Chiu Hwa-Yen, Chao Heng-Sheng, Chen Yuh-Min
Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan.
Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
Cancers (Basel). 2022 Mar 8;14(6):1370. doi: 10.3390/cancers14061370.
Lung cancer is the leading cause of malignancy-related mortality worldwide due to its heterogeneous features and diagnosis at a late stage. Artificial intelligence (AI) is good at handling a large volume of computational and repeated labor work and is suitable for assisting doctors in analyzing image-dominant diseases like lung cancer. Scientists have shown long-standing efforts to apply AI in lung cancer screening via CXR and chest CT since the 1960s. Several grand challenges were held to find the best AI model. Currently, the FDA have approved several AI programs in CXR and chest CT reading, which enables AI systems to take part in lung cancer detection. Following the success of AI application in the radiology field, AI was applied to digitalized whole slide imaging (WSI) annotation. Integrating with more information, like demographics and clinical data, the AI systems could play a role in decision-making by classifying EGFR mutations and PD-L1 expression. AI systems also help clinicians to estimate the patient's prognosis by predicting drug response, the tumor recurrence rate after surgery, radiotherapy response, and side effects. Though there are still some obstacles, deploying AI systems in the clinical workflow is vital for the foreseeable future.
肺癌因其异质性特征和晚期诊断,是全球恶性肿瘤相关死亡的主要原因。人工智能(AI)擅长处理大量的计算和重复性劳动工作,适用于协助医生分析如肺癌这类以图像为主的疾病。自20世纪60年代以来,科学家们长期致力于将AI应用于通过胸部X光片(CXR)和胸部CT进行肺癌筛查。举办了几次重大挑战赛以寻找最佳的AI模型。目前,美国食品药品监督管理局(FDA)已批准了多个用于CXR和胸部CT读片的AI程序,这使得AI系统能够参与肺癌检测。随着AI在放射学领域应用的成功,AI被应用于数字化全切片成像(WSI)标注。通过整合更多信息,如人口统计学和临床数据,AI系统可以通过对表皮生长因子受体(EGFR)突变和程序性死亡受体配体1(PD-L1)表达进行分类,在决策中发挥作用。AI系统还通过预测药物反应、术后肿瘤复发率、放疗反应和副作用,帮助临床医生评估患者的预后。尽管仍存在一些障碍,但在可预见的未来,在临床工作流程中部署AI系统至关重要。