Beyond Known Reality: Exploiting Counterfactual Explanations for Medical Research

This study employs counterfactual explanations to explore "what if?" scenarios in medical research, with the aim of expanding our understanding beyond existing boundaries. Specifically, we focus on utilizing MRI features for diagnosing pediatric posterior fossa brain tumors as a case study. The field of artificial intelligence and explainability has witnessed a growing number of studies and increasing scholarly interest. However, the lack of human-friendly interpretations in explaining the outcomes of machine learning algorithms has significantly hindered the acceptance of these methods by clinicians in their clinical practice. To address this, our approach incorporates counterfactual explanations, providing a novel way to examine alternative decision-making scenarios. These explanations offer personalized and context-specific insights, enabling the validation of predictions and clarification of variations under diverse circumstances. Importantly, our approach maintains both statistical and clinical fidelity, allowing for the examination of distinct tumor features through alternative realities. Additionally, we explore the potential use of counterfactuals for data augmentation and evaluate their feasibility as an alternative approach in medical research. The results demonstrate the promising potential of counterfactual explanations to enhance trust and acceptance of AI-driven methods in clinical settings

Review of influential clinical factors in reducing the risk of unsuccessful MRI-guided HIFU treatment outcome of uterine fibroids

Magnetic resonance imaging-guided high-intensity focused ultrasound (MRI-guided HIFU) is an effective noninvasive treatment option for symptomatic uterine fibroids. However, tissue characteristics of uterine fibroids and technical limitations can limit the patient population that can benefit from this therapy. In this article, we present our literature review focusing on the influential clinical factors that might reduce the risk of an unsuccessful MRI-guided HIFU treatment outcome of uterine fibroids

Emerging clinical applications of high-intensity focused ultrasound

High-intensity focused ultrasound (HIFU) is a minimally-invasive and non-ionizing promising technology and has been assessed for its role in the treatment of not only primary tumors but also metastatic lesions under the guidance of ultrasound or magnetic resonance imaging. Its performance is notably effective in neurologic, genitourinary, hepato-pancreato-biliary, musculoskeletal, oncologic, and other miscellaneous applications. In this article, we reviewed the emerging technology of HIFU and its clinical applications

Regional cerebral blood perfusion changes in chronic stroke survivors as potential brain correlates of the functional outcome following gamiied home-based rehabilitation (IntelliRehab)—a pilot study

Background: Hospital-based stroke rehabilitation for stroke survivors in developing countries may be limited by staffing ratios and length of stay that could hamper recovery potential. Thus, a home-based, gamified rehabilitation system (i.e., IntelliRehab) was tested for its ability to increase cerebral blood flow (CBF), and the secondary impact of changes on the upper limb motor function and functional outcomes. Objective: To explore the effect of IntelliRehab on CBF in chronic stroke patients and its correlation with the upper limb motor function. Methods: Two-dimensional pulsed Arterial Spin Labelling (2D-pASL) was used to obtain CBF images of stable, chronic stroke subjects (n = 8) over 3-months intervention period. CBF alterations were mapped, and the detected differences were marked as regions of interest. Motor functions represented by Fugl-Meyer Upper Extremity Assessment (FMA) and Stroke Impact Scale (SIS) were used to assess the primary and secondary outcomes, respectively. Results: Regional CBF were significantly increased in right inferior temporal gyrus and left superior temporal white matter after 1-month (p = 0.044) and 3-months (p = 0.01) of rehabilitation, respectively. However, regional CBF in left middle fronto-orbital gyrus significantly declined after 1-month of rehabilitation (p = 0.012). Moreover, SIS-Q7 and FMA scores significantly increased after 1-month and 3-months of rehabilitation. There were no significant correlations, however, between CBF changes and upper limb motor function. Conclusions: Participants demonstrated improved motor functions, supporting the benefit of using IntelliRehab as a tool for home-based rehabilitation. However, within-participant improvements may have limited potential that suggests the need for a timely administration of IntelliRehab to get the maximum capacity of improvement