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Sohn SY, Inoue K, Rhee CM, Leung AM. Risks of Iodine Excess. Endocr Rev 2024:bnae019. [PMID: 38870258 DOI: 10.1210/endrev/bnae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/15/2024]
Abstract
Iodine is a micronutrient that is required for thyroid hormone synthesis. The iodide cycle in thyroid hormone synthesis consists of a series of transport, oxidation, organification, and binding/coupling steps in thyroid follicular cells. Common sources of iodine include the consumption of an iodine-rich diet or iodine fortified foods, the administration of amiodarone, iodine-containing supplements, or iodinated contrast media, and other miscellaneous sources. Methods to assess population iodine status include the measurement of urinary iodine concentrations, blood thyroglobulin levels, prevalence of elevated neonatal TSH levels, and thyroid volume. Although excessive iodine intake or exposure is generally well tolerated, an acute iodine load may result in thyroid dysfunction (hypothyroidism or hyperthyroidism) in certain susceptible individuals due to the failure to escape from the Wolff-Chaikoff effect and to the Jod-Basedow phenomenon, respectively. In this review, we discuss the associations between excessive iodine intake or exposure, with particular focus on iodinated contrast media as a common source of excess iodine in healthcare settings, and risks of incident thyroid dysfunction. We also summarize the risks of iodine excess in vulnerable populations and review current guidelines regarding the screening and monitoring of iodinated contrast-induced thyroid dysfunction. Finally, we discuss the long-term potential nonthyroidal health risks associated with iodine excess and suggest the need for more data to define safe upper limits for iodine intake, particularly in high-risk populations.
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Affiliation(s)
- Seo Young Sohn
- Division of Endocrinology, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea
| | - Kosuke Inoue
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Hakubi Center, Kyoto University, Kyoto, Japan
| | - Connie M Rhee
- Division of Nephrology, Department of Medicine, Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
- Division of Nephrology, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Angela M Leung
- Division of Endocrinology, Diabetes, and Metabolism; Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
- Division of Endocrinology, Diabetes, and Metabolism; Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
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2
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Li Y, Wang J. Contrast-induced acute kidney injury: a review of definition, pathogenesis, risk factors, prevention and treatment. BMC Nephrol 2024; 25:140. [PMID: 38649939 PMCID: PMC11034108 DOI: 10.1186/s12882-024-03570-6] [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: 01/25/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Contrast-induced acute kidney injury (CI-AKI) has become the third leading cause of hospital-acquired AKI, which seriously threatens the health of patients. To date, the precise pathogenesis of CI-AKI has remained not clear and may be related to the direct cytotoxicity, hypoxia and ischemia of medulla, and oxidative stress caused by iodine contrast medium, which have diverse physicochemical properties, including cytotoxicity, permeability and viscosity. The latest research shows that microRNAs (miRNAs) are also involved in apoptosis, pyroptosis, and autophagy which caused by iodine contrast medium (ICM), which may be implicated in the pathogenesis of CI-AKI. Unfortunately, effective therapy of CI-AKI is very limited at present. Therefore, effective prevention of CI-AKI is of great significance, and several preventive options, including hydration, antagonistic vasoconstriction, and antioxidant drugs, have been developed. Here, we review current knowledge about the features of iodine contrast medium, the definition, pathogenesis, molecular mechanism, risk factors, prevention and treatment of CI-AKI.
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Affiliation(s)
- Yanyan Li
- Department of Pharmacy, Chongqing Traditional Chinese Medicine Hospital, 400021, Chongqing, P.R. China
| | - Junda Wang
- Department of Radiology, Chongqing Traditional Chinese Medicine Hospital, No. 6 Panxi 7 Branch Road, 400021, Chongqing, P.R. China.
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3
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Ali Al Saidi AK, Ghazanfari A, Baek A, Tegafaw T, Ahmad MY, Zhao D, Liu Y, Yang JU, Park JA, Yang BW, Chae KS, Nam SW, Chang Y, Lee GH. Ultrasmall cerium oxide nanoparticles as highly sensitive X-ray contrast agents and their antioxidant effect. RSC Adv 2024; 14:3647-3658. [PMID: 38268539 PMCID: PMC10805080 DOI: 10.1039/d3ra08372a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024] Open
Abstract
Owing to their theranostic properties, cerium oxide (CeO2) nanoparticles have attracted considerable attention for their key applications in nanomedicine. In this study, ultrasmall CeO2 nanoparticles (particle diameter = 1-3 nm) as X-ray contrast agents with an antioxidant effect were investigated for the first time. The nanoparticles were coated with hydrophilic and biocompatible poly(acrylic acid) (PAA) and poly(acrylic acid-co-maleic acid) (PAAMA) to ensure satisfactory colloidal stability in aqueous media and low cellular toxicity. The synthesized nanoparticles were characterized using high-resolution transmission electron microscopy, X-ray diffraction, Fourier transform-infrared spectroscopy, thermogravimetric analysis, dynamic light scattering, cell viability assay, photoluminescence spectroscopy, and X-ray computed tomography (CT). Their potential as X-ray contrast agents was demonstrated by measuring phantom images and in vivo CT images in mice injected intravenously and intraperitoneally. The X-ray attenuation of these nanoparticles was greater than that of the commercial X-ray contrast agent Ultravist and those of larger CeO2 nanoparticles reported previously. In addition, they exhibited an antioxidant effect for the removal of hydrogen peroxide. The results confirmed that the PAA- and PAAMA-coated ultrasmall CeO2 nanoparticles demonstrate potential as highly sensitive radioprotective or theranostic X-ray contrast agents.
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Affiliation(s)
| | - Adibehalsadat Ghazanfari
- Department of Chemistry, College of Natural Sciences, Kyungpook National University Taegu 41566 South Korea
| | - Ahrum Baek
- Institute of Biomedical Engineering, School of Medicine, Kyungpook National University Taegu 41944 South Korea
| | - Tirusew Tegafaw
- Department of Chemistry, College of Natural Sciences, Kyungpook National University Taegu 41566 South Korea
| | - Mohammad Yaseen Ahmad
- Department of Chemistry, College of Natural Sciences, Kyungpook National University Taegu 41566 South Korea
| | - Dejun Zhao
- Department of Chemistry, College of Natural Sciences, Kyungpook National University Taegu 41566 South Korea
| | - Ying Liu
- Department of Chemistry, College of Natural Sciences, Kyungpook National University Taegu 41566 South Korea
| | - Ji-Ung Yang
- Division of Applied RI, Korea Institute of Radiological & Medical Sciences Seoul 01812 South Korea
| | - Ji Ae Park
- Division of Applied RI, Korea Institute of Radiological & Medical Sciences Seoul 01812 South Korea
| | - Byeong Woo Yang
- Theranocure Medlifescience Bldg. 1, Chilgok, Bukgu Taegu 41405 South Korea
| | - Kwon Seok Chae
- Department of Biology Education, Teachers' College, Kyungpook National University Taegu 41566 South Korea
| | - Sung-Wook Nam
- Department of Molecular Medicine, School of Medicine, Kyungpook National University Taegu 41944 South Korea
| | - Yongmin Chang
- Department of Molecular Medicine, School of Medicine, Kyungpook National University Taegu 41944 South Korea
| | - Gang Ho Lee
- Department of Chemistry, College of Natural Sciences, Kyungpook National University Taegu 41566 South Korea
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4
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Rossi S, Bussi S, Bonafè R, Incardona C, Vurro E, Visigalli M, Buonsanti F, Fretta R. Mutagenicity assessment of two potential impurities in preparations of 5-amino-2,4,6 triiodoisophthalic acid, a key intermediate in the synthesis of the iodinated contrast agent iopamidol. MUTATION RESEARCH. GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2024; 893:503720. [PMID: 38272634 DOI: 10.1016/j.mrgentox.2023.503720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 01/27/2024]
Abstract
5-Aminoisophthalic acid and 5-nitroisophthalic acid (5-NIPA) are potential impurities in preparations of 5-amino-2,4,6-triiodoisophthalic acid, which is a key intermediate in the synthesis of the iodinated contrast agent iopamidol. We have studied their mutagenicity in silico (quantitative structure-activity relationships, QSAR) and by the bacterial reverse mutation assay (Ames test). First, the compounds were screened with the tools Derek Nexus™ and Leadscope®. Both compounds were flagged as potentially mutagenic (class 3 under ICH M7). However, contrary to the in silico prediction, neither chemical was mutagenic in the Ames test (plate incorporation method) with or without S9 metabolic activation.
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Affiliation(s)
- Silvia Rossi
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy.
| | - Simona Bussi
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy
| | - Roberta Bonafè
- Bracco Imaging SpA, Global Medical & Regulatory Affairs, Medical Writing, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy
| | - Carola Incardona
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy
| | - Emanuela Vurro
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy
| | - Massimo Visigalli
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy
| | - Federica Buonsanti
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy
| | - Roberta Fretta
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy
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Ahmad MY, Liu S, Tegafaw T, Saidi AKAA, Zhao D, Liu Y, Nam SW, Chang Y, Lee GH. Heavy Metal-Based Nanoparticles as High-Performance X-ray Computed Tomography Contrast Agents. Pharmaceuticals (Basel) 2023; 16:1463. [PMID: 37895934 PMCID: PMC10609879 DOI: 10.3390/ph16101463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/01/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
X-ray computed tomography (CT) contrast agents offer extremely valuable tools and techniques in diagnostics via contrast enhancements. Heavy metal-based nanoparticles (NPs) can provide high contrast in CT images due to the high density of heavy metal atoms with high X-ray attenuation coefficients that exceed that of iodine (I), which is currently used in hydrophilic organic CT contrast agents. Nontoxicity and colloidal stability are vital characteristics in designing heavy metal-based NPs as CT contrast agents. In addition, a small particle size is desirable for in vivo renal excretion. In vitro phantom imaging studies have been performed to obtain X-ray attenuation efficiency, which is a critical parameter for CT contrast agents, and the imaging performance of CT contrast agents has been demonstrated via in vivo experiments. In this review, we focus on the in vitro and in vivo studies of various heavy metal-based NPs in pure metallic or chemical forms, including Au, Pt, Pd, Ag, Ce, Gd, Dy, Ho, Yb, Ta, W, and Bi, and provide an outlook on their use as high-performance CT contrast agents.
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Affiliation(s)
- Mohammad Yaseen Ahmad
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea; (M.Y.A.); (S.L.); (T.T.); (A.K.A.A.S.); (D.Z.); (Y.L.)
| | - Shuwen Liu
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea; (M.Y.A.); (S.L.); (T.T.); (A.K.A.A.S.); (D.Z.); (Y.L.)
| | - Tirusew Tegafaw
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea; (M.Y.A.); (S.L.); (T.T.); (A.K.A.A.S.); (D.Z.); (Y.L.)
| | - Abdullah Khamis Ali Al Saidi
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea; (M.Y.A.); (S.L.); (T.T.); (A.K.A.A.S.); (D.Z.); (Y.L.)
| | - Dejun Zhao
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea; (M.Y.A.); (S.L.); (T.T.); (A.K.A.A.S.); (D.Z.); (Y.L.)
| | - Ying Liu
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea; (M.Y.A.); (S.L.); (T.T.); (A.K.A.A.S.); (D.Z.); (Y.L.)
| | - Sung-Wook Nam
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Taegu 41944, Republic of Korea;
| | - Yongmin Chang
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Taegu 41944, Republic of Korea;
| | - Gang Ho Lee
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea; (M.Y.A.); (S.L.); (T.T.); (A.K.A.A.S.); (D.Z.); (Y.L.)
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6
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Zanardo M, Cozzi A, Cardani R, Renna LV, Pomati F, Asmundo L, Di Leo G, Sardanelli F. Reducing contrast agent residuals in hospital wastewater: the GREENWATER study protocol. Eur Radiol Exp 2023; 7:27. [PMID: 37142839 PMCID: PMC10160294 DOI: 10.1186/s41747-023-00337-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/09/2023] [Indexed: 05/06/2023] Open
Abstract
The potential enviromental impact of iodinated (ICAs) and gadolinium-based contrast agents (GBCAs) have recently come under scrutiny, considering the current nonselective wastewater treatment. However, their rapid excretion after intravenous administration could allow their potential recovery by targeting hospital sewage. The GREENWATER study aims to appraise the effective quantities of ICAs and GBCAs retrievable from patients' urine collected after computed tomography (CT) and magnetic resonance imaging (MRI) exams, selecting ICA/GBCA per-patient urinary excretion and patients' acceptance rate as study endpoints. Within a prospective, observational, single-centre, 1-year framework, we will enrol outpatients aged ≥ 18 years, scheduled to perform contrast-enhanced CT or MRI, willing to collect post-examination urine in dedicated canisters by prolonging their hospital stay to 1 h after injection. Collected urine will be processed and partially stored in the institutional biobank. Patient-based analysis will be performed for the first 100 CT and 100 MRI patients, and then, all analyses will be conducted on the pooled urinary sample. Quantification of urinary iodine and gadolinium will be performed with spectroscopy after oxidative digestion. The evaluation of the acceptance rate will assess the "environmental awareness" of patients and will aid to model how procedures to reduce ICA/GBCA enviromental impact could be adapted in different settings. Key points • Enviromental impact of iodinated and gadolinium-based contrast agents represents a growing point of attention.• Current wastewater treatment is unable to retrieve and recycle contrast agents.• Prolonging hospital stay may allow contrast agents retrieval from patients' urine.• The GREENWATER study will assess the effectively retrievable contrast agents' quantities.• The enrolment acceptance rate will allow to evaluate patients' "green sensitivity".
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Affiliation(s)
- Moreno Zanardo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
| | - Andrea Cozzi
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Rosanna Cardani
- Biobank BioCor, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | | | - Luigi Asmundo
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Di Leo
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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7
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Khaw MS, Yap CW, Lee P, Ong SJ. What you need to know about: imaging in patients with renal failure. Br J Hosp Med (Lond) 2023; 84:1-9. [PMID: 37235678 DOI: 10.12968/hmed.2022.0544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Contrast-enhanced medical imaging is commonly requested in clinical practice. Contrast media provide better differentiation of tissue enhancement, improves the soft tissue contrast resolution, and enhances the ability to study the physiology and function of the organs and/or systems. However, contrast media may cause complications, especially in patients with renal failure. This article discusses the use of contrast media in common imaging modalities and the relationship between contrast media and renal function. Administration of iodinated contrast media in computed tomography may cause contrast-associated acute kidney injury; the risk factors and preventive strategies for this are elaborated in this article. Administration of gadolinium-based contrast media in magnetic resonance imaging may lead to nephrogenic systemic fibrosis. Therefore, precautions should be taken when planning for medical imaging for patients with pre-existing acute kidney injury or end-stage chronic kidney disease, for whom contrast media administration in computed tomography or magnetic resonance imaging may be relatively contraindicated. Alternatively, ultrasound contrast agents can be safely used in patients with acute kidney injury or chronic kidney disease. Clinical teams should discuss these patients with radiologists, taking into account the risk-benefits of contrast media, to determine the optimal imaging protocol or modality to answer the clinical query.
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Affiliation(s)
- Mun Sze Khaw
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Chee Woei Yap
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Peishan Lee
- Department of General Medicine (Renal Medicine), Sengkang General Hospital, Singapore
| | - Shao Jin Ong
- Department of Diagnostic Imaging, National University Hospital, Singapore
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8
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Muacevic A, Adler JR, Mohan M, Mathews K, Greenstein J. The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department. Cureus 2022; 14:e32846. [PMID: 36694480 PMCID: PMC9867569 DOI: 10.7759/cureus.32846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Iodinated contrast media (ICM) is essential to emergency department care in differentiating and delineating life-threatening pathologies. In May 2022, due to the COVID-19 outbreak, there was an unprecedented disruption in the manufacturing of iodinated contrast. The primary goal of this study was to describe the effects of an ICM shortage on the ordering patterns of emergency medicine physicians. Methods This was a retrospective, observational study with a pre-/post-test design. The study included two 28-day periods. All subjects who underwent a CT were included in the study. The subgroup of patients who underwent a repeat CT with ICM contrast within 1-24 hours was identified. Results During the pre- and post-implementation study periods, 4,574 and 3,973 CT studies were performed. The median length of stay (p=0.013) and time to first CT (p<0.001) both decreased during the post-implementation period. During the post-implementation period, more non-contrast CTs were ordered (p<0.001). During the post-implementation period, there was an increase in non-contrast studies followed by a repeat study with contrast (p=0.003). Conclusions A global ICM shortage resulted in a shift in the ordering patterns of Emergency Medicine (EM) physicians. More non-contrast CT scans were ordered. However, there was also an increase in repeat imaging with ICM material.
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Houshyar S, Yin H, Pope L, Zizhou R, Dekiwadia C, Hill-Yardin EL, Yeung JMC, John S, Fox K, Tran N, Cole I, Elbourne A, Truong VK, Truskewycz A. Smart Suture with Iodine Contrasting Nanoparticle for Computed Tomography. OPENNANO 2022. [DOI: 10.1016/j.onano.2022.100120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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10
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Al-Shawadfy MG, Kamel GAM, Abd-Allah ARA. Crosstalk among apoptosis, inflammation, and autophagy in relation to melatonin protective effect against contrast-induced nephropathy in rats. Can J Physiol Pharmacol 2022; 100:858-867. [PMID: 36017872 DOI: 10.1139/cjpp-2022-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Contrast medium (CM) is a chemical substance that is used for imaging anatomical boundaries and to explore normal and abnormal physiological findings; the use of CM was associated with kidney injury and acute renal failure. Melatonin (M) possesses antioxidant, anti-inflammatory, and antiapoptotic effects in addition to autophagy modulation. This study aimed to investigate the protective effect of M against contrast-induced nephropathy (CIN) and its impact on the crosstalk between inflammasome, apoptosis, and autophagy in CIN. Male albino rats received M (10, 20, and 40 mg/kg/day, intraperitoneally) for 3 days. One hour after the last administration, rats were subjected to CIN induction (10 mg/kg indomethacin, double doses of l-NAME 10 mg/kg, i.v., and meglumine diatrizoate 60% 6 mL/kg, i.v.). CIN-induced kidney damage was evidenced through elevated kidney function biomarkers and induced renal histopathological changes. Pretreatment with M caused a significant decrease in nephrotoxicity biomarkers and histopathological alterations. Moreover, CIN-induced oxidative stress, NLRP3 inflammasome, and apoptosis were attenuated by M. Furthermore, M modulates autophagy in CIN rats. M inhibits CIN-induced NLRP3-inflammasome activation and apoptosis as well as enhances autophagy.
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Affiliation(s)
- Marwa Gamal Al-Shawadfy
- Pharmacology and Toxicology Department, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, 11754, Egypt
| | - Gellan Alaa Mohamed Kamel
- Pharmacology and Toxicology Department, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, 11754, Egypt
| | - Adel R A Abd-Allah
- Pharmacology and Toxicology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, 11754, Egypt
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Im JH, Lee IJ, Choi Y, Sung J, Ha JS, Lee H. Impact of Denoising on Deep-Learning-Based Automatic Segmentation Framework for Breast Cancer Radiotherapy Planning. Cancers (Basel) 2022; 14:cancers14153581. [PMID: 35892839 PMCID: PMC9332287 DOI: 10.3390/cancers14153581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/08/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: This study aimed to investigate the segmentation accuracy of organs at risk (OARs) when denoised computed tomography (CT) images are used as input data for a deep-learning-based auto-segmentation framework. Methods: We used non-contrast enhanced planning CT scans from 40 patients with breast cancer. The heart, lungs, esophagus, spinal cord, and liver were manually delineated by two experienced radiation oncologists in a double-blind manner. The denoised CT images were used as input data for the AccuContourTM segmentation software to increase the signal difference between structures of interest and unwanted noise in non-contrast CT. The accuracy of the segmentation was assessed using the Dice similarity coefficient (DSC), and the results were compared with those of conventional deep-learning-based auto-segmentation without denoising. Results: The average DSC outcomes were higher than 0.80 for all OARs except for the esophagus. AccuContourTM-based and denoising-based auto-segmentation demonstrated comparable performance for the lungs and spinal cord but showed limited performance for the esophagus. Denoising-based auto-segmentation for the liver was minimal but had statistically significantly better DSC than AccuContourTM-based auto-segmentation (p < 0.05). Conclusions: Denoising-based auto-segmentation demonstrated satisfactory performance in automatic liver segmentation from non-contrast enhanced CT scans. Further external validation studies with larger cohorts are needed to verify the usefulness of denoising-based auto-segmentation.
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Affiliation(s)
- Jung Ho Im
- CHA Bundang Medical Center, Department of Radiation Oncology, CHA University School of Medicine, Seongnam 13496, Korea;
| | - Ik Jae Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul 03722, Korea; (I.J.L.); (J.S.)
| | - Yeonho Choi
- Department of Radiation Oncology, Gangnam Severance Hospital, Seoul 06273, Korea; (Y.C.); (J.S.H.)
| | - Jiwon Sung
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul 03722, Korea; (I.J.L.); (J.S.)
| | - Jin Sook Ha
- Department of Radiation Oncology, Gangnam Severance Hospital, Seoul 06273, Korea; (Y.C.); (J.S.H.)
| | - Ho Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul 03722, Korea; (I.J.L.); (J.S.)
- Correspondence: ; Tel.: +82-2-2228-8109; Fax: +82-2-2227-7823
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12
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Di Gregorio E, Arena F, Gianolio E, Ferrauto G, Aime S. The interaction between iodinated X‐ray contrast agents and macrocyclic
GBCAs
provides a signal enhancement in
T
1
‐weighted MR
images: Insights into the renal excretion pathways of
Gd‐HPDO3A
and iodixanol in healthy mice. Magn Reson Med 2022; 88:357-364. [PMID: 35253921 PMCID: PMC9314041 DOI: 10.1002/mrm.29190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/15/2021] [Accepted: 01/18/2022] [Indexed: 12/17/2022]
Abstract
Purpose This work aims to investigate the supramolecular binding interactions that occur between iodinated X‐ray contrast agents (CAs) and macrocyclic gadolinium (Gd)–based MRI contrast agents (GBCAs). This study provides some new insights in the renal excretion pathways of the two types of imaging probes. Methods The water‐proton relaxivities (r1) of clinically approved macrocyclic and linear GBCAs have been measured in the presence of different iodinated X‐ray contrast agents at different magnetic field strengths in buffer and in serum. The in vivo MRI and X‐ray CT of mice injected with either Gd‐HPDO3A or a Gd‐HPDO3A + iodixanol mixture were then acquired to assess the biodistribution of the two probes. Results A significant increase in r1 (up to approximately 200%) was observed for macrocyclic GBCAs when measured in the presence of an excess of iodinated X‐ray CAs (1:100 mol:mol) in serum. The co‐administration of Gd‐HPDO3A and iodixanol in vivo resulted in a marked increase in the signal intensity of the kidney regions in T1‐weighted MR images. Moreover, the co‐presence of the two agents resulted in the extended persistence of the MRI signal enhancement, suggesting that the Gd‐HPDO3A/iodixanol adduct was eliminated more slowly than the typical washing out of Gd‐HPDO3A. Conclusions The reported results show that it is possible to detect the co‐presence of iodinated agents and macrocyclic GBCAs in contrast‐enhanced MR images. The new information may be useful in the design of novel experiments toward improved diagnostic outcomes.
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Affiliation(s)
- Enza Di Gregorio
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences University of Turin Turin Italy
| | - Francesca Arena
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences University of Turin Turin Italy
| | - Eliana Gianolio
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences University of Turin Turin Italy
| | - Giuseppe Ferrauto
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences University of Turin Turin Italy
| | - Silvio Aime
- Istituto di ricovero e cura a carattere scientifico Naples Italy
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13
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de Abreu JSS, Fernandes J. The contrast agent 2,3,5-triiodobenzoic acid (TIBA) induces cell death in tumor cells through the generation of reactive oxygen species. Mol Biol Rep 2021; 48:5199-5207. [PMID: 34196897 DOI: 10.1007/s11033-021-06524-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/25/2021] [Indexed: 11/28/2022]
Abstract
The 2,3,5-triiodobenzoic acid (TIBA) is an iodine contrast agent used for visualization of tissue in X-ray techniques. However, TIBA induces physiological complications like increase in oxygen reactive species (ROS), and consequently, contrast-induced nephropathies. TIBA's antitumor activity was demonstrated in lung cancer, but the subcellular mechanisms involving its activity in tumor cells are still unknown. Thus, the objective of this work was evaluate whether the anti-tumor activity of TIBA involves ROS increase, in tumor lines of non-small cell lung cancer (H460), chronic myeloid leukemia (K562), and its cytotoxicity in normal renal epithelial (VERO). The MTT (3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide) assay was used for evaluation of cell viability, the H2DCFDA (cell-permeant 2',7'-dichlorodihydrofluorescein diacetate) fluorescent probe to evaluate ROS induction, cell cycle analysis was performed using flow cytometry to measure cell death, and immunofluorescence with annexin/7-AAD (7-amino-actinomycin D), to assess the association of cell death with the ROS generation. TIBA decreases cell viability in a dose-dependent manner for the H460 and K562. However, VERO cells showed less response to the drug, with 70% viable cells after 72 h of treatment in the highest concentration of the drug. While the tumor cells with only 20% viable cells. Besides, tumor cells exhibited higher DNA fragmentation, compared to the renal line (VERO with 5% of fragmented DNA, H460 with 26%, and 56% in K562). Finally, TIBA-induced ROS increase and apoptosis in all lines, which is significantly decreased after treatment with the antioxidant N-acetyl-cysteine (NAC). These data demonstrate the relationship between the increased cellular oxidative stress and the anti-tumor action of the TIBA.
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Affiliation(s)
- Jéssica Sodré Silva de Abreu
- Nucleus of Multidisciplinary Research in Biology (Numpex-Bio), Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Duque de Caxias, Brazil
| | - Janaína Fernandes
- Nucleus of Multidisciplinary Research in Biology (Numpex-Bio), Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Duque de Caxias, Brazil.
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14
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Bednarczuk T, Brix TH, Schima W, Zettinig G, Kahaly GJ. 2021 European Thyroid Association Guidelines for the Management of Iodine-Based Contrast Media-Induced Thyroid Dysfunction. Eur Thyroid J 2021; 10:269-284. [PMID: 34395299 PMCID: PMC8314764 DOI: 10.1159/000517175] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/11/2021] [Indexed: 12/26/2022] Open
Abstract
Given the fact that a large number of radiological examinations using iodine-based contrast media (ICM) are performed in everyday practice, clinicians should be aware of potential ICM-induced thyroid dysfunction (TD). ICM can induce hyperthyroidism (Hyper) or hypothyroidism (Hypo) due to supraphysiological concentrations of iodine in the contrast solution. The prevalence of ICM-induced TD varies from 1 to 15%. ICM-induced Hyper is predominantly found in regions with iodine deficiency and in patients with underlying nodular goiter or latent Graves' disease. Patients at risk for ICM-induced Hypo include those with autoimmune thyroiditis, living in areas with sufficient iodine supply. Most cases of ICM-induced TD are mild and transient. In the absence of prospective clinical trials on the management of ICM-induced TD, an individualized approach to prevention and treatment, based on patient's age, clinical symptoms, pre-existing thyroid diseases, coexisting morbidities and iodine intake must be advised. Treatment of ICM-induced Hyper with antithyroid drugs (in selected cases in combination with sodium perchlorate) should be considered in patients with severe or prolonged hyperthyroid symptoms or in older patients with underlying heart disease. It is debated whether preventive therapy with methimazole and/or perchlorate prior to ICM administration is justified. In ICM-induced overt Hypo, temporary levothyroxine may be considered in younger patients with symptoms of Hypo, with an underlying autoimmune thyroiditis and in women planning pregnancy. Additional clinical trials with clinically relevant endpoints are warranted to further aid in clinical decision-making in patients with ICM-induced TD.
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Affiliation(s)
- Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Thomas H. Brix
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Wolfgang Schima
- Department of Diagnostic and Interventional Radiology, Goettlicher Heiland Krankenhaus, Barmherzige Schwestern Krankenhaus, and Sankt Josef Krankenhaus, Vienna, Austria
| | | | - George J. Kahaly
- Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany
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15
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Li W, Zeng G, Yan J, Liu X, Jiang X, Yang J, Liu J, Sun D. One-pot green synthesis of I@CNDs-Fe 3O 4 hybrid nanoparticles from kelp for multi-modal imaging in vivo. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 124:112037. [PMID: 33947537 DOI: 10.1016/j.msec.2021.112037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 12/21/2022]
Abstract
Multi-modal imaging technologies are playing an increasingly important role in biomedical research. However, there remains a demanding challenge to develop biocompatible contrast agents via a simple, green synthetic route for multi-modal imaging. Here we report the synthesis and applications of a new contrast agent for triple-modal imaging, that is, iodine-containing N-doping carbon nano-dots hybridized with Fe3O4 nanoparticles (I@CNDs-Fe3O4). We develop a one-pot, environment friendly hydrothermal method to synthesize the hybrid nanoparticles, primarily using kelp as the bioresource. I@CNDs-Fe3O4 nanoparticles have been demonstrated to exhibit excellent multi-modal imaging capabilities, including wavelength-tunable fluorescent imaging, X-ray attenuation for CT imaging enhancement, and T2-Weighted MR imaging. Importantly, the formulation of the hybrid nanoparticle provides an optimal solution to address the disequilibrium of osmotic pressure caused by the conventional CT imaging contrast agents of iodine compounds. The I@CNDs-Fe3O4 nanoparticles promise important applications in multi-modal imaging technologies in vivo as a versatile and biocompatible contrast agent.
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Affiliation(s)
- Wenping Li
- Institute of Chemicobiology and Functional Materials, School of Chemical Engineering, Nanjing University of Science and Technology, 200 Xiao Ling Wei Street, Nanjing, Jiangsu Province, China
| | - Ganmin Zeng
- Institute of Chemicobiology and Functional Materials, School of Chemical Engineering, Nanjing University of Science and Technology, 200 Xiao Ling Wei Street, Nanjing, Jiangsu Province, China
| | - Jun Yan
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials & Devices, Soochow University, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, Jiangsu Province, China
| | - Xiaoli Liu
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Department of Pharmacy, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, Jiangsu 210023, China.
| | - Xiaohong Jiang
- Institute of Chemicobiology and Functional Materials, School of Chemical Engineering, Nanjing University of Science and Technology, 200 Xiao Ling Wei Street, Nanjing, Jiangsu Province, China
| | - Jiazhi Yang
- Institute of Chemicobiology and Functional Materials, School of Chemical Engineering, Nanjing University of Science and Technology, 200 Xiao Ling Wei Street, Nanjing, Jiangsu Province, China.
| | - Jian Liu
- Institute of Functional Nano and Soft Materials (FUNSOM), Jiangsu Key Laboratory for Carbon-Based Functional Materials & Devices, Soochow University, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, Jiangsu Province, China
| | - Dongping Sun
- Institute of Chemicobiology and Functional Materials, School of Chemical Engineering, Nanjing University of Science and Technology, 200 Xiao Ling Wei Street, Nanjing, Jiangsu Province, China
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16
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Supawat B, Wattanapongpitak S, Tima S, Kothan S, Tungjai M. Effect of fluoroscopic X-rays combined with iodinated radiographic contrast media on human hematological parameters. TOXICOLOGY AND ENVIRONMENTAL HEALTH SCIENCES 2021. [DOI: 10.1007/s13530-021-00093-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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17
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Cytotoxicity of radiocontrast dyes in human umbilical cord mesenchymal stem cells. Toxicol Appl Pharmacol 2018; 349:72-82. [PMID: 29705293 DOI: 10.1016/j.taap.2018.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 04/13/2018] [Accepted: 04/24/2018] [Indexed: 11/22/2022]
Abstract
Radiocontrast dyes are used for a wide range of diagnostic procedures for enhancing the image of anatomical structures, pain targets, and vascular uptake. While some of these dyes show toxicity to primary cells, their effect on stem cells, particularly mesenchymal stem cells (MSCs), is unknown. This study investigates the cytotoxic effects of two clinically used radiocontrast dyes, iohexol and iopamidol, on bone marrow and human umbilical cord MSCs. Exposure to these dyes significantly affected morphology of MSCs from both sources, as treated cells appeared transparent and no longer fibroblastoid. Cell viability decreased as determined by trypan blue and Annexin-V/PI staining, in a dose dependent manner with simultaneous loss of CD90 and CD105 concurrent with spontaneous differentiation in MSCs treated with iohexol and iopamidol. In addition, significantly higher cell death was observed in MSCs exposed to iopamidol than iohexol. At a concentration of 1:1, iohexol and iopamidol induced apoptosis in 19% and 92% (<.01) of MSCs, respectively. Global transcriptome analysis of treated MSCs revealed 139 and 384 differentially expressed genes in iohexol vs control and iopamidol vs control at p ≤ .01 and 1.5-fold, respectively. This suggested that iopamidol had more significant effect on the transcription of MSCs. Based on these results a molecular mechanism of radiocontast dye induced cell death via intrinsic apoptosis pathway mediated by p53 was proposed. Since iopamidol was significantly more toxic than iohexol in human MSCs, a more careful examination of safety of radiocontrast dyes for clinical use is warranted.
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Yang JS, Peng YR, Tsai SC, Tyan YS, Lu CC, Chiu HY, Chiu YJ, Kuo SC, Tsai YF, Lin PC, Tsai FJ. The molecular mechanism of contrast-induced nephropathy (CIN) and its link to in vitro studies on iodinated contrast media (CM). Biomedicine (Taipei) 2018; 8:1. [PMID: 29480796 PMCID: PMC5826038 DOI: 10.1051/bmdcn/2018080101] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/07/2017] [Indexed: 11/24/2022] Open
Abstract
Iodinated contrast media (iodinated CM) have increased ability to absorb x-rays and to visualize structures that normally are impossible to observe in a radiological examination. The use of iodinated CM may destory renal function, commonly known as contrast-induced nephropathy (CIN), which can result in acute renal failure (ARF). This review article mainly focuses on the following areas: (1) classifications of iodinated CM: ionic or non-ionic, high-osmolarity contrast media (HOCM), low-osmolarity contrast media (LOCM) and iso-osmolarity contrast media (IOCM); (2) an introduction to the physical and chemical properties of the non-ionic iodinated CM; (3) the management of anaphylactic reaction by iodinated CM; (4) a suggested single injection of adult doses and maximum dose for non-ionic iodinated CM; (5) the molecular mechanism of contrast-induced nephropathy (CIN); (6) In vitro studies on iodinated CM. Based on above information, this review article provide an insight for understanding the drug safety of iodinated CM.
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Affiliation(s)
- Jai-Sing Yang
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404, Taiwan
| | - Yan-Ru Peng
- School of Medicine, China Medical University, Taichung 404, Taiwan
| | - Shih-Chang Tsai
- Department of Biological Science and Technology, China Medical University, Taichung 404, Taiwan
| | - Yeu-Sheng Tyan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung 402, Taiwan - School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung 402, Taiwan - School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Chi-Cheng Lu
- Department of Pharmacy, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan
| | - Hong-Yi Chiu
- Department of Pharmacy, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan
| | - Yu-Jen Chiu
- Division of Reconstructive and Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Sheng-Chu Kuo
- Chinese Medicinal Research and Development Center, China Medical University Hospital, China Medical University, Taichung 404, Taiwan - School of Pharmacy, China Medical University, Taichung 404, Taiwan
| | - Yuh-Feng Tsai
- Department of Diagnostic Radiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan - School of Medicine, Fu-Jen Catholic University, Taipei 242, Taiwan
| | - Ping-Chin Lin
- Department of Medical Imaging, Chia-Yi Christian Hospital, Chiayi 600, Taiwan
| | - Fuu-Jen Tsai
- Genetics Center, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan - School of Chinese Medicine, China Medical University, Taichung 404, Taiwan - Department of Medical Genetics, China Medical University Hospital, Taichung 404, Taiwan
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