Objective: To investigate whether local lesions created by stereo-electroencephalography (SEEG)–guided radiofrequency thermocoagulation (RFTC) affect distant brain connectivity and excitability in patients with focal, drug-resistant epilepsy (DRE). Methods: Ten patients with focal DRE underwent SEEG implantation and subsequently 1 Hz bipolar repetitive electrical stimulation (RES) for 30 s before and after RFTC. Root mean square (RMS) of cortico-cortical evoked potentials (CCEPs) was calculated for 15 ms to 300 ms post-stimulation with baseline correction. Contact pairs were categorized as both coagulated, hybrid, or both non-coagulated. The data were divided into nine categories based on the stimulating and recording contact pair combinations. RMS of CCEPs was compared before and after (<12 h) RFTC using a two-sample t test (Hochberg corrected, p < 0.05) for each patient. Boost score, indicating power increase during seizures before RFTC relative to baseline, was analyzed in 4 s windows with 1 s overlap during seizure duration. Results: RFTC altered connectivity across all categories. Of interest, decreases and increases in RMS were observed in connections between non-coagulated contacts distant from coagulation site (range: 1.09–85 mm, median = 17.7 mm, interquartile range [IQR] 10.1–32.3). Contact pairs involved in significantly altered non-coagulated connections showed a higher boost score correlation in the theta, beta, and gamma bands, as well as a stronger maximum correlation with coagulated sites in the delta band than contacts for which connectivity did not change after RFTC. Significance: This study highlights how local lesions alter distant brain connectivity, providing insights for future research on epilepsy network changes and seizure outcomes following RFTC.

Dynamic contrast-enhanced ultrasound (DCEUS) is an imaging modality for assessing microvascular perfusion and dispersion kinetics. However, the presence of speckle noise may hamper the quantitative analysis of the contrast kinetics. Common speckle denoising techniques based on low-rank approximations typically model the speckle noise as white Gaussian noise (WGN) after the log transformation and apply matrix-based algorithms. We address the high dimensionality of the 4D DCEUS data and apply low-rank tensor decomposition techniques to denoise speckles. Although there are many tensor decompositions that can describe low rankness, we limit our research to multilinear rank and tubal rank. We introduce a gradient-based extension of the multilinear singular value decomposition to model low multilinear rankness, assuming that the log-transformed speckle noise follows a Fisher-tippet distribution. In addition, we apply an algorithm based on tensor singular value decomposition to model low tubal rankness, assuming that the log-transformed speckle noise is WGN with sparse outliers. The effectiveness of the methods is evaluated through simulations and phantom studies. Additionally, the tensor-based algorithms’ real-world performance is assessed using DCEUS prostate recordings. Comparative analyses with existing DCEUS denoising literature are conducted, and the algorithms’ capabilities are showcased in the context of prostate cancer classification. The addition of Fisher-tippet distribution did not improve the results of tr-MLSVD in the in vivo case. However, most cancer markers are better distinguishable when using a tensor denoising technique than state-of-the-art approaches.

A cost-effective, widely available, and practical diagnostic imaging tool for prostate cancer (PCa) localization is still lacking. Recently, the contrast-ultrasound dispersion imaging (CUDI) technique has been developed for PCa localization by quantifying dynamic contrast-enhanced ultrasound (DCE-US) acquisitions. Tissue stiffness is an additional PCa biomarker that can be quantified by ultrasound shear-wave elastography (SWE). In this work, a dedicated preprocessing of 3D DCE-US acquisitions was investigated by using multilinear singular value decomposition (MLSVD), aiming at improving the CUDI performance. Moreover, the diagnostic potential of a multiparametric ultrasound imaging approach combining 3D CUDI features with SWE tissue elasticity for clinically significant (cs)PCa localization was evaluated by comparison with the histopathological outcome of systematic biopsies. In this multiparametric approach, the performance of five classifiers was evaluated and compared for biopsy-region csPCa classification. The classification performance was assessed by the area under the Receiver Operating Characteristics curve (AUC) in a k-fold cross validation fashion comprising sequential floating forward selection of the features. The combination of CUDI features with MLSVD preprocessing and SWE elasticity yielded the best AUC=0.87 for csPCa localization. Our results suggest 3D multiparametric ultrasound imaging approach combing a dedicated preprocessing step to be a useful tool for PCa diagnostics.