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David B. Agus, MD
Professor of Medicine and Engineering
Founding Director and CEO
Lawrence J. Ellison Institute for Transformative Medicine
University of Southern California
Los Angeles, California
Goal: To create novel tools that will improve breast cancer diagnosis and outcome prediction.
Impact: Dr. Agus is using advanced technologies to produce 3-D images of the structure of breast tumors and the location of cells within them. Such a highly detailed view of tumor tissue could provide information about a tumor’s aggressiveness and predict prognosis.
What’s next: He and his team will use artificial intelligence (AI) techniques to explore the relationship of the structure of tumors to the degree of lymph node involvement.
To determine breast cancer subtype, pathologists study thinly cut, flat tissue slices under a microscope. This 2-dimensional view, however, does not provide the level of detail that would reveal crucial information about a patient’s prognosis, such as whether the cancer is contained or invasive. Dr. Agus is investigating whether AI can produce 3D images that clearly show patterns of cells, fat and connective tissue that are used to predict a patient’s prognosis.
Full Research Summary
Research area: To explore the ability of artificial intelligence-enhanced digital pathology analysis of breast cancer specimens to improve diagnosis and outcome prediction.
Impact: The best avenue for effective breast cancer treatment depends on the ability to discern specific patient subtypes from tumor samples. Currently, this is achieved by two-dimensional slicing of tumor samples and viewing them under a microscope. Dr. Agus is investigating the efficacy of three-dimensional analysis and has developed an artificial intelligence-based algorithm to enhance such analyses. He hopes that this will provide a better understanding of how 3D tumor architecture might aid in more accurately assessing patient prognosis and disease outcome.
Current investigation: He and his colleagues have been investigating digital pathology in breast cancer specimens, specifically, the three-dimensional architecture of tumors and how this may be related to disease outcomes. They are now employing an AI algorithm to better analyze tumor samples and create new architecture-based breast cancer predictors.
What he’s learned so far: Dr. Agus assesses tumor structure in three dimensions. He uses sequential tumor slices and, by computer, digitally stacks the images of dozens of slices together to visualize tumor structure in depth. This technique provides precise three-dimensional locations of all cells within the tumor thus enabling the use of advanced data analysis techniques to find architectural patterns that may relate to disease outcomes. The complexity of these three-dimensional arrangements makes analysis by eye difficult and has necessitated the development of AI assisted techniques. Dr. Agus has developed an AI algorithm to facilitate such analyses.
What’s next: The team will use the AI algorithm they have developed to ascertain tumor architectures and relate them to the degree of lymph node involvement, a key prognostic indicator in breast cancer. They will thereby be able to determine how much more clinical information can be gleaned from tissue structure in three dimensions.
David Agus is professor of medicine and engineering at the University of Southern California, where he is the founding CEO of USC’s Lawrence J. Ellison Institute for Transformative Medicine. Dr. Agus leads a multidisciplinary team of researchers dedicated to the development and use of technologies to guide doctors in making health-care decisions tailored to individual needs, and directs a National Cancer Institute Physical Sciences in Oncology Center at USC. He is a medical oncologist and an international leader in new technologies and approaches for personalized healthcare. He serves as a CBS News contributor. Dr. Agus’ first book, The End of Illness, was published in 2012 and is a New York Times #1 and international best seller, and subject of a PBS special. His second book, New York Times best-selling A Short Guide to a Long Life, was published January 2014, and his newest book The Lucky Years: How to thrive in the brave new world of health, also a New York Times bestseller was published in 2016. He is a 2017 recipient of the Ellis Island Medal of Honor.