Topic: Artificial Intelligence Techniques for The Prediction of Bladder Cancer Progression

This research paper is about the use of Artificial Intelligence in predicting bladder cancer
outcome. Due to statistical analysis that has a bad accuracy and not applicable to the individual,
new techniques for tumor behavior prediction is really needed for improving the patient
healthcare. Both patients and physicians in the future would get obvious benefit with the accurate
prediction of future cancer behavior. This is because the patients with non-relapsing tumor could
be safely reassured and discharged, while relapsing tumors could be treated more aggressively.
The discovery of robust biomarkers combined with improved methods of data modeling is likely
to deliver this ability.
In this research, 122 patients with primary TCC of the bladder were studied. The median age at
diagnosis was 70 years, the majority patients were male (65%) and 62% were smokers. Using
NFM and ANN, two models were developed in this studies which are a classifier and a predictor.
The classifier will predict the possibility of a tumor relapse (yes or no) while the predictor will
predict the relapse timing (months after surgery). These two models were then combined
together in series, thus predicting if and when a relapse would occur, to produce the most
clinically useful model. To determine the putative molecular biomarkers values, the data were
analyzed 4 ways in each model where analysis A studied only about standard clinicopathological
data (cancer stage, grade, age, sex, smoking, other cancers), analysis B there was an additional
p53 molecular putative biomarker, analysis C was based on the standard clinicopathological data
plus the degree of methylation in a tumour, and analysis D was the same as C plus RARB
(sensitive predictor of tumor behavior).
Both NFM and ANN methods were developed using software called Matlab and they were
trained on 90% of the patients before testing on the final 10%. This was then repeated through a
test called ensembling, where all the patients tested the model. In each session, there would be
10 models available and only the best model selected in the end. The best fit model was then
re-tested for producing and getting the final results. In a traditional statistical analysis, a logistic
regression (LR) was performed for obtaining the tumor relapses probability. With these three
methods available for prediction of bladder cancer, the accuracy of ANN, NFM and LR were
then performed and compared statistically.
From the results obtained (scatter plots of time of predicted relapse vs time of actual relapse), AI
methods show greater accuracy in predicting tumor behavior than traditional methods. However,
in AI method, better prediction and more accurate result was shown by NFM than ANN in this
study. Before AI method was introduced, LR was the best in predicting the behavior of the tumor
but due to bad accuracy of tumor prediction and the fact that a general probability is not
applicable to an individual patient, LR method needs to be improved.
This research study has shown that NFM produces better result than LR, and it is equivalent to or
better than ANN method. NFM approach is transparent compared to ANN which using the
blackbox approach. The NFM approach enables the assessment of the importance of individual
markers and the representation of problem-specific qualitative modeling can be easily translated
into more simplified and reasonable medical terms. To complete a profile for each variable in
NFM, a fuzzy logic model is used. The fuzzy logic model generates a set of parallel rules, which
are summated in series and interpreted to produce a quantitative output. Because of the fuzzy
representation is easily understandable, the expertise can be integrated into the assortment of the
inputs and the model rules manipulation. As a result, nonsensible variables, which may be
incidentally overrepresented in the training dataset, can be removed or have their importance
reduced.
As a conclusion, NFM appears to have a better prediction of bladder cancer rather than ANN and
LR. This is due to NFMs transparency, its ability to integrate expertise, its good presentation
with sparse data and its capability to opt for the most practical input criteria

Reference:
Abbod, M. F., Catto, J. W., Chen, M. Y., Linkens, D. A., & Hamdy, F. C. (2005, April).
Artificial intelligence techniques for the prediction of bladder cancer progression. In ESANN.