Treatment allocation in hepatocellular carcinoma: Assessment of the BCLC algorithm

BACKGROUND AND AIMS The Barcelona Clinic Liver Cancer (BCLC) staging system is the algorithm most widely used to manage patients with hepatocellular carcinoma (HCC). We aimed to investigate the extent to which the BCLC recommendations effectively guide clinical practice and assess the reasons for any deviation from the recommendations. MATERIAL AND METHODS The first-line treatments assigned to patients included in the prospective Bern HCC cohort were analyzed. RESULTS Among 223 patients included in the cohort, 116 were not treated according to the BCLC algorithm. Eighty percent of the patients in BCLC stage 0 (very early HCC) and 60% of the patients in BCLC stage A (early HCC) received recommended curative treatment. Only 29% of the BCLC stage B patients (intermediate HCC) and 33% of the BCLC stage C patients (advanced HCC) were treated according to the algorithm. Eighty-nine percent of the BCLC stage D patients (terminal HCC) were treated with best supportive care, as recommended. In 98 patients (44%) the performance status was disregarded in the stage assignment. CONCLUSION The management of HCC in clinical practice frequently deviates from the BCLC recommendations. Most of the curative therapy options, which have well-defined selection criteria, were allocated according to the recommendations, while the majority of the palliative therapy options were assigned to patients with tumor stages not aligned with the recommendations. The only parameter which is subjective in the algorithm, the performance status, is also the least respected.

Metal Artifact Reduction in Pelvic Computed Tomography With Hip Prostheses: Comparison of Virtual Monoenergetic Extrapolations From Dual-Energy Computed Tomography and an Iterative Metal Artifact Reduction Algorithm in a Phantom Study.

OBJECTIVE The aim of this study was to directly compare metal artifact reduction (MAR) of virtual monoenergetic extrapolations (VMEs) from dual-energy computed tomography (CT) with iterative MAR (iMAR) from single energy in pelvic CT with hip prostheses. MATERIALS AND METHODS A human pelvis phantom with unilateral or bilateral metal inserts of different material (steel and titanium) was scanned with third-generation dual-source CT using single (120 kVp) and dual-energy (100/150 kVp) at similar radiation dose (CT dose index, 7.15 mGy). Three image series for each phantom configuration were reconstructed: uncorrected, VME, and iMAR. Two independent, blinded radiologists assessed image quality quantitatively (noise and attenuation) and subjectively (5-point Likert scale). Intraclass correlation coefficients (ICCs) and Cohen κ were calculated to evaluate interreader agreements. Repeated measures analysis of variance and Friedman test were used to compare quantitative and qualitative image quality. Post hoc testing was performed using a corrected (Bonferroni) P < 0.017. RESULTS Agreements between readers were high for noise (all, ICC ≥ 0.975) and attenuation (all, ICC ≥ 0.986); agreements for qualitative assessment were good to perfect (all, κ ≥ 0.678). Compared with uncorrected images, VME showed significant noise reduction in the phantom with titanium only (P < 0.017), and iMAR showed significantly lower noise in all regions and phantom configurations (all, P < 0.017). In all phantom configurations, deviations of attenuation were smallest in images reconstructed with iMAR. For VME, there was a tendency toward higher subjective image quality in phantoms with titanium compared with uncorrected images, however, without reaching statistical significance (P > 0.017). Subjective image quality was rated significantly higher for images reconstructed with iMAR than for uncorrected images in all phantom configurations (all, P < 0.017). CONCLUSIONS Iterative MAR showed better MAR capabilities than VME in settings with bilateral hip prosthesis or unilateral steel prosthesis. In settings with unilateral hip prosthesis made of titanium, VME and iMAR performed similarly well.

SOMS: SurrOgate MultiStart algorithm for use with nonlinear programming for global optimization

SOMS is a general surrogate-based multistart algorithm, which is used in combination with any local optimizer to find global optima for computationally expensive functions with multiple local minima. SOMS differs from previous multistart methods in that a surrogate approximation is used by the multistart algorithm to help reduce the number of function evaluations necessary to identify the most promising points from which to start each nonlinear programming local search. SOMS’s numerical results are compared with four well-known methods, namely, Multi-Level Single Linkage (MLSL), MATLAB’s MultiStart, MATLAB’s GlobalSearch, and GLOBAL. In addition, we propose a class of wavy test functions that mimic the wavy nature of objective functions arising in many black-box simulations. Extensive comparisons of algorithms on the wavy testfunctions and on earlier standard global-optimization test functions are done for a total of 19 different test problems. The numerical results indicate that SOMS performs favorably in comparison to alternative methods and does especially well on wavy functions when the number of function evaluations allowed is limited.

CHEOPS Performance for Exomoons: The Detectability of Exomoons by Using Optimal Decision Algorithm

Many attempts have already been made to detect exomoons around transiting exoplanets, but the first confirmed discovery is still pending. The experiences that have been gathered so far allow us to better optimize future space telescopes for this challenge already during the development phase. In this paper we focus on the forthcoming CHaraterising ExOPlanet Satellite (CHEOPS), describing an optimized decision algorithm with step-by-step evaluation, and calculating the number of required transits for an exomoon detection for various planet moon configurations that can be observable by CHEOPS. We explore the most efficient way for such an observation to minimize the cost in observing time. Our study is based on PTV observations (photocentric transit timing variation) in simulated CHEOPS data, but the recipe does not depend on the actual detection method, and it can be substituted with, e.g., the photodynamical method for later applications. Using the current state-of-the-art level simulation of CHEOPS data we analyzed transit observation sets for different star planet moon configurations and performed a bootstrap analysis to determine their detection statistics. We have found that the detection limit is around an Earth-sized moon. In the case of favorable spatial configurations, systems with at least a large moon and a Neptune-sized planet, an 80% detection chance requires at least 5-6 transit observations on average. There is also a nonzero chance in the case of smaller moons, but the detection statistics deteriorate rapidly, while the necessary transit measurements increase quickly. After the CoRoT and Kepler spacecrafts, CHEOPS will be the next dedicated space telescope that will observe exoplanetary transits and characterize systems with known Doppler-planets. Although it has a smaller aperture than Kepler (the ratio of the mirror diameters is about 1/3) and is mounted with a CCD that is similar to Kepler's, it will observe brighter stars and operate with larger sampling rate; therefore, the detection limit for an exomoon can be the same as or better, which will make CHEOPS a competitive instruments in the quest for exomoons.

Analysis of Synthetic Diamond Wafer Interferograms Using a Parallelized Simulated Annealing Algorithm

Diamonds are known for both their beauty and their durability. Jefferson National Lab in Newport News, VA has found a way to utilize the diamond's strength to view the beauty of the inside of the atomic nucleus with the hopes of finding exotic forms of matter. By firing very fast electrons at a diamond sheet no thicker than a human hair, high energy particles of light known as photons are produced with a high degree of polarization that can illuminate the constituents of the nucleus known as quarks. The University of Connecticut Nuclear Physics group has responsibility for crafting these extremely thin, high quality diamond wafers. These wafers must be cut from larger stones that are about the size of a human finger, and then carefully machined down to the final thickness. The thinning of these diamonds is extremely challenging, as the diamond's greatest strength also becomes its greatest weakness. The Connecticut Nuclear Physics group has developed a novel technique to assist industrial partners in assessing the quality of the final machining steps, using a technique based on laser interferometry. The images of the diamond surface produced by the interferometer encode the thickness and shape of the diamond surface in a complex way that requires detailed analysis to extract. We have developed a novel software application to analyze these images based on the method of simulated annealing. Being able to image the surface of these diamonds without requiring costly X-ray diffraction measurements allows rapid feedback to the industrial partners as they refine their thinning techniques. Thus, by utilizing a material found to be beautiful by many, the beauty of nature can be brought more clearly into view.

Genome-wide algorithm for detecting CNV associations with diseases

SNP genotyping arrays have been developed to characterize single-nucleotide polymorphisms (SNPs) and DNA copy number variations (CNVs). The quality of the inferences about copy number can be affected by many factors including batch effects, DNA sample preparation, signal processing, and analytical approach. Nonparametric and model-based statistical algorithms have been developed to detect CNVs from SNP genotyping data. However, these algorithms lack specificity to detect small CNVs due to the high false positive rate when calling CNVs based on the intensity values. Association tests based on detected CNVs therefore lack power even if the CNVs affecting disease risk are common. In this research, by combining an existing Hidden Markov Model (HMM) and the logistic regression model, a new genome-wide logistic regression algorithm was developed to detect CNV associations with diseases. We showed that the new algorithm is more sensitive and can be more powerful in detecting CNV associations with diseases than an existing popular algorithm, especially when the CNV association signal is weak and a limited number of SNPs are located in the CNV.^

EVALUATION OF THE EFFECTIVENESS OF ANISOTROPIC ANALYTICAL ALGORITHM IN FLATTENED AND FLATTENING-FILTER-FREE BEAMS FOR HIGH ENERGY LUNG DOSE DELIVERY USING THE RADIOLOGICAL PHYSICS CENTER LUNG PHANTOM

The effectiveness of the Anisotropic Analytical Algorithm (AAA) implemented in the Eclipse treatment planning system (TPS) was evaluated using theRadiologicalPhysicsCenteranthropomorphic lung phantom using both flattened and flattening-filter-free high energy beams. Radiation treatment plans were developed following the Radiation Therapy Oncology Group and theRadiologicalPhysicsCenterguidelines for lung treatment using Stereotactic Radiation Body Therapy. The tumor was covered such that at least 95% of Planning Target Volume (PTV) received 100% of the prescribed dose while ensuring that normal tissue constraints were followed as well. Calculated doses were exported from the Eclipse TPS and compared with the experimental data as measured using thermoluminescence detectors (TLD) and radiochromic films that were placed inside the phantom. The results demonstrate that the AAA superposition-convolution algorithm is able to calculate SBRT treatment plans with all clinically used photon beams in the range from 6 MV to 18 MV. The measured dose distribution showed a good agreement with the calculated distribution using clinically acceptable criteria of ±5% dose or 3mm distance to agreement. These results show that in a heterogeneous environment a 3D pencil beam superposition-convolution algorithms with Monte Carlo pre-calculated scatter kernels, such as AAA, are able to reliably calculate dose, accounting for increased lateral scattering due to the loss of electronic equilibrium in low density medium. The data for high energy plans (15 MV and 18 MV) showed very good tumor coverage in contrast to findings by other investigators for less sophisticated dose calculation algorithms, which demonstrated less than expected tumor doses and generally worse tumor coverage for high energy plans compared to 6MV plans. This demonstrates that the modern superposition-convolution AAA algorithm is a significant improvement over previous algorithms and is able to calculate doses accurately for SBRT treatment plans in the highly heterogeneous environment of the thorax for both lower (≤12 MV) and higher (greater than 12 MV) beam energies.

Pathway Semantics: An Algebraic Data Driven Algorithm to Generate Hypotheses about Molecular Patterns Underlying Disease Progression

The overarching goal of the Pathway Semantics Algorithm (PSA) is to improve the in silico identification of clinically useful hypotheses about molecular patterns in disease progression. By framing biomedical questions within a variety of matrix representations, PSA has the flexibility to analyze combined quantitative and qualitative data over a wide range of stratifications. The resulting hypothetical answers can then move to in vitro and in vivo verification, research assay optimization, clinical validation, and commercialization. Herein PSA is shown to generate novel hypotheses about the significant biological pathways in two disease domains: shock / trauma and hemophilia A, and validated experimentally in the latter. The PSA matrix algebra approach identified differential molecular patterns in biological networks over time and outcome that would not be easily found through direct assays, literature or database searches. In this dissertation, Chapter 1 provides a broad overview of the background and motivation for the study, followed by Chapter 2 with a literature review of relevant computational methods. Chapters 3 and 4 describe PSA for node and edge analysis respectively, and apply the method to disease progression in shock / trauma. Chapter 5 demonstrates the application of PSA to hemophilia A and the validation with experimental results. The work is summarized in Chapter 6, followed by extensive references and an Appendix with additional material.

Pencil -beam redefinition algorithm dose calculations for electron therapy treatment planning

The electron pencil-beam redefinition algorithm (PBRA) of Shiu and Hogstrom has been developed for use in radiotherapy treatment planning (RTP). Earlier studies of Boyd and Hogstrom showed that the PBRA lacked an adequate incident beam model, that PBRA might require improved electron physics, and that no data existed which allowed adequate assessment of the PBRA-calculated dose accuracy in a heterogeneous medium such as one presented by patient anatomy. The hypothesis of this research was that by addressing the above issues the PBRA-calculated dose would be accurate to within 4% or 2 mm in regions of high dose gradients. A secondary electron source was added to the PBRA to account for collimation-scattered electrons in the incident beam. Parameters of the dual-source model were determined from a minimal data set to allow ease of beam commissioning. Comparisons with measured data showed 3% or better dose accuracy in water within the field for cases where 4% accuracy was not previously achievable. A measured data set was developed that allowed an evaluation of PBRA in regions distal to localized heterogeneities. Geometries in the data set included irregular surfaces and high- and low-density internal heterogeneities. The data was estimated to have 1% precision and 2% agreement with accurate, benchmarked Monte Carlo (MC) code. PBRA electron transport was enhanced by modeling local pencil beam divergence. This required fundamental changes to the mathematics of electron transport (divPBRA). Evaluation of divPBRA with the measured data set showed marginal improvement in dose accuracy when compared to PBRA; however, 4% or 2mm accuracy was not achieved by either PBRA version for all data points. Finally, PBRA was evaluated clinically by comparing PBRA- and MC-calculated dose distributions using site-specific patient RTP data. Results show PBRA did not agree with MC to within 4% or 2mm in a small fraction (<3%) of the irradiated volume. Although the hypothesis of the research was shown to be false, the minor dose inaccuracies should have little or no impact on RTP decisions or patient outcome. Therefore, given ease of beam commissioning, documentation of accuracy, and calculational speed, the PBRA should be considered a practical tool for clinical use. ^

Classification of Satellite Images by means of Fuzzy Rules generated by a Genetic Algorithm

The data acquired by Remote Sensing systems allow obtaining thematic maps of the earth's surface, by means of the registered image classification. This implies the identification and categorization of all pixels into land cover classes. Traditionally, methods based on statistical parameters have been widely used, although they show some disadvantages. Nevertheless, some authors indicate that those methods based on artificial intelligence, may be a good alternative. Thus, fuzzy classifiers, which are based on Fuzzy Logic, include additional information in the classification process through based-rule systems. In this work, we propose the use of a genetic algorithm (GA) to select the optimal and minimum set of fuzzy rules to classify remotely sensed images. Input information of GA has been obtained through the training space determined by two uncorrelated spectral bands (2D scatter diagrams), which has been irregularly divided by five linguistic terms defined in each band. The proposed methodology has been applied to Landsat-TM images and it has showed that this set of rules provides a higher accuracy level in the classification process

A recursive algorithm to compute a basis of a similarity

Se definen conceptos y se aplica el teorema de Valverde para escribir un algoritmo que computa bases de similaridades. This paper studies sorne theory and methods to build a representation theorem basis of a similarity from the basis of its subsimilarities, providing an alternative recursive method to compute the basis of a similarity.

A low power routing algorithm for localization in IEEE 802.15.4 networks

Many context-aware applications rely on the knowledge of the position of the user and the surrounding objects to provide advanced, personalized and real-time services. In wide-area deployments, a routing protocol is needed to collect the location information from distant nodes. In this paper, we propose a new source-initiated (on demand) routing protocol for location-aware applications in IEEE 802.15.4 wireless sensor networks. This protocol uses a low power MAC layer to maximize the lifetime of the network while maintaining the communication delay to a low value. Its performance is assessed through experimental tests that show a good trade-off between power consumption and time delay in the localization of a mobile device.

B-Neck: A Distributed and Quiescent Max-Min Fair Algorithm

The problem of fairly distributing the capacity of a network among a set of sessions has been widely studied. In this problem, each session connects via a single path a source and a destination, and its goal is to maximize its assigned transmission rate (i.e., its throughput). Since the links of the network have limited bandwidths, some criterion has to be defined to fairly distribute their capacity among the sessions. A popular criterion is max-min fairness that, in short, guarantees that each session i gets a rate λi such that no session s can increase λs without causing another session s' to end up with a rate λs/ <; λs. Many max-min fair algorithms have been proposed, both centralized and distributed. However, to our knowledge, all proposed distributed algorithms require control data being continuously transmitted to recompute the max-min fair rates when needed (because none of them has mechanisms to detect convergence to the max-min fair rates). In this paper we propose B-Neck, a distributed max-min fair algorithm that is also quiescent. This means that, in absence of changes (i.e., session arrivals or departures), once the max min rates have been computed, B-Neck stops generating network traffic. Quiescence is a key design concept of B-Neck, because B-Neck routers are capable of detecting and notifying changes in the convergence conditions of max-min fair rates. As far as we know, B-Neck is the first distributed max-min fair algorithm that does not require a continuous injection of control traffic to compute the rates. The correctness of B-Neck is formally proved, and extensive simulations are conducted. In them, it is shown that B-Neck converges relatively fast and behaves nicely in presence of sessions arriving and departing.

Self-organizing Routing Algorithm fo Wireless Sensors Networks (WSN) using Ant Colony Optimization (ACO) with Tinyos.

This paper describes the basic tools to work with wireless sensors. TinyOShas a componentbased architecture which enables rapid innovation and implementation while minimizing code size as required by the severe memory constraints inherent in sensor networks. TinyOS's component library includes network protocols, distributed services, sensor drivers, and data acquisition tools ? all of which can be used asia or be further refined for a custom application. TinyOS was originally developed as a research project at the University of California Berkeley, but has since grown to have an international community of developers and users. Some algorithms concerning packet routing are shown. Incar entertainment systems can be based on wireless sensors in order to obtain information from Internet, but routing protocols must be implemented in order to avoid bottleneck problems. Ant Colony algorithms are really useful in such cases, therefore they can be embedded into the sensors to perform such routing task.