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To investigate if the pretreatment dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)-based radiomics machine learning predicts the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients.Seventy-eight breast cancer patients who underwent DCE-MRI before NAC and confirmed as pCR or non-pCR were enrolled. Early enhancement mapping images of pretreatment DCE-MRI were created using subtraction formula as follows: Early enhancement mapping = (SignalThe best diagnostic performance based on F-score was achieved when both first and second order texture features with clinical information and subjective radiological findings were used (AUC = 0.77). The second best diagnostic performance was achieved with an AUC of 0.76 for first order texture features followed by an AUC of 0.76 for first and second order texture features.Pretreatment DCE-MRI can improve the prediction of pCR in breast cancer patients when all texture features with clinical information and subjective radiological findings are input to build the prediction model.

BACKGROUND The spring ligament complex (SLC) supports the medial longitudinal arch of the foot, particularly in standing. We evaluated posture-related changes in the thickness and length of the three SLC bundles and their histology. METHODS The thickness and length of the supramedial calcaneonavicular ligament (smCNL), medioplantar oblique calcaneonavicular ligament (mpoCNL), and inferoplantar calcaneonavicular ligament (iplCNL) were measured in the supine and standing positions, using a multiposture magnetic resonance imaging system, in 72 healthy adult feet. Histological examination was performed for 10 feet from five cadavers. RESULTS The smCNL thickness decreased and its length increased from the supine to the standing position (P < 0.001); no other posture-related effects were noted. Histologically, smCNL fibers overlapped along multiple directions while mpoCNL and iplCNL, fibers were oriented horizontally along the longitudinal axis and vertically along the short axis, respectively. CONCLUSION The complex, multidirectional, orientation of the smCNL allows an adaptive response to changes in loading.

Objective Chlamydia pneumoniae and Mycoplasma pneumoniae are both common causes of atypical pneumonia. We conducted an annual national survey of Japanese children to screen them for C. pneumoniae infections during the M. pneumoniae epidemic season. Methods Nasopharyngeal swab specimens were collected from children aged 0–15 years with suspected acute lower respiratory tract infection due to atypical pathogens, at 85 medical facilities in Japan from June 2008 to March 2018. Specimens were tested for infection using real-time polymerase chain reaction assays. Results Of 5002 specimens tested, 1822 (36.5%) were positive for M. pneumoniae alone, 42 (0.8%) were positive for C. pneumoniae alone, and 20 (0.4%) were positive for both organisms. In children with C. pneumoniae infection, the median C. pneumoniae DNA copy number was higher in those with single infections than in those with M. pneumoniae coinfection (p = 0.08); however it did not differ significantly according to whether the children had received antibiotics prior to sample collection (p = 0.34). Conclusions The prevalence of C. pneumoniae infection was substantially lower than that of M. pneumoniae infection during the study period. The change in prevalence of C. pneumoniae was not influenced by that of M. pneumoniae. Children with single C. pneumoniae infection are likely to have had C. pneumoniae infection, while those with coinfection are likely to have been C. pneumoniae carriers.

Purpose This study aimed to clarify exercise-induced changes in intravoxel incoherent motion (IVIM) parameters obtained from diffusion-weighted imaging (DWI) of the calf muscle, as well as the relationships between IVIM parameters, perfusion, and water content in muscle tissue. Materials and methods Thirteen healthy volunteers underwent IVIM-DWI, arterial spin labeling (ASL), and multi-echo spin-echo T2 mapping of the right calf on a 3.0-T magnetic resonance imaging scanner before and after performing dorsiflexion exercise. From the data, we derived the perfusion-related diffusion coefficient (D⁎), perfusion component fraction (F), blood flow parameter (FD⁎), and restricted diffusion coefficient (D) in the tibialis anterior muscle. The muscle blood flow (MBF) and transverse relaxation time (T2) were also calculated from the ASL and multi-echo spin-echo data, respectively. We compared the parameters measured before and after exercise and assessed the relationship of each IVIM-derived perfusion parameter (D⁎, F, and FD⁎) with MBF and each diffusion parameter (D and ADC) or F with T2. Results Notably, all these parameters were significantly increased after exercise. Before exercise, the FD⁎ exhibited a significant positive correlation with the MBF, whereas no significant correlation was observed between D⁎ or F and MBF. After exercise, both D⁎ and FD⁎ exhibited significant positive correlations with MBF, whereas F was not significantly correlated with MBF. Additionally, D was significantly correlated with T2 after exercise, but not before exercise. No significant correlations were found between ADC and T2 either before or after exercise. Conclusions The IVIM analyses before and after exercise enable the simultaneous evaluation of exercise-induced changes in perfusion and water diffusion in the muscle and increases the body of information on muscle physiology.

Meniscal morphology under full weight-loading conditions is currently unknown. This study aimed to evaluate extrusion in the medial meniscus between unloaded and upright-loaded conditions in healthy adults using upright magnetic resonance imaging (MRI) and ultrasonography and to investigate the relationship between MRI and ultrasonography in upright-loaded conditions.Eighteen healthy adult volunteers (13 men and 5 women) participated in the study. MRI and ultrasonography were performed with patients in the supine, double-leg upright (DLU), and single-leg upright (SLU) positions. Medial, anterior, and posterior extrusions of the medial meniscus against the tibial edge were evaluated and compared across the three positions. Medial extrusion correlations between MRI and ultrasonography were examined. Demographic data and hip-knee-ankle (HKA) angles were measured and correlated with changes in the medial extrusion. The medial meniscal extrusions detected via MRI and ultrasonography were compared across the three positions. Correlations were examined using Pearson's correlation coefficients.Negative correlations were found between the change in medial extrusion of the medial meniscus and HKA angle (MRI: r = -0.52, ultrasonography: r = -0.51). Although no significant differences among the three conditions were observed for the anterior and posterior extrusions of the medial meniscus, the medial extrusion of the medial meniscus was significantly greater in DLU and SLU positions than that in the supine position for MRI and ultrasonography (P 0.05). Positive correlations for the medial extrusion of the medial meniscus were found between MRI and ultrasonography in all three positions (supine: r = 0.74, DLU; r = 0.71, SLU; r = 0.61).Although no significant differences in anterior and posterior extrusions of the medial meniscus were seen across the studied positions, the medial meniscus was found to undergo significant medial extrusion during upright weight-loading conditions. The strong correlation between MRI and ultrasonography highlighted the usefulness of ultrasonography.Level IV.

Purpose To suppress olefinic signals and enable simultaneous and quantitative estimation of multiple functional parameters associated with water and lipid, we investigated a modified method using chemical shift displacement and recovery-based separation of lipid tissue (SPLIT) involving acquisitions with different inversion times (TIs), echo times (TEs), and b-values. Materials and methods Single-shot diffusion echo-planar imaging (SSD-EPI) with multiple b-values (0–3000 s/mm2) was performed without fat suppression to separate water and lipid images using the chemical shift displacement of lipid signals in the phase-encoding direction. An inversion pulse (TI = 292 ms) was applied to SSD-EPI to remove olefinic signals. Consecutively, SSD-EPI (b = 0 s/mm2) was performed with TI = 0 ms and TE = 31.8 ms for T1 and T2 measurements, respectively. Under these conditions, transverse water and lipid images at the maximum diameter of the right calf were obtained in six healthy subjects. T1, T2, and the apparent diffusion coefficients (ADC) were then calculated for the tibialis anterior (TA), gastrocnemius (GM), and soleus (SL) muscles, tibialis bone marrow (TB), and subcutaneous fat (SF). Perfusion-related (D*) and restricted diffusion coefficients (D) were calculated for the muscles. Lastly, the lipid fractions (LF) of the muscles were determined after T1 and T2 corrections. Results The modified SPLIT method facilitated sufficient separation of water and lipid images of the calf, and the inversion pulse with TI of 292 ms effectively suppressed olefinic signals. All quantitative parameters obtained with the modified SPLIT method were found to be in general agreement with those previously reported in the literature. Conclusion The modified SPLIT technique enabled sufficient suppression of olefinic signals and simultaneous acquisition of quantitative parameters including diffusion, perfusion, T1 and T2 relaxation times, and LF.

The study aimed to investigate whether intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) can differentiate luminal-B from luminal-A breast cancer MATERIALS AND METHODS: Biexponential analyses of IVIM and DCE MRI were performed using a 3.0-T MRI scanner, involving 134 patients with 137 pathologically confirmed luminal-type invasive breast cancers. Luminal-type breast cancer was categorized as luminal-B breast cancer (LBBC, Ki-67 ≧ 14%) or luminal-A breast cancer (LABC, Ki-67 14%). Quantitative parameters from IVIM (pure diffusion coefficient [D], perfusion-related diffusion coefficient [D*], and fraction [f]) and DCE MRI (initial percentage of enhancement and signal enhancement ratio [SER]) were calculated. The apparent diffusion coefficient (ADC) was also calculated using monoexponential fitting. We correlated these data with the Ki-67 status.The D and ADC values of LBBC were significantly lower than those of LABC (P = 0.028, P = 0.037). The SER of LBBC was significantly higher than that of LABC (P = 0.004). A univariate analysis showed that a significantly lower D (0.847 x 10The SER derived from DCE MRI and the D derived from IVIM are associated independently with the Ki-67 status in patients with luminal-type breast cancer.

Introduction To clarify the mechanism underlying apparent diffusion coefficient (ADC) changes in regional intracranial tissue during the cardiac cycle, we investigated relationships among ADC changes, volume loading, and intracranial pressure using a hemodialyzer phantom in magnetic resonance imaging (MRI). Materials and Methods The hemodialyzer phantom consisted of hollow fibers (HF), the external space of HFs (ES), and a gateway of dialysis solution, filled with syrup solution and air. The high-volume and low-volume loadings were periodically applied to HFs by a to-and-fro flow pump, and syrup solution was permitted to enter or leave HFs during the volume loading cycles. ADC maps at each volume loading phase were obtained using ECG-triggered single-shot diffusion echo-planar imaging. Dynamic phase contrast MRI was also used to measure volume loading to the phantom. We compared the ADC changes, volume loading, and intracranial pressure in the phantom during the cardiac cycle. Results ADC changes synchronized significantly with absolute volumetric flow rate change. The maximum ADC change was higher in high-volume loading cycles than in low-volume loading cycles. Results showed that the water molecules in ES fluctuated according to the force transferred from HF to ES. ADC changes were dependent upon the volumetric flow rate during the cardiac cycle. Conclusions Our original phantom allowed us to clarify the mechanism underlying water fluctuations in intracranial tissues. Measurement of maximum changes in ADC is an effective method to define the transfer characteristics of the arterial pulsatile force in regional intracranial tissue.