Impact of various iodine concentrations of iohexol and iodixanol contrast media on image reconstruction techniques in a vascular-specific contrast media phantom: quantitative and qualitative image quality assessment

New Frontiers in Oncological Imaging With Computed Tomography: From Morphology to Function

The latest evolutions in Computed Tomography (CT) technology have several applications in oncological imaging. The innovations in hardware and software allow for the optimization of the oncological protocol. Low-kV acquisitions are possible thanks to the new powerful tubes. Iterative reconstruction algorithms and artificial intelligence are helpful for the management of image noise during image reconstruction. Functional information is provided by spectral CT (dual-energy and photon counting CT) and perfusion CT.

Computed Tomography Urography: State of the Art and Beyond

Computed Tomography Urography (CTU) is a multiphase CT examination optimized for imaging kidneys, ureters, and bladder, complemented by post-contrast excretory phase imaging. Different protocols are available for contrast administration and image acquisition and timing, with different strengths and limits, mainly related to kidney enhancement, ureters distension and opacification, and radiation exposure. The availability of new reconstruction algorithms, such as iterative and deep-learning-based reconstruction has dramatically improved the image quality and reducing radiation exposure at the same time. Dual-Energy Computed Tomography also has an important role in this type of examination, with the possibility of renal stone characterization, the availability of synthetic unenhanced phases to reduce radiation dose, and the availability of iodine maps for a better interpretation of renal masses. We also describe the new artificial intelligence applications for CTU, focusing on radiomics to predict tumor grading and patients' outcome for a personalized therapeutic approach. In this narrative review, we provide a comprehensive overview of CTU from the traditional to the newest acquisition techniques and reconstruction algorithms, and the possibility of advanced imaging interpretation to provide an up-to-date guide for radiologists who want to better comprehend this technique.

Current Standards for and Clinical Impact of Emergency Radiology in Major Trauma

In industrialized countries, high energy trauma represents the leading cause of death and disability among people under 35 years of age. The two leading causes of mortality are neurological injuries and bleeding. Clinical evaluation is often unreliable in determining if, when and where injuries should be treated. Traditionally, surgery was the mainstay for assessment of injuries but advances in imaging techniques, particularly in computed tomography (CT), have contributed in progressively changing the classic clinical paradigm for major traumas, better defining the indications for surgery. Actually, the vast majority of traumas are now treated nonoperatively with a significant reduction in morbidity and mortality compared to the past. In this sense, another crucial point is the advent of interventional radiology (IR) in the treatment of vascular injuries after blunt trauma. IR enables the most effective nonoperative treatment of all vascular injuries. Indications for IR depend on the CT evidence of vascular injuries and, therefore, a robust CT protocol and the radiologist's expertise are crucial. Emergency and IR radiologists form an integral part of the trauma team and are crucial for tailored management of traumatic injuries.

Cardiothoracic CTA in Infants Referred for Aortic Arch Evaluation-Retrospective Comparison of Iomeprol 350, Ioversol 350, Iopromide 370 and Iodixanol 320

Background: Computed tomography angiography (CTA) in infants is considered one of the most challenging radiological examinations due to difficulties in balancing start delay, contrast agent (CA) volume and flow in order to achieve optimal opacification of the large vessels. This study aimed to compare the contrast enhancement achieved by four CAs when taking into consideration CA injection parameters and patient characteristics. Methods: We performed a retrospective assessment of forty-eight consecutive cardiothoracic CTAs performed for aortic arch evaluation on children aged 0–1 year. All examinations were performed using the same 64-slice scanner and power injector using the bolus tracking technique. Axial 0.6 mm slices were used to measure large vessel enhancement using regions of interest at the level of the main pulmonary artery, ascending and descending aorta. The recorded variables included anthropometric measurements, CA type, flow rate, volume, and the average Hounsfield unit (HU) values of the blood pool. Descriptive statistics are presented as averages and standard deviations (SD) for normal distributed data or otherwise as medians and interquartile ranges (IQRs). Results: We found no statistically significant differences between age and anthropometric parameters when looking at different CAs. The median CA volume was 7 (IQR, 7–9) mL with the average flow rate of 0.94 (SD, 0.23) mL/s. Ascending aorta average HU values were 605.9 (SD, 177.23) for Iomeprol 350, 626 (SD, 183.83) for Ioversol 350, 530.83 (SD, 175.56) for Iopromide 370 and 354.91 (SD, 115.81) for Iodixanol 320. The difference in HU value for Iodixanol 320 compared to the other CAs was statistically significant. Similar differences were found for the other vascular structures. Conclusion: In CTA of infants suspected of aortic arch hypoplasia/coarctation, Iodixanol 320 provided up to 40% less enhancement of the great vessels when compared to Iomeprol 350, Ioversol 350 and Iopromide 370.

The contrast agent 2,3,5-triiodobenzoic acid (TIBA) induces cell death in tumor cells through the generation of reactive oxygen species

The 2,3,5-triiodobenzoic acid (TIBA) is an iodine contrast agent used for visualization of tissue in X-ray techniques. However, TIBA induces physiological complications like increase in oxygen reactive species (ROS), and consequently, contrast-induced nephropathies. TIBA's antitumor activity was demonstrated in lung cancer, but the subcellular mechanisms involving its activity in tumor cells are still unknown. Thus, the objective of this work was evaluate whether the anti-tumor activity of TIBA involves ROS increase, in tumor lines of non-small cell lung cancer (H460), chronic myeloid leukemia (K562), and its cytotoxicity in normal renal epithelial (VERO). The MTT (3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide) assay was used for evaluation of cell viability, the H₂DCFDA (cell-permeant 2',7'-dichlorodihydrofluorescein diacetate) fluorescent probe to evaluate ROS induction, cell cycle analysis was performed using flow cytometry to measure cell death, and immunofluorescence with annexin/7-AAD (7-amino-actinomycin D), to assess the association of cell death with the ROS generation. TIBA decreases cell viability in a dose-dependent manner for the H460 and K562. However, VERO cells showed less response to the drug, with 70% viable cells after 72 h of treatment in the highest concentration of the drug. While the tumor cells with only 20% viable cells. Besides, tumor cells exhibited higher DNA fragmentation, compared to the renal line (VERO with 5% of fragmented DNA, H460 with 26%, and 56% in K562). Finally, TIBA-induced ROS increase and apoptosis in all lines, which is significantly decreased after treatment with the antioxidant N-acetyl-cysteine (NAC). These data demonstrate the relationship between the increased cellular oxidative stress and the anti-tumor action of the TIBA.