FLAIR vessel hyperintensities predict functional outcomes in patients with acute ischemic stroke treated with medical therapy.

OBJECTIVES: The prognostic value of fluid-attenuated inversion recovery vessel hyperintensity (FVH) remains controversial in acute ischemic stroke (AIS). The objective was to investigate whether the presence of FVH could predict long-term functional outcomes in patients with AIS receiving medical therapy. METHODS: Consecutive AIS patients with anterior circulation large vessel stenosis (LVS) in multiple centers between January 2019 and December 2020 were studied. Presence of FVH was identified and evaluated as FVH (+). Quantification of FVH was performed using an FVH-Alberta Stroke Program Early CT Score (ASPECTS) system and divided into grades: FVH-ASPECTS of 0 = grade 0; 1-2 = grade 1; 3-7 = grade 2. Poor functional outcome was defined as modified Rankin scale > 2 at 3 months. RESULTS: Overall, 175 patients were analyzed (age, 64.31 ± 13.47 years; men, 65.1%), and 78.9% patients presented with FVH. Larger infarct volume (19.90 mL vs. 5.50 mL, p < 0.001), higher rates of FVH (+) (92.0% vs. 65.9%, p < 0.001), and higher FVH grades (grade 2, 34.5% vs. 10.2%, p < 0.001) were more prone to be observed in patients with poor functional outcomes. FVH (+) with infarct volume larger than 6.265 mL (adjusted odds ratio [aOR] 6.03, 95% confidence interval [CI] 1.82-19.98) and FVH grade (grade 1, aOR 3.07, 95% CI 1.12-8.43; grade 2, aOR 5.80, 95% CI 1.59-21.11) were independently associated with poor functional outcomes. CONCLUSION: FVH (+) combined with large infarct volume and high FVH grade can predict poor long-term functional outcomes in patients with LVS who receive medical therapy. KEY POINTS: • FVH is expected to be a contrast agent-independent alternative for assessing hemodynamic status in the acute stage of stroke. • FVH (+) and high FVH grade, quantified by FVH-ASPECTS rating system and grades, are associated with large infarct volume. • The combination of FVH and DWI-based infarct volume has independent predictive value for long-term functional outcomes in AIS patients with large artery stenosis treated with medical therapy.

1H-MRSI of prostate cancer: the relationship between metabolite ratio and tumor proliferation.

PURPOSE: To investigate whether 1H-MRSI can be used to predict the proliferative activity of prostate cancer. MATERIALS AND METHODS: Thirty-eight patients with prostate cancer (PCa) and thirty-three patients with benign prostate hyperplasia (BPH) were included in this study. Patients were examined in supine position using a 1.5T superconducting magnetic scanner equipped with a pelvic phased-array multi-coil and CSI-3D-PROSTATE sequence. Commercial software was used to acquire and process MR spectroscopic imaging data. Mean (Cho+Cr)/Cit ratios of PCa, BPH, and peripheral zone (PZ) were calculated. Cellularity of PCa was recorded based on hematoxylin and eosin staining. PCNA was detected using immunohistochemical techniques. RESULTS: The mean (Cho+Cr)/Cit ratio of the peripheral zone (0.38+/-0.09) was lower than that of BPH (0.51+/-0.19) (P<0.05). The average value of (Cho+Cr)/Cit ratio of prostate cancer was 3.98+/-0.12. The (Cho+Cr)/Cit ratio of prostate cancer was higher than that of the peripheral zone and BPH (P<0.05). The cellularity and PCNA LI of prostate cancer were 12.90+/-4.07% and 72.1+/-19.01%, respectively. The (Cho+Cr)/Cit ratio of prostate cancer positively correlated with tumor cellularity (r=0.582, P=0.027) and PCNA LI (r=0.495, P=0.022). CONCLUSION: The (Cho+Cr)/Cit ratio of PCa can reveal the differences in proliferative activity between PCa and BPH. MRSIs are therefore able to predict the proliferative rate of variously differentiated prostate cancers.

[Diffusion weighted MRI helps evaluate angiogenesis and vascular endothelial growth factor expression in prostate cancer].

OBJECTIVE: To study whether diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) can reflect angiogenesis and the expression of the vascular endothelial growth factor (VEGF) by analyzing the correlation between the features of DWI and angiogenesis in prostate cancer (PCa). METHODS: We studied the clinical and pathological data of 38 patients with histologically proven PCa, who were examined in the supine position with a 1.5T superconductive magnetic scanner (Siemens Sonata) with a pelvic phased array multi-coil. DWI was obtained by echo planar imaging (EPI) sequence. Another 33 cases of benign prostate hyperplasia (BPH) and 15 healthy volunteers were detected for the ADC value in the PCa and BPH tissues and the peripheral zone (PZ). All the PCa samples were examined for microvascular density (MVD) and VEGF. RESULTS: The ADC values of PCa, BPH and PZ were (49.32 +/- 12.68) x 10(-5) mm2/s, (86.73 +/- 26.75) x 10(-5) mm2/s and (126.25 +/- 27.21) x 10(-5) mm2/s, the former lower than the latter two (P < 0.05). The expressions of MVD and VEGF in PCa were higher than in BPH (P < 0.05). The correlation was negative between the ADC value and MVD of PCa (r = -0.510, P < 0.05) , and positive between the expressions of VEGF and MVD (r = 0.481, P < 0.05). The ADC values of the VEGF-positive and -negative groups were (47.27 +/- 9.55) x 10(-5) mm2/s and (55.06 +/- 11.6) x 10(-5) mm2/s (P < 0.05). CONCLUSION: The ADC value reflects the angiogenesis in differentiated prostate cancer, and DWI therefore helps to evaluate the biological features of PCa in vivo.

Diffusion-weighted imaging of prostate cancer: correlation between apparent diffusion coefficient values and tumor proliferation.

PURPOSE: To investigate whether the apparent diffusion coefficient (ADC) values of prostate cancer (PCa) are able to reflect tumor proliferation. MATERIALS AND METHODS: The clinical and pathological information for 38 patients with PCa and 33 patients with benign prostate hyperplasia (BPH) were studied. Examination of the patients was performed using a 1.5 T superconducting magnetic scanner equipped with a pelvic phased-array multicoil. Diffusion-weighted images (DWIs) were acquired using an echo-planar imaging sequence. The ADC values of PCa, BPH, and peripheral zone (PZ) were calculated. The cellularity of PCa was recorded based on hematoxylin and eosin staining. The proliferating cell nuclear antigen (PCNA) was detected using an immunohistochemical technique. RESULTS: The ADC values of PCa, BPH, and PZ were 49.32 +/- 12.68 x 10(-5) mm(2)/s, 86.73 +/- 26.75 x 10(-5) mm(2)/s, and 126.25 +/- 27.21 x 10(-5) mm(2)/s, respectively. The ADC values of PCa were lower than those of BPH and PZ (P < 0.05). The cellularity and PCNA labeling index (LI) of PCa were higher than those of BPH (P < 0.05). The ADC values of PCa were negatively correlated with those of cellularity and PCNA LI (r = -0.646 and -0.446, respectively; P < 0.05). CONCLUSION: The ADC values of PCa can reveal the differences in proliferative activity between PCa and BPH. These values are therefore able to predict the proliferative rate of variously differentiated prostate cancers.