Noninvasive Diagnosis Research Articles

САРКОИДОЗ, ТРУДНОСТИ ДИАГНОСТИКИ

The incidence of sarcoidosis in Russia has not been studied enough. The clinical signs of sarcoidosis are diverse, and the lack of specific diagnostic tests makes noninvasive diagnosis difficult. In general therapeutic practice, in the case of an atypical course of the disease, diagnosis is complicated by the need for a differential diagnosis with many syndrome-like diseases. The etiology of sarcoidosis is still unknown. According to recent concepts, the cause of its occurrence cannot be considered a single factor, it is a combination of genetic, environmental, infectious and immunological causes. In this article, the author examines the main difficulties faced by doctors in the diagnosis of sarcoidosis. The clinical manifestations of the disease are analyzed, as well as methods of its detection, such as bronchoscopy, biopsy and laboratory tests. Possible diagnostic errors and how to avoid them are also considered. Understanding these difficulties will help improve the diagnosis and treatment of sarcoidosis, leading to more effective disease management.

The role of enteroscopy in the diagnosis and treatment of hidden gastrointestinal bleeding

Aim. Gastrointestinal occult bleeding (OGB) is defined as persistent or recurrent bleeding from the gastrointestinal tract in which the source has not been identified endoscopically. New advances in small bowel diagnostics and the ability to successfully perform endoscopic therapy have largely replaced surgical procedures and have led to a trend towards non-invasive diagnosis and endoscopic treatment of OGB. The purpose of this literature review is to study the current state of diagnosis and treatment of occult gastrointestinal bleeding.Materials and methods. An electronic literature search was carried out using databases: PubMed, Medline, Cochrane Library.Results. This literature review includes systematic reviews and meta-analyses, prospective and retrospective studies, and literature reviews.Conclusion. The introduction of new methods of imaging and endoscopy has contributed to a significant improvement in the effectiveness of methods for diagnosing and treating occult bleeding.

NEW POSSIBILITIES OF MODERN RADIOLOGY DIAGNOSIS OF HEPATOCELLULAR CARCINOMA: A LITERATURE REVIEW

Relevance: Hepatocellular carcinoma (HCC) is the most common primary malignant liver tumor (80-90%), ranks 6th among malignant neoplasms and is the 3rd leading cause of cancer mortality worldwide. Despite advances in locoregional therapy, targeted therapy, and immunotherapy, the median survival for advanced HCC does not exceed 2 years, and the 5-year survival rate is 18%. Diagnosis of the tumor at an early stage allows for resection and liver transplantation, which can increase the 5-year survival rate by 1.5-2 times. The options for biopsy are limited by sensitivity and potential complications for the patient. In most cases, HCC can be detected by non-invasive radiology. The study aimed to evaluate the effectiveness of modern methods of radiological diagnosis of HCC. Methods: This literature review included published articles and studies on the capacity of modern methods of radiological diagnosis of hepatocellular carcinoma. Data were found in PubMed, BMC Medicine, and Google Scientific using the keywords ‘hepatocellular carcinoma,’ ‘ultrasound examination,’ ‘computed tomography,’ ‘magnetic resonance imaging,’ and ‘radiomics.’ A total of 123 publications were found; 49 sources were included in this review. Results: The review article addresses current issues of HCC epidemiology, genetics, etiology, and radiology diagnosis. Updated data on the efficacy of CEUS and MFI, LDCT and DECT, and a-MRI are presented. The prospects of MRI-radiomics, which solves the problem of subjectivity in radiology and offers new possibilities in the non-invasive diagnosis of HCC, are described. The study of the possibilities of radiology methods in the diagnosis of HCC continues. Conclusion: CEUS is highly effective for imaging tumor vascularization. LDCT is superior to ultrasound in sensitivity and specificity. A shortened MRI protocol delivers better results than an ultrasound as a screening tool for high-risk groups. MRI-radiomics can determine the tumor histological classification and radiogenomics, predict recurrence after surgical resection, and evaluate measurement methodology and response to transarterial chemoembolization and systemic therapy.

Establishment of nomogram prediction model of contrast-enhanced ultrasound and Gd-EOB-DTPA-enhanced MRI for vessels encapsulating tumor clusters pattern of hepatocellular carcinoma.

To establish clinical prediction models of vessels encapsulating tumor clusters (VETC) pattern using preoperative contrast-enhanced ultrasound (CEUS) and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (EOB-MRI) in patients with hepatocellular carcinoma (HCC). A total of 111 resected HCC lesions from 101 patients were included. Preoperative imaging features of CEUS and EOB-MRI, postoperative recurrence, and survival information were collected from medical records. The best subset regression and multivariable Cox regression were used to select variables to establish the prediction model. The VETC-positive group had a statistically lower survival rate than the VETC-negative group. The selected variables were peritumoral enhancement in the arterial phase (AP), hepatobiliary phase (HBP) on EOB-MRI, intratumoral branching enhancement in the AP of CEUS, intratumoral hypoenhancement in the portal phase of CEUS, incomplete capsule, and tumor size. A nomogram was developed. High and low nomogram scores with a cutoff value of 168 points showed different recurrence-free survival rates and overall survival rates. The area under the curve (AUC) and accuracy were 0.804 and 0.820, respectively, indicating good discrimination. Decision curve analysis showed a good clinical net benefit (threshold probability > 5%), while the Hosmer-Lemeshow test yielded excellent calibration (P = 0.6759). The AUC of the nomogram model combining EOB-MRI and CEUS was higher than that of the models with EOB-MRI factors only (0.767) and CEUS factors only (0.7). The nomogram verified by bootstrapping showed AUC and calibration curves similar to those of the nomogram model. The Prediction model based on CEUS and EOB-MRI is effective for preoperative noninvasive diagnosis of VETC.

A pathway for detection of gastric cancer biomarkers via using a layer-by-layer coated D-shaped grinding long-period fiber grating sensor

Gastric cancer significantly contributes to global cancer mortality, often leading to inoperable stages and high recurrence rates post-surgery. Elevated levels of G-17 and G-gly have been identified as potential risk factors, particularly in patients with duodenal ulcers. This study introduces an innovative D-shaped grinding long-period fiber grating sensor (D-LLPFGs) designed for non-invasive detection of the gastrin G-17 antigen, employing a layer-by-layer chemical self-assembly to bond G-17 antibodies onto the fiber surface through hydrogen bonding. The D-LLPFGs sensor demonstrated significant spectral shifts within 1 min of antigen-antibody interaction, highlighting its rapid detection capability. At an optimized antibody concentration of 4 μg/ml, antigen testing across different concentrations (10, 12.5, 20, 50 μg/ml) showed peak changes at 12.5 μg/ml antigen, with a 1.186 nm shift and 0.503 dB loss. The sensor exhibited a wavelength sensitivity of 0.095 nm/μg/ml, indicating its high sensitivity and potential in gastric cancer classification, diagnosis, and treatment. This research concludes that the D-shaped fiber sensor is an effective and sensitive tool for detecting G-17 antigen levels, presenting a significant advancement in non-invasive gastric cancer diagnosis. Its quick response time and high sensitivity highlight its potential for broad biomedical applications, offering a new avenue for early cancer detection and improving patient prognosis. The success of this study opens the door to further exploration and implementation of fiber optic sensors in clinical settings, marking a significant step forward in the fight against gastric cancer.

Untargeted Metabolomic Analysis Reveals Plasma Differences between Mares with Endometritis and Healthy Ones.

The aim of this study was to explore alterations in plasma metabolites among mares afflicted with endometritis. Mares were divided into two groups, namely, the equine endometritis group (n = 8) and the healthy control group (n = 8), which included four pregnant and four non-pregnant mares, using a combination of clinical assessment and laboratory confirmation. Plasma samples from both groups of mares were analyzed through untargeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) metabolomics. A total of 28 differentially abundant metabolites were identified by screening and identifying differentially abundant metabolites and analyzing the pathway enrichment of differentially. Ten metabolites were identified as potential biomarkers for the diagnosis of endometritis in mares. Among them, seven exhibited a decrease in the endometritis groups, including hexadecanedioic acid, oleoyl ethanolamide (OEA), [fahydroxy(18:0)]12_13-dihydroxy-9z-octa (12,13-diHOME), deoxycholic acid 3-glucuronide (DCA-3G), 2-oxindole, and (+/-)9-HPODE, and 13(S)-HOTRE. On the other hand, three metabolites, adenosine 5'-monophosphate (AMP), 5-hydroxy-dl-tryptophan (5-HTP), and l-formylkynurenine, demonstrated an increase. These substances primarily participate in the metabolism of tryptophan and linolenic acid, as well as fat and energy. In conclusion, metabolomics revealed differentially abundant metabolite changes in patients with mare endometritis. These specific metabolites can be used as potential biomarkers for the non-invasive diagnosis of mare endometritis.

Non-invasive detection of Aspergillosis in ventilated patients: Galactomannan analysis in exhaled breath

This study evaluates the non-invasive diagnosis of Invasive Aspergillosis Pneumonia (IPA) in mechanically ventilated patients by measuring galactomannan (GM) in exhaled breath condensate (EBC). Utilizing a rat model and a novel EBC collection device, we compared GM levels in bronchoalveolar lavage fluid (BALF) and EBC, supplemented by cytokine profiling. Analysis of 75 patients confirmed the device's efficacy, with EBC-GM and BALF-GM showing high diagnostic accuracy (AUC = 0.88). The threshold of 0.235 ng/ml for EBC-GM achieved 92.8 % sensitivity and 66.7 % specificity, with a strong correlation (r = 0.707, P < 0.001) with BALF-GM. This approach offers a safe, effective alternative to invasive diagnostics, enhancing precision with IL-6 and TNF-α measurements.The number registered on clinicaltrails.gov is NCT06333379.

Characterization of urinary metabolites associated with malaria infection using infra-red spectroscopy and liquid chromatography–mass spectrometry in South Western Uganda

Early malaria diagnosis improves outcomes during malaria treatment; routine diagnostic techniques rely on blood samples obtained invasively. Therefore, this study used infra-red (IR) spectroscopy coupled with Principle Component Analysis (PCA) to study the urinary profile of malaria patients and that of controls aimed at understanding metabolite perturbation during malaria infection so as to contribute towards development of non-invasive malaria diagnosis methods. Freeze dried human urine samples form malaria infected individuals (cases) and controls were screened in the IR region of 4000 cm−1 to 600 cm−1 and overall spectral differences were observed at wave numbers 1618 cm−1, 1679 cm−1 (amino acids). Peaks at 3030 cm−1 (NH4+) and 940 cm−1 (O–H of carboxylic acids) showed high absorbance in patients compared to controls. Liquid-chromatography–mass spectrometry (LC–MS/MS) was used to quantify amino acids in the urine samples and the results indicated a significant increase of amino acid cystine (P = 0.012). Lysine and tyrosine also increased in patients compared to controls. The use of IR-PCA differentiated clusters of urine samples from patients with malaria from control and the demonstrated amino acid perturbation is consistent with malaria infection. This data provides baseline information for application in development of a non-invasive diagnostic tests for malaria.

Metabolic Dysfunction-Associated Steatotic Liver Disease in Severe Obesity and Concordance between Invasive (Biopsy) and Noninvasive (OWLiver®) Diagnoses

Introduction: Nonalcoholic fatty liver disease (NAFLD), now termed metabolic dysfunction-associated steatotic liver disease (MASLD), is an escalating health concern linked to obesity and type 2 diabetes. Despite liver biopsy being the gold standard, its invasiveness underscores the need for noninvasive diagnostic methods. Methods: A cross-sectional study was performed to assess MASLD using the noninvasive OWLiver® serum lipidomics test in a cohort of 117 patients with severe obesity undergoing bariatric surgery, comparing outcomes with liver biopsy. Exclusions (n = 24) included insufficient data, liver disease etiology other than MASLD, corticosteroid treatment, excessive alcohol consumption, low glomerular filtration rate, and declination to participate. Comprehensive laboratory tests, demographic assessments, and liver biopsies were performed. Serum metabolites were analyzed using OWLiver®, a serum lipidomic test that discriminates between healthy liver, steatosis, metabolic dysfunction-associated steatohepatitis (MASH), and MASH with fibrosis ≥2 by means of three algorithms run sequentially. Results: Liver biopsy revealed a MASLD prevalence of 95.7%, with MASH present in 28.2% of cases. OWLiver® demonstrated a tendency to diagnose more severe cases. Body mass index (BMI), rather than the presence of type 2 diabetes, emerged as the sole independent factor linked to the probability of concordance. Therefore, the all-population concordance of 63.2% between OWLiver® and liver biopsy notably raised to 77.1% in patients with a BMI <40 kg/m2. These findings suggest a potential correlation between lower BMI and enhanced concordance between OWLiver® and biopsy. Conclusion: This study yields valuable insights into the concordance between liver biopsy and the noninvasive serum lipidomic test, OWLiver®, in severe obesity. OWLiver® demonstrated a tendency to amplify MASLD severity, with BMI values influencing concordance. Patients with BMI <40 kg/m2 may derive optimal benefits from this noninvasive diagnostic approach.

Large-scale, comprehensive plasma metabolomic analyses reveal potential biomarkers for the diagnosis of early-stage coronary atherosclerosis

BackgroundCoronary atherosclerosis (CAS) is a prevalent and chronic life-threatening disease. However, the detection of CAS at an early stage is difficult because of the lack of effective noninvasive diagnostic methods. The present study aimed to characterize the plasma metabolome of early-stage CAS patients to discover metabolomic biomarkers, develop a novel metabolite-based model for accurate noninvasive diagnosis of early-stage CAS, and explore the underlying metabolic mechanisms involved. MethodsA total of 100 patients with early-stage CAS and 120 age- and sex-matched control subjects were recruited from the Chinese Han population and further randomly divided into training (n = 120) and test sets (n = 100). The metabolomic profiles of the plasma samples were analyzed by an integrated untargeted liquid chromatography–mass spectrometry approach, including two separation modes and two ionization modes. Univariate and multivariate statistical analyses were employed to identify potential biomarkers and construct an early-stage CAS diagnostic model. ResultsThe integrated analytical method established herein improved metabolite coverage compared with single chromatographic separation and MS ionization mode. A total of 80 metabolites were identified as potential biomarkers of early-stage CAS, and these metabolites were mainly involved in glycerophospholipid, fatty acid, sphingolipid, and amino acid metabolism. An effective diagnostic model for early-stage CAS was established, incorporating 11 metabolites and achieving areas under the receiver operating characteristic curve (AUCs) of 0.984 and 0.908 in the training and test sets, respectively. ConclusionsOur study not only successfully developed an effective noninvasive diagnostic model for identifying early-stage CAS but also provided novel insights into the pathogenesis of CAS.

The Diagnosis of Intestinal Fibrosis in Crohn's Disease-Present and Future.

Crohn's disease (CD) progresses with periods of remission and exacerbations. During exacerbations, chronic inflammation leads to tissue destruction. As a result, intestinal fibrosis may develop in response to the ongoing inflammatory process. Fibrosis in CD should be considered the result of the response of the intestinal wall (over) to the presence of inflammation in the deep structures of the intestinal wall. In the absence of ideal noninvasive methods, endoscopic evaluation in combination with biopsy, histopathological analysis, stool analysis, and blood analysis remains the gold standard for assessing both inflammation and fibrosis in CD. On the contrary, the ability to identify markers of intestinal fibrosis would help to develop new diagnostic and therapeutic methods to detect early stages of fibrosis. It is speculated that miRNAs may, in the future, become biomarkers for early noninvasive diagnosis in the treatment of intestinal fibrosis. The purpose of this review is to summarise existing diagnostic methods for Crohn's disease and present recent scientific reports on molecular testing.

The potential of the ultrasound method in diagnosing pulmonary edema in critically ill patients with liver failure

Background. Pulmonary edema is a common complication in critically ill patients. The liberal tactics of fluid therapy and pathological accumulation of extravascular lung water increase the risks of mortality in Intensive Care Unit patients. Timely and non-invasive diagnosis of pulmonary edema is a primary goal in the intensive care of patients in the Critical Care Unit. We prefer to use lung ultrasound with the registration of B-lines to diagnose lung edema. However, in our country, this method is not validated due to the lack of a sufficient number of clinical studies and necessary regulatory framework.Objective. To assess the potential of diagnostic ultrasonography for pulmonary edema in critically ill patients.Material and methods. A retrospective study was conducted on 27 patients, including 15 males and 12 females aged from 43 to 67 years old (mean age 45.05±17.2 years). All patients were in critical condition due either to acute liver failure, or acute-on-chronic liver failure, or early post-transplant liver graft failure, or posthepatectomy liver failure. Some patients had a systemic inflammatory response syndrome with the development of multiple organ failure and clinical signs of redistribution shock. All patients underwent ultrasound examination of the lungs, and had hemodynamic parameters measured using the transpulmonary thermodilution technique. The data obtained by the two diagnostic modalities were compared.Results. A significant correlation (p&lt;0.05) was found between the extravascular lung water index and the presence of lung edema. We identified a significant correlation (p&lt;0.05) between the number of B-lines and the presence of pulmonary edema. In assessing the relationship between the "B-line" parameter and the "EVLWI" parameter, a strong positive correlation was identified. The area under the ROC curve (AUC) was 0.9±0.06 with a 95% CI [0.77–1.00].Conclusions. Ultrasound data in diagnosing pulmonary edema have a significant correlation with the level of extravascular pulmonary water. Lung ultrasound is an accurate, non-invasive method for assessing extravascular lung water. It can be used for the rapid and accurate diagnosis of pulmonary edema.

Free-breathing, fat-corrected T1 mapping of the liver with stack-of-stars MRI, and joint estimation of T1, PDFF, , and .

Quantitative T1 mapping has the potential to replace biopsy for noninvasive diagnosis and quantitative staging of chronic liver disease. Conventional T1 mapping methods are confounded by fat and inhomogeneities, resulting in unreliable T1 estimations. Furthermore, these methods trade off spatial resolution and volumetric coverage for shorter acquisitions with only a few images obtained within a breath-hold. This work proposes a novel, volumetric (3D), free-breathing T1 mapping method to account for multiple confounding factors in a single acquisition. Free-breathing, confounder-corrected T1 mapping was achieved through the combination of non-Cartesian imaging, magnetization preparation, chemical shift encoding, and a variable flip angle acquisition. A subspace-constrained, locally low-rank image reconstruction algorithm was employed for image reconstruction. The accuracy of the proposed method was evaluated through numerical simulations and phantom experiments with a T1/proton density fat fraction phantom at 3.0 T. Further, the feasibility of the proposed method was investigated through contrast-enhanced imaging in healthy volunteers, also at 3.0 T. The method showed excellent agreement with reference measurements in phantoms across a wide range of T1 values (200 to 1000 ms, slope = 0.998 (95% confidence interval (CI) [0.963 to 1.035]), intercept = 27.1 ms (95% CI [0.4 54.6]), r2 = 0.996), and a high level of repeatability. In vivo imaging studies demonstrated moderate agreement (slope = 1.099 (95% CI [1.067 to 1.132]), intercept = -96.3 ms (95% CI [-82.1 to -110.5]), r2 = 0.981) compared to saturation recovery-based T1 maps. The proposed method produces whole-liver, confounder-corrected T1 maps through simultaneous estimation of T1, proton density fat fraction, and in a single, free-breathing acquisition and has excellent agreement with reference measurements in phantoms.

Ultrasensitive and Wash-Free Detection of Tumor Extracellular Vesicles by Aptamer-Proximity-Ligation-Activated Rolling Circle Amplification Coupled to Single Particle ICP-MS.

Tumor-derived extracellular vesicles (TEVs) are rich in cellular information and hold great promise as a biomarker for noninvasive cancer diagnosis. However, accurate measurement of TEVs presents challenges due to their low abundance and potential interference from a high number of EVs derived from normal cells. Herein, an aptamer-proximity-ligation-activated rolling circle amplification (RCA) method for EV membrane recognition, coupled with single particle inductively coupled plasma mass spectrometry (sp-ICP-MS) for the quantification of TEVs, is developed. When DNA-labeled ultrasmall gold nanoparticle (AuNP) probes bind to the long chains formed by RCA, they aggregate to form large particles. Notably, small AuNPs scarcely produce pulse signals in sp-ICP-MS, thereby detecting TEVs in a wash-free manner. By leveraging the strong binding affinity of aptamers, dual aptamers for EpCAM and PD-L1 recognition, and the sp-ICP-MS technique, this method offers remarkable sensitivity and selectivity in tracing TEVs. Under optimized conditions, the present method shows a favorable linear relationship between the pulse signal frequency of sp-ICP-MS and TEV concentration within the range of 105-107 particles/mL, along with a detection limit of 1.1 × 104 particles/mL. The pulse signals from sp-ICP-MS combined with machine learning algorithms are used to discriminate cancer patients from healthy donors with 100% accuracy. Due to its simple and fast operation and excellent sensitivity and accuracy, this approach holds significant potential for diverse applications in life sciences and personalized medicine.

Quantitative evaluation of lower limb varicose veins using photoacoustic imaging

PurposeVaricose veins in the lower extremities are dilated subcutaneous varicose veins with a diameter of ≥ 3 mm, caused by increased venous pressure resulting from backflow of blood due to venous valve insufficiency (Gloviczki in Handbook of venous disorders: guidelines of the American venous forum, Hodder Arnold, London, 2009). When diagnosing varicose veins, the shape and thickness of the blood vessels should be accurately visualized in three dimensions. In this study, we investigated a new method for numerical evaluation of vascular morphology related to varicose veins in the lower extremities, using a photoacoustic imaging (PAI) system, which can acquire high-resolution and three-dimensional images noninvasively.MethodsNine patients with varicose veins participated in the study, and their images were captured using an optical camera and PAI system. We visualized the vascular structure, created a blood presence density (BPD) heat map, and examined the correlation between BPD and location of varicose veins.ResultsThe obtained photoacoustic (PA) images demonstrated the ability of this method to visualize vessels ranging from as small as 0.2 mm in diameter to large, dilated vessels in three dimensions. Furthermore, the study revealed a correlation between the high-density part of the BPD heat map generated from the PAI images and the presence of varicose veins.ConclusionPAI is a promising technique for noninvasive and accurate diagnosis of varicose veins in the lower extremities. By providing valuable information on the morphology and hemodynamics of the varicose veins, PAI may facilitate their early detection and treatment.

Precise Prostate Cancer Assessment Using IVIM-Based Parametric Estimation of Blood Diffusion from DW-MRI.

Prostate cancer is a significant health concern with high mortality rates and substantial economic impact. Early detection plays a crucial role in improving patient outcomes. This study introduces a non-invasive computer-aided diagnosis (CAD) system that leverages intravoxel incoherent motion (IVIM) parameters for the detection and diagnosis of prostate cancer (PCa). IVIM imaging enables the differentiation of water molecule diffusion within capillaries and outside vessels, offering valuable insights into tumor characteristics. The proposed approach utilizes a two-step segmentation approach through the use of three U-Net architectures for extracting tumor-containing regions of interest (ROIs) from the segmented images. The performance of the CAD system is thoroughly evaluated, considering the optimal classifier and IVIM parameters for differentiation and comparing the diagnostic value of IVIM parameters with the commonly used apparent diffusion coefficient (ADC). The results demonstrate that the combination of central zone (CZ) and peripheral zone (PZ) features with the Random Forest Classifier (RFC) yields the best performance. The CAD system achieves an accuracy of 84.08% and a balanced accuracy of 82.60%. This combination showcases high sensitivity (93.24%) and reasonable specificity (71.96%), along with good precision (81.48%) and F1 score (86.96%). These findings highlight the effectiveness of the proposed CAD system in accurately segmenting and diagnosing PCa. This study represents a significant advancement in non-invasive methods for early detection and diagnosis of PCa, showcasing the potential of IVIM parameters in combination with machine learning techniques. This developed solution has the potential to revolutionize PCa diagnosis, leading to improved patient outcomes and reduced healthcare costs.

Advances in blood biomarkers for Alzheimer disease (AD): A review.

Alzheimer disease (AD) and Alzheimer Disease and Related Dementias (AD/ADRD) are growing public health challenges globally affecting millions of older adults, necessitating concerted efforts to advance our understanding and management of these conditions. AD is a progressive neurodegenerative disorder characterized pathologically by amyloid plaques and tau neurofibrillary tangles that are the primary cause of dementia in older individuals. Early and accurate diagnosis of AD dementia is crucial for effective intervention and treatment but has proven challenging to accomplish. Although testing for AD brain pathology with cerebrospinal fluid (CSF) or positron emission tomography (PET) has been available for over 2 decades, most patients never underwent this testing because of inaccessibility, high out-of-pocket costs, perceived risks, and the lack of AD-specific treatments. However, in recent years, rapid progress has been made in developing blood biomarkers for AD/ADRD. Consequently, blood biomarkers have emerged as promising tools for non-invasive and cost-effective diagnosis, prognosis, and monitoring of AD progression. This review presents the evolving landscape of blood biomarkers in AD/ADRD and explores their potential applications in clinical practice for early detection, prognosis, and therapeutic interventions. It covers recent advances in blood biomarkers, including amyloid beta (Aβ) peptides, tau protein, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP). It also discusses their diagnostic and prognostic utility while addressing associated challenges and limitations. Future research directions in this rapidly evolving field are also proposed.

Dynamic contrast enhanced ultrasound in differential diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis.

Non-invasive differential diagnosis between hepatocellular carcinoma (HCC) and other liver cancer (i.e. cholangiocarcinoma or metastasis) is highly challenging and definitive diagnosis still relies on histological exam. The patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical features. Dynamic contrast-enhanced ultrasound (DCEUS) with standardized software could help to overcome these obstacles, providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor perfusion. To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver nodules. A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological diagnosis. In accordance with the study protocol, a qualitative and quantitative analysis of the evidence was planned. Rise time was significantly higher in HCC patients with a standardized mean difference (SMD) of 0.83 (95%CI: 0.48-1.18). Similarly, other statistically significant parameters were mean transit time local with a SMD of 0.73 (95%CI: 0.20-1.27), peak enhancement with a SMD of 0.37 (95%CI: 0.03-0.70), area wash-in area under the curve with a SMD of 0.47 (95%CI: 0.13-0.81), wash-out area under the curve with a SMD of 0.55 (95%CI: 0.21-0.89) and wash-in and wash-out area under the curve with SMD of 0.51 (95%CI: 0.17-0.85). SMD resulted not significant in fall time and wash-in rate, but the latter presented a trend towards greater values in HCC compared to intrahepatic cholangiocarcinoma. DCEUS could improve non-invasive diagnosis of HCC, leading to less liver biopsy and early treatment. This quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.

Assessment of Uterine Fibroids in Pre and Post Menopausal Women by Transabdominal Ultrasound

Background: Uterine fibroids are common benign tumors of the uterus, affecting a significant proportion of women, particularly during their reproductive years. These growths can lead to symptoms such as heavy menstrual bleeding, pelvic pain, and reproductive issues, thus impacting women's quality of life. Objective: The objective of this study was to evaluate the prevalence of uterine fibroids in pre- and post-menopausal women and to assess the sensitivity of transabdominal ultrasound in diagnosing these fibroids. Methods: This cross-sectional study was conducted over six months in the Radiology Department of District Headquarter Hospital, Swabi, KP, Pakistan. The study included pre- and post-menopausal women presenting with abnormal vaginal bleeding or diagnosed with symptomatic uterine fibroids, excluding those with known endometrial hyperplasia, adenomyosis, pelvic inflammatory disease, gynecologic malignancies, adnexal pathology, or pregnancy. Transabdominal ultrasound was performed with patients in a supine position and a filled urinary bladder, using both longitudinal and transverse sections. Data were collected on demographic information, clinical presentation, and ultrasound findings, and were analyzed using SPSS version 25. Results: A total of 112 women participated in the study. Among these, 94 (83.9%) reported pelvic pain, while 18 (16.1%) did not. The locations of fibroids identified were anterior (44, 39.3%), fundal (25, 22.3%), and posterior (43, 38.4%). Intramural fibroids were present in 61 (54.5%) patients, submucosal fibroids in 32 (28.5%), and subserosal fibroids in 19 (17.0%). Premenopausal women had a higher prevalence of fibroids (80) compared to postmenopausal women (32). Conclusion: Transabdominal ultrasound is a sensitive and reliable diagnostic tool for detecting uterine fibroids. It should be considered the primary imaging modality for evaluating abnormal uterine bleeding across different age groups, providing accurate and non-invasive diagnosis.

Unlocking the NIR-II AIEgen for High Brightness through Intramolecular Electrostatic Locking.

Fluorescent imaging and biosensing in the near-infrared-II (NIR-II) window holds great promise for non-invasive, radiation-free, and rapid-response clinical diagnosis. However, it's still challenging to develop bright NIR-II fluorophores. In this study, we report a new strategy to enhance the brightness of NIR-II aggregation-induced emission (AIE) fluorophores through intramolecular electrostatic locking. By introducing sulfur atoms into the side chains of the thiophene bridge in TSEH molecule, the molecular motion of the conjugated backbone can be locked through intramolecular interactions between the sulfur and nitrogen atoms. This leads to enhanced NIR-II fluorescent emission of TSEH in both solution and aggregation states. Notably, the encapsulated nanoparticles (NPs) of TSEH show enhanced brightness, which is 2.6-fold higher than TEH NPs with alkyl side chains. The in vivo experiments reveal the feasibility of TSEH NPs in vascular and tumor imaging with a high signal-to-background ratio and precise resection for tiny tumors. In addition, polystyrene nanospheres encapsulated with TSEH are utilized for antigen detection in lateral flow assays, showing a signal-to-noise ratio 1.9-fold higher than the TEH counterpart in detecting low-concentration antigens. This work highlights the potential for developing bright NIR-II fluorophores through intramolecular electrostatic locking and their potential applications in clinical diagnosis and biomedical research.