Comparison of weighting algorithms to mitigate respiratory motion in free-breathing neonatal pulmonary radial UTE-MRI

Background. Thoracoabdominal MRI is limited by respiratory motion, especially in populations who cannot perform breath-holds. One approach for reducing motion blurring in radially-acquired MRI is respiratory gating. Straightforward 'hard-gating' uses only data from a specified respiratory window and suffers from reduced SNR. Proposed 'soft-gating' reconstructions may improve scan efficiency but reduce motion correction by incorporating data with nonzero weight acquired outside the specified window. However, previous studies report conflicting benefits, and importantly the choice of soft-gated weighting algorithm and effect on image quality has not previously been explored. The purpose of this study is to map how variable soft-gated weighting functions and parameters affect signal and motion blurring in respiratory-gated reconstructions of radial lung MRI, using neonates as a model population.Methods. Ten neonatal inpatients with respiratory abnormalities were imaged using a 1.5 T neonatal-sized scanner and 3D radial ultrashort echo-time (UTE) sequence. Images were reconstructed using ungated, hard-gated, and several soft-gating weighting algorithms (exponential, sigmoid, inverse, and linear weighting decay outside the period of interest), with %Nprojrepresenting the relative amount of data included. The apparent SNR (aSNR) and motion blurring (measured by the maximum derivative of image intensity at the diaphragm, MDD) were compared between reconstructions.Results. Soft-gating functions produced higher aSNR and lower MDD than hard-gated images using equivalent %Nproj, as expected. aSNR was not identical between different gating schemes for given %Nproj. While aSNR was approximately linear with %Nprojfor each algorithm, MDD performance diverged between functions as %Nprojdecreased. Algorithm performance was relatively consistent between subjects, except in images with high noise.Conclusion. The algorithm selection for soft-gating has a notable effect on image quality of respiratory-gated MRI; the timing of included data across the respiratory phase, and not simply the amount of data, plays an important role in aSNR. The specific soft-gating function and parameters should be considered for a given imaging application's requirements of signal and sharpness.

Functional xenon-129 magnetic resonance imaging response to antifibrotic treatment in idiopathic pulmonary fibrosis

A measure of regional gas exchange on HP ¹²⁹Xe MRI was able to detect apparent improvements in IPF patients treated with antifibrotic medication after 1 year, while no such improvements were found in patients treated with conventional therapies https://bit.ly/3ZXipzD.

Hyperpolarized 129Xe MR Spectroscopy in the Lung Shows 1-year Reduced Function in Idiopathic Pulmonary Fibrosis

Background Idiopathic pulmonary fibrosis (IPF) is a temporally and spatially heterogeneous lung disease. Identifying whether IPF in a patient is progressive or stable is crucial for treatment regimens. Purpose To assess the role of hyperpolarized (HP) xenon 129 (129Xe) MRI measures of ventilation and gas transfer in IPF generally and as an early signature of future IPF progression. Materials and Methods In a prospective study, healthy volunteers and participants with IPF were consecutively recruited between December 2015 and August 2019 and underwent baseline HP 129Xe MRI and chest CT. Participants with IPF were followed up with forced vital capacity percent predicted (FVC%p), diffusing capacity of the lungs for carbon monoxide percent predicted (DLco%p), and clinical outcome at 1 year. IPF progression was defined as reduction in FVC%p by at least 10%, reduction in DLco%p by at least 15%, or admission to hospice care. CT and MRI were spatially coregistered and a measure of pulmonary gas transfer (red blood cell [RBC]-to-barrier ratio) and high-ventilation percentage of lung volume were compared across groups and across fibrotic versus normal-appearing regions at CT by using Wilcoxon signed rank tests. Results Sixteen healthy volunteers (mean age, 57 years ± 14 [SD]; 10 women) and 22 participants with IPF (mean age, 71 years ± 9; 15 men) were evaluated, as follows: nine IPF progressors (mean age, 72 years ± 7; five women) and 13 nonprogressors (mean age, 70 years ± 10; 11 men). Reduction of high-ventilation percent (13% ± 6.1 vs 8.2% ± 5.9; P = .03) and RBC-to-barrier ratio (0.26 ± 0.06 vs 0.20 ± 0.06; P = .03) at baseline were associated with progression of IPF. Participants with progressive disease had reduced RBC-to-barrier ratio in structurally normal-appearing lung at CT (0.21 ± 0.07 vs 0.28 ± 0.05; P = .01) but not in fibrotic regions of the lung (0.15 ± 0.09 vs 0.14 ± 0.04; P = .62) relative to the nonprogressive group. Conclusion In this preliminary study, functional measures of gas transfer and ventilation measured with xenon 129 MRI and the extent of fibrotic structure at CT were associated with idiopathic pulmonary fibrosis disease progression. Differences in gas transfer were found in regions of nonfibrotic lung. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gleeson and Fraser in this issue.

Dynamic contrast enhanced MRI for the evaluation of lung perfusion in idiopathic pulmonary fibrosis

BACKGROUND

The objective of this work was to apply quantitative and semiquantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) methods to evaluate lung perfusion in idiopathic pulmonary fibrosis (IPF).

METHODS

In this prospective trial 41 subjects, including healthy control and IPF subjects, were studied using DCE-MRI at baseline. IPF subjects were then followed for 1 year; progressive IPF (IPF_prog) subjects were distinguished from stable IPF (IPF_stable) subjects based on a decline in percent predicted forced vital capacity (FVC % pred) or diffusing capacity of the lung for carbon monoxide (D _LCO % pred) measured during follow-up visits. 35 out of 41 subjects were retained for final baseline analysis (control: n=15; IPF_stable: n=14; IPF_prog: n=6). Seven measures and their coefficients of variation (CV) were derived using temporally resolved DCE-MRI. Two sets of global and regional comparisons were made: control versus IPF groups and control versus IPF_stable versus IPF_prog groups, using linear regression analysis. Each measure was compared with FVC % pred, D _LCO % pred and the lung clearance index (LCI % pred) using a Spearman rank correlation.

RESULTS

DCE-MRI identified regional perfusion differences between control and IPF subjects using first moment transit time (FMTT), contrast uptake slope and pulmonary blood flow (PBF) (p≤0.05), while global averages did not. FMTT was shorter for IPF_prog compared with both IPF_stable (p=0.004) and control groups (p=0.023). Correlations were observed between PBF CV and D _LCO % pred (r_s= -0.48, p=0.022) and LCI % pred (r_s= +0.47, p=0.015). Significant group differences were detected in age (p<0.001), D _LCO % pred (p<0.001), FVC % pred (p=0.001) and LCI % pred (p=0.007).

CONCLUSIONS

Global analysis obscures regional changes in pulmonary haemodynamics in IPF using DCE-MRI in IPF. Decreased FMTT may be a candidate marker for IPF progression.

Dynamic imaging using motion-compensated smoothness regularization on manifolds (MoCo-SToRM)

Objective. We introduce an unsupervised motion-compensated reconstruction scheme for high-resolution free-breathing pulmonary magnetic resonance imaging.Approach. We model the image frames in the time series as the deformed version of the 3D template image volume. We assume the deformation maps to be points on a smooth manifold in high-dimensional space. Specifically, we model the deformation map at each time instant as the output of a CNN-based generator that has the same weight for all time-frames, driven by a low-dimensional latent vector. The time series of latent vectors account for the dynamics in the dataset, including respiratory motion and bulk motion. The template image volume, the parameters of the generator, and the latent vectors are learned directly from the k-t space data in an unsupervised fashion.Main results. Our experimental results show improved reconstructions compared to state-of-the-art methods, especially in the context of bulk motion during the scans.Significance. The proposed unsupervised motion-compensated scheme jointly estimates the latent vectors that capture the motion dynamics, the corresponding deformation maps, and the reconstructed motion-compensated images from the raw k-t space data of each subject. Unlike current motion-resolved strategies, the proposed scheme is more robust to bulk motion events during the scan.

Optimizing CIGB-300 intralesional delivery in locally advanced cervical cancer

BACKGROUND

We conducted a phase 1 trial in patients with locally advanced cervical cancer by injecting 0.5 ml of the CK2-antagonist CIGB-300 in two different sites on tumours to assess tumour uptake, safety, pharmacodynamic activity and identify the recommended dose.

METHODS

Fourteen patients were treated with intralesional injections containing 35 or 70 mg of CIGB-300 in three alternate cycles of three consecutive days each before standard chemoradiotherapy. Tumour uptake was determined using (99)Tc-radiolabelled peptide. In situ B23/nucleophosmin was determined by immunohistochemistry.

RESULTS

Maximum tumour uptake for CIGB-300 70-mg dose was significantly higher than the one observed for 35 mg: 16.1 ± 8.9 vs 31.3 ± 12.9 mg (P = 0.01). Both, AUC24h and biological half-life were also significantly higher using 70 mg of CIGB-300 (P < 0.001). Unincorporated CIGB-300 diffused rapidly to blood and was mainly distributed towards kidneys, and marginally in liver, lungs, heart and spleen. There was no DLT and moderate allergic-like reactions were the most common systemic side effect with strong correlation between unincorporated CIGB-300 and histamine levels in blood. CIGB-300, 70 mg, downregulated B23/nucleophosmin (P = 0.03) in tumour specimens.

CONCLUSION

Intralesional injections of 70 mg CIGB-300 in two sites (0.5 ml per injection) and this treatment plan are recommended to be evaluated in phase 2 studies.

Antihypertensive and antiarrhythmic properties of a para-hydroxy[bis(ortho-morpholinylmethyl)]phenyl-1,4-DHP compound: comparison with other compounds of the same kind and relationship with logP values

A new para-hydroxy[bis(ortho-morpholinylmethyl)]phenyl-1,4-DHP substituted compound, (4-(4-hydroxy-3,5-bis(morpholin-4-ylmethyl)phenyl)-2,6-dimethyl-1,4-dihydropyridine-3,5-dicarboxylic acid diethyl ester, LQM300), with antihypertensive and antiarrhythmic properties, has been synthesized. Four pKa values of this compound have been determined with the aid of the program SQUAD, at pseudo-physiological conditions (T = 37 degrees C and I = 0.15 M) by UV spectrophotometry and at T = 25 degrees C and I = 0.05 M by Capillary Zone Electrophoresis (CZE). The logP = 2.7 +/- 0.2 between n-octanol and water, has been estimated by UV spectrophotometry. The antihypertensive and antiarrhythmic efficacies as well as the logP values have been compared with other compounds of the same kind and related with their structure.

Genomics and proteomics: a new approach for assessing thrombotic risk in autoimmune diseases

Several systemic autoimmune conditions, including rheumatoid arthritis, systemic lupus erythematosus and antiphospholipid syndrome, are characterised by enhanced atherosclerosis and, consequently, higher cardiovascular morbidity and mortality rates. The association of these diseases with atherosclerosis suggests a common pathogenic mechanism. Genomic and proteomic studies performed on atherosclerotic plaques have further confirmed the presence of a gene and protein profile similar to that observed in autoimmune diseases with cardiovascular risks. Human sera and body fluids have been analysed and have resulted in the identification of auto-antibodies that can be used as diagnostic markers in specific autoimmune diseases, and proteomic fingerprints of blood cells, tissues and body fluids have resulted in the identification of individual proteins or patterns of protein expression that are deregulated. The information provided by these proteomic studies is of diagnostic and therapeutic potential. In this review, we discuss new approaches available for assessing thrombotic risk in autoimmune diseases, focusing in the genomic and proteomic methods now available to deep into the origin of the mechanisms associated with vascular involvement in systemic autoimmune diseases. The increasing data available suggests that when treating patients with these autoimmune disorders, paying attention to the increased risk of cardiovascular disease is essential.

Synthesis and antihypertensive effects of new methylthiomorpholinphenol derivatives

We present in this work the synthesis and cardiovascular effects of new methylthiomorpholine compounds and they were compared with cardiovascular drugs such as captopril, losartan and omapatrilat.

Vascular endothelial growth factor expression in monocytes from patients with primary antiphospholipid syndrome

BACKGROUND

One of the described mechanisms leading to thrombosis in antiphospholipid syndrome (APS) is overexpression of tissue factor (TF) in the monocytes and endothelial cells of patients with antiphospholipid antibodies (aPL). Vascular endothelial growth factor (VEGF) may stimulate monocyte TF expression through its receptor, the tyrosine kinase Flt-1.

OBJECTIVES

This study aimed to analyze the following in monocytes of 55 primary APS patients: VEGF and Flt-1 expression levels, their potential regulation by aPL, and the association of VEGF and Flt-1 expression with the increased TF expression found in APS patients.

RESULTS

Purified monocytes from APS patients showed higher levels of VEGF and Flt-1 than healthy donors, which further correlated with immunoglobulin G (IgG) anticardiolipin titers and TF expression rank. Moreover, monocyte VEGF and Flt-1 levels were significantly higher in patients with than in patients without previous thrombosis. In vitro, IgG from APS patients increased monocyte VEGF and Flt-1 expression in a dose-dependent manner. VEGF and Flt-1 expression was significantly inhibited by the p38 mitogen-activated protein kinase (MAPK) inhibitor SB203580; this suggests the involvement of this kinase in the aPL-induced VEGF and Flt-1 upregulation.

CONCLUSIONS

Our data show, for the first time in vivo, that monocytes from primary APS patients have an increased expression of VEGF and Flt-1. Furthermore, in vitro results indicated that this cytokine is produced by monocytes when treated with aPL, and that the p38 MAPK signaling pathway plays an important role. Thus, VEGF might act as a regulatory factor in aPL-mediated monocyte activation and TF expression, thereby contributing to the proinflammatory-prothrombotic phenotype of APS patients.

Nonlinear software sensor for monitoring genetic regulation processes with noise and modeling errors

Nonlinear control techniques by means of a software sensor that are commonly used in chemical engineering could be also applied to genetic regulation processes. We provide here a realistic formulation of this procedure by introducing an additive white Gaussian noise, which is usually found in experimental data. Besides, we include model errors, meaning that we assume we do not know the nonlinear regulation function of the process. In order to illustrate this procedure, we employ the Goodwin dynamics of the concentrations [B. C. Goodwin, (Academic, New York, 1963)] in the simple form recently applied to single gene systems and some operon cases [H. De Jong, J. Comput. Biol. 9, 67 (2002)], which involves the dynamics of the mRNA, given protein and metabolite concentrations. Further, we present results for a three gene case in coregulated sets of transcription units as they occur in prokaryotes. However, instead of considering their full dynamics, we use only the data of the metabolites and a designed software sensor. We also show, more generally, that it is possible to rebuild the complete set of nonmeasured concentrations despite the uncertainties in the regulation function or, even more, in the case of not knowing the mRNA dynamics. In addition, the rebuilding of concentrations is not affected by the perturbation due to the additive white Gaussian noise and also we managed to filter the noisy output of the biological system.

Towards an understanding of the heat capacity of liquids. A simple two-state model for molecular association

A model for the temperature dependence of the isobaric heat capacity of associated pure liquids C(p,m)(o)(T) is proposed. Taking the ideal gas as a reference state, the residual heat capacity is divided into nonspecific C(p) (res,ns) and associational C(p) (res,ass) contributions. Statistical mechanics is used to obtain C(p)(res,ass) by means of a two-state model. All the experimentally observed C(p,m)(o)(T) types of curves in the literature are qualitatively described from the combination of the ideal gas heat capacity C(p)(id)(T) and C(p)(res,ass)(T). The existence of C(p,m)(o)(T) curves with a maximum is predicted and experimentally observed, for the first time, through the measurement of C(p,m)(o)(T) for highly sterically hindered alcohols. A detailed quantitative analysis of C(p,m)(o)(T) for several series of substances (n-alkanes, linear and branched alcohols, and thiols) is made. All the basic features of C(p,m)(o)(T) at atmospheric and high pressures are successfully described, the model parameters being physically meaningful. In particular, the molecular association energies and the C(p)(res,ns) values from the proposed model are found to be in agreement with those obtained through quantum mechanical ab initio calculations and the Flory model, respectively. It is concluded that C(p,m)(o)(T) is governed by the association energy between molecules, their self-association capability and molecular size.

Markovian chemicals "in silico" design (MARCH-INSIDE), a promising approach for computer-aided molecular design I: discovery of anticancer compounds

A simple stochastic approach, designed to model the movement of electrons throughout chemical bonds, is introduced. This model makes use of a Markov matrix to codify useful structural information in QSAR. The self-return probabilities of this matrix throughout time ((SR)pi(k)) are then used as molecular descriptors. Firstly, a calculation of (SR)pi(k) is made for a large series of anticancer and non-anticancer chemicals. Then, k-Means Cluster Analysis allows us to split the data series into clusters and ensure a representative design of training and predicting series. Next, we develop a classification function through Linear Discriminant Analysis (LDA). This QSAR discriminates between anticancer compounds and non-active compounds with a correct global classification of 90.5% in the training series. The model also correctly classified 86.07% of the compounds in the predicting series. This classification function is then used to perform a virtual screening of a combinatorial library of coumarins. In this connection, the biological assay of some furocoumarins, selected by virtual screening using the present model, gives good results. In particular, a tetracyclic derivative of 5-methoxypsoralen (5-MOP) has an IC50 against HL-60 tumoral line around 6 to 10 times lower than those for 8-MOP and 5-MOP (reference drugs), respectively. Finally, application of Iso-contribution Zone Analysis (IZA) provides structural interpretation of the biological activity predicted with this QSAR.

[Quality of contraception services in El Alto, Bolivia]

The objective of this study was to evaluate the quality of contraception services in the city of El Alto, Bolivia. In the study design, four components were considered: 1) interpersonal relations between service providers and users, 2) the availability of various contraceptive methods, 3) conditions in the service centers, and 4) user satisfaction. The opinions of three groups were taken into account: service providers, service users, and nonusers. The service centers were classified as either governmental or nongovernmental, depending on the management of the institution to which the service center belonged. The study data came from a situation analysis of the services and from comments gathered from study participants in 1995. The study found that providers held a more favorable view than did service users of the interpersonal relations and personal treatment that physicians provided. Nonusers had an unfavorable perception of physicians' treatment of users. Users' perceptions of receiving egalitarian treatment correlated with their style of dress. With regard to the availability of contraceptive methods, 15 of the 36 centers surveyed did not have modern methods, despite there being a national policy to provide them to the public. The supply of contraception services for couples and for adolescents is limited, especially in the governmental institutions. The analysis of the conditions in the service centers demonstrated that some institutions had serious difficulties providing services of at least a minimum quality. Finally, the study describes how most of the service limitations in El Alto can be corrected through moderate-cost strategies.

Technetium-99m-labeled anti-EGF-receptor antibody in patients with tumor of epithelial origin: I. Biodistribution and dosimetry for radioimmunotherapy

Accurate estimation of biodistribution and absorbed dose to normal organs and tumors is important for immunoscintigraphic studies and radioimmunotherapy treatment planning.

METHODS

Four patients (3 men, 1 woman; mean age 54.8 +/- 9.2 yr; range 42-64 yr) were administered 3 mg of anti-human epidermal growth factor receptor (anti-hEGF-r) antibody (ior egf/r3), radiolabeled with 99mTc activity of 39.5 +/- 1.1 mCi (range 38.5 mCi-40.7 mCi) by intravenous bolus infusion. After administration, blood and urine samples were collected from three patients up to 24 hr after injection. Whole-body anterior and posterior scans were obtained at 5 min and 1, 3, 5 and 24 hr after injection. Using a computer program, regions of interest were drawn over the heart, liver, spleen, bladder and tumor to measure the activity in the source organs at each scanning time. Time-activity curves for each source organ were then fitted to monoexponential or biexponential functions by nonlinear least squares regression using the flexible polyhedrals method, which adequately fit our data with the correlation coefficient of 0.985 +/- 0.013, and were integrated to determine organ residence times. The mean absorbed doses to the whole body and various normal organs were then estimated from residence times and from blood and urine samples using the methods developed by the Medical Internal Radiation Dose Committee. The effective dose equivalent and effective dose were calculated as prescribed in ICRP Publication Nos. 30 and 60.

RESULTS

Plasma disappearance curves of 99mTc-labeled anti-hEGF-r antibody were best-fit by a two-compartment model in all patients with a distribution half-life (t(1/2alpha)) of 0.207 hr +/- 0.059 hr (mean +/- s.d., n = 3) and an elimination half-life (t(1/2beta)) of 13.9 hr +/- 2.2 hr. Among the various organs, significant accumulation of the radiolabeled antibody was found in the liver (48.5% +/- 4.4%, mean +/- s.d.), heart (3.50% +/- 0.17%) and spleen (3.1% +/- 1.8%) at 5 min postadministration. These values were reduced to 3.2% +/- 0.4%, 0.1% +/- 0.01% and 0.1% +/- 0.1%, respectively, at 24 hr. Mean cumulative urinary excretion of 99mTc-labeled anti-hEGF-r antibody was 4.6% +/- 0.6% at 24 hr postinjection. Estimates of radiation absorbed dose to normal organs in rad/mCi administered (mean +/- s.d., n = 4) were: whole body 0.017 +/- 0.002; gallbladder wall 0.074 +/- 0.007; spleen 0.136 +/- 0.076; and liver 0.267 +/- 0.036. The effective dose equivalent and effective dose estimates for adults were 0.041 +/- 0.008 rem/mCi and 0.027 +/- 0.004 rem/mCi administered.

CONCLUSION

This feasibility study indicates that 99mTc-labeled anti-hEGF-r antibody (ior egf/r3) can be used safely; this analysis provides a dosimetric framework for future studies. This monoclonal antibody, labeled with 188Re, could possibly permit a successful regional radioimmunotherapy of tumors of epithelial origin.

Brain single-photon emission tomography with technetium-99m hexamethylpropylene amine oxime in adolescents with initial-stage schizophrenia

The objective of this study was to search for regional cerebral blood flow (rCBF) abnormalities in adolescents with initial-stage schizophrenia by means of brain single-photon emission tomography (SPET) using technetium-99m hexamethylpropylene amine oxime (HMPAO). SPET studies were performed on a homogeneous sample of 15 carefully selected adolescents with a recent diagnosis of schizophrenia, and without previous electroconvulsive or antipsychotic drug treatment. Computed tomography (CT) and electro-encephalographic (EEG) studies were performed in all patients. Qualitative and semiquantitative analysis of 99mTc-HMPAO SPET studies showed an impaired rCBF in 12 patients (80%). The most common pattern was a decreased uptake of 99mTc-HMPAO in the frontal lobes, usually in the left hemisphere. Conventional and quantitative EEG was positive in 12 (80%) and 15 (100%) patients, respectively. CT findings were positive in two patients (13%). There was a high level of concordance between SPET and EEG results and between SPET and clinical features (P>0.05). This study suggests that previously untreated patients in the first stages of schizophrenia present functional abnormalities that are revealed by brain SPET.

Do calcium antagonists act directly on calcium channels to alter baroreceptor function?

This study examined the effects of antagonists known to act on voltage-dependent calcium channels (chiefly nitrendipine, diltiazem and verapamil) on arterial baroreceptor function. Single fiber discharge of aortic arch baroreceptor preparations of the rat was not altered at concentrations ranging from 10(-11) to 10(-6) M. Increasing pressure in an isolated perfused carotid sinus in the cat produced a reflex arterial pressure response which was not altered significantly when the carotid perfusate contained an antagonist concentration of 10(-7) to 10(-6) M. A higher concentration (10(-5) M) of all three antagonists decreased baroreceptor discharge and depressed the reflex response. In addition, nimodipine and nifedipine had uniformly similar dose-related effects. It is likely that the effects found at the elevated concentrations are nonspecific and probably are independent of voltage-dependent calcium channels. No differences between the dihydropyridine blockers and verapamil were found even at very high doses. Our results suggest that within the range of doses used clinically these antagonists do not directly affect baroreceptor function. In addition, the present results reinforce the notion that voltage-dependent calcium channels are not importantly involved in baroreceptor transduction as suggested by earlier studies of the effects of changing external calcium concentration.