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BACKGROUND: Hemiablation is a less morbid treatment alternative for appropriately selected patients with unilateral prostate cancer (PCa). However, to the authors knowledge, traditional diagnostic techniques inadequately identify appropriate candidates. In the current study, the authors quantified the accuracy for identifying hemiablation candidates using contemporary diagnostic techniques, including multiparametric magnetic resonance imaging (mpMRI) and MRI-fusion with complete systematic template biopsy. METHODS: A retrospective analysis of patients undergoing MRI and MRI-fusion prostate biopsy, including full systematic template biopsy, prior to radical prostatectomy in a single tertiary academic institution between June 2010 and February 2018 was performed. Hemiablation candidates had unilateral intermediate-risk PCa (Gleason score [GS] of 3+4 or 4+3, clinical T classification ≤T2, and prostate-specific antigen level

With the increased incidence of stage T1a renal cell carcinoma (RCC) has come the recognition that these lesions tend to be low grade and slow growing, with low probability of metastasis not necessarily requiring surgery. As alternatives to surgery, both active surveillance and ablation have been advocated for the management of selected patients with stage T1a renal cancers due to slow rate of tumor growth and low metastatic potential based on recent epidemiological studies. Thermal ablation also has consistently reported favorable complication and renal preservation rates compared with surgical approaches. However, most studies are single-center case series and meta-analysis of these series and comparative prospective series with long-term follow-up are lacking. The purpose of this article is to review the principal thermal ablation modalities and oncological outcomes for the treatment of stage T1 RCCs with long-term follow-up.

OBJECTIVE. The purpose of this article is to evaluate restriction spectrum imaging (RSI) in men undergoing MRI-ultrasound fusion biopsy for suspected prostate cancer (PCa) and to compare the performance of RSI with that of conventional DWI. MATERIALS AND METHODS. One hundred ninety-eight biopsy-naïve men enrolled in a concurrent prospective clinical trial evaluating MRI-targeted prostate biopsy underwent multiparametric MRI with RSI. Clinical and imaging features were compared between men with and without clinically significant (CS) PCa (MRI-ultrasound fusion biopsy Gleason score ≥ 3 + 4). RSI z score and apparent diffusion coefficient (ADC) were correlated, and their diagnostic performances were compared. RESULTS. CS PCa was detected in 109 of 198 men (55%). Using predefined thresholds of ADC less than or equal to 1000 μm2/s and RSI z score greater than or equal to 3, sensitivity and specificity for CS PCa were 86% and 38%, respectively, for ADC and 61% and 70%, respectively, for RSI. In the transition zone (n = 69), the sensitivity and specificity were 94% and 17%, respectively, for ADC and 59% and 69%, respectively, for RSI. Among lesions with CS PCa, RSI z score and ADC were significantly inversely correlated in the peripheral zone (ρ = -0.4852; p < 0.01) but not the transition zone (ρ = -0.2412; p = 0.17). Overall diagnostic accuracies of RSI and DWI were 0.70 and 0.68, respectively (p = 0.74). CONCLUSION. RSI and DWI achieved equivalent diagnostic performance for PCa detection in a large population of men undergoing first-time prostate biopsy for suspected PCa, but RSI had superior specificity for transition zone lesions.

Background and objectives: Fanconi anemia (FA) is an autosomal recessive disorder that usually manifest in forms of pancytopenia, hyperpigmentation, and skeletal complications. Mutation in the DNA repair regulatory genes is associated with the development of FA. Examination of chromosomal breakages when chromosomes are exposed to cross-linking agents is a common method of FA diagnosis. This study aimed to evaluate the prevalence and characteristics of patients with FA in Mashhad, northeast of Iran. Methods: In this study, we evaluated 312 suspected FA patients who had been referred to the laboratory of Ghaem Hospital during 2014-2020. The mitomycin C method was used to identify FA-positive subjects. Results: After the examinations, 84 patients (26.9%) were cytogenetically positive for FA. Of 84 patients, 48 (57.1%) were male and 36 (42.9%) were female. Thumb abnormality was the most common congenital anomaly (43.2%). Conclusion: Based on the findings, males are more susceptible to FA, and thumb abnormality is the most common congenital anomaly associated with FA. Combination of clinical manifestations and genetic susceptibility in patients may contribute to a more accurate diagnosis. [ABSTRACT FROM AUTHOR]

Background: Chromosomal aberrations which occur in different hematologic malignancies are believed to be highly applicable for identifying the prognosis and treatment protocols. We conducted the present study to investigate the chromosomal and molecular abnormalities in bone marrow of acute myeloid leukemia (AML), acute lymphoid leukemia (ALL), and myelodysplastic syndrome patients. Method: We performed this cross-sectional study in molecular pathology and cancer research center of Mashhad University of Medical Sciences (MUMS), during 2017-2019; the total number of our cases was 252. We did all the molecular and cytogenetic tests on these patients. SPSS V.16 software was utilized for the analysis of our data. Results: In this research, the ALL patients were meaningfully younger than AML ones. There were significant associations between karyotype patterns and types of malignancy; normal diploid was more frequent in myelodysplastic syndrome (P<0.05). Among numerical abnormalities, trisomy 3 and monosomy 14 were the most prevalent ones. Conclusion: The results of similar studies from different areas with different ethnics would help to identify new parameters for prognosis determination. Cytogenetic analysis is highly applicable for leukemia diagnosis and prognosis. [ABSTRACT FROM AUTHOR]

Background: Prostate diffusion-weighted imaging (DWI) using monopolar encoding is sensitive to eddy-current-induced distortion artifacts. Twice-refocused bipolar encoding suppresses eddy current artifacts, but increases echo time (TE), leading to lower signal-to-noise ratio (SNR). Optimization of the diffusion encoding might improve prostate DWI.Purpose: To evaluate eddy current nulled convex optimized diffusion encoding (ENCODE) for prostate DWI with minimal TE.Study Type: Prospective cohort study.Population: A diffusion phantom, an ex vivo prostate specimen, 10 healthy male subjects (27 ± 3 years old), and five prostate cancer patients (62 ± 7 years old).Field Strength/sequence: 3T; single-shot spin-echo echoplanar DWI.Assessment: Eddy-current artifacts, TE, SNR, apparent diffusion coefficient (ADC), and image quality scores from three independent readers were compared between monopolar, bipolar, and ENCODE prostate DWI for standard-resolution (1.6 × 1.6 mm2 , partial Fourier factor [pF] = 6/8) and higher-resolution protocols (1.6 × 1.6 mm2 , pF = off; 1.0 × 1.0 mm2 , pF = 6/8).Statistical Testing: SNR and ADC differences between techniques were tested with Kruskal-Wallis and Wilcoxon signed-rank tests (P < 0.05 considered significant).Results: Eddy current suppression with ENCODE was comparable to bipolar encoding (mean coefficient of variation across three diffusion directions of 9.4% and 9%). For a standard-resolution protocol, ENCODE achieved similar TE as monopolar and reduced TE by 14 msec compared to bipolar, resulting in 27% and 29% higher mean SNR in prostate transition zone (TZ) and peripheral zone (PZ) (P < 0.05) compared to bipolar, respectively. For higher-resolution protocols, ENCODE achieved the shortest TE (67 msec), with 17-21% and 58-70% higher mean SNR compared to monopolar (TE = 77 msec) and bipolar (TE = 102 msec) in PZ and TZ (P < 0.05). No significant differences were found in mean TZ (P = 0.91) and PZ ADC (P = 0.94) between the three techniques. ENCODE achieved similar or higher image quality scores than bipolar DWI in patients, with mean intraclass correlation coefficient of 0.77 for overall quality between three independent readers.Data Conclusion: ENCODE minimizes TE (improves SNR) and reduces eddy-current distortion for prostate DWI compared to monopolar and bipolar encoding.Level Of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:1526-1539. [ABSTRACT FROM AUTHOR]

Background: Excess proliferation of blood cells may lead to leukemia, which is associated with structural and numerical chromosomal aberrations. Cytogenetic findings of acute lymphoblastic leukemia can be applicable in diagnosis, prognosis, and treatment selection for patients. In the present study we have evaluated molecular, cytogenetic, and immunophenotypic findings in acute lymphoblastic leukemia patients from Mashhad, a city in Northeast Iran. Methods: This cross-sectional study enrolled 124 patients with acute lymphoblastic leukemia during 2015-2017. Two expert hematopathologists confirmed the diagnosis of acute lymphoblastic leukemia in patients' peripheral blood and bone marrow smears. Molecular tests that included t(4;11), t (1;19), t (9;22)-190, and t (12;21) were done by reverse transcriptase real-time quantitative PCR. We performed karyotyping and immunophenotyping of the bone marrow samples. The data were analyzed by SPSS v.17.Results: Mean age of studied cases was 20.01 years. Participants consisted of 64% males and 36% females. Cytogenetic results showed that 23.37% of participants had a normal karyotype; the other participants had the following abnormalities: hyperdiploidy (12.06%), hypodiploidy (21.55%), pseudodiploidy (24.13%), and high hyperdiploidy (18.10%). Molecular analysis of karyotype patterns indicated that 14% of the acute lymphoblastic leukemia patients had the t(12;21), 9% with t(1;19), 2.5% with t(4;11), and 2.5% had the t(9;22). Conclusion: The unique findings of the present study were the presence of previously unreported novel abnormalities. These findings might be useful for oncologists and hematologists in predicting outcome, remission, survival, and treatment response in acute lymphoblastic leukemia patients. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to propose a deep transfer learning (DTL)-based model to distinguish indolent from clinically significant prostate cancer (PCa) lesions and to compare the DTL-based model with a deep learning (DL) model without transfer learning and PIRADS v2 score on 3 Tesla multi-parametric MRI (3T mp-MRI) with whole-mount histopathology (WMHP) validation. Methods: With IRB approval, 140 patients with 3T mp-MRI and WMHP comprised the study cohort. The DTL-based model was trained on 169 lesions in 110 arbitrarily selected patients and tested on the remaining 47 lesions in 30 patients. We compared the DTL-based model with the same DL model architecture trained from scratch and the classification based on PIRADS v2 score with a threshold of 4 using accuracy, sensitivity, specificity, and area under curve (AUC). Bootstrapping with 2000 resamples was performed to estimate the 95% confidence interval (CI) for AUC. Results: After training on 169 lesions in 110 patients, the AUC of discriminating indolent from clinically significant PCa lesions of the DTL-based model, DL model without transfer learning and PIRADS v2 score ≥ 4 were 0.726 (CI [0.575, 0.876]), 0.687 (CI [0.532, 0.843]), and 0.711 (CI [0.575, 0.847]), respectively, in the testing set. The DTL-based model achieved higher AUC compared to the DL model without transfer learning and PIRADS v2 score ≥ 4 in discriminating clinically significant lesions in the testing set. Conclusion: The DeLong test indicated that the DTL-based model achieved comparable AUC compared to the classification based on PIRADS v2 score (p = 0.89). [ABSTRACT FROM AUTHOR]

Background: Variable flip angle (VFA) imaging is widely used for the estimation of T1 relaxation in the prostate, but may have limited repeatability and reproducibility due to its sensitivity to B1+ inhomogeneity.Purpose: To assess the repeatability and reproducibility of prostate T1 estimation with and without compensating for B1+ variation.Study Type: Prospective.Population: Twenty-one volunteers were prospectively recruited and scanned twice on two 3 T MRI scanners, resulting in 84 VFA T1 exams.Field Strength/sequence: 3 T/2D saturated turbo fast low angle shot (FLASH) and 3D dual-echo FLASH.Assessment: Two B1+ mapping techniques, including reference region VFA (RR-VFA) and saturated turbo FLASH (satTFL), were used for B1+ correction, and T1 maps with and without B1+ correction were tested for intrascanner repeatability and interscanner reproducibility. Volumetric regions of interest (ROIs) were drawn on the transition zone, peripheral zone of the prostate, and the obturator internus left and right muscles in the corresponding slices.Statistical Tests: The average T1 within each ROI for each scan was compared for both intra- and interscanner variability using concordance correlation coefficient and a Bland-Altman plot.Results: Both RR-VFA-corrected T1 and satTFL-corrected T1 showed higher intra- and interscanner correlation (0.89/0.87 and 0.87/0.84, respectively) than VFA T1 (0.84 and 0.74). Bland-Altman plots showed that VFA T1 had wider 95% limits of agreement and a larger range of T1 for each tissue compared with T1 with B1+ correction.Data Conclusion: The application of B1+ correction (both RR-VFA and satTFL) to VFA T1 results in more repeatable and reproducible T1 estimation than VFA T1 . This can potentially provide improved quantification of the prostate dynamic contrast-enhanced MRI parameters. Level of Evidence 1. Technical Efficacy Stage 1. J. Magn. Reson. Imaging 2018. [ABSTRACT FROM AUTHOR]

Background: Patient-specific 3D-printed molds and ex vivo MRI of the resected prostate have been two important strategies to align MRI with whole-mount histopathology (WMHP) for prostate cancer (PCa) research, but the combination of these two strategies has not been systematically evaluated.Purpose: To develop and evaluate a system that combines patient-specific 3D-printed molds with ex vivo MRI (ExV) to spatially align in vivo MRI (InV), ExV, and WMHP in PCa patients.Study Type: Prospective cohort study.Population: Seventeen PCa patients who underwent 3T MRI and robotic-assisted laparoscopic radical prostatectomy (RALP).Field Strength/sequences: T2 -weighted turbo spin-echo sequences at 3T.Assessment: Immediately after RALP, the fresh whole prostate specimens were imaged in patient-specific 3D-printed molds by 3T MRI and then sectioned to create WMHP slides. The time required for ExV was measured to assess impact on workflow. InV, ExV, and WMHP images were registered. Spatial alignment was evaluated using: slide offset (mm) between ExV slice locations and WMHP slides; overlap of the 3D prostate contour on InV versus ExV using Dice's coefficient (0 to 1); and 2D target registration error (TRE, mm) between corresponding landmarks on InV, ExV, and WMHP. Data are reported as mean ± standard deviation (SD).Statistical Testing: Differences in 2D TRE before versus after registration were compared using the Wilcoxon signed-rank test (P < 0.05 considered significant).Results: ExV (duration 115 ± 15 min) was successfully incorporated into the workflow for all cases. Absolute slide offset was 1.58 ± 1.57 mm. Dice's coefficient was 0.865 ± 0.035. 2D TRE was significantly reduced after registration (P < 0.01) with mean (±SD of per patient means) of 1.9 ± 0.6 mm for InV versus ExV, 1.4 ± 0.5 mm for WMHP versus ExV, and 2.0 ± 0.5 mm for WMHP versus InV.Data Conclusion: The proposed system combines patient-specific 3D-printed molds with ExV to achieve spatial alignment between InV, ExV, and WMHP with mean 2D TRE of 1-2 mm.Level Of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:270-279. [ABSTRACT FROM AUTHOR]

Background and Objective: BRAF mutations were studied in various populations for prostate carcinoma (PC); however, mutations in BRAF gene are unusual compared to KRAS. Oncogenic activating of BRAF mutations were studied lately in almost 0%- 10% of prostate cancer cases. Methods: In this retrospective study, we gathered 100 formalin-fixed paraffin-embedded samples of prostate adenocarcinoma. A hundred archived samples of adjacent benign prostatic hyperplasia were chosen as normal control. This study was done in pathology laboratory of Qaem Hospital during 2013-2015. Results: Total number of 200 PC and normal cases was investigated for BRAF V600E mutation. The BRAF V600E mutation was found in only 4 patients but it was not detected in normal cases. There were no significant differences between patient and control groups for this mutation (P>0.99). The frequency of BRAF V600E mutation was not significant in different age groups (P>0.285); the most frequency was related to the age range of 71-80. No significant difference was observed between tumor grade and BRAF mutation (P=0.21). Conclusion: According to our findings, BRAF gene mutations did not play essential role in PC. Therefore, anti-BRAF (V600E) could not be considered as a proper target for therapy. [ABSTRACT FROM AUTHOR]

Background and Objective: Janus kinase 2 (JAK2) and Myeloproliferative Leukemia (MPL) mutations are confirmatory indicators for Myeloproliferative Neoplasm (MPN). The current study was performed to determine the frequency of MPL mutation in MPN patients without JAK2 mutation, in order to assign MPL mutation frequency in North-East of Iran. Methods: Total of 105 negative JAK2 cases including 5 Myeloproliferative Disorders (MPD), 15 Polycytemia Vera (PV) and 15 Essential Thrombocytosis (ET) who referred to Qaem Medical Center were assigned to this study. ARMS-PCR was carried out for measuring MPL mutations. Results: A significant difference was observed between MPL mutant and non-mutant groups from overview of MPL mutation (P=0.00001). From the total studied population, 14.28% were ET cases and 4.71% of them had splenomegaly. About 66.66% had thrombocytosis and 33.33% of all the individuals had leukocytosis according to WHO criteria, and 4.76% of non-MPL mutant individuals had splenomegaly (P=1). This mutation was reported in 4-6% of ET and PMF individuals. In this research, 4.76% of studied individuals had MPL (W515L/K) mutation, which were diagnosed with ET. Conclusion: Generally, the presence of JAK2 and MPL mutations are the most important criteria for MPN diagnosis. The obtained frequency of MPL mutation was similar to previous studies. Despite the high frequency of JAK2 and Philadelphia abnormality, MPL mutation was rare in myeloprolifrative disorders. Further studies are suggested to investigate its prognostic effects for these diseases. [ABSTRACT FROM AUTHOR]

Introduction: Plasma cell myeloma is the distortion of differentiated B lymphocytes which is associated with uncontrolled proliferation of plasma cells in bone marrow. Some studies propound a role for HHV-8 virus in pathogenesis of plasma cell myeloma. Yet the findings are inconsistent. In this article we reviewed the literatures to determine the HHV-8 virus role in plasma cell myeloma pathogenesis. Methods: In this systematic review, scientific databanks including PubMed, Scopus, Embase, ISI, and Google scholar were searched. The search was based on the subsequent keywords and medical terms in title; different combinations of keywords were used, they were compatible with MeSH terms. Result: Four articles declared that there is no link between the HHV-8 and the pathogenesis of plasma cell myeloma; while five reported a connection between the virus and myeloma, arguing that virus infection will lead to disease progression. Conclusion: There are differences between the results of the studies. It is required to do further researches about the association of HHV-8 and plasma cell myeloma. [ABSTRACT FROM AUTHOR]

Background & objective: KRAS mutations are reported in many types of cancers including pancreas, lung, colon, breast, and gastric (GC). High frequency of KRAS mutation is observed in the pancreas, colon, and lung cancers; they commonly arise in codon 12 and 13 of exon 2. Due to the lack of information about the frequency of KRAS mutations in the Northeast of Iran, the currentstudy aimed at evaluating KRAS frequency in cases with GC in this region. Methods: A total of120 formalin-fixed, paraffin-embedded blocks of patients with GC were assessed. The assays to detect KRAS in codon 12 and13 were obtained through the peptide nucleic acid (PNA)-clamp. Results: Totally 87 male and 33 female patients were analyzed in the current study. The mean age of the subjects was 55years. The most common tumoral fragment was located on the body with 48 cases (40%) and the less frequent was related to fondues with six cases (5%).Of the 120 GC samples, 16(13.3%) caseshad codon 12 KRAS mutation, and 16.7% had codon 13 mutations. There were no significant relationships between gender, age, and KRAS mutations in the studied specimens. Conclusion: In conclusion, the overall frequency of KRAS codon 12 and 13 mutations in GC was 30% in the current study population. Frequency of KRAS codon 12 and 13 mutations hadsignificant correlation with tumors location. Different pathogenic mechanismsare suggested for GC according to tumor location. The current study resultsmay be an important diagnostic tool for physicians managing atrophic gastritis. [ABSTRACT FROM AUTHOR]

Background & Objective: The current study aimed at assessing the relationship between gastritis and peptic ulcer susceptibility and inflammation-related gene polymorphisms in Iranian patients. Gastritis and peptic ulcer are common medical complications with serious outcomes on the quality of life. Inflammatory responses of gastric mucosa are associated with helicobacter pylori, but most infected patients remain asymptomatic. There is strong evidence that inflammatory response is a major part of its etiology. Methods: The current case-control study aimed atexamining genetic polymorphisms in inflammatory cytokines interleukin (IL)-4, and IL-10 using polymerase chain reaction- variable number tandem reaped (PCR-VNTR) and PCR-restriction fragment length polymorphism(RFLP) methods, respectively in 603 genotyped patients admitted to Mohammadi Hospital in Bandar Abbas, Iran(198 patients with gastritis, 84 with peptic ulcer, and 321 patients as controls). Results: No significant associations were detected in genotype and allele frequencies of IL-10 and IL-4 between the case (with gastritis and peptic ulcer) and control groups. Conclusion: In conclusion, the results of the analyses suggested that these polymorphisms may not predispose the carriers to gastritis and peptic ulcer development. [ABSTRACT FROM AUTHOR]

Background:Brain and Acute Leukemia Cytoplasmic (BAALC) is a gene which its expression is confined to progenitor cells; therefore, no expression has been illustrated in mature cells of bone marrow or white blood cells (WBC). In addition, high BAALC expression is associated with poor prognosis in Acute Myeloid Leukemia (AML) individuals and is considered as an important risk factor in Cytogenetic Normal Acute Myeloid Leukemia. Materials and Methods: This retrospective study was designed to evaluate prognostic importance of BAALC gene expression in pediatric AML patients. Recently, recognized 114 AML Iranian children with age range of 1-15 years were entered in this study during 2012-2015. Real-Time PCR was applied for BAALC gene. Results: High BAALC gene expression was detected in 47 patients (41.2%) and low expression in 67 patients (58.8%). High BAALC gene expression group (n=47) contained23 males and 24 females. All patients were followed up for 2 years to measure disease prognosis. BAALC expression was a main unfavorable prognostic factor in AML patient's especially normal karyotype. AML cases with high BAALC expression had considerable further cumulative risk after 25 months; it was 39 months in low expressed cases. All of cytogenetic normal acute myeloid leukemias (CN-AML) and high BAALC expressed patients died. High BAALC expression in AML cases was associated with considerable shorter overall survival (OS). Conclusion: According to our findings, BAALC expression is a significance poor prognostic factor in AML patients with normal karyotype. This study suggests new therapeutic strategies to ameliorate the treat rate of AML patients. Further research with longer follow up and larger sample size is required to definite statistical perusals. [ABSTRACT FROM AUTHOR]

Background: Sepsis is defined as a systematic inflammatory reaction against infection. Despite the recent advances in medical and pediatric sciences, sepsis remains a significant life-threatening health issue. The main problem associated with this disorder is the nonspecific and non-discriminative symptoms of noninfectious diseases. The present study aimed to introduce diagnostic parameters of high sensitivity and specificity for neonatal sepsis. Methods: This case-control study was conducted in Mashhad, Iran during 2013-2015. Subjects included 40 septic neonates with confirmed diagnosis by a subspecialist of pediatrics and 40 neonates without clinical and laboratory findings of sepsis as the control group. Blood samples were collected from all the infants. In addition, differential white blood cell count of peripheral blood smear was performed, and immature/total neutrophil ratio (I/T) was calculated for all the PBS slides. Plasma calprotectin levels were also determined using the sandwich ELISA method. Results: Mean plasma concentration of calprotectin was 33190±23760 and 18980±13410 ng/ml in the septic and control groups, respectively. Moreover, mean I/T was 0.61±0.22 and 0.51±0.26 in the septic and control groups, respectively. The obtained results indicated that calprotectin levels and I/T were significantly higher in the septic group compared to the control group (P<0.05). Conclusion: According to the results, nucleated red blood cell count and calprotectin levels were the most specific parameters for the definite diagnosis of neonatal sepsis, while neutrophils had the highest sensitivity in this regard. [ABSTRACT FROM AUTHOR]