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Objectives: To evaluate the identification of tumor deposits (TDs) and the prognostic significance of an MRI tumor regression grade for TDs in patients with rectal cancer treated with neoadjuvant chemoradiotherapy (nCRT). Methods: Ninety-one patients with cT3 or cT4 rectal cancer who underwent surgery following nCRT between August 2014 and June 2020 were retrospectively analyzed. Changes in pre-nCRT MRI-detected TDs (mrTDs) were described as mrTD regression grade. The diagnostic performance of post-nCRT MRI-detected TDs (ymrTDs) was compared with histopathological reference standard. The correlation between ymrTDs, mrTD regression grade, and disease-free survival (DFS) was assessed. Results: The sensitivity and specificity of ymrTDs were 88.00% and 89.39%, respectively. The area under the receiver operating characteristic curve was 0.887 (95% confidence interval [CI]: 0.803–0.944). The 3-year DFS of patients with positive ymrTDs was significantly lower than of the negative group (44.83% vs 82.73%, p < 0.001). The 3-year DFS was 33.33% for patients with poor regression of mrTDs following nCRT and 55.56% for those with moderate regression, compared to 69.23% in good responders and 83.97% in patients without mrTDs (p < 0.001). On multivariable Cox regression, mrTD regression grade was the only independent MRI factor associated with DFS (p = 0.042). Conclusions: Diagnostic performance of ymrTDs was moderate. The mrTD regression grade was independently correlated with DFS, which may have a prognostic implication for treatment and follow-up. Clinical relevance statement: Patients with poor regression of MRI-detected tumor deposits may benefit from more aggressive treatments, such as chemoradiation therapy plus induction or consolidation chemotherapy. Key Points: • MRI provides a preoperative and noninvasive way to visualize tumor deposits (TDs) after neoadjuvant chemoradiotherapy (nCRT). • Post-nCRT MRI-detected TDs are a poor prognostic marker in cT3 and cT4 rectal cancer patients. • The regression of MRI-detected TDs after nCRT is associated with an improved disease-free survival. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of deep learning reconstruction (DLR) on bladder MRI, specifically examination time, image quality, and diagnostic performance of vesical imaging reporting and data system (VI-RADS) within a prospective clinical cohort. Methods: Seventy participants with bladder cancer who underwent MRI between August 2022 and February 2023 with a protocol containing standard T2-weighted imaging (T2WIS), standard diffusion-weighted imaging (DWIS), fast T2WI with DLR (T2WIDL), and fast DWI with DLR (DWIDL) were enrolled in this prospective study. Imaging quality was evaluated by measuring signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and qualitative image quality scoring. Additionally, the apparent diffusion coefficient (ADC) of bladder lesions derived from DWIS and DWIDL was measured and VI-RADS scoring was performed. Paired t-test or paired Wilcoxon signed-rank test were performed to compare image quality score, SNR, CNR, and ADC between standard sequences and fast sequences with DLR. The diagnostic performance for VI-RADS was assessed using the area under the receiver operating characteristic curve (AUC). Results: Compared to T2WIS and DWIS, T2WIDL and DWIDL reduced the acquisition time from 5:57 min to 3:13 min and showed significantly higher SNR, CNR, qualitative image quality score of overall image quality, image sharpness, and lesion conspicuity. There were no significant differences in ADC and AUC of VI-RADS between standard sequences and fast sequences with DLR. Conclusions: The application of DLR to T2WI and DWI reduced examination time and significantly improved image quality, maintaining ADC and the diagnostic performance of VI-RADS for evaluating muscle invasion in bladder cancer. [ABSTRACT FROM AUTHOR]

Objectives: To explore the potential of dynamic contrast-enhanced MRI (DCE-MRI) quantitative parameters in predicting severe acute radiation-induced rectal injury (RRI) in rectal cancer. Methods: This retrospective study enrolled 49 patients with rectal cancer who underwent neoadjuvant chemoradiotherapy and rectal MRI including a DCE-MRI sequence from November 2014 to March 2021. Two radiologists independently measured DCE-MRI quantitative parameters, including the forward volume transfer constant (Ktrans), rate constant (kep), fractional extravascular extracellular space volume (ve), and the thickness of the rectal wall farthest away from the tumor. These parameters were compared between mild and severe acute RRI groups based on histopathological assessment. Receiver operating characteristic curve analysis was performed to analyze statistically significant parameters. Results: Forty-nine patients (mean age, 54 years ± 12 [standard deviation]; 37 men) were enrolled, including 25 patients with severe acute RRI. Ktrans was lower in severe acute RRI group than mild acute RRI group (0.032 min−1 vs 0.054 min−1; p = 0.008), but difference of other parameters (kep, ve and rectal wall thickness) was not significant between these two groups (all p > 0.05). The area under the receiver operating characteristic curve of Ktrans was 0.72 (95% confidence interval: 0.57, 0.84). With a Ktrans cutoff value of 0.047 min−1, the sensitivity and specificity for severe acute RRI prediction were 80% and 54%, respectively. Conclusion: Ktrans demonstrated moderate diagnostic performance in predicting severe acute RRI. Clinical relevance statement: Dynamic contrast-enhanced MRI can provide non-invasive and objective evidence for perioperative management and treatment strategies in rectal cancer patients with acute radiation-induced rectal injury. Key Points: • To our knowledge, this study is the first to evaluate the predictive value of contrast-enhanced MRI (DCE-MRI) quantitative parameters for severe acute radiation-induced rectal injury (RRI) in patients with rectal cancer. • Forward volume transfer constant (Ktrans), derived from DCE-MRI, exhibited moderate diagnostic performance (AUC = 0.72) in predicting severe acute RRI of rectal cancer, with a sensitivity of 80% and specificity of 54%. • DCE-MRI is a promising imaging marker for distinguishing the severity of acute RRI in patients with rectal cancer. [ABSTRACT FROM AUTHOR]

Purpose: To explore the diagnostic efficacy of MR-based texture analysis in differentiation of small (≤ 4 cm) and very small (≤ 2 cm) renal cell carcinoma subtypes. Methods: One hundred and eight patients with pT1a (≤ 4 cm) renal cell carcinoma and pretreatment MRI were enrolled in this retrospective study. Histogram and gray-level co-occurrence matrix (GLCM) parameters were extracted from whole-tumor images. Among subtypes, patient age, tumor size, histological grading and texture parameters were compared. Diagnostic model using combination of texture parameters was constructed using logistic regression and validated using fivefold cross-validation. AUC with 95% CI, accuracy, sensitivity and specificity for subtype differentiation are reported. Further we explored the distinguishing ability of texture parameters and diagnostic model in very small (≤ 2 cm) RCC subgroups. Results: Significant texture parameters among RCC subtypes were identified. For small (≤ 4 cm) renal cell carcinoma subtyping, combining models based on texture parameters achieved good AUCs for differentiating ccRCC vs. non-ccRCC, chRCC vs. non-chRCC and ccRCC vs. chRCC (0.79, 0.74 and 0.81). Further, in subgroups of very small (≤ 2 cm) RCCs, diagnostic models had better differentiating performances, achieving AUCs of 0.88, 0.99, 0.96 in differentiating ccRCC vs. non-ccRCC, chRCC vs. non-chRCC and ccRCC vs. chRCC. Conclusion: MR texture analysis may help to differentiate small (≤ 4 cm) and very small (≤ 2 cm) RCC subtypes. This non-invasive method can potentially provide additional information for localized RCC treatment and surveillance strategy. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the value of magnetic resonance imaging (MRI)-based radiomics in predicting the treatment response to concurrent chemoradiotherapy (CCRT) in patients with locally advanced cervical squamous cell cancer (LACSC). Methods: In total, 198 patients (training: n = 138; testing: n = 60) with LACSC treated with CCRT between January 2014 and December 2019 were retrospectively enrolled in this study. Responses were evaluated by MRI and clinical data performed at one month after completion of CCRT according to RECIST standards, and patients were divided into the residual group and nonresidual group. Overall, 200 radiomics features were extracted from T2-weighted imaging and apparent diffusion coefficient maps. The radiomics score (Rad-score) was constructed with a feature selection strategy. Logistic regression analysis was used for multivariate analysis of radiomics features and clinical variables. The performance of all models was assessed using receiver operating characteristic curves. Results: Among the clinical variables, tumor grade and FIGO stage were independent risk factors, and the areas under the curve (AUCs) of the clinical model were 0.741 and 0.749 in the training and testing groups. The Rad-score, consisting of 4 radiomics features selected from 200 radiomics features, showed good predictive performance with an AUC of 0.819 in the training group and 0.776 in the testing group, which were higher than the clinical model, but the difference was not statistically significant. The combined model constructed with tumor grade, FIGO stage, and Rad-score achieved the best performance, with an AUC of 0.857 in the training group and 0.842 in the testing group, which were significantly higher than the clinical model. Conclusion: MRI-based radiomics features could be used as a noninvasive biomarker to improve the ability to predict the treatment response to CCRT in patients with LACSC. [ABSTRACT FROM AUTHOR]

Purpose: To assess the value of orthogonal axial images (OAI) of MRI in gastric cancer T staging.This retrospective study enrolled 133 patients (median age, 63 [range, 24–85] years) with gastric adenocarcinoma who underwent both CT and MRI followed by surgery. MRI lacking or incorporating OAI and CT images were evaluated, respectively. Diagnostic performance (accuracy, sensitivity, and specificity) for each T stage, overall diagnostic accuracy and rates of over- and understaging were quantified employing pathological T stage as a reference standard. The McNemar’s test was performed to compare the overall accuracy.Among patients with pT1–pT4 disease, MRI with OAI (accuracy: 88.7–94.7%, sensitivity: 66.7–93.0%, specificity: 91.5–100.0%) exhibited superior diagnostic performance compared to MRI without OAI (accuracy: 81.2–88.7%, sensitivity: 46.2–83.1%, specificity: 85.5–99.1%) and CT (accuracy: 88.0–92.5%, sensitivity: 53.3–90.1%, specificity: 88.7–98.1%). The overall accuracy of MRI with OAI was significantly higher (83.5%) than that of MRI without OAI (67.7%) (p < .001). However, there was no significant difference in the overall accuracy of MRI with OAI and CT (78.9%) (p = .35). The over- and understaging rates of MRI with OAI (12.0, 4.5%) were lower than those of MRI without OAI (21.8, 10.5%) and CT (12.8, 8.3%).OAI play a pivotal role in the T staging of gastric cancer. MRI incorporating OAI demonstrated commendable performance for gastric cancer T-staging, with a slight tendency toward its superiority over CT.Methods: To assess the value of orthogonal axial images (OAI) of MRI in gastric cancer T staging.This retrospective study enrolled 133 patients (median age, 63 [range, 24–85] years) with gastric adenocarcinoma who underwent both CT and MRI followed by surgery. MRI lacking or incorporating OAI and CT images were evaluated, respectively. Diagnostic performance (accuracy, sensitivity, and specificity) for each T stage, overall diagnostic accuracy and rates of over- and understaging were quantified employing pathological T stage as a reference standard. The McNemar’s test was performed to compare the overall accuracy.Among patients with pT1–pT4 disease, MRI with OAI (accuracy: 88.7–94.7%, sensitivity: 66.7–93.0%, specificity: 91.5–100.0%) exhibited superior diagnostic performance compared to MRI without OAI (accuracy: 81.2–88.7%, sensitivity: 46.2–83.1%, specificity: 85.5–99.1%) and CT (accuracy: 88.0–92.5%, sensitivity: 53.3–90.1%, specificity: 88.7–98.1%). The overall accuracy of MRI with OAI was significantly higher (83.5%) than that of MRI without OAI (67.7%) (p < .001). However, there was no significant difference in the overall accuracy of MRI with OAI and CT (78.9%) (p = .35). The over- and understaging rates of MRI with OAI (12.0, 4.5%) were lower than those of MRI without OAI (21.8, 10.5%) and CT (12.8, 8.3%).OAI play a pivotal role in the T staging of gastric cancer. MRI incorporating OAI demonstrated commendable performance for gastric cancer T-staging, with a slight tendency toward its superiority over CT.Results: To assess the value of orthogonal axial images (OAI) of MRI in gastric cancer T staging.This retrospective study enrolled 133 patients (median age, 63 [range, 24–85] years) with gastric adenocarcinoma who underwent both CT and MRI followed by surgery. MRI lacking or incorporating OAI and CT images were evaluated, respectively. Diagnostic performance (accuracy, sensitivity, and specificity) for each T stage, overall diagnostic accuracy and rates of over- and understaging were quantified employing pathological T stage as a reference standard. The McNemar’s test was performed to compare the overall accuracy.Among patients with pT1–pT4 disease, MRI with OAI (accuracy: 88.7–94.7%, sensitivity: 66.7–93.0%, specificity: 91.5–100.0%) exhibited superior diagnostic performance compared to MRI without OAI (accuracy: 81.2–88.7%, sensitivity: 46.2–83.1%, specificity: 85.5–99.1%) and CT (accuracy: 88.0–92.5%, sensitivity: 53.3–90.1%, specificity: 88.7–98.1%). The overall accuracy of MRI with OAI was significantly higher (83.5%) than that of MRI without OAI (67.7%) (p < .001). However, there was no significant difference in the overall accuracy of MRI with OAI and CT (78.9%) (p = .35). The over- and understaging rates of MRI with OAI (12.0, 4.5%) were lower than those of MRI without OAI (21.8, 10.5%) and CT (12.8, 8.3%).OAI play a pivotal role in the T staging of gastric cancer. MRI incorporating OAI demonstrated commendable performance for gastric cancer T-staging, with a slight tendency toward its superiority over CT.Conclusion: To assess the value of orthogonal axial images (OAI) of MRI in gastric cancer T staging.This retrospective study enrolled 133 patients (median age, 63 [range, 24–85] years) with gastric adenocarcinoma who underwent both CT and MRI followed by surgery. MRI lacking or incorporating OAI and CT images were evaluated, respectively. Diagnostic performance (accuracy, sensitivity, and specificity) for each T stage, overall diagnostic accuracy and rates of over- and understaging were quantified employing pathological T stage as a reference standard. The McNemar’s test was performed to compare the overall accuracy.Among patients with pT1–pT4 disease, MRI with OAI (accuracy: 88.7–94.7%, sensitivity: 66.7–93.0%, specificity: 91.5–100.0%) exhibited superior diagnostic performance compared to MRI without OAI (accuracy: 81.2–88.7%, sensitivity: 46.2–83.1%, specificity: 85.5–99.1%) and CT (accuracy: 88.0–92.5%, sensitivity: 53.3–90.1%, specificity: 88.7–98.1%). The overall accuracy of MRI with OAI was significantly higher (83.5%) than that of MRI without OAI (67.7%) (p < .001). However, there was no significant difference in the overall accuracy of MRI with OAI and CT (78.9%) (p = .35). The over- and understaging rates of MRI with OAI (12.0, 4.5%) were lower than those of MRI without OAI (21.8, 10.5%) and CT (12.8, 8.3%).OAI play a pivotal role in the T staging of gastric cancer. MRI incorporating OAI demonstrated commendable performance for gastric cancer T-staging, with a slight tendency toward its superiority over CT. [ABSTRACT FROM AUTHOR]

Unilateral temporal lobe epilepsy (TLE) is the most common type of focal epilepsy characterized by foci in the unilateral temporal lobe grey matters of regions such as the hippocampus. However, it remains unclear how the functional features of white matter are altered in TLE. In the current study, resting-state functional magnetic resonance imaging (fMRI) was performed on 71 left TLE (LTLE) patients, 79 right TLE (RTLE) patients and 47 healthy controls (HC). Clustering analysis was used to identify fourteen white matter networks (WMN). The functional connectivity (FC) was calculated among WMNs and between WMNs and grey matter. Furthermore, the FC laterality of hemispheric WMNs was assessed. First, both patient groups showed decreased FCs among WMNs. Specifically, cerebellar white matter illustrated decreased FCs with the cerebral superficial WMNs, implying a dysfunctional interaction between the cerebellum and the cerebral cortex in TLE. Second, the FCs between WMNs and the ipsilateral hippocampus (grey matter foci) were also reduced in patient groups, which may suggest insufficient functional integration in unilateral TLE. Interestingly, RTLE showed more severe abnormalities of white matter FCs, including links to the bilateral hippocampi and temporal white matter, than LTLE. Taken together, these findings provide functional evidence of white matter abnormalities, extending the understanding of the pathological mechanism of white matter impairments in unilateral TLE. [ABSTRACT FROM AUTHOR]

Introduction: Patients with knee osteoarthritis (KOA) often complain about clinical symptoms affected by weather-related factors. The purpose of the present study was to use cross-sectional analysis to determine whether weather sensitivity was associated with clinical symptoms, as well as structure abnormalities, in KOA patients. Methods: Data from 80 participants were obtained from the Feng Hans Shi Effects on OA (FHS) study, an OA cohort study initiated in China in 2015. The weather sensitivity of each participant was determined by a self-reported questionnaire. The following measurements were used to assess clinical outcomes: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for symptoms, and semi-quantitative Whole-Organ Magnetic Resonance Imaging Score (WORMS) for cartilage defects and marrow abnormalities of magnetic resonance imaging (MRI). Chi-square with Cochran–Armitage test for trend and regression analysis were used to evaluate the associations between weather sensitivity and WOMAC and WORMS of KOA patients. Results: Most of the KOA participants (57.5%) perceived the weather as affecting their knee-joint clinical symptoms. After adjusting for age, gender, and body mass index (BMI), weather sensitivity was not only associated with knee pain [OR = 3.3 (95% CI 1.1, 9.9), P = 0.032], dysfunction [OR = 5.5 (95% CI 1.8, 16.8), P = 0.003], and overall clinical symptoms [OR = 3.3 (95% CI 1.1, 10.2), P = 0.034], but also associated with cartilage defect [OR = 3.1 (95% CI 1.1, 8.5), P = 0.027] and marrow abnormality [OR = 3.0 (95% CI 1.1, 8.1), P = 0.029]. Conclusions: In KOA patients, weather sensitivity was associated with clinical symptoms and structural abnormalities. Future longitudinal study is warranted for the causal relationship. Infographic: [ABSTRACT FROM AUTHOR]

Purpose: With advancements in medical imaging, more renal tumors are detected early, but it remains a challenge for radiologists to accurately distinguish subtypes of renal parenchymal tumors. We aimed to establish a novel deep convolutional neural network (CNN) model and investigate its effect on identifying subtypes of renal parenchymal tumors in T2-weighted fat saturation sequence magnetic resonance (MR) images. Methods: This retrospective study included 199 patients with pathologically confirmed renal parenchymal tumors, including 77, 46, 34, and 42 patients with clear cell renal cell carcinoma (ccRCC), chromophobe renal cell carcinoma (chRCC), angiomyolipoma (AML), and papillary renal cell carcinoma (pRCC), respectively. All enrolled patients underwent kidney MR scans with the field strength of 1.5 Tesla (T) or 3.0 T before surgery. We selected T2-weighted fat saturation sequence images of all patients and built a deep learning model to determine the type of renal tumors. Receiver operating characteristic (ROC) curve was depicted to estimate the performance of the CNN model; the accuracy, precision, sensitivity, specificity, F1-score, and area under the curve (AUC) were calculated. One-way analysis of variance and χ2 tests of independent samples were used to analyze the variables. Results: The experimental results demonstrated that the model had a 60.4% overall accuracy, a 61.7% average accuracy, and a macro-average AUC of 0.82. The AUCs for ccRCC, chRCC, AML, and pRCC were 0.94, 0.78, 0.80, and 0.76, respectively. Conclusion: Deep CNN model based on T2-weighted fat saturation sequence MR images was useful to classify the subtypes of renal parenchymal tumors with a relatively high diagnostic accuracy. [ABSTRACT FROM AUTHOR]

This article was to explore the application of deep learning algorithms in the classification and diagnosis of deep pelvic endometriosis (DPE) by ultrasound and magnetic resonance imaging (MRI). Vaginal ultrasound (VU) and MRI images of 118 patients with DPE and 206 patients with other gynaecological diseases who were treated in our hospital from January 2015 to January 2018 were analysed. Firstly, the global average pooling (GAP) was introduced based on the visual geometry group (VGG) network to design the VGG-GAP model for VU image recognition. Next, the C3D model was improved as the IC3D model for MRI image recognition. The diagnostic values of patients with DPE based on classified VU and MRI images were compared and analysed. The results revealed that the classification accuracy of the VGG-GAP model in the VU image was 96.5%, and the classification accuracy of the IC3D model in the MRI image was 99.2%. The diagnosis accuracy using VU images and MRI images was 90.68% and 92.37%, respectively. Based on this, the classification of VU or MRI images based on deep learning algorithms could provide a basis for improving the diagnosis efficiency of DPE. The value of MRI in the diagnosis of DPE was significantly higher than that of VU. [ABSTRACT FROM AUTHOR]

Calcification causes mixed signal intensity in the lymph node (LN) on high-resolution magnetic resonance imaging (MRI), which is a strong indicator of regional LN metastasis in rectal cancer. Calcified metastatic LNs in rectal cancer commonly display scattered fine punctate calcifications to varying degrees on computed tomography (CT). On high-resolution MRI, the calcifications manifest a patchy area of signal loss in corresponding calcified area that is larger than on CT. It is necessary to recognize the appearance of metastatic LN calcifications on high-resolution MRI in rectal cancer because it is the primary imaging method for local staging in rectal cancer. This pictorial essay aims to introduce an important imaging finding that can contribute to the diagnosis of LN metastasis by illustrating features and differences between CT and high-resolution MRI of metastatic LN calcifications in rectal cancer. [ABSTRACT FROM AUTHOR]

Background: Maturity-onset Diabetes of the Young type 5 (MODY5) is clinically heterogeneous, and the genetic examination is important to provide the accurate diagnosis. Identification of more cases will better understand the genotype-phenotype correlations of this disorder. Methods: We collected the clinical and biochemical data, using the whole-exome gene detection and multiplex ligation–dependent probe Amplification to detect the pathogenic gene variants. Results: The proband is a 39-year-old female, and presenting with symptoms including polyuria, polydipsia, and weight loss for 6 months. Her BMI was 17.6 kg/m2. Laboratory tests indicated hypokalemia (3.1 mmol/L), hypomagnesemia (0.4 mmol/L), and hypocalcemia (1.91 mmol/L). Glycated hemoglobin (HbA1c) was 13.7%, fasting C-peptide was 0.24 ng/mL (normal range: 0.3–3.73 ng/mL). Both glutamic acid decarboxylase and islet cell antibodies were negative. Abdominal magnetic resonance image showed the agenesis of the tail and body of the pancreas and the presence of disseminated cysts of the left kidney. Genetic examination displayed a de novo heterozygous deletion of the whole HNF-1Β gene (NM_000458.3). Three-year follow-up after the diagnosis showed that the patient has sustained hypomagnesemia and cannot maintain an appreciable increase in serum magnesium levels (0.52–0.61 mmol/L), although she was using the double-dose magnesium aspartate. Moreover, she cannot achieve good glucose control either. Conclusion: Our findings indicted that MODY is highly heterogeneous and patients with additional extrapancreatic clinical features and hypomagnesemia should be screened for MODY5. [ABSTRACT FROM AUTHOR]

Purpose: The present study aims to investigate structural and functional connectivity (SC and FC) in cerebello-cerebral circuit in idiopathic generalized epilepsy (IGE).Methods: Diffusion tensor imaging and resting-state imaging data were collected from 57 patients with IGE and 66 controls in the present study. First, we performed bidirectional probabilistic fiber tracking between cerebellum and cerebral cortex, consisting of cerebellar efferent and afferent fibers. Then, strength of structural connectivity (SCS), fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) were extracted and compared between groups. Finally, cerebellar FC with cerebral cortex was evaluated with seeding at dentate nucleus. Between-group comparisons were performed using t tests with a significant level setting at p < 0.05 with threshold-free cluster enhancement correction.Results: The patients with IGE showed decreased SCS in cerebellar efferent fibers to sensorimotor cortex in anterior corona radiate and increased SCS in efferent fibers to occipital cortex in posterior corona radiata. The SCS in cerebellar afferent fibers in corticospinal tract from frontal and in retrolenticular part of the internal capsule from occipital cortices were increased in IGE, and SCS in afferent fibers in posterior limb of internal capsule from parietal cortex was decreased. Decreased FA and increased MD and RD were observed in cerebello-cerebral tracts. Besides, decreased cerebellar FC with putamen and motor cortex was observed in IGE.Conclusion: The patients with IGE demonstrated distinct alterations in efferent and afferent pathways between cerebellum and different cerebral cortices, which might be the pathological anatomical basis for cerebellar modulation effect on epileptic activities and contribute to motor deficits.Key Points: • IGE showed decreased SCS in cerebellar efferent fibers to the sensorimotor cortex and increased SCS in efferent fibers to the occipital cortex. • Patients demonstrated increased SCS in cerebellar afferent fibers from the frontal and the occipital cortex and decreased SCS in afferent fibers from parietal cortex. • Decreased FC between motor-related regions and dentate nucleus was observed in IGE. [ABSTRACT FROM AUTHOR]

Purpose: To compare the diagnostic accuracies of MDCT and high-resolution MRI (HR-MRI) for regional nodal metastases with different short-axis diameter ranges in rectal cancer patients. Methods: Rectal adenocarcinoma patients who underwent both MDCT and HR-MRI before surgery were included. The maximum short-axis diameters of the nodes were measured, and were classified as benign or malignant on imaging findings. All of the nodes were subdivided as follows: ≤ 5 mm (Group A), > 5 mm and ≤ 10 mm (Group B) , and > 10 mm (Group C). The postoperative pathological reports were used as the standard, and the sensitivity, specificity, accuracy, ROC curve, and AUC value were calculated for each subgroup. Results: A total of 592 nodes were included in the node-to-node evaluation. In Group A, the specificity and accuracy of HR-MRI were significantly higher than those of MDCT (99.28% vs. 93.99%, P < 0.001; 95.78% vs. 89.56%, P = 0.010; respectively). In Group B, the specificity and accuracy of HR-MRI were also higher than those of MDCT (98.36% vs. 55.74%, P < 0.001; 80.45% vs. 66.17%, P < 0.001; respectively). For Groups A and B, the AUCs of MDCT were both 0.65, whereas those of HR-MRI were 0.76 and 0.82, respectively. In Group C, all nine malignant nodes were correctly diagnosed metastases on MDCT, whereas one was misjudged as benign on HR-MRI. Conclusions: The diagnostic value of HR-MRI is superior to that of MDCT, with higher specificity, accuracy, and AUC values for HR-MRI than for MDCT. [ABSTRACT FROM AUTHOR]

Objectives: To explore the sensitivity of potential DTI-based biomarkers in detecting microstructural changes for whole-brain white matter in early stage amyotrophic lateral sclerosis (ALS), analyze the relationship between the DTI indices and disease status, and further clarify potential brain regions for disease monitoring and clinical assessment.Methods: Thirty-three non-demented ALS patients and 32 age- and gender-matched subjects participated in this study. DTI data were acquired via 3.0T MRI scanner. Maps of diffusion-related indices including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were obtained. Tract-based spatial statistics (TBSS) were used to investigate whole-brain white matter changes of each index. Correlation analyses between both brain-wide and volume-of-interest (VOI)-wide white matter alterations and clinical factors including ALSFRS-R scores, disease duration, and progression rate were performed.Results: Compared to healthy subjects, ALS patients showed significantly increased RD, MD and reduced FA, mainly along the corticospinal tract (CST) and the body of corpus callosum (CC). Increases in RD were broader than decreases in FA, in CST of both hemispheres. Meanwhile, involvement of several extra-motor regions was also revealed by RD. Significant positive correlation between ALSFRS-R scores and FA, negative correlation between ALSFRS-R and RD were found in left CST.Conclusions: RD may be the most sensitive biomarker for the detection of early demyelination of white matter. Both RD and FA may serve as objective biomarkers for disease severity assessment. CST may be the most affected brain region in non-demented ALS.Key Points: • Changes in RD were broader than those in FA in bilateral CST. • Involvement of extra-motor regions was uncovered by RD. • FA and RD in CST were related to ALSFRS-R scores. [ABSTRACT FROM AUTHOR]

Objectives: To determine association of gross tumour volume (GTV) of resectable oesophageal squamous cell carcinoma (SCC) measured on T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE-T1WI) and diffusion-weighted imaging (DWI) with T category and lymphatic metastasis (LM).Methods: Sixty oesophageal SCC patients underwent fat-suppressed T2WI, CE-T1WI and DWI with b values of 0, 500 and 800 s/mm2. GTV was measured on three sequences. Statistical analyses were performed to determine association of GTV with T category and LM.Results: Spearman's rank correlation analysis showed positive association of GTV with T category and LM (all p values < 0.01). Differences in GTV were found between T1 and T2 or T3 categories shown by Kruskal-Wallis H and one-way ANOVA tests, and between T1/T2 and T3 and between tumours with and without LM by Mann-Whitney U tests (all p values < 0.05). Receiver operating characteristic analyses showed cut-off GTVs of 5.795, 5.276 and 10.11 cm3 on CE-T1WI could better differentiate T1 from T2 categories, T1 from T3, and T1-2 from T3 than those of 7.066, 7.045 and 8.504 cm3 on T2WI, of 5.793, 6.609 and 6.989 cm3 on DWI with b value of 500 s/mm2, and of 4.156, 4.519 and 4.985 cm3 with b value of 800 s/mm2, respectively. Cut-off of 10.462 cm3 on DWI with b value of 500 s/mm2 could better identify LM than of 12.38, 8.793 and 9.600 cm3 on T2WI, CE-T1WI and DWI with b value of 800 s/mm2, respectively.Conclusions: GTVs on T2WI, CE-T1WI and DWI are associated with T category of and LM of oesophageal SCC.Key Points: • GTV is associated with T category and lymphatic metastasis of oesophageal SCC • GTV measured on contrast-enhanced T 1 -weighted imaging better identifies T category • GTV measured on DWI with b value of 500 s/mm 2 better identifies lymphatic metastasis. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to analyze MR imaging features of renal epithelioid angiomyolipoma (EAML).Methods: This study included 17 patients with histopathologically confirmed renal EAML who underwent renal MRI scanning before radical or partial nephrectomy. MR images were retrospectively reviewed and correlated with pathological findings.Result: Fifteen lesions (88.2%) appeared as round or oval. The tumor-kidney interface was round in 14 lesions (82.4%). Fifteen tumors (88.2%) presented mainly isointensity on T1WI, and eleven tumors (64.7%) presented mainly hypointensity on T2WI. Twelve lesions (70.6%) showed restricted diffusion on DWI, and the mean ADC value was 1.23 ± 0.28 × 10−3mm2/s. Minimal fat component was identified as loss of signal intensity on opposed-phase MR images in 6 cases (35.3%). Sixteen lesions (100%) demonstrated inhomogeneous enhancement, and 7 of 16 masses (43.8%) showed reticular enhancement. Rapid wash-in and wash-out enhancement was seen in 13 masses (81.3%). In the corticomedullary phase, the mass showed markedly enhancement in 14 cases (87.5%). The irregular vessels and hemorrhage were detected in 4 cases (23.5%) and 7 cases (41.2%), respectively. One patient (5.9%) had a lymph node involvement at initial diagnosis, and showed distant metastasis after operation. In the immunohistochemical analysis, 15 tumors (88.2%) were positive for melanocytic marker (HMB45 or Melan-A), and all cases (100%) were negative for epithelial-associated markers (CK or AE1/AE3).Conclusion: The presence of hypointensity on T2WI, restricted diffusion on DWI, round tumor-kidney interface, reticular, and marked enhancement (rapid wash-in and wash-out) should further raise suspicion for renal EAML. The diagnosis may be confirmed by pathological analysis. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the potential of various metrics derived from mono-exponential model (MEM), bi-exponential model (BEM) and stretched exponential model (SEM)-based diffusion-weighted imaging (DWI) in diagnosing and differentiating the pathological subtypes and grades of uterine cervical carcinoma.Methods: 71 newly diagnosed patients with cervical carcinoma (50 cases of squamous cell carcinoma [SCC] and 21 cases of adenocarcinoma [AC]) and 32 healthy volunteers received DWI with multiple b values. The apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), water molecular diffusion heterogeneity index (alpha), and distributed diffusion coefficient (DDC) were calculated and compared between tumour and normal cervix, among different pathological subtypes and grades.Results: All of the parameters were significantly lower in cervical carcinoma than normal cervical stroma except alpha. SCC showed lower ADC, D, f and DDC values and higher D* value than AC; D and DDC values of SCC and ADC and D values of AC were lower in the poorly differentiated group than those in the well-moderately differentiated group.Conclusion: Compared with MEM, diffusion parameters from BEM and SEM may offer additional information in cervical carcinoma diagnosis, predicting pathological tumour subtypes and grades, while f and D showed promising significance.Key Points: • DWI-derived parameters by different models are related but provide diversified information. • Commonly used ADC by MEM of DWI overestimates the tissue water diffusivity. • DWI processed by BEM could separate blood perfusion from true diffusion effects. • The derived diffusion-related and perfusion-related parameters by BEM are superior to ADC. [ABSTRACT FROM AUTHOR]

Objectives: To investigate functional cerebral abnormalities in patients with amyotrophic lateral sclerosis (ALS) using functional magnetic resonance imaging (fMRI) during action observation. Methods: Thirty patients with ALS and 30 matched healthy controls underwent fMRI with an experimental paradigm while observing a video of repetitive flexion-extension of the fingers at three frequency levels or three complexity levels, alternated with periods of a static hand. A parametric analysis was applied to determine the effects of each of the two factors. Results: Action observation activated similar neural networks as the research on execution of action in the ALS patients and healthy subjects in several brain regions related to the mirror-neuron system (MNS). In the ALS patients, in particular, the dorsal lateral premotor cortex (dPMC), inferior parietal gyrus (IPG), and SMA, were more activated compared with the activation in the controls. Increased activation within the primary motor cortex (M1), dPMC, inferior frontal gyrus (IFG), and superior parietal gyrus (SPG) mainly correlated with hand movement frequency/complexity in the videos in the patients compared with controls. Conclusions: The findings indicated an ongoing compensatory process occurring within the higher order motor-processing system of ALS patients, likely to overcome the loss of function. Key Points: • Action observation activated similar core nodes of MNS in ALS and controls. • Increased activation within M1, dPMC, IFG and SPG mainly correlated with hand movement frequency/complexity. • Differences in patients and controls may be due to compensatory processes in ALS. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to construct a radiomics-based model for prognosis and benefit prediction of concurrent chemoradiotherapy (CCRT) versus intensity-modulated radiotherapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (LANPC) following induction chemotherapy (IC).A cohort of 718 LANPC patients treated with IC + IMRT or IC + CCRT were retrospectively enrolled and assigned to a training set (n = 503) and a validation set (n = 215). Radiomic features were extracted from pre-IC and post-IC MRI. After feature selection, a delta-radiomics signature was built with LASSO-Cox regression. A nomogram incorporating independent clinical indicators and the delta-radiomics signature was then developed and evaluated for calibration and discrimination. Risk stratification by the nomogram was evaluated with Kaplan–Meier methods.The delta-radiomics signature, which comprised 19 selected features, was independently associated with prognosis. The nomogram, composed of the delta-radiomics signature, age, T category, N category, treatment, and pre-treatment EBV DNA, showed great calibration and discrimination with an area under the receiver operator characteristic curve of 0.80 (95% CI 0.75–0.85) and 0.75 (95% CI 0.64–0.85) in the training and validation sets. Risk stratification by the nomogram, excluding the treatment factor, resulted in two groups with distinct overall survival. Significantly better outcomes were observed in the high-risk patients with IC + CCRT compared to those with IC + IMRT, while comparable outcomes between IC + IMRT and IC + CCRT were shown for low-risk patients.The radiomics-based nomogram can predict prognosis and survival benefits from concurrent chemotherapy for LANPC following IC. Low-risk patients determined by the nomogram may be potential candidates for omitting concurrent chemotherapy during IMRT.The radiomics-based nomogram was constructed for risk stratification and patient selection. It can help guide clinical decision-making for patients with locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy, and avoid unnecessary toxicity caused by overtreatment.• The benefits from concurrent chemotherapy remained controversial for locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy.• Radiomics-based nomogram achieved prognosis and benefits prediction of concurrent chemotherapy.• Low-risk patients defined by the nomogram were candidates for de-intensification.Materials and methods: This study aimed to construct a radiomics-based model for prognosis and benefit prediction of concurrent chemoradiotherapy (CCRT) versus intensity-modulated radiotherapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (LANPC) following induction chemotherapy (IC).A cohort of 718 LANPC patients treated with IC + IMRT or IC + CCRT were retrospectively enrolled and assigned to a training set (n = 503) and a validation set (n = 215). Radiomic features were extracted from pre-IC and post-IC MRI. After feature selection, a delta-radiomics signature was built with LASSO-Cox regression. A nomogram incorporating independent clinical indicators and the delta-radiomics signature was then developed and evaluated for calibration and discrimination. Risk stratification by the nomogram was evaluated with Kaplan–Meier methods.The delta-radiomics signature, which comprised 19 selected features, was independently associated with prognosis. The nomogram, composed of the delta-radiomics signature, age, T category, N category, treatment, and pre-treatment EBV DNA, showed great calibration and discrimination with an area under the receiver operator characteristic curve of 0.80 (95% CI 0.75–0.85) and 0.75 (95% CI 0.64–0.85) in the training and validation sets. Risk stratification by the nomogram, excluding the treatment factor, resulted in two groups with distinct overall survival. Significantly better outcomes were observed in the high-risk patients with IC + CCRT compared to those with IC + IMRT, while comparable outcomes between IC + IMRT and IC + CCRT were shown for low-risk patients.The radiomics-based nomogram can predict prognosis and survival benefits from concurrent chemotherapy for LANPC following IC. Low-risk patients determined by the nomogram may be potential candidates for omitting concurrent chemotherapy during IMRT.The radiomics-based nomogram was constructed for risk stratification and patient selection. It can help guide clinical decision-making for patients with locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy, and avoid unnecessary toxicity caused by overtreatment.• The benefits from concurrent chemotherapy remained controversial for locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy.• Radiomics-based nomogram achieved prognosis and benefits prediction of concurrent chemotherapy.• Low-risk patients defined by the nomogram were candidates for de-intensification.Results: This study aimed to construct a radiomics-based model for prognosis and benefit prediction of concurrent chemoradiotherapy (CCRT) versus intensity-modulated radiotherapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (LANPC) following induction chemotherapy (IC).A cohort of 718 LANPC patients treated with IC + IMRT or IC + CCRT were retrospectively enrolled and assigned to a training set (n = 503) and a validation set (n = 215). Radiomic features were extracted from pre-IC and post-IC MRI. After feature selection, a delta-radiomics signature was built with LASSO-Cox regression. A nomogram incorporating independent clinical indicators and the delta-radiomics signature was then developed and evaluated for calibration and discrimination. Risk stratification by the nomogram was evaluated with Kaplan–Meier methods.The delta-radiomics signature, which comprised 19 selected features, was independently associated with prognosis. The nomogram, composed of the delta-radiomics signature, age, T category, N category, treatment, and pre-treatment EBV DNA, showed great calibration and discrimination with an area under the receiver operator characteristic curve of 0.80 (95% CI 0.75–0.85) and 0.75 (95% CI 0.64–0.85) in the training and validation sets. Risk stratification by the nomogram, excluding the treatment factor, resulted in two groups with distinct overall survival. Significantly better outcomes were observed in the high-risk patients with IC + CCRT compared to those with IC + IMRT, while comparable outcomes between IC + IMRT and IC + CCRT were shown for low-risk patients.The radiomics-based nomogram can predict prognosis and survival benefits from concurrent chemotherapy for LANPC following IC. Low-risk patients determined by the nomogram may be potential candidates for omitting concurrent chemotherapy during IMRT.The radiomics-based nomogram was constructed for risk stratification and patient selection. It can help guide clinical decision-making for patients with locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy, and avoid unnecessary toxicity caused by overtreatment.• The benefits from concurrent chemotherapy remained controversial for locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy.• Radiomics-based nomogram achieved prognosis and benefits prediction of concurrent chemotherapy.• Low-risk patients defined by the nomogram were candidates for de-intensification.Conclusion: This study aimed to construct a radiomics-based model for prognosis and benefit prediction of concurrent chemoradiotherapy (CCRT) versus intensity-modulated radiotherapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (LANPC) following induction chemotherapy (IC).A cohort of 718 LANPC patients treated with IC + IMRT or IC + CCRT were retrospectively enrolled and assigned to a training set (n = 503) and a validation set (n = 215). Radiomic features were extracted from pre-IC and post-IC MRI. After feature selection, a delta-radiomics signature was built with LASSO-Cox regression. A nomogram incorporating independent clinical indicators and the delta-radiomics signature was then developed and evaluated for calibration and discrimination. Risk stratification by the nomogram was evaluated with Kaplan–Meier methods.The delta-radiomics signature, which comprised 19 selected features, was independently associated with prognosis. The nomogram, composed of the delta-radiomics signature, age, T category, N category, treatment, and pre-treatment EBV DNA, showed great calibration and discrimination with an area under the receiver operator characteristic curve of 0.80 (95% CI 0.75–0.85) and 0.75 (95% CI 0.64–0.85) in the training and validation sets. Risk stratification by the nomogram, excluding the treatment factor, resulted in two groups with distinct overall survival. Significantly better outcomes were observed in the high-risk patients with IC + CCRT compared to those with IC + IMRT, while comparable outcomes between IC + IMRT and IC + CCRT were shown for low-risk patients.The radiomics-based nomogram can predict prognosis and survival benefits from concurrent chemotherapy for LANPC following IC. Low-risk patients determined by the nomogram may be potential candidates for omitting concurrent chemotherapy during IMRT.The radiomics-based nomogram was constructed for risk stratification and patient selection. It can help guide clinical decision-making for patients with locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy, and avoid unnecessary toxicity caused by overtreatment.• The benefits from concurrent chemotherapy remained controversial for locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy.• Radiomics-based nomogram achieved prognosis and benefits prediction of concurrent chemotherapy.• Low-risk patients defined by the nomogram were candidates for de-intensification.Clinical relevance statement: This study aimed to construct a radiomics-based model for prognosis and benefit prediction of concurrent chemoradiotherapy (CCRT) versus intensity-modulated radiotherapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (LANPC) following induction chemotherapy (IC).A cohort of 718 LANPC patients treated with IC + IMRT or IC + CCRT were retrospectively enrolled and assigned to a training set (n = 503) and a validation set (n = 215). Radiomic features were extracted from pre-IC and post-IC MRI. After feature selection, a delta-radiomics signature was built with LASSO-Cox regression. A nomogram incorporating independent clinical indicators and the delta-radiomics signature was then developed and evaluated for calibration and discrimination. Risk stratification by the nomogram was evaluated with Kaplan–Meier methods.The delta-radiomics signature, which comprised 19 selected features, was independently associated with prognosis. The nomogram, composed of the delta-radiomics signature, age, T category, N category, treatment, and pre-treatment EBV DNA, showed great calibration and discrimination with an area under the receiver operator characteristic curve of 0.80 (95% CI 0.75–0.85) and 0.75 (95% CI 0.64–0.85) in the training and validation sets. Risk stratification by the nomogram, excluding the treatment factor, resulted in two groups with distinct overall survival. Significantly better outcomes were observed in the high-risk patients with IC + CCRT compared to those with IC + IMRT, while comparable outcomes between IC + IMRT and IC + CCRT were shown for low-risk patients.The radiomics-based nomogram can predict prognosis and survival benefits from concurrent chemotherapy for LANPC following IC. Low-risk patients determined by the nomogram may be potential candidates for omitting concurrent chemotherapy during IMRT.The radiomics-based nomogram was constructed for risk stratification and patient selection. It can help guide clinical decision-making for patients with locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy, and avoid unnecessary toxicity caused by overtreatment.• The benefits from concurrent chemotherapy remained controversial for locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy.• Radiomics-based nomogram achieved prognosis and benefits prediction of concurrent chemotherapy.• Low-risk patients defined by the nomogram were candidates for de-intensification.Key Points: This study aimed to construct a radiomics-based model for prognosis and benefit prediction of concurrent chemoradiotherapy (CCRT) versus intensity-modulated radiotherapy (IMRT) in locoregionally advanced nasopharyngeal carcinoma (LANPC) following induction chemotherapy (IC).A cohort of 718 LANPC patients treated with IC + IMRT or IC + CCRT were retrospectively enrolled and assigned to a training set (n = 503) and a validation set (n = 215). Radiomic features were extracted from pre-IC and post-IC MRI. After feature selection, a delta-radiomics signature was built with LASSO-Cox regression. A nomogram incorporating independent clinical indicators and the delta-radiomics signature was then developed and evaluated for calibration and discrimination. Risk stratification by the nomogram was evaluated with Kaplan–Meier methods.The delta-radiomics signature, which comprised 19 selected features, was independently associated with prognosis. The nomogram, composed of the delta-radiomics signature, age, T category, N category, treatment, and pre-treatment EBV DNA, showed great calibration and discrimination with an area under the receiver operator characteristic curve of 0.80 (95% CI 0.75–0.85) and 0.75 (95% CI 0.64–0.85) in the training and validation sets. Risk stratification by the nomogram, excluding the treatment factor, resulted in two groups with distinct overall survival. Significantly better outcomes were observed in the high-risk patients with IC + CCRT compared to those with IC + IMRT, while comparable outcomes between IC + IMRT and IC + CCRT were shown for low-risk patients.The radiomics-based nomogram can predict prognosis and survival benefits from concurrent chemotherapy for LANPC following IC. Low-risk patients determined by the nomogram may be potential candidates for omitting concurrent chemotherapy during IMRT.The radiomics-based nomogram was constructed for risk stratification and patient selection. It can help guide clinical decision-making for patients with locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy, and avoid unnecessary toxicity caused by overtreatment.• The benefits from concurrent chemotherapy remained controversial for locoregionally advanced nasopharyngeal carcinoma following induction chemotherapy.• Radiomics-based nomogram achieved prognosis and benefits prediction of concurrent chemotherapy.• Low-risk patients defined by the nomogram were candidates for de-intensification. [ABSTRACT FROM AUTHOR]