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Mellander H, Fransson V, Ydström K, Lätt J, Ullberg T, Wassélius J, Ramgren B. Metal artifact reduction by virtual monoenergetic reconstructions from spectral brain CT. Eur J Radiol Open 2023; 10:100479. [PMID: 36819113 DOI: 10.1016/j.ejro.2023.100479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose Conventional computed tomography (CT) images are severely affected by metal artifacts in patients with intracranial coils. Monoenergetic images have been suggested to reduce metal artifacts.The aim of this study was to assess metal artifacts in virtual monoenergetic images (VMIs) reconstructed from spectral brain CT. Methods Thirty-two consecutive patients with intracranial coils examined by spectral non contrast brain CT (NCCT) at our center between November 2017 and April 2019 were included. Attenuation and standard deviations were measured in regions of interest (ROIs) at predefined areas in artifact-free and artifact-affected areas. Measurements were performed in conventional polyenergetic images (CIs) and the corresponding data for VMIs were retrieved through spectral diagrams for the each ROI. Subjective analysis was performed by visual grading of CIs and specific VMIs by two neuroradiologists, independently. Results In artefact-affected image areas distal from the metal objects, the attenuation values decreased with higher energy level VMIs. The same effect was not seen for artefact-affected image areas close to the metal.Subjective rating of the artefact severity was significantly better in VMIs at 50 keV for one of the two reviewers compared to the CIs. Overall image quality and tissue differentiation scores were significantly higher for both reviewers in VMIs at 60 and 70 keV compared to CIs. Conclusion Our quantitative and qualitative image analysis shown that there is a small significant reduction of intracranial coils artifacts severity by all monoenergetic reconstructions from 50 to 200 keV with preserved or increased overall subjective image quality compared to conventional images.
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Key Words
- Aneurysm
- CIs, conventional images
- CSF, cerebrospinal fluid
- CT, computed tomography
- DECT, dual energy computed tomography
- DLP, dose length product
- DSA, digital subtraction angiography
- Diagnostic imaging
- HU, Hounsfield units
- IQR, interquartile range
- MRI, magnetic resonance imaging
- Metal artifacts
- Monoenergetic imaging
- PACS, Picture Archiving and Communication System
- ROI, region of interest
- SD, standard deviation
- SNR, signal-to-noise ratio
- VMIs, virtual monoenergetic images
- WM, white matter
- X-ray computed tomography
- keV, kiloelectron volt
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Uchinami Y, Kanehira T, Fujita Y, Miyamoto N, Yokokawa K, Koizumi F, Shido M, Takahashi S, Otsuka M, Yasuda K, Taguchi H, Nakazato K, Kobashi K, Katoh N, Aoyama H. Evaluation of short-term gastrointestinal motion and its impact on dosimetric parameters in stereotactic body radiation therapy for pancreatic cancer. Clin Transl Radiat Oncol 2023; 39:100576. [PMID: 36686564 DOI: 10.1016/j.ctro.2023.100576] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/26/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
Background The aim of this study is to quantify the short-term motion of the gastrointestinal tract (GI-tract) and its impact on dosimetric parameters in stereotactic body radiation therapy (SBRT) for pancreatic cancer. Methods The analyzed patients were eleven pancreatic cancer patients treated with SBRT or proton beam therapy. To ensure a fair analysis, the simulation SBRT plan was generated on the planning CT in all patients with the dose prescription of 40 Gy in 5 fractions. The GI-tract motion (stomach, duodenum, small and large intestine) was evaluated using three CT images scanned at spontaneous expiration. After fiducial-based rigid image registration, the contours in each CT image were generated and transferred to the planning CT, then the organ motion was evaluated. Planning at risk volumes (PRV) of each GI-tract were generated by adding 5 mm margins, and the volume receiving at least 33 Gy (V33) < 0.5 cm3 was evaluated as the dose constraint. Results The median interval between the first and last CT scans was 736 s (interquartile range, IQR:624-986). To compensate for the GI-tract motion based on the planning CT, the necessary median margin was 8.0 mm (IQR: 8.0-10.0) for the duodenum and 14.0 mm (12.0-16.0) for the small intestine. Compared to the planned V33 with the worst case, the median V33 in the PRV of the duodenum significantly increased from 0.20 cm3 (IQR: 0.02-0.26) to 0.33 cm3 (0.10-0.59) at Wilcoxon signed-rank test (p = 0.031). Conclusion The short-term motions of the GI-tract lead to high dose differences.
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Key Words
- 4DCT, four-dimensional computed tomography,
- CTV, clinical target volume
- FFF, flattening filter-free
- GI-tract, gastrointestinal tract
- GTV, gross tumor volume
- Gastrointestinal tract
- IQR, interquartile range
- Intra-fractional motion
- MV, mega-voltage
- PRV, planning at risk volume
- PTV, planning target volume
- Pancreatic cancer
- ROI, region of interest
- SBRT
- SBRT, stereotactic body radiation therapy
- SD, standard deviation
- Short-term organ motion
- VMAT, volumetric modulated arc therapy
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Li G, Liu S, Chen Y, Xu H, Qi T, Xiong A, Wang D, Yu F, Weng J, Zeng H. Teriparatide ameliorates articular cartilage degradation and aberrant subchondral bone remodeling in DMM mice. J Orthop Translat 2022; 38:241-255. [PMID: 36514714 PMCID: PMC9731868 DOI: 10.1016/j.jot.2022.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/22/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Knee osteoarthritis (KOA) is a highly prevalent musculoskeletal disorder characterized by degeneration of cartilage and abnormal remodeling of subchondral bone (SCB). Teriparatide (PTH (1-34)) is an effective anabolic drug for osteoporosis (OP) and regulates osteoprotegerin (OPG)/receptor activator of nuclear factor ligand (RANKL)/RANK signaling, which also has a therapeutic effect on KOA by ameliorating cartilage degradation and inhibiting aberrant remodeling of SCB. However, the mechanisms of PTH (1-34) in treating KOA are still uncertain and remain to be explored. Therefore, we compared the effect of PTH (1-34) on the post-traumatic KOA mouse model to explore the potential therapeutic effect and mechanisms. Methods In vivo study, eight-week-old male mice including wild-type (WT) (n = 54) and OPG-/- (n = 54) were investigated and compared. Post-traumatic KOA model was created by destabilization of medial meniscus (DMM). WT mice were randomly assigned into three groups: the sham group (WT-sham; n = 18), the DMM group (WT-DMM; n = 18), and the PTH (1-34)-treated group (WT-DMM + PTH (1-34); n = 18). Similarly, the OPG-/- mice were randomly allocated into three groups as well. The designed mice were executed at the 4th, 8th, and 12th weeks to evaluate KOA progression. To further explore the chondro-protective of PTH (1-34), the ATDC5 chondrocytes were stimulated with different concentrations of PTH (1-34) in vitro. Results Compared with the WT-sham mice, significant wear of cartilage in terms of reduced cartilage thickness and glycosaminoglycan (GAG) loss was detected in the WT-DMM mice. PTH (1-34) exhibited cartilage-protective by alleviating wear, retaining the thickness and GAG contents. Moreover, the deterioration of the SCB was alleviated and the expression of PTH1R/OPG/RANKL/RANK were found to increase after PTH (1-34) treatment. Among the OPG-/- mice, the cartilage of the DMM mice displayed typical KOA change with higher OARSI score and thinner cartilage. The damage of the cartilage was alleviated but the abnormal remodeling of SCB didn't show any response to the PTH (1-34) treatment. Compared with the WT-DMM mice, the OPG-/--DMM mice caught more aggressive KOA with thinner cartilage, sever cartilage damage, and more abnormal remodeling of SCB. Moreover, both the damaged cartilage from the WT-DMM mice and the OPG-/--DMM mice were alleviated but only the deterioration of SCB in WT-DMM mice was alleviated after the administration of PTH (1-34). In vitro study, PTH (1-34) could promote the viability of chondrocytes, enhance the synthesis of extracellular matrix (ECM) (AGC, COLII, and SOX9) at the mRNA and protein level, but inhibit the secretion of inflammatory cytokines (TNF-α and IL-6). Conclusion Both wear of the cartilage was alleviated and aberrant remodeling of the SCB was inhibited in the WT mice, but only the cartilage-protective effect was observed in the OPG-/- mice. PTH (1-34) exhibited chondro-protective effect by decelerating cartilage degeneration in vivo as well as by promoting the proliferation and enhancing ECM synthesis of chondrocytes in vitro. The current investigation implied that the rescue of the disturbed SCB is dependent on the regulation of OPG while the chondro-protective effect is independent of modulation of OPG, which provides proof for the treatment of KOA. The translational potential of this article Systemic administration of PTH (1-34) could exert a therapeutic effect on both cartilage and SCB in different mechanisms to alleviate KOA progression, which might be a novel therapy for KOA.
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Key Words
- AB, Alican blue
- ADAMTS5, ADAM Metallopeptidase with Thrombospondin Type 1 Motif 5
- AGC, Aggrecan
- AGC, aggrecan
- ANOVA, one-way analysis of variance
- ARRIVE, Animal Research: Reporting of In Vivo Experiments
- BMD, bone mineral density
- BV/TV, bone volume fraction
- CCK-8, cell counting kit-8
- CLSM, confocal laser scanning microscope
- COLII, Type II collagen
- COLX, Type X collagen
- Cartilage
- DMEM, Dulbecco's Modified Eagle's Medium
- DMM, destabilization of medical meniscus
- ECM, extracellular matrix
- EDTA, ethylene diamine tetra acetic acid
- ELISA, enzyme-linked immunosorbent assay
- EdU, 5-ethynyl-2′-deoxyuridine
- FBS, fatal bovine serum
- GAG, glycosaminoglycan
- GAPDH, glyceraldehyde-3-phosphate dehydrogenase
- HE, hematoxylin and eosin
- HPLC, High Performance Liquid Chromatography
- IL-1β, Interleukin-1β
- IL-6, Interleukin-6
- KOA, knee osteoarthritis
- Knee osteoarthritis
- MMP13, Matrix Metallopeptidase 13
- MT, masson's trichrome
- Micro-CT, microcomputer tomography
- NCBI, National Center for Biotechnology Information
- OARSI, Osteoarthritis Research Society International
- OD, optical density
- OP, osteoporosis
- OPG, osteoprotegerin
- OPG−/−, osteoprotegerin-knockout
- Osteoprotegerin (OPG)
- PBS, phosphate buffer solution
- PCR, polymerase chain reaction
- PTH (1–34), Teriparatide
- ROI, region of interest
- RT-qPCR, quantitative reverse transcription polymerase chain reaction
- S.I, subcutaneous injection
- SCB, subchondral bone
- SMI, structure model index
- SOFG, Safranin O-fast green
- SOX9, SRY-Box Transcription Factor 9
- Subchondral bone
- TB, toluidine blue O
- TNF-α, tumor necrosis factor-α
- Tb.N, trabecular number
- Tb.Th, trabecular thickness
- Teriparatide (PTH (1–34))
- WT, wild type
- nM, nMol/L
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Affiliation(s)
- Guoqing Li
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Su Liu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Yixiao Chen
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Huihui Xu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Tiantian Qi
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Ao Xiong
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Deli Wang
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Fei Yu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- Corresponding author. Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
| | - Jian Weng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- Corresponding author. Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
| | - Hui Zeng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- Corresponding author. National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
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Pinhas A, Migacz JV, Zhou DB, Castanos Toral MV, Otero-Marquez O, Israel S, Sun V, Gillette PN, Sredar N, Dubra A, Glassberg J, Rosen RB, Chui TY. Insights into Sickle Cell Disease through the Retinal Microvasculature: Adaptive Optics Scanning Light Ophthalmoscopy Correlates of Clinical OCT Angiography. Ophthalmol Sci 2022; 2:100196. [PMID: 36531581 PMCID: PMC9754983 DOI: 10.1016/j.xops.2022.100196] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/14/2022] [Accepted: 07/01/2022] [Indexed: 05/06/2023]
Abstract
PURPOSE Clinical OCT angiography (OCTA) of the retinal microvasculature offers a quantitative correlate to systemic disease burden and treatment efficacy in sickle cell disease (SCD). The purpose of this study was to use the higher resolution of adaptive optics scanning light ophthalmoscopy (AOSLO) to elucidate OCTA features of parafoveal microvascular compromise identified in SCD patients. DESIGN Case series of 11 SCD patients and 1 unaffected control. PARTICIPANTS A total of 11 eyes of 11 SCD patients (mean age, 33 years; range, 23-44; 8 female, 3 male) and 1 eye of a 34-year-old unaffected control. METHODS Ten sequential 3 × 3 mm parafoveal OCTA full vascular slab scans were obtained per eye using a commercial spectral domain OCT system (Avanti RTVue-XR; Optovue). These were used to identify areas of compromised perfusion near the foveal avascular zone (FAZ), designated as regions of interest (ROIs). Immediately thereafter, AOSLO imaging was performed on these ROIs to examine the cellular details of abnormal perfusion. Each participant was imaged at a single cross-sectional time point. Additionally, 2 of the SCD patients were imaged prospectively 2 months after initial imaging to study compromised capillary segments across time and with treatment. MAIN OUTCOME MEASURES Detection and characterization of parafoveal perfusion abnormalities identified using OCTA and resolved using AOSLO imaging. RESULTS We found evidence of abnormal blood flow on OCTA and AOSLO imaging among all 11 SCD patients with diverse systemic and ocular histories. Adaptive optics scanning light ophthalmoscopy imaging revealed a spectrum of phenomena, including capillaries with intermittent blood flow, blood cell stasis, and sites of thrombus formation. Adaptive optics scanning light ophthalmoscopy imaging was able to resolve single sickled red blood cells, rouleaux formations, and blood cell-vessel wall interactions. OCT angiography and AOSLO imaging were sensitive enough to document improved retinal perfusion in an SCD patient 2 months after initiation of oral hydroxyurea therapy. CONCLUSIONS Adaptive optics scanning light ophthalmoscopy imaging was able to reveal the cellular details of perfusion abnormalities detected using clinical OCTA. The synergy between these clinical and laboratory imaging modalities presents a promising avenue in the management of SCD through the development of noninvasive ocular biomarkers to prognosticate progression and measure the response to systemic treatment.
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Key Words
- ADD, airy disk diameter
- AOSLO, adaptive optics scanning light ophthalmoscopy
- Adaptive optics
- BCVA, best-corrected visual acuity
- D, diopters
- FA, fluorescein angiography
- FAZ, foveal avascular zone
- HbSC, hemoglobin SC
- HbSS, hemoglobin SS
- IOP, intraocular pressure
- OCT angiography
- OCTA, OCT angiography
- Oculomics
- RBC, red blood cell
- ROI, region of interest
- Retinal microvasculature
- SCD, sickle cell disease
- SCR, sickle cell retinopathy
- Sickle cell disease
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Affiliation(s)
- Alexander Pinhas
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Justin V. Migacz
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Davis B. Zhou
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Maria V. Castanos Toral
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Oscar Otero-Marquez
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Sharon Israel
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
- Department of Human Biology, City University of New York Hunter College, New York, New York
| | - Vincent Sun
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Peter N. Gillette
- Department of Hematology, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Nripun Sredar
- Department of Ophthalmology, Stanford University, Palo Alto, California
| | - Alfredo Dubra
- Department of Ophthalmology, Stanford University, Palo Alto, California
| | | | - Richard B. Rosen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Toco Y.P. Chui
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
- Icahn School of Medicine at Mount Sinai, New York, New York
- Correspondence: Toco Y.P. Chui, PhD, New York Eye and Ear Infirmary of Mount Sinai, 310 E 14th Street, New York, NY 10003.
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Kleino I, Frolovaitė P, Suomi T, Elo LL. Computational solutions for spatial transcriptomics. Comput Struct Biotechnol J 2022; 20:4870-4884. [PMID: 36147664 PMCID: PMC9464853 DOI: 10.1016/j.csbj.2022.08.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022] Open
Abstract
Transcriptome level expression data connected to the spatial organization of the cells and molecules would allow a comprehensive understanding of how gene expression is connected to the structure and function in the biological systems. The spatial transcriptomics platforms may soon provide such information. However, the current platforms still lack spatial resolution, capture only a fraction of the transcriptome heterogeneity, or lack the throughput for large scale studies. The strengths and weaknesses in current ST platforms and computational solutions need to be taken into account when planning spatial transcriptomics studies. The basis of the computational ST analysis is the solutions developed for single-cell RNA-sequencing data, with advancements taking into account the spatial connectedness of the transcriptomes. The scRNA-seq tools are modified for spatial transcriptomics or new solutions like deep learning-based joint analysis of expression, spatial, and image data are developed to extract biological information in the spatially resolved transcriptomes. The computational ST analysis can reveal remarkable biological insights into spatial patterns of gene expression, cell signaling, and cell type variations in connection with cell type-specific signaling and organization in complex tissues. This review covers the topics that help choosing the platform and computational solutions for spatial transcriptomics research. We focus on the currently available ST methods and platforms and their strengths and limitations. Of the computational solutions, we provide an overview of the analysis steps and tools used in the ST data analysis. The compatibility with the data types and the tools provided by the current ST analysis frameworks are summarized.
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Key Words
- AOI, area of illumination
- BICCN, Brain Initiative Cell Census Network
- BOLORAMIS, barcoded oligonucleotides ligated on RNA amplified for multiplexed and parallel in situ analyses
- Baysor, Bayesian Segmentation of Spatial Transcriptomics Data
- BinSpect, Binary Spatial Extraction
- CCC, cell–cell communication
- CCI, cell–cell interactions
- CNV, copy-number variation
- Computational biology
- DSP, digital spatial profiling
- DbiT-Seq, Deterministic Barcoding in Tissue for spatial omics sequencing
- FA, factor analysis
- FFPE, formalin-fixed, paraffin-embedded
- FISH, fluorescence in situ hybridization
- FISSEQ, fluorescence in situ sequencing of RNA
- FOV, Field of view
- GRNs, gene regulation networks
- GSEA, gene set enrichment analysis
- GSVA, gene set variation analysis
- HDST, high definition spatial transcriptomics
- HMRF, hidden Markov random field
- ICG, interaction changed genes
- ISH, in situ hybridization
- ISS, in situ sequencing
- JSTA, Joint cell segmentation and cell type annotation
- KNN, k-nearest neighbor
- LCM, Laser Capture Microdissection
- LCM-seq, laser capture microdissection coupled with RNA sequencing
- LOH, loss of heterozygosity analysis
- MC, Molecular Cartography
- MERFISH, multiplexed error-robust FISH
- NMF (NNMF), Non-negative matrix factorization
- PCA, Principal Component Analysis
- PIXEL-seq, Polony (or DNA cluster)-indexed library-sequencing
- PL-lig, padlock ligation
- QC, quality control
- RNAseq, RNA sequencing
- ROI, region of interest
- SCENIC, Single-Cell rEgulatory Network Inference and Clustering
- SME, Spatial Morphological gene Expression normalization
- SPATA, SPAtial Transcriptomic Analysis
- ST Pipeline, Spatial Transcriptomics Pipeline
- ST, Spatial transcriptomics
- STARmap, spatially-resolved transcript amplicon readout mapping
- Single-cell analysis
- Spatial data analysis frameworks
- Spatial deconvolution
- Spatial transcriptomics
- TIVA, Transcriptome in Vivo Analysis
- TMA, tissue microarray
- TME, tumor micro environment
- UMAP, Uniform Manifold Approximation and Projection for Dimension Reduction
- UMI, unique molecular identifier
- ZipSeq, zipcoded sequencing.
- scRNA-seq, single-cell RNA sequencing
- scvi-tools, single-cell variational inference tools
- seqFISH, sequential fluorescence in situ hybridization
- sequ-smFISH, sequential single-molecule fluorescent in situ hybridization
- smFISH, single molecule FISH
- t-SNE, t-distributed stochastic neighbor embedding
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Affiliation(s)
- Iivari Kleino
- Turku Bioscience Centre, University of Turku and Åbo Akademi University Turku, Turku, Finland
| | - Paulina Frolovaitė
- Turku Bioscience Centre, University of Turku and Åbo Akademi University Turku, Turku, Finland
| | - Tomi Suomi
- Turku Bioscience Centre, University of Turku and Åbo Akademi University Turku, Turku, Finland
| | - Laura L. Elo
- Turku Bioscience Centre, University of Turku and Åbo Akademi University Turku, Turku, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
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Cortenbach KRG, Morales Cano D, Meek J, Gorris MAJ, Staal AHJ, Srinivas M, Jolanda M de Vries I, Fog Bentzon J, van Kimmenade RRJ. Topography of immune cell infiltration in different stages of coronary atherosclerosis revealed by multiplex immunohistochemistry. Int J Cardiol Heart Vasc 2023; 44:101111. [PMID: 36820389 DOI: 10.1016/j.ijcha.2022.101111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/01/2022] [Accepted: 08/14/2022] [Indexed: 01/15/2023]
Abstract
Background Aim of this study was to investigate immune cells and subsets in different stages of human coronary artery disease with a novel multiplex immunohistochemistry (mIHC) technique. Methods Human left anterior descending coronary artery specimens were analyzed: eccentric intimal thickening (N = 11), pathological intimal thickening (N = 10), fibroatheroma (N = 9), and fibrous plaque (N = 9). Eccentric intimal thickening was considered normal, and pathological intimal thickening, fibroatheroma, and fibrous plaque were considered diseased coronary arteries. Two mIHC panels, consisting of six and five primary antibodies, autofluoresence, and DAPI, were used to detect adaptive and innate immune cells. Via semi-automated analysis, (sub)types of immune cells in whole plaques and specific plaque regions were quantified. Results Increased numbers of CD3+ T cells (P < 0.001), CD20+ B cells (P = 0.013), CD68+ macrophages (P = 0.003), CD15+ neutrophils (P = 0.017), and CD31+ endothelial cells (P = 0.024) were identified in intimas of diseased coronary arteries compared to normal. Subset analyses of T cells and macrophages showed that diseased coronary arteries contained an abundance of CD3+CD8- non-cytotoxic T cells and CD68+CD206- non-M2-like macrophages. Proportions of CD3+CD45RO+ memory T cells were similar to normal coronary arteries. Among pathological intimal thickening, fibroatheroma, and fibrous plaque, all immune cell numbers and subsets were similar. Conclusions The type of immune response does not differ substantially between different stages of plaque development and may provide context for mechanistic research into immune cell function in atherosclerosis. We provide the first comprehensive map of immune cell subtypes across plaque types in coronary arteries demonstrating the potential of mIHC for vascular research.
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Dai Z, Iguchi N, Takamisawa I, Takayama M, Nanasato M, Kanisawa M, Mizuno N, Miyazaki S, Isobe M. Alcohol septal ablation markedly reduces energy loss in hypertrophic cardiomyopathy with left ventricular outflow tract obstruction: A four-dimensional flow cardiac magnetic resonance study. Int J Cardiol Heart Vasc 2021; 37:100886. [PMID: 34692989 PMCID: PMC8515238 DOI: 10.1016/j.ijcha.2021.100886] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022]
Abstract
Background Functional follow-up modalities of hypertrophic cardiomyopathy (HCM) with left ventricular (LV) outflow tract obstruction (LVOTO) subjected to alcohol septal ablation (ASA) are limited. Methods This retrospective cohort study included patients of HCM with LVOTO who underwent ASA and four-dimensional (4D) flow cardiac magnetic resonance imaging (MRI) both before and after ASA. We analyzed energy loss in one cardiac cycle within the three-chamber plane of the LV and aortic root, and compared between pre- and post-ASA measurements. Results Of the 26 included patients, 10 (39%) were male, and median age was 71 (interquartile range 58–78) years. ASA significantly reduced not only LVOT pressure gradient (70 [19–50] to 9 [3–16], P < 0.001), but also energy loss during one cardiac cycle within the three-chamber plane of the LV and aortic root (80 [65–99] to 56 [45–70], P < 0.001). A linear association was observed between the reductions of energy loss and pressure gradient (R2 = 0.58, P < 0.001). Conclusions ASA significantly reduced energy loss within the LV and aortic root as quantified by 4D flow MRI, reflecting the decreased cardiac workload. This approach is a promising candidate for serial functional follow-up in patients undergoing ASA.
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Key Words
- 4D flow MRI
- 4D, four-dimensional
- ASA, alcohol septal ablation
- Alcohol septal ablation
- Energy loss
- HCM, hypertrophic cardiomyopathy
- Hypertrophic cardiomyopathy
- LV, left ventricle/left ventricular
- LVOT, left ventricular outflow tract
- LVOTO, left ventricular outflow tract obstruction
- Left ventricular outflow tract obstruction
- MRI, magnetic resonance imaging
- NYHA, New York Heart Association
- ROI, region of interest
- TTE, transthoracic echocardiography
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Affiliation(s)
- Zhehao Dai
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan.,Department of Cardiovascular Medicine, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Nobuo Iguchi
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan.,Department of Radiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan
| | - Itaru Takamisawa
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan
| | - Morimasa Takayama
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan
| | - Mamoru Nanasato
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan
| | - Mitsuru Kanisawa
- Department of Radiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan
| | - Naokazu Mizuno
- Department of Radiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan
| | - Shohei Miyazaki
- Cardio Flow Design Inc., 22-3 Ichibancho, Chiyoda-ku, Tokyo 102-0082, Japan
| | - Mitsuaki Isobe
- Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo 183-0003, Japan
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8
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González EA, Calsbeek JJ, Tsai YH, Tang MY, Andrew P, Vu J, Berg EL, Saito NH, Harvey DJ, Supasai S, Gurkoff GG, Silverman JL, Lein PJ. Sex-specific acute and chronic neurotoxicity of acute diisopropylfluorophosphate (DFP)-intoxication in juvenile Sprague-Dawley rats. Curr Res Toxicol 2021; 2:341-356. [PMID: 34622217 PMCID: PMC8484742 DOI: 10.1016/j.crtox.2021.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 12/12/2022] Open
Abstract
Preclinical efforts to improve medical countermeasures against organophosphate (OP) chemical threat agents have largely focused on adult male models. However, age and sex have been shown to influence the neurotoxicity of repeated low-level OP exposure. Therefore, to determine the influence of sex and age on outcomes associated with acute OP intoxication, postnatal day 28 Sprague-Dawley male and female rats were exposed to the OP diisopropylfluorophosphate (DFP; 3.4 mg/kg, s.c.) or an equal volume of vehicle (∼80 µL saline, s.c.) followed by atropine sulfate (0.1 mg/kg, i.m.) and pralidoxime (2-PAM; 25 mg/kg, i.m.). Seizure activity was assessed during the first 4 h post-exposure using behavioral criteria and electroencephalographic (EEG) recordings. At 1 d post-exposure, acetylcholinesterase (AChE) activity was measured in cortical tissue, and at 1, 7, and 28 d post-exposure, brains were collected for neuropathologic analyses. At 1 month post-DFP, animals were analyzed for motor ability, learning and memory, and hippocampal neurogenesis. Acute DFP intoxication triggered more severe seizure behavior in males than females, which was supported by EEG recordings. DFP caused significant neurodegeneration and persistent microglial activation in numerous brain regions of both sexes, but astrogliosis occurred earlier and was more severe in males compared to females. DFP males and females exhibited pronounced memory deficits relative to sex-matched controls. In contrast, acute DFP intoxication altered hippocampal neurogenesis in males, but not females. These findings demonstrate that acute DFP intoxication triggers seizures in juvenile rats of both sexes, but the seizure severity varies by sex. Some, but not all, chronic neurotoxic outcomes also varied by sex. The spatiotemporal patterns of neurological damage suggest that microglial activation may be a more important factor than astrogliosis or altered neurogenesis in the pathogenesis of cognitive deficits in juvenile rats acutely intoxicated with OPs.
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Key Words
- 2-PAM, pralidoxime
- AChE, acetylcholinesterase
- AS, atropine-sulfate
- BChE, butyrylcholinesterase
- CT, computed tomography
- ChE, cholinesterase
- Cognitive deficits
- DFP, diisopropylfluorophosphate
- EEG, electroencephalogram
- FJC, Fluoro-Jade C
- Neurodegeneration
- Neurogenesis
- Neuroinflammation
- OP, organophosphate
- PBS, phosphate-buffered saline
- ROI, region of interest
- SE, status epilepticus
- Seizures
- Sex differences
- T2w, T2-weighted
- VEH, vehicle
- i.m., intramuscular
- i.p., intraperitoneal
- s.c., subcutaneous
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Affiliation(s)
- Eduardo A González
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - Jonas J Calsbeek
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - Yi-Hua Tsai
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - Mei-Yun Tang
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - Peter Andrew
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - Joan Vu
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - Elizabeth L Berg
- Department of Psychiatry, University of California, Davis, School of Medicine, 2230, Stockton Boulevard, Sacramento, CA 95817, USA
| | - Naomi H Saito
- Department of Public Health Sciences, University of California, Davis, One Shields Avenue, School of Medicine, Davis, CA 95616, USA
| | - Danielle J Harvey
- Department of Public Health Sciences, University of California, Davis, One Shields Avenue, School of Medicine, Davis, CA 95616, USA
| | - Suangsuda Supasai
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA
| | - Gene G Gurkoff
- Department of Neurological Surgery, University of California, Davis, School of Medicine, 4860 Y Street, Sacramento, CA 95817, USA.,Center for Neuroscience, University of California, Davis, 1544 Newton Court, Davis, CA 95618, USA
| | - Jill L Silverman
- Department of Psychiatry, University of California, Davis, School of Medicine, 2230, Stockton Boulevard, Sacramento, CA 95817, USA.,MIND Institute, University of California, Davis, 2825 50th Street, Sacramento, CA 95817, USA
| | - Pamela J Lein
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA.,MIND Institute, University of California, Davis, 2825 50th Street, Sacramento, CA 95817, USA
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9
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Fossdal G, Mjelle AB, Wiencke K, Bjørk I, Gilja OH, Folseraas T, Karlsen TH, Rosenberg W, Giil LM, Vesterhus M. Fluctuating biomarkers in primary sclerosing cholangitis: A longitudinal comparison of alkaline phosphatase, liver stiffness, and ELF. JHEP Rep 2021; 3:100328. [PMID: 34485881 PMCID: PMC8403583 DOI: 10.1016/j.jhepr.2021.100328] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/25/2021] [Accepted: 06/16/2021] [Indexed: 02/08/2023] Open
Abstract
Background & Aims Primary sclerosing cholangitis (PSC) is a progressive liver disease characterised by fluctuating liver biochemistries and highly variable disease progression. The Enhanced Liver Fibrosis (ELF®) test and liver stiffness measurements (LSMs) reflect fibrosis and predict clinical outcomes in PSC; however, longitudinal assessments are missing. We aimed to characterise the systematic change in ELF and LSM over time in a prospective cohort of patients with PSC, along with their longitudinal relationship to alkaline phosphatase (ALP) and bilirubin. Methods We included 113 non-transplant PSC patients (86 males [76.1%]; mean age 43.3 ± 15.7 years) with annual study visits between 2013 and 2019 at 2 Norwegian centres. ELF test, LSM, clinical data, liver biochemistries, and revised Mayo risk score were measured. We used linear mixed-effects models to estimate change over time, intraclass correlations (ICCs), and their relationship with ALP and bilirubin. Results At baseline, the median (range) ELF test was 9.3 (7.5–12.9) and median LSM 1.26 m/s (0.66–3.04 m/s). ELF and LSM increased over time (0.09 point/year, 95% CI [0.03, 0.15], p = 0.005, vs. 0.12 point/year, 95% CI [0.03, 0.21], p = 0.009). Between-patient effects explained 78% of ELF variation (ICC 0.78) and 56% of LSM variation (ICC 0.56). ALP also increased and showed the highest ICC (0.86). Conclusions ELF and LSM increased over a 5-year period. Longitudinal analyses demonstrated differences regarding within- and between-patient effects, suggesting that the ELF test may have superior reliability for risk stratification compared with LSM in PSC. Lay summary Primary sclerosing cholangitis (PSC) is characterised by substantial disease variability between patients and fluctuating liver biochemistries. Hence, new biomarkers are needed to identify individuals with an increased risk of developing end-stage liver disease. We explore the change over time of 2 putative prognostic biomarkers in PSC, the serum Enhanced Liver Fibrosis (ELF®) test and LSMs by ultrasound, demonstrating differences that may reflect differing abilities to discriminate risk. ELF and LSM increased in patients with PSC, but only in patients with ALP >1.5× ULN. ELF may be more reliable for PSC risk stratification (low within-patient variation). A subgroup showed concomitant spontaneous reduction in ALP, ELF, and LSM.
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Key Words
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- Alkaline phosphatase
- Biomarker
- CRP, C-reactive protein
- ELF, enhanced liver fibrosis
- Elastography
- Enhanced liver fibrosis test
- FIB-4, Fibrosis-4 Index for Liver Fibrosis
- GGT, gamma-glutamyl transferase
- HA, hyaluronic acid
- ICC, intraclass correlation
- INR, international normalised ratio
- IgG4, immunoglobulin G4
- LSM, liver stiffness measurement
- Liver stiffness
- PIIINP, propeptide of type III procollagen
- PSC, primary sclerosing cholangitis
- Primary sclerosing cholangitis
- ROI, region of interest
- Risk stratification
- TE, transient elastography
- TIMP-1, tissue inhibitor of metalloproteinases-1
- UDCA, ursodeoxycholic acid
- ULN, upper limit of normal
- pSWE, point shear wave elastography
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Affiliation(s)
- Guri Fossdal
- Norwegian PSC Research Centre, Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Anders B Mjelle
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Kristine Wiencke
- Norwegian PSC Research Centre, Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Ida Bjørk
- Department of Radiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Odd Helge Gilja
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Trine Folseraas
- Norwegian PSC Research Centre, Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Tom Hemming Karlsen
- Norwegian PSC Research Centre, Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - William Rosenberg
- UCL Institute for Liver and Digestive Health, University College London & Royal Free London NHS Foundation Trust, London, UK
| | - Lasse M Giil
- Department of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Mette Vesterhus
- Norwegian PSC Research Centre, Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
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10
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Larsen SKA, Sivesgaard K, Pedersen EM. Multi-band whole-body diffusion-weighted imaging with inversion recovery fat saturation: Effects of respiratory compensation. Eur J Radiol Open 2021; 8:100374. [PMID: 34485628 PMCID: PMC8403743 DOI: 10.1016/j.ejro.2021.100374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 10/25/2022] Open
Abstract
Purpose To prospectively compare artefacts and image quality in testicular stage I cancer patients using different combinations of breathing schemes and Multi-band (MB) in whole-body DWIBS at 1.5 T.Diffusion-Weighted whole-body Imaging with Background body signal Suppression (DWIBS) using inversion recovery (IR) fat saturation is a cornerstone in oncologic whole-body MRI, but implementation is restrained by long acquisition times. The new Multi-Band (MB) technique reduces scan time which can be reinvested in respiratory compensation. Methods Thirty testicular cancer stage I patients were included. Three variations of whole-body DWIBS were tested: Standard free Breathing (FB)-DWIBS, FB-MB-DWIBS and Respiratory triggered (RT)-MB-DWIBS. Artefacts and image quality of b = 800 s/mm2 images were evaluated using a Likert scale. No pathology was revealed. SNR was calculated in a healthy volunteer. Results RT-MB-DWIBS was rated significantly better than FB-DWIBS in the thorax (p < 0.001) and abdomen (p < 0.001), but not in the pelvis (p = 0.569). FB-MB-DWIBS was ranked significantly lower than both FB-DWIBS (p < 0.001) and RT-MB-DWIBS (p < 0.001) at all locations. However, FB-MB-DWIBS was scanned in half the time without being less than "satisfactory". Few artefacts were encountered. SNR was similar for low-intensity tissues, but the SNR in high-intensity and respiratory-prone tissue (spleen) was slightly lower for FB-DWIBS than the other sequences. Conclusion Images produced by the sequences were similar. MB enables the use of respiratory trigger or can be used to produce very fast free-breathing DWI with acceptable image quality.
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Key Words
- ADC, apparent diffusion coefficient
- CT, computed tomography
- DWI, diffusion-weighted imaging
- DWIBS, diffusion-weighted whole-body imaging with background body signal suppression
- Diffusion magnetic resonance imaging
- EPI, echo planar imaging
- FB, free-breathing
- IR, inversion recovery
- MB, multi-band
- MRI, magnetic resonance imaging
- Multi-band
- NSA, number of signal averages
- Pet, positron emission tomography
- RF, radio frequency
- ROI, region of interest
- RT, respiratory triggered
- Respiratory compensation
- SAR, specific absorption rate
- SMS, simultaneous multislice
- SNR, signal-to-noise ratio
- SPAIR, spectral attenuated inversion recovery
- T, tesla
- TE, echo time
- TR, repetition time
- Testicular neoplasm
- WB, whole-body
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Affiliation(s)
| | - Kim Sivesgaard
- Department of Radiology, Aarhus University Hospital, Denmark
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11
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Xie W, Feng T, Zhang M, Li J, Ta D, Cheng L, Cheng Q. Wavelet transform-based photoacoustic time-frequency spectral analysis for bone assessment. Photoacoustics 2021; 22:100259. [PMID: 33777692 PMCID: PMC7985564 DOI: 10.1016/j.pacs.2021.100259] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 05/08/2023]
Abstract
In this study, we investigated the feasibility of using photoacoustic time-frequency spectral analysis (PA-TFSA) for evaluating the bone mineral density (BMD) and bone structure. Simulations and ex vivo experiments on bone samples with different BMDs and mean trabecular thickness (MTT) were conducted. All photoacoustic signals were processed using the wavelet transform-based PA-TFSA. The power-weighted mean frequency (PWMF) was evaluated to obtain the main frequency component at different times. The y-intercept, midband-fit, and slope of the linearly fitted curve of the PWMF over time were also quantified. The results show that the osteoporotic bone samples with lower BMD and thinner MTT have higher frequency components and lower acoustic frequency attenuation over time, thus higher y-intercept, midband-fit, and slope. The midband-fit and slope were found to be sensitive to the BMD; therefore, both parameters could be used to distinguish between osteoporotic and normal bones (p < 0.05).
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Key Words
- ARTB, area ratio of trabecular bone
- BMD, bone mineral density
- Bone assessment
- CWT, continuous wavelet transform
- DEXA, dual energy X-ray absorptiometry
- EDTA, ethylenediaminetetraacetic acid
- MTT, mean trabecular thickness
- PA, photoacoustic
- PA-TFS, photoacoustic time-frequency spectrum
- PA-TFSA, photoacoustic time-frequency spectral analysis
- PWMF, power-weighted mean frequency
- Photoacoustic measurement
- QUS, quantitative ultrasound
- ROI, region of interest
- Time-frequency spectral analysis
- US, ultrasound
- Wavelet transform
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Affiliation(s)
- Weiya Xie
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
- The Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Ting Feng
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
- School of Electronic and Optical Engineering, Nanjing University of Science and Technology, Nanjing, PR China
| | - Mengjiao Zhang
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
| | - Jiayan Li
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
| | - Dean Ta
- Department of Electronic Engineering, Fudan University, Shanghai, PR China
| | - Liming Cheng
- The Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Qian Cheng
- Institute of Acoustics, School of Physics Science and Engineering, Tongji University, Shanghai, PR China
- The Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, PR China
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12
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Suh JS, Kim HS, Kim TJ. Development of a SARS-CoV-2-derived receptor-binding domain-based ACE2 biosensor. Sens Actuators B Chem 2021; 334:129663. [PMID: 33612970 PMCID: PMC7885701 DOI: 10.1016/j.snb.2021.129663] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/16/2020] [Accepted: 02/10/2021] [Indexed: 05/05/2023]
Abstract
The global outbreak of coronavirus disease and rapid spread of the causative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represent a significant threat to human health. A key mechanism of human SARS-CoV-2 infection is initiated by the combination of human angiotensin-converting enzyme 2 (hACE2) and the receptor-binding domain (RBD) of the SARS-CoV-2-derived spike glycoprotein. Despite the importance of these protein interactions, there are still insufficient detection methods to observe their activity at the cellular level. Herein, we developed a novel fluorescence resonance energy transfer (FRET)-based hACE2 biosensor to monitor the interaction between hACE2 and SARS-CoV-2 RBD. This biosensor facilitated the visualization of hACE2-RBD activity with high spatiotemporal resolutions at the single-cell level. Further studies revealed that the FRET-based hACE2 biosensors were sensitive to both exogenous and endogenous hACE2 expression, suggesting that they might be safely applied to the early stage of SARS-CoV-2 infection without direct virus use. Therefore, our novel biosensor could potentially help develop drugs that target SARS-CoV-2 by inhibiting hACE2-RBD interaction.
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Key Words
- ACE2
- Biosensor
- CQ, chloroquine
- FRET
- HCQ, hydroxychloroquine
- Live-cell imaging
- NA, numerical aperture
- RBD, receptor-binding domain
- RBM, receptor-binding motif
- ROI, region of interest
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SEM, standard error of the mean
- bg, background
- hACE2, human angiotensin-converting enzyme 2
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Affiliation(s)
- Jung-Soo Suh
- Department of Integrated Biological Science, Pusan National University, Pusan 46241, Republic of Korea
| | - Heon-Su Kim
- Department of Integrated Biological Science, Pusan National University, Pusan 46241, Republic of Korea
| | - Tae-Jin Kim
- Department of Integrated Biological Science, Pusan National University, Pusan 46241, Republic of Korea
- Department of Biological Sciences, Pusan National University, Pusan 46241, Republic of Korea
- Institute of Systems Biology, Pusan National University, Pusan 46241, Republic of Korea
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13
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Dobson R, Ghosh AK, Ky B, Marwick T, Stout M, Harkness A, Steeds R, Robinson S, Oxborough D, Adlam D, Stanway S, Rana B, Ingram T, Ring L, Rosen S, Plummer C, Manisty C, Harbinson M, Sharma V, Pearce K, Lyon AR, Augustine DX. BSE and BCOS Guideline for Transthoracic Echocardiographic Assessment of Adult Cancer Patients Receiving Anthracyclines and/or Trastuzumab. JACC CardioOncol 2021; 3:1-16. [PMID: 34396303 PMCID: PMC8352267 DOI: 10.1016/j.jaccao.2021.01.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 01/06/2023] Open
Abstract
The subspecialty of cardio-oncology aims to reduce cardiovascular morbidity and mortality in patients with cancer or following cancer treatment. Cancer therapy can lead to a variety of cardiovascular complications, including left ventricular systolic dysfunction, pericardial disease, and valvular heart disease. Echocardiography is a key diagnostic imaging tool in the diagnosis and surveillance for many of these complications. The baseline assessment and subsequent surveillance of patients undergoing treatment with anthracyclines and/or human epidermal growth factor receptor (HER) 2-positive targeted treatment (e.g., trastuzumab and pertuzumab) form a significant proportion of cardio-oncology patients undergoing echocardiography. This guideline from the British Society of Echocardiography and British Cardio-Oncology Society outlines a protocol for baseline and surveillance echocardiography of patients undergoing treatment with anthracyclines and/or trastuzumab. The methodology for acquisition of images and the advantages and disadvantages of techniques are discussed. Echocardiographic definitions for considering cancer therapeutics-related cardiac dysfunction are also presented.
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Key Words
- 2D, 2-dimensional
- 3D, 3-dimensional
- A2C, apical 2-chamber
- A3C, apical 3-chamber
- A4C, apical 4-chamber
- BSE, British Society of Echocardiography
- CMR, cardiac magnetic resonance
- CTRCD, cancer therapy–related cardiac dysfunction
- ECG, electrocardiogram
- GLS, global longitudinal strain
- HER2 therapy
- HER2, human epidermal growth factor receptor 2
- LV, left ventricular
- LVEF, left ventricular ejection fraction
- MV, mitral valve
- RH, right heart
- ROI, region of interest
- RV, right ventricular
- TDI, tissue Doppler imaging
- TRV, tricuspid regurgitant velocity
- anthracycline
- echocardiography
- guidelines
- imaging
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Affiliation(s)
- Rebecca Dobson
- Cardio-Oncology Service, Liverpool Heart and Chest NHS Foundation Trust, Liverpool, United Kingdom
| | - Arjun K. Ghosh
- Cardio-Oncology Service, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom
- Cardio-Oncology Service, Hatter Cardiovascular Research Institute, University College London and University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Bonnie Ky
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Tom Marwick
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Martin Stout
- University Hospital South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Allan Harkness
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
| | - Rick Steeds
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | | | | | - David Adlam
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Susannah Stanway
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Bushra Rana
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Thomas Ingram
- The Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, United Kingdom
| | - Liam Ring
- West Suffolk NHS Foundation Trust, Bury St. Edmunds, United Kingdom
| | - Stuart Rosen
- Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, United Kingdom
| | - Chris Plummer
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
| | - Charlotte Manisty
- Cardio-Oncology Service, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom
| | - Mark Harbinson
- Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Vishal Sharma
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Keith Pearce
- University Hospital South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Alexander R. Lyon
- Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, United Kingdom
| | - Daniel X. Augustine
- Department of Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom
| | - British Society of Echocardiography (BSE) and theBritish Society of Cardio-Oncology (BCOS)
- Cardio-Oncology Service, Liverpool Heart and Chest NHS Foundation Trust, Liverpool, United Kingdom
- Cardio-Oncology Service, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom
- Cardio-Oncology Service, Hatter Cardiovascular Research Institute, University College London and University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
- Baker Heart and Diabetes Institute, Melbourne, Australia
- University Hospital South Manchester NHS Foundation Trust, Manchester, United Kingdom
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- North West Anglia Foundation Trust, United Kingdom
- Liverpool John Moores University, Liverpool, United Kingdom
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- The Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, United Kingdom
- West Suffolk NHS Foundation Trust, Bury St. Edmunds, United Kingdom
- Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
- Belfast Health and Social Care Trust, Belfast, United Kingdom
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
- Department of Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom
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14
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Okada R, Yamato K, Kawakami M, Kodama J, Kushioka J, Tateiwa D, Ukon Y, Zeynep B, Ishimoto T, Nakano T, Yoshikawa H, Kaito T. Low magnetic field promotes recombinant human BMP-2-induced bone formation and influences orientation of trabeculae and bone marrow-derived stromal cells. Bone Rep 2021; 14:100757. [PMID: 33681430 PMCID: PMC7910497 DOI: 10.1016/j.bonr.2021.100757] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 01/16/2021] [Accepted: 02/17/2021] [Indexed: 11/01/2022] Open
Abstract
Effects of high magnetic fields [MFs, ≥ 1 T (T)] on osteoblastic differentiation and the orientation of cells or matrix proteins have been reported. However, the effect of low MFs (< 1 T) on the orientation of bone formation is not well known. This study was performed to verify the effects of low MFs on osteoblastic differentiation, bone formation, and orientation of both cells and newly formed bone. An apparatus was prepared with two magnets (190 mT) aligned in parallel to generate a parallel MF. In vitro, bone marrow-derived stromal cells of rats were used to assess the effects of low MFs on cell orientation, osteoblastic differentiation, and mineralization. A bone morphogenetic protein (BMP)-2-induced ectopic bone model was used to elucidate the effect of low MFs on microstructural indices, trabecula orientation, and the apatite c-axis orientation of newly formed bone. Low MFs resulted in an increased ratio of cells oriented perpendicular to the direction of the MF and promoted osteoblastic differentiation in vitro. Moreover, in vivo analysis demonstrated that low MFs promoted bone formation and changed the orientation of trabeculae and apatite crystal in a direction perpendicular to the MF. These changes led to an increase in the mechanical strength of rhBMP-2-induced bone. These results suggest that the application of low MFs has potential to facilitate the regeneration of bone with sufficient mechanical strength by controlling the orientation of newly formed bone.
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Key Words
- ALP, alkaline phosphatase
- BMD, bone mineral density
- BMDCs, bone marrow derived stromal cells
- BV, bone volume
- Bone marrow-derived stromal cells
- COL1a1, collagen type1 a1
- FFT, fast Fourier transform
- GFP, green fluorescent protein
- MF, magnetic field
- Magnetic field
- Mechanical strength
- OCN, osteocalcin
- OPN, osteopontin
- OSX, osterix
- Orientation intensity
- Osteoblastic differentiation
- PBS, phosphate-buffered saline
- PEMF, pulsed electromagnetic field
- ROI, region of interest
- RT-PCR, reverse transcription polymerase chain reaction
- RUNX2, runt-related transcription factor 2
- micro-CT, micro-computed tomography
- rhBMP, recombinant human bone morphogenetic protein
- μXRD, microbeam X-ray diffractometer
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Affiliation(s)
- Rintaro Okada
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kai Yamato
- Department of Research Institute, PIP Corporation, Ibaraki, Osaka, Japan
| | - Minoru Kawakami
- Department of Research Institute, PIP Corporation, Ibaraki, Osaka, Japan
| | - Joe Kodama
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Junichi Kushioka
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Daisuke Tateiwa
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yuichiro Ukon
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Bal Zeynep
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takuya Ishimoto
- Division of Materials and Manufacturing Science, Osaka University Graduate School of Engineering, Suita, Osaka, Japan
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Osaka University Graduate School of Engineering, Suita, Osaka, Japan
| | - Hideki Yoshikawa
- Department of Orthopedic Surgery, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan
| | - Takashi Kaito
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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15
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Lockard CA, Nolte PC, Gawronski KMB, Elrick BP, Goldenberg BT, Horan MP, Dornan GJ, Ho CP, Millett PJ. Quantitative T2 mapping of the glenohumeral joint cartilage in asymptomatic shoulders and shoulders with increasing severity of rotator cuff pathology. Eur J Radiol Open 2021; 8:100329. [PMID: 33644264 PMCID: PMC7895706 DOI: 10.1016/j.ejro.2021.100329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 02/02/2023] Open
Abstract
Glenohumeral cartilage T2 values were correlated to increasing rotator cuff pathology severity. Massive tear versus lesser injury differences were most evident in superior humeral cartilage. Sagittal T2 mapping best captures superior humeral head cartilage change in massive tear patients.
Purpose To examine the relationship between glenohumeral cartilage T2 mapping values and rotator cuff pathology. Method Fifty-nine subjects (age 48.2 ± 13.5 years, 15 asymptomatic volunteers and 10 tendinosis, 13 partial-thickness tear, 8 full-thickness tear, and 13 massive tear patients) underwent glenohumeral cartilage T2 mapping. The humeral head cartilage was segmented in the sagittal and coronal planes. The glenoid cartilage was segmented in the coronal plane. Group means for each region were calculated and compared between the groups. Results Massive tear group T2 values were significantly higher than the asymptomatic group values for the humeral head cartilage included in the sagittal (45 ± 7 versus 32 ± 4 ms, p < .001) and coronal (44 ± 6 versus 38 ± 1 ms, p = 0.01) plane images. Mean T2 was also significantly higher for massive than full-thickness tears (45 ± 7 versus 38 ± 5 ms, p = 0.02), massive than partial-thickness tears (45 ± 7 versus 34 ± 4 ms, p < 0.001), and massive tears than tendinosis (45 ± 7 versus 35 ± 4 ms, p = 0.001) in the sagittal-images humeral head region and significantly higher for massive tears than asymptomatic shoulders (44 ± 6 versus 38 ± 1 ms, p = 0.01) in the coronal-images humeral head region. Conclusion Humeral head cartilage T2 values were significantly positively correlated with rotator cuff pathology severity. Massive rotator cuff tear patients demonstrated significantly higher superior humeral head cartilage T2 mapping values relative to subjects with no/lesser degrees of rotator cuff pathology.
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Key Words
- Cartilage
- Cuff tear arthropathy
- FS, fat suppressed
- GCor, glenoid, coronal plane
- HH, humeral head
- HHCor, humeral head, coronal plane
- HHSag, humeral head, sagittal plane
- MRI, magnetic resonance imaging
- Magnetic resonance imaging
- PD, proton density
- RC, rotator cuff
- ROI, region of interest
- Rotator cuff
- SPACE, sampling perfection with application-optimized contrasts using different flip angle evolution
- Shoulder
- T2, transverse relaxation time
- TSE, turbo spin echo
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Affiliation(s)
- Carly A Lockard
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Philip-C Nolte
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Karissa M B Gawronski
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Bryant P Elrick
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Brandon T Goldenberg
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Marilee P Horan
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Grant J Dornan
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Charles P Ho
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Peter J Millett
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA.,The Steadman Clinic, 181 W Meadow Dr, Ste 400, Vail, CO 81657, USA
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16
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Lench DH, Hutchinson S, Woodbury ML, Hanlon CA. Kinematic Measures of Bimanual Performance are Associated With Callosum White Matter Change in People With Chronic Stroke. Arch Rehabil Res Clin Transl 2021; 2:100075. [PMID: 33543100 PMCID: PMC7853365 DOI: 10.1016/j.arrct.2020.100075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives To investigate the relationship between bimanual performance deficits measured using kinematics and callosum (CC) white matter changes that occur in people with chronic stroke. Design Cross-sectional, observational study of participants with chronic stroke and age-matched controls. Setting Recruitment and assessments occurred at a stroke recovery research center. Behavioral assessments were performed in a controlled laboratory setting. Magnetic resonance imaging scans were performed at the Center for Biomedical Imaging. Participants Individuals were enrolled and completed the study (N=39; 21 participants with chronic stroke; 18 age-matched controls with at least 2 stroke risk factors). Main Outcome Measures Diffusion imaging metrics were obtained for each individual’s CC and corticospinal tract (CST), including mean kurtosis (MK) and fractional anisotropy (FA). A battery of motor assessments, including bimanual kinematics, were collected from individuals while performing bimanual reaching. Results Participants with stroke had lower FA and MK in the CST of the lesioned hemisphere when compared with the non-lesioned hemisphere. The FA and MK values in the CST were correlated with measures of unimanual hand performance. In addition, participants with stroke had significantly lower FA and MK in the CC than matched controls. CC diffusion metrics positively correlated with hand asymmetry and trunk displacement during bimanual performance, even when correcting for age and lesion volume. Conclusions These data confirm previous studies that linked CST integrity to unimanual performance and provide new data demonstrating a link between CC integrity and both bimanual motor deficits and compensatory movements. Fractional anisotropy and mean kurtosis in the corpus callosum are lower in participants with stroke. Hand position symmetry and trunk displacement are disrupted during bimanual tasks. Corpus callosum white matter correlated with bimanual kinematics in participants with stroke.
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Key Words
- ANOVA, analysis of variance
- ARAT, Action Research Arm Test
- CC, corpus callosum
- CST, corticospinal tract
- DKI, diffusion kurtosis imaging
- DTI, diffusion tensor imaging
- Diffusion
- FA, fractional anisotropy
- FMA, Fugl-Meyer Assessment
- M1, primary motor cortex
- MK, mean kurtosis
- MRI, magnetic resonance imaging
- Motor Activity
- Pyramidal Tracts
- ROI, region of interest
- Rehabilitation
- SMA, supplementary motor area
- Stroke
- UE, upper extremity
- WMFT, Wolf Motor Function Test
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Affiliation(s)
- Daniel H. Lench
- Departments of Psychiatry and Neurosciences, College of Medicine, Medical University of South Carolina, Charleston, SC
| | - Scott Hutchinson
- Department of Health Research, College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Michelle L. Woodbury
- Department of Health Research, College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Colleen A. Hanlon
- Departments of Psychiatry and Neurosciences, College of Medicine, Medical University of South Carolina, Charleston, SC
- Department of Health Research, College of Health Professions, Medical University of South Carolina, Charleston, SC
- Department of Cancer Biology, College of Medicine, Wake Forest Health Sciences, Winston-Salem, NC
- Corresponding author Colleen A. Hanlon, PhD, 1 Medical Center Blvd, Wake Forest School of Medicine, Winston-Salem, NC 27157.
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17
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Suyama Y, Tomita K, Soga S, Kuwamura H, Murakami W, Hokari R, Shinmoto H. T1ρ magnetic resonance imaging value as a potential marker to assess the severity of liver fibrosis: A pilot study. Eur J Radiol Open 2021; 8:100321. [PMID: 33490312 DOI: 10.1016/j.ejro.2021.100321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/24/2020] [Accepted: 12/30/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose Assessment of liver fibrosis is essential for the management of liver disease. Although liver biopsy is the gold-standard modality for the diagnosis of liver fibrosis, it has some limitations. Thus, other methods are required to overcome the disadvantages of a liver biopsy. T1ρ magnetic resonance imaging (MRI) values are potential biomarkers for liver cirrhosis. This study aimed to assess the relationship between T1ρ MRI values and liver fibrosis severity by measuring the correlation between T1ρ values and shear wave elastography (SWE) values, which are routinely used for the diagnosis of liver fibrosis. Methods T1ρ imaging and SWE values were obtained from four healthy volunteers and 16 patients with chronic liver disease. The regions of interest on MR images were drawn and matched with those of the right liver lobe on SWE images. Results The mean T1ρ values of the right liver lobe correlated positively with the mean SWE values (Pearson’s correlation coefficient: 0.783; p < 0.0001; 95 % confidence interval: 0.623–0.880). Conclusion The mean T1ρ values of the right liver lobe may be correlated with the severity of liver fibrosis.
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18
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Truong M, Lennartsson F, Bibic A, Sundius L, Persson A, Siemund R, In’t Zandt R, Goncalves I, Wassélius J. Classifications of atherosclerotic plaque components with T1 and T2* mapping in 11.7 T MRI. Eur J Radiol Open 2021; 8:100323. [PMID: 33532518 PMCID: PMC7822939 DOI: 10.1016/j.ejro.2021.100323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND AIMS Histopathology is the gold standard for analysis of atherosclerotic plaques but has drawbacks due to the destructive nature of the method. Ex vivo MRI is a non-destructive method to image whole plaques. Our aim was to use quantitative high field ex vivo MRI to classify plaque components, with histology as gold standard. METHODS Surgically resected carotid plaques from 12 patients with recent TIA or stroke were imaged at 11.7 T MRI. Quantitative T1/T2* mapping sequences and qualitative T1/T2* gradient echo sequences with voxel size of 30 × 30 × 60 μm3 were obtained prior to histological preparation, sectioning and staining for lipids, inflammation, hemorrhage, and fibrous tissue. Regions of interest (ROI) were selected based on the histological staining at multiple levels matched between histology and MRI. The MRI parameters of each ROI were then analyzed with quadratic discriminant analysis (QDA) for classification. RESULTS A total of 965 ROIs, at 70 levels matched between histology and MRI, were registered based on histological staining. In the nine plaques where three or more plaque components were possible to co-localize with MRI, the mean degree of misclassification by QDA was 16.5 %. One of the plaques contained mostly fibrous tissue and lipids and had no misclassifications, and two plaques mostly contained fibrous tissue. QDA generally showed good classification for fibrous tissue and lipids, whereas plaques with hemorrhage and inflammation had more misclassifications. CONCLUSION 11.7 T ex vivo high field MRI shows good visual agreement with histology in carotid plaques. T1/T2* maps analyzed with QDA is a promising non-destructive method to classify plaque components, but with a higher degree of misclassifications in plaques with hemorrhage or inflammation.
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Key Words
- 11.7 T MRI
- 11.7T, 11.7 Tesla
- 3T, 3 Tesla
- Atherosclerosis
- BSA, bovine serum albumin
- CI, confidence interval
- CTA, computed tomography angiography
- Carotid plaque
- Classification
- FA, flip angle
- FOV, field of view
- GE3D, gradient echo three dimensional
- HRP, horse radish peroxidase
- ICA, internal carotid artery
- IPH, intra-plaque hemorrhage
- LRNC, lipid rich necrotic core
- MRI, magnetic resonance imaging
- OCT, optimal cutting temperature
- Plaque components
- RF, radio frequency
- ROI, region of interest
- SD, standard deviation
- T1 maps
- T1w, T1 weighted
- T2*maps
- T2*w, T2 star weighted
- TBS, tris-buffered saline
- TE, echo time
- TIA, transient ischemic attack
- TR, repetition time
- ms, millisecond
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Affiliation(s)
- My Truong
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Medical Imaging Department, Neuroradiology, 22185, Lund, Sweden
| | - Finn Lennartsson
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Medical Imaging Department, Neuroradiology, 22185, Lund, Sweden
| | - Adnan Bibic
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, F. M. Kirby Center, 707 North Broadway, Baltimore, MD, 21 205, USA
| | - Lena Sundius
- Clinical Sciences Malmö, Lund University, Jan Waldenströmsg 35, 91-12, Skåne University Hospital, 20502, Malmö, Sweden
| | - Ana Persson
- Clinical Sciences Malmö, Lund University, Jan Waldenströmsg 35, 91-12, Skåne University Hospital, 20502, Malmö, Sweden
| | - Roger Siemund
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Medical Imaging Department, Neuroradiology, 22185, Lund, Sweden
| | - René In’t Zandt
- Lund University Bioimaging Centre, Lund University, Klinikgatan 32, BMC D11, SE-221 84, Lund, Sweden
| | - Isabel Goncalves
- Cardiology, Skåne University Hospital, Sweden
- Clinical Sciences Malmö, Lund University, Jan Waldenströmsg 35, 91-12, Skåne University Hospital, 20502, Malmö, Sweden
| | - Johan Wassélius
- Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Medical Imaging Department, Neuroradiology, 22185, Lund, Sweden
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19
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Rodge GA, Goenka MK, Goenka U, Afzalpurkar S, Shah BB. Quantification of Liver Fat by MRI-PDFF Imaging in Patients with Suspected Non-alcoholic Fatty Liver Disease and Its Correlation with Metabolic Syndrome, Liver Function Test and Ultrasonography. J Clin Exp Hepatol 2021; 11:586-91. [PMID: 34511820 DOI: 10.1016/j.jceh.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/25/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI)-estimated proton density fat fraction (PDFF) has emerged to be a promising tool in quantification of liver fat. Aim of this study was to quantify liver fat using MRI-PDFF in patients with suspected non-alcoholic fatty liver disease (NAFLD) and to correlate it with the presence of metabolic syndrome (MetS), ultrasonography (USG) and liver function test (LFT). METHODS We included 111 consecutive patients who were suspected to have NAFLD on the basis of clinical, laboratory or USG findings. A 3 Tesla Phillips MRI machine was used with a software named "mDixon Quant" for quantification of the liver fat. RESULTS MRI-PDFF revealed hepatic steatosis grading as Grade 0 in 31 patients (28%), Grade I in 40 (36%), Grade II in 19 (17.1%) and Grade III in 21 patients (18.9%). MetS patients had higher proportion of advanced steatosis (Grades II and III) as compared to those without MetS (P < 0.001). ALT (alanine transaminase) was found to be significantly elevated (>1.5 times) in the patients with advanced steatosis as compared to patients with Grades I and 0 fatty liver on MRI-PDFF (P < 0.001). The Kappa measure of agreement between USG and MRI-PDFF was found to be 0.2, which suggests a low level of agreement between the two tests. CONCLUSION MetS patients have higher proportion of advanced steatosis (Grades II and III) at MRI-PDFF as compared to those without MetS. Patients with advanced steatosis at MRI-PDFF had higher proportion of abnormal LFTs as compared to those with Grades 0 and I hepatic steatosis. There was a dis-correlation between MRI-PDFF and USG in the evaluation of NAFLD.
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Key Words
- ALT, alanine transaminase
- BMI, body mass index
- CAP, controlled attenuation parameter
- HDL, high-density lipoprotein
- LFT, liver function test
- MRI, magnetic resonance imaging
- MRI-PDFF
- MRS, magnetic resonance spectroscopy
- MetS, metabolic syndrome
- NAFLD
- NAFLD, non-alcoholic fatty liver disease
- NASH
- NASH, non-alcoholic steatohepatitis
- PDFF, proton density fat fraction
- ROI, region of interest
- ULN, upper limit of normal
- USG, ultrasonography
- liver fat quantification
- metabolic syndrome
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20
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Mio M, Fujiwara Y, Tani K, Toyofuku T, Maeda T, Inoue T. Quantitative evaluation of focal liver lesions with T1 mapping using a phase-sensitive inversion recovery sequence on gadoxetic acid-enhanced MRI. Eur J Radiol Open 2021; 8:100312. [PMID: 33392362 DOI: 10.1016/j.ejro.2020.100312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose To determine the usefulness of T1 values measured using a phase-sensitive inversion recovery (PSIR) sequence for the diagnosis of focal liver lesions. Method The study enrolled 87 patients who underwent gadoxetic acid-enhanced magnetic resonance imaging (MRI) for assessment of 38 hepatocellular carcinomas, 33 hepatic hemangiomas, 30 metastatic liver tumors, and 14 hepatic cysts. PSIR was performed before and 15 min after contrast agent administration, and then the respective T1 values were measured and the T1 reduction rate was calculated. Wilcoxon matched-pairs signed-rank test was used to compare T1 values pre- and post-contrast administration in each tumor. The Kruskal-Wallis test and Dunn's post-hoc test were used to compare T1 values among all tumors pre- and post-contrast administration and the T1 reduction rate among all tumors. Results The T1 values measured before and after contrast enhancement were 1056 ± 292 ms and 724 ± 199 ms for hepatocellular carcinoma, 1757 ± 723 ms and 1033 ± 406 ms for metastatic liver tumor, 2524 ± 908 ms and 1071 ± 390 ms for hepatic hemangioma, and 3793 ± 207 ms and 3671 ± 241 ms for liver cysts, respectively. The T1 values obtained before and after contrast administration showed significant differences for all tumors except liver cysts (P < 0.0001). T1 reduction rate was not significantly different between hepatocellular carcinoma and metastatic liver tumor, but was significantly different among other tumors (P < 0.05). Conclusions T1 mapping using the PSIR sequence is useful to differentiate focal liver lesions.
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21
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Huang TY, Wu CC, Weng PW, Chen JM, Yeh WL. Effect of ErhBMP-2-loaded β-tricalcium phosphate on ulna defects in the osteoporosis rabbit model. Bone Rep 2020; 14:100739. [PMID: 33364265 PMCID: PMC7750155 DOI: 10.1016/j.bonr.2020.100739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 12/25/2022] Open
Abstract
Purpose Autografts, the gold standard treatment for large bone defects, present complications, especially in conditions with reduced bone-repair capacity, such as osteoporosis. Escherichia coli-derived recombinant human bone morphogenesis protein-2 (ErhBMP-2), was used in this study to improve the osteoinductivity of β-tricalcium phosphate (β-TCP). This study evaluated the bone-repair capacity of ErhBMP-2-loaded β-TCP on osteoporosis rabbit model, relative to the sole use of autograft and β-TCP treatments. Methods The osteoporosis rabbit model was induced through ovariectomy and glucocorticoid dosing; 2-cm segmental ulnar defects were created, which were treated with either autograft, β-TCP alone, or ErhBMP-2-loaded β-TCP or left untreated. The quality of newly formed ulnae was evaluated 8 weeks after ulnar surgery through micro-CT, biomechanical, histological, and histomorphometric assessments. Results The osteoporosis rabbit model was developed and maintained till the end of the study. The maximal load and stiffness in the ErhBMP-2-loaded TCP group were significantly higher than those in the autograft group, whereas the TCP-alone group performed similarly as did the untreated group in the force loading and stiffness tests. According to the micro-CT evaluation, the ErhBMP-2-loaded TCP group had significantly higher bone volume relative to the autograft and TCP-alone groups. Histological assessments revealed better defect bridging and marrow formation in the ErhBMP-2-loaded TCP group relative to the TCP-alone group. Mineral apposition rates were significantly higher in the ErhBMP-2-loaded TCP and autograft groups than in the TCP-alone and untreated groups. Conclusion Relative to autografts, ErhBMP-2-loaded TCP, as an alternative grafting material, provides better or comparable healing on critical-sized long bone defects in the osteoporosis rabbit model. Erh-BMP-2 promoted the bone healing ability of β-TCP in osteoporosis animal model. New bone generated by Erh-BMP-2-loaded β-TCP was stiffer than that generated by autograft. ErhBMP-2-loaded TCP potentially being an alternative grafting material relative to autograft.
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Affiliation(s)
- Tse-Yin Huang
- Ph.D. Program for Biotech Pharmaceutical Industry, School of Pharmacy, China Medical University, Taichung 40402, Taiwan
| | - Chang-Chin Wu
- Department of Orthopedics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10002, Taiwan.,Department of Biomedical Engineering, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan.,Department of Orthopedics, En Chu Kong Hospital, New Taipei City 23702, Taiwan
| | - Pei-Wei Weng
- Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taiwan.,Department of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Jian-Ming Chen
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital-Linkou, Tao-Yuan 33305, Taiwan
| | - Weng-Ling Yeh
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital-Linkou, Tao-Yuan 33305, Taiwan.,Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Liu JE, Barac A, Thavendiranathan P, Scherrer-Crosbie M. Strain Imaging in Cardio-Oncology. JACC CardioOncol 2020; 2:677-689. [PMID: 34396282 PMCID: PMC8352045 DOI: 10.1016/j.jaccao.2020.10.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023] Open
Abstract
Echocardiographic imaging is crucial for patient management during cardiotoxic cancer therapy. Left ventricular ejection fraction is the most commonly used parameter for identifying left ventricular dysfunction. However, it lacks sensitivity to detect subclinical changes in cardiac function due to cardiotoxic treatment. Global longitudinal strain (GLS) is the best studied strain parameter with established diagnostic and prognostic value. Multiple studies have demonstrated changes in GLS as an early marker of cardiotoxicity. This document serves as a primer to help clinicians in the acquisition and interpretation of strain in cardio-oncology. Cases with embedded videos illustrate a step-by-step approach to obtaining GLS measurements and common pitfalls to avoid. The document includes a concise summary of the indications of GLS in cardio-oncology and its role in guiding oncological therapy. Practical approaches on how to implement strain in the echo laboratory with guidance on training and quality assurance are also discussed.
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Key Words
- 2D, 2-dimensional
- 3D, 3-dimensional
- ACC, American College of Cardiology
- AL, amyloid light chains
- ASE, American Society of Echocardiography
- CMRI, cardiac magnetic resonance imaging
- CTRCD, cancer treatment–related cardiac dysfunction
- DICOM, Digital Imaging and Communications in Medicine
- EACVI, European Association of Cardiovascular Imaging
- GLS, global longitudinal strain
- LV, left ventricle
- LVEF, left ventricular ejection fraction
- ROI, region of interest
- STE, speckle tracking echocardiography
- VEGF, vascular endothelium growth factor
- cancer
- cardiotoxicity
- echocardiography
- global longitudinal strain
- left ventricular function
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Affiliation(s)
- Jennifer E. Liu
- Cardiology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Ana Barac
- Department of Cardiology, Medstar Washington Hospital Center, MedStar Heart and Vascular Institute, Georgetown University, Washington, DC, USA
| | - Paaladinesh Thavendiranathan
- Department of Medicine, Division of Cardiology, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Marielle Scherrer-Crosbie
- Division of Cardiology, The Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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23
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Buus TW, Sivesgaard K, Fris TL, Christiansen PM, Jensen AB, Pedersen EM. Fat fractions from high-resolution 3D radial Dixon MRI for predicting metastatic axillary lymph nodes in breast cancer patients. Eur J Radiol Open 2020; 7:100284. [PMID: 33204769 PMCID: PMC7653281 DOI: 10.1016/j.ejro.2020.100284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/21/2020] [Accepted: 10/25/2020] [Indexed: 12/24/2022] Open
Abstract
High-Resolution 3D radial Dixon MRI allows for the creation of quantitative fat fraction images. Lymph node fat fractions improves diagnostic performance of MRI to detect axillary lymph node metastases. Lymph node fat fractions are a promising quantitative indicator of metastases in axillary lymph nodes.
Purpose To assess diagnostic performance of fat fractions (FF) from high-resolution 3D radial Dixon MRI for differentiating metastatic and non-metastatic axillary lymph nodes in breast cancer patients. Method High-resolution 3D radial Dixon MRI was prospectively performed on 1.5 T in 70 biopsy-verified breast cancer patients. 35 patients were available for analysis with histopathologic and imaging data. FF images were calculated as fat / in-phase. Two radiologists measured lymph node FF and assessed morphological features in one ipsilateral and one contralateral lymph node in consensus. Diagnostic performance of lymph node FF and morphological criteria were compared using histopathology as reference. Results 22 patients had metastatic axillary lymph nodes. Mean lymph node FF were 0.20 ± 0.073, 0.31 ± 0.079, and 0.34 ± 0.15 (metastatic, non-metastatic ipsi- and non-metastatic contralateral lymph nodes, respectively). Metastatic lymph node FF were significantly lower than non-metastatic ipsi- (p < 0.001) and contralateral lymph nodes (p < 0.001). Area under the receiver operating characteristics curve for lymph node FF was 0.80 compared to 0.76 for morphological criteria (p = 0.29). Lymph node FF yielded sensitivity 0.91, specificity 0.69, positive predictive value (PPV) 0.83, and negative predictive value (NPV) 0.82, while morphological criteria yielded sensitivity 0.91, specificity 0.62, PPV 0.80, and NPV 0.80 (p = 0.71). Combining lymph node FF and morphological criteria increased diagnostic performance with sensitivity 1.00, specificity 0.67, PPV 0.86, NPV 1.00, and AUC 0.83. Conclusions Lymph node FF from high-resolution 3D Dixon images are a promising quantitative indicator of metastases in axillary lymph nodes.
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Key Words
- ADC, apparent diffusion coefficient
- ALND, axillary lymph node dissection
- AUC, area under the ROC curve
- Axilla
- Breast neoplasms
- DWI, diffusion-weighted imaging
- F, fat
- FF, fat fraction
- IDC, invasive ductal carcinoma
- ILC, invasive lobular carcinoma
- IP, in-phase
- LN, lymph node
- Lymphatic metastasis
- Magnetic resonance imaging
- NPV, negative predictive value
- OP, opposed-phase
- PPV, positive predictive value
- ROC, receiver operating characteristics
- ROI, region of interest
- SLNB, sentinel lymph node biopsy
- SPAIR, spectral attenuated inversion recovery
- STIR, short tau inversion recovery
- TE, echo time
- TR, repetition time
- US, ultrasonography
- W, water
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Affiliation(s)
- Thomas Winther Buus
- Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Kim Sivesgaard
- Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Tanja Linde Fris
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, 8200, Aarhus N, Denmark
| | - Peer Michael Christiansen
- Department of Plastic and Breast Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, 8200, Aarhus N, Denmark
| | - Anders Bonde Jensen
- Department of Oncology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Erik Morre Pedersen
- Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
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Abstract
Quantitative CT is a highly accurate but underutilized method for identifying pulmonary edema on CT. There is a moderatelystrong correlation between CT HUs and CXR pulmonary edema grade in every lobe with correlation coefficients ranging from 0.585−0.685. CT Hounsfield unit measurement yields excellent accuracy in differentiating no edema from mild to severe edema, with AUCs up to 0.995 in the LUL. Qualitative CT with a % versus 84 % and specificity 95 % versus 78 Qualitative CT with a HU cut-off of -825 in the LUL is more sensitive (100% vs 84%) and specific (95% vs 78%) than qualitative CT.
Purpose To determine the accuracy of quantitative CT to diagnose pulmonary edema compared to qualitative CT and CXR and to determine a threshold Hounsfield unit (HU) measurement for pulmonary edema on CT examinations. Method Electronic medical records were searched for patients with a billing diagnosis of heart failure and a Chest CT and CXR performed within three hours between 1/1/2016 to 10/1/2016, yielding 100 patients. CXR and CT examinations were scored for the presence and severity of edema, using a 0–5 scale, and CT HU measurements were obtained in each lobe. Polyserial correlation coefficients evaluated the association between CT HUs and CXR scores, and receiver operating characteristic (ROC) curve analysis determined a cutoff CT HU value for identification of pulmonary edema. Results Correlation between CT HU and CXR score was moderately strong (r = 0.585−0.685) with CT HU measurements demonstrating good to excellent accuracy in differentiating between no edema (grade 0) and mild to severe edema (grades 1–5) in every lobe, with AUCs ranging between 0.869 and 0.995. The left upper lobe demonstrated the highest accuracy, using a cutoff value of -825 HU (AUC of 0.995, sensitivity = 100 % and specificity = 95.1 %). Additionally, qualitative CT evaluation was less sensitive (84 %) than portable CXR in identifying pulmonary edema. However, quantitative CT evaluation was as sensitive as portable CXR (100 %) and highly specific (95 %). Conclusions Quantitative CT enables the identification of pulmonary edema with high accuracy and demonstrates a greater sensitivity than qualitative CT in assessment of pulmonary edema.
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Affiliation(s)
- Maria Barile
- Departments of Radiology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Radiology at University of Massachusetts Memorial Medical Center, Worcester, MA, United States
- Corresponding author at: Department of Radiology at University of Massachusetts Memorial Medical Center, Worcester, MA, United States.
| | - Tomoyuki Hida
- Departments of Radiology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Radiology, Kyushu University Hospital, Japan
| | - Mark Hammer
- Department of Radiology, Kyushu University Hospital, Japan
| | - Hiroto Hatabu
- Departments of Radiology, Brigham and Women’s Hospital, Boston, MA, United States
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25
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Manava P, Galster M, Schoen M, Ficker J, Lell MM, Adamus R, Bruch M. Improving Contrast Enhancement in Pulmonary CTA: The value of breathing maneuvers. Eur J Radiol Open 2020; 7:100280. [PMID: 33102639 PMCID: PMC7578205 DOI: 10.1016/j.ejro.2020.100280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/03/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose To investigate contrast dynamics and artifacts associated with different breathing maneuvers during pulmonary computed tomography angiography (pCTA) in a prospective randomized clinical trial. Method Three different breathing maneuvers (inspiration, expiration, Mueller) were randomly assigned to 146 patients receiving pCTA for suspected pulmonary embolism (PE). Contrast enhancement of central and peripheral arteries and imaging quality of lung parenchyma were compared and analyzed. Results were compared by using the analysis of variances (ANOVA) and Kruskal-Wallis-Test. Results Mean enhancement in the pulmonary trunk was highest during breath-hold in inspiration (293 HU, range 195-460 HU) compared to Mueller (259 HU, range 136-429 HU, p = 0022) and expiration (267 HU, range 115-376 HU). This was similar for the right pulmonary artery (inspiration 289 HU, range 173-454 HU; Mueller 250 HU, range 119-378 HU; p = 0.007; expiration 257 HU, range 114-366 HU; p = 0.032) and left pulmonary artery (inspiration 280.3 HU, range 170-462 HU; Mueller 245 HU, range 111-371 HU; p = 0.016; expiration 252 HU, range 110-371 HU).Delineation of peripheral arteries was significantly better in inspiration vs Mueller (p = 0.006) and expiration (p = 0.049). Assessment of the lung parenchyma was significantly better in inspiration vs Mueller (p = 0.013) or expiration (p < 0.001). Conclusions Resting inspiratory position achieved the highest enhancement levels in central and peripheral pulmonary arteries and best image quality of the pulmonary parenchyma in comparison to other breathing maneuvers. It is necessary to train the maneuver prior to the examination in order to avoid deep inspiration with the risk of suboptimal opacification of the pulmonary arteries.
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Key Words
- ANOVA, analysis of variances
- Breathing
- Computed tomography angiography
- Contrast density
- GCP, good clinical practice
- ICC, intraclass correlation coefficient
- IDR, iodine delivery rate
- IRB, institutional review board
- IVC, inferior vena cava
- Image quality
- MPR, multiplanar reformations
- PE, pulmonary embolism
- Pulmonary arteries
- Pulmonary embolism
- ROI, region of interest
- SVC, superior vena cava
- pCTA, pulmonary computed tomography angiography
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Affiliation(s)
- P Manava
- Department of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany.,Institute of Radiology, Friedrich-Alexander University, Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - M Galster
- Department of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany
| | - M Schoen
- Department of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany
| | - J Ficker
- Department of Pulmonology, Klinikum Nuernberg, Paracelsus Medical University, Germany
| | - M M Lell
- Department of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany.,Institute of Radiology, Friedrich-Alexander University, Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - R Adamus
- Institute of Radiology, Friedrich-Alexander University, Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - M Bruch
- Department of Radiology and Nuclear Medicine, Klinikum Nuernberg, Paracelsus Medical University, Germany
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26
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Fukumoto W, Nagaoka M, Higaki T, Tatsugami F, Nakamura Y, Oostveen L, Klein W, Prokop M, Awai K. Measurement of coronary artery calcium volume using ultra-high-resolution computed tomography: A preliminary phantom and cadaver study. Eur J Radiol Open 2020; 7:100253. [PMID: 32964073 PMCID: PMC7490539 DOI: 10.1016/j.ejro.2020.100253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/24/2020] [Indexed: 11/26/2022] Open
Abstract
Small calcifications were moe accurately detectable on SHR- than NR images. The mean CAC volume was significantly higher on SHR- than NR images of the cadavers. SHR imaging may facilitate the accurate quantification of the CAC.
Objectives In this phantom- and cadaver study we investigated the differences of coronary artery calcium (CAC) volume on ultra-high-resolution computed tomography (U-HRCT) scans and conventional CT. Methods We scanned a coronary calcium phantom and the coronary arteries of five cadavers using U-HRCT in normal- and super-high resolution (NR, SHR) mode. The NR mode was similar to conventional CT; 896 detector channels, a matrix size of 512, and a slice thickness of 0.5 mm were applied. In SHR mode, we used 1792 detector channels, a matrix size of 1024, and a slice thickness of 0.25 mm. The CAC volume on NR- and SHR images were recorded. Differences in the physical- and the calculated CAC volume were defined as the error value and compared between NR- and SHR images of the phantom. Differences between the CAC volume on NR- and SHR scans of the cadavers were also recorded. Results The mean error value was lower on SHR- than NR images of the phantom (14.0 %, SD 11.1 vs 20.1 %, SD 15.2, p = 0.01). The mean CAC volume was significantly higher on SHR- than NR images of the cadavers (153.4 mm3, SD 161.0 vs 144.7 mm3, SD 164.8, p < 0.01). Conclusions As small calcifications were more clearly visualized on U-HRCT images in SHR mode than on conventional (NR) CT scans, SHR imaging may facilitate the accurate quantification of the CAC.
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Key Words
- AEC, automatic exposure control
- CAC, coronary artery calcium
- CTDI, CT dose index
- Cadaver
- Coronary artery calcium scores
- DLP, dose-length product
- ERD, edge rise distance
- ERS, edge rise slope
- FOV, field of view
- FWHM, full-width at half maximum
- HA, hydroxyapatite
- HU, hounsfield units
- LAD, left anterior descending
- LCX, left circumflex
- NR, normal resolution
- RCA, right coronary artery
- ROI, region of interest
- SD, standard deviation
- SHR, super-high resolution
- U-HRCT, ultra-high-resolution CT
- Ultra-high-resolution CT
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Affiliation(s)
- Wataru Fukumoto
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
- Corresponding author at: Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima 734-8551, Japan.
| | | | - Toru Higaki
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
| | - Fuminari Tatsugami
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
| | - Yuko Nakamura
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
| | - Luuk Oostveen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, the Netherlands
| | - Willemijn Klein
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, the Netherlands
| | - Mathias Prokop
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, the Netherlands
| | - Kazuo Awai
- Department of Diagnostic Radiology, Institute of Biomedical Health Sciences, Hiroshima University, Japan
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Sequerra EB, Rocha AJ, de Medeiros GOC, Neto MM, Maia CRS, Arrais NMR, Bezerra M, Jeronimo SMB, Barros AK, Sousa PS, Nogueira de Melo A, Queiroz CM. Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: A cross-sectional, observational study. EClinicalMedicine 2020; 26:100508. [PMID: 33089122 PMCID: PMC7565198 DOI: 10.1016/j.eclinm.2020.100508] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 07/30/2020] [Accepted: 07/30/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Intrauterine infection with the Zika virus (ZIKV) has been connected to severe brain malformations, microcephaly, and abnormal electrophysiological activity. METHODS We describe the interictal electroencephalographic (EEG) recordings of 47 children born with ZIKV-derived microcephaly. EEGs were recorded in the first year of life and correlated with brain morphology. In 31 subjects, we tested the association between computed tomography (CT) findings and interictal epileptiform discharges (IED). In eighteen, CTs were used for correlating volumetric measurements of the brainstem, cerebellum, and prosencephalon with the rate of IED. FINDINGS Twenty-nine out of 47 (62%) subjects were diagnosed as having epilepsy. Those subjects presented epileptiform discharges, including unilateral interictal spikes (26/29, 90%), bilateral synchronous and asynchronous interictal spikes (21/29, 72%), and hypsarrhythmia (12/29, 41%). Interestingly, 58% of subjects with clinical epilepsy were born with rhombencephalon malformations, while none of the subjects without epilepsy showed macroscopic abnormalities in this region. The presence of rhombencephalon malformation was associated with epilepsy (odds ratio of 34; 95% CI: 2 - 654). Also, the presence of IED was associated with smaller brain volumes. Age-corrected total brain volume was inversely correlated with the rate of IED during sleep. Finally, 11 of 44 (25%) subjects presented sleep spindles. We observed an odds ratio of 0·25 (95% CI: 0·06 - 1·04) for having sleep spindles given the IED presence. INTERPRETATION The findings suggest that certain CT imaging features are associated with an increased likelihood of developing epilepsy, including higher rates of IED and impaired development of sleep spindles, in the first year of life of CZVS subjects. FUNDING This work was supported by the Brazilian Federal Government through a postdoctoral fellowship for EBS (Talented Youth, Science without Borders), an undergraduate scholarship for AJR (Institutional Program of Science Initiation Scholarships, Federal University of Rio Grande do Norte, Brazil), by International Centre for Genetic Engineering and Biotechnology (CRP/BRA18-05_EC) and by CAPES (Grant number 440893/2016-0), and CNPq (Grant number 88881.130729/2016-01).
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Affiliation(s)
- Eduardo B Sequerra
- Brain Institute, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, Brazil
| | - Antonio J Rocha
- Brain Institute, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, Brazil
| | - Galtieri O C de Medeiros
- Imaging Diagnostic Center, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, Brazil
| | - Manuel M Neto
- Imaging Diagnostic Center, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, Brazil
| | - Claudia R S Maia
- Department of Pediatrics, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, Brazil
| | - Nívia M R Arrais
- Department of Pediatrics, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, Brazil
| | - Mylena Bezerra
- Department of Pediatrics, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, Brazil
| | - Selma M B Jeronimo
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, Brazil
- National Institute of Science and Technology of Tropical Diseases, Natal, RN, Brazil
| | - Allan Kardec Barros
- Department of Electrical Engineering, Federal University of Maranhão, 65080-040 São Luís, MA, Brazil
| | - Patrícia S Sousa
- Brain Institute, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, Brazil
- Department of Electrical Engineering, Federal University of Maranhão, 65080-040 São Luís, MA, Brazil
| | - Aurea Nogueira de Melo
- Department of Pediatrics, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, Brazil
| | - Claudio M Queiroz
- Brain Institute, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, Brazil
- Corresponding author.
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28
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Wang Z, He B, Liu Y, Huo M, Fu W, Yang C, Wei J, Abliz Z. In situ metabolomics in nephrotoxicity of aristolochic acids based on air flow-assisted desorption electrospray ionization mass spectrometry imaging. Acta Pharm Sin B 2020; 10:1083-1093. [PMID: 32642414 PMCID: PMC7332651 DOI: 10.1016/j.apsb.2019.12.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/11/2019] [Accepted: 11/21/2019] [Indexed: 12/29/2022] Open
Abstract
Understanding of the nephrotoxicity induced by drug candidates is vital to drug discovery and development. Herein, an in situ metabolomics method based on air flow-assisted desorption electrospray ionization mass spectrometry imaging (AFADESI-MSI) was established for direct analysis of metabolites in renal tissue sections. This method was subsequently applied to investigate spatially resolved metabolic profile changes in rat kidney after the administration of aristolochic acid I, a known nephrotoxic drug, aimed to discover metabolites associated with nephrotoxicity. As a result, 38 metabolites related to the arginine–creatinine metabolic pathway, the urea cycle, the serine synthesis pathway, metabolism of lipids, choline, histamine, lysine, and adenosine triphosphate were significantly changed in the group treated with aristolochic acid I. These metabolites exhibited a unique distribution in rat kidney and a good spatial match with histopathological renal lesions. This study provides new insights into the mechanisms underlying aristolochic acids nephrotoxicity and demonstrates that AFADESI-MSI-based in situ metabolomics is a promising technique for investigation of the molecular mechanism of drug toxicity.
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Key Words
- AA, aristolochic acids
- AAI, aristolochic acids I
- AAN, AA-induced nephrotoxicity
- AFADESI
- AFADESI, air flow-assisted desorption electrospray ionization
- ATP, adenosine triphosphate
- Aristolochic acid
- CPT1, xarnitine palmitoyltransferase 1
- DESI, desorption electrospray ionization
- DG, diglyceride
- GC, gas chromatograph
- H&E, hematoxylin and eosin
- HDL, high-density lipoprotein
- In situ metabolomics
- LC, liquid chromatography
- LDL, low-density lipoprotein
- MALDI, matrix-assisted laser desorption ionization
- MG, monoglyceride
- MS, mass spectrometry
- MSI, mass spectrometry imaging
- Mass spectrometry imaging
- Nephrotoxicity
- OPLS-DA, orthogonal projections to the latent structures' discriminant analysis
- PC, phosphatidylcholine
- PE, phosphatidylethanolamine
- PG, phosphatidylglycerol
- PS, phosphatidylserine
- ROI, region of interest
- RSD, relative standard deviation
- TG, triglyceride
- TIC, total ion current
- Ucr, urine creatinine
- Upr, urine protein
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29
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Fehrmann A, Garcia Borrega J, Holz J, Shapira N, Doerner J, Boell B, Maintz D, Hickethier T. Metastatic pulmonary calcification: First report of pulmonary calcium suppression using dual-energy CT. Radiol Case Rep 2020; 15:900-903. [PMID: 32395190 PMCID: PMC7203511 DOI: 10.1016/j.radcr.2020.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/05/2020] [Accepted: 04/07/2020] [Indexed: 12/14/2022] Open
Abstract
Metastatic pulmonary calcification is an underdiagnosed metabolic lung disease characterized by diffuse calcium deposition in the lungs, often associated with secondary hyperparathyroidism due to chronic renal failure. A 31-year-old man with chronic renal failure initially presented with diffuse pain symptoms, deterioration of general condition, and respiratory insufficiency. Noncontrast-enhanced computed tomography of the chest was performed using a spectral-detector-based dual-energy CT. It showed multiple, centrilobular, ground-glass opacities, and nodules, ultimately leading to the diagnosis. Calcium suppression proved to be highly useful to classify the pulmonary alterations.
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Affiliation(s)
- Ana Fehrmann
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany
| | - Jorge Garcia Borrega
- Department I of Internal Medicine, Intensive Care Unit, University Hospital of Cologne, Cologne, Germany
| | - Jasmin Holz
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany
| | - Nadav Shapira
- Philips Healthcare, Haifa, Israel.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jonas Doerner
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany
| | - Boris Boell
- Department I of Internal Medicine, Intensive Care Unit, University Hospital of Cologne, Cologne, Germany
| | - David Maintz
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany
| | - Tilman Hickethier
- Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany
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30
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Sauter AP, Shapira N, Kopp FK, Aichele J, Bodden J, Knipfer A, Rummeny EJ, Noël PB. CTPA with a conventional CT at 100 kVp vs. a spectral-detector CT at 120 kVp: Comparison of radiation exposure, diagnostic performance and image quality. Eur J Radiol Open 2020; 7:100234. [PMID: 32420413 PMCID: PMC7215101 DOI: 10.1016/j.ejro.2020.100234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/10/2020] [Accepted: 04/18/2020] [Indexed: 12/15/2022] Open
Abstract
With SD-CT, increased radiation exposure is not present. In the current study, CTDIvol was lower with SD-CT than with C-CT, even when 100 kVp was used for the latter. With SD-CT, higher levels of diagnostic performance and image quality can be achieved. SD-CT may be the system of choice due to the availability of spectral data and thus additional image information.
Purpose To compare CT pulmonary angiographies (CTPAs) as well as phantom scans obtained at 100 kVp with a conventional CT (C-CT) to virtual monochromatic images (VMI) obtained with a spectral detector CT (SD-CT) at equivalent dose levels as well as to compare the radiation exposure of both systems. Material and Methods In total, 2110 patients with suspected pulmonary embolism (PE) were examined with both systems. For each system (C-CT and SD-CT), imaging data of 30 patients with the same mean CT dose index (4.85 mGy) was used for the reader study. C-CT was performed with 100 kVp and SD-CT was performed with 120 kVp; for SD-CT, virtual monochromatic images (VMI) with 40, 60 and 70 keV were calculated. All datasets were evaluated by three blinded radiologists regarding image quality, diagnostic confidence and diagnostic performance (sensitivity, specificity). Contrast-to-noise ratio (CNR) for different iodine concentrations was evaluated in a phantom study. Results CNR was significantly higher with VMI at 40 keV compared to all other datasets. Subjective image quality as well as sensitivity and specificity showed the highest values with VMI at 60 keV and 70 keV. Hereby, a significant difference to 100 kVp (C-CT) was found for image quality. The highest sensitivity was found using VMI at 60 keV with a sensitivity of more than 97 % for all localizations of PE. For diagnostic confidence and subjective contrast, highest values were found with VMI at 40 keV. Conclusion Higher levels of diagnostic performance and image quality were achieved for CPTAs with SD-CT compared to C-CT given similar dose levels. In the clinical setting SD-CT may be the modality of choice as additional spectral information can be obtained.
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Key Words
- BMI, body mass index
- C-CT, conventional spiral CT
- CNR, contrast-to-noise ratio
- CT, computed tomography
- CTDIVOL, volume-weighted CT dose index
- CTPA, CT pulmonary angiography
- Computed tomography angiography
- DE-CT, dual-Energy CT
- DLP, dose length product
- DS-CT, dual-Source CT
- ED, effective dose
- HU, Hounsfield Units
- IQ, image quality
- PE, pulmonary embolism
- Patient safety
- Pulmonary embolism
- ROI, region of interest
- Radiation exposure
- Radiologic
- SD-CT, spectral-detector CT
- Technology
- VMI, virtual monochromatic images
- kVp, peak kilovoltage
- keV, kilo-electronvolt
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Affiliation(s)
- Andreas P Sauter
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Nadav Shapira
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.,Philips Healthcare, Haifa, Israel
| | - Felix K Kopp
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Juliane Aichele
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Jannis Bodden
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Andreas Knipfer
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Ernst J Rummeny
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Radiology, Munich, Germany
| | - Peter B Noël
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Radiology, Munich, Germany.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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Trudel G, Melkus G, Sheikh A, Ramsay T, Laneuville O. Marrow adipose tissue gradient is preserved through high protein diet and bed rest. A randomized crossover study. Bone Rep 2019; 11:100229. [PMID: 31799339 PMCID: PMC6883331 DOI: 10.1016/j.bonr.2019.100229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 10/21/2019] [Indexed: 12/17/2022] Open
Abstract
Context Marrow adipose tissue (MAT) has a peripheral to central distribution in adults, higher in peripheral bones. Similarly, the spine has a caudal to cephalad MAT distribution, higher in lumbar vertebras. Diet and the level of physical activities are known modulators of MAT with significant impact on bone; however, whether these can modulate the MAT gradient is unknown. Objective To measure the effect of high protein diet and bed rest interventions on the lumbar MAT gradient. Design participants intervention In a prospective randomized crossover trial, 10 healthy men participated in 2 consecutive campaigns of 21days head-down-tilt-bed-rest (HDTBR). They received either whey protein and potassium bicarbonate-supplemented or control diet separated by a 4-month washout period. Main outcome measures Ten serial MRI measures of lumbar vertebral fat fraction (VFF) were performed at baseline, 10days and 20days of HDTBR and 3 and 28days after HDTBR of each bed rest campaign. Results The mean L5-L1 VFF difference of 4.2 ± 1.2 percentage point higher at L5 (p = 0.008) constituted a caudal to cephalad lumbar MAT gradient. High protein diet did not alter the lumbar VFF differences during both HDTBR campaigns (all time points p > 0.05). Similarly, 2 campaigns of 21days of HDTBR did not change the lumbar VFF differences (all time points p > 0.05). Conclusions This pilot study established that the lumbar vertebral MAT gradient was not altered by a high protein nor by 2 × 21days bed rest interventions. These findings demonstrated that this lack of mechanical stimulus was not an important modulator of the lumbar MAT gradient. The highly preserved MAT gradient needs to be measured in more situations of health and disease and may potentially serve to detect pathological situations.
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Key Words
- BDC, baseline data collection
- Bed rest study
- DLR, German Aerospace Center
- FOV, field of view
- HDT, head-down tilt
- HDTBR, head-down-tilt-bed-rest
- IOP, in-phase and out-phase imaging
- Lumbar vertebral fat fraction
- MAT, marrow adipose tissue
- MEP, whey protein study
- MR, magnetic resonance
- Magnetic resonance imaging
- Marrow adipose tissue
- PDFF, proton-density fat fraction
- R, recovery
- ROI, region of interest
- TR, repetition time
- VFF, vertebral fat fraction
- Whey protein
- in-phase, echo time 1 (TE1)
- out-phase, echo time 2 (TE2)
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Affiliation(s)
- Guy Trudel
- Bone and Joint Research Laboratory, Department of Physical Medicine and Rehabilitation, Department of Medicine, Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ontario, Canada
| | - Gerd Melkus
- The Ottawa Hospital Research Institute, Ontario, Canada.,Department of Radiology, University of Ottawa, Ontario, Canada
| | - Adnan Sheikh
- The Ottawa Hospital Research Institute, Ontario, Canada.,Department of Radiology, University of Ottawa, Ontario, Canada
| | - Tim Ramsay
- The Ottawa Hospital Research Institute, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada
| | - Odette Laneuville
- Bone and Joint Research Laboratory, Department of Physical Medicine and Rehabilitation, Department of Medicine, Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ontario, Canada.,Department of Biology, Faculty of Science, University of Ottawa, Ontario, Canada
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Jerban S, Ma Y, Dorthe EW, Kakos L, Le N, Alenezi S, Sah RL, Chang EY, D'Lima D, Du J. Assessing cortical bone mechanical properties using collagen proton fraction from ultrashort echo time magnetization transfer (UTE-MT) MRI modeling. Bone Rep 2019; 11:100220. [PMID: 31440531 PMCID: PMC6700521 DOI: 10.1016/j.bonr.2019.100220] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/02/2019] [Indexed: 12/19/2022] Open
Abstract
Cortical bone shows as a signal void when using conventional clinical magnetic resonance imaging (MRI). Ultrashort echo time MRI (UTE-MRI) can acquire high signal from cortical bone, thus enabling quantitative assessments. Magnetization transfer (MT) imaging combined with UTE-MRI can indirectly assess protons in the organic matrix of bone. This study aimed to examine UTE-MT MRI techniques to estimate the mechanical properties of cortical bone. A total of 156 rectangular human cortical bone strips were harvested from the tibial and femoral midshafts of 43 donors (62 ± 22 years old, 62 specimens from females, 94 specimens from males). Bone specimens were scanned using UTE-MT sequences on a clinical 3 T MRI scanner and on a micro-computed tomography (μCT) scanner. A series of MT pulse saturation powers (400°, 600°, 800°) and frequency offsets (2, 5, 10, 20, 50 kHz) was used to measure the macromolecular fraction (MMF) utilizing a two-pool MT model. Failure mechanical properties of the bone specimens were measured using 4-point bending tests. MMF from MRI results showed significant strong correlations with cortical bone porosity (R = -0.72, P < 0.01) and bone mineral density (BMD) (R = +0.71, P < 0.01). MMF demonstrated significant moderate correlations with Young modulus, yield stress, and ultimate stress (R = 0.60-0.61, P < 0.01). These results suggest that the two-pool UTE-MT model focusing on the organic matrix of bone can potentially serve as a novel tool to detect the variations of bone mechanical properties and intracortical porosity.
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Key Words
- 3D, three-dimensional
- 3D-UTE, three-dimensional ultrashort echo time imaging
- BMD, bone mineral density
- Bone microstructure
- CT, computed tomography
- Cortical bone
- DEXA, dual-energy X-ray absorptiometry
- FA, flip angle
- FOV, field of view
- MMF, macromolecular proton fraction
- MR, magnetic resonance
- MRI
- MRI, magnetic resonance imaging
- MT, magnetization transfer
- Magnetization transfer
- Mechanical properties
- PBS, phosphate-buffered saline
- RF, radio frequency
- ROI, region of interest
- T2MM, macromolecular T2
- TE, echo time
- TR, repetition time
- Ultrashort echo time
- μCT, micro-computed tomography
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Erik W Dorthe
- Shiley Center for Orthopedic Research and Education at Scripps Clinic, La Jolla, CA 92037, USA
| | - Lena Kakos
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Nicole Le
- Radiology Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Salem Alenezi
- Research and Laboratories Sector, Saudi Food and Drug Authority, Riyadh 3292, Saudi Arabia
| | - Robert L Sah
- Department of Bioengineering, University of California, San Diego, CA 92093, USA.,Department of Orthopaedic Surgery, University of California, San Diego, CA 92093, USA
| | - Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, CA 92161, USA.,Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Darryl D'Lima
- Shiley Center for Orthopedic Research and Education at Scripps Clinic, La Jolla, CA 92037, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA 92093, USA
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Rydhög A, Pasternak O, Ståhlberg F, Ahlgren A, Knutsson L, Wirestam R. Estimation of diffusion, perfusion and fractional volumes using a multi-compartment relaxation-compensated intravoxel incoherent motion (IVIM) signal model. Eur J Radiol Open 2019; 6:198-205. [PMID: 31193664 PMCID: PMC6538803 DOI: 10.1016/j.ejro.2019.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/14/2019] [Indexed: 12/12/2022] Open
Abstract
Compartmental diffusion MRI models that account for intravoxel incoherent motion (IVIM) of blood perfusion allow for estimation of the fractional volume of the microvascular compartment. Conventional IVIM models are known to be biased by not accounting for partial volume effects caused by free water and cerebrospinal fluid (CSF), or for tissue-dependent relaxation effects. In this work, a three-compartment model (tissue, free water and blood) that includes relaxation terms is introduced. To estimate the model parameters, in vivo human data were collected with multiple echo times (TE), inversion times (TI) and b-values, which allowed a direct relaxation estimate alongside estimation of perfusion, diffusion and fractional volume parameters. Compared to conventional two-compartment models (with and without relaxation compensation), the three-compartment model showed less effects of CSF contamination. The proposed model yielded significantly different volume fractions of blood and tissue compared to the non-relaxation-compensated model, as well as to the conventional two-compartment model, suggesting that previously reported parameter ranges, using models that do not account for relaxation, should be reconsidered.
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Key Words
- CSF, cerebrospinal fluid
- Diffusion
- GM, grey matter
- IR, inversion recovery
- IVIM, intravoxel incoherent motion
- Intravoxel incoherent motion
- PVE, partial volume effect
- Perfusion fraction
- Pseudo-diffusion
- ROI, region of interest
- Relaxation
- SNR, signal-to-noise ratio
- T1, longitudinal relaxation time
- T2, transverse relaxation time
- TE, echo time
- TI, inversion time
- TR, repetition time
- WM, white matter
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Affiliation(s)
- Anna Rydhög
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Freddy Ståhlberg
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,Department of Diagnostic Radiology, Lund University, Lund, Sweden.,Lund University Bioimaging Center, Lund University, Lund, Sweden
| | - André Ahlgren
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ronnie Wirestam
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
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Wakefield CB, Yumol JL, Sacco SM, Sullivan PJ, Comelli EM, Ward WE. Bone structure is largely unchanged in growing male CD-1 mice fed lower levels of vitamin D and calcium than in the AIN-93G diet. Bone Rep 2019; 10:100191. [PMID: 30656199 PMCID: PMC6324019 DOI: 10.1016/j.bonr.2018.100191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/29/2018] [Accepted: 12/27/2018] [Indexed: 11/15/2022] Open
Abstract
Background Calcium (Ca) and vitamin D (vit D) in the AIN-93G diet may be higher than required for healthy bone development, and mask the potential benefit of a dietary intervention. Objective The objective was to determine if lower levels of Ca and vit D than is present in the AIN-93G diet supports bone development in growing male CD-1 mice. Methods Weanling male CD-1 mice were randomized to modified AIN-93G diets containing either 100 (Trial 1) or 400 (Trial 2) IU vit D/kg diet within one of two or three Ca levels (0.35, 0.30, or 0.25% Ca diet in Trial 1 or 0.35% or 0.25% in Trial 2) or the AIN-93G diet (1000 IU/kg vit D and 0.5% Ca) from weaning to 4 months of age (n = 13–15/group). At 2 and 4 months of age, BMD and structural properties of the tibia were analyzed in vivo. Structure of lumbar vertebra 4 (L4) and mandible, and femur strength were assessed ex vivo at age 4 months. Results There were no differences in tibia, L4, and mandible structure between the AIN-93G diet and the 0.35% Ca groups at either vit D level. A few structure outcomes were compromised with the 0.25 and/or 0.3% Ca diets but there were no differences in femur biomechanical strength compared to AIN-93G group in either Trial. Conclusion At 400 or 100 IU vit D/kg diet, Ca can be lowered to 0.35% without detriment to BMD or bone structure while bone strength is not altered at lower Ca (0.25%) compared to CD-1 mice fed AIN-93G diet. Because of genetic variation in CD-1 mice among different breeding facilities, results in CD-1 mice from other facilities may differ from the present study.
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Key Words
- AIN-93G
- BMD, bone mineral density
- BV/TV, percent bone volume
- Bone mineral density
- Bone structure
- Ca, calcium
- Calcium
- Conn.D, connectivity density
- Ct.Ar/Tt.Ar, cortical area fraction
- Ct.Th, cortical thickness
- DA, degree anisotropy
- Ec.Pm, endocortical perimeter
- Ecc., eccentricity
- L4, lumbar vertebra 4
- Ma.Ar, medullary area
- Ps.Pm, periosteal perimeter
- ROI, region of interest
- Rodent diet
- Tb.N, trabecular number
- Tb.Sp, trabecular separation
- Tb.Th, trabecular thickness
- Vitamin D
- vit D, vitamin D
- μCT, micro-computed tomography
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Affiliation(s)
| | - Jenalyn L. Yumol
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Sandra M. Sacco
- Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | | | - Elena M. Comelli
- Kinesiology, Brock University, St. Catharines, Ontario, Canada
- Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Ontario, Canada
| | - Wendy E. Ward
- Kinesiology, Brock University, St. Catharines, Ontario, Canada
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Corresponding author at: Department of Kinesiology, Faculty of Applied Health Science, Brock University, 1812 Sir Isaac Brock Way, St Catharines, Ontario L2S 3A1, Canada.
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Ozeki M, Asada R, Saito AM, Hashimoto H, Fujimura T, Kuroda T, Ueno S, Watanabe S, Nosaka S, Miyasaka M, Umezawa A, Matsuoka K, Maekawa T, Yamada Y, Fujino A, Hirakawa S, Furukawa T, Tajiri T, Kinoshita Y, Souzaki R, Fukao T. Efficacy and safety of sirolimus treatment for intractable lymphatic anomalies: A study protocol for an open-label, single-arm, multicenter, prospective study (SILA). Regen Ther 2019; 10:84-91. [PMID: 30705924 PMCID: PMC6348766 DOI: 10.1016/j.reth.2018.12.001] [Citation(s) in RCA: 20] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/22/2018] [Accepted: 12/06/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction Lymphatic anomalies (LAs) refer to a group of diseases involving systemic dysplasia of lymphatic vessels. These lesions are classified as cystic lymphatic malformation (macrocystic, microcystic or mixed), generalized lymphatic anomaly, and Gorham–Stout disease. LAs occur mainly in childhood, and present with various symptoms including chronic airway problems, recurrent infection, and organ disorders. Individuals with LAs often experience progressively worsening symptoms with a deteriorating quality of life. Although limited treatment options are available, their efficacy has not been validated in prospective clinical trials, and are usually based on case reports. Thus, there are no validated standards of care for these patients because of the lack of prospective clinical trials. Methods This open-label, single-arm, multicenter, prospective study will assess the efficacy and safety of a mammalian target of the rapamycin inhibitor sirolimus in the treatment of intractable LAs. Participants will receive oral sirolimus once a day for 52 weeks. The dose is adjusted so that the nadir concentration remains within 5–15 ng/ml. The primary endpoint is the response rate of radiological volumetric change of the target lesion confirmed by central review at 52 weeks after treatment. The secondary endpoints are the response rates at 12 and 24 weeks, respiratory function, pleural effusion, ascites, blood coagulation parameters, bleeding, pain, quality of life, activities of daily living, adverse events, side effects, laboratory examinations, vital signs, and pharmacokinetic data. Results This is among the first multicenter studies to evaluate sirolimus treatment for intractable LAs, and few studies to date have focused on the standard assessment of the efficacy for LAs treatment. Our protocol uses novel, uncomplicated methods for radiological assessment, with reference to the results of our previous retrospective survey and historical control data from the literature. Conclusions We propose a multicenter study to investigate the efficacy and safety of sirolimus for intractable LAs (SILA study; trial registration UMIN000028905). Our results will provide pivotal data to support the approval of sirolimus for the treatment of intractable LAs. This is among the first multicenter studies to evaluate sirolimus for intractable LAs. The study design is useful for evaluating sirolimus treatment in LAs. Our study protocol uses novel, uncomplicated methods of radiological assessment.
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Key Words
- ADL, activities of daily living
- BSA, body surface area
- DICOM, Digital Imaging and Communications in Medicine
- FACT-G, Functional Assessment of Cancer Therapy-General
- GLA, generalized lymphatic anomaly
- GSD, Gorham–Stout Disease
- Generalized lymphatic anomaly
- Gorham–Stout disease
- LAs, lymphatic anomalies
- LM, lymphatic malformation
- Lymphatic abnormalities
- Lymphatic malformation
- MRI, magnetic resonance imaging
- Mammalian target of rapamycin
- QOL, quality of life
- ROI, region of interest
- mTOR, mammalian target of rapamycin
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Affiliation(s)
- Michio Ozeki
- Department of Pediatrics, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan.,Clinical Research Center, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi 460-0001, Japan
| | - Ryuta Asada
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi 460-0001, Japan.,Innovative and Clinical Research Promotion Center, Graduate School of Medicine, Gifu University, 1-1, Yanagido, Gifu, Gifu 501-1194, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi 460-0001, Japan
| | - Hiroya Hashimoto
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi 460-0001, Japan
| | - Takumi Fujimura
- Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Shigeru Ueno
- Department of Pediatric Surgery, Tokai University School of Medicine, 4-1-1 Kitakaname, Hiratsuka, Kanagawa 259-1292, Japan
| | - Shoji Watanabe
- Department of Plastic Surgery, Saitama Children's Medical Center, 1-2 Shin-Toshin, Chuo-ku, Saitama 330-8777, Japan
| | - Shunsuke Nosaka
- Department of Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Mikiko Miyasaka
- Department of Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Akihiro Umezawa
- Department of Reproductive Biology and Pathology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Kentaro Matsuoka
- Department of Pathology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama 343-8555, Japan
| | - Takanobu Maekawa
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Yohei Yamada
- Division of Surgery, Department of Surgical Subspecialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Akihiro Fujino
- Division of Surgery, Department of Surgical Subspecialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Satoshi Hirakawa
- Department of Dermatology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan
| | - Taizo Furukawa
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tatsuro Tajiri
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yoshiaki Kinoshita
- Department of Pediatric Surgery, Niigata University Medical and Dental Hospital, 754-banchi, Asahi-machi-Dori 1-bancho, Chuo-ku, Niigata-shi, Niigata 951-8520, Japan
| | - Ryota Souzaki
- Department of Pediatric Surgery, Developmental Surgery & Intestinal Transplant Surgery, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Toshiyuki Fukao
- Department of Pediatrics, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan
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Higashigaito K, Hinzpeter R, Baumueller S, Benz D, Manka R, Keller DI, Alkadhi H, Morsbach F. Chest pain CT in the emergency department: Watch out for the myocardium. Eur J Radiol Open 2018; 5:202-208. [PMID: 30456219 PMCID: PMC6232643 DOI: 10.1016/j.ejro.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/21/2018] [Indexed: 12/31/2022] Open
Abstract
Hypodense myocardium (HM) can be observed often in chest pain CT examinations of patients presenting to the emergency department with chest pain. There is benefit when the myocardium is also analyzed for the presence of HM, even when the heart and coronary arteries were not specifically asked-for. Sensitivity, specificity, PPV and NPV for the detection of acute myocardial infarction by assessing HM was 52%, 100%, 100% and 95% respectively. Assessment of hypodense myocardium may increase the diagnostic confidence in ambiguous coronary findings in chest pain CT.
Rationale and Objectives To evaluate the frequency and relevance of hypodense myocardium (HM) encountered in patients undergoing chest-pain CT in the emergency department (ED). Material and Methods In this IRB-approved retrospective study, ECG-gated chest-pain CT examinations of 300 consecutive patients (mean age 60 ± 17 years) presenting with acute chest-pain to our ED were evaluated. Once ST-segment elevation infarction was excluded, chest-pain CT including the coronary arteries (rule-out acute coronary syndrome (ACS), pulmonary embolism (PE) and acute aortic syndrome (AAS): chest-pain CTcoronary, n = 121) or not including the coronary arteries was performed (rule-out PE and AAS: chest-pain CTw/o coronary, n = 179). Each myocardial segment was assessed for the presence of HM; attenuation was measured and compared to normal myocardium. Results HM was identified in 27/300 patients (9%): 12/179 in chest-pain CTw/o coronary (7%) and 15/121 in chest-pain CTcoronary (12%). Mean attenuation of HM (40 ± 17 HU) was significantly lower than that of healthy myocardium (103 ± 18 HU, p < 0.001), with a mean difference of 61 ± 19 HU. In 15/27 patients (55.6%) with HM, the final diagnosis was acute MI, and in the remaining 12/27 patients (44.4%) previous MI was found in the patients’ history. Chest-pain CTw/o coronary identified HM in 10/15 patients (66.6%) with a final diagnosis of acute MI. Conclusion HM indicating acute MI are often encountered in chest pain CT in the ED, also in chest-pain CTw/o coronary when MI is not suspected. This indicates that the myocardium should always be analyzed for hypodense regions even when MI not suspected.
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Key Words
- AAC/AHA, American College of Cardiology / American Heart Association
- AAS, acute aortic syndrome
- ACS, acute coronary syndrome
- Acute chest pain
- BPM, beats per minute
- CAD, coronary artery disease
- CI, confidence interval
- CT, computed tomography
- CX, circumflex artery
- Cardiac
- Computed tomography
- ECG, electrocardiography
- ED, emergency department
- Emergency department
- HU, hounsfield unit
- ICC, intraclass correlation coefficients
- LAD, left anterior descending artery
- MH, hypodense myocardium
- MI, myocardial infarction
- NPV, negative predictive value
- NSTEMI, non-ST elevation myocardial infarction
- PE, pulmonary embolism
- PPV, positive predictive value
- RCA, right coronary artery
- ROI, region of interest
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Affiliation(s)
- Kai Higashigaito
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Ricarda Hinzpeter
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Stephan Baumueller
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - David Benz
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Robert Manka
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland.,Department of Cardiology, University Hospital Zurich, University of Zurich, Switzerland.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Dagmar I Keller
- Institute for Emergency Medicine, University Hospital Zurich, University of Zurich, Switzerland
| | - Hatem Alkadhi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Fabian Morsbach
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
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Swerkersson S, Grundberg O, Kölbeck K, Carlberg A, Nyrén S, Skorpil M. Optimizing diffusion-weighted magnetic resonance imaging for evaluation of lung tumors: A comparison of respiratory triggered and free breathing techniques. Eur J Radiol Open 2018; 5:189-193. [PMID: 30450371 PMCID: PMC6222289 DOI: 10.1016/j.ejro.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/09/2018] [Accepted: 10/21/2018] [Indexed: 12/17/2022] Open
Abstract
Purpose The aim of this study was to compare respiratory-triggered (RT) and free breathing (FB) diffusion weighted imaging (DWI) techniques regarding apparent diffusion coefficient (ADC) measurements and repeatability in non-squamous non-small cell lung cancer (NSCLC) measuring the total tumor volume. Material and Methods A total of 57 magnetic resonance imaging (MRI) examinations were analyzed. DWI was obtained by a single-shot spin-echo echo-planar imaging sequence, and for each MRI examination 2 consecutive RT and 2 consecutive FB DWI sequences were performed. Two radiologists independently read the images and made measurements. For each tumor the mean ADC value of the whole tumor volume was calculated. The difference in mean ADCs between FB and RT DWI was evaluated using the paired-sample t-test. The repeatability of ADC measurements related to imaging method was evaluated by intra class correlations (ICC) for each of the FB and RT DWI pairs. Results There were no significant differences in mean ADCs between FB and RT (Reader 1 p = 0.346, Reader 2 p = 0.583). The overall repeatability of ADC measurement was good for both acquisition methods, with ICCs > 0.9. Subgroup analysis showed somewhat poorer repeatability in small tumors (50 ml or less) and tumors in the lower lung zones for the RT acquisition, with ICC as low as 0.72. Conclusions No difference in ADC measurement or repeatability between FB and RT DWI in whole lesion ADC measurements of adenocarcinomas in the lung was demonstrated. The results imply that in this setting the FB acquisition method is accurate and possibly more robust than the RT acquisition technique.
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Key Words
- ADC, apparent diffusion coefficient
- BH, breath-hold
- DWI, diffusion weighted imaging
- Diffusion weighted imaging
- FB, free breathing
- ICC, intra class correlations
- MRI, magnetic resonance imaging
- Magnetic resonance imaging
- NSCLC, non-squamous non-small cell lung cancer
- ROI, region of interest
- RT, respiratory-triggered
- SNR, signal-to-noise ratio
- non-Small cell lung cancer
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Affiliation(s)
- Signe Swerkersson
- Department of Radiology, St Göran’s Hospital, St Göransplan 1, 11281 Stockholm, Sweden
- Corresponding author.
| | - Oscar Grundberg
- Department of Respiratory Medicine & Allergology, Karolinska University Hospital, 17176 Solna, Sweden
| | - Karl Kölbeck
- Department of Respiratory Medicine & Allergology, Karolinska University Hospital, 17176 Solna, Sweden
| | - Andreas Carlberg
- Siemens Healthcare AB, Johanneslundsvägen 12, 194 61 Upplands Väsby, Sweden
| | - Sven Nyrén
- Department of Thoracic radiology, Karolinska University Hospital, 17176 Solna, Sweden
| | - Mikael Skorpil
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden
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Ashoor M, Khorshidi A, Sarkhosh L. Estimation of microvascular capillary physical parameters using MRI assuming a pseudo liquid drop as model of fluid exchange on the cellular level. Rep Pract Oncol Radiother 2019; 24:3-11. [PMID: 30337842 DOI: 10.1016/j.rpor.2018.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 04/30/2018] [Accepted: 09/06/2018] [Indexed: 11/20/2022] Open
Abstract
Aim One of the most important microvasculatures' geometrical variables is number of pores per capillary length that can be evaluated using MRI. The transportation of blood from inner to outer parts of the capillary is studied by the pores and the relationship among capillary wall thickness, size and the number of pores is examined. Background Characterization of capillary space may obtain much valuable information on the performance of tissues as well as the angiogenesis. Methods To estimate the number of pores, a new pseudo-liquid drop model along with appropriate quantitative physiological purposes has been investigated toward indicating a package of data on the capillary space. This model has utilized the MRI perfusion, diffusion and relaxivity parameters such as cerebral blood volume (CBV), apparent diffusion coefficient (ADC), ΔR 2 and Δ R 2 * values. To verify the model, a special protocol was designed and tested on various regions of eight male Wistar rats. Results The maximum number of pores per capillary length in the various conditions such as recovery, core, normal-recovery, and normal-core were found to be 183 ± 146, 176 ± 160, 275 ± 166, and 283 ± 143, respectively. This ratio in the normal regions was more than that of the damaged ones. The number of pores increased with increasing mean radius of the capillary and decreasing the thickness of the wall in the capillary space. Conclusion Determination of the number of capillary pore may most likely help to evaluate angiogenesis in the tissues and treatment planning of abnormal ones.
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Key Words
- 2DFT, two-dimensional Fourier transform
- ADC, apparent diffusion coefficient
- CBF, cerebral blood flow
- CBV, cerebral blood volume
- DWI, diffusion weighted imaging
- Diameter
- Diffusion MRI
- FLASH, fast low angle shot
- FOV, field of view
- MCA, middle cerebral artery
- MTT, mean transit time
- Microvasculature
- PWI, perfusion weighted imaging
- Pores
- Pseudo-liquid drop model
- RF, radio frequency
- ROI, region of interest
- TCL, total capillary length
- VSI, vessel size index
- Wistar rats
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Clements KN, Miller TH, Keever JM, Hall AM, Issa FA. Social Status-Related Differences in Motor Activity Between Wild-Type and Mutant Zebrafish. Biol Bull 2018; 235:71-82. [PMID: 30358446 DOI: 10.1086/699514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Use of zebrafish as a model organism in biomedical research has led to the generation of many genetically modified mutant lines to investigate various aspects of developmental and cellular processes. However, the broader effects of the underlying mutations on social and motor behavior remain poorly examined. Here, we compared the dynamics of social interactions in the Tüpfel long-fin nacre mutant line, which lacks skin pigmentation, to wild-type zebrafish; and we determined whether status-dependent differences in escape and swimming behavior existed within each strain. We show that despite similarities in aggressive activity, Tüpfel long-fin nacre pairs exhibit unstable social relationships characterized by frequent reversals in social dominance compared to wild-type pairs. The lack of strong dominance relationships in Tüpfel long-fin nacre pairs correlates with weak territoriality and overlapping spatial distribution of dominants and subordinates. Conversely, wild-type dominants displayed strong territoriality that severely limited the movement of subordinates. Additionally, the sensitivity of the startle escape response was significantly higher in wild-type subordinates compared to dominants. However, status-related differences in sensitivity of escape response in Tüpfel long-fin nacre pairs were absent. Finally, we present evidence suggesting that these differences could be a consequence of a disruption of proper visual social signals. We show that in wild-type pairs dominants are more conspicuous, and that in wild-type and Tüpfel long-fin nacre pairings wild-type fish are more likely to dominate Tüpfel long-fin nacres. Our results serve as a cautionary note in research design when morphologically engineered zebrafish for color differences are utilized in the study of social behavior and central nervous system function.
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Rebhun JF, Du Q, Hood M, Guo H, Glynn KM, Cen H, Scholten JD, Tian F, Gui M, Li M, Zhao Y. Evaluation of selected traditional Chinese medical extracts for bone mineral density maintenance: A mechanistic study. J Tradit Complement Med 2019; 9:227-35. [PMID: 31193882 DOI: 10.1016/j.jtcme.2017.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 07/25/2017] [Indexed: 01/02/2023] Open
Abstract
Objective To investigate the development of a minimal traditional Chinese medicine (TCM) formula using selected TCM ingredients and evaluating their biological activity with bone-specific in vitro tests. Finally, determining if the minimal formula can maintain bone mineral density (BMD) in a low bone mass (LBM)/osteoporosis (OP) model system. Methods and results Sixteen different TCM plant extracts were tested for estrogenic, osteogenic and osteoclastic activities. Despite robust activation of the full-length estrogen receptors α and β by Psoralea corylifolia and Epimedium brevicornu, these extracts do not activate the isolated estrogen ligand binding domains (LBD) of either ERα or ERβ; estrogen (17-β estradiol) fully activates the LBD of ERα and ERβ. E. brevicornu and Drynaria fortunei extracts activated cyclic AMP response elements (CRE) individually and when combined these ingredients stimulated the production of osteoblastic markers Runx2 and Bmp4 in MC3T3-E1 cells. E. brevicornu, Salvia miltiorrhiza, and Astragalus onobrychis extracts inhibited the Il-1β mediated activation of NF-κβ and an E. brevicornu/D. fortunei combination inhibited the development of osteoclasts from precursor cells. Further, a minimal formula containing the E. brevicornu/D. fortunei combination with or without a third ingredient (S. miltiorrhiza, Angelica sinensis, or Lycium barbarum) maintained bone mineral density (BMD) similar to an estradiol-treated control group in the ovariectomized rat; a model LBM/OP system. Conclusion A minimal formula consisting of TCM plant extracts that activate CRE and inhibit of NF-κβ activation, but do not behave like estrogen, maintain BMD in a LBM/OP model system.
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Key Words
- Anti-inflammatory
- BMD, bone mineral density
- BSA, bovine serum albumin
- Bmp4, bone morphogenic protein 4
- CRE, cyclic adenosine monophosphate response element
- CREB, cyclic adenosine monophosphate response element binding protein
- DEXA, dual-energy X-ray absorptiometry
- DMSO, Dimethyl sulfoxide
- Drynaria fortunei
- E2, estradiol
- ER, estrogen receptor
- ERE, estrogen response element
- Epimedium brevicornu
- Estrogenic
- FBS, fetal bovine serum
- Fsk, forskolin
- Hprt, hypoxanthine-guanine phosphoribosyl-transferase
- IL-1, interleukin 1
- LBD, ligand binding domain
- LBM, low bone mass
- M-CSF, macrophage colony-stimulating factor
- MAPK, mitogen activated protein kinase
- NF-κβ, nuclear factor kappa beta
- OP, osteoporosis
- Osteoporosis
- PTH, parathyroid hormone
- PTHrp, PTH related peptide
- RANKL, receptor activator of nuclear factor kappa beta ligand
- RLU, relative luminescence unit
- ROI, region of interest
- Runx2, runt-related transcription factor 2
- SFM, serum free media
- TCM, traditional Chinese medicine
- TNFα, tumor necrosis factor alpha
- TRAP, tartrate-resistant acid phosphatase
- UAS, upstream activating sequence
- cAMP, cyclic adenosine monophosphate
- qPCR, quantitative polymerase chain reaction
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Picchi E, Di Giuliano F, Ferrari D, Pistolese CA, Garaci F, Floris R. Pleural thymoma: Radiological and histological findings. Eur J Radiol Open 2018; 5:147-152. [PMID: 30191163 PMCID: PMC6125801 DOI: 10.1016/j.ejro.2018.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 08/12/2018] [Accepted: 08/12/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Eliseo Picchi
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Donatella Ferrari
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Francesco Garaci
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
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Hofmeier B, Wolpert S, Aldamer ES, Walter M, Thiericke J, Braun C, Zelle D, Rüttiger L, Klose U, Knipper M. Reduced sound-evoked and resting-state BOLD fMRI connectivity in tinnitus. Neuroimage Clin 2018; 20:637-649. [PMID: 30202725 PMCID: PMC6128096 DOI: 10.1016/j.nicl.2018.08.029] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 01/02/2023]
Abstract
The exact neurophysiological basis of chronic tinnitus, which affects 10-15% of the population, remains unknown and is controversial at many levels. It is an open question whether phantom sound perception results from increased central neural gain or not, a crucial question for any future therapeutic intervention strategies for tinnitus. We performed a comprehensive study of mild hearing-impaired participants with and without tinnitus, excluding participants with co-occurrences of hyperacusis. A right-hemisphere correlation between tinnitus loudness and auditory perceptual difficulty was observed in the tinnitus group, independent of differences in hearing thresholds. This correlation was linked to reduced and delayed sound-induced suprathreshold auditory brain responses (ABR wave V) in the tinnitus group, suggesting subsided rather than exaggerated central neural responsiveness. When anatomically predefined auditory regions of interest were analysed for altered sound-evoked BOLD fMRI activity, it became evident that subcortical and cortical auditory regions and regions involved in sound detection (posterior insula, hippocampus), responded with reduced BOLD activity in the tinnitus group, emphasizing reduced, rather than increased, central neural gain. Regarding previous findings of evoked BOLD activity being linked to positive connectivities at rest, we additionally analysed r-fcMRI responses in anatomically predefined auditory regions and regions associated with sound detection. A profound reduction in positive interhemispheric connections of homologous auditory brain regions and a decline in the positive connectivities between lower auditory brainstem regions and regions involved in sound detection (hippocampus, posterior insula) were observed in the tinnitus group. The finding went hand-in-hand with the emotional (amygdala, anterior insula) and temporofrontal/stress-regulating regions (prefrontal cortex, inferior frontal gyrus) that were no longer positively connected with auditory cortex regions in the tinnitus group but were instead positively connected to lower-level auditory brainstem regions. Delayed sound processing, reduced sound-evoked BOLD fMRI activity and altered r-fcMRI in the auditory midbrain correlated in the tinnitus group and showed right hemisphere dominance as did tinnitus loudness and perceptual difficulty. The findings suggest that reduced central neural gain in the auditory stream may lead to phantom perception through a failure to energize attentional/stress-regulating networks for contextualization of auditory-specific information. Reduced auditory-specific information flow in tinnitus has until now escaped detection in humans, as low-level auditory brain regions were previously omitted from neuroimaging studies. TRIAL REGISTRATION German Clinical Trials Register DRKS0006332.
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Key Words
- ABR wave
- ABR, auditory brainstem response
- BA, Brodmann area
- BA13A, anterior insula
- BA13P, posterior insula
- BA28, entorhinal cortex
- BB-chirp, broadband chirp
- BERA, brainstem-evoked response audiometry
- CN, cochlear nucleus
- CSF, cerebrospinal fluid
- Cortisol
- DL, dorsolateral
- EFR, envelope-followed responses
- ENT, ear, nose and throat
- FA, flip angle
- FDR, false discovery rate
- FOV, field of view
- FWHM, full width at half maximum
- G-H-S, Goebel-Hiller-Score
- HF-chirp, high-frequency chirp
- HPA, hypothalamic-pituitary-adrenal
- High-SR AF, high-spontaneous firing rates auditory fibers
- IC, inferior colliculus
- L, left
- LF-chirp, low-frequency chirp
- Low-SR AF, low-spontaneous firing rates auditory fibers
- M, medial
- MGB, medial geniculate body
- MNI, Montreal Neurological Institute
- PFC, prefrontal cortex
- PTA, pure tone audiogram
- R, right
- ROI, region of interest
- SD, standard deviation
- SOC, superior olivary complex
- SPL, sound pressure level
- SPM, Statistical Parametric Mapping
- TA, acquisition time
- TE, echo time
- TR, repetition time
- Tinnitus
- VBM, voxel-based morphometry
- fMRI
- r-fcMRI
- rCBF, resting-state cerebral blood flow
- rCBV, resting-state cerebral blood volume
- zFC, z-values functional connectivity
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Affiliation(s)
- Benedikt Hofmeier
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Stephan Wolpert
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Ebrahim Saad Aldamer
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Moritz Walter
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - John Thiericke
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany/HNO Ärzte Praxis Part GmbB, Aschaffenburg, Germany
| | - Christoph Braun
- MEG Center, University Hospital Tübingen, Otfried-Müller-Str. 47, D-72076 Tübingen, Germany
| | - Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Lukas Rüttiger
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, D-73076 Tübingen, Germany.
| | - Marlies Knipper
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany.
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Seif M, Curt A, Thompson AJ, Grabher P, Weiskopf N, Freund P. Quantitative MRI of rostral spinal cord and brain regions is predictive of functional recovery in acute spinal cord injury. Neuroimage Clin 2018; 20:556-563. [PMID: 30175042 PMCID: PMC6115607 DOI: 10.1016/j.nicl.2018.08.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/11/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
Abstract
Objective To reveal the immediate extent of trauma-induced neurodegenerative changes rostral to the level of lesion and determine the predictive clinical value of quantitative MRI (qMRI) following acute spinal cord injury (SCI). Methods Twenty-four acute SCI patients and 23 healthy controls underwent a high-resolution T1-weighted protocol. Eighteen of those patients and 20 of controls additionally underwent a multi-parameter mapping (MPM) MRI protocol sensitive to the content of tissue structure, including myelin and iron. Patients were examined clinically at baseline, 2, 6, 12, and 24 months post-SCI. We assessed volume and microstructural changes in the spinal cord and brain using T1-weighted MRI, magnetization transfer (MT), longitudinal relaxation rate (R1), and effective transverse relaxation rate (R2*) maps. Regression analysis determined associations between acute qMRI parameters and recovery. Results At baseline, cord area and its anterior-posterior width were decreased in patients, whereas MT, R1, and R2* parameters remained unchanged in the cord. Within the cerebellum, volume decrease was paralleled by increases of MT and R2* parameters. Early grey matter changes were observed within the primary motor cortex and limbic system. Importantly, early volume and microstructural changes of the cord and cerebellum predicted functional recovery following injury. Conclusions Neurodegenerative changes rostral to the level of lesion occur early in SCI, with varying temporal and spatial dynamics. Early qMRI markers of spinal cord and cerebellum are predictive of functional recovery. These neuroimaging biomarkers may supplement clinical assessments and provide insights into the potential of therapeutic interventions to enhance neural plasticity.
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Key Words
- APW, anterior posterior width
- Acute micro-structural changes
- Brain and spinal cord atrophy
- ISNCSCI, international standards for the neurological classification of spinal cord injury
- LRW, left right width
- MPM, multi-parameter mapping
- MT, magnetization transfer
- PD*, effective proton density
- Quantitative neuroimaging
- R1, longitudinal relaxation rate
- R2*, effective transverse relaxation rate
- ROI, region of interest
- SCA, spinal cord area
- SCI, spinal cord injury
- SCIM, spinal cord independence measure
- Spinal cord injury
- VBCT, voxel based cortical thickness
- VBM, voxel based morphometry
- VBQ, voxel based quantification
- Voxel-based morphometry and quantification
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Affiliation(s)
- Maryam Seif
- Spinal Cord Injury Center Balgrist, University of Zurich, Switzerland; Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Armin Curt
- Spinal Cord Injury Center Balgrist, University of Zurich, Switzerland
| | - Alan J Thompson
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK
| | - Patrick Grabher
- Spinal Cord Injury Center Balgrist, University of Zurich, Switzerland
| | - Nikolaus Weiskopf
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, UK
| | - Patrick Freund
- Spinal Cord Injury Center Balgrist, University of Zurich, Switzerland; Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK; Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, UK.
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Ogren JA, Tripathi R, Macey PM, Kumar R, Stern JM, Eliashiv DS, Allen LA, Diehl B, Engel J, Rani MRS, Lhatoo SD, Harper RM. Regional cortical thickness changes accompanying generalized tonic-clonic seizures. Neuroimage Clin 2018; 20:205-215. [PMID: 30094170 PMCID: PMC6073085 DOI: 10.1016/j.nicl.2018.07.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/27/2018] [Accepted: 07/15/2018] [Indexed: 12/12/2022]
Abstract
Objective Generalized tonic-clonic seizures are accompanied by cardiovascular and respiratory sequelae that threaten survival. The frequency of these seizures is a major risk factor for sudden unexpected death in epilepsy (SUDEP), a leading cause of untimely death in epilepsy. The circumstances accompanying such fatal events suggest a cardiovascular or respiratory failure induced by unknown neural processes rather than an inherent cardiac or lung deficiency. Certain cortical regions, especially the insular, cingulate, and orbitofrontal cortices, are key structures that integrate sensory input and influence diencephalic and brainstem regions regulating blood pressure, cardiac rhythm, and respiration; output from those cortical regions compromised by epilepsy-associated injury may lead to cardiorespiratory dysregulation. The aim here was to assess changes in cortical integrity, reflected as cortical thickness, relative to healthy controls. Cortical alterations in areas that influence cardiorespiratory action could contribute to SUDEP mechanisms. Methods High-resolution T1-weighted images were collected with a 3.0-Tesla MRI scanner from 53 patients with generalized tonic-clonic seizures (Mean age ± SD: 37.1 ± 12.6 years, 22 male) at Case Western Reserve University, University College London, and the University of California at Los Angeles. Control data included 530 healthy individuals (37.1 ± 12.6 years; 220 male) from UCLA and two open access databases (OASIS and IXI). Cortical thickness group differences were assessed at all non-cerebellar brain surface locations (P < 0.05 corrected). Results Increased cortical thickness appeared in post-central gyri, insula, and subgenual, anterior, posterior, and isthmus cingulate cortices. Post-central gyri increases were greater in females, while males showed more extensive cingulate increases. Frontal and temporal cortex, lateral orbitofrontal, frontal pole, and lateral parietal and occipital cortices showed thinning. The extents of thickness changes were sex- and hemisphere-dependent, with only males exhibiting right-sided and posterior cingulate thickening, while females showed only left lateral orbitofrontal thinning. Regional cortical thickness showed modest correlations with seizure frequency, but not epilepsy duration. Significance Cortical thickening and thinning occur in patients with generalized tonic-clonic seizures, in cardiovascular and somatosensory areas, with extent of changes sex- and hemisphere-dependent. The data show injury in key autonomic and respiratory cortical areas, which may contribute to dysfunctional cardiorespiratory patterns during seizures, as well as to longer-term SUDEP risk.
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Affiliation(s)
- Jennifer A Ogren
- Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Raghav Tripathi
- Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Paul M Macey
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Rajesh Kumar
- Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA; Department of Anesthesiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Department of Radiological Sciences, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - John M Stern
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Dawn S Eliashiv
- Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | - Luke A Allen
- Institute of Neurology, University College London, London, United Kingdom
| | - Beate Diehl
- Institute of Neurology, University College London, London, United Kingdom
| | - Jerome Engel
- Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA; Department of Neurology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA
| | | | | | - Ronald M Harper
- Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA.
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Kong Z, Yan C, Zhu R, Wang J, Wang Y, Wang Y, Wang R, Feng F, Ma W. Imaging biomarkers guided anti-angiogenic therapy for malignant gliomas. Neuroimage Clin 2018; 20:51-60. [PMID: 30069427 PMCID: PMC6067083 DOI: 10.1016/j.nicl.2018.07.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 03/13/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 12/24/2022]
Abstract
Antiangiogenic therapy is a universal approach to the treatment of malignant gliomas but fails to prolong the overall survival of newly diagnosed or recurrent glioblastoma patients. Imaging biomarkers are quantitative imaging parameters capable of objectively describing biological processes, pathological changes and treatment responses in some situations and have been utilized for outcome predictions of malignant gliomas in anti-angiogenic therapy. Advanced magnetic resonance imaging techniques (including perfusion-weighted imaging and diffusion-weighted imaging), positron emission computed tomography and magnetic resonance spectroscopy are imaging techniques that can be used to acquire imaging biomarkers, including the relative cerebral blood volume (rCBV), Ktrans, and the apparent diffusion coefficient (ADC). Imaging indicators for a better prognosis when treating malignant gliomas with antiangiogenic therapy include the following: a lower pre- or post-treatment rCBV, less change in rCBV during treatment, a lower pre-treatment Ktrans, a higher vascular normalization index during treatment, less change in arterio-venous overlap during treatment, lower pre-treatment ADC values for the lower peak, smaller ADC volume changes during treatment, and metabolic changes in glucose and phenylalanine. The investigation and utilization of these imaging markers may confront challenges, but may also promote further development of anti-angiogenic therapy. Despite considerable evidence, future prospective studies are critically needed to consolidate the current data and identify novel biomarkers. Anti-angiogenic therapy only benefits specific populations of glioma patients. Advanced imaging techniques can produce quantitative imaging biomarkers. Physiological and metabolic parameter can predict outcome for anti-angiogenic therapy. Larger prospective studies are needed to provide further evidence.
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Key Words
- 18F-FDOPA, 3,4-dihydroxy-6-[18F]-fluoro-l-phenylalanine
- 18F-FLT, [18F]-fluoro-3-deoxy-3-L-fluorothymidine
- ADC, apparent diffusion coefficient
- AVOL, arterio-venous overlap
- Anti-angiogenic
- BBB, blood brain barrier
- Biomarkers
- CBF, cerebral blood flow
- CBV, cerebral blood volume
- CNS, central nervous system
- CT, computed tomography
- D-2HG, D-2-hydroxypentanedioic acid
- DCE-MRI, dynamic contrast-enhanced magnetic resonance imaging
- DSC-MRI, dynamic susceptibility contrast magnetic resonance imaging
- DWI, diffusion-weighted imaging
- FDG, fluorodeoxyglucose
- FLAIR, fluid-attenuated inversion recovery
- FSE pcASL, fast spin echo pseudocontinuous artery spin labeling
- GBM, glioblastoma
- Glioma
- Imaging
- Ktrans, volume transfer constant between blood plasma and extravascular extracellular space
- MRI, magnetic resonance imaging
- MRS, magnetic resonance spectroscopy
- OS, overall survival
- PET, positron emission computed tomography
- PFS, progression-free survival
- PWI, perfusion-weighted imaging
- RANO, Response Assessment in Neuro-Oncology
- ROI, region of interest
- RSI, restriction spectrum imaging
- SUV, standardized uptake value
- TMZ, temozolomide
- Therapy
- VAI, vessel architectural imaging
- VEGF-A, vascular endothelial growth factor A
- VNI, vascular normalization index.
- fDMs, functional diffusion maps
- nGBM, newly diagnosed glioblastoma
- rCBF, relative cerebral blood flow
- rCBV, relative cerebral blood volume
- rGBM, recurrent glioblastoma
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Affiliation(s)
- Ziren Kong
- Department of Neurosurgery, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Chengrui Yan
- Department of Neurosurgery, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China; Department of Neurosurgery, Peking University International Hospital, Peking University, Beijing, China
| | - Ruizhe Zhu
- Department of Neurosurgery, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Jiaru Wang
- Department of Neurosurgery, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Yaning Wang
- Department of Neurosurgery, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Yu Wang
- Department of Neurosurgery, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.
| | - Renzhi Wang
- Department of Neurosurgery, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.
| | - Feng Feng
- Department of Radiology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China..
| | - Wenbin Ma
- Department of Neurosurgery, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.
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Spray A, Beer AL, Bentall RP, Sluming V, Meyer G. Microstructure of the superior temporal gyrus and hallucination proneness - a multi-compartment diffusion imaging study. Neuroimage Clin 2018; 20:1-6. [PMID: 29988951 PMCID: PMC6034584 DOI: 10.1016/j.nicl.2018.06.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 04/07/2018] [Revised: 06/21/2018] [Accepted: 06/24/2018] [Indexed: 01/16/2023]
Abstract
Previous studies reported that the volume of the left superior temporal gyrus (STG) is reduced in patients with schizophrenia and negatively correlated with hallucination severity. Moreover, diffusion-tensor imaging studies suggested a relationship between the brain microstructure in the STG of patients and auditory hallucinations. Hallucinations are also experienced in non-patient groups. This study investigated the relationship between hallucination proneness and the brain structure of the STG. Hallucination proneness was assessed by the Launey Slade Hallucination Scale (LSHS) in 25 healthy individuals who varied in their propensity to hear voices. Brain volume and microstructure of the STG was assessed by magnetic resonance imaging (MRI). Microstructure was examined by conventional diffusion-tensor imaging as well as by neurite orientation dispersion and density imaging (NODDI). The latter decomposes diffusion-based MRI into multiple compartments that characterize the brain microstructure by its neurite complexity known as orientation dispersion (ODI) and by its neurite density (NDI). Hallucination proneness was negatively correlated with the volume and microstructure (fractional anisotropy, neurite complexity) of the left but not the right STG. The strongest relationship (r = −0.563) was observed for neurite complexity (ODI). No correlation was observed for neurite density (NDI). These findings suggest that there is a relationship between the volume and the microstructure of the left STG and hallucination proneness. Dendritic complexity (but not neurite density) is inversely related to hallucination proneness. Metrics based on multi-compartment diffusion models seem to be more sensitive for hallucination-related neural processes than conventional MRI-based metrics. Hallucination proneness is predicted by structural characteristics of left STG Hallucination proneness negatively correlates with left STG volume Hallucination proneness negatively correlates with left STG fractional anisotropy Hallucination proneness negatively correlates with left STG orientation dispersion Reduced functional integration may be due to reduced dendritic complexity of neurons
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Key Words
- AVH, auditory verbal hallucination
- CVH, clinical voice hearer
- DTI, diffusion-tensor imaging
- DWI, diffusion-weighted imaging
- Diffusion MRI
- FA, fractional anisotropy
- HVH, healthy voice hearer
- Hallucination
- LSHS
- LSHS, Launey Slade Hallucination Scale
- MD, mean diffusivity
- MRI, magnetic resonance imaging
- NDI, neurite density index
- NODDI
- NODDI, neurite orientation dispersion and density imaging
- ODI, orientation dispersion index
- ROI, region of interest
- STG, superior temporal gyrus
- Schizophrenia
- Superior temporal gyrus
- fMRI, functional magnetic resonance imaging
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Affiliation(s)
- Amy Spray
- University of Liverpool, Liverpool, UK.
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Hennawy B, El Kilany W, Galal H, Mamdouh A. Role of speckle tracking echocardiography in detecting early left atrial dysfunction in hypertensive patients. Egypt Heart J 2018; 70:217-223. [PMID: 30190649 PMCID: PMC6123346 DOI: 10.1016/j.ehj.2018.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/21/2018] [Indexed: 12/03/2022] Open
Abstract
Background Arterial hypertension adversely affects left atrial (LA) size and function, effect on function may precede effect on size. Many techniques were used to assess LA function but with pitfalls. Objectives Early detection of left atrial dysfunction with speckle tracking echocardiography in hypertensive patients with normal left atrial size. Patients and methods The study was conducted on 50 hypertensive patients and 50 age matched normotensive controls, all with normal LA volume index and free from any other cardiovascular disease that may affect the LA size or function. They were all subjected to history taking, clinical examination and echocardiographic study with assessment of LA functions [total LA stroke volume, LA expansion index by conventional 2D echocardiography and Global peak atrial longitudinal strain by speckle tracking (PALS)], left ventricular (LV) systolic and diastolic functions, and LV mass. Results Different indices of LA dysfunction (Total LA stroke volume, LA expansion index and global PALS) were significantly lower in the hypertensive group despite the normal LA volume index in all the studied subjects. The presence of diabetes mellitus (DM) and higher grade of LV diastolic dysfunction were significantly associated with lower global PALS. The higher age, systolic blood pressure (BP), body mass index (BMI), LA volume index, and LV mass index and the lower LA expansion index were associated with lower global PALS. Conclusion Speckle tracking echocardiography is a useful novel technique in detecting LA dysfunction in hypertension even before LA enlargement occurs.
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Key Words
- BMI, body mass index
- BP, blood pressure
- DM, diabetes mellitus
- HR, heart rate
- Hypertension
- LA, left atrium
- LASV, LA stroke volume
- LV, left ventricle
- Left atrial dysfunction
- Left atrium
- PALS, peak atrial longitudinal strain
- ROI, region of interest
- STE, speckle-tracking echocardiography
- Speckle tracking
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Affiliation(s)
- Bassam Hennawy
- Cardiology Department, Ain Shams University Hospital, Cairo, Egypt
| | - Wael El Kilany
- Cardiology Department, Ain Shams University Hospital, Cairo, Egypt
| | - Haitham Galal
- Cardiology Department, Ain Shams University Hospital, Cairo, Egypt
| | - Ahmed Mamdouh
- Cardiology Department, Ain Shams University Hospital, Cairo, Egypt
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Faber I, Martinez ARM, de Rezende TJR, Martins CR, Martins MP, Lourenço CM, Marques W, Montecchiani C, Orlacchio A, Pedroso JL, Barsottini OGP, Lopes-Cendes Í, França MC. SPG11 mutations cause widespread white matter and basal ganglia abnormalities, but restricted cortical damage. Neuroimage Clin 2018; 19:848-857. [PMID: 29946510 PMCID: PMC6008284 DOI: 10.1016/j.nicl.2018.05.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 05/20/2018] [Accepted: 05/22/2018] [Indexed: 12/12/2022]
Abstract
SPG11 mutations are the major cause of autosomal recessive Hereditary Spastic Paraplegia. The disease has a wide phenotypic variability indicating many regions of the nervous system besides the corticospinal tract are affected. Despite this, anatomical and phenotypic characterization is restricted. In the present study, we investigate the anatomical abnormalities related to SPG11 mutations and how they relate to clinical and cognitive measures. Moreover, we aim to depict how the disease course influences the regions affected, unraveling different susceptibility of specific neuronal populations. We performed clinical and paraclinical studies encompassing neuropsychological, neuroimaging, and neurophysiological tools in a cohort of twenty-five patients and age matched controls. We assessed cortical thickness (FreeSurfer software), deep grey matter volumes (T1-MultiAtlas tool), white matter microstructural damage (DTI-MultiAtlas) and spinal cord morphometry (Spineseg software) on a 3 T MRI scan. Mean age and disease duration were 29 and 13.2 years respectively. Sixty-four percent of the patients were wheelchair bound while 84% were demented. We were able to unfold a diffuse pattern of white matter integrity loss as well as basal ganglia and spinal cord atrophy. Such findings contrasted with a restricted pattern of cortical thinning (motor, limbic and parietal cortices). Electromyography revealed motor neuronopathy affecting 96% of the probands. Correlations with disease duration pointed towards a progressive degeneration of multiple grey matter structures and spinal cord, but not of the white matter. SPG11-related hereditary spastic paraplegia is characterized by selective neuronal vulnerability, in which a precocious and widespread white matter involvement is later followed by a restricted but clearly progressive grey matter degeneration.
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Key Words
- ACE-R, Addenbrooke's Cognitive Examination Revised
- ALS, amyotrophic lateral sclerosis
- CA, cord area
- CE, cord eccentricity
- CMAP, compound muscle action potential
- CST, corticospinal tract
- Complicated hereditary spastic paraplegia
- DTI, diffusion tensor imaging
- FA, fractional anisotropy
- GM, grey matter
- Grey matter
- HSP, hereditary spastic paraplegia
- LH, left hemisphere
- MD, mean diffusivity
- MOCA, Montreal cognitive assessment
- Motor neuron disorder
- NPI, neuropsychiatric inventory
- PNP, sensory-motor polyneuropathy
- PNS, peripheral nervous system
- RH, right hemisphere
- ROI, region of interest
- SC, spinal cord
- SNAP, sensory nerve action potential
- SPG11
- SPRS, Spastic Paraplegia Rating Scale
- STS, cortex adjacent to the superior temporal sulcus
- Spinal cord
- Thinning of the corpus callosum
- WES, whole exome sequencing
- WM, white matter
- White matter
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Affiliation(s)
- Ingrid Faber
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | | | | | | | | | - Wilson Marques
- Department of Neurology, University of São Paulo (USP-RP), Ribeirão Preto, Brazil
| | - Celeste Montecchiani
- Laboratorio di Neurogenetica, Centro Europeo di Ricerca sul Cervello (CERC) - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia, Rome, Italy
| | - Antonio Orlacchio
- Laboratorio di Neurogenetica, Centro Europeo di Ricerca sul Cervello (CERC) - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia, Rome, Italy; Dipartimento di Scienze Chirurgiche e Biomediche, Università di Perugia, Perugia, Italy
| | - Jose Luiz Pedroso
- Department of Neurology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Íscia Lopes-Cendes
- Department of Medical Genetics, University of Campinas (UNICAMP), Campinas, Brazil
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Berman BD, Honce JM, Shelton E, Sillau SH, Nagae LM. Isolated focal dystonia phenotypes are associated with distinct patterns of altered microstructure. Neuroimage Clin 2018; 19:805-12. [PMID: 30013924 DOI: 10.1016/j.nicl.2018.06.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/17/2018] [Accepted: 06/03/2018] [Indexed: 01/21/2023]
Abstract
Objective Isolated adult-onset focal dystonia is considered a network disorder with disturbances to the motor basal ganglia and cerebellar circuits playing a pathophysiological role, but why specific body regions become affected remains unknown. We aimed to use diffusion tensor imaging to determine if the two most common phenotypes of focal dystonia are associated with distinguishing microstructural changes affecting the motor network. Methods Fifteen blepharospasm patients, 20 cervical dystonia patients, and 30 age- and sex-matched healthy controls were recruited. Maps of fractional anisotropy and mean diffusivity were analyzed using a voxel-based approach and an automated region-of-interest technique to evaluate deep gray matter nuclei. Correlations between diffusion measures and dystonia severity were tested, and post hoc discriminant analyses were conducted. Results Voxel-based analyses revealed significantly reduced fractional anisotropy in the right cerebellum and increased mean diffusivity in the left caudate of cervical dystonia patients compared to controls, as well as lower fractional anisotropy in the right cerebellum in cervical dystonia patients relative to blepharospasm patients. In addition to reduced fractional anisotropy in the bilateral caudate nucleus of cervical dystonia patients relative to controls and blepharospasm patients, region-of-interest analyses revealed significantly reduced fractional anisotropy in the right globus pallidus internus and left red nucleus of blepharospasm patients compared to both controls and cervical dystonia patients. Diffusivity measures in the red nucleus of blepharospasm patients correlated with disease severity. In a three-group discriminant analysis, participants were correctly classified with only modest reliability (67-75%), but in a two-group discriminant analysis, patients could be distinguished from each other with high reliability (83-100%). Conclusions Different focal dystonia phenotypes are associated with distinct patterns of altered microstructure within constituent regions of basal ganglia and cerebellar circuits.
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Key Words
- BSP, blepharospasm
- Basal ganglia
- Blepharospasm
- CD, cervical dystonia
- Cerebellum
- Cervical dystonia
- DTI, diffusion tensor imaging
- Diffusion tensor imaging
- FA, fractional anisotropy
- HC, healthy control
- JRS, Jankovic Rating Scale
- MD, mean diffusivity
- MNI, Montreal Neurological Institute
- ROI, region of interest
- TWSTRS, Toronto Western Spasmodic Torticollis Rating Scale
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Yumol JL, Wakefield CB, Sacco SM, Sullivan PJ, Comelli EM, Ward WE. Bone development in growing female mice fed calcium and vitamin D at lower levels than is present in the AIN-93G reference diet. Bone Rep 2018; 8:229-38. [PMID: 29955642 DOI: 10.1016/j.bonr.2018.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/09/2018] [Accepted: 05/17/2018] [Indexed: 12/31/2022] Open
Abstract
Background The AIN-93G reference (REF) diet is used to allow the comparison within and between studies of different research groups but its levels of vitamin D (vit D) and calcium (Ca) may be higher than required for healthy bone structure and bone mineral density (BMD). Objective To determine if lower dietary levels of Ca (3.5, 3 or 2.5 g Ca/kg diet) at 1 of 2 levels of vit D (100 or 400 IU/kg diet) supports similar development of bone structure and BMD compared to AIN-93G reference (REF) diet in female CD-1 mice at 2 and 4 months of age. Methods Within a trial, weanling female mice (n = 12–15/group) were randomized to 1 of 4 diets until necropsy at 4 months of age: Trial 1: 100 IU vit D/kg + 3.5, 3 or 2.5 g Ca/kg diet or 1000 IU vit D/kg + 5 g Ca/kg diet (REF); and Trial 2: 400 IU vit D/kg + 3.5, 3 or 2.5 g Ca/kg diet or 1000 IU vit D/kg + 5 g/kg diet (REF). At age 2 and 4 months, in vivo bone structure and BMD were assessed using micro-computed tomography (μCT) at the proximal and midpoint tibia. At age 4 months, lumbar vertebra 4 (L4) and mandible structure were analyzed ex vivo, femur strength at midpoint and neck was assessed and serum 25(OH)D3 and PTH were quantified. Results For Trial 1 (100 IU vit D/kg), there were no differences in tibia structure at age 2 and 4 months nor L4 or mandible structure or femur strength at the midpoint or neck at 4 months of age despite lower serum 25(OH)D3 among all groups compared to REF. For Trial 2 (400 IU vit D/kg), mice fed 2.5 g Ca/kg diet had lower (p < 0.05) Ct.Ar/Tt.Ar and Ct.Th at the tibia midpoint compared to REF. Furthermore, Ct.Th. was greater in REF and 3.5 g Ca/kg diet compared to 2.5 g Ca/kg diet at age 2 but not 4 months of age. At L4, BV/TV was lower (p < 0.05) in the 3 g Ca/kg diet group compared to REF at age 4 months. There were no differences among groups for serum 25(OH)D3 or femur strength at the midpoint or neck. Serum PTH was not elevated compared to REF in either Trial. Conclusion Lowering both dietary vit D (100 IU/kg) and Ca (2.5 g/kg) in AIN-93G diet did not result in differences in bone development of female CD-1 mice at early adulthood. Translational relevance of bone studies conducted using the AIN-93G diet may be affected by its high vit D and Ca content.
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Key Words
- AIN93G
- ANOVA, analysis of variance
- BMC, bone mineral content
- BMD, bone mineral density
- BV/TV, percent bone volume
- Bone mineral density
- Bone structure
- Ca, calcium
- Calcium
- Conn.Dn, connectivity density
- Ct.Ar/Tt.Ar, cortical area fraction
- Ct.Th, cortical thickness
- DA, degree anisotropy
- Ec.Pm, endocortical perimeter
- Ecc, mean eccentricity
- ISO, isoflavones
- L4, lumbar vertebrae 4
- Ma.Ar, medullary area
- Micro-computed tomography
- P, phosphorus
- PBM, peak bone mass
- PTH, parathyroid hormone
- Ps.Pm, periosteum perimeter
- REF, AIN-93G reference diet
- ROI, region of interest
- SEM, standard error mean
- Tb.N, trabecular number
- Tb.Sp, trabecular separation
- Tb.Th, trabecular thickness
- Vitamin D
- vit D, vitamin D
- μCT, micro computed tomography
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