Objective: In radiation therapy, cancerous region segmentation in magnetic resonance images (MRI) is a critical step. For rectal cancer, the automatic segmentation of rectal tumors from an MRI is a great challenge. There are two main shortcomings in existing deep learning-based methods that lead to incorrect segmentation: 1) there are many organs surrounding the rectum, and the shape of some organs is similar to that of rectal tumors; 2) high-level features extracted by conventional neural networks often do not contain enough high-resolution information. Therefore, an improved U-Net segmentation network based on attention mechanisms is proposed to replace the traditional U-Net network.
Methods: The overall framework of the proposed method is based on traditional U-Net. A ResNeSt module was added to extract the overall features, and a shape module was added after the encoder layer. We then combined the outputs of the shape module and the decoder to obtain the results. Moreover, the model used different types of attention mechanisms, so that the network learned information to improve segmentation accuracy.
Results: We validated the effectiveness of the proposed method using 3773 2D MRI datasets from 304 patients. The results showed that the proposed method achieved 0.987, 0.946, 0.897, and 0.899 for Dice, MPA, MioU, and FWIoU, respectively; these values are significantly better than those of other existing methods.
Conclusion: Due to time savings, the proposed method can help radiologists segment rectal tumors effectively and enable them to focus on patients whose cancerous regions are difficult for the network to segment.
Significance: The proposed method can help doctors segment rectal tumors, thereby ensuring good diagnostic quality and accuracy.
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http://dx.doi.org/10.1186/s12880-024-01269-6 | DOI Listing |
Colorectal Dis
January 2025
Division of General Surgery, Department of Surgery, Queen's University, Kingston, Ontario, Canada.
Aim: Local excision (LE) for T1 rectal cancer may be recommended in those with low-risk disease, while resection is typically recommended in those with a high risk of luminal recurrence or lymph node metastasis. The aim of this work was to compare survival between resection and LE.
Method: This was a population-based retrospective cohort study set in the Canadian province of Ontario.
J Clin Med
December 2024
General Surgery Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Colorectal cancer (CRC) is the third most diagnosed cancer worldwide and the second most common cause of cancer death. About 20% of patients diagnosed with rectal cancer present with emergency symptoms. Typical symptoms include acute bleeding, obstruction, and perforation.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Surgery, Rabin Medical Center-Hasharon Hospital, Faculty of Medicine, Tel Aviv University, Petach Tikva 49100, Israel.
Transanal endoscopic microsurgery (TEM) is a minimally invasive approach for excising rectal polyps, particularly those with high-grade dysplasia (HGD) or early-stage rectal cancer (T1). This study aimed to evaluate the recurrence risk and its associated factors in patients treated with TEM for HGD and T1 rectal tumors. A retrospective review was conducted on 79 patients who underwent TEM for rectal lesions at Rabin Medical Center-Hasharon Hospital from 2005 to 2019.
View Article and Find Full Text PDFDiagnostics (Basel)
January 2025
2nd Department of Obstetrics and Gynecology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
Retrorectal cystic hamartomas ("Tailgut cysts") are rare developmental cysts that appear in the retrorectal space, arising from aberrant remnants of the post-anal primitive gut in case of an incomplete embryogenetic involution. We present the case of a 30-year-old woman with a history of chronic lower abdominal pain. Other digestive symptoms, like rectal fullness, constipation, pain on defecation, rectal bleeding or genitourinary obstruction symptoms, were not associated.
View Article and Find Full Text PDFCell Rep Med
January 2025
Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Key Laboratory of Precision Radiation Oncology, Wuhan, China. Electronic address:
In our previously reported phase 2 and phase 3 studies, the combination of short-course radiotherapy and neoadjuvant immunochemotherapy (SIC) is established as effective cancer therapies for locally advanced rectal cancer (LARC). Here, we apply multi-omic analyses to paired pre- and post-treatment LARC specimens undergoing SIC. The peripheral blood-derived TREM1 mono-macrophage subsets that display a pro-inflammatory phenotype are identified and correlate with complete response to SIC.
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