Resonance Imaging For Early Detection Research Articles

CARDIOMIOPATIA INDUZIDA POR QUIMIOTERAPIA: UMA REVISÃO INTEGRATIVA SOBRE MECANISMOS, DIAGNÓSTICO E TRATAMENTO

Chemotherapy-induced cardiomyopathy is a significant complication associated with the use of chemotherapeutic agents, particularly anthracyclines such as doxorubicin. This condition adversely affects cardiac function and can limit cancer treatment due to the increased risk of cardiac side effects. Studies have shown that doxorubicin and other agents, such as paclitaxel, are effective in cancer treatment but also present a high risk of cardiac toxicity. Mechanisms of cardiotoxicity include oxidative stress, mitochondrial dysfunction, and cellular signaling alterations. Prevention and management of cardiotoxicity have evolved, with the use of cardiac protectors such as dexrazoxane and carvedilol, as well as ACE inhibitors like captopril and enalapril. Clinical guidelines recommend rigorous monitoring of cardiac function using echocardiography and magnetic resonance imaging for early detection of toxicity. This integrative review examines the mechanisms, diagnosis, and treatment options for chemotherapy-induced cardiomyopathy, highlighting the importance of preventive strategies and therapeutic interventions to improve the management of this condition.

The Role of Magnetic Resonance Imaging in Early Detection of Cancer: Present and Prospective Challenges for Future Research

The Role of Magnetic Resonance Imaging in Early Detection of Cancer: Present and Prospective Challenges for Future Research

Role of feature tracking cardiac magnetic resonance imaging in early detection of cardiac dysfunction in β-thalassemia patients recovered from COVID-19: A cross-sectional study.

β-Thalassemia patients may have cardiac complications due to iron overload, which puts them at higher risk of cardiac complications induced by coronavirus disease 2019 (COVID-19) compared with the normal population. The present study aims to evaluate early cardiovascular complications following iron overload in β-thalassemia patients who had early recovery from COVID-19 by cardiac magnetic resonance imaging (MRI) and feature-tracking technique. Thirty-two confirmed COVID-19-recovered β-thalassemia cases were evaluated within 3 weeks to 3 months after a positive reverse-transcriptase polymerase chain reactionCOVID-19 test. Both the heart and liver of all patients were examined using cardiac MRI. We analyzed 32 patients with mean age of 32.84 ± 6.45 years at baseline. Left ventricular global strain values were significantly associated with myocardial T2*. A cut-off value of -15.08% for global longitudinal strain (GLS) with sensitivity and specificity of 90% and 61.1% (p = 0.017), 32.33% for global radial strain (GRS) with sensitivity and specificity of 80% and 94.4% (p = 0.001) and -16.21 for global circumferential strain(GCS), with sensitivity and specificity of 80% and 89.9% (p = 0.013) may indicate cardiac iron overload. GLS, GRS, and GCS were significantly decreased in patients with myocardial T2* <20 ms (iron overload), while no significant change was observed in the right and left ventricular ejection fraction (RV- and LVEF). Cardiac MRI feature-tracking may be helpful in the early detection of cardiac complications resulting from iron overload in β-thalassemia patients who had early recovery from COVID-19.

Role of Cardiovascular Magnetic Resonance Imaging in Early Detection of Myocarditis in Patients Recovered from COVID-19

Objective: To assess cardiac involvement in patients recovered from COVID-19 with no clinical evidence of myocarditis, using various non-invasive parameters including Transthoracic Two-dimensional Speckle Tracking Echocardiography (STE) and cardiac magnetic resonance imaging (CMR). Methods: This prospective study was conducted in the Cardiology Departments of Maadi Military Hospital and Benha University Hospitals. A total of 74 patients were initially enrolled during their hospital stay, but only 50 of them met the inclusion and exclusion criteria. The CMR examination was performed in conjunction with echocardiography, ECG, and laboratory investigations on the same day, which occurred 2-12 weeks after recovering from confirmed COVID-19 infection. Patient scheduling for CMR and other examinations depended on the availability of the CMR machine. Results: According to CMR diagnosis, 23 (46%) patients were diagnosed to have myocarditis by CMR, the patients were categorized into two groups based on these results: normal group (27 patients) &amp; myocarditis group (23 patients). According to GLS, 21 (42%) patients were diagnosed to have myocarditis by STE (diagnosis of Myocarditis with Global longitudinal strain was considered with cut-off point of &gt;-21.33 with Sensitivity of 91.30% and Specificity of 92.59% (P &lt;0.0001). 2D STE showed 87.50% sensitivity, 92.31% specificity and 90.00% accuracy to diagnose myocarditis, while CMR showed a 95.83% sensitivity, 96.15% specificity of and 96.00% accuracy. Conclusion: Myocarditis was found in 46% of asymptomatic COVID-19-recovered patients. CMR is a valuable tool for early myocarditis detection when combined with 2D STE, offering high accuracy. Significant differences were observed between suspected myocarditis patients and those with normal results on both 2D STE and CMR.

Role of orbital magnetic resonance imaging in early detection of graves’ orbitopathy and disease activity

We aim to evaluate feasibility of using orbital diffusion tensor imaging (DTI) magnetic resonance imaging (MRI) of extraocular muscles (EOMs) in patients with Graves’ orbitopathy (GO) versus clinical activity score (CAS) in early detection of GO activity. This case control study was conducted on 20 consecutive patients (10 males, 10 females with a mean age of 35.50±13.65 years) with Graves’ orbitopathy and 10 age- and sex-matched volunteers without any thyroid abnormality as a health control (HC). The patients and HCs underwent DTI MRI of the orbit in the coronal plane. The mean diffusivity (MD) was calculated. Thyroid stimulating hormone receptor antibody (TRAb) was measured using third generation thyroid binding inhibiting immunoglobulin (TBII) with ELISA method. CAS score, according to the standardized criteria of the European Group on Graves Orbitopathy (EUGOGO), was calculated for the patients. GO patients’ EOMs showed significantly higher MD values and higher compared to HCs’ (P &lt; 0.001). Median CAS score was 4. A statistically significant positive correlation was only detected between CAS score and inferior rectus (IR) MD (r=.360, p=.023).

Circulating Cell-Free DNA Combined to Magnetic Resonance Imaging for Early Detection of HCC in Patients with Liver Cirrhosis.

Simple SummaryLiver cirrhosis can develop into malignant disease over time. Frequent monitoring would be advisable to detect the earliest signs of HCC progress resulting in a possible earlier treatment of the patient. Our study showed that the combination of genetic analysis of DNA freely circulating in the blood of the cirrhotic patients with MRI can represent a powerful strategy to timely identify suspect lesions, which can then be followed up more closely and thus potentially be treated earlier. In this way, personalized medicine can be applied to liver diseases such as cirrhosis.Liquid biopsy based on circulating cell-free DNA (cfDNA) is a promising non-invasive tool for the prognosis of hepatocellular cancer (HCC). In this exploratory study we investigated whether cfDNA and gene variants associated with HCC may be found in patients with liver cirrhosis (LC) and thus identify those at an increased risk for HCC. A cohort of 40 LC patients with no suspect neoplastic lesions was included in this study. Next generation sequencing (NGS) of cfDNA isolated from plasma was performed on a panel of 597 selected genes. Images of the patients who underwent MRI with hepatospecific contrast media during the study period were retrospectively re-evaluated (imaging was not part of the prospective study). cfDNA was detected in the plasma of 36 patients with LC. NGS-based analyses identified 20 variants in different combinations. Re-evaluation of the MRI images that were available for a proportion of the patients (n = 27) confirmed the absence of lesions in 8 cases carrying cfDNA without variants. In 6 of 19 patients with identified variants and MRI images available, MRI revealed a precursor lesion compatible with HCC and new lesions were discovered at follow-up in two patients. These precursor lesions were amenable for curative treatments. Mutation analysis revealed selective HCC related gene mutations in a subset of patients with LC, raising the suspect that these patients were at an increased risk for HCC development. MRI findings confirmed suspect nodular lesions of early stage HCC not detected with current standard screening procedures, which were only seen in patients carrying cfDNA variants. This opens a perspective for an HCC screening strategy combining both liquid biopsy and MRI in patients with LC.

MRI ROLE IN CHEMOTHERAPEUTIC INDUCED PRES

Background: Posterior reversible encephalopathy syndrome is a very common neurotoxic side effect of chemotherapeutics. Aim of the work: To display the importance of Magnetic resonance imaging in early detection of the chemotherapeutic induced neurotoxicity. Patients & Methods: Fifty cancer patients (12 females and 38 males), their age ranged from 2 to 61 years on chemotherapy having neurological manifestations. Magnetic resonance imaging wasperformed to evaluate the radiological findings of neurological manifestations. Results: 31 cases were found to have Posterior reversible encephalopathy syndrome, while the others 19 cases showed other complications. Conclusion: MRI showed an important role in detecting PRES in cancer patients due to chemotherapeutics.

P3117Usefulness of cardiac magnetic resonance imaging for early detection of subclinical chemotherapy-related cardiac dysfunction in cancer patients

Abstract Background Long-term prognosis of cancer patients has been improved along with the progress in chemotherapies. However, chemotherapy-related cardiac dysfunction (CTRCD) is emerging as a serious adverse effect as it worsens patients' outcome and quality of life. Thus, early detection of subclinical CTRCD is an important emerging issue in the management of cancer patients. Cardiac magnetic resonance (CMR) utilizes parametric mapping approach and strain analysis to provide detailed information about cardiac tissue and diastolic cardiac function. Purpose We examined whether the novel CMR imaging techniques are useful for early detection of CTRCD. Methods and results We performed both retrospective and prospective studies. (1) Retrospective study: We retrospectively enrolled 52 cancer patients (mean age 55.6±13 yrs., M/F=14/38) who had been treated with anthracyclines. We examined the usefulness of CMR for quantitative assessment of myocardial fibrosis caused by chemotherapies. We found that native T1 value was significantly prolonged in cancer patients compared with healthy controls (N=10) (1,279±56 vs. 1,240±34 msec, P=0.036). (2) Prospective study: A total of 99 consecutive female patients with breast cancer treated with chemotherapies were enrolled in this study from August 2017 to January 2019. To evaluate CTRCD in those patients, we performed CMR (at baseline and/or 6 months) and biomarkers analysis for cardiac troponin T (cTnT) and BNP at baseline and every 3 months during chemotherapies. In the 99 patients, 52 (mean age 53.0±12.7 yrs.) completed cardiac assessment at 6 months, and 6 (12%) developed CTRCD defined as a reduction in left ventricular ejection fraction (LVEF) &gt;10% from baseline and below 53% without symptoms. In patients with CTRCD (CTRCD group, N=6), as compared with those without it (non-CTRCD group, N=46), native T1 value was significantly prolonged after chemotherapies (1,303±32 vs. 1,322±22 msec at 6 months, P=0.03). Plasma cTnT levels at 3 months were also significantly higher in the CTRCD group compared with the non-CTRCD group [0.022 (IQR 0.015–0.026) vs. 0.01 (0.006–0.014) ng/mL, P=0.024], whereas there was no difference in BNP values. In the 52 patients, 28 (mean age 56.3±12.3 yrs.) underwent CMR both before and 6 months after chemotherapies. In those patients, LVEF and global radial strain were significantly decreased at 6 months from baseline (LVEF, from 70.5±4.6 to 66.0±7.1%; global radial strain, from 70.0±22.5 to 61.1±22.6%, respectively, both P&lt;0.05). In patients with elevated cTnT levels at 3 months, as compared with those without it, LVEF and extracellular volume fraction (ECV) at 6 months were significantly worse (LVEF, 59.0±6.0 vs. 62.7±2.6%, P=0.042; ECV, 32.3±2.9 vs. 30.2±2.3%, P=0.049, respectively). Conclusions These results indicate that novel CMR imaging techniques are useful for early detection of CTRCD among cancer patients treated with chemotherapies.

Diffusion-Weighted Magnetic Resonance Imaging for Early Detection of Chemotherapy Resistance in Non-Small Cell Lung Cancer.

BackgroundThe aim of this study was to examine the role of magnetic resonance imaging-diffusion weighted imaging (MRI-DWI) in the early detection of chemotherapy resistance in non-small cell lung cancer (NSCLC) patients.Material/MethodsMRI-DWI and computed tomography (CT) were carried out in 75 patients with newly diagnostic NSCLC before and after first, second, fourth, and sixth cycles of chemotherapy. Resistance to chemotherapy was assessed based on the change in the largest tumor diameter after chemotherapy. Diffusion of water molecule in each lesion was quantitatively measured by apparent diffusion coefficient (ADC). The diagnostic results of DWI after first and second cycle of chemotherapy were analyzed by the area under receiver operating characteristics curve (ROC).ResultsAmong the patients, 43 patients were chemo-resistance while 32 patients were chemo-sensitive. The ADC changing rate between second and first cycle of chemotherapy was significantly higher in chemo-sensitive patients compared with chemo-resistance patients (t=3.236, P=0.002). The ROC showed cutoff values of the ADC changing rate after first and second cycles of chemotherapy for resistance/sensitive discrimination were 23.6% and 5.56%, respectively. DWI after first and second cycles of therapy showed sensitivities of 55.8% and 55.8%, specificities of 65.6% and 87.5%, and area under ROC of 0.568 and 0.733, respectively.ConclusionsADC changing rate between first and second cycles of chemotherapy could sensitively distinguish chemo-sensitive and chemo-resistant tumors at earlier stages, which may direct treatment adjustment and improve the prognosis of patients.

The role of magnetic resonance imaging in early detection of recurrent breast cancer

PurposeThe purpose of this work was the evaluation of new advances of magnetic resonance imaging (MRI) in diagnosis of recurrent breast cancer after conservative surgery, chemotherapy and radiotherapy. IntroductionBreast conservation surgery followed by breast radiotherapy and chemotherapy produces changes on both physical examination and on post-treatment breast imaging. Distinguishing these normal treatment-related findings from breast cancer recurrence in the original lumpectomy site or elsewhere in the breast (new primary tumors) is challenging.Our prospective study is done on fifty female patients who had undergone breast-conserving therapy at least 6months since the end of radiation therapy. All cases were suspected for either recurrence or post-operative complications by clinical examination in conjunction with mammography and/or US. Confirmation of different lesions was achieved by fine needle aspiration biopsy, core or excisional biopsy. All patients were examined by dynamic contrast enhanced MRI (DCE-MRI). If one of imaging modalities suspected recurrence, all of the imaging modalities were performed.From our study we concluded that MRI is useful examination that can provide very valuable information in patient with suspected recurrence. It is a technique that offers not only information on lesion cross sectional morphology but also on functional lesion features such as tissue perfusion and enhancement kinetics.

Role of multiparametric magnetic resonance imaging in early detection of prostate cancer.

Most prostate cancers (PC) are currently found on the basis of an elevated PSA, although this biomarker has only moderate accuracy. Histological confirmation is traditionally obtained by random transrectal ultrasound guided biopsy, but this approach may underestimate PC. It is generally accepted that a clinically significant PC requires treatment, but in case of an non-significant PC, deferment of treatment and inclusion in an active surveillance program is a valid option. The implementation of multiparametric magnetic resonance imaging (mpMRI) into a screening program may reduce the risk of overdetection of non-significant PC and improve the early detection of clinically significant PC. A mpMRI consists of T2-weighted images supplemented with diffusion-weighted imaging, dynamic contrast enhanced imaging, and/or magnetic resonance spectroscopic imaging and is preferably performed and reported according to the uniform quality standards of the Prostate Imaging Reporting and Data System (PIRADS). International guidelines currently recommend mpMRI in patients with persistently rising PSA and previous negative biopsies, but mpMRI may also be used before first biopsy to improve the biopsy yield by targeting suspicious lesions or to assist in the selection of low-risk patients in whom consideration could be given for surveillance.Teaching Points• MpMRI may be used to detect or exclude significant prostate cancer.• MpMRI can guide targeted rebiopsy in patients with previous negative biopsies.• In patients with negative mpMRI consideration could be given for surveillance.• MpMRI may add valuable information for the optimal treatment selection.

Current roles of endoscopy in the management of intraductal papillary mucinous neoplasm of the pancreas.

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is characterized by intraductal papillary proliferation of mucin‐producing epithelial cells that exhibit various degrees of dysplasia. IPMN is classified into four histological subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) according to its histomorphological and immunohistochemical characteristics. Endoscopic retrograde cholangiopancreatography plays a crucial role in the evaluation of these features of IPMN. Endoscopic ultrasonography (EUS) has proven to be more sensitive than computed tomography or magnetic resonance imaging for early detection of malignancy. The present review addresses the current roles of endoscopy and related techniques in the management of IPMN. The particular focus is on diagnosing IPMN and malignancy within IPMN, detecting pancreatic cancer concomitant with IPMN, differentiating the epithelial subtypes of IPMN, determining the optimal strategy for the management of branch duct IPMN, and discussing innovative endoscopic technology related to IPMN. The disadvantages of endoscopic examinations of IPMN and different attitudes toward EUS‐guided fine‐needle aspiration for IPMN between Japan (negative) and other countries (active) are also discussed.

Musculoskeletal Ultrasonography and Magnetic Resonance Imaging in Early Detection of Inflammatory Arthropathy in Patients with Systemic Sclerosis

Musculoskeletal Ultrasonography and Magnetic Resonance Imaging in Early Detection of Inflammatory Arthropathy in Patients with Systemic Sclerosis

Manganese-enhanced magnetic resonance imaging for early detection and characterization of breast cancers.

Very early cancer detection is the key to improving cure. Our objective was to investigate manganese (Mn)-enhanced magnetic resonance imaging (MRI) for very early detection and characterization of breast cancers. Eighteen NOD scid gamma mice were inoculated with MCF7, MDA, and LM2 breast cancer cells and imaged periodically on a 3 T scanner beginning on day 6. T1-weighted imaging and T1 measurements were performed before and 24 hours after administering MnCl2. At the last imaging session, Gd-DTPA was administered and tumors were excised for histology (hematoxylin-eosin and CD34 staining). All mice, except for two inoculated with MCF7 cells, developed tumors. Tumors enhanced uniformly on Mn and showed clear borders. Early small tumors (≤ 5 mm3) demonstrated the greatest enhancement with a relative R1 (1/T1) change of 1.57 ± 0.13. R1 increases correlated with tumor size (r = -.34, p = .04). Differences in R1 increases among the three tumor subtypes were most evident in early tumors. Histology confirmed uniform cancer cell distribution within tumor masses and vasculature in the periphery, which was consistent with rim-like enhancement on Gd-DTPA. Mn-enhanced MRI is a promising approach for detecting very small breast cancers in vivo and may be valuable for very early cancer detection.

Noninvasive Manganese-Enhanced Magnetic Resonance Imaging for Early Detection of Breast Cancer Metastatic Potential

Cancer cells with a high metastatic potential will more likely escape and form distant tumors. Once the cancer has spread, a cure is rarely possible. Unfortunately, metastasis often proceeds unnoticed until a secondary tumor has formed. The culprit is that current imaging-based cancer screening and diagnosis are limited to assessing gross physical changes, not the earliest cellular changes that drive cancer progression. The purpose of this study is to develop a novel noninvasive magnetic resonance (MR) cellular imaging capability for characterizing the metastatic potential of breast cancer and enable early cancer detection. This MR method relies on imaging cell uptake of manganese, an endogenous calcium analogue and an MR contrast agent, to detect aggressive cancer cells. Studies on normal breast epithelial cells and three breast cancer cell lines, from nonmetastatic to highly metastatic, demonstrated that aggressive cancer cells appeared significantly brighter on MR as a result of altered cell uptake of manganese. In vivo results in nude rats showed that aggressive tumors that are otherwise unseen on conventional gadolinium-enhanced MR imaging are detected after manganese injection. This cellular MR imaging technology brings a critically needed, unique dimension to cancer imaging by enabling us to identify and characterize metastatic cancer cells at their earliest appearance.

Evaluation of osteochondral sample collection guided by computed tomography and magnetic resonance imaging for early detection of osteoarthritis in centrodistal joints of young Icelandic horses

To evaluate the use of CT and MRI for guidance of osteochondral sample collection for histologic detection of early osteoarthritic lesions in centrodistal (distal intertarsal) joints of horses. Right tarsal joints from the cadavers of 24 Icelandic horses aged 29 to 31 months. CT and MRI were used to evaluate the extent of suspected osteoarthritic changes in centrodistal joints, which were graded with a semiquantitative system. The anatomic regions with the highest grade of change were identified, and osteochondral samples were obtained from these regions. Samples were also obtained from the same centrodistal joints at predetermined sites. Histologic examination of all samples was performed, with samples classified as negative or positive for osteoarthritis, and results were compared between sample collection methods. Histologic examination revealed osteoarthritic lesions in 29% (7/24) of centrodistal joints with the predetermined method and in 63% (15/24) with the image-guided method. Significant associations were identified between histologic osteoarthritis detection and the summed image-guided sample collection site image grades, central osteophytes, articular cartilage thickness abnormalities, grade 2 articular mineralization front defects, and grade 2 marginal osteophytes. CT and MRI aided the detection of focal changes suggestive of early-stage osteoarthritis in the centrodistal joints of equine cadavers and may be useful for detection of similar disease in live horses. The first morphological changes of centrodistal joint osteoarthritis were suspected to be in the articular cartilage and the articular mineralization front regions.

Magnetic resonance imaging in early detection and treatment of rheumatoid arthritis

Magnetic resonance imaging in early detection and treatment of rheumatoid arthritis

Magnetic resonance imaging in early detection of rheumatoid arthritis.

Magnetic resonance imaging (MRI) is the modality of choice in early diagnosis and management of rheumatoid arthritis (RA). The pathologic processes in RA involve synovitis, joint effusion, proliferation of fibrovascular connective tissue, and the formation of pannus. Other imaging techniques available for imaging of RA include ultrasound, scintigraphy, computed tomography, and plain radiography (PR). MRI provides high sensitivity in detecting inflammatory changes in the joints. Several studies report high intra- and interobserver reliability and low variation for MRI. MRI allows detection and, in some cases, quantification of synovial changes. Dynamic MRI is a new technique that utilizes rate of synovial enhancement in evaluation of inflammatory changes. MRI allows visualization of erosions in three orthogonal planes. MRI has been shown in many studies to have much greater sensitivity than PR in detecting erosions. Use of a contrast agent further increases the sensitivity in detecting erosions and differentiates and outlines synovial proliferation from fluid collection. Other manifestations of RA such as intraosseous cysts, tenosynovitis, bone marrow edema, and carpal tunnel syndrome can also be visualized on magnetic resonance images. Advances in MRI include contrast-enhancement, dynamic, and quantitative techniques. MRI assists in the early detection of RA, which allows earlier initiation of treatment with disease-modifying therapies.

Neurofibromatose 1 : recommandations de prise en charge

Twenty experts, members of a French medical network devoted to neurofibromatosis 1 have elaborated recommendations for the management of the disease. Bibliography was obtained through a Medline of articles from 1966 to 1999 for the terms neurofibromatosis, NF1, neurofibroma and from textbooks. A consensual document was written taking into account extracted data. An annual careful clinical examination is recommended except in cases with complications. Screening investigations are not recommended due to the rarity of complications, generally symptomatic and easily detected during the clinical follow-up. The only controversial exception might be magnetic resonance imaging for early detection of optic pathway gliomas in young children. A co-ordinated follow-up in specialised multidisciplinary centres, providing patients with a rational management, is recommended.

Isolated Candida albicans Arthritis In a Non-Intravenous Drug-Abusing Patient With Acquired Immune Deficiency Syndrome

We describe a case of isolated Candida albicans arthritis in a non-intravenous drug-abusing, human immunodeficiency virus positive patient. This presentation is extremely unusual without other systemic features or risk factors for candidemia, as Candida septic arthritis normally reflects disseminated infection. In terms of diagnosis, this case also highlights the potential utility of magnetic resonance imaging for early detection of osteomyelitis.