Exploring approaches for predictive cancer patient digital twins: Opportunities for collaboration and innovation.

We are rapidly approaching a future in which cancer patient digital twins will reach their potential to predict cancer prevention, diagnosis, and treatment in individual patients. This will be realized based on advances in high performance computing, computational modeling, and an expanding repertoire of observational data across multiple scales and modalities. In 2020, the US National Cancer Institute, and the US Department of Energy, through a trans-disciplinary research community at the intersection of advanced computing and cancer research, initiated team science collaborative projects to explore the development and implementation of predictive Cancer Patient Digital Twins.

Percutaneous Thrombectomy in Patients with Occlusions of the Aortoiliac Segment: A Case Series.

Objective: Thrombectomy of the aortoiliac segment remains a challenge for surgical and endovascular revision. This study aimed to evaluate the concept of percutaneous thrombectomy in patients with aortoiliac segment occlusions.

Materials & Methods: Eighteen patients with aortoiliac occlusion who underwent percutaneous thrombectomy were retrospectively identified using the local picture archive and divided into the stent-graft (N = 10) and native vessels (N  =  8) groups.

Five-year outcomes of the Bi- versus Trimodular EndurantTM stent-graft in 100 patients with infrarenal abdominal aortic repair.

Background: Recent studies on the Endurant™ endografts mainly compared outcomes of the bimodular stent-graft to other manufacturer's endografts or reported results for cases outside manufacturer's instructions for use (IFU), while data on the experience of standard endovascular aortic repair (EVAR) of infrarenal abdominal aortic aneurysms (AAA) inside manufacturer's IFU comparing the bi- with the trimodular device is limited.

Methods: Inclusion criteria were: 1) infrarenal aneurysms (>50 mm diameter) treated by Endurant II (END II) or Endurant IIs (END IIs) stent-graft inside manufacturer's IFU; 2) available CTA with 1 mm reconstruction of the entire aorta prior to intervention. Endpoints comparing the devices included technical success, 30-day mortality, rate of complications (bleeding with conversion to open repair, stent-graft stenosis/occlusion, acute distal embolism, infection or postprocedural necessity of dialysis), endoleaks and reinterventions (5-year follow-up).

Predictive Radiation Oncology - A New NCI-DOE Scientific Space and Community.

With a widely attended virtual kickoff event on January 29, 2021, the National Cancer Institute (NCI) and the Department of Energy (DOE) launched a series of 4 interactive, interdisciplinary workshops-and a final concluding "World Café" on March 29, 2021-focused on advancing computational approaches for predictive oncology in the clinical and research domains of radiation oncology. These events reflect 3,870 human hours of virtual engagement with representation from 8 DOE national laboratories and the Frederick National Laboratory for Cancer Research (FNL), 4 research institutes, 5 cancer centers, 17 medical schools and teaching hospitals, 5 companies, 5 federal agencies, 3 research centers, and 27 universities. Here we summarize the workshops by first describing the background for the workshops.

Radiation-Free Thoracic Endovascular Aneurysm Repair with Fiberoptic and Electromagnetic Guidance: A Phantom Study.

Purpose: To evaluate the feasibility and accuracy of a radiation-free implantation of a thoracic aortic stent graft employing fiberoptic and electromagnetic tracking in an anthropomorphic phantom.

Materials And Methods: An anthropomorphic phantom was manufactured based on computed tomography (CT) angiography data from a patient. An aortic stent graft application system was equipped with a fiber Bragg gratings and 3 electromagnetic sensors.

A cross-study analysis of drug response prediction in cancer cell lines.

To enable personalized cancer treatment, machine learning models have been developed to predict drug response as a function of tumor and drug features. However, most algorithm development efforts have relied on cross-validation within a single study to assess model accuracy. While an essential first step, cross-validation within a biological data set typically provides an overly optimistic estimate of the prediction performance on independent test sets.

Retrograde Revascularization of Tibial Arteries in Patients with Critical Limb Ischemia: Plantar-Arch Versus Transpedal Approach.

Purpose: To compare retrograde plantar-arch and transpedal-access approach for revascularization of below-the-knee (BTK) arteries in patients with critical limb ischemia (CLI) after a failed antegrade approach.

Materials And Methods: Retrospectively we identified 811 patients who underwent BTK revascularization between 1/2014 and 1/2020. In 115/811 patients (14.

Automated segmentation and quantification of the healthy and diseased aorta in CT angiographies using a dedicated deep learning approach.

Objectives: To develop and validate a deep learning-based algorithm for segmenting and quantifying the physiological and diseased aorta in computed tomography angiographies.

Methods: CTA exams of the aorta of 191 patients (68.1 ± 14 years, 128 male), performed between 2015 and 2018, were retrospectively identified from our imaging archive and manually segmented by two investigators.

Accuracy of registration techniques and vascular imaging modalities in fusion imaging for aortic endovascular interventions: a phantom study.

Background: This study aimed to assess the error of different registration techniques and imaging modalities for fusion imaging of the aorta in a standardized setting using a anthropomorphic body phantom.

Materials And Methods: A phantom with the 3D printed vasculature of a patient suffering from an infrarenal aortic aneurysm was constructed. Pulsatile flow was generated via an external pump.

Heating of an Aortic Stent for Coarctation Treatment During Magnetic Particle Imaging and Magnetic Resonance Imaging-A Comparative In Vitro Study.

Purpose: To evaluate heating of a redilatable stent for the treatment of aortic coarctation in neonates and small children in the new imaging modality magnetic particle imaging and established magnetic resonance imaging.

Materials And Methods: The cobalt-chromium stent (BabyStent, OSYPKA AG, Rheinfelden, Germany) has a stent design which allows for redilatation and adjustment of the diameter from 6 to 16 mm for a use in aortic coarctation. The stent loses its radial integrity while opening at predetermined breaking points at a diameter of 14 mm or 16 mm, respectively.

Mechanical rotational thrombectomy in long femoropopliteal artery and bypass occlusions: risk factors for periprocedural peripheral embolization.

Purpose: We aimed to examine lesion characteristics influencing technical outcome and periprocedural peripheral embolization (PPE) during percutaneous mechanical rotational thrombectomy (PMT) of long femoropopliteal artery and bypass occlusions.

Methods: Retrospectively, 65 consecutive patients (43 male patients, mean age 70±12 years; Rutherford category I-III), undergoing PMT (Rotarex®, Straub Medical AG) with acutely/subacutely occluded femoropopliteal arteries/bypasses were included. Occlusions (mean length, 217±98 mm) were treated by PMT followed by percutaneous transluminal angioplasty (PTA) plus drug-coated balloon or PTA plus stenting/stentgrafting.

Magnetic Particle Imaging: In vitro Signal Analysis and Lumen Quantification of 21 Endovascular Stents.

Purpose: Endovascular stents are medical devices, which are implanted in stenosed blood vessels to ensure sufficient blood flow. Due to a high rate of in-stent re-stenoses, there is the need of a noninvasive imaging method for the early detection of stent occlusion. The evaluation of the stent lumen with computed tomography (CT) and magnetic resonance imaging (MRI) is limited by material-induced artifacts.

Accuracy evaluation of patient-specific 3D-printed aortic anatomy.

Introduction: 3D printing has a wide range of applications in medicine. In surgery, this technique can be used for preoperative planning of complex procedures, production of patient specific implants, as well as training. However, accuracy evaluations of 3D vascular models are rare.

[Computed tomography or cardiovascular magnetic resonance imaging for diagnosis of chronic coronary syndrome?].

Background: Noninvasive imaging modalities are of central importance in the diagnosis of chronic coronary syndrome (CCS) in the current guidelines of the European Society of Cardiology (ESC), while the role of primary invasive coronary angiography in this context is increasingly being questioned. This review provides a summary of the most important diagnostic strategies from the radiology perspective.

Methodological Issue: The diagnostic algorithm is guided by the pretest probability (PTP) for the presence of CCS, which can be estimated based on age, sex, and symptoms.

Post-dilatation of an interwoven nitinol stent using a paclitaxel-coated balloon for revascularization of complex femoro-popliteal lesions.

To evaluate technical success, safety and efficacy of post-dilatation of an interwoven nitinol stent using a paclitaxel-coated balloon (PCB) for revascularization of complex femoro-popliteal lesions. Thirty patients (26 male, mean age 70 ± 7 years) suffering from peripheral artery disease (PAD) (Rutherford category II-III) underwent revascularization of chronic total occlusions (n = 22, 73%) or severe stenosis (n = 8, 27%) of the femoro-popliteal segment. Mean lesion length was 251 ± 85 mm.

Accelerating Therapeutics for Opportunities in Medicine: A Paradigm Shift in Drug Discovery.

Conventional drug discovery is long and costly, and suffers from high attrition rates, often leaving patients with limited or expensive treatment options. Recognizing the overwhelming need to accelerate this process and increase success, the ATOM consortium was formed by government, industry, and academic partners in October 2017. ATOM applies a team science and open-source approach to foster a paradigm shift in drug discovery.

The generality of the GUGA MRCI approach in COLUMBUS for treating complex quantum chemistry.

The core part of the program system COLUMBUS allows highly efficient calculations using variational multireference (MR) methods in the framework of configuration interaction with single and double excitations (MR-CISD) and averaged quadratic coupled-cluster calculations (MR-AQCC), based on uncontracted sets of configurations and the graphical unitary group approach (GUGA). The availability of analytic MR-CISD and MR-AQCC energy gradients and analytic nonadiabatic couplings for MR-CISD enables exciting applications including, e.g.

Rapid study assessment in follow-up whole-body computed tomography in patients with multiple myeloma using a dedicated bone subtraction software.

Objectives: The diagnostic reading of follow-up low-dose whole-body computed tomography (WBCT) examinations in patients with multiple myeloma (MM) is a demanding process. This study aimed to evaluate the diagnostic accuracy and benefit of a novel software program providing rapid-subtraction maps for bone lesion change detection.

Methods: Sixty patients (66 years ± 10 years) receiving 120 WBCT examinations for follow-up evaluation of MM bone disease were identified from our imaging archive.

AI Meets Exascale Computing: Advancing Cancer Research With Large-Scale High Performance Computing.

The application of data science in cancer research has been boosted by major advances in three primary areas: (1) Data: diversity, amount, and availability of biomedical data; (2) Advances in Artificial Intelligence (AI) and Machine Learning (ML) algorithms that enable learning from complex, large-scale data; and (3) Advances in computer architectures allowing unprecedented acceleration of simulation and machine learning algorithms. These advances help build ML models that can provide transformative insights from data including: molecular dynamics simulations, next-generation sequencing, omics, imaging, and unstructured clinical text documents. Unique challenges persist, however, in building ML models related to cancer, including: (1) access, sharing, labeling, and integration of multimodal and multi-institutional data across different cancer types; (2) developing AI models for cancer research capable of scaling on next generation high performance computers; and (3) assessing robustness and reliability in the AI models.

Fusion Imaging Reduces Radiation and Contrast Medium Exposure During Endovascular Revascularization of Iliac Steno-Occlusive Disease.

Introduction: To evaluate feasibility, safety and efficacy of fusion imaging in order to guide endovascular revascularization of iliac steno-occlusive disease.

Materials And Methods: Retrospectively, we identified twenty-six patients (20 male, mean age 63 ± 8y; Rutherford II-V) who underwent revascularization of a chronic total occlusion (n = 6; 23%) or severe stenosis (n = 20; 77%) of the common and/or external iliac artery. Median lesion length was 33 mm (IQR 20-60).

Patient-Reported Nonadherence with Glaucoma Therapy.

Effective glaucoma therapy relies to a great extent on the patients' ability to regularly self-administer eye drops. This study aimed to assess self-reported nonadherence and to identify potential barriers to adherence in glaucoma patients. Participants completed a 16-item questionnaire, designed to examine nonadherence rate and assess the therapy experience.