Predicting Prostate Biopsy Outcomes: A Preliminary Investigation on Screening with Ultrahigh B-Value Diffusion-Weighted Imaging as an Innovative Diagnostic Biomarker

Background

Routine screening of prostate specific antigen (PSA) is no longer recommended because of a high rate of over-diagnosis of prostate cancer (PCa).

Objective

To evaluate the efficacy of diffusion-weighted magnetic resonance imaging (DW-MRI) for PCa detection, and to explore the clinical utility of ultrahigh b-value DW-MRI in predicting prostate biopsy outcomes.

Methodology

73 male patients were selected for the study. They underwent 3T MRI using T2WI conventional DW-MRI with b-value 1000 s/mm², and ultrahigh b-value DW-MRI with b-values of 2000 s/mm² and 3000 s/mm². Two radiologists evaluated individual prostate gland images on a 5-point rating scale using PI-RADS, for the purpose of region-specific comparisons among modalities. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios (LR) were investigated for each MRI modality. The area under the receiver operating characteristic (ROC) curve (AUC) was also calculated.

Results

Results showed the improved diagnostic value of ultrahigh b-value DWI-MRI for detection of PCa when compared to other b values and conventional MRI protocols. Sensitivity values for 3000 s/mm² in both peripheral zone (PZ) and transition zone (TZ) were significantly higher than those observed with conventional DW-MRI—Specificity values for 3000 s/mm² in the TZ were significantly higher than other b-value images, whereas specificity values using 3000 s/mm² in the PZ were not significantly higher than 2000 s/mm² images. PPV and NPV between 3000 s/mm² and the other three modalities were significantly higher for both PZ and TZ images. The PLRs and NLRs of b-value 3000 s/mm² DW-MRI in the PZ and TZ were also recorded. ROC analysis showed greater AUCs for the b value 3000 s/mm² DWI than for the other three modalities.

Conclusions

DW-MRI with a b-value of 3000 s/mm² was found to be the most accurate and reliable MRI modality for PCa tumor detection and localization, particularly for TZ lesion discrimination. It may be stated that the b-value of 3000 s/mm² is a novel, improved diagnostic biomarker with greater predictive accuracy for PCa prior to biopsy.     

Prostate cancer identification: quantitative analysis of T2-weighted MR images based on a back propagation artificial neural network model

Computer-aided diagnosis (CAD) systems have been proposed to assist radiologists in making diagnostic decisions by providing helpful information. As one of the most important sequences in prostate magnetic resonance imaging (MRI), image features from T2-weighted images (T2WI) were extracted and evaluated for the diagnostic performances by using CAD. We extracted 12 quantitative image features from prostate T2-weighted MR images. The importance of each feature in cancer identification was compared in the peripheral zone (PZ) and central gland (CG), respectively. The performance of the computer-aided diagnosis system supported by an artificial neural network was tested. With computer-aided analysis of T2-weighted images, many characteristic features with different diagnostic capabilities can be extracted. We discovered most of the features (10/12) had significant difference (P<0.01) between PCa and non-PCa in the PZ, while only five features (sum average, minimum value, standard deviation, 10th percentile, and entropy) had significant difference in CG. CAD prediction by features from T2w images can reach high accuracy and specificity while maintaining acceptable sensitivity. The outcome is convictive and helpful in medical diagnosis.     

Infrared spectroscopy with multivariate analysis potentially facilitates the segregation of different types of prostate cell

The prostate gland is conventionally divided into zones or regions. This morphology is of clinical significance as prostate cancer (CaP) occurs mainly in the peripheral zone (PZ). We obtained tissue sets consisting of paraffin-embedded blocks of cancer-free transition zone (TZ) and PZ and adjacent CaP from patients (n = 6) who had undergone radical retropubic prostatectomy; a seventh tissue set of snap-frozen PZ and TZ was obtained from a CaP-free gland removed after radical cystoprostatectomy. Paraffin-embedded tissue slices were sectioned (10-mum thick) and mounted on suitable windows to facilitate infrared (IR) spectra acquisition before being dewaxed and air dried; cryosections were dessicated on BaF(2) windows. Spectra were collected employing synchrotron Fourier-transform infrared (FTIR) microspectroscopy in transmission mode or attenuated total reflection-FTIR (ATR) spectroscopy. Epithelial cell and stromal IR spectra were subjected to principal component analysis to determine whether wavenumber-absorbance relationships expressed as single points in "hyperspace" might on the basis of multivariate distance reveal biophysical differences between cells in situ in different tissue regions. After spectroscopic analysis, plotted clusters and their loadings curves highlighted marked variation in the spectral region containing DNA/RNA bands ( approximately 1490-1000 cm(-1)). By interrogating the intrinsic dimensionality of IR spectra in this small cohort sample, we found that TZ epithelial cells appeared to align more closely with those of CaP while exhibiting marked structural differences compared to PZ epithelium. IR spectra of PZ stroma also suggested that these cells are structurally more different to CaP than those located in the TZ. Because the PZ exhibits a higher occurrence of CaP, other factors (e.g., hormone exposure) may modulate the growth kinetics of initiated epithelial cells in this region. The results of this pilot study surprisingly indicate that TZ epithelial cells are more likely to exhibit what may be a susceptibility-to-adenocarcinoma spectral signature. Thus, IR spectroscopy on its own may not be sufficient to identify premalignant prostate epithelial cells most likely to progress to CaP.     

Differential protein expression in anatomical zones of the prostate

The prostate has three anatomical zones: the peripheral (PZ), the transition (TZ), and the central (CZ) zone. It is proposed that the CZ may be of mesodermal origin, whereas the other two are of endodermal origin. Proteome patterns in the zones were characterized to test for differences. Cells were scraped from macroscopically normal areas of PZ, TZ, and CZ in radical prostatectomy specimens. After exclusion of samples with cancer or prostatic intraepithelial neoplasia, 18 cases remained for analysis. Cells were collected in a medium with protease inhibitors, and the protein material was prepared for two-dimensional gel electrophoresis. The proteins in spots that differed quantitatively between regions were identified via mass spectrometric fingerprinting of tryptic fragments and selected tandem mass spectrometry sequence analysis. Ten proteins with significant zonal differential expression were identified, eight with underexpression in the CZ versus the PZ and the TZ (arginase II, ATP synthase, cytokeratin 8, lamin A/C, peroxiredoxin 4, protein disulfide isomerase A3, tropomyosin, and vimentin), and two with overexpression in the CZ (peroxiredoxin 2 and creatine kinase B). The PZ and TZ, although differing in terms of incidence of cancer and hyperplasia, have epithelium with highly similar major protein expression profiles. However, the protein profile of the CZ differs from that of the other regions, suggesting functional differences.     

Selecting proper combination of mpMRI sequences for prostate cancer classification using multi-input convolutional neuronal network

PurposeThis study aims to develop a deep-learning-based method to classify clinically significant (CS) and clinically insignificant (CiS) prostate cancer (PCa) on multiparametric magnetic resonance imaging (mpMRI) automatically, and to select suitable mpMRI sequences for PCa classification in different anatomic zones.MethodsA multi-input selection network (MISN) is proposed for both PCa classification and the selection of the optimal combination of sequences for PCa classification in a specific zone. MISN is a multi-input/-output classification network consisting of nine branches to process nine input images from the mpMRI data. To improve classification accuracy and reduce model parameters, a pruning strategy is proposed to select a subset of the nine branches of MIST to form two more effective networks for the peripheral zone (PZ) PCa and transition zone (TZ) PCa, which are named as PZN and TZN, respectively. Besides, a new penalized cross-entropy loss function is adopted to train the networks to balance the classification sensitivity and specificity.ResultsThe proposed methods were evaluated on the PROSTATEx challenge dataset and achieved an area under the receiver operator characteristics curve of 0.95, which was much higher than currently published results and ranked first out of more than 1500 entries submitted to the challenge at the time of submission of this paper. For PZ-PCa and TZ-PCa classification, PZN and TZN achieved better performance than MISN.ConclusionsHigher performance can be achieved by selecting a suitable subset of the mpMRI sequences in PCa classification.     

不同年龄段前列腺外周带基质细胞超微结构差异

目的：研究不同年龄段前列腺外周带基质细胞超微结构并探讨其意义。方法：透射电镜观察3例年轻组（23-、26-、32-岁）和3例老年组（56-、64-、71-岁）正常前列腺外周带和3例前列腺癌组织的超微结构。Masson＇s Trichrome染色法观察前列腺外周带基质胶原的分布情况。结果：年轻组、老年组前列腺外周带间质均以平滑肌细胞分布为主,间杂成纤维细胞,但老年组平滑肌细胞和成纤维细胞体积较大、形态不规则。与正常年轻组相比,老年组前列腺外周带成纤维细胞存在明显老化和肌化改变,部分细胞内与蛋白合成相关的细胞器粗面内质网发达,呈现肌成纤维细胞特征。与年轻组和老年组外周带相比,前列腺癌基质中功能更加活跃的肌成纤维细胞和胶原蛋白数量增加明显。Masson＇s Trichrome染色支持超微观察到的基质胶原分布差异：年轻组〈老年组〈前列腺癌组。结论：不同年龄段前列腺外周带基质细胞超微结构间存在差异,老年组前列腺外周带和前列腺癌基质组织中具有活性的肌成纤维细胞的增加可能是造成老年前列腺癌高发和恶性进展的重要病理基础之一。     

Development of a Nuclear Morphometric Signature for Prostate Cancer Risk in Negative Biopsies

Background

Our objective was to develop and validate a multi-feature nuclear score based on image analysis of direct DNA staining, and to test its association with field effects and subsequent detection of prostate cancer (PCa) in benign biopsies.

Methods

Tissue sections from 39 prostatectomies were Feulgen-stained and digitally scanned (400×), providing maps of DNA content per pixel. PCa and benign epithelial nuclei were randomly selected for measurement of 52 basic morphometric features. Logistic regression models discriminating benign from PCa nuclei, and benign from malignant nuclear populations, were built and cross-validated by AUC analysis. Nuclear populations were randomly collected <1 mm or >5 mm from cancer foci, and from cancer-free prostates, HGPIN, and PCa Gleason grade 3–5. Nuclei also were collected from negative biopsy subjects who had a subsequent diagnosis of PCa and age-matched cancer-free controls (20 pairs).

Results

A multi-feature nuclear score discriminated cancer from benign cell populations with AUCs of 0.91 and 0.79, respectively, in training and validation sets of patients. In prostatectomy samples, both nuclear- and population-level models revealed cancer-like features in benign nuclei adjacent to PCa, compared to nuclei that were more distant or from PCa-free glands. In negative biopsies, a validated model with 5 variance features yielded significantly higher scores in cases than controls (P = 0.026).

Conclusions

A multifeature nuclear morphometric score, obtained by automated digital analysis, was validated for discrimination of benign from cancer nuclei. This score demonstrated field effects in benign epithelial nuclei at varying distance from PCa lesions, and was associated with subsequent PCa detection in negative biopsies.

Impact

This nuclear score shows promise as a risk predictor among men with negative biopsies and as an intermediate biomarker in Phase II chemoprevention trials. The results also suggest that subvisual disturbances in nuclear structure precede the development of pre-neoplastic lesions.     

Pentazocine monitoring in rat hair and plasma by HPLC-fluorescence detection with DIB-Cl as a labelling reagent.

Pentazocine (PZ) in rat hair and plasma was determined by HPLC-fluorescence detection with 4-(4,5-diphenyl-1H-imidazol-2-yl)benzoyl chloride (DIB-Cl) as a labelling reagent and cyclazocine (CZ) as an internal standard (IS). PZ and IS extracted from hair or plasma sample were derivatized with DIB-Cl and the resulted solution was cleaned up with solid phase extraction. The isocratic separation of DIB-PZ and -CZ within 20 min could be achieved by a Wakopak Handy-ODS column (250 x 4.6 mm i.d.) using a mobile phase composed of 0.1 mol/L acetate buffer (pH 6.2):acetonitrile (25:75, v/v). The detection limits of PZ at a signal-to-noise ratio of 3 for rat hair and plasma were 0.18 ng/mg and 0.57 ng/mL, respectively. Reproducible and precise results could be obtained by an IS method with RSD values less than 6.6% for within- and between-day measurements. The method was successfully applied for the monitoring of PZ levels in Zucker rat hair and plasma samples after a single administration of 25 mg/kg PZ. Moreover, incorporation rates of PZ into black and white hair of Zucker rat were evaluated.     

RELATIONSHIPS AMONG SHOOT APICAL MERISTEM ONTOGENIC FEATURES IN TRICHOCEREUS PACHANOI AND MELOCACTUS MATANZANUS (CACTACEAE)

Various morphometric parameters of shoot apical meristems were measured during the ontogeny of Melocactus matanzanus and Trichocereus pachanoi. While some ontogenic features varied dramatically (i.e., apical surface curvature, dK/dl, varied by 0.15–0.17, while the apical volume increased from 10⁵ μm³ to 10⁷ or 10⁸ μm³), the percent volume of the central-mother-cell zone (CMCZ), pith-rib meristem (PRM), and the peripheral zone (PZ) showed remarkable intraspecific constancy: CMCZ = 9.2%, PRM = 10.4%, PZ = 80% for M. matanzanus, and CMCZ = 10%, PRM = 24.5%, PZ = 65% for T. pachanoi. Seedlings (2 plastochrons old) showed distinctly different percent volumes from older forms: CMCZ = 7.8%, PRM = 5.9%, PZ = 86% for M. matanzanus, and CMCZ = 8.9%, PRM = 13%, PZ = 77% for T. pachanoi. Geometric expressions of cell patterns within zones of the apex remained relatively constant throughout development. On the basis of intra- and interspecific comparisons of the percent volumes among 23 taxa and the chronology in the appearance of zones within the apex, it is concluded that while there are no apparent biological reasons for the actual percent volume values computed from our sample set, the constancy in zones reflects a high degree of homeostasis which is achieved early in ontogeny.     

Transformation zone sampling rate is a useful performance indicator for practitioners collecting cervical samples using SurePathTM liquid-based cytology system

An analysis of the reports of 53 982 liquid-based cytology (LBC) samples processed at the Royal Victoria Infirmary, Newcastle, reveals a significant relationship between the transformation zone (TZ) sampling rate observed in specimens submitted from different practices and their overall detection rate for dyskaryosis. The observed correlation (R = 0.184; P = 0.033, CI = 0.017 to 0.397) is very similar to that described previously using conventional cervical smears and confirms the potential relevance of TZ sampling rates as an indicator of consistently effective specimen collection. The correlation between unsatisfactory sample rates and detection rates for high-grade dyskaryosis (R = -0.188, P = 0.030, CI = -0.865 to -0.045) also shows a significant relationship for LBC samples which was not previously seen in conventional smears. The essential role of smear taker feedback, the use of transformation zone sampling and unsatisfactory smear rates as key indicators and the practical issues relating to routine reporting of transformation zone components are discussed.     

In vivo optical imaging of the viable epidermis around the nailfold capillaries for the assessment of heart failure severity in humans

Heart failure (HF) is among the socially significant diseases, involving over 2% of the adult population in the developed countries. Diagnostics of the HF severity remains complicated due to the absence of specific symptoms and objective criteria. Here, we present an indicator of the HF severity based on the imaging of tissue parameters around the nailfold capillaries. High resolution nailfold video capillaroscopy was performed to determine the perivascular zone (PZ) size around nailfold capillaries, and 2‐photon tomography with fluorescence lifetime imaging was used to investigate PZ composition. We found that the size of PZ around the nailfold capillaries strongly correlates with HF severity. Further investigations using 2‐photon tomography demonstrated that PZ corresponds to the border of viable epidermis and it was suggested that the PZ size variations were due to the different amounts of interstitial fluid that potentially further translates in clinically significant oedema. The obtained results allow for the development of a quantitative indicator of oedematous syndrome, which can be used in various applications to monitor the dynamics of interstitial fluid retention. We therefore suggest PZ size measured with nailfold video capillaroscopy as a novel quantitative sensitive non‐invasive marker of HF severity.      

The morphological study on the adrenal gland of African ostrich chicks

The morphology of the adrenal gland has been studied for a number of animal species all over the world, yet the detailed data about ostrich chick has not been reported. In the present study, the morphological features of the adrenal gland in African ostrich chicks were investigated by means of gross anatomy, light and electron microscope. Differences between the left and right adrenal glands were found in shape, size and location. The interrenal tissue and chromaffin cell interdigitated irregularly. The interrenal tissue was divided into a peripheral zone (PZ) and a central inner zone (CZ), and the PZ was further distinguished into an outer area (subcapsular zone, SCZ) and an inner area (IZ). The cellular arrangement in these zones showed evident zonation that resembled the mammalian. This phenomenon had been previously described only for the pelicanus. The cytoplasm of interrenal cells in SCZ was stained lightly than in IZ and CZ, and contained several vacuoles. Additionally, unlike CZ cells, SCZ cells appeared to contain more mitochondria and less lipid droplets. Two types of chromaffin cells: epinephrine cells and norepinephrine cells could be detected. The type 1 granules possessed a central core and a variable distance between membrane and core; the type 2 granules had an eccentric core, which leant to one side of granule and sticked to the membrane, giving a lager lacouna appearance in another side of the granule.     

P-5AN UNUSUAL FORM OF THYROID PAPILLARY CARCINOMA: COLUMNAR CELL VARIANT WITH NEUROENDOCRINE FEATURES

Introduction:  Quality assurance guidelines for the UK cervical screening programme recommend that more than 80% of cervical samples from women aged 20–50 years should contain adequate numbers of Transformation zone (TZ) cells i.e. 10 or more endocervical or squamous metaplastic cells. This study was conducted to assess the frequency of TZ component in Liquid Based Cytology (LBC) both for ThinPrep (TP) and SurePath (SP) LBC. Also to assess the degree to which this is recorded by individual screeners and to determine the percentage of samples with evidence of TZ component for the different smear takers.
Method:  All LBC cervical specimens received at a tertiary cytology centre in the year 2004 from women aged 20–50 years were included in the study. Evidence of TZ sampling was recorded as: TP = TZ present (10 or more TZ cells)TA = TZ absentTS = TZ scanty (less than 10 TZ cells)TN = atrophic smears, TZ cells not recognisable
Results:  The total number of LBC cervical cases was 7445. TP = 4300 (mostly primary care) and SP = 3145 (mostly colposcopy). Overall TZ sampling rate in LBC was 82%. TP = 77.17%; SP = 88.24%. When scanty TZ was included, the standard was met for both systems (TP = 93.7%; SP = 88.24%). Presence/absence of TZ component was recorded in 6370 cases (85.1%); range 0%–97.79%. 56.7% of smear takers achieved the minimum standard for TZ sampling.
Discussion:  The percentage of ThinPrep samples containing adequate TZ cells was 77.17% compared to SurePath, which was 88.24%. This may be due to different patient populations i.e. primary care versus colposcopy. Screeners recorded TZ sampling in approximately 85% of samples. 56.7% of smear takers met the standard for TZ sampling.     

P‐4TRANSFORMATION ZONE COMPONENT IN LIQUID BASED CERVICAL CYTOLOGY

Introduction: Quality assurance guidelines for the UK cervical screening programme recommend that more than 80% of cervical samples from women aged 20–50 years should contain adequate numbers of Transformation zone (TZ) cells i.e. 10 or more endocervical or squamous metaplastic cells. This study was conducted to assess the frequency of TZ component in Liquid Based Cytology (LBC) both for ThinPrep (TP) and SurePath (SP) LBC. Also to assess the degree to which this is recorded by individual screeners and to determine the percentage of samples with evidence of TZ component for the different smear takers. Method: All LBC cervical specimens received at a tertiary cytology centre in the year 2004 from women aged 20–50 years were included in the study. Evidence of TZ sampling was recorded as: TP = TZ present (10 or more TZ cells)TA = TZ absentTS = TZ scanty (less than 10 TZ cells)TN = atrophic smears, TZ cells not recognisable Results: The total number of LBC cervical cases was 7445. TP = 4300 (mostly primary care) and SP = 3145 (mostly colposcopy). Overall TZ sampling rate in LBC was 82%. TP = 77.17%; SP = 88.24%. When scanty TZ was included, the standard was met for both systems (TP = 93.7%; SP = 88.24%). Presence/absence of TZ component was recorded in 6370 cases (85.1%); range 0%–97.79%. 56.7% of smear takers achieved the minimum standard for TZ sampling. Discussion: The percentage of ThinPrep samples containing adequate TZ cells was 77.17% compared to SurePath, which was 88.24%. This may be due to different patient populations i.e. primary care versus colposcopy. Screeners recorded TZ sampling in approximately 85% of samples. 56.7% of smear takers met the standard for TZ sampling.     

不同年龄段前列腺外周带基质细胞超微结构差异

目的:研究不同年龄段前列腺外周带基质细胞超微结构并探讨其意义。方法:透射电镜观察3例年轻组(23-、26-、32-岁)和3例老年组(56-、64-、71-岁)正常前列腺外周带和3例前列腺癌组织的超微结构。Masson’s Trichrome染色法观察前列腺外周带基质胶原的分布情况。结果:年轻组、老年组前列腺外周带间质均以平滑肌细胞分布为主,间杂成纤维细胞,但老年组平滑肌细胞和成纤维细胞体积较大、形态不规则。与正常年轻组相比,老年组前列腺外周带成纤维细胞存在明显老化和肌化改变,部分细胞内与蛋白合成相关的细胞器粗面内质网发达,呈现肌成纤维细胞特征。与年轻组和老年组外周带相比,前列腺癌基质中功能更加活跃的肌成纤维细胞和胶原蛋白数量增加明显。Masson’s Trichrome染色支持超微观察到的基质胶原分布差异:年轻组<老年组<前列腺癌组。结论:不同年龄段前列腺外周带基质细胞超微结构间存在差异,老年组前列腺外周带和前列腺癌基质组织中具有活性的肌成纤维细胞的增加可能是造成老年前列腺癌高发和恶性进展的重要病理基础之一。     

Local regulation of auxin transport in root-apex transition zone mediates aluminium-induced Arabidopsis root-growth inhibition

Aluminium (Al) stress is a major limiting factor for worldwide crop production in acid soils. In Arabidopsis thaliana, the TAA1-dependent local auxin biosynthesis in the root-apex transition zone (TZ), the major perception site for Al toxicity, is crucial for the Al-induced root-growth inhibition, while the mechanism underlying Al-regulated auxin accumulation in the TZ is not fully understood. In the present study, the role of auxin transport in Al-induced local auxin accumulation in the TZ and root-growth inhibition was investigated. Our results showed that PIN-FORMED (PIN) proteins such as PIN1, PIN3, PIN4 and PIN7 and AUX1/LAX proteins such as AUX1, LAX1 and LAX2 were all ectopically up-regulated in the root-apex TZ in response to Al stress and coordinately regulated local auxin accumulation in the TZ and root-growth inhibition. The ectopic up-regulation of PIN1 in the TZ under Al stress was regulated by both ethylene and auxin, with auxin signalling acting downstream of ethylene. Al-induced PIN1 up-regulation and auxin accumulation in the root-apex TZ was also regulated by the calossin-like protein BIG. Together, our results provide insight into how Al stress induces local auxin accumulation in the TZ and root-growth inhibition through the local regulation of auxin transport.     

Cell Sorting and Chondrogenic Aggregate Formation in Limb Bud Recombinants and in Culture

The cartilage pattern of the developing chick limb changes along the proximal-distal (PD) axis. It is assumed that these spatial changes are brought about by differences in the cellular properties of distal mesoderm, the progress zone (PZ). To examine whether these differences are actually maintained in the individual cells composing the PZ, we dissociated early (stage 20) and late (stage 25) PZ tissues into single cells, then mixed and recombined them with ectodermal jackets. The recombinants were grafted to limb bud stumps and allowed to develop into limb-like structures. Early PZ cells were distributed within whole cartilage elements along the PD axis of the limb-like structures, while cells from late PZ participated only in the formation of distal cartilage elements.
A difference in distribution pattern between the cells of early and late PZ in mixed culture was also observed. Cells of early PZ aggregated rapidly in patches and formed cartilage nodules, while the cells of late PZ distributed in regions surrounding these cell aggregates and gradually differentiated to cartilage cells. These results suggest that the cellular properties in the PZ concerning the rate of chondrogenic aggregate formation change during limb bud development, and that this change may relate to the cartilage pattern formation along the PD axis.     

Range restricted grasshoppers better conserved in a terrestrial zone than in a riparian zone

Riparian zones (RZs) functionally connect aquatic and terrestrial ecosystems, and have azonal and geographically widespread plant communities that differ from those of the neighboring terrestrial zone (TZ). Although well studied botanically, RZs are not well understood in terms of their terrestrial insect diversity, including grasshoppers. The Cape Floristic Region (CFR) is a global biodiversity hotspot with small rocky rivers running through highly diverse sclerophyllous vegetation. It has high levels of endemism among many taxa, including grasshoppers, making it ideal for testing the effect of azonal vegetation on grasshopper assemblages of the RZ, and determining whether conservation efforts should be focused on the RZ as well as the TZ. We determine grasshopper dispersion patterns along the RZ of an important CFR river, and compare these patterns with those of the TZ to understand the habitat occupancy relative to 27 environmental variables of the zones and geographical distribution of the grasshoppers. Forty percent of individuals we collected were CFR endemics. We found only weak differences in the grasshopper assemblages between the RZ and TZ, apparently driven by deep history, complex geomorphology, stressful environmental conditions, a diverse vegetation and land mosaic, and probable high predator pressure. There were two groups: large-sized, well-flighted, geographically widespread generalists that were overall more abundant in the RZ than TZ, and small, flightless or poorly-flighted, vegetation-specialists which are narrow-range endemics adapted to both RZ and TZ, but still more abundant in the TZ. We conclude that although the vegetation of this riparian zone may require some special conservation attention, this is not so for the grasshoppers which overall are best conserved in the TZ.     

Efficiency of Non-Contrast-Enhanced Liver Imaging Sequences Added to Initial Rectal MRI in Rectal Cancer Patients

Purpose

The purpose of this study was to estimate the value of addition of liver imaging to initial rectal magnetic resonance imaging (MRI) for detection of liver metastasis and evaluate imaging predictors of a high risk of liver metastasis on rectal MRI.

Methods

We enrolled 144 patients who from October 2010 to May 2013 underwent rectal MRI with T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) (b values = 50, 500, and 900 s/mm²) of the liver and abdominopelvic computed tomography (APCT) for the initial staging of rectal cancer. Two reviewers scored the possibility of liver metastasis on different sets of liver images (T2WI, DWI, and combined T2WI and DWI) and APCT and reached a conclusion by consensus for different analytic results. Imaging features from rectal MRI were also analyzed. The diagnostic performances of CT and an additional liver scan to detect liver metastasis were compared. Multivariate logistic regression to determine independent predictors of liver metastasis among rectal MRI features and tumor markers was performed. This retrospective study was approved by the Institutional Review Board, and the requirement for informed consent was waived.

Results

All sets of liver images were more effective than APCT for detecting liver metastasis, and DWI was the most effective. Perivascular stranding and anal sphincter invasion were statistically significant for liver metastasis (p = 0.0077 and p = 0.0471), while extramural vascular invasion based on MRI (mrEMVI) was marginally significant (p = 0.0534).

Conclusion

The addition of non-contrast-enhanced liver imaging, particularly DWI, to initial rectal MRI in rectal cancer patients could facilitate detection of liver metastasis without APCT. Perivascular stranding, anal sphincter invasion, and mrEMVI detected on rectal MRI were important imaging predictors of liver metastasis.