Publications by authors named "Jakob Kather"

Background: Genomic data is essential for clinical decision-making in precision oncology. Bioinformatic algorithms are widely used to analyze next-generation sequencing (NGS) data, but they face two major challenges. First, these pipelines are highly complex, involving multiple steps and the integration of various tools.

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Background & Aims: Biliary abnormalities in autoimmune hepatitis (AIH) and interface hepatitis in primary biliary cholangitis (PBC) occur frequently, and misinterpretation may lead to therapeutic mistakes with a negative impact on patients. This study investigates the use of a deep learning (DL)-based pipeline for the diagnosis of AIH and PBC to aid differential diagnosis.

Methods: We conducted a multicenter study across six European referral centers, and built a library of digitized liver biopsy slides dating from 1997 to 2023.

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Accurate melanoma diagnosis is crucial for patient outcomes and reliability of AI diagnostic tools. We assess interrater variability among eight expert pathologists reviewing histopathological images and clinical metadata of 792 melanoma-suspicious lesions prospectively collected at eight German hospitals. Moreover, we provide access to the largest panel-validated dataset featuring dermoscopic and histopathological images with metadata.

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Cancer immunotherapy-including immune checkpoint inhibition (ICI) and adoptive cell therapy (ACT)-has become a standard, potentially curative treatment for a subset of advanced solid and liquid tumors. However, most patients with cancer do not benefit from the rapidly evolving improvements in the understanding of principal mechanisms determining cancer immune responsiveness (CIR); including patient-specific genetically determined and acquired factors, as well as intrinsic cancer cell biology. Though CIR is multifactorial, fundamental concepts are emerging that should be considered for the design of novel therapeutic strategies and related clinical studies.

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The development of new therapeutic strategies such as immune checkpoint inhibitors (ICIs) and targeted therapies has increased the complexity of the treatment landscape for solid tumors. At the current rate of annual FDA approvals, the potential treatment options could increase by tenfold over the next 5 years. The cost of personalized medicine technologies limits its accessibility, thus increasing socioeconomic disparities in the treated population.

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Current assays fail to address breast cancer's complex biology and accurately predict treatment response. On a retrospective cohort of 1082 female breast tissues, we develop and validate mFISHseq, which integrates multiplexed RNA fluorescent in situ hybridization with RNA-sequencing, guided by laser capture microdissection. This technique ensures tumor purity, unbiased whole transcriptome profiling, and explicitly quantifies intratumoral heterogeneity.

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Introduction: The accurate distinction between benign and malignant biliary strictures (BS) poses a significant challenge. Despite the use of bile duct biopsies and brush cytology via endoscopic retrograde cholangiopancreaticography (ERCP), the results remain suboptimal. Single-operator cholangioscopy can enhance the diagnostic yield in BS, but its limited availability and high costs are substantial barriers.

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Artificial intelligence (AI) methods enable humans to analyse large amounts of data, which would otherwise not be feasibly quantifiable. This is especially true for unstructured visual and textual data, which can contain invaluable insights into disease. The hepatology research landscape is complex and has generated large amounts of data to be mined.

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Medical image classification requires labeled, task-specific datasets which are used to train deep learning networks de novo, or to fine-tune foundation models. However, this process is computationally and technically demanding. In language processing, in-context learning provides an alternative, where models learn from within prompts, bypassing the need for parameter updates.

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Background: Deep learning can extract predictive and prognostic biomarkers from histopathology whole slide images, but its interpretability remains elusive.

Methods: We develop and validate MoPaDi (Morphing histoPathology Diffusion), which generates counterfactual mechanistic explanations. MoPaDi uses diffusion autoencoders to manipulate pathology image patches and flip their biomarker status by changing the morphology.

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The WHO guidelines for classifying central nervous system (CNS) tumours are changing considerably with each release. The classification of CNS tumours is uniquely complex among most other solid tumours as it incorporates not just morphology, but also genetic and epigenetic features. Keeping current with these changes across medical fields can be challenging, even for clinical specialists.

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Purpose: Rapidly expanding medical literature challenges oncologists seeking targeted cancer therapies. General-purpose large language models (LLMs) lack domain-specific knowledge, limiting their clinical utility. This study introduces the LLM system Medical Evidence Retrieval and Data Integration for Tailored Healthcare (MEREDITH), designed to support treatment recommendations in precision oncology.

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Article Synopsis
  • Large language models (LLMs) show promise in medicine due to their extensive knowledge and reasoning abilities across various medical domains.
  • This study reveals a significant vulnerability where manipulating just 1.1% of the LLM's weights can introduce incorrect biomedical facts, affecting the accuracy of its outputs.
  • These findings highlight critical security and trust issues regarding LLMs in healthcare, underscoring the necessity for stronger safeguards, verification processes, and controlled access to ensure their safe and reliable usage.
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Large language models (LLMs) are undergoing intensive research for various healthcare domains. This systematic review and meta-analysis assesses current applications, methodologies, and the performance of LLMs in clinical oncology. A mixed-methods approach was used to extract, summarize, and compare methodological approaches and outcomes.

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Structured reporting (SR) has long been a goal in radiology to standardize and improve the quality of radiology reports. Despite evidence that SR reduces errors, enhances comprehensiveness, and increases adherence to guidelines, its widespread adoption has been limited. Recently, large language models (LLMs) have emerged as a promising solution to automate and facilitate SR.

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The advent of digital pathology and the deployment of high-throughput molecular techniques are generating an unprecedented mass of data. Thanks to advances in computational sciences, artificial intelligence (AI) approaches represent a promising avenue for extracting relevant information from complex data structures. From diagnostic assistance to powerful research tools, the potential fields of application of machine learning techniques in pathology are vast and constitute the subject of considerable research work.

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Article Synopsis
  • Structured reporting improves the quality and detail of radiology reports, and a study investigated the use of a large language model (LLM) to automate this process without affecting radiologists' workflow.
  • The study used a dataset of de-identified chest radiograph reports in English and German to assess the performance of a locally hosted LLM, Llama-2-70B-chat, against human readers using a structured reporting template.
  • Results showed that the LLM generated structured reports with comparable accuracy to humans, achieving a Matthews correlation coefficient of around 0.75 for English and slightly lower for German reports, although semantic understanding varied by language.
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  • Homologous recombination deficiency (HRD) is a key biomarker for predicting which cancer patients might respond to PARP inhibitors, but testing for HRD is complex.* -
  • The researchers created a deep learning pipeline using attention-weighted multiple instance learning (attMIL) to predict HRD status from routine histology images, achieving varying accuracy rates across different cancer types.* -
  • Results showed that HRD can be predicted directly from histology slides for multiple cancers, with the model demonstrating promising accuracy, particularly for endometrial, pancreatic, and lung cancers.*
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  • The study investigates the effectiveness of using deep learning for automating the process of quantifying infarct size (IS) in heart experiments, which is traditionally done manually using TTC staining.
  • Researchers collected high-resolution images from pig heart experiments and developed a deep learning model (dynamic U-Net) to analyze these images for IS measurement.
  • Evaluation of the model showed strong performance metrics, suggesting that the automated method is a reliable and time-saving alternative to traditional IS quantification methods.
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Introduction: The research field of artificial intelligence (AI) in medicine and especially in gastroenterology is rapidly progressing with the first AI tools entering routine clinical practice, for example, in colorectal cancer screening. Contrast-enhanced ultrasound (CEUS) is a highly reliable, low-risk, and low-cost diagnostic modality for the examination of the liver. However, doctors need many years of training and experience to master this technique and, despite all efforts to standardize CEUS, it is often believed to contain significant interrater variability.

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Article Synopsis
  • Recent advancements in large language models (LLMs) present significant opportunities for improving the management of multiple sclerosis (MS), particularly in producing and analyzing human-like text.
  • While AI integration into medical imaging and disease prognosis has gained attention, the specific application of LLMs in MS management is still largely uncharted territory.
  • Potential uses of LLMs include enhancing clinical decision-making for therapy selection, utilizing real-world data for research, and creating personalized educational resources for healthcare professionals and patients with MS.
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