Nephrogenic systemic fibrosis and its impact on abdominal imaging.
ABSTRACT The objective of this article is to review the current knowledge about nephrogenic systemic fibrosis (NSF) and how to prevent it. More than 300 cases of NSF in patients with severe chronic renal insufficiency or acute renal failure or in patients undergoing dialysis have been reported in the peer-reviewed literature, with an overwhelming majority occurring within weeks to months after injection of a gadolinium-based contrast agent (GBCA). Because administration of a high dose of a GBCA is a primary risk factor and because most high-dose magnetic resonance (MR) imaging applications involve abdominal imaging (eg, liver and abdominal MR angiography), NSF cases have been associated with abdominal MR imaging. Additional major risk factors for developing NSF include proinflammatory conditions, failure to perform dialysis promptly after GBCA administration, use of nonionic linear contrast agents, hyperphosphatemia, and younger age. Recent recommendations to use GBCAs with caution in patients with acute renal failure, patients receiving dialysis, or patients with an estimated glomerular filtration rate of less than 30 mL/min have resulted in virtually no new NSF cases being reported with onset in 2008 or 2009 in spite of a high level of awareness about this entity. In conclusion, NSF has been virtually eliminated by using caution in administering GBCAs to patients known to have severe or acute renal failure. In these patients, avoid high doses; and for patients undergoing dialysis, schedule MR imaging to occur just before a dialysis session to ensure rapid elimination of gadolinium.
SourceAvailable from: Danyang Li[Show abstract] [Hide abstract]
ABSTRACT: T 1 contrast agents based on Mn(II) were conjugated on amphiphilic dextran micelles via click chemistry. The obtained paramagnetic nanomicelle contrast agent has a higher T1 relaxivity (13.3 Mn mmol−1 s−1) and better sensitivity than those of free Mn(II) complexes. Studies carried out in vivo suggest that this contrast agent has a better and long-acting vascular enhancement effect at a lower manganese dosage (0.1 Mn mmol kg−1 BW).02/2015; 3(8). DOI:10.1039/C4TB02036G
[Show abstract] [Hide abstract]
ABSTRACT: Paramagnetic gadolinium (Gd-III)-ion-doped upconversion nanoparticles (UCNPs) are attractive optical-magnetic molecule imaging probes and are a highly promising nanoplatform for future theranostic nanomedicine design. However, the related relaxivity mechanism of this contrast agent is still not well understood and no significant breakthrough in relaxivity enhancement has been achieved. Here, the origin and optimization of both the longitudinal (r1) and transverse (r2) relaxivities are investigated using models of water soluble core@shell structured Gd3+-doped UCNPs. The longitudinal relaxivity enhancement of the nanoprobe is demonstrated to be co-contributed by inner-and outer-sphere mechanisms for ligand-free probes, and mainly by outer-sphere mechanism for silica-shielded probes. The origin of the transverse relaxivity is inferred to be mainly from an outer-sphere mechanism regardless of surface-coating, but with the r2 values highly related to the surface-state. Key factors that influence the observed relaxivities and r2/r1 ratios are investigated in detail and found to be dependent on the thickness of the NaGdF4 interlayer and the related surface modifications. A two orders of magnitude (105-fold) enhancement in r1 relaxivity and 18-fold smaller r2/r1 ratio compared to the first reported values are achieved, providing a new perspective for magnetic resonance (MR) sensitivity optimization and multimodality biological imaging using Gd3+-doped UCNPs.Advanced Functional Materials 01/2013; 23(3). DOI:10.1002/adfm.201201469 · 10.44 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Modern radiologic imaging is an aid to treatment planning for localized renal cancer, enabling characterization of mass lesions. For patients who present with advanced renal cancer, new imaging techniques enable a functional assessment of treatment response not possible using anatomic measurements alone. Multidetector CT urography permits simultaneous assessment of the kidneys and urinary tract for patients with unexplained hematuria. Both CT and MRI play a significant role in staging and follow up of patients treated for urothelial cancer. Newer imaging methods such as diffusion-weighted MRI have shown promising results for improving accuracy of staging and follow up of urothelial cancer.Surgical Oncology Clinics of North America 10/2014; 23(4). DOI:10.1016/j.soc.2014.06.001 · 1.67 Impact Factor