The impact of radiomics in the management of soft tissue sarcoma.

INTRODUCTION: Soft tissue sarcomas (STSs) are rare malignancies. Pre-therapeutic tumour grading and assessment are crucial in making treatment decisions. Radiomics is a high-throughput method for analysing imaging data, providing quantitative information beyond expert assessment. This review highlights the role of radiomic texture analysis in STSs evaluation. MATERIALS AND METHODS: We conducted a systematic review according to the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in PubMed/MEDLINE and Scopus using the search terms: 'radiomics [All Fields] AND ("soft tissue sarcoma" [All Fields] OR "soft tissue sarcomas" [All Fields])'. Only original articles, referring to humans, were included. RESULTS: A preliminary search conducted on PubMed/MEDLINE and Scopus provided 74 and 93 studies respectively. Based on the previously described criteria, 49 papers were selected, with a publication range from July 2015 to June 2023. The main domains of interest were risk stratification, histological grading prediction, technical feasibility/reproductive aspects, treatment response. CONCLUSIONS: With an increasing interest over the last years, the use of radiomics appears to have potential for assessing STSs from initial diagnosis to predicting treatment response. However, additional and extensive research is necessary to validate the effectiveness of radiomics parameters and to integrate them into a comprehensive decision support system.

Motor learning- and consolidation-related resting state fast and slow brain dynamics across wake and sleep.

Motor skills dynamically evolve during practice and after training. Using magnetoencephalography, we investigated the neural dynamics underpinning motor learning and its consolidation in relation to sleep during resting-state periods after the end of learning (boost window, within 30 min) and at delayed time scales (silent 4 h and next day 24 h windows) with intermediate daytime sleep or wakefulness. Resting-state neural dynamics were investigated at fast (sub-second) and slower (supra-second) timescales using Hidden Markov modelling (HMM) and functional connectivity (FC), respectively, and their relationship to motor performance. HMM results show that fast dynamic activities in a Temporal/Sensorimotor state network predict individual motor performance, suggesting a trait-like association between rapidly recurrent neural patterns and motor behaviour. Short, post-training task re-exposure modulated neural network characteristics during the boost but not the silent window. Re-exposure-related induction effects were observed on the next day, to a lesser extent than during the boost window. Daytime naps did not modulate memory consolidation at the behavioural and neural levels. These results emphasise the critical role of the transient boost window in motor learning and memory consolidation and provide further insights into the relationship between the multiscale neural dynamics of brain networks, motor learning, and consolidation.

The Impact of Edema on MRI Radiomics for the Prediction of Lung Metastasis in Soft Tissue Sarcoma.

INTRODUCTION: This study aimed to evaluate whether radiomic features extracted solely from the edema of soft tissue sarcomas (STS) could predict the occurrence of lung metastasis in comparison with features extracted solely from the tumoral mass. MATERIALS AND METHODS: We retrospectively analyzed magnetic resonance imaging (MRI) scans of 32 STSs, including 14 with lung metastasis and 18 without. A segmentation of the tumor mass and edema was assessed for each MRI examination. A total of 107 radiomic features were extracted for each mass segmentation and 107 radiomic features for each edema segmentation. A two-step feature selection process was applied. Two predictive features for the development of lung metastasis were selected from the mass-related features, as well as two predictive features from the edema-related features. Two Random Forest models were created based on these selected features; 100 random subsampling runs were performed. Key performance metrics, including accuracy and area under the ROC curve (AUC), were calculated, and the resulting accuracies were compared. RESULTS: The model based on mass-related features achieved a median accuracy of 0.83 and a median AUC of 0.88, while the model based on edema-related features achieved a median accuracy of 0.75 and a median AUC of 0.79. A statistical analysis comparing the accuracies of the two models revealed no significant difference. CONCLUSION: Both models showed promise in predicting the occurrence of lung metastasis in soft tissue sarcomas. These findings suggest that radiomic analysis of edema features can provide valuable insights into the prediction of lung metastasis in soft tissue sarcomas.

Unravelling Peritoneal Carcinomatosis Using Cross-Sectional Imaging Modalities.

Peritoneal carcinomatosis (PC) refers to malignant epithelial cells that spread to the peritoneum, principally from abdominal malignancies. Until recently, PC prognosis has been considered ill-fated, with palliative therapies serving as the only treatment option. New locoregional treatments are changing the outcome of PC, and imaging modalities have a critical role in early diagnosis and disease staging, determining treatment decision making strategies. The aim of this review is to provide a practical approach for detecting and characterizing peritoneal deposits in cross-sectional imaging modalities, taking into account their appearances, including the secondary complications, the anatomical characteristics of the peritoneal cavity, together with the differential diagnosis with other benign and malignant peritoneal conditions. Among the cross-sectional imaging modalities, computed tomography (CT) is widely available and fast; however, magnetic resonance (MR) performs better in terms of sensitivity (92% vs. 68%), due to its higher contrast resolution. The appearance of peritoneal deposits on CT and MR mainly depends on the primary tumour histology; in case of unknown primary tumour (3-5% of cases), their behaviour at imaging may provide insights into the tumour origin. The timepoint of tumour evolution, previous or ongoing treatments, and the peritoneal spaces in which they occur also play an important role in determining the appearance of peritoneal deposits. Thus, knowledge of peritoneal anatomy and fluid circulation is essential in the detection and characterisation of peritoneal deposits. Several benign and malignant conditions show similar imaging features that overlap those of PC, making differential diagnosis challenging. Knowledge of peritoneal anatomy and primary tumour histology is crucial, but one must also consider clinical history, laboratory findings, and previous imaging examinations to achieve a correct diagnosis. In conclusion, to correctly diagnose PC in cross-sectional imaging modalities, knowledge of peritoneal anatomy and peritoneal fluid flow characteristics are mandatory. Peritoneal deposit features reflect the primary tumour characteristics, and this specificity may be helpful in its identification when it is unknown. Moreover, several benign and malignant peritoneal conditions may mimic PC, which need to be considered even in oncologic patients.

Optimization of workflow for detection of brain metastases at 3T: is a black-blood MTC prepared 3D T1 used alone robust enough to replace the combination of conventional 3D T1 and the black-blood 3D T1 MTC?

PURPOSE: Sampling perfection with application-optimized contrasts by using different flip angle evolutions (SPACE) is a black-blood 3D T1-weighted (T1w) magnetic resonance imaging (MRI) sequence that has shown robust performance for brain metastases detection. However, this could generate false positive results due to suboptimal blood signal suppression. For that reason, SPACE is used in our institution alongside a non-black-blood T1w sequence: volumetric interpolated breath-hold examination (VIBE). Our study aims to (i) evaluate the diagnostic accuracy of SPACE compared to its use in combination with VIBE, (ii) investigate the effect of radiologist's experience in the sequence's performance, and (iii) analyze causes of discordants results. METHODS: Four hundred seventy-three 3T MRI scans were retrospectively analyzed following a monocentric study design. Two studies were formed: one including SPACE alone and one combining both sequences (SPACE + VIBE, the reference). An experienced neuroradiologist and a radiology trainee independently reviewed the images of each study and reported the number of brain metastases. The sensitivity (Se) and specificity (Sp) of SPACE compared to SPACE + VIBE in metastases detection were reported. Diagnostic accuracy of SPACE compared to SPACE + VIBE was assessed by using McNemar's test. Significance was set at p < 0.05. Cohen's kappa was used for inter-method and inter-observer variability. RESULTS: No significant difference was found between the two methods, with SPACE having a Se > 93% and a Sp > 87%. No effect of readers' experience was disclosed. CONCLUSION: Independently of radiologist's experience, SPACE alone is robust enough to replace SPACE + VIBE for brain metastases detection.

Atypical procedural learning skills in children with Developmental Coordination Disorder.

We investigated the procedural learning deficit hypothesis in Developmental Coordination Disorder (DCD) while controlling for global performance such as slower reaction times (RTs) and variability. Procedural (sequence) learning was assessed in 31 children with DCD and 31 age-matched typically developing (TD) children through a serial reaction time task (SRTT). Sequential and random trial conditions were intermixed within five training epochs. Two repeated measures ANOVAs were conducted on a Sequence-Specific Learning Index (SSLI) and a Global Performance Index (GPI, speed/accuracy measure) with Epoch (for SSLI and GPI) and Condition (for GPI) as within-subjects factors, and Group as between-subjects factor. Controlling for RTs differences through normalized RTs, revealed a global reduction of SSLI in children with DCD compared with TD peers suggesting reduced sequence learning skills in DCD. Still, a significant Group x Condition interaction observed on GPI indicated that children from both groups were able to discriminate between sequential and random trials. DCD presented reduced procedural learning skills after controlling for global performance. This finding highlights the importance of considering the general functioning of the child while assessing learning skills in patients.

Resting state fast brain dynamics predict interindividual variability in motor performance.

Motor learning features rapid enhancement during practice then offline post-practice gains with the reorganization of related brain networks. We hypothesised that fast transient, sub-second variations in magnetoencephalographic (MEG) network activity during the resting-state (RS) reflect early learning-related plasticity mechanisms and/or interindividual motor variability in performance. MEG RS activity was recorded before and 20 min after motor learning. Hidden Markov modelling (HMM) of MEG power envelope signals highlighted 8 recurrent topographical states. For two states, motor performance levels were associated with HMM temporal parameters both in pre- and post-learning resting-state sessions. However, no association emerged with offline changes in performance. These results suggest a trait-like relationship between spontaneous transient neural dynamics at rest and interindividual variations in motor abilities. On the other hand, transient RS dynamics seem not to be state-dependent, i.e., modulated by learning experience and reflect neural plasticity, at least on the short timescale.

Assessing spino-cortical proprioceptive processing in childhood unilateral cerebral palsy with corticokinematic coherence.

OBJECTIVE: To develop an electrophysiological marker of proprioceptive spino-cortical tracts integrity based on corticokinematic coherence (CKC) in young children with unilateral cerebral palsy (UCP), in whom behavioral measures are not applicable. METHODS: Electroencephalography (EEG) signals from 12 children with UCP aged 19 to 57 months were recorded using 128-channel EEG caps while their fingers were moved at 2 Hz by an experimenter, in separate sessions for the affected and non-affected hands. The coherence between movement kinematics and EEG signals (i.e., CKC) was computed at the sensor and source (using a realistic head model) levels. Peaks of CKC obtained for the affected and non-affected hands were compared for location and strength. The relation between CKC strength on the lesion-side, the lesion-type (cortico-subcortical vs. subcortical) and the level of manual ability were studied with 2-way repeated-measures ANOVA. RESULTS: At the individual level, a significant CKC peak at the central area contralateral to the moved hand was found in all young children with their non-affected hand and in 8 out of 12 children with their affected hand. At the group level, CKC to the affected hand movements was weaker than CKC to the non-affected hand movements. This difference was influenced by the type of lesion, the effect being predominant in the subgroup (n = 5) with cortico-subcortical lesions. CONCLUSION: CKC is measurable with EEG in young children with UCP and provides electrophysiological evidence for altered proprioceptive spino-cortical tracts on the lesioned brain hemisphere, particularly in children with cortico-subcortical lesions.

Atypical resting-state functional brain connectivity in children with developmental coordination disorder.

Children with developmental coordination disorder (DCD) present lower abilities to acquire and execute coordinated motor skills. DCD is frequently associated with visual perceptual (with or without motor component) impairments. This magnetoencephalography (MEG) study compares the brain resting-state functional connectivity (rsFC) and spectral power of children with and without DCD. 29 children with DCD and 28 typically developing (TD) peers underwent 2 × 5 min of resting-state MEG. Band-limited power envelope correlation and spectral power were compared between groups using a functional connectome of 59 nodes from eight resting-state networks. Correlation coefficients were calculated between fine and gross motor activity, visual perceptual and visuomotor abilities measures on the one hand, and brain rsFC and spectral power on the other hand. Nonparametric statistics were used. Significantly higher rsFC between nodes of the visual, attentional, frontoparietal, default-mode and cerebellar networks was observed in the alpha (maximum statistics, p = .0012) and the low beta (p = .0002) bands in children with DCD compared to TD peers. Lower visuomotor performance (copying figures) was associated with stronger interhemispheric rsFC within sensorimotor areas and power in the cerebellum (right lobule VIII). Children with DCD showed increased rsFC mainly in the dorsal extrastriate visual brain system and the cerebellum. However, this increase was not associated with their coordinated motor/visual perceptual abilities. This enhanced functional brain connectivity could thus reflect a characteristic brain trait of children with DCD compared to their TD peers. Moreover, an interhemispheric compensatory process might be at play to perform visuomotor task within the normative range.

Decreased Alpha Peak Frequency Is Linked to Episodic Memory Impairment in Pathological Aging.

The Free and Cued Selective Reminding Test (FCSRT) is a largely validated neuropsychological test for the identification of amnestic syndrome from the early stage of Alzheimer's disease (AD). Previous electrophysiological data suggested a slowing down of the alpha rhythm in the AD-continuum as well as a key role of this rhythmic brain activity for episodic memory processes. This study therefore investigates the link between alpha brain activity and alterations in episodic memory as assessed by the FCSRT. For that purpose, 37 patients with altered FCSRT performance underwent a comprehensive neuropsychological assessment, supplemented by 18F-fluorodeoxyglucose positron emission tomography/structural magnetic resonance imaging (18FDG-PET/MR), and 10 min of resting-state magnetoencephalography (MEG). The individual alpha peak frequency (APF) in MEG resting-state data was positively correlated with patients' encoding efficiency as well as with the efficacy of semantic cues in facilitating patients' retrieval of previous stored word. The APF also correlated positively with patients' hippocampal volume and their regional glucose consumption in the posterior cingulate cortex. Overall, this study demonstrates that alterations in the ability to learn and store new information for a relatively short-term period are related to a slowing down of alpha rhythmic activity, possibly due to altered interactions in the extended mnemonic system. As such, a decreased APF may be considered as an electrophysiological correlate of short-term episodic memory dysfunction accompanying pathological aging.

Age of onset modulates resting-state brain network dynamics in Friedreich Ataxia.

This magnetoencephalography (MEG) study addresses (i) how Friedreich ataxia (FRDA) affects the sub-second dynamics of resting-state brain networks, (ii) the main determinants of their dynamic alterations, and (iii) how these alterations are linked with FRDA-related changes in resting-state functional brain connectivity (rsFC) over long timescales. For that purpose, 5 min of resting-state MEG activity were recorded in 16 FRDA patients (mean age: 27 years, range: 12-51 years; 10 females) and matched healthy subjects. Transient brain network dynamics was assessed using hidden Markov modeling (HMM). Post hoc median-split, nonparametric permutations and Spearman rank correlations were used for statistics. In FRDA patients, a positive correlation was found between the age of symptoms onset (ASO) and the temporal dynamics of two HMM states involving the posterior default mode network (DMN) and the temporo-parietal junctions (TPJ). FRDA patients with an ASO <11 years presented altered temporal dynamics of those two HMM states compared with FRDA patients with an ASO > 11 years or healthy subjects. The temporal dynamics of the DMN state also correlated with minute-long DMN rsFC. This study demonstrates that ASO is the main determinant of alterations in the sub-second dynamics of posterior associative neocortices in FRDA patients and substantiates a direct link between sub-second network activity and functional brain integration over long timescales.

Resting-state functional brain connectivity is related to subsequent procedural learning skills in school-aged children.

This magnetoencephalography (MEG) study investigates how procedural sequence learning performance is related to prior brain resting-state functional connectivity (rsFC), and to what extent sequence learning induces rapid changes in brain rsFC in school-aged children. Procedural learning was assessed in 30 typically developing children (mean age ± SD: 9.99 years ± 1.35) using a serial reaction time task (SRTT). During SRTT, participants touched as quickly and accurately as possible a stimulus sequentially or randomly appearing in one of the quadrants of a touchscreen. Band-limited power envelope correlation (brain rsFC) was applied to MEG data acquired at rest pre- and post-learning. Correlation analyses were performed between brain rsFC and sequence-specific learning or response time indices. Stronger pre-learning interhemispheric rsFC between inferior parietal and primary somatosensory/motor areas correlated with better subsequent sequence learning performance and faster visuomotor response time. Faster response time was associated with post-learning decreased rsFC within the dorsal extra-striate visual stream and increased rsFC between temporo-cerebellar regions. In school-aged children, variations in functional brain architecture at rest within the sensorimotor network account for interindividual differences in sequence learning and visuomotor performance. After learning, rapid adjustments in functional brain architecture are associated with visuomotor performance but not sequence learning skills.

Age of onset determines intrinsic functional brain architecture in Friedreich ataxia.

OBJECTIVE: Friedreich ataxia (FRDA) is the commonest hereditary ataxia in Caucasians. Most patients are homozygous for expanded GAA triplet repeats in the first intron of the frataxin (FXN) gene, involved in mitochondrial iron metabolism. Here, we used magnetoencephalography (MEG) to characterize the main determinants of FRDA-related changes in intrinsic functional brain architecture. METHODS: Five minutes of MEG signals were recorded at rest from 18 right-handed FRDA patients (mean age 27 years, 9 females; mean SARA score: 21.4) and matched healthy individuals. The MEG connectome was estimated as resting-state functional connectivity (rsFC) matrices involving 37 nodes from six major resting state networks and the cerebellum. Source-level rsFC maps were computed using leakage-corrected broad-band (3-40 Hz) envelope correlations. Post hoc median-split was used to contrast rsFC in FRDA patients with different clinical characteristics. Nonparametric permutations and Spearman rank correlation test were used for statistics. RESULTS: High rank correlation levels were found between rsFC and age of symptoms onset in FRDA mostly between the ventral attention, the default-mode, and the cerebellar networks; patients with higher rsFC developing symptoms at an older age. Increased rsFC was found in FRDA with later age of symptoms onset compared to healthy subjects. No correlations were found between rsFC and other clinical parameters. CONCLUSION: Age of symptoms onset is a major determinant of FRDA patients' intrinsic functional brain architecture. Higher rsFC in FRDA patients with later age of symptoms onset supports compensatory mechanisms for FRDA-related neural network dysfunction and position neuromagnetic rsFC as potential marker of FRDA neural reserve.

Synchrony, metastability, dynamic integration, and competition in the spontaneous functional connectivity of the human brain.

The human brain is functionally organized into large-scale neural networks that are dynamically interconnected. Multiple short-lived states of resting-state functional connectivity (rsFC) identified transiently synchronized networks and cross-network integration. However, little is known about the way brain couplings covary as rsFC states wax and wane. In this magnetoencephalography study, we explore the synchronization structure among the spontaneous interactions of well-known resting-state networks (RSNs). To do so, we extracted modes of dynamic coupling that reflect rsFC synchrony and analyzed their spatio-temporal features. These modes identified transient, sporadic rsFC changes characterized by the widespread integration of RSNs across the brain, most prominently in the ß band. This is in line with the metastable rsFC state model of resting-state dynamics, wherein our modes fit as state transition processes. Furthermore, the default-mode network (DMN) stood out as being structured into competitive cross-network couplings with widespread DMN-RSN interactions, especially among the ß-band modes. These results substantiate the theory that the DMN is a core network enabling dynamic global brain integration in the ß band.

Multichannel Time-Frequency Complexity Measures for the Analysis of Age-Related Changes in Neuromagnetic Resting-State Activity.

We propose new multichannel time-frequency complexity measures to evaluate differences on magnetoencephalograpy (MEG) recordings between healthy young and old subjects at rest at different spatial scales. After reviewing the Rényi and singular value decomposition entropies based on time-frequency representations, we introduce multichannel generalizations, using multilinear singular value decomposition for one of them. We test these quantities on synthetic data, illustrating how the introduced complexity measures focus on number of components, nonstationarity, and similarity across channels. Friedman tests are used to confirm the differences between young and old groups, and heterogeneity within groups. Experimental results show a consistent increase in complexity measures for the old group. When analyzing the topographical distribution of complexity values, we found clusters in the frontal sensors. The complexity measures here introduced seem to be a better indicator of the neurophysiologic changes of aging than power envelope connectivity. Here, we applied new multichannel time-frequency complexity measures to resting-state MEG recordings from healthy young and old subjects. We showed that these features are able to reveal regional clusters. The multichannel time-frequency complexities can be used to monitor the aging of subjects. They also allow a mutual information approach, and could be applied to a wider range of problems.

Comparing the potential of MEG and EEG to uncover brain tracking of speech temporal envelope.

During connected speech listening, brain activity tracks speech rhythmicity at delta (∼0.5 Hz) and theta (4-8 Hz) frequencies. Here, we compared the potential of magnetoencephalography (MEG) and high-density electroencephalography (EEG) to uncover such speech brain tracking. Ten healthy right-handed adults listened to two different 5-min audio recordings, either without noise or mixed with a cocktail-party noise of equal loudness. Their brain activity was simultaneously recorded with MEG and EEG. We quantified speech brain tracking channel-by-channel using coherence, and with all channels at once by speech temporal envelope reconstruction accuracy. In both conditions, speech brain tracking was significant at delta and theta frequencies and peaked in the temporal regions with both modalities (MEG and EEG). However, in the absence of noise, speech brain tracking estimated from MEG data was significantly higher than that obtained from EEG. Furthemore, to uncover significant speech brain tracking, recordings needed to be ∼3 times longer in EEG than MEG, depending on the frequency considered (delta or theta) and the estimation method. In the presence of noise, both EEG and MEG recordings replicated the previous finding that speech brain tracking at delta frequencies is stronger with attended speech (i.e., the sound subjects are attending to) than with the global sound (i.e., the attended speech and the noise combined). Other previously reported MEG findings were replicated based on MEG but not EEG recordings: 1) speech brain tracking at theta frequencies is stronger with attended speech than with the global sound, 2) speech brain tracking at delta frequencies is stronger in noiseless than noisy conditions, and 3) when noise is added, speech brain tracking at delta frequencies dampens less in the left hemisphere than in the right hemisphere. Finally, sources of speech brain tracking reconstructed from EEG data were systematically deeper and more posterior than those derived from MEG. The present study demonstrates that speech brain tracking is better seen with MEG than EEG. Quantitatively, EEG recordings need to be ∼3 times longer than MEG recordings to uncover significant speech brain tracking. As a consequence, MEG appears more suited than EEG to pinpoint subtle effects related to speech brain tracking in a given recording time.