MRI of Breast Lesions

In Magnetic Resonance Mammography (MRM) high spatial as well as temporal resolution is of utmost importance for differentiating between malignant and benign lesions. Therefore, a so‐called dynamic technique (i.e., the repetitive imaging of the same slices before and in short time intervals after the injection of contrast medium) is essential to detect the differences in initial enhancements between malignant and benign lesions which are reflected by the tumorangiogenetic vascular network of malignant lesions. This unit presents a basic protocol and several alternate protocols for dynamic MRM.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145284/1/cpmia2101.pd

The delivery of personalised, precision medicines via synthetic proteins

Introduction: The design of advanced drug delivery systems based on synthetic and su-pramolecular chemistry has been very successful. Liposomal doxorubicin (Caelyx®), and liposomal daunorubicin (DaunoXome®), estradiol topical emulsion (EstrasorbTM) as well as soluble or erodible polymer systems such as pegaspargase (Oncaspar®) or goserelin acetate (Zoladex®) represent considerable achievements. The Problem: As deliverables have evolved from low molecular weight drugs to biologics (currently representing approximately 30% of the market), so too have the demands made of advanced drug delivery technology. In parallel, the field of membrane trafficking (and endocytosis) has also matured. The trafficking of specific receptors i.e. material to be recycled or destroyed, as well as the trafficking of protein toxins has been well characterized. This, in conjunction with an ability to engineer synthetic, recombinant proteins provides several possibilities. The Solution: The first is using recombinant proteins as drugs i.e. denileukin diftitox (Ontak®) or agalsidase beta (Fabrazyme®). The second is the opportunity to use protein toxin architecture to reach targets that are not normally accessible. This may be achieved by grafting regulatory domains from multiple species to form synthetic proteins, engineered to do multiple jobs. Examples include access to the nucleocytosolic compartment. Herein the use of synthetic proteins for drug delivery has been reviewed

Macrosocial determinants of population health in the context of globalization

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55738/1/florey_globalization_2007.pd

Multi-trait genome-wide association study identifies new loci associated with optic disc parameters

A new avenue of mining published genome-wide association studies includes the joint analysis of related traits. The power of this approach depends on the genetic correlation of traits, which reflects the number of pleiotropic loci, i.e. genetic loci influencing multiple traits. Here, we applied new meta-analyses of optic nerve head (ONH) related traits implicated in primary open-angle glaucoma (POAG); intraocular pressure and central corneal thickness using Haplotype reference consortium imputations. We performed a multi-trait analysis of ONH parameters cup area, disc area and vertical cup-disc ratio. We uncover new variants; rs11158547 in PPP1R36-PLEKHG3 and rs1028727 near SERPINE3 at genome-wide significance that replicate in independent Asian cohorts imputed to 1000 Genomes. At this point, validation of these variants in POAG cohorts is hampered by the high degree of heterogeneity. Our results show that multi-trait analysis is a valid approach to identify novel pleiotropic variants for ONH

Reply to Byung Kwan Park's Letter to the Editor re: Baris Turkbey, Andrew B. Rosenkrantz, Masoom A. Haider, et al. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2. Eur Urol 2019;76:329-40

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PI-RADS Version 2: A Pictorial Update

The Prostate Imaging Reporting and Data System (PI-RADS) is the result of an extensive international collaborative effort. PI-RADS provides a comprehensive yet practical set of guidelines for the interpretation and reporting of prostate multiparametric magnetic resonance (MR) imaging that will promote the use of this modality for detecting clinically significant prostate cancer. The revised PI-RADS version (PI-RADS version 2) introduces important changes to the original system used for assessing the level of suspicion for clinically significant cancer with multiparametric MR imaging. For peripheral zone abnormalities in PI-RADS version 2, the score obtained from the apparent diffusion coefficient (ADC) map in combination with diffusion-weighted imaging (DWI) performed with high b values (>/=1400 sec/mm2) is the dominant parameter for determining the overall level of suspicion for clinically significant cancer. For transition zone abnormalities, the score obtained from T2-weighted MR imaging is dominant for overall lesion assessment. Dynamic contrast material-enhanced MR imaging has ancillary roles in the characterization of peripheral zone lesions considered equivocal for clinically significant cancer on the basis of the DWI-ADC combination and in the detection of lesions missed with other multiparametric MR pulse sequences. Assessment with dynamic contrast-enhanced MR imaging is also simplified, being considered positive or negative on the basis of qualitative evaluation for a focal area of rapid enhancement matching an abnormality on DWI-ADC or T2-weighted MR images. In PI-RADS version 2, MR spectroscopic imaging is not incorporated into lesion assessment. In this article, a pictorial overview is provided of the revised PI-RADS version 2 assessment categories for the likelihood of clinically significant cancer. PI-RADS version 2 is expected to evolve with time, with updated versions being released as experience in the use of PI-RADS version 2 increases and as new scientific evidence and technologies emerge. (c)RSNA, 2016

PI-RADS Steering Committee: The PI-RADS Multiparametric MRI and MRI-directed Biopsy Pathway

Contains fulltext : 206232.pdf (publisher's version ) (Closed access