Single and joint toxic effects of four antibiotics on some metabolic pathways of zebrafish (Danio rerio) larvae

In China, antibiotics are commonly used for human and veterinary medicine, and they are present in various environmental media. Thus, the toxic effects of antibiotics on organisms have attracted the attention of society and scientists alike. In this study, zebrafish embryos were used to test the single and joint toxicity of four antibiotics, sulfamonomethoxine (SMM), cefotaxime sodium (CFT), tetracycline (TC), enrofloxacin (ENR), and their combinations, combining the results of experimental and omics techniques. Following exposure to antibiotics for 120 h, the body lengths of zebrafish larvae in all 100 μg/L antibiotic groups were significantly shortened, and the reactive oxygen species (ROS) content in the 100 μg/L Mix group was significantly increased. Transcriptome sequencing (RNA-seq) showed that the mRNA level of numerous genes was significantly changed in the five antibiotic treatment groups. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the differentially expressed genes revealed a significant enrichment of the steroid biosynthesis and other metabolism pathways. Hub gene analysis highlighted dhcr24, acat1, aldh1a2, aldh8a1, suclg2, hadh, and hsdl2 as the key genes, and hub gene expression changes because of the antibiotic treatment suggested that the metabolic system of the zebrafish larvae was severely disrupted by the interaction with other genes. In conclusion, single or joint exposure to different antibiotics at environmental concentrations affected the early development and metabolic system of zebrafish larvae, and our results provide fundamental evidence for future studies of antibiotic toxicity in aquatic organisms.

Performance of TGSE BLADE DWI compared with RESOLVE DWI in the diagnosis of cholesteatoma

Background

Based on its high resolution in soft tissue, MRI, especially diffusion-weighted imaging (DWI), is increasingly important in the evaluation of cholesteatoma. The purpose of this study was to evaluate the role of the 2D turbo gradient- and spin-echo (TGSE) diffusion-weighted (DW) pulse sequence with the BLADE trajectory technique in the diagnosis of cholesteatoma at 3 T and to qualitatively and quantitatively compare image quality between the TGSE BLADE and RESOLVE methods.

Method

A total of 42 patients (23 males, 19 females; age range, 7–65 years; mean, 40.1 years) with surgically confirmed cholesteatoma in the middle ear were enrolled in this study. All patients underwent DWI (both a prototype TGSE BLADE DWI sequence and the RESOLVE DWI sequence) using a 3-T scanner with a 64-channel brain coil.

Qualitative imaging parameters (imaging sharpness, geometric distortion, ghosting artifacts, and overall imaging quality) and quantitative imaging parameters (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR], contrast, and contrast-to-noise ratio [CNR]) were assessed for the two diffusion acquisition techniques by two independent radiologists.

Result

A comparison of qualitative scores indicated that TGSE BLADE DWI produced less geometric distortion, fewer ghosting artifacts (P < 0.001) and higher image quality (P < 0.001) than were observed for RESOLVE DWI. A comparison of the evaluated quantitative image parameters between TGSE and RESOLVE showed that TGSE BLADE DWI produced a significantly lower SNR (P < 0.001) and higher parameter values (both contrast and CNR (P < 0.001)) than were found for RESOLVE DWI.

The ADC (P < 0.001) was significantly lower for TGSE BLADE DWI (0.763 × 10^− 3 mm²/s) than RESOLVE DWI (0.928 × 10^− 3 mm²/s).

Conclusion

Compared with RESOLVE DWI, TGSE BLADE DWI significantly improved the image quality of cholesteatoma by reducing magnetic sensitive artifacts, distortion, and blurring. TGSE BLADE DWI is more valuable than RESOLVE DWI for the diagnosis of small-sized (2 mm) cholesteatoma lesions. However, TGSE BLADE DWI also has some disadvantages: the whole image intensity is slightly low, so that the anatomical details of the air-bone interface are not shown well, and this shortcoming should be improved in the future.

Operation performance and microbial community of sulfur-based autotrophic denitrification sludge with different sulfur sources

Operation performance and bacterial community structure of sulfur-based autotrophic denitrification (SAD) based on different sulfur sources served as electron donor was first parallelly compared among three sequencing batch reactors. Sulfur and sodium thiosulfate systems achieved similar operation performance and were superior to that of sodium sulfide. When the influent NO₃^--N concentration ranged from 50 to 150 mg/L, the effluent NO₃^--N concentrations of the sulfur and sodium thiosulfate systems were 0-5.99 mg/L and 0-4.52 mg/L, respectively, without NO₂^--N accumulation. However, when the effluent concentration of NO₃^--N in the sodium sulfide system was 0-10.38 mg/L, that of NO₂^--N in the effluent was 0-39.85 mg/L. In addition, participation of sulfur sources presented obvious pressure on the bacterial community structure based on the high-throughput sequencing. Microbial diversity results indicated that sludge with elemental sulfur as electron donor had the richest microbial diversity, followed by sodium thiosulfate and sodium sulfide. Moreover, sludge with elemental sulfur and sodium thiosulfate as electron donor demonstrated more similar community structure compared with the sludge that denitrified with sodium sulfide according to the microbial similarity analysis. The 9.34%, 24.3% and 29.6% of sequences could be assigned to potential SAD organisms from sludge denitrifying with elemental sulfur, sodium thiosulfate and sodium sulfide, respectively. Furthermore, all sludge denitrifying with different sulfur sources showed an enrichment of separate core functional microorganisms. This study could provide an insight into improving the understanding of SAD in engineering applications.

Left ventricular myocardial deformation: a study on diastolic function in the Chinese male population and its relationship with fat distribution

Background

Obesity has become an epidemic in China with its increased prevalence, especially in the male population. Disparities in fat distribution rather than increasing body mass index (BMI) confer the risk of different diseases, including cardiac abnormalities. Therefore, early detection of cardiac abnormalities is important for treatment to reverse the progression to heart failure. Nowadays, strain analysis based on cardiac magnetic resonance (CMR) imaging has been established to assess myocardial function in diverse cardiac diseases. We aimed to assess the relationship between fat distribution and subclinical diastolic dysfunction in obese Chinese men assessed by deformation registration algorithm (DRA)-based myocardial strain rate (SR) analysis.

Methods

A total of 115 male participants with different BMI underwent CMR scanning using a 1.5T MAGNETOM Aera (Siemens Healthcare, Erlangen, Germany) and computed tomography (CT) scan. All the participants were enrolled from September 2017 to April 2018. They were classified into 3 groups according to their BMIs with 23 and 27.5 kg/m² being the cutoff values. A Trufi-Strain prototype software (version 2.0, Siemens Healthcare, Erlangen, Germany) was used to quantify SR in both early and late diastole from CMR cine images. Ratios of early and late SRs were calculated. Areas of epicardial and pericardial adipose tissue (EAT and PAT) were measured on a single 4-chamber-view slice of cine images. Volumes of visceral and subcutaneous adipose tissue (VAT and SAT) were acquired semi-automatically from CT images using the dedicated software Cardiac Risk2.0 (Siemens Healthcare). Waist and hip circumferences were manually measured (WC and HC). Analysis of variance or nonparametric tests, along with correlation and stepwise multivariate regression analysis models, was applied for statistical analysis.

Results

Peak late diastolic SRs were higher in obese men compared with their lean counterparts [-36.25±10.46 vs. -29.46±8.17, 66.97±18.58 vs. 45.62 (42.44, 55.96), and 56.81±15.07 vs. 41.40±6.41 for radial, circumferential, and longitudinal SRs, respectively; P<0.05]. All SR ratios in the obese subgroups were lower than those of lean men (3.12±1.14 vs. 4.63±1.24, 2.12±0.58 vs. 2.96±0.62 and 1.63±0.50 vs. 2.20±0.63 for radial, circumferential, and longitudinal directions, respectively; P<0.05). EAT was a significant predictor of diastolic function assessed by radial and circumferential SR ratios (β=-0.439 and -0.337 respectively; all P<0.001), while VAT was a significant predictor of circumferential and longitudinal SR ratios (β=-0.216 and -0.355, respectively, P<0.05).

Conclusions

Decreased LV diastolic function assessed by DRA-based SR analysis in obesity is associated with fat distribution. Furthermore, EAT and VAT might be better predictors of a decrease of diastolic function in obese Chinese men than BMI.

The usefulness of b value threshold map in the evaluation of rectal adenocarcinoma

PURPOSE

To investigate the usefulness of b value threshold (b_Threshold) map in the evaluation of rectal adenocarcinoma by comparing it with diffusion-weighted images and ADC maps regarding lesion detection and the prediction of pathological features.

MATERIALS AND METHODS

Thirty-five patients with rectal tumors were enrolled and underwent axial DWI using a 3-Tesla MRI system. Contrast-to-noise ratio (CNR) between the lesions and normal tissues were assessed on the diffusion-weighted images and b_Threshold maps. Reproducibility for ADC and b_Threshold values were assessed. Significant differences between different groups for pathological prognostic factors were evaluated. Diagnostic performance of ADC and b_Threshold values for those factors were assessed.

RESULTS

Reproducibility was excellent for the ADC and b_Threshold values (ICC 0.985 and 0.992; CV 3.8% and 4.0%) measurements. The CNR between lesions and normal tissues on b_Threshold maps was significantly higher than that on diffusion-weighted images (9.91 ± 5.35 vs. 7.68 ± 3.08, p = 0.012). There were significant differences in the ADC and b_Threshold values between different pathologic differentiation degrees and T stages; significant difference was observed in the b_Threshold values between the different N stage groups (all p values < 0.050). No significant differences were observed between the ROC curves of ADC and the b_Threshold values of rectal lesions for pathologic differentiation and T stage. b_Threshold maps showed good diagnostic performance for N stage.

CONCLUSION

Both ADC and b_Threshold values can differentiate between degrees of pathologic differentiation and T1-2 versus T3-4. Potential added advantages however of the b_Threshold map include a higher CNR compared with DWI images, thereby improving lesion visualization detection, and better diagnostic performance for end staging than ADC. Thus, the b_Threshold map may compliment DWI and ADC to evaluate pathologic features of rectal primary tumors and metastatic lymph nodes.

Recent Intraplaque Hemorrhage Is Associated with a Higher Risk of Ipsilateral Cerebral Embolism During Carotid Artery Stenting

OBJECTIVE

The purpose of this study was to identify which stage of intraplaque hemorrhage (IPH) is an independent risk factor for ipsilateral new ischemic lesions (NILs) after carotid artery stenting (CAS).

METHODS

In 268 patients treated with CAS, the association between postoperative ipsilateral NILs on diffusion-weighted imaging (DWI) and patient demographics, intraoperative factors, and plaque characteristics on multicontrast atherosclerosis characterization sequence was retrospectively analyzed.

RESULTS

A total of 268 patients were enrolled in the study. Ipsilateral NILs on DWI were detected in 32.8% of patients. Univariate analysis showed that the stage of IPH (along with lipid-rich necrotic core [LRNC]) (P < 0.001) in the carotid plaque, predilation (P = 0.012), stent type (P = 0.002), and aortic arch ulcer (P = 0.009) were associated with postoperative ipsilateral NILs, whereas other patient-related factors (P >0.05), type of embolic protection device (P = 0.072), postdilation (P = 0.388), calcification (P = 0.140), and LRNC (without IPH) (P = 0.086) were not. Multivariate logistic regression analysis showed that the acute and recent IPH (along with LRNC) (odds ratio [OR], 3.78, P = 0.011 and OR, 16.73, P < 0.001, respectively), aortic arch ulcer (OR, 2.46; P = 0.006), predilation (OR, 4.78; P = 0.015), and open cell stent (OR, 4.19; P < 0.001) were significantly associated with postoperative ipsilateral NILs on DWI.

CONCLUSIONS

Screening for recent IPH in carotid plaques using multicontrast atherosclerosis characterization sequence may identify plaques at a higher risk for cerebral embolism during CAS.

Degradation of bisphenol A by persulfate coupled with dithionite: Optimization using response surface methodology and pathway

The degradation efficiency of bisphenol A (BPA) was investigated in the process of persulfate (PS) coupled with dithionite (DTN) as a function of concentration of BPA, PS, DTN and solution pH. A simple response surface methodology (RSM) based on central composite design (CCD) was employed to determine the influence of individual and interaction of above variables and the optimum processing parameters. It is satisfactory of a quadratic model with low probabilities (<0.0001) at a confidence level of 95% to predict the BPA degradation efficiency. The model was well fitted to the actual data and the correlation coefficients of R² and R²-adj were 0.9270 and 0.8885, respectively. In addition, the obtained optimum conditions for BPA degradation were 1.79 μM, 131.77 μM, 93.64 μM for BPA, PS, DTN and pH = 3.62, respectively. It achieved a degradation efficiency >90% within 150 min. Moreover, the trapping experiment of active species demonstrated that SO₄^·- and ·OH were the dominant species and natural water matrix showed an obvious inhibition effect on BPA degradation. The BPA degradation pathway was predicted based on GC-MS results in this study.

Differentiation between idiopathic granulomatous mastitis and invasive breast carcinoma, both presenting with non-mass enhancement without rim-enhanced masses: The value of whole-lesion histogram and texture analysis using apparent diffusion coefficient

PURPOSE

The aim of this study was to investigate whether whole-lesion histogram and texture analysis using apparent diffusion coefficient can discriminate between idiopathic granulomatous mastitis (IGM) and invasive breast carcinoma (IBC), both of which appeared as non-mass enhancement lesions without rim-enhanced masses.

METHOD

This retrospective study included 58 pathology-proven female patients at two independent study sites (27 IGM patients and 31 IBC patients). Diffusion-weighted imaging (3b values, 50, 400 or 500, and 800 s/mm²) was performed using 1.5 T or 3 T MR scanners from the same vendor. Whole-lesions were segmented and 11 features were extracted. Univariate analysis and multivariate logistic regression analysis were performed to identify significant variables for differentiating IGM from IBC. Receiver operating characteristic curve was assessed. The interobserver reliability between two observers for the histogram and texture measurement was also reported.

RESULTS

The 5th percentile, difference entropy and entropy of apparent diffusion coefficient showed significant differences between the two groups. An area under the curve of 0.778 (95 % CI: 0.648, 0.908), accuracy of 79.3 %, and sensitivity of 87.1 % was achieved using these three significant features. No significant feature was found with the multivariate analysis. For the interobserver reliability, all apparent diffusion coefficient parameters except skewness and kurtosis indicated good or excellent agreement, while these two features showed moderate agreement.

CONCLUSIONS

Whole-lesion histogram and texture analysis using apparent diffusion coefficient provide a non-invasive analytical approach to the differentiation between IGM and IBC, both presenting with non-mass enhancement without rim-enhanced masses.

Sulfadiazine biodegradation by Phanerochaete chrysosporium: Mechanism and degradation product identification

Antibiotic contaminants have become a severe environmental problem in recent years and finding effective ways to deal with this issue is of great importance. In this study, Phanerochaete chrysosporium was used to degrade sulfadiazine (SDZ), which is frequently detected in the culture medium of isolates from soil and surface water systems. The results demonstrate that 10 mg L^-1 SDZ can be completely degraded by P. chrysosporium under conditions of pH 5.7 and 30 °C within 6 days. The Q-Exactive-MS/MS analysis identified and confirmed several different SDZ degradation intermediates, and four proposed degradation pathways of SDZ were deduced. Moreover, enzyme activity tests revealed that manganese peroxidase and ligninolytic peroxidase played important roles in SDZ degradation. Moreover, a transcriptome analysis method was performed to explore the mechanism and pathways of SDZ degradation by P. chrysosporium in greater detail. The results of GO and KEGG analysis strongly suggest that the metabolism pathway is significantly activated and plays an important role in antibiotic degradation. Further, this is the first study to identify SDZ degradation intermediates and two main intermediates were found to be involved in possible SDZ degradation pathways. This study is also the first report results from RNA sequencing to evaluate genome-wide changes of P. chrysosporium to further explore SDZ degradation mechanism.

The feasibility of b-value maps based on threshold DWI for detection of breast cancer: A case-control STROBE compliant study

Diffusion-weighted imaging (DWI) plays an important role in the diagnosis of breast cancer as well as the evaluation of treatment effects. A novel technique named b-value map based on thresholded DWI images has been proposed and can achieve good contrast for demonstrating prostate lesions only by manipulating the window width and center of the images. Its application on the breast has not yet explored, so the aim of the study was to investigate the feasibility of b-value maps based on threshold DWI for detection of breast cancer. A total of 25 patients with pathologically proven invasive ductal breast carcinoma were included and underwent preoperative magnetic resonance imaging (MRI) examinations including DWI at 3T. The capabilities to display lesions of DWIb=800, b-value maps and optimal computed DWI (cDWI) images were evaluated by using a 4-point method of scoring. Apparent diffusion coefficient (ADC) values of lesions were measured for the breast carcinoma. Mean scores indicating the display capability were compared among DWIb=800, optimal cDWI and b-value maps by using Kruskal-Wallis test followed by Nemenyi test. The scores of both b-value maps (3.92 ± 0.28) and optimal cDWI images (3.80 ± 0.41) were higher than that of DWIb=800 (3.48 ± 0.51), with statistical differences (P = .001 and P = .033, respectively). The optimal b values for manifesting breast carcinoma based on cDWI were 1000 to 1200 s/mm. The b-value map enables fast identification for breast lesions and shows similar performance to the optimal cDWI images.

Copper(II) complex as a turn on fluorescent sensing platform for acetylcholinesterase activity with high sensitivity

Acetylcholinesterase (AChE) is an important enzyme associated with many nervous diseases, demonstrating the great need for smarter sensing platform with improved sensitivity, selectivity and simplified operation. A "turn on" fluorometric assay is described herein for AChE activity detection, according to the specific enzyme catalyzed reaction of acetylcholine (ATCh) by AChE, which generates thiocholine (TCh) as the product. The well-designed fluorescent probe HBTP possesses ESIPT (Excited State Intramolecular Proton Transfer) nature, leading to a larger Stokes shift, which could be quenched upon coordination with Cu²⁺. The fluorescence-silent HBTP-Cu²⁺ complex could be broken by TCh generated from reaction of ATCh with AChE, giving rise to HBTP release which originates from competitive coordination of TCh with Cu²⁺. This complex probe HBTP-Cu²⁺ offers a limit detection as low as 0.02 mU mL^-1, which is lower than most reported literatures. Furthermore, both HBTP-Cu²⁺ and HBTP show little toxicity to live cells and is available in visualizing cellular AChE activity.

Ratiometric Fluorescent Strategy for Localizing Alkaline Phosphatase Activity in Mitochondria Based on the ESIPT Process

Fluorescent probes are powerful tools for detecting and mapping the species of interest in vitro and in vivo. Although the probes always show high selectivity and sensitivity, they are usually affected by some factors, such as detecting conditions and the probe concentrations. Ratiometric fluorescent strategies, possessing advantage of low background noise, would solve the problem effectively and lead to a higher sensing performance. Thus, an ESIPT-based ratiometric probe (HBTP-mito) was developed on the basis of a phosphorylated 2-(2'-hydroxyphenyl)-benzothiazole derivative for the determination of ALP activity. HBTP-mito is water soluble and emits green fluorescence in TBS buffer due to the blockage of ESIPT. Upon the introduction of ALP, the phosphate ester of HBTP-mito was hydrolyzed and the ESIPT process was restored. Accordingly, the fluorescence at 514 nm decreases, while emission at 650 nm shows a "turn-on" response. The ratio of intensity (I_514nm/I_650nm) decreases linearly with ALP activity increasing from 0 to 60 mU/mL, obtained an LOD of 0.072 mU/mL. The favorable performance of the probe enables its application not only in the detection of ALP activity in biological samples, but also in the localization of the ALP levels in living cells and in vivo.

Bacterial Acid Resistance Toward Organic Weak Acid Revealed by RNA-Seq Transcriptomic Analysis in Acetobacter pasteurianus

Under extreme acidic environments, bacteria exploit several acid resistance (AR) mechanisms for enhancing their survival, which is concerned with several aspects, such as issues in human health and fermentation for acidic products. Currently, knowledge of bacterial AR mainly comes from the strong acid (such as hydrochloric acid) stresses, whereas AR mechanisms against organic weak acids (such as acetic acid), which are indeed encountered by bacteria, are less understood. Acetic acid bacteria (AAB), with the ability to produce acetic acid up to 20 g/100 mL, possess outstanding acetic acid tolerance, which is conferred by their unique AR mechanisms, including pyrroloquinoline quinine-dependent alcohol dehydrogenase, acetic acid assimilation and molecular chaperons. The distinguished AR of AAB toward acetic acid may provide a paradigm for research in bacterial AR against weak organic acids. In order to understand AAB’s AR mechanism more holistically, omics approaches have been employed in the corresponding field. However, the currently reported transcriptomic study was processed under a low-acidity (1 g/100 mL) environment, which could not reflect the general conditions that AAB are usually faced with. This study performed RNA-Seq transcriptomic analysis investigating AR mechanisms in Acetobacter pasteurianus CGMCC 1.41, a widely used vinegar-brewing AAB strain, at different stages of fermentation, namely, under different acetic acid concentrations (from 0.6 to 6.03 g/100 mL). The results demonstrated the even and clustered genomic distribution of up- and down-regulated genes, respectively. Difference in AR between AAB and other microorganisms was supported by the down-regulation of urea degradation and trehalose synthesis-related genes in response to acetic acid. Detailed analysis reflected the role of ethanol respiration as the main energy source and the limited effect of acetic acid assimilation on AR during fermentation as well as the competition between ethanol respiratory chain and NADH, succinate dehydrogenase-based common respiratory chain. Molecular chaperons contribute to AR, too, but their regulatory mechanisms require further investigation. Moreover, pathways of glucose catabolism and fatty acid biosynthesis are also related to AR. Finally, 2-methylcitrate cycle was proposed as an AR mechanism in AAB for the first time. This study provides new insight into AR mechanisms of AAB, and it also indicates the existence of numerous undiscovered AR mechanisms.

[The renal protective effect and mechanism of liraglutide in diabetic mice induced by high-fat diet]

Objective: To investigate the protective effect of liraglutide on kidney of diabetic mice induced by high-fat diet and its possible mechanisms. Methods: C57BL/6J male mice were randomly divided into normal chow diet (NC) group and high-fat diet (HFD) group, which were fed with normal chow diet and HFD for 12 weeks respectively. After diet challenge, the mice were randomly divided into normal control group, normal chow diet with liraglutide treatment (NC+Lira) group, HFD group and high-fat diet with liraglutide treatment (HFD+Lira) group. The mice in NC+Lira and HFD+Lira groups were given intraperitoneal injection of liraglutide (400 μg·kg(-1)·d(-1)) for 8 weeks, while mice in NC and HFD groups were given intraperitoneal injection of same amount of normal saline. Urinary albumin and creatinine levels were measured by enzyme-linked immunosorbent assay (ELISA). Renal morphology was observed by HE staining. The expression levels of silent mating type information regulation 2 homolog 1 (SIRT1) and thioredoxin-interacting protein (TXNIP) were determined by Western blot. Results: Compared with HFD group, liraglutide significantly lowered the body weight [(30.98±1.29) g vs (39.43±2.58) g], fasting blood glucose (FBG) [(7.21±0.15) mmol/L vs (9.55±0.29) mmol/L] and urinary albumin/creatinine ratio (ACR) [(205.48±17.14) μg/mg vs (319.86±34.14) μg/mg] in HFD+Lira group (all P<0.05). HE staining showed that glomerular hypertrophy of HFD group alleviated after liraglutide treatment. The expression level of TXNIP in the kidney of HFD mice significantly decreased after liraglutide treatment (0.41±0.10 vs 3.50±0.70), while expression level of SIRT1 significantly increased (0.75±0.15 vs 0.32±0.04) (both P<0.05). Conclusion: Liraglutide could improve diabetic nephropathy by up-regulation of SIRT1 expression and down-regulation of TXNIP expression in diabetic mice induced by HFD.

Supervised risk predictor of central gland lesions in prostate cancer using 1 H MR spectroscopic imaging with gradient offset-independent adiabaticity pulses

BACKGROUND

Due to the histological heterogeneity of the central gland, accurate detection of central gland prostate cancer remains a challenge.

PURPOSE

To evaluate the efficacy of in vivo 3D ¹ H MR spectroscopic imaging (3D ¹ H MRSI) with a semi-localized adiabatic selective refocusing (sLASER) sequence and gradient-modulated offset-independent adiabatic (GOIA) pulses for detection of central gland prostate cancer. Additionally four risk models were developed to differentiate 1) normal vs. cancer, 2) low- vs. high-risk cancer, 3) low- vs. intermediate-risk cancer, and 4) intermediate- vs. high-risk cancer voxels.

STUDY TYPE

Prospective.

SUBJECTS

Thirty-six patients with biopsy-proven central gland prostate cancer.

FIELD STRENGTH/SEQUENCE

3T MRI / 3D ¹ H MRSI using GOIA-sLASER.

ASSESSMENT

Cancer and normal regions of interest (ROIs) were selected by an experienced radiologist and ¹ H MRSI voxels were placed within the ROIs to calculate seven metabolite signal ratios. Voxels were split into two subsets, 80% for model training and 20% for testing.

STATISTICAL TESTS

Four support vector machine (SVM) models were built using the training dataset. The accuracy, sensitivity, and specificity for each model were calculated for the testing dataset.

RESULTS

High-quality MR spectra were obtained for the whole central gland of the prostate. The normal vs. cancer diagnostic model achieved the highest predictive performance with an accuracy, sensitivity, and specificity of 96.2%, 95.8%, and 93.1%, respectively. The accuracy, sensitivity, and specificity of the low- vs. high-risk cancer and low- vs. intermediate-risk cancer models were 82.5%, 89.2%, 70.2%, and 73.0%, 84.7%, 60.8%, respectively. The intermediate- vs. high-risk cancer model yielded an accuracy, sensitivity, and specificity lower than 55%.

DATA CONCLUSION

The GOIA-sLASER sequence with an external phased-array coil allows for fast assessment of central gland prostate cancer. The classification offers a promising diagnostic tool for discriminating normal vs. cancer, low- vs. high-risk cancer, and low- vs. intermediate-risk cancer.

LEVEL OF EVIDENCE

2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1926-1936.

In vivo actions of Bisphenol F on the reproductive neuroendocrine system after long-term exposure in zebrafish

Although Bisphenol F (BPF), a bisphenol A (BPA) analogue with a similar chemical structure to that of BPA, is widely used in commercial products, little is known about its potential toxic effects on the reproductive neuroendocrine system in vivo. The present study aimed to comprehensively evaluate the effects of BPF on the reproductive neuroendocrine system in zebrafish and to assess the potential mechanisms underlying its association with estrogen receptor (ER) and aromatase (AROM) pathways. Long-term exposure to environmentally relevant and low levels of BPF led to increased expression of reproductive neuroendocrine-related genes (kiss1, kiss1r, gnrh3, lhβ, and fshβ) in the zebrafish brain, as well as increased levels of adrenocorticotropic, gonadotropin-releasing, luteinizing, and follicle-stimulating hormones in the zebrafish brain and vitellogenin in the zebrafish liver. In addition, these effects were associated with an increase in erα, erβ, cyp19a, and cyp19b activity. Meanwhile, ER and AROM antagonists, alone or in combination, significantly attenuated the stimulation of kiss1, lhβ, vtg, and gnrh3 expression, thereby suggesting that chronic BPF exposure affects the regulation of the reproductive neuroendocrine system through activation of the ER and AROM pathways. Moreover, since BPF and bisphenol S induced toxic and reproductive neuroendocrine effects similar to those of BPA, the current accepted usage of BPA and its analogs should be reconsidered in the future.

Associations between carotid intraplaque hemorrhage and new ipsilateral ischemic lesions after carotid artery stenting: a quantitative study with conventional multi-contrast MRI

The risk of cerebral embolism after CAS in patients with carotid IPH is still controversial. This study was to further investigate the relationship between IPH and new ipsilateral ischemic lesion (NIIL) after CAS, and to perform a volumetric analysis of IPH for predicting the risk of NIIL following CAS. One hundred and seventeen patients with carotid stenosis undergoing CAS were prospectively enrolled. Preprocedural multi-contrast carotid MRI was performed. NIIL was evaluated by brain DWI before and after CAS. IPH volume, wall volume at the plaque (WV_plaque) and relative IPH volume were calculated. Associations between IPH and postprocedural NIIL were studied. NIILs were shown in 52 patients. IPH were identified in 53 patients. NIILs were found more frequently in IPH-positive (33/53, 62.3%) than in IPH-negative patients (19/64, 29.7%, p < 0.001). There was no significant difference of WV_plaque between NIIL-positive and NIIL-negative patients (1166.6 ± 432.0 mm³ vs 1124.6 ± 410.4 mm³, p = 0.592). The IPH volume from NIIL-positive group was significantly larger than that of NIIL-negative group (252.8 ± 264.9 mm³ vs 59.3 ± 131.1 mm³, p < 0.001), with also higher relative IPH volume (20.4 ± 19.1% vs 5.7 ± 12.2%, p < 0.001). ROC curve showed that 183.45 mm³ of the IPH volume was the most reliable cutoff value for predicting NIIL with a specificity of 92.3% and a positive predictive value of 86.1%. Larger IPH volume is associated with increased risk of NIIL after CAS procedure. Quantification of IPH volume may be useful for predicting cerebral ischemic events after CAS.

A comparative study of MR extracellular volume fraction measurement and two-dimensional shear-wave elastography in assessment of liver fibrosis with chronic hepatitis B

OBJECTIVE

To evaluate the value of MR liver extracellular volume (ECV_liver) in assessment of liver fibrosis with chronic hepatitis B (CHB), and to compare its performance with two-dimensional (2D) shear-wave elastography (SWE).

MATERIALS AND METHODS

A total of 68 CHB patients who were histologically diagnosed as fibrosis stages F0 to F4 were retrospectively analyzed. All patients underwent gadopentetate dimeglumine-enhanced T1-mapping and 2D SWE. ECV_liver and liver stiffness were measured and compared between fibrosis subgroups; their correlations with histologic findings were evaluated using Spearman correlation test and multiple regression analysis. Diagnostic performance in evaluating liver fibrosis stages was assessed and compared using receiver-operating characteristic analysis.

RESULTS

Both ECV_liver and liver stiffness increased as the fibrosis score increased (F = 17.08 to 10.99, P < 0.001). ECV_liver displayed a strong correlation with fibrosis stage (r = 0.740, P < 0.001), and liver stiffness displayed a moderate correlation (r = 0.651, P < 0.001); multivariate analysis revealed that only ECV_liver was independently correlated with fibrosis stage (P < 0.001). Univariate analyses showed significant correlations of ECV_liver with fibrosis stage, inflammatory activity, and platelet count; among all, the fibrosis stage had the highest correlation coefficient and was the only independent factor (P < 0.001). Overall, ECV_liver had no significant different performance compared with 2D SWE for the identification of both fibrosis stage s ≥ F2 and F4 (P = 0.868 and 0.171).

CONCLUSION

MR ECV_liver plays a promising role in the prediction of liver fibrosis for patients with CHB, comparable to 2D SWE.

Computer-aided pancreas segmentation based on 3D GRE Dixon MRI: a feasibility study

Background

Pancreas segmentation is of great significance for pancreatic cancer radiotherapy positioning, pancreatic structure, and function evaluation.

Purpose

To investigate the feasibility of computer-aided pancreas segmentation based on optimized three-dimensional (3D) Dixon magnetic resonance imaging (MRI).

Material and Methods

Seventeen healthy volunteers (13 men, 4 women; mean age = 53.4 ± 13.2 years; age range = 28–76 years) underwent routine and optimized 3D gradient echo (GRE) Dixon MRI at 3.0 T. The computer-aided segmentation of the pancreas was executed by the Medical Imaging Interaction ToolKit (MITK) with the traditional segmentation algorithm pipeline (a threshold method and a morphological method) on the opposed-phase and water images of Dixon. The performances of our proposed computer segmentation method were evaluated by Dice coefficients and two-dimensional (2D)/3D visualization figures, which were compared for the opposed-phase and water images of routine and optimized Dixon sequences.

Results

The dice coefficients of the computer-aided pancreas segmentation were 0.633 ± 0.080 and 0.716 ± 0.033 for opposed-phase and water images of routine Dixon MRI, respectively, while they were 0.415 ± 0.143 and 0.779 ± 0.048 for the optimized Dixon MRI, respectively. The Dice index was significantly higher based on the water images of optimized Dixon than those in the other three groups (all P values < 0.001), including water images of routine Dixon MRI and both of the opposed-phase images of routine and optimized Dixon sequences.

Conclusion

Computer-aided pancreas segmentation based on Dixon MRI is feasible. The water images of optimized Dixon obtained the best similarity with a good stability.

[Strategy and clinical outcome of deceased donor kidney transplantation for presensitized recipients]

Objective: To explore the management strategy and clinical outcome of renal transplantation in presensitized recipients using deceased donor kidneys. Methods: From January 2011 to June 2018, twenty-one presensitized patients, including 8 with positive donor specific antibodies (DSA) and 13 with positive panel-reactive antibodies (PRA) but no DSA, received renal retransplantation from deceased donors in our center. The incidence of delayed graft function (DGF) and acute rejection (AR), changes of DSA, and the graft and patient survival were retrospectively analyzed. Results: None of the renal allografts had primary non-function (PNF) and DGF after transplantation. Four of the 13 recipients with PRA(+)/DSA-had a total of 5 episodes of acute cell-mediated rejection (CMR), while 5 of 8 recipients with pre-existing DSA(+) developed AR, including 3 cases with CMR alone and 2 cases with mixed AR. All episodes of rejection were successfully reversed after targeted treatment. Interestingly, of the 8 recipients with positive preformed DSA, 4 cases with positive DR-DSA and/or class Ⅰ-DSA had their DSA disappeared after transplantation, whereas DQ-DSA remained positive in 4 of 5 recipients. After a median follow-up of 26 months, all recipients maintained normal renal allograft function, and the survival rates of both graft and recipient were 100%. Conclusions: With the use of deceased donors, kidney transplantation can be successfully performed in presensitized patients by appropriate HLA-matching screening, choosing donor kidneys with good quality, and the combination of optimal perioperative treatment.

Abstract P4-08-20: Pre-analytical effects of FFPE extraction methods on targeted and whole transcriptome sequencing assays for endocrine sensitivity in metastatic breast cancer

Background: The clinical management of patients with metastatic HR-positive breast cancer is often uncertain due to decreased sensitivity to anti-estrogen therapy over time. Recently, we developed a targeted RNAseq based 18-transcript SET ER/PR assay of endocrine sensitivity from biopsies of metastatic cancer. In this work we assess the effect of pre-analytical factors, specifically RNA extraction methods for FFPE tissue samples, on the reliability of the targeted RNAseq assay.

Methods: FFPE blocks and matched fresh frozen (FF) sections from 12 tumors were collected at MD Anderson Cancer Center. RNA from FFPE slides was extracted in duplicate using three kits (Norgen, Qiagen, Roche), and RNAseq libraries from all samples were prepared using Kapa Total RNAseq kit. Targeted RNA libraries were prepared using droplet-based PCR (RainDance), and also by transcriptome-wide RNAseq for comparison. Reads were mapped to genomic sequence using STAR and expression was quantified using RSEM. Expression data were normalized based on expression of 10 reference genes. The effect of FFPE RNA extraction kit on the reliability of the SET index was assessed using linear mixed effects model (LME) analysis, and agreement with FF was assessed using the concordance correlation coefficient (CCC).

Results: Analysis of the whole transcriptome RNAseq data confirmed minimal 3'-end transcript bias from FFPE samples, irrespective of transcript size or FFPE kit. All 18 genes included in the SET index had high overall concordance between FFPE and FF (median CCC percentile=98.8, range 57.2-99.9 for Norgen; similar for the other two kits) and relatively consistent bias across genes, as estimated by the random effects of the LME model. Furthermore, compared to random 18-gene indices, concordance in the SET index values between FF and FFPE was higher than 99.8% of the random samples, verifying the analytical reliability of the selected genes. For the targeted RNAseq assay, RNA from FFPE extracted with the Norgen kit showed the highest concordance compared to FF (CCC=0.956, 95%CI 0.871-0.985). In general, the analytical variation of SET from FFPE samples was greater than that from FF (1.71-2.71 fold greater), with the lowest variation associated with the Norgen kit. The SET index values from targeted RNAseq for both FF and FFPE samples were consistently lower compared to transcriptome-wide RNAseq but were highly correlated, with the Norgen kit having the highest correlation between targeted and transcriptome-wide RNAseq (rho=0.915).

Conclusions: All three FFPE RNA extraction kits have excellent analytical performance compared to FF samples. The Norgen kit may be marginally better yielding higher concordance with FF and lower analytical variation between replicates. All genes in the SET ER/PR showed very good analytical performance in comparison to random indices and individual genes. Targeted gene RNA sequencing appears very promising as a platform for clinical deployment of quantitative assays, showing only a small (fixable) bias compared to RNAseq.

Citation Format: Marczyk M, Fu C, Lau R, Du L, Trevarton AJ, Sinn BV, Gould RE, Symmans WF, Hatzis C. Pre-analytical effects of FFPE extraction methods on targeted and whole transcriptome sequencing assays for endocrine sensitivity in metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-08-20.

Human health risk assessment of antibiotic resistance associated with antibiotic residues in the environment: A review

The extensive use of antibiotics leading to the rapid spread of antibiotic resistance poses high health risks to humans, but to date there is still lack of a quantitative model to properly assess the risks. Concerns over the health risk of antibiotic residues in the environment are mainly (1) the potential hazard of ingested antibiotic residues in the environment altering the human microbiome and promoting emergence and selection for bacteria resistance inhabiting the human body, and (2) the potential hazard of creating a selection pressure on environmental microbiome and leading to reservoirs of antibiotic resistance in the environment. We provide a holistic view of health risk assessment of antibiotic resistance associated with antibiotic residues in the environment in contrast with that of the antibiotic resistant bacteria and discuss the main knowledge gaps and the future research that should be prioritized to achieve the quantitative risk assessment. We examined and summarized the available data and information on the four core elements of antibiotic resistance associated with antibiotic residues in the environment: hazard identification, exposure assessment, dose-response assessment, and risk characterization. The data required to characterize the risks of antibiotic residues in the environment is severely limited. The main future research needs have been identified to enable better assessments of antibiotic resistance associated with antibiotic residues in the environment: (1) establishment of a standardized monitoring guide of antibiotic residues and antibiotic resistance in the environment, (2) derivation of the relationship between antibiotic levels and pathogenic antibiotic-resistance development in different settings, and (3) establishment of the dose-response relationship between pathogenic antibiotic resistant bacteria and various infection diseases. After identification of key risk determinant parameters, we propose a conceptual framework of human health risk assessments of antibiotic residues in the environment. CAPSULE: A holistic view of human health risk assessment of antibiotic residues in the environment was provided.

Hyaluronic acid-mediated multifunctional iron oxide-based MRI nanoprobes for dynamic monitoring of pancreatic cancer

Regarded as the most promising technology for an early and precise detection of pancreatic cancer, a sensitive nanoprobe has been developed to enhance the accumulation of contrast agent at the tumor site. Hyaluronic acid (HA)-mediated multifunctional Fe₃O₄ nanoparticles (NPs) were used to target pancreatic cancer cells because on their cytomembrane they overexpress CD44, a receptor protein that has a high affinity to HA. The formation of HA-mediated multifunctional Fe₃O₄ nanoparticles began with the synthesis of polyethyleneimine (PEI·NH₂) stabled Fe₃O₄ NPs by slight reduction. Subsequently, the formed Fe₃O₄@PEI·NH₂ NPs were modified with fluorescein isothiocyanate (FITC), polyethylene glycol (mPEG-COOH) and HA in succession to form the multifunctional Fe₃O₄ NPs denoted as HA-Fe₃O₄ NPs. HA served as a targeting molecule to identify the surface antibody of CD44. As nanoparticles with a diameter of ca. 11.9 nm, the HA-Fe₃O₄ NPs exhibited very high r₂ relaxivity of 321.4 mM⁻¹ s⁻¹ and this has proved that HA-Fe₃O₄ NPs could be efficient T₂-weighted magnetic resonance imaging (MRI) contrast agents. In a CCK8 cell proliferation assay of HA-Fe₃O₄ NPs, there was no toxic response for Fe concentrations up to 100 μg mL⁻¹. Flow cytometry, confocal microscopy observation, and cell MRI results show that the HA-targeted groups had significantly higher cellular uptake than the nontargeted groups. This demonstrates that the HA-Fe₃O₄ NPs are uptaken by pancreatic cells via an HA-mediated targeting pathway. The HA-mediated active targeting strategy could be applied to other biomedical projects.

HA-Fe₃O₄ NPs hold enormous promise for highly efficient pancreatic tumor diagnosis as well as being CD44-mediated MR imaging contrast agents.

A colorimetric and near -infrared ratiometric fluorescent probe for the determination of endogenous tyrosinase activity based on cyanine aggregation

A ratiometric fluorescent probe for TYR activity with high sensitivity was developed based on the H-aggregation of a cyanine dye.

Near-infrared mito-specific fluorescent probe for ratiometric detection and imaging of alkaline phosphatase activity with high sensitivity

A NIR ratiometric fluorescent probe based on cyanine dye was developed for detecting and intracellular imaging of ALP activity with high sensitivity.

Highly efficient deep-blue OLEDs based on hybridized local and charge-transfer emitters bearing pyrene as the structural unit

Pyrene is a quite promising structural unit for HLCT emitters, and deep-blue OLEDs showing quite high brightness over 10 000 cd m⁻² and EQE_max over 10.5% have been achieved.

Role of Myocardial Extracellular Volume Fraction Measured with Magnetic Resonance Imaging in the Prediction of Left Ventricular Functional Outcome after Revascularization of Chronic Total Occlusion of Coronary Arteries

Objective

The purpose of this study was to prospectively investigate the value of the myocardial extracellular volume fraction (ECV) in predicting myocardial functional outcome after revascularization of coronary chronic total occlusion (CTO).

Materials and Methods

Thirty patients with CTO underwent cardiovascular magnetic resonance (CMR) before and 6 months after revascularization. Three baseline markers of functional outcome were evaluated in the dysfunctional segments assigned to the CTO vessels: ECV, transmural extent of infarction (TEI), and unenhanced rim thickness (RIM). At the global level, the ECV values of the whole myocardium with and without a hyperenhanced region (global and remote ECV) were respectively measured.

Results

In per-segment analysis, ECV was superior to TEI and RIM in predicting functional recovery (area under receiver operating characteristic curve [AUC]: 0.86 vs. 0.75 and 0.73, all p values < 0.010), and it emerged as the only independent predictor of regional functional outcome (odds ratio [OR] = 0.83, 95% confidence interval [CI]: 0.77–0.89; p < 0.001) independent of collateral circulation. In per-patient analysis, global baseline ECV was indicative of ejection fraction (EF) at the follow-up examination (β = −0.61, p < 0.001) and changes in EF (β = −0.57, p = 0.001) in multivariate regression analysis. A patient with global baseline ECV less than 30.0% (AUC, 0.93; sensitivity 94%, specificity 80%) was more likely to demonstrate significant EF improvement (OR: 0.38; 95% CI: 0.17–0.85; p = 0.019).

Conclusion

Extracellular volume fraction obtained by CMR may provide incremental value for the prediction of functional recovery both at the segmental and global levels in CTO patients, and may facilitate the identification of patients who can benefit from revascularization.

Differentiation of triple-negative breast cancer from other subtypes through whole-tumor histogram analysis on multiparametric MR imaging

PURPOSE

To identify triple-negative (TN) breast cancer imaging biomarkers in comparison to other molecular subtypes using multiparametric MR imaging maps and whole-tumor histogram analysis.

MATERIALS AND METHODS

This retrospective study included 134 patients with invasive ductal carcinoma. Whole-tumor histogram-based texture features were extracted from a quantitative ADC map and DCE semi-quantitative maps (washin and washout). Univariate analysis using the Student's t test or Mann-Whitney U test was performed to identify significant variables for differentiating TN cancer from other subtypes. The ROC curves were generated based on the significant variables identified from the univariate analysis. The AUC, sensitivity, and specificity for subtype differentiation were reported.

RESULTS

The significant parameters on the univariate analysis achieved an AUC of 0.710 (95% confidence interval [CI] 0.562, 0.858) with a sensitivity of 63.6% and a specificity of 73.1% at the best cutoff point for differentiating TN cancers from Luminal A cancers. An AUC of 0.763 (95% CI 0.608, 0.917) with a sensitivity of 86.4% and a specificity of 72.2% was achieved for differentiating TN cancers from human epidermal growth factor receptor 2 (HER2) positive cancers. Also, an AUC of 0.683 (95% CI 0.556, 0.809) with a sensitivity of 54.5% and a specificity of 83.9% was achieved for differentiating TN cancers from non-TN cancers. There was no significant feature on the univariate analysis for TN cancers versus Luminal B cancers.

CONCLUSIONS

Whole-tumor histogram-based imaging features derived from ADC, along with washin and washout maps, provide a non-invasive analytical approach for discriminating TN cancers from other subtypes.

KEY POINTS

• Whole-tumor histogram-based features on MR multiparametric maps can help to assess biological characterization of breast cancer. • Histogram-based texture analysis may predict the molecular subtypes of breast cancer. • Combined DWI and DCE evaluation helps to identify triple-negative breast cancer.

Magnetic resonance imaging features for the differential diagnosis of local recurrence of bone sarcoma after prosthesis replacement

Objective

To explore the imaging features of local recurrences (LRs) based on magnetic resonance imaging (MRI) after oncological orthopaedic surgery with prosthesis reconstruction.

Methods

A total of 78 cases totalling 157 scans were retrospectively reviewed. Patients with nodule/mass-like signals were retrospectively classified into LR, infectious pseudotumour, and asymptomatic pseudotumour according to clinicopathological data. LRs were histologically confirmed, and the patients without recurrences were followed up for at least 2 years. Mass size distribution and radiological characteristics were analysed for differential diagnosis of the LR versus pseudotumour.

Results

Thirty-three of 78 cases were positive with nodule/mass-like signal findings on the post-operative MRI images. By analysing the size distribution, we found that masses >2.1 cm (14) were almost attributable (98% specificity) to LRs and mostly (84.6%) timely treated. Contrarily, masses ≤2.1 cm (19) are challenging for differential diagnosis of LRs versus pseudotumour and were undertreated in five of the nine LR cases. MRI characteristics of masses ≤2.1 cm were found to be highly heterogeneous, with solid appearance, adjacent infiltration, and less peritumour oedema being significant indicators for LRs (P＜0.05). Receiver operating characteristic curve showed area under curve of 0.93 for this predictive model.

Conclusions

For the post-operative MRI surveillance of oncological orthopaedic surgery with prosthesis reconstruction, a mass larger than 2.1 cm was highly specific for recurrence. When a mass was smaller than 2.1 cm, more solid property, more adjacent tissue infiltration, and less muscular oedema indicated recurrence rather than a benign mass.

The translational potential of this article

There has been very little data associated with the post-operative magnetic resonance imaging features indicating recurrence in patients with malignant bone sarcoma after prosthesis replacement. This study could help develop diagnostic features of magnetic resonance imaging for differentiating recurrence from benign changes in these patients after prosthesis replacement.

Acquiring High-Performance Deep-Blue OLED Emitters through an Unexpected Blueshift Color-Tuning Effect Induced by Electron-Donating -OMe Substituents

A series of blue-emissive 7-(diphenylamino)-4-phenoxycoumarin derivatives bearing -CF₃ , -OMe, or -N(Me)₂ substituents on the phenoxy subunit were synthesized. Although both the -CF₃ and -N(Me)₂ modifications were found to trigger redshifted fluorescence, the -OMe substitution was demonstrated to exert an unexpected blueshift color-tuning effect toward the deep-blue region. The reason is that the moderate electron-donating -OMe group can endow coumarins with unaltered HOMO but elevated LUMO energy levels. Moreover, the -OMe substitution was found to be beneficial to the thermal stability of these coumarins. Therefore, the trimethoxy-substituted objective compound can act as a high-performance deep-blue organic light-emitting diode (OLED) emitter, and OLED based on it emits deep-blue light with CIE coordinates of (0.148, 0.084), maximum luminance of 7800 cd m^-2 , and maximum external quantum efficiency of 5.1 %. These results not only shed light on the molecular design strategy for high-performance deep-blue OLED emitters through color-tuning, but also show the perspective of coumarin derivatives as deep-blue OLED emitters.

Quantitative perfusion imaging of neoplastic liver lesions: A multi-institution study

We describe multi-institutional experience using free-breathing, 3D Spiral GRAPPA-based quantitative perfusion MRI in characterizing neoplastic liver masses. 45 patients (age: 48–72 years) were prospectively recruited at University Hospitals, Cleveland, USA on a 3 Tesla (T) MRI, and at Zhongshan Hospital, Shanghai, China on a 1.5 T MRI. Contrast-enhanced volumetric T1-weighted images were acquired and a dual-input single-compartment model used to derive arterial fraction (AF), distribution volume (DV) and mean transit time (MTT) for the lesions and normal parenchyma. The measurements were compared using two-tailed Student’s t-test, with Bonferroni correction applied for multiple-comparison testing. 28 hepatocellular carcinoma (HCC) and 17 metastatic lesions were evaluated. No significant difference was noted in perfusion parameters of normal liver parenchyma and neoplastic masses at two centers (p = 0.62 for AF, 0.015 for DV, 0.42 for MTT for HCC, p = 0.13 for AF, 0.97 for DV, 0.78 for MTT for metastases). There was statistically significant difference in AF, DV, and MTT of metastases and AF and DV of HCC compared to normal liver parenchyma (p < 0.5/9 = 0.0055). A statistically significant difference was noted in the MTT of metastases compared to hepatocellular carcinoma (p < 0.001*10-5). In conclusion, 3D Spiral-GRAPPA enabled quantitative free-breathing perfusion MRI exam provides robust perfusion parameters.

Quantitative analysis of hepatic iron in patients suspected of coexisting iron overload and steatosis using multi-echo single-voxel magnetic resonance spectroscopy: Comparison with fat-saturated multi-echo gradient echo sequence

BACKGROUND

The coexistence of hepatic iron and fat is common in patients with hyperferritinemia, which plays an interactive and aggressive role in the progression of diseases (fibrosis, cirrhosis, and hepatocellular carcinomas).

PURPOSE

To evaluate a modified high-speed T₂ -corrected multi-echo, single voxel spectroscopy sequence (HISTOV) for liver iron concentration (LIC) quantification in patients with hyperferritinemia, with simultaneous fat fraction (FF) estimation.

STUDY TYPE

Retrospective cohort study.

POPULATION

Thirty-eight patients with hyperferritinemia were enrolled.

FIELD STRENGTH/SEQUENCE

HISTOV, a fat-saturated multi-echo gradient echo (GRE) sequence, and a spin echo sequence (FerriScan) were performed at 1.5T.

ASSESSMENT

R₂ of the water signal and FF were calculated with HISTOV, and R2* values were derived from the GRE sequence, with R₂ and LIC from FerriScan serving as the references.

STATISTICAL TESTS

Linear regression, correlation analyses, receiver operating characteristic analyses, and Bland-Altman analyses were conducted.

RESULTS

Abnormal hepatic iron load was detected in 32/38 patients, of whom 10/32 had coexisting steatosis. Strong correlation was found between R2* and FerriScan-LIC (R² = 0.861), and between HISTOV-R_{2_} water and FerriScan-R₂ (R²  = 0.889). Furthermore, HISTOV-R_{2_} water was not correlated with HISTOV-FF. The area under the curve (AUC) for HISTOV-R_{2_} water was 0.974, 0.971, and 1, corresponding to clinical FerriScan-LIC thresholds of 1.8, 3.2, and 7.0 mg/g dw, respectively. No significant difference in the AUC was found between HISTOV-R_{2_} water and R2* at any of the LIC thresholds, with P-values of 0.42, 0.37, and 1, respectively. HISTOV-LIC showed excellent agreement with FerriScan-LIC, with a mean bias of 0.00 ± 1.18 mg/g dw, whereas the mean bias between GRE-LIC and FerriScan-LIC was 0.53 ± 1.49 mg/g dw.

DATA CONCLUSION

HISTOV is useful for the quantification and grading of liver iron overload in patients with hyperferritinemia, particularly in cases with coexisting steatosis. HISTOV-LIC showed no systematic bias compared with FerriScan-LIC, making it a promising alternative for iron quantification.

LEVEL OF EVIDENCE

3 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2018.

Quantitative susceptibility mapping in combination with water-fat separation for simultaneous liver iron and fat fraction quantification

PURPOSES

To evaluate the feasibility of simultaneous quantification of liver iron concentration (LIC) and fat fraction (FF) using water-fat separation and quantitative susceptibility mapping (QSM).

METHODS

Forty-five patients suspected of liver iron overload (LIO) were included. A volumetric interpolated breath-hold examination sequence for QSM and FF, a fat-saturated gradient echo sequence for R₂^*, a spin echo sequence for LIC measurements and MRS analyses for FF (FF-MRS) were performed. Magnetic susceptibility and FF were calculated using a water-fat separation method (FF-MRI). Correlation and receiver operating characteristic analyses were performed.

RESULTS

Magnetic susceptibility showed strong correlation with LIC (r_s=0.918). The optimal susceptibility cut-off values were 0.34, 0.63, 1.29 and 2.23 ppm corresponding to LIC thresholds of 1.8, 3.2, 7.0 and 15.0 mg/g dry weight. The area under the curve (AUC) were 0.948, 0.970, 1 and 1, respectively. No difference in AUC was found between susceptibility and R₂^* at all LIC thresholds. Correlation was found between FF-MRI and FF-MRS (R²=0.910).

CONCLUSIONS

QSM has a high diagnostic performance for LIC quantification, similar to that of R₂^*. FF-MRI provides simultaneous fat quantification. Findings suggest QSM in combination with water-fat separation has potential value for evaluating LIO, especially in cases with coexisting steatosis.

KEY POINTS

• Magnetic susceptibility showed strong correlation with LIC (r _s =0.918). • QSM showed high diagnostic performance for LIC, similar to that of R ₂^* . • Simultaneously estimated FF-MRI showed strong correlation with MR-Spectroscopy-based FF (R ² =0.910). • QSM combining water-fat separation has quantitative value for LIO with coexisted steatosis.

Diagnostic value of whole-body MRI with diffusion-weighted sequence for detection of peritoneal metastases in colorectal malignancy

Objective:

To assess the diagnostic accuracy of whole-body MRI using diffusion-weighted sequence (WB-DWI) to determine the peritoneal cancer index (PCI) in correlation with surgical and histopathological findings.

Methods:

Twenty-seven patients underwent preoperative WB-MRI, followed by cytoreductive surgery for primary tumors of the appendix (n = 15), colorectum (n = 12), and associated peritoneal disease. A total of 351 regions were retrospectively reviewed. The sensitivity, specificity, and accuracy were calculated at 13 anatomical sites. The WB-DWI PCI and PCI type were compared with surgical and histopathological findings.

Results:

No statistical difference was found between the WB-DWI PCI and surgical PCI (P = 0.574). WB-DWI correctly predicted the PCI type in 24 of 27 patients with high accuracy (88.9%), including 10 of 10 patients with small-volume tumor, 12 of 14 with moderate-volume tumor, and 2 of 3 with large-volume tumor. WB-DWI correctly depicted tumors in 163 of 203 regions, with 40 false-negative and 23 false-positive regions. The overall sensitivity, specificity, and accuracy of WB-DWI for the detection of peritoneal tumors were 80.3%, 84.5%, and 82.1%, respectively. For lesions < 0.5 cm in diameter, WB-DWI demonstrated good sensitivity (69.4%).

Conclusions:

WB-DWI accurately predicted PCI before surgery in patients undergoing evaluation for cytoreductive surgery.

Intravoxel incoherent motion diffusion-weighted imaging for the assessment of renal fibrosis of chronic kidney disease: A preliminary study

PURPOSE

To investigate the potential of Intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI) for the assessment of renal fibrosis in chronic kidney disease (CKD), using histopathology as a reference standard.

METHODS

Eighty-five CKD patients and twenty healthy volunteers were recruited in this study. IVIM-DWI was performed in all of the participants, and all of the CKD patients underwent renal biopsy. The mean values of the true diffusion coefficient (D), pseudo diffusion coefficient (D*) and perfusion fraction (f) in the renal cortex and medulla were compared between the CKD patients and healthy volunteers. The Spearman correlation coefficient was calculated to assess the relationship between the D, D*,f values and the estimated glomerular filtration rate (eGFR), serum creatinine level (SCr), 24h urinary protein level (24h-UPRO), histopathological fibrosis scores.

RESULTS

The D, D* and f values were significantly lower in medulla than in the cortex for all of the participants. All of the IVIM parameters were significantly lower in the CKD patients than in the healthy controls. In the CKD patients, a significant negative correlation was found between the renal parenchymal D, D*,f values and the 24h-UPRO, as well as between the renal parenchymal D, f values and the SCr. There was a significant positive correlation between all of the IVIM parameters and the eGFR. All of the IVIM parameters exhibited a significant negative correlation with the histopathological fibrosis score.

CONCLUSION

IVIM-DWI shows great potential in the noninvasive assessment of renal fibrosis in CKD.