• Title/Summary/Keyword: Contrast Agent

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Diagnostic Efficacy and Safety of Low-Contrast-Dose Dual-Energy CT in Patients With Renal Impairment Undergoing Transcatheter Aortic Valve Replacement

  • Suyon Chang;Jung Im Jung;Kyongmin Sarah Beck;Kiyuk Chang;Yaeni Kim;Kyunghwa Han
    • Korean Journal of Radiology
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    • v.25 no.7
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    • pp.634-643
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    • 2024
  • Objective: This study aimed to evaluate the diagnostic efficacy and safety of low-contrast-dose, dual-source dual-energy CT before transcatheter aortic valve replacement (TAVR) in patients with compromised renal function. Materials and Methods: A total of 54 consecutive patients (female:male, 26:38; 81.9 ± 7.3 years) with reduced renal function underwent pre-TAVR dual-energy CT with a 30-mL contrast agent between June 2022 and March 2023. Monochromatic (40- and 50-keV) and conventional (120-kVp) images were reconstructed and analyzed. The subjective quality score, vascular attenuation, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were compared among the imaging techniques using the Friedman test and post-hoc analysis. Interobserver reliability for aortic annular measurement was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. The procedural outcomes and incidence of post-contrast acute kidney injury (AKI) were assessed. Results: Monochromatic images achieved diagnostic quality in all patients. The 50-keV images achieved superior vascular attenuation and CNR (P < 0.001 in all) while maintaining a similar SNR compared to conventional CT. For aortic annular measurement, the 50-keV images showed higher interobserver reliability compared to conventional CT: ICC, 0.98 vs. 0.90 for area and 0.97 vs. 0.95 for perimeter; 95% limits of agreement width, 0.63 cm2 vs. 0.92 cm2 for area and 5.78 mm vs. 8.50 mm for perimeter. The size of the implanted device matched CT-measured values in all patients, achieving a procedural success rate of 92.6%. No patient experienced a serum creatinine increase of ≥ 1.5 times baseline in the 48-72 hours following CT. However, one patient had a procedural delay due to gradual renal function deterioration. Conclusion: Low-contrast-dose imaging with 50-keV reconstruction enables precise pre-TAVR evaluation with improved image quality and minimal risk of post-contrast AKI. This approach may be an effective and safe option for pre-TAVR evaluation in patients with compromised renal function.

Polymeric nanoparticles as dual-imaging probes for cancer management

  • Menon, Jyothi U.;Jadeja, Parth;Tambe, Pranjali;Thakore, Dheeraj;Zhang, Shanrong;Takahashi, Masaya;Xie, Zhiwei;Yang, Jian;Nguyen, Kytai T.
    • Biomaterials and Biomechanics in Bioengineering
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    • v.3 no.3
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    • pp.129-140
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    • 2016
  • This article reports the development of biodegradable photoluminescent polymer (BPLP)-based nanoparticles (NPs) incorporating either magnetic nanoparticles (BPLP-MNPs) or gadopentate dimeglumine (BPLP-Gd NPs), for cancer diagnosis and treatment. The aim of the study is to compare these nanoparticles in terms of their surface properties, fluorescence intensities, MR imaging capabilities, and in vitro characteristics to choose the most promising dual-imaging nanoprobe. Results indicate that BPLP-MNPs and BPLP-Gd NPs had a size of $195{\pm}43nm$ and $161{\pm}55nm$, respectively and showed good stability in DI water and 10% serum for 5 days. BPLP-Gd NPs showed similar fluorescence as the original BPLP materials under UV light, whereas BPLP-MNPs showed comparatively less fluorescence. VSM and MRI confirmed that the NPs retained their magnetic properties following encapsulation within BPLP. Further, in vitro studies using HPV-7 immortalized prostate epithelial cells and human dermal fibroblasts (HDFs) showed > 70% cell viability up to $100{\mu}g/ml$ NP concentration. Dose-dependent uptake of both types of NPs by PC3 and LNCaP prostate cancer cells was also observed. Thus, our results indicate that BPLP-Gd NPs would be more appropriate for use as a dual-imaging probe as the contrast agent does not mask the fluorescence of the polymer. Future studies would involve in vivo imaging following administration of BPLP-Gd NPs for biomedical applications including cancer detection.

Gadoxetate-Enhanced MRI as a Diagnostic Tool in the Management of Hepatocellular Carcinoma: Report from a 2020 Asia-Pacific Multidisciplinary Expert Meeting

  • Cher Heng Tan;Shu-cheng Chou;Nakarin Inmutto;Ke Ma;RuoFan Sheng;YingHong Shi;Zhongguo Zhou;Akira Yamada;Ryosuke Tateishi
    • Korean Journal of Radiology
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    • v.23 no.7
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    • pp.697-719
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    • 2022
  • Gadoxetate magnetic resonance imaging (MRI) is widely used in clinical practice for liver imaging. For optimal use, we must understand both its advantages and limitations. This article is the outcome of an online advisory board meeting and subsequent discussions by a multidisciplinary group of experts on liver diseases across the Asia-Pacific region, first held on September 28, 2020. Here, we review the technical considerations for the use of gadoxetate, its current role in the management of patients with hepatocellular carcinoma (HCC), and its relevance in consensus guidelines for HCC imaging diagnosis. In the latter part of this review, we examine recent evidence evaluating the impact of gadoxetate on clinical outcomes on a continuum from diagnosis to treatment decision-making and follow-up. In conclusion, we outline the potential future roles of gadoxetate MRI based on an evolving understanding of the clinical utility of this contrast agent in the management of patients at risk of, or with, HCC.

Principles and Technical Aspects of Perfusion Magnetic Resonance Imaging (관류 자기공명영상의 원리 및 기술)

  • Jahng, Geon-Ho;Kim, Ho-Sung;Kim, Sun-Mi;Ryu, Chang-Woo
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.2
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    • pp.91-101
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    • 2011
  • Perfusion magnetic resonance imaging (pMRI) is a special technique for evaluation of blood flow. Exogenous pMRI methods which are dynamic susceptibility contrast (DSC) and dynamic contrast-enhanced (DCE) use an intravenous bolus injection of paramagnetic contrast agent. In contrast, an endogenous pMRM method which is arterial spin labeling (ASL) use diffusible blood in body. In order to scan pMRI in human, technical optimizations are very important according to disease conditions. For examples, DSC is popularly used in patients with acute stroke due to its short scan time, while DSC or DCE provides the various perfusion indices for patients with tumor. ASL is useful for children, women who are expected to be pregnant, and in patients with kidney diseases which are problematic in nephrogenic systemic fibrosis (NSF). Perfusion MRI does not require any injection of radioisotopes. We expect that demand for perfusion MRI will be higher in evaluating drug efficacy and other treatment effects.

Comparison of Multilevel with Single Level Injection during Lumbar Sympathetic Ganglion Block: Efficacy of Sympatholysis and Incidence of Psoas Muscle Injection

  • Hong, Ji-Hee;Oh, Min-Ju
    • The Korean Journal of Pain
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    • v.23 no.2
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    • pp.131-136
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    • 2010
  • Background: We prospectively evaluated the incidence and possible factors causing intramuscular injection during lumbar sympathetic ganglion block and compared the multiple needle technique to the single technique to obtain a profound and complete block effect. Methods: Among 83 patients, 58 patients (group A, n = 27, multiple needle technique and group B, n = 31, single needle technique) were reevaluated for the changes of skin temperature (Ts) and mean segment of longitudinal contrast spread. After injecting the contrast agent, the incidence of psoas muscle injection and the change of Ts was compared between two groups. Results: The incidence of psoas muscle injection was 21.3% (46/216) and it was associated with the level of injection (L2) significantly (${\chi}_2$ = 14.773, P = 0.001). $DT^{post}$ (postblock temperature difference between ipsilateral and contralateral great toe, $4.6{\pm}2.8^{\circ}C$, $1.8{\pm}1.6^{\circ}C$, P < 0.001 for group A and B) and $DT^{net}$ ($DT^{post}$ - $DT^{pre}$, $3.9{\pm}2.7^{\circ}C$, $1.5{\pm}1.5^{\circ}C$, P < 0.001 for group A and B) was significantly higher in group A. The mean segment of longitudinal contrast spread was $8.1{\pm}0.9$ for group A and $3.2{\pm}1.6$ for group B (P < 0.001). Conclusions: The LSGB at the L2 level showed the lowest incidence of psoas muscle injection of contrast. Multiple needle approach showed more significant increase of $DT^{net}$ and $DT^{post}$.

Evaluation by Contrast-Enhanced MR Imaging of the Lateral Border Zone in Reperfused Myocardial Infarction in a Cat Model

  • Ae Kyung Jeong;Sang Il Choi;Dong Hun Kim;Sung Bin Park;Seoung Soo Lee;Seong Hoon Choi;Tae-Hwan Lim
    • Korean Journal of Radiology
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    • v.2 no.1
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    • pp.21-27
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    • 2001
  • Objective: To identify and evaluate the lateral border zone by comparing the size and distribution of the abnormal signal area demonstrated by MR imaging with the infarct area revealed by pathological examination in a reperfused myocardial infarction cat model. Materials and Methods: In eight cats, the left anterior descending coronary artery was occluded for 90 minutes, and this was followed by 90 minutes of reperfusion. ECG-triggered breath-hold turbo spin-echo T2-weighted MR images were initially obtained along the short axis of the heart before the administration of contrast media. After the injection of Gadomer-17 and Gadophrin-2, contrast-enhanced T1-weighted MR images were obtained for three hours. The size of the abnormal signal area seen on each image was compared with that of the infarct area after TTC staining. To assess ultrastructural changes in the myocardium at the infarct area, lateral border zone and normal myocardium, electron microscopic examination was performed. Results: The high signal area seen on T2-weighted images and the enhanced area seen on Gadomer-17-enhanced T1WI were larger than the enhanced area on Gadophrin-2-enhanced T1WI and the infarct area revealed by TTC staining; the difference was expressed as a percentage of the size of the total left ventricle mass (T2= 39.2 %; Gadomer-17 =37.25 % vs Gadophrin-2 = 29.6 %; TTC staining = 28.2 %; p < 0.05). The ultrastructural changes seen at the lateral border zone were compatible with reversible myocardial damage. Conclusion: In a reperfused myocardial infarction cat model, the presence and size of the lateral border zone can be determined by means of Gadomer-17- and Gadophrin-2-enhanced MR imaging.

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Effects of Gadolinium Contrast agent on Bone Mineral Density Measurement using Dual Energy X-ray Absorptiometry (가돌리늄조영제가 이중에너지 X-선 흡수법을 이용한 골밀도검사에 미치는 영향)

  • Lee, Keun-Ohk;Lee, Min-Su
    • Journal of the Korean Society of Radiology
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    • v.15 no.1
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    • pp.63-70
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    • 2021
  • Radiographic contrast agents are used for diagnostic purposes and are one of the factors affecting measured values in bone density tests. They are absorbed into tissues and have an effect of increasing the measured values of bone density, so they are avoided as much as possible before performing a bone density test. MRI contrast agents, which have different physical properties and mechanisms of action than radiographic contrast agents, are based on gadolinium, a metal element. They have radiopacity characteristics, so MRI are generally performed prior to examination using radiation. The purpose of this study was to investigate the effects of MRI contrast agents on bone mineral density examination using dual energy X-ray absorption. Two types of gadolinium based MRI contrast agents were injected into an acrylic water tank for each volume, and the humanoid spine phantom was inserted and the BMD and T-score from (L1-L4) were analyzed by scanning a total of 30 times, 5 times for each injection type. The average value of the measured total (L1-L4) bone density for each of the two contrast agents was 0.952±0.052, 0.957±0.050, and 0.956±0.05g/㎠, respectively, for the Gadoterate Meglumine component 0mL, 7.5mL and 15mL, when the gadobutrol components were 0mL, 5mL, and 10mL, there was no statistically significant difference at all sites at 0.953±0.001, 0.954±0.001, and 0.945±0.001g/㎠, respectively(p>0.05). The average value of total T-score was -0.46±0.05, -0.4±0, -0.42±0.04 when the Gadoterate Meglumine component was 0mL, 7.5mL and 15mL, respectively. When the Gadobutrol ingredients were 0mL, 5mL and 10mL, there was no statistically significant difference in all areas, with -0.46±0.05, -0.46±0.05, and 0.5±0.00, respectively. In this experiment, the MRI contrast agent was found to have no effect on bone density tests, using the dual-energy X-ray absorption method. There is a limitation in that physical conditions such as kidney and health conditions etc. were not taken into consideration, so further clinical research is expected to be conducted in the future.

Radiation Shielding to Minimize Image Information Loss (영상 정보 손실을 최소화하는 방사선 차폐체 연구)

  • Su-han Jang;Sang-Hyeun Park;Myeong-Sik Ju
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.449-457
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    • 2023
  • Shielding for reducing exposure dose can make the diagnosis limited. The purpose of this study is to increase the efficiency of radiation protection and minimize the loss of image information by producing the shielding made of the water and the contrast medium which has different proportion and finding out the ideal proportion of them. Each shielding materials were made of water and water-soluble iodine contrast medium with the different proportion. The attenuation rate of absorbed dose was evaluated by the shielding materials in the plastic contents for measuring the efficiency of the radiation protection. As a result, the higher ratio of the contrast medium, the more efficient it is for radiation attenuation. The anatomical structure was observed most properly in case of the solution with 20 ml of the contrast medium and most difficultly in case of more than 60 ml of the contrast medium. In case of the signal intensity between skeleton and gas, the difference of average value had a significant as p < 0.001. Shielding with contrast medium attenuates less than the conventional shielding but in the examination for the sensitive part to radiation, it can be used to minimize the loss of the image information and reduce the exposure dose.

A Recommender Agent using Association Item Trees (연관 아이템 트리를 이용한 추천 에이전트)

  • Ko, Su-Jeong
    • Journal of KIISE:Software and Applications
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    • v.36 no.4
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    • pp.298-305
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    • 2009
  • In contrast to content_based filtering systems, collaborative filtering systems not only don't contain information of items, they can not recommend items when users don't provide the information of their interests. In this paper, we propose the recommender agent using association item tree to solve the shortcomings of collaborative filtering systems. Firstly, the proposed method clusters users into groups using vector space model and K-means algorithm and selects group typical rating values. Secondly, the degree of associations between items is extracted from computing mutual information between items and an associative item tree is generated by group. Finally, the method recommends items to an active user by using a group typical rating value and an association item tree. The recommender agent recommends items by combining user information with item information. In addition, it can accurately recommend items to an active user, whose information is insufficient at first rate, by using an association item tree based on mutual information for the similarity between items. The proposed method is compared with previous methods on the data set of MovieLens recommender system.

Persulfate Oxidation of 2,4-D: Effect of Hydroxylamine and Chelating Agent (과황산을 이용한 2,4-D의 산화: 하이드록실아민, 킬레이트제의 영향)

  • Choi, Jiyeon;Yoon, Na Kyeong;Shin, Won Sik
    • Journal of Soil and Groundwater Environment
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    • v.26 no.1
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    • pp.54-64
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    • 2021
  • The chemical warfare agents (CWAs) have been developed for offensive or defensive purposes and used as chemical weapons in war and terrorism. The CWAs are exposed to the natural environment, transported through the water system and then eventually contaminate soil and groundwater. Therefore, effective decontamination technology to remediate CWAs are needed. The CWAs are extremely dangerous and prodution is strictly prohibited, therefore, it is difficult to use CWAs even in experimental purpose. In this study, 2,4-dichlorophenoxyacetic acid (2,4-D) was chosen as a model representative CWA because it is a simulant of anti-plant CWAs and one of the major component of agent orange. The optimum degradation conditions such as oxidant:activator ratio were determined. The effects of hydroxylamine and chelating agents such as citric acid (CA), oxalic acid (OA), malic acid (MA), and EDTA addition to increase Fe2+ activation were also investigated. Scavenger experiments using tert-butyl alcohol (TBA) and ethanol confirmed that although both sulfate (SO4•-) and hydroxyl radical (•OH) existed in Fe2+-persulfate system, sulfate radical was the predominant radical. To promote the Fe2+ activator effect, the effect of hydroxylamine as a reducing agent was investigated. In chelating agents assisted Fe2+-persulfate oxidation, the addition of 2 mM of CA and MA enhanced 2,4-D degradation. In contrast, EDTA and OA inhibited the 2,4-D removal due to steric hindrance effect.