Assessment of the accuracy of biparametric MRI/TRUS fusion-guided biopsy for index tumor evaluation using postoperative pathology specimens.

BACKGROUND: Multiparametric MRI (mpMRI) is widely used for the diagnosis, surveillance, and staging of prostate cancer. However, it has several limitations, including higher costs, longer examination times, and the use of gadolinium-based contrast agents. This study aimed to investigate the accuracy of preoperatively assessed index tumors (ITs) using biparametric MRI (bpMRI)/transrectal ultrasound (TRUS) fusion biopsy compared with radical prostatectomy (RP) specimens. METHODS: We included 113 patients diagnosed with prostate cancer through bpMRI/TRUS fusion-guided biopsies of lesions with a Prostate Imaging Reporting and Data System (PI-RADS) category ≥ 3. These patients underwent robot-assisted laparoscopic radical prostatectomy (RARP) at our institution between July 2017 and March 2023. We examined the localization of preoperative and postoperative ITs, the highest Gleason score (GS), and tumor diameter in these patients. RESULTS: The preoperative cT stage matched the postoperative pT stage in 53 cases (47%), while 31 cases (27%) were upstaged, and 29 cases (26%) were downstaged (Weighted Kappa = 0.21). The preoperative and postoperative IT localizations were consistent in 97 cases (86%). The concordance rate between Gleason groups in targeted biopsies and RP specimens was 51%, with an upgrade in 25 cases (23%) and a downgrade in 27 cases (25%) (Weighted Kappa = 0.42). The maximum diameter of the IT and the maximum cancer core length on biopsy were correlated with the RP tumor's maximum diameter (p < 0.001 for both). CONCLUSION: The diagnostic accuracy of bpMRI/TRUS fusion biopsy is comparable to mpMRI, suggesting that it can be a cost-effective and time-saving alternative.

13N-ammonia positron emission tomography-derived endocardial strain for the assessment of ischemia using feature-tracking in high-resolution cine imaging.

BACKGROUND: Assessing endocardial strain using a single 13N-ammonia positron emission tomography (PET) scan would be clinically useful, given the association between ischemia and myocardial deformation. However, no software has been developed for strain analysis using PET. We evaluated the clinical potential of feature tracking-derived strain values measured using PET, based on associations with the myocardial flow reserve (MFR). METHODS AND RESULTS: This retrospective study included 95 coronary artery disease patients who underwent myocardial 13N-ammonia PET. Semi-automatic measurements were made using a feature-tracking technique during myocardial cine imaging, and values were calculated using a 16-segment model. Adenosine-stressed global circumferential strain (CS) and global longitudinal strain (LS) values were compared with global MFR values. Stressed and resting global strain values were also compared. Global strain values were significantly lower in 39 patients with abnormal MFRs [< 2.0] than in 56 patients with normal MFRs [≥ 2.0]. The global CS values in the stressed state were significantly decreased than the resting state values in patients with abnormal MFRs. CONCLUSIONS: This study applied endocardial feature-tracking to 13N-ammonia PET, and the results suggested that blood flow and myocardial motility could be clinically assessed in ischemic patients using a single PET scan.

Prognosis and recurrence in cardiac sarcoidosis: Serial assessment of BMIPP SPECT and FDG-PET.

BACKGROUND: We analyzed 18F-Fludeoxyglucose positron emission tomography (FDG-PET) and 123I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) single-photon emission computed tomography (SPECT) performed for cardiac sarcoidosis (CS) patients taking prednisolone, identified recurrence by FDG-PET, and investigated BMIPP as a recurrence and prognostic factor in CS. METHODS AND RESULTS: CS patients who underwent BMIPP and FDG-PET within 2 months were enrolled. The recurrence-free group included patients with standardized uptake value (SUVmax) < 4 in the myocardium consecutively for ≥ 2 years. The total BMIPP SPECT defect score (BDS) was used to estimate myocardial damage. The predictability of the initial BDS and SUVmax for major adverse cardiac events (MACE) was analyzed using Kaplan-Meier analysis. Overall, 73 patients and 250 BMIPP and FDG-PET sets were analyzed retrospectively (mean follow-up, 3.5 years). The BDS was significantly greater for the recurrence group (N = 21) vs recurrence-free group (20 ± 13 vs 14 ± 12, P = 0.041). Patients with BDS ≥16 had a significantly higher MACE rate than patients with BDS < 16 (log-rank test, P = 0.016). However, MACE occurrence was comparable between patients with SUVmax ≥ 4 and < 4. CONCLUSIONS: BDS is a predictive marker of recurrence and MACE. SUV is not related to MACE. Recurrence, defined by prednisolone treatment-induced SUV variability, was observed in approximately 30% of CS patients.

Assessment of lenvatinib treatment for unresectable hepatocellular carcinoma with liver cirrhosis.

BACKGROUND: The present study aimed to assess the clinical features of patients who received lenvatinib treatment for unresectable hepatocellular carcinoma (HCC). METHODS: The clinical characteristics, adverse events, and radiological responses were evaluated for 51 consecutive patients. RESULTS: Of the study subjects, 37 patients had Child-Pugh class A (CPA) liver function, and 14 patients had Child-Pugh class B (CPB) liver function. The overall response rates in the CPA and CPB groups were 42.9% and 25.0%, respectively, and disease control rates were 82.9% and 83.3%, respectively, without significant difference (p = 0.2621 and 0.9697). There was no significant difference between CPA and CPB groups regarding the incidence of adverse events, except for hepatic coma. No significant difference was observed in the relative dose intensity between the CPA and CPB groups, for the first month, 1-2 months, or 2-3 months (p = 0.2368, 0.9368, and 0.9293). CONCLUSION: The comparable outcomes between the CPA and CPB groups suggest the acceptability of lenvatinib treatment in patients with impaired liver function, at least in the acute phase. With careful follow-up, the dose can be relatively intensified, even in patients with impaired liver function and this may contribute to offering comparable treatment.

Assessment of the Relationship between Pelvic Tilt and the Sacro-Femoral-Pubic Angle in Middle-Aged and Elderly Asian Individuals.

STUDY DESIGN: Cross-sectional study. PURPOSE: The purpose of this study was to evaluate the correlation between pelvic tilt (PT) and the sacro-femoral-pubic (SFP) angle, which is easier to identify than PT, in middle-aged and elderly Asian subjects from the general population. OVERVIEW OF LITERATURE: Measuring PT is important in the diagnosis and treatment of adult spinal deformity. However, identifying femoral heads, which are necessary to determine PT, using sagittal radiographs is often difficult. METHODS: Standing coronal and sagittal pelvic radiographs of individuals aged more than 50 years were taken during a local medical examination. The subjects were divided into female, male, and total groups at the time of evaluation. Linear regression analysis was performed to investigate the relationship between PT and the SFP angle, which were obtained from the X-rays. RESULTS: The present study included 291 subjects. There were no statistically significant differences between the left and right SFP angles, and there was gender difference regarding the SFP angle. However, a gender difference was observed regarding PT. The correlation between PT and the SFP angle was substantiated in each group. Pearson's correlation coefficients between PT and the SFP angle in the total, female, and male groups were 0.696, 0.853, and 0.619, respectively. In the linear regression analysis, PT was calculated as follows: PT=60.1-0.77×(SFP angle) in the total group, PT=62.8-0.80×(SFP angle) in the female group, and PT=51.5-0.64×(SFP angle) in the male group. CONCLUSIONS: A significant correlation between PT and the SFP angle was observed in middle-aged and elderly Asian subjects from the general population.

Relations between quantitative ultrasound assessment of calcaneus and grip and key pinch power in Japanese mountain village residents.

PURPOSE: It seems to be important to recognize bone health condition using a simple method in Japanese super-aged society. The aim of our study was to investigate whether grip and key pinch strength were associated with bone quality. METHODS: Medical examinations were conducted of 337 adult residents (123 men, 214 women; average age of 64.7 years) of a mountain village. Bilateral grip and key pinch strength were measured. The sound of speed (SOS) of calcaneus was assessed using an ultrasound bone densitometer. Study participants were divided into non-osteoporotic and osteoporotic groups according to the relevant WHO classification to evaluate statistical significance by age-adjusted analysis. Stepwise linear regression was used to identify the predictor of SOS using the following factors as explanatory variables: age, height, weight BMI, grip and key pinch power strength in bilateral side. A P value of < .05 was regarded as statistically significant. RESULTS: In age-adjusted analysis, significant associations were found between osteoporosis and BMI (OR 0.87, 95%CI 0.80-0.95), gender (OR 3.21, 95%CI 1.83-5.62), grip strength (right side:, OR 0.95, 95%CI 0.92-0.98; left side: OR 0.95, 95% CI 0.92-0.98) and key pinch strength (right side: OR 0.76, 95%CI 0.65-0.88; left side: OR 0.79, 95%CI 0.68-0.91). In stepwise linear regression, age and left key pinch strength were predictors of calcaneal SOS (age ß coefficient = -0.46, P = .00; left key pinch strength ß coefficient = 0.17, P = .0049). CONCLUSIONS: Key pinch strength assessment might be useful to predict calcaneal SOS in general population.

The economic importance of acaricides in the control of phytophagous mites and an update on recent acaricide mode of action research.

Acaricides are one of the cornerstones of an efficient control program for phytophagous mites. An analysis of the global acaricide market reveals that spider mites such as Tetranychus urticae, Panonychus citri and Panonychus ulmi are by far the most economically important species, representing more than 80% of the market. Other relevant mite groups are false spider mites (mainly Brevipalpus), rust and gall mites and tarsonemid mites. Acaricides are most frequently used in vegetables and fruits (74% of the market), including grape vines and citrus. However, their use is increasing in major crops where spider mites are becoming more important, such as soybean, cotton and corn. As revealed by a detailed case study of the Japanese market, major shifts in acaricide use are partially driven by resistance development and the commercial availability of compounds with novel mode of action. The importance of the latter cannot be underestimated, although some compounds are successfully used for more than 30 years. A review of recent developments in mode of action research is presented, as such knowledge is important for devising resistance management programs. This includes spirocyclic keto-enols as inhibitors of acetyl-CoA carboxylase, the carbazate bifenazate as a mitochondrial complex III inhibitor, a novel class of complex II inhibitors, and the mite growth inhibitors hexythiazox, clofentezine and etoxazole that interact with chitin synthase I.

Assessment of Osgood-Schlatter Disease and the Skeletal Maturation of the Distal Attachment of the Patellar Tendon in Preadolescent Males.

BACKGROUND: Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tuberosity. Ultrasonography (US) is able to detect pathologic changes, such as cartilage swelling and fragmentation of the tibial tubercle ossification center. PURPOSE: To compare the US stages of tibial tuberosity development and the physical features and prevalence of OSD in this patient cohort. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Subjects included 238 males (n = 476 joints) with a mean age of 11.4 ± 1.6 years (range, 7-14 years). The tibial tuberosity development on US was divided into 3 stages: the cartilaginous stage (stage C), apophyseal stage (stage A), and epiphyseal stage (stage E). It was then investigated whether the subjects had pain in the tibial tuberosity on application of pressure. Age, height, body weight, body mass index (BMI), heel-buttock distance (HBD, cm), and straight-leg raise angle (SLRA) were evaluated. To confirm the diagnosis of OSD, the participant had to fulfill the following clinical criteria: pain with direct pressure on the tibial apophysis, fragmentation of the bone, and irregularity of the ossification center detected by US. RESULTS: The tibial tuberosity was stage C in 195 knees, stage A in 105 knees, and stage E in 176 knees. The subjects' heights, weights, and BMIs significantly increased with advancing development of the tibial tuberosity. The HBD increased in stage E (P < .01). The SLRA was not significantly different among groups. There was fragmentation of the bone and irregularity of the ossification center in 32 knees (6.8%): 0 in stage C, 21 (4.3%) in stage A, and 11 (2.3%) in stage E. Fragmentation of the bone and irregularity were observed significantly more often in stage A (P < .01). On the other hand, there were 10 joints with OSD (2.1%): 0 in stage C, 3 (0.6%) in stage A, and 7 (1.5%) in stage E. OSD was observed significantly more often in stage E than in the other stages (P < .05). CONCLUSION: The present study showed that the HBD increased from stage A to stage E. The prevalence of OSD was highest in stage E.

Thyroid remnant ablation using 1,110 MBq of I-131 after total thyroidectomy: regulatory considerations on release of patients after unsealed radioiodine therapy.

OBJECTIVES: This study was undertaken to measure the radiation exposure level of caregivers following outpatient NaI (I-131) 1,110 MBq therapy for remnant thyroid ablation after total thyroidectomy in patients with differentiated thyroid cancer, and to evaluate the influence of activities of daily living on radiation exposure level, with the goal of proposing an optimum method of I-131 therapy. METHODS: The study included 37 patients with differentiated thyroid cancer, who had undergone total thyroidectomy and received outpatient based remnant thyroid ablation using NaI (I-131) 1,110 MBq, who were satisfying the following requirements: (1) patients who have no evidence of distant metastases, (2) whose living environments were appropriate for outpatient I-131 (1,110 MBq) therapy, and (3) patients who gave written informed consent. The dose rate at a distance of 1 m from the body surface of the patient at the moment of release was measured using survey meters of the GM type or ionization chamber type. The dose level for the caregiver was measured with a personal dosimeter in all cases. RESULTS: The dose rate at a distance of 1 m from the patient's body surface 1 h after I-131 administration was in the range of 29-115 µSv/h (mean 63.8 µSv/h). The 7-day cumulative effective dose of caregivers was 0.11 ± 0.08 mSv, on an average, in 34 dosimeters. In 31 of 34 dosimeters, cumulative effective dose of caregivers was below 0.2 mSv. Dose levels exceeding 0.2 mSv were recorded in 3 cases (0.21, 0.35 and 0.43 mSv in one case each). These results suggest that the exposure level of family members (caregiver and others) was minimal and is lower than the radiation levels affecting human environments. CONCLUSION: Outpatient-based remnant thyroid ablation with I-131 (1,110 MBq) performed after total thyroidectomy in patients with differentiated thyroid cancer is safe if applied in accordance with the appropriate supervision and guidance by experts with certain qualifications.

Aquatic toxicity and ecological risk assessment of seven parabens: Individual and additive approach.

In the present study, aquatic concentrations of seven parabens were determined in urban streams highly affected by treated or untreated domestic sewage in Tokushima and Osaka, Japan. The detected highest concentrations were 670, 207, and 163ngl(-1) for methylparaben, n-propylparaben, and n-butylparaben, respectively in sampling sites with watershed area of no sewer system in Tokushima. Conventional acute/chronic toxicity tests were conducted using medaka (Oryzias latipes), Daphnia magna, and Psuedokirchneriella subcapitata for four parabens, which was consistent with our previous study on three parabens, n-butylparaben, i-butylparaben, and benzylparaben. The aquatic toxicity on fish, daphnia, and algae was weaker for the parabens with a shorter alkyl chain than those with a longer alkyl chain as predicted by their hydrophobicity. Medaka vitellogenin assays and DNA microarray analysis were carried out for methylparaben and found induction of significant vitellogenin in male medaka at 630µgl(-1) of methylparaben, while the expression levels of genes encoding proteins such as choriogenin and vitellogenin increased for concentrations at 10µgl(-1) of methylparaben. Measured environmental concentrations (MECs) of seven parabens in Tokushima and Osaka were divided by predicted no effect concentrations (PNECs) and hazard quotient (MEC/PNEC) was determined for individual parabens. The MEC/PNEC was highest for n-propylparaben and was 0.010 followed by n-butylparaben (max. of 0.0086) and methylparaben (max. of 0.0042). The sum of the MEC/PNEC for the seven parabens was 0.0049. Equivalence factors were assigned for each paraben on the basis of the toxicity of n-butylparaben for each species, and n-butylparaben equivalence was calculated for the measured environmental concentrations. The MEC/PNEC approach was also conducted for the n-butylparaben-based equivalence values. The maximum MEC/PNEC was 0.018, which is lower than the trigger level for further detailed study such as large-scale monitoring for chronic toxicity tests including full-life cycle tests for fish.