Search Results (22)

Contrast-induced acute kidney injury (CIAKI) is a common complication after percutaneous coronary intervention (PCI) in type 2 diabetes mellitus (T2DM). The protective role of sodium-glucose co-transporter 2 inhibitors (SGLT2i) against CIAKI remains unclear. We aimed to evaluate the effects of SGLT2i using nationwide database analysis and experimental models. A nationwide nested case–control study using Taiwan’s National Health Insurance Research Database assessed the association between SGLT2i use and risk of post-PCI dialysis. Parallel in vitro experiments examined dapagliflozin in iopamidol-treated HK-2 cells, and in vivo studies tested dapagliflozin in diabetic rats exposed to iopamidol. Clinically, SGLT2i use significantly reduced the risk of post-PCI dialysis (adjusted OR 0.33, 95% CI 0.14–0.76; p = 0.0094). In vitro, dapagliflozin attenuated iopamidol-induced cytotoxicity and NLRP3 inflammasome activation in HK-2 cells. In diabetic rats, dapagliflozin improved renal function, reduced tubular injury, and suppressed inflammasome-driven inflammation. In conclusion, SGLT2i protect against CIAKI by mitigating tubular injury and inflammasome activation. These findings highlight their potential as a preventive strategy for CIAKI in T2DM patients undergoing PCI. Full article

Iodine-based contrast agents (ICMs) are crucial substances in medical imaging because of their potent X-ray characteristics and chemical stability. However, their persistence and poor removal in conventional wastewater treatment have led to increasing environmental concern. Although ICMs exhibit low acute toxicity, their transformation during water disinfection can generate iodine-based disinfection by-products (I-DBPs), like iodo-trihalomethanes, which display notable cytotoxic, genotoxic, and ecotoxic effects and compromise drinking water quality. Advanced oxidation processes (AOPs) have become promising methods for breaking down persistent ICMs and limiting the formation of I-DBPs. Techniques including ozonation, UV/H₂O₂, UV/chlorine, photocatalysis with TiO₂, Fenton reactions, and electrochemical oxidation utilize highly reactive radicals to decompose persistent compounds like iopamidol, iohexol, iopromide, and diatrizoate. Despite high degradation efficiencies under laboratory conditions, limitations such as incomplete mineralization, secondary product formation, and elevated operational costs hinder large-scale implementation. Future research should focus on optimizing AOP conditions under realistic water matrices, evaluating by-product toxicity, and developing cost-effective hybrid systems. Advancing these technologies is critical to reducing the environmental burden of ICMs and safeguarding aquatic ecosystems and public health. Full article

Iopamidol (IPM), as a typical recalcitrant emerging pollutant and precursor of iodinated disinfection by-products (I-DBPs), is unsuccessfully removed by conventional wastewater treatment processes. This study comprehensively evaluated the ozone/peracetic acid (O₃/PAA) process for IPM degradation, focusing on degradation kinetics, environmental impacts, transformation products, ecotoxicity, disinfection byproducts (DBPs), and microbial inactivation. The O₃/PAA system synergistically activates PAA via O₃ to generate hydroxyl radicals (^•OH) and organic radicals (CH₃COO^• and CH₃CO(O)O^•), achieving an IPM degradation rate constant of 0.10 min⁻¹, which was significantly higher than individual O₃ or PAA treatments. The degradation efficiency of IPM in the O₃/PAA system exhibited a positive correlation with solution pH, achieving a maximum degradation rate constant of 0.23 min⁻¹ under alkaline conditions (pH 9.0). Furthermore, the process demonstrated strong resistance to interference from coexisting anions, maintaining robust IPM removal efficiency in the presence of common aqueous matrix constituents. Furthermore, quenching experiments revealed ^•OH dominated IPM degradation in O₃/PAA system, while the direct oxidation by O₃ and R-O^• played secondary roles. Additionally, based on transformation products (TPs) identification and ECOSAR predictions, the primary degradation pathways were elucidated and the potential ecotoxicity of TPs was systematically assessed. DBPs analysis after chlorination revealed that the O₃/PAA (2.5:3) system achieved the lowest total DBPs concentration (99.88 μg/L), representing a 71.5% reduction compared to PAA alone. Amongst, dichloroacetamide (DCAM) dominated the DBPs profile, comprising > 60% of total species. Furthermore, the O₃/PAA process achieved rapid 5–6 log reductions of E. coli. and S. aureus within 3 min. These results highlight the dual advantages of O₃/PAA in effective disinfection and byproduct control, supporting its application in sustainable wastewater treatment. Full article

Objective: We aimed to evaluate the feasibility, added value, and radiation dose of coronary computed tomography angiography (CCTA) and stress dynamic CT myocardial perfusion imaging (MPI) in patients with coronary artery disease (CAD) in a real-world setting. Materials and Methods: This retrospective study included 65 patients (mean age: 51.2 ± 11.5 years; 21 female) with moderate CAD, selected from the Radiological Database of our hospital between May 2022 and December 2024. All patients underwent CCTA and stress dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used for CT-MPI with 60 mL of contrast (iopamidol, 370 mg iodine/mL) administered at a flow rate of 6 mL/s. The mean myocardial blood flow (MBF) and other quantitative parameters were measured for both CAD and reference segments (RSs). A 17-segment-based analysis was employed (excluding the apex). The MBF ratio, defined as the mean MBF value of CAD segments divided by that of RS, was used with a cut-off value of 0.85 to distinguish hypoperfused from non-hypoperfused segments within CAD territories. Non-parametric statistical tests were applied. Results: A total of 1040 segments were evaluated. In 62 segments, the mean MBF of CAD territories was found to have decreased. The mean MBF and myocardial blood volume (MBV) in hypoperfused CAD segments were 65.1 ± 19.8 mL/100 mL/min and 14.5 ± 2.7 mL/100 mL, respectively, both significantly lower compared to non-hypoperfused CAD segments and RSs (p < 0.001). The mean effective dose of the protocol was 6.3 ± 1.4 mSv, corresponding to an estimated individual lifetime cancer risk of approximately 0.06% per test, based on BEIR VII Phase 2 modeling. This risk is cumulative, with repeat testing over a 10-year period potentially increasing lifetime cancer risk in proportion to total radiation exposure. The mean total examination time was 26 ± 4 min. Conclusion: The combined CCTA and dynamic CT-MPI protocol is feasible in real-world clinical practice and offers a comprehensive morphological and functional assessment of moderate CAD, with a manageable radiation dose and examination time. Full article

Background/Objectives: Hypersensitivity to iodinated contrast media (ICM) agents is a significant concern in clinical practice, potentially limiting their use in essential medical imaging studies and interventions. This cohort study reflects real-world clinical settings, with the aim of characterizing patients with a history of an ICM allergy and to analyze the potential cross-reactivity between different ICM agents. Methods: We conducted a retrospective review of patients with a documented history of an allergy to ICM. Data were collected from a six-year period, (2018 to 2023), and included a total of 26,465 procedures carried out with contrast. Data on patient demographics, reaction characteristics, culprit ICM agents, and outcomes of re-exposure were analyzed. Results: One hundred and eighty-three patients were identified as being allergic to at least one type of ICM. The majority of reactions were immediate (60.7%) versus delayed (39.3%). The most common culprit agent was Ioversol (3.84%) and related to the total time used. Among those who were ever exposed to more than one agent, the highest rate of recurrent hypersensitivity reactions was observed between Iohexol and Iodixanol (three out of six cases) and between Iopromide and Iopamidol (one out of two cases). No recurrent hypersensitivity reaction rate was observed between Iodixanol and Iopamidol (0 out of 12 cases). The highest proportion of severe allergies among those with allergic reactions was 3/15 (20%) for Iodixanol. Conclusions: Allergic reactions to ICM are uncommon and mostly non-severe. Although our findings do not confirm immunologic cross-reactivity, the occurrence of recurrent reactions to different ICMs in certain cases underscores the need for careful clinical judgment when selecting appropriate agents. Full article

In chlorination disinfection treatment, residual iodinated X-ray contrast media (ICMs) are the precursors to iodinated disinfection by-products (I-DBPs). This study employed CoFe₂O₄ nanoparticle catalytic peracetic acid oxidation (CoFe₂O₄/PAA) to remove iopamidol (IPM) and control I-DBP formation. The experimental results demonstrated that over 90% of the IPM degradation was achieved in 40 min. The metastable intermediate (≡Co(II)-OO(O)CCH₃), rather than the alkoxyl radicals, was identified as the dominant oxidation species (ROS). The electron transfer pathways between the metastable intermediate and IPM were oxygen-atom transfer and single-electron transfer. The monoiodoacetic acid formation potential (MIAAFP) was investigated. In ultraviolet-activated ClO⁻ (UV/chlorine), a portion of I⁻ generated through IPM dehalogenation underwent conversion to reactive iodine species (RIS), consequently elevating the MIAAFP. In CoFe₂O₄/PAA, the MIAAFP was less than 43% of that in UV/chlorine, which can be attributed to the complete conversion of I⁻ into iodate IO₃⁻ without generating RIS. CoFe₂O₄/PAA is thus a promising treatment for removing ICMs and controlling I-DBP formation due to the efficient degradation of ICMs while avoiding the generation of RIS. Full article

Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) is a novel MRI technology to image certain compounds at extremely low concentrations. Long acquisition time to measure signals at a set of offset frequencies of the Z-spectra and to repeat measurements to reduce noise pose significant challenges to its applications. This study explores correlations of CEST MR images along the spatial and Z-spectral dimensions to improve MR image quality and robustness of magnetization transfer ratio (MTR) asymmetry estimation via a joint k-$\omega$ reconstruction model. The model was formulated as an optimization problem with respect to MR images at all frequencies $\omega$, while incorporating regularizations along the spatial and spectral dimensions. The solution was subject to a self-consistency condition that the Z-spectrum of each pixel follows a multi-peak data fitting model corresponding to different CEST pools. The optimization problem was solved using the alternating direction method of multipliers. The proposed joint reconstruction method was evaluated on a simulated CEST MRI phantom and semi-experimentally on choline and iopamidol phantoms with added Gaussian noise of various levels. Results demonstrated that the joint reconstruction method was more tolerable to noise and reduction in number of offset frequencies by improving signal-to-noise ratio (SNR) of the reconstructed images and reducing uncertainty in MTR asymmetry estimation. In the choline and iopamidol phantom cases with 10.5% noise in the measurement data, our method achieved an averaged SNR of 31.0 dB and 32.2 dB compared to the SNR of 24.7 dB and 24.4 dB in the conventional reconstruction approach. It reduced uncertainty of the MTR asymmetry estimation over all regions of interest by 54.4% and 43.7%, from 1.71 and 2.38 to 0.78 and 1.71, respectively. Full article

CEST-MRI is an emerging imaging technique suitable for various in vivo applications, including the quantification of tumor acidosis. Traditionally, CEST contrast is calculated by asymmetry analysis, but the presence of fat signals leads to wrong contrast quantification and hence to inaccurate pH measurements. In this study, we investigated four post-processing approaches to overcome fat signal influences and enable correct CEST contrast calculations and tumor pH measurements using iopamidol. The proposed methods involve replacing the Z-spectrum region affected by fat peaks by (i) using a linear interpolation of the fat frequencies, (ii) applying water pool Lorentzian fitting, (iii) considering only the positive part of the Z-spectrum, or (iv) calculating a correction factor for the ratiometric value. In vitro and in vivo studies demonstrated the possibility of using these approaches to calculate CEST contrast and then to measure tumor pH, even in the presence of moderate to high fat fraction values. However, only the method based on the water pool Lorentzian fitting produced highly accurate results in terms of pH measurement in tumor-bearing mice with low and high fat contents. Full article

Background: The advancement of medical interventions towards minimally invasive procedures highlights the crucial role of precise pre-procedural evaluation, particularly in catheter-based treatments for heart and cardiovascular conditions. This study investigates innovative techniques such as mitral loop cerclage (MLC) and transcatheter intramyocardial radiofrequency ablation (TIRA), emphasizing the importance of preprocedural cardiac CT scans for accurate anatomical guidance in these emerging therapies. Purpose: The objective of this study was to assess the cardiac cycle through examination of the proximal septal vein (ps) for mitral loop cerclage and the distal septal vein (ds) for transcatheter intramyocardial radiofrequency ablation. Materials and Methods: Forty patients (mean age 59.4 ± 14.7 years) undergoing third-generation dual-source computed tomography (DSCT) for chest pain evaluation were enrolled. CT scans, utilizing dual-energy CT (DECT) with iopamidol and saline, encompassed the carina to the heart base. A noise-optimized linear blended image was reconstructed at 10% intervals throughout the cardiac cycle, and the presence of ps and ds in each phase was noted by two radiologists. Results: This study identified ps in 62.5% and ds in 72.5% of patients, with both present in 45% of cases. The observation of septal veins occurred more frequently in the sequence of 70, 60, 40, 80, 30, 20, and 10% for ps, and 60, 70, 40, 80, 30, 90, 20, and 10% for ds, respectively. Conclusions: DECT in cardiac imaging is instrumental in assessing septal vein frequency. The 70% phase is optimal for MLC, while the 60% phase is preferred for TIRA. Full article

The occurrence of micropollutants, including pharmaceuticals, personal care products, pesticides, and hormones in various aquatic ecosystems is a matter of grave concern due to their possible repercussions on human and wildlife endocrine systems. The wastewater containing pharmaceuticals from various sites is usually introduced to sewage treatment plants (STPs); therefore, monitoring of pharmaceuticals in STPs is crucial. In this study, we determined the occurrence of 58 pharmaceuticals in the influent and effluent of 13 STPs based on regional and linked wastewater differences and investigated their removal rates. Furthermore, we assessed the contribution rates of some STP effluents on pharmaceutical concentration in the upstream and downstream areas of the discharge source. Different kinds of pharmaceuticals were measured in the STPs. The top five pharmaceuticals with high concentrations in the influent of each STP were similar due to the dominance of domestic sewage in the influent. The average concentration of acetaminophen, caffeine, acetylsalicylic acid, naproxen, and ibuprofen in the influent of the STPs was higher than that of other pharmaceuticals, and their removal was 94–100%. In contrast, iopamidol, cimetidine, diphenhydramine, and carbamazepine showed a high average concentration in the effluent. The monitoring results of nine streams near STPs indicated that the effluent could contribute to the increase in the types of pharmaceuticals in the receiving streams. The detected pharmaceuticals’ types were 9–29 and 17–33 in the upstream and downstream areas, respectively, of STP discharge channels. Based on flowrate data, the contribution rate of the STP effluent on the stream was −69–326%. Full article

We compared the image quality of abdominopelvic single-energy CT with 100 kVp (SECT-100 kVp) and dual-energy CT with 65 keV (DECT-65 keV) obtained with customized injection protocols to standard abdominopelvic CT scans (SECT-120 kVp) with fixed volumes of contrast media (CM). We retrospectively included 91 patients (mean age, 60.7 ± 15.8 years) with SECT-100 kVp and 83 (mean age, 60.3 ± 11.7 years) patients with DECT-65 keV in portovenous phase. Total body weight-based customized injection protocols were generated by a software using the following formula: patient weight (kg) × 0.40/contrast concentration (mgI/mL) × 1000. Patients had a prior abdominopelvic SECT-120 kVp with fixed injection. Iopamidol-370 was administered for all examinations. Quantitative and qualitative image quality comparisons were made between customized and fixed injection protocols. Compared to SECT-120 kVp, customized injection yielded a significant reduction in CM volume (mean difference = 9–12 mL; p ≤ 0.001) and injection rate (mean differences = 0.2–0.4 mL/s; p ≤ 0.001) in all weight categories. Improvements in attenuation, noise, signal-to-noise and contrast-to-noise ratios were observed for both SECT-100 kVp and DECT-65 keV compared to SECT-120 kVp in all weight categories (e.g., pancreas DECT-65 keV, 1.2-attenuation-fold increase vs. SECT-120 kVp; p < 0.001). Qualitative scores were ≥4 in 172 cases (98.8.4%) with customized injections and in all cases with fixed injections (100%). These findings suggest that customized CM injection protocols may substantially reduce iodine dose while yielding higher image quality in SECT-100 kVp and DECT-65 keV abdominopelvic scans compared to SECT-120 kVp using fixed CM volumes. Full article

Novel anticancer treatments target the pH regulating system that plays a major role in tumor progression by creating an acidic microenvironment, although few studies have addressed their effect on tumor acidosis. In this study, we investigated in vivo several proton pump inhibitors (PPIs) targeting NHE-1 (Amiloride and Cariporide) and V-ATPase (Esomeprazole and Lansoprazole) proton transporters in the DU145 androgen-insensitive human prostate cancer model. In cellulo results showed that DU145 are sensitive, with decreasing efficacy, to Amiloride, Esomeprazole and Lansoprazole, with marked cell toxicity both in normoxia and in hypoxia, with almost any change in pH. In vivo studies were performed upon administration of Esomeprazole to assess both the acute and chronic effects, and Iopamidol-based tumor pH imaging was performed to evaluate tumor acidosis. Although statistically significant tumor pH changes were observed a few hours after Esomeprazole administration in both the acute study and up to one week of treatment in the chronic study, longer treatment resulted in a lack of changes in tumor acidosis, which was associated to similar tumor growth curves between treated and control groups in both the subcutaneous and orthotopic models. Overall, this study highlights MRI-CEST tumor pH imaging as a valid approach to monitoring treatment response to PPIs. Full article

The consumption of pharmaceuticals has increased the presence of micropollutants (MPs) in the environment. The removal and degradation of pharmaceutical mixtures in different water matrices are thus of significant importance. The photocatalytic degradation of four micropollutants—diclofenac (DCF), iopamidol (INN), methylene blue (MB), and metoprolol (MTP)—have been analyzed in this study by using a photocatalytic ceramic membrane. We experimentally analyzed the degradation rate by using several water matrices by changing the feed composition of micropollutants in the mixture (from mg· L${}^{-1}$ to $\mathsf{\mu }$g·L${}^{-1}$), adding different concentrations of inorganic compounds (NaHCO₃ and NaCl), and by using tap water. A maximum degradation of 97% for DCF and MTP, and 85% for INN was observed in a micropollutants (MPs) mixture in tap water at environmentally relevant feed concentrations [1–6 $\mathsf{\mu }$g·L${}^{-1}$]${}_{\mathrm{o}};$ and 86% for MB in an MPs mixture [1–3 mg·L${}^{-1}$]${}_{\mathrm{o}}$ with 100 mg·L${}^{-1}$ of NaCl. This work provides further insights into the applicability of photocatalytic membranes and illustrates the importance of the water matrix to the photocatalytic degradation of micropollutants. Full article

The tumor microenvironment acidification confers treatment resistance; therefore, the interference with pH regulating systems is considered a new therapeutic strategy. In this study, two human prostate cancer cell lines, PC3 and LNCaP, have been treated in vitro with proton pump inhibitors (PPIs), namely Lansoprazole, Esomeprazole (V-ATPases-inhibitors), Cariporide, and Amiloride (NHE1-inhibitors). The cell viability and pH were assessed at several drug concentrations either at normoxic or hypoxic conditions. Since Esomeprazole showed the highest toxicity towards the PC3 cancer cells compared to LNCaP ones, athymic nude mice bearing subcutaneous or orthotopic PC3 tumors were treated with Esomeprazole (dose: 2.5 mg/kg body weight) for a period of three weeks—and tumor growth was monitored. MRI-CEST tumor pH imaging with Iopamidol was performed upon treatment at 3 h, 1 week (in combination with FDG-PET), and after 2 weeks for evaluating acute, early, and late responses. Although acute tumor pH changes were observed in vivo, long-term studies on both PC3 prostate cancer models did not provide any significant change in tumor acidosis or tumor growth. In conclusion, this work shows that MRI-CEST tumor pH imaging is a valuable tool for assessing the in vivo treatment response to PPIs. Full article

The present work aims to explore steam activation of sisal or glucose-derived acid-chars as an alternative to KOH activation to prepare superactivated carbons, and to assess the adsorption performance of acid-chars and derived activated carbons for pharmaceuticals removal. Acid-chars were prepared from two biomass precursors (sisal and glucose) using various H₂SO₄ concentrations (13.5 M, 12 M, and 9 M) and further steam-activated at increasing burn-off degrees. Selected materials were tested for the removal of ibuprofen and iopamidol from aqueous solution (kinetic and equilibrium assays) in single-solute conditions. Activated carbons prepared from acid-char carbonized with 13.5 M and 12 M H₂SO₄ are mainly microporous solids composed of compact rough particles, yielding a maximum surface area and a total pore volume of 1987 m² g⁻¹ and 0.96 cm³ g⁻¹, respectively. Solid state NMR reveals that steam activation increased the aromaticity degree and amount of C=O functionalities. Steam activation improved the acid-chars adsorption capacity for ibuprofen from 20-65 mg g⁻¹ to higher than 280 mg g⁻¹, leading to fast adsorption kinetics (15–20 min). The maximum adsorption capacities of selected activated samples for ibuprofen and iopamidol were 323 and 1111 mg g⁻¹, respectively. Full article