Diagnostics

13 pages, 1875 KiB

Open AccessArticle

Inhaled Xenon Washout as a Biomarker of Alzheimer’s Disease

by Francis T. Hane, Tao Li, Jennifer-Anne Plata, Ayman Hassan, Karl Granberg and Mitchell S. Albert

Diagnostics 2018, 8(2), 41; https://doi.org/10.3390/diagnostics8020041 - 6 Jun 2018

Cited by 15 | Viewed by 6668

Abstract

Biomarkers have the potential to aid in the study of Alzheimer’s disease (AD); unfortunately, AD biomarker values often have a high degree of overlap between healthy and AD individuals. This study investigates the potential utility of a series of novel AD biomarkers, the [...] Read more.

Biomarkers have the potential to aid in the study of Alzheimer’s disease (AD); unfortunately, AD biomarker values often have a high degree of overlap between healthy and AD individuals. This study investigates the potential utility of a series of novel AD biomarkers, the sixty second ¹²⁹Xe retention time, and the xenon washout parameter, based on the washout of hyperpolarized ¹²⁹Xe from the brain of AD participants following inhalation. The xenon washout parameter is influenced by cerebral perfusion, T1 relaxation of xenon, and the xenon partition coefficient, all factors influenced by AD. Participants with AD (n = 4) and healthy volunteers (n = 4) were imaged using hyperpolarized ¹²⁹Xe magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) to determine the amount of retained xenon in the brain. At 60 s after the breath hold, AD patients retained significantly higher amounts of ¹²⁹Xe compared to healthy controls. Data was fit to a pharmacokinetic model and the xenon washout parameter was extracted. Xenon washout in white and grey matter occurs at a slower rate in Alzheimer’s participants (¹²⁹Xe half-life time of 42 s and 43 s, respectively) relative to controls (20 s and 16 s, respectively). Following larger scale clinical trials for validation, the xenon washout parameter has the potential to become a useful biomarker for the support of AD diagnosis. Full article

(This article belongs to the Special Issue Alzheimer's Disease Imaging Biomarkers)

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38 pages, 1638 KiB

Open AccessReview

Open-Ended Coaxial Probe Technique for Dielectric Measurement of Biological Tissues: Challenges and Common Practices

by Alessandra La Gioia, Emily Porter, Ilja Merunka, Atif Shahzad, Saqib Salahuddin, Marggie Jones and Martin O’Halloran

Diagnostics 2018, 8(2), 40; https://doi.org/10.3390/diagnostics8020040 - 5 Jun 2018

Cited by 237 | Viewed by 15884

Abstract

Electromagnetic (EM) medical technologies are rapidly expanding worldwide for both diagnostics and therapeutics. As these technologies are low-cost and minimally invasive, they have been the focus of significant research efforts in recent years. Such technologies are often based on the assumption that there [...] Read more.

Electromagnetic (EM) medical technologies are rapidly expanding worldwide for both diagnostics and therapeutics. As these technologies are low-cost and minimally invasive, they have been the focus of significant research efforts in recent years. Such technologies are often based on the assumption that there is a contrast in the dielectric properties of different tissue types or that the properties of particular tissues fall within a defined range. Thus, accurate knowledge of the dielectric properties of biological tissues is fundamental to EM medical technologies. Over the past decades, numerous studies were conducted to expand the dielectric repository of biological tissues. However, dielectric data is not yet available for every tissue type and at every temperature and frequency. For this reason, dielectric measurements may be performed by researchers who are not specialists in the acquisition of tissue dielectric properties. To this end, this paper reviews the tissue dielectric measurement process performed with an open-ended coaxial probe. Given the high number of factors, including equipment- and tissue-related confounders, that can increase the measurement uncertainty or introduce errors into the tissue dielectric data, this work discusses each step of the coaxial probe measurement procedure, highlighting common practices, challenges, and techniques for controlling and compensating for confounders. Full article

(This article belongs to the Special Issue Electromagnetic Technologies for Medical Diagnostics: Fundamental Issues, Clinical Applications and Perspectives)

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Graphical abstract

18 pages, 2189 KiB

Open AccessReview

Developments in Point-of-Care Diagnostic Technology for Cancer Detection

by Bryony Hayes, Caroline Murphy, Aoife Crawley and Richard O’Kennedy

Diagnostics 2018, 8(2), 39; https://doi.org/10.3390/diagnostics8020039 - 2 Jun 2018

Cited by 90 | Viewed by 10866

Abstract

Cancer is the cause of death for one in seven individuals worldwide. It is widely acknowledged that screening and early diagnosis are of vital importance for improving the likelihood of recovery. However, given the costly, time-consuming, and invasive nature of the many methods [...] Read more.

Cancer is the cause of death for one in seven individuals worldwide. It is widely acknowledged that screening and early diagnosis are of vital importance for improving the likelihood of recovery. However, given the costly, time-consuming, and invasive nature of the many methods currently in use, patients often do not take advantage of the services available to them. Consequently, many researchers are exploring the possibility of developing fast, reliable, and non-invasive diagnostic tools that can be used directly or by local physicians at the point-of-care. Herein, we look at the use of established biomarkers in cancer therapy and investigate emerging biomarkers exhibiting future potential. The incorporation of these biomarkers into point-of-care devices could potentially reduce the strain currently experienced by screening programs in hospitals and healthcare systems. Results derived from point-of-care tests should be accurate, sensitive, and generated rapidly to assist in the selection of the best course of treatment for optimal patient care. Essentially, point-of-care diagnostics should enhance the well-being of patients and lead to a reduction in cancer-related deaths. Full article

(This article belongs to the Special Issue Novel Point-of-Care Technologies in Diagnostics 2018)

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1 pages, 130 KiB

Open AccessReply

Response to Comment on Thigpen D. et al. The Role of Ultrasound in Screening Dense Breasts—A Review of the Literature and Practical Solutions for Implementation. Diagnostics 2018, 8, 20

by Denise Thigpen, Amanda Kappler and Rachel Brem

Diagnostics 2018, 8(2), 38; https://doi.org/10.3390/diagnostics8020038 - 24 May 2018

Cited by 11 | Viewed by 4480

Abstract

Thank you for your thoughtful comments regarding breast density legislation[...] Full article

(This article belongs to the Special Issue Breast Imaging)

2 pages, 182 KiB

Open AccessComment

Comment on Thigpen D. et al. The Role of Ultrasound in Screening Dense Breasts—A Review of the Literature and Practical Solutions for Implementation. Diagnostics 2018, 8, 20

by Wendie A. Berg and JoAnn Pushkin

Diagnostics 2018, 8(2), 37; https://doi.org/10.3390/diagnostics8020037 - 24 May 2018

Viewed by 4417

Abstract

We read with interest the article by Thigpen et al. [1]. With 34 states now having some form of density inform legislation[...] Full article

(This article belongs to the Special Issue Breast Imaging)

22 pages, 767 KiB

Open AccessArticle

Diagnosing Breast Cancer with Microwave Technology: Remaining Challenges and Potential Solutions with Machine Learning

by Bárbara L. Oliveira, Daniela Godinho, Martin O’Halloran, Martin Glavin, Edward Jones and Raquel C. Conceição

Diagnostics 2018, 8(2), 36; https://doi.org/10.3390/diagnostics8020036 - 19 May 2018

Cited by 27 | Viewed by 6616

Abstract

Currently, breast cancer often requires invasive biopsies for diagnosis, motivating researchers to design and develop non-invasive and automated diagnosis systems. Recent microwave breast imaging studies have shown how backscattered signals carry relevant information about the shape of a tumour, and tumour shape is [...] Read more.

Currently, breast cancer often requires invasive biopsies for diagnosis, motivating researchers to design and develop non-invasive and automated diagnosis systems. Recent microwave breast imaging studies have shown how backscattered signals carry relevant information about the shape of a tumour, and tumour shape is often used with current imaging modalities to assess malignancy. This paper presents a comprehensive analysis of microwave breast diagnosis systems which use machine learning to learn characteristics of benign and malignant tumours. The state-of-the-art, the main challenges still to overcome and potential solutions are outlined. Specifically, this work investigates the benefit of signal pre-processing on diagnostic performance, and proposes a new set of extracted features that capture the tumour shape information embedded in a signal. This work also investigates if a relationship exists between the antenna topology in a microwave system and diagnostic performance. Finally, a careful machine learning validation methodology is implemented to guarantee the robustness of the results and the accuracy of performance evaluation. Full article

(This article belongs to the Special Issue Electromagnetic Technologies for Medical Diagnostics: Fundamental Issues, Clinical Applications and Perspectives)

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3 pages, 156 KiB

Open AccessEditorial

The Art of Caring in the Treatment of Thoracic Outlet Syndrome

by Julie Ann Freischlag

Diagnostics 2018, 8(2), 35; https://doi.org/10.3390/diagnostics8020035 - 19 May 2018

Cited by 6 | Viewed by 5369

Abstract

Those who diagnose and treat patients with thoracic outlet syndrome, especially those patients
with neurogenic thoracic outlet syndrome, have a practice, which needs to include many modalities to
diagnose, treat, and intervene to improve their quality of life for the present and for [...] Read more.

Those who diagnose and treat patients with thoracic outlet syndrome, especially those patients
with neurogenic thoracic outlet syndrome, have a practice, which needs to include many modalities to
diagnose, treat, and intervene to improve their quality of life for the present and for the future.[...] Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Thoracic Outlet Syndrome)

10 pages, 681 KiB

Open AccessCommentary

Dutch Health Council Advisory Report on Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: Taking the Wrong Turn

by Frank Twisk

Diagnostics 2018, 8(2), 34; https://doi.org/10.3390/diagnostics8020034 - 16 May 2018

Cited by 4 | Viewed by 17084

Abstract

Recently, the Dutch Health Council published their advisory report on Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) which is meant to determine the medical policy with regard to ME in the Netherlands. The Health Council briefly discusses several diagnostic criteria and proposes to use [...] Read more.

Recently, the Dutch Health Council published their advisory report on Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) which is meant to determine the medical policy with regard to ME in the Netherlands. The Health Council briefly discusses several diagnostic criteria and proposes to use new diagnostic criteria for “ME/CFS” in research and clinical practice in the future. The advisory report then summarizes organic abnormalities observed in the last decades and concludes that “ME/CFS” is a “serious, chronic, multisystem disease”. According to the Health Council there are no curative treatments for “ME/CFS”, due to lack of knowledge, but specific medication could bring symptomatic relief. The Health Council recommends conducting more research, to (re)educate medical professionals about “ME/CFS”, to appoint three academic expertise centres, which will install a care network for patients, and to fairly judge the limitations (disability) of patients when they apply for a disability income, medical aid and care. The advisory report was welcomed by many patients, because it puts an end to the dominance of the (bio)psychosocial explanatory model and seems to offer a perspective of improving the situation of patients. However, the starting point of the advisory report, a new definition of “ME/CFS”, will have serious (long-lasting) consequences for patients and researchers. Full article

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Graphical abstract

12 pages, 1241 KiB

Open AccessArticle

Angiogenesis PET Tracer Uptake (⁶⁸Ga-NODAGA-E[(cRGDyK)]₂) in Induced Myocardial Infarction and Stromal Cell Treatment in Minipigs

by Thomas Rasmussen, Bjarke Follin, Jens Kastrup, Malene Brandt-Larsen, Jacob Madsen, Thomas Emil Christensen, Morten Juhl, Smadar Cohen, Karsten Pharao Hammelev, Christian Holdflod Møller, Jens Peter Goetze, Philip Hasbak and Andreas Kjær

Diagnostics 2018, 8(2), 33; https://doi.org/10.3390/diagnostics8020033 - 16 May 2018

Cited by 11 | Viewed by 5722

Abstract

Angiogenesis is considered integral to the reparative process after ischemic injury. The α_vβ₃ integrin is a critical modulator of angiogenesis and highly expressed in activated endothelial cells. ⁶⁸Ga-NODAGA-E[(cRGDyK)]₂ (RGD) is a positron-emission-tomography (PET) ligand targeted towards α_v [...] Read more.

Angiogenesis is considered integral to the reparative process after ischemic injury. The α_vβ₃ integrin is a critical modulator of angiogenesis and highly expressed in activated endothelial cells. ⁶⁸Ga-NODAGA-E[(cRGDyK)]₂ (RGD) is a positron-emission-tomography (PET) ligand targeted towards α_vβ₃ integrin. The aim was to present data for the uptake of RGD and correlate it with histology and to further illustrate the differences in angiogenesis due to porcine adipose-derived mesenchymal stromal cell (pASC) or saline treatment in minipigs after induction of myocardial infarction (MI). Three minipigs were treated with direct intra-myocardial injection of pASCs and two minipigs with saline. MI was confirmed by ⁸²Rubidium (⁸²Rb) dipyridamole stress PET. Mean Standardized Uptake Values (SUV_mean) of RGD were higher in the infarct compared to non-infarct area one week and one month after MI in both pASC-treated (SUV_mean: 1.23 vs. 0.88 and 1.02 vs. 0.86, p < 0.05 for both) and non-pASC-treated minipigs (SUV_mean: 1.44 vs. 1.07 and 1.26 vs. 1.04, p < 0.05 for both). However, there was no difference in RGD uptake, ejection fractions, coronary flow reserves or capillary density in histology between the two groups. In summary, indications of angiogenesis were present in the infarcted myocardium. However, no differences between pASC-treated and non-pASC-treated minipigs could be demonstrated. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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11 pages, 675 KiB

Open AccessReview

The Clinical Relevance of Methods for Handling Inconclusive Medical Test Results: Quantification of Uncertainty in Medical Decision-Making and Screening

by Johannes A. Landsheer

Diagnostics 2018, 8(2), 32; https://doi.org/10.3390/diagnostics8020032 - 9 May 2018

Cited by 20 | Viewed by 7409

Abstract

Background: although the existence of inconclusive medical test results or bio-markers is widely recognized, there are indications that this inherent diagnostic uncertainty is sometimes ignored. This paper discusses three methods for defining and determining inconclusive medical test results, which use different definitions and [...] Read more.

Background: although the existence of inconclusive medical test results or bio-markers is widely recognized, there are indications that this inherent diagnostic uncertainty is sometimes ignored. This paper discusses three methods for defining and determining inconclusive medical test results, which use different definitions and differ in clinical relevance. Methods: the TG-ROC (two graphs receiver operating characteristics) method is the easiest to use, while the grey zone method and the uncertain interval method require more extensive calculations. Results: this paper discusses the technical details of the methods, as well as advantages and disadvantages for their clinical use. TG-ROC and the grey zone method can help in the acquisition of high rates of diagnostic certainty, but can exclude large groups. The uncertain interval method can prevent decisions that are the most uncertain, invalid and unreliable, while excluding smaller groups. Conclusions: the identification of uncertain test scores is relevant, because these scores indicate the need to obtain better information or to await further developments. The methods presented help to determine inconclusive test scores and can help to reduce erroneous decisions. However, further research and development is desirable. Full article

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18 pages, 270 KiB

Open AccessReview

Cancer Diagnosis Using a Liquid Biopsy: Challenges and Expectations

by Francesc Castro-Giner, Sofia Gkountela, Cinzia Donato, Ilaria Alborelli, Luca Quagliata, Charlotte K. Y. Ng, Salvatore Piscuoglio and Nicola Aceto

Diagnostics 2018, 8(2), 31; https://doi.org/10.3390/diagnostics8020031 - 9 May 2018

Cited by 104 | Viewed by 14249

Abstract

The field of cancer diagnostics has recently been impacted by new and exciting developments in the area of liquid biopsy. A liquid biopsy is a minimally invasive alternative to surgical biopsies of solid tissues, typically achieved through the withdrawal of a blood sample [...] Read more.

The field of cancer diagnostics has recently been impacted by new and exciting developments in the area of liquid biopsy. A liquid biopsy is a minimally invasive alternative to surgical biopsies of solid tissues, typically achieved through the withdrawal of a blood sample or other body fluids, allowing the interrogation of tumor-derived material including circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) fragments that are present at a given time point. In this short review, we discuss a few studies that summarize the state-of-the-art in the liquid biopsy field from a diagnostic perspective, and speculate on current challenges and expectations of implementing liquid biopsy testing for cancer diagnosis and monitoring in the clinical setting. Full article

(This article belongs to the Special Issue Circulating Tumor Cells as Cancer Diagnostic Biomarkers)

19 pages, 3111 KiB

Open AccessReview

Circulating Tumor Cell Analysis in Preclinical Mouse Models of Metastasis

by Jenna Kitz, Lori E. Lowes, David Goodale and Alison L. Allan

Diagnostics 2018, 8(2), 30; https://doi.org/10.3390/diagnostics8020030 - 28 Apr 2018

Cited by 21 | Viewed by 12409

Abstract

The majority of cancer deaths occur because of metastasis since current therapies are largely non-curative in the metastatic setting. The use of in vivo preclinical mouse models for assessing metastasis is, therefore, critical for developing effective new cancer biomarkers and therapies. Although a [...] Read more.

The majority of cancer deaths occur because of metastasis since current therapies are largely non-curative in the metastatic setting. The use of in vivo preclinical mouse models for assessing metastasis is, therefore, critical for developing effective new cancer biomarkers and therapies. Although a number of quantitative tools have been previously developed to study in vivo metastasis, the detection and quantification of rare metastatic events has remained challenging. This review will discuss the use of circulating tumor cell (CTC) analysis as an effective means of tracking and characterizing metastatic disease progression in preclinical mouse models of breast and prostate cancer and the resulting lessons learned about CTC and metastasis biology. We will also discuss how the use of clinically-relevant CTC technologies such as the CellSearch^® and Parsortix™ platforms for preclinical CTC studies can serve to enhance the study of cancer biology, new biomarkers, and novel therapies from the bench to the bedside. Full article

(This article belongs to the Special Issue Circulating Tumor Cells as Cancer Diagnostic Biomarkers)

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16 pages, 1140 KiB

Open AccessReview

Sialidosis: A Review of Morphology and Molecular Biology of a Rare Pediatric Disorder

by Aiza Khan and Consolato Sergi

Diagnostics 2018, 8(2), 29; https://doi.org/10.3390/diagnostics8020029 - 25 Apr 2018

Cited by 51 | Viewed by 10999

Abstract

Sialidosis (MIM 256550) is a rare, autosomal recessive inherited disorder, caused by α-N-acetyl neuraminidase deficiency resulting from a mutation in the neuraminidase gene (NEU1), located on 6p21.33. This genetic alteration leads to abnormal intracellular accumulation as well as urinary [...] Read more.

Sialidosis (MIM 256550) is a rare, autosomal recessive inherited disorder, caused by α-N-acetyl neuraminidase deficiency resulting from a mutation in the neuraminidase gene (NEU1), located on 6p21.33. This genetic alteration leads to abnormal intracellular accumulation as well as urinary excretion of sialyloligosaccharides. A definitive diagnosis is made after the identification of a mutation in the NEU1 gene. So far, 40 mutations of NEU1 have been reported. An association exists between the impact of the individual mutations and the severity of clinical presentation of sialidosis. According to the clinical symptoms, sialidosis has been divided into two subtypes with different ages of onset and severity, including sialidosis type I (normomorphic or mild form) and sialidosis type II (dysmorphic or severe form). Sialidosis II is further subdivided into (i) congenital; (ii) infantile; and (iii) juvenile. Despite being uncommon, sialidosis has enormous clinical relevance due to its debilitating character. A complete understanding of the underlying pathology remains a challenge, which in turn limits the development of effective therapeutic strategies. Furthermore, in the last few years, some atypical cases of sialidosis have been reported as well. We herein attempt to combine and discuss the underlying molecular biology, the clinical features, and the morphological patterns of sialidosis type I and II. Full article

(This article belongs to the Special Issue Diagnosis and Management of Pediatric Diseases)

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11 pages, 1293 KiB

Open AccessReview

Fine Needle Aspiration Cytology for Neck Masses in Childhood. An Illustrative Approach

by Consolato Sergi, Aneesh Dhiman and Jo-Ann Gray

Diagnostics 2018, 8(2), 28; https://doi.org/10.3390/diagnostics8020028 - 22 Apr 2018

Cited by 14 | Viewed by 13383

Abstract

The primary indication of fine-needle aspiration cytology of the head and neck region is a thyroid nodule or a mass located in the cervical area or the head. Although a thyroid nodule may raise the suspicion of malignancy, less than one in 20 [...] Read more.

The primary indication of fine-needle aspiration cytology of the head and neck region is a thyroid nodule or a mass located in the cervical area or the head. Although a thyroid nodule may raise the suspicion of malignancy, less than one in 20 cases results in a carcinoma. In addition, the list of differential diagnoses is quite different according to the age of the patient. A number of benign lesions, such as branchial cysts, sialadenosis, and sialoadenitis are often seen in childhood and youth. The malignant lesions that are on the top of the list of a pediatric mass of the head and neck (H&N) region include rhabdomyosarcoma, neuroblastoma, and papillary carcinoma of the thyroid gland. This critical review of the diagnostic features of a pediatric mass of the H&N region is accompanied by panels of several cytology features that may be of help to the cytopathologist and clinician. Full article

(This article belongs to the Special Issue Diagnosis and Management of Pediatric Diseases)

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4 pages, 1295 KiB

Open AccessInteresting Images

Concomitant Polymyalgia Rheumatica and Large-Vessel Vasculitis Visualized on ¹⁸F-FDG PET/CT

by Jane Maestri Brittain, Lars Christian Gormsen, Eric Von Benzon and Kim Francis Andersen

Diagnostics 2018, 8(2), 27; https://doi.org/10.3390/diagnostics8020027 - 22 Apr 2018

Cited by 5 | Viewed by 6974

Abstract

Polymyalgia rheumatica (PMR) and large-vessel vasculitis (LVV) are related rheumatic diseases which are occasionally present concomitantly. PMR is characterized by synovitis and bursitis. In LVV, inflammation of the blood vessel wall is seen. Both disorders can be difficult to diagnose since patients often [...] Read more.

Polymyalgia rheumatica (PMR) and large-vessel vasculitis (LVV) are related rheumatic diseases which are occasionally present concomitantly. PMR is characterized by synovitis and bursitis. In LVV, inflammation of the blood vessel wall is seen. Both disorders can be difficult to diagnose since patients often present non-specific symptoms and results of blood tests. The non-specific symptoms cannot always be distinguished from symptoms indicating an occult malignancy. We present a case of PMR and LVV in a Scandinavian man visualized on [¹⁸F]-2-deoxy-D-glucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) with the presentation of typically affected sites of joints and arteries and with the same imaging modality ruling out occult malignancy. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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13 pages, 1591 KiB

Open AccessReview

Aneuploid CTC and CEC

by Peter Ping Lin

Diagnostics 2018, 8(2), 26; https://doi.org/10.3390/diagnostics8020026 - 18 Apr 2018

Cited by 34 | Viewed by 9004

Abstract

Conventional circulating tumor cell (CTC) detection technologies are restricted to large tumor cells (> white blood cells (WBCs)), or those unique carcinoma cells with double positive expression of surface epithelial cell adhesion molecule (EpCAM) for isolation, and intracellular structural protein cytokeratins (CKs) for [...] Read more.

Conventional circulating tumor cell (CTC) detection technologies are restricted to large tumor cells (> white blood cells (WBCs)), or those unique carcinoma cells with double positive expression of surface epithelial cell adhesion molecule (EpCAM) for isolation, and intracellular structural protein cytokeratins (CKs) for identification. With respect to detecting the full spectrum of highly heterogeneous circulating rare cells (CRCs), including CTCs and circulating endothelial cells (CECs), it is imperative to develop a strategy systematically coordinating all tri-elements of nucleic acids, biomarker proteins, and cellular morphology, to effectively enrich and comprehensively identify CRCs. Accordingly, a novel strategy integrating subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH), independent of cell size variation and free of hypotonic damage as well as anti-EpCAM perturbing, has been demonstrated to enable in situ phenotyping multi-protein expression, karyotyping chromosome aneuploidy, and detecting cytogenetic rearrangements of the ALK gene in non-hematologic CRCs. Symbolic non-synonymous single nucleotide variants (SNVs) of both the TP53 gene (P33R) in each single aneuploid CTCs, and the cyclin-dependent kinase inhibitor 2A (CDKN2A) tumor suppressor gene in each examined aneuploid CECs, were identified for the first time across patients with diverse carcinomas. Comprehensive co-detecting observable aneuploid CTCs and CECs by SE-iFISH, along with applicable genomic and/or proteomic single cell molecular profiling, are anticipated to facilitate elucidating how those disparate categories of aneuploid CTCs and CECs cross-talk and functionally interplay with tumor angiogenesis, therapeutic drug resistance, tumor progression, and cancer metastasis. Full article

(This article belongs to the Special Issue Circulating Tumor Cells as Cancer Diagnostic Biomarkers)

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6 pages, 916 KiB

Open AccessReview

Percutaneous, Imaging-Guided Biopsy of Bone Metastases

by Dimitrios Filippiadis, Argyro Mazioti and Alexios Kelekis

Diagnostics 2018, 8(2), 25; https://doi.org/10.3390/diagnostics8020025 - 18 Apr 2018

Cited by 18 | Viewed by 7308

Abstract

Approximately 70% of cancer patients will eventually develop bone metastases. Spine, due to the abundance of red marrow in the vertebral bodies and the communication of deep thoracic-pelvic veins with valve-less vertebral venous plexuses, is the most common site of osseous metastatic disease. [...] Read more.

Approximately 70% of cancer patients will eventually develop bone metastases. Spine, due to the abundance of red marrow in the vertebral bodies and the communication of deep thoracic-pelvic veins with valve-less vertebral venous plexuses, is the most common site of osseous metastatic disease. Open biopsies run the risk of destabilizing an already diseased spinal or peripheral skeleton segment. Percutaneous biopsies obviate such issues and provide immediate confirmation of correct needle location in the area of interest. Indications for percutaneous bone biopsy include lesion characterization, optimal treatment and tumor recurrence identification, as well as tumor response and recurrence rate prediction. Predicting recurrence in curative cases could help in treatment stratification, identification, and validation of new targets. The overall accuracy of percutaneous biopsy is 90–95%; higher positive recovery rates govern biopsy of osteolytic lesions. The rate of complications for percutaneous biopsy approaches is <5%. The purpose of this review is to provide information about performing bone biopsy and what to expect from it as well as choosing the appropriate imaging guidance. Additionally, factors governing the appropriate needle trajectory that would likely give the greatest diagnostic yield and choice of the most appropriate biopsy system and type of anesthesia will be addressed. Full article

(This article belongs to the Special Issue Imaging of Bone Metastases in Oncology)

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14 pages, 7399 KiB

Open AccessArticle

Optimization of Stress-Based Microfluidic Testing for Methicillin Resistance in Staphylococcus aureus Strains

by Maxim Kalashnikov, Jean C. Lee and Alexis F. Sauer-Budge

Diagnostics 2018, 8(2), 24; https://doi.org/10.3390/diagnostics8020024 - 17 Apr 2018

Cited by 2 | Viewed by 6566

Abstract

The rapid evolution of antibiotic resistance in bacterial pathogens is driving the development of innovative, rapid antibiotic susceptibility testing (AST) tools as a way to provide more targeted and timely antibiotic treatment. We have previously presented a stress-based microfluidic method for the rapid [...] Read more.

The rapid evolution of antibiotic resistance in bacterial pathogens is driving the development of innovative, rapid antibiotic susceptibility testing (AST) tools as a way to provide more targeted and timely antibiotic treatment. We have previously presented a stress-based microfluidic method for the rapid determination of antibiotic susceptibility in methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA). In this method, stress is used to potentiate the action of antibiotics, and cell death is measured as a proxy for susceptibility. The method allows antibiotic susceptibility to be determined within an hour from the start of the antibiotic introduction. However, the relatively low dynamic range of the signal (2–10% cell response) even with high antibiotic concentrations (10–50 µg/mL) left room for the method’s optimization. We have conducted studies in which we varied the flow patterns, the media composition, and the antibiotic concentration to increase the cell death response and concordantly decrease the required antibiotic concentration down to 1–3 µg/mL, in accordance with the Clinical and Laboratory Standards Institute’s (CLSI) guidelines for AST breakpoint concentrations. Full article

(This article belongs to the Section Point-of-Care Diagnostics and Devices)

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9 pages, 250 KiB

Open AccessOpinion

Perspective on Cancer Therapeutics Utilizing Analysis of Circulating Tumor Cells

by Keun-Yeong Jeong, Eun Kyung Kim, Min Hee Park and Hwan Mook Kim

Diagnostics 2018, 8(2), 23; https://doi.org/10.3390/diagnostics8020023 - 11 Apr 2018

Cited by 9 | Viewed by 5921

Abstract

Various methods are available for cancer screening, and the methods are performed depending on the origin site of cancer. Among these methods, biopsy followed by medical imaging is the most common. After cancer progression is determined, an optimal treatment—such as surgery, chemotherapy, and/or [...] Read more.

Various methods are available for cancer screening, and the methods are performed depending on the origin site of cancer. Among these methods, biopsy followed by medical imaging is the most common. After cancer progression is determined, an optimal treatment—such as surgery, chemotherapy, and/or radiation therapy—is selected. A new assay has been developed that detects circulating tumor cells (CTCs). Tracking changes in CTCs may reveal important tumoral sensitivity information or resistance patterns to specific regimens and prompt changes in therapy on a personalized basis. Characterization of CTCs at the DNA, RNA, and protein levels is important for gaining insight for clinical applications. A small number of CTCs can be analyzed to obtain genome information such as the progression of cancer including metastasis, even in a single cluster. Although many clinical studies, particularly CTC enumeration and detection of specific oncogene expression, have increased the success rate of diagnosis and predicting prognosis, there is no consensus regarding the technical approaches and various aspects of the methodology, making it difficult to standardize optimal methods for CTC analysis. However, ongoing technological advances are currently being achieved and large-scale clinical studies are being conducted. Applying CTC analysis in the clinic would be very useful for advancing diagnosis, prognosis prediction, and therapeutics. Full article

(This article belongs to the Special Issue Circulating Tumor Cells as Cancer Diagnostic Biomarkers)

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15 pages, 18637 KiB

Open AccessReview

Synthesized Mammography: Clinical Evidence, Appearance, and Implementation

by Melissa A. Durand

Diagnostics 2018, 8(2), 22; https://doi.org/10.3390/diagnostics8020022 - 4 Apr 2018

Cited by 39 | Viewed by 11105

Abstract

Digital breast tomosynthesis (DBT) has improved conventional mammography by increasing cancer detection while reducing recall rates. However, these benefits come at the cost of increased radiation dose. Synthesized mammography (s2D) has been developed to provide the advantages of DBT with nearly half the [...] Read more.

Digital breast tomosynthesis (DBT) has improved conventional mammography by increasing cancer detection while reducing recall rates. However, these benefits come at the cost of increased radiation dose. Synthesized mammography (s2D) has been developed to provide the advantages of DBT with nearly half the radiation dose. Since its F.D.A. approval, multiple studies have evaluated the clinical performance of s2D. In clinical practice, s2D images are not identical to conventional 2D images and are designed for interpretation with DBT as a complement. This article reviews the present literature to assess whether s2D is a practical alternative to conventional 2D, addresses the differences in mammographic appearance of findings, and provides suggestions for implementation into clinical practice. Full article

(This article belongs to the Special Issue Breast Imaging)

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