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Guagliano G, Volpini C, Sardelli L, Briatico Vangosa F, Visai L, Petrini P. Bioinspired Bioinks for the Fabrication of Chemomechanically Relevant Standalone Disease Models of Hepatic Steatosis. Adv Healthc Mater 2024; 13:e2303349. [PMID: 38323754 DOI: 10.1002/adhm.202303349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/17/2024] [Indexed: 02/08/2024]
Abstract
Hepatotoxicity-related issues are poorly predicted during preclinical experimentation, as its relevance is limited by the inadequacy to screen all the non-physiological subclasses of the population. These pitfalls can be solved by implementing complex in vitro models of hepatic physiology and pathologies in the preclinical phase. To produce these platforms, extrusion-based bioprinting is focused on, since it allows to manufacture tridimensional cell-laden constructs with controlled geometries, in a high-throughput manner. Different bioinks, whose formulation is tailored to mimic the chemomechanical environment of hepatic steatosis, the most prevalent hepatic disorder worldwide, are proposed. Internally crosslinked alginate hydrogels are chosen as structural components of the inks. Their viscoelastic properties (G' = 512-730 Pa and G″ = 94-276 Pa, depending on frequency) are tuned to mimic those of steatotic liver tissue. Porcine hepatic ECM is introduced as a relevant biochemical cue. Sodium oleate is added to recall the accumulation of lipids in the tissue. Downstream analyses on 14-layered bioprinted structures cultured for 10 days reveal the establishment of steatotic-like features (intracellular lipid vesicles, viability decrease up to ≈50%) without needing external conditionings. The presented bioinks are thus suitable to fabricate complex models of hepatic steatosis to be implemented in a high-throughput experimental frame.
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Affiliation(s)
- Giuseppe Guagliano
- Department of Chemistry, Materials, and Chemical Engineering "G. Natta", Politecnico di Milano, P.zza L. Da Vinci 32, Milan, 20133, Italy
| | - Cristina Volpini
- Molecular Medicine Department (DMM), Center for Health Technologies (CHT), UdR INSTM, University of Pavia, Pavia, 65-27100, Italy
- Medicina Clinica-Specialistica, UOR5 Laboratorio Di Nanotecnologie, ICS Maugeri, IRCCS, Pavia, Via Boezio, Pavia, 28-27100, Italy
| | - Lorenzo Sardelli
- Department of Chemistry, Materials, and Chemical Engineering "G. Natta", Politecnico di Milano, P.zza L. Da Vinci 32, Milan, 20133, Italy
| | - Francesco Briatico Vangosa
- Department of Chemistry, Materials, and Chemical Engineering "G. Natta", Politecnico di Milano, P.zza L. Da Vinci 32, Milan, 20133, Italy
| | - Livia Visai
- Molecular Medicine Department (DMM), Center for Health Technologies (CHT), UdR INSTM, University of Pavia, Pavia, 65-27100, Italy
- Medicina Clinica-Specialistica, UOR5 Laboratorio Di Nanotecnologie, ICS Maugeri, IRCCS, Pavia, Via Boezio, Pavia, 28-27100, Italy
- Interuniversity Center for the promotion of the 3Rs principles in teaching and research (Centro 3R), Università di Pavia Unit, Pavia, 5-27100, Italy
| | - Paola Petrini
- Department of Chemistry, Materials, and Chemical Engineering "G. Natta", Politecnico di Milano, P.zza L. Da Vinci 32, Milan, 20133, Italy
- Interuniversity Center for the promotion of the 3Rs principles in teaching and research (Centro 3R), Politecnico di Milano Unit, Milano, 32-20133, Italy
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Lemine AS, Ahmad Z, Al-Thani NJ, Hasan A, Bhadra J. Mechanical properties of human hepatic tissues to develop liver-mimicking phantoms for medical applications. Biomech Model Mechanobiol 2024; 23:373-396. [PMID: 38072897 PMCID: PMC10963485 DOI: 10.1007/s10237-023-01785-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/17/2023] [Indexed: 03/26/2024]
Abstract
Using liver phantoms for mimicking human tissue in clinical training, disease diagnosis, and treatment planning is a common practice. The fabrication material of the liver phantom should exhibit mechanical properties similar to those of the real liver organ in the human body. This tissue-equivalent material is essential for qualitative and quantitative investigation of the liver mechanisms in producing nutrients, excretion of waste metabolites, and tissue deformity at mechanical stimulus. This paper reviews the mechanical properties of human hepatic tissues to develop liver-mimicking phantoms. These properties include viscosity, elasticity, acoustic impedance, sound speed, and attenuation. The advantages and disadvantages of the most common fabrication materials for developing liver tissue-mimicking phantoms are also highlighted. Such phantoms will give a better insight into the real tissue damage during the disease progression and preservation for transplantation. The liver tissue-mimicking phantom will raise the quality assurance of patient diagnostic and treatment precision and offer a definitive clinical trial data collection.
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Affiliation(s)
- Aicha S Lemine
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar
- Qatar University Young Scientists Center (QUYSC), Qatar University, 2713, Doha, Qatar
| | - Zubair Ahmad
- Qatar University Young Scientists Center (QUYSC), Qatar University, 2713, Doha, Qatar
- Center for Advanced Materials (CAM), Qatar University, PO Box 2713, Doha, Qatar
| | - Noora J Al-Thani
- Qatar University Young Scientists Center (QUYSC), Qatar University, 2713, Doha, Qatar
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar
| | - Jolly Bhadra
- Qatar University Young Scientists Center (QUYSC), Qatar University, 2713, Doha, Qatar.
- Center for Advanced Materials (CAM), Qatar University, PO Box 2713, Doha, Qatar.
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Ali MA, El-Abd E, Morsi M, El Safwany MM, El-Sayed MZ. The effect of hepatic steatosis on 18F-FDG uptake in PET-CT examinations of cancer Egyptian patients. Eur J Hybrid Imaging 2023; 7:19. [PMID: 37840056 PMCID: PMC10577118 DOI: 10.1186/s41824-023-00173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/24/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Hepatic steatosis is the most common chronic hepatic disease. Imaging diagnosis of hepatic steatosis has been evaluated as an alternative to invasive histological diagnosis. STUDY AIMS The study aimed to assess the effect of hepatic steatosis on Flourine-18 fluorodeoxyglucose (18F-FDG) uptakes in cancer patients. PATIENTS AND METHODS Blood samples were collected from 50 cancer patients and analyzed to calculate fatty liver index and Hepatic steatosis index (HIS). Hepatic steatosis examined using high-resolution ultrasound and positron emission tomography-computed tomography (PET-CT). Linear attenuation coefficient, standardized-uptake value (SUV) mean (SUV mean), and SUV maximum (SUVmax) were measured. Accordingly, patients were divided equally into non-fatty liver, and fatty liver groups. RESULTS A significant increase in SUVmax and SUV mean was observed in the fatty liver group more than in the non-fatty liver group. HSI significantly increased in the fatty liver group compared to the non-fatty liver group. Liver tissue uptake FDG was significantly correlated with HSI values. SUV max significantly correlated with body mass index (BMI) in the non-fatty group only. CONCLUSION Hepatic changes in cancer patients affect the liver metabolic activity and thus the 18 F-FDG uptake. Therefore, further corrections should be considered when the liver is used as a comparator for PET-CT scans of cancer patients.
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Affiliation(s)
- Magdi A Ali
- Faculty of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates.
| | - Eman El-Abd
- Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Mohamed Morsi
- Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Mohamed M El Safwany
- Faculty of Applied Health Science Technology, Pharos University in Alexandria, Alexandria, Egypt
| | - Mohamed Z El-Sayed
- Faculty of Applied Health Science Technology, Pharos University in Alexandria, Alexandria, Egypt
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Platz Batista da Silva N, Scharf G, Lürken L, Verloh N, Schleder S, Stroszczynski C, Jung EM, Haimerl M. Different Ultrasound Shear Wave Elastography Techniques as Novel Imaging-Based Approaches for Quantitative Evaluation of Hepatic Steatosis-Preliminary Findings. Tomography 2023; 9:681-692. [PMID: 36961013 PMCID: PMC10037607 DOI: 10.3390/tomography9020054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Modern ultrasound (US) shear-wave dispersion (SWD) and attenuation imaging (ATI) can be used to quantify changes in the viscosity and signal attenuation of the liver parenchyma, which are altered in hepatic steatosis. We aimed to evaluate modern shear-wave elastography (SWE), SWD and ATI for the assessment of hepatic steatosis. METHODS We retrospectively analyzed the US data of 15 patients who underwent liver USs and MRIs for the evaluation of parenchymal disease/liver lesions. The USs were performed using a multifrequency convex probe (1-8 MHz). The quantitative US measurements for the SWE (m/s/kPa), the SWD (kPa-m/s/kHz) and the ATI (dB/cm/MHz) were acquired after the mean value of five regions of interest (ROIs) was calculated. The liver MRI (3T) quantification of hepatic steatosis was performed by acquiring proton density fat fraction (PDFF) mapping sequences and placing five ROIs in artifact-free areas of the PDFF scan, measuring the fat-signal fraction. We correlated the SWE, SWD and ATI measurements to the PDFF results. RESULTS Three patients showed mild steatosis, one showed moderate steatosis and eleven showed no steatosis in the PDFF sequences. The calculated SWE cut-off (2.5 m/s, 20.4 kPa) value identified 3/4 of patients correctly (AUC = 0.73, p > 0.05). The SWD cut-off of 18.5 m/s/kHz, which had a significant correlation (r = 0.55, p = 0.034) with the PDFF results (AUC = 0.73), identified four patients correctly (p < 0.001). The ideal ATI (AUC = 0.53 (p < 0.05)) cut-off was 0.59 dB/cm/MHz, which showed a significantly good correlation with the PDFF results (p = 0.024). CONCLUSION Hepatic steatosis can be accurately detected using all the US-elastography techniques applied in this study, although the SWD and the SWE showed to be more sensitive than the PDFF.
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Affiliation(s)
| | - Gregor Scharf
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Lukas Lürken
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Niklas Verloh
- Department of Diagnostic and Interventional Radiology, Medical Center University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
| | - Stephan Schleder
- Department of Diagnostic and Interventional Radiology, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany
| | - Christian Stroszczynski
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Ernst Michael Jung
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Michael Haimerl
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
- Department of Diagnostic and Interventional Radiology, Hospital Wuerzburg Mitte, 97074 Wuerzburg, Germany
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Sif Julie F, Torben Strøm H, Mette P, Hans G, Jens Vinge N. Dynamic viscoelastic properties of porcine gastric tissue: Effects of loading frequency, region and direction. J Biomech 2022; 143:111302. [PMID: 36126503 DOI: 10.1016/j.jbiomech.2022.111302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/18/2022] [Accepted: 09/09/2022] [Indexed: 12/30/2022]
Abstract
The gastric biomechanics influences digestive function as well as a range of topics of medical and scientific interests such as interaction between the stomach and gastric devices. Hence, the mechanical properties are essential for understanding gastric tissue and function in health and disease, and for the development of diagnostic or therapeutic devices. A key characteristic to be characterized is the time dependent mechanical tissue properties. The aim of this study was to characterize viscoelastic properties of the stomach across a frequency range. Longitudinal and circumferential stomach samples from the porcine fundus, corpus and antrum were pre-stretched 10 % and sinusoidally loaded with 10 % dynamic strain. The viscoelastic properties were assessed from 0.01 - 15 Hz using dynamic mechanical analysis. The storage moduli, loss moduli and tan δ had a significant second-order polynomial trend with increasing frequency. For the loss moduli, significant differences were observed between 0.01 and 15 Hz and between 0.05 and 15 Hz (p = 0.023 to 0.041). Significant differences were not found for storage moduli. Tan δ was frequency-independent, indicating that the two moduli varied proportionally. Fundus had significantly smaller storage moduli for longitudinal samples compared to corpus (p = 0.034) and antrum (p = 0.014) but was not significantly different for circumferential samples. Analysis of direction-dependency showed significant differences between longitudinal and circumferential samples (p = 0.002 to 0.042). The presented work provides insight into tensile viscoelastic properties of gastric tissue, which is useful for developing biomaterials, devices and computational models for device development specification calibrations.
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Affiliation(s)
- Friis Sif Julie
- Department of Biological and Chemical Engineering, Aarhus University, Aarhus, Denmark; Alternative Delivery Technologies, Device & Delivery Solutions, Novo Nordisk A/S, Hilleroed, Denmark
| | | | - Poulsen Mette
- Alternative Delivery Technologies, Device & Delivery Solutions, Novo Nordisk A/S, Hilleroed, Denmark
| | - Gregersen Hans
- California Medical Innovations Institute, San Diego, CA, United States
| | - Nygaard Jens Vinge
- Department of Biological and Chemical Engineering, Aarhus University, Aarhus, Denmark.
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Li N, Zhang X, Zhou J, Li W, Shu X, Wu Y, Long M. Multiscale biomechanics and mechanotransduction from liver fibrosis to cancer. Adv Drug Deliv Rev 2022; 188:114448. [PMID: 35820602 DOI: 10.1016/j.addr.2022.114448] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/08/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023]
Abstract
A growing body of multiscale biomechanical studies has been proposed to highlight the mechanical cues in the development of hepatic fibrosis and cancer. At the cellular level, changes in mechanical microenvironment induce phenotypic and functional alterations of hepatic cells, initiating a positive feedback loop that promotes liver fibrogenesis and hepatocarcinogenesis. Tumor mechanical microenvironment of hepatocellular carcinoma facilitates tumor cell growth and metastasis, and hinders the drug delivery and immunotherapy. At the molecular level, mechanical forces are sensed and transmitted into hepatic cells via allosteric activation of mechanoreceptors on the cell membrane, leading to the activation of various mechanotransduction pathways including integrin and YAP signaling and then regulating cell function. Thus, the application of mechanomedicine concept in the treatment of liver diseases is promising for rational design and cell-specific delivery of therapeutic drugs. This review mainly discusses the correlation between biomechanical cues and liver diseases from the viewpoint of mechanobiology.
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Affiliation(s)
- Ning Li
- Center for Biomechanics and Bioengineering, Key Laboratory of Microgravity (National Microgravity Laboratory), and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China; School of Engineering Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiaoyu Zhang
- Center for Biomechanics and Bioengineering, Key Laboratory of Microgravity (National Microgravity Laboratory), and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China; School of Engineering Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jin Zhou
- Center for Biomechanics and Bioengineering, Key Laboratory of Microgravity (National Microgravity Laboratory), and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China
| | - Wang Li
- Center for Biomechanics and Bioengineering, Key Laboratory of Microgravity (National Microgravity Laboratory), and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China; School of Engineering Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xinyu Shu
- Center for Biomechanics and Bioengineering, Key Laboratory of Microgravity (National Microgravity Laboratory), and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China; School of Engineering Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yi Wu
- Center for Biomechanics and Bioengineering, Key Laboratory of Microgravity (National Microgravity Laboratory), and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China; School of Engineering Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Mian Long
- Center for Biomechanics and Bioengineering, Key Laboratory of Microgravity (National Microgravity Laboratory), and Beijing Key Laboratory of Engineered Construction and Mechanobiology, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China; School of Engineering Sciences, University of Chinese Academy of Sciences, Beijing 100049, China.
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Zhang C, Meng S, Li C, Yang Z, Wang G, Wang X, Ma Y. Primary Broiler Hepatocytes for Establishment of a Steatosis Model. Vet Sci 2022; 9:vetsci9070316. [PMID: 35878333 PMCID: PMC9319065 DOI: 10.3390/vetsci9070316] [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: 05/07/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/19/2022] Open
Abstract
Fatty liver hemorrhage syndrome (FLHS) in chickens is characterized by steatosis and bleeding in the liver, which has caused huge losses to the poultry industry. This study aimed to use primary cultured broiler hepatocytes to establish a steatosis model to explore the optimal conditions for inducing steatosis by incubating the cells with a fat emulsion. Primary hepatocytes were isolated from an AA broiler by a modified two-step in situ perfusion method. Hepatocytes were divided into an untreated control group and a fat emulsion group that was incubated with 2.5, 5, 10, or 20% fat emulsion for different times to determine the optimal conditions for inducing steatosis of primary hepatocytes. Incubation of the cells with 10% fat emulsion resulted in cell viability at 48 h of 67%, which was higher than the control group and met the requirements of the model. In the second experiment, steatosis was induced by incubating hepatocytes with 10% fat emulsion for 48 h. In consequence, the apoptosis rate decreased (p > 0.05) and the concentration of ALT (p < 0.001), AST (p < 0.01), and TG (p < 0.05) increased significantly; the expression level of SREBP-1c (p < 0.05) increased, and the expression levels of PPARα (p < 0.001), CPT1 (p < 0.001), and CPT2 (p < 0.05) were lower in the fat emulsion group than in the control group. In conclusion, the induction condition was selected as 10% fat emulsion incubation for 48 h, and we successfully established a fatty liver degeneration model for broilers.
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Wiwatsamphan P, Chirachanchai S. Persistently Reversible pH-/Thermo-responsive Chitosan/Poly (N-isopropyl acrylamide) Hydrogel through Clickable Crosslinked Interpenetrating Network. Polym Degrad Stab 2022. [DOI: 10.1016/j.polymdegradstab.2022.109874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Aryeetey OJ, Frank M, Lorenz A, Estermann SJ, Reisinger AG, Pahr DH. A parameter reduced adaptive quasi-linear viscoelastic model for soft biological tissue in uniaxial tension. J Mech Behav Biomed Mater 2022; 126:104999. [PMID: 34999491 DOI: 10.1016/j.jmbbm.2021.104999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/04/2021] [Accepted: 11/24/2021] [Indexed: 11/15/2022]
Abstract
Mechanical characterisation of soft viscous materials is essential for many applications including aerospace industries, material models for surgical simulation, and tissue mimicking materials for anatomical models. Constitutive material models are, therefore, necessary to describe soft biological tissues in physiologically relevant strain ranges. Hereby, the adaptive quasi-linear viscoelastic (AQLV) model enables accurate modelling of the strain-dependent non-linear viscoelastic behaviour of soft tissues with a high flexibility. However, the higher flexibility produces a large number of model parameters. In this study, porcine muscle and liver tissue samples were modelled in the framework of the originally published AQLV (3-layers of Maxwell elements) model using four incremental ramp-hold experiments in uniaxial tension. AQLV model parameters were reduced by decreasing model layers (M) as well as the number of experimental ramp-hold steps (N). Leave One out cross validation tests show that the original AQLV model (3M4N) with 19 parameters, accurately describes porcine muscle tissue with an average R2 of 0.90 and porcine liver tissue, R2 of 0.86. Reducing the number of layers (N) in the model produced acceptable model fits for 1-layer (R2 of 0.83) and 2-layer models (R2 of 0.89) for porcine muscle tissue and 1-layer (R2 of 0.84) and 2-layer model (R2 of 0.85) for porcine liver tissue. Additionally, a 2 step (2N) ramp-hold experiment was performed on additional samples of porcine muscle tissue only to further reduce model parameters. Calibrated spring constant values for 2N ramp-hold tests parameters k1 and k2 had a 16.8% and 38.0% deviation from those calibrated for a 4 step (4N) ramp hold experiment. This enables further reduction of material parameters by means of step reduction, effectively reducing the number of parameters required to calibrate the AQLV model from 19 for a 3M4N model to 8 for a 2M2N model, with the added advantage of reducing the time per experiment by 50%. This study proposes a 'reduced-parameter' AQLV model (2M2N) for the modelling of soft biological tissues at finite strain ranges. Sequentially, the comparison of model parameters of soft tissues is easier and the experimental burden is reduced.
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Affiliation(s)
- Othniel J Aryeetey
- TU Wien, Institute of Lightweight Design and Structural Biomechanics, Gumpendorfer Straße 7, 1060, Vienna, Austria; Karl Landsteiner University of Health Sciences, Department of Anatomy and Biomechanics, Division Biomechanics, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Martin Frank
- Karl Landsteiner University of Health Sciences, Department of Anatomy and Biomechanics, Division Biomechanics, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Andrea Lorenz
- Austrian Center for Medical Innovation & Technology (ACMIT), Viktor Kaplan-Straße 2/1, 2700, Wiener Neustadt, Austria
| | - Sarah-Jane Estermann
- TU Wien, Institute of Lightweight Design and Structural Biomechanics, Gumpendorfer Straße 7, 1060, Vienna, Austria; Karl Landsteiner University of Health Sciences, Department of Anatomy and Biomechanics, Division Biomechanics, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria; Austrian Center for Medical Innovation & Technology (ACMIT), Viktor Kaplan-Straße 2/1, 2700, Wiener Neustadt, Austria
| | - Andreas G Reisinger
- TU Wien, Institute of Lightweight Design and Structural Biomechanics, Gumpendorfer Straße 7, 1060, Vienna, Austria; Karl Landsteiner University of Health Sciences, Department of Anatomy and Biomechanics, Division Biomechanics, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Dieter H Pahr
- TU Wien, Institute of Lightweight Design and Structural Biomechanics, Gumpendorfer Straße 7, 1060, Vienna, Austria; Karl Landsteiner University of Health Sciences, Department of Anatomy and Biomechanics, Division Biomechanics, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria.
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Zhao L, Lin H, Hu Y, Chen X, Chen S, Zhang X. Corneal Lamb wave imaging for quantitative assessment of collagen cross-linking treatment based on comb-push ultrasound shear elastography. ULTRASONICS 2021; 116:106478. [PMID: 34174743 DOI: 10.1016/j.ultras.2021.106478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/03/2021] [Accepted: 05/24/2021] [Indexed: 06/13/2023]
Abstract
Keratoconus, a serious corneal disorder, often causes highly irregular astigmatism and different degrees of visual impairment. Riboflavin/UVA corneal collagen cross-linking(CXL) is currently approved for effective treatment of keratoconus by enhancing the mechanical strength of collagen fibers in the cornea. However, few methods are capable of quantitatively and non-destructively assessing the mechanical properties of the cornea before and after CXL treatments. This study developed a corneal viscoelasticity imaging method based on comb-push ultrasound shear elastography (CUSE) and implemented this method on a Verasonics™ Vantage 256 ultrasound open system with a high-frequency linear array ultrasound transducer. Push beams were generated by three teeth each consisting of 10 elements (working frequency = 10.41 MHz) for inducing Lamb wave propagation in the cornea, and then the system immediately switched to the plane wave imaging mode using 60 elements in the middle (working frequency = 18 MHz). This method can provide a high-resolution 2D Lamb wave velocity image overlapping with a B-mode image as well as quantitative viscoelasticity estimation according to experimentally obtained phase velocity dispersion of Lamb waves. The validation experiments were performed on ex vivo porcine corneas, and the accuracy of elasticity estimation was verified by a tensile test. The results showed that the shear elasticity increased and the viscosity decreased after CXL treatment. The shear elasticity results (reported as mean ± standard deviation) of one control group with no CXL treatment and three CXL-treated groups named as 10 min, 30 min, and 60 min groups according to UV irradiation time were 14.62 ± 3.38 kPa, 49.47 ± 3.63 kPa, 116.54 ± 23.99 kPa, and 197.89 ± 39.64 kPa, respectively, which was in agreement with the results of tensile tests. The ultrasound safety measurement indicated that this method could have acceptable safety, but further to ocular tissue and vision function. The study demonstrated the possibility of using a commercial ultrasound system to obtain high-resolution images of corneal mechanical properties as well as the ability to quantify changes induced by CXL treatment. Therefore, the proposed method could serve as a helpful tool in the studies related in corneal biomechanics.
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Affiliation(s)
- Linfeng Zhao
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China; Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Haoming Lin
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China; Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Yaxin Hu
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China; Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Xin Chen
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China; Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Siping Chen
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China; Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China
| | - Xinyu Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen, China; Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, China.
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Pi Z, Wang M, Lin H, Guo Y, Chen S, Diao X, Xia H, Liu G, Zeng J, Zhang X, Chen X. Viscoelasticity measured by shear wave elastography in a rat model of nonalcoholic fatty liver disease: comparison with dynamic mechanical analysis. Biomed Eng Online 2021; 20:45. [PMID: 33941179 PMCID: PMC8091696 DOI: 10.1186/s12938-021-00879-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 04/20/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is rapidly becoming one of the most common liver diseases. Ultrasound elastography has been used for the diagnosis of NAFLD. However, clinical research on steatosis by elastography technology has mainly focused on steatosis with fibrosis or non-alcoholic steatohepatitis (NASH), while steatosis without fibrosis has been poorly studied. Moreover, the relationship between liver viscoelasticity and steatosis grade is not clear. In this study, we evaluated the degree of liver steatosis in a simple steatosis rat model using shear wave elastography (SWE). RESULTS The viscoelasticity values of 69 rats with hepatic steatosis were measured quantitatively by SWE in vivo and validated by a dynamic mechanical analysis (DMA) test. Pathological sections were used to determine the steatosis grade for each rat. The results showed that the elasticity values µ obtained by the two methods followed the same trend, and µ is significantly correlated with liver steatosis. The Pearson's correlation coefficients indicate that [Formula: see text] obtained by SWE is positively linear correlated with DMA (r = 0.628, p = 7.85 × 10-9). However, the viscosity values [Formula: see text] obtained by SWE were relatively independent of those obtained by DMA with a correlation coefficient of - 0.01. The combined Voigt elasticity measurements have high validity in the prediction of steatosis (S0 vs. S1-S4), with an AUROC of 0.755 (95% CI 0.6175-0.8925, p < 0.01) and the optimal cutoff value was 2.08 kPa with a sensitivity of 78% and specificity of 63%. CONCLUSION SWE might have the feasibility to be introduced as an auxiliary technique for NAFLD patients in clinical settings. However, the viscosity results measured by SWE and DMA are significantly different, because the two methods work in different frequency bands.
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Affiliation(s)
- Zhaoke Pi
- School of Biomedical Engineering, Health Science Center, Shenzhen University, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, 518000, China
| | - Mengke Wang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, 518000, China
| | - Haoming Lin
- School of Biomedical Engineering, Health Science Center, Shenzhen University, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, 518000, China
| | - Yanrong Guo
- School of Biomedical Engineering, Health Science Center, Shenzhen University, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, 518000, China
| | - Siping Chen
- School of Biomedical Engineering, Health Science Center, Shenzhen University, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, 518000, China
| | - Xianfen Diao
- School of Biomedical Engineering, Health Science Center, Shenzhen University, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, 518000, China
| | - Hui Xia
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, 100000, China
| | - Guoqiang Liu
- Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, 100000, China
| | - Jie Zeng
- Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510000, China
| | - Xinyu Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, 518000, China.
| | - Xin Chen
- School of Biomedical Engineering, Health Science Center, Shenzhen University, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen, 518000, China.
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12
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How does liver steatosis affect diagnostic performance of 2D-SWE.SSI: assessment from aspects of steatosis degree and pathological types. Eur Radiol 2020; 31:3207-3215. [PMID: 33119813 DOI: 10.1007/s00330-020-07288-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/11/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Two-dimensional shear wave elastography performed by SurperSonics (2D-SWE.SSI) performs well in evaluating liver fibrosis. Steatosis is one of confounding factors which might decrease accuracy, and its effect on 2D-SWE.SSI is still controversial. Our purpose is to evaluate the diagnostic performance of 2D-SWE.SSI affected by different steatosis stages and pathological types in chronic hepatitis B (CHB) patients. METHODS 2D-SWE.SSI was performed on 1306 CHB patients. All patients were divided into mild steatosis, moderate to severe steatosis, and non-steatosis groups. Subgroup analysis was performed according to pathological type. Liver biopsy was reference standard. Propensity score matching was performed to adjust for differences in patient characteristics. The median values of different steatosis group were compared by non-parametric tests before and after propensity score matching. The area under the receiver operating characteristic curve (AUC) was analyzed to assess the diagnostic performance in different steatosis groups. RESULTS The median values were not significantly different in different steatosis degrees expected in F0-1 patients. The AUC of 2D-SWE.SSI was not affected by different stages of liver steatosis for cirrhosis (= F4) (0.896, 0.853, 0.929, p = 0.34). The high AUCs (0.847, 0.856) were achieved in the non-steatosis and mild steatosis groups, and all were significantly higher than those of the moderate to severe steatosis group for ≥ F2. Moreover, the panacinar type had the best AUC (0.980 for F4 and 0.930 for ≥ F2). CONCLUSION In conclusion, moderate to severe steatosis affects 2D-SWE.SSI in CHB patients. These patients had high LSM values in patients with F0-1 and lower accuracy in ≥ F2. Patients with panacinar steatosis have the highest overall diagnostic performance. KEY POINTS • 2D-SWE.SSI was widely used in evaluating liver fibrosis and it has many confounding factors. Steatosis is one of the confounding factors and its effect on 2D-SWE.SSI was controversial. • Our study based on 1306 CHB patients with liver biopsy found that 2D-SWE.SSI might be affected by moderate to severe liver steatosis in diagnostically significant fibrosis (≥ F2) of CHB patients. • Patients with steatosis of the panacinar type have the highest overall diagnostic performance.
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13
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Huber AK, Patel N, Pagani CA, Marini S, Padmanabhan KR, Matera DL, Said M, Hwang C, Hsu GCY, Poli AA, Strong AL, Visser ND, Greenstein JA, Nelson R, Li S, Longaker MT, Tang Y, Weiss SJ, Baker BM, James AW, Levi B. Immobilization after injury alters extracellular matrix and stem cell fate. J Clin Invest 2020; 130:5444-5460. [PMID: 32673290 PMCID: PMC7524473 DOI: 10.1172/jci136142] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 07/09/2020] [Indexed: 11/17/2022] Open
Abstract
Cells sense the extracellular environment and mechanical stimuli and translate these signals into intracellular responses through mechanotransduction, which alters cell maintenance, proliferation, and differentiation. Here we use a mouse model of trauma-induced heterotopic ossification (HO) to examine how cell-extrinsic forces impact mesenchymal progenitor cell (MPC) fate. After injury, single-cell (sc) RNA sequencing of the injury site reveals an early increase in MPC genes associated with pathways of cell adhesion and ECM-receptor interactions, and MPC trajectories to cartilage and bone. Immunostaining uncovers active mechanotransduction after injury with increased focal adhesion kinase signaling and nuclear translocation of transcriptional coactivator TAZ, inhibition of which mitigates HO. Similarly, joint immobilization decreases mechanotransductive signaling, and completely inhibits HO. Joint immobilization decreases collagen alignment and increases adipogenesis. Further, scRNA sequencing of the HO site after injury with or without immobilization identifies gene signatures in mobile MPCs correlating with osteogenesis, and signatures from immobile MPCs with adipogenesis. scATAC-seq in these same MPCs confirm that in mobile MPCs, chromatin regions around osteogenic genes are open, whereas in immobile MPCs, regions around adipogenic genes are open. Together these data suggest that joint immobilization after injury results in decreased ECM alignment, altered MPC mechanotransduction, and changes in genomic architecture favoring adipogenesis over osteogenesis, resulting in decreased formation of HO.
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MESH Headings
- Acyltransferases
- Adipogenesis/genetics
- Animals
- Cell Differentiation
- Cell Lineage
- Disease Models, Animal
- Extracellular Matrix/metabolism
- Extremities/injuries
- Focal Adhesion Kinase 1/deficiency
- Focal Adhesion Kinase 1/genetics
- Focal Adhesion Kinase 1/metabolism
- Humans
- Male
- Mechanotransduction, Cellular/genetics
- Mechanotransduction, Cellular/physiology
- Mesenchymal Stem Cells/pathology
- Mesenchymal Stem Cells/physiology
- Mice
- Mice, Inbred C57BL
- Mice, Transgenic
- Ossification, Heterotopic/etiology
- Ossification, Heterotopic/pathology
- Ossification, Heterotopic/physiopathology
- Osteogenesis/genetics
- Restraint, Physical/adverse effects
- Restraint, Physical/physiology
- Signal Transduction/genetics
- Signal Transduction/physiology
- Transcription Factors/genetics
- Transcription Factors/metabolism
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Affiliation(s)
| | - Nicole Patel
- Section of Plastic Surgery, Department of Surgery
| | | | | | | | - Daniel L Matera
- Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Mohamed Said
- Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Andrea A Poli
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Amy L Strong
- Section of Plastic Surgery, Department of Surgery
| | | | | | | | - Shuli Li
- Section of Plastic Surgery, Department of Surgery
| | - Michael T Longaker
- Institute for Stem Cell Biology and Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Yi Tang
- Life Sciences Institute, University of Michigan, Ann Arbor, Michigan, USA
| | - Stephen J Weiss
- Life Sciences Institute, University of Michigan, Ann Arbor, Michigan, USA
| | - Brendon M Baker
- Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Aaron W James
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
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14
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Estermann SJ, Pahr DH, Reisinger A. Hyperelastic and viscoelastic characterization of hepatic tissue under uniaxial tension in time and frequency domain. J Mech Behav Biomed Mater 2020; 112:104038. [PMID: 32889334 DOI: 10.1016/j.jmbbm.2020.104038] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/03/2020] [Accepted: 08/10/2020] [Indexed: 01/28/2023]
Abstract
In order to create accurate anatomical models for medical training and research, mechanical properties of biological tissues need to be studied. However, non-linear and viscoelastic behaviour of most soft biological tissues complicates the evaluation of their mechanical properties. In the current study, a method for measuring hyperelasticity and viscoelasticity of bovine and porcine hepatic parenchyma in tension is presented. First, non-linear stress-stretch curves resulting from ramp loading and unloading, were interpreted based on a hyperelastic framework, using a Veronda-Westmann strain energy function. Strain-specific elastic moduli, such as initial stiffness EI, were thereupon defined in certain parts of the stress-stretch curves. Furthermore, dissipated and stored energy density were calculated. Next, the viscoelastic nature of liver tissue was examined with two different methods: stress relaxation and dynamic cyclic testing. Both tests yielded dissipated and stored energy density, as well as loss tangent (tanδ), storage modulus (E'), and loss modulus (E''). In tension, stress relaxation was experimentally more convenient than dynamic cyclic testing. Thus we considered whether relaxation could be used for approximating the results of the cyclic tests. Regarding the resulting elastic moduli, initial stiffness was similar for porcine and bovine liver (EI∼30kPa), while porcine liver was stiffer for higher strains. Comparing stress relaxation with dynamic cyclic testing, tanδ of porcine and bovine liver was the same for both methods (tanδ=0.05-0.25 at 1 Hz). Storage and loss moduli matched well for bovine, but not as well for porcine tissue. In conclusion, the utilized Veronda-Westmann model was appropriate for representing the hyperelasticity of liver tissue seen in ramp tests. Concerning viscoelasticity, both chosen testing methods - stress relaxation and dynamic cyclic testing - yielded comparable results for E', E'', and tanδ, as long as elasticity non-linearities were heeded. The here presented method provides novel insight into the tensile viscoelastic properties of hepatic tissue, and provides guidelines for convenient evaluation of soft tissue mechanical properties.
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Affiliation(s)
- Sarah-Jane Estermann
- Department Anatomy and Biomechanics, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria; Austrian Center for Medical Innovation and Technology, Viktor Kaplan-Straße 2/1, 2700 Wiener Neustadt, Austria; Institute for Lightweight Design and Structural Biomechanics, TU-Wien, Getreidemarkt 9, 1060 Wien, Austria
| | - Dieter H Pahr
- Department Anatomy and Biomechanics, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria; Institute for Lightweight Design and Structural Biomechanics, TU-Wien, Getreidemarkt 9, 1060 Wien, Austria
| | - Andreas Reisinger
- Department Anatomy and Biomechanics, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria.
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15
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Wu B, Pu P, Zhao S, Izadikhah I, Shi H, Liu M, Lu R, Yan B, Ma S, Markert B. Frequency-related viscoelastic properties of the human incisor periodontal ligament under dynamic compressive loading. PLoS One 2020; 15:e0235822. [PMID: 32658896 PMCID: PMC7357742 DOI: 10.1371/journal.pone.0235822] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 06/22/2020] [Indexed: 12/19/2022] Open
Abstract
Studies concerning the mechanical properties of the human periodontal ligament under dynamic compression are rare. This study aimed to determine the viscoelastic properties of the human periodontal ligament under dynamic compressive loading. Ten human incisor specimens containing 5 maxillary central incisors and 5 maxillary lateral incisors were used in a dynamic mechanical analysis. Frequency sweep tests were performed under the selected frequencies between 0.05 Hz and 5 Hz with a compression amplitude that was 2% of the PDL's initial width. The compressive strain varied over a range of 4%-8% of the PDL's initial width. The storage modulus, ranging from 28.61 MPa to 250.21 MPa, increased with the increase in frequency. The loss modulus (from 6.00 MPa to 49.28 MPa) also increased with frequency from 0.05 Hz- 0.5 Hz but remained constant when the frequency was higher than 0.5 Hz. The tanδ showed a negative logarithmic correlation with frequency. The dynamic moduli and the loss tangent of the central incisor were higher than those of the lateral incisor. This study concluded that the human PDL exhibits viscoelastic behavior under compressive loadings within the range of the used frequency, 0.05 Hz- 5 Hz. The tooth position and testing frequency may have effects on the viscoelastic properties of PDL.
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Affiliation(s)
- Bin Wu
- College of Mechanical and Electronic Engineering, Nanjing Forestry University, Nanjing, China
| | - Panjun Pu
- Jiangsu Key Laboratory of Oral Diseases, Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Siyu Zhao
- Jiangsu Key Laboratory of Oral Diseases, Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Iman Izadikhah
- Jiangsu Key Laboratory of Oral Diseases, Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Haotian Shi
- Jiangsu Key Laboratory of Oral Diseases, Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Mao Liu
- Jiangsu Key Laboratory of Oral Diseases, Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Ruxin Lu
- College of Mechanical Engineering, Southeast University, Nanjing, China
| | - Bin Yan
- Jiangsu Key Laboratory of Oral Diseases, Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
- * E-mail:
| | - Songyun Ma
- Institute of General Mechanics, RWTH-Aachen University, Aachen, Nordrhein-Westfalen, Germany
| | - Bernd Markert
- Institute of General Mechanics, RWTH-Aachen University, Aachen, Nordrhein-Westfalen, Germany
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16
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3D printed soft surgical planning prototype for a biliary tract rhabdomyosarcoma. J Mech Behav Biomed Mater 2020; 109:103844. [PMID: 32543408 DOI: 10.1016/j.jmbbm.2020.103844] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 04/08/2020] [Accepted: 04/28/2020] [Indexed: 12/18/2022]
Abstract
Biliary tract rhabdomyosarcoma is a soft tissue malignant musculoskeletal tumor which is located in the biliary tract. Although this tumor represents less than 1% of the total amount of childhood cancers, when localized, a >70% overall 5-year survival rate, the resection is clinically challenging and complications might exist during the biliary obstruction. Although surgery remains a mainstay, complete tumor resection is generally difficult to achieve without mutilation and severe long-term sequelae. Therefore, manufacturing multi-material 3D surgical planning prototypes of the case provides a great opportunity for surgeons to learn beforehand what they can expect. Additionally, practicing before the operation enhances the probability of success. That is why different compositions of materials have been characterized to match the mechanical properties of the liver. To do this, Dynamic Mechanical Analysis (DMA) tests and Shore hardness tests have been carried out. Amongst the material samples produced, 6%wt PVA (poly vinyl alcohol)/1%wt PHY (Phytagel)-1FT (Freeze-Thaw cycles) and 1%wt agarose appear as the best options for mimicking the liver tissue in terms of viscoelasticity. Regarding the Shore hardness, the best solution is 1%wt agarose. Additionally, a surgical planning prototype using this last material mentioned was manufactured and validated using a CT (Computed Tomography) scanner. In most of the structures the difference between the 3D model and the organ in terms of dimensions is less than 3.35 mm, which represents a low dimensional error, around 1%. On the other hand, the total manufacturing cost of the 3D physical model was €513 which is relatively low in comparison with other technologies.
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17
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Pirmoazen AM, Khurana A, El Kaffas A, Kamaya A. Quantitative ultrasound approaches for diagnosis and monitoring hepatic steatosis in nonalcoholic fatty liver disease. Theranostics 2020; 10:4277-4289. [PMID: 32226553 PMCID: PMC7086372 DOI: 10.7150/thno.40249] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 02/14/2020] [Indexed: 12/13/2022] Open
Abstract
Nonalcoholic fatty liver disease is a major global health concern with increasing prevalence, associated with obesity and metabolic syndrome. Recently, quantitative ultrasound-based imaging techniques have dramatically improved the ability of ultrasound to detect and quantify hepatic steatosis. These newer ultrasound techniques possess many inherent advantages similar to conventional ultrasound such as universal availability, real-time capability, and relatively low cost along with quantitative rather than a qualitative assessment of liver fat. In addition, quantitative ultrasound-based imaging techniques are less operator dependent than traditional ultrasound. Here we review several different emerging quantitative ultrasound-based approaches used for detection and quantification of hepatic steatosis in patients at risk for nonalcoholic fatty liver disease. We also briefly summarize other clinically available imaging modalities for evaluating hepatic steatosis such as MRI, CT, and serum analysis.
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Affiliation(s)
- Amir M. Pirmoazen
- Department of Radiology, School of Medicine, Stanford University, Stanford, California
| | - Aman Khurana
- Department of Radiology, University of Kentucky, Lexington, Kentucky
| | - Ahmed El Kaffas
- Department of Radiology, Molecular Imaging Program at Stanford, School of Medicine, Stanford University, Stanford, California
| | - Aya Kamaya
- Department of Radiology, School of Medicine, Stanford University, Stanford, California
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