Magnetic Resonance Imaging of Hard Tissues and Hard Tissue Engineered Bio-substitutes

A pilot study to identify suitable MRI protocols for preoperative planning of total hip arthroplasty

PURPOSE

The purpose of this study is to identify suitable MRI sequences and evaluate the feasibility and performance of MRI for total hip arthroplasty (THA) preoperative planning.

METHOD

A multicentric pilot study was conducted to evaluate DP TSE and T1 GRE 3D sequences. High-resolution pelvis, hip, knee and ankle images were acquired. Protocols were optimised to enhance image quality (IQ) and reduce acquisition time to fit clinical practice. The final protocol was validated with 19 healthy volunteers with variable BMIs at 1.5 and 3 Tesla. Visual assessment was performed by five radiographers and radiologists using the ViewDEX software. Visual Grading Analysis (VGA), Intraclass Correlation Coefficient (ICC), Prevalence-adjusted and bias-adjusted kappa (PABAK) and Visual Grading Characteristics (VGC) were performed to analyse data.

RESULTS

VGA scores indicated that the optimised 3D DP TSE and 3D T1 GRE sequences at 3 T, as well as 3D DP TSE sequence at 1.5 T offer adequate IQ and allow a correct visualisation of the anatomy. Overall ICC analysis was moderate to good reliability at 0.749 (95 % CI 0.69-0.79) and increased from good to excellent at 0.846 (95 % CI 0.72-0.91) for DP at 3 T. PABAK shows fair agreement at 0.25 (95 % CI 0.227-0.273). VGC analysis showed that 3D DP TSE sequences performed statistically better than 3D T1 GRE at 1.5 and 3 T (p-value ≤ 0.05). Furthermore, 3 T sequences showed a statistically better performance compared to 1.5 T (p-value ≤ 0.05).

CONCLUSIONS

According to the results, 3D DP and T1 MRI sequences can be considered for preoperative planning for THA. Further research is required to emphasize the clinical validation of the results.

Automatic detection and visualization of temporomandibular joint effusion with deep neural network

This study investigated the usefulness of deep learning-based automatic detection of temporomandibular joint (TMJ) effusion using magnetic resonance imaging (MRI) in patients with temporomandibular disorder and whether the diagnostic accuracy of the model improved when patients' clinical information was provided in addition to MRI images. The sagittal MR images of 2948 TMJs were collected from 1017 women and 457 men (mean age 37.19 ± 18.64 years). The TMJ effusion diagnostic performances of three convolutional neural networks (scratch, fine-tuning, and freeze schemes) were compared with those of human experts based on areas under the curve (AUCs) and diagnosis accuracies. The fine-tuning model with proton density (PD) images showed acceptable prediction performance (AUC = 0.7895), and the from-scratch (0.6193) and freeze (0.6149) models showed lower performances (p < 0.05). The fine-tuning model had excellent specificity compared to the human experts (87.25% vs. 58.17%). However, the human experts were superior in sensitivity (80.00% vs. 57.43%) (all p < 0.001). In gradient-weighted class activation mapping (Grad-CAM) visualizations, the fine-tuning scheme focused more on effusion than on other structures of the TMJ, and the sparsity was higher than that of the from-scratch scheme (82.40% vs. 49.83%, p < 0.05). The Grad-CAM visualizations agreed with the model learned through important features in the TMJ area, particularly around the articular disc. Two fine-tuning models on PD and T2-weighted images showed that the diagnostic performance did not improve compared with using PD alone (p < 0.05). Diverse AUCs were observed across each group when the patients were divided according to age (0.7083-0.8375) and sex (male:0.7576, female:0.7083). The prediction accuracy of the ensemble model was higher than that of the human experts when all the data were used (74.21% vs. 67.71%, p < 0.05). A deep neural network (DNN) was developed to process multimodal data, including MRI and patient clinical data. Analysis of four age groups with the DNN model showed that the 41-60 age group had the best performance (AUC = 0.8258). The fine-tuning model and DNN were optimal for judging TMJ effusion and may be used to prevent true negative cases and aid in human diagnostic performance. Assistive automated diagnostic methods have the potential to increase clinicians' diagnostic accuracy.

Quality assessment of regenerated bone in intraosseous and intramuscular scaffolds by spectroscopy and nanoindentation

The efficiency of synthetic bone grafts can be evaluated either in osseous sites, to analyze osteoconduction or ectopically, in intramuscular or subcutaneous sites, to assess osteoinduction. Bone regeneration is usually evaluated in terms of the presence and quantity of newly formed bone, but little information is normally provided on the quality of this bone. Here, we propose a novel approach to evaluate bone quality by the combined use of spectroscopy techniques and nanoindentation. Calcium phosphate scaffolds with different architectures, either foamed or 3D-printed, that were implanted in osseous or intramuscular defects in Beagle dogs for 6 or 12 weeks were analyzed. ATR-FTIR and Raman spectroscopy were performed, and mineral-to-matrix ratio, crystallinity, and mineral and collagen maturity were calculated and mapped for the newly regenerated bone and the mature cortical bone from the same specimen. For all the parameters studied, the newly-formed bone showed lower values than the mature host bone. Hardness and elastic modulus were determined by nanoindentation and, in line with what was observed by spectroscopy, lower values were observed in the regenerated bone than in the cortical bone. While, as expected, all techniques pointed to an increase in the maturity of the newly-formed bone between 6 and 12 weeks, the bone found in the intramuscular samples after 12 weeks presented lower mineralization than the intraosseous counterparts. Moreover, scaffold architecture also played a role in bone maturity, with the foamed scaffolds showing higher mineralization and crystallinity than the 3D-printed scaffolds after 12 weeks.

Emerging Strategies in Mesenchymal Stem Cell-Based Cardiovascular Therapeutics

Cardiovascular diseases continue to challenge global health, demanding innovative therapeutic solutions. This review delves into the transformative role of mesenchymal stem cells (MSCs) in advancing cardiovascular therapeutics. Beginning with a historical perspective, we trace the development of stem cell research related to cardiovascular diseases, highlighting foundational therapeutic approaches and the evolution of cell-based treatments. Recognizing the inherent challenges of MSC-based cardiovascular therapeutics, which range from understanding the pro-reparative activity of MSCs to tailoring patient-specific treatments, we emphasize the need to refine the pro-regenerative capacity of these cells. Crucially, our focus then shifts to the strategies of the fourth generation of cell-based therapies: leveraging the secretomic prowess of MSCs, particularly the role of extracellular vesicles; integrating biocompatible scaffolds and artificial sheets to amplify MSCs' potential; adopting three-dimensional ex vivo propagation tailored to specific tissue niches; harnessing the promise of genetic modifications for targeted tissue repair; and institutionalizing good manufacturing practice protocols to ensure therapeutic safety and efficacy. We conclude with reflections on these advancements, envisaging a future landscape redefined by MSCs in cardiovascular regeneration. This review offers both a consolidation of our current understanding and a view toward imminent therapeutic horizons.

MRI-only based material mass density and relative stopping power estimation via deep learning for proton therapy: a preliminary study

Magnetic Resonance Imaging (MRI) is increasingly being used in treatment planning due to its superior soft tissue contrast, which is useful for tumor and soft tissue delineation compared to computed tomography (CT). However, MRI cannot directly provide mass density or relative stopping power (RSP) maps, which are required for calculating proton radiotherapy doses. Therefore, the integration of artificial intelligence (AI) into MRI-based treatment planning to estimate mass density and RSP directly from MRI has generated significant interest. A deep learning (DL) based framework was developed to establish a voxel-wise correlation between MR images and mass density as well as RSP. To facilitate the study, five tissue substitute phantoms were created, representing different tissues such as skin, muscle, adipose tissue, 45% hydroxyapatite (HA), and spongiosa bone. The composition of these phantoms was based on information from ICRP reports. Additionally, two animal tissue phantoms, simulating pig brain and liver, were prepared for DL training purposes. The phantom study involved the development of two DL models. The first model utilized clinical T1 and T2 MRI scans as input, while the second model incorporated zero echo time (ZTE) MRI scans. In the patient application study, two more DL models were trained: one using T1 and T2 MRI scans as input, and another model incorporating synthetic dual-energy computed tomography (sDECT) images to provide accurate bone tissue information. The DECT empirical model was used as a reference to evaluate the proposed models in both phantom and patient application studies. The DECT empirical model was selected as the reference for evaluating the proposed models in both phantom and patient application studies. In the phantom study, the DL model based on T1, and T2 MRI scans demonstrated higher accuracy in estimating mass density and RSP for skin, muscle, adipose tissue, brain, and liver. The mean absolute percentage errors (MAPE) were 0.42%, 0.14%, 0.19%, 0.78%, and 0.26% for mass density, and 0.30%, 0.11%, 0.16%, 0.61%, and 0.23% for RSP, respectively. The DL model incorporating ZTE MRI further improved the accuracy of mass density and RSP estimation for 45% HA and spongiosa bone, with MAPE values of 0.23% and 0.09% for mass density, and 0.19% and 0.07% for RSP, respectively. These results demonstrate the feasibility of using an MRI-only approach combined with DL methods for mass density and RSP estimation in proton therapy treatment planning. By employing this approach, it is possible to obtain the necessary information for proton radiotherapy directly from MRI scans, eliminating the need for additional imaging modalities.

Catalytic Nanoparticles in Biomedical Applications: Exploiting Advanced Nanozymes for Therapeutics and Diagnostics

Catalytic nanoparticles (CNPs) as heterogeneous catalyst reveals superior activity due to their physio-chemical features, such as high surface-to-volume ratio and unique optical, electric, and magnetic properties. The CNPs, based on their physio-chemical nature, can either increase the reactive oxygen species (ROS) level for tumor and antibacterial therapy or eliminate the ROS for cytoprotection, anti-inflammation, and anti-aging. In addition, the catalytic activity of nanozymes can specifically trigger a specific reaction accompanied by the optical feature change, presenting the feasibility of biosensor and bioimaging applications. Undoubtedly, CNPs play a pivotal role in pushing the evolution of technologies in medical and clinical fields, and advanced strategies and nanomaterials rely on the input of chemical experts to develop. Herein, a systematic and comprehensive review of the challenges and recent development of CNPs for biomedical applications is presented from the viewpoint of advanced nanomaterial with unique catalytic activity and additional functions. Furthermore, the biosafety issue of applying biodegradable and non-biodegradable nanozymes and future perspectives are critically discussed to guide a promising direction in developing span-new nanozymes and more intelligent strategies for overcoming the current clinical limitations.

Spatially resolved polymer mobilization revisited - Three-dimensional, UltraShort Echo Time (3D UTE) magnetic resonance imaging of sodium alginate matrix tablets

HYPOTHESIS

Three-dimensional 1H UltraShort Echo Time magnetic resonance imaging (1H 3D UTE MRI) of the matrix tablet made of hydrophilic polymer hydrated in heavy water (D2O) will allow investigation of the hydration-induced spatiotemporal evolution of the material originally included in the matrix tablet during manufacturing (i.e., polymer chains and bound water).

EXPERIMENTS

The oblong-shaped sodium alginate matrix tablets were used to verify the hypothesis. The matrix was measured before and during hydration in D2O for up to 2 h using the 1H 3D UTE MRI. Five echo times (first at 20 μs) were used, resulting in five three-dimensional images (one image for each echo time). In chosen cross-sections, two parametric images, i.e., amplitude and T2* relaxation time maps, were calculated using "pixel-by-pixel" mono-exponential fitting.

FINDINGS

The regions of the alginate matrix with T2* shorter than 600 μs were analyzed before (air-dry matrix) and during hydration (parametric, spatiotemporal analysis). During the study, only hydrogen nuclei (protons) pre-existing in the air-dry sample (polymer and bound water) were monitored because the hydration medium (D2O) was not visible. As a result, it was found that morphological changes in regions having T2* shorter than 300 μs were the effect of fast initial water ingress into the core of the matrix and subsequent polymer mobilization (early hydration providing additional 5% w/w hydration medium content relating to air-dry matrix). In particular, evolving layers in T2* maps were detected, and a fracture network was formed shortly after the matrix immersion in D2O. The current study presented a coherent picture of polymer mobilization accompanied by local polymer density decrease. We concluded, that the T2* mapping using 3D UTE MRI can effectively be applied as a polymer mobilization marker.

Unleashing novel horizons in advanced prostate cancer treatment: investigating the potential of prostate specific membrane antigen-targeted nanomedicine-based combination therapy

Prostate cancer (PCa) is a prevalent malignancy with increasing incidence in middle-aged and older men. Despite various treatment options, advanced metastatic PCa remains challenging with poor prognosis and limited effective therapies. Nanomedicine, with its targeted drug delivery capabilities, has emerged as a promising approach to enhance treatment efficacy and reduce adverse effects. Prostate-specific membrane antigen (PSMA) stands as one of the most distinctive and highly selective biomarkers for PCa, exhibiting robust expression in PCa cells. In this review, we explore the applications of PSMA-targeted nanomedicines in advanced PCa management. Our primary objective is to bridge the gap between cutting-edge nanomedicine research and clinical practice, making it accessible to the medical community. We discuss mainstream treatment strategies for advanced PCa, including chemotherapy, radiotherapy, and immunotherapy, in the context of PSMA-targeted nanomedicines. Additionally, we elucidate novel treatment concepts such as photodynamic and photothermal therapies, along with nano-theragnostics. We present the content in a clear and accessible manner, appealing to general physicians, including those with limited backgrounds in biochemistry and bioengineering. The review emphasizes the potential benefits of PSMA-targeted nanomedicines in enhancing treatment efficiency and improving patient outcomes. While the use of PSMA-targeted nano-drug delivery has demonstrated promising results, further investigation is required to comprehend the precise mechanisms of action, pharmacotoxicity, and long-term outcomes. By meticulous optimization of the combination of nanomedicines and PSMA ligands, a novel horizon of PSMA-targeted nanomedicine-based combination therapy could bring renewed hope for patients with advanced PCa.

DC-cycleGAN: Bidirectional CT-to-MR synthesis from unpaired data

Magnetic resonance (MR) and computer tomography (CT) images are two typical types of medical images that provide mutually-complementary information for accurate clinical diagnosis and treatment. However, obtaining both images may be limited due to some considerations such as cost, radiation dose and modality missing. Recently, medical image synthesis has aroused gaining research interest to cope with this limitation. In this paper, we propose a bidirectional learning model, denoted as dual contrast cycleGAN (DC-cycleGAN), to synthesize medical images from unpaired data. Specifically, a dual contrast loss is introduced into the discriminators to indirectly build constraints between real source and synthetic images by taking advantage of samples from the source domain as negative samples and enforce the synthetic images to fall far away from the source domain. In addition, cross-entropy and structural similarity index (SSIM) are integrated into the DC-cycleGAN in order to consider both the luminance and structure of samples when synthesizing images. The experimental results indicate that DC-cycleGAN is able to produce promising results as compared with other cycleGAN-based medical image synthesis methods such as cycleGAN, RegGAN, DualGAN, and NiceGAN. Code is available at https://github.com/JiayuanWang-JW/DC-cycleGAN.

Management Algorithm for Osseous Metastatic Disease: What the Treatment Teams Want to Know

Radiologists play a primary role in identifying, characterizing, and classifying spinal metastases and can play a lifesaving role in the care of these patients by triaging those with instability to urgent spine surgery consultation. For this reason, an understanding of current treatment algorithms and principles of spinal stability in patients with cancer is vital for all who interpret spine studies. In addition, advances in imaging allow radiologists to provide more accurate diagnoses and characterize pathology, thereby improving patient safety.

Magnetic Nanoparticle-Based High-Performance Positive and Negative Magnetic Resonance Imaging Contrast Agents

In recent decades, magnetic nanoparticles (MNPs) have attracted considerable research interest as versatile substances for various biomedical applications, particularly as contrast agents in magnetic resonance imaging (MRI). Depending on their composition and particle size, most MNPs are either paramagnetic or superparamagnetic. The unique, advanced magnetic properties of MNPs, such as appreciable paramagnetic or strong superparamagnetic moments at room temperature, along with their large surface area, easy surface functionalization, and the ability to offer stronger contrast enhancements in MRI, make them superior to molecular MRI contrast agents. As a result, MNPs are promising candidates for various diagnostic and therapeutic applications. They can function as either positive (T₁) or negative (T₂) MRI contrast agents, producing brighter or darker MR images, respectively. In addition, they can function as dual-modal T₁ and T₂ MRI contrast agents, producing either brighter or darker MR images, depending on the operational mode. It is essential that the MNPs are grafted with hydrophilic and biocompatible ligands to maintain their nontoxicity and colloidal stability in aqueous media. The colloidal stability of MNPs is critical in order to achieve a high-performance MRI function. Most of the MNP-based MRI contrast agents reported in the literature are still in the developmental stage. With continuous progress being made in the detailed scientific research on them, their use in clinical settings may be realized in the future. In this study, we present an overview of the recent developments in the various types of MNP-based MRI contrast agents and their in vivo applications.

Research progress on deep learning in magnetic resonance imaging-based diagnosis and treatment of prostate cancer: a review on the current status and perspectives

Multiparametric magnetic resonance imaging (mpMRI) has emerged as a first-line screening and diagnostic tool for prostate cancer, aiding in treatment selection and noninvasive radiotherapy guidance. However, the manual interpretation of MRI data is challenging and time-consuming, which may impact sensitivity and specificity. With recent technological advances, artificial intelligence (AI) in the form of computer-aided diagnosis (CAD) based on MRI data has been applied to prostate cancer diagnosis and treatment. Among AI techniques, deep learning involving convolutional neural networks contributes to detection, segmentation, scoring, grading, and prognostic evaluation of prostate cancer. CAD systems have automatic operation, rapid processing, and accuracy, incorporating multiple sequences of multiparametric MRI data of the prostate gland into the deep learning model. Thus, they have become a research direction of great interest, especially in smart healthcare. This review highlights the current progress of deep learning technology in MRI-based diagnosis and treatment of prostate cancer. The key elements of deep learning-based MRI image processing in CAD systems and radiotherapy of prostate cancer are briefly described, making it understandable not only for radiologists but also for general physicians without specialized imaging interpretation training. Deep learning technology enables lesion identification, detection, and segmentation, grading and scoring of prostate cancer, and prediction of postoperative recurrence and prognostic outcomes. The diagnostic accuracy of deep learning can be improved by optimizing models and algorithms, expanding medical database resources, and combining multi-omics data and comprehensive analysis of various morphological data. Deep learning has the potential to become the key diagnostic method in prostate cancer diagnosis and treatment in the future.

Non-invasive molecular imaging for precision diagnosis of metastatic lymph nodes: opportunities from preclinical to clinical applications

Lymph node metastasis is an indicator of the invasiveness and aggressiveness of cancer. It is a vital prognostic factor in clinical staging of the disease and therapeutic decision-making. Patients with positive metastatic lymph nodes are likely to develop recurrent disease, distant metastasis, and succumb to death in the coming few years. Lymph node dissection and histological analysis are needed to detect whether regional lymph nodes have been infiltrated by cancer cells and determine the likely outcome of treatment and the patient's chances of survival. However, these procedures are invasive, and tissue biopsies are prone to sampling error. In recent years, advanced molecular imaging with novel imaging probes has provided new technologies that are contributing to comprehensive management of cancer, including non-invasive investigation of lymphatic drainage from tumors, identifying metastatic lymph nodes, and guiding surgeons to operate efficiently in patients with complex lesions. In this review, first, we outline the current status of different molecular imaging modalities applied for lymph node metastasis management. Second, we summarize the multi-functional imaging probes applied with the different imaging modalities as well as applications of cancer lymph node metastasis from preclinical studies to clinical translations. Third, we describe the limitations that must be considered in the field of molecular imaging for improved detection of lymph node metastasis. Finally, we propose future directions for molecular imaging technology that will allow more personalized treatment plans for patients with lymph node metastasis.

Designing Intelligent Nanomaterials to Achieve Highly Sensitive Diagnoses and Multimodality Therapy of Bladder Cancer

Bladder cancer (BC) is among the most common malignant tumors of the genitourinary system worldwide. In recent years, the rate of BC incidence has increased, and the recurrence rate is high, resulting in poor quality of life for patients. Therefore, how to develop an effective method to achieve synchronous precise diagnoses and BC therapies is a difficult problem to solve clinically. Previous reports usually focus on the role of nanomaterials as drug delivery carriers, while a summary of the functional design and application of nanomaterials is lacking. Summarizing the application of functional nanomaterials in high-sensitivity diagnosis and multimodality therapy of BC is urgently needed. This review summarizes the application of nanotechnology in BC diagnosis, including the application of nanotechnology in the sensoring of BC biomarkers and their role in monitoring BC. In addition, conventional and combination therapies strategy in potential BC therapy are analyzed. Moreover, different kinds of nanomaterials in BC multimodal therapy according to pathological features of BC are also outlined. The goal of this review is to present an overview of the application of nanomaterials in the theranostics of BC to provide guidance for the application of functional nanomaterials to precisely diagnose and treat BC.

Image-guided drug delivery in nanosystem-based cancer therapies

The past decades have shown significant advancements in the development of solid tumor treatment. For instance, implementation of nanosystems for drug delivery has led to a reduction in side effects and improved delivery to the tumor region. However, clinical translation has faced challenges, as tumor drug levels are still considered to be inadequate. Interdisciplinary research has resulted in the development of more advanced drug delivery systems. These are coined "smart" due to the ability to be followed and actively manipulated in order to have better control over local drug release. Therefore, image-guided drug delivery can be a powerful strategy to improve drug activity at the target site. Being able to visualize the inflow of the administered smart nanosystem within the tumor gives the potential to determine the right moment to apply the facilitator to initiate drug release. Here we provide an overview of available nanosystems, imaging moieties, and imaging techniques. We discuss preclinical application of these smart drug delivery systems, the strength of image-guided drug delivery, and the future of personalized treatment.

Dual-Layer Spectral-Computed Tomography Enhances the Separability of Calcium-Based Implant Material from Bone: An Ex Vivo Quantitative Imaging Study

Local treatment of bone loss with an injection of a resorbable, calcium-based implant material to replace bone has a long history of clinical use. The in vivo discrimination of changes in bone versus implant is challenging with standard computed tomography (CT). However, spectral-CT techniques enable the separation between tissues of similar densities but different chemical compositions. Dual-layer spectral-CT imaging and postprocessing analysis methods were applied to investigate the separability of AGN1 (a triphasic calcium-based implant) and bone after AGN1 injection in n = 10 male cadaveric femurs ex vivo. Using the area under the curve (AUC) from receiver-operating characteristic (ROC) analyses, the separability of AGN1 from bone was assessed for AGN1 (postoperatively) versus compact and versus femoral neck cancellous bone (both preoperatively). CT techniques included conventional Hounsfield (HU) and density-equivalent units (BMD, mg hydroxyapatite [HA]/cm³ ) and spectral-CT measures of effective atomic number (Zeff) and electron density (ED). The samples had a wide range of femoral neck BMD (55.66 to 241.71 mg HA/cm³ ). At the injection site average BMD, HU, Zeff, and ED increased from 69.5 mg HA/cm³ , 109 HU, 104.38 EDW, and 8.30 Zeff in the preoperative to 1233 mg HA/cm³ , 1741 HU, 181.27 EDW, and 13.55 Zeff in the postoperative CT scan, respectively. For compact bone at the femoral shaft the preoperative values were 1124.15 mg HA/cm³ , 1648 HU, 177 EDW, and 13.06 Zeff and were maintained postoperatively. Zeff showed substantially sharper distributions and significantly greater separability compared to ED, BMD, and HU (all p < 0.002, for both regions) with average AUCs for BMD, HU, ED, and Zeff of 0.670, 0.640, 0.645, and 0.753 for AGN1 versus compact and 0.996, 0.995, 0.994, and 0.998 for AGN1 versus femoral neck cancellous sites, respectively. Spectral-CT permits better discrimination of calcium-based implants like AGN1 from bone ex vivo. Our results warrant application of spectral-CT in patients undergoing procedures with similar implants. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Making the invisible visible-ultrashort echo time magnetic resonance imaging: Technical developments and applications

Magnetic resonance imaging (MRI) uses a large magnetic field and radio waves to generate images of tissues in the body. Conventional MRI techniques have been developed to image and quantify tissues and fluids with long transverse relaxation times (T2s), such as muscle, cartilage, liver, white matter, gray matter, spinal cord, and cerebrospinal fluid. However, the body also contains many tissues and tissue components such as the osteochondral junction, menisci, ligaments, tendons, bone, lung parenchyma, and myelin, which have short or ultrashort T2s. After radio frequency excitation, their transverse magnetizations typically decay to zero or near zero before the receiving mode is enabled for spatial encoding with conventional MR imaging. As a result, these tissues appear dark, and their MR properties are inaccessible. However, when ultrashort echo times (UTEs) are used, signals can be detected from these tissues before they decay to zero. This review summarizes recent technical developments in UTE MRI of tissues with short and ultrashort T2 relaxation times. A series of UTE MRI techniques for high-resolution morphological and quantitative imaging of these short-T2 tissues are discussed. Applications of UTE imaging in the musculoskeletal, nervous, respiratory, gastrointestinal, and cardiovascular systems of the body are included.

Multinuclear MRI in Drug Discovery

The continuous development of magnetic resonance imaging broadens the range of applications to newer areas. Using MRI, we can not only visualize, but also track pharmaceutical substances and labeled cells in both in vivo and in vitro tests. ¹H is widely used in the MRI method, which is determined by its high content in the human body. The potential of the MRI method makes it an excellent tool for imaging the morphology of the examined objects, and also enables registration of changes at the level of metabolism. There are several reports in the scientific publications on the use of clinical MRI for in vitro tracking. The use of multinuclear MRI has great potential for scientific research and clinical studies. Tuning MRI scanners to the Larmor frequency of a given nucleus, allows imaging without tissue background. Heavy nuclei are components of both drugs and contrast agents and molecular complexes. The implementation of hyperpolarization techniques allows for better MRI sensitivity. The aim of this review is to present the use of multinuclear MRI for investigations in drug delivery.

Generation of synthetic megavoltage CT for MRI-only radiotherapy treatment planning using a 3D deep convolutional neural network

BACKGROUND

Megavoltage computed tomography (MVCT) has been implemented on many radiotherapy treatment machines for on-board anatomical visualization, localization, and adaptive dose calculation. Implementing an MR-only workflow by synthesizing MVCT from magnetic resonance imaging (MRI) would offer numerous advantages for treatment planning and online adaptation.

PURPOSE

In this work, we sought to synthesize MVCT (sMVCT) datasets from MRI using deep learning to demonstrate the feasibility of MRI-MVCT only treatment planning.

METHODS

MVCTs and T1-weighted MRIs for 120 patients treated for head-and-neck cancer were retrospectively acquired and co-registered. A deep neural network based on a fully-convolutional 3D U-Net architecture was implemented to map MRI intensity to MVCT HU. Input to the model were volumetric patches generated from paired MRI and MVCT datasets. The U-Net was initialized with random parameters and trained on a mean absolute error (MAE) objective function. Model accuracy was evaluated on 18 withheld test exams. sMVCTs were compared to respective MVCTs. Intensity-modulated volumetric radiotherapy (IMRT) plans were generated on MVCTs of four different disease sites and compared to plans calculated onto corresponding sMVCTs using the gamma metric and dose-volume-histograms (DVHs).

RESULTS

MAE values between sMVCT and MVCT datasets were 93.3 ± 27.5, 78.2 ± 27.5, and 138.0 ± 43.4 HU for whole body, soft tissue, and bone volumes, respectively. Overall, there was good agreement between sMVCT and MVCT, with bone and air posing the greatest challenges. The retrospective dataset introduced additional deviations due to sinus filling or tumor growth/shrinkage between scans, differences in external contours due to variability in patient positioning, or when immobilization devices were absent from diagnostic MRIs. Dose distributions of IMRT plans evaluated for four test cases showed close agreement between sMVCT and MVCT images when evaluated using DVHs and gamma dose metrics, which averaged to 98.9 ± 1.0% and 96.8 ± 2.6% analyzed at 3%/3 mm and 2%/2 mm, respectively.

CONCLUSIONS

MVCT datasets can be generated from T1-weighted MRI using a 3D deep convolutional neural network with dose calculation on a sample sMVCT in close agreement with the MVCT. These results demonstrate the feasibility of using MRI-derived sMVCT in an MR-only treatment planning workflow.

Theranostic Applications of an Ultra-Sensitive T1 and T2 Magnetic Resonance Contrast Agent Based on Cobalt Ferrite Spinel Nanoparticles

Nano-dimensional materials have become a focus of multiple clinical applications due to their unique physicochemical properties. Magnetic nanoparticles represent an important class of nanomaterials that are widely studied for use as magnetic resonance (MR) contrast and drug delivery agents, especially as they can be detected and manipulated remotely. Using magnetic cobalt ferrite spinel (MCFS) nanoparticles, this study was aimed at developing a multifunctional drug delivery platform with MRI capability for use in cancer treatment. We found that MCFS nanoparticles demonstrated outstanding properties for contrast MRI (r₁ = 22.1 s^-1mM^-1 and r₂ = 499 s^-1mM^-1) that enabled high-resolution T₁- and T₂-weighted MRI-based signal detection. Furthermore, MCFS nanoparticles were used for the development of a multifunctional targeted drug delivery platform for cancer treatment that is concurrently empowered with the MR contrast properties. Their therapeutic effect in systemic chemotherapy and unique MRI double-contrast properties were confirmed in vivo using a breast cancer mouse tumor model. Our study thus provides an empirical basis for the development of a novel multimodal composite drug delivery system for anticancer therapy combined with noninvasive MRI capability.

Prepolarized MRI of hard tissues and solid-state matter

Prepolarized MRI (PMRI) is a long-established technique conceived to counteract the loss in signal-to-noise ratio (SNR) inherent to low-field MRI systems. When it comes to hard biological tissues and solid-state matter, PMRI is severely restricted by their ultra-short characteristic relaxation times. Here we demonstrate that efficient hard-tissue prepolarization is within reach with a special-purpose 0.26 T scanner designed for ex vivo dental MRI and equipped with suitable high-power electronics. We have characterized the performance of a 0.5 T prepolarizer module, which can be switched on and off in 200 μs. To this end, we have used resin, dental and bone samples, all with T1 times of the order of 20 ms at our field strength. The measured SNR enhancement is in good agreement with a simple theoretical model, and deviations in extreme regimes can be attributed to mechanical vibrations due to the magnetic interaction between the prepolarization and main magnets.

Zero Echo Time Musculoskeletal MRI: Technique, Optimization, Applications, and Pitfalls

Zero echo time (ZTE) imaging is an MRI technique that produces images similar to those obtained with radiography or CT. In ZTE MRI, the very short T2 signal from the mineralized trabecular bone matrix and especially cortical bone-both of which have a low proton density (PD)-is sampled in a unique sequence setup. Additionally, the PD weighting of the ZTE sequence results in less contrast between soft tissues. Therefore, along with gray-scale inversion from black to white and vice versa, ZTE imaging provides excellent contrast between cortical bone and soft tissues similar to that of radiography and CT. However, despite isotropic or near-isotropic three-dimensional (3D) imaging capabilities of the ZTE sequence, spatial resolution in this technique is still inferior to that of radiography and CT, and 3D volume renderings are currently time-consuming and require postprocessing software that features segmentation and manual contouring. Optimization of ZTE MRI mostly entails adjustments of bandwidth, flip angle, field of view, and image matrix. A wide range of structural abnormalities and disease or healing processes in the musculoskeletal system are well delineated with ZTE MRI, including conditions that involve bone-based morphometric analyses (which aid diagnosis, help prognostication, and guide surgery), impaction, avulsion and stress fractures, loose bodies or erosions in and around joints, soft-tissue calcifications and ossifications, and bone tumors (including treatment response). The pitfalls of ZTE imaging include mimics of foci of calcification or ossification such as intra-articular gas and susceptibility artifacts from surgical materials and hemosiderin deposition, which can be avoided in many instances by cross-referencing images obtained with other MRI sequences. Online supplemental material is available for this article. ^©RSNA, 2022.

Development of in situ bioprinting: A mini review

Bioprinting has rapidly progressed over the past decade. One branch of bioprinting known as in situ bioprinting has benefitted considerably from innovations in biofabrication. Unlike ex situ bioprinting, in situ bioprinting allows for biomaterials to be printed directly into or onto the target tissue/organ, eliminating the need to transfer pre-made three-dimensional constructs. In this mini-review, recent progress on in situ bioprinting, including bioink composition, in situ crosslinking strategies, and bioprinter functionality are examined. Future directions of in situ bioprinting are also discussed including the use of minimally invasive bioprinters to print tissues within the body.

Enhancing Stem Cell-Based Therapeutic Potential by Combining Various Bioengineering Technologies

Stem cell-based therapeutics have gained tremendous attention in recent years due to their wide range of applications in various degenerative diseases, injuries, and other health-related conditions. Therapeutically effective bone marrow stem cells, cord blood- or adipose tissue-derived mesenchymal stem cells (MSCs), embryonic stem cells (ESCs), and more recently, induced pluripotent stem cells (iPSCs) have been widely reported in many preclinical and clinical studies with some promising results. However, these stem cell-only transplantation strategies are hindered by the harsh microenvironment, limited cell viability, and poor retention of transplanted cells at the sites of injury. In fact, a number of studies have reported that less than 5% of the transplanted cells are retained at the site of injury on the first day after transplantation, suggesting extremely low (<1%) viability of transplanted cells. In this context, 3D porous or fibrous national polymers (collagen, fibrin, hyaluronic acid, and chitosan)-based scaffold with appropriate mechanical features and biocompatibility can be used to overcome various limitations of stem cell-only transplantation by supporting their adhesion, survival, proliferation, and differentiation as well as providing elegant 3-dimensional (3D) tissue microenvironment. Therefore, stem cell-based tissue engineering using natural or synthetic biomimetics provides novel clinical and therapeutic opportunities for a number of degenerative diseases or tissue injury. Here, we summarized recent studies involving various types of stem cell-based tissue-engineering strategies for different degenerative diseases. We also reviewed recent studies for preclinical and clinical use of stem cell-based scaffolds and various optimization strategies.

Emerging nanobiotechnology-encoded relaxation tuning establishes new MRI modes to localize, monitor and predict diseases

Magnetic resonance imaging (MRI) is one of the most important techniques in the diagnosis of many diseases including cancers, where contrast agents (CAs) are usually necessary to improve its precision and sensitivity. Previous MRI CAs are confined to the signal-to-noise ratio (SNR) elevation of lesions for precisely localizing lesions. As nanobiotechnology advances, some new MRI CAs or nanobiotechnology-enabled MRI modes have been established to vary the longitudinal or transverse relaxation of CAs, which are harnessed to detect lesion targets, monitor disease evolution, predict or evaluate curative effect, etc. These distinct cases provide unexpected insights into the correlation of the design principles of these nanobiotechnologies and corresponding MRI CAs with their potential applications. In this review, first, we briefly present the principles, classifications and applications of conventional MRI CAs, and then elucidate the recent advances in relaxation tuning via the development of various nanobiotechnologies with emphasis on the design strategies of nanobiotechnology and the corresponding MRI CAs to target the tumor microenvironment (TME) and biological targets or activities in tumors or other diseases. In addition, we exemplified the advantages of these strategies in disease theranostics and explored their potential application fields. Finally, we analyzed the present limitations, potential solutions and future development direction of MRI after its combination with nanobiotechnology.

Bone hydration: How we can evaluate it, what can it tell us, and is it an effective therapeutic target?

Water constitutes roughly a quarter of the cortical bone by volume yet can greatly influence mechanical properties and tissue quality. There is a growing appreciation for how water can dynamically change due to age, disease, and treatment. A key emerging area related to bone mechanical and tissue properties lies in differentiating the role of water in its four different compartments, including free/pore water, water loosely bound at the collagen/mineral interfaces, water tightly bound within collagen triple helices, and structural water within the mineral. This review summarizes our current knowledge of bone water across the four functional compartments and discusses how alterations in each compartment relate to mechanical changes. It provides an overview on the advent of- and improvements to- imaging and spectroscopic techniques able to probe nano-and molecular scales of bone water. These technical advances have led to an emerging understanding of how bone water changes in various conditions, of which aging, chronic kidney disease, diabetes, osteoporosis, and osteogenesis imperfecta are reviewed. Finally, it summarizes work focused on therapeutically targeting water to improve mechanical properties.

In vitro and in vivo assessment of a 3D printable gelatin methacrylate hydrogel for bone regeneration applications

Bone tissue engineering (BTE) has made significant progress in developing and assessing different types of bio-substitutes. However, scaffolds production through standardized methods, as required for good manufacturing process (GMP), and post-transplant in vivo monitoring still limit their translation into the clinic. 3D printed 5% GelMA scaffolds have been prepared through an optimized and reproducible process in this work. Mesenchymal stem cells (MSC) were encapsulated in the 3D printable GelMA ink, and their biological properties were assessed in vitro to evaluate their potential for cell delivery application. Moreover, in vivo implantation of the pristine 3D printed GelMA has been performed in a rat condyle defect model. Whereas optimal tissue integration was observed via histology, no signs of fibrotic encapsulation or inhibited bone formation were attained. A multimodal imaging workflow based on computed tomography (CT) and magnetic resonance imaging (MRI) allowed the simultaneous monitoring of both new bone formation and scaffold degradation. These outcomes point out the direction to undertake in developing 3D printed-based hydrogels for BTE that can allow a faster transition into clinical use.

Composites Containing Nanohydroxyapatites and a Stable TEMPO Radical: Preparation and Characterization Using Spectrophotometry, EPR and 1H MAS NMR

Hydroxyapatite is the main constituent of mammalian hard tissues. Basic applications of synthetic hydroxyapatites include bone and dental implantology and drug delivery systems. The study of hydroxyapatite surface properties could give greater insight into the processes of bone mineralization and degradation. Nitroxide radicals are stable radicals that exhibit anticancer and antioxidative properties and are often used as spin probes to study the dynamics of complex biological systems. In this work, we attempted to adsorb the stable 2,2,6,6-tetramethylpiperidine-1-oxyl radical (TEMPO) on two hydroxyapatites (HAs) differing in specific surface area and the degree of hydration. The adsorption was carried out from cyclohexane, 1-chlorobutane and water. The solutions after adsorption were studied spectrophotometrically, while the obtained composites were characterized via NMR and EPR spectroscopy. The results show that it is possible to reproducibly obtain fairly stable composites, where the main factors influencing the adsorbed amount of the radical are solvent polarity and specific surface area of hydroxyapatite. The Langmuir isotherm was determined to be the most suitable adsorption model. The analysis of EPR and NMR spectra allowed us to determine the distribution of the TEMPO molecules on the hydroxyapatite surface, as well as a probable adsorption mechanism. The HA/TEMPO composites could potentially be used to study certain properties of hydroxyapatite surfaces with EPR spectroscopy. They could also be used as fillers after hard tissue surgery, as well as metal-free MRI contrasts.

Articular Cartilage Assessment Using Ultrashort Echo Time MRI: A Review

Articular cartilage is a major component of the human knee joint which may be affected by a variety of degenerative mechanisms associated with joint pathologies and/or the aging process. Ultrashort echo time (UTE) sequences with a TE less than 100 µs are capable of detecting signals from both fast- and slow-relaxing water protons in cartilage. This allows comprehensive evaluation of all the cartilage layers, especially for the short T₂ layers which include the deep and calcified zones. Several ultrashort echo time (UTE) techniques have recently been developed for both morphological imaging and quantitative cartilage assessment. This review article summarizes the current catalog techniques based on UTE Magnetic Resonance Imaging (MRI) that have been utilized for such purposes in the human knee joint, such as T₁, T2∗ , T_1ρ, magnetization transfer (MT), double echo steady state (DESS), quantitative susceptibility mapping (QSM) and inversion recovery (IR). The contrast mechanisms as well as the advantages and disadvantages of these techniques are discussed.

MR Imaging of the Pelvic Bones: The Current and Cutting-Edge Techniques

This review presents an overview of the spectrum of the current and cutting-edge MRI techniques for pelvic bone imaging in clinical practice. The current MRI sequences and their advantages, disadvantages and usefullness in the imaging of this complex anatomical region are addressed. Finally, cutting-edge techniques are discussed, including susceptibility weighted MRI, ultrashort echo time MRI, zero echo time MRI and a deep learning-based multiparametric MRI technique named 'synthetic CT,' creating CT-like images without ionizing radiaton.

MAIN POINTS

GRE, SWI, UTE, ZTE MRI and synthetic CT sequences depict the cortical outline of the bones better in comparison to conventional MR images.MRI-based synthetic CT can create HU maps and allows for automated segmentation of pelvic bones.The current and cutting-edge MR techniques for bone imaging are complementary in the characterization of a variety of musculoskeletal disorders.

Synthesis of Fluorinated Polyhydroxyalkanoates from Marine Bioresources as a Promising Biomaterial Coating

By successive enzymatic and chemical modifications, novel fluorinated polyhydroxyalkanoates were synthesized and characterized. Unsaturated polyhydroxyalkanoate, PHAU, was first produced by fermentation using marine bacteria Pseudomonas raguenesii, and a graft copolymer PHAU-g-C₈F₁₇ was further prepared by controlled thiol-ene reaction in the presence of perfluorodecanethiol (PFDT). The PFDT grafting is realized by two different processes. In the first method, PHAU was previously solubilized in toluene. The grafting in solution is more efficient than the direct heterogeneous grafting onto a PHAU film. The degrees of grafting were determined by ¹H NMR. The characterization of the microstructure by SEM-EDX and modulated and conventional DSC showed the formation of microdomains due to the organization of the hydrophobic segments of graft PFDT. Biomaterials prepared by 3D printing and coated by PHAU-g-C₈F₁₇ have the potential to be used as novel contrast agents as shown by Hahn echo experiments.

MRI-based synthetic CT of the lumbar spine: Geometric measurements for surgery planning in comparison with CT

PURPOSE

MRI is the imaging modality of choice for soft tissue-related spine disease. However, CT is superior to MRI in providing clear visualization of bony morphology. The purpose of this study is to test equivalency of MRI-based synthetic CT to conventional CT in quantitatively assessing bony morphology of the lumbar spine.

METHOD

A prospective study with an equivalency design was performed. Adult patients who had undergone MRI and CT of the lumbar spine were included. Synthetic CT images were generated from MRI using a deep learning-based image synthesis method. Two readers independently measured pedicle width, spinal canal width, neuroforamen length, anterior and posterior vertebral body height, superior and inferior vertebral body length, superior and inferior vertebral body width, maximal disc height, lumbar curvature and spinous process length on synthetic CT and CT. The agreement among CT and synthetic CT was evaluated using equivalency statistical testing.

RESULTS

Thirty participants were included (14 men and 16 women, range 20-60 years). The measurements performed on synthetic CT of pedicle width, spinal canal width, vertebral body height, vertebral body width, vertebral body length and spinous process length were statistically equivalent to CT measurements at the considered margins. Excellent inter- and intra-reader reliability was found for both synthetic CT and CT.

CONCLUSIONS

Equivalency of MRI-based synthetic CT to CT was demonstrated on geometrical measurements in the lumbar spine. In combination with the soft tissue information of the conventional MRI, this provides new possibilities in diagnosis and surgical planning without ionizing radiation.

3D MRI of the Spine

Three-dimensional (3D) magnetic resonance imaging of the spine is now clinically feasible due to technological advancements. Its advantages over two-dimensional imaging include higher in-plane spatial resolution and the ability for reformation in any plane that enables time savings in image acquisition and aids more accurate interpretation. Multispectral 3D techniques for imaging around metal are sometimes useful for evaluating anatomy adjacent to spinal fixation hardware. 3D gradient-recalled echo sequences, including ultrashort or zero time to echo sequences, can provide osseous detail similar to conventional computed tomography.

Effects of Therapy with Fibrin Glue combined with Mesenchymal Stem Cells (MSCs) on Bone Regeneration: A Systematic Review

Cell therapy strategies using mesenchymal stem cells (MSCs) carried in fibrin glue have shown promising results in regenerative medicine. MSCs are crucial for tissue healing because they have angiogenic, anti-apoptotic and immunomodulatory properties, in addition to the ability to differentiate into several specialized cell lines. Fibrin sealant or fibrin glue is a natural polymer involved in the coagulation process. Fibrin glue provides a temporary structure that favors angiogenesis, extracellular matrix deposition and cell-matrix interactions. Additionally, fibrin glue maintains the local and paracrine functions of MSCs, providing tissue regeneration through less invasive clinical procedures. Thus, the objective of this systematic review was to assess the potential of fibrin glue combined with MSCs in bone or cartilage regeneration. The bibliographic search was performed in the PubMed/MEDLINE, LILACS and Embase databases, using the descriptors (“fibrin sealant” OR “fibrin glue”) AND “stem cells” AND “bone regeneration”, considering articles published until 2021. In this case, 12 preclinical and five clinical studies were selected to compose this review, according to the eligibility criteria. In preclinical studies, fibrin glue loaded with MSCs, alone or associated with bone substitute, significantly favored bone defects regeneration compared to scaffold without cells. Similarly, fibrin glue loaded with MSCs presented considerable potential to regenerate joint cartilage injuries and multiple bone fractures, with significant improvement in clinical parameters and absence of postoperative complications. Therefore, there is clear evidence in the literature that fibrin glue loaded with MSCs, alone or combined with bone substitute, is a promising strategy for treating lesions in bone or cartilaginous tissue.

Geometric accuracy of magnetic resonance imaging-derived virtual 3-dimensional bone surface models of the mandible in comparison to computed tomography and cone beam computed tomography: A porcine cadaver study

BACKGROUND

Providing accurate 3-dimensional virtual bone surface models is a prerequisite for virtual surgical planning and additive manufacturing in craniomaxillofacial surgery. For this purpose, magnetic resonance imaging (MRI) may be a radiation-free alternative to computed tomography (CT) and cone beam computed tomography (CBCT).

PURPOSE

The aim of this study was to assess the geometric accuracy of 3-dimensional T1-weighted MRI-derived virtual bone surface models of the mandible in comparison to CT and CBCT.

MATERIALS AND METHODS

Specimens of the mandible from porcine cadavers were scanned with (1) a 3-dimensional T1-weighted MRI sequence (0.6 mm isotropic voxel) optimized for bone imaging, (2) CT, and (3) CBCT. Cortical mandibular structures (n = 10) were segmented using semiautomated and manual techniques. Imaging-based virtual 3-dimensional models were aligned with a high-resolution optical 3-dimensional surface scan of the dissected bone (=ground truth) and global geometric deviations were calculated (mean surface distance [MSD]/root-mean-square distance [RMSD]). Agreement between the imaging modalities was assessed by equivalence testing and Bland-Altman analysis.

RESULTS

Intra- and inter-rater agreement was on a high level for all modalities. Global geometric deviations (MSD/RMSD) between optical scans and imaging modalities were 0.225 ± 0.020 mm/0.345 ± 0.074 mm for CT, 0.280 ± 0.067 mm/0.371 ± 0.074 mm for MRI, and 0.352 ± 0.076 mm/0.454 ± 0.071 mm for CBCT. All imaging modalities were statistically equivalent within an equivalence margin of ±0.3 mm, and Bland-Altman analysis indicated high agreement as well.

CONCLUSIONS

The results of this study indicate that the accuracy and reliability of MRI-derived virtual 3-dimensional bone surface models is equal to CT and CBCT. MRI may be considered as a reliable alternative to CT and CBCT in computer-assisted craniomaxillofacial surgery.

Iron Oxide Nanoparticles as T1 Contrast Agents for Magnetic Resonance Imaging: Fundamentals, Challenges, Applications, and Prospectives

Gadolinium-based chelates are a mainstay of contrast agents for magnetic resonance imaging (MRI) in the clinic. However, their toxicity elicits severe side effects and the Food and Drug Administration has issued many warnings about their potential retention in patients' bodies, which causes safety concerns. Iron oxide nanoparticles (IONPs) are a potentially attractive alternative, because of their nontoxic and biodegradable nature. Studies in developing IONPs as T1 contrast agents have generated promising results, but the complex, interrelated parameters influencing contrast enhancement make the development difficult, and IONPs suitable for T1 contrast enhancement have yet to make their way to clinical use. Here, the fundamental principles of MRI contrast agents are discussed, and the current status of MRI contrast agents is reviewed with a focus on the advantages and limitations of current T1 contrast agents and the potential of IONPs to serve as safe and improved alternative to gadolinium-based chelates. The past advances and current challenges in developing IONPs as a T1 contrast agent from a materials science perspective are presented, and how each of the key material properties and environment variables affects the performance of IONPs is assessed. Finally, some potential approaches to develop high-performance and clinically relevant T1 contrast agents are discussed.

Strategies for the design of nanoparticles: starting with long-circulating nanoparticles, from lab to clinic

Short half-life is one of the main causes of drug attrition in clinical development, which also leads to the failure of many leading compounds and hits to become drug candidates. Nowadays, nanomaterials have been applied to drug development to address this problem. In fact, the clinical application of nanoparticles (NPs) is severely limited due to their rapid elimination by the reticuloendothelial system (RES) in vivo. In this paper, we aim to summarize representative strategies on prolonging the circulation time for bridging the gap between excellent pharmaceutics and proper half-life and encourage clinical translation.

Survey of MRI Usefulness for the Clinical Assessment of Bone Microstructure

Bone microarchitecture has been shown to provide useful information regarding the evaluation of skeleton quality with an added value to areal bone mineral density, which can be used for the diagnosis of several bone diseases. Bone mineral density estimated from dual-energy X-ray absorptiometry (DXA) has shown to be a limited tool to identify patients' risk stratification and therapy delivery. Magnetic resonance imaging (MRI) has been proposed as another technique to assess bone quality and fracture risk by evaluating the bone structure and microarchitecture. To date, MRI is the only completely non-invasive and non-ionizing imaging modality that can assess both cortical and trabecular bone in vivo. In this review article, we reported a survey regarding the clinically relevant information MRI could provide for the assessment of the inner trabecular morphology of different bone segments. The last section will be devoted to the upcoming MRI applications (MR spectroscopy and chemical shift encoding MRI, solid state MRI and quantitative susceptibility mapping), which could provide additional biomarkers for the assessment of bone microarchitecture.

MRI-traceable theranostic nanoparticles for targeted cancer treatment

Current cancer therapies, including chemotherapy and radiotherapy, are imprecise, non-specific, and are often administered at high dosages - resulting in side effects that severely impact the patient's overall well-being. A variety of multifunctional, cancer-targeted nanotheranostic systems that integrate therapy, imaging, and tumor targeting functionalities in a single platform have been developed to overcome the shortcomings of traditional drugs. Among the imaging modalities used, magnetic resonance imaging (MRI) provides high resolution imaging of structures deep within the body and, in combination with other imaging modalities, provides complementary diagnostic information for more accurate identification of tumor characteristics and precise guidance of anti-cancer therapy. This review article presents a comprehensive assessment of nanotheranostic systems that combine MRI-based imaging (T1 MRI, T2 MRI, and multimodal imaging) with therapy (chemo-, thermal-, gene- and combination therapy), connecting a range of topics including hybrid treatment options (e.g. combined chemo-gene therapy), unique MRI-based imaging (e.g. combined T1-T2 imaging, triple and quadruple multimodal imaging), novel targeting strategies (e.g. dual magnetic-active targeting and nanoparticles carrying multiple ligands), and tumor microenvironment-responsive drug release (e.g. redox and pH-responsive nanomaterials). With a special focus on systems that have been tested in vivo, this review is an essential summary of the most advanced developments in this rapidly evolving field.

Simultaneous imaging of hard and soft biological tissues in a low-field dental MRI scanner

Magnetic Resonance Imaging (MRI) of hard biological tissues is challenging due to the fleeting lifetime and low strength of their response to resonant stimuli, especially at low magnetic fields. Consequently, the impact of MRI on some medical applications, such as dentistry, continues to be limited. Here, we present three-dimensional reconstructions of ex-vivo human teeth, as well as a rabbit head and part of a cow femur, all obtained at a field strength of 260 mT. These images are the first featuring soft and hard tissues simultaneously at sub-Tesla fields, and they have been acquired in a home-made, special-purpose, pre-medical MRI scanner designed with the goal of demonstrating dental imaging at low field settings. We encode spatial information with two pulse sequences: Pointwise-Encoding Time reduction with Radial Acquisition and a new sequence we have called Double Radial Non-Stop Spin Echo, which we find to perform better than the former. For image reconstruction we employ Algebraic Reconstruction Techniques (ART) as well as standard Fourier methods. An analysis of the resulting images shows that ART reconstructions exhibit a higher signal-to-noise ratio with a more homogeneous noise distribution.

Quantitative Ultrashort Echo Time (UTE) Magnetic Resonance Imaging of Bone: An Update

Bone possesses a highly complex hierarchical structure comprised of mineral (~45% by volume), organic matrix (~35%) and water (~20%). Water exists in bone in two forms: as bound water (BW), which is bound to bone mineral and organic matrix, or as pore water (PW), which resides in Haversian canals as well as in lacunae and canaliculi. Magnetic resonance (MR) imaging has been increasingly used for assessment of cortical and trabecular bone. However, bone appears as a signal void on conventional MR sequences because of its short T2*. Ultrashort echo time (UTE) sequences with echo times (TEs) 100-1,000 times shorter than those of conventional sequences allow direct imaging of BW and PW in bone. A series of quantitative UTE MRI techniques has been developed for bone evaluation. UTE and adiabatic inversion recovery prepared UTE (IR-UTE) sequences have been developed to quantify BW and PW. UTE magnetization transfer (UTE-MT) sequences have been developed to quantify collagen backbone protons, and UTE quantitative susceptibility mapping (UTE-QSM) sequences have been developed to assess bone mineral.

Influence of Oxidation Degree of Graphene Oxide on Its Nuclear Relaxivity and Contrast in MRI

Graphene oxide (GO) serves as a versatile platform for various applications, with the oxygen content of GO playing an important role in governing its properties. In the present study, different GO types covering a wide range of oxidation degree were prepared using our newly developed two-step method involving ball milling of graphite followed by its oxidation to GO. In addition to the variations in their physicochemical properties, the different GO types exhibited differences in proton relaxivity due to their paramagnetic nature. Nuclear magnetic resonance spectroscopy studies showed that the degree of oxidation of GO perturbs its nuclear relaxation properties and, together with intercalated Mn2+ ions, provides large contrast variation in magnetic resonance imaging (MRI). The study for the first time reveals that the surface chemistry of GO affects its relaxivity and opens up new avenues for developing tunable GO-based contrast agents in magnetic resonance imaging for diagnostics and therapies.

Recent Advances of Polyaniline-Based Biomaterials for Phototherapeutic Treatments of Tumors and Bacterial Infections

Conventional treatments fail to completely eradicate tumor or bacterial infections due to their inherent shortcomings. In recent years, photothermal therapy (PTT) has emerged as an attractive treatment modality that relies on the absorption of photothermal agents (PTAs) at a specific wavelength, thereby transforming the excitation light energy into heat. The advantages of PTT are its high efficacy, specificity, and minimal damage to normal tissues. To this end, various inorganic nanomaterials such as gold nanostructures, carbon nanostructures, and transition metal dichalcogenides have been extensively explored for PTT applications. Subsequently, the focus has shifted to the development of polymeric PTAs, owing to their unique properties such as biodegradability, biocompatibility, non-immunogenicity, and low toxicity when compared to inorganic PTAs. Among various organic PTAs, polyaniline (PANI) is one of the best-known and earliest-reported organic PTAs. Hence, in this review, we cover the recent advances and progress of PANI-based biomaterials for PTT application in tumors and bacterial infections. The future prospects in this exciting area are also addressed.

Effect of Mineral Composition on Transverse Relaxation Time Distributions and MR Imaging of Tight Rocks from Offshore Ireland

In this paper, we investigate the effect of magnetic field strength on the transverse relaxation time constant (T2) in six distinct core plugs from four different rock types (three sandstones, one basalt, one volcanic tuff and one siltstone), retrieved from offshore Ireland. The CPMG pulse-sequence was used at two different magnetic field strengths: high-field at 4.70 T and low-field at 0.28 T. Axial images of the core plugs were also acquired with the RAREst sequence at high magnetic field strength. Thin-sections of the core plugs were prepared for optical imaging and SEM analysis, and provided qualitative information on the porosity and quantification of the elemental composition of the rock material. The content of iron varied from 4 wt. % to close to zero in the rock samples. Nevertheless, the effective T2 distributions obtained at low-field were used to successfully predict the porosity of the core plugs. Severe signal attenuations from internal magnetic gradients resulted in an underestimation of the porosity at high-field. No definitive trend was identified on the evolution of discrete relaxation time components between magnetic field strengths. The low-field measurements demonstrate that NMR is a powerful quantitative tool for petrophysical rock analysis as compared to thin-section analysis. The results of this study are of interest to the research community who characterizes natural gas hydrates in tight heterogeneous core plugs, and who typically relies on MR imaging to distinguish between solid hydrates and fluid phases. It further exemplifies the importance of selecting appropriate magnetic field strengths when employing NMR/MRI for porosity calculation in tight rock.