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Akt kinase plays a central role in cell growth, metabolism, and tumorigenesis. The TRAF6 E3 ligase orchestrates IGF-1-mediated Akt ubiquitination and activation. Here, we show that Akt ubiquitination is also induced by activation of ErbB receptors; unexpectedly, and in contrast to IGF-1 induced activation, the Skp2 SCF complex, not TRAF6, is a critical E3 ligase for ErbB-receptor-mediated Akt ubiquitination and membrane recruitment in response to EGF. Skp2 deficiency impairs Akt activation, Glut1 expression, glucose uptake and glycolysis, and breast cancer progression in various tumor models. Moreover, Skp2 overexpression correlates with Akt activation and breast cancer metastasis and serves as a marker for poor prognosis in Her2-positive patients. Finally, Skp2 silencing sensitizes Her2-overexpressing tumors to Herceptin treatment. Our study suggests that distinct E3 ligases are utilized by diverse growth factors for Akt activation and that targeting glycolysis sensitizes Her2-positive tumors to Herceptin treatment.
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Anticuerpos Monoclonales Humanizados/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Transformación Celular Neoplásica , Proteínas F-Box/metabolismo , Glucólisis , Proteínas Quinasas Asociadas a Fase-S/metabolismo , Proteínas Supresoras de Tumor/metabolismo , Animales , Neoplasias de la Mama/metabolismo , Modelos Animales de Enfermedad , Resistencia a Antineoplásicos , Femenino , Humanos , Ratones , Receptor ErbB-2/metabolismo , Proteínas Quinasas Asociadas a Fase-S/genética , Trastuzumab , UbiquitinaciónRESUMEN
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) is characterized morphologically by numerous small lymphocytes and pale nodules composed of prolymphocytes and paraimmunoblasts known as proliferation centers (PCs). Patients with CLL can undergo transformation to a more aggressive lymphoma, most often diffuse large B-cell lymphoma (DLBCL), known as Richter transformation (RT). An accelerated phase of CLL (aCLL) also may be observed which correlates with subsequent transformation to DLBCL, and may represent an early stage of transformation. Distinguishing PCs in CLL from aCLL or RT can be diagnostically challenging, particularly in small needle biopsy specimens. Available guidelines pertaining to distinguishing CLL from its' progressive forms are limited, subject to the morphologist's experience and are often not completely helpful in the assessment of scant biopsy specimens. To objectively assess the extent of PCs in aCLL and RT, and enhance diagnostic accuracy, we sought to design an artificial intelligence (AI)-based tool to identify and delineate PCs based on feature analysis of the combined individual nuclear size and intensity, designated here as the heat value. Using the mean heat value from the generated heat value image of all cases, we were able to reliably separate CLL, aCLL and RT with sensitive diagnostic predictive values.
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Leucemia Linfocítica Crónica de Células B , Linfoma de Células B Grandes Difuso , Inteligencia Artificial , Proliferación Celular , Transformación Celular Neoplásica/patología , Humanos , Leucemia Linfocítica Crónica de Células B/patología , Linfoma de Células B Grandes Difuso/patologíaRESUMEN
Lipid-based formulations provide a nanotechnology platform that is widely used in a variety of biomedical applications because it has several advantageous properties including biocompatibility, reduced toxicity, relative ease of surface modifications, and the possibility for efficient loading of drugs, biologics, and nanoparticles. A combination of lipid-based formulations with magnetic nanoparticles such as iron oxide was shown to be highly advantageous in a growing number of applications including magnet-mediated drug delivery and image-guided therapy. Currently, lipid-based formulations are prepared by multistep protocols. Simplification of the current multistep procedures can lead to a number of important technological advantages including significantly decreased processing time, higher reaction yield, better product reproducibility, and improved quality. Here, we introduce a one-pot, single-step synthesis of drug-loaded magnetic multimicelle aggregates (MaMAs), which is based on controlled flow infusion of an iron oxide nanoparticle/lipid mixture into an aqueous drug solution under ultrasonication. Furthermore, we prepared molecular-targeted MaMAs by directional antibody conjugation through an Fc moiety using Cu-free click chemistry. Fluorescence imaging and quantification confirmed that antibody-conjugated MaMAs showed high cell-specific targeting that was enhanced by magnetic delivery.
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Nanopartículas , Sistemas de Liberación de Medicamentos , Lípidos , Fenómenos Magnéticos , Nanopartículas/química , Preparaciones Farmacéuticas , Reproducibilidad de los ResultadosRESUMEN
The Professional Doctorate in Medical Physics (DMP) was originally conceived as a solution to the shortage of medical physics residency training positions. While this shortage has now been largely satisfied through conventional residency training positions, the DMP has expanded to multiple institutions and grown into an educational pathway that provides specialized clinical training and extends well beyond the creation of additional training spots. As such, it is important to reevaluate the purpose and the value of the DMP. Additionally, it is important to outline the defining characteristics of the DMP to assure that all existing and future programs provide this anticipated value. Since the formation and subsequent accreditation of the first DMP program in 2009-2010, four additional programs have been created and accredited. However, no guidelines have yet been recommended by the American Association of Physicists in Medicine. CAMPEP accreditation of these programs has thus far been based only on the respective graduate and residency program standards. This allows the development and operation of DMP programs which contain only the requisite Master of Science (MS) coursework and a 2-year clinical training program. Since the MS plus 2-year residency pathway already exists, this form of DMP does not provide added value, and one may question why this existing pathway should be considered a doctorate. Not only do we, as a profession, need to outline the defining characteristics of the DMP, we need to carefully evaluate the potential advantages and disadvantages of this pathway within our education and training infrastructure. The aims of this report from the Working Group on the Professional Doctorate Degree for Medical Physicists (WGPDMP) are to (1) describe the current state of the DMP within the profession, (2) make recommendations on the structure and content of the DMP for existing and new DMP programs, and (3) evaluate the value of the DMP to the profession of medical physics.
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Física Sanitaria , Internado y Residencia , Humanos , Estados Unidos , Física Sanitaria/educación , Acreditación , Informe de Investigación , Educación de Postgrado en MedicinaRESUMEN
The complexity of modern in vivo magnetic resonance imaging (MRI) methods in oncology has dramatically changed in the last 10 years. The field has long since moved passed its (unparalleled) ability to form images with exquisite soft-tissue contrast and morphology, allowing for the enhanced identification of primary tumors and metastatic disease. Currently, it is not uncommon to acquire images related to blood flow, cellularity, and macromolecular content in the clinical setting. The acquisition of images related to metabolism, hypoxia, pH, and tissue stiffness are also becoming common. All of these techniques have had some component of their invention, development, refinement, validation, and initial applications in the preclinical setting using in vivo animal models of cancer. In this review, we discuss the genesis of quantitative MRI methods that have been successfully translated from preclinical research and developed into clinical applications. These include methods that interrogate perfusion, diffusion, pH, hypoxia, macromolecular content, and tissue mechanical properties for improving detection, staging, and response monitoring of cancer. For each of these techniques, we summarize the 1) underlying biological mechanism(s); 2) preclinical applications; 3) available repeatability and reproducibility data; 4) clinical applications; and 5) limitations of the technique. We conclude with a discussion of lessons learned from translating MRI methods from the preclinical to clinical setting, and a presentation of four fundamental problems in cancer imaging that, if solved, would result in a profound improvement in the lives of oncology patients. Level of Evidence: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:1377-1392.
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Imagen por Resonancia Magnética/métodos , Oncología Médica/tendencias , Neoplasias/diagnóstico por imagen , Animales , Neoplasias Encefálicas/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética/métodos , Humanos , Concentración de Iones de Hidrógeno , Hipoxia , Procesamiento de Imagen Asistido por Computador , Inmunoterapia , Sustancias Macromoleculares , Metástasis de la Neoplasia , Trasplante de Neoplasias , Oxígeno/metabolismo , Reproducibilidad de los Resultados , Nanomedicina Teranóstica , Investigación Biomédica Traslacional/tendenciasRESUMEN
PURPOSE: This pilot study evaluates the feasibility of automated volumetric quantification of hepatocellular carcinoma (HCC) as an imaging biomarker to assess treatment response for sorafenib. METHODS: In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study, a training database of manually labeled background liver, enhancing and nonenhancing tumor tissue was established using pretherapy and first posttherapy multiphasic computed tomography images from a registry of 13 HCC patients. For each patient, Hounsfield density and geometry-based feature images were generated from registered multiphasic computed tomography data sets and used as the input for a random forest-based classifier of enhancing and nonenhancing tumor tissue. Leave-one-out cross-validation of the dice similarity measure was applied to quantify the classifier accuracy. A Cox regression model was used to confirm volume changes as predictors of time to progression (TTP) of target lesions for both manual and automatic methods. RESULTS: When compared with manual labels, an overall classification accuracy of dice similarity coefficient of 0.71 for pretherapy and 0.66 posttherapy enhancing tumor labels and 0.45 for pretherapy and 0.59 for posttherapy nonenhancing tumor labels was observed. Automated methods for quantifying volumetric changes in the enhancing lesion agreed with manual methods and were observed as a significant predictor of TTP. CONCLUSIONS: Automated volumetric analysis was determined to be feasible for monitoring HCC response to treatment. The information extracted using automated volumetrics is likely to reproduce labor-intensive manual data and provide a good predictor for TTP. Further work will extend these studies to additional treatment modalities and larger patient populations.
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Carcinoma Hepatocelular/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico/métodos , Neoplasias Hepáticas/diagnóstico por imagen , Sorafenib/administración & dosificación , Anciano , Carcinoma Hepatocelular/tratamiento farmacológico , Femenino , Humanos , Neoplasias Hepáticas/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Proyectos Piloto , Análisis de Regresión , Estudios Retrospectivos , Sorafenib/uso terapéutico , Resultado del TratamientoRESUMEN
Purpose To compare functional magnetic resonance (MR) imaging for language mapping (hereafter, language functional MR imaging) with direct cortical stimulation (DCS) in patients with brain tumors and to assess factors associated with its accuracy. Materials and Methods PubMed/MEDLINE and related databases were searched for research articles published between January 2000 and September 2016. Findings were pooled by using bivariate random-effects and hierarchic summary receiver operating characteristic curve models. Meta-regression and subgroup analyses were performed to evaluate whether publication year, functional MR imaging paradigm, magnetic field strength, statistical threshold, and analysis software affected classification accuracy. Results Ten articles with a total of 214 patients were included in the analysis. On a per-patient basis, the pooled sensitivity and specificity of functional MR imaging was 44% (95% confidence interval [CI]: 14%, 78%) and 80% (95% CI: 54%, 93%), respectively. On a per-tag basis (ie, each DCS stimulation site or "tag" was considered a separate data point across all patients), the pooled sensitivity and specificity were 67% (95% CI: 51%, 80%) and 55% (95% CI: 25%, 82%), respectively. The per-tag analysis showed significantly higher sensitivity for studies with shorter functional MR imaging session times (P = .03) and relaxed statistical threshold (P = .05). Significantly higher specificity was found when expressive language task (P = .02), longer functional MR imaging session times (P < .01), visual presentation of stimuli (P = .04), and stringent statistical threshold (P = .01) were used. Conclusion Results of this study showed moderate accuracy of language functional MR imaging when compared with intraoperative DCS, and the included studies displayed significant methodologic heterogeneity. © RSNA, 2017 Online supplemental material is available for this article.
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Neoplasias Encefálicas/cirugía , Mapeo Encefálico/métodos , Mapeo Encefálico/normas , Neoplasias Encefálicas/patología , Humanos , Imagen por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/normas , Cuidados Preoperatorios/métodos , Sesgo de Publicación , Curva ROC , Sensibilidad y EspecificidadRESUMEN
Post-treatment imaging is the principal method for evaluating thermal lesions following image-guided thermal ablation procedures. While real-time temperature feedback using magnetic resonance temperature imaging (MRTI) is a complementary tool that can be used to optimise lesion size throughout the procedure, a thermal dose model is needed to convert temperature-time histories to estimates of thermal damage. However, existing models rely on empirical parameters derived from laboratory experiments that are not direct indicators of post-treatment radiologic appearance. In this work, we investigate a technique that uses perioperative MR data to find novel thermal dose model parameters that are tailored to the appearance of the thermal lesion on post-treatment contrast-enhanced imaging. Perioperative MR data were analysed for five patients receiving magnetic resonance-guided laser-induced thermal therapy (MRgLITT) for brain metastases. The characteristic enhancing ring was manually segmented on post-treatment T1-weighted imaging and registered into the MRTI geometry. Post-treatment appearance was modelled using a coupled Arrhenius-logistic model and non-linear optimisation techniques were used to find the maximum-likelihood kinetic parameters and dose thresholds that characterise the inner and outer boundary of the enhancing ring. The parameter values and thresholds were consistent with previous investigations, while the average difference between the predicted and segmented boundaries was on the order of one pixel (1 mm). The areas predicted using the optimised model parameters were also within 1 mm of those predicted by clinically utilised dose models. This technique makes clinically acquired data available for investigating new thermal dose model parameters driven by clinically relevant endpoints.
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Imagen por Resonancia Magnética/métodos , Anciano , Femenino , Humanos , Persona de Mediana EdadRESUMEN
PURPOSE: Neurosurgical laser ablation is experiencing a renaissance. Computational tools for ablation planning aim to further improve the intervention. Here, global optimisation and inverse problems are demonstrated to train a model that predicts maximum laser ablation extent. METHODS: A closed-form steady state model is trained on and then subsequently compared to N = 20 retrospective clinical MR thermometry datasets. Dice similarity coefficient (DSC) is calculated to provide a measure of region overlap between the 57 °C isotherms of the thermometry data and the model-predicted ablation regions; 57 °C is a tissue death surrogate at thermal steady state. A global optimisation scheme samples the dominant model parameter sensitivities, blood perfusion (ω) and optical parameter (µeff) values, throughout a parameter space totalling 11 440 value-pairs. This represents a lookup table of µeff-ω pairs with the corresponding DSC value for each patient dataset. The µeff-ω pair with the maximum DSC calibrates the model parameters, maximising predictive value for each patient. Finally, leave-one-out cross-validation with global optimisation information trains the model on the entire clinical dataset, and compares against the model naïvely using literature values for ω and µeff. RESULTS: When using naïve literature values, the model's mean DSC is 0.67 whereas the calibrated model produces 0.82 during cross-validation, an improvement of 0.15 in overlap with the patient data. The 95% confidence interval of the mean difference is 0.083-0.23 (p < 0.001). CONCLUSIONS: During cross-validation, the calibrated model is superior to the naïve model as measured by DSC, with +22% mean prediction accuracy. Calibration empowers a relatively simple model to become more predictive.
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Encéfalo/diagnóstico por imagen , Terapia por Láser/métodos , Imagen por Resonancia Magnética/métodos , Calibración , Humanos , Resultado del TratamientoRESUMEN
PURPOSE: To develop a flexible fast spin echo (FSE) triple-echo Dixon (FTED) technique. METHODS: An FSE pulse sequence was modified by replacing each readout gradient with three fast-switching bipolar readout gradients with minimal interecho dead time. The corresponding three echoes were used to generate three raw images with relative phase shifts of -θ, 0, and θ between water and fat signals. A region growing-based two-point Dixon phase correction algorithm was used to joint process two separate pairs of the three raw images, yielding a final set of water-only and fat-only images. The flexible FTED technique was implemented on 1.5T and 3.0T scanners and evaluated in five subjects for fat-suppressed T2-weighted imaging and in one subject for post-contrast fat-suppressed T1-weighted imaging. RESULTS: The flexible FTED technique achieved a high data acquisition efficiency, comparable to that of FSE, and was flexible in scan protocols. The joint two-point Dixon phase correction algorithm helped to ensure consistency in the processing of the two separate pairs of raw images. Reliable and uniform separation of water and fat was achieved in all of the test cases. CONCLUSION: The flexible FTED technique incorporates the benefits of both FSE and Dixon imaging and provided more flexibility than the original FTED in applications such as fat-suppressed T2-weighted and T1-weighted imaging. Magn Reson Med 77:1049-1057, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Tejido Adiposo/diagnóstico por imagen , Agua Corporal/diagnóstico por imagen , Mama/anatomía & histología , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Procesamiento de Señales Asistido por Computador , Algoritmos , Femenino , Humanos , Aumento de la Imagen/métodos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
PURPOSE: To develop an improved region-growing algorithm for phase correction in MRI. METHODS: Phase correction in MRI can sometimes be formulated as selecting a vector for each pixel of an image from two candidate vectors so that the orientation of the output is spatially smooth. Existing algorithms may run into difficulty in the presence of high noise, artifacts, or spatially isolated objects. In this study, we developed an improved region-growing algorithm to include the following novel and salient features: 1) automated quality guidance for determining the sequence of region growing, 2) joint consideration of two candidate vectors in selecting the output vector, and 3) automated segmentation during region growing for handling spatially isolated objects. The phase correction algorithm was tested in different body parts of five healthy volunteers at 3.0T and of one healthy volunteer at 1.5T for two-point Dixon water and fat imaging with flexible echo times. RESULTS: The algorithm achieved successful phase correction in all the data sets tested, providing improvement in areas of known difficulty, when compared with an algorithm lacking the new features. CONCLUSION: The improved region-growing algorithm can be used for reliable and robust phase correction even when regions of high noise, artifacts, or spatially isolated objects are present in an image. Magn Reson Med 76:519-529, 2016. © 2015 Wiley Periodicals, Inc.
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Algoritmos , Artefactos , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Humanos , Imagen por Resonancia Magnética/instrumentación , Fantasmas de Imagen , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
PURPOSE: Several methods in MRI use the phase information of the complex signal and require phase unwrapping (e.g., B0 field mapping, chemical shift imaging, and velocity measurements). In this work, an algorithm was developed focusing on the needs and requirements of MR temperature imaging applications. METHODS: The proposed method performs fully automatic unwrapping using a list of all pixels sorted by magnitude in descending order and creates and merges clusters of unwrapped pixels until the entire image is unwrapped. The algorithm was evaluated using simulated phantom data and in vivo clinical temperature imaging data. RESULTS: The evaluation of the phantom data demonstrated no errors in regions with signal-to-noise ratios of at least 4.5. For the in vivo data, the algorithm did not fail at an average of more than one pixel for signal-to-noise ratios greater than 6.3. Processing times less than 30 ms per image were achieved by unwrapping pixels inside a region of interest (53 × 53 pixels) used for referenceless MR temperature imaging. CONCLUSIONS: The algorithm has been demonstrated to operate robustly with clinical in vivo data in this study. The processing time for common regions of interest in referenceless MR temperature imaging allows for online updates of temperature maps without noticeable delay.
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Algoritmos , Temperatura Corporal/fisiología , Encéfalo/fisiología , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Termografía/métodos , Encéfalo/anatomía & histología , Humanos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
This study aims to identify the temporal kinetics of intravoxel incoherent motion (IVIM) MRI in patients with human papillomavirus-associated (HPV+) oropharyngeal squamous cell carcinoma. Patients were enrolled under an Institutional Review Board (IRB)-approved protocol as part of an ongoing prospective clinical trial. All patients underwent two MRI studies: a baseline scan before chemoradiotherapy and a mid-treatment scan 3-4 weeks after treatment initiation. Parametric maps representing pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f) and apparent diffusion coefficient (ADC) were generated. The Mann-Whitney U-test was used to assess the temporal variation of IVIM metrics. Bayesian quadratic discriminant analysis (QDA) was used to evaluate the extent to which mid-treatment changes in IVIM metrics could be combined to predict sites that would achieve complete response (CR) in multivariate analysis. Thirty-one patients were included in the final analysis with 59 lesions. Pretreatment ADC and D values of the CR lesions (n = 19) were significantly lower than those of non-CR lesions (n = 33). Mid-treatment ADC, D and f values were significantly higher (p < 0.0001) than pretreatment values for all lesions. Each increase in normalized ΔADC of size 0.1 yielded a 1.45-fold increase in the odds of CR (p < 0.0003), each increase in normalized ΔD of size 0.1 yielded a 1.53-fold increase in the odds of CR (p < 0.0002), and each unit increase in Δf yielded a 2.29-fold increase in the odds of CR (p < 0.02). Combined ΔD and ΔADC were integrated into a multivariate prediction model and attained an AUC of 0.87 (95% confidence interval: 0.79, 0.96), as well as a sensitivity of 0.63, specificity of 0.85 and accuracy of 0.78, under leave-one-out cross-validation. In conclusion, IVIM is feasible and potentially useful in the prediction and assessment of the early response of HPV+ oropharyngeal squamous cell carcinoma to chemoradiotherapy.
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Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Quimioradioterapia/métodos , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/terapia , Imagen por Resonancia Magnética/métodos , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/terapia , Carcinoma de Células Escamosas/complicaciones , Neoplasias de Cabeza y Cuello/complicaciones , Interpretación de Imagen Asistida por Computador/métodos , Imagenología Tridimensional/métodos , Cinética , Movimiento (Física) , Neoplasias Orofaríngeas/complicaciones , Evaluación de Resultado en la Atención de Salud/métodos , Papillomaviridae , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/terapia , Proyectos Piloto , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Carcinoma de Células Escamosas de Cabeza y Cuello , Resultado del TratamientoRESUMEN
A cross-validation analysis evaluating computer model prediction accuracy for a priori planning magnetic resonance-guided laser-induced thermal therapy (MRgLITT) procedures in treating focal diseased brain tissue is presented. Two mathematical models are considered. (1) A spectral element discretisation of the transient Pennes bioheat transfer equation is implemented to predict the laser-induced heating in perfused tissue. (2) A closed-form algorithm for predicting the steady-state heat transfer from a linear superposition of analytic point source heating functions is also considered. Prediction accuracy is retrospectively evaluated via leave-one-out cross-validation (LOOCV). Modelling predictions are quantitatively evaluated in terms of a Dice similarity coefficient (DSC) between the simulated thermal dose and thermal dose information contained within N = 22 MR thermometry datasets. During LOOCV analysis, the transient model's DSC mean and median are 0.7323 and 0.8001 respectively, with 15 of 22 DSC values exceeding the success criterion of DSC ≥ 0.7. The steady-state model's DSC mean and median are 0.6431 and 0.6770 respectively, with 10 of 22 passing. A one-sample, one-sided Wilcoxon signed-rank test indicates that the transient finite element method model achieves the prediction success criteria, DSC ≥ 0.7, at a statistically significant level.
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Hipertermia Inducida/métodos , Terapia por Láser , Modelos Biológicos , Algoritmos , Calibración , Humanos , Imagen por Resonancia Magnética , Planificación de Atención al PacienteRESUMEN
OBJECTIVE: To compare conventional diffusion-weighted imaging (DWI) with spectral spatial excitation (cDWI) and an enhanced DWI with additional adiabatic spectral inversion recovery (eDWI) for 3-T breast magnetic resonance imaging (MRI). METHODS: Twenty-four patients were enrolled in the study with both cDWI and eDWI. Three breast radiologists scored cDWI and eDWI images of each patient for fat-suppression quality, geometric distortion, visibility of normal structure and biopsy-proven lesions, and overall image quality. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) for evaluable tissues were measured. Statistical tests were performed for qualitative and quantitative comparisons. RESULTS: Diffusion-weighted imaging with spectral spatial excitation yielded significantly higher CNR and SNR on a lesion basis, and higher glandular CNR and SNR and muscle SNR on a patient basis. Enhanced DWI also yielded significantly higher qualitative scores in all categories. No significant difference was found in ADC values. CONCLUSIONS: Enhanced DWI provided superior image quality and higher CNR and SNR on a lesion basis. Enhanced DWI can replace cDWI for 3-T breast DWI.
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Neoplasias de la Mama/patología , Mama/patología , Imagen de Difusión por Resonancia Magnética/métodos , Imagen Eco-Planar/métodos , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Imagenología Tridimensional/métodos , Adulto , Anciano , Femenino , Humanos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
PURPOSE: Optically activated nanoparticle-mediated heating for thermal therapy applications is an area of intense research. The ability to characterise the spatio-temporal heating potential of these particles for use in modelling under various exposure conditions can aid in the exploration of new approaches for therapy as well as more quantitative prospective approaches to treatment planning. The purpose of this research was to investigate an inverse solution to the heat equation using magnetic resonance temperature imaging (MRTI) feedback, for providing optical characterisation of two types of nanoparticles (gold-silica nanoshells and gold nanorods). METHODS: The optical absorption of homogeneous nanoparticle-agar mixtures was measured during exposure to an 808 nm laser using real-time MRTI. A coupled finite element solution of heat transfer was registered with the data and used to solve the inverse problem. The L2 norm of the difference between the temperature increase in the model and MRTI was minimised using a pattern search algorithm by varying the absorption coefficient of the mixture. RESULTS: Absorption fractions were within 10% of literature values for similar nanoparticles. Comparison of temporal and spatial profiles demonstrated good qualitative agreement between the model and the MRTI. The weighted root mean square error was <1.5 σMRTI and the average Dice similarity coefficient for ΔT = 5 °C isotherms was >0.9 over the measured time interval. CONCLUSION: This research demonstrates the feasibility of using an indirect method for making minimally invasive estimates of nanoparticle absorption that might be expanded to analyse a variety of geometries and particles of interest.
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Imagen por Resonancia Magnética , Nanocáscaras/química , Nanotubos/química , Absorción , Algoritmos , Análisis de Elementos Finitos , Oro/química , Hipertermia Inducida , Imagen por Resonancia Magnética/instrumentación , Imagen por Resonancia Magnética/métodos , Fenómenos Ópticos , Fantasmas de Imagen , Dióxido de Silicio/química , Temperatura , Conductividad TérmicaRESUMEN
[18F]Fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) are indispensable components in modern medicine. Although PET can provide additional diagnostic value, it is costly and not universally accessible, particularly in low-income countries. To bridge this gap, we have developed a conditional generative adversarial network pipeline that can produce FDG-PET from diagnostic CT scans based on multi-center multi-modal lung cancer datasets (n = 1,478). Synthetic PET images are validated across imaging, biological, and clinical aspects. Radiologists confirm comparable imaging quality and tumor contrast between synthetic and actual PET scans. Radiogenomics analysis further proves that the dysregulated cancer hallmark pathways of synthetic PET are consistent with actual PET. We also demonstrate the clinical values of synthetic PET in improving lung cancer diagnosis, staging, risk prediction, and prognosis. Taken together, this proof-of-concept study testifies to the feasibility of applying deep learning to obtain high-fidelity PET translated from CT.
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Neoplasias Pulmonares , Tomografía Computarizada por Tomografía de Emisión de Positrones , Humanos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Fluorodesoxiglucosa F18 , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/genética , Tomografía Computarizada por Rayos X , PronósticoRESUMEN
PURPOSE: A generalised polynomial chaos (gPC) method is used to incorporate constitutive parameter uncertainties within the Pennes representation of bioheat transfer phenomena. The stochastic temperature predictions of the mathematical model are critically evaluated against MR thermometry data for planning MR-guided laser-induced thermal therapies (MRgLITT). METHODS: The Pennes bioheat transfer model coupled with a diffusion theory approximation of laser tissue interaction was implemented as the underlying deterministic kernel. A probabilistic sensitivity study was used to identify parameters that provide the most variance in temperature output. Confidence intervals of the temperature predictions are compared to MR temperature imaging (MRTI) obtained during phantom and in vivo canine (n = 4) MRgLITT experiments. The gPC predictions were quantitatively compared to MRTI data using probabilistic linear and temporal profiles as well as 2-D 60 °C isotherms. RESULTS: Optical parameters provided the highest variance in the model output (peak standard deviation: anisotropy 3.51 °C, absorption 2.94 °C, scattering 1.84 °C, conductivity 1.43 °C, and perfusion 0.94 °C). Further, within the statistical sense considered, a non-linear model of the temperature and damage-dependent perfusion, absorption, and scattering is captured within the confidence intervals of the linear gPC method. Multivariate stochastic model predictions using parameters with the dominant sensitivities show good agreement with experimental MRTI data. CONCLUSIONS: Given parameter uncertainties and mathematical modelling approximations of the Pennes bioheat model, the statistical framework demonstrates conservative estimates of the therapeutic heating and has potential for use as a computational prediction tool for thermal therapy planning.
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Hipertermia Inducida/métodos , Modelos Teóricos , Animales , Encéfalo , Perros , Rayos Láser , Imagen por Resonancia Magnética , Dinámicas no Lineales , Temperatura , IncertidumbreRESUMEN
Understanding imaging research experiences, challenges, and strategies for academic radiology departments during and after COVID-19 is critical to prepare for future disruptive events. We summarize key insights and programmatic initiatives at major academic hospitals across the world, based on literature review and meetings of the Radiological Society of North America Vice Chairs of Research (RSNA VCR) group. Through expert discussion and case studies, we provide suggested guidelines to maintain and grow radiology research in the postpandemic era.