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Keywords = conventional MRI (cMRI)

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12 pages, 456 KB  
Article
From Variability to Standardization: The Impact of Breast Density on Background Parenchymal Enhancement in Contrast-Enhanced Mammography and the Need for a Structured Reporting System
by Graziella Di Grezia, Antonio Nazzaro, Luigi Schiavone, Cisternino Elisa, Alessandro Galiano, Gatta Gianluca, Cuccurullo Vincenzo and Mariano Scaglione
Cancers 2025, 17(15), 2523; https://doi.org/10.3390/cancers17152523 - 30 Jul 2025
Viewed by 1119
Abstract
Introduction: Breast density is a well-recognized factor in breast cancer risk assessment, with higher density linked to increased malignancy risk and reduced sensitivity of conventional mammography. Background parenchymal enhancement (BPE), observed in contrast-enhanced imaging, reflects physiological contrast uptake in non-pathologic breast tissue. [...] Read more.
Introduction: Breast density is a well-recognized factor in breast cancer risk assessment, with higher density linked to increased malignancy risk and reduced sensitivity of conventional mammography. Background parenchymal enhancement (BPE), observed in contrast-enhanced imaging, reflects physiological contrast uptake in non-pathologic breast tissue. While extensively characterized in breast MRI, the role of BPE in contrast-enhanced mammography (CEM) remains uncertain due to inconsistent findings regarding its correlation with breast density and cancer risk. Unlike breast density—standardized through the ACR BI-RADS lexicon—BPE lacks a uniform classification system in CEM, leading to variability in clinical interpretation and research outcomes. To address this gap, we introduce the BPE-CEM Standard Scale (BCSS), a structured four-tiered classification system specifically tailored to the two-dimensional characteristics of CEM, aiming to improve consistency and diagnostic alignment in BPE evaluation. Materials and Methods: In this retrospective single-center study, 213 patients who underwent mammography (MG), ultrasound (US), and contrast-enhanced mammography (CEM) between May 2022 and June 2023 at the “A. Perrino” Hospital in Brindisi were included. Breast density was classified according to ACR BI-RADS (categories A–D). BPE was categorized into four levels: Minimal (< 10% enhancement), Light (10–25%), Moderate (25–50%), and Marked (> 50%). Three radiologists independently assessed BPE in a subset of 50 randomly selected cases to evaluate inter-observer agreement using Cohen’s kappa. Correlations between BPE, breast density, and age were examined through regression analysis. Results: BPE was Minimal in 57% of patients, Light in 31%, Moderate in 10%, and Marked in 2%. A significant positive association was found between higher breast density (BI-RADS C–D) and increased BPE (p < 0.05), whereas lower-density breasts (A–B) were predominantly associated with minimal or light BPE. Regression analysis confirmed a modest but statistically significant association between breast density and BPE (R2 = 0.144), while age showed no significant effect. Inter-observer agreement for BPE categorization using the BCSS was excellent (κ = 0.85; 95% CI: 0.78–0.92), supporting its reproducibility. Conclusions: Our findings indicate that breast density is a key determinant of BPE in CEM. The proposed BCSS offers a reproducible, four-level framework for standardized BPE assessment tailored to the imaging characteristics of CEM. By reducing variability in interpretation, the BCSS has the potential to improve diagnostic consistency and facilitate integration of BPE into personalized breast cancer risk models. Further prospective multicenter studies are needed to validate this classification and assess its clinical impact. Full article
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25 pages, 418 KB  
Review
Emerging Diagnostic Approaches for Musculoskeletal Disorders: Advances in Imaging, Biomarkers, and Clinical Assessment
by Rahul Kumar, Kiran Marla, Kyle Sporn, Phani Paladugu, Akshay Khanna, Chirag Gowda, Alex Ngo, Ethan Waisberg, Ram Jagadeesan and Alireza Tavakkoli
Diagnostics 2025, 15(13), 1648; https://doi.org/10.3390/diagnostics15131648 - 27 Jun 2025
Viewed by 1148
Abstract
Musculoskeletal (MSK) disorders remain a major global cause of disability, with diagnostic complexity arising from their heterogeneous presentation and multifactorial pathophysiology. Recent advances across imaging modalities, molecular biomarkers, artificial intelligence applications, and point-of-care technologies are fundamentally reshaping musculoskeletal diagnostics. This review offers a [...] Read more.
Musculoskeletal (MSK) disorders remain a major global cause of disability, with diagnostic complexity arising from their heterogeneous presentation and multifactorial pathophysiology. Recent advances across imaging modalities, molecular biomarkers, artificial intelligence applications, and point-of-care technologies are fundamentally reshaping musculoskeletal diagnostics. This review offers a novel synthesis by unifying recent innovations across multiple diagnostic imaging modalities, such as CT, MRI, and ultrasound, with emerging biochemical, genetic, and digital technologies. While existing reviews typically focus on advances within a single modality or for specific MSK conditions, this paper integrates a broad spectrum of developments to highlight how use of multimodal diagnostic strategies in combination can improve disease detection, stratification, and clinical decision-making in real-world settings. Technological developments in imaging, including photon-counting detector computed tomography, quantitative magnetic resonance imaging, and four-dimensional computed tomography, have enhanced the ability to visualize structural and dynamic musculoskeletal abnormalities with greater precision. Molecular imaging and biochemical markers such as CTX-II (C-terminal cross-linked telopeptides of type II collagen) and PINP (procollagen type I N-propeptide) provide early, objective indicators of tissue degeneration and bone turnover, while genetic and epigenetic profiling can elucidate individual patterns of susceptibility. Point-of-care ultrasound and portable diagnostic devices have expanded real-time imaging and functional assessment capabilities across diverse clinical settings. Artificial intelligence and machine learning algorithms now automate image interpretation, predict clinical outcomes, and enhance clinical decision support, complementing conventional clinical evaluations. Wearable sensors and mobile health technologies extend continuous monitoring beyond traditional healthcare environments, generating real-world data critical for dynamic disease management. However, standardization of diagnostic protocols, rigorous validation of novel methodologies, and thoughtful integration of multimodal data remain essential for translating technological advances into improved patient outcomes. Despite these advances, several key limitations constrain widespread clinical adoption. Imaging modalities lack standardized acquisition protocols and reference values, making cross-site comparison and clinical interpretation difficult. AI-driven diagnostic tools often suffer from limited external validation and transparency (“black-box” models), impacting clinicians’ trust and hindering regulatory approval. Molecular markers like CTX-II and PINP, though promising, show variability due to diurnal fluctuations and comorbid conditions, complicating their use in routine monitoring. Integration of multimodal data, especially across imaging, omics, and wearable devices, remains technically and logistically complex, requiring robust data infrastructure and informatics expertise not yet widely available in MSK clinical practice. Furthermore, reimbursement models have not caught up with many of these innovations, limiting access in resource-constrained healthcare settings. As these fields converge, musculoskeletal diagnostics methods are poised to evolve into a more precise, personalized, and patient-centered discipline, driving meaningful improvements in musculoskeletal health worldwide. Full article
(This article belongs to the Special Issue Advances in Musculoskeletal Imaging: From Diagnosis to Treatment)
23 pages, 6234 KB  
Article
Characterizing Breast Tumor Heterogeneity Through IVIM-DWI Parameters and Signal Decay Analysis
by Si-Wa Chan, Chun-An Lin, Yen-Chieh Ouyang, Guan-Yuan Chen, Chein-I Chang, Chin-Yao Lin, Chih-Chiang Hung, Chih-Yean Lum, Kuo-Chung Wang and Ming-Cheng Liu
Diagnostics 2025, 15(12), 1499; https://doi.org/10.3390/diagnostics15121499 - 12 Jun 2025
Viewed by 1863
Abstract
Background/Objectives: This research presents a novel analytical method for breast tumor characterization and tissue classification by leveraging intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) combined with hyperspectral imaging techniques and deep learning. Traditionally, dynamic contrast-enhanced MRI (DCE-MRI) is employed for breast tumor diagnosis, but [...] Read more.
Background/Objectives: This research presents a novel analytical method for breast tumor characterization and tissue classification by leveraging intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) combined with hyperspectral imaging techniques and deep learning. Traditionally, dynamic contrast-enhanced MRI (DCE-MRI) is employed for breast tumor diagnosis, but it involves gadolinium-based contrast agents, which carry potential health risks. IVIM imaging extends conventional diffusion-weighted imaging (DWI) by explicitly separating the signal decay into components representing true molecular diffusion (D) and microcirculation of capillary blood (pseudo-diffusion or D*). This separation allows for a more comprehensive, non-invasive assessment of tissue characteristics without the need for contrast agents, thereby offering a safer alternative for breast cancer diagnosis. The primary purpose of this study was to evaluate different methods for breast tumor characterization using IVIM-DWI data treated as hyperspectral image stacks. Dice similarity coefficients and Jaccard indices were specifically used to evaluate the spatial segmentation accuracy of tumor boundaries, confirmed by experienced physicians on dynamic contrast-enhanced MRI (DCE-MRI), emphasizing detailed tumor characterization rather than binary diagnosis of cancer. Methods: The data source for this study consisted of breast MRI scans obtained from 22 patients diagnosed with mass-type breast cancer, resulting in 22 distinct mass tumor cases analyzed. MR images were acquired using a 3T MRI system (Discovery MR750 3.0 Tesla, GE Healthcare, Chicago, IL, USA) with axial IVIM sequences and a bipolar pulsed gradient spin echo sequence. Multiple b-values ranging from 0 to 2500 s/mm2 were utilized, specifically thirteen original b-values (0, 15, 30, 45, 60, 100, 200, 400, 600, 1000, 1500, 2000, and 2500 s/mm2), with the last four b-value images replicated once for a total of 17 bands used in the analysis. The methodology involved several steps: acquisition of multi-b-value IVIM-DWI images, image pre-processing, including correction for motion and intensity inhomogeneity, treating the multi-b-value data as hyperspectral image stacks, applying hyperspectral techniques like band expansion, and evaluating three tumor detection methods: kernel-based constrained energy minimization (KCEM), iterative KCEM (I-KCEM), and deep neural networks (DNNs). The comparisons were assessed by evaluating the similarity of the detection results from each method to ground truth tumor areas, which were manually drawn on DCE-MRI images and confirmed by experienced physicians. Similarity was quantitatively measured using the Dice similarity coefficient and the Jaccard index. Additionally, the performance of the detectors was evaluated using 3D-ROC analysis and its derived criteria (AUCOD, AUCTD, AUCBS, AUCTDBS, AUCODP, AUCSNPR). Results: The findings objectively demonstrated that the DNN method achieved superior performance in breast tumor detection compared to KCEM and I-KCEM. Specifically, the DNN yielded a Dice similarity coefficient of 86.56% and a Jaccard index of 76.30%, whereas KCEM achieved 78.49% (Dice) and 64.60% (Jaccard), and I-KCEM achieved 78.55% (Dice) and 61.37% (Jaccard). Evaluation using 3D-ROC analysis also indicated that the DNN was the best detector based on metrics like target detection rate and overall effectiveness. The DNN model further exhibited the capability to identify tumor heterogeneity, differentiating high- and low-cellularity regions. Quantitative parameters, including apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (PF), were calculated and analyzed, providing insights into the diffusion characteristics of different breast tissues. Analysis of signal intensity decay curves generated from these parameters further illustrated distinct diffusion patterns and confirmed that high cellularity tumor regions showed greater water molecule confinement compared to low cellularity regions. Conclusions: This study highlights the potential of combining IVIM-DWI, hyperspectral imaging techniques, and deep learning as a robust, safe, and effective non-invasive diagnostic tool for breast cancer, offering a valuable alternative to contrast-enhanced methods by providing detailed information about tissue microstructure and heterogeneity without the need for contrast agents. Full article
(This article belongs to the Special Issue Recent Advances in Breast Cancer Imaging)
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8 pages, 662 KB  
Brief Report
Microwave-Assisted Optimization of Polyvinyl Alcohol Cryogel (PVA-C) Manufacturing for MRI Phantom Production
by Ivan Vogt, Martin Volk, Emma-Luise Kulzer, Janis Seibt, Maciej Pech, Georg Rose and Oliver S. Grosser
Bioengineering 2025, 12(2), 171; https://doi.org/10.3390/bioengineering12020171 - 10 Feb 2025
Cited by 2 | Viewed by 1224
Abstract
Objectives: Anthropomorphic phantoms offer a promising solution to minimize animal testing, enable medical training, and support the efficient development of medical devices. The adjustable mechanical, biochemical, and imaging properties of the polyvinyl alcohol cryogel (PVA-C) make it an appropriate phantom material for mimicking [...] Read more.
Objectives: Anthropomorphic phantoms offer a promising solution to minimize animal testing, enable medical training, and support the efficient development of medical devices. The adjustable mechanical, biochemical, and imaging properties of the polyvinyl alcohol cryogel (PVA-C) make it an appropriate phantom material for mimicking soft tissues. Conventional manufacturing (CM) of aqueous solutions requires constant stirring, using a heated water bath, and monitoring. Methods: To explore potential improvements in the dissolution of PVA crystals in water, a microwave-based manufacturing method (MWM) was employed. Samples created using CM and MWM (n = 14 each) were compared. Because PVA-C is a multifunctional phantom material (e.g., in magnetic resonance imaging (MRI)), its MRI properties (T1/T2 relaxation times) and elasticity were determined. Results: T1 relaxation times did not significantly differ between the two methods (p = 0.3577), whereas T2 and elasticity for the MWM were significantly higher than those for the CM (p < 0.001). The MWM reduced the production time by 11% and decreased active user involvement by 93%. Conclusions: The MWM offers a promising, easily implementable, and time-efficient method for manufacturing PVA-C-based phantoms. Nevertheless, manufacturing-related microstructural properties and sample molding require further study. Full article
(This article belongs to the Special Issue Hydrogels for Biomedical Applications, 2nd Edition)
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17 pages, 7005 KB  
Article
K-Means Clustering of Hyperpolarised 13C-MRI Identifies Intratumoral Perfusion/Metabolism Mismatch in Renal Cell Carcinoma as the Best Predictor of the Highest Grade
by Ines Horvat-Menih, Alixander S. Khan, Mary A. McLean, Joao Duarte, Eva Serrao, Stephan Ursprung, Joshua D. Kaggie, Andrew B. Gill, Andrew N. Priest, Mireia Crispin-Ortuzar, Anne Y. Warren, Sarah J. Welsh, Thomas J. Mitchell, Grant D. Stewart and Ferdia A. Gallagher
Cancers 2025, 17(4), 569; https://doi.org/10.3390/cancers17040569 - 7 Feb 2025
Cited by 1 | Viewed by 1360
Abstract
Background: Early and accurate grading of renal cell carcinoma (RCC) improves patient risk stratification and has implications for clinical management and mortality. However, current diagnostic approaches using imaging and renal mass biopsy have limited specificity and may lead to undergrading. Methods: [...] Read more.
Background: Early and accurate grading of renal cell carcinoma (RCC) improves patient risk stratification and has implications for clinical management and mortality. However, current diagnostic approaches using imaging and renal mass biopsy have limited specificity and may lead to undergrading. Methods: This study explored the use of hyperpolarised [1-13C]pyruvate MRI (HP 13C-MRI) to identify the most aggressive areas within the tumour of patients with clear cell renal cell carcinoma (ccRCC) as a method to guide biopsy targeting and to reduce undergrading. Six patients with ccRCC underwent presurgical HP 13C-MRI and conventional contrast-enhanced MRI. From the imaging data, three k-means clusters were computed by combining the kPL as a marker of metabolic activity, and the 13C-pyruvate signal-to-noise ratio (SNRPyr) as a perfusion surrogate. The combined clusters were compared to those derived from individual parameters and to those derived from the percentage of enhancement on the nephrographic phase (%NG). The diagnostic performance of each cluster was assessed based on its ability to predict the highest histological tumour grade in postsurgical tissue samples. The postsurgical tissue samples underwent immunohistochemical staining for the pyruvate transporter (monocarboxylate transporter 1, MCT1), as well as RNA and whole-exome sequencing. Results: The clustering approach combining SNRPyr and kPL demonstrated the best performance for predicting the highest tumour grade: specificity 85%; sensitivity 64%; positive predictive value 82%; and negative predictive value 68%. Epithelial MCT1 was identified as the major determinant of the HP 13C-MRI signal. The perfusion/metabolism mismatch cluster showed an increased expression of metabolic genes and markers of aggressiveness. Conclusions: This study demonstrates the potential of using HP 13C-MRI-derived metabolic clusters to identify intratumoral variations in tumour grade with high specificity. This work supports the use of metabolic imaging to guide biopsies to the most aggressive tumour regions and could potentially reduce sampling error. Full article
(This article belongs to the Special Issue Magnetic Resonance in Cancer Research)
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19 pages, 7890 KB  
Article
Using the Tissue Impulse Response Function to Streamline Fractionated MRgFUS-Induced Hyperthermia
by Pauline C. Guillemin, Yacine M’Rad, Giovanna Dipasquale, Orane Lorton, Vanessa Fleury, Shahan Momjian, Anna Borich, Lindsey A. Crowe, Thomas Zilli, Sana Boudabbous and Rares Salomir
Cancers 2025, 17(3), 515; https://doi.org/10.3390/cancers17030515 - 4 Feb 2025
Viewed by 961
Abstract
Background/Objectives: Combining radiation therapy with mild hyperthermia, especially via magnetic resonance-guided focused ultrasound (MRgFUS), holds promise for enhancing tumor control and alleviating symptoms in cancer patients. However, current clinical applications of MRgFUS focus primarily on ablative treatments, and using MRI guidance for [...] Read more.
Background/Objectives: Combining radiation therapy with mild hyperthermia, especially via magnetic resonance-guided focused ultrasound (MRgFUS), holds promise for enhancing tumor control and alleviating symptoms in cancer patients. However, current clinical applications of MRgFUS focus primarily on ablative treatments, and using MRI guidance for each radiation session increases treatment costs and logistical demands. This study aimed to test a streamlined workflow for repeated hyperthermia treatments that reduces the need for continuous MRI monitoring, using an approach based on impulse response function (Green’s function) to optimize acoustic power settings in advance. Methods: We implemented the Green’s function approach in a perfused, tissue-mimicking phantom, conducting 30 experiments to simulate hyperthermia delivery via MRgFUS. Pre-calculated acoustic power settings were applied to maintain a stable hyperthermia target without the need for real-time feedback control from MRI thermometry. Additionally, a retrospective analysis of patient thermometry data from MRgFUS sonications was performed to assess feasibility in clinical contexts. Results: Our experiments demonstrated consistent, stable hyperthermia (+7 °C) for 15 min across varying perfusion rates, outperforming conventional closed-loop MRI feedback methods in maintaining temperature stability. The retrospective analysis confirmed that this method is noise-robust and clinically applicable. Conclusions: This off-line approach to hyperthermia control could simplify the integration of MRgFUS hyperthermia in cancer treatment, reducing costs and logistical barriers. These findings suggest that our method may enable the broader adoption of hyperthermia in radiation therapy, supporting its role as a viable adjuvant treatment in oncology. Full article
(This article belongs to the Special Issue Novel Approaches and Advances in Interventional Oncology)
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4 pages, 893 KB  
Interesting Images
Spinal Infection with Rare Cervical Epidural Air Bubbles
by Chen-Hao Liao and Tse-Hao Chen
BioMed 2025, 5(1), 2; https://doi.org/10.3390/biomed5010002 - 9 Jan 2025
Viewed by 1358
Abstract
Spinal infections involving gas-forming pathogens are exceedingly rare, particularly in the cervical spine. We report the case of a 63-year-old male with a history of hypopharyngeal cancer who presented with neck pain and right upper limb weakness. Imaging studies revealed cervical epidural air [...] Read more.
Spinal infections involving gas-forming pathogens are exceedingly rare, particularly in the cervical spine. We report the case of a 63-year-old male with a history of hypopharyngeal cancer who presented with neck pain and right upper limb weakness. Imaging studies revealed cervical epidural air bubbles and spinal cord edema at C1–C3. Laboratory findings were indicative of infection, and Streptococcus was identified through blood cultures. Urgent surgical decompression via laminectomy was performed, followed by antibiotic treatment. This case highlights the critical role of multimodal imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), in diagnosing spinal infections, especially when conventional radiographs are inconclusive. CT scans identified gas inclusions and soft tissue changes, while MRI provided superior visualization of spinal edema and complications such as medullary compression. Management requires a multidisciplinary approach combining timely surgical intervention with prolonged antibiotic regimens. Full article
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26 pages, 5504 KB  
Article
Advanced Hybrid Brain Tumor Segmentation in MRI: Elephant Herding Optimization Combined with Entropy-Guided Fuzzy Clustering
by Baiju Karun, Arunprasath Thiyagarajan, Pallikonda Rajasekaran Murugan, Natarajan Jeyaprakash, Kottaimalai Ramaraj and Rakhee Makreri
Math. Comput. Appl. 2025, 30(1), 1; https://doi.org/10.3390/mca30010001 - 25 Dec 2024
Cited by 3 | Viewed by 1416
Abstract
Accurate and early detection of brain tumors is essential for improving clinical outcomes and guiding effective treatment planning. Traditional segmentation techniques in MRI often struggle with challenges such as noise, intensity variations, and complex tumor morphologies, which can hinder their effectiveness in critical [...] Read more.
Accurate and early detection of brain tumors is essential for improving clinical outcomes and guiding effective treatment planning. Traditional segmentation techniques in MRI often struggle with challenges such as noise, intensity variations, and complex tumor morphologies, which can hinder their effectiveness in critical healthcare scenarios. This study proposes an innovative hybrid methodology that integrates advanced metaheuristic optimization and entropy-based fuzzy clustering to enhance segmentation precision in brain tumor detection. This method combines the nature-inspired Elephant Herding Optimization (EHO) algorithm with Entropy-Driven Fuzzy C-Means (EnFCM) clustering, offering significant improvements over conventional methods. EHO is utilized to optimize the clustering process, enhancing the algorithm’s ability to delineate tumor boundaries, while entropy-based fuzzy clustering accounts for intensity inhomogeneity and diverse tumor characteristics, promoting more consistent and reliable segmentation results. This approach was evaluated using the BraTS challenge dataset, a benchmark in the field of brain tumor segmentation. The results demonstrate marked improvements across several performance metrics, including Dice similarity, mean squared error (MSE), peak signal-to-noise ratio (PSNR), and the Tanimoto coefficient (TC), underscoring this method’s robustness and segmentation accuracy. By managing image noise and reducing computational demands, the EHO-EnFCM approach not only captures intricate tumor structures but also facilitates efficient image processing, making it suitable for real-time clinical applications. Overall, the findings reveal the potential of this hybrid approach to advance MRI-based tumor detection, offering a promising tool that enhances both accuracy and computational efficiency for medical imaging and diagnosis. Full article
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20 pages, 6909 KB  
Article
8-Anilino-1-naphthalenesulfonate-Conjugated Carbon-Coated Ferrite Nanodots for Fluoromagnetic Imaging, Smart Drug Delivery, and Biomolecular Sensing
by Anbazhagan Thirumalai, Koyeli Girigoswami, Alex Daniel Prabhu, Pazhani Durgadevi, Venkatakrishnan Kiran and Agnishwar Girigoswami
Pharmaceutics 2024, 16(11), 1378; https://doi.org/10.3390/pharmaceutics16111378 - 26 Oct 2024
Cited by 11 | Viewed by 1784
Abstract
Background: Superparamagnetic properties and excitation independence have been incorporated into carbon-decorated manganese ferrite nanodots (MnFe@C) to introduce an economical and safer multimodal agent for use in both T1-T2 MRI and fluorescence-based imaging to replace the conventional highly toxic heavy metal contrast agents. Methods: [...] Read more.
Background: Superparamagnetic properties and excitation independence have been incorporated into carbon-decorated manganese ferrite nanodots (MnFe@C) to introduce an economical and safer multimodal agent for use in both T1-T2 MRI and fluorescence-based imaging to replace the conventional highly toxic heavy metal contrast agents. Methods: The surface conjugation of 8-anilino-1-naphthalenesulfonate (ANS) to MnFe@C nanodots (ANS-MnFe@C) enhances both longitudinal and transverse MRI relaxation, improves fluorescence for optical imaging, and increases protein detection sensitivity, showing higher multimodal efficacy in terms of molar relaxivity, radiant efficiencies, and fluorescence sensitivity compared to MnFe@C. Results: The band gap energy was determined using Tauc’s equation to be 3.32 eV, while a 72% quantum yield demonstrated that ANS-MnFe@C was highly fluorescent, with the linear range and association constant calculated using the Stern–Volmer relation. The synthesized ANS-MnFe@C demonstrated excellent selectivity and sensitivity for bovine serum albumin (BSA), with a nanomolar detection limit of 367.09 nM and a broad linear range from 0.015 to 0.225 mM. Conclusions: In conclusion, ANS-MnFe@C holds ease of fabrication, good biocompatibility, as assessed in A375 cells, and an effective pH-sensitive doxorubicin release profile to establish anticancer activity in lung cancer cell line (A549), highlighting its potential as an affordable therapeutic agent for multimodal imaging, drug delivery, and protein sensing. Full article
(This article belongs to the Section Drug Delivery and Controlled Release)
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11 pages, 2022 KB  
Review
Value of 11C-Methionine PET Imaging in High-Grade Gliomas: A Narrative Review
by Zsanett Debreczeni-Máté, Omar Freihat, Imre Törő, Mihály Simon, Árpád Kovács and David Sipos
Cancers 2024, 16(18), 3200; https://doi.org/10.3390/cancers16183200 - 20 Sep 2024
Cited by 5 | Viewed by 2677
Abstract
11C-Methionine (MET) is a widely utilized amino acid tracer in positron emission tomography (PET) imaging of primary brain tumors. 11C-MET PET offers valuable insights for tumor classification, facilitates treatment planning, and aids in monitoring therapeutic response. Its tracer properties allow better delineation of [...] Read more.
11C-Methionine (MET) is a widely utilized amino acid tracer in positron emission tomography (PET) imaging of primary brain tumors. 11C-MET PET offers valuable insights for tumor classification, facilitates treatment planning, and aids in monitoring therapeutic response. Its tracer properties allow better delineation of the active tumor volume, even in regions that show no contrast enhancement on conventional magnetic resonance imaging (MRI). This review focuses on the role of MET-PET in brain glioma imaging. The introduction provides a brief clinical overview of the problems of high-grade and recurrent gliomas. It discusses glioma management, radiotherapy planning, and the difficulties of imaging after chemoradiotherapy (pseudoprogression or radionecrosis). The mechanism of MET-PET is described. Additionally, the review encompasses the application of MET-PET in the context of primary gliomas, addressing its diagnostic precision, utility in tumor classification, prognostic value, and role in guiding biopsy procedures and radiotherapy planning. Full article
(This article belongs to the Special Issue Recent Trends in PET/CT Tracer Development and Multimodal Imaging)
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69 pages, 6125 KB  
Review
A Comprehensive Review of Cardiovascular Disease Management: Cardiac Biomarkers, Imaging Modalities, Pharmacotherapy, Surgical Interventions, and Herbal Remedies
by Vasudeva Reddy Netala, Sireesh Kumar Teertam, Huizhen Li and Zhijun Zhang
Cells 2024, 13(17), 1471; https://doi.org/10.3390/cells13171471 - 1 Sep 2024
Cited by 30 | Viewed by 14806
Abstract
Cardiovascular diseases (CVDs) continue to be a major global health concern, representing a leading cause of morbidity and mortality. This review provides a comprehensive examination of CVDs, encompassing their pathophysiology, diagnostic biomarkers, advanced imaging techniques, pharmacological treatments, surgical interventions, and the emerging role [...] Read more.
Cardiovascular diseases (CVDs) continue to be a major global health concern, representing a leading cause of morbidity and mortality. This review provides a comprehensive examination of CVDs, encompassing their pathophysiology, diagnostic biomarkers, advanced imaging techniques, pharmacological treatments, surgical interventions, and the emerging role of herbal remedies. The review covers various cardiovascular conditions such as coronary artery disease, atherosclerosis, peripheral artery disease, deep vein thrombosis, pulmonary embolism, cardiomyopathy, rheumatic heart disease, hypertension, ischemic heart disease, heart failure, cerebrovascular diseases, and congenital heart defects. The review presents a wide range of cardiac biomarkers such as troponins, C-reactive protein, CKMB, BNP, NT-proBNP, galectin, adiponectin, IL-6, TNF-α, miRNAs, and oxylipins. Advanced molecular imaging techniques, including chest X-ray, ECG, ultrasound, CT, SPECT, PET, and MRI, have significantly enhanced our ability to visualize myocardial perfusion, plaque characterization, and cardiac function. Various synthetic drugs including statins, ACE inhibitors, ARBs, β-blockers, calcium channel blockers, antihypertensives, anticoagulants, and antiarrhythmics are fundamental in managing CVDs. Nonetheless, their side effects such as hepatic dysfunction, renal impairment, and bleeding risks necessitate careful monitoring and personalized treatment strategies. In addition to conventional therapies, herbal remedies have garnered attention for their potential cardiovascular benefits. Plant extracts and their bioactive compounds, such as flavonoids, phenolic acids, saponins, and alkaloids, offer promising cardioprotective effects and enhanced cardiovascular health. This review underscores the value of combining traditional and modern therapeutic approaches to improve cardiovascular outcomes. This review serves as a vital resource for researchers by integrating a broad spectrum of information on CVDs, diagnostic tools, imaging techniques, pharmacological treatments and their side effects, and the potential of herbal remedies. Full article
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17 pages, 8313 KB  
Article
Automatic Brain Tissue and Lesion Segmentation and Multi-Parametric Mapping of Contrast-Enhancing Gliomas without the Injection of Contrast Agents: A Preliminary Study
by Jing Liu, Angela Jakary, Javier E. Villanueva-Meyer, Nicholas A. Butowski, David Saloner, Jennifer L. Clarke, Jennie W. Taylor, Nancy Ann Oberheim Bush, Susan M. Chang, Duan Xu and Janine M. Lupo
Cancers 2024, 16(8), 1524; https://doi.org/10.3390/cancers16081524 - 17 Apr 2024
Cited by 2 | Viewed by 1688
Abstract
This study aimed to develop a rapid, 1 mm3 isotropic resolution, whole-brain MRI technique for automatic lesion segmentation and multi-parametric mapping without using contrast by continuously applying balanced steady-state free precession with inversion pulses throughout incomplete inversion recovery in a single 6 [...] Read more.
This study aimed to develop a rapid, 1 mm3 isotropic resolution, whole-brain MRI technique for automatic lesion segmentation and multi-parametric mapping without using contrast by continuously applying balanced steady-state free precession with inversion pulses throughout incomplete inversion recovery in a single 6 min scan. Modified k-means clustering was performed for automatic brain tissue and lesion segmentation using distinct signal evolutions that contained mixed T1/T2/magnetization transfer properties. Multi-compartment modeling was used to derive quantitative multi-parametric maps for tissue characterization. Fourteen patients with contrast-enhancing gliomas were scanned with this sequence prior to the injection of a contrast agent, and their segmented lesions were compared to conventionally defined manual segmentations of T2-hyperintense and contrast-enhancing lesions. Simultaneous T1, T2, and macromolecular proton fraction maps were generated and compared to conventional 2D T1 and T2 mapping and myelination water fraction mapping acquired with MAGiC. The lesion volumes defined with the new method were comparable to the manual segmentations (r = 0.70, p < 0.01; t-test p > 0.05). The T1, T2, and macromolecular proton fraction mapping values of the whole brain were comparable to the reference values and could distinguish different brain tissues and lesion types (p < 0.05), including infiltrating tumor regions within the T2-lesion. Highly efficient, whole-brain, multi-contrast imaging facilitated automatic lesion segmentation and quantitative multi-parametric mapping without contrast, highlighting its potential value in the clinic when gadolinium is contraindicated. Full article
(This article belongs to the Special Issue Magnetic Resonance Imaging of Brain Tumor)
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10 pages, 1293 KB  
Article
Retrospective Long-Term Evaluation of Conventional Transarterial Chemoembolization for Hepatocellular Carcinoma over 20 Years
by Thomas J. Vogl, Hamzah Adwan, Leonard Wolff, Maximilian Lahrsow, Tatjana Gruber-Rouh, Nour-Eldin Abdelrehim Nour-Eldin, Jörg Trojan, Wolf-Otto Bechstein and Nagy N. N. Naguib
Cancers 2024, 16(8), 1498; https://doi.org/10.3390/cancers16081498 - 14 Apr 2024
Cited by 3 | Viewed by 1840
Abstract
The aim of this study was to retrospectively evaluate the effects of conventional transarterial chemoembolization (cTACE) for the treatment of hepatocellular carcinoma over 20 years regarding overall survival (OS) and prognostic factors for OS. During the period from 1996 to 2016, 836 patients [...] Read more.
The aim of this study was to retrospectively evaluate the effects of conventional transarterial chemoembolization (cTACE) for the treatment of hepatocellular carcinoma over 20 years regarding overall survival (OS) and prognostic factors for OS. During the period from 1996 to 2016, 836 patients with HCC were treated with cTACE. Data evaluation was performed on the basis of pre- and postinterventional MRI and CT scans. Survival analysis was performed by Kaplan–Meier estimator; prognostic factors were determined by the use of Cox regression analysis. Overall, 4084 (mean 4.89 TACE sessions/patient) procedures were assessed. Median OS was 700 days (99% CI, 632.8–767.2). Depending on the indication, patients treated with a neoadjuvant intention showed the best OS (1229 days, 99% CI 983.8–1474.2) followed by curative intention (787 days, 99% CI 696.3–877.7), and then palliative intention (360 days, 99% CI 328.4–391.6). Portal vein thrombosis (HR 2.19, CI 1.63–2.96, and p < 0.01) and Child–Pugh class B or worse (HR 1.44, CI 1.11–1.86, and p < 0.001) were significantly associated with shorter OS. Patients with HCC benefit from TACE after careful patient selection. Portal vein thrombosis and Child–Pugh class B or worse are significantly unfavorable prognostic factors for patients’ survival. Full article
(This article belongs to the Collection Treatment of Hepatocellular Carcinoma and Cholangiocarcinoma)
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25 pages, 4781 KB  
Article
Brain Tumor Detection and Categorization with Segmentation of Improved Unsupervised Clustering Approach and Machine Learning Classifier
by Usharani Bhimavarapu, Nalini Chintalapudi and Gopi Battineni
Bioengineering 2024, 11(3), 266; https://doi.org/10.3390/bioengineering11030266 - 8 Mar 2024
Cited by 30 | Viewed by 5736
Abstract
There is no doubt that brain tumors are one of the leading causes of death in the world. A biopsy is considered the most important procedure in cancer diagnosis, but it comes with drawbacks, including low sensitivity, risks during biopsy treatment, and a [...] Read more.
There is no doubt that brain tumors are one of the leading causes of death in the world. A biopsy is considered the most important procedure in cancer diagnosis, but it comes with drawbacks, including low sensitivity, risks during biopsy treatment, and a lengthy wait for results. Early identification provides patients with a better prognosis and reduces treatment costs. The conventional methods of identifying brain tumors are based on medical professional skills, so there is a possibility of human error. The labor-intensive nature of traditional approaches makes healthcare resources expensive. A variety of imaging methods are available to detect brain tumors, including magnetic resonance imaging (MRI) and computed tomography (CT). Medical imaging research is being advanced by computer-aided diagnostic processes that enable visualization. Using clustering, automatic tumor segmentation leads to accurate tumor detection that reduces risk and helps with effective treatment. This study proposed a better Fuzzy C-Means segmentation algorithm for MRI images. To reduce complexity, the most relevant shape, texture, and color features are selected. The improved Extreme Learning machine classifies the tumors with 98.56% accuracy, 99.14% precision, and 99.25% recall. The proposed classifier consistently demonstrates higher accuracy across all tumor classes compared to existing models. Specifically, the proposed model exhibits accuracy improvements ranging from 1.21% to 6.23% when compared to other models. This consistent enhancement in accuracy emphasizes the robust performance of the proposed classifier, suggesting its potential for more accurate and reliable brain tumor classification. The improved algorithm achieved accuracy, precision, and recall rates of 98.47%, 98.59%, and 98.74% on the Fig share dataset and 99.42%, 99.75%, and 99.28% on the Kaggle dataset, respectively, which surpasses competing algorithms, particularly in detecting glioma grades. The proposed algorithm shows an improvement in accuracy, of approximately 5.39%, in the Fig share dataset and of 6.22% in the Kaggle dataset when compared to existing models. Despite challenges, including artifacts and computational complexity, the study’s commitment to refining the technique and addressing limitations positions the improved FCM model as a noteworthy advancement in the realm of precise and efficient brain tumor identification. Full article
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12 pages, 2619 KB  
Article
Straightforward Magnetic Resonance Temperature Measurements Combined with High Frame Rate and Magnetic Susceptibility Correction
by Sangwoo Kim, Donghyuk Kim and Sukhoon Oh
Bioengineering 2023, 10(11), 1299; https://doi.org/10.3390/bioengineering10111299 - 9 Nov 2023
Cited by 1 | Viewed by 1733
Abstract
Proton resonance frequency shift (PRFS) is an MRI-based simple temperature mapping method that exhibits higher spatial and temporal resolution than temperature mapping methods based on T1 relaxation time and diffusion. PRFS temperature measurements are validated against fiber-optic thermal sensors (FOSs). However, the use [...] Read more.
Proton resonance frequency shift (PRFS) is an MRI-based simple temperature mapping method that exhibits higher spatial and temporal resolution than temperature mapping methods based on T1 relaxation time and diffusion. PRFS temperature measurements are validated against fiber-optic thermal sensors (FOSs). However, the use of FOSs may introduce temperature errors, leading to both underestimation and overestimation of PRFS measurements, primarily due to material susceptibility changes caused by the thermal sensors. In this study, we demonstrated susceptibility-corrected PRFS (scPRFS) with a high frame rate and accuracy for suitably distributed temperatures. A single-echo-based background removal technique was employed for phase variation correction, primarily owing to magnetic susceptibility, which enabled fast temperature mapping. The scPRFS was used to validate the temperature fidelity by comparing the temperatures of fiber-optic sensors and conventional PRFS through phantom-mimicked human and ex vivo experiments. This study demonstrates that scPRFS measurements in agar-gel are in good agreement with the thermal sensor readings, with a root mean square error (RMSE) of 0.33–0.36 °C in the phantom model and 0.12–0.16 °C in the ex vivo experiment. These results highlight the potential of scPRFS for precise thermal monitoring and ablation in both low- and high-temperature non-invasive therapies. Full article
(This article belongs to the Special Issue Recent Advances of Biosensors for Biomedical Applications)
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