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Rovira À, Doniselli FM, Auger C, Haider L, Hodel J, Severino M, Wattjes MP, van der Molen AJ, Jasperse B, Mallio CA, Yousry T, Quattrocchi CC. Use of gadolinium-based contrast agents in multiple sclerosis: a review by the ESMRMB-GREC and ESNR Multiple Sclerosis Working Group. Eur Radiol 2024; 34:1726-1735. [PMID: 37658891 DOI: 10.1007/s00330-023-10151-y] [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: 04/24/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 09/05/2023]
Abstract
Magnetic resonance imaging (MRI) is the most sensitive technique for detecting inflammatory demyelinating lesions in multiple sclerosis (MS) and plays a crucial role in diagnosis and monitoring treatment effectiveness, and for predicting the disease course. In clinical practice, detection of MS lesions is mainly based on T2-weighted and contrast-enhanced T1-weighted sequences. Contrast-enhancing lesions (CEL) on T1-weighted sequences are related to (sub)acute inflammation, while new or enlarging T2 lesions reflect the permanent footprint from a previous acute inflammatory demyelinating event. These two types of MRI features provide redundant information, at least in regular monitoring of the disease. Due to the concern of gadolinium deposition after repetitive injections of gadolinium-based contrast agents (GBCAs), scientific organizations and regulatory agencies in Europe and North America have proposed that these contrast agents should be administered only if clinically necessary. In this article, we provide data on the mode of action of GBCAs in MS, the indications of the use of these agents in clinical practice, their value in MS for diagnostic, prognostic, and monitoring purposes, and their use in specific populations (children, pregnant women, and breast-feeders). We discuss imaging strategies that achieve the highest sensitivity for detecting CELs in compliance with the safety regulations established by different regulatory agencies. Finally, we will briefly discuss some alternatives to the use of GBCA for detecting blood-brain barrier disruption in MS lesions. CLINICAL RELEVANCE STATEMENT: Although use of GBCA at diagnostic workup of suspected MS is highly valuable for diagnostic and prognostic purposes, their use in routine monitoring is not mandatory and must be reduced, as detection of disease activity can be based on the identification of new or enlarging lesions on T2-weighted images. KEY POINTS: • Both the EMA and the FDA state that the use of GBCA in medicine should be restricted to clinical scenarios in which the additional information offered by the contrast agent is required. • The use of GBCA is generally recommended in the diagnostic workup in subjects with suspected MS and is generally not necessary for routine monitoring in clinical practice. • Alternative MRI-based approaches for detecting acute focal inflammatory MS lesions are not yet ready to be used in clinical practice.
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Affiliation(s)
- Àlex Rovira
- Section of Neuroradiology, Department of Radiology, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
| | - Fabio M Doniselli
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Cristina Auger
- Section of Neuroradiology, Department of Radiology, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - Lukas Haider
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jerome Hodel
- Department of Radiology, Groupe Hospitalier Paris-Saint Joseph, Paris, France
| | | | - Mike P Wattjes
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | | | - Bas Jasperse
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Carlo A Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Rome, Italy
| | - Tarek Yousry
- Lysholm Department of Neuroradiology, UCLH National Hospital for Neurology and Neurosurgery, Neuroradiological Academic Unit, UCL Institute of Neurology, London, UK
| | - Carlo C Quattrocchi
- Centre for Medical Sciences CISMed, University of Trento, Trento, Italy
- Radiology, Multizonal Unit of Rovereto and Arco, APSS Provincia Autonoma Di Trento, Trento, Italy
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Porrello G, Cannella R, Bernuau J, Agman A, Brancatelli G, Dioguardi Burgio M, Vilgrain V. Liver imaging and pregnancy: what to expect when your patient is expecting. Insights Imaging 2024; 15:66. [PMID: 38411871 PMCID: PMC10899155 DOI: 10.1186/s13244-024-01622-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/07/2024] [Indexed: 02/28/2024] Open
Abstract
Liver diseases in pregnancy can be specific to gestation or only coincidental. In the latter case, the diagnosis can be difficult. Rapid diagnosis of maternal-fetal emergencies and situations requiring specialized interventions are crucial to preserve the maternal liver and guarantee materno-fetal survival. While detailed questioning of the patient and a clinical examination are highly important, imaging is often essential to reach a diagnosis of these liver diseases and lesions. Three groups of liver diseases may be observed during pregnancy: (1) diseases related to pregnancy: intrahepatic cholestasis of pregnancy, pre-eclampsia, eclampsia, hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, and acute fatty liver of pregnancy; (2) liver diseases that are more frequent during or exacerbated by pregnancy: acute herpes simplex hepatitis, Budd-Chiari syndrome, hemorrhagic hereditary telangiectasia, hepatocellular adenoma, portal vein thrombosis, and cholelithiasis; (3) coincidental conditions, including acute hepatitis, incidental focal liver lesions, metabolic dysfunction-associated steatotic liver disease, cirrhosis, hepatocellular carcinoma, liver abscesses and parasitosis, and liver transplantation. Specific knowledge of the main imaging findings is required to reach an early diagnosis, for adequate follow-up, and to avoid adverse consequences in both the mother and the fetus.Critical relevance statement Pregnancy-related liver diseases are the most important cause of liver dysfunction in pregnant patients and, in pregnancy, even common liver conditions can have an unexpected turn. Fear of radiations should never delay necessary imaging studies in pregnancy.Key points• Pregnancy-related liver diseases are the most frequent cause of liver dysfunction during gestation.• Fear of radiation should never delay necessary imaging studies.• Liver imaging is important to assess liver emergencies and for the diagnosis and follow-up of any other liver diseases.• Common liver conditions and lesions may take an unexpected turn during pregnancy.• Pregnancy-specific diseases such as pre-eclampsia and HELLP syndrome must be rapidly identified. However, imaging should never delay delivery when it is considered to be urgent for maternal-fetal survival.
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Affiliation(s)
- Giorgia Porrello
- Service de Radiologie, AP-HP Nord, Hôpital Beaujon, Paris, Clichy, France.
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University Hospital "Paolo Giaccone", Palermo, Italy.
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University Hospital "Paolo Giaccone", Palermo, Italy
| | - Jacques Bernuau
- AP-HP Nord, Hôpital Beaujon, Service d'Hépatologie, Paris, Clichy, France
| | - Antoine Agman
- Service de Gynécologie obstétrique maternité, AP-HP Nord, Hôpital Beaujon, Paris, Clichy, France
| | - Giuseppe Brancatelli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University Hospital "Paolo Giaccone", Palermo, Italy
| | - Marco Dioguardi Burgio
- Service de Radiologie, AP-HP Nord, Hôpital Beaujon, Paris, Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018, Paris, France
| | - Valérie Vilgrain
- Service de Radiologie, AP-HP Nord, Hôpital Beaujon, Paris, Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018, Paris, France
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3
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Bailey CR, Herrera DG, Neumeister N, Weiss CR. Magnetic resonance - guided treatment of low-flow vascular malformations and the technologies to potentiate adoption. Front Med (Lausanne) 2024; 11:1319046. [PMID: 38420359 PMCID: PMC10899448 DOI: 10.3389/fmed.2024.1319046] [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: 10/11/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
Vascular malformations are congenital, non-neoplastic lesions that arise secondary to defects in angiogenesis. Vascular malformations are divided into high-flow (arteriovenous malformation) and low-flow (venous malformations and lymphatic malformations). Magnetic resonance imaging (MRI) is the standard for pre-and post-intervention assessments, while ultrasound (US), X-ray fluoroscopy and computed tomography (CT) are used for intra-procedural guidance. Sclerotherapy, an image-guided therapy that involves the injection of a sclerosant directly into the malformation, is typically the first-line therapy for treating low-flow vascular malformations. Sclerotherapy induces endothelial damage and necrosis/fibrosis with eventual involution of the malformation. Image-guided thermal therapies involve freezing or heating target tissue to induce cell death and necrosis. MRI is an alternative for intra-procedural guidance and monitoring during the treatment of vascular malformations. MR can provide dynamic, multiplanar imaging that delineates surrounding critical structures such as nerves and vasculature. Multiple studies have demonstrated that MR-guided treatment of vascular malformations is safe and effective. This review will detail (1) the use of MR for the classification and diagnosis of vascular malformations, (2) the current literature surrounding MR-guided treatment of vascular malformations, (3) a series of cases of MR-guided sclerotherapy and thermal ablation for the treatment of vascular malformations, and (4) a discussion of technologies that may potentiate interventional MRI adoption including high intensity focused ultrasound and guided laser ablation.
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Affiliation(s)
- Christopher Ravi Bailey
- Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Daniel Giraldo Herrera
- Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins Medicine, Baltimore, MD, United States
| | | | - Clifford Rabbe Weiss
- Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins Medicine, Baltimore, MD, United States
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Albakri AA, Alzahrani MM, Alghamdi SH. Medical Imaging in Pregnancy: Safety, Appropriate Utilization, and Alternative Modalities for Imaging Pregnant Patients. Cureus 2024; 16:e54346. [PMID: 38500900 PMCID: PMC10945608 DOI: 10.7759/cureus.54346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 03/20/2024] Open
Abstract
This article reviews the existing literature on diagnostic and medical imaging of pregnant women, the risks and safety measures of different medical imaging modalities, and alternative modalities for imaging pregnant patients. Different medical imaging modalities such as MRI, CT scan, ultrasound, nuclear medicine, and X-ray imaging help to evaluate women with recognized or unrecognized pregnancies and identify any underlying complications among pregnant patients. Fetuses are more sensitive to radiation and the effects of medical imaging as compared to adults since they have a rapidly developing cell system. During cell proliferation, migration, and differentiation, fetuses suffer greatly from imaging radiation since they are developing under a dynamic system. To ensure safety, pregnant women should discuss the benefits and risks of medical imaging with their physicians. In addition, radiologists should not perform any medical imaging procedure without the patient's consent, unless the patient cannot make any sound decision. Fetal risks of medical imaging include slow growth and development of the fetus, abortion, malformations, impaired brain function, abnormal childhood growth, and neurological development. Diagnostic imaging procedures are necessary when a condition that needs medical evaluation arises during pregnancy such as appendicitis.
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Affiliation(s)
| | | | - Saeed H Alghamdi
- Interventional Radiology, King Fahad General Hospital, Al Baha, SAU
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5
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Gatta G, Somma F, Sardu C, De Chiara M, Massafra R, Fanizzi A, La Forgia D, Cuccurullo V, Iovino F, Clemente A, Marfella R, Grezia GD. Automated 3D Ultrasound as an Adjunct to Screening Mammography Programs in Dense Breast: Literature Review and Metanalysis. J Pers Med 2023; 13:1683. [PMID: 38138910 PMCID: PMC10744838 DOI: 10.3390/jpm13121683] [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: 09/13/2023] [Revised: 11/10/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Purpose: The purpose of this meta-analysis is to investigate the effectiveness of supplementing screening mammography with three-dimensional automated breast ultrasonography (3D ABUS) in improving breast cancer detection rates in asymptomatic women with dense breasts. Materials and Methods: We conducted a thorough review of scientific publications comparing 3D ABUS and mammography. Articles for inclusion were sourced from peer-reviewed journal databases, namely MEDLINE (PubMed) and Scopus, based on an initial screening of their titles and abstracts. To ensure a sufficient sample size for meaningful analysis, only studies evaluating a minimum of 20 patients were retained. Eligibility for evaluation was further limited to articles written in English. Additionally, selected studies were required to have participants aged 18 or above at the time of the study. We analyzed 25 studies published between 2000 and 2021, which included a total of 31,549 women with dense breasts. Among these women, 229 underwent mammography alone, while 347 underwent mammography in combination with 3D ABUS. The average age of the women was 50.86 years (±10 years standard deviation), with a range of 40-56 years. In our efforts to address and reduce bias, we applied a range of statistical analyses. These included assessing study variation through heterogeneity assessment, accounting for potential study variability using a random-effects model, exploring sources of bias via meta-regression analysis, and checking for publication bias through funnel plots and the Egger test. These methods ensured the reliability of our study findings. Results: According to the 25 studies included in this metanalysis, out of the total number of women, 27,495 were diagnosed with breast cancer. Of these, 211 were diagnosed through mammography alone, while an additional 329 women were diagnosed through the combination of full-field digital mammography (FFDSM) and 3D ABUS. This represents an increase of 51.5%. The rate of cancers detected per 1000 women screened was 23.25‱ (95% confidence interval [CI]: 21.20, 25.60; p < 0.001) with mammography alone. In contrast, the addition of 3D ABUS to mammography increased the number of tumors detected to 20.95‱ (95% confidence interval [CI]: 18.50, 23; p < 0.001) per 1000 women screened. Discussion: Even though variability in study results, lack of long-term outcomes, and selection bias may be present, this systematic review and meta-analysis confirms that supplementing mammography with 3D ABUS increases the accuracy of breast cancer detection in women with ACR3 to ACR4 breasts. Our findings suggest that the combination of mammography and 3D ABUS should be considered for screening women with dense breasts. Conclusions: Our research confirms that adding 3D automated breast ultrasound to mammography-only screening in patients with dense breasts (ACR3 and ACR4) significantly (p < 0.05) increases the cancer detection rate.
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Affiliation(s)
- Gianluca Gatta
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (M.D.C.); (A.C.)
| | - Francesco Somma
- U.O.C. Neurodiology, ASL Center Naples 1, P.O. Ospedale del Mare, 80147 Naples, Italy;
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia 2, 80138 Naples, Italy; (C.S.); (R.M.)
| | - Marco De Chiara
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (M.D.C.); (A.C.)
| | - Raffaella Massafra
- Department of Breast Radiology, Giovanni Paolo II/I.R.C.C.S. Cancer Institute, 70124 Bari, Italy; (R.M.); (A.F.); (D.L.F.)
| | - Annarita Fanizzi
- Department of Breast Radiology, Giovanni Paolo II/I.R.C.C.S. Cancer Institute, 70124 Bari, Italy; (R.M.); (A.F.); (D.L.F.)
| | - Daniele La Forgia
- Department of Breast Radiology, Giovanni Paolo II/I.R.C.C.S. Cancer Institute, 70124 Bari, Italy; (R.M.); (A.F.); (D.L.F.)
| | - Vincenzo Cuccurullo
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (M.D.C.); (A.C.)
| | - Francesco Iovino
- Department of Translational Medical Science, School of Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Alfredo Clemente
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (M.D.C.); (A.C.)
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Luigi Miraglia 2, 80138 Naples, Italy; (C.S.); (R.M.)
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Flores-Sanga HS, Salas-Cuadros D, Saucedo-Chinchay JL, Arriola-Montenegro J, Torres-Valencia J, Muñoz-Moreno JM. Clinically Suspected Acute Myocarditis in the First Trimester of Twin Gestation: A Case Report. Cureus 2023; 15:e50851. [PMID: 38249237 PMCID: PMC10798798 DOI: 10.7759/cureus.50851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Acute myocarditis (AM) in early pregnancy is a rare disease. Its clinical presentation varies from asymptomatic disease to cardiogenic shock and death. A 28-year-old woman, 12 weeks primigravida of a dichorionic and diamniotic pregnancy, was admitted for hyperemesis gravidarum, associated with a common cold-like condition. During hospitalization, she developed new-onset sinus tachycardia and dyspnea. An electrocardiogram revealed sinus tachycardia and diffuse ST-segment elevation. Laboratory tests showed elevated levels of troponin and pro-B-type natriuretic peptide. Pelvic obstetric ultrasound and chest X-ray were normal. Speckle-tracking echocardiography showed mild apical hypokinesia with preserved left ventricular ejection fraction. In view of these findings, AM was suspected, and cardiac magnetic resonance imaging was highly suggestive of AM. The patient had a favorable recovery without cardiovascular or obstetric complications.
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Affiliation(s)
- Herson S Flores-Sanga
- Department of Cardiology, Hospital Nacional Carlos Alberto Seguin Escobedo, Arequipa, PER
| | - Dafne Salas-Cuadros
- Victor Alzamora Castro Postgraduate School, Universidad Peruana Cayetano Heredia, Lima, PER
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Maralani PJ, Pai V, Ertl-Wagner BB. Safety of Magnetic Resonance Imaging in Pregnancy. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:34-40. [PMID: 37747489 DOI: 10.1007/s00117-023-01207-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/26/2023]
Abstract
Magnetic resonance imaging is being increasingly used to diagnose and follow up a variety of medical conditions in pregnancy, both for maternal and fetal indications. However, limited data regarding its safe use in pregnancy may be a source of anxiety and avoidance for both patients and their healthcare providers. In this review, we critically discuss the main safety concerns of Magnetic Resonance Imaging (MRI) in pregnancy including energy deposition, acoustic noise, and use of contrast agents, supported by data from animal and human studies. Use of maternal sedatives and concerns related to occupational exposure in pregnant personnel are also addressed. Exposure to gadolinium-based contrast agents and sedation for MRI during pregnancy should be avoided whenever feasible.
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Affiliation(s)
- Pejman Jabehdar Maralani
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Bayview Avenue, Room AG270C, 2075, Toronto, Ontario, Canada.
| | - Vivek Pai
- Department of Medical Imaging, University of Toronto, The Hospital for Sick Children, 555 University Ave, M5G 1X8, Toronto, ON, Canada
| | - Birgit B Ertl-Wagner
- Department of Medical Imaging, University of Toronto, The Hospital for Sick Children, 555 University Ave, M5G 1X8, Toronto, ON, Canada
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Nunna B, Parihar P, Wanjari M, Shetty N, Bora N. High-Resolution Imaging Insights into Shoulder Joint Pain: A Comprehensive Review of Ultrasound and Magnetic Resonance Imaging (MRI). Cureus 2023; 15:e48974. [PMID: 38111406 PMCID: PMC10725840 DOI: 10.7759/cureus.48974] [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: 08/28/2023] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
Shoulder joint pain is a complex and prevalent clinical concern affecting individuals across various ages and lifestyles. This review delves into the pivotal role of high-resolution imaging techniques, namely ultrasound and magnetic resonance imaging (MRI), in the comprehensive assessment and management of shoulder joint pain. We explore the anatomical foundations of the shoulder, common etiologies of pain, and the significance of precise diagnosis. High-resolution imaging facilitates the identification of various shoulder pathologies and is crucial in treatment planning, surgical interventions, and long-term prognosis assessment. We examine emerging technologies, discuss challenges and limitations, and chart potential future developments, emphasizing the ongoing evolution of imaging in this critical healthcare domain. In conclusion, high-resolution imaging is an indispensable tool, continually advancing to meet the diagnostic and therapeutic needs of individuals grappling with shoulder joint pain.
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Affiliation(s)
- Bhagyasri Nunna
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pratap Parihar
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Mayur Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Neha Shetty
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Nikita Bora
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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9
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Fico N, Di Grezia G, Cuccurullo V, Salvia AAH, Iacomino A, Sciarra A, Gatta G. Breast Imaging Physics in Mammography (Part I). Diagnostics (Basel) 2023; 13:3227. [PMID: 37892053 PMCID: PMC10606465 DOI: 10.3390/diagnostics13203227] [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: 09/19/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023] Open
Abstract
Breast cancer is the most frequently diagnosed neoplasm in women in Italy. There are several risk factors, but thanks to screening and increased awareness, most breast cancers are diagnosed at an early stage when surgical treatment can most often be conservative and the adopted therapy is more effective. Regular screening is essential but advanced technology is needed to achieve quality diagnoses. Mammography is the gold standard for early detection of breast cancer. It is a specialized technique for detecting breast cancer and, thus, distinguishing normal tissue from cancerous breast tissue. Mammography techniques are based on physical principles: through the proper use of X-rays, the structures of different tissues can be observed. This first part of the paper attempts to explain the physical principles used in mammography. In particular, we will see how a mammogram is composed and what physical principles are used to obtain diagnostic images.
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Affiliation(s)
- Noemi Fico
- Department of Physics Ettore Pancini, Università di Napoli Federico II, 80126 Naples, Italy
| | | | - Vincenzo Cuccurullo
- Nuclear Medicine Unit, Department of Precision Medicine, Università della Campania Luigi Vanvitelli, 81100 Napoli, Italy;
| | | | - Aniello Iacomino
- Department of Human Science, Guglielmo Marconi University, 00193 Rome, Italy;
| | - Antonella Sciarra
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, 80138 Napoli, Italy;
| | - Gianluca Gatta
- Department of Precision Medicine, Università della Campania Luigi Vanvitelli, 81100 Napoli, Italy; (A.A.H.S.); (G.G.)
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10
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Al Saeedi M, Lerman LO. Use of Magnetic Resonance Imaging to Detect Placental Microvascular Rarefaction That Heralds Preeclampsia. Hypertension 2023; 80:1668-1670. [PMID: 37470771 PMCID: PMC10372807 DOI: 10.1161/hypertensionaha.123.21324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Affiliation(s)
- Mina Al Saeedi
- Divisions of Nephrology and Hypertension (M.A.S.), Mayo Clinic, Rochester, MN
- Department of Cardiovascular Diseases (M.A.S., L.O.L.), Mayo Clinic, Rochester, MN
| | - Lilach O Lerman
- Department of Cardiovascular Diseases (M.A.S., L.O.L.), Mayo Clinic, Rochester, MN
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11
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Cuccurullo V, Rapa M, Catalfamo B, Cascini GL. Role of Nuclear Sentinel Lymph Node Mapping Compared to New Alternative Imaging Methods. J Pers Med 2023; 13:1219. [PMID: 37623469 PMCID: PMC10455335 DOI: 10.3390/jpm13081219] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/22/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
With the emergence of sentinel node technology, many patients can be staged histopathologically using lymphatic mapping and selective lymphadenectomy. Structural imaging by using US, CT and MR permits precise measurement of lymph node volume, which is strongly associated with neoplastic involvement. Sentinel lymph node detection has been an ideal field of application for nuclear medicine because anatomical data fails to represent the close connections between the lymphatic system and regional lymph nodes, or, more specifically, to identify the first draining lymph node. Hybrid imaging has demonstrated higher accuracy than standard imaging in SLN visualization on images, but it did not change in terms of surgical detection. New alternatives without ionizing radiations are emerging now from "non-radiological" fields, such as ophthalmology and dermatology, where fluorescence or opto-acoustic imaging, for example, are widely used. In this paper, we will analyze the advantages and limits of the main innovative methods in sentinel lymph node detection, including innovations in lymphoscintigraphy techniques that persist as the gold standard to date.
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Affiliation(s)
- Vincenzo Cuccurullo
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Marco Rapa
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Barbara Catalfamo
- Nuclear Medicine Unit, Department of Diagnostic Imaging, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy (G.L.C.)
| | - Giuseppe Lucio Cascini
- Nuclear Medicine Unit, Department of Diagnostic Imaging, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy (G.L.C.)
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12
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Tegafaw T, Liu S, Ahmad MY, Saidi AKAA, Zhao D, Liu Y, Nam SW, Chang Y, Lee GH. Magnetic Nanoparticle-Based High-Performance Positive and Negative Magnetic Resonance Imaging Contrast Agents. Pharmaceutics 2023; 15:1745. [PMID: 37376193 DOI: 10.3390/pharmaceutics15061745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
In recent decades, magnetic nanoparticles (MNPs) have attracted considerable research interest as versatile substances for various biomedical applications, particularly as contrast agents in magnetic resonance imaging (MRI). Depending on their composition and particle size, most MNPs are either paramagnetic or superparamagnetic. The unique, advanced magnetic properties of MNPs, such as appreciable paramagnetic or strong superparamagnetic moments at room temperature, along with their large surface area, easy surface functionalization, and the ability to offer stronger contrast enhancements in MRI, make them superior to molecular MRI contrast agents. As a result, MNPs are promising candidates for various diagnostic and therapeutic applications. They can function as either positive (T1) or negative (T2) MRI contrast agents, producing brighter or darker MR images, respectively. In addition, they can function as dual-modal T1 and T2 MRI contrast agents, producing either brighter or darker MR images, depending on the operational mode. It is essential that the MNPs are grafted with hydrophilic and biocompatible ligands to maintain their nontoxicity and colloidal stability in aqueous media. The colloidal stability of MNPs is critical in order to achieve a high-performance MRI function. Most of the MNP-based MRI contrast agents reported in the literature are still in the developmental stage. With continuous progress being made in the detailed scientific research on them, their use in clinical settings may be realized in the future. In this study, we present an overview of the recent developments in the various types of MNP-based MRI contrast agents and their in vivo applications.
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Affiliation(s)
- Tirusew Tegafaw
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea
| | - Shuwen Liu
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea
| | - Mohammad Yaseen Ahmad
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea
| | - Abdullah Khamis Ali Al Saidi
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea
| | - Dejun Zhao
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea
| | - Ying Liu
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea
| | - Sung-Wook Nam
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Taegu 41944, Republic of Korea
| | - Yongmin Chang
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Taegu 41944, Republic of Korea
| | - Gang Ho Lee
- Department of Chemistry, College of Natural Sciences, Kyungpook National University, Taegu 41566, Republic of Korea
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13
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Shehata M, Abouelkheir RT, Gayhart M, Van Bogaert E, Abou El-Ghar M, Dwyer AC, Ouseph R, Yousaf J, Ghazal M, Contractor S, El-Baz A. Role of AI and Radiomic Markers in Early Diagnosis of Renal Cancer and Clinical Outcome Prediction: A Brief Review. Cancers (Basel) 2023; 15:2835. [PMID: 37345172 DOI: 10.3390/cancers15102835] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/10/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023] Open
Abstract
Globally, renal cancer (RC) is the 10th most common cancer among men and women. The new era of artificial intelligence (AI) and radiomics have allowed the development of AI-based computer-aided diagnostic/prediction (AI-based CAD/CAP) systems, which have shown promise for the diagnosis of RC (i.e., subtyping, grading, and staging) and prediction of clinical outcomes at an early stage. This will absolutely help reduce diagnosis time, enhance diagnostic abilities, reduce invasiveness, and provide guidance for appropriate management procedures to avoid the burden of unresponsive treatment plans. This survey mainly has three primary aims. The first aim is to highlight the most recent technical diagnostic studies developed in the last decade, with their findings and limitations, that have taken the advantages of AI and radiomic markers derived from either computed tomography (CT) or magnetic resonance (MR) images to develop AI-based CAD systems for accurate diagnosis of renal tumors at an early stage. The second aim is to highlight the few studies that have utilized AI and radiomic markers, with their findings and limitations, to predict patients' clinical outcome/treatment response, including possible recurrence after treatment, overall survival, and progression-free survival in patients with renal tumors. The promising findings of the aforementioned studies motivated us to highlight the optimal AI-based radiomic makers that are correlated with the diagnosis of renal tumors and prediction/assessment of patients' clinical outcomes. Finally, we conclude with a discussion and possible future avenues for improving diagnostic and treatment prediction performance.
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Affiliation(s)
- Mohamed Shehata
- Department of Bioengineering, University of Louisville, Louisville, KY 40292, USA
| | - Rasha T Abouelkheir
- Department of Radiology, Urology and Nephrology Center, Mansoura University, Mansoura 35516, Egypt
| | | | - Eric Van Bogaert
- Department of Radiology, University of Louisville, Louisville, KY 40202, USA
| | - Mohamed Abou El-Ghar
- Department of Radiology, Urology and Nephrology Center, Mansoura University, Mansoura 35516, Egypt
| | - Amy C Dwyer
- Kidney Disease Program, University of Louisville, Louisville, KY 40202, USA
| | - Rosemary Ouseph
- Kidney Disease Program, University of Louisville, Louisville, KY 40202, USA
| | - Jawad Yousaf
- Electrical, Computer, and Biomedical Engineering Department, Abu Dhabi University, Abu Dhabi 59911, United Arab Emirates
| | - Mohammed Ghazal
- Electrical, Computer, and Biomedical Engineering Department, Abu Dhabi University, Abu Dhabi 59911, United Arab Emirates
| | - Sohail Contractor
- Department of Radiology, University of Louisville, Louisville, KY 40202, USA
| | - Ayman El-Baz
- Department of Bioengineering, University of Louisville, Louisville, KY 40292, USA
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14
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Alghamdi SA. Gadolinium-Based Contrast Agents in Pregnant Women: A Literature Review of MRI Safety. Cureus 2023; 15:e38493. [PMID: 37273372 PMCID: PMC10237509 DOI: 10.7759/cureus.38493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Gadolinium-based contrast agents (GBCAs) are commonly used in magnetic resonance imaging (MRI) to enhance the visualisation and characterisation of the region of interest/lesion. Internal structures are well seen with MRI with good spatial resolution. Although MRI is generally considered safe during pregnancy, concerns have been raised regarding the safety of GBCAs, particularly during the first trimester. Limited studies have been conducted to assess the safety of GBCAs in pregnant women, with conflicting results. A comprehensive literature search was conducted using PubMed, SpringerLink, Medscape, ResearchGate and Wiley Online Library. The search terms included various combinations of MRI, pregnancy, first trimester, gadolinium contrast agents, foetus, risk, and toxicity. The search criteria were articles published in English in the last 20 years and indexed in the MEDLINE or Embase databases. The majority of studies found no definitive evidence that GBCAs are harmful during pregnancy, particularly during the first trimester. Some studies reported no increased risk of adverse outcomes in infants exposed to GBCAs during the first trimester. However, other studies showed inconsistent results. Retrospective cohort studies provided some reassurance regarding the safety of GBCAs when indicated in pregnant women but did not address potential long-term adverse outcomes in infants exposed to GBCAs during gestation. The literature review also highlights the importance of further evaluating the subacute and chronic effects of GBCA exposure in infants. The safety of GBCAs during pregnancy, particularly during the first trimester, remains uncertain. More large-scale, long-term studies are needed to clarify the safety of GBCAs in pregnant women and their potential effects on foetal and neonatal outcomes. Until conclusive evidence is available, healthcare providers should carefully weigh the benefits and risks of using GBCAs during pregnancy and consider alternative imaging modalities, such as non-contrast MRI or ultrasound, when necessary.
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Affiliation(s)
- Sami A Alghamdi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, SAU
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15
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Eze IE, Ahmed AR, Gyimah C, Lasisi OG, Nwaogwugwu U. Large Renal Abscess in Pregnancy: Case Report of a Rare Finding. Cureus 2023; 15:e35610. [PMID: 37007389 PMCID: PMC10063324 DOI: 10.7759/cureus.35610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/04/2023] Open
Abstract
The incidence of renal abscesses during pregnancy has not been well-established. A renal abscess is usually secondary to the complications of acute pyelonephritis and can lead to severe consequences, including fetal and/or maternal death. Little is known about the incidence of renal abscesses in pregnant women; however, the literature consistently refers to it as an extremely rare occurrence. We report a case of a large renal abscess discovered in the early postpartum period following a recurrent urinary tract infection and flank pain during pregnancy. The patient was successfully managed with abscess drainage and prolonged antibiotics.
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Verstraeten V, Erzeel J, van de Vrande S, Scharpé K. Gastric band slippage in pregnancy: A diagnostic dilemma. Obstet Med 2023. [DOI: 10.1177/1753495x231155961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Pregnancy after laparoscopic adjusted gastric banding (LAGB) is thought to be safe and lowers the risk for maternal obstetric complications, without causing a difference in birth weight or a higher incidence of neonatal complications. Even though LAGB complications in pregnancy are rare, they are often severe and can cause significant maternal and neonatal morbidity. This report outlines the case of a pregnant 32-year-old female with gastric band slippage in the third trimester and provides a summary of the literature on LAGB complications in pregnancy and their management.
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Affiliation(s)
- Victoria Verstraeten
- Department of Obstetrics & Gynaecology, AZ Sint-Blasius, Dendermonde, Belgium
- Department of Obstetrics and Gynaecology, University Hospital, Leuven, Belgium
| | - Jonas Erzeel
- Department of Obstetrics & Gynaecology, AZ Sint-Blasius, Dendermonde, Belgium
| | | | - Kathleen Scharpé
- Department of Obstetrics & Gynaecology, AZ Sint-Blasius, Dendermonde, Belgium
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17
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Editorial: Precision Medicine in Obstetrics: Pregnancy Complication. J Pers Med 2023; 13:jpm13020305. [PMID: 36836539 PMCID: PMC9963980 DOI: 10.3390/jpm13020305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Millions of women give birth every year worldwide [...].
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18
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Perelli F, Turrini I, Giorgi MG, Renda I, Vidiri A, Straface G, Scatena E, D’Indinosante M, Marchi L, Giusti M, Oliva A, Grassi S, De Luca C, Catania F, Vizzielli G, Restaino S, Gullo G, Eleftheriou G, Mattei A, Signore F, Lanzone A, Scambia G, Cavaliere AF. Contrast Agents during Pregnancy: Pros and Cons When Really Needed. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416699. [PMID: 36554582 PMCID: PMC9779218 DOI: 10.3390/ijerph192416699] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 05/13/2023]
Abstract
Many clinical conditions require radiological diagnostic exams based on the emission of different kinds of energy and the use of contrast agents, such as computerized tomography (CT), positron emission tomography (PET), magnetic resonance (MR), ultrasound (US), and X-ray imaging. Pregnant patients who should be submitted for diagnostic examinations with contrast agents represent a group of patients with whom it is necessary to consider both maternal and fetal effects. Radiological examinations use different types of contrast media, the most used and studied are represented by iodinate contrast agents, gadolinium, fluorodeoxyglucose, gastrographin, bariumsulfate, and nanobubbles used in contrast-enhanced ultrasound (CEUS). The present paper reports the available data about each contrast agent and its effect related to the mother and fetus. This review aims to clarify the clinical practices to follow in cases where a radiodiagnostic examination with a contrast medium is indicated to be performed on a pregnant patient.
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Affiliation(s)
- Federica Perelli
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santa Maria Annunziata Hospital, 50012 Florence, Italy
| | - Irene Turrini
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
- Correspondence:
| | - Maria Gabriella Giorgi
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
| | - Irene Renda
- Division of Obstetrics and Gynecology, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, 50134 Florence, Italy
| | - Annalisa Vidiri
- School of Medicine, Catholic University of the Sacred Hearth, 00168 Rome, Italy
| | - Gianluca Straface
- Obstetrics and Gynecology Unit, Policlinico Abano Terme, 35031 Abano Terme, Italy
| | - Elisa Scatena
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
| | - Marco D’Indinosante
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
| | - Laura Marchi
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santo Stefano Hospital, 59100 Prato, Italy
| | - Marco Giusti
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santa Maria Annunziata Hospital, 50012 Florence, Italy
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Simone Grassi
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Carmen De Luca
- Teratology Information Service, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Francesco Catania
- Department of Obstetrics and Gynecology, Ospedale “Santa Maria Alla Gruccia”, 52025 Montevarchi, Italy
| | - Giuseppe Vizzielli
- Department of Medicinal Area (DAME) Clinic of Obstetrics and Gynecology, Santa Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy
| | - Stefano Restaino
- Department of Medicinal Area (DAME) Clinic of Obstetrics and Gynecology, Santa Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy
| | - Giuseppe Gullo
- IVF Public Center, Azienda Ospedaliera Ospedali Riuniti (AOOR) Villa Sofia Cervello, University of Palermo, 90146 Palermo, Italy
| | - Georgios Eleftheriou
- Poison Control Center and Teratology Information Service, Hospital Papa Giovanni XIII, 24127 Bergamo, Italy
| | - Alberto Mattei
- Azienda USL Toscana Centro, Gynecology and Obstetric Department, Santa Maria Annunziata Hospital, 50012 Florence, Italy
| | - Fabrizio Signore
- Obstetrics and Gynecology Unit, Santo Eugenio Hospital, 00144 Rome, Italy
- School of Medicine, Unicamillus University Rome, 00131 Rome, Italy
| | - Antonio Lanzone
- School of Medicine, Catholic University of the Sacred Hearth, 00168 Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Giovanni Scambia
- School of Medicine, Catholic University of the Sacred Hearth, 00168 Rome, Italy
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Anna Franca Cavaliere
- School of Medicine, Catholic University of the Sacred Hearth, 00168 Rome, Italy
- Division of Gynecology and Obstetrics Fatebenefratelli Isola Tiberina, 00186 Rome, Italy
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Bertozzi S, Corradetti B, Seriau L, Diaz Ñañez JA, Cedolini C, Fruscalzo A, Cesselli D, Cagnacci A, Londero AP. Nanotechnologies in Obstetrics and Cancer during Pregnancy: A Narrative Review. J Pers Med 2022; 12:jpm12081324. [PMID: 36013273 PMCID: PMC9410527 DOI: 10.3390/jpm12081324] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/01/2022] [Accepted: 08/14/2022] [Indexed: 11/30/2022] Open
Abstract
Nanotechnology, the art of engineering structures on a molecular level, offers the opportunity to implement new strategies for the diagnosis and management of pregnancy-related disorders. This review aims to summarize the current state of nanotechnology in obstetrics and cancer in pregnancy, focusing on existing and potential applications, and provides insights on safety and future directions. A systematic and comprehensive literature assessment was performed, querying the following databases: PubMed/Medline, Scopus, and Endbase. The databases were searched from their inception to 22 March 2022. Five independent reviewers screened the items and extracted those which were more pertinent within the scope of this review. Although nanotechnology has been on the bench for many years, most of the studies in obstetrics are preclinical. Ongoing research spans from the development of diagnostic tools, including optimized strategies to selectively confine contrast agents in the maternal bloodstream and approaches to improve diagnostics tests to be used in obstetrics, to the synthesis of innovative delivery nanosystems for therapeutic interventions. Using nanotechnology to achieve spatial and temporal control over the delivery of therapeutic agents (e.g., commonly used drugs, more recently defined formulations, or gene therapy-based approaches) offers significant advantages, including the possibility to target specific cells/tissues of interest (e.g., the maternal bloodstream, uterus wall, or fetal compartment). This characteristic of nanotechnology-driven therapy reduces side effects and the amount of therapeutic agent used. However, nanotoxicology appears to be a significant obstacle to adopting these technologies in clinical therapeutic praxis. Further research is needed in order to improve these techniques, as they have tremendous potential to improve the accuracy of the tests applied in clinical praxis. This review showed the increasing interest in nanotechnology applications in obstetrics disorders and pregnancy-related pathologies to improve the diagnostic algorithms, monitor pregnancy-related diseases, and implement new treatment strategies.
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Affiliation(s)
- Serena Bertozzi
- Breast Unit, Department of Surgery, DAME, University Hospital of “Santa Maria della Misericordia”, 33100 Udine, Italy
- Ennergi Research (Non-Profit Organisation), 33050 Lestizza, Italy
| | - Bruna Corradetti
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX 77030, USA
| | - Luca Seriau
- Breast Unit, Department of Surgery, DAME, University Hospital of “Santa Maria della Misericordia”, 33100 Udine, Italy
| | - José Andrés Diaz Ñañez
- Breast Unit, Department of Surgery, DAME, University Hospital of “Santa Maria della Misericordia”, 33100 Udine, Italy
- Ennergi Research (Non-Profit Organisation), 33050 Lestizza, Italy
| | - Carla Cedolini
- Breast Unit, Department of Surgery, DAME, University Hospital of “Santa Maria della Misericordia”, 33100 Udine, Italy
- Ennergi Research (Non-Profit Organisation), 33050 Lestizza, Italy
| | - Arrigo Fruscalzo
- Clinic of Obstetrics and Gynecology, University Hospital of Fribourg, 1752 Fribourg, Switzerland
| | - Daniela Cesselli
- Institute of Pathology, DAME, University of Udine, University Hospital of Udine, 33100 Udine, Italy
| | - Angelo Cagnacci
- Academic Unit of Obstetrics and Gynaecology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, Italy
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Ambrogio P. Londero
- Ennergi Research (Non-Profit Organisation), 33050 Lestizza, Italy
- Academic Unit of Obstetrics and Gynaecology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, Italy
- Correspondence: or
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20
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Gadolinium in Medical Imaging—Usefulness, Toxic Reactions and Possible Countermeasures—A Review. Biomolecules 2022; 12:biom12060742. [PMID: 35740867 PMCID: PMC9221011 DOI: 10.3390/biom12060742] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 12/29/2022] Open
Abstract
Gadolinium (Gd) is one of the rare-earth elements. The properties of its trivalent cation (Gd3+) make it suitable to serve as the central ion in chelates administered intravenously to patients as a contrast agent in magnetic resonance imaging. Such Gd-chelates have been used for more than thirty years. During the past decades, knowledge has increased about potential harmful effects of Gd-chelates in patients with severe renal dysfunction. In such patients, there is a risk for a potentially disabling and lethal disease, nephrogenic systemic fibrosis. Restricting the use of Gd-chelates in persons with severely impaired renal function has decreased the occurrence of this toxic effect in the last decade. There has also been an increasing awareness of Gd-retention in the body, even in patients without renal dysfunction. The cumulative number of doses given, and the chemical structure of the chelate given, are factors of importance for retention in tissues. This review describes the chemical properties of Gd and its medically used chelates, as well as its toxicity and potential side effects related to injection of Gd-chelates.
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Nayak G, Padhy N, Mishra TK. 2D-DOST for seizure identification from brain MRI during pregnancy using KRVFL. HEALTH AND TECHNOLOGY 2022. [DOI: 10.1007/s12553-022-00669-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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