Superparamagnetic iron oxide nanoparticles: nodal metastases and beyond

Reversible sulcal fluid-attenuated inversion recovery hyperintensity after combined bypass surgery for moyamoya disease - A "crevasse" sign

Background

Transient fluid-attenuated inversion recovery (FLAIR) hyperintensity is often observed on the operated brain surface after direct or combined bypass surgery for moyamoya disease, but its pathophysiology and clinical significance are still obscure. This study was aimed to clarify the underlying mechanism and clinical significance.

Methods

This prospective study included 106 hemispheres of 61 patients with moyamoya disease and analyzed their radiological findings before and after combined bypass surgery. This study also included 11 patients who underwent superficial temporal artery to middle cerebral artery anastomosis for occlusive carotid artery diseases as the controls. Magnetic resonance imaging examination was serially repeated, and cerebral blood flow was measured before and after surgery. Signal intensity ratio (SIR) in the cortical sulci and cortex to the adjacent white matter on FLAIR images was calculated, and the postoperative SIR changes were semi-quantitatively evaluated to assess the temporal profile of postoperative FLAIR hyperintensity.

Results

Postoperative FLAIR hyperintensity occurred within the cortical sulci on the operated hemispheres in all moyamoya patients but not in patients with occlusive carotid artery diseases. SIR values started to increase immediately after surgery, peaked at about 4-fold at 4-13 days post-surgery, then declined, and recovered to baseline values over 28 days or later. The magnitude of this phenomenon was proportional to the severity of cerebral ischemia but not to postoperative hyperperfusion.

Conclusion

Reversible sulcal FLAIR hyperintensity specifically occurs in the operated hemispheres after direct bypass surgery for moyamoya disease. This "crevasse sign" may represent the mixture of the extensive leakage of oxygen and proteins from the pial arteries into the CSF.

In Vivo PET Detection of Lung Micrometastasis in Mice by Targeting Endothelial VCAM-1 Using a Dual-Contrast PET/MRI Probe

Current clinical diagnostic imaging methods for lung metastases are sensitive only to large tumours (1-2 mm cross-sectional diameter), and early detection can dramatically improve treatment. We have previously demonstrated that an antibody-targeted MRI contrast agent based on microparticles of iron oxide (MPIO; 1 μm diameter) enables the imaging of endothelial vascular cell adhesion molecule-1 (VCAM-1). Using a mouse model of lung metastasis, upregulation of endothelial VCAM-1 expression was demonstrated in micrometastasis-associated vessels but not in normal lung tissue, and binding of VCAM-MPIO to these vessels was evident histologically. Owing to the lack of proton MRI signals in the lungs, we modified the VCAM-MPIO to include zirconium-89 (89Zr, t1/2 = 78.4 h) in order to allow the in vivo detection of lung metastases by positron emission tomography (PET). Using this new agent (89Zr-DFO-VCAM-MPIO), it was possible to detect the presence of micrometastases within the lung in vivo from ca. 140 μm in diameter. Histological analysis combined with autoradiography confirmed the specific binding of the agent to the VCAM-1 expressing vasculature at the sites of pulmonary micrometastases. By retaining the original VCAM-MPIO as the basis for this new molecular contrast agent, we have created a dual-modality (PET/MRI) agent for the concurrent detection of lung and brain micrometastases.

Contrast Enhancement in MRI Using Combined Double Action Contrast Agents and Image Post-Processing in the Breast Cancer Model

Gd- and Fe-based contrast agents reduce T₁ and T₂ relaxation times, respectively, are frequently used in MRI, providing improved cancer detection. Recently, contrast agents changing both T₁/T₂ times, based on core/shell nanoparticles, have been introduced. Although advantages of the T₁/T₂ agents were shown, MR image contrast of cancerous versus normal adjacent tissue induced by these agents has not yet been analyzed in detail as authors considered changes in cancer MR signal or signal-to-noise ratio after contrast injection rather than changes in signal differences between cancer and normal adjacent tissue. Furthermore, the potential advantages of T₁/T₂ contrast agents using image manipulation such as subtraction or addition have not been yet discussed in detail. Therefore, we performed theoretical calculations of MR signal in a tumor model using T₁-weighted, T₂-weighted, and combined images for T₁-, T₂-, and T₁/T₂-targeted contrast agents. The results from the tumor model are followed by in vivo experiments using core/shell NaDyF₄/NaGdF₄ nanoparticles as T₁/T₂ non-targeted contrast agent in the animal model of triple negative breast cancer. The results show that subtraction of T₂-weighted from T₁-weighted MR images provides additional increase in the tumor contrast: over two-fold in the tumor model and 12% in the in vivo experiment.

Carboxymethyl chitosan bounded iron oxide nanoparticles and gamma-irradiated avian influenza subtype H9N2 vaccine to development of immunity on mouse and chicken

BACKGROUND

Avian influenza virus (AIV) subtype H9N2 is a low pathogenic avian influenza virus (LPAIV).

OBJECTIVE

This study aims to evaluate the humoral and cellular immunity in vaccinated mice and broiler chicken by irradiated AIV antigen plus carboxymethyl chitosan bounded iron oxide nanoparticles (CMC-IO NPs) as an adjuvant.

METHODS

AIV subtype H9N2 with 108.5 EID50 /ml and haemagglutinin antigen assay about 10 log2 was irradiated by 30 kGy gamma radiation dose. Then, the gamma-irradiated AIV was used as an inactivated vaccine and conjugated with CMC-IO NPs to improve immune responses on mice. IO NPs must be applied in all activated tests using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) and N-hydroxysulfosuccinimide sodium salt (sulfo-NHS), and then functionalized by CMC as IO-CMC. Fourier transform infrared (FTIR) spectra on functionalized IO-CMC showed a peak of 638 cm-1 which is a band between metal and O (Fe-O).

RESULTS

Based on the comparison between the two X-ray diffraction (XRD) patterns on Fe2 O3 -NPs and IO-CMC, the characteristics of IO-NPs did not change after carboxymethylation. A CHN Analyzer was applied to measure the molecular weight of IO-CMC that was calculated as 1045 g. IO-CMC, irradiated AIV-IO-CMC and formalin AIV-IO-CMC were injected into 42 BALB/c mice in six groups. The fourth group was the negative control, and the fifth and sixth groups were inoculated by irradiated AIV-ISA70 and formalin AIV-ISA70 vaccines. An increase in haemagglutination inhibition (HI) antibody titration was observed in the irradiated AIV-IO-CMC and formalin AIV-IO-CMC groups (p < 0.05). In addition, increases in the lymphoproliferative activity of re-stimulated splenic lymphocytes, interfron-γ (IFN-γ) and interleukin-2 (IL-2) concentration in the irradiated AIV-IO-CMC group demonstrated the activation of Type 1 helper cells. The concentration of IL-4 was without any significant increases in non-group.

CONCLUSIONS

Accordingly, Th2 activation represented no increase. Finally, the finding showed that AIV-IO-CMC was effective on enhancing immunogenicity as irradiated AIV antigen administered with a clinically acceptable adjuvant (i.e. IO-CMC).

Novel Diagnostic Approaches for Assessment of the Clinically Negative Neck in Head and Neck Cancer Patients

In head and neck cancer, the presence of nodal disease is a strong determinant of prognosis and treatment. Despite the use of modern multimodality diagnostic imaging, the prevalence of occult nodal metastases is relatively high. This is why in clinically node negative head and neck cancer the lymphatics are treated “electively” to eradicate subclinical tumor deposits. As a consequence, many true node negative patients undergo surgery or irradiation of the neck and suffer from the associated and unnecessary early and long-term morbidity. Safely tailoring head and neck cancer treatment to individual patients requires a more accurate pre-treatment assessment of nodal status. In this review, we discuss the potential of several innovative diagnostic approaches to guide customized management of the clinically negative neck in head and neck cancer patients.

Magnetic nanoformulations for prostate cancer

Magnetic nanoparticles (MNPs) play a vital role for improved imaging applications. Recently, a number of studies demonstrate MNPs can be applied for targeted delivery, sustained release of therapeutics, and hyperthermia. Based on stable particle size and shape, biocompatibility, and inherent contrast enhancement characteristics, MNPs have been encouraged for pre-clinical studies and human use. As a theranostic platform development, MNPs need to balance both delivery and imaging aspects. Thus, this review provides significant insight and advances in the theranostic role of MNPs through the documentation of unique magnetic nanoparticles used in prostate cancer, their interaction with prostate cancer cells, in vivo fate, targeting, and biodistribution. Specific and custom-made applications of various novel nanoformulations in prostate cancer are discussed.

Superparamagnetic iron oxide-enhanced MRI at 3 T for accurate axillary staging in breast cancer

BACKGROUND

The aim of this study was to evaluate whether MRI at 3 T with superparamagnetic iron oxide (SPIO) enhancement is an accurate and useful method for detecting metastases in sentinel nodes identified by CT-lymphography (CT-LG) in patients with breast cancer. The results were compared with those obtained using CT-LG alone and diagnosing metastasis according to size criteria.

METHODS

Patients with clinically node-negative breast cancer were included. Sentinel nodes identified by CT-LG were evaluated prospectively using SPIO-enhanced MRI at 3 T. Sentinel node size was measured on CT-LG, and a node larger than 5 mm in short-axis diameter was considered metastatic. Sentinel nodes localized by CT-LG were removed, and imaging results and histopathological findings were compared.

RESULTS

Sentinel nodes were identified successfully by CT-LG in 69 (99 per cent) of 70 patients. All 19 patients with a finding of metastasis in sentinel nodes at pathology were also shown to have metastases on MRI. Forty-eight of 50 patients with non-metastatic sentinel nodes diagnosed at pathology were classified as having non-metastatic nodes on MRI. On a patient-by-patient basis, the sensitivity, specificity and accuracy of MRI for the diagnosis of sentinel node metastases were 100, 96 and 97 per cent; respective values for CT-LG were 79, 56 and 62 per cent. The specificity and accuracy of MRI were superior to those of CT-LG (P < 0·001 and P = 0·002 respectively).

CONCLUSION

SPIO-enhanced MRI at 3 T is useful for accurate diagnosis of metastatic sentinel nodes, indicating that sentinel node biopsy may be avoided in patients with breast cancer who have non-metastatic sentinel nodes on imaging.

Lymph node staging in prostate cancer

Nodal staging is important in prostate cancer treatment. While surgical lymph node dissection is the classic method of determining whether lymph nodes harbor malignancy, this is a very invasive technique. Current noninvasive approaches to identifying malignant lymph nodes are limited. Conventional imaging methods rely on size and morphology of lymph nodes and have notoriously low sensitivity for detecting malignant nodes. New imaging techniques such as targeted positron emission tomography (PET) imaging and magnetic resonance lymphography (MRL) with iron oxide particles are promising for nodal staging of prostate cancer. In this review, the strengths and limitations of imaging techniques for lymph node staging of prostate cancer are discussed.

Bone Marrow-Derived Mesenchymal Stem Cells Repair Necrotic Pancreatic Tissue and Promote Angiogenesis by Secreting Cellular Growth Factors Involved in the SDF-1 α /CXCR4 Axis in Rats

Acute pancreatitis (AP), a common acute abdominal disease, 10%-20% of which can evolve into severe acute pancreatitis (SAP), is of significant morbidity and mortality. Bone marrow-derived mesenchymal stem cells (BMSCs) have been reported to have a potential therapeutic role on SAP, but the specific mechanism is unclear. Therefore, we conducted this experiment to shed light on the probable mechanism. We validated that SDF-1α significantly stimulated the expressions of VEGF, ANG-1, HGF, TGF-β, and CXCR4 in BMSCs, which were inhibited by its receptor agonist, AMD3100. The capacities of proliferation, migration, and repair of human umbilical vein endothelial cells were enhanced by BMSCs supernatant. Meanwhile, BMSCs supernatant could also promote angiogenesis, especially after the stimulation with SDF-1α. In vivo, the migration of BMSCs was regulated by SDF-1α/CXCR4 axis. Moreover, transplanted BMSCs could significantly alleviate SAP, reduce the systematic inflammation (TNF-α↓, IL-1β↓, IL-6↓, IL-4↑, IL-10↑, and TGF-β↑), and promote tissue repair and angiogenesis (VEGF↑, ANG-1↑, HGF↑, TGF-β↑, and CD31↑), compared with the SAP and anti-CXCR4 groups. Taken together, the results showed that BMSCs ameliorated SAP and the SDF-1α/CXCR4 axis was involved in the repair and regeneration process.

Progress on the diagnosis and evaluation of brain tumors

Brain tumors are one of the most challenging disorders encountered, and early and accurate diagnosis is essential for the management and treatment of these tumors. In this article, diagnostic modalities including single-photon emission computed tomography, positron emission tomography, magnetic resonance imaging, and optical imaging are reviewed. We mainly focus on the newly emerging, specific imaging probes, and their potential use in animal models and clinical settings.

Iron oxide nanoparticles as a clinically acceptable delivery platform for a recombinant blood-stage human malaria vaccine

This study explored the novel use of iron oxide (IO) nanoparticles (<20 nm) as a vaccine delivery platform without additional adjuvants. A recombinant malaria vaccine antigen, the merozoite surface protein 1 (rMSP1), was conjugated to IO nanoparticles (rMSP1-IO). Immunizations in outbred mice with rMSP1-IO achieved 100% responsiveness with antibody titers comparable to those obtained with rMSP1 formulated with a clinically acceptable adjuvant, Montanide ISA51 (2.7×10 vs. 1.6×10; respectively). Only rMSP1-1O could induce significant levels (80%) of parasite inhibitory antibodies. The rMSP1-IO was highly stable at 4°C and was amenable to lyophilization, maintaining its antigenicity, immunogenicity, and ability to induce inhibitory antibodies. Further testing in nonhuman primates, Aotus monkeys, also elicited 100% immune responsiveness and high levels of parasite inhibitory antibodies (55-100% inhibition). No apparent local or systemic toxicity was associated with IO immunizations. Murine macrophages and dendritic cells efficiently (>90%) internalized IO nanoparticles, but only the latter were significantly activated, with elevated expression/secretion of CD86, cytokines (IL-6, TNF-α, IL1-b, IFN-γ, and IL-12), and chemokines (CXCL1, CXCL2, CCL2, CCL3, CCL4, and CXCL10). Thus, the IO nanoparticles is a novel, safe, and effective vaccine platform, with built-in adjuvancy, that is highly stable and field deployable for cost-effective vaccine delivery.

Therapeutic response in musculoskeletal soft tissue sarcomas: evaluation by MRI

This article provides a literature review of the use of MRI in monitoring the treatment response of soft tissue sarcomas. The basic classification and physiology of soft tissue tumors are introduced. Then, the major treatment options for soft tissue sarcomas are summarized with brief coverage of possible responses and grading systems. Four major branches of MRI techniques are covered, including conventional T(1) - and T(2) -weighted imaging, contrast-enhanced MRI, MR diffusion and perfusion imaging, and MRS, with a focus on the tumor microenvironment. Although this literature survey focuses on recent clinical developments using these MRI techniques, research venues in preclinical studies, as well as in potential applications other than soft tissue sarcomas, are also included when comparable and/or mutually supporting. Examples from other less-discussed MRI modalities are also briefly covered, not only to complement, but also to expand, the scope and depth of information for various kinds of lesions.

Molecular imaging of tumor invasion and metastases: the role of MRI

The processes of tumor invasion and metastasis have been well characterized at the molecular level, and numerous biomarkers of tumor aggressiveness have been discovered. Molecular imaging offers the opportunity to depict specific cell markers relevant to tumor aggressiveness. Here, we describe the role of MRI in identifying tumor invasiveness and metastasis with reference to other methods. Target-specific molecular imaging probes for tumor invasiveness have been developed for positron emission tomography and optical imaging, but progress in MRI has been slower. For example, proteases associated with tumor invasion, such as specific matrix metalloproteinases or cathepsins, can be targeted in vivo using optical and positron emission tomography methods, but have not yet been successful with MRI. In addition, we describe the use of MRI to detect metastases. Novel MR contrast agents based on iron oxide and dendrimer nanomaterials allow for better characterization of tumor metastases. Organ-specific MR contrast agents are used to identify metastatic disease in the liver. Finally, diffusion-weighted whole-body MRI is discussed as an alternative offered by MRI that does not require the use of molecular probes to screen distant metastases.

Perfluorocarbon-loaded Shell Crosslinked Knedel-like Nanoparticles: Lessons regarding polymer mobility and self assembly

Reversible addition-fragmentation chain transfer polymerization was employed to synthesize a set of copolymers of styrene (PS) and 2,3,4,5,6-pentafluorostyrene (PPFS), as well as block copolymers with tert-butyl acrylate (PtBA)-b-PS-co-PPFS, with control over molecular weight and polydispersity. It was found that the copolymerization of styrene and PFS allowed for the preparation of gradient copolymers with opposite levels of monomer consumption, depending on the feed ratio. Conversion to amphiphilic block copolymers, PAA-b-(PS-co-PPFS), by removing the protecting groups was followed by fitting with monomethoxy poly(ethylene glycol) chains. Solution-state assembly and intramicellar crosslinking afforded shell crosslinked (SCK) block copolymer nanoparticles. These fluorinated nanoparticles (ca. 20 nm diameters) were studied as potential magnetic resonance imaging (MRI) contrast agents based on the (19)F-nuclei, however, it was found that packaging of the hydrophobic fluorinated polymers into the core domain restricted the mobility of the chains and prohibited (19)F-NMR spectroscopy when the particles were dispersed in water without an organic cosolvent. Packing of perflouro-15-crown-5-ether (PFCE) into the polymer micelle was demonstrated with good uptake efficiency, however, it was necessary to swell the core with a good solvent (DMSO) to increase the mobility and observe the (19)F-NMR signal of the PFCE.

Evaluation of lymph nodes with RECIST 1.1

Lymph nodes are common sites of metastatic disease in many solid tumours. Unlike most metastases, lymph nodes are normal anatomic structures and as such, normal lymph nodes will have a measurable size. Additionally, the imaging literature recommends that lymph nodes be measured in the short axis, since the short axis measurement is a more reproducible measurement and predictive of malignancy. Therefore, the RECIST committee recommends that lymph nodes be measured in their short axis and proposes measurement values and rules for categorising lymph nodes as normal or pathologic; either target or non-target lesions. Data for the RECIST warehouse are presented to demonstrate the potential change in response assessment following these rules. These standardised lymph node guidelines are designed to be easy to implement, focus target lesion measurements on lesions that are likely to be metastatic and prevent false progressions due to minimal change in size.

Utility of a new bolus-injectable nanoparticle for clinical cancer staging

BACKGROUND

In this study, we report on the use of a new, bolus-injectable, carboxymethyl dextran-based magnetic nanoparticle (MNP), ferumoxytol, to improve detection in loco-regional lymph nodes by magnetic resonance imaging (MRI).

METHODS

This preliminary study was performed as a prospective, single-center, open label pilot study to determine the magnitude of nodal MRI signal changes and to determine the optimal time points for imaging following intravenous (IV) bolus injection of the MNP. The study group consisted of 10 patients, all of whom were diagnosed with prostate cancer before any systemic therapy.

RESULTS

All 10 patients had lymph nodes evaluated by histopathology. Of the evaluated 26 lymph nodes, 20 were benign and 6 were malignant. The mean short-axis diameter of benign lymph nodes was 6 mm and the mean short-axis diameter of malignant lymph nodes was 7 mm. Following IV administration, there was a significant change in mean signal-to-noise ratio (SNR) of benign lymph nodes (P < .0001) whereas there was little change in the mean SNR of malignant nodes (P = .1624). No adverse events were encountered.

CONCLUSION

Ferumoxytol is safe and, at the appropriate circulation interval, modulates nodal signal intensity, allowing for identification of malignant nodal involvement by MRI.

Advances in imaging head and neck tumours

PURPOSE OF REVIEW

The intention of this article is to review the recently published studies summarizing new developments in medical imaging for head and neck tumours.

RECENT FINDINGS

Recent technological improvements in imaging have modified the diagnostic approach to these tumours. The main trends can be summarized as follows: improvement in resolution owing to the detection and study of smaller lesions (achieved with magnetic resonance surface coils and parallel imaging); acceleration of data acquisition thus achieving high-quality vascular imaging; improvement in data manipulation and fusion techniques with metabolic imaging from positron emission tomography scanners, permitting more accurate delineation of target volumes for new radiation therapy techniques. In addition, new techniques are emerging leading to a switch from purely anatomical imaging to more functional or metabolic techniques, including dynamic contrast-enhanced approaches to studying tumour perfusion and vascularization, magnetic resonance spectroscopic techniques to assess tissue metabolites, and magnetic resonance diffusion techniques to evaluate free water motion and interstitial space.

SUMMARY

Finally, new contrast agents have been developed to detect and characterize metastatic lymph nodes, even when they do not match the classical size criteria.

Magnetic resonance imaging of sinonasal malignancies

OBJECTIVES

To discuss common sinonasal malignancies with emphasis on squamous cell carcinoma and describe preoperative and postoperative magnetic resonance imaging evaluation for these lesions.

METHODS

Literature and institutional review.

RESULTS

Because of the large variety of the normal cell population, a variety of malignant neoplasms may occur in the sinonasal tract. For a large number of reasons, they are often advanced at the time of diagnosis and are difficult to treat given the complex anatomy of the sinonasal region and its proximity to critical structures. Magnetic resonance imaging is a vital tool in the diagnosis of these lesions and is used in conjunction with computed tomography to precisely delineate the extent of these neoplasms. Involvement of the skull base, the orbits, the intracranial compartment, and potential perineural spread of tumor can influence treatment options. Magnetic resonance is essential to evaluate these tumors.

CONCLUSIONS

Magnetic resonance plays a vital role in the diagnosis of sinonasal neoplasms and is essential to accurately determine the precise extent of these tumors for treatment planning. It is also a useful tool in tumor surveillance.

Head and neck cancer: carcinoma of unknown primary

Carcinoma of unknown primary is uncommon, estimated to represent only 3% to 5% of all head and neck cancers. Squamous cell carcinoma accounts for 70% to 90% of these lesions, most commonly from sites in the upper aerodigestive tract, including tonsils, base of tongue, nasopharynx, and piriform sinus. Magnetic resonance, computed tomography (CT), and positron emission tomography all play a role in the assessment of patients with an unknown primary. The location of a metastatic lymph node may give an indication of the primary tumor site, and knowledge of lymph node drainage patterns is important for anyone evaluating these patients. Magnetic resonance and CT are both used for evaluation for extracapsular nodal disease, perineural tumor spread, osseous skull base or perivertebral space involvement, and vascular invasion, findings that seriously impact treatment and prognosis. Positron emission tomography/CT also plays a significant role in detecting primary tumor sites and identifying distant metastatic disease.

Nanotechnology: a focus on nanoparticles as a drug delivery system

This review will provide an in-depth discussion on the previous development of nanoparticle-based drug delivery systems (DDS) and discuss original research data that includes the therapeutic enhancement of antiretroviral therapy. The use of nanoparticle DDS will allow practitioners to use drugs to target specific areas of the body. In the treatment of malignancies, the use of nanoparticles as a DDS is making measurable treatment impact. Medical imaging will also utilize DDS to illuminate tumors, the brain, or other cellular functions in the body. The utility of nanoparticle DDS to improve human health is potentially enormous.

Imaging of oral cavity cancer

Despite many advances in surgical techniques, technology, radiation therapy, and chemotherapy, survival rates for head and neck cancer (HNCa) have not improved significantly in decades, with many patients being diagnosed at advanced disease stages. Adequate assessment of oral cavity malignancies is critical for appropriate planning of surgical, radiation, and chemotherapy treatment. Imaging modalities used to evaluate the oral cavity include plain radiography (panoramic radiography and intraoral radiography), nuclear medicine scintigraphy, ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). This review describes these imaging techniques and their utility, primarily CT and MRI.

Macromolecular MRI contrast agents for imaging tumor angiogenesis

Angiogenesis has long been accepted as a vital process in the growth and metastasis of tumors. As a result it is the target of several novel anti-cancer medications. Consequently, there is an urgent clinical need to develop accurate, non-invasive imaging techniques to improve the characterization of tumor angiogenesis and the monitoring of the response to anti-angiogenic therapy. Macromolecular MR contrast media (MMCM) offer this diagnostic potential by preferentially exploiting the inherent hyperpermeable nature of new tumor vessels compared with normal vessels. Over the last 10-15 years many classes of MMCM have been developed. When evaluated with dynamic contrast enhanced (DCE) MRI, a number of MMCM have demonstrated in vivo imaging properties that correlate with ex vivo histological features of angiogenesis. The enhancement patterns with some MMCM have been reported to correlate with tumor grade, as well as show response to anti-angiogenic and anti-vascular drugs. Future applications of MMCM include targeted angiogenesis imaging and drug delivery of anti-cancer 'payloads'. Herein we discuss the best known MMCMs along with their advantages and disadvantages.

Template synthesis of multifunctional nanotubes for controlled release

In the past few decades, nanoscale materials have been widely used for controlled release applications. Importantly, many researches have focused on multifunctional nanoparticles for targeted delivery of bioactive and imaging agents as therapeutics and diagnostics. Recent advances in nanotechnology have made possible the design and development of tubular nanoscale particles called nanotubes. The tubular shape of such particles is highly attractive since it is possible to differentially functionalize the inner and outer surfaces to facilitate drug loading, biocompatibility and biorecognition. Novel synthetic strategies allow the fabrication of tubular structures with well-defined diameters and lengths. This can have important implications in biodistribution, subcellular trafficking and drug release. In this article the biomedical applications of nanotubes will be discussed with emphasis on the template synthesis of composite nanotubes containing silica and iron oxide that have potential use in drug delivery, magnetic resonance imaging (MRI), and chemical and biochemical separations.

Superparamagnetic Iron Oxide Nanoparticle Probes for Molecular Imaging

The field of molecular imaging has recently seen rapid advances in the development of novel contrast agents and the implementation of insightful approaches to monitor biological processes non-invasively. In particular, superparamagnetic iron oxide nanoparticles (SPIO) have demonstrated their utility as an important tool for enhancing magnetic resonance contrast, allowing researchers to monitor not only anatomical changes, but physiological and molecular changes as well. Applications have ranged from detecting inflammatory diseases via the accumulation of non-targeted SPIO in infiltrating macrophages to the specific identification of cell surface markers expressed on tumors. In this article, we attempt to illustrate the broad utility of SPIO in molecular imaging, including some of the recent developments, such as the transformation of SPIO into an activatable probe termed the magnetic relaxation switch.

Imaging in head and neck cancer

The goals of imaging in head and neck cancer are to establish tumor extent and size, to assess nodal disease, to evaluate for perineural tumor spread, and to distinguish recurrent tumor from post-treatment changes. MRI is the preferred modality for assessment of nasopharyngeal, sinonasal, and parotid tumors, because of better contrast resolution, high frequency of perineural spread, and less prominent motion artifacts. MRI is the best modality to delineate the extent of intraorbital and intracranial extension of malignant tumors. Tumors of the oropharynx, larynx, and hypopharynx are frequently primarily imaged with CT, which is less affected by breathing and swallowing artifacts. MRI is also the initial study of choice for tumors confined to the oral tongue, and possibly also for other oral cavity locations because MRI is superior in detection of tumor spread into the bone marrow. There is no clear advantage of CT or MRI for evaluation of nodal disease. Positron emission tomography (PET) is very sensitive for metastatic lymph nodes that are at least 8 mm in size and is the technique of choice in dubious cases. Imaging-guided biopsies are performed whenever needed. For imaging of treated head and neck cancer, PET scans have been found to generally offer higher sensitivity than MRI or CT. Combined PET/CT may be the modality of choice because it almost completely eliminates the false-positive and false-negative PET findings. Patients with head and neck cancer who are referred to tertiary care centers commonly arrive with cross-sectional images obtained at other institutions. Reinterpretation of these studies by dedicated radiologists frequently leads to changes in findings, which alter treatment and affect prognosis.

Nanotechnology: Towards the detection and treatment of inflammatory diseases

Biological systems operate at the nanoscale. Nanomedicine is the application of nanotechnology to monitor and treat biological systems in health and disease. This is accomplished by real time monitoring of molecular signaling at the cellular and tissue level. During the past decade, there has been an explosion in this field, resulting in revolutionary advances in determining the microstructure and function of living systems. These discoveries have led to the development of powerful tools for fundamental biological and medical research. Nanotechnology has been applied to targeted drug delivery to minimize side effects, creating implantable materials as scaffolds for tissue engineering, creating implantable devices, surgical aids and nanorobotics, as well as throughput drug screening and medical diagnostic imaging. The nanoinitiatives are funded by governments and private sources throughout the world to develop or further refine the technology to provide the beyond-imaginable, most sophisticated tools to a physician and scientists to inflammatory diseases. No doubt, there will be many technical, regulatory and legal challenges in the deployment of these technologies. Unquestionably, there is enough desire and commitment to meet these challenges for the good of society and betterment of the quality of life.

Future Horizons in MR Imaging

In this article, we defined the major areas of active research in clinical MR imaging. Further increases in the number of parallel coils within an imaging array and in advances in parallel imaging pulse sequences and postprocessing will lead to further reductions in imaging time analogous to the impact of multidetector CT on helical CT. The synergism between parallel and high-field imaging will aid the development of high-field imaging. The combined dynamic and hepatic parenchymal enhancement of new contrast agents that have or may soon receive FDA approval will enable improved detection and characterization of liver lesions. The lymphotropic SPIO agents will remain an active area of clinical research to further assess their role in oncologic staging. Molecular imaging contrast research using magnetic particles and MR microscopy will continue to flourish. Screening examinations by MR imaging will re-main an area of research for the short- and intermediate term, with the final outcome dependent more on socioeconomic costs than the underlying capability of achieving high-quality screening studies.

Future directions in body magnetic resonance imaging

Technologic innovations in instrumentation and contrast agents naturally lead to new clinical and research applications in body MRI. Although long-range predictions of innovation are an uncertain process, short-term trends in development are more readily discernable. This review will provide examples of recent developments in magnetic resonance spectroscopic imaging, contrast agent development and molecular imaging, instrumentation, post-processing, and screening in an attempt to describe areas of active research.