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Herrera CL, Kim MJ, Do QN, Owen DM, Fei B, Twickler DM, Spong CY. The human placenta project: Funded studies, imaging technologies, and future directions. Placenta 2023; 142:27-35. [PMID: 37634371 DOI: 10.1016/j.placenta.2023.08.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/29/2023]
Abstract
The placenta plays a critical role in fetal development. It serves as a multi-functional organ that protects and nurtures the fetus during pregnancy. However, despite its importance, the intricacies of placental structure and function in normal and diseased states have remained largely unexplored. Thus, in 2014, the National Institute of Child Health and Human Development launched the Human Placenta Project (HPP). As of May 2023, the HPP has awarded over $101 million in research funds, resulting in 41 funded studies and 459 publications. We conducted a comprehensive review of these studies and publications to identify areas of funded research, advances in those areas, limitations of current research, and continued areas of need. This paper will specifically review the funded studies by the HPP, followed by an in-depth discussion on advances and gaps within placental-focused imaging. We highlight the progress within magnetic reasonance imaging and ultrasound, including development of tools for the assessment of placental function and structure.
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Affiliation(s)
- Christina L Herrera
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, and Parkland Health Dallas, Texas, USA; Green Center for Reproductive Biology Sciences, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Meredith J Kim
- University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Quyen N Do
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - David M Owen
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, and Parkland Health Dallas, Texas, USA; Green Center for Reproductive Biology Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Baowei Fei
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA; Department of Bioengineering, University of Texas at Dallas, Dallas, TX, USA
| | - Diane M Twickler
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, and Parkland Health Dallas, Texas, USA; Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Catherine Y Spong
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, and Parkland Health Dallas, Texas, USA
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2
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Vinogradov E, Keupp J, Dimitrov IE, Seiler S, Pedrosa I. CEST-MRI for body oncologic imaging: are we there yet? NMR Biomed 2023; 36:e4906. [PMID: 36640112 DOI: 10.1002/nbm.4906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 05/23/2023]
Abstract
Chemical exchange saturation transfer (CEST) MRI has gained recognition as a valuable addition to the molecular imaging and quantitative biomarker arsenal, especially for characterization of brain tumors. There is also increasing interest in the use of CEST-MRI for applications beyond the brain. However, its translation to body oncology applications lags behind those in neuro-oncology. The slower migration of CEST-MRI to non-neurologic applications reflects the technical challenges inherent to imaging of the torso. In this review, we discuss the application of CEST-MRI to oncologic conditions of the breast and torso (i.e., body imaging), emphasizing the challenges and potential solutions to address them. While data are still limited, reported studies suggest that CEST signal is associated with important histology markers such as tumor grade, receptor status, and proliferation index, some of which are often associated with prognosis and response to therapy. However, further technical development is still needed to make CEST a reliable clinical application for body imaging and establish its role as a predictive and prognostic biomarker.
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Affiliation(s)
- Elena Vinogradov
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Ivan E Dimitrov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Philips Healthcare, Gainesville, FL, USA
| | - Stephen Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ivan Pedrosa
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Knutsson L, Xu X, van Zijl PCM, Chan KWY. Imaging of sugar-based contrast agents using their hydroxyl proton exchange properties. NMR Biomed 2023; 36:e4784. [PMID: 35665547 PMCID: PMC9719573 DOI: 10.1002/nbm.4784] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/30/2022] [Accepted: 06/03/2022] [Indexed: 05/13/2023]
Abstract
The ability of CEST MRI to detect the presence of millimolar concentrations of non-metallic contrast agents has made it possible to study, non-invasively, important biological molecules such as proteins and sugars, as well as drugs already approved for clinical use. Here, we review efforts to use sugar and sugar polymers as exogenous contrast agents, which is possible based on the exchange of their hydroxyl protons with water protons. While this capability has raised early enthusiasm, for instance about the possibility of imaging D-glucose metabolism with MRI in a way analogous to PET, experience over the past decade has shown that this is not trivial. On the other hand, many studies have confirmed the possibility of imaging a large variety of sugar analogues, each with potentially interesting applications to assess tissue physiology. Some promising applications are the study of (i) sugar delivery and transport to assess blood-brain barrier integrity and (ii) sugar uptake by cells for their characterization (e.g., cancer versus healthy), as well as (iii) clearance of sugars to assess tissue drainage-for instance, through the glymphatic system. To judge these opportunities and their challenges, especially in the clinic, it is necessary to understand the technical aspects of detecting the presence of rapidly exchanging protons through the water signal in MRI, especially as a function of magnetic field strength. We expect that novel approaches in terms of MRI detection (both saturation transfer and relaxation based), MRI data analysis, and sugar design will push this young field forward in the next decade.
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Affiliation(s)
- Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, US
| | - Xiang Xu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Peter CM van Zijl
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, US
| | - Kannie WY Chan
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering, Hong Kong, China
- Tung Biomedical Sciences Centre, City University of Hong Kong
- City University of Hong Kong Shenzhen Institute, Shenzhen, China
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Aghaei Z, Mercer GV, Schneider CM, Sled JG, Macgowan CK, Baschat AA, Kingdom JC, Helm PA, Simpson AJ, Simpson MJ, Jobst KJ, Cahill LS. Maternal exposure to polystyrene microplastics alters placental metabolism in mice. Metabolomics 2022; 19:1. [PMID: 36538272 DOI: 10.1007/s11306-022-01967-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The rapid growth in the worldwide use of plastics has resulted in a vast accumulation of microplastics in the air, soil and water. The impact of these microplastics on pregnancy and fetal development remains largely unknown. In pregnant mice, we recently demonstrated that exposure to micro- and nanoplastics throughout gestation resulted in significant fetal growth restriction. One possible explanation for reduced fetal growth is abnormal placental metabolism. OBJECTIVES To evaluate the effect of maternal exposure to microplastics on placental metabolism. METHODS In the present study, CD-1 pregnant mice were exposed to 5 μm polystyrene microplastics in filtered drinking water at one of four concentrations (0 ng/L (controls), 102 ng/L, 104 ng/L, 106 ng/L) throughout gestation (n = 7-11/group). At embryonic day 17.5, placental tissue samples were collected (n = 28-44/group). Metabolite profiles were determined using 1 H high-resolution magic angle spinning magnetic resonance spectroscopy. RESULTS The relative concentration of lysine (p = 0.003) and glucose (p < 0.0001) in the placenta were found to decrease with increasing microplastic concentrations, with a significant reduction at the highest exposure concentration. Multivariate analysis identified shifts in the metabolic profile with MP exposure and pathway analysis identified perturbations in the biotin metabolism, lysine degradation, and glycolysis/gluconeogenesis pathways. CONCLUSION Maternal exposure to microplastics resulted in significant alterations in placental metabolism. This study highlights the potential impact of microplastic exposure on pregnancy outcomes and that efforts should be made to minimize exposure to plastics, particularly during pregnancy.
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Affiliation(s)
- Zahra Aghaei
- Department of Chemistry, Memorial University of Newfoundland, Arctic Avenue St. John's, A1C 5S7, Newfoundland, NL, Canada
| | - Grace V Mercer
- Department of Chemistry, Memorial University of Newfoundland, Arctic Avenue St. John's, A1C 5S7, Newfoundland, NL, Canada
| | - Céline M Schneider
- Department of Chemistry, Memorial University of Newfoundland, Arctic Avenue St. John's, A1C 5S7, Newfoundland, NL, Canada
| | - John G Sled
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, ON, Canada
- Translational Medicine, Hospital for Sick Children, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
| | - Christopher K Macgowan
- Translational Medicine, Hospital for Sick Children, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Ahmet A Baschat
- Department of Gynecology & Obstetrics, Johns Hopkins Center for Fetal Therapy, Johns Hopkins University, Baltimore, MD, USA
| | - John C Kingdom
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Paul A Helm
- School of the Environment, University of Toronto, Toronto, ON, Canada
| | - André J Simpson
- Environmental NMR Centre, Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON, Canada
| | - Myrna J Simpson
- Environmental NMR Centre, Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON, Canada
| | - Karl J Jobst
- Department of Chemistry, Memorial University of Newfoundland, Arctic Avenue St. John's, A1C 5S7, Newfoundland, NL, Canada
| | - Lindsay S Cahill
- Department of Chemistry, Memorial University of Newfoundland, Arctic Avenue St. John's, A1C 5S7, Newfoundland, NL, Canada.
- Discipline of Radiology, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
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Kim M, Eleftheriou A, Ravotto L, Weber B, Rivlin M, Navon G, Capozza M, Anemone A, Longo DL, Aime S, Zaiss M, Herz K, Deshmane A, Lindig T, Bender B, Golay X. What do we know about dynamic glucose-enhanced (DGE) MRI and how close is it to the clinics? Horizon 2020 GLINT consortium report. MAGMA 2022; 35:87-104. [PMID: 35032288 PMCID: PMC8901523 DOI: 10.1007/s10334-021-00994-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 12/27/2022]
Abstract
Cancer is one of the most devastating diseases that the world is currently facing, accounting for 10 million deaths in 2020 (WHO). In the last two decades, advanced medical imaging has played an ever more important role in the early detection of the disease, as it increases the chances of survival and the potential for full recovery. To date, dynamic glucose-enhanced (DGE) MRI using glucose-based chemical exchange saturation transfer (glucoCEST) has demonstrated the sensitivity to detect both d-glucose and glucose analogs, such as 3-oxy-methyl-d-glucose (3OMG) uptake in tumors. As one of the recent international efforts aiming at pushing the boundaries of translation of the DGE MRI technique into clinical practice, a multidisciplinary team of eight partners came together to form the “glucoCEST Imaging of Neoplastic Tumors (GLINT)” consortium, funded by the Horizon 2020 European Commission. This paper summarizes the progress made to date both by these groups and others in increasing our knowledge of the underlying mechanisms related to this technique as well as translating it into clinical practice.
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Affiliation(s)
- Mina Kim
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.,Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - Afroditi Eleftheriou
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Luca Ravotto
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Bruno Weber
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, Zurich, Switzerland
| | - Michal Rivlin
- School of Chemistry, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Gil Navon
- School of Chemistry, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Martina Capozza
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Annasofia Anemone
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Dario Livio Longo
- Institute of Biostructures and Bioimaging (IBB), National Research Council of Italy (CNR), Torino, Italy
| | - Silvio Aime
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Moritz Zaiss
- Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Neuroradiology, University Clinic Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Kai Herz
- Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Anagha Deshmane
- Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Tobias Lindig
- Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Xavier Golay
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
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Andescavage N, Limperopoulos C. Emerging placental biomarkers of health and disease through advanced magnetic resonance imaging (MRI). Exp Neurol 2021; 347:113868. [PMID: 34562472 DOI: 10.1016/j.expneurol.2021.113868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/09/2021] [Accepted: 09/19/2021] [Indexed: 12/12/2022]
Abstract
Placental dysfunction is a major cause of fetal demise, fetal growth restriction, and preterm birth, as well as significant maternal morbidity and mortality. Infant survivors of placental dysfunction are at elevatedrisk for lifelong neuropsychiatric morbidity. However, despite the significant consequences of placental disease, there are no clinical tools to directly and non-invasively assess and measure placental function in pregnancy. In this work, we will review advanced MRI techniques applied to the study of the in vivo human placenta in order to better detail placental structure, architecture, and function. We will discuss the potential of these measures to serve as optimal biomarkers of placental dysfunction and review the evidence of these tools in the discrimination of health and disease in pregnancy. Efforts to advance our understanding of in vivo placental development are necessary if we are to optimize healthy pregnancy outcomes and prevent brain injury in successive generations. Current management of many high-risk pregnancies cannot address placental maldevelopment or injury, given the standard tools available to clinicians. Once accurate biomarkers of placental development and function are constructed, the subsequent steps will be to introduce maternal and fetal therapeutics targeting at optimizing placental function. Applying these biomarkers in future studies will allow for real-time assessments of safety and efficacy of novel interventions aimed at improving maternal-fetal well-being.
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Affiliation(s)
- Nickie Andescavage
- Developing Brain Institute, Department of Radiology, Children's National, Washington DC, USA; Department of Neonatology, Children's National, Washington DC, USA
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Abstract
The importance of prenatal diagnosis and fetal intervention has been increasing as a preventative strategy for improving the morbidity and mortality in congenital heart disease (CHD). The advancements in medical imaging technology have greatly enhanced our understanding of disease progression, assessment, and impact in those with CHD. In particular, there has been a growing focus on improving the morbidity and mortality of fetuses diagnosed with left-sided lesions. The disruption of fetal hemodynamics resulting from poor structural developmental of the left outflow tract during cardiogenesis is considered a major factor in the progressive lethal underdevelopment of the left ventricle (LV). This positive feedback cycle of inadequate flow and underdevelopment of the LV leads to a disrupted fetal circulation, which has been described to impact fetal brain growth where systemic outflow is poor and, in some cases, the fetal lungs in the setting of a restrictive interatrial communication. For the past decade, maternal hyperoxygenation (MH) has been investigated as a diagnostic tool to assess the pulmonary vasculature and a therapeutic agent to improve the development of the heart and brain in fetuses with CHD with a focus on left-sided cardiac defects. This review discusses the findings of these studies as well as the utility of acute and chronic administration of MH in CHD.
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Affiliation(s)
- Fu-Tsuen Lee
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Davide Marini
- Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Mike Seed
- Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada.,Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Liqun Sun
- Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada
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