Publications by authors named "KLEN R"

Dynamic positron emission tomography (PET) can be used to non-invasively estimate the blood flow of different organs via compartmental modeling. Out of different PET tracers, water labeled with the radioactive O isotope of oxygen (half-life of 2.04 min) is freely diffusable, and therefore, very well-suited for blood flow quantification.

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This perspective paper explores the untapped potential of artificial intelligence (AI), particularly machine learning-based dimension reduction techniques in multimodal neuroimaging analysis of Long COVID fatigue. The complexity and high dimensionality of neuroimaging data from modalities such as positron emission tomography (PET) and magnetic resonance imaging (MRI) pose significant analytical challenges. Deep neural networks and other machine learning approaches offer powerful tools for managing this complexity and extracting meaningful patterns.

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Article Synopsis
  • The stability-plasticity dilemma is a key issue in creating AI that can learn continuously without losing previous knowledge.
  • This paper suggests a new AI approach inspired by the way the mammalian hippocampus and cortex balance quick learning and long-term memory retention.
  • The authors propose innovative AI designs, such as dual learning rates and dynamic plasticity, and aim to connect insights from neuroscience with advancements in AI technology.
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Long COVID (Coronavirus disease), affecting millions globally, presents unprecedented challenges to healthcare systems due to its complex, multifaceted nature and the lack of effective treatments. This perspective review explores the potential of artificial intelligence (AI)-guided transcranial direct current stimulation (tDCS) as an innovative approach to address the urgent need for effective Long COVID management. The authors examine how AI could optimize tDCS protocols, enhance clinical trial design, and facilitate personalized treatment for the heterogeneous manifestations of Long COVID.

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The quality of sleep plays a significant role in determining human well-being, and studying sleep and sleep disorders using various methods can aid in the prevention and treatment of diseases. Positron emission tomography (PET) is a noninvasive and highly sensitive medical imaging technique that has been widely adopted in the clinic. This review article provides data on research activity related to sleep and sleep apnea and discusses the use of PET in investigating sleep apnea and other sleep disorders.

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Objectives: The objectives of this narrative review are to summarize the current state of AI applications in neuroimaging for early Alzheimer's disease (AD) prediction and to highlight the potential of AI techniques in improving early AD diagnosis, prognosis, and management.

Methods: We conducted a narrative review of studies using AI techniques applied to neuroimaging data for early AD prediction. We examined single-modality studies using structural MRI and PET imaging, as well as multi-modality studies integrating multiple neuroimaging techniques and biomarkers.

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Background: We developed an explainable deep-learning (DL)-based classifier to identify flow-limiting coronary artery disease (CAD) by O-15 HO perfusion positron emission tomography computed tomography (PET/CT) and coronary CT angiography (CTA) imaging. The classifier uses polar map images with numerical data and visualizes data findings.

Methods: A DLmodel was implemented and evaluated on 138 individuals, consisting of a combined image-and data-based classifier considering 35 clinical, CTA, and PET variables.

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Background: Cardiac positron emission tomography (PET) can visualize and quantify the molecular and physiological pathways of cardiac function. However, cardiac and respiratory motion can introduce blurring that reduces PET image quality and quantitative accuracy. Dual cardiac- and respiratory-gated PET reconstruction can mitigate motion artifacts but increases noise as only a subset of data are used for each time frame of the cardiac cycle.

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Research on different machine learning (ML) has become incredibly popular during the past few decades. However, for some researchers not familiar with statistics, it might be difficult to understand how to evaluate the performance of ML models and compare them with each other. Here, we introduce the most common evaluation metrics used for the typical supervised ML tasks including binary, multi-class, and multi-label classification, regression, image segmentation, object detection, and information retrieval.

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Clustering time activity curves of PET images have been used to separate clinically relevant areas of the brain or tumours. However, PET image segmentation in multiorgan level is much less studied due to the available total-body data being limited to animal studies. Now, the new PET scanners providing the opportunity to acquire total-body PET scans also from humans are becoming more common, which opens plenty of new clinically interesting opportunities.

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Recently, PET systems with a long axial field of view have become the current state of the art. Total-body PET scanners enable unique possibilities for scientific research and clinical diagnostics, but this new technology also raises numerous challenges. A key advantage of total-body imaging is that having all the organs in the field of view allows studying biologic interaction of all organs simultaneously.

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Aims: To evaluate the incremental value of positron emission tomography (PET) myocardial perfusion imaging (MPI) over coronary computed tomography angiography (CCTA) in predicting short- and long-term outcome using machine learning (ML) approaches.

Methods And Results: A total of 2411 patients with clinically suspected coronary artery disease (CAD) underwent CCTA, out of whom 891 patients were admitted to downstream PET MPI for haemodynamic evaluation of obstructive coronary stenosis. Two sets of Extreme Gradient Boosting (XGBoost) ML models were trained, one with all the clinical and imaging variables (including PET) and the other with only clinical and CCTA-based variables.

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Background: Machine Learning (ML) allows integration of the numerous variables delivered by cardiac PET/CT, while traditional survival analysis can provide explainable prognostic estimates from a restricted number of input variables. We implemented a hybrid ML-and-survival analysis of multimodal PET/CT data to identify patients who developed myocardial infarction (MI) or death in long-term follow up.

Methods: Data from 739 intermediate risk patients who underwent coronary CT and selectively stress O-water-PET perfusion were analyzed for the occurrence of MI and all-cause mortality.

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Article Synopsis
  • New variants of SARS-CoV-2, changes in public health measures, and decreased immunity in high-risk groups are leading to predictions of increased hospitalizations and intensive care admissions, highlighting a need for effective Early Warning Scores (EWSs) to predict patient complications within 24-48 hours.* -
  • The developed COVID-19 Early Warning Score (COEWS) relies on easily accessible laboratory parameters, distinguishing it from existing models like NEWS2, and assesses risk in both vaccinated and unvaccinated patients.* -
  • The COEWS model incorporates key lab results, transforming predictive coefficients into individual scores that help identify patients at risk of mechanical ventilation or death; its predictive performance shows promising results with a discrimination score of
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The aim of this study was to develop a convolutional neural network (CNN) for classifying positron emission tomography (PET) images of patients with and without head and neck squamous cell carcinoma (HNSCC) and other types of head and neck cancer. A PET/magnetic resonance imaging scan with F-fluorodeoxyglucose (F-FDG) was performed for 200 head and neck cancer patients, 182 of which were diagnosed with HNSCC, and the location of cancer tumors was marked to the images with a binary mask by a medical doctor. The models were trained and tested with five-fold cross-validation with the primary data set of 1990 2D images obtained by dividing the original 3D images of 178 HNSCC patients into transaxial slices and with an additional test set with 238 images from the patients with head and neck cancer other than HNSCC.

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The aim of this study was to analyze whether the coronavirus disease 2019 (COVID-19) vaccine reduces mortality in patients with moderate or severe COVID-19 disease requiring oxygen therapy. A retrospective cohort study, with data from 148 hospitals in both Spain (111 hospitals) and Argentina (37 hospitals), was conducted. We evaluated hospitalized patients for COVID-19 older than 18 years with oxygen requirements.

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Background And Purpose: Periprosthetic joint infection (PJI) is the commonest reason for revision after total knee arthroplasty (TKA). We assessed the risk factors for revision due to PJI following TKA based on the Finnish Arthroplasty Register (FAR).

Patients And Methods: We analyzed 62,087 primary condylar TKAs registered between June 2014 and February 2020 with revision for PJI as the endpoint.

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Carimas is a multi-purpose medical imaging data processing tool, which can be used to visualize, analyze, and model different medical images in research. Originally, it was developed only for positron emission tomography data in 2009, but the use of this software has extended to many other tomography imaging modalities, such as computed tomography and magnetic resonance imaging. Carimas is especially well-suited for analysis of three- and four-dimensional image data and creating polar maps in modeling of cardiac perfusion.

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Aims: Combined anatomical and functional imaging enables detection of non-obstructive and obstructive coronary artery disease (CAD) as well as myocardial ischaemia. We evaluated sex differences in disease profile and outcomes after combined computed tomography angiography (CTA) and positron emission tomography (PET) perfusion imaging in patients with suspected obstructive CAD.

Methods And Results: We retrospectively evaluated 1948 patients (59% women) referred for coronary CTA due to suspected CAD during the years 2008-2016.

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Article Synopsis
  • New SARS-CoV-2 variants, breakthrough infections, waning immunity, and low vaccination rates are causing increased hospitalizations and deaths, highlighting the need for better resource allocation tools in hospitals, especially in resource-limited areas.
  • The CODOP tool, developed using machine learning, predicts the clinical outcomes of hospitalized COVID-19 patients by analyzing 12 clinical parameters, demonstrating high accuracy levels (AUROC: 0.90-0.96) before clinical resolution.
  • CODOP's effectiveness is consistent across different virus variants and vaccination statuses, and it includes online calculators for efficient patient triage, validated through extensive testing in Latin America.
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Background: Attenuation correction is crucial in quantitative positron emission tomography-magnetic resonance (PET-MRI) imaging. We evaluated three methods to improve the segmentation and modelling of the attenuation coefficients in the nasal sinus region. Two methods (cuboid and template method) included a MRI-CT conversion model for assigning the attenuation coefficients in the nasal sinus region, whereas one used fixed attenuation coefficient assignment (bulk method).

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We implemented a two-dimensional convolutional neural network (CNN) for classification of polar maps extracted from Carimas (Turku PET Centre, Finland) software used for myocardial perfusion analysis. 138 polar maps from O-HO stress perfusion study in JPEG format from patients classified as ischemic or non-ischemic based on finding obstructive coronary artery disease (CAD) on invasive coronary artery angiography were used. The CNN was evaluated against the clinical interpretation.

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As machine learning-based artificial intelligence (AI) continues to revolutionize the way in which we analyze data, the field of nuclear cardiology provides fertile ground for the implementation of these complex analytics. This review summarizes and discusses the principles regarding nuclear cardiology techniques and AI, and the current evidence regarding its performance and contribution to the improvement of risk prediction in cardiovascular disease. There is a growing body of evidence on the experimentation with and implementation of machine learning-based AI on nuclear cardiology studies both concerning SPECT and PET technology for the improvement of risk-of-disease (classification of disease) and risk-of-events (prediction of adverse events) estimations.

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The cardiac benefits of gastrointestinal hormones have been of interest in recent years. The aim of this study was to explore the myocardial and renal effects of the gastrointestinal hormone secretin in the GUTBAT trial (NCT03290846). A placebo-controlled crossover study was conducted on 15 healthy males in fasting conditions, where subjects were blinded to the intervention.

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