Fluxapyroxad induced toxicity of earthworms: Insights from multi-level experiments and molecular simulation studies.

Fluxapyroxad, an emerging succinate dehydrogenase inhibitor fungicide, is widely used due to its excellent properties. Given its persistence in soil with a 50 % disappearance time of 183-1000 days, it is crucial to evaluate the long-term effects of low-dose fluxapyroxad on non-target soil organisms such as earthworms (Eisenia fetida). The present study investigated the impacts of fluxapyroxad (0.01, 0.1, and 1 mg kg-1) on Eisenia fetida over 56 days, focusing on oxidative stress, digestive and nervous system functions, and histopathological changes. We also explored the mechanisms of fluxapyroxad-enzyme interactions through molecular docking and dynamics simulations. Results demonstrated a significant dose-response relationship in the integrated biomarker response of 12 biochemical indices. Fluxapyroxad altered expression levels of functional genes and induced histopathological damage in earthworm epidermis and intestines. Molecular simulations revealed that fluxapyroxad is directly bound to active sites of critical enzymes, potentially disrupting their structure and function. Even at low doses, long-term fluxapyroxad exposure significantly impacted earthworm physiology, with effects becoming more pronounced over time. Our findings provide crucial insights into the chronic toxicity of fluxapyroxad and emphasize the importance of long-term, low-dose studies in pesticide risk assessment in soil. This research offers valuable guidance for the responsible management and application of fungicides.

Unraveling the Distribution, Metabolization, and Catabolism of Foliar Sprayed Carbon Dots in Maize and Effect on Soil Environment.

The enormous potential of carbon dots (CDs) in agriculture has been widely reported, whereas their accurate distribution, transformation, and metabolic fate and potential soil health effects are not clearly understood. Herein, 13C-labeled CDs (13C-CDs) were sprayed on maize leaf, accumulated in all tissues, and promoted photosynthesis. Specifically, 13C-CDs were internalized to participate in the synthesis of glucose, sucrose, citric acid, glyoxylate, and chlorogenic acid, promoting tricarboxylic acid cycle (TCA) and phenylalanine metabolism. Additionally, the catabolism of 13C-CDs in vivo was mainly mediated by O2•- produced by oxidative stress. 13C-CDs did not have an obvious impact on the soil environment at the overall level. The detection of 13C signals in soil fauna suggested 13C-CDs in soil food chain transmission. This study systematically described the exact fate of CDs in plants and potential soil ecological risks and provided a more comprehensive analysis and support for the potential advantages of CDs in agricultural application.

Discovery of a Hybrid Molecule with Phytotoxic Activity by Genome Mining, Heterologous Expression, and OSMAC Strategy.

Genome mining in association with the OSMAC (one strain, many compounds) approach provides a feasible strategy to extend the chemical diversity and novelty of natural products. In this study, we identified the biosynthetic gene cluster (BGC) of restricticin, a promising antifungal agent featuring a reactive primary amine, from the fungus Aspergillus sclerotiorum LZDX-33-4 by genome mining. Combining heterologous expression and the OSMAC strategy resulted in the production of a new hybrid product (1), along with N-acetyl-restricticin (2) and restricticinol (3). The structure of 1 was determined by spectroscopic data, including optical rotation and electronic circular dichroism (ECD) calculations, for configurational assignment. Compound 1 represents a fusion of restricticin and phytotoxic cichorin. The biosynthetic pathway of 1 was proposed, in which the condensation of a primary amine of restricticin with a precursor of cichorine was postulated. Compound 1 at 5 mM concentration inhibited the growth of the shoots and roots of Lolium perenne, Festuca arundinacea, and Lactuca sativa with inhibitory rates of 71.3 and 88.7% for L. perenne, 79.4 and 73.0% for F. arundinacea, and 58.2 and 52.9% for L. sativa. In addition, compound 1 at 25 µg/mL showed moderate antifungal activity against Fusarium fujikuroi and Trichoderma harzianum with inhibition rates of 22.6 and 31.6%, respectively. These results suggest that heterologous expression in conjunction with the OSMAC approach provides a promising strategy to extend the metabolite novelty due to the incorporation of endogenous metabolites from the host strain with exogenous compounds, leading to the production of more complex compounds and the acquisition of new physiological functions.

Role of short-chain fatty acids in host physiology.

Short-chain fatty acids (SCFAs) are major metabolites produced by the gut microbiota through the fermentation of dietary fiber, and they have garnered significant attention due to their close association with host health. As important mediators between the gut microbiota and the host, SCFAs serve as energy substrates for intestinal epithelial cells and maintain homeostasis in host immune and energy metabolism by influencing host epigenetics, activating G protein-coupled receptors, and inhibiting pathogenic microbial infections. This review provides a comprehensive summary of SCFAs synthesis and metabolism and offering an overview of the latest research progress on their roles in protecting gut health, enhancing energy metabolism, mitigating diseases such as cancer, obesity, and diabetes, modulating the gut-brain axis and gut-lung axis, and promoting bone health.

Biosynthesis of Epipyrone A Reveals a Highly Specific Membrane-Bound Fungal C-Glycosyltransferase for Pyrone Galactosylation.

Epipyrone A is a unique C-galactosylated 4-hydroxy-2-pyrone derivative with an antifungal potential from the fungus Epicoccum nigrum. We elucidated its biosynthesis via heterologous expression and characterized an unprecedented membrane-bound pyrone C-glycosyltransferase biochemically. Molecular docking and mutagenesis experiments suggested a possible mechanism for the heterocyclic C-glycosylation and the importance of a transmembrane helix for its catalysis. These results expand the repertoire of C-glycosyltransferases and provide new insights into the formation of C-glycosides in fungi.

ent-Atisane Diterpenoids from Euphorbia helioscopia and Their Anti-inflammatory Activities.

Phytochemical investigation on the anti-inflammatory fraction extracted from the whole plant of Euphorbia helioscopia L. led to the isolation of three new ent-atisane diterpenoids (1-3) and five known analogues (4-8). The structures and absolute configurations of the new compounds were elucidated by comprehensive analysis of the NMR, MS, IR, ECD, and X-ray crystallography. It is worth mentioning that compound 3 belongs to a rare class of ent-atisane diterpenoid featuring a hydroxyl group at C-9. Bioactivity investigation showed that compounds 4, 7, and 8 exhibited significant inhibitory effects on LPS-induced NO production in a dose-dependent manner, which indicates their anti-inflammatory potential.

Jatrophane diterpenoids with cytotoxic activity from the whole plant of Euphorbia heliosocpia L.

Eight undescribed jatrophane diterpenoids, euphohelinoids A-H, along with 11 known analogues were isolated from the whole plant of Euphorbia heliosocpia L. Among them, euphohelinoids A and B contain a rare type of jatrophane diterpenoid skeleton with a 7,8-seco scaffold. To the best of our knowledge, only two such jatrophane diterpenoids have been reported. In addition, euphohelinoids G and H belong to a rare class of jatrophane diterpene possessing a ß-hydroxy group at C-11. Structure elucidation of these undescribed diterpenoids was performed by spectroscopic analysis, including NMR, HRESIMS, IR, electronic circular dichroism (ECD) and DP4+ analysis. The cytotoxicity of 17 abundant jatrophane diterpenes was evaluated against HepG2, HeLa, HL-60, and SMMC-7721 cell lines. Seven compounds presented potent cytotoxicity against the four tested cell lines with IC50 values from 8.1 to 29.7 µM. Moreover, preliminary structure-activity relationships for these jatrophane diterpenoids were discussed.

Quassinoids with Inhibitory Activities against Plant Fungal Pathogens from Picrasma javanica.

A bioactivity-guided study on the leaves of Picrasma javanica led to the isolation of 19 quassinoids, including 13 new compounds. The structures of the new compounds were elucidated by a combination of spectroscopic data analysis, X-ray crystallography studies, and electronic circular dichroism (ECD) data interpretation. Compounds 1-7 are rare examples of quassinoids with a keto carbonyl group at C-12. The biological activities of 11 of the more abundant isolates were evaluated against five phytopathogenic fungi in vitro, and several of them including 6 and 15 showed moderate inhibitory effects that were comparative to those of the positive control, carbendazim. In addition, the preliminary structure-activity relationships (SARs) of these quassinoids were also investigated.

Systemic Immune-Inflammation Index Is Superior to Neutrophil to Lymphocyte Ratio in Prognostic Assessment of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy.

RESULTS: SII, NLR, and PLR did not define patient groups with distinct clinicopathological characteristics. SII, NLR, and PLR cut-off values were 547, 2.13, and 88.23, as determined by ROC analysis; the corresponding areas under the curve (AUCs) were 0.625, 0.555, and 0.571, respectively. Cox regression models identified SII as independently associated with OS. Patients with low SII had prolonged OS (65 vs. 41 months, P = 0.017, HR: 3.24, 95% CI: 1.23-8.55). In the Z test, the difference in AUC between SII and NLR was statistically significant (Z = 2.721, 95% CI: 0.0194-0.119, P = 0.0065). CONCLUSION: Our study suggests that the pretreatment SII value is significantly correlated with OS in breast cancer patients undergoing NAC and that the prognostic utility of SII is superior to that of NLR and PLR.

Tailoring neoadjuvant chemotherapy for patients with breast cancer who have achieved pathologic complete response.

BACKGROUND: We retrospectively examined whether different cycles of chemotherapy affected the prognosis of patients who achieved a pathologic complete response (pCR). METHODS: We reviewed data from patients who achieved pCR after neoadjuvant chemotherapy (NACT) between 2008 and 2018. In total, 286 patients were divided into three groups: group one (n=148, 52%) completed standard chemotherapy cycles before surgery, group two (n=81, 28%) did not complete standard chemotherapy cycles before surgery or received chemotherapy after surgery, and group three (n=57, 20%) did not complete standard chemotherapy cycles before surgery but completed them after surgery. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method, and differences between groups were evaluated by the log-rank test. Cox proportional hazards regression analysis was adjusted for different NACT groups, age, Ki-67 levels, and clinical stages. RESULTS: After a median follow-up of 26 months, there were no significant differences in RFS among the NACT groups (P=0.14). Multivariate analysis showed that Ki-67 ≥40% (P=0.03) and clinical stage (IIIB + IIIC) (P=0.002) might be risk factors for recurrence in patients with pCR. There were no significant differences in survival among subgroups according to Ki-67 levels and clinical stages. CONCLUSIONS: Our study suggests that, even with pCR, patients with baseline stage IIIB or IIIC or Ki-67 levels ≥40% may have an increased risk of recurrence. The RFS of patients with pCR was not associated with the completion of standard chemotherapy cycles, even in high-risk patients. Therefore, the prevention of excessive chemotherapeutic treatment by de-escalation is necessary for patients with pCR.

An Abbreviated Scale for the Assessment of Skeletal Bone Age Using Radiographs of the Knee.

Hand and wrist radiographs are the most common means for estimating skeletal bone age. There is no widely used scale for estimating skeletal bone age using knee radiographs. Do skeletal bone age estimates from knee-maturity scales correlate sufficiently with both chronologic age and estimates from a hand-wrist scale to potentially substitute for estimates from the latter? The authors reviewed the records of 503 patients 6 to 19 years old who had hand and knee radiographs obtained within 30 days of each other. They analyzed radiographs using the O'Connor knee scale (based on 10 maturation markers) and a new, abbreviated version of the O'Connor scale (based on 7 markers). The authors also analyzed radiographs of the hands of boys 12.5 to 16 years old and girls 10 to 16 years old using the shorthand method. Multivariate linear regression was used for analysis. Inter- and intrarater reliabilities were assessed. Skeletal bone age derived from the O'Connor and abbreviated knee scales correlated with chronologic age (adjusted R2=0.88 and 0.90, respectively). Compared with estimates from the hand-wrist scale, estimates were lower by a mean of 0.91 years for boys and 0.38 years for girls when using the O'Connor scale and 0.96 years for boys and 0.52 years for girls when using the abbreviated scale. Inter- and intrarater reliabilities were very good (κ=0.82 and 0.90, respectively) and were substantial at each bony landmark measured. Knee radiographs can be used to estimate skeletal bone age using an abbreviated knee scale. [Orthopedics. 2018; 41(5):e676-e680.].

MR-guided percutaneous biopsy of solitary pulmonary lesions using a 1.0-T open high-field MRI scanner with respiratory gating.

OBJECTIVES: To prospectively evaluate the feasibility, safety and accuracy of MR-guided percutaneous biopsy of solitary pulmonary lesions using a 1.0-T open MR scanner with respiratory gating. METHODS: Sixty-five patients with 65 solitary pulmonary lesions underwent MR-guided percutaneous coaxial cutting needle biopsy using a 1.0-T open MR scanner with respiratory gating. Lesions were divided into two groups according to maximum lesion diameters: ≤2.0 cm (n = 31) and >2.0 cm (n = 34). The final diagnosis was established in surgery and subsequent histology. Diagnostic accuracy, sensitivity and specificity were compared between the groups using Fisher's exact test. RESULTS: Accuracy, sensitivity and specificity of MRI-guided percutaneous pulmonary biopsy in diagnosing malignancy were 96.9 %, 96.4 % and 100 %, respectively. Accuracy, sensitivity and specificity were 96.8 %, 96.3 % and 100 % for lesions 2.0 cm or smaller and 97.1 %, 96.4 % and 100 %, respectively, for lesions larger than 2.0 cm. There was no significant difference between the two groups (P > 0.05). Biopsy-induced complications encountered were pneumothorax in 12.3 % (8/65) and haemoptysis in 4.6 % (3/65). There were no serious complications. CONCLUSIONS: MRI-guided percutaneous biopsy using a 1.0-T open MR scanner with respiratory gating is an accurate and safe diagnostic technique in evaluation of pulmonary lesions. KEY POINTS: • MRI-guided percutaneous lung biopsy using a 1.0-T open MR scanner is feasibility. • 96.9 % differentiation accuracy of malignant and benign lung lesions is possible. • No serious complications occurred in MRI-guided lung biopsy.

Cystoid angiocentric glioma: A case report and literature review.

Angiocentric glioma is a rare subtype of neuroepithelial tumor that is associated with a history of epilepsy. We report a case of cystoid angiocentric glioma associated with an area of calcification. This 25 year old male patient presented with tonic clonic spasm. He underwent craniotomy with complete resection of the lesion. Pathologic specimen showed monomorphous bipolar cells with angiocentric growth pattern.

MRI-guided percutaneous transpedicular biopsy of thoracic and lumbar spine using a 0.23t scanner with optical instrument tracking.

PURPOSE: To prospectively evaluate the safety and accuracy of magnetic resonance imaging (MRI)-guided percutaneous transpedicular biopsy of thoracic and lumbar spine using 0.23T magnetic resonance imaging with optical tracking. MATERIALS AND METHODS: Sixty-seven thoracic and lumbar spine lesions in 67 patients underwent MRI-guided percutaneous transpedicular biopsy using 0.23T MRI with optical tracking. These lesions were divided into two groups according to the location: 16 lesions in the thoracic spine and 51 lesions in the lumbar spine. The diagnostic accuracy, sensitivity, and specificity were calculated, and comparison of the two groups was performed using Fisher's exact test. Each patient was monitored for complications. RESULTS: All specimens obtained were sufficient for diagnosis. Histological examination of MRI-guided percutaneous biopsy revealed 38 malignant and 29 benign lesions. The final diagnoses from surgery or clinical follow-up were 42 malignant lesions and 25 benign lesions. The combined diagnostic performance of MRI-guided percutaneous transpedicular thoracic and lumbar biopsy in diagnosing malignant tumors was as follows: accuracy, 94%; sensitivity, 89%; and specificity, 100%. There was no significant difference between the two groups (P = 1, Fisher's exact test). No serious complications occurred. CONCLUSION: MRI-guided percutaneous transpedicular biopsy is a safe and accurate diagnostic technique to evaluate thoracic and lumbar spine lesions.

The systematic assessment of traditional evidence from the premodern Chinese medical literature: a text-mining approach.

OBJECTIVES: This project aimed to develop an approach to evaluating information contained in the premodern Traditional Chinese Medicine (TCM) literature that was (1) comprehensive, systematic, and replicable and (2) able to produce quantifiable output that could be used to answer specific research questions in order to identify natural products for clinical and experimental research. METHODS: The project involved two stages. In stage 1, 14 TCM collections and compendia were evaluated for suitability as sources for searching; 8 of these were compared in detail. The results were published in the Journal of Alternative and Complementary Medicine. Stage 2 developed a text-mining approach for two of these sources. RESULTS: The text-mining approach was developed for Zhong Hua Yi Dian; Encyclopaedia of Traditional Chinese Medicine, 4th edition) and Zhong Yi Fang Ji Da Ci Dian; Great Compendium of Chinese Medical Formulae). This approach developed procedures for search term selection; methods for screening, classifying, and scoring data; procedures for systematic searching and data extraction; data checking procedures; and approaches for analyzing results. Examples are provided for studies of memory impairment and diabetic nephropathy, and issues relating to data interpretation are discussed. CONCLUSIONS: This approach to the analysis of large collections of the premodern TCM literature uses widely available sources and provides a text-mining approach that is systematic, replicable, and adaptable to the requirements of the particular project. Researchers can use these methods to explore changes in the names and conceptions of a disease over time, to identify which therapeutic methods have been more or less frequently used in different eras for particular disorders, and to assist in the selection of natural products for research efforts.

MRI-guided stereotactic aspiration of brain abscesses by use of an optical tracking navigation system.

BACKGROUND: Owing to the high risk of abscess drainage by craniotomy, imaging-guided stereotactic aspiration is considered an ideal choice in the management of brain abscesses. Interventional magnetic resonance imaging (MRI) represents a valuable technique for the treatment of brain abscess as a guiding modality. PURPOSE: To evaluate the safety and efficacy of an interventional MRI system in performing the procedure. MATERIAL AND METHODS: Thirteen brain abscesses in 11 patients were treated with percutaneous aspiration. All procedures were performed solely under the guidance of a 0.23-T open-configuration MRI scanner with optical tracking. Clinical and imaging follow-up was at 1 week, 1 month, 3 months, and 6 months. The changes of abscess, MRI features, and clinical symptoms were recorded. Procedure efficacy and safety were evaluated by success rate, procedure time, decrease of abscess, recovery rate, and complication. Descriptive statistical analysis was performed. RESULTS: MRI-guided stereotactic aspirations were performed successfully in 13/13 (100%) abscesses. The mean operating time was 70 min (range, 45-100 min). Follow-up MRI at 1 week after the procedure showed average reduction of abscesses by 60% (2.1/3.5). And the abscesses continued to get smaller by up to 89.7% (3.14/3.5) at 1-month follow-up. All cavities resolved at the end of the 6-month follow-up period. The recovery rate was 100% for fever, headache, vomiting, papilledema, meningismus, altered sensorium, 75% (3/4) for hemiparesis, and 83.3% (5/6) for epilepsy. There were no complications. CONCLUSION: Punctures of brain abscesses with subsequent aspiration can be performed safely and efficiently by monitoring the procedure using an open interventional MRI system.

The prevalence of osteoarthritis of the atlanto-odontoid joint in adults using multidetector computed tomography.

BACKGROUND: The prevalence of osteoarthritis of the atlanto-odontoid joint has been reported by radiology, autopsy, and conventional computed tomography (CT), but the prevalence has not yet been assessed by multidetector computed tomography (MDCT). PURPOSE: To reveal the prevalence of osteoarthritis of the atlanto-odontoid joint and to analyze the inter-relationships among gender, age, and osteoarthritis with MDCT in adults. MATERIAL AND METHODS: First, a series of 700 selected domestic patients aged >18 years undergoing an upper cervical MDCT scan were divided equally into seven age groups. Second, using the postprocessing technique of multiplanar reconstruction, osteoarthritis of the atlanto-odontoid joint was viewed from any direction and classified into four grades, which were normal, mild, moderate, and severe. Lastly, the incidence of the different grades of osteoarthritis was assessed, and the reproducibility was tested. RESULTS: There was no significant difference between gender and osteoarthritis of atlanto-odontoid joint (P > 0.05). The rate of osteoarthritis was 16% in the age group 18-25 years, 23% in the age group 25-30 years, 33% in the age group 30-40 years, 54% in the age group 40-50 years, 70% in the age group 50-60 years, 87% in the age group 60-70 years, and 93% in the age group >70 years. Mild osteoarthritis appeared at the earliest at age 19.6 years, moderate osteoarthritis in at earliest at age 24.2 years, and severe osteoarthritis at the earliest at age 48.5 years. The inter-observer reliability was excellent (k = 0.86). CONCLUSION: Osteoarthritis of the atlanto-odontoid joint could be detected by MDCT in a young adult. It increased rapidly with increasing age on MDCT.

Chinese herbs for memory disorders: a review and systematic analysis of classical herbal literature.

Text mining and other literature-based investigations can assist in identifying natural products for experimental and clinical research. This article details a method for systematically analyzing data derived from the classical Chinese medical literature. We present the results of electronic searches of Zhong Hua Yi Dian ("Encyclopaedia of Traditional Chinese Medicine"), a CD of 1000 premodern (before 1950) medical books, for single herbs, and other natural products used for dementia, memory disorders, and memory improvement. This review explores how the terminology for these disorders has changed over time and which herbs have been used more or less frequently, and compares the results from the premodern literature with the herbs indexed for memory disorders in a modern pharmacopoeia. The searches located 731 citations deriving from 127 different books written between ca. 188 ad and ca. 1920. Of the 110 different natural products identified, those most frequently cited for forgetfulness were yuan zhi (Polygala tenuifolia), fu shen (Poria cocos), and chang pu (Acorus spp.), all of which have been cited repeatedly over the past 1800 years and appear among the 31 herbs indexed in a modern pharmacopoeia. By providing a complete, hierarchically organized list of herbs for a specific disorder, this approach can assist researchers in selecting herbs for research.

Systematic assessment of the representativeness of published collections of the traditional literature on Chinese medicine.

BACKGROUND: The traditional Chinese medical literature provides a substantial resource for natural products research. When undertaking systematic searches, investigators need to assess the scope, content, and relevance of collections both singly and in comparison. OBJECTIVES: This study examines eight collections of pre-modern literature, develops an approach to quantitatively assess their content, and compares their relative inclusivity. METHODS: All publications listed in each collection were collated and a uniform scoring system was developed to account for variant editions, incorporation of multiple books under a single title, addition of commentaries, and other factors affecting content. Comparisons were undertaken between collections to determine the degree of overlap, genres of literature represented, and relevance to natural products research. RESULTS: Following adjustments for differences in how books were listed, duplications, and variant editions, Zhong Hua Yi Dian (Encyclopaedia of Traditional Chinese Medicine) (4th edition CD) is the largest collection of complete books containing 1009 different books. Zhong Guo Ben Cao Quan Shu (The Complete Collection of Traditional Texts on Chinese Materia Medica) contains 2026 titles including multiple editions and extracts, so after adjustments the number of different complete books is approximately 740. No collection was fully inclusive of the others, but Zhong Hua Yi Dian includes between 52.1% and 91.5% of the books in the six smaller collections. CONCLUSIONS: Comparing traditional collections is complex due to variant editions and multiple titles. This necessitates examination of the text rather than title alone. Prior to undertaking systematic searches, the characteristics of collections need to be investigated, duplicated books identified, and differences between editions should be assessed. Its size, electronic format, and broad spread of genres makes Zhong Hua Yi Dian suitable for systematic searches, but due to the lack of bibliographical detail on included books, cross-referencing to other collections is recommended.

Magnetic resonance imaging-guided percutaneous biopsy of mediastinal masses: diagnostic performance and safety.

OBJECTIVE: The objective of this study was to evaluate the diagnostic performance and safety of magnetic resonance (MR) imaging-guided percutaneous mediastinal biopsy procedures using a 0.23-T open MR system with optical tracking navigation. MATERIALS AND METHODS: A retrospective analysis of 59 participants (38 males and 21 females; mean age, 45 years; range, 16-73 years) who underwent MR imaging-guided percutaneous mediastinal biopsy procedures was performed. The access techniques included extrapleural (40 of 59; 67.8%) and transpulmonary (19 of 59; 32.2%) needle paths. Tissue sampling techniques included fine-needle aspiration (22 of 59; 37.3%) and core-needle biopsy (37 of 59; 62.7%). Histopathological analysis of surgical specimen and clinical and imaging follow-ups were used as the reference standard. The procedures were evaluated for technical success rate, number of biopsy passes, diagnostic performance, procedure time, and complications. RESULTS: Technical success was achieved in 57 of the 59 procedures (96.6%). For the fine-needle aspiration, a mean of 3 passes (range, 2-4 passes) was performed. For the core-needle biopsy, a mean of 4 passes (range, 3-6 passes) was performed. Pathological and cytological analysis of biopsy specimens showed 41 of 57 malignant lesions (71.9%) and 16 of 57 benign lesions (28.1%), with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 93.2% (41 of 44), 100% (13 of 13), 100% (41 of 41), 81.2% (13 of 16), and 94.7% (54 of 57), respectively. Procedure time was 30 minutes (range, 20-50 minutes). Mild hemoptysis occurred in 3 cases, and in 2 cases, a small pneumothorax occurred. CONCLUSIONS: Magnetic resonance imaging-guided biopsy of mediastinal masses has a high diagnostic performance and is safe for use in clinical practice.