Gout is characterized by an acute inflammatory reaction and the accumulation of neutrophils in response to monosodium urate (MSU) crystals. Inflammation resolves spontaneously within a few days, although MSU crystals can still be detected in the synovial fluid and affected tissues. Here we report that neutrophils recruited to sites of inflammation undergo oxidative burst and form neutrophil extracellular traps (NETs). Under high neutrophil densities, these NETs aggregate and degrade cytokines and chemokines via serine proteases. Tophi, the pathognomonic structures of chronic gout, share characteristics with aggregated NETs, and MSU crystals can induce NETosis and aggregation of NETs. In individuals with impaired NETosis, MSU crystals induce uncontrolled production of inflammatory mediators from neutrophils and persistent inflammation. Furthermore, in models of neutrophilic inflammation, NETosis-deficient mice develop exacerbated and chronic disease that can be reduced by adoptive transfer of aggregated NETs. These findings suggest that aggregated NETs promote the resolution of neutrophilic inflammation by degrading cytokines and chemokines and disrupting neutrophil recruitment and activation.
NMAR clearly outperforms the other methods for both moderate and severe artifacts. The proposed method reliably reduces metal artifacts from simulated as well as from clinical CT data. Computationally efficient and inexpensive compared to iterative methods, NMAR can be used as an additional step in any conventional sinogram inpainting-based MAR method.
In non-obese patients with a low and stable heart rate, prospectively ECG-triggered high-pitch spiral coronary CTA provides excellent image quality at a consistent dose below 1.0 mSv.
FSMAR should be used together with NMAR, a combination which ensures an accurate correction of both high and low frequencies. The algorithm is computationally inexpensive compared to iterative methods and methods with complex inpainting schemes. No parameters were chosen manually; it is ready for an application in clinical routine.
Substantial differences in the performance of today's DECT approaches were found for the application of virtual non-contrast and iodine imaging. Future MECT with realistic photon counting detectors currently can only perform comparably to dual source DECT at 100 kV/Sn 140 kV. Dual source concepts with photon counting detectors could be a solution to this problem, promising a better performance.
The advent of computed tomography (CT) has revolutionized radiology, and this revolution is still going on. Starting as a pure head scanner, modern CT systems are now able to perform whole-body examinations within a couple of seconds in isotropic resolution, single-rotation whole-organ perfusion, and temporal resolution to fulfill the needs of cardiac CT. Because of the increasing number of CT examinations in all age groups and overall medical-driven radiation exposure, dose reduction remains a hot topic. Although fast gantry rotation, broad detector arrays, and different dual-energy solutions were main topics in the past years, new techniques such as photon counting detectors, powerful x-ray tubes for low-kV scanning, automated image preprocessing, and machine learning algorithms have moved into focus today.
The aim of this article is to give an overview of the technical specifications of up-to-date available CT systems and recent hardware and software innovations for CT systems in the near future.
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