DeepImageTranslator V2: Analysis of Multimodal Medical Images using Semantic Segmentation Maps Generated through Deep Learning

Introduction: Analysis of multimodal medical images often requires the selection of one or many anatomical regions of interest (ROIs) for extraction of useful statistics. This task can prove laborious when a manual approach is used. We have previously developed a user-friendly software tool for image-to-image translation using deep learning. Therefore, we present herein an update to the DeepImageTranslator V2 software with the addition of a tool for multimodal medical image segmentation analysis (hereby referred to as the MMMISA). Methods: The MMMISA was implemented using the Tkinter library; backend computations were implemented using the Pydicom, Numpy, and OpenCV libraries. We tested our software using 4188 slices from whole-body axial 2-deoxy-2-[18F]-fluoroglucose-position emission tomography/ computed tomography scans ([¹⁸F]-FDG-PET/CT) of 10 patients from the American College of Radiology Imaging Network-Head and Neck Squamous Cell Carcinoma (ACRIN-HNSCC) database. Using the deep learning software DeepImageTranslator, a model was trained with 36 randomly selected CT slices and manually labelled semantic segmentation maps. Utilizing the trained model, all the CT scans of the 10 HNSCC patients were segmented with high accuracy. Segmentation maps generated using the deep convolutional network were then used to measure organ specific [¹⁸F]-FDG uptake. We also compared measurements performed using the MMMISA and those made with manually selected ROIs. Results: The MMMISA is a tool that allows user to select ROIs based on deep learning-generated segmentation maps and to compute accurate statistics for these ROIs based on coregistered multimodal images. We found that organ-specific [¹⁸F]-FDG uptake measured using multiple manually selected ROIs is concordant with whole-tissue measurements made with segmentation maps using the MMMISA tool. Doi: 10.28991/HIJ-2022-03-03-07 Full Text: PD

The Pure Heart: A Medieval Japanese Buddhist Political Theory of Legitimacy

Due to narratives stemming from the currently-dominant Eurocentric belief-system, contemporary works on legitimacy generally avoid the inclusion of ‘belief’ as a core analytical tool. However, pioneer of social science studies Max Webber clarified in The Profession and Vocation of Politics (1919) the necessary relationship between beliefs and legitimacy when he demonstrated that structures of authority/power can never be legitimate based only on their existence alone; rather, they find their legitimacy through the belief system which sustains them. This means that to understand catalyzers of political change – even more so the legitimizing of new political dynamics – political theorists need to set aside their Eurocentric assumptions and start engaging with beliefs seriously again. Translating and applying an East-Asian commentary methodology to texts written in the Heian 平安 (794-1185) and Kamakura 鎌倉 (1185-1333) era of Japanese history, this work excavates key beliefs that play a central role in discussions surrounding politics. More specifically, this work focuses on passages found in the works of Buddhist authors, namely Eisai 栄西 (1141-1215), Dōgen 道元 (1200-1253), and Nichiren 日蓮 (1222-1282). Ultimately, the goal of this paper is to systematize these passages into a coherent medieval Japanese Buddhist political theory of legitimacy, while clarifying the core beliefs in which this theory is anchored. This work first establishes that the medieval Japanese Buddhist political theory of legitimacy places at its core beliefs in the heart (kokoro 心), purity (shōjō 淸淨) and karma (gō 業), and proposes political analyses of and solutions to legitimate leadership stemming from such beliefs

Pontomedullary junction as a reference for spinal cord cross-sectional area: validation across neck positions

Abstract Spinal cord cross-sectional area (CSA) is an important MRI biomarker to assess spinal cord atrophy in various neurodegenerative and traumatic spinal cord diseases. However, the conventional method of computing CSA based on vertebral levels is inherently flawed, as the prediction of spinal levels from vertebral levels lacks reliability, leading to considerable variability in CSA measurements. Computing CSA from an intrinsic neuroanatomical reference, the pontomedullary junction (PMJ), has been proposed in previous work to overcome limitations associated with using a vertebral reference. However, the validation of this alternative approach, along with its variability across and within participants under variable neck extensions, remains unexplored. The goal of this study was to determine if the variability of CSA across neck flexions/extensions is reduced when using the PMJ, compared to vertebral levels. Ten participants underwent a 3T MRI T2w isotropic scan at 0.6 mm3 for 3 neck positions: extension, neutral and flexion. Spinal cord segmentation, vertebral labeling, PMJ labeling, and CSA were computed automatically while spinal segments were labeled manually. Mean coefficient of variation for CSA across neck positions was 3.99 ± 2.96% for the PMJ method vs. 4.02 ± 3.01% for manual spinal segment method vs. 4.46 ± 3.10% for the disc method. These differences were not statistically significant. The PMJ method was slightly more reliable than the disc-based method to compute CSA at specific spinal segments, although the difference was not statistically significant. This suggests that the PMJ can serve as a valuable alternative and reliable method for estimating CSA when a disc-based approach is challenging or not feasible, such as in cases involving fused discs in individuals with spinal cord injuries

Structural Connectivity Alterations in Operculo-Insular Epilepsy

Operculo-insular epilepsy (OIE) is an under-recognized condition that can mimic temporal and extratemporal epilepsies. Previous studies have revealed structural connectivity changes in the epileptic network of focal epilepsy. However, most reports use the debated streamline-count to quantify 'connectivity strength' and rely on standard tracking algorithms. We propose a sophisticated cutting-edge method that is robust to crossing fibers, optimizes cortical coverage, and assigns an accurate microstructure-reflecting quantitative conectivity marker, namely the COMMIT (Convex Optimization Modeling for Microstructure Informed Tractography)-weight. Using our pipeline, we report the connectivity alterations in OIE. COMMIT-weighted matrices were created in all participants (nine patients with OIE, eight patients with temporal lobe epilepsy (TLE), and 22 healthy controls (HC)). In the OIE group, widespread increases in 'connectivity strength' were observed bilaterally. In OIE patients, 'hyperconnections' were observed between the insula and the pregenual cingulate gyrus (OIE group vs. HC group) and between insular subregions (OIE vs. TLE). Graph theoretic analyses revealed higher connectivity within insular subregions of OIE patients (OIE vs. TLE). We reveal, for the first time, the structural connectivity distribution in OIE. The observed pattern of connectivity in OIE likely reflects a diffuse epileptic network incorporating insular-connected regions and may represent a structural signature and diagnostic biomarker