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1.
19 F MRI Nanotheranostics for Cancer Management: Progress and Prospects.
Li, Y, Cui, J, Li, C, Zhou, H, Chang, J, Aras, O, An, F
ChemMedChem. 2022;(4):e202100701
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Abstract
Fluorine magnetic resonance imaging (19 F MRI) is a promising imaging technique for cancer diagnosis because of its excellent soft tissue resolution and deep tissue penetration, as well as the inherent high natural abundance, almost no endogenous interference, quantitative analysis, and wide chemical shift range of the 19 F nucleus. In recent years, scientists have synthesized various 19 F MRI contrast agents. By further integrating a wide variety of nanomaterials and cutting-edge construction strategies, magnetically equivalent 19 F atoms are super-loaded and maintain satisfactory relaxation efficiency to obtain high-intensity 19 F MRI signals. In this review, the nuclear magnetic resonance principle underlying 19 F MRI is first described. Then, the construction and performance of various fluorinated contrast agents are summarized. Finally, challenges and future prospects regarding the clinical translation of 19 F MRI nanoprobes are considered. This review will provide strategic guidance and panoramic expectations for designing new cancer theranostic regimens and realizing their clinical translation.
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Analysis of clinical characteristics of Kounis syndrome induced by contrast media.
Wang, C, Deng, Z, Song, L, Sun, W, Fang, W, Li, Z
The American journal of emergency medicine. 2022;:203-207
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Abstract
BACKGROUND Understanding the relationship between contrast agents and Kounis syndrome (KS) is mainly based on case reports. The purpose of this research is to explore the clinical characteristics of contrast media induced KS. METHODS We searched for contrast-induced KS case reports through Chinese and English databases from 1991 to October 31, 2021. RESULTS A total of 26 patients (19 men and 7 women,) were included, with a median age of 60 years (range 30-83). The contrast agents that cause KS mainly included gadolinium-based contrast agent (7 cases), iodine-containing contrast media (12 cases). KS mainly occurred within 30 min after administration and mainly manifests as chest pain and allergic reactions. Electrocardiogram (ECG) mainly showed ST elevation. Echocardiography mainly revealed normal. Coronary angiography showed normal, coronary vasospasm, stent thrombosis, occlusion and stenosis. After treatment with steroids, antihistamines and anti-ischemic therapy, 24 patients recovered completely and 2 patients died. CONCLUSIONS KS is a rare adverse reaction of contrast media. Radiologists should recognize this rare but serious disease to ensure rapid diagnosis and proper management.
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Assessment of immediate and non-immediate hypersensitivity contrast reactions by skin tests and provocation tests: A review.
Bansie, RD, Karim, AF, van Maaren, MS, Hermans, MA, van Daele, P, Gerth van Wijk, R, Rombach, SM
International journal of immunopathology and pharmacology. 2021;:20587384211015061
Abstract
INTRODUCTION Allergic and nonallergic hypersensitivity reactions to iodinated contrast media (ICM) and gadolinium-based contrast media are classified as immediate or non-immediate hypersensitivity reactions (IHR and NIHR), respectively. Skin tests and provocation tests are recommended for the evaluation of hypersensitivity reactions to contrast agents; however provocations are not common in clinical practice. METHODS A MEDLINE search was conducted to investigate studies comprising both skin tests and provocation tests that evaluated hypersensitivity reactions to ICM. RESULTS Nineteen studies were identified that reported on skin tests, followed by provocations. In the case of IHR to ICM, 65/69 (94%) patients with a positive skin test for the culprit media tolerated a challenge with a skin-test-negative alternative ICM. In IHR to ICM with a negative skin test for the culprit media, provocations were positive in 3.2%-9.1% patients. In the case of a NIHR to ICM with a positive skin test, provocation with a skin-test-negative agent was tolerated in 75/105 (71%) of cases. In NIHR with a negative skin test for the culprit agent, re-exposure to the culprit or an alternative was positive in 0%-34.6% patients. Provocations with the same ICM in skin test positive patients with IHR or NIHR were positive for a majority of the patients, although such provocation tests were rarely performed. Data on hypersensitivity reactions, skin tests and provocations with gadolinium-based contrast media were limited; however, they exhibited a pattern similar to that observed in ICM. CONCLUSION In both ICM and gadolinium-based contrast media, the risk of an immediate repeat reaction is low when skin tests are negative. In contrast, a provocation with a skin-test-positive contrast medium showed a high risk of an immediate repeat hypersensitivity reaction. Therefore, a thorough medical history is necessary, followed by skin tests. A provocation is recommended, for diagnostic work-up, when the diagnosis is uncertain.
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Myocardial inflammation and energetics by cardiac MRI: a review of emerging techniques.
Tsampasian, V, Swift, AJ, Assadi, H, Chowdhary, A, Swoboda, P, Sammut, E, Dastidar, A, Cabrero, JB, Del Val, JR, Nair, S, et al
BMC medical imaging. 2021;(1):164
Abstract
The role of inflammation in cardiovascular pathophysiology has gained a lot of research interest in recent years. Cardiovascular Magnetic Resonance has been a powerful tool in the non-invasive assessment of inflammation in several conditions. More recently, Ultrasmall superparamagnetic particles of iron oxide have been successfully used to evaluate macrophage activity and subsequently inflammation on a cellular level. Current evidence from research studies provides encouraging data and confirms that this evolving method can potentially have a huge impact on clinical practice as it can be used in the diagnosis and management of very common conditions such as coronary artery disease, ischaemic and non-ischaemic cardiomyopathy, myocarditis and atherosclerosis. Another important emerging concept is that of myocardial energetics. With the use of phosphorus magnetic resonance spectroscopy, myocardial energetic compromise has been proved to be an important feature in the pathophysiological process of several conditions including diabetic cardiomyopathy, inherited cardiomyopathies, valvular heart disease and cardiac transplant rejection. This unique tool is therefore being utilized to assess metabolic alterations in a wide range of cardiovascular diseases. This review systematically examines these state-of-the-art methods in detail and provides an insight into the mechanisms of action and the clinical implications of their use.
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Preventing contrast-induced nephropathy (CIN) with herbal medicines: A review.
Boozari, M, Hosseinzadeh, H
Phytotherapy research : PTR. 2021;(3):1130-1146
Abstract
OBJECTIVES Currently, the use of iodinated contrast media in diagnostic imaging has been increased in clinical medicine. Contrast-induced nephropathy (CIN) is an important adverse effect of contrast media injection. According to the significant role of oxidative stress in the pathophysiology of CIN, different herbal antioxidants have been used for the prevention of nephropathy in different studies. In this review, we discussed the preventive effects of herbal medicine and natural products against CIN. METHODS We searched the electronic databases or search engines including PubMed, Scopus, ISI, Google Scholar with search terms such as "Contrast-induced nephropathy" and "Herbal medicine," "Contrast acute kidney injury" AND "natural products" and similar headings such as plant and extract. RESULTS Known medicinal plants and active ingredients such as green tea, ginger, garlic, silymarin, curcumin, resveratrol, and thymoquinone have been examined for prophylactic effects or treatment of contrast media nephropathy. CONCLUSION Herbal medicines have promising effects in the laboratory-based studies for the prevention and/or treatment of CIN. However, more practical and completed clinical trials are needed to investigate the clinical benefits of natural products against CIN.
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Tantalum oxide nanoparticles as an advanced platform for cancer diagnostics: a review and perspective.
Koshevaya, E, Krivoshapkina, E, Krivoshapkin, P
Journal of materials chemistry. B. 2021;(25):5008-5024
Abstract
The development of new safe and effective contrast agents (CAs) is a crucial factor to increase the effectiveness of computed tomography (CT). For now, tantalum oxide-based nanoparticles (TaOx NPs) are among the most promising CAs for CT due to their superior properties: high X-ray attenuation coefficient, excellent biocompatibility, and easily modifiable surface chemistry. Compared to the commercially available analogs (iodine-based CAs), TaOx NPs provide better contrast performance, long-circulation, and high safety profiles (reduced exposure of X-rays and CA dosage). Among the investigated nanoparticulate CAs they afford higher cost-effectiveness (Au, Pt, Lu). TaOx NPs can also be easily modified to include other imaging or therapeutic modalities. This review aims to summarize the current state-of-the-art knowledge in the field of tantalum oxide-based CAs used for single or multimodal imaging and theranostic purposes. The design specification of TaOx NPs in terms of size, surface functionalization, composition, and their influence on the contrast performance, toxicity, and pharmacokinetics are discussed. Finally, the future opportunities and challenges of TaOx NPs used as CT CAs are addressed.
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Pharmacologic Prophylaxis of Contrast-Induced Nephropathy.
Toso, A, Leoncini, M, Maioli, M, Bellandi, F
Interventional cardiology clinics. 2020;(3):369-383
Abstract
Different pharmacologic agents have been tested in the effort to prevent contrast-induced acute kidney injury (AKI) in the last two decades. To date, however, no individual drug has received unanimous approval for this aim. Since 2014 statins have been included as preventive treatment in the European guidelines for revascularization procedures in cardiac patients. The present update presents the latest findings in this field focusing on the changing paradigms in the definition and consequently the approach to nephroprotection that considers clinical prognosis as the major issue. We note the current shift from attention to contrast-induced AKI to contrast-associated AKI.
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Contrast-Induced Acute Kidney Injury-Definitions, Epidemiology, and Implications.
Azzalini, L, Kalra, S
Interventional cardiology clinics. 2020;(3):299-309
Abstract
Contrast-induced acute kidney injury (CI-AKI) is the acute onset of renal injury following exposure to iodinated contrast media. Several definitions have been used, which complicates the estimation of the epidemiological relevance of this condition and comparisons in outcome research. The incidence of CI-AKI increases as a function of patient and procedure complexity in coronary, endovascular, and structural interventions. CI-AKI is associated with a high burden of short- and long-term adverse events, and leads to increased healthcare costs. This review will provide an overview of the definitions, epidemiology, and implications of CI-AKI in patients undergoing coronary, endovascular, and structural catheter-based procedures.
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Utility of Iodine Density Perfusion Maps From Dual-Energy Spectral Detector CT in Evaluating Cardiothoracic Conditions: A Primer for the Radiologist.
Kikano, EG, Rajdev, M, Salem, KZ, Laukamp, K, Felice, CD, Gilkeson, RC, Gupta, A
AJR. American journal of roentgenology. 2020;(4):775-785
Abstract
OBJECTIVE. The purpose of this article is to outline the utility of iodine density maps for evaluating cardiothoracic disease and abnormalities. Multiple studies have shown that the variety of images generated from dual-energy spectral detector CT (SDCT) improve identification of cardiothoracic conditions. CONCLUSION. Understanding the technique of SDCT and being familiar with the features of different cardiothoracic conditions on iodine density map images help the radiologist make a better diagnosis.
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10.
MnDPDP: Contrast Agent for Imaging and Protection of Viable Tissue.
Jynge, P, Skjold, AM, Falkmer, U, Andersson, RGG, Seland, JG, Bruvold, M, Blomlie, V, Eidsaunet, W, Karlsson, JOG
Contrast media & molecular imaging. 2020;:3262835
Abstract
The semistable chelate manganese (Mn) dipyridoxyl diphosphate (MnDPDP, mangafodipir), previously used as an intravenous (i.v.) contrast agent (Teslascan™, GE Healthcare) for Mn-ion-enhanced MRI (MEMRI), should be reappraised for clinical use but now as a diagnostic drug with cytoprotective properties. Approved for imaging of the liver and pancreas, MnDPDP enhances contrast also in other targets such as the heart, kidney, glandular tissue, and potentially retina and brain. Transmetallation releases paramagnetic Mn2+ for cellular uptake in competition with calcium (Ca2+), and intracellular (IC) macromolecular Mn2+ adducts lower myocardial T 1 to midway between native values and values obtained with gadolinium (Gd3+). What is essential is that T 1 mapping and, to a lesser degree, T 1 weighted imaging enable quantification of viability at a cellular or even molecular level. IC Mn2+ retention for hours provides delayed imaging as another advantage. Examples in humans include quantitative imaging of cardiomyocyte remodeling and of Ca2+ channel activity, capabilities beyond the scope of Gd3+ based or native MRI. In addition, MnDPDP and the metabolite Mn dipyridoxyl diethyl-diamine (MnPLED) act as catalytic antioxidants enabling prevention and treatment of oxidative stress caused by tissue injury and inflammation. Tested applications in humans include protection of normal cells during chemotherapy of cancer and, potentially, of ischemic tissues during reperfusion. Theragnostic use combining therapy with delayed imaging remains to be explored. This review updates MnDPDP and its clinical potential with emphasis on the working mode of an exquisite chelate in the diagnosis of heart disease and in the treatment of oxidative stress.