scholarly journals Hyperpolarized Magnetic Resonance and Artificial Intelligence: Frontiers of Imaging in Pancreatic Cancer (Preprint)

2020 ◽  
Author(s):  
José S Enriquez ◽  
Yan Chu ◽  
Shivanand Pudakalakatti ◽  
Kang Lin Hsieh ◽  
Duncan Salmon ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Magnetic Resonance ◽  
Early Detection ◽  
Real Time ◽  
Unmet Need ◽  
Ductal Adenocarcinoma ◽  
Imaging Biomarkers ◽  
Non Invasive ◽  
Computational Tomography ◽  
Scoping Reviews

BACKGROUND There is an unmet need for non-invasive imaging markers that help identify the aggressive sub-type(s) of pancreatic ductal adenocarcinoma (PDAC) at diagnosis and to evaluate the efficacy of therapy prior to tumor reduction. In the last few years, there are two major developments that can have a significant impact in developing imaging biomarkers for PDAC: I) hyperpolarized metabolic Magnetic Resonance (HP-MR) and II) applications of Artificial Intelligence (AI). OBJECTIVE Our objective is to discuss these two exciting but independent developments in the realm of PDAC imaging and detection from the available literature to date. METHODS A systematic review following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines was conducted. The manuscript addressing the utilization of Hyperpolarization-based magnetic resonance (HP-MR) and/or Artificial Intelligence for early detection, assessing aggressiveness, and interrogating the early efficacy of therapy in PDAC cited in recent clinical guidelines were extracted from PubMed and Google Scholar. The studies were reviewed by reviewers following the exclusion and inclusion criteria and grouped based on the utilization of HP-MR and AI in PDAC diagnosis. RESULTS HP-MR increases the sensitivity of conventional MR by over 10,000-fold enabling real-time metabolic measurements. The utility of HP-MR in PDAC has been verified in several preclinical studies, but has not been proven in a clinical setting. In contrast, AI applications in PDAC imaging in the clinic are nascent, but mostly limited to Computational Tomography (CT) imaging datasets. CONCLUSIONS Combining AI and HP-MR applications may lead to the development of real-time biomarkers of early detection, assessing aggressiveness, and interrogating the early efficacy of therapy in PDAC.

scholarly journals A non-invasive magnetic resonance imaging approach for assessment of real-time microcirculation dynamics

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Tameshwar Ganesh ◽  
Marvin Estrada ◽  
Herman Yeger ◽  
James Duffin ◽  
Hai-Ling Margaret Cheng
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Real Time ◽  
Resonance Imaging ◽  
Non Invasive ◽  
Imaging Approach

scholarly journals An Early Detection of Acute Compartment Syndrome in Fastened Zip-Tie Rat Model Using Dynamic Phosphorous-31 Magnetic Resonance Spectroscopy at 9.4 Tesla

2021 ◽  
Author(s):  
Hiroki Ohta ◽  
Nhat-Minh Van Vo ◽  
Junichi Hata ◽  
Koshiro Terawaki ◽  
Takako Shirakawa ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Early Detection ◽  
Magnetic Resonance Spectroscopy ◽  
Compartment Syndrome ◽  
Rat Model ◽  
Resonance Spectroscopy ◽  
Non Invasive ◽  
Arterial Ph ◽  
Invasive Method ◽  
Muscular Damage

Abstract IntroductionAcute compartment syndrome (ACS) leads to a series of health problems, limb salvage, disability, and even death. In vivo phosphorus-31 magnetic resonance spectroscopy (31P-MRS) provides a unique non-invasive method to assess skeletal muscle metabolisms such as inorganic phosphate (Pi), phosphocreatine (PCr), and adenosine triphosphate (ATP). The study aims to assess the ability of dynamic 31P-MRS in the early detection of muscular damage in ACS.Materials & MethodsThe study induced the fastened zip-tie model of ACS on normotensive Sprague-Dawley rats (n = 6). The spectra were acquired in Bruker 9.4-Tesla preclinical scanner using 1H/31P surface coil. 31P-MRS spectra and blood samples were obtained at time 0 (pre-ischemic phase) and every 15 minutes during the compression (120 minutes) and the reperfusion phase (90 minutes). 31P-MRS spectra findings were compared with plasma creatine phosphokinase (CPK).ResultsPCr/(Pi + PCr) ratio significantly decreased after muscle was compressed (P < 0.05). In contrast to this, CPK did not change significantly (P > 0.05). Both intracellular pH and arterial pH decreased over time. However, intracellular declined significantly (P < 0.05) at 60 minutes of ischemic state, and at 5 minutes and 60 minutes of reperfusion, while arterial pH slightly changed. After 30 minutes of ischemic, phosphomonoesters (PME) peak was detected, which was not seen at the pre-ischemic phase. It gradually increased and reached its highest peak at 120 minutes. At reperfusion state, 31P-MRS spectra and pH did not fully recover to their pre-ischemic state, and PME peak disappeared. There was a correlation between T2-weighted images and CPK from blood tests (R2 = 0.1996, P < 0.05).ConclusionsDynamic 31P-MRS technique is more clearly and rapidly detect the bioenergetic and mitochondrial functions change than blood test in a fastened zip-tie rat model of ACS. This technique is a promising non-invasive method to detect the early ischemic muscular damage in ACS.

Abstract 15545: Exercise-stress Real-time Cardiac Magnetic Resonance Imaging for Non-invasive Characterisation of Heart Failure With Preserved Ejection Fraction: The Hfpef Stress Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Soeren Jan Backhaus ◽  
Torben Lange ◽  
Elisabeth George ◽  
Kristian Hellenkamp ◽  
Roman Gertz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Real Time ◽  
Left Ventricular ◽  
Exercise Stress ◽  
Volume Index ◽  
Diastolic Filling ◽  
Preserved Ejection Fraction ◽  
Non Invasive

Introduction: Invasive right heart catherization (RHC) using exercise-stress is the reference-standard for the diagnosis of heart failure with preserved ejection fraction (HFpEF) but carries the risk of the procedure. Real-time cardiovascular magnetic resonance (RT-CMR) imaging allows bicycle exercise CMR with unprecedented temporal and spatial resolution and may represent a novel non-invasive alternative. Methods: The HFpEF stress trial (NCT03260621) prospectively included 75 patients with echocardiographic signs of diastolic dysfunction and dyspnoea on exertion (E/E’>8, NYHA≥II) who underwent echocardiography, RHC and RT-CMR at rest and exercise-stress. HFpEF was defined according to pulmonary capillary wedge pressure (PCWP ≥15mmHg at rest or ≥25mmHg during exercise stress). RT-CMR functional assessments included time-volume-curves for total and early (1/3) diastolic left ventricular (LV) filling or left atrial (LA) emptying and LV/LA long axis strain (LAS). Results: HFpEF patients (n=34, mean PCWP rest 13mmHg, stress 27mmHg) had higher E/e’ (12.5 vs 9.15), NT-proBNP (255 vs 75ng/l) and LA volume index (43.8 vs 36.2ml/m 2 ) compared to non-HFpEF patients (n=34, rest 8mmHg, stress 18mmHg, p≤0.001 for all). There were no differences in RT-CMR LV total and early diastolic filling at rest and during exercise-stress (p≥0.164). In contrast, RT-CMR revealed impaired stress LA total (p=0.033) and early (p<0.001) diastolic emptying in HFpEF. LA LAS was the only impaired parameter at rest (p<0.001) and emerged as the best predictor for the presence of HFpEF during exercise-stress testing (AUC rest 0.82 vs stress 0.93, p=0.029). Conclusions: RT-CMR allows highly accurate identification of HFpEF during physiological exercise and may establish itself as a novel non-invasive diagnostic alternative for routine clinical use.

scholarly journals Exercise-Stress Real-time Cardiac Magnetic Resonance Imaging for Non-Invasive Characterisation of Heart Failure with Preserved Ejection Fraction: The HFpEF Stress Trial

Circulation ◽  
2021 ◽  
Author(s):  
Sören J. Backhaus ◽  
Torben Lange ◽  
Elisabeth F. George ◽  
Kristian Hellenkamp ◽  
Roman J. Gertz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Real Time ◽  
Left Ventricular ◽  
Exercise Stress ◽  
Volume Index ◽  
Preserved Ejection Fraction ◽  
Non Invasive ◽  
Right Heart Catheterisation

Background: Right heart catheterisation (RHC) using exercise-stress is the reference standard for the diagnosis of heart failure with preserved ejection fraction (HFpEF) but carries the risk of the invasive procedure. We hypothesized that real-time cardiovascular magnetic resonance (RT-CMR) exercise imaging with pathophysiologic data at excellent temporal and spatial resolution may represent a contemporary non-invasive alternative for diagnosing HFpEF. Methods: The HFpEF stress trial (DZHK-17, NCT03260621) prospectively recruited 75 patients with echocardiographic signs of diastolic dysfunction and dyspnea on exertion (E/e'>8, New York Heart Association (NYHA) class ≥II) to undergo echocardiography, RHC and RT-CMR at rest and during exercise-stress. HFpEF was defined according to pulmonary capillary wedge pressure (PCWP ≥15mmHg at rest or ≥25mmHg during exercise stress). RT-CMR functional assessments included time-volume curves for total and early (1/3) diastolic left ventricular (LV) filling, left atrial (LA) emptying and LV/LA long axis strain (LAS). Results: HFpEF patients (n=34, median PCWP rest 13mmHg, stress 27mmHg) had higher E/e' (12.5 vs. 9.15), NT-proBNP (255 vs. 75ng/l) and LA volume index (43.8 vs. 36.2ml/m 2 ) compared to non-cardiac dyspnea patients (n=34, rest 8mmHg, stress 18mmHg, p≤0.001 for all). Seven patients were excluded due to the presence of non HFpEF cardiac disease causing dyspnea on imaging. There were no differences in RT-CMR LV total and early diastolic filling at rest and during exercise-stress (p≥0.164) between HFpEF and non-cardiac dyspnea. RT-CMR revealed significantly impaired LA total and early (p<0.001) diastolic emptying in HFpEF during exercise-stress. RT-CMR exercise-stress LA LAS was independently associated with HFpEF (adjusted odds ratio 0.657, 95% confidence interval [0.516; 0.838], p=0.001) after adjustment for clinical and imaging parameters and emerged as the best predictor for HFpEF (area under the curve rest 0.82 vs. exercise-stress 0.93, p=0.029). Conclusions: RT-CMR allows highly accurate identification of HFpEF during physiological exercise and qualifies as a suitable non-invasive diagnostic alternative. These results will need to be confirmed in multi-centre prospective research studies to establish widespread routine clinical use. Clinical Trial Registration: URL: https://www.clinicaltrials.gov Unique Identifier: NCT03260621

scholarly journals Molecular Approaches Using Body Fluid for the Early Detection of Pancreatic Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 375
Author(s):  
Kennichi Satoh
Keyword(s):  
Early Detection ◽  
Invasive Carcinoma ◽  
Early Stage ◽  
Genetic Alterations ◽  
Disease Stage ◽  
Ductal Adenocarcinoma ◽  
Genetic Changes ◽  
Non Invasive ◽  
Molecular Approaches ◽  
Cause Of Deaths

Pancreatic ductal adenocarcinoma (PDAC) is the most malignant form of gastrointestinal tumor and is the fourth leading cause of deaths due to cancer in Japan. This cancer shows a poor outcome due to the difficulty of its early diagnosis and its rapid growth. Once this disease becomes clinically evident, it is frequently accompanied by distant metastasis at the time of diagnosis. A recent multicenter study in Japan revealed that patients with the early stage of this disease (stage 0 and I) showed favorable prognosis after surgical resection, indicating the importance of early detection for improvement of PDAC prognosis. PDAC develops through a stepwise progression from the precursor lesion, and over the last few decades molecular analyses have shown the detailed genetic alterations that occur in this process. Since advances in molecular technologies have enabled the detection of genetic changes from a very small quantity of samples, a large number of non-invasive molecular approaches have been utilized in an attempt to find precursor or non-invasive carcinoma lesions. In this review, the current efforts in terms of the molecular approaches applied for the early detection of PDAC—especially using body fluids such as pancreatic juice, blood, and saliva—are summarized.

Circulating tumor DNA methylation as markers for early detection of pancreatic ductal adenocarcinoma (PDAC).

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 395-395
Author(s):  
Xiaoding Liu ◽  
Shiwei Guo ◽  
Chengcheng Ma ◽  
Yatong Li ◽  
Xiaoqian Liu ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Early Detection ◽  
Circulating Tumor Dna ◽  
Detection Methods ◽  
Ductal Adenocarcinoma ◽  
Plasma Samples ◽  
Average Sensitivity ◽  
Reduced Representation ◽  
Non Invasive ◽  
Normal Plasma

395 Background: PDAC is a cancer of high mortality and low survival. Its early detection is critical due to symptoms often occur only at advanced stages. However there is no reliable screening tool to identify high-risk patients. ctDNA methylation has recently emerged as a promising new target to differentiate PDAC plasma from normal plasma for its early detection. Methods: Reduced representation bisulfite sequencing libraries were made in 46 PDAC tissues, 30 para-PDAC tissues and 20 PDAC plasmas to screen PDAC-specific markers, which was done by quantifying and comparing methylation levels of genomic regions and individual CpG sites between those groups. Markers were validated in plasma samples from 84 PDAC patients and 64 normal controls to propose a blood classifier. The best-performing markers were developed into a targeted sequencing panel, which was tested on a larger collection of plasma samples from patients of a variety of pancreatic diseases to build and validate a PDAC-predicting model. Results: We profiled genome-wide methylation patterns of tissues samples to identify 171 PDAC-specific markers. We reiterated training and cross-validating PDAC classification models using SVM method, and achieved an average sensitivity of 86% and specificity of 88%. To prove the feasibility of a non-invasive detection in plasma, a targeted methylation assay using those markers was tested on PDAC and normal plasmas, and yielded an average sensitivity of 68.4% and a specificity of 85.8%. We refined the panel by selecting the most discriminatory markers and built the version II of the panel, which was named PANcreatic Cancer Detection Assay, or PANDA, for a more efficient target capture, which was validated in an independent cohort of plasma samples that included 94 PDAC cases, 25 chronic pancreatitis (CP) cases and 80 normal samples from multiple centers. The PANDA achieved an AUC of 0.906 when classifying PDAC from normal, and an AUC of 0.882 when separating PDAC from CPs, both of which are more accurate than CA19-9, the conventional blood marker for PDAC. We further integrated test subjects’ age and their CA19-9 level as features into the PANDA model, which further elevated their AUC to 0.882 and 0.933 when classifying PDAC plasma from either CP plasma or normal plasma, respectively. Conclusions: We have developed PANDA, an NGS based target assay covering PDAC-specific DNA methylation targets by screening and validation on PDAC tissues and plasmas. Combined with age and CA19-9 blood level, PANDA has shown encouraging results to classify PDAC plasma from non-malignant diseases, demonstrating its potential to be optimized into non-invasive diagnostics for blood-based early PDAC screening.

Sign in / Sign up

Export Citation Format

Share Document