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  1. Artikel ; Online: Machine learning models in the prediction of 1-year mortality in patients with advanced hepatocellular cancer on immunotherapy: a proof-of-concept study.

    Lui, Thomas Ka Luen / Cheung, Ka Shing / Leung, Wai Keung

    Hepatology international

    2022  Band 16, Heft 4, Seite(n) 879–891

    Abstract: Introduction: Immunotherapy is a new promising treatment for patients with advanced hepatocellular carcinoma (HCC), but is costly and potentially associated with considerable side effects. This study aimed to evaluate the role of machine learning (ML) ... ...

    Abstract Introduction: Immunotherapy is a new promising treatment for patients with advanced hepatocellular carcinoma (HCC), but is costly and potentially associated with considerable side effects. This study aimed to evaluate the role of machine learning (ML) models in predicting the 1-year cancer-related mortality in advanced HCC patients treated with immunotherapy.
    Method: 395 HCC patients who had received immunotherapy (including nivolumab, pembrolizumab or ipilimumab) between 2014 and 2019 in Hong Kong were included. The whole data sets were randomly divided into training (n = 316) and internal validation (n = 79) set. The data set, including 47 clinical variables, was used to construct six different ML models in predicting the risk of 1-year mortality. The performances of ML models were measured by the area under receiver operating characteristic curve (AUC) and their performances were compared with C-Reactive protein and Alpha Fetoprotein in ImmunoTherapY score (CRAFITY) and albumin-bilirubin (ALBI) score. The ML models were further validated with an external cohort between 2020 and 2021.
    Results: The 1-year cancer-related mortality was 51.1%. Of the six ML models, the random forest (RF) has the highest AUC of 0.92 (95% CI 0.87-0.98), which was better than logistic regression (0.82, p = 0.01) as well as the CRAFITY (0.68, p < 0.01) and ALBI score (0.84, p = 0.04). RF had the lowest false positive (2.0%) and false negative rate (5.2%), and performed better than CRAFITY score in the external validation cohort (0.91 vs 0.66, p < 0.01). High baseline AFP, bilirubin and alkaline phosphatase were three common risk factors identified by all ML models.
    Conclusion: ML models could predict 1-year cancer-related mortality in HCC patients treated with immunotherapy, which may help to select patients who would benefit from this treatment.
    Mesh-Begriff(e) Bilirubin ; Carcinoma, Hepatocellular/pathology ; Humans ; Immunotherapy ; Liver Neoplasms/pathology ; Machine Learning ; Retrospective Studies
    Chemische Substanzen Bilirubin (RFM9X3LJ49)
    Sprache Englisch
    Erscheinungsdatum 2022-07-02
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2270316-0
    ISSN 1936-0541 ; 1936-0533
    ISSN (online) 1936-0541
    ISSN 1936-0533
    DOI 10.1007/s12072-022-10370-3
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Endocuff With or Without Artificial Intelligence-Assisted Colonoscopy in Detection of Colorectal Adenoma: A Randomized Colonoscopy Trial.

    Lui, Thomas Ka-Luen / Lam, Carla Pui-Mei / To, Elvis Wai-Pan / Ko, Michael Kwan-Lung / Tsui, Vivien Wai Man / Liu, Kevin Sze-Hang / Hui, Cynthia Ka-Yin / Cheung, Michael Ka-Shing / Mak, Loey Lung-Yi / Hui, Rex Wan-Hin / Wong, Siu-Yin / Seto, Wai Kay / Leung, Wai K

    The American journal of gastroenterology

    2024  

    Abstract: Introduction: Both artificial intelligence (AI) and distal attachment devices have been shown to improve adenoma detection rate and reduce miss rate during colonoscopy. We studied the combined effect of Endocuff and AI on enhancing detection rates of ... ...

    Abstract Introduction: Both artificial intelligence (AI) and distal attachment devices have been shown to improve adenoma detection rate and reduce miss rate during colonoscopy. We studied the combined effect of Endocuff and AI on enhancing detection rates of various colonic lesions.
    Methods: This was a 3-arm prospective randomized colonoscopy study involving patients aged 40 years or older. Participants were randomly assigned in a 1:1:1 ratio to undergo Endocuff with AI, AI alone, or standard high-definition (HD) colonoscopy. The primary outcome was adenoma detection rate (ADR) between the Endocuff-AI and AI groups while secondary outcomes included detection rates of polyp (PDR), sessile serrated lesion (sessile detection rate [SDR]), and advanced adenoma (advanced adenoma detection rate) between the 2 groups.
    Results: A total of 682 patients were included (mean age 65.4 years, 52.3% male), with 53.7% undergoing diagnostic colonoscopy. The ADR for the Endocuff-AI, AI, and HD groups was 58.7%, 53.8%, and 46.3%, respectively, while the corresponding PDR was 77.0%, 74.0%, and 61.2%. A significant increase in ADR, PDR, and SDR was observed between the Endocuff-AI and AI groups (ADR difference: 4.9%, 95% CI: 1.4%-8.2%, P = 0.03; PDR difference: 3.0%, 95% CI: 0.4%-5.8%, P = 0.04; SDR difference: 6.4%, 95% CI: 3.4%-9.7%, P < 0.01). Both Endocuff-AI and AI groups had a higher ADR, PDR, SDR, and advanced adenoma detection rate than the HD group (all P < 0.01).
    Discussion: Endocuff in combination with AI further improves various colonic lesion detection rates when compared with AI alone.
    Sprache Englisch
    Erscheinungsdatum 2024-03-18
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000002684
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel: Feasibility study of a single-use balloon-assisted robotic colonoscope in healthy volunteers.

    Foo, Chi-Chung / Leung, Wai-Keung / Lui, Thomas Ka-Luen / Cheung, Jo Lai-Ken / Lam, Kwok-Wai / Sreedhar, Biji / Yeung, Chung-Kwong

    Endoscopy international open

    2021  Band 9, Heft 4, Seite(n) E537–E542

    Abstract: Background and study ... ...

    Abstract Background and study aims
    Sprache Englisch
    Erscheinungsdatum 2021-03-17
    Erscheinungsland Germany
    Dokumenttyp Journal Article
    ZDB-ID 2761052-4
    ISSN 2196-9736 ; 2364-3722
    ISSN (online) 2196-9736
    ISSN 2364-3722
    DOI 10.1055/a-1352-3688
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel ; Online: Blue-light imaging or narrow-band imaging for proximal colonic lesions: a prospective randomized tandem colonoscopy study.

    Leung, Wai K / Tsui, Vivien Wai Man / Mak, Loey Lung-Yi / Cheung, Michael Ka-Shing / Hui, Cynthia Ka-Yin / Lam, Carla Pui-Mei / Wong, Siu-Yin / Liu, Kevin Sze-Hang / Ko, Michael Kwan-Lung / To, Elvis Wai-Pan / Guo, Chuan-Guo / Lui, Thomas Ka-Luen

    Gastrointestinal endoscopy

    2023  Band 98, Heft 5, Seite(n) 813–821.e3

    Abstract: Background and aims: Blue-light imaging (BLI) is a new image-enhanced endoscopy with a wavelength filter similar to narrow-band imaging (NBI). We compared the 2 with white-light imaging (WLI) on proximal colonic lesion detection and miss rates.: ... ...

    Abstract Background and aims: Blue-light imaging (BLI) is a new image-enhanced endoscopy with a wavelength filter similar to narrow-band imaging (NBI). We compared the 2 with white-light imaging (WLI) on proximal colonic lesion detection and miss rates.
    Methods: In this 3-arm prospective randomized study with tandem examination of the proximal colon, we enrolled patients aged ≥40 years. Eligible patients were randomized in 1:1:1 ratio to receive BLI, NBI, or WLI during the first withdrawal from the proximal colon. The second withdrawal was performed using WLI in all patients. Primary outcomes were proximal polyp (pPDRs) and adenoma (pADRs) detection rates. Secondary outcomes were miss rates of proximal lesions found on tandem examination.
    Results: Of 901 patients included (mean age, 64.7 years; 52.9% men), 48.1% underwent colonoscopy for screening or surveillance. The corresponding pPDRs of the BLI, NBI, and WLI groups were 45.8%, 41.6, and 36.6%, whereas the corresponding pADRs were 36.6%, 33.8%, and 28.3%. There was a significant difference in pPDR and pADR between BLI and WLI groups (difference, 9.2% [95% confidence interval {CI}, 3.3-16.9] and 8.3% [95% CI, 2.7-15.9]) and between NBI and WLI groups (difference, 5.0% [95% CI, 1.4-12.9] and 5.6% [95% CI, 2.1-13.3]). Proximal adenoma miss rates were significantly lower with BLI (19.4%) than with WLI (27.4%; difference, -8.0%; 95% CI, -15.8 to -.1) but not between NBI (27.2%) and WLI.
    Conclusions: Both BLI and NBI were superior to WLI on detecting proximal colonic lesions, but only BLI had lower proximal adenoma miss rates than WLI. (Clinical trial registration number: NCT03696992.).
    Mesh-Begriff(e) Humans ; Male ; Female ; Middle Aged ; Colonoscopy/methods ; Narrow Band Imaging/methods ; Adenoma/diagnostic imaging ; Aged ; Prospective Studies ; Colonic Polyps/diagnostic imaging ; Colonic Neoplasms/diagnostic imaging ; Missed Diagnosis ; Light ; Colon, Ascending/diagnostic imaging ; Colon, Ascending/pathology ; Image Enhancement/methods
    Sprache Englisch
    Erscheinungsdatum 2023-06-10
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Randomized Controlled Trial ; Comparative Study
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2023.06.004
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel: Feasibility study of a single-use balloon-assisted robotic colonoscope in healthy volunteers

    Foo, Chi-Chung / Leung, Wai-Keung / Lui, Thomas Ka-Luen / Cheung, Jo Lai-Ken / Lam, Kwok-Wai / Sreedhar, Biji / Yeung, Chung-Kwong

    Endoscopy International Open

    2021  Band 09, Heft 04, Seite(n) E537–E542

    Abstract: Background and study aims : Despite its widespread adoption, colonoscope still has its limitations. Advancement is often limited by the looping of colon. The isolation of SARS-CoV-2 in stool raises concern for the risk of disease transmission. A single- ... ...

    Abstract Background and study aims : Despite its widespread adoption, colonoscope still has its limitations. Advancement is often limited by the looping of colon. The isolation of SARS-CoV-2 in stool raises concern for the risk of disease transmission. A single-use robotic colonoscope, the NISInspire-C System, that features a balloon-suction anchorage mechanism was developed to address these.
    Methods : The NISInspire-C balloons are designed to provide anchorage for straightening of the colon during advancement. Angulation at the bending section is tendon-wire driven by servo mechanisms integrated into a robotic control console. This was a pilot, prospective trial to evaluate the safety and feasibility of this system. Healthy volunteers underwent examination with the NISInspire-C, followed by the conventional colonoscope. The procedure time, cecal intubation rates (CIR), complications, and level of pain were measured.
    Results : A total of 19 subjects underwent the examination. The cecal intubation rate was 89.5 % (17/19) and the overall time-to-cecum was 26.3 minutes (SD: 17.9 mins). There were no procedure-related complications. Polyps were detected in seven of 19 (36.8 %) subjects during the NISInspire-C procedure. Three more subjects were found to have adenomatous polyps with the conventional colonoscope. There was minimal variation in level of pain during the procedures with the two colonoscopes.
    Conclusion : The single-use robotic colonoscope NISInspire-C is a safe and feasible alternative to the conventional colonoscope. Further technical refinement is needed to improve the CIR. This study was limited by its small sample size.
    Sprache Englisch
    Erscheinungsdatum 2021-03-17
    Verlag Georg Thieme Verlag KG
    Erscheinungsort Stuttgart ; New York
    Dokumenttyp Artikel
    ZDB-ID 2761052-4
    ISSN 2196-9736 ; 2364-3722 ; 2196-9736
    ISSN (online) 2196-9736
    ISSN 2364-3722 ; 2196-9736
    DOI 10.1055/a-1352-3688
    Datenquelle Thieme Verlag

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