A decision support system for the identification of metastases of Metastatic Melanoma using whole-body FDG PET/CT images

Metastatic Melanoma (MM) is an aggressive type of cancer which produces metastases throughout the body with very poor survival rates. Recent advances in immunotherapy have shown promising results for controlling disease's progression. Due to the often rapid progression, fast and accurate diagnosis and treatment response assessment is vital for the whole patient management. These procedures prerequisite accurate, whole-body tumor identification. This can be offered by the imaging modality Positron Emission Tomography (PET)/Computed Tomography (CT) with the radiotracer F 18-Fluorodeoxyglucose (FDG). However, manual segmentation of PET/CT images is a very time-consuming and labor intensive procedure that requires expert knowledge. Most of the previously published segmentation techniques focus on a specific type of tumor or part of the body and require a great amount of manually labeled data, which is, however, difficult for MM. Multimodal analysis of PET/CT is also crucial because FDG-PET contains only the functional information of tumors which can be complemented by the anatomical information of CT. In this paper, we propose a whole-body segmentation framework capable of efficiently identifying the highly heterogeneous tumor lesions of MM from the whole-body 3D FDG-PET/CT images. The proposed decision support system begins with an Ensemble Unsupervised Segmentation of regions of high FDG-uptake based on Fuzzy C-means and a custom region growing algorithm. Then, a region classification model based on radiomics features and Neural Networks classifies these regions as tumors or not. Experimental results showed high performance in the identification of MM lesions with Sensitivity 83.68%, Specificity 91.82%, F1-score 75.42%, AUC 94.16% and Balanced accuracy 87.75% which were also supported by the public dataset evaluation.

Machine Learning Model for Predicting CVD Risk on NHANES Data

Cardiovascular disease (CVD) is a major health problem throughout the world. It is the leading cause of morbidity and mortality and also causes considerable economic burden to society. The early symptoms related to previous observations and abnormal events, which can be subjectively acquired by self-assessment of individuals, bear significant clinical relevance and are regularly preserved in the patient's health record. The aim of our study is to develop a machine learning model based on selected CVD-related information encompassed in NHANES data in order to assess CVD risk. This model can be used as a screening tool, as well as a retrospective reference in association with current clinical data in order to improve CVD assessment. In this form it is planned to be used for mass screening and evaluation of young adults entering their army service. The experimental results are promising in that the proposed model can effectively complement and support the CVD prediction for the timely alertness and control of cardiovascular problems aiming to prevent the occurrence of serious cardiac events.

Vertebrae, IVD and spinal canal boundary extraction on MRI, utilizing CT-trained active shape models

PURPOSE

Vertebrae, intervertebral disc (IVD) and spinal canal (SC) displacements are in the root of several spinal cord pathologies. The localization and boundary extraction of these structures, along with the quantification of their displacements, provide valuable clues for assessing each pathological condition. In this work, we propose a computational method for boundary extraction of vertebrae, IVD and SC in magnetic resonance images (MRI).

METHOD

Vertebrae shape priors derived from computed tomography (CT) images are used to guide vertebrae, IVD and SC boundary extraction in MRI. This strategy is dictated by three considerations: (1) CT is the modality of choice for highlighting solid structures such as vertebrae, (2) vertebrae boundaries indirectly impose constraints on the boundaries of neighbouring structures (IVD and SC), and (3) it can be observed that edges are similarly located in CT and MR images; therefore, gradient profiles and shape priors learned by active shape models (ASMs) from CT are also valid in MRI.

RESULTS

Experimental comparisons on two MR image datasets demonstrate that the proposed approach obtains segmentation results, which are comparable to the state of the art. Moreover, the adopted bimodal strategy is validated by demonstrating that CT-derived shape priors lead to more accurate boundary extraction than MRI-derived shape priors, even in the case of MR image applications.

CONCLUSION

Unlike existing bimodal methods, the proposed one is not dependent on the availability of CT/MR image pairs, which are not usually acquired from the same patient. In addition, unlike state-of-the-art deep learning-based methods, it is not dependent on large amounts of training data. The proposed method requires a limited amount of user intervention.

A Wavelet-Based Approach for Estimating Time-Varying Connectivity in Resting-State Functional Magnetic Resonance Imaging

Introduction: The selection of an appropriate window size, window function, and functional connectivity (FC) metric in the sliding window method is not straightforward due to the absence of ground truth. Methods: A previously proposed wavelet-based method was accordingly adjusted for estimating time-varying FC (TVFC) and was applied to a large high-quality, low-motion dataset of 400 resting-state functional magnetic resonance imaging data. Specifically, the wavelet coherence magnitude and relative phase were averaged across wavelet (frequency) scales to yield TVFC and synchronization patterns. To assess whether the observed fluctuations in TVFC were statistically significant (dynamic FC [dFC]; the distinction between TVFC and dFC is intentional), surrogate data were generated using the multivariate phase randomization (MVPR) and multivariate autoregressive randomization (MVAR) methods to define the null hypothesis of dFC absence. Results: By averaging across all frequencies, core regions of the default mode network (DMN; medial prefrontal and posterior cingulate cortices, inferior parietal lobes, hippocampal formation) were found to exhibit dFC (test-retest reproducibility of 90%) and were also synchronized in activity (-15° ≤ phase ≤15°). When averaging across distinct frequency bands, the same dynamic connections were identified, with the majority of them identified in the frequency range (0.01, 0.198) Hz, though with lower test-retest reproducibility (<66%). Additional analysis suggested that MVPR method better preserved properties (p < 10^-10), including time-averaged coherence, of the original data compared with MVAR approach. Conclusions: The wavelet-based approach identified dynamic associations between the core DMN regions with fewer choices in parameters, compared with sliding window method. Impact statement We employed a wavelet-based method, previously used in the literature, and proposed modifications to assess time-varying functional connectivity in resting-state functional magnetic resonance imaging. With this approach, dynamic connections within the default mode network were identified, involving the medial prefrontal and posterior cingulate cortices, inferior parietal lobes, and hippocampal formation, which were also highly consistent in test-retest analysis (test-retest reproducibility of 90%), without the need to select window size, window function, and functional connectivity metric as with the sliding window method, whereby no consensus on the appropriate choices of hyperparameters currently exists in the literature.

Deformable image registration to assist clinical decision for radiotherapy treatment adaptation for head and neck cancer patients

Head and neck (H&N) cancer patients often present anatomical and geometrical changes in tumors and organs at risk (OARs) during radiotherapy treatment. These changes may result in the need to adapt the existing treatment planning, using an expert's subjective opinion, for offline adaptive radiotherapy and a new treatment planning before each treatment, for online adaptive radiotherapy. In the present study, a fast methodology is proposed to assist in planning adaptation clinical decision using tumor and parotid glands percentage volume changes during treatment. The proposed approach was applied to 40 Η&Ν cases, with one planning Computed Tomography (pCT) image and CBCT scans for 6 weeks of treatment per case. Deformable registration was used for each patient's pCT image alignment to its weekly CBCT. The calculated transformations were used to align each patient's anatomical structures to the weekly anatomy. Clinical target volume (CTV) and parotid gland volume percentage changes were calculated in each case. The accuracy of the achieved image alignment was validated qualitatively and quantitatively. Furthermore, statistical analysis was performed to test if there is a statistically significant correlation between CTV and parotid glands volume percentage changes. Average MDA for CTV and parotid glands between corresponding structures defined by an expert in CBCTs and automatically calculated through registration was 1.4 ± 0.1 mm and 1.5 ± 0.1 mm, respectively. The mean registration time of the first CBCT image registration for 40 cases was lower than 3.4 min. Five patients show more than 20% tumor volume change. Six patients show more than 30% parotid glands volume change. Ten out of 40 patients proposed for planning adaptation. All the statistical tests performed showed no correlation between CTV/parotid glands percentage volume changes. The aim to assist in clinical decision making on a fast and automatic way was achieved using the proposed methodology, thereby reducing workload in clinical practice.

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 emphasizes their utility in serving as promising indicators for different workload conditions applications.

ISOMAP and machine learning algorithms for the construction of embedded functional connectivity networks of anatomically separated brain regions from resting state fMRI data of patients with Schizophrenia

We construct Functional Connectivity Networks (FCN) from resting state fMRI (rsfMRI) recordings towards the classification of brain activity between healthy and schizophrenic subjects using a publicly available dataset (the COBRE dataset) of 145 subjects (74 healthy controls and 71 schizophrenic subjects). First, we match the anatomy of the brain of each individual to the Desikan-Killiany brain atlas. Then, we use the conventional approach of correlating the parcellated time series to construct FCN and ISOMAP, a nonlinear manifold learning algorithm to produce low-dimensional embeddings of the correlation matrices. For the classification analysis, we computed five key local graph-theoretic measures of the FCN and used the LASSO and Random Forest (RF) algorithms for feature selection. For the classification we used standard linear Support Vector Machines. The classification performance is tested by a double cross-validation scheme (consisting of an outer and an inner loop of "Leave one out" cross-validation (LOOCV)). The standard cross-correlation methodology produced a classification rate of 73.1%, while ISOMAP resulted in 79.3%, thus providing a simpler model with a smaller number of features as chosen from LASSO and RF, namely the participation coefficient of the right thalamus and the strength of the right lingual gyrus.

Chemotherapy-Induced Brain Effects in Small-Cell Lung Cancer Patients: A Multimodal MRI Study

The golden standard of treating Small Cell Lung Cancer (SCLC) entails application of platinum-based chemotherapy, is often accompanied by Prophylactic Cranial Irradiation (PCI), which have been linked to neurotoxic side-effects in cognitive functions. The related existing neuroimaging research mainly focuses on the effect of PCI treatment in life quality and expectancy, while little is known regarding the distinct adverse effects of chemotherapy. In this context, a multimodal MRI analysis based on structural and functional brain data is proposed in order to evaluate chemotherapy-specific effects on SCLC patients. Data from 20 patients (after chemotherapy and before PCI) and 14 healthy controls who underwent structural MRI, DTI and resting state fMRI were selected in this study. From a structural aspect, the proposed analysis included volumetry and thickness measurements on structural MRI data for assessing gray matter dissimilarities, as well as deterministic tractography and Tract-Based Spatial Statistics (TBSS) on DTI data, aiming to investigate potential white matter abnormalities. Functional data were also processed on the basis of connectivity analysis, evaluating brain network parameters to identify potential manifestation of functional inconsistencies. By comparing patients to healthy controls, the obtained results revealed statistically significant differences, with the patients' brains presenting reduced volumetry/thickness and fractional anisotropy values, accompanied by prominent differences in functional connectivity measurements. All above mentioned findings were observed in patients that underwent chemotherapy.

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.

Effects of motion related outliers in dynamic functional connectivity using the sliding window method

BACKGROUND

It has been suggested that the use of window functions, other than the rectangular, in the sliding window method, may be beneficial for reducing the effects of motion-related outliers in the time-series, when assessing dynamic functional connectivity (dFC) in resting-state fMRI (rs-fMRI).

METHODOLOGY

Ten window functions for a wide range of window lengths (20-150 s) combined with Pearson and Kendall correlation metrics, were investigated. One hundred high quality rs-fMRI datasets from healthy controls, were used to systematically assess the effect of varying the window function and length on dFC assessment. To this end, two approaches were implemented: a) simulated outliers were added to the experimental data and b) the experimental data were divided into low and high motion subgroups.

RESULTS

The presence of experimental motion-noise tended to inflate the number of dynamic connections for longer (≥100 s) wide-shaped windows, while shorter (20-30 s) narrow-shaped windows exhibited increased sensitivity in the presence of simulated outliers. Moreover, window sizes from 60 s to 90 s were mildly affected by motion-related effects. In most cases, the number of dynamic connections increased, and gradually lower frequencies were captured, with an increasing window size.

CONCLUSIONS

Subject motion considerably affects the obtained dFC patterns; thus, it is preferable to perform motion artefact removal in the pre-processing stage rather than using alternative window functions to mitigate their effects. Provided that motion-noise is not excessive, the choice of a rectangular window is adequate. Finally, low frequency oscillations in functional connectivity seem to play an important role in the context of dFC assessment.

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.

Assessment of dynamic functional connectivity in resting-state fMRI using the sliding window technique

INTRODUCTION

Recent studies related to assessing functional connectivity (FC) in resting-state functional magnetic resonance imaging have revealed that the resulting connectivity patterns exhibit considerable fluctuations (dynamic FC [dFC]). A widely applied method for quantifying dFC is the sliding window technique. According to this method, the data are divided into segments with the same length (window size) and a correlation metric is employed to assess the connectivity within these segments, whereby the window size is often empirically chosen.

METHODS

In this study, we rigorously investigate the assessment of dFC using the sliding window approach. Specifically, we perform a detailed comparison between different correlation metrics, including Pearson, Spearman and Kendall correlation, Pearson and Spearman partial correlation, Mutual Information (MI), Variation of Information (VI), Kullback-Leibler divergence, Multiplication of Temporal Derivatives and Inverse Covariance.

RESULTS

Using test-retest datasets, we show that MI and VI yielded the most consistent results by achieving high reliability with respect to dFC estimates for different window sizes. Subsequent hypothesis testing, based on multivariate phase randomization surrogate data generation, allowed the identification of dynamic connections between the posterior cingulate cortex and regions in the frontal lobe and inferior parietal lobes, which were overall in agreement with previous studies.

CONCLUSIONS

In the case of MI and VI, a window size of at least 120 s was found to be necessary for detecting dFC for some of the previously identified dynamically connected regions.

Detection of retinal pigment epithelium detachment from OCT images using multiscale Gaussian filtering

Macular diseases, including neovascular age-related macular degeneration (nvAMD), are leading causes of irreversible blindness and visual impairment. One prominent feature of nvAMD is the detachment of the retinal pigment epithelium. The aim of this study is to implement an automated method for the segmentation of the pigment epithelial detachment (PED) using optical coherence tomography (OCT). OCT datasets from 8 patients with nvAMD were acquired during multiple sessions. At each session, 17 images with a resolution of 1020 × 640 pixels were obtained. The images were segmented using Gaussian filtering and template matching for the detection of the upper and lower border of the PED, respectively. The results of the method were compared with the ones obtained from the manual segmentation of the images by an expert. Four well-known metrics were used to evaluate the performance of the method with respect to the manual segmentation, resulting in high scores of consistency. Furthermore, the proposed method was also compared with four other well-known methods providing similar or superior performance.

3D dental image registration using exhaustive deformable models: a comparative study

OBJECTIVES

Image registration is commonly used in dental applications for aligning imaging data sets, which is particularly useful when assessing the progression or regression of particular pathomorphic conditions. However, due to the nature of the processed data or the data acquisition process itself, rigid body registration may be insufficient to accurately align the processed data sets. In such cases, deformable models are employed. This study presents a comparison of four well-established deformable models for aligning CBCT volumes.

METHODS

The compared models include the original Demons algorithm, symmetric forces Demons, diffeomorphic Demons and level-set motion. The compared techniques are incorporated into a general image registration scheme featuring two distinct stages: a common, fast, rigid-based alignment for pre-registering the data and a finer elastic registration phase, based on the four compared deformation models.

RESULTS

The proposed framework was applied to a total of 40 CBCT volume pairs with known and unknown initial differences.

CONCLUSIONS

After both qualitative and quantitative assessment of the produced aligned data, it was concluded that the level-set motion method outperformed all other techniques for data pairs with both unknown initial differences, as well as with known elastic deviations based on fixed sinusoidal models and B-splines.

An Independent Active Contours Segmentation framework for bone micro-CT images

Micro-CT is an imaging technique for small tissues and objects that is gaining increased popularity especially as a pre-clinical application. Nevertheless, there is no well-established micro-CT segmentation method, while typical procedures lack sophistication and frequently require a degree of manual intervention, leading to errors and subjective results. To address these issues, a novel segmentation framework, called Independent Active Contours Segmentation (IACS), is proposed in this paper. The proposed IACS is based on two autonomous modules, namely automatic ROI extraction and IAC Evolution, which segments the ROI image using multiple Active Contours that evolve simultaneously and independently of one another. The proposed method is applied on a Phantom dataset and on real datasets. It is tested against several established segmentation methods that include Adaptive Thresholding, Otsu Thresholding, Region Growing, Chan-Vese (CV) AC, Geodesic AC and Automatic Local Ratio-CV AC, both qualitatively and quantitatively. The results prove its superior performance in terms of object identification capability, accuracy and robustness, under normal circumstances and under four types of artificially introduced noise. These enhancements can lead to more reliable analysis, better diagnostic procedures and treatment evaluation of several bone-related pathologies, and to the facilitation and further advancement of bone research.

A New Ensemble Classification System For Fracture Zone Prediction Using Imbalanced Micro-CT Bone Morphometrical Data

Trabecular bone fractures constitute a major health issue for the modern societies, with the currently established prediction methods of fracture risk, such as bone mineral density (BMD), resulting in errors up to 40%. Fracture-zone prediction based on bone's microstructure has been recently proposed as an alternative prediction method of fracture risk. In this paper, a classification system (CS) for the automatic fracture-zone prediction based on an Ensemble of Imbalanced Learning methods is proposed, following the observation that the percentage of the actual fractured bone area is significantly smaller than the intact bone in the case of a fracture event. The sample is divided into Volumes of Interest (VOIs) of specific size and 29 morphometrical parameters are calculated from each VOI, which serve as input features for the CS in order for it to separate the input patterns in to two classes: fractured and nonfractured. To this end, two well-established Imbalanced Learning methods, namely Random Undersampling and Synthetic Minority Oversampling, and two popular classification algorithms, namely Multilayer Perceptrons and Support Vector Machines, are tested and combined accordingly, to provide the best possible performance on a dataset that contains 45 specimens' pre- and postfailure scans. The best combination is then compared with three well-established Ensembles of Imbalanced Learning methods, namely RUSBoost, UnderBagging and SMOTEBagging. The experimental results clearly show that the proposed CS outperforms the competition, scoring in some occasions more than 90% in G-Mean and Area under Curve metrics. Finally, an investigation on the significance of the various trabecular bone's biomechanical parameters is made using the sequential forward floating selection technique, in order to identify possible biomarkers for fracture-zone prediction.

An automatic panoramic image reconstruction scheme from dental computed tomography images

OBJECTIVES

Panoramic images of the jaws are extensively used for dental examinations and/or surgical planning because they provide a general overview of the patient's maxillary and mandibular regions. Panoramic images are two-dimensional projections of three-dimensional (3D) objects. Therefore, it should be possible to reconstruct them from 3D radiographic representations of the jaws, produced by CBCT scanning, obviating the need for additional exposure to X-rays, should there be a need of panoramic views. The aim of this article is to present an automated method for reconstructing panoramic dental images from CBCT data.

METHODS

The proposed methodology consists of a series of sequential processing stages for detecting a fitting dental arch which is used for projecting the 3D information of the CBCT data to the two-dimensional plane of the panoramic image. The detection is based on a template polynomial which is constructed from a training data set.

RESULTS

A total of 42 CBCT data sets of real clinical pre-operative and post-operative representations from 21 patients were used. Eight data sets were used for training the system and the rest for testing.

CONCLUSIONS

The proposed methodology was successfully applied to CBCT data sets, producing corresponding panoramic images, suitable for examining pre-operatively and post-operatively the patients' maxillary and mandibular regions.

Isocenter Verification in Radiotherapy Clinical Practice Using Virtual Simulation

This chapter presents an overview of the procedures that are used for the verification of the patient position during radiotherapy. Furthermore, a method for the verification of the radiotherapy isocenter prior to treatment delivery is proposed. The method is based on the alignment of two Computed Tomography (CT) scans: a scan, which is acquired for treatment planning, and an additional verification scan, which is acquired prior to the treatment delivery. The proposed method was applied to CT scans, acquired from 20 patients with abdominal tumors and 20 patients with breast/lung cancer. The results of the proposed method were compared with the ones obtained using conventional methods, indicating that the estimated isocenter displacement can be translated into patient setup error inside the treatment room.

Discrete states of attention during active visual fixation revealed by Markovian analysis of the time series of intrusive saccades

The frequency of intrusive saccades during maintenance of active visual fixation has been used as a measure of sustained visual attention in studies of healthy subjects as well as of neuropsychiatric patient populations. In this study, the mechanism that generates intrusive saccades during active visual fixation was investigated in a population of young healthy men performing three sustained fixation tasks (fixation to a visual target, fixation to a visual target with visual distracters, and fixation straight ahead in the dark). Markov Chain modeling of inter-saccade intervals (ISIs) was utilized. First- and second-order Markov modeling provided indications for the existence of a non-random pattern in the production of intrusive saccades. Accordingly, the system of intrusive saccade generation may operate in two "attractor" states, one in which intrusive saccades occur at short consecutive ISIs and another in which intrusive saccades occur at long consecutive ISIs. These states might correspond to two distinct states of the attention system, one of low focused - high distractibility and another of high focused - low distractibility, such as those proposed in the adaptive gain theory for the control of attention by the noradrenergic system in the brain. To the authors knowledge, this is the first time that Markov Chain modeling has been applied to the analysis of the ISIs of intrusive saccades.

A computer-aided automated methodology for the detection and classification of occlusal caries from photographic color images

The aim of this work is to present a computer-aided automated methodology for the assessment of carious lesions, according to the International Caries Detection and Assessment System (ICDAS II), which are located on the occlusal surfaces of posterior permanent teeth from photographic color tooth images. The proposed methodology consists of two stages: (a) the detection of regions of interest and (b) the classification of the detected regions according to ICDAS ΙΙ. In the first stage, pre-processing, segmentation and post-processing mechanisms were employed. For each pixel of the detected regions, a 15×15 neighborhood is used and a set of intensity-based and texture-based features were extracted. A correlation based technique was applied to select a subset of 36 features which were given as input into the classification stage, where five classifiers (J48, Random Tree, Random Forests, Support Vector Machines and Naïve Bayes) were compared to conclude to the best one, in our case, to Random Forests. The methodology was evaluated on a set of 103 digital color images where 425 regions of interest from occlusal surfaces of extracted permanent teeth were manually segmented and classified, based on visual assessments by two experts. The methodology correctly detected 337 out of 340 regions in the detection stage with accuracy of detection 80%. For the classification stage an overall accuracy 83% is achieved. The proposed methodology provides an objective and fully automated caries diagnostic system for occlusal carious lesions with similar or better performance of a trained dentist taking into consideration the available medical knowledge.

Computational Construction of Antibody-Drug Conjugates Using Surface Lysines as the Antibody Conjugation Site and a Non-cleavable Linker

Antibody–drug conjugates (ADCs) constitute a category of anticancer targeted therapy that has gathered great interest during the last few years because of their potential to kill cancer cells while causing significantly fewer side effects than traditional chemotherapy. In this paper, a process of computational construction of ADCs is described, using the surface lysines of an antibody and a non-covalent linker molecule, as well as a cytotoxic substance, as files in Protein Data Bank format. Also, aspects related to the function, properties, and development of ADCs are discussed.