X-ray Attenuation Research Articles

Utility of Dual-Energy Computed Tomography in Clinical Conundra.

Advancing medical technology revolutionizes our ability to diagnose various disease processes. Conventional Single-Energy Computed Tomography (SECT) has multiple inherent limitations for providing definite diagnoses in certain clinical contexts. Dual-Energy Computed Tomography (DECT) has been in use since 2006 and has constantly evolved providing various applications to assist radiologists in reaching certain diagnoses SECT is rather unable to identify. DECT may also complement the role of SECT by supporting radiologists to confidently make diagnoses in certain clinically challenging scenarios. In this review article, we briefly describe the principles of X-ray attenuation. We detail principles for DECT and describe multiple systems associated with this technology. We describe various DECT techniques and algorithms including virtual monoenergetic imaging (VMI), virtual non-contrast (VNC) imaging, Iodine quantification techniques including Iodine overlay map (IOM), and two- and three-material decomposition algorithms that can be utilized to demonstrate a multitude of pathologies. Lastly, we provide our readers commentary on examples pertaining to the practical implementation of DECT's diverse techniques in the Gastrointestinal, Genitourinary, Biliary, Musculoskeletal, and Neuroradiology systems.

Selective concentration of iron, titanium, and zirconium substrate minerals within Gregory's diverticulum, an organ unique to derived sand dollars (Echinoidea: Scutelliformes).

Gregory's diverticulum, a digestive tract structure unique to a derived group of sand dollars (Echinoidea: Scutelliformes), is filled with sand grains obtained from the substrate the animals inhabit. The simple methods of shining a bright light through a specimen or testing response to a magnet can reveal the presence of a mineral-filled diverticulum. Heavy minerals with a specific gravity of >2.9 g/cm3 are selectively concentrated inside the organ, usually at concentrations one order of magnitude, or more, greater than found in the substrate. Analyses of diverticulum content for thirteen species from nine genera, using optical mineralogy, powder X-ray diffraction, scanning electron microscopy and energy dispersive X-ray spectroscopy, as well as micro-computed tomography shows the preference for selection of five major heavy minerals: magnetite (Fe3O4), hematite (Fe2O3), ilmenite (FeTiO3), rutile (TiO2), and zircon (ZrSiO4). Minor amounts of heavy or marginally heavy amphibole, pyroxene and garnet mineral grains may also be incorporated. In general, the animals exhibit a preference for mineral grains with a specific gravity of >4.0 g/cm3, although the choice is opportunistic and the actual mix of mineral species depends on the mineral composition of the substrate. The animals also select for grain size, with mineral grains generally in the range of 50 to 150 μm, and do not appear to alter this preference during ontogeny. A comparison of analytical methods demonstrates that X-ray attenuation measured using micro-computed tomography is a reliable non-destructive method for heavy mineral quantification when supported by associated analyses of mineral grains extracted destructively from specimens or from substrate collected together with the specimens. Commonalities in the electro-chemical surface properties of the ingested minerals suggest that such characteristics play an important role in the selection process.

Ultrasmall Glucose-Functionalized Au-Carbon Nanohybrids: Exploiting the Warburg Effect to Image Tumors by Multimodal CT/Fluorescence Imaging

Utilizing glucose as a targeting agent represents a pioneering approach in selectively directing nanoparticles towards cancer cells, capitalizing on the pronounced glucose uptake observed in tumors attributable to the Warburg effect. In this study, we have successfully adopted this targeting strategy to facilitate the specific uptake of advanced nanotools, comprising carbon nanocrystals incorporating gold seeds (AuCDs). Leveraging the advantageous optical and size-related properties of carbon nanodots in conjunction with gold-mediated X-ray attenuation capabilities, these hybrid nanomaterials have been engineered as contrast agents for a bi-modal imaging modality, exploiting the synergistic benefits of fluorescence imaging and X-ray computed tomography. Notably, for the synthesis of AuCDs, we present, for the first time, the incorporation of gold seeds within the molecular precursors of carbon nanodots during their solvothermal synthesis process, showcasing the efficacy of this synthetic pathway in yielding nanoscale carbon structures incorporating bioeliminable gold ultrasmall nanoparticles (d < 5 nm). Subsequently, we employed an azido-alkyne click chemistry reaction to functionalize the nanoparticle surface with 2-deoxy-D-glucose as a targeting moiety. The demonstrated cancer-targeting proficiency, as assessed via fluorescence imaging, renders the proposed nanosystem highly promising for a spectrum of applications in precision anticancer theranostics, encompassing both diagnostic and therapeutic endeavors.

The effect of different treatment strategies on glycolipid metabolism disorders and cardiovascular events in primary aldosteronism.

Recent studies have explored the association between primary aldosteronism and cardiovascular disease incidence. The association between specific primary aldosteronism treatments and differential improvement in cardiovascular event rates is yet to be established. This study was designed to compare the relative effects of spironolactone therapy and surgical intervention on cardiovascular outcomes among primary aldosteronism patients. This retrospective observational study included 853 primary aldosteronism patients from the First Affiliated Hospital of China Medical University between 2014 and 2022. Patients who had completed abdominal computed tomography (CT) examinations with similar metabolic characteristics and 6-month follow-up analyses were included in this study. These patients were separated into a surgical treatment group (n = 33) and a spironolactone treatment group (n = 51). Demographic data, biochemical analysis results, liver/spleen (L/S) X-ray attenuation ratio, hospitalization frequency, and cardiovascular events were compared between the two groups. The spironolactone group demonstrated significantly improved metabolic characteristics compared to the surgical group, shown by lower BMI, blood pressure, total cholesterol (TC), insulin resistance index (IRI), and reduced non-alcoholic fatty liver disease prevalence. Metabolic parameters did not differ significantly within the surgical treatment group when comparing pre- and postoperative values. The incidence of cardiovascular events was lower in the spironolactone group compared to the surgery group (23/33 vs. 20/51, P < 0.001) despite higher hospitalization rates(37/31 vs. 61/53, P < 0.001). In patients with primary aldosteronism, spironolactone treatment is more effective than surgical intervention in remediating abnormal lipid and glucose metabolism while improving cardiovascular outcomes. Chinese clinical trial registry registration number: ChiCTR2300074574.

Optimising total knee replacement imaging: a novel 3D printed PET/CT anthropomorphic phantom for metal artefact simulation

PurposeArthroplasty phantoms, including total knee replacement (TKR) phantoms, have been frequently used to test metal artefact reduction methods applied to positron emission tomography/computed tomography (PET/CT) images. These phantoms generally simulate either simple anatomical features or simple activity distribution around the metal inserts in the PET/CT scans. 3D printing has been used recently to fabricate fillable anthropomorphic phantoms that accurately simulate volume and geometry. This study aims to describe the process of image segmentation, phantom modelling, 3D printing and validation of a population-based fillable TKR phantom that simulates human TKR PET/CT metal artefacts.Methods10 participants (5 male and 5 female) were scanned using 3T MRI and the images were segmented to create average male and average female 3D knee models, inversely with void cortical and porous trabecular compartments for 3D printing and contrast media. Virtual total knee replacement (TKR) surgery was implemented on these models to prepare the insertion locations for knee prosthetic implants. Subsequently, TKR models were printed using a 3D photopolymer resin printer and then injected with normal saline to test the phantoms for any leaks. Subsequently, diluted iodinated contrast media was injected into the cortical compartment and saline with 18F-FDG was injected into the trabecular compartment and the phantom was scanned with PET/CT. The images were then evaluated and compared to the human knee radiographic features reported in the literature.ResultsPhantoms were shown to be fluid-tight with distinct compartments. They showed comparable volume and geometry to the segmented human MRI knees. The phantoms demonstrated similar values for x-ray attenuation and Hounsfield units (HU) to the literature for both cortical and trabecular compartments. The phantoms displayed a uniform distribution for the radioactive tracer, resembling that seen in human trabecular bone PET. TKR phantom PET/CT images with metal inserts replicated the clinical metal artefacts seen clinically in the periprosthetic area.ConclusionThis novel, 3D-printed, and customisable phantom effectively mimics the geometric, radiographic and radiotracer distribution features of real TKRs. Importantly, it simulates TKR image metal artefacts, making it suitable for repeatable and comprehensive evaluation of various metal artefact reduction methods in future research.

High-resolution X-Ray imaging of small animal samples based on Commercial-Off-The-Shelf CMOS image sensors.

An automated system for acquiring microscopic-resolution radiographic images of biological samples was developed. Mass-produced, low-cost, and easily automated components were used, such as Commercial-Off-The-Self CMOS image sensors (CIS), stepper motors, and control boards based on Arduino and RaspberryPi. System configuration, imaging protocols, and Image processing (filtering and stitching) were defined to obtain high-resolution images and for successful computational image reconstruction. Radiographic images were obtained for animal samples including the widely used animal models zebrafish (Danio rerio) and the fruit-fly (Drosophila melanogaster), as well as other small animal samples. The use of phosphotungstic acid (PTA) as a contrast agent was also studied. Radiographic images with resolutions of up to (7±0.6)μm were obtained, making this system comparable to commercial ones. This work constitutes a starting point for the development of more complex systems such as X-ray attenuation micro-tomography systems based on low-cost off-the-shelf technology. It will also bring the possibility to expand the studies that can be carried out with small animal models at many institutions (mostly those working on tight budgets), particularly those on the effects of ionizing radiation and absorption of heavy metal contaminants in animal tissues.

A blurring correction method suitable to analyze quantitative x-ray images derived from energy-resolving photon counting detector

Objective. The purpose of this study is to propose a novel blurring correction method that enables accurate quantitative analysis of the object edge when using energy-resolving photon counting detectors (ERPCDs). Although the ERPCDs have the ability to generate various quantitative analysis techniques, such as the derivations of effective atomic number (Z eff) and bone mineral density values, at the object edge in these quantitative images, accurate quantitative information cannot be obtained. This is because image blurring prevents the gathering of accurate primary x-ray attenuation information. Approach. We developed the following procedure for blurring correction. A 5 × 5 pixels masking region was set as the processing area, and the pixels affected by blurring were extracted from the analysis of pixel value distribution. The blurred pixel values were then corrected to the proper values estimated by analyzing minimum and/or maximum values in the set mask area. The suitability of our correction method was verified by a simulation study and an experiment using a prototype ERPCD. Main results. When Z eff image of aluminum objects (Z eff = 13) were analyzed without applying our correction method, regardless of raw data or correction data applying a conventional edge enhancement method, the proper Z eff values could not be derived for the object edge. In contrast, when applying our correction method, 82% of pixels affected by blurring were corrected and the proper Z eff values were calculated for those pixels. As a result of investigating the applicability limits of our method through simulation, it was proven that it works effectively for objects with 4 × 4 pixels or more. Significance. Our method is effective in correcting image blurring when the quantitative image is calculated based on multiple images. It will become an in-demand technology for putting a quantitative diagnosis into actual medical examinations.

A systematic investigation on the potential X-ray attenuation properties of Mg-doped SnO2 epoxy nanocomposite-based aprons as an alternate for lead commercial aprons

A systematic investigation on the potential X-ray attenuation properties of Mg-doped SnO2 epoxy nanocomposite-based aprons as an alternate for lead commercial aprons

Through-Space Charge-Transfer Organogold(III) Complexes Enable High-Performance X-ray Scintillation and Imaging.

Organic scintillators have recently attracted growing attention for X-ray detection in industrial and medical applications. However, these materials still face critical obstacles of low attenuation efficiency and/or inefficient triplet exciton utilization. Here we developed a new category of organogold(III) complexes, Tp-Au-1 and Tp-Au-2, through adopting a through-space interaction motif to realize high X-ray attenuation efficiency and efficient harvesting of triplet excitons for emission. Thanks to the efficient through-space charge transfer process, this panel of complexes achieved higher photoluminescence quantum yield and shorter radiative lifetimes compared with the through-bond reference complexes. Inspiringly, these organogold(III) complexes exhibited polarity-dependent emission origins: thermally activated delayed fluorescence and/or phosphorescence. Under X-ray irradiation, Tp-Au-2 manifested intense radioluminescence together with a record-high scintillation light yield of 77,600 photons MeV-1 for organic scintillators. The resulting scintillator screens demonstrated high-quality X-ray imaging with >16.0 line pairs mm-1 spatial resolution, outstripping most organic and inorganic scintillators. This finding provides a feasible strategy for the design of superior organic X-ray scintillators.

Bi2S3/Ti3C2-TPP nano-heterostructures induced by near-infrared for photodynamic therapy combined with photothermal therapy on hypoxic tumors

BackgroundPhotodynamic therapy (PDT) efficacy of bismuth sulfide (Bi2S3) semiconductor has been severely restricted by its electron–hole pairs (e−−h+) separation inefficiency and oxygen (O2) deficiency in tumors, which greatly hinders reactive oxygen species (ROS) generation and further clinical application of Bi2S3 nanoparticles (NPs) in biomedicine.ResultsHerein, novel Bi2S3/titanium carbide (Ti3C2) two-dimensional nano-heterostructures (NHs) are designed to realize multimode PDT of synchronous O2 self-supply and ROS generation combined with highly efficient photothermal tumor elimination for hypoxic tumor therapy. Bi2S3/Ti3C2 NHs were synthesized via the in situ synthesis method starting from Ti3C2 nanosheets (NSs), a classical type of MXene nanostructure. Compared to simple Bi2S3 NPs, Bi2S3/Ti3C2 NHs significantly extend the absorption to the near-infrared (NIR) region and enhance the photocatalytic activity owing to the improved photogenerated carrier separation, where the hole on the valence band (VB) of Bi2S3 can react with water to supply O2 for the electron on the Ti3C2 NSs to generate ·O2− and ·OH through electron transfer. Furthermore, they also achieve 1O2 generation through energy transfer due to O2 self-supply. After the modification of triphenylphosphium bromide (TPP) on Bi2S3/Ti3C2 NHs, systematic in vitro and in vivo evaluations were conducted, revealing that the synergistic-therapeutic outcome of this nanoplatform enables complete eradication of the U251 tumors without recurrence by NIR laser irradiation, and it can be used for computed tomography (CT) imaging because of the strong X-ray attenuation ability.ConclusionThis work expands the phototherapeutic effect of Bi2S3-based nanoplatforms, providing a new strategy for hypoxic tumor theranostics.

Experimental evaluation of electrospun ZnO/WO3/PVA-coated glass nanocomposites for a potential radiation dosimetry application

This research aimed to fabricate a potential radiation dosimeter using electrospun ZnO/WO3/PVA-coated glass nanocomposites. Samples with varying ZnO molarities (2.46, 3.69, 4.91, 5, and 7 M) and 5 wt% of WO3 collected at different times were examined. Field emission scanning electron microscopy (FESEM) and energy dispersive X-ray analysis (EDX) revealed favorable nanofiber morphology, although certain conditions produced larger nanofibers. The optical properties, analyzed via ultraviolet–visible (UV–Vis) spectroscopy, exhibited varying responses in different samples with changes in nanofiber collection time. The calculated optical energy band gap (Eg) for all samples is lower than Eg of pure ZnO. Moreover, the effective atomic number (Zeff), calculated based on EDX results, did not approach Zeff of human tissues, in all samples in general. Crucially, all samples demonstrated a strong linear response and low energy dependence when subjected to different X-ray exposure settings, closely resembling an Al2O3-based OSL dosimeter. Sample E3, consisting of 7.00 M ZnO and 5 wt% of WO3 collected over 4 h, emerged as the most promising candidate for a radiation dosimeter. Prior studies neglected to examine the influence of different amounts of ZnO on the radiation dosimetry properties of ZnO/WO3/PVA nanofibers. In contrast, this study specifically investigated the radiation dosimetry properties of ZnO/WO3/PVA nanofibers. The exceptional properties of ZnO in response to X-rays, combined with the desired X-ray attenuation capabilities of WO3, make them a distinct option as substitute materials in radiation dosimeters. This research paves the way for an alternative dosimeter solution with robust radiation detection capabilities.

X-ray dark-field computed tomography for monitoring of tissue freezing

Accurately monitoring the extent of freezing in biological tissue is an important requirement for cryoablation, a minimally invasive cancer treatment that induces cell death by freezing tissue with a cryoprobe. During the procedure, monitoring is required to avoid unnecessary harm to the surrounding healthy tissue and to ensure the tumor is properly encapsulated. One commonly used monitoring method is attenuation-based computed tomography (CT), which visualizes the ice ball by utilizing its hypoattenuating properties compared to unfrozen tissue. However, the contrast between frozen and unfrozen tissue remains low. In a proof-of-principle experiment, we show that the contrast between frozen and unfrozen parts of a porcine phantom mimicking breast tissue can be greatly enhanced by acquiring X-ray dark-field images that capture the increasing small-angle scattering caused by the ice crystals formed during the procedure. Our results show that, compared to X-ray attenuation, the frozen region is detected significantly better in dark-field radiographs and CT scans of the phantom. These findings demonstrate that X-ray dark-field imaging could be a potential candidate for improved monitoring of cryoablation procedures.

Beam hardening correction based on image noise statistics

Beam hardening artefacts in x-ray computed tomography (CT) result from energy-dependent attenuation of x-rays in matter and cause inaccuracies in reconstructed 3D volume data. Effects due to beam hardening can easily be corrected if the detected spectrum of x-rays is known after having passed through an object. Conventional scintillator x-ray detectors, however, are incapable of measuring spectral information directly. The innovative idea of this paper is to extract information about the detected spectrum from image noise statistics and to estimate the spectrum using a new semi-empirical model function for a partially absorbed x-ray spectrum depending on a single unknown variable. The beam hardening correction factor is thus determined for each image pixel prior to the 3D reconstruction, does not require knowledge of the material of the CT-scanned object and is determined by modelling physical effects directly, without relying on an iterative approach or elaborate image processing.

Image classification system for COVID-19 patient X-Ray results using median filter with deep learning method

An image is a representation of an object that is rewritten on a medium with specific values (intensity) and has x and y coordinates. X-ray images are one type of medical image that can be used to detect and study a disease. However, X-ray images can sometimes appear blurry, making interpretation a bit challenging. Furthermore, there is variation in X-ray attenuation between normal tissue and tissue affected by a disease. By using the median filter and implementing deep learning as a method for classifying images based on feature extraction and weights in artificial neural networks. The stages carried out include preprocessing, with training and testing, feature extraction using layers of artificial neural networks that have undergone the filtering process. Then, a custom classifier layer is created to train the classification of COVID and normal classes using data from bottleneck.npy. The results of training and testing yielded an average accuracy of 95%, while the F1 Score evaluation result was 0.9."

Improvement of metal artifact reduction in dental CBCT using a CdTe photon-counting detector: Simulation study

In dental cone-beam computed tomography (CBCT), the image quality often degrades when patients have metallic objects such as metal implants and/or metal prostheses. Metal artifacts typically appear as streaks and shadows in the reconstructed CT images, limiting their clinical usefulness. Although various metal artifact reduction (MAR) methods are used in dental CBCT, no algorithm that can robustly remove metal artifacts has been universally accepted. Recent research has explored the potential benefits of using of a photon-counting detector (PCD) to advance enhanced MAR. PCD can classify x-ray photons into several different energy bins, allowing for more precise measurements of x-ray attenuation. Therefore, in this study, we propose a new MAR method based on the use of a PCD, named the high-energy trace normalized-MAR (HT-NMAR) algorithm, to ensure improved image quality. The proposed MAR algorithm consists of three main steps: 1) Segmentation of the metal trace using a high-energy binned sinogram, 2) Generation of a residual artifact-reduced prior, 3) Sinogram completion with the segmented metal trace and the prior, followed by CBCT reconstruction. We conducted a simulation on a numerical head phantom with metal inserts using a PCD simulation toolkit to demonstrate its efficacy. Our simulation study indicates that the proposed MAR method considerably reduces metal artifacts in CBCT and shows a better image performance than other existing MAR methods in reducing streak artifacts without any contrast anomaly.

Monolacunary Wells-Dawson Polyoxometalate as a Novel Contrast Agent for Computed Tomography: A Comprehensive Study on In Vivo Toxicity and Biodistribution.

Polyoxotungstate nanoclusters have recently emerged as promising contrast agents for computed tomography (CT). In order to evaluate their clinical potential, in this study, we evaluated the in vitro CT imaging properties, potential toxic effects in vivo, and tissue distribution of monolacunary Wells-Dawson polyoxometalate, α2-K10P2W17O61.20H2O (mono-WD POM). Mono-WD POM showed superior X-ray attenuation compared to other tungsten-containing nanoclusters (its parent WD-POM and Keggin POM) and the standard iodine-based contrast agent (iohexol). The calculated X-ray attenuation linear slope for mono-WD POM was significantly higher compared to parent WD-POM, Keggin POM, and iohexol (5.97 ± 0.14 vs. 4.84 ± 0.05, 4.55 ± 0.16, and 4.30 ± 0.09, respectively). Acute oral (maximum-administered dose (MAD) = 960 mg/kg) and intravenous administration (1/10, 1/5, and 1/3 MAD) of mono-WD POM did not induce unexpected changes in rats' general habits or mortality. Results of blood gas analysis, CO-oximetry status, and the levels of electrolytes, glucose, lactate, creatinine, and BUN demonstrated a dose-dependent tendency 14 days after intravenous administration of mono-WD POM. The most significant differences compared to the control were observed for 1/3 MAD, being approximately seventy times higher than the typically used dose (0.015 mmol W/kg) of tungsten-based contrast agents. The highest tungsten deposition was found in the kidney (1/3 MAD-0.67 ± 0.12; 1/5 MAD-0.59 ± 0.07; 1/10 MAD-0.54 ± 0.05), which corresponded to detected morphological irregularities, electrolyte imbalance, and increased BUN levels.

Effect of aspect ratio on the x-ray attenuation of nanoparticles: A theoretical study

PurposeThere has been a significant focus on the potential applications of nanoparticle suspensions in the past few decades particularly as targeted contrast agents for specific pathological conditions. However, the question of optimal size and shape of nanoparticles for contrast enhancement is inadequately addressed. MethodsWe present a comprehensive and conclusive theoretical analysis using first principles by considering the attenuating property of a single nanoparticle of any arbitrary shape. As a special case, ellipsoidal nanoparticles and nanorods are considered, for two independent directions of incidence of x-rays. These results are extended for a suspension of nanoparticles in a liquid. ResultsIt is seen that for a nanoparticle with dimensions much less than 1/μ(E), where μ(E) is the attenuation coefficient of the material, the attenuation by the nanoparticle is independent of its shape and size; and attenuation per unit mass reduces as the nanoparticle size increases. ConclusionsTo achieve maximum attenuation, the nanoparticle sizes should be as small as possible, immaterial of the shape, as long as the dimensions are smaller than 150 nm.

The effect of modified Tin oxide on X-ray attenuation: An experimental and theoretical study

In this study, Graphene oxide modified SnO2 (GOMS) was synthesized with a chemical method. The PVC composites containing 50 wt% of SnO2 and GOMS were prepared. X-ray attenuation parameters were investigated. Also, composites' tensile strength, Anti-bacterial, and structure morphology were compared. The results indicated that using GOMS maintained X-ray attenuation and enhanced other properties under study. The results of attenuation percent of SnO2 composite in 40, 80, and 120 kVp are 94.19%, 89.14%, and 77.13%. The results for the GOMS composite are 94.07%, 89.19%, and 77.19%, respectively. In addition, the composite attenuation percent was simulated with MCNPX code and compared with experimental results. This work also concentrated on developing environmental X-ray shielding composites due to the X-ray protection fabrics required in medical devices. According to the acceptable X-ray attenuation results and the unique mechanical properties, it can be further investigated as a product for radiation protection equipment in industrial R&D.

Radiopacity Enhancements in Polymeric Implant Biomaterials: A Comprehensive Literature Review.

Polymers as biomaterials possess favorable properties, which include corrosion resistance, light weight, biocompatibility, ease of processing, low cost, and an ability to be easily tailored to meet specific applications. However, their inherent low X-ray attenuation, resulting from the low atomic numbers of their constituent elements, i.e., hydrogen (1), carbon (6), nitrogen (7), and oxygen (8), makes them difficult to visualize radiographically. Imparting radiopacity to radiolucent polymeric implants is necessary to enable noninvasive evaluation of implantable medical devices using conventional imaging methods. Numerous studies have undertaken this by blending various polymers with contrast agents consisting of heavy elements. The selection of an appropriate contrast agent is important, primarily to ensure that it does not cause detrimental effects to the relevant mechanical and physical properties of the polymer depending upon the intended application. Furthermore, its biocompatibility with adjacent tissues and its excretion from the body require thorough evaluation. We aimed to summarize the current knowledge on contrast agents incorporated into synthetic polymers in the context of implantable medical devices. While a single review was found that discussed radiopacity in polymeric biomaterials, the publication is outdated and does not address contemporary polymers employed in implant applications. Our review provides an up-to-date overview of contrast agents incorporated into synthetic medical polymers, encompassing both temporary and permanent implants. We expect that our results will significantly inform and guide the strategic selection of contrast agents, considering the specific requirements of implantable polymeric medical devices.

Cu2WS4-PEG Nanozyme as Multifunctional Sensitizers for Enhancing Immuno-Radiotherapy by Inducing Ferroptosis.

Unavoidable damage to normal tissues and tumor microenvironment (TME) resistance make it challenging to eradicate breast carcinoma through radiotherapy. Therefore, it is urgent to develop radiotherapy sensitizers that can effectively reduce radiation doses and reverse the suppressive TME. Here, a novel biomimetic PEGylated Cu2WS4 nanozyme (CWP) with multiple enzymatic activities is synthesized by the sacrificing template method to have physical radiosensitization and biocatalyzer-responsive effects on the TME. Experiment results show that CWP can improve the damage efficiency of radiotherapy on breast cancer cell 4T1 through its large X-ray attenuation coefficient of tungsten and nucleus-penetrating capacity. CWP also exhibit strong Fenton-like reactions that produced abundant ROS and GSH oxidase-like activity decreasing GSH. This destruction of redox balance further promotes the effectiveness of radiotherapy. Transcriptome sequencing reveals that CWP induced ferroptosis by regulating the KEAP1/NRF2/HMOX1/GPX4 molecules. Therefore, owing to its multiple enzymatic activities, high-atomic W elements, nucleus-penetrating, and ferroptosis-inducing capacities, CWP effectively improves the efficiency of radiotherapy for breast carcinoma in vitro and in vivo. Furthermore, CWP-mediated radiosensitization can trigger immunogenic cell death (ICD) to improve the anti-PD-L1 treatments to inhibit the growth of primary and distant tumors effectively. These results indicate that CWP is a multifunctional nano-sensitizers for radiotherapy and immunotherapy.