aim

Artificial Intelligence for the Myometrium

By the age of 50 at least 70-80% of African women will develop tumors in their uterus that are called leiomyomas, or, more commonly, fibroids (Reference). In the vast majority of instances, fibroids do not cause any symptoms at all, they are "asymptomatic" and so, frequently, when a woman experiences symptoms of abnormal vaginal bleeding, pressure or even infertility, fibroids that she might have are not associated with the problem facing her. However, in some instances, fibroids can cause heavy menstrual bleeding (HMB) - sometimes without even enlarging the uterus, or they may contribute to infertility or recurrent pregnancy loss, and, if they become very large, they can manifest with symptoms related to pressure on surrounding organs and structures. Indeed, the prevalence of uterine leiomyomas is so great and the impact on cost,  quality of life, productivity and fertility so great that one of the first actions of US Vice President Kamala Harris was to introduce the Uterine Fibroid Research and Education Act to Congress, and act that would apportion $30M to the NIH every year for five years. Indeed, the AWARrD Principal Investigator, Dr Essam Othman, from Assiut University has contributed substantially to our understanding of leiomyoma growth and development (Reference).

While this is an issue in the foreground, there is another lurking issue and that is the risk of the fibroid actually being a cancer - a leiomyosarcoma. Compared to benign or non-malignant fibroids, leiomyosarcomas are quite rare, but when you consider the frequency of leiomyomas, it is a consideration. There are at least three unfortunate issues. One is that we don't have a good idea about the frequency of malignancy - estimates range from about 1/250 to 1/8,300 generally being higher in women in their fifth and sixth decades. The second problem is that leiomyosarcomas are associated with a high death rate it is difficult to successfully treat these tumors before they have spread to other organs. The last issues is that we don't, as of yet, have a way to accurately diagnose leiomyomas that are suspected to be malignant (Reference). So that is where the AWARrD team and data science comes in.