Operating room technology
While the AI algorithm has found success in pediatric and adult brain surgeries, human pathologists still have a role to play.
Interventional and Surgical Sciences (Weiss), University College London. “The surgical implications for this alone are far-reaching. Intraoperative tissue diagnosis has been a focus and goal for surgeons and pathologists alike for many years, and the ability of Sturgeon to conduct real-time tumour sequencing advances this paradigm.” In Williams’ view, neuro-oncology is ideally suited to AI integration. Not only is the field awash with data but there is a vast unmet clinical need, with patient outcomes largely unchanged over the past few decades. His team at Weiss have developed an AI platform that identifies relevant anatomy in pituitary tumour surgery, an area where numerous critical structures are at risk of damage. So far, this platform is proving to be extremely useful to neurosurgeons, particularly those in training. “We are hopeful that incremental changes brought about by AI – in the areas of clinical decision support, risk stratification, and researching novel treatments – will improve outcomes for patients in the coming decades,” he says.
The caveat here is that AI is no silver bullet – it is unlikely to change outcomes for brain tumour patients overnight. As it gains more of a stronghold, we may see the emergence of poorly trained AI platforms that don’t work well with real-world data or contain an inbuilt bias. Then there’s the issue of trust – without a proper understanding of how predictions are made, clinicians may justifiably ask “Why should I trust you?” De Ridder agrees that, as exciting as these technologies are, we need to be careful not to get swept away by the hype. “We shouldn’t treat them like magic, because they clearly are not,” he says. “Let’s take it slowly and not overestimate their utility until we know for a fact that they’re safe.” That said, Williams thinks that there are ways of mitigating these concerns, not least by ensuring that
48
all AI-assisted decisions are sense-checked by clinicians and that monitoring strategies are put in place for new technologies. He suspects that countries like the UK and the Netherlands are about five to ten years away from AI integration that all clinicians will palpably experience in their day-to-day lives. “Close collaboration between innovators, regulators, clinicians and managers will be essential in ensuring that a balance is struck between ensuring appropriate evaluation and avoiding stymying progress,” he says. Going forward, the Dutch team plans to refine their algorithm still further, training it on additional data that have become available since their initial research. They also hope to apply a similar approach to other cancer types.
“There are lots of other tumour types in which having to wait a week for diagnosis is very burdensome for the patient,” says De Ridder. “This approach could be used across any type of cancer where methylation is a good biomarker for tumour variant, such as soft tissue sarcoma.”
The technology has another key advantage, in that the equipment used is very affordable. You need a high-performance laptop (around €1,500), a nanopore sequencer and chips that can be reused several times. That’s vastly cheaper than existing microarray technologies, which often require machines worth hundreds of thousands of euros along with chips that can only be used once. “We have already had some interest from low and middle-income countries to use these types of diagnostics,” says Tops. “These countries usually lack the equipment to get a specific molecular diagnosis, but with nanopore sequencing, it’s a much lower investment. That’s perhaps where we will have the most impact on achieving better outcomes for children and adults with a brain tumour.”
Practical Patient Care /
www.practical-patient-care.com
Have a nice day Photo/
Shutterstock.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61
