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Maes L, Versweyveld L, Evans NR, McCabe JJ, Kelly P, Van Laere K, Lemmens R. Novel Targets for Molecular Imaging of Inflammatory Processes of Carotid Atherosclerosis: A Systematic Review. Semin Nucl Med 2024; 54:658-673. [PMID: 37996309 DOI: 10.1053/j.semnuclmed.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023]
Abstract
Computed tomography angiography (CTA), magnetic resonance angiography (MRA) and 18F-FDG-PET have proven clinical value when evaluating patients with carotid atherosclerosis. In this systematic review, we will focus on the role of novel molecular imaging tracers in that assessment and their potential strengths to stratify stroke risk. We systematically searched PubMed, Embase, the Web of Science Core Collection, and Cochrane Library for articles reporting on molecular imaging to noninvasively detect or characterize inflammation in carotid atherosclerosis. As our focus was on nonclassical novel targets, we omitted reports solely on 18F-FDG and 18F-NaF. We summarized and mapped the selected studies to provide an overview of the current clinical development in molecular imaging in relation to risk factors, imaging and histological findings, diagnostic and prognostic performance. We identified 20 articles in which the utilized tracers to visualize carotid wall inflammation were somatostatin subtype-2- (SST2-) (n = 5), CXC-motif chemokine receptor 4- (CXCR4-) (n = 3), translocator protein- (TSPO-) (n = 2) and aVβ3 integrin-ligands (n = 2) and choline-tracers (n = 2). Tracer uptake correlated with traditional cardiovascular risk factors, that is, age, gender, diabetes, hypercholesterolemia, and hypertension as well as prior cardiovascular disease. We identified discrepancies between tracer uptake and grade of stenosis, plaque calcification, and 18F-FDG uptake, suggesting the importance of alternative characterization of atherosclerosis beyond classical neuroimaging features. Immunohistochemical analysis linked tracer uptake to markers of macrophage infiltration and neovascularization. Symptomatic carotid arteries showed higher uptake compared to asymptomatic (including contralateral, nonculprit) arteries. Some studies demonstrated a potential role of these novel molecular imaging as a specific intermediary (bio)marker for outcome. Several novel tracers show promise for identification of high-risk plaque inflammation. Based on the current evidence we cautiously propose the SST2-ligands and the choline radiotracers as viable candidates for larger prospective longitudinal outcome studies to evaluate their predictive use in clinical practice.
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Affiliation(s)
- Louise Maes
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium; Department of Neurosciences, Experimental Neurology, KULeuven - University of Leuven, Leuven, Belgium.
| | - Louis Versweyveld
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium; Department of Neurosciences, Experimental Neurology, KULeuven - University of Leuven, Leuven, Belgium
| | - Nicholas R Evans
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - John J McCabe
- Health Research Board (HRB), Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland; School of Medicine, University College Dublin (UCD), Dublin, Ireland; Department of Geriatric Medicine, Mater Misericordiae University Hospital Dublin, Dublin, Ireland
| | - Peter Kelly
- Health Research Board (HRB), Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland; School of Medicine, University College Dublin (UCD), Dublin, Ireland; Mater Misericordiae University Hospital Dublin, Stroke Service, Dublin, Ireland
| | - Koen Van Laere
- Division of Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, KULeuven - University of Leuven - Nuclear Medicine and Molecular Imaging, Leuven, Belgium
| | - Robin Lemmens
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium; Department of Neurosciences, Experimental Neurology, KULeuven - University of Leuven, Leuven, Belgium
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Cau R, Anzalone N, Mannelli L, Edjlali M, Balestrieri A, Nardi V, Lanzino G, Lerman A, Suri JS, Saba L. Pericarotid Fat as a Marker of Cerebrovascular Risk. AJNR Am J Neuroradiol 2024:ajnr.A8300. [PMID: 39147585 DOI: 10.3174/ajnr.a8300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/27/2024] [Indexed: 08/17/2024]
Abstract
Vascular inflammation is widely recognized as an important factor in the atherosclerotic process, particularly in terms of plaque development and progression. Conventional tests, such as measuring circulating inflammatory biomarkers, lack the precision to identify specific areas of vascular inflammation. In this context, noninvasive imaging modalities can detect perivascular fat changes, serving as a marker of vascular inflammation. This review aims to provide a comprehensive overview of the key concepts related to perivascular carotid fat and its pathophysiology. Additionally, we examine the existing literature on the association of pericarotid fat with features of plaque vulnerability and cerebrovascular events. Finally, we scrutinize the advantages and limitations of the noninvasive assessment of pericarotid fat.
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Affiliation(s)
- Riccardo Cau
- From the Department of Radiology (R.C., A.B., L.S.), Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Nicoletta Anzalone
- Vita-Salute San Raffaele University (N.A.), Milan, Italy
- Neuroradiology Unit and CERMAC (N.A.), IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Myriam Edjlali
- Department of Neuroradiology (M.E.), Université Paris-Descartes-Sorbonne-Paris-Cité, IMABRAIN-INSERM-UMR1266, DHU-Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France
| | - Antonella Balestrieri
- From the Department of Radiology (R.C., A.B., L.S.), Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Valentina Nardi
- Department of Neurosurgery (V.N., G.L.), Mayo Clinic, Rochester, Minnesota
| | - Giuseppe Lanzino
- Department of Neurosurgery (V.N., G.L.), Mayo Clinic, Rochester, Minnesota
| | - Amir Lerman
- Department of Cardiovascular Medicine (A.L.), Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division (J.S.S.), AtheroPoint, Roseville, California
| | - Luca Saba
- From the Department of Radiology (R.C., A.B., L.S.), Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
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Sekita A, Unterweger H, Berg S, Ohlmeyer S, Bäuerle T, Zheng KH, Coolen BF, Nederveen AJ, Cabella C, Rossi S, Stroes ESG, Alexiou C, Lyer S, Cicha I. Accumulation of Iron Oxide-Based Contrast Agents in Rabbit Atherosclerotic Plaques in Relation to Plaque Age and Vulnerability Features. Int J Nanomedicine 2024; 19:1645-1666. [PMID: 38406599 PMCID: PMC10893894 DOI: 10.2147/ijn.s430693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/14/2023] [Indexed: 02/27/2024] Open
Abstract
Purpose In this study, a detailed characterization of a rabbit model of atherosclerosis was performed to assess the optimal time frame for evaluating plaque vulnerability using superparamagnetic iron oxide nanoparticle (SPION)-enhanced magnetic resonance imaging (MRI). Methods The progression of atherosclerosis induced by ballooning and a high-cholesterol diet was monitored using angiography, and the resulting plaques were characterized using immunohistochemistry and histology. Morphometric analyses were performed to evaluate plaque size and vulnerability features. The accumulation of SPIONs (novel dextran-coated SPIONDex and ferumoxytol) in atherosclerotic plaques was investigated by histology and MRI and correlated with plaque age and vulnerability. Toxicity of SPIONDex was evaluated in rats. Results Weak positive correlations were detected between plaque age and intima thickness, and total macrophage load. A strong negative correlation was observed between the minimum fibrous cap thickness and plaque age as well as the mean macrophage load. The accumulation of SPION in the atherosclerotic plaques was detected by MRI 24 h after administration and was subsequently confirmed by Prussian blue staining of histological specimens. Positive correlations between Prussian blue signal in atherosclerotic plaques, plaque age, and macrophage load were detected. Very little iron was observed in the histological sections of the heart and kidney, whereas strong staining of SPIONDex and ferumoxytol was detected in the spleen and liver. In contrast to ferumoxytol, SPIONDex administration in rabbits was well tolerated without inducing hypersensitivity. The maximum tolerated dose in rat model was higher than 100 mg Fe/kg. Conclusion Older atherosclerotic plaques with vulnerable features in rabbits are a useful tool for investigating iron oxide-based contrast agents for MRI. Based on the experimental data, SPIONDex particles constitute a promising candidate for further clinical translation as a safe formulation that offers the possibility of repeated administration free from the risks associated with other types of magnetic contrast agents.
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Affiliation(s)
- Alexander Sekita
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Harald Unterweger
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sonja Berg
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sabine Ohlmeyer
- Institute of Radiology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Tobias Bäuerle
- Preclinical Imaging Platform Erlangen (PIPE), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Kang H Zheng
- Department of Vascular Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Bram F Coolen
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Claudia Cabella
- Bracco Imaging SpA, Centro Ricerche Bracco, Colleretto Giacosa, Turin, Italy
| | - Silvia Rossi
- Bracco Imaging SpA, Centro Ricerche Bracco, Colleretto Giacosa, Turin, Italy
| | - Erik S G Stroes
- Department of Vascular Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Christoph Alexiou
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Stefan Lyer
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Iwona Cicha
- ENT-Department, Section of Experimental Oncology Und Nanomedicine (SEON), Else Kröner-Fresenius-Stiftung-Professorship, Universitätsklinikum Erlangen, Erlangen, Germany
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Cheng J, Huang H, Chen Y, Wu R. Nanomedicine for Diagnosis and Treatment of Atherosclerosis. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2304294. [PMID: 37897322 PMCID: PMC10754137 DOI: 10.1002/advs.202304294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/11/2023] [Indexed: 10/30/2023]
Abstract
With the changing disease spectrum, atherosclerosis has become increasingly prevalent worldwide and the associated diseases have emerged as the leading cause of death. Due to their fascinating physical, chemical, and biological characteristics, nanomaterials are regarded as a promising tool to tackle enormous challenges in medicine. The emerging discipline of nanomedicine has filled a huge application gap in the atherosclerotic field, ushering a new generation of diagnosis and treatment strategies. Herein, based on the essential pathogenic contributors of atherogenesis, as well as the distinct composition/structural characteristics, synthesis strategies, and surface design of nanoplatforms, the three major application branches (nanodiagnosis, nanotherapy, and nanotheranostic) of nanomedicine in atherosclerosis are elaborated. Then, state-of-art studies containing a sequence of representative and significant achievements are summarized in detail with an emphasis on the intrinsic interaction/relationship between nanomedicines and atherosclerosis. Particularly, attention is paid to the biosafety of nanomedicines, which aims to pave the way for future clinical translation of this burgeoning field. Finally, this comprehensive review is concluded by proposing unresolved key scientific issues and sharing the vision and expectation for the future, fully elucidating the closed loop from atherogenesis to the application paradigm of nanomedicines for advancing the early achievement of clinical applications.
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Affiliation(s)
- Jingyun Cheng
- Department of UltrasoundShanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai200080P. R. China
| | - Hui Huang
- Materdicine LabSchool of Life SciencesShanghai UniversityShanghai200444P. R. China
| | - Yu Chen
- Materdicine LabSchool of Life SciencesShanghai UniversityShanghai200444P. R. China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health)Wenzhou Institute of Shanghai UniversityWenzhouZhejiang325088P. R. China
| | - Rong Wu
- Department of UltrasoundShanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai200080P. R. China
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Li X, Wu M, Li J, Guo Q, Zhao Y, Zhang X. Advanced targeted nanomedicines for vulnerable atherosclerosis plaque imaging and their potential clinical implications. Front Pharmacol 2022; 13:906512. [PMID: 36313319 PMCID: PMC9606597 DOI: 10.3389/fphar.2022.906512] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 09/20/2022] [Indexed: 12/24/2022] Open
Abstract
Atherosclerosis plaques caused by cerebrovascular and coronary artery disease have been the leading cause of death and morbidity worldwide. Precise assessment of the degree of atherosclerotic plaque is critical for predicting the risk of atherosclerosis plaques and monitoring postinterventional outcomes. However, traditional imaging techniques to predict cardiocerebrovascular events mainly depend on quantifying the percentage reduction in luminal diameter, which would immensely underestimate non-stenotic high-risk plaque. Identifying the degree of atherosclerosis plaques still remains highly limited. vNanomedicine-based imaging techniques present unique advantages over conventional techniques due to the superior properties intrinsic to nanoscope, which possess enormous potential for characterization and detection of the features of atherosclerosis plaque vulnerability. Here, we review recent advancements in the development of targeted nanomedicine-based approaches and their applications to atherosclerosis plaque imaging and risk stratification. Finally, the challenges and opportunities regarding the future development and clinical translation of the targeted nanomedicine in related fields are discussed.
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Affiliation(s)
| | | | | | | | | | - Xuening Zhang
- Department of Radiology, Tianjin Medical University Second Hospital, Tianjin, China
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Kure AJ, Savas H, Hijaz TA, Hussaini SF, Korutz AW. Advancements in Positron Emission Tomography/Magnetic Resonance Imaging and Applications to Diagnostic Challenges in Neuroradiology. Semin Ultrasound CT MR 2021; 42:434-451. [PMID: 34537113 DOI: 10.1053/j.sult.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Since the clinical adoption of magnetic resonance (MR) in medical imaging, MR has proven to be a workhorse in diagnostic neuroradiology, with the ability to provide superb anatomic detail as well as additional functional and physiologic data, depending on the techniques utilized. Positron emission tomography/computed tomography has also shown irreplaceable diagnostic value in certain disease processes of the central nervous system by providing molecular and metabolic information through the development of numerous disease-specific PET tracers, many of which can be utilized as a diagnostic technique in and of themselves or can provide a valuable adjunct to information derived from MR. Despite these advances, many challenges still remain in neuroradiology, particularly in malignancy, neurodegenerative disease, epilepsy, and cerebrovascular disease. Through improvements in attenuation correction, motion correction, and PET detectors, combining the 2 modalities of PET and MR through simultaneous imaging has proven feasible and allows for improved spatial and temporal resolution without compromising either of the 2 individual modalities. The complementary information offered by both technologies has provided increased diagnostic accuracy in both research and many clinical applications in neuroradiology.
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Affiliation(s)
- Andrew J Kure
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
| | - Hatice Savas
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
| | - Tarek A Hijaz
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
| | - Syed F Hussaini
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
| | - Alexander W Korutz
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
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Friedrich RP, Cicha I, Alexiou C. Iron Oxide Nanoparticles in Regenerative Medicine and Tissue Engineering. NANOMATERIALS 2021; 11:nano11092337. [PMID: 34578651 PMCID: PMC8466586 DOI: 10.3390/nano11092337] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 12/13/2022]
Abstract
In recent years, many promising nanotechnological approaches to biomedical research have been developed in order to increase implementation of regenerative medicine and tissue engineering in clinical practice. In the meantime, the use of nanomaterials for the regeneration of diseased or injured tissues is considered advantageous in most areas of medicine. In particular, for the treatment of cardiovascular, osteochondral and neurological defects, but also for the recovery of functions of other organs such as kidney, liver, pancreas, bladder, urethra and for wound healing, nanomaterials are increasingly being developed that serve as scaffolds, mimic the extracellular matrix and promote adhesion or differentiation of cells. This review focuses on the latest developments in regenerative medicine, in which iron oxide nanoparticles (IONPs) play a crucial role for tissue engineering and cell therapy. IONPs are not only enabling the use of non-invasive observation methods to monitor the therapy, but can also accelerate and enhance regeneration, either thanks to their inherent magnetic properties or by functionalization with bioactive or therapeutic compounds, such as drugs, enzymes and growth factors. In addition, the presence of magnetic fields can direct IONP-labeled cells specifically to the site of action or induce cell differentiation into a specific cell type through mechanotransduction.
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Chen J, Zhang X, Millican R, Sherwood J, Martin S, Jo H, Yoon YS, Brott BC, Jun HW. Recent advances in nanomaterials for therapy and diagnosis for atherosclerosis. Adv Drug Deliv Rev 2021; 170:142-199. [PMID: 33428994 PMCID: PMC7981266 DOI: 10.1016/j.addr.2021.01.005] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/02/2021] [Accepted: 01/03/2021] [Indexed: 12/18/2022]
Abstract
Atherosclerosis is a chronic inflammatory disease driven by lipid accumulation in arteries, leading to narrowing and thrombosis. It affects the heart, brain, and peripheral vessels and is the leading cause of mortality in the United States. Researchers have strived to design nanomaterials of various functions, ranging from non-invasive imaging contrast agents, targeted therapeutic delivery systems to multifunctional nanoagents able to target, diagnose, and treat atherosclerosis. Therefore, this review aims to summarize recent progress (2017-now) in the development of nanomaterials and their applications to improve atherosclerosis diagnosis and therapy during the preclinical and clinical stages of the disease.
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Affiliation(s)
- Jun Chen
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Xixi Zhang
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL, United States
| | | | | | - Sean Martin
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Hanjoong Jo
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States; Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, United States
| | - Young-Sup Yoon
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Brigitta C Brott
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ho-Wook Jun
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL, United States.
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Calcagno C, Fayad ZA. Clinical imaging of cardiovascular inflammation. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2020; 64:74-84. [PMID: 32077666 DOI: 10.23736/s1824-4785.20.03228-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cardiovascular disease due to atherosclerosis is the number one cause of morbidity and mortality worldwide. In the past twenty years, compelling preclinical and clinical data have indicated that a maladaptive inflammatory response plays a crucial role in the development of atherosclerosis initiation and progression in the vasculature, all the way to the onset of life-threatening cardiovascular events. Furthermore, inflammation is key to heart and brain damage and healing after myocardial infarction or stroke. Recent evidence indicates that this interplay between the vasculature, organs target of ischemia and the immune system is mediated by the activation of hematopoietic organs (bone marrow and spleen). In this evolving landscape, non-invasive imaging is becoming more and more essential to support either mechanistic preclinical studies to investigate the role of inflammation in cardiovascular disease (CVD), or as a translational tool to quantify inflammation in the cardiovascular system and hematopoietic organs in patients. In this review paper, we will describe the clinical applications of non-invasive imaging to quantify inflammation in the vasculature, infarcted heart and brain, and hematopoietic organs in patients with cardiovascular disease, with specific focus on [18F]FDG PET and other novel inflammation-specific radiotracers. Furthermore, we will briefly describe the most recent clinical applications of other imaging techniques such as MRI, SPECT, CT, CEUS and OCT in this arena.
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Affiliation(s)
- Claudia Calcagno
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zahi A Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA - .,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Usman A, Patterson AJ, Yuan J, Cluroe A, Patterson I, Graves MJ, Gillard JH, Sadat U. Ferumoxytol-enhanced three-dimensional magnetic resonance imaging of carotid atheroma- a feasibility and temporal dependence study. Sci Rep 2020; 10:1808. [PMID: 32020031 PMCID: PMC7000763 DOI: 10.1038/s41598-020-58708-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/01/2020] [Indexed: 12/25/2022] Open
Abstract
Ferumoxytol is an ultrasmall super paramagnetic particles of iron oxide (USPIO) agent recently used for magnetic resonance (MR) vascular imaging. Other USPIOs have been previously used for assessing inflammation within atheroma. We aim to assess feasibility of ferumoxytol in imaging carotid atheroma (with histological assessment); and the optimum MR imaging time to detect maximum quantitative signal change post-ferumoxytol infusion. Ten patients with carotid artery disease underwent high-resolution MR imaging of their carotid arteries on a 1.5 T MR system. MR imaging was performed before and at 24, 48, 72 and 96 hrs post ferumoxytol infusion. Optimal ferumoxytol uptake time was evaluated by quantitative relaxometry maps indicating the difference in T2* (ΔT2*) and T2 (ΔT2) between baseline and post-Ferumoxytol MR imaging using 3D DANTE MEFGRE qT2*w and iMSDE black-blood qT2w sequences respectively. 20 patients in total (10 symptomatic and 10 with asymptomatic carotid artery disease) had ferumoxytol-enhanced MR imaging at the optimal imaging window. 69 carotid MR imaging studies were completed. Ferumoxytol uptake (determined by a decrease in ΔT2* and ΔT2) was identified in all carotid plaques (symptomatic and asymptomatic). Maximum quantitative decrease in ΔT2* (10.4 [3.5-16.2] ms, p < 0.001) and ΔT2 (13.4 [6.2-18.9] ms; p = 0.001) was found on carotid MR imaging at 48 hrs following the ferumoxytol infusion. Ferumoxytol uptake by carotid plaques was assessed by histopathological analysis of excised atheroma. Ferumoxytol-enhanced MR imaging using quantitative 3D MR pulse sequences allows assessment of inflammation within carotid atheroma in symptomatic and asymptomatic patients. The optimum MR imaging time for carotid atheroma is 48 hrs after its administration.
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Affiliation(s)
- Ammara Usman
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Andrew J Patterson
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Jianmin Yuan
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Alison Cluroe
- Department of Pathology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Ilse Patterson
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- University Department of Radiology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | | | - Umar Sadat
- University Department of Surgery, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
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Management of Iron Overload in Resource Poor Nations: A Systematic Review of Phlebotomy and Natural Chelators. J Toxicol 2020; 2020:4084538. [PMID: 32399029 PMCID: PMC7204175 DOI: 10.1155/2020/4084538] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/13/2019] [Accepted: 09/20/2019] [Indexed: 12/29/2022] Open
Abstract
Iron is an essential element and the most abundant trace metal in the body involved in oxygen transport and oxygen sensing, electron transfer, energy metabolism, and DNA synthesis. Excess labile and unchelated iron can catalyze the formation of tissue-damaging radicals and induce oxidative stress. English abstracts were identified in PubMed and Google Scholar using multiple and various search terms based on defined inclusion and exclusion criteria. Full-length articles were selected for systematic review, and secondary and tertiary references were developed. Although bloodletting or phlebotomy remains the gold standard in the management of iron overload, this systematic review is an updated account of the pitfalls of phlebotomy and classical synthetic chelators with scientific justification for the use of natural iron chelators of dietary origin in resource-poor nations.
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12
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Fayad ZA, Swirski FK, Calcagno C, Robbins CS, Mulder W, Kovacic JC. Monocyte and Macrophage Dynamics in the Cardiovascular System: JACC Macrophage in CVD Series (Part 3). J Am Coll Cardiol 2019; 72:2198-2212. [PMID: 30360828 DOI: 10.1016/j.jacc.2018.08.2150] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 07/16/2018] [Accepted: 08/03/2018] [Indexed: 12/12/2022]
Abstract
It has long been recognized that the bone marrow is the primary site of origin for circulating monocytes that may later become macrophages in atherosclerotic lesions. However, only in recent times has the complex relationship among the bone marrow, monocytes/macrophages, and atherosclerotic plaques begun to be understood. Moreover, the systemic nature of these interactions, which also involves additional compartments such as extramedullary hematopoietic sites (i.e., spleen), is only just becoming apparent. In parallel, progressive advances in imaging and cell labeling techniques have opened new opportunities for in vivo imaging of monocyte/macrophage trafficking in atherosclerotic lesions and at the systemic level. In this Part 3 of a 4-part review series covering the macrophage in cardiovascular disease, the authors intersect systemic biology with advanced imaging techniques to explore monocyte and macrophage dynamics in the cardiovascular system, with an emphasis on how events at the systemic level might affect local atherosclerotic plaque biology.
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Affiliation(s)
- Zahi A Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Filip K Swirski
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Claudia Calcagno
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Clinton S Robbins
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Peter Munk Cardiac Centre, Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada; Departments of Laboratory Medicine and Pathobiology and Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Willem Mulder
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jason C Kovacic
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
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Calcagno C, Fayad ZA. Intraplaque and Cellular Distribution of Dextran-Coated Iron Oxide Fluorescently Labeled Nanoparticles: Insights Into Atherothrombosis and Plaque Rupture. Circ Cardiovasc Imaging 2019; 10:CIRCIMAGING.117.006533. [PMID: 28487323 DOI: 10.1161/circimaging.117.006533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Claudia Calcagno
- From the Translational and Molecular Imaging Institute (C.C., Z.A.F.) and Department of Radiology (C.C., Z.A.F.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Zahi A Fayad
- From the Translational and Molecular Imaging Institute (C.C., Z.A.F.) and Department of Radiology (C.C., Z.A.F.), Icahn School of Medicine at Mount Sinai, New York, NY.
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Hedgire S, Krebill C, Wojtkiewicz GR, Oliveira I, Ghoshhajra BB, Hoffmann U, Harisinghani MG. Ultrasmall superparamagnetic iron oxide nanoparticle uptake as noninvasive marker of aortic wall inflammation on MRI: proof of concept study. Br J Radiol 2018; 91:20180461. [PMID: 30160173 DOI: 10.1259/bjr.20180461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE: Radiation therapy for cancer can lead to atherosclerosis by inducing inflammatory changes in the vascular wall. It is difficult to quantitatively measure inflammation on CT and MRI studies. The purpose of this study was to assess the use of ferumoxytol, an ultrasmall superparamagnetic iron oxide nanoparticle, as a noninvasive marker of vessel wall inflammation secondary to radiation therapy in pancreatic cancer patients in comparison with healthy volunteers. METHODS: MRI of upper abdomen (T1, T2, multi echo T2* weighted imaging) was performed on 3 T magnet before and 48 h after intravenous administration of ferumoxytol in pancreatic cancer patients who underwent radiation therapy (n = 8) and in healthy volunteers (n = 8). R2* value was obtained by drawing regions of interest outlining the aortic wall directly on the T2* medic image and subsequently transposed to the R2* image using Amira software (v. 5.3.2, FEI, Bordeaux, France). The change in R2* values was analyzed by student's t-test. RESULTS: The average change in R2* value of the pancreatic cancer patients was determined to be 216.1 ms-1. The average change R2* value of the control patients was determined to be 54.6 ms-1. Thus, pancreatic cancer patients following radiation therapy had a greater uptake of ferumoxytol (p = 0.0082) in their aortic wall as compared to healthy controls. CONCLUSION: This proof of concept study suggests that greater uptake of ferumoxytol in the aortic wall in cancer patients without visible atherosclerosis may be the expression of increased inflammation. ADVANCES IN KNOWLEDGE: Ultrasmall superparamagnetic iron oxide enhanced MRI can offer an imaging biomarker for quantitative estimation of aortic inflammation preceding atherosclerosis.
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Affiliation(s)
- Sandeep Hedgire
- 1 Department of Radiology, Division of Cardiovascular Imaging Massachusetts General Hospital , Boston, MA , USA
| | - Cicely Krebill
- 2 Department of Biology, Northeastern University , Boston, MA , USA
| | - Gregory R Wojtkiewicz
- 3 Center for Systems Biology, Richard B Simches Research Center, Massachusetts General Hospital, , Boston , MA
| | - Irai Oliveira
- 4 Departamento de Radiologia da, Faculdade de Medicina da Universidade de São Paulo , São Paulo - SP , Brazil.,5 Department of Radiology, Hospital Sírio Libanês , São Paulo - SP , Brazil
| | - Brian B Ghoshhajra
- 1 Department of Radiology, Division of Cardiovascular Imaging Massachusetts General Hospital , Boston, MA , USA
| | - Udo Hoffmann
- 1 Department of Radiology, Division of Cardiovascular Imaging Massachusetts General Hospital , Boston, MA , USA
| | - Mukesh G Harisinghani
- 6 Department of Radiology, Division of Abdominal Imaging Massachusetts General Hospital , Boston, MA , USA
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15
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Usman A, Yuan J, Patterson AJ, Graves MJ, Varty K, Sadat U, Gillard JH. Neovascularization in Vertebral Artery Atheroma—A Dynamic Contrast-Enhanced Magnetic Resonance Imaging-Based Comparative Study in Patients with Symptomatic and Asymptomatic Carotid Artery Disease. J Stroke Cerebrovasc Dis 2018; 27:2505-2512. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 05/06/2018] [Indexed: 11/16/2022] Open
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16
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Carvalho PM, Felício MR, Santos NC, Gonçalves S, Domingues MM. Application of Light Scattering Techniques to Nanoparticle Characterization and Development. Front Chem 2018; 6:237. [PMID: 29988578 PMCID: PMC6026678 DOI: 10.3389/fchem.2018.00237] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/04/2018] [Indexed: 01/07/2023] Open
Abstract
Over the years, the scientific importance of nanoparticles for biomedical applications has increased. The high stability and biocompatibility, together with the low toxicity of the nanoparticles developed lead to their use as targeted drug delivery systems, bioimaging systems, and biosensors. The wide range of nanoparticles size, from 10 nm to 1 μm, as well as their optical properties, allow them to be studied using microscopy and spectroscopy techniques. In order to be effectively used, the physicochemical properties of nanoparticle formulations need to be taken into account, namely, particle size, surface charge distribution, surface derivatization and/or loading capacity, and related interactions. These properties need to be optimized considering the final nanoparticle intended biodistribution and target. In this review, we cover light scattering based techniques, namely dynamic light scattering and zeta-potential, used for the physicochemical characterization of nanoparticles. Dynamic light scattering is used to measure nanoparticles size, but also to evaluate their stability over time in suspension, at different pH and temperature conditions. Zeta-potential is used to characterize nanoparticles surface charge, obtaining information about their stability and surface interaction with other molecules. In this review, we focus on nanoparticle characterization and application in infection, cancer and cardiovascular diseases.
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Affiliation(s)
- Patrícia M Carvalho
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Mário R Felício
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Nuno C Santos
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Sónia Gonçalves
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Marco M Domingues
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Sadat U, Usman A, Gillard JH. Imaging pathobiology of carotid atherosclerosis with ultrasmall superparamagnetic particles of iron oxide: an update. Curr Opin Cardiol 2018; 32:437-440. [PMID: 28463893 PMCID: PMC5617556 DOI: 10.1097/hco.0000000000000413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose of review To provide brief overview of the developments regarding use of ultrasmall superparamagnetic particles of iron oxide in imaging pathobiology of carotid atherosclerosis. Recent findings MRI is a promising technique capable of providing morphological and functional information about atheromatous plaques. MRI using iron oxide particles, called ultrasmall superparamagnetic iron oxide (USPIO) particles, allows detection of macrophages in atherosclerotic tissue. Ferumoxytol has emerged as a new USPIO agent, which has an excellent safety profile. Based on the macrophage-selective properties of ferumoxytol, there is increasing number of recent reports suggesting its effectiveness to detect pathological inflammation. Summary USPIO particles allow magnetic resonance detection of macrophages in atherosclerotic tissue. Ferumoxytol has emerged as a new USPIO agent, with an excellent safety profile. This has the potential to be used for MRI of the pathobiology of atherosclerosis.
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Affiliation(s)
- Umar Sadat
- aCambridge Vascular Unit bUniversity Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
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18
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Smits LP, Tiessens F, Zheng KH, Stroes ES, Nederveen AJ, Coolen BF. Evaluation of ultrasmall superparamagnetic iron-oxide (USPIO) enhanced MRI with ferumoxytol to quantify arterial wall inflammation. Atherosclerosis 2017; 263:211-218. [PMID: 28662398 DOI: 10.1016/j.atherosclerosis.2017.06.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/23/2017] [Accepted: 06/07/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Inflammation in atherosclerotic plaques is an important determinant of plaque vulnerability, and can be detected non-invasively using ultra-small superparamagnetic iron-oxide (USPIO) enhanced MRI. The aims of the current study were: 1) to determine whether ferumoxytol can be used for USPIO-MRI of atherosclerotic plaques, 2) to establish a protocol for quantitative USPIO-MRI of carotid artery plaques using ferumoxytol, and 3) to study the relation between USPIO uptake and plaque burden and 18F-fluorodeoxyglucose (FDG) uptake (measured by 18F-FDG PET/CT scan) in atherosclerotic plaques. METHODS In 9 patients with carotid artery stenosis >30% and 4 healthy controls, quantitative R2* MRI scans of the carotid arteries were performed before and 72 h after USPIO administration (4 mg/kg ferumoxytol). USPIO uptake was assessed by quantifying the difference in R2* (ΔR2*) between baseline and post-USPIO scans. In addition to MRI, 18F-FDG PET/CT was performed on both carotid arteries. MR and PET/CT images were co-registered, and 18F-FDG uptake was quantified in all slices containing atherosclerotic plaque. RESULTS Infusion of ferumoxytol resulted in higher R2* values after 72 h in atherosclerotic plaques (ΔR2* 24.6 ± 19.8 s-1; p = 0.0003), but not in the healthy control vessel wall (ΔR2* 2.6 ± 5.6 s-1, p = 0.23). USPIO uptake in patients was higher in atherosclerotic plaques compared to the patient non-plaque vessel wall (ΔR2* of 24.6 ± 19.8 vs. 7.5 ± 9.3 s-1, p = 0.004). No correlation was found between USPIO uptake and 18F-FDG uptake in atherosclerotic plaques (R2 = 0.03, p = 0.55). CONCLUSIONS Ferumoxytol is selectively taken up by atherosclerotic plaques and can thus be used for carotid USPIO-MRI. As USPIO and 18F-FDG uptake in atherosclerotic plaque do not correlate in this cohort, these agents may visualize different pathophysiological aspects of plaque inflammation.
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Affiliation(s)
- Loek P Smits
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Feiko Tiessens
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands; The Netherlands MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, The Netherlands
| | - Kang He Zheng
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Erik S Stroes
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Bram F Coolen
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands; Preclinical and Translational MRI, Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands.
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19
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Magnetic Resonance Imaging-Based Assessment of Carotid Atheroma: a Comparative Study of Patients with and without Coronary Artery Disease. J Stroke Cerebrovasc Dis 2017; 26:347-351. [DOI: 10.1016/j.jstrokecerebrovasdis.2016.09.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 07/24/2016] [Accepted: 09/15/2016] [Indexed: 11/21/2022] Open
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20
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Hyafil F, Schindler A, Sepp D, Obenhuber T, Bayer-Karpinska A, Boeckh-Behrens T, Höhn S, Hacker M, Nekolla SG, Rominger A, Dichgans M, Schwaiger M, Saam T, Poppert H. High-risk plaque features can be detected in non-stenotic carotid plaques of patients with ischaemic stroke classified as cryptogenic using combined (18)F-FDG PET/MR imaging. Eur J Nucl Med Mol Imaging 2015; 43:270-279. [PMID: 26433367 DOI: 10.1007/s00259-015-3201-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/17/2015] [Indexed: 01/08/2023]
Abstract
PURPOSE The aim of this study was to investigate in 18 patients with ischaemic stroke classified as cryptogenic and presenting non-stenotic carotid atherosclerotic plaques the morphological and biological aspects of these plaques with magnetic resonance imaging (MRI) and (18)F-fluoro-deoxyglucose positron emission tomography ((18)F-FDG PET) imaging. METHODS Carotid arteries were imaged 150 min after injection of (18)F-FDG with a combined PET/MRI system. American Heart Association (AHA) lesion type and plaque composition were determined on consecutive MRI axial sections (n = 460) in both carotid arteries. (18)F-FDG uptake in carotid arteries was quantified using tissue to background ratio (TBR) on corresponding PET sections. RESULTS The prevalence of complicated atherosclerotic plaques (AHA lesion type VI) detected with high-resolution MRI was significantly higher in the carotid artery ipsilateral to the ischaemic stroke as compared to the contralateral side (39 vs 0 %; p = 0.001). For all other AHA lesion types, no significant differences were found between ipsilateral and contralateral sides. In addition, atherosclerotic plaques classified as high-risk lesions with MRI (AHA lesion type VI) were associated with higher (18)F-FDG uptake in comparison with other AHA lesions (TBR = 3.43 ± 1.13 vs 2.41 ± 0.84, respectively; p < 0.001). Furthermore, patients presenting at least one complicated lesion (AHA lesion type VI) with MRI showed significantly higher (18)F-FDG uptake in both carotid arteries (ipsilateral and contralateral to the stroke) in comparison with carotid arteries of patients showing no complicated lesion with MRI (mean TBR = 3.18 ± 1.26 and 2.80 ± 0.94 vs 2.19 ± 0.57, respectively; p < 0.05) in favour of a diffuse inflammatory process along both carotid arteries associated with complicated plaques. CONCLUSION Morphological and biological features of high-risk plaques can be detected with (18)F-FDG PET/MRI in non-stenotic atherosclerotic plaques ipsilateral to the stroke, suggesting a causal role for these plaques in stroke. Combined (18)F-FDG PET/MRI systems might help in the evaluation of patients with ischaemic stroke classified as cryptogenic.
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Affiliation(s)
- Fabien Hyafil
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. .,Department of Nuclear Medicine, Bichat University Hospital, Inserm 1148, DHU FIRE, Assistance Publique - Hôpitaux de Paris, Paris, France.
| | - Andreas Schindler
- Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Munich, Germany
| | - Dominik Sepp
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Tilman Obenhuber
- Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Munich, Germany
| | - Anna Bayer-Karpinska
- Institute for Stroke and Dementia Research, Ludwig Maximilians University Hospital Munich, Munich, Germany
| | - Tobias Boeckh-Behrens
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Sabine Höhn
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Stephan G Nekolla
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, Ludwig Maximilians University Hospital Munich, Munich, Germany
| | - Martin Dichgans
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Markus Schwaiger
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Tobias Saam
- Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Munich, Germany
| | - Holger Poppert
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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21
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Usman A, Sadat U, Patterson AJ, Tang TY, Varty K, Boyle JR, Armon MP, Hayes PD, Graves MJ, Gillard JH. Use of ultrasmall superparamagnetic iron oxide particles for imaging carotid atherosclerosis. Nanomedicine (Lond) 2015; 10:3077-3087. [PMID: 26420349 DOI: 10.2217/nnm.15.136] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Based on the results of histopathological studies, inflammation within atherosclerotic tissue is now widely accepted as a key determinant of the disease process. Conventional imaging methods can highlight the location and degree of luminal stenosis but not the inflammatory activity of the plaque. Iron oxide-based MRI contrast media particularly ultrasmall supermagnetic particles of iron oxide have shown potential in assessing atheromatous plaque inflammation and in determining efficacy of antiatherosclerosis pharmacological treatments. In this paper, we review current data on the use of ultrasmall superparamagnetic iron oxides in atherosclerosis imaging with focus on ferumoxtran-10 and ferumoxytol. The basic chemistry, pharmacokinetics and dynamics, potential applications, limitations and future perspectives of these contrast media nanoparticles are discussed.
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Affiliation(s)
- Ammara Usman
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Box 218, Level 5, Hills Road, Cambridge, CB2 0QQ, UK
| | - Umar Sadat
- Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Andrew J Patterson
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Box 218, Level 5, Hills Road, Cambridge, CB2 0QQ, UK
| | - Tjun Y Tang
- Department of Surgery, Changi General Hospital, Singapore
| | - Kevin Varty
- Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Jonathan R Boyle
- Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Mathew P Armon
- Department of Vascular Surgery, Norfolk & Norwich University Hospital, Norwich, NR4 7UY, UK
| | - Paul D Hayes
- Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Box 218, Level 5, Hills Road, Cambridge, CB2 0QQ, UK
| | - Jonathan H Gillard
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Box 218, Level 5, Hills Road, Cambridge, CB2 0QQ, UK
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Alam SR, Stirrat C, Richards J, Mirsadraee S, Semple SIK, Tse G, Henriksen P, Newby DE. Vascular and plaque imaging with ultrasmall superparamagnetic particles of iron oxide. J Cardiovasc Magn Reson 2015; 17:83. [PMID: 26381872 PMCID: PMC4574723 DOI: 10.1186/s12968-015-0183-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 08/16/2015] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular Magnetic Resonance (CMR) has become a primary tool for non-invasive assessment of cardiovascular anatomy, pathology and function. Existing contrast agents have been utilised for the identification of infarction, fibrosis, perfusion deficits and for angiography. Novel ultrasmall superparamagnetic particles of iron oxide (USPIO) contrast agents that are taken up by inflammatory cells can detect cellular inflammation non-invasively using CMR, potentially aiding the diagnosis of inflammatory medical conditions, guiding their treatment and giving insight into their pathophysiology. In this review we describe the utilization of USPIO as a novel contrast agent in vascular disease.
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Affiliation(s)
- Shirjel R Alam
- Centre for Cardiovascular Science, The University of Edinburgh, The Chancellor's Building, Little France Crescent, Edinburgh, EH16 5SA, UK.
- Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, EH16 5SA, UK.
| | - Colin Stirrat
- Centre for Cardiovascular Science, The University of Edinburgh, The Chancellor's Building, Little France Crescent, Edinburgh, EH16 5SA, UK.
- Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, EH16 5SA, UK.
| | - Jennifer Richards
- Centre for Cardiovascular Science, The University of Edinburgh, The Chancellor's Building, Little France Crescent, Edinburgh, EH16 5SA, UK.
| | - Saeed Mirsadraee
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, EH16 5SA, UK.
- Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, EH16 5SA, UK.
| | - Scott I K Semple
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, EH16 5SA, UK.
| | - George Tse
- MRC Centre for Inflammation Research, The University of Edinburgh, Edinburgh, EH16 5SA, UK.
| | - Peter Henriksen
- Centre for Cardiovascular Science, The University of Edinburgh, The Chancellor's Building, Little France Crescent, Edinburgh, EH16 5SA, UK.
- Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, EH16 5SA, UK.
| | - David E Newby
- Centre for Cardiovascular Science, The University of Edinburgh, The Chancellor's Building, Little France Crescent, Edinburgh, EH16 5SA, UK.
- Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, EH16 5SA, UK.
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Matuszak J, Dörfler P, Zaloga J, Unterweger H, Lyer S, Dietel B, Alexiou C, Cicha I. Shell matters: Magnetic targeting of SPIONs and in vitro effects on endothelial and monocytic cell function. Clin Hemorheol Microcirc 2015; 61:259-77. [DOI: 10.3233/ch-151998] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Jasmin Matuszak
- Section of Experimental Oncology und Nanomedicine (SEON), ENT-Department, Erlangen, Germany
| | - Philipp Dörfler
- Section of Experimental Oncology und Nanomedicine (SEON), ENT-Department, Erlangen, Germany
| | - Jan Zaloga
- Section of Experimental Oncology und Nanomedicine (SEON), ENT-Department, Erlangen, Germany
| | - Harald Unterweger
- Section of Experimental Oncology und Nanomedicine (SEON), ENT-Department, Erlangen, Germany
| | - Stefan Lyer
- Section of Experimental Oncology und Nanomedicine (SEON), ENT-Department, Erlangen, Germany
| | - Barbara Dietel
- Laboratory of Molecular Cardiology, Department of Cardiology and Angiology, University Hospital Erlangen, Germany
| | - Christoph Alexiou
- Section of Experimental Oncology und Nanomedicine (SEON), ENT-Department, Erlangen, Germany
| | - Iwona Cicha
- Section of Experimental Oncology und Nanomedicine (SEON), ENT-Department, Erlangen, Germany
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25
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Iron-based superparamagnetic nanoparticle contrast agents for MRI of infection and inflammation. AJR Am J Roentgenol 2015; 204:W302-13. [PMID: 25714316 DOI: 10.2214/ajr.14.12733] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE. In this article, we summarize the progress to date on the use of superparamagnetic iron oxide nanoparticles (SPIONs) as contrast agents for MRI of inflammatory processes. CONCLUSION. Phagocytosis by macrophages of injected SPIONs results in a prolonged shortening of both T2 and T2* leading to hypointensity of macrophage-infiltrated tissues in contrast-enhanced MR images. SPIONs as contrast agents are therefore useful for the in vivo MRI detection of macrophage infiltration, and there is substantial research and clinical interest in the use of SPION-based contrast agents for MRI of infection and inflammation. This technique has been used to identify active infection in patients with septic arthritis and osteomyelitis; importantly, the MRI signal intensity of the tissue has been found to return to its unenhanced value on successful treatment of the infection. In SPION contrast-enhanced MRI of vascular inflammation, animal studies have shown decreased macrophage uptake in atherosclerotic plaques after treatment with statin drugs. Human studies have shown that both coronary and carotid plaques that take up SPIONs are more prone to rupture and that abdominal aneurysms with increased SPION uptake are more likely to grow. Studies of patients with multiple sclerosis suggest that MRI using SPIONs may have increased sensitivity over gadolinium for plaque detection. Finally, SPIONs have enabled the tracking and imaging of transplanted stem cells in a recipient host.
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Sadat U, Usman A, Howarth SP, Tang TY, Alam F, Graves MJ, Gillard JH. Carotid Artery Stiffness in Patients with Symptomatic Carotid Artery Disease with Contralateral Asymptomatic Carotid Artery Disease and in Patients with Bilateral Asymptomatic Carotid Artery Disease: A Cine Phase-contrast Carotid MR Study. J Stroke Cerebrovasc Dis 2014; 23:743-8. [DOI: 10.1016/j.jstrokecerebrovasdis.2013.06.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 05/27/2013] [Accepted: 06/29/2013] [Indexed: 10/26/2022] Open
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Affiliation(s)
- Farouc A Jaffer
- Massachusetts General Hospital, Harvard Medical School, Cardiovascular Research Center, Boston, Massachusetts, USA
| | - Johan W Verjans
- Massachusetts General Hospital, Harvard Medical School, Cardiovascular Research Center, Boston, Massachusetts, USA Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
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Sadat U, Howarth SPS, Usman A, Tang TY, Graves MJ, Gillard JH. Sequential imaging of asymptomatic carotid atheroma using ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance imaging: a feasibility study. J Stroke Cerebrovasc Dis 2012; 22:e271-6. [PMID: 22841932 DOI: 10.1016/j.jstrokecerebrovasdis.2012.06.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 06/23/2012] [Accepted: 06/26/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Inflammation within atheromatous plaques is a known risk factor for plaque vulnerability. This can be detected in vivo on high-resolution magnetic resonance imaging (MRI) using ultrasmall superparamagnetic iron oxide (USPIO) contrast medium. The purpose of this study was to assess the feasibility of performing sequential USPIO studies over a 1-year period. METHODS Ten patients with moderate asymptomatic carotid stenosis underwent carotid MRI imaging both before and 36 hours after USPIO infusion at 0, 6, and 12 months. Images were manually segmented into quadrants, and the signal change per quadrant was calculated at these time points. A mixed repeated measures statistical model was used to determine signal change attributable to USPIO uptake over time. RESULTS All patients remained asymptomatic during the study. The mixed model revealed no statistical difference in USPIO uptake between the 3 time points. Intraclass correlation coefficients revealed a good agreement of quadrant signal pre-USPIO infusion between 0 and 6 months (0.70) and 0 and 12 months (0.70). Good agreement of quadrant signal after USPIO infusion was shown between 0 and 6 months (0.68) and moderate agreement was shown between 0 and 12 months (0.33). CONCLUSIONS USPIO-enhanced sequential MRI of atheromatous carotid plaques is clinically feasible. This may have important implications for future longitudinal studies involving pharmacologic intervention in large patient cohorts.
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Affiliation(s)
- Umar Sadat
- Department of Radiology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom; Department of Surgery, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom.
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Bogiatzi C, Cocker MS, Beanlands R, Spence JD. Identifying high-risk asymptomatic carotid stenosis. ACTA ACUST UNITED AC 2012; 6:139-51. [DOI: 10.1517/17530059.2012.662954] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Synthetic and natural iron chelators: therapeutic potential and clinical use. Future Med Chem 2011; 1:1643-70. [PMID: 21425984 DOI: 10.4155/fmc.09.121] [Citation(s) in RCA: 161] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Iron-chelation therapy has its origins in the treatment of iron-overload syndromes. For many years, the standard for this purpose has been deferoxamine. Recently, considerable progress has been made in identifying synthetic chelators with improved pharmacologic properties relative to deferoxamine. Most notable are deferasirox (Exjade(®)) and deferiprone (Ferriprox(®)), which are now available clinically. In addition to treatment of iron overload, there is an emerging role for iron chelators in the treatment of diseases characterized by oxidative stress, including cardiovascular disease, atherosclerosis, neurodegenerative diseases and cancer. While iron is not regarded as the underlying cause of these diseases, it does play an important role in disease progression, either through promotion of cellular growth and proliferation or through participation in redox reactions that catalyze the formation of reactive oxygen species and increase oxidative stress. Thus, iron chelators may be of therapeutic benefit in many of these conditions. Phytochemicals, many of which bind iron, may also owe some of their beneficial properties to iron chelation. This review will focus on the advances in iron-chelation therapy for the treatment of iron-overload disease and cancer, as well as neurodegenerative and chronic inflammatory diseases. Established and novel iron chelators will be discussed, as well as the emerging role of dietary plant polyphenols that effectively modulate iron biochemistry.
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Non-invasive assessment of acute vascular inflammation after PCI using USPIO enhanced MRI in vivo. Int J Cardiol 2011; 151:110-2. [PMID: 21715029 DOI: 10.1016/j.ijcard.2011.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 06/05/2011] [Indexed: 11/22/2022]
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32
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James G, Zhou Y, Miller S. Modeling data with structural and temporal correlation using lower level and higher level multilevel models. Pharm Stat 2011; 10:395-406. [PMID: 21956947 DOI: 10.1002/pst.479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Novel imaging techniques are playing an increasingly important role in drug development, providing insight into the mechanism of action of new chemical entities. The data sets obtained by these methods can be large with complex inter-relationships, but the most appropriate statistical analysis for handling this data is often uncertain--precisely because of the exploratory nature of the way the data are collected. We present an example from a clinical trial using magnetic resonance imaging to assess changes in atherosclerotic plaques following treatment with a tool compound with established clinical benefit. We compared two specific approaches to handle the correlations due to physical location and repeated measurements: two-level and four-level multilevel models. The two methods identified similar structural variables, but higher level multilevel models had the advantage of explaining a greater proportion of variation, and the modeling assumptions appeared to be better satisfied.
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Affiliation(s)
- Gareth James
- Applied Statistics, University of Reading, Reading, UK
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Li ZY, Tang TY, Jiang F, Zhang Y, Gillard JH. Reduction in Arterial Wall Strain With Aggressive Lipid-Lowering Therapy in Patients With Carotid Artery Disease. Circ J 2011; 75:1486-92. [DOI: 10.1253/circj.cj-10-1210] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Zhi-Yong Li
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University
- University Department of Radiology, University of Cambridge
| | - Tjun Y Tang
- University Department of Radiology, University of Cambridge
| | - Fan Jiang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University
| | - Yun Zhang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University
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Abstract
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. Current clinical techniques that rely on stenosis measurement alone appear to be insufficient for risk prediction in atherosclerosis patients. Many novel imaging methods have been developed to study atherosclerosis progression and to identify new features that can predict future clinical risk. MRI of atherosclerotic vessel walls is one such method. It has the ability to noninvasively evaluate multiple biomarkers of the disease such as luminal stenosis, plaque burden, tissue composition and plaque activity. In addition, the accuracy of in vivo MRI has been validated against histology with high reproducibility, thus paving the way for application to epidemiological studies of disease pathogenesis and, by serial MRI, in monitoring the efficacy of therapeutic intervention. In this review, we describe the various MR techniques used to evaluate aspects of plaque progression, discuss imaging-based measurements (imaging biomarkers), and also detail their validation. The application of plaque MRI in clinical trials as well as emerging imaging techniques used to evaluate plaque compositional features and biological activities are also discussed.
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Affiliation(s)
- Jinnan Wang
- Clinical Sites Research Program, Philips Research North America, Briarcliff Manor, NY, 10510
- Department of Radiology, University of Washington, Seattle, WA, 98109
| | - Niranjan Balu
- Department of Radiology, University of Washington, Seattle, WA, 98109
| | - Gador Canton
- Department of Radiology, University of Washington, Seattle, WA, 98109
| | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, WA, 98109
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Murkin JM. Panvascular inflammation and mechanisms of injury in perioperative CNS outcomes. Semin Cardiothorac Vasc Anesth 2010; 14:190-5. [PMID: 20656746 DOI: 10.1177/1089253210378177] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this review, the evidence for inflammatory processes as being of fundamental importance in end-organ dysfunction- specifically stroke and neurocognitive impairment in patients undergoing cardiac surgery-will be reviewed. The risk of central nervous system (CNS) impairment following an off-pump cardiac surgery will be contrasted with that of patients undergoing percutaneous coronary intervention (PCI) or medical management, and the role of progression of underlying cerebrovascular disease and, in particular, panvascular inflammation as an accompaniment to unstable angina with attendant risk of stroke will be explored. In addition, the various roles of preoperative comorbidities, aortic atheroma, and the use of selective avoidance of aortic instrumentation as well as carotid endarterectomy as risk modification strategies will be evaluated. Finally, a summary of recommendations for strategies to decrease risk of perioperative CNS impairment will be presented.
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36
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te Boekhorst BC, Bovens SM, Nederhoff MG, van de Kolk KW, Cramer MJ, van Oosterhout MF, ten Hove M, Doevendans PA, Pasterkamp G, van Echteld CJ. Negative MR contrast caused by USPIO uptake in lymph nodes may lead to false positive observations with in vivo visualization of murine atherosclerotic plaque. Atherosclerosis 2010; 210:122-9. [DOI: 10.1016/j.atherosclerosis.2009.10.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Revised: 10/17/2009] [Accepted: 10/22/2009] [Indexed: 10/20/2022]
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Recent developments and new perspectives on imaging of atherosclerotic plaque: role of anatomical, cellular and molecular MRI part III. Int J Cardiovasc Imaging 2010; 26:447-57. [PMID: 20058083 DOI: 10.1007/s10554-009-9566-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Accepted: 12/17/2009] [Indexed: 10/20/2022]
Abstract
Atherosclerotic plaque disruption accounts for the major part of cardiovascular mortality and the risk of disruption appears to depend on plaque composition. Carotid plaques in patients, scheduled for endarterectomy, have been successfully characterised with MRI. MRI has the advantage of combining information about morphology and function. Unfortunately, the tortuosity and size of the coronary arteries, and the respiratory and cardiac motion hinder the in vivo characterisation of human coronary plaque. In addition to plaque composition several molecular markers of the different processes involved in atherosclerosis, such as integrins, matrix metalloproteinases and fibrin seem to correlate with risk of plaque rupture and clinical outcome. These molecular markers can be targeted with antibodies coupled to carriers, which are loaded with gadolinium for detection (molecular MRI). Several cellular/molecular MRI studies in animal models and some in human patients have been conducted with varying levels of success. The advent of clinical high field magnets, the development of contrast agent carriers with high relaxivity and the development of relatively new MR contrast techniques appear to be promising in the field of plaque imaging. Future MRI studies will have to focus on the molecular target of the atherosclerotic process, which has the highest prognostic value with regard to acute coronary syndromes and on the most suitable contrast agent to visualize that target.
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Tang TY, Muller KH, Graves MJ, Li ZY, Walsh SR, Young V, Sadat U, Howarth SP, Gillard J. Iron Oxide Particles for Atheroma Imaging. Arterioscler Thromb Vasc Biol 2009; 29:1001-8. [DOI: 10.1161/atvbaha.108.165514] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tjun Y. Tang
- From the University Department of Radiology (T.Y.T., M.J.G., Z.Y.L., V.Y., U.S., S.P.S.H., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, UK; the Cambridge Vascular Unit (T.Y.T., S.R.W.), Cambridge University Hospitals NHS Foundation Trust, UK; and the Multi-Imaging Centre (K.H.M.), University of Cambridge, UK
| | - Karin H. Muller
- From the University Department of Radiology (T.Y.T., M.J.G., Z.Y.L., V.Y., U.S., S.P.S.H., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, UK; the Cambridge Vascular Unit (T.Y.T., S.R.W.), Cambridge University Hospitals NHS Foundation Trust, UK; and the Multi-Imaging Centre (K.H.M.), University of Cambridge, UK
| | - Martin J. Graves
- From the University Department of Radiology (T.Y.T., M.J.G., Z.Y.L., V.Y., U.S., S.P.S.H., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, UK; the Cambridge Vascular Unit (T.Y.T., S.R.W.), Cambridge University Hospitals NHS Foundation Trust, UK; and the Multi-Imaging Centre (K.H.M.), University of Cambridge, UK
| | - Zhi Y. Li
- From the University Department of Radiology (T.Y.T., M.J.G., Z.Y.L., V.Y., U.S., S.P.S.H., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, UK; the Cambridge Vascular Unit (T.Y.T., S.R.W.), Cambridge University Hospitals NHS Foundation Trust, UK; and the Multi-Imaging Centre (K.H.M.), University of Cambridge, UK
| | - Stewart R. Walsh
- From the University Department of Radiology (T.Y.T., M.J.G., Z.Y.L., V.Y., U.S., S.P.S.H., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, UK; the Cambridge Vascular Unit (T.Y.T., S.R.W.), Cambridge University Hospitals NHS Foundation Trust, UK; and the Multi-Imaging Centre (K.H.M.), University of Cambridge, UK
| | - Victoria Young
- From the University Department of Radiology (T.Y.T., M.J.G., Z.Y.L., V.Y., U.S., S.P.S.H., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, UK; the Cambridge Vascular Unit (T.Y.T., S.R.W.), Cambridge University Hospitals NHS Foundation Trust, UK; and the Multi-Imaging Centre (K.H.M.), University of Cambridge, UK
| | - Umar Sadat
- From the University Department of Radiology (T.Y.T., M.J.G., Z.Y.L., V.Y., U.S., S.P.S.H., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, UK; the Cambridge Vascular Unit (T.Y.T., S.R.W.), Cambridge University Hospitals NHS Foundation Trust, UK; and the Multi-Imaging Centre (K.H.M.), University of Cambridge, UK
| | - Simon P.S. Howarth
- From the University Department of Radiology (T.Y.T., M.J.G., Z.Y.L., V.Y., U.S., S.P.S.H., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, UK; the Cambridge Vascular Unit (T.Y.T., S.R.W.), Cambridge University Hospitals NHS Foundation Trust, UK; and the Multi-Imaging Centre (K.H.M.), University of Cambridge, UK
| | - J.H. Gillard
- From the University Department of Radiology (T.Y.T., M.J.G., Z.Y.L., V.Y., U.S., S.P.S.H., J.H.G.), Cambridge University Hospitals NHS Foundation Trust, UK; the Cambridge Vascular Unit (T.Y.T., S.R.W.), Cambridge University Hospitals NHS Foundation Trust, UK; and the Multi-Imaging Centre (K.H.M.), University of Cambridge, UK
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Temporal dependence of in vivo USPIO-enhanced MRI signal changes in human carotid atheromatous plaques. Neuroradiology 2009; 51:457-65. [DOI: 10.1007/s00234-009-0523-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Accepted: 03/09/2009] [Indexed: 10/21/2022]
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