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Automated artificial intelligence-based analysis of skeletal muscle volume predicts overall survival after cystectomy for urinary bladder cancer

Ying, Thomas ; Borrelli, Pablo ; Edenbrandt, Lars ; Enqvist, Olof ; Kaboteh, Reza ; Trägårdh, Elin LU ; Ulén, Johannes and Kjölhede, Henrik (2021) In European Radiology Experimental 5(1).
Abstract

Background: Radical cystectomy for urinary bladder cancer is a procedure associated with a high risk of complications, and poor overall survival (OS) due to both patient and tumour factors. Sarcopenia is one such patient factor. We have developed a fully automated artificial intelligence (AI)-based image analysis tool for segmenting skeletal muscle of the torso and calculating the muscle volume. Methods: All patients who have undergone radical cystectomy for urinary bladder cancer 2011–2019 at Sahlgrenska University Hospital, and who had a pre-operative computed tomography of the abdomen within 90 days of surgery were included in the study. All patients CT studies were analysed with the automated AI-based image analysis tool. Clinical... (More)

Background: Radical cystectomy for urinary bladder cancer is a procedure associated with a high risk of complications, and poor overall survival (OS) due to both patient and tumour factors. Sarcopenia is one such patient factor. We have developed a fully automated artificial intelligence (AI)-based image analysis tool for segmenting skeletal muscle of the torso and calculating the muscle volume. Methods: All patients who have undergone radical cystectomy for urinary bladder cancer 2011–2019 at Sahlgrenska University Hospital, and who had a pre-operative computed tomography of the abdomen within 90 days of surgery were included in the study. All patients CT studies were analysed with the automated AI-based image analysis tool. Clinical data for the patients were retrieved from the Swedish National Register for Urinary Bladder Cancer. Muscle volumes dichotomised by the median for each sex were analysed with Cox regression for OS and logistic regression for 90-day high-grade complications. The study was approved by the Swedish Ethical Review Authority (2020-03985). Results: Out of 445 patients who underwent surgery, 299 (67%) had CT studies available for analysis. The automated AI-based tool failed to segment the muscle volume in seven (2%) patients. Cox regression analysis showed an independent significant association with OS (HR 1.62; 95% CI 1.07–2.44; p = 0.022). Logistic regression did not show any association with high-grade complications. Conclusion: The fully automated AI-based CT image analysis provides a low-cost and meaningful clinical measure that is an independent biomarker for OS following radical cystectomy.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Artificial intelligence, Body composition, Image analysis (computer-assisted), Sarcopenia, Urinary bladder cancer
in
European Radiology Experimental
volume
5
issue
1
article number
50
publisher
Springer
external identifiers
  • pmid:34796422
  • scopus:85119440821
ISSN
2509-9280
DOI
10.1186/s41747-021-00248-8
language
English
LU publication?
yes
id
db192357-32b6-4fdc-9115-2eb8f6a34306
date added to LUP
2021-12-08 13:20:16
date last changed
2024-04-20 17:18:40
@article{db192357-32b6-4fdc-9115-2eb8f6a34306,
  abstract     = {{<p>Background: Radical cystectomy for urinary bladder cancer is a procedure associated with a high risk of complications, and poor overall survival (OS) due to both patient and tumour factors. Sarcopenia is one such patient factor. We have developed a fully automated artificial intelligence (AI)-based image analysis tool for segmenting skeletal muscle of the torso and calculating the muscle volume. Methods: All patients who have undergone radical cystectomy for urinary bladder cancer 2011–2019 at Sahlgrenska University Hospital, and who had a pre-operative computed tomography of the abdomen within 90 days of surgery were included in the study. All patients CT studies were analysed with the automated AI-based image analysis tool. Clinical data for the patients were retrieved from the Swedish National Register for Urinary Bladder Cancer. Muscle volumes dichotomised by the median for each sex were analysed with Cox regression for OS and logistic regression for 90-day high-grade complications. The study was approved by the Swedish Ethical Review Authority (2020-03985). Results: Out of 445 patients who underwent surgery, 299 (67%) had CT studies available for analysis. The automated AI-based tool failed to segment the muscle volume in seven (2%) patients. Cox regression analysis showed an independent significant association with OS (HR 1.62; 95% CI 1.07–2.44; p = 0.022). Logistic regression did not show any association with high-grade complications. Conclusion: The fully automated AI-based CT image analysis provides a low-cost and meaningful clinical measure that is an independent biomarker for OS following radical cystectomy.</p>}},
  author       = {{Ying, Thomas and Borrelli, Pablo and Edenbrandt, Lars and Enqvist, Olof and Kaboteh, Reza and Trägårdh, Elin and Ulén, Johannes and Kjölhede, Henrik}},
  issn         = {{2509-9280}},
  keywords     = {{Artificial intelligence; Body composition; Image analysis (computer-assisted); Sarcopenia; Urinary bladder cancer}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Springer}},
  series       = {{European Radiology Experimental}},
  title        = {{Automated artificial intelligence-based analysis of skeletal muscle volume predicts overall survival after cystectomy for urinary bladder cancer}},
  url          = {{http://dx.doi.org/10.1186/s41747-021-00248-8}},
  doi          = {{10.1186/s41747-021-00248-8}},
  volume       = {{5}},
  year         = {{2021}},
}