Whole-Body Radiomics for Prediction of Treatment Failure in Cervical Cancer
Bibliographic record
Abstract
Purpose/Objective(s): Over the past decade increasing access to high quality imaging modalities has allowed for improved conformality in cervical cancer (CC) brachytherapy (BT) planning, especially in the utilization of interstitial brachytherapy (ISBT).The purpose of this study was to document current ISBT practices across Canada, and compare them with practices from 4 years ago.Materials/Methods: All Canadian centers with gynecologic BT (n Z 38) were identified, and one gynecology radiation oncologist per center was sent a 64-item e-mail questionnaire regarding the center's practice for CC patients and ISBT.Aggregate responses regarding utilization of ISBT are reported and compared with practice patterns identified in our 2015 survey.Descriptive statistics were used to summarize the data and Fisher's exact test was used for comparison.Results: 37 of 38 center respondents completed the survey (RR: 97.4%).MRI has been incorporated into treatment of CC by 100% and 68% of respondents, prior to EBRT and BT, respectively.In 2019, a significantly higher proportion of respondents indicated they offered ISBT to radical CC patients compared to 2015, p Z 0.023.In the 2019, 22/37 (59.4%) respondents reported their center has ability to perform ISBT, compared to 14/28 (50%) in 2015 (p Z 0.121).For selecting patients for ISBT, 74% of respondents in 2019 indicated that they used pre-EBRT and pre-BT imaging compared 48% to 2015, p Z 0.05.There was an increase in the use of hybrid applicators: 5/14 (36%) centers with availability of ISBT and 5/ 28 (18%) of centers overall in 2015 versus 17/22 (77%) centers with availability of ISBT and 17/37 (46%) of centers overall in 2019, p Z 0.02 and p Z 0.03, respectively.Perineal template-based (which includes Venezia applicator) also increased slightly over this time: 71% of ISBT centers and 36% of overall centers in 2015 versus 73% of ISBT centers and 43% of centers overall in 2019, p>0.05.Of the respondents who use hybrid applicators, most (78%) utilized 3-4 interstitial needles, while those who used perineal template 61.5% implanted on average 10-15 needles.Most (56%) respondents used general anesthesia for performing ISBT, 31% used epidural and 14% used spinal anesthesia.For determining needle positioning, the majority (60%) of respondents used intra-operative transabdominal or trans-rectal ultrasound; pre-operative imaging was the second most common modality; laparoscopic guidance was used by 1 respondent.48% of respondents perform ISBT as an outpatient procedure, with an average of 3 (range 2-4) fractions delivered over multiple implants.Conclusion: In Canada, there is general trend towards increased utilization of interstitial brachytherapy for treatment of cervical patients.Increased utilization of imaging modalities such as MRI and availability of hybrid applicators are potential contributors for this upwards trend.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".