Malignant paraganglioma of the prostate invading the bladder and bilateral seminal vesicles: a case report.

Malignant paraganglioma (PGL) of the prostate is extremely rare, with only 3 cases reported in the English literature to date. In this article, we present a case of malignant prostatic PGL invading the bladder and bilateral seminal vesicles, in which the patient had a history of long-term haematuria and normal serum prostate specific antigen (PSA) level, and was misdiagnosed as a bladder tumour invading the prostate preoperatively. As this case belongs to functional tumour, there is a risk of developing hypertensive crisis during diagnostic biopsy or radical resection. The CT manifestations of prostatic PGL are characteristic, but its imaging features are rarely described due to the rarity of the tumour site. Meanwhile, improving the comprehensive understanding of CT, MRI, functional imaging, and clinical features of prostate PGL is conducive to make the correct diagnosis before surgery and ensure the safety of surgical treatment.

Microorganisms in the rumen and intestine of camels have the ability to degrade 2-amino-3-methylimidazo[4, 5-f]quinoline.

Heterocyclic amines (HAs) are a group of mutagenic and carcinogenic compounds produced from the processing of high-protein foods, which include 2-amino-3-methylimidazo[4, 5-f]quinoline (IQ) showing the strongest carcinogenic effect. Camels are able to digest HAs in foods, which provide rich microbial resources for the study. Thus, camel rumen and intestinal microbiota were used to degrade IQ, and the dominant microorganisms and their degradation characteristics were investigated. After three generations of culture with IQ as the sole carbon source, the highest abundance in rumen and intestinal microbes was found in the Proteobacteria phylum. The strains of third generation of the rumen contents were mainly attributed to the genera Brevundimonas and Pseudomonas, and the dominant genera in intestine were Ochrobactrum, Bacillus, and Pseudomonas. Microorganisms were further isolated and purified from the third generation cultures. These 27 strains from the rumen (L1-L27) and 23 strains from the intestine (C1-C23) were obtained. Among them, four strains with the most effective degrading abilities were as follows: L6 (28.55% of IQ degrading rate) and C1 (25.19%) belonged to the genus Ochrobactrum, L15 (23.41%) belonged to the genus Pseudomonas, and C16 (20.89%) were of the genus Bacillus. This study suggested the application of abundant microbial resources from camels' digestive tract to biodegrade foodborne toxins.

Integrated approach to hydrogeochemical appraisal of groundwater quality concerning arsenic contamination and its suitability analysis for drinking purposes using water quality index.

Arsenic (As), contamination in drinking groundwater resources is commonly environmental problem in many developing countries including Pakistan, with significant human health risk reports. In order to examine the groundwater quality concerning As contamination, its geochemical behavior along with physicochemical parameters, 42 samples were collected from community tube wells from District Bahawalpur, Punjab, Pakistan. The results showed the concentration of elevated As, its source of mobilization, and associated public health risk. The As concentration detected in groundwater samples varied from 0.12 to 104 µg/L with an average value of 34.7 µg/L. Among 42 groundwater samples, 27 samples were beyond the permitted limit of 10 µg/L recommended by World Health Organization (WHO), for drinking purposes. Statistical analysis result show that the groundwater cations values are in decreasing order such as: Na+ > Mg2+ > Ca2+ > K+, while anions were HCO3- > SO42- > Cl- > NO3-. Hydrochemical facies result depict that the groundwater samples of the study area, 14 samples belong to CaHCO3 type, 5 samples belong to NaCl type, 20 samples belong to Mixed CaMgCl type, and 3 samples belong to CaCl2 type. It can be accredited due to weathering and recharge mechanism, evaporation processes, and reverse ion exchange. Gibbs diagram shows that rock water interaction controls the hydrochemistry of groundwater resources of the study area. Saturation Index (SI) result indicated the saturation of calcite, dolomite, gypsum, geothite, and hematite mineral due their positive SI values. The principal component analysis (PCA) results possess a total variability of 80.69% signifying the anthropogenic and geogenic source of contamination. The results of the exposure-health-risk-assessment method for measuring As reveal significant potential non-carcinogenic risk (HQ), exceeding the threshold level of (> 1) for children in the study area. Water quality assessment results shows that 24 samples were not suitable for drinking purposes.

Evaluation of condylar osseous changes using a wireless detector with proton density-weighted imaging sequences.

Background: Cone-beam computed tomography (CBCT) is the gold standard for evaluating condylar osseous changes. However, the radiation risk and low soft-tissue resolution of CBCT make it unsuitable for evaluating soft tissue such as the articular disc and lateral pterygoid muscle. This study aimed to qualitatively and quantitatively evaluate the feasibility and advantages of using wireless detectors (WD) with proton density-weighted imaging (PDWI) sequences to image condyle changes in patients with temporomandibular disorders (TMD). Methods: This study involved 20 patients (male =8, female =12; mean age 31.65 years, SD 12.68 years) with TMD. All participants underwent a closed oblique sagittal PDWI scan with head/neck coupling coiling (HNCC) and wireless detector-HNCC (WD-HNCC) on a 3.0 T magnetic resonance imaging (MRI) scanner. Subsequently, the changes in the condyle bones in the scanned images for the 2 image types were scored subjectively and compared qualitatively. The contrast-to-noise ratio (CNR) of the 2 types of scanned images was compared quantitatively. The comparison of CNR differences between the 2 types of images was performed using the paired t-test. The kappa statistic was used to test the consistency of quantitative analyses of MRI images between observers. The subjective scores of condylar osseous changes in the 2 types of images were compared by paired rank-sum test. A P value <0.05 was considered statistically significant. Results: A total of 40 condyles from 20 patients were scanned. Among them, 8 condyles showed no bone changes, and the other 32 condyles demonstrated condylar osseous changes of varying degrees and nature. These 32 condyles were used in the subsequent analysis. As compared to images acquired by HNCC in the PDWI sequence, the WD-HNCC images more clearly showed mandibular osteophyte, bone cortical erosion, subcortical cystic focus, and bone cortical hyperplasia and thickening. In addition, the WD-HNCC was demonstrated to improve image CNR by 158.9% compared to HNCC (28.17±16.01 vs. 10.88±6.53; t=8.63; P=0.001). Conclusions: WD-HNCC in PDWI sequences is suitable for imaging the condylar bone changes of patients with TMD and significantly improves the image quality.

Non-Carcinogenic Health Risk Evaluation of Elevated Fluoride in Groundwater and Its Suitability Assessment for Drinking Purposes Based on Water Quality Index.

Fluoride (F-) contamination in drinking groundwater is a significant human health risk in Pakistan. Moreover, high fluoride pollution in drinking water causes a variety of disorders, including dental, neurological, and skeletal fluorosis. The aim of this research was to evaluate the health risk of elevated fluoride in groundwater and its suitability assessment for drinking purposes. The total of (n = 37) samples were collected from community tube wells of Quetta Valley, Balochistan, Pakistan. The results show a mean pH value of 7.7, TDS of 404.6 mg/L, EC of 500 µs/cm, depth of 96.8 feet, and turbidity of 1.7 nephelometric turbidity units. The mean values of HCO3-, Ca2+, Mg2+, and Na+, were 289.5, 47.5, 30.6, and 283.3 mg/L, respectively. The mean values of SO42-, NO3-, K+, Cl-, and Fe2+, were 34.9, 1.0, 1.6, 25.6, and 0.01 mg/L, respectively. The F- concentration in the groundwater varied between 0.19 and 6.21, with a mean value of 1.8 mg/L, and 18 samples out of 37 were beyond the WHO recommended limit of 1.5 mg/L. The hydrochemical analysis results indicated that among the groundwater samples of the study area, 54% samples were Na-HCO3 type and 46% were mixed CaNaHCO3 type. The saturation indices of the mineral phases reveal that the groundwater sources of the study area were saturated with CaCO3 and halide minerals due to their positive (SI) values. Such minerals include calcite, dolomite, gypsum, and fluorite. The principal component analysis results reveal that the groundwater sources of the study area are contaminated due to geological and anthropogenic actions. The health risk assessment results of the F- concentrations show the ranges of ADDingestion for children, females, and males in the Quetta Valley, and their mean values were observed to be 0.093052, 0.068825, and 0.065071, respectively. The HQingestion mean values were 1.55086, 1.147089, and 1.084521 for children, females, and males, respectively. It was noticed that children had the highest maximum and average values of ADDingestion and HQingestion in the research area, indicating that groundwater fluoride intake poses the greatest health risk to children. The water quality index (WQI) analyses show that 44% of the samples belong to the poor-quality category, 49% were of good quality, and 8% of the samples of the study area belong to the excellent category.

Value of artificial intelligence model based on unenhanced computed tomography of urinary tract for preoperative prediction of calcium oxalate monohydrate stones in vivo.

BACKGROUND: Urolithiasis is a global disease with a high incidence and recurrence rate, and stone composition is closely related to the choice of treatment and preventive measures. Calcium oxalate monohydrate (COM) is the most common in clinical practice, which is hard and difficult to fragment. Preoperative identification of its components and selection of effective surgical methods can reduce the risk of patients having a second operation. Methods that can be used for stone composition analysis include infrared spectroscopy, X-ray diffraction, and polarized light microscopy, but they are all performed on stone specimens in vitro after surgery. This study aimed to design and develop an artificial intelligence (AI) model based on unenhanced computed tomography (CT) images of the urinary tract, and to investigate the predictive ability of the model for COM stones in vivo preoperatively, so as to provide surgeons with more accurate diagnostic information. METHODS: Preoperative unenhanced CT images of patients with urinary calculi whose components were determined by infrared spectroscopy in a single center were retrospectively analyzed, including 337 cases of COM stones and 170 of non-COM stones. All images were manually segmented and the image features were extracted, and randomly divided into the training and testing sets in a ratio of 7:3. The least absolute shrinkage and selection operation algorithm (LASSO) was used to construct the AI model, and classification of the training and testing sets was carried out. RESULTS: A total of 1,218 radiomics imaging features were extracted, and 8 features with non-zero coefficients were finally obtained. The sensitivity, specificity and accuracy of the AI model were 90.5%, 84.3% and 88.5% for the training set, and 90.1%, 84.3% and 88.3% for the testing set. The area under the curve was 0.935 for the training set and 0.933 for the testing set. CONCLUSIONS: The AI model based on unenhanced CT images of the urinary tract can predict COM and non-COM stones in vivo preoperatively, and the model has high sensitivity, specificity and accuracy.

Virtual or real: lifelike cinematic rendering of adrenal tumors.

The adrenal gland is small in size and hidden in location. Adrenal tumors are relatively difficult to diagnose due to the wide variety of tumors and partial overlap of image features. Cinematic rendering (CR) is a novel, three-dimensional post-processing technology that simulates how light propagates in the real world, providing high-resolution visualizations that truly present subtle anatomical details. We retrospectively collected a series of pathologically confirmed adrenal tumor cases, raw data was introduced into the post-processing workstation, and different tools and templates of CR software were used for reconstruction and rendering. Compared with traditional black and white two-dimensional images and three-dimensional volume rendering (VR) images, CR images were more colorful, layered, and closer to the truth. CR has potential in diagnosing and preoperative planning of adrenal tumors, allowing vivid and realistic visualization of tumor location, morphology, different components (solid, cystic, fat, calcification, etc.), the pattern of enhancement, and the relationship with surrounding tissues and organs.

Quantitative Study of the Changes in Cerebral Blood Flow and Iron Deposition During Progression of Alzheimer's Disease.

BACKGROUND: Advanced Alzheimer's disease (AD) has no effective treatment, and identifying early diagnosis markers can provide a time window for treatment. OBJECTIVE: To quantify the changes in cerebral blood flow (CBF) and iron deposition during progression of AD. METHODS: 94 subjects underwent brain imaging on a 3.0-T MRI scanner with techniques of three-dimensional arterial spin labeling (3D-ASL) and quantitative susceptibility mapping (QSM). The subjects included 22 patients with probable AD, 22 patients with mild cognitive impairment (MCI), 25 patients with subjective cognitive decline (SCD), and 25 normal controls (NC). The CBF and QSM values were obtained using a standardized brain region method based on the Brainnetome Atlas. The differences in CBF and QSM values were analyzed between and within groups using variance analysis and correlation analysis. RESULTS: CBF and QSM identified several abnormal brain regions of interest (ROIs) at different stages of AD (p < 0.05). Regionally, the CBF values in several ROIs of the AD and MCI subjects were lower than for NC subjects (p < 0.001). Higher QSM values were observed in the globus pallidus. The CBF and QSM values in multiple ROI were negatively correlated, while the putamen was the common ROI of the three study groups (p < 0.05). The CBF and QSM values in hippocampus were cross-correlated with scale scores during the progression of AD (p < 0.05). CONCLUSION: Iron deposition in the basal ganglia and reduction in blood perfusion in multiple regions existed during the progression of AD. The QSM values in putamen can be used as an imaging biomarker for early diagnosis of AD.

Preoperative CT Radiomics Predicting the SSIGN Risk Groups in Patients With Clear Cell Renal Cell Carcinoma: Development and Multicenter Validation.

Objective: The stage, size, grade, and necrosis (SSIGN) score can facilitate the assessment of tumor aggressiveness and the personal management for patients with clear cell renal cell carcinoma (ccRCC). However, this score is only available after the postoperative pathological evaluation. The aim of this study was to develop and validate a CT radiomic signature for the preoperative prediction of SSIGN risk groups in patients with ccRCC in multicenters. Methods: In total, 330 patients with ccRCC from three centers were classified into the training, external validation 1, and external validation 2 cohorts. Through consistent analysis and the least absolute shrinkage and selection operator, a radiomic signature was developed to predict the SSIGN low-risk group (scores 0-3) and intermediate- to high-risk group (score ≥ 4). An image feature model was developed according to the independent image features, and a fusion model was constructed integrating the radiomic signature and the independent image features. Furthermore, the predictive performance of the above models for the SSIGN risk groups was evaluated with regard to their discrimination, calibration, and clinical usefulness. Results: A radiomic signature consisting of sixteen relevant features from the nephrographic phase CT images achieved a good calibration (all Hosmer-Lemeshow p > 0.05) and favorable prediction efficacy in the training cohort [area under the curve (AUC): 0.940, 95% confidence interval (CI): 0.884-0.973] and in the external validation cohorts (AUC: 0.876, 95% CI: 0.811-0.942; AUC: 0.928, 95% CI: 0.844-0.975, respectively). The radiomic signature performed better than the image feature model constructed by intra-tumoral vessels (all p < 0.05) and showed similar performance with the fusion model integrating radiomic signature and intra-tumoral vessels (all p > 0.05) in terms of the discrimination in all cohorts. Moreover, the decision curve analysis verified the clinical utility of the radiomic signature in both external cohorts. Conclusion: Radiomic signature could be used as a promising non-invasive tool to predict SSIGN risk groups and to facilitate preoperative clinical decision-making for patients with ccRCC.

A Computed Tomography-Based Radiomics Nomogram to Preoperatively Predict Tumor Necrosis in Patients With Clear Cell Renal Cell Carcinoma.

Objective: To develop and validate a radiomics nomogram for preoperative prediction of tumor necrosis in patients with clear cell renal cell carcinoma (ccRCC). Methods: In total, 132 patients with pathologically confirmed ccRCC in one hospital were enrolled as a training cohort, while 123 ccRCC patients from second hospital served as the independent validation cohort. Radiomic features were extracted from corticomedullary and nephrographic phase contrast-enhanced computed tomography (CT) images. A radiomics signature based on optimal features selected by consistency analysis and the least absolute shrinkage and selection operator was developed. An image features model was constructed based on independent image features according to visual assessment. By integrating the radiomics signature and independent image features, a radiomics nomograph was constructed. The predictive performance of the above models was evaluated using receiver operating characteristic (ROC) curve analysis. Furthermore, the nomogram was assessed using calibration curve and decision curve analysis. Results: Thirty-seven features were used to establish a radiomics signature, which demonstrated better predictive performance than did the image features model constructed using tumor size and intratumoral vessels in the training and validation cohorts (p <0.05). The radiomics nomogram demonstrated satisfactory discrimination in the training (area under the ROC curve [AUC] 0.93 [95% CI 0.87-0.96]) and validation (AUC 0.87 [95% CI 0.79-0.93]) cohorts and good calibration (Hosmer-Lemeshow p>0.05). Decision curve analysis verified that the radiomics nomogram had the best clinical utility compared with the other models. Conclusion: The radiomics nomogram developed in the present study is a promising tool to predict tumor necrosis and facilitate preoperative clinical decision-making for patients with ccRCC.

Longitudinal volume changes of hippocampal subfields and cognitive decline in Parkinson's disease.

BACKGROUND: Neuropathological studies have shown that the hippocampus is affected in Parkinson's disease (PD) with cognitive impairment. Our goal was to assess the longitudinal volume change of different hippocampal subfields in PD patients with and without cognitive decline using magnetic resonance imaging (MRI). METHODS: A total of 28 nondemented PD patients and 27 neurologically unimpaired elderly controls were enrolled in this study, and three-dimensional (3D) T1-weighted MRI was performed. All PD patients that were followed up and rescanned after 2 years were divided into two groups: PD without cognitive decline (n=15) and PD with cognitive decline (n=13). A Bayesian model implemented in FreeSurfer was used to segment the hippocampal subfields automatically. Scale for global cognitive status included the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). RESULTS: In the cross sectional study, the bilateral hippocampal volume was smaller in PD patients compared to healthy controls, and the bilateral subiculum, CA2/3, CA4, and molecular layer (ML) subfields, and the right granule cell layer of the dentate gyrus (GC-DG) subfield, were significantly decreased in the PD patients. Significant correlations were found between the MoCA score and total hippocampus volume in PD patients. In the follow-up group, bilateral CA4, ML, and GC-DG subfields, and left CA2/3 and right presubiculum subfields, were significantly smaller in PD patients with cognitive decline compared to PD patients without cognitive decline. Significant correlations were found between the longitudinal change of the MMSE or MoCA scores and percent change rate of total bilateral hippocampal, bilateral ML, and right CA4 in all PD patients. CONCLUSIONS: Our results demonstrated the selective regional vulnerability of the hippocampus in the progression of PD. These findings corroborate neuropathological findings and add novel information about the involvement of the hippocampus in the cognitive dysfunction of PD.

Inhibitory effect of nitrate/nitrite on the microbial reductive dissolution of arsenic and iron from soils into pore water.

It was well established that microbial communities are the major drive for the formation of arsenic-contaminated groundwater. However, it remains to be elucidated for how nitrate/nitrite affects the microorganisms-catalyzed dissolution and reduction of arsenic. To address this issue, we collected soil samples containing high-contents of arsenic from the Shimen Realgar Mine area. Microcosm assay indicated that addition of nitrate/nitrite significantly inhibited the dissolution, reduction and release of As and Fe caused by the biological catalysis of microbial communities in the soils, meanwhile nitrate/nitrite was reduced into N2. To further investigate the molecular mechanism of this finding, we used a representative dissimilatory arsenate-respiring strain Shewanella sp. GL90 from the soils to perform the arsenic release assay. GL90 can efficiently catalyze the reductive dissolution, and promote the release of As and Fe in soils. It is interesting to see that the addition of nitrate/nitrite to the soils led to marked decreases in the GL90-mediated dissolution of As and Fe in the soils. Moreover, we found that this finding was attributed to that nitrate/nitrite significantly inhibited the transcription of the gene of the respiratory arsenate reductase protein in GL90 cells. This work provided new insights into the mechanisms for the coupling of As, N and Fe geochemical cycles in arsenic-rich soils, and for how environmental factors affect As concentration in groundwater.

A Study of the Correlation of Perfusion Parameters in High-Resolution GRASP MRI With Microvascular Density in Lung Cancer.

BACKGROUND: The histological count of microvascular density (MVD) is the current clinical standard for assessing tumor angiogenesis. Although it is hypothesized that perfusion MRI can be a noninvasive alternative to MVD, there have been few studies to validate their correlations, particularly in lung cancer. PURPOSE: To investigate the correlation between MVD and perfusion parameters obtained from high-resolution GRASP (Golden-angle RAdial Sparse Parallel) dynamic contrast-enhanced (DCE)-MRI in a cohort of lung cancer patients, and to validate that GRASP MRI can serve as a free-breathing, noninvasive imaging approach for studying tumor angiogenesis. STUDY TYPE: Prospective. POPULATION: Twenty-five lung cancer patients (16 male, 9 female, mean age = 57.3 ± 11.7 years). FIELD STRENGTH/SEQUENCE: 3T MRI; a prototype golden-angle stack-of-stars sequence. ASSESSMENT: Contrast-enhanced MR data were acquired during free breathing and were reconstructed using GRASP with a temporal resolution of ∼3 sec/phase. For all data, perfusion analysis was performed using a standard Tofts model to generate the volume transfer coefficient (Ktrans ) and the interstitial volume (Ve ). The MVD of corresponding tumor specimens, obtained from Computed Tomography-guided biopsies, were counted with CD34 staining. STATISTICAL TESTS: Pearson correlation analysis; one-way analysis of variance analysis; least significant difference-t method of multiple comparisons. RESULTS: The correlation coefficient was 0.983 and 0.972 for the measurement and remeasurement of Ktrans and Ve . The mean values of Ktrans , Ve , and MVD were 0.33 ± 0.22 min-1 , 0.25 ± 0.12, and 49.68 ± 27.08 vessels/0.723 mm2 , respectively, in all patients (n = 25); 0.36 ± 0.26 min-1 , 0.27 ± 0.13, and 49.09 ± 29.84 vessels/0.723 mm2 , respectively, in adenocarcinoma (n = 15); 0.34 ± 0.17 min-1 , 0.26 ± 0.12, and 53.85 ± 23.53 vessels/0.723 mm2 , respectively, in squamous cell carcinoma (n = 8); and 0.13 ± 0.15 min-1 , 0.14 ± 0.06, and 37.20 ± 28.28 vessels/0.723 mm2 , respectively, in small-cell carcinoma (n = 2). There was a positive relationship between the Ktrans and MVD in all patients (r = 0.738, P < 0.001). DATA CONCLUSION: High spatiotemporal resolution DCE-MRI using GRASP is a promising noninvasive alternative to the histological count of MVD for assessing tumor angiogenesis in lung cancer. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1186-1194.

Inhibitory Effect of an Acidic Peptide on the Activity of an Antimicrobial Peptide from the Scorpion Mesobuthus martensii Karsch.

Highly acidic peptides with no disulfide bridges are widely present in the scorpion venoms; however, none of them has been functionally characterized so far. Here, we cloned the full-length cDNA of a short-chain highly acidic peptide (referred to as HAP-1) from a cDNA library made from the venom glands of the Chinese scorpion Mesobuthus martensii Karsch. HAP-1 contains 19 amino acid residues with a predicted IP value of 4.25. Acidic amino residues account for 33.3% of the total residues in the molecule of HAP-1. HAP-1 shows 76⁻98% identities to some scorpion venom peptides that have not yet been functionally characterized. Secondary structure prediction showed that HAP-1 contains a beta-sheet region (residues 9⁻17), and two coiled coil regions (residues 1⁻8 and 18⁻19) located at the N-terminal and C-terminal regions of the peptide, respectively. Antimicrobial assay showed that HAP-1 does not have any effect on the growth of the bacterium Staphylococcus aureus AB94004. However, it potently inhibits the antimicrobial activity of a 13-mer peptide from M. martensii Karsch against Staphylococcus aureus AB94004. This finding is the first characterization of the function of such highly acidic peptides from scorpions.

Wireless amplified NMR detector for improved visibility of image contrast in heterogeneous lesions.

To demonstrate the capability of a wireless amplified NMR detector (WAND) to improve the visibility of lesion heterogeneity without the use of exogenous contrast agents, a cylindrically symmetric WAND was constructed to sensitively detect and simultaneously amplify MR signals emitted from adjacent tissues. Based on a two-leg high-pass birdcage coil design, this WAND could be activated by a pumping field aligned along the main field (B0 ), without perturbing MR signal reception. Compared with an equivalent pair of external detectors, the WAND could achieve more than 10-fold gain for immediately adjacent regions. Even for regions with 3.4 radius distance separation from the detector's cylindrical center, the WAND was at least 1.4 times more sensitive than an equivalent pair of surface arrays or at least twice as sensitive as a single-sided external surface detector. When the WAND was inserted into a rat's rectum to observe adjacent tumors implanted beneath the mucosa, it could enhance the detection sensitivity of lesion regions, and thus enlarge the observable signal difference between heterogeneous tissues and clearly identify lesion boundaries as continuous lines in the intensity gradient profile. Hyperintense regions observable by the WAND existed due to higher levels of blood supply, which was indicated by a similar pattern of signal enhancement after contrast agent administration. By better observing the endogenous signal contrast, the endoluminal WAND could characterize lesions without the use of exogenous contrast agents, and thus reduce contrast-induced toxicity.