Computed Tomography Tissue Characterization of Pediatric Cardiac Tumor
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SUBMITTER: Zonana Amkie R
PROVIDER: S-EPMC10500330 | biostudies-literature | 2023 Jul
REPOSITORIES: biostudies-literature
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Project description:AimsUnderstanding cardiac function after anthracycline administration is very important from the perspective of preventing the onset of heart failure. Although cardiac magnetic resonance and echocardiography are recognized as the 'gold standard' for detecting cardiotoxicity, they have many shortcomings. We aimed to investigate whether cardiac computed tomography (CCT) could replace these techniques, assessing serial changes in cardiac tissue characteristics as determined by CCT after anthracycline administration.Methods and resultsWe prospectively investigated 15 consecutive breast cancer patients who were scheduled to receive anthracycline therapy. We performed echocardiography and CCT before and 3, 6, and 12 months after anthracycline treatment. The mean cumulative administered anthracycline dose was 269.9 ± 14.6 mg/m2 (doxorubicin-converted dose). Of the 15 enrolled patients who received anthracycline treatment for breast cancer, none met the definition of cardiotoxicity. The CCT-derived extracellular volume fraction tended to continue to increase after anthracycline treatment and had relatively similar dynamics to the left ventricular ejection fraction and global longitudinal strain as determined by echocardiography.ConclusionsOur findings indicated that CCT could provide adequate information about the characteristics of myocardial tissue after anthracycline administration. CCT may improve the understanding of cardiotoxicity by compensating for the weaknesses of echocardiography. This technique could be useful for understanding cardiac tissue characterization as a 'one-stop shop' evaluation, providing new insight into cardiooncology.
| S-EPMC9065838 | biostudies-literature
Project description:Background It’s clinically relevant to reduce the radiation dose to children while ensuring their positron emission tomography/computed tomography (PET/CT) image quality. The optimal protocol for whole-body PET/CT imaging in children (non-model) has been less studied. In this study, we investigated the optimal protocol for PET/CT imaging of pediatric oncology by analyzing the radiation dose and image quality in18F-fluoro-2-deoxy-D-glucose (18F-FDG) PET/CT imaging of children with oncology. Methods One hundred children with tumors who underwent 18F-FDG PET/CT were included. CT grouping: randomly divided into 18 groups A–R according to the combination of three parameters: tube voltage (80/120 kV), automatic milliamp range (20–39/40–59/60–80 mA), and noise index (NI) (8/12/14). PET grouping: randomly divided into 9 groups a–i according to the combination of two parameters: the pharmaceuticals injection dose (0.08/0.12/0.15 mCi/kg) and time per bed (120/150/180 s). The effective radiation dose (ED) was calculated separately for each group and the image quality of CT and PET was evaluated subjectively using standard deviation (SD) and coefficient of variation (CV) objective evaluation and 5-point evaluation method, respectively. Results Ninety-seven images in CT and 57 images in PET were included. The best quality of CT images was in group K (120 kV/40–59 mA/8); there are 9 groups had good image quality and lower dose length product (DLP) than group K (SD ±10), while the difference in DLP between groups was large. The Kruskal-Wallis (K-W) test showed that the difference in image quality between the 9 groups was not statistically significant. The best PET image quality was in group i [0.15 (mCi/kg)/180 s]; there are four groups had good image quality and lower EDPET than group i (CV ±3.5%), while the difference in EDPET between groups was large (4.4–6.5 mSv), and the K-W test showed that the difference in image quality between the four groups was not statistically significant (P>0.05), with the lowest EDPET being in the g group. Conclusions The optimal protocols for CT scanning and PET imaging in this experiment were group H (80 kV/40–59 mA/14) and group g [0.08 (mCi/kg)/180 s], respectively. Trial Registration Chinese Clinical Trial Registry ChiCTR2200061386.
| S-EPMC9561506 | biostudies-literature
Project description: Not available
| S-EPMC10672590 | biostudies-literature
Project description:To successfully implement tissue-engineered (TE) constructs as part of a clinical therapy, it is necessary to develop quality control tools that will ensure accurate and consistent TE construct release specifications. Hence, advanced methods to monitor TE construct properties need to be further developed. In this study, we showed proof of concept for contrast-enhanced nanofocus computed tomography (CE-nano-CT) as a whole-construct imaging technique with a noninvasive potential that enables three-dimensional (3D) visualization and quantification of in vitro engineered extracellular matrix (ECM) in TE constructs. In particular, we performed a 3D qualitative and quantitative structural and spatial assessment of the in vitro engineered ECM, formed during static and perfusion bioreactor cell culture in 3D TE scaffolds, using two contrast agents, namely, Hexabrix® and phosphotungstic acid (PTA). To evaluate the potential of CE-nano-CT, a comparison was made to standardly used techniques such as Live/Dead viability/cytotoxicity, Picrosirius Red staining, and to net dry weight measurements of the TE constructs. When using Hexabrix as the contrast agent, the ECM volume fitted linearly with the net dry ECM weight independent from the flow rate used, thus suggesting that it stains most of the ECM. When using PTA as the contrast agent, comparing to net weight measurements showed that PTA only stains a part of the ECM. This was attributed to the binding specificity of this contrast agent. In addition, the PTA-stained CE-nano-CT data showed pronounced distinction between flow conditions when compared to Hexabrix, indicating culture-specific structural ECM differences. This novel type of information can contribute to optimize bioreactor culture conditions and potentially critical quality characteristics of TE constructs such as ECM quantity and homogeneity, facilitating the gradual transformation of TE constructs in well-characterized TE products.
| S-EPMC3936499 | biostudies-literature
Project description:Stress cardiac MRI and stress computed tomography (CT) perfusion are relatively new, noninvasive cardiovascular stress-testing modalities. Both of these tests have undergone rapid technical improvements. Data from randomized controlled trials in stress cardiac MRI are becoming gradually incorporated into cardiovascular clinical practice, not only to assess physiological significance of coronary artery disease, but also to provide prognostic information. As CT perfusion protocols become more uniform with adequate handling of artifacts and decreasing radiation exposure with combined CT coronary angiography/CT perfusion imaging, it has the potential to become a comprehensive diagnostic test.
| S-EPMC3856631 | biostudies-literature
Project description:INTRODUCTION:Anatomic stenosis evaluation on coronary CT angiography (CCTA) lacks specificity in indicating the functional significance of a stenosis. Recent developments in CT techniques (including dual-layer spectral detector CT [SDCT] and static stress CT perfusion [CTP]) and image analyses (including fractional flow reserve [FFR] derived from CCTA images [FFRCT] and deep learning analysis [DL]) are potential strategies to increase the specificity of CCTA by combining both anatomical and functional information in one investigation. The aim of the current study is to assess the diagnostic performance of (combinations of) SDCT, CTP, FFRCT and DL for the identification of functionally significant coronary artery stenosis. METHODS AND ANALYSIS:Seventy-five patients aged 18 years and older with stable angina and known coronary artery disease and scheduled to undergo clinically indicated invasive FFR will be enrolled. All subjects will undergo the following SDCT scans: coronary calcium scoring, static stress CTP, rest CCTA and if indicated (history of myocardial infarction) a delayed enhancement acquisition. Invasive FFR of ≤0.80, measured within 30 days after the SDCT scans, will be used as reference to indicate a functionally significant stenosis. The primary study endpoint is the diagnostic performance of SDCT (including CTP) for the identification of functionally significant coronary artery stenosis. Secondary study endpoint is the diagnostic performance of SDCT, CTP, FFRCT and DL separately and combined for the identification of functionally significant coronary artery stenosis. ETHICS AND DISSEMINATION:Ethical approval was obtained. All subjects will provide written informed consent. Study findings will be disseminated through peer-reviewed conference presentations and journal publications. TRIAL REGISTRATION NUMBER:NCT03139006; Pre-results.
| S-EPMC6429912 | biostudies-literature
Project description:AimsTo assess pericoronary adipose tissue (PCAT) density on coronary computed tomography angiography (CCTA) as a marker of inflammatory disease activity in coronary allograft vasculopathy (CAV).Methods and resultsPCAT density, lesion volumes, and total vessel volume-to-myocardial mass ratio (V/M) were retrospectively measured in 126 CCTAs from 94 heart transplant patients [mean age 49 (SD 14.5) years, 40% female] who underwent imaging between 2010 and 2021; age- and sex-matched controls; and patients with atherosclerosis. PCAT density was higher in transplant patients with CAV [n = 40; -73.0 HU (SD 9.3)] than without CAV [n = 86; -77.9 HU (SD 8.2)], and controls [n = 12; -86.2 HU (SD 5.4)], P < 0.01 for both. Unlike patients with atherosclerotic coronary artery disease (n = 32), CAV lesions were predominantly non-calcified and comprised of mostly fibrous or fibrofatty tissue. V/M was lower in patients with CAV than without [32.4 mm3/g (SD 9.7) vs. 41.4 mm3/g (SD 12.3), P < 0.0001]. PCAT density and V/M improved the ability to predict CAV from area under the receiver operating characteristic curve (AUC) 0.75-0.85 when added to donor age and donor hypertension status (P < 0.0001). PCAT density above -66 HU was associated with a greater incidence of all-cause mortality {odds ratio [OR] 18.0 [95% confidence interval (CI) 3.25-99.6], P < 0.01} and the composite endpoint of death, CAV progression, acute rejection, and coronary revascularization [OR 7.47 (95% CI 1.8-31.6), P = 0.01] over 5.3 (SD 2.1) years.ConclusionHeart transplant patients with CAV have higher PCAT density and lower V/M than those without. Increased PCAT density is associated with adverse clinical outcomes. These CCTA metrics could be useful for the diagnosis and monitoring of CAV severity.
| S-EPMC11210971 | biostudies-literature
Project description:BackgroundThe relationship between the characteristics of cardiac implantable electronic device (CIED) leads and subclinical cardiac perforations remains unclear. This study aimed to evaluate the incidence of subclinical cardiac perforation among various CIED leads using cardiac computed tomography (CT).MethodsA total of 271 consecutive patients with 463 CIED leads, who underwent cardiac CT after CIED implantation, were included in this retrospective observational study. Cardiac CT images were reviewed by one radiologist and two cardiologists. Subclinical perforation was defined as traversal of the lead tip past the outer myocardial layer without symptoms and signs related to cardiac perforation. We compared the subclinical cardiac perforation rates of the available lead types.ResultsA total of 219, 49, and 3 patients had pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy, respectively. The total subclinical cardiac perforation rate was 5.6%. Subclinical cardiac perforation by screw-in ventricular leads was significantly more frequent than that caused by tined ventricular leads (13.3% vs 3.3%, respectively, p = 0.002). There were no significant differences in the incidence of cardiac perforation between atrial and ventricular leads, screw-in and tined atrial leads, pacing and defibrillator ventricular leads, nor between magnetic resonance (MR)-conditional and MR-unsafe screw-in ventricular leads. Screw-in ventricular leads were significantly associated with subclinical cardiac perforation [odds ratio, 4.554; 95% confidence interval, 1.587-13.065, p = 0.005]. There was no case subclinical cardiac perforation by septal ventricular leads.ConclusionsSubclinical cardiac perforation by screw-in ventricular leads is not rare. Septal pacing may be helpful in avoiding cardiac perforation.
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Project description:The separation of mixtures of substances into their individual components plays an important role in many areas of science. In medical imaging, one method is the established analysis using dual-energy computed tomography. However, when analyzing mixtures consisting of more than three individual basis materials, a physical limit is reached that no longer allows this standard analysis. In addition, the X-ray attenuation coefficients of chemically complicated basis materials may not be known and also cannot be determined by other or previous analyses. To address these issues, we developed a novel theoretical approach and algorithm and tested it on samples prepared in the laboratory as well as on ex-vivo medical samples. This method allowed both five-material decomposition and determination or optimization of the X-ray attenuation coefficients of the sample base materials via optimizations of objective functions. After implementation, this new multimodal method was successfully tested on self-mixed samples consisting of the aqueous base solutions iomeprol, eosin Y disodiumsalt, sodium chloride, and pure water. As a first proof of concept of this technique for detailed material decomposition in medicine we analyzed exact percentage composition of ex vivo clots from patients with acute ischemic stroke, using histological analysis as a reference standard.
| S-EPMC9556609 | biostudies-literature
Project description:Spontaneous coronary artery dissection (SCAD) is a cause of myocardial infarction with nonobstructive coronary arteries. We describe a case of SCAD in a 39-year-old postpartum woman who presented with acute anterior myocardial infarction, no coronary occlusion but a suspicious coronary angiography. A coronary computed tomography angiogram demonstrated a left anterior descending intramural hematoma confirming the diagnosis. Teaching points emerging from this case are that SCAD and other causes of myocardial infarction with nonobstructive coronary arteries should be investigated, especially because the outcome is not benign. Also, coronary computed tomography angiogram should be considered as a part of the workup and follow-up for SCAD.
| S-EPMC7499376 | biostudies-literature