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Imaging and Therapy Basics

Module 1. Imaging and Therapy Basics. BioE 498/598DP. Dipanjan Pan, PhD Department of Bioengineering Beckman Institute of Advanced Imaging and Science dipanjan@illinois.edu. What is Imaging?. ( Ans : Let’s google it!). verb gerund or present participle:  imaging

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Imaging and Therapy Basics

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  1. Module 1 Imagingand Therapy Basics BioE 498/598DP Dipanjan Pan, PhD Department of Bioengineering Beckman Institute of Advanced Imaging and Science dipanjan@illinois.edu BioE 498/598DP

  2. What is Imaging? (Ans: Let’s google it!) BioE 498/598DP

  3. verb gerund or present participle: imaging make a representation of the external form of. "artworks that imaged women's bodies" • make a visual representation of (something) by scanning it with a detector or electromagnetic beam. "every point on the Earth's surface was imaged by the satellite" • COMPUTING make an exact copy of (a computer's hard disk). "the hard disk drive should be imaged using a specialized bit stream backup product" • form a mental picture or idea of. "it is possible for us to image a society in which no one committed crime" BioE 498/598DP Randall Munroe, XKCD: http://petapixel.com/2012/07/11/the-visual-field-of-the-human-eye/

  4. Why Imaging? BioE 498/598DP

  5. Images Speak for Themselves First Flight (Wright Brothers, 1903) Triassic period, 231.4 million years Tyrannosaurus rex(1902 and 1908, Montana, U.S.) First landing on Moon Neil Armstrong July 20, 1969 3500 BCE "First" clear image ever transmitted from the surface of Mars - shows rocks near the Viking 1 Lander (July 20, 1976) BioE 498/598DP

  6. Image Provides Us Information to Use For various purposes What is our goal: Use it for human health BioE 498/598DP

  7. The First Image Ever Taken circa 1826 1838 Taken by Louis Daguerre, in Paris View from the Window at Le Gras, Joseph NicéphoreNiépce BioE 498/598DP http://www.burnstudio.co.za/blog/first-photo-of-a-human-being/ http://www.hrc.utexas.edu/exhibitions/permanent/firstphotograph/

  8. How It All Started? U.S. President James Garfield was shot in 1881 Physicians were unable to determine if the bullet had entered a vital organ. This knowledge was needed quickly to decide the medical treatment required to save Garfield’s life. For the next 80 days, 16 doctors were consulted.The first doctor, stuck a non-sterile finger into the wound followed this by inserting a non sterile probing instrument to find the bullet. He never found the bullet. Followed by the navy surgeon general who searched with his finger so deeply that he really did puncture the liver. President James Garfield 20th President of the US Mar 4, 1881-Sept 19, 1881 Alexander Graham Bell Inventor of phone Mar 3, 1847 – Aug 2, 1922 BioE 498/598DP

  9. Alexander Graham Bell had just invented telephone and an induction coil (metal detector) Alexander Graham Bell rigged up a crude metal detector to help find the bullet. Bell had located the bullet and it was much deeper than was originally thought.  With Garfield's condition growing steadily worse, doctors decided to cut him open to remove the bullet. It was not found.  What Bell had actually located so deep in the body was the metal spring under the mattress!! Failed but “first” attempt to locate something inside human body Noninvasively BioE 498/598DP

  10. Why We Need Imaging for Human Health? Because it is dark inside! Various imaging methods cut through darkness noninvasively Fluorescence, ultrasound, computed tomography (CT), positron emission tomography, Magnetic resonance imaging Bioluminescent Jellyfish BioE 498/598DP

  11. First Medical Image Ever Taken Image of Röntgen’swife's hand The first X-ray image ever recorded Sharper X-ray image 116 yrs 1895 The first x-ray of the human body, taken by Conrad Röntgen on November 8, 1895. He called the new form of radiation he had discovered x-rays, with the X standing for unknown. BioE 498/598DP

  12. An x-ray revealed that an 18-month-old boyhad swallowed two disc batteries. (Source: Cedars-Sinai) BioE 498/598DP

  13. Probing the Past This CAT scan shows calcification in the bilateral carotid, bilateral subclavian, and brachiocephalic veins of Hatiay, a male Egyptian scribe aged 40–50 yrs, (1570–1293 Before Common Era), BioE 498/598DP

  14. A recent CT scan of a 2,400-year-old Egyptian mummy held in the Archaeological Museum of Zagreb, Croatia, revealed a rare example of an ancient tool used by embalmers for the removal of the brain during the mummification procedure BioE 498/598DP

  15. CT image of a hip replacement CT image of a broken arm with pins BioE 498/598DP

  16. Aortic aneurysm A volume rendering (VR) of a three-dimensional set of computed tomography (CT) images shown as a two-dimensional projection. BioE 498/598DP http://www.cedars-sinai.edu/Patients/Programs-and-Services/Imaging-Center/Image-Gallery-images/CapAngio01-Color-Pirouette.gif

  17. Heart valve, left, and heart valve in a heart, right. left: Normal subclavians; right: abnormal subclavians with positive occlusion (arrow). BioE 498/598DP

  18.  A specialized MRI of the Brain with Diffusion Tensor Imaging (DTI) Analysis showing the neural pathways, which displays how different parts of the brain are connected. When the pathways are tangled it can be an indication of shaken-baby syndrome. BioE 498/598DP

  19. “A man’s brain being removed and cut into hundreds of pieces to be handed out all around the world—without his family’s knowledge……..” BioE 498/598DP

  20. The Story • Year 1955: Autopsy on Albert Einstein was performed by pathologist Thomas S. Harvey • Photographed the scientist’s brain • Shared slices of it with fellow pathologists! • Harvey kept pictures of the dissected brain and pieces (170) of it for himself! • No permission for the removal and preservation had been given by Einstein or his family • Year 2007: Harvey died • Items eventually unearthed and given to the National Museum of Health & Medicine, in Silver Spring, Md. Harvey with Einstein’s ‘pickled’ brain BioE 498/598DP

  21. MRI Distribution Maps of Corpus Callosum Thickness Between Einstein and the Old Age Control Group BioE 498/598DP Brain2013, DOI: 10.1093/brain/awt252).

  22. MRI Distribution Maps of Corpus Callosum Thickness Between Einstein and the Young Age Control Group BioE 498/598DP

  23. Measurements of corpus callosum (CC) morphology and brain between Einstein and the two different age control groups BioE 498/598DP

  24. Close to Our Heart Paul C Lauterbur (May 6, 1929 -Mar 27, 2007) Raymond Damadian, First MRI Patent, 1974 When Lauterbur’s paper was rejected by Nature, however, after his persistance, it was published and is now acknowledged as a classic Nature paper. The Nature editors pointed out that the pictures accompanying the paper were too fuzzy They were the first images to show thedifferencebetween heavy water and ordinary water! Sir Peter Mansfield Nobel Prize for MRI, 2003 BioE 498/598DP Nature 242, 190-191 (1973)

  25. Why Contrast Agents? (Ans: Let’s google it!) BioE 498/598DP

  26. con·trast noun noun: contrast; plural noun: contrasts ˈkänˌtrast/ 1. the state of being strikingly different from something else, typically something in juxtaposition or close association. "the day began cold and blustery, in contrast to almost two weeks of uninterrupted sunshine" synonyms: difference, dissimilarity, disparity, distinction, contradistinction, divergence, variance, variation, differentiation; More antonyms: similarity the degree of difference between tones in a television picture, photograph, or other image. enhancement of the apparent brightness or clarity of a design provided by the juxtaposition of different colors or textures. the action of calling attention to notable differences. "use knowledge of other languages for contrast and comparison with English" a thing or person having qualities noticeably different from another. "the castle is quite a contrast to other places where the singer has performed" synonyms: opposite, antithesis; More verb verb: contrast; 3rd person present: contrasts; past tense: contrasted; past participle: contrasted; gerund or present participle: contrasting BioE 498/598DP

  27. Types of Contrast Agents-1 Optical Contrast Agent Radio Contrast Agent MRI Contrast Agent A mouse’s brain cerebellum tumor in optical imaging Stroke Modality Specific Cerebral angiogram Improve the visibility of internal structures in  X-ray based imaging altering the magnetic properties of nearby hydrogen nuclei Sonographic Contrast Agent Nuclear Contrast Agent Hepatocellular carcinoma Whole body PET scans showing the distribution of radio-labeled monamineoxidase Sound waves are reflected from interfaces between substances (backscattering) BioE 498/598DP

  28. Types of Contrast Agents-2 Biological Targeting BioE 498/598DP

  29. Orange areas of a PET/CT image indicate the uptake of 18F-fluoro-2-deoxy-D-glucose in a primary cancer lesion and a lymph node (Sam Gambhir, Stanford) Colon cancer scan captured by GE's PET/CT and the imaging agent FDG. The fused volume rendering of a PET/CT angiography provides both vascular and metabolic information. Bone (gray), vessels (red), and skin (brown) SEEING BLOOD A normal mouse reveals its vasculature with Fenestra. BioE 498/598DP

  30. Trends in Imaging En route to ‘Molecular’ Imaging Anatomical Imaging Physiological Imaging Molecular Imaging Structure Mechanism Target Morphology Morphometry Hemodynamics Vascular Permeability Tissue oxygenation/hypoxia CNS activity Metabolites pH Receptor mediated imaging Targeted contrast agents In vivo distributive properties BioE 498/598DP

  31. So Many Modalities Photoacoustic tomography Spectral Computed tomography Things to consider Resolution Depth penetration Speed of acquisition Quantification Sensitivity Ca interference “Speckle artifacts” Slow; Strong influence from motion Fast Ca interference No single modality is ideal for every application Quantitative Quantitative Comparison of resolution and imaging depths of the modalities; the "pendulum" length represents imaging depth, and the "sphere" size represents resolution. BioE 498/598DP Modified from http://obel.ee.uwa.edu.au/research/oct/intro/

  32. Sensitivity Temporal Resolution Spatial Resolution One imaging modality cannot cover the all aspects encountered in non-invasive imaging High spatial resolution (<100mm) High temporal resolution (<1s) High sensitivity (concentrations < 1mM) BioE 498/598DP

  33. What is Therapy (Ans: Let’s google it!) BioE 498/598DP

  34. Therapy(Latin therapīa; Greek: θεραπεία) literally means "curing, healing" and is the attempted remediation of a health problem, usually following a diagnosis. In the medical field, it is synonymous with the word "treatment". BioE 498/598DP

  35. Egyptian Reflexology Treatment EARLY 6th DYNASTY ABOUT 2,330 B.C. WALL PAINTING IN TOMB OF ANKHMAHOR(HIGHEST OFFICIAL AFTER THE KING) AT SAQQARA, AND IS KNOWN AS THE PHYSICIAN'S TOMBTRANSLATION READS "DON'T HURT ME." THE PRACTITIONER'S REPLY: "I SHALL ACT SO YOU PRAISE ME." BioE 498/598DP

  36. Eastern Rock Therapy Intelligence collects from generation to generation and gradually forms this unique BianstoneTherapeutics. It is lost since Eastern Han Dynasty (25-220 A.D.) for over 2000 years since the lack of suitable rock materials for making therapeutic tools BioE 498/598DP

  37. Middle Eastern Cupping Therapy This is an ancient therapy used by many cultures for thousands of years. It was employed in the Western hospitals, as well as the East BioE 498/598DP

  38. Spinal decompression therapy (SDT) is an alternative to surgery for those who suffer from chronic spine issues BioE 498/598DP  http://www.basicspine.com/blog/spinal-decompression-therapy/#ixzz2pULi2Hzc 

  39. A Whole Spectrum of Modern Therapies Vitruvian Man: a male figure in two superimposed positions with his arms and legs apart and simultaneously inscribed in a circle and square • Conventional • Surgery • Chemotherapy • Radiation • Immunotherapy • Stem cell transplant • Hormone therapy • Complementary • Nutrition • Pain management • Exercise • Spiritual support • Neutraceuticals • Physical therapy Leonardo da Vinci circa 1490 (correlations of ideal human proportions with geometry described by Roman architect Vitruvius -Book III of  De Architectura) Symmetry of the human body BioE 498/598DP

  40. Cancer Therapy BioE 498/598DP

  41. Cancer Therapy BioE 498/598DP

  42. Cancer Therapy Personalized therapy Drugs that block the growth and spread of cancer by interfering with specific molecules involved in carcinogenesis (the process by which normal cells are transformed into cancer cells) and tumor growth. BioE 498/598DP

  43. Next Lecture: Biological Barriers Targeting Nanomedicine BioE 498/598DP

  44. Specific Examples of “directed therapy” systems in the clinic today BioE 498/598DP

  45. Case 1: Rituximab • The Fc portion of rituximab mediates  • antibody-dependent cellular cytotoxicity (ADCC) • complement-dependent cytotoxicity (CDC) • has a general regulatory effect on the cell cycle • It induces apoptosis of CD20+ cells. • Elimination of B cells (including the cancerous ones) from the body, allowing a new population of healthy B cells to develop from lymphoid stem cells. Rituximab binding to CD20. The CD20 proteins are sticking out of the cell membrane, and rituximab, the Y-shaped antibody, is binding to the CD20 proteins Rituxan("Rituximab”) (for Non Hodgkins B-cell (CD20+) Lymphoma) BioE 498/598DP

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