iRadiology最新文献

Quantitative susceptibility mapping (QSM) is an advanced post-processing technique in magnetic resonance imaging that offers precise measurements of tissue magnetic susceptibility with impressive spatial resolution and sensitivity. This review examines the potential of QSM as a biomarker for early detection and monitoring of amyotrophic lateral sclerosis (ALS). Since 2015, studies have consistently reported increased QSM values in the motor regions of individuals with ALS, indicating significant iron deposition. Iron accumulation is associated with dysfunction of the upper motor neurons and faster disease progression. Notably, increased QSM values were also observed in the critical subcortical areas responsible for motor function and cognitive control. However, standardizing optimized protocols, including background field removal algorithms, phase unwrapping approaches, and methods for final susceptibility map reconstruction, has the potential to enhance the consistency and reliability of QSM as an ALS biomarker. Overall, the current body of evidence strongly supports QSM in detecting iron dysregulation associated with neurodegeneration in both motor and extra-motor regions in ALS. Furthermore, QSM's remarkable sensitivity to early pathological iron changes and its high specificity in distinguishing ALS positions make it a promising diagnostic and progression-tracking biomarker.

Extracellular vesicles (EVs) are tiny vesicles released by various cells that contain a variety of proteins, lipids, and nucleic acids, which can have a wide range of effects on other cells. The dynamic composition and contents of EVs can serve as sensitive biomarkers for diagnosing and monitoring various cardiovascular diseases (CVDs). In addition to their diagnostic potential, EVs are therapeutic agents capable of precise modulation and amelioration of CVDs, because of their innate ability to encapsulate and deliver bioactive molecules. This growing field reveals the intricate interplay between EVs and cardiovascular pathophysiology, showing that EVs can act as messengers of intercellular communication for CVD regenerative therapy. Extracellular vesicles serve as dual agents in the field of theranostics, both as diagnostic biomarkers able to decode nuanced molecular signatures of CVDs and as potent vehicles for targeted therapeutic interventions. This review delves into the evolving landscape of EVs, uncovering their diagnostic and therapeutic prospects and emphasizing their growing importance in shaping the future of cardiovascular theranostics.

A 69-year-old male with a known history (Hx) of chronic kidney disease (CKD) was presented with a 2-day Hx of inability to flex the proximal and distal interphalangeal (DIP) joints of the first, second, and third digits of his left hand. Notably, he retained the ability to flex the proximal and DIP joints of the fourth and fifth fingers. This presentation followed balloon fistuloplasty (BF) performed to address stenosis of an arteriovenous fistula between the radial artery and cephalic vein.

Physical examination revealed swelling and erythema on the ventral aspect of left upper arm. He was referred for ultrasonography (USG) for the same.

Ultrasound imaging of the left upper arm was conducted. The examination revealed a well-defined cystic lesion measuring 27 × 7 × 10 mm, originating from the wall of the brachial artery. Doppler study demonstrated a “ying yang” sign on color Doppler, indicative of a pseudoaneurysm (PNA). Notably, the PNA was observed to pulsate against the median nerve (MN), leading to neuropraxia (Figure 1).

Under ultrasound guidance, compression therapy for 15 min was performed and complete obliteration of lumen was achieved and was confirmed on Doppler study showing no flow in the lumen of PNA (Figure 2).

The MN descends down the arm, initially lateral to the brachial artery. Halfway down the arm, the nerve crosses over the brachial artery and becomes situated medially [1]. The MN is formed from all anterior rami of C5-T1 [2]. It predominantly provides motor innervation to the flexor muscles of the forearm and hand and also provides sensory innervation to the dorsal aspect (nail bed) of the distal first two digits of the hand, the palmar aspect of the thumb, index, middle, and half of the ring finger, the palm, as well as the medial aspect of the forearm [3].

MN neuropraxia associated with post iatrogenic vascular injury to the brachial artery is very low and is a degraded complication. Brachial PNA could result in compression of the MN in the arm leading to an ischemic injury [4]. In this case, the patient was presented with pain and erythema of the left upper arm. From the given Hx, the patient was a known case of CKD and was undergoing hemodialysis for the same. A fistula between the radial artery and cephalic vein was created. Later, after 5 months of arterio-venous fistula, he developed features of arterio-venous fistula stenosis, and BF was advised for the same.

In this patient, a complication of arterio-venous stenosis was diagnosed. USG and color Doppler of the upper arm at the incision site showed a PNA, which was seen pulsating and compressing the MN. Thus, a diagnosis of neuropraxia was made. Compression therapy for 15 min was performed, and complete occlusion of the PNA was obtained.

Our case underscores the significance of prompt recognition and management of PNAs following vascular interventions. Utilization of high-re

Positron emission tomography (PET) is a noninvasive molecular imaging technique that utilizes biologically active radiolabeled compounds to image biochemical processes. As such, PET can provide important pathophysiological information associated with pain of different etiologies. Consequently, the information obtained using PET often combined with magnetic resonance imaging or computed tomography can provide useful information for diagnosing and monitoring changes associated with pain. This review covers the most important PET tracers that have been used to image pain including tracers for fundamental biological processes such as glucose metabolism and cerebral blood flow, to receptor-specific tracers such as ion channels and neurotransmitters. For each tracer, we describe the structure and radiochemical synthesis of the tracer followed by a brief summary of the available preclinical and clinical studies. By providing a summary of the PET tracers that have been employed for PET imaging of pain, this review aims to serve as a reference for preclinical, translational, and clinical investigators interested in molecular imaging of pain. Finally, the review ends with an outlook of the needs and opportunities in this area.

Recently, the use of ultrasound (US) for triggering drug release to specific tissues was explored, but its direct effects on cells have not been thoroughly understood. For this reason, this study aimed to investigate the impact of US powers and US irradiation times on fibroblast cells (NIH-3T3). The results showed that the diverse US settings had varying effects on cell proliferation and distribution in the polystyrene culture dish. Interestingly, at 10 W, 43 kHz with changing exposed time up to 30 min either stimulated or inhibited fibroblast cell growth after 24 and 72 h of cultivation compared to the control sample in the absence of US, while longer US exposure time led to a moderate reduction in cell quantity. Moreover, higher US levels of 20 and 30 W could cause an aggregation of cells and sublethal damage to the cells. Importantly, the morphology of fibroblast was changed from stellate-shape to round-shape under greater US powers. Elevated US power also influenced interactions between proteins and lipids, affecting the atomic and molecular charges, leading to changes in both zeta potential and pH of the dispensed cell solution.

In this scoping review, we evaluated the performance of artificial intelligence (AI) in clinical radiology practice and examined health professionals' perspectives regarding AI use in radiology. This review followed the Joanna Briggs Institute (JBI) methodological guidelines. We searched multiple databases and the gray literature from March 15, 2016 to December 31, 2023. Of 49 articles reviewed, 13 assessed the performance of AI in radiology clinical practice, and 36 examined the attitudes of health professionals toward the use of AI in radiology. In four separate studies, AI significantly improved the diagnostic sensitivity or detection rate. Furthermore, six articles emphasized a significant reduction in case reading times with AI use. Although three studies suggested an increase in specificity with the assistance of AI, these findings did not reach statistical significance. Health professionals expressed the belief that AI would have a significant impact on radiology but would not replace radiologists in the near future. Limited knowledge of AI was observed among health professionals, who supported increased education and explicit regulations and guidelines related to AI. Overall, AI can enhance diagnostic efficiency and accuracy in clinical radiology practice. However, knowledge gaps and the concerns of health professionals should be addressed by prioritizing education and reinforcing ethical and legal regulations to facilitate the advancement of AI use in radiology. This scoping review provides evidence toward a comprehensive understanding of AI's potential in clinical radiology practice, promoting its use and stimulating further discussion on related challenges and implications.

Optimal therapeutic and diagnostic efficacy is essential for healthcare's global mission of advancing oncologic drug development. Accurate diagnosis and detection are crucial prerequisites for effective risk stratification and personalized patient care in clinical oncology. A paradigm shift is emerging with the promise of multi-receptor-targeting compounds. While existing detection and staging methods have demonstrated some success, the traditional approach of monotherapy is being reevaluated to enhance therapeutic effectiveness. Heterodimeric site-specific agents are a versatile solution by targeting two distinct biomarkers with a single theranostic agent. This review describes the innovation of dual-targeting compounds, examining their design strategies, therapeutic implications, and the promising path they present for addressing complex diseases.