Value of MRI diffusion weighted imaging in localization of prostate cancer with whole-mount step section pathology

Objective To evaluate the value of MRI diffusion weighted imaging in localization of prostate cancer with whole-mount step section pathology. Methods We treated 36 patients using laparoscopic radical prostatectomy from Oct. 2009 to Jun. 2010. Patients who did not have an MRL /DWI examination or a surgical history of pros-

Diagnostic Utility of Diffusion-weighted Magnetic Resonance Imaging in Differentiating Small Solid Renal Tumors （≤4 cm） at 3.0T Magnetic Resonance Imaging

Background： The aim of this study was to assess the performance of apparent diffusion coefficient （ADC） measurement obtained with diffusion-weighted magnetic resonance imaging （DW-MRI） to distinguish renal cell carcinomas （RCCs） from small benign solid renal tumors （〈4 cm）. Methods： In this cross-sectional study, 49 consecutive patients with histopathologically confirmed small solid renal tumors, and seven healthy volunteers were imaged using nonenhanced MRI and DW-MRI. The ADC map was calculated using the b values of 0, 50, 400, and 600 s/ mm2 and values compared via the Kruskal-Wallis and Mann-Whitney tests. The utility of ADC for differentiating RCCs and benign lesions was assessed using a receiver operating characteristic curve. Multiple nonenhanced MRI features were analyzed by Logistic regression. Results： The tumors consisted of 33 cases of clear-cell RCCs （ccRCCs） and 16 cases of benign tumors, including 14 cases of minimal fat angiomyolipomas and 2 cases ofoncocytomas. The ADCs showed significant differences among benign tumors （[0.90 ±0.52] x 10 x mm2/s）, ccRCCs （[1.53 ± 0.31 ] x 10 ^3 mm2/s） and the normal renal parenchyma （[2.22 ± 0.12]x 10^-3 mmVs） （P 〈 0.001）. Moreover, there was statistically significant difference between high and low-grade ccRCCs （P = 0.004）. Using a cut-offADC of 1.36± 10 3 mm2/s, DW-MRI resulted in an area under the curve （AUC）, sensitivity, and specificity equal to 0.839, 75.8%, and 87.5%, respectively. Nonenhanced MRI alone and the combination of imaging methods led to an AUC, sensitivity and specificity equal to 0.919, 93.9%, and 81.2%, 0.998, 97%, and 100%, respectively. The Logistic regression showed that the location of the center of the tumor （inside the contour of the kidney） and appearance of stiffblood vessel were significantly helpful for diagnosing ccRCCs. Conclusions： DW-MRI has potential in distinguishing ccRCCs from benign lesions in human small solid renal tumors （〈4 cm）, and in increasing the accuracy for diagnosing ccRCCs when combined with nonenhanced MRI.

Evaluation of the malignant potential of gliomas using diffusion-weighted and gadolinium-enhanced magnetic resonance imaging

Objective:This study aimed to determine whether the apparent diffusion coefficients(ADCs)determined by diffusion-weighted imaging(DWI)of magnetic resonance imaging(MRI)could facilitate the malignancy grading of various gliomas.Methods:Sixty patients with a primary cerebral glioma underwent diffusion-weighted and gadolinium-enhanced(Gd)T1-weighted MRI using a 1.5-T MRI scanner.Scoring was performed based on signal intensities on DWI and Gd images.The mean and minimum ADC values were calculated,and Ki-67 staining was performed for each histological sample to evaluate their tumor proliferative potential.Then,the DWI,Gd,and combined scores were analyzed and compared with the Ki-67 staining index and malignant grade.The relationships among the mean and minimum ADC values,Ki-67staining index,and malignant grade were also evaluated.Results:The minimum ADC was inversely correlated with the Ki-67staining index,with a low minimum ADC suggestive of tumor malignancy.The qualitative evaluation of the D score of water molecule diffusion on DWI accurately reflected the pathological grades of gliomas,with an effectiveness that was at least as good as the quantitative analysis using the minimum ADC.The diagnostic value of Gd images in determining glioma malignancy grades was inferior to that of DWI.Conclusion:Both DWI and gadolinium-enhanced images of MRI should be considered essential for the diagnosis of tumor malignancy.

Different pathways of the second demographic transition in four East Asian societies:evidence from the 2006 and 2016 East Asian Social Surveys

This study uses the 2006 and 2016 East Asian Social Surveys to map value changes related to the second demographic transition in China's Mainland,Japan,South Korea,and Taiwan.The study examines trends in attitudes towards cohabitation,childrearing,and divorce over a 10-year period in the four East Asian societies.The findings suggest that the second demographic transition,if any in East Asia,is an uneven process between societies,and China's Mainland stands out as the only society in which attitudes had become more conservative,even after controlling for compositional differences in population.In the other three societies,attitudes had shifted to be more liberal.Moreover,the study finds little evidence on the diffusion within societies,given their similar trends across different sociodemographic groups.From an ideational perspective,China's Mainland and the other three East Asian societies illustrated different patterns of attitude changes regarding marriage and family.From a behavioral perspective,trends in attitudes do not always align with demographic patterns at the macro level,especially in China's Mainland.More studies are needed to understand the nuanced differences in ideational shifts between societies and the relationship between ideational and behavioral changes in East Asia.