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Klontzas ME, Protonotarios A. High-Resolution Imaging for the Analysis and Reconstruction of 3D Microenvironments for Regenerative Medicine: An Application-Focused Review. Bioengineering (Basel) 2021; 8:182. [PMID: 34821748 PMCID: PMC8614770 DOI: 10.3390/bioengineering8110182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022] Open
Abstract
The rapid evolution of regenerative medicine and its associated scientific fields, such as tissue engineering, has provided great promise for multiple applications where replacement and regeneration of damaged or lost tissue is required. In order to evaluate and optimise the tissue engineering techniques, visualisation of the material of interest is crucial. This includes monitoring of the cellular behaviour, extracellular matrix composition, scaffold structure, and other crucial elements of biomaterials. Non-invasive visualisation of artificial tissues is important at all stages of development and clinical translation. A variety of preclinical and clinical imaging methods-including confocal multiphoton microscopy, optical coherence tomography, magnetic resonance imaging (MRI), and computed tomography (CT)-have been used for the evaluation of artificial tissues. This review attempts to present the imaging methods available to assess the composition and quality of 3D microenvironments, as well as their integration with human tissues once implanted in the human body. The review provides tissue-specific application examples to demonstrate the applicability of such methods on cardiovascular, musculoskeletal, and neural tissue engineering.
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Affiliation(s)
- Michail E. Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, 71110, Heraklion, Crete, Greece
- Computational Biomedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology (FORTH), 70013 Heraklion, Crete, Greece
- Department of Radiology, School of Medicine, Voutes Campus, University of Crete, 71003 Heraklion, Crete, Greece
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Klontzas ME, Kakkos GA, Papadakis GZ, Marias K, Karantanas AH. Advanced clinical imaging for the evaluation of stem cell based therapies. Expert Opin Biol Ther 2021; 21:1253-1264. [PMID: 33576278 DOI: 10.1080/14712598.2021.1890711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: As stem cell treatments reach closer to the clinic, the need for appropriate noninvasive imaging for accurate disease diagnosis, treatment planning, follow-up, and early detection of complications, is constantly rising. Clinical radiology affords an extensive arsenal of advanced imaging techniques, to provide anatomical and functional information on the whole spectrum of stem cell treatments from diagnosis to follow-up.Areas covered: This manuscript aims at providing a critical review of major published studies on the utilization of advanced imaging for stem cell treatments. Uses of magnetic resonance imaging (MRI), computed tomography (CT), ultrasound, and positron emission tomography (PET) are reviewed and interrogated for their applicability to stem cell imaging.Expert opinion: A wide spectrum of imaging methods have been utilized for the evaluation of stem cell therapies. The majority of published techniques are not clinically applicable, using methods exclusively applicable to animals or technology irrelevant to current clinical practice. Harmonization of preclinical methods with clinical reality is necessary for the timely translation of stem cell therapies to the clinic. Methods such as diffusion weighted MRI, hybrid imaging, and contrast-enhanced ultrasound hold great promise and should be routinely incorporated in the evaluation of patients receiving stem cell treatments.
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Affiliation(s)
- Michail E Klontzas
- Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.,Advanced Hybrid Imaging Systems, Institute of Computer Science, Foundation for Research and Technology (FORTH), Heraklion, Crete, Greece
| | - George A Kakkos
- Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece
| | - Georgios Z Papadakis
- Advanced Hybrid Imaging Systems, Institute of Computer Science, Foundation for Research and Technology (FORTH), Heraklion, Crete, Greece.,Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), Heraklion, Crete, Greece.,Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Kostas Marias
- Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), Heraklion, Crete, Greece.,Department of Electrical and Computer Engineering, Hellenic Mediterranean University, Heraklion, Crete, Greece
| | - Apostolos H Karantanas
- Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.,Advanced Hybrid Imaging Systems, Institute of Computer Science, Foundation for Research and Technology (FORTH), Heraklion, Crete, Greece.,Computational Biomedicine Laboratory (CBML), Foundation for Research and Technology Hellas (FORTH), Heraklion, Crete, Greece.,Department of Radiology, School of Medicine, University of Crete, Heraklion, Crete, Greece
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Ballard DH, Garrett JD, Simoncini AA, Barbeito S, Morandi MM. Safety and image quality of MR-conditional external fixators for 1.5 Tesla extremity MR. Emerg Radiol 2021; 28:581-588. [PMID: 33449260 DOI: 10.1007/s10140-020-01880-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/02/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the safety and image quality of extremity MR examinations performed with two MR conditional external fixators located in the MR bore. MATERIALS AND METHODS Single-center retrospective study of a prospectively maintained imaging dataset that evaluated MR examinations of extremities in patients managed with external fixations instrumentation and imaged on a single 1.5T MR scanner. The fixation device was one of two MR-conditional instrumentation systems: DuPuy Synthes (aluminum, stainless steel, carbonium and Kevlar) or Dolphix temporary fixation system (PEEK-CA30). Safety events were recorded by the performing MR radiologic technologist. A study musculoskeletal radiologist assessed all sequences to evaluate for image quality, signal- and contrast-to-noise ratios (SNR/CNR), and injury patterns/findings. RESULTS In the 13 men and 9 women with a mean age of 42 years (range 18 to 72 years), most patients (19/22 patients; 86%) were involved with trauma resulting in extremity injury requiring external fixation. MR examinations included 19 knee, 2 ankle, and 1 elbow examinations. There were no adverse safety events, heating that caused patient discomfort, fixation dislodgement/perturbment, or early termination of MR examinations. All examinations were of diagnostic quality. Fat-suppressed proton density sequences had significantly higher SNR and CNR compared to STIR (p = 0.01 to 0.04). The lower SNR of STIR and increased quality of fat-suppressed proton density during the study period led to the STIR sequence being dropped in standard MR protocol. CONCLUSION MR of the extremity using the two study MR conditional external fixators within the MR bore is safe and feasible.
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Affiliation(s)
- David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kings Highway Blvd Campus Box 8131, St Louis, MO, 63110, USA.
| | - John D Garrett
- Department of Radiology, LSUHSC-Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
| | - Alberto A Simoncini
- Department of Radiology, LSUHSC-Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
| | - Silvia Barbeito
- Department of Radiology, LSUHSC-Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
| | - Massimo Max Morandi
- Department of Orthopaedic Surgery, LSUHSC-Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
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Zhang T, Wu J, Chen YC, Wu X, Lu L, Mao C. Magnetic Resonance Imaging has Better Accuracy in Detecting New-Onset Rib Fractures as Compared to Computed Tomography. Med Sci Monit 2021; 27:e928463. [PMID: 33424019 PMCID: PMC7812695 DOI: 10.12659/msm.928463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background The aim of this study was to explore the magnetic resonance imaging (MRI) manifestations of new-onset rib fractures and determine the utility of MRI through a comparative study of MRI and computed tomography (CT). Material/Methods Twenty-one patients with mild chest trauma who sought medical care from February 2019 to June 2020 were included in this study. The patients were subjected to CT and MRI scanning within 2 weeks after the trauma, and CT rescanning was scheduled 4–8 weeks later to classify rib fractures and determine the diagnostic accuracy of MRI and CT for new-onset rib fractures. Results Seventy-seven rib fractures were confirmed by CT rescanning, of which 72 (93.51%) were type I fractures and 5 (6.49%) were type II. MRI identified 76 fractures, of which 3 were false positive, with the diagnostic accuracy rate of 91.25% and sensitivity rate of 94.81%. Among them, type I fractures (n=71, 3 were false positive) showed the MRI “sandwich” sign (heterogeneous high-signal shadow within bone marrow of the inner layer, low-signal bony cortex of the middle layer, and high-signal subperiosteal effusion of the outer layer) in T2-weighted fat-suppressed sequences; type II fractures (n=5) displayed intramedullary high-signal intensities and no subperiosteal effusion. Forty-four fractures (all type I) were discovered in the initial CT examination, and the corresponding diagnostic accuracy rate and sensitivity rate were 57.14%, which were lower than that of MRI. Conclusions MRI is highly sensitive for new-onset rib fractures, especially type I, so it is a preferred method for patients with mild chest trauma.
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Affiliation(s)
- Tao Zhang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Jing Wu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Xinying Wu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Lingquan Lu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Cunnan Mao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
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Abstract
Bone marrow oedema (BME) is commonly found in hip MR imaging. BME is a nonspecific finding which can be related to a wide variety of diseases. However, there are cases where its existence or its pattern can narrow the differential or even point to a specific diagnosis. Therefore, deep understanding of its pathophysiology is of utmost importance for clinicians and radiologists in order to avoid diagnostic pitfalls. We hereby present currently established knowledge on BME related to adult hip pathology, aiming to raise physicians' suspicion and to highlight that it is mandatory to combine specific imaging patterns with the history, clinical and laboratory findings in order to achieve accurate diagnosis.
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Derby E, Imrecke J, Henckel J, Hirschmann A, Amsler F, Hirschmann MT. How sensitive and specific is 1.5 Tesla MRI for diagnosing injuries in patients with knee dislocation? Knee Surg Sports Traumatol Arthrosc 2017; 25:517-523. [PMID: 26572629 DOI: 10.1007/s00167-015-3857-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 10/30/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to assess the sensitivity and specificity of 1.5 T magnetic resonance imaging (MRI) in diagnosing and identifying the specific injury pattern in patients with knee dislocation. The hypothesis was that the sensitivity and specificity are low in patients with posterolateral corner injury and/or PCL tear. METHODS A retrospective study was performed on 38 patients (m:f = 29:9, mean age ± SD 34.3 ± 14.0) with traumatic knee dislocation, who underwent 1.5 T MRI prior to surgery. MRI scans were analysed by a musculoskeletal radiologist, and the presence and type of tears to ligaments, tendons and meniscus or bone were recorded. Comparison was made with the intraoperative findings from the surgical records using the same reporting scheme. The agreement between MRI and surgical findings was assessed using kappa statistics, and the sensitivity and specificity were calculated. RESULTS In patients with knee dislocation, MRI was found to have low sensitivity (25-38 %) but high specificity (94-97 %) for diagnosing injury to the posterolateral corner. There was high sensitivity in the diagnosis of tears in the cruciate and collateral ligaments (97-100 %); the specificity, however, was lower (50-67 %). The diagnosis of meniscal injury showed low sensitivity (36-56 %) and moderate specificity (69-83 %). CONCLUSIONS MRI is a sensitive measure of cruciate and collateral ligament injury in acute knee dislocation; however, it does not reliably diagnose injury to the posterolateral corner or meniscus, and therefore, a higher index of suspicion is required during arthroscopy to prevent misdiagnosis which could affect long-term clinical outcome. LEVEL OF EVIDENCE Diagnostic study, Level II.
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Affiliation(s)
- Emma Derby
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - Julia Imrecke
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), 4101, Bruderholz, Switzerland
| | - Johann Henckel
- Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK
| | - Anna Hirschmann
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | | | - Michael T Hirschmann
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), 4101, Bruderholz, Switzerland.
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