Exudates of non-healing wounds contain drivers of pathogenicity. We utilized >800 exudates from non-healing and healing wounds of diverse etiologies, collected by three different methods, to develop a wound-specific, cell-based functional biomarker assay. Human dermal fibroblast proliferation served as readout to a) to differentiate between healing and non-healing wounds, b) follow the healing process of individual patients, and c) assess the effects of therapeutics for chronic wounds ex vivo. We observed a strong correlation between wound chronicity and inhibitory effects of individual exudates on fibroblast proliferation, with good diagnostic sensitivity (76-90%, depending on the sample collection method). Transition of a clinically non-healing to a healing phenotype restored fibroblast proliferation and extracellular matrix formation while reducing inflammatory cytokine production. Transcriptional analysis of fibroblasts exposed to ex vivo non-healing wound exudates revealed an induction of inflammatory cytokine- and chemokine pathways and the unfolded protein response, indicating that these changes may contribute to the pathology of non-healing wounds. Testing the wound therapeutics platelet derived growth factor and silver sulfadiazine yielded responses in line with clinical experience and indicate the usefulness of the assay to search for and profile new therapeutics.

BACKGROUND:The 2022 mpox outbreak continues, and while progress has been made in prevention strategies and potential treatment options, data on late sequelae following mpox are scarce. OBJECTIVE:This analysis aimed to assess the incidence of scar formation in individuals affected by the 2022 mpox outbreak. METHODS:All individuals diagnosed with mpox at the Department of Dermatology at the Medical University of Vienna in 2022 were included in this analysis. Follow-up data were collected throughout November 2023. 'Scar formation' was defined as having at least one scar at the former active mpox lesions. RESULTS:At our clinic, 28 cases of mpox presented between June 2022 and October 2022 and exclusively occurred in men who have sex with men (100%, 28/28), of whom 46% (13/28) were living with HIV, and 32% (9/28) were using pre-exposure prophylaxis (PrEP). Secondary bacterial infection of mpox lesions was suspected in six individuals, and all received systemic antibiotics. Overall, 26 were followed up in November 2023 after a median time of 15 months, and scar formations were found in 43% of cases. CONCLUSIONS:Our data provide insights into the late yet cumulating disease burden caused by the 2022 mpox outbreak. Highly effective prevention strategies are warranted to overcome the mpox epidemic and its potential late sequelae.

CMR at 3.0T in the presence of active cardiac implants remains a challenge due to susceptibility artifacts. Beyond a signal void that cancels image information, magnetic field inhomogeneities may cause distorted appearances of anatomical structures. Understanding influencing factors and the extent of distortion are a first step towards optimizing the image quality of CMR with active implants at 3.0T. All measurements were obtained at a clinical 3.0T scanner. An in-house designed phantom with a 3D cartesian grid of water filled spheres was used to analyze the distortion caused by four representative active cardiac devices (cardiac loop recorder, pacemaker, 2 ICDs). For imaging a gradient echo (3D-TFE) sequence and a turbo spin echo (2D-TSE) sequence were used. The work defines metrics to quantify the different features of distortion such as changes in size, location and signal intensity. It introduces a specialized segmentation technique based on a reaction-diffusion-equation. The distortion features are dependent on the amount of magnetic material in the active implants and showed a significant increase when measured with the 3D TFE compared to the 2D TSE. This work presents a quantitative approach for the evaluation of image distortion at 3.0T caused by active cardiac implants and serves as foundation for both further optimization of sequences and devices but also for planning of imaging procedures.

Cardiac myocyte sodium (Na+) homoeostasis is pivotal in cardiac diseases and heart failure. Intracellular Na+ ([Na+]i) is an important regulator of excitation–contraction coupling and mitochondrial energetics. In addition, extracellular Na+ ([Na+]e) and its water-free storage trigger collagen cross-linking, myocardial stiffening and impaired cardiac function. Therefore, understanding the allocation of tissue Na+ to intra- and extracellular compartments is crucial in comprehending the pathophysiological processes in cardiac diseases. We extrapolated [Na+]e using a three-compartment model, with tissue Na+ concentration (TSC) measured by in vivo 23Na-MRI, extracellular volume (ECV) data calculated from T1 maps, and [Na+]i measured by in vitro fluorescence microscopy using Na+ binding benzofuran isophthalate (SBFI). To investigate dynamic changes in Na+ compartments, we induced pressure overload (TAC) or myocardial infarction (MI) via LAD ligation in mice. Compared to SHAM mice, TSC was similar after TAC but increased after MI. Both TAC and MI showed significantly higher [Na+]i compared to SHAM (around 130% compared to SHAM). Calculated [Na+]e increased after MI, but not after TAC. Increased TSC after TAC was primarily driven by increased [Na+]i, but the increase after MI by elevations in both [Na+]i and [Na+]e.

Mycoplasma genitalium (MG) is an emerging sexually transmitted infection, often harboring resistance-associated mutations to azithromycin (AZM). Global surveillance has been mandated to tackle the burden caused by MG, yet no data are available for Austria. Thus, we aimed to investigate the prevalence of MG, disease characteristics, and treatment outcomes at the largest Austrian HIV—and STI clinic. All MG test results at the Medical University of Vienna from 02/2019 to 03/2022 were evaluated. Azithromycin resistance testing was implemented in 03/2021. Among 2671 MG tests, 199 distinct and mostly asymptomatic (68

Cardiac magnetic resonance (CMR) imaging allows precise non-invasive quantification of cardiac function. It requires reliable image segmentation for myocardial tissue. Clinically used software usually offers automatic approaches for this step. These are, however, designed for segmentation of human images obtained at clinical field strengths. They reach their limits when applied to preclinical data and ultrahigh field strength (such as CMR of pigs at 7 T). In our study, eleven animals (seven with myocardial infarction) underwent four CMR scans each. Short-axis cine stacks were acquired and used for functional cardiac analysis. End-systolic and end-diastolic images were labelled manually by two observers and inter- and intra-observer variability were assessed. Aiming to make the functional analysis faster and more reproducible, an established deep learning (DL) model for myocardial segmentation in humans was re-trained using our preclinical 7 T data (n = 772 images and labels). We then tested the model on n = 288 images. Excellent agreement in parameters of cardiac function was found between manual and DL segmentation: For ejection fraction (EF) we achieved a Pearson’s r of 0.95, an Intraclass correlation coefficient (ICC) of 0.97, and a Coefficient of variability (CoV) of 6.6%. Dice scores were 0.88 for the left ventricle and 0.84 for the myocardium.

BACKGROUND:Men who have sex with men (MSM) are more vulnerable to acquiring sexually transmitted infections (STIs). In 2019, for instance, 74% of European Neisseria gonorrhoeae (Ng) cases among males affected MSM. A recent report by the World Health Organization showed that most of the 2020' interim targets to end STIs by 2030 had not been met. A broadened understanding of STI transmission networks could guide future elimination strategies and reduce the STI burden. Therefore, we used whole-genome sequencing (WGS) to determine Ng-clusters and assess sexual mixing. METHODS:WGS was performed on Ng-isolates collected at the Medical University of Vienna, Austria and was used for core genome multi-locus sequencing typing cluster analysis. Epidemiologic and infection-specific details were extracted from medical records. RESULTS:Genomic analysis and demographic data were available for 415 isolates, and 43.9% (182/415) were allocated to 31 Ng-clusters. Nine clusters comprised samples from heterosexual individuals only (women N = 4, human immunodeficiency virus (HIV)-negative men N = 49, HIV-positive man N = 1), nine clusters included MSM only (HIV-negative N = 22, HIV-positive N = 13) and 13 clusters included both heterosexuals and MSM (HIV-negative N = 75, HIV-positive N = 18). Current use of HIV pre-exposure prophylaxis (PrEP) was reported by 22.8% of MSM. In multivariate analysis, only 'MSM' predicted clustering with isolates from HIV-positive individuals (adjusted odds ratio 10.24 (95% CI 5.02-20.90)). CONCLUSIONS:Sexual mixing of HIV-positive, HIV-negative MSM and non-MSM was frequently observed. Furthermore, HIV-serodiscordant clustering highlights the importance of PrEP rollout to avert HIV transmission. Our findings can inform future STI prevention strategies and continuous surveillance efforts are required to keep up with transmission dynamics.

Background and Objectives: Serovar L1-L3 of Chlamydia trachomatis (CT) causes lymphogranuloma venereum (LGV). A surge in LGV-cases has been observed among HIV-positive men who have sex with men (MSM). Discrimination between LGV and non-LGV is pivotal since it has major treatment implications. Here, we aimed to determine the prevalence and characteristics of LGV among CT-infections. Patients and Methods: All CT-positive results from 04/2014-12/2021 at the four largest Austrian HIV and STI clinics were evaluated. Disease characteristics and patient demographics were analyzed. Results: Overall, n = 2,083 infections of CT were documented in n = 1,479 individual patients: median age was 31.4 years, 81% were male, 59% MSM, 44% HIV-positive, 13% on HIV pre-exposure-prophylaxis. Available serovar analyses (61% [1,258/2,083]) showed L1-L3 in 15% (192/1,258). Considering only MSM with rectal CT-infection, LGV accounted for 23% (101/439). Cases of LGV vs. other CT-infections were primarily MSM (92% [177/192] vs. 62% [1,179/1,891], p < 0.001), more often HIV-positive (64% [116/180] vs. 46% [631/1,376]; p < 0.001) and had frequently concomitant syphilis infection (18% [32/180] vs. 7% [52/749]; p < 0.001). LGV commonly manifested as proctitis (38% [72/192]) whereas 45% (87/192) were asymptomatic. Conclusions: Lymphogranuloma venereum accounted for 23% of rectal CT-infections in MSM. Furthermore, 45% of all LGV-cases were asymptomatic. In the absence of CT-serovar analysis, a high LGV prevalence should be considered in risk-populations and guide empiric treatment selection.

Purpose: After acute myocardial infarction (MI), lymphocytes play a pivotal role in the scar formation and remodeling of the remote myocardium. Activation of lymphocytes takes places in mediastinal lymph nodes (MLN). Therefore, imaging of MLN as a read-out of the adaptive immune response to MI may identify subjects at increased risk for cardiac functional decline. Methods: The on-going prospective study (NCT05519735) enrolls patients with acute ST-elevation MI followed by complete reperfusion and multimodal imaging with C-X-C motif chemokine receptor 4 (CXCR4)-directed PET/CT and cardiac MRI (CMR) as baseline imaging. Follow-up (FU) CMR scans are repeated after 6 and 12 months. The CMR scans are analyzed regarding LV function, myocardial and LGE mass. Tracer uptake (SUVpeak) in the myocardium and MLN (defined as LN with most intense uptake) are determined. Infarct/remote myocardial (IRR), MLN/Remote LN (LNR) ratios and the overall LNR (including uptake from all LN) are calculated. Association of uptake with the function CMR parameters is tested. Results: Currently, 41 patients (29 males, median age 59 yo) were enrolled in the study (6 months FU 27/41, 12 months FU 17/41). At baseline, the median CMR EF was 49% and improved with the FUs (6mo: 52.8%, 12 mo 53.2%). LGE mass was 30.3 g and declined to 13.8 g after 12 months (LGE/Myocardial 15.8%). SUV peak from infarcted myocardium and mediastinal LN were consistently >1, indicating increased uptake relative to background. Changes of LVEF correlated with LNR (6 mo FU: %LVEF, r= - 0.48; P = 0.01, 12 mo FU: %LVEF, r= - 0.55; P = 0.02) and overall LNR (6 mo FU: %LVEF, r= - 0.52; P< 0.01; 12 mo FU: %LVEF; r= - 0.61; P = 0.01), but not with IRR (P= 0.498). LNR was increased in subjects with decreased LVEF. In logistic regression analysis, increasing LNR and overall LNR were significantly associated with decreased LVEF at the 12 months FU (LNR OR 1.32 (95% CL: 1.06-1.81, p = 0.03), Overall LNR OR 1.36 (95 % CL: 1.09-1.92, p = 0.03)). Conclusion: CXCR4-directed imaging of MLN provides information on the extent of local and systemic tissue inflammation in patients after acute MI. Especially MLN CXCR4 uptake holds predictive potential for cardiac adverse remodelling during follow up (LVEF decline) and may be used to identify patients who benefit from a selective immune modulation after acute MI. Funding: German Research Foundation (453989101).

Abstract Background 7 T cardiac magnetic resonance imaging (MRI) studies may enable higher precision in clinical metrics like cardiac function, ventricular mass, and more. Higher precision may allow early detection of functional impairment and early evaluation of treatment responses in clinical practice and pre-clinical studies. Methods: Seven female German Landrace pigs were scanned prior to and at three time points (3–4 days, 7–10 days, and ~60 days) post myocardial infarction using a whole body 7 T system and three radiofrequency (RF) coils developed and built in-house to accompany animal growth. Results: The combination of dedicated RF hardware and 7 T MRI enables a longitudinal study in a pig model of acute and chronic infarction, providing consistent blood tissue contrast and high signal-to-noise ratio (SNR) in measurements of cardiac function, as well as low coefficients of variation (CoV) for ejection fraction (CoVintra-observer: 2%, CoVinter-observer: 3.8%) and infarct size (CoVintra-observer: 8.4%, CoVinter-observer: 3.8%), despite drastic animal growth. Conclusions: Best results are achieved via manual segmentation. We define state-of-the-art procedures for large animal studies at 7 T.

Background: The pulmonary artery wedge pressure (PAWP) is regarded as a reliable indicator of left ventricular end-diastolic pressure (LVEDP), but this association is weaker in patients with left-sided heart disease (LHD). We compared morphological differences in cardiac magnetic resonance imaging (CMR) in patients with heart failure (HF) and a reduced left ventricular ejection fraction (LVEF), with or without elevation of PAWP or LVEDP. Methods: We retrospectively identified 121 patients with LVEF < 50% who had undergone right heart catheterization (RHC) and CMR. LVEDP data were available for 75 patients. Results: The mean age of the study sample was 63 ± 14 years, the mean LVEF was 32 ± 10%, and 72% were men. About 53% of the patients had an elevated PAWP (>15 mmHg). In multivariable logistic regression analysis, NT-proBNP, left atrial ejection fraction (LAEF), and LV end-systolic volume index independently predicted an elevated PAWP. Of the 75 patients with available LVEDP data, 79% had an elevated LVEDP, and 70% had concomitant PAWP elevation. By contrast, all but one patient with elevated PAWP and half of the patients with normal PAWP had concomitant LVEDP elevation. The Bland–Altman plot revealed a systematic bias of +5.0 mmHg between LVEDP and PAWP. Notably, LAEF was the only CMR variable that differed significantly between patients with elevated LVEDP and a PAWP ≤ or >15 mmHg. Conclusions: In patients with LVEF < 50%, a normal PAWP did not reliably exclude LHD, and an elevated LVEDP was more frequent than an elevated PAWP. LAEF was the most relevant determinant of an increased PAWP, suggesting that a preserved LAEF in LHD may protect against backward failure into the lungs and the subsequent increase in pulmonary pressure.

AIDS Patient Care and STDsVol. 37, No. 3 Letter to the EditorHigh Prevalence of Asymptomatic Sexually Transmitted Infections in Austrian Pre-Exposure Prophylaxis Users: A Prospective Observational StudyDavid Chromy, Nikolaus Urban, Katharina Grabmeier-Pfistershammer, Veronique Touzeau-Roemer, Michael Skoll, Alexandra Geusau, Georg Stary, Thomas Reiberger, Robert Strassl, Birgit Willinger, Wolfgang Weninger, Armin Rieger, and Wolfgang Michael BauerDavid Chromyhttps://orcid.org/0000-0002-1807-8258Department of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Nikolaus UrbanDepartment of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Katharina Grabmeier-PfistershammerDepartment of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Veronique Touzeau-RoemerDepartment of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Michael SkollDepartment of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Alexandra GeusauDepartment of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Georg StaryDepartment of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Thomas ReibergerDivision of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Robert StrasslDepartment of Laboratory Medicine, Institute of Clinical Virology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Birgit WillingerDivision of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Wolfgang WeningerDepartment of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, Armin RiegerDepartment of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this author, and Wolfgang Michael BauerAddress correspondence to: Wolfgang Bauer, MD, Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria E-mail Address: [email protected]Department of Dermatology, Medical University of Vienna, Vienna, Austria.Search for more papers by this authorPublished Online:10 Mar 2023https://doi.org/10.1089/apc.2022.0154AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetails Volume 37Issue 3Mar 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:David Chromy, Nikolaus Urban, Katharina Grabmeier-Pfistershammer, Veronique Touzeau-Roemer, Michael Skoll, Alexandra Geusau, Georg Stary, Thomas Reiberger, Robert Strassl, Birgit Willinger, Wolfgang Weninger, Armin Rieger, and Wolfgang Michael Bauer.High Prevalence of Asymptomatic Sexually Transmitted Infections in Austrian Pre-Exposure Prophylaxis Users: A Prospective Observational Study.AIDS Patient Care and STDs.Mar 2023.115-118.http://doi.org/10.1089/apc.2022.0154Published in Volume: 37 Issue 3: March 10, 2023Online Ahead of Print:February 23, 2023PDF download

As atherosclerosis is one of the main causes of death in industrial nations, noninvasive imaging modalities for studying its underlying mechanisms are in great demand. The quantification of hemodynamic parameters such as pulse wave velocity (PWV) assessed by flow sensitive magnetic resonance imaging (MRI) is a promising tool to observe plaque progression in preclinical models. Mostly, a global PWV value is assessed, however, previous studies already pointed to heterogeneous elasticity profiles in the presence of atherosclerotic plaques. Here, we present the measurement of local PWV values in the murine aortic arch assessed by 4D-flow MRI for spatially resolved elasticity measurements.

Zusammenfassung Immunfluoreszenzoptische Untersuchungen haben seit langer Zeit einen fixen Stellenwert in der dermatologischen Diagnostik. Sie sind unerlässlich für die Diagnose von blasenbildenden Autoimmunerkrankungen und liefern wertvolle diagnostische Hinweise in der Beurteilung von Kollagenosen, Vaskulitiden und lichenoiden Erkrankungen sowie in der orientierenden Beurteilung angeborener, blasenbildender Erkrankungen. Mithilfe der direkten Immunfluoreszenzuntersuchung werden in einer Biopsie vorhandene Ablagerungen von Antigen-Antikörperkomplexen nachgewiesen, bei indirekten Methoden wird das Serum von Patienten auf das Vorhandensein von Autoantikörpern untersucht. Ein wesentlicher limitierender Faktor in der Qualität dieser Untersuchungen ist die korrekte Entnahme sowie der Transport der Hautbiopsie ins Labor.

Cancer-associated fibroblasts (CAFs) play a key role in cancer progression and treatment outcome. Here, we elucidate the yet unresolved intra-tumoral CAF variety in three skin cancer types at molecular and spatial single-cell resolution in a large cohort. We show that two out of three CAF subtypes contribute to tumor immune surveillance with distinct mechanisms. Matrix CAFs (mCAFs), a previously unknown subtype present in early-stage tumors, ensheath tumor nests and synthesize extracellular-matrix to prevent T cell invasion. Immuno CAFs (iCAFs), which express proinflammatory and immunomodulatory factors, are only detected in high abundance in aggressive tumors. Strikingly, iCAFs but not tumor cells are the exclusive celltype producing chemokines and, thus, play a key role in immune cell recruitment and activation. Mechanistically, we show that cancer cells transform adjacent healthy fibroblasts into cytokine-expressing iCAFs, which subsequently recruit immune cells and modulate the immune response. In conclusion, targeting CAF variants holds promise for improved efficacy of immunotherapy. Statement of significance: While it is accepted that fibroblasts affect cancer progression, the underlying molecular programs remain unclear. We unravel a multi-step cascade demonstrating that tumor cells transform healthy fibroblasts into CAFs, which critically impact immune surveillance via iCAFs being the exclusive source of chemokines and mCAFs promoting T cell exclusion.

A key step in translational cardiovascular research is the use of large animal models to better understand normal and abnormal physiology, to test drugs or interventions, or to perform studies which would be considered unethical in human subjects. Ultrahigh field magnetic resonance imaging (UHF-MRI) at 7 T field strength is becoming increasingly available for imaging of the heart and, when compared to clinically established field strengths, promises better image quality and image information content, more precise functional analysis, potentially new image contrasts, and as all in-vivo imaging techniques, a reduction of the number of animals per study because of the possibility to scan every animal repeatedly. We present here a solution to the dual use problem of whole-body UHF-MRI systems, which are typically installed in clinical environments, to both UHF-MRI in large animals and humans. Moreover, we provide evidence that in such a research infrastructure UHF-MRI, and ideally combined with a standard small-bore UHF-MRI system, can contribute to a variety of spatial scales in translational cardiovascular research: from cardiac organoids, Zebra fish and rodent hearts to large animal models such as pigs and humans. We present pilot data from serial CINE, late gadolinium enhancement, and susceptibility weighted UHF-MRI in a myocardial infarction model over eight weeks. In 14 pigs which were delivered from a breeding facility in a national SARS-CoV-2 hotspot, we found no infection in the incoming pigs. Human scanning using CINE and phase contrast flow measurements provided good image quality of the left and right ventricle. Agreement of functional analysis between CINE and phase contrast MRI was excellent. MRI in arrested hearts or excised vascular tissue for MRI-based histologic imaging, structural imaging of myofiber and vascular smooth muscle cell architecture using high-resolution diffusion tensor imaging, and UHF-MRI for monitoring free radicals as a surrogate for MRI of reactive oxygen species in studies of oxidative stress are demonstrated. We conclude that UHF-MRI has the potential to become an important precision imaging modality in translational cardiovascular research.

Abstract Introduction Cardiac tissue characterisation using T2-based MRI promises non-invasive diagnosis or monitoring of inflammatory heart disease, toxic heart damage after chemotherapy and myocardial infarction or post-infarction patients. T2 relaxation is also an indicator for the detection of myocardial oedema or intramyocardial haemorrhage [1]. However, accurate T2 quantification is challenging due to motion, blood flow and field inhomogeneities, especially in high-field MRI [2]. In this work, we present an alternative to T2 imaging that uses spin-locking (SL) to provide a robust measurement of T2ρ relaxation. It is known from relaxation theory that T2ρ has a sensitivity almost identical to T2 [3]. In the small animal study presented here, cardiac T2ρ quantification is tested for the first time using a newly developed pulse sequence and compared with established methods. Methods All measurements were performed on a preclinical 7T MRI. T2 contrast was prepared using a CPMG (Carr-Purcell-Meiboom-Gill) sequence. T2ρ contrast was conventionally generated by a balanced-SL (BSL) preparation [4]. Furthermore, a new approach for T2ρ was developed based on a MLEV sequence (Malcolm-Levitt, [2]). In contrast to [2], all pulse delays were minimised here, producing pure T2ρ contrast (Fig. 1). The new method was first validated in phantom experiments and then tested in three mice with radial image acquisition accelerated for cardio-MRI. Results The results of the phantom study are shown in figure 2. No significant differences were found between BSL and MLEV for T2ρ quantification (mean deviation 0.74%). In vivo, significant artefacts were observed for T2 (Fig. 3), while both T2ρ methods showed improved image quality. For the evaluation of relaxation times in the left ventricle, the mean across all animals was: T2=22.9±2.6ms (R2=0.979), BSL-T2ρ=51.4±5.4ms (R2=0.983) and MLEV-T2ρ=60.0±3.4ms (R2>0.99). Thus, the MLEV-T2ρ method achieves the most robust quantification with a mean R2>0.99 and provides relaxation time maps with diagnostic image quality. Discussion: In the present study, myocardial T2ρ mapping was tested at 7T. While no significant differences between BSL and MLEV appeared in phantom experiments, significant difference was found in vivo. Here, only the MLEV technique could achieve robust quantification. One reason for the improved performance is the continuous refocusing and minimisation of free dephasing of the transverse magnetisation. The results also show that MLEV-T2ρ has improved image quality and more robust quantification compared to CPMG-T2. Conclusion Cardiac T2ρ quantification is a robust alternative to established T2 imaging and can be applied under high-field conditions. A combined measurement of T1ρ and T2ρ relaxation time could be used for native detection of myocardial fibrosis and oedema.Figure 1)Comparison of image qualityFigure 2)Results in a knockout model

Fluorine-19 ( 19 F) magnetic resonance imaging is a unique quantitative molecular imaging modality that makes use of an injectable fluorine-containing tracer that generates the only visible 19 F signal in the body. This hot spot imaging technique has recently been used to characterize a wide array of cardiovascular diseases and seen a broad range of technical improvements. Concurrently, its potential to be translated to the clinical setting is being explored. This review provides an overview of this emerging field and demonstrates its diagnostic potential, which shows promise for clinical translation. We will describe 19 F magnetic resonance imaging hardware, pulse sequences, and tracers, followed by an overview of cardiovascular applications. Finally, the challenges on the road to clinical translation are discussed.

Intracavitary thrombi are an important differential diagnosis of cardiac masses. Cardiac magnetic resonance imaging (CMR) allows their non-invasive characterization. This case highlights extensive cardiac thrombi detected by CMR as solitary presentation of antiphospholipid syndrome.