Asymmetry of bilateral mammographic tissue density and patterns is a potentially strong indicator of having or developing breast abnormalities or early cancers. The purpose of this study is to design and test the global asymmetry features from bilateral mammograms to predict the near-term risk of women developing detectable high risk breast lesions or cancer in the next sequential screening mammography examination. The image dataset includes mammograms acquired from 90 women who underwent routine screening examinations, all interpreted as negative and not recalled by the radiologists during the original screening procedures. A computerized breast cancer risk analysis scheme using four image processing modules, including image preprocessing, suspicious region segmentation, image feature extraction, and classification was designed to detect and compute image feature asymmetry between the left and right breasts imaged on the mammograms. The highest computed area under curve (AUC) is 0.754 ± 0.024 when applying the new computerized aided diagnosis (CAD) scheme to our testing dataset. The positive predictive value and the negative predictive value were 0.58 and 0.80, respectively.
To test the above proposition, I conduct the empirical analysis in three steps. In the first step, I investigate foreign banks’ management model by surveying 13 major foreign banks locally incorporated in Mainland China. The results suggest that these 13 foreign banks can be categorized into three distinct groups based on their management model: intergrators, customer-followers, and parent-followers. The results also indicate that intergrators have the highest level of localization while parent-followers have the lowest level of localization.
In the second step, I conduct DEA (Data Envelope Analysis) and CAMEL (Capital Adequacy, Asset Quality, Management, Earnings, Liquidity Analysis) to assess the operating efficiency of these 13 foreign banks. The assessment is conducted in two ways: 1) the inter-group comparison between foreign banks and local Chinese banks; 2) the intra-group comparison between the three distinct groups of foreign banks identified in the first step. The results indicates that the principal factor driving the operating efficiency of both local Chinese banks and foreign banks is the comprehensive technical efficiency, which includes both the quality of management and the quality of technical elements. I also find the uptrend of technical efficiency of the integrators is more stable than that of the other two groups of foreign banks.
Finally, I integrate the results from step one and step two to assess the relevance between foreign banks’ localization level and operating efficiency. I find that foreign banks that score higher in localization tend to have a higher level of operating efficiency. Although this finding is not conclusive about the causal relationship between localization and operating efficiency, it nevertheless suggests that the management model of the higher performing integrators can serve as references for the other foreign banks attempting to enhance their localization and operating efficiency. I also discuss the future trends of development in the banking industry in China and what foreign banks can learn from local Chinese banks to improve their market positions.
Background: Genetic profiling represents the future of neuro-oncology but suffers from inadequate biopsies in heterogeneous tumors like Glioblastoma (GBM). Contrast-enhanced MRI (CE-MRI) targets enhancing core (ENH) but yields adequate tumor in only ~60% of cases. Further, CE-MRI poorly localizes infiltrative tumor within surrounding non-enhancing parenchyma, or brain-around-tumor (BAT), despite the importance of characterizing this tumor segment, which universally recurs. In this study, we use multiple texture analysis and machine learning (ML) algorithms to analyze multi-parametric MRI, and produce new images indicating tumor-rich targets in GBM.
Methods: We recruited primary GBM patients undergoing image-guided biopsies and acquired pre-operative MRI: CE-MRI, Dynamic-Susceptibility-weighted-Contrast-enhanced-MRI, and Diffusion Tensor Imaging. Following image coregistration and region of interest placement at biopsy locations, we compared MRI metrics and regional texture with histologic diagnoses of high- vs low-tumor content (≥80% vs <80% tumor nuclei) for corresponding samples. In a training set, we used three texture analysis algorithms and three ML methods to identify MRI-texture features that optimized model accuracy to distinguish tumor content. We confirmed model accuracy in a separate validation set.
Results: We collected 82 biopsies from 18 GBMs throughout ENH and BAT. The MRI-based model achieved 85% cross-validated accuracy to diagnose high- vs low-tumor in the training set (60 biopsies, 11 patients). The model achieved 81.8% accuracy in the validation set (22 biopsies, 7 patients).
Conclusion: Multi-parametric MRI and texture analysis can help characterize and visualize GBM’s spatial histologic heterogeneity to identify regional tumor-rich biopsy targets.