Body Magnetic Resonance Research Articles

The Effectiveness of Whole Body Magnetic Resonance Imaging Used in Health Screening Programs in Early Stage Cancer Diagnosis

Objective: We aim to present the findings and effectiveness of Whole Body Magnetic Resonance Imaging (WBMRI), which we use in the Health Screening Program (HSP) to diagnose cancer in early stage. Methods: This retrospective study was conducted between January 2017-February 2023. 393 individuals, between the ages of 18 and 85, who underwent WBMRI for HSP purposes, were included. The mean age was 50. Results: Malignancy suspicious lesions were observed in the head/neck region in 25 cases. Additional Magnetic Resonance (MRI) and Ultrasound (US) were performed. Mediastinal pathology was observed in 23 cases, and non-mediastinal thoracic pathologies were detected in 15. Therefore thorax Computed Tomography (CT), mammography, and breast US were performed. Benign lesions were observed in the liver in 44 cases, and US was performed. Malignancy-suspicious lesions in the liver were observed in 4, and dynamic abdominal MRI was performed. Cholelithiasis was observed in 16, and confirmed by US. The most common renal findings were; cysts and pelvicalyceal ectasia. Adrenal adenoma was observed in 5 cases. Two of the females had suspicion of gynecological malignancy. Massive diffuse concentric wall thickening was observed in the sigmoid colon, and colonoscopy was performed on one male. Musculoskeletal benign lesions were detected in 99 cases, and malignancy-suspicious lesions were detected in 35. Additional examinations such as US, CT, MRI, PET-CT, scintigraphy, and colonoscopy were performed on 172 cases. Malignancy was detected in 11 cases (2.8%). Conclusion: WBMRI is a radiation-free, non-invasive, short-term examination method. WBMRI is beneficial in diagnosing early-stage cancer.

Whole body magnetic resonance imaging (WB MRI) in the diagnosis and evaluation of the effectiveness of treatment of metastatic prostate cancer: Met-RADS-P system standards

INTRODUCTION: Whole-body magnetic resonance imaging (WB MRI) including diffusion-weighted imaging (DWI) is increasingly used in clinical practice. For metastatic prostate cancer, the radiologic reporting and data system Met-RADS-P (METastasis Reporting and Data System for Prostate Cancer) has been proposed to determine the prevalence of the metastatic process and subsequently evaluate the response to specific treatment based on WB MRI data.OBJECTIVE: To present an overview of the methodological aspects of WB MRI in patients with metastatic prostate cancer in relation to the Met-RADS-P system, to outline its terminology and principles for assessing study results, and to discuss the possibilities of its clinical use.MATERIALS AND METHODS: A search was conducted for publications for the period from January 1, 2017 to December 1, 2023 in Russian and English in the electronic databases eLibrary, Medline, PubMed, using the keywords: «диффузионно-взвешенная томография всего тела», «метастатический рак предстательной железы», «Met-RADS-P», «Whole Body MRI, WB MRI», «Whole Body DWI, WB DWI», «metastatic prostate cancer», supplemented by examination of references in the retrieved articles.RESULTS: Based on the literature data and our own experience, WB MRI protocols in patients with metastatic prostate cancer are described, the algorithm of MR image analysis, the criteria for evaluating the response of metastatic foci in the skeleton, lymph nodes, and internal organs, and the response assessment categories according to the RAC (response assessment categories) scale, as well as summarize the results and discuss the prospects for the clinical use of Met-RADS-P.DISCUSSION: The few publications in the literature using the Met-RADS-P system primarily concern the assessment of its reliability (inter-reader agreement). The authors conclude that it is appropriate to use it in monitoring metastases in patients with castration-resistant prostate cancer, emphasizing the clinical importance of identifying discordant responses after therapy. They also note the obstacles to the widespread introduction of WB MRI imaging into clinical practice, including the duration of the examination procedure and the large volume of diagnostic data that requires significant time for analysis and reporting, which can be overcome by automating the assessment of MR images using artificial intelligence.CONCLUSION: The Met-RADS-P system systematizes the approach to performing and describing WB MRI in patients with advanced prostate cancer, allowing the technique to be reproduced on virtually any modern scanner, from the scan protocol to a standardized report of findings. This makes the WB MRI technique reproducible in a variety of medical settings, and therefore increases its value. Nevertheless, Met-RADS-P is a relatively new system and requires large multicenter clinical trials to confirm its efficacy and representativeness, as well as to level out its shortcomings.

The role of whole body magnetic resonance imaging in pediatric rheumatology

The role of whole body magnetic resonance imaging in pediatric rheumatology

Chronic Noninfectious Osteomyelitis: A Review of Imaging Findings

AbstractChronic noninfectious osteomyelitis or chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis, is an autoinflammatory bone disorder primarily affecting the pediatric age group. Currently, it is diagnosed on the basis of clinical, laboratory, and imaging features. Imaging plays a crucial role in the diagnosis and follow-up of CNO with whole body magnetic resonance imaging (WBMRI) being the main modality. Radiographs assist in exclusion of common differential diagnoses like infections and malignancy. WBMRI aids in disease detection and exclusion of differential diagnoses, identifies additional lesions, and has a role in ascertaining the pattern of bony involvement which helps with prognostication and grading. Recent recognition of specific morphological and distribution patterns on WBMRI is increasingly allowing an upfront diagnosis of this entity to be made on imaging alone. It is also helpful for assessment of response to therapy during follow-up. This review aims to summarize the role of imaging in the evaluation of CNO, with special emphasis on WBMRI in its assessment.

Liver transplant recipients have worse metabolic body phenotype compared with matched non-transplant controls.

Quantification of body compartments, particularly the interaction between adipose tissue and skeletal muscle, is emerging as novel a biomarker of metabolic health. The present study evaluated the impact of liver transplant (LT) on body compartments. Totally 66 adult LT recipients were enrolled in whom body compartments including visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT), muscle fat infiltration (MFI), fat-free muscle volume (FFMV), and liver fat (LF) were quantified via whole body magnetic resonance imaging (MRI). To provide non-LT comparison, each LT recipient was matched to at least 150 non-LT controls for same sex, age, and body mass index (BMI) from the UK Biobank registry. LT recipients (vs matched non-LT controls) had significantly higher subcutaneous (13.82 ± 5.47 vs 12.10 ± 5.10 L, P < 0.001) and visceral fat (7.59 ± 3.75 vs 6.72 ± 3.06 L, P = 0.003) and lower LF (5.88 ± 7.14 vs 8.75 ± 6.50%, P < 0.001) and muscle volume (11.69 ± 2.95 vs 12.12 ± 2.90 L, P = 0.027). In subgroup analysis, patients transplanted for metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis (vs non-MASH cirrhosis) had higher ASAT, VAT, and MFI. A trend toward higher LF content was noted; however, this did not reach statistical significance (6.90 ± 7.35 vs 4.04 ± 6.23%, P = 0.189). Finally, compared with matched non-LT controls, patients transplanted for MASH cirrhosis had higher ASAT and VAT; however, FFMV and MFI were similar. Using non-LT controls, the current study established the higher-than-expected adiposity burden among LT recipients, which is even higher among patients transplanted for MASH cirrhosis. These findings provide data needed to design future studies developing radiomics-based risk-stratification strategies in LT recipients.

Correlation analysis of dynamic changes of abdominal fat during rapid weight loss after bariatric surgery: A prospective magnetic resonance imaging study

ObjectiveThe factors related to the changes in the liver and abdominal adipose tissue during the rapid weight loss after bariatric surgery remain uncertain. MethodsThis study included 44 participants who had undergone sleeve gastrectomy. The study aimed to analyze changes and correlations of body weight (BW), laboratory tests, and magnetic resonance imaging (MRI) indicators of the liver and abdominal adipose tissue conducted before and after bariatric surgery at 1, 3, and 6 months. ResultsFollowing a rapid weight loss within 6 months of surgery, there was a concurrent decrease in blood glucose, blood lipids, and fat content of the liver and abdomen and the changes showed a correlation. The change of BW (ΔBW) was positively correlated with the change of hepatic proton density fat fraction (ΔPDFF) in one and three months after surgery and was positively correlated with the change of abdominal visceral fat area (ΔAVFA) in six months after surgery, (P<0.05). In one month after surgery, ΔPDFF was positively correlated with the change of aspartate aminotransferase (ΔAST), change of alanine aminotransferase (ΔALT), and change of triglyceride glucose (ΔTYG) index (P<0.05). ΔPDFF was positively correlated with the change of hepatic native T1 values (P<0.001) and was moderately negatively correlated with the change of hepatic apparent diffusion coefficient (ΔADC) values in three months after surgery (P<0.05). ConclusionΔBW can serve as an indirect indicator for evaluating changes in liver fat fraction at 1 and 3 months after bariatric surgery and indicative of changes in visceral fat 6 months after surgery. ΔPDFF was positively correlated with ΔAST, ΔALT and ΔTYG index in 1 months after surgery.

Body MRI in pediatrics: where we are and what the future holds.

Body magnetic resonance imaging (MRI) is increasingly used for disease diagnosis, characterization, and monitoring in children of all ages. MRI has numerous advantages when compared to other imaging modalities, including a lack of ionizing radiation, superior soft tissue image contrast, and ability to provide objective, quantitative assessments. As MRI continues to evolve, pediatric body MRI examinations of the future will certainly be different than our current and past protocols. In this review article, we will discuss the present and likely future states of pediatric body MRI, including the increasing application of quantitative MRI methods, faster imaging techniques and implementation of abbreviated targeted protocols, and the growing use of artificial intelligence methods.

Safe and Informed Use of Gadolinium-Based Contrast Agent in Body Magnetic Resonance Imaging: Where We Were and Where We Are.

Gadolinium-based contrast agents (GBCAs) have helped to improve the role of magnetic resonance imaging (MRI) for the diagnosis and treatment of diseases. There are currently nine different commercially available gadolinium-based contrast agents (GBCAs) that can be used for body MRI cases, and which are classifiable according to their structures (cyclic or linear) or biodistribution (extracellular-space agents, target/specific-agents, and blood-pool agents). The aim of this review is to illustrate the commercially available MRI contrast agents, their effect on imaging, and adverse reaction on the body, with the goal to lead to their proper selection in different clinical contexts. When we have to choose between the different GBCAs, we have to consider several factors: (1) safety and clinical impact; (2) biodistribution and diagnostic application; (3) higher relaxivity and better lesion detection; (4) higher stability and lower tissue deposit; (5) gadolinium dose/concentration and lower volume injection; (6) pulse sequences and protocol optimization; (7) higher contrast-to-noise ratio at 3.0 T than at 1.5 T. Knowing the patient's clinical information, the relevant GBCAs properties and their effect on body MRI sequences are the key features to perform efficient and high-quality MRI examination.

Differences between whole body magnetic resonance imaging (WB-MRI) and chest/abdomen/pelvis computed tomography (CT)/bone scan (CT/B) in patients staged as having metastatic hormone-sensitive prostate cancer (mHSPC): A retrospective comparative study within a single trust in the UK.

37 Background: Diagnostic imaging for metastases detection in HSPC varies across different countries with increasing use of WB-MRI and PSMA-PET. However, CT/B has still been the most used modality in the real world and recent registration clinical trials in this disease setting. Methods: We performed a cross-sectional retrospective descriptive study comparing WB-MRI with CT/B used as baseline staging modalities in patients diagnosed with mHSPC between February 2017 and August 2023 in two hospitals belonging to the same NHS trust in the UK routinely using one of the two. The study aimed at the detection of differences between the two modalities in the identification of metastatic sites and CHAARTED volume/LATITUDE risk, and the relative impact on patients’ received therapies and outcomes. Results: Of 213 patients diagnosed with mHSPC, 121 had baseline WB-MRI, 86 CT/B and 7 choline or PSMA PET. Compared to CT/B, patients staged by WB-MRI were diagnosed with significantly higher bone-only (47 vs 24%, p=0.002) and lower lymph-node only disease (11 vs 27%, p=0.005); higher high-volume (49 vs 21%, p&lt;0.001) and -risk disease (48 vs 17%, p&lt;0.001); higher de-novo metastatic disease (91 vs 66%, p&lt;0.001); had previously received less radical surgery (2 vs 13%, p=0.003) or radiotherapy (7 vs 24%, p&lt;0.001); received more frequently ADT plus Docetaxel (65 vs 44%, p=0.005). Treatment and outcome results in the overall cohorts’ populations and according to disease volume/risk will be presented. Conclusions: In a homogenous cohort of patients, we found a relevant discrepancy between the use of WB-MRI and CT/B in the identification of high-volume/risk and de-novo disease in mHSPC related to a higher detection rate of bone-only disease by the WB-MRI. This may prompt clinicians to offer different systemic therapies according to the disease burden and could also have a role in avoiding overtreatments for the under-staged disease.

Assessing head muscles measured with MRI as alternative to estimate muscle mass in older persons with dementia

AbstractBackgroundCurrent evidence suggests an association between sarcopenia and multiple negative outcomes. Traditional methods to diagnose sarcopenia are based on dual‐energy X‐ray absorptiometry (DXA) and whole body magnetic resonance imaging. These tests are complicated, time‐consuming and expensive. We aim to bring a more accessible way to diagnose sarcopenia, making its detection easier in a neurological and dementia setting where brain MRI are regularly ordered. Therefore, we aim to compare the traditional methods of muscle mass and function vs. muscle quantification using the tongue and the masseter muscle in a standard brain MRI to diagnose sarcopenia in clinical settings.MethodThe H70 study, is a longitudinal study of people born in the Gothenburg area of Sweden aged 70 at baseline. We included 791 participants with available clinical data and MRI. DXA and bioimpedance analyses were used as reference measures. Images were analyzed using 3Dslicer.(figure 1) Adjusted speermarRo coefficients were calculated to assess the correlation between the gold standard (DXA) and the muscle mass of the tongue and masseters.ResultThere was a higher prevalence of women (55,7%). When comparing the different tests to assess muscle mass, we found significant and positive coefficient between both tongue and masseter. Total lean tissue mass (DXA) &amp; Tongue volume (Cm3) Rho = 0,375, total lean tissue mass (DXA) &amp; Total masseter volume (Cm3) Rho = 0,326. &lt; 0.001. (table1,2 Figure 2.)ConclusionThere is a significant positive correlation between total lean tissue mass using DXA and muscle mass calculated with MRI measuring tongue and masseter. Clinical longitudinal Implications of these measurements will be tested in further steps of this research and exposed at the conference.

Body fat distribution, fat-free mass and cardiovascular function in the UK Biobank

Abstract Background Excess adiposity and high body mass index have been associated with cardiac dysfunction and heart failure. However, the role of whole body imaging and independent associations of regional fat and fat-free mass on left ventricular and vascular function is unclear. Purpose This study determined the cross-sectional associations of regional fat depots and fat-free mass on left ventricular function and arterial stiffness to explain obesity-related cardiac dysfunction. Methods Participants who underwent whole body magnetic resonance imaging (MRI) and dual energy X-ray absorptiometry (DXA) in an ongoing imaging study of 100,000 individuals in the UK were included in this analysis. Analyses exclude individuals with major cardiac and vascular diseases at initial baseline assessment. Regional fat distribution was quantified using MRI while body fat-free mass was quantified with DXA. Cardiac MRI was used to measure left ventricular (LV) ejection fraction and LV mass while pulse wave velocity from finger photo-plethysmography was used to measure arterial stiffness index. Associations of body fat distribution (visceral fat, abdominal subcutaneous fat, other body fat) and fat-free mass with each of LV ejection fraction, LV mass and arterial stiffness index, after mutual adjustment for one another and potential confounders were determined using multivariable linear regression. Results We included 31,088 individuals (mean age 63.4 years, 53% women). Among regional body fat measures, higher visceral fat was associated with lower LVEF (β=-0.43; 95% CI: -0.55, -0.31 per SD) and higher arterial stiffness index (β=0.44; 95% CI: 0.34, 0.54 per SD) while none of the regional fat and fat-free mass showed significant association with LV function or arterial stiffness. None of the fat or fat-free mass measures showed significant association with LV mass. These associations were not explained by inflammatory markers, blood pressure or glycaemic profile. Conclusion Visceral fat is the main driver of obesity-related cardiac and vascular dysfunction. There is need for further studies to understand the biological causal pathways of obesity-heart disease.Figure 1Figure 2

Energy Expenditure, Body Composition, and Skeletal Muscle Oxidative Capacity in Patients with Myotonic Dystrophy Type 1.

Myotonic dystrophy type 1 (DM1) patients are at risk for metabolic abnormalities and commonly experience overweight and obesity. Possibly, weight issues result from lowered resting energy expenditure (EE) and impaired muscle oxidative metabolism. This study aims to assess EE, body composition, and muscle oxidative capacity in patients with DM1 compared to age-, sex- and BMI-matched controls. A prospective case control study was conducted including 15 DM1 patients and 15 matched controls. Participants underwent state-of-the-art methodologies including 24 h whole room calorimetry, doubly labeled water and accelerometer analysis under 15-days of free-living conditions, muscle biopsy, full body magnetic resonance imaging (MRI), dual-energy x-ray absorptiometry (DEXA), computed tomography (CT) upper leg, and cardiopulmonary exercise testing. Fat ratio determined by full body MRI was significantly higher in DM1 patients (56 [49-62] %) compared to healthy controls (44 [37-52] % ; p = 0.027). Resting EE did not differ between groups (1948 [1742-2146] vs (2001 [1853-2425>] kcal/24 h, respectively; p = 0.466). In contrast, total EE was 23% lower in DM1 patients (2162 [1794-2494] vs 2814 [2424-3310] kcal/24 h; p = 0.027). Also, DM1 patients had 63% less steps (3090 [2263-5063] vs 8283 [6855-11485] steps/24 h; p = 0.003) and a significantly lower VO2 peak (22 [17-24] vs 33 [26-39] mL/min/kg; p = 0.003) compared to the healthy controls. Muscle biopsy citrate synthase activity did not differ between groups (15.4 [13.3-20.0] vs 20.1 [16.6-25.8] μM/g/min, respectively; p = 0.449). Resting EE does not differ between DM1 patients and healthy, matched controls when assessed under standardized circumstances. However, under free living conditions, total EE is substantially reduced in DM1 patients due to a lower physical activity level. The sedentary lifestyle of DM1 patients seems responsible for the undesirable changes in body composition and aerobic capacity.

Patient centered radiology: investigating 3 Tesla whole body MRI acceptance in cancer patients

IntroductionWhole body magnetic resonance imaging (WB-MRI) is a promising emerging imaging technology for detecting bone and soft tissue pathology, especially in the onco-hematological field. This study aims to evaluate cancer patients' experience of WB-MRI performed on a 3T scanner compared to other diagnostic total body examinations.Material and methodIn this prospective committee-approved study, patients completed a questionnaire in person (n = 134) after undergoing a WB-MRI scan to collect data on their physical and psychological reactions during the scan, the global satisfaction level, and preference for other types of MRI or computed tomography (CT), or positron emission tomography (PET/CT). Of all patients who had performed a CT or PET/CT the previous year, 61.9% had already undergone an MRI. The most common symptoms reported were: 38.1% perceived a localized increase in temperature and 34.4% numbness and tingling of the limbs. The scan time averaged 45 min and was well tolerated by most patients (112, 85.5%). Overall, WB-MRI was appreciated by the majority (121/134—90.3%) of patients who said they would probably undergo the procedure again. Patients preferred the WB-MRI in 68.7% of cases (92/134), followed by CT in 15.7% of cases (21/134) and by PET/CT in 7.4% (10/134), with 8.4% (11/134) of patients without any preference. The preference for imaging modalities was age-dependent (p = 0.011), while (p > 0.05) was independent of sex and a primary cancer site.ConclusionThese results demonstrate a high degree of WB-MRI acceptance from a patient's point of view.

Association of abdominal adiposity, hepatic shear stiffness with subclinical left-ventricular remodeling evaluated by magnetic resonance in adults free of overt cardiovascular diseases: a prospective study

BackgroundAbdominal ectopic fat deposition and excess visceral fat depots in obesity may be related to cardiovascular disease (CVD) as both are involved in the metabolic syndrome (MetS). The awareness of the link between abdominal adiposity and subclinical cardiac remodeling would help improve treatment and outcome. Besides, liver fibrosis has also shown a potential relationship with cardiac dysfunction. Thus, we aimed to investigate the associations of magnetic resonance (MR)-based abdominal adiposity and hepatic shear stiffness with subclinical left ventricular (LV) remodeling while taking account of MetS-related confounders in adults free of overt CVD.MethodsThis was an exploratory, prospective study of 88 adults (46 subjects with obesity, 42 healthy controls) who underwent 3 T cardiac and body MR exams. Measures of abdominal MR included hepatic and pancreatic proton density fat fraction (H-PDFF and P-PDFF), hepatic shear stiffness by MR elastography, and subcutaneous and visceral adipose tissue (SAT and VAT). Cardiac measures included epicardial adipose tissue (EAT) and parameters of LV geometry and function. Associations were assessed using Pearson correlation and multivariable linear regression analyses, in which age, sex, and MetS-related confounders were adjusted for.ResultsThe LV ejection fractions of all participants were within the normal range. Higher H-PDFF, P-PDFF, SAT and VAT were independently associated with lower LV global myocardial strain parameters (radial, circumferential and longitudinal peak strain [PS], longitudinal peak systolic strain rate and diastolic strain rate) (β = − 0.001 to − 0.41, p < 0.05), and P-PDFF, SAT and VAT were independently and positively associated with LV end-diastolic volume and stroke volume (β = 0.09 to 3.08, p ≤ 0.02) in the over-all cohort. In the obesity subgroup, higher P-PDFF and VAT were independently associated with lower circumferential and longitudinal PS, respectively (β = − 0.29 to − 0.05, p ≤ 0.01). No independent correlation between hepatic shear stiffness and EAT or LV remodeling was found (all p ≥ 0.05).ConclusionsEctopic fat depositions in the liver and pancreas, and excess abdominal adipose tissue pose a risk of subclinical LV remodeling beyond MetS-related CVD risk factors in adults without overt CVD. VAT may play a more considerable role as a risk factor for subclinical LV dysfunction than does SAT in individuals with obesity. The underlying mechanisms of these associations and their longitudinal clinical implications need further investigation.

Pleural Effusions on MRI in Autosomal Dominant Polycystic Kidney Disease.

Autosomal dominant polycystic kidney disease (ADPKD) has cystic fluid accumulations in the kidneys, liver, pancreas, arachnoid spaces as well as non-cystic fluid accumulations including pericardial effusions, dural ectasia and free fluid in the male pelvis. Here, we investigate the possible association of ADPKD with pleural effusion. ADPKD subjects (n = 268) and age-gender matched controls without ADPKD (n = 268) undergoing body magnetic resonance imaging from mid-thorax down into the pelvis were independently evaluated for pleural effusion by 3 blinded expert observers. Subjects with conditions associated with pleural effusion were excluded from both populations. Clinical and laboratory data as well as kidney, liver and spleen volume, pleural fluid volume, free pelvic fluid and polycystic kidney disease genotype were evaluated. Pleural effusions were observed in 56 of 268 (21%) ADPKD subjects compared with 21 of 268 (8%) in controls (p < 0.0001). In a subpopulation controlling for renal function by matching estimated glomerular filtration rate (eGFR), 28 of 110 (25%) ADPKD subjects had pleural effusions compared to 5 of 110 (5%) controls (p < 0.001). Pleural effusions in ADPKD subjects were more prevalent in females (37/141; 26%) than males (19/127,15%; p = 0.02) and in males were weakly correlated with the presence of free pelvic fluid (r = 0.24, p = 0.02). ADPKD subjects with pleural effusions were younger (48 ± 14 years old vs. 43 ± 14 years old) and weighed less (77 vs. 70 kg; p ≤ 0.02) than those without pleural effusions. For ADPKD subjects with pleural effusions, the mean volume of fluid layering dependently in the posterior−inferior thorax was 19 mL and was not considered to be clinically significant. Pleural effusion is associated with ADPKD, but its role in the pathogenesis of ADPKD requires further evaluation.

Adherence to 24-Hour Movement Recommendations and Health Indicators in Early Adolescence: Cross-Sectional and Longitudinal Associations in the Adolescent Brain Cognitive Development Study

PurposeAdherence to 24-hour movement guidelines of ≥60 minutes of physical activity, ≤2 hours of screen time, and 9–11 hours of sleep has been shown to benefit cognitive, physical, and psychosocial health in children and young adolescents aged 5–13 years. However, these findings have mostly been based on cross-sectional studies or relatively small samples and the associations between adherence to guidelines and brain structure remain to be evaluated. MethodsData from the Adolescent Brain Cognitive Development℠ (ABCD) study of 10,574 early adolescents aged 9–14 years from September 2016 to January 2021 were used to examine whether adherence to 24-hour movement guidelines benefits cognition (general cognitive ability, executive function, and learning/memory assessed by the National Institutes of Health Toolbox neurocognitive battery), body mass index, psychosocial health (internalizing, externalizing, and total problems from the parent-reported Child Behavior Checklist), and magnetic resonance imaging–derived brain morphometric measures at baseline (T1), ∼2 years later (T2), and longitudinally from T1 to T2 (T2-T1). Multivariable linear mixed models were used, with adjustments for sociodemographic confounders. Time elapsed and T1 outcome measures were also controlled for in longitudinal models. ResultsBetter cognitive scores, fewer behavioral problems, lower adiposity levels, and greater gray matter volumes were observed in those who met both sleep and screen time recommendations compared to those who met none. Longitudinal follow-up further supports these findings; participants who met both recommendations at T1 and T2 evidenced better outcome measures than those who met none. DiscussionThese findings support consideration of integrated rather than isolated movement recommendations across the day in early adolescence for better cognitive, physical and psychosocial health. Although the associations between physical activity and health indicators were less consistent in this study, the significant findings from sleep and screen time demonstrate the importance of considering movement recommendations in an integrated rather than isolated manner for adolescent health. It is recommended that movement behaviors be simultaneously targeted for better developmental outcomes.

A Radiation-Free Approach Based on the Whole-Body-MRI Has Shown a High Level of Accuracy in the Follow up of Lymphoma Patients. a Single Center Retrospective Study

Introduction: lymphoproliferative disorders are a heterogeneous group of oncological diseases characterized by a variable prognosis and different risk of recurrence that can occur even after years from the last line of treatment. Therefore, it is mandatory to follow up all the patients in complete remission (CR) of disease. For this purpose, the most recent guidelines do not recommend the use of imaging methods that are recommended at diagnosis including multidetector computed tomography with intravenous iodinated contrast enhancement (CE-CT) and 2-[18F]-fluoro-2-deoxy-D-glucose-positron-emission tomography (18F-FDG PET- CT) because of the potential damage from ionizing radiation especially in young patients. Whole body magnetic resonance imaging with diffusion-weighted imaging (WB-MRI-DWI) is an emerging method that, without using contrast medium and ionizing radiation, can provide similar results, if not superior in some histological subtypes, to 18F-FDG PET-CT in detecting lymphomatous localizations. This method could potentially be suitable for the follow-up of lymphoma patients. In this retrospective single center study, we aimed to assess the accuracy of WB-MRI-DWI during follow-up of lymphoma patients in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Materials and methods: 191 lymphoma patients who underwent at list one WB-MRI-DWI in our center during follow-up between February 2010 and February 2022 were enrolled. Seventy-five were Hodgkin Lymphomas, 47 diffuse large B cell lymphomas (DLBCL), 33 follicular lymphomas (FL); 10 Marginal zone lymphomas, 7 primitive mediastinal B cell lymphomas (PMBCL), 6 mantle cell lymphomas, 3 Burkitt lymphomas and 10 with more rare histotypes). Twenty-seven patients have been identified as relapsed by WB-MRI-DWI. Results: In our cohort of patients the calculated sensitivity of WB-MRI-DWI in lymphoma surveillance was 100% (95% CI: 99.4-100.0), while specificity was 98.6% (95% CI: 97.4-99.3). The positive predictive value (PPV) was 79% (95% CI: 75.9-81.9) and the negative predictive value (NPV) 100% (95% CI: 99.4-100.0). Conclusion: despite some limitations of the whole body magnetic resonance including the possibility of poor patient compliance and the identification of some false positives (6.3% of the total), WB-MRI-DWI is an investigation with excellent sensitivity that can identify recurrence of the disease and at the same time it could eliminate the risk of ionizing radiation.

Enhanced Global Disease Assessment with Advanced Imaging and Targeted Myeloma Lesion Biopsy Highlights Spatial Heterogeneity and Detects Residual Disease in Multiple Myeloma

Background: Multiple myeloma (MM) is a biologically complex disease with marked heterogeneity; limitations remain in our standard myeloma disease assessment at diagnosis and in response to therapy. In this study, we aimed to prospectively investigate the utilization of advanced imaging and targeted focal lesion (FL) biopsies to augment global disease evaluation, detect residual tumor burden, and explore the diverse histologic and molecular landscape of this multifocal neoplasm. Herein, we present our final analysis of this clinical trial. Methods: Adult patients with newly diagnosed clinical MM (NDMM) and bone or extramedullary (EM) FL were eligible to participate in this prospective study. Advanced imaging with positron emission tomography/computed tomography (PET/CT) or whole body magnetic resonance imaging (WB-MRI), standard bone marrow (BM) biopsy and aspiration, and targeted FL biopsy were performed at enrollment and after four 28-day cycles of induction therapy with carfilzomib (36 mg/m2 intravenously twice weekly), lenalidomide (25 mg orally days 1-21), and dexamethasone (40 mg orally weekly) (KRd), with dose modifications as needed. Conventional clinical response, using IMWG Response Criteria (Kumar S et al, 2016), was also measured after each cycle of treatment. Patients were followed for 12 months after end of treatment or until data cutoff on February 23rd, 2022. Results: 27 patients were enrolled in this study between June 2018 and August 2021, with 25 evaluable for global response assessment. Median age was 61 years (range, 42-76 years) and 14.8% of patients were of Black or African American race. 85.2% of patients had Revised International Staging System (R-ISS) stage II or III disease. 51.9% of patients were identified as having EM disease arising out of bone or soft tissue and 44.4% of patients had high risk cytogenetics inclusive of chromosome 1 abnormalities. In sum, 70.4% of our cohort had at least 1 high risk feature at diagnosis (Table 1). 80% of patients had myeloma FL identified on advanced imaging that were missed on conventional skeletal survey. Of the 7 patients with cytogenetic and fluorescence in situ hybridization (FISH) testing performed on initial FL biopsy, 6 (85.7%) had findings discrepant from those seen on cytogenetic testing from standard BM samples. 9 patients had cytogenetic and FISH studies on repeat myeloma FL biopsy after KRd induction with 2 showing residual FISH abnormalities that were not detected on standard BM obtained for response assessment. Clinical response rates after 4 cycles of KRd were high in our study population with 88% of patients achieving a very good partial response (VGPR) or better and 20% with a stringent complete response (sCR) with minimal residual disease (MRD) negativity by flow cytometry. However, of the 22 patients with ≥VGPR by IMWG response assessment, 18 had residual disease on advanced imaging with WB-MRI (10 patients), PET/CT (7 patients), or MRI total spine (1 patient), including 3 of the 5 patients with sCR (Figure 1). 2 patients experienced disease progression during the study period with median progression free survival not reached by the patient cohort. Both patients with progression had a VGPR by conventional response assessment, though with residual FL on advanced imaging post-KRd induction. Conclusions: While tumor spatial differences in MM have been observed retrospectively, prospective data on this important component of myelomagenesis is limited. In our cohort of high risk NDMM, we demonstrated spatial heterogeneity both at diagnosis and after KRd induction. Despite the deep clinical responses observed by IMWG response assessment, 81.8% of patients with ≥VGPR had ongoing abnormalities on advanced imaging which could potentially serve as disease reservoirs for future progression and development of treatment resistance. A novel assessment method in MM, inclusive of advanced imaging and targeted FL biopsies, may overcome the limitations of our standard response assessment with resultant improved knowledge of the varied intra-tumor disease biology as well as development of more refined treatment approaches. A potential limitation of our study is the smaller sample size with underrepresentation of minority populations. Data on whole exome sequencing of paired BM and FL biopsies will be reported separately. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Comparison of Three Ultrasmall, Superparamagnetic Iron Oxide Nanoparticles for MRI at 3.0 T.

The ultrasmall, superparamagnetic iron oxide (USPIO) nanoparticle ferumoxytol has unique applications in cardiac, vascular, and body magnetic resonance imaging (MRI) due to its long intravascular half-life and suitability as a blood pool agent. However, limited availability and high cost have hindered its clinical adoption. A new ferumoxytol generic, and the emergence of MoldayION as an alternative USPIO, represent opportunities to expand the use of USPIO-enhanced MRI techniques. To compare in vitro and in vivo MRI relaxometry and enhancement of Feraheme, generic ferumoxytol, and MoldayION. Prospective. Ten healthy swine and six swine with artificially induced coronary narrowing underwent cardiac MRI. 3.0 T; T1-weighted (4D-MUSIC, 3D-VIBE, 2D-MOLLI) and T2-weighted (2D-HASTE) sequences pre- and post-contrast. We compared the MRI relaxometry of Feraheme, generic ferumoxytol, and MoldayION using saline, plasma, and whole blood MRI phantoms with contrast concentrations from 0.26 mM to 2.10 mM. In-vivo contrast effects on T1- and T2-weighted sequences and fractional intravascular contrast distribution volume in myocardium, liver, and spleen were evaluated. Analysis of variance and covariance were used for group comparisons. A P value <0.05 was considered statistically significant. The r1 relaxivities for Feraheme, generic ferumoxytol, and MoldayION in saline (22 °C) were 7.11 ± 0.13 mM-1 s-1 , 8.30 ± 0.29 mM-1 s-1 , 8.62 ± 0.16 mM-1 s-1 , and the r2 relaxivities were 111.74 ± 3.76 mM-1 s-1 , 105.07 ± 2.20 mM-1 s-1 , and 109.68 ± 2.56 mM-1 s-1 , respectively. The relationship between contrast concentration and longitudinal (R1) and transverse (R2) relaxation rate was highly linear in saline and plasma. The three agents produced similar in vivo contrast effects on T1 and T2 relaxation time-weighted sequences. Relative to clinically approved ferumoxytol formulations, MoldayION demonstrates minor differences in in vitro relaxometry and comparable in vivo MRI characteristics. 2 TECHNICAL EFFICACY: Stage 1.

Association between plasma desmosine, a marker of elastin degradation, and total atherosclerotic burden measured by whole body magnetic resonance angiography

Abstract Background Elastin degradation has been implicated in the pathophysiology of vulnerable atherosclerotic plaque. Desmosine is the cross-link component in the elastin molecule and is exclusively released from mature elastin breakdown, thus has the potential to be a physiologically relevant biomarker of atherosclerosis. Objectives The aim of the present study was: 1. To investigate whether patients with known cardiovascular disease (CVD) have higher elastin degradation as indicated by plasma desmosine (pDES); 2. to determine the relationship between pDES and total atherosclerotic burden. Methods We measured pDES by a validated stable isotope dilution LC-MS/MS method1 in a total of 146 subjects from the SUMMIT (SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools) study2. (62% male, mean age 64±8 (SD) years). This included 62 patients with prior clinical diagnosis of CVD (including coronary artery disease (CAD), cerebrovascular disease and/or lower extremity arterial disease (LEAD)), and 84 patients without a clinical diagnosis of CVD. Total atherosclerotic burden was measured by whole body magnetic resonance angiography (WB-MRA). The WB-MRA data was divided into 31 anatomical arterial segments with each segment scored according to degree of luminal narrowing: 0 = no stenosis, 1 = &amp;lt;50% stenosis, 2 = 51–70% stenosis, 3 = 71–99% stenosis, 4 = vessel occlusion. The segment scores were summed and from this, a standardized atheroma score (SAS) was calculated by summing each individual segment's stenosis score, and divided by the number of diagnostic segments before dividing by 4 which is the maximum potential score. Relationship between SAS and pDES levels was investigated using multiple linear regression models Results pDES levels were significantly greater in patients with established clinical CVD compared to patients with no CVD (CVD patients, 0.56 (0.45–0.67) ng/mL; patients with no CVD, 0.47 (0.41–0.54)ng/mL; p=0.001). Median SAS for the study population was 4 (2–10). Overall pDES levels showed a strong correlation with SAS (r=0.44, p≤0.001). Univariable analysis suggested a significant association between pDES and whole-body atheroma score as measured by SAS. (β 29.31, p&amp;lt;0.001). This association persisted in the multivariable regression model adjusting for traditional cardiovascular risk factors including age, gender, BMI, systolic blood pressure, diabetes, smoking status and LDL. (adjusted β 18.75, p=0.004) Conclusion pDES levels are elevated in patients with clinical CVD when compared to those with no clinical history of CVD. pDES is also strongly associated with global atheroma burden. Overall, these findings support the role of pDES as a potential biomarker for atherosclerosis. Funding Acknowledgement Type of funding sources: None.