Automated system for supporting medical decision-making in the treatment of patients with renal parenchyma neoplasms – first experience of using the web-platform «Sechenov.AI_nephro» – results of multicenter testing

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Аннотация

Corresponding author: A.A. Zholdubaev – urologist, Ph.D. student, Institute of Urology and Reproductive Health, FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia; е-mail: dr_agabek@mail.ru

Aim. To evaluate the automated medical decision support system «Sechenov.AI_nephro» in the treatment of patients with renal parenchymal tumors.

Materials and methods: The beta version of the web-platform «Sechenov.AI_nephro» consists of a neural network based on MONAI (Medical open network for AI) and a web interface, with algorithms classified based on segmentation data in manual mode using the 3D modeling program «Amira». A total of 441 patients with renal parenchymal tumors were included in the multicenter prospective study. Testing was carried out over 12 months in 3 urological centers: 358 (81.2%) patients from I.M. Sechenov First Moscow State Medical University, Moscow; 73 (16.6%) patients from Bashkir State Medical University; and 10 (2.3%) patients from Saratov State Medical University named after V.I. Razumovsky. In all cases, contrast-enhanced computed tomography (CT) was performed preoperatively. DICOM (Digital Imaging and Communications in Medicine) data of each patient's CT was uploaded to the web-platform «Sechenov.AI_nephro» for automatic construction of a 3D model of the tumor. The work of the web-platform «Sechenov.AI_nephro» was evaluated based on a questionnaire completed by surgeons who performed the surgical intervention. The questionnaire consisted of 14 questions, with a scoring system from 1 to 10 points. It was divided into 3 main sections, including first for assessment of the quality of work of the web-platform «Sechenov.AI_nephro»; second for evaluation of the use of the 3D model in communication with the patient, for surgical planning and intraoperative navigation; and third for analysis of the choice of useful data display mode, errors in constructing the 3D model.

Results. The questionnaire was completed in 253 (57.37% of 441) cases. The quality of 3D models was rated 7.8–9.4 points, and the use of the 3D model in communication with the patient, for surgical planning and intraoperative navigation was rated 7.8–9.4 points. The 3D models were constructed correctly in 70% of cases. The area of interest was the useful mode of 3D models display in surgical planning. Incorrectly constructed anatomical elements were veins in 25.5% and the tumor in 26.4% of cases, respectively.

Conclusion. The automated medical decision support system in the treatment of patients with renal parenchymal tumors «Sechenov.AI_nephro» demonstrated satisfactory quality of 3D reconstruction of pathological process. 3D models allow for personalized determination of the surgical tactic for treating patients with renal tumors.

Толық мәтін

Рұқсат жабық

Авторлар туралы

A. Zholdubaev

FGAOU VO I.M. Sechenov First Moscow State Medical University

Хат алмасуға жауапты Автор.
Email: dr_agabek@mail.ru

urologist, Ph.D. student, Institute of Urology and Reproductive Health

Ресей, Moscow

P. Glybochko

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: glybochko_v_p@staff.sechenov.ru

Ph.D., MD, academician of RSA, rector, Institute of Urology and Reproductive Health

Ресей, Moscow

Yu. Alyaev

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: ugalyaev@mail.ru

corresponding member of RAS, Ph.D., MD, professor at the Institute of Urology and Reproductive Health

Ресей, Moscow

D. Butnaru

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: butnaru_d_v@staff.sechenov.ru

Ph.D., MD, urologist, Chief Physician of the University Clinical Hospital No. 1, Institute of Urology and Reproductive Health

Ресей, Moscow

E. Shpot

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: shpot@inbox.ru

Ph.D., MD, urologist, oncologist, deputy director on scientific work at the Department of Urology at the Institute for Urology and Human Reproductive Health 

Ресей, Moscow

M. Chernenky

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: chernenkiy_m_m@staff.sechenov.ru

physical engineer, Institute of Urology and Reproductive Health

Ресей, Moscow

I. Chernenky

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: chernenkiy_i_m@staff.sechenov.ru

software engineer at the Institute of Urology and Reproductive Health

Ресей, Moscow

D. Fiev

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: fiev_d_n@staff.sechenov.ru

Ph.D., MD, urologist, chief researcher at the Institute of Urology and Reproductive Health

Ресей, Moscow

A. Proskura

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: proskura_a_v_1@staff.sechenov.ru

Ph.D., urologist, oncologist, assistant of the Institute for Urology and Human Reproductive Health 

Ресей, Moscow

A. Konyshev

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: urokulez@yandex.ru

urologist, applicant of the Institute of Urology and Reproductive Health

Ресей, Moscow

E. Syrota

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: sirota_e_s@staff.sechenov.ru

Ph.D., MD, urologist, oncologist, Chief of the Center of Neural Network Technologies of Institute of Urology and Reproductive Health

Ресей, Moscow

H Ismailov

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: halilismailov2013@mail.ru

urologist, Ph.D. student, Institute of Urology and Reproductive Health

Ресей, Moscow

R. Shurygina

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: Yourolog@yandex.ru

Ph.D. student, Institute of Urology and Reproductive Health

Ресей, Moscow

S. Amrakhov

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: gradmonaco@yandex.ru

urologist, Ph.D. student, Institute of Urology and Reproductive Health

Ресей, Moscow

A. Izmailova

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: izmailovaa20@gmail.com

4-year student, Institute of Urology and Reproductive Health

Ресей, Moscow

I. Sarkisyan

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: ig.sark.0201@gmail.com

4-year student, Institute of Urology and Reproductive Health

Ресей, Moscow

A. Suvorov

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: suvorov_a_yu_1@staff.sechenov.ru

Chief Biostatistician, Research Services Division, Department of Scientific Development and Clinical Research, Institute of Urology and Reproductive Health

Ресей, Moscow

V. Pavlov

Bashkir State Medical University of the Ministry of Health of Russia

Email: pavlov@bashgmu.ru

academician of RAS, professor, Ph.D., MD, Director of the Institute of Urology and Clinical Oncology, rector 

Ресей, Ufa

I Kabirov

Bashkir State Medical University of the Ministry of Health of Russia

Email: ildarkabirov@gmail.com

Ph.D., associate professor at the Department of Urology and Oncology 

Ресей, Ufa

M. Urmantsev

Bashkir State Medical University of the Ministry of Health of Russia

Email: urmantsev85@mail.ru

Ph.D., Head of the Department of Oncology of the Clinic 

Ресей, Ufa

D. Baykov

Bashkir State Medical University of the Ministry of Health of Russia

Email: dr_agabek@mail.ru

Ph.D., MD, professor at the Department of General Surgery with a course of transplantology and X-ray diagnoctics

Ресей, Ufa

A. Itkulov

Bashkir State Medical University of the Ministry of Health of Russia

Email: dr_agabek@mail.ru

Head of the Laboratory of radionuclide diagnostics 

Ресей, Ufa

M. Khafizov

Bashkir State Medical University of the Ministry of Health of Russia

Email: dr_agabek@mail.ru

Head of the X-ray department of the Clinic

Ресей, Ufa

R. Gilmetdinov

Bashkir State Medical University of the Ministry of Health of Russia

Email: dr_agabek@mail.ru

radiologist of the Laboratory of radionuclide diagnostics 

Ресей, Ufa

A. Antipina

Bashkir State Medical University of the Ministry of Health of Russia

Email: dr_agabek@mail.ru

radiologist of the Laboratory of radionuclide diagnostics 

Ресей, Ufa

A. Rossolovsky

Saratov State Medical University named after V.I. Razumovsky of the Ministry of Health of Russia

Email: rossol@list.ru

Ph.D., MD, associate professor, Deputy chief on the Surgery of University Clinical Hospital No1

Ресей, Saratov

D. Durnov

Saratov State Medical University named after V.I. Razumovsky of the Ministry of Health of Russia

Email: dendurnov@mail.ru

Ph.D., associate professor, Head of the Department of Oncourology of University Clinical Hospital No1

Ресей, Saratov

D. Bobylev

Saratov State Medical University named after V.I. Razumovsky of the Ministry of Health of Russia

Email: dreik2006@mail.ru

Ph.D., assistant at the Department of X-ray Diagnostics named after prof. N.E. Stern of University Clinical Hospital No1

Ресей, Saratov

S. Ivanov

Saratov State Medical University named after V.I. Razumovsky of the Ministry of Health of Russia

Email: ivanovsd24@gmail.ru

assistant at the Department of X-ray Diagnostics named after prof. N.E. Stern, radiologist at the University Clinical Hospital No1

Ресей, Saratov

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1. JATS XML
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2. Fig. 1. MSCT with contrast in three planes: A - axial, B - sagittal and C - frontal (the neoplasm is indicated by a red circle and an arrow)

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3. Рис. 2. Заполнение клинических и демографических данных пациента

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4. Fig. 3. Uploading DICOM data to the web platform "Sechenov.AI_nephro"

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5. Fig. 4. Definition of 4 phases of MSCT in the interface of the web platform "Sechenov.AI_nephro": 1 - native phase, 2 - arterial phase, 3 - venous phase, 4 - excretory phase

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6. Fig. 5. Determination of the area of ​​interest by the arterial phase of MSCT in three planes: A - axial, B - sagittal and C - frontal

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7. Fig. 6 ED model of the pathological process of a tumor of the left kidney (A - neoplasm of the parenchyma of the left kidney, B - the area of ​​the hilum of the right kidney, C - the area of ​​the hilum of the left kidney, D - the inferior vena cava, E - the aorta)

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8. Fig. 7. Virtual planning of surgery on the web platform “Sechenov.AI_nephro”

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9. Fig. 8. Questionnaire for surveying urologists

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