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Objective: The factors related to the changes in the liver and abdominal adipose tissue during the rapid weight loss after bariatric surgery remain uncertain., Methods: This study included 44 participants who had undergone sleeve gastrectomy. The study aimed to analyze changes and correlations of body weight (BW), laboratory tests, and magnetic resonance imaging (MRI) indicators of the liver and abdominal adipose tissue conducted before and after bariatric surgery at 1, 3, and 6 months., Results: Following a rapid weight loss within 6 months of surgery, there was a concurrent decrease in blood glucose, blood lipids, and fat content of the liver and abdomen and the changes showed a correlation. The change of BW (ΔBW) was positively correlated with the change of hepatic proton density fat fraction (ΔPDFF) in one and three months after surgery and was positively correlated with the change of abdominal visceral fat area (ΔAVFA) in six months after surgery, (P<0.05). In one month after surgery, ΔPDFF was positively correlated with the change of aspartate aminotransferase (ΔAST), change of alanine aminotransferase (ΔALT), and change of triglyceride glucose (ΔTYG) index (P<0.05). ΔPDFF was positively correlated with the change of hepatic native T1 values (P<0.001) and was moderately negatively correlated with the change of hepatic apparent diffusion coefficient (ΔADC) values in three months after surgery (P<0.05)., Conclusion: ΔBW can serve as an indirect indicator for evaluating changes in liver fat fraction at 1 and 3 months after bariatric surgery and indicative of changes in visceral fat 6 months after surgery. ΔPDFF was positively correlated with ΔAST, ΔALT and ΔTYG index in 1 months after surgery., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: A better understanding of the mechanisms underlying cognitive impairment in schizophrenia is imperative, as it causes poor functional outcomes and a lack of effective treatments., Aims: This study aimed to investigate the relationships of two proposed main pathophysiology of schizophrenia, altered prefrontal-striatal connectivity and the dopamine system, with cognitive impairment and their interactions., Methods: Thirty-three patients with schizophrenia and 27 healthy controls (HCs) who are right-handed and matched for age and sex were recruited. We evaluated their cognition, functional connectivity (FC) between the dorsolateral prefrontal cortex (DLPFC)/middle frontal gyrus (MiFG) and striatum, and the availability of striatal dopamine transporter (DAT) using a cognitive battery investigating attention, memory, and executive function, resting-state functional magnetic resonance imaging with group independent component analysis and single-photon emission computed tomography with 99mTc-TRODAT., Results: Patients with schizophrenia exhibited poorer cognitive performance, reduced FC between DLPFC/MiFG and the caudate nucleus (CN) or putamen, decreased DAT availability in the left CN, and decreased right-left DAT asymmetry in the CN compared to HCs. In patients with schizophrenia, altered imaging markers are associated with cognitive impairments, especially the relationship between DLPFC/MiFG-putamen FC and attention and between DAT asymmetry in the CN and executive function., Conclusions: This study is the first to demonstrate how prefrontal-striatal hypoconnectivity and altered striatal DAT markers are associated with different domains of cognitive impairment in schizophrenia. More research is needed to evaluate their complex relationships and potential therapeutic implications., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Emotion plays an important role in people's life. However, the existing researches do not give a unified conclusion on the brain function network under different emotional states. In this study, pictures from the international affective picture system (IAPS) of different valences were presented to subjects with a fixed frequency blinking frequency to induce stable state visual evoked potential (SSVEP). With the source location method, the cerebral cortex source signal was reconstructed based on EEG signals, and then the difference in SSVEP amplitudes in key brain areas under different emotional states and the difference in brain function network connections among different brain areas were analysed in cortical space. The results of the study show that positive and negative emotions evoked greater activation intensities in the prefrontal, temporal, and parietal lobes compared with those of neutral emotion. The network connections with a significant difference between emotional states mainly appear in the alpha and gamma bands, and the network connections with significant differences between positive emotion and negative emotion mainly exist in the right middle temporal gyrus and the superior frontal gyrus on both sides. In addition, the long-range connections play an important role in the process of emotional processing, especially the connections among frontal gyrus, middle temporal gyrus, and middle occipital gyrus. The results of this study provide a reliable scientific basis for revealing and elucidating the neural mechanism of emotion processing and the selection of brain regions and frequency bands in emotion recognition based on EEG signals., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2021 Zhongyang He et al.)

Radiotherapy occupies an essential position in curing and palliating a wide range of solid tumors based on DNA damage responses to eradicate cancer cells. However, the tumor microenvironment generally exhibits the characteristics of hypoxia and glutathione overexpression, which play a critical role in radioresistance, to prevent irreparable breaks to DNA and necrocytosis of cancer cells. Herein, polyethylene glycol (PEG) functionalized manganese ferrite nanoparticles (MnFe 2 O 4 -PEG) are designed to enable self-sufficiency of oxygen by continuously catalyzing the decomposition of endogenous hydrogen peroxide. Simultaneously, the nano-platform can consume GSH to reduce the loss of reactive oxygen species in radiotherapy and achieve better therapeutic effects at the cellular and animal levels. In addition, the MnFe 2 O 4 -PEG could act as an optimal T 1 - and T 2 -weighted contrast medium for tumor-specific magnetic resonance imaging. This work proposes a systematically administered radiosensitizer that can selectively reside in tumor sites via the enhanced permeability and retention effect to relieve hypoxia and reduce GSH concentration, combined with dual-mode magnetic resonance imaging, achieving precise and effective image-guided tumor therapy.

Background: The effect of intraoperative magnetic resonance imaging (iMRI) on tumor control during endoscopic transsphenoidal surgery (TSS) for nonfunctioning pituitary adenomas (NFPAs) has not yet been completely characterized. The present study assessed the effect of the iMRI findings on gross total resection (GTR) and progression-free survival at a mean follow-up of 62 ± 9.4 months., Methods: Retrospective analyses were performed on the data from 133 consecutive patients with NFPA who had undergone endoscopic TSS with iMRI using a 1.5T scanner., Results: Compared with the first and final iMRI scans, the GTR rate increased from 42.9% to 63.9%. Multivariate logistic regression analysis revealed that a lower GTR rate was associated with a higher Knosp score (odds ratio [OR], 3.612; 95% confidence interval [CI], 1.568-8.321; P = 0.003), an increased tumor volume (OR, 0.926; 95% CI, 0.866-0.991; P = 0.025), and a history of surgery (OR, 0.376; 95% CI, 0.155-0.917; P = 0.031). During follow-up, 8 tumors (9.4%) recurred, and 29 remnants (60.4%) regenerated. The recurrence and regeneration rates were 0.019 and 0.121 patient/year, respectively. Kaplan-Meier analysis revealed that the tumor recurrence rates were lower for patients who had undergone GTR (P < 0.01) compared with those who had not. Univariate Cox regression analysis suggested that the presence of tumor remnants (hazard ratio, 1.546; 95% CI, 1.071-2.232; P = 0.02) was the influencing factor associated with tumor progression., Conclusions: High-field iMRI can increase the GTR rate in endoscopic TSS for NPFAs. The increased GTR rate was associated with longer progression-free survival. Cavernous sinus invasion, tumor size, and surgical history were important predictors of GTR in patients with NFPA., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Medical image fusion is important in the field of clinical diagnosis because it can improve the availability of information contained in images. Magnetic Resonance Imaging (MRI) provides excellent anatomical details as well as functional information on regional changes in physiology, hemodynamics, and tissue composition. In contrast, although the spatial resolution of Positron Emission Tomography (PET) provides is lower than that an MRI, PET is capable of depicting the tissue's molecular and pathological activities that are not available from MRI. Fusion of MRI and PET may allow us to combine the advantages of both imaging modalities and achieve more precise localization and characterization of abnormalities. Previous image fusion algorithms, based on the estimation theory, assume that all distortions follow Gaussian distribution and are therefore susceptible to the model mismatch problem. To overcome this mismatch problem, we propose a new image fusion method with multi-resolution and nonparametric density models (MRNDM). The RGB space registered from the source multi-modal medical images is first transformed into a generalized intensity-hue-saturation space (GIHS), and then is decomposed into the low- and high-frequency components using the non-subsampled contourlet transform (NSCT). Two different fusion rules, which are based on the nonparametric density model and the theory of variable-weight, are developed and used to fuse low- and high-frequency coefficients. The fused images are constructed by performing the inverse of the NSCT operation with all composite coefficients. Our experimental results demonstrate that the quality of images fused from PET and MRI brain images using our proposed method MRNDM is higher than that of those fused using six previous fusion methods., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The aim of the study is to verify the effect of hyperglycemia on ischemia-reperfusion injury and to explore the feasibility of noninvasive observation of ischemic-reperfusion injury in hyperglycemic ischemic stroke by MRI technique. According to the duration of ischemia and blood glucose levels, 40 rats were divided into hyperglycemic ischemic 2-hr (H-I2h), hyperglycemic ischemic 6-hr (H-I6h), non- hyperglycemic ischemic 2-hr (NH-I2h), and non- hyperglycemic ischemic 6-hr (NH-I6h) groups. T2W imaging, DW imaging, T2 mapping, T2* mapping, DCE, and T1 mapping after enhancement sequences were acquired before reperfusion and approximately 3-hr after reperfusion. ADC, T1, T2, T2*, and K trans values of ischemic lesion were obtained in different groups. After reperfusion, the variation of ADC values showed no significant difference between groups with diabetes and groups without diabetes and between different recanalization time-points (2-hr vs 6-hr). After reperfusion, T2, T2*, and K trans values increased in different degrees in all four groups. Only the T1 value decreased in all groups. The change of all parameters in groups with hyperglycemia was more obvious than that in groups without hyperglycemia and was more obvious in groups with H-I6h versus those with H-I2h. This study confirms that hyperglycemia aggravates ischemia-reperfusion injury and may be an important risk factor for the prognosis of ischemic stroke. The K trans values should be noninvasive imaging indicators to monitor blood brain barrier permeability and ischemic-reperfusion injury in ischemic stroke.

The use of X-rays instead of UV/Vis light to trigger photodynamic therapy, named X-ray inducible photodynamic therapy, holds tremendous promise due to a high penetration capacity in tissues and is worthy of in-depth study. In this study, a novel multifunctional nanoagent based on Merocyanine 540-coupled Gd 2 (WO 4 ) 3 :Tb nanoscintillators and the vitalization of its abilities for dual-modal computed tomography and the magnetic-resonance-imaging-guided synergistic radio-/X-ray inducible photodynamic therapy of tumors is reported. Synergistic therapies show a higher tumor growth inhibition efficiency at a lower X-ray dose than radiotherapy alone. Through this proof-of-concept work, a way to tactfully understand and utilize nanoscintillators for cancer theranostics is shown., (© 2019 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Objective: Because of the balance between achieving complete seizure freedom and minimizing the postoperative neurologic deficits, surgery for refractory epilepsy originating from the primary motor cortex is difficult. Here, we report the outcomes of surgery for magnetic resonance imaging-negative refractory epilepsy originating from the primary motor cortex in a case series., Methods: Nine patients with refractory epilepsy originating from the primary motor cortex underwent intracranial electrodes implantation after preoperative evaluation. Subdural grid electrodes and depth electrodes were implanted through craniotomy assisted by stereotactic technique. We delineated the epileptic zone and executed tailored resection according to results of intracranial electroencephalography and mapping. The patients were followed up for at least 1 year. Muscle strength was evaluated at different postoperative times (day 1, 2 weeks, and 1 year)., Results: Regarding seizure outcome at the last follow-up, Engel class I outcome was achieved in 5 patients, class II was achieved in 3 patients, and class III was achieved in 1 patient. All cases had postoperative hemiparesis of different degree on the first day after operation. Three patients experienced distal muscle strength of single limb with grade 3 or lower and had obvious dysfunction at 1 year after operation. Six patients experienced distal muscle strength of grade 4 or 5 (Medical Research Council 6-point scale) and had no obvious dysfunction at that time., Conclusions: Most patients of refractory epilepsy originating from the primary motor cortex were seizure free and had no obvious neurologic deficits at follow-up. Epileptogenic zone resection may not always be contraindicated for patients with nonlesional refractory epilepsy originating from the primary motor cortex., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Although conventional radiotherapy (RT) has been widely used in the clinic to treat cancer, it often has limited therapeutic outcomes and severe toxic effects. There is still a need to develop theranostic agents with both imaging and RT-enhancing functions to improve the accuracy and efficiency of RT. Herein we synthesize Au@MnS@ZnS core/shell/shell nanoparticles with polyethylene glycol (PEG) functionalization, yielding Au@MnS@ZnS-PEG nanoparticles with great stability in different physiological solutions and no significant cytotoxicity. It is found that Au@MnS@ZnS-PEG nanoparticles can enhance the cancer cell killing efficiency induced by RT, as evidenced by multiple in vitro assays. Owing to the existence of paramagnetic Mn(2+) in the nanoparticle shell, our Au@MnS@ZnS-PEG can be used as a contrast agent for T1-weighted magnetic resonance (MR) imaging, which reveals the efficient accumulation and retention of nanoparticles in the tumors of mice after intravenous injection. Importantly, by exposing tumor-bearing mice that were injected with Au@MnS@ZnS-PEG to X-ray irradiation, the tumor growth can be significantly inhibited. This result shows clearly improved therapeutic efficacy compared to RT alone. Furthermore, no obvious side effect of Au@MnS@ZnS-PEG is observed in the injected mice. Therefore, our work presents a new type of radiosensitizing agent, which is promising for the imaging-guided enhanced RT treatment of cancer.

Purpose: This study was conducted to characterize topographic variations of the optic chiasm (OC) and the pituitary stalk (PS) in situ based on MR images., Methods: Normal T2-weighted midsagittal MR images were obtained in 157 children and 323 adults. The height of OC (PC) and the inclination angle of PS (PS-AP angle) were measured in each case. All chiasms were classified into prefixed, normal and postfixed types, and low, medium and high types, respectively. All stalks were performed classification (prefixed, centered and postfixed PS) and grading (Grade 1-3 according to the relationship between PS and the dorsum sellae), respectively., Results: PC averaged 4.33 ± 1.59 mm. Adults had a greater PC (P = 0.023) than children. There were 80 (16.7 %) prefixed, 354 (73.8 %) normal and 46 (9.6 %) postfixed chiasms, and 112 (23.3 %), 295 (61.5 %) and 73 (15.2 %) cases with low, medium and high OC, respectively. High OC was more frequent in adults than in children (P = 0.001). The mean PS-AP angle of the whole group was 59.47 ± 8.62º. Children had a greater PS-AP angle than adults (P = 0.012). Adults had a greater percentage of postfixed (P = 0.000) and grade 3 (P = 0.000) PS than children, whereas centered (P = 0.002) and grade 1 (P = 0.001) PS were more prevalent in children than in adults., Conclusions: The classifications of OC and PS based on MR images reflect the topographic variations of their real position in vivo. It would be helpful to identify and characterize the anomalies involving OC and PS and understand the anatomical and physiological influence in pathological situations.

Theranostics, the combination of diagnostics and therapies, has become a new concept in the battles with various major diseases such as cancer. Herein, we develop multifunctional nanoparticles (MFNPs) with highly integrated functionalities including upconversion luminescence, superparamagnetism, and strong optical absorption in the near-infrared (NIR) region with high photostability. In vivo dual modal optical/magnetic resonance imaging of mice uncovers that by placing a magnet nearby the tumor, MFNPs tend to migrate toward the tumor after intravenous injection and show high tumor accumulation, which is ~8 folds higher than that without magnetic targeting. NIR laser irradiation is then applied to the tumors grown on MFNP-injected mice under magnetic tumor-targeting, obtaining an outstanding photothermal therapeutic efficacy with 100% of tumor elimination in a murine breast cancer model. We present here a strategy for multimodal imaging-guided, magnetically targeted physical cancer therapy and highlight the promise of using multifunctional nanostructures for cancer theranostics., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Purpose: To test the feasibility of first-pass contrast-enhanced myocardial perfusion imaging at 3 Tesla and to evaluate the change in perfusion index between normal, remote and ischemic myocardium, we obtained perfusion index from healthy subjects and patients with coronary artery stenosis., Materials and Methods: First-pass contrast-enhanced perfusion imaging was performed on 12 patients and 32 age-matched healthy subjects in both rest and dipyridamole-induced stress states. After bolus injection of contrast agent, Gd-DTPA with dose of 0.025 mmol/kg body weight and injection time of 1.5 s, three short-axis images from apex to base of the left ventricle (LV) were acquired for 80 cardiac cycles using saturation recovery turbo FLASH sequence. The maximal upslope (Upslope) was derived from the signal-time curves of the LV cavity and myocardium to measure myocardial perfusion. Within 72 hours after cardiovascular magnetic resonance examination, patients received coronary angiography, and the results were correlated with cardiovascular magnetic resonance results., Results: Using our protocol of contrast agent administration, sufficient perfusion contrast was obtained without susceptibility-induced signal drop-out at the interface between LV cavity and the myocardium. In healthy volunteers, Upslope showed no dependence on myocardial segments or coronary territories. Upslope increased significantly from rest to stress in normal myocardium (0.09 +/- 0.03 vs. 0.16 +/- 0.05, p < 0.001) and remote myocardium (0.09 +/- 0.03 vs. 0.13 +/- 0.03, p < 0.001), whereas in ischemic myocardium the change was insignificant (0.11 +/- 0.03 vs. 0.10 +/- 0.04, p = ns). This resulted in significant difference in the ratio of Upslope at stress to that at rest, representing myocardial perfusion reserve, between ischemic and non-ischemic myocardium (0.96 +/- 0.41 vs. 1.71 +/- 0.42, p < 0.001 for ischemic vs. normal myocardium; 0.96 +/- 0.41 vs. 1.59 +/- 0.40, p < 0.001 for ischemic vs. remote myocardium)., Conclusions: First-pass gadolinium-enhanced myocardial perfusion imaging at 3 Tesla is feasible. The Upslope ratio can differentiate ischemic from non-ischemic myocardium.

Objectives: Endocardial global longitudinal strain (endo‐GLS) measured with echocardiography (echo) has been demonstrated to be associated with myocardial fibrosis (MF) and is a prognostic predictor in patients with hypertrophic cardiomyopathy (HCM). Late gadolinium enhancement cardiac magnetic resonance (LGE‐CMR) imaging showed that MF is primarily located in the myocardial layer of the extremely hypertrophic septal or ventricular wall. We hypothesized that GLS of the myocardial layer (myo‐GLS) is more strongly correlated with the extent of LGE (%LGE) and is a more powerful prognostic factor than endo‐GLS. Methods: A total of 177 inpatients (54.0 [IQR: 43.0, 64.0] years, female 37.3%) with HCM were retrospectively included from May 2019 to April 2021. Among them, 162 patients underwent echocardiographic examination and contrast‐enhanced CMR within 7 days. Myo‐GLS and %LGE were blindly assessed in a core laboratory. All the patients were followed after they were discharged. Results: During a mean follow‐up of 33.77 [IQR 30.05, 35.40] months, 14 participants (7.91%) experienced major adverse cardiac events (MACE). The MACE (+) group showed lower absolute endo‐GLS and myo‐GLS than the MACE (‐) group. Myo‐GLS was more associated with %LGE (r = ‐.68, P <.001) than endo‐GLS (r = ‐.64, P <.001). Cox multivariable analysis indicated that absolute myo‐GLS was independently associated with MACE (adjusted hazard ratio =.75, P <.05). Myo‐GLS was better than endo‐GLS at detecting MACE (+) patients (‐8.64%, AUC.939 vs. ‐ 16.375%, AUC.898, P <.05). Conclusions: Myo‐GLS is a stronger predictor of MACE than endo‐GLS in patients with HCM and is highly correlated with %LGE. [ABSTRACT FROM AUTHOR]

(1) Background: The hippocampus (HP) and amygdala are essential structures in obsessive–compulsive behavior (OCB); however, the specific role of the HP in patients with behavioral variant frontotemporal dementia (bvFTD) and OCB remains unclear. (2) Objective: We investigated the alterations of hippocampal and amygdalar volumes in patients with bvFTD and OCB and assessed the correlations of clinical severity with hippocampal subfield and amygdalar nuclei volumes in bvFTD patients with OCB. (3) Materials and methods: Eight bvFTD patients with OCB were recruited and compared with eight age- and sex-matched healthy controls (HCs). Hippocampal subfield and amygdalar nuclei volumes were analyzed automatically using a 3T magnetic resonance image and FreeSurfer v7.1.1. All participants completed the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS), Neuropsychiatric Inventory (NPI), and Frontal Behavioral Inventory (FBI). (4) Results: We observed remarkable reductions in bilateral total hippocampal volumes. Compared with the HCs, reductions in the left hippocampal subfield volume over the cornu ammonis (CA)1 body, CA2/3 body, CA4 body, granule cell layer, and molecular layer of the dentate gyrus (GC-ML-DG) body, molecular layer of the HP body, and hippocampal tail were more obvious in patients with bvFTD and OCB. Right subfield volumes over the CA1 body and molecular layer of the HP body were more significantly reduced in bvFTD patients with OCB than in those in HCs. We observed no significant difference in amygdalar nuclei volume between the groups. Among patients with bvFTD and OCB, Y-BOCS score was negatively correlated with left CA2/3 body volume (τb = −0.729, p < 0.001); total NPI score was negatively correlated with left GC-ML-DG body (τb = −0.648, p = 0.001) and total bilateral hippocampal volumes (left, τb = −0.629, p = 0.002; right, τb = −0.455, p = 0.023); and FBI score was negatively correlated with the left molecular layer of the HP body (τb = −0.668, p = 0.001), CA4 body (τb = −0.610, p = 0.002), and hippocampal tail volumes (τb = −0.552, p < 0.006). Mediation analysis confirmed these subfield volumes as direct biomarkers for clinical severity, independent of medial and lateral orbitofrontal volumes. (5) Conclusions: Alterations in hippocampal subfield volumes appear to be crucial in the pathophysiology of OCB development in patients with bvFTD. [ABSTRACT FROM AUTHOR]

Coxsackievirus, a common pathogen causing pediatric infection, typically causes a mild, nonspecific illness with low-grade fever, but can cause severe illness on rare occasions. Encephalitis is an uncommon but important complication of coxsackievirus infection. The magnetic resonance imaging (MRI) findings of coxsackievirus B3 (CVB3) encephalitis have not been reported in the literature, and there are few descriptions of MRI findings of encephalitis induced by coxsackieviruses of other serotypes. We report the MRI findings of CVB3 encephalitis in a two-year-old girl, review the MRI findings in previously reported cases of pediatric coxsackievirus encephalitis, and present the MRI characteristics of coxsackievirus encephalitis.

Unpredictable in vivo therapeutic feedback of reactive oxygen species (ROS) efficiency is the major bottleneck of photodynamic therapy (PDT). Herein, novel PDT‐based nanotheranostics Pa–Mn&CH‐A@P are elaborately constructed for in vivo tracking biodistribution and in situ self‐reporting PDT, which innovatively unites magnetic resonance imaging (MRI) and chemiluminescence (CL) signals. Taking advantages of the versatility of lanthanide coordination chemistry and flash nanoprecipitation (FNP) technology, photosensitizers, MRI, and CL agents are unprecedently integrated within a stable and uniform nanotheranostic. Specifically, MRI signal offers detailed dose distribution of nanotheranostics with high‐spatial resolution, and CL signal timely performs in situ evaluation of ROS generation with high sensitivity. This dual‐modal MRI/CL nanotheranostic makes a breakthrough in high fidelity feedback for oral tumor, conquering the inherent unpredictable obstacles on spatially and sensitively reporting PDT. [ABSTRACT FROM AUTHOR]

• Identification of patients with high risk for chronic ankle instability (CAI) is crucial for more effective and efficient treatment of acute lateral ankle sprain (LAS). • For patients who had at least 1 positive clinical finding in the 10-meter walk test, the anterior drawer test, or the inversion tilt test, magnetic resonance imaging (MRI) scans were helpful in predicting CAI after first-episode LAS. • Age, body mass index, posterior talofibular injury, large talus bone marrow lesion, and Grade 2 tibiotalar joint effusion were 5 prognostic factors that MRI scanning used to predict CAI after first-episode LAS. Chronic ankle instability (CAI) is a common sequela following an acute lateral ankle sprain (LAS). To treat an acute LAS more effectively and efficiently, it is important to identify patients at substantial risk for developing CAI. This study identifies magnetic resonance imaging (MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients. All patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1, 2017 to December 1, 2019 were identified. Data were collected using the Cumberland Ankle Instability Tool at final follow-up. Demographic and other related clinical variables, including age, sex, body mass index, and treatment were also recorded. Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS. A total 131 out of 362 patients with a mean follow-up of 3.0 ± 0.6 years (mean ± SD; 2.0–4.1 years) developed CAI after first-episode LAS. According to multivariable regression, development of CAI after first-episode LAS was associated with 5 prognostic factors: age (odds ratio (OR) = 0.96, 95% confidence interval (95%CI): 0.93–1.00, p = 0.032); body mass index (OR = 1.09, 95%CI: 1.02–1.17, p = 0.009); posterior talofibular ligament injury (OR = 2.17, 95%CI: 1.05–4.48, p = 0.035); large bone marrow lesion of the talus (OR = 2.69, 95%CI: 1.30–5.58, p = 0.008), and Grade 2 effusion of the tibiotalar joint (OR = 2.61, 95%CI: 1.39–4.89, p = 0.003). When patients had at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, or inversion tilt test, they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI. MRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, and inversion tilt test. Further prospective and large-scale studies are necessary for validation. [Display omitted] [ABSTRACT FROM AUTHOR]

Aims This study aims to validate and compare the feasibility of T1ρ and native longitudinal relaxation time (T1) mapping in detection of myocardial fibrosis in patients with non-ischaemic cardiomyopathy, focusing on the performance of both methods in identifying late gadolinium enhancement (LGE) grey zone. Methods and results Twenty-seven hypertrophic cardiomyopathy (HCM) patients, 16 idiopathic dilated cardiomyopathy (DCM) patients, and 18 healthy controls were prospectively enrolled for native T1 and T1ρ mapping imaging and then all the patients underwent enhancement scan for LGE extent and extracellular volume (ECV) values. In LGE positive patients, the LGE areas were divided into LGE core (6 SDs above remote myocardium) and grey zone (2–6 SDs above remote myocardium) according to the signal intensity of LGE. Both HCM and DCM patients showed significantly higher native T1 values and T1ρ values than controls no matter the presence of LGE (all P < 0.01). There were significant differences in native T1 and T1ρ values among four different types of myocardia (LGE core, grey zone, remote area and control, P < 0.0001). However, the T1ρ values of grey zone were significantly higher than control (P < 0.01), while the native T1 values were not (P = 0.089). T1ρ values were significantly associated with both native T1 values (r = 0.54, P < 0.001) and ECV values (r = 0.54, P < 0.001). Conclusion T1ρ mapping is a feasible method to detect myocardial fibrosis in patients with non-ischaemic cardiomyopathy no matter the presence of LGE. Compared with native T1, T1ρ may serve as a better discriminator in the identification of LGE grey zone. [ABSTRACT FROM AUTHOR]

Background: Assessing the structure and function of left atrium (LA) is crucial in hypertrophic obstructive cardiomyopathy (HOCM) because LA remodeling correlates with atrial fibrillation. However, few studies have investigated the potential effect of myomectomy on LA phasic remodeling in HOCM after myectomy using cardiovascular magnetic resonance (CMR) feature tracking (FT). This study aims to evaluate the LA structural and functional remodeling with HOCM after myectomy by CMR-FT and to further investigate the determinants of LA reverse remodeling. Methods: In this single-center study, we retrospectively studied 88 patients with HOCM who received CMR before and after myectomy between January 2011 and June 2021. Preoperative and postoperative LA parameters derived from CMR-FT were compared, including LA reservoir function (total ejection fraction [EF], total strain [εs], peak positive strain rate [SRs]), conduit function (passive EF, passive strain [εe], peak early negative strain rate [SRe]) and booster function (booster EF, active strain [εa], late peak negative strain rate [SRa]). Eighty-six healthy participants were collected for comparison. Univariate and multivariate linear regression identified variables associated with the rate of change of εa. Results: Compared with preoperative parameters, LA reservoir function (total EF, εs, SRs), booster function (booster EF, εa, SRa), and SRe were significantly improved after myectomy (all P < 0.05), while no significant differences were observed in passive EF and εe. Postoperative patients with HOCM still had larger LA and worse LA function than healthy controls (all P < 0.05). After analyzing the rates of change in LA parameters, LA boost function, especially εa, showed the most dramatic improvement beyond the improvements in reservoir function, conduit function, and volume. In multivariable regression analysis, minimum LA volume index (adjusted β = − 0.39, P < 0.001) and Δleft ventricular outflow tract (LVOT) pressure gradient (adjusted β = − 0.29, P = 0.003) were significantly related to the rate of change of εa. Conclusions: Patients with HOCM after septal myectomy showed LA reverse remodeling with a reduction in LA size and restoration in LA reservoir and booster function but unchanged LA conduit function. Among volumetric and functional changes, booster function had the greatest improvement postoperatively. Besides, preoperative LAVmin index and ΔLVOT might be potential factors associated with the degree of improvement in εa. [ABSTRACT FROM AUTHOR]

Background: Arthroscopic microfracture for osteochondral lesion of the talus (OLT) has shown good functional outcomes in the short and long term. Purpose: To investigate 5-year radiographic and clinical outcomes after arthroscopic microfracture in treatment of OLT and the effectiveness of adjunct therapies including platelet-rich plasma (PRP) and hyaluronic acid (HA). Study Design: Cohort study; Level of evidence, 2. Methods: We prospectively enrolled 432 patients who underwent arthroscopic microfracture for OLT from May 1, 2011, to May 31, 2015. Magnetic resonance imaging (MRI) and weightbearing radiographs were performed annually after the initial surgery. The MOCART (magnetic resonance observation of cartilage repair tissue) score was used to evaluate the structure of the repaired cartilage on MRI, and patient-reported outcomes (American Orthopaedic Foot and Ankle Society ankle-hindfoot scale [AOFAS] and the Foot and Ankle Outcome Score) were collected annually. The primary outcome measure was 5-year AOFAS score. We recorded baseline characteristics including age, body mass index (BMI), and lesion size, and other potentially related factors including number of PRP/HA injection and change in BMI from baseline. Results: Included were 355 patients, all with minimum 5-year follow-up data. The overall reoperation rate was 9.0% (32 of 355). According to multivariable analysis, 5-year AOFAS scores were associated with number of PRP injections (correlation coefficient, 3.12 [95% CI, 2.36 to 3.89]; P <.001), BMI at baseline (correlation coefficient, -0.222 [95% CI, -0.363 to -0.082]; P =.002), and mean BMI change from baseline (correlation coefficient, -1.15 [95% CI, -1.32 to -0.98]; P <.001). When comparing number of PRP injections (0, 1-2, or ≥3), we found that patients who had serial PRP injection (≥3 with at least a 3-month interval between injections) had diminished functional and radiographic deterioration over time. Conclusion: Arthroscopic microfracture improved patient-reported and structural outcomes for patients with OLT at 5 years after surgery. Serial PRP injections and reduction in BMI from baseline were able to slow radiographic and functional deterioration. Future trials regarding the combination of microfracture and PRP in treatment of OLT should focus on the efficacy of longer term, intra-articular, serial injections of PRP instead of single injections. [ABSTRACT FROM AUTHOR]

Aims Echocardiographic studies suggest that strain is related to myocardial fibrosis (MF) and ventricular arrhythmias (VA) in hypertrophic cardiomyopathy (HCM) patients. Cardiac magnetic resonance feature tracking (CMR-FT) also allows strain analysis, but little is known whether it provides incremental value to late gadolinium enhancement imaging (LGE). This study aimed to explore the relationship between CMR-FT-derived strain parameters and histopathology MF and VA and its incremental value to LGE in obstructive HCM (HOCM) patients undergoing septal myectomy. Methods and results One hundred and twenty-three symptomatic HOCM patients underwent CMR examination, followed by septal myectomy. The abnormally increased histological MF was defined as higher than the mean + 2 standard deviation (SD) of nine control autopsy subjects who had no history of cardiovascular disease. Septal strain parameters and septal LGE were evaluated at the site of surgical myectomy. Among HOCM patients without LGE, septal circumferential (P = 0.003), longitudinal (P = 0.001), and radial (P = 0.02) strains were significantly impaired in patients with increased histological MF than those without. Histological MF was significantly associated with septal circumferential strain (r = 0.32, P < 0.001), septal longitudinal strain (r = 0.42, P < 0.001), and septal radial strain (r = −0.27, P = 0.003). On multivariate analysis, septal longitudinal strain was independently associated with histological MF [ β , 0.19 (0.05–0.34); P = 0.01], and VA [odds ratio, 1.10 (1.01–1.19); P = 0.02]. Moreover, septal longitudinal strain was incremental to septal %LGE in detecting increased MF (P = 0.001) and VA (P = 0.048). Conclusions Septal longitudinal strain at CMR is independently related to histological MF and occurrence of VA in HOCM patients. Moreover, it provides incremental value over LGE in detecting increased MF and VA. [ABSTRACT FROM AUTHOR]

Plantar fasciitis is a common cause of heel pain, and the disorder is generally self-limiting after adequate conservative treatment. When conservative treatment is unsuccessful, surgical release is an effective treatment option. Here we report a case of iatrogenic plantar fascia rupture after surgical release for treatment of recalcitrant plantar fasciitis. Preoperative MRI revealed a 4.2 cm gap between the distal fascia stump and the calcaneal tuberosity in the sagittal view at 8 months post-injury. To circumvent the possibility of rupture site retear or poor tissue healing by direct repair, we used tendon allografting for the reconstruction of the chronic plantar fascia rupture. The patient gradually recovered after the surgery. Complications of plantar fascia rupture after surgical release is a potential risk but rarely observed. Chronic plantar fascia rupture with medial arch collapse is difficult to treat. We used a tendon allograft to reconstruct the plantar fascia, restoring its function and mechanical strength. After 5 years of follow-up, no complications were reported, and magnetic resonance imaging indicated the reconstructed plantar fascia tissue to be in good condition. [ABSTRACT FROM AUTHOR]

Background and objective: To develop a machine-learning model by integrating clinical and imaging modalities for predicting tumor response and survival of hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE). Methods: 140 HCC patients with TACE were retrospectively included from two centers. Tumor response were evaluated using modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Response-related radiomics scores (Rad-scores) were constructed on T2-weighted images (T2WI) and dynamic contrast-enhanced (DCE) imaging separately, and then integrated with conventional clinic-radiological variables into a logistic regression (LR) model for predicting tumor response. LR model was trained in 94 patients in center 1 and independently tested in 46 patients in center 2. Results: Among 4 MRI sequences, T2WI achieved better performance than DCE (area under the curve [AUC] 0.754 vs 0.602 to 0.752). LR model by combining Rad-score on T2WI with Barcelona Clinic Liver Cancer (BCLC) stage and albumin-bilirubin (ALBI) grade resulted in an AUC of 0.813 in training and 0.781 in test for predicting tumor response. In survival analysis, progression-free survival (PFS) and overall survival (OS) presented significant difference between LR-predicted responders and non-responders. The ALBI grade and BCLC stage were independent predictors of PFS; and LR-predicted response, ALBI grade, satellite node, and BCLC stage were independent predictors of OS. The resulting Cox model produced concordance-indexes of 0.705 and 0.736 for predicting PFS and OS, respectively. Conclusions: The model combined MRI radiomics with clinical factors demonstrated favorable performance for predicting tumor response and clinical outcomes, thus may help personalized clinical management. [ABSTRACT FROM AUTHOR]

Objective: To provide the cobweb classification system (CCS) for the precise digital location and description of the neurological compression in cervical degenerative disease (CDD), and the reliability and the clinical subgroup analysis of the system were tested and analyzed. Methods: The CCS consisted of three parts: compression zones (1‐12), degrees (a, b) and ossification (s, m, h). Computerized tomography (CT) and magnetic resonance imaging (MRI) images from 238 CDD patients were reviewed. All compression cases were classified by five independent reviewers with varied clinical experience in spine surgery. The reliability of the CCS was tested by calculating the kappa (κ) statistics value. Finally, 74 patients with anterior cervical surgery treatment were enrolled for the clinical subgroup analysis. Results: For the small compression, including single and double compression zones, there was a good interobserver reliability between the reviewers (κ coefficient =.855, P <.001). For the large compression with three or more involved zones, there was a fair reliability between the reviewers (κ coefficient =.696, P <.001). The whole intraobserver reliability was good (κ coefficient =.923, P <.001). For clinical practice, the operative time in the large compression and the m/h group was significantly longer than the small compression and the s group, respectively (P <.05), and the blood loss in the m/h group was significantly increased as well (P <.01). Though the preoperative Japanese Orthopedic Association score in Group b was lower than Group a (P <.05), all patients had achieved significant clinical improvement at last follow‐up. Conclusions: The CCS can be used to provide detailed and objective descriptions of the location, extent, and severity of neurological compressions in CDD with satisfactory reliability. Surgeons should pay more attention to the patient with large zone, degree b, and ossification compression, because the operation may be more challenging. [ABSTRACT FROM AUTHOR]

Cerebral small vessel disease is one of the most common causes of cognitive decline and stroke. While several lines of evidence have established a relationship between inflammation and cerebrovascular pathology, the mechanistic link has not yet been elucidated. Recent studies suggest activation of immune mediators, including the soluble form of triggering receptor expressed on myeloid cells 2 (TREM2), may be critical regulators. In this study, we compared the plasma levels of soluble TREM2 and its correlations with neuroimaging markers and cerebral amyloid load in 10 patients with Alzheimer's disease and 66 survivors of spontaneous intracerebral haemorrhage with cerebral amyloid angiopathy or hypertensive small vessel disease, two of the most common types of sporadic small vessel disease. We performed brain MRI and 11C-Pittsburgh compound B PET for all participants to evaluate radiological small vessel disease markers and cerebral amyloid burden, and 18F-T807 PET in a subgroup of patients to evaluate cortical tau pathology. Plasma soluble TREM2 levels were comparable between patients with Alzheimer's disease and small vessel disease (P = 0.690). In patients with small vessel disease, plasma soluble TREM2 was significantly associated with white matter hyperintensity volume (P < 0.001), but not with cerebral amyloid load. Among patients with Alzheimer's disease and cerebral amyloid angiopathy, plasma soluble TREM2 was independently associated with a tau-positive scan (P = 0.001) and white matter hyperintensity volume (P = 0.013), but not amyloid load (P = 0.221). Our results indicate plasma soluble TREM2 is associated with white matter hyperintensity independent of amyloid and tau pathology. These findings highlight the potential utility of plasma soluble TREM2 as a strong predictive marker for small vessel disease-related white matter injury and hold clinical implications for targeting the innate immune response when treating this disease. [ABSTRACT FROM AUTHOR]

Aims Hypertrophic cardiomyopathy (HCM) with left ventricular apical aneurysm (LVAA) is associated with an increased risk of adverse cardiovascular events. However, the clinical significance of LVAA in apical HCM (ApHCM) has not been reported. This study aimed to investigate the prevalence, cardiac magnetic resonance (CMR) characteristics, and prognosis of LVAA in ApHCM patients. Methods and results A total of 1332 consecutive ApHCM patients confirmed by CMR in our hospital were retrospectively analysed. LVAAs were identified in 31 patients of all ApHCM patients (2.3%, 31/1332). Besides, 31 age- and gender-matched ApHCM patients without LVAA were used for comparison. Of the 31 aneurysm patients (mean age, 53.8 ± 15.1 years old), 28 (90.3%) had clinical symptoms, and 3 (9.7%) had a family history of HCM. The rate of missed diagnosis of echocardiography for detecting LVAA was 64.5% (20/31), most (90%, 18/20) of unidentified LVAAs by echocardiography were small aneurysms (<20 mm). Compared with ApHCM patients without LVAA, the proportion of systolic mid-cavity obstruction and late gadolinium enhancement (LGE) presence, and the LGE extent in ApHCM patients with LVAA were significantly higher (all P <0.05). The Kaplan–Meier curves showed that the event-free survival rate in ApHCM patients with LVAA was significantly lower than that in ApHCM patients without LVAA (log rank, P  =   0.010). Conclusion ApHCM with LVAA is a very rare condition, which is often missed by echocardiography and could be reliably detected with CMR and is associated with a higher risk of adverse cardiovascular events compared with ApHCM without LVAA. [ABSTRACT FROM AUTHOR]

This study aimed to compare the diagnostic accuracy of stress myocardial perfusion imaging between cardiac magnetic resonance (CMR) and nuclear medical imaging, including single-photon emission computed tomography (SPECT) and positron emission tomography (PET), for the diagnosis of hemodynamically significant coronary artery disease (CAD) with fractional flow reserve (FFR) as the reference standard. We searched PubMed and Embase for all published studies that evaluated the diagnostic accuracy of stress myocardial perfusion imaging modalities, including CMR, SPECT, and PET, to diagnose hemodynamically significant CAD with FFR as the reference standard. A total of 28 articles met the inclusion criteria and were included in the meta-analysis: 14 CMR, 13 SPECT, and 5 PET articles. The results demonstrated a pooled sensitivity of 0.88 (95% confidence interval [CI]: 0.80–0.93), 0.69 (95% CI: 0.56–0.79), and 0.83 (95% CI: 0.70–0.91), and a pooled specificity of 0.89 (95% CI: 0.85–0.93), 0.85 (95% CI, 0.80–0.89), and 0.89 (95% CI, 0.86–0.91) for CMR, SPECT, and PET, respectively. The area under the curve (AUC) of CMR, PET, and SPECT was 0.94 (95% CI, 0.92–0.96), 0.92 (95% CI, 0.89–0.94), and 0.87 (95% CI, 0.83–0.89), respectively. CMR and PET both have high accuracy and SPECT has moderate accuracy to detect hemodynamically significant CAD with FFR as the reference standard. Furthermore, the diagnostic accuracy of CMR at 3.0 T is superior to 1.5 T. • CMR and PET both have high accuracy to detect hemodynamically significant CAD. • The diagnostic accuracy of CMR at 3.0 T is superior to 1.5 T. • SPECT has stable specificity in different percentage of patients with MVD. • SPECT has a trend towards decreasing sensitivity with increasing percentage of MVD. • CMR may have higher sensitivity compared with SPECT in patients with MVD. [ABSTRACT FROM AUTHOR]

The use of X‐rays instead of UV/Vis light to trigger photodynamic therapy, named X‐ray inducible photodynamic therapy, holds tremendous promise due to a high penetration capacity in tissues and is worthy of in‐depth study. In this study, a novel multifunctional nanoagent based on Merocyanine 540‐coupled Gd2(WO4)3:Tb nanoscintillators and the vitalization of its abilities for dual‐modal computed tomography and the magnetic‐resonance‐imaging‐guided synergistic radio‐/X‐ray inducible photodynamic therapy of tumors is reported. Synergistic therapies show a higher tumor growth inhibition efficiency at a lower X‐ray dose than radiotherapy alone. Through this proof‐of‐concept work, a way to tactfully understand and utilize nanoscintillators for cancer theranostics is shown. Two for the price of one: A multifunctional nanoagent based on Gd2(WO4)3:Tb@MC540 nanoparticles with capabilities for dual‐modal CT/MRI‐guided synergistic radio‐/X‐ray inducible photodynamic therapy of tumors was developed. This type of therapy exhibits a higher tumor growth inhibition efficiency than radiotherapy alone, indicating a promising prospect of nanoscintillators for cancer theranostics. [ABSTRACT FROM AUTHOR]

Objectives: To quantify the effect of IV contrast, tube current and slice thickness on skeletal muscle cross-sectional area (CSA) and density (SMD) on routine CT.Methods: CSA and SMD were computed on 216 axial CT images obtained at the L3 level in 72 patients with variations in IV contrast, slice thickness and tube current. Intra-patient mean difference (MD), 95 % CI and limits of agreement were calculated using the Bland-Altman approach. Inter- and intra-analyst agreement was evaluated.Results: IV contrast significantly increased CSA by 1.88 % (MD 2.33 cm2; 95 % CI 1.76-2.89) and SMD by 5.99 % (p<0.0001). Five mm slice thickness significantly increased mean CSA by 1.11 % compared to 2 mm images (1.32 cm2; 0.78-1.85) and significantly decreased SMD by 11.64 % (p<0.0001). Low tube current significantly decreased mean CSA by 4.79 % (6.44 cm2; 3.78-9.10) and significantly increased SMD by 46.46 % (p<0.0001). Inter- and intra-analyst agreement was excellent.Conclusions: IV contrast, slice thickness and tube current significantly affect CSA and SMD. Investigators designing and analysing clinical trials using CT for body composition analysis should report CT acquisition parameters and consider the effect of slice thickness, IV contrast and tube current on myometric data.Key Points: • Intravenous contrast, slice thickness and tube current significantly affect myometric data. • Image acquisition parameter variations may obscure intrapatient muscle differences on serial measurements. • Investigators using CT for body composition analysis should report CT acquisition parameters. [ABSTRACT FROM AUTHOR]

ABSTRACT: The caudal discs of rats have been proposed as a puncture model in which intervertebral disc (IVD) degeneration can be induced and novel therapies can be tested. For biological repair, treatments for ongoing IVD degeneration are ideally administered during the earlier stages. The purpose of this study was to elucidate the optimal puncture needle size for creating a model that mimicked the earlier stages of IVD degeneration. According to the disc height index, histologic score, and MRI grading, a puncture needle sized 21G or larger induced rapid degenerative processes in rat caudal discs during the initial 2–4 weeks. The degenerative changes were severe and continued deteriorating after 4 weeks. Conversely, puncture injury induced by needles sized 25G or smaller also produced degenerative changes in rat caudal discs during initial 2–4 weeks; however, the changes were less severe. Furthermore, the degenerative process became stabilized and showed no further deterioration or spontaneous recovery after 4 weeks. In the discs punctured by 25G needles, the expression of collagen I was increased at 2–4 weeks with a gradually fibrotic transformation thereafter. The expressions of collagen II and SOX9 were enhanced initially but returned to pre‐injury levels at 4–8 weeks. The above‐mentioned findings were more compatible with earlier degeneration in discs punctured by needles sized 25G or smaller than by needles sized 21G or larger, and the appropriate timing for intradiscal administration of proposed therapeutic agents would be 4 weeks or longer after puncture. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:202–211, 2018. [ABSTRACT FROM AUTHOR]

Imaging guided combined therapy has attracted great attention in recent years. This study develops core-shell Au@FeS nanoparticles with polyethylene glycol (PEG) coating as multifunctional nanotheranostic agent for tumor imaging and combined photothermal therapy (PTT) and radiotherapy (RT). In this Au@FeS nanostructure, the gold core can act as a radiosensitizer for enhanced RT, while FeS shell offers contrast for T2-weighted magnetic resonance imaging and endows the nanoparticles with strong high near-infrared (NIR) for photoacoustic imaging and PTT. As demonstrated by both in vitro and in vivo experiments, Au@FeS-PEG can act as excellent therapeutic agent for cancer synergistic treatment. More importantly, mild PTT boosts the blood flow into tumor and increases oxygenation to overcome the tumor hypoxia microenvironment, further enhancing the efficacy of RT. Moreover, Au@FeS-PEG induces on obvious toxicity at a high dose (20 mg kg−1) to the treated mice as evidenced by blood biochemistry. Therefore, this study brings an excellent strategy for cancer enhanced RT through NIR-triggered mild PTT to overcome hypoxia-associated radioresistance. [ABSTRACT FROM AUTHOR]

The booming development of nanomedicine offers great opportunities for cancer diagnostics and therapeutics. Herein, a magnetic targeting-enhanced cancer theranostic strategy using a multifunctional magnetic-plasmonic nano-agent is developed, and a highly effective in vivo tumor photothermal therapy, which is carefully planed based on magnetic resonance (MR)/photoacoustic (PA) multimodal imaging, is realized. By applying an external magnetic field (MF) focused on the targeted tumor, a magnetic targeting mediated enhanced permeability and retention (MT-EPR) effect is observed. While MR scanning provides tumor localization and reveals time-dependent tumor homing of nanoparticles for therapeutic planning, photoacoustic imaging with higher spatial resolution allows noninvasive fine tumor margin delineation and vivid visualization of three dimensional distributions of theranostic nanoparticles inside the tumor. Utilizing the near-infrared (NIR) plasmonic absorbance of those nanoparticles, selective photothermal tumor ablation, whose efficacy is predicted by real-time infrared thermal imaging intra-therapeutically, is carried out and then monitored by MR imaging for post-treatment prognosis. Overall, this study illustrates the concept of imaging-guided MF-targeted photothermal therapy based on a multifunctional nano-agent, aiming at optimizing therapeutic planning to achieve the most efficient cancer therapy. [ABSTRACT FROM AUTHOR]

Abstract: Herein, we develop FePt@Fe2O3 core-shell magnetic nanoparticles as a T2 magnetic resonance (MR) imaging contrast agent as well as a drug carrier for potential cancer theranostic applications. The FePt@Fe2O3 core-shell nanoparticles are synthesized and then functionalized with polyethylene glycol (PEG). Folic acid (FA) is conjugated on the surface of FePt@Fe2O3-PEG nanoparticles for effective targeting of folate receptor (FR)-positive tumor cells. A chemotherapy drug, doxorubicin (DOX), is then loaded onto those nanoparticles via hydrophobic physical adsorption, for targeted intracellular drug delivery and selective cancer cell killing. We then use those FePt@Fe2O3-PEG nanoparticles for in vivo MR imaging, observing obvious tumor MR contrasts, which resulted from both passive tumor accumulation and active tumor targeting of nanoparticles. Moreover, both in vitro and in vivo studies uncover no obvious toxicity for FePt@Fe2O3-PEG nanoparticles. Therefore, our PEGylated FePt@Fe2O3 core-shell nanoparticles could serve as a promising multifunctional theranostic nano-platform in imaging guided cancer therapy. From the Clinical Editor: In this study of PEGylated FePt@Fe2O3 core-shell magnetic nanoparticles, both therapeutic and diagnostic applications are demonstrated. Folic acid surface-conjugation resulted in uptake by folate receptor positive cancer cells, the iron oxide particles enabled MRI imaging using T2* weighted sequences, and the absorbed doxorubicin provided treatment effects in this model. Similar multi-modality approaches will hopefully find their way to clinical applications in the near future. [Copyright &y& Elsevier]

Abstract: Orgasmic headache (OH) is an “explosive” headache that occurs at orgasm. Historically, it was considered benign with no treatment needed. Reversible cerebral vasoconstriction syndrome (RCVS) refers to a group of disorders characterized by recurrent thunderclap headache (TCH) and multifocal vasoconstriction. Patients who have RCVS often recover completely, but some may have persistent neurological deficits. We report a 34-year-old woman who presented with isolated and recurrent TCH at orgasm, which fulfilled the diagnosis of OH. However, she was post-partum and had recent exposure to ecstasy, making her symptoms highly suggestive of RCVS. Brain magnetic resonance angiography showed segmental vasoconstriction. We concluded that she could be considered to have either OH or RCVS. This patient suggests the theory that OH could be a presentation of RCVS. Given that RCVS is potentially treatable, early recognition by clinicians is vital in order to prevent devastating complications. [ABSTRACT FROM AUTHOR]

Taking advantage of nuclear spins for electronic structure analysis, magnetic resonance imaging, and quantum devices hinges on knowledge and control of the surrounding atomic-scale environment. We measured and manipulated the hyperfine interaction of individual iron and titanium atoms placed on a magnesium oxide surface by using spin-polarized scanning tunneling microscopy in combination with single-atom electron spin resonance. Using atom manipulation to move single atoms, we found that the hyperfine interaction strongly depended on the binding configuration of the atom. We could extract atom- and position-dependent information about the electronic ground state, the state mixing with neighboring atoms, and properties of the nuclear spin. Thus, the hyperfine spectrum becomes a powerful probe of the chemical environment of individual atoms and nanostructures. [ABSTRACT FROM AUTHOR]

• First report on distribution of level II-V nodes assessed per vertebral levels in NPC. • When assessed per vertebral levels, level II-V nodes still show the non-skip pattern. • Low-risk CTV could be reduced to two vertebral levels below metastatic level II-V nodes. The current cervical lymph nodes classification system is not perfectly reasonable for radiotherapy of nasopharyngeal carcinoma (NPC). This study aimed to determine the metastatic patterns of level II-V lymph nodes in NPC by using vertebrae as anatomical landmarks. Four hundred and forty node-positive NPC patients were selected. Metastatic lymph nodes were diagnosed using positron emission tomography/computed tomography scan or magnetic resonance imaging. We evaluated univariate and multivariate logistic correlations between the vertebral levels of metastatic level II-V lymph nodes. The metastasis rate of level II-V lymph nodes gradually decreased from C2 (66.5%) and C3 (68.2%) to T1 (4.1%) vertebral levels. When assessed per vertebral level, 98.4% were non-skip metastasis. The interval of vertebral levels and distance between the inferior border of the tumor and the metastatic lymph nodes were similar in N1 and N2 patients. Univariate correlation analysis showed the metastasis of level II-V lymph nodes at each vertebral level was associated with the metastasis at any other vertebral level. In the multivariate analysis, metastasis at any one of the C2-C7 vertebral levels strongly and positively correlated with metastasis at two adjacent vertebral levels, including one level above and one below. This is the first study to report the distribution and non-skip metastatic patterns of level II-V lymph nodes assessed per vertebral levels in NPC. The low-risk clinical target volume could be reduced to two vertebral levels below the vertebral level of the metastatic level II-V nodes when both imaging modalities are available. [ABSTRACT FROM AUTHOR]