美国国家公共电台 NPR For Some Hard-To-Find Tumors, Doctors See Promise In Artificial Intelligence

 

MARY LOUISE KELLY, HOST:

Artificial intelligence is getting a foothold in medicine. Last week, the Food and Drug Administration approved a computer algorithm that can help doctors identify wrist fractures. Researchers at Johns Hopkins have much more ambitious plans, too. They are using AI to train computers to do something very difficult, diagnose pancreatic cancer. NPR's Richard Harris visited what is called The Felix project.

RICHARD HARRIS, BYLINE¹: Elliot Fishman has spent his career as a radiologist pushing one vision, to bring powerful computing² into his field of medicine.

ELLIOT FISHMAN: When I started radiology, they said, OK, don't worry about reading the chest X-rays because in two years, the computers will read them. That's 35 years ago.

HARRIS: Computers still can't perform that seemingly simple task, despite sky-high expectations and more than a little hype around the role of artificial intelligence. Fishman is undaunted. In fact, he's taken on one of the deadliest malignancies, cancer of the pancreas.

FISHMAN: Five year survival is 7 percent.

HARRIS: One reason it's so deadly is doctors usually diagnose the disease when it's too late to remove the tumors with surgery. Fishman and his team want to change that by training computers to recognize pancreatic cancer early. Dr. Karen Horton, chair of the radiology department, is part of this effort.

KAREN HORTON: Elliot and I are very subspecialized, so we are really, really good, right? So we see more pancreatic cancer than probably anybody in the world. So if you could put - box in a computer every case that Elliot and I saw and let the computer learn from that, you could be, I would argue, better than us but certainly as good as us, which would be better than most of the practicing radiologists.

HARRIS: The idea is to build pancreatic cancer detection into CT scanner software. Americans get 40 million CT scans of the abdomen⁴ every year for everything from car accidents to back pain. Horton says imagine if a computer program with expert abilities could look for pancreas tumors in all of those scans.

HORTON: And that's the ultimate opportunity, to be able to diagnose it before you have any symptoms and at a stage where maybe it's even too subtle for a radiologist to be able to detect it.

HARRIS: The challenge lies in bringing this idea to fruition, Fishman says.

FISHMAN: You know, this idea sometimes people say is, oh, you just take a bunch of cases, you put them into the computer, the computer will figure out what to do. That's nonsensical.

HARRIS: Even a program perfectly⁵ attuned⁶ to finding patterns can't figure out what's cancer and what's not if it doesn't have reliable starting material. So the core of The Felix Project at Hopkins is to pour a huge amount of human time, labor⁷ and intellect into training computers to recognize the difference between a normal pancreas and one with a tumor³. Of all the internal organs, Fishman says...

FISHMAN: The pancreas is the hardest. You know, the kidney looks like a kidney. The liver is a big thing, the spleen - the pancreas is a very soft organ, sits way in the middle - you saw the pictures - and the shape varies from patient to patient. Just finding the pancreas even for radiologists at times is a challenge.

This is my lab. So we do a lot of the 3-D here. And Eva will show you how we do some of the segmentation.

EVA ZINREICH: Eva Zinreich. How are you?

HARRIS: I'm Richard Harris. It's nice to meet you.

Eva is Dr. Eva Zinreich, a retired⁸ oncologist who now comes in to train computers to recognize the difference between a healthy pancreas and one with disease.

ZINREICH: So I show you in 3-D because that's the fun stuff, OK?

HARRIS: She mouses across the screen and starts filling in the various parts of a CT scan with a digital paintbrush. She starts with the biggest blood vessel⁹, the aorta¹⁰. The computer program helps her draw within the lines.

ZINREICH: It's pretty good, right?

HARRIS: Yeah.

ZINREICH: Now we can do whatever organ you would like to see.

HARRIS: Well, let's do the pancreas.

ZINREICH: OK, let's do the pancreas.

HARRIS: She colors the pancreas yellow and then pulls out a red pallet to mark a darker area inside the organ.

ZINREICH: You see this shaded area? That's the tumor.

HARRIS: It looks like a pretty big tumor.

ZINREICH: It's a very large tumor.

HARRIS: It will take her almost four hours just to mark up this single scan. Four medical experts have been working full time for more than a year on this project, and they've done this painstaking¹¹ work for about 1,000 healthy volunteers and they're now approaching 1,000 images that have pancreatic tumors. In another workstation in the lab, Linda Chu is trying to make the computer system even better than Elliot Fishman and Karen Horton by having the computer look for signs of cancer in the scans beyond what the human eye can see.

LINDA CHU: I believe that there's more to the images.

HARRIS: She says she's making progress - for example, training software to identify subtle clues that distinguish between a benign¹² cyst and cancer.

CHU: We don't truly understand what the computer is seeing, but clearly the computer is able to see something in the images that us humans cannot comprehend at this point so...

HARRIS: That's kind of exciting.

CHU: Yeah, very exciting work.

HARRIS: But it's also part of the challenge of AI. If the computer highlights something that a human expert can't see and you don't know how it arrived at that conclusion, can you trust it?

CHU: But that's what makes the research interesting.

HARRIS: Horton says if The Felix Project for pancreatic cancer succeeds, all the information they collected on healthy people can be used to study other organs.

HORTON: You could have Felix kidney, Felix liver, Felix lung, Felix heart. And but you have to attack it that way, each organ - what's the pathology, what's the cancer? - if you want to focus on cancer.

HARRIS: It's not as simple as dumping piles of data into a computer and just letting the algorithm sort it all out. Richard Harris, NPR News.

1 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

2 computing   

n.计算

参考例句：

• to work in computing 从事信息处理
• Back in the dark ages of computing, in about 1980, they started a software company. 早在计算机尚未普及的时代（约1980年），他们就创办了软件公司。

3 tumor   

n.（肿）瘤，肿块(英)tumour

参考例句：

• He was died of a malignant tumor.他死于恶性肿瘤。
• The surgeons irradiated the tumor.外科医生用X射线照射那个肿瘤。

4 abdomen   

n.腹，下腹(胸部到腿部的部分)

参考例句：

• How to know to there is ascarid inside abdomen?怎样知道肚子里面有蛔虫？
• He was anxious about an off-and-on pain the abdomen.他因时隐时现的腹痛而焦虑。

5 perfectly   

adv.完美地，无可非议地，彻底地

参考例句：

• The witnesses were each perfectly certain of what they said.证人们个个对自己所说的话十分肯定。
• Everything that we're doing is all perfectly above board.我们做的每件事情都是光明正大的。

6 attuned   

v.使协调( attune的过去式和过去分词 )；调音

参考例句：

• She wasn't yet attuned to her baby's needs. 她还没有熟悉她宝宝的需要。
• Women attuned to sensitive men found Vincent Lord attractive. 偏爱敏感男子的女人，觉得文森特·洛德具有魅力。 来自辞典例句

7 labor   

n.劳动，努力，工作，劳工；分娩；vi.劳动，努力，苦干；vt.详细分析；麻烦

参考例句：

• We are never late in satisfying him for his labor.我们从不延误付给他劳动报酬。
• He was completely spent after two weeks of hard labor.艰苦劳动两周后，他已经疲惫不堪了。

8 retired   

adj.隐退的，退休的，退役的

参考例句：

• The old man retired to the country for rest.这位老人下乡休息去了。
• Many retired people take up gardening as a hobby.许多退休的人都以从事园艺为嗜好。

9 vessel   

n.船舶；容器，器皿；管，导管，血管

参考例句：

• The vessel is fully loaded with cargo for Shanghai.这艘船满载货物驶往上海。
• You should put the water into a vessel.你应该把水装入容器中。

10 aorta   

n.主动脉

参考例句：

• The abdominal aorta is normally smaller than the thoracic aorta.腹主动脉一般比胸主动脉小。
• Put down that jelly doughnut and look carefully at this aorta.放下手头上的东西，认真观察这张大动脉图片。

11 painstaking   

adj.苦干的；艰苦的，费力的，刻苦的

参考例句：

• She is not very clever but she is painstaking.她并不很聪明，但肯下苦功夫。
• Through years of our painstaking efforts,we have at last achieved what we have today.大家经过多少年的努力，才取得今天的成绩。

12 benign   

adj.善良的，慈祥的；良性的，无危险的

参考例句：

• The benign weather brought North America a bumper crop.温和的气候给北美带来大丰收。
• Martha is a benign old lady.玛莎是个仁慈的老妇人。