Smartphone image analysis for real time adequacy assessment during kidney biopsy

智能手机图像分析用于肾活检期间实时充分性评估

• 批准号: 10546275
• 负责人: Vijaya B. Kolachalama
• 金额: $ 25.21万
• 依托单位: NEPHROPATHOLOGY ASSOCIATES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10546275
• 关键词: Adoption; Algorithmic Analysis; Algorithms; Biopsy; Boston; Caliber; Cellular Phone; Consensus; Core Biopsy; Data; Data Set; Diagnosis; Ensure; Evaluation; Fatty acid glycerol esters; Feedback; Formalin; Goals; Guns; Healthcare Systems; Image; Image Analysis; Kidney; Kidney Diseases; Laboratories; Learning; Measures; Medical; Microscope; Modeling; Needle biopsy procedure; Needles; Paraffin Embedding; Pathologist; Patient Care; Patient risk; Patients; Phase; Physicians; Procedures; Process; Research; Resources; Risk; Sampling; Secure; Slide; Stains; Standardization; Testing; Time; Tissues; Training; Translations; United Network for Organ Sharing; Universities; accurate diagnosis; capsule; deep learning model; deep neural network; improved; interest; kidney biopsy; kidney cortex; kidney imaging; kidney medulla; lens; precision medicine; predictive modeling; preference; programs; radiologist; response; smartphone Application; technology development; tool; virtual

SUMMARY. The goal of this project is to develop image analysis tools that can be deployed as a smartphone application to aid in the real time assessment of biopsy adequacy during percutaneous renal biopsy (PRB) procedures. PRB remains an essential tool for the diagnosis and treatment of patients with medical kidney disease and involves obtaining a small needle core of tissue from the kidney with the use of a biopsy gun. A biopsy is deemed “adequate” if sufficient renal cortical tissue is obtained to meet criteria for rendering a histopathologic diagnosis. If insufficient tissue is obtained, or if the tissue does not contain renal cortex with enough glomeruli, then the core is deemed “inadequate”. Over the last 15 years, the rate of kidney biopsies that are inadequate for complete diagnosis due to insufficient tissue has risen to 15%, representing a significant drain on the health care system as well as a direct risk to patients who must be re-biopsied or go without an accurate diagnosis. Ideally, adequacy can be assessed at the time of biopsy by examination of the obtained cores under a microscope by a pathologist. Such real time assessment enables the biopsy physician to obtain additional cores of tissue if existing cores are deemed to be inadequate. However, resource constraints have markedly limited the availability of adequacy evaluation within many biopsy suites. With the widespread adoption of smartphones, there is now an opportunity to evaluate biopsy tissue via macro images instead of a microscope. An additional step is to build image analysis capabilities into an application on the smartphone, thus enabling the biopsy physician to obtain reliable instantaneous feedback about whether the material they have collected is sufficient or whether the biopsy “missed”, and more tissue needs to be obtained. A recent study of 123,372 native kidney biopsies found that the miss rate in PRB increased markedly from 2% in 2005 to 14% in 2020, largely attributed to the increased involvement of radiologists performing the biopsies and their preference for smaller diameter biopsy needles. This increase in kidney biopsy miss rate significantly impacts patient care in the management of medical kidney disease and highlights the need for improved tools for assessing the adequacy of tissue collected before the patient leaves the biopsy suite. In Phase I, Arkana Laboratories will collaborate with the Kolachalama laboratory at Boston University using biopsy cores taken from unused deceased donor kidneys to develop a deep neural network that can accurately classify which portions of a biopsy core represent renal cortex vs non-cortex tissue, which may include renal medulla, perirenal fat, fibrous capsule, and non-renal tissue. In Phase II, we will extend these efforts using images taken from kidney biopsies received by Arkana to optimize the algorithmic assessment of adequacy and then use these results to develop a professional version of the smartphone application that will be available to all kidney biopsy practitioners using virtually any smartphone camera.

概括。该项目的目的是开发可以部署为智能手机的图像分析工具 应用肾脏活检（PRB）期间活检充分性的实时评估 程序。 PRB仍然是诊断和治疗医疗肾脏患者的必不可少的工具 疾病，涉及使用活检枪从肾脏中获取组织的小针芯。一个 如果获得足够的肾皮质组织，则认为活检是“足够的” 组织病理学诊断。如果获得组织不足，或者组织不包含肾皮质 足够的glomerulli，然后将核心视为“不足”。在过去的15年中，肾脏活检率 由于组织不足，由于不足而无法完全诊断，已上升到15％，代表大量排水 在医疗保健系统上，以及必须重新生成或无准确的患者的直接风险 诊断。理想情况下，可以通过检查在活检时检查适当性，通过检查在 病理学家的显微镜。这样的实时评估使活检能够获得更多 组织核，如果现有核心被认为不足。但是，资源限制明显 限制了许多活检套件中充足性评估的可用性。采用宽度 智能手机现在有机会通过宏观图像而不是显微镜评估活检组织。 另一个步骤是将图像分析功能构建到智能手机上的应用程序中，从而实现 活检物理学人获得有关其收集的材料是否为的可靠的瞬时反馈 充分或需要“错过”活检，需要获得更多的组织。最近对123,372本人的研究 肾脏活检发现，PRB的失误率从2005年的2％显着提高到2020年的14％，在很大程度上 归因于进行活检的放射性者的参与增加及其对较小的偏好 直径活检针。肾脏活检率的增加显着影响 治疗医疗肾脏疾病，并强调需要改进的工具来评估 在患者离开活检套件之前收集的组织的充分性。在第一阶段，阿卡纳实验室 将使用未使用的活检核与波士顿大学的Kolachalama实验室合作 已故的捐助者孩子开发一个深层神经网络，可以准确地对活检的哪些部分进行分类 核心代表肾皮质与非皮质组织，其中可能包括肾脏髓质，周围脂肪，纤维囊， 和非肾脏组织。在第二阶段，我们将使用收到的肾脏活检拍摄的图像来扩展这些努力 Arkana通过优化对充分性的算法评估，然后使用这些结果来开发 使用智能手机应用程序的专业版本将使用所有肾脏活检从业者使用 几乎任何智能手机相机。