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Li Z, Bai R, Yi J, Zhou H, Xian J, Chen C. Designing Smart Iron Oxide Nanoparticles for MR Imaging of Tumors. CHEMICAL & BIOMEDICAL IMAGING 2023; 1:315-339. [PMID: 37501794 PMCID: PMC10369497 DOI: 10.1021/cbmi.3c00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 07/29/2023]
Abstract
Iron oxide nanoparticles (IONPs) possess unique magnetism and good biocompatibility, and they have been widely applied as contrast agents (CAs) for magnetic resonance imaging (MRI). Traditional CAs typically show a fixed enhanced signal, thus exhibiting the limitations of low sensitivity and a lack of specificity. Nowadays, the progress of stimulus-responsive IONPs allows alteration of the relaxation signal in response to internal stimuli of the tumor, or external stimuli, thus providing an opportunity to overcome those limitations. This review summarizes the current status of smart IONPs as tumor imaging MRI CAs that exhibit responsiveness to endogenous stimuli, such as pH, hypoxia, glutathione, and enzymes, or exogenous stimuli, such as magnets, light, and so on. We discuss the challenges and future opportunities for IONPs as MRI CAs and comprehensively illustrate the applications of these stimuli-responsive IONPs. This review will help provide guidance for designing IONPs as MRI CAs and further promote the reasonable design of magnetic nanoparticles and achieve early and accurate tumor detection.
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Affiliation(s)
- Zhenzhen Li
- CAS
Key Laboratory for Biomedical Effects of Nanoparticles and Nanosafety
& CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
- Department
of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Ru Bai
- CAS
Key Laboratory for Biomedical Effects of Nanoparticles and Nanosafety
& CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
- Research
Unit of Nanoscience and Technology, Chinese
Academy of Medical Sciences, Beijing 100021, China
| | - Jia Yi
- Guangdong
Provincial Development and Reform Commission, Guangzhou 510031, China
| | - Huige Zhou
- CAS
Key Laboratory for Biomedical Effects of Nanoparticles and Nanosafety
& CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
- Research
Unit of Nanoscience and Technology, Chinese
Academy of Medical Sciences, Beijing 100021, China
| | - Junfang Xian
- Department
of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Chunying Chen
- CAS
Key Laboratory for Biomedical Effects of Nanoparticles and Nanosafety
& CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
- Research
Unit of Nanoscience and Technology, Chinese
Academy of Medical Sciences, Beijing 100021, China
- The
GBA National Institute for Nanotechnology Innovation, Guangzhou 510700, China
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Liang M, Li LD, Li L, Li S. Nanotechnology in diagnosis and therapy of gastrointestinal cancer. World J Clin Cases 2022; 10:5146-5155. [PMID: 35812681 PMCID: PMC9210884 DOI: 10.12998/wjcc.v10.i16.5146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/07/2022] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
Advances in nanotechnology have opened new frontiers in the diagnosis and treatment of cancer. Nanoparticle-based technology improves the precision of tumor diagnosis when combined with imaging, as well as the accuracy of drug target delivery, with fewer side effects. Optimized nanosystems have demonstrated advantages in many fields, including enhanced specificity of detection, reduced toxicity of drugs, enhanced effect of contrast agents, and advanced diagnosis and therapy of gastrointestinal (GI) cancers. In this review, we summarize the current nanotechnologies in diagnosis and treatment of GI cancers. The development of nanotechnology will lead to personalized approaches for early diagnosis and treatment of GI cancers.
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Affiliation(s)
- Meng Liang
- Department of Otolaryngology, Huazhong University of Science and Technology Union Shenzhen Hospital, The sixth Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518053, Guangdong Province, China
| | - Li-Dan Li
- National Clinical Research Center for Infectious Diseases, Shenzhen Third People's Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen 518112, Guangdong Province, China
| | - Liang Li
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518059, Guangdong Province, China
| | - Shuo Li
- Department of Otolaryngology, Huazhong University of Science and Technology Union Shenzhen Hospital, The sixth Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518053, Guangdong Province, China
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Zhu FD, Hu YJ, Yu L, Zhou XG, Wu JM, Tang Y, Qin DL, Fan QZ, Wu AG. Nanoparticles: A Hope for the Treatment of Inflammation in CNS. Front Pharmacol 2021; 12:683935. [PMID: 34122112 PMCID: PMC8187807 DOI: 10.3389/fphar.2021.683935] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/26/2021] [Indexed: 12/12/2022] Open
Abstract
Neuroinflammation, an inflammatory response within the central nervous system (CNS), is a main hallmark of common neurodegenerative diseases, including Alzheimer’s disease (AD), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS), among others. The over-activated microglia release pro-inflammatory cytokines, which induces neuronal death and accelerates neurodegeneration. Therefore, inhibition of microglia over-activation and microglia-mediated neuroinflammation has been a promising strategy for the treatment of neurodegenerative diseases. Many drugs have shown promising therapeutic effects on microglia and inflammation. However, the blood–brain barrier (BBB)—a natural barrier preventing brain tissue from contact with harmful plasma components—seriously hinders drug delivery to the microglial cells in CNS. As an emerging useful therapeutic tool in CNS-related diseases, nanoparticles (NPs) have been widely applied in biomedical fields for use in diagnosis, biosensing and drug delivery. Recently, many NPs have been reported to be useful vehicles for anti-inflammatory drugs across the BBB to inhibit the over-activation of microglia and neuroinflammation. Therefore, NPs with good biodegradability and biocompatibility have the potential to be developed as an effective and minimally invasive carrier to help other drugs cross the BBB or as a therapeutic agent for the treatment of neuroinflammation-mediated neurodegenerative diseases. In this review, we summarized various nanoparticles applied in CNS, and their mechanisms and effects in the modulation of inflammation responses in neurodegenerative diseases, providing insights and suggestions for the use of NPs in the treatment of neuroinflammation-related neurodegenerative diseases.
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Affiliation(s)
- Feng-Dan Zhu
- Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Yu-Jiao Hu
- Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China.,Department of Anesthesia, Southwest Medical University, Luzhou, China
| | - Lu Yu
- Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Xiao-Gang Zhou
- Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Jian-Ming Wu
- Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Yong Tang
- Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Da-Lian Qin
- Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Qing-Ze Fan
- Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China.,Department of Pharmacy, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - An-Guo Wu
- Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China.,Department of Pharmacy, Affiliated Hospital of Southwest Medical University, Luzhou, China
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Suto DJ, Nair G, Sudarshana DM, Steele SU, Dwyer J, Beck ES, Ohayon J, McFarland H, Koretsky AP, Cortese ICM, Reich DS. Manganese-Enhanced MRI in Patients with Multiple Sclerosis. AJNR Am J Neuroradiol 2020; 41:1569-1576. [PMID: 32763897 DOI: 10.3174/ajnr.a6665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/31/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND PURPOSE Cellular uptake of the manganese ion, when administered as a contrast agent for MR imaging, can noninvasively highlight cellular activity and disease processes in both animals and humans. The purpose of this study was to explore the enhancement profile of manganese in patients with multiple sclerosis. MATERIALS AND METHODS Mangafodipir is a manganese chelate that was clinically approved for MR imaging of liver lesions. We present a case series of 6 adults with multiple sclerosis who were scanned at baseline with gadolinium, then injected with mangafodipir, and followed at variable time points thereafter. RESULTS Fourteen new lesions formed during or shortly before the study, of which 10 demonstrated manganese enhancement of varying intensity, timing, and spatial pattern. One gadolinium-enhancing extra-axial mass, presumably a meningioma, also demonstrated enhancement with manganese. Most interesting, manganese enhancement was detected in lesions that formed in the days after mangafodipir injection, and this enhancement persisted for several weeks, consistent with contrast coming from intracellular uptake of manganese. Some lesions demonstrated a diffuse pattern of manganese enhancement in an area larger than that of both gadolinium enhancement and T2-FLAIR signal abnormality. CONCLUSIONS This work demonstrates the first use of a manganese-based contrast agent to enhance MS lesions on MR imaging. Multiple sclerosis lesions were enhanced with a temporal and spatial profile distinct from that of gadolinium. Further experiments are necessary to uncover the mechanism of manganese contrast enhancement as well as cell-specific uptake.
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Affiliation(s)
- D J Suto
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - G Nair
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - D M Sudarshana
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - S U Steele
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - J Dwyer
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - E S Beck
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - J Ohayon
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - H McFarland
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - A P Koretsky
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - I C M Cortese
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - D S Reich
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
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Dadfar SM, Roemhild K, Drude NI, von Stillfried S, Knüchel R, Kiessling F, Lammers T. Iron oxide nanoparticles: Diagnostic, therapeutic and theranostic applications. Adv Drug Deliv Rev 2019; 138:302-325. [PMID: 30639256 PMCID: PMC7115878 DOI: 10.1016/j.addr.2019.01.005] [Citation(s) in RCA: 569] [Impact Index Per Article: 113.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/19/2018] [Accepted: 01/04/2019] [Indexed: 12/27/2022]
Abstract
Many different iron oxide nanoparticles have been evaluated over the years, for a wide variety of biomedical applications. We here summarize the synthesis, surface functionalization and characterization of iron oxide nanoparticles, as well as their (pre-) clinical use in diagnostic, therapeutic and theranostic settings. Diagnostic applications include liver, lymph node, inflammation and vascular imaging, employing mostly magnetic resonance imaging but recently also magnetic particle imaging. Therapeutic applications encompass iron supplementation in anemia and advanced cancer treatments, such as modulation of macrophage polarization, magnetic fluid hyperthermia and magnetic drug targeting. Because of their properties, iron oxide nanoparticles are particularly useful for theranostic purposes. Examples of such setups, in which diagnosis and therapy are intimately combined and in which iron oxide nanoparticles are used, are image-guided drug delivery, image-guided and microbubble-mediated opening of the blood-brain barrier, and theranostic tissue engineering. Together, these directions highlight the versatility and the broad applicability of iron oxide nanoparticles, and indicate the integration in future medical practice of multiple iron oxide nanoparticle-based materials.
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Affiliation(s)
- Seyed Mohammadali Dadfar
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany
| | - Karolin Roemhild
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany; Institute of Pathology, Medical Faculty, RWTH Aachen University Clinic, Aachen, Germany
| | - Natascha I Drude
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany; Department of Nuclear Medicine, RWTH Aachen University Clinic, Aachen, Germany; Leibniz Institute for Interactive Materials - DWI, RWTH Aachen University, Aachen, Germany
| | - Saskia von Stillfried
- Institute of Pathology, Medical Faculty, RWTH Aachen University Clinic, Aachen, Germany
| | - Ruth Knüchel
- Institute of Pathology, Medical Faculty, RWTH Aachen University Clinic, Aachen, Germany
| | - Fabian Kiessling
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany
| | - Twan Lammers
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, Aachen, Germany; Department of Pharmaceutics, Utrecht University, Utrecht, The Netherlands; Department of Targeted Therapeutics, University of Twente, Enschede, The Netherlands.
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6
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Preoperative evaluation of colorectal liver metastases: comparison of gadopentetate dimeglumine and gadoxetic-acid-enhanced 1.5-T MRI. Clin Imaging 2014; 38:273-8. [PMID: 24559747 DOI: 10.1016/j.clinimag.2013.12.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 12/16/2013] [Accepted: 12/31/2013] [Indexed: 12/27/2022]
Abstract
PURPOSE The aim of this study was to compare the diagnostic performance of gadopentetate dimeglumine and gadoxetic-acid-enhanced MRI in patients with colorectal liver metastases. METHODS Thirty patients were included and divided into three sets, as follows: gadopentetate dimeglumine set-hepatic arterial phase, portal venous phase, and delay phase; gadoxetic acid set-hepatic arterial phase, portal venous phase, and delay phase; combined set-gadoxetic acid set and hepatobiliary phase. The accuracy was assessed by the area under the alternative-free response receiver operating characteristic curve; the sensitivity and positive predictive value were calculated. RESULTS There were 81 colorectal liver metastases in all. Both readers noted higher diagnostic accuracies of the combined set than the other two sets. In the group of small lesions, both readers detected significantly higher sensitivities and positive predictive value on the combined set than the other two sets. CONCLUSIONS The combined set showed higher accuracy and sensitivity, especially significantly higher accuracy and sensitivity on small lesions.
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Smith JT, Ward J, Guthrie JA, Sheridan MB, Boyes S, Wilson D, Wyatt JI, Treanor D, Robinson PJ. Detection of colorectal metastases in patients being treated with chemotherapy utilising SPIO-MRI: a radiological–pathological study. Magn Reson Imaging 2012; 30:1446-53. [DOI: 10.1016/j.mri.2012.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 04/03/2012] [Accepted: 04/18/2012] [Indexed: 12/12/2022]
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Muhi A, Ichikawa T, Motosugi U, Sou H, Nakajima H, Sano K, Sano M, Kato S, Kitamura T, Fatima Z, Fukushima K, Iino H, Mori Y, Fujii H, Araki T. Diagnosis of colorectal hepatic metastases: Comparison of contrast-enhanced CT, contrast-enhanced US, superparamagnetic iron oxide-enhanced MRI, and gadoxetic acid-enhanced MRI. J Magn Reson Imaging 2011; 34:326-35. [DOI: 10.1002/jmri.22613] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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9
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Chung WS, Kim MJ, Chung YE, Kim YE, Park MS, Choi JY, Kim KW. Comparison of gadoxetic acid-enhanced dynamic imaging and diffusion-weighted imaging for the preoperative evaluation of colorectal liver metastases. J Magn Reson Imaging 2011; 34:345-53. [PMID: 21702068 DOI: 10.1002/jmri.22671] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 05/06/2011] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To retrospectively compare the diagnostic accuracy for the detection of colorectal liver metastases between gadoxetic acid-enhanced MRI (EOB-MRI) and diffusion-weighted imaging (DWI) on 3.0 Tesla (T) system, and then to determine whether a combination of the two techniques may improve the diagnostic performance. MATERIALS AND METHODS Forty-seven patients underwent MR imaging at 3.0T, including DWI (DWI set) and dynamic and hepatobiliary phase EOB-MRI (EOB set) for the preoperative evaluation of colorectal liver metastases. All suspicious metastases were confirmed by hepatic surgery. Two blinded readers independently reviewed three different image sets, which consisted of DWI set, EOB set, and combined set. The accuracy was assessed by the area (Az) under the alternative-free response receiver operating characteristic curve, and the sensitivity and positive predictive value (PPV) were calculated. RESULTS We found a total of 78 confirmed colorectal liver metastases in 42 of 47 patients. Each reader noted higher diagnostic accuracy of combined set of EOB-MRI and DWI than DWI set and EOB set, without statistical significance. Regardless of the size of colorectal liver metastasis, each reader detected significantly more metastases on combined set than on DWI set, and PPV was significantly higher with DWI set than with EOB set or with combined set for one reader. CONCLUSION EOB-MRI was more useful for the detection of colorectal liver metastases, while DWI was more useful for their characterization. The combination of EOB-MRI and DWI showed significantly higher accuracy and sensitivity for the preoperative detection of small colorectal liver metastases than DWI.
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Affiliation(s)
- Woo-Suk Chung
- Department of Diagnostic Radiology, Institute of Gastroenterology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Donati OF, Hany TF, Reiner CS, von Schulthess GK, Marincek B, Seifert B, Weishaupt D. Value of retrospective fusion of PET and MR images in detection of hepatic metastases: comparison with 18F-FDG PET/CT and Gd-EOB-DTPA-enhanced MRI. J Nucl Med 2010; 51:692-9. [PMID: 20395324 DOI: 10.2967/jnumed.109.068510] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
UNLABELLED The purpose of this study was to compare the accuracy of lesion detection and diagnostic confidence between (18)F-FDG PET/CT, gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI, and retrospectively fused PET and MRI (PET/MRI). METHODS Thirty-seven patients (mean age +/- SD, 60.2 +/- 12 y) with suspected liver metastases underwent PET/CT and Gd-EOB-DTPA-enhanced MRI within 0-30 d (mean, 11.9 +/- 9 d). PET and Gd-EOB-DTPA-enhanced MR image data were retrospectively fused. Images were reviewed independently by 2 readers who identified and characterized liver lesions using PET/CT, Gd-EOB-DTPA-enhanced MRI, and PET/MRI. Each liver lesion was graded on a 5-point confidence scale ranging from definitely benign (grade of 1) to definitely malignant (grade of 5). The accuracy of each technique was determined by receiver-operating-characteristic analysis. Histopathology served as the standard of reference for all patients with malignant lesions. RESULTS A total of 85 liver lesions (55 liver metastases [65%] and 30 benign lesions [35%]) were present in 29 (78%) of the 37 patients. Twenty-four (65%) of the 37 patients had liver metastases. The detection rate of liver lesions was significantly lower for PET/CT than for Gd-EOB-DTPA-enhanced MRI (64% and 85%; P = 0.002). Sensitivity in the detection and characterization of liver metastases for PET/CT, Gd-EOB-DTPA-enhanced MRI, PET/MRI in reader 1, and PET/MRI in reader 2 was 76%, 91%, 93%, and 93%, respectively; the respective specificity values were 90%, 100%, 87%, and 97%. The difference in sensitivity between PET/CT and PET/MRI was significant (P = 0.023). The level of confidence regarding liver lesions larger than 1 cm in diameter was significantly higher in PET/MRI than in PET/CT (P = 0.046). Accuracy values (area under the receiver-operating-characteristic curve) for PET/CT, Gd-EOB-DTPA-enhanced MRI, PET/MRI in reader 1, and PET/MRI in reader 2 were 0.85, 0.94, 0.92, and 0.96, respectively. CONCLUSION The sensitivity of Gd-EOB-DTPA-enhanced MRI and PET/MRI in the detection of liver metastases is higher than that of PET/CT. Diagnostic confidence was significantly better with PET/MRI than with PET/CT regarding lesions larger than 1 cm in diameter. Compared with Gd-EOB-DTPA-enhanced MRI, PET/MRI resulted in a nonsignificant increase in sensitivity and diagnostic confidence.
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Affiliation(s)
- Olivio F Donati
- Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland.
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12
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Abstract
For most solid neoplasms, medical imaging is a vital component of tumor staging and surveillance. Imaging strategies vary according to the type and grade of primary neoplasm, tumor stage at diagnosis, tumor markers, previous therapies, and patient symptoms. In this article, we address imaging of individual organs (lung, liver, adrenals) and outline imaging strategies for specific types of neoplasms.
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Affiliation(s)
- Donald L Klippenstein
- State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, NY 14214, USA.
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Detection of colorectal hepatic metastases using MnDPDP MR imaging and diffusion-weighted imaging (DWI) alone and in combination. Eur Radiol 2008; 18:903-10. [PMID: 18193234 DOI: 10.1007/s00330-007-0847-z] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Revised: 11/16/2007] [Accepted: 12/17/2007] [Indexed: 12/15/2022]
Abstract
To compare the diagnostic accuracy of MnDPDP MR imaging and diffusion-weighted imaging (DWI), alone and in combination, for detecting colorectal liver metastases in patients with suspected metastatic disease. Thirty-three consecutive patients with suspected colorectal liver metastases underwent MR imaging. Three image sets (MnDPDP, DWI and combined MnDPDP and DWI) were reviewed independently by two observers. Lesions were scored on a five-point scale for malignancy and the areas (Az) under the receiver operating characteristic curves were calculated for each observer and image set. The sensitivity and specificity for lesion detection were calculated for each image set and compared. There were 83 metastases, 49 cysts and 1 haemangioma. Using the combined set resulted in the highest diagnostic accuracy for both observers (Az=0.94 and 0.96), with improved averaged sensitivity of lesion detection compared with the DWI set (p=0.01), and a trend towards improved sensitivity compared with the MnDPDP set (p=0.06). There was no difference in the averaged specificity using any of the three image sets (p>0.5). Combination of MnDPDP MR imaging and DWI resulted in the highest diagnostic accuracy and can increase sensitivity without loss in specificity.
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Abstract
With recent technical advances in hardware, software, and intravenous contrast agents, MRI has evolved into a clinically useful procedure to detect and characterise liver tumours. The combination of MRI systems with larger gradients, improved surface coils, and parallel imaging techniques have produced substantial improvements in MRI quality and speed of image acquisition. Images that previously needed several minutes to acquire can now be obtained in several seconds. The notably faster imaging capabilities of new MRI scanners are ideally suited for dynamic contrast-enhanced liver imaging in which early arterial-phase imaging is best for detecting hepatocellular carcinomas and hypervascular liver metastases. The inherent excellent soft-tissue contrast of MRI can be further improved by non-specific extracellular contrast agents and by liver-specific contrast agents. These contrast agents are now routinely used for liver imaging and improve the sensitivity and specificity of hepatobiliary MRI.
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Affiliation(s)
- Russell N Low
- Sharp and Children MRI Center, 7901 Frost Street, and San Diego Imaging Medical Group, 7910 Frost Street, San Diego, CA 92123, USA.
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