Contrast Concentrations Research Articles

Application and Optimization of a Fast Non-Local Means Noise Reduction Algorithm in Pediatric Abdominal Virtual Monoenergetic Images

In this study, we applied and optimized a fast non-local means (FNLM) algorithm to reduce noise in pediatric abdominal virtual monoenergetic images (VMIs). To analyze various contrast agent concentrations, we produced contrast agent concentration samples (20, 40, 60, 80, and 100%) and inserted them into a phantom model of a one-year-old pediatric patient. Single-energy computed tomography (SECT) and dual-energy computed tomography (DECT) images were acquired from the phantom, and 40 kilo-electron-volt (keV) VMI was acquired based on the DECT images. For the 40 keV VMI, the smoothing factor of the FNLM algorithm was applied from 0.01 to 1.00 in increments of 0.01. We derived the optimized value of the FNLM algorithm based on quantitative evaluation and performed a comparative assessment with SECT, DECT, and a total variation (TV) algorithm. As a result of the analysis, we found that the average contrast to noise ratio (CNR) and coefficient of variation (COV) of each concentration were most improved at a smoothing factor of 0.02. Based on these results, we derived the optimized smoothing factor value of 0.02. Comparative evaluation shows that the optimized FNLM algorithm improves the CNR and COV results by approximately 3.14 and 2.45 times, respectively, compared with the DECT image, and the normalized noise power spectrum result shows a 10−1 mm2 improvement. The main contribution of this study is to demonstrate the effectiveness of an optimized FNLM algorithm in reducing noise in pediatric abdominal VMI, allowing high-quality images to be acquired while reducing contrast dose. This advancement has significant implications for minimizing the risk of contrast-induced toxicity, especially in pediatric patients. Our approach addresses the problem of limited datasets in pediatric imaging by providing a computationally efficient noise reduction technique and highlights the clinical applicability of the FNLM algorithm. In addition, effective noise reduction enables high-contrast imaging with minimal radiation and contrast exposure, which is expected to be suitable for repeat CT examinations of pediatric liver cancer patients and other abdominal diseases.

Computed tomography image quality in patients with primary hepatocellular carcinoma: intraindividual comparison of contrast agent concentrations.

This study aimed to assess the impact of the different concentrations of iodine contrast agents used on the quality of computed tomography (CT) images obtained intraindividually in hepatocellular carcinoma patients. In this retrospective study, data from a cohort of 29 patients diagnosed with primary hepatocellular carcinoma who had undergone two preoperative CT-enhanced examinations within a 3-month timeframe were analyzed. Each patient was randomly assigned to receive either a low-concentration contrast agent (300 mg I/mL iohexol) or a high-concentration contrast agent (350 mg I/mL iohexol) for the first scan and the alternative contrast agent for the second scan. CT images of different liver regions of each patient were compared between low-and high-concentration scans using their before-and-after control design. Subjective image quality scores for portal vein images were also assessed. The findings of this study indicate that patients in the high-concentration group presented significantly elevated CT values across various anatomical regions, including the liver parenchyma, abdominal aorta, and hepatic portal vein, compared to those in the low-concentration group (p < 0.05). Moreover, the high-concentration group demonstrated superior subjective image ratings (p < 0.05). Nevertheless, there was no statistically significant difference in the CT values observed in liver cancer parenchyma scans at different phases between the two groups (p > 0.05). In summary, using a high-concentration iodine contrast agent is efficient in enhancing the visual clarity of the liver parenchyma, the aorta, and the portal vein in individuals diagnosed with primary hepatocellular carcinoma.

Quantitative brain T1 maps derived from T1-weighted MRI acquisitions: a proof-of-concept study.

Longitudinal T1 relaxation time is a key imaging biomarker. In addition, T1 values are modulated by the administration of T1 contrast agents used in patients with tumors and metastases. However, in clinical practice, dedicated T1 mapping sequences are often not included in brain MRI protocols. The aim of this study is to address the absence of dedicated T1 mapping sequences in imaging protocol by deriving T1 maps from standard T1-weighted sequences. A phantom, composed of 144 solutions of paramagnetic agents at different concentrations, was imaged with a three-dimensional (3D) T1-weighed turbo spin-echo (TSE) sequence designed for brain imaging. The relationship between the T1 values and the signal intensities was established using this phantom acquisition. T1 mapping derived from 3D T1-weighted TSE acquisitions in four healthy volunteers and one patient with brain metastases were established and compared to reference T1 mapping technique. The concentration of Gd-based contrast agents in brain metastases were assessed from the derived T1 maps. Based on the phantom acquisition, the relationship between T1 values and signal intensity (SI) was found equal to T1 = 0.35 × SI-1.11 (R2 = 0.97). TSE-derived T1 values measured in white matter and gray matter in healthy volunteers were equal to 0.997 ± 0.096 s and 1.358 ± 0.056 s (mean ± standard deviation), respectively. Mean Gd3+ concentration value in brain metastases was 94.7 ± 30.0 μM. The in vivo results support the relevance of the phantom-based approach: brain T1 maps can be derived from T1-weighted acquisitions. High-resolution brain T1 maps can be generated, and contrast agent concentration can be quantified and imaged in brain metastases using routine 3D T1-weighted TSE acquisitions. Quantitative T1 mapping adds significant value to MRI diagnostics. T1 measurement sequences are rarely included in routine protocols. T1 mapping and concentration of contrast agents can be derived from routine standard scans. The diagnostic value of MRI can be improved without additional scan time.

Estimating pharmacokinetic parameters from Dynamic Contrast-Enhanced T 1-weighted MRI using a three level hierarchical Bayesian model

Abstract Nowadays, Dynamic Contrast Enhanced MRI (DCE-MRI) is becoming the most widely explored technique in clinical practice for tumor assessment. In acquiring DCE-MRI, a contrast agent (CA), also called tracer, is injected into the blood flow before or during the acquisition of a time series of T 1 {T_{1}} -weighted images with fast imaging techniques. When the CA goes through the tissue, MR signal intensity measurements in voxels of the region of interest (ROI) are registered and used to calculate the CA concentration in each voxel. The Tofts models have become standard for the analysis of DCE-MRI and which express tissue CA concentration C ⁢ ( t ) {C(t)} as function of time t. The analysis of quantitative parameters in DCE-MRI provides the quantitative criterion as a reference rather than relying only on the shape of the DCE-curve, as it is used for diagnosis of prostate cancer (PCa). This study aim to provide a new thinking in quantitative analysis which may therefore improve diagnostic accuracy for detection of prostate cancer and could be used in patient baseline prediction and guide management. A hierarchical Bayesian model was built to estimate the values of the four pharmacokinetic parameters ( K trans {K_{\mathrm{trans}}} , k ep {k_{\mathrm{ep}}} , υ p {\upsilon_{\mathrm{p}}} , υ e {\upsilon_{\mathrm{e}}} ) for both prostate healthy and lesion tissues in the peripheral zone. This estimation is important because it help to understand the behavior of the CA in the body and how this latter reacts to the CA in order to emphasize the expectation or the absence of prostate lesion during the diagnosis step.

Exploring the Neural Mechanisms of Mirrored-Self Misidentification in Alzheimer's Disease.

Alzheimer's disease (AD) is a complex neurodegenerative condition that causes a range of cognitive disturbances, including mirror-self misidentification syndrome (MSM), in which patients cannot recognize themselves in a mirror. However, the mechanism of action of MSM is not precisely known. This study aimed to explore the possible neural mechanisms of action of MSM in AD using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). This study included 48 AD patients, 13 in the MSM group and 35 in the non-MSM group. The permeability of the blood-brain barrier (BBB) was quantitatively monitored by measuring the transfer rate (Ktrans) of the contrast agent from the vasculature to the surrounding tissue using DCE-MRI. The concentration of contrast agents in different brain regions was measured, and the Patlak model was used to calculate Ktrans. Ktrans values were compared between the left and right cerebral hemispheres in different brain areas between the MSM and non-MSM groups. Additionally, the difference in Ktrans values between mild and severe MSM was assessed. Logistic regression analysis was used to examine the risk factors for MSM. The Mann‒Whitney U test was used to compare two groups and revealed elevated Ktrans values in the left thalamus, left putamen, left globus pallidus, left corona radiata, and right caudate in the MSM group (p<0.05). Logistic regression analysis revealed that increased Ktrans values in the left putamen (OR=1.53, 95% CI=1.04, 2.26) and left globus pallidus (OR=1.54, 95% CI=1.02, 2.31) may be risk factors for MSM. After dividing MSM patients into mild and moderate-severe groups, the Ktrans values of the thalamus in the moderate-severe group were greater than those in the mild group (p<0.05). Our study revealed the relationship between BBB permeability and MSM in AD. MSM is associated with BBB breakdown in the left putamen and globus pallidus. The left putamen and globus pallidus may function in mirror self-recognition. Higher BBB permeability in the thalamus may reflect the severity of AD in MSM.

Development of a Monte Carlo simulation platform for the systematic evaluation of photon-counting detector-based micro-CT

PurposeThis study aimed to develop a photon-counting detector (PCD) based micro-CT simulation platform for assessing the performance of three different PCD sensor materials: cadmium telluride (CdTe), gallium arsenide (GaAs), and silicon (Si). The evaluation encompasses the components of primary and scatter signals, performance of imaging contrast agents, and detector efficiency. MethodsSimulations were performed using the Geant4 Monte Carlo toolkit, and a micro-PCD-CT system was meticulously modeled based on realistic geometric parameters. Results.The simulation can obtain HU values consistent with measured results for iodine and calcium hydroxyapatite contrast agents. The two major components of scatter signals for CdTe and GaAs based PCD are fluorescent X-ray photons and photoelectrons, whereas for Si, the components are photoelectrons and Compton electrons. Scattering counts of CdTe and GaAs sensors can be effectively reduced by using energy thresholds, whereas those of Si sensor are insensitive to the applied threshold. The optimal threshold values for CdTe and GaAs are 30 and 15 keV, respectively. For contrast agent imaging, GaAs exhibits enhanced sensitivity to low photon energies compared to CdTe, while it’s contrast-to-noise ratio (CNR) values are slightly lower than those of CdTe at the same contrast agent concentration. Among the three sensor materials, Si has the lowest CNR and detector efficiency; CdTe exhibits the highest efficiency, except in low-energy ranges (< 45 keV), where GaAs has superior efficiency. ConclusionsThe proposed methods are expected to benefit PCD optimization and applications, including energy threshold selection, scattering correction, and may reduce the need for large-scale experiments.

Simultaneous iodine and barium imaging with photon-counting CT

Photon-counting computed tomography (PCCT) could potentially offer significant improvements in image quality over conventional CT. This study leverages PCCT technology to achieve simultaneous multi-contrast imaging of barium (Z=56) and iodine (Z=53), addressing the limitations of conventional CT in differentiating materials with similar atomic numbers. Using a bench-top PCCT system with a cadmium zinc telluride (CZT) detector, experiments were conducted with various phantom setups and 1-5\% contrast agent concentrations and in a biological sample. Energy thresholds were adjusted to the K-edge absorption energies of barium (37.4 keV) and iodine (33.2 keV) to capture multi-energy CT images. K-edge decomposition was performed with K-edge subtraction and principal component analysis (PCA) techniques, demonstrating clear differentiation and accurate quantification of contrast agents in phantom combinations and the biological sample. The PCCT system successfully differentiated and quantified barium and iodine, with high correlations ($R^2 \approx 1$) between true and reconstructed concentrations. PCA outperformed K-edge subtraction by providing a superior capability to differentiate barium and iodine, particularly when calcium was present in the scanned object. These findings highlight the potential of PCCT for reliable, detailed imaging in clinical and research applications, particularly for contrast agents with close atomic numbers.

Capillary-scale Microvessel Imaging with High-frequency Ultrasound Localization Microscopy in Mouse Brain.

Ultrasound localization microscopy is a super-resolution vascular imaging technique which has garnered substantial interest as a tool for small animal neuroimaging, neuroscience research, and the characterization of vascular pathologies. In the pursuit of increasingly high-fidelity reconstructions of microvasculature, there remains several outstanding questions concerning this sub-diffraction imaging technology, including the accurate reconstruction of microvessels approaching the capillary scale and the pragmatic challenges associated with long data acquisition times. In the context of small animal neurovascular imaging, we posit that increasing the ultrasound imaging frequency is a straightforward approach to enable higher concentrations of microbubble contrast agents, thus increasing the likelihood of microvascular/capillary mapping and decreasing the imaging duration. We demonstrate that higher frequency imaging results in improved ULM fidelity and more efficient microbubble localization due to a smaller microbubble point-spread function that is easier to localize, and which can achieve a higher localizable concentration within the same unit volume of tissue. A select example of in vivo capillary-level vascular reconstruction is demonstrated for the highest frequency imaging probe, which has substantial implications for neuroscientists investigating microvascular function in disease states, regulation, and brain development. High frequency ULM yielding a spatial resolution of 7.1μm, as measured by Fourier ring correlation, throughout the entire depth of the brain, highlighting this technology as a highly relevant tool for neuroimaging research.

Bioimaging of sense organs and the central nervous system in extant fishes and reptiles in situ: A review.

Bioimaging is changing the field of sensory biology, especially for taxa that are lesser-known, rare, and logistically difficult to source. When integrated with traditional neurobiological approaches, developing an archival, digital repository of morphological images can offer the opportunity to improve our understanding of whole neural systems without the issues of surgical intervention and negate the risk of damage and artefactual interpretation. This review focuses on current approaches to bioimaging the peripheral (sense organs) and central (brain) nervous systems in extant fishes (cartilaginous and bony) and non-avian reptiles in situ. Magnetic resonance imaging (MRI), micro-computed tomography (μCT), both super-resolution track density imaging and diffusion tensor-based imaging, and a range of other new technological advances are presented, together with novel approaches in optimizing both contrast and resolution, for developing detailed neuroanatomical atlases and enhancing comparative analyses of museum specimens. For MRI, tissue preparation, including choice of fixative, impacts tissue MR responses, where both resolving power and signal-to-noise ratio improve as field strength increases. Time in fixative, concentration of contrast agent, and duration of immersion in the contrast agent can also significantly affect relaxation times, and thus image quality. For μCT, the use of contrast-enhancing stains (iodine-, non-iodine-, or nanoparticle-based) is critical, where the type of fixative used, and the concentration of stain and duration of staining time often require species-specific optimization. Advanced reconstruction algorithms to reduce noise and artifacts and post-processing techniques, such as deconvolution and filtering, are now being used to improve image quality and resolution.

Using Adaptive Imaging Parameters to Improve PEGylated Ultrasmall Iron Oxide Nanoparticles-Enhanced Magnetic Resonance Angiography.

The PEGylated ultrasmall iron oxide nanoparticles (PUSIONPs) exhibit longer blood residence time and better biodegradability than conventional gadolinium-based contrast agents (GBCAs), enabling prolonged acquisitions in contrast-enhanced magnetic resonance angiography (CE-MRA) applications. The image quality of CE-MRA is dependent on the contrast agent concentration and the parameters of the pulse sequences. Here, a closed-form mathematical model is demonstrated and validated to automatically optimize the concentration, echo time (TE), repetition time (TR) and flip angle (FA). The pharmacokinetic studies are performed to estimate the dynamic intravascular concentrations within 12h postinjection, and the adaptive concentration-dependent sequence parameters are determined to achieve optimal signal enhancement during a prolonged measurement window. The presented model is tested on phantom and in vivo rat images acquired from a 3T scanner. Imaging results demonstrate excellent agreement between experimental measurements and theoretical predictions, and the adaptive sequence parameters obtain better signal enhancement than the fixed ones. The low-dose PUSIONPs (0.03mmol kg-1 and 0.05mmol kg-1) give a comparable signal intensity to the high-dose one (0.10mmol kg-1) within 2h postinjection. The presented mathematical model provides guidance for the optimization of the concentration and sequence parameters in PUSIONPs-enhanced MRA, and has great potential for further clinical translation.

3D MR fingerprinting for dynamic contrast-enhanced imaging of whole mouse brain.

Quantitative MRI enables direct quantification of contrast agent concentrations in contrast-enhanced scans. However, the lengthy scan times required by conventional methods are inadequate for tracking contrast agent transport dynamically in mouse brain. We developed a 3D MR fingerprinting (MRF) method for simultaneous T1 and T2 mapping across the whole mouse brain with 4.3-min temporal resolution. We designed a 3D MRF sequence with variable acquisition segment lengths and magnetization preparations on a 9.4T preclinical MRI scanner. Model-based reconstruction approaches were employed to improve the accuracy and speed of MRF acquisition. The method's accuracy for T1 and T2 measurements was validated in vitro, while its repeatability of T1 and T2 measurements was evaluated in vivo (n = 3). The utility of the 3D MRF sequence for dynamic tracking of intracisternally infused gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) in the whole mouse brain was demonstrated (n = 5). Phantom studies confirmed accurate T1 and T2 measurements by 3D MRF with an undersampling factor of up to 48. Dynamic contrast-enhancedMRF scans achieved a spatial resolution of 192 × 192 × 500 μm3 and a temporal resolution of 4.3 min, allowing for the analysis and comparison of dynamic changes in concentration and transport kinetics of intracisternally infused Gd-DTPA across brain regions. The sequence also enabled highly repeatable, high-resolution T1 and T2 mapping of the whole mouse brain (192 × 192 × 250 μm3) in 30 min. We present the first dynamic and multi-parametric approach for quantitatively tracking contrast agent transport in the mouse brain using 3D MRF.

Structural and practical identifiability of contrast transport models for DCE-MRI.

Contrast transport models are widely used to quantify blood flow and transport in dynamic contrast-enhanced magnetic resonance imaging. These models analyze the time course of the contrast agent concentration, providing diagnostic and prognostic value for many biological systems. Thus, ensuring accuracy and repeatability of the model parameter estimation is a fundamental concern. In this work, we analyze the structural and practical identifiability of a class of nested compartment models pervasively used in analysis of MRI data. We combine artificial and real data to study the role of noise in model parameter estimation. We observe that although all the models are structurally identifiable, practical identifiability strongly depends on the data characteristics. We analyze the impact of increasing data noise on parameter identifiability and show how the latter can be recovered with increased data quality. To complete the analysis, we show that the results do not depend on specific tissue characteristics or the type of enhancement patterns of contrast agent signal.

Excimer laser coronary angioplasty combined with drug-coated balloon in the treatment of in-stent restenosis.

The aim of this study is to investigate the safety and efficacy of excimer laser coronary angioplasty (ELCA) combined with drug-coated balloons(DCBs) in the treatment of in-stent restenosis (ISR), and to explore whether the contrast injection technique would improve the neointimal tissue ablation of ELCA. We studied patients diagnosed with ISR between January 2019 and October 2022 at two medical centers. These patients underwent DCB angioplasty guided by optical coherence tomography (OCT). Based on whether ELCA was performed before DCB treatment, patients were categorized into two groups: the ELCA + DCB group and the DCB group. All patients underwent clinical follow-up 1 year after the procedure. The primary endpoint was the 1-year rate of target lesion revascularization (TLR), which was defined as any repeat percutaneous intervention or bypass surgery on the target vessel conducted to address restenosis or other complications related to the target lesion. The secondary endpoints including immediate luminal gain (ΔMLA, defined as the difference in minimum lumen area before and after the intervention). A total of 85 lesions in 75 patients were included. The mean age of the study population was 64.2 ± 12.0 years, with 81.3% male. Baseline clinical characteristics were well-balanced, and procedural success was 100% in both groups. The ELCA + DCB group (n = 24) exhibited a greater ΔMLA compared to the DCB group (n = 61) (3.57 ± 0.79 mm² vs. 2.50 ± 1.06 mm², [95% confidence interval,CI: 0.57-1.69], p < 0.001), The reduction in 1-year TLR was more frequently observed in patients from the ELCA + DCB group compared to the DCB group (hazard ratio 0.33 [95% CI: 0.11-0.99]; log-rank p = 0.048). The exploratory analysis showed that ELCA with contrast infusion is associated with greater acute lumen gain compared to ELCA with saline infusion (p < 0.001). The combination of ELCA and DCB is a safe and effective treatment strategy for in-stent stenosis. Additionally, compared with saline injection, ELCA with contrast injection is associated with greater acute lumen gain. However, the optimal contrast agent concentration and long-term outcome of the contrast injection technique need confirmation through larger sample sizes and prospective studies.

Pulmonary Transit Time Assessment by CEUS in Healthy Rabbits: Feasibility, and the Effects of UCAs Dilution Concentration.

To evaluate the inter-observer variability and the intra-observer repeatability of pulmonary transit time (PTT) measurement using contrast-enhanced ultrasound (CEUS) in healthy rabbits, and assess the effects of dilution concentration of ultrasound contrast agents (UCAs) on PTT. Thirteen healthy rabbits were selected, and five concentrations UCAs of 1:200, 1:100, 1:50, 1:10, and 1:1 were injected into the right ear vein. Five digital loops were obtained from the apical 4-chamber view. Four sonographers obtained PTT by plotting the TIC of right atrium (RA) and left atrium (LA) at two time points (T1 and T2). The frame counts of the first appearance of UCAs in RA and LA had excellent inter-observer agreement, with intra-class correlations (ICC) of 0.996, 0.988, respectively. The agreement of PTT among four observers was all good at five different concentrations, with an ICC of 0.758-0.873. The reproducibility of PTT obtained by four observers at T1 and T2 was performed well, with ICC of 0.888-0.961. The median inter-observer variability across 13 rabbits was 6.5% and the median variability within 14 days for 4 observers was 1.9%, 1.7%, 2.2%, 1.9%, respectively; The PTT of 13 healthy rabbits is 1.01 ± 0.18 second. The difference of PTT between five concentrations is statistically significant. The PTT obtained by a concentration of 1:200 and 1:100 were higher than that of 1:1, while there were no significantly differences in PTT of a concentration of 1:1, 1:10, and 1:50. PTT measured by CEUS in rabbits is feasible, with excellent inter-observer and intra-observer reliability and reproducibility, and dilution concentration of UCAs influences PTT results.

Magnetic resonance lymphangiography: Establishing normal

BackgroundDespite an increased interest in visualizing the lymphatic vessels with magnetic resonance lymphangiography (MRL), little literature is available describing their appearance in nonlymphedematous individuals. To determine lymphatic abnormalities, an understanding of how healthy lymphatic vessels appear and behave needs to be established. Therefore, in this study, MRL of individuals without a history of lymphatic disease was performed. MethodsA total of 25 individuals (15 women) underwent MRL of their lower limbs using a 3.0 T Philips magnetic resonance imaging scanner (Philips Medical Systems). The first nine participants were recruited to establish the concentration of gadolinium-based contrast agent (GBCA) to administer, with the remainder imaged before and after interdigital forefoot GBCA injections at the optimized dose. Outcomes, including lymphatic vessel diameter, tortuosity, and frequency of drainage via particular drainage routes, were recorded. ResultsHealthy lymphatic vessels following the anteromedial pathway were routinely observed in post-contrast T1-weighted images (average tortuosity, 1.09 ± 0.03), with an average of 2.16 ± 0.93 lymphatic vessels with a diameter of 2.47 ± 0.50 mm crossing the anterior ankle. In six limbs, vessels following the anterolateral pathways were observed. No vessels traversing the posterior of the legs were seen. In a subset of 10 vessels, the lymphatic signal, measured at the ankle, peaked 29 minutes, 50 seconds ± 9 minutes, 29 seconds after GBCA administration. No lymphatic vessels were observed in T2-weighted images. ConclusionsContrast-enhanced MRL reliably depicts the lymphatic vessels in the legs of healthy controls. Following interdigital contrast injection, anteromedial drainage appears dominant. Quantitative measures related to lymphatic vessel size, tortuosity, and drainage rate are readily obtainable and could be beneficial for detecting even subtle lymphatic impairment.

The evaluation of microbubble concentration using the techniques of optical spectroscopy

We present an accurate and low-cost method for the evaluation of concentration of ultrasound contrast agents, microbubbles (MBs) by utilizing light-scattering properties of MBs. Illuminated by near-infrared light, MBs act as Mie scattering particles. We used absorption spectroscopy to detect the optical density immediately after the preparation of Sonovue MBs, and after MB insonification for total of 187 MB samples. Strong linear correlation (r = 0.97) was determined between optical density of MB suspension, evaluated at 790 nm, and MB concentration in vitro (measured by hematocytometer, up to 3.3 × 107 MBs/ml).Optical density of MB suspension was assessed by simultaneously performing diffuse reflectance spectroscopy and absorption spectroscopy measurements in vitro. Further we aimed to assess MB optical density in tibialis cranialis muscles of C57Bl/CBA mice. The results of diagnostic B-scan imaging and diffuse reflectance spectroscopy shows that optical techniques are excellent for monitoring the changes in MB concentration both in vitro and in vivo.

Radiation source personalization for nanoparticle-enhanced radiotherapy using dynamic contrast-enhanced MRI in the treatment planning process

Nanoparticle-enhanced radiotherapy offers the potential to selectively increase the radiation dose imparted to the tumor while at the same time sparing the healthy structures around it. Among the recommendations of an interdisciplinary group for the clinical translation of this treatment modality, is the developing of methods to quantify the effects that the nanoparticle concentration has on the radiation dosimetry and incorporate these effects into the treatment planning process. In this work, using Monte Carlo simulations and dynamic contrast-enhanced MRI images, treatment plans for nanoparticle-enhanced radiotherapy are calculated in order to evaluate the effects that realistic distributions of the nanoparticles have on the resultant plans and to devise treatment strategies to account for these effects, including the selection of the proper x-ray source configuration in terms of energy and collimation. Dynamic contrast-enhanced MRI studies were obtained for two treatment sites, namely brain and breast. A model to convert the MRI signal to contrast agent concentration was applied to each set of images. Two treatment modalities, 3D conformal radiotherapy and Stereotactic Body Radiation Therapy, were evaluated at three different x-ray spectra, namely 6 MV from a linear accelerator, 110 kVp and 220 kVp from a tungsten target. For the breast patient, as the nanoparticle distribution varies markedly with time, the treatment plans were obtained at two different times after administration. It was determined that maximum doses to the healthy structures around the tumor are mostly determined by the minimum nanoparticle concentration in the tumor. The presence of highly hypoxic or necrotic tissue, which fails to accumulate the nanoparticles, or leakage of the contrast agent into the surrounding healthy tissue, make irradiation with conventional conformal radiotherapy unfeasible for kilovoltage beam energies, as the uniform beam apertures lack the ability to compensate for the non-uniform distribution of the nanoparticles. Therefore, proper quantification of the nanoparticle distribution not only in the target volume but also in the surrounding tissues and structures is crucial for the proper planning of nanoparticle-enhanced radiotherapy and a treatment delivery with a high-degree of freedom, such as small-field stereotactic body radiotherapy, should be the method of choice for this treatment modality.

Experimental study on the effects of different exposure conditions and contrast agent concentrations on spectral computed tomography virtual non-contrast images.

The early diagnosis of thrombosis and fat embolism is important for subsequent treatment regimens. Spectral computed tomography (CT) virtual non-contrast (VNC) scanning can not only accurately diagnose thrombosis and medium fat embolism but can also reduce the radiation dose and scanning time. However, there is a relative paucity of studies on what contrast concentration and exposure conditions are best for the quality of VNC images. To address this issue, this study aimed to investigate the effects of different exposure conditions and contrast concentrations on the quality of VNC images of low-density substances in spectral CT. Four solution groups [i.e., groups A (15 mgI/mL), B (10 mgI/mL), C (5 mgI/mL), and D (the control group)] were matched with normal saline and contrast agent groups. Four groups of solution, duck blood clots, and fat were injected into four sections of the pig large intestine, respectively. CT scans with different exposure amounts were performed under the condition of 120 KV. Comparing the true non-contrast (TNC) image based on solution D group with the VNC images of the other three solution groups. The differences in the CT values, standard deviation (SD) values, and contrast noise ratio (CNR) values of the duck blood and fat under different iodine concentrations and exposures were compared. The image quality was evaluated using a three-point method and the Kappa consistency test was performed. The consistency of the tissue CT values in the TNC and VNC images was analyzed by drawing Bland-Altman scatter plots. The CT values of the duck blood in the VNC20mAs and VNCC groups were lower than those in the TNC groups (P<0.05). Under different exposures and contrast agent concentrations, the CT value of the fat in the VNC group was higher than that in the TNC group (P<0.05). The SD values of the duck blood and fat in three groups (i.e., groups A, B, and C) were lower than those in the TNC group (P<0.05). The CNR value of the duck blood in the VNC20mAs group was lower than that in the TNC group (Z=-2.10, P=0.04), and the CNR values of the duck blood and fat in the VNC group were higher than those in the TNC groups in the remaining different exposure and concentration groups (P<0.05). The CT values of the lesions in the two groups were consistent, and there were no statistically significant differences between the subjective scores of the TNC and VNC images (z=-1.34, P=0.18); the subjective evaluations of the two physicians had good consistency (K=0.80). Under the conditions of higher contrast agent concentrations and proper exposure conditions, the VNC images were better able to restore the CT values of the blood clots, reduce the SD values of the blood clots and fat. In addition, and improve the CNR values of the blood clots and fat. In addition, the quality of the two images was similar.

Numerical modeling of skin tumors subjected to gold nanoparticle assisted laser-induced thermal therapy

Gold nanoparticle (GNP) laser-induced thermal therapy (LITT) for cancer tumor treatment, is a promising therapeutic procedure. It combines the laser deep penetration when operating in near-infrared band and the contrast agent high absorption at the considered wavelengths. Nevertheless, the treatment success is highly sensitive to the nanoparticles spatial/temporal distribution. Therefore, in this work we investigate the LITT effectiveness under conditions of non-uniform GNPs arrangement. In particular, the impact of gold nanoparticles diffusion mass transfer for different waiting periods between the GNPs injection and the treatment start was assessed. Moreover, the inoculated contrast agent concentration effect on the thermal therapy was also evaluated. Therefore, a numerical solver relying on foam-extend v.5.0 library was developed for modeling: (i) realistic intra-tumor injection. (ii) GNPs diffusion in the target area. (iii) thermal effects on skin tumors by means of LITT. It was found that a waiting period of about 24 h between the contrast agent inoculation and the treatment start is recommended. Lastly, injected GNPs concentration has to be also accurately calibrated to guarantee LITT success.

Ureteropelvic junction obstruction with polyps in children: clinical manifestations and supranormal preoperative differential renal function.

To describe and analyze the clinical manifestation and pre-DRF of UPJO children with polyps and explore the possible influencing factors of supranormal pre-DRF. All patients undergoing primary Anderson-Hynes pyeloplasty for UPJO due to polyp were retrospectively reviewed. Patients' characteristics, parameters of ultrasound and dynamic renograms (DR) were recorded in elaborate. Pre-DRF in groups of different age, weight, gender, pain, grade of hydronephrosis, anterio-posterior pelvic diameter (APD), length of kidney and postoperative ultrasonic parameters were compared. A total of 18 UPJO children with polyps were included. Five (27.78%) patients had SFU III grade of hydronephrosis. Seven (38.89%) patients were supranormal pre-DRF. All patients had pre-DRF > 40%. Drainage curve was delayed excretion in 12 (66.67%) patients and T1/2 < 20min was in 4 (22.22%) patients. Among the 16 patients who underwent preoperative IVP examination, 15 (93.75%) patients had concentration of intrarenal pelvis contrast agent within 10min. No significant difference in post-APD reduction rate and post-minPT increased was found between supranormal pre-DRF and non-supranormal pre-DRF groups. The supranormal pre-DRF was more likely to occur in young and low-weight children. The preoperative renal function of UPJO patients with polyps was well preserved, and 38.89% of them had supranormal pre-DRF. Patients with supranormal pre-DRF can be managed with the same strategies as those with normal renal function.