scholarly journals Cardiac amyloidosis: a review of the literature and a practical approach for the clinicians

2019 ◽  
Vol 13 (2) ◽  
pp. 73-90 ◽  
Author(s):  
Annalisa Angelini ◽  
Francesca Zanco ◽  
Chiara Castellani ◽  
Andrea Di Francesco ◽  
Mila Della Barbera ◽  
...  
Keyword(s):  
Cardiac Amyloidosis ◽  
Imaging Techniques ◽  
Systemic Disease ◽  
Treatment Strategies ◽  
Diagnostic Methods ◽  
Review Of The Literature ◽  
Cardiac Tissues ◽  
Non Invasive ◽  
Precursor Proteins ◽  
Recent Treatment

Amyloidosis is a group of progressive and devastating disorders resulting from misfolded proteins extracellular deposition into tissues. When deposition of fibrils occurs in cardiac tissues, this systemic disease can lead to a very poor prognosis. In this review, we focused on the most common types of cardiac amyloidosis and their treatments. Early diagnosis remains critically important, and here we reviewed the diagnostic methods adopted starting from the non-invasive imaging techniques to more invasive approaches, and the typing of precursor proteins. Typing the different misfolding proteins is mandatory since therapy differs accordingly and thus guiding therapy. We highlighted the most updated and recent treatment strategies to cure amyloidosis.

scholarly journals Current Trends in Non-Invasive Imaging of Interactions in the Liver Tumor Microenvironment Mediated by Tumor Metabolism

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3645
Author(s):  
Isabel Theresa Schobert ◽  
Lynn Jeanette Savic
Keyword(s):  
Tumor Microenvironment ◽  
Liver Cancer ◽  
Cancer Cells ◽  
Imaging Techniques ◽  
Treatment Strategies ◽  
Tumor Metabolism ◽  
Resistance Mechanisms ◽  
Metabolic Reprogramming ◽  
Non Invasive

With the increasing understanding of resistance mechanisms mediated by the metabolic reprogramming in cancer cells, there is a growing clinical interest in imaging technologies that allow for the non-invasive characterization of tumor metabolism and the interactions of cancer cells with the tumor microenvironment (TME) mediated through tumor metabolism. Specifically, tumor glycolysis and subsequent tissue acidosis in the realms of the Warburg effect may promote an immunosuppressive TME, causing a substantial barrier to the clinical efficacy of numerous immuno-oncologic treatments. Thus, imaging the varying individual compositions of the TME may provide a more accurate characterization of the individual tumor. This approach can help to identify the most suitable therapy for each individual patient and design new targeted treatment strategies that disable resistance mechanisms in liver cancer. This review article focuses on non-invasive positron-emission tomography (PET)- and MR-based imaging techniques that aim to visualize the crosstalk between tumor cells and their microenvironment in liver cancer mediated by tumor metabolism.

Cardiac involvement in systemic diseases

2011 ◽  
Author(s):  
Andreas Hagendorff
Keyword(s):  
Cardiac Tissue ◽  
Cardiac Involvement ◽  
Imaging Techniques ◽  
Coronary Thrombosis ◽  
Systemic Disease ◽  
Diagnostic Technique ◽  
Invasive Procedure ◽  
Diagnostic Methods ◽  
Systemic Diseases ◽  
Cardiac Events

Systemic diseases are generally an interdisciplinary challenge in clinical practice. Systemic diseases are able to induce tissue damage in different organs with ongoing duration of the illness. The heart and the circulation are important targets in systemic diseases. The cardiac involvement in systemic diseases normally introduces a chronic process of alterations in cardiac tissue, which causes cardiac failure in the end stage of the diseases or causes dangerous and life-threatening problems by induced acute cardiac events, such as myocardial infarction due to coronary thrombosis. Thus, diagnostic methods—especially imaging techniques—are required, which can be used for screening as well as for the detection of early stages of the diseases. Two-dimensional echocardiography is the predominant diagnostic technique in cardiology for the detection of injuries in cardiac tissue—e.g. the myocardium, endocardium, and the pericardium—due to the overall availability of the non-invasive procedure.The quality of the echocardiography and the success rate of detecting cardiac pathologies in patients with primary non-cardiac problems depend on the competence and expertise of the investigator. Especially in this scenario clinical knowledge about the influence of the systemic disease on cardiac anatomy and physiology is essential for central diagnostic problem. Therefore the primary echocardiography in these patients should be performed by an experienced clinician or investigator. It is possible to detect changes of cardiac morphology and function at different stages of systemic diseases as well as complications of the systemic diseases by echocardiography.The different parts of this chapter will show proposals for qualified transthoracic echocardiography focusing on cardiac structures which are mainly involved in different systemic diseases.

Cardiac amyloidosis: non-invasive diagnosis and current treatment strategies

2010 ◽  
Vol 71 (4) ◽  
pp. 230-231
Author(s):  
FM Lodge ◽  
SW Dubrey ◽  
J Collinson ◽  
SK Prasad
Keyword(s):  
Cardiac Amyloidosis ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Non Invasive

Molecular and Functional Imaging Technology for the Development of Efficient Treatment Strategies for Gliomas

2002 ◽  
Vol 1 (3) ◽  
pp. 187-204 ◽  
Author(s):  
A. H. Jacobs ◽  
A. Winkeler ◽  
C. Dittmar ◽  
A. Gossmann ◽  
M. Deckert ◽  
...  
Keyword(s):  
Gene Expression ◽  
Metabolic Activity ◽  
Pet Imaging ◽  
Imaging Techniques ◽  
Treatment Strategies ◽  
Genetic Changes ◽  
Efficient Treatment ◽  
Endogenous Gene ◽  
Functional Changes ◽  
Non Invasive

Gliomas are the most common types of brain tumors, which invariably lead to death over months or years. Before new and potentially more effective treatment strategies, such as gene therapy, can be effectively introduced into clinical application the following goals must be reached: (1) the determination of localization, extent and metabolic activity of the glioma; (2) the assessment of functional changes within the surrounding brain tissue; (3) the identification of genetic changes on the molecular level leading to disease; and in addition (4) a detailed non-invasive analysis of both endogenous and exogenous gene expression in animal models and in the clinical setting. Non-invasive imaging of endogenous gene expression by means of positron emission tomography (PET) may reveal insight into the molecular basis of pathogenesis and metabolic activity of the glioma and the extent of treatment response. When exogenous genes are introduced to serve for a therapeutic function, PET imaging techniques may reveal the assessment of the location, magnitude and duration of therapeutic gene expression and its relation to the therapeutic effect. Here, we review the main principles of PET imaging and its key roles in neurooncology research.

scholarly journals Amyloid Heart Disease

2018 ◽  
Vol 12 (2) ◽  
pp. 113
Author(s):  
Yaser Nemshah ◽  
Alex Clavijo ◽  
Gyanendra Sharma ◽  
◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Disease ◽  
Light Chain ◽  
Cardiac Amyloidosis ◽  
Imaging Techniques ◽  
Systemic Disease ◽  
Amyloid Proteins ◽  
Advanced Imaging ◽  
Amyloid Light Chain

Cardiac amyloidosis is a group of disorders that develop secondary to the deposition of misfolded proteins in the heart. It can occur in isolation or as part of a systemic disease and can be inherited or acquired. Amyloid light chain (AL) and amyloid transthyretin (ATTR) are the two main forms of amyloid proteins that can infiltrate the heart. With the increased use of advanced imaging techniques and protocols, the recognition and diagnosis of cardiac amyloidosis, especially ATTR, has become easier. New therapies intended to improve survival and quality of life in patients with cardiac amyloidosis are emerging. This article provides an up-to-date review of cardiac amyloidosis.

scholarly journals Minimally invasive diagnosis of endometriosis

2021 ◽  
Vol 16 (1) ◽  
pp. 25-31
Author(s):  
Cătălina Diana STANICA ◽  
◽  
Adrian NEACSU ◽  
Romina Marina SIMA ◽  
Raluca Gabriela IOAN ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Serum Markers ◽  
Diagnostic Methods ◽  
Reproductive Age ◽  
Routine Practice ◽  
Effective Management ◽  
Women Of Reproductive Age ◽  
Positive Diagnosis ◽  
Non Invasive ◽  
Golden Standard

Endometriosis is a common condition among women of reproductive age that can cause chronic pelvic pain and infertility. Rapid establishment of a positive diagnosis of endometriosis is essential for effective management. The positive diagnosis of endometriosis is difficult to establish and requires invasive methods. The "golden standard" for diagnosis is still laparoscopy. Current research has not yet established specific non-invasive diagnostic methods for endometriosis. Imaging techniques, endometrial or serum markers facilitate diagnosis and are useful in monitoring the patient's progress. A number of noninvasive investigations, such as imaging techniques, or biomarkers are currently being evaluated for use in routine practice. A combination of these noninvasive tests could be the standard for diagnosing endometriosis in the future.

scholarly journals From Clinical Clues to Final Diagnosis: The Return of Detective Work to Clinical Medicine in Cardiac Amyloidosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Hani Sabbour ◽  
Khwaja Yousuf Hasan ◽  
Firas Al Badarin ◽  
Haluk Alibazoglu ◽  
Andrew L. Rivard ◽  
...  
Keyword(s):  
Cardiac Amyloidosis ◽  
Clinical Medicine ◽  
Imaging Techniques ◽  
Diagnostic Algorithm ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Diagnostic Tools ◽  
Case Examples ◽  
Non Invasive ◽  
High Index Of Suspicion

Cardiac amyloidosis is frequently misdiagnosed, denying patients the opportunity for timely and appropriate management of the disease. The purpose of this review and case studies is to raise awareness of the diagnostic “red flags” associated with cardiac amyloidosis and the currently available non-invasive strategies for diagnosis. The review focuses on the identification of one of the two main types of cardiac amyloidosis, transthyretin amyloid cardiomyopathy, and non-invasive tools to distinguish this from light-chain amyloidosis. A diagnostic algorithm centered around the use of non-invasive imaging and laboratory analysis is presented. The algorithm generates four differential diagnoses for patients presenting with signs and symptoms consistent with cardiac amyloidosis. Case examples are presented, representing the four potential outcomes of diagnosis using the algorithm. The review provides a guide on how to recognize the often-overlooked presentations of this disease in clinical practice. Non-invasive imaging techniques and diagnostic tools that do not require the involvement of a specialty center have allowed for the improved diagnosis of cardiac amyloidosis. Timely diagnosis of this life-threatening disease is essential for optimal management and it is imperative that clinicians have a high index of suspicion for patients presenting with “red flag” symptoms.

Multimodality imaging for the diagnosis of infiltrative cardiomyopathies

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318001
Author(s):  
Mahesh K Vidula ◽  
Paco E Bravo
Keyword(s):  
Iron Overload ◽  
Cardiac Amyloidosis ◽  
Cardiac Sarcoidosis ◽  
Multimodality Imaging ◽  
Imaging Techniques ◽  
Nuclear Imaging ◽  
Non Invasive ◽  
Iron Overload Cardiomyopathy ◽  
Appropriate Treatment ◽  
Infiltrative Cardiomyopathies

Infiltrative cardiomyopathies result from the deposition or anomalous storage of specific substances in the heart, leading to impaired cardiac function and heart failure. In this review, we describe the utility of a variety of imaging modalities for the diagnosis of infiltrative cardiomyopathies and provide algorithms for clinicians to use to evaluate patients with these disorders. We have divided infiltrative cardiomyopathies into two different categories: (1) infiltrative cardiomyopathies characterised by increased wall thickness (eg, cardiac amyloidosis and Anderson-Fabry disease (AFD)) and (2) infiltrative cardiomyopathies that can mimic ischaemic or dilated cardiomyopathies (eg, cardiac sarcoidosis (CS) and iron overload cardiomyopathy). Echocardiography is the first modality of choice for the evaluation of cardiomyopathies in either category, and the differential can be narrowed using cardiac magnetic resonance (CMR) and nuclear imaging techniques. The diagnosis of cardiac amyloidosis is supported with key findings seen on echocardiography, CMR and nuclear imaging, whereas AFD can be suggested by unique features on CMR. CMR and nuclear imaging are also important modalities for the diagnosis of CS, while iron overload cardiomyopathy is mostly diagnosed using tissue characterisation on CMR. Overall, multimodality imaging is necessary for the accurate non-invasive diagnosis of infiltrative cardiomyopathies, which is important to ensure appropriate treatment and prognostication.

scholarly journals The Validation Path of Hypoxia PET Imaging: Focus on Brain Tumours

2018 ◽  
Vol 25 (26) ◽  
pp. 3074-3095 ◽  
Author(s):  
Natale Quartuccio ◽  
Marie-Claude Asselin
Keyword(s):  
Brain Tumours ◽  
Imaging Techniques ◽  
Treatment Strategies ◽  
Imaging Method ◽  
Therapeutic Implications ◽  
Non Invasive ◽  
Positron Emission ◽  
Malignant Brain Tumours ◽  
The Central Nervous System ◽  
Different Levels

Background: Gliomas are brain tumours arising from the glia, the supportive tissue of the central nervous system (CNS), and constitute the commonest primary malignant brain tumours. Gliomas are graded from grade I to IV according to their appearance under the microscope. One of the most significant adverse features of high-grade gliomas is hypoxia, a biological phenomenon that develops when the oxygen concentration becomes insufficient to guarantee the normal tissue functions. Since tumour hypoxia influences negatively patient outcome and targeting hypoxia has potential therapeutic implications, there is currently great interest in imaging techniques measuring hypoxia. Objectives: The aim of this review is to provide up to date evidence on the radiotracers available for measuring hypoxia in brain tumours by means of positron emission tomography (PET), the most extensively investigated imaging approach to quantify hypoxia. Methods: The review is based on preclinical and clinical papers and describes the validation status of the different available radiotracers. Results: To date, [F-18] fluoromisonidazole ([18F]FMISO) remains the most widely used radiotracer for imaging hypoxia in patients with brain tumours, but experience with other radiotracers has expanded in the last two decades. Validation of hypoxia radiotracers is still on-going and essential before these radiopharmaceuticals can become widely used in the clinical setting. Conclusion: Availability of a non-invasive imaging method capable of reliably measuring and mapping different levels of oxygen in brain tumours would provide the critical means of selecting patients that may benefit from tailored treatment strategies targeting hypoxia.

scholarly journals Diagnosis and treatment of cardiac amyloidosis: position statement of the German Cardiac Society (DGK)

2021 ◽  
Author(s):  
A. Yilmaz ◽  
J. Bauersachs ◽  
F. Bengel ◽  
R. Büchel ◽  
I. Kindermann ◽  
...  
Keyword(s):  
Cardiac Amyloidosis ◽  
Imaging Techniques ◽  
Diagnostic Algorithm ◽  
Position Statement ◽  
Histopathological Diagnosis ◽  
Wild Type ◽  
Non Invasive ◽  
Specific Serum ◽  
Conventional Echocardiography ◽  
Cardiac Society

AbstractSystemic forms of amyloidosis affecting the heart are mostly light-chain (AL) and transthyretin (ATTR) amyloidoses. The latter is caused by deposition of misfolded transthyretin, either in wild-type (ATTRwt) or mutant (ATTRv) conformation. For diagnostics, specific serum biomarkers and modern non-invasive imaging techniques, such as cardiovascular magnetic resonance imaging (CMR) and scintigraphic methods, are available today. These imaging techniques do not only complement conventional echocardiography, but also allow for accurate assessment of the extent of cardiac involvement, in addition to diagnosing cardiac amyloidosis. Endomyocardial biopsy still plays a major role in the histopathological diagnosis and subtyping of cardiac amyloidosis. The main objective of the diagnostic algorithm outlined in this position statement is to detect cardiac amyloidosis as reliably and early as possible, to accurately determine its extent, and to reliably identify the underlying subtype of amyloidosis, thereby enabling subsequent targeted treatment.

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