Classification of brain lesions using a machine learning approach with cross-sectional ADC value dynamics.

Diffusion-weighted imaging (DWI) and its numerical expression via apparent diffusion coefficient (ADC) values are commonly utilized in non-invasive assessment of various brain pathologies. Although numerous studies have confirmed that ADC values could be pathognomic for various ring-enhancing lesions (RELs), their true potential is yet to be exploited in full. The article was designed to introduce an image analysis method allowing REL recognition independently of either absolute ADC values or specifically defined regions of interest within the evaluated image. For this purpose, the line of interest (LOI) was marked on each ADC map to cross all of the RELs' compartments. Using a machine learning approach, we analyzed the LOI between two representatives of the RELs, namely, brain abscess and glioblastoma (GBM). The diagnostic ability of the selected parameters as predictors for the machine learning algorithms was assessed using two models, the k-NN model and the SVM model with a Gaussian kernel. With the k-NN machine learning method, 80% of the abscesses and 100% of the GBM were classified correctly at high accuracy. Similar results were obtained via the SVM method. The proposed assessment of the LOI offers a new approach for evaluating ADC maps obtained from different RELs and contributing to the standardization of the ADC map assessment.

[Day care clinics central and/or distributed. A standard element of child and adolescent psychiatric care]. / Tageskliniken zentral und/oder disloziert. Ein Standardelement der kinder- und jugendpsychiatrischen Versorgung.

BACKGROUND: Day-care clinics as specialized care units of child and adolescent psychiatric care in Austria represent an important component for person-orientated treatment offers. In addition to numerous advantages, they also put higher demands on the young patients and their relatives. METHODS: The Austrian structure for day-care settings is recorded in the Austrian structure plan for health. Therefore, particular attention is paid to structural quality criteria, which are based on the Austrian concept of performance-oriented hospital financing. RESULTS: A high demand and need for readiness for transdisciplinary, multimodal treatment concepts and forms is discussed. It becomes ovious that there is a need for large spatial resource requirements. The establishment of several day clinic groups at one location and spatial requirements cannot be found in the concept of performance-oriented hospital financing. CONCLUSION: To ensure and evaluate the quality of treatment, recommendations are made on a patient-related and team- or organization-related level. The workgroup "day-care-clinic" of the Austrian Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy recommends a treatment structure characterized by transdisciplinarity and participation. Further, it regionalized and local access and the integration of the day clinic into the community is necessary. Networking with other care structures and using social-psychiatric networks is essential. Regional characteristics should be taken into account and specialized, topic-specific day clinic groups should be increasingly included in further planning and concepts.