Whole-body diffusion-weighted imaging vs. FDG-PET for the detection of non-small-cell lung cancer. How do they measure up?

Objective

To compare the diagnostic efficacy of whole-body diffusion-weighted imaging (WB-DWI) and [18F] fluoro-2-D-glucose PET/CT(FDG-PET/CT)for assessment of non–small cell lung cancer (NSCLC) patients.

Materials and Methods

A group of 56 patients (21 female, 35 male; 35–76 years) with NSCLC proved by pathologic examination or follow-up imaging findings was set as reference standards, and all patients underwent both WB-DWI at 1.5T (MAGNETOM Avanto) and PET/CT (Biograph 16). For WB-DWI, a free breathing diffusion-weighted single-shot spin-echo epi-sequence in five-stations (head-neck, thorax, abdomen, pelvis-thigh) was used. Each station-series contained 30 contiguous axial slices. Imaging parameters: FOV 360×360 mm, matrix size 128×80. B-values: 0 and 1000 s/mm² applied along x, y and z, 5 averages, acquisition time: 2.23 min/series, total: 11.55 min. The efficacy of WB-DWI and PET/CT were determined in a blinded reading by two radiologists and two nuclear medicine physicians using pathology and size change during follow up exams as the reference standard.

Results

Primary tumors (n=56 patients) were correctly detected in 56 (100%) patients by both PET/CT and WB-DWI. Ninety-six lymph nodes metastases were determined with pathologic and follow-up examinations. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) being for lymph node metastases: 91%, 90%, 90%, 96%, 80% with WB-DWI and 98%, 97%, 97%, 99%, 93% with PET-CT, other metastases: 90%, 95%, 92%, 97%, 83% with WB-DWI and 98%, 100%, 98%, 100%, 95% with PET-CT). Differences in the accuracy of lymph node metastasis detection between PET/CT and WB-DWI (P=.031) were significant. The differences were not statistically significant for detection of other metastases.

Conclusions

WB-DWI is a feasible clinical technique for the assessment of NSCLC, lymph nodes and metastastic spread with high sensitivity and accuracy, but it was limited in the evaluation of neck lymph node metastases and small metastastic lung nodules.     

Magnetic resonance imaging screening in women at genetic risk of breast cancer: imaging and analysis protocol for the UK multicentre study. UK MRI Breast Screening Study Advisory Group

The imaging and analysis protocol of the UK multicentre study of magnetic resonance imaging (MRI) as a method of screening for breast cancer in women at genetic risk is described. The study will compare the sensitivity and specificity of contrast-enhanced MRI with two-view x-ray mammography. Approximately 500 women below the age of 50 at high genetic risk of breast cancer will be recruited per year for three years, with annual MRI and x-ray mammography continuing for up to 5 years. A symptomatic cohort will be measured in the first year to ensure consistent reporting between centres. The MRI examination comprises a high-sensitivity three-dimensional contrast-enhanced assessment, followed by a high-specificity contrast-enhanced study in equivocal cases. Multiparametric analysis will encompass morphological assessment, the kinetics of contrast agent uptake and determination of quantitative pharmacokinetic parameters. Retrospective analysis will identify the most specific indicators of malignancy. Sensitivity and specificity, together with diagnostic performance, diagnostic impact and therapeutic impact will be assessed with reference to pathology, follow-up and changes in diagnostic certainty and therapeutic decisions. Mammography, lesion localisation, pathology and cytology will be performed in accordance with the UK NHS Breast Screening Programme quality assurance standards. Similar standards of quality assurance will be applied for MR measurements and evaluation.     

Prognostic and therapeutic evaluation of nasopharyngeal carcinoma by dynamic contrast-enhanced (DCE), diffusion-weighted (DW) magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS)

Nasopharyngeal carcinoma (NPC) is an aggressive head and neck malignancy, and radiotherapy (with or without chemotherapy) is the primary treatment modality. Reliable tumour assessment during the treatment phase, which can portend the efficacy of radiotherapy and early identification of potential treatment failure in radioresistant disease, has been implicit for better cancer management. Technological advancement in the last decade has fostered the development of functional magnetic resonance imaging (fMRI) techniques into a promising tool for diagnostic and therapeutic assessments in head and neck cancer. Apart from conventional morphological assessment, early detection of the physiological environment by fMRI allows a more thorough investigation in monitoring tumour response. This article discusses the relevant fMRI utilities in NPC as an early prognostic and monitoring tool for treatment. Challenges and future developments of fMRI in radiation oncology are also discussed.     

儿童发育性髋关节脱位的磁共振形态学定量

发育性髋关节脱位（developmental dysplasia of the hip,DDH）作为一类常见的、严重威胁儿童健康成长的髋关节疾病会严重影响到儿童的肢体发育和生活质量,其早诊断、早治疗非常重要.磁共振成像（magnetic resonance imaging,MRI）技术可提供丰富的有关髋关节发育情况的形态学信息.目前,基于磁共振图像的DDH临床诊断主要凭借医生的肉眼观测,对医生要求甚高,而且无法定量判断DDH病情.本文提出了一种针对儿童DDH磁共振图像的形态学定量评估方法,通过对DDH病理改变密切相关的形态学参数的自动测定,完成形态学参数的定量评估,为临床提供辅助的量化参考.该方法包括磁共振图像预处理、股骨及盆骨分割、髋关节三维模型重建,以及结合了厚度搜索、三维霍夫变换和最小二乘拟合等算法实现的中心边缘角（center-edge angle,CEA）、髋臼角（acetabular index,AI）和股骨颈前倾角（femoral neck anteversion,FNA）等重要指标的自动测量.儿童DDH形态学定量评估方法的建立对儿童DDH的筛查、诊断和确诊患儿手术方案的制定,以及术后的动态随访,都具有重要参考价值.     

In vivo NMR in pharmaceutical research.

In vivo NMR techniques are currently well established in pharmaceutical research and will likely become increasingly important in the future, as they procure noninvasively morphological, physiological, and biochemical information. The status of magnetic resonance imaging (MRI) and spectroscopy (MRS) in drug development is discussed on the basis of the characterization and evaluation of a rat model of ischemic stroke and the development and profiling of drugs for cerebral ischemia in this model. It can be concluded that MRI is well suited for drug screening (quantitative determination of lesion size), while dynamic MRI and MRS techniques provide relevant information on the mechanism of drug actions. The possibility to follow changes, pathological and therapeutic, in the same individual is important from two points of view. First, variations due to interindividual differences may be eliminated, increasing the statistical power of the results. Second, dose and/or time dependence of a drug can be explored in the same individual. As a result, the number of animals required for a study will be reduced, which from both ethical and economic aspects is highly desirable.     

Repeatability of echo-planar-based diffusion measurements of the human prostate at 3 T

Echo-planar-based diffusion-weighted imaging (DWI) of the prostate is increasingly being suggested as a viable technique, complementing information derived from conventional magnetic resonance imaging methods for use in tissue discrimination. DWI has also been suggested as a potentially useful tool in the assessment of tumor response to treatment. In this study, the repeatability of apparent diffusion coefficient (ADC) values obtained from both DWI and diffusion tensor imaging (DTI) has been assessed as a precursor to determining the magnitude of treatment-induced changes required for reliable detection. The repeatability values of DWI and DTI were found to be similar, with ADC values repeatable to within 35% or less over a short time period of a few minutes and a longer time period of a month. Fractional anisotropy measurements were found to be less repeatable (between 26% and 71%), and any changes duly recorded in longitudinal studies must therefore be treated with a degree of caution.     

Sodium and proton diffusion MRI as biomarkers for early therapeutic response in subcutaneous tumors

The ability to quantitate early effects of tumor therapeutic response using noninvasive imaging would have a major impact in clinical oncology. One area of active research interest is the ability to use MR techniques to detect subtle changes in tumor cellular density. In this study, sodium and proton diffusion MRI were compared for their ability to detect early cellular changes in tumors treated with a cytotoxic chemotherapy. Subcutaneous 9L gliosarcomas were treated with a single dose of 1,3-bis(2-chloroethyl)-1-nitrosourea. Both sodium and diffusion imaging modalities were able to detect changes in tumor cellularity as early as 2 days after treatment, which continued to evolve as increased signal intensities reached a maximum approximately 8 days posttreatment. Early changes in tumor sodium and apparent diffusion coefficient values were predictive of subsequent tumor shrinkage, which occurred approximately 10 days later. Overall, therapeutical induced changes in sodium and diffusion values were found to have similar dynamic and spatial changes. These findings suggest that these imaging modalities detected similar early cellular changes after treatment. The results of this study support the continued clinical testing of diffusion MRI for evaluation of early tumor treatment response and demonstrate the complementary insights of sodium MRI for oncology applications.     

Infrared spectroscopy combined with imaging: A new developing analytical tool in health and plant science

Modern infrared (IR) spectroscopy and imaging has a wide range of applications in health and plant sciences. Initially, it was extensively used for the study of proteins, nucleotides, lipids and carbohydrates. With time, its use has extended to disease assessment to discriminate healthy and diseased samples on the basis of chemical changes. The application of an advanced focal plane array detector, which is able to scan a large area of samples in a short time, helps in investigating specific changes that could be correlated with different environmental stresses. An IR microscope connected with a synchrotron light source further enhances the lateral spatial resolution at diffraction limit because of the compact beam size. For example, synchrotron-based IR spectroscopy imaging in combination with multivariate statistical analysis has been proven to be a powerful non-destructive analytical tool to probe changes in plant cell wall composition/structure in response to biological processes and environmental stresses. New development of nano-Fourier transform infrared spectroscopy (FTIR) combined with scattering type scanning near-field optical microscopy breaks the diffraction limitation, which opens the new area of applications. This review focuses on a new area of diagnostic research as well as development of IR spectroscopy and imaging for biological specimens including compositional changes in plant cell wall.     

In vivo imaging of blood flow in the mouse Achilles tendon using high-frequency ultrasound

Objective

Achilles tendinitis is a common clinical problem with many treatment modalities, including physical therapy, exercise and therapeutic ultrasound. However, evaluating the effects of current therapeutic modalities and studying the therapeutic mechanism(s) in vivo remains problematic. In this study, we attempted to observe the morphology and microcirculation changes in mouse Achilles tendons between pre- and post-treatment using high-frequency (25 MHz) ultrasound imaging. A secondary aim was to assess the potential of high-frequency ultrasound in exploring therapeutic mechanisms in small-animal models in vivo.

Methods

A collagenase-induced mouse model of Achilles tendinitis was adopted, and 5 min treatment of continuous-mode low-frequency (45 kHz) ultrasound with 47 mW/cm² maximum intensity and 16.3 cm² effective beam radiating area was applied. The B-mode images showed no focal hypoechoic regions in normal Achilles tendons either pre- or post-treatment. The Doppler power energy and blood flow rate were measured within the peritendinous space of the Achilles tendon.

Conclusion

An increase in the microcirculation was observed soon after the low-frequency ultrasound treatment, which was due to immediate induction of vascular dilatation. The results suggest that applying high-frequency Doppler imaging to small-animal models will be an invaluable aid in explorations of the therapeutic mechanism(s). Our future work includes using imaging to assess microcirculation changes in tendinitis between before and after treatment over a long time period, which is expected to yield useful physiological data for future human studies.     

Imaging errors in arrayed waveguide gratings

A detailed assessment of imaging errors in arrayed waveguide gratings (AWG) is presented, focussing on possible design related imaging errors as well as on typical imaging errors mediated by the fabrication process. From a design point of view, special interest is drawn to the effect of coupling within the array of grating waveguides and to the impact of the paraxial approximation for the star couplers which is commonly used in the design of AWGs. Both become important design issues affecting the performance of AWG devices when moving to high numbers of narrowly spaced channels. For the technology related imaging errors we focus on one side on the impact of almost uncorrelated phase errors at high spatial frequencies. They can typically be attributed to fluctuations in the index profile and waveguide dimensions in the grating region. On the other side correlated long range phase errors are treated which occur in the grating region as well as within the star couplers and which are typical for stress induced index changes in silica-on-silicon waveguides. It is shown that only modelling tools which include all types of the above imaging effects can provide reliable boundary conditions for a comprehensive design of high end AWG concerning spectral shape and chromatic dispersion.     

Physiological assessment of in vivo human knee articular cartilage using sodium MR imaging at 1.5 T

Osteoarthritis is a common joint disorder that is most prevalent in the knee joint. Knee osteoarthritis (OA) can be characterized by the gradual loss of articular cartilage (AC). Formation of lesion, fissures and cracks on the cartilage surface has been associated with degenerative AC and can be measured by morphological assessment. In addition, loss of proteoglycan from extracellular matrix of the AC can be measured at early stage of cartilage degradation by physiological assessment. In this case, a biochemical phenomenon of cartilage is used to assess the changes at early degeneration of AC. In this paper, a method to measure local sodium concentration in AC due to proteoglycan has been investigated. A clinical 1.5-T magnetic resonance imaging (MRI) with multinuclear spectroscopic facility is used to acquire sodium images and quantify local sodium content of AC. An optimised 3D gradient-echo sequence with low echo time has been used for MR scan. The estimated sodium concentration in AC region from four different data sets is found to be ~ 225 ± 19 mmol/l, which matches the values that has been reported for the normal AC. This study shows that sodium images acquired at clinical 1.5-T MRI system can generate an adequate quantitative data that enable the estimation of sodium concentration in AC. We conclude that this method is potentially suitable for non-invasive physiological (sodium content) measurement of articular cartilage.     

Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase: PASL vs DSC-MRI

Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5 hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment.     

The 3D characteristics of post‐traumatic syringomyelia in a rat model: a propagation‐based synchrotron radiation microtomography study

Many published literature sources have described the histopathological characteristics of post‐traumatic syringomyelia (PTS). However, three‐dimensional (3D) visualization studies of PTS have been limited due to the lack of reliable 3D imaging techniques. In this study, the imaging efficiency of propagation‐based synchrotron radiation microtomography (PB‐SRµCT) was determined to detect the 3D morphology of the cavity and surrounding microvasculature network in a rat model of PTS. The rat model of PTS was established using the infinite horizon impactor to produce spinal cord injury (SCI), followed by a subarachnoid injection of kaolin to produce arachnoiditis. PB‐SRµCT imaging and histological examination, as well as fluorescence staining, were conducted on the animals at the tenth week after SCI. The 3D morphology of the cystic cavity was vividly visualized using PB‐SRµCT imaging. The quantitative parameters analyzed by PB‐SRµCT, including the lesion and spared spinal cord tissue area, the minimum and maximum diameters in the cystic cavity, and cavity volume, were largely consistent with the results of the histological assessment. Moreover, the 3D morphology of the cavity and surrounding angioarchitecture could be simultaneously detected on the PB‐SRµCT images. This study demonstrated that high‐resolution PB‐SRµCT could be used for the 3D visualization of trauma‐induced spinal cord cavities and provides valuable quantitative data for cavity characterization. PB‐SRµCT could be used as a reliable imaging technique and offers a novel platform for tracking cavity formation and morphological changes in an experimental animal model of PTS.     

Newer nanoparticles in hyperthermia treatment and thermometry

Abstract  Heating tumors by nanoparticles and resistance in hypoxic tumor cells to a high temperature is emerging as an effective tool in therapeutic oncology as nanomedicine tool. The art of imaging temperature in a tumor at various locations is emerging as the selective approach of hyperthermia to monitor temperature and treat the tumor. However, thermometry and tumor cell interaction with nanoparticles may monitor and evaluate the tumor cell survival after exposure to high physiological temperatures. The application of 10–100 nanometer sized nanoparticles in tumor hyperthermia has emerged as an effective monitoring tool as magnetic resonance (MR) thermal mapping. The temperature and nanoparticle magnetic moment relationship is specific. Furthermore, there are two main issues that are unsolved as of yet. First issue is the relationship of tumor energy changes due to tumor magnetization; linear attenuation after magnetic field and X-ray exposure with tissue temperature increase. The second issue is the undefined behavior of the nanoparticle inside the tumor as diamagnetic or paramagnetic can be therapeutic and it depends on the tumor tissue temperature. In vivo imaging such as MR thermometry mapping of different hypoxic tumor locations solves these issues to some extent. The art of the nanoparticle-induced hyperthermia does have a great impact on public health as alternative therapeutic oncology. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Earlier detection of tumor treatment response using magnetic resonance diffusion imaging with oscillating gradients

An improved method for detecting early changes in tumors in response to treatment, based on a modification of diffusion-weighted magnetic resonance imaging, has been demonstrated in an animal model. Early detection of therapeutic response in tumors is important both clinically and in pre-clinical assessments of novel treatments. Noninvasive imaging methods that can detect and assess tumor response early in the course of treatment, and before frank changes in tumor morphology are evident, are of considerable interest as potential biomarkers of treatment efficacy. Diffusion-weighted magnetic resonance imaging is sensitive to changes in water diffusion rates in tissues that result from structural variations in the local cellular environment, but conventional methods mainly reflect changes in tissue cellularity and do not convey information specific to microstructural variations at sub-cellular scales. We implemented a modified imaging technique using oscillating gradients of the magnetic field for evaluating water diffusion rates over very short spatial scales that are more specific for detecting changes in intracellular structure that may precede changes in cellularity. Results from a study of orthotopic 9L gliomas in rat brains indicate that this method can detect changes as early as 24 h following treatment with 1,3-bis(2-chloroethyl)-1-nitrosourea, when conventional approaches do not find significant effects. These studies suggest that diffusion imaging using oscillating gradients may be used to obtain an earlier indication of treatment efficacy than previous magnetic resonance imaging methods.     

Novel extraction,rapid assessment and bioavailability improvement of quercetin: A review

Quercetin (QUR) have got the attention of scientific society frequently due to their wide range of potential applications. QUR has been the focal point for research in various fields, especially in food development. But, the QUR is highly unstable and can be interrupted by using conventional assessment methods. Therefore, researchers are focusing on novel extraction and non-invasive tools for the non-destructive assessment of QUR. The current review elaborates the different novel extraction (ultrasound-assisted extraction, microwave-assisted extraction, supercritical fluid extraction, and enzyme-assisted extraction) and non-destructive assessment techniques (fluorescence spectroscopy, terahertz spectroscopy, near-infrared spectroscopy, hyperspectral imaging, Raman spectroscopy, and surface-enhanced Raman spectroscopy) for the extraction and identification of QUR in agricultural products. The novel extraction approaches facilitate shorter extraction time, involve less organic solvent, and are environmentally friendly. While the non-destructive techniques are non-interruptive, label-free, reliable, accurate, and environmental friendly. The non-invasive spectroscopic and imaging methods are suitable for the sensitive detection of bioactive compounds than conventional techniques. QUR has potential therapeutic properties such as anti-obesity, anti-diabetes, antiallergic, antineoplastic agent, neuroprotector, antimicrobial, and antioxidant activities. Besides, due to the low bioavailability of QUR innovative drug delivery strategies (QUR loaded gel, QUR polymeric micelle, QUR nanoparticles, glucan-QUR conjugate, and QUR loaded mucoadhesive nanoemulsions) have been proposed to improve its bioavailability and providing novel therapeutic approaches.     

MRI of tarantulas: morphological and perfusion imaging

This paper describes a study performed to evaluate the feasibility of using a 1.5-T whole-body magnetic resonance imaging (MRI) equipment, in combination with pharmacokinetic modeling, to obtain in vivo information about the morphology and perfusion of tarantulas (Eurypelma californicum). MRI was performed on three tarantulas using spin-echo sequences for morphological imaging and a rapid spoiled gradient-echo sequence for dynamic imaging during and after contrast medium (CM; Gd-DTPA) injection. Signal enhancement in dynamic measurements was evaluated with a pharmacokinetic two-compartment model. Spin-echo images showed morphological structures well. Dynamic images were of sufficient quality and allowed a model analysis of CM kinetics, which provides information about regional perfusion. In conclusion, morphological and dynamic contrast-enhanced MRI of tarantulas is feasible with a conventional clinical scanner. Studies of this kind are therefore possible without a dedicated high-field animal scanner.     

Computer-aided quantification of focal cartilage lesions of osteoarthritic knee using MRI

Noninvasive assessment of articular cartilage using magnetic resonance imaging (MRI) has gained popularity in the diagnosis of osteoarthritis (OA), a condition that affects 20 million Americans. Focal cartilage lesions, a defect found in roughly 19% of the OA population, currently can only be evaluated with confidence using minimally invasive arthroscopy. This article presents a computer-aided procedure using MRI to quantify focal cartilage lesions and aims to support clinical practices of diagnosis and monitoring of lesion progress. Upon a local minima search for identifying focal lesions, the proposed gradient peak method outlines lesion boundaries and then generates morphological properties, such as lesion volume and lesion area. The procedure was evaluated using simulated and in vivo data. First, a simulated lesion was created and analyzed, and the results were compared with the exact solutions. Second, an in vivo evaluation was carried out on seven human knees in which nine focal lesions were identified and quantified. Three of the subjects had follow-up analyses, at either 1 or 2 years. Finally, in an attempt to characterize local biochemical changes underlying focal lesions, MR-derived T2 values of defective cartilage within the lesion boundaries were examined and compared with the values of adjacent cartilage compartments.     

近海微塑料含量的相干反斯托克斯拉曼光谱成像研究

由于塑料工业的发展,微塑料成为一种主要的环境污染物.它在自然界中不易降解,对人类的生存环境及健康都存在不可忽视的潜在危险.因此,环境中微塑料的检测和分析,成为了近年来研究的热点问题.目前人们大多数采用浮选法、密度分离法、离心法等方法提取微塑料,然后放在显微镜下进行目视观察,并结合拉曼光谱分析、傅里叶红外光谱分析、高光谱...     

Microcirculatory fraction (MCF(I)) as a potential imaging marker for tumor heterogeneity in breast cancer

Cancer is a heterogeneous disease by nature. Current imaging studies usually ignore intratumor variability in imaging biomarkers. We postulate that quantifying tumor heterogeneity with imaging techniques can provide useful information about cancer biology and potentially serve as novel imaging biomarkers. In this retrospective study, we identify a potential imaging marker, the microcirculatory fraction (MCF(I)), that quantifies tumor heterogeneity in normoxic/hypoxic cellular composition. We demonstrate its application on a test population of 22 women with stage II/III HER-2 negative breast cancer receiving antiangiogenic-cytotoxic combination neoadjuvant chemotherapy. Early change in MCF(I) (ΔMCF(I)) is assessed with dynamic contrast enhanced magnetic resonance imaging at the end of Cycle 2 and associated with pathologic response. Its performance is compared with other established volumetric imaging biomarkers (initial tumor volume and volume change) by statistical and graphic methods. We demonstrate that a significant (P<.01) difference in ΔMCF(I) can be detected between good (median ΔMCF(I) 0.27) and poor (median ΔMCF(I) -0.12) responders, despite the limited population size. Differences in the volumetric biomarkers are not statistically significant. Receiver operating characteristic analysis also shows that ΔMCF(I) is a good predictor for pathologic response (AUC=0.86, 95% CI 0.69-1.00, P<.01), while predictions made with the established volumetric biomarkers are not significantly better than random guesses. We conclude that ΔMCF(I) has the potential of being a better predictive biomarker for therapeutic response assessment. Our findings support our postulation that quantifying tumor heterogeneity with imaging techniques can provide additional information that can serve as novel biomarkers.