Common indications for multiphase CT
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More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
\n'}],latestNews:[{slug:"stanford-university-identifies-top-2-scientists-over-1-000-are-intechopen-authors-and-editors-20210122",title:"Stanford University Identifies Top 2% Scientists, Over 1,000 are IntechOpen Authors and Editors"},{slug:"intechopen-authors-included-in-the-highly-cited-researchers-list-for-2020-20210121",title:"IntechOpen Authors Included in the Highly Cited Researchers List for 2020"},{slug:"intechopen-maintains-position-as-the-world-s-largest-oa-book-publisher-20201218",title:"IntechOpen Maintains Position as the World’s Largest OA Book Publisher"},{slug:"all-intechopen-books-available-on-perlego-20201215",title:"All IntechOpen Books Available on Perlego"},{slug:"oiv-awards-recognizes-intechopen-s-editors-20201127",title:"OIV Awards Recognizes IntechOpen's Editors"},{slug:"intechopen-joins-crossref-s-initiative-for-open-abstracts-i4oa-to-boost-the-discovery-of-research-20201005",title:"IntechOpen joins Crossref's Initiative for Open Abstracts (I4OA) to Boost the Discovery of Research"},{slug:"intechopen-hits-milestone-5-000-open-access-books-published-20200908",title:"IntechOpen hits milestone: 5,000 Open Access books published!"},{slug:"intechopen-books-hosted-on-the-mathworks-book-program-20200819",title:"IntechOpen Books Hosted on the MathWorks Book Program"}]},book:{item:{type:"book",id:"1819",leadTitle:null,fullTitle:"Biochemical Testing",title:"Biochemical Testing",subtitle:null,reviewType:"peer-reviewed",abstract:"Biochemical testing necessitates the determination of different parameters, and the identification of the main biological chemical compounds, by using molecular and biochemical tools. 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\r\n\tNowadays marine propulsion systems, based on thermal machines operating under the diesel cycle, have positioned themselves as one of the main options for this type of applications. Their main comparative advantages, compared to other propulsion systems, based on thermal machines, are the low specific fuel consumption and their higher thermal efficiency. However, its main disadvantage lies in the emissions produced by combustion, such as carbon dioxide (CO2), oxide sulphur (SOx) and oxide nitrogen (NOx).
\r\n\r\n\tOver the last decade, the International Maritime Organization (IMO), has adopted a series of regulations to reduce these emissions, based on the introduction of several energy efficiency design and operational indicators for new and existing vessels.
\r\n\r\n\tIn this context, this book will focus on design and operation efficiency of ships throughout an analysis of the main propulsion systems. Starting from the use of alternative alternative fuels, to the integration of hybrid and full electric propulsion systems.
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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3621",title:"Silver Nanoparticles",subtitle:null,isOpenForSubmission:!1,hash:null,slug:"silver-nanoparticles",bookSignature:"David Pozo Perez",coverURL:"https://cdn.intechopen.com/books/images_new/3621.jpg",editedByType:"Edited by",editors:[{id:"6667",title:"Dr.",name:"David",surname:"Pozo",slug:"david-pozo",fullName:"David Pozo"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"43704",title:"Computed Tomography in Abdominal Imaging: How to Gain Maximum Diagnostic Information at the Lowest Radiation Dose",doi:"10.5772/55903",slug:"computed-tomography-in-abdominal-imaging-how-to-gain-maximum-diagnostic-information-at-the-lowest-ra",body:'Computed Tomography (CT) was first introduced as a medical device in the 1970’s, and has since become a ubiquitous imaging tool. Recent technical advances including faster scan times, improved spatial resolution, and advanced multi-planar reconstruction techniques have led to the application of CT for the evaluation of numerous anatomic abnormalities and disease processes. Approximately 3 million CT scans were performed annually in the United States in 1980, but by 2008 that number had grown to 67 million and it continues to rise. [1] Over two-thirds of all medical radiation is attributable to CT, with 75% of CT scans being performed in the hospital setting. Approximately 40% of CT scans are of the head/neck/spine, 10% of the chest, 47% of the abdomen/pelvis, and the remainder of the extremities or as a procedural tool. [2, 3, 4]
Increasing awareness of medical radiation has paralleled the increase in CT usage with permeation into the popular and scientific press. This has resulted in an emphasis by several organizations on reducing overall medical radiation exposure without compromising diagnostic accuracy and usefulness. Despite this increased awareness and attention, the significance of the increased radiation exposure to the population caused by CT remains unclear. High levels of ionizing radiation exposure are known to increase cancer risk [5, 6, 7] but the data for lower doses of radiation, like those seen during medical imaging (including CT), is less clear and remains controversial. [8, 9, 10] Therefore, in the absence of clarity on this topic, the American College of Radiology (ACR), Health Physics Society (HPS) and other interested organizations have adopted the principles of As Low As Reasonably Achievable (ALARA), Image Gently in pediatrics and Image Wisely in adults. The common theme of all of these guidelines is to advise physicians to limit radiation exposure to only what is medically necessary. [11, 12]
Several strategies to reduce CT-associated radiation have been attempted. One strategy is to vet CT as the appropriate diagnostic test with preferential use of other imaging modalities such as ultrasound and MRI when able, particularly in pediatrics, and to limit the CT examination to the anatomic area in question. A second strategy involves optimizing scanning parameters (such as kVp, pitch and mA) in order to reduce exposure in all patient populations. [13, 14, 15] If CT is felt to be necessary, applying optimized technical parameters and limiting the scan area can substantially reduce radiation exposure and result in dose reductions as high as 65%. [12, 15] These important techniques are described in other chapters of this book and are not our focus. Rather, we will concentrate on an important, but potentially overlooked source of unnecessary medical radiation, namely, multiphase examinations. We will discuss how multiphasic examination should be used in abdominal imaging with an emphasis on utilizing the minimum number of phases that will suffice for the clinical indication. [16]
The different phases that are possible with state-of-the-art CT scanners are myriad and include scanning before and after contrast administration, delayed imaging, venous and arterial phases, and several others (table 1). Specific patterns of contrast enhancement or evolution of findings over time can dramatically aid in diagnosis in abdominal pathology, thus justifying these additional phases in some patients. However, additional phases should only be necessary in very specific clinical indications, and should be used judiciously as each phase will result in additional radiation. If these additional phases are performed for a specific examination with the same technical parameters as the original phase, which is often the case, the radiation dose is multiplied by the number of phases making it important that the phases performed are clinically indicated and relevant.
\n\t\t\t\tPhase\n\t\t\t | \n\t\t\t\n\t\t\t\tTypical indication\n\t\t\t | \n\t\t\t\n\t\t\t\tTiming after contrast injection\n\t\t\t | \n\t\t|||
\n\t\t\t\tNon-contrast\n\t\t\t | \n\t\t\t\n\t\t\t\tIdentify calcifications\n\t\t\t | \n\t\t\t\n\t\t\t\tN/A\n\t\t\t | \n\t\t|||
Contrast Enhanced | \n\t\t\t\n\t\t\t | \n\t\t | |||
Angiography | \n\t\t\tEvaluate vascular anatomy | \n\t\t\t15-35 sec | \n\t\t|||
Arterial phase | \n\t\t\tEarly | \n\t\t\tArterial structures | \n\t\t\t15-35 sec | \n\t\t||
Late | \n\t\t\tHypervascular tumors | \n\t\t\t15-35 sec | \n\t\t|||
Portal venous phase | \n\t\t\tMajority of routine imaging is performed with this phase. Provides excellent solid organ visualization | \n\t\t\t60-90 sec | \n\t\t|||
Venous Imaging | \n\t\t\tEvaluate for venous thrombosis | \n\t\t\t180 sec | \n\t\t|||
Delayed | \n\t\t\tCholangiocarcinoma | \n\t\t\t10-15 minutes | \n\t\t|||
Adrenal adenoma | \n\t\t\t10-15 minutes | \n\t\t||||
Extravasation (i.e. active bleeding) | \n\t\t\t7-10 minutes | \n\t\t||||
Renal | \n\t\t\tCorticomedullary phase | \n\t\t\tIdentification of renal cortical abnormalities | \n\t\t\t70 sec | \n\t\t||
Nephrogenic phase | \n\t\t\tCharacterization and improved visualization of renal masses | \n\t\t\t100-200 sec | \n\t\t|||
Excretory phase | \n\t\t\tEvaluation of the renal collecting system | \n\t\t\t10 min | \n\t\t
Common indications for multiphase CT
Multiphase CT examinations are extremely useful in a certain subset of patients. The temptation in a busy practice is to perform CT with a “one size fits all” approach such that physicians will not miss the opportunity to completely characterize even the most unexpected findings. This approach usually means utilizing multiphase scans in all patients to cover multiple potential scenarios. Since most patients do not benefit from additional phases, this practice results in unnecessary radiation in the majority of patients. The dose-multiplication effect of these unnecessary phases can be dramatically reduced or eliminated with individual tailoring of CT exams to the specific clinical scenario. [16]
In an attempt to address this issue, the American College of Radiology (ACR) has developed evidence and expert opinion-based appropriateness criteria matching scanning protocols for various clinical conditions. [17] Unfortunately, the criteria often do not address the most appropriate phase for use in a specific clinical scenario, but rather allude to a “CT Abdomen and Pelvis with IV contrast”. Therefore, identification of the most appropriate phases requires a literature review to identify scenarios when additional phases can be expected to add additional useful information. Our approach is to perform single phase imaging (generally the portal venous phase) unless there is specific literature or recommendations to support additional phases. Thus, for the indications addressed by the ACR appropriateness criteria, a portal venous phase is the most likely recommendation. For each indication in the appropriateness criteria, the varying imaging modalities are ranked, but they generally do not discuss the use of different phases in CT. They define 1 as being the least appropriate study for the given indication and 9 as being the most appropriate. Similarly, the Royal College of Radiology has also developed guidelines for the same purpose and these guidelines have many similarities to, but are not identical to the ACR guidelines [18]. For the purposes of this discussion, we will attempt to describe utilization patterns for CT phases that are supported by the medical literature and while these recommendations are partially based upon the ACR guidelines, we also recommend that physicians become familiar with medical literature supporting the use of multiphasic CT.
The majority of CT imaging in the head, chest and extremities are performed with single-phase imaging and won’t be specifically addressed. However, abdominal imaging is associated with many potential uses for multiple-phase imaging and will be discussed in detail. The majority of abdominal and pelvic CT’s can be performed using a single-phase, but the evaluation of some tumor types (hepatic/pancreatic/renal), the urinary collecting system, and trauma patients among others, may be best performed with multiple phases which is described in more detail below.
In discussing the numerous phases and indications for CT, it should be noted that best patient care requires individualized CT protocols based upon each patient’s specific symptoms, pathology, and underlying co-morbidities. Although labor intensive, this provides the highest likelihood of an accurate diagnosis with the lowest necessary radiation dose. The following discussion will provide a basic outline of current best practice, but not all clinical scenarios can be accounted for. Note that the ACR appropriateness criteria can be found on the ACR website (http://www.acr.org/ac).
Non-contrast CT scans Figure 1a (left) and 1b (right) are of limited use for the differentiation of soft tissue structures. However, materials like blood, calcium (renal stones, vascular atherosclerosis), bone, and pulmonary parenchyma are highly visible and can usually be adequately assessed with non-contrast CT. For example, in the abdomen and pelvis, there are several indications for non-contrast imaging. These include: evaluation of renal calculi; assessment for gross intra-abdominal hemorrhage; and post-endostent volume measurements. In addition, non-contrast images are often obtained in conjunction with contrast enhanced images in evaluating potential renal transplant donors and in the evaluation of the pancreas (in combination with contrast phases). Of note, dual-energy CT and the development of virtual “non-contrast” images may ultimately obviate the combination scans. Additionally, CT angiography examinations performed for pathologies like aneurysms and dissection are frequently performed in conjunction with non-contrast imaging. The non-contrast images facilitate the differentiation of active extravasation or acute bleeding from vascular calcifications.
Non-contrast CT demonstrating multiple bilateral renal calculi (arrows), which can be obscured on contrast-enhanced images, particularly delayed images when there is excreted contrast in the renal collecting system; axial left, coronal reformat on right.
Contrast enhanced CT examinations can be acquired at a variety of specific time points after intravenous contrast injection (timing is dependent on the phase of contrast enhancement needed and organ system being evaluated). The timing should be chosen specifically to optimize contrast distribution within the solid organ parenchyma in question.
The most common technique is to perform portal venous phase imaging in the abdomen and pelvis (approximately 60-90 seconds after contrast administration, figure 2). This results in near optimal contrast opacification of the majority of the solid abdominal organs and it is used for a wide variety of indications: nonspecific abdominal pain; hernia; infection; masses (with a few exceptions such as hypervascular, renal, and some hepatic tumors); and in most follow-up examinations. As a general rule, this single phase is adequate unless there is a specific clinical indication that has been shown to benefit from other phases.
Contrast enhanced CT demonstrating parenchymal enhancement of the intra-abdominal organs in the portal venous phase (axial left, coronal reformat right).
CT angiography (CTA) is highly effective for evaluation of the arterial system, and has largely replaced conventional angiography due to the lower risk profile and ability to survey the entire abdomen. Images are acquired after a rapid bolus of intravenous contrast material (3-7 cc/s) during the arterial phase (15-35 seconds after injection) when the concentration of contrast material in the arterial system is high (figures 3). Images are usually acquired using narrow collimation (<1 mm) and can be retrospectively reconstructed using dedicated 3-dimensional workstations and software. CTA is commonly used in the head and chest in the evaluation of pulmonary emboli, aneurysms, vascular malformations, dissection, bleeding and ischemia. Indications for early arterial phase imaging include: evaluation of aneurysms or dissections (cerebral, aortic, etc.), hepatic, splanchnic or renal arterial anatomy, and arterial imaging in liver or kidney transplantation. Single phase arterial imaging is often used in the evaluation of trauma patients either a complete chest/abdomen/pelvis examination with arterial phase imaging of the chest and portal venous phase imaging of the abdomen/pelvis or just a portal venous phase of abdomen and pelvis depending on the mechanism and severity of the trauma. CTA is also commonly performed in the abdomen and pelvis for evaluating vascular malformations and in the evaluation of bleeding. Mesenteric ischemia can also be evaluated using CT angiography. CTA of the abdomen and pelvis is often performed in combination with a CTA for evaluating the extremity vasculature.
Axial (left) and coronal (right) CT angiography images of the abdominal aorta evaluating for aortic aneurysm.
The late arterial phase is timed to correspond to the peak concentration of contrast material in highly vascular tumors and is performed approximately 20-35 seconds after the injection of intravenous contrast. Early arterial phase imaging is predominantly utilized for angiography and will be discussed separately. Late arterial phase imaging is almost always performed in conjunction with other phases (e.g. portal venous phase) to allow more complete characterization of any identified abnormalities (figure 4). The primary indication for a late arterial phase is for the evaluation of hypervascular tumors of the liver such as hepatocellular carcinoma or hypervascular metastases (figure 4). Typical hypervascular tumors for which this would be used include: hepatocellular carcinoma; renal cell carcinoma; melanoma; carcinoid/neuroendocrine tumors; some sarcomas; choriocarcinoma; and thyroid carcinoma. Although a “hypervascular”, biphasic evaluation would generally be used for these patients, note that a single phase is often adequate for follow up imaging.
Selected images from a biphasic CT demonstrating early arterial enhancement of a posterior right hepatic lobe mass with mild wash out on delayed phase images in the setting of cirrhosis characteristic of hepatocellular carcinoma.
CT imaging specific for the venous structures is performed uncommonly. Most venous structures are partially opacified on the routine contrast enhancing images and suffice for most examinations. However, occasionally evaluation of the inferior vena cava is desired, such as prior to IVC filter placement/removal or evaluation of IVC thrombosis.
Delayed phase imaging (figure 5) encompasses scanning at a variety of different times following contrast administration, and depends on the pathology in question. Typical delayed imaging times range from a few minutes to up to 15 minutes or longer. The most common indications for delayed phase imaging are evaluation of the kidneys, collecting system (ureters and bladder) and specific kidney, liver, and adrenal tumors. [19, 20] Evaluation of the kidneys, ureters and bladder are discussed separately in the renal imaging section. Cholangiocarcinoma occurring within the extrahepatic biliary tree or intrahepatic cholangiocarcinomas are a common reason for delayed imaging. Cholangiocarcinomas are fibrotic tumors which enhance slowly, and are usually imaged following a 10-15 minute delay. Similarly, adrenal masses can be evaluated with multiphase imaging including an unenhanced CT, portal venous phase and a 10 minute delay CT which allows for evaluation and calculation of the enhancement and washout characteristics aiding in distinguishing benign adrenal adenomas from other adrenal masses.
Outside of the evaluation of masses, delayed phase images can be used in the evaluation of active vascular extravasation in trauma patients, vascular malformations, and aneurysm disruption.
Selected images form CT performed using a Cholangiocarcinoma specific protocol. 5a is a portal venous phase image demonstrating a single low attenuation mass which does not appear to enhance. 5b is a 15 minute delayed image which demonstrates delayed enhancement of the liver mass (arrow) characteristic of Cholangiocarcinoma. Several other enhancing masses (arrowheads) are also seen which were not evident on the portal venous phase images.
When evaluating hepatic masses, it can be advantageous to have both late arterial and portal venous phase images (biphasic imaging, figure 4) since some tumors enhance briskly during the arterial phase (hepatocellular carcinoma, hepatic adenoma, follicular nodular hyperplasia (FNH), and hypervascular metastasis), but may be occult or difficult to characterize on portal venous phase imaging alone (figure 6). However, it should be stressed that the addition of late arterial phase images is only indicated if one of these tumors is suspected, or if there is a need for further characterization of a hepatic mass, since the large majority of patients will not benefit from the addition of this phase. In addition, if there is a need to definitively characterize a hepatic mass, MRI is generally more sensitive and specific, with no associated radiation dose.
Selected images from a biphasic CT of Focal Nodular Hyperplasia in the left hepatic lobe (arrow). These masses have characteristic early arterial enhancement (6a) with contrast wash out on the portal venous phase images (6b) from the mass making these lesions difficult to identify on portal venous phase images alone.
Detection and characterization of renal parenchymal masses is a frequent indication for CT. An initial noncontrast CT is important for detecting calcium or fat in a lesion, and to provide baseline attenuation of any renal masses. Following noncontrast scanning, intravenous contrast is injected and a corticomedullary phase is obtained at approximately 70 seconds (figure 7a, 7b). The corticomedullary phase is characterized by enhancement of the renal cortex as well as the renal vasculature. This phase is valuable in the evaluation of benign renal variants, lymphadenopathy and vasculature, however certain medullary renal masses may not be visible during this phase due to minimal enhancement of the medulla and collecting system. The parenchymal phase is obtained approximately 100-200 seconds after the injection of contrast material (figure 7c). Parenchymal phase imaging demonstrates continued enhancement of the cortex, enhancement of the medulla, and various levels of contrast material in the collecting system. The parenchymal phase is highly important for the detection and characterization of renal masses, parenchymal abnormalities, and the renal collecting system. [21] This method of imaging does not evaluate for abnormalities of the collecting system.
Selected images from a renal mass specific protocol CT. Corticomedullary phase (axial 7a) demonstrates peripheral enhancement of the renal cortex with minimal opacification of the renal medulla. There is a large renal cell carcinoma in the right kidney which can be differentiated from the normal renal parenchyma by the heterogeneous and differential enhancement. The renal artery and vein are opacified in this phase as well. The collecting system is not opacified (coronal reformat 7b). In the parenchymal phase, the renal cortex and the medulla are enhancing. The renal cell carcinoma in the left kidney is not as well defined when compared to the corticomedullary phase images, but is actually slightly more conspicuous. There is some contrast noted within the collecting system during this phase (7c).
Common renal masses can occasionally be differentiated from each other using this imaging technique. Renal cell carcinomas and oncocytomas typically demonstrate intense heterogeneous enhancement on the parenchymal phase images and cannot be reliably differentiated from each other but can be distinguished from other renal masses. Angiomyolipomas (AML’s) also demonstrate intense contrast enhancement but characteristically contain macroscopic fat which can be detected on the noncontrast images, and can help to differentiate AML’s from renal cell carcinomas and oncocytomas. Renal lymphoma on the other hand, will often have decreased enhancement when compared to the renal parenchyma on the parenchymal phase images.
CT urography (CTU) is commonly used in the evaluation of hematuria, and specifically tailored to image the renal collecting system, ureters and bladder in addition to the renal parenchyma. Initial imaging includes a noncontrast phase to detect renal calculi as a source of hematuria. Note that dual energy CT may eventually allow the noncontrast phase to be eliminated. Contrast enhancement techniques for CTU vary from institution to institution. A common technique used at our institution and others is a double bolus, single phase imaging algorithm. This technique is a hybrid contrast injection strategy that results in opacification of the renal parenchyma (parenchymal phase, figure 8a) and the collecting system, ureters, and bladder (excretory phase, figure 8b and 8c). At our institution, a small contrast bolus is administered initially, followed 10 minutes later with a larger bolus that is imaged in the corticomedullary phase. This ensures that contrast is being excreted by the kidneys and thus the collecting system is opacified (excretory phase) from the initial injection, and that the renal parenchyma is enhancing as well from the second injection (parenchymal phase). At the conclusion of the urography protocol, we also perform a scout image in the supine and prone position to allow a global evaluation of the collecting system. Excretory phase imaging allows for not only evaluation of the ureteral lumen, but also periureteral abnormalities including external masses and lymphadenopathy. [22]
Selected images from a CT Urography protocol CT. 8a is an axial CT image from the renal parenchymal phase. There is a mildly enhancing soft tissue mass in the left renal pelvis (arrow) consistent with a transitional cell carcinoma. Figure 8b (coronal reformats) and 8c (left oblique coronal reformats) demonstrate the double bolus technique of CT Urography. These images confirm soft tissue mass (arrows) in the renal pelvis with contrast excretion into the collecting system (arrowheads).
Pancreatic masses are often evaluated using both an early arterial (to evaluate for vascular involvement and thus resectability, figure 9a) and a later “pancreatic” phase (which optimizes pancreatic parenchymal enhancement and thus is best at differentiating pancreatic tumors from pancreatic parenchyma, figure 9b). Pancreatic adenocarcinoma typically is hypoenhancing when compared to the surrounding parenchyma. Most other common pancreatic tumors are hypervascular with avid enhancement (such as pancreatic neuroendocrine tumors) and appear brighter than the surrounding pancreatic parenchyma after the injection of intravenous contrast material.
Selected images from a pancreatic protocol. 9a is a noncontrast CT image demonstrating subtle fullness in the region of the pancreatic neck (arrow). 9b is a CT image performed during the early arterial phase during which there is opacification of the arterial structure with subtle fullness in the pancreatic neck (arrow). The pancreas is not enhancing during this phase. 9c was performed in a late arterial/pancreatic phase demonstrating normal enhancement of the pancreas (arrowhead) with a hypoenhancing mass (arrow) in the pancreatic neck. The pancreatic mass is more visible during this phase.
CT imaging should be performed to evaluate the specific clinical question, however incidental findings are noted in approximately 5-16 % of patients scanned for an unrelated reasons. [23, 24] It is not acceptable practice to anticipate the possibility of incidental lesions given their low incidence and prospectively add additional phases to routine protocols. Unfortunately, several recent surveys demonstrated that this practice is more common than might be anticipated, and contributes to unnecessary medical radiation exposure to a large population of patients. [16] Even more egregious is the fact that many of these findings could potentially be more accurately evaluated with other non-radiation imaging modalities such as MRI or ultrasound.
Although the management of incidental findings is not the focus of this chapter, some of these findings will require complete characterization with further CT phases such as arterial phase (certain liver tumors) or delayed images (adrenal lesions). Management of incidental findings has been controversial since they are relatively common, especially in the elderly, and more CT scanning may be required for further characterization of what is frequently a benign finding. In an effort to provide guidance on which incidental findings should be appropriately further evaluated and what the appropriate imaging modality should be, the ACR published a white paper on management of incidental findings detected at CT of the abdomen in 2010. [25]
Multiphase CT examinations are very important for the detection and characterization of certain clinical conditions, but should not be generalized for every patient undergoing CT of the abdomen and pelvis. A recent survey demonstrated that many physicians are routinely performing multiphase CT for the majority of patients in an attempt to prospectively characterize potential lesions detected during the scan. However, unindicated multiphase CT examinations are an important source of medical radiation that does not contribute to the care of patients. Adherence to published standards such as the ACR Appropriateness Criteria can both decrease medical radiation and optimize imaging for the specific clinical indication.
CT (computed tomography)
kVp (Kilovoltage)
ma (Milliamperes)
CTA (Computed Tomography Angiography)
CTU (Computed Tomography Urography)
MRI (Magnetic Resonance Imaging)
ACR (American College of Radiology)
Currently, food manufacturers and scientists worldwide are aiming to identify and characterize foods that can be used as sources of beneficial nutrients to promote the health and well-being of consumers. Based on this new paradigm, the development of new food products must combine novel technologies with the use of traditional methods to the control bio-accessibility of certain components in foods. As the interactions among health, nutrition, and genetics are clarified, this approach will become increasingly important.
\nOne effective method for achieving these aims is microencapsulation [1], which was used as early as 1930. The first products containing microencapsulated materials were successfully fabricated in 1954. This advancement promoted further research on the use of microencapsulation in the pharmaceutical industry, wherein researchers found they could use these techniques to achieve controlled release of drugs in the body or in specific organs. Thus, pharmaceutical companies were crucial for developing improved techniques for microencapsulation [2]. In the 1960s, the first studies of microencapsulation in food technology were performed using essential oils; scientists attempted to prevent lipid oxidation, volatile compound losses, and aroma-controlled release. Subsequently, many more studies regarding microencapsulation of food products were published [3].
\nThe goals of microencapsulation are to coat an active compound (core) by an encapsulating agent, also known as wall material, which will isolate the active material, thereby protecting the active material from adverse changes or to hide sensory properties that are not appreciated by consumers. The isolation provided by the encapsulating material will break under the application of a specific stimulus (e.g., pH or heat), releasing the active substance in the specific target location or under ideal conditions [2].
\nIn this review, we summarize the latest applications of microencapsulation and microcapsule production methods in the food industry.
\nThe techniques for producing microcapsules are significantly more challenging in the food industry than in other industries because the sensory qualities of foods cannot be compromised by the addition of encapsulated components. Furthermore, food matrices are more complex than those used in pharmaceutical and cosmetic industries. Moreover, in the food industry, microcapsules must be ingested orally, resist the adverse conditions of the gastrointestinal tract, and exhibit mucoadhesive properties [1]. Several different methods for microcapsule production have been developed, and microcapsules can be fabricated using various materials, which are chosen depending on the function of the microcapsules [4].
\nMicroencapsulation is used to reduce adverse aromas, volatility, and reactivity of food products and to provide food products with greater stability when exposed to adverse conditions (e.g., light, O2, and pH) [5, 6]. Favaro-Trindade et al. [1] stated that microencapsulation is used in the food industry to reduce the reactivity of the active material in the external environment, reduce the speed of losses and evaporation of the core material into the medium, improve food handling, provide controlled release of the active product, mask unpleasant odor and taste, and allow the encapsulated material to be distributed in a food formulation homogeneously. However, microencapsulation is associated with dramatically increased costs of production, which may limit the economic viability of the method.
\nNotably, consumers are becoming increasingly aware of the importance of consuming meals that benefit health. Thus, products are being developed to provide health benefits to consumers; microencapsulation of various active compounds, such as vitamins, minerals, essential oils, and omega-3 polyunsaturated fat acids, among others, may be used to protect these compounds from nutrient loss and oxidation reactions and to hide sensory characteristics [2]. Therefore, while there are a wide range of applications of microencapsulation in the food industry, more studies are needed to determine the effectiveness of microencapsulation and the consumer acceptance of products manufactured using microencapsulation [7].
\nMicroencapsulation is the science of trapping components (core or active) into a secondary material (encapsulant, wall material, carrier, or cover), producing small solid particles (1–500 μm in size) [8]. These particles are able to release their contents at a specified rate or under specific conditions [1].
\nThe first step in microencapsulation consists of mixing the active material with the encapsulant material, making an emulsion. The mixture can be made with one or two agents. The mixture is then dried, producing microcapsules of different diameters and forms depending on the preparation method and materials used [7].
\nPhysicochemical methods (simple or complex coacervation, separation of organic phase, and liposomal wrapping), physical methods (spray-drying, spray chilling, spray coating, fluidized bed, extrusion, centrifugation with multiple orifices, co-crystallization, and lyophilization), and chemical methods (interfacial polymerization and molecular inclusion) have been developed for microencapsulation [9].
\nTechniques and materials for microencapsulation are described in Table 1 [1].
\nThe methods most used by the food industry and which deserve attention are described below.
\nThe oldest microencapsulation technique and one of the most widely used techniques is coacervation, which involves macromolecular aggregates that form a colloidal system with two existing phases: one that is rich in colloids (coacervate) and one that is poor in colloids (supernatant). This method is performed by depositing the encapsulating agent around the active compound through physicochemical changes, such as temperature, polarity, pH, or ionic strength [2, 6].
\nCoacervation occurs when medium changes make the wall material form polymeric chain units, which then interact with others close chains, forming aggregates. After this step, the aggregates interact with each other through high-intensity attraction forces. Consequently, the aggregated polymer chains will be deposited around the droplets of the hydrophobic phase dispersed in the emulsion, forming a protective film [4].
\nThe microcapsules obtained by coacervation can be classified as mononuclear or multinuclear according to their internal structure. When a drop of core material is encapsulated by coacervation, the particle formed is mononuclear; multinuclear particles are formed by aggregation of various mononuclear microcapsules. Multinuclear microcapsules have a matrix structure, and the core material can be released slowly unless the wall has been broken. However, mononuclear microcapsules have a vessel structure and release all their contents quickly. These particles are also irregular in structure because the wall material is not equally distributed over the surface of the core drop. The thinnest part of the wall layer will be more susceptible to disruption and release of the core.
\nTherefore, multinuclear microcapsules have greater controlled release and are produced more easily than mononuclear microcapsules [10].
\nThe microcapsules produced by coacervation may have small diameters ranging from 1 to 500 μm for complex coacervation and from 20 to 500 μm for simple coacervation [1]. An example is presented in Figure 1. When using lipophilic materials with a hydrophilic coating, high encapsulation efficiency (85–90%) is generally observed [11, 12, 13, 14, 15].
\nMicrocapsules obtained by complex coacervation with gelatin/gum arabic (A) and soybean protein (B). Source: Author.
Complex coacervation has been used for microencapsulation of sensitive microorganisms and compounds, such as probiotics bacteria, omega-3 products, and bioactive compounds [16, 17, 18].
\nThe use of spray-drying for microencapsulation is another widely used technique due to its low-cost and easy application [19]. Spray-drying technique is used in the food industry for microencapsulating juice, pulp, and vegetal extracts [20, 21], probiotics [22], and fish oil [23].
\nDuring spray-drying, a homogeneous mixture of the active material and wall material in aqueous or organic solution is subjected to a hot airstream that promotes the evaporation of the solvent drying the microcapsules. Thus technique generates no solvent residues and does not require a washing process. However, the use of high temperatures may compromise the integrity of the core and wall materials. This microcapsule production process has a high efficiency rate, which can be affected by the concentration of the wall material, the system speed, and the feed temperature [24]. Moreover, spray-drying is more widely used than other methods owing to its relatively low cost and capacity for large-scale production [25].
\nHowever, according to Kolanowski et al. [11], spray-drying results in porous particles, and this characteristic may increase the susceptibility of the core material to oxidation. Additional disadvantages include the requirement for expensive equipment and the irregularity of the produced microcapsules [6, 24].
\nTable 2 shows some recent studies about spray-drying application on food microencapsulation.
\nMethods for encapsulation | \nEncapsulated materials | \n
---|---|
Physical methods | \n|
Stationary extrusion | \nLiquid/solid/gas | \n
Submerged nozzle | \nLiquid/solid/gas | \n
Centrifugal extrusion | \nLiquid/solid/gas | \n
Vibrant nozzle | \nLiquid/solid/gas | \n
Spray-drying | \nLiquid/solid | \n
Rotating disc | \nLiquid/solid | \n
Pan coating | \nSolid | \n
Air suspension | \nSolid | \n
Spray chilling and spray cooling | \nLiquid/solid | \n
Fluidized bed | \nSolid | \n
Co-crystallization | \nLiquid/solid | \n
Lyophilization | \nLiquid | \n
Chemical methods | \n|
Interfacial polymerization | \nLiquid/solid | \n
Molecular inclusion | \nLiquid | \n
In situ polymerization | \nLiquid/solid | \n
Physical-chemical methods | \n|
Simple coacervation | \nLiquid/solid | \n
Complex coacervation | \nLiquid/solid | \n
Liposomes | \nLiquid/solid | \n
Lipospheres (solid lipid nanoparticles and nanostructured lipid carriers) | \nLiquid/solid | \n
Evaporation of the solvent | \nLiquid/solid | \n
Methods and kind of materials utilized for food products encapsulation.
Paper | \nSource | \n
---|---|
Flavonoid microparticles by spray-drying: influence of enhancers of the dissolution rate on properties and stability | \nSansone et al. [26] | \n
Microencapsulation of linseed oil by spray-drying for functional food application | \nGallardo et al. [27] | \n
Optimization of microencapsulation of fish oil with gum arabic/casein/beta-cyclodextrin mixtures by spray-drying | \nLi et al. [28] | \n
Retention of saffron bioactive components by spray-drying encapsulation using maltodextrin, gum arabic, and gelatin as wall materials | \nRajabi et al. [29] | \n
Spray-drying microencapsulation of synergistic antioxidant mushroom extracts and their use as functional food ingredients | \nRibeiro et al. [30] | \n
Spray-drying microencapsulation of cinnamon infusions (Cinnamomum zeylanicum) with maltodextrin | \nSantiago-Adame et al. [31] | \n
Influence of different combinations of wall materials on the microencapsulation of jussara pulp (Euterpe edulis) by spray-drying | \nSantana et al. [32] | \n
Sulfur aroma compounds in gum arabic/maltodextrin microparticles | \nUekane et al. [33] | \n
Spray-drying studies for microencapsulated food products.
In fluidized bed encapsulation, while the particles of the core material are suspended, the wall material is atomized into the chamber, depositing on the core. When the particles reach the top of the ascending column, they are released into a descending column of air which releases them back into the fluidized bed, where they are again coated, dried, and hardened, ensuring a uniform coating. Fluidized bed encapsulation is one of the few technologies that allow particles to be coated with any wall material (polysaccharides, proteins, emulsifiers, fats, etc.). This method has been used, for example, to isolate iron from ascorbic acid in multivitamin formulations or to encapsulate salt and acidulants avoiding, this way, the interaction of such ingredients with others [34].
\nRegardless of the method for microencapsulation, release of the core material depends on various factors, including pH, temperature, diffusion, medium solubility, mechanical rupture, and biodegradation. Additionally, the thickness of the encapsulating material may alter the stability and permeability of the microcapsules [1].
\nOne of the most promising possibilities of flavor stabilization is the formation of inclusion complex (molecular encapsulation) with β-cyclodextrin. Szente and Szejtli [35] investigating the stabilization of natural and synthetic coffee compounds with β-cyclodextrin, and thermal stability of this carbohydrate, observed the molecular encapsulation with natural and synthetic coffee compounds. They also noted that β-cyclodextrin is thermally destroyed at 260°C.
\nInclusion compounds of β and γ-cyclodextrins with essential oils of lemon, orange, and camomile have been studied. Lemon and orange oils resulted in the union with β and γ-cyclodextrin. With camomile oil, the complex observed was only with γ-cyclodextrin [36].
\nThe wall material should be able to form a film that is cohesive with the core material, be chemically compatible and nonreactive with the core material, and provide the desired coating properties, for example, strength, flexibility, impermeability, and stability [37]. In order to be able to be applied in food, the wall material must be food grade, biodegradable, and capable of forming a barrier between the active agent and the medium [19].
\nImportantly, some core materials are insoluble in aqueous solutions and may not easily form emulsions [38]. Specific proteins may function as emulsifiers, and polysaccharides contribute to the stability of emulsions; the interactions between proteins and carbohydrates can also help stabilize the emulsions.
\nAmong the polysaccharides utilized as wall materials, gum arabic, maltodextrins, and modified starches are the most usual because of the high molecular weight and the high glass transition temperature [19]. However, other polysaccharides are also used, such as carrageenan, carboxymethylcellulose (CMC), and chitosan.
\nGums are a group of polysaccharides and polysaccharide derivatives obtained from plants or secreted by bacteria and are commonly used for microcapsule production in the food industry.
\nGum arabic has low viscosity in water, provides good retention of volatile compounds (>85%), and protects the core material from oxidation, which is crucial for microencapsulating essential oils and volatile substances [7]. Gum arabic has advantages for having this property emulsifier in a wide pH range, as well as other texturing, training film around the droplets and binding properties [38]. Conto et al. [17] studied the complex coacervation of soy proteins with gum arabic (GA); Renard et al. [39] worked with vitamin E microencapsulated on β-lactoglobulin/GA matrix.
\nAlternatively, alginate can be used for microencapsulation. This material forms strong, elastic gels with a distinct three-dimensional network. The gel network and homogeneity depends on the cation concentration; excess Ca2+ may result in multiple alginate chains having different physicochemical properties.
\nAlginate can also be used to produce microcapsules and cell immobilization through ionotropic gelation, which involves dropping the concentrated alginate solution into calcium chloride solution, externally gelling the polymer into a microcapsule. The size of the microcapsules formed using external gelation is governed by the size of droplets formed during the extrusion process [40] and ranges from tens of microns to millimeter size. Less commonly, microcapsules may be formed by internal gelation, in which the alginate in solution contains calcium carbonate [41].
\nAnother common use of alginate microcapsules is to reduce the viability losses of probiotic bacteria, like Bifidobacterium and Lactobacillus. Some works with probiotics alginate encapsulation are presented by Cook et al. [42] and are summarized in Table 3.
\nEncapsulation material | \nBacteria | \nReference apud Cook et al. [42] | \n
---|---|---|
Alginate | \nLactobacillus acidophilus | \nChandramouli et al. [40] | \n
Alginate coated with palm oil and poly- | \n8 different Lactobacilli and Bifidobacteria | \nDing et al. [43] | \n
Alginate and xanthan gum | \nLactobacillus acidophilus | \nKim et al. [44] | \n
Alginate coated with either chitosan, alginate, or poly- | \nLactobacillus acidophilus, Bifidobacterium bifidum, Lactobacillus casei | \nKrasaekoopt et al. [45] | \n
Alginate | \nLactobacillus casei | \nMandal et al. [46] | \n
Alginate Alginate and pectin | \nLactobacillus casei | \nSandoval-Castilla et al. [41] | \n
Alginate coated with whey protein | \nLactobacillus plantarum | \nGbassi et al. [47] | \n
Alginate coated with chitosan, Sureteric, or Acryl-EZE | \nBifidobacterium animalis | \nLiserre et al. [48] | \n
Alginate coated with chitosan | \nBifidobacterium breve | \nCook et al. [42] | \n
Overview of literature available on the alginate encapsulation of probiotics cited by Cook et al. [42].
Carrageenans are widely used as thickening and stabilizing agents. Previous studies have reported microcapsules produced by carrageenan and oligochitosan polymer, but most reports have described the use of carrageenan for the encapsulation of microbial cells due to its capacity for gelation with the change in temperature from 40 to 45°C [49], suggesting the potential for use in probiotic foods.
\nStarch and modified starch can also be used as a wall material owing to its low viscosity, outstanding retention volatility (>93%), and ability to stabilize the emulsion with the core material [7]. Starches and their derivatives have been applied for the microencapsulation of vitamins, such as ascorbic acid [50, 51]. Maltodrextrin, which is inexpensive and has low hygroscopicity, can be used to prevent particle agglomeration [17] and has antioxidant effects [7].
\nChitosan is also commonly used as a gelation agent in the food and pharmaceutical industries. Chitosan also allows concurrent cell permeabilization and immobilization; thus, chitosan-containing complexes of coacervated capsules have been widely explored [52].
\nAdditionally, carboxymethylcellulose (CMC), an anionic water-soluble polymer, is used as an industrial agent owing to its capacity as a thickener, suspending agent, stabilizer, and binder. CMC forms resistant films that can protect against organic solvents, oils, and greases [53].
\nProtein films are excellent oxygen and aroma barriers and can be used to produce microcapsules using coacervation techniques [54] or double emulsions with subsequent reticulation using glutaraldehyde or heat gelation [55]. Usually, proteins have been utilized with other biopolymers; some examples are presented in Table 4.
\nWall material | \nCore material | \nSource | \n
---|---|---|
Gelatin/gum arabic | \nSoybean oil, olive oil, and peanut oil | \nRabišková, Valasková [68] | \n
Gelatin/gum arabic | \nEPA | \nLamprecht, Schäfer, Lehr [69] | \n
Gelatin/gum arabic | \nFish oil | \nJouzel et al. [70] | \n
Whey protein/gum arabic | \nSunflower oil, lemon, and orange essential oil | \nWeinbreck, Minor, DeKuif [58] | \n
Hydroxpropyl methylcellulose | \nFish oil | \nWu, Chai, Chen [71] | \n
Gelatin/gum arabic | \nOleoresin and soybean oil | \nAlvim [72] | \n
Gelatin/gum arabic | \nBaking flavor | \nYeo et al. [73] | \n
Gelatin/pectin/gum arabic | \nOils | \nPrata [74] | \n
Gelatin/gum arabic | \nPeppermint oil | \nDong et al. [10] | \n
Gelatin | \nStigmasterol | \nOliveira [75] | \n
SPI/pectin | \nCasein hydrolyzate | \nMedanha et al. [76] | \n
b-Lg/pectin | \nDHA | \nZimet, Livney [77] | \n
Gelatin/polyphosphate | \nFish oil ethyl ester | \nBarrow, Nolan, Holub [78] | \n
Gelatin/gum arabic | \nFlavors | \nLeclercq, Milo, Reineccius [79] | \n
Gelatin/gum arabic | \nSoybean oil and paprika resin oil | \nCélis [80] | \n
Gelatin/gum arabic | \n1-Dodecanol (C12OH) | \nKong et al. [81] | \n
HPMC/NaCMC/SDS | \nSunflower oil | \nKatona, Sovilj, Petrovic [82] | \n
SPI/gum arabic | \nOrange essential oil | \nJun-Xia, Hai-Yan, Jian [13] | \n
Overview of literature available on the proteins as encapsulant material.
Whey proteins (WPC and WPI) have also been investigated as wall materials for microencapsulation. For example, whey protein has been used for encapsulation of volatile and nonvolatile materials [56], typically through spray-drying, complex coacervation, heat gelation, and enzymatic gelation [57, 58]. Combinations such as whey protein isolate/gum arabic [59], β-lactoglobulin/pectin [60], β-lactoglobulin (b-Lg)/κ-carrageenan [61], whey protein/chitosan/gum arabic [62], and milk protein products/xanthan [63] are frequently used.
\nDespite these studies, proteins from plant sources have not been commonly used as carrier or wall materials in microencapsulation applications owing to limitations related to heat instability and organic solvent sensitivity. However, the use of reticulating agents to convert the proteins into a more stable form may improve their industrial applicability [64].
\nAdditionally, soy proteins have the benefits of renewability, low-cost, and healthful effects [65]. Soy protein has high compatibility with gum arabic. SPI has been successfully used for microencapsulation of casein hydrolysate by spray-drying [66], orange essential oil by complex coacervation [13], and fish oil by enzymatic gelation [57]. Figure 2 presents microcapsules obtained with SPI by complex coacervation and enzymatic gelation.
\nMEV of SPI microcapsules obtained by complex coacervation (A) and enzymatic gelation (B). Source: Author.
Gelatin can also be used as a foaming agent, emulsifier, and humectants in food, pharmaceutical, medical, and technical application sowing to its surface-active properties. Type A gelatin has a high isoelectric point and can form oil/water emulsions with positive charges at a wide range of pH values [67].
\nAmong core materials, essential oils are highly unstable and are sensitive to variations in light, air, temperature, and humidity. Therefore, new methods are needed to protect oils against these changes in order to increase their shelf life and their chemical stability under adverse conditions [1, 7].
\nVitamins and minerals are generally added to foods to increase nutritional value, such as cereals, dairy products, infant foods, etc. However, these compounds can cause the food to taste unpleasant or may react with other food constituents, changing their sensory characteristics. Therefore, microencapsulation is widely used to protect vitamins and minerals against adverse conditions, such as temperature and humidity, to prevent undesirable reactions in food [1].
\nMicroorganism microencapsulation has been applied to allow reuse of bacteria during the production of lactic acid and fermented milk products; increase production and cell concentrations in reactors; provide protection against oxygen gas, freezing temperatures, and the unfavorable pH of gastric juices and other acids; remove cell sand stop acidification; provide greater stability and maintain the viability of cultures during product storage; and increase their useful life [1].
\nMicroencapsulation is widely used for enzyme immobilization, allowing reuse of enzymes and providing enzymes with superior stability; these features also reduced costs associated with the relevant processes. Moreover, microencapsulation for immobilization of enzymes is simple and permits the production of microcapsules having a variety of compositions [83].
\nMany studies have shown that consumption of omega-3 polyunsaturated fatty acids provides multiple health benefits, including reducing the risk of cardiovascular disease. Polyunsaturated fatty acids of the omega-3 group are mainly found in marine animals, such as plankton and fish in cold and deep waters, and fish oil has been the traditional source of these fatty acids. However, fish oil has an undesirable flavor. Thus, microencapsulation has been used for incorporation of fish oil as the core material, hiding the unpleasant sensory characteristics of the oil [17].
\nIn studies with omega-3 microcapsules applied in food products, Chavez-Servín et al. [84] examined the addition of microencapsulated omega-3 fatty acids in infant formulas. Lysine and lactose degradation were observed; however, it was determined that the microcapsules did not affect the sensory acceptance of the final product. Moreover, Yep et al. [85] applied omega-3 microcapsules in bakery products and evaluated the effects of consumption of small daily doses of omega-3 fatty acids by intake of commercial bread compared to supplementation with capsules. They concluded that the effects depended on the amount of EPA and DHA in the blood of the individuals studied. Serna-Saldivar et al. [86] determined the shelf life of bread enriched with DHA and microencapsulated fish oil, showing that the development of off-flavors occurred more quickly in the breads containing liquid fish oil. Davidov-Pardo et al. [87] also observed changes in technological and sensory characteristics of breads containing omega-3 microcapsules.
\nThe encapsulation of acids such as ascorbic, citric, fumaric, and lactic acids is usually carried out to avoid oxidation and allow them to be dissolved under specific conditions. Three specific applications stand out in this case: the dough improver, because the encapsulated ascorbic acid is often used to alter dough strength and improve slicing properties, color, and texture of baked products, being released during the proofing and baking stages, the aroma complement, and as an auxiliary agent in the meat processing, allowing the desired cured meat pigments to form [88].
\nSome natural colorants, such as urucum, β-carotene, and Curcuma, have solubility problems. It can be solved by encapsulation processes, which make them easier to handle during the process and improve the solubility and oxidation stability. Another advantage that can be associated with its use is in the shelf life extension, which can exceed 2 years, compared to the 6 months for non-encapsulated ones [88].
\nFoods and other substances microencapsulated exhibit wide applicability, being an effective and extremely important tool in the preservation of various nutritional components, microorganisms, enzymes, dyes, etc., protecting food and other products from the most aggressive processing methods.
\nSeveral materials can be used as encapsulants, the most common being carbohydrates and some proteins, due to their higher affinity with various types of materials to be encapsulated. There are several methods of encapsulation by physical, chemical, and physicochemical, the most used being atomization, fluidized bed, and coacervation.
\nDespite the wide applicability, encapsulation has found little space in the food industry because of the cost. While the pharmaceutical and cosmetic sectors often support the use of high-cost techniques, the food industry works with lower profit margins, reducing production costs. In addition, industries often have strong resistance to the adoption of new technologies, due to the cost of implementation and the need for training.
\nDevelopment of methodologies for incorporation of functional compounds in foods is needed to improve the health benefits and marketability of foods. Finally, microencapsulation of nutrients is a relatively new technology in the food industry, and further studies are needed to determine how to apply this technology most effectively.
\nThis work was partly funded by the Federal Institute of Triangulo Mineiro—Campus Uberlândia and a FAPEMIG research scholarship.
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