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1.
Medicine (Baltimore) ; 100(25): e26262, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34160389

RESUMO

BACKGROUND: Shear wave elastography (SWE) is a new ultrasonic elastography technique for evaluating the hardness of living tissue by measuring the propagation velocity of shear wave in tissue, which is characterized by real-time, non-invasive and quantitative. The SWE technique can be used to diagnose the lesions of different tissues and organs, and the quantitative measurement of SWE is considered as more objective information about breast masses. Superb microvascular imaging (SMI) is a new noninvasive Doppler ultrasound imaging method, which can display blood flow information with high spatial resolution and high frame rate, while keeping the minimum low-speed blood flow components. Therefore, SMI can diagnose diseases closely related to angiogenesis at a relatively early stage. However, the results of these studies have been contradictory. The present meta-analysis aimed at determining the accuracy of SWE combined with SMI in the differential diagnosis between benign and malignant breast lesions. METHODS: We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the April 18, 2021, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14. 0 software will be used for data analysis. RESULTS: This systematic review will determine the accuracy of shear wave elastography combined with superb microvascular imaging in the differential diagnosis between benign and malignant breast tumors. CONCLUSION: Its findings will provide helpful evidence for the accuracy of shear wave elastography combined with superb microvascular imaging in the differential diagnosis between benign and malignant breast tumors. SYSTEMATIC REVIEW REGISTRATION: INPLASY202150075.


Assuntos
Neoplasias da Mama/diagnóstico , Técnicas de Imagem por Elasticidade/métodos , Neovascularização Patológica/diagnóstico , Ultrassonografia Doppler/métodos , Ultrassonografia Mamária/métodos , Mama/irrigação sanguínea , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/irrigação sanguínea , Neoplasias da Mama/patologia , Estudos de Casos e Controles , Estudos de Coortes , Diagnóstico Diferencial , Feminino , Humanos , Metanálise como Assunto , Microvasos/diagnóstico por imagem , Imagem Multimodal/métodos , Neovascularização Patológica/patologia , Valor Preditivo dos Testes , Revisões Sistemáticas como Assunto
2.
Medicine (Baltimore) ; 100(26): e26531, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34190189

RESUMO

ABSTRACT: The aim of this study was to compare the sensitivity of mammography (MG), ultrasound (US), magnetic resonance imaging (MRI), and combinations of these imaging modalities for the detection of small (≤2 cm) breast cancer and to evaluate the benefit of preoperative breast MRI after performing conventional imaging techniques for small breast cancer.This was an observational retrospective review of 475 patients with pathologically confirmed breast cancer. We reviewed the medical records; assessed the preoperative reports of MG, US, and MRI; and categorized them as benign features (BI-RADS 1-3) or malignant features (BI-RADS 4 or 5). The criterion standard for detection was the pathologic assessment of the surgical specimen. The sensitivities of the different techniques were compared using the McNemar test.Among the 475 women, the sensitivity of MG was significantly greater in patients with low breast density than in those with high breast density (84.5% vs 65.8%, P < .001). US had higher sensitivity than MG (P < .001), and the combination of MG + US showed better sensitivity than MG or US alone (P < .001). Further addition of MRI to the combination of MG and US statistically contributed to the sensitivity yield (from 93.3% to 98.2%; P < .001) but did not significantly increase the mastectomy rate (from 48.2% to 49.3%; P = .177).MG has limited diagnostic sensitivity in patients with small breast cancer, especially in those with dense breast tissue. US is better than MG at detecting small breast cancer, regardless of breast density. The addition of MRI to MG and US could increase sensitivity without increasing the mastectomy rate. This study suggests performing MRI routinely on the basis of MG and US for small (≤2 cm) breast cancer.


Assuntos
Neoplasias da Mama , Imageamento por Ressonância Magnética/métodos , Mamografia/métodos , Mastectomia , Ultrassonografia Mamária/métodos , Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , China/epidemiologia , Feminino , Humanos , Mastectomia/métodos , Mastectomia/estatística & dados numéricos , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Cuidados Pré-Operatórios/métodos , Estudos Retrospectivos , Carga Tumoral
3.
Nat Commun ; 12(1): 3689, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-34140486

RESUMO

Calcium imaging is a powerful tool for recording from large populations of neurons in vivo. Imaging in rhesus macaque motor cortex can enable the discovery of fundamental principles of motor cortical function and can inform the design of next generation brain-computer interfaces (BCIs). Surface two-photon imaging, however, cannot presently access somatic calcium signals of neurons from all layers of macaque motor cortex due to photon scattering. Here, we demonstrate an implant and imaging system capable of chronic, motion-stabilized two-photon imaging of neuronal calcium signals from macaques engaged in a motor task. By imaging apical dendrites, we achieved optical access to large populations of deep and superficial cortical neurons across dorsal premotor (PMd) and gyral primary motor (M1) cortices. Dendritic signals from individual neurons displayed tuning for different directions of arm movement. Combining several technical advances, we developed an optical BCI (oBCI) driven by these dendritic signalswhich successfully decoded movement direction online. By fusing two-photon functional imaging with CLARITY volumetric imaging, we verified that many imaged dendrites which contributed to oBCI decoding originated from layer 5 output neurons, including a putative Betz cell. This approach establishes new opportunities for studying motor control and designing BCIs via two photon imaging.


Assuntos
Interfaces Cérebro-Computador , Cálcio/metabolismo , Dendritos/fisiologia , Microscopia Intravital/instrumentação , Microscopia Intravital/métodos , Córtex Motor/diagnóstico por imagem , Imagem Multimodal/métodos , Animais , Proteínas de Ligação ao Cálcio/metabolismo , Dendritos/metabolismo , Proteínas de Fluorescência Verde/metabolismo , Implantes Experimentais , Macaca mulatta , Masculino , Modelos Neurológicos , Atividade Motora/fisiologia , Córtex Motor/fisiologia , Neurônios/fisiologia , Fótons
4.
Int J Mol Sci ; 22(11)2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34071740

RESUMO

Bicuspid aortic valve (BAV) associated with aortopathy is the most common congenital heart disease in the general population. Far from being a simple harmless valve malformation, it can be a complex and heterogeneous disease and a source of chronic and acute pathology (early valvular disease, aneurysm, dissection). In the previous years, intense research has been carried out to find out and understand its mechanisms, but the pathophysiology of the disease is still not fully understood and many questions remain open. Recent studies have discovered several genetic mutations involved in the development of valvular and aortic malformations, but still cannot explain more than 5-10% of cases. Other studies have also focused on molecular alterations and cellular processes (TGF-ß pathway, microRNAs, degradation of the extracellular matrix, metalloproteinases, etc.), being a field in constant search and development, looking for a therapeutic target to prevent the development of the disease. Increased knowledge about this multifaceted disorder, derived from both basic and clinical research, may influence the diagnosis, follow-up, prognosis, and therapies of affected patients in the near future. This review focuses on the latest and outstanding developments on the molecular and genetic investigations of the bicuspid aortopathy.


Assuntos
Doença da Válvula Aórtica Bicúspide/diagnóstico , Doença da Válvula Aórtica Bicúspide/etiologia , Suscetibilidade a Doenças , Predisposição Genética para Doença , Alelos , Animais , Doença da Válvula Aórtica Bicúspide/terapia , Biomarcadores , Gerenciamento Clínico , Epigênese Genética , Estudos de Associação Genética , Genótipo , Humanos , Padrões de Herança , MicroRNAs/genética , Imagem Multimodal/métodos , Fenótipo
5.
Int J Mol Sci ; 22(10)2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34069002

RESUMO

Precise measurement of particulate matter (PM) on skin is important for managing and preventing PM-related skin diseases. This study aims to directly visualize the deposition and penetration of PM into human skin using a multimodal nonlinear optical (MNLO) imaging system. We successfully obtained PM particle signals by merging two different sources, C-C vibrational frequency and autofluorescence, while simultaneously visualizing the anatomical features of the skin via keratin, collagen, and elastin. As a result, we found morphologically dependent PM deposition, as well as increased deposition following disruption of the skin barrier via tape-stripping. Furthermore, PM penetrated more and deeper into the skin with an increase in the number of tape-strippings, causing a significant increase in the secretion of pro-inflammatory cytokines. Our results suggest that MNLO imaging could be a useful technique for visualizing and quantifying the spatial distribution of PM in ex vivo human skin tissues.


Assuntos
Imagem Multimodal/métodos , Imagem Óptica/métodos , Material Particulado/análise , Dermatopatias/diagnóstico , Pele/metabolismo , Humanos , Dermatopatias/metabolismo
6.
Int J Comput Assist Radiol Surg ; 16(6): 979-988, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33966155

RESUMO

PURPOSE: CESM (contrast-enhanced spectral mammography) is an efficient tool for detecting breast cancer because of its image characteristics. However, among most deep learning-based methods for breast cancer classification, few models can integrate both its multiview and multimodal features. To effectively utilize the image features of CESM and thus help physicians to improve the accuracy of diagnosis, we propose a multiview multimodal network (MVMM-Net). METHODS: The experiment is carried out to evaluate the in-house CESM images dataset taken from 95 patients aged 21-74 years with 760 images. The framework consists of three main stages: the input of the model, image feature extraction, and image classification. The first stage is to preprocess the CESM to utilize its multiview and multimodal features effectively. In the feature extraction stage, a deep learning-based network is used to extract CESM images features. The last stage is to integrate different features for classification using the MVMM-Net model. RESULTS: According to the experimental results, the proposed method based on the Res2Net50 framework achieves an accuracy of 96.591%, sensitivity of 96.396%, specificity of 96.350%, precision of 96.833%, F1_score of 0.966, and AUC of 0.966 on the test set. Comparative experiments illustrate that the classification performance of the model can be improved by using multiview multimodal features. CONCLUSION: We proposed a deep learning classification model that combines multiple features of CESM. The results of the experiment indicate that our method is more precise than the state-of-the-art methods and produces accurate results for the classification of CESM images.


Assuntos
Neoplasias da Mama/diagnóstico , Mama/diagnóstico por imagem , Meios de Contraste/farmacologia , Mamografia/métodos , Imagem Multimodal/métodos , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem
7.
Medicine (Baltimore) ; 100(18): e25800, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950980

RESUMO

ABSTRACT: We aimed to determine the incremental value of magnetic resonance generated synthetic computed tomography (MRCT), evaluate cervical ossification of the posterior longitudinal ligament (OPLL), and compare the computed tomography (CT) numbers between MRCT and conventional CT.Twenty-two patients who underwent magnetic resonance imaging (MRI) with MRCT protocols and CT were enrolled. MRCT images were generated from 3D-T2-weighted imaging, 3D-pointwise-encoding time reduction with radial acquisition, 3D-T1-Dixon, and 3D-time-of-flight sequences. Two radiologists independently evaluated the presence of OPLL at each cervical spine level during sessions 1 (MRI alone) and 2 (MRI + MRCT). CT was the reference standard for the presence of OPLL. One reader measured the mean CT number of the vertebral body and spinous process at each cervical spine level in the MRCT and CT images.Sensitivity for the detection of OPLL was markedly higher in session 2 (MRI + MRCT) than in session 1 (MRI alone), as measured by both readers (47% vs. 90%, reader 1; 63% vs. 93%, reader 2). The mean CT number of MRCT and CT showed a moderate to strong positive correlation (ρ = .42-.72, P < .001).The combined use of MRCT and MRI showed improved sensitivity for the evaluation of cervical OPLL. The mean CT number of MRCT and CT showed a positive correlation.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/métodos , Ossificação do Ligamento Longitudinal Posterior/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Vértebras Cervicais/patologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Ossificação do Ligamento Longitudinal Posterior/patologia , Estudos Retrospectivos , Sensibilidade e Especificidade
8.
BMC Pregnancy Childbirth ; 21(1): 288, 2021 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-33838651

RESUMO

BACKGROUND: Malignancy during pregnancy is increasing, and the most common type of malignancy is uterine cervical cancer. When planning the treatment of cervical cancer, it is important to look for signs of metastasis before surgery, especially metastasis to the lymph nodes. In this report, we assessed the diagnostic value of positron emission tomography/magnetic resonance imaging (PET/MRI) for evaluating cervical cancer propagation before surgery, with a focus on pregnant women. CASE PRESENTATION: 18F Fluorodeoxyglucose (FDG)-PET/MRI was performed in seven pregnant cervical cancer patients (28-34 years old) at 9-18 gestational weeks. In case #5, a second PET/MRI was performed at 24 gestational weeks. Of seven FDG-PET/MRI examination series in six cases (cases #1-6), FDG-PET/MR imaging could detect cervical tumors with abnormal FDG accumulation; these tumors were confirmed with a standardized uptake value max (SUV max) titer of 4.5-16. A second PET/MRI examination in case #5 revealed the same SUV max titer as the first examination. In these six imaging series (cases #1-5), there were no signs of cancer metastasis to the parametrium and lymph nodes. However, in case #6, abnormal FDG accumulation in the left parametrial lymph nodes was also detectable. Pathological examination showed lymph node metastasis in case #6. In case #7, PET/MRI could not detect any abnormal FDG accumulation in the cervix and other sites. Cone biopsy demonstrated only micro-invasive squamous cell carcinoma. After treatment for cervical cancer, all seven patients have had no recurrence of disease within the follow-up period (2.8-5.6 years), and their children have developed appropriately. CONCLUSION: PET/MRI is an effective imaging tool to evaluate cervical cancer progression in pregnancy.


Assuntos
Colo do Útero/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Complicações Neoplásicas na Gravidez/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Adulto , Progressão da Doença , Estudos de Viabilidade , Feminino , Fluordesoxiglucose F18/administração & dosagem , Humanos , Imagem Multimodal/métodos , Estadiamento de Neoplasias , Teste de Papanicolaou , Gravidez , Complicações Neoplásicas na Gravidez/patologia , Complicações Neoplásicas na Gravidez/cirurgia , Período Pré-Operatório , Compostos Radiofarmacêuticos/administração & dosagem , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Esfregaço Vaginal
9.
Eur J Endocrinol ; 184(6): 879-889, 2021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-33852422

RESUMO

Objective: To obtain direct quantifications of glucose turnover, volumes and fat content of several tissues in the development of type 2 diabetes (T2D) using a novel integrated approach for whole-body imaging. Design and methods: Hyperinsulinemic-euglycemic clamps and simultaneous whole-body integrated [18F]FDG-PET/MRI with automated analyses were performed in control (n = 12), prediabetes (n = 16) and T2D (n = 13) subjects matched for age, sex and BMI. Results: Whole-body glucose uptake (Rd) was reduced by approximately 25% in T2D vs control subjects, and partitioning to brain was increased from 3.8% of total Rd in controls to 7.1% in T2D. In liver, subcutaneous AT, thigh muscle, total tissue glucose metabolic rates (MRglu) and their % of total Rd were reduced in T2D compared to control subjects. The prediabetes group had intermediate findings. Total MRglu in heart, visceral AT, gluteus and calf muscle was similar across groups. Whole-body insulin sensitivity assessed as glucose infusion rate correlated with liver MRglu but inversely with brain MRglu. Liver fat content correlated with MRglu in brain but inversely with MRglu in other tissues. Calf muscle fat was inversely associated with MRglu only in the same muscle group. Conclusions: This integrated imaging approach provides detailed quantification of tissue-specific glucose metabolism. During T2D development, insulin-stimulated glucose disposal is impaired and increasingly shifted away from muscle, liver and fat toward the brain. Altered glucose handling in the brain and liver fat accumulation may aggravate insulin resistance in several organs.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Glucose/metabolismo , Hiperinsulinismo/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Estado Pré-Diabético/diagnóstico por imagem , Idoso , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Técnica Clamp de Glucose , Humanos , Resistência à Insulina/fisiologia , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Músculo Esquelético/metabolismo , Tomografia por Emissão de Pósitrons/métodos
10.
Int J Mol Sci ; 22(9)2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33922728

RESUMO

Bc-DLFL.1 is a novel spontaneous, high-grade transplantable mouse B-cell lymphoma model for selective serosal propagation. These cells attach to the omentum and mesentery and show dissemination in mesenteric lymph nodes. We aimed to investigate its early stage spread at one day post-intraperitoneal inoculation of lymphoma cells (n = 18 mice), and its advanced stage at seven days post-inoculation with in vivo [18F]FDG-PET and [18F]PET/MRI, and ex vivo by autoradiography and Cherenkov luminescence imaging (CLI). Of the early stage group, nine animals received intraperitoneal injections, and nine received intravenous [18F]FDG injections. The advanced stage group (n = 3) received intravenous FDG injections. In the early stage, using autoradiography we observed a marked accumulation in the mesentery after intraperitoneal FDG injection. Using other imaging methods and autoradiography, following the intravenous injection of FDG no accumulations were detected. At the advanced stage, tracer accumulation was clearly detected in mesenteric lymph nodes and in the peritoneum after intravenous administration using PET. We confirmed the results with immunohistochemistry. Our results in this model highlight the importance of local FDG administration during diagnostic imaging to precisely assess early peritoneal manifestations of other malignancies (colon, stomach, ovary). These findings also support the importance of applying topical therapies, in addition to systemic treatments in peritoneal cancer spread.


Assuntos
Modelos Animais de Doenças , Glucose/metabolismo , Linfoma/patologia , Imagem Multimodal/métodos , Animais , Fluordesoxiglucose F18/metabolismo , Injeções Intraperitoneais , Metástase Linfática , Linfoma/diagnóstico por imagem , Camundongos , Camundongos Endogâmicos BALB C , Micrometástase de Neoplasia , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos/metabolismo , Tomografia Computadorizada por Raios X/métodos
11.
Ann Hematol ; 100(6): 1525-1535, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33909101

RESUMO

To compare FDG-PET/unenhanced MRI and FDG-PET/diagnostic CT in detecting infiltration in patients with newly diagnosed Hodgkin lymphoma (HL). The endpoint was equivalence between PET/MRI and PET/CT in correctly defining the revised Ann Arbor staging system. Seventy consecutive patients with classical-HL were prospectively investigated for nodal and extra-nodal involvement during pretreatment staging with same-day PET/CT and PET/MRI. Findings indicative of malignancy with the imaging procedures were regarded as lymphoma infiltration; in case of discrepancy, positive-biopsy and/or response to treatment were evidenced as lymphoma. Sixty of the 70 (86%) patients were evaluable having completed the staging program. Disease staging based on either PET/MRI or PET/CT was correct for 54 of the 60 patients (90% vs. 90%), with difference between proportions of 0.0 (95% CI, -9 to 9%; P=0.034 for the equivalence test). As compared with reference standard, invasion of lymph nodes was identified with PET/MRI in 100% and with PET/CT in 100%, of the spleen with PET/MRI in 66% and PET/CT in 55%, of the lung with PET/MRI in 60% and PET/CT in 100%, of the liver with PET/MRI in 67% and PET/CT in 100%, and of the bone with PET/MRI in 100% and PET/CT in 50%. The only statistically significant difference between PET/MRI and PET/CT was observed in bony infiltration detection rates. For PET/CT, iodinate contrast medium infusions' average was 86 mL, and exposure to ionizing radiation was estimated to be 4-fold higher than PET/MRI. PET/MRI is a promising safe new alternative in the care of patients with HL.


Assuntos
Doença de Hodgkin/diagnóstico por imagem , Adulto , Idoso , Feminino , Fluordesoxiglucose F18/análise , Doença de Hodgkin/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Invasividade Neoplásica/diagnóstico por imagem , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons/métodos , Estudos Prospectivos , Adulto Jovem
12.
Medicine (Baltimore) ; 100(14): e25378, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832124

RESUMO

INTRODUCTION: Multimodality assessment of coronary artery lesions has demonstrated superior effectiveness compared to the conventional approach, for assessing both anatomical and functional significance of a coronary stenosis. Multiple imaging modalities can be integrated into a fusion imaging tool to better assess myocardial ischemia. MATERIAL AND METHODS: The FUSE-HEART trial is a single center, prospective, cohort study that will assess the impact of a coronary artery stenosis on myocardial function and viability, based on advanced fusion imaging technics derived from Cardiac Computed Tomography Angiography (CCTA). Moreover, the study will investigate the correlation between morphology and composition of the coronary plaques and myocardial ischemia in the territory irrigated by the same coronary artery. At the same time, imaging parameters will be correlated with inflammatory status of the subjects. The trial will include 100 subjects with coronary lesions found on CCTA examination. The study population will be divided into 2 groups: first group will consist of subjects with anatomically significant coronary lesions on native coronary arteries and the second one will include subjects surviving an acute myocardial infarction. The vulnerability score of the subjects will be calculated based on presence of CCTA vulnerability markers of the coronary plaques: napkin ring sign, positive remodeling, spotty calcifications, necrotic core, and low-density plaques. 3D fusion images of the coronary tree will be generated, integrating the images reflecting wall motion with the ones of coronary circulation. The fusion models will establish the correspondence between plaque composition and wall motion in the subtended myocardium of the coronary artery. The study primary outcome will be represented by the rate of major adverse cardiac events related to myocardial ischemia at 1-year post assessment, in correlation with the degree of coronary artery stenosis and myocardial ischemia or viability.The secondary outcomes are represented by the rate of re-hospitalization, rate of survival and rate of major adverse cardiovascular events (including cardiovascular death or stroke), in correlation with the morphology and composition of atheromatous plaques located in a coronary artery, and myocardial ischemia in the territory irrigated by the same coronary artery. CONCLUSION: In conclusion, FUSE-HEART will be a study based on modern imaging tools that will investigate the impact of a coronary artery stenosis on myocardial function and viability, using advanced fusion imaging technics derived from CCTA, sighting to validate plaque composition and morphology, together with inflammatory biomarkers, as predictors to myocardial viability.


Assuntos
Vasos Coronários/diagnóstico por imagem , Imagem Multimodal/métodos , Isquemia Miocárdica/complicações , Imagem de Perfusão do Miocárdio/métodos , Estudos de Coortes , Angiografia por Tomografia Computadorizada/métodos , Estenose Coronária/complicações , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/fisiopatologia , Vasos Coronários/patologia , Humanos , Mediadores da Inflamação/metabolismo , Ensaios Clínicos Controlados não Aleatórios como Assunto , Avaliação de Resultados em Cuidados de Saúde , Placa Aterosclerótica/diagnóstico por imagem , Placa Aterosclerótica/fisiopatologia , Estudos Prospectivos
13.
Int J Mol Sci ; 22(8)2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33923839

RESUMO

PET/CT molecular imaging has been imposed in clinical oncological practice over the past 20 years, driven by its two well-grounded foundations: quantification and radiolabeled molecular probe vectorization. From basic visual interpretation to more sophisticated full kinetic modeling, PET technology provides a unique opportunity to characterize various biological processes with different levels of analysis. In clinical practice, many efforts have been made during the last two decades to standardize image analyses at the international level, but advanced metrics are still under use in practice. In parallel, the integration of PET imaging with radionuclide therapy, also known as radiolabeled theranostics, has paved the way towards highly sensitive radionuclide-based precision medicine, with major breakthroughs emerging in neuroendocrine tumors and prostate cancer. PET imaging of tumor immunity and beyond is also emerging, emphasizing the unique capabilities of PET molecular imaging to constantly adapt to emerging oncological challenges. However, these new horizons face the growing complexity of multidimensional data. In the era of precision medicine, statistical and computer sciences are currently revolutionizing image-based decision making, paving the way for more holistic cancer molecular imaging analyses at the whole-body level.


Assuntos
Tomografia por Emissão de Pósitrons/métodos , Humanos , Imagem Multimodal/métodos , Neoplasias/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/normas , Medicina de Precisão/métodos , Compostos Radiofarmacêuticos/classificação
14.
Medicine (Baltimore) ; 100(16): e25517, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879689

RESUMO

RATIONALE: Primary schwannoma of the thyroid gland is very rare, and its preoperative diagnosis is difficult. PATIENT CONCERNS: We report the case of a thyroid nodule in an 18-year-old woman, who presented with a mass in her left neck with stiffness and normal thyroid function. However, the patient complained of numbness in her left upper extremity, and ultrasound (US) features were suspicious of malignancy. DIAGNOSES: Multimodal US imaging was performed using B-mode, color doppler, ultrasonic elastography (UE), and contrast-enhanced ultrasound (CEUS). CEUS revealed heterogeneous enhancement and "target sign" within the tumor. The nodule was suspicious for malignancy and classified as TI-RADS 4b, while the elasticity values measured by UE indicated a benign lesion. Fine needle aspiration (FNA) was subsequently performed in the markedly contrast-enhanced area for biopsy. Cytological results revealed a benign schwannoma. INTERVENTION: The patient underwent left lobe resection. Postoperative pathology confirmed it to be a primary benign schwannoma of the thyroid. OUTCOMES: After thyroidectomy, the patient was followed-up with US. At present, all laboratory tests and thyroid imaging are normal, and the numbness of the left upper limb has disappeared. LESSONS: The combination of different US modalities is useful for the diagnosis of thyroid lesions. FNA performed under CEUS guidance improves the accuracy of biopsy sampling.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Neurilemoma/diagnóstico , Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia Doppler em Cores/métodos , Adolescente , Biópsia por Agulha Fina , Meios de Contraste/administração & dosagem , Feminino , Humanos , Imagem Multimodal/métodos , Neurilemoma/patologia , Neurilemoma/cirurgia , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Resultado do Tratamento
15.
J Mater Chem B ; 9(10): 2494-2504, 2021 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-33656039

RESUMO

Multiple imaging by combining magnetic resonance (MR) and fluorescence imaging into a single nanosystem displays distinctive merits, which is desirable for precise in vivo imaging. In this work, we proposed a new tumor-targeting dual-modal diagnosis strategy by designing and fabricating a biocompatible nano-erythrocyte and successfully delivering it into in vivo tumors. The novel nano-contrast agent (CMR) was prepared by encapsulating human heavy-chain ferritin (HFn) nanoparticles with Cy5.5 binding and mineralized iron oxide nanoparticles (Fe3O4 NPs) into erythrocyte membranes (RBCs). We demonstrated that the as-prepared CMR displayed excellent biocompatibility with low hepatotoxicity and long blood circulation time. More importantly, by functionalizing the CMR with different types of targeting moieties, the nanosystem could precisely target both subcutaneous and orthotopic tumors, and exhibited excellent MR and fluorescence dual-model imaging ability. Moreover, we demonstrated that the CMR was able to modulate the tumor microenvironment to achieve an efficient antitumor effect.


Assuntos
Materiais Biomiméticos/química , Materiais Biomiméticos/uso terapêutico , Ferritinas/química , Imageamento por Ressonância Magnética/métodos , Terapia de Alvo Molecular/métodos , Imagem Multimodal/métodos , Imagem Óptica/métodos , Carbocianinas/química , Linhagem Celular Tumoral , Corantes Fluorescentes/química , Corantes Fluorescentes/uso terapêutico , Humanos , Imãs/química
16.
Lancet Oncol ; 22(3): 341-350, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33662286

RESUMO

BACKGROUND: In addition to increased availability of treatment modalities, advanced imaging modalities are increasingly recommended to improve global cancer care. However, estimates of the costs and benefits of investments to improve cancer survival are scarce, especially for low-income and middle-income countries (LMICs). In this analysis, we aimed to estimate the costs and lifetime health and economic benefits of scaling up imaging and treatment modality packages on cancer survival, both globally and by country income group. METHODS: Using a previously developed model of global cancer survival, we estimated stage-specific cancer survival and life-years gained (accounting for competing mortality) in 200 countries and territories for patients diagnosed with one of 11 cancers (oesophagus, stomach, colon, rectum, anus, liver, pancreas, lung, breast, cervix uteri, and prostate) representing 60% of all cancer diagnoses between 2020 and 2030 (inclusive of full years). We evaluated the costs and health and economic benefits of scaling up packages of treatment (chemotherapy, surgery, radiotherapy, and targeted therapy), imaging modalities (ultrasound, x-ray, CT, MRI, PET, single-photon emission CT), and quality of care to the mean level of high-income countries, separately and in combination, compared with no scale-up. Costs and benefits are presented in 2018 US$ and discounted at 3% annually. FINDINGS: For the 11 cancers studied, we estimated that without scale-up (ie, with current availability of treatment, imaging, and quality of care) there will be 76·0 million cancer deaths (95% UI 73·9-78·6) globally for patients diagnosed between 2020 and 2030, with more than 70% of these deaths occurring in LMICs. Comprehensive scale-up of treatment, imaging, and quality of care could avert 12·5% (95% UI 9·0-16·3) of these deaths globally, ranging from 2·8% (1·8-4·3) in high-income countries to 38·2% (32·6-44·5) in low-income countries. Globally, we estimate that comprehensive scale-up would cost an additional $232·9 billion (95% UI 85·9-422·0) between 2020 and 2030 (representing a 6·9% increase in cancer treatment costs), but produce $2·9 trillion (1·8-4·0) in lifetime economic benefits, yielding a return of $12·43 (6·47-33·23) per dollar invested. Scaling up treatment and quality of care without imaging would yield a return of $6·15 (2·66-16·71) per dollar invested and avert 7·0% (3·9-10·3) of cancer deaths worldwide. INTERPRETATION: Simultaneous investment in cancer treatment, imaging, and quality of care could yield substantial health and economic benefits, especially in LMICs. These results provide a compelling rationale for the value of investing in the global scale-up of cancer care. FUNDING: Harvard TH Chan School of Public Health and National Cancer Institute.


Assuntos
Simulação por Computador , Atenção à Saúde , Saúde Global , Custos de Cuidados de Saúde/tendências , Serviços de Saúde/estatística & dados numéricos , Imagem Multimodal/métodos , Neoplasias/mortalidade , Adolescente , Adulto , Idoso , Terapia Combinada , Países em Desenvolvimento , Feminino , Seguimentos , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Neoplasias/economia , Neoplasias/patologia , Neoplasias/terapia , Prognóstico , Taxa de Sobrevida , Adulto Jovem
17.
J Cancer Res Clin Oncol ; 147(8): 2421-2433, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33521862

RESUMO

INTRODUCTION: Proper management of the clinically involved neck in OSCC patients continues to be a matter of debate. Our aim was to analyze the accuracy of computerized tomography (CT) and ultrasound (US) in anticipating the exact location of lymph node (LN) metastases of OSCC patients across the AAO-HNS (American Academy of Otolaryngology-Head and Neck Surgery) levels ipsi- and contralaterally. Furthermore, we wanted to assess the suitability of therapeutic selective neck dissection (SND) in patients with one or two ipsilateral positive nodes upon clinical staging (cN1/cN2a and cN2b(2/x) patients). METHODS: We prospectively analyzed the LN status of patients with primary OSCC using CT and US from 2007 to 2013. LNs were individually assigned to a map containing the AAO-HNS levels; patients bearing a single or just two ipsilateral positive nodes (designated cN1/cN2a or cN2b(2/x) patients either by CT (CT group) or US alone (US group) or in a group combining findings of CT and US (CTUS group)) received an ipsi-ND (I-V) and a contra-ND (I-IV). 78% of the LNs were sent individually for routine histopathological examination; the remaining were dissected and analyzed per neck level. RESULTS: Upon the analysis of 1.670 LNs of 57 patients, the exact location of pathology proven LN metastases in cN1 patients was more precisely predicted by US compared to CT with confirmed findings only in levels IA, IB und IIA. Clearly decreasing the number of missed lesions, the findings in the CTUS group nearly kept the spatial reliability of the US group. The same analysis for patients with exactly two supposed ipsilateral lesions (cN2b(2/x)) yielded confirmed metastases from levels I to V for both methods individually and in combination and, therefore, render SND insufficient for these cases. CONCLUSION: Our findings stress the importance of conducting both, CT and US, in patients with primary OSCC. Only the combination of their findings warrants the application of therapeutic SND in patients with a single ipsilateral LN metastasis (cN1/cN2a patients) but not in patients with more than one lesion upon clinical staging (≥ cN2b).


Assuntos
Carcinoma de Células Escamosas , Linfonodos/diagnóstico por imagem , Neoplasias Bucais , Esvaziamento Cervical , Seleção de Pacientes , Adulto , Idoso , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Imagem Multimodal/métodos , Esvaziamento Cervical/métodos , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X , Ultrassonografia
18.
Phys Med Biol ; 66(6): 065009, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33596555

RESUMO

Positron emission tomography (PET) remains the gold standard for quantitative imaging of the cerebral metabolic rate of oxygen (CMRO2); however, it is an invasive and complex procedure that requires accounting for recirculating [15O]H2O (RW) and the cerebral blood volume (CBV). This study presents a non-invasive reference-based technique for imaging CMRO2 that was developed for PET/magnetic resonance imaging (MRI) with the goal of simplifying the PET procedure while maintaining its ability to quantify metabolism. The approach is to use whole-brain (WB) measurements of oxygen extraction fraction (OEF) and cerebral blood flow (CBF) to calibrate [15O]O2-PET data, thereby avoiding the need for invasive arterial sampling. Here we present the theoretical framework, along with error analyses, sensitivity to PET noise and inaccuracies in input parameters, and initial assessment on PET data acquired from healthy participants. Simulations showed that neglecting RW and CBV corrections caused errors in CMRO2 of less than ±10% for changes in regional OEF of ±25%. These predictions were supported by applying the reference-based approach to PET data, which resulted in remarkably similar CMRO2 images to those generated by analyzing the same data using a modeling approach that incorporated the arterial input functions and corrected for CBV contributions. Significant correlations were observed between regional CMRO2 values from the two techniques (slope = 1.00 ± 0.04, R 2 > 0.98) with no significant differences found for integration times of 3 and 5 min. In summary, results demonstrate the feasibility of producing quantitative CMRO2 images by PET/MRI without the need for invasive blood sampling.


Assuntos
Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Imagem Multimodal/métodos , Consumo de Oxigênio , Tomografia por Emissão de Pósitrons/métodos , Adulto , Algoritmos , Encéfalo/metabolismo , Circulação Cerebrovascular , Humanos , Imageamento por Ressonância Magnética/normas , Imagem Multimodal/normas , Tomografia por Emissão de Pósitrons/normas , Padrões de Referência
20.
Jpn J Radiol ; 39(7): 669-680, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33641056

RESUMO

PURPOSE: To evaluate the clinical feasibility of a newly developed mobile PET system with MR-compatibility (flexible PET; fxPET), compared with conventional PET (cPET)/CT for brain imaging. METHODS: Twenty-one patients underwent cPET/CT with subsequent fxPET/MRI using 18F-FDG. As qualitative evaluation, we visually rated image quality of MR and PET images using a four-point scoring system. We evaluated overall image quality for MR, while we evaluated overall image quality, sharpness and lesion contrast. As quantitative evaluation, we compared registration accuracy between two modalities [(fxPET and MRI) and (cPET and CT)] measuring spatial coordinates. We also examined the accuracy of regional 18F-FDG uptake. RESULTS: All acquired images were of diagnostic quality and the number of detected lesions did not differ significantly between fxPET/MR and cPET/CT. Mean misregistration was significantly larger with fxPET/MRI than with cPET/CT. SUVmax and SUVmean for fxPET and cPET showed high correlations in the lesions (R = 0.84, 0.79; P < 0.001, P = 0.002, respectively). In normal structures, we also showed high correlations of SUVmax (R = 0.85, 0.87; P < 0.001, P < 0.001, respectively) and SUVmean (R = 0.83, 0.87; P < 0.001, P < 0.001, respectively) in bilateral caudate nuclei and a moderate correlation of SUVmax (R = 0.65) and SUVmean (R = 0.63) in vermis. CONCLUSIONS: The fxPET/MRI system showed image quality within the diagnostic range, registration accuracy below 3 mm and regional 18F-FDG uptake highly correlated with that of cPET/CT.


Assuntos
Encefalopatias/diagnóstico , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Imagem Multimodal/métodos , Tomografia por Emissão de Pósitrons/instrumentação , Tomografia Computadorizada por Raios X/métodos , Imagem Corporal Total/métodos , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuroimagem/métodos , Adulto Jovem
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