Browsing by Author "Pendse, Avani A"

Now showing 1 - 3 of 3
  • Thumbnail Image
    ItemOpen Access
    A Deep-Learning Algorithm for Thyroid Malignancy Prediction From Whole Slide Cytopathology Images
    Dov, David; Kovalsky, Shahar Z; Assaad, Serge; Cohen, Jonathan; Range, Danielle Elliott; Pendse, Avani A; Henao, Ricardo; Carin, Lawrence
    We consider thyroid-malignancy prediction from ultra-high-resolution whole-slide cytopathology images. We propose a deep-learning-based algorithm that is inspired by the way a cytopathologist diagnoses the slides. The algorithm identifies diagnostically relevant image regions and assigns them local malignancy scores, that in turn are incorporated into a global malignancy prediction. We discuss the relation of our deep-learning-based approach to multiple-instance learning (MIL) and describe how it deviates from classical MIL methods by the use of a supervised procedure to extract relevant regions from the whole-slide. The analysis of our algorithm further reveals a close relation to hypothesis testing, which, along with unique characteristics of thyroid cytopathology, allows us to devise an improved training strategy. We further propose an ordinal regression framework for the simultaneous prediction of thyroid malignancy and an ordered diagnostic score acting as a regularizer, which further improves the predictions of the network. Experimental results demonstrate that the proposed algorithm outperforms several competing methods, achieving performance comparable to human experts.
  • Thumbnail Image
    ItemOpen Access
    Refractory Cytomegalovirus Colitis Followed by De Novo Inflammatory Bowel Disease Post-Orthotopic Liver Transplantation.
    (ACG case reports journal, 2023-12) Selvan, Bharathi; Pendse, Avani A; Zhang, Cecelia; Cauthen, Jeffriann; Kappus, Matthew R; Messina, Julia A
    Cytomegalovirus (CMV) and inflammatory bowel disease (IBD) are both immune-mediated complications that affect orthotopic liver transplantation patients. In this report, we present a 60-year-old man who underwent orthotopic liver transplantation for cryptogenic cirrhosis with serologies notable for CMV-seropositive donor and seronegative recipient. His post-transplant course was initially complicated by probable refractory CMV colitis. However, his gastrointestinal symptoms persisted, eventually leading to a diagnosis of post-transplant de novo IBD. The discussion highlights theories regarding the association between CMV and IBD, a topic that has been widely debated for decades.
  • Thumbnail Image
    ItemOpen Access
    Successful Diagnosis and Treatment of Occult Prostate Cancer Despite Multiple Negative Prostate Biopsies and Negative Prostate MRIs.
    (Oncology (Williston Park, N.Y.), 2022-03) Morris, Kostantinos E; Grimberg, Dominic C; Gupta, Rajan T; Pendse, Avani A; Moul, Judd W
    Prostate-specific antigen (PSA) values above 100 ng/mL often suggest metastatic prostate cancer. We present the case of a patient with a PSA of 110 ng/mL, 4 negative prostate biopsies, and 4 negative prostate MRIs. After his fifth MRI revealed a PI-RADS 5 lesion, he underwent his fifth transrectal biopsy; this revealed Gleason 3 + 4 = 7. He was found to have organ-confined pT2 disease on subsequent radical prostatectomy pathology. This case highlights that there may be no PSA for which one can assume metastatic disease with certainty. Depending on life expectancy, patients with extremely elevated PSA may still warrant a full staging workup.