Molecular imaging in oncology: Current impact and future directions.

The authors define molecular imaging, according to the Society of Nuclear Medicine and Molecular Imaging, as the visualization, characterization, and measurement of biological processes at the molecular and cellular levels in humans and other living systems. Although practiced for many years clinically in nuclear medicine, expansion to other imaging modalities began roughly 25 years ago and has accelerated since. That acceleration derives from the continual appearance of new and highly relevant animal models of human disease, increasingly sensitive imaging devices, high-throughput methods to discover and optimize affinity agents to key cellular targets, new ways to manipulate genetic material, and expanded use of cloud computing. Greater interest by scientists in allied fields, such as chemistry, biomedical engineering, and immunology, as well as increased attention by the pharmaceutical industry, have likewise contributed to the boom in activity in recent years. Whereas researchers and clinicians have applied molecular imaging to a variety of physiologic processes and disease states, here, the authors focus on oncology, arguably where it has made its greatest impact. The main purpose of imaging in oncology is early detection to enable interception if not prevention of full-blown disease, such as the appearance of metastases. Because biochemical changes occur before changes in anatomy, molecular imaging-particularly when combined with liquid biopsy for screening purposes-promises especially early localization of disease for optimum management. Here, the authors introduce the ways and indications in which molecular imaging can be undertaken, the tools used and under development, and near-term challenges and opportunities in oncology.

Clinical and Prognostic Implications of Right Ventricular Uptake on Bone Scintigraphy in Transthyretin Amyloid Cardiomyopathy.

BACKGROUND: The extent of myocardial bone tracer uptake with technetium pyrophosphate, hydroxymethylene diphosphonate, and 3,3-diphosphono-1,2-propanodicarboxylate in transthyretin amyloid cardiomyopathy (ATTR-CM) might reflect cardiac amyloid burden and be associated with outcome. METHODS: Consecutive patients with ATTR-CM who underwent diagnostic bone tracer scintigraphy with acquisition of whole-body planar and cardiac single-photon emission computed tomography (SPECT) images from the National Amyloidosis Centre and 4 Italian centers were included. Cardiac uptake was defined according to the Perugini classification: 0=absent cardiac uptake; 1=mild uptake less than bone; 2=moderate uptake equal to bone; and 3=high uptake greater than bone. Extent of right ventricular (RV) uptake was defined as focal (basal segment of the RV free wall only) or diffuse (extending beyond basal segment) on the basis of SPECT imaging. The primary outcome was all-cause mortality. RESULTS: Among 1422 patients with ATTR-CM, RV uptake accompanying left ventricular uptake was identified by SPECT imaging in 100% of cases at diagnosis. Median follow-up in the whole cohort was 34 months (interquartile range, 21 to 50 months), and 494 patients died. By Kaplan-Meier analysis, diffuse RV uptake on SPECT imaging (n=936) was associated with higher all-cause mortality compared with focal (n=486) RV uptake (77.9% versus 22.1%; P<0.001), whereas Perugini grade was not associated with survival (P=0.27 in grade 2 versus grade 3). On multivariable analysis, after adjustment for age at diagnosis (hazard ratio [HR], 1.03 [95% CI, 1.02-1.04]; P<0.001), presence of the p.(V142I) TTR variant (HR, 1.42 [95% CI, 1.20-1.81]; P=0.004), National Amyloidosis Centre stage (each category, P<0.001), stroke volume index (HR, 0.99 [95% CI, 0.97-0.99]; P=0.043), E/e' (HR, 1.02 [95% CI, 1.007-1.03]; P=0.004), right atrial area index (HR, 1.05 [95% CI, 1.02-1.08]; P=0.001), and left ventricular global longitudinal strain (HR, 1.06 [95% CI, 1.03-1.09]; P<0.001), diffuse RV uptake on SPECT imaging (HR, 1.60 [95% CI, 1.26-2.04]; P<0.001) remained an independent predictor of all-cause mortality. The prognostic value of diffuse RV uptake was maintained across each National Amyloidosis Centre stage and in both wild-type and hereditary ATTR-CM (P<0.001 and P=0.02, respectively). CONCLUSIONS: Diffuse RV uptake of bone tracer on SPECT imaging is associated with poor outcomes in patients with ATTR-CM and is an independent prognostic marker at diagnosis.

Cholinergic changes in Lewy body disease: implications for presentation, progression and subtypes.

Cholinergic degeneration is significant in Lewy body disease, including Parkinson's disease, dementia with Lewy bodies, and isolated REM sleep behaviour disorder. Extensive research has demonstrated cholinergic alterations in the CNS of these disorders. More recently, studies have revealed cholinergic denervation in organs that receive parasympathetic denervation. This enables a comprehensive review of cholinergic changes in Lewy body disease, encompassing both central and peripheral regions, various disease stages and diagnostic categories. Across studies, brain regions affected in Lewy body dementia show equal or greater levels of cholinergic impairment compared to the brain regions affected in Lewy body disease without dementia. This observation suggests a continuum of cholinergic alterations between these disorders. Patients without dementia exhibit relative sparing of limbic regions, whereas occipital and superior temporal regions appear to be affected to a similar extent in patients with and without dementia. This implies that posterior cholinergic cell groups in the basal forebrain are affected in the early stages of Lewy body disorders, while more anterior regions are typically affected later in the disease progression. The topographical changes observed in patients affected by comorbid Alzheimer pathology may reflect a combination of changes seen in pure forms of Lewy body disease and those seen in Alzheimer's disease. This suggests that Alzheimer co-pathology is important to understand cholinergic degeneration in Lewy body disease. Thalamic cholinergic innervation is more affected in Lewy body patients with dementia compared to those without dementia, and this may contribute to the distinct clinical presentations observed in these groups. In patients with Alzheimer's disease, the thalamus is variably affected, suggesting a different sequential involvement of cholinergic cell groups in Alzheimer's disease compared to Lewy body disease. Patients with isolated REM sleep behaviour disorder demonstrate cholinergic denervation in abdominal organs that receive parasympathetic innervation from the dorsal motor nucleus of the vagus, similar to patients who experienced this sleep disorder in their prodrome. This implies that REM sleep behaviour disorder is important for understanding peripheral cholinergic changes in both prodromal and manifest phases of Lewy body disease. In conclusion, cholinergic changes in Lewy body disease carry implications for understanding phenotypes and the influence of Alzheimer co-pathology, delineating subtypes and pathological spreading routes, and for developing tailored treatments targeting the cholinergic system.

Polarization-Selective Enhancement of Telecom Wavelength Quantum Dot Transitions in an Elliptical Bullseye Resonator.

Semiconductor quantum dots are promising candidates for the generation of nonclassical light. Coupling a quantum dot to a device capable of providing polarization-selective enhancement of optical transitions is highly beneficial for advanced functionalities, such as efficient resonant driving schemes or applications based on optical cyclicity. Here, we demonstrate broadband polarization-selective enhancement by coupling a quantum dot emitting in the telecom O-band to an elliptical bullseye resonator. We report bright single-photon emission with a degree of linear polarization of 96%, Purcell factor of 3.9 ± 0.6, and count rates up to 3 MHz. Furthermore, we present a measurement of two-photon interference without any external polarization filtering. Finally, we demonstrate compatibility with compact Stirling cryocoolers by operating the device at temperatures up to 40 K. These results represent an important step toward practical integration of optimal quantum dot photon sources in deployment-ready setups.

Tunable Single-Photon Emission with Wafer-Scale Plasmonic Array.

Bright, scalable, and deterministic single-photon emission (SPE) is essential for quantum optics, nanophotonics, and optical information systems. Recently, SPE from hexagonal boron nitride (h-BN) has attracted intense interest because it is optically active and stable at room temperature. Here, we demonstrate a tunable quantum emitter array in h-BN at room temperature by integrating a wafer-scale plasmonic array. The transient voltage electrophoretic deposition (EPD) reaction is developed to effectively enhance the filling of single-crystal nanometals in the designed patterns without aggregation, which ensures the fabricated array for tunable performances of these single-photon emitters. An enhancement of ∼500% of the SPE intensity of the h-BN emitter array is observed with a radiative quantum efficiency of up to 20% and a saturated count rate of more than 4.5 × 106 counts/s. These results suggest the integrated h-BN-plasmonic array as a promising platform for scalable and controllable SPE photonics at room temperature.

Coherently and Incoherently Pumped Telecom C-Band Single-Photon Source with High Brightness and Indistinguishability.

Long-range, terrestrial quantum networks require high-brightness single-photon sources emitting in the telecom C-band for maximum transmission rates. For solid-state quantum emitters, the underlying pumping process, i.e., coherent or incoherent excitation schemes, impacts several photon properties such as photon indistinguishability, single-photon purity, and photon number coherence. These properties play a major role in quantum communication applications, the latter in particular for quantum cryptography. Here, we present a versatile telecom C-band single-photon source that is operated coherently and incoherently using two complementary pumping schemes. The source is based on a quantum dot coupled to a circular Bragg grating cavity, whereas coherent (incoherent) operation is performed via the novel SUPER scheme (phonon-assisted excitation). In this way, high end-to-end-efficiencies (ηend) of 5.36% (6.09%) are achieved simultaneously with a small multiphoton contribution g(2)(0) of 0.076 ± 0.001 [g(2)(0) of 0.069 ± 0.001] for coherent (incoherent) operation.

Off-Normal Polarized Single-Photon Emission with Anisotropic Holography Metasurfaces.

Solid-state quantum emitters (QEs) with arbitrary direction emission and well-defined polarization are critical for scalable single-photon sources and quantum information processing. However, the design strategy for on-chip generation of off-normal photon emission with high-purity polarization characteristics has so far remained elusive. Here, we introduce the anisotropic holography metasurfaces for efficiently manipulating the emission direction and polarization of QE. The proposed method offers a flexible way to realize phase matching in surface plasmon scattering with spatially varying filling factors and provides an efficient route for designing advanced QE-coupled metasurfaces. By nonradiatively coupling nanodiamonds with metasurfaces, we experimentally demonstrate on-chip generation of well-collimated single-photon emission propagating along off-normal directions (i.e., 20° and 30°) featuring a divergence angle lower than 2.5°. The experimental average degree of linear polarization attains up to >0.98, thereby revealing markedly high polarization purity. This study facilitates applications of QEs in the deployment of integrated quantum networks.

Carbon-Related Quantum Emitter in Hexagonal Boron Nitride with Homogeneous Energy and 3-Fold Polarization.

Most hexagonal boron nitride (hBN) single-photon emitters (SPEs) studied to date suffer from variable emission energy and unpredictable polarization, two crucial obstacles to their application in quantum technologies. Here, we report an SPE in hBN with an energy of 2.2444 ± 0.0013 eV created via carbon implantation that exhibits a small inhomogeneity of the emission energy. Polarization-resolved measurements reveal aligned absorption and emission dipole orientations with a 3-fold distribution, which follows the crystal symmetry. Photoluminescence excitation (PLE) spectroscopy results show the predictability of polarization is associated with a reproducible PLE band, in contrast with the non-reproducible bands found in previous hBN SPE species. Photon correlation measurements are consistent with a three-level model with weak coupling to a shelving state. Our ab initio excited-state calculations shed light on the atomic origin of this SPE defect, which consists of a pair of substitutional carbon atoms located at boron and nitrogen sites separated by a hexagonal unit cell.

Polarized and Bright Telecom C-Band Single-Photon Source from InP-Based Quantum Dots Coupled to Elliptical Bragg Gratings.

Bright, polarized, and high-purity single-photon sources in telecom wavelengths are crucial components in long-distance quantum communication, optical quantum computation, and quantum networks. Semiconductor InAs/InP quantum dots (QDs) combined with photonic cavities provide a competitive path, leading to optimal single-photon sources in this range. Here, we demonstrate a bright and polarized single-photon source operating in the telecom C-band based on an elliptical Bragg grating (EBG) cavity. With a significant Purcell enhancement of 5.25 ± 0.05, the device achieves a polarization ratio of 0.986, a single-photon purity of g2(0) = 0.078 ± 0.016, and a single-polarized photon collection efficiency of ∼24% at the first lens (NA = 0.65) without blinking. These findings suggest that C-band QD-based single-photon sources are potential candidates for advancing quantum communication.

Control of Quantized Spontaneous Emission from Single GaAs Quantum Dots Embedded in Huygens' Metasurfaces.

Advancements in photonic quantum information systems (QIS) have driven the development of high-brightness, on-demand, and indistinguishable semiconductor epitaxial quantum dots (QDs) as single photon sources. Strain-free, monodisperse, and spatially sparse local-droplet-etched (LDE) QDs have recently been demonstrated as a superior alternative to traditional Stranski-Krastanov QDs. However, integration of LDE QDs into nanophotonic architectures with the ability to scale to many interacting QDs is yet to be demonstrated. We present a potential solution by embedding isolated LDE GaAs QDs within an Al0.4Ga0.6As Huygens' metasurface with spectrally overlapping fundamental electric and magnetic dipolar resonances. We demonstrate for the first time a position- and size-independent, 1 order of magnitude increase in the collection efficiency and emission lifetime control for single-photon emission from LDE QDs embedded within the Huygens' metasurfaces. Our results represent a significant step toward leveraging the advantages of LDE QDs within nanophotonic architectures to meet the scalability demands of photonic QIS.

Probing the Nature of Single-Photon Emitters in a WSe2 Monolayer by Magneto-Photoluminescence Spectroscopy.

Monolayer transition metal dichalcogenides (TMDs) have emerged as promising materials to generate single-photon emitters (SPEs). While there are several previous reports in the literature about TMD-based SPEs, the precise nature of the excitonic states involved in them is still under debate. Here, we use magneto-optical techniques under in-plane and out-of-plane magnetic fields to investigate the nature of SPEs in WSe2 monolayers on glass substrates under different strain profiles. Our results reveal important changes on the exciton localization and, consequently, on the optical properties of SPEs. Remarkably, we observe an anomalous PL energy redshift with no significant changes of photoluminescence (PL) intensity under an in-plane magnetic field. We present a model to explain this redshift based on intervalley defect excitons under a parallel magnetic field. Overall, our results offer important insights into the nature of SPEs in TMDs, which are valuable for future applications in quantum technologies.

Acoustic Modulation of Individual Nanowire Quantum Dots Integrated into a Hybrid Thin-Film Lithium Niobate Photonic Platform.

Surface acoustic waves are a powerful tool for controlling quantum systems, including quantum dots (QDs), where the oscillating strain field can modulate the emission wavelengths. We integrate InAsP/InP nanowire QDs onto a thin-film lithium niobate platform and embed them within Si3N4-loaded waveguides. We achieve a 0.70 nm peak-to-peak wavelength modulation at 13 dBm using a single focused interdigital transducer (FIDT) operating at 400 MHz, and we double this amplitude to 1.4 nm by using two FIDTs as an acoustic cavity. Additionally, we independently modulate two QDs with an initial wavelength difference of 0.5 nm, both integrated on the same chip. We show that their modulated emissions overlap, demonstrating the potential to bring them to a common emission wavelength after spectral filtering. This local strain-tuning represents a significant step toward generating indistinguishable single photons from remote emitters heterogeneously integrated on a single chip, advancing on-chip quantum information processing with multiple QDs.

Cavity-Enhanced Emission from a Silicon T Center.

Silicon T centers present the promising possibility of generating optically active spin qubits in an all-silicon device. However, these color centers exhibit long excited state lifetimes and a low Debye-Waller factor, making them dim emitters with low efficiency into the zero-phonon line. Nanophotonic cavities can solve this problem by enhancing radiative emission into the zero-phonon line through the Purcell effect. In this work, we demonstrate cavity-enhanced emission from a single T center in a nanophotonic cavity. We achieve a 2 order of magnitude increase in the brightness of the zero-phonon line relative to waveguide-coupled emitters, a 23% collection efficiency from emitter to fiber, and an overall emission efficiency into the zero-phonon line of 63.4%. We also observe a lifetime enhancement of 5, corresponding to a Purcell factor exceeding 18 when correcting for the emission to the phonon sideband. These results pave the way toward efficient spin-photon interfaces in silicon photonics.

Room-Temperature Fiber-Coupled Single-Photon Sources based on Colloidal Quantum Dots and SiV Centers in Back-Excited Nanoantennas.

We demonstrate an important step toward on-chip integration of single-photon sources at room temperature. Excellent photon directionality is achieved with a hybrid metal-dielectric bullseye antenna, while back-excitation is permitted by placement of the emitter in a subwavelength hole positioned at its center. The unique design enables a direct back-excitation and very efficient front coupling of emission either to a low numerical aperture (NA) optics or directly to an optical fiber. To show the versatility of the concept, we fabricate devices containing either a colloidal quantum dot or a nanodiamond containing silicon-vacancy centers, which are accurately positioned using two different nanopositioning methods. Both of these back-excited devices display front collection efficiencies of ∼70% at NAs as low as 0.5. The combination of back-excitation with forward directionality enables direct coupling of the emitted photons into a proximal optical fiber without any coupling optics, thereby facilitating and simplifying future integration.

Enhancing Single Photon Emission Purity via Design of van der Waals Heterostructures.

Quantum emitters are essential components of quantum photonic circuitry envisioned beyond the current optoelectronic state-of-the-art. Two dimensional materials are attractive hosts for such emitters. However, the high single photon purity required is rarely realized due to the presence of spectrally degenerate classical light originating from defects. Here, we show that design of a van der Waals heterostructure effectively eliminates this spurious light, resulting in purities suitable for a variety of quantum technological applications. Single photon purity from emitters in monolayer WSe2 increases from 60% to 92% by incorporating this monolayer in a simple graphite/WSe2 heterostructure. Fast interlayer charge transfer quenches a broad photoluminescence background by preventing radiative recombination through long-lived defect bound exciton states. This approach is generally applicable to other 2D emitter materials, circumvents issues of material quality, and offers a path forward to achieve the ultrahigh single photon purities ultimately required for photon-based quantum technologies.

Simultaneously Enhancing Brightness and Purity of WSe2 Single Photon Emitter Using High-Aspect-Ratio Nanopillar Array on Metal.

A monolayer semiconductor transferred on nanopillar arrays provides site-controlled, on-chip single photon emission, which is a scalable light source platform for quantum technologies. However, the brightness of these emitters reported to date often falls short of the perceived requirement for such applications. Also, the single photon purity usually degrades as the brightness increases. Hence, there is a need for a design methodology to achieve an enhanced emission rate while maintaining high single photon purity. By using WSe2 on high-aspect-ratio (∼3, at least 2-fold higher than previous reports) nanopillar arrays, here we demonstrate >10 MHz single photon emission rate in the 770-800 nm band that is compatible with quantum memory and repeater networks (Rb-87-D1/D2 lines) and satellite quantum communication. The emitters exhibit excellent purity (even at high emission rates) and improved out-coupling due to the use of a gold back reflector that quenches the emission away from the nanopillar.

Purcell-Induced Bright Single Photon Emitters in Hexagonal Boron Nitride.

Single photon emitters (SPEs) in hexagonal boron nitride (hBN) are elementary building blocks for room-temperature on-chip quantum photonic technologies. However, fundamental challenges, such as slow radiative decay and nondeterministic placement of the emitters, limit their full potential. Here, we demonstrate large-area arrays of plasmonic nanoresonators (PNRs) for Purcell-induced room-temperature SPEs by engineering emitter-cavity coupling and enhancing radiative emission. Gold-coated silicon pillars with an alumina spacer enable a 10-fold local-field enhancement in the emission band of native hBN defects. We observe bright SPEs with an average saturated emission rate surpassing 5 million counts per second, an average lifetime of <0.5 ns, and 29% yield. Density functional theory reveals the beneficial role of an alumina spacer between hBN and gold, mitigating the electronic broadening of emission from defects proximal to the metal. Our results offer arrays of bright, heterogeneously integrated single-photon sources, paving the way for robust and scalable quantum information systems.

Continuously tunable single-photon level nonlinearity with Rydberg state wave-function engineering.

Extending optical nonlinearity into the extremely weak light regime is at the heart of quantum optics, since it enables the efficient generation of photonic entanglement and implementation of photonic quantum logic gate. Here, we demonstrate the capability for continuously tunable single-photon level nonlinearity, enabled by precise control of Rydberg interaction over two orders of magnitude, through the use of microwave-assisted wave-function engineering. To characterize this nonlinearity, light storage and retrieval protocol utilizing Rydberg electromagnetically induced transparency is employed, and the quantum statistics of the retrieved photons are analyzed. As a first application, we demonstrate our protocol can speed up the preparation of single photons in low-lying Rydberg states by a factor of up to∼40. Our work holds the potential to accelerate quantum operations and to improve the circuit depth and connectivity in Rydberg systems, representing a crucial step towards scalable quantum information processing with Rydberg atoms.

Significant Association of Serum Albumin With the Severity of Coronary Microvascular Dysfunction Using Dynamic CZT-SPECT.

OBJECTIVE: Both low serum albumin (SA) concentration and coronary microvascular dysfunction (CMD) are risk factors for the development of heart failure (HF). We hypothesized that SA concentration is associated with myocardial flow reserve (MFR) and implicated in pathophysiological mechanism of HF. METHODS: We retrospectively studied 454 patients undergoing dynamic cardiac cadmium-zinc-telluride myocardial perfusion imaging from April 2018 to February 2020. The population was categorized into three groups according to SA level (g/dL): Group 1: >4, Group 2: 3.5-4, and Group 3: <3.5. Myocardial blood flow (MBF) and myocardial flow reserve (MFR, defined as stress/rest MBF ratio) were compared. RESULTS: The mean age of the whole cohort was 66.2 years, and 65.2% were men. As SA decreased, stress MBF (mL min-1 g-1) and MFR decreased (MBF: 3.29 ± 1.03, MFR: 3.46 ± 1.33 in Group 1, MBF: 2.95 ± 1.13, MFR: 2.51 ± 0.93 in Group 2, and MBF: 2.64 ± 1.16, MFR: 1.90 ± 0.50 in Group 3), whereas rest MBF (mL min-1 g-1) increased (MBF: 1.05 ± 0.42 in Group 1, 1.27 ± 0.56 in Group 2, and 1.41 ± 0.61 in Group 3). After adjusting for covariates, compared with Group 1, the odds ratios for impaired MFR (defined as MFR < 2.5) were 3.57 (95% CI: 2.32-5.48) for Group 2 and 34.9 (95% CI: 13.23-92.14) for Group 3. The results would be similar if only regional MFR were assessed. The risk prediction for CMD using SA was acceptable, with an AUC of 0.76. CONCLUSION: Low SA concentration was associated with the severity of CMD in both global and regional MFR as well as MBF.

Feasibility Study of Single-Photon Emission Computed Tomography with Iodine-123 Labeled Metaiodobenzylguanidine for Preclinical Evaluation of Labetalol as a ß-Adrenergic Receptor Blocker.

Among clinically used radiopharmaceuticals, iodine-123 labeled metaiodobenzylguanidine ([123I]mIBG) serves for diagnosing neuroendocrine tumors and obtaining images of myocardial sympathetic innervation. mIBG, a structural analogue of norepinephrine (NE), a neurotransmitter acting in peripheral and central nerves, follows a pathway similar to NE, transmitting signals through the NE transporter (NET) located at synaptic terminals. It moves through the body without decomposing, enabling noninvasive image evaluation. In this study, we aimed to quantify [123I]mIBG uptake in the adrenal glands using small animal single-photon emission computed tomography/computed tomography (SPECT/CT) images post [123I]mIBG administration. We investigated the possibility of assessing the effectiveness of ß-adrenergic receptor blockers by quantifying SPECT/CT images and biodistribution results to determine the degree of [123I]mIBG uptake in the adrenal glands treated with labetalol, a known ß-adrenergic receptor blocker. Upon intravenous administration of [123I]mIBG to mice, SPECT/CT images were acquired over time to confirm the in vivo distribution pattern, revealing a clear uptake in the adrenal glands. Labetalol inhibited the uptake of [123I]mIBG in cell lines expressing NET. A decrease in [123I]mIBG uptake in the adrenal glands was observed in the labetalol-treated group compared with the normal group through SPECT/CT imaging and biodistribution studies. These results demonstrate that SPECT/CT imaging with [123I]mIBG could be applicable for evaluating the preclinical efficacy of new antihypertensive drug candidates such as labetalol, a ß-adrenergic receptor blocker.