Jan Witowski

• MD PhD
• PostDoc Position at New York University

Purpose: Three-dimensional (3D) printing for preoperative planning has been intensively developed in the recent years. However, the implementation of these solutions in hospitals is still difficult due to high costs, extremely expensive industrial-grade printers, and software that is difficult to obtain and learn along with a lack of a defined proc...

Background: Rapid growth of three-dimensional (3D) printing in recent years has led to new applications of this technology across all medical fields. This review article presents a broad range of examples on how 3D printing is facilitating liver surgery, including models for preoperative planning, education, and simulation. Materials and methods:...

Purpose Although high costs are often cited as the main limitation of 3D printing (3DP) in the medical field, current lack of clinical evidence is asserting itself as an impost as the field begins to mature. The aim is to review clinical trials in the field of 3DP, an area of research which has grown dramatically in recent years. Methods We survey...

Background: Percutaneous pulmonary interventions require extensive and accurate navigation planning and guidance, especially in regard to the three-dimensional (3D) relationships between anatomical structures. In this study, we are demonstrating the feasibility of novel visualization techniques: 3D printing (3DP) and augmented reality (AR) in plan...

Background The advantages of laparoscopy are widely known. Nevertheless, its legitimacy in liver surgery is often questioned because of the uncertain value associated with minimally invasive methods. Our main goal was to compare the outcomes of pure laparoscopic (LLR) and open liver resection (OLR) in patients with hepatocellular carcinoma. Method...

e13595 Background: Accurate risk stratification in hormone receptor positive, HER2 negative (HR+/HER2-) breast cancer (BC) is critical for guiding personalised treatment. Oncotype DX (ODX) demonstrates limitations in intermediate-risk groups and high-risk subpopulations. The Ataraxis Breast test addresses these gaps by integrating digital pathology...

549 Background: Breast cancer (BC) treatment selection is traditionally guided by clinical characteristics. However, as clinical characteristics cannot capture the complexity of a disease, genomic tools have been developed. Recent advances in artificial intelligence (AI) have allowed pathology imaging to be used to build more accurate and comprehen...

Although digital breast tomosynthesis (DBT) improves diagnostic performance over full-field digital mammography (FFDM), false-positive recalls remain a concern in breast cancer screening. We developed a multi-modal artificial intelligence system integrating FFDM, synthetic mammography, and DBT to provide breast-level predictions and bounding-box lo...

Treatment selection in breast cancer is guided by molecular subtypes and clinical characteristics. Recurrence risk assessment plays a crucial role in personalizing treatment. Current methods, including genomic assays, have limited accuracy and clinical utility, leading to suboptimal decisions for many patients. We developed a test for breast cancer...

3D imaging enables accurate diagnosis by providing spatial information about organ anatomy. However, using 3D images to train AI models is computationally challenging because they consist of 10x or 100x more pixels than their 2D counterparts. To be trained with high-resolution 3D images, convolutional neural networks resort to downsampling them or...

Predictive artificial intelligence (AI) systems based on deep learning have been shown to achieve expert-level identification of diseases in multiple medical imaging settings, but can make errors in cases accurately diagnosed by clinicians and vice versa. We developed Complementarity-Driven Deferral to Clinical Workflow (CoDoC), a system that can l...

Pathology reports are considered the gold standard in medical research due to their comprehensive and accurate diagnostic information. Natural language processing (NLP) techniques have been developed to automate information extraction from pathology reports. However, existing studies suffer from two significant limitations. First, they typically fr...

Importance: An accurate and robust artificial intelligence (AI) algorithm for detecting cancer in digital breast tomosynthesis (DBT) could significantly improve detection accuracy and reduce health care costs worldwide. Objectives: To make training and evaluation data for the development of AI algorithms for DBT analysis available, to develop we...

Diagnostic AI systems trained using deep learning have been shown to achieve expert-level identification of diseases in multiple medical imaging settings1,2. However, such systems are not always reliable and can fail in cases diagnosed accurately by clinicians and vice versa³. Mechanisms for leveraging this complementarity by learning to select opt...

3D imaging enables a more accurate diagnosis by providing spatial information about organ anatomy. However, using 3D images to train AI models is computationally challenging because they consist of tens or hundreds of times more pixels than their 2D counterparts. To train with high-resolution 3D images, convolutional neural networks typically resor...

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has a high sensitivity in detecting breast cancer but often leads to unnecessary biopsies and patient workup. We used a deep learning (DL) system to improve the overall accuracy of breast cancer diagnosis and personalize management of patients undergoing DCE-MRI. On the internal test se...

Introduction: As the number of elderly patients requiring surgical intervention rises, it is believed that frailty syndrome has a greater impact on perioperative course than on chronological age. The aim of this study was to evaluate the efficacy of various imaging features for frailty assessment in patients undergoing emergency laparotomy. Metho...

The value of kinematic data for skill assessment is being investigated. This is the first virtual reality simulator developed for liver surgery. This simulator was coded in C++ using PhysX and FleX with a novel cutting algorithm and used a patient data-derived model and two instruments functioning as ultrasonic shears. The simulator was evaluated b...

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has a very high sensitivity in detecting breast cancer, but it often leads to unnecessary biopsies and patient workup. In this paper, we used an artificial intelligence (AI) system to improve the overall accuracy of breast cancer diagnosis and personalize management of patients undergoi...

Objective Comprehensive analysis and comparison of HRQoL following different bariatric interventions through systematic review with network meta-analysis. Background Different types of bariatric surgeries have been developed throughout the years. Apart from weight loss and comorbidities remission, improvement of health-related quality of life (HRQ...

Though consistently shown to detect mammographically occult cancers, breast ultrasound has been noted to have high false-positive rates. In this work, we present an AI system that achieves radiologist-level accuracy in identifying breast cancer in ultrasound images. Developed on 288,767 exams, consisting of 5,442,907 B-mode and Color Doppler images...

Artificial intelligence (AI) is transforming medicine and showing promise in improving clinical diagnosis. In breast cancer screening, several recent studies show that AI has the potential to improve radiologists' accuracy, subsequently helping in early cancer diagnosis and reducing unnecessary workup. As the number of proposed models and their com...

A new international competition aims to speed up the development of AI models that can assist radiologists in detecting suspicious lesions from hundreds of millions of pixels in 3D mammograms. The top three winning teams compare notes.

Current research on medical image processing relies heavily on the amount and quality of input data. Specifically, supervised machine learning methods require well-annotated datasets. A lack of annotation tools limits the potential to achieve high-volume processing and scaled systems with a proper reward mechanism. We developed MarkIt, a web-based...

Ultrasound is an important imaging modality for the detection and characterization of breast cancer. Though consistently shown to detect mammographically occult cancers, especially in women with dense breasts, breast ultrasound has been noted to have high false-positive rates. In this work, we present an artificial intelligence (AI) system that ach...

During the coronavirus disease 2019 (COVID-19) pandemic, rapid and accurate triage of patients at the emergency department is critical to inform decision-making. We propose a data-driven approach for automatic prediction of deterioration risk using a deep neural network that learns from chest X-ray images and a gradient boosting model that learns f...

Introduction In order to select high-risk patients, many prognostic scales have been invented. Among them, Rockall, Glasgow-Blatchford and AIMS 65 scales were considered the most useful. Material and methods Patients with upper GI tract bleeding, treated between 2017 and 2018 were retrospectively enrolled to the study. Every patient had a Rockall,...

Aim Three-dimensional (3D) noninvasively acquired datasets containing anatomical information about the heart are a modern option for procedural support during percutaneous cardiac interventions. We present initial experience of patent ductus arteriosus (PDA) closure with workflow integrated with innovative mixed reality display (MRD) to improve 3D...

Background: Medical 3D printing has demonstrated value in anatomic models for abdominal, hepatobiliary, and gastrointestinal conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for abdominal, hepatobiliary, and gastrointestinal 3D pri...

Knowledge of the mutual relationship between the main arteries and veins of the heart is crucial for the safety and effectiveness of interventional and electrophysiological procedures. Thus, the aim of this study was to assess the spatial relationships of main coronary blood vessels using virtual three‐dimensional visualizations. Seventy patients t...

The puncture of the gluteal artery (GA) is a rare and difficult procedure. Less experienced clinicians do not always have the opportunity to practice and prepare for it, which creates a need for novel training tools. We aimed to investigate the feasibility of developing a 3D-printed, patient-specific phantom of the GA and its surrounding tissues to...

Introduction: The ERAS (Enhanced Recovery after Surgery) protocol revolutionized perioperative care for gastrointestinal surgical procedures. However, little is known about the association between adherence to the ERAS protocol in gastric cancer surgery and the oncological outcome. Aim: To explore the relation between adherence to the ERAS proto...

Objectives The aim of this study was to evaluate impact of 3D printed models on decision-making in context of laparoscopic liver resections (LLR) performed with intraoperative ultrasound (IOUS) guidance. Methods Nineteen patients with liver malignances (74% were colorectal cancer metastases) were prospectively qualified for LLR or radiofrequency a...

Purpose: Rectal cancer is one of the most common malignancies of the gastrointestinal tract. The gold standard method is surgical resection. The approach to rectal cancer is still controversial. Nowadays, robotic approach gains popularity in comparison to traditional laparoscopy. However, there is lack of studies assessing rectal resections with p...

Introduction: Defunctioning ileostomy has been widely used in patients undergoing low anterior rectal resection to reduce the rate of postoperative leakage. It is still not clear whether interval between primary procedure and ileostomy reversal has an impact on treatment outcomes. Methods: In our prospective observational study we reviewed 164 cons...

Background: Aim of this study was to evaluate functional outcomes of transanal total mesorectal excision (TaTME) in comparison to conventional laparoscopic approach (LaTME) in terms of low anterior resection syndrome (LARS). Methods: Forty-six patients who underwent total mesorectal excision for low rectal cancer between 2013 and 2017 were enrol...

Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure which is performed on patients with aortic valve defects that are posing a high-risk for conducting a surgical treatment. Preoperative surgical planning and valve sizing play a crucial role in reducing surgery complications and adverse effects such as paravalvular leak...

Purpose: To demonstrate the feasibility of augmented reality visualization in planning and navigating endovascular aortic repair. Technique: A 77-year-old patient with abdominal aortic aneurysm was treated with endovascular repair. An augmented reality head-mounted display was used during the procedure. The aneurysm and bones were projected as 3-di...

Facial vascular lesions are considered a great therapeutic challenge due to the considerable variability of clinical presentations. Surgical removal requires precise planning and advanced visualization to understand the three-dimensional anatomical relationships better. The aim of the study was to evaluate the feasibility of three-dimensional print...

A perioperative treatment protocol, enhanced recovery after surgery (ERAS) focuses on accelerating patient recovery. Previous studies confirmed that ERAS decreases surgical trauma and the stress response, which improved outcomes including reduced length of hospital stay (LOS) and decreased postoperative morbidity. While ERAS protocols have been suc...

Introduction: Transanal total mesorectal excision (TaTME) has been recently proposed to overcome the difficulties of the standard TME approach, allowing better visualization and dissection of the mesorectal fascia. Although TaTME seems very promising, the evidence and body of knowledge on achieving proficiency in performing it are still sparse. A...

Introduction: The enhanced recovery after surgery (ERAS) protocol relies on patients' compliance and their awareness of its principles. Patients' views on ERAS implementation have never been evaluated in Poland before. Aim: To analyse patients' opinions about this protocol. Material and methods: One hundred forty consecutive patients undergoin...

Background: The aim of this study was to evaluate the accuracy of three-dimensional (3D) printed liver models developed by a cost-effective approach for establishing validity of using these models in a clinical setting. Methods: Fifteen patients undergoing laparoscopic liver resection in a single surgical department were included. Patient-specif...

Introduction Thanks to laparoscopy and enhanced recovery protocols (ERAS) it is possible to shorten hospitalization. Therefore, it seems reasonable to search for new early markers of infectious complications in order to select patients who are prone to development of complications. Aim To assess the usefulness of serum levels of C-reactive protein...

Background: Our aim was to evaluate the usefulness of serum amyloid A (SAA) measurements in comparison with C-reactive protein (CRP) in the early prediction of infectious complications among patients undergoing laparoscopic surgery for colorectal cancer Methods: Consecutive patients undergoing laparoscopic resection for colorectal cancer were anal...

Background: Combination of laparoscopic approach with ERAS protocol in colorectal surgery allows for an early discharge. However there is a risk that some of the discharged patients are developing, asymptomatic at the time, infectious complications. This may lead to a delay in diagnostics and proper treatment introduction. We aimed to assess the u...

Introduction Left atrial appendage occlusion procedure (LAAO) became an alternative method for stroke prevention in atrial fibrillation (AF) patients with contraindication or intolerance for oral anticoagulation therapy. However, LAA anatomy is complex with several different types of LAA morphology. Therefore matching the correct size of a delivery...

Introduction Laparoscopic splenectomy (LS) is the gold standard in treating immune thrombocytopenia (ITP). However, there are still some problems in decision-making when considering LS in patients with a very low platelet count (PLT). Aim To evaluate safety outcomes of LS in patients with severe ITP and very low PLT in comparison to those with hig...

Introduction Over the past years the incidence of colorectal cancers has increased worldwide. Currently it is the most common gastrointestinal malignancy worldwide. The laparoscopic approach has become the gold standard for surgical treatment. However, a recently published meta-analysis showed no difference in short- and long-term oncological outco...

Enhanced Recovery After Surgery (ERAS) is an evidence-based paradigm shift in perioperative care, proven to lower both recovery time and postoperative complication rates. The role of ERAS in several surgical disciplines was reviewed. In colorectal surgery, ERAS protocol is currently well established as the best care. In gastric surgery, 2014 saw an...

The age at which patients are undergoing pancreatoduodenectomy is increasing worldwide. The data on the outcome of this surgical procedure in the elderly is constantly expanding. This meta-analysis aims to assess the safety of pancreatoduodenectomy in elderly population, primarily focusing on morbidity and mortality. We searched the Medline, Embase...

Objectives The role of a defunctioning ileostomy in every anterior rectal resection with total mesorectal excision (TME) is still controversial. In this study, we aimed to review the current literature to determine the impact of ileostomy creation on postoperative outcomes in patients undergoing anterior rectal resection with TME. Methods MEDLINE,...

Background: The most commonly performed bariatric procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). There are major differences between LSG and LRYGB during postoperative period. Optimization of the postoperative care may be achieved by using enhanced recovery after surgery (ERAS) protocol, whi...

Background: 3D-printing (3DP) has been found to be a promising adjunct in the care of patients undergoing cardiac surgery. The value of accurate, patient-specific models is becoming apparent in preoperative planning, patient and trainee education. However, high costs and complex workflows are major limitations preventing surgical centers from adopt...

Most current guidelines do not recommend primary tumor resection in stage IV unresectable colorectal cancer. Rapid chemotherapy development over the last decade has substantially changed the decision making. However, results of recently published trials and meta-analyses suggest that primary tumor resection may in fact be beneficial, principally in...

Background Until recently there has been little data available about long-term outcomes of laparoscopic rectal cancer surgery. But new randomized controlled trials regarding laparoscopic colorectal surgery have been published. The aim of this study was to compare the short- and long-term oncologic outcomes of laparoscopy and open surgery for rectal...

Surgery remains the only option to cure pancreatic cancer. Although the use of laparoscopy in oncology is rapidly growing worldwide, its efficacy in pancreatic surgery remains controversial. A number of studies have compared outcomes of minimally invasive and open pancreatic resections. However, they are mostly non-randomized trials including relat...

Purpose: Rapid growth of three-dimensional (3D) printing in recent years has led to new applications of this technology across all medical fields. Our review presents a broad range of examples on how 3D printing is facilitating liver surgery, including models for preoperative planning, education and simulation. Methodology: We performed an extensiv...

We have analyzed and extracted data from 15 papers on the use of three-dimensional (3D) printing in liver surgery. Reviewed studies have covered predominately models used in preoperative planning and as an intraoperative guidance. It has also been noted that most of developed 3D-printed structures have been accurate enough to provide valuable insig...

Wstęp: Druk 3D jest technologią, która w medycynie zostaje w ostatnich latach wdrażana jako narzędzie pomagające w przygotowaniu przed operacjami, pomoc edukacyjna czy też metoda służąca lepszemu kontaktowi z pacjentami. Złożona budowa anatomiczna wątroby oraz zaawansowane zabiegi chirurgiczne przeprowadzane w obrębie jamy brzusznej pokazują, że po...

Wstęp: Przytarczyce są gruczołami endokrynnymi produkującymi parathormon (PTH)- hormon biorący udział w regulacji gospodarki wapniowo-fosforanowej. Subtrakcyjna scyntygrafia przytarczyc jest badaniem wykonywanym w przypadku klinicznego podejrzenia gruczolaka przytarczyc. Cel: Celem niniejszej pracy było wprowadzenie na temat scyntygrafii przytarcz...

Development of three-dimensional printing technologies allowed educators to implement printed models in tactile teaching processes. This paper presents the case of 3D-printed models of body structures, including major body organs. Thanks to many possibilities of adjusting models details, they can be used in every stage of education. Realistic mater...