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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 20720

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Prof. Dr. Hidehiko Okazawa

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Guest Editor

Biomedical Imaging Research Center, University of Fukui, Eiheiji-cho 910-1193, Japan
Interests: molecular imaging; positron emission tomography; functional imaging; MRI; neuroimaging; brain science; nuclear oncology
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Special Issue Information

Dear Colleagues,

Molecular imaging methods have seen improvements for more than a decade based on advances in molecular biology and progress in imaging technology. Recent improvements to multimodality imaging methods including PET/MRI can provide us with a better understanding of pathophysiologic changes in various diseases. The application of molecular and functional imaging for the early detection of pathologic events will play an important role in the early diagnosis and continuous observation of biologically targeted markers to predict the effects of treatment. The simultaneous assessment of multimodality images is very useful, and we can observe a single pathophysiologic change from various aspects noninvasively in terms of molecular, functional, and morphologic features. The advancement of various imaging modalities will provide for the evidence-based translation of molecular alterations in pathologic events, which is very informative in clinical diagnosis and individualized medical treatment. The aim of this Special Issue entitled “Advances in Multimodality Molecular Imaging” is to share information about newly developed methodologies and knowledge of molecular imaging using multiple modalities based on advancements in imaging technology. The scope of the Issue will include studies on molecular imaging with PET/CT, PET/MRI, and SPECT/CT, as well as the integration of multiple imaging methods of functional and anatomical images including radiomics and radiogenomics.

Prof. Dr. Hidehiko Okazawa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Molecular imaging
Positron emission tomography
Nuclear medicine
Functional imaging
Clinical radiology
Brain science
Nuclear oncology
MRI
PET/MRI
SPECT/CT

Published Papers (7 papers)

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11 pages, 1412 KiB

Open AccessArticle

Evaluation of Arterial Spin Labeling MRI—Comparison with ¹⁵O-Water PET on an Integrated PET/MR Scanner

by Markus Fahlström, Lieuwe Appel, Eva Kumlien, Torsten Danfors, Mathias Engström, Johan Wikström, Gunnar Antoni, Elna-Marie Larsson and Mark Lubberink

Diagnostics 2021, 11(5), 821; https://doi.org/10.3390/diagnostics11050821 - 01 May 2021

Cited by 4 | Viewed by 2501

Abstract

Cerebral blood flow (CBF) measurements are of high clinical value and can be acquired non-invasively with no radiation exposure using pseudo-continuous arterial spin labeling (ASL). The aim of this study was to evaluate accordance in resting state CBF between ASL (CBF_ASL) and ¹⁵O-water positron emission tomography (PET) (CBF_PET) acquired simultaneously on an integrated 3T PET/MR system. The data comprised ASL and dynamic ¹⁵O-water PET data with arterial blood sampling of eighteen subjects (eight patients with focal epilepsy and ten healthy controls, age 21 to 61 years). ¹⁵O-water PET parametric CBF images were generated using a basis function implementation of the single tissue compartment model. Cortical and subcortical regions were automatically segmented using Freesurfer. Average CBF_ASL and CBF_PET in grey matter were 60 ± 20 and 75 ± 22 mL/100 g/min respectively, with a relatively high correlation (r = 0.78, p < 0.001). Bland-Altman analysis revealed poor agreement (bias = −15 mL/100 g/min, lower and upper limits of agreements = −16 and 45 mL/100 g/min, respectively) with a negative relationship. Accounting for the negative relationship, the width of the limits of agreement could be narrowed from 61 mL/100 g/min to 35 mL/100 g/min using regression-based limits of agreements. Although a high correlation between CBF_ASL and CBF_PET was found, the agreement in absolute CBF values was not sufficient for ASL to be used interchangeably with ¹⁵O-water PET. Full article

(This article belongs to the Special Issue Advances in Multimodality Molecular Imaging)

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13 pages, 1095 KiB

Open AccessArticle

FDG-PET/CT for Response Monitoring in Metastatic Breast Cancer: The Feasibility and Benefits of Applying PERCIST

by Marianne Vogsen, Jakob Lykke Bülow, Lasse Ljungstrøm, Hjalte Rasmus Oltmann, Tural Asgharzadeh Alamdari, Mohammad Naghavi-Behzad, Poul-Erik Braad, Oke Gerke and Malene Grubbe Hildebrandt

Diagnostics 2021, 11(4), 723; https://doi.org/10.3390/diagnostics11040723 - 19 Apr 2021

Cited by 12 | Viewed by 2121

Abstract

Background: We aimed to examine the feasibility and potential benefit of applying PET Response Criteria in Solid Tumors (PERCIST) for response monitoring in metastatic breast cancer (MBC). Further, we introduced the nadir scan as a reference. Methods: Response monitoring FDG-PET/CT scans in 37 women with MBC were retrospectively screened for PERCIST standardization and measurability criteria. One-lesion PERCIST based on changes in SULpeak measurements of the hottest metastatic lesion was used for response categorization. The baseline (PERCIST_baseline) and the nadir scan (PERCIST_nadir) were used as references for PERCIST analyses. Results: Metastatic lesions were measurable according to PERCIST in 35 of 37 (94.7%) patients. PERCIST was applied in 150 follow-up scans, with progression more frequently reported by PERCIST_nadir (36%) than PERCIST_baseline (29.3%; p = 0.020). Reasons for progression were (a) more than 30% increase in SUL_peak of the hottest lesion (n = 7, 15.9%), (b) detection of new metastatic lesions (n = 28, 63.6%), or both (a) and (b) (n = 9, 20.5%). Conclusions: PERCIST, with the introduction of PERCIST_nadir, allows a graphical interpretation of disease fluctuation that may be beneficial in clinical decision-making regarding potential earlier termination of non-effective toxic treatment. PERCIST seems feasible for response monitoring in MBC but prospective studies are needed to come this closer. Full article

(This article belongs to the Special Issue Advances in Multimodality Molecular Imaging)

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16 pages, 4068 KiB

Open AccessArticle

Novel Multimodal, Multiscale Imaging System with Augmented Reality

by Christopher Mela, Francis Papay and Yang Liu

Diagnostics 2021, 11(3), 441; https://doi.org/10.3390/diagnostics11030441 - 04 Mar 2021

Cited by 2 | Viewed by 2617

Abstract

A novel multimodal, multiscale imaging system with augmented reality capability were developed and characterized. The system offers 3D color reflectance imaging, 3D fluorescence imaging, and augmented reality in real time. Multiscale fluorescence imaging was enabled by developing and integrating an in vivo fiber-optic microscope. Real-time ultrasound-fluorescence multimodal imaging used optically tracked fiducial markers for registration. Tomographical data are also incorporated using optically tracked fiducial markers for registration. Furthermore, we characterized system performance and registration accuracy in a benchtop setting. The multiscale fluorescence imaging facilitated assessing the functional status of tissues, extending the minimal resolution of fluorescence imaging to ~17.5 µm. The system achieved a mean of Target Registration error of less than 2 mm for registering fluorescence images to ultrasound images and MRI-based 3D model, which is within clinically acceptable range. The low latency and high frame rate of the prototype system has shown the promise of applying the reported techniques in clinically relevant settings in the future. Full article

(This article belongs to the Special Issue Advances in Multimodality Molecular Imaging)

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12 pages, 3140 KiB

Open AccessArticle

Diagnostic Value of ¹⁸F-FDG PET/MRI for Revised 2018 FIGO Staging in Patients with Cervical Cancer

by Hideaki Tsuyoshi, Tetsuya Tsujikawa, Shizuka Yamada, Hidehiko Okazawa and Yoshio Yoshida

Diagnostics 2021, 11(2), 202; https://doi.org/10.3390/diagnostics11020202 - 29 Jan 2021

Cited by 14 | Viewed by 2188

Abstract

Purpose: To evaluate the diagnostic potential of PET/MRI with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) in cervical cancer based on the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system. Materials and Methods: Seventy-two patients with biopsy-proven primary cervical cancer underwent pretreatment ¹⁸F-FDG PET/MRI, CT, and pelvic MRI. The diagnostic performance of ¹⁸F-FDG PET/MRI and MRI for assessing extent of the primary tumor and ¹⁸F-FDG PET/MRI and CT for assessing nodal and distant metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. McNemar test was employed for statistical analysis. Results: Accuracy for the invasion of vagina, parametrium, side wall, and adjacent organs was 97.2%, 93.1%, 97.2%, and 100% for ¹⁸F-FDG PET/MRI; and 97.2%, 91.7%, 97.2%, and 100% for pelvic MRI, respectively (p > 0.05). Patient-based accuracy for metastasis to pelvic and paraaortic lymph nodes and distant organs was 95.8%, 98.6%, and 100% for ¹⁸F-FDG PET/MRI; and 83.3%, 95.8%, and 97.2% for CT, respectively; metastasis to pelvic lymph nodes was statistically significant (p < 0.01). Lesion-based sensitivity, specificity, and accuracy for lymph nodes were 83.3%, 95.9%, and 94.8% for ¹⁸F-FDG PET/MRI; and 29.2%, 98.9% and 93.1% for CT, respectively; sensitivity was statistically significant (p < 0.001). After excluding patients diagnosed by conization, accuracy for revised FIGO staging 2018 was significantly better for ¹⁸F-FDG PET/MRI (82.1%) than for CT and MRI (60.7%) (p < 0.01). Conclusions: ¹⁸F-FDG PET/MRI offers higher diagnostic value for revised 2018 FIGO staging, suggesting that ¹⁸F-FDG PET/MRI might provide an optimal diagnostic strategy for preoperative staging. Full article

(This article belongs to the Special Issue Advances in Multimodality Molecular Imaging)

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9 pages, 3546 KiB

Open AccessArticle

Preoperative Texture Analysis Using ¹¹C-Methionine Positron Emission Tomography Predicts Survival after Surgery for Glioma

by Osamu Manabe, Shigeru Yamaguchi, Kenji Hirata, Kentaro Kobayashi, Hiroyuki Kobayashi, Shunsuke Terasaka, Takuya Toyonaga, Keiichi Magota, Yuji Kuge, Nagara Tamaki, Tohru Shiga and Kohsuke Kudo

Diagnostics 2021, 11(2), 189; https://doi.org/10.3390/diagnostics11020189 - 28 Jan 2021

Cited by 4 | Viewed by 1812

Abstract

Background: Positron emission tomography with ¹¹C-methionine (MET) is well established in the diagnostic work-up of malignant brain tumors. Texture analysis is a novel technique for extracting information regarding relationships among surrounding voxels, in order to quantify their inhomogeneity. This study evaluated whether the texture analysis of MET uptake has prognostic value for patients with glioma. Methods: We retrospectively analyzed adults with glioma who had undergone preoperative metabolic imaging at a single center. Tumors were delineated using a threshold of 1.3-fold of the mean standardized uptake value for the contralateral cortex, and then processed to calculate the texture features in glioma. Results: The study included 42 patients (median age: 56 years). The World Health Organization classifications were grade II (7 patients), grade III (17 patients), and grade IV (18 patients). Sixteen (16.1%) all-cause deaths were recorded during the median follow-up of 18.8 months. The univariate analyses revealed that overall survival (OS) was associated with age (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.01–1.08, p = 0.0093), tumor grade (HR 3.64, 95% CI 1.63–9.63, p = 0.0010), genetic status (p < 0.0001), low gray-level run emphasis (LGRE, calculated from the gray-level run-length matrix) (HR 2.30 × 10¹¹, 95% CI 737.11–4.23 × 10¹⁹, p = 0.0096), and correlation (calculated from the gray-level co-occurrence matrix) (HR 5.17, 95% CI 1.07–20.93, p = 0.041). The multivariate analyses revealed OS was independently associated with LGRE and correlation. The survival curves were also significantly different (both log-rank p < 0.05). Conclusion: Textural features obtained using preoperative MET positron emission tomography may compliment the semi-quantitative assessment for prognostication in glioma cases. Full article

(This article belongs to the Special Issue Advances in Multimodality Molecular Imaging)

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12 pages, 5857 KiB

Open AccessArticle

Noninvasive Measurement of [¹¹C]PiB Distribution Volume Using Integrated PET/MRI

by Hidehiko Okazawa, Masamichi Ikawa, Tetsuya Tsujikawa, Akira Makino, Tetsuya Mori, Yasushi Kiyono and Hirotaka Kosaka

Diagnostics 2020, 10(12), 993; https://doi.org/10.3390/diagnostics10120993 - 24 Nov 2020

Cited by 3 | Viewed by 2063

Abstract

A noninvasive image-derived input function (IDIF) method using PET/MRI was applied to quantitative measurements of [¹¹C] Pittsburgh compound-B (PiB) distribution volume (DV) and compared with other metrics. Fifty-three patients suspected of early dementia (71 ± 11 y) underwent 70 min [¹¹C]PiB PET/MRI. Nineteen of them (68 ± 11 y) without head motion during the scan were enrolled in this study and compared with 16 age-matched healthy controls (CTL: 68 ± 11 y). The dynamic frames reconstructed from listmode PET data were used for DV calculation. IDIF with metabolite correction was applied to the Logan plot method, and DV was normalized into DV ratio (DVR) images using the cerebellar reference (DVR_L). DVR and standardized uptake value ratio (SUVR) images were also calculated using the reference tissue graphical method (DVR_r) and the 50–70 min static data with cerebellar reference, respectively. Cortical values were compared using the 3D-T1WI MRI segmentation. All patients were assigned to the early Alzheimer’s disease (eAD) group because of positive [¹¹C]PiB accumulation. The correlations of regional values were better for DVR_L vs. DVR_r (r² = 0.97) than for SUVR vs. DVR_r (r² = 0.88). However, all metrics clearly differentiated eAD from CTL with appropriate thresholds. Noninvasive quantitative [¹¹C]PiB PET/MRI measurement provided equivalent DVRs with the two methods. SUVR images showed acceptable results despite inferior variability and image quality to DVR images. Full article

(This article belongs to the Special Issue Advances in Multimodality Molecular Imaging)

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17 pages, 7125 KiB

Open AccessProtocol

A Proposed Dedicated Breast PET Lexicon: Standardization of Description and Reporting of Radiotracer Uptake in the Breast

by Kanae K. Miyake, Masako Kataoka, Takayoshi Ishimori, Yoshiaki Matsumoto, Masae Torii, Masahiro Takada, Yoko Satoh, Kazunori Kubota, Hiroko Satake, Masahiro Yakami, Hiroyoshi Isoda, Debra M. Ikeda, Masakazu Toi and Yuji Nakamoto

Diagnostics 2021, 11(7), 1267; https://doi.org/10.3390/diagnostics11071267 - 15 Jul 2021

Cited by 14 | Viewed by 5967

Abstract

Dedicated breast positron emission tomography (dbPET) is a new diagnostic imaging modality recently used in clinical practice for the detection of breast cancer and the assessment of tumor biology. dbPET has higher spatial resolution than that of conventional whole body PET systems, allowing recognition of detailed morphological attributes of radiotracer accumulation within the breast. ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) accumulation in the breast may be due to benign or malignant entities, and recent studies suggest that morphology characterization of ¹⁸F-FDG uptake could aid in estimating the probability of malignancy. However, across the world, there are many descriptors of breast ¹⁸F-FDG uptake, limiting comparisons between studies. In this article, we propose a lexicon for breast radiotracer uptake to standardize description and reporting of image findings on dbPET, consisting of terms for image quality, radiotracer fibroglandular uptake, breast lesion uptake. Full article

(This article belongs to the Special Issue Advances in Multimodality Molecular Imaging)

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