Background. Chronic pain is a common, often disabling condition thought to involve a combination of peripheral and central neurobiological factors. However, the extent and nature of changes in the brain is poorly understood. Methods. We investigated brain network architecture using resting-state fMRI data in chronic back pain patients in the UK and Japan (41 patients, 56 controls), as well as open data from USA. We applied machine learning and deep learning (conditional variational autoencoder architecture) methods to explore classification of patients/controls based on network connectivity. We then studied the network topology of the data, and developed a multislice modularity method to look for consensus evidence of modular reorganisation in chronic back pain. Results. Machine learning and deep learning allowed reliable classification of patients in a third, independent open data set with an accuracy of 63%, with 68% in cross validation of all data. We identified robust evidence of network hub disruption in chronic pain, most consistently with respect to clustering coefficient and betweenness centrality. We found a consensus pattern of modular reorganisation involving extensive, bilateral regions of sensorimotor cortex, and characterised primarily by negative reorganisation - a tendency for sensorimotor cortex nodes to be less inclined to form pairwise modular links with other brain nodes. Furthermore, these regions were found to display increased connectivity with the pregenual anterior cingulate cortex, a region known to be involved in endogenous pain control. In contrast, intraparietal sulcus displayed a propensity towards positive modular reorganisation, suggesting that it might have a role in forming modules associated with the chronic pain state. Conclusion. The results provide evidence of consistent and characteristic brain network changes in chronic pain, characterised primarily by extensive reorganisation of the network architecture of the sensorimotor cortex.

The amounts of muscle and fat in a person's body, known as body composition, are correlated with cancer risks, cancer survival, and cardiovascular risk. The current gold standard for measuring body composition requires time-consuming manual segmentation of CT images by an expert reader. In this work, we describe a two-step process to fully automate the analysis of CT body composition using a DenseNet to select the CT slice and U-Net to perform segmentation. We train and test our methods on independent cohorts. Our results show Dice scores (0.95-0.98) and correlation coefficients (R=0.99) that are favorable compared to human readers. These results suggest that fully automated body composition analysis is feasible, which could enable both clinical use and large-scale population studies. Equal contribution

We propose a deep learning-based technique for detection and quantification of abdominal aortic aneurysms (AAAs). The condition, which leads to more than 10,000 deaths per year in the United States, is asymptomatic, often detected incidentally, and often missed by radiologists. Our model architecture is a modified 3D U-Net combined with ellipse fitting that performs aorta segmentation and AAA detection. The study uses 321 abdominal-pelvic CT examinations performed by Massachusetts General Hospital Department of Radiology for training and validation. The model is then further tested for generalizability on a separate set of 57 examinations with differing patient demographics and acquisition characteristics than the original dataset. DeepAAA achieves high performance on both sets of data (sensitivity/specificity 0.91/0.95 and 0.85 / 1.0 respectively), on contrast and non-contrast CT scans and works with image volumes with varying numbers of images. We find that DeepAAA exceeds literature-reported performance of radiologists on incidental AAA detection. It is expected that the model can serve as an effective background detector in routine CT examinations to prevent incidental AAAs from being missed.

Chronic pain is a common and often disabling condition, and is thought to involve a combination of peripheral and central neurobiological factors. However, the extent and nature of changes in the brain is poorly understood. Here, we investigated brain network architecture using resting state fMRI data collected from chronic back pain patients in UK and Japan (41 patients, 56 controls). Using a machine learning approach (support vector machine), we found that brain network patterns reliably classified chronic pain patients in a third, independent open data set with an accuracy of 63%, whilst 68% was attained in cross validation of all data. We then developed a deep learning classifier using a conditional variational autoencoder, which also yield yielded 63% generalisation and 68% cross-validation accuracy. Given the existence of reliable network changes, we next studied the graph topology of the network, and found consistent evidence of hub disruption based on clustering and betweenness centrality of brain nodes in pain patients. To examine this in more detail, we developed a multislice modularity algorithm to identify a consensus pattern of modular reorganisation of brain nodes across the entire data set. This revealed evidence of significant changes in the modular identity of several brain regions, most notably including broad regions of bilateral sensorimotor cortex, subregions of which also contributed to classifier performance. These results provide evidence of consistent and characteristic brain network changes in chronic pain, and highlight extensive reorganisaton of the network architecture of sensorimotor cortex.

Background. Chronic pain is a common, often disabling condition thought to involve a combination of peripheral and central neurobiological factors. However, the extent and nature of changes in the brain is poorly understood. Methods. We investigated brain network architecture using resting-state fMRI data in chronic back pain patients in the UK and Japan (41 patients, 56 controls), as well as open data from USA. We applied machine learning and deep learning (conditional variational autoencoder architecture) methods to explore classification of patients/controls based on network connectivity. We then studied the network topology of the data, and developed a multislice modularity method to look for consensus evidence of modular reorganisation in chronic back pain. Results. Machine learning and deep learning allowed reliable classification of patients in a third, independent open data set with an accuracy of 63%, with 68% in cross validation of all data. We identified robust evidence of network hub disruption in chronic pain, most consistently with respect to clustering coefficient and betweenness centrality. We found a consensus pattern of modular reorganisation involving extensive, bilateral regions of sensorimotor cortex, and characterised primarily by negative reorganisation - a tendency for sensorimotor cortex nodes to be less inclined to form pairwise modular links with other brain nodes. In contrast, intraparietal sulcus displayed a propensity towards positive modular reorganisation, suggesting that it might have a role in forming modules associated with the chronic pain state. Conclusion. The results provide evidence of consistent and characteristic brain network changes in chronic pain, characterised primarily by extensive reorganisation of the network architecture of the sensorimotor cortex.