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Ouyang M, Bao L. Gadolinium Contrast Agent Deposition in Children. J Magn Reson Imaging 2024. [PMID: 38597340 DOI: 10.1002/jmri.29389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024] Open
Abstract
Over the past few years, a large number of studies have evidenced increased signal intensity in the deep brain nuclei on unenhanced T1-MRI images achieved by the application of gadolinium-based contrast agents (GBCAs). The deposition of gadolinium in the brain, bone, and other tissues following administration of GBCAs has also been confirmed in histological studies in rodents and in necropsy studies in adults and children. Given the distinct physiological characteristics of children, this review focuses on examining the current research on gadolinium deposition in children, particularly studies utilizing novel methods and technologies. Furthermore, the article compares safety research findings of linear GBCAs and macrocyclic GBCAs in children, with the aim of offering clinicians practical guidance based on the most recent research outcomes. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Minglei Ouyang
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Bao
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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2
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Ali J, Tuzen M, Jatoi WB, Hazer B. A novel block copolymer containing gadolinium oxide nanoparticles in ultrasound assisted-dispersive solid phase microextraction of total arsenic in human foodstuffs: A multivariate optimization methodology. Food Chem 2024; 437:137908. [PMID: 37925781 DOI: 10.1016/j.foodchem.2023.137908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
A new poly(3-hydroxy butyrate)-b-poly(dimethyl amino ethyl methacrylate) amphiphilic block copolymer containing gadolinium oxide nanoparticles (PHB-PDMAEMA-Gd2O3-NPs) were synthesized and used as composite adsorbent for extraction of total arsenic. Characterization of the composite adsorbent material PHB-PDMAEMA-Gd2O3-NP was studied using spectroscopic techniques. Plackett-Burman design and central composite design were employed to screening and optimization of the experimental parameters. This composite adsorbent was utilized in ultrasound assisted-dispersive solid phase microextraction (UA-dSPµE) for the determination of total inorganic arsenic in foodstuffs through hydride generation atomic absorption spectrometry (HG-AAS). It demonstrates a linear relationship across arsenic concentration range of 0.07-1.12 µg/L with a correlation coefficient (0.996). It's showed an enrichment factor of 128 and a limit of detection 0.02 µg/L for total inorganic arsenic determination. Accuracy of the developed method was confirmed through the analysis of certified reference materials with 96.0-98.5% recovery. It proved to be significantly useful UA-dSPµE method for determining total inorganic arsenic in different foodstuffs.
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Affiliation(s)
- Jamshed Ali
- State Key Laboratory of Environmental Geochemistry, Institute of Geochemistry, Chinese Academy of Sciences, Guiyang 550081, China; Tokat Gaziosmanpaşa University, Faculty of Science and Arts, Chemistry Department, 60250 Tokat, Turkey; Institute of Chemistry, Shah Abdul Latif University, Khairpur Mir's 66020, Sindh, Pakistan
| | - Mustafa Tuzen
- Tokat Gaziosmanpaşa University, Faculty of Science and Arts, Chemistry Department, 60250 Tokat, Turkey.
| | - Wahid Bux Jatoi
- Institute of Chemistry, Shah Abdul Latif University, Khairpur Mir's 66020, Sindh, Pakistan
| | - Baki Hazer
- Department of Aircraft Airframe Engine Maintenance, Kapadokya University, 50420 Nevşehir, Turkey; Departments of Chemistry/Nano Technology Engineering, Zonguldak Bülent Ecevit University, 67100 Zonguldak, Turkey
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3
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Rovira À, Doniselli FM, Auger C, Haider L, Hodel J, Severino M, Wattjes MP, van der Molen AJ, Jasperse B, Mallio CA, Yousry T, Quattrocchi CC. Use of gadolinium-based contrast agents in multiple sclerosis: a review by the ESMRMB-GREC and ESNR Multiple Sclerosis Working Group. Eur Radiol 2024; 34:1726-1735. [PMID: 37658891 DOI: 10.1007/s00330-023-10151-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 09/05/2023]
Abstract
Magnetic resonance imaging (MRI) is the most sensitive technique for detecting inflammatory demyelinating lesions in multiple sclerosis (MS) and plays a crucial role in diagnosis and monitoring treatment effectiveness, and for predicting the disease course. In clinical practice, detection of MS lesions is mainly based on T2-weighted and contrast-enhanced T1-weighted sequences. Contrast-enhancing lesions (CEL) on T1-weighted sequences are related to (sub)acute inflammation, while new or enlarging T2 lesions reflect the permanent footprint from a previous acute inflammatory demyelinating event. These two types of MRI features provide redundant information, at least in regular monitoring of the disease. Due to the concern of gadolinium deposition after repetitive injections of gadolinium-based contrast agents (GBCAs), scientific organizations and regulatory agencies in Europe and North America have proposed that these contrast agents should be administered only if clinically necessary. In this article, we provide data on the mode of action of GBCAs in MS, the indications of the use of these agents in clinical practice, their value in MS for diagnostic, prognostic, and monitoring purposes, and their use in specific populations (children, pregnant women, and breast-feeders). We discuss imaging strategies that achieve the highest sensitivity for detecting CELs in compliance with the safety regulations established by different regulatory agencies. Finally, we will briefly discuss some alternatives to the use of GBCA for detecting blood-brain barrier disruption in MS lesions. CLINICAL RELEVANCE STATEMENT: Although use of GBCA at diagnostic workup of suspected MS is highly valuable for diagnostic and prognostic purposes, their use in routine monitoring is not mandatory and must be reduced, as detection of disease activity can be based on the identification of new or enlarging lesions on T2-weighted images. KEY POINTS: • Both the EMA and the FDA state that the use of GBCA in medicine should be restricted to clinical scenarios in which the additional information offered by the contrast agent is required. • The use of GBCA is generally recommended in the diagnostic workup in subjects with suspected MS and is generally not necessary for routine monitoring in clinical practice. • Alternative MRI-based approaches for detecting acute focal inflammatory MS lesions are not yet ready to be used in clinical practice.
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Affiliation(s)
- Àlex Rovira
- Section of Neuroradiology, Department of Radiology, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
| | - Fabio M Doniselli
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Cristina Auger
- Section of Neuroradiology, Department of Radiology, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - Lukas Haider
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jerome Hodel
- Department of Radiology, Groupe Hospitalier Paris-Saint Joseph, Paris, France
| | | | - Mike P Wattjes
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | | | - Bas Jasperse
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Carlo A Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Rome, Italy
| | - Tarek Yousry
- Lysholm Department of Neuroradiology, UCLH National Hospital for Neurology and Neurosurgery, Neuroradiological Academic Unit, UCL Institute of Neurology, London, UK
| | - Carlo C Quattrocchi
- Centre for Medical Sciences CISMed, University of Trento, Trento, Italy
- Radiology, Multizonal Unit of Rovereto and Arco, APSS Provincia Autonoma Di Trento, Trento, Italy
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Li J, Wang Y, Distefano MD, Wagner CR, Pomerantz WCK. Multivalent Fluorinated Nanorings for On-Cell 19F NMR. Biomacromolecules 2024; 25:1330-1339. [PMID: 38254252 DOI: 10.1021/acs.biomac.3c01391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
The design of imaging agents with a high fluorine content is necessary for overcoming the challenges of low sensitivity in 19F magnetic resonance imaging (MRI)-based molecular imaging. Chemically self-assembled nanorings (CSANs) provide a strategy to increase the fluorine content through multivalent display. We previously reported an 19F NMR-based imaging tracer, in which case a CSAN-compatible epidermal growth factor receptor (EGFR)-targeting protein E1-dimeric dihydrofolate (E1-DD) was bioconjugated to a highly fluorinated peptide. Despite good 19F NMR performance in aqueous solutions, a limited signal was observed in cell-based 19F NMR using this monomeric construct, motivating further design. Here, we design several new E1-DD proteins bioconjugated to peptides of different fluorine contents. Flow cytometry analysis was used to assess the effect of variable fluorinated peptide sequences on the cellular binding characteristics. Structure-optimized protein, RTC-3, displayed an optimal spectral performance with high affinity and specificity for EGFR-overexpressing cells. To further improve the fluorine content, we next engineered monomeric RTC-3 into CSAN, η-RTC-3. With an approximate eightfold increase in the fluorine content, multivalent η-RTC-3 maintained high cellular specificity and optimal 19F NMR spectral behavior. Importantly, the first cell-based 19F NMR spectra of η-RTC-3 were obtained bound to EGFR-expressing A431 cells, showing a significant amplification in the signal. This new design illustrated the potential of multivalent fluorinated CSANs for future 19F MRI molecular imaging applications.
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Affiliation(s)
- Jiaqian Li
- Department of Chemistry, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Yiao Wang
- Department of Chemistry, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Mark D Distefano
- Department of Chemistry, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Carston R Wagner
- Department of Chemistry, University of Minnesota, Minneapolis, Minnesota 55455, United States
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - William C K Pomerantz
- Department of Chemistry, University of Minnesota, Minneapolis, Minnesota 55455, United States
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Morin CE, Hasweh R, Anton C, Dillman JR, Orscheln E, Smith EA, Kotagal M, Weiss BD, Ouyang J, Zhang B, Trout AT, Towbin AJ. Gadolinium-based contrast media does not improve the staging of neuroblastoma image-defined risk factors at diagnosis. Pediatr Blood Cancer 2024; 71:e30724. [PMID: 37845799 DOI: 10.1002/pbc.30724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/23/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Neuroblastoma risk stratification relies on prognostic risk factors and image-defined risk factors (IDRFs). Evaluating neuroblastoma typically involves magnetic resonance imaging (MRI) with gadolinium-based contrast media (GBCM, "contrast"). However, there are concerns regarding adverse effects and cost of GBCM. We aimed to assess the impact of intravenous GBCM on interobserver agreement for neuroblastoma staging on baseline MRI. PROCEDURE We reviewed baseline MRI scans of 50 children with abdominopelvic neuroblastomas confirmed by histopathology. Duplicate sets of images were created, with post-contrast T1-weighted sequences removed from one set. Four pediatric radiologists independently analyzed the scans in a randomized manner. They recorded primary tumor size, presence of IDRFs, and metastatic lesions. Agreement among the reviewers was measured using kappa and Fleiss kappa statistics. RESULTS Mean age of included children was 3.3 years (range: 0.01-14.9 years), and 20 [40%] were females. Mean tumor size was 5.7 cm in greatest axial diameter. Pre-contrast versus post-contrast MRI showed excellent agreement for tumor measurement. Overlapping confidence intervals (CIs) were seen in nearly all categories of interobserver agreement on the presence or absence of individual IDRFs, with agreement ranging from poor to substantial, regardless of the presence of contrast. The overall interobserver agreement on the presence of at least one IDRF was substantial with contrast (kappa = .63; 95% CI: .52-.75) and moderate without contrast (kappa = .5; 95% CI: .39-.61); although the overlapping CIs suggest a lack of meaningful difference. Similarly, interobserver agreement on the presence or absence of individual sites of metastatic disease ranged from poor to substantial. The interobserver agreement on the overall determination of presence of metastatic disease was fair with contrast (kappa = .49; 95% CI: .38-.61) and moderate without contrast (kappa = .71; 95% CI: .59-.826). CONCLUSIONS Contrast does not improve tumor size measurement or radiologist agreement on the presence or absence of IDRFs or metastatic disease in children with newly diagnosed neuroblastoma.
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Affiliation(s)
- Cara E Morin
- Department of Radiology, Cincinnati Children's Hospital and University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Reem Hasweh
- Division of Radiology, Al-Balqa Applied University, Al-Salt, Jordan
| | - Chris Anton
- Department of Radiology, Cincinnati Children's Hospital and University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Jonathan R Dillman
- Department of Radiology, Cincinnati Children's Hospital and University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Emily Orscheln
- Department of Radiology, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Ethan A Smith
- Department of Surgery, University of Cincinnati College of Medicine, Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Meera Kotagal
- Cancer and Blood Disease Institute, Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Brian D Weiss
- Department of Mathematical Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jiarong Ouyang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Bin Zhang
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Andrew T Trout
- Department of Radiology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital and University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Hachem A, Copley LAB. What's New in Pediatric Septic Arthritis? A Review of Pertinent Clinical Questions. J Pediatr Orthop 2023; 43:578-583. [PMID: 37332197 DOI: 10.1097/bpo.0000000000002453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND The evaluation and treatment of children with septic arthritis (SA) is challenging and requires an organized approach to address the spectrum of pathogens which appear to aggregate in age-specific groups. Although evidence-based guidelines have recently been published for the evaluation and treatment of children with acute hematogenous osteomyelitis, there is a relative dearth of literature devoted exclusively to SA. METHODS Recently published guidance for the evaluation and treatment of children with SA was reviewed and evaluated with respect to pertinent clinical questions to summarize what is new in this area of practice for pediatric orthopaedic surgeons. RESULTS Evidence suggests that there is a profound difference between children with primary SA and those who have contiguous osteomyelitis. This disruption of the commonly accepted paradigm of a continuum of osteoarticular infections has important implications in the evaluation and treatment of children with primary SA. Clinical prediction algorithms have been established to help determine the applicability of magnetic resonance imaging during the evaluation of children suspected to have SA. Antibiotic duration for SA has been recently studied with some evidence in favor of short-course parenteral followed by short-course oral therapy may be successful if the pathogen is not methicillin-resistant Staphylococcus aureus . CONCLUSION Recent studies of children with SA have provided better guidance for evaluation and treatment to improve diagnostic accuracy, processes of evaluation, and clinical outcomes. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Ahmad Hachem
- Department of Pediatrics, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL
| | - Lawson A B Copley
- Department of Orthopaedic Surgery and Pediatrics, University of Texas Southwestern, Dallas, TX
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Kolmanovich DD, Chukavin NN, Savintseva IV, Mysina EA, Popova NR, Baranchikov AE, Sozarukova MM, Ivanov VK, Popov AL. Hybrid Polyelectrolyte Capsules Loaded with Gadolinium-Doped Cerium Oxide Nanoparticles as a Biocompatible MRI Agent for Theranostic Applications. Polymers (Basel) 2023; 15:3840. [PMID: 37765694 PMCID: PMC10536467 DOI: 10.3390/polym15183840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Layer-by-layer (LbL) self-assembled polyelectrolyte capsules have demonstrated their unique advantages and capability in drug delivery applications. These ordered micro/nanostructures are also promising candidates as imaging contrast agents for diagnostic and theranostic applications. Magnetic resonance imaging (MRI), one of the most powerful clinical imaging modalities, is moving forward to the molecular imaging field and requires advanced imaging probes. This paper reports on a new design of MRI-visible LbL capsules, loaded with redox-active gadolinium-doped cerium oxide nanoparticles (CeGdO2-x NPs). CeGdO2-x NPs possess an ultrasmall size, high colloidal stability, and pronounced antioxidant properties. A comprehensive analysis of LbL capsules by TEM, SEM, LCSM, and EDX techniques was carried out. The research demonstrated a high level of biocompatibility and cellular uptake efficiency of CeGdO2-x-loaded capsules by cancer (human osteosarcoma and adenocarcinoma) cells and normal (human mesenchymal stem) cells. The LbL-based delivery platform can also be used for other imaging modalities and theranostic applications.
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Affiliation(s)
- Danil D. Kolmanovich
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino 142290, Russia
| | - Nikita N. Chukavin
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino 142290, Russia
| | - Irina V. Savintseva
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino 142290, Russia
| | - Elena A. Mysina
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino 142290, Russia
| | - Nelli R. Popova
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino 142290, Russia
| | - Alexander E. Baranchikov
- Kurnakov Institute of General and Inorganic Chemistry, Russian Academy of Sciences, Moscow 119991, Russia
| | - Madina M. Sozarukova
- Kurnakov Institute of General and Inorganic Chemistry, Russian Academy of Sciences, Moscow 119991, Russia
| | - Vladimir K. Ivanov
- Kurnakov Institute of General and Inorganic Chemistry, Russian Academy of Sciences, Moscow 119991, Russia
| | - Anton L. Popov
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino 142290, Russia
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Gräfe D, Simion SH, Rosolowski M, Merkenschlager A, Frahm J, Voit D, Hirsch FW. Brain deposition of gadobutrol in children-a cross-sectional and longitudinal MRI T1 mapping study. Eur Radiol 2023; 33:4580-4588. [PMID: 36520178 PMCID: PMC10289941 DOI: 10.1007/s00330-022-09297-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/04/2022] [Accepted: 11/13/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Depositions of linear gadolinium-based MRI contrast agents are readily visible in T1-weighted MRIs of certain brain regions in both adults and children. Macrocyclic contrast agents such as gadobutrol have so far escaped detection by qualitative MRI in children. This study aimed to assess whether there is evidence for deposition of gadobutrol in children using quantitative T1 mapping. METHODS This retrospective study included patients, naive to other gadolinium-based contrast agents than gadobutrol, who had received gadobutrol as part of a clinically indicated MRI. For each patient, T1 relaxation times at 3 T were measured using single-shot T1 mapping at two time points. In each of six brain regions, age-adjusted T1 relaxation times were correlated with a number of previous gadobutrol administrations. To combine interindividual, cross-sectional effects with intraindividual, longitudinal effects, both linear mixed model and generalized additive mixed model were applied. RESULTS One hundred four examinations of 52 children (age median 11.4, IQR 6.3-15, 26 female) with a median of 7 doses of gadobutrol in the history of their neurological or neurooncological disease were included. After correction for age and indeterminate disease-related effects to T1 time, a negative correlation of T1 time with the number of gadobutrol doses administered was observed in both mixed models in the putamen (beta - 1.65, p = .03) and globus pallidus (beta - 1.98, p = .012) CONCLUSIONS: The results indicate that in children, gadobutrol is deposited in the globus pallidus and putamen. KEY POINTS • Previous gadobutrol administration correlates with reduced T1 relaxation times in the globus pallidus and putamen in children. • This decreased T1 might be caused by gadobutrol retention within these gray-matter nuclei.
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Affiliation(s)
- Daniel Gräfe
- Department of Pediatric Radiology, University Hospital, Leipzig University, Liebigstraße 20a, 04103, Leipzig, Germany.
| | | | - Maciej Rosolowski
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | | | - Jens Frahm
- Biomedizinische NMR, Max-Planck-Institut für Multidisziplinäre Naturwissenschaften, Göttingen, Germany
| | - Dirk Voit
- Biomedizinische NMR, Max-Planck-Institut für Multidisziplinäre Naturwissenschaften, Göttingen, Germany
| | - Franz Wolfgang Hirsch
- Department of Pediatric Radiology, University Hospital, Leipzig University, Liebigstraße 20a, 04103, Leipzig, Germany
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Gräfe D, Prenzel F, Hirsch FW. Chest magnetic resonance imaging in cystic fibrosis: technique and clinical benefits. Pediatr Radiol 2023; 53:640-648. [PMID: 36372855 PMCID: PMC10027634 DOI: 10.1007/s00247-022-05539-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/31/2022] [Accepted: 10/14/2022] [Indexed: 11/15/2022]
Abstract
Cystic fibrosis (CF) is one of the most common inherited and life-shortening pulmonary diseases in the Caucasian population. With the widespread introduction of newborn screening and the development of modulator therapy, tremendous advances have been made in recent years both in diagnosis and therapy. Since paediatric CF patients tend to be younger and have lower morbidity, the type of imaging modality that should be used to monitor the disease is often debated. Computed tomography (CT) is sensitive to many pulmonary pathologies, but radiation exposure limits its use, especially in children and adolescents. Conventional pulmonary magnetic resonance imaging (MRI) is a valid alternative to CT and, in most cases, provides sufficient information to guide treatment. Given the expected widespread availability of sequences with ultra-short echo times, there will be even fewer reasons to perform CT for follow-up of patients with CF. This review aims to provide an overview of the process and results of monitoring CF with MRI, particularly for centres not specialising in the disease.
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Affiliation(s)
- Daniel Gräfe
- Department of Pediatric Radiology, Leipzig University Hospital, Liebigstraße 20a, 04103, Leipzig, Germany.
| | - Freerk Prenzel
- Department of Pediatrics, Leipzig University Hospital, Liebigstraße 20a, 04103, Leipzig, Germany
| | - Franz Wolfgang Hirsch
- Department of Pediatric Radiology, Leipzig University Hospital, Liebigstraße 20a, 04103, Leipzig, Germany
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Nabavizadeh A, Barkovich MJ, Mian A, Ngo V, Kazerooni AF, Villanueva-Meyer JE. Current state of pediatric neuro-oncology imaging, challenges and future directions. Neoplasia 2023; 37:100886. [PMID: 36774835 PMCID: PMC9945752 DOI: 10.1016/j.neo.2023.100886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/20/2023] [Accepted: 02/05/2023] [Indexed: 02/12/2023]
Abstract
Imaging plays a central role in neuro-oncology including primary diagnosis, treatment planning, and surveillance of tumors. The emergence of quantitative imaging and radiomics provided an uprecedented opportunity to compile mineable databases that can be utilized in a variety of applications. In this review, we aim to summarize the current state of conventional and advanced imaging techniques, standardization efforts, fast protocols, contrast and sedation in pediatric neuro-oncologic imaging, radiomics-radiogenomics, multi-omics and molecular imaging approaches. We will also address the existing challenges and discuss future directions.
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Affiliation(s)
- Ali Nabavizadeh
- Department of Radiology, Hospital of University of Pennsylvania, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Data-Driven Discovery in Biomedicine (D3b), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
| | - Matthew J Barkovich
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Ali Mian
- Division of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University in St. Louis, Missouri, USA
| | - Van Ngo
- Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Anahita Fathi Kazerooni
- Center for Data-Driven Discovery in Biomedicine (D3b), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
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11
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Wang C, Wang Y, Xiao W, Chen X, Li R, Shen Z, Lu F. Carboxylated superparamagnetic Fe 3O 4 nanoparticles modified with 3-amino propanol and their application in magnetic resonance tumor imaging. BMC Cancer 2023; 23:54. [PMID: 36647053 PMCID: PMC9841710 DOI: 10.1186/s12885-023-10514-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/04/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles are of potential magnetic resonance imaging (MRI) contrast agents for tumor diagnosis. However, ultrasmall particle size or negative surface charge lead to relative short half-life which limit the utilization of USPIO for in vivo MRI contrast agents. METHODS Superparamagnetic Fe3O4 nanoparticles coated with polyacrylic acid (PAA)were synthetized, and modified by 3-amino propanol and 3-diethyl amino propyl amine. The characteristics of superparamagnetic Fe3O4 nanoparticles were investigated through transmission electron microscopy, X-ray diffraction analysis, Zata potential analysis, thermogravimetric analysis, and relaxation properties analysis. Magnetic resonance imaging animal experiment was performed. RESULTS The synthetized nanoparticles were irregular spherical, with small particle size, few agglomeration, and good dispersion in water. After modification, the potential fluctuation of nanoparticles was small, and the isoelectric point of nanoparticles changed to high pH. After 3-amino propanol modification, the weight loss of the curve from 820 to 940 °C was attributed to the decomposition of 3-amino propanol molecules on the surface. The T1 relaxation rate of nanoparticles changed little before and after modification, which proved that the modification didn't change the relaxation time. Brighter vascular images were observed after 3-amino propanol modification through measurement of magnetic resonance tumor imaging. CONCLUSION These data indicated the Fe3O4 nanoparticles modified by 3-amino propanol should be a better contrast agent in the field of magnetic resonance tumor imaging.
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Affiliation(s)
- Changyuan Wang
- grid.411176.40000 0004 1758 0478Department of Pediatric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, 350001 Fuzhou, Fujian China
| | - Yang Wang
- grid.411176.40000 0004 1758 0478Department of Pediatric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, 350001 Fuzhou, Fujian China
| | - Wangchuan Xiao
- grid.411176.40000 0004 1758 0478Department of Pediatric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, 350001 Fuzhou, Fujian China ,grid.440620.40000 0004 1799 2210School of resources and chemical engineering, Sanming University, No. 25, Jindong Road, 365004 Sanming, Fujian China
| | - Xiaohua Chen
- grid.411176.40000 0004 1758 0478Department of Pediatric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, 350001 Fuzhou, Fujian China
| | - Renfu Li
- grid.411176.40000 0004 1758 0478Department of Pediatric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, 350001 Fuzhou, Fujian China
| | - Zhiyong Shen
- grid.411176.40000 0004 1758 0478Department of Pediatric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, 350001 Fuzhou, Fujian China
| | - Fengchun Lu
- grid.411176.40000 0004 1758 0478Department of Pancreatic Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, 350001 Fuzhou, Fujian China
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Neale H, Plumptre I, Belazarian L, Wiss K, Hawryluk EB. Central nervous system magnetic resonance imaging abnormalities and neurologic outcomes in pediatric patients with congenital nevi: A 10-year multi-institutional retrospective study. J Am Acad Dermatol 2022; 87:1060-1068. [PMID: 35716834 DOI: 10.1016/j.jaad.2022.05.062] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/28/2022] [Accepted: 05/19/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND High-risk congenital melanocytic nevi (CMN) are associated with abnormalities of the central nervous system (CNS), prompting magnetic resonance imaging (MRI) screening guidelines. OBJECTIVE Describe MRI brain and spine abnormalities in children with CMN and report trends between nevus features, MRI findings, and neurologic outcomes. METHODS Retrospective review of individuals aged ≤18 years with an MRI of the brain and/or spine and at least 1 dermatologist-diagnosed CMN. RESULTS Three hundred fifty-two patients were identified. Forty-six children had CMN that prompted an MRI of the brain and/or spine (50% male, average age at first image, 354.8 days). In these children, 8 (17%) had melanin detected in the CNS, of whom all had >4 CMN. One developed brain melanoma (fatal). In patients without CNS melanin, 4 had concerning imaging. Concerning MRI patients had more neurodevelopmental problems, seizures, neurosurgery, and death than individuals with unremarkable imaging. Three hundred six patients received MRIs for other reasons; none detected melanin. No children with only multiple small CMN (n = 15) had concerning imaging. LIMITATIONS Lack of a control group, cohort size, and retrospective methods. CONCLUSION MRI of the brain and spine is useful for detecting intervenable abnormalities in high-risk children. Healthy infants with few small CMN may not require screening MRI.
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Affiliation(s)
- Holly Neale
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Isabella Plumptre
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Leah Belazarian
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Karen Wiss
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Department of Allergy and Immunology, Dermatology Program, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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13
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Gadolinium-doped fluorescent carbon quantum dots as MRI contrast agents and fluorescent probes. Sci Rep 2022; 12:17681. [PMID: 36271121 PMCID: PMC9587221 DOI: 10.1038/s41598-022-22518-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/17/2022] [Indexed: 01/18/2023] Open
Abstract
In this research passivated gadolinium-doped carbon quantum dots (Gd-doped CQDs) were synthesized from starch by a hydrothermal method. The X-ray diffraction (XRD) pattern of the Gd-doped CQDs showed the formation of highly amorphous carbon. The Fourier transform infrared spectroscopy (FTIR) results suggested that the CQDs are functionalized with C-N and N-H bonds. The synthesized CQDs with a size distribution of 2-8 nm have an absorption peak at 271 nm in UV-Visible spectroscopy (UV-Vis). The photoluminescence (PL) in CQDs was dependent on the excitation wavelength. The QY of the synthesized CQDs was calculated to be 13.2%. The Gd-doped CQDs exhibited sustained PL in ionic solutions with different ionic strengths and different temperatures up to 65 °C. Fluorescence imaging on mouse C34/connective tissue-L929 cells confirmed that Gd-doped CQDs could be well distributed over the cytoplasm. The magnetic resonance imaging (MRI) showed that the Gd-doped CQDs have extremely high longitudinal and transverse relaxivity values of as high as 218.28 mM-1 s-1 and 364.68 mM-1 s-1. The synthesized Gd-doped CQDs are promising candidates as multifunctional imaging probes and MRI contrast agents in biomedical diagnosis and brain mapping applications.
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14
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Cell sorting microbeads as novel contrast agent for magnetic resonance imaging. Sci Rep 2022; 12:17640. [PMID: 36271098 PMCID: PMC9586996 DOI: 10.1038/s41598-022-21762-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 09/30/2022] [Indexed: 01/18/2023] Open
Abstract
The success of several cell-based therapies and prevalent use of magnetic resonance imaging (MRI) in the clinic has fueled the development of contrast agents for specific cell tracking applications. Safe and efficient labeling of non-phagocytic cell types such as T cells nonetheless remains challenging. We developed a one-stop shop approach where the T cell sorting agent also labels the cells which can subsequently be depicted using non-invasive MRI. We compared the MR signal effects of magnetic-assisted cell sorting microbeads (CD25) to the current preclinical gold standard, ferumoxytol. We investigated in vitro labeling efficiency of regulatory T cells (Tregs) with MRI and histopathologic confirmation. Thereafter, Tregs and T cells were labeled with CD25 microbeads in vitro and delivered via intravenous injection. Liver MRIs pre- and 24 h post-injection were performed to determine in vivo tracking feasibility. We show that CD25 microbeads exhibit T2 signal decay properties similar to other iron oxide contrast agents. CD25 microbeads are readily internalized by Tregs and can be detected by non-invasive MRI with dose dependent T2 signal suppression. Systemically injected labeled Tregs can be detected in the liver 24 h post-injection, contrary to T cell control. Our CD25 microbead-based labeling method is an effective tool for Treg tagging, yielding detectable MR signal change in cell phantoms and in vivo. This novel cellular tracking method will be key in tracking the fate of Tregs in inflammatory pathologies and solid organ transplantation.
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15
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Habre C, Botti P, Laurent M, Ceroni D, Toso S, Hanquinet S. Benefits of diffusion-weighted imaging in pediatric acute osteoarticular infections. Pediatr Radiol 2022; 52:1086-1094. [PMID: 35376979 PMCID: PMC9107444 DOI: 10.1007/s00247-022-05329-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Contrast-enhanced magnetic resonance imaging (MRI) is recommended for the diagnosis of acute osteoarticular infections in children. Diffusion-weighted imaging (DWI) may be an alternative to the injection of gadolinium. OBJECTIVE To evaluate unenhanced MRI with DWI in comparison to contrast-enhanced MRI for the diagnostic work-up of acute osteoarticular infections in children. MATERIALS AND METHODS This retrospective study included 36 children (age range: 7 months-12 years) with extra-spinal osteoarticular infections and MRI performed within 24 h of admission. MRI protocol included short tau inversion recovery (STIR), water-only T2 Dixon, T1, DWI, and gadolinium-enhanced T1 sequences. Two readers reviewed three sets of images: 1) unenhanced sequences, 2) unenhanced sequences with DWI and 3) unenhanced followed by contrast-enhanced sequences (reference standard). Sensitivity and specificity of sets 1 and 2 were compared to set 3 and assessed to identify osteoarticular infections: osteomyelitis (long bones, metaphyseal equivalents), septic arthritis and abscess (soft tissues, bone). RESULTS All 14 cases of osteomyelitis in the metaphyses and diaphyses of long bones and all 27 cases of septic arthritis were identified by unenhanced sequences, but 4/16 abscesses were missed. For the diagnosis of abscess, DWI increased sensitivity to 100%. Among the 18 osteomyelitis in metaphyseal equivalents, 4 femoral head chondroepiphyses were identified by contrast-enhanced sequences only. CONCLUSION MRI for suspected pediatric acute osteoarticular infections is the best diagnostic modality to guide patient management. An unenhanced protocol with DWI may be an alternative to a contrast-based protocol, even in the presence of an abscess. However, gadolinium remains necessary to assess for chondroepiphyseal involvement of the femoral head.
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Affiliation(s)
- Céline Habre
- Pediatric Radiology Unit, Radiology Division, Diagnostic Department, Children's Hospital, University Hospitals of Geneva, CH-1211, Geneva 14, Switzerland.
| | - Paul Botti
- Pediatric Radiology Unit, Radiology Division, Diagnostic Department, Children's Hospital, University Hospitals of Geneva, CH-1211, Geneva 14, Switzerland
| | - Méryle Laurent
- Pediatric Radiology Unit, Radiology Division, Diagnostic Department, Children's Hospital, University Hospitals of Geneva, CH-1211, Geneva 14, Switzerland
| | - Dimitri Ceroni
- Pediatric Orthopedics Unit, Surgery Division, Department of Women-Children-Teenagers, Children's Hospital, University Hospitals of Geneva, Geneva, Switzerland
| | - Seema Toso
- Pediatric Radiology Unit, Radiology Division, Diagnostic Department, Children's Hospital, University Hospitals of Geneva, CH-1211, Geneva 14, Switzerland
| | - Sylviane Hanquinet
- Pediatric Radiology Unit, Radiology Division, Diagnostic Department, Children's Hospital, University Hospitals of Geneva, CH-1211, Geneva 14, Switzerland
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16
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Rao C, Liao D, Pan Y, Zhong Y, Zhang W, Ouyang Q, Nezamzadeh-Ejhieh A, Liu J. Novel formulations of metal-organic frameworks for controlled drug delivery. Expert Opin Drug Deliv 2022; 19:1183-1202. [DOI: 10.1080/17425247.2022.2064450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Congying Rao
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, China
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
- These authors have equal contributions
| | - Donghui Liao
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, China
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
- These authors have equal contributions
| | - Ying Pan
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
- These authors have equal contributions
| | - Yuyu Zhong
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
| | - Wenfeng Zhang
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
| | - Qin Ouyang
- Department of general surgery, Dalang Hospital, Dongguan, 523800, China
| | | | - Jianqiang Liu
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, China
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17
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Noda SM, Oztek MA, Stanescu AL, Maloney E, Shaw DWW, Iyer RS. Gadolinium retention: should pediatric radiologists be concerned, and how to frame conversations with families. Pediatr Radiol 2022; 52:345-353. [PMID: 33978802 DOI: 10.1007/s00247-021-04973-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/01/2020] [Accepted: 01/15/2021] [Indexed: 02/07/2023]
Abstract
Gadolinium retention in the brain and other organs has recently been identified by imaging and confirmed histologically. No direct clinical effects of gadolinium retention, which occurs after gadolinium-based contrast agent (GBCA) administration for MRI, have been scientifically accepted at this time. However, there is understandable concern among medical professionals and the public about the potential effects of gadolinium retention, particularly in the brain. Part of this concern might stem from the identification of nephrogenic systemic fibrosis caused by GBCAs in people with severe renal failure in 2006. This article briefly describes the characteristics of GBCAs; reviews and differentiates gadolinium retention, nephrogenic systemic fibrosis, and "gadolinium deposition disease" or "gadolinium toxicity"; and discusses societal guidelines and current usage in children. With the belief that GBCAs should not be withheld for appropriate indications in the absence of evidence of its potential risks, we offer a framework for determining when GBCA use is appropriate and suggestions for discussing its risks and benefits with children and their families.
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Affiliation(s)
- Sakura M Noda
- Department of Radiology, Seattle Children's Hospital, M/S MA.7.220, P.O. Box 5731, Seattle, WA, 98145-5005, USA. .,Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA.
| | - Murat Alp Oztek
- Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - A Luana Stanescu
- Department of Radiology, Seattle Children's Hospital, M/S MA.7.220, P.O. Box 5731, Seattle, WA, 98145-5005, USA.,Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Ezekiel Maloney
- Department of Radiology, Seattle Children's Hospital, M/S MA.7.220, P.O. Box 5731, Seattle, WA, 98145-5005, USA.,Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Dennis W W Shaw
- Department of Radiology, Seattle Children's Hospital, M/S MA.7.220, P.O. Box 5731, Seattle, WA, 98145-5005, USA.,Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Ramesh S Iyer
- Department of Radiology, Seattle Children's Hospital, M/S MA.7.220, P.O. Box 5731, Seattle, WA, 98145-5005, USA.,Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
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18
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MRI in Pregnancy and Precision Medicine: A Review from Literature. J Pers Med 2021; 12:jpm12010009. [PMID: 35055324 PMCID: PMC8778056 DOI: 10.3390/jpm12010009] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/11/2021] [Accepted: 12/15/2021] [Indexed: 12/29/2022] Open
Abstract
Magnetic resonance imaging (MRI) offers excellent spatial and contrast resolution for evaluating a wide variety of pathologies, without exposing patients to ionizing radiations. Additionally, MRI offers reproducible diagnostic imaging results that are not operator-dependent, a major advantage over ultrasound. MRI is commonly used in pregnant women to evaluate, most frequently, acute abdominal and pelvic pain or placental abnormalities, as well as neurological or fetal abnormalities, infections, or neoplasms. However, to date, our knowledge about MRI safety during pregnancy, especially about the administration of gadolinium-based contrast agents, which are able to cross the placental barrier, is still limited, raising concerns about possible negative effects on both the mother and the health of the fetus. Contrast agents that are unable to cross the placenta in a way that is safe for the fetus are desirable. In recent years, some preclinical studies, carried out in rodent models, have evaluated the role of long circulating liposomal nanoparticle-based blood-pool gadolinium contrast agents that do not penetrate the placental barrier due to their size and therefore do not expose the fetus to the contrast agent during pregnancy, preserving it from any hypothetical risks. Hence, we performed a literature review focusing on contrast and non-contrast MRI use during pregnancy.
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19
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Garifo S, Stanicki D, Boutry S, Larbanoix L, Ternad I, Muller RN, Laurent S. Functionalized silica nanoplatform as a bimodal contrast agent for MRI and optical imaging. NANOSCALE 2021; 13:16509-16524. [PMID: 34590110 DOI: 10.1039/d1nr04972k] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The preparation of an efficient bimodal single probe for magnetic resonance (MRI) and optical imaging (OI) is reported. Paramagnetic properties have been obtained by the non-covalent encapsulation of the clinically used Gd3+ chelate (i.e., Gd-HP-DO3A) within silica nanoparticles through a water-in-oil microemulsion process. To ensure colloidal stability, the surface of the particles was modified by means of treatment using PEG-silane, and further functionalized photochemically using a diazirine linker bearing carboxylic functions. Optical properties were obtained by the covalent grafting of a near-infrared emitting probe (NIR) on the resulting surface. The confinement of Gd complexes within the permeable matrix resulted in a significant increase in longitudinal relaxivities (>500% at 20 MHz) in comparison with the relaxivities of free chelate, while the post-functionalization process of PEG with fluorescent compounds appeared promising for the derivatization procedure. Several physico-chemical properties attested to the efficient surface modification and confirmed covalent grafting. Preliminary imaging experiments complete this study and confirm the potential of the presented system for preclinical imaging experiments.
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Affiliation(s)
- Sarah Garifo
- General, Organic and Biomedical Chemistry Unit, NMR and Molecular Imaging Laboratory, University of Mons, 19 avenue Maistriau, 7000 Mons, Belgium.
| | - Dimitri Stanicki
- General, Organic and Biomedical Chemistry Unit, NMR and Molecular Imaging Laboratory, University of Mons, 19 avenue Maistriau, 7000 Mons, Belgium.
| | - Sébastien Boutry
- Center for Microscopy and Molecular Imaging (CMMI), 8 rue Adrienne Bolland, 6041 Gosselies, Belgium
| | - Lionel Larbanoix
- Center for Microscopy and Molecular Imaging (CMMI), 8 rue Adrienne Bolland, 6041 Gosselies, Belgium
| | - Indiana Ternad
- General, Organic and Biomedical Chemistry Unit, NMR and Molecular Imaging Laboratory, University of Mons, 19 avenue Maistriau, 7000 Mons, Belgium.
| | - Robert N Muller
- General, Organic and Biomedical Chemistry Unit, NMR and Molecular Imaging Laboratory, University of Mons, 19 avenue Maistriau, 7000 Mons, Belgium.
- Center for Microscopy and Molecular Imaging (CMMI), 8 rue Adrienne Bolland, 6041 Gosselies, Belgium
| | - Sophie Laurent
- General, Organic and Biomedical Chemistry Unit, NMR and Molecular Imaging Laboratory, University of Mons, 19 avenue Maistriau, 7000 Mons, Belgium.
- Center for Microscopy and Molecular Imaging (CMMI), 8 rue Adrienne Bolland, 6041 Gosselies, Belgium
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20
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Glutig K, Pfeil A, Renz DM. [Imaging of tumor predisposition syndromes]. Radiologe 2021; 61:658-666. [PMID: 34170362 DOI: 10.1007/s00117-021-00861-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/26/2022]
Abstract
CLINICAL ISSUE Tumor predisposition syndromes (TPS) are a heterogeneous group of genetic cancers. About 10% of the approximately 2200 malignancies in the childhood in Germany develop due to an inherited disposition, whereby TPS may be underdiagnosed. The focus of this review is set on imaging of Li-Fraumeni syndrome, neurofibromatoses, tuberous sclerosis, overgrowth, and neuroendocrine syndromes. STANDARD RADIOLOGICAL METHODS In order to detect tumors at an early stage, screening at specific time intervals for each TPS are required. Ultrasonography and magnetic resonance imaging (MRI), especially whole-body MRI, are particularly important imaging modalities. METHODOLOGICAL INNOVATIONS Innovative MRI techniques can increase image quality and patient comfort. MRI acquisition time can be significantly reduced through optimized acceleration factors, motion robust radial sequences and joint acquisition and readout of multiple slices during excitation. Thus, shorter MRI examinations can be performed in younger children without anesthesia. PRACTICAL RECOMMENDATION Regular screening with ultrasound and MRI can reduce the morbidity and mortality of the patients affected with TPS.
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Affiliation(s)
- K Glutig
- Institut für Diagnostische und Interventionelle Radiologie, Sektion Kinderradiologie, Universitätsklinikum Jena, 07740, Jena, Deutschland.
| | - A Pfeil
- Klinik für Innere Medizin III, Universitätsklinikum Jena, 07740, Jena, Deutschland
| | - D M Renz
- Institut für Diagnostische und Interventionelle Radiologie, Arbeitsbereich Kinderradiologie, Medizinische Hochschule Hannover, 30625, Hannover, Deutschland
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21
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Cotton CH, Ahluwalia J, Balkin DM, Frieden IJ, Haggstrom AN, Castelo-Soccio LA, Liy-Wong C, Pope E, Steiner JE, Siegel DH, Fernandez-Faith E, Morel KD, Lauren CT, Garzon MC, Mancini AJ, Chamlin SL, Tollefson MM, Liang MG, Delano S, Glick SA, Hogeling M, Barrio VR. Association of Demographic Factors and Infantile Hemangioma Characteristics With Risk of PHACE Syndrome. JAMA Dermatol 2021; 157:2781293. [PMID: 34132754 PMCID: PMC8209569 DOI: 10.1001/jamadermatol.2021.1901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/21/2021] [Indexed: 11/14/2022]
Abstract
Importance A 2010 prospective study of 108 infants estimated the incidence of PHACE (posterior fossa malformations, hemangioma, arterial anomalies, cardiac defects, eye anomalies) syndrome to be 31% in children with facial infantile hemangiomas (IHs) of at least 22 cm2. There is little evidence regarding the associations among IH characteristics, demographic characteristics, and risk of PHACE syndrome. Objectives To evaluate demographic characteristics and comorbidities in a large cohort of patients at risk for PHACE syndrome and assess the clinical features of large head and neck IH that may be associated with a greater risk of a diagnosis of PHACE syndrome. Design, Setting, and Participants This multicenter, retrospective cohort study assessed all patients with a facial, head, and/or neck IH who were evaluated for PHACE syndrome from August 1, 2009, to December 31, 2014, at 13 pediatric dermatology referral centers across North America. Data analysis was performed from June 15, 2017, to February 29, 2020. Main Outcomes and Measures The main outcome was presence or absence of PHACE syndrome. Data included age at diagnosis, sex, patterns of IH presentation (including size, segment location, and depth), diagnostic procedures and results, and type and number of associated anomalies. Results A total of 238 patients (mean [SD] age, 2.96 [4.71] months; 184 [77.3%] female) were included in the analysis; 106 (44.5%) met the criteria for definite (n = 98) or possible (n = 8) PHACE syndrome. A stepwise linear regression model found that a surface area of 25 cm2 or greater (odds ratio [OR] 2.99; 95% CI, 1.49-6.02) and involvement of 3 or more locations (OR, 17.96; 95% CI, 6.10-52.85) to be statistically significant risk factors for PHACE syndrome. Involvement of the parotid gland (OR, 0.39; 95% CI, 0.18-0.85) and segment S2 (OR, 0.38; 95% CI, 0.16-0.91) was associated with a lower risk. Race and ethnicity may also be associated with PHACE syndrome risk, although more studies are needed. Conclusions and Relevance This cohort study further described factors associated with both a higher and lower risk of PHACE syndrome. The presence of multiple anatomical sites and large surface area were associated with greater risk, whereas S2 or parotid IHs were associated with lower, but still potential, risk. These findings can help in counseling families and decision-making regarding evaluation of infants with large head and neck IHs.
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Affiliation(s)
- Colleen H. Cotton
- Division of Dermatology, University of Arizona, Tucson
- now with Departments of Dermatology and Pediatrics, Medical University of South Carolina, Charleston
| | | | - Daniel M. Balkin
- Department of Plastic & Oral Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ilona J. Frieden
- Department of Dermatology, School of Medicine, University of California, San Francisco
| | - Anita N. Haggstrom
- Department of Dermatology, Indiana University School of Medicine, Indianapolis
| | | | - Carmen Liy-Wong
- Section of Pediatric Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elena Pope
- Section of Pediatric Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jack E. Steiner
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Dawn H. Siegel
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Esteban Fernandez-Faith
- Division of Dermatology, Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
| | - Kimberly D. Morel
- Department of Dermatology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
- Department of Pediatrics, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Christine T. Lauren
- Department of Dermatology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
- Department of Pediatrics, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Maria C. Garzon
- Department of Dermatology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
- Department of Pediatrics, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Anthony J. Mancini
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sarah L. Chamlin
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Megha M. Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
- Department of Pediatrics, Mayo Clinic, Rochester, Minnesota
| | - Marilyn G. Liang
- Department of Dermatology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sophia Delano
- Department of Dermatology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sharon A. Glick
- Departments of Dermatology and Pediatrics, Kings County Medical Center, Brooklyn, New York
| | - Marcia Hogeling
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Victoria R. Barrio
- Department of Dermatology, University of California, San Diego, Rady Children's Hospital, San Diego
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22
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Watson TA, Barber J, Woodley H. Paediatric gastrointestinal and hepatobiliary radiology: why do we need subspecialists, and what is new? Pediatr Radiol 2021; 51:554-569. [PMID: 33743039 DOI: 10.1007/s00247-020-04778-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/06/2020] [Accepted: 07/08/2020] [Indexed: 12/17/2022]
Abstract
We present the case for subspecialisation in paediatric gastrointestinal and hepato-pancreatico-biliary radiology. We frame the discussion around a number of questions: What is different about the paediatric patient and paediatric gastrointestinal system? What does the radiologist need to do differently? And finally, what can be translated from these subspecialty areas into everyday practice? We cover conditions that the sub-specialist might encounter, focusing on entities such as inflammatory bowel disease and hepatic vascular anomalies. We also highlight novel imaging techniques that are a focus of research in the subspecialties, including contrast-enhanced ultrasound, MRI motility, magnetisation transfer factor, and magnetic resonance elastography.
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Affiliation(s)
- Tom A Watson
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
| | - Joy Barber
- Department of Radiology, St. George's Hospital NHS Foundation Trust, London, UK
| | - Helen Woodley
- Department of Radiology, Leeds Teaching Hospital NHS Trust, Leeds, UK
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Kelgeri C, Renz D, McGuirk S, Schmid I, Sharif K, Baumann U. Liver Tumours in Children: The Hepatologist's View. J Pediatr Gastroenterol Nutr 2021; 72:487-493. [PMID: 33264187 DOI: 10.1097/mpg.0000000000003006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT Diagnostic and therapeutic innovations have changed the way we now approach liver tumours in children and adolescents. Novel imaging tools, increasing awareness, and surveillance has led to early diagnosis of benign and malignant liver tumours. Multidisciplinary interventions have favourably altered the natural course in some liver tumours. The role of liver transplantation is expanding and has become fully integrated into today's therapeutic algorithms. Transarterial locoregional and ablation therapies have been successful in adults and are being explored in children to facilitate resectability and improve outcome. For the first time, North American, Japanese, and European experts have designed a global trial to optimize management of malignant liver tumours and aim to find signature molecular profiles that will translate to individualised treatment strategies.This article aims to offer an overview of recent advances in our understanding of liver tumours in children. It focuses on the paediatric hepatologist's view and their role in the multidisciplinary management of benign and malignant liver tumours.
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Affiliation(s)
- Chayarani Kelgeri
- Paediatric Liver Unit including Intestinal Transplantation, Birmingham Women's and Children's NHS Foundation Trust, UK
| | - Diane Renz
- Institute of Diagnostic and Interventional Radiology, Department of Paediatric Radiology, Medizinische Hochschule Hannover, Germany
| | - Simon McGuirk
- Department of Radiology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Irene Schmid
- Paediatric Oncology, Ludwig Maximilians University, Munich, Germany
| | - Khalid Sharif
- Paediatric Liver Unit including Intestinal Transplantation, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Ulrich Baumann
- Paediatric Gastroenterology and Hepatology, Medizinische Hochschule Hannover, Germany
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Safety and diagnostic efficacy of gadoteridol for magnetic resonance imaging of the brain and spine in children 2 years of age and younger. Pediatr Radiol 2021; 51:1895-1906. [PMID: 33950270 PMCID: PMC8426253 DOI: 10.1007/s00247-021-05069-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/11/2021] [Accepted: 03/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Neonates and young children require efficacious magnetic resonance imaging (MRI) examinations but are potentially more susceptible to the short- and long-term adverse effects of gadolinium-based contrast agents due to the immaturity of their body functions. OBJECTIVE To evaluate the acute safety and diagnostic efficacy of gadoteridol (ProHance) for contrast-enhanced MRI of the central nervous system (CNS) in children ≤2 years of age. MATERIALS AND METHODS One hundred twenty-five children ≤2 years old (including 57 children <6 months old) who underwent contrast-enhanced MRI of the CNS with gadoteridol at 0.1 mmol/kg body weight were retrospectively enrolled at five imaging centers. Safety data were assessed for acute/subacute adverse events in the 48 h following gadoteridol administration and, when available, vital signs, electrocardiogram (ECG) and clinical laboratory values obtained from blood samples taken from 48 h before until 48 h following the MRI exam. The efficacy of gadoteridol-enhanced MRI compared to unenhanced MRI for disease diagnosis was evaluated prospectively by three blinded, unaffiliated readers. RESULTS Thirteen changes of laboratory values (11 mild, 1 moderate, 1 unspecified) were reported as adverse events in 7 (5.6%) patients. A relationship to gadoteridol was deemed possible though doubtful for two of these adverse events in two patients (1.6%). There were no clinical adverse events, no serious adverse events and no clinically meaningful changes in vital signs or ECG recordings. Accurate differentiation of tumor from non-neoplastic disease, and exact matching of specific MRI-determined diagnoses with on-site final diagnoses, was achieved in significantly more patients by each reader following the evaluation of combined pre- and post-contrast images compared to pre-contrast images alone (84.6-88.0% vs. 70.9-76.9%; P≤0.006 and 67.5-79.5% vs. 47.0-66.7%; P≤0.011, respectively). CONCLUSION Gadoteridol at 0.1 mmol/kg body weight is safe, well tolerated and effective for contrast-enhanced MRI of the CNS in children ≤2 years of age.
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Perucca G, de Lange C, Franchi-Abella S, Napolitano M, Riccabona M, Ključevšek D, Toso S, Herrmann J, Stafrace S, Darge K, Damasio MB, Bruno C, Woźniak MM, Lobo L, Ibe D, Smets AM, Petit P, Ording Müller LS. Surveillance of Fontan-associated liver disease: current standards and a proposal from the European Society of Paediatric Radiology Abdominal Task Force. Pediatr Radiol 2021; 51:2598-2606. [PMID: 34654967 PMCID: PMC8599216 DOI: 10.1007/s00247-021-05173-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/08/2021] [Accepted: 07/31/2021] [Indexed: 12/16/2022]
Abstract
Since Francis Fontan first introduced the eponymous technique, the Fontan procedure, this type of surgical palliation has allowed thousands of children affected by specific heart malformations to reach adulthood. Nevertheless, abdominal, thoracic, lymphatic and neurologic complications are the price that is paid by these patients. Our review focuses on Fontan-associated liver disease; the purpose is to summarize the current understanding of its physiopathology, the aim of follow-up and the specific radiologic follow-up performed in Europe. Finally, we as members of the Abdominal Task Force of the European Society of Paediatric Radiology propose a consensus-based imaging follow-up algorithm.
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Affiliation(s)
- Giulia Perucca
- Department of Pediatric Radiology, Regina Margherita Children’s Hospital, Turin, Italy
| | - Charlotte de Lange
- Department of Radiology and Clinical Physiology, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Stéphanie Franchi-Abella
- Pediatric Radiology Department, Hôpital Bicêtre, Hôpitaux Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Marcello Napolitano
- Department of Paediatric Radiology and Neuroradiology, V. Buzzi Children’s Hospital, Milan, Italy
| | - Michael Riccabona
- Department of Radiology, Division of Pediatric Radiology, Medical University Graz and University Hospital LKH, Graz, Austria
| | - Damjana Ključevšek
- Department of Radiology, University Children’s Hospital Ljubljana, Ljubljana, Slovenia
| | - Seema Toso
- Department of Pediatric Radiology, University Hospital of Geneva, Geneva, Switzerland
| | - Jochen Herrmann
- Department of Pediatric Radiology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Samuel Stafrace
- Department of Diagnostic Imaging, Sidra Medicine, Doha, Qatar ,Weill Cornell Medicine, Doha, Qatar
| | - Kassa Darge
- Department of Radiology, The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA USA
| | | | - Costanza Bruno
- Department of Radiology, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Verona, Italy
| | | | - Luisa Lobo
- Serviço de Imagiologia Geral, Hospital de Santa Maria–Centro Hospitalar Universitário Lisboa, Norte (CHULN), Lisbon, Portugal
| | - Donald Ibe
- Department of Radiology, Silhouette Diagnostic Consultants, Abuja, Nigeria
| | - Anne M. Smets
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Philippe Petit
- Aix Marseille Université, AP-HM, Equipe d’Accueil 3279 - IFR 125, Hôpital Timone Enfants, Service d’Imagerie Pédiatrique et Prénatale, Marseille, France
| | - Lil-Sofie Ording Müller
- Unit for Paediatric Radiology, Department of Radiology, Oslo University Hospital, Rikshospitalet, PB 4950 Nydalen, 0424 Oslo, Norway.
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Steele L, Shipman AR. Neuroimaging in infants and children in select neurocutaneous disorders. Clin Exp Dermatol 2020; 46:438-443. [PMID: 33180972 DOI: 10.1111/ced.14471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 11/30/2022]
Abstract
The role of neuroimaging in neurocutaneous disorders is an evolving field. Research can be inconsistent and inconclusive, leading to divergent practice for some disorders. This study provides an overview of the current role of magnetic resonance imaging (MRI) of the brain in select neurocutaneous disorders, namely Sturge-Weber syndrome, congenital melanocytic naevus syndrome, neurofibromatosis type 1, tuberous sclerosis complex, incontinentia pigmenti and basal cell naevus syndrome. Future research assessing new targeted treatments and novel MRI techniques may change current practice.
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Affiliation(s)
- L Steele
- Department of Dermatology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - A R Shipman
- Department of Dermatology, St Mary's Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
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Abstract
OBJECTIVE. Pediatric CT angiography (CTA) presents unique challenges compared with adult CTA. Because of the ionizing radiation exposure, CTA should be used judiciously in children. The pearls offered here are observations gleaned from the authors' experience in the use of pediatric CTA. We also present some potential follies to be avoided. CONCLUSION. Understanding the underlying principles and paying meticulous attention to detail can substantially optimize dose and improve the diagnostic quality of pediatric CTA.
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Bunnell KM, Hemke R, Husseini JS, Torriani M, Huang SY, Bredella MA. Does MR arthrography cause intracranial gadolinium deposition? Skeletal Radiol 2020; 49:1051-1056. [PMID: 31982970 DOI: 10.1007/s00256-020-03380-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/14/2020] [Accepted: 01/20/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine (i) whether intra-articular gadolinium from MR arthrography (MRA) results in gadolinium deposition in the brain and (ii) whether there is a correlation between intra-articular gadolinium dose and intracranial gadolinium deposition. MATERIALS AND METHODS This retrospective study was institutional review board (IRB) approved and HIPAA compliant. The study group included consecutive adult patients who had undergone MRA of the hip or shoulder and subsequent MRI of the brain. None of the patients had a history of intravenous gadolinium exposure. A control group of patients of similar age and sex who were never exposed to gadolinium and had brain MRIs available was included. Signal intensities (SI) of four brain regions: pons, dentate nuclei (DN), globus pallidi (GP), and thalamus (Thal) normalized to cerebrospinal fluid (CSF) and expressed in SI ratios were measured on T1-weighted non-contrast MR images. Groups were compared using the student's t test. Linear correlation analysis of gadolinium dose and brain SI ratios was performed, and Pearson correlation coefficients (r) are reported. RESULTS We identified 109 patients (mean age 44 ± 14 years, 54% men) who had undergone MRA and 149 controls of similar age and sex distribution. There was no significant difference in mean SI ratios of the brain regions between patients and controls: pons/CSF (p = 0.7), DN/CSF (p = 0.4), GP/CSF (p > 0.99), Thal/CSF (p = 0.3). Within the MRA group, gadolinium dose was not associated with SI ratios (p > 0.2). CONCLUSION Our study found no MR evidence of intracranial gadolinium deposition following MRA. In addition, there was no association between intra-articular gadolinium dose and SI ratios in commonly affected regions of the brain.
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Affiliation(s)
- Katherine M Bunnell
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Robert Hemke
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Jad S Husseini
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Martin Torriani
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Susie Y Huang
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Yawkey 6E, 55 Fruit Street, Boston, MA, 02114, USA.
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Mokry T, Mlynarska-Bujny A, Kuder TA, Hasse FC, Hog R, Wallwiener M, Dinkic C, Brucker J, Sinn P, Gnirs R, Kauczor HU, Schlemmer HP, Rom J, Bickelhaupt S. Ultra-High- b-Value Kurtosis Imaging for Noninvasive Tissue Characterization of Ovarian Lesions. Radiology 2020; 296:358-369. [PMID: 32544033 DOI: 10.1148/radiol.2020191700] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background MRI with contrast material enhancement is the imaging modality of choice to evaluate sonographically indeterminate adnexal masses. The role of diffusion-weighted MRI, however, remains controversial. Purpose To evaluate the diagnostic performance of ultra-high-b-value diffusion kurtosis MRI in discriminating benign and malignant ovarian lesions. Materials and Methods This prospective cohort study evaluated consecutive women with sonographically indeterminate adnexal masses between November 2016 and December 2018. MRI at 3.0 T was performed, including diffusion-weighted MRI (b values of 0-2000 sec/mm2). Lesions were segmented on b of 1500 sec/mm2 by two readers in consensus and an additional independent reader by using full-lesion segmentations on a single transversal slice. Apparent diffusion coefficient (ADC) calculation and kurtosis fitting were performed. Differences in ADC, kurtosis-derived ADC (Dapp), and apparent kurtosis coefficient (Kapp) between malignant and benign lesions were assessed by using a logistic mixed model. Area under the receiver operating characteristic curve (AUC) for ADC, Dapp, and Kapp to discriminate malignant from benign lesions was calculated, as was specificity at a sensitivity level of 100%. Results from two independent reads were compared. Histopathologic analysis served as the reference standard. Results A total of 79 ovarian lesions in 58 women (mean age ± standard deviation, 48 years ± 14) were evaluated. Sixty-two (78%) lesions showed benign and 17 (22%) lesions showed malignant histologic findings. ADC and Dapp were lower and Kapp was higher in malignant lesions: median ADC, Dapp, and Kapp were 0.74 µm2/msec (range, 0.52-1.44 µm2/msec), 0.98 µm2/msec (range, 0.63-2.12 µm2/msec), and 1.01 (range, 0.69-1.30) for malignant lesions, and 1.13 µm2/msec (range, 0.35-2.63 µm2/msec), 1.45 µm2/msec (range, 0.44-3.34 µm2/msec), and 0.65 (range, 0.44-1.43) for benign lesions (P values of .01, .02, < .001, respectively). AUC for Kapp of 0.85 (95% confidence interval: 0.77, 0.94) was higher than was AUC from ADC of 0.78 (95% confidence interval: 0.67, 0.89; P = .047). Conclusion Diffusion-weighted MRI by using quantitative kurtosis variables is superior to apparent diffusion coefficient values in discriminating benign and malignant ovarian lesions and might be of future help in clinical practice, especially in patients with contraindication to contrast media application. © RSNA, 2020 Online supplemental material is available for this article.
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Affiliation(s)
- Theresa Mokry
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Anna Mlynarska-Bujny
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Tristan Anselm Kuder
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Felix Christian Hasse
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Robert Hog
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Markus Wallwiener
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Christine Dinkic
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Janina Brucker
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Peter Sinn
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Regula Gnirs
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Hans-Ulrich Kauczor
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Heinz-Peter Schlemmer
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Joachim Rom
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
| | - Sebastian Bickelhaupt
- From the Department of Diagnostic and Interventional Radiology, Clinic of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany (T.M., F.C.H., H.U.K.); Department of Radiology (T.M., A.M.B., R.H., R.G., H.P.S., S.B.) and Department of Medical Physics in Radiology (A.M.B., T.A.K.), German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany (A.M.B.); Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany (M.W., C.D., J.B.); Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany (P.S.); Hospital for General Obstetrics and Gynecology, Frankfurt Hoechst, Germany (J.R.); Junior Group Medical Imaging and Radiology-Cancer Prevention, German Cancer Research Center, Heidelberg, Germany (R.H., S.B.); and Institute of Radiology, University Hospital Erlangen, Erlangen, Germany (S.B.)
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Tailored Optimization of Pediatric Body MR Angiography for Successful Outcomes in Thoracic Applications. AJR Am J Roentgenol 2020; 214:1031-1041. [DOI: 10.2214/ajr.19.22253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Harrell AD, Johnson D, Samet J, Omar IM, Deshmukh S. With or without? A retrospective analysis of intravenous contrast utility in magnetic resonance neurography. Skeletal Radiol 2020; 49:577-584. [PMID: 31691835 DOI: 10.1007/s00256-019-03321-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the utility of intravenous contrast in magnetic resonance neurography (MRN). MATERIALS AND METHODS A search of our PACS for MRN studies performed in 2015 yielded 74 MRN exams, 57 of which included pre- and post-contrast images. All studies were independently reviewed by 3 musculoskeletal radiologists with peripheral nerve imaging experience for presence/absence of nerve pathology, presence/absence of muscle denervation, and contrast utility score based on a 4-point Likert scale. The medical record was reviewed for demographic and clinical data. RESULTS The mean contrast utility score across all readers and all cases was 1.65, where a score of 1 indicated no additional information and a score of 2 indicated mild additional information/supports interpretation. The mean contrast utility score was slightly higher in cases with a clinical indication of amputation/stump neuroma or mass (2.3 and 2.1 respectively) and lower in cases with a clinical indication of trauma (1.5). The mean contrast utility score was lowest in patients undergoing MRN for pain, numbness, and/or weakness (1.2). CONCLUSION Intravenous contrast provides mild to no additional information for the majority of MRN exams. Given the invasive nature of contrast and recent concerns regarding previously unrecognized risks of repetitive contrast exposure, assessment of the necessity of intravenous contrast in MRN is important. Consensus evidence-based practice guidelines regarding intravenous contrast use in MRN are necessary.
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Affiliation(s)
- Alan D Harrell
- Department of Radiology, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA
| | - Daniel Johnson
- Department of Orthopedic Surgery, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA
| | - Jonathan Samet
- Department of Radiology, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA.,Department of Radiology, Ann & Robert H Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL, 60611, USA
| | - Imran M Omar
- Department of Radiology, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA
| | - Swati Deshmukh
- Department of Radiology, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA.
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32
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Perez FA, Oesch G, Amlie-Lefond CM. MRI Vessel Wall Enhancement and Other Imaging Biomarkers in Pediatric Focal Cerebral Arteriopathy-Inflammatory Subtype. Stroke 2020; 51:853-859. [DOI: 10.1161/strokeaha.119.027917] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background and Purpose—
Focal cerebral arteriopathy-inflammatory type (FCA-i) is a common cause of pediatric arterial ischemic stroke characterized angiographically by unifocal and unilateral stenosis/irregularity of the large anterior circulation arteries with a presumed inflammatory cause. Arterial vessel wall enhancement (VWE) on vessel wall magnetic resonance imaging is a potential biomarker of inflammation that may improve diagnosis, guide treatment, and predict outcomes in patients with FCA-i. We hypothesized that patients with FCA-i with more severe or extensive VWE would have worse arteriopathy, larger infarcts, worse clinical outcome, and increased risk for infarct progression/recurrence.
Methods—
Pediatric patients with arterial ischemic stroke, classified as FCA-i, and who underwent vessel wall imaging were retrospectively identified at our institution. Clinical data were reviewed and the Pediatric Stroke Outcome Measure at 1 year was determined as the primary clinical end point. Neuroimaging studies were assessed for infarct size, arteriopathy severity (Focal Cerebral Arteriopathy Severity Score), and VWE.
Results—
Nine cases of FCA-i with vessel wall imaging were evaluated, and there was a strong correlation between clinical outcome at 1-year with initial infarct volume (Spearman correlation coefficient rho=0.84;
P
<0.01) and arteriopathy severity (Focal Cerebral Arteriopathy Severity Score; rho=0.85;
P
<0.01). Patients with infarct progression/recurrence had worse Focal Cerebral Arteriopathy Severity Score at presentation compared with those without progression/recurrence (median [IQR]; 9.0 [8.0–11.8] and 5.0 [4.0–7.0], respectively;
P
<0.05). On the contrary, measures of VWE were not correlated with arteriopathy severity, infarct size, clinical outcome, or risk of infarct progression/recurrence. Moreover, not all patients with FCA-i demonstrated VWE.
Conclusions—
VWE may not be a reliable biomarker for the diagnosis or assessment of FCA-i, and future work is needed to assess the utility of vessel wall imaging in pediatric arterial ischemic stroke and FCA-i.
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Affiliation(s)
- Francisco A. Perez
- From the Department of Radiology, Seattle Children’s and University of Washington (F.A.P.)
| | - Gabriela Oesch
- University Children’s Hospital, Zurich, Switzerland (G.O.)
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33
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Lum M, Tsiouris AJ. MRI safety considerations during pregnancy. Clin Imaging 2020; 62:69-75. [PMID: 32109683 DOI: 10.1016/j.clinimag.2020.02.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/11/2020] [Accepted: 02/18/2020] [Indexed: 12/12/2022]
Abstract
The use of magnetic resonance imaging (MRI) during pregnancy is on the rise due its ability to provide detailed cross-sectional anatomy without ionizing radiation. Despite the favorable radiation profile, theoretically concerns regarding the safety of MRI and gadolinium-based contrast agent (GBCA) administration have been raised. Currently there are no studies that have shown any attributable harms of MRI during any trimester of pregnancy although prospective and longitudinal studies are lacking. GBCA administration may be associated with a slightly higher rate of neonatal death, although this is based on a single, large cohort study. Understanding the available evidence regarding MRI safety during pregnancy in the context of current society guidelines will help the radiologist serve as a valuable resource to patients and referring providers.
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Affiliation(s)
- Mark Lum
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, New York, NY 10065, United States of America.
| | - A John Tsiouris
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 E 68th St, New York, NY 10065, United States of America
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Kellenberger CJ, Amaxopoulou C, Moehrlen U, Bode PK, Jung A, Geiger J. Structural and perfusion magnetic resonance imaging of congenital lung malformations. Pediatr Radiol 2020; 50:1083-1094. [PMID: 32303778 PMCID: PMC7329781 DOI: 10.1007/s00247-020-04658-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/30/2019] [Accepted: 03/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND A radiation-free advanced imaging modality is desirable for investigating congenital thoracic malformations in young children. OBJECTIVE To describe magnetic resonance imaging (MRI) findings of congenital bronchopulmonary foregut malformations and investigate the ability of lung MRI for their classification. MATERIALS AND METHODS This is a retrospective analysis of consecutive MRI examinations performed for suspected congenital lung anomalies in 39 children (median age: 3.8 months, range: 2 days-15 years). Morphological and perfusion findings were characterised on respiratory-gated fast spin echo and dynamic contrast-enhanced sequences obtained at 1.5 tesla. Abnormalities were classified independently by two readers and compared to an expert diagnosis based on pathology, surgery and/or other imaging. RESULTS Main diagnoses included bronchopulmonary lesions in 33 patients, scimitar syndrome in 4 patients, pulmonary arteriovenous malformation and oesophageal duplication cyst in one patient each. Of 46 observed abnormalities, 44 (96%) were classified correctly with very good interobserver agreement (96% concordance rate). The 39 detected lung lesions included isolated overinflation (17/39, 44%), cystic pulmonary airway malformation (8/39, 21%), bronchopulmonary sequestration (7/39, 18%), bronchogenic cyst (4/39, 10%) and hybrid lesion (3/39, 8%). All lung lesions presented as perfusion defect at peak pulmonary enhancement. Non-cystic lesions showed a delayed peak (median delay: 2.8 s, interquartile range: 0.5 to 4.0 s) in relation to normal lung parenchyma. CONCLUSION A dedicated lung MRI protocol including respiratory compensated sequences, dynamic angiography and perfusion is able to reliably delineate parenchymal and vascular components of congenital bronchopulmonary foregut malformations. Therefore, MRI may be considered for comprehensive postnatal evaluation of congenital thoracic malformations.
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Affiliation(s)
- Christian J. Kellenberger
- Department of Diagnostic Imaging, University Children’s Hospital Zürich, Steinwiesstr. 75, CH 8032 Zürich, Switzerland ,Children’s Research Centre, University Children’s Hospital Zürich, Zürich, Switzerland
| | - Christina Amaxopoulou
- Department of Diagnostic Imaging, University Children’s Hospital Zürich, Steinwiesstr. 75, CH 8032 Zürich, Switzerland ,Children’s Research Centre, University Children’s Hospital Zürich, Zürich, Switzerland
| | - Ueli Moehrlen
- Children’s Research Centre, University Children’s Hospital Zürich, Zürich, Switzerland ,Department of Pediatric Surgery, University Children’s Hospital Zürich, Zürich, Switzerland
| | - Peter K. Bode
- Institute of Pathology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Andreas Jung
- Children’s Research Centre, University Children’s Hospital Zürich, Zürich, Switzerland ,Division of Pulmonology, University Children’s Hospital Zürich, Zürich, Switzerland
| | - Julia Geiger
- Department of Diagnostic Imaging, University Children’s Hospital Zürich, Steinwiesstr. 75, CH 8032 Zürich, Switzerland ,Children’s Research Centre, University Children’s Hospital Zürich, Zürich, Switzerland
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35
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Familial Aortopathies - State of the Art Review. Heart Lung Circ 2019; 29:607-618. [PMID: 32067919 DOI: 10.1016/j.hlc.2019.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/18/2019] [Accepted: 12/03/2019] [Indexed: 02/06/2023]
Abstract
Aortopathies are conditions that result in aortic dilatation, aneurysm formation and dissection. Familial aortopathies (perhaps better known as heritable thoracic aortic aneurysm and dissection, h-TAAD, as not all have a positive family history) are recognised to have an underlying genetic cause and affect the aorta, predisposing it to the above pathologies. These conditions can also affect the extra-aortic vasculature, particularly large elastic arteries and other body systems. Mutations in a number of genes have been associated with h-TAAD. However, not all affected families have a pathogenic gene variant identified-highlighting the importance of a three-generational family history and the likely role of both environmental factors and future gene discoveries in furthering knowledge. Survival has improved over the last few decades, essentially due to surgical intervention. The benefit of identifying affected individuals depends upon a regular surveillance program and timely referral for surgery before complications such as dissection. Further research is required to appreciate fully the effects of individual gene variants and improve evidence for prophylactic medical therapy, as well as to understand the effect of h-TAAD on quality of life and life choices, particularly around exercise and pregnancy, for affected individuals. This will be complemented by laboratory-based research that seeks to understand the tissue pathways that underlie development of arterial pathology, ideally providing targets for novel medical therapies and a means of non-invasively identifying individuals at increased vascular risk to reduce dissection, which remains a devastating life-threatening event.
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de Boer A, Harteveld AA, Pieters TT, Blankestijn PJ, Bos C, Froeling M, Joles JA, Verhaar MC, Leiner T, Hoogduin H. Decreased native renal T 1 up to one week after gadobutrol administration in healthy volunteers. J Magn Reson Imaging 2019; 52:622-631. [PMID: 31799793 PMCID: PMC7496302 DOI: 10.1002/jmri.27014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/20/2019] [Indexed: 12/18/2022] Open
Abstract
Background Gadolinium‐based contrast agents (GBCAs) are widely used in MRI, despite safety concerns regarding deposition in brain and other organs. In animal studies gadolinium was detected for weeks after administration in the kidneys, but this has not yet been demonstrated in humans. Purpose To find evidence for the prolonged presence of gadobutrol in the kidneys in healthy volunteers. Study Type Combined retrospective and prospective analysis of a repeatability study. Population Twenty‐three healthy volunteers with normal renal function (12 women, age range 40–76 years), of whom 21 were used for analysis. Field Strength/Sequence Inversion recovery‐based T1 map at 3T. Assessment T1 maps were obtained twice with a median interval of 7 (range: 4–16) days. The T1 difference (ΔT1) between both scans was compared between the gadolinium group (n = 16, 0.05 mmol/kg gadobutrol administered after T1 mapping during both scan sessions) and the control group (n = 5, no gadobutrol). T1 maps were analyzed separately for cortex and medulla. Statistical Tests Mann–Whitney U‐tests to detect differences in ΔT1 between groups and linear regression to relate time between scans and estimated glomerular filtration rate (eGFR) to ΔT1. Results ΔT1 differed significantly between the gadolinium and control group: median ΔT1 cortex –98 vs. 7 msec (P < 0.001) and medulla –68 msec vs. 19 msec (P = 0.001), respectively. The bias corresponds to renal gadobutrol concentrations of 8 nmol/g tissue (cortex) and 4 nmol/g tissue (medulla), ie, ~2.4 μmol for both kidneys (0.05% of original dose). ΔT1 correlated in the gadolinium group with duration between acquisitions for both cortex (regression coefficient (β) 16.5 msec/day, R2 0.50, P < 0.001) and medulla (β 11.5 msec/day, R2 0.32, P < 0.001). Medullary ΔT1 correlated with eGFR (β 1.13 msec/(ml/min) R2 0.25, P = 0.008). Data Conclusion We found evidence of delayed renal gadobutrol excretion after a single contrast agent administration in subjects with normal renal function. Even within this healthy population, elimination delay increased with decreasing kidney function. Level of Evidence: 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;52:622–631.
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Affiliation(s)
- Anneloes de Boer
- Department of Radiology, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Anita A Harteveld
- Department of Radiology, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Tobias T Pieters
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Peter J Blankestijn
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Clemens Bos
- Department of Radiology, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Martijn Froeling
- Department of Radiology, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Jaap A Joles
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Marianne C Verhaar
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Hans Hoogduin
- Department of Radiology, University Medical Center Utrecht, Utrecht University, The Netherlands
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Felder PS, Keller S, Gasser G. Polymetallic Complexes for Applications as Photosensitisers in Anticancer Photodynamic Therapy. ADVANCED THERAPEUTICS 2019. [DOI: 10.1002/adtp.201900139] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Patrick S. Felder
- Chimie ParisTechPSL UniversityCNRSInstitute of Chemistry for Life and Health SciencesLaboratory for Inorganic Chemical BiologyF‐75005 Paris France
| | - Sarah Keller
- Chimie ParisTechPSL UniversityCNRSInstitute of Chemistry for Life and Health SciencesLaboratory for Inorganic Chemical BiologyF‐75005 Paris France
| | - Gilles Gasser
- Chimie ParisTechPSL UniversityCNRSInstitute of Chemistry for Life and Health SciencesLaboratory for Inorganic Chemical BiologyF‐75005 Paris France
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Flood TF, Bhatt PR, Jensen A, Maloney JA, Stence NV, Mirsky DM. Age-Dependent Signal Intensity Changes in the Structurally Normal Pediatric Brain on Unenhanced T1-Weighted MR Imaging. AJNR Am J Neuroradiol 2019; 40:1824-1828. [PMID: 31601575 DOI: 10.3174/ajnr.a6254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 08/21/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Various pathologic and nonpathologic states result in brain parenchymal signal intensity changes on unenhanced T1-weighted MR imaging. However, the absence of quantitative data to characterize typical age-related signal intensity values limits evaluation. We sought to establish a range of age-dependent brain parenchymal signal intensity values on unenhanced T1WI in a sample of individuals (18 years of age or younger) with structurally normal brains. MATERIALS AND METHODS A single-center retrospective study was performed. Gadolinium-naïve pediatric patients with structurally normal MR brain imaging examination findings were analyzed (n = 114; 50% female; age range, 68 days to 18 years). ROI signal intensity measurements were obtained from the globus pallidus, thalamus, dentate nucleus, pons, and frontal lobe cortex and subcortical white matter. Multivariable linear regression was used to analyze the relationship between signal intensity values and age. RESULTS Results demonstrated a statistically significant association between signal intensity values and linear age in all neuroanatomic areas tested, except the frontal gray matter, (P < .01). There were no statistically significant differences attributable to patient sex. CONCLUSIONS Age-dependent signal intensity values were determined on unenhanced T1WI in structurally normal pediatric brains. Increased age correlated with increased signal intensity in all brain locations, except the frontal gray matter, irrespective of sex. The biologic mechanisms underlying our results remain unclear and may be related to chronologic changes in myelin density, synaptic density, and water content. Establishing age-dependent signal intensity parameters in the structurally normal pediatric brain will help clarify developmental aberrations and enhance gadolinium-deposition research by providing an improved understanding of the confounding effect of age.
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Affiliation(s)
- T F Flood
- From the Departments of Radiology (T.F.F., P.R.B.)
| | - P R Bhatt
- From the Departments of Radiology (T.F.F., P.R.B.)
| | - A Jensen
- Biostatistics & Informatics (A.J.), University of Colorado, Aurora, Colorado
| | - J A Maloney
- Department of Radiology (J.A.M., N.V.S., D.M.M.), University of Colorado Children's Hospital, Aurora, Colorado
| | - N V Stence
- Department of Radiology (J.A.M., N.V.S., D.M.M.), University of Colorado Children's Hospital, Aurora, Colorado
| | - D M Mirsky
- Department of Radiology (J.A.M., N.V.S., D.M.M.), University of Colorado Children's Hospital, Aurora, Colorado
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Blumfield E, Swenson DW, Iyer RS, Stanescu AL. Gadolinium retention and clearance after administration of macrocyclic MR contrast agents to rats: reply to Bussi et al. Pediatr Radiol 2019; 49:1112. [PMID: 31254023 DOI: 10.1007/s00247-019-04440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 05/13/2019] [Accepted: 05/27/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Einat Blumfield
- Department of Radiology, Children's Hospital of Montefiore, Albert Einstein College of Medicine, 1400 Pelham Pkwy. S., Bronx, NY, 10461, USA.
| | - David W Swenson
- Department of Diagnostic Imaging, Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA
| | - Ramesh S Iyer
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - A Luana Stanescu
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
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40
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Gadolinium retention and clearance after administration of macrocyclic magnetic resonance contrast agents to rats. Pediatr Radiol 2019; 49:1110-1111. [PMID: 31254022 PMCID: PMC6598947 DOI: 10.1007/s00247-019-04439-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 04/09/2019] [Accepted: 05/21/2019] [Indexed: 02/02/2023]
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