Population pharmacokinetic analysis of mycophenolic acid in renal transplant recipients following oral administration of mycophenolate mofetil

Aim To develop a population pharmacokinetic model for mycophenolic acid in adult kidney transplant recipients, quantifying average population pharmacokinetic parameter values, and between- and within-subject variability and to evaluate the influence of covariates on the pharmacokinetic variability. Methods Pharmacokinetic data for mycophenolic acid and covariate information were previously available from 22 patients who underwent kidney transplantation at the Princess Alexandra Hospital. All patients received mycophenolate mofetil 1 g orally twice daily. A total of 557 concentration-time points were available. Data were analysed using the first-order method in NONMEM (version 5 level 1.1) using the G77 FORTRAN compiler. Results The best base model was a two-compartment model with a lag time (apparent oral clearance was 271 h(-1), and apparent volume of the central compartment 981). There was visual evidence of complex absorption and time-dependent clearance processes, but they could not be successfully modelled in this study. Weight was investigated as a covariate, but no significant relationship was determined. Conclusions The complexity in determining the pharmacokinetics of mycophenolic acid is currently underestimated. More complex pharmacokinetic models, though not supported by the limited data collected for this study, may prove useful in the future. The large between-subject and between-occasion variability and the possibility of nonlinear processes associated with the pharmacokinetics of mycophenolic acid raise questions about the value of the use of therapeutic monitoring and limited sampling strategies.

Genetic algorithm optimization of adaptive multi-scale GLCM features

We introduce a new second-order method of texture analysis called Adaptive Multi-Scale Grey Level Co-occurrence Matrix (AMSGLCM), based on the well-known Grey Level Co-occurrence Matrix (GLCM) method. The method deviates significantly from GLCM in that features are extracted, not via a fixed 2D weighting function of co-occurrence matrix elements, but by a variable summation of matrix elements in 3D localized neighborhoods. We subsequently present a new methodology for extracting optimized, highly discriminant features from these localized areas using adaptive Gaussian weighting functions. Genetic Algorithm (GA) optimization is used to produce a set of features whose classification worth is evaluated by discriminatory power and feature correlation considerations. We critically appraised the performance of our method and GLCM in pairwise classification of images from visually similar texture classes, captured from Markov Random Field (MRF) synthesized, natural, and biological origins. In these cross-validated classification trials, our method demonstrated significant benefits over GLCM, including increased feature discriminatory power, automatic feature adaptability, and significantly improved classification performance.