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Objective: To develop and validate a multi-index nomogram prediction model for clinically significant prostate cancer(CSPCa) by combining the PI-RADS V2.1, quantitative magnetic resonance imaging (MRI) parameters and clinical indicators. Methods: A total of 1740 patients (75% in the derivation cohort and 25% in the internal validation cohort) and 342 patients (the external validation cohort) were retrospectively included in the MRI follow-up database of the First Affiliated Hospital of Kunming Medical University between January 2015 and April 2021,and Gejiu People's Hospital between January 2020 and December 2022.Important predictors of CSPCa in MRI-related quantitative parameters, PSA-derived indicators, and clinical indicators, such as age, were screened. The Net Reclassification Improvement Index(NRI),Integrated Discrimination Improvement Index(IDI), and clinical decision curve analysis (DCA) were calculated to compare the performances of the different models. Receiver operating characteristic(ROC) curves and clinical calibration curves were used to analyze and compare diagnostic effects. Results: The AUC value, best cut-off value, specificity, sensitivity and accuracy of model 1(PI-RADS + PSAD) derivation cohort were 0.935, 0.304, 0.861, 0.895 and 0.872, respectively. The AUC values of the internal and external validation cohorts for model 1 were 0.956 and 0.955, respectively. The AUC value, best cut-off value, specificity, sensitivity and accuracy of model 2(PI-RADS +PSAD + ADCmean) derivation cohort were 0.939, 0.401, 0.895, 0.853 and 0.882, respectively. The AUC values of the internal and external validation cohorts for model 2 were 0.940 and 0.960,respectively. After adding the ADCmean to the model, the NRI(categorical), NRI(continuous) and IDI values were 0.0154, 0.3498 and 0.0222, respectively. There was no significant difference between the predicted probability and actual probability (p> 0.05). Conclusion: Models 1 and 2 had reliable, efficient and visual predictive value for CSPCa. The ADCmean is an important predictive indicator. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this study are to explore the apparent diffusion coefficient (ADC)-dependent thresholds for time to reperfusion in reversible lesions following mechanical thrombectomy for acute ischemic stroke, and to investigate the associated risks of hemorrhagic transformation. Methods: We conducted a retrospective case-control study, enrolling patients with large-vessel occlusion who underwent mechanical thrombectomy in Otaru General Hospital from 2016 to 2021. Reversible lesions were identified using volumetric ADC data, and the mean time from image to reperfusion (TIR) in each ADC range was compared between groups with and without reversible lesions, as well as those with and without parenchymal hematoma. The Wilcoxon rank sum test and chi-square test were used for comparison between two groups, and receiver operating characteristic curves were created to determine optimal thresholds. Results: Seventy-five patients were included and 581 volumetric data were obtained. The mean TIR in the group with reversible lesions was shorter than in that without, and time thresholds were 131, 123 and 112 min for ADC values > 540 × 10−6, 500–540 × 10−6 and 440–500 × 10−6 mm2/s, respectively. Furthermore, in patients with parenchymal hematoma, the mean TIR was significantly longer, and the average ADC value was significantly lower than those without hematoma. Conclusion: The time thresholds for the irreversible ischemic core may vary depending on the ADC value, and they may be shorter when the ADC value is lower. Moreover, both the low ADC value and the late reperfusion might be associated with an increased risk of parenchymal hematoma. [ABSTRACT FROM AUTHOR]

Background: Carpal tunnel syndrome is the commonest upper limb peripheral neuropathy. Diffusion tensor imaging evaluates the tissue microarchitecture and measures the movement of water protons. It is non-time-consuming, not invasive and not operator dependent. The aim of our study was to evaluate whether diffusion tensor imaging can diagnose carpal tunnel syndrome and whether DTI parameters can correlate with severity of carpal tunnel syndrome. Results: Seventy-two wrists were assessed, 36 diagnosed with carpal tunnel syndrome and 36 age and sex matched controls. FA & ADC were measured at four locations (distal radioulnar joint, proximal, middle and distal carpal tunnel), and the mean for the whole median nerve was calculated. FA & ADC showed statistically significant difference between cases and control at each of the measured four locations and the mean of the whole median nerve. FA & ADC at the hook of hamate (distal CT) showed the most significant difference between cases and control. For FA, the cut-off point at the hook of hamate was 0.5 (sensitivity 94.4%, specificity of 88.9%, positive predictive value 89.5% and negative predictive value 94.1%) and the cut-off point for the mean of the whole nerve was 0.545 (sensitivity 97.22%, specificity 77.78%, positive predictive value 81.4% and negative predictive value 96.6%). For ADC, the cut-off point at the hook of hamate was 1.44 (sensitivity 97.22%, specificity 86.11%, positive predictive value 87.5% and negative predictive value 96.9%) and the cut-off point for the mean of the whole nerve was 1.415 (sensitivity 86.11%, specificity, 83.33%, positive predictive value 83.8% and negative predictive value 85.7%). Conclusion: Diffusion tensor imaging can diagnose carpal tunnel syndrome with accuracy compared to the gold standard nerve conduction studies. Both FA and ADC showed statistically significant differences between cases & controls with FA measurements found to be more significant. [ABSTRACT FROM AUTHOR]

Background: The aim was to investigate which of two different b values (b 500 s/mm² and b 800 s/mm²) are more effective in the differentiation of benign-malignant nodules using Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI). Materials and methods: Patients presenting with a preoperative diagnosis of nodular goiter or multinodular goiter were included in this study. These patients underwent neck MRI examinations, and their cases were analyzed retrospectively. A total of 26 patients were included in the study. A total of 46 nodules meeting the study criteria were examined. Measurements were performed on Apparent Diffusion Coefficient (ADC) maps of patients at two different b values (b 500 s/mm² and b 800 s/mm²), and the results were compared with histopathological findings. Results: Out of a total of 46 nodules, 37 were identified as benign, and 9 as malignant based on histopathological analysis. The mean ADC value at b 500 was lower in malignant nodules (1259.65 ± 328.13) compared to benign nodules (19037.48 ± 472.74). Similarly, the mean ADC value at b 800 was lower in malignant nodules (1081.72 ± 200.23) compared to benign nodules (1610.44 ± 418.06). When a cut-off value of 1.1 × 10− 3 was accepted for the differentiation of pathology, the sensitivity for distinguishing pathology with ADC values at b 500 was 83.3%, with a specificity of 90.0%, and for ADC values at b 800, the sensitivity was 71.4%, with a specificity of 89.7%. Conclusion: DW-MRI without the need for contrast agent administration is a useful method in the differentiation of benign-malignant thyroid nodules. [ABSTRACT FROM AUTHOR]

Purpose: To determine the diagnostic accuracy of quantitative diffusion-weighted (DW) MRI apparent diffusion coefficient (ADC) and tumour volumes to differentiate between malignant (neuroblastoma (NB)) and benign types of neuroblastic tumours (ganglioneuroma (GN) and ganglioneuroblastoma (GNB)) using different region-of-interest (ROI) sizes. Materials and Methods: This single-centre retrospective study included malignant and benign paediatric neuroblastic tumours that had undergone DW MRI at diagnosis. The outcome was diagnostic accuracy of the tumour volume from structural and ADC DW MRI, in comparison to histopathology (reference standard). Results: Data from 40 patients (NB, n = 24; GNB, n = 6; GN, n = 10), 18 (45%) females and 22 (55%) males, with a median age at diagnosis of 21 months (NB), 64 months (GNB), and 133 months (GN), respectively, ranging from 0 to 193 months, were evaluated. The area under the receiver operating characteristic (AUROC) curve for ADC for discriminating between neuroblastic tumours' histopathology for a small ROI was 0.86 (95% CI: 0.75–0.98), and for a large ROI, 0.83 (95% CI: 0.71–0.96). An ADC cut-off value of 1.06 × 10−3 mm2/s was able to distinguish malignant from benign tumours with 83% (68–98%) sensitivity and 75% (95% CI: 54–98%) specificity. Tumour volume was not indicative of malignant vs. benign tumour diagnosis. Conclusions: In this study, both small and large ROIs used to derive ADC DW MRI metrics demonstrated high accuracy to differentiate malignant from benign neuroblastic tumours, with the ADC AUROC for the averaged multiple small ROIs being slightly greater than that of large ROIs, but with overlapping 95% CIs. This should be taken into consideration for standardisation of ROI-related data analysis by international initiatives. [ABSTRACT FROM AUTHOR]

Background: The pancreas plays an important role in the nutrition and metabolism of the whole body. Many disease processes including obesity, diabetes mellitus (DM), acute or chronic pancreatitis, and pancreatic carcinoma result in abnormality of pancreas morphology and function. Magnetic resonance imaging (MRI) provides quantitative parameters including T1, T2, and apparent diffusion coefficient (ADC) values for evaluating normal and abnormal pancreas. Based on the normal range of these quantitative parameters, pancreatic abnormality could be detected early. However, the range and the relationship of T1, T2, and ADC values with gender and age groups using the same dataset have not been explored. Purpose: To establish the ranges of MRI tissue and functional parameters, including T1, T2, and ADC values, in healthy adult pancreas and their correlations with gender, subregion, and age. Materials and methods: The T1, T2, and ADC values of healthy pancreas in 86 adults were measured using a 3.0-T MRI scanner. The average T1, T2, and ADC values were obtained in the whole pancreas and subregions (head, neck, body, and tail). Their correlations with gender and age were investigated. Results: The T1, T2, and ADC values of the whole pancreas from all subjects were 870.07 ± 61.86 ms, 44.07 ± 6.14 ms, and 1.072 ± 0.212 × 10−3 mm2/s, respectively. T2 values were significantly different between genders (P < 0.05). No significant differences were found between subregions. The T1, T2, and ADC values differed significantly among the age groups (P < 0.05). The T1 value revealed a moderately positive correlation, while the T2 and ADC values displayed negative correlations with age (r = 0.31, −0.45, and −0.39, respectively). The combination of T1, T2, and ADC values achieved the highest AUC value and showed a significant difference compared to T1, T2, and ADC values alone in predicting age older than 45 years. Conclusion: This study established the normal ranges of T1, T2, and ADC. We found that T2 is different between men and women, and T1, T2, and ADC are age-dependent. These results could be useful for quantitative MRI of pancreatic disease. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Infected pancreatic necrosis (IPN) is a major determinant of mortality in acute pancreatitis (AP). Non‐invasive diagnosis of IPN could guide the intervention in AP. We aimed to investigate the role of non‐invasive methods like diffusion weighted magnetic resonance imaging (DW‐MRI) and clinico‐laboratory parameters as predictors of IPN.Prospective evaluation for predictors of IPN by diffusion restriction (DR) on DW‐MRI and clinico‐laboratory parameters was performed.Out of 39 patients included, 31 were analysed after exclusion. Twenty‐six (83.8%) patients had moderately severe AP, and the rest had severe disease. They were categorized into Group A: patients with documented infection after intervention (n = 17) and Group B: successfully managed without intervention or negative culture after intervention (n = 14). On univariate analysis, Group A had significantly more incidence of fever (P = 0.020), persistent unwellness (P = 0.003), elevated neutrophil count (P = 0.007), lymphocyte count (P = 0.007), neutrophil lymphocyte ratio (NLR) (P = 0.028), DR on DW‐MRI (P = 0.001) and low apparent diffusion coefficient (ADC) (P = 0.086). Multivariate analysis revealed DR on DW‐MRI (P = 0.004) and NLR (P = 0.035) as significant predictors of IPN, among other factors. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DW‐MRI were 94.1%, 78.6%, 91.66%, and 84.21%, respectively. The area under curve of NLR on the ROC plot was 0.85 and the best cutoff was >3.5, with sensitivity, specificity, PPV, and NPV of 70.6%, 78.6%, 80%, and 68.7% respectively.DW‐MRI and NLR are promising non‐invasive tools for accurate prediction of IPN and hence can guide the need for intervention in acute pancreatitis. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to quantify the submandibular gland in suppurative sialadenitis, primary Sjögren's syndrome (pSS) and radiation‐induced sialadenitis using the apparent diffusion coefficient (ADC) for differential diagnosis. Subjects and Methods: This retrospective study included 16 patients with suppurative sialadenitis (n = 9), pSS (n = 3) and radiation‐induced sialadenitis (n = 4) who underwent magnetic resonance imaging between June 2006 and May 2022. The ADC of the submandibular glands in each state was calculated, and the differences were analysed using a one‐way analysis of variance and Tukey's post hoc test. Receiver operating characteristic curves were used to assess the ability of the ADC to distinguish each condition. Statistical significance was set at p < 0.05. Results: The mean ADC value (×10−3 mm2/s) ± standard deviation in the control (non‐affected side of the suppurative sialadenitis group), suppurative sialadenitis, pSS and radiation‐induced groups were 0.94 ± 0.16, 1.24 ± 0.16, 1.33 ± 0.13 and 1.5 ± 0.12, respectively (p < 0.001). The diagnostic value for distinguishing each group was ≥0.75. Conclusion: ADC values are useful for quantitatively assessing and distinguishing submandibular glands in suppurative sialadenitis, primary Sjögren's syndrome and radiation‐induced sialadenitis. [ABSTRACT FROM AUTHOR]

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

The utility of the apparent diffusion coefficient (ADC) of diffusion-weighted image (DWI) magnetic resonance imaging was examined for evaluating malignancy and prognosis in gallbladder tumors. A total of 63 patients (benign tumors, n=33; cancer, n=30) were included after surgical resection for gallbladder tumors, and their mean ADC values by DWI were obtained. Cases of advanced gallbladder cancer (n=25) were divided into ADCHigh and ADCLow groups, and clinicopathological factors were compared. In 63 cases, ADC values in advanced gallbladder cancer were significantly lower compared with benign tumors and non-advanced gallbladder cancer (P<0.05), and ADC values in early gallbladder cancer were also significantly lower compared with benign tumors (P<0.05). In 25 advanced gallbladder cancer cases, the ADCLow group tended to have a higher rate of advanced stage disease (P=0.09). Disease-free survival and overall survival (OS) of the ADCLow group were worse compared with the ADCHigh group (P<0.01). In the multivariate analysis of OS, poor differentiation and low ADC value were independent prognostic factors. ADC values may be useful for evaluating tumor malignancies in gallbladder tumors. [ABSTRACT FROM AUTHOR]

Based on Apparent Diffusion Coefficient (ADC) images, a nomogram model is established to accurately predict the high-risk capsular characteristics associated with pleomorphic adenoma of the parotid gland (PAP) recurrence. This retrospective study analyzed 190 patients with PAPs. Significant clinical radiological factors were identified through univariate difference analysis and multivariate regression analysis. The optimal threshold was determined by analyzing the average ADC value of the entire tumor, using the best Youden index and sensitivity analysis, and tumor subregions were delineated accordingly. Three radiomic models were constructed for the whole tumor and for high/low ADC areas, with the best model determined through statistical analysis. Ultimately, a nomogram model was constructed by combining the independent predictive factor of high-risk capsular features with the optimal radiomic predictive score. Model performance was comprehensively assessed by the area under the receiver operating characteristic curve (ROC AUC), accuracy, sensitivity, and specificity. The best ADC division threshold as 1.25 × 10-3 mm2/s. Multivariate analysis identified High-ADC Zone Volume Percentage as an independent predictor for PAPs with high-risk capsular characteristics. The radiomic model based on the low ADC tumor subregion was optimal (AUC 0.899). The nomogram model, combining independent predictors and optimal imaging studies predictive score, demonstrated high performance (AUC 0.909). Decision curve analysis confirmed the nomogram's clinical applicability. The nomogram model constructed from ADC quantitative imaging can predict PAPs patients with high-risk capsular features. These patients require intraoperative preventive measures to avoid tumor spillage and residuals, as well as extended postoperative follow-up. [ABSTRACT FROM AUTHOR]

We explored the feasibility of using total tumor apparent diffusion coefficient (ttADC) histogram parameters to predict high-risk cytogenetic abnormalities (HRCA) in patients with multiple myeloma (MM) and compared the performance of an image prediction model based on these parameters with that of a combined prediction model based on these parameters and clinical indicators. We retrospectively analyzed the parameters of the ttADC histogram based on whole-body diffusion-weighted images(WB-DWI) and clinical indicators in 92 patients with MM. The patients were divided into HRCA and non-HRCA groups according to the results of the fluorescence in situ hybridization. Logistic regression analysis was used to construct the image prediction and combined prediction models. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to evaluate the performance of the models to identify HRCA. The DeLong test was used to compare the AUC differences of each prediction model. Logistic regression analysis results revealed that the ttADC histogram parameter, ttADC entropy < 7.959 (OR: 39.167; 95% confidence interval [CI]: 3.891–394.208; P < 0.05), was an independent risk factor for HRCA. The image prediction model consisted of ttADC entropy and ttADC SD. The combined prediction model included ttADC entropy along with patient clinical indicators such as biological sex and M protein percentage. The AUCs of the image prediction and combined prediction models were 0.739 and 0.811, respectively (P <.05). The image prediction model showed a sensitivity of 73.9% and a specificity of 68.1%. The combined prediction model showed 82.6% sensitivity and 72.5% specificity. Using ttADC histogram parameters based on WB-DWI images to predict HRCA in patients with MM is feasible, and combining ttADC parameters with clinical indicators can achieve better predictive performance. [ABSTRACT FROM AUTHOR]

Early tumor response prediction can help avoid overtreatment with unnecessary chemotherapy sessions. It is important to determine whether multiple apparent diffusion coefficient indices (S index, ADC‐diff) are effective in the early prediction of pathological response to neoadjuvant chemotherapy (NAC) in breast cancer (BC). Patients with stage II and III BCs who underwent T1WI, diffusion‐weighted imaging (DWI), and dynamic contrast‐enhanced MRI using a 3 T system were included. They were divided into two groups: major histological responders (MHRs, Miller–Payne G4/5) and nonmajor histological responders (nMHRs, Miller–Payne G1–3). Three b values were used for DWI to derive the S index; ADC‐diff values were obtained using b = 0 and 1000 s/mm2. The different interquartile ranges of percentile S‐index and ADC‐diff values after treatment were calculated and compared. The assessment was performed at baseline and after two and four NAC cycles. A total of 59 patients were evaluated. There are some correlations of interquartile ranges of S‐index parameters and ADC‐diff values with histopathological prognostic factors (such as estrogen receptor and human epidermal growth factor receptor 2 expression, all p < 0.05), but no significant differences were found in some other interquartile ranges of S‐index parameters or ADC‐diff values between progesterone receptor positive and negative or for Ki‐67 tumors (all P > 0.05). No differences were found in the dynamic contrast‐enhanced MRI characteristics between the two groups. HER‐2 expression and kurtosis of the S‐index distribution were screened out as independent risk factors for predicting MHR group (p < 0.05, area under the curve (AUC) = 0.811) before NAC. After early NAC (two cycles), only the 10th percentile S index was statistically significant between the two groups (p < 0.05, AUC = 0.714). No significant differences were found in ADC‐diff value at any time point of NAC between the two groups (P > 0.1). These findings demonstrate that the S‐index value may be used as an early predictor of pathological response to NAC in BC; the value of ADC‐diff as an imaging biomarker of NAC needs to be further confirmed by ongoing multicenter prospective trials. [ABSTRACT FROM AUTHOR]

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

Introduction: This article focused on probing the correlation of magnetic resonance imaging (MRI) and computed tomography (CT) manifestations with biological factor expression and lymph node metastasis (LNM) in aggressive prostate cancer (PCa). Methods: A total of 136 PCa patients underwent surgical treatment and received CT and MRI examinations before surgery, whereby the apparent diffusion coefficient (ADC) values of quantitative MRI (qMRI) parameters were obtained. Patients were categorized into the non-aggressive PCa group and the aggressive PCa group according to the postoperative pathological results and Gleason scores. The expression of biological factors (prostate-specific antigen [PSA], proliferating cell nuclear antigen [PCNA], p27, and Ki-67) in both groups was tested. CT and MRI manifestations of aggressive PCa patients were analyzed. The qMRI parameters, biological factors levels, and LNM were compared in two groups; the relationships between CT and MRI manifestations, qMRI parameters, and positive expression of biological factors and LNM were probed in two groups. Results: In the aggressive PCa group, MRI and CT presented different degrees of abnormal prostate changes. In the aggressive PCa group, PSA and p27 expression and ADC values were lower, and PCNA and Ki-67, and LNM rates were higher. Patients’ LNM rate was higher than that of ≤2 cm when the tumor diameter was >2 cm. ADC values were positively correlated with PSA and p27 positive expression and negatively correlated with PCNA, Ki-67, and LNM in the aggressive PCa group. Conclusion: MRI and CT manifestations of aggressive PCa had certain characteristics; MRI manifestations and qMRI possessed a correlation with biological factors and LNM; ADC could be employed to assess the aggressiveness of PCa. [ABSTRACT FROM AUTHOR]

Objective To assess the value of non-contrast CT attenuation of the solid tumor region in differentiating high- grade and low-grade infratentorial tumors in children. Methods 87 children with primary infratentorial brain tumors including 34 low-grade tumors and 53 high-grade tumors were included in this retrospective study. CT attenuations of the solid regions of the tumors, caudate nuclei, and centrum semiovale were measured on non-contrast CT images. Standardized CT attenuation 1 (CT attenuation ratio of the solid tumor to caudate nucleus, CT-1) and standardized CT attenuation 2 (CT attenuation ratio of the solid tumor to centrum semiovale, CT-2) were calculated. The area under the receiver operating characteristic curve (AUC) was used to determine the diagnostic efficacy of each parameter. The diagnostic efficacy of ADC value and CT parameters was compared in 30 children with 8 low-grade and 22 high-grade tumors, who completed non-contrast CT and MRI. Results The CT attenuation [(42.94±5.75) HU], CT-1 (1.19±0.15), and CT-2 (1.77±0.31) of the solid portions in high-grade tumors were significantly (P< 0.001) higher than those of the low-grade tumors [(30.88±7.53) HU, 0.84±0.18, 1.25±0.37]. CT-1 cutoff value of 0.99 had higher diagnostic efficacy with 0.922 AUC, 92.5% sensitivity, and 85.3% specificity for distinguishing high-grade and low-grade tumors. In 30 children with non-contrast CT and MRI, the sensitivity and specificity of CT-1 (95.5%, 86.4%) and ADC (100%, 100%) values for distinguishing high-grade and low-grade tumors were similar (P>0.05). Conclusion Non-contrast CT attenuation of the solid tumor region is valuable in differentiating high - grade and low - grade infratentorial tumors in children. [ABSTRACT FROM AUTHOR]

Idiopathic Intracranial Hypertension (IIH) is a condition in which patients have elevated intracranial pressure which does not have an apparent cause. To diagnose IIH, evaluation excluding other causes of elevated pressure must be performed. This typically includes magnetic resonance imaging (MRI) of the brain and venous sinuses. Despite there being known radiographic signs suggestive of IIH on MRI, there currently are no established correlations between radiographic findings and visual outcomes. Previous work revealed diffusion weighted imaging (DWI), a qualitative measurement on MRI, correlated with clinical findings (i.e presence and grade of papilloedema), but not visual outcomes. We hypothesized that the apparent diffusion coefficient (ADC), a quantitative value obtained during clinical MRI, may correlate with visual outcomes. We conducted a retrospective chart review to correlate findings on the ADC sequence on routine brain MRIs in patients with papilloedema with visual outcomes. In 49 patients with IIH, this study shows the ADC in the retrobulbar optic nerve to be 1,487 ± 559 × 10−6 mm2 /s, 15% lower than reported value of 1744 ± 413 in healthy controls. This suggests that there is true restricted diffusion in patients with IIH and papilloedema, as previously reported visually by MRI. However, there was no significant correlation with clinical outcomes of papilloedema grade, mean deviation on standard perimetry, and retinal nerve fibre layer (RNFL) on optical coherence tomography (OCT). We discuss reasons why the ADC measurement may be confounded by motion and partial volume and propose methods that may reduce these confounders for future studies. [ABSTRACT FROM AUTHOR]

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

Background: Diffusion-weighted imaging (DWI) has come up as a newer diagnostic modality for the diagnosis of early functional changes in various organs including the pancreas. DWI has shown the ability of early and accurate diagnosis of inflammatory pathologies, before the appearance of morphological changes on imaging. Objectives: The objectives of this study were to study the diagnostic accuracy of DWI in the diagnosis of early acute interstitial pancreatitis. Materials and Methods: The present retrospective observational study was conducted at the department of radiodiagnosis of a tertiary teaching hospital for 1 year. Fifty patients who underwent magnetic resonance imaging of the pancreas with clinical or laboratory diagnosis of early pancreatitis were included in the study. The diagnostic accuracy of DWI was analyzed on the basis of quantitative (apparent diffusion coefficient [ADC] values) evaluation in the diagnosis of early acute pancreatitis. Threshold values for ADC were derived for differentiation of inflamed versus normal pancreas. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were obtained by drawing the receiver operating characteristic (ROC) curve. Results: The mean ADC values in the patient group (0.882 × 10−3 mm2/s ± 0.102) were significantly lower than the control group (1.178 × 10−3 mm2/s ± 0.232) with P < 0.001. The ROC curve deciphered a cutoff value of 0.937 × 10−3 mm2/s with a sensitivity of 84%, specificity of 86%, PPV of 85.71%, and NPV of 84.31% for diagnosis of acute pancreatitis using quantitative ADC values. Conclusion: DWI can thus be a succinct modality for early diagnosis of pancreatitis with excellent diagnostic accuracy and superlative advantage of lack of contrast and radiation in comparison to computed tomography scan. [ABSTRACT FROM AUTHOR]

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

Purpose: To investigate the clinical application of zonally magnified oblique multislice (ZOOM) imaging technology in patients with degenerative cervical myelopathy (DCM) and compare it with T2WI imaging. Methods: A total of 111 patients diagnosed with DCM were recruited. According to mJOA, patients with DCM were divided into ND + group with neurological dysfunction and ND- group without neurological dysfunction. Routine MRI and ZOOM-DWI were performed on 3.0 T MRI to obtain sagittal T2WI and apparent diffusion coefficient (ADC) diagram. ADC values of the narrow segment and its adjacent upper and lower segments were measured, and compared between the ND + and ND- groups. The correlation between ADC value of cervical spinal cord and mJOA score was analyzed. Additionally, ROC curves were plotted to calculate the AUC values. Results: The comparison between ND + and ND– groups shows that there are significant differences in mJOA score, T2WI, anteroposterior diameter of spinal canal, ADC values of narrow, upper and lower segment (P < 0.05). In ND + group, there is a significant difference between ADC values of the narrow and its upper and lower segments (P < 0.001), while with no significant difference in ADC values of the upper and lower segments (P > 0.05). Results of correlation analysis indicate that in the ND + group, neurological dysfunction evaluated by mJOA scores is correlated with increased ADC values of the narrow segment (r = –0.52, P < 0.001), but not significantly correlated with ADC values of the upper and lower segments. Furthermore, T2WI, anteroposterior diameter of the spinal canal, and cervical cord ADC values all has diagnostic efficacy in evaluating neurological dysfunction in DCM (AUC > 0.5, P < 0.05), with the ADC value of the narrow segment being optimal. Conclusion: The ADC value of spinal cord obtained by small-field ZOOM-DWI can be used to evaluate neurological dysfunction in DCM, and is superior to traditional T2WI. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether idiopathic intracranial hypertension (IIH) may affect white matter integrity and optic pathways by using diffusion tensor imaging (DTI) and to correlate the DTI metrics with intracranial pressure (ICP). Methods: This study is a retrospective case–control study. A total of 42 patients who underwent lumbar puncture and those with elevated ICP, meeting the diagnostic criteria for IIH, were included in the study. All patients had supportive magnetic resonance imaging findings for the diagnosis of IIH. The headache control group comprised 36 patients who presented to the Neurology Department with infrequent episodic tension‐type headache, had a normal neurologic examination, and had clinical and radiological findings suggestive of normal ICP. For each patient with IIH, clinical findings and ophthalmological measurements were recorded. The apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) values were calculated using a region of interest‐based method in different white matter tracts and optic pathways and compared. Results: A total of 42 patients diagnosed with IIH (three males, 39 females), with a mean (standard deviation [SD] age of 38.1 (8.9) years), and 36 headache controls (10 males, 26 females, mean [SD] age; 38.1 [9.4] years) were included in the study. The mean (SD) body mass index (BMI) of the patients with IIH was 25.2 (1.9) kg/m2, and the mean (SD) BMI of the headache controls was 23.3 (1.5) kg/m2 (p < 0.001). Decreased FA values and increased RD values in the cingulum were detected in patients with IIH compared to the headache controls (p = 0.003, Cohen's d = 0.681; p = 0.002 Cohen's d = −0.710). Decreased AD values in the left and right superior cerebellar peduncle and increased ADC values in the middle cerebellar peduncle were detected in patients with IIH compared to the headache controls (p < 0.001, Cohen's d = 0.961; p = 0.009, Cohen's d = 0.607; p = 0.015, Cohen's d = −0.564). Increased ADC and RD values and decreased FA values in optic nerve were detected in patients with IIH (p = 0.010, Cohen's d = −0.603; p = 0.004, Cohen's d = −0.676; p = 0.015 Cohen's d = 0.568). A positive correlation was found between the cerebrospinal fluid pressure and ADC values of the left and right superior and left inferior longitudinal fasciculus, genu of the corpus callosum, and right optic radiation (r = 0.43, p = 0.005; r = 0.31, p = 0.044; r = 0.39, p = 0.010; r = 0.35, p = 0.024; r = 0,41, p = 0.007). There was a positive correlation between the retinal nerve fiber layer thickness and the ADC values of the optic nerve (r = 0.32, p = 0.039). Conclusions: Intracranial hypertension can be associated with deteriorated DTI values, which might be interpreted as a sign of impaired white matter microstructural integrity in many brain regions beyond the periventricular white matter. Pressure‐induced edema and axonal degeneration may be the potential underlying mechanisms of this microstructural damage. Plain Language Summary: Females of reproductive age with obesity are disproportionately affected by idiopathic intracranial hypertension (IIH), and the incidence of this diagnosis is increasing along with the prevalence of obesity. We do not yet understand how IIH develops, but dysregulation of intracranial pressure is an important area of research interest, so we hypothesized that increased intracranial pressure may affect white matter microstructure and optic pathways in patients with IIH. Using data from a specialized imaging technique, we found that patients with IIH may have impaired white matter microstructural integrity in several areas of the brain and microstructural alterations in the optic nerve. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate a new motion correction method, named RT + NV Track, for upper abdominal DWI that combines the respiratory triggering (RT) method using a respiration sensor and the Navigator Track (NV Track) method using navigator echoes. Materials and methods: To evaluate image quality acquired upper abdominal DWI and ADC images with RT, NV, and RT + NV Track in 10 healthy volunteers and 35 patients, signal-to-noise efficiency (SNRefficiency) and the coefficient of variation (CV) of ADC values were measured. Five radiologists independently performed qualitative image-analysis assessments. Results: RT + NV Track showed significantly higher SNRefficiency than RT and NV (14.01 ± 4.86 vs 12.05 ± 4.65, 10.05 ± 3.18; p < 0.001, p < 0.001). RT + NV Track was superior to RT and equal or better quality than NV in CV and visual evaluation of ADC values (0.033 ± 0.018 vs 0.080 ± 0.042, 0.057 ± 0.034; p < 0.001, p < 0.001). RT + NV Track tends to acquire only expiratory data rather than NV, even in patients with relatively rapid breathing, and can correct for respiratory depth variations, a weakness of RT, thus minimizing image quality degradation. Conclusion: The RT + NV Track method is an efficient imaging method that combines the advantages of both RT and NV methods in upper abdominal DWI, providing stably good images in a short scan time. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: The apparent diffusion coefficient (ADC) derived from diffusion-weighted MRI (DWI-MRI) has been proposed as a measure of changes in kidney microstructure, including kidney fibrosis. In advanced kidney disease, the kidneys often become atrophic; however, in the initial phase of type 2 diabetes, there is an increase in renal size. Glucagon-like peptide-1 receptor agonists and sodium–glucose cotransporter 2 inhibitors both provide protection against progression of kidney disease in diabetes. However, the mechanisms are incompletely understood. To explore this, we examined the effects of semaglutide, empagliflozin and their combination on renal ADC and total kidney volume (TKV). Methods: This was a substudy of a randomised clinical trial on the effects of semaglutide and empagliflozin alone or in combination. Eighty patients with type 2 diabetes and high risk of CVD were randomised into four groups (n=20 in each) receiving either tablet placebo, empagliflozin, a combination of semaglutide and tablet placebo (herein referred to as the 'semaglutide' group), or the combination of semaglutide and empagliflozin (referred to as the 'combination-therapy' group). The semaglutide and the combination-therapy group had semaglutide treatment for 16 weeks and then had either tablet placebo or empagliflozin added to the treatment, respectively, for a further 16 weeks; the placebo and empagliflozin groups were treated with the respective monotherapy for 32 weeks. We analysed the effects of treatment on changes in ADC (cortical, medullary and the cortico–medullary difference [ΔADC; medullary ADC subtracted from cortical ADC]), as well as TKV measured by MRI. Results: Both semaglutide and empagliflozin decreased cortical ADC significantly compared with placebo (semaglutide: −0.20×10−3 mm2/s [95% CI −0.30, −0.10], p<0.001; empagliflozin: −0.15×10−3 mm2/s [95% CI −0.26, −0.04], p=0.01). No significant change was observed in the combination-therapy group (−0.05×10−3 mm2/s [95%CI −0.15, 0.05]; p=0.29 vs placebo). The changes in cortical ADC were not associated with changes in GFR, albuminuria, TKV or markers of inflammation. Further, there were no changes in medullary ADC in any of the groups compared with placebo. Only treatment with semaglutide changed ΔADC significantly from placebo, showing a decrease of −0.13×10−3 mm2/s (95% CI −0.22, −0.04; p=0.01). Compared with placebo, TKV decreased by −3% (95% CI −5%, −0.3%; p=0.04), −3% (95% CI −5%, −0.4%; p=0.02) and −5% (95% CI −8%, −2%; p<0.001) in the semaglutide, empagliflozin and combination-therapy group, respectively. The changes in TKV were associated with changes in GFR, albuminuria and HbA1c. Conclusions/interpretation: In a population with type 2 diabetes and high risk of CVD, semaglutide and empagliflozin significantly reduced cortical ADC compared with placebo, indicating microstructural changes in the kidneys. These changes were not associated with changes in GFR, albuminuria or inflammation. Further, we found a decrease in TKV in all active treatment groups, which was possibly mediated by a reduction in hyperfiltration. Our findings suggest that DWI-MRI may serve as a promising tool for investigating the underlying mechanisms of medical interventions in individuals with type 2 diabetes but may reflect effects not related to fibrosis. Trial registration: European Union Drug Regulating Authorities Clinical Trials Database (EudraCT) 2019-000781-38 [ABSTRACT FROM AUTHOR]

Abstract Background The aim was to investigate which of two different b values (b 500 s/mm² and b 800 s/mm²) are more effective in the differentiation of benign-malignant nodules using Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI). Materials and methods Patients presenting with a preoperative diagnosis of nodular goiter or multinodular goiter were included in this study. These patients underwent neck MRI examinations, and their cases were analyzed retrospectively. A total of 26 patients were included in the study. A total of 46 nodules meeting the study criteria were examined. Measurements were performed on Apparent Diffusion Coefficient (ADC) maps of patients at two different b values (b 500 s/mm² and b 800 s/mm²), and the results were compared with histopathological findings. Results Out of a total of 46 nodules, 37 were identified as benign, and 9 as malignant based on histopathological analysis. The mean ADC value at b 500 was lower in malignant nodules (1259.65 ± 328.13) compared to benign nodules (19037.48 ± 472.74). Similarly, the mean ADC value at b 800 was lower in malignant nodules (1081.72 ± 200.23) compared to benign nodules (1610.44 ± 418.06). When a cut-off value of 1.1 × 10− 3 was accepted for the differentiation of pathology, the sensitivity for distinguishing pathology with ADC values at b 500 was 83.3%, with a specificity of 90.0%, and for ADC values at b 800, the sensitivity was 71.4%, with a specificity of 89.7%. Conclusion DW-MRI without the need for contrast agent administration is a useful method in the differentiation of benign-malignant thyroid nodules.

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

Objectives: To identify factors influencing the diagnostic performance of the quantitative imaging biomarkers ADC and ADCratio in prostate cancer (PCa) detection. Materials and methods: A systematic literature search was conducted in Embase, Medline and Web of Science, for studies evaluating ADC values and ADCratio for PCa diagnosis, using the same patient cohorts and using histopathological references as ground truth. Pooled sensitivities, specificities, summary ROC curves and AUCs were calculated from constructed contingency data tables. Diagnostic performance (AUC) was quantitatively pooled using a bivariate mixed effects model. For identifying influencing factors, subgroup analysis, publication bias and heterogeneity assessment were investigated. Results: Thirteen studies, involving 1038 patients and 1441 lesions, were included. For ADC, the pooled sensitivity and specificity was 80% (95% CI: 74–85%) and 78% (95% CI: 70–85%), respectively. For ADCratio pooled sensitivity and specificity was 80% (95% CI: 74–84%) and 80% (95% CI: 71–87%). Summary ROC analysis revealed AUCs of 0.86 (95% CI: 0.83–0.89) and 0.86 (95% CI: 0.83–0.89), respectively. Meta-regression showed heterogeneity between both imaging biomarkers. Subgroup analysis showed that ADCratio improved diagnostic performance in comparison to ADC when including both peripheral and transitional zone lesions (AUC: 0.87 [95% CI: 0.84–0.90] and 0.82 [95% CI: 0.79–0.85], respectively). Conclusion: Both ADC and ADCratio imaging biomarkers showed good and comparable diagnostic performance in PCa diagnosis. However, ADCratio shows better diagnostic performance than ADC in diagnosing transition zone cancers. Clinical relevance statement: In quantitative MRI-based PCa diagnosis, the imaging biomarker ADCratio is useful in challenging MRI readings of lesions. Understanding the performance of quantitative imaging biomarkers better can aid diagnostic MRI protocols, enhancing the precision of PCa assessments. Key Points: MRI diffusion-weighted imaging-based ADC and ADCratio have comparable diagnostic performance in PCa assessment. In contrast to ADC, the ADCratio improves diagnostic performance, when assessing whole gland lesions. Compared to ADCratio, the ADC demonstrates enhanced diagnostic performance when evaluating peripheral zone lesions. [ABSTRACT FROM AUTHOR]

Abstract Background To investigate the values of apparent diffusion coefficient (ADC) for the treatment response evaluation in pancreatic cancer (PC) patients receiving neoadjuvant therapy (NAT). Methods This study included 103 NAT patients with histologically proven PC. ADC maps were generated using monoexponential diffusion-weighted imaging (b values: 50, 800 s/mm2). Tumors’ minimum, maximum, and mean ADCs were measured and compared pre- and post-NAT. Variations in ADC values measured between pre- and post-NAT completion for NAT methods (chemotherapy, chemoradiotherapy), tumor locations (head/neck, body/tail), tumor regression grade (TRG) levels (0–2, 3), N stages (N0, N1/N2) and tumor resection margin status (R0, R1), were further analyzed. Results The minimum, maximum, and mean ADC values all increased dramatically after NAT, rising from 23.4 to 25.4% (all p

Abstract Background Although endometrial cancer (EC) is staged surgically, magnetic resonance imaging (MRI) plays a critical role in assessing and selecting the most appropriate treatment planning. We aimed to assess the diagnostic performance of quantitative analysis of diffusion-weighted imaging (DWI) in preoperative assessment of EC. Methods Prospective analysis was done for sixty-eight patients with pathology-proven endometrial cancer who underwent MRI and DWI. Apparent diffusion coefficient (ADC) values were measured by two independent radiologists and compared with the postoperative pathological results. Results There was excellent inter-observer reliability in measuring ADCmean values. There were statistically significant lower ADCmean values in patients with deep myometrial invasion (MI), cervical stromal invasion (CSI), type II EC, and lympho-vascular space involvement (LVSI) (AUC = 0.717, 0.816, 0.999, and 0.735 respectively) with optimal cut-off values of ≤ 0.84, ≤ 0.84, ≤ 0.78 and ≤ 0.82 mm2/s respectively. Also, there was a statistically significant negative correlation between ADC values and the updated 2023 FIGO stage and tumor grade (strong association), and the 2009 FIGO stage (medium association). Conclusions The preoperative ADCmean values of EC were significantly correlated with main prognostic factors including depth of MI, CSI, EC type, grade, nodal involvement, and LVSI.

Tumor grading plays a decisive role in glioma classification, which impacts the treatment strategy and prognosis of the patient. Diffusion weighted imaging (DWI) technique is a noninvasive technique used in tumor grading. This study explores whether DWI can be effectively used in tumor grading and the identification of low-grade glioma (LGG) by analyzing apparent diffusion coefficient (ADC) values. Publicly available English databases, PubMed and Google Scholar, were queried from 2015 to 2021. We mined a total of 465 research documents; of which nine articles were selected based on the inclusion and exclusion criteria. The overall findings show cutoff threshold min ADC values with higher b value playing a significant role in the differentiation of high-grade gliomas and LGGs, tumor grading, and determining tumor progression and stability. This systematic review suggests the development of unified DWI imaging parameters with better sensitivity and specificity for grading LGG tumors.

Abstract Objectives To explore the value of preoperative magnetic resonance imaging (MRI) characterization of intracranial solitary fibrous tumors (ISFT) and to evaluate the effectiveness of preoperative MRI features in predicting pathological grading. Materials and methods This retrospective analysis comprised the clinical and preoperative MRI characterization of 55 patients with ISFT in our hospital, including 27 grade II cases and 28 grade III cases confirmed by postoperative pathology. Variables included age, sex, tumor location, cross-midline status, signal characteristics of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), T2-fluid-attenuated inversion recovery (T2-FLAIR), and diffusion‑weighted imaging (DWI), peritumoral edema, intralesional hemorrhage, focal necrosis/cystic degeneration, tumor empty vessel, maximum tumor diameter, maximum, minimum, and average values of apparent diffusion coefficient (ADCmax, ADCmin, and ADCmean), tumors enhancement mode, meningeal tail sign, skull invasion, cerebral parenchymal invasion, and venous sinus involvement. The independent samples t test or Mann–Whitney U test was performed to compare continuous data between the two groups, and the Pearson chi-squared test or Fisher’s exact test was used to compare categorical data. In addition, bivariate logistic regression was performed to construct a comprehensive model, and receiver operating characteristic (ROC) curves were generated to calculate the areas under the curve (AUCs), thereby determining the value of each parameter in the differential diagnosis of grades II and III ISFT. Results The mean age at onset was similar between patients with grades II and III ISFT (46.77 ± 14.66 years and 45.82 ± 12.07 years, respectively). The proportions of men among patients with grades II and III ISFT were slightly higher than those of female patients (male/female: 1.25 [15/12] and 1.33 [16/12], respectively). There were significant differences between grades II and III ISFT in the T2-FLAIR and DWI signal characteristics, maximum, minimum, and average values of the apparent diffusion coefficient (ADCmax, ADCmin, and ADCmean), tumor location, and skull invasion (P = 0.001, P = 0.018, P = 0.000, P = 0.000, P = 0.000, P = 0.010, and P = 0.032, respectively). However, no significant differences were noted between grades II and III ISFT in age, sex, cross-midline status, T1WI and T2WI signal characteristics, peritumoral edema, intralesional hemorrhage, focal necrosis/cystic degeneration, tumor empty vessel shadow, enhancement mode, meningeal tail sign, maximum tumor diameter, brain parenchyma invasion, or venous sinus involvement (all P > 0.05). Moreover, binary logistic regression analysis showed that the model accuracy was 89.1% when ADCmin was included in the regression equation. Moreover, ROC curve analysis showed that the AUC of ADCmin was 0.805 (0.688, 0.922), sensitivity was 74.1%, specificity was 75.0%, and the cutoff value was 672 mm2/s. Conclusions Grade III ISFT patients displayed more mixed T2-FLAIR signal characteristics and DWI signal characteristics than grade II patients, as shown by higher skull invasion and tumor mass collapse midline distribution and lower ADCmax, ADCmean, and ADCmin values. The ADCmin value was significant in the preoperative assignment of grades II and III ISFT, thereby contributing to enhanced accuracy in the imaging grading diagnosis of the disease.

Bevacizumab is a common strategy for the treatment of recurrent glioblastoma. Survival status is a crucial issue for patients with recurrent glioblastoma, and the apparent diffusion coefficient (ADC) values of the lower Gaussian curve have been reported to have the potential to predict prognosis in recurrent glioblastoma. In the present study, we aimed to clarify the survival prediction of ADC values in patients with recurrent glioblastoma receiving bevacizumab treatment through a systematic review and meta-analysis of randomized clinical trials, comparing ADC values higher than the cut-off values with those lower than the cut-off values to determine which type of ADC values can be associated with significant survival benefits. Different survival indicators were analyzed, including overall survival (OS) and progression-free survival (PFS). Ten studies with a total of 782 patients with recurrent glioblastoma were included. The focused outcomes were OS and PFS. Our results showed that ADC values lower than the cut-off values were associated with significant benefits for OS status compared with ADC values higher than the cut-off values. Similar significant benefits were observed for PFS. The meta-analysis results suggest that ADC values lower than the cut-off values might be associated with significant benefits for OS and PFS when compared with ADC values higher than the cut-off values. However, bias in relation to the different stages of recurrent glioblastoma and different types, doses, and regimens of bevacizumab should not be ignored.

Background: To investigate the values of apparent diffusion coefficient (ADC) for the treatment response evaluation in pancreatic cancer (PC) patients receiving neoadjuvant therapy (NAT). Methods: This study included 103 NAT patients with histologically proven PC. ADC maps were generated using monoexponential diffusion-weighted imaging (b values: 50, 800 s/mm2). Tumors' minimum, maximum, and mean ADCs were measured and compared pre- and post-NAT. Variations in ADC values measured between pre- and post-NAT completion for NAT methods (chemotherapy, chemoradiotherapy), tumor locations (head/neck, body/tail), tumor regression grade (TRG) levels (0–2, 3), N stages (N0, N1/N2) and tumor resection margin status (R0, R1), were further analyzed. Results: The minimum, maximum, and mean ADC values all increased dramatically after NAT, rising from 23.4 to 25.4% (all p < 0.001): mean (average: 1.626 × 10− 3 mm2/s vs. 1.315 × 10− 3 mm2/s), minimum (median: 1.274 × 10− 3 mm2/s vs. 1.034 × 10− 3 mm2/s), and maximum (average: 1.981 × 10− 3 mm2/s vs. 1.580 × 10− 3 mm2/s). The ADCs between the subgroups of all the criteria under investigation did not differ significantly for the minimum, maximum, or mean values pre- or post-NAT (P = 0.08 to 1.00). In the patients with borderline resectable PC (n = 47), the rate of tumor size changes after NAT was correlated with the pre-NAT mean ADC values (Spearman's coefficient: 0.288, P = 0.049). Conclusions: The ADC values of PC increased significantly following NAT; however, the percentage increases failed to provide any predictive value for the resection margin status or TRG levels. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical value of preoperative four-point peritumoral apparent diffusion coefficient (ADC) value and the largest layer of the tumor body's ADC value on MRI in predicting the prognosis of patients with hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE) . Methods Totally 103 HCC patients who received TACE were selected for preoperative MRI examination. The largest lesion in the liver was taken as the target lesion, and the directions of 3, 6, 9, and 12 o'clock along the margin of the largest layer of target lesion were taken as the the region of interest (ROI), and the average value of the four regions as the four-point peritumoral ADC value. The ADC value of the largest layer of the target lesion was measured as the largest layer of the tumor body's ADC value. After 6 and 12 months of TACE treatment, enhanced CT or MRI examination was performed to evaluate the clinical efficacy according to mRECIST criteria. CR, PR and SD were defined as stable disease, and disease control rate (DCR) was calculated. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of preoperative four-point peritumoral ADC value and the largest layer of the tumor body's ADC value in tumor progression at 6 and 12 months after TACE treatment. Results According to mRECIST criteria, after 6 months of TACE treatment, there were 12 cases of CR, 18 cases of PR, 22 cases of SD, 51 cases of PD, and DCR was 50. 5% (52/103) . After 12 months of TACE treatment, there were 7 cases of CR, 10 cases of PR, 15 cases of SD, 71 cases of PD, and DCR was 31. 1% (32/103) . After 6 and 12 months of TACE treatment, both the preoperative four-point peritumoral ADC values and the largest layer of the tumor body's ADC values in the progressive patients were higher than those in the stable patients (all P<0. 05), while there were no significant differences in serum AFP, cholinesterase or globulin levels between the progressive patients and the stable patients (all P>0. 05) . The area under the curve of preoperative four-point peritumoral ADC value and the largest layer of the tumor body's ADC value in predicting 6-month progression of TACE treatment were 0. 893 and 0. 785, and the optimal cut-off values were 1. 394 × 10-3 and 1. 505 × 10-3 mm2 /s. The sensitivities were 82. 4% and 62. 7%, and the specificities were 84. 6% and 88. 5%, respectively. The area under the curve of preoperative four-point peritumoral ADC value and the largest layer of the tumor body's ADC value in predicting 12-month progression of TACE treatment were 0. 848 and 0. 734, and the optimal cut-off values were 1. 309 × 10-3 and 1. 505 × 10-3 mm2 /s, with the sensitivities of 78. 9% and 49. 3%, and the specificities of 84. 4% and 90. 6%, respectively. Conclusion Both preoperative four-point peritumoral ADC value and the largest layer of the tumor body's ADC value can predict the prognosis of HCC patients, and the predictive value of preoperative four-point peritumoral ADC value is relatively higher. [ABSTRACT FROM AUTHOR]

Magnetic resonance imaging (MRI) has emerged as a promising and appealing alternative to endoscopy in the objective assessment of patients with inflammatory bowel disease (IBD). Diffusion-weighted imaging (DWI) is a specialized imaging technique that enables the mapping of water molecule diffusion within biological tissues, eliminating the need for intravenous gadolinium contrast injection. It is expanding the capability of traditional MRI sequences in Ulcerative Colitis (UC). Recently, there has been growing interest in the application of intravoxel incoherent motion (IVIM) imaging in the field of IBD. This technique combines diffusion and perfusion information, making it a valuable tool for assessing IBD treatment response. Previous studies have extensively studied the use of DWI techniques for evaluating the severity of activity in IBD. However, the majority of these studies have primarily focused on Crohn's disease (CD), with only a limited number of reports specifically examining UC. Therefore, this review briefly introduces the basics of DWI and IVIM imaging and conducts a review of relevant studies that have investigated its application in UC to show whether these techniques are useful techniques for evaluating patients with UC in terms of detection, characterization, and quantification of disease activity. Through the extensive literature survey, most of these studies indicate that DWI proves valuable in the differential diagnosis of UC and could be used as an effective modality for staging UC. [ABSTRACT FROM AUTHOR]

Apparent diffusion coefficient (ADC) derived from diffusion-weighted magnetic resonance imaging (DWI) may help diagnose endometrial cancer (EC). However, the association between ADC and the recurrence and survival of EC remains unknown. We performed a systematic review and meta-analysis to investigate whether pretreatment ADC on DWI could predict the prognosis of women with EC. PubMed, Embase, and Cochrane's Library were searched for relevant cohort studies comparing the clinical outcomes between women with EC having low versus high ADC on pretreatment DWI. Two authors independently conducted data collection, literature searching, and statistical analysis. Using a heterogeneity-incorporating random-effects model, we analyzed the results. In the meta-analysis, 1358 women with EC were included from eight cohort studies and followed for a median duration of 40 months. Pooled results showed that a low pretreatment ADC on DWI was associated with poor disease-free survival (DFS, hazard ratio [HR]: 3.29, 95% CI: 2.04 to 5.31, p < 0.001; I2 = 41%). Subgroup analysis according to study design, tumor stage, MRI Tesla strength, ADC cutoff, follow-up duration, and study quality score showed consistent results (p for subgroup analysis all > 0.05). The predictive value of low ADC for poor DFS in women with EC decreased in multivariate studies compared to univariate studies (HR: 2.59 versus 32.57, p = 0.002). Further studies showed that a low ADC was also associated with poor overall survival (HR: 3.36, 95% CI: 1.33 to 8.50, p = 0.01, I2 = 0). In conclusion, a low ADC on pretreatment DWI examination may predict disease recurrence and survival in women with EC. [ABSTRACT FROM AUTHOR]

Purpose: This study explored models of monoexponential diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), stretched exponential (SEM), fractional-order calculus (FROC), and continuous-time random-walk (CTRW) as diagnostic tools for assessing pathological prognostic factors in patients with resectable rectal cancer (RRC). Methods: RRC patients who underwent radical surgery were included. The apparent diffusion coefficient (ADC), the mean kurtosis (MK) and mean diffusion (MD) from the DKI model, the distributed diffusion coefficient (DDC) and α from the SEM model, D, β and u from the FROC model, and D, α and β from the CTRW model were assessed. Results: There were a total of 181 patients. The area under the receiver operating characteristic (ROC) curve (AUC) of CTRW-α for predicting histology type was significantly higher than that of FROC-u (0.780 vs. 0.671, p = 0.043). The AUC of CTRW-α for predicting pT stage was significantly higher than that of FROC-u and ADC (0.786 vs.0.683, p = 0.043; 0.786 vs. 0.682, p = 0.030), the difference in predictive efficacy of FROC-u between ADC and MK was not statistically significant [0.683 vs. 0.682, p = 0.981; 0.683 vs. 0.703, p = 0.720]; the difference between the predictive efficacy of MK and ADC was not statistically significant (p = 0.696). The AUC of CTRW (α + β) (0.781) was significantly higher than that of FROC-u (0.781 vs. 0.625, p = 0.003) in predicting pN stage but not significantly different from that of MK (p = 0.108). Conclusion: The CTRW and DKI models may serve as imaging biomarkers to predict pathological prognostic factors in RRC patients before surgery. [ABSTRACT FROM AUTHOR]

Purpose: To assess the ability of tumor apparent diffusion coefficient (ADC) values obtained from multiparametric magnetic resonance imaging (mpMRI) to predict the risk of 5-year biochemical recurrence (BCR) after radical prostatectomy (RP). Materials and methods: This retrospective analysis included 1207 peripheral and 232 non-peripheral zone prostate cancer (PCa) patients who underwent mpMRI before RP (2012–2015), with the outcome of interest being 5-year BCR. ADC was evaluated as a continuous variable and as categories: low (< 850 µm2/s), intermediate (850–1100 µm2/s), and high (> 1100 µm2/s). Kaplan–Meier curves with log-rank testing of BCR-free survival, multivariable Cox proportional hazard regression models were formed to estimate the risk of BCR. Results: Among the 1439 males with median age 63 (± 7) years, the median follow-up was 59 months, and 306 (25%) patients experienced BCR. Peripheral zone PCa patients with BCR had lower tumor ADC values than those without BCR (874 versus 1025 µm2/s, p < 0.001). Five-year BCR-free survival rates were 52.3%, 74.4%, and 87% for patients in the low, intermediate, and high ADC value categories, respectively (p < 0.0001). Lower ADC was associated with BCR, both as continuously coded variable (HR: 5.35; p < 0.001) and as ADC categories (intermediate versus high ADC-HR: 1.56, p = 0.017; low vs. high ADC-HR; 2.36, p < 0.001). In the non-peripheral zone PCa patients, no association between ADC and BCR was observed. Conclusion: Tumor ADC values and categories were found to be predictive of the 5-year BCR risk after RP in patients with peripheral zone PCa and may serve as a prognostic biomarker. [ABSTRACT FROM AUTHOR]

Background: Although endometrial cancer (EC) is staged surgically, magnetic resonance imaging (MRI) plays a critical role in assessing and selecting the most appropriate treatment planning. We aimed to assess the diagnostic performance of quantitative analysis of diffusion-weighted imaging (DWI) in preoperative assessment of EC. Methods: Prospective analysis was done for sixty-eight patients with pathology-proven endometrial cancer who underwent MRI and DWI. Apparent diffusion coefficient (ADC) values were measured by two independent radiologists and compared with the postoperative pathological results. Results: There was excellent inter-observer reliability in measuring ADCmean values. There were statistically significant lower ADCmean values in patients with deep myometrial invasion (MI), cervical stromal invasion (CSI), type II EC, and lympho-vascular space involvement (LVSI) (AUC = 0.717, 0.816, 0.999, and 0.735 respectively) with optimal cut-off values of ≤ 0.84, ≤ 0.84, ≤ 0.78 and ≤ 0.82 mm2/s respectively. Also, there was a statistically significant negative correlation between ADC values and the updated 2023 FIGO stage and tumor grade (strong association), and the 2009 FIGO stage (medium association). Conclusions: The preoperative ADCmean values of EC were significantly correlated with main prognostic factors including depth of MI, CSI, EC type, grade, nodal involvement, and LVSI. [ABSTRACT FROM AUTHOR]

Objective To explore the diagnostic accuracy and correlation of Vesical Imaging-Reporting and Data System (VI-RADS) and apparent diffusion coefficient (ADC) value histogram in muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). Methods Multiparametric MRI of 81 patients with pathologically confirmed bladder cancer after transurethral resection of bladder tumors or radical cystectomy was retrospectively analyzed. Two radiologists scored all MRI examinations according to the VI-RADS criteria and ADC histogram parameters were obtained. Differences of VI-RADS and quantitative parameters between MIBC and NMIBC were evaluated. The diagnostic performance of the VI-RADS, ADC histogram parameter with statistically significant difference and combined diagnosis were evaluated for predictive ability of each model using the receiver operating characteristic (ROC) curves. Results of 81 patients including 40 (49.4%) MIBC and 41 (50.6%) NMIBC, 53 (65.4%) lesions with VI-RADS≥3 points, and 28 (34.6%) lesions with VI-RADS<3 points were analyzed. VI-RADS had the highest area under the ROC curve (AUC) of 0.903 among all parameters. The ADCmin, ADCmedian, ADCmean, 10% ADC (10th percentile ADC value), 25% ADC (25th percentile ADC value), 75% ADC (75th percentile ADC value), 90% ADC (90th percentile ADC value) of MIBC were significantly lower than those of NMIBC and were negatively correlated with the VI-RADS score (r=-0.439, -0.526, -0.305, -0.368, -0.547, -0.527, -0.396, all P<0.05) whereas kurtosis and entropy of MIBC were significantly higher than that of NMIBC and had positive correlation with the VI-RADS score (r=0.593, 0.296; P<0.05). VI-RADS+75% ADC (P=0.038), VI-RADS+ADCmedian (P=0.018), and VI-RADS+ADCmean (P=0.029) showed statistical differences compared to VI-RADS alone with the highest AUC value obtained by combining ADCmedian with VI-RADS (AUC=0.950). Conclusion VI-RADS and ADC histogram analysis can effectively. discriminate between MIBC and NMIBC. ADC histogram can supplement VI-RADS. [ABSTRACT FROM AUTHOR]

Objectives: To develop and validate a prediction model for identifying non-prostate cancer (non-PCa) in biopsy-naive patients with PI-RADS category ≥ 4 lesions and PSA ≤ 20 ng/ml to avoid unnecessary biopsy. Patients and methods: Eligible patients who underwent transperineal biopsies at West China Hospital between 2018 and 2022 were included. The patients were randomly divided into training cohort (70%) and validation cohort (30%). Logistic regression was used to screen for independent predictors of non-PCa, and a nomogram was constructed based on the regression coefficients. The discrimination and calibration were assessed by the C-index and calibration plots, respectively. Decision curve analysis (DCA) and clinical impact curves (CIC) were applied to measure the clinical net benefit. Results: A total of 1580 patients were included, with 634 non-PCa. Age, prostate volume, prostate-specific antigen density (PSAD), apparent diffusion coefficient (ADC) and lesion zone were independent predictors incorporated into the optimal prediction model, and a corresponding nomogram was constructed (https://nomogramscu.shinyapps.io/PI-RADS-4-5/). The model achieved a C-index of 0.931 (95% CI, 0.910–0.953) in the validation cohort. The DCA and CIC demonstrated an increased net benefit over a wide range of threshold probabilities. At biopsy-free thresholds of 60%, 70%, and 80%, the nomogram was able to avoid 74.0%, 65.8%, and 55.6% of unnecessary biopsies against 9.0%, 5.0%, and 3.6% of missed PCa (or 35.9%, 30.2% and 25.1% of foregone biopsies, respectively). Conclusion: The developed nomogram has favorable predictive capability and clinical utility can help identify non-PCa to support clinical decision-making and reduce unnecessary prostate biopsies. [ABSTRACT FROM AUTHOR]

Background: Our aim was to determine whether the Apparent Diffusion Coefficient is able to predict the presence of a symptomatic pineal cyst by detecting cerebral edema. Methods: We retrospectively analyzed MRIs of 45 patients with pineal cysts before and after resection and 51 patients without pineal cysts, comparing ADC values of thalamus, central, periventricular and subcortical white matter. Furthermore we evaluated cyst size and morphology and analyzed its correlation to ADC values in corresponding patients. Results: Differences between patients with symptomatic pineal cyst and control group were not significant (p = 0.200 – 0.968). ADC ratios did not change significantly after resection of the cyst (p = 0.575 – 0.862). Cyst size showed no significant correlation to ADC ratios (p = 0.071 – 0.918). Raw data analyses revealed more significance, especially periventricularly and in central white matter, which resulted in significant interhemispheric differences in ADC ratios in both subgroups (p < 0.001 and p = 0.031). MRI of 1.5T showed consistently higher values than 3T but mostly insignificant. Conclusion: Our analysis revealed no evidence that pineal cysts lead to intracerebral edema caused by venous compression. Since variability was higher than the differences seen, ADC sequences do not appear to be an appropriate diagnostic tool for symptomatic pineal cysts. [ABSTRACT FROM AUTHOR]

To compare the differences in apparent diffusion coefficient (ADC) and synthetic magnetic resonance (MR) measurements of four region of interest (ROI) placement methods for breast tumor and to investigate their diagnostic performance. 110 (70 malignant, 40 benign) newly diagnosed breast tumors were evaluated. The patients underwent 3.0 T MR examinations including diffusion-weighted imaging and synthetic MR. Two radiologists independently measured ADCs, T 1 relaxation time (T 1), T 2 relaxation time (T 2), and proton density (PD) using four ROI methods: round, square, freehand, and whole-tumor volume (WTV). The interclass correlation coefficient (ICC) was used to assess their measurement reliability. Diagnostic performance was evaluated using multivariate logistic regression analysis and the receiver operating characteristic (ROC) curves. The mean values of all ROI methods showed good or excellent interobserver reproducibility (0.79–0.99) and showed the best diagnostic performance compared to the minimum and maximum values. The square ROI exhibited superior performance in differentiating between benign from malignant breast lesions, followed by the freehand ROI. T 2 , PD, and ADC values were significantly lower in malignant breast lesions compared to benign ones for all ROI methods (p < 0.05). Multiparameters of T 2 + ADC demonstrated the highest AUC values (0.82–0.95), surpassing the diagnostic efficacy of ADC or T 2 alone (p < 0.05). ROI placement significantly influences ADC and synthetic MR values measured in breast tumors. Square ROI and mean values showed superior performance in differentiating benign and malignant breast lesions. The multiparameters of T 2 + ADC surpassed the diagnostic efficacy of a single parameter. [ABSTRACT FROM AUTHOR]

Background and purpose: Biomarkers for prediction of outcome in patients with pancreatic cancer are wanted in order to personalize the treatment. This study investigated the value of longitudinal diffusion-weighted magnetic resonance imaging (DWI) for prediction of overall survival (OS) in patients with locally advanced pancreatic cancer (LAPC) treated with stereotactic body radiotherapy (SBRT). Materials and methods: The study included 45 patients with LAPC who received 5 fractions of 10 Gy on a 1.5T MRI-Linac. DWI was acquired prior to irradiation at each fraction. The analysis included baseline values and time-trends of the apparent diffusion coefficient (ADC) and DWI parameters obtained using a decomposition method. A multivariable Cox proportional hazards model for OS was made using best-subset selection, using cross-validation based on Bootstrap. Results: The median OS from the first day of SBRT was 15.5 months (95% CI: 13.2-20.6), and the median potential follow-up time was 19.8 months. The bestperforming multivariable model for OS included two decomposition-based DWI parameters: one baseline and one time-trend parameter. The C-Harrell index describing the model's discriminating power was 0.754. High baseline ADC values were associated with reduced OS, whereas no association between the ADC time-trend and OS was observed. Conclusion: Decomposition-based DWI parameters indicated value in the prediction of OS in LAPC. A DWI time-trend parameter was included in the best-performing model, indicating a potential benefit of acquiring longitudinal DWI during the SBRT course. These findings support both baseline and longitudinal DWI as candidate prognostic biomarkers, which may become tools for personalization of the treatment of patients with LAPC. [ABSTRACT FROM AUTHOR]

Objective: Rare disease. Background: Leigh disease (LD) is a rare progressive mitochondrial neurodegenerative disorder characterized by subacute necrotizing encephalopathy and symmetrical spongiform lesions in the brain. Cytochrome C oxidase deficiencies due to SURF1 Cytochrome C Oxidase Assembly Factor (SURF1) gene mutations are seen only in 15% of LD cases. Consideration of these genetic mutations in young patients is crucial for early diagnosis, intervention, and further genetic counseling. Although only a few cases of the SURF1 mutation have been reported, there are anecdotal case reports describing imaging features. Case report: We report a case of a 2-year-old boy with developmental delay, hypotonia, involuntary movements, shortness of breath, and reduced activity since age 6 months. On blood examination there was mildly elevated lactate levels and increased lactate to pyruvate ratio and cerebrospinal fluid lactate levels. Magnetic resonance imaging findings showed symmetrical lesions in the dentate nucleus, subthalamic nucleus, midbrain (substantia nigra, periaqueductal gray matter), posterolateral pons, and olivary nucleus of the medulla extending into the cervical spinal cord, with mild elevation of the lactate peak on magnetic resonance spectroscopy. Conclusions: These findings prompted further genetic analysis, which indicated a mitochondrial type IV deficiency with the SURF1 gene defect, an intranuclear type 1 mutation (MC4DN1) (OMIM 220110). Treatment is usually supportive with vitamins supplementation and physiotherapy, and genetic counseling of the parents is mandatory. [ABSTRACT FROM AUTHOR]

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Objectives: To explore the value of preoperative magnetic resonance imaging (MRI) characterization of intracranial solitary fibrous tumors (ISFT) and to evaluate the effectiveness of preoperative MRI features in predicting pathological grading. Materials and methods: This retrospective analysis comprised the clinical and preoperative MRI characterization of 55 patients with ISFT in our hospital, including 27 grade II cases and 28 grade III cases confirmed by postoperative pathology. Variables included age, sex, tumor location, cross-midline status, signal characteristics of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), T2-fluid-attenuated inversion recovery (T2-FLAIR), and diffusion‑weighted imaging (DWI), peritumoral edema, intralesional hemorrhage, focal necrosis/cystic degeneration, tumor empty vessel, maximum tumor diameter, maximum, minimum, and average values of apparent diffusion coefficient (ADCmax, ADCmin, and ADCmean), tumors enhancement mode, meningeal tail sign, skull invasion, cerebral parenchymal invasion, and venous sinus involvement. The independent samples t test or Mann–Whitney U test was performed to compare continuous data between the two groups, and the Pearson chi-squared test or Fisher's exact test was used to compare categorical data. In addition, bivariate logistic regression was performed to construct a comprehensive model, and receiver operating characteristic (ROC) curves were generated to calculate the areas under the curve (AUCs), thereby determining the value of each parameter in the differential diagnosis of grades II and III ISFT. Results: The mean age at onset was similar between patients with grades II and III ISFT (46.77 ± 14.66 years and 45.82 ± 12.07 years, respectively). The proportions of men among patients with grades II and III ISFT were slightly higher than those of female patients (male/female: 1.25 [15/12] and 1.33 [16/12], respectively). There were significant differences between grades II and III ISFT in the T2-FLAIR and DWI signal characteristics, maximum, minimum, and average values of the apparent diffusion coefficient (ADCmax, ADCmin, and ADCmean), tumor location, and skull invasion (P = 0.001, P = 0.018, P = 0.000, P = 0.000, P = 0.000, P = 0.010, and P = 0.032, respectively). However, no significant differences were noted between grades II and III ISFT in age, sex, cross-midline status, T1WI and T2WI signal characteristics, peritumoral edema, intralesional hemorrhage, focal necrosis/cystic degeneration, tumor empty vessel shadow, enhancement mode, meningeal tail sign, maximum tumor diameter, brain parenchyma invasion, or venous sinus involvement (all P > 0.05). Moreover, binary logistic regression analysis showed that the model accuracy was 89.1% when ADCmin was included in the regression equation. Moreover, ROC curve analysis showed that the AUC of ADCmin was 0.805 (0.688, 0.922), sensitivity was 74.1%, specificity was 75.0%, and the cutoff value was 672 mm2/s. Conclusions: Grade III ISFT patients displayed more mixed T2-FLAIR signal characteristics and DWI signal characteristics than grade II patients, as shown by higher skull invasion and tumor mass collapse midline distribution and lower ADCmax, ADCmean, and ADCmin values. The ADCmin value was significant in the preoperative assignment of grades II and III ISFT, thereby contributing to enhanced accuracy in the imaging grading diagnosis of the disease. [ABSTRACT FROM AUTHOR]

Background. The anterior cruciate ligament (ACL) is a structure that is vital to preserving the knee's normal stability. However, because the ACL is the ligament that sustains injuries the most frequently, it is essential to distinguish between complete and incomplete tears in order to treat patients with incomplete tears without surgery. To diagnose cruciate ligament tears, knee joint magnetic resonance imaging (MRI) is frequently used. But sometimes it's difficult because edema may hide the ligament fibers. ADC mapping may be useful to confirm whether or not the ligament is continuous for an appropriate diagnosis of incomplete tears because it has been demonstrated that ligament fibers are better visible on diffusion weighted imaging (DWI) and ADC mapping. Objective. To ascertain how anterior cruciate ligament (ACL) tears are diagnosed and classified as partial or complete using diffusion-weighted (DW) magnetic resonance imaging (MRI) and to compare it with conventional MRI sequences. Results. For partial tears, 10 cases (50%) were identified using arthroscopy/follow-up, while observer 1 identified 12 cases (60%) and observer 2 identified 9 cases (45%) using DWI/ADC. For complete tears, 10 cases (50%) were identified using arthroscopy/follow-up, while observer 1 identified 8 cases (40%) and observer 2 identified 11 cases (55%) using DWI/ADC. Conclusions. DWI and ADC are useful tools for diagnosing tears, particularly complete tears, but that caution should be exercised when using these techniques to diagnose partial tears. [ABSTRACT FROM AUTHOR]

Objectives: Our aim is to estimate the long-term neurological sequelae and prognosis in term neonatal asphyxia treated with hypothermia via volumetric apparent diffusion coefficient (ADC) map histogram analysis (HA). Methods: Brain MRI studies of 83 term neonates with asphyxia who received whole-body hypothermia treatment and examined between postnatal (PN) fourth and sixth days were retrospectively re-evaluated by 2 radiologists. Volumetric HA was performed for the areas frequently affected in deep and superficial asphyxia (thalamus, lentiform nucleus, posterior limb of internal capsule, corpus callosum forceps major, and perirolandic cortex-subcortical white matter) on ADC map. The quantitative ADC values were obtained separately for each region. Qualitative-visual (conventional) MRI findings were also re-evaluated. Neonates were examined neurodevelopmentally according to the Revised Brunet-Lezine scale. The distinguishability of long-term neurodevelopmental outcomes was statistically investigated. Results: With HA, the adverse neurodevelopmental outcomes could only be distinguished from mild-moderated impairment and normal development at the thalamus with 10th percentile ADC (P = .02 and P = .03, respectively) and ADCmin (P = .03 and P = .04, respectively). Also with the conventional MRI findings, adverse outcome could be distinguished from mild-moderated impairment (P = .04) and normal development (P = .04) via cytotoxic oedema of the thalamus, corpus striatum, and diffuse cerebral cortical. Conclusion: The long-term adverse neurodevelopmental outcomes in newborns with asphyxia who received whole-body hypothermia treatment can be estimated similarly with volumetric ADC-HA and the conventional assessment of the ADC map. Advances in knowledge: This study compares early MRI ADC-HA with neurological sequelae in term newborns with asphyxia who received whole-body hypothermia treatment. We could not find any significant difference in predicting adverse neurological sequelae between the visual-qualitative evaluation of the ADC map and HA. [ABSTRACT FROM AUTHOR]

Aim: Tumor Ki‐67 expression reflects prognosis and cancer grade, and biopsy‐based preoperative assessment of Ki‐67 expression is key to treatment. Apparent diffusion coefficient (ADC) values obtained with this imaging may noninvasively predict Ki‐67 by reflecting tumor cell density and limited water molecule movement from irregular alignment. This study aimed to investigate the ability of ADC values to predict Ki‐67 expression in intrahepatic cholangiocarcinoma (ICC). Method: We retrospectively analyzed 39 cases of ICC confirmed by surgical pathology. All patients had undergone magnetic resonance imaging, and ADC values (mean, minimum, and maximum) were calculated. Ki‐67 expression was assessed by immunohistochemistry, and patients were divided into groups of high (n = 18) and low (n = 21) Ki‐67 expression. To assess the diagnostic performance of the ADC values for Ki‐67 expression, we used the receiver operating characteristic curve and compared the areas under the curve (AUC). Results: The mean and minimum ADC values were significantly lower in the group with high Ki‐67 expression. For predicting high Ki‐67 expression, the AUC values were 0.701 for mean ADC, 0.818 for minimum ADC, and 0.571 for maximum ADC. The diagnostic sensitivity and specificity of the minimum ADC values were 88.9% and 76.2%, respectively. In addition, with ADC values combined, the AUC increased to 0.831. Apparent diffusion coefficient is a useful predictor of Ki‐67 expression level in ICC. Conclusion: Apparent diffusion coefficient values, especially minimum ADC values, can noninvasively predict ICC associated with high Ki‐67 expression. [ABSTRACT FROM AUTHOR]