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Gomes RAMP, Catarino L, Santos AL. The Role of Fe, S, P, Ca, and Sr in Porous Skeletal Lesions: A Study on Non-adult Individuals Using pXRF. Biol Trace Elem Res 2024:10.1007/s12011-024-04187-4. [PMID: 38691307 DOI: 10.1007/s12011-024-04187-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/12/2024] [Indexed: 05/03/2024]
Abstract
Portable X-ray fluorescence is a new tool in the study of human bone. This research aims to investigate if variations in bone elemental concentrations are related with porous skeletal lesions (PSLs). One hundred well-preserved non-adult skeletons aged 0-11 years were selected from the archaeological site Convent of São Domingos, Lisbon (18th-19th century). Measuring a standard reference material and calculating the technical error of measurement assured elemental data reliability. Moreover, measuring soil samples excluded possible contamination of bones with elements from the soil, except for Pb. Additionally, the Ca/P ratio indicates maintenance of bone integrity. Cribra cranii, orbitalia, humeralis, and femoralis were recorded as present/absent, and the estimated intra-/inter-observer errors were low. The multivariate analysis found higher odds of having cribra orbitalia (OR = 1.76; CI = 0.97-3.20) and cribra femoralis (OR = 1.42; CI = 0.73-2.74) in individuals with lower Fe and higher S. Furthermore, higher levels of P, Ca, and Sr increased the odds of individuals developing cribra femoralis (OR = 2.30; CI = 1.23-4.29). Age also correlated with increased odds of exhibiting cribra orbitalia (OR = 1.86; CI = 0.94-3.68), cribra femoralis (OR = 6.97; CI = 2.78-17.45), and cribra humeralis (OR = 8.32; CI = 2.71-25.60). These findings suggest a shared etiology for these three cribras, contrasting with the higher Fe levels in individuals with cribra cranii. Lower Fe and higher S levels in individuals with cribra suggest a complex etiology, possibly involving conditions like megaloblastic or chronic disease anemia(s). Age-related elemental changes support the hypothesis that age influences cribra frequencies. This study highlights PSL complexity and opens new avenues for research.
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Affiliation(s)
- Ricardo A M P Gomes
- Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, University of Coimbra, Rua Do Arco da Traição, 3000-056, Coimbra, Portugal.
- Carrera de Antropologia, University of Concepción, Barrio Universitário S/N, Concepción, Chile.
| | - Lidia Catarino
- Geosciences Center, Department of Earth Sciences, University of Coimbra, Rua Sílvio Lima - Pólo II, 3030-790, Coimbra, Portugal
| | - Ana Luisa Santos
- Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, University of Coimbra, Rua Do Arco da Traição, 3000-056, Coimbra, Portugal
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Samuels C, Marsh J, Leggett R. An age- and sex-specific biokinetic model for radon . JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:041502. [PMID: 37725955 DOI: 10.1088/1361-6498/acfb19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/19/2023] [Indexed: 09/21/2023]
Abstract
Publication 137 of the International Commission on Radiological Protection (ICRP) describes a biokinetic model for radon used to derive dose coefficients for occupational intake of radon isotopes. The model depicts transfer of inhaled or ingested radon to blood, exchange of radon between blood and tissues, and gradual loss of radon from the body based on physical laws governing transfer of a non-reactive and soluble gas between materials. This paper describes an age- and sex-specific variation of that model developed for use in an upcoming ICRP series of reports on environmental intake of radionuclides by members of the public titled 'Dose Coefficients for Intakes of Radionuclides by Members of the Public'. The proposed model modifies the model structure and transfer coefficients presented in Publication 137 to allow more realistic dosimetric treatment of bone marrow and breast and expands the model to address pre-adult ages, based on the physical principles used in the development of the model of Publication 137 together with anatomical and physiological changes occurring during human development.
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Affiliation(s)
- Caleigh Samuels
- Environmental Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN, United States of America
| | - James Marsh
- UK Health Security Agency, London, United Kingdom
| | - Rich Leggett
- Environmental Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN, United States of America
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3
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Tewattanarat N, Junhasavasdikul T, Panwar S, Joshi SD, Abadeh A, Greer MLC, Goldenberg A, Zheng G, Villani A, Malkin D, Doria AS. Diagnostic accuracy of imaging approaches for early tumor detection in children with Li-Fraumeni syndrome. Pediatr Radiol 2022; 52:1283-1295. [PMID: 35391548 DOI: 10.1007/s00247-022-05296-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 12/17/2021] [Accepted: 01/18/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Toronto protocol for cancer surveillance in children with Li-Fraumeni syndrome has been adopted worldwide. OBJECTIVE To assess the diagnostic accuracy of the imaging used in this protocol. MATERIALS AND METHODS We conducted a blinded retrospective review of imaging modalities in 31 pediatric patients. We compared imaging findings with the reference standards, which consisted of (1) histopathological diagnosis, (2) corresponding dedicated imaging or subsequent surveillance imaging or (3) clinical outcomes. We individually analyzed each modality's diagnostic performance for cancer detection and assessed it on a per-study basis for chest and abdominal regional whole-body MRI (n=115 each), brain MRI (n=101) and abdominal/pelvic US (n=292), and on a per-lesion basis for skeleton/soft tissues on whole-body MRI (n=140). RESULTS Of 763 studies/lesions, approximately 80% had reference standards that identified 4 (0.7%) true-positive, 523 (85.3%) true-negative, 5 (0.8%) false-positive, 3 (0.5%) false-negative and 78 (12.7%) indeterminate results. There were 3 true-positives on whole-body MRI and 1 true-positive on brain MRI as well as 3 false-negatives on whole-body MRI. Sensitivities and specificities of tumor diagnosis using a worst-case scenario analysis were, respectively, 40.0% (95% confidence interval [CI]: 7.3%, 83.0%) and 38.2% (95% CI: 29.2%, 48.0%) for skeleton/soft tissues on whole-body MRI; sensitivity non-available and 97.8% (95% CI: 91.4%, 99.6%) for chest regional whole-body MRI; 100.0% (95% CI: 5.5%, 100.0%) and 96.8% (95% CI: 90.2%, 99.2%) for abdominal regional whole-body MRI; sensitivity non-available and 98.3% (95% CI: 95.3, 99.4) for abdominal/pelvic US; and 50.0% (95% CI: 2.7%, 97.3%) and 93.8% (95% CI: 85.6%, 97.7%) for brain MRI. CONCLUSION Considerations for optimizing imaging protocol, defining criteria for abnormalities, developing a structured reporting system, and practicing consensus double-reading may enhance the diagnostic accuracy for tumor surveillance.
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Affiliation(s)
- Nipaporn Tewattanarat
- Department of Medical Imaging, The Hospital for Sick Children University of Toronto, 555 University Ave., 2nd floor, Toronto, ON, M5G1X8, Canada.,Department of Radiology, Khon Kaen University, Mueang, Khon Kaen, Thailand
| | - Thitiporn Junhasavasdikul
- Department of Medical Imaging, The Hospital for Sick Children University of Toronto, 555 University Ave., 2nd floor, Toronto, ON, M5G1X8, Canada.,Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Rajthevi, Bangkok, Thailand
| | - Sanuj Panwar
- Department of Medical Imaging, The Hospital for Sick Children University of Toronto, 555 University Ave., 2nd floor, Toronto, ON, M5G1X8, Canada.,Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sayali D Joshi
- Department of Medical Imaging, The Hospital for Sick Children University of Toronto, 555 University Ave., 2nd floor, Toronto, ON, M5G1X8, Canada
| | - Armin Abadeh
- Department of Medical Imaging, The Hospital for Sick Children University of Toronto, 555 University Ave., 2nd floor, Toronto, ON, M5G1X8, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mary Louise C Greer
- Department of Medical Imaging, The Hospital for Sick Children University of Toronto, 555 University Ave., 2nd floor, Toronto, ON, M5G1X8, Canada
| | - Anna Goldenberg
- Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
| | - Gang Zheng
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Anita Villani
- Division of Hematology/Oncology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - David Malkin
- Division of Hematology/Oncology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Andrea S Doria
- Department of Medical Imaging, The Hospital for Sick Children University of Toronto, 555 University Ave., 2nd floor, Toronto, ON, M5G1X8, Canada. .,Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada.
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4
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Ahmed AA, Strong MJ, Zhou X, Robinson T, Rocco S, Siegel GW, Clines GA, Moore BB, Keller ET, Szerlip NJ. Differential immune landscapes in appendicular versus axial skeleton. PLoS One 2022; 17:e0267642. [PMID: 35476843 PMCID: PMC9045623 DOI: 10.1371/journal.pone.0267642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/12/2022] [Indexed: 11/18/2022] Open
Abstract
Roughly 400,000 people in the U.S. are living with bone metastases, the vast majority occurring in the spine. Metastases to the spine result in fractures, pain, paralysis, and significant health care costs. This predilection for cancer to metastasize to the bone is seen across most cancer histologies, with the greatest incidence seen in prostate, breast, and lung cancer. The molecular process involved in this predilection for axial versus appendicular skeleton is not fully understood, although it is likely that a combination of tumor and local micro-environmental factors plays a role. Immune cells are an important constituent of the bone marrow microenvironment and many of these cells have been shown to play a significant role in tumor growth and progression in soft tissue and bone disease. With this in mind, we sought to examine the differences in immune landscape between axial and appendicular bones in the normal noncancerous setting in order to obtain an understanding of these landscapes. To accomplish this, we utilized mass cytometry by time-of-flight (CyTOF) to examine differences in the immune cell landscapes between the long bone and vertebral body bone marrow from patient clinical samples and C57BL/6J mice. We demonstrate significant differences between immune populations in both murine and human marrow with a predominance of myeloid progenitor cells in the spine. Additionally, cytokine analysis revealed differences in concentrations favoring a more myeloid enriched population of cells in the vertebral body bone marrow. These differences could have clinical implications with respect to the distribution and permissive growth of bone metastases.
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Affiliation(s)
- Aqila A. Ahmed
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
- Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Michael J. Strong
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Xiaofeng Zhou
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Tyler Robinson
- Department of Urology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Sabrina Rocco
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Geoffrey W. Siegel
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Gregory A. Clines
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
- Veterans Affairs Medical Center, Ann Arbor, Michigan, United States of America
| | - Bethany B. Moore
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Evan T. Keller
- Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Urology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Nicholas J. Szerlip
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, United States of America
- Veterans Affairs Medical Center, Ann Arbor, Michigan, United States of America
- * E-mail:
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Elangovan SM, Meyers AB. Pearls and Pitfalls of Imaging of the Developing Pediatric Skeleton: Differentiating Normal and Pathology With MRI. Semin Ultrasound CT MR 2022; 43:73-87. [PMID: 35164912 DOI: 10.1053/j.sult.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Developmental changes occurring in the pediatric skeleton throughout childhood cause imaging appearances that may be confused with pathology. Knowledge of the typical pattern of red to yellow bone marrow conversion and areas of normal developmental irregular ossification is essential for radiologists interpreting musculoskeletal imaging in children to avoid mistaking normal findings for disease. Here we review the normal conversion of hematopoietic to yellow marrow on pediatric MRI and illustrate how MRI can distinguish the normal areas of irregular ossification from various pathology that can occur at and around growth centers in the developing skeleton.
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Affiliation(s)
- Stacey M Elangovan
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Arthur B Meyers
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
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Vo MT, Singh A, Meng T, Kaur J, Venn A, Cicuttini F, March L, Cross M, Dwyer T, Halliday A, Jones G, Ding C, Antony B. Prevalence and Clinical Significance of Residual or Reconverted Red Bone Marrow on Knee MRI. Diagnostics (Basel) 2021; 11:diagnostics11091531. [PMID: 34573874 PMCID: PMC8466981 DOI: 10.3390/diagnostics11091531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Residual/reconverted red bone marrow (RBM) in adult knees is occasionally observed on routine knee magnetic resonance imaging (MRI). We aimed to identify its prevalence, distribution, and associations with lifestyle factors, knee structural abnormalities, and knee symptoms in young adults. Methods: Participants (n = 327; aged = 31–41 years) were selected from the Childhood Determinants of Adult Health (CDAH) knee study. They underwent T1-weighted and proton-density-weighted fat-suppressed MRI scans of knees. Residual/reconverted RBM in distal femur and proximal tibia were graded semi-quantitatively (grades: 0–3) based on the percentage area occupied. Knee structural abnormalities were graded semi-quantitatively using previously published MRI scoring systems. Knee symptoms (pain, stiffness, and dysfunction) were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale during CDAH knee study (year: 2008–2010) and at 6–9-year follow-up during the CDAH-3 study (year: 2014–2019). Associations between definite RBM (grade ≥ 2) and lifestyle factors, knee symptoms, and structural abnormalities were described using log-binomial regressions. Results: Definite RBM was seen in females only, in 29 out of 154 cases (18.8%), with femoral involvement preceding tibial involvement. Definite RBM was associated with increased BMI (PR = 1.09/kg/m2; 95% CI: 1.03, 1.16), overweight status (PR = 2.19; 95% CI: 1.07, 4.51), and WOMAC knee pain (PR = 1.75; 95% CI: 1.11, 2.74) in cross-section analysis. However, there was no association between RBM and knee-pain after seven years (PR = 1.15; 95% CI: 0.66, 2.00). There were no associations between RBM and knee structural abnormalities. Conclusion: Presence of definite RBM in young adult knees was observed in females only. Definite RBM was associated with overweight measures, and the modest association with knee pain may not be causally related.
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Affiliation(s)
- Minh Tu Vo
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7000, Australia; (M.T.V.); (A.S.); (T.M.); (J.K.); (A.V.); (T.D.); (G.J.); (C.D.)
| | - Ambrish Singh
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7000, Australia; (M.T.V.); (A.S.); (T.M.); (J.K.); (A.V.); (T.D.); (G.J.); (C.D.)
| | - Tao Meng
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7000, Australia; (M.T.V.); (A.S.); (T.M.); (J.K.); (A.V.); (T.D.); (G.J.); (C.D.)
| | - Jasveen Kaur
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7000, Australia; (M.T.V.); (A.S.); (T.M.); (J.K.); (A.V.); (T.D.); (G.J.); (C.D.)
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7000, Australia; (M.T.V.); (A.S.); (T.M.); (J.K.); (A.V.); (T.D.); (G.J.); (C.D.)
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
| | - Lyn March
- Institute of Bone and Joint Research, University of Sydney, Sydney, NSW 2065, Australia; (L.M.); (M.C.)
| | - Marita Cross
- Institute of Bone and Joint Research, University of Sydney, Sydney, NSW 2065, Australia; (L.M.); (M.C.)
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7000, Australia; (M.T.V.); (A.S.); (T.M.); (J.K.); (A.V.); (T.D.); (G.J.); (C.D.)
- The George Institute for Global Health, Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford OX3 9DU, UK
| | - Andrew Halliday
- Department of Radiology, Royal Hobart Hospital, Hobart, TAS 7000, Australia;
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7000, Australia; (M.T.V.); (A.S.); (T.M.); (J.K.); (A.V.); (T.D.); (G.J.); (C.D.)
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7000, Australia; (M.T.V.); (A.S.); (T.M.); (J.K.); (A.V.); (T.D.); (G.J.); (C.D.)
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
- Clinical Research Centre, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, China
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS 7000, Australia; (M.T.V.); (A.S.); (T.M.); (J.K.); (A.V.); (T.D.); (G.J.); (C.D.)
- Correspondence:
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Chaturvedi A. Pediatric skeletal diffusion-weighted magnetic resonance imaging: part 1 - technical considerations and optimization strategies. Pediatr Radiol 2021; 51:1562-1574. [PMID: 33792751 DOI: 10.1007/s00247-021-04975-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/12/2020] [Accepted: 01/15/2021] [Indexed: 12/28/2022]
Abstract
Diffusion-weighted MRI, or DWI, is a fast, quantitative technique that is easily integrated into a morphological MR acquisition. The ability of DWI to aid in detecting multifocal skeletal pathology and in characterizing tissue cellularity to a level beyond that possible with other techniques makes it a niche component of multiparametric MR imaging of the skeleton. Besides its role in disease detection and establishing cellularity and character of osseous lesions, DWI continues to be examined as a surrogate biomarker for therapeutic response of several childhood bone tumors. There is increasing interest in harnessing DWI as a potential substitute to alternative modes of imaging evaluation that involve radiation or administration of intravenous contrast agent or radiopharmaceuticals, for example in early detection and diagnosis of capital femoral epiphyseal ischemia in cases of Legg-Calvé-Perthes disease, or diagnosis and staging of lymphoma. The expected evolution of skeletal diffusivity characteristics with maturation and the unique disease processes that affect the pediatric skeleton necessitate a pediatric-specific discussion. In this article, the author examines the developmentally appropriate normal appearances, technique, artifacts and pitfalls of pediatric skeletal DWI.
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Affiliation(s)
- Apeksha Chaturvedi
- Division of Pediatric Radiology, Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA.
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8
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Person A, Janitz E, Thapa M. Pediatric Bone Marrow: Normal and Abnormal MRI Appearance. Semin Roentgenol 2021; 56:325-337. [PMID: 34281683 DOI: 10.1053/j.ro.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kristensen HB, Andersen TL, Patriarca A, Kallenbach K, MacDonald B, Sikjaer T, Ejersted C, Delaisse JM. Human hematopoietic microenvironments. PLoS One 2021; 16:e0250081. [PMID: 33878141 PMCID: PMC8057613 DOI: 10.1371/journal.pone.0250081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/30/2021] [Indexed: 11/18/2022] Open
Abstract
Dormancy of hematopoietic stem cells and formation of progenitors are directed by signals that come from the bone marrow microenvironment. Considerable knowledge has been gained on the murine hematopoietic stem cell microenvironment, while less so on the murine progenitor microenvironment and even less so on these microenvironments in humans. Characterization of these microenvironments is decisive for understanding hematopoiesis and finding new treatment modalities against bone marrow malignancies in the clinic. However, it is equally challenging, because hematopoietic stem cells are difficult to detect in the complex bone marrow landscape. In the present study we are characterizing the human hematopoietic stem cell and progenitor microenvironment. We obtained three adjacent bone marrow sections from ten healthy volunteers. One was used to identify a population of CD34+/CD38- “hematopoietic stem cells and multipotent progenitors” and a population of CD34+/CD38+ “progenitors” based on immunofluorescence pattern/intensity and cellular morphology. The other two were immunostained respectively for CD34/CD56 and for CD34/SMA. Using the combined information we performed a non-computer-assisted quantification of nine bone marrow components (adipocytes, megakaryocytes, bone surfaces, four different vessel types (arteries, capillaries, sinusoids and collecting sinuses), other “hematopoietic stem cells and multipotent progenitors” and other “progenitors”) within 30 μm of “hematopoietic stem cells and multipotent progenitors”, “progenitors”, and “random cell profiles”. We show that the microenvironment of the “hematopoietic stem cells and multipotent progenitors” is significantly enriched in sinusoids and megakaryocytes, while the microenvironment of the “progenitors” is significantly enriched in capillaries, other “progenitors”, bone surfaces and arteries.
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Affiliation(s)
- Helene Bjoerg Kristensen
- Department of Clinical Cell Biology, Institute of Regional Health Science, University of Southern Denmark, Lillebaelt Hospital, Vejle, Denmark
- Department of Pathology, Clinical Cell Biology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research and Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Thomas Levin Andersen
- Department of Clinical Cell Biology, Institute of Regional Health Science, University of Southern Denmark, Lillebaelt Hospital, Vejle, Denmark
- Department of Pathology, Clinical Cell Biology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research and Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Andrea Patriarca
- Division of Hematology, Department of Oncology, Hospital "Maggiore della Carità", Novara, Italy
| | - Klaus Kallenbach
- Department of Pathology, Zealand University Hospital, Roskilde, Denmark
| | - Birgit MacDonald
- Department of Clinical Cell Biology, Institute of Regional Health Science, University of Southern Denmark, Lillebaelt Hospital, Vejle, Denmark
| | - Tanja Sikjaer
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Charlotte Ejersted
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Jean-Marie Delaisse
- Department of Clinical Cell Biology, Institute of Regional Health Science, University of Southern Denmark, Lillebaelt Hospital, Vejle, Denmark
- Department of Pathology, Clinical Cell Biology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research and Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
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Patel MD, Brian J, Chauvin NA. Pearls and Pitfalls in Imaging Bone Marrow in Pediatric Patients. Semin Ultrasound CT MR 2020; 41:472-487. [DOI: 10.1053/j.sult.2020.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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11
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Menashe SJ, Aboughalia H, Zhao Y, Ngo AV, Otjen JP, Thapa MM, Iyer RS. The Many Faces of Pediatric Chronic Recurrent Multifocal Osteomyelitis (CRMO): A Practical Location- and Case-Based Approach to Differentiate CRMO From Its Mimics. J Magn Reson Imaging 2020; 54:391-400. [PMID: 32841445 DOI: 10.1002/jmri.27299] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disease of childhood and adolescence characterized by episodic bone pain. Diagnosis relies heavily on whole-body MRI and is made by excluding a wide variety of other disorders with overlapping imaging features, depending on location, marrow distribution, and the presence or absence of multifocality. We present an overview of the clinical and imaging features of CRMO and, through various clinical scenarios, provide tips for tailoring the differential diagnosis based on location and distribution of encountered abnormalities. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Sarah J Menashe
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Hassan Aboughalia
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Yongdong Zhao
- Department of Rheumatology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Anh-Vu Ngo
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Jeffrey P Otjen
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Mahesh M Thapa
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Ramesh S Iyer
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
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12
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Boroumand P, Klip A. Bone marrow adipose cells - cellular interactions and changes with obesity. J Cell Sci 2020; 133:133/5/jcs238394. [PMID: 32144195 DOI: 10.1242/jcs.238394] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The bone marrow is a spatially restricted niche, housing cells of the hematopoietic and mesenchymal lineages in various hierarchical commitment states. Although highly localized, cells within this niche are also subject to regulation by environmental and/or circulatory changes through extensive vascularization. Bone marrow adipocytes, derived from mesenchymal stem cells and once known as marrow space fillers, are a heterogeneous population. These cells reside in distinct niches within the bone marrow and interact with proximal cells, such as hematopoietic precursors and lineage-committed cells. In this diverse cellular milieu, bone marrow adipocytes influence commitment decisions and cellular lineage selection by interacting with stem and progenitor cells. In addition, bone marrow adipocytes respond to environmental changes, such as obesity, by undergoing hypertrophy, hyperplasia or adoption of characteristics resembling those of peripheral brown, beige or white adipocytes. Here, we review recent findings and concepts on the influence of bone marrow adipocytes on hematopoietic and other cellular lineages within this niche. We discuss how changes in local, systemic, cellular and secreted signals impact on mesenchymal stem cell expansion, differentiation and lineage commitment. Furthermore, we highlight that bone marrow adipocytes may be intermediaries conveying environmental cues to influence hematopoietic cellular survival, proliferation and preferential differentiation.
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Affiliation(s)
- Parastoo Boroumand
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada.,Department of Biochemistry, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Amira Klip
- Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada .,Department of Biochemistry, University of Toronto, Toronto, Ontario M5S 1A8, Canada
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13
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Tschauner S, Marterer R, Nagy E, Singer G, Riccabona M, Sorantin E. Experiences with image quality and radiation dose of cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) in pediatric extremity trauma. Skeletal Radiol 2020; 49:1939-1949. [PMID: 32535775 PMCID: PMC7652807 DOI: 10.1007/s00256-020-03506-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Novel dedicated extremity cone beam computed tomography (CBCT) devices, recently introduced to the market, raised attention as a possible alternative in advanced diagnostic pediatric trauma imaging, today usually performed by multidetector computed tomography (MDCT). This work aimed to compare image quality and radiation dose of CBCT and MDCT. MATERIALS AND METHODS Fifty-four CBCT-MDCT examination pairs, containing nine MDCTs acquired in parallel prospectively and 45 MDCTs matched in retrospect, were included in this study. Image quality was analyzed semi-objectively by measuring noise, contrast-to-noise ratio (CNR), and signal-to-noise ratios (SNR) and subjectively by performing image impression ratings. CT dose records were readout. RESULTS Image noise was significantly lower in CBCT compared with MDCT, both semi-objectively and subjectively (both p < 0.001). CNR and SNRs were also in favor of CBCT, though CBCT examinations exhibited significantly more beam hardening artifacts that diminished the advantages of the superior semi-objective image quality. These artifacts were believed to occur more often in children due to numerous bone-cartilage transitions in open growth plates and may have led to a better subjective diagnostic certainty rating (p = 0.001). Motion artifacts were infrequently, but exclusively observed in CBCT. CT dose index (CTDIvol) was substantially lower in CBCT (p < 0.001). CONCLUSION Dedicated extremity CBCT could be an alternative low-dose modality in the diagnostic pathway of pediatric fractures. At lower doses compared with MDCT and commonly affected by beam hardening artifacts, semi-objective CBCT image quality parameters were generally better than in MDCT.
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Affiliation(s)
- Sebastian Tschauner
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria.
| | - Robert Marterer
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria
| | - Eszter Nagy
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria
| | - Georg Singer
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, Graz, 8036, Austria
| | - Michael Riccabona
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria
| | - Erich Sorantin
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria
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14
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Coutel X, Delattre J, Marchandise P, Falgayrac G, Béhal H, Kerckhofs G, Penel G, Olejnik C. Mandibular bone is protected against microarchitectural alterations and bone marrow adipose conversion in ovariectomized rats. Bone 2019; 127:343-352. [PMID: 31276849 DOI: 10.1016/j.bone.2019.06.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/02/2019] [Accepted: 06/29/2019] [Indexed: 02/05/2023]
Abstract
Osteoporosis is a disease that leads to a loss of bone mass and to alterations in the bone microarchitecture that occur in a site-specific manner; however it remains controversial in the jaw. The involvement of bone marrow adipose tissue (BMAT) in the bone metabolism has been suggested in several physiopathological contexts, such as in aging and osteoporosis. To test whether the BMAT content is related to mandibular bone loss, this study aimed to investigate the potential correlations between the trabecular bone microarchitecture on one hand and BMAT content and its spatial distribution in relation to bone surface on the other hand during aging and ovariectomy (OVX) during a long-term follow-up in a mature rat model. No age-related microarchitectural or BMAT changes were observed in the mandible. The OVX-induced bone loss was three-fold lower in the mandible than in the tibia and was observed only in the alveolar bone (not in the condyle). We also report a delayed increase in the mandibular BMAT content that remained 4-6-fold lower compared to tibia. This low BMAT content in the mandible was located at a distance from the trabecular bone surface (only 5% in contact with the bone surface versus 87% in the tibia). These findings highlight a specific mandibular response to OVX, in particular fewer microarchitectural alterations compared to that in the tibia. For the latter, the trabecular bone thickness and surface were correlated with the BMAT content. Oral functions may have a protective effect on the mandibular BMAT conversion in an OVX context.
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Affiliation(s)
- Xavier Coutel
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, EA 4490 - PMOI, F-59000 Lille, France.
| | - Jérôme Delattre
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, EA 4490 - PMOI, F-59000 Lille, France
| | - Pierre Marchandise
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, EA 4490 - PMOI, F-59000 Lille, France
| | - Guillaume Falgayrac
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, EA 4490 - PMOI, F-59000 Lille, France
| | - Hélène Béhal
- Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Unité de Méthodologie et Biostatistiques, F-59000 Lille, France
| | - Greet Kerckhofs
- Biomechanics Lab, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium; Institute of Experimental and Clinical Research, UCLouvain, Woluwe, Belgium; Department Materials Engineering, KU Leuven, Leuven, Belgium; Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium
| | - Guillaume Penel
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, EA 4490 - PMOI, F-59000 Lille, France
| | - Cécile Olejnik
- Univ. Lille, Univ. Littoral Côte d'Opale, CHU Lille, EA 4490 - PMOI, F-59000 Lille, France
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15
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Brickley MB. Cribra orbitalia
and porotic hyperostosis: A biological approach to diagnosis. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 167:896-902. [DOI: 10.1002/ajpa.23701] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/17/2018] [Accepted: 07/29/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Megan B. Brickley
- Department of Anthropology; McMaster University; Hamilton Ontario Canada
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16
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Zhao F, Shen J, Yu X, Zhou H, Lu Z, Yan S. Bone marrow reconversion mimicking pelvis metastases in a patient with rectal cancer: a pitfall on magnetic resonance images. Quant Imaging Med Surg 2018; 8:621-626. [PMID: 30140624 PMCID: PMC6081354 DOI: 10.21037/qims.2018.07.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/30/2018] [Indexed: 01/14/2023]
Affiliation(s)
- Feng Zhao
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jiayan Shen
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Xiaokai Yu
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Hua Zhou
- Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Zhongjie Lu
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Senxiang Yan
- Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
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Marshall EL, Borrego D, Fudge JC, Rajderkar D, Bolch WE. Organ doses in pediatric patients undergoing cardiac-centered fluoroscopically guided interventions: Comparison of three methods for computational phantom alignment. Med Phys 2018; 45:10.1002/mp.13044. [PMID: 29896882 PMCID: PMC6292782 DOI: 10.1002/mp.13044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/15/2018] [Accepted: 06/07/2018] [Indexed: 01/16/2023] Open
Abstract
PURPOSE To assess various computational phantom alignment techniques within Monte Carlo radiation transport models of pediatric fluoroscopically guided cardiac interventional studies. METHODS Logfiles, including all procedure radiation and machine data, were extracted from a Toshiba infinix-I unit in the University of Florida Pediatric Catheterization Laboratory for a cohort of 10 patients. Two different alignment methods were then tested against a ground truth standard based upon identification of a unique anatomic reference point within images co-registered to specific irradiation events within each procedure. The first alignment method required measurement of the distance from the edge of the exam table to the top of the patient's head (table alignment method). The second alignment method fixed the anatomic reference point to be the geometric center of the heart muscle, as all 10 studies were cardiac in nature. Monte Carlo radiation transport simulations were performed for each patient and intervention using morphometry-matched hybrid computational phantoms for the reference and two tested alignment methods. For each combination, absorbed doses were computed for 28 organs and root mean square organ doses were assessed and compared across the alignment methods. RESULTS The percent error in root mean square organ dose ranged from -57% to +41% for the table alignment method, and from -27% to +22% for the heart geometric centroid alignment method. Absorbed doses to specific organs, such as the heart and lungs, demonstrated higher accuracy in the heart geometric centroid alignment method, with average percent errors of 10% and 1.4%, respectively, compared to average percent errors of -32% and 24%, respectively, using the table alignment method. CONCLUSIONS Of the two phantom alignment methods investigated in this study, the use of an anatomical reference point - in this case the geometric centroid of the heart - provided a reliable method for radiation transport simulations of organ dose in pediatric interventional cardiac studies. This alignment method provides the added benefit of requiring no physician input, making retrospective calculations possible. Moving forward, additional anatomical reference methods can be tested to assess the reliability of anatomical reference points beyond cardiac centered procedures.
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Affiliation(s)
- Emily L Marshall
- J. Crayton Pruitt Family, Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - David Borrego
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - James C Fudge
- Div. of Pediatric Cardiology, UF Health Congenital Heart Center, University of Florida, Gainesville, FL, USA
| | - Dhanashree Rajderkar
- Department of Radiology, Chief of Pediatric Radiology, University of Florida, Gainesville, FL, USA
| | - Wesley E Bolch
- J. Crayton Pruitt Family, Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
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18
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Budzik JF, Lefebvre G, Behal H, Verclytte S, Hardouin P, Teixeira P, Cotten A. Assessment of the zonal variation of perfusion parameters in the femoral head: a 3-T dynamic contrast-enhanced MRI pilot study. Skeletal Radiol 2018; 47:261-270. [PMID: 29143112 DOI: 10.1007/s00256-017-2802-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/11/2017] [Accepted: 10/16/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective was to describe MR perfusion characteristics of the femoral head, with a focus on the subchondral bone. MATERIALS AND METHODS This prospective monocentric study was approved by our local Ethics Committee. Written informed consent was obtained from all subjects. Dynamic contrast-enhanced MRI of the right hip was performed in 59 adults with suspected spondyloarthritis (32 women, 28 men). Mean age was 37.5 (±12.5) years. Regions of interest were drawn in the femoral head epiphysis, in the subchondral areas the most exposed to mechanical load (superolateral, anterosuperior, and posterior zones) and in areas less exposed to mechanical load (inferior subchondral zone and center of the femoral head). Semi-quantitative and pharmacokinetic parameters were calculated using the Tofts model. Statistical analysis was performed with a linear mixed model to compare the perfusion parameters in the different femoral head zones. RESULTS Extravascular extracellular volume and area under the curve were lower in the superolateral zone than in the inferior zone (p = 0.0135 and p < 0.0001 respectively) and the central zone (p = 0.007 and p = 0.0134 respectively). Extravascular extracellular volume and rate constant were lower in the anterosuperior zone than in the inferior zones (p = 0.011 and p = 0.029). In the anterosuperior zone, extravascular extracellular volume was lower, and time to peak was higher than in the central zones (p = 0.0056 and p = 0.0013 respectively). No significant differences were found for any values between other paired zones. CONCLUSION The perfusion of femoral head subchondral bone assessed with dynamic contrast-enhanced magnetic resonance imaging is not homogeneous: the areas exposed to more mechanical loading are less perfused.
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Affiliation(s)
- Jean-François Budzik
- Imaging Department, Lille Catholic Hospitals, Lille Catholic University, F-59000, Lille, France.
- Lille University, Littoral Côte d'Opale University, EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, F-59000, Lille, France.
| | - Guillaume Lefebvre
- Musculoskeletal Imaging Department, Centre de Consultation et d'Imagerie de l'Appareil Locomoteur, CHU Lille, University of Lille Nord de France, F-59000, Lille, France
| | - Hélène Behal
- Biostatistics Department, Lille Regional University Hospital, University of Lille Nord de France, F-59000, Lille, France
| | - Sébastien Verclytte
- Imaging Department, Lille Catholic Hospitals, Lille Catholic University, F-59000, Lille, France
| | - Pierre Hardouin
- Littoral Côte d'Opale University, Lille University, EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, F-59000, Lille, France
| | - Pedro Teixeira
- Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, F-54035, Nancy, France
| | - Anne Cotten
- Lille University, Littoral Côte d'Opale University, EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, F-59000, Lille, France
- Musculoskeletal Imaging Department, Centre de Consultation et d'Imagerie de l'Appareil Locomoteur, CHU Lille, University of Lille Nord de France, F-59000, Lille, France
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19
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Tschauner S, Marterer R, Nagy E, Apfaltrer G, Riccabona M, Singer G, Stücklschweiger G, Guss H, Sorantin E. Surface radiation dose comparison of a dedicated extremity cone beam computed tomography (CBCT) device and a multidetector computed tomography (MDCT) machine in pediatric ankle and wrist phantoms. PLoS One 2017; 12:e0178747. [PMID: 28570626 PMCID: PMC5453596 DOI: 10.1371/journal.pone.0178747] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 05/18/2017] [Indexed: 11/24/2022] Open
Abstract
Objectives To evaluate and compare surface doses of a cone beam computed tomography (CBCT) and a multidetector computed tomography (MDCT) device in pediatric ankle and wrist phantoms. Methods Thermoluminescent dosimeters (TLD) were used to measure and compare surface doses between CBCT and MDCT in a left ankle and a right wrist pediatric phantom. In both modalities adapted pediatric dose protocols were utilized to achieve realistic imaging conditions. All measurements were repeated three times to prove test-retest reliability. Additionally, objective and subjective image quality parameters were assessed. Results Average surface doses were 3.8 ±2.1 mGy for the ankle, and 2.2 ±1.3 mGy for the wrist in CBCT. The corresponding surface doses in optimized MDCT were 4.5 ±1.3 mGy for the ankle, and 3.4 ±0.7 mGy for the wrist. Overall, mean surface dose was significantly lower in CBCT (3.0 ±1.9 mGy vs. 3.9 ±1.2 mGy, p<0.001). Subjectively rated general image quality was not significantly different between the study protocols (p = 0.421), whereas objectively measured image quality parameters were in favor of CBCT (p<0.001). Conclusions Adapted extremity CBCT imaging protocols have the potential to fall below optimized pediatric ankle and wrist MDCT doses at comparable image qualities. These possible dose savings warrant further development and research in pediatric extremity CBCT applications.
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Affiliation(s)
- Sebastian Tschauner
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
- * E-mail:
| | - Robert Marterer
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Eszter Nagy
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Georg Apfaltrer
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Michael Riccabona
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Georg Singer
- Division of General Pediatric and Adolescence Surgery, Medical University of Graz, Graz, Austria
| | - Georg Stücklschweiger
- Competence Centre for Medical Physics and Radiation Protection, University Hospital Graz, Graz, Austria
| | - Helmuth Guss
- Competence Centre for Medical Physics and Radiation Protection, University Hospital Graz, Graz, Austria
| | - Erich Sorantin
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
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20
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Chan BY, Gill KG, Rebsamen SL, Nguyen JC. MR Imaging of Pediatric Bone Marrow. Radiographics 2016; 36:1911-1930. [DOI: 10.1148/rg.2016160056] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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21
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Huovinen V, Bucci M, Lipponen H, Kiviranta R, Sandboge S, Raiko J, Koskinen S, Koskensalo K, Eriksson JG, Parkkola R, Iozzo P, Nuutila P. Femoral Bone Marrow Insulin Sensitivity Is Increased by Resistance Training in Elderly Female Offspring of Overweight and Obese Mothers. PLoS One 2016; 11:e0163723. [PMID: 27669153 PMCID: PMC5036877 DOI: 10.1371/journal.pone.0163723] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 09/09/2016] [Indexed: 12/25/2022] Open
Abstract
Bone marrow insulin sensitivity may be an important factor for bone health in addition to bone mineral density especially in insulin resistant conditions. First we aimed to study if prenatal maternal obesity plays a role in determining bone marrow insulin sensitivity in elderly female offspring. Secondly we studied if a four-month individualized resistance training intervention increases bone marrow insulin sensitivity in elderly female offspring and whether this possible positive outcome is regulated by the offspring’s mother’s obesity status. 37 frail elderly females (mean age 71.9 ± 3.1 years) of which 20 were offspring of lean/normal-weight mothers (OLM, maternal BMI ≤ 26.3 kg/m2) and 17 were offspring of obese/overweight mothers (OOM, maternal BMI ≥ 28.1 kg/m2) were studied before and after a four-month individualized resistance training intervention. Nine age- and sex-matched non-frail controls (maternal BMI ≤ 26.3 kg/m2) were studied at baseline. Femoral bone marrow (FBM) and vertebral bone marrow (VBM) insulin sensitivity were measured using [18F]fluoro-2-deoxy-D-glucose positron emission tomography with computer tomography under hyperinsulinemic euglycemic clamp. We found that bone marrow insulin sensitivity was not related to maternal obesity status but FBM insulin sensitivity correlated with whole body insulin sensitivity (R = 0.487, p = 0.001). A four-month resistance training intervention increased FBM insulin sensitivity by 47% (p = 0.006) only in OOM, while VBM insulin sensitivity remained unchanged regardless of the maternal obesity status. In conclusion, FBM and VBM glucose metabolism reacts differently to a four-month resistance training intervention in elderly women according to their maternal obesity status. TRIAL REGISTRATION ClinicalTrials.gov NCT01931540.
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Affiliation(s)
- Ville Huovinen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Marco Bucci
- Turku PET Centre, University of Turku, Turku, Finland
| | - Heta Lipponen
- Turku PET Centre, University of Turku, Turku, Finland
| | - Riku Kiviranta
- Department of Endocrinology, Turku University Hospital, Turku, Finland
- Departments of Medicine and Medical Biochemistry and Genetics, University of Turku, Turku, Finland
| | - Samuel Sandboge
- Folkhälsan Research Centre, Helsinki, Finland
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
| | - Juho Raiko
- Turku PET Centre, University of Turku, Turku, Finland
| | - Suvi Koskinen
- Turku PET Centre, University of Turku, Turku, Finland
| | | | - Johan G. Eriksson
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital Finland, Helsinki, Finland
| | - Riitta Parkkola
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Patricia Iozzo
- Turku PET Centre, University of Turku, Turku, Finland
- Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
- * E-mail:
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22
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Winfeld M, Ahlawat S, Safdar N. Utilization of chemical shift MRI in the diagnosis of disorders affecting pediatric bone marrow. Skeletal Radiol 2016; 45:1205-12. [PMID: 27179650 DOI: 10.1007/s00256-016-2403-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 04/20/2016] [Accepted: 04/28/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE MRI signal intensity of pediatric bone marrow can be difficult to interpret using conventional methods. Chemical shift imaging (CSI), which can quantitatively assess relative fat content, may improve the ability to accurately diagnose bone marrow abnormalities in children. METHODS Consecutive pelvis and extremity MRI at a children's hospital over three months were retrospectively reviewed for inclusion of CSI. Medical records were reviewed for final pathological and/or clinical diagnosis. Cases were classified as normal or abnormal, and if abnormal, subclassified as marrow-replacing or non-marrow-replacing entities. Regions of interest (ROI) were then drawn on corresponding in and out-of-phase sequences over the marrow abnormality or over a metaphysis and epiphysis in normal studies. Relative signal intensity ratio for each case was then calculated to determine the degree of fat content in the ROI. RESULTS In all, 241 MRI were reviewed and 105 met inclusion criteria. Of these, 61 had normal marrow, 37 had non-marrow-replacing entities (osteomyelitis without abscess n = 17, trauma n = 9, bone infarction n = 8, inflammatory arthropathy n = 3), and 7 had marrow-replacing entities (malignant neoplasm n = 4, bone cyst n = 1, fibrous dysplasia n = 1, and Langerhans cell histiocytosis n = 1). RSIR averages were: normal metaphyseal marrow 0.442 (0.352-0.533), normal epiphyseal marrow 0.632 (0.566-698), non-marrow-replacing diagnoses 0.715 (0.630-0.799), and marrow-replacing diagnoses 1.06 (0.867-1.26). RSIR for marrow-replacing entities proved significantly different from all other groups (p < 0.05). ROC analysis demonstrated an AUC of 0.89 for RSIR in distinguishing marrow-replacing entities. CONCLUSION CSI techniques can help to differentiate pathologic processes that replace marrow in children from those that do not.
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Affiliation(s)
- Matthew Winfeld
- University of Pennsylvania Perelman School of Medicine, 3737 Market St, 6th floor, Philadelphia, PA, 19102, USA.
| | - Shivani Ahlawat
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, 601 N Caroline St, Baltimore, MD, 21287, USA
| | - Nabile Safdar
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 201 Dowman Drive, Atlanta, GA, 30322, USA
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Paediatric vertebral marrow signal: defining a normal reference range for the marrow-to-disc signal ratio. Clin Radiol 2016; 71:1069.e7-1069.e12. [PMID: 27349473 DOI: 10.1016/j.crad.2016.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/28/2016] [Accepted: 05/23/2016] [Indexed: 11/20/2022]
Abstract
AIM To establish a normal reference range of bone marrow from birth to 16 years of age. MATERIALS AND METHODS Two independent observers performed region-of-interest measurements of the magnetic resonance imaging (MRI) signal on sagittal non-contrast T1-weighted images of the spine of paediatric patients collected from a 12-year picture archiving and communication system (PACS) archive. The mean signal of the bone marrow and adjacent intervertebral disc were recorded. The mean marrow signal of the L1-L5 vertebrae was expressed as a ratio to the mean signal from the adjacent disc. RESULTS Two hundred and ninety-seven MRI studies (149 males, 148 females) met inclusion criteria. The ratio of the signal from the vertebral marrow to disc increased with age. The normal reference range was calculated for each of six age groups and defined as two standard deviations above and below the mean. The lower limit of the reference range crossed the isointense line at the age of 2 years. CONCLUSION The ratio of disc to marrow signal increases until the age of 2 years, after which it remains stable. It can be normal to see a bright disc on T1 below the age of 1 year, but after the age of 2 years a hyperintense disc on T1 is outside the 95% reference range.
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Nouh MR, Eid AF. Magnetic resonance imaging of the spinal marrow: Basic understanding of the normal marrow pattern and its variant. World J Radiol 2015; 7:448-458. [PMID: 26753060 PMCID: PMC4697119 DOI: 10.4329/wjr.v7.i12.448] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/29/2015] [Accepted: 10/27/2015] [Indexed: 02/06/2023] Open
Abstract
For now, magnetic resonance (MR) is the best noninvasive imaging modality to evaluate vertebral bone marrow thanks to its inherent soft-tissue contrast and non-ionizing nature. A daily challenging scenario for every radiologist interpreting MR of the vertebral column is discerning the diseased from normal marrow. This requires the radiologist to be acquainted with the used MR techniques to judge the spinal marrow as well as its normal MR variants. Conventional sequences used basically to image marrow include T1W, fat-suppressed T2W and short tau inversion recovery (STIR) imaging provides gross morphological data. Interestingly, using non-routine MR sequences; such as opposed phase, diffusion weighted, MR spectroscopy and contrasted-enhanced imaging; may elucidate the nature of bone marrow heterogeneities; by inferring cellular and chemical composition; and adding new functional prospects. Recalling the normal composition of bone marrow elements and the physiologic processes of spinal marrow conversion and reconversion eases basic understanding of spinal marrow imaging. Additionally, orientation with some common variants seen during spinal marrow MR imaging as hemangiomas and bone islands is a must. Moreover, awareness of the age-associated bone marrow changes as well as changes accompanying different variations of the subject’s health state is essential for radiologists to avoid overrating normal MR marrow patterns as pathologic states and metigate unnecessary further work-up.
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Picco P, Naselli A, Pala G, Rizzo F, Damasio B, Buoncompagni A, Martini A. Whole-body MRI as an unconventional diagnostic tool in a pediatric patient with systemic infection. Acta Radiol Short Rep 2014; 3:2047981614549571. [PMID: 25535572 PMCID: PMC4271715 DOI: 10.1177/2047981614549571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 08/10/2014] [Indexed: 11/15/2022] Open
Abstract
Anaplasma phagocytophilum, an obligate intracellular bacterium, is the causative agent of human granulocytic anaplasmosis (HGA), a tickborne infection usually manifesting as fever, malaise, cytopenia, spleen enlargement, and hepatitis. Herein, we report a case of a 14-year-old girl with HGA whose whole-body magnetic resonance imaging (MRI) disclosed an unusual picture characterized by small, widespread punctuate millimetric nodules, hypointense on T1-weighted and hyperintense on STIR sequences. This firstly reported finding may represent an alternative tool for identifying atypical infectious diseases.
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Affiliation(s)
- Paolo Picco
- 2nd Pediatric Division, IRCCS Giannina Gaslini Insitute and University of Genoa, Genova, Italy
| | - Aldo Naselli
- 2nd Pediatric Division, IRCCS Giannina Gaslini Insitute and University of Genoa, Genova, Italy
| | - Giovanna Pala
- 2nd Pediatric Division, IRCCS Giannina Gaslini Insitute and University of Genoa, Genova, Italy
| | - Francesca Rizzo
- Unit of Radiology, IRCCS Giannina Gaslini Insitute and University of Genoa, Genova, Italy
| | - Beatrice Damasio
- Unit of Radiology, IRCCS Giannina Gaslini Insitute and University of Genoa, Genova, Italy
| | - Antonella Buoncompagni
- 2nd Pediatric Division, IRCCS Giannina Gaslini Insitute and University of Genoa, Genova, Italy
| | - Alberto Martini
- 2nd Pediatric Division, IRCCS Giannina Gaslini Insitute and University of Genoa, Genova, Italy
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Budzik JF, Lefebvre G, Forzy G, El Rafei M, Chechin D, Cotten A. Study of proximal femoral bone perfusion with 3D T1 dynamic contrast-enhanced MRI: a feasibility study. Eur Radiol 2014; 24:3217-23. [PMID: 25120203 DOI: 10.1007/s00330-014-3340-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 05/28/2014] [Accepted: 07/10/2014] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this study was to compare measurements of semi-quantitative and pharmacokinetic parameters in areas of red (RBM) and yellow bone marrow (YBM) of the hip, using an in-house high-resolution DCE T1 sequence, and to assess intra- and inter-observer reproducibility of these measurements. METHODS The right hips of 21 adult patients under 50 years of age were studied. Spatial resolution was 1.8 × 1.8 × 1.8 mm(3), and temporal resolution was 13.5 seconds. Two musculoskeletal radiologists independently processed DCE images and measured semi-quantitative and pharmacokinetic parameters in areas of YBM and RBM. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Intra- and inter-observer reproducibility was assessed. RESULTS Area under the curve (AUC) and initial slope (IS) were significantly greater for RBM than for YBM (p < 0.05). K(trans) and kep were also significantly greater for RBM (p < 0.05). There was no significant difference in time to peak between the regions (p < 0.05). SNR, CNR, and intra- and inter-observer reproducibility were all good. CONCLUSIONS DCE study of the whole hip is feasible with high spatial resolution using a 3D T1 sequence. Measures were possible even in low vascularized areas of the femoral head. K(trans), kep, AUC, and IS values were significantly different between red and yellow marrow, whereas TTP values were not. KEY POINTS High-spatial-resolution dynamic contrast-enhanced MRI of hip structures is feasible. Intra- and inter-observer reproducibility is good. Red and yellow bone marrow have different perfusion patterns.
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Affiliation(s)
- Jean-François Budzik
- Service d'Imagerie Médicale, Groupe Hospitalier de l'Institut Catholique de Lille / Faculté Libre de Médecine, 59000, Lille, France,
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