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Sanchez de Blas B, Temprano AG, Cives-Losada C, Briz O, Lozano E, Martinez-Chantar ML, Avila MA, Mori M, Ghallab A, Hengstler JG, Perez-Melero C, Bermejo-Gonzalez FA, Monte MJ, Romero MR, Marin JJG. A novel noninvasive test based on near-infrared fluorescent cholephilic probes for hepatobiliary secretory function assessment. Biomed Pharmacother 2025; 187:118074. [PMID: 40300393 DOI: 10.1016/j.biopha.2025.118074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Revised: 03/03/2025] [Accepted: 04/17/2025] [Indexed: 05/01/2025] Open
Abstract
Routine serum biomarkers do not always accurately reflect impaired liver function. To overcome this limitation, we synthesized novel bile acid (BA) derivatives (NIRBADs) with near-infrared (NIR) fluorescence that can penetrate the abdominal wall and be detected extracorporeally. NIRBAD dynamics in the liver parenchyma were recorded through intravital imaging in mice and extracorporeally in both rats and mice. NIRBAD metabolism was analyzed using HPLC-MS/MS and fluorimetry. Transport was investigated in cells expressing BA transporters, whose interactions with NIRBADs were assessed through molecular docking and dynamics simulations. The hepatic NIRBAD clearance time (NCT) was evaluated in animal models with impaired secretory function: rats with hepatocellular cholestatic damage induced by phalloidin and mice with obstructive cholestasis caused by bile duct ligation (BDL), as well as with spontaneous development of sclerosing cholangitis (Mdr2-/-). NIRBADs were taken up by cells expressing NTCP or OATP1B3, but minimally by OATP1B1. These findings were consistent with the NIRBAD dynamics in the liver parenchyma and in silico studies. Following intravenous administration of a non-toxic dose, the time course of NIR fluorescence in the rat liver aligned with biliary output. In mice with BDL, hepatic NIR fluorescence remained stable throughout the experimental period. Phalloidin administration impaired rat bile flow, induced a decrease in biliary NIRBAD-1 output, and caused an increase in NCT. Furthermore, the NCT was significantly longer in Mdr2-/- than in wild-type mice. In conclusion, a novel, noninvasive, real-time test based on cholephilic probes with NIR fluorescence detectable extracorporeally serves as a valuable tool for assessing hepatobiliary secretory function.
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Affiliation(s)
- Beatriz Sanchez de Blas
- Experimental Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca, Spain; Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain
| | - Alvaro G Temprano
- Experimental Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca, Spain; Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain
| | - Candela Cives-Losada
- Experimental Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca, Spain; Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain
| | - Oscar Briz
- Experimental Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca, Spain; Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain
| | - Elisa Lozano
- Experimental Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca, Spain; Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain
| | - Maria L Martinez-Chantar
- Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain; Liver Disease Laboratory, Center for Cooperative Research in Biosciences (CICbioGUNE), Basque Research and Technology Alliance (BRTA), Derio, Spain
| | - Matias A Avila
- Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain; Hepatology Laboratory, Solid Tumors Program, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain
| | - Mattia Mori
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Ahmed Ghallab
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Technical University of Dortmund, Germany; Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt
| | - Jan G Hengstler
- Department of Toxicology, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Technical University of Dortmund, Germany
| | - Concepción Perez-Melero
- Pharmaceutical Chemistry Laboratory, Pharmaceutical Sciences Department, University of Salamanca, IBSAL, Salamanca, Spain
| | | | - Maria J Monte
- Experimental Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca, Spain; Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain
| | - Marta R Romero
- Experimental Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca, Spain; Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain
| | - Jose J G Marin
- Experimental Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca, Spain; Center for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid, Spain.
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Dai H, Xiao Y, Fu C, Grimm R, von Busch H, Stieltjes B, Choi MH, Xu Z, Chabin G, Yang C, Zeng M. Deep Learning-Based Approach for Identifying and Measuring Focal Liver Lesions on Contrast-Enhanced MRI. J Magn Reson Imaging 2025; 61:111-120. [PMID: 38826142 DOI: 10.1002/jmri.29404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/12/2024] [Accepted: 04/12/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND The number of focal liver lesions (FLLs) detected by imaging has increased worldwide, highlighting the need to develop a robust, objective system for automatically detecting FLLs. PURPOSE To assess the performance of the deep learning-based artificial intelligence (AI) software in identifying and measuring lesions on contrast-enhanced magnetic resonance imaging (MRI) images in patients with FLLs. STUDY TYPE Retrospective. SUBJECTS 395 patients with 1149 FLLs. FIELD STRENGTH/SEQUENCE The 1.5 T and 3 T scanners, including T1-, T2-, diffusion-weighted imaging, in/out-phase imaging, and dynamic contrast-enhanced imaging. ASSESSMENT The diagnostic performance of AI, radiologist, and their combination was compared. Using 20 mm as the cut-off value, the lesions were divided into two groups, and then divided into four subgroups: <10, 10-20, 20-40, and ≥40 mm, to evaluate the sensitivity of radiologists and AI in the detection of lesions of different sizes. We compared the pathologic sizes of 122 surgically resected lesions with measurements obtained using AI and those made by radiologists. STATISTICAL TESTS McNemar test, Bland-Altman analyses, Friedman test, Pearson's chi-squared test, Fisher's exact test, Dice coefficient, and intraclass correlation coefficients. A P-value <0.05 was considered statistically significant. RESULTS The average Dice coefficient of AI in segmentation of liver lesions was 0.62. The combination of AI and radiologist outperformed the radiologist alone, with a significantly higher detection rate (0.894 vs. 0.825) and sensitivity (0.883 vs. 0.806). The AI showed significantly sensitivity than radiologists in detecting all lesions <20 mm (0.848 vs. 0.788). Both AI and radiologists achieved excellent detection performance for lesions ≥20 mm (0.867 vs. 0.881, P = 0.671). A remarkable agreement existed in the average tumor sizes among the three measurements (P = 0.174). DATA CONCLUSION AI software based on deep learning exhibited practical value in automatically identifying and measuring liver lesions. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY Stage 2.
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Affiliation(s)
- Haoran Dai
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuyao Xiao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Caixia Fu
- MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Robert Grimm
- MR Predevelopment, Siemens Healthineers AG, Erlangen, Germany
| | - Heinrich von Busch
- Innovation Owner Artificial Intelligence for Oncology, Siemens Healthineers AG, Erlangen, Germany
| | | | - Moon Hyung Choi
- Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Zhoubing Xu
- Technology Excellence, Digital Technology and Innovation, Siemens Healthineers, Princeton, New Jersey, USA
| | - Guillaume Chabin
- Technology Excellence, Digital Technology and Innovation, Siemens Healthecare SAS, Paris, France
| | - Chun Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Department of Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
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Boraschi P, Mazzantini V, Donati F, Coco B, Vianello B, Pinna A, Morganti R, Colombatto P, Brunetto MR, Neri E. Primary sclerosing cholangitis: Is qualitative and quantitative 3 T MR imaging useful for the evaluation of disease severity? Eur J Radiol Open 2024; 13:100595. [PMID: 39206437 PMCID: PMC11357777 DOI: 10.1016/j.ejro.2024.100595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/02/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Purpose To analyze the role of qualitative and quantitative 3 T MR imaging assessment as a non-invasive method for the evaluation of disease severity in patients with primary sclerosing cholangitis (PSC). Methods A series of 26 patients, with histological diagnosis of PSC undergoing 3 T MRI and hepatological evaluation, was retrospectively enrolled. All MR examinations included diffusion-weighted imaging (DWI), T2-weighted (T2w) and T1-weighted (T1w) sequences, before and after administration of Gd-EOB-DTPA with the acquisition of both dynamic and hepato-biliary phase (HBP). Qualitative analysis was performed by assessment of liver parenchyma and biliary tract changes, also including biliary excretion of gadoxetic acid on HBP. Quantitative evaluation was conducted on liver parenchyma by measurement of apparent diffusion coefficient (ADC) and relative enhancement (RE) on 3-minute delayed phase and on HBP. Results of blood tests (ALT, ALP, GGT, total and direct bilirubin, albumin, and platelets) and transient elastography-derived liver stiffness measurements (TE-LSM) were collected and correlated with qualitative and quantitative MRI findings. Results Among qualitative and quantitative findings, fibrosis visual assessment and RE had the best performance in estimating disease severity, showing a statistically significant correlation with both biomarkers of cholestasis and TE-LSM. Statistical analysis also revealed a significant correlation of gadoxetic acid biliary excretion with ALT and direct bilirubin, as well as of ADC with total bilirubin. Conclusion Qualitative and quantitative 3 T MR evaluation is a promising non-invasive method for the assessment of disease severity in patients with PSC.
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Affiliation(s)
- Piero Boraschi
- 2nd Unit of Radiology, Department of Radiological Nuclear and Laboratory Medicine - Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Valentina Mazzantini
- Academic Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Francescamaria Donati
- 2nd Unit of Radiology, Department of Radiological Nuclear and Laboratory Medicine - Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Barbara Coco
- Hepatology Unit, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Barbara Vianello
- Hepatology Unit, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Andrea Pinna
- Hepatology Unit, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | - Riccardo Morganti
- Departmental Section of Statistical Support for Clinical Trials, Pisa University Hospital, Via Roma 67, Pisa 56126, Italy
| | - Piero Colombatto
- Hepatology Unit, Pisa University Hospital, Via Paradisa 2, Pisa 56124, Italy
| | | | - Emanuele Neri
- Academic Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 67, Pisa 56126, Italy
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Vadlamudi S, Kumar V, Ghosh D, Abraham A. Artificial intelligence-powered precision: Unveiling the landscape of liver disease diagnosis—A comprehensive review. ENGINEERING APPLICATIONS OF ARTIFICIAL INTELLIGENCE 2024; 138:109452. [DOI: 10.1016/j.engappai.2024.109452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2025]
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Gao J, Flick A, Allen A, Krasnoff M, Kinder D, Nguyen T. Variability in Liver Size Measurements Using Different View Angles in Ultrasound Imaging. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:2345-2355. [PMID: 39248553 DOI: 10.1002/jum.16570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/10/2024]
Abstract
PURPOSE The aim of this study was to compare liver size measurements in different conventional B-mode ultrasound image (US) field views using magnetic resonance imaging (MRI) measurement as a reference. METHODS After receiving Institutional Review Board approval and informed consent, three operators measured the largest sagittal and transverse dimensions of adult livers on three US image field views (90°, 120°, and 140°) with a single curvilinear transducer. We analyzed the differences in liver size across three image field views using one-way analysis of variance (ANOVA) and examined the correlations between MRI and ultrasound measurements using Spearman regression. We used 95% Bland-Altman limits of agreement (95% LOA) to analyze the confidence interval for liver size measurements between MRI and US. Intra-observer and inter-observer reliability in measuring liver size were assessed using intraclass correlation coefficient (ICC). RESULTS Based on sagittal liver length, 28 adult participants (7 men and 21 women, mean age 43 years) were divided into Group 1 (<17 cm, n = 10) or Group 2 (≥17 cm, n = 18). There was a significant difference in the liver size measurements across the three image field views (P < .001) in both groups. The highest correlation in liver size measurements between MRI and US was with ultra-wide-view (R2 = .87 in sagittal; R2 = .79 in transverse). Bland-Altman LOA also indicated good agreement between MRI and ultra-wide-view measurements. Intra-observer and inter-observer reliability in measuring liver size were good (ICC = 0.82-0.98). CONCLUSION The study suggests that ultrasound ultra-wide-view provides the most accurate liver size measurement and good intra- and inter-operator reliability.
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Affiliation(s)
- Jing Gao
- Rocky Vista University, Montana College of Osteopathic Medicine, Billings, Montana, USA
| | - Andrew Flick
- Rocky Vista University, Montana College of Osteopathic Medicine, Billings, Montana, USA
| | - Austin Allen
- Rocky Vista University, Montana College of Osteopathic Medicine, Billings, Montana, USA
| | - Masha Krasnoff
- Rocky Vista University, Montana College of Osteopathic Medicine, Billings, Montana, USA
| | - Dennis Kinder
- Rocky Vista University, Montana College of Osteopathic Medicine, Billings, Montana, USA
| | - Trinh Nguyen
- Department of Radiology, Billings Clinic, Billings, Montana, USA
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Temprano A, Sanchez de Blas B, Pérez-Melero C, Espinosa-Escudero R, Briz O, Cinca-Fernando P, Llera L, Monte MJ, Bermejo-Gonzalez FA, Marin JJ, Romero MR. Synthesis, Characterization, and Potential Usefulness in Liver Function Assessment of Novel Bile Acid Derivatives with Near-Infrared Fluorescence (NIRBAD). Bioconjug Chem 2024; 35:971-980. [PMID: 38958375 PMCID: PMC11261600 DOI: 10.1021/acs.bioconjchem.4c00168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
Conventional serum markers often fail to accurately detect cholestasis accompanying many liver diseases. Although elevation in serum bile acid (BA) levels sensitively reflects impaired hepatobiliary function, other factors altering BA pool size and enterohepatic circulation can affect these levels. To develop fluorescent probes for extracorporeal noninvasive hepatobiliary function assessment by real-time monitoring methods, 1,3-dipolar cycloaddition reactions were used to conjugate near-infrared (NIR) fluorochromes with azide-functionalized BA derivatives (BAD). The resulting compounds (NIRBADs) were chromatographically (FC and PTLC) purified (>95%) and characterized by fluorimetry, 1H NMR, and HRMS using ESI ionization coupled to quadrupole TOF mass analysis. Transport studies using CHO cells stably expressing the BA carrier NTCP were performed by flow cytometry. Extracorporeal fluorescence was detected in anesthetized rats by high-resolution imaging analysis. Three NIRBADs were synthesized by conjugating alkynocyanine 718 with cholic acid (CA) at the COOH group via an ester (NIRBAD-1) or amide (NIRBAD-3) spacer, or at the 3α-position by a triazole link (NIRBAD-2). NIRBADs were efficiently taken up by cells expressing NTCP, which was inhibited by taurocholic acid (TCA). Following i.v. administration of NIRBAD-3 to rats, liver uptake and consequent release of NIR fluorescence could be extracorporeally monitored. This transient organ-specific handling contrasted with the absence of release to the intestine of alkynocyanine 718 and the lack of hepatotropism observed with other probes, such as indocyanine green. NIRBAD-3 administration did not alter serum biomarkers of hepatic and renal toxicity. NIRBADs can serve as probes to evaluate hepatobiliary function by noninvasive extracorporeal methods.
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Affiliation(s)
- Alvaro
G. Temprano
- Experimental
Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca 37007, Spain
| | - Beatriz Sanchez de Blas
- Experimental
Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca 37007, Spain
- Center
for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid 28029, Spain
| | - Concepción Pérez-Melero
- Pharmaceutical
Chemistry Laboratory, Pharmaceutical Sciences Department, University of Salamanca, IBSAL, Salamanca 37007, Spain
| | - Ricardo Espinosa-Escudero
- Experimental
Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca 37007, Spain
| | - Oscar Briz
- Experimental
Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca 37007, Spain
- Center
for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid 28029, Spain
| | - Paula Cinca-Fernando
- Experimental
Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca 37007, Spain
| | - Lucia Llera
- Experimental
Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca 37007, Spain
| | - Maria J. Monte
- Experimental
Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca 37007, Spain
- Center
for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid 28029, Spain
| | | | - Jose J.G. Marin
- Experimental
Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca 37007, Spain
- Center
for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid 28029, Spain
| | - Marta R. Romero
- Experimental
Hepatology and Drug Targeting (HEVEPHARM), University of Salamanca, IBSAL, Salamanca 37007, Spain
- Center
for the Study of Liver and Gastrointestinal Diseases (CIBEREHD), Carlos III National Institute of Health, Madrid 28029, Spain
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Braun J, Bernarding J, Snellings J, Meyer T, Dantas de Moraes PA, Safraou Y, Wells RG, Guo J, Tzschätzsch H, Zappe A, Pagel K, Sauer IM, Hillebrandt KH, Sack I. On the relationship between viscoelasticity and water diffusion in soft biological tissues. Acta Biomater 2024; 182:42-53. [PMID: 38729549 DOI: 10.1016/j.actbio.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/10/2024] [Accepted: 05/03/2024] [Indexed: 05/12/2024]
Abstract
Magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) are complementary imaging techniques that detect disease based on viscoelasticity and water mobility, respectively. However, the relationship between viscoelasticity and water diffusion is still poorly understood, hindering the clinical translation of combined DWI-MRE markers. We used DWI-MRE to study 129 biomaterial samples including native and cross-linked collagen, glycosaminoglycans (GAGs) with different sulfation levels, and decellularized specimens of pancreas and liver, all with different proportions of solid tissue, or solid fractions. We developed a theoretical framework of the relationship between mechanical loss and tissue-water mobility based on two parameters, solid and fluid viscosity. These parameters revealed distinct DWI-MRE property clusters characterizing weak, moderate, and strong water-network interactions. Sparse networks interacting weakly with water, such as collagen or diluted decellularized tissue, resulted in marginal changes in water diffusion over increasing solid viscosity. In contrast, dense networks with larger solid fractions exhibited both free and hindered water diffusion depending on the polarity of the solid components. For example, polar and highly sulfated GAGs as well as native soft tissues hindered water diffusion despite relatively low solid viscosity. Our results suggest that two fundamental properties of tissue networks, solid fraction and network polarity, critically influence solid and fluid viscosity in biological tissues. Since clinical DWI and MRE are sensitive to these viscosity parameters, the framework we present here can be used to detect tissue remodeling and architectural changes in the setting of diagnostic imaging. STATEMENT OF SIGNIFICANCE: The viscoelastic properties of biological tissues provide a wealth of information on the vital state of cells and host matrix. Combined measurement of viscoelasticity and water diffusion by medical imaging is sensitive to tissue microarchitecture. However, the relationship between viscoelasticity and water diffusion is still poorly understood, hindering full exploitation of these properties as a combined clinical biomarker. Therefore, we analyzed the parameter space accessible by diffusion-weighted imaging (DWI) and magnetic resonance elastography (MRE) and developed a theoretical framework for the relationship between water mobility and mechanical parameters in biomaterials. Our theory of solid material properties related to particle motion can be translated to clinical radiology using clinically established MRE and DWI.
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Affiliation(s)
- Jürgen Braun
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Germany
| | | | - Joachim Snellings
- Department of Radiology, Charité - Universitätsmedizin Berlin, Germany
| | - Tom Meyer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Germany
| | | | - Yasmine Safraou
- Department of Radiology, Charité - Universitätsmedizin Berlin, Germany
| | - Rebecca G Wells
- Perelman School of Medicine, University of Pennsylvania, PA, USA
| | - Jing Guo
- Department of Radiology, Charité - Universitätsmedizin Berlin, Germany
| | - Heiko Tzschätzsch
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Germany
| | - Andreas Zappe
- Department of Chemistry and Biochemistry, Freie Universität Berlin, Germany
| | - Kevin Pagel
- Department of Chemistry and Biochemistry, Freie Universität Berlin, Germany
| | - Igor M Sauer
- Department of Surgery, CCM | CVK, Experimental Surgery, Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany
| | - Karl H Hillebrandt
- Department of Surgery, CCM | CVK, Experimental Surgery, Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Charitéplatz 1, 10117 Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité - Universitätsmedizin Berlin, Germany.
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Chen S, Zhuang D, Jia Q, Guo B, Hu G. Advances in Noninvasive Molecular Imaging Probes for Liver Fibrosis Diagnosis. Biomater Res 2024; 28:0042. [PMID: 38952717 PMCID: PMC11214848 DOI: 10.34133/bmr.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/08/2024] [Indexed: 07/03/2024] Open
Abstract
Liver fibrosis is a wound-healing response to chronic liver injury, which may lead to cirrhosis and cancer. Early-stage fibrosis is reversible, and it is difficult to precisely diagnose with conventional imaging modalities such as magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, and ultrasound imaging. In contrast, probe-assisted molecular imaging offers a promising noninvasive approach to visualize early fibrosis changes in vivo, thus facilitating early diagnosis and staging liver fibrosis, and even monitoring of the treatment response. Here, the most recent progress in molecular imaging technologies for liver fibrosis is updated. We start by illustrating pathogenesis for liver fibrosis, which includes capillarization of liver sinusoidal endothelial cells, cellular and molecular processes involved in inflammation and fibrogenesis, as well as processes of collagen synthesis, oxidation, and cross-linking. Furthermore, the biological targets used in molecular imaging of liver fibrosis are summarized, which are composed of receptors on hepatic stellate cells, macrophages, and even liver collagen. Notably, the focus is on insights into the advances in imaging modalities developed for liver fibrosis diagnosis and the update in the corresponding contrast agents. In addition, challenges and opportunities for future research and clinical translation of the molecular imaging modalities and the contrast agents are pointed out. We hope that this review would serve as a guide for scientists and students who are interested in liver fibrosis imaging and treatment, and as well expedite the translation of molecular imaging technologies from bench to bedside.
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Affiliation(s)
- Shaofang Chen
- Department of Radiology, Shenzhen People’s Hospital (The Second Clinical Medical College,
Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Danping Zhuang
- Department of Radiology, Shenzhen People’s Hospital (The Second Clinical Medical College,
Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Qingyun Jia
- Department of Radiology, Shenzhen People’s Hospital (The Second Clinical Medical College,
Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Bing Guo
- School of Science, Shenzhen Key Laboratory of Flexible Printed Electronics Technology, Shenzhen Key Laboratory of Advanced Functional Carbon Materials Research and Comprehensive Application,
Harbin Institute of Technology, Shenzhen 518055, China
| | - Genwen Hu
- Department of Radiology, Shenzhen People’s Hospital (The Second Clinical Medical College,
Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
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An W, Xu W, Zhou Y, Huang C, Huang W, Huang J. Renal-clearable nanoprobes for optical imaging and early diagnosis of diseases. Biomater Sci 2024; 12:1357-1370. [PMID: 38374725 DOI: 10.1039/d3bm01776a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Optical imaging has played an indispensable role in clinical diagnostics and fundamental biomedical research due to its high sensitivity, high spatiotemporal resolution, cost-effectiveness, and easy accessibility. However, the issues of light scattering and low tissue penetration make them effective only for superficial imaging. To overcome these issues, renal-clearable optical nanoprobes have recently emerged, which are activated by abnormal disease-associated biomarkers and initiate a pharmacokinetic switch by undergoing degradation and eventually releasing signal reporters into urine, for simple imaging and sensitive optical in vitro urinalysis. In this review, we focus on the advancements of renal-clearable organic nanoprobes for optical imaging and remote urinalysis. The versatile design strategies of these nanoprobes are discussed along with their sensing mechanisms toward biomolecules of interest as well as their unique biological applications. Finally, challenges and perspectives are discussed to further advance the next-generation renal-clearable nanoprobes for in vivo imaging and in vitro urinalysis.
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Affiliation(s)
- Wei An
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, Fujian, 350002, China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Weiping Xu
- Department School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, 510006, China.
| | - Ya Zhou
- Department School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, 510006, China.
| | - Changwen Huang
- General surgery department, the Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, Guangdong, 511518, China
| | - Weiguo Huang
- State Key Laboratory of Structural Chemistry, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, Fujian, 350002, China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Jiaguo Huang
- Department School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, 510006, China.
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10
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Hu Q, Su Y, Ma S, Wei P, He C, Yang D, Qian Y, Shen Y, Zhou X, Zhou Z, Hu H. Integrin-Targeted Theranostic Nanoparticles for Clinical MRI-Traceable Treatment of Liver Fibrosis. ACS APPLIED MATERIALS & INTERFACES 2024; 16:2012-2026. [PMID: 38165274 DOI: 10.1021/acsami.3c12776] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Liver fibrosis is the critical stage in the development of chronic liver disease (CLD), from simple injury to irreversible cirrhosis. Timely detection and intervention of liver fibrosis are crucial for preventing CLD from progressing into a fatal condition. Herein, we developed iron oxide (Fe3O4) nanoparticles (IONPs) and ferulic acid (FA) coencapsulated poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs), followed by surface modification with cRGD peptides (cRGD-PLGA/IOFA) for integrin-targeted clinical magnetic resonance imaging (MRI)-traceable treatment of liver fibrosis. The cRGD peptide linked on the surface of the PLGA/IOFA NPs could specifically bind to the overexpressed integrin αvβ3 on activated hepatic stellate cells (HSCs) in the fibrotic liver, enabling the high-sensitive clinical MR imaging (3 T) and precise staging of liver fibrosis. The FA encapsulated in cRGD-PLGA/IOFA showed excellent efficacy in reducing oxidative stress and inhibiting the activation of HSCs through the transforming growth factor-β (TGF-β)/Smad pathway. Notably, the IONPs encapsulated in cRGD-PLGA/IOFA NPs could alleviate liver fibrosis by regulating hepatic macrophages through the NF-κB pathway, lowering the proportion of Ly6Chigh/CD86+, and degrading collagen fibers. The FA and IONPs in the cRGD-PLGA/IOFA produced a synergistic enhancement effect on collagen degradation, which was more effective than the IONPs treatment alone. This study demonstrates that cRGD-PLGA/IOFA NPs could effectively relieve liver fibrosis by acting on macrophages and HSCs and provide a new strategy for the clinical MRI-traceable treatment of liver fibrosis.
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Affiliation(s)
- Qiuhui Hu
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH) of School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang, China
| | - Yongzhao Su
- Zhejiang Key Laboratory of Smart Biomaterials and Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China
| | - Siying Ma
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH) of School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang, China
| | - Peiying Wei
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Chengbin He
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH) of School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang, China
| | - Di Yang
- Department of Radiology, Zhejiang Hospital, Hangzhou 310030, China
| | - Yue Qian
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH) of School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang, China
| | - Youqing Shen
- Zhejiang Key Laboratory of Smart Biomaterials and Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China
| | - Xiaoxuan Zhou
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH) of School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang, China
| | - Zhuxian Zhou
- Zhejiang Key Laboratory of Smart Biomaterials and Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China
| | - Hongjie Hu
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH) of School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang, China
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11
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Bai J, Du YQ, Yang W, Bai XM, Wang S, Wu W, Yan K, Chen MH. The Role of Contrast-Enhanced Ultrasound Plus Color Parametric Imaging in the Differential Diagnosis of Subpleural Pulmonary Lesions. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2777-2789. [PMID: 37594990 DOI: 10.1002/jum.16316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/16/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVES To distinguish benign and malignant subpleural pulmonary lesions (SPLs) with contrast-enhanced ultrasound (CEUS) and color parametric imaging (CPI), and evaluate the role of CEUS plus CPI in the differential diagnosis of pathological types of SPLs. METHODS One hundred and thirty-six patients underwent CEUS with a Logiq E9 XD Clear ultrasonic machine equipped with a 3.5- to 5.0-MHz C5-1 transducer in our center were enrolled in our study, including 27 cases of benign lesions and 109 cases of malignant lesions. The ultrasound contrast agent used in this study was SonoVue. CEUS images and CPI of all cases were reviewed and analyzed by the resident and staff radiologist groups separately. RESULTS With CEUS alone, by both the two groups, the main enhancement pattern of benign SPLs was arborization (P < .001), while centripetal enhancement pattern occurred more frequently in malignant SPLs (P < .001). With CEUS plus CPI, by both the two groups, the main enhancement pattern of benign SPLs was arborization (P < .001), while those of malignant SPLs were centripetal (P < .001) and eccentric (P < .05). The diagnosis performance of CEUS plus CPI was significantly higher than that of CEUS alone in both the resident (area under the curve [AUC] = 0.857 vs 0.677, P < .001) and staff (AUC = 0.866 vs 0.681, P < .001) groups. Moreover, CPI offered remarkable inter-consistency improvements in the enhancement pattern determination between the two groups. CONCLUSION The CEUS enhancement patterns would provide information of blood perfusion patterns in the differential diagnosis of benign and malignant SPLs. The diagnosis performance could be significantly improved by CEUS plus CPI compared with CEUS alone.
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Affiliation(s)
- Jing Bai
- Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Yu-Qing Du
- Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei Yang
- Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiu-Mei Bai
- Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Song Wang
- Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei Wu
- Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Kun Yan
- Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - Min-Hua Chen
- Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
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Abstract
ABSTRACT The mechanical traits of cancer include abnormally high solid stress as well as drastic and spatially heterogeneous changes in intrinsic mechanical tissue properties. Whereas solid stress elicits mechanosensory signals promoting tumor progression, mechanical heterogeneity is conducive to cell unjamming and metastatic spread. This reductionist view of tumorigenesis and malignant transformation provides a generalized framework for understanding the physical principles of tumor aggressiveness and harnessing them as novel in vivo imaging markers. Magnetic resonance elastography is an emerging imaging technology for depicting the viscoelastic properties of biological soft tissues and clinically characterizing tumors in terms of their biomechanical properties. This review article presents recent technical developments, basic results, and clinical applications of magnetic resonance elastography in patients with malignant tumors.
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Affiliation(s)
- Jing Guo
- From the Department of Radiology
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13
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Huang M, Qi M, Yang H, Peng Z, Chen S, Liang M, Hu Y, Deng L, Hu M. Noninvasive Strategies for the Treatment of Tiny Liver Cancer: Integrating Photothermal Therapy and Multimodality Imaging EpCAM-Guided Nanoparticles. ACS APPLIED MATERIALS & INTERFACES 2023; 15:21843-21853. [PMID: 37102323 DOI: 10.1021/acsami.3c00211] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Surgical resection and ablation therapy have been shown to achieve the purpose of a radical cure for liver cancer with a size of less than 3 cm; however, tiny liver cancer lesions of diameters smaller than 2 cm remain challenging to diagnose and cure due to the failure of the generation of new blood vessels within tumors. Emerging evidence has revealed that optical molecular imaging combined with nanoprobes can detect tiny cancer from the perspective of molecular and cellular levels and kill cancer cells by the photothermal effect of nanoparticles in real time, thereby achieving radical goals. In the present study, we designed and synthesized multicomponent and multifunctional ICG-CuS-Gd@BSA-EpCAM nanoparticles (NPs) with a potent antineoplastic effect on tiny liver cancer. Using subcutaneous and orthotopic liver cancer xenograft mouse models, we found that the components of the NPs, including ICG and CuS-Gd@BSA, showed synergistic photothermal effects on the eradication of tiny liver cancer. We also found that the ICG-CuS-Gd@BSA-EpCAM NPs exhibited triple-modal functions of fluorescence imaging, magnetic resonance imaging, and photoacoustic imaging, with targeted detection and photothermal treatment of tiny liver cancer under near-infrared light irradiation. Together, our study demonstrates that the ICG-CuS-Gd@BSA-EpCAM NPs in combination with optical imaging technique might be a potential approach for detecting and noninvasively and radically curing tiny liver cancer by the photothermal effect.
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Affiliation(s)
- Maohua Huang
- Department of Hepatobiliary Surgery, Jinan University First Affiliated Hospital, Jinan University, Guangzhou 510632, China
- College of Pharmacy, Jinan University, Guangzhou 510632, China
| | - Ming Qi
- College of Pharmacy, Jinan University, Guangzhou 510632, China
| | - Hongyan Yang
- Department of Hepatobiliary Surgery, Jinan University First Affiliated Hospital, Jinan University, Guangzhou 510632, China
| | - Zhi Peng
- Department of Hepatobiliary Surgery, Jinan University First Affiliated Hospital, Jinan University, Guangzhou 510632, China
| | - Shouguo Chen
- School of Traditional Chinese Medicine, Jinan University, Guangzhou 510630, China
| | - Mingchao Liang
- Department of Hepatobiliary Surgery, Jinan University Affiliated Shunde Hospital, Jinan University, Foshan 528305, China
| | - Youzhu Hu
- Department of Hepatobiliary Surgery, Jinan University First Affiliated Hospital, Jinan University, Guangzhou 510632, China
- Department of Hepatobiliary Surgery, Jinan University Affiliated Shunde Hospital, Jinan University, Foshan 528305, China
| | - Lijuan Deng
- School of Traditional Chinese Medicine, Jinan University, Guangzhou 510630, China
| | - Min Hu
- Department of Hepatobiliary Surgery, Jinan University First Affiliated Hospital, Jinan University, Guangzhou 510632, China
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Nithiyaraj E, Selvaraj A. CTSC-Net: an effectual CT slice classification network to categorize organ and non-organ slices from a 3-D CT image. Neural Comput Appl 2022; 34:22141-22156. [PMID: 35990533 PMCID: PMC9376041 DOI: 10.1007/s00521-022-07701-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022]
Abstract
Computed tomography (CT) is a non-invasive diagnostic imaging modality that reveals more insight into human organs than conventional X-rays. In general, the CT output is a 3-D image that is formed by combining multiple 2D images or slices together. It is essential to keep in mind that not all of the slices provide significant information to detect tumours. Usually, a 3-D CT image obtained from the CT scanners has a significant number of unwanted non-organ slices in it. Radiologists typically devote a significant amount of time to select the slices with organ from a 3-D CT image. The presence of a tumour is only evident in the organ slice; hence, radiologists must be cautious not to skip any organ slices. This work is evaluated on the LITS, 3DIRCADb and COVID-19 CT datasets. The three datasets collectively contain 22,435 organ slices and 53,661 non-organ slices, and there is a huge gap between the number of organ and non-organ slices. There is a need for the automatic elimination of non-organ slices in 3-D CT volumes to assist the physicians, and hence, this work focuses on the automatic recognition of organ slices from 3-D CT volumes. In this paper, a new deep model called the computed tomography slice classification network (CTSC-Net) is proposed for CT slice classification between organ and non-organ slices. The model is trained on 77,980 CT slices, validated on 9748 slices and tested on 12,571 slices. Nine CNN architectures with different layer settings are trained and tested to arrive at the final optimal model. The performance measures are computed in terms of true positive rate, true negative rate, sensitivity, specificity and accuracy. The 20-layer CTSC-Net achieves a validation accuracy of 95.04% and an overall testing accuracy of 99.96%. The proposed model is compared to eight different pre-trained CNN models, and the results of the proposed CTSC-Net surpassed all the comparable models. The activation feature maps of different layers of the CTSC-Net are visualized to verify the discriminative features learned by the network. Hence, the proposed CTSC-Net can be employed as a computer-aided diagnosis tool to help physicians discard unnecessary non-organ slices from the 3-D CT volume and to speed up the CT diagnosis process.
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Affiliation(s)
- Emerson Nithiyaraj
- Department of Electronics and Communication Engineering, Centre for Image Processing and Pattern Recognition, Mepco Schlenk Engineering College, Sivakasi, 626005 India
| | - Arivazhagan Selvaraj
- Department of Electronics and Communication Engineering, Centre for Image Processing and Pattern Recognition, Mepco Schlenk Engineering College, Sivakasi, 626005 India
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15
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Cassinotto C, Jacq T, Anselme S, Ursic-Bedoya J, Blanc P, Faure S, Belgour A, Guiu B. Diagnostic Performance of Attenuation to Stage Liver Steatosis with MRI Proton Density Fat Fraction as Reference: A Prospective Comparison of Three US Machines. Radiology 2022; 305:353-361. [PMID: 35819322 DOI: 10.1148/radiol.212846] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background US tools to quantify liver fat content have recently been made clinically available by different vendors, but comparative data on their accuracy are lacking. Purpose To compare the diagnostic performances of the attenuation parameters of US machines from three different manufacturers (vendors 1, 2, and 3) in participants who underwent liver fat quantification with the MRI-derived proton density fat fraction (PDFF). Materials and Methods From July 2020 to June 2021, consecutive participants with chronic liver disease were enrolled in this prospective single-center study and underwent MRI PDFF quantification (reference standard) and US on the same day. US was performed with two different machines from among three vendors assessed. Areas under the receiver operating characteristic curve (AUCs) for the staging of liver steatosis (MRI PDFF: ≥5.5% for grade ≥S1 and ≥15.5% for grade ≥S2) were calculated in test and validation samples and then compared between vendors in the study sample. Results A total of 534 participants (mean age, 60 years ± 13 [SD]; 320 men) were evaluated. Failure of measurements occurred in less than 1% of participants for all vendors. Correlation coefficients with the MRI PDFF were 0.71, 0.73, and 0.54 for the attenuation coefficients of vendors 1, 2, and 3, respectively. In the test sample, AUCs for diagnosis of steatosis grade S1 and higher and grade S2 and higher were 0.89 and 0.93 for vendor 1 attenuation, 0.88 and 0.92 for vendor 2 attenuation, and 0.79 and 0.79 for vendor 3 attenuation, respectively. In the validation sample, a threshold value of 0.65 for vendor 1 and 0.66 for vendor 2 yielded sensitivity of 77% and 84% and specificity of 78% and 85%, respectively, for diagnosis of grade S1 and higher. Vendor 2 attenuation had greater AUCs than vendor 3 attenuation (P = .001 and P = .003) for diagnosis of grade S1 and higher and grade S2 and higher, respectively, and vender 2 had greater AUCs for attenuation than vendor 1 for diagnosis of grade S2 and higher (P = .04). For all vendors, attenuation was not associated with liver stiffness (correlation coefficients <0.05). Conclusion To stage liver steatosis, attenuation coefficient accuracy varied among US devices across vendors when using MRI proton density fat fraction quantification as the reference standard, with some demonstrating excellent diagnostic performance and similar cutoff values. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Dubinsky in this issue.
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Affiliation(s)
- Christophe Cassinotto
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Tony Jacq
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Sophie Anselme
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - José Ursic-Bedoya
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Pierre Blanc
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Stéphanie Faure
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Ali Belgour
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
| | - Boris Guiu
- From the Departments of Diagnostic and Interventional Radiology (C.C., T.J., S.A., A.B., B.G.), Hepatology A (J.U.B., S.F.), and Hepatology B (P.B.), Saint-Eloi Hospital, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34090 Montpellier, France; and Institut Desbrest d'Epidémiologie et de Santé Publique, IDESP UMR UA11 INSERM, Montpellier University, Montpellier, France (C.C., B.G.)
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Tardieu M, Salameh N, Souris L, Rousseau D, Jourdain L, Skeif H, Prévot F, de Rochefort L, Ducreux D, Louis B, Garteiser P, Sinkus R, Darrasse L, Poirier-Quinot M, Maître X. Magnetic resonance elastography with guided pressure waves. NMR IN BIOMEDICINE 2022; 35:e4701. [PMID: 35088465 DOI: 10.1002/nbm.4701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
Magnetic resonance elastography aims to non-invasively and remotely characterize the mechanical properties of living tissues. To quantitatively and regionally map the shear viscoelastic moduli in vivo, the technique must achieve proper mechanical excitation throughout the targeted tissues. Although it is straightforward, ante manibus, in close organs such as the liver or the breast, which practitioners clinically palpate already, it is somewhat fortunately highly challenging to trick the natural protective barriers of remote organs such as the brain. So far, mechanical waves have been induced in the latter by shaking the surrounding cranial bones. Here, the skull was circumvented by guiding pressure waves inside the subject's buccal cavity so mechanical waves could propagate from within through the brainstem up to the brain. Repeatable, reproducible and robust displacement fields were recorded in phantoms and in vivo by magnetic resonance elastography with guided pressure waves such that quantitative mechanical outcomes were extracted in the human brain.
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Affiliation(s)
- Marion Tardieu
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
- Montpellier Cancer Research Institute (IRCM), Inserm U1194, University of Montpellier, Montpellier, France
| | - Najat Salameh
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
- Center for Adaptable MRI Technology, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Line Souris
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | | | - Laurène Jourdain
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | - Hanadi Skeif
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | - François Prévot
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | - Ludovic de Rochefort
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
- Aix-Marseille Université, CNRS, CRMBM, Marseille, France
- AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Denis Ducreux
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | - Bruno Louis
- Inserm-UPEC UMR955, CNRS EMR7000, Equipe Biomécanique Cellulaire et Respiratoire, Créteil, France
| | - Philippe Garteiser
- Laboratory of Imaging Biomarkers, Center for Research on Inflammation, UMR 1149, Inserm, Université de Paris, Paris, France
| | - Ralph Sinkus
- Imaging Sciences & Biomedical Engineering Division, King's College, London, United Kingdom
| | - Luc Darrasse
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | | | - Xavier Maître
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
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Perera D, Wang Q, Schniepp HC. Multi-Point Nanoindentation Method to Determine Mechanical Anisotropy in Nanofibrillar Thin Films. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2202065. [PMID: 35780468 DOI: 10.1002/smll.202202065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/26/2022] [Indexed: 06/15/2023]
Abstract
Biomaterials with outstanding mechanical properties, including spider silk, wood, and cartilage, often feature an oriented nanofibrillar structure. The orientation of nanofibrils gives rise to a significant mechanical anisotropy, which is extremely challenging to characterize, especially for microscopically small or inhomogeneous samples. Here, a technique utilizing atomic force microscope indentation at multiple points combined with finite element analysis to sample the mechanical anisotropy of a thin film in a microscopically small area is reported. The system studied here is the tape-like silk of the Chilean recluse spider, which entirely consists of strictly oriented nanofibrils giving rise to a large mechanical anisotropy. The most detailed directional nanoscale structure-property characterization of spider silk to date is presented, revealing the tensile and transverse elastic moduli as 9 and 1 GPa, respectively, and the binding strength between silk nanofibrils as 159 ± 13 MPa. Furthermore, based on this binding strength, the nanofibrils' surface energy is derived as 37 mJ m-2 , and concludes that van der Waals forces play a decisive role in interfibrillar binding. Due to its versatility, this technique has many potential applications, including early disease diagnostics, as underlying pathological conditions can alter the local mechanical properties of tissues.
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Affiliation(s)
- Dinidu Perera
- Department of Applied Science, William & Mary, P.O. Box 8795, Williamsburg, VA, 23187-8795, USA
| | - Qijue Wang
- Department of Applied Science, William & Mary, P.O. Box 8795, Williamsburg, VA, 23187-8795, USA
| | - Hannes C Schniepp
- Department of Applied Science, William & Mary, P.O. Box 8795, Williamsburg, VA, 23187-8795, USA
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Huang J, Xian S, Liu Y, Chen X, Pu K, Wang H. A Renally Clearable Activatable Polymeric Nanoprobe for Early Detection of Hepatic Ischemia-Reperfusion Injury. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2201357. [PMID: 35436014 DOI: 10.1002/adma.202201357] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/05/2022] [Indexed: 06/14/2023]
Abstract
Although hepatic ischemia-reperfusion injury (IRI) represents a major complication in many clinical settings, it remains a diagnostic dilemma due to its reliance on insensitive assays or invasive biopsy. The development of an activatable polymeric nanoprobe (APNSO ) for real-time in vivo near-infrared fluorescence (NIRF) imaging and urinalysis of hepatic IRI is reported here. APNSO has a backbone comprising renally clearable fluorophore fragments and self-immolative structural units. In the presence of an oxidative stress biomarker (superoxide anion, O2 •- ) during hepatic IRI, APNSO can be fluorescently activated for in vivo NIRF imaging and depolymerized to release renally clearable fluorophores for urinalysis. By virtue of its high hepatic accumulation, sensitive response toward O2 •- , and effective release of renally clearable fluorophores, APNSO -based imaging and urinalysis detect hepatic IRI at least 7 h earlier than typical clinical assays in a mouse model. This study not only provides new opportunities for noninvasive diagnosis of hepatic IRI, but also reveals guidelines for the development of optical nanosensors for early urinalysis.
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Affiliation(s)
- Jiaguo Huang
- The First Affiliated Hospital, NHC Key Laboratory of Combined Multi-Organ Transplantation, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, 310003, P. R. China
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, 510006, P. R. China
| | - Shiyun Xian
- The First Affiliated Hospital, NHC Key Laboratory of Combined Multi-Organ Transplantation, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, 310003, P. R. China
| | - Yi Liu
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, 510006, P. R. China
| | - Xiaona Chen
- The First Affiliated Hospital, NHC Key Laboratory of Combined Multi-Organ Transplantation, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, 310003, P. R. China
| | - Kanyi Pu
- School of Chemical and Biomedical Engineering, Nanyang Technological University, 70 Nanyang Drive, Singapore, 637457, Singapore
| | - Hangxiang Wang
- The First Affiliated Hospital, NHC Key Laboratory of Combined Multi-Organ Transplantation, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, 310003, P. R. China
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Hill TA, Crooks CJ, West J, Morling JR. Trends in indirect liver function marker testing in Wales from 2000 to 2017 and their association with age and sex: an observational study. BMJ Open Gastroenterol 2022; 9:bmjgast-2022-000885. [PMID: 35487590 PMCID: PMC9058682 DOI: 10.1136/bmjgast-2022-000885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/27/2022] [Indexed: 11/28/2022] Open
Abstract
Objective If non-invasive markers of liver fibrosis were recorded frequently enough in clinical practice, it might be feasible to use them for opportunistic community screening for liver disease. We aimed to determine their current pattern of usage in the national primary care population in Wales. Design Using the Secure Anonymised Information Linkage (SAIL) Databank at Swansea University (2000–2017), we quantified the frequency of common liver blood tests (aspartate aminotransferase (AST), alanine aminotransferase (ALT), platelet count and albumin) used in fibrosis marker algorithms. We examined measurement variation by age and sex. Results During the 18-year study period, there were 2 145 178 adult patients with at least one blood test available for analysis. Over the study period, the percentage of SAIL patients receiving an ALT test in each year increased from 2% to 33%, with platelet count and albumin measurement increasing by a similar factor. AST testing, although initially rising, had decreased to 1% by the end of the study. AST and ALT values varied by age and sex, particularly in males with the upper normal range of ALT values decreasing rapidly from 90 U/L at age 30 to 45 U/L by age 80. Conclusion The reduction in AST testing to only 1% of the adult population limits the use of many non-invasive liver marker algorithms. To enable widespread screening, alternative algorithms for liver fibrosis that do not depend on AST should be developed. Liver fibrosis markers should be modified to include age-specific and sex-specific normal ranges.
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Affiliation(s)
- Trevor Alexander Hill
- Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Nottingham, UK
| | - Colin John Crooks
- Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Nottingham, UK
| | - Joe West
- Population and Lifespan Sciences, NIHR Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Nottingham, UK
| | - Joanne R Morling
- Population and Lifespan Sciences, NIHR Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Nottingham, UK
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Han X, Wu X, Wang S, Xu L, Xu H, Zheng D, Yu N, Hong Y, Yu Z, Yang D, Yang Z. Automated segmentation of liver segment on portal venous phase MR images using a 3D convolutional neural network. Insights Imaging 2022; 13:26. [PMID: 35201517 PMCID: PMC8873293 DOI: 10.1186/s13244-022-01163-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/24/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE We aim to develop and validate a three-dimensional convolutional neural network (3D-CNN) model for automatic liver segment segmentation on MRI images. METHODS This retrospective study evaluated an automated method using a deep neural network that was trained, validated, and tested with 367, 157, and 158 portal venous phase MR images, respectively. The Dice similarity coefficient (DSC), mean surface distance (MSD), Hausdorff distance (HD), and volume ratio (RV) were used to quantitatively measure the accuracy of segmentation. The time consumed for model and manual segmentation was also compared. In addition, the model was applied to 100 consecutive cases from real clinical scenario for a qualitative evaluation and indirect evaluation. RESULTS In quantitative evaluation, the model achieved high accuracy for DSC, MSD, HD and RV (0.920, 3.34, 3.61 and 1.01, respectively). Compared to manual segmentation, the automated method reduced the segmentation time from 26 min to 8 s. In qualitative evaluation, the segmentation quality was rated as good in 79% of the cases, moderate in 15% and poor in 6%. In indirect evaluation, 93.4% (99/106) of lesions could be assigned to the correct segment by only referring to the results from automated segmentation. CONCLUSION The proposed model may serve as an effective tool for automated anatomical region annotation of the liver on MRI images.
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Affiliation(s)
- Xinjun Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xinru Wu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuhui Wang
- Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Lixue Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hui Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Dandan Zheng
- Shukun (Beijing) Technology Co., Ltd., Beijing, China
| | - Niange Yu
- Shukun (Beijing) Technology Co., Ltd., Beijing, China
| | - Yanjie Hong
- Shukun (Beijing) Technology Co., Ltd., Beijing, China
| | - Zhixuan Yu
- Shukun (Beijing) Technology Co., Ltd., Beijing, China
| | - Dawei Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Hall RC, Qin J, Laney V, Ayat N, Lu ZR. Manganese(II) EOB-Pyclen Diacetate for Liver-Specific MRI. ACS APPLIED BIO MATERIALS 2022; 5:451-458. [PMID: 35148050 DOI: 10.1021/acsabm.1c01259] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
MRI is increasingly utilized for the diagnosis of liver disease and focal liver lesions. Although liver-targeted gadolinium-based contrast agents (GBCAs) have high efficacy, there continue to be safety concerns regarding release of toxic Gd(III) ions. Herein, Mn(EOB-PC2A) is synthesized as a nongadolinium alternative for liver-specific MRI. Mn(EOB-PC2A) has an r1 relaxivity of 2.8 mM-1 s-1 in Dulbecco's phosphate-buffered saline (DPBS) and 5.9 mM-1 s-1 in saline containing human serum albumin at 1.5 T. It has a strong uptake in hepatocytes with minimal toxicity and demonstrated robust liver-specific enhancement at a dose of 60 μmol/kg. Mn(EOB-PC2A) is a promising liver-specific contrast agent for liver MRI.
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Affiliation(s)
- Ryan C Hall
- Department of Biomedical Engineering, Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Jingcan Qin
- Department of Biomedical Engineering, Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Victoria Laney
- Department of Biomedical Engineering, Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Nadia Ayat
- Department of Biomedical Engineering, Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Zheng-Rong Lu
- Department of Biomedical Engineering, Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio 44106, United States
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Automatic Classification of Fatty Liver Disease Based on Supervised Learning and Genetic Algorithm. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12010521] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Fatty liver disease is considered a critical illness that should be diagnosed and detected at an early stage. In advanced stages, liver cancer or cirrhosis arise, and to identify this disease, radiologists commonly use ultrasound images. However, because of their low quality, radiologists found it challenging to recognize this disease using ultrasonic images. To avoid this problem, a Computer-Aided Diagnosis technique is developed in the current study, using Machine Learning Algorithms and a voting-based classifier to categorize liver tissues as being fatty or normal, based on extracting ultrasound image features and a voting-based classifier. Four main contributions are provided by our developed method: firstly, the classification of liver images is achieved as normal or fatty without a segmentation phase. Secondly, compared to our proposed work, the dataset in previous works was insufficient. A combination of 26 features is the third contribution. Based on the proposed methods, the extracted features are Gray-Level Co-Occurrence Matrix (GLCM) and First-Order Statistics (FOS). The fourth contribution is the voting classifier used to determine the liver tissue type. Several trials have been performed by examining the voting-based classifier and J48 algorithm on a dataset. The obtained TP, TN, FP, and FN were 94.28%, 97.14%, 5.71%, and 2.85%, respectively. The achieved precision, sensitivity, specificity, and F1-score were 94.28%, 97.05%, 94.44%, and 95.64%, respectively. The achieved classification accuracy using a voting-based classifier was 95.71% and in the case of using the J48 algorithm was 93.12%. The proposed work achieved a high performance compared with the research works.
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Elrefaey Hasan BM, Abd ElHamid HAE, Khater NH, ElGendy W, Abdelrahman AS. Role of DWI in evaluation of HCC after radiofrequency ablation compared to dynamic MRI using MRI (3 T). THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00647-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The purpose of this study was to investigate the diagnostic performance of diffusion weight imaging (DWI), apparent diffusion coefficient (ADC) map, normalized ADC liver, and normalized ADC spleen compared to the dynamic contrast-enhanced MRI (DCE-MRI) in the evaluation of residual hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) using 3 T (T) magnetic resonance imaging (MRI).
Results
A prospective study was performed on 40 patients with radiofrequency-ablated HCC, and 15 (37.5%) patients had viable lesion post-RFA, while 25 (62.5%) had non-viable lesions. DCE-MRI had a sensitivity, specificity, and accuracy of 100%, 100%, and 100%, respectively, compared to DWI which had a sensitivity, specificity, and accuracy of 80%, 88%, and 85%, respectively, for identifying post-RFA viable HCC. The sensitivity, specificity, and accuracy of ADC at a cutoff value of 1.01 × 10−3 mm2/s were 80%, 100%, and 97.1%, respectively. The optimal cutoff value of normalized ADC liver was 0.81 with a sensitivity of 73.3%, specificity of 96%, and accuracy of 92.8%. The sensitivity, specificity, and accuracy of normalized ADC spleen at a cutoff value of 1.22 were 80%, 92%, and 91.1%, respectively.
Conclusions
DWI-MRI is a reliable technique for assessing HCC after radiofrequency ablation. DWI-MRI with ADC may be used as an alternate sequence for assessing radiofrequency-ablated lesions in individuals who have a contraindication to the contrast media, and the normalized ADC value may be of additional benefit.
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Wang SH, Du J, Xu H, Yang D, Ye Y, Chen Y, Zhu Y, Ba T, Yuan C, Yang ZH. Automatic discrimination of different sequences and phases of liver MRI using a dense feature fusion neural network: a preliminary study. Abdom Radiol (NY) 2021; 46:4576-4587. [PMID: 34057565 DOI: 10.1007/s00261-021-03142-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/16/2021] [Accepted: 05/22/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To develop and validate a dense feature fusion neural network (DFuNN) to automatically recognize different sequences and phases of liver magnetic resonance imaging (MRI). MATERIALS AND METHODS In total, 3869 sequences and phases from 384 liver MRI examinations, divided into training/validation (n = 2886 sequences from 287 patients) and test (n = 983 sequences from 97 patients) sets, were used in this retrospective study. Ten unenhanced sequences and enhanced phases were included. Manual sequence recognition, performed by two radiologists (20 and 10 years of experience) in a consensus reading, was used as the reference standard. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) were calculated to evaluate the performance of the DFuNN on an identical unseen test set. Finally, we evaluated the factors impacting the model precision. RESULTS A fusion block improved the performance of the DFuNN. DFuNN with a fusion block achieved good recognition performance for both complete and incomplete sequences and phases in the test set. The average sensitivity of recognition performance for complete sequence and phase inputs ranged from 88.06 to 100%, the average specificity ranged from 99.12 to 99.94%, and the median accuracy ranged from 98.02 to 99.95%. The DFuNN prediction accuracy for patients without cirrhosis were significantly higher than those for patients with cirrhosis (P = 0.0153). No significant difference was found in the accuracy across other factors. CONCLUSION DFuNN can automatically and accurately identify specific unenhanced MRI sequences and enhanced MRI phases.
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Affiliation(s)
- Shu-Hui Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
- Department of Radiology, Weihai Municipal Hospital, Weihai, Shandong Province, China
| | - Jing Du
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Hui Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Dawei Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Yuxiang Ye
- Shanghai SenseTime Intelligent Technology Co. Ltd, Beijing, China
| | - Yinan Chen
- Shanghai SenseTime Intelligent Technology Co. Ltd, Beijing, China
| | - Yajing Zhu
- Shanghai SenseTime Intelligent Technology Co. Ltd, Beijing, China
| | - Te Ba
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Chunwang Yuan
- Center of Interventional Oncology and Liver Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Zheng-Han Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, 100050, China.
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Evaluation of Rabbits Liver Fibrosis Using Gd-DTPA-BMA of Dynamic Contrast-Enhanced Magnetic Resonance Imaging. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2791142. [PMID: 34567208 PMCID: PMC8463207 DOI: 10.1155/2021/2791142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/25/2021] [Accepted: 09/03/2021] [Indexed: 11/17/2022]
Abstract
Objective To evaluate the different pharmacokinetic parameters of the DCE-MRI method on diagnosing and staging of rabbits' liver fibrosis. Methods We had performed DCE-MRI for rabbits that had been divided into the experiment group and the control group. Then, rabbits' images were transferred to a work station to get three parameters such as K trans, K ep, and V e, which had been measured to calculate. After data were analyzed, ROC analyses were performed to assess the diagnostic performance of K trans, K ep, and V e to judge liver fibrosis. Results The distribution of the different liver fibrosis group was as follows: F1, n = 8; F2, n = 9; F3, n = 6; F4, n = 5. No fibrosis was deemed as F0, n = 6. K ep is statistically significant (P < 0.05) for F0 and mild liver fibrosis stage, and the K ep shows AUC of 0.814. Three parameters are statistically significant for F0 and advanced liver fibrosis stage (K trans and K ep, P < 0.01; V e, P < 0.05), and the K trans shows AUC of 0.924; the K ep shows AUC of 0.909; the V e shows AUC of 0.848; K trans and K ep are statistically significant for mild and advanced liver fibrosis stages (K trans, P < 0.01; K ep, P < 0.05), and the K trans shows AUC of 0.840; the K ep shows AUC of 0.765. Both K trans and K ep are negatively correlated with the liver fibrosis stage. V e is positively correlated with the liver fibrosis stage. Conclusion K trans is shown to be the best DCE parameter to distinguish the fibrotic liver from the normal liver and mild and advanced fibrosis. On the contrary, K ep is moderate and V e is worst. And K ep is a good DCE parameter to differentiate mild fibrosis from the normal liver.
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Belkahla H, Antunes JC, Lalatonne Y, Sainte Catherine O, Illoul C, Journé C, Jandrot-Perrus M, Coradin T, Gigoux V, Guenin E, Motte L, Helary C. USPIO-PEG nanoparticles functionalized with a highly specific collagen-binding peptide: a step towards MRI diagnosis of fibrosis. J Mater Chem B 2021; 8:5515-5528. [PMID: 32490469 DOI: 10.1039/d0tb00887g] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Fibrosis is characterized by a pathologic deposition of collagen I, leading to impaired function of organs. Tissue biopsy is the gold standard method for the diagnosis of fibrosis but this is an invasive procedure, subject to sampling errors. Several non-invasive techniques such as magnetic resonance imaging (MRI) using non-specific probes have been developed but they are not fully satisfying as they allow diagnosis at a late stage. In this study, collagelin, a collagen-binding peptide has been covalently linked using click chemistry to pegylated Ultra Small Super Paramagnetic Iron Oxide Nanoparticles (USPIO-PO-PEG-collagelin NPs) with the aim of diagnosing fibrosis at an early stage by MRI. USPIO-PO-PEG-collagelin NPs showed a high affinity for collagen I, two times higher than that of free collagelin whereas not peptide labeled USPIO NPs (USPIO-PO-PEG-yne) did not present any affinity. NPs were not toxic for macrophages and fibroblasts. Diffusion through collagen hydrogels concentrated at 3 and 10 mg mL-1 revealed a large accumulation of USPIO-PO-PEG-collagelin NPs within the collagen network after 72 hours, ca. 3 times larger than that of unlabeled USPIO, thereby evidencing the specific targeting of collagen I. Moreover, the quantity of USPIO-PO-PEG-collagelin NPs accumulated within hydrogels was proportional to the collagen concentration. Subsequently, the NPs diffusion through collagen hydrogels was monitored by MRI. The MRI T2 time relaxation decreased much more significantly with depth for USPIO-PO-PEG-collagelin NPs compared to unlabeled ones. Taken together, these results show that USPIO-PEG-collagelin NPs are promising as effective MRI nanotracers for molecular imaging of fibrosis at an early stage.
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Affiliation(s)
- Hanene Belkahla
- Université Sorbonne Paris Nord, Laboratory for Vascular Translational Science, LVTS, INSERM, UMR 1148, F-93000 Bobigny, Université de Paris, INSERM, UMR 1148, F-75018, Paris, France. and Sorbonne Université, CNRS, Laboratoire de la Chimie de la Matière Condensée (LCMCP), Paris, F-75005, France.
| | - Joana C Antunes
- Université Sorbonne Paris Nord, Laboratory for Vascular Translational Science, LVTS, INSERM, UMR 1148, F-93000 Bobigny, Université de Paris, INSERM, UMR 1148, F-75018, Paris, France.
| | - Yoann Lalatonne
- Université Sorbonne Paris Nord, Laboratory for Vascular Translational Science, LVTS, INSERM, UMR 1148, F-93000 Bobigny, Université de Paris, INSERM, UMR 1148, F-75018, Paris, France. and AP-HP, Hôpital Avicenne, Services de Biochimie et de Medécine Nucléaire Service, F-93009 Bobigny, France
| | - Odile Sainte Catherine
- Université Sorbonne Paris Nord, Laboratory for Vascular Translational Science, LVTS, INSERM, UMR 1148, F-93000 Bobigny, Université de Paris, INSERM, UMR 1148, F-75018, Paris, France.
| | - Corinne Illoul
- Sorbonne Université, CNRS, Laboratoire de la Chimie de la Matière Condensée (LCMCP), Paris, F-75005, France.
| | - Clément Journé
- INSERM, UMR 1148, LVTS, Université de Paris, F-75018, Université Paris Nord, F-93430, Inserm, Plateforme de Recherche FRIM 6-Inserm U1148, Université de Paris, Paris, France
| | - Martine Jandrot-Perrus
- Université Sorbonne Paris Nord, Laboratory for Vascular Translational Science, LVTS, INSERM, UMR 1148, F-93000 Bobigny, Université de Paris, INSERM, UMR 1148, F-75018, Paris, France.
| | - Thibaud Coradin
- Sorbonne Université, CNRS, Laboratoire de la Chimie de la Matière Condensée (LCMCP), Paris, F-75005, France.
| | - Véronique Gigoux
- INSERM ERL1226-Receptology and Therapeutic Targeting of Cancers, Laboratoire de Physique et Chimie des Nano-Objets, CNRS UMR5215-INSA, Université de Toulouse III, F-31432 Toulouse, France
| | - Erwann Guenin
- Université Sorbonne Paris Nord, Laboratory for Vascular Translational Science, LVTS, INSERM, UMR 1148, F-93000 Bobigny, Université de Paris, INSERM, UMR 1148, F-75018, Paris, France. and Sorbonne Universités, Université de Technologie de Compiègne, Integrated Transformations of Renewable Matter Laboratory (EA TIMR 4297 UTC-ESCOM), Compiègne, France
| | - Laurence Motte
- Université Sorbonne Paris Nord, Laboratory for Vascular Translational Science, LVTS, INSERM, UMR 1148, F-93000 Bobigny, Université de Paris, INSERM, UMR 1148, F-75018, Paris, France.
| | - Christophe Helary
- Sorbonne Université, CNRS, Laboratoire de la Chimie de la Matière Condensée (LCMCP), Paris, F-75005, France.
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Quantification of liver function using gadoxetic acid-enhanced MRI. Abdom Radiol (NY) 2020; 45:3532-3544. [PMID: 33034671 PMCID: PMC7593310 DOI: 10.1007/s00261-020-02779-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/20/2020] [Accepted: 09/21/2020] [Indexed: 02/06/2023]
Abstract
The introduction of hepatobiliary contrast agents, most notably gadoxetic acid (GA), has expanded the role of MRI, allowing not only a morphologic but also a functional evaluation of the hepatobiliary system. The mechanism of uptake and excretion of gadoxetic acid via transporters, such as organic anion transporting polypeptides (OATP1,3), multidrug resistance-associated protein 2 (MRP2) and MRP3, has been elucidated in the literature. Furthermore, GA uptake can be estimated on either static images or on dynamic imaging, for example, the hepatic extraction fraction (HEF) and liver perfusion. GA-enhanced MRI has achieved an important role in evaluating morphology and function in chronic liver diseases (CLD), allowing to distinguish between the two subgroups of nonalcoholic fatty liver diseases (NAFLD), simple steatosis and nonalcoholic steatohepatitis (NASH), and help to stage fibrosis and cirrhosis, predict liver transplant graft survival, and preoperatively evaluate the risk of liver failure if major resection is planned. Finally, because of its noninvasive nature, GA-enhanced MRI can be used for long-term follow-up and post-treatment monitoring. This review article aims to describe the current role of GA-enhanced MRI in quantifying liver function in a variety of hepatobiliary disorders.
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Zhou IY, Catalano OA, Caravan P. Advances in functional and molecular MRI technologies in chronic liver diseases. J Hepatol 2020; 73:1241-1254. [PMID: 32585160 PMCID: PMC7572718 DOI: 10.1016/j.jhep.2020.06.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023]
Abstract
MRI has emerged as the most comprehensive non-invasive diagnostic tool for liver diseases. In recent years, the value of MRI in hepatology has been significantly enhanced by a wide range of contrast agents, both clinically available and under development, that add functional information to anatomically detailed morphological images, or increase the distinction between normal and pathological tissues by targeting molecular and cellular events. Several classes of contrast agents are available for contrast-enhanced hepatic MRI, including i) conventional non-specific extracellular fluid contrast agents for assessing tissue perfusion; ii) hepatobiliary-specific contrast agents that are taken up by functioning hepatocytes and excreted through the biliary system for evaluating hepatobiliary function; iii) superparamagnetic iron oxide particles that accumulate in Kupffer cells; and iv) novel molecular contrast agents that are biochemically targeted to specific molecular/cellular processes for staging liver diseases or detecting treatment responses. The use of different functional and molecular MRI methods enables the non-invasive assessment of disease burden, progression, and treatment response in a variety of liver diseases. A high diagnostic performance can be achieved with MRI by combining imaging biomarkers.
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Affiliation(s)
- Iris Y Zhou
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States; Harvard Medical School, Boston, MA, USA; Institute for Innovation in Imaging (i(3)), Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Onofrio A Catalano
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States; Harvard Medical School, Boston, MA, USA; Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
| | - Peter Caravan
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States; Harvard Medical School, Boston, MA, USA; Institute for Innovation in Imaging (i(3)), Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.
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Moga TV, Sporea I, Lupușoru R, Popescu A, Popa A, Bota S, Șirli R, Danilă M, Schlesinger A, Tzschätzsch H. Performance of a Noninvasive Time-Harmonic Elastography Technique for Liver Fibrosis Evaluation Using Vibration Controlled Transient Elastography as Reference Method. Diagnostics (Basel) 2020; 10:653. [PMID: 32878078 PMCID: PMC7554698 DOI: 10.3390/diagnostics10090653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022] Open
Abstract
AIM This study aimed to evaluate the diagnosis performance of time-harmonic elastography (THE) technique in real life in assessing liver fibrosis, considering vibration-controlled transient elastography (VCTE) as a reference method. MATERIAL AND METHOD We prospectively evaluated outpatients from the gastroenterology department. Liver stiffness (LS) was measured by the THE system by dedicated operators, and by VCTE by experienced operators. The diagnostic accuracy of THE in staging liver fibrosis was assessed. We also performed an intra- and interobserver reproducibility sub-analysis on a sub-group of 27 subjects, where liver stiffness measurements (LSM) were performed by a novice, an elastography expert, and an ultrasound expert. RESULTS Of the 165 patients, using VCTE cut-off values, 49.6% were F0-F1, 15.7% were F2, 6.6% were F3, and 28.1% were F4. A direct, significant and strong correlation (r = 0.82) was observed between LSM assessed by VCTE and THE, p < 0.0001. The cut-off for ruling out liver cirrhosis (LC) by THE on our study group was <1.61 m/s (7.77 kPa)-AUROC = 0.90 [95% CI (0.82-0.93)], Se = 90.7%, Sp = 66.6%, PPV = 55.7%, NPV = 93.9%. The cut-off for ruling in LC by THE was >1.83 m/s (10 kPa)-AUROC = 0.90 [95% CI (0.82-0.93)], p < 0.0001, Se = 65.1%, Sp = 96.7%, PPV = 90.3%, NPV = 85.7%. The overall agreement between examiners was excellent: 0.94 (95% CI: 0.89-0.97); still, the ICCs were higher for the more experienced elastography examiner: 0.92 (95% CI: 0.82-0.96) vs. 0.94 (95% CI: 0.87-0.97) vs. 0.97 (95% CI: 0.95-0.99). CONCLUSIONS THE is a feasible and reproducible elastography technique that can accurately rule in and rule out advanced liver disease.
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Affiliation(s)
- Tudor Voicu Moga
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babeș”, 300041 Timișoara, Romania; (T.V.M.); (I.S.); (R.L.); (A.P.); (R.Ș.); (M.D.)
| | - Ioan Sporea
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babeș”, 300041 Timișoara, Romania; (T.V.M.); (I.S.); (R.L.); (A.P.); (R.Ș.); (M.D.)
| | - Raluca Lupușoru
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babeș”, 300041 Timișoara, Romania; (T.V.M.); (I.S.); (R.L.); (A.P.); (R.Ș.); (M.D.)
- Department of Functional Science, University of Medicine and Pharmacy “Victor Babeș”, 300041 Timișoara, Romania
| | - Alina Popescu
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babeș”, 300041 Timișoara, Romania; (T.V.M.); (I.S.); (R.L.); (A.P.); (R.Ș.); (M.D.)
| | - Alexandru Popa
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babeș”, 300041 Timișoara, Romania; (T.V.M.); (I.S.); (R.L.); (A.P.); (R.Ș.); (M.D.)
| | - Simona Bota
- Department of Internal Medicine and Gastroenterology, Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine, Klinikum Klagenfurt am Wörthersee, 9020 Klagenfurt, Austria;
| | - Roxana Șirli
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babeș”, 300041 Timișoara, Romania; (T.V.M.); (I.S.); (R.L.); (A.P.); (R.Ș.); (M.D.)
| | - Mirela Danilă
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babeș”, 300041 Timișoara, Romania; (T.V.M.); (I.S.); (R.L.); (A.P.); (R.Ș.); (M.D.)
| | - Anton Schlesinger
- GAMPT mbH and Institute of Medical Informatics, 06217 Merseburg, Germany;
| | - Heiko Tzschätzsch
- Department of Radiology, Charité–Universitätsmedizin, 10115 Berlin, Germany;
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McMahon A, McNamara J, Griffin M. A Review of Heart Transplantation for Adults With Congenital Heart Disease. J Cardiothorac Vasc Anesth 2020; 35:752-762. [PMID: 32839039 DOI: 10.1053/j.jvca.2020.07.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/30/2020] [Accepted: 07/05/2020] [Indexed: 12/16/2022]
Abstract
As techniques for corrective and palliative surgery in congenital heart disease improve, the number of patients surviving to become adults with congenital heart disease (ACHD) has increased. A significant proportion of these patients will progress to develop advanced heart failure, the symptoms of which vary, complicating prediction of life expectancy. Unlike acquired heart failure, there is a lack of evidence-based treatments with which to relieve symptoms and prolong survival. As a result, a number of ACHD patients will proceed to heart transplantation. Referral for transplantation should be considered early, given the difficulties with prognostication, and should take place in a center with surgical and medical expertise in the management of ACHD patients and transplantation. In addition to assessing contraindications to heart transplantation for the general population, factors specific to ACHD should be considered. These include pulmonary hypertension, cyanosis, liver disease, previous surgeries, and the degree of allosensitization. Once listed for transplantation, ACHD patients spend longer on the waitlist, and are more likely to die or be delisted than their non-ACHD counterparts. Mechanical circulatory support is used less commonly as a bridge to transplantation given the difficulties with implantation and unfamiliarity of use. Recent evidence suggests that with increased experience and early consideration, mechanical circulatory support can be used successfully as a bridging therapy. Despite a higher early mortality, long-term survival is greater for ACHD patients after transplant due to younger age and relative lack of comorbidities. With early referral, careful assessment of each individual's unique anatomy and physiology, and care in a center experienced with ACHD patients and transplantation, outcomes will continue to improve.
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Affiliation(s)
- Aisling McMahon
- Department of Anaesthesiology and Intensive Care Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.
| | - John McNamara
- Department of Anaesthesiology and Intensive Care Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Michael Griffin
- Department of Anaesthesiology and Intensive Care Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
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A Novel Diagnostic Nomogram for Noninvasive Evaluating Liver Fibrosis in Patients with Chronic Hepatitis B Virus Infection. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5218930. [PMID: 32596321 PMCID: PMC7290880 DOI: 10.1155/2020/5218930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/01/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022]
Abstract
Objective To establish a novel nomogram for diagnosing liver fibrosis in patients with chronic hepatitis B virus (HBV) infection and verify the diagnostic performance of the established nomogram. Methods Patients with chronic HBV infection who met the inclusion and exclusion criteria were enrolled in this retrospective study; 70% and 30% of patients were randomly assigned to training dataset and validation dataset, respectively. The risk factors for liver fibrosis were screened using the univariate and multivariate logistic regression analyses. Based on the results, a nomogram was established and verified. Results 508 patients with chronic HBV infection were included in this study (n = 355 for training dataset and n = 153 for validation dataset). The logistic regression analysis showed that liver stiffness measurement (LSM), platelet (PLT) count, and prothrombin time (PT) were independent risk factors for liver fibrosis (P < 0.01), which were used to establish the nomogram. The consistency index (C-index) of the nomogram established for diagnosing liver fibrosis was 0.875. The calibration line and the ideal line were consistent, which indicated that diagnosis of liver fibrosis by the established model was accurate. The values of area under the receiver operator characteristic (ROC) curve (AUROC) for diagnosing liver fibrosis by the nomogram were 0.857 and 0.862 in the training dataset and validation dataset, respectively, which were noticeably higher than those in the well-known serological models, including the aspartate aminotransferase- (AST-) to-platelet ratio index (APRI) scoring model, fibrosis-4 (FIB-4) scoring model, APAG model (including age, PT, albumin, and γ-glutamyl transferase), and S-index model (all P < 0.05). Conclusion LSM, PT, and PLT were found as independent risk factors for liver fibrosis. The established nomogram exhibited an excellent diagnostic performance, and it can more visually and individually evaluate the probability of liver fibrosis in patients with chronic HBV infection.
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Jiang X, Xu J, Gore JC. Mapping hepatocyte size in vivo using temporal diffusion spectroscopy MRI. Magn Reson Med 2020; 84:2671-2683. [PMID: 32333469 DOI: 10.1002/mrm.28299] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 03/11/2020] [Accepted: 04/03/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE The goal of this study is to implement a noninvasive method for in vivo mapping of hepatocyte size. This method will have a broad range of clinical and preclinical applications, as pathological changes in hepatocyte sizes are relevant for the accurate diagnosis and assessments of treatment response of liver diseases. METHODS Building on the concepts of temporal diffusion spectroscopy in MRI, a clinically feasible imaging protocol named IMPULSED (Imaging Microstructural Parameters Using Limited Spectrally Edited Diffusion) has been developed, which is able to report measurements of cell sizes noninvasively. This protocol acquires a selected set of diffusion imaging data and fits them to a model of water compartments in tissues to derive robust estimates of the cellular structures that restrict free diffusion. Here, we adapt and further develop this approach to measure hepatocyte sizes in vivo. We validated IMPULSED in livers of mice and rats and implemented it to image healthy human subjects using a clinical 3T MRI scanner. RESULTS The IMPULSED-derived mean hepatocyte sizes for rats and mice are about 15-20 µm and agree well with histological findings. Maps of mean hepatocyte size for humans can be achieved in less than 15 minutes, a clinically feasible scan time. CONCLUSION Our results suggest that this method has potential to overcome major limitations of liver biopsy and provide noninvasive mapping of hepatocyte sizes in clinical applications.
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Affiliation(s)
- Xiaoyu Jiang
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Junzhong Xu
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA.,Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - John C Gore
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA.,Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.,Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
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Liu HF, Wang Q, Du YN, Zhu ZH, Li YF, Zou LQ, Xing W. Dynamic contrast-enhanced MRI with Gd-EOB-DTPA for the quantitative assessment of early-stage liver fibrosis induced by carbon tetrachloride in rabbits. Magn Reson Imaging 2020; 70:57-63. [PMID: 32325235 DOI: 10.1016/j.mri.2020.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/31/2020] [Accepted: 04/15/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To explore quantitative parameters obtained by dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) with Gd-EOB-DTPA in discriminating early-stage liver fibrosis (LF) in a rabbit model. MATERIALS AND METHODS LF was established in 60 rabbits by the injection of 50% CCl4 oil solution, whereas 30 rabbits served as the control group. All rabbits underwent pathological examination to determine the LF stage using the METAVIR classification system. DCE MRI was performed, and quantitative parameters, including Ktrans, Kep, Ve, Vp and Re were measured and evaluated among the different LF stages using spearman correlation coefficients and receiver operating characteristic curve. RESULTS In all, 24, 25, and 22 rabbits had stage F0, stage F1, and stage F2 LF, respectively. Ktrans (r = 0.803) increased, and Kep (r = -0.495) and Re (r = -0.701) decreased with LF stage progression (P < 0.001), while no significant correlation was found for Ve or Vp. Ktrans and Re were significantly different between all LF stage pairs compared (F0 vs. F1, F0 vs. F2, F1 vs. F2, F0 vs. F1-F2, P < 0.05). With the exception of F0 vs. F1, Kep differed significantly between stages (P < 0.05). The AUC of Ktrans was higher than that of other quantitative parameters, with an AUC of 0.92, 0.99, 0.94 and 0.92 for staging F0 vs. F1, F0 vs. F2, F1 vs. F2, and F0 vs. F1-F2, respectively. CONCLUSION Among quantitative parameters of Gd-EOB-DTPA DCE MRI, Ktrans was the best predictor for quantitatively differentiating early-stage LF.
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Affiliation(s)
- Hai-Feng Liu
- Department of Radiology, Third Affiliated Hospital of Soochow University & Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China
| | - Qing Wang
- Department of Radiology, Third Affiliated Hospital of Soochow University & Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China
| | - Ya-Nan Du
- Department of Radiology, Third Affiliated Hospital of Soochow University & Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China
| | - Zu-Hui Zhu
- Department of Radiology, Third Affiliated Hospital of Soochow University & Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China
| | - Yu-Feng Li
- Department of Radiology, Third Affiliated Hospital of Soochow University & Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China
| | - Li-Qiu Zou
- Department of Radiology, The Sixth Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen 518052, China.
| | - Wei Xing
- Department of Radiology, Third Affiliated Hospital of Soochow University & Changzhou First People's Hospital, Changzhou 213003, Jiangsu, China
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Wu XF, Bai XM, Yang W, Sun Y, Wang H, Wu W, Chen MH, Yan K. Differentiation of atypical hepatic hemangioma from liver metastases: Diagnostic performance of a novel type of color contrast enhanced ultrasound. World J Gastroenterol 2020; 26:960-972. [PMID: 32206006 PMCID: PMC7081006 DOI: 10.3748/wjg.v26.i9.960] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/12/2020] [Accepted: 01/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In clinical practice, the diagnosis is sometimes difficult with contrast-enhanced ultrasound (CEUS) when the case has an atypical perfusion pattern. Color parametric imaging (CPI) is an analysis software for CEUS with better detection of temporal differences in CEUS imaging using arbitrary colors. It measures the differences in arrival time of the contrast agent in lesions so that the perfusion features of atypical hemangioma and colorectal cancer (CRC) liver metastasis can be distinguished. AIM To evaluate the role of a novel type of CPI of CEUS in the differential diagnosis of atypical hemangioma from liver metastases in patients with a history of CRC. METHODS From January 2016 to July 2018, 42 patients including 20 cases of atypical hemangioma and 22 cases of liver metastases from CRC were enrolled. These patients had a mean age of 60.5 ± 9.3 years (range: 39-75 years). All patients received ultrasound, CEUS and CPI examinations. Resident and staff radiologists independently and retrospectively reviewed CEUS and CPI images. Two sets of criteria were assigned: (1) Routine CEUS alone; and (2) CEUS and CPI. The diagnostic sensitivity, specificity, accuracy and receiver operating characteristic (ROC) curve of resident and staff radiologists were analyzed. RESULTS The following CPI features were significantly different between liver hemangioma and liver metastases analyzed by staff and resident radiologists: Peripheral nodular enhancement (65%-70.0% vs 4.5%-13.6%, P < 0.001, P = 0.001), mosaic/chaotic enhancement (5%-10% vs 68.2%-63.6%, P < 0.001, P < 0.001) and feeding artery (20% vs 59.1%-54.5%, P = 0.010, P = 0.021). CPI imaging offered significant improvements in detection rates compared with routine CEUS in both resident and staff groups. By resident radiologists, the specificity and accuracy of CEUS+CPI were significantly increased compared with that of CEUS (77.3% vs 45.5%, P = 0.030; 78.6% vs 50.0%, P = 0.006). In addition, the area under the curve (AUC) of CEUS+CPI was significantly higher than that of CEUS (0.803 vs 0.757, P = 0.036). By staff radiologists, accuracy was improved in CEUS+CPI (81.0% vs 54.8%, P = 0.010), whereas no significant differences in specificity and sensitivity were found (P = 0.144, P = 0.112). The AUC of CEUS+CPI was significantly higher than that of CEUS (0.890 vs 0.825, P = 0.013) by staff radiologists. CONCLUSION Compared with routine CEUS, CPI could provide specific information on the hemodynamic features of liver lesions and help to differentiate atypical hemangioma from liver metastases in patients with CRC, even for senior radiologists.
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Affiliation(s)
- Xiao-Feng Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Xiu-Mei Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Wei Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yu Sun
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Hong Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Wei Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Min-Hua Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Kun Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital & Institute, Beijing 100142, China
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Application Value of Magnetic Resonance Perfusion Imaging in the Early Diagnosis of Rat Hepatic Fibrosis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5095934. [PMID: 31950040 PMCID: PMC6949670 DOI: 10.1155/2019/5095934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/24/2019] [Accepted: 12/09/2019] [Indexed: 12/17/2022]
Abstract
Objective To assess the application value of perfusion-weighted imaging (PWI) in early diagnosis, quantitation, and hepatic fibrosis staging by analyzing the related parameters in hepatic fibrosis. Methods A total of 60 rats were randomly divided into the hepatic fibrosis and control groups, and carbon tetrachloride (CCL4) was used to establish the liver fibrosis model. All rats underwent PWI examination, and the trend of the time-signal intensity curve (TIC, automatically generated by the software) was observed. Also, the perfusion parameters, maximum signal reduction ratio (SRRmax), time to peak (TTP), and mean transit time (MTT), were analyzed and compared with pathological staging. Results The TIC curve was characterized by slow wash-in and wash-out with a low and wide peak. The PWI perfusion parameters were statistically significant in specific groups (P < 0.05): SRRmax values (control group and F3, F4), TTP, and MTT values (control group and F2–F4, F1 and F3, F1 and F4, and F2 and F4 in addition to TTP values for F1 and F2). Pearson's correlation analysis showed a negative correlation of SRRmax with hepatic fibrosis stage (r = −0.439, P < 0.05), while TTP and MTT values were positively correlated with hepatic fibrosis stage (TTP, r = 0.798; MTT, r = 0.647; all P < 0.001). Conclusions PWI perfusion parameters reflect the degree of hepatic fibrosis, especially TTP and MTT, and PWI is recommended for the early diagnosis of liver fibrosis for timely intervention and treatment of the disease and delaying its progression.
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Mehana SM. Assessment of the follow-up interval changes of the less than 2 cm arterial phase enhancing hepatic nodules in correlation with Liver Imaging Reporting and Data System (LI-RADS) classification version 18 using contrast-enhanced multidetector computed tomography. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0068-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Balaceanu LA. Biomarkers vs imaging in the early detection of hepatocellular carcinoma and prognosis. World J Clin Cases 2019; 7:1367-1382. [PMID: 31363465 PMCID: PMC6656675 DOI: 10.12998/wjcc.v7.i12.1367] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/07/2019] [Accepted: 05/03/2019] [Indexed: 02/05/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is the 5th most frequently diagnosed cancer in the world, according to the World Health Organization. The incidence of HCC is between 3/100000 and 78.1/100000, with a high incidence reported in areas with viral hepatitis B and hepatitis C, thus affecting Asia and Africa predominantly. Several international clinical guidelines address HCC diagnosis and are structured according to the geographical area involved. All of these clinical guidelines, however, share a foundation of diagnosis by ultrasound surveillance and contrast imaging techniques, particularly computed tomography, magnetic resonance imaging, and sometimes contrast-enhanced ultrasound. The primary objective of this review was to systematically summarize the recent published studies on the clinical utility of serum biomarkers in the early diagnosis of HCC and for the prognosis of this disease.
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Affiliation(s)
- Lavinia Alice Balaceanu
- Department of Internal Medicine, Carol Davila University of Medicine and Pharmacy, Sf. Ioan Clinical Emergency Hospital, Bucharest 42122, Romania
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Kishimoto R, Kikuchi K, Koyama A, Kershaw J, Omatsu T, Tachibana Y, Suga M, Obata T. Intra- and inter-operator reproducibility of US point shear-wave elastography in various organs: evaluation in phantoms and healthy volunteers. Eur Radiol 2019; 29:5999-6008. [PMID: 31089847 PMCID: PMC6795636 DOI: 10.1007/s00330-019-06195-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE This study was conducted in order to assess the intra- and interoperator reproducibility of shear-wave speed (SWS) measurement on elasticity phantoms and healthy volunteers using ultrasound-based point shear-wave elastography. MATERIALS AND METHODS This study was approved by the institutional review board. Two operators measured the SWS of five elasticity phantoms and seven organs (thyroid, lymph node, muscle, spleen, kidney, pancreas, and liver) of 30 healthy volunteers with 1.0-4.5 MHz convex (4C1) and 4.0-9.0 MHz linear (9L4) transducers. The phantom measurements were repeated ten times, while the volunteer measurements were performed five times each. Intra- and interoperator reproducibility was assessed. Interoperator reproducibility was also evaluated with the 95% Bland-Altman limits of agreement (LOA). RESULTS In phantoms, all intraclass correlation coefficients (ICCs) were above 0.90 and the 95% LOA between the two operators were less than ± 18%. In volunteers, intraoperator ICCs were > 0.75 for all regions except the pancreas. Interoperator ICC was above 0.75 for the right lobe of the liver (depth 4 cm) and the kidney, but the 95% LOA was less than ± 25% only for the liver. CONCLUSION Although excellent in phantoms, interoperator reproducibility was insufficient for all regions in the volunteers other than the right hepatic lobe at a depth of 4 cm. Clinicians should be aware of the 95% LOA when using SWS in patients. KEY POINTS • Our phantom study indicated a high reproducibility for shear-wave speed (SWS) measurements with point shear-wave elastography (pSWE). • In volunteers, intraoperator reproducibility was generally high, but the interoperator reproducibility was not high enough except for the right hepatic lobe at 4 cm depth. • To evaluate interoperator reproducibility, the 95% limits of agreement (LOA) between operators should be considered in addition to the intraclass correlation coefficient (ICC).
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Affiliation(s)
- Riwa Kishimoto
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Chiba, 263-8555, Japan.
| | - Katsuhiko Kikuchi
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Chiba, 263-8555, Japan.,Tokyo-Kita Medical Center, 4-17-56, Akabanedai, Tokyo, 115-0053, Japan
| | - Atsuhisa Koyama
- Center for Frontier Medical Engineering, Chiba University, 1-33, Yayoi-chou, Chiba, 263-8522, Japan
| | - Jeff Kershaw
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Chiba, 263-8555, Japan
| | - Tokuhiko Omatsu
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Chiba, 263-8555, Japan
| | - Yasuhiko Tachibana
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Chiba, 263-8555, Japan
| | - Mikio Suga
- Center for Frontier Medical Engineering, Chiba University, 1-33, Yayoi-chou, Chiba, 263-8522, Japan
| | - Takayuki Obata
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Chiba, 263-8555, Japan
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Sensitivity of multifrequency magnetic resonance elastography and diffusion-weighted imaging to cellular and stromal integrity of liver tissue. J Biomech 2019; 88:201-208. [DOI: 10.1016/j.jbiomech.2019.03.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 12/16/2022]
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Poetter-Lang S, Staufer K, Baltzer P, Tamandl D, Muin D, Bastati N, Halilbasic E, Hodge JC, Trauner M, Kazemi-Shirazi L, Ba-Ssalamah A. The Efficacy of MRI in the diagnostic workup of cystic fibrosis-associated liver disease: A clinical observational cohort study. Eur Radiol 2019; 29:1048-1058. [PMID: 30054796 PMCID: PMC6302923 DOI: 10.1007/s00330-018-5650-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE To identify independent imaging features and establish a diagnostic algorithm for diagnosis of cystic fibrosis (CF)-associated liver disease (CFLD) in CF patients compared to controls using gadoxetic acid-enhanced MRI. METHODS A total of 90 adult patients were enrolled: 50 with CF, 40 controls. The CF group was composed of two subgroups: a retrospective test subgroup (n = 33) and a prospective validation subgroup (n = 17). Controls (patients with normal liver enzymes and only benign focal liver lesions) were divided accordingly (27:13). MRI variables, including quantitative and qualitative parameters, were used to distinguish CFLD from controls using clinical symptoms, laboratory tests and Debray criteria. Disease severity was classified according to Child-Pugh and Albumin-Bilirubin (ALBI) scores. Fifteen qualitative single-lesion CF descriptors were defined. Two readers independently evaluated the images. Univariate statistical analysis was performed to obtain significant imaging features that differentiate CF patients from controls. Through multivariate analysis using chi-squared automatic interaction detector (CHAID) methodology the most important descriptors were identified. Diagnostic performance was assessed by receiver-operating characteristic (ROC) analysis. RESULTS Three independent imaging descriptors distinguished CFLD from controls: (1) presence of altered gallbladder morphology; (2) periportal tracking; and (3) periportal fat deposition. Prospective validation of the classification algorithm demonstrated a sensitivity of 94.1% and specificity of 84.6% for discriminating CFLD from controls. Disease severity was well associated with the imaging features. CONCLUSIONS A short unenhanced MRI protocol can identify the three cardinal imaging features of CFLD. The hepatobiliary phase of gadoxetic acid-enhanced MRI can define CFLD progression. KEY POINTS • Using a multivariate classification analysis, we identified three independent imaging features, altered gallbladder morphology (GBAM), periportal tracking (PPT) and periportal fat deposition (PPFD), that could diagnose CFLD with high sensitivity, 94.1 % (95% CI: 71.3-99.9) and moderate specificity, 84.6 % (95% CI: 54.6-98.1). • Based upon the results of this study, gadoxetic acid-enhanced MRI with DWI is able to diagnose early-stage CFLD, as well as its progression.
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Affiliation(s)
- Sarah Poetter-Lang
- General Hospital of Vienna (AKH), Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Katharina Staufer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, General Hospital of Vienna (AKH), Medical University of Vienna, Vienna, Austria
| | - Pascal Baltzer
- General Hospital of Vienna (AKH), Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Dietmar Tamandl
- General Hospital of Vienna (AKH), Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Dina Muin
- General Hospital of Vienna (AKH), Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Nina Bastati
- General Hospital of Vienna (AKH), Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Emina Halilbasic
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, General Hospital of Vienna (AKH), Medical University of Vienna, Vienna, Austria
| | - Jacqueline C Hodge
- General Hospital of Vienna (AKH), Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, General Hospital of Vienna (AKH), Medical University of Vienna, Vienna, Austria
| | - Lili Kazemi-Shirazi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, General Hospital of Vienna (AKH), Medical University of Vienna, Vienna, Austria
| | - Ahmed Ba-Ssalamah
- General Hospital of Vienna (AKH), Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
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Influence of Gadolinium-Based Contrast Agents on Tissue Sodium Quantification in Sodium Magnetic Resonance Imaging. Invest Radiol 2018; 53:555-562. [DOI: 10.1097/rli.0000000000000487] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Abe H, Midorikawa Y, Okada M, Takayama T. Clinical application of magnetic resonance elastography in chronic liver disease. Hepatol Res 2018; 48:780-787. [PMID: 30014566 DOI: 10.1111/hepr.13231] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/05/2018] [Accepted: 07/09/2018] [Indexed: 02/08/2023]
Abstract
Recent evidence highlighted that the accurate assessment of liver fibrosis is important for evaluating the progression of chronic liver disease. During the past decade, many non-invasive methods have been developed to reduce the need for core-needle biopsy in fibrosis staging and to overcome its limitations, such as invasiveness, high cost, low reproducibility, and poor patient consent. The diagnostic performance of magnetic resonance elastography (MRE) is promising for use in clinical practice to evaluate not only liver fibrosis, but also survival and major clinical end-points such as liver decompensation, portal hypertension, development of hepatocellular carcinoma, and surgical outcomes. Together with other clinical markers, MRE can be used to better categorize patients with advanced fibrosis and cirrhosis, and assign them to different classes of risk for significant clinical outcomes. This review discusses clinical applications of MRE in the management strategy of patients with chronic liver disease.
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Affiliation(s)
- Hayato Abe
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Yutaka Midorikawa
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Masahiro Okada
- Department of Radiology, Nihon University School of Medicine, Tokyo, Japan
| | - Tadatoshi Takayama
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
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Karageorgis A, Lenhard SC, Yerby B, Forsgren MF, Liachenko S, Johansson E, Pilling MA, Peterson RA, Yang X, Williams DP, Ungersma SE, Morgan RE, Brouwer KLR, Jucker BM, Hockings PD. A multi-center preclinical study of gadoxetate DCE-MRI in rats as a biomarker of drug induced inhibition of liver transporter function. PLoS One 2018; 13:e0197213. [PMID: 29771932 PMCID: PMC5957399 DOI: 10.1371/journal.pone.0197213] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 04/28/2018] [Indexed: 12/12/2022] Open
Abstract
Drug-induced liver injury (DILI) is a leading cause of acute liver failure and transplantation. DILI can be the result of impaired hepatobiliary transporters, with altered bile formation, flow, and subsequent cholestasis. We used gadoxetate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), combined with pharmacokinetic modelling, to measure hepatobiliary transporter function in vivo in rats. The sensitivity and robustness of the method was tested by evaluating the effect of a clinical dose of the antibiotic rifampicin in four different preclinical imaging centers. The mean gadoxetate uptake rate constant for the vehicle groups at all centers was 39.3 +/- 3.4 s-1 (n = 23) and 11.7 +/- 1.3 s-1 (n = 20) for the rifampicin groups. The mean gadoxetate efflux rate constant for the vehicle groups was 1.53 +/- 0.08 s-1 (n = 23) and for the rifampicin treated groups was 0.94 +/- 0.08 s-1 (n = 20). Both the uptake and excretion transporters of gadoxetate were statistically significantly inhibited by the clinical dose of rifampicin at all centers and the size of this treatment group effect was consistent across the centers. Gadoxetate is a clinically approved MRI contrast agent, so this method is readily transferable to the clinic. Conclusion: Rate constants of gadoxetate uptake and excretion are sensitive and robust biomarkers to detect early changes in hepatobiliary transporter function in vivo in rats prior to established biomarkers of liver toxicity.
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Affiliation(s)
- Anastassia Karageorgis
- Safety and ADME Translational Sciences, Drug Safety and Metabolism, AstraZeneca, Gothenburg, Sweden
- * E-mail:
| | - Stephen C. Lenhard
- Bioimaging, Platform Technology and Sciences, GlaxoSmithKline, King of Prussia, Pennsylvania, United States of America
| | - Brittany Yerby
- Research Imaging Sciences, Amgen, Thousand Oaks, California, United States of America
| | - Mikael F. Forsgren
- Center for Medical Image Science and Visualization (CMIV), Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Wolfram MathCore, Linköping, Sweden
| | - Serguei Liachenko
- National Center for Toxicological Research, Division of Neurotoxicology, United States Food and Drug Administration, Jefferson, Arkansas, United States of America
| | - Edvin Johansson
- Personalised Healthcare and Biomarkers, Imaging group, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Mark A. Pilling
- Biostatistics, Quantitative Biology, Discovery Sciences, Innovative Medicines and Early Development, AstraZeneca R&D, Cambridge, United Kingdom
| | - Richard A. Peterson
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, Durham, North Carolina, United States of America
| | - Xi Yang
- National Center for Toxicological Research, Division of Systems Biology, United States Food and Drug Administration, Jefferson, Arkansas, United States of America
| | - Dominic P. Williams
- Safety and ADME Translational Sciences, Drug Safety and Metabolism, AstraZeneca, Cambridge, United Kingdom
| | - Sharon E. Ungersma
- Research Imaging Sciences, Amgen, Thousand Oaks, California, United States of America
| | - Ryan E. Morgan
- Department of Comparative Biology and Safety Sciences, Amgen Inc., Thousand Oaks, California, United States of America
| | - Kim L. R. Brouwer
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of N orth Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Beat M. Jucker
- Bioimaging, Platform Technology and Sciences, GlaxoSmithKline, King of Prussia, Pennsylvania, United States of America
| | - Paul D. Hockings
- Antaros Medical, BioVenture Hub, Mölndal, Sweden
- MedTech West, Chalmers University of Technology, Gothenburg, Sweden
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Luna A, Martín Noguerol T, Mata LA. Bases de la imagen funcional II: técnicas emergentes de resonancia magnética y nuevos métodos de análisis. RADIOLOGIA 2018. [DOI: 10.1016/j.rx.2018.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Keller S, Aigner A, Zenouzi R, Kim AC, Meijer A, Weidemann SA, Krech T, Lohse AW, Adam G, Schramm C, Yamamura J. Association of gadolinium-enhanced magnetic resonance imaging with hepatic fibrosis and inflammation in primary sclerosing cholangitis. PLoS One 2018. [PMID: 29513767 PMCID: PMC5841815 DOI: 10.1371/journal.pone.0193929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective To evaluate magnetic resonance imaging (MRI) parameters T2 signal, contrast enhancement (CE), and relative liver enhancement (RLE) of extracellular gadolinium-based contrast agent (GBCA)-enhanced MRI as a marker for hepatic fibrosis and inflammation in patients with primary sclerosing cholangitis (PSC). Methods 3.0-Tesla MRI scans and liver biopsies of 40 patients (41.2 ± 17.1 years) were retrospectively reviewed. Biopsies were obtained within a mean time of 54 ± 55 days to MRI scans and specimens were categorized according to Ishak modified hepatic activity index (mHAI) and Scheuer staging of fibrosis. T2 signal (N = 40), CE alterations (N = 29), and RLE (N = 29) were assessed by two raters. Mixed-effects regression models were applied to estimate the association between histopathology and MRI parameters. Results No significant association was observed between T2 signal or CE alterations with stages of fibrosis or mHAI grading. Regression models revealed significant positive associations of portal venous phase RLE with mHAI grade ≥ 7 points [β = 25.5; 95% CI (2.53; 48.62); p = 0.04] and delayed phase RLE with stages of fibrosis [stage 2: β = 35.13; 95% CI (11.35; 58.87); p = 0.007; stage 3/4: β = 69.24; 95% CI (45.77; 92.75); p < 0.001]. The optimal cut-off value of 66.6% delayed phase RLE distinguished fibrosis stages 0–2 from 3–4 with a sensitivity of 0.833 and specificity of 0.972. Inter-rater reliability (IRR) for quantification of RLE was ‘excellent’ (r = 0.90–0.98). IRR was ‘substantial’ for detection of T2 signal in the right liver lobe (RL) (Kappa = 0.77) and ‘almost perfect’ for T2 signal of the left liver lobe (LL) and CE of both lobes (Kappa = 0.87–1.0). Conclusion The simple and reproducible method of RLE quantification on standard extracellular GBCA-enhanced MRI may provide a correlate measure of advanced stages of hepatic fibrosis and potentially also inflammation in PSC patients, if validated in larger cohorts.
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Affiliation(s)
- Sarah Keller
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- * E-mail:
| | - Annette Aigner
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Roman Zenouzi
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anne C. Kim
- Department Stroke and Neurovascular Imaging, The Permanente Medical Group, San Francisco, California, United States of America
| | - Arnoud Meijer
- Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Sören A. Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ansgar W. Lohse
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christoph Schramm
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jin Yamamura
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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deSouza NM, Liu Y, Chiti A, Oprea-Lager D, Gebhart G, Van Beers BE, Herrmann K, Lecouvet FE. Strategies and technical challenges for imaging oligometastatic disease: Recommendations from the European Organisation for Research and Treatment of Cancer imaging group. Eur J Cancer 2018; 91:153-163. [DOI: 10.1016/j.ejca.2017.12.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 12/07/2017] [Indexed: 02/06/2023]
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Lee DH, Lee JM, Yoon JH, Kim YJ, Lee JH, Yu SJ, Han JK. Liver Stiffness Measured by Two-Dimensional Shear-Wave Elastography: Prognostic Value after Radiofrequency Ablation for Hepatocellular Carcinoma. Liver Cancer 2018; 7:65-75. [PMID: 29662834 PMCID: PMC5892360 DOI: 10.1159/000484445] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To evaluate the prognostic value of liver stiffness (LS) measured using two-dimensional (2D) shear-wave elastography (SWE) in patients with hepatocellular carcinoma (HCC) treated by radiofrequency ablation (RFA). METHODS The Institutional Review Board approved this retrospective study and informed consent was obtained from all patients. A total of 134 patients with up to 3 HCCs ≤5 cm who had undergone pre-procedural 2D-SWE prior to RFA treatment between January 2012 and December 2013 were enrolled. LS values were measured using real-time 2D-SWE before RFA on the procedural day. After a mean follow-up of 33.8 ± 9.9 months, we analyzed the overall survival after RFA using the Kaplan-Meier method and Cox proportional hazard regression model. The optimal cutoff LS value to predict overall survival was determined using the minimal p value approach. RESULTS During the follow-up period, 22 patients died, and the estimated 1- and 3-year overall survival rates were 96.4 and 85.8%, respectively. LS measured by 2D-SWE was found to be a significant predictive factor for overall survival after RFA of HCCs, as was the presence of extrahepatic metastases. As for the optimal cutoff LS value for the prediction of overall survival, it was determined to be 13.3 kPa. In our study, 71 patients had LS values ≥13.3 kPa, and the estimated 3-year overall survival was 76.8% compared to 96.3% in 63 patients with LS values <13.3 kPa. This difference was statistically significant (hazard ratio = 4.30 [1.26-14.7]; p = 0.020). CONCLUSION LS values measured by 2D-SWE was a significant predictive factor for overall survival after RFA for HCC.
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Affiliation(s)
- Dong Ho Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea,Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea,*Jeong Min Lee, MD, Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744 (Korea), E-Mail
| | - Jung-Hwan Yoon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yoon Jun Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jeong-Hoon Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Su Jong Yu
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea,Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
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Prognostic Role of Liver Stiffness Measurements Using Magnetic Resonance Elastography in Patients with Compensated Chronic Liver Disease. Eur Radiol 2018; 28:3513-3521. [PMID: 29488082 DOI: 10.1007/s00330-017-5278-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/13/2017] [Accepted: 12/21/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE To retrospectively evaluate the prognostic role of liver stiffness (LS) measurement using magnetic resonance elastography (MRE) in patients with compensated chronic liver disease (cCLD). METHODS We enrolled 217 patients with cCLD who underwent MRE. After mean follow-up of 45.0 ± 17.6 months, cumulative incidence (CI) of hepatocellular carcinoma (HCC) occurrence, development of decompensation and overall survival (OS) were estimated using the Kaplan-Meier method. Prognostic factors were evaluated using the Cox proportional hazard regression model. RESULTS During the follow-up period, HCC occurred in 33 patients, and 1-, 3- and 5-year CIs of HCC occurrence were 3.8%, 14.8% and 18.9%, respectively. The LS value was a significant predictive factor for HCC occurrence [p < 0.001, hazard ratio (HR) = 1.59 per unit (1.25-2.03)]. Eighteen patients experienced hepatic decompensation, and 1-, 3- and 5-year CIs of decompensation were 2.8%, 7.3% and 11.3%, respectively. The LS value was also significantly associated with decompensation development [p < 0.001, HR = 2.02 per unit (1.37-2.98)]. Fourteen patients died, and 1-, 3- and 5-year OSs were 99.1%, 98.0% and 89.8%, respectively. The LS value was demonstrated to be a significant affecting factor for OS [p = 0.008, HR = 1.39 per unit (1.10-1.78)]. CONCLUSIONS LS obtained from MRE was a significant predictive factor for the development of decompensation, HCC occurrence and OS in cCLD patients. KEY POINTS • Liver stiffness (LS) values obtained from MRE can provide prognostic information. • The LS value was a significant predictive factor for occurrence of hepatocellular carcinoma. • The LS value was significantly associated with development of hepatic decompensation. • Survival of compensated chronic liver disease patients was affected by the LS value.
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Assessing the Non-tumorous Liver: Implications for Patient Management and Surgical Therapy. J Gastrointest Surg 2018; 22:344-360. [PMID: 28924922 DOI: 10.1007/s11605-017-3562-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 08/24/2017] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Hepatic resection is performed for various benign and malignant liver tumors. Over the last several decades, there have been improvements in the surgical technique and postoperative care of patients undergoing liver surgery. Despite this, liver failure following an extended hepatic resection remains a critical potential postoperative complication. Patients with underlying parenchymal liver diseases are at particular risk of liver failure due to impaired liver regeneration with an associated mortality risk as high as 60 to 90%. In addition, live donor liver transplantation requires a thorough presurgical assessment of the donor liver to minimize the risk of postoperative complications. RESULTS AND CONCLUSION Recently, cross-sectional imaging assessment of diffuse liver diseases has gained momentum due to its ability to provide both anatomical and functional assessments of normal and abnormal tissues. Various imaging techniques are being employed to assess diffuse liver diseases including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound (US). MRI has the ability to detect abnormal intracellular and molecular processes and tissue architecture. CT has a high spatial resolution, while US provides real-time imaging, is inexpensive, and readily available. We herein review current state-of-the-art techniques to assess the underlying non-tumorous liver. Specifically, we summarize current approaches to evaluating diffuse liver diseases including fatty liver alcoholic or non-alcoholic (NAFLD, AFLD), hepatic fibrosis (HF), and iron deposition (ID) with a focus on advanced imaging techniques for non-invasive assessment along with their implications for patient management. In addition, the role of and techniques to assess hepatic volume in hepatic surgery are discussed.
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Suo L, Chang R, Padmanabhan V, Jain S. For diagnosis of liver masses, fine-needle aspiration versus needle core biopsy: which is better? J Am Soc Cytopathol 2018; 7:46-49. [PMID: 31043250 DOI: 10.1016/j.jasc.2017.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 09/18/2017] [Accepted: 09/18/2017] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Both fine needle aspiration (FNA) and needle core biopsy (NCB) are widely accepted methods for obtaining diagnostic material. There is variability in how different institutions use these techniques in assessing liver masses. The aim of this study is to compare the diagnostic accuracy and tissue quality between FNA and NCB, and create a cost-effective algorithm for evaluating liver masses. MATERIALS AND METHODS A database search was performed to detect all liver FNA cases and their corresponding NCB between January 2014 and August 2016. A retrospective chart review was performed to gather pertinent clinicopathologic information. RESULTS Seventy-seven FNA and 68 corresponding NCB were reviewed from 74 patients. Diagnoses in the 74 patients included 36 hepatocellular carcinomas (HCC), 29 metastatic malignancies (MET), 5 poorly differentiated carcinomas (PDC), 2 cholangiocarcinomas (CHO), and 2 benign lesions (BEN). More immunohistochemical (IHC) studies (P < 0.05) were performed on NCB tissues than FNA tissues in HCC (mean, 2.1 versus 0.8), MET (2.5 versus 0.5), and PDC groups (11.2 versus 0.2). The false negative rate (FNR) of NCB was lower (P < 0.05) than that of FNA in the HCC group; and FNR of NCB was higher (P < 0.05) than that of FNA in the MET group. CONCLUSIONS For HCC, NCB usually has better tissue quality and diagnostic accuracy than FNA; for metastatic lesions in the liver, FNA has better diagnostic accuracy than NCB, although NCB can provide more tissue for ancillary testing and has better diagnostic quality. Appropriate diagnostic method is important for improving diagnostic accuracy and saving medical resources.
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Affiliation(s)
- Liye Suo
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas; Department of Pathology, Ben Taub General Hospital, Houston, Texas
| | - Ruby Chang
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas; Department of Pathology, Ben Taub General Hospital, Houston, Texas
| | - Vijayalakshmi Padmanabhan
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas; Department of Pathology, Ben Taub General Hospital, Houston, Texas.
| | - Shilpa Jain
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas; Department of Pathology, Ben Taub General Hospital, Houston, Texas.
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