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In recent years, large language models(LLMs) have attracted significant attention due to their exceptional performance across a multitude of natural language process tasks, and have been widely applied in various fields. However, the application of large language models in the Intellectual Property (IP) domain is challenging due to the strong need for specialized knowledge, privacy protection, processing of extremely long text in this field. In this technical report, we present for the first time a low-cost, standardized procedure for training IP-oriented LLMs, meeting the unique requirements of the IP domain. Using this standard process, we have trained the PatentGPT series models based on open-source pretrained models. By evaluating them on the open-source IP-oriented benchmark MOZIP, our domain-specific LLMs outperforms GPT-4, indicating the effectiveness of the proposed training procedure and the expertise of the PatentGPT models in the IP domain. Remarkably, our model surpassed GPT-4 on the 2019 China Patent Agent Qualification Examination, scoring 65 and matching human expert levels. Additionally, the PatentGPT model, which utilizes the SMoE architecture, achieves performance comparable to that of GPT-4 in the IP domain and demonstrates a better cost-performance ratio on long-text tasks, potentially serving as an alternative to GPT-4 within the IP domain., Comment: 19 pages, 9 figures

Lymph node (LN) metastasis status is one of the most critical prognostic and cancer staging factors for patients with resectable pancreatic ductal adenocarcinoma (PDAC), or in general, for any types of solid malignant tumors. Preoperative prediction of LN metastasis from non-invasive CT imaging is highly desired, as it might be straightforwardly used to guide the following neoadjuvant treatment decision and surgical planning. Most studies only capture the tumor characteristics in CT imaging to implicitly infer LN metastasis and very few work exploit direct LN's CT imaging information. To the best of our knowledge, this is the first work to propose a fully-automated LN segmentation and identification network to directly facilitate the LN metastasis status prediction task. Nevertheless LN segmentation/detection is very challenging since LN can be easily confused with other hard negative anatomic structures (e.g., vessels) from radiological images. We explore the anatomical spatial context priors of pancreatic LN locations by generating a guiding attention map from related organs and vessels to assist segmentation and infer LN status. As such, LN segmentation is impelled to focus on regions that are anatomically adjacent or plausible with respect to the specific organs and vessels. The metastasized LN identification network is trained to classify the segmented LN instances into positives or negatives by reusing the segmentation network as a pre-trained backbone and padding a new classification head. More importantly, we develop a LN metastasis status prediction network that combines the patient-wise aggregation results of LN segmentation/identification and deep imaging features extracted from the tumor region. Extensive quantitative nested five-fold cross-validation is conducted on a discovery dataset of 749 patients with PDAC., Comment: 14 pages,5 figures

Qiaoyan Lin,1 Yongwei Lu,2 Rong Lu,1 Yujuan Chen,1 Linghua Wang,3 Jianping Lu,4 Xianren Ye1,5 1Department of Blood Transfusion, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People’s Republic of China; 2Department of Gyn-Surgical Oncology Section 9, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People’s Republic of China; 3Department of Gynecologic Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People’s Republic of China; 4Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People’s Republic of China; 5Fujian Provincial Key Laboratory of Tumor Biotherapy, Fuzhou, People’s Republic of ChinaCorrespondence: Xianren Ye, Department of Blood Transfusion, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350014, People’s Republic of China, Email fjthy@sina.comObjective: This study analyzed metabolic factors associated with lymphovascular space invasion (LVSI) and compared the difference between type 1 and type 2 endometrial cancer (EC).Methods: Four hundred patients primarily diagnosed with EC who underwent hysterectomy with pathological results at Fujian Medical University Cancer Hospital from January 2019 to January 2021 were included. Demographic variable data were collected as well as pathological results. Laboratory evaluations included fasting blood glucose (FBG), serum cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein A (Apo A) and apolipoprotein B (Apo B). Characterization of binary logistic regression models was used to test the odds ratios (ORs) between LVSI and its metabolic parameters with different subtypes of EC.Results: The results indicated that CA125, ROMA, Ki67 score, FBG and TC were higher in EC patients with LVSI (all p< 0.05). Negative ER and PR expression was positively associated with LV

BackgroundIntracranial artery dissection (IAD) often causes headache and cerebral vascular ischemic events. The imaging characteristics of IAD remain unclear. This study aims to characterize the appearance of culprit and non-culprit IAD using high-resolution cardiovascular magnetic resonance imaging (hrCMR) and quantify the incremental value of hrCMR in identifying higher risk lesions.MethodsImaging data from patients who underwent intervention examination or treatment using digital subtraction angiography (DSA) and hrCMR using a 3 T CMR system within 30 days after the onset of neurological symptoms were collected. The CMR protocol included diffusion-weighted imaging (DWI), black blood T1-, T2- and contrast-enhanced T1-weighted sequences. Lesions were classified as culprit and non-culprit according to imaging findings and patient clinical presentations. Univariate and multivariate analyses were performed to assess the difference between culprit and non-culprit lesions and complementary value of hrCMR in identifying higher risk lesions.ResultsIn total, 75 patients were included in this study. According to the morphology, lesions could be classified into five types: Type I, classical dissection (n = 50); Type II, fusiform aneurysm (n = 1); Type III, long dissected aneurysm (n = 3); Type IV, dolichoectatic dissecting aneurysm (n = 9) and Type V, saccular aneurysm (n = 12). Regression analyses showed that age and hypertension were both associated with culprit lesions (age: OR, 0.83; 95% CI 0.75-0.92; p < 0.001 and hypertension: OR, 66.62; 95% CI 5.91-751.11; p = 0.001). Hematoma identified by hrCMR was significantly associated with culprit lesions (OR, 16.80; 95% CI 1.01-280.81; p = 0.037). Moreover, 17 cases (16 lesions were judged to be culprit) were diagnosed as IAD but not visible in DSA and 15 were Type I lesion.ConclusionhrCMR is helpful in visualizing and characterizing IAD. It provides a significant complementary value over DSA for the diagnosis of

BackgroundPatients with intracranial atherosclerotic disease (ICAD) have a high frequency of stroke recurrence. However, there has been little investigation into the prognostic value of higher-resolution magnetic resonance imaging (HR-MRI).PurposeTo investigate the use of intracranial atherosclerotic plaques features in predicting risk of recurrent cerebrovascular ischemic events using HR-MRI.Study typeProspective.PopulationFifty-eight patients with acute/subacute stroke (N = 46) or transient ischemic attack (N = 12).Field strength/sequenceA 3.0 T, 3D time-of-flight gradient echo sequence and T1- and T2-weighted fast spin echo sequences with 0.31 x 0.39 mm2 in-plane resolution, twice (with >3 months between scans) following the initial event.AssessmentPatients were also followed clinically for recurrent ischemic events for up to 48 months or until a subsequent event occurred. The degree of stenosis, plaque burden (PB), minimal lumen area (MLA), and contrast enhancement ratio were assessed at each scanning session and the percentage change of each over time was calculated.Statistical testsUnivariable and multivariable Cox regression analyses were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for predicting recurrent events.ResultsThe mean time interval between baseline and follow-up MRI scans was 6.2 ± 4.1 months. After the second MRI scan, 20.7% of patients (N = 12) had experienced ipsilateral recurrent TIA/stroke within 10.9 ± 9.2 months. Univariable analyses showed that baseline triglyceride, percentage change of PB, and progression of PB were significantly associated with recurrent events (all P < 0.05). Multivariable Cox regression indicated that progression of PB (HR, 6.293; 95% CI, 1.620-24.444; P < 0.05) was a significant independent imaging feature for recurrent ischemic events.Data conclusionProgression of PB was independently associated with recurrent ischemic cerebrovascular events. HR-MRI

BackgroundPatients with intracranial atherosclerotic disease (ICAD) have a high frequency of stroke recurrence. However, there has been little investigation into the prognostic value of higher-resolution magnetic resonance imaging (HR-MRI).PurposeTo investigate the use of intracranial atherosclerotic plaques features in predicting risk of recurrent cerebrovascular ischemic events using HR-MRI.Study typeProspective.PopulationFifty-eight patients with acute/subacute stroke (N = 46) or transient ischemic attack (N = 12).Field strength/sequenceA 3.0 T, 3D time-of-flight gradient echo sequence and T1- and T2-weighted fast spin echo sequences with 0.31 x 0.39 mm2 in-plane resolution, twice (with >3 months between scans) following the initial event.AssessmentPatients were also followed clinically for recurrent ischemic events for up to 48 months or until a subsequent event occurred. The degree of stenosis, plaque burden (PB), minimal lumen area (MLA), and contrast enhancement ratio were assessed at each scanning session and the percentage change of each over time was calculated.Statistical testsUnivariable and multivariable Cox regression analyses were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for predicting recurrent events.ResultsThe mean time interval between baseline and follow-up MRI scans was 6.2 ± 4.1 months. After the second MRI scan, 20.7% of patients (N = 12) had experienced ipsilateral recurrent TIA/stroke within 10.9 ± 9.2 months. Univariable analyses showed that baseline triglyceride, percentage change of PB, and progression of PB were significantly associated with recurrent events (all P < 0.05). Multivariable Cox regression indicated that progression of PB (HR, 6.293; 95% CI, 1.620-24.444; P < 0.05) was a significant independent imaging feature for recurrent ischemic events.Data conclusionProgression of PB was independently associated with recurrent ischemic cerebrovascular events. HR-MRI

BackgroundIntracranial artery dissection (IAD) often causes headache and cerebral vascular ischemic events. The imaging characteristics of IAD remain unclear. This study aims to characterize the appearance of culprit and non-culprit IAD using high-resolution cardiovascular magnetic resonance imaging (hrCMR) and quantify the incremental value of hrCMR in identifying higher risk lesions.MethodsImaging data from patients who underwent intervention examination or treatment using digital subtraction angiography (DSA) and hrCMR using a 3 T CMR system within 30 days after the onset of neurological symptoms were collected. The CMR protocol included diffusion-weighted imaging (DWI), black blood T1-, T2- and contrast-enhanced T1-weighted sequences. Lesions were classified as culprit and non-culprit according to imaging findings and patient clinical presentations. Univariate and multivariate analyses were performed to assess the difference between culprit and non-culprit lesions and complementary value of hrCMR in identifying higher risk lesions.ResultsIn total, 75 patients were included in this study. According to the morphology, lesions could be classified into five types: Type I, classical dissection (n = 50); Type II, fusiform aneurysm (n = 1); Type III, long dissected aneurysm (n = 3); Type IV, dolichoectatic dissecting aneurysm (n = 9) and Type V, saccular aneurysm (n = 12). Regression analyses showed that age and hypertension were both associated with culprit lesions (age: OR, 0.83; 95% CI 0.75-0.92; p < 0.001 and hypertension: OR, 66.62; 95% CI 5.91-751.11; p = 0.001). Hematoma identified by hrCMR was significantly associated with culprit lesions (OR, 16.80; 95% CI 1.01-280.81; p = 0.037). Moreover, 17 cases (16 lesions were judged to be culprit) were diagnosed as IAD but not visible in DSA and 15 were Type I lesion.ConclusionhrCMR is helpful in visualizing and characterizing IAD. It provides a significant complementary value over DSA for the diagnosis of

BACKGROUND:Intraluminal thrombus (ILT) signal intensity on MRI has been studied as a potential marker of abdominal aortic aneurysm (AAA) progression. PURPOSE:1) To characterize the relationship between ILT signal intensity and AAA diameter; 2) to evaluate ILT change over time; and 3) to assess the relationship between ILT features and AAA growth. STUDY TYPE:Prospective. SUBJECTS:Eighty AAA patients were imaged, and a subset (n = 41) were followed with repeated MRI for 16 ± 9 months. FIELD STRENGTH/SEQUENCE:3D black-blood fast-spin-echo sequence at 3 T. ASSESSMENT:ILT was designated as "bright" if the signal was greater than 1.2 times that of adjacent psoas muscle. AAAs were divided into three groups based on ILT: Type 1: bright ILT; Type 2: isointense ILT; Type 3: no ILT. During follow-up, an active ILT change was defined as new ILT formation or an increase in ILT signal intensity to bright; stable ILT was defined as no change in ILT type or ILT became isointense from bright previously. STATISTICAL TESTS:Shapiro-Wilk test; Mann-Whitney U-test; Fisher's exact test; Kruskal-Wallis test; Spearman's r; intraclass correlation coefficient (ICC), Cohen's kappa. RESULTS:AAAs with Type 1 ILT were larger than those with Types 2 and 3 ILT (5.1 ± 1.1 cm, 4.4 ± 0.9 cm, 4.2 ± 0.8 cm, P = 0.008). The growth rate of AAAs with Type 1 ILT was significantly greater than that of AAAs with Types 2 and 3 ILT (2.6 ± 2.5, 0.6 ± 1.3, 1.5 ± 0.6 mm/year, P = 0.01). During follow-up, AAAs with active ILT changes had a 3-fold increased growth rate compared with AAAs with stable ILT (3.6 ± 3.0 mm/year vs. 1.2 ± 1.5 mm/year, P = 0.008). DATA CONCLUSION:AAAs with bright ILT are larger in diameter and grow faster. Active ILT change is associated with faster AAA growth. Black-blood MRI can characterize ILT features and monitor their change over time, which may provide new insights into AAA risk assessment. LEVEL OF EVIDENCE:2 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2019;50:994-1001.

OBJECTIVES:To evaluate a quantitative radiomic approach based on high-resolution magnetic resonance imaging (HR-MRI) to differentiate acute/sub-acute symptomatic basilar artery plaque from asymptomatic plaque. METHODS:Ninety-six patients with basilar artery stenosis underwent HR-MRI between January 2014 and December 2016. Patients were scanned with T1- and T2-weighted imaging, as well as T1 imaging following gadolinium-contrast injection (CE-T1). The stenosis value, plaque area/burden, lumen area, minimal luminal area (MLA), intraplaque haemorrhage (IPH), contrast enhancement ratio and 94 quantitative radiomic features were extracted and compared between acute/sub-acute and asymptomatic patients. Multi-variate logistic analysis and a random forest model were used to evaluate the diagnostic performance. RESULTS:IPH, MLA and enhancement ratio were independently associated with acute/subacute symptoms. Radiomic features in T1 and CE-T1 images were associated with acute/subacute symptoms, but the features from T2 images were not. The combined IPH, MLA and enhancement ratio had an area under the curve (AUC) of 0.833 for identifying acute/sub-acute symptomatic plaques, and the combined T1 and CE-T1 radiomic approach had a significantly higher AUC of 0.936 (p = 0.01). Combining all features achieved an AUC of 0.974 and accuracy of 90.5%. CONCLUSIONS:Radiomic analysis of plaque texture on HR-MRI accurately distinguished between acutely symptomatic and asymptomatic basilar plaques. KEY POINTS:• High-resolution magnetic resonance imaging can assess basilar artery atherosclerotic plaque. • Radiomic features in T1 and CE-T1 images are associated with acute symptoms. • Radiomic analysis can accurately distinguish between acute symptomatic and asymptomatic plaque. • The highest accuracy may be achieved by combining radiomic and conventional features.

OBJECTIVES:To evaluate a quantitative radiomic approach based on high-resolution magnetic resonance imaging (HR-MRI) to differentiate acute/sub-acute symptomatic basilar artery plaque from asymptomatic plaque. METHODS:Ninety-six patients with basilar artery stenosis underwent HR-MRI between January 2014 and December 2016. Patients were scanned with T1- and T2-weighted imaging, as well as T1 imaging following gadolinium-contrast injection (CE-T1). The stenosis value, plaque area/burden, lumen area, minimal luminal area (MLA), intraplaque haemorrhage (IPH), contrast enhancement ratio and 94 quantitative radiomic features were extracted and compared between acute/sub-acute and asymptomatic patients. Multi-variate logistic analysis and a random forest model were used to evaluate the diagnostic performance. RESULTS:IPH, MLA and enhancement ratio were independently associated with acute/subacute symptoms. Radiomic features in T1 and CE-T1 images were associated with acute/subacute symptoms, but the features from T2 images were not. The combined IPH, MLA and enhancement ratio had an area under the curve (AUC) of 0.833 for identifying acute/sub-acute symptomatic plaques, and the combined T1 and CE-T1 radiomic approach had a significantly higher AUC of 0.936 (p = 0.01). Combining all features achieved an AUC of 0.974 and accuracy of 90.5%. CONCLUSIONS:Radiomic analysis of plaque texture on HR-MRI accurately distinguished between acutely symptomatic and asymptomatic basilar plaques. KEY POINTS:• High-resolution magnetic resonance imaging can assess basilar artery atherosclerotic plaque. • Radiomic features in T1 and CE-T1 images are associated with acute symptoms. • Radiomic analysis can accurately distinguish between acute symptomatic and asymptomatic plaque. • The highest accuracy may be achieved by combining radiomic and conventional features.

OBJECTIVE:Develop and optimize an accelerated, high-resolution (0.5 mm isotropic) 3D black blood MRI technique to reduce scan time for whole-brain intracranial vessel wall imaging. MATERIALS AND METHODS:A 3D accelerated T1-weighted fast-spin-echo prototype sequence using compressed sensing (CS-SPACE) was developed at 3T. Both the acquisition [echo train length (ETL), under-sampling factor] and reconstruction parameters (regularization parameter, number of iterations) were first optimized in 5 healthy volunteers. Ten patients with a variety of intracranial vascular disease presentations (aneurysm, atherosclerosis, dissection, vasculitis) were imaged with SPACE and optimized CS-SPACE, pre and post Gd contrast. Lumen/wall area, wall-to-lumen contrast ratio (CR), enhancement ratio (ER), sharpness, and qualitative scores (1-4) by two radiologists were recorded. RESULTS:The optimized CS-SPACE protocol has ETL 60, 20% k-space under-sampling, 0.002 regularization factor with 20 iterations. In patient studies, CS-SPACE and conventional SPACE had comparable image scores both pre- (3.35 ± 0.85 vs. 3.54 ± 0.65, p = 0.13) and post-contrast (3.72 ± 0.58 vs. 3.53 ± 0.57, p = 0.15), but the CS-SPACE acquisition was 37% faster (6:48 vs. 10:50). CS-SPACE agreed with SPACE for lumen/wall area, ER measurements and sharpness, but marginally reduced the CR. CONCLUSION:In the evaluation of intracranial vascular disease, CS-SPACE provides a substantial reduction in scan time compared to conventional T1-weighted SPACE while maintaining good image quality.

Bing Tian,1 Ri Liu,1 Shiyue Chen,1 Luguang Chen,1 Fang Liu,1 Guorong Jia,1 Yinmei Dong,1 Jing Li,1 Huaiwen Chen,2,3 Jianping Lu11Department of Radiology, 2Center of Clinical and Translational Medicine, Shanghai Changhai Hospital, The Second Military Medical University, 3Sunlipo Biotech Research Center for Nanomedicine, Shanghai, People’s Republic of ChinaBackground: Acute pancreatitis (AP) is an acute inflammatory condition of the pancreas. The symptoms, treatment, and prognosis of mild and severe AP are different, and severe AP is a potentially life-threatening disease with a high incidence of complications and high mortality rate. Thus, it is urgent to develop an effective approach to reliably discriminate between mild and severe AP.Methods: We have developed novel gadolinium-diethylenetriaminepentaacetic (Gd-DTPA)-loaded mannosylated liposomes (named thereafter M-Gd-NL) that preferably target macrophages in AP. The targeting ability of M-Gd-NL toward macrophages in AP and its ability to discriminate between mild and severe AP were evaluated.Results: The liposomes were of desired particle size (~100 nm), Gd-DTPA encapsulation efficiency (~85%), and stability. M-Gd-NL and non-targeted Gd-DTPA-loaded liposomes (Gd-NL) exhibited increased relaxivity compared with Gd-DTPA. Compared with Gd-NL and Gd-DTPA, M-Gd-NL showed increased uptake in macrophages, resulting in increased T1 imaging ability both in vitro (macrophage cell line) and in vivo (severe AP model). Importantly, M-Gd-NL had the ability to discriminate between mild and severe AP, as reflected by a significantly higher T1 magnetic resonance imaging signal in severe AP than in mild AP. M-Gd-NL did not show severe organ toxicity in rats.Conclusion: Our data suggest that M-Gd-NL had enhanced magnetic resonance imaging ability by targeting macrophages in AP and good ability to discriminate between mild and severe AP. We believe that M-Gd-NL could shed new light on the diagnosis of AP in the near future.

ObjectivesManagement of abdominal aortic aneurysms (AAAs) is based on diameter. CT angiography (CTA) is commonly used, but requires radiation and iodinated contrast. Non-contrast MRI is an appealing alternative that may allow better characterization of intraluminal thrombus (ILT). This study aims to 1) validate non-contrast MRI for measuring AAA diameter, and 2) to assess ILT with CTA and MRI.Method28 patients with AAAs (diameter 50.7 ± 12.3 mm) underwent CTA and non-contrast MRI. MRI was acquired at 3 T using 1) a conventional 3D gradient echo (GRE) sequence and 2) a 3D T1-weighted black blood fast-spin-echo sequence. Two radiologists independently measured the AAA diameter. The ratio of signal of ILT and adjacent psoas muscle (ILTr = signalILT/signalMuscle) was quantified.ResultsStrong agreement between CTA and non-contrast MRI was shown for AAA diameter (intra-class coefficient > 0.99). Both approaches had excellent inter-observer reproducibility (ICC > 0.99). ILT appeared homogenous on CTA, whereas MRI revealed compositional variations. Patients with AAAs ≥5.5 cm and <5.5 cm had a variety of distributions of old/fresh ILT types.ConclusionsNon-contrast 3D black blood MRI provides accurate and reproducible AAA diameter measurements as validated by CTA. It also provides unique information about ILT composition, which may be linked with elevated risk for disease progression.Key points• Non-contrast MRI is an appealing alternative to CTA for AAA management. • Non-contrast MRI can accurately measure AAA diameters compared to CTA. • MRI affords unique characterization of intraluminal thrombus composition.

Bing Tian,1 Ri Liu,1 Shiyue Chen,1 Luguang Chen,1 Fang Liu,1 Guorong Jia,1 Yinmei Dong,1 Jing Li,1 Huaiwen Chen,2,3 Jianping Lu11Department of Radiology, 2Center of Clinical and Translational Medicine, Shanghai Changhai Hospital, The Second Military Medical University, 3Sunlipo Biotech Research Center for Nanomedicine, Shanghai, People’s Republic of ChinaBackground: Acute pancreatitis (AP) is an acute inflammatory condition of the pancreas. The symptoms, treatment, and prognosis of mild and severe AP are different, and severe AP is a potentially life-threatening disease with a high incidence of complications and high mortality rate. Thus, it is urgent to develop an effective approach to reliably discriminate between mild and severe AP.Methods: We have developed novel gadolinium-diethylenetriaminepentaacetic (Gd-DTPA)-loaded mannosylated liposomes (named thereafter M-Gd-NL) that preferably target macrophages in AP. The targeting ability of M-Gd-NL toward macrophages in AP and its ability to discriminate between mild and severe AP were evaluated.Results: The liposomes were of desired particle size (~100 nm), Gd-DTPA encapsulation efficiency (~85%), and stability. M-Gd-NL and non-targeted Gd-DTPA-loaded liposomes (Gd-NL) exhibited increased relaxivity compared with Gd-DTPA. Compared with Gd-NL and Gd-DTPA, M-Gd-NL showed increased uptake in macrophages, resulting in increased T1 imaging ability both in vitro (macrophage cell line) and in vivo (severe AP model). Importantly, M-Gd-NL had the ability to discriminate between mild and severe AP, as reflected by a significantly higher T1 magnetic resonance imaging signal in severe AP than in mild AP. M-Gd-NL did not show severe organ toxicity in rats.Conclusion: Our data suggest that M-Gd-NL had enhanced magnetic resonance imaging ability by targeting macrophages in AP and good ability to discriminate between mild and severe AP. We believe that M-Gd-NL could shed new light on the diagnosis of AP in the near future.

To determine the reproducibility of 3D proton magnetic resonance spectroscopic imaging ((1)H-MRSI) of the human prostate in a multicenter setting at 1.5T., Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, FLWIN, SCOPUS: ar.j, info:eu-repo/semantics/published

To determine the reproducibility of 3D proton magnetic resonance spectroscopic imaging ((1)H-MRSI) of the human prostate in a multicenter setting at 1.5T., Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, FLWIN, SCOPUS: ar.j, info:eu-repo/semantics/published

Objectives: A prospective multicenter validation of the ability of H magnetic resonance spectroscopic imaging (MRSI) to distinguish cancer from noncancer tissues throughout the prostate with histopathology of the resected organ as the standard of reference. Materials and methods: Institutional review board approval was obtained for all centers and all participating patients and volunteers provided written informed consent. Ninety-nine patients and 10 age-matched volunteers from 8 participating centers underwent magnetic resonance imaging and 3-dimensional MRSI with an endorectal coil at 1.5 T. Selected MRSI voxels were assigned to the peripheral zone (PZ), the central gland (CG), the periurethral area, and cancer tissue. Signal ratios of choline + creatine to citrate (CC/C) in spectra of these voxels were automatically calculated. Receiver operating characteristic curves were constructed to assess the accuracy by which this ratio can discriminate cancer from noncancer tissue. Results: A total of 70% of voxels in noncancer tissue and 90% of voxels in cancer tissue passed the quality check of the automatically fitted spectra. The median CC/C was significantly different between any noncancer and cancer tissue (P < 0.0001), but not between the different contributing centers. CC/C increased with cancer focus size (P = 0.0008) and certainty of voxel mapping to histopathologic cancer site (P < 0.0001). The area under the receiver operating characteristic curve for discriminating voxels of cancer tissue from noncancer tissue was 0.88 (confidence interval: 0.84-0.92) in the PZ and 0.76 (confidence interval: 0.71-0.81) in the CG. Conclusions: In patients with prostate cancer, recruited from different institutions, 3-dimensional MRSI is demonstrated to be a robust and quantitative technique, producing significantly different CC/C values for cancer compared with noncancer tissue for both the CG and the PZ. © 2010 by Lippincott Williams & Wilkins., SCOPUS: ar.j, info:eu-repo/semantics/published

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Objectives: A prospective multicenter validation of the ability of H magnetic resonance spectroscopic imaging (MRSI) to distinguish cancer from noncancer tissues throughout the prostate with histopathology of the resected organ as the standard of reference. Materials and methods: Institutional review board approval was obtained for all centers and all participating patients and volunteers provided written informed consent. Ninety-nine patients and 10 age-matched volunteers from 8 participating centers underwent magnetic resonance imaging and 3-dimensional MRSI with an endorectal coil at 1.5 T. Selected MRSI voxels were assigned to the peripheral zone (PZ), the central gland (CG), the periurethral area, and cancer tissue. Signal ratios of choline + creatine to citrate (CC/C) in spectra of these voxels were automatically calculated. Receiver operating characteristic curves were constructed to assess the accuracy by which this ratio can discriminate cancer from noncancer tissue. Results: A total of 70% of voxels in noncancer tissue and 90% of voxels in cancer tissue passed the quality check of the automatically fitted spectra. The median CC/C was significantly different between any noncancer and cancer tissue (P < 0.0001), but not between the different contributing centers. CC/C increased with cancer focus size (P = 0.0008) and certainty of voxel mapping to histopathologic cancer site (P < 0.0001). The area under the receiver operating characteristic curve for discriminating voxels of cancer tissue from noncancer tissue was 0.88 (confidence interval: 0.84-0.92) in the PZ and 0.76 (confidence interval: 0.71-0.81) in the CG. Conclusions: In patients with prostate cancer, recruited from different institutions, 3-dimensional MRSI is demonstrated to be a robust and quantitative technique, producing significantly different CC/C values for cancer compared with noncancer tissue for both the CG and the PZ. © 2010 by Lippincott Williams & Wilkins., SCOPUS: ar.j, info:eu-repo/semantics/published

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