Musculoskeletal Applications of Magnetic Resonance-Guided Focused Ultrasound

Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive therapy that uses focused sound energy to thermally ablate focal pathology within the body. In the United States, MRgFUS is approved by the Food and Drug Administration for the treatment of uterine fibroids, palliation of painful bone metastases, and thalamotomy for the treatment of essential tremor. However, it has also demonstrated utility for the treatment of a wide range of additional musculoskeletal (MSK) conditions that currently are treated as off-label indications. Advantages of the technology include the lack of ionizing radiation, the completely noninvasive technique, and the precise targeting that offer unprecedented control of the delivery of the thermal dose, as well as real-time monitoring capability with MR thermometry. In this review, we describe the most common MSK applications of MRgFUS: palliation of bone metastases, treatment of osteoid osteomas, desmoid tumors, facet arthropathy, and other developing indications.

An Optimized Approach for Prostate Image Segmentation Using K-Means Clustering Algorithm with Elbow Method

Prostate cancer disease is one of the common types that cause men’s prostate damage all over the world. Prostate-specific membrane antigen (PSMA) expressed by type-II is an extremely attractive style for imaging-based diagnosis of prostate cancer. Clinically, photodynamic therapy (PDT) is used as noninvasive therapy in treatment of several cancers and some other diseases. This paper aims to segment or cluster and analyze pixels of histological and near-infrared (NIR) prostate cancer images acquired by PSMA-targeting PDT low weight molecular agents. Such agents can provide image guidance to resection of the prostate tumors and permit for the subsequent PDT in order to remove remaining or noneradicable cancer cells. The color prostate image segmentation is accomplished using an optimized image segmentation approach. The optimized approach combines the k-means clustering algorithm with elbow method that can give better clustering of pixels through automatically determining the best number of clusters. Clusters’ statistics and ratio results of pixels in the segmented images show the applicability of the proposed approach for giving the optimum number of clusters for prostate cancer analysis and diagnosis.

Case Report: End-Stage Recurrent Glioblastoma Treated With a New Noninvasive Non-Contact Oncomagnetic Device

Alternating electric field therapy has been approved for glioblastoma (GBM). We have preclinical evidence for anticancer effects in GBM cell cultures and mouse xenografts with an oscillating magnetic field (OMF) generating device. Here we report OMF treatment of end-stage recurrent glioblastoma in a 53-year-old man who had undergone radical surgical excision and chemoradiotherapy, and experimental gene therapy for a left frontal tumor. He experienced tumor recurrence and progressive enlargement with leptomeningeal involvement. OMF for 5 weeks was well tolerated, with 31% reduction of contrast-enhanced tumor volume and reduction in abnormal T2-weighted Fluid-Attenuated Inversion Recovery volume. Tumor shrinkage appeared to correlate with treatment dose. These findings suggest a powerful new noninvasive therapy for glioblastoma.

Phenotyping COVID-19 Patients by Ventilation Therapy: Data Quality Challenges and Cohort Characterization

The COVID-19 pandemic introduced unique challenges for treating acute respiratory failure patients and highlighted the need for reliable phenotyping of patients using retrospective electronic health record data. In this study, we applied a rule-based phenotyping algorithm to classify COVID-19 patients requiring ventilatory support. We analyzed patient outcomes of the different phenotypes based on type and sequence of ventilation therapy. Invasive mechanical ventilation, noninvasive positive pressure ventilation, and high flow nasal insufflation were three therapies used to phenotype patients leading to a total of seven subgroups; patients treated with a single therapy (3), patients treated with either form of noninvasive ventilation and subsequently requiring intubation (2), and patients initially intubated and then weaned onto a noninvasive therapy (2). In addition to summary statistics for each phenotype, we highlight data quality challenges and importance of mapping to standard terminologies. This work illustrates potential impact of accurate phenotyping on patient-level and system-level outcomes including appropriate resource allocation under resource constrained circumstances.

Treatment of Increased Intracranial Pressure and Vasospasm after Subarachnoid Hemorrhage in a 9-Year-Old Child—A Case Report

We report a 9-year-old patient who suffered severe subarachnoid hemorrhage due to ruptured dissecting aneurysm of the left parieto-occipital artery. After endovascular occlusion of the aneurysm, increased intracranial pressure refractory to noninvasive therapy required secondary decompressive hemicraniectomy. Critical vasospasm and delayed neurological deterioration were treated by oral nimodipine and successful endovascular rescue therapy consisting of intra-arterial balloon dilatation.

Innovative strategies for enhanced tumor photodynamic therapy

Photodynamic therapy (PDT) is an approved and promising treatment approach that utilizes photosensitizer (PS) to produce cytotoxic reactive oxygen species (ROS) through irradiation to achieve tumor noninvasive therapy. Whereas, the...

A novel self-targeting theranostic nanoplatform for photoacoustic imaging-monitored and enhanced chemo-sonodynamic therapy

Sonodynamic therapy has attracted wide attention as a noninvasive therapy due to deep tissue penetration. However, the majority of sonosensitizers often suffer from poor physiological stability, rapid blood clearance and...

Oral adjuvant therapy for colorectal cancer: recent developments and future targets

Colorectal cancer is considered the third most frequent malignant neoplasm occurring in both men and women worldwide. Most approaches that have been used to fight and treat this type of malignancy are either invasive or nonselective. Noninvasive therapy using oral route can increase patient compliance and reduce treatment costs. Innovative measures such as use of nanotechnology and theranostic systems have been initiated in the oral therapy, which has been proven to be greatly advantageous in decreasing side effects, improving detection and diagnoses. This manuscript investigates recent innovative and novel therapeutic approaches through oral route and potential targets in the treatment of colorectal cancer.

Update Regarding Imaging of Neuroendocrine Neoplasms

Background Neuroendocrine neoplasms (NEN) are a heterogeneous group of tumors characterized by the expression of typical proteins. A wide range of morphological and functional imaging methods is required in order to adequately assess the course of the disease and to optimally treat the patient. The spectrum of indications ranges from the detection of small primary tumors to the documentation of the metastasis pattern and the assessment of the suitability for certain invasive or noninvasive therapy methods. The exact recording and quantification of findings is indispensable. Methods This article is based on a comprehensive literature search on the different aspects of neuroendocrine neoplasm imaging. Results This article is intended to provide an overview of the available imaging procedures with their respective advantages and disadvantages for diagnostics and their value for the follow-up of neuroendocrine neoplasms. Recommendations for examination protocols, typical image findings, and an outlook regarding future developments are presented. Key Points: Citation Format