Background: Prostate cancer is the most common malignancy in men and the second leading cause of death in all countries of the world. The exact mechanism of prostate cancer is not known. On the other hand, early detection of prostate cancer can lead to a complete cure. Several clinical experiments including Digital Rectum Examination (DRE), biochemistry such as Prostate Specific Antigen (PSA), and pathology such as Trans Rectal Ultra Sonography (TRUS) are used to assess the size and spread of prostate cancer. In this study, the relationship between mean serum PSA and Gleason score as a standard method in patients with prostate cancer was compared using the parameters extracted from DCE MRI. Methods: This applied-fundamental study was performed on 90 patients with prostate cancer, according to McDonald's criteria who were referred to Shafa Imaging Center in Isfahan, from March 2020 to October 2020. Quantitative analysis is based on modeling the change of concentration of the contrast agent using pharmacokinetic modeling techniques. The pathologist then determined the Gleason score using anatomical landmarks (such as prostate urethra) in the same areas suspected of being cancerous. Existing commercial software captures DCE-MRI data and creates parametric maps such as Ktrans and Kep maps that can be used for diagnostic purposes. Results: Kep and Ktrans maps showed a significant difference between healthy and cancerous tissue. Kep and Ktrans in prostate cancer were significantly higher than in healthy tissue (P<0. 05). Pearson correlation coefficient was used to investigate the relationship between DCE-MRI parameters and histopathological findings. No significant relationship was observed between Gleason score and DCE MRI parameters. Conclusion: DCE MRI parameters significantly improve the accurate diagnosis of prostate cancer and are useful and effective for diagnosis, management, and evaluation of men with prostate cancer, but should not be considered as a substitute for tissue biopsy.

Background: this study focused on evaluating the effectiveness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with cervical cancer (CC) undergoing neoadjuvant chemotherapy and radiation therapy. Materials and Methods: a total of 58 CC patients were included, undergoing examination through DCE-MRI scans. Subsequently, all cases were divided into two groups: the chemotherapy-effective group (32 cases) including complete response (CR) and partial response (PR), and the chemotherapy-ineffective group (26 cases) including stable disease (SD) and disease progression (PD). Results: after treatment, the average maximum diameter of tumors in the chemotherapy and radiation therapy failure group was 4.38 ± 1.23 cm, drastically larger than the 2.51±0.64 cm in the chemotherapy and radiation therapy response group (P < 0.05). Before treatment, the Ktrans of the chemotherapy and radiation therapy response group was superior to that of the failure group, while Ve was inferior to the latter (P < 0.05). After treatment, the Ktrans of the chemotherapy and radiation therapy response group decreased, showing a more drastic reduction compared to the failure group (P < 0.05). The Ktrans of the chemotherapy and radiation therapy response group was drastically inferior to that of the failure group, with statistical significance (P<0.05). The ΔKtrans% in the chemotherapy and radiation therapy response group was negative, inferior to pre-treatment values. In contrast, the ΔKtrans% in the chemotherapy and radiation therapy failure group was positive, superior to pre-treatment values (P < 0.05). Conclusion: DCE-MRI demonstrates excellent scanning performance for CC, accurately monitoring the blood flow signals of CC tumors. Ktrans, Ve, and ΔKtrans have high predictive value in neoadjuvant chemotherapy and radiation therapy.

Background: Dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) is a relatively new imaging technique that provides additional information on vascularity and permeability of the uterine tissues to improve decision making in patient management. Objectives: The purpose of this study was to obtain the quantitative DCE-MRI parameters of symptomatic uterine fibroids and compare to the parameters obtained from normal myometrium, endometrium, and cervix. Patients and Methods: Nineteen patients (aged 40 5 years) with the clinical diagnosis of uterine fibroids were recruited. After routine MRI pelvis scan, DCE-MRI was performed using T1 volumetric liver acquisition with volume acceleration (LAVA) sequence. The data were post-processed using an independent DCE-MRI analysis software. ROI was drawn on the fibroid and the quantitative DCE-MRI parameters i. e. Ktrans (volume transfer between the blood plasma and extracellular fluid), Kep [flux rate constant between the extracellular extravascular space (EES) and blood plasma], Ve (EES fractional volume), and semi-quantitative parameters i. e. TTP (time to peak), and IAUGC (initial area under the gadolinium concentration-time curve) were determined. The patients then underwent hysterectomy and uterine fibroids were confirmed in all the patients by histopathology results. In the control group, fifteen healthy volunteers (aged 32 6 years) who did not have uterine fibroid confirmed by sonography examination were recruited. The volunteers underwent the same DCE-MRI scan as the patients and the quantitative DCE-MRI parameters of the normalmyometrium, endometrium and cervix were obtained. The DCE-MRI parameters from these two groups were then compared. Results: The median Ktrans in the myometrium, endometrium and cervix of the healthy volunteers were 0. 26  0. 13, 0. 20  0. 15, and 0. 30  0. 13 min-1, respectively. No statistical significant difference was found in all the DCE-MRI parameters between the myometrium, endometrium and cervix of the healthy volunteers. The median Ktrans in fibroids was 0. 50  0. 25 min-1. There were statistically significant differences (P < 0. 05) found in Ktrans and Ve between the normal myometrium and fibroid tissue. Conclusions: The Ktrans and Ve of fibroid tissue were statistically significantly higher than those obtained from the normal myometrium, whereby the suggested cut-off values were 0. 47min-1 (sensitivity 64. 7%, specificity 92. 3%) and 0. 62 (sensitivity 70. 6%, specificity 78. 6%), respectively. Quantitative DCE-MRI findings from this study may provide a foundation for assessment of other uterine pathologies.

Background: To differentiate prostate cancer and benignprostatichyperplasia by WAHPP (the whole lesion histogram analysis of the pharmacokineticparameters) of dynamic contrast-enhancedMRI (DCE-MRI). Materials and Methods: Totally 62 patients with elevated prostate specific antigen (PSA) (> 4 ng/ml) were grouped as prostate cancer (PCa) group (n=33) and benign prostatic hyperplasia (BPH) group (n=29) based on transrectal ultrasound (TRUS)-guided random biopsy diagnosis and their WAHPP-Ktrans (constant is transferred from the blood plasma to the extracellular extravascular (EE) space), Kep (back into blood plasma at a steady rate from EE space), Ve (EE volume fraction) and Vp (fractional blood plasma volume) were compared. Results: WHAPP shows the 5th percentile and entropy of Ktrans, 5th/10th/25th/50th/75th/90th/95th percentiles, mean value and entropy of Kep, 5th percentile and uniformity of Ve, 5th/10th/25th/50th/75th percentiles, Vp had a considerably greater mean value and entropy in PCa than in BPH (p0. 05). The 90th percentile of Kep's maximum AUC (area under the curve) was 0. 764, according to receiver operating characteristic (ROC) study, the Youden index 0. 5507, the sensitivity 75. 76%, and the specificity 79. 31%. Conclusion: Ktrans, Kep, and Ve of WHAPP canbe used to quantify prostate DCE-MRI. The 90th percentile of Kep possibly will be the best indicator for the differential diagnosis of malignant and BPH.

Background: Magnetic resonance imaging (MRI) can provide a reference for tumor treatment and its quantitative parameters canserve as imaging indicators that reflect tumor angiogenesis and vascularity. Kanglaite (KLT) has therapeutic effects on cancers. Inthis study, DCE-MRI was used to investigate its application in evaluating KLT anti-colorectal cancer. Objectives: Evaluating the efficacy of Kanglaite (KLT) injection for treatment of colorectal cancer with dynamic contrast-enhancedMRI (DCE-MRI) parameters. Methods: This study was an experimental study. The 20 successfully modeled nude mice were randomly assigned to 2 groups: blank control group (n = 10) and the KLT injection group (n = 10). The research protocol was approved by the ethics committee ofthe second affiliated hospital of Xinjiang medical university (protocol NO: 20140216-12) in 2015. A subcutaneous xenograft colorectaltumor model was subjected to KLT treatment. DCE-MRI obtain the parameters including Ktrans, Ve, Kep, Vp, immunohistochemicalstaining measure microvascular density (MVD), levels of vascular endothelial growth factor (VEGF), and proliferating cell nuclearantigen (PCNA). Results: Compared to the blank control, the volume of tumor in the KLT group markedly reduced by 49%. 48 hours after, comparedto the blank control, the Ktrans (0. 028 0. 009 vs 0. 012 0. 006), Ve (0. 312 0. 089 vs 0. 287 0. 037), and Kep values (0. 321 0. 056vs 0. 577  0. 033) decreased in KLT group (P < 0. 05). In contrast, the Vp value (0. 094  0. 037 vs 0. 043  0. 017) was significantlyelevated in the KLT group (P < 0. 05). There is a correlation between Ktrans, Kep and VEGF score, MVD count, and PCNA score. Conclusions: Theparameters of DCE-MRImaybeused asimagingbiomarkers for assessing the status of tumor-bearing vasculaturesand provide a basis for evaluating the efficacy of anti-tumor drugs.

Introduction: blood-brain-barrier perfusion characterization impaired in MS as some studies have shown recently but a comparison between perfusion parameters in contrast-enhanced and non-enhanced lesions not have been well documented. Pharmacokinetic quantitative parameters have obtained from dynamic contrast-enhanced in magnetic resonance imaging is a useful way to quantify blood-brain barrier permeability leakage. Methods: MR examination was performed on 28 patients with Relapsing-remitted Multiple Sclerosis (RRMS) with (Mean±, SD age: 34. 7±, 9. 28) which had multiple lesions in the brain. 3D dynamic T1-weighted spoiled gradient echo was obtained and Perfusion parameters and its map assessed in enhanced and non-enhanced lesions after intravascular injection differences in parameters and map obtained by analyzing ROI in Extended Toft model. Results: permeability as measured Krtans was a significantly higher value in CE to compare NE lesions. Ktrans and Kep have significant differences in NAWM and CE and NE lesions. Vb was slightly different in NE and CE lesions. Conclusion: Permeability measured as Ktrans was the good parameter to show permeability impairment of BBB in CE lesions. Dysregulation in BBB is an acceptable sign to indicate existence inflammation in CE lesions

Background: Our study was to evaluate the value of contrast-enhanced ultrasonography (CEUS) and contrast-enhanced magnetic resonance imaging (CE-MRI) in analyzing the blood vessels associated with ovarian tumors. Materials and Methods: A total of 100 patients with ovarian tumors underwent CEUS and CE-MRI before surgery. After surgery, the resected ovarian tissues were evaluated via immunohistochemistry to calculate the tumor microvessel density (MVD), and the correlation between the parameters of CEUS and CE-MRI and MVD in ovarian tumors was determined. Results: The MVD level between ovarian tumors was significantly different (p = 0. 03),the peak intensity (PI) and area under the curve (AUC) of CEUS parameters in malignant tumors were significantly higher than those in benign tumors (p = 0. 03, p = 0. 03),and were significantly positively correlated with MVD (r = 0. 57, p = 0. 00,r = 0. 50, p = 0. 00). The Ktrans and Ve of CE-MRI parameters in malignant tumors were significantly higher than those in benign tumors (p = 0. 01 and p = 0. 04), and were also significantly positively correlated with MVD (r = 0. 66, p = 0. 00,r = 0. 55, p = 0. 00). Moreover, there was no significant difference between CEUS and CE-MRI in terms of sensitivity (Se), specificity (Sp), negative predictive value (NPV) and positive predictive value (PPV) in malignant ovarian tumors (p > 0. 05). Conclusion: Both CEUS and CE-MRI parameters can reflect the MVD level in ovarian tumors,therefore, CEUS is expected to become a viable alternative approach for evaluating ovarian tumors.

Background: Characterization of parotid tumors before surgery using multiparametric magnetic resonance imaging (MRI) scans can support clinical decision making about the best-suited therapeutic strategy for each patient. Objective: This study aims to differentiate benign from malignant parotid tumors through radiomics analysis of multi-parametric MR images, incorporating T2-w images with ADC-map and parametric maps generated from Dynamic Contrast Enhanced MRI (DCE-MRI). Material and Methods: MRI scans of 31 patients with histopathologicallyconfirmed parotid gland tumors (23 benign, 8 malignant) were included in this retrospective study. For DCE-MRI, semi-quantitative analysis, Tofts pharmacokinetic (PK) modeling, and five-parameter sigmoid modeling were performed and parametric maps were generated. For each patient, borders of the tumors were delineated on whole tumor slices of T2-w image, ADC-map, and the late-enhancement dynamic series of DCE-MRI, creating regions-of-interest (ROIs). Radiomic analysis was performed for the specified ROIs. Results: Among the DCE-MRI-derived parametric maps, wash-in rate (WIR) and PK-derived Ktrans parameters surpassed the accuracy of other parameters based on support vector machine (SVM) classifier. Radiomics analysis of ADC-map outperformed the T2-w and DCE-MRI techniques using the simpler classifier, suggestive of its inherently high sensitivity and specificity. Radiomics analysis of the combination of T2-w image, ADC-map, and DCE-MRI parametric maps resulted in accuracy of 100% with both classifiers with fewer numbers of selected texture features than individual images. Conclusion: In conclusion, radiomics analysis is a reliable quantitative approach for discrimination of parotid tumors and can be employed as a computeraided approach for pre-operative diagnosis and treatment planning of the patients.

Background: Studying different pathological aspects of lesions in multiple sclerosis (MS) patients could be useful to modify the diagnosis and treatment of this neurological disorder. Magnetic resonance imaging (MRI) modalities have the potential to investigate variations in brain tissue because of inflammatory and neurodegenerative processes in various types of MS-related lesions. Objectives: This study was done to investigate the quantitative changes in MRI-based parameters, like perfusion and magnetization transfer ratio (MTR) of different types of brain lesions, to demonstrate the ability of MRI to detect structural and pathological differences in MS lesions. Methods: Quantitative MRI modalities were performed on 18 patients with five different kinds of lesions (T1 holes, acute and chronic white matter (WM), and acute and chronic gray matter (GM) lesions) using a 3 T MRI scanner. The following protocols were used to characterize the pathology of lesions: (I) fluid-attenuated inversion recovery (FLAIR); (II) pre-and post-contrast T1-weighted; (III) dynamic contrast-enhanced (DCE); and (IV)MTRimaging. Quantitative comparison of Ktrans, cerebral blood volume (CBV), cerebral blood flow (CBF), and MTR was done to find the best parameter to distinguish different lesions. Finally, a multivariate classifier was applied to introduce the best parameter to indicate differences in lesions. Results: Five lesions were characterized by perfusion and MTR parameters. The pathological changes were measured, including: (I) the highest value of parameters in both acuteWMand GM lesions; (II) the lowest value of four parameters in both chronicWMand GM lesions; (III) MTR had the highest rank among parameters using the classifier. Conclusions: The degree of pathological alterations due to inflammatory and neurodegenerative processes in MS-related lesions was indicated through the used parameters in different kinds of lesions. Inflammation was the dominant process in acute lesions, while neurodegeneration and tissue loss were observed mostly in chronic lesions. Both inflammation and neurodegeneration were detected in T1 holes. Perfusion parameters and MTR were reasonable parameters to describe differences in brain lesions. Thus, it could be confirmed that magnetization transfer imaging (MTI) and DCE-MRI are high-sensitivity methods to detect microstructural changes in the brain and subtle changes in the blood-brain-barrier. Classification of the parameters indicated that MTR was the best biomarker than others to show variations in lesions pathology.