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Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus.

Thurman JM, Serkova NJ - F1000Res (2015)

Bottom Line: For neurological symptoms, vessel size imaging (VSI, an MRI approach utilizing T2-relaxing iron oxide nanoparticles) has shown promise as a diagnostic tool.Molecular imaging probes (mostly for MRI and nuclear medicine imaging) have also been developed for diagnosing SLE with high sensitivity, and for monitoring disease activity.We describe novel MRI and positron-emission tomography (PET) molecular imaging protocols using targeted iron oxide nanoparticles and radioactive ligands, respectively, for detection of SLE-associated inflammation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Colorado School of Medicine, Aurora, CO, 80045, USA.

ABSTRACT
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple different organs, including the kidneys and central nervous system (CNS). Conventional radiological examinations in SLE patients include volumetric/ anatomical computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US). The utility of these modalities is limited, however, due to the complexity of the disease. Furthermore, standard CT and MRI contrast agents are contraindicated in patients with renal impairment. Various radiologic methods are currently being developed to improve disease characterization in patients with SLE beyond simple anatomical endpoints. Physiological non-contrast MRI protocols have been developed to assess tissue oxygenation, glomerular filtration, renal perfusion, interstitial diffusion, and inflammation-driven fibrosis in lupus nephritis (LN) patients. For neurological symptoms, vessel size imaging (VSI, an MRI approach utilizing T2-relaxing iron oxide nanoparticles) has shown promise as a diagnostic tool. Molecular imaging probes (mostly for MRI and nuclear medicine imaging) have also been developed for diagnosing SLE with high sensitivity, and for monitoring disease activity. This paper reviews the challenges in evaluating disease activity in patients with LN and neuropsychiatric systemic lupus erythematosus (NPSLE). We describe novel MRI and positron-emission tomography (PET) molecular imaging protocols using targeted iron oxide nanoparticles and radioactive ligands, respectively, for detection of SLE-associated inflammation.

No MeSH data available.


Related in: MedlinePlus

Comparison of different molecular imaging modalities.The anatomic spatial resolution and sensitivity for different molecular imaging methods are shown. CT and MRI based methods have excellent anatomic resolution, whereas PET/CT and SPECT/CT have very high sensitivity.
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f1: Comparison of different molecular imaging modalities.The anatomic spatial resolution and sensitivity for different molecular imaging methods are shown. CT and MRI based methods have excellent anatomic resolution, whereas PET/CT and SPECT/CT have very high sensitivity.

Mentions: Radiologic imaging (US, CT, MRI and nuclear medicine,Figure 1) has presently only a minor role in the assessment of disease activity in patients with LN or NPSLE, but possesses promising potential for future molecular assessment. CT is based on scattering and absorbing of X-ray beams while passing through the tissues; CT has a great anatomical discrimination (spatial resolution 5 mm,Figure 1) but rather a limited soft tissues contrast. It has limited application in LN patients with renal impairment since iodine-based CT contrast dyes (which are necessary due to the poor intrinsic soft tissue contrast by CT) are often contra-indicated. US sends out pulses of high-frequency sound waves and detects returning echoes scattered from the tissues. It has a very good anatomical resolution and an excellent potential for dynamic scans (Doppler). US was recently reported as a valuable platform to identify sub-clinical joint manifestations (to predict the risk of chronic deformities such as Jaccoud’s Arthropathy) in SLE patients6. US is also frequently performed to examine the kidneys of patients with renal abnormalities, and it is also routinely used to guide kidney biopsies. Conventional US can detect gross changes in the kidney size and contour. Radiologically small kidneys have likely sustained chronic, irreversible changes. Decreased blood flow by Doppler might indicate irreversible disease, and it has been postulated that inflammation can initially manifest with increased blood flow. Beyond this, however, US is not useful for detecting or staging LN.


Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus.

Thurman JM, Serkova NJ - F1000Res (2015)

Comparison of different molecular imaging modalities.The anatomic spatial resolution and sensitivity for different molecular imaging methods are shown. CT and MRI based methods have excellent anatomic resolution, whereas PET/CT and SPECT/CT have very high sensitivity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4536614&req=5

f1: Comparison of different molecular imaging modalities.The anatomic spatial resolution and sensitivity for different molecular imaging methods are shown. CT and MRI based methods have excellent anatomic resolution, whereas PET/CT and SPECT/CT have very high sensitivity.
Mentions: Radiologic imaging (US, CT, MRI and nuclear medicine,Figure 1) has presently only a minor role in the assessment of disease activity in patients with LN or NPSLE, but possesses promising potential for future molecular assessment. CT is based on scattering and absorbing of X-ray beams while passing through the tissues; CT has a great anatomical discrimination (spatial resolution 5 mm,Figure 1) but rather a limited soft tissues contrast. It has limited application in LN patients with renal impairment since iodine-based CT contrast dyes (which are necessary due to the poor intrinsic soft tissue contrast by CT) are often contra-indicated. US sends out pulses of high-frequency sound waves and detects returning echoes scattered from the tissues. It has a very good anatomical resolution and an excellent potential for dynamic scans (Doppler). US was recently reported as a valuable platform to identify sub-clinical joint manifestations (to predict the risk of chronic deformities such as Jaccoud’s Arthropathy) in SLE patients6. US is also frequently performed to examine the kidneys of patients with renal abnormalities, and it is also routinely used to guide kidney biopsies. Conventional US can detect gross changes in the kidney size and contour. Radiologically small kidneys have likely sustained chronic, irreversible changes. Decreased blood flow by Doppler might indicate irreversible disease, and it has been postulated that inflammation can initially manifest with increased blood flow. Beyond this, however, US is not useful for detecting or staging LN.

Bottom Line: For neurological symptoms, vessel size imaging (VSI, an MRI approach utilizing T2-relaxing iron oxide nanoparticles) has shown promise as a diagnostic tool.Molecular imaging probes (mostly for MRI and nuclear medicine imaging) have also been developed for diagnosing SLE with high sensitivity, and for monitoring disease activity.We describe novel MRI and positron-emission tomography (PET) molecular imaging protocols using targeted iron oxide nanoparticles and radioactive ligands, respectively, for detection of SLE-associated inflammation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Colorado School of Medicine, Aurora, CO, 80045, USA.

ABSTRACT
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple different organs, including the kidneys and central nervous system (CNS). Conventional radiological examinations in SLE patients include volumetric/ anatomical computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US). The utility of these modalities is limited, however, due to the complexity of the disease. Furthermore, standard CT and MRI contrast agents are contraindicated in patients with renal impairment. Various radiologic methods are currently being developed to improve disease characterization in patients with SLE beyond simple anatomical endpoints. Physiological non-contrast MRI protocols have been developed to assess tissue oxygenation, glomerular filtration, renal perfusion, interstitial diffusion, and inflammation-driven fibrosis in lupus nephritis (LN) patients. For neurological symptoms, vessel size imaging (VSI, an MRI approach utilizing T2-relaxing iron oxide nanoparticles) has shown promise as a diagnostic tool. Molecular imaging probes (mostly for MRI and nuclear medicine imaging) have also been developed for diagnosing SLE with high sensitivity, and for monitoring disease activity. This paper reviews the challenges in evaluating disease activity in patients with LN and neuropsychiatric systemic lupus erythematosus (NPSLE). We describe novel MRI and positron-emission tomography (PET) molecular imaging protocols using targeted iron oxide nanoparticles and radioactive ligands, respectively, for detection of SLE-associated inflammation.

No MeSH data available.


Related in: MedlinePlus