ABSTRACT
BACKGROUND: Prostate cancer, a significant contributor to male cancer mortality globally, demands improved diagnostic strategies. In Saudi Arabia, where the incidence is expected to double, this study assessed the compliance of multiparametric MRI (mpMRI) practices with Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) guidelines across diverse healthcare institutions. METHODS: A survey was distributed to the radiology departments of all tertiary referral hospitals in Saudi Arabia (n=60) to assess their compliance with the technical specifications outlined in PI-RADS v2. Statistical analysis included chi-square, Fisher exact, ANOVA, and Student t-tests to examine the collected data. RESULTS: The study revealed an overall commendable compliance rate of 95.23%. However, significant variations were observed in technical parameters, particularly between 1.5 Tesla and 3 Tesla scanners and tertiary versus non-tertiary hospitals. Notable adherence in certain sequences contrasted with discrepancies in T2-weighted and diffusion-weighted imaging parameters. CONCLUSION: These findings underscore the need for nuanced approaches to optimize prostate imaging protocols, considering field strength and institutional differences. The study contributes to the ongoing refinement of standardized mpMRI practices, aiming to enhance diagnostic accuracy and improve clinical outcomes in prostate cancer.
ABSTRACT
Glioblastoma (GBM) is an aggressive and incurable primary brain tumor that causes severe neurologic, cognitive, and psychologic symptoms. Symptoms are caused and exacerbated by the infiltrative properties of GBM cells, which enable them to pervade the healthy brain and disrupt normal function. Recent research has indicated that although radiotherapy (RT) remains the most effective component of multimodality therapy for patients with GBM, it can provoke a more infiltrative phenotype in GBM cells that survive treatment. Here, we demonstrate an essential role of the actin-myosin regulatory kinase myotonic dystrophy kinase-related CDC42-binding kinase (MRCK) in mediating the proinvasive effects of radiation. MRCK-mediated invasion occurred via downstream signaling to effector molecules MYPT1 and MLC2. MRCK was activated by clinically relevant doses per fraction of radiation, and this activation was concomitant with an increase in GBM cell motility and invasion. Furthermore, ablation of MRCK activity either by RNAi or by inhibition with the novel small-molecule inhibitor BDP-9066 prevented radiation-driven increases in motility both in vitro and in a clinically relevant orthotopic xenograft model of GBM. Crucially, treatment with BDP-9066 in combination with RT significantly increased survival in this model and markedly reduced infiltration of the contralateral cerebral hemisphere.Significance: An effective new strategy for the treatment of glioblastoma uses a novel, anti-invasive chemotherapeutic to prevent infiltration of the normal brain by glioblastoma cells.Cancer Res; 78(22); 6509-22. ©2018 AACR.
