologic surgeries in 2018.

Full story at ScienceDaily

See also: BBC News: ‘Pen’ identifies cancer in 10 seconds

Full reference: Zhang, J. et al. Nondestructive tissue analysis for ex vivo and in vivo cancer diagnosis using a handheld mass spectrometry system  Science Translational Medicine 06 Sep 2017: Vol. 9, Issue 406

 

New advances in cancer diagnosis

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New technology could revolutionize how some cancers are diagnosed, suggests a new article. A high-tech computer system is able to read samples of human tissue and aid pathologists in the identification of minute changes in cells that can indicate cancer is present.

More than 10,000 slides were examined in the first phase of the study which shows that pathologists are as good at accurately diagnosing cancer on a computer as they are with a microscope.

Full reference: Snead, D et al. Validation of digital pathology imaging for primary histopathological diagnosis. Histopathology.  published online: 6 DEC 2015

Health apps: a note of caution

There’s a running joke that if you check your symptoms on the Internet, it will probably diagnose you with cancer.

But there seems to be a growing trend that we are starting to rely more and more on digital technology to help us with our health. For example, WebMD last reported an average of 156 million unique users per month – a 33 per cent increase from the previous year.

Health apps (applications that offer health-related services on your mobile phone or tablet) are flooding the market. And the same goes for wearable technology, or ‘wearables’, like the Fitbit, JawBone and most recently the Apple Watch.

One recent study in JAMA Dermatology, which looked at various skin cancer apps, found that three out of the four apps they examined incorrectly classified at least 30 per cent of melanomasas ‘unconcerning’.

The only one that was accurate wasn’t a diagnostic app at all – it helped people with suspected skin cancer by sending a picture directly to a certified dermatologist.

Another study, this time published in the British Journal of Dermatology, examined 39 skin cancer-focused apps and found that none them had been validated for diagnostic accuracy or usefulness by any established research methods.

View the full story here http://scienceblog.cancerresearchuk.org/2015/04/24/health-apps-a-note-of-caution/