Multimodality imaging techniques

To see or not to see: In vivo nanocarrier detection methods in the brain and their challenges

Nanoparticles have a great potential to significantly improve the delivery of therapeutics to the brain and may also be equipped with properties to investigate brain function. The brain, being a highly complex organ shielded by selective barriers, requires its own specialized detection system. However, a significant hurdle to achieve these goals is still the identification of individual nanoparticles within the brain with sufficient cellular, subcellular, and temporal resolution. This review aims to provide a comprehensive summary of the current knowledge on detection systems for tracking nanoparticles across the blood-brain barrier and within the brain. We discuss commonly employed in vivo and ex vivo nanoparticle identification and quantification methods, as well as various imaging modalities able to detect nanoparticles in the brain. Advantages and weaknesses of these modalities as well as the biological factors that must be considered when interpreting results obtained through nanotechnologies are summarized. Finally, we critically evaluate the prevailing limitations of existing technologies and explore potential solutions.

Revolutionizing tumor detection and classification in multimodality imaging based on deep learning approaches: methods, applications and limitations

BACKGROUND

The emergence of deep learning (DL) techniques has revolutionized tumor detection and classification in medical imaging, with multimodal medical imaging (MMI) gaining recognition for its precision in diagnosis, treatment, and progression tracking.

OBJECTIVE

This review comprehensively examines DL methods in transforming tumor detection and classification across MMI modalities, aiming to provide insights into advancements, limitations, and key challenges for further progress.

METHODS

Systematic literature analysis identifies DL studies for tumor detection and classification, outlining methodologies including convolutional neural networks (CNNs), recurrent neural networks (RNNs), and their variants. Integration of multimodality imaging enhances accuracy and robustness.

RESULTS

Recent advancements in DL-based MMI evaluation methods are surveyed, focusing on tumor detection and classification tasks. Various DL approaches, including CNNs, YOLO, Siamese Networks, Fusion-Based Models, Attention-Based Models, and Generative Adversarial Networks, are discussed with emphasis on PET-MRI, PET-CT, and SPECT-CT.

FUTURE DIRECTIONS

The review outlines emerging trends and future directions in DL-based tumor analysis, aiming to guide researchers and clinicians toward more effective diagnosis and prognosis. Continued innovation and collaboration are stressed in this rapidly evolving domain.

CONCLUSION

Conclusions drawn from literature analysis underscore the efficacy of DL approaches in tumor detection and classification, highlighting their potential to address challenges in MMI analysis and their implications for clinical practice.

Multimodality Imaging Diagnosis in Infective Endocarditis

Imaging is an important tool in the diagnosis and management of infective endocarditis (IE). Echocardiography is an essential examination, especially in native valve endocarditis (NVE), but its diagnostic accuracy is reduced in prosthetic valve endocarditis (PVE). The diagnostic ability is superior for transoesophageal echocardiography (TEE), but a negative test cannot exclude PVE. Both transthoracic echocardiography (TTE) and TEE can provide normal or inconclusive findings in up to 30% of cases, especially in patients with prosthetic devices. New advanced non-invasive imaging tests are increasingly used in the diagnosis of IE. Nuclear medicine imaging techniques have demonstrated their superiority over TEE for the diagnosis of PVE and cardiac implantable electronic device infective endocarditis (CIED-IE). Cardiac computed tomography angiography imaging is useful in PVE cases with inconclusive TTE and TEE investigations and for the evaluation of paravalvular complications. In the present review, imaging tools are described with their values and limitations for improving diagnosis in NVE, PVE and CIED-IE. Current knowledge about multimodality imaging approaches in IE and imaging methods to assess the local and distant complications of IE is also reviewed. Furthermore, a potential diagnostic work-up for different clinical scenarios is described. However, further studies are essential for refining diagnostic and management approaches in infective endocarditis, addressing limitations and optimizing advanced imaging techniques across different clinical scenarios.

Multimodality PET and Near-Infrared Fluorescence Intraoperative Imaging of CEA-Positive Colorectal Cancer

PURPOSE

Molecular imaging is a major diagnostic component for cancer management, enabling detection, staging of disease, targeting therapy, and monitoring the therapeutic response. The coordination of multimodality imaging techniques further enhances tumor localization. The development of a single agent for real-time non-invasive targeted positron emission tomography (PET) imaging and fluorescence guided surgery (FGS) will provide the next generation tool in the surgical management of cancer.

PROCEDURES

The humanized anti-CEA M5A-IR800 "sidewinder" (M5A-IR800-SW) antibody-dye conjugate was designed with a NIR 800 nm dye incorporated into a PEGylated linker and conjugated with the metal chelate p-SCN-Bn-deferoxamine (DFO) for zirconium-89 PET imaging (⁸⁹Zr, half-life 78.4 h). The dual-labeled ⁸⁹Zr-DFO-M5A-SW-IR800 was evaluated for near infrared (NIR) fluorescence imaging, PET/MRI imaging, terminal tissue biodistribution, and blood clearance in a human colorectal cancer LS174T xenograft mouse model.

RESULTS

The ⁸⁹Zr-DFO-M5A-SW-IR800 NIR fluorescence imaging showed high tumor targeting with normal liver uptake. Serial PET/MRI imaging was performed at 24 h, 48 h, and 72 h and showed tumor localization visible at 24 h that persisted throughout the experiment. However, the PET scans showed higher activity for the liver than the tumor, compared to the NIR fluorescence imaging. This difference is an important finding as it quantifies the expected difference due to the sensitivity and depth of penetration between the 2 modalities.

CONCLUSIONS

This study demonstrates the potential of a pegylated anti-CEA M5A-IR800-Sidewinder for NIR fluorescence/PET/MR multimodality imaging for intraoperative fluorescence guided surgery.

Exploring the Role of External Beam Radiation Therapy in Osteosarcoma Treatment: Impact of Diagnostic Imaging Delays and Innovative Techniques

Osteosarcomas are a type of bone cancer that typically affect young adults, often in the bones of the arms and legs. To treat osteosarcoma, doctors typically use a combination of chemotherapy, radiotherapy, and surgery, with External Beam Radiation Therapy (EBRT) being the most commonly used form of radiotherapy. EBRT involves directing high-energy photons, X-rays, gamma rays, protons, and electrons at the tumor to induce cancer cell death. Additionally, healthcare providers use imaging techniques to monitor treatment success. This literature review aims to explore the relationship between osteosarcomas and EBRT, investigate the impact of the delayed diagnosis on survival rates, and examine the effectiveness of innovative uses of EBRT for treating osteosarcomas in unusual locations using comprehensive diagnostic techniques. To achieve these objectives, the review examines case studies and literary analyses and categorizes them based on the delay between symptom onset and diagnosis. The null hypothesis is that the presence or absence of a delay in diagnosis does not significantly impact outcomes for the "Delay" category. A lack of delay results in a more favorable outcome in the "Lack of Delay" category. However, the data and statistical results suggest that additional follow-up care in patients with rare or commonly recurring cancers could benefit outcomes. It is important to note that due to the rarity of osteosarcoma with EBRT, the small sample size in the studies warrants further investigation. Interestingly, many patients presented with head and neck tumors despite the most common location of osteosarcoma being in the long bones.

Sex Disparities of the Sacroiliac Joint: Focus on Joint Anatomy and Imaging Appearance

The sacroiliac joint (SIJ) is an anatomically complex joint which, as a functional unit with the pelvis and spine, is of decisive biomechanical importance for the human body. It is also a commonly overlooked source of lower back pain. Like the entire bony pelvis, the SIJ exhibits major sexual dimorphisms; thus, the sex-dependent evaluation of this joint is becoming increasingly important in clinical practice, both anatomically with joint shape variations and biomechanical differences as well as in terms of image appearance. The influence of the SIJ shape, which differs in women and men, is crucial for the different biomechanical joint properties. These differences are important in the development of joint diseases at the SIJ, which shows a specific difference between the sexes. This article aims to provide an overview of sex disparities of the SIJ regarding different anatomical and imaging appearances to further understand the insights into the interplay of sex differences and SIJ disease.

Novel candidate theranostic radiopharmaceutical based on strontium hexaferrite nanoparticles conjugated with azacrown ligand

In this article, we report to the best of our knowledge the first modification of NPs with ligands for combined radiopharmaceuticals. Nanoparticles with suitable magnetic properties can be used both for diagnostics as a contrast for MRI and for therapy, including the insufficiently studied magneto-mechanical therapy. Strontium hexaferrite is one of the few hard-magnetic materials for which stable biocompatible colloidal solutions can be obtained. Strontium hexaferrite nanoparticles coated with silicon dioxide (SHF@SiO₂) were modified with an amino silane coupling agent (3-aminopropyl)triethoxysilane and azacrown ether derivatives with six heteroatoms in rings were covalently linked to the amine group through the carboxyl group. The hard magnetic nanoparticles were then radiolabeled with ²⁰⁷Bi with a labelling yield of up to 99.8%. In vitro experiments showed that the complex SHF@SiO₂-APTES-L2-²⁰⁷Bi is stable enough to be a potential theranostic radiopharmaceutical.

Guidelines and evaluation of clinical explainable AI in medical image analysis

Explainable artificial intelligence (XAI) is essential for enabling clinical users to get informed decision support from AI and comply with evidence-based medical practice. Applying XAI in clinical settings requires proper evaluation criteria to ensure the explanation technique is both technically sound and clinically useful, but specific support is lacking to achieve this goal. To bridge the research gap, we propose the Clinical XAI Guidelines that consist of five criteria a clinical XAI needs to be optimized for. The guidelines recommend choosing an explanation form based on Guideline 1 (G1) Understandability and G2 Clinical relevance. For the chosen explanation form, its specific XAI technique should be optimized for G3 Truthfulness, G4 Informative plausibility, and G5 Computational efficiency. Following the guidelines, we conducted a systematic evaluation on a novel problem of multi-modal medical image explanation with two clinical tasks, and proposed new evaluation metrics accordingly. Sixteen commonly-used heatmap XAI techniques were evaluated and found to be insufficient for clinical use due to their failure in G3 and G4. Our evaluation demonstrated the use of Clinical XAI Guidelines to support the design and evaluation of clinically viable XAI.

Targeting Tumor-Associated Macrophages for Imaging

As an important component of the tumor immune microenvironment (TIME), tumor-associated macrophages (TAMs) occupy a significant niche in tumor margin aggregation and respond to changes in the TIME. Thus, targeting TAMs is important for tumor monitoring, surgical guidance and efficacy evaluation. Continuously developing nanoprobes and imaging agents paves the way toward targeting TAMs for precise imaging and diagnosis. This review summarizes the commonly used nanomaterials for TAM targeting imaging probes, including metal-based nanoprobes (iron, manganese, gold, silver), fluorine-19-based nanoprobes, radiolabeled agents, near-infrared fluorescence dyes and ultrasonic nanobubbles. Additionally, the prospects and challenges of designing nanomaterials for imaging and diagnosis (targeting efficiency, pharmacokinetics, and surgery guidance) are described in this review. Notwithstanding, TAM-targeting nanoplatforms provide great potential for imaging, diagnosis and therapy with a greater possibility of clinical transformation.

7-Tesla PET/MRI: A promising tool for multimodal brain imaging?

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Real-time multiple target segmentation with multimodal few-shot learning

Deep learning-based target segmentation requires a big training dataset to achieve good results. In this regard, few-shot learning a model that quickly adapts to new targets with a few labeled support samples is proposed to tackle this issue. In this study, we introduce a new multimodal few-shot learning [e.g., red-green-blue (RGB), thermal, and depth] for real-time multiple target segmentation in a real-world application with a few examples based on a new squeeze-and-attentions mechanism for multiscale and multiple target segmentation. Compared to the state-of-the-art methods (HSNet, CANet, and PFENet), the proposed method demonstrates significantly better performance on the PST900 dataset with 32 time-series sets in both Hand-Drill, and Survivor classes.

Imaging the human brain on oral contraceptives: A review of structural imaging methods and implications for future research goals

Worldwide over 150 million women use oral contraceptives (OCs), which are the most prescribed form of contraception in both the United States and in European countries. Sex hormones, such as estradiol and progesterone, are important endogenous hormones known for shaping the brain across the life span. Synthetic hormones, which are present in OCs, interfere with the natural hormonal balance by reducing the endogenous hormone levels. Little is known how this affects the brain, especially during the most vulnerable times of brain maturation. Here, we review studies that investigate differences in brain gray and white matter in women using OCs in comparison to naturally cycling women. We focus on two neuroimaging methods used to quantify structural gray and white matter changes, namely structural MRI and diffusion MRI. Finally, we discuss the potential of these imaging techniques to advance knowledge about the effects of OCs on the brain and wellbeing in women.

Classification of lungs infected COVID-19 images based on inception-ResNet

OBJECTIVE

Nowadays, COVID-19 is spreading rapidly worldwide, and seriously threatening lives . From the perspective of security and economy, the effective control of COVID-19 has a profound impact on the entire society. An effective strategy is to diagnose earlier to prevent the spread of the disease and prompt treatment of severe cases to improve the chance of survival.

METHODS

The method of this paper is as follows: Firstly, the collected data set is processed by chest film image processing, and the bone removal process is carried out in the rib subtraction module. Then, the set preprocessing method performed histogram equalization, sharpening, and other preprocessing operations on the chest film. Finally, shallow and high-level feature mapping through the backbone network extracts the processed chest radiographs. We implement the self-attention mechanism in Inception-Resnet, perform the standard classification, and identify chest radiograph diseases through the classifier to realize the auxiliary COVID-19 diagnosis process at the medical level, all in an effort to further enhance the classification performance of the convolutional neural network. Numerous computer simulations demonstrate that the Inception-Resnet convolutional neural network performs CT image categorization and enhancement with greater efficiency and flexibility than conventional segmentation techniques.

RESULTS

The experimental COVID-19 CT dataset obtained in this paper is the new data for CT scans and medical imaging of normal, early COVID-19 patients and severe COVID-19 patients from Jinyintan hospital. The experiment plots the relationship between model accuracy, model loss and epoch, using ACC, TPR, SPE, F1 score and G-mean to measure the image maps of patients with and without the disease. Statistical measurement values are obtained by Inception-Resnet are 88.23%, 83.45%, 89.72%, 95.53% and 88.74%. The experimental results show that Inception-Resnet plays a more effective role than other image classification methods in evaluation indicators, and the method has higher robustness, accuracy and intuitiveness.

CONCLUSION

With CT images in the clinical diagnosis of COVID-19 images being widely used and the number of applied samples continuously increasing, the method in this paper is expected to become an additional diagnostic tool that can effectively improve the diagnostic accuracy of clinical COVID-19 images.

Emerging Biomaterials Imaging Antitumor Immune Response

Immunotherapy is one of the most promising clinical modalities for the treatment of malignant tumors and has shown excellent therapeutic outcomes in clinical settings. However, it continues to face several challenges, including long treatment cycles, high costs, immune-related adverse events, and low response rates. Thus, it is critical to predict the response rate to immunotherapy by using imaging technology in the preoperative and intraoperative. Here, the latest advances in nanosystem-based biomaterials used for predicting responses to immunotherapy via the imaging of immune cells and signaling molecules in the immune microenvironment are comprehensively summarized. Several imaging methods, such as fluorescence imaging, magnetic resonance imaging, positron emission tomography imaging, ultrasound imaging, and photoacoustic imaging, used in immune predictive imaging, are discussed to show the potential of nanosystems for distinguishing immunotherapy responders from nonresponders. Nanosystem-based biomaterials aided by various imaging technologies are expected to enable the effective prediction and diagnosis in cases of tumors, inflammation, and other public diseases.

Web-Based Application for Biomedical Image Registry, Analysis, and Translation (BiRAT)

Imaging has become an invaluable tool in preclinical research for its capability to non-invasively detect and monitor disease and assess treatment response. With the increased use of preclinical imaging, large volumes of image data are being generated requiring critical data management tools. Due to proprietary issues and continuous technology development, preclinical images, unlike DICOM-based images, are often stored in an unstructured data file in company-specific proprietary formats. This limits the available DICOM-based image management database to be effectively used for preclinical applications. A centralized image registry and management tool is essential for advances in preclinical imaging research. Specifically, such tools may have a high impact in generating large image datasets for the evolving artificial intelligence applications and performing retrospective analyses of previously acquired images. In this study, a web-based server application is developed to address some of these issues. The application is designed to reflect the actual experimentation workflow maintaining detailed records of both individual images and experimental data relevant to specific studies and/or projects. The application also includes a web-based 3D/4D image viewer to easily and quickly view and evaluate images. This paper briefly describes the initial implementation of the web-based application.

Dual Function Antibody Conjugates for Multimodal Imaging and Photoimmunotherapy of Cancer Cells

Precision imaging, utilizing molecular targeted agents, is an important tool in cancer diagnostics and guiding therapies. While there are limitations associated with single mode imaging probes, multimodal molecular imaging probes enabling target visualization through complementary imaging technologies provides an attractive alternative. However, there are several challenges associated with designing molecular probes carrying contrast agents for complementary multimodal imaging. Here, we propose a dual function antibody conjugate (DFAC) comprising an FDA approved photosensitizer Benzoporphyrin derivative (BPD) and a naphthalocyanine-based photoacoustic dye (SiNc(OH)) for multimodal infrared (IR) imaging. While fluorescence imaging, through BPD, provides sensitivity, complementing it with photoacoustic imaging, through SiNc(OH), provides a depth-resolved spatial resolution much beyond the optical diffusion limits of fluorescence measurements. Through a series of in vitro experiments, we demonstrate the development and utilization of DFACs for multimodal imaging and photodynamic treatment of squamous cell carcinoma (A431) cell line. The proposed DFACs have potential use in precision imaging applications such as guiding tumor resection surgeries and photodynamic treatment of residual microscopic disease thereby minimizing local recurrence. The data demonstrated in this study merits further investigation for its preclinical and clinical translation.

Recent Progress in Technetium-99m-Labeled Nanoparticles for Molecular Imaging and Cancer Therapy

Nanotechnology has played a tremendous role in molecular imaging and cancer therapy. Over the last decade, scientists have worked exceptionally to translate nanomedicine into clinical practice. However, although several nanoparticle-based drugs are now clinically available, there is still a vast difference between preclinical products and clinically approved drugs. An efficient translation of preclinical results to clinical settings requires several critical studies, including a detailed, highly sensitive, pharmacokinetics and biodistribution study, and selective and efficient drug delivery to the target organ or tissue. In this context, technetium-99m (^99mTc)-based radiolabeling of nanoparticles allows easy, economical, non-invasive, and whole-body in vivo tracking by the sensitive clinical imaging technique single-photon emission computed tomography (SPECT). Hence, a critical analysis of the radiolabeling strategies of potential drug delivery and therapeutic systems used to monitor results and therapeutic outcomes at the preclinical and clinical levels remains indispensable to provide maximum benefit to the patient. This review discusses up-to-date ^99mTc radiolabeling strategies of a variety of important inorganic and organic nanoparticles and their application to preclinical imaging studies.

19 F MRI Probes for Multimodal Imaging*

Magnetic resonance imaging (MRI) is one of the most powerful imaging tools today, capable of displaying superior soft-tissue contrast. This review discusses developments in the field of ¹⁹ F MRI multimodal probes in combination with optical fluorescence imaging (OFI), ¹ H MRI, chemical exchange saturation transfer (CEST) MRI, ultrasonography (USG), X-ray computed tomography (CT), single photon emission tomography (SPECT), positron emission tomography (PET), and photoacoustic imaging (PAI). In each case, multimodal ¹⁹ F MRI probes compensate for the deficiency of individual techniques and offer improved sensitivity or accuracy of detection over unimodal counterparts. Strategies for designing ¹⁹ F MRI multimodal probes are described with respect to their structure, physicochemical properties, biocompatibility, and the quality of images.

Targeting and pharmacology of an anti-IL13Rα2 antibody and antibody-drug conjugate in a melanoma xenograft model

IL13Rα2 is a cell surface tumor antigen that is overexpressed in multiple tumor types. Here, we studied biodistribution and targeting potential of an anti-IL13Rα2 antibody (Ab) and anti-tumor activity of anti-IL13Rα2-antibody-drug conjugate (ADC). The anti-IL13Rα2 Ab was labeled with fluorophore AF680 or radioisotope ⁸⁹Zr for in vivo tracking using fluorescence molecular tomography (FMT) or positron emission tomography (PET) imaging, respectively. Both imaging modalities showed that the tumor was the major uptake site for anti-IL13Rα2-Ab, with peak uptake of 5–8% ID and 10% ID/g as quantified from FMT and PET, respectively. Pharmacological in vivo competition with excess of unlabeled anti-IL13Rα2-Ab significantly reduced the tumor uptake, indicative of antigen-specific tumor accumulation. Further, FMT imaging demonstrated similar biodistribution and pharmacokinetic profiles of an auristatin-conjugated anti-IL13Rα2-ADC as compared to the parental Ab. Finally, the anti-IL13Rα2-ADC exhibited a dose-dependent anti-tumor effect on A375 xenografts, with 90% complete responders at a dose of 3 mg/kg. Taken together, both FMT and PET showed a favorable biodistribution profile for anti-IL13Rα2-Ab/ADC, along with antigen-specific tumor targeting and excellent therapeutic efficacy in the A375 xenograft model. This work shows the great potential of this anti-IL13Rα2-ADC as a targeted anti-cancer agent.

Modular Synthesis of Peptide-Based Single- and Multimodal Targeted Molecular Imaging Agents

A practical, modular synthesis of targeted molecular imaging agents (TMIAs) containing near-infrared dyes for optical molecular imaging (OMI) or chelated metals for magnetic resonance imaging (MRI) and single-photon emission correlation tomography (SPECT) or positron emission tomography (PET) has been developed. In the method, imaging modules are formed early in the synthesis by attaching imaging agents to the side chain of protected lysines. These modules may be assembled to provide a given set of single- or dual-modal imaging agents, which may be conjugated in the last steps of the synthesis under mild conditions to linkers and targeting groups. A key discovery was the ability of a metal such as gadolinium, useful in MRI, to serve as a protecting group for the chelator, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA). It was further discovered that two lanthanide metals, La and Ce, can double as protecting groups and placeholder metals, which may be transmetalated under mild conditions by metals used for PET in the final step. The modular method enabled the synthesis of discrete targeted probes with two of the same or different dyes, two same or different metals, or mixtures of dyes and metals. The approach was exemplified by the synthesis of single- or dual-modal imaging modules for MRI-OMI, PET-OMI, and PET-MRI, followed by conjugation to the integrin-seeking peptide, c(RGDyK). For Gd modules, their efficacy for MRI was verified by measuring the NMR spin-lattice relaxivity. To validate functional imaging of TMIAs, dual-modal agents containing Cy5.5 were shown to target A549 cancer cells by confocal fluorescence microscopy.

Watching the embryo: Evolution of the microscope for the study of embryogenesis

Embryos and microscopes share a long, remarkable history and biologists have always been intrigued to watch how embryos develop under the microscope. Here we discuss the advances in microscopy which have greatly influenced our current understanding of embryogenesis. We highlight the evolution of microscopes and the optical technologies that have been instrumental in studying various developmental processes. These imaging modalities provide mechanistic insights into the dynamic cellular and molecular events which drive lineage commitment and morphogenetic changes in the developing embryo. We begin the journey with a brief history of microscopy to study embryos. First, we review the principles and optics of light, fluorescence, confocal, and electron microscopy which have been key techniques for imaging cellular and molecular events during embryonic development. Next, we discuss recent key imaging modalities such as light-sheet microscopy, which are suitable for whole embryo imaging. Further, we highlight imaging techniques like multiphoton and super resolution microscopy for beyond light diffraction limit, high resolution imaging. Lastly, we review some of the scattering-based imaging methods and techniques used for imaging human embryos.

Simultaneous photoacoustic microscopy, spectral-domain optical coherence tomography, and fluorescein microscopy multi-modality retinal imaging

The goal of this study is to further develop a multi-modality eye imaging system and evaluate its feasibility of acquiring images of different modalities simultaneously. An integrated multimodality imaging system combining spectral-domain optical coherence tomography (SD-OCT), photoacoustic microscopy (PAM), and fluorescence microscopy (FM) was developed, and its performance for eye imaging was validated on multiple clinically-relevant retinal disease models in vivo in rabbits. OCT imaging allows for visualization of the different anatomic retinal layers with high axial resolution. PAM can be used to image vasculature, angiogenesis, and hemorrhages. The leakage of neovascularization can be verified with FM and fluorescein dye. Simultaneous imaging with OCT, PAM, and FM ensures co-registration of the three modalities without being affected by motion artifacts caused by breathing, body or eye movements, and heartbeat. This simultaneous multi-modality eye imaging system could be a new tool for applications both in ophthalmology and other fields.

Hybrid MPI-MRI System for Dual-Modal In Situ Cardiovascular Assessments of Real-Time 3D Blood Flow Quantification-A Pre-Clinical In Vivo Feasibility Investigation

Non-invasive quantification of functional parameters of the cardiovascular system, in particular the heart, remains very challenging with current imaging techniques. This aspect is mainly due to the fact, that the spatio-temporal resolution of current imaging methods, such as Magnetic Resonance Imaging (MRI) or Positron Emission Tomography (PET), does not offer the desired data repetition rates in the context of real-time data acquisition and thus, can cause artifacts and misinterpretations in accelerated data acquisition approaches. We present a fast non-invasive and quantitative dual-modal in situ cardiovascular assessment using a hybrid imaging system which combines the new imaging modality Magnetic Particle Imaging (MPI) and MRI. This pre-clinical hybrid imaging system provides either a 0.5 T homogeneous B₀ field for MRI or a 2.2 T/m gradient field featuring a Field-Free-Point for MPI. A comprehensive coil system allows in both imaging modes for spatial encoding, signal excitation and reception. In this work, 3-dimensional anatomical information acquired with MRI is combined with in situ sequentially acquired time-resolved 3D (i.e. 3D + t) MPI bolus tracking of superparamagnetic iron oxide nanoparticles. MPI data were acquired during a 21 [Formula: see text] (40 μ mol(Fe)/kg_BW) bolus tail vein injection under free-breathing with an ungated and non-triggered MPI scan with a repetition rate of 46 volumes per seconds. We successfully determined quantitative hemodynamics as 3D + t velocity vector estimations of a beating rat's heart by analyzing 3 seconds of 3D + t MPI image data. The used hybrid system allows for MR-based MPI Field-of-View planning and cardiac cross-sectional anatomy analysis, precise co-registration of dual-modal datasets, as well as for MPI-based hemodynamic functional analysis using an optical flow technique. We present the first in-vivo results of a new methodology, allowing for fast, non-invasive, quantitative and in situ hybrid cardiovascular assessment, showing its potential for future clinical applications.

Cyanine Conjugate-Based Biomedical Imaging Probes

Cyanine is a class of fluorescent dye with meritorious fluorescence properties and has motivated numerous researchers to explore its imaging capabilities by miscellaneous structural modification and functionalization strategies. The covalent conjugation with other functional molecules represents a distinctive design strategy and has shown immense potential in both basic and clinical research. This review article summarizes recent achievements in cyanine conjugate-based probes for biomedical imaging. Particular attention is paid to the conjugation with targeting warheads and other contrast agents for targeted fluorescence imaging and multimodal imaging, respectively. Additionally, their clinical potential in cancer diagnostics is highlighted and some concurrent impediments for clinical translation are discussed.

Radiolabeled Peptides for Molecular Imaging of Apoptosis

Apoptosis is a regulated cell death induced by extrinsic and intrinsic stimulants. Tracking of apoptosis provides an opportunity for the assessment of cardiovascular and neurodegenerative diseases as well as monitoring of cancer therapy at early stages. There are some key mediators in apoptosis cascade, which could be considered as specific targets for delivering imaging or therapeutic agents. The targeted radioisotope-based imaging agents are able to sensitively detect the physiological signal pathways which make them suitable for apoptosis imaging at a single-cell level. Radiopeptides take advantage of both the high sensitivity of nuclear imaging modalities and favorable features of peptide scaffolds. The aim of this study is to review the characteristics of those radiopeptides targeting apoptosis with different mechanisms.

CT Image-Guided Electrical Impedance Tomography for Medical Imaging

This study presents a computed tomography (CT) image-guided electrical impedance tomography (EIT) method for medical imaging. CT is a robust imaging modality for accurately reconstructing the density structure of the region being scanned. EIT can detect electrical impedance abnormalities to which CT scans may be insensitive, but the poor spatial resolution of EIT is a major concern for medical applications. A cross-gradient method has been introduced for oil and gas exploration to jointly invert multiple geophysical datasets associated with different medium properties in the same geological structure. In this study, we develop a CT image-guided EIT (CEIT) based on the cross-gradient method. We assume that both CT scanning and EIT imaging are conducted for the same medical target. A CT scan is first acquired to help solve the subsequent EIT imaging problem. During EIT imaging, we apply cross gradients between the CT image and the electrical conductivity distribution to iteratively constrain the conductivity inversion. The cross-gradient based method allows the mutual structures of different physical models to be referenced without directly affecting the polarity and amplitude of each model during the inversion. We apply the CEIT method to both numerical simulations and phantom experiments. The effectiveness of CEIT is demonstrated in comparison with conventional EIT. The comparison shows that the CEIT method can significantly improve the quality of conductivity images.

Research of Low-Rank Representation and Discriminant Correlation Analysis for Alzheimer's Disease Diagnosis

As population aging is becoming more common worldwide, applying artificial intelligence into the diagnosis of Alzheimer's disease (AD) is critical to improve the diagnostic level in recent years. In early diagnosis of AD, the fusion of complementary information contained in multimodality data (e.g., magnetic resonance imaging (MRI), positron emission tomography (PET), and cerebrospinal fluid (CSF)) has obtained enormous achievement. Detecting Alzheimer's disease using multimodality data has two difficulties: (1) there exists noise information in multimodal data; (2) how to establish an effective mathematical model of the relationship between multimodal data? To this end, we proposed a method named LDF which is based on the combination of low-rank representation and discriminant correlation analysis (DCA) to fuse multimodal datasets. Specifically, the low-rank representation method is used to extract the latent features of the submodal data, so the noise information in the submodal data is removed. Then, discriminant correlation analysis is used to fuse the submodal data, so the complementary information can be fully utilized. The experimental results indicate the effectiveness of this method.

A Microfluidic Platform to design Multimodal PEG - crosslinked Hyaluronic Acid Nanoparticles (PEG-cHANPs) for diagnostic applications

The combination of different imaging modalities can allow obtaining simultaneously morphological and functional information providing a more accurate diagnosis. This advancement can be reached through the use of multimodal tracers, and nanotechnology-based solutions allow the simultaneous delivery of different diagnostic compounds moving a step towards their safe administration for multimodal imaging acquisition. Among different processes, nanoprecipitation is a consolidate method for the production of nanoparticles and its implementation in microfluidics can further improve the control over final product features accelerating its potential clinical translation. A Hydrodynamic Flow Focusing (HFF) approach is proposed to produce through a ONE-STEP process Multimodal Pegylated crosslinked Hyaluronic Acid NanoParticles (PEG-cHANPs). A monodisperse population of NPs with an average size of 140 nm is produced and Gd-DTPA and ATTO488 compounds are co-encapsulated, simultaneously. The results showed that the obtained multimodal nanoparticle could work as MRI/Optical imaging probe. Furthermore, under the Hydrodenticity effect, a boosting of the T1 values with respect to free Gd-DTPA is preserved.

Nano-immunoimaging

Immunoimaging is a rapidly growing field stoked in large part by the intriguing triumphs of immunotherapy. On the heels of immunotherapy's successes, there exists a growing need to evaluate tumor response to therapy particularly immunotherapy, stratify patients into responders vs. non-responders, identify inflammation, and better understand the fundamental roles of immune system components to improve both immunoimaging and immunotherapy. Innovative nanomaterials have begun to provide novel opportunities for immunoimaging, in part due to their sensitivity, modularity, capacity for many potentially varied ligands (high avidity), and potential for multifunctionality/multimodality imaging. This review strives to comprehensively summarize the integration of nanotechnology and immunoimaging, and the field's potential for clinical applications.

Nuclear imaging approaches facilitating nanomedicine translation

Nanomedicine approaches can effectively modulate the biodistribution and bioavailability of therapeutic agents, improving their therapeutic index. However, despite the ever-increasing amount of literature reporting on preclinical nanomedicine, the number of nanotherapeutics receiving FDA approval remains relatively low. Several barriers exist that hamper the effective preclinical evaluation and clinical translation of nanotherapeutics. Key barriers include insufficient understanding of nanomedicines' in vivo behavior, inadequate translation from murine models to larger animals, and a lack of patient stratification strategies. Integrating quantitative non-invasive imaging techniques in nanomedicine development offers attractive possibilities to address these issues. Among the available imaging techniques, nuclear imaging by positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are highly attractive in this context owing to their quantitative nature and uncontested sensitivity. In basic and translational research, nuclear imaging techniques can provide critical quantitative information about pharmacokinetic parameters, biodistribution profiles or target site accumulation of nanocarriers and their associated payload. During clinical evaluation, nuclear imaging can be used to select patients amenable to nanomedicine treatment. Here, we review how nuclear imaging-based approaches are increasingly being integrated into nanomedicine development and discuss future developments that will accelerate their clinical translation.

Biomimetic nanoparticle technology for cardiovascular disease detection and treatment

Cardiovascular disease (CVD), which encompasses a number of conditions that can affect the heart and blood vessels, presents a major challenge for modern-day healthcare. Nearly one in three people has some form of CVD, with many suffering from multiple or intertwined conditions that can ultimately lead to traumatic events such as a heart attack or stroke. While the knowledge obtained in the past century regarding the cardiovascular system has paved the way for the development of life-prolonging drugs and treatment modalities, CVD remains one of the leading causes of death in developed countries. More recently, researchers have explored the application of nanotechnology to improve upon current clinical paradigms for the management of CVD. Nanoscale delivery systems have many advantages, including the ability to target diseased sites, improve drug bioavailability, and carry various functional payloads. In this review, we cover the different ways in which nanoparticle technology can be applied towards CVD diagnostics and treatments. The development of novel biomimetic platforms with enhanced functionalities is discussed in detail.

Next-generation nanotheranostics targeting cancer stem cells

Cancer is depicted as the most aggressive malignancy and is one the major causes of death worldwide. It originates from immortal tumor-initiating cells called 'cancer stem cells' (CSCs). This devastating subpopulation exhibit potent self-renewal, proliferation and differentiation characteristics. Dynamic DNA repair mechanisms can sustain the immortality phenotype of cancer to evade all treatment strategies. To date, current conventional chemo- and radio-therapeutic strategies adopted against cancer fail in tackling CSCs. However, new advances in nanotechnology have paved the way for creating next-generation nanotheranostics as multifunctional smart 'all-in-one' nanoparticles. These particles integrate diagnostic, therapeutic and targeting agents into one single biocompatible and biodegradable carrier, opening up new avenues for breakthroughs in early detection, diagnosis and treatment of cancer through efficient targeting of CSCs.

Three-Layer Image Representation by an Enhanced Illumination-Based Image Fusion Method

The recently developed multiscale-based fusion methods can be improved with two approaches: an advanced image decomposition scheme and an advanced fusion rule. In this paper, three-layer image decomposition, enhanced illumination fusion rule-based method is proposed. The proposed method includes three steps. First, each input image is decomposed into its corresponding smooth, texture, and edge layers using defined local extrema and low-pass filters in the spatial domain. Second, three different strategies are applied as fusion rules for the three-layer representation. To preserve the illumination closely related to tumors, the illumination is corrected by applying a higher contrast to the decomposed image details, including the texture and edge inputs, such as those found in grayscale CT and MRI images. The final fused image is created by the addition of the normalized smooth, texture, and edge image layers. The experiments demonstrate that the proposed method performs better than the existing state-of-the-art fusion methods.

Methods for Optical Skin Clearing in Molecular Optical Imaging in Dermatology

This short review describes recent progress in using optical clearing (OC) technique in skin studies. Optical clearing is an efficient tool for enhancing the probing depth and data quality in multiphoton microscopy and Raman spectroscopy. Here, we discuss the main mechanisms of OC, its safety, advantages, and limitations. The data on the OC effect on the skin water content are presented. It was demonstrated that 70% glycerol and 100% Omnipaque^TM 300 reduce the water content in the skin. Both OC agents (OCAs) significantly affect the strongly bound and weakly bound water. However, Omnipaque^TM 300 causes considerably less skin dehydration than glycerol. In addition, the results of examination of the OC effect on autofluorescence in two-photon excitation and background fluorescence in Raman scattering at different skin depths are presented. It is shown that Omnipaque^TM 300 is a promising OCA due to its ability to reduce background fluorescence in the upper skin layers. The possibility of multimodal imaging combining optical methods and OC technique is discussed.

Surface electrogram-guided left ventricular lead placement improves response to cardiac resynchronization therapy

OBJECTIVE

Failure to select the optimal left ventricular (LV) segment for lead implantation is one of the most important causes of unresponsiveness to the cardiac resynchronization therapy (CRT). In our study, we aimed to investigate the echocardiographic and clinical benefits of LV lead implantation guided by an intraoperative 12-lead surface electrocardiogram (ECG) in patients with multiple target veins.

METHODS

We included 80 [42 (62.5%) male] heart failure patients who successfully underwent CRT defibrillator (CRT-D) implantation. Patients were divided into two groups. In group 1, LV lead was positioned at the site with the shortest biventricular-paced (BiV-paced) QRS duration (QRSd), as intraprocedurally measured using surface ECG. In group 2 (control), we included patients who underwent the standard unguided CRT. ECG, echocardiogram, and functional status were evaluated before and 6 months after CRT implantation in all patients.

RESULTS

In group 1, BiV-paced QRSd measurements were successfully performed in 112 of 120 coronary sinus branches during CRT and an LV lead was successfully placed at the optimal site in all patients. Compared with group 2, group 1 had a significantly higher rate (85% vs. 50%, p=0.02) of response (>15% reduction in LV end-systolic volume) to CRT as well as a shorter QRSd (p<0.001) and a greater QRS shortening (ΔQRS) associated with CRT compared with baseline (p<0.001). The mean New York Heart Association functional class was significantly improved in both groups, and no significant differences were found in clinical response to CRT (85% vs. 70%, p=0.181).

CONCLUSION

Surface ECG can be used to guide LV lead placement in patients with multiple target veins for improving response to CRT. Thus, it is a safe, feasible, and economic approach for CRT-D implantation.

Vitamin E-inspired multi-scale imaging agent

The production and use of multi-modal imaging agents is on the rise. The vast majority of these imaging agents are limited to a single length scale for the agent (e.g. tissues only), which is typically at the organ or tissue scale. This work explores the synthesis of such an imaging agent and discusses the applications of our vitamin E-inspired multi-modal and multi-length scale imaging agents TB-Toc ((S,E)-5,5-difluoro-7-(2-(5-((6-hydroxy-2,5,7,8-tetramethylchroman-2-yl) methyl) thiophen-2-yl) vinyl)-9-methyl-5H-dipyrrolo-[1,2-c:2',1'-f][1,3,2]diazaborinin-4-ium-5-uide). We investigate the toxicity of TB-Toc along with the starting materials and lipid based delivery vehicle in mouse myoblasts and fibroblasts. Further we investigate the uptake of TB-Toc delivered to cultured cells in both solvent and liposomes. TB-Toc has low toxicity, and no change in cell viability was observed up to concentrations of 10 mM. TB-Toc shows time-dependent cellular uptake that is complete in about 30 min. This work is the first step in demonstrating our vitamin E derivatives are viable multi-modal and length scale diagnostic tools.

LARAMED: A Laboratory for Radioisotopes of Medical Interest

The widespread availability of novel radioactive isotopes showing nuclear characteristics suitable for diagnostic and therapeutic applications in nuclear medicine (NM) has experienced a great development in the last years, particularly as a result of key advancements of cyclotron-based radioisotope production technologies. At Legnaro National Laboratories of the National Institute of Nuclear Physics (LNL-INFN), Italy, a 70-MeV high current cyclotron has been recently installed. This cyclotron will be dedicated not only to pursuing fundamental nuclear physics studies, but also to research related to other scientific fields with an emphasis on medical applications. LARAMED project was established a few years ago at LNL-INFN as a new research line aimed at exploiting the scientific power of nuclear physics for developing innovative applications to medicine. The goal of this program is to elect LNL as a worldwide recognized hub for the development of production methods of novel medical radionuclides, still unavailable for the scientific and clinical community. Although the research facility is yet to become fully operative, the LARAMED team has already started working on the cyclotron production of conventional medical radionuclides, such as Tc-99m, and on emerging radionuclides of high potential medical interest, such as Cu-67, Sc-47, and Mn-52.

Registration and Fusion of Thermographic and Visual-Light Images in Neurosurgery

An intraoperative imaging system facilitating the localisation and characterisation of functional areas, pathological tissue, or perfusion disorders, could enormously support medical decisions during neurosurgical interventions and, thus, reduce the risk for the patients. To provide both structural and functional information of the brain tissue to the surgeon, a novel multimodal approach based on the measurement of long-wave infrared radiation and visual-light imaging is very promising. In this contribution, we discuss various methods for the registration and fusion of thermographic and visual-light images. The methods are evaluated quantitatively and qualitatively regarding their practicability during surgery. Furthermore, we introduce appropriate architectures for a digital hardware implementation of the registration and fusion algorithms. The designs are implemented on our reconfigurable intraoperative imaging system, revealing real-time processing performance.

A Single Simulation Platform for Hybrid Photoacoustic and RF-Acoustic Computed Tomography

In recent years, multimodal thermoacoustic imaging has demonstrated superior imaging quality compared to other emerging modalities. It provides functional and molecular information, arising due to electromagnetic absorption contrast, at ultrasonic resolution using inexpensive and non-ionizing imaging methods. The development of optical- as well as radio frequency (RF)-induced thermoacoustic imaging systems would benefit from reliable numerical simulations. To date, most numerical models use a combination of different software in order to model the hybrid thermoacoustic phenomenon. Here, we demonstrate the use of a single open source finite element software platform (ONELAB) for photo- and RF-acoustic computed tomography. The solutions of the optical diffusion equation, frequency domain Maxwell’s equations, and time-domain wave equation are used to solve the optical, electromagnetic, and acoustic propagation problems, respectively, in ONELAB. The results on a test homogeneous phantom and an approximate breast phantom confirm that ONELAB is a very effective software for both photo- and RF-acoustic simulations, and invaluable for developing new reconstruction algorithms and hardware systems.

PET/MRI: a frontier in era of complementary hybrid imaging

With primitive approaches, the diagnosis and therapy were operated at the cellular, molecular, or even at the genetic level. As the diagnostic techniques are more concentrated towards molecular level, multi modal imaging becomes specifically essential. Multi-modal imaging has extensive applications in clinical as well as in pre-clinical studies. Positron Emission Tomography (PET) has flourished in the field of nuclear medicine, which has motivated it to fuse with Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) for PET/CT and PET/MRI respectively. However, the challenges in PET/CT are due to the inability of simultaneous acquisition and reduced soft tissue contrast, which has led to the development of PET/MRI. Also, MRI offers the better soft tissue contrast over CT. Hence, fusion of PET and MRI results in combining structural information with functional image from PET. Yet, it has many technical challenges due to the interference between the modalities. Also, it must be resolved with various approaches for addressing the shortcomings of each system and improvise on the image quantification system. This review elaborates on the various challenges in the present PET/MRI system and the future directions of the hybrid modality. Also, the different data acquisition and analysis techniques of PET/MRI system are discussed with enhanced details on the software tools.

Wavelet-based joint CT-MRI reconstruction

Since their inceptions, the multimodal imaging techniques have received a great deal of attention for achieving enhanced imaging performance. In this work, a novel joint reconstruction framework using sparse computed tomography (CT) and magnetic resonance imaging (MRI) data is developed and evaluated. CT and MRI images are synchronously acquired and registered from a hybrid CT-MRI platform. Because image data are highly undersampled, analytic methods are unable to generate decent image quality. To overcome this drawback, we resort to the compressed sensing (CS) techniques, which employ sparse priors that result from an application of a wavelet transform. To utilize multimodal information, projection distance is introduced and is tuned to tailor the texture and pattern of the final images. Specifically, CT and MRI images are alternately reconstructed using the updated multimodal results that are calculated at the latest step of the iterative optimization algorithm. The method exploits the structural similarities shared by the CT and MRI images to achieve better reconstruction quality. The good performance of the proposed approach is demonstrated on a pair of undersampled CT and MRI body images. Clinical CT and MRI images are tested with the joint reconstruction, the analytic reconstruction, and the independent reconstruction which does not uses multimodal imaging information. Results show that the proposed method improves about 5dB in signal to noise ratio (SNR) and nearly 10% in structural similarity measure comparing to independent reconstruction. It offers similar quality with fully sampled analytic reconstruction with only 20% sampling rate for CT and 40% for MRI. Structural similarities and correlations residing in images from different modalities are useful to mutually promote the quality of image reconstruction.

Multimodal molecular 3D imaging for the tumoral volumetric distribution assessment of folate-based biosensors

The aim of this study was to characterize the in vivo volumetric distribution of three folate-based biosensors by different imaging modalities (X-ray, fluorescence, Cerenkov luminescence, and radioisotopic imaging) through the development of a tridimensional image reconstruction algorithm. The preclinical and multimodal Xtreme imaging system, with a Multimodal Animal Rotation System (MARS), was used to acquire bidimensional images, which were processed to obtain the tridimensional reconstruction. Images of mice at different times (biosensor distribution) were simultaneously obtained from the four imaging modalities. The filtered back projection and inverse Radon transformation were used as main image-processing techniques. The algorithm developed in Matlab was able to calculate the volumetric profiles of ^99mTc-Folate-Bombesin (radioisotopic image), ¹⁷⁷Lu-Folate-Bombesin (Cerenkov image), and FolateRSense™ 680 (fluorescence image) in tumors and kidneys of mice, and no significant differences were detected in the volumetric quantifications among measurement techniques. The imaging tridimensional reconstruction algorithm can be easily extrapolated to different 2D acquisition-type images. This characteristic flexibility of the algorithm developed in this study is a remarkable advantage in comparison to similar reconstruction methods.

Dual nano-sized contrast agents in PET/MRI: a systematic review

Nowadays molecular imaging plays a vital role in achieving a successful targeted and personalized treatment. Hence, the approach of combining two or more medical imaging modalities was developed. The objective of this review is to systematically compare recent dual contrast agents in Positron Emission Tomography (PET)/Magnetic Resonance Imaging (MRI) and in some cases Single photon emission computed tomography (SPECT)/MRI in terms of some their characteristics, such as tumor uptake, and reticuloendothelial system uptake (especially liver) and their relaxivity rates for early detection of primary cancer tumor. To the best of our knowledge, this is the first systematic and integrated overview of this field. Two reviewers individually directed the systematic review search using PubMed, MEDLINE and Google Scholar. Two other reviewers directed quality assessment, using the criteria checklist from the CAMARADES (Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies) tool, and differences were resolved by consensus. After reviewing all 49 studies, we concluded that a size range of 20-200 nm can be used for molecular imaging, although it is better to try to achieve as small a size as it is possible. Also, small nanoparticles with a hydrophilic coating and positive charge are suitable as a T₂ contrast agent. According to our selected data, the most successful dual probes in terms of high targeting were with an average size of 40 nm, PEGylated using peptides as a biomarker and radiolabeled with copper 64 and gallium 68. Copyright © 2017 John Wiley & Sons, Ltd.