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Zhang C, Wang X, Xu J, Xu L, Sun Y, Lu C, Liao S, Liu H, Zhang XB, Song G. Ultrathin Gd-Oxide Nanosheet as Ultrasensitive Companion Diagnostic Tool for MR Imaging and Therapy of Submillimeter Microhepatocellular Carcinoma. NANO LETTERS 2024; 24:11002-11011. [PMID: 39166738 DOI: 10.1021/acs.nanolett.4c03078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Early stage hepatocellular carcinoma (HCC) presents a formidable challenge in clinical settings due to its asymptomatic progression and the limitations of current imaging techniques in detecting micro-HCC lesions. Addressing this critical issue, we introduce a novel ultrathin gadolinium-oxide (Gd-oxide) nanosheet-based platform with heightened sensitivity for high-field MRI and as a therapeutic agent for HCC. Synthesized via a digestive ripening process, these Gd-oxide nanosheets exhibit an exceptional acid-responsive profile. The integration of the ultrathin Gd-oxide with an acid-responsive polymer creates an ultrasensitive high-field MRI probe, enabling the visualization of submillimeter-sized tumors with superior sensitivity. Our research underscores the ultrasensitive probe's efficacy in the treatment of orthotopic HCC. Notably, the ultrasensitive probe functions dually as a companion diagnostic tool, facilitating simultaneous imaging and therapy with real-time treatment monitoring capabilities. In conclusion, this study showcases an innovative companion diagnostic tool that holds promise for the early detection and effective treatment of micro-HCC.
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Affiliation(s)
- Cheng Zhang
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
| | - Xia Wang
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
- College of Chemistry and Materials Science, Hunan Agricultural University, Changsha 410128, China
| | - Juntao Xu
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
| | - Li Xu
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
| | - Yue Sun
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
| | - Chang Lu
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
| | - Shiyi Liao
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
| | - Huiyi Liu
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
| | - Xiao-Bing Zhang
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
| | - Guosheng Song
- State Key Laboratory for Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, China
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2
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Ouyang M, Bao L. Gadolinium Contrast Agent Deposition in Children. J Magn Reson Imaging 2024. [PMID: 38597340 DOI: 10.1002/jmri.29389] [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: 01/20/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024] Open
Abstract
Over the past few years, a large number of studies have evidenced increased signal intensity in the deep brain nuclei on unenhanced T1-MRI images achieved by the application of gadolinium-based contrast agents (GBCAs). The deposition of gadolinium in the brain, bone, and other tissues following administration of GBCAs has also been confirmed in histological studies in rodents and in necropsy studies in adults and children. Given the distinct physiological characteristics of children, this review focuses on examining the current research on gadolinium deposition in children, particularly studies utilizing novel methods and technologies. Furthermore, the article compares safety research findings of linear GBCAs and macrocyclic GBCAs in children, with the aim of offering clinicians practical guidance based on the most recent research outcomes. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Minglei Ouyang
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Bao
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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Mitin D, Bullinger F, Dobrynin S, Engelmann J, Scheffler K, Kolokolov M, Krumkacheva O, Buckenmaier K, Kirilyuk I, Chubarov A. Contrast Agents Based on Human Serum Albumin and Nitroxides for 1H-MRI and Overhauser-Enhanced MRI. Int J Mol Sci 2024; 25:4041. [PMID: 38612851 PMCID: PMC11012161 DOI: 10.3390/ijms25074041] [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: 02/27/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
In cancer diagnostics, magnetic resonance imaging (MRI) uses contrast agents to enhance the distinction between the target tissue and background. Several promising approaches have been developed to increase MRI sensitivity, one of which is Overhauser dynamic nuclear polarization (ODNP)-enhanced MRI (OMRI). In this study, a macromolecular construct based on human serum albumin and nitroxyl radicals (HSA-NIT) was developed using a new synthesis method that significantly increased the modification to 21 nitroxide residues per protein. This was confirmed by electron paramagnetic resonance (EPR) spectroscopy and matrix-assisted laser desorption/ionization time-of-flight (MALDI ToF) mass spectrometry. Gel electrophoresis and circular dichroism showed no significant changes in the structure of HSA-NITs, and no oligomers were formed during modification. The cytotoxicity of HSA-NITs was comparable to that of native albumin. HSA-NITs were evaluated as potential "metal-free" organic radical relaxation-based contrast agents for 1H-MRI and as hyperpolarizing contrast agents for OMRI. Relaxivities (longitudinal and transversal relaxation rates r1 and r2) for HSA-NITs were measured at different magnetic field strengths (1.88, 3, 7, and 14 T). Phantoms were used to demonstrate the potential use of HSA-NIT as a T1- and T2-weighted relaxation-based contrast agent at 3 T and 14 T. The efficacy of 1H Overhauser dynamic nuclear polarization (ODNP) in liquids at an ultralow magnetic field (ULF, B0 = 92 ± 0.8 μT) was investigated for HSA-NIT conjugates. The HSA-NITs themselves did not show ODNP enhancement; however, under the proteolysis conditions simulating cancer tissue, HSA-NIT conjugates were cleaved into lower-molecular-weight (MW) protein fragments that activate ODNP capabilities, resulting in a maximum achievable enhancement |Emax| of 40-50 and a radiofrequency power required to achieve half of Emax, P1/2, of 21-27 W. The HSA-NIT with a higher degree of modification released increased the number of spin probes upon biodegradation, which significantly enhanced the Overhauser effect. Thus, HSA-NITs may represent a new class of MRI relaxation-based contrast agents as well as novel cleavable conjugates for use as hyperpolarizing contrast agents (HCAs) in OMRI.
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Affiliation(s)
- Dmitry Mitin
- Institute of Chemical Biology and Fundamental Medicine SB RAS, 630090 Novosibirsk, Russia;
| | - Friedemann Bullinger
- High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, 72076 Tuebingen, Germany; (F.B.); (J.E.); (K.S.); (K.B.)
| | - Sergey Dobrynin
- N.N. Vorozhtsov Institute of Organic Chemistry SB RAS, 630090 Novosibirsk, Russia;
| | - Jörn Engelmann
- High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, 72076 Tuebingen, Germany; (F.B.); (J.E.); (K.S.); (K.B.)
| | - Klaus Scheffler
- High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, 72076 Tuebingen, Germany; (F.B.); (J.E.); (K.S.); (K.B.)
- Department of Biomedical Magnetic Resonance, Eberhard-Karls University, 72076 Tuebingen, Germany
| | - Mikhail Kolokolov
- International Tomography Center SB RAS, 630090 Novosibirsk, Russia; (M.K.); (O.K.)
| | - Olesya Krumkacheva
- International Tomography Center SB RAS, 630090 Novosibirsk, Russia; (M.K.); (O.K.)
| | - Kai Buckenmaier
- High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, 72076 Tuebingen, Germany; (F.B.); (J.E.); (K.S.); (K.B.)
| | - Igor Kirilyuk
- N.N. Vorozhtsov Institute of Organic Chemistry SB RAS, 630090 Novosibirsk, Russia;
| | - Alexey Chubarov
- Institute of Chemical Biology and Fundamental Medicine SB RAS, 630090 Novosibirsk, Russia;
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Wang L, Wang Y, Zhao Q. Data mining and analysis of the adverse events derived signals of 4 gadolinium-based contrast agents based on the US Food and drug administration adverse event reporting system. Expert Opin Drug Saf 2024; 23:339-352. [PMID: 37837355 DOI: 10.1080/14740338.2023.2271834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/13/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND To detect and analyze risk signals of the drug-related adverse events (AEs) of 4 gadolinium-based contrast agents (GBCAs) (gadopentetate dimeglumine (Gd-DTPA), gadobenate dimeglumine (Gd-BOPTA), gadoteridol (Gd-HP-DO3A), and gadobutrol (Gd-BT-DO3A)) according to the US Food and Drug Administration Adverse Event Reporting System (FAERS) database and ensure the clinical safety. RESEARCH DESIGN AND METHODS The AEs that are associated with the 4 GBCAs were collected from the FAERS database from 2004Q1 to 2022Q3. The risk signals were mined using reporting odds ratio (ROR) and proportional reporting ratio (PRR). RESULTS 424 risk signals were excavated, in which 151 risk signals were associated with Gd-DTPA, 93 risk signals were related to Gd-BOPTA, 79 risk signals were relevant to Gd-HP-DO3A, and 101 risk signals were associated with Gd-BT-DO3A. The AE signals involved 20 system organ classes (SOCs). Two of the top four SOCs were identical, namely 'skin and subcutaneous tissue disorders' and 'general disorders and administration site conditions.' CONCLUSIONS The safety signals of 4 GBCAs were detected, and the SOCs associated with the AEs of the 4 GBCAs were different. Besides, some AEs obtained in this study were not mentioned in the package inserts, which need more attention and research to ensure the clinical safety.
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Affiliation(s)
- Lu Wang
- Department of Pharmacy, Yantai Yuhuangding Hospital, Yantai, Shandong, P. R. China
| | - Yinglin Wang
- Department of Pharmacy, Yantai Yuhuangding Hospital, Yantai, Shandong, P. R. China
| | - Quan Zhao
- Department of Pharmacy, Yantai Yuhuangding Hospital, Yantai, Shandong, P. R. China
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Abstract
ABSTRACT Recent safety concerns surrounding the use of gadolinium-based contrast agents (GBCAs) have spurred research into identifying alternatives to GBCAs for use with magnetic resonance imaging. This review summarizes the molecular and pharmaceutical properties of a GBCA replacement and how these may be achieved. Complexes based on high-spin, divalent manganese (Mn 2+ ) have shown promise as general purpose and liver-specific contrast agents. A detailed description of the complex Mn-PyC3A is provided, describing its physicochemical properties, its behavior in different animal models, and how it compares with GBCAs. The review points out that, although there are parallels with GBCAs in how the chemical properties of Mn 2+ complexes can predict in vivo behavior, there are also marked differences between Mn 2+ complexes and GBCAs.
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Affiliation(s)
- Peter Caravan
- From the Athinoula A. Martinos Center for Biomedical Imaging, Institute for Innovation in Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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6
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Englman C, Barrett T, Moore CM, Giganti F. Active Surveillance for Prostate Cancer: Expanding the Role of MR Imaging and the Use of PRECISE Criteria. Radiol Clin North Am 2024; 62:69-92. [PMID: 37973246 DOI: 10.1016/j.rcl.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Multiparametric magnetic resonance (MR) imaging has had an expanding role in active surveillance (AS) for prostate cancer. It can improve the accuracy of prostate biopsies, assist in patient selection, and help monitor cancer progression. The PRECISE recommendations standardize reporting of serial MR imaging scans during AS. We summarize the evidence on MR imaging-led AS and provide a clinical primer to help report using the PRECISE criteria. Some limitations to both serial imaging and the PRECISE recommendations must be considered as we move toward a more individualized risk-stratified approach to AS.
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Affiliation(s)
- Cameron Englman
- Department of Radiology, University College London Hospital NHS Foundation Trust, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK; Division of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK
| | - Tristan Barrett
- Department of Radiology, University of Cambridge, Box 218, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK; Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Box 218, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - Caroline M Moore
- Division of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK; Department of Urology, University College London Hospital NHS Foundation Trust, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK
| | - Francesco Giganti
- Department of Radiology, University College London Hospital NHS Foundation Trust, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK; Division of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley Street, London, W1W7TY, UK.
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7
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Han Z, MacCuaig WM, Gurcan MN, Claros-Sorto J, Garwe T, Henson C, Holter-Chakrabarty J, Hannafon B, Chandra V, Wellberg E, McNally LR. Dynamic 2-deoxy-D-glucose-enhanced multispectral optoacoustic tomography for assessing metabolism and vascular hemodynamics of breast cancer. PHOTOACOUSTICS 2023; 32:100531. [PMID: 37485041 PMCID: PMC10362308 DOI: 10.1016/j.pacs.2023.100531] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/22/2023] [Accepted: 07/08/2023] [Indexed: 07/25/2023]
Abstract
Clinical tools for measuring tumor vascular hemodynamics, such as dynamic contrast-enhanced MRI, are clinically important to assess tumor properties. Here we explored the use of multispectral optoacoustic tomography (MSOT), which has a high spatial and temporal resolution, to measure the intratumoral pharmacokinetics of a near-infrared-dye-labeled 2-Deoxyglucose, 2-DG-800, in orthotropic 2-LMP breast tumors in mice. As uptake of 2-DG-800 is dependent on both vascular properties, and glucose transporter activity - a widely-used surrogate for metabolism, we evaluate hemodynamics of 2-DG-MP by fitting the dynamic MSOT signal of 2-DG-800 into two-compartment models including the extended Tofts model (ETM) and reference region model (RRM). We showed that dynamic 2-DG-enhanced MSOT (DGE-MSOT) is powerful in acquiring hemodynamic rate constants, including Ktrans and Kep, via systemically injecting a low dose of 2-DG-800 (0.5 µmol/kg b.w.). In our study, both ETM and RRM are efficient in deriving hemodynamic parameters in the tumor. Area-under-curve (AUC) values (which correlate to metabolism), and Ktrans and Kep values, can effectively distinguish tumor from muscle. Hemodynamic parameters also demonstrated correlations to hemoglobin, oxyhemoglobin, and blood oxygen level (SO2) measurements by spectral unmixing of the MSOT data. Together, our study for the first time demonstrated the capability of DGE-MSOT in assessing vascular hemodynamics of tumors.
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Affiliation(s)
- Zheng Han
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
- Center for Health Systems Innovation, Oklahoma State University, Stillwater, OK 74078, USA
| | - William M. MacCuaig
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
- Department of Bioengineering, University of Oklahoma, Norman, OK 73019, USA
| | - Metin N. Gurcan
- Center for Biomedical Informatics, Wake Forest Baptist Health, Winston-Salem, NC 27101, USA
| | - Juan Claros-Sorto
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Tabitha Garwe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Christina Henson
- Department of Internal Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | | | - Bethany Hannafon
- Department of Obstetrics and Gynecology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Vishal Chandra
- Department of Obstetrics and Gynecology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Elizabeth Wellberg
- Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Lacey R. McNally
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
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8
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Fluorinated Human Serum Albumin as Potential 19F Magnetic Resonance Imaging Probe. Molecules 2023; 28:molecules28041695. [PMID: 36838682 PMCID: PMC9959765 DOI: 10.3390/molecules28041695] [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] [Received: 01/25/2023] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
Fluorinated human serum albumin conjugates were prepared and tested as potential metal-free probes for 19F magnetic resonance imaging (MRI). Each protein molecule was modified by several fluorine-containing compounds via the N-substituted natural acylating reagent homocysteine thiolactone. Albumin conjugates retain the protein's physical and biological properties, such as its 3D dimensional structure, aggregation ability, good solubility, proteolysis efficiency, biocompatibility, and low cytotoxicity. A dual-labeled with cyanine 7 fluorescence dye and fluorine reporter group albumin were synthesized for simultaneous fluorescence imaging and 19F MRI. The preliminary in vitro studies show the prospects of albumin carriers for multimodal imaging.
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Rao C, Liao D, Pan Y, Zhong Y, Zhang W, Ouyang Q, Nezamzadeh-Ejhieh A, Liu J. Novel formulations of metal-organic frameworks for controlled drug delivery. Expert Opin Drug Deliv 2022; 19:1183-1202. [DOI: 10.1080/17425247.2022.2064450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Congying Rao
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, China
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
- These authors have equal contributions
| | - Donghui Liao
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, China
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
- These authors have equal contributions
| | - Ying Pan
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
- These authors have equal contributions
| | - Yuyu Zhong
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
| | - Wenfeng Zhang
- Guangdong Provincial Key Laboratory of Research and Development of Natural Drugs, and School of Pharmacy, Guangdong Medical University, Guangdong Medical University Key Laboratory of Research and Development of New Medical Materials, Dongguan, 523808, China
| | - Qin Ouyang
- Department of general surgery, Dalang Hospital, Dongguan, 523800, China
| | | | - Jianqiang Liu
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, 523808, China
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Landsberg R, Schneider S, Masalha M, Margulis A, Guindy M, Luckman J. Comparison of CT and adjusted MRI for evaluating paranasal sinuses surgical key landmarks. RHINOLOGY ONLINE 2022. [DOI: 10.4193/rhinol/21.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Sinus CT is the imaging technique of choice for planning endoscopic sinus surgery (ESS). Although MRI has a better soft tissue demonstration, it is not commonly used for ESS due to suboptimal bone demonstration. We hypothesised that adjustment of certain MRI parameters, would allow better demonstration of bones and enable the surgeon to adequately identify surgical landmarks. Methodology: Twenty patients identified as candidates for ESS underwent CT and adjusted MRI exams of the paranasal sinuses (40 in total). rhinologist and a neuroradiologist independently compared and graded 46 bony structures (23 on each side) in each patient's CT and MRI. Overall, 920 anatomical structures were graded by each observer (1840 structures in total). Statistical analysis included overall and per variable grading distribution for each observer, and overall agreement. Results: MRI images were equal, or superior to CT for assessing paranasal anatomy in 66.8% and 86.4% of structures evaluated by the rhinologist and neuroradiologist, respectively. Overall agreement between observers (77%) was moderate. Conclusion: The rhinologist prefers CT demonstration of bony structures, while the neuroradiologist prefers MRI. Still, with the MRI protocol used in this study, according to both, most bony structures are well demonstrated by MRI.
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11
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Susceptibility artifacts and PIRADS 3 lesions in prostatic MRI: how often is the dynamic contrast-enhance sequence necessary? Abdom Radiol (NY) 2021; 46:3401-3409. [PMID: 33683430 DOI: 10.1007/s00261-021-03011-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/15/2021] [Accepted: 02/20/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To assess the need of the dynamic contrast-enhanced (DCE) sequence in addition to T2-weighted imaging (T2-WI) and diffusion-weighted imaging (DWI) for the detection of clinically significant prostate cancer in the presence of artifacts associated with rectal gas (which compromise the diffusion assessment) and/or PIRADS 3 lesions. METHODS This retrospective study was approved by the institutional review board; informed consent was not required. Patients referred consecutively over a period of 5 months for elevated PSA underwent multiparametric magnetic resonance imaging (mpMRI). mpMRI was performed using a 3T MRI system without an endorectal coil. The MRI findings were reviewed by two radiologists and were scored according to the Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2). Any discrepancies were resolved by consensus. For statistical purposes, lesions were classified as PIRADS 1-2, PIRADS 3, or PIRADS 4-5. First, all studies were reviewed using a biparametric assessment (T2-WI + DWI), and the presence or absence of susceptibility artifacts was assessed for each prostate. Subsequently, all images were analyzed using the standard multiparametric approach (T2-WI + DWI + DCE). RESULTS The biparametric evaluation (T2-WI + DWI) showed artifacts (due to the presence of rectal gas or other) in 87 patients (43.5%) and no artifacts in 113 patients (56.5%). In the latter group, 15 patients had peripheral zone (PZ) PIRADS 3 lesions. Thus, a total of 102 patients (51%) had artifacts or PZ PIRADS 3 lesions and therefore required DCE. When evaluating the group of prostates without artifacts, 13.3% of prostates required DCE. A total of 17 (23.9%) PIRADS 4-5 prostate lesions would have not been detected without the use of DCE. CONCLUSION Biparametric evaluation of the prostate revealed some limitation due to the presence of artifacts or PIRADS 3 PZ lesions. Artifacts were present in almost 44% of our patients, but when the DWI was correctly evaluated, only 13.3% of prostates required DCE.
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12
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Demir Duman F, Forgan RS. Applications of nanoscale metal-organic frameworks as imaging agents in biology and medicine. J Mater Chem B 2021; 9:3423-3449. [PMID: 33909734 DOI: 10.1039/d1tb00358e] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Nanoscale metal-organic frameworks (NMOFs) are an interesting and unique class of hybrid porous materials constructed by the self-assembly of metal ions/clusters with organic linkers. The high storage capacities, facile synthesis, easy surface functionalization, diverse compositions and excellent biocompatibilities of NMOFs have made them promising agents for theranostic applications. By combination of a large variety of metal ions and organic ligands, and incorporation of desired molecular functionalities including imaging modalities and therapeutic molecules, diverse MOF structures with versatile functionalities can be obtained and utilized in biomedical imaging and drug delivery. In recent years, NMOFs have attracted great interest as imaging agents in optical imaging (OI), magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET) and photoacoustic imaging (PAI). Furthermore, the significant porosity of MOFs allows them to be loaded with multiple imaging agents and therapeutics simultaneously and applied for multimodal imaging and therapy as a single entity. In this review, which is intended as an introduction to the use of MOFs in biomedical imaging for a reader entering the subject, we summarize the up-to-date progress of NMOFs as bioimaging agents, giving (i) a broad perspective of the varying imaging techniques that MOFs can enable, (ii) the different routes to manufacturing functionalised MOF nanoparticles and hybrids, and (iii) the integration of imaging with differing therapeutic techniques. The current challenges and perspectives of NMOFs for their further clinical translation are also highlighted and discussed.
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Affiliation(s)
- Fatma Demir Duman
- WestCHEM, School of Chemistry, University of Glasgow, University Avenue, Glasgow G12 8QQ, UK.
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13
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Qualitative characterization of breast tumors with diffusion-weighted imaging has comparable accuracy to quantitative analysis. Clin Imaging 2021; 77:17-24. [PMID: 33639496 DOI: 10.1016/j.clinimag.2021.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/22/2021] [Accepted: 02/10/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the applicability and accuracy of a new qualitative diffusion-weighted imaging (DWI) assessment method in the characterization of breast tumors compared to quantitative ADC measurement and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS After review board approval, MRIs of 216 consecutive women with final diagnoses (131 malignant, 85 benign) were retrospectively analyzed. Two radiologists independently scored DWI and dynamic contrast-enhanced MRI (DCE-MRI) according to malignancy probability. Qualitative assessments were performed by combined analysis of tumor morphology and diffusion signal. Quantitative data was obtained from apparent diffusion coefficient (ADC) measurements. Lastly, descriptive DWI features were evaluated and recorded. Cohen's kappa, receiver operating characteristic and multivariate analyzes were applied. RESULTS Of malignant tumors, 97% were visible on DWI. Qualitative and quantitative DWI assessments provided comparable sensitivities of 89-94% and 88-92% and specificities of 51-61% and 59-67%, respectively. There was no statistical difference between the accuracies of qualitative and quantitative DWI (p ≥ 0.105). Best diagnostic values were obtained with DCE-MRI (sensitivity, 99-100%; specificity, 69-71%). Inter-reader agreement was moderate (kappa = 0.597) for qualitative DWI and substantial (kappa = 0.689) for DCE-MRI (p < 0.001). Agreement between qualitative DWI and DCE-MRI scores was moderate (kappa = 0.536 and 0.442). Visual diffusion signal, mass margin and shape were the most predictive features of malignancy on multivariate analysis of qualitative assessment. CONCLUSION Qualitative characterization of breast tumors on DWI has comparable accuracy to quantitative ADC analysis. This method might be used to make DWI more widely available with eliminating the need to a predetermined ADC threshold in tumor characterization. However, lower accuracy and inter-reader agreement of it compared to DCE-MRI should be considered.
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Can T1 mapping be an alternative of post-contrast magnetic resonance sequences in patients with surgically corrected tetralogy of Fallot? Anatol J Cardiol 2020; 24:377-381. [PMID: 33253132 PMCID: PMC7791296 DOI: 10.14744/anatoljcardiol.2020.73576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: The objective of this study is to investigate the ability of native T1 mapping in the determination of myocardial fibrosis in patients with surgically corrected tetralogy of Fallot (TOF). Methods: We included 35 patients with surgically corrected TOF who underwent cardiac magnetic resonance imaging in this study. Additionally, we added pre- and post-contrast T1 mapping sequences at the right ventricular outflow tract (RVOT) and short-axis planes to the routine protocol. We visually evaluated the pre-contrast native T1 mapping images to determine the presence of areas with higher T1 times that indicate focal fibrosis. We compared the findings with the findings of post-contrast images. Results: In 22 of the 35 cases, RVOT enhancement was observed in the delayed enhancement images; however, none of these cases could be distinguished on the native T1 maps. When compared to post-contrast imaging, 28 of the 30 contrast enhancements at right ventricle insertion points and 14 of the 17 contrast enhancements at the remaining left ventricle walls were visually observed on the color-coded native T1 maps. The sensitivity, specificity, positive and negative predictive values of native T1 mapping for the detection of focal fibrosis at the right ventricle insertion points were found to be 93.3%, 100%, 100%, and 71.4%, respectively, whereas these values were found to be 82.4%, 100%, 100%, and 85.8% in the detection of fibrosis in the remaining left ventricle walls. Conclusion: Native T1 mapping is valuable in the detection of focal fibrosis at the right ventricle insertion points and the remaining left ventricle walls; however, it was not possible to visually detect RVOT fibrosis by native T1 mapping. Hence, T1 mapping may not replace the contrast-enhanced imaging in patients with surgically corrected TOF. (Anatol J Cardiol 2020; 24: 377-81)
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15
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Round table: arguments in supporting abbreviated or biparametric MRI of the prostate protocol. Abdom Radiol (NY) 2020; 45:3974-3981. [PMID: 32303773 DOI: 10.1007/s00261-020-02510-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 update, in the attempt to improve clinical guidelines for multiparametric magnetic resonance imaging (mpMRI) of the prostate, has clear limitations. The role of dynamic contrast-enhanced sequences is not defined, precise guidance on the clinical management (biopsy or clinical surveillance) for score 3 lesions [equivocal for clinical significant prostate cancer (sPCa)] is not offered and criteria for lesions interpretation remain difficult and subjective. We report criteria and arguments in supporting the use of abbreviated or biparametric prostate MRI protocol in clinical practice for detection and management of PCa.
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16
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Parfenov VA, Petrov SV, Pereira FDAS, Levin AA, Koudan EV, Nezhurina EK, Karalkin PA, Vasiliev MM, Petrov OF, Komlev VS, Khesuani YD, Mironov VA. Scaffold-free, Label-free, and Nozzle-free Magnetic Levitational Bioassembler for Rapid Formative Biofabrication of 3D Tissues and Organs. Int J Bioprint 2020; 6:304. [PMID: 33088991 PMCID: PMC7557351 DOI: 10.18063/ijb.v6i3.304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 07/14/2020] [Indexed: 01/15/2023] Open
Abstract
Scaffolding is the conceptual framework of conventional tissue engineering. Over the past decade, scaffold-free approaches as a potential alternative to classic scaffold-based methods have emerged, and scaffold-free magnetic levitational tissue engineering (magnetic force-based tissue engineering [Mag-TE]) is a type of this novel tissue engineering strategy. However, Mag-TE is often based on the use of potentially toxic magnetic nanoparticles. Scaffold-free and label-free magnetic levitational bioassembly do not employ magnetic nanoparticles and thus, the potential toxicity of magnetic nanoparticles can be avoided. In this short review, we describe the conceptual foundation of scaffold-free, label-free, and nozzle-free formative biofabrication using magnetic fields as “scaffields.” The design and implementation of “Organ.Aut,” the first commercial magnetic levitational bioassembler, and the potential applications of magnetic bioassembler are discussed as well.
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Affiliation(s)
- Vladislav A Parfenov
- Laboratory for Biotechnological Research, "3D Bioprinting Solutions," Moscow, Russia.,A.A. Baikov Institute of Metallurgy and Materials Science, Russian Academy of Sciences, Moscow, Russia
| | - Stanislav V Petrov
- Laboratory for Biotechnological Research, "3D Bioprinting Solutions," Moscow, Russia
| | | | - Aleksandr A Levin
- Laboratory for Biotechnological Research, "3D Bioprinting Solutions," Moscow, Russia
| | - Elizaveta V Koudan
- Laboratory for Biotechnological Research, "3D Bioprinting Solutions," Moscow, Russia
| | - Elizaveta K Nezhurina
- P.A. Hertsen Moscow Oncology Research Center, National Medical Research Radiological Center, Moscow, Russia
| | - Pavel A Karalkin
- Laboratory for Biotechnological Research, "3D Bioprinting Solutions," Moscow, Russia.,P.A. Hertsen Moscow Oncology Research Center, National Medical Research Radiological Center, Moscow, Russia
| | - Mikhail M Vasiliev
- Joint Institute for High Temperatures, Russian Academy of Sciences, Moscow, Russia
| | - Oleg F Petrov
- Joint Institute for High Temperatures, Russian Academy of Sciences, Moscow, Russia
| | - Vladimir S Komlev
- A.A. Baikov Institute of Metallurgy and Materials Science, Russian Academy of Sciences, Moscow, Russia
| | - Yusef D Khesuani
- Laboratory for Biotechnological Research, "3D Bioprinting Solutions," Moscow, Russia
| | - Vladimir A Mironov
- Laboratory for Biotechnological Research, "3D Bioprinting Solutions," Moscow, Russia.,I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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17
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Zhou J, Zhou Q, Shu G, Wang X, Lu Y, Chen H, Hu T, Cai J, Du Y, Yu R. Dual-Effect of Magnetic Resonance Imaging Reporter Gene in Diagnosis and Treatment of Hepatocellular Carcinoma. Int J Nanomedicine 2020; 15:7235-7249. [PMID: 33061378 PMCID: PMC7533905 DOI: 10.2147/ijn.s257628] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/10/2020] [Indexed: 12/22/2022] Open
Abstract
Propose The early diagnosis of hepatocellular carcinoma (HCC) with ferritin heavy chain (Fth) modified by alpha-fetoprotein (AFP) promoter has been studied. However, no study has focused on the considerable upregulation and specific targeting effects of transferrin receptors (TfR) caused by the transfection of plasmids encoded with the AFP promoter. Thus, the objective of our study was to investigate whether the transfection of Fth gene modified with AFP promoter (AFP@Fth) could be used for early diagnosis and enhanced treatment of HCC. Methods The AFP@Fth plasmid was transfected into AFP positive cells. The expression of intracellular Ferritin was verified by Western blot, and the upregulation of TfR was confirmed by immunofluorescence and flow cytometry analysis. Cellular iron accumulation resulting in decreased imaging signals was examined by magnetic resonance imagining. Doxorubicin liposome modified with transferrin (Tf-LPD) was prepared to investigate the efficiency of the subsequent treatment after transfection. The enhanced drug distribution and effects were investigated both in vitro and in vivo. Results Both Ferritin and TfR were overexpressed after transfection. The transfected cells showed higher intracellular iron accumulation and resulted in a lower MR T2-weighted imaging (T2WI) intensity, suggesting that the transfection of AFP@Fth could be a potential strategy for early diagnosis of liver cancer. The following treatment efficacy was revealed by Tf-LPD. As compared with un-transfected cells, transfected cells exhibited higher uptake of transferrin-modified liposomes (Tf-LP), which was due to the specific interaction between Tf and TfR overexpressed on the transfected cells. This is also the reason why Tf-LPD showed better in vitro and in vivo anticancer ability than doxorubicin loaded liposome (LPD). These results suggested that transfection of AFP@Fth could result in enhanced therapy of liver cancer. Conclusion Transfection of AFP@Fth could be used for early diagnosis and for enhanced treatment of live cancers.
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Affiliation(s)
- Jiaping Zhou
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China
| | - Qiaomei Zhou
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China
| | - Gaofeng Shu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, People's Republic of China
| | - Xiaojie Wang
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China
| | - Yuanfei Lu
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China
| | - Haiyan Chen
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China
| | - Tingting Hu
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China
| | - Jinsong Cai
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China
| | - Yongzhong Du
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, People's Republic of China
| | - Risheng Yu
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, People's Republic of China
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18
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Belanova A, Chmykhalo V, Beseda D, Belousova M, Butova V, Soldatov A, Makarenko Y, Zolotukhin P. A mini-review of X-ray photodynamic therapy (XPDT) nonoagent constituents' safety and relevant design considerations. Photochem Photobiol Sci 2020; 19:1134-1144. [PMID: 32776036 DOI: 10.1039/c9pp00456d] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Conventional photodynamic therapy (PDT) has proved effective in the management of primary tumors and individual metastases. However, most cancer mortality arises from wide-spread multiple metastases. The latter has thus become the principal target in oncology, and X-ray induced photodynamic therapy (XPDT or PDTX) offers a great solution for adapting the PDT principle to deep tumors and scattered metastases. Developing agents capable of being excited by X-rays and emitting visible light to excite photosensitizers is based on challenging physical and chemical technologies, but there are fundamental biological limitations that are to be accounted for as well. In the present review, we have established eight major groups of safety determinants of NPs encompassing 22 parameters of clinical applicability of XPDT nanoparticulate formulations. Most, if not all, of these parameters can be accounted for and optimized during the design and development of novel XPDT nanoparticles.
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Affiliation(s)
- A Belanova
- Biomedical Innovations LLC, Russian Federation
| | - V Chmykhalo
- Southern Federal University, Russian Federation
| | - D Beseda
- Biomedical Innovations LLC, Russian Federation
| | - M Belousova
- Southern Federal University, Russian Federation
| | - V Butova
- Southern Federal University, Russian Federation
| | - A Soldatov
- Southern Federal University, Russian Federation
| | - Y Makarenko
- Rostov-on-Don Pathological-anatomical bureau No. 1, Russian Federation
| | - P Zolotukhin
- Southern Federal University, Russian Federation.
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19
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Lersy F, Diepenbroek AL, Lamy J, Willaume T, Bierry G, Cotton F, Kremer S. Signal changes in enhanced T1-weighted images related to gadolinium retention: A three-time-point imaging study. J Neuroradiol 2020; 48:82-87. [PMID: 32615207 DOI: 10.1016/j.neurad.2020.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/03/2020] [Accepted: 06/17/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Concern has grown about the finding of gadolinium deposits in the brain after administering gadolinium-based contrast agents (GBCAs). The mechanism is unclear, and related questions remain unanswered, including the stability over time. Therefore, we conducted a three-time-point study to explore T1-weighted (W) signal changes in the dentate nucleus (DN) and globus pallidus (GP), after the first, fifth, and tenth injections of either a macrocyclic agent (gadoterate meglumine) or a linear agent (gadobenate dimeglumine). MATERIALS AND METHODS For this retrospective, multicenter, longitudinal study, two groups of 18 (gadoterate meglumine) and 19 (gadobenate dimeglumine) patients were identified. The evolution of the signal over time was analyzed using DN/pons (DN/P) and GP/thalamus (GP/T) ratios. RESULTS DN/P and GP/T ratios tended to increase after the fifth administration of gadobenate dimeglumine, following by a downward trend. A trend in a decrease in DN/P and GP/T ratios were found after the fifth and tenth administrations of gadoterate meglumine. CONCLUSION After exposure to gadobenate dimeglumine, the signal intensity (SI) tended to increase after the fifth injection owing to gadolinium accumulation, however, a SI increase was not found after the tenth administration supporting the hypothesis of a slow elimination of the previously retained gadolinium (wash-out effect) from the brain or of a change in form (by dechelation), causing the signal to fade. No increasing SI was found in the DN and GP after exclusive exposure to gadoterate meglumine, thus confirming its stability. We found, instead, a trend for a significative gadolinium elimination over time.
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Affiliation(s)
- François Lersy
- Service de Radiologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, 67200 Strasbourg Cedex, France.
| | - Anne-Lise Diepenbroek
- Faculté de médecine de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France.
| | - Julien Lamy
- ICube, Université de Strasbourg-CNRS, ICube - Institut de physique biologique, 4, rue Kirschleger, 67000 Strasbourg, France.
| | - Thibault Willaume
- Service de Radiologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, 67200 Strasbourg Cedex, France.
| | - Guillaume Bierry
- Service de Radiologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, 67200 Strasbourg Cedex, France.
| | - François Cotton
- Service de Radiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France.
| | - Stéphane Kremer
- Service de Radiologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, 67200 Strasbourg Cedex, France.
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20
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Human Serum Albumin Labelled with Sterically-Hindered Nitroxides as Potential MRI Contrast Agents. Molecules 2020; 25:molecules25071709. [PMID: 32276437 PMCID: PMC7180620 DOI: 10.3390/molecules25071709] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 11/29/2022] Open
Abstract
Four albumin-nitroxide conjugates were prepared and tested as metal-free organic radical contrast agents (ORCAs) for magnetic resonance imaging (MRI). Each human serum albumin (HSA) carrier bears multiple nitroxides conjugated via homocysteine thiolactones. These molecular conjugates retain important physical and biological properties of their HSA component, and the resistance of their nitroxide groups to bioreduction was retained or enhanced. The relaxivities are similar for these four conjugates and are much greater than those of their individual components: the HSA or the small nitroxide molecules. This new family of conjugates has excellent prospects for optimization as ORCAs.
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21
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Gadolinium Deposition Disease: A New Risk Management Threat. J Am Coll Radiol 2020; 17:546-550. [DOI: 10.1016/j.jacr.2019.11.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 01/06/2023]
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22
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Dhar AV, Huang CJ, Sue PK, Patel K, Farrow-Gillespie AC, Hammer MR, Zia AN, Mittal VS, Copley LA. Team Approach: Pediatric Musculoskeletal Infection. JBJS Rev 2020; 8:e0121. [PMID: 32224640 DOI: 10.2106/jbjs.rvw.19.00121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A team approach is optimal in the evaluation and treatment of musculoskeletal infection in pediatric patients given the complexity and uncertainty with which such infections manifest and progress, particularly among severely ill children. The team approach includes emergency medicine, pediatric intensive care, pediatric hospitalist medicine, infectious disease service, orthopaedic surgery, radiology, anesthesiology, pharmacology, and hematology.
These services follow evidence-based clinical practice guidelines with integrated processes of care so that children and their families may benefit from data-driven continuous process improvement. Important principles based on our experience in the successful treatment of pediatric musculoskeletal infection include relevant information gathering, pattern recognition, determination of the severity of illness, institutional workflow management, closed-loop communication, patient and family-centered care, ongoing dialogue among key stakeholders within and outside the context of direct patient care, and periodic data review for programmatic improvement over time. Such principles may be useful in almost any setting, including rural communities and developing countries, with the understanding that the team composition, institutional capabilities or limitations, and specific approaches to treatment may differ substantially from one setting or team to another.
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Affiliation(s)
- Archana V Dhar
- University of Texas Southwestern, Dallas, Texas.,Children's Health System of Texas, Dallas, Texas
| | - Craig J Huang
- University of Texas Southwestern, Dallas, Texas.,Children's Health System of Texas, Dallas, Texas
| | - Paul K Sue
- University of Texas Southwestern, Dallas, Texas.,Children's Health System of Texas, Dallas, Texas
| | | | - Alan C Farrow-Gillespie
- University of Texas Southwestern, Dallas, Texas.,Children's Health System of Texas, Dallas, Texas
| | - Matthew R Hammer
- University of Texas Southwestern, Dallas, Texas.,Children's Health System of Texas, Dallas, Texas
| | - Ayesha N Zia
- University of Texas Southwestern, Dallas, Texas.,Children's Health System of Texas, Dallas, Texas
| | - Vineeta S Mittal
- University of Texas Southwestern, Dallas, Texas.,Children's Health System of Texas, Dallas, Texas
| | - Lawson A Copley
- University of Texas Southwestern, Dallas, Texas.,Children's Health System of Texas, Dallas, Texas.,Texas Scottish Rite Hospital for Children, Dallas, Texas.,Texas Scottish Rite Hospital for Children, Dallas, Texas
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23
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Cosma I, Tennstedt-Schenk C, Winzler S, Psychogios MN, Pfeil A, Teichgraeber U, Malich A, Papageorgiou I. The role of gadolinium in magnetic resonance imaging for early prostate cancer diagnosis: A diagnostic accuracy study. PLoS One 2019; 14:e0227031. [PMID: 31869380 PMCID: PMC6927639 DOI: 10.1371/journal.pone.0227031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/10/2019] [Indexed: 01/01/2023] Open
Abstract
Objective Prostate lesions detected with multiparametric magnetic resonance imaging (mpMRI) are classified for their malignant potential according to the Prostate Imaging-Reporting And Data System (PI-RADS™2). In this study, we evaluate the diagnostic accuracy of the mpMRI with and without gadolinium, with emphasis on the added diagnostic value of the dynamic contrast enhancement (DCE). Materials and methods The study was retrospective for 286 prostate lesions / 213 eligible patients, n = 116/170, and 49/59% malignant for the peripheral (Pz) and transitional zone (Tz), respectively. A stereotactic MRI-guided prostate biopsy served as the histological ground truth. All patients received a mpMRI with DCE. The influence of DCE in the prediction of malignancy was analyzed by blinded assessment of the imaging protocol without DCE and the DCE separately. Results Significant (CSPca) and insignificant (IPca) prostate cancers were evaluated separately to enhance the potential effects of the DCE in the detection of CSPca. The Receiver Operating Characteristics Area Under Curve (ROC-AUC), sensitivity (Se) and specificity (Spe) of PIRADS-without-DCE in the Pz was 0.70/0.47/0.86 for all cancers (IPca and CSPca merged) and 0.73/0.54/0.82 for CSPca. PIRADS-with-DCE for the same patients showed ROC-AUC/Se/Spe of 0.70/0.49/0.86 for all Pz cancers and 0.69/0.54/0.81 for CSPca in the Pz, respectively, p>0.05 chi-squared test. Similar results for the Tz, AUC/Se/Spe for PIRADS-without-DCE was 0.75/0.61/0.79 all cancers and 0.67/0.54/0.71 for CSPca, not influenced by DCE (0.66/0.47/0.81 for all Tz cancers and 0.61/0.39/0.75 for CSPca in Tz). The added Se and Spe of DCE for the detection of CSPca was 88/34% and 78/33% in the Pz and Tz, respectively. Conclusion DCE showed no significant added diagnostic value and lower specificity for the prediction of CSPca compared to the non-enhanced sequences. Our results support that gadolinium might be omitted without mitigating the diagnostic accuracy of the mpMRI for prostate cancer.
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Affiliation(s)
- Ilinca Cosma
- Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
- Institute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany
| | | | - Sven Winzler
- Institute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany
| | - Marios Nikos Psychogios
- Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Alexander Pfeil
- Department of Internal Medicine, University Hospital Jena, Jena, Germany
| | - Ulf Teichgraeber
- Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Ansgar Malich
- Institute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany
| | - Ismini Papageorgiou
- Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
- Institute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany
- * E-mail:
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Lu JY, Yu H, Zou XL, Li Z, Hu XM, Shen YQ, Hu DY. Apparent diffusion coefficient-based histogram analysis differentiates histological subtypes of periampullary adenocarcinoma. World J Gastroenterol 2019; 25:6116-6128. [PMID: 31686767 PMCID: PMC6824280 DOI: 10.3748/wjg.v25.i40.6116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/17/2019] [Accepted: 09/28/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND For periampullary adenocarcinoma, the histological subtype is a better prognostic predictor than the site of tumor origin. Intestinal-type periampullary adenocarcinoma (IPAC) is reported to have a better prognosis than the pan-creatobiliary-type periampullary adenocarcinoma (PPAC). However, the classification of histological subtypes is difficult to determine before surgery. Apparent diffusion coefficient (ADC) histogram analysis is a noninvasive, non-enhanced method with high reproducibility that could help differentiate the two subtypes.
AIM To investigate whether volumetric ADC histogram analysis is helpful for distinguishing IPAC from PPAC.
METHODS Between January 2015 and October 2018, 476 consecutive patients who were suspected of having a periampullary tumor and underwent magnetic resonance imaging (MRI) were reviewed in this retrospective study. Only patients who underwent MRI at 3.0 T with different diffusion-weighted images (b-values = 800 and 1000 s/mm2) and who were confirmed with a periampullary adenocarcinoma were further analyzed. Then, the mean, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ADC values and ADCmin, ADCmax, kurtosis, skewness, and entropy were obtained from the volumetric histogram analysis. Comparisons were made by an independent Student's t-test or Mann-Whitney U test. Multiple-class receiver operating characteristic curve analysis was performed to determine and compare the diagnostic value of each significant parameter.
RESULTS In total, 40 patients with histopathologically confirmed IPAC (n = 17) or PPAC (n = 23) were enrolled. The mean, 5th, 25th, 50th, 75th, 90th, and 95th percentiles and ADCmax derived from ADC1000 were significantly lower in the PPAC group than in the IPAC group (P < 0.05). However, values derived from ADC800 showed no significant difference between the two groups. The 75th percentile of ADC1000 values achieved the highest area under the curve (AUC) for differentiating IPAC from PPAC (AUC = 0.781; sensitivity, 91%; specificity, 59%; cut-off value, 1.50 × 10-3 mm2/s).
CONCLUSION Volumetric ADC histogram analysis at a b-value of 1000 s/mm2 might be helpful for differentiating the histological subtypes of periampullary adenocarcinoma before surgery.
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Affiliation(s)
- Jing-Yu Lu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
- Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Hao Yu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xian-Lun Zou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xue-Mei Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Ya-Qi Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Dao-Yu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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Ojeaga PO, Hammer MR, Lindsay EA, Tareen NG, Jo CH, Copley LA. Quality Improvement of Magnetic Resonance Imaging for Musculoskeletal Infection in Children Results in Decreased Scan Duration and Decreased Contrast Use. J Bone Joint Surg Am 2019; 101:1679-1688. [PMID: 31567805 DOI: 10.2106/jbjs.19.00035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is a heavily utilized resource to evaluate children suspected to have a musculoskeletal infection. Complex interdisciplinary workflows are involved with decision-making with regard to indications, anesthesia, contrast use, and procedural timing relative to the scan. This study assesses the impact of a quality improvement endeavor on MRI workflows at a tertiary pediatric medical center. METHODS A registry of consecutively enrolled children for a multidisciplinary musculoskeletal infection program identified those evaluated with MRI from 2012 to 2018. Annual MRI process improvement feedback was provided to the key stakeholders. Demographic characteristics, laboratory parameters, MRI indications, anesthesia use, MRI findings, final diagnoses, scan duration, imaging protocol, surgical intervention following MRI, and length of stay were retrospectively compared between the 3 cohorts (initial, middle, and final) representing 2-year increments to assess the impact of the initiative. RESULTS There were 526 original MRI scans performed to evaluate 1,845 children with suspected musculoskeletal infection. Anesthesia was used in 401 children (76.2%). When comparing the initial, middle, and final study period cohorts, significant improvement was demonstrated for the number of sequences per scan (7.5 sequences for the initial cohort, 5.8 sequences for the middle cohort, and 4.6 sequences for the final cohort; p < 0.00001), scan duration (73.6 minutes for the initial cohort, 52.1 minutes for the middle cohort, and 34.9 minutes for the final cohort; p < 0.00001), anesthesia duration (94.1 minutes for the initial cohort, 68.9 minutes for the middle cohort, and 53.2 minutes for the final cohort; p < 0.00001), and the rate of contrast use (87.6% for the initial cohort, 67.7% for the middle cohort, and 26.3% for the final cohort; p < 0.00001). There was also a trend toward a higher rate of procedures under continued anesthesia immediately following the MRI (70.2% in the initial cohort, 77.8% in the middle cohort, and 84.6% in the final cohort). During the final 6-month period, the mean scan duration was 24.4 minutes, anesthesia duration was 40.9 minutes, and the rate of contrast administration was 8.5%. CONCLUSIONS Progressive quality improvement through collaborative interdisciplinary communication and workflow redesign led to improved utilization of MRI and minimized contrast use for suspected musculoskeletal infection. There was a high rate of procedural intervention under continued anesthesia for children with confirmed musculoskeletal infection. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Patrick O Ojeaga
- University of Texas Rio Grande Valley School of Medicine, Edinburg, Texas
| | - Matthew R Hammer
- Departments of Radiology (M.R.H.), Orthopaedic Surgery (L.A.C.), and Pediatrics (L.A.C.), University of Texas Southwestern, Dallas, Texas
| | - Eduardo A Lindsay
- Department of Orthopaedic Surgery, Children's Health System of Texas, Dallas, Texas
| | - Naureen G Tareen
- Department of Orthopaedic Surgery, Children's Health System of Texas, Dallas, Texas
| | - Chan Hee Jo
- Department of Clinical Orthopaedic Research, Texas Scottish Rite Hospital for Children, Dallas, Texas
| | - Lawson A Copley
- Departments of Radiology (M.R.H.), Orthopaedic Surgery (L.A.C.), and Pediatrics (L.A.C.), University of Texas Southwestern, Dallas, Texas
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Zhu G, Jiang B, Tong L, Xie Y, Zaharchuk G, Wintermark M. Applications of Deep Learning to Neuro-Imaging Techniques. Front Neurol 2019; 10:869. [PMID: 31474928 PMCID: PMC6702308 DOI: 10.3389/fneur.2019.00869] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/26/2019] [Indexed: 12/12/2022] Open
Abstract
Many clinical applications based on deep learning and pertaining to radiology have been proposed and studied in radiology for classification, risk assessment, segmentation tasks, diagnosis, prognosis, and even prediction of therapy responses. There are many other innovative applications of AI in various technical aspects of medical imaging, particularly applied to the acquisition of images, ranging from removing image artifacts, normalizing/harmonizing images, improving image quality, lowering radiation and contrast dose, and shortening the duration of imaging studies. This article will address this topic and will seek to present an overview of deep learning applied to neuroimaging techniques.
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Affiliation(s)
| | | | | | | | | | - Max Wintermark
- Neuroradiology Section, Department of Radiology, Stanford Healthcare, Stanford, CA, United States
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Abstract
Ultrasound (US) and Doppler are often the first imaging to be carried out for arterial disease, and with good reason. US is noninvasive, free of radiation exposure and crucial for follow up imaging. The review that follows aims to highlight the various applications of US in imaging of the arterial system.
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Affiliation(s)
- Prashant Gupta
- Department of Radiology, Scunthorpe General Hospital, Northern Lincolnshire and Goole NHS Foundation Trust, UK
| | - Shannon Lyons
- Division of Cardiovascular Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sandeep Hedgire
- Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Blumfield E, Swenson DW, Iyer RS, Stanescu AL. Gadolinium-based contrast agents - review of recent literature on magnetic resonance imaging signal intensity changes and tissue deposits, with emphasis on pediatric patients. Pediatr Radiol 2019; 49:448-457. [PMID: 30923876 DOI: 10.1007/s00247-018-4304-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/01/2018] [Accepted: 10/31/2018] [Indexed: 12/29/2022]
Abstract
Gadolinium has been used as a base for contrast agents in MRI for the last three decades. Numerous studies over the last 4 years have reported increased signal intensity in deep brain nuclei in non-contrast MRI images following gadolinium-based contrast agent (GBCA) administration. Pathology studies performed on adults and children, and rodent necropsy studies have also shown gadolinium deposition in brain and other tissues after GBCA administration. The purpose of this review was to summarize and discuss the knowledge gained from these reports and the relevance for imaging pediatric patients.
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Affiliation(s)
- Einat Blumfield
- Department of Radiology, Children's Hospital of Montefiore, Albert Einstein College of Medicine, 111E 210th St, Bronx, NY, 10461, USA.
| | - David W Swenson
- Department of Diagnostic Imaging, Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI, USA
| | - Ramesh S Iyer
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - A Luana Stanescu
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
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Le Fur M, Caravan P. The biological fate of gadolinium-based MRI contrast agents: a call to action for bioinorganic chemists. Metallomics 2019; 11:240-254. [PMID: 30516229 PMCID: PMC6486840 DOI: 10.1039/c8mt00302e] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Gadolinium-based contrast agents (GBCAs) are widely used with clinical magnetic resonance imaging (MRI), and 10 s of millions of doses of GBCAs are administered annually worldwide. GBCAs are hydrophilic, thermodynamically stable and kinetically inert gadolinium chelates. In clinical MRI, 5-10 millimoles of Gd ion is administered intravenously and the GBCA is rapidly eliminated intact primarily through the kidneys into the urine. It is now well-established that the Gd3+ ion, in some form(s), is partially retained in vivo. In patients with advanced kidney disease, there is an association of Gd retention with nephrogenic systemic fibrosis (NSF) disease. However Gd is also retained in the brain, bone, skin, and other tissues in patients with normal renal function, and the presence of Gd can persist months to years after the last administration of a GBCA. Regulatory agencies are restricting the use of specific GBCAs and inviting health care professionals to evaluate the risk/benefit ratio prior to using GBCAs. Despite the growing number of studies investigating this issue both in animals and humans, the biological distribution and the chemical speciation of the residual gadolinium are not fully understood. Is the GBCA retained in its intact form? Is the Gd3+ ion dissociated from its chelator, and if so, what is its chemical form? Here we discuss the current state of knowledge regarding the issue of Gd retention and describe the analytical and spectroscopic methods that can be used to investigate the Gd speciation. Many of the physical methods that could be brought to bear on this problem are in the domain of bioinorganic chemistry and we hope that this review will serve to inspire this community to take up this important problem.
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Affiliation(s)
- Mariane Le Fur
- The Athinoula A. Martinos Center for Biomedical Imaging, The Institute for Innovation in Imaging, Massachusetts General Hospital and Harvard Medical School, 149 Thirteenth Street, Charlestown, Massachusetts 02129, USA.
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Ackermans N, Taylor C, Tam R, Carruthers R, Kolind S, Kang H, Freedman MS, Li DK, Traboulsee AL. Effect of different doses of gadolinium contrast agent on clinical outcomes in MS. Mult Scler J Exp Transl Clin 2019; 5:2055217318823796. [PMID: 30800415 PMCID: PMC6378456 DOI: 10.1177/2055217318823796] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 02/04/2023] Open
Abstract
Objective The objective of this paper is to evaluate potential dose-dependent adverse effects of gadolinium-based contrast agents (GBCAs) on MS progression. Methods Outcomes from a cohort of 612 secondary progressive MS (SPMS) patients, enrolled in a two-year, placebo-controlled (negative) trial assessing the efficacy of MBP8298, were acquired. Patients received one to four (infrequent cohort; IFR) or 5–11 (frequent cohort; FR) GBCA injections between week 4 and week 104. The primary outcome was the change in Expanded Disability Status Scale (EDSS) and time to confirmed EDSS progression. Secondary outcomes included the changes in the Multiple Sclerosis Functional Composite (MSFC), Timed 25-Foot Walk (T25FW), 9-Hole-Peg Test (9HPT), and Paced Auditory Serial Addition Test (PASAT) from baseline to week 104. Results The 512 IFR and 100 FR participants showed no differences in baseline demographics or disease history. The mean change from baseline to week 104 in EDSS was +0.21 (IFR) and +0.13 (FR); MSFC –0.38 (IFR) and –0.14 (FR); T25FW +1.28 (IFR) and +0.55 (FR); 9HPT –0.06 (IFR) and –0.08 (FR); and PASAT +0.22 (IFR) and +0.20 (FR). The FR to IFR progression hazard ratio equaled 0.68 (p = 0.09). There were no significant differences in any of the outcomes between the two cohorts. Conclusion There were no differences in the disability progression measures between the two cohorts, indicating that gadolinium does not result in greater clinical worsening in SPMS after a two-year period.
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Affiliation(s)
- Nathalie Ackermans
- University of British Columbia, Department of Medicine (Neurology), Canada
| | - Carolyn Taylor
- University of British Columbia, Department of Statistics, Canada
| | - Roger Tam
- University of British Columbia, Department of Radiology, Canada
| | - Robert Carruthers
- University of British Columbia, Department of Medicine (Neurology), Canada
| | - Shannon Kolind
- University of British Columbia, Department of Medicine (Neurology), Canada
| | - Heejun Kang
- University of British Columbia, Department of Radiology, Canada
| | - Mark S Freedman
- University of Ottawa and the Ottawa Hospital Research Institute, Canada
| | - David Kb Li
- University of British Columbia, Department of Medicine (Neurology), Canada.,University of British Columbia, Department of Radiology, Canada
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Zhu DY, Lu B, Yin JH, Ke QF, Xu H, Zhang CQ, Guo YP, Gao YS. Gadolinium-doped bioglass scaffolds promote osteogenic differentiation of hBMSC via the Akt/GSK3β pathway and facilitate bone repair in vivo. Int J Nanomedicine 2019; 14:1085-1100. [PMID: 30804672 PMCID: PMC6375113 DOI: 10.2147/ijn.s193576] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Biomaterial-induced osteogenesis is mainly related to hierarchically porous structures and bioactive components. Rare earth elements are well known to promote osteogenesis and stimulate bone repair; however, the underlying biological effects of gadolinium (Gd) element on bone regeneration are not yet known. METHODS In this study, we successfully fabricated gadolinium-doped bioglass (Gd-BG) scaffolds by combining hollow mesoporous Gd-BG microspheres with chitosan and evaluated in vitro effects and underlying mechanisms with Cell Counting Kit-8, scanning electron microscopy, alkaline phosphatase, Alizarin red staining, and polymerase chain reaction. Cranial defect model of rats was constructed to evaluate their in vivo effects. RESULTS The results indicated that Gd-BG scaffolds could promote the proliferation and osteogenic differentiation of human bone marrow-derived mesenchymal stem cells (hBMSCs). Mechanistically, the Akt/GSK3β signaling pathway was activated by the Gd-BG scaffolds. The enhancing effect of Gd-BG scaffolds on the osteogenic differentiation of hBMSCs was inhibited by the addition of LY294002, an inhibitor of Akt. Moreover, the in vivo cranial defect model of rats indicated that the Gd-BG scaffolds could effectively promote bone regeneration. CONCLUSION Both in vitro and in vivo results suggested that Gd-BG scaffolds have promising applications in bone tissue engineering.
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Affiliation(s)
- Dao-Yu Zhu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China,
| | - Bin Lu
- The Education Ministry Key Lab of Resource Chemistry, Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai 200234, China,
| | - Jun-Hui Yin
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China,
| | - Qin-Fei Ke
- The Education Ministry Key Lab of Resource Chemistry, Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai 200234, China,
| | - He Xu
- The Education Ministry Key Lab of Resource Chemistry, Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai 200234, China,
| | - Chang-Qing Zhang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China,
| | - Ya-Ping Guo
- The Education Ministry Key Lab of Resource Chemistry, Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai 200234, China,
| | - You-Shui Gao
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China,
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA 6009, Australia
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Choi JW, Moon WJ. Gadolinium Deposition in the Brain: Current Updates. Korean J Radiol 2018; 20:134-147. [PMID: 30627029 PMCID: PMC6315073 DOI: 10.3348/kjr.2018.0356] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022] Open
Abstract
Gadolinium-based contrast agents (GBCAs) are commonly used for enhancement in MR imaging and have long been considered safe when administered at recommended doses. However, since the report that nephrogenic systemic fibrosis is linked to the use of GBCAs in subjects with severe renal diseases, accumulating evidence has suggested that GBCAs are not cleared entirely from our bodies; some GBCAs are deposited in our tissues, including the brain. GBCA deposition in the brain is mostly linked to the specific chelate structure of the GBCA: linear GBCAs were responsible for brain deposition in almost all reported studies. This review aimed to summarize the current knowledge about GBCA brain deposition and discuss its clinical implications.
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Affiliation(s)
- Jin Woo Choi
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Won-Jin Moon
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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State of the art in magnetic resonance imaging of hepatocellular carcinoma. Radiol Oncol 2018; 52:353-364. [PMID: 30511939 PMCID: PMC6287184 DOI: 10.2478/raon-2018-0044] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 10/19/2018] [Indexed: 12/12/2022] Open
Abstract
Background Liver cancer is the sixth most common cancer worldwide and the second leading cause of cancer mortality. Chronic liver disease caused by viral infection, alcohol abuse, or other factors can lead to cirrhosis. Cirrhosis is the most important clinical risk factor for hepatocellular carcinoma (HCC) whereby the normal hepatic architecture is replaced by fibrous septa and a spectrum of nodules ranging from benign regenerative nodules to HCC, each one of them with different imaging features. Conclusions Furthermore, advanced techniques including the quantification of hepatic and intralesional fat and iron, magnetic resonance elastography, radiomics, radiogenomics, and positron emission tomography (PET)-MRI are highly promising for the extraction of new imaging biomarkers that reflect the tumor microenvironment and, in the future, may add decision-making value in the management of patients with HCC.
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Gadolinium Chloride Rescues Niemann⁻Pick Type C Liver Damage. Int J Mol Sci 2018; 19:ijms19113599. [PMID: 30441844 PMCID: PMC6274821 DOI: 10.3390/ijms19113599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 02/07/2023] Open
Abstract
Niemann–Pick type C (NPC) disease is a rare neurovisceral cholesterol storage disorder that arises from loss of function mutations in the NPC1 or NPC2 genes. Soon after birth, some patients present with an aggressive hepatosplenomegaly and cholestatic signs. Histopathologically, the liver presents with large numbers of foam cells; however, their role in disease pathogenesis has not been explored in depth. Here, we studied the consequences of gadolinium chloride (GdCl3) treatment, a well-known Kupffer/foam cell inhibitor, at late stages of NPC liver disease and compared it with NPC1 genetic rescue in hepatocytes in vivo. GdCl3 treatment successfully blocked the endocytic capacity of hepatic Kupffer/foam measured by India ink endocytosis, decreased the levels CD68—A marker of Kupffer cells in the liver—and normalized the transaminase levels in serum of NPC mice to a similar extent to those obtained by genetic Npc1 rescue of liver cells. Gadolinium salts are widely used as magnetic resonance imaging (MRI) contrasts. This study opens the possibility of targeting foam cells with gadolinium or by other means for improving NPC liver disease. Synopsis: Gadolinium chloride can effectively rescue some parameters of liver dysfunction in NPC mice and its potential use in patients should be carefully evaluated.
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Gadolinium Deposition in the Brain: A Systematic Review of Existing Guidelines and Policy Statement Issued by the Canadian Association of Radiologists. Can Assoc Radiol J 2018; 69:373-382. [DOI: 10.1016/j.carj.2018.04.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 04/08/2018] [Indexed: 12/20/2022] Open
Abstract
Emerging evidence has confirmed that, following administration of a gadolinium-based contrast agent (GBCA), very small amounts of gadolinium will deposit in the brain of humans with intact blood-brain barriers. The literature is evolving rapidly and the degree to which gadolinium will deposit for a particular GBCA or class of GBCAs remains undetermined. Several studies suggest that linear GBCAs deposit more gadolinium in the brain compared with macrocyclic GBCAs; however, our understanding of the molecular composition of deposited gadolinium is preliminary, and the clinical significance of gadolinium deposition remains unknown. To date, there is no conclusive evidence linking gadolinium deposition in the brain with any adverse patient outcome. A panel of radiologists representing the Canadian Association of Radiologists was assembled to assist the Canadian medical imaging community in making informed decisions regarding the issue of gadolinium deposition in the brain. The objectives of the working group were: 1) to review the evidence from animal and human studies; 2) to systematically review existing guidelines and position statements issued by other organizations and health agencies; and 3) to formulate an evidence-based position statement on behalf of the Canadian Association of Radiologists. Based on our appraisal of the evidence and systematic review of 9 guidelines issued by other organizations, the working group established the following consensus statement. GBCA administration should be considered carefully with respect to potential risks and benefits, and only used when required. Standard dosing should be used and repeat administrations should be avoided unless necessary. Gadolinium deposition is one of several issues to consider when prescribing a particular GBCA. Currently there is insufficient evidence to recommend one class of GBCA over another. The panel considered it inappropriate to withhold a linear GBCA if a macrocyclic agent is unavailable, if hepatobiliary phase imaging is required, or if there is a history of severe allergic reaction to a macrocyclic GBCA. Further study in this area is required, and the evidence should be monitored regularly with policy statements updated accordingly.
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Guo BJ, Yang ZL, Zhang LJ. Gadolinium Deposition in Brain: Current Scientific Evidence and Future Perspectives. Front Mol Neurosci 2018; 11:335. [PMID: 30294259 PMCID: PMC6158336 DOI: 10.3389/fnmol.2018.00335] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 08/27/2018] [Indexed: 01/18/2023] Open
Abstract
In the past 4 years, many publications described a concentration-dependent deposition of gadolinium in the brain both in adults and children, seen as high signal intensities in the globus pallidus and dentate nucleus on unenhanced T1-weighted images. Postmortem human or animal studies have validated gadolinium deposition in these T1-hyperintensity areas, raising new concerns on the safety of gadolinium-based contrast agents (GBCAs). Residual gadolinium is deposited not only in brain, but also in extracranial tissues such as liver, skin, and bone. This review summarizes the current evidence on gadolinium deposition in the human and animal bodies, evaluates the effects of different types of GBCAs on the gadolinium deposition, introduces the possible entrance or clearance mechanism of the gadolinium and potential side effects that may be related to the gadolinium deposition on human or animals, and puts forward some suggestions for further research.
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Affiliation(s)
- Bang J. Guo
- Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, Nanjing, China
| | - Zhen L. Yang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Long J. Zhang
- Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, Nanjing, China
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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De Bondt T, Kalai M, Vanhevel F, Morhedec O, Thery D, Zanca F, Parizel PM. [P068] Management of clinical MRI workflow and gadolinium dosing using a dedicated software tool. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.06.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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The role of magnetic resonance angiography in peripheral artery disease. Curr Opin Pharmacol 2018; 39:129-133. [DOI: 10.1016/j.coph.2018.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/21/2018] [Accepted: 05/17/2018] [Indexed: 11/20/2022]
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MRI and multiple sclerosis––the evolving role of MRI in the diagnosis and management of MS: the radiologist’s perspective. Ir J Med Sci 2017; 187:781-787. [DOI: 10.1007/s11845-017-1714-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
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