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OBJECTIVE: Cardiac magnetic resonance (CMR) is a diagnostic tool that provides precise and reproducible information about cardiac structure, function, and tissue characterization, aiding in the monitoring of chemotherapy response in patients with light-chain cardiac amyloidosis (AL-CA). This study aimed to evaluate the feasibility of CMR in monitoring responses to chemotherapy in patients with AL-CA. MATERIALS AND METHODS: In this prospective study, we enrolled 111 patients with AL-CA (50.5% male; median age, 54 [interquartile range, 49-63] years). Patients underwent longitudinal monitoring using biomarkers and CMR imaging. At follow-up after chemotherapy, patients were categorized into superior and inferior response groups based on their hematological and cardiac laboratory responses to chemotherapy. Changes in CMR findings across therapies and differences between response groups were analyzed. RESULTS: Following chemotherapy (before vs. after), there were significant increases in myocardial T2 (43.6 ± 3.5 ms vs. 44.6 ± 4.1 ms; P = 0.008), recovery in right ventricular (RV) longitudinal strain (median of -9.6% vs. -11.7%; P = 0.031), and decrease in RV extracellular volume fraction (ECV) (median of 53.9% vs. 51.6%; P = 0.048). These changes were more pronounced in the superior-response group. Patients with superior cardiac laboratory response showed significantly greater reductions in RV ECV (-2.9% [interquartile range, -8.7%-1.1%] vs. 1.7% [-5.5%-7.1%]; P = 0.017) and left ventricular ECV (-2.0% [-6.0%-1.3%] vs. 2.0% [-3.0%-5.0%]; P = 0.01) compared with those with inferior response. CONCLUSION: Cardiac amyloid deposition can regress following chemotherapy in patients with AL-CA, particularly showing more prominent regression, possibly earlier, in the RV. CMR emerges as an effective tool for monitoring associated tissue characteristics and ventricular functional recovery in patients with AL-CA undergoing chemotherapy, thereby supporting its utility in treatment re

This thesis primarily focuses on investigating atrial remodeling using cardiovascular MRI (CMR) in patients scheduled for an atrial fibrillation (AF) ablation procedure. Atrial remodeling refers to changes in atrial function, shape, and structure, which contribute to the development and perpetuation of AF. Our studies examined various imaging markers of atrial remodeling, and their association with the success of the ablation procedure. One of the most promising novel CMR-based markers is the non-invasive visualization and quantification of atrial fibrosis, as fibrotic tissue transformation is considered to be directly related to the mechanisms governing the development of AF. We performed a critical evaluation of this CMR-based atrial fibrosis detection. Furthermore, we explored the clinical feasibility of interventional CMR (iCMR) for performing flutter ablation procedures.

Aims To characterize acute lesions during cardiac magnetic resonance (CMR)-guided radiofrequency (RF) ablation of cavo-tricuspid isthmus (CTI)-dependent atrial flutter by combining T2-weighted imaging (T2WI), T1 mapping, first-pass perfusion, and late gadolinium enhancement (LGE) imaging. CMR-guided catheter ablation offers a unique opportunity to investigate acute ablation lesions. Until present, studies only used T2WI and LGE CMR to assess acute lesions. . Methods Fifteen patients with CTI-dependent atrial flutter scheduled for CMR-guided RF ablation were prospectively enrolled. and results Directly after achieving bidirectional block of the CTI line, CMR imaging was performed using: T2WI (n = 15), T1 mapping (n = 10), first-pass perfusion (n = 12), and LGE (n = 12) imaging. In case of acute reconnection, additional RF ablation was performed. In all patients, T2WI demonstrated oedema in the ablation region. Right atrial T1 mapping was feasible and could be analysed with a high inter-observer agreement (r = 0.931, ICC 0.921). The increase in T1 values post-ablation was significantly lower in regions showing acute reconnection compared with regions without reconnection [37 ± 90 ms vs. 115 ± 69 ms (P = 0.014), and 3.9 ± 9.0% vs. 11.1 ± 6.8% (P = 0.022)]. Perfusion defects were present in 12/12 patients. The LGE images demonstrated hyper-enhancement with a central area of hypo-enhancement in 12/12 patients. . Conclusion Tissue characterization of acute lesions during CMR-guided CTI-dependent atrial flutter ablation demonstrates oedema, perfusion defects, and necrosis with a core of microvascular damage. Right atrial T1 mapping is feasible, and may identify regions of acute reconnection that require additional RF ablation.

PURPOSE: To develop a free-breathing, non-electrocardiogram technique for simultaneous myocardial T1 , T2 , T2 *, and fat-fraction (FF) mapping in a single scan. METHODS: The MR Multitasking framework is adapted to quantify T1 , T2 , T2 *, and FF simultaneously. A variable TR scheme is developed to preserve temporal resolution and imaging efficiency. The underlying high-dimensional image is modeled as a low-rank tensor, which allows accelerated acquisition and efficient reconstruction. The accuracy and/or repeatability of the technique were evaluated on static and motion phantoms, 12 healthy volunteers, and 3 patients by comparing to the reference techniques. RESULTS: In static and motion phantoms, T1 /T2 /T2 */FF measurements showed substantial consistency (R > 0.98) and excellent agreement (intraclass correlation coefficient > 0.93) with reference measurements. In human subjects, the proposed technique yielded repeatable T1 , T2 , T2 *, and FF measurements that agreed with those from references. CONCLUSIONS: The proposed free-breathing, non-electrocardiogram, motion-resolved Multitasking technique allows simultaneous quantification of myocardial T1 , T2 , T2 *, and FF in a single 2.5-min scan.

Purpose Rapid acquisition scheme and parameter estimation method are proposed to acquire distortion-free spin- and stimulated-echo signals and combine the signals with a physics-driven unsupervised network to estimate T-1, T-2, and proton density (M-0) parameter maps, along with B-0 and B-1 information from the acquired signals. Theory and Methods An imaging sequence with three 90 degrees RF pulses is utilized to acquire spin- and stimulated-echo signals. We utilize blip-up/-down acquisition to eliminate geometric distortion incurred by the effects of B-0 inhomogeneity on rapid EPI acquisitions. For multislice imaging, echo-shifting is applied to utilize dead time between the second and third RF pulses to encode information from additional slice positions. To estimate parameter maps from the spin- and stimulated-echo signals with high fidelity, 2 estimation methods, analytic fitting and a novel unsupervised deep neural network method, are developed. Results The proposed acquisition provided distortion-free T-1, T-2, relative proton density (M0), B-0, and B-1 maps with high fidelity both in phantom and in vivo brain experiments. From the rapidly acquired spin- and stimulated-echo signals, analytic fitting and the network-based method were able to estimate T-1, T-2, M-0, B-0, and B-1 maps with high accuracy. Network estimates demonstrated noise robustness owing to the fact that the convolutional layers take information into account from spatially adjacent voxels. Conclusion The proposed acquisition/reconstruction technique enabled whole-brain acquisition of coregistered, distortion-free, T-1, T-2, M-0, B-0, and B-1 maps at 1 x 1 x 5 mm(3) resolution in 50 s. The proposed unsupervised neural network provided noise-robust parameter estimates from this rapid acquisition.

BACKGROUND: Late gadolinium enhancement (LGE) is a widely used cardiac magnetic resonance imaging (MRI) technique to diagnose a broad range of ischemic and non-ischemic cardiomyopathies. Since its development and validation against histology already more than two decades ago, the clinical utility of LGE and its span of applications have increased considerably.METHODS: In this review we will present the basic concepts of LGE imaging and its diagnostic and prognostic value, elaborate on recent developments and emerging methods, and finally discuss future prospects.RESULTS: Continuous developments in 3 D imaging methods, motion correction techniques, water/fat-separated imaging, dark-blood methods, and scar quantification improved the performance and further expanded the clinical utility of LGE imaging.CONCLUSION: LGE imaging is the current noninvasive reference standard for the assessment of myocardial viability. Improvements in spatial resolution, scar-to-blood contrast, and water/fat-separated imaging further strengthened its position.KEY POINTS: · LGE MRI is the reference standard for the noninvasive assessment of myocardial viability. · LGE MRI is used to diagnose a broad range of non-ischemic cardiomyopathies in everyday clinical practice.. · Improvements in spatial resolution and scar-to-blood contrast further strengthened its position. · Continuous developments improve its performance and further expand its clinical utility.CITATION FORMAT: · Holtackers RJ, Emrich T, Botnar RM et al. Late Gadolinium Enhancement Cardiac Magnetic Resonance Imaging: From Basic Concepts to Emerging Methods. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1718-4355.

Ischemic cardiomyopathy (ICM) is one of the most common causes of congestive heart failure. In patients with ICM, tissue characterization with cardiac magnetic resonance imaging (CMR) allows for evaluation of myocardial abnormalities in acute and chronic settings. Myocardial edema, microvascular obstruction (MVO), intracardiac thrombus, intramyocardial hemorrhage, and late gadolinium enhancement of the myocardium are easily depicted using standard CMR sequences. In the acute setting, tissue characterization is mainly focused on assessment of ventricular thrombus and MVO, which are associated with poor prognosis. Conversely, in chronic ICM, it is important to depict late gadolinium enhancement and myocardial ischemia using stress perfusion sequences. Overall, with CMR's ability to accurately characterize myocardial tissue in acute and chronic ICM, it represents a valuable diagnostic and prognostic imaging method for treatment planning. In particular, tissue characterization abnormalities in the acute setting can provide information regarding the patients that may develop major adverse cardiac event and show the presence of ventricular thrombus; in the chronic setting, evaluation of viable myocardium can be fundamental for planning myocardial revascularization. In this review, the main findings on tissue characterization are illustrated in acute and chronic settings using qualitative and quantitative tissue characterization.

Background: Patients with chronic kidney disease (CKD) have a higher risk of cardiovascular morbidity and mortality compared to the healthy populous. The mechanisms are complex but involve cardiac fibrosis (CFib) and related dysfunction. Cardiac magnetic resonance imaging (cMRI) allows evaluation of both, and we explored CFib in patients with CKD compared to healthy volunteers (HV) with normal kidney function. Method(s): Cardiac function, morphology and tissue characterization were compared between 10 patients with CKD Stages 3-5, 12 patients on maintenance haemodialysis (HD) and 26 HV. Cardiac function and native T1 mapping time (nT1mt), using saturation recovery single-shot acquisition (SASHA) and shortened modified look-locker inversion recovery (ShMOLLI) to measure CFib, were compared across groups using analysis of variance (ANOVA) and post-hoc comparison. Result(s): Left ventricular (LV) ejection fraction was 62 +/- 5%, 62 +/- 8%, and 64 +/- 10% (p = 0.692), and LV mass was 111 +/- 34 g/m2, 136 +/- 32 g/m2, and 137 +/- 34 g/m2 (p = 0.056) in HV, CKD and HD groups, respectively. The nT1mt (SASHA) were 1485 +/- 42 ms, 1547 +/- 45 ms and 1600 +/- 105 ms (p < 0.001), and (ShMOLLI) 1157 +/- 63 ms, 1186 +/- 36 ms and 1219 +/- 47 ms (p < 0.001), respectively. In post hoc comparisons, nT1mt were significantly lower in HV than CKD (p = 0.034 for SASHA, p < 0.01 for ShMOLLI) or HD (p < 0.01 for both), but not different between CKD and HD (p = 0.152 for SASHA, p = 0.255 for ShMOLLI). Conclusion(s): Despite similar LV ejection fraction and LV mass, cMRI detected increased CFib in patients with CKD and HD. Thus, CFib appears early in CKD and may help identify CKD patients at higher risk of adverse cardiac outcomes.

Background: Although the incidence of positive resection margins in breast-conserving surgery has decreased, both incomplete resection and unnecessary large resections still occur. This is especially the case in the surgical treatment of ductal carcinoma in situ (DCIS). Diffuse reflectance spectroscopy (DRS), an optical technology based on light tissue interactions, can potentially characterize tissue during surgery thereby guiding the surgeon intraoperatively. DRS has shown to be able to discriminate pure healthy breast tissue from pure invasive carcinoma (IC) but limited research has been done on (1) the actual optical characteristics of DCIS and (2) the ability of DRS to characterize measurements that are a mixture of tissue types. Methods: In this study, DRS spectra were acquired from 107 breast specimens from 107 patients with proven IC and/or DCIS (1488 measurement locations). With a generalized estimating equation model, the differences between the DRS spectra of locations with DCIS and IC and only healthy tissue were compared to see if there were significant differences between these spectra. Subsequently, different classification models were developed to be able to predict if the DRS spectrum of a measurement location represented a measurement location with “healthy” or “malignant” tissue. In the development and testing of the models, different definitions for “healthy” and “malignant” were used. This allowed varying the level of homogeneity in the train and test data. Results: It was found that the optical characteristics of IC and DCIS were similar. Regarding the classification of tissue with a mixture of tissue types, it was found that using mixed measurement locations in the development of the classification models did not tremendously improve the accuracy of the classification of other measurement locations with a mixture of tissue types. The evaluated classification models were able to classify measurement locations with > 5% malignant cells wit, Medical Instruments & Bio-Inspired Technology

Many previous studies on the mechanical properties of Parasagittal Bridging Veins (PSBVs) found that strain rate had a significant effect on some mechanical properties, but did not extensively study the viscoelastic effects, which are difficult to detect with uniaxial simple tensile tests. In this study, relaxation tests and tests under cyclic loading were performed, and it was found that PSBVs do indeed exhibit clear viscoelastic effects. In addition, a complete viscoelastic model for the PSBVs is proposed and data from relaxation, cyclic load and load-unload tests for triangular loads are used to find reference values that characterize the viscoelastic behavior of the PSBVs. Although such models have been proposed for other types of blood vessels, this is the first study that clearly demonstrates the existence of viscoelastic effects from an experimental point of view and also proposes a specific model to explain the data obtained. Finally, this study provides reference values for the usual viscoelastic properties, which would allow more accurate numerical simulation of PSBVs by means of computational models., Peer Reviewed, Postprint (published version)

The distinction between malignant and benign tumors is essential to the treatment of cancer. The tissue's elasticity can be used as an indicator for the required tissue characterization. Optical coherence elastography (OCE) probes have been proposed for needle insertions but have so far lacked the necessary load sensing capabilities. We present a novel OCE needle probe that provides simultaneous optical coherence tomography (OCT) imaging and load sensing at the needle tip. We demonstrate the application of the needle probe in indentation experiments on gelatin phantoms with varying gelatin concentrations. We further implement two deep learning methods for the end-toend sample characterization from the acquired OCT data. We report the estimation of gelatin sample weight ratios [wt%] in unseen samples with a mean error of 1.21 ± 0.91 wt%. Both evaluated deep learning models successfully provide sample characterization with different advantages regarding the accuracy and inference time., Deutsche Forschungsgemeinschaft (DFG)

The mechanical properties of the cerebral bridging veins (CBVs) were studied using advanced microtensile equipment. Detailed high-quality curves were obtained at different strain rates, showing a clearly nonlinear stress–strain response. In addition, the tissue of the CBVs exhibits stress relaxation and a preconditioning effect under cyclic loading, unequivocal indications of viscoelastic behavior. Interestingly, most previous literature that conducts uniaxial tensile tests had not found significant viscoelastic effects in CBVs, but the use of more sensitive tests allowed to observe the viscoelastic effects. For that reason, a careful mathematical analysis is presented, clarifying why in uniaxial tests with moderate strain rates, it is difficult to observe any viscoelastic effect. The analysis provides a theoretical explanation as to why many recent studies that investigated mechanical properties did not find a significant viscoelastic effect, even though in other circumstances, the CBV tissue would clearly exhibit viscoelastic behavior. Finally, this study provides reference values for the usual mechanical properties, as well as calculations of constitutive parameters for nonlinear elastic and viscoelastic models that would allow more accurate numerical simulation of CBVs in Finite Element-based computational models in future works., Peer Reviewed, Postprint (published version)

Purpose: MRI can be utilized for quantitative characterization of tissue. To assess e.g. water fractions or diffusion coefficients for compartments in the brain, a decomposition of the signal is necessary. Imposing standard models carries the risk of estimating biased parameters if model assumptions are violated. This work introduces a data-driven multicomponent analysis, the monotonous slope non-negative matrix factorization (msNMF), tailored to extract data features expected in MR signals. Methods: The msNMF was implemented by extending the standard NMF with monotonicity constraints on the signal profiles and their first derivatives. The method was validated using simulated data, and subsequently applied to both ex vivo DWI data and in vivo relaxometry data. Reproducibility of the method was tested using the latter. Results: The msNMF recovered the multi-exponential signals in the simulated data and showed superiority to standard NMF (based on the explained variance, area under the ROC curve, and coefficient of variation). Diffusion components extracted from the DWI data reflected the cell density of the underlying tissue. The relaxometry analysis resulted in estimates of edema water fractions (EWF) highly correlated with published results, and demonstrated acceptable reproducibility. Conclusion: The msNMF can robustly separate MR signals into components with relation to the underlying tissue composition, and may potentially be useful for e.g. tumor tissue characterization.

In current clinical systems, magnetic resonance imaging scans for disease diagnosis and prognosis are dominated by qualitative contrast-weighted imaging. These qualitative MR images reveal regional differences in signal intensities between tissues with focal structural or functional abnormalities and tissues that are supposedly in healthy states, facilitating subjective determination for disease diagnosis. The administration of gadolinium-based contrast agents is prevalent in clinical MRI exams, which alternates the relaxation time of neighboring water protons and creates enhanced signal intensities from damaged tissues with high vascular density and thin vessel wall for better visualization. Nowadays, nearly 50% of the MRI studies were conducted with contrast agents. However, patients with renal insufficiency are at risk of developing nephrogenic system fibrosis if exposed to gadolinium-based contrast agents, and chronic toxic effects of possible gadolinium retention have been reported. In the meantime, qualitative contrast-weighted images have limited sensitivity to subtle alteration in tissue states, lack of biological specificity and multi-center reproducibility, and limited predictive values. One promising alternative is quantitative multiparametric MRI, which contains various methods to quantify multiple parameters with interpretable physical units that are intrinsic to tissue properties. Most of these quantitative approaches do not involve the administration of contrast agents, therefore ensuring the safety of the application to a wide range of patients and reducing the costs of MRI. These quantitative parameters are highly reproducible, sensitive to subtle physiological tissue changes, and specific for disease pathologies. More importantly, each of these parameters reveal tissue properties in different aspects, having the potential to offer complementary information for comprehensive tissue characterization, and acting as biomarkers that are directly associa

Background: Patients with chronic kidney disease (CKD) are at increased risk for cardiovascular complications, and dialysis patients often receive iron supplementation. Cardiac magnetic resonance (CMR) allows evaluation of cardiac function, fibrosis and iron deposition. We used CMR to explore mechanistic links between cardiac iron and abnormal myocardial substrate in patients with CKD. Method(s): Cardiac function and morphology, tissue characterisation and iron deposition were compared in 24 healthy controls,10 patients with CKD stage 3-5, and 30 patients dialysed for >1 year. Result(s): There were no between group differences in left ventricular (LV) ejection fraction (65+/-5 v 62+/-7 v 61+/-10%, p=0.908), end diastolic volume (84+/-16 v 69+/-13 v 76+/-22 ml/m2, p=0.532) or left atrial size (21+/-5 v 22+/-4 v 23+/-7m2, p=0.473). LV mass (58+/-13 v 66+/-9 v 76+/-27 g/m2, p=0.005) and global longitudinal strain (-22+/-3 v -20+/-4 v -14+/-4%, p<0.001) were abnormal in the dialysis group, but not the CKD group. Native T1 and T2 times were increased in both CKD and dialysis patients (ShMOLLI 1127+/-43 v 1189+/-37 v 1223+/-61ms, p<0.001; and T2 FLASH 35+/-2 v42+/-4 v 39+/-2ms, p<0.001). No group had significant iron deposition by T2-star. Conclusion(s): Despite no significant myocardial iron deposition, CMR detects abnormal myocardial structure and function across the spectrum of CKD, with abnormal global longitudinal strain seen only in dialysis patients. CMR may aid in identifying CKD patients at higher risk of adverse cardiac outcomes.Copyright © 2020

Purpose of Review Pulmonary arterial hypertension (PAH) is a progressive disease with high mortality. A greater understanding of the physiology and function of the cardiovascular system in PAH will help improve survival. This review covers the latest advances within cardiovascular magnetic resonance imaging (CMR) regarding diagnosis, evaluation of treatment, and prognostication of patients with PAH. Recent Findings New CMR measures that have been proven relevant in PAH include measures of ventricular and atrial volumes and function, tissue characterization, pulmonary artery velocities, and arterio-ventricular coupling. Summary CMR markers carry prognostic information relevant for clinical care such as treatment response and thereby can affect survival. Future research should investigate if CMR, as a non-invasive method, can improve existing measures or even provide new and better measures in the diagnosis, evaluation of treatment, and determination of prognosis of PAH.

Purpose:The aim of this study was to assess the reliability of single-shot 2-dimensional multislice late gadolinium enhancement (2D-MSLGE) compared with gold standard single-slice 2D inversion recovery segmented gradient echo (2D-SSLGE).Materials and Methods:Sixty-seven patients prospectively underwent clinically indicated cardiac magnetic resonance (CMR) imaging and were enrolled. The image quality was assessed using a 4-point scale. Segments positive for LGE were classified as ischemic or nonischemic for 2D-MSLGE and 2D-SSLGE. Interobserver and intraobserver variability was assessed for both sequences by 2 readers. The endpoints were as follows: (a) detection of myocardial segments involved by LGE and (b) classification of LGE as ischemic and nonischemic pattern. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy value were calculated for the 2 endpoints.Results:2D-MSLGE and 2D-SSLGE were successfully performed in all patients with comparable image quality (1.56±0.59 vs. 1.54±0.58, P=0.84). For the overall population, 2D-MSLGE correctly identified 1093 of 1139 myocardial segments positive for LGE (96%; 95% confidence interval [CI]: 95%-97%), as compared with 2D-SSLGE. Similarly, 2D-MSLGE correctly identified 1128 of 1139 (99%; 95% CI: 98%-99%) and 1108 of 1139 (97%; 95% CI: 96%-98%) of nonischemic and ischemic LGE patterns.Interobserver and intraobserver variability for quantification of LGE using 2D-MSLGE was 0.98 and 0.99, respectively. The acquisition time was shorter for 2D-MSLGE as compared with 2D-SSLGE (2.0±0.5 vs. 6.0±2.0 min, P: 0.01).Conclusions:As compared with 2D-SSLGE, 2D-MSLGE is a reliable tool in both ischemic and nonischemic cardiac disease; it is associated with shorter scan times without the need for prolonged breath holding and may be beneficial for those with dysrhythmia.

Purpose: Accurate prostate cancer (PCa) detection is essential for planning focal external beam radiotherapy (EBRT). While biparametric MRI (bpMRI) including T2-weighted (T2w) and diffusion-weighted images (DWI) is an accurate tool to localize PCa, its value is less clear in the case of additional androgen deprivation therapy (ADT). The aim of this study was to investigate the value of a textural feature (TF) approach on bpMRI analysis in prostate cancer patients with and without neoadjuvant ADT with respect to future dose-painting applications. Methods: 28 PCa patients (54–80 years) with (n = 14) and without (n = 14) ADT who underwent bpMRI with T2w and DWI were analyzed retrospectively. Lesions, central gland (CG), and peripheral zone (PZ) were delineated by an experienced urogenital radiologist based on localized pre-therapeutic histopathology. Histogram parameters and 20 Haralick TF were calculated. Regional differences (i. e., tumor vs. PZ, tumor vs. CG) were analyzed for all imaging parameters. Receiver-operating characteristic (ROC) analysis was performed to measure diagnostic performance to distinguish PCa from benign prostate tissue and to identify the features with best discriminative power in both patient groups. Results: The obtained sensitivities were equivalent or superior when utilizing the TF in the no-ADT group, while specificity was higher for the histogram parameters. However, in the ADT group, TF outperformed the conventional histogram parameters in both specificity and sensitivity. Rule-in and rule-out criteria for ADT patients could exclusively be defined with the aid of TF. Conclusions: The TF approach has the potential for quantitative image-assisted boost volume delineation in PCa patients even if they are undergoing neoadjuvant ADT.

PurposeTo evaluate the accuracy and repeatability of a free-breathing, non-electrocardiogram (ECG), continuous myocardial T1 and extracellular volume (ECV) mapping technique adapted from the Multitasking framework.MethodsThe Multitasking framework is adapted to quantify both myocardial native T1 and ECV with a free-breathing, non-ECG, continuous acquisition T1 mapping method. We acquire interleaved high-spatial resolution image data and high-temporal resolution auxiliary data following inversion-recovery pulses at set intervals and perform low-rank tensor imaging to reconstruct images at 344 inversion times, 20 cardiac phases, and 6 respiratory phases. The accuracy and repeatability of Multitasking T1 mapping in generating native T1 and ECV maps are compared with conventional techniques in a phantom, a simulation, 12 healthy subjects, and 10 acute myocardial infarction patients.ResultsIn phantoms, Multitasking T1 mapping correlated strongly with the gold-standard spin-echo inversion recovery (R2 = 0.99). A simulation study demonstrated that Multitasking T1 mapping has similar myocardial sharpness to the fully sampled ground truth. In vivo native T1 and ECV values from Multitasking T1 mapping agree well with conventional MOLLI values and show good repeatability for native T1 and ECV mapping for 60 seconds, 30 seconds, or 15 seconds of data. Multitasking native T1 and ECV in myocardial infarction patients correlate positively with values from MOLLI.ConclusionMultitasking T1 mapping can quantify native T1 and ECV in the myocardium with free-breathing, non-ECG, continuous scans with good image quality and good repeatability in vivo in healthy subjects, and correlation with MOLLI T1 and ECV in acute myocardial infarction patients.

Breathing involves fluid-solid interactions in the lung; however, the lack of experimental data inhibits combining the mechanics of air flow to airway deformation, challenging the understanding of how biomaterial constituents contribute to tissue response. As such, lung mechanics research is increasingly focused on exploring the relationship between structure and function. To address these needs, we characterize mechanical properties of porcine airways using uniaxial tensile experiments, accounting for bronchial orientation- and location- dependency. Structurally-reinforced constitutive models are developed to incorporate the role of collagen and elastin fibers embedded within the extrafibrillar matrix. The strain-energy function combines a matrix description (evaluating six models: compressible NeoHookean, unconstrained Ogden, uncoupled Mooney-Rivlin, incompressible Ogden, incompressible Demiray and incompressible NeoHookean), superimposed with non-linear fibers (evaluating two models: exponential and polynomial). The best constitutive formulation representative of all bronchial regions is determined based on curve-fit results to experimental data, accounting for uniqueness and sensitivity. Glycosaminoglycan and collagen composition, alongside tissue architecture, indicate fiber form to be primarily responsible for observed airway anisotropy and heterogeneous mechanical behavior. To the authors' best knowledge, this study is the first to formulate a structurally-motivated constitutive model, augmented with biochemical analysis and microstructural observations, to investigate the mechanical function of proximal and distal bronchi. Our systematic pulmonary tissue characterization provides a necessary foundation for understanding pulmonary mechanics; furthermore, these results enable clinical translation through simulations of airway obstruction in disease, fluid-structure interaction insights during breathing, and potentially, predictive capabilities for medical inte

We demonstrate the feasibility of short wave infrared (SWIR) spectroscopy combined with tape stripping for depth profiling of lipids and water in the stratum corneum of human skin. The proposed spectroscopic technique relies on differential detection at three wavelengths of 1720, 1750, and 1770 nm, with varying ratio of the lipid-to-water absorption coefficient and an ‘isosbestic point’. Comparison of the data acquired using SWIR spectroscopy with that obtained by a gold standard for non-invasive quantitative molecularspecific skin measurements, namely confocal Raman spectroscopy (CRS), revealed specificity of the proposed modality for water and lipid quantification. At the same time, we provide evidence showing aberrant sensitivity of Corneometer hydration read-outs to the presence of skin surface lipids, and a lack of sensitivity of the Sebumeter when attempting to measure the lipids of the cornified lipid envelope and intracellular lipid layers. We conclude that a spectroscopic SWIR-based spectroscopic method combined with tape stripping has the potential for depth profiling of the stratum corneum water and lipids, due to superior measurement sensitivity and specificity compared to the Corneometer and Sebumeter., ImPhys/Optics

H-Scan is a new ultrasound imaging technique that relies on matching a model of pulse-echo formation to the mathematics of a class of Gaussian-weighted Hermite polynomials. This technique may be beneficial in the measurement of relative scatterer sizes and in cancer therapy, particularly for early response to drug treatment. Because current H-scan techniques use focused ultrasound data acquisitions, spatial resolution degrades away from the focal region and inherently affects relative scatterer size estimation. Although the resolution of ultrasound plane wave imaging can be inferior to that of traditional focused ultrasound approaches, the former exhibits a homogeneous spatial resolution throughout the image plane. The purpose of this study was to implement H-scan using plane wave imaging and investigate the impact of spatial angular compounding on H-scan image quality. Parallel convolution filters using two different Gaussian-weighted Hermite polynomials that describe ultrasound scattering events are applied to the radiofrequency data. The H-scan processing is done on each radiofrequency image plane before averaging to get the angular compounded image. The relative strength from each convolution is color-coded to represent relative scatterer size. Given results from a series of phantom materials, H-scan imaging with spatial angular compounding more accurately reflects the true scatterer size caused by reductions in the system point spread function and improved signal-to-noise ratio. Preliminary in vivo H-scan imaging of tumor-bearing animals suggests this modality may be useful for monitoring early response to chemotherapeutic treatment. Overall, H-scan imaging using ultrasound plane waves and spatial angular compounding is a promising approach for visualizing the relative size and distribution of acoustic scattering sources.

The spatial fluctuations of the refractive index within biological tissues exhibit multifractal anisotropy, leaving its signature as a spectral linear diattenuation of scattered polarized light. The multifractal anisotropy has been quantitatively assessed by the processing of relevant Mueller matrix elements in the Fourier domain, utilizing the Born approximation and subsequent multifractal analysis. The differential scaling exponent and width of the singularity spectrum appear to be highly sensitive to the structural multifractal anisotropy at the micron/sub-micron length scales. An immediate practical use of these multifractal anisotropy parameters was explored for non-invasive screening of cervical precancerous alterations ex vivo, with the indication of a strong potential for clinical diagnostic purposes.

Utilizing a polarized light approach, we reconstruct the spatial distribution of birefringence and optical activity in polycrystalline films of biological fluids. The Jones-matrix formalism is used for an accessible quantitative description of these types of optical anisotropy. We demonstrate that differentiation of polycrystalline films of biological fluids can be performed based on a statistical analysis of the distribution of rotation angles and phase shifts associated with the optical activity and birefringence, respectively. Finally, practical operational characteristics, such as sensitivity, specificity and accuracy of the Jones-matrix reconstruction of optical anisotropy, were identified with special emphasis on biomedical application, specifically for differentiation of bile films taken from healthy donors and from patients with cholelithiasis.

In this paper, we present an approach for communication through human body tissue in the R-band frequency range. This study examines the ranges of microwave frequencies suitable for intra-body communication. The human body tissues are characterized with respect to their transmission properties using simulation modeling and phantom measurements. The variations in signal coupling with respect to different tissue thicknesses are studied. The simulation and phantom measurement results show that electromagnetic communication in the fat layer is viable with attenuation of approximately 2 dB per 20 mm., Eurostars project (grant E-9655-COMFORT), Swedish Vinnova project (grant BDAS), eSSENCE

最終講義, びまん性肝疾患の診断は,肝実質の組織性状解析から始まる.それにはBモード超音波検査による詳細な検討が必須であるが,腫瘤性病変と異なり肝全体が病変であるびまん性肝疾患では,病変と非病変を同一画面上で比較できない.このように多少取り付きにくいびまん性肝疾患の超音波診断ではあるが,すでに臨床現場では欠くことのできない最も身近な診断ツールとなっていることも事実である.本講義ではこの役に立つツールをいかに考え使うかについて解説する.Ultrasonographic characterization of liver tissue has been extensively studied; however, liver disease diagnosis using only ultrasound remains difficult. Despite this limitation, ultrasound is very useful for observing liver characteristics. This presentation describes how B-mode ultrasound can be used to diagnose liver diseases.

Purpose of Review: The purpose of the present paper is to analytically review the diagnostic and prognostic role of CMR in ST-segment elevation myocardial infarction (STEMI) survivors. Percutaneous coronary intervention (PCI) is the treatment of choice in patients STEMI. However, risk of future events remains substantial. Assessment of the extent of myocardial infarction (MI), cardiac function and ventricular remodelling has become the focus of recent studies. Electrocardiography, angiography and echocardiography parameters, as well as risk scores, lack sensitivity and reproducibility in predicting future cardiovascular events. A major advantage of cardiac magnetic resonance imaging (CMR) is that it provides myocardial tissue characterization. Recent Findings: CMR is able to quantify both reversible and irreversible myocardial injury and correlates with future events. Summary: This review will illustrate how microvascular function indices (myocardial salvage index, presence and amount of microvascular obstruction and intramyocardial haemorrhage) detectable by CMR add prognostic information and could impact on future strategies to improve outcomes in revascularized patients.

In order to obtain successful catheter ablation of ventricular arrhythmias in patients with chronic myocardial infarction is essential the precise identification of the infarct scar. Nowadays, endocardial voltage mapping is used to delineate the healed tissue. However, this technique is not sensitive enough to differentiate distinct degrees of transmural injury in the scar and, moreover, it is influenced by the direction of the activation wavefront. A new technique, mapping local myocardial electrical impedance, which uses an intracavitary catheter inside the left ventricle, could overcome these limitations, but it has just started being investigated now. Trials with pigs are being taken to establish the viability of the technique. Throughout this project different methods and materials have been used including the usage of experimental data and finite elements models, aimed to verify the accuracy of this novel mapping system, to evaluate the influence of different factors on the measurements in order to understand completely the technique and, also, to find the origin of the observed amplitude modulation of the signals that is around of 20%. We have proved that this novel technique is able to identify the longitudinal extent of the scars (mainly transmural and non-transmural scars located in the inner part of the wall) very accurately: the maximum sensitivity of the catheter is at its surroundings and decays by more than four orders of magnitude by moving away 2 cm from the tip. Moreover, the scar is sensed in a very concentrated region without extending its influence towards healthy tissue. We have also demonstrated that the position of the external measuring electrode has no influence on the measurements., Para realizar con éxito ablaciones de arritmias ventriculares en pacientes con infarto de miocardio crónico es esencial una identificación precisa de la cicatriz del infarto. Actualmente, se utiliza el mapeo de voltaje endocardio para delinear el tejido cicatrizado. Sin embargo, esta técnica no es suficientemente sensible a diferentes grados de transmuralidad en la lesión y, además, está influenciada por la dirección del frente de onda de activación. Una nueva técnica, el mapeo local de impedancia eléctrica del miocardio, que utiliza un catéter intracavitario dentro del ventrículo izquierdo, podría superar estas limitaciones, pero se está justo empezando a investigar. Ahora mismo, pruebas experimentales con cerdos se están llevando a cabo para establecer la validez de la técnica. En este proyecto se han utilizado diferentes métodos y materiales, incluyendo el uso de datos experimentales y modelos de elementos finitos, dirigidos a la verificación de la precisión de este nuevo sistema de mapeo, la evaluación de la influencia de diferentes factores en las medidas para entender completamente la técnica y, también, a la búsqueda del origen de la amplitud observada en la modulación de las señales, que es de un 20%. Se ha probado que la nueva técnica es capaz de identificar la extensión longitudinal de la cicatriz (principalmente en cicatrices transmurales y no-transmurales situadas en la parte interna de la pared del corazón) de manera muy precisa: la máxima sensibilidad del catéter se encuentra en sus alrededores y decae en más de cuatro órdenes de magnitud en alejarnos 2 cm de su punta. Además, la cicatriz se detecta en una región muy concentrada sin extender su influencia hacia el tejido sano. Se ha demostrado también que la posición del electrodo externo de medida no influye en las medidas., Per tal de realitzar amb èxit ablacions d'arrítmies ventriculars en pacients amb infart de miocardi crònic és essencial una identificació precisa de la cicatriu de l'infart. Actualment, s'utilitza el mapatge de voltatge endocardi per a delinear el teixit cicatritzat. Tot i això, aquesta tècnica no és suficientment sensible a diferents graus de transmuralitat en la lesió i , a més, està influenciada per la direcció del front d'ona d'activació. Una nova tècnica, el mapatge local d'impedància elèctrica del miocardi, que utilitza un catèter intracavitari dins del ventricle esquerre, podria superar aquestes limitacions, però s'està just començant a investigar. Ara mateix, proves experimentals amb porcs s'estan duent a terme per establir la validesa de la tècnica. En aquest projecte s'han utilitzat diferents mètodes i materials, incloent l'ús de dades experimentals i models d'elements finits, adreçats a la verificació de la precisió d'aquest nou sistema de mapatge, a l'avaluació de la influència de diferents factors en les mesures per tal d'entendre completament la tècnica i, també, a la cerca de l'origen de la amplitud observada en la modulació dels senyals, que és d'un 20%. S'ha provat que la nova tècnica es capaç d'identificar l'extensió longitudinal de la cicatriu (principalment en cicatrius transmurals i no-transmurals situades a la part interna de la paret del cor) de forma molt precisa: la màxima sensibilitat del catèter és als seus voltants i decau en més de quatre ordres de magnitud en allunyar-nos 2 cm de la seva punta. A més, la cicatriu es detecta en una regió molt concentrada sense estendre la seva influència cap al teixit sa. S'ha demostrat també que la posició de l'elèctrode extern de mesura no influeix en les mesures.

We report the implementation of fast Interferometric Second Harmonic Generation (I-SHG) microscopy to study the polarity of non-centrosymmetric structures in biological tissues. Using a sample quartz plate, we calibrate the spatially varying phase shift introduced by the laser scanning system. Compensating this phase shift allows us to retrieve the correct phase distribution in periodically poled lithium niobate, used as a model sample. Finally, we used fast interferometric second harmonic generation microscopy to acquire phase images in tendon. Our results show that the method exposed here, using a laser scanning system, allows to recover the polarity of collagen fibrils, similarly to standard I-SHG (using a sample scanning system), but with an imaging time about 40 times shorter. OCIS codes: (180.4315) Nonlinear microscopy, (190.2620) Harmonic generation and mixing, (170.6935) Tissue characterization, (190.4180) Multiphoton processes, (190.4710) Optical nonlinearities in organic materials

Due to the knowledge of the cellular structure of biological tissues and the ability to extract a parametric passive electrical model of tissue based on a two terminals element with a given spectral relaxation of impedance (Cole-Cole model), bio-impedance spectroscopy allows us to relate these parameters to tissue physical features, such as cell density or the dispersion of the size and shape of cells among others. These physical aspects are variable with time in tissues that are subject to mechanical changes, which sometimes can be relatively fast, as it is the case of the in-vivo heart tissue. As a result, it is also of interest to make the measurements quickly and continuously during a given time interval, aiming to see its evolution. Research teams of Sant Pau Hospital together with the Instrumentation and Bioengineering research team of the Electronics Engineering Department, are studying the effectiveness of the bio-impedance measurement in the diagnosis and localization of lung tumors and myocardial infarctions, common pathologies that present a decrease in quality of life, even death, in patients who suffer them, justifying the clinical need for a device capable of improving their diagnosis. According to preliminary research results, this technique would be useful as a complementary tool, improving the ability of distinguishing pathological tissues of current techniques. Commercially available instruments for measurement of impedance spectroscopy are usually expensive, bulky and incomplete, making it difficult and more expensive the use of these tools for this purpose, as well as progress in the procedure of investigation and validation of such practice as a method of clinical diagnosis. Therefore, the objective of this project is to design and prototype a standalone and low cost measuring instrument capable of measuring bio-impedance satisfying the required characteristics. Such a system will be prototyped using an open-hardware development tool recently ap, Debido al conocimiento de la estructura celular de los tejidos biológicos y la capacidad de extraer un modelo eléctrico paramétrico del mismo basado en elemento de dos terminales con una cierta relajación espectral de impedancia (modelo de Cole-Cole), la espectroscopia de bio-impedancia nos permite determinar los parámetros directamente relacionados con información física del tejido, como pueden ser la densidad celular o la dispersión del tamaño de las células, entre otros. Estos aspectos físicos son variantes con el tempo en tejidos que están sometidos a cambios mecánicos que en ocasiones pueden ser muy rápidos, como es el caso particular del tejido cardiaco. Debido a ello, también es de interés poder realizar la medida de manera rápida y continua durante un cierto intervalo de tiempo, con el objetivo de poder ver su evolución. Equipos de investigación del hospital de Sant Pau, juntamente con el grupo de investigación de Instrumentación Electrónica y Biomédica del Departament d’Enginyeria Electrònica de la UPC, están estudiando la eficacia de la medida de bio-impedancia en el diagnostico i localización de infartos de miocardio o tumores pulmonares, patologías comunes y que presentan una disminución en la calidad de vida, incluso el fallecimiento, a los pacientes que la sufren, justificando la necesidad clínica de un dispositivo capaz de dar soporte a su diagnosis. Según los resultados preliminares de la investigación, este método puede tener un papel complementario, mejorando la capacidad de distinguir algunos tejidos patológicos de las técnicas actuales. Los instrumentos presentes en el mercado actual válidos para la medida de espectroscopia de impedancia acostumbran a ser costosos, voluminosos e incompletos, dificultando y encareciendo la capacidad de uso de dichas herramientas para tal objetivo, así como el avance en el procedimiento de investigación y validación de dicha técnica como método de diagnóstico clínico. Por tanto, el objetivo de este proyecto en conc, Degut al coneixement de la estructura cel·lular dels teixits biològics i la capacitat d’extraure un model elèctric paramètric del mateix basat en un element de dos terminals amb una certa relaxació espectral d’impedància (model de Cole-Cole), l’espectroscòpia de bio-impedància ens permet determinar els paràmetres directament lligats amb informació física del teixit, com pot ser la densitat cel·lular o la dispersió de la mida de les cèl·lules, entre d’altres. Aquest aspectes físics són variants en el temps en teixits que estan sotmesos a canvis mecànics que en ocasions poden ser molt ràpids, com en el cas particular del teixit cardíac. Degut a això, també es d’interès poder fer la mesura de manera ràpida i continuada durant un cert interval de temps, amb l’objectiu de poder veure la seva evolució. Equips de recerca de l’hospital de Sant Pau, juntament amb el grup de recerca d’Instrumentació Electrònica i Biomèdica del Departament d’Enginyeria Electrònica de la UPC, estan estudiant la eficàcia de la mesura de bio-impedància en el diagnòstic i localització d’infarts de miocardi o tumors pulmonars, patologies comuns i que presenten una disminució de la qualitat de vida, inclús mortalitat, als pacients que les pateixen, justificant la necessitat clínica d’un dispositiu capaç de donar suport a la seva diagnosi. Segons els resultats preliminars de la recerca, aquest mètode pot tenir un paper complementari, millorant la capacitat de distingir alguns teixits patològics de les tècniques actuals. Els instruments presents al mercat actual per a mesurar espectroscòpia de impedància acostumen a ser costosos, voluminosos i incomplerts, dificultant i encarint la capacitat d’us d’aquestes eines per a l’objectiu esmentat, així com l’avenç en el procediment de recerca i validació d’aquesta tècnica com a mètode de diagnosi clínica. Per tant, l’objectiu d’aquest projecte en concret és desenvolupar un instrument de mesura auto contingut i de baix cost que sigui capaç de mesurar bio-imped

Detection of an early stage of subglottic edema is vital for airway management and prevention of stenosis, a life-threatening condition in critically ill neonates. As an observer for the task of diagnosing edema in vivo, we investigated spatiotemporal correlation (STC) of full-range optical coherence tomography (OCT) images acquired in the rabbit airway with experimentally simulated edema. Operating the STC observer on OCT images generates STC coefficients as test statistics for the statistical decision task. Resulting from this, the receiver operating characteristic (ROC) curves for the diagnosis of airway edema with full-range OCT in-vivo images were extracted and areas under ROC curves were calculated. These statistically quantified results demonstrated the potential clinical feasibility of the STC method as a means to identify early airway edema.

Diagnosis of articular cartilage pathology in the early disease stages using current clinical diagnostic imaging modalities is challenging, particularly because there is often no visible change in the tissue surface and matrix content, such as proteoglycans (PG). In this study, we propose the use of near infrared (NIR) spectroscopy to spatially map PG content in articular cartilage. The relationship between NIR spectra and reference data (PG content) obtained from histology of normal and artificially induced PG-depleted cartilage samples was investigated using principal component (PC) and partial least squares (PLS) regression analyses. Significant correlation was obtained between both data (R2 = 91.40%, p<0.0001). The resulting correlation was used to predict PG content from spectra acquired from whole joint sample, this was then employed to spatially map this component of cartilage across the intact sample. We conclude that NIR spectroscopy is a feasible tool for evaluating cartilage contents and mapping their distribution across mammalian joint

BACKGROUND: The purpose of the present study was to investigate the diagnostic value of T2-mapping in acute myocarditis (ACM) and to define cut-off values for edema detection. METHODS: Cardiovascular magnetic resonance (CMR) data of 31 patients with ACM were retrospectively analyzed. 30 healthy volunteers (HV) served as a control. Additionally to the routine CMR protocol, T2-mapping data were acquired at 1.5 T using a breathhold Gradient-Spin-Echo T2-mapping sequence in six short axis slices. T2-maps were segmented according to the 16-segments AHA-model and segmental T2 values as well as the segmental pixel-standard deviation (SD) were analyzed. RESULTS: Mean differences of global myocardial T2 or pixel-SD between HV and ACM patients were only small, lying in the normal range of HV. In contrast, variation of segmental T2 values and pixel-SD was much larger in ACM patients compared to HV. In random forests and multiple logistic regression analyses, the combination of the highest segmental T2 value within each patient (maxT2) and the mean absolute deviation (MAD) of log-transformed pixel-SD (madSD) over all 16 segments within each patient proved to be the best discriminators between HV and ACM patients with an AUC of 0.85 in ROC-analysis. In classification trees, a combined cut-off of 0.22 for madSD and of 68 ms for maxT2 resulted in 83% specificity and 81% sensitivity for detection of ACM. CONCLUSIONS: The proposed cut-off values for maxT2 and madSD in the setting of ACM allow edema detection with high sensitivity and specificity and therefore have the potential to overcome the hurdles of T2-mapping for its integration into clinical routine.

Background: Robotic assisted minimally invasive surgery systems not only have the advantages of traditional laparoscopic procedures but also restore the surgeon's hand-eye coordination and improve the surgeon's precision by filtering hand tremors. Unfortunately, these benefits have come at the expense of the surgeon's ability to feel. Several research efforts have already attempted to restore this feature and study the effects of force feedback in robotic systems. The proposed methods and studies have some shortcomings. The main focus of this research is to overcome some of these limitations and to study the effects of force feedback in palpation in a more realistic fashion. Material(s) and Method(s): A parallel robot assisted minimally invasive surgery system (PRAMiSS) with force feedback capabilities was employed to study the effects of realistic force feedback in palpation of artificial tissue samples. PRAMiSS is capable of actually measuring the tip/tissue interaction forces directly from the surgery site. Four sets of experiments using only vision feedback, only force feedback, simultaneous force and vision feedback and direct manipulation were conducted to evaluate the role of sensory feedback from sideways tip/tissue interaction forces with a scale factor of 100% in characterising tissues of varying stiffness. Twenty human subjects were involved in the experiments for at least 1440 trials. Friedman and Wilcoxon signed-rank tests were employed to statistically analyse the experimental results. Result(s): Providing realistic force feedback in robotic assisted surgery systems improves the quality of tissue characterization procedures. Force feedback capability also increases the certainty of characterizing soft tissues compared with direct palpation using the lateral sides of index fingers. Conclusion(s): The force feedback capability can improve the quality of palpation and characterization of soft tissues of varying stiffness by restoring sense of touch in rob

Deep imaging in turbid media such as biological tissue is challenging due to scattering and optical aberrations. Adaptive optics has the potential to compensate the tissue aberrations. We present a wavefront sensing scheme for multi-photon scanning microscopes using the pulsed, near-infrared light reflected back from the sample utilising coherence gating and a confocal pinhole to isolate the light from a layer of interest. By interfering the back-reflected light with a tilted reference beam, we create a fringe pattern with a known spatial carrier frequency in an image of the back-aperture plane of the microscope objective. The wavefront aberrations distort this fringe pattern and thereby imprint themselves at the carrier frequency, which allows us to separate the aberrations in the Fourier domain from low spatial frequency noise. A Fourier analysis of the modulated fringes combined with a virtual Shack-Hartmann sensor for smoothing yields a modal representation of the wavefront suitable for correction. We show results with this method correcting both DM-induced and sample-induced aberrations in rat tail collagen fibres as well as a Hoechst-stained MCF-7 spheroid of cancer cells., Delft Center for Systems and Control, Mechanical, Maritime and Materials Engineering

The vulnerable atherosclerotic plaque is believed to be at the root of the majority of acute coronary events. Even though the exact origins of plaque vulnerability remain elusive, the thin-cap fibroatheroma, characterized by a lipid-rich necrotic core covered by a thin fibrous cap, is considered to be the most prominent type of vulnerable plaque. No clinically available imaging technique can characterize atherosclerotic lesions to the extent needed to determine plaque vulnerability prognostically. Intravascular photoacoustic imaging (IVPA) has the potential to take a significant step in that direction by imaging both plaque structure and composition. IVPA is a natural extension of intravascular ultrasound that adds tissue type specificity to the images. IVPA utilizes the optical contrast provided by the differences in the absorption spectra of plaque components to image composition. Its capability to image lipids in human coronary atherosclerosis has been shown extensively ex vivo and has recently been translated to an in vivo animal model. Other disease markers that have been successfully targeted are calcium and inflammatory markers, such as macrophages and matrix metalloproteinase; the latter two through application of exogenous contrast agents. By simultaneously displaying plaque morphology and composition, IVPA can provide a powerful prognostic marker for disease progression, and as such has the potential to transform the current practice in percutaneous coronary intervention., ImPhys/Imaging Physics, Applied Sciences

Spectroscopic intravascular photoacoustic imaging (sIVPA) has shown promise to detect and distinguish lipids in atherosclerotic plaques. sIVPA generally utilizes one of the two high absorption bands in the lipid absorption spectrum at 1.2 ?m and 1.7 ?m. Specific absorption signatures of various lipid compounds within the bands in either wavelength range can potentially be used to differentiate between plaque lipids and peri-adventitial lipids. With the aim to quantify any differences between the two bands, we performed combined sIVPA imaging in both absorption bands on a vessel phantom and an atherosclerotic human coronary artery ex vivo. Lipid detection in a human atherosclerotic lesion with sIVPA required lower pulse energy at 1.7 ?m than at 1.2 ?m (0.4 mJ versus 1.2 mJ). The imaging depth was twice as large at 1.2 ?m compared to 1.7 ?m. Adequate differentiation between plaque and peri-adventitial lipids was achieved at 1.2 ?m only., ImPhys/Imaging Physics, Applied Sciences

The presence of lipids in atherosclerotic coronary lesions is an important determinant of their potential to trigger acute coronary events. Spectroscopic intravascular photoacoustic imaging (sIVPA) has the potential to automatically detect lipids in atherosclerotic lesions. For realtime in vivo imaging, limiting the number of excitation wavelengths is crucial. We explored methods for plaque lipid detection using sIVPA, with the aim to minimize the number of laser pulses per image line. A combined intravascular ultrasound (IVUS) and photoacoustic imaging system was used to image a vessel phantom and human coronary arteries ex vivo. We acquired co-registered cross-sectional images at several wavelengths near 1200 nm, a lipid-specific absorption band. Correlating the photoacoustic spectra at 6 or 3 wavelengths from 1185 to 1235 nm with the absorption spectrum of cholesterol and peri-adventitial tissue, we could detect and differentiate the lipids in the atherosclerotic plaque and peri-adventitial lipids, respectively. With two wavelengths, both plaque and peri-adventitial lipids were detected but could not be distinguished., ImPhys/Imaging Physics, Applied Sciences

Electrical Bioimpedance Spectroscopy (EBIS) is currently used in different tissue characterization applications. In this work we aim to use EBIS to study changes in electrical properties of the cerebral tissues after an incident of hemorrhage/ischemic stroke. To do so a case-control study was conducted using six controls and three stroke cases. The preliminary results of this study show that by using Cole-based analysis on EBIS measurements and analyzing the Cole parameters R0 and R∞, it is possible to detect changes on electrical properties of cerebral tissue after stroke., QC 20121213

Background: Every year approximately 74,000 women die of endometrial cancer, mainly due to recurrent or metastatic disease. The presence of tumor infiltrating lymphocytes (TILs) as well as progesterone receptor (PR) positivity has been correlated with improved prognosis. This study describes two mechanisms by which p

The tactile resonance method (TRM) and Raman spectroscopy (RS) are promising for tissue characterization in vivo. Our goal is to combine these techniques into one instrument, to use TRM for swift scanning, and RS for increasing the diagnostic power. The aim of this study was to determine the classification accuracy, using support vector machines, for measurements on porcine tissue and also produce preliminary data on human prostate tissue. This was done by developing a new experimental set-up combining micro-scale TRMscanning haptic microscopy (SHM)for assessing stiffness on a micro-scale, with fibre optic RS measurements for assessing biochemical content. We compared the accuracy using SHM alone versus SHM combined with RS, for different degrees of tissue homogeneity. The cross-validation classification accuracy for healthy porcine tissue types using SHM alone was 6581%, and when RS was added it increased to 8187%. The accuracy for healthy and cancerous human tissue was 6770% when only SHM was used, and increased to 7277% for the combined measurements. This shows that the potential for swift and accurate classification of healthy and cancerous prostate tissue is high. This is promising for developing a tool for probing the surgical margins during prostate cancer surgery.

Grayscale IVUS and IVUS-based imaging modalities during the last years have become useful in the assessment not only of drug eluting stent, but also of new bioresorbable vascular scaffolds. Although IVUS resolution is not sufficient for determining stent coverage (optical coherence tomography is the gold standard), serial IVUS can measure intimal hyperplasia, assess acute and late incomplete stent apposition, detect the presence and persistence of edge dissections, study edge effects and look for causes of restenosis and thrombosis. In addition other IVUS-based imaging modalities, such as IVUS-VH, iMAP or palpography, can be used to study the serial compositional and mechanical changes of the plaque behind stent struts and also to follow the bioresorption of the new bioresorbable scaffolds, analyzing the backscattering signal coming from the polymeric struts. This revie

Cardiovascular disease remains the leading cause of mortality, morbidity and disability in the developed world, predominantly affecting the adult population. In the early 1990s coronary heart disease (CHD) was established as affecting one in two men and one in three women by the age of forty. Despite the dramatic progress in the field of cardiovascular medicine in terms of diagnosis and treatment of heart disease, modest improvements have only been achieved when the reduction of cardiovascular mortality and morbidity indices are assessed. To better understand coronary atherosclerosis, new imaging modalities have been introduced. These novel imaging modalities have been used in two ways: (1) for the characterization of plaque types; (2) for the assessment of the progression and regression of tissue types. These two aspects will be discussed in this review.

Gray-scale intravascular ultrasound (IVUS) is the modality that has been established as the golden standard for in vivo imaging of the vessel wall of the coronary arteries. The use of IVUS in clinical practice is an important diagnostic tool used for quantitative assessment of coronary artery disease. This has made IVUS the de-facto invasive imaging method to evaluate new interventional therapies such as new stent designs and for atherosclerosis progression-regression studies. However, the gray-scale representation of the coronary vessel wall and plaque morphology in combination with the limited resolution of the current IVUS catheters makes it difficult, if not impossible, to identify qualitatively (e.g. visually) the plaque morphology similar as that of histopathology, the golden standard to characterize and quantify coronary plaque tissue components. Meanwhile, this limitation has been partially overcome by new innovative IVUS-based post-processing methods such as: virtual histology IVUS (VH-IVUS, Volcano Therapeutics, Rancho Cordova, CA, USA), iMAP-IVUS (Bostoc Scientific, Santa Clara, CA, USA), Integrated Backscatter IVUS (IB-IVUS) and Automated Differential Echogenicity (ADE).

Tissue characterization is fundamental for identification of pathological conditions. Raman spectroscopy (RS) and tactile resonance measurement (TRM) are two promising techniques that measure biochemical content and stiffness, respectively. They have potential to complement the golden standard-–histological analysis. By combining RS and TRM, complementary information about tissue content can be obtained and specific drawbacks can be avoided. The aim of this study was to develop a multivariate approach to compare RS and TRM information. The approach was evaluated on measurements at the same points on porcine abdominal tissue. The measurement points were divided into five groups by multivariate analysis of the RS data. A regression analysis was performed and receiver operating characteristic (ROC) curves were used to compare the RS and TRM data. TRM identified one group efficiently (area under ROC curve 0.99). The RS data showed that the proportion of saturated fat was high in this group. The regression analysis showed that stiffness was mainly determined by the amount of fat and its composition. We concluded that RS provided additional, important information for tissue identification that was not provided by TRM alone. The results are promising for development of a method combining RS and TRM for intraoperative tissue characterization.

Imaging Science and Technology, Applied Sciences

To dispose of a precise and non-invasive temperature measurement over the treated area becomes very important during hyperthermia treatments, in order to make possible an optimization of their healing effects. A performance analysis of some previously reported ultrasonic techniques, which were proposed for non-invasive temperature estimation, is made in this work over phantoms mimicking human tissues. A first technique is based on discrete scattering modeling for tissue characterization and spectral analysis of frequency distributions related to average scatters spacing [R. Seip & E.S. Ebbini]. Other technique uses certain relations between tissue temperature changes and time-shifts in echoes due to thermally induced sound velocity changes and expansions [R. Maass-Moreno & C.A. Damianou]. And finally, the third procedure analyzed here, is a recently proposed alternative, based on phase demodulation processing, to estimate the indirect effects of echoes time-shifts in the phase domain [M. Vázquez, A. Ramos, et al.]. The three options are analyzed for the same simulated & measured multi-pulse echo patterns, looking for detecting possible advantages and inconveniences in each case. Finally, some improvement paths over the basic estimation methods are also explored.

Objective. To evaluate the safety of the antimicrobial peptide, lactocin 160. Methods. Lactocin 160, a product of vaginal probiotic Lactobacillus rhamnosus 160 was evaluated for toxicity and irritation. An in vitro human organotypic vaginal-ectocervical tissue model (EpiVaginal) was employed for the safety testing by determining the exposure time to reduce tissue viability to 50% (ET-50). Hemolytic activity of lactocin160 was tested using 8% of human erythrocyte suspension. Susceptibility of lactobacilli to lactocin160 was also studied. Rabbit vaginal irritation (RVI) model was used for an in vivo safety evaluation. Results. The ET-50 value was 17.5 hours for lactocin 160 (4.9 hours for nonoxynol 9, N9). Hemolytic activity of lactocin 160 was 8.2% (N9 caused total hemolysis). Lactobacilli resisted to high concentrations of peptide preparation. The RVI model revealed slight vaginal irritation. An average irritation index grade was evaluated as "none." Conclusions. Lactocin 160 showed minimal irritation and has a good potential for intravaginal application., QC 20141125

The use of bioactive nanostructured TiO2 has recently been proposed for improving orthopaedic implant adhesion due to its improved biocompatibility with bone, since it induces: (i) osteoblast function, (ii) apatite nucleation and (iii) protein adsorption. The present work focuses on a non-ionizing radiation emitting technique for quantifying in real time the improvement in terms of mechanical properties of the surrounding bone due to the presence of the nanostructured TiO2 prepared by controlled precipitation and acid ageing. The mechanical strength is the ultimate goal of a bone implant and is directly related to the elastic moduli. Ultrasonics are high frequency mechanical waves and are therefore suited for characterizing elastic moduli. As opposed to echographic techniques, which are not correlated to elastic properties and are not able to penetrate bone, a low frequency ultrasonic transmission test is proposed, in which a P-wave is transmitted through the specimen and recorded. The problem is posed as an inverse problem, in which the unknown is a set of parameters that describe the mechanical constants of the sequence of layers. A finite element numerical model that depends on these parameters is used to predict the transformation of the waveform and compare to the measurement. The parameters that best describe the real tissue are obtained by minimizing the discrepancy between the real and numerically predicted waveforms. A sensitivity study to the uncertainties of the model is performed for establishing the feasibility of using this technique to investigate the macroscopic effect on bone growth of nanostructured TiO2 and its beneficial effect on implant adhesion.