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Article: A Systematic Review of the Efficacy and Safety of Mulberry Formulations for Chemotherapy- and/or Radiotherapy-Induced Oral Mucositis.

Raghunand Sindhe, J / Asha, V / Arvind, Muthukrishnan / Shabana, Shaik / Sowbhagya Lakshmi, A / Tanvi, Khandekar / Ananta, Gimre

Cureus

2024 Volume 16, Issue 1, Page(s) e52340

Abstract: ... with other interventions. Out of 30 articles retrieved, four articles with a cumulative sample size of (N = 297) were ...

Abstract	Oral mucositis (OM) is one of the common side effects of radiotherapy and chemotherapy. It is an extremely painful condition characterized by erythema, edema, and ulceration of the oral mucosa. Many plant-based and chemical formulations are used to prevent OM. The aim of the study is to evaluate the efficacy and safety of different black mulberry formulations in chemotherapy and/or radiotherapy-induced OM. A systematic search was performed using PubMed, Excerpta Medica database (Embase), the Cochrane Library, and Web of Science databases for articles published until March 2023. We have included studies conducted on people undergoing chemotherapy and/or radiotherapy and compared the effect of any mulberry formulation with other interventions. Out of 30 articles retrieved, four articles with a cumulative sample size of (N = 297) were included in the review. Mulberry formulations were compared with no intervention, grape molasses, chlorhexidine, and sodium bicarbonate. Out of the four articles, in three articles, mulberry formulations showed a significant decrease in grade 2 and grade 3 OM and also showed better prevention of OM as compared to the other intervention and control groups, and in one article, the grape molasses was more preventive for the occurrence of OM. Mulberry showed a significant decrease in dry mouth. Mulberry showed more improvement in the pain score and quality of life. The incidence and severity were lower in the mulberry group than in other interventions. One article showed less weight loss, and another article showed gradual weight gain from the use of mulberries. From this, we conclude that mulberry is effective for the treatment of OM. Mulberry also shows improvement in the pain score and quality of life.
Language	English
Publishing date	2024-01-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.52340
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Article: Analysis of MRI radiomic pelvimetry and correlation with margin status after robotic prostatectomy.

Youssef, Irini / Poch, Michael / Raghunand, Natarajan / Pow-Sang, Julio / Johnstone, Peter A S

The Canadian journal of urology

2022 Volume 29, Issue 1, Page(s) 10976–10978

Abstract: ... at our center between 1/1/2018 and 12/31/2019 (n = 314) who had undergone prior prostate MRI imaging (n = 102 ...

Abstract	Introduction: To evaluate the use of preoperative magnetic resonance imaging (MRI) as a predictor of positive margins after radical prostatectomy (RP). This is important as such patients may benefit from postoperative radiotherapy. With the advent of preoperative MRI, we posited that pelvimetry could predict positive margins after RP in patients with less-than ideal pelvic dimensions undergoing robotic-assisted laparoscopic surgery. Materials and methods: After IRB approval, data from patients undergoing RP at our center between 1/1/2018 and 12/31/2019 (n = 314) who had undergone prior prostate MRI imaging (n = 102) were analyzed. All RPs were performed using robotic-assisted laparoscopic technique. Data from the cancer center data warehouse were retrieved, to include postoperative T-stage, gland size, responsible surgeon, PSA, patient body mass index, and surgical margin status. These data were analyzed with corresponding pelvimetry data from 91 preoperative scans with complete data and imaging. Results: On multivariable analysis, pathologic T-stage (p = 0.004), anteroposterior pelvic outlet (p = 0.015) and pelvic depth (length of the pubic symphysis; p = 0.019) were all statistically correlated with positive surgical margins. Conclusions: With the widespread use of MRI in the initial staging of prostate cancer, automated radiomic analysis could augment the critical data already being accumulated in terms of seminal vesical involvement, extracapsular extension, and suspicious lymph nodes as risk factors for postoperative salvage radiation. Such automated data could help screen patients preoperatively for robotic RP.
MeSH term(s)	Humans ; Magnetic Resonance Imaging ; Male ; Margins of Excision ; Pelvimetry ; Prostate-Specific Antigen ; Prostatectomy/methods ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/surgery ; Retrospective Studies ; Robotic Surgical Procedures/adverse effects
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2022-02-25
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2064475-9
ISSN	1195-9479
ISSN	1195-9479
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Article ; Online: Bridging cell-scale simulations and radiologic images to explain short-time intratumoral oxygen fluctuations.

Kingsley, Jessica L / Costello, James R / Raghunand, Natarajan / Rejniak, Katarzyna A

PLoS computational biology

2021 Volume 17, Issue 7, Page(s) e1009206

Abstract: Radiologic images provide a way to monitor tumor development and its response to therapies in a longitudinal and minimally invasive fashion. However, they operate on a macroscopic scale (average value per voxel) and are not able to capture microscopic ... ...

Abstract	Radiologic images provide a way to monitor tumor development and its response to therapies in a longitudinal and minimally invasive fashion. However, they operate on a macroscopic scale (average value per voxel) and are not able to capture microscopic scale (cell-level) phenomena. Nevertheless, to examine the causes of frequent fast fluctuations in tissue oxygenation, models simulating individual cells' behavior are needed. Here, we provide a link between the average data values recorded for radiologic images and the cellular and vascular architecture of the corresponding tissues. Using hybrid agent-based modeling, we generate a set of tissue morphologies capable of reproducing oxygenation levels observed in radiologic images. We then use these in silico tissues to investigate whether oxygen fluctuations can be explained by changes in vascular oxygen supply or by modulations in cellular oxygen absorption. Our studies show that intravascular changes in oxygen supply reproduce the observed fluctuations in tissue oxygenation in all considered regions of interest. However, larger-magnitude fluctuations cannot be recreated by modifications in cellular absorption of oxygen in a biologically feasible manner. Additionally, we develop a procedure to identify plausible tissue morphologies for a given temporal series of average data from radiology images. In future applications, this approach can be used to generate a set of tissues comparable with radiology images and to simulate tumor responses to various anti-cancer treatments at the tissue-scale level.
MeSH term(s)	Cell Hypoxia/physiology ; Computational Biology ; Computer Simulation ; Humans ; Mathematical Concepts ; Models, Biological ; Neoplasms/blood supply ; Neoplasms/diagnostic imaging ; Neoplasms/metabolism ; Oxygen/metabolism ; Radiography ; Systems Analysis ; Tumor Hypoxia/physiology ; Tumor Microenvironment/physiology
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2021-07-26
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2193340-6
ISSN	1553-7358 ; 1553-734X
ISSN (online)	1553-7358
ISSN	1553-734X
DOI	10.1371/journal.pcbi.1009206
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Article: Tumor Response to Stroma-Modifying Therapy: Magnetic Resonance Imaging Findings in Early-Phase Clinical Trials of Pegvorhyaluronidase alpha (PEGPH20).

Arias-Lorza, Andrés M / Costello, James R / Hingorani, Sunil R / Von Hoff, Daniel D / Korn, Ronald L / Raghunand, Natarajan

Research square

2023

Abstract: Pre-clinical and clinical studies have shown that PEGPH20 depletes intratumoral hyaluronic acid (HA), which is linked to high interstitial fluid pressures and poor distribution of chemotherapies. 29 patients with metastatic advanced solid tumors received ...

Abstract	Pre-clinical and clinical studies have shown that PEGPH20 depletes intratumoral hyaluronic acid (HA), which is linked to high interstitial fluid pressures and poor distribution of chemotherapies. 29 patients with metastatic advanced solid tumors received quantitative magnetic resonance imaging (qMRI) in 3 prospective clinical trials of PEGPH20, HALO-109-101 (NCT00834704), HALO-109-102 (NCT01170897), and HALO-109-201 (NCT01453153). Apparent Diffusion Coefficient of water (ADC), T1,
Language	English
Publishing date	2023-09-05
Publishing country	United States
Document type	Preprint
DOI	10.21203/rs.3.rs-3314770/v1
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Article ; Online: Joint total variation-based reconstruction of multiparametric magnetic resonance images for mapping tissue types.

Pandey, Shraddha / Snider, A David / Moreno, Wilfrido A / Ravi, Harshan / Bilgin, Ali / Raghunand, Natarajan

NMR in biomedicine

2021 Volume 34, Issue 12, Page(s) e4597

Abstract: Multispectral analysis of coregistered multiparametric magnetic resonance (MR) images provides a powerful method for tissue phenotyping and segmentation. Acquisition of a sufficiently varied set of multicontrast MR images and parameter maps to ... ...

Abstract	Multispectral analysis of coregistered multiparametric magnetic resonance (MR) images provides a powerful method for tissue phenotyping and segmentation. Acquisition of a sufficiently varied set of multicontrast MR images and parameter maps to objectively define multiple normal and pathologic tissue types can require long scan times. Accelerated MRI on clinical scanners with multichannel receivers exploits techniques such as parallel imaging, while accelerated preclinical MRI scanning must rely on alternate approaches. In this work, tumor-bearing mice were imaged at 7 T to acquire k-space data corresponding to a series of images with varying T1-, T2- and T2-weighting. A joint reconstruction framework is proposed to reconstruct a series of T1-weighted images and corresponding T1 maps simultaneously from undersampled Cartesian k-space data. The ambiguity introduced by undersampling was resolved by using model-based constraints and structural information from a reference fully sampled image as the joint total variation prior. This process was repeated to reconstruct T2-weighted and T2-weighted images and corresponding maps of T2 and T2* from undersampled Cartesian k-space data. Validation of the reconstructed images and parameter maps was carried out by computing tissue-type maps, as well as maps of the proton density fat fraction (PDFF), proton density water fraction (PDwF), fat relaxation rate (
MeSH term(s)	Animals ; Female ; Image Processing, Computer-Assisted/methods ; Magnetic Resonance Imaging/methods ; Mice ; Mice, Inbred C57BL ; Neoplasms, Experimental/diagnostic imaging
Language	English
Publishing date	2021-08-13
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1000976-0
ISSN	1099-1492 ; 0952-3480
ISSN (online)	1099-1492
ISSN	0952-3480
DOI	10.1002/nbm.4597
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Zs.A 2869: Show issues

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Jg. 1995 - 2021: Lesesall (2.OG)
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Article: Tissue pH measurement by magnetic resonance spectroscopy and imaging.

Raghunand, Natarajan

Methods in molecular medicine

2006 Volume 124, Page(s) 347–364

Abstract: Noninvasive techniques for measurement of tissue pH can be invaluable in assessing disease extent and response to therapy in a variety of pathological conditions, such as renal acidosis and alkalosis, and cancers. We present the details of three ... ...

Abstract	Noninvasive techniques for measurement of tissue pH can be invaluable in assessing disease extent and response to therapy in a variety of pathological conditions, such as renal acidosis and alkalosis, and cancers. We present the details of three techniques for noninvasive measurement of tissue pH: magnetic resonance spectroscopy (MRS), magnetic resonance spectroscopic imaging (MRSI), and contrast-enhanced magnetic resonance imaging (MRI). These techniques exploit the pH-sensitivity of three different molecules, 3-aminopropylphosphonate (3-APP), (+/-) 2-imidazole-1-yl-3-ethoxycarbonyl propionic acid (IEPA), and 1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetrakis(acetamidomethylenephosphonic acid) (Gd-DOTA-4AmP), to examine local extracellular pH in vivo. The level of detail presented will enable nonnovice users of MRS and MRI to reproduce these methodologies in their own laboratories.
MeSH term(s)	Animals ; Connective Tissue/chemistry ; Contrast Media ; Humans ; Hydrogen-Ion Concentration ; Image Enhancement/methods ; Magnetic Resonance Imaging/methods ; Magnetic Resonance Spectroscopy/methods
Chemical Substances	Contrast Media
Language	English
Publishing date	2006-02-13
Publishing country	United States
Document type	Journal Article ; Review
ISSN	1543-1894
ISSN	1543-1894
DOI	10.1385/1-59745-010-3:347
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Article: Rules-based Volumetric Segmentation of Multiparametric MRI for Response Assessment in Recurrent High-Grade Glioma.

Ravi, Harshan / Hawkins, Samuel H / Stringfield, Olya / Pereira, Malesa / Chen, Dung-Tsa / Enderling, Heiko / Michael Yu, Hsiang-Hsuan / Arrington, John A / Sahebjam, Solmaz / Raghunand, Natarajan

Research square

2023

Abstract: We report domain knowledge-based rules for assigning voxels in brain multiparametric MRI (mpMRI) to distinct tissuetypes based on their appearance on Apparent Diffusion Coefficient of water (ADC) maps, T1-weighted unenhanced and contrast-enhanced, T2- ... ...

Abstract	We report domain knowledge-based rules for assigning voxels in brain multiparametric MRI (mpMRI) to distinct tissuetypes based on their appearance on Apparent Diffusion Coefficient of water (ADC) maps, T1-weighted unenhanced and contrast-enhanced, T2-weighted, and Fluid-Attenuated Inversion Recovery images. The development dataset comprised mpMRI of 18 participants with preoperative high-grade glioma (HGG), recurrent HGG (rHGG), and brain metastases. External validation was performed on mpMRI of 235 HGG participants in the BraTS 2020 training dataset. The treatment dataset comprised serial mpMRI of 32 participants (total 231 scan dates) in a clinical trial of immunoradiotherapy in rHGG (NCT02313272). Pixel intensity-based rules for segmenting contrast-enhancing tumor (CE), hemorrhage, Fluid, non-enhancing tumor (Edema1), and leukoaraiosis (Edema2) were identified on calibrated, co-registered mpMRI images in the development dataset. On validation, rule-based CE and High FLAIR (Edema1 + Edema2) volumes were significantly correlated with ground truth volumes of enhancing tumor (R = 0.85;p < 0.001) and peritumoral edema (R = 0.87;p < 0.001), respectively. In the treatment dataset, a model combining time-on-treatment and rule-based volumes of CE and intratumoral Fluid was 82.5% accurate for predicting progression within 30 days of the scan date. An explainable decision tree applied to brain mpMRI yields validated, consistent, intratumoral tissuetype volumes suitable for quantitative response assessment in clinical trials of rHGG.
Language	English
Publishing date	2023-09-11
Publishing country	United States
Document type	Preprint
DOI	10.21203/rs.3.rs-3318286/v1
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Article ; Online: Pretherapy Ferumoxytol-enhanced MRI to Predict Response to Liposomal Irinotecan in Metastatic Breast Cancer.

Ravi, Harshan / Arias-Lorza, Andres M / Costello, James R / Han, Hyo Sook / Jeong, Daniel K / Klinz, Stephan G / Sachdev, Jasgit C / Korn, Ronald L / Raghunand, Natarajan

Radiology. Imaging cancer

2023 Volume 5, Issue 2, Page(s) e220022

Abstract: Purpose To investigate ferumoxytol (FMX)-enhanced MRI as a pretreatment predictor of response to liposomal irinotecan (nal-IRI) for thoracoabdominal and brain metastases in women with metastatic breast cancer (mBC). Materials and Methods In this phase 1 ... ...

Abstract	Purpose To investigate ferumoxytol (FMX)-enhanced MRI as a pretreatment predictor of response to liposomal irinotecan (nal-IRI) for thoracoabdominal and brain metastases in women with metastatic breast cancer (mBC). Materials and Methods In this phase 1 expansion trial (ClinicalTrials.gov identifier, NCT01770353; 27 participants), 49 thoracoabdominal (19 participants; mean age, 48 years ± 11 [SD]) and 19 brain (seven participants; mean age, 54 years ± 8) metastases were analyzed on MR images acquired before, 1-4 hours after, and 16-24 hours after FMX administration. In thoracoabdominal metastases, tumor transverse relaxation rate (R*
MeSH term(s)	Female ; Humans ; Middle Aged ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/drug therapy ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/drug therapy ; Ferrosoferric Oxide ; Irinotecan/therapeutic use ; Magnetic Resonance Imaging/methods
Chemical Substances	Ferrosoferric Oxide (XM0M87F357) ; Irinotecan (7673326042)
Language	English
Publishing date	2023-02-03
Publishing country	United States
Document type	Clinical Trial, Phase I ; Journal Article ; Research Support, N.I.H., Extramural
ISSN	2638-616X
ISSN (online)	2638-616X
DOI	10.1148/rycan.220022
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Article ; Online: Identification of sarcomatoid differentiation in renal cell carcinoma by machine learning on multiparametric MRI.

Mazin, Asim / Hawkins, Samuel H / Stringfield, Olya / Dhillon, Jasreman / Manley, Brandon J / Jeong, Daniel K / Raghunand, Natarajan

Scientific reports

2021 Volume 11, Issue 1, Page(s) 3785

Abstract: Sarcomatoid differentiation in RCC (sRCC) is associated with a poor prognosis, necessitating more aggressive management than RCC without sarcomatoid components (nsRCC). Since suspected renal cell carcinoma (RCC) tumors are not routinely biopsied for ... ...

Abstract	Sarcomatoid differentiation in RCC (sRCC) is associated with a poor prognosis, necessitating more aggressive management than RCC without sarcomatoid components (nsRCC). Since suspected renal cell carcinoma (RCC) tumors are not routinely biopsied for histologic evaluation, there is a clinical need for a non-invasive method to detect sarcomatoid differentiation pre-operatively. We utilized unsupervised self-organizing map (SOM) and supervised Learning Vector Quantizer (LVQ) machine learning to classify RCC tumors on T2-weighted, non-contrast T1-weighted fat-saturated, contrast-enhanced arterial-phase T1-weighted fat-saturated, and contrast-enhanced venous-phase T1-weighted fat-saturated MRI images. The SOM was trained on 8 nsRCC and 8 sRCC tumors, and used to compute Activation Maps for each training, validation (3 nsRCC and 3 sRCC), and test (5 nsRCC and 5 sRCC) tumor. The LVQ classifier was trained and optimized on Activation Maps from the 22 training and validation cohort tumors, and tested on Activation Maps of the 10 unseen test tumors. In this preliminary study, the SOM-LVQ model achieved a hold-out testing accuracy of 70% in the task of identifying sarcomatoid differentiation in RCC on standard multiparameter MRI (mpMRI) images. We have demonstrated a combined SOM-LVQ machine learning approach that is suitable for analysis of limited mpMRI datasets for the task of differential diagnosis.
MeSH term(s)	Algorithms ; Carcinoma, Renal Cell/diagnosis ; Carcinoma, Renal Cell/diagnostic imaging ; Carcinoma, Renal Cell/pathology ; Cell Differentiation/genetics ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms/diagnosis ; Kidney Neoplasms/diagnostic imaging ; Kidney Neoplasms/pathology ; Machine Learning ; Male ; Multiparametric Magnetic Resonance Imaging
Language	English
Publishing date	2021-02-15
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-83271-4
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Article: Pancreatic Cyst Size Measurement on Magnetic Resonance Imaging Compared to Pathology.

Cancers

2024 Volume 16, Issue 1

Abstract: Background: While multiple cyst features are evaluated for stratifying pancreatic intraductal papillary mucinous neoplasms (IPMN), cyst size is an important factor that can influence treatment strategies. When magnetic resonance imaging (MRI) is used to ...

Abstract	Background: While multiple cyst features are evaluated for stratifying pancreatic intraductal papillary mucinous neoplasms (IPMN), cyst size is an important factor that can influence treatment strategies. When magnetic resonance imaging (MRI) is used to evaluate IPMNs, no universally accepted sequence provides optimal size measurements. T2-weighted coronal/axial have been suggested as primary measurement sequences; however, it remains unknown how well these and maximum all-sequence diameter measurements correlate with pathology size. This study aims to compare agreement and bias between IPMN long-axis measurements on seven commonly obtained MRI sequences with pathologic size measurements. Methods: This retrospective cohort included surgically resected IPMN cases with preoperative MRI exams. Long-axis diameter tumor measurements and the presence of worrisome features and/orhigh-risk stigmata were noted on all seven MRI sequences. MRI size and pathology agreement and MRI inter-observer agreement involved concordance correlation coefficient (CCC) and intraclass correlation coefficient (ICC), respectively. The presence of worrisome features and high-risk stigmata were compared to the tumor grade using kappa analysis. The Bland-Altman analysis assessed the systematic bias between MRI-size and pathology. Results: In 52 patients (age 68 ± 13 years, 22 males), MRI sequences produced mean long-axis tumor measurements from 2.45-2.65 cm. The maximum MRI lesion size had a strong agreement with pathology (CCC = 0.82 (95% CI: 0.71-0.89)). The maximum IPMN size was typically observed on the axial T1 arterial post-contrast and MRCP coronal series and overestimated size versus pathology with bias +0.34 cm. The radiologist interobserver agreement reached ICCs 0.74 to 0.91 on the MRI sequences. Conclusion: The maximum MRI IPMN size strongly correlated with but tended to overestimate the length compared to the pathology, potentially related to formalin tissue shrinkage during tissue processing.
Language	English
Publishing date	2024-01-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16010206
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