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Bhandari A, Gu B, Kashkooli FM, Zhan W. Image-based predictive modelling frameworks for personalised drug delivery in cancer therapy. J Control Release 2024; 370:721-746. [PMID: 38718876 DOI: 10.1016/j.jconrel.2024.05.004] [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: 02/04/2024] [Revised: 04/11/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024]
Abstract
Personalised drug delivery enables a tailored treatment plan for each patient compared to conventional drug delivery, where a generic strategy is commonly employed. It can not only achieve precise treatment to improve effectiveness but also reduce the risk of adverse effects to improve patients' quality of life. Drug delivery involves multiple interconnected physiological and physicochemical processes, which span a wide range of time and length scales. How to consider the impact of individual differences on these processes becomes critical. Multiphysics models are an open system that allows well-controlled studies on the individual and combined effects of influencing factors on drug delivery outcomes while accommodating the patient-specific in vivo environment, which is not economically feasible through experimental means. Extensive modelling frameworks have been developed to reveal the underlying mechanisms of drug delivery and optimise effective delivery plans. This review provides an overview of currently available models, their integration with advanced medical imaging modalities, and code packages for personalised drug delivery. The potential to incorporate new technologies (i.e., machine learning) in this field is also addressed for development.
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Affiliation(s)
- Ajay Bhandari
- Biofluids Research Lab, Department of Mechanical Engineering, Indian Institute of Technology (Indian School of Mines), Dhanbad, India
| | - Boram Gu
- School of Chemical Engineering, Chonnam National University, Gwangju, Republic of Korea
| | | | - Wenbo Zhan
- School of Engineering, University of Aberdeen, Aberdeen, UK.
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2
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Zöllner FG, Sadick M. Editorial for "Cotyledon-Specific Flow Evaluation of Rhesus Macaque Placental Injury Using Ferumoxytol Dynamic Contrast-Enhanced MRI". J Magn Reson Imaging 2024. [PMID: 38389260 DOI: 10.1002/jmri.29292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 02/24/2024] Open
Affiliation(s)
- Frank G Zöllner
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Cooperative Core Facility Animal Scanner ZI, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maliha Sadick
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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3
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Smith GCS. Predicting and preventing stillbirth at term. Semin Perinatol 2024; 48:151869. [PMID: 38135621 DOI: 10.1016/j.semperi.2023.151869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Stillbirth at term affects ∼1 per 1000 pregnancies at term in high income countries. A range of maternal characteristics are associated with stillbirth risk. However, given the low a priori risk of stillbirth, the vast majority of women with clinical risk factors would not experience a stillbirth in the absence of intervention. Stillbirth is the end point of multiple pathways, including both fetal growth restriction and fetal overgrowth. In most term stillbirths there is no mechanistic understanding of the cause of death and a sizeable proportion are completely unexplained. Term stillbirth is potentially preventable by early delivery, providing a rationale for screening. "Omic" analyses of blood taken prior to the onset of some of the conditions associated with stillbirth may help identify women at high risk and allow the potentially harmful intervention of early term medically indicated delivery to be targeted to the pregnancies most likely to benefit.
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Affiliation(s)
- Gordon C S Smith
- Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Biomedical Research Centre, Cambridge, CB2 0SW, UK.
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4
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Clark A, Flouri D, Mufti N, James J, Clements E, Aughwane R, Aertsen M, David A, Melbourne A. Developments in functional imaging of the placenta. Br J Radiol 2023; 96:20211010. [PMID: 35234516 PMCID: PMC10321248 DOI: 10.1259/bjr.20211010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/26/2022] [Accepted: 02/22/2022] [Indexed: 12/21/2022] Open
Abstract
The placenta is both the literal and metaphorical black box of pregnancy. Measurement of the function of the placenta has the potential to enhance our understanding of this enigmatic organ and serve to support obstetric decision making. Advanced imaging techniques are key to support these measurements. This review summarises emerging imaging technology being used to measure the function of the placenta and new developments in the computational analysis of these data. We address three important examples where functional imaging is supporting our understanding of these conditions: fetal growth restriction, placenta accreta, and twin-twin transfusion syndrome.
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Affiliation(s)
- Alys Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | | | | | - Joanna James
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Eleanor Clements
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Rosalind Aughwane
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, UK
| | - Michael Aertsen
- Department of Radiology, University Hospitals KU Leuven, Leuven, Belgium
| | - Anna David
- Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, UK
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Sinagra L, Orlandi R, Caspanello T, Troisi A, Iannelli NM, Vallesi E, Pettina G, Bargellini P, De Majo M, Boiti C, Cristarella S, Quartuccio M, Polisca A. Contrast-Enhanced Ultrasonography (CEUS) in Imaging of the Reproductive System in Dogs: A Literature Review. Animals (Basel) 2023; 13:ani13101615. [PMID: 37238045 DOI: 10.3390/ani13101615] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
The use of contrast-enhanced ultrasound (CEUS) has been widely reported for reproductive imaging in humans and animals. This review aims to analyze the utility of CEUS in characterizing canine reproductive physiology and pathologies. In September 2022, a search for articles about CEUS in canine testicles, prostate, uterus, placenta, and mammary glands was conducted on PubMed and Scopus from 1990 to 2022, showing 36 total results. CEUS differentiated testicular abnormalities and neoplastic lesions, but it could not characterize tumors. In prostatic diseases, CEUS in dogs was widely studied in animal models for prostatic cancer treatment. In veterinary medicine, this diagnostic tool could distinguish prostatic adenocarcinomas. In ovaries, CEUS differentiated the follicular phases. In CEH-pyometra syndrome, it showed a different enhancement between endometrium and cysts, and highlighted angiogenesis. CEUS was shown to be safe in pregnant dogs and was able to assess normal and abnormal fetal-maternal blood flow and placental dysfunction. In normal mammary glands, CEUS showed vascularization only in diestrus, with differences between mammary glands. CEUS was not specific for neoplastic versus non-neoplastic masses and for benign tumors, except for complex carcinomas and neoplastic vascularization. Works on CEUS showed its usefulness in a wide spectrum of pathologies of this non-invasive, reliable diagnostic procedure.
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Affiliation(s)
- Letizia Sinagra
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Riccardo Orlandi
- Anicura Tyrus Clinica Veterinaria, Via Bartocci 1G, 05100 Terni, Italy
| | - Tiziana Caspanello
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Alessandro Troisi
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Macerata, Italy
| | - Nicola Maria Iannelli
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
- Clinica Veterinaria Camagna-VetPartners, Via Fortunato Licandro 13, 89124 Reggio di Calabria, Italy
| | - Emanuela Vallesi
- Anicura Tyrus Clinica Veterinaria, Via Bartocci 1G, 05100 Terni, Italy
- Anicura CMV Clinica Veterinaria, Via G.B. Aguggiari 162, 21100 Varese, Italy
| | - Giorgia Pettina
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Paolo Bargellini
- Anicura Tyrus Clinica Veterinaria, Via Bartocci 1G, 05100 Terni, Italy
| | - Massimo De Majo
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Cristiano Boiti
- Tyrus Science Foundation, Via Bartocci 1G, 05100 Terni, Italy
| | - Santo Cristarella
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Marco Quartuccio
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 13, 98168 Messina, Italy
| | - Angela Polisca
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
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Wilson RC, Lo JO, Romero Jimenez G, Lindner JR, Slayden OD, Roberts VHJ. Utilizing Contrast-Enhanced Ultrasonography with Phosphatidylserine Microbubbles to Detect Placental Inflammation in Rhesus Macaques. Molecules 2023; 28:2894. [PMID: 37049657 PMCID: PMC10096139 DOI: 10.3390/molecules28072894] [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: 02/03/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
The ability to comprehensively monitor physiological and detect pathophysiologic processes early during pregnancy can reduce maternal and fetal morbidity and mortality. Contrast-enhanced ultrasound (CEUS) is a non-invasive imaging technology that utilizes the acoustic detection of microbubbles to examine vascular spaces. Furthermore, microbubbles conjugated to specific compounds can focus studies on precise physiological pathways. We hypothesized that CEUS with phosphatidylserine microbubbles (MB-PS) could be employed to monitor placental inflammation. We tested this hypothesis in rhesus macaques (Macaca mulatta), a translational and relevant animal model of human placental health. As placental inflammation impacts many at-risk pregnancies, we performed CEUS with MB-PS in pregnant macaques fed a high-fat diet (e.g., a western-style diet, WSD) in the presence or absence of testosterone (T) to mimic the increased risk of polycystic ovary syndrome and subfertility. We have previously demonstrated a placental inflammation phenotype in this model, and, thus, we related the MB-PS CEUS signal intensity to placental inflammation markers: selectin p and angiopoietins. Testosterone exposure increased the MB-PS signal in the placental microcirculation on the maternal side compared to control animals. We found that T increased placental weight and decreased angiopoietin 2 (ANGPT2) immunoreactivity. Furthermore, a significant inverse correlation was found between MB-PS signal and ANGPT2. This indicated that CEUS with MB-PS can be used to monitor placental parameters. We propose that CEUS with MB-PS could aid in the identification of pregnancies at risk of placental vascular compromise.
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Affiliation(s)
- Rachel C. Wilson
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| | - Jamie O. Lo
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA
| | - Gabriel Romero Jimenez
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| | - Jonathan R. Lindner
- Cardiovascular Division, University of Virginia Medical Center, Charlottesville, VA 22903, USA
| | - Ov D. Slayden
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| | - Victoria H. J. Roberts
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR 97006, USA
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Zhu H, Li Z, Zhou Y, Zheng R, Diao C, Li K, Feng Q, Wang D. Neutrophil-lymphocyte ratio as a risk factor for osteoporotic vertebrae fractures and femoral neck fractures. Medicine (Baltimore) 2022; 101:e32125. [PMID: 36482639 PMCID: PMC9726278 DOI: 10.1097/md.0000000000032125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022] Open
Abstract
Fracture is associated with osteopenia after osteoporosis. Neutrophil-lymphocyte ratio (NLR) is common in inflammatory diseases. NLR can be used as an effective clinical tool to assess postmenopausal osteoporosis. The aim of this study is to further explore the relationship between elevated NLR and the severity of osteoporotic vertebrae fractures and femoral neck fracture based on magnetic resonance imaging (MRI). A total of 80 patients with osteoporotic vertebrae fractures, osteoporotic femoral neck fracture in Baoding Second Central Hospital from 2017 to 2020 were selected as the research objects. This study included a series of pretreatment factors, mainly including white blood cell count, red blood cell count, hemoglobin, and the general condition of the patients. Statistical methods included Pearson chi-square test, Spearman correlation test, logistic regression analysis and receiver operator characteristic (ROC) curve. According to Pearson chi-square test, Spearman correlation test, univariate/multivariate logistic regression analysis, the severity of osteoporotic vertebrae fractures, osteoporotic femoral neck fracture was significantly correlated with NLR (P < .001). NLR (odds ratio [OR] = 13.229, 95% CI: 4.167-41.998, P < .001) was a significant independent risk factor for osteoporotic vertebrae fractures, osteoporotic femoral neck fracture. receiver operator characteristic (ROC) curve was used to detect the specificity and sensitivity. The level of NLR has an important influence on the severity of osteoporotic vertebrae fractures and femoral neck fracture. The higher the level of NLR, the more serious the osteoporotic vertebrae fractures and femoral neck fracture.
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Affiliation(s)
- Hao Zhu
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Zheng Li
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Yizhai Zhou
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Rugeng Zheng
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Cong Diao
- Obstetrics Department, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Kepeng Li
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou City, Hebei Province, PR China
| | - Qi Feng
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Donglai Wang
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
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8
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Zhang X. Magnetic resonance imaging of the monkey fetal brain in utero. INVESTIGATIVE MAGNETIC RESONANCE IMAGING 2022; 26:177-190. [PMID: 36937817 PMCID: PMC10019598 DOI: 10.13104/imri.2022.26.4.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Non-human primates (NHPs) are the closest living relatives of the human and play a critical role in investigating the effects of maternal viral infection and consumption of medicines, drugs, and alcohol on fetal development. With the advance of contemporary fast MRI techniques with parallel imaging, fetal MRI is becoming a robust tool increasingly used in clinical practice and preclinical studies to examine congenital abnormalities including placental dysfunction, congenital heart disease (CHD), and brain abnormalities non-invasively. Because NHPs are usually scanned under anesthesia, the motion artifact is reduced substantially, allowing multi-parameter MRI techniques to be used intensively to examine the fetal development in a single scanning session or longitudinal studies. In this paper, the MRI techniques for scanning monkey fetal brains in utero in biomedical research are summarized. Also, a fast imaging protocol including T2-weighted imaging, diffusion MRI, resting-state functional MRI (rsfMRI) to examine rhesus monkey fetal brains in utero on a clinical 3T scanner is introduced.
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Affiliation(s)
- Xiaodong Zhang
- EPC Imaging Center and Division of Neuropharmacology and Neurologic Diseases, Emory National Primate Research Center, Emory University, Atlanta, Georgia, 30329, USA
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9
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David AL, Spencer RN. Clinical Assessment of Fetal Well-Being and Fetal Safety Indicators. J Clin Pharmacol 2022; 62 Suppl 1:S67-S78. [PMID: 36106777 PMCID: PMC9544851 DOI: 10.1002/jcph.2126] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/24/2022] [Indexed: 12/03/2022]
Abstract
Delivering safe clinical trials of novel therapeutics is central to enable pregnant women and their babies to access medicines for better outcomes. This review describes clinical monitoring of fetal well‐being and safety. Current pregnancy surveillance includes regular antenatal checks of blood pressure and urine for signs of gestational hypertension. Fetal and placental development is assessed routinely using the first‐trimester “dating” and mid‐trimester “anomaly” ultrasound scans, but the detection of fetal anomalies can continue throughout pregnancy using targeted sonography or magnetic resonance imaging (MRI). Serial sonography can be used to assess fetal size, well‐being, and placental function. Carefully defined reproducible imaging parameters, such as the head circumference (HC), abdominal circumference (AC), and femur length (FL), are combined to calculate an estimate of the fetal weight. Doppler analysis of maternal uterine blood flow predicts placental insufficiency, which is associated with poor fetal growth. Fetal doppler analysis can indicate circulatory decompensation and fetal hypoxia, requiring delivery to be expedited. Novel ways to assess fetal well‐being and placental function using MRI, computerized cardiotocography (CTG), serum circulating fetoplacental proteins, and mRNA may improve the assessment of the safety and efficacy of maternal and fetal interventions. Progress has been made in how to define and grade clinical trial safety in pregnant women, the fetus, and neonate. A new system for improved safety monitoring for clinical trials in pregnancy, Maternal and Fetal Adverse Event Terminology (MFAET), describes 12 maternal and 18 fetal adverse event (AE) definitions and severity grading criteria developed through an international modified Delphi consensus process. This fills a vital gap in maternal and fetal translational medicine research.
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Affiliation(s)
- Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,National Institute for Health and Care Research (NIHR) University College London Hospitals NHS Foundation Trust (UCLH), Biomedical Research Centre, London, UK
| | - Rebecca N Spencer
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.,School of Medicine, University of Leeds, Leeds, UK
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