AI Helps Physicians Better Assess the Effectiveness of Bladder Cancer Treatment

In a small but multi-institutional study, an artificial intelligence (AI)-based system improved providers' assessments of whether patients with bladder cancer had complete response to chemotherapy before a radical cystectomy (bladder removal surgery).

Yet the researchers caution that AI isn't a replacement for human expertise and that their tool shouldn’t be used as such.

"If you use the tool smartly, it can help you," said Lubomir Hadjiyski, Ph.D., a professor of radiology at the University of Michigan Medical School and the senior author of the study.

When patients develop bladder cancer, surgeons often remove the entire bladder in an effort to keep the cancer from returning or spreading to other organs or areas. More evidence is building, though, that surgery may not be necessary if a patient has zero evidence of disease after chemotherapy.

However, it's difficult to determine whether the lesion left after treatment is simply tissue that’s become necrotic or scarred as a result of treatment or whether cancer remains. The researchers wondered if AI could help.

"The big question was when you have such an artificial device next to you, how is it going to affect the physician?" Hadjiyski said. "Is it going to help? Is it going to confuse them? Is it going to raise their performance or will they simply ignore it?"

Fourteen physicians from different specialties - including radiology, urology and oncology - as well as two fellows and a medical student looked at pre- and post-treatment scans of 157 bladder tumors. The providers gave ratings for three measures that assessed the level of response to chemotherapy as well as a recommendation for the next treatment to be done for each patient (radiation or surgery).

Then the providers looked at a score calculated by the computer. Lower scores indicated a lower likelihood of complete response to chemo and vice versa for higher scores. The providers could revise their ratings or leave them unchanged. Their final ratings were compared against samples of the tumors taken during their bladder removal surgeries to gauge accuracy.

Across different specialties and experience levels, providers saw improvements in their assessments with the AI system. Those with less experience had even more gains, so much so that they were able to make diagnoses at the same level as the experienced participants.

"That was the distinct part of that study that showed interesting observations about the audience," Hadjiyski said.

The tool helped providers from academic institutions more than those that worked at health centers focused solely on clinical care.

The study is part of an NIH-funded project, led by Hadjiyski and Ajjai Alva, M.D., an associate professor of internal medicine at U-M, to develop and evaluate biomarker-based tools for treatment response decision support of bladder cancer.

Over the course of more than two decades of conducting AI-based studies to assess different types of cancer and their treatment response, Hadjiyski says he’s observed that machine learning tools can be useful as a second opinion to assist physicians in decision making, but they can also make mistakes.

"One interesting thing that we figured out is that the computer makes mistakes on a different subset of cases than a radiologist would," he added. "Which means that if the tool is used correctly, it gives a chance to improve but not replace the physician's judgment."

Sun D, Hadjiiski L, Alva A, Zakharia Y, Joshi M, Chan HP, Garje R, Pomerantz L, Elhag D, Cohan RH, Caoili EM, Kerr WT, Cha KH, Kirova-Nedyalkova G, Davenport MS, Shankar PR, Francis IR, Shampain K, Meyer N, Barkmeier D, Woolen S, Palmbos PL, Weizer AZ, Samala RK, Zhou C, Matuszak M.
Computerized Decision Support for Bladder Cancer Treatment Response Assessment in CT Urography: Effect on Diagnostic Accuracy in Multi-Institution Multi-Specialty Study.
Tomography. 2022 Mar 2;8(2):644-656. doi: 10.3390/tomography8020054

Most Popular Now

Northern Lincolnshire and Goole NHS Foun…

Northern Lincolnshire and Goole NHS Foundation Trust (NLAG) has launched new NHS App features to transform the way patients access and manage their appointments within the NHS. The programme, known...

Genomics England Deploys Sectra Imaging …

Genomics England has completed installation of an enterprise imaging system that will help to support a world-pioneering initiative for cancer research. The programme is linking whole genome sequencing, pathology and...

Orion Health Strengthens French Business…

Orion Health is strengthening its presence in France with the appointment of digital health industry heavyweight, Tristan Debove, to lead its operations. Tristan Debove has more than 25 years of experience...

AI Approach may Help Detect Alzheimer's …

Although investigators have made strides in detecting signs of Alzheimer's disease using high-quality brain imaging tests collected as part of research studies, a team at Massachusetts General Hospital (MGH) recently...

AI Predicts Cancer Patient Survival by R…

A team of researchers from the University of British Columbia and BC Cancer have developed an artificial intelligence (AI) model that predicts cancer patient survival more accurately and with more...

Virtual Reality Games can be Used as a T…

Virtual reality gamers (VR game) who finished it faster than their fellow gamers also have higher levels of general intelligence and processing capacity. This was the result of a study...

Will Future Computers Run on Human Brain…

A "biocomputer" powered by human brain cells could be developed within our lifetime, according to Johns Hopkins University researchers who expect such technology to exponentially expand the capabilities of modern...

Detecting Anaemia Earlier in Children Us…

Researchers at UCL and University of Ghana have successfully predicted whether children have anaemia using only a set of smartphone images. The study, published in PLOS ONE, brought together researchers and...

AI can Help Optimize CT Scan X-Ray Radia…

Computed tomography (CT) is one of the most powerful and well-established diagnostic tools available to modern medicine. An increasing number of people have been opting for CT scans, raising concerns...

Study Reveals Smartphone Spyware Apps ar…

Smartphone spyware apps that allow people to spy on each other are not only hard to notice and detect, they also will easily leak the sensitive personal information they...

Orion Health Appoints Mark Hindle as Vic…

Orion Health has appointed Mark Hindle as its new vice president for the UK and Ireland. Mark has joined the leading supplier of digital tools to improve healthcare experience from...