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Sakka SG. Assessment of liver perfusion and function by indocyanine green in the perioperative setting and in critically ill patients. J Clin Monit Comput 2017; 32:787-796. [PMID: 29039062 DOI: 10.1007/s10877-017-0073-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/06/2017] [Indexed: 12/13/2022]
Abstract
Indocyanine green (ICG) is a water-soluble dye that is bound to plasma proteins when administered intravenously and nearly completely eliminated from the blood by the liver. ICG elimination depends on hepatic blood flow, hepatocellular function and biliary excretion. ICG elimination is considered as a useful dynamic test describing liver function and perfusion in the perioperative setting, i.e., in liver surgery and transplantation, as well as in critically ill patients. ICG plasma disappearance rate (ICG-PDR) which can be measured today by transcutaneous systems at the bedside is a valuable method for dynamic assessment of liver function and perfusion, and is regarded as a valuable prognostic tool in predicting survival of critically ill patients, presenting with sepsis, ARDS or acute liver failure.
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Affiliation(s)
- Samir G Sakka
- Department of Anesthesiology and Operative Intensive Care Medicine, Medical Center Cologne-Merheim, University Witten/ Herdecke, Ostmerheimerstrasse 200, 51109, Cologne, Germany.
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Asayama B, Sato K, Fukui T, Okuma M, Nakagaki Y, Nakagaki Y, Osato T, Nakamura H. Skull bone tumor resection with intraoperative indocyanine green fluorescence imaging: A series of four surgical cases. INTERDISCIPLINARY NEUROSURGERY 2017. [DOI: 10.1016/j.inat.2017.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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53
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Dynamic and accurate assessment of acetaminophen-induced hepatotoxicity by integrated photoacoustic imaging and mechanistic biomarkers in vivo. Toxicol Appl Pharmacol 2017; 332:64-74. [PMID: 28755860 DOI: 10.1016/j.taap.2017.07.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 07/22/2017] [Accepted: 07/25/2017] [Indexed: 12/14/2022]
Abstract
The prediction and understanding of acetaminophen (APAP)-induced liver injury (APAP-ILI) and the response to therapeutic interventions is complex. This is due in part to sensitivity and specificity limitations of currently used assessment techniques. Here we sought to determine the utility of integrating translational non-invasive photoacoustic imaging of liver function with mechanistic circulating biomarkers of hepatotoxicity with histological assessment to facilitate the more accurate and precise characterization of APAP-ILI and the efficacy of therapeutic intervention. Perturbation of liver function and cellular viability was assessed in C57BL/6J male mice by Indocyanine green (ICG) clearance (Multispectral Optoacoustic Tomography (MSOT)) and by measurement of mechanistic (miR-122, HMGB1) and established (ALT, bilirubin) circulating biomarkers in response to the acetaminophen and its treatment with acetylcysteine (NAC) in vivo. We utilised a 60% partial hepatectomy model as a situation of defined hepatic functional mass loss to compared acetaminophen-induced changes to. Integration of these mechanistic markers correlated with histological features of APAP hepatotoxicity in a time-dependent manner. They accurately reflected the onset and recovery from hepatotoxicity compared to traditional biomarkers and also reported the efficacy of NAC with high sensitivity. ICG clearance kinetics correlated with histological scores for acute liver damage for APAP (i.e. 3h timepoint; r=0.90, P<0.0001) and elevations in both of the mechanistic biomarkers, miR-122 (e.g. 6h timepoint; r=0.70, P=0.005) and HMGB1 (e.g. 6h timepoint; r=0.56, P=0.04). For the first time we report the utility of this non-invasive longitudinal imaging approach to provide direct visualisation of the liver function coupled with mechanistic biomarkers, in the same animal, allowing the investigation of the toxicological and pharmacological aspects of APAP-ILI and hepatic regeneration.
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Kanoria S, Robertson FP, Mehta NN, Fusai G, Sharma D, Davidson BR. Effect of Remote Ischaemic Preconditioning on Liver Injury in Patients Undergoing Major Hepatectomy for Colorectal Liver Metastasis: A Pilot Randomised Controlled Feasibility Trial. World J Surg 2017; 41:1322-1330. [PMID: 27933431 PMCID: PMC5394145 DOI: 10.1007/s00268-016-3823-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Liver resection produces excellent long-term survival for patients with colorectal liver metastases but is associated with significant morbidity and mortality from ischaemia reperfusion injury (IRI). Remote ischaemic preconditioning (RIPC) can reduce the effect of IRI. This pilot randomised controlled trial evaluated RIPC in patients undergoing major hepatectomy at the Royal Free Hospital, London. Methods Sixteen patients were randomised to RIPC or sham control. RIPC was induced through three 10-min cycles of alternate ischaemia and reperfusion to the leg. At baseline and immediately post-resection, transaminases and indocyanine green (ICG) clearance were measured. Findings The RIPC group had lower ALT and AST levels immediately post-resection (ALT: 43% lower 497 ± 165 vs 889 ± 170 IU/L; p = 0.019 AST: 54% lower 408 ± 166 vs 836 ± 167 IU/L; p = 0.001) and at 24 h (ALT: 41% lower 412 ± 144 vs 698 ± 137 IU/L; p = 0.026 AST: 50% lower 316 ± 116 vs 668 ± 115 IU/L; p = 0.02). ICG clearance was reduced in controls versus RIPC immediately after resection (ICG-PDR: 11.1 ± 1.1 vs 16.5 ± 1.4%/min; p = 0.035). Conclusions This pilot study shows that RIPC has potential to reduce liver injury following hepatectomy justifying a prospective RCT powered to demonstrate clinical benefits.
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Affiliation(s)
- Sanjeev Kanoria
- Hepato-Pancreatico-Biliary and Liver Transplant Unit, University Department of Surgery, Royal Free Hospital, London, NW3 2QG, UK.,Department of Surgical and Interventional Science, Royal Free Campus, University College London, 9th Floor Royal Free Hospital, Pond Street, London, NW3 2QG, UK
| | - Francis P Robertson
- Hepato-Pancreatico-Biliary and Liver Transplant Unit, University Department of Surgery, Royal Free Hospital, London, NW3 2QG, UK. .,Department of Surgical and Interventional Science, Royal Free Campus, University College London, 9th Floor Royal Free Hospital, Pond Street, London, NW3 2QG, UK.
| | - Naimish N Mehta
- Hepato-Pancreatico-Biliary and Liver Transplant Unit, University Department of Surgery, Royal Free Hospital, London, NW3 2QG, UK.,Department of Surgical and Interventional Science, Royal Free Campus, University College London, 9th Floor Royal Free Hospital, Pond Street, London, NW3 2QG, UK
| | - Giuseppe Fusai
- Hepato-Pancreatico-Biliary and Liver Transplant Unit, University Department of Surgery, Royal Free Hospital, London, NW3 2QG, UK.,Department of Surgical and Interventional Science, Royal Free Campus, University College London, 9th Floor Royal Free Hospital, Pond Street, London, NW3 2QG, UK
| | - Dinesh Sharma
- Hepato-Pancreatico-Biliary and Liver Transplant Unit, University Department of Surgery, Royal Free Hospital, London, NW3 2QG, UK
| | - Brian R Davidson
- Hepato-Pancreatico-Biliary and Liver Transplant Unit, University Department of Surgery, Royal Free Hospital, London, NW3 2QG, UK.,Department of Surgical and Interventional Science, Royal Free Campus, University College London, 9th Floor Royal Free Hospital, Pond Street, London, NW3 2QG, UK
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Li XM, Chen Z, Xiao EH, Shang QL, Ma C. Diagnostic value of gadobenate dimeglumine-enhanced hepatocyte-phase magnetic resonance imaging in evaluating hepatic fibrosis and hepatitis. World J Gastroenterol 2017; 23:3133-3141. [PMID: 28533670 PMCID: PMC5423050 DOI: 10.3748/wjg.v23.i17.3133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/16/2017] [Accepted: 03/15/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the diagnostic value of gadobenate dimeglumine (Gd-BOPTA)-enhanced hepatocyte-phase magnetic resonance imaging (MRI) in evaluating hepatic fibrosis and hepatitis.
METHODS Hepatocyte-phase images of Gd-BOPTA-enhanced MRI were retrospectively evaluated in 76 patients with chronic liver disease. These patients were classified into five groups according to either the histopathological fibrosis stage (S0-S4) or the histopathological hepatitis grade (G0-G4). The relative enhancement ratio (RE) of the liver parenchyma in the T1-vibe sequence was calculated by measuring the signal intensity before (SI pre) and 90 min after (SI post) intravenous injection of Gd-BOPTA using the following formula: RE = (SI post - SI pre)/SI pre. One-way analysis of variance was used to compare the difference between the relative RE in the hepatocyte phase (REh) and the stage of hepatic fibrosis and the grade of hepatitis. Pearson’s product-moment correlation analysis was used to evaluate the relationship between the REh and the levels of serologic liver functional parameters.
RESULTS According to histopathological hepatic fibrosis stage, the 76 patients were classified into five groups: 16 in S0, 15 in S1, 21 in S2, 9 in S3, and 15 in S4 group. According to histopathological hepatitis grade, the 76 patients were also classified into five groups: 0 in G0, 44 in G1, 22 in G2, 8 in G3, and 2 in G3 group. With regard to the stage of hepatic fibrosis, REh showed significant differences between the S2 and S3 groups and between the S2 and S4 groups (P < 0.05), but no significant difference was observed between the other groups. With regard to the grade of hepatitis, REh showed significant differences between the G1 and G2 groups and between the G1 and G4 groups (P < 0.05), but no significant difference was observed between the other groups. Increased REh showed correlations with decreased serum levels of TB, ALT and AST (P < 0.05).
CONCLUSION To some extent, measuring the REh using Gd-BOPTA-enhanced MRI might be a noninvasive technique for assessing the stage of hepatic fibrosis. This method is able to differentiate no/mild hepatitis from advanced hepatitis. TB, ALT and AST levels can predict the degree of liver enhancement in the hepatocyte phase of Gd-BOPTA-enhanced MRI.
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Deán-Ben XL, Fehm TF, Ford SJ, Gottschalk S, Razansky D. Spiral volumetric optoacoustic tomography visualizes multi-scale dynamics in mice. LIGHT, SCIENCE & APPLICATIONS 2017; 6:e16247. [PMID: 30167242 PMCID: PMC6062167 DOI: 10.1038/lsa.2016.247] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 10/20/2016] [Accepted: 10/28/2016] [Indexed: 05/04/2023]
Abstract
Imaging dynamics at different temporal and spatial scales is essential for understanding the biological complexity of living organisms, disease state and progression. Optoacoustic imaging has been shown to offer exclusive applicability across multiple scales with excellent optical contrast and high resolution in deep-tissue observations. Yet, efficient visualization of multi-scale dynamics remained difficult with state-of-the-art systems due to inefficient trade-offs between image acquisition time and effective field of view. Herein, we introduce the spiral volumetric optoacoustic tomography technique that provides spectrally enriched high-resolution contrast across multiple spatiotemporal scales. In vivo experiments in mice demonstrate a wide range of dynamic imaging capabilities, from three-dimensional high-frame-rate visualization of moving organs and contrast agent kinetics in selected areas to whole-body longitudinal studies with unprecedented image quality. The newly introduced paradigm shift in imaging of multi-scale dynamics adds to the multifarious advantages provided by the optoacoustic technology for structural, functional and molecular imaging.
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Affiliation(s)
- X Luís Deán-Ben
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, 85764 Neuherberg, Germany
| | - Thomas F Fehm
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, 85764 Neuherberg, Germany
- School of Medicine and School of Bioengineering, Technical University of Munich, 81675 Munich, Germany
| | - Steven J Ford
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, 85764 Neuherberg, Germany
| | - Sven Gottschalk
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, 85764 Neuherberg, Germany
| | - Daniel Razansky
- Institute for Biological and Medical Imaging (IBMI), Helmholtz Center Munich, 85764 Neuherberg, Germany
- School of Medicine and School of Bioengineering, Technical University of Munich, 81675 Munich, Germany
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57
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Lodewick T, Alizai P, van Dam R, Roeth A, Schmeding M, Heidenhain C, Andert A, Gassler N, Dejong C, Neumann U. Effect of Age on Liver Function in Patients Undergoing Partial Hepatectomy. Dig Surg 2017; 34:233-240. [PMID: 28196354 PMCID: PMC5516418 DOI: 10.1159/000452494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 10/13/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Postresectional liver failure is the most frequent cause of fatal outcome following liver surgery. Diminished preoperative liver function in the elderly might contribute to this. Therefore, the aim of the present study was to evaluate preoperative liver function in patients <60 or >70 years of age scheduled for liver resection. METHODS All consecutive patients aged <60 or >70 years who are about to undergo elective liver surgery between 2011 and 2013 and underwent the methacetin breath liver function test (LiMAx) preoperatively were included. Histologic assessment of the resected liver gave insight into background liver disease. Correlation between age and liver function was calculated with Pearson's test. RESULTS Fifty-nine patients were included, 31 were aged <60 and 28 were aged >70 years. General patient characteristics and liver function LiMAx values (340 (137-594) vs. 349 (191-530) μg/kg/h, p = 0.699) were not significantly different between patients aged <60 and >70 years. Moreover, no correlation between age and preoperative liver function LiMAx values was found (R = 0.04, p = 0.810). CONCLUSION Liver function did not seem to differ between younger and older patients.
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Affiliation(s)
- T.M. Lodewick
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany,Euregional HPB Collaboration Aachen-Maastricht, Aachen-Maastricht, Maastricht, The Netherlands,Department of Surgery, Maastricht University Medical Centre and Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht, The Netherlands,*Toine M. Lodewick, MD, Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, PO Box 5800, NL-6202 AZ Maastricht (The Netherlands), E-Mail
| | - P.H. Alizai
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany,Euregional HPB Collaboration Aachen-Maastricht, Aachen-Maastricht, Maastricht, The Netherlands
| | - R.M. van Dam
- Euregional HPB Collaboration Aachen-Maastricht, Aachen-Maastricht, Maastricht, The Netherlands,Department of Surgery, Maastricht University Medical Centre and Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht, The Netherlands
| | - A.A.J. Roeth
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany,Euregional HPB Collaboration Aachen-Maastricht, Aachen-Maastricht, Maastricht, The Netherlands
| | - M. Schmeding
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany,Euregional HPB Collaboration Aachen-Maastricht, Aachen-Maastricht, Maastricht, The Netherlands
| | - C. Heidenhain
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany,Euregional HPB Collaboration Aachen-Maastricht, Aachen-Maastricht, Maastricht, The Netherlands
| | - A. Andert
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany,Euregional HPB Collaboration Aachen-Maastricht, Aachen-Maastricht, Maastricht, The Netherlands
| | - N. Gassler
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - C.H.C. Dejong
- Euregional HPB Collaboration Aachen-Maastricht, Aachen-Maastricht, Maastricht, The Netherlands,Department of Surgery, Maastricht University Medical Centre and Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht, The Netherlands,GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - U.P. Neumann
- Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany,Euregional HPB Collaboration Aachen-Maastricht, Aachen-Maastricht, Maastricht, The Netherlands,Department of Surgery, Maastricht University Medical Centre and Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht, The Netherlands
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Haimerl M, Verloh N, Zeman F, Fellner C, Nickel D, Lang SA, Teufel A, Stroszczynski C, Wiggermann P. Gd-EOB-DTPA-enhanced MRI for evaluation of liver function: Comparison between signal-intensity-based indices and T1 relaxometry. Sci Rep 2017; 7:43347. [PMID: 28266528 PMCID: PMC5339723 DOI: 10.1038/srep43347] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/24/2017] [Indexed: 02/06/2023] Open
Abstract
Gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) is a paramagnetic hepatobiliary magnetic resonance (MR) contrast agent. Due to its OATP1B1/B3-dependent hepatocyte-specific uptake and paramagnetic properties increasing evidence has emerged to suggest that Gd-EOB-DTPA-enhanced MRI can be potentially used for evaluation of liver function. In this paper we compare the diagnostic performance of Gd-EOB-DTPA-enhanced relaxometry-based and commonly used signal-intensity (SI)-based indices, including the hepatocellular uptake index (HUI) and SI-based indices corrected by spleen or muscle, for evaluation of liver function, determined using the Indocyanin green clearance (ICG) test. Simple linear regression model showed a significant correlation of the plasma disappearance rate of ICG (ICG-PDR) with all Gd-EOB-DTPA-enhanced MRI-based liver function indices with a significantly better correlation of relaxometry-based indices on ICG-PDR compared to SI-based indices. Among SI-based indices, HUI achieved best correlation on ICG-PDR and no significant difference of respective correlations on ICG-PDR could be shown. Assessment of liver volume and consecutive evaluation of multiple linear regression model revealed a stronger correlation of ICG-PDR with both (SI)-based and T1 relaxometry-based indices. Thus, liver function can be estimated quantitatively from Gd-EOB-DTPA-enhanced MRI-based indices. Here, indices derived from T1 relaxometry are superior to SI-based indices, and all indices benefit from taking into account respective liver volumes.
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Affiliation(s)
- Michael Haimerl
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Niklas Verloh
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Florian Zeman
- Center for Clinical Trials, University Hospital Regensburg, Regensburg, Germany
| | - Claudia Fellner
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Dominik Nickel
- MR Applications Predevelopment, Siemens AG, Healthcare GmbH, Erlangen, Germany
| | - Sven A. Lang
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Andreas Teufel
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | | | - Philipp Wiggermann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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Haimerl M, Poelsterl S, Beyer L, Wiesinger I, Nießen C, Stroszczynski C, Wiggermann P, Jung EM. Chronic liver disease: Quantitative MRI vs CEUS-based microperfusion. Clin Hemorheol Microcirc 2017; 64:435-446. [DOI: 10.3233/ch-168112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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60
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Ni Y, Kannadorai RK, Yu SWK, Chang YT, Wu J. Push–pull type meso-ester substituted BODIPY near-infrared dyes as contrast agents for photoacoustic imaging. Org Biomol Chem 2017; 15:4531-4535. [DOI: 10.1039/c7ob00965h] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Push–pull meso-ester BODIPYs with intense NIR absorption and good photo-stability were used for in vitro and in vivo photoacoustic imaging.
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Affiliation(s)
- Yong Ni
- Department of Chemistry
- National University of Singapore
- Singapore
- Laboratory of Bioimaging Probe Development
- Singapore Bioimaging Consortium (SBIC)
| | | | - Sidney W.-K. Yu
- Department of Nuclear Medicine & PET
- Singapore General Hospital
- Singapore
| | - Young-Tae Chang
- Department of Chemistry
- National University of Singapore
- Singapore
- Laboratory of Bioimaging Probe Development
- Singapore Bioimaging Consortium (SBIC)
| | - Jishan Wu
- Department of Chemistry
- National University of Singapore
- Singapore
- Institute of Materials Research and Engineering
- A*STAR
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61
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A pH sensitive fluorescence probe based on tricarbocyanine. Chem Res Chin Univ 2016. [DOI: 10.1007/s40242-016-6213-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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62
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Perioperative Non-Invasive Indocyanine Green-Clearance Testing to Predict Postoperative Outcome after Liver Resection. PLoS One 2016; 11:e0165481. [PMID: 27812143 PMCID: PMC5094749 DOI: 10.1371/journal.pone.0165481] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 10/12/2016] [Indexed: 02/06/2023] Open
Abstract
Background Postoperative liver dysfunction may lead to morbidity and mortality after liver resection. Preoperative liver function assessment is critical to identify preexisting liver dysfunction in patients prior to resection. The aim of this study was to evaluate the predictive potential of perioperative indocyanine green (ICG)-clearance testing to prevent postoperative liver dysfunction and morbidity using standardized outcome parameters in a routine Western-clinical-setting. Study Design 137 patients undergoing partial hepatectomy between 2011 and 2013, at the general hospital of Vienna, were included. ICG-clearance was recorded one day prior to surgery as well as on the first and fifth postoperative day. Postoperative liver dysfunction was defined according to the International Study Group of Liver Surgery and evaluation of morbidity was based on the Dindo-Clavien classification. Statistical analyses were based on non-parametric tests. Results Preoperative reduced ICG—plasma disappearance rate (PDR) as well as increased ICG—retention rate at 15 min (R15) were able to significantly predict postoperative liver dysfunction (Area under the curve = PDR: 0.716, P = 0.018; R15: 0.719, P = 0.016). Furthermore, PDR <17%/min. or R15 >8%, were able to accurately predict postoperative complications prior to surgery. In addition to this, ICG-clearance on postoperative day 1 comparably predicted postoperative liver dysfunction (Area under the curve = PDR: 0.895; R15: 0.893; both P <0.001), specifically, PDR <10%/min or R15 >20% on postoperative day 1 predicted poor postoperative outcome. Conclusion PDR and R15 may represent useful parameters to distinguish preoperative high and low risk patients in a Western collective as well as on postoperative day 1, to identify patients who require closer monitoring for potential complications.
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Histogram analysis of noncancerous liver parenchyma on gadoxetic acid-enhanced MRI: predictive value for liver function and pathology. Abdom Radiol (NY) 2016; 41:1751-7. [PMID: 27138437 DOI: 10.1007/s00261-016-0753-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To clarify whether the heterogeneity of hepatic parenchyma in the hepatobiliary phase on gadoxetic acid-magnetic resonance (MR) imaging is correlated with liver damage. MATERIALS AND METHODS We retrospectively examined the cases of 98 patients with or without chronic liver disease who underwent gadoxetic acid-enhanced 3T MR imaging before a hepatectomy between December 2010 and October 2014. For the evaluation of the heterogeneity of the signal intensity in the hepatobiliary phase, we placed the region of interest on the hepatic parenchyma, and the skewness and kurtosis were calculated using ImageJ software. A discriminant analysis was performed to examine the routine preoperative laboratory test results including indocyanine green retention at 15 min (ICG-R15), necro-inflammation grade, and liver fibrosis stage according to the METAVIR system: A0/1 (n = 69) and A2 (n = 29); F0/1 (n = 47), F2/3 (n = 31), and F4 (n = 20). RESULTS The combination of skewness and kurtosis could discriminate the high ICG-R15 (>20) and low (<20) groups (lambda; 0.925, p = 0.025), necro-inflammatory grade (lambda; 0.926, p = 0.026), and fibrosis stage (lambda; 0.752, p < 0.0001) with statistical significance. The difference between the patients with normal values and those with an abnormal platelet count or aspartate transaminase level was also detectable (lambda; 0.901, p < 0.007, and lambda; 0.864, p = 0.001, respectively). CONCLUSION Histogram analyses of the hepatobiliary phase of gadoxetic acid-enhanced MR imaging have potential as a biomarker for the assessment of liver function, liver fibrosis, and necro-inflammation.
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Etemad L, Oskouei Shirvan Z, Vahdati-Mashhadian N, Adel Moallem S, Zafari R, Hosseinzadeh H. Acute, Subacute, and Cell Toxicity of the Aqueous Extract of Lippia citriodora. Jundishapur J Nat Pharm Prod 2016. [DOI: 10.17795/jjnpp-32546] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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65
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Barabino G, Porcheron J, Cottier M, Cuilleron M, Coutard JG, Berger M, Molliex S, Beauchesne B, Phelip JM, Grichine A, Coll JL. Improving Surgical Resection of Metastatic Liver Tumors With Near-Infrared Optical-Guided Fluorescence Imaging. Surg Innov 2016; 23:354-9. [DOI: 10.1177/1553350615618287] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective. The aim of this study was to investigate the feasibility and future clinical applications of near-infrared (NIR) fluorescence imaging to guide liver resection surgery for metastatic cancer to improve resection margins. Summary Background Data. A subset of patients with metastatic hepatic tumors can be cured by surgery. The degree of long-term and disease-free survival is related to the quality of surgery, with the best resection defined as “R0” (complete removal of all tumor cells, as evidenced by microscopic examination of the margins). Although intraoperative ultrasonography can evaluate the surgical margins, surgeons need a new tool to perfect the surgical outcome. Methods. A preliminary study was performed on 3 patients. We used NIR imaging postoperatively “ex vivo” on the resected liver tissue. The liver tumors were preoperatively labelled by intravenously injecting the patient with indocyanine green (ICG), a NIR fluorescent agent (24 hours before surgery, 0.25 mg/kg). Fluorescent images were obtained using a miniaturized fluorescence imaging system (FluoStic, Fluoptics, Grenoble, France). Results. After liver resection, the surgical specimens from each patient were sliced into 10-mm sections in the operating room and analyzed with the FluoStic. All metastatic tumors presented rim-type fluorescence. Two specimens had incomplete rim fluorescence. The pathologist confirmed the presence of R1 margins (microscopic residual resection), even though the ultrasonographic analysis indicated that the result was R0. Conclusions. Surgical liver resection guided by NIR fluorescence can help detect potentially uncertain anatomical areas that may be missed by preoperative imaging and by ultrasonography during surgery. These preliminary results will need to be confirmed in a larger prospective patient series.
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Affiliation(s)
- Gabriele Barabino
- Université Jean Monnet, Saint Etienne, France
- Saint Etienne University Hospital, Saint Etienne, France
- INSERM-UJF U823, Institut Albert Bonniot, Grenoble, France
| | - Jack Porcheron
- Saint Etienne University Hospital, Saint Etienne, France
| | | | | | | | | | - Serge Molliex
- Saint Etienne University Hospital, Saint Etienne, France
| | | | | | | | - Jean-Luc Coll
- INSERM-UJF U823, Institut Albert Bonniot, Grenoble, France
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Bioartificial Therapy of Sepsis: Changes of Norepinephrine-Dosage in Patients and Influence on Dynamic and Cell Based Liver Tests during Extracorporeal Treatments. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7056492. [PMID: 27433475 PMCID: PMC4940519 DOI: 10.1155/2016/7056492] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 06/02/2016] [Indexed: 01/28/2023]
Abstract
Purpose. Granulocyte transfusions have been used to treat immune cell dysfunction in sepsis. A granulocyte bioreactor for the extracorporeal treatment of sepsis was tested in a prospective clinical study focusing on the dosage of norepinephrine in patients and influence on dynamic and cell based liver tests during extracorporeal therapies. Methods and Patients. Ten patients with severe sepsis were treated twice within 72 h with the system containing granulocytes from healthy donors. Survival, physiologic parameters, extended hemodynamic measurement, and the indocyanine green plasma disappearance rate (PDR) were monitored. Plasma of patients before and after extracorporeal treatments were tested with a cell based biosensor for analysis of hepatotoxicity. Results. The observed mortality rate was 50% during stay in hospital. During the treatments, the norepinephrine-dosage could be significantly reduced while mean arterial pressure was stable. In the cell based analysis of hepatotoxicity, the viability and function of sensor-cells increased significantly during extracorporeal treatment in all patients and the PDR-values increased significantly between day 1 and day 7 only in survivors. Conclusion. The extracorporeal treatment with donor granulocytes showed promising effects on dosage of norepinephrine in patients, liver cell function, and viability in a cell based biosensor. Further studies with this approach are encouraged.
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67
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Chia HY, Yau WP, Ho HK. Establishing population distribution of drug-metabolizing enzyme activities for the use of salivary caffeine as a dynamic liver function marker in a Singaporean Chinese population. Biopharm Drug Dispos 2016; 37:168-81. [DOI: 10.1002/bdd.2006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 10/19/2015] [Accepted: 01/31/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Hazel Yiting Chia
- Department of Pharmacy; National University of Singapore; 18 Science Drive 4 Singapore 117543
| | - Wai-Ping Yau
- Department of Pharmacy; National University of Singapore; 18 Science Drive 4 Singapore 117543
| | - Han Kiat Ho
- Department of Pharmacy; National University of Singapore; 18 Science Drive 4 Singapore 117543
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68
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Chang CC, Huang HC, Liu KL, Wu YM, Lee JJS, Jiang SF, Su MYM. Clinical feasibility of Gd-EOB-DTPA-enhanced MR imaging for assessing liver function: validation with ICG tests and parenchymal cell volume. Clin Imaging 2016; 40:797-800. [PMID: 27317227 DOI: 10.1016/j.clinimag.2016.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/17/2016] [Accepted: 03/04/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Using Gd-EOB-DTPA-enhanced MRI to assess liver function and validate with indocyanine green (ICG) tests and parenchymal cell volume (PCV). METHODS Nineteen patients scheduled for operation were enrolled. Functional liver volume (FLV) was computed from 20min post-contrast images. ICG retention was measured in serum 15min after injection. The histological PCV was determined from resected liver specimen. RESULTS FLV showed significantly correlated with ICG retention (ICG-R15: r=-0.47, P=.042) and PCV (r=0.814, P<.001). CONCLUSIONS Gd-EOB-DTPA-enhanced MRI is clinically feasible for quantifying liver function.
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Affiliation(s)
- Chin-Chen Chang
- Departments of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei 100, Taiwan; Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, No.155, Sec. 2, Li-Nong St., Taipei 112, Taiwan.
| | - Hsu-Cheng Huang
- Departments of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei 100, Taiwan.
| | - Kao-Lang Liu
- Departments of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei 100, Taiwan.
| | - Yao-Ming Wu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei 100, Taiwan.
| | - Jason J S Lee
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, No.155, Sec. 2, Li-Nong St., Taipei 112, Taiwan.
| | - Shu-Fen Jiang
- Departments of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei 100, Taiwan.
| | - Mao-Yuan M Su
- Departments of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei 100, Taiwan.
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69
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De Gasperi A, Mazza E, Prosperi M. Indocyanine green kinetics to assess liver function: Ready for a clinical dynamic assessment in major liver surgery? World J Hepatol 2016; 8:355-367. [PMID: 26981173 PMCID: PMC4779164 DOI: 10.4254/wjh.v8.i7.355] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 07/03/2015] [Accepted: 02/24/2016] [Indexed: 02/06/2023] Open
Abstract
Indocyanine green (ICG) kinetics (PDR/R15) used to quantitatively assess hepatic function in the perioperative period of major resective surgery and liver transplantation have been the object of an extensive, updated and critical review. New, non invasive bedside monitors (pulse dye densitometry technology) make this opportunity widely available in clinical practice. After having reviewed basic concepts of hepatic clearance, we analysed the most common indications ICG kinetic parameters have nowadays in clinical practice, focusing in particular on the diagnostic and prognostic role of PDR and R15 in the perioperative period of major liver surgery and liver transplantation. As recently pointed out, even if of extreme interest, ICG clearance parameters have still some limitations, to be considered when using these tests.
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70
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Chikhani M, Evans DL, Blatcher AW, Jackson AP, Guha IN, Aithal GP, Moppett IK. The effect of prone positioning with surgical bolsters on liver blood flow in healthy volunteers. Anaesthesia 2016; 71:550-5. [PMID: 26948476 DOI: 10.1111/anae.13416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 11/29/2022]
Abstract
This study sought to identify changes in hepatic flood flow and cardiac output during prone positioning on surgical bolsters in awake volunteers, and was prompted by a local incident of significant hepatic dysfunction following surgery in the prone position. Cardiac output was determined using the non-invasive Peñáz technique, and plasma disappearance rate of indocyanine green (ICG-PDR) was measured as a surrogate maker for hepatic blood flow along with serum hepatic enzyme assays. Measurements were made after one hour in supine, prone and returned supine positions. Ten volunteers completed the study. There were significant changes in the disappearance rate of indocyanine green, which decreased this from mean (SD) 31.1 (9.70) supine to 19.6 (4.37)%.min prone, respectively (p = 0.02), increasing on return to the supine position to 24.6 (5.54)%.min (p = 0.019). Cardiac output was also significantly reduced when changing from the supine to the prone position, from mean (SD) 4.7 (1.0 to 3.5 (1.1) (l.min(-1) ), respectively (p = 0.002). We demonstrated an acute and reversible change in both hepatocellular function and cardiac output associated with the prone position.
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Affiliation(s)
- M Chikhani
- Anaesthesia and Critical Care, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - D L Evans
- Anaesthesia and Critical Care, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - A P Jackson
- NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - I N Guha
- NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - G P Aithal
- NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - I K Moppett
- Anaesthesia and Critical Care, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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71
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Kanazaki K, Sano K, Makino A, Yamauchi F, Takahashi A, Homma T, Ono M, Saji H. Feasibility of poly(ethylene glycol) derivatives as diagnostic drug carriers for tumor imaging. J Control Release 2016; 226:115-23. [DOI: 10.1016/j.jconrel.2016.02.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/26/2016] [Accepted: 02/06/2016] [Indexed: 01/24/2023]
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72
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Pena MA, Horga JF, Zapater P. Variations of pharmacokinetics of drugs in patients with cirrhosis. Expert Rev Clin Pharmacol 2016; 9:441-58. [DOI: 10.1586/17512433.2016.1135733] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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73
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Dietrich CG, Götze O, Geier A. Molecular changes in hepatic metabolism and transport in cirrhosis and their functional importance. World J Gastroenterol 2016; 22:72-88. [PMID: 26755861 PMCID: PMC4698509 DOI: 10.3748/wjg.v22.i1.72] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 09/24/2015] [Accepted: 11/13/2015] [Indexed: 02/06/2023] Open
Abstract
Liver cirrhosis is the common endpoint of many hepatic diseases and represents a relevant risk for liver failure and hepatocellular carcinoma. The progress of liver fibrosis and cirrhosis is accompanied by deteriorating liver function. This review summarizes the regulatory and functional changes in phase I and phase II metabolic enzymes as well as transport proteins and provides an overview regarding lipid and glucose metabolism in cirrhotic patients. Interestingly, phase I enzymes are generally downregulated transcriptionally, while phase II enzymes are mostly preserved transcriptionally but are reduced in their function. Transport proteins are regulated in a specific way that resembles the molecular changes observed in obstructive cholestasis. Lipid and glucose metabolism are characterized by insulin resistance and catabolism, leading to the disturbance of energy expenditure and wasting. Possible non-invasive tests, especially breath tests, for components of liver metabolism are discussed. The heterogeneity and complexity of changes in hepatic metabolism complicate the assessment of liver function in individual patients. Additionally, studies in humans are rare, and species differences preclude the transferability of data from rodents to humans. In clinical practice, some established global scores or criteria form the basis for the functional evaluation of patients with liver cirrhosis, but difficult treatment decisions such as selection for transplantation or resection require further research regarding the application of existing non-invasive tests and the development of more specific tests.
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74
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Ni Y, Kannadorai RK, Peng J, Yu SWK, Chang YT, Wu J. Naphthalene-fused BODIPY near-infrared dye as a stable contrast agent for in vivo photoacoustic imaging. Chem Commun (Camb) 2016; 52:11504-11507. [DOI: 10.1039/c6cc05126j] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Naphthalene-fused BODIPY near infrared dye (Na-BD) was synthesized and used as a stable contrast agent for in vivo photoacoustic imaging.
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Affiliation(s)
- Yong Ni
- Department of Chemistry
- National University of Singapore
- Singapore
- Laboratory of Bioimaging Probe Development
- Singapore Bioimaging Consortium (SBIC)
| | - Ravi K. Kannadorai
- Department of Nuclear Medicine & PET Singapore General Hospital
- Singapore
| | - Juanjuan Peng
- Laboratory of Bioimaging Probe Development
- Singapore Bioimaging Consortium (SBIC)
- A*STAR
- Singapore
| | - Sidney W.-K. Yu
- Department of Nuclear Medicine & PET Singapore General Hospital
- Singapore
| | - Young-Tae Chang
- Department of Chemistry
- National University of Singapore
- Singapore
- Laboratory of Bioimaging Probe Development
- Singapore Bioimaging Consortium (SBIC)
| | - Jishan Wu
- Department of Chemistry
- National University of Singapore
- Singapore
- Institute of Materials Research and Engineering
- A*STAR
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75
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Chen JB, Zhang HX, Guo XF, Wang H, Zhang HS. Boron-chelating fluorescent probe (BOPB) in the red region combined with CE-LIF for the detection of NO in mice liver. Electrophoresis 2015; 37:609-15. [DOI: 10.1002/elps.201500341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 01/13/2023]
Affiliation(s)
- Jian-Bo Chen
- Key Laboratory of Analytical Chemistry for Biology and Medicine (Ministry of Education), Department of Chemistry; Wuhan University; Wuhan P. R. China
- Institute of Chemical Materials; CAEP; Mianyang P. R. China
| | - Hui-Xian Zhang
- Key Laboratory of Analytical Chemistry for Biology and Medicine (Ministry of Education), Department of Chemistry; Wuhan University; Wuhan P. R. China
| | - Xiao-Feng Guo
- Key Laboratory of Analytical Chemistry for Biology and Medicine (Ministry of Education), Department of Chemistry; Wuhan University; Wuhan P. R. China
| | - Hong Wang
- Key Laboratory of Analytical Chemistry for Biology and Medicine (Ministry of Education), Department of Chemistry; Wuhan University; Wuhan P. R. China
| | - Hua-Shan Zhang
- Key Laboratory of Analytical Chemistry for Biology and Medicine (Ministry of Education), Department of Chemistry; Wuhan University; Wuhan P. R. China
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76
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Grobelna AP, Honkavaara J, Restitutti F, Huuskonen V, Sakka SG, Spillmann T. Evaluation of a transcutaneous method to assess canine liver function by indocyanine green plasma disappearance rate in healthy adult Beagle dogs. Vet J 2015; 209:169-73. [PMID: 26831155 DOI: 10.1016/j.tvjl.2015.10.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 10/23/2015] [Accepted: 10/26/2015] [Indexed: 11/29/2022]
Abstract
A non-invasive, transcutaneous method using near infrared spectroscopy to assess indocyanine green plasma disappearance rate (ICG-PDR) in healthy dogs subjected to different conditions was evaluated in eight healthy purpose-bred Beagles under isoflurane-anaesthesia (Trial 1) and when they had initially recovered from anaesthesia (Trial 2). Plasma ICG concentrations (0, 5, 10, 15, 30 min after rapid ICG injection (0.5 mg/kg) into a peripheral vein were determined by high-performance liquid chromatography in parallel with transcutaneous measurements. ICG clearance (mL/min/kg) and retention rate after 15 min (R15, %) were calculated from plasma concentrations to be 3.09 ± 0.83 (mean ± SD) and 30.6 ± 8.3 in anaesthetised dogs and 3.63 ± 0.88 and 28.1 ± 7.3 in recovering dogs, respectively. ICG-PDR (%/min) and R15 (%) obtained using the transcutaneous method were 7.11 ± 3.18 and 34.6 ± 12.4 (Trial 1) and 7.79 ± 3.33 and 32.3 ± 9.2 (Trial 2). The coefficients of determination (r(2)) for ICG clearance and ICG-PDR were 0.14 (Trial 1) and 0.81 (Trial 2) and 0.47 (Trial 1) and 0.29 (Trial 2) for R15, respectively. The mean bias (lower, upper limit of agreement) for R15 were 5.6 (-12.3, 23.5) (Trial 1) and 3.9 (-12.4, 20.1) (Trial 2). The results suggest good agreement between the two methods in dogs recovering from isoflurane-anaesthesia and the transcutaneous method might be useful in real-time assessment of liver function in conscious dogs.
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Affiliation(s)
- A P Grobelna
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, PO Box 59 (Viikintie 49), 00014 Helsinki, Finland
| | - J Honkavaara
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, PO Box 59 (Viikintie 49), 00014 Helsinki, Finland
| | - F Restitutti
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, PO Box 59 (Viikintie 49), 00014 Helsinki, Finland
| | - V Huuskonen
- UCD Veterinary Hospital, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - S G Sakka
- Department of Anesthesiology and Operative Intensive Care Medicine, Cologne-Merheim Medical Center (CMMC),Witten/Herdecke University, Witten, Germany
| | - T Spillmann
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, PO Box 59 (Viikintie 49), 00014 Helsinki, Finland.
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77
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Levesque E, Martin E, Dudau D, Lim C, Dhonneur G, Azoulay D. Current use and perspective of indocyanine green clearance in liver diseases. Anaesth Crit Care Pain Med 2015; 35:49-57. [PMID: 26477363 DOI: 10.1016/j.accpm.2015.06.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 06/12/2015] [Indexed: 02/06/2023]
Abstract
Indocyanine green (ICG) is a water-soluble anionic compound that binds to plasma proteins after intravenous administration. It is selectively taken up at the first pass by hepatocytes and excreted unchanged into the bile. With the development of ICG elimination measurement by spectrophotometry, the ICG retention test has become a safe, rapid, reproducible, inexpensive and noninvasive tool for the assessment of liver function. Clinical evidence suggests that the ICG retention test can enable the establishment of tailored management strategies by providing prognostic information. In particular, this method has been evaluated as a prognostic marker in patients with advanced cirrhosis or awaiting liver transplantation. In addition, it is used as a marker of portal hypertension in cirrhotic patients, as a prognostic factor in intensive care units and for the assessment of liver function in patients undergoing liver surgery. Since recent technology enables ICG-PDR to be measured noninvasively at the bedside, this parameter is an attractive addition to liver function and regional haemodynamic monitoring. However, the current state-of-the-art as concerns this technology remains at a low level of evidence and thorough assessment is required.
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Affiliation(s)
- Eric Levesque
- AP-HP, Hôpital Henri-Mondor, Service d'Anesthésie et des Réanimations Chirurgicales, 94000 Créteil, France.
| | - Eléonore Martin
- AP-HP, Hôpital Henri-Mondor, Service d'Anesthésie et des Réanimations Chirurgicales, 94000 Créteil, France
| | - Daniela Dudau
- AP-HP, Hôpital Henri-Mondor, Service d'Anesthésie et des Réanimations Chirurgicales, 94000 Créteil, France
| | - Chetana Lim
- AP-HP, Hôpital Henri-Mondor, Service de Chirurgie Digestive, Hépatobiliaire, Pancréatique et Transplantation Hépatique, 94000 Créteil, France
| | - Gilles Dhonneur
- AP-HP, Hôpital Henri-Mondor, Service d'Anesthésie et des Réanimations Chirurgicales, 94000 Créteil, France
| | - Daniel Azoulay
- AP-HP, Hôpital Henri-Mondor, Service de Chirurgie Digestive, Hépatobiliaire, Pancréatique et Transplantation Hépatique, 94000 Créteil, France
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78
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Wang H, Feng M, Jackson A, Ten Haken RK, Lawrence TS, Cao Y. Local and Global Function Model of the Liver. Int J Radiat Oncol Biol Phys 2015; 94:181-188. [PMID: 26700712 DOI: 10.1016/j.ijrobp.2015.09.044] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 09/21/2015] [Accepted: 09/28/2015] [Indexed: 02/08/2023]
Abstract
PURPOSE To develop a local and global function model in the liver based on regional and organ function measurements to support individualized adaptive radiation therapy (RT). METHODS AND MATERIALS A local and global model for liver function was developed to include both functional volume and the effect of functional variation of subunits. Adopting the assumption of parallel architecture in the liver, the global function was composed of a sum of local function probabilities of subunits, varying between 0 and 1. The model was fit to 59 datasets of liver regional and organ function measures from 23 patients obtained before, during, and 1 month after RT. The local function probabilities of subunits were modeled by a sigmoid function in relating to MRI-derived portal venous perfusion values. The global function was fitted to a logarithm of an indocyanine green retention rate at 15 minutes (an overall liver function measure). Cross-validation was performed by leave-m-out tests. The model was further evaluated by fitting to the data divided according to whether the patients had hepatocellular carcinoma (HCC) or not. RESULTS The liver function model showed that (1) a perfusion value of 68.6 mL/(100 g · min) yielded a local function probability of 0.5; (2) the probability reached 0.9 at a perfusion value of 98 mL/(100 g · min); and (3) at a probability of 0.03 [corresponding perfusion of 38 mL/(100 g · min)] or lower, the contribution to global function was lost. Cross-validations showed that the model parameters were stable. The model fitted to the data from the patients with HCC indicated that the same amount of portal venous perfusion was translated into less local function probability than in the patients with non-HCC tumors. CONCLUSIONS The developed liver function model could provide a means to better assess individual and regional dose-responses of hepatic functions, and provide guidance for individualized treatment planning of RT.
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Affiliation(s)
- Hesheng Wang
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
| | - Mary Feng
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Andrew Jackson
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Randall K Ten Haken
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Theodore S Lawrence
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Yue Cao
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan; Department of Radiology, University of Michigan, Ann Arbor, Michigan; Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
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79
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Jing L, Shi J, Fan D, Li Y, Liu R, Dai Z, Wang F, Tian J. (177)Lu-Labeled Cerasomes Encapsulating Indocyanine Green for Cancer Theranostics. ACS APPLIED MATERIALS & INTERFACES 2015; 7:22095-105. [PMID: 26398723 DOI: 10.1021/acsami.5b07856] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This Article reported the fabrication of a robust theranostic cerasome encapsulating indocyanine green (ICG) by incorporating 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[carboxy(polyethylene glycol)2000]-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid monoamide (DSPE-PEG2000-DOTA), followed by chelating radioisotope of (177)Lu. Its applications in optical and nuclear imaging of tumor uptake and biodistribution, as well as photothermal killing of cancer cells, were investigated. It was found that the obtained cerasome could act efficiently as fluorescence contrast agent as well as nuclear imaging tracer. Encapsulating ICG into cerasome could protect ICG from degradation, aggregation, and fast elimination from body, resulting in remarkable improvement in near-infrared fluorescence imaging, photothermal stability, and in vivo pharmacokinetic profile. Both fluorescence and nuclear imaging showed that such agent could selectively accumulate in tumor site after intravenous injection of the cerasome agent into Lewis lung carcinoma tumor bearing mice, resulting in efficient photothermal ablation of tumor through a one-time NIR laser irradiation at the best time window. The ability to track the uptake of cerasomes on a whole body basis could provide researchers with an excellent tool for developing cerasome-based drug delivery agents, especially the strategy of labeling cerasomes with theranostic radionuclide (177)Lu, enabling the ability of the (177)Lu-labeled cerasomes for radionuclide cancer therapy and even the combined therapy.
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Affiliation(s)
- Lijia Jing
- School of Life Science and Technology, Harbin Institute of Technology , Harbin 150080, China
| | - Jiyun Shi
- Department of Radiation Medicine, Basic Medical Sciences, Peking University , Beijing 100191, China
- Interdisciplinary Laboratory, Institute of Biophysics, Chinese Academy of Sciences , Beijing 100101, China
| | - Di Fan
- Department of Radiation Medicine, Basic Medical Sciences, Peking University , Beijing 100191, China
| | - Yaqian Li
- Key Laboratory of Molecular Imaging, Institute of Automation, The State Key Laboratory of Management and Control for Complex Systems, Chinese Academy of Sciences , Beijing 100190, China
| | - Renfa Liu
- Department of Biomedical Engineering, College of Engineering, Peking University , Beijing 100871, China
| | - Zhifei Dai
- Department of Biomedical Engineering, College of Engineering, Peking University , Beijing 100871, China
| | - Fan Wang
- Department of Radiation Medicine, Basic Medical Sciences, Peking University , Beijing 100191, China
- Interdisciplinary Laboratory, Institute of Biophysics, Chinese Academy of Sciences , Beijing 100101, China
| | - Jie Tian
- Key Laboratory of Molecular Imaging, Institute of Automation, The State Key Laboratory of Management and Control for Complex Systems, Chinese Academy of Sciences , Beijing 100190, China
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80
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Xu MY, Wang P, Sun YJ, Wang HP, Liang YJ, Zhu L, Wu YJ. Redox status in liver of rats following subchronic exposure to the combination of low dose dichlorvos and deltamethrin. PESTICIDE BIOCHEMISTRY AND PHYSIOLOGY 2015; 124:60-65. [PMID: 26453231 DOI: 10.1016/j.pestbp.2015.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 04/13/2015] [Accepted: 04/14/2015] [Indexed: 06/05/2023]
Abstract
Organophosphates and pyrethroids are widely used pesticides with prominent toxicity to humans. However, their joint toxicity has not been thoroughly investigated. In this study, we investigated the oxidative damages induced by low dose dichlorvos (DDVP) and deltamethrin (DM), the representative organophosphate and pyrethroid, respectively, and their mixtures in the liver of rats for 90 consecutive days. Two oxidative stress markers, malondialdehyde (MDA) and protein carbonyl (PCO) levels, were measured to reflect the extent of lipid peroxidation and protein oxidation, respectively. DDVP, DM, and their mixtures induced levels of MDA and PCO dose-dependently, although no toxic signs and pathological changes of liver were found in the rats following 90-day exposure. DDVP and DM induced greater increase of MDA than PCO, which indicated that lipids were particularly sensitive to the oxidative damage. We found that DDVP, DM and their mixtures could inhibit the activity of two antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT). The effects of DM on SOD activity, lipid peroxidation and protein oxidation were greater than those of DDVP. The combined effect of DDVP and DM was lower than the sum of their individual effects. Thus the interaction between dichlorvos and deltamethrin may be antagonistic on the induction of oxidative stress in rat liver.
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Affiliation(s)
- Ming-Yuan Xu
- Laboratory of Molecular Toxicology, State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, 1-5 Beichenxi Road, Beijing 100101, China
| | - Pan Wang
- Laboratory of Molecular Toxicology, State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, 1-5 Beichenxi Road, Beijing 100101, China
| | - Ying-Jian Sun
- Laboratory of Molecular Toxicology, State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, 1-5 Beichenxi Road, Beijing 100101, China; Department of Veterinary Medicine and Animal Science, Beijing University of Agriculture, Beijing 102206, China
| | - Hui-Ping Wang
- Laboratory of Molecular Toxicology, State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, 1-5 Beichenxi Road, Beijing 100101, China
| | - Yu-Jie Liang
- Laboratory of Molecular Toxicology, State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, 1-5 Beichenxi Road, Beijing 100101, China
| | - Li Zhu
- Laboratory of Molecular Toxicology, State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, 1-5 Beichenxi Road, Beijing 100101, China
| | - Yi-Jun Wu
- Laboratory of Molecular Toxicology, State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, 1-5 Beichenxi Road, Beijing 100101, China.
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Volume-assisted estimation of liver function based on Gd-EOB-DTPA-enhanced MR relaxometry. Eur Radiol 2015; 26:1125-33. [PMID: 26186960 DOI: 10.1007/s00330-015-3919-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/15/2015] [Accepted: 07/02/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine whether liver function as determined by indocyanine green (ICG) clearance can be estimated quantitatively from hepatic magnetic resonance (MR) relaxometry with gadoxetic acid (Gd-EOB-DTPA). METHODS One hundred and seven patients underwent an ICG clearance test and Gd-EOB-DTPA-enhanced MRI, including MR relaxometry at 3 Tesla. A transverse 3D VIBE sequence with an inline T1 calculation was acquired prior to and 20 minutes post-Gd-EOB-DTPA administration. The reduction rate of T1 relaxation time (rrT1) between pre- and post-contrast images and the liver volume-assisted index of T1 reduction rate (LVrrT1) were evaluated. The plasma disappearance rate of ICG (ICG-PDR) was correlated with the liver volume (LV), rrT1 and LVrrT1, providing an MRI-based estimated ICG-PDR value (ICG-PDRest). RESULTS Simple linear regression model showed a significant correlation of ICG-PDR with LV (r = 0.32; p = 0.001), T1post (r = 0.65; p < 0.001) and rrT1 (r = 0.86; p < 0.001). Assessment of LV and consecutive evaluation of multiple linear regression model revealed a stronger correlation of ICG-PDR with LVrrT1 (r = 0.92; p < 0.001), allowing for the calculation of ICG-PDRest. CONCLUSIONS Liver function as determined using ICG-PDR can be estimated quantitatively from Gd-EOB-DTPA-enhanced MR relaxometry. Volume-assisted MR relaxometry has a stronger correlation with liver function than does MR relaxometry. KEY POINTS • Measurement of T1 relaxation times in Gd-EOB-DTPA-enhanced MR imaging quantifies liver function. • Volume-assisted Gd-EOB-DTPA-enhanced MR relaxometry has stronger correlation with ICG-PDR than does Gd-EOB-DTPA-enhanced MR relaxometry. • Gd-EOB-DTPA-enhanced MR relaxometry may provide robust parameters for detecting and characterizing liver disease. • Gd-EOB-DTPA-enhanced MR relaxometry may be useful for monitoring liver disease progression. • Gd-EOB-DTPA-enhanced MR relaxometry has the potential to become a novel liver function index.
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Sano K, Ohashi M, Kanazaki K, Ding N, Deguchi J, Kanada Y, Ono M, Saji H. In vivo photoacoustic imaging of cancer using indocyanine green-labeled monoclonal antibody targeting the epidermal growth factor receptor. Biochem Biophys Res Commun 2015; 464:820-5. [PMID: 26168727 DOI: 10.1016/j.bbrc.2015.07.042] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 07/08/2015] [Indexed: 02/02/2023]
Abstract
Photoacoustic (PA) imaging is an attractive imaging modality for sensitive and depth imaging of biomolecules with high resolution in vivo. The aim of this study was to evaluate the effectiveness of an anti-epidermal growth factor receptor (EGFR) monoclonal antibody (panitumumab; Pan) labeled with indocyanine green derivative (ICG-EG4-Sulfo-OSu), Pan-EG4-ICG, as a PA imaging probe to target cancer-associated EGFR. In vitro PA imaging studies demonstrated that Pan-EG4-ICG yielded high EGFR-specific PA signals in EGFR-positive cells. To determine the optimal injection dose and scan timing, we investigated the biodistribution of radiolabeled Pan-EG4-ICG (200-400 μg) in A431 tumor (EGFR++)-bearing mice. The highest tumor accumulation (29.4% injected dose/g) and high tumor-to-blood ratio (2.1) was observed 7 days after injection of Pan-EG4-ICG (400 μg). In in vivo PA imaging studies using Pan-EG4-ICG (400 μg), the increase in PA signal (114%) was observed in A431 tumors inoculated in the mammary glands 7 days post-injection. Co-injection of excess Pan resulted in a 35% inhibition of this PA signal, indicating the EGFR-specific accumulation. In conclusion, the ICG-labeled monoclonal antibody (i.e., panitumumab) has the potential to enhance target-specific PA signal, leading to the discrimination of aggressiveness and metastatic potential of tumors and the selection of effective therapeutic strategies.
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Affiliation(s)
- Kohei Sano
- Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan; Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Manami Ohashi
- Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Kengo Kanazaki
- Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan; Medical Imaging Project, Corporate R&D Headquarters, Canon Inc., 3-30-2 Shimomaruko, Ohta-ku, Tokyo 146-8501, Japan
| | - Ning Ding
- Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Jun Deguchi
- Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Yuko Kanada
- Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Masahiro Ono
- Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Hideo Saji
- Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan.
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Zhao X, Huang M, Zhu Q, Wang T, Liu Q. The relationship between liver function and liver parenchymal contrast enhancement on Gd-BOPTA-enhanced MR imaging in the hepatocyte phase. Magn Reson Imaging 2015; 33:768-73. [DOI: 10.1016/j.mri.2015.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 02/06/2015] [Accepted: 03/30/2015] [Indexed: 12/12/2022]
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Li B, Min J, Liang WR, Zhang GQ, Wu JJ, Jin K, Huang W, Ying CY, Chao M. Use of magnetic resonance elastography for assessing liver functional reserve: A clinical study. World J Gastroenterol 2015; 21:7522-7528. [PMID: 26139999 PMCID: PMC4481448 DOI: 10.3748/wjg.v21.i24.7522] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/14/2015] [Accepted: 03/31/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the value of magnetic resonance elastography (MRE) with regard to assessing liver functional reserve.
METHODS: Data from inpatients diagnosed with a liver tumor at an interventional radiology department from July 2013 to June 2014 were analyzed. A 3.0 Tesla magnetic resonance unit was used to scan 32 patients with confirmed diagnoses of hepatocellular carcinoma (HCC); an MRE sequence was added to the protocol, and the data were reconstructed and analyzed by two attending radiologists. Regions of interest were identified in different slices of the non-tumor liver parenchyma to measure average stiffness. In addition, the indocyanine green (ICG) test was performed no more than 1 wk before or after the magnetic resonance examination for all 32 patients; the ICG retention rate at 15 min (ICGR-15) and the ICG plasma clearance rate (ICG-K) were recorded. Correlational analyses were performed between the liver stiffness values and the ICGR-15 as well as between the liver stiffness values and the ICG-K.
RESULTS: Magnetic resonance imaging, including an MRE sequence and the ICG test, was performed successfully in all 32 enrolled patients. None of the patients developed complications. The mean ± SD of the elasticity values measured by the two attending radiologists were 4.7 ± 2.2 kPa and 4.7 ± 2.1 kPa, respectively. The average liver stiffness value of the non-tumor parenchyma measured using MRE in HCC patients was 4.7 ± 2.2 kPa. The average ICGR-15 was 0.089 ± 0.077, and the average ICG-K was 0.19 ± 0.07. We found that the liver stiffness value of the non-tumor parenchyma was significantly and positively related to the ICGR-15 (r = 0.746, P < 0.01) as well as significantly and negatively related to the ICG-K (r = -0.599, P < 0.01). The ICGR-15 was significantly and negatively related to the ICG-K (r = -0.852, P < 0.01).
CONCLUSION: MRE is accurate and non-invasive; furthermore, it can be used to effectively assess the liver functional reserve of HCC patients.
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85
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Sato Y, Matsushima S, Inaba Y, Sano T, Yamaura H, Kato M, Shimizu Y, Senda Y, Ishiguchi T. Preoperative estimation of future remnant liver function following portal vein embolization using relative enhancement on gadoxetic acid disodium-enhanced magnetic resonance imaging. Korean J Radiol 2015; 16:523-30. [PMID: 25995681 PMCID: PMC4435982 DOI: 10.3348/kjr.2015.16.3.523] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 01/12/2015] [Indexed: 12/23/2022] Open
Abstract
Objective To retrospectively evaluate relative enhancement (RE) in the hepatobiliary phase of gadoxetic acid disodium-enhanced magnetic resonance (MR) imaging as a preoperative estimation of future remnant liver (FRL) function in a patients who underwent portal vein embolization (PVE). Materials and Methods In 53 patients, the correlation between the indocyanine green clearance (ICG-K) and RE imaging was analyzed before hepatectomy (first analysis). Twenty-three of the 53 patients underwent PVE followed by a repeat RE imaging and ICG test before an extended hepatectomy and their results were further analyzed (second analysis). Whole liver function and FRL function were calculated on the MR imaging as follows: RE x total liver volume (RE Index) and FRL-RE x FRL volume (Rem RE Index), respectively. Regarding clinical outcome, posthepatectomy liver failure (PHLF) was evaluated in patients undergoing PVE. Results Indocyanine green clearance correlated with the RE Index (r = 0.365, p = 0.007), and ICG-K of FRL (ICG-Krem) strongly correlated with the Rem RE Index (r = 0.738, p < 0.001) in the first analysis. Both the ICG-Krem and the Rem RE Index were significantly correlated after PVE (r = 0.508, p = 0.013) at the second analysis. The rate of improvement of the Rem RE Index from before PVE to after PVE was significantly higher than that of ICG-Krem (p = 0.014). Patients with PHLF had a significantly lower Rem RE Index than patients without PHLF (p = 0.023). Conclusion Relative enhancement imaging can be used to estimate FRL function after PVE.
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Affiliation(s)
- Yozo Sato
- Department of Radiology, Aichi Medical University, Aichi 480-1195, Japan. ; Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Shigeru Matsushima
- Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Yoshitaka Inaba
- Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Tsuyoshi Sano
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Hidekazu Yamaura
- Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Mina Kato
- Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Yoshiki Senda
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Tsuneo Ishiguchi
- Department of Radiology, Aichi Medical University, Aichi 480-1195, Japan
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Hessin A, Hegazy R, Hassan A, Yassin N, Kenawy S. Lactoferrin Enhanced Apoptosis and Protected Against Thioacetamide-Induced Liver Fibrosis in Rats. Open Access Maced J Med Sci 2015; 3:195-201. [PMID: 27275221 PMCID: PMC4877853 DOI: 10.3889/oamjms.2015.038] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Liver fibrosis is the common pathologic consequence of all chronic liver diseases. AIM: Lactoferrin (Lf) was investigated for its possible hepatoprotective effect against thioacetamide (TAA)-induced liver fibrosis rat model. MATERIAL AND METHODS: Rats received TAA (200 mg/kg/biweekly, ip) for four successive weeks. Lf (200 mg/kg/day, p.o.) or vehicle (VHC) was administered for one month before and another month during TAA injection. Body weight and mortality rate were assessed during the month of TAA-intoxication. Thereafter, serum and liver tissues were analyzed for liver function, oxidative, fibrotic and apoptotic markers. RESULTS: Lf conserved rats against TAA-induced body weight-loss and mortality. Preservation of serum albumin, alkaline phosphatase and total bilirubin levels was also observed. Lf also protected rats against TAA-induced decrease in reduced glutathione and increase in malondialdehyde liver contents. Normal liver contents of hydroxyproline, nuclear factor kappa B and alpha fetoprotein; as markers of fibrosis; were increased with TAA and conserved with Lf-TAA. Lf maintained the normal architecture of the liver and immunohistochemical findings revealed increase in apoptotic bodies compared to TAA that favored necrosis. CONCLUSION: In conclusion, Lf improved liver function, reduced oxidative stress and liver fibrosis, and enhanced apoptosis in rats with liver fibrosis, suggesting it to have useful therapeutic potential in patients with liver fibrosis.
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Affiliation(s)
- Alyaa Hessin
- National Research Center, Medical Division, Pharmacology Department, Giza, Egypt
| | - Rehab Hegazy
- National Research Center, Medical Division, Pharmacology Department, Giza, Egypt
| | - Azza Hassan
- Cairo University, Faculty of Veterinary Medicine, Pathology Department, Giza, Egypt
| | - Nemat Yassin
- National Research Center, Medical Division, Pharmacology Department, Giza, Egypt
| | - Sanaa Kenawy
- Cairo University, Faculty of Pharmacy, Pharmacology and Toxicology Department, Cairo, Egypt
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Ali T, Nakajima T, Sano K, Sato K, Choyke PL, Kobayashi H. Dynamic fluorescent imaging with indocyanine green for monitoring the therapeutic effects of photoimmunotherapy. CONTRAST MEDIA & MOLECULAR IMAGING 2014; 9:276-82. [PMID: 24706611 DOI: 10.1002/cmmi.1570] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 08/13/2013] [Accepted: 08/26/2013] [Indexed: 01/01/2023]
Abstract
A new type of monoclonal antibody (mAb)-based, highly specific phototherapy (photoimmunotherapy; PIT) that uses a near-infrared (NIR) phthalocyanine dye, IRDye700DX (IR700) conjugated with an mAb, has recently been described. NIR light exposure leads to immediate, target-selective necrotic cell death. However, tumor shrinkage takes several days to occur, making it difficult to detect earlier changes in the tumor. In this study, Panitumumab targeting the epidermal growth factor receptor (EGFR1) conjugated to IR700 was used to treat EGFR-expressing A431 tumor cells and in vivo xenografts. PIT was performed at varying doses of NIR light (10, 30, 50 and 100 J cm(-2)) in xenograft tumors in mice. Indocyanine green (ICG) dynamic imaging was evaluated for monitoring cytotoxic effects for the first hour after PIT. Our results demonstrated a statistical difference (p < 0.05) in ICG intensity between control and PIT treated tumors in the higher light exposure groups (50 J cm(-2): 2.94 ± 0.35 vs 5.22 ± 0.92, p = 0.02; and 100 J cm(-2) : 3.56 ± 0.96 vs 5.71 ± 1.43, p = 0.008) as early as 20 min post ICG injection. However, no significant difference (p > 0.05) in ICG intensity between control and PIT treated tumors was evident in the lower light exposure group at any time points up to 60 min (10 J cm(-2) : 1.92 ± 0.49 vs 1.71 ± 0.3, p = 0.44; and 30 J cm(-2): 1.57 ± 0.35 vs 2.75 ± 0.59, p = 0.07). Similarly, the retention index (background to corrected uptake ratio of ICG) varied with light exposure. In conclusion, ICG may serve as a potential indicator of acute cytotoxic effects of mAb-IR700-induced PIT even before morphological changes can be seen in targeted tumors.
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Affiliation(s)
- Towhid Ali
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, 20892-1088, USA
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88
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HALLE BM, POULSEN TD, PEDERSEN HP. Indocyanine green plasma disappearance rate as dynamic liver function test in critically ill patients. Acta Anaesthesiol Scand 2014; 58:1214-9. [PMID: 25307706 DOI: 10.1111/aas.12406] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Indocyanine green (ICG) is a water-soluble fluorescent dye that is bound to plasma protein when administered intravenously. Removal of ICG from the blood depends on hepatic blood flow, function of the parenchymal cells and biliary excretion. ICG elimination is described as a useful dynamic liver function test. METHODS In this review, we looked at the most recent literature to clarify why ICG is useful in critically ill patients, the validity of the ICG plasma disappearance rate (ICG-PDR) measured transcutaneously and whether ICG-PDR has any prognostic value. CONCLUSION In conclusion, measuring ICG-PDR is a valuable method for dynamic assessment of liver function, and is found to be a valuable prognostic tool in predicting survival for septic patients, patients presenting with acute liver failure and critically ill patients.
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Affiliation(s)
- B. M. HALLE
- Department of Anesthesia and Intensive Care; Copenhagen University Hospital Roskilde; Roskilde Region Zealand Denmark
| | - T. D. POULSEN
- Department of Anesthesia and Intensive Care; Copenhagen University Hospital Roskilde; Roskilde Region Zealand Denmark
| | - H. P. PEDERSEN
- Department of Anesthesia and Intensive Care; Copenhagen University Hospital Roskilde; Roskilde Region Zealand Denmark
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89
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Bonfrate L, Grattagliano I, Palasciano G, Portincasa P. Dynamic carbon 13 breath tests for the study of liver function and gastric emptying. Gastroenterol Rep (Oxf) 2014; 3:12-21. [PMID: 25339354 PMCID: PMC4324868 DOI: 10.1093/gastro/gou068] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
In gastroenterological practice, breath tests (BTs) are diagnostic tools used for indirect, non-invasive assessment of several pathophysiological metabolic processes, by monitoring the appearance in breath of a metabolite of a specific substrate. Labelled substrates originally employed radioactive carbon 14 (14C) and, more recently, the stable carbon 13 isotope (13C) has been introduced to label specific substrates. The ingested 13C-substrate is metabolized, and exhaled 13CO2 is measured by mass spectrometry or infrared spectroscopy. Some 13C-BTs evaluate specific (microsomal, cytosolic, and mitochondrial) hepatic metabolic pathways and can be employed in liver diseases (i.e. simple liver steatosis, non-alcoholic steato-hepatitis, liver fibrosis, cirrhosis, hepatocellular carcinoma, drug and alcohol effects). Another field of clinical application for 13C-BTs is the assessment of gastric emptying kinetics in response to liquids (13C-acetate) or solids (13C-octanoic acid in egg yolk or in a pre-packed muffin or the 13C-Spirulina platensis given with a meal or a biscuit). Studies have shown that 13C-BTs, used for gastric emptying studies, yield results that are comparable to scintigraphy and can be useful in detecting either delayed- (gastroparesis) or accelerated gastric emptying or changes of gastric kinetics due to pharmacological effects. Thus, 13C-BTs represent an indirect, cost-effective and easy method of evaluating dynamic liver function and gastric kinetics in health and disease, and several other potential applications are being studied.
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Affiliation(s)
- Leonilde Bonfrate
- Department of Biomedical Sciences and Human Oncology, Clinica Medica 'A. Murri', University of Bari Medical School, Bari, Italy and Italian College of General Practitioners, Florence and Bari, Italy
| | - Ignazio Grattagliano
- Department of Biomedical Sciences and Human Oncology, Clinica Medica 'A. Murri', University of Bari Medical School, Bari, Italy and Italian College of General Practitioners, Florence and Bari, Italy
| | - Giuseppe Palasciano
- Department of Biomedical Sciences and Human Oncology, Clinica Medica 'A. Murri', University of Bari Medical School, Bari, Italy and Italian College of General Practitioners, Florence and Bari, Italy
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica 'A. Murri', University of Bari Medical School, Bari, Italy and Italian College of General Practitioners, Florence and Bari, Italy
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90
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Kubilay NZ, Sengel BE, Wood KE, Layon AJ. Biomarkers in Hepatic Disease: A Review Focused on Critically Ill Patients. J Intensive Care Med 2014; 31:104-12. [PMID: 25324195 DOI: 10.1177/0885066614554897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 07/17/2014] [Indexed: 11/15/2022]
Abstract
The ability to make a diagnosis early and appropriately is paramount for the survival of the critically ill ICU patient. Along with the myriad physical examination and imaging modalities available, biomarkers provide a window on the disease process. Herein we review hepatic biomarkers in the context of the critical care patient.
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Affiliation(s)
- Nejla Zeynep Kubilay
- The Department of Critical Care Medicine, The Geisinger Health System, Danville, PA, USA Department of Medicine, The Marmara University Teaching and Education Hospital, Istanbul, Turkey
| | - Buket Erturk Sengel
- The Department of Critical Care Medicine, The Geisinger Health System, Danville, PA, USA Department of Medicine, The Marmara University Teaching and Education Hospital, Istanbul, Turkey
| | - Kenneth E Wood
- The Department of Critical Care Medicine, The Geisinger Health System, Danville, PA, USA The Geisinger Medical Center, Danville, PA, USA
| | - A Joseph Layon
- The Department of Critical Care Medicine, The Geisinger Health System, Danville, PA, USA
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91
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Jara M, Malinowski M, Lüttgert K, Schott E, Neuhaus P, Stockmann M. Prognostic value of enzymatic liver function for the estimation of short-term survival of liver transplant candidates: a prospective study with the LiMAx test. Transpl Int 2014; 28:52-8. [PMID: 25263095 DOI: 10.1111/tri.12441] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 06/02/2014] [Accepted: 08/27/2014] [Indexed: 12/11/2022]
Abstract
LiMAx has been recently proposed as a new quantitative liver function test. Thus, we aimed to evaluate the diagnostic ability of LiMAx to assess short-term survival in liver transplant candidates and compare its performance to the model for end-stage liver disease (MELD) and indocyanine green plasma disappearance rate (ICG-PDR). Liver function of 167 chronic liver failure patients without hepatocellular carcinoma was prospectively investigated when they were evaluated for liver transplantation. Primary study endpoints were liver-related death within 6 months of follow-up. Within 6 months of follow-up, 18 patients died and 36 underwent liver transplantation. Median LiMAx results on evaluation day were significantly lower in patients who died (99 μg/kg/h vs. 55 μg/kg/h; P = 0.024), while median ICG-PDR results did not differ within both groups (4.4%/min vs. 3.5%/min; P = 0.159). LiMAx showed a higher negative predictive value (NPV: 0.93) as compared with ICG-PDR (NPV: 0.90) and the MELD (NPV: 0.91) in predicting risk of death within 6 months. In conclusion, LiMAx provides good prognostic information of liver transplant candidates. In particular, patients who are not at risk of death can be identified reliably by measuring actual enzymatic liver function capacity.
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Affiliation(s)
- Maximilian Jara
- Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Stieger B, Unadkat JD, Prasad B, Langer O, Gali H. Role of (drug) transporters in imaging in health and disease. Drug Metab Dispos 2014; 42:2007-15. [PMID: 25249691 DOI: 10.1124/dmd.114.059873] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This report is the summary of presentations at the symposium sponsored by the American Society for Pharmacology and Experimental Therapeutics, April 26-30, at Experimental Biology 2014 in San Diego, CA. The presentations focused on the role of transporters in imaging in health and disease and on assessing transporter function in vivo. Imaging is an important diagnostic tool in clinics and is a novel tool for in vivo visualization of transporter function. Many imaging substrates and endogenous markers for organ function are organic anions. In this symposium, the bile salt transporter sodium taurocholate cotransporting polypeptide and the liver organic anion transporting polypeptides (OATPs) as well as the renal organic anion transporters (OATs) were addressed in detail; e.g., OATPs mediate transport of contrast agents used for magnetic resonance imaging of the liver or transport agents used for hepatobiliary scintigraphy, and OATs transport substances used in renography. In addition, the symposium also focused on the multidrug-resistance transporter 1 (MDR1 or P-gp), which is the most important gatekeeper in epithelial or endothelial barriers for preventing entry of potentially harmful substances into organs. Novel substrates suitable for positron emission tomography (PET) allow the study of such transporters at the blood-brain barrier or while they are mediating uptake of drugs into hepatocytes, and, importantly, PET tracers also now allow renography. Finally, quantitative data on transporter expression in human organs allow the development of improved physiologically based pharmacokinetic (PBPK) models for drug disposition. Hence, the combined efforts using novel substrates for in vivo visualization of transporters and quantification of transporters will lead to a deeper understanding of transporter function in disease and allow development of novel PBPK models for disease states.
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Affiliation(s)
- Bruno Stieger
- Department of Clinical Pharmacology and Toxicology, University Hospital, Zurich, Switzerland (B.S.); Department of Pharmaceutics, University of Washington, Seattle, Washington (J.D.U., B.P.); Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria and Health and Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria (O.L.); and the Department of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (H.G.)
| | - Jashvant D Unadkat
- Department of Clinical Pharmacology and Toxicology, University Hospital, Zurich, Switzerland (B.S.); Department of Pharmaceutics, University of Washington, Seattle, Washington (J.D.U., B.P.); Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria and Health and Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria (O.L.); and the Department of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (H.G.)
| | - Bhagwat Prasad
- Department of Clinical Pharmacology and Toxicology, University Hospital, Zurich, Switzerland (B.S.); Department of Pharmaceutics, University of Washington, Seattle, Washington (J.D.U., B.P.); Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria and Health and Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria (O.L.); and the Department of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (H.G.)
| | - Oliver Langer
- Department of Clinical Pharmacology and Toxicology, University Hospital, Zurich, Switzerland (B.S.); Department of Pharmaceutics, University of Washington, Seattle, Washington (J.D.U., B.P.); Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria and Health and Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria (O.L.); and the Department of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (H.G.)
| | - Hariprasad Gali
- Department of Clinical Pharmacology and Toxicology, University Hospital, Zurich, Switzerland (B.S.); Department of Pharmaceutics, University of Washington, Seattle, Washington (J.D.U., B.P.); Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria and Health and Environment Department, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria (O.L.); and the Department of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (H.G.)
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93
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Kaulen SA, Hübner C, Mieth J, Spindler K, Schwab R, Wimmer R, Wilhelm J, Amoury M, Girndt M, Werdan K, Ebelt H. [Indocyanine green elimination for the evaluation of liver function: prognostic value in patients with community-acquired sepsis]. Med Klin Intensivmed Notfmed 2014; 109:531-40. [PMID: 25179001 DOI: 10.1007/s00063-014-0374-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 02/26/2014] [Accepted: 04/06/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND The aim of our clinical study was to correlate liver function measured by indocyanine green (ICG) elimination and clinical outcomes in patients with an early stage of community-acquired sepsis (CAS). MATERIALS AND METHODS A total of 341 patients (≥ 18 years) presenting with suspicion of CAS or evidence of an infection and fulfillment of ≥ 2 systemic inflammatory response syndrome (SIRS) criteria were included in the observational study"Prognosis of early sepsis 2" (Prognose der frühen Sepsis 2, ProFS 2). Patients who had been hospitalized within the last 7 days were excluded. In a subgroup of these patients (n = 72) who were transferred to an intensive or intermediate care unit according to the clinical judgment of the treating physicians, ICG elimination (plasma disappearance rate, ICG-PDR; 15 min retention rate, ICG-R15) was assessed by using a noninvasive monitoring system (LiMON, PULSION Medical Systems, Germany). ICG-PDR and -R15 were determined on the day of admission (n = 72) and after 96 h (n = 34). The primary end point of the study was defined as death within 30 days. Secondary endpoints were need for renal replacement therapy, requirement for invasive mechanical ventilation, and length of stay in an intermediate or intensive care unit. RESULTS AND CONCLUSION In contrast to patients with sepsis or severe sepsis, ICG elimination was found to be significantly impaired in patients with septic shock. Furthermore, a significant predictive value of ICG-PDR and -R15 on the day of admission for the need for subsequent renal replacement therapy (n = 12) was observed. In addition, reduced ICG elimination was associated with a longer stay in an intermediate or intensive care unit. However, ICG elimination on admission could not predict 30-day mortality (n = 14) or requirement of mechanical ventilation (n = 20).
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Affiliation(s)
- S A Kaulen
- Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06097, Halle (Saale), Deutschland,
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94
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Kanazaki K, Sano K, Makino A, Takahashi A, Deguchi J, Ohashi M, Temma T, Ono M, Saji H. Development of human serum albumin conjugated with near-infrared dye for photoacoustic tumor imaging. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:96002. [PMID: 25191833 DOI: 10.1117/1.jbo.19.9.096002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 08/12/2014] [Indexed: 06/03/2023]
Abstract
Photoacoustic (PA) imaging has emerged as a noninvasive diagnostic method which detects ultrasonic waves thermoelastically induced by optical absorbers irradiated with laser. For tumor diagnosis, PA contrast agent has been proposed to enhance the PA effect for detecting tumors sensitively. Here, we prepared a human serum albumin (HSA) conjugated with indocyanine green (ICG) as a PA contrast agent allowing enhanced permeability and retention effect for sensitive tumor imaging. The feasibility of PA imaging with HSA-ICG to detect allografted tumors was evaluated in tumor-bearing mice. In vivo fluorescence imaging and radiolabeled biodistribution study showed that the biodistribution dramatically changed as the number of ICG bound to HSA increased, and the maximum accumulation of ICG was achieved when around three ICG molecules were loaded on an HSA. In vivo PA imaging demonstrated a tumor-selective and dose-dependent increase of PA signal intensity in mice injected with HSA-ICG (R2 = 0.88, 387% increase for HSA-ICG, 104 nmol ICG). In conclusion, HSA-ICG clearly visualized the allografted tumors with high tumor-to-background ratios having high quantitative and spatial resolution for the sensitive PA imaging of tumors. HSA-ICG could be useful as a favorable contrast agent for PA tumor imaging for the management of cancer.
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Affiliation(s)
- Kengo Kanazaki
- Canon Inc., Medical Imaging Project, Corporate R&D Headquarters, 3-30-2 Shimomaruko, Ohta-ku, Tokyo 146-8501, Japan
| | - Kohei Sano
- Kyoto University, Department of Patho-Functional Bioanalysis Graduate School of Pharmaceutical Sciences, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, JapancKyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akira Makino
- Kyoto University, Department of Patho-Functional Bioanalysis Graduate School of Pharmaceutical Sciences, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, JapandUniversity of Fukui, Biomedical Imaging Research Center, 23-3 Matsuokashimoaizuki, Eihe
| | - Atsushi Takahashi
- Canon Inc., Medical Imaging Project, Corporate R&D Headquarters, 3-30-2 Shimomaruko, Ohta-ku, Tokyo 146-8501, Japan
| | - Jun Deguchi
- Kyoto University, Department of Patho-Functional Bioanalysis Graduate School of Pharmaceutical Sciences, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Manami Ohashi
- Kyoto University, Department of Patho-Functional Bioanalysis Graduate School of Pharmaceutical Sciences, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Takashi Temma
- Kyoto University, Department of Patho-Functional Bioanalysis Graduate School of Pharmaceutical Sciences, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Masahiro Ono
- Kyoto University, Department of Patho-Functional Bioanalysis Graduate School of Pharmaceutical Sciences, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Hideo Saji
- Kyoto University, Department of Patho-Functional Bioanalysis Graduate School of Pharmaceutical Sciences, 46-29 Yoshida Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
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95
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Borlak J, Chougule A, Singh PK. How useful are clinical liver function tests in in vitro human hepatotoxicity assays? Toxicol In Vitro 2014; 28:784-95. [DOI: 10.1016/j.tiv.2014.03.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 03/07/2014] [Accepted: 03/19/2014] [Indexed: 12/11/2022]
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96
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Quintero J, Miserachs M, Ortega J, Bueno J, Dopazo C, Bilbao I, Castells L, Charco R. Indocyanine green plasma disappearance rate: a new tool for the classification of paediatric patients with acute liver failure. Liver Int 2014; 34:689-94. [PMID: 24112412 DOI: 10.1111/liv.12298] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 06/15/2013] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS Pediatric acute liver failure is a rare disorder which results in death or the need for liver transplantation in 25-50% of cases. The adults scores are unable to predict survival without liver transplantation of pediatric patients. The present study assessed the use the of indocyanine green plasma disappearance rate as a tool to predict the evolution of pediatric patients with acute liver failure. PATIENTS AND METHODS All patients met the criteria of acute liver failure according to the Pediatric Acute Liver Failure Study Group. King's College, Clichy's criteria and ICG-PDR were obtained on admission or when acute liver failure was diagnosed and repeated every 12-24 hours, respectively. RESULTS Thirteen out of 48 patients suffered an irreversible liver damage. Seven of them underwent a liver transplantation and 6 died on the waiting. A total of 154 ICG-PDR measurements were taken during the study (Median 12.4 %/min, r:6.2 - 26.3). The ICG-PDR was significantly lower in patients who suffered irreversible liver damage compared with those who survived without liver transplantation (median ICG-PDR 4.1 %/min; r:4.0 - 5.7 vs median ICG-PDR 20.3 %/min; r: 9.1 - 30.1; respectively. P < 0.001). Using a ROC curve the cutoff of ICG-PDR for assessing the need for liver transplantation was set at 5.9 %/min (sensitivity 92.3%, specificity 97.1%). Sensitivity, specificity, PPV, NPV and DA for ICG-PDR were higher than the King's College and Clichy's criteria. CONCLUSIONS ICG-PDR is a powerful tool that would improve the categorization of patients with pediatric acute liver failure.
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Affiliation(s)
- Jesús Quintero
- Pediatric Liver Transplant Unit, Hospital Universitari Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, Catalunya, Spain
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97
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Wang H, Cao Y. Spatially resolved assessment of hepatic function using 99mTc-IDA SPECT. Med Phys 2014; 40:092501. [PMID: 24007177 DOI: 10.1118/1.4816655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE 99mTc-iminodiacetic acid (IDA) hepatobiliary imaging is usually quantified for hepatic function on the entire liver or regions of interest (ROIs) in the liver. The authors presented a method to estimate the hepatic extraction fraction (HEF) voxel-by-voxel from single-photon emission computed tomography (SPECT)∕CT with a 99mTc-labeled IDA agent of mebrofenin and evaluated the spatially resolved HEF measurements with an independent physiological measurement. METHODS Fourteen patients with intrahepatic cancers were treated with radiation therapy (RT) and imaged by 99mTc-mebrofenin SPECT before and 1 month after RT. The dynamic SPECT volumes were with a resolution of 3.9 × 3.9 × 2.5 mm(3). Throughout the whole liver with approximate 50 000 voxels, voxelwise HEF quantifications were estimated and compared between using arterial input function (AIF) from the heart and using vascular input function (VIF) from the spleen. The correlation between mean of the HEFs over the nontumor liver tissue and the overall liver function measured by Indocyanine green clearance half-time (T1∕2) was assessed. Variation of the voxelwise estimation was evaluated in ROIs drawn in relatively homogeneous regions of the livers. The authors also examined effects of the time range parameter on the voxelwise HEF quantification. RESULTS Mean of the HEFs over the liver estimated using AIF significantly correlated with the physiological measurement T1∕2 (r = 0.52, p = 0.0004), and the correlation was greatly improved by using VIF (r = 0.79, p < 0.0001). The parameter of time range for the retention phase did not lead to a significant difference in the means of the HEFs in the ROIs. Using VIF and a retention phase time range of 7-30 min, the relative variation of the voxelwise HEF in the ROIs was 10% ± 6% of respective mean HEF. CONCLUSIONS The voxelwise HEF derived from 99mTc-IDA SPECT by the deconvolution analysis is feasible to assess the spatial distribution of hepatic function in the liver.
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Affiliation(s)
- Hesheng Wang
- Department of Radiation Oncology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109, USA.
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98
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Jeong HS, Na KS, Hwang H, Oh PS, Kim DH, Lim ST, Sohn MH, Jeong HJ. Effect of space length of mannose ligand on uptake of mannosylated liposome in RAW 264.7 cells: In vitro and in vivo studies. J Biomed Mater Res A 2014; 102:4545-53. [PMID: 24677479 DOI: 10.1002/jbm.a.35112] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/08/2014] [Accepted: 02/10/2014] [Indexed: 11/08/2022]
Abstract
The most widely used method for increasing uptake on macrophage is specific targeting for mannose receptor (MR) presented on macrophages. Efficiency of the uptake for MR is influenced by the space length and flexibility of mannose ligand in liposome (LP). We prepared mannosylated liposomes (M-EGn-LP-ICG) encapsulated indocyanine green (ICG) with mannose ligand of various ethylene glycol units (EG), LP-ICG, and mannosylated liposome (M-LP-ICG) incorporated with p-aminophenyl-α-d-mannopyranoside. We studied the effect of space length of the mannose ligand in vitro and in vivo with prepared liposomes. A space length of two ethylene glycol units at least was needed for uptake by macrophages and the uptake was increased as the space length increased up to EG4. We measured near-infrared (NIR) fluorescence intensity by ICG and the fluorescence value of cell-associated N-(4-nitrobenzo-2-oxa-1,3-diazole) (NBD) in liposome after cellular uptake. M-EG4-LP-ICG showed lower NIR fluorescence intensity but higher NBD fluorescence value than M-LP-ICG. The result of pre-treatment with d(+)-mannose as an inhibitor showed significant decreasing in uptake of mannosylated LP-ICG but no difference in LP-ICG. These were explained that mannosylated LP-ICG was taken up by macrophages through the MR and M-EG4-LP-ICG showed more specific uptake than M-LP-ICG. We obtained images as time passed in the NIR range after intravenous administration using a Balb/c mouse with inflammatory model. The results showed high uptake in liver at early time and rapid degradation of mannosylated LP-ICG. M-EG4-LP-ICG was more selectively taken up by macrophages than M-LP-ICG.
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Affiliation(s)
- Hwan-Seok Jeong
- Department of Nuclear Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, 561-712, Republic of Korea; Molecular Imaging & Therapeutic Medicine Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, 561-712, Republic of Korea; Cyclotron Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, 561-712, Republic of Korea; Institute for Medical Sciences, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, 561-712, Republic of Korea; Biomedical Research Institute, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, 561-712, Republic of Korea
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99
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Hannah A, Luke G, Wilson K, Homan KA, Emelianov S. Indocyanine green-loaded photoacoustic nanodroplets: dual contrast nanoconstructs for enhanced photoacoustic and ultrasound imaging. ACS NANO 2014; 8:250-9. [PMID: 24303934 PMCID: PMC3916902 DOI: 10.1021/nn403527r] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Recently, perfluorocarbon (PFC) nanodroplets were introduced as contrast agents for imaging and image-guided therapy. For example, in sonography, high-intensity ultrasound pulses were used to phase-transition liquid perfluorocarbon to produce gas microbubbles. More recently, perfluorocarbon nanodroplets with encapsulated gold nanorods were used as dual ultrasound/photoacoustic contrast agents. To expedite clinical translation, we synthesized and characterized ICG-loaded perfluorocarbon nanodroplets, i.e., constructs comprising biocompatible, nontoxic and biologically safe materials. We then demonstrated enhanced photoacoustic contrast through optically triggered phase transition of PFC nanodroplets and ultrasound contrast from the resulting PFC bubbles. We assessed the quality enhancement of photoacoustic and ultrasound images through analysis of contrast and contrast-to-noise ratio. We further investigated the changes in image contrast due to increased ambient temperature. Our studies suggest that ICG-loaded perfluorocarbon nanodroplets may become a valuable tool for various imaging modalities, and have promising therapeutic applications.
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Affiliation(s)
| | | | | | | | - Stanislav Emelianov
- Corresponding Author, , Mailing Address: 107 W Dean Keeton Stop C0800, Austin, TX 78712
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100
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Pastor CM, Müllhaupt B, Stieger B. The Role of Organic Anion Transporters in Diagnosing Liver Diseases by Magnetic Resonance Imaging. Drug Metab Dispos 2014; 42:675-84. [DOI: 10.1124/dmd.113.055707] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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