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Early Detection of Ureteropelvic Junction Obstruction Using Signal Analysis and Machine Learning: A Dynamic Solution to a Dynamic Problem.

Published on Oct 1, 2017in The Journal of Urology5.647
· DOI :10.1016/j.juro.2017.09.147
Emily S. Blum1
Estimated H-index: 1
,
Antonio R. Porras7
Estimated H-index: 7
+ 7 AuthorsMarius George Linguraru17
Estimated H-index: 17
(GW: George Washington University)
Abstract
Purpose: We sought to define features that describe the dynamic information in diuresis renograms for the early detection of clinically significant hydronephrosis caused by ureteropelvic junction obstruction.Materials and Methods: We studied the diuresis renogram of 55 patients with a mean ± SD age of 75 ± 66 days who had congenital hydronephrosis at initial presentation. Five patients had bilaterally affected kidneys for a total of 60 diuresis renograms. Surgery was performed on 35 kidneys. We extracted 45 features based on curve shape and wavelet analysis from the drainage curves recorded after furosemide administration. The optimal features were selected as the combination that maximized the ROC AUC obtained from a linear support vector machine classifier trained to classify patients as with or without obstruction. Using these optimal features we performed leave 1 out cross validation to estimate the accuracy, sensitivity and specificity of our framework. Results were compared to those obtained using p...
  • References (23)
  • Citations (2)
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References23
Newest
#1Rachael D. Sussman (MedStar Georgetown University Hospital)H-Index: 2
#2Emily S. BlumH-Index: 2
Last. Hans G. PohlH-Index: 6
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3 CitationsSource
#1Paul Kruszka (NIH: National Institutes of Health)H-Index: 12
#2Antonio R. PorrasH-Index: 7
Last. Maximilian Muenke (NIH: National Institutes of Health)H-Index: 66
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Down syndrome is the most common cause of cognitive impairment and presents clinically with universally recognizable signs and symptoms. In this study, we focus on exam findings and digital facial analysis technology in individuals with Down syndrome in diverse populations. Photos and clinical information were collected on 65 individuals from 13 countries, 56.9% were male and the average age was 6.6 years (range 1 month to 26 years; SD = 6.6 years). Subjective findings showed that clinical featu...
20 CitationsSource
#1Juan J. CerrolazaH-Index: 9
#2Nabile M. Safdar (Emory University)H-Index: 11
Last. Marius George LinguraruH-Index: 13
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Ultrasound (US) imaging is the primary imaging modality for pediatric hydronephrosis, which manifests as the dilation of the renal collecting system (CS). In this paper, we present a new framework for the segmentation of renal structures, kidney and CS, from 3DUS scans. First, the kidney is segmented using an active shape model-based approach, tailored to deal with the challenges raised by US images. A weighted statistical shape model allows to compensate the image variation with the propagation...
12 CitationsSource
#1Matthew R. Acker (UM: University of Miami)H-Index: 2
#2Roderick Clark (UWO: University of Western Ontario)H-Index: 2
Last. Peter Anderson (Dal: Dalhousie University)H-Index: 6
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Introduction: As early detection of hydronephrosis increases, we require better methods of distinguishing between pediatric patients who require pyeloplasty vs. those with transient obstruction. Gravity-assisted drainage (GAD) as part of a standardized diuretic renography protocol has been suggested as a simple and safe method to differentiate patients. Methods: Renal scans of 89 subjects with 121 hydronephrotic renal units between January 2004 and March 2007 were identified and analyzed. Result...
3 CitationsSource
#1Juan J. CerrolazaH-Index: 9
#2Craig A. PetersH-Index: 58
Last. Marius George Linguraru (GW: George Washington University)H-Index: 17
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Purpose: We define sonographic biomarkers for hydronephrotic renal units that can predict the necessity of diuretic nuclear renography.Materials and Methods: We selected a cohort of 50 consecutive patients with hydronephrosis of varying severity in whom 2-dimensional sonography and diuretic mercaptoacetyltriglycine renography had been performed. A total of 131 morphological parameters were computed using quantitative image analysis algorithms. Machine learning techniques were then applied to ide...
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Aug 1, 2015 in EMBC (International Conference of the IEEE Engineering in Medicine and Biology Society)
#1Juan J. Cerrolaza (Children's National Medical Center)H-Index: 5
#2Enrico Grisan (UNIPD: University of Padua)H-Index: 19
Last. Marius George Linguraru (GW: George Washington University)H-Index: 17
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This paper introduces a complete framework for the quantification of renal structures (parenchyma, and collecting system) in 3D ultrasound (US) images. First, the segmentation of the kidney is performed using Gabor-based appearance models (GAM), a variant of the popular active shape models, properly tailored to the imaging physics of US image data. The framework also includes a new graph-cut based method for the segmentation of the collecting system, including brightness and contrast normalizati...
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#1Dennis B. Liu (NU: Northwestern University)H-Index: 10
#2William R. Armstrong (UIC: University of Illinois at Chicago)H-Index: 1
Last. Max Maizels (NU: Northwestern University)H-Index: 11
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Antenatal hydronephrosis (ANH) is one of the most frequently detected abnormalities found on routine prenatal ultrasounds, affecting 1% to 4.5% of all pregnancies. Despite its prevalence, there continues to be uncertainty regarding the clinical impact after birth. Prognosis depends on the severity of the dilation. Expectant prenatal management is the rule with fetal intervention rarely needed in a few select cases. Ureteropelvic junction obstruction and vesicoureteral reflux are the most common ...
25 CitationsSource
#1Qian Zhao (Children's National Medical Center)H-Index: 8
#2Kazunori Okada (SFSU: San Francisco State University)H-Index: 16
Last. Marius George Linguraru (GW: George Washington University)H-Index: 17
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Abstract Down syndrome, the most common single cause of human birth defects, produces alterations in physical growth and mental retardation. If missed before birth, the early detection of Down syndrome is crucial for the management of patients and disease. However, the diagnostic accuracy for pediatricians prior to cytogenetic results is moderate and the access to specialists is limited in many social and low-economic areas. In this study, we propose a simple, non-invasive and automated framewor...
31 CitationsSource
OBJECTIVE. The purpose of this study was to facilitate interpretation of 99mTc-mercaptoacetyltriglycine (MAG3) diuretic scans by identifying key interpretative variables and developing a predictive model for computer-assisted diagnosis. MATERIALS AND METHODS. Ninety-seven studies were randomly selected from an archived database of MAG3 baseline and furosemide acquisitions and scan interpretations (obstruction, equivocal finding, or no obstruction) derived from a consensus of three experts. Sixty...
9 CitationsSource
Although renography has been used for half a century to evaluate the function of the infant kidney, there are still important disagreements among the specialists involved in this particular pathology. Each department of nuclear medicine has his own way to acquire and process a renogram; to interpret the obtained images, curves, and quantitative parameters; and to make recommendations for the referring physician. The urologist has his or her part of responsibilities because the decision for opera...
28 CitationsSource
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#1Jian Chen (SC: University of Southern California)H-Index: 6
#2Daphne Remulla (SC: University of Southern California)H-Index: 1
Last. Andrew J. Hung (SC: University of Southern California)H-Index: 18
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OBJECTIVE: To investigate the applications of artificial intelligence (AI) in diagnosis, treatment and outcome predictionin urologic diseases and evaluate its advantages over traditional models and methods. MATERIALS AND METHODS: A literature search was performed after PROSPERO registration (CRD42018103701) and in compliance with Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) methods. Articles between 1994 and 2018 using the search terms "urology", "artificial intelli...
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#1Christopher E. Bayne (UF: University of Florida)
Last. H.G. RushtonH-Index: 6
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Summary Diuresis renography (DR) is widely used in the evaluation of hydronephrosis and hydroureter in infants and children. The goal of this provocative nuclear imaging examination should be to detect the hydronephrotic kidneys at risk for loss of function and development of pain, hematuria, and urinary tract infection. The reliability of DR is dependent on the acquisition and processing of the data as well as interpretation and utilization of the results. In this review, the key concepts of st...
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