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Heart failure with preserved ejection fraction (HFpEF) traditionally has been characterized as a form of heart failure without therapeutic options, in particular with a lack of response to the established therapies of heart failure with reduced ejection fraction (HFrEF). However, this is no longer true. Besides physical exercise, risk factor modification, aldosterone blocking agents, and sodium-glucose cotransporter 2 inhibitors, specific therapies are emerging for specific HFpEF etiologies, such as hypertrophic cardiomyopathy or cardiac amyloidosis. This development justifies increased efforts to arrive at specific diagnoses within the umbrella of HFpEF. Cardiac imaging plays by far the largest role in this effort and is discussed in the following review.

Heart failure with preserved ejection fraction (HFpEF) traditionally has been characterized as a form of heart failure without therapeutic options, in particular with a lack of response to the established therapies of heart failure with reduced ejection fraction (HFrEF). However, this is no longer true. Besides physical exercise, risk factor modification, aldosterone blocking agents, and sodium-glucose cotransporter 2 inhibitors, specific therapies are emerging for specific HFpEF etiologies, such as hypertrophic cardiomyopathy or cardiac amyloidosis. This development justifies increased efforts to arrive at specific diagnoses within the umbrella of HFpEF. Cardiac imaging plays by far the largest role in this effort and is discussed in the following review.

Heart failure with preserved ejection fraction (HFpEF) traditionally has been characterized as a form of heart failure without therapeutic options, in particular with a lack of response to the established therapies of heart failure with reduced ejection fraction (HFrEF). However, this is no longer true. Besides physical exercise, risk factor modification, aldosterone blocking agents, and sodium-glucose cotransporter 2 inhibitors, specific therapies are emerging for specific HFpEF etiologies, such as hypertrophic cardiomyopathy or cardiac amyloidosis. This development justifies increased efforts to arrive at specific diagnoses within the umbrella of HFpEF. Cardiac imaging plays by far the largest role in this effort and is discussed in the following review.

Heart failure with preserved ejection fraction (HFpEF) traditionally has been characterized as a form of heart failure without therapeutic options, in particular with a lack of response to the established therapies of heart failure with reduced ejection fraction (HFrEF). However, this is no longer true. Besides physical exercise, risk factor modification, aldosterone blocking agents, and sodium-glucose cotransporter 2 inhibitors, specific therapies are emerging for specific HFpEF etiologies, such as hypertrophic cardiomyopathy or cardiac amyloidosis. This development justifies increased efforts to arrive at specific diagnoses within the umbrella of HFpEF. Cardiac imaging plays by far the largest role in this effort and is discussed in the following review.

Heart failure with preserved ejection fraction (HFpEF) traditionally has been characterized as a form of heart failure without therapeutic options, in particular with a lack of response to the established therapies of heart failure with reduced ejection fraction (HFrEF). However, this is no longer true. Besides physical exercise, risk factor modification, aldosterone blocking agents, and sodium-glucose cotransporter 2 inhibitors, specific therapies are emerging for specific HFpEF etiologies, such as hypertrophic cardiomyopathy or cardiac amyloidosis. This development justifies increased efforts to arrive at specific diagnoses within the umbrella of HFpEF. Cardiac imaging plays by far the largest role in this effort and is discussed in the following review.

Heart failure with preserved ejection fraction (HFpEF) is a syndrome defined by the presence of heart failure symptoms and increased levels of circulating natriuretic peptide (NP) in patients with preserved left ventricular ejection fraction and various degrees of diastolic dysfunction (DD). HFpEF is a complex condition that encompasses a wide range of different etiologies. Cardiovascular imaging plays a pivotal role in diagnosing HFpEF, in identifying specific underlying etiologies, in prognostic stratification, and in therapeutic individualization. Echocardiography is the first line imaging modality with its wide availability; it has high spatial and temporal resolution and can reliably assess systolic and diastolic function. Cardiovascular magnetic resonance (CMR) is the gold standard for cardiac morphology and function assessment, and has superior contrast resolution to look in depth into tissue changes and help to identify specific HFpEF etiologies. Differently, the most important role of nuclear imaging [i.e., planar scintigraphy and/or single photon emission CT (SPECT)] consists in the screening and diagnosis of cardiac transthyretin amyloidosis (ATTR) in patients with HFpEF. Cardiac CT can accurately evaluate coronary artery disease both from an anatomical and functional point of view, but tissue characterization methods have also been developed. The aim of this review is to critically summarize the current uses and future perspectives of echocardiography, nuclear imaging, CT, and CMR in patients with HFpEF.

Background: The aim of this prospective study was to assess the diagnostic value of nuclear imaging with F-18-FDG PET/CT (FDG PET/CT), combined In-111-WBC/(99)mTc-Nanocoll, and Tc-99m-HDP SPECT/CT (dual-isotope WBC/bone marrow scan) for patients with chronic problems related to knee or hip prostheses (TKA or THA) scheduled by a structured multidisciplinary algorithm. Materials and Methods: Fifty-five patients underwent imaging with Tc-99m-HDP SPECT/CT (bone scan), dual-isotope WBC/bone marrow scan, and FDG PET/CT. The final diagnosis of prosthetic joint infection (PJI) and/or loosening was based on the intraoperative findings and microbiological culture results and the clinical follow-up. Results: The diagnostic performance of dual-isotope WBC/bone marrow SPECT/CT for PJI showed a sensitivity of 100% (CI 0.74-1.00), a specificity of 97% (CI 0.82-1.00), and an accuracy of 98% (CI 0.88-1.00); for PET/CT, the sensitivity, specificity, and accuracy were 100% (CI 0.74-1.00), 71% (CI 0.56-0.90), and 79% (CI 0.68-0.93), respectively. Conclusions: In a standardized prospectively scheduled patient group, the results showed highly specific performance of combined dual-isotope WBC/bone marrow SPECT/CT in confirming chronic PJI. FDG PET/CT has an appropriate accuracy, but the utility of its use in the clinical diagnostic algorithm of suspected PJI needs further evidence.

Background: The aim of this prospective study was to assess the diagnostic value of nuclear imaging with F-18-FDG PET/CT (FDG PET/CT), combined In-111-WBC/(99)mTc-Nanocoll, and Tc-99m-HDP SPECT/CT (dual-isotope WBC/bone marrow scan) for patients with chronic problems related to knee or hip prostheses (TKA or THA) scheduled by a structured multidisciplinary algorithm. Materials and Methods: Fifty-five patients underwent imaging with Tc-99m-HDP SPECT/CT (bone scan), dual-isotope WBC/bone marrow scan, and FDG PET/CT. The final diagnosis of prosthetic joint infection (PJI) and/or loosening was based on the intraoperative findings and microbiological culture results and the clinical follow-up. Results: The diagnostic performance of dual-isotope WBC/bone marrow SPECT/CT for PJI showed a sensitivity of 100% (CI 0.74-1.00), a specificity of 97% (CI 0.82-1.00), and an accuracy of 98% (CI 0.88-1.00); for PET/CT, the sensitivity, specificity, and accuracy were 100% (CI 0.74-1.00), 71% (CI 0.56-0.90), and 79% (CI 0.68-0.93), respectively. Conclusions: In a standardized prospectively scheduled patient group, the results showed highly specific performance of combined dual-isotope WBC/bone marrow SPECT/CT in confirming chronic PJI. FDG PET/CT has an appropriate accuracy, but the utility of its use in the clinical diagnostic algorithm of suspected PJI needs further evidence.

Background: The aim of this prospective study was to assess the diagnostic value of nuclear imaging with F-18-FDG PET/CT (FDG PET/CT), combined In-111-WBC/(99)mTc-Nanocoll, and Tc-99m-HDP SPECT/CT (dual-isotope WBC/bone marrow scan) for patients with chronic problems related to knee or hip prostheses (TKA or THA) scheduled by a structured multidisciplinary algorithm. Materials and Methods: Fifty-five patients underwent imaging with Tc-99m-HDP SPECT/CT (bone scan), dual-isotope WBC/bone marrow scan, and FDG PET/CT. The final diagnosis of prosthetic joint infection (PJI) and/or loosening was based on the intraoperative findings and microbiological culture results and the clinical follow-up. Results: The diagnostic performance of dual-isotope WBC/bone marrow SPECT/CT for PJI showed a sensitivity of 100% (CI 0.74-1.00), a specificity of 97% (CI 0.82-1.00), and an accuracy of 98% (CI 0.88-1.00); for PET/CT, the sensitivity, specificity, and accuracy were 100% (CI 0.74-1.00), 71% (CI 0.56-0.90), and 79% (CI 0.68-0.93), respectively. Conclusions: In a standardized prospectively scheduled patient group, the results showed highly specific performance of combined dual-isotope WBC/bone marrow SPECT/CT in confirming chronic PJI. FDG PET/CT has an appropriate accuracy, but the utility of its use in the clinical diagnostic algorithm of suspected PJI needs further evidence.

Background: The aim of this prospective study was to assess the diagnostic value of nuclear imaging with F-18-FDG PET/CT (FDG PET/CT), combined In-111-WBC/(99)mTc-Nanocoll, and Tc-99m-HDP SPECT/CT (dual-isotope WBC/bone marrow scan) for patients with chronic problems related to knee or hip prostheses (TKA or THA) scheduled by a structured multidisciplinary algorithm. Materials and Methods: Fifty-five patients underwent imaging with Tc-99m-HDP SPECT/CT (bone scan), dual-isotope WBC/bone marrow scan, and FDG PET/CT. The final diagnosis of prosthetic joint infection (PJI) and/or loosening was based on the intraoperative findings and microbiological culture results and the clinical follow-up. Results: The diagnostic performance of dual-isotope WBC/bone marrow SPECT/CT for PJI showed a sensitivity of 100% (CI 0.74-1.00), a specificity of 97% (CI 0.82-1.00), and an accuracy of 98% (CI 0.88-1.00); for PET/CT, the sensitivity, specificity, and accuracy were 100% (CI 0.74-1.00), 71% (CI 0.56-0.90), and 79% (CI 0.68-0.93), respectively. Conclusions: In a standardized prospectively scheduled patient group, the results showed highly specific performance of combined dual-isotope WBC/bone marrow SPECT/CT in confirming chronic PJI. FDG PET/CT has an appropriate accuracy, but the utility of its use in the clinical diagnostic algorithm of suspected PJI needs further evidence.

Autizam je neurorazvojni poremećaj koji često prate različita komorbidna stanja, u koje, između ostalog, spadaju i bolesti štitaste žlezde. Jedna od često korišćenih dijagnostičkih metoda za utvrđivanje izgleda i funkcije štitaste žlezde je scintigrafija. Iako se u centrima za nuklearnu medicinu scintigrafija štitnjače izvodi rutinski, sa aspekta osobe sa autizmom i stručnjaka koji joj pružaju podršku priprema za snimanje može da bude veoma kompleksna. Mnoge osobe sa autizmom imaju tripanofobiju (strah od igle), zbog čega se moraju posebno pripremati za venepunkciju tokom koje se radiofarmak ubrizgava u organizam. Osim toga, snimanje gama-kamerom, iako potpuno bezbolno, može da bude veoma zahtevno za pacijenta sa autizmom, koji sve vreme snimanja mora da miruje, da ne govori i da ne vokalizuje. Kliničko osoblje može da se suoči sa poteškoćama i u realizaciji svih ostalih faza ove dijagnostičke procedure. Zato je u ovom radu predložena grupa intervencija, zasnovanih na dokazima, koje se mogu koristiti u pripremi osoba sa autizmom za scintigrafiju štitnjače. Predložene su tehnike postepenog izlaganja, gašenja, potkrepljivanja, modelovanja, pisanja socijalnih priča, koje pripadaju kategoriji fokusiranih intervencija za osobe sa autizmom., Autism is a neurodevelopmental disorder that is often accompanied by various co-morbid conditions, among other things, thyroid diseases. One of the frequently used diagnostic methods to determine the appearance and function of the thyroid gland is scintigraphy. Although thyroid scintigraphy is routinely performed at Clinics for Nuclear Medicine, preparation for nuclear imaging can be very complex from the perspective of people with autism and the experts who support them. Many people with autism have trypanophobia (fear of needles), which is why they have to be specially prepared for venipuncture, during which radiopharmaceutical is injected into the organism. In addition, nuclear imaging with a gamma camera, though completely painless, can be very demanding for a patient with autism who must remain still, without speaking and vocalising during the entire imaging. Clinical staff may also face difficulties in implementing all other stages of this diagnostic procedure. Therefore, this paper proposes a set of evidence-based interventions that can be used to prepare people with autism for thyroid scintigraphy. Techniques of gradual exposure, extinction, reinforcement, modelling, and writing social stories, belonging to the category of focused interventions for people with autism, are proposed.

Innate defense regulators (IDRs) are synthetic host-defense peptides (HDPs) with broad-spectrum anti-infective properties, including immunomodulatory, anti-biofilm and direct antimicrobial activities. A lack of pharmacokinetic data about these peptides hinders their development and makes it challenging to fully understand how they work in vivo since their mechanism of action is dependent on tissue concentrations of the peptide. Here, we set out to define in detail the pharmacokinetics of a well-characterized IDR molecule, IDR-1018. To make the peptide traceable, it was radiolabeled with the long-lived gamma-emitting isotope gallium-67. After a series of bench-top characterizations, the radiotracer was administered to healthy mice intravenously (IV) or subcutaneously (SQ) at various dose levels (2.5–13 mg/kg). Nuclear imaging and ex-vivo biodistributions were used to quantify organ and tissue uptake of the radiotracer over time. When administered as an IV bolus, the distribution profile of the radiotracer changed as the dose was escalated. At 2.5 mg/kg, the peptide was well-tolerated, poorly circulated in the blood and was cleared predominantly by the reticuloendothelial system. Higher doses (7 and 13 mg/kg) as an IV bolus were almost immediately lethal due to respiratory arrest; significant lung uptake of the radiotracer was observed from nuclear scans of these animals, and histological examination found extensive damage to the pulmonary vasculature and alveoli. When administered SQ at a dose of 3 mg/kg, radiolabeled IDR-1018 was rapidly absorbed from the site of injection and predominately cleared renally. Apart from the SQ injection site, no other tissue had a concentration above the minimum inhibitory concentration that would enable this peptide to exert direct antimicrobial effects against most pathogenic bacteria. Tissue concentrations were sufficient, however, to disrupt microbial biofilms and alter the host immune response. Overall, this study demonstrated

Proton sound detectors rely on sensing the weak thermoacoustic signals emitted by the fast energy deposition at the end of the beam penetration path through the energy absorber. The energy of the ions/protons is first converted into heat, and then, into pressure by a thermodynamic process. The pressure signal propagates through the energy absorber, and it is read by an acoustic sensor, which, in turn, converts the pressure wave into an analog electrical voltage. Such an analog signal is digitalized by the analog front-end. Its digital representation is used for the measurement of the beam depth. This emerging technique attracts attention in both physics experiments and medical applications (hadron therapy). This article investigates the signal-to-noise-ratio performance in proton sound detectors exploring all critical steps that lead to both reduction of the power of the electrical signal and noise power increasing. Nonetheless, this article proposes specific technical solutions to mitigate such signal-to-noise-ratio degradations with particular attention to higher energy (i.e., 200 MeV) proton beams, which are crucial for medical applications, and where the maximum achievable signal-to-noise ratio can be 50/60 dB lower than 20 MeV acoustic pulses.

Background: The aim of this prospective study was to assess the diagnostic value of nuclear imaging with F-18-FDG PET/CT (FDG PET/CT), combined In-111-WBC/(99)mTc-Nanocoll, and Tc-99m-HDP SPECT/CT (dual-isotope WBC/bone marrow scan) for patients with chronic problems related to knee or hip prostheses (TKA or THA) scheduled by a structured multidisciplinary algorithm. Materials and Methods: Fifty-five patients underwent imaging with Tc-99m-HDP SPECT/CT (bone scan), dual-isotope WBC/bone marrow scan, and FDG PET/CT. The final diagnosis of prosthetic joint infection (PJI) and/or loosening was based on the intraoperative findings and microbiological culture results and the clinical follow-up. Results: The diagnostic performance of dual-isotope WBC/bone marrow SPECT/CT for PJI showed a sensitivity of 100% (CI 0.74-1.00), a specificity of 97% (CI 0.82-1.00), and an accuracy of 98% (CI 0.88-1.00); for PET/CT, the sensitivity, specificity, and accuracy were 100% (CI 0.74-1.00), 71% (CI 0.56-0.90), and 79% (CI 0.68-0.93), respectively. Conclusions: In a standardized prospectively scheduled patient group, the results showed highly specific performance of combined dual-isotope WBC/bone marrow SPECT/CT in confirming chronic PJI. FDG PET/CT has an appropriate accuracy, but the utility of its use in the clinical diagnostic algorithm of suspected PJI needs further evidence.

Non-invasive imaging methodologies, especially nuclear imaging techniques, have undergone an extraordinary development over the last years. Interest in the development of innovative tracers has prompted the emergence of new nanomaterials with a focus on nuclear imaging and therapeutical applications. Among others, organic nanoparticles are of the highest interest due to their translational potential related to their biocompatibility and biodegradability. Our group has developed a promising new type of biocompatible nanomaterials, sphingomyelin nanoemulsions (SNs). The aim of this study is to explore the potential of SNs for nuclear imaging applications.

Objective I-123-15-(p-iodophenyl)-3(R,S)-methylpentadecanoic acid ([I-123]BMIPP), a fatty acid analog, is widely used for the diagnosis of cardiac diseases. Feeding condition is one of the important factors in the myocardial fatty acid uptake, which may also affect myocardial accumulation of [I-123]BMIPP and image quality of [I-123]BMIPP scintigraphy. However, the relationship between the myocardial accumulation of [I-123]BMIPP and the feeding condition is not entirely clear. Therefore, we determined the myocardial accumulation of [I-125]BMIPP in mice at various metabolic statuses induced by fasting in comparison with the hepatic accumulation. Methods Fed or fasted (6-, 12-, and 24-h fasted) mice were intravenously injected with [I-125]BMIPP (35.2-75.0 kBq, 4 nmol). Radioactivities in the heart and liver were measured at 1, 5, 10, 30, 60, and 120 min after the injection (n = 5-15/time point for each group), and then, the heart-to-liver (H/L) ratios were calculated. Results The myocardial accumulation level of [I-125]BMIPP in the fed group was almost the same as that in the 6-h-fasted group at each time point, although it was decreased by 12- and 24-h fasting. The H/L ratios of [I-125]BMIPP accumulation level were significantly decreased by fasting (1.92 +/- 0.22, 1.45 +/- 0.13, 1.12 +/- 0.13, and 0.91 +/- 0.15 at 10 min, and 3.30 +/- 0.62, 2.09 +/- 0.35, 1.79 +/- 0.34, and 1.27 +/- 0.06 at 30 min after the injection, respectively, for the fed group and the 6-, 12-, and 24-h-fasted groups;p < 0.0001), largely owing to the increase in the hepatic accumulation level in the fasting groups. Conclusion Although short-period (6 h) fasting did not affect the myocardial accumulation level of [I-125]BMIPP, the hepatic accumulation level was increased. The present results indicate that the fed condition may provide higher-contrast images in myocardial [I-123]BMIPP scintigraphy.

Objective I-123-15-(p-iodophenyl)-3(R,S)-methylpentadecanoic acid ([I-123]BMIPP), a fatty acid analog, is widely used for the diagnosis of cardiac diseases. Feeding condition is one of the important factors in the myocardial fatty acid uptake, which may also affect myocardial accumulation of [I-123]BMIPP and image quality of [I-123]BMIPP scintigraphy. However, the relationship between the myocardial accumulation of [I-123]BMIPP and the feeding condition is not entirely clear. Therefore, we determined the myocardial accumulation of [I-125]BMIPP in mice at various metabolic statuses induced by fasting in comparison with the hepatic accumulation. Methods Fed or fasted (6-, 12-, and 24-h fasted) mice were intravenously injected with [I-125]BMIPP (35.2-75.0 kBq, 4 nmol). Radioactivities in the heart and liver were measured at 1, 5, 10, 30, 60, and 120 min after the injection (n = 5-15/time point for each group), and then, the heart-to-liver (H/L) ratios were calculated. Results The myocardial accumulation level of [I-125]BMIPP in the fed group was almost the same as that in the 6-h-fasted group at each time point, although it was decreased by 12- and 24-h fasting. The H/L ratios of [I-125]BMIPP accumulation level were significantly decreased by fasting (1.92 +/- 0.22, 1.45 +/- 0.13, 1.12 +/- 0.13, and 0.91 +/- 0.15 at 10 min, and 3.30 +/- 0.62, 2.09 +/- 0.35, 1.79 +/- 0.34, and 1.27 +/- 0.06 at 30 min after the injection, respectively, for the fed group and the 6-, 12-, and 24-h-fasted groups;p < 0.0001), largely owing to the increase in the hepatic accumulation level in the fasting groups. Conclusion Although short-period (6 h) fasting did not affect the myocardial accumulation level of [I-125]BMIPP, the hepatic accumulation level was increased. The present results indicate that the fed condition may provide higher-contrast images in myocardial [I-123]BMIPP scintigraphy.

This paper analyzes how to improve the precision of ionoacoustic proton range verification by optimizing the analog signal processing stages with particular emphasis on analog filters. The ionoacoustic technique allows one to spatially detect the proton beam penetration depth/range in a water absorber, with interesting possible applications in real‐time beam monitoring during hadron therapy treatments. The state of the art uses nonoptimized detectors that have low signal quality and thus require a higher total dose, which is not compatible with clinical applications. For these reasons, a comprehensive analysis of acoustic signal bandwidth, signal‐to‐noise‐ratio and noise power/bandwidth will be presented. The correlation between these signal‐quality parameters with maximum achievable proton range measurement precision will be discussed. In particular, the use of an optimized analog filter allows one to decrease the dose required to achieve a given precision by as much as 98.4% compared to a nonoptimized filter approach.

Non-invasive imaging methodologies, especially nuclear imaging techniques, have undergone an extraordinary development over the last years. Interest in the development of innovative tracers has prompted the emergence of new nanomaterials with a focus on nuclear imaging and therapeutical applications. Among others, organic nanoparticles are of the highest interest due to their translational potential related to their biocompatibility and biodegradability. Our group has developed a promising new type of biocompatible nanomaterials, sphingomyelin nanoemulsions (SNs). The aim of this study is to explore the potential of SNs for nuclear imaging applications.

This work presents the experimental results of a wavelet transform-based denoising algorithm to improve the signal-to-noise ratio (SNR) in Proton Sound Detectors (ProSDs). ProSDs are thermoacoustic detectors that exploit the acoustic signal generated by pulsed proton beams in energy absorbers to locate energy deposition with sub-millimeter precision, with interesting applications in beam monitoring during oncological hadron therapy treatments. This work shows how the application of a denoising algorithm allows to improve the signal-to-noise ratio and reduce the extra-dose necessary to characterize the beam. The algorithm was validated with the thermoacoustic signal generated by a proton beam at 20 MeV, where it allowed to increase the SNR by 19 dB and decrease the dose necessary to characterize the beam by a factor of 80 compared to the state of the art.

This paper presents the design of a multichannel acoustic detector optimized for sensing proton induced thermo-acoustic signals (ionoacoustic signals) in clinical scenarios experiments. Ionoacoustics is a promising technique for real-time monitoring of proton beams with interesting possible applications in oncological hadron therapy. However, clinical scenarios are characterized by very low signal amplitudes (few tens millipascals). State-of-the-art experiments use general purpose acoustic sensors and heavily rely on averaging (up to thousands beam shots) to detect a clear signal, at the cost of a significant extra-dose above clinical limits. To overcome this limit, this paper presents the design of a dedicated acoustic sensor that exploits spatial correlation (multichannel sensor) to increase the SNR with no extra-dose and localize the maximum energy deposition of a 200 MeV proton beam in clinical scenarios (35 mGy/shot dose, 25 mPa signal amplitude). The results are validated by a complete cross-domain simulation of the physical (proton beam), acoustic (wave propagation) and electrical (sensor and electronics frequency response and noise) environments. The presented detector achieves a clear 20.5 dB single-shot SNR (35 mGy total dose) and can localize the maximum energy deposition with 0.5 mm precision (<1% w.r.t. the particle range) with ~1/100 dose reduction compared to state-of-the-art.

OBJECTIVES: This dual-site study evaluated the diagnostic accuracy of the method. BACKGROUND: Pittsburgh compound ([11C]PIB) positron emission tomography (PIB-PET) has shown promise as a specific and noninvasive method for the diagnosis of cardiac amyloidosis (CA). METHODS: The study had 2 parts. In the initial study, 51 subjects were included, 36 patients with known CA and increased wall thickness (15 immunoglobulin light chain [AL] and 21 transthyretin [ATTR] amyloidosis) and 15 control patients (7 were nonamyloid hypertrophic and 8 healthy volunteers). Subjects underwent PIB-PET and echocardiography. Sensitivity and specificity of PIB-PET were established for 2 simple semiquantitative approaches, standardized uptake value ratio (SUVR) and retention index (RI). The second part of the study included 11 amyloidosis patients (5 AL and 6 hereditary ATTR) without increased wall thickness to which the optimal cutoff values of SUVR (>1.09) and RI (>0.037 min-1) were applied prospectively. RESULTS: The diagnostic accuracy of visual inspection of [11C]PIB uptake was 100% in discriminating CA patients with increased wall thickness from controls. Semiquantitative [11C]PIB uptake discriminated CA from controls with a 94% (95% confidence interval [CI]: 80% to 99%) sensitivity for both SUVR and RI and specificity of 93% (95% CI: 66% to 100%) for SUVR and 100% (95% CI: 75% to 100%) for RI. [11C]PIB uptake was significantly higher in AL-CA than in ATTR-CA patients (p < 0.001) and discriminated AL-CA from controls with 100% (95% CI: 88% to 100%) accuracy for both the semiquantitative measures. In the prospective group without increased wall thickness, RI was elevated compared to controls (p = 0.001) and 5 of 11 subjects were evaluated as [11C]PIB PET positive. CONCLUSIONS: In a dual-center setting, [11C]PIB PET was highly accurate in detecting cardiac involvement in the main amyloid subtypes, with 100% accuracy in AL amyloidosis. A proportion of amyloidosis patients witho

Diagnosing a peri-prosthetic joint infection (PJI) remains challenging despite the availability of a variety of clinical signs, serum and synovial markers, imaging techniques, microbiological and histological findings. Moreover, the one and only true definition of PJI does not exist, which is reflected by the existence of at least six different definitions by independent societies. These definitions are composed of major and minor criteria for defining a PJI, but most of them do not include imaging techniques. This paper highlights the pros and cons of available imaging techniques--ray, ultrasound, computed tomography (CT), Magnetic Resonance Imaging (MRI), bone scintigraphy, white blood cell scintigraphy (WBC), anti-granulocyte scintigraphy, and fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), discusses the added value of hybrid camera systems-single photon emission tomography/computed tomography (SPECT/CT), PET/CT and PET/MRI and reports consensus answers on important clinical questions that were discussed during the Third European Congress on Inflammation/Infection Imaging in Rome, December 2019.

Cardiovascular (CV) imaging is an important tool in baseline risk assessment and detection of CV disease in oncology patients receiving cardiotoxic cancer therapies. This position statement examines the role of echocardiography, cardiac magnetic resonance, nuclear cardiac imaging and computed tomography in the management of cancer patients. The Imaging and Cardio-Oncology Study Groups of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in collaboration with the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the ESC have evaluated the current evidence for the value of modern CV imaging in the cardio-oncology field. The most relevant echocardiographic parameters, including global longitudinal strain and three-dimensional ejection fraction, are proposed. The protocol for baseline pre-treatment evaluation and specific surveillance algorithms or pathways for anthracycline chemotherapy, HER2-targeted therapies such as trastuzumab, vascular endothelial growth factor tyrosine kinase inhibitors, BCr-Abl tyrosine kinase inhibitors, proteasome inhibitors and immune checkpoint inhibitors are presented. The indications for CV imaging after completion of oncology treatment are considered. The typical consequences of radiation therapy and the possibility of their identification in the long term are also summarized. Special populations are discussed including female survivors planning pregnancy, patients with carcinoid disease, patients with cardiac tumours and patients with right heart failure. Future directions and ongoing CV imaging research in cardio-oncology are discussed.

Boron neutron capture therapy (BNCT) is a binary approach for cancer treatment in which boron-10 atoms and thermal neutrons need to colocalize to become effective. Recent research in the development of BNCT drug candidates focuses increasingly on nanomaterials, with the advantages of high boron loadings and passive targeting due to the enhanced permeability and retention (EPR) effect. The use of small boron-rich gold nanoparticles (AuNPs) in combination with a pretargeting approach is proposed. Small sized polyethylene glycol–stabilized AuNPs (core size 4.1 ± 1.5 nm), are synthesized and functionalized with thiolated cobalt bis(dicarbollide) and tetrazine. To enable in vivo tracking of the AuNPs by positron emission tomography (PET), the core is doped with [64Cu]CuCl2. For the pretargeting approach, the monoclonal antibody Trastuzumab is functionalized with trans-cyclooctene-N-hydroxysuccinimide ester. After proving in vitro occurrence of the antibody conjugation onto the AuNPs by click reaction and the low toxicity of the AuNPs, the boron delivery system is evaluated in vivo using breast cancer xenograft bearing mice and PET imaging. Tumor uptake due to the EPR effect can be witnessed with ≈5% injected dose (ID) cm−3 at 24 h postinjection, but with slower clearance than expected. Therefore, no increased retention can be observed using the pretargeting strategy.

Infective endocarditis (IE) is a serious cardiac condition, which includes a wide range of clinical presentations, with varying degrees of severity. The diagnosis is multifactorial and a proper characterization of disease requires the identification of the primary site of infection (usually the cardiac valve) and the search of secondary systemic complications. Early depiction of local complications or distant embolization has a great impact on patient management and prognosis, as it may induce to aggressive antibiotic treatment or, in more advanced cases, cardiac surgery. In this setting, the multimodality imaging has assumed a pivotal role in the clinical decision making and it requires the physician to be aware of the advantages and disadvantages of each imaging technique. Echocardiography is the first imaging test, but it has several limitations. Therefore, the integration with other imaging modalities (computed tomography, magnetic resonance imaging, nuclear imaging) becomes often necessary. Different strategies should be applied depending on whether the infection is suspected or already ascertained, whether located in native or prosthetic valves, in the left or right chambers, or if it involves an implanted cardiac device. In addition, detection of extracardiac IE-related lesions is crucial for a correct management and treatment. The aim of this review is to illustrate strengths and weaknesses of the various methods in the most common clinical scenarios.

Radiation therapy along with chemotherapy and surgery remain the main cancer treatments. Radiotherapy can be applied to patients externally (external beam radiotherapy) or internally (brachytherapy and radioisotope therapy). Previously, nanoencapsulation of radioactive crystals within carbon nanotubes, followed by end-closing, resulted in the formation of nanocapsules that allowed ultrasensitive imaging in healthy mice. Herein we report on the preparation of nanocapsules initially sealing “cold” isotopically enriched samarium (152Sm), which can then be activated on demand to their “hot” radioactive form (153Sm) by neutron irradiation. The use of “cold” isotopes avoids the need for radioactive facilities during the preparation of the nanocapsules, reduces radiation exposure to personnel, prevents the generation of nuclear waste, and evades the time constraints imposed by the decay of radionuclides. A very high specific radioactivity is achieved by neutron irradiation (up to 11.37 GBq/mg), making the “hot” nanocapsules useful not only for in vivo imaging but also therapeutically effective against lung cancer metastases after intravenous injection. The high in vivo stability of the radioactive payload, selective toxicity to cancerous tissues, and the elegant preparation method offer a paradigm for application of nanomaterials in radiotherapy.

[Abstract] Amyloidosis is an infiltrative disease caused by extracellular protein deposition that has accumulated a lot of scientific production in recent years. Different types of amyloidosis can affect the heart. Transthyretin amyloidosis and light chain amyloidosis are the two most common types of cardiac amyloidosis. These entities have a poor prognosis, so accurate diagnostic techniques are imperative for determining an early therapeutic approach. Recent advances in cardiac imaging and diagnostic strategies show that these tools are safe and can avoid the use of invasive diagnostic techniques to histological confirmation, such as endomyocardial biopsy. We performed a review on the diagnostic and prognostic implications of different cardiac imaging techniques in cardiac amyloidosis. We mainly focus on reviewing echocardiography, cardiac magnetic resonance, computed tomography and nuclear imaging techniques and the different safety measurements that can be done with each of them.

Heavy metals such as zinc are essential for plant growth, but toxic at high concentrations. Despite our knowledge of the molecular mechanisms of heavy metal uptake by plants, experimentally addressing the real-time whole-plant dynamics of heavy metal uptake and partitioning has remained a challenge. To overcome this, we applied a high sensitivity gamma-ray imaging system to image uptake and transport of radioactive 65 Zn in whole-plant assays of Arabidopsis thaliana and the Zn hyperaccumulator Arabidopsis halleri. We show that our system can be used to quantitatively image and measure uptake and root-to-shoot translocation dynamics of zinc in real time. In the metal hyperaccumulator Arabidopsis halleri, 65 Zn uptake and transport from its growth media to the shoot occurs rapidly and on time scales similar to those reported in rice. In transgenic A. halleri plants in which expression of the zinc transporter gene HMA4 is suppressed by RNAi, 65 Zn uptake is completely abolished.

Heavy metals such as zinc are essential for plant growth, but toxic at high concentrations. Despite our knowledge of the molecular mechanisms of heavy metal uptake by plants, experimentally addressing the real-time whole-plant dynamics of heavy metal uptake and partitioning has remained a challenge. To overcome this, we applied a high sensitivity gamma-ray imaging system to image uptake and transport of radioactive 65Zn in whole-plant assays of Arabidopsis thaliana and the Zn hyperaccumulator Arabidopsis halleri. We show that our system can be used to quantitatively image and measure uptake and root-to-shoot translocation dynamics of zinc in real time. In the metal hyperaccumulator Arabidopsis halleri, 65Zn uptake and transport from its growth media to the shoot occurs rapidly and on time scales similar to those reported in rice. In transgenic A. halleri plants in which expression of the zinc transporter gene HMA4 is suppressed by RNAi, 65Zn uptake is completely abolished.

This review addresses nuclear SPECT and PET imaging in small animals in relation to the atherosclerotic disease process, one of our research topics of interest. Imaging of atherosclerosis in small animal models is challenging, as it operates at the limits of current imaging possibilities regarding sensitivity, a

Heavy metals such as zinc are essential for plant growth, but toxic at high concentrations. Despite our knowledge of the molecular mechanisms of heavy metal uptake by plants, experimentally addressing the real-time whole-plant dynamics of heavy metal uptake and partitioning has remained a challenge. To overcome this, we applied a high sensitivity gamma-ray imaging system to image uptake and transport of radioactive 65Zn in whole-plant assays of Arabidopsis thaliana and the Zn hyperaccumulator Arabidopsis halleri. We show that our system can be used to quantitatively image and measure uptake and root-to-shoot translocation dynamics of zinc in real time. In the metal hyperaccumulator Arabidopsis halleri, 65Zn uptake and transport from its growth media to the shoot occurs rapidly and on time scales similar to those reported in rice. In transgenic A. halleri plants in which expression of the zinc transporter gene HMA4 is suppressed by RNAi, 65Zn uptake is completely abolished.

Myriad advances in all fields of cardiac imaging have stimulated and reflected new understanding of cardiac performance, myocardial damage and the mechanisms of heart failure. In this paper, the Heart Failure Association assesses the potential usefulness of innovative imaging modalities in enabling more precise diagnostic and prognostic evaluation, as well as in guiding treatment strategies. Many new methods have gradually penetrated clinical practice and are on their way to becoming a part of routine evaluation. This paper focuses on myocardial deformation and three- dimensional ultrasound imaging; stress tests for the evaluation of contractile and filling function; the progress of magnetic resonance techniques; molecular imaging and other sound innovations. The Heart Failure Association aims to highlight the ways in which paradigms have shifted in several areas of cardiac assessment. These include reassessing of the simplified concept of ejection fraction and implementation of the new parameters of cardiac performance applicable to all heart failure phenotypes; switching from two-dimensional to more accurate and reproducible three-dimensional ultrasound volumetric evaluation; greater tissue characterization via recently developed magnetic resonance modalities; moving from assessing cardiac function and congestion at rest to assessing it during stress; from invasive to novel non-invasive hybrid techniques depicting coronary anatomy and myocardial perfusion; as well as from morphometry to the imaging of pathophysiologic processes such as inflammation and apoptosis. This position paper examines the specific benefits of imaging innovations for practitioners dealing with heart failure aetiology, risk stratification and monitoring, and, in addition, for scientists involved in the development of future research.

Nuclear medicine is a branch of medicine that uses radiation to provide infor¬mation about the functioning of a person’s specific tissue/organs or to treat a disease. Radiolabeled nanoparticles (NPs) represent a new class of agents with a great potential for nuclear medicine applications. The key advantage of using radiolabeled NPs is that a very small amount can be used to obtain information of great importance.1 They may be used to detect and characterize disease, to deliver relevant therapeutics, and to monitor the therapeutic effect as well. Furthermore radiotracer-based imaging either using single-photon emission computed tomog¬raphy (SPECT) or positron emission tomography (PET) is particularly suited in the study of pharmacokinetic/pharmacodynamic parameters of nanomaterials and determination of their optimal nanodimensional architecture for tissue/organ re¬generation. Measuring radiation from radioactive tracers attached to NPs has been demonstrated to be a highly sensitive and specific method that allows accurate quantification, without limits to tissue penetration in any organ. Nuclear imaging approaches are highly suitable for detection, as they offer a high detection sensitiv¬ity at high temporal and spatial resolutions, requiring a radionuclide concentration of around 10−10 M at the site of interest.Nanoparticulate agents typically demonstrate pharmacokinetic behavior differ¬ent from that of small molecules2 and provide flexible platforms for integration of multiple functional entities, including targeting ligands, multiple types of contrast materials, and/or therapeutics. In contrast to traditional compounds used for radio¬pharmaceutical preparation, nanomaterials have an immense available surface area per unit of volume and tunable optical, electronic, magnetic, and biological proper¬ties. Generally, they can be tailored to meet the needs of specific applications and engineered to have different physicochemical properties that affect in vivo biodis¬tri

Nuclear medicine is a branch of medicine that uses radiation to provide infor¬mation about the functioning of a person’s specific tissue/organs or to treat a disease. Radiolabeled nanoparticles (NPs) represent a new class of agents with a great potential for nuclear medicine applications. The key advantage of using radiolabeled NPs is that a very small amount can be used to obtain information of great importance.1 They may be used to detect and characterize disease, to deliver relevant therapeutics, and to monitor the therapeutic effect as well. Furthermore radiotracer-based imaging either using single-photon emission computed tomog¬raphy (SPECT) or positron emission tomography (PET) is particularly suited in the study of pharmacokinetic/pharmacodynamic parameters of nanomaterials and determination of their optimal nanodimensional architecture for tissue/organ re¬generation. Measuring radiation from radioactive tracers attached to NPs has been demonstrated to be a highly sensitive and specific method that allows accurate quantification, without limits to tissue penetration in any organ. Nuclear imaging approaches are highly suitable for detection, as they offer a high detection sensitiv¬ity at high temporal and spatial resolutions, requiring a radionuclide concentration of around 10−10 M at the site of interest.Nanoparticulate agents typically demonstrate pharmacokinetic behavior differ¬ent from that of small molecules2 and provide flexible platforms for integration of multiple functional entities, including targeting ligands, multiple types of contrast materials, and/or therapeutics. In contrast to traditional compounds used for radio¬pharmaceutical preparation, nanomaterials have an immense available surface area per unit of volume and tunable optical, electronic, magnetic, and biological proper¬ties. Generally, they can be tailored to meet the needs of specific applications and engineered to have different physicochemical properties that affect in vivo biodis¬tri

Nuclear medicine is a branch of medicine that uses radiation to provide infor¬mation about the functioning of a person’s specific tissue/organs or to treat a disease. Radiolabeled nanoparticles (NPs) represent a new class of agents with a great potential for nuclear medicine applications. The key advantage of using radiolabeled NPs is that a very small amount can be used to obtain information of great importance.1 They may be used to detect and characterize disease, to deliver relevant therapeutics, and to monitor the therapeutic effect as well. Furthermore radiotracer-based imaging either using single-photon emission computed tomog¬raphy (SPECT) or positron emission tomography (PET) is particularly suited in the study of pharmacokinetic/pharmacodynamic parameters of nanomaterials and determination of their optimal nanodimensional architecture for tissue/organ re¬generation. Measuring radiation from radioactive tracers attached to NPs has been demonstrated to be a highly sensitive and specific method that allows accurate quantification, without limits to tissue penetration in any organ. Nuclear imaging approaches are highly suitable for detection, as they offer a high detection sensitiv¬ity at high temporal and spatial resolutions, requiring a radionuclide concentration of around 10−10 M at the site of interest.Nanoparticulate agents typically demonstrate pharmacokinetic behavior differ¬ent from that of small molecules2 and provide flexible platforms for integration of multiple functional entities, including targeting ligands, multiple types of contrast materials, and/or therapeutics. In contrast to traditional compounds used for radio¬pharmaceutical preparation, nanomaterials have an immense available surface area per unit of volume and tunable optical, electronic, magnetic, and biological proper¬ties. Generally, they can be tailored to meet the needs of specific applications and engineered to have different physicochemical properties that affect in vivo biodis¬tri

Introduction: Detection of vulnerable plaques is critically important for the selection of appropriate treatment and/or the prevention of atherosclerosis and ensuing cardiovascular diseases. In order to clarify the utility of [11C]acetate for atherosclerosis imaging, we determined the uptake and metabolism of acetate by in vitro studies using rabbit atherosclerotic arteries and [14C]acetate. Methods: Rabbits were fed with a conventional (n = 5) or a 0.5% cholesterol diet (n = 6). One side of the iliac-femoral arteries was injured by a balloon catheter. Radioactivity levels in the iliac-femoral arteries were measured after incubation in DMEM containing [1-14C]acetate for 60 min (% dpm/mg tissue). Radioactive components in the homogenized arteries were partitioned into aqueous, organic, and residue fractions by the Folch method, and analyzed by thin-layer chromatography (TLC). Results: The radioactivity level in the injured arteries of rabbits fed with the 0.5% cholesterol diet (atherosclerotic arteries) was significantly higher than that in either the non-injured or injured arteries of rabbits fed with the conventional diet (p < 0.05) (% dpm/mg tissue: conventional diet groups; 0.022 ± 0.005 and 0.024 ± 0.007, cholesterol diet groups; 0.029 ± 0.007 and 0.034 ± 0.005 for non-injured and injured arteries). In metabolite analysis, most of the radioactivity was found in the aqueous fraction in each group (87.4-94.6% of total radioactivity in the arteries), and glutamate was a dominant component (67.4-69.7% of the aqueous fraction in the arteries). Conclusions: The level of [14C]acetate-derived radioactivity into the arteries was increased by balloon injury and the burden of a cholesterol diet. Water-soluble metabolites were the dominant components with radioactivity in the atherosclerotic lesions. These results provide a biological basis for imaging atherosclerotic lesions by PET using [11C]acetate.

Introduction: Detection of vulnerable plaques is critically important for the selection of appropriate treatment and/or the prevention of atherosclerosis and ensuing cardiovascular diseases. In order to clarify the utility of [11C]acetate for atherosclerosis imaging, we determined the uptake and metabolism of acetate by in vitro studies using rabbit atherosclerotic arteries and [14C]acetate. Methods: Rabbits were fed with a conventional (n = 5) or a 0.5% cholesterol diet (n = 6). One side of the iliac-femoral arteries was injured by a balloon catheter. Radioactivity levels in the iliac-femoral arteries were measured after incubation in DMEM containing [1-14C]acetate for 60 min (% dpm/mg tissue). Radioactive components in the homogenized arteries were partitioned into aqueous, organic, and residue fractions by the Folch method, and analyzed by thin-layer chromatography (TLC). Results: The radioactivity level in the injured arteries of rabbits fed with the 0.5% cholesterol diet (atherosclerotic arteries) was significantly higher than that in either the non-injured or injured arteries of rabbits fed with the conventional diet (p < 0.05) (% dpm/mg tissue: conventional diet groups; 0.022 ± 0.005 and 0.024 ± 0.007, cholesterol diet groups; 0.029 ± 0.007 and 0.034 ± 0.005 for non-injured and injured arteries). In metabolite analysis, most of the radioactivity was found in the aqueous fraction in each group (87.4-94.6% of total radioactivity in the arteries), and glutamate was a dominant component (67.4-69.7% of the aqueous fraction in the arteries). Conclusions: The level of [14C]acetate-derived radioactivity into the arteries was increased by balloon injury and the burden of a cholesterol diet. Water-soluble metabolites were the dominant components with radioactivity in the atherosclerotic lesions. These results provide a biological basis for imaging atherosclerotic lesions by PET using [11C]acetate.

Introduction: Detection of vulnerable plaques is critically important for the selection of appropriate treatment and/or the prevention of atherosclerosis and ensuing cardiovascular diseases. In order to clarify the utility of [11C]acetate for atherosclerosis imaging, we determined the uptake and metabolism of acetate by in vitro studies using rabbit atherosclerotic arteries and [14C]acetate. Methods: Rabbits were fed with a conventional (n = 5) or a 0.5% cholesterol diet (n = 6). One side of the iliac-femoral arteries was injured by a balloon catheter. Radioactivity levels in the iliac-femoral arteries were measured after incubation in DMEM containing [1-14C]acetate for 60 min (% dpm/mg tissue). Radioactive components in the homogenized arteries were partitioned into aqueous, organic, and residue fractions by the Folch method, and analyzed by thin-layer chromatography (TLC). Results: The radioactivity level in the injured arteries of rabbits fed with the 0.5% cholesterol diet (atherosclerotic arteries) was significantly higher than that in either the non-injured or injured arteries of rabbits fed with the conventional diet (p < 0.05) (% dpm/mg tissue: conventional diet groups; 0.022 ± 0.005 and 0.024 ± 0.007, cholesterol diet groups; 0.029 ± 0.007 and 0.034 ± 0.005 for non-injured and injured arteries). In metabolite analysis, most of the radioactivity was found in the aqueous fraction in each group (87.4-94.6% of total radioactivity in the arteries), and glutamate was a dominant component (67.4-69.7% of the aqueous fraction in the arteries). Conclusions: The level of [14C]acetate-derived radioactivity into the arteries was increased by balloon injury and the burden of a cholesterol diet. Water-soluble metabolites were the dominant components with radioactivity in the atherosclerotic lesions. These results provide a biological basis for imaging atherosclerotic lesions by PET using [11C]acetate.

Nuclear medicine is a branch of medicine that uses radiation to provide infor¬mation about the functioning of a person’s specific tissue/organs or to treat a disease. Radiolabeled nanoparticles (NPs) represent a new class of agents with a great potential for nuclear medicine applications. The key advantage of using radiolabeled NPs is that a very small amount can be used to obtain information of great importance.1 They may be used to detect and characterize disease, to deliver relevant therapeutics, and to monitor the therapeutic effect as well. Furthermore radiotracer-based imaging either using single-photon emission computed tomog¬raphy (SPECT) or positron emission tomography (PET) is particularly suited in the study of pharmacokinetic/pharmacodynamic parameters of nanomaterials and determination of their optimal nanodimensional architecture for tissue/organ re¬generation. Measuring radiation from radioactive tracers attached to NPs has been demonstrated to be a highly sensitive and specific method that allows accurate quantification, without limits to tissue penetration in any organ. Nuclear imaging approaches are highly suitable for detection, as they offer a high detection sensitiv¬ity at high temporal and spatial resolutions, requiring a radionuclide concentration of around 10−10 M at the site of interest.Nanoparticulate agents typically demonstrate pharmacokinetic behavior differ¬ent from that of small molecules2 and provide flexible platforms for integration of multiple functional entities, including targeting ligands, multiple types of contrast materials, and/or therapeutics. In contrast to traditional compounds used for radio¬pharmaceutical preparation, nanomaterials have an immense available surface area per unit of volume and tunable optical, electronic, magnetic, and biological proper¬ties. Generally, they can be tailored to meet the needs of specific applications and engineered to have different physicochemical properties that affect in vivo biodis¬tri

Clinical ions beams for cancer treatment provide maximum energy deposition (Bragg peak (BP)) at the end of their range and practically no dose behind. This enables a more efficient therapeutic option comparing with classical photon-based radiotherapy where maximum energy is deposited at the body interface. Obviously, minimum-error BP detection is, thus, a key aspect of this treatment. This paper investigates a promising detection technique, based on the so-called ionoacoustic effect. The BP energy deposition causes a small (millikelvin) heating of the surrounding volume that in turn induces a pressure variation. This generates a sound signal that can be detected by an acoustic sensor placed at a certain distance from the BP point. Thus, the sound time-of-flight measure aims, with sound speed, to detect the BP position with very high accuracy (<1 mm). This paper presents the results of a complete cross-domain model that starting from proton beam energy provides the induced pressure variation in water, emulates the propagation of sound waves in the medium, and finally, returns a voltage signal whose time evolution determines BP position with an average deviation from effective position of 1% accuracy.

Purpose: Brown adipose tissue (BAT) research has evolved from an underestimated to a fast developing field. Its assumed curing properties for the world wide epidemic obesity, and its related diseases, makes this tissue an interesting target for a broad amount of non-invasive molecular BAT tracers. Apart from F-18-FDG PET/CT there are several methods to detect BAT and measure its metabolism in a more appropriate way. Especially interesting is the measure of lipid turnover, because fatty acids comprise the main fuel for active BAT. This review outlines different imaging modalities suitable for BAT imaging with the overall goal to explain the yet not completely understood mechanism in BAT and its quantitative contribution to whole body lipid and energy metabolism.Methods: Publications with focus on brown adipose tissue and lipid metabolism imaging are analyzed, different imaging approaches are introduced and promising BAT tracers are presented.Results: Radiolabelled and fluorescent fatty acids, labelled particles, H-3-Triolein and ADIFAB staining can give information about the inflow and therefore about the utilization of fatty acids which represents the activation state in vivo/in vitro. Non-invasive scanning with CT or MRI is a useful addition to those techniques.Conclusion: Lipid metabolism imaging offers the opportunity to visualize and quantify yet undiscovered aspects of BAT metabolic activities and is key to completely clarify its role in whole body lipid and energy metabolism. (C) 2017 Elsevier Inc. All rights reserved.

Restrictive cardiomyopathies (RCMs) are a diverse group of myocardial diseases with a wide range of aetiologies, including familial, genetic and acquired diseases and ranging from very rare to relatively frequent cardiac disorders. In all these diseases, imaging techniques play a central role. Advanced imaging techniques provide important novel data on the diagnostic and prognostic assessment of RCMs. This EACVI consensus document provides comprehensive information for the appropriateness of all non-invasive imaging techniques for the diagnosis, prognostic evaluation, and management of patients with RCM.

Purpose: Brown adipose tissue (BAT) research has evolved from an underestimated to a fast developing field. Its assumed curing properties for the world wide epidemic obesity, and its related diseases, makes this tissue an interesting target for a broad amount of non-invasive molecular BAT tracers. Apart from F-18-FDG PET/CT there are several methods to detect BAT and measure its metabolism in a more appropriate way. Especially interesting is the measure of lipid turnover, because fatty acids comprise the main fuel for active BAT. This review outlines different imaging modalities suitable for BAT imaging with the overall goal to explain the yet not completely understood mechanism in BAT and its quantitative contribution to whole body lipid and energy metabolism.Methods: Publications with focus on brown adipose tissue and lipid metabolism imaging are analyzed, different imaging approaches are introduced and promising BAT tracers are presented.Results: Radiolabelled and fluorescent fatty acids, labelled particles, H-3-Triolein and ADIFAB staining can give information about the inflow and therefore about the utilization of fatty acids which represents the activation state in vivo/in vitro. Non-invasive scanning with CT or MRI is a useful addition to those techniques.Conclusion: Lipid metabolism imaging offers the opportunity to visualize and quantify yet undiscovered aspects of BAT metabolic activities and is key to completely clarify its role in whole body lipid and energy metabolism. (C) 2017 Elsevier Inc. All rights reserved.

Increased cardiovascular morbidity and mortality in patients with type 2 diabetes is well established; diabetes is associated with at least a 2-fold increased risk of coronary heart disease. Approximately two-thirds of deaths among persons with diabetes are related to cardiovascular disease. Previously, diabetes was regarded as a "coronary risk equivalent," implying a high 10-year cardiovascular risk for every diabetes patient. Following the original study by Haffner et al., multiple studies from different cohorts provided varying conclusions on the validity of the concept of coronary risk equivalency in patients with diabetes. New guidelines have started to acknowledge the heterogeneity in risk and include different treatment recommendations for diabetic patients without other risk factors who are considered to be at lower risk. Furthermore, guidelines have suggested that further risk stratification in patients with diabetes is warranted before universal treatment. The Imaging Council of the American College of Cardiology systematically reviewed all modalities commonly used for risk stratification in persons with diabetes mellitus and summarized the data and recommendations. This document reviews the evidence regarding the use of noninvasive testing to stratify asymptomatic patients with diabetes with regard to coronary heart disease risk and develops an algorithm for screening based on available data.

OpenPET is an open source, modular, extendible, and high-performance platform suitable for multi-channel data acquisition and analysis. Due to the flexibility of the hardware, firmware, and software architectures, the platform is capable of interfacing with a wide variety of detector modules not only in medical imaging but also in homeland security applications. Analog signals from radiation detectors share similar characteristics - a pulse whose area is proportional to the deposited energy and whose leading edge is used to extract a timing signal. As a result, a generic design method of the platform is adopted for the hardware, firmware, and software architectures and implementations. The analog front-end is hosted on a module called a Detector Board, where each board can filter, combine, timestamp, and process multiple channels independently. The processed data is formatted and sent through a backplane bus to a module called Support Board, where 1 Support Board can host up to eight Detector Board modules. The data in the Support Board, coming from 8 Detector Board modules, can be aggregated or correlated (if needed) depending on the algorithm implemented or runtime mode selected. It is then sent out to a computer workstation for further processing. The number of channels (detector modules), to be processed, mandates the overall OpenPET System Configuration, which is designed to handle up to 1,024 channels using 16-channel Detector Boards in the Standard System Configuration and 16,384 channels using 32-channel Detector Boards in the Large System Configuration.

Prosthetic heart valve (PHV) dysfunction is rare but potentially life-threatening. Although often challenging, establishing the exact cause of PHV dysfunction is essential to determine the appropriate treatment strategy. In clinical practice, a comprehensive approach that integrates several parameters of valve morphology and function assessed with 2D/3D transthoracic and transoesophageal echocardiography is a key to appropriately detect and quantitate PHV dysfunction. Cinefluoroscopy, multidetector computed tomography, cardiac magnetic resonance imaging, and to a lesser extent, nuclear imaging are complementary tools for the diagnosis and management of PHV complications. The present document provides recommendations for the use of multimodality imaging in the assessment of PHVs.

OpenPET is an open source, modular, extendible, and high-performance platform suitable for multi-channel data acquisition and analysis. Due to the flexibility of the hardware, firmware, and software architectures, the platform is capable of interfacing with a wide variety of detector modules not only in medical imaging but also in homeland security applications. Analog signals from radiation detectors share similar characteristics - a pulse whose area is proportional to the deposited energy and whose leading edge is used to extract a timing signal. As a result, a generic design method of the platform is adopted for the hardware, firmware, and software architectures and implementations. The analog front-end is hosted on a module called a Detector Board, where each board can filter, combine, timestamp, and process multiple channels independently. The processed data is formatted and sent through a backplane bus to a module called Support Board, where 1 Support Board can host up to eight Detector Board modules. The data in the Support Board, coming from 8 Detector Board modules, can be aggregated or correlated (if needed) depending on the algorithm implemented or runtime mode selected. It is then sent out to a computer workstation for further processing. The number of channels (detector modules), to be processed, mandates the overall OpenPET System Configuration, which is designed to handle up to 1,024 channels using 16-channel Detector Boards in the Standard System Configuration and 16,384 channels using 32-channel Detector Boards in the Large System Configuration.