Towards Automation in Radiotherapy Planning: A Deep Learning Approach for the Delineation of Parotid Glands in Head and Neck Cancer.

The delineation of parotid glands in head and neck (HN) carcinoma is critical to assess radiotherapy (RT) planning. Segmentation processes ensure precise target position and treatment precision, facilitate monitoring of anatomical changes, enable plan adaptation, and enhance overall patient safety. In this context, artificial intelligence (AI) and deep learning (DL) have proven exceedingly effective in precisely outlining tumor tissues and, by extension, the organs at risk. This paper introduces a DL framework using the AttentionUNet neural network for automatic parotid gland segmentation in HN cancer. Extensive evaluation of the model is performed in two public and one private dataset, while segmentation accuracy is compared with other state-of-the-art DL segmentation schemas. To assess replanning necessity during treatment, an additional registration method is implemented on the segmentation output, aligning images of different modalities (Computed Tomography (CT) and Cone Beam CT (CBCT)). AttentionUNet outperforms similar DL methods (Dice Similarity Coefficient: 82.65% ± 1.03, Hausdorff Distance: 6.24 mm ± 2.47), confirming its effectiveness. Moreover, the subsequent registration procedure displays increased similarity, providing insights into the effects of RT procedures for treatment planning adaptations. The implementation of the proposed methods indicates the effectiveness of DL not only for automatic delineation of the anatomical structures, but also for the provision of information for adaptive RT support.

µ-STAR: A novel framework for spatio-temporal M/EEG source imaging optimized by microstates.

Source imaging of Electroencephalography (EEG) and Magnetoencephalography (MEG) provides a noninvasive way of monitoring brain activities with high spatial and temporal resolution. In order to address this highly ill-posed problem, conventional source imaging models adopted spatio-temporal constraints that assume spatial stability of the source activities, neglecting the transient characteristics of M/EEG. In this work, a novel source imaging method µ-STAR that includes a microstate analysis and a spatio-temporal Bayesian model was introduced to address this problem. Specifically, the microstate analysis was applied to achieve automatic determination of time window length with quasi-stable source activity pattern for optimal reconstruction of source dynamics. Then a user-specific spatial prior and data-driven temporal basis functions were utilized to characterize the spatio-temporal information of sources within each state. The solution of the source reconstruction was obtained through a computationally efficient algorithm based upon variational Bayesian and convex analysis. The performance of the µ-STAR was first assessed through numerical simulations, where we found that the determination and inclusion of optimal temporal length in the spatio-temporal prior significantly improved the performance of source reconstruction. More importantly, the µ-STAR model achieved robust performance under various settings (i.e., source numbers/areas, SNR levels, and source depth) with fast convergence speed compared with five widely-used benchmark models (including wMNE, STV, SBL, BESTIES, & SI-STBF). Additional validations on real data were then performed on two publicly-available datasets (including block-design face-processing ERP and continuous resting-state EEG). The reconstructed source activities exhibited spatial and temporal neurophysiologically plausible results consistent with previously-revealed neural substrates, thereby further proving the feasibility of the µ-STAR model for source imaging in various applications.

Individualized Prediction of Task Performance Decline Using Pre-Task Resting-State Functional Connectivity.

As a common complaint in contemporary society, mental fatigue is a key element in the deterioration of the daily activities known as time-on-task (TOT) effect, making the prediction of fatigue-related performance decline exceedingly important. However, conventional group-level brain-behavioral correlation analysis has the limitation of generalizability to unseen individuals and fatigue prediction at individual-level is challenging due to the significant differences between individuals both in task performance efficiency and brain activities. Here, we introduced a cross-validated data-driven analysis framework to explore, for the first time, the feasibility of utilizing pre-task idiosyncratic resting-state functional connectivity (FC) on the prediction of fatigue-related task performance degradation at individual level. Specifically, two behavioral metrics, namely ∆RT (between the most vigilant and fatigued states) and TOTslope over the course of the 15-min sustained attention task, were estimated among three sessions from 37 healthy subjects to represent fatigue-related individual behavioral impairment. Then, a connectome-based prediction model was employed on pre-task resting-state FC features, identifying the network-related differences that contributed to the prediction of performance deterioration. As expected, prominent populational TOT-related performance declines were revealed across three sessions accompanied with substantial inter-individual differences. More importantly, we achieved significantly high accuracies for individualized prediction of both TOT-related behavioral impairment metrics using pre-task neuroimaging features. Despite the distinct patterns between both behavioral metrics, the identified top FC features contributing to the individualized predictions were mainly resided within/between frontal, temporal and parietal areas. Overall, our results of individualized prediction framework extended conventional correlation/classification analysis and may represent a promising avenue for the development of applicable techniques that allow precaution of the TOT-related performance declines in real-world scenarios.

Early Prediction of Planning Adaptation Requirement Indication Due to Volumetric Alterations in Head and Neck Cancer Radiotherapy: A Machine Learning Approach.

BACKGROUND: During RT cycles, the tumor response pattern could affect tumor coverage and may lead to organs at risk of overdose. As such, early prediction of significant volumetric changes could therefore reduce potential radiation-related adverse effects. Nevertheless, effective machine learning approaches based on the radiomic features of the clinically used CBCT images to determine the tumor volume variations due to RT not having been implemented so far. METHODS: CBCT images from 40 HN cancer patients were collected weekly during RT treatment. From the obtained images, the Clinical Target Volume (CTV) and Parotid Glands (PG) regions of interest were utilized to calculate 104 delta-radiomics features. These features were fed on a feature selection and classification procedure for the early prediction of significant volumetric alterations. RESULTS: The proposed framework was able to achieve 0.90 classification performance accuracy while detecting a small subset of discriminative characteristics from the 1st week of RT. The selected features were further analyzed regarding their effects on temporal changes in anatomy and tumor response modeling. CONCLUSION: The use of machine learning algorithms offers promising perspectives for fast and reliable early prediction of large volumetric deviations as a result of RT treatment, exploiting hidden patterns in the overall anatomical characteristics.

Inferring the Individual Psychopathologic Deficits With Structural Connectivity in a Longitudinal Cohort of Schizophrenia.

The prediction of schizophrenia-related psychopathologic deficits is exceedingly important in the fields of psychiatry and clinical practice. However, objective association of the brain structure alterations to the illness clinical symptoms is challenging. Although, schizophrenia has been characterized as a brain dysconnectivity syndrome, evidence accounting for neuroanatomical network alterations remain scarce. Moreover, the absence of generalized connectome biomarkers for the assessment of illness progression further perplexes the prediction of long-term symptom severity. In this paper, a combination of individualized prediction models with quantitative graph theoretical analysis was adopted, providing a comprehensive appreciation of the extent to which the brain network properties are affected over time in schizophrenia. Specifically, Connectome-based Prediction Models were employed on Structural Connectivity (SC) features, efficiently capturing individual network-related differences, while identifying the anatomical connectivity disturbances contributing to the prediction of psychopathological deficits. Our results demonstrated distinctions among widespread cortical circuits responsible for different domains of symptoms, indicating the complex neural mechanisms underlying schizophrenia. Furthermore, the generated models were able to significantly predict changes of symptoms using SC features at follow-up, while the preserved SC features suggested an association with improved positive and overall symptoms. Moreover, cross-sectional significant deficits were observed in network efficiency and a progressive aberration of global integration in patients compared to healthy controls, representing a group-consensus pathological map, while supporting the dysconnectivity hypothesis.

EEG Fingerprints of Task-Independent Mental Workload Discrimination.

In the nascent field of neuroergonomics, mental workload assessment is one of the most important issues and has an apparent significance in real-world applications. Although prior research has achieved efficient single-task classification, scatted studies on cross-task mental workload assessment usually result in unsatisfactory performance. Here, we introduce a data-driven analysis framework to overcome the challenges regarding task-independent workload assessment using a fusion of EEG spectral characteristics and unveil the common neural mechanisms underlying mental workload. Specifically, multi-frequency power spectrum and functional connectivity (FC) were estimated for two workload levels in two working-memory tasks performed by 40 healthy participants, subsequently being fed into a machine learning approach to obtain the importance of each feature vector and evaluate classification performance in a cross-task fashion. Our framework achieved a classification accuracy of 0.94 for task-independent mental workload discrimination. Further investigation of the designated features in terms of their spectral and localization properties revealed task-independent common patterns in the neural mechanisms governing workload. In particular, increased workload was associated with elevated frontal delta and theta power but reduced parietal alpha power, whereas FC exhibited complex frequency- and region-dependent alterations. By implication, the employment of the EEG feature fusion emphasized their utility in serving as promising indicators for different workload conditions applications.

A condition-independent framework for the classification of error-related brain activity.

The cognitive processing and detection of errors is important in the adaptation of the behavioral and learning processes. This brain activity is often reflected as distinct patterns of event-related potentials (ERPs) that can be employed in the detection and interpretation of the cerebral responses to erroneous stimuli. However, high-accuracy cross-condition classification is challenging due to the significant variations of the error-related ERP components (ErrPs) between complexity conditions, thus hindering the development of error recognition systems. In this study, we employed support vector machines (SVM) classification methods, based on waveform characteristics of ErrPs from different time windows, to detect correct and incorrect responses in an audio identification task with two conditions of different complexity. Since the performance of the classifiers usually depends on the salience of the features employed, a combination of the sequential forward floating feature selection (SFFS) and sequential forward feature selection (SFS) methods was implemented to detect condition-independent and condition-specific feature subsets. Our framework achieved high accuracy using a small subset of the available features both for cross- and within-condition classification, hence supporting the notion that machine learning techniques can detect hidden patterns of ErrP-based features, irrespective of task complexity while additionally elucidating complexity-related error processing variations. Graphical abstract A schematic of the proposed approach. (a) EEG recordings in an auditory experiment in two conditions of different complexity. (b) Characteristic event related activity feature extraction. (c) Selection of feature vector subsets for easy and hard conditions corresponding to correct (Class1) and incorrect (Class2) responses. (d) Performance for individual and cross-condition classification.

Mental Workload Drives Different Reorganizations of Functional Cortical Connectivity Between 2D and 3D Simulated Flight Experiments.

Despite the apparent usefulness of efficient mental workload assessment in various real-world situations, the underlying neural mechanism remains largely unknown, and studies of the mental workload are limited to well-controlled cognitive tasks using a 2D computer screen. In this paper, we investigated functional brain network alterations in a simulated flight experiment with three mental workload levels and compared the reorganization pattern between computer screen (2D) and virtual reality (3D) interfaces. We constructed multiband functional networks in electroencephalogram (EEG) source space, which were further assessed in terms of network efficiency and workload classification performances. We found that increased alpha band efficiencies and beta band local efficiency were associated with elevated mental workload levels, while beta band global efficiency exhibited distinct development trends between 2D and 3D interfaces. Furthermore, using a small subset of connectivity features, we achieved a satisfactory multi-level workload classification accuracy in both interfaces (82% for both 2D and 3D). Further inspection of these discriminative connectivity subsets, we found predominant alpha band connectivity features followed by beta and theta band features with different topological patterns between 2D and 3D interfaces. These findings allow for a more comprehensive interpretation of the neural mechanisms of mental workload in relation to real-world assessment.

Functional Connectivity Analysis of Mental Fatigue Reveals Different Network Topological Alterations Between Driving and Vigilance Tasks.

Despite the apparent importance of mental fatigue detection, a reliable application is hindered due to the incomprehensive understanding of the neural mechanisms of mental fatigue. In this paper, we investigated the topological alterations of functional brain networks in the theta band (4 - 7 Hz) of electroencephalography (EEG) data from 40 male subjects undergoing two distinct fatigue-inducing tasks: a low-intensity one-hour simulated driving and a high-demanding half-hour sustained attention task [psychomotor vigilance task (PVT)]. Behaviorally, subjects demonstrated a robust mental fatigue effect, as reflected by significantly declined performances in cognitive tasks prior and post these two tasks. Furthermore, characteristic path length presented a positive correlation with task duration, which led to a significant increase between the first and the last five minutes of both tasks, indicating a fatigue-related disruption in information processing efficiency. However, significantly increased clustering coefficient was revealed only in the driving task, suggesting distinct network reorganizations between the two fatigue-inducing tasks. Moreover, high accuracy (92% for driving; 97% for PVT) was achieved for fatigue classification with apparently different discriminative functional connectivity features. These findings augment our understanding of the complex nature of fatigue-related neural mechanisms and demonstrate the feasibility of using functional connectivity as neural biomarkers for applicable fatigue monitoring.

Neuroprotective assessment of prolonged local hypothermia post contusive spinal cord injury in rodent model.

BACKGROUND CONTEXT: Although general hypothermia is recognized as a clinically applicable neuroprotective intervention, acute moderate local hypothermia post contusive spinal cord injury (SCI) is being considered a more effective approach. Previously, we have investigated the feasibility and safety of inducing prolonged local hypothermia in the central nervous system of a rodent model. PURPOSE: Here, we aimed to verify the efficacy and neuroprotective effects of 5 and 8 hours of local moderate hypothermia (30±0.5°C) induced 2 hours after moderate thoracic contusive SCI in rats. STUDY DESIGN: Rats were induced with moderate SCI (12.5 mm) at its T8 section. Local hypothermia (30±0.5°C) was induced 2 hours after injury induction with an M-shaped copper tube with flow of cold water (12°C), from the T6 to the T10 region. Experiment groups were divided into 5-hour and 8-hour hypothermia treatment groups, respectively, whereas the normothermia control group underwent no hypothermia treatment. METHODS: The neuroprotective effects were assessed through objective weekly somatosensory evoked potential (SSEP) and motor behavior (basso, beattie and bresnahan Basso, Beattie and Bresnahan (BBB) scoring) monitoring. Histology on spinal cord was performed until at the end of day 56. All authors declared no conflict of interest. This work was supported by the Singapore Institute for Neurotechnology Seed Fund (R-175-000-121-733), National University of Singapore, Ministry of Education, Tier 1 (R-172-000-414-112.). RESULTS: Our results show significant SSEP amplitudes recovery in local hypothermia groups starting from day 14 post-injury onward for the 8-hour treatment group, which persisted up to days 28 and 42, whereas the 5-hour group showed significant improvement only at day 42. The functional improvement plateaued after day 42 as compared with control group of SCI with normothermia. This was supported by both 5-hour and 8-hour improvement in locomotion as measured by BBB scores. Local hypothermia also observed insignificant changes in its SSEP latency, as compared with the control. In addition, 5- and 8-hour hypothermia rats' spinal cord showed higher percentage of parenchyma preservation. CONCLUSIONS: Early local moderate hypothermia can be induced for extended periods of time post SCI in the rodent model. Such intervention improves functional electrophysiological outcome and motor behavior recovery for a long time, lasting until 8 weeks.

A mental fatigue index based on regression using mulitband EEG features with application in simulated driving.

Development of accurate fatigue level prediction models is of great importance for driving safety. In parallel, a limited number of sensors is a prerequisite for development of applicable wearable devices. Several EEG-based studies so far have performed classification in two or few levels, while others have proposed indices based on power ratios. Here, we utilized a regression Random Forest model in order to provide more accurate continuous fatigue level prediction. In detail, multiband power features were extracted from EEG data recorded from one hour simulated driving task. Next, cross-subject regression was performed to obtain common fatigue-related discriminative features. We achieved satisfactory prediction accuracy and simultaneously we minimized required electrodes, proposing to use a set of 3 electrodes.

Task-Independent Mental Workload Classification Based Upon Common Multiband EEG Cortical Connectivity.

Efficient classification of mental workload, an important issue in neuroscience, is limited, so far to single task, while cross-task classification remains a challenge. Furthermore, network approaches have emerged as a promising direction for studying the complex organization of the brain, enabling easier interpretation of various mental states. In this paper, using two mental tasks (N-back and mental arithmetic), we present a framework for cross- as well as within-task workload discrimination by utilizing multiband electroencephalography (EEG) cortical brain connectivity. In detail, we constructed functional networks in EEG source space in different frequency bands and considering the individual functional connections as classification features, we identified salient feature subsets based on a sequential feature selection algorithm. These connectivity subsets were able to provide accuracy of 87% for cross-task, 88% for N-back task, and 86% for mental arithmetic task. In conclusion, our method achieved to detect a small number of discriminative interactions among brain areas, leading to high accuracy in both within-task and cross-task classifications. In addition, the identified functional connectivity features, the majority of which were detected in frontal areas in theta and beta frequency bands, helped delineate the shared as well as the distinct neural mechanisms of the two mental tasks.