The effect of konjac glucomannan on enzyme kinetics and fluorescence spectrometry of digestive enzymes: An in vitro research from the perspective of macromolecule crowding.

Konjac glucomannan (KGM) can significantly prolong gastrointestinal digestion. However, it is still worth investigating whether the macromolecular crowding (MMC) induced by KGM is correlated with digestion. In this paper, the MMC effect was quantified by fluorescence resonance energy transfer and microrheology, and the digests of starch, protein, and oil were determined. The digestive enzymes were analyzed by enzyme reaction kinetic and fluorescence quenching. The results showed that higher molecular weight (604.85 âˆ¼ 1002.21 kDa) KGM created a larger MMC (>0.8), and influenced the digestion of macronutrients; the digests of starch, protein, and oil all decreased significantly. MMC induced by KGM decreased the Michaelis-Menten constants (Km and Vmax) of pancreatic α-amylase (PPA), pepsin (PEP), and pancreatic lipase (PPL). The larger MMC (>0.8) induced by KGM resulted in the decrease of fluorescence quenching constants (Ksv) in PPA and PPL, and the increase of Ksv in PEP. Therefore, varying degrees of MMC induced by KGM could play a role in regulating digestion and the inhibitory effect on digestion was more significant in a relatively more crowded environment induced by KGM. This study provides theoretical support for the strategies of nutrient digestion regulation from the perspective of MMC caused by dietary fiber.

Special electromyographic features in a child with paramyotonia congenita: A case report and review of literature.

BACKGROUND: Paramyotonia congenita (PMC) stands as a rare sodium channelopaty of skeletal muscle, initially identified by Eulenburg. The identification of PMC often relies on electromyography (EMG), a diagnostic technique. The child's needle EMG unveiled trains of myotonic discharges with notably giant amplitudes, alongside irregular wave trains of myotonic discharges. This distinctive observation had not surfaced in earlier studies. CASE SUMMARY: We report the case of a 3-year-old female child with PMC, who exhibited laryngeal stridor, muffled speech, myotonia from birth. Cold, exposure to cool water, crying, and physical activity exacerbated the myotonia, which was relieved in warmth, yet never normalized. Percussion myotonia was observable in bilateral biceps. Myotonia symptoms remained unchanged after potassium-rich food consumption like bananas. Hyperkalemic periodic paralysis was excluded. Cranial magnetic resonance imaging yielded normal results. Blood potassium remained within normal range, while creatine kinase showed slight elevation. Exome-wide genetic testing pinpointed a heterozygous mutation on chromosome SCN4A: c.3917G>A (p.G1306E). After a six-month mexiletine regimen, symptoms alleviated. CONCLUSION: In this case revealed the two types of myotonic discharges, and had not been documented in other studies. We underscore two distinctive features: Giant-amplitude potentials and irregular waves.

Physicochemical properties, phenolic content and in vitro digestion profile of Chinese black rice (Oryza sativa L.).

Yangxian black rice, as one of the ancient Chinese black rice varieties, is widely planted in the Yangxian area of China. This study investigated the physicochemical properties, phenolic content and in vitro digestion profile of Chinese black rice under gradient milling treatment. The chemical composition, color, pasting and thermal properties of black rice with different milling degrees were comprehensively compared. In vitro digestion analysis indicated that cooked rice flour had higher rapidly digestible starch (RDS) and lower resistant starch (RS) contents compared with the uncooked one. Besides, all cooked black rice samples exhibited high predicted glycemic index (pGI) value and whole black rice showed a lower pGI than refined rice. The microstructure and the abundance of phenolic compounds in the solid matrix during different treatments or digestion stages were observed by CLSM. Furthermore, a total of 102 phenolic constituents were absolutely quantified by targeted metabolomics techniques. Methanol extraction and moderate cooking treatment contributed to the release of phenolic compounds from the solid matrix of whole black rice. Besides, compared to the gastric digestion stage, the transition in the intestinal environment caused a decrease in the majority of the analyzed polyphenols. Identifying the phenolic constituents was favorable for a better elucidation of the chemical basis of the function and nutritional value of Chinese black rice.

Evaluation of Association Between Menstrual Cycle Timing and Quantitative Background Parenchymal Enhancement on Breast MRI in Premenopausal Women.

OBJECTIVES: To evaluate the influence of menstrual cycle timing on quantitative background parenchymal enhancement and to assess an optimal timing of breast MRI in premenopausal women. METHODS: A total of 197 premenopausal women were enrolled, 120 of which were in the malignant group and 77 in the benign group. Two radiologists depicted the regions of interest (ROI) of the three consecutive biggest slices of glandular tissue in the unaffected side and calculated the ratio (=[SIpost - SIpre]/SIpre) in ROI from the precontrast and early phase to assess BPE quantitatively. Association of BPE with menstrual cycle timing was compared in three categories. The relationships between BPE and age /body mass index (BMI) were also explored. RESULTS: We found that the BPE ratio presented lower in patients with the follicular phase (day1-14) compared to the luteal phase (day15-30) in the benign group (P = .036). Also, the BPE ratio presented significantly lower in the proliferative phase (day5-14) than the menstrual phase (day1-4) and the secretory phase(day15-30) in the benign group (P = .006). While the BPE ratio was not significantly different among the respective weeks (1-4) of the menstrual cycle in the benign group (P > .05). In the malignant group, the BPE ratio did not significantly differ between/among any menstrual cycle phase or week (all P > .05). CONCLUSION: It seems more suitable for Asian women whose lesions need to follow up or are suspected of malignant to undergo breast MRI within the 1st to 14th day of the menstrual cycle, especially on the 5th to 14th day.

Recent advances in the development of bitter gourd seed oil: from chemical composition to potential applications.

Non-conventional seed oils are being considered novelty foods due to the unique properties of their chemical constituents. Numerous such seed oils serve as nutritional and functional supplements, making them a point of interest for scholars. Bitter gourd (Momordica charantia L.) seed oil (BGSO) has been widely used in folk medicine worldwide for the treatment of different pathologies, such as diabetes, cancer, and several inflammatory diseases. Therefore, its nutritional and medicinal value has been extensively studied. Considering the potential use of BGSO, it is imperative to have a comprehensive understanding of this product to develop and use its biologically active ingredients in innovative food and pharmaceutical products. An extensive understanding of BGSO would also help improve the economic feasibility of the bitter gourd seed processing industry and help prevent environmental pollution associated with the raw waste produced during the processing of bitter gourd seeds. This review addresses the potential uses of BGSO in terms of food and pharmaceuticals industry perspectives and comprehensively summarizes the oil extraction process, chemical composition, biological activity, and the application prospects of BGSO in clinical medicine.

Studies on the interaction between homological proteins and anthocyanins from purple sweet potato (PSP): Structural characterization, binding mechanism and stability.

The protein-bound anthocyanin complexes are naturally existed in food systems by their spontaneous interaction. In this study, the interaction mechanism of homological proteins (p-PSP) and anthocyanins (FAC-PSP) was investigated to explore the binding characteristic of native protein-bound anthocyanins from purple sweet potato (p-BAC-PSP). The structural characterization, stability and anti-ultraviolet property of p-BAC-PSP were also evaluated. Results revealed that hydrophobic interaction is dominant binding force for forming p-BAC-PSP. The binding resulted in protein secondary structure changes with more ß-sheet and lower ß-turn, random coil structures. Fluorescence spectroscopy demonstrated that FAC-PSP quenched p-PSP fluorescence in a combination of static and dynamic mode (static dominant) with a binding constant of 105 L/mol reflecting strong affinity of FAC-PSP to p-PSP. Moreover, the complex form exhibited better protective effects on anthocyanins for pH, light, thermal stabilities and higher anti-ultraviolet activity. These findings further expanded the application of anthocyanins as stable, functional food and cosmetic ingredients.

Preparation of nanoliposomes loaded with anthocyanins from grape skin extracts: stability, gastric absorption and antiproliferative properties.

Anthocyanin nanoliposomes (ANLs) were produced by a thin film ultrasonic dispersion method to improve the stability and bioavailability of anthocyanins (ACNs) obtained from grape skin extracts. The preparation parameters were predicted to be a soy lecithin to cholesterol ratio of 80 : 19 (w/w, 2 mg of ACNs) under ultrasonication at 120 W for 3.12 min by the response surface methodology. Under the optimal conditions, the fabricated ANLs presented an encapsulation efficiency of 40.1% with an average particle size of 117 nm, a PDI of 0.254 and a ζ-potential of 8.56 mV. The stability of ACNs was improved by nanoliposome encapsulation under various temperature and light conditions. Moreover, a MKN-28 (stomach) barrier model was established to evaluate the cellular transport of ACNs before and after nanoliposome encapsulation. HPLC-DAD/MS analyses demonstrated that ACNs obtained from grape skin extracts mainly consisted of five monomers. After 180 min of transportation, peonidin-3-5-diglucoside and malvidin-3-5-diglucoside (two representative monomers) present in ANLs (0.5 mg mL-1) showed the maximum transport efficiencies of 17.25 ± 1.62% and 18.94 ± 1.05%, respectively. However, their maximum transport efficiencies were 11.68 ± 1.01% and 15.33 ± 1.24%, respectively, existing in ACNs (non-encapsulated form, 0.5 mg mL-1). Furthermore, the antiproliferative properties of ANLs were assessed in two cancer cell lines MKN-28 and HepG-2 (liver). The ANLs presented more effective antiproliferative effects towards MKN-28 than the HepG-2 cell line. This study provides theories and a practice foundation for further application of ACNs as nutraceutical and functional foods.

The botanical profile, phytochemistry, biological activities and protected-delivery systems for purple sweet potato (Ipomoea batatas (L.) Lam.): An up-to-date review.

Purple sweet potato (PSP) is an important economic crop in many countries, as a staple food and a source of bioactive compounds, which has attracted considerable attention. This review provides an up-to-date summary and discusses the available literature concerning PSP. Different issues, including its bioactive compounds, health effects and various efficient encapsulation strategies for PSP powders, extracts or individual substance are covered in detail, along with its utilization. In addition to the valuable nutritional composition, more than 135 bioactive compounds have been isolated and identified from these plants so far. Among the plenty of constituents, polysaccharides and flavonoids are the focus of attention and exhibit various biological activities.Additionally, protected-delivery systems are strongly proposed to shelter the bioactive compounds providing a better stability and improved pharmacological activities. Normally, PSP roots are the most attractive part to human because of their economic value. Even though PSP anthocyanins are the focus of researchers and industrial due to their attractive color and wide range of biological activities, PSP starch and protein also have wide applications in foods and nonfoods industries. However, the exploitation of PSP considering comprehensive utilization of various compounds, such as starch, non-starch polysaccharides, protein, and bioactive compounds should be considered.

Senegalia macrostachya seed polysaccharides attenuate inflammation-induced intestinal epithelial barrier dysfunction in a Caco-2 and RAW264.7 macrophage co-culture model by inhibiting the NF-κB/MLCK pathway.

The intestinal barrier dysfunction associated with chronic inflammation is a major health concern. This work aimed to investigate the protective effect and molecular mechanism of Senegalia macrostachya seed polysaccharide fraction (SMSP2) on inflammation-induced barrier dysfunction using Caco-2 cells and RAW264.7 macrophage co-culture model. The results showed that LPS stimulation of the basolateral RAW264.7 compromised the integrity of the apical differentiated Caco-2 cells monolayer, resulting in decreased transepithelial electrical resistance (TER) and increased inflammatory markers. SMSP2 apical treatment maintained a higher TER value and reduced the epithelial permeability to lucifer yellow (LY) dye. In addition, the SMSP2 group showed a significant decrease in the mRNA level of inflammatory factors such as inducible nitric oxide synthase (iNOS), cyclooxygenase 2 (COX-2), interleukin (IL)-8, and tumor necrosis factor-α (TNF-α) in the Caco-2 monolayer compared to the LPS group. Moreover, SMSP2 increased the expression of the tight junctions (TJ) zonula occludens (ZO-1), occludin, and claudin-1 at the mRNA and protein levels. Furthermore, the immunofluorescence assay showed that SMSP2 ameliorated the overall distribution of the TJ proteins in the Caco-2 monolayer. SMSP2 application also resulted in the downregulation of the nuclear factor kappa-B (NF-κB) phosphorylation and the myosin light chain kinase (MLCK) expression, which implies that SMSP2 preserved the monolayer integrity from the inflammation-induced barrier disruption through the inhibition of the NF-kB-mediated MLCK signaling pathway activation. Senegalia macrostachya seeds could therefore be a promising functional food that could be used to improve intestinal barrier function.

[Analysis of PRX gene variants in a child with Charcot-Marie-Tooth disease type 4F].

OBJECTIVE: To explore the genetic etiology of a child suspected for peroneal muscular atrophy. METHODS: The child and his parents were analyzed by using next generation sequencing. RESULTS: The child was found to harbor compound heterozygous variants of c.52G>T (p.Glu18X) and c.1390C>T (p.Arg464X) of the PRX gene, which were inherited from his father and mother, respectively. Among these, the c.52G>T variant was previously unreported. Based on the standards and guidelines of the American College of Medical Genetics and Genomics, both variants were predicted to be pathogenic (PVS1+PM2+PM3, PVS1+PM3-Strong+PM2+BS2). CONCLUSION: The compound heterozygous variants of the PRX gene probably underlay the Charcot-Marie-Tooth disease type 4F in this child. Above finding has enriched the mutational spectrum of the PRX gene.

Assessment of breast lesions by the Kaiser score for differential diagnosis on MRI: the added value of ADC and machine learning modeling.

OBJECTIVES: To evaluate the diagnostic performance of Kaiser score (KS) adjusted with the apparent diffusion coefficient (ADC) (KS+) and machine learning (ML) modeling. METHODS: A dataset of 402 malignant and 257 benign lesions was identified. Two radiologists assigned the KS. If a lesion with KS > 4 had ADC > 1.4 × 10-3 mm2/s, the KS was reduced by 4 to become KS+. In order to consider the full spectrum of ADC as a continuous variable, the KS and ADC values were used to train diagnostic models using 5 ML algorithms. The performance was evaluated using the ROC analysis, compared by the DeLong test. The sensitivity, specificity, and accuracy achieved using the threshold of KS > 4, KS+ > 4, and ADC ≤ 1.4 × 10-3 mm2/s were obtained and compared by the McNemar test. RESULTS: The ROC curves of KS, KS+, and all ML models had comparable AUC in the range of 0.883-0.921, significantly higher than that of ADC (0.837, p < 0.0001). The KS had sensitivity = 97.3% and specificity = 59.1%; and the KS+ had sensitivity = 95.5% with significantly improved specificity to 68.5% (p < 0.0001). However, when setting at the same sensitivity of 97.3%, KS+ could not improve specificity. In ML analysis, the logistic regression model had the best performance. At sensitivity = 97.3% and specificity = 65.3%, i.e., compared to KS, 16 false-positives may be avoided without affecting true cancer diagnosis (p = 0.0015). CONCLUSION: Using dichotomized ADC to modify KS to KS+ can improve specificity, but at the price of lowered sensitivity. Machine learning algorithms may be applied to consider the ADC as a continuous variable to build more accurate diagnostic models. KEY POINTS: • When using ADC to modify the Kaiser score to KS+, the diagnostic specificity according to the results of two independent readers was improved by 9.4-9.7%, at the price of slightly degraded sensitivity by 1.5-1.8%, and overall had improved accuracy by 2.6-2.9%. • When the KS and the continuous ADC values were combined to train models by machine learning algorithms, the diagnostic specificity achieved by the logistic regression model could be significantly improved from 59.1 to 65.3% (p = 0.0015), while maintaining at the high sensitivity of KS = 97.3%, and thus, the results demonstrated the potential of ML modeling to further evaluate the contribution of ADC. • When setting the sensitivity at the same levels, the modified KS+ and the original KS have comparable specificity; therefore, KS+ with consideration of ADC may not offer much practical help, and the original KS without ADC remains as an excellent robust diagnostic method.

Dietary polyglycosylated anthocyanins, the smart option? A comprehensive review on their health benefits and technological applications.

Over the years, anthocyanins have emerged as one of the most enthralling groups of natural phenolic compounds and more than 700 distinct structures have already been identified, illustrating the exceptional variety spread in nature. The interest raised around anthocyanins goes way beyond their visually appealing colors and their acknowledged structural and biological properties have fueled intensive research toward their application in different contexts. However, the high susceptibility of monoglycosylated anthocyanins to degradation under certain external conditions might compromise their application. In that regard, polyglycosylated anthocyanins (PGA) might offer an alternative to overcome this issue, owing to their peculiar structure and consequent less predisposition to degradation. The most recent scientific and technological findings concerning PGA and their food sources are thoroughly described and discussed in this comprehensive review. Different issues, including their physical-chemical characteristics, consumption, bioavailability, and biological relevance in the context of different pathologies, are covered in detail, along with the most relevant prospective technological applications. Due to their complex structure and acyl groups, most of the PGA exhibit an overall higher stability than the monoglycosylated ones. Their versatility allows them to act in a wide range of pathologies, either by acting directly in molecular pathways or by modulating the disease environment attributing an added value to their food sources. Their recent usage for technological applications has also been particularly successful in different industry fields including food and smart packaging or in solar energy production systems. Altogether, this review aims to put into perspective the current state and future research on PGA and their food sources.

Sodium caseinate enhances the effect of konjac flour on delaying gastric emptying based on a dynamic in vitro human stomach-IV (DIVHS-IV) system.

BACKGROUND: In the context of the increasing prevalence of overweight and obesity worldwide, satiety-enhancing foods may help people control their energy intake and weight. In this study, an advanced near-real human gastric simulator equipped with a dynamic in vitro human stomach-IV (DIVHS-IV) system was used to determine the gastric digestion and gastric retention ratio of konjac flour (KF)/sodium caseinate (SC) mixtures with different ratios. RESULTS: The apparent viscosity, viscoelastic properties, confocal laser scanning microscopy (CLSM) of the digested products were collected and analyzed to further study the effect of SC on the physical properties of KF during digestion. The results showed that the addition of SC could enhance the effect of KF on delaying gastric emptying in vitro. Besides, the addition of SC was shown to weaken the effect of gastric juice on the dilution of gastric contents by forming SC gel blocks in the acid environment. In particular, the synergistic gastric emptying delaying effect was the strongest in the KF/SC mixture containing 1% KF and 8% SC, and obvious massive aggregates were observed. CONCLUSION: The combination of 1% KF and 8% SC was shown to synergistically delay gastric emptying and potentially enhance the sense of fullness. © 2022 Society of Chemical Industry.

Properties of soybean protein isolate/curdlan based emulsion gel for fat analogue: Comparison with pork backfat.

To obtain an analogue of pork backfat (PBF), we combined emulsion and gel to fabricate emulsion gel, which was prepared by using soybean protein isolate (SPI) and curdlan (CL) through a facile heat-treatment method in this paper. The microstructures, rheology properties, water holding capacity and freeze-thawing stability of the emulsion gel were investigated. The results suggested that the SPI/CL-stabilized emulsion gel was thermal-irreversible, and SPI was the emulsifying agent of the emulsion gel. Oil contents significantly affect the water holding capacity and freeze-thawing stability of emulsion gel. Subsequently, the TPA, gel strength and color of emulsion gels with different oil contents were compared with PBF. The hardness, chewiness, springiness, and gel strength of emulsion gel with 10 wt% oil contents were no significant differences from that of PBF (P > 0.05). Hence, this SPI/CL based emulsion gel can be used as an analogue to PBF, providing an alternative ingredient for the development of plant-based low-fat meat products.

Preparation and characterization of konjac glucomannan (KGM) and deacetylated KGM (Da-KGM) obtained by sonication.

BACKGROUND: Konjac glucomannan (KGM) has been widely applied in the food industry as a thickening and gelation agent because of its unique colloidal properties of viscosity enhancement and gelling ability. The current study aimed to prepare and characterize KGM and deacetylated KGM (Da-KGM) samples obtained by sonication in neutral and alkali ethanol-water solutions. RESULTS: The results showed that the deacetylation degree (DD) of Da-KGM increased exponentially with alkali concentration. Fourier transform infrared spectrometry further confirmed the deacetylation reaction through the dramatic decrease in the acetyl group band at 1740 cm-1 . Besides, the high similarity among the tested groups in terms of X-ray diffraction (XRD) spectra implied a similar crystalline structure, while differential scanning calorimetry (DSC) curves revealed that the water binding capacity and decomposition temperature of KGM changed slightly with alkali and sonication treatment. The rheological profiles indicated that apparent viscosity (η0 ) of sonicated KGM samples was unchanged except for the T60 group (60 min sonication treatment). Particularly, ultrasonic treatment under high alkaline conditions (0.10 mol L-1 NaOH) was noted to promote the deacetylation reaction, and the obtained samples showed decreased apparent viscosity and weakened the gelation process in aqueous solution. Partial correction analysis indicated that alkali rather than ultrasonic treatment resulted in the change of DD and η0 in Da-KGM. Moreover, sonication contributed to off-white color by reducing the browning caused by alkali in Da-KGM products. CONCLUSION: Ultrasound-mediated heterogeneous deacetylation reaction is a feasible way to prepare Da-KGM samples with lightened browning and controllable DD. © 2022 Society of Chemical Industry.

Konjac Glucomannan (KGM), Deacetylated KGM (Da-KGM), and Degraded KGM Derivatives: A Special Focus on Colloidal Nutrition.

Konjac flour, mainly obtained and purified from the tubers ofAmorphophallus konjac C. Koch, yields a high molecular weight (Mw) and viscous hydrocolloidal polysaccharide: konjac glucomannan (KGM). KGM has been widely applied in the food industry as a thickening and gelation agent as a result of its unique colloidal properties of effective viscosity enhancement and thermal-irreversible gelling. This review first narrates the typical commercial KGM source species, the industrial production, and the purification process of KGM flour. The structural information on native KGM, gelation mechanisms of alkali-induced deacetylated KGM (Da-KGM) hydrogel, progress on degraded KGM derivatives, cryoprotection effect, and colloidal nutrition are highlighted. Finally, the regulatory requirements of konjac flour and KGM among different countries are briefly introduced. The fine structure and physicochemical properties of KGM can be regulated in a great range via the deacetylation or degradation reaction. Here, the relationship between the physicochemical properties, such as viscosity, solubility, gelation, and nutritional effects, of native KGM, Da-KGM, and degraded KGM derivatives was preliminary established, which would provide theoretical guidance for designing KGM-based products with certain nutritional needs.

Radiomics Model for Evaluating the Level of Tumor-Infiltrating Lymphocytes in Breast Cancer Based on Dynamic Contrast-Enhanced MRI.

BACKGROUND: To help identify potential breast cancer (BC) candidates for immunotherapies, we aimed to develop and validate a radiology-based biomarker (radiomic score) to predict the level of tumor-infiltrating lymphocytes (TILs) in patients with BC. PATIENTS AND METHODS: This retrospective study enrolled 172 patients with histopathology-confirmed BC assigned to the training (n = 121) or testing (n = 51) cohorts. Radiomic features were extracted and selected using Analysis-Kit software. The correlation between TIL levels and clinical features and radiomic features was evaluated. The clinical features model, radiomic signature model, and combined prediction model were constructed and compared. Predictive performance was assessed by receiver operating characteristic analysis and clinical utility by implementing a nomogram. RESULTS: Seven radiomic features were selected as the best discriminators to construct the radiomic signature model, the performance of which was good in both the training and validation data sets, with an area under the curve (AUC) of 0.742 (95% confidence interval [CI], 0.642-0.843) and 0.718 (95% CI, 0.558-0.878), respectively. Estrogen receptor status and tumor diameter were confirmed to be significant features for building the clinical feature model, which had an AUC of 0.739 (95% CI, 0.632-0.846) and 0.824 (95% CI, 0.692-0.957), respectively. The combined prediction model had an AUC of 0.800 (95% CI, 0.709-0.892) and 0.842 (95% CI, 0.730-0.954), respectively. CONCLUSION: The radiomic signature could be an important predictor of the TIL level in BC, which, when validated, could be useful in identifying BC patients who can benefit from immunotherapies. The nomogram may help clinicians make decisions.

[Clinical and genetic analysis of a patient with slow-channel congenital myasthenic syndrome].

OBJECTIVE: To explore the genetic basis for a female patient featuring unstable head upright and hypotonia of limbs. METHODS: The child was examined clinically. Peripheral blood samples of the child, her parents and siblings were collected. Genomic DNA was extracted and subjected to next generation sequencing (NGS). Suspected variant was verified by Sanger sequencing and bioinformatic analysis. RESULTS: DNA sequencing found that the patient has carried a de novo heterozygous c.354C>A (p.N118K) variant of the CHRND gene, which was not found in her parents and sibling. Bioinformatics analysis predicted that the variant was likely to be pathogenic. Literature review suggested that the phenotype of the patient was very similar to previously reported ones. CONCLUSION: The child was diagnosed with slow-channel congenital myasthenic syndrome (SCCMS) type 3A caused by heterozygous variant of the CHRND gene. NGS has provided a powerful tool for the diagnosis of such disorders.

Quantitative evaluation of computed and voxelwise computed diffusion-weighted imaging in breast cancer.

OBJECTIVES: To assess the value of computed diffusion-weighted imaging (cDWI) and voxelwise computed diffusion-weighted imaging (vcDWI) in breast cancer. METHODS: This retrospective study involved 130 patients (age range, 25-70 years; mean age ± standard deviation, 48.6 ± 10.5 years) with 130 malignant lesions, who underwent MRI examinations, including a DWI sequence, prior to needle biopsy or surgery. cDWIs with higher b-values of 1500, 2000, 2500, 3000, 3500, and 4000 s/mm2, and vcDWI were generated from measured (m) DWI with two lower b-values of 0/600, 0/800, or 0/1000 s/mm2. The signal-to-noise ratio (SNR) and contrast ratio (CR) of all image sets were computed and compared among different DWIs by two experienced radiologists independently. To better compare the CR with the SNR, the CR value was multiplied by 100 (CR100). RESULTS: The CR of vcDWI, and cDWIs, except for cDWI1000, differed significantly from that of measured diffusion-weighted imaging (mDWI) (cDWI1000: CR = 0.4904, p = 0.394; cDWI1500: CR = 0.5503, p = 0.006; cDWI2000: CR = 0.5889, p < 0.001; cDWI2500: CR = 0.6109, p < 0.001; cDWI3000: mean = 0.6214, p < 0.001; cDWI3500: CR = 0.6245, p < 0.001; cDWI4000: CR = 0.6228, p < 0.001). The vcDWI provided the highest CR, while the CRs of all cDWI image sets improved with increased b-values. The SNR of neither cDWI1000 nor vcDWI differed significantly from that of mDWI, but the mean SNRs of the remaining cDWIs were significantly lower than that of mDWI. The SNRs of cDWIs declined with increasing b-values, and the initial decrease at low b-values was steeper than the gradual attenuation at higher b-values; the CR100 rose gradually, and the two converged on the b-value interval of 1500-2000 s/mm2 . CONCLUSIONS: The highest CR was achieved with vcDWI; this could be a promising approach easier detection of breast cancer. ADVANCES IN KNOWLEDGE: This study comprehensively compared and evaluated the value of the emerging post-processing DWI techniques (including a set of cDWIs and vcDWI) in breast cancer.

Feasibility and Diagnostic Performance of Voxelwise Computed Diffusion-Weighted Imaging in Breast Cancer.

BACKGROUND: Conventional diffusion-weighted imaging (DWI) with high b-values may improve lesion conspicuity, but with a low signal intensity and thus a low signal-to-noise ratio (SNR). The voxelwise computed DWI (vcDWI) may generate high-quality images with a strong lesion signal and low background. PURPOSE: To evaluate the feasibility and diagnostic performance of vcDWI. STUDY TYPE: Retrospective. POPULATION: In all, 67 patients with 72 lesions, 33 malignant and 39 benign. FIELD STRENGTH/SEQUENCE: 3T, including T2 /T1 , DWI with two b-values, and dynamic contrast-enhanced MRI (DCE-MRI). ASSESSMENT: Computed DWI (cDWI) with high b-values of 1500, 2000, 2500 s/mm2 (cDWI1500 , cDWI2000 , cDWI2500 ) and vcDWI were generated from measured DWI (mDWI). The mDWI, cDWIs and vcDWI were evaluated by three readers independently to determine lesion conspicuity, background signal suppression, overall image quality using 1-5 rating scales, as well as to give BI-RADS scores. The mean apparent diffusion coefficient (ADC) value for each lesion was measured. STATISTICAL TESTS: Agreement among the three readers was evaluated by the intraclass correlation coefficient. Receiver operating characteristic (ROC) analysis was performed to compare the diagnostic performance based on reading of mDWI, cDWIs, vcDWI, and the measured ADC values. RESULTS: vcDWI provided the best lesion conspicuity compared with mDWI and cDWIs (P < 0.005). For overall image quality, vcDWI was significantly better than cDWI (P < 0.005), but not significantly better compared with mDWI for two readers (P = 0.037 and P = 0.013) and significantly worse for the third reader (P < 0.005). Background signal suppression was the best on cDWI2500 , and better on vcDWI than on mDWI, cDWI1500 , and cDWI2000 . The AUC value for differential diagnosis was 0.868 for mDWI, 0.862 for cDWI1500 , 0.781 for cDWI2000 , 0.704 for cDWI2500 , 0.946 for vcDWI, 0.704 for ADC value, and 0.961 for DCE-MRI. DATA CONCLUSION: vcDWI was implemented without increasing scanning time, and it provided excellent lesion conspicuity for detection of breast lesions and assisted in differentiating malignant from benign breast lesions. LEVEL OF EVIDENCE: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.