Contrast Agent Solution Research Articles

Microbubble-enhanced HIFU therapy for vascularized tumors using Levovist contrast agent

High-intensity focused ultrasound (HIFU) has enormous potential in the treatment of cancers; however, there is still plenty of challenges associated with using acoustic energy to treat vascularized tumors. Among them, the blood flow cooling reduces the treatment efficiency significantly and results in a long treatment period. Various studies have shown that the HIFU improves cancer treatment by targeting the cancer tissue. Unfortunately, the issues related to vascularization have remained unsolved. In the present study, through a novel approach, a promising strategy is proposed by injecting Levovist contrast agent solution in the vascularized tumor. The complicated interaction between the Levovist microbubble (MB) and the ultrasonic waves is innovatively modeled by considering the coupled effect of HIFU wave propagation, fluid flow, MB oscillations, and transient heat transfer for a multi-layered porous model of liver tumor. The proposed strategy is evaluated in terms of the extent of irreversible TD and treatment duration. The results reflect the role of MB oscillation on the temperature rise, as injection of a 2 μm-MB during 15 s of HIFU sonication increases the temperature by 9.61% compared to no-MB condition. Meanwhile, the MB oscillation advances the irreversible damage, and tumor cells undergo thermal ablation by 48.94% earlier than the case with no-MB agent. Additionally, it is found that the MB size has a substantial effect on the amount of heat deposition. At an operating condition of 1.25 MHz and 10 W, the viscous power deposition for a 2 μm-MB is3.81 mW, while for a 50 μm-MB, it is reduced to 0.96 mW. On the contrary, the heat source due to the secondary acoustic power deposition is proportional to the MB size, as it increases from 60.5 mW for a 2 μm-MB to 180 mW for a 50 μm-MB, demonstrating a 2.97-fold increase. Eventually, an assessment of the extent of the necrotic area shows an increase at all frequencies by injecting an MB into the tumor area. At an operating condition of 1.5 MHz, oscillation of 2 μm-MB expands the necrotic area by 4.01% compared to the no-MB condition. Based on the obtained results, the injection of Levovist contrast agent solution in the vascularized tumor can be regarded as an effective method for reducing the treatment time and avoiding several sonication.

Can gadolinium contrast agents be replaced with saline for direct MR arthrography of the hip? A pilot study with arthroscopic comparison.

To compare image quality and diagnostic performance of preoperative direct hip magnetic resonance arthrography (MRA) performed with gadolinium contrast agent and saline solution. IRB-approved retrospective study of 140 age and sex-matched symptomatic patients with femoroacetabular impingement, who either underwent intra-articular injection of 15-20mL gadopentetate dimeglumine (GBCA), 2.0mmol/L ("GBCA-MRA" group, n = 70), or 0.9% saline solution ("Saline-MRA" group, n = 70) for preoperative hip MRA and subsequent hip arthroscopy. 1.5 T hip MRA was performed including leg traction. Two readers assessed image quality using a 5-point Likert scale (1-5, excellent-poor), labrum and femoroacetabular cartilage lesions. Arthroscopic diagnosis was used to calculate diagnostic accuracy which was compared between groups with Fisher's exact tests. Image quality was compared with the Mann-Whitney U tests. Mean age was 33years ± 9, 21% female patients. Image quality was excellent (GBCA-MRA mean range, 1.1-1.3 vs 1.1-1.2 points for Saline-MRA) and not different between groups (all p > 0.05) except for image contrast which was lower for Saline-MRA group (GBCA-MRA 1.1 ± 0.4 vs Saline-MRA 1.8 ± 0.5; p < 0.001). Accuracy was high for both groups for reader 1/reader 2 for labrum (GBCA-MRA 94%/ 96% versus Saline-MRA 96%/93%; p > 0.999/p = 0.904) and acetabular (GBCA-MRA 86%/ 83% versus Saline-MRA 89%/87%; p = 0.902/p = 0.901) and femoral cartilage lesions (GBCA-MRA 97%/ 99% versus Saline-MRA 97%/97%; both p > 0.999). Diagnostic accuracy and image quality of Saline-MRA and GBCA-MRA is high in assessing chondrolabral lesions underlining the potential role of non-gadolinium-based hip MRA. • Image quality of Saline-MRA and GBCA-MRA was excellent for labrum, acetabular and femoral cartilage, ligamentum teres, and the capsule (all p > 0.18). • The overall image contrast was lower for Saline-MRA (Saline-MRA 1.8 ± 0.5 vs. GBCA-MRA 1.1 ± 0.4; p < 0.001). • Diagnostic accuracy was high for Saline-MRA and GBCA-MRA for labrum (96% vs. 94%; p > 0.999), acetabular cartilage damage (89% vs. 86%; p = 0.902), femoral cartilage damage (97% vs. 97%; p > 0.999), and extensive cartilage damage (97% vs. 93%; p = 0.904).

Quantification of reagent mixing in liquid flow cells for Liquid Phase-TEM

Liquid-Phase Transmission Electron Microscopy (LP-TEM) offers the opportunity to study nanoscale dynamics of phenomena related to materials and life science in a native liquid environment and in real time. Until now, the opportunity to control/induce such dynamics by changing the chemical environment in the liquid flow cell (LFC) has rarely been exploited due to an incomplete understanding of hydrodynamic properties of LP-TEM flow systems. This manuscript introduces a method for hydrodynamic characterization of LP-TEM flow systems based on monitoring transmitted intensity while flowing a strongly electron scattering contrast agent solution. Key characteristic temporal indicators of solution replacement for various channel geometries were experimentally measured. A numerical physical model of solute transport based on realistic flow channel geometries was successfully implemented and validated against experiments. The model confirmed the impact of flow channel geometry on the importance of convective and diffusive solute transport, deduced by experiment, and could further extend understanding of hydrodynamics in LP-TEM flow systems. We emphasize that our approach can be applied to hydrodynamic characterization of any customized LP-TEM flow system. We foresee the implemented predictive model driving the future design of application-specific LP-TEM flow systems and, when combined with existing chemical reaction models, to a flourishing of the planning and interpretation of experimental observations.

Notes on quantitative susceptibility mapping reconstruction accuracy under challenging conditions: Phantom measurements and simulations

Magnetic susceptibility can be assessed by quantitative susceptibility mapping (QSM), based on measured magnetic resonance imaging (MRI) phase data. The QSM reconstruction process is, however, mathematically challenging and still not fully robust. A signal-generating holmium [Ho(III)] aqueous solution with air-equivalent magnetic susceptibility was prepared, and used as a surrounding medium in a water phantom with tubes filled with a solution of gadolinium contrast agent at various concentrations. Extended analyses under controlled conditions were accomplished by simulations of the phantom construction. Without surrounding holmium solution, a gadolinium tube positioned centrally, parallel with B0, showed a susceptibility difference that agreed well with theoretical values, whereas a peripheral parallel tube position showed larger deviation. Orientation perpendicular to B0 resulted in less variation between the internal tube positions. Air-equivalent magnetic susceptibility corresponded to 16.5 mM Ho(III) solution. With surrounding holmium solution, several post-processing steps became challenging. Simulations indicated higher degree of underestimation when the theoretical susceptibility difference increased. Details in the mathematical implementation, for example, background field removal can strongly influence the result. Simulated results were, in part, unexpected, and provided awareness of limitations in the reconstruction technique, mainly related to conditions with large susceptibility differences between compartments.

DEVELOPMENT AND OPTIMIZATION OF A SPECTROPHOTOMETRIC METHOD WITH CLOUD POINT EXTRACTION FOR DETERMINATION OF GADOLINIUM

This work describes a simple, sensible, and low-cost analytical method, based on cloud-point extraction (CPE) of the surfactant (1,1,3,3-Tetramethylbutyl)phenyl-polyethylene glycol (Triton X-114), for the efficient extraction and sensible determination of gadolinium after its complexation with 1-(2-pyridylazo)-2-naphthol (PAN) and subsequent determination by ultraviolet-visible molecular absorption spectrophotometry at the wavelength of 556 nm. Full two-level and Doehlert experimental designs were applied to investigate and optimize the variables (pH, complexing concentration, and TX-114 concentration) involved in the extraction efficiency of Gd3+. The CPE was satisfactory for the determination of gadolinium with limits of detection (LoD) and quantification (LoQ) of 1.0 and 3.2 µg L-1, respectively, as well as an enrichment factor of 9.4. Accuracy was confirmed by spike tests with recovery values between 98.4 and 78.3%. The precision was expressed as relative standard deviation (%RSD, n =3), being found: 2.3% (10 µg L-1) and 2.7% (100 µg L-1). The proposed analytical method is suitable for the determination of Gd in tap water and contrast agent solutions.

Organic nanoparticle-doped microdroplets as dual-modality contrast agents for ultrasound microvascular flow and photoacoustic imaging

Tumor blood vessels are chaotic and abundantly distributed, owing to their heterogeneity. Therefore, imaging techniques which reveal abnormalities of tumor vasculature play significant roles in both mechanistic and clinical diagnostic tumor studies. Photoacoustic (PA) imaging uses the intrinsic characteristics of hemoglobin, to acquire tumor hemodynamic information, while ultrasound (US) imaging provides information about tumoral vessel structures and blood flow. To improve the imaging contrast performance, hydrogel-based microdroplets were designed for both US blood flow and PA imaging in this study. The microdroplets served as carriers for PA contrast agent solution in the innermost part while oil and hydrogel formed the inner and outer layers of the droplets. In vitro experiments firstly demonstrated the dual modality contrast effects of the microdroplets on US flow determination and PA imaging. In vivo experiments were then carried out in both healthy nude mice and nude mice with subcutaneous tumor to validate the contrast effects and to monitor the duration of contrast effects in animals. Using the dual-modality microdroplets, we were able to obtain distinct edges of tumor and blood flow mapping of the tumor microvascular with improved sensitivity up to 11.09 dB for PA and 6.69 dB for US flow. Besides, the in vivo evaluation with microdroplets showed US flow enhancement for more than 60 min. Therefore, the microdroplets are able to provide the contrast effects for both US flow and PA in a relative long duration and have potential to be applied in the tumor related diagnoses and studies.

Photon-counting computed tomography of lanthanide contrast agents with a high-flux 330-μm-pitch cadmium zinc telluride detector in a table-top system.

Purpose: We present photon-counting computed tomography (PCCT) imaging of contrast agent triplets similar in atomic number ( ) achieved with a high-flux cadmium zinc telluride (CZT) detector. Approach: The table-top PCCT imaging system included a -pitch CZT detector of size capable of using six energy bins. Four 3D-printed 3-cm-diameter phantoms each contained seven 6-mm-diameter vials with water and low and high concentration solutions of various contrast agents. Lanthanum ( ), gadolinium (Gd) ( ), and lutetium ( ) were imaged together and so were iodine ( ), Gd, and holmium ( ). Each phantom was imaged with 1-mm aluminum-filtered 120-kVp cone beam x rays to produce six energy-binned computed tomography (CT) images. Results: -edge images were reconstructed using a weighted sum of six CT images, which distinguished each contrast agent with a root-mean-square error (RMSE) of and 0.51% for the 0.5% and 5% concentrations, respectively. Minimal cross-contamination in each -edge image was seen, with RMSE values in vials with no contrast. Conclusion: This is the first preliminary demonstration of simultaneously imaging three similar contrast agents with a difference in as low as 3.

Quantitative imaging performance of MARS spectral photon-counting CT for radiotherapy.

To evaluate the quantitative imaging performance of a spectral photon-counting computed tomography (SPCCT) scanner for radiotherapy applications. An experimental comparison of the quantitative performance of a Siemens dual-energy CT (DECT) and a MARS SPCCT scanner is performed to estimate physical properties relevant to radiotherapy of human substitute materials and contrast agent solutions. In human substitute materials, the accuracy of quantities relevant to photon therapy, proton therapy, and Monte-Carlo simulations, such as the electron density, proton stopping power, and elemental composition is evaluated. For contrast agent solutions, the accuracy of the contrast agent concentrations and the virtual non-contrast (VNC) electron density is evaluated. Human tissue substitute phantoms (Gammex 467 and 472) as well as diluted solutions of contrast agents (iodine and gadolinium based) are scanned with two commercial systems: a Siemens dual-source CT (SOMATOM Definition Flash, Siemens Healthineers, Forchheim, Germany) and a MARS spectral photon-counting micro-CT (MARS V5.2, MARS Bioimaging Ltd., Christchurch, New Zealand). Material decomposition is performed in a maximum a posteriori framework with an optimized material basis tailored to characterize either human substitute materials or contrast agents in the context of experimental multi-energy CT data. The root-mean-square error (RMSE) of the electron density calculated over all Gammex inserts is reduced from 1.09 to 0.89% when going from DECT to SPCCT. For the proton stopping power, the RMSE is reduced from 1.92 to 0.89%. Elemental mass fractions of hydrogen, carbon, nitrogen, oxygen, and calcium are more accurately estimated with the MARS scanner. The RMSE on the iodine-based contrast agents concentration is reduced from 0.27 to 0.12mg/mL with SPCCT, and the VNC electron density from 0.40 to 0.22%. In the present phantom study, a MARS photon-counting scanner provides superior accuracy compared to a Siemens SOMATOM Definition Flash DECT scanner to quantify physical parameters relevant to radiotherapy. This work experimentally demonstrates the benefits of using more energies to characterize human tissue equivalent materials. This highlights the potential of SPCCT for particle therapy, where more accurate tissue characterization is needed, as well as for Monte-Carlo based planning, which requires accurate elemental mass fractions.

Placental vascular tree characterization based on ex-vivo MRI with a potential application for placental insufficiency assessment

IntroductionUnderstanding regarding the whole placental vascular network structure is limited. Our aim was to quantitatively characterize the human placental vascular tree ex-vivo using high-resolution MRI. Methods34 normal placentas were rinsed and injected with a solution of gelatin and contrast agent through the umbilical vessels. A sample of six placentas taken from pregnancies with intrauterine-growth-restriction (IUGR) was used to demonstrate the potential application to cases with placental insufficiency. Structural ex-vivo MR scans of the placenta were performed using high resolution T1 weighted images. A semi-automatic method was developed to segment and characterize the placental vascular architecture: placental volume and cord insertion location, number of bifurcations, generations and vessels diameters. ResultsDifferent vascular patterns were found in placentas with central versus marginal cord-insertion. Based on the placental volume and number of bifurcations we were able to predict birth weight. Furthermore, preliminary results on IUGR sample demonstrated the potential of this method to differentiate between small newborns with suspected IUGR from small normal newborns who reached their full growth potential. Results obtained using the automatic method were validated against manual values demonstrating no significant differences or bias. Histopathology supported the imaging findings. DiscussionThis is the first study to quantitatively characterize the human placental vascular architecture using high resolution ex-vivo MRI. Different patterns of vascular architecture may be related to different functioning of the placenta and affect fetal development. This method is simple, relatively fast, provides detailed information of the placental vascular architecture, and may have important clinical applications.

The Role of 3D-MSCT Gastric Pouch Volumetric Study In Sleeve Gastrectomy

Background: Laparoscopic sleeve gastrectomy (LSG) has now a surge in popularity in treatment of morbid obesity patients. Multi-slice computed tomography has an increasing role in management of this patients’ group through the availability and efficiency of post processing reconstructive facilities of MSCT software in 3D reconstruction. The purpose of this study is to evaluate MSCT-based volumetric assessment of stomach and gastric sleeves in patients before and after bariatric surgery and correlation between operative gastric volume reduction and body weight reduction. Methods: Thirty sleeve gastrectomy-candidate patients received abdominal MSCT immediately after oral administration of an ionic contrast agent solution. The examination was done pre and three months postoperatively. The gastric and sleeve volumes were measured via 3D volume rendering and 3D masks on dedicated workstations. Results: The correlation between the body weight and gastric volume measured initially in the preoperative state in the studied patients was found to be insignificant. The correlation between body weight reduction percentage and gastric volume reduction percentage in the studied patients was found to be also insignificant. Conclusion: MSCT allows crucial anatomical measurements and provides helpful information about the relation between gastric volume reduction and body weight reduction in sleeve gastrectomy-candidate obese patients.

Intracavitary contrast-enhanced ultrasonography in children: review with procedural recommendations and clinical applications from the European Society of Paediatric Radiology abdominal imaging task force.

Contrast-enhanced ultrasonography (US) has become an important supplementary tool in many clinical applications in children. Contrast-enhanced voiding urosonography and intravenous US contrast agents have proved useful in routine clinical practice. Other applications of intracavitary contrast-enhanced US, particularly in children, have not been widely investigated but could serve as a practical and radiation-free problem-solver in several clinical settings. Intracavitary contrast-enhanced US is a real-time imaging modality similar to fluoroscopy with iodinated contrast agent. The US contrast agent solution is administered into physiological or non-physiological body cavities. There is no definitive list of established indications for intracavitary US contrast agent application. However, intracavitary contrast-enhanced US can be used for many clinical applications. It offers excellent real-time spatial resolution and allows for a more accurate delineation of the cavity anatomy, including the internal architecture of complex collections and possible communications within the cavity or with the surrounding structures through fistulous tracts. It can provide valuable information related to the insertion of catheters and tubes, and identify related complications such as confirming the position and patency of a catheter and identifying causes for drainage dysfunction or leakage. Patency of the ureter and biliary ducts can be evaluated, too. US contrast agent solution can be administered orally or a via nasogastric tube, or as an enema to evaluate the gastrointestinal tract. In this review we present potential clinical applications and procedural and dose recommendations regarding intracavitary contrast-enhanced ultrasonography.

Synchrotron MicroCT Reveals the Potential of the Dual Contrast Technique for Quantitative Assessment of Human Articular Cartilage Composition.

ABSTRACTDual contrast micro computed tomography (CT) shows potential for detecting articular cartilage degeneration. However, the performance of conventional CT systems is limited by beam hardening, low image resolution (full‐body CT), and long acquisition times (conventional microCT). Therefore, to reveal the full potential of the dual contrast technique for imaging cartilage composition we employ the technique using synchrotron microCT. We hypothesize that the above‐mentioned limitations are overcome with synchrotron microCT utilizing monochromatic X‐ray beam and fast image acquisition. Human osteochondral samples (n = 41, four cadavers) were immersed in a contrast agent solution containing two agents (cationic CA4+ and non‐ionic gadoteridol) and imaged with synchrotron microCT at an early diffusion time point (2 h) and at diffusion equilibrium (72 h) using two monochromatic X‐ray energies (32 and 34 keV). The dual contrast technique enabled simultaneous determination of CA4+ (i.e., proteoglycan content) and gadoteridol (i.e., water content) partitions within cartilage. Cartilage proteoglycan content and biomechanical properties correlated significantly (0.327 < r < 0.736, p < 0.05) with CA4+ partition in superficial and middle zones at both diffusion time points. Normalization of the CA4+ partition with gadoteridol partition within the cartilage significantly (p < 0.05) improved the detection sensitivity for human osteoarthritic cartilage proteoglycan content, biomechanical properties, and overall condition (Mankin, Osteoarthritis Research Society International, and International Cartilage Repair Society grading systems). The dual energy technique combined with the dual contrast agent enables assessment of human articular cartilage proteoglycan content and biomechanical properties based on CA4+ partition determined using synchrotron microCT. Additionally, the dual contrast technique is not limited by the beam hardening artifact of conventional CT systems. © 2019 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 38:563–573, 2020

A simple approach for ultrasound-guided pararadicular injections in the sacral spine: a pilot computer tomography controlled cadaver study.

Injection therapies play an increasingly decisive role in the treatment of lower back pain. Cumulative studies couldshow the benefits of ultrasound-guided instillation procedures in the cervical and lumbar spine. We conducted this study toprovide a new simple sonographic approach for pararadicular injections of the sacral spinal nerves and to prove the feasibilityand accuracy by means of CT and anatomic dissection. Eight ultrasound-guided injections at fourdifferent levels of the sacral spine on a human ethanol-glycerol-embalmed cadaver (S1-S4) were performed. By means ofsonography the sacral foramina were identified and the spinal needles were advanced in "in-plane technique" to the medialmargin of the respective sacral foramen. Subsequently a solution of blue dye and contrast agent were injected. Then CT scansand anatomic dissection of the cadaver were performed to verify the correct placement of the needle tips and to visualize thedispersion of the injected solution in the respective compartment. Altogether a 100% success rate for a correct injectioncould be achieved. CT examination confirmed the correct placement of every needle tip within the intended compartment.Also, the anatomic dissections affirmed the appropriate needle positioning. Moreover, the blue dye dispersion was seen in thecorrect compartments and around the targeted spinal nerves. Although this study was only performed on cadavericmodels, this new sonographic approach for pararadicular injections in the sacral spine allows an easy, precise and unerringneedle placement within the dorsal sacral foramen.

Classification and prediction of inertial cavitation activity induced by pulsed high-intensity focused ultrasound

Classification and prediction of ultrasound-induced microbubble inertial cavitation (IC) activity may play an important role in better design of ultrasound treatment strategy with improved efficiency and safety. Here, a new method was proposed by combining support vector machine (SVM) algorithm with passive cavitation detection (PCD) measurements to fulfill the tasks of IC event classification and IC dose prediction. By using the PCD system, IC thresholds and IC doses were firstly measured for various ultrasound contrast agent (UCA) solutions exposed to pulsed high-intensity focused ultrasound (pHIFU) at different driving pressures and pulse lengths. Then, after trained and tested by measured data, two SVM models (viz. C-SVC and ε-SVR) were established to classify the likelihood of IC event occurrence and predict IC dose, respectively, under different parameter conditions. The findings of this study indicate that the combination of SVM and PCD could be used as a useful tool to optimize the operation strategy of cavitation-facilitated pHIFU therapy.

Assessment of healthy trapeziometacarpal cartilage properties using indentation testing and contrast-enhanced computed tomography

BackgroundThe trapeziometacarpal joint is a common site for osteoarthritis development in the hand. When osteoarthritis is present, it results in significant functional disabilities due to the broad range of activities performed by this joint. However, our understanding of osteoarthritis initiation and progression at this joint is limited because of the current lack of knowledge regarding the properties and structure of the corresponding cartilage layers. The objective of this study is to assess the morphological and mechanical properties of trapeziometacarpal cartilage via the combination of indentation testing and contrast-enhanced computed tomography. Such research may lead to the development of medical imaging-based approaches to measure cartilage properties in vivo. MethodsIntact first metacarpals and trapezia were extracted from 16 fresh-frozen human cadaver hands. For each specimen, load-displacement behavior was measured at 9 testing sites using a standardized indentation testing device to calculate the normal force and Young's modulus of the cartilage sub-regions. The specimens were then immersed in CA4+ contrast agent solution for 48 h and subsequently scanned with a resolution of 41 μm in a HR-pQCT scanner to measure cartilage thickness and attenuation. Finally, correlations between compressive Young's modulus and contrast-enhanced computed tomography attenuation of the cartilage were assessed. FindingsNo significant difference was found in cartilage thickness between the trapezium and first metacarpal, but the comparison between articular regions showed thinner cartilage around the volar aspect of both the first metacarpal and the trapezium. The first metacarpal cartilage was stiffer than the trapezial cartilage. A significant positive correlation was observed between Young's modulus and mean contrast-enhanced CT attenuations in superficial and full-depth cartilage in both the first metacarpal and the trapezium cartilage. InterpretationThe quantitative measurements of trapeziometacarpal thickness and stiffness as well as a correlation between Young's modulus and contrast-enhanced computed tomography attenuation provides a method for the non-destructive in vivo assessment of cartilage properties, a greater understanding of thumb cartilage behavior, and a dataset for the development of more accurate computer models.

Robust quantitative contrast-enhanced dual-energy CT for radiotherapy applications.

The purpose of this study was to develop and validate accurate methods for determining iodine content and virtual noncontrast maps of physical parameters, such as electron density, in the context of radiotherapy. A simulation environment is developed to compare three methods allowing extracting iodine content and virtual noncontrast composition: (a) two-material decomposition, (b) three-material decomposition with the conservation of volume constraint, and (c) eigentissue decomposition. The simulation allows comparing the performance of the methods using iodine-based contrast agent contents in tissues from a reference dataset with variable density and elemental composition. The comparison is performed in two ways: (a) with a priori knowledge on the composition of the targeted tissue, and (b) without a priori knowledge on the base tissue. The three methods are tested with patient images scanned with dual-energy CT and iodine-based contrast agent. An experimental calibration adapted to the presence of iodine is performed by imaging tissue equivalent materials and diluted contrast agent solutions with known atomic composition. Results show that in the case of known a priori on the composition of the targeted tissue, the two-material decomposition is robust to variable densities and atomic compositions without biasing the results. In the absence of a priori knowledge on the target tissue composition, the eigentissue decomposition method yields minimal bias and higher robustness to variations. Results from the experimental calibration and the images of two patients show that the extracted quantities are accurate and the bias is negligible for both methods with respect to clinical applications in their respective scope of use. For the patient imaged with a contrast agent, virtual noncontrast electron densities are found in good agreement with values extracted from the scan without contrast agent. This study identifies two accurate methods to quantify iodine-based contrast agents and virtual noncontrast composition images with dual-energy CT. One is the two-material decomposition with a priori knowledge of the constituent components focused on organ-specific applications, such as kidney or lung function assessment. The other method is the eigentissue decomposition and is useful for general radiotherapy applications, such as treatment planning where accurate dose calculations are needed in the absence of contrast agent.

An open source, 3D printed preclinical MRI phantom for repeated measures of contrast agents and reference standards

In medical imaging, clinicians, researchers and technicians have begun to use 3D printing to create specialized phantoms to replace commercial ones due to their customizable and iterative nature. Presented here is the design of a 3D printed open source, reusable magnetic resonance imaging (MRI) phantom, capable of flood-filling, with removable samples for measurements of contrast agent solutions and reference standards, and for use in evaluating acquisition techniques and image reconstruction performance. The phantom was designed using SolidWorks, a computer-aided design software package. The phantom consists of custom and off-the-shelf parts and incorporates an air hole and Luer Lock system to aid in flood filling, a marker for orientation of samples in the filled mode, and bolt and tube holes for assembly. The cost of construction for all materials is under $90. All design files are open-source and available for download. To demonstrate utility, B0 field mapping was performed using a series of gadolinium concentrations in both the unfilled and flood-filled mode. An excellent linear agreement (R2 > 0.998) was observed between measured relaxation rates (R1, R2) and gadolinium concentration. The phantom provides a reliable setup to test data acquisition and reconstruction methods and verify physical alignment in alternative nuclei MRI techniques (e.g. carbon-13 and fluorine-19 MRI). A cost-effective, open-source MRI phantom design for repeated quantitative measurement of contrast agents and reference standards in preclinical research is presented. Specifically, the work is an example of how the emerging technology of 3D printing improves flexibility and access for custom phantom design.

The regulatory role of the erythrocytic membranes’ lipid components in ensuring oxygen-binding capacity of hemoglobin in cardiovascular diseases

Cross-talk of subchondral bone and articular cartilage could be an important aspect in the etiology of osteoarthritis. Previous research has provided some evidence of transport of small molecules (~370 Da) through the calcified cartilage and subchondral bone plate in murine osteoarthritis models. The current study, for the first time, uses a neutral diffusing computed tomography (CT) contrast agent (iodixanol, ~1550 Da) to study the permeability of the osteochondral interface in equine and human samples. Sequential CT monitoring of diffusion after injecting a finite amount of contrast agent solution onto the cartilage surface using a micro-CT showed penetration of the contrast molecules across the cartilage-bone interface. Moreover, diffusion through the cartilage-bone interface was affected by thickness and porosity of the subchondral bone as well as the cartilage thickness in both human and equine samples. Our results revealed that porosity of the subchondral plate contributed more strongly to the diffusion across osteochondral interface compared to other morphological parameters in healthy equine samples. However, thickness of the subchondral plate contributed more strongly to the diffusion in slightly osteoarthritic human samples.

Solute transport at the interface of cartilage and subchondral bone plate: Effect of micro-architecture

Cross-talk of subchondral bone and articular cartilage could be an important aspect in the etiology of osteoarthritis. Previous research has provided some evidence of transport of small molecules (~370Da) through the calcified cartilage and subchondral bone plate in murine osteoarthritis models. The current study, for the first time, uses a neutral diffusing computed tomography (CT) contrast agent (iodixanol, ~1550Da) to study the permeability of the osteochondral interface in equine and human samples. Sequential CT monitoring of diffusion after injecting a finite amount of contrast agent solution onto the cartilage surface using a micro-CT showed penetration of the contrast molecules across the cartilage-bone interface. Moreover, diffusion through the cartilage-bone interface was affected by thickness and porosity of the subchondral bone as well as the cartilage thickness in both human and equine samples. Our results revealed that porosity of the subchondral plate contributed more strongly to the diffusion across osteochondral interface compared to other morphological parameters in healthy equine samples. However, thickness of the subchondral plate contributed more strongly to the diffusion in slightly osteoarthritic human samples.

Feasibility of Antegrade Contrast-enhanced US Nephrostograms to Evaluate Ureteral Patency.

Purpose To demonstrate the feasibility of contrast material-enhanced ulrasonographic (US) nephrostograms to assess ureteral patency after percutaneous nephrolithotomy (PCNL) in this proof-of-concept study. Materials and Methods For this HIPAA-compliant, institutional review board-approved prospective blinded pilot study, patients undergoing PCNL provided consent to undergo contrast-enhanced US and fluoroscopic nephrostograms on postoperative day 1. For contrast-enhanced US, 1.5 mL of Optison (GE Healthcare, Oslo, Norway) microbubble contrast agent solution (perflutren protein-type A microspheres) was injected via the nephrostomy tube. Unobstructed antegrade ureteral flow was defined by the presence of contrast material in the bladder. Contrast-enhanced US results were compared against those of fluoroscopic nephrostograms for concordance. Results Ten studies were performed in nine patients (four women, five men). Contrast-enhanced US demonstrated ureteral patency in eight studies and obstruction in two. One patient underwent two studies, one showing obstruction and the second showing patency. Concordance between US and fluoroscopic assessments of ureteral patency was evaluated by using a Clopper-Pearson exact binomial test. These results were perfectly concordant with fluoroscopic nephrostogram results, with a 95% confidence interval of 69.2% and 100%. No complications or adverse events related to contrast-enhanced US occurred. Conclusion Contrast-enhanced US nephrostograms are simple to perform and are capable of demonstrating both patency and obstruction of the ureter. The perfect concordance with fluoroscopic results across 10 studies demonstrated here is not sufficient to establish diagnostic accuracy of this technique, but motivates further, larger scale investigation. If subsequent larger studies confirm these preliminary results, contrast-enhanced US may provide a safer, more convenient way to evaluate ureteral patency than fluoroscopy. © RSNA, 2016 Online supplemental material is available for this article.