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ObjectiveMesenchymal stem cells (MSCs) are novel therapeutics for treatment of Crohn’s disease. However, their mechanism of action is unclear, especially in disease-relevant chronic models of inflammation. Thus, we used SAMP-1/YitFc, a chronic and spontaneous murine model of small intestinal inflammation, to study the therapeutic effect and mechanism of human bone marrow-derived MSCs (hMSC).DesignhMSC immunosuppressive potential was evaluated through in vitro mixed lymphocyte reaction, ELISA, macrophage co-culture, and RT-qPCR. Therapeutic efficacy and mechanism in SAMP were studied by stereomicroscopy, histopathology, MRI radiomics, flow cytometry, RT-qPCR, small animal imaging, and single-cell RNA sequencing (Sc-RNAseq).ResultshMSC dose-dependently inhibited naïve T lymphocyte proliferation in MLR via PGE2secretion and reprogrammed macrophages to an anti-inflammatory phenotype. hMSC promoted mucosal healing and immunologic response early after administration in SAMP model of chronic small intestinal inflammation when live hMSCs are present (until day 9) and resulted in complete response characterized by mucosal, histological, immunologic, and radiological healing by day 28 when no live hMSCs are present. hMSC mediate their effect via modulation of T cells and macrophages in the mesentery and mesenteric lymph nodes (mLN). Sc-RNAseq confirmed the anti-inflammatory phenotype of macrophages and identified macrophage efferocytosis of apoptotic hMSCs as a mechanism of action that explains their long-term efficacy.ConclusionhMSCs result in healing and tissue regeneration in a chronic model of small intestinal inflammation. Despite being short-lived, exert long-term effects via macrophage reprogramming to an anti-inflammatory phenotype.Data Transparency StatementSingle-cell RNA transcriptome datasets are deposited in an online open access repository ‘Figshare’ (DOI:https://doi.org/10.6084/m9.figshare.21453936.v1)

Magnetic resonance T1 mapping before and after Gd-EOB-DTPA administration allows quantification of the T1 reduction rate as a non-invasive surrogate marker of liver function. A major limitation of T1 relaxation time measurement is its dependency on MRI field strengths. Since T1 reduction rate is calculated as the relative shortening of T1 relaxation time before and after contrast administration, we hypothesized that the T1 reduction rate is comparable between 1.5 and 3��T. We thus compared liver T1 relaxation times between 1.5 and 3��T in a total of 243 consecutive patients (124, 1.5��T and 119, 3��T) between 09/2018 and 07/2019. T1 reduction rates were compared between patients with no cirrhosis and patients with cirrhosis Child-Pugh A-C. There was no significant difference of T1 reduction rate between 1.5 and 3��T in any patient group (p-value 0.126-0.861). On both 1.5��T and 3��T, T1 reduction rate allowed to differentiate between patients with no cirrhosis and patients with liver cirrhosis Child A-C (p���

Background: In CT imaging, a high concentration of iodinated contrast media in axillary and subclavian veins after brachialapplication can cause perivenous artifacts impairing diagnostic assessment of local vascular structures and soft tissue. Purpose:To investigate reduction of perivenous hypo- and hyperattenuating artifacts of the axillary and subclavian veinsusing virtual monoenergetic images (VMI) in comparison to conventional CT images (CI), acquired on spectral-detector CT. Material and Methods:50 spectral-detector CT datasets of patients with perivenous artifacts from contrast mediawere included in this retrospective, institutional review board-approved study. CT images and virtual monoenergeticimages (range 40–200 keV, 10-keV increments) were reconstructed from the same scans. Quantitative analysis wasperformed by region of interest-based assessment of mean attenuation (HU) and standard deviation in most pro-nounced hypo- and hyperdense artifacts and artifact-impaired arteries as well as muscle. Visually, artifact reduction,assessment of vessels, and surrounding soft tissue were rated on 5-point Likert-scales by two radiologists. Results:In comparison to CT images, virtual monoenergetic images of ≥90 keV showed a significant reduction of hypo- and hyperattenuating artifacts (hypodense: CI -220.0±171.2 HU; VMI130keV -13.4±49.1 HU; hyperdense: CI 274.6±184.4 HU; VMI130keV 24.2±84.9 HU; P

Magnetic resonance (MR) T and T* mapping allows quantification of liver relaxation times for non-invasive characterization of diffuse liver disease. We hypothesized that liver relaxation times are not only influenced by liver fibrosis, inflammation and fat, but also by air in liver segments adjacent to the lung - especially in MR imaging at 3T. A total of 161 study participants were recruited, while 6 patients had to be excluded due to claustrophobia or technically uninterpretable MR elastography. Resulting study population consisted of 12 healthy volunteers and 143 patients who prospectively underwent multiparametric MR imaging at 3T. Of those 143 patients, 79 had normal liver stiffness in MR elastography (shear modulus

Castleman disease (CD) is a rare lymphoproliferative disorder of unknown etiology that may occur anywhere in the lymphatic system. Imaging plays an important role in detecting and staging this disease. Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) combines the metabolic information derived from nuclear medical imaging with the high soft tissue resolution from MRI. We review the features of CD in standard diagnostic imaging, analyze the specific imaging findings of CD in FDG-PET/MRI and discuss a potential benefit of PET/MRI based on the case of a 15-year-old female patient with retroperitoneal CD.

Splenic artery steal syndrome (SASS) is a severe complication affecting up to 10% of orthotopic liver transplant (OLT) patients. In this case report, we present a 35-year-old male with OLT secondary to liver failure due to hemochromatosis, who developed SASS. We describe potential application of different imaging techniques for diagnosis of SASS with focus on the value of time-resolved contrast enhanced 4D magnetic resonance angiography (MRA).

OBJECTIVES The well-known boost of iodine associated-attenuation in low-keV virtual monoenergetic images (VMI_low) is frequently used to improve visualization of lesions and structures taking up contrast media. This study aimed to evaluate this concept in reverse. Hence to investigate if increased attenuation within the liver allows for improved visualization of little or not-enhancing lesions. METHODS A 3D-printed phantom mimicking the shape of a human liver exhibiting a lesion in its center was designed and printed. Both, parenchyma- and lesion-mimic were filled with different solutions exhibiting 80/100/120HU and 0/15/40/60HU, respectively. Further, a total of 74 contrast-enhanced studies performed on a spectral detector CT scanner (SDCT) were included in this retrospective study. Patients had MRI or follow-up proven cysts and/or hypodense metastases. VMI of 40-200 keV as well as conventional images (CI) were reconstructed. ROI were placed in lesion and parenchyma(-mimics) on CI and transferred to VMI. Signal- and contrast-to-noise ratio were calculated (S-/CNR). Further, two radiologists independently evaluated image quality. Data was statistically assessed using ANOVA or Wilcoxon-test. RESULTS In phantoms, S/CNR was significantly higher in VMI_low. The cyst-mimic in highly attenuating parenchyma-mimic on CI yielded a CNR of 6.4 ± 0.8; using VMI_40 keV, mildly hypodense lesion-mimic in poorly attenuating parenchyma-mimic exhibited a similar CNR (5.8 ± 0.9; p ≤ 0.05). The same tendency was observed in patients (cyst in CI/metastasis in VMI_40 keV: 4.4 ± 1.2/3.9 ± 1.8; p ≤ 0.05). Qualitative analysis indicated a benefit of VMI_40 keV (p ≤ 0.05). CONCLUSIONS VMI_low from SDCT allow for an improved visualization of hypodense focal liver lesions exploiting the concept of contrast blooming in reverse.

OBJECTIVES In this phantom CT study, we investigated whether images reconstructed using filtered back projection (FBP) and iterative reconstruction (IR) with reduced tube voltage and current have equivalent quality. We evaluated the effects of different acquisition and reconstruction parameter settings on image quality and radiation doses. Additionally, patient CT studies were evaluated to confirm our phantom results. METHODS Helical and axial 256 multi-slice computed tomography scans of the phantom (Catphan(®)) were performed with varying tube voltages (80-140kV) and currents (30-200mAs). 198 phantom data sets were reconstructed applying FBP and IR with increasing iterations, and soft and sharp kernels. Further, 25 chest and abdomen CT scans, performed with high and low exposure per patient, were reconstructed with IR and FBP. Two independent observers evaluated image quality and radiation doses of both phantom and patient scans. RESULTS In phantom scans, noise reduction was significantly improved using IR with increasing iterations, independent from tissue, scan-mode, tube-voltage, current, and kernel. IR did not affect high-contrast resolution. Low-contrast resolution was also not negatively affected, but improved in scans with doses

Objective: Mesenchymal stem cells (MSCs) are novel therapeutics for treatment of Crohn's disease. However, their mechanism of action is unclear, especially in disease-relevant chronic models of inflammation. Thus, we used SAMP-1/YitFc, a chronic and spontaneous murine model of small intestinal inflammation, to study the therapeutic effect and mechanism of human bone marrow-derived MSCs (hMSC)., Design: hMSC immunosuppressive potential was evaluated through in vitro mixed lymphocyte reaction, ELISA, macrophage co-culture, and RT-qPCR. Therapeutic efficacy and mechanism in SAMP were studied by stereomicroscopy, histopathology, MRI radiomics, flow cytometry, RT-qPCR, small animal imaging, and single-cell RNA sequencing (Sc-RNAseq)., Results: hMSC dose-dependently inhibited naïve T lymphocyte proliferation in MLR via PGE 2 secretion and reprogrammed macrophages to an anti-inflammatory phenotype. hMSC promoted mucosal healing and immunologic response early after administration in SAMP model of chronic small intestinal inflammation when live hMSCs are present (until day 9) and resulted in complete response characterized by mucosal, histological, immunologic, and radiological healing by day 28 when no live hMSCs are present. hMSC mediate their effect via modulation of T cells and macrophages in the mesentery and mesenteric lymph nodes (mLN). Sc-RNAseq confirmed the anti-inflammatory phenotype of macrophages and identified macrophage efferocytosis of apoptotic hMSCs as a mechanism of action that explains their long-term efficacy., Conclusion: hMSCs result in healing and tissue regeneration in a chronic model of small intestinal inflammation. Despite being short-lived, exert long-term effects via macrophage reprogramming to an anti-inflammatory phenotype., Data Transparency Statement: Single-cell RNA transcriptome datasets are deposited in an online open access repository 'Figshare' (DOI: https://doi.org/10.6084/m9.figshare.21453936.v1 ).