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Multidisciplinary Teams in Cancer Screening

Kerala Cancer Crusade and Cancer Literacy Mission and IRIA Preventive Radiology National Program conducted a Webinar Series on “Kerala Cancer Crusade and Cancer Literacy Mission” in association with IRIA Kerala, Swasthi Foundation and Community Oncology, Regional Cancer Centre, Journo Med. The sixth-day webinar discussed “Panel Discussion among Multidisciplinary Teams in Cancer Screening”. The event was held on 20th October 2022.

Dr Rijo Mathew, President of IRIA Kerala spoke about curable Cancer and early detection can significantly improve the quality of life among cancer patients. On this day, the role of multidisciplinary teams in cancer screening is being discussed. The focus of preventive radiology is to utilize the biomedical markers and the clinical parameters which identify the high-risk groups of cancers at a very early stage. Medical disciplines and engineering branches also contribute significantly to accelerating early detection and that will help in the down staging of cancer. With this intention in mind, a preventive onco-summit was conducted in Trivandrum. This program was a follow-up of a preventive one-summit. There is an old moment all across Kerala this month, where breast cancer awareness month is going on. A cancer screening program is going on in all districts of Kerala. 

Padmashree Dr Harsh Mahajan, Founder and Chief Radiologist of Mahajan Imaging and President at Nathealth, Healthcare Federation of India, has performed significant work in the field of advanced Neurology research Imaging and Genomics and also in Artificial Intelligence. He works in federation with major universities and research centres across the World i.e., Harvard, Stanford and Oxford. So, a lot of od research was performed by him as an entrepreneur. He is part of several government committees that are involved in the immigration of technology especially the indigenous technology for “ Aathma Nirbhar Bharath.” 

Dr Harsh Mahajan spoke about working on the ground and conducting screening, though not only working on theory and translating into practice. This on-ground delivers a strong message to society at large to “physicians who help in saving lives.” He delivered that prevention is always better than cure.  That is a maxim that rings true in so many cases. For many chronic diseases especially cancer, if picked up early, detection and cure can remain easier. For a country like India where resources are limited, one has to think about preventive medicine, predictive medicine and precision medicine. Especially in the field of oncology during the pandemic, there are multiple centres which are capable of performing next-generation sequencing and providing the maximum support. He is also a believer in the usage of integrative diagnostics where using genomics and another such lab pathological, lab medicine tests, one can detect the high-risk performance targetted screening at regular intervals as may be mandated to pick up cancer as early as possible. The unfortunate scenario in this country is that even though there are 2 million fresh cancer cases available. The number of patients diagnosed possibly is much higher, and this disease burden only grows. The Cancer Crusade Mission must not only get limited to Kerala but must be widespread across the country. 

Dr Rijo with enthusiasm and passion spread cancer awareness across the country. The academic sessions work as a condor for radiologists, physicians and society, at last, to participate in the cancer crusade. The professionals try to reduce the burden that cancers place on society at large both financially, emotionally and socio-economically. 

Dr Harsh Mahajan was an eminent entrepreneur and role model for radiologists across the World. Preventive Radiology is the future of diagnostics integrating patronymics, radionics and genomics. That is going to make a significant difference in integrative diagnostics which spreads across the country. Cancer screening or lifestyle metabolic screening helps us to have a screen-positive population. It has to be tackled specifically for medical interventions and lifestyle modifications. 

Dr Rangarajan Rajgopal, an Associate Professor of Radiology from AIIMS, Jodhpur spoke about the “Multidisciplinary Teams in Cancer Screening.” Cancer screening is not only limited to physicians but is also extended to other experts.

Multidisciplinary Teams in Cancer Screening 

Need for Artificial Intelligence 

There is an ever-increasing imaging volume, there is a provision of accurate reports because the diagnosis of cancer is a huge change indeed. It also adds crucial and economic value to the patients. It also maintains a lower proportion of discrepancy rate. The reports must be obtained around time because these patients consider the loss of time considerably important. 

Does Artificial Intelligence Application improve Cancer Skills?

Yes, it improves. This is the sort of improving the wheel much more efficiently and the system becomes much more efficient delivering a greater output. 

Artificial Intelligence Applications

  • Screening 
  • Clinical decision support
  • Triaging cases
  • Imaging protocol selection
  • Image acquisition
  • Classification and feature detection
  • Workflow optimization
  • Communication with clinical terms 
  • Patient prognostication 

Other than Artificial Intelligence, there is a lot of ongoing research on developing image acquisition tools. There is one device which does not particularly pertain to cancer screening. There are other technologies which are mentioned during the session, that come along with scanning. These technologies are rather invented, in collaboration with the engineering and medical fields. Some the companies utilize these technologies for team research and mass screening. 

Major Challenges  

Bridging proof of concept to successful clinical implementation. 

  • Curation of data with QC Standards
  • Data disparity 
  • The problem of overfitting 
  • Seamless integration
  • Cross institution inter-operability 

Mr Rohit Kalla, Ph D Artificial Intelligence, IIT Madras spoke about the presentation on how one can leverage artificial intelligence technology in cancer screening. 

Artificial Intelligence in Cancer Screening and Detection 

  • Introduction 
  • Recent Advancements in cancer screening
  • Future of Artificial Intelligence in Cancer Screening 

What is Cancer?

Cancer is a disease in which a damaged body cell grows uncontrollably leading to a lump of damaged tissues called a “Tumor”. 

  • Malignant Tumour spreads to the body
  • Benign Tumour spreads to the place from the large lump 

Why is Artificial Intelligence required?

  • Artificial Intelligence is used for cancer detection.
  • Early detection of cancer is required for a better prognosis.
  • Artificial Intelligence detection is more accurate compared to humans. It can be more reliable. Past two years, it has had promising results in detecting cancer.

    Tumour Segmentation
    Brain Tumour Segmentation

    Nowadays, AI is used for segmenting out the tumour from medical images. The MRI Image is captured at the ground level. The author runs a deeper algorithm to segment out the tumour area from the image. This is the image in which the results are recorded more accurately from the past two years. 

Tumour Classification

Looking upon AI for classification of different tumours. As in the image, there are several types of tumours which have been detected from cancer. In most cases, 99% of AI is accurate in detecting the different kinds of tumours. Here, the high-grade tumours, brain meta tumours also can be detected by AI. 

Grand Challenges 

To find cutting-edge results in cancer screening and detection, researchers and medical organizations post frequent grand challenges. Several medical organizations throughout the World and most of them are related to cancer varied. There are seeking accuracy and novel ideas for detecting cancer or tumours in the body. Many cancer challenges are popping up very frequently and are published on the website.

Interpretable decision-making using Artificial Intelligence 

Recently in the last year, Interpretable decision-making using an Artificial Intelligence algorithm has been published. Some deplaning network is used on the mammogram uses identifies whether the cancer is malignant or benign. But it’s an interpretable network. Not only that it classifies benign and malignant tumour but it also helps in taking a decision further, at what stage the malignant tumour is and what sort of treatment can be suggested for the patient. A mammogram image is sent through the network, they use the prototype network wherein different prototypes are learnt throughout the network and these prototypes are compared at a time of training for learning purposes and at a time of testing. These prototypes are used to complete the code. So, based on that a histogram approach is used wherein, three different types of cancers can be predicted. The images shown show that the score of a malignant tumour is very high. Based on this, the surgeon or a doctor can suggest a treatment to a patient. This kind of deep learning technology, people are using nowadays. 

Digital Twin   

A digital twin approach enables interoperability between the physical and virtual environments through data analysis using machine learning (ML).
Cancer Patient Digital Twin predictions based on virtual experiments will be integrated into medical workflows for patients’ decision-making and continuous learning.

Conclusion 

Real-time monitoring of the patient is done, and the data is captured. The data is being processed, there is a deep learning model at the back end. It identifies the segmented region or the cancerous growth and it estimates the growth of the cancer region. So, based on that. This information is visible on the virtual platform so based on that; the expert can deliver real-time suggestions. Thus, the future approach is taken care of in the case of Artificial Intelligence and the usage of AI in cancer treatment.

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