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Abdominal Radiology – Study using texture analysis (TexRAD) of the liver at MDCT for assessing hepatic fibrosis – Feedback plc
By Lubner MG, et al. Abdom Radiol (NY). 2017. Source PubMed.
PURPOSE: To evaluate CT texture analysis (CTTA) for staging of hepatic fibrosis (stages F0-F4) METHODS: Quantitative texture analysis (QTA) of the liver was performed on abdominal MDCT scans using commercially available software (TexRAD), which uses a filtration-histogram statistic-based technique. Single-slice ROI measurements of the total liver, Couinaud segments IV-VIII, and segments I-III were obtained. CTTA parameters were correlated against fibrosis stage (F0-F4), with biopsy performed within one year for all cases with intermediate fibrosis (F1-F3).
RESULTS: The study cohort consisted of 289 adults (158M/131W; mean age, 51 years), including healthy controls (F0, n = 77), and patients with increasing stages of fibrosis (F1, n = 42; F2 n = 37; F3 n = 53; F4 n = 80). Mean gray-level intensity increased with fibrosis stage, demonstrating an ROC AUC of 0.78 at medium filtration for F0 vs F1-4, with sensitivity and specificity of 74% and 74% at cutoff 0.18. For significant fibrosis (≥F2), mean showed AUCs ranging from 0.71-0.73 across medium- and coarse- filtered textures with sensitivity and specificity of 71% and 68% at cutoff of 0.3, with similar performance also observed for advanced fibrosis (≥F3). Entropy showed a similar trend. Conversely, kurtosis and skewness decreased with increasing fibrosis, particularly in cirrhotic patients. For cirrhosis (≥F4), kurtosis and skewness showed AUCs of 0.86 and 0.87, respectively, at coarse-filtered scale, with skewness showing a sensitivity and specificity of 84% and 75% at cutoff of 1.3.
CONCLUSION: CTTA may be helpful in detecting the presence of hepatic fibrosis and discriminating between stages of fibrosis, particularly at advanced levels.
Dr Ganeshan, Director of New Business at Feedback Plc stated, “This study, and a number of others recently published in the run up to the European Congress of Radiology at the start of March serves to demonstrate the broad range of existing and potential new applications for TexRAD software. The recent high profile press coverage of MRI scan analysis for prostate cancer highlighted TexRAD’s potential to enhance early discovery of significant cancers. Similarly this study of texture analysis of the liver on routinely acquired CT scans highlights the potential of TexRAD to act as a non-invasive biomarker (tool) in the diagnosis of hepatic fibrosis and assessment of severity of the disease. This can potentially assist in minimising the need for frequent liver biopsies and additional examinations.”
Link here to view the PubMed article
Feedback (FDBK) – Re Media Articles
Feedback plc (AIM: FDBK), the medical imaging software company, is pleased to update shareholders following the recent media articles regarding the use of multi-parametric MRI scans for the diagnosis of prostate cancer.
It was widely reported in the national press and on the BBC website on 20 January 2017 that a trial led by Mr Hashim Ahmed, MRC Clinical Scientist and Honorary Consultant Urological Surgeon at University College London (“UCL”) found that over a quarter of men with a clinical suspicion of prostate cancer could avoid a biopsy if they undergo an MRI scan first.
Around 100,000 men are sent for a biopsy each year in Britain following blood tests showing a raised prostate-specific antigen (PSA) score which suggest prostate cancer might be present. But many will not have an aggressive tumour or cancer at all and run the risk of developing sepsis or urinary problems through the unnecessary exploratory surgery.
Dr Balaji Ganeshan, Director of New Business at Feedback and Senior Imaging Scientist at UCL’s Institute of Nuclear Medicine, believes that the MRI scan analysis for prostate cancer could be improved further, according to data from another recently published study from UCL which included the use of TexRAD texture analysis software.
Typically up to 1,000 multi-parametric (mp) MRI images are taken per patient, looking at tumour size, how densely packed its cells are and its blood supply. There is an essential need to identify tumours in the transition zone of the prostate and differentiate between those of low clinical significance not requiring immediate treatment and those of high clinical significance which are generally aggressive tumours requiring treatment. This task of identification is difficult even for an experienced radiologist.
In a separate UCL retrospective study of 67 prostate cancer patients published in September 2016, it was shown that TexRAD analysis of mp-MRI images may be able to identify the presence of clinically significant prostate cancers in the transition zone and therefore could potentially assist in optimising the prostate radiologist’s workflow.
A further UCL study was presented at the International Society for Magnetic Resonance in Medicine (ISMRM 2016) in Singapore which demonstrated the application of TexRAD analysis of mp-MRI in peripheral zone prostate cancers in 66 patients.
Dr Ganeshan stated, “Approximately 30% of mp-MRI scans for peripheral zone prostate cancer are scored as ‘equivocal’. TexRAD analysis of prostate cancers in the peripheral zone on mp-MRI scans may differentiate which of these ‘equivocal’ cancers are clinically significant requiring further treatment and which are insignificant not requiring treatment. We believe the use of TexRAD software could be a step forward along the road to enhancing the MRI prostate scan reporting process.”
Further information on the UCL studies and other TexRAD research papers can be found on the links below:
http://dev.ismrm.org/2016/2496.html
http://texrad.com/papers-presentations /
BBC article:
http://www.bbc.co.uk/news/health-38665618
Daily Telegraph article:
http://www.telegraph.co.uk/science/2017/01/19/prostate-cancer-could-ruled-simple-mri-scan-prevents-25000-biopsies/
The Guardian article:
https://www.theguardian.com/society/2017/jan/19/mri-biopsy-prostate-cancer-diagnosis-research-nhs
For further information contact:
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Feedback plc |
Tel: 01954 718072 |
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Allenby Capital Limited (Nominated Adviser and Joint Broker) |
Tel: 020 3328 5656 |
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Peterhouse Corporate Finance Ltd (Joint Broker) Brand Communications |
Tel: 020 7469 0936 Tel: 07976 431608 |
Feedback PLC (FDBK) – Attendance at RSNA 2016
Feedback plc (AIM: FDBK), the medical imaging software company, is pleased to provide an update on the Company’s attendance at the 102nd Scientific Assembly and Annual Meeting of the Radiological Society of North America to be held 27 November – 2 December 2016, in Chicago, Illinois, USA. (“RSNA 2016”). This is the premier global event for radiologists and features scientific paper presentations and educational courses.
RSNA 2016 is expected to include 19 scientific paper presentations which contain results of TexRAD analysis. TexRAD is the Company’s patented texture analysis software which has been sold worldwide to leading centres of oncology research. Several further presentations are expected to review the broader potential of Computed Tomography Texture Analysis (CTTA) as a tool to assist clinicians in quantifying tissue heterogeneity and assessing primary lesions and response to therapy in multiple tumour types.
The results of the Company’s development work in conjunction with Alliance Medical Group are to be presented in an Informatics poster discussion entitled “PET/CT in Lung Cancer: An Automated Imaging Tool for Decision Support.” This preliminary study assesses the performance of an automated PET/CT analysis in lung cancer. An automated PET/CT lung cancer tool may standardise clinical performance whilst allowing access to quantitative texture analysis to improve prognostication and fit within clinical workflow.
Further information on the papers to be presented at RSNA 2016 can be found at https://rsna2016.rsna.org/program/
For further information contact:
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Feedback plc |
Tel: 01954 718072 |
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Allenby Capital Limited (Nominated Adviser and Joint Broker) |
Tel: 020 3328 5656 |
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Peterhouse Corporate Finance Ltd (Joint Broker) |
Tel: 020 7469 0936 |
Feedback PLC – ICENI Centre & ISLCRS study to investigate whether textural features of rectal cancer on Magnetic Resonance can predict long term survival
Magnetic resonance based texture parameters as potential imaging biomarkers for predicting long term survival in locally advanced rectal cancer patients.
Omer Jalil, Asim Afaq, Balaji Ganeshan, Uday Patel, Raymond Endozo, Darren Boone, Ashley Groves, David Humber, Tan Arulampalam
ICENI Centre
Colchester University Hospital
Colchester
CO4 5JL
Introduction:
Heterogeneity is a well-known feature of malignancy and is associated with adverse outcomes. Tumour heterogeneity can be quantified on imaging using textural analysis (TA), which assesses the distribution of pixel grey-level intensity, coarseness and regularity and have shown to predict survival outcomes in a number of oncological applications. The main objective of this study was to investigate whether textural features of rectal cancer on MR can predict long term survival.
Methodology:
Patients with primary non-metastatic locally advanced rectal adenocarcinoma treated with long course chemoradiotherapy (LCRT) with curative intent from 01/2006 to 06/2011 in our institution were included. TA of T2-weighted pre and post LCRT MR images was undertaken using TexRAD, a proprietary software algorithm (TexRAD Ltd www.texrad.com, part of Feedback Plc). Tumour region of interest (ROI) delineating the largest cross-sectional area underwent MRTA comprising an image filtration-histogram technique. Filtration step extracted features of different sizes (fine, medium, coarse – texture scales) followed by quantification of statistical features (mean intensity, standard-deviation, entropy, skewness, kurtosis and mean of positive pixels – MPP) using histogram analysis. Univariate Kaplan Meier analysis was used to assess the ability of the biomarkers (textures and other clinically employed radiological and histological features) to predict survival. Cox-multiple regression analysis determined which significant univariate markers were independent predictors of survival.
Results:
For overall survival (OS), pre-treatment texture features (MPP at fine-texture, p=0.008, Mean at medium-texture, p=0.03) were significant univaraite markers of OS. Using multi-variate analysis, these pre-treatment textures (MPP at fine-texture, HR: 6.5, 95% CI: 1.9 – 22.0, p=0.002, Mean at medium-texture, HR: 5.6, 95% CI: 1.4 – 21.7, p=0.013) and post-treatment EMVI positive status (HR: 5.2, 95% CI: 1.6 – 16.8, p=0.006) were the only independent predictors of OS.
For disease-free survival (DFS), pre-treatment texture (Mean at medium-texture, p=0.007) and post-treatment texture (Kurtosis at medium-texture, p=0.009) were significant univaraite markers of DFS. Using multi-variate analysis, the post-treatment textures (Kurtosis at medium-texture, HR: 3.5, 95% CI: 1.3 – 9.5, p=0.013) and pre-treatment CRM involvement (HR: 5.2, 95% CI: 1.5 – 18.1, p=0.010) were the only independent predictors of DFS
Conclusion:
Non-invasive imaging features derived during the filtration histogram method of MR Textural analysis can predict patients with poorer prognosis before undergoing surgery, and could lead to selection of patients for more intensive treatment before undergoing surgery.
Table1- Significant features on univariate and multivariate analysis-OS
| OS: Significant pre-treatment texture parameters | Filter value | Univariate analysis P value | Multivariate analysis p value |
| Mean | 3 | 0.03 | .013 |
| MPP | 2 | 0.008 | .002 |
| 3 | 0.029 | ||
| 4 | 0.019 | ||
| OS: Significant post-treatment texture parameters | |||
| Skewness | 2 | .034 | |
| OS: Significant Clinical Variables | |||
| Pre treatment | |||
| EMVI status | .017 | ||
| CRM status | .036 | ||
| Post treatment | |||
| EMVI status | .002 | .006 | |
| CRM status | .027 | ||
| TRG status | .002 | ||
| ypCRM involvement | .007 |
Table 2: Significant features on univariate and multivariate analysis- DFS
| DFS: Significant pre-treatment texture parameters | Filter Value | Univariate Analysis P value | Multivariate Analysis P value |
| Mean | 2 | 0.031 | |
| 3 | 0.007 | ||
| 4 | 0.027 | ||
| 6 | 0.043 | ||
| MPP | 2 | 0.022 | |
| 3 | 0.045 | ||
| 4 | 0.022 | ||
| 5 | 0.047 | ||
| 6 | 0.047 | ||
| Skewness | 2 | 0.044 | |
| DFS: Significant post-treatment texture parameters | |||
| MPP | 2 | 0.032 | |
| Skewness | 2 | 0.034 | |
| Kurtosis | 3 | 0.042 | |
| 4 | 0.009 | .013 | |
| DFS- Significant Clinical Variables | |||
| Pre treatment | |||
| CRM status | .006 | .010 | |
| EMVI status | .017 | ||
| CRM status | .019 | ||
| TRG status | .022 | ||
| PCR (ypT0N0M0) | .035 | ||
Feedback Plc – Presentation of Study Results
Feedback Plc – Presentation of Study Results
On July 20th 2015, Feedback plc announced the successful completion of a large evaluation of TexRAD CT texture analysis (CTTA) as a pre-therapy imaging biomarker in 241 metastatic renal (kidney) cell cancer (m-RCC) patients treated with anti-angiogenic therapy (AAT – drugs that block cancer blood-vessel growth).
The research study was led by Dr. Andrew Smith (Associate Professor in Radiology and Director of Radiology Research) along with colleagues from the University of Mississippi Medical Center, Jackson, Mississippi, USA (UMMC).
Specifically the results from this large study demonstrated that TexRAD texture analysis on conventional CT imaging acquired before m-RCC patients underwent AAT was a very strong predictor of overall survival at 2 years. Dr. Smith and colleagues further demonstrated that in a multivariate model comprising of known clinical biomarkers in this cancer population, TexRAD CTTA additionally demonstrated to be a strongly independent predictor of overall survival. The authors have developed a “new prognostic risk index” comprising of TexRAD CTTA and other known clinical factors which has demonstrated superior accuracy in predicting patient survival and classified patients into low, medium and high-risk groups with strong statistical significance (p<0.0001). Dr. Smith and colleagues also concluded that pre-therapy TexRAD CTTA is a significant prognostic marker in patients with m-RCC treated with AAT.
On October 7th-11th, 2015 Dr Andrew Smith presented the data from this large patient study (n=241) on the use of TexRAD texture analysis on CT scans in predicting survival in secondary kidney cancer patients treated with anti-vascular drugs.
The presentation at the Society of Computed Body Tomography and Magnetic Resonance (SCBT-MR) Conference was awarded the Best Junior Researcher Presentation. Below are some slides from the presentation.
Feedback (FDBK) – Exercise of Options
Feedback plc (FDBK), the medical imaging software company, has received notification of an exercise of options over 1.6 million new ordinary shares by an employee under its EMI share option scheme. The exercise price of the options is 1.25 pence each.
The New Ordinary Shares will rank pari passu with the existing ordinary shares and application will be made for the New Ordinary Shares to be admitted to trading on AIM. It is expected that Admission will become effective and dealings in the New Ordinary Shares will commence by 8.00 a.m. on 15 July 2015.
Following Admission the Company will have a total issued share capital of 203,673,857 ordinary shares with voting rights. This number may be used by shareholders as the denominator for the calculations by which they will determine if they are required to notify their interest in, or a change to their interest in, the share capital of the Company under the Financial Conduct Authority’s Disclosure and Transparency Rules.
For further information contact:
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Feedback plc |
Tel: 01954 718072 |
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Simon Barrell / Trevor Brown / Tom Charlton |
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Sanlam Securities UK (Nominated Adviser and Joint Broker) |
Tel: 020 7628 2200 |
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Simon Clements / Virginia Bull |
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Peterhouse Corporate Finance Ltd (Joint Broker) |
Tel: 020 7469 0936 |
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Lucy Williams / Duncan Vasey |
Feedback PLC – Issue of equity
Feedback plc (FDBK), the medical imaging software company, announces that it has issued and allotted 216,000 new ordinary shares of 0.25 pence each at a price of 1.25 pence per ordinary share to Brand UK Limited, the Company’s PR adviser, in lieu of fees for professional services provided to the Company.
The New Ordinary Shares will rank pari passu with the existing ordinary shares and application will be made for the New Ordinary Shares to be admitted to trading on AIM. It is expected that Admission will become effective and dealings in the New Ordinary Shares will commence by 8.00 a.m. on 10 July 2015.
Following Admission of the Placing Shares, the Company’s enlarged issued share capital will consist of 202,073,857 ordinary shares with voting rights. This number may be used by shareholders, following the Placing, as the denominator for the calculations by which they will determine if they are required to notify their interest in, or a change to their interest in, the share capital of the Company under the Financial Conduct Authority’s Disclosure and Transparency Rules.
For further information contact:
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Feedback plc |
Tel: 01954 718072 |
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Simon Barrell / Trevor Brown / Tom Charlton |
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Sanlam Securities UK (Nominated Adviser and Joint Broker) |
Tel: 020 7628 2200 |
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Simon Clements / Virginia Bull |
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Peterhouse Corporate Finance Ltd (Joint Broker) |
Tel: 020 7469 0936 |
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Lucy Williams / Duncan Vasey |
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See Brand Communications disclosure statement here
Feedback PLC – Dr Balaji Ganeshan interviewed by Justin Waite on the ADVFN podcast
Feedback PLC – Chief Scientist & News Business Officer Dr Balaji Ganeshan is interviewed by Justin Waite on the ADVFN podcast.
The interview can be found 20 minutes & 30 seconds into the podcast, click here to listen to the podcast.
Feedback PLC announces the first server sale of TexRAD in Canada
Feedback plc (FDBK), the medical imaging software company, is pleased to announce its first server sale for research purposes in Canada of the Group’s TexRAD texture analysis software. The software will be installed in the Department of Diagnostic Radiology at the McGill University Health Centre’s Montreal General Hospital site.
The MUHC is one of the leading academic health centres in North America. It was founded in 1997 through the merger of five hospitals including the Montreal General Hospital which was established in 1819 and was one of the world’s first teaching hospitals.
Professor Benoit Gallix, Chairman, Department of Diagnostic Radiology (McGill University Director, MUHC) commented, “We are very excited with the prospect of evaluating the TexRAD imaging research software platform at our institution as a potential imaging risk-stratification tool. TexRAD will form part of a research study of breast cancer patients who have had digital mammography imaging examinations. The MUHC database has approximately 20,000 digital mammograms with clinical follow-up acquired over a period of 15 to 20 years. This comprehensive research study could help to provide an evidence base for the potential application of TexRAD in breast cancer patient management”
Dr. Balaji Ganeshan, Chief Scientist and New Business Officer at the Group’s subsidiaries TexRAD Ltd and Cambridge Computed Imaging Ltd, commented, “We are delighted to receive this first server order in Canada, particularly from the very prestigious MUHC, Montreal, Quebec and we are honoured to be working with Professor Benoit Gallix and his team. Breast cancer is the most common cancer in the UK with around 55,000 people (predominantly women) diagnosed with the disease every year. Research and development into non-invasive imaging based risk-stratification tools such as TexRAD research software could potentially lead to TexRAD’s use as a supplementary tool in digital mammography to achieve better patient management and improved overall outcomes in the future.”
For further information contact:
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Feedback plc |
Tel: 01954 718072 |
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Simon Barrell / Trevor Brown / Tom Charlton |
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Sanlam Securities UK (Nominated Adviser and Joint Broker) |
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Simon Clements / Virginia Bull |
Tel: 020 7628 2200 |
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Peterhouse Corporate Finance Ltd (Joint Broker) |
Tel: 020 7469 0936 |
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Lucy Williams / Duncan Vasey |
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Feedback PLC – Statement re Share Price Movement
The Board of Feedback plc (FDBK), the medical imaging software company, notes the increase in the Company’s share price, trading volume and speculation on bulletin boards.
As announced on the 3 June 2015, the Company completed a successful placing with Director participation which has attracted positive media comment however the Board can confirm they know of no other reason that would lead to such a movement in the Company’s share price and the increase in trading volumes.
For further information contact:
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Feedback plc |
Tel: 01954 718072 |
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Simon Barrell / Trevor Brown / Tom Charlton |
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Sanlam Securities UK (Nominated Adviser and Joint Broker) |
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Simon Clements / Virginia Bull |
Tel: 020 7628 2200 |
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Peterhouse Corporate Finance Ltd (Joint Broker) |
Tel: 020 7469 0936 |
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Lucy Williams / Duncan Vasey |
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