Elucidating charge transfer process and enhancing electrochemical performance of laser-induced graphene via surface engineering with sustainable hydrogel membranes: An electrochemist's perspective.

Laser-induced graphene (LIG) has emerged as a promising solvent-free strategy for producing highly porous, 3D graphene structures, particularly for electrochemical applications. However, the unique character of LIG and hydrogel membrane (HM) coated LIG requires accounting for the specific conditions of its charge transfer process. This study investigates electron transfer kinetics and the electroactive surface area of LIG electrodes, finding efficient kinetics for the [Fe(CN)6]3-/4- redox process, with a high rate constant of 4.89 x 10-3 cm/s. The impact of polysaccharide HM coatings (cationic chitosan, neutral agarose and anionic sodium alginate) on LIG's charge transfer behavior is elucidated, considering factors like ohmic drop across porous LIG and Coulombic interactions/permeability affecting diffusion coefficient (D), estimated from amperometry.It was found that D of redox species is lower for HM-coated LIGs, and is the lowest for chitosan HM. Chitosan coating results in increased capacitive share in the total current while does not apparently reduce Faradaic current. Experimental findings are supported by ab-initio calculations showing an electrostatic potential map's negative charge distribution upon chitosan chain protonation, having an effect in over a two-fold redox current increase upon switching the pH from 7.48 to 1.73. This feature is absent for other studied HMs. It was also revealed that the chitosan's band gap was reduced to 3.07 eV upon acetylation, due to the introduction of a new LUMO state. This study summarizes the operating conditions enhanced by HM presence, impacting redox process kinetics and presenting unique challenges for prospective LIG/HM systems' electrochemical applications.

MRI-based radiogenomics analysis for predicting prognosis and XRCC1 gene polymorphism in pancreatic ductal adenocarcinoma.

PURPOSE: To evaluate the prognostic effects of apparent diffusion coefficient (ADC) values, qualitative MRI findings, and XRCC1 polymorphism in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: Between January 2019 and December 2021, 41 PDAC patients (23 males; 66.6 ± 8.9 years) diagnosed with MRI and treated with chemotherapy were included in this prospective, unicenter study. Quantitative b:0-800 ADC values were calculated at the workstation using a circular region of interest with a diameter of 2 cm2. Polymerase chain reaction restriction fragment length polymorphism was used to detect XRCC1 genotypes from blood samples. Demographic data, MRI findings, and survival times were recorded. Sensitivity, specificity of ADCmin values, and relationship between XRCC1 genes in predicting survival were calculated and compared. RESULTS: The median overall survival time was calculated as 9.27 ± 1.4 months. The cut-off value of ADCmin was found to be 0.996 × 10-3 mm2/s for predicting a 4.6-month survival with 77.3% sensitivity and 84.2% specificity. The distribution of XRCC1 codon 399 polymorphism was determined as 26.8% (n = 11) GG, 65.9% (n = 27) AG, and 7.3% (n = 3) AA. There was no statistical correlation between ADCmin values and XRCC1 gene polymorphism (p > 0.05). ADCmin < 0.996 × 10-3 and the XRCC1 codon 399 AG/AA genotype was the subgroup with the worst prognosis (p = 0.035). The mean age at diagnosis was 71.0 ± 9.1 years in cases with GG genotype, while it was 64.6 ± 8.9 years in cases with AG/AA genotype, which was statistically significant (p = 0.038). CONCLUSIONS: ADCmin values are useful for predicting prognosis in patients with PDAC. XRCC1 gene polymorphism may affect the age at diagnosis.

Quantitative magnetic resonance imaging in prostate cancer: A review of current technology.

Prostate cancer (PCa) imaging forms an important part of PCa clinical management. Magnetic resonance imaging is the modality of choice for prostate imaging. Most of the current imaging assessment is qualitative i.e., based on visual inspection and thus subjected to inter-observer disagreement. Quantitative imaging is better than qualitative assessment as it is more objective, and standardized, thus improving interobserver agreement. Apart from detecting PCa, few quantitative parameters may have potential to predict disease aggressiveness, and thus can be used for prognosis and deciding the course of management. There are various magnetic resonance imaging-based quantitative parameters and few of them are already part of PIRADS v.2.1. However, there are many other parameters that are under study and need further validation by rigorous multicenter studies before recommending them for routine clinical practice. This review intends to discuss the existing quantitative methods, recent developments, and novel techniques in detail.

Mechanical Properties and Chloride Penetration Resistance of Concrete Combined with Ground Granulate Blast Furnace Slag and Macro Synthetic Fiber.

Concrete with good mechanical properties and durability has always been a necessity in engineering. The addition of fibers and supplementary cementitious materials to concrete can enhance its mechanical and durability performance through a series of chemical and physical interactions. This study aims to investigate the effects of key parameters on the compressive strength, splitting tensile strength, and chloride penetration resistance of concrete combined with ground granulate blast furnace slag (GGBS) and macro polypropylene synthetic fiber (MSF). Based on the Taguchi method, a total of eighteen mixtures were evaluated, considering the effects of GGBS content, MSF content, water-to-binder (w/b) ratio, and chloride solution concentration on concrete properties. The results showed that the w/b ratio has a significant impact on the properties of concrete, which are enhanced by a decrease in w/b ratio. The GGBS content had little effect on the 28-day strength of concrete, which even decreased with a large GGBS content, but GGBS had a positive effect on the long-term strength of concrete. Moreover, the chloride penetration resistance of concrete was enhanced by an increase in the GGBS content. The MSF content had no obvious effects on the compressive strength and chloride penetration resistance of concrete, but it could enhance the splitting tensile strength to some extent, and this enhancement was more obvious over time. The chloride diffusion coefficient of concrete changed with the concentration of chloride solution, and the two increased simultaneously.

Usefulness of apparent diffusion coefficient values for assessment of MRI abnormality at term equivalent age in low-birth-weight infants weighing less than 1500 g.

OBJECTIVE: To determine whether apparent diffusion coefficient (ADC) measurements at term equivalent age (TEA) are useful for assessment of major abnormalities revealed by MRI. MATERIALS AND METHODS: Of 405 neonates who underwent MRI during the period 2016-2022, 101 low birth weight (LBW) infants (birth weight < 1500 g) were imaged at TEA. ADC values were measured in the thalamus, basal ganglia, anterior and posterior centrum semiovale, pons, and cerebellar hemisphere. The ADC values in LBW infants with and without major abnormalities evident on MRI were compared at the above six sites. Abnormal findings included IVH-3 IVH-4, more than six punctate white matter lesion, white matter injury (cystic or non-cystic), and major cerebellar hemorrhage. LBW infants overall (N = 101) and an extreme LBW (ELBW) group (< 1000 g) (N = 55) were compared and area under the curve was calculated using ROC analysis. RESULT: There were no difference in ADC values between LBW infants with and without major abnormalities. In ELBW infants, ADC values in the cerebellum were higher when major abnormalities were present (p = 0.045). ROC analysis yielded AUC < 0.7 for both LBW cases overall and ELBW cases. CONCLUSION: For LBW infants overall, ADC measurements alone at TEA are not very useful for differentiation between individuals with and without major abnormalities, but ELBW infants with major abnormalitiesshowed higher ADC values in the cerebellum, suggesting that the normal reduction of ADC occurring with maturation between preterm birth and TEA may be impaired.

The Prediction of Radiation-Induced Trismus by the Apparent Diffusion Coefficient Values of Masseter Muscles before Chemoradiotherapy in Locally Advanced Nasopharyngeal Carcinomas.

PURPOSE: Although the apparent diffusion coefficient (ADC) value from diffusion-weighted imaging can provide insights into various pathological processes, no studies have examined the relationship between the pre-concurrent chemoradiotherapy (CCRT) mean ADC (ADCmean) values of the masseter muscles and radiation-induced trismus (RIT) in locally advanced nasopharyngeal carcinoma (LA-NPC) patients. Therefore, the current research aimed to investigate the significance of pre-CCRT masseter muscle ADCmean values for predicting the RIT rates in LA-NPC patients treated with definitive CCRT. MATERIALS AND METHODS: The pre-CCRT ADCmean values of the masseter muscles and the post-CCRT RIT rates were evaluated. A receiver operating characteristic curve analysis was employed to determine the optimal ADCmean cutoff. The primary objective was to examine the relationship between the pre-CCRT masseter muscle ADCmean values and the post-CCRT RIT rates. RESULTS: Seventy-seven patients were included. The optimal ADCmean cutoff value was 1381.30 × 10-6 mm2/s, which divided the patients into two groups: an ADCmean < 1381.30 × 10-6 mm2/s (n = 49) versus an ADCmean > 1381.30 × 10-6 mm2/s (n = 28). A masseter muscle ADCmean > 1381.30 × 10-6 mm2/s was found to be associated with significantly higher RIT rates than an ADCmean < 1381.30 × 10-6 mm2/s (71.42% vs. 6.12%; p < 0.001). The multivariate analysis results confirmed a pre-CCRT masseter muscle ADCmean > 1381.30 × 10-6 mm2/s as an independent predictor of RIT. CONCLUSIONS: Our study presents the first evidence establishing a connection between elevated masseter muscle ADCmean values and higher RIT rates in LA-NPC patients following CCRT. If confirmed with further research, these findings may help to categorize the risk of RIT in these patients.

Application of Quantitative Magnetic Resonance Imaging (QMRI) to Evaluate the Effectiveness of Ultrasonic Atomization of Water in Truffle Preservation.

Truffles of the Tuber genus (Pezizales, Ascomycetes) are among the most valuable and expensive foods, but their shelf life is limited to 7-10 days when stored at 4 °C. Alternative preservation methods have been proposed to extend their shelf life, though they may alter certain quality parameters. Recently, a hypogeal display case equipped with an ultrasonic humidity system (HDC) was developed, extending the shelf life to 2-3 weeks, depending on the truffle species. This study assesses the efficacy of HDC in preserving Tuber melanosporum and Tuber borchii ascomata over 16 days, using quantitative magnetic resonance imaging (QMRI) to monitor water content and other parameters. Sixteen T. melanosporum and six T. borchii ascomata were stored at 4 °C in an HDC or a static fridge (SF) as controls. QMRI confirmed that T. borchii has a shorter shelf life than T. melanosporum under all conditions. HDC reduced the rate of shrinkage, water, and mass loss in both species. Additionally, the Apparent Diffusion Coefficient (ADC), longitudinal relaxation time (T1), and transverse relaxation time (T2), which reflect molecular changes, decreased more slowly in HDC than SF. QMRI proves useful for studying water-rich samples and assessing truffle preservation technologies. Further optimization of this method for industrial use is needed.

The value of predicting neoadjuvant chemotherapy early efficacy in nasopharyngeal carcinoma based on amide proton transfer imaging and diffusion weighted imaging.

Background: Early detection of nasopharyngeal carcinoma (NPC) patients who are not sensitive to neoadjuvant chemotherapy (NAC) can guard against overtreatment. This study aimed to evaluate the effectiveness of amide proton transfer (APT) imaging and diffusion-weighted imaging (DWI) in predicting the early response to NAC in patients with NPC. Methods: This prospective study enrolled fifty patients with biopsy-confirmed NPC from September 2021 to May 2023. Magnetic resonance imaging (MRI) including APT and DWI, was performed before NAC. After NAC, patients were divided into complete response (CR), partial response (PR), and stable disease (SD) and progressive disease (PD) groups based on the Response Evaluation Criteria in Solid Tumours Version 1.1. The Kruskal-Wallis H test was used for statistical analysis. The differences in APT and apparent diffusion coefficient (ADC) values among the different efficacy groups were compared, the receiver operating characteristic (ROC) curve was drawn for statistically significant parameters, and the area under the curve (AUC) was calculated. Results: Fifty patients (mean age: 47±14 years; 42 males and 8 females) were included in the final analysis (11 were in the CR group, 30 in the PR group, 9 in the SD group, and 0 in the PD group). The ADC values showed no significant differences among the different treatment response groups. The SD group showed significantly lower APTmax (P=0.025), APTskewness (P=0.025) and APT90% (P=0.001) values than the CR and PR groups. Setting APT90% =3.10% as the cut-off value, optimal diagnostic performance (AUC: 0.831; sensitivity: 0.778; specificity: 0.878) was obtained in predicting the SD group. Conclusions: APT imaging can predict the early tumour response to NAC in patients with NPC. APT imaging may be superior to DWI in predicting tumour response.

Comparison of single shot and multishot diffusion-weighted imaging in 5-T magnetic resonance imaging for brain disease diagnosis.

Background: Diffusion-weighted imaging (DWI) with single-shot echo-planar imaging (ssEPI) is a valuable tool for detecting acute brain lesions but does suffer from image distortions. Multishot echo-planar imaging (msEPI) is a technique for reducing such distortions. This study aimed to compare the image quality and diagnostic efficacy of ssEPI- and msEPI-DWI at 5.0 T for brain disease detection. Methods: This study retrospectively reviewed images of 107 consecutive patients with suspected brain diseases who underwent ssEPI- and msEPI-DWI at 5.0 T at the First Affiliated Hospital of University of Science and Technology of China from August 2023 to September 2023. Two radiologists independently graded image quality and measured the image distortion. Signal-to-noise ratio, contrast-to-noise ratio, and apparent diffusion coefficient (ADC) were calculated and compared between ssEPI- and msEPI-DWI. Image quality scores were compared using the Wilcoxon test and other continuous variables by the paired t-test. The diagnostic accuracy of ADC values in distinguishing lesions from normal-appearing tissues was measured with the area under the curve (AUC). Results: Image quality evaluation and distortion analysis revealed that msEPI-DWI significantly outperformed ssEPI-DWI (two-sided P<0.001). No significant difference was observed in signal-to-noise ratio, contrast-to-noise ratio, or ADC values between msEPI- and ssEPI-DWI (two-sided P≥0.601). The ADC values of msEPI- and ssEPI-DWI showed strong correlations for both lesions (r=0.97) and contralateral normal tissues (r=0.91) (two-sided P<0.001). Compared to those of the contralateral white matter, ADC values of low-grade gliomas (LGGs) were significantly higher [ssEPI-DWI: 1,119.9±273.1 vs. 805.1±73.9; msEPI-DWI: 1,196.2±355.6 vs. 757.3±98.0 (unit: ×10-6 mm2/s)], while the ADC values of acute cerebral infarction (ACI) lesions were significantly lower [ssEPI-DWI: 603.9±273.2 vs. 888.9±212.0; msEPI-DWI: 538.0±281.2 vs. 905.0±188.9 (unit: ×10-6 mm2/s)] (two-sided P≤0.003). The AUCs for detecting LGGs were excellent for both ssEPI-DWI [AUC =0.934; 95% confidence interval (CI): 0.84-1.00] and msEPI-DWI (AUC =0.944; 95% CI: 0.86-1.00) (two-sided P<0.001; two-sided DeLong test: P=0.833). Conclusions: As compared to ssEPI-DWI, msEPI-DWI, when performed at 5.0 T, demonstrated superior image quality and less anatomical distortion in a wide spectrum of brain diseases and showed promising diagnostic performance for LGGs and ACI. In the future, msEPI-DWI at 5.0 T could become clinically routine in the diagnosis and grading of brain disorders.

Clinical value of a radiomics model based on machine learning for the prediction of prostate cancer.

OBJECTIVE: Radiomics models have demonstrated good performance for the diagnosis and evaluation of prostate cancer (PCa). However, there are currently no validated imaging models that can predict PCa or clinically significant prostate cancer (csPCa). Therefore, we aimed to identify the best such models for the prediction of PCa and csPCa. METHODS: We performed a retrospective study of 942 patients with suspected PCa before they underwent prostate biopsy. MRI data were collected to manually segment suspicious regions of the tumor layer-by-layer. We then constructed models using the extracted imaging features. Finally, the clinical value of the models was evaluated. RESULTS: A diffusion-weighted imaging (DWI) plus apparent diffusion coefficient (ADC) random-forest model and a T2-weighted imaging plus ADC and DWI multilayer perceptron model were the best models for the prediction of PCa and csPCa, respectively. Areas under the curve (AUCs) of 0.942 and 0.999, respectively, were obtained for a training set. Internal validation yielded AUCs of 0.894 and 0.605, and external validation yielded AUCs of 0.732 and 0.623. CONCLUSION: Models based on machine learning comprising radiomic features and clinical indicators showed good predictive efficiency for PCa and csPCa. These findings demonstrate the utility of radiomic models for clinical decision-making.

Diagnostic Value Analysis of PI-RADS v2.1 Combined with ADC Values in the Risk Stratification of Prostate Cancer Gleason Scores: A Retrospective Study.

BACKGROUND: Prostate cancer is a remarkable global health concern, necessitating accurate risk stratification for optimal treatment and outcome prediction. By highlighting the potential of imaging-based approaches to improve risk assessment in prostate cancer, this research aims to evaluate the diagnostic efficacy of the Prostate Imaging Reporting and Data System (PI-RADS) v2.1 combined with apparent diffusion coefficient (ADC) values to gain increased context within the broad landscape of clinical needs and advancements in prostate cancer management. METHODS: The clinical data of 145 patients diagnosed with prostate cancer were retrospectively analysed. The patients were divided into low-moderate- and high-risk groups on the basis of Gleason scores. PI-RADS v2.1 scores were assessed by senior radiologists and ADC values were calculated by using diffusion-weighted imaging. Statistical, univariate logistic regression, and receiver operating characteristic curve analyses were employed to evaluate the diagnostic efficacy of each index and combined PI-RADS v2.1 scores and ADC values. RESULTS: This study found significant differences in PI-RADS v2.1 scores and ADC values between the low-moderate- and high-risk groups (p < 0.001). Logistic regression analysis revealed associations of various clinical indicators, PI-RADS score and ADC values with Gleason risk classification. Amongst indices, mean ADC demonstrated the highest sensitivity (0.912) and area under curve (AUC) value (0.962) and the combination of PI-RADS v2.1 with mean ADC showed high predictive value for the Gleason risk grading of prostate cancer with a high AUC value (0.966). CONCLUSIONS: This study provides valuable evidence for the potential utility of imaging-based approaches, specifically PI-RADS v2.1 combined with ADC values, in enhancing the accuracy of risk stratification in prostate cancer.

Sinonasal adenoid cystic carcinoma: preoperative apparent diffusion coefficient histogram analysis in prediction of prognosis and Ki-67 proliferation status.

PURPOSE: To investigate the value of preoperative apparent diffusion coefficient (ADC) histogram analysis in predicting the prognosis of patients with sinonasal adenoid cystic carcinoma (ACC) and the correlation between ADC histogram parameters and Ki-67 labeling index (LI). MATERIALS AND METHODS: The study enrolled 66 patients with sinonasal ACC who were surgically resected and confirmed by histopathology. The disease-free survival (DFS) was evaluated with clinical-pathologic and radiologic characteristics using the Cox proportion hazard model. Spearman correlation analysis was used to evaluate the correlation between ADC histogram parameters and Ki-67 LI. The predictive performance of ADC histogram parameters for Ki-67 LI was assessed using the receiver operating characteristic (ROC) curve. RESULTS: Multivariable analysis showed Ki-67 LI (hazard ratio: 9.279; 95% confidence interval 1.099-78.338; P = 0.041) and ADCskewness (hazard ratio: 5.942; 95% confidence interval 1.832-19.268; P = 0.003) were significant independent predictors of DFS. The combination of these two variables achieved the predictive ability with a C-index of 0.717 (95% confidence interval 0.607-0.826). ADCmean and all ADC percentiles (10th, 50th, and 90th) significantly and inversely correlated with Ki-67 LI of ACC (Correlation coefficients = - 0.574 to - 0.591, Ps < 0.001). Among the ADC histogram parameters, the ADC50th showed superior performance for the differentiation of the high from low Ki-67 LI groups with an area under the curve (AUC) of 0.834 and an accuracy of 80.30%. CONCLUSION: ADC histogram analysis had predictive value for DFS and Ki-67 LI, which may be a valuable biomarker for prognosis and proliferation status for ACC in clinical practice.

The apparent diffusion coefficient can serve as a predictor of survival in patients with gliomas.

BACKGROUND AND PURPOSE: Magnetic resonance imaging is indispensable for the preoperative diagnosis of glioma. This study aimed to investigate the role of the apparent diffusion coefficient values as predictors of survival in patients with gliomas. METHODS AND MATERIALS: A retrospective analysis was conducted on 101 patients with gliomas who underwent surgery between 2015 and 2020. Diffusion-weighted MRI was performed before the surgery. The regions of interest were categorized into parenchymal area, non-enhancing peritumoral area, and necrotic or cystic area. All the patients were divided into three subgroups: the parenchyma group, the non-enhancing peritumoral signal abnormality group, and the necrosis or cyst group. Univariate and multivariate analyses were performed using COX regression. RESULTS: In the parenchymal group, Ki67, P53, IDH, and the high or low ADC values were identified as independent prognosticators for disease-free survival, while Ki67, IDH, and the high or low ADC values for overall survival. In the non-enhancing peritumoral signal abnormality group, Ki67, P53, IDH, and the ADC parenchymal area/ADC non-enhancing peritumoral area ratio were identified as independent prognostic factors for disease-free survival, while Ki67, IDH, and the ADC parenchymal area/ADC non-enhancing peritumoral area ratio for overall survival. In the necrosis or cyst group, Ki67 was significantly associated with disease-free survival, while Ki67 and the ADC value of the necrotic or cystic area for overall survival. CONCLUSIONS: The ADC values, including the ADC value in the parenchymal area, the ADC parenchymal area/ADC non-enhancing peritumoral area ratio, and the ADC value in the necrotic or cystic area, can serve as an efficient and potential index for predicting the survival of patients with glioma.

Siglec-15 expression in diffuse gliomas and its correlation with MRI morphologic features and apparent diffusion coefficient.

BACKGROUND: Sialic acid-binding immunoglobulin-like lectin 15 (Siglec-15) enhances tumor immune escape and leads to tumor growth. PURPOSE: To investigate the expression of Siglec-15 in diffuse gliomas and its correlation with tumor magnetic resonance imaging (MRI) features. MATERIAL AND METHODS: This study included 57 patients with gliomas. Morphological MRI features, including the largest tumor diameter, enhancement category, location, calcification, cysts, and hemorrhage, were visually rated. Apparent diffusion coefficient (ADC) values were calculated in tumor region. MRI morphologic features and ADC were compared between patients with positive and negative Siglec-15 expression. Receiver operating characteristic (ROC) curves were further constructed to assess the diagnostic performance. RESULTS: Siglec-15 was expressed in immunocytes, such as macrophages in the peritumoral area. Siglec-15 expression was positive in 20/57 (35.09%) patients, with higher expression in patients with IDH-mutant gliomas and lower grade gliomas. The tumor diameter was significantly smaller in patients with positive Siglec-15 expression than in those with negative expression for all patients (P = 0.017) and for patients with IDH-mutant gliomas (P = 0.020). Moreover, ADC values of the tumor were significantly higher in patients with positive Siglec-15 expression than in those with negative expression for all patients (P = 0.027). The areas under the ROC curve (AUCs) of the diameter and ADC were 0.702 and 0.686, respectively. A combination of these two parameters generated an improved AUC of 0.762. CONCLUSION: Siglec-15 was expressed in immunocytes such as macrophages in the peritumoral area, with a positive rate of 35.09%. Positive Siglec-15 expression in diffuse gliomas was correlated with smaller tumor size and higher ADC values.

Real-Time Visualization of HIV-1 RNA Detection Using Loop-Mediated Isothermal Amplification-Enabled Particle Diffusometry.

Isothermal nucleic acid amplification tests, NAATs, such as reverse transcription-loop-mediated isothermal amplification (RT-LAMP), offer promising capabilities to perform real-time semiquantitative detection of viral pathogens. These tests provide rapid results, utilize simple instrumentation for single-temperature reactions, support efficient user workflows, and are suitable for field use. Herein, we present a novel and robust method for real-time monitoring of HIV-1 RNA RT-LAMP utilizing a novel implementation of particle diffusometry (PD), a diffusivity quantification technique using fluorescent particles, to quantify viral concentration in nuclease-free water. We monitor changes in particle diffusion dynamics of 400 nm fluorescently labeled particles throughout the RT-LAMP of HIV-1 RNA in nuclease-free water, enabling measurement within 20 min and detection of concentrations as low as 25 virus particles per µL. Moreover, in a single-blind study, we demonstrate semiquantitative detection by accurately determining the initial concentration of an unknown HIV-1 RNA within a 10% absolute error margin. These results highlight the potential of real-time PD readout for quantifying HIV-1 RNA via RT-LAMP, offering promise for viral load monitoring of HIV and other chronic infections.

Fotemustine in recurrent high­grade glioma: MRI neuro­radiological findings.

The use of fotemustine (FTM) has been authorized in certain countries for the treatment of recurrent high-grade gliomas (HGG) after Stupp therapy. However, to the best of our knowledge, no studies have assessed changes in magnetic resonance imaging (MRI) during treatment with FTM monotherapy. The aim of the present study was to assess the neuroradiological findings in a cohort of patients with recurrent HGG treated with FTM monotherapy. Patients with HGG already undergoing the Stupp protocol were retrospectively included. MRIs (pre- and post-FTM treatment) were analyzed by two neuroradiologists in consensus: Volume and diffusion values of the contrast-enhanced component were measured on T1-weighted volumetric sequences after gadolinium injection and on apparent diffusion coefficient (ADC) maps, respectively. A total of 19 patients [median age, 49 years; interquartile range (IQR), 43-57 years] were included, 17 of whom had glioblastoma and 2 had astrocytoma isocitrate dehydrogenase-mutated grade 4. The median duration of FTM therapy was 4 months (IQR, 2-6 months). The median tumor volume measured on the contrast-enhanced component was 2,216 mm3 (IQR, 768-13,169 mm3) at baseline and 9,217 mm3 (IQR, 3,455-16,697 mm3) at the end of treatment, with a median change of +38% (IQR, -45-+574%). A total of seven patients showed a volume decrease. ADC value analysis of the enhancement area demonstrated no significant difference between the pre- and the post-FTM treatment periods (P=0.36); however, in three patients, the decreases in ADC levels were particularly marked. In conclusion, the present study described a series of patients with recurrent HGG treated with FTM in monotherapy, demonstrating a prevalent increase in lesion enhancement and three cases of marked restrictions on diffusion-weighted imaging. Further prospective studies are required to corroborate such preliminary results.

Optimizing prostate cancer detection in transition zone: an analysis of apparent diffusion coefficient values in prostate magnetic resonance imaging evaluation with Prostate Imaging Reporting and Data System (PI-RADS) assessment.

Background: Multiparametric magnetic resonance imaging (mpMRI) is increasingly used for the early detection of clinically significant prostate cancer (csPCa). However, the achievement of accurate detection rates, particularly for transition zone (TZ) lesions, remains challenging. We investigated the relationship between apparent diffusion coefficient (ADC) values in Prostate Imaging Reporting and Data System (PI-RADS) 3-5 lesions and csPCa within the TZ. Methods: We retrospectively evaluated TZ lesions in patients who underwent 3.0 Tesla MRI followed by MRI-targeted/transrectal ultrasound fusion biopsies (MRI-FBx). Fusion biopsies were performed for potentially cancerous lesions, defined as lesions with PI-RADS scores 3-5. We analyzed 196 lesions for which fusion biopsies were performed. Results: The overall prostate cancer (PCa) detection rate was 53.6% (105/196); csPCa constituted 33.7% (66/196) of cases. The minimum ADC value was significantly lower for patients with csPCa (484.9±112.3 µm2/s) than for patients with benign histology or non-csPCa (P<0.001). Older age, higher initial prostate-specific antigen level, larger region of interest, and minimum and mean ADC values were associated with the presence of csPCa. Multivariate analysis indicated that only the minimum ADC value was an independent predictor of csPCa. Using a cutoff minimum ADC value <561 µm2/s to detect csPCa in TZ lesions increased the detection rate to 57.4% (54/94). Conclusions: The minimum ADC value provides substantial additional information regarding the presence of csPCa in the TZ, potentially improving the detection rates for lesions rated as PI-RADS 3-5 and informing the need for follow-up biopsies in areas that are initially cancer-free.

Apparent Diffusion Coefficient Measurements. A Reliable Tool for the Diagnosis of Creutzfeldt-Jakob Disease.

BACKGROUND AND PURPOSE: Creutzfeldt-Jakob disease (CJD) is a rare, rapidly fatal neurodegenerative disorder. The gold standard test for a positive diagnosis of definite CJD is histopathological confirmation, usually post-mortem; however, an autopsy study is not always feasible in all health settings. MATERIALS AND METHODS: We performed a cross-sectional analysis of a retrospectively enrolled cohort of patients with suspected prion disease between 2008 and 2019. Only patients with complete medical histories who fulfilled a diagnostic checklist were enrolled. The magnetic resonance imaging (MRI) sequences (T2-FLAIR and DWI) were analyzed, and the apparent diffusion coefficients (ADCs) were calculated for five regions of interest (ROIs) in each cerebral hemisphere. RESULTS: In total, 72 MRI scans were post-processed. The series included 47 cases of CJD, including 25 genetic and 22 sporadic cases, in addition to 25 age-paired controls with non-prion encephalopathies. The neostriatum showed the most significant difference in ADC values (×10-3 mm2/s) at 0.5946 in the left anterior putamen vs. 0.8644 in the control encephalopathies (p < 0.001; 95% confidence interval: 0.5751-0.6142 vs. 0.7812-0.9476), while the other ROIs also showed significant differences. The best cut-off value to differentiate CJD from other encephalopathies was identified as 0.65×10-3 mm2/s, with no significant differences in this coefficient between sporadic and genetic cases. CONCLUSIONS: Quantitative ADC measurements made in the basal ganglia seem to be the most useful ante-mortem diagnostic tool for differentiating CJD from non-prion encephalopathies when cerebrospinal fluid real-time quaking-induced conversion or other specific misfolded protein detection tests are inaccessible.

Transient elastography and diffusion-weighted magnetic resonance imaging for assessment of liver fibrosis in children with chronic hepatitis C.

BACKGROUND: Chronic hepatitis C (CHC) is a health burden with consequent morbidity and mortality. Liver biopsy is the gold standard for evaluating fibrosis and assessing disease severity and prognostic purposes post-treatment. Noninvasive alternatives for liver biopsy such as transient elastography (TE) and diffusion-weighted magnetic resonance imaging (DW-MRI) are critical needs. AIM: To evaluate TE and DW-MRI as noninvasive tools for predicting liver fibrosis in children with CHC. METHODS: This prospective cross-sectional study initially recruited 100 children with CHC virus infection. Sixty-four children completed the full set of investigations including liver stiffness measurement (LSM) using TE and measurement of apparent diffusion coefficient (ADC) of the liver and spleen using DW-MRI. Liver biopsies were evaluated for fibrosis using Ishak scoring system. LSM and liver and spleen ADC were compared in different fibrosis stages and correlation analysis was performed with histopathological findings and other laboratory parameters. RESULTS: Most patients had moderate fibrosis (73.5%) while 26.5% had mild fibrosis. None had severe fibrosis or cirrhosis. The majority (68.8%) had mild activity, while only 7.8% had moderate activity. Ishak scores had a significant direct correlation with LSM (P = 0.008) and were negatively correlated with both liver and spleen ADC but with no statistical significance (P = 0.086 and P = 0.145, respectively). Similarly, histopathological activity correlated significantly with LSM (P = 0.002) but not with liver or spleen ADC (P = 0.84 and 0.98 respectively). LSM and liver ADC were able to significantly discriminate F3 from lower fibrosis stages (area under the curve = 0.700 and 0.747, respectively) with a better performance of liver ADC. CONCLUSION: TE and liver ADC were helpful in predicting significant fibrosis in children with chronic hepatitis C virus infection with a better performance of liver ADC.

The potential role of breast MRI in evaluation of triple-negative breast cancer and fibroadenoma of less than 3 cm.

Background: The majority of small-sized (<3 cm) triple-negative breast cancer (TNBC) exhibit smooth margins upon palpation and are often oval or rounded masses. Distinguishing these masses preoperatively from fibroadenomas (FAs) would be very meaningful for clinical practice. The aim of our study was to evaluate the magnetic resonance imaging (MRI) appearance of TNBC and differentiate it from FAs. Methods: In this retrospective single-center study, we included 37 patients with TNBCs and 36 patients with FAs who underwent breast MRI. We employed the χ2 test and t-test to compare the differences in morphological features, dynamic contrast-enhanced MRI (DCE-MRI) parameters, and apparent diffusion coefficient (ADC) values between the two groups. Additionally, we constructed non-parametric receiver operating characteristic (ROC) curves using ADC values, with pathological results serving as the gold standard. Results: A total of 37 TNBC lesions and 39 FA lesions were included in the final analysis. TNBCs exhibited more frequent irregular shape, irregular margins, peritumoral edema, fast enhancement in the initial phase, rim enhancement, and time-signal intensity curve (TIC) type III compared to FAs (all P<0.05). Conversely, low-signal segregation in T2-weighted imaging (T2WI) and TIC type I were commonly found in FAs. The mean ADC value of TNBCs was significantly lower than that of FAs [(1.104±0.13)×10-3 vs. (1.613±0.16)×10-3 mm2/s, P<0.05]. The cutoff ADC for differentiating TNBCs from FAs was 1.239×10-3 mm2/s, yielding an area under the curve (AUC) of 0.997, a sensitivity of 94.6%, and a specificity of 100%. Conclusions: The morphological presentation of MRI, internal enhancement features of the mass, TIC curves, and ADC values provide valuable differential diagnostic information for TNBC and FA masses with a maximum diameter of less than 3 cm.