VI-RADS for bladder cancer: current applications and future developments

Bladder cancer (BCa) is among the ten most frequent cancers globally. It is the tumor with the highest lifetime treatment-associated costs, and among the tumors with the heaviest impacts on postoperative quality of life. The purpose of this article is to review the current applications and future perspectives of the Vesical Imaging Reporting and Data System (VI-RADS). VI-RADS is a newly developed scoring system aimed at standardization of MRI acquisition, interpretation, and reporting for BCa. An insight will be given on the BCa natural history, current MRI applications for local BCa staging with assessment of muscle invasiveness, and clinical implications of the score for disease management. Future applications include risk stratification of nonmuscle invasive BCa, surveillance, and prediction and monitoring of therapy response. Level of Evidence: 3. Technical Efficacy Stage: 2

Interobserver reproducibility of the PRECISE scoring system for prostate MRI on active surveillance: results from a two-centre pilot study

OBJECTIVES: We aimed to determine the interobserver reproducibility of the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) criteria for magnetic resonance imaging in patients on active surveillance (AS) for prostate cancer (PCa) at two different academic centres. METHODS: The PRECISE criteria score the likelihood of clinically significant change over time. The system is a 1-to-5 scale, where 1 or 2 implies regression of a previously visible lesion, 3 denotes stability and 4 or 5 indicates radiological progression. A retrospective analysis of 80 patients (40 from each centre) on AS with a biopsy-confirmed low- or intermediate-risk PCa (i.e. ≤ Gleason 3 + 4 and prostate-specific antigen ≤ 20 ng/ml) and ≥ 2 prostate MR scans was performed. Two blinded radiologists reported all scans independently and scored the likelihood of radiological change (PRECISE score) from the second scan onwards. Cohen's κ coefficients and percent agreement were computed. RESULTS: Agreement was substantial both at a per-patient and a per-scan level (κ = 0.71 and 0.61; percent agreement = 79% and 81%, respectively) for each PRECISE score. The agreement was superior (κ = 0.83 and 0.67; percent agreement = 90% and 91%, respectively) when the PRECISE scores were grouped according to the absence/presence of radiological progression (PRECISE 1-3 vs 4-5). Higher inter-reader agreement was observed for the scans performed at University College London (UCL) (κ = 0.81 vs 0.55 on a per-patient level and κ = 0.70 vs 0.48 on a per-scan level, respectively). The discrepancies between institutions were less evident for percent agreement (80% vs 78% and 86% vs 75%, respectively). CONCLUSIONS: Expert radiologists achieved substantial reproducibility for the PRECISE scoring system, especially when data were pooled together according to the absence/presence of radiological progression (PRECISE 1-3 vs 4-5). KEY POINTS: • Inter-reader agreement between two experienced prostate radiologists using the PRECISE criteria was substantial. • The agreement was higher when the PRECISE scores were grouped according to the absence/presence of radiological progression (i.e. PRECISE 1-3 vs PRECISE 4 and 5). • Higher inter-reader agreement was observed for the scans performed at UCL, but the discrepancies between institutions were less evident for percent agreement

Reconciling the stratigraphy and depositional history of the Lycian orogen-top basins, SW Anatolia

Terrestrial fossil records from the SWAnatolian basins are crucial both for regional correlations and palaeoenvironmental reconstructions. By reassessing biostratigraphic constraints and incorporating new fossil data, we calibrated and reconstructed the late Neogene andQuaternary palaeoenvironments within a regional palaeogeographical framework. The culmination of the Taurides inSWAnatolia was followed by a regional crustal extension from the late Tortonian onwards that created a broad array of NE-trending orogen-top basins with synchronic associations of alluvial fan, fluvial and lacustrine deposits. The terrestrial basins are superimposed on the upper Burdigalian marine units with a c. 7 myr of hiatus that corresponds to a shift from regional shortening to extension. The initial infill of these basins is documented by a transition from marginal alluvial fans and axial fluvial systems into central shallow-perennial lakes coinciding with a climatic shift from warm/humid to arid conditions. The basal alluvial fan deposits abound in fossil macro-mammals of an early Turolian (MN11–12; late Tortonian) age. The Pliocene epoch in the region was punctuated by subhumid/humid conditions resulting in a rise of local base levels and expansion of lakes as evidenced by marsh-swamp deposits containing diverse fossilmammal assemblages indicating late Ruscinian (lateMN15; late Zanclean) ageWe are grateful for the support of the international bilateral project between The Scientific and Technological Research Council of Turkey (TUBITAK) and The Russian Scientific Foundation (RFBR) with grant a number of 111Y192. M.C.A. is grateful to the Turkish Academy of Sciences (TUBA) for a GEBIP (Young Scientist Award) grant. T.K. and S.M. are grateful to the Ege University Scientific Research Center for the TTM/002/2016 and TTM/001/2016 projects. M.C.A., H.A., S.M. and M.B. have obtained Martin and Temmick Fellowships at Naturalis Biodiversity Center (Leiden). F.A.D. is supported by a Mehmet Akif Ersoy University Scientific Research Grant. T.A.N. is supported by an Alexander-von-Humboldt Scholarship. L.H.O. received support from TUBITAK under the 2221 program for visiting scientists

"If two witches would watch two watches, which witch would watch which watch?" tDCS over the left frontal region modulates tongue twister repetition in healthy subjects

Recent studies have demonstrated that transcranial direct current stimulation (tDCS) modulates cortical activity in the human brain. In the language domain, it has already been shown that during a naming task tDCS reduces vocal reaction times in healthy individuals and speeds up the recovery process in left brain-damaged aphasic subjects. In this study, we wondered whether tDCS would influence the ability to articulate tongue twisters during a repetition task. Three groups of 10 healthy individuals were asked to repeat a list of tongue twisters in three different stimulation conditions: one group performed the task during anodal tDCS (atDCS) (20min, 2mA) over the left frontal region; a second group during cathodal tDCS delivered over the same region; and, in a third group, sham stimulation was applied. Accuracy and vocal reaction times in repeating each tongue twister before, during and 1h after the stimulation were recorded. Participants were more accurate and faster at repeating the stimuli during atDCS than at baseline, while cathodal tDCS significantly reduced their performance in terms of accuracy and reaction times. No significant differences were observed among the three time points during the sham condition. We believe that these data clearly confirm that the left frontal region is critically involved in the process of speech repetition. They are also in line with recent evidence suggesting that frontal tDCS might be used as a therapeutic tool in patients suffering from articulatory deficits

High-frequency cyclicity in the latest Messinian Adriatic foreland basin: Iinsight into palaeoclimate and palaeoenvironments of the Mediterranean Lago-Mare episode

Late Messinian Lago-Mare deposits show high-frequency cyclicity in the whole Mediterranean Basin. Both millimeter- and centimeter-scale cyclicities have been observed in several ODP sites as well as in stratigraphic sections from the Mediterranean borderland. We have analyzed a well-exposed late Messinian Lago-Mare section from the Adriatic side of the central Apennines (Italy). At the Fonte dei Pulcini section (SE Majella Mts.), millimeter- and centimeter-scale white-and-dark couplets have been observed in the field. A 50 cm regular-spaced sampling has been performed in the uppermost 53 m of the late Messinian Lago- Mare clays. On the 107 collected samples, geochemical (CaCO3 content), mineralogical (XRD analyses), and micropalaeontological investigations have been performed. In addition, SEM and microprobe investigations as well as mineralogical and micropalaeontological analyses have been carried out on single lamina from a 34-cm-thick interval of millimeter-scale laminites. Besides the 103 cycles/m and 102 cycles/m frequencies observed in the field, spectral analyses performed on the CaCO3 data set indicated other high-frequency cyclicities: 0.47 cycles/m, 0.35 cycles/m, and 0.17 cycles/m. Taking into account the estimated sedimentation rate, these frequencies correspond, respectively, to periodicities of: 1 year, 10 years, 2.1 kyr, 2.8 kyr, and 5.6 kyr. These sub-Milankovitch cyclicities have been related to annual and sunspot solar activity. The millimeter-scale couplets are interpreted as varves sedimented in an ephemeral water environment marginal to a perennial brackish water lagoonal basin. These varved sediments reflect a marked seasonality characterized by the alternation of arid and more humid climatic phases. The presence of high values of smectite (60–80%) in the clay minerals of the analyzed samples could be a consequence of these climatic oscillations from drier to moister conditions. The climatic scenario suggested in this paper for the late Messinian Lago-Mare episode is in agreement with the monsoon system that, according to some authors, starting from 5.8 Ma developed in the Mediterranean area

High-frequency cyclicity in the latest Messinian Adriatic foreland basin: Insight into palaeoclimate and palaeoenvironments of the Mediterranean Lago-Mare episode

Late Messinian Lago-Mare deposits show high-frequency cyclicity in the whole Mediterranean Basin. Both millimeter- and centimeter-scale cyclicities have been observed in several ODP sites as well as in stratigraphic sections from the Mediterranean borderland. We have analyzed a well-exposed late Messinian Lago-Mare section from the Adriatic side of the central Apennines (Italy). At the Fonte dei Pulcini section (SE Majella Mts.), millimeter- and centimeter-scale white-and-dark couplets have been observed in the field. A 50 cm regular-spaced sampling has been performed in the uppermost 53 m of the late Messinian Lago- Mare clays. On the 107 collected samples, geochemical (CaCO3 content), mineralogical (XRD analyses), and micropalaeontological investigations have been performed. In addition, SEM and microprobe investigations as well as mineralogical and micropalaeontological analyses have been carried out on single lamina from a 34-cm-thick interval of millimeter-scale laminites. Besides the 103 cycles/m and 102 cycles/m frequencies observed in the field, spectral analyses performed on the CaCO3 data set indicated other high-frequency cyclicities: 0.47 cycles/m, 0.35 cycles/m, and 0.17 cycles/m. Taking into account the estimated sedimentation rate, these frequencies correspond, respectively, to periodicities of: 1 year, 10 years, 2.1 kyr, 2.8 kyr, and 5.6 kyr. These sub-Milankovitch cyclicities have been related to annual and sunspot solar activity. The millimeter-scale couplets are interpreted as varves sedimented in an ephemeral water environment marginal to a perennial brackish water lagoonal basin. These varved sediments reflect a marked seasonality characterized by the alternation of arid and more humid climatic phases. The presence of high values of smectite (60–80%) in the clay minerals of the analyzed samples could be a consequence of these climatic oscillations from drier to moister conditions. The climatic scenario suggested in this paper for the late Messinian Lago-Mare episode is in agreement with the monsoon system that, according to some authors, starting from 5.8 Ma developed in the Mediterranean area