A cortical hierarchical architecture is vital for encoding and integrating sensorimotor-to-cognitive information. However, whether this gradient structure is disrupted in end-stage renal disease (ESRD) patients and how this disruption provides valuable information for potential clinical symptoms remain unknown. We prospectively enrolled 77 ESRD patients and 48 healthy controls. Using resting-state functional magnetic resonance imaging, we studied ESRD-related hierarchical alterations. The Neurosynth platform and machine-learning models with 10-fold cross-validation were applied. ESRD patients had abnormal gradient metrics in core regions of the default mode network, sensorimotor network, and frontoparietal network. These changes correlated with creatinine, depression, and cognitive functions. A logistic regression classifier achieved a maximum performance of 84.8% accuracy and 0.901 area under the ROC curve (AUC). Our results highlight hierarchical imbalances in ESRD patients that correlate with diverse cognitive deficits, which may be used as potential neuroimaging markers for clinical symptoms.

Progression free survival (PFS) is a critical clinical outcome endpoint during cancer management and treatment evaluation. Yet, PFS is often missing from publicly available datasets due to the current subjective, expert, and time-intensive nature of generating PFS metrics. Given emerging research in multi-modal machine learning (ML), we explored the benefits and challenges associated with mining different electronic health record (EHR) data modalities and automating extraction of PFS metrics via ML algorithms. We analyzed EHR data from 92 pathology-proven GBM patients, obtaining 233 corticosteroid prescriptions, 2080 radiology reports, and 743 brain MRI scans. Three methods were developed to derive clinical PFS: 1) frequency analysis of corticosteroid prescriptions, 2) natural language processing (NLP) of reports, and 3) computer vision (CV) volumetric analysis of imaging. Outputs from these methods were compared to manually annotated clinical guideline PFS metrics. Employing data-driven methods, standalone progression rates were 63% (prescription), 78% (NLP), and 54% (CV), compared to the 99% progression rate from manually applied clinical guidelines using integrated data sources. The prescription method identified progression an average of 5.2 months later than the clinical standard, while the CV and NLP algorithms identified progression earlier by 2.6 and 6.9 months, respectively. While lesion growth is a clinical guideline progression indicator, only half of patients exhibited increasing contrast-enhancing tumor volumes during scan-based CV analysis. Our results indicate that data-driven algorithms can extract tumor progression outcomes from existing EHR data. However, ML methods are subject to varying availability bias, supporting contextual information, and pre-processing resource burdens that influence the extracted PFS endpoint distributions. Our scan-based CV results also suggest that the automation of clinical criteria may not align with human intuition. Our findings indicate a need for improved data source integration, validation, and revisiting of clinical criteria in parallel to multi-modal ML algorithm development.

Advancements in medical imaging technology have facilitated the acquisition of high-quality brain images through computed tomography (CT) or magnetic resonance imaging (MRI), enabling professional brain specialists to diagnose brain tumors more effectively. However, manual diagnosis is time-consuming, which has led to the growing importance of automatic detection and classification through brain imaging. Conventional object detection models for brain tumor detection face limitations in brain tumor detection owing to the significant differences between medical images and natural scene images, as well as challenges such as complex backgrounds, noise interference, and blurred boundaries between cancerous and normal tissues. This study investigates the application of deep learning to brain tumor detection, analyzing the effect of three factors, the number of model parameters, input data batch size, and the use of anchor boxes, on detection performance. Experimental results reveal that an excessive number of model parameters or the use of anchor boxes may reduce detection accuracy. However, increasing the number of brain tumor samples improves detection performance. This study, introduces a backbone network built using RepConv and RepC3, along with FGConcat feature map splicing module to optimize the brain tumor detection model. The experimental results show that the proposed RepConv-RepC3-FGConcat Network (RRFNet) can learn underlying semantic information about brain tumors during training stage, while maintaining a low number of parameters during inference, which improves the speed of brain tumor detection. Compared with YOLOv8, RRFNet achieved a higher accuracy in brain tumor detection, with a mAP value of 79.2%. This optimized approach enhances both accuracy and efficiency, which is essential in clinical settings where time and precision are critical.

This study proposes a novel deep learning-based approach for aneurysm wall characteristics, including thin-walled (TW) and hyperplastic-remodeling (HR) regions. We analyzed fifty-two unruptured cerebral aneurysms employing 4D-computed tomography angiography (4D-CTA) and intraoperative recordings. The TW and HR regions were identified in intraoperative images. The 3D trajectories of observation points on aneurysm walls were processed to compute a time series of 3D speed, acceleration, and smoothness of motion, aiming to evaluate the aneurysm wall characteristics. To facilitate point-level risk evaluation using the time-series data, we developed a convolutional neural network (CNN)-long- short-term memory (LSTM)-based regression model enriched with attention layers. In order to accommodate patient heterogeneity, a patient-independent feature extraction mechanism was introduced. Furthermore, unlabeled data were incorporated to enhance the data-intensive deep model. The proposed method achieved an average diagnostic accuracy of 92%, significantly outperforming a simpler model lacking attention. These results underscore the significance of patient-independent feature extraction and the use of unlabeled data. This study demonstrates the efficacy of a fine-grained deep learning approach in predicting aneurysm wall characteristics using 4D-CTA. Notably, incorporating an attention-based network structure proved to be particularly effective, contributing to enhanced performance.

In recent times, appropriate diagnosis of brain tumour is a crucial task in medical system. Therefore, identification of a potential brain tumour is challenging owing to the complex behaviour and structure of the human brain. To address this issue, a deep learning-driven framework consisting of four pre-trained models viz DenseNet169, VGG-19, Xception, and EfficientNetV2B2 is developed to classify potential brain tumours from medical resonance images. At first, the deep learning models are trained and fine-tuned on the training dataset, obtained validation scores of trained models are considered as model-wise weights. Then, trained models are subsequently evaluated on the test dataset to generate model-specific predictions. In the weight-aware decision module, the class-bucket of a probable output class is updated with the weights of deep models when their predictions match the class. Finally, the bucket with the highest aggregated value is selected as the final output class for the input image. A novel weight-aware decision mechanism is a key feature of this framework, which effectively deals tie situations in multi-class classification compared to conventional majority-based techniques. The developed framework has obtained promising results of 98.7%, 97.52%, and 94.94% accuracy on three different datasets. The entire framework is seamlessly integrated into an end-to-end web-application for user convenience. The source code, dataset and other particulars are publicly released at https://github.com/SaiSanthosh1508/Brain-Tumour-Image-classification-app [Rishik Sai Santhosh, "Brain Tumour Image Classification Application," https://github.com/SaiSanthosh1508/Brain-Tumour-Image-classification-app] for academic, research and other non-commercial usage.

Tuberculous meningitis (TBM) leads to high mortality, especially amongst individuals with HIV. Predicting the incidence of disease-related complications is challenging, for which purpose the value of brain magnetic resonance imaging (MRI) has not been well investigated. We used a convolutional neural network (CNN) to explore the complementary contribution of brain MRI to the conventional prognostic determinants. We pooled data from two randomised control trials of HIV-positive and HIV-negative adults with clinical TBM in Vietnam to predict the occurrence of death or new neurological complications in the first two months after the subject's first MRI session. We developed and compared three models: a logistic regression with clinical, demographic and laboratory data as reference, a CNN that utilised only T1-weighted MRI volumes, and a model that fused all available information. All models were fine-tuned using two repetitions of 5-fold cross-validation. The final evaluation was based on a random 70/30 training/test split, stratified by the outcome and HIV status. Based on the selected model, we explored the interpretability maps derived from the models. 215 patients were included, with an event prevalence of 22.3%. On the test set our non-imaging model had higher AUC (71.2% [Formula: see text] 1.1%) than the imaging-only model (67.3% [Formula: see text] 2.6%). The fused model was superior to both, with an average AUC = 77.3% [Formula: see text] 4.0% in the test set. The non-imaging variables were more informative in the HIV-positive group, while the imaging features were more predictive in the HIV-negative group. All three models performed better in the HIV-negative cohort. The interpretability maps show the model's focus on the lateral fissures, the corpus callosum, the midbrain, and peri-ventricular tissues. Imaging information can provide added value to predict unwanted outcomes of TBM. However, to confirm this finding, a larger dataset is needed.

Acute ischemic stroke (AIS) has a poor prognosis and a high recurrence rate. Predicting the outcomes of AIS patients in the early stages of the disease is therefore important. The establishment of intracerebral collateral circulation significantly improves the survival of brain cells and the outcomes of AIS patients. However, no machine learning method has been applied to investigate the correlation between the dynamic evolution of intracerebral venous collateral circulation and AIS prognosis. Therefore, we employed a support vector machine (SVM) algorithm to analyze asymmetrically prominent cortical veins (APCVs) and deep medullary veins (DMVs) to establish a radiomic model for predicting the prognosis of AIS by combining clinical indicators. The magnetic resonance imaging (MRI) data and clinical indicators of 150 AIS patients were retrospectively analyzed. Regions of interest corresponding to the DMVs and APCVs were delineated, and least absolute shrinkage and selection operator (LASSO) regression was used to select features extracted from these regions. An APCV-DMV radiomic model was created via the SVM algorithm, and independent clinical risk factors associated with AIS were combined with the radiomic model to generate a joint model. The SVM algorithm was selected because of its proven efficacy in handling high-dimensional radiomic data compared with alternative classifiers (<i>e.g.</i>, random forest) in pilot experiments. Nine radiomic features associated with AIS patient outcomes were ultimately selected. In the internal training test set, the AUCs of the clinical, DMV-APCV radiomic and joint models were 0.816, 0.976 and 0.996, respectively. The DeLong test revealed that the predictive performance of the joint model was better than that of the individual models, with a test set AUC of 0.996, sensitivity of 0.905, and specificity of 1.000 (<i>P</i> < 0.05). Using radiomic methods, we propose a novel joint predictive model that combines the imaging histologic features of the APCV and DMV with clinical indicators. This model quantitatively characterizes the morphological and functional attributes of venous collateral circulation, elucidating its important role in accurately evaluating the prognosis of patients with AIS and providing a noninvasive and highly accurate imaging tool for early prognostic prediction.

The rapid advancement of the civil aviation industry has attracted significant attention to research on pilots. However, the brain changes experienced by flight cadets following their training remain, to some extent, an unexplored territory compared to those of the general population. The aim of this study was to examine the impact of flight training on brain function by employing machine learning(ML) techniques. We collected resting-state functional magnetic resonance imaging (resting-state fMRI) data from 79 flight cadets and ground program cadets, extracting blood oxygenation level-dependent (BOLD) signal, amplitude of low frequency fluctuation (ALFF), regional homogeneity (ReHo), and functional connectivity (FC) metrics as feature inputs for ML models. After conducting feature selection using a two-sample t-test, we established various ML classification models, including Extreme Gradient Boosting (XGBoost), Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM), and Gaussian Naive Bayes (GNB). Comparative analysis of the model results revealed that the LR classifier based on BOLD signals could accurately distinguish flight cadets from the general population, achieving an AUC of 83.75% and an accuracy of 0.93. Furthermore, an analysis of the features contributing significantly to the ML classification models indicated that these features were predominantly located in brain regions associated with auditory-visual processing, motor function, emotional regulation, and cognition, primarily within the Default Mode Network (DMN), Visual Network (VN), and SomatoMotor Network (SMN). These findings suggest that flight-trained cadets may exhibit enhanced functional dynamics and cognitive flexibility.

This work aims to promote early and accurate diagnosis of Temporal Lobe Epilepsy (TLE) by developing state-of-the-art deep learning techniques, with the goal of minimizing the consequences of epilepsy on individuals and society. Current approaches for TLE detection have drawbacks, including applicability to particular MRI sequences, moderate ability to determine the side of the onset zones, and weak cross-validation with different patient groups, which hampers their practical use. To overcome these difficulties, a new Hybrid Attention-Enhanced Transformer Network (HAETN) is introduced for early TLE diagnosis. This approach uses newly developed Fuzzy-AAL Segmentation Framework (FASF) which is a combination of Fuzzy Possibilistic C-Means (FPCM) algorithm for segmentation of tissue and AAL labelling for labelling of tissues. Furthermore, an effective feature selection method is proposed using the Dipper- grey wolf optimization (DGWO) algorithm to improve the performance of the proposed model. The performance of the proposed method is thoroughly assessed by accuracy, sensitivity, and F1-score. The performance of the suggested approach is evaluated on the Temporal Lobe Epilepsy-UNAM MRI Dataset, where it attains an accuracy of 98.61%, a sensitivity of 99.83%, and F1-score of 99.82%, indicating its efficiency and applicability in clinical practice.

Brain tumors pose a significant medical challenge, necessitating early detection and precise classification for effective treatment. This study aims to address this challenge by introducing an automated brain tumor classification system that utilizes deep learning (DL) and Magnetic Resonance Imaging (MRI) images. The main purpose of this research is to develop a model that can accurately detect and classify different types of brain tumors, including glioma, meningioma, pituitary tumors, and normal brain scans. A convolutional neural network (CNN) architecture with pretrained VGG16 as the base model is employed, and diverse public datasets are utilized to ensure comprehensive representation. Data augmentation techniques are employed to enhance the training dataset, resulting in a total of 17,136 brain MRI images across the four classes. The accuracy of this model was 99.24%, a higher accuracy than other similar works, demonstrating its potential clinical utility. This higher accuracy was achieved mainly due to the utilization of a large and diverse dataset, the improvement of network configuration, the application of a fine-tuning strategy to adjust pretrained weights, and the implementation of data augmentation techniques in enhancing classification performance for brain tumor detection. In addition, a web application was developed by leveraging HTML and Dash components to enhance usability, allowing for easy image upload and tumor prediction. By harnessing artificial intelligence (AI), the developed system addresses the need to reduce human error and enhance diagnostic accuracy. The proposed approach provides an efficient and reliable solution for brain tumor classification, facilitating early diagnosis and enabling timely medical interventions. This work signifies a potential advancement in brain tumor classification, promising improved patient care and outcomes.