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BACKGROUND: Ischemia with no obstructive coronary artery disease (INOCA) is prevalent in women and is associated with increased risk of developing heart failure with preserved ejection fraction (HFpEF); however, the mechanism(s) contributing to this progression remains unclear. Given that diastolic dysfunction is common in women with INOCA, defining mechanisms related to diastolic dysfunction in INOCA could identify therapeutic targets to prevent HFpEF. METHODS: Cardiac MRI was performed in 65 women with INOCA and 12 reference controls. Diastolic function was defined by left ventricular early diastolic circumferential strain rate (eCSRd). Contributors to diastolic dysfunction were chosen a priori as coronary vascular dysfunction (myocardial perfusion reserve index [MPRI]), diffuse myocardial fibrosis (extracellular volume [ECV]), and aortic stiffness (aortic pulse wave velocity [aPWV]). RESULTS: Compared to controls, eCSRd was lower in INOCA (1.61±0.33/s vs. 1.36±0.31/s, P=0.016); however, this difference was not exaggerated when the INOCA group was sub-divided by low and high MPRI (P>0.05) nor was ECV elevated in INOCA (29.0±1.9% vs. 28.0±3.2%, control vs. INOCA; P=0.38). However, aPWV was higher in INOCA vs. controls (8.1±3.2m/s vs. 6.1±1.5m/s; P=0.045), and was associated with eCSRd (r = −0.50, P < 0.001). By multivariable linear regression analysis, aPWV was an independent predictor of decreased eCSRd (standardized β = −0.39, P=0.003), as was having an elevated left ventricular mass index (standardized β = −0.25, P=0.024) and lower ECV (standardized β = 0.30, P=0.003). CONCLUSIONS: These data provide mechanistic insight into diastolic dysfunction in women with INOCA, identifying aortic stiffness and ventricular remodeling as putative therapeutic targets.

Alonso Cano is considered one of the most original and brilliant artists from the Spanish Golden Age (known in Spanish as Siglo de Oro), a period of flourishing in arts and literature. He was also ...

Noninvasive imaging of myocardial function has limitations as a readout of myocardial biology and therefore as the basis for cardiomyopathy treatments. Measuring scar by using cardiovascular magnetic resonance (CMR) adds value but does not inform about non-scarred myocardium, the key therapeutic

Background/Aims: This study aimed to assess the validity and diagnostic performance of the imaging criteria of Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) 2018 using magnetic resonance imaging (MRI) in high-risk patients for HCC. Methods: This retrospective study included 142 treatment-naive patients (81 patients who underwent MRI with extracellular contrast agent and 61 who underwent MRI with hepatobiliary agent; 183 lesions including 149 HCCs) with a high risk of HCC who underwent multiphasic contrast-enhanced MRI from January to December 2015. All lesions were categorized according to the KLCA-NCC 2018 imaging diagnostic criteria by two readers, and per-lesion diagnostic performances were compared. Results: According to the KLCA-NCC 2018, none (0%) of the 13 benign category lesions, 11 (44.0%) of 25 indeterminate category lesions, 15 (93.8%) of 16 probable HCC category lesions, and 97 (99.0%) of 98 definite HCC category lesions were ultimately diagnosed as HCCs. The sensitivity and specificity of definite HCC category were 65.1% and 97.1%, respectively, and those of the combination of definite and probable HCC categories were 75.2% and 94.1%, respectively. The sensitivity of the combination of definite and probable HCC categories was significantly higher than that of definite HCC (P 0.999). Conclusions: The noninvasive imaging diagnosis of KLCA-NCC 2018 on MRI is reliable and useful for diagnosing HCC in high-risk patients. Combining definite and probable HCC categories of KLCA-NCC 2018 improves the sensitivity while maintaining a high specificity. (J Liver Cancer 2020;20:120-127)

The reported incidence of pediatric pancreatitis is increasing. Noninvasive imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), play important roles in the diagnosis, staging, follow-up, and management of pancreatitis in children. In this position paper, generated by members of the Pancreas Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the Abdominal Imaging Committee of The Society for Pediatric Radiology (SPR), we review the roles of noninvasive imaging in pediatric acute, acute recurrent, and chronic pancreatitis. We discuss available evidence related to noninvasive imaging, highlighting evidence specific to pediatric populations, and we make joint recommendations for use of noninvasive imaging. Further, we highlight the need for research to define the performance and role of noninvasive imaging in pediatric pancreatitis.

International audience; Scanning macro-XRF, XRF point measurements and hyperspectral reflectance imaging in the visible and near-infrared range were combined to characterize the pigments of a Tibetan painting. The complementary use of the different investigation techniques allowed us to (i) clearly identify the pigments used by the artist, (ii) strengthen the few data present in historical and contemporary sources and (iii) provide data necessary for any accurate conservation treatment of the painting. The proposed methodology allows an in-depth characterization of the materials used in thangkas, with the identification of all the pigments used by Tibetan artists, as shown by the analyses of reference samples. In the present study traditional pigments, commonly cited in historical sources, were identified such as vermilion, minium, orpiment and azurite, but also more unusual compounds such as brochantite and antlerite (in blue/green areas). Elemental distribution images confirmed that some parts of the thangka were restored, without taking into account the original pigments or the original design. Underlying annotations and a carbon black under-drawing were highlighted by the application of near-infrared hyperspectral imaging technique, which proved to be particularly useful for the study of such paintings.

Adrenal masses are commonly encountered in clinical practice, many of whom are incidental. Identifying malignancy, and excess hormone production is essential for appropriate management. Biochemical workup and imaging tests (dedicated adrenal CT and/or MRI) are used to determine the likelihood of excessive hormone function and malignancy, respectively. However, imaging cannot provide information about function and biochemical workup cannot localize the source. Furthermore, in primary aldosteronism, adrenal vein sampling, the gold standard for lateralization, has important limitations such as the technical expertise required, the elevated costs, and potential complications. Over the last decades, there has been a renewed interest in alternative noninvasive imaging techniques that provide information about adrenal function without the need for invasive procedures. In this review, we will evaluate the evidence and the potential role of 11C-metomidate as a promising positron emission tomography (PET) tracer in clinical practice. A review of the English literature for articles describing the use of the tracer 11C-metomidate in adrenal disorders. A total of 12 studies were included in the systematic review, which altogether addressed the use of 11C-metomidate in adrenal masses and the application of this tracer in primary aldosteronism. 11C-metomidate, a selective inhibitor of 11-β-hydroxylase, demonstrated a high specificity for adrenocortical tissue. In addition, 11C-metomidate is correlated with this enzyme activity making it a potentially useful PET tracer for the identification primary aldosteronism, in addition to detection of adrenocortical masses.

This study investigated a novel SPECT agent for the noninvasive imaging of EGFR-overexpressing tumors. The EGFR-targeting peptide GE11 was synthesized with the introduction of four amino acids (GGG...

Antibodies and antibody fragments have found wide application for therapeutic and diagnostic purposes. Single-domain antibody fragments, also known as 'heavy-chain variable domains' or 'nanobodies', are a recent addition to the toolbox. Discovered some 30 years ago, nanobodies are the smallest antibody-derived fragments that retain antigen-binding properties. Their small size, stability, specificity, affinity and ease of manufacture make them appealing for use as imaging agents in the laboratory and the clinic. With the recent surge in immunotherapeutics and the success of cancer immunotherapy, it is important to be able to image immune responses and cancer biomarkers non-invasively to allocate resources and guide the best possible treatment of patients with cancer. This article reviews recent advances in the application of nanobodies as cancer imaging agents. While much work has been done in preclinical models, first-in-human applications are beginning to show the value of nanobodies as imaging agents.

Pseudocyst formation is common in chronic pancreatitis. A rare subset of these patients may develop fistulization between the pseudocyst and the portal vein system. We report a case of spontaneous pancreatic pseudocyst - superior mesenteric vein fistula in a 61-year-old male with a history of chronic recurrent calcifying pancreatitis. The fistulous connection was correctly identified on both computed tomography and magnetic resonance cholangiopancreatography (MRCP), and the patient was treated successfully with a conservative approach. Our case report aims to educate on this rare and potentially fatal vascular complication of chronic pancreatitis and to discuss the role of modern noninvasive imaging techniques, such as T2-weighted MRI/MRCP, in establishing this diagnosis and making a decision regarding its management.

Introduction.Currently, numerous studies are published by authors of different countries to demonstrate the effectiveness of noninvasive methods in the diagnosis of melanoma.Methods.A systematic search was conducted independently in the databases PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) until April 2020 according to certain inclusion criteria. Data extraction was carried out independently, followed by generalization using descriptive tables. Due to the heterogeneity of the included studies and the impossibility of carrying out a meta-analysis in view of this, we performed a narrative description.Results.A total of 765 potential publications for inclusion were found and checked, of which 53 were included. By design, the studies were assigned to studies of simultaneous design – 40, to randomized clinical trials – 7, to meta-analysis – 6. Data in the included publications on 76802 skin neoplasms were reported, of which 9070 were melanomas. The extracted data were summarized in descriptive tables.Conclusion.With continuing technological progress, the development of noninvasive imaging technologies in the diagnosis of skin melanoma should follow the path of cost-effective, simple and accurate diagnosis.

Magnetic resonance imaging (MRI) is a noninvasive imaging tool for neuroradiological diagnosis. Numerous concepts of automated MRI analysis and the use of machine learning have been proposed to assist diagnosis and prognosis. While these academic innovations have proven effective in principle within controlled environments, their application to clinical practice has faced unmet requirements, such as the ability to perform reliably across a heterogeneous population, to work robustly in the presence of comorbidities, and to be invariant to scanner hardware and image quality. The lack of realistic confidence bounds and the inability to handle missing data have also reduced the application of most of these methods outside of academic studies. Mastering the complex challenges in the diagnostic process may help researchers discover novel biological constructs in multimodal data and improve stratification for clinical trials, paving the way for precision medicine. This review presents the state of the art of computerized brain MRI analysis for diagnostic purposes. We critically evaluate the current clinical usefulness of the methods and highlight challenges and future perspectives of the field.

Background The extent and depth of facial nonmelanoma skin cancers and the involvement of adjacent structures are critical features for surgical planning, but they are difficult to assess clinically. High-resolution MRI (HR-MRI) with microscopy coil may facilitate detailed evaluation of skin lesions. The authors performed this prospective study to determine the value of high-resolution microscopy coil MRI in the preoperative evaluation of nonmelanoma skin cancer. Materials and methods Between October 2018 and August 2019, 16 lesions from fifteen consecutive patients with facial nonmelanoma skin cancer were evaluated using high-resolution microscopy coil MRI about tumor extent, depth, margins, characteristic, and their spatial relationship with adjacent structures. The preoperative HR-MRI results were compared with the intraoperative findings and with the histopathology, with special note to the depth of invasion. Results Among the 16 lesions, HR-MRI imaging was found to provide accurate evaluation of tumor extent, depth, and margins and determine whether there was involvement of adjacent structures. The tumor depth measured on HR-MRI showed good correlation with histopathologic results (CCC: 0.973), and Bland-Altman analysis finding no significant bias existed between the two measurements. All lesions except one were completely resected with primary excision. Only one lesion required further excision. During follow-up for 3-15 months, no tumor recurrence was observed in any case. Conclusions HR-MRI is an accurate, noninvasive imaging technique that can be used as preoperative evaluation tool for facial nonmelanoma skin cancer. It can accurate predict tumor depth, margins, and involvement of structure. The valuable information it provided facilitates surgeons optimize surgical planning.

Duodenal gastrointestinal stromal tumors (GISTs) are rare, and studies on their management are not sufficient. Owing to the complex anatomy of the duodenum and pancreatic head, GISTs can be misdiagnosed as pancreatic head tumors. Surgical resection is the first treatment for localized duodenal GISTs; thus, noninvasive imaging is important for the diagnosis and treatment of GISTs. Computed tomography, magnetic resonance imaging and endoscopic ultrasonography findings can be helpful for the diagnosis of duodenal GISTs and can help differentiate GISTs from other adjacent tumors.

The coronavirus disease 2019 (COVID-19) outbreak, first reported in Wuhan, China, is gradually spreading worldwide. For diagnosis, chest computed tomography is a conventional, noninvasive imaging modality that is very accurate for detection and evaluation of pneumonia and is an important adjunct to real-time reverse transcription polymerase chain reaction diagnosis of the virus. Previous studies have reported typical computed tomography imaging features indicative of COVID-19, such as multifocal ground-glass opacities with or without consolidation. With the sharply increasing demand for computed tomography examination during the outbreak, ensuring appropriate infection control in radiology departments is challenging. Thus, advanced training and education in standardized infection control and prevention practice are essential. The purpose of this brief review is to summarize such training and education for clinical management of this outbreak for radiology department personnel. We will describe standard transmission-based precautions, workflow for computed tomography examination of fever patients, and decontamination management of a radiology department.

Background Vertebral arteriovenous fistulas (VAVFs) are uncommon high-flow communications between a vertebral artery and surrounding venous plexus that occur spontaneously or secondary to trauma. Case Description A woman aged 57 years presented with a multiday history of rapidly progressive numbness and weakness in the left C5-C6 dermomyotomes. Her physical examination findings and subsequent electrophysiological testing were suggestive of a brachial radiculoplexopathy. Noninvasive imaging demonstrated venous congestion with multilevel compromise of the left-sided cervical foramina, and subsequent vertebral angiography confirmed a VAVF, which was treated with trapping of the involved vertebral artery segment. Her numbness and weakness progressively improved with concurrent involution of the dilated veins. Conclusions This is a rare case of VAVF manifesting as a brachial radiculoplexopathy. Although rare, VAVF may be considered as a potential cause in patients presenting with similar symptoms.

Highlights • A novel MRI technique capable of detecting the size, shape and distribution of human motor units is described. • Human motor units have a range of different outlines including elliptical, complex or split. • This technique demonstrates a heterogeneous remodelling of motor units with age., Objective To determine the size, shape and distribution of single human motor units in-vivo in healthy controls of different ages. Methods A novel diffusion-weighted magnetic resonance imaging (MRI) technique was used in combination with in-scanner electrical stimulation to quantify the shape, cross-sectional area, and dimensions of individual motor units in 10 healthy subjects. Results Thirty-one discrete motor units were studied. The majority were elliptical or crescent shaped, but occasional split motor units were observed. The mean motor unit cross sectional area was 26.7 ± 11.2 mm2, the mean maximum dimension was 10.7 ± 3.3 mm, and the mean minimum dimension was 4.5 ± 1.2 mm. Subjects aged over 40 had significantly larger maximum dimensions than those below this age (p

Noninvasive imaging methods of internal body temperature are in high demand in both clinical medicine and physiological research. Thermography and thermometry can be used to assess tissue temperature during thermal therapies: ablative and hyperthermia treatments to ensure adequate temperature rise in target tissues but also to avoid collateral damage by heating healthy tissues. In research use, measurement of internal body temperature enables us the production of thermal maps on muscles, internal organs, and other tissues of interest. The most used methods for noninvasive imaging of internal body temperature are based on different parameters acquired with magnetic resonance imaging, ultrasound, computed tomography, microwave radiometry, photoacoustic imaging, and near-infrared spectroscopy. In the current review, we examine the aforementioned imaging methods, their use in estimating internal body temperature in vivo with their advantages and disadvantages, and the physical phenomena the thermography or thermometry modalities are based on.

Isolated external iliac vein compression syndrome is an uncommon cause of nonthrombotic venous stenosis that causes chronic venous hypertension leading to painful swelling, skin discoloration, and ulcer formation. We present a case of an 86-year old man with refractory lower extremity edema for several years who had been treated with diuretics and antibiotics without relief of symptoms. With the help of invasive and noninvasive imaging modalities, we were able to diagnose and manage isolated nonthrombotic left external iliac vein stenosis as a result of ipsilateral external iliac artery compression.

Objective Gather information from physicians about factors contributing to unnecessary noninvasive imaging and impact of possible solutions. Methods Qualitative study of 14 physicians using a phenomenological approach and the Theoretical Domains Framework. Results Most participants ( n = 9) self-reported that >10% of the imaging tests they order are unnecessary. External sources of pressure included: peer-review, patient demands, nursing expectations, specialist requests (social demands), as well as prior experience with patient advocates, and the compensation and pension system (environmental context). Internal sources of pressure included reliance on anecdote (emotion), self-doubt about diagnoses (beliefs about capabilities), and fear of missing a diagnosis and of professional liability (beliefs about consequences). Participants expressed both optimism and concern about potential solutions, such as adopting decision support software. Conclusion Physicians are under pressure from multiple sources to order unnecessary imaging. Peer review, nursing expectations, and perceptions about Veteran compensation and pension are newly reported contributing factors.

In this study bevacizumab was labeled with 99mTc using p-SCN-Bzl-TCMC as a chelator for non invasive imaging of VEGF receptor in ovarian tumor Sprague Dawley rat and New Zealand rabbit models. High radiochemical purity and stability were observed using 0.4 mL of conjugated TCMC-bevacizumab. In vitro binding studies showed higher uptake of labeled conjugated bevacizumab with high metastatic SKOV-3 ipl cells as compared to poor metastatic SKOV-3. Biodistribution in rat model confirmed higher accumulation of labeled conjugated bevacizumab in the site infected with SKOV-3 ipl cells as compared to SKOV-3. Images of ovarian tumor rabbit model validated its specificity and efficacy as a promising ovarian tumor imaging agent.

Ophthalmologists usually evaluate melanocytic conjunctival tumor on clinical and slit-lamp examination and perform biopsies in cases of malignancy suspicion. However, differential diagnosis can be ...

Because of a recent increase in survival rates and life expectancy of patients with congenital heart disease (CHD), radiologists are facing new challenges when imaging the peculiar anatomy of individuals with repaired CHD. Cardiac computed tomography and magnetic resonance are paramount noninvasive imaging tools that are useful in assessing patients with repaired CHD, and both techniques are increasingly performed in centers where CHD is not the main specialization. This review provides general radiologists with insight into the main issues of imaging patients with repaired CHD, and the most common findings and complications of each individual pathology and its repair.

Purpose of review The present review describes the current role of metabolic imaging techniques such as multiparametric MRI (mpMRI), magnetic resonance spectroscopic imaging (MRSI), hyperpolarized MRSI, and positron emission tomography (PET) in the diagnosis of primary prostate cancer, surveillance of low-grade disease, detection of metastases, and evaluation of biochemical recurrence after therapy. Recent findings The natural history of prostate cancer ranges from indolent disease that is optimally monitored by active surveillance, to highly aggressive disease that can be lethal. Current diagnostic methods remain imperfect in noninvasively distinguishing between silent versus aggressive tumors. Hence, there is a high demand for noninvasive imaging techniques that offer insight into biological behavior of prostate cancer cells. Characterization of prostate cancer metabolism is a promising area to provide such insights. Summary Metabolic imaging may allow for greater detection and ultimately characterization of tumor based on aggressiveness and spread. Hence, it has the potential to monitor tumor activity, predict prognostic outcomes, and guide individualized therapies.

Objectives: To review whether adenomyosis causes infertility or not, the current available methods of its diagnosis, the lines of ade- nomyosis associated infertility treatment, and why future research is needed. Materials and methods: Electronic databases for studies on adeno- myosis and infertility published between 1995-2020 were searched and reviewed using the PUBMED as a search engine. The follow- ing keywords were used: adenomyosis, infertility, ultrasonography, MRI, IVF/ICSI, cytoreductive surgery, GnRHa, NSAIDs and HIFU. No language limitations were applied. Findings: Adenomyosis is a disease of women in reproductive age and contributes to infertility. It can be accurately diagnosed by non invasive imaging. There are different lines of treatment of adenomy- osis associated infertility. However all currently available methods have their limitations. There is a need to expand research in this area to be able to answer the enigma of adenomyosis and infertility. Conclusion: Reproductive medicine physicians should be aware of the possible contribution of adenomyosis to infertility and look for its presence during infertility workup. This will enable them to prop- erly counsel the patients and choose the most appropriate methods for management of their infertility.

The immune system’s role in atherosclerosis has long been an important research topic and is increasingly investigated for therapeutic and diagnostic purposes. Therefore, noninvasive imaging of hematopoietic organs and immune cells will undoubtedly improve atherosclerosis phenotyping and serve as a monitoring method for immunotherapeutic treatments. Among the available imaging techniques, positron emission tomography’s unique features make it an ideal tool to quantitatively image the immune response in the context of atherosclerosis and afford reliable readouts to guide medical interventions in cardiovascular disease. Here, we summarize the state of the art in the field of atherosclerosis positron emission tomography immunoimaging and provide an outlook on current and future applications.

Background Skin breakdown due to limb-socket interface stress is a significant problem for lower limb prosthesis users. While it is known that skin can adapt to stress to become more resistant to breakdown, little is understood about skin adaptation and few methods exist to noninvasively investigate it. In this study, we present novel, noninvasive imaging methods using Optical Coherence Tomography (OCT) to assess key features of the cutaneous microvasculature that may be involved in skin adaptation. Materials and methods Eight able-bodied participants wore a modified below-knee prosthetic socket for two weeks to stress the skin of their lower limb. Two OCT-based imaging tests were used to assess the function and structure, respectively, of the cutaneous microvasculature at multiple time points throughout the socket wear protocol. Results A measurable reactive hyperemia response was reliably induced in the skin of study participants in the vascular function assessment test. The vascular structure assessment demonstrated excellent field-of-view repeatability, providing rich data sets of vessel structure. No statistically significant differences were found in any of the measurements when compared between time points of the adaptation protocol. The participants' limbs were likely not stressed enough by the able-bodied socket to induce measurable skin adaptation. Conclusion This study introduced new techniques to investigate skin adaptation to mechanical stress. If the key limitations are addressed, these methods have the potential to provide insight into the function and structure of the cutaneous microvasculature that previously could not be attained noninvasively.

Background Intracranial vascular abnormalities in Sturge-Weber syndrome, including leptomeningeal angiomatosis, anomalous cortical venous structures, and transmedullary developmental venous anomalies, are well recognized. Prominent vascular flow voids on T2-weighted magnetic resonance imaging (MRI) are occasionally identified in patients with Sturge-Weber syndrome, raising concern of arteriovenous malformations, a congenital high-flow vascular malformation with a risk of bleeding. Methods We report four patients with prominent flow voids on conventional MRI that suggested high-flow lesions. Results Diagnostic evaluation was performed with cerebral angiography in one patient and with a combination of magnetic resonance angiography and magnetic resonance venography in three patients. In all four patients, the conventional MRI-identified lesions represented prominent developmental venous anomalies and not arteriovenous malformations. Conclusions This series highlights that developmental venous anomalies may appear in individuals with Sturge-Weber syndrome as unusually large and seemingly high-flow lesions on MRI. Noninvasive imaging with magnetic resonance angiography and magnetic resonance venography can be used in the management of such patients for further characterization of these vascular structures.

Objectives: The objective of this study was to demonstrate the feasibility of using noninvasive photoacoustic imaging technology along with novel semiconducting polymer nanoparticles for in vivo identifying inflammatory components in carotid atherosclerosis and assessing the severity of inflammation using mouse models. Methods and Results: Healthy carotid arteries and atherosclerotic carotid arteries were imaged in vivo by the noninvasive photoacoustic imaging system. Molecular probes PBD-CD36 were used to label the inflammatory cells to show the inflammation information by photoacoustic imaging. In in vivo imaging experiments, we observed the maximum photoacoustic signal enhancement of 4.3, 5.2, 8 and 16.3 times between 24 h post probe injection and that before probe injection in four carotid arteries belonging to three atherosclerotic mice models. In the corresponding carotid arteries stained with CD36, the ratio of 0.043, 0.061, 0.082 and 0.113 was found between CD36 positive (CD36(+)) expression area and intima-media area (P < 0.05). For the CD36(+) expression less than 0.008 in eight arteries, no photoacoustic signal enhancement was found due to the limited system sensitivity. The photoacoustic signal reflects CD36(+) expression in plaques, which shows the feasibility of using photoacoustic imaging for in vivo assessment of carotid atherosclerosis. Conclusion: This research demonstrates a semiconducting polymer nanoparticle along with photoacoustic technology for noninvasive imaging and assessment of inflammation of carotid atherosclerotic plaques in vivo.

Magnetic resonance lymphangiography (MRL) is a noninvasive imaging technique that can be used in the management of lymphatic disorders to delineate the central lymphatic system for treatment planning. This article reviews the MRL technique, its advantages, limitations, indications, and impact on patient management. Level of Evidence 5 Technical Efficacy Stage 3 J. MAGN. RESON. IMAGING 2021;53:374-380.

Saw tooth cardiomyopathy is an unusual and rare type of left ventricular dysplasia that is characterized by multiple projections of compacted myocardium that makes the appearance of ‘saw tooth’ in noninvasive imaging. We present a young man with signs and symptoms of heart failure and reduced left ventricular function in echocardiography who showed distinctive left ventricle features of saw tooth cardiomyopathy (saw tooth appearance of myocardium in basal inferolateral and basal to mid lateral segments) in cardiac magnetic resonance imaging.

The increasing rate of incidence and prevalence of basal cell carcinomas (BCCs) worldwide, combined with the morbidity associated with conventional surgical treatment has led to the development and use of alternative minimally invasive non-surgical treatments. Biopsy and pathology are used to guide BCC diagnosis and assess margins and subtypes, which then guide the decision and choice of surgical or non-surgical treatment. However, alternatively, a noninvasive optical approach based on combined reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) imaging may be used. Optical imaging may be used to guide diagnosis and margin assessment at the bedside, and potentially facilitate non-surgical management, along with long-term monitoring of treatment response. Noninvasive imaging may also complement minimally invasive treatments and help further reduce morbidity. In this paper, we highlight the current state of an integrated RCM/OCT imaging approach for diagnosis and triage of BCCs, as well as for assessing margins, which therefore may be ultimately used for guiding therapy.

A novel dual-targeted CeO2-DNA nanosensor by modifying with folic acid (FA) and CD36 antibody was designed. This fluorescent nanosensor enables noninvasive imaging of alterations in H2O2in vitro and in vivo with good sensitivity and selectivity, accurately evaluating the inflammation level and providing early warning of plaque vulnerability.

PURPOSE OF REVIEW: Osteoarthritis is a major source of disability, pain and socioeconomic cost worldwide. The epidemiology of the disorder is multifactorial including genetic, biological and biomechanical components, some of them detectable by MRI. This review provides the most recent update on MRI biomarkers which can provide functional information of the joint structures for diagnosis, prognosis and treatment response monitoring in osteoarthritis trials. RECENT FINDINGS: Compositional or functional MRI can provide clinicians with valuable information on glycosaminoglycan content (chemical exchange saturation transfer, sodium MRI, T(1ρ)) and collagen organization (T(2), T(2)*, apparent diffusion coefficient, magnetization transfer) in joint structures. Other parameters may also provide useful information, such as volumetric measurements of joint structures or advanced image data postprocessing and analysis. Automated tools seem to have a great potential to be included in these efforts providing standardization and acceleration of the image data analysis process. SUMMARY: Functional or compositional MRI has great potential to provide noninvasive imaging biomarkers for osteoarthritis. Osteoarthritis as a whole joint condition needs to be diagnosed in early stages to facilitate selection of patients into clinical trials and/or to measure treatment effectiveness. Advanced evaluation including machine learning, neural networks and multidimensional data analysis allow for wall-to-wall understanding of parameter interactions and their role in clinical evaluation of osteoarthritis.

Rationale: Diagnosis and monitoring of patients with pulmonary artery hypertension (PAH) is currently difficult.Objectives: We aimed to develop a noninvasive imaging modality for PAH that tracks th...

[Figure][1] “Everything should be made as simple as possible, but no simpler.”—Albert Einstein ![Figure][1] Left ventricular (LV) diastolic function determines LV filling and diastolic pressures. It is a complex process that depends on many factors, including LV end diastolic

Despite various therapeutic or diagnostic developments, cancer is still one of the most lethal diseases due to insufficiently adequate treatments and the delay of the early stage of disease detection. An image-guided drug delivery system (IGDDS), as a real-time noninvasive imaging assessment of therapeutic response, has the strong potential to improve the diagnosis and treatment of cancer because its imaging property offers the quantification of nanomedicine at the intended disease sites, the possible assurance of adequate treatment and elimination of undesirable delay of early-stage diagnosis due to low resolution. One of potential modality that overcomes these challenges could be the nanoconfinement of gold (Au) nanoparticles within other nanoparticles called "Particle-in-Particle (PIP)", which is a strong candidate of cancer treatment because of its "theranostic (therapy + diagnostics)" advantages including imaging (e.g., CT) and therapeutic hyperthermia application. In this review, we will elaborate on the current application of theranostic by nanoconfinement. Then, we will narrow down the gold nanoparticle-mediated theranostic application and its nanoconfinement advantages. Finally, the future direction for maximum nanoconfinement mediated cancer therapy will be included.

Magnetic Resonance Imaging (MRI) is a noninvasive imaging technique that provides exquisite soft-tissue contrast without using ionizing radiation. The clinical application of MRI may be limited by long data acquisition times; therefore, MR image reconstruction from highly undersampled k-space data has been an active area of research. Many works exploit rank deficiency in a Hankel data matrix to recover unobserved k-space samples; the resulting problem is non-convex, so the choice of numerical algorithm can significantly affect performance, computation, and memory. We present a simple, scalable approach called Convolutional Framework (CF). We demonstrate the feasibility and versatility of CF using measured data from 2D, 3D, and dynamic applications., Comment: IEEE ISBI 2020, International Symposium on Biomedical Imaging

Myocarditis is an inflammatory heart muscle disease characterized by heterogeneous clinical presentation and outcome. Clinical heterogeneity of myocarditis, ranging from acute onset chest pain with electrocardiographic changes resembling an acute coronary syndrome, to arrhythmic storm and chronic decompensated heart failure, makes diagnosis challenging. However, a correct diagnosis is fundamental to proper patients' management and should always be seeked. Although a definite diagnosis is only provided by endomyocardial biopsy, the European Society of Cardiology task force on myocardial and pericardial diseases provided specific criteria for the diagnosis of clinically suspected myocarditis, which has been facilitated by the advent of noninvasive imaging tests (i.e. cardiovascular magnetic resonance based myocardial tissue characterization). Due to the heterogeneous presentation and disease course of myocarditis, a tailored treatment would be the best strategy, but a standardized management is still not available. However, over the years, new, promising therapies, such as antiviral and immune-suppressive treatment, have come side by side to the standard pharmacological heart treatment, i.e. antiheart failure medications. In this paper we will review the basic principles of myocarditis management in clinical practice, including diagnostic work-up, conventional and disease-specific therapy and patients' follow-up.

Recent advances in cancer immunotherapies show promise for revolutionizing the oncologic treatment of both solid and hematologic malignancies. While progress has been made in understanding immunotherapy mechanisms of action in laboratory investigations and preclinical models, there remain significant gaps in knowledge of how therapies in this class operate in patients. A better understanding of the distribution and dynamic action of cancer immunotherapies in patients aims to support patient stratification, earlier evaluation of treatment response and toxicities, and integration with other cancer treatment modalities. Noninvasive imaging tools offer influential contributions to guide the evaluation of cancer immunotherapy for these purposes. In this chapter, we review clinically relevant imaging modalities that are being developed and used to evaluate cancer immunotherapy. Image-guided approaches to assess the innate and adaptive immune system, as well as adoptive cell therapies, will be described. Finally, image-guided interventional approaches to guide the directed delivery of immunotherapies will also be outlined.

Fused imaging with FDG-PET/CT is a hybrid technique that provides a unique combination of functional and anatomic imaging. It has recently emerged as a very useful tool in the management of rectal carcinoma despite its limitation in defining local invasion of tumors in adjacent tissues. As a whole-body, noninvasive imaging modality, PET/CT has an established role in the detection of suspected recurrent disease in patients with unexplained progressive rise of CEA serum levels, staging before surgical resection of recurrence, and assessment of residual disease after treatment. Furthermore, this technique appears to be able to monitor and predict tumor response to preoperative radiochemotherapy in locally advanced or metastatic rectal cancer and also seems to have a role in planning radiotherapy.

Purpose To study the choroidal vascular pattern in patients with Sturge-Weber syndrome (SWS) using swept-source OCT (SS-OCT). Design Prospective comparative observational study. Participants All patients with SWS with no history of prior treatment for posterior segment pathology were included. Methods Both eyes of all patients were studied using fundus imaging, SS-OCT, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICG) by 2 independent observers. Main Outcome Measures The FFA and ICG were screened for any vascular abnormalities. The SS-OCT was evaluated for choroidal changes. Results A total of 34 eyes of 17 patients with diagnosed SWS in the age group 9 to 26 years were studied. The FFA and ICG in 7 and 11 patients, respectively, showed some vascular abnormalities. SS-OCT was performed in all patients. The diffuse choroidal hemangioma (DCH) was characterized by loss of the choroidal vascular pattern, increase in the choroidal thickness and loss of visualization of the sclerochoroidal interface. Based on the FFA, ICG, and SS-OCT imaging, there were 3 patients with no DCH, 5 with bilateral DCH, and the remaining 9 patients had unilateral DCH. The detection rate was 50% clinically: 52.94% with FFA, 82.35% with ICG, and 86.36% with SS-OCT. There was substantial agreement between the 2 observers for all 3 investigations. Conclusion SS-OCT is a reliable noninvasive imaging modality for early diagnosis and follow-up of DCH over time.

The periodontal disease and gingival bleeding are highly prevalent in the adult population worldwide. The World Health Organization (WHO) data shows that 90–100% of the 34-year-old adults present gingival inflammation. Therefore, an investigation method is required to allow the assessment of the periodontal disease as well as the monitoring of the evolution of the gingival inflammation after periodontal treatments. Non-invasive and operator-independent methods for periodontal examination are necessary for diagnosing and monitoring the periodontal disease. The periodontal ultrasonography is a reliable technique for visualizing the anatomical elements which are necessary to diagnose the periodontal status. Using this imaging technique the dentino-enamel junction, the cortical bone, the radicular surface from the crown to the alveolar bone, the gingival tissue can be seen without interfering with those elements during the examination. Also, calculus visualization is possible before and after scaling in order to evaluate the quality of the treatment. Using 2D ultrasonography is not feasible in dental practice as it requires extensive experience and is also time consuming. The reproducibility of the 2D slices is very difficult in order to have the possibility to compare different investigations efficiently. 3D reconstructions of the periodontal tissue can be a very good alternative to eliminate the operator dependence. Ultrasonography allows the practitioner to visualize the anatomic elements involved in making a periodontal diagnosis. It also allows tracking of subsequent changes. This method is not commonly used for periodontal examination and further studies are required. Previous studies show that ultrasonography can be a reliable non-invasive method to diagnose and monitor the periodontal disease.

Introduction People with Down's syndrome (DS) have a high prevalence of early-onset Alzheimer's disease. Early markers of Alzheimer's disease pathology identifiable before clinical change are needed for the evaluation of preventative treatments. The retina, an extension of the brain, may provide a noninvasive imaging site. Methods Forty-nine adults with DS and 36 age-matched controls completed retinal nerve fibre layer (RNFL) assessments using optical coherence tomography. RNFL thickness was analyzed in relation to cognitive status and age and previously acquired cortical thickness and cerebral amyloid β binding data in a subgroup. Results RNFL thickness was greater in the DS group and did not show age-related thinning. RNFL correlated positively with cognitive scores and cortical thickness and was reduced in participants with positive cerebral amyloid β binding. Discussion Increased RNFL in adults with DS may represent early Alzheimer's disease–related changes. Thinning was present in those with cerebral amyloid β binding, independent of age., Highlights •Novel study investigating retinal thickness in adults with DS at risk of dementia. •Unexpected finding of no correlation between age and RNFL thickness. •Evidence of decreased thickness in the RNFL in those with positive cerebral Aβ binding.

Background & Aims Criteria defined by the European Association for the Study of the Liver (EASL) and Liver Imaging Reporting and Data System (LI-RADS) enable hepatocellular carcinoma (HCC) diagnosis based on imaging in cirrhosis. Non-cirrhotic patients require biopsy given the lower pre-test probability of HCC. The objective of our study was to assess the performance of EASL and LI-RADS criteria for the diagnosis of HCC in non-cirrhotic patients with chronic HBV infection. Methods This was a cross-sectional study performed at a referral center. We included all patients with HBV without cirrhosis with focal liver lesions who underwent contrast-enhanced CT or MRI at our clinic between 2005-2018. Studies were reviewed by 2 radiologists blinded to the diagnosis. Results We included 280 patients, median age was 56.8 (IQR 48.2-65.45) years and 223 (80%) were male. In 191 (79%) cases the lesion was found as a result of screening. Cirrhosis was excluded based on pathology in 252 (90%) cases. We assessed 338 nodules: 257 (76%) HCC, 40 (12%) non-HCC malignant lesions, and 41 (12%) benign lesions. EASL criteria and LR-5/LR-tumor-in-vein (TIV) categories had a 100% agreement in categorizing lesions as HCC, and 226 nodules (67%) were classified as HCCs. The sensitivity, specificity, positive predictive value, and negative predictive value were 82.1 (76.9-86.6), 81.5 (71.3-89.2), 93.4 (89.3-96.2), and 58.9 (49.2-68.1), respectively. When the pre-test probability of HCC is >70%, estimated as a PAGE-B score above 9, and EASL or LR-5/LR-TIV criteria are met, post-test probability would be >90%. Conclusions EASL criteria and LR-5/LR-TIV categories show a positive predictive value in patients with HBV without cirrhosis that is comparable to that seen in patients with cirrhosis. These criteria can be used when the pre-test probability of HCC is >70%. Lay summary Current guidelines recommend performing a biopsy to confirm the diagnosis of presumed hepatocellular carcinoma (HCC) in patients without cirrhosis. We showed that specific imaging criteria had a 100% agreement for categorizing lesions as HCC, with a positive predictive value of 93.4%. These imaging criteria could be used to diagnose HCC in HBV patients without cirrhosis with a pre-test probability of HCC of ≥70%, avoiding the need for a liver biopsy., Graphical abstract, Highlights • Imaging criteria defined by the EASL and LI-RADS enable the diagnosis of HCC without biopsy in patients with cirrhosis. • A biopsy is recommended in all patients without cirrhosis. • Imaging criteria had a good performance in patients with HBV infection without cirrhosis when pre-test probability was >70%. • HCC may be diagnosed based solely on imaging criteria in patients with HBV subject to HCC screening (i.e. PAGE-B score >9).