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Background: Venous tumor thrombus (VTT) consistency of renal cell carcinoma (RCC) is an important consideration in nephrectomy plus thrombectomy. However, evaluation of VTT consistency through preoperative MR imaging is lacking. Purpose: To evaluate VTT consistency of RCC through intravoxel incoherent motion‐diffusion weighted imaging (IVIM‐DWI) derived parameters (Dt, Dp, f, and ADC) and the apparent diffusion coefficient (ADC) value. Study Type: Retrospective. Population: One hundred and nineteen patients (aged 55.8 ± 11.5 years, 85 male) with histologically‐proven RCC and VTT who underwent radical resection. Field Strength/Sequences: 3.0‐T; two‐dimensional single‐shot diffusion‐weighted echo planar imaging sequence at 9 b‐values (0–800 s/mm2). Assessment: IVIM parameters and ADC values of the primary tumor and the VTT were calculated. The VTT consistency (friable vs. solid) was determined through intraoperative findings of two urologists. The accuracy of VTT consistency classification based on the individual IVIM parameters of primary tumors and of VTT, and based on models combining parameters, was assessed. Type of operation, intra‐operative blood loss, and operation length were recorded. Statistical Tests: Shapiro–Wilk test; Mann–Whitney U test; Student's t‐test; Chi‐square test; Receiver operating characteristic (ROC) analysis. Statistical significance level was P < 0.05. Results: Of the enrolled 119 patients, 33 patients (27.7%) had friable VTT. Patients with friable VTT were significantly more likely to experience open surgery, have significantly more intraoperative blood loss, and significantly longer operative duration. The area under the ROC curve (AUC) values of Dt of the primary tumor and VTT in classifying VTT consistency were 0.758 (95% CI 0.671–0.832) and 0.712 (95% CI 0.622–0.792), respectively. The AUC value of the model combining Dp and Dt of VTT was 0.800 (95% CI 0.717–0.868). Furthermore, the AUC of the model combining Dp and Dt of VTT and Dt of the primary tumor was 0.886 (95% CI 0.814–0.937). Conclusion: IVIM‐derived parameters had the potential to predict VTT consistency of RCC. Evidence Level: 3 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Ten compounds (1 − 10) including one new neoclerodane diterpenoid (1) and nine known compounds were isolated from the whole plants of Ajuga nipponensis. Their structures were established by performing detailed analysis of NMR, the structure of 1 was determined using HRESIMS, 1D and 2D NMR, UV, and IR. Compounds 1 and 4 – 10 were isolated from Ajuga nipponensis for the first time. And it was the first time to report compounds 9 and 10 as natural products. Based on network pharmacology methods, 45 key targets were selected, which were compounds mapping to diseases. And compounds 2 , 3 , 7 , and a (ajugacumbin B) exhibited excellent AKR1B10 inhibitory activities, with IC 50 values of 53.05 ± 0.75, 87.22 ± 0.85, 61.85 ± 0.66, and 85.19±1.02 nM respectively, with Epalrestat used as the positive control (82.09 ± 1.62 nM). Additionally, the interaction between active compounds and AKR1B10 had been discussed according to the molecular docking results. Ultimately, the analysis of GO and KEGG enrichment indicated that the key signaling pathway of the active compounds may be related to prostate cancer. Our study results demonstrate the hypoglycemic and anti-tumor properties of A. nipponensis for the first time, and provide a comprehensive understanding of its application in traditional medicine. Furthermore, this article establishes a reference for further research on the optimized experimental design of novel AKR1B10 inhibitors. [Display omitted] [ABSTRACT FROM AUTHOR]

Rationale and Objectives: To improve the diagnostic recognition of papillary renal neoplasm with reverse polarity (PRNRP) through comprehensive analysis of computed tomography (CT) and magnetic resonance imaging (MRI) findings., Materials and Methods: A retrospective multi-center study was conducted on patients with pathologically confirmed PRNRPs from 2019 to 2024, encompassing six institutions. Clinical and pathological data were meticulously documented. Preoperative CT (n=23) and MRI (n=9) features were independently evaluated in consensus by two genitourinary radiologists, focusing on tumor location, morphologic features, attenuation, signal intensity, and enhancement patterns. Postoperative outcomes were assessed through medical record review or telephone follow-up., Results: The study cohort comprised 26 patients (mean age 62±12 years, 13 men) with 26 well-defined PRNRPs (mean diameter 2.2±1.0 cm) were included. 15 cases (58%) were situated in the right kidney, 18(69%) were exophytic, and 23(88%) were quasi-spherical. A pseudocapsule was identified in eight cases (89%) on MRI. All cases demonstrated iso- or slight hyperattenuation (43.1±13.6 HU) on non-contrast CT, hypointensity on T2-weighted imaging (T2WI), and mild diffusion restriction on diffusion-weighted imaging (DWI). All cases exhibited mild or moderate enhancement in the corticomedullary phase, followed by progressive enhancement in the nephrographic and excretory phases. Concomitant renal cysts were found in 17 cases (65%). All cases showed no evidence of recurrence or metastasis., Conclusion: PRNRP typically presents as a small hypovascular renal mass, and characterized by a pseudocapsule, iso- or slight hyperattenuation on non-contrast CT, heterogeneous T2WI hypointensity, and mild diffusion restriction on DWI., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)