Imaging Techniques Research Articles

Diagnostic performance of dual-energy CT with electron-density reconstruction for lumbar disc herniation

Background: Magnetic resonance imaging (MRI) is used for the evaluation of degenerative spinal disease. However, its utility is restricted in routine practice because of contraindications and a lack of widespread availability. Dual-energy computed tomography (DECT) is a newer technique for the evaluation of degenerative spinal disease.Objectives: This study aimed to evaluate the diagnostic performance of DECT with electron-density (ED) image reconstruction compared to standard CT for the detection of lumbar disc herniation, with MRI as the gold standard.Method: The retrospective study included 84 patients between 01 July 2023 to 31 December 2023 who underwent DECT and 1.5-T MRI within 1 week. Four radiologists, blinded to the clinical and MRI information, independently evaluated the standard CT series and DECT series with ED reconstructions for lumbar disc herniation and spinal nerve root impingement. The gold standard for comparison was lumbar spine MRI, and diagnostic accuracy was measured with sensitivity and specificity.Results: MRI revealed 417 lumbar disc herniations. Dual-energy computed tomography with ED reconstruction showed higher sensitivity (86.36% [532/616] vs. 57.79% [356/616]) and specificity (96.86% [1019/1052] vs. 95.82% [1008/1052]) for the detection of lumbar disc herniation compared to standard CT.Conclusion: Dual-energy computed tomography with ED reconstruction shows better diagnostic performance for the detection of lumbar disc herniation compared to standard CT and can be a useful alternative imaging modality when MRI is contraindicated or unavailable.Contribution: This study shows the usefulness of DECT as an alternative imaging technique for screening of degenerative spinal disease whenever MRI is contraindicated or unavailable.

Clinical Evaluation of the NaviNetics Stereotactic System Using Intraoperative Portable Surgical Imaging System in DBS Surgery

BACKGROUND AND OBJECTIVES: A typical workflow for deep brain stimulation (DBS) surgery consists of head frame placement, followed by stereotactic computed tomography (CT) or MRI before surgical implantation of the hardware. At some institutions, this workflow is prolonged when the imaging scanner is located far away from the operating room, thereby increasing workflow times by the addition of transport times. Recently, the intraoperative O-arm has been shown to provide accurate image fusion with preoperative CT or MR imaging, suggesting the possibility of obtaining an intraoperative localization scan and postoperative confirmation. In this article, we aim to evaluate the compatibility of the stereotactic frame system with the intraoperative O-arm system regarding lead accuracy and surgical flow. METHODS: A total of 17 patients undergoing DBS surgery for movement disorders were evaluated. One patient underwent both the stereotactic CT and O-arm localization, while 16 patients underwent only intraoperative O-arm localization. Following lead placement, intraoperative O-arm imaging was obtained to evaluate the accuracy of the lead placement. Accuracy was defined as the error measured as the distance from the center of the planned trajectory to the cannula. RESULTS: Less than 0.1 mm difference was found between the O-arm imaging technique and CT image localization of the NaviNetics stereotactic head frame in DBS surgery. Of the 16 patients who underwent the intraoperative O-arm imaging alone, the targets included bilateral ventral intermediate nucleus (16 leads), bilateral globus pallidus internus (4 leads), and subthalamic nucleus (12 leads). The mean ± SD radial error in the probe's eye view was 0.71 ± 0.33 mm for n = 32 leads. No tract hemorrhage was observed. CONCLUSION: Intraoperative O-arm imaging can be used safely and effectively for stereotactic registration and lead placement confirmation with the stereotactic system in both awake and asleep DBS surgery.

Abstract PR014: DNA associated with EVs is uniquely chromatinized and prevents metastasis by enhancing anti-tumor immunity

Abstract Cells release extracellular vesicles (EVs) loaded with functional biomolecules that facilitate intercellular communication in health and disease. These EVs contain DNA (EV-DNA), mirroring the mutational profile of parental cells, yet the mechanism of DNA packaging onto EVs and its role in diseases like cancer remain unclear. Using advanced imaging and biochemical techniques, we discovered that EV-DNA predominantly resides on the vesicle surface, bound to modified histones. Through genome-wide CRISPR knockout screens in cancer cell lines, we identified immune-related pathways and genes crucial for EV-DNA loading, such as APAF1 and NCF1. In several cancer models, loss of APAF1 reduced EV-DNA packaging, and enhancing metastasis, thus implicating EV-DNA in immune surveillance against cancer spread. We demonstrated that EV-DNA uptake by liver macrophages triggers DNA damage response, altering cytokine production and promoting immune activation in pre-metastatic sites. Moreover, quantifying EV-DNA in colorectal cancer biopsies revealed its potential as a predictive metastatic risk biomarker. Our findings shed light on EV-DNA packaging mechanisms and its significance, suggesting that elevated levels of tumor-derived EV-DNA bolster anti-tumor immunity and inhibit metastasis. Citation Format: Inbal Wortzel, Han-Sang Kim, David C. Lyden. DNA associated with EVs is uniquely chromatinized and prevents metastasis by enhancing anti-tumor immunity [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor-body Interactions: The Roles of Micro- and Macroenvironment in Cancer; 2024 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(22_Suppl):Abstract nr PR014.

Qualitative and quantitative interpretations of high-resolution aeromagnetic data of Saki-East area, for basement and structural framework

Earth tremor is a small earthquake or seismic event that occurs in seismically unstable region. However there have been little information about the earth tremor before year 1987, but events between 1990 and 2000 have triggered further researches. This research work is aimed at qualitatively and quantitatively interpret high resolution aeromagnetic data of Saki-East area to provide basement and structural framework of the study area. The aeromagnetic data of the study area consisting of Igboho data sheet 200 and Lechilaku sheet 221 were processed using Oasis Montaj software and interpreted for mapping basement and structural stability in the area. Enhancement process was further carried out on the data to generate residual aeromagnetic data used in determining the lineament orientations in the study area. 3D Euler deconvolution and Source Parameter Imaging (SPI) techniques were implored to determine basement depth of subsurface geological structures. The result shows positive correlation with geologic structures, low magnetic anomalies revealed subsurface deformation of crystalline basement rocks. 3D Euler solutions for SI = 1 shows large clusters depicting geological bodies associating with faults. The magnetic basement depth from 3D Euler and SPI shows over 90% dominance of shallow depth range of 3-600 m in the study area, this revealed that the dominant shallow depth of magnetic basement causes the faulting system of the study area becoming weak zones through which tremor occurs. The lineaments in the study areas are classified into major and minor lineaments, the major lineaments are prominent within the basement rocks and are possibly produced by the regional historic orogenic movement that affected Nigeria basement.

Metamaterial-based Artificial magnetic conductor for efficient breast cancer diagnosis using a low-cost antenna array.

Breast cancer is the most common malignancy in women globally, stemming from gene mutations that prompt irregular cellular growth and subsequent tumor development. Early-stage detection of cancer cells results in a remarkable 99% survival rate. This research presents a microwave imaging technique for the non-invasive identification of tumors in the initial stages within the women's breast. A low-cost antenna array with an Artificial Magnetic Conductor (AMC) is proposed, featuring a compact structure size of 37.2 37.2 mm . The AMC, a metamaterial, acts as a reflective surface to enhance frequency selectivity, specifically at 8.48 GHz. The maximum gains reached 9.35 dBi in simulated results and 10.51 dBi in measured results. The fabricated antenna validates the simulated findings, and its operational efficiency has undergone experimental validation. Moreover, fidelity factors in face-to-face (FtF) and side-by-side (SbS) scenarios are delineated. The antenna, operating as a transceiver, is applied to a modeled breast phantom across five distinct cases for numerical simulations pertaining to cancer cell detection applications. The outcomes of this research bear considerable implications for advancing early-stage breast cancer detection methodologies.

Misdiagnosis in breast imaging: a statement paper from European Society Breast Imaging (EUSOBI)-Part 1: The role of common errors in radiology in missed breast cancer and implications of misdiagnosis.

Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the healthcare system as a whole. Some of the potential implications of misdiagnosis in breast imaging include delayed diagnosis or false reassurance, which can result in a delay in treatment and potentially a worse prognosis. Misdiagnosis can also lead to unnecessary procedures, which can cause physical discomfort, anxiety, and emotional distress for patients, as well as increased healthcare costs. All these events can erode patient trust in the healthcare system and in individual healthcare providers. This can have negative implications for patient compliance with screening and treatment recommendations, as well as overall health outcomes. Moreover, misdiagnosis can also result in legal consequences for healthcare providers, including medical malpractice lawsuits and disciplinary action by licensing boards. To minimize the risk of misdiagnosis in breast imaging, it is important for healthcare providers to use appropriate imaging techniques and interpret images accurately and consistently. This requires ongoing training and education for radiologists and other healthcare providers, as well as collaboration and communication among healthcare providers to ensure that patients receive appropriate and timely care. If a misdiagnosis does occur, it is important for healthcare providers to communicate with patients and provide appropriate follow-up care to minimize the potential implications of the misdiagnosis. This may include repeat imaging, additional biopsies or other procedures, and referral to specialists for further evaluation and management. Question What factors most contribute to and what implications stem from misdiagnosis in breast imaging? Findings Ongoing training and education for radiologists and other healthcare providers, as well as interdisciplinary collaboration and communication, is paramount. Clinical relevance Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the entire healthcare system.

The Role of Small-Bowel Endoscopy in the Diagnosis and Management of Small-Bowel Neuroendocrine Tumours

Neuroendocrine tumours (NETs) are relatively rare neoplasms but represent one of the most frequent types of primary small-bowel tumours. Their incidence is rising, and this is most likely because of their more frequent early-stage detection, physician awareness, and increasing availability and use of imaging and small-bowel endoscopic techniques, such as video capsule endoscopy and device-assisted enteroscopy, which enable the detection, localisation, and histological sampling of previously inaccessible and underdiagnosed small-bowel lesions. This review summarises the role of small-bowel endoscopy in the diagnosis and management of small-bowel NETs to assist clinicians in their practice. Small-bowel endoscopy may play a complementary role in the diagnosis of these tumours alongside other diagnostic tests, such as biomarkers, conventional radiology, and functional imaging. In addition, small-bowel enteroscopy may play a role in the preoperative setting for the identification and marking of these tumours for surgical resection and the management of rare complications, such as small-bowel variceal bleeding, in cases of portal hypertension due to the encasement of mesenteric vessels in fibrotic small-bowel NETs.

Concordance between preoperative ultrasound arterial mapping in the femoropopliteal and distal sector and intraoperative angiography.

The present study analyzes the concordance between arterial mapping of this sector using duplex ultrasound and intraoperative angiography. A retrospective, single-center observational study was carried out. The study sample consisted of patients subjected to open or endovascular surgery of the femoropopliteal and distal sector with prior ultrasound arterial mapping from January 2017 to December 2022. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of arterial mapping with duplex ultrasound versus intraoperative angiography were evaluated, the degree of concordance between the two techniques and the correlation between surgical planning and the surgery finally performed. 167 patients were analyzed. A total of 1837 segments were explored, of which 149 (8.1%) were not able to be evaluated. Regarding the global precision of ultrasound in predicting significant arterial lesions (stenosis > 50% or occlusion), sensitivity was 85.26% (95% confidence interval [95%CI]: 82.33-88.19%), specificity 88.57% (95%CI: 86.63-90.51%), PPV 80.41% (95%CI: 77.24-83.58%), and NPV 91.61% (95%CI: 89.89-93.34%). Global concordance assessed by the kappa index was 0.725 (95%CI: 0.691-759). The surgical indications based on arterial mapping coincided with the final surgery performed in 97.6% of the cases. Arterial mapping of the femoropopliteal and distal sector with duplex ultrasound could be considered as the sole preoperative imaging technique for surgical planning.

Value of high frame rate contrast-enhanced ultrasound in predicting microvascular invasion of hepatocellular carcinoma.

To investigate the value of vascular morphology on high frame rate contrast-enhanced ultrasound (H-CEUS) and CEUS Li-RADS in predicting microvascular invasion (MVI), Ki-67 expression and recurrence of hepatocellular carcinoma (HCC). This retrospective study enrolled 78 patients with single HCC diagnosed by postoperative pathology between January 1, 2021, and June 30, 2022. All patients underwent ultrasound and H-CEUS examination before operation. H-CEUS image features and CEUS Li-RADS were compared in different MVI status and Ki-67 level. Multiple logistic regression analysis was performed to select independent variables for MVI. Differences in recurrence among different H-CEUS image features, MVI status and Ki-67 level were further analyzed. Tumor shape, vascular morphology, LR-M category, necrosis and AFP level were different between the MVI-positive group and MVI-negative group (p < 0.05). Vascular morphology and LR-M category were independent risk factors related to MVI (p < 0.05). Vascular morphology was also different between the high Ki-67 expression group and low Ki-67 expression group (p < 0.05). Vascular morphology, MVI status and Ki-67 expression were different between the recurrence group and no recurrence group (p < 0.05). The vascular morphology of HCC on H-CEUS can indicate the risk of MVI status, Ki-67 expression and recurrence, which provides a feasible imaging technique for predicting the prognosis before operation. H-CEUS shows the different vascular morphology of HCC in arterial phase and indicates the risk of MVI, Ki-67 expression and recurrence, which provides a feasible imaging technique for clinician to judge the risk of MVI pre-operation and adopt appropriate treatment. H-CEUS can clearly show different vascular morphology of HCC in arterial phase. Vascular morphology on H-CEUS is associated with MVI status, Ki-67 expression and HCC recurrence. Preoperative MVI and Ki-67 expression prediction could help surgeons choose a more appropriate treatment plan.

Volumetric Imaging From Raman Perspective: Review and Prospect

AbstractVolumetric imaging, which supports quantitative and comprehensive assessment of a 3D sample from an entire volume, has attracted tremendous attention in biomedical research. Fluorescence imaging techniques, such as optical sectioning and light sheet microscopy, enable to reconstruct the 3D distribution of chemicals within a sample. However, current methods rely on exogenous labels, from which considerable perturbation may be introduced in living systems. Raman imaging offers a feasible solution to visualize components in biological samples in a label‐free manner. Besides, the integration of Raman microscopy with 3D approaches will benefit the research of biomedical samples on novel devices, which is dominated by the strongly enhanced spatial resolution, imaging speed, and overall field of view as well as complemented more details of samples. In this overview, recent achievements in 3D visualization of biological samples from the Raman perspective, are explored including scanning mechanism, light sheet, tomography strategy, compressive sensing, holography, and tissue clearing. Importantly, these platforms are compatible with biomedical research, thus allowing the imaging of chemical constituents and the distribution of samples in a whole volume. As a unique volumetric imaging tool for biological discovery, these methods may provide a strategy to accelerate new discoveries across diverse fields of research.

Is it Time to Adopt a New Nomenclature and Classification for White Dot Syndromes Using Multimodal Imaging Techniques? Report 1 from Multimodal Imaging in Uveitis (MUV) Task Force

ABSTRACT Purpose The survey aims to explore the use of existing nomenclature and current clinical and multimodal imaging (MMI) approach in diagnosing white dot syndromes (WDS) among uveitis and retina specialists. Methods The members of the International Uveitis Study Group (IUSG) task force MUV (Multimodal imaging in UVeitis) developed a survey. The questionnaire, created using Qualtrics, consisted of 22 questions. The responses were compared against regions, workplace setting, sub-specialty, and experience of the participants. Results A total of 432 participants initiated the background section; 343 initiated the investigation section and 263/343 completed the survey (76.7%). The majority (43.7%) reported a specialty/practice focus mostly on uveitis, 32.2% on uveitis and retina, and 20.1% mostly on retina. Specifically, 55.7% were in practice > 10 years post-fellowship and 65.8% worked in academic settings. The term WDS was not universally used in clinical practice, with no significant differences by region, subspecialty, experience, workplace setting or number of WDS patients managed in the prior year (p > 0.01). Nearly 90% of participants reported using MMI to diagnose WDS. More than 70% advocated redefining the nomenclature and classification of WDS based on the primary anatomical location of disease using MMI without significant regional or professional differences (p > 0.01). Conclusion These results underscore the widespread adoption of MMI among uveitis and retina specialists in the characterization of entities traditionally grouped under the term WDS. Respondents strongly agree that MMI provides a precise distinction between these posterior uveitis, advocating for the overcoming of the clinical term WDS in favor of a patho-anatomic redefinition.

Open-chest cardiac ultrasound-mediated imaging with a vacuum coupler.

A fundamental obstacle for the preclinical development of ultrasound-(US) mediated cardiac imaging remains cardiac motion, which limits interframe correlation during extended acquisition periods. To address this need, we present the design and implementation of a 3D-printed vacuum coupler that stabilizes a US transducer on the epicardial surface of the heart for feasibility assessment and development of advanced, cardiac, US-mediated imaging approaches. The vacuum coupler was 3D printed with biocompatible resins and secured with a standard intraoperative suction aspirator. US-mediated imaging (i.e., B-mode and photoacoustic [PA] imaging) was performed in an open-chest porcine model with and without the vacuum coupler. Based on inter-frame displacement tracking and cross-correlation (CC) coefficients, changes in frame motion and stability were compared for each imaging mode/configuration through a prolonged (∼1min) acquisition, while the impact on PA-based SO2 accuracy was assessed. When compared to conventional handheld imaging, stand-off imaging, and coupler without suction, epicardial imaging with the vacuum coupler and suction applied led to a significantly reduced mean axial displacement of 0.15 mm versus 0.89, 0.49, & 0.49 mm, respectively (p-values≤8.65e-7). Comparing the coupler without suction to that with suction applied, physiologically unrealistic SO2 estimates reduced from 1.72 to 0.81%, respectively, and lateral interframe displacement reduced from 4.58 to 2.01mm, respectively (p-value=5.07e-23). Overall,reduced cardiac tissue motion and increased interframe CC coefficient (baseline=0.43vs. coupler with suction=0.80) allow for more accurate PA unmixing. Epicardial US-mediated imaging with a vacuum coupler reduces cardiac motion artifact, providing a consistent sampling of an intended region of interest (ROI) over multiple cardiac cycles. This could help facilitate the development of advanced US-mediated imaging, which is often hindered by cardiac motion. Stable implementation of these imaging techniques could allow for intra-operative assessments of local cardiac perfusion as well as tissue characterization.

Photodissociation dynamics of H2S+ via the A2A1 (0, 8, 0) state.

The photodissociation dynamics of the hydrogen sulfide cation (H2S+) (X2B1) were investigated using the time-sliced velocity map ion imaging technique. S+ (4Su) product images were measured at four photolysis wavelengths around 393.70nm, corresponding to the excitation of the H2S+ (X2B1) cation to the A2A1 (0, 8, 0) state. The raw images and the derived total kinetic energy releases (TKERs) spectra exhibited partial rotational resolution for the H2 products. A sensitive dependence on the photolysis wavelength was observed in the TKER spectra and anisotropy parameters. Within a narrow excitation energy range of ∼12cm-1, the H2 products showed two distinct rotational excitations. Furthermore, clear differences in anisotropy parameters were observed. These phenomena indicate that the rotational excitation of the H2S+ ions plays a role in the non-adiabatic photodissociation dynamics.

Effect of meat type and fat level on burger meat characteristics: A combined approach using imaging and sensory techniques.

This study aimed to evaluate the effect of fat level and meat cut type on burger meat through color, texture, image, and sensory analyses, and to explore the ability of the imaging technique as a complementary tool for consumer quality perception. For this purpose, burger meat samples were prepared by combining pork and beef meat (50/50%) with other nonmeat ingredients. The differences between samples were fat level: around 15 g fat/100 g (code HF) or 10.5 g fat/100 g (code LF); cut types: from cow carcasses (code C) or yearling (code Y). Instrumental color and texture measures analysis, an image analysis, and a sensory evaluation were carried out on samples (raw and cooked) at two times: day 0 and day 1 before expiry dates. The results showed that the samples made with meat from cows presented lower L* and higher a* and b* values than the samples made from yearling. However, the fat level did not affect this parameter. This same pattern was observed for the image measurements. Regarding texture, the samples with higher fat content (and lower moisture content) had higher hardness values. Generally, meat type had no effect on textural parameters. The samples that consumers gave the highest overall acceptance scores were those made of cow meat at both fat content levels. These samples also had the highest raw and cooked color scores. The fat level slightly affected hardness, with the same pattern observed for the instrumental measures of texture. The analyses showed a good correlation between instrumental techniques and sensory evaluation.

MIGRAINE

Background Migraine is a prevalent neurological disorder characterized by chronic headaches, significantly impacting the global population. This comprehensive review aims to advance the understanding of migraine pathogenesis and treatment, focusing on molecular markers and novel therapeutic strategies. Material Molecular markers such as calcitonin gene-related peptide (CGRP) and their role in migraine development. Traditional medical treatments and emerging therapeutic strategies, including neuromodulation, are analyzed for their effectiveness and limitations. Clinical studies and imaging techniques are leveraged to identify key mechanisms and triggers in migraine pathology. Approximately 95% of people experience a headache at some point, with migraines being a significant contributor. Migraine is recognized by the World Health Organization as one of the top ten causes of disability globally, particularly affecting women. CGRP is identified as a crucial factor in migraine development. Inhibitors targeting CGRP have shown significant effectiveness in managing migraines. Other molecular markers, including proinflammatory cytokines and neurotransmitters, are discussed for their roles in pain transmission and migraine pathophysiology. Traditional treatments, such as triptans and NSAIDs, are evaluated alongside new therapies, including CGRP inhibitors and neuromodulation techniques. Neuromodulation, involving devices like external trigeminal nerve stimulators, shows promise in migraine management. Genetic markers associated with familial hemiplegic migraine (FHM) and common migraine forms are reviewed. Recent genome-wide association studies (GWAS) have identified several genetic variants linked to migraine susceptibility. Conclusion This presentation enhances the understanding of migraine pathogenesis and introduces novel therapeutic possibilities. By focusing on molecular markers like CGRP and exploring advanced treatment options, the study aims to improve migraine management and patient care. The findings underscore the need for continued research and innovation in migraine treatments to reduce the global burden of this debilitating condition.

Indocyanine green fluorescence imaging for lymph node detection and long-term clinical outcomes in colorectal cancer surgery: A systematic review and meta-analysis.

The indocyanine green fluorescence imaging (ICG-FI) technique is increasingly being used in laparoscopic colorectal surgery for lymph node mapping. However, there is no definitive standard regarding whether the application of this technique can significantly increase the detection rate of metastatic lymph nodes and improve long-term prognosis. PubMed, Embase, Web of Science, and Cochrane Library databases were searched to include studies including ICG-FI in laparoscopic colorectal surgery. Data on the detection rate of lymph nodes, metastatic rate of ICG-positive nodes, and long-term clinical outcomes were extracted following inclusion criteria. Eighteen studies with a total of 1552 patients 922 with ICG-guided laparoscopic and 630 without ICG technique were finally included. Clinical stage II/III colorectal tumors were the most commonly studies types. The patients using the ICG-FI technique had more harvested lymph nodes (weighted mean: 23.5 vs. 18.9; WMD=4.6; p<0.00001) during dissection but a lower metastasis rate of ICG-positive nodes (61/218 [28%] vs. 96/333 [28.9%]; OR=1.45; p=0.08). Compared with conventional laparoscopic colorectal surgery, additional ICG-FI technique did not improve the 3year overall survival rate (272/289 [94.1%] vs. 269/289 [93.1%]; OR=1.19; p=0.61), relapse-free survival (246/289 [85.1%] vs. 249/289 [86.2%]; OR=0.92; p=0.72), and local recurrence rate (22/289 [7.6%] vs. 28/289 [9.7%]; OR=0.77; p=0.38). The overall detection rate of sentinel lymph nodes, lymph flow, and metastatic rate of ICG-positive nodes with the help of ICG-FI were 86.8%, 89.9%, and 22.8%, respectively. No patients experienced major adverse events during ICG injection preoperatively or postoperatively. Indocyanine green fluorescence imaging-guided procedure, compared to conventional laparoscopic dissection, can assist in obtaining a greater number of harvested lymph nodes and metastatic lymph nodes, however, it did not significantly improve the long-term clinical outcomes. Level III systematic review of randomized control and nonrandomized studies.

Imaging of Viral Genomic RNA Replication with Nanoprobes.

Viruses are a great threat to human life and health. Different viruses have its unique mechanism to efficiently infect cells, and the entry process and the nucleic acid replication using cell machine are two critical processes related to the fate of virus progeny. Real-time and long-term imaging techniques can be used to thoroughly investigate the viral infection events. This chapter will present the labeling of viral genomic RNA (gRNA) replication by developing new nanoprobes, one-donor-two-acceptors one, for example, in which the synergistic coupling of multiple energy transfer strategy, so as that the journey of viruses in live cells could be monitored and imaged in real time. Methods of labeling as well as that used for fluorescent and dark field scattering imaging are outlined.

Pre-symptomatic scintigraphic and genetic cascade screening in cardiac transthyretin amyloidosis.

While early diagnosis is crucial, as new treatments can significantly slow the progression of the disease, there is growing evidence on the application of novel imaging techniques for detecting transthyretin amyloidosis (ATTR) in pre-symptomatic stages. This study aimed to evaluate the utility of pre-symptomatic scintigraphic imaging cascade screening for early detection of ATTR. During the period from 2020 to 2024, we conducted a prospective study that enrolled 100 consecutive adults. The study utilized a multimodal cascade screening approach to assess asymptomatic relatives of individuals with ATTR (ClinicalTrials.gov Identifier: NCT05814380). The analysis incorporated clinical data, genetic testing, echocardiography, scintigraphy and single-photon emission computed tomography/computed tomography (SPECT/CT) with [99mTc]Tc-DPD, regardless of the predicted age of disease onset. Overall, scintigraphy identified cardiac amyloidosis (CA) in 8.2% of relatives, while 20.5% carried a pathogenic transthyretin variant without radiotracer uptake, with Phe53Leu being predominant. Notably, no relatives of wild-type ATTR patients exhibited CA on scintigraphy or carried a transthyretin variant. Additionally, newly-diagnosed relatives with ATTR CA presented elevated high-sensitivity troponin levels and exhibited a higher incidence of pathological electrocardiographic Q waves, greater thickness of the intraventricular septum and left ventricular posterior wall, a notable decline in lateral wall and intraventricular septal E' tissue velocities measured by TDI, and the "5-5-5" sign (p < 0.05). The presented findings demonstrate that implementing a systematic screening protocol, which integrates genetic and scintigraphic testing, facilitates the early detection of ATTR. Crucially, a significant proportion of asymptomatic relatives of patients with hereditary ATTR may suffer from underlying CA. ClinicalTrials.gov Identifier: NCT05814380.

Emerging Imaging Techniques for Atherosclerosis in Systemic Immune-Mediated Inflammatory Conditions.

Atherosclerosis affects patients with systemic immune-mediated inflammatory diseases at an increased rate compared with the general population. In recent years, our understanding of the pathophysiology of atherosclerosis has advanced considerably. Nevertheless, cardiovascular imaging modalities that can adequately assess the biological background of atherosclerosis have not reached widespread clinical adoption. Novel developments in cardiac imaging have the potential to enhance the diagnostic yield of these modalities further while providing essential insights into the anatomy, composition, and biology of atherosclerotic lesions. In this review, we highlight some of the latest developments in the field for the evaluation of atherosclerosis using advances in echocardiography, computed tomography, positron emission tomography, and cardiovascular magnetic resonance. Additionally, we discuss evidence specifically in patients with immune-mediated inflammatory diseases and outline unmet research needs for future development.

Going with the flow: Implementing a 4D flow MRI program at a children's hospital.

Four-dimensional phase contrast MRI (4D flow) has emerged as a versatile imaging technique for comprehensive visualization and both qualitative and quantitative assessment of cardiovascular blood flow. 4D flow is a three-dimensional, time-resolved acquisition that is gated to the cardiac cycle. 4D flow provides cardiovascular velocity and flow assessment across the volume of acquisition and yields a multitude of advanced hemodynamic parameters that help to assess the impact of cardiovascular disease on flow and vice versa, guiding the clinical and surgical management of patients with congenital and acquired heart disease. In the past, lengthy scan acquisition and complex post-processing workflows hindered 4D flow adoption into routine clinical practice. Decreasing image acquisition times and improvements in post-processing techniques have made 4D flow a clinically useful tool. The purpose of this communication is to facilitate more widespread adoption of 4D flow by describing its clinical utility, technical acquisition, optimization, and post-processing in pediatric cardiovascular imaging at our center.