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Background: The diagnostic performance of magnetic resonance imaging (MRI) modalities and/or endoscopy for assessing complete response in rectal cancer after neoadjuvant chemoradiotherapy (nCRT) is unclear. Purpose: To summarize existing evidence on the diagnostic performance of diffusion-weighted MRI, perfusion-weighted MRI, T2-weighted MR tumor regression grade, and/or endoscopy for assessing complete tumor response after nCRT. Material and Methods: MEDLINE and Embase databases were searched. The PRISMA guidelines were followed. Sensitivity, specificity, negative predictive, and positive predictive values were retrieved from included studies. Results: In total, 81 studies were eligible for inclusion. Evidence suggests that combined use of MRI and endoscopy tends to improve the diagnostic performance compared to single imaging modality. The positive predictive value of a complete response varies substantially between studies. There is considerable heterogeneity between studies. Conclusion: Combined re-staging tends to improve diagnostic performance compared to single imaging modality, but the vast majority of studies fail to offer true clinical value due to the study heterogeneity. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is characterised by accelerated brain atrophy, which relates to disease progression. Previous research shows that progressive resistance training (PRT) can counteract brain atrophy in other populations. Objective: To evaluate the effects of PRT by magnetic resonance imaging (MRI) and clinical measures of disease progression in people with MS. Methods: This study was a 24-week randomised controlled cross-over trial, including a Training (n = 18, 24 weeks of PRT followed by self-guided physical activity) and Waitlist group (n = 17, 24 weeks of habitual lifestyle followed by PRT). Assessments included disability measures and MRI (lesion load, global brain volume, percentage brain volume change (PBVC) and cortical thickness). Results: While the MS Functional Composite score improved, Expanded Disability Status Scale, lesion load and global brain volumes did not differ between groups. PBVC tended to differ between groups and higher absolute cortical thickness values were observed in 19 of 74 investigated cortical regions after PRT. Observed changes were confirmed and reproduced when comparing relative cortical thickness changes between groups for four areas: anterior cingulate gyrus, temporal pole, orbital sulcus and inferior temporal sulcus. Conclusion: PRT seem to induce an increase in cortical thickness, indicating that PRT have a neuroprotective or even neuroregenerative effect in relapsing-remitting MS. [ABSTRACT FROM AUTHOR]

Background Active surveillance (AS) of low-risk prostate cancer (PCa) is an accepted alternative to active treatment. However, the conventional diagnostic trans-rectal ultrasound guided biopsies (TRUS-bx) underestimate PCa aggressiveness in almost half of the cases, when compared with the surgical specimen. Purpose To investigate if additional multi-parametric magnetic resonance imaging (mpMRI) of the prostate and MRI-guided in-bore biopsies (MRGB) at AS inclusion would improve selection of patients for active treatment. Material and Methods All patients enrolled in AS programs at two Danish centers, from October 2014 to January 2016, were offered an mpMRI 8-12 weeks after the initial diagnostic TRUS-bx. Candidates had low-risk disease (PSA < 10 ng/mL,  6 or GS 6 (3 + 3) lesions with ≥ 6 mm maximal cancer core length (MCCL). Results A total of 78 patients were included and in 21 patients a total of 22 PIRADS-score 4 or 5 lesions were detected. MRGB pathology revealed that 17 (81%) of these and 22% of the entire AS population harbored significant cancers at AS inclusion. In eight (38%) cases, the GS was upgraded. Also, nine patients (43%) had GS 6 (3 + 3) foci with MCCL ≥ 6 mm. Conclusion In an AS cohort based on TRUS and TRUS-bx diagnostic strategies, supplemental mpMRI and in-bore MRGB were able to efficiently reclassify a substantial number of patients as candidates for immediate active treatment. [ABSTRACT FROM AUTHOR]

Objectives:To evaluate the use of multi-parametric magnetic resonance imaging (mpMRI) and mpMRI guided biopsies (MRGB) for monitoring an active surveillance (AS) prostate cancer cohort. Materials and methods:One year after initial diagnostic TRUS guided biopsy (TRUS-bx), baseline mpMRI, and enrolment in an AS program patients underwent a one year follow-up comprising the usual TRUS-bx and an mpMRI. Prostate MRI lesions were scored on the five-point PIRADS scale version 2. In cases without TRUS-bx progression, patients with PIRADS 4 or 5 lesions were scheduled for MRGB. Progression in TRUS-bx was defined as Gleason score (Gs) up-grades, >3 tumor positive cores or a maximal cancer core length (MCCL) > 50%. In MRGB, Gs upgrade or a MCCL ≥6 mm Gs 3 + 3 lesions were considered to reflect progression. PSA increase or progression in clinical T-classification alone was not considered clinical progression. Results:50 patients were included in the study. In total 10 (20%) patients had per definition progression at one year follow-up. Seven patients (7/50 = 14%) had clinical progression based on TRUS-bx. mpMRI identified seven newly emerged PIRADS 4 lesions. Three patients with PIRADS 4 lesions had no sign of TRUS-bx progression, while MRGB revealed significant cancer (Gs 7 (3 + 4) and Gs 8 (3 + 5)). Consequently, seven patients underwent definitive treatment. Of these, six and four had a progression on MRI and TRUS-bx, respectively. Conclusions:Our study suggests that mpMRI is at least equal to TRUS-bx in detecting progression at one year follow-up in prostate cancer patients undergoing active surveillance. [ABSTRACT FROM AUTHOR]