Prostate Indeterminate Lesions on Magnetic Resonance Imaging-Biopsy Versus Surveillance: A Literature Review

CONTEXT: The indeterminate multiparametric prostate magnetic resonance image (mpMRI) lesion is one which cannot be classified as "positive" or "negative" for suspected cancer. Currently, there is no consensus on how to manage patients with indeterminate mpMRIs where areas cannot be classified as positives or negatives (Prostate Imaging Reporting and Data System [PI-RADS] 3 or Likert 3). OBJECTIVE: To define the concept of indeterminate lesion and describe the management strategies that may be adopted for these patients. EVIDENCE ACQUISITION: A literature search of the PubMed database was performed including the search terms "prostate indeterminate lesions", "PI-RADS 3", "Likert 3", "magnetic resonance imaging", and "prostate cancer". EVIDENCE SYNTHESIS: There is no universally accepted definition of what constitutes an indeterminate lesion on mpMRI. This is partly due to the experience of the reporting radiologist and their willingness to call a lesion indeterminate, knowing that this may have consequences for biopsy decisions. This is also partly due to the significant variation in mpMRI acquisition parameters used between different sites. Strategies for managing the indeterminate lesion include: (1) biopsy, where there is a highly variable prevalence of prostate cancer (PCa), reflecting the differences in clinically significant PCa definitions, mpMRI protocols and interobserver variability in characterization of indeterminate lesions and (2) surveillance, where early results suggest that this strategy may be of value for some selected patients with prostate-specific antigen (PSA) monitoring and/or interval mpMRI. The use of prebiopsy MRI, in conjunction with traditional clinical parameters and secondary biomarkers-nomograms, may allow a more accurate selection of patients who can avoid biopsy. CONCLUSIONS: A strategy of close surveillance based on PSA monitoring and interval mpMRI is a feasible management option for motivated patients with indeterminate mpMRI. This surveillance strategy could result in fewer men needing to undergo biopsy, and although early results are promising, long-term results for such a strategy are awaited. PATIENT SUMMARY: In some patients who have an MRI scan of their prostate, the scan may identify an area which may or may not contain cancer. This area is typically called the "indeterminate" lesion. In this report, we attempted to define the concept of indeterminate lesion on multiparametric magnetic resonance (mpMRI) and described the strategies that may be performed for these patients. The use of mpMRI in conjunction with traditional clinical parameters may allow more accurate risk stratification and assessment of the need for prostate biopsy

Comparison of corneal morphologic parameters and high order aberrations in keratoconus and normal eyes

The aim of this study is evaluating the influence of corneal geometry in the optical system’s aberrations, and its usefulness as diagnostic criterion for keratoconus.159 normal eyes (normal group, mean age 37.8 ± 11.6 years) and 292 eyes with the diagnosis of keratoconus (keratoconus group, mean age 42.2 ± 17.6 years) were included in this study. All eyes received a comprehensive ophthalmologic examination. A virtual 3D model of each eye was made using CAD software and different anatomical parameters related with surface and volume were measured. Statistically significant differences were found for all anatomical parameters (all p < 0.001). AUROC analysis showed that all parameters reached values above 0.7, with the exception of the total corneal surface area (TCSAA-S). In conclusion, the methodology explained in this research, that bases in anatomical parameters obtained from a virtual corneal model, allow to analyze the diagnostic value of corneal geometry correlation with optical aberrations in keratoconus pathology.This publication has been carried out in the framework of the Thematic Network for Co-Operative Research in Health (RETICS), reference number RD16/0008/0012, financed by the Carlos III Health Institute–General Subdirection of Networks and Cooperative Investigation Centers (R&D&I National Plan 2013–2016) and the European Regional Development Fund (FEDER)

Objectively measured and self-reported leisure-time sedentary behavior and academic performance in youth: The UP & DOWN Study

Objective: To examine the associations of (i) objectively measured and self-reported sedentary behavior during leisure time with academic performance and (ii) patterns of sedentary behavior with academic performance. Methods: This study was conducted with 1146 youth aged 12.5 ± 2.5 years in Spain during 2011–2012. Leisure-time sedentary behavior during out-of-school hours was assessed by accelerometry and self-report. Academic performance was assessed through school grades. Results: Objectively measured sedentary leisure-time was not significantly associated with academic performance. Time spent in Internet surfing, listening to music, and sitting without doing anything were negatively associated with all academic performance indicators (β ranging from − 0.066 to − 0.144; all p < 0.05). However, time spent in doing homework/study without computer and reading for fun were positively associated (β ranging from 0.058 to 0.154; all p < 0.05). Five major sedentary patterns were identified. The “high social-low TV/video” and the “low studying-high TV/video” patterns were negatively associated with all academic indicators (β ranging from − 0.085 to − 0.148; all p < 0.05). The “educational” pattern was positively associated with all academic indicators (β ranging from 0.063 to 0.105; all p < 0.05). Conclusions: Specific domains of self-reported sedentary behavior during leisure-time, but not objectively measured sedentary leisure time, may influence academic performance

Bidirectional associations between fitness and fatness in youth: A longitudinal study.

The aim was to examine the bidirectional association between cardiorespiratory fitness (CRF) and fatness in a 2-year longitudinal study conducted in young people. A total of 1082 children (512 females) and 727 adolescents (342 females) with complete data at baseline and follow-up were included. CRF was determined by the 20-m shuttle run test. Height and weight were measured, and body mass index and fat mass index (kg/m2 ) were calculated. Triceps and subscapular skinfolds were assessed to compute body fat percentage. Bidirectionality was tested by including CRF and each fatness index as exposures and outcomes, alternatively, in different regression models. CRF was prospectively associated with fatness index levels (ß from -0.186 to -0.528; P

Maternal physical activity before and during the prenatal period and the offspring's academic performance in youth. The UP & DOWN study

Objective: To examine the association of maternal physical activity before and during pregnancy with academic performance in youth. Methods: This study included 1868 youth (6–18 years) and their mothers. Mothers recalled their physical activity before and during pregnancy. Mothers were categorized into four groups: “remained active”, “became inactive”, “became active” and “remained inactive”. Academic performance was assessed through school records. Results: Boys whose mothers practiced physical activity before or during pregnancy had significantly higher scores in academic performance indicators independently of physical activity, fitness, current body mass index (BMI) and birthweight than those whose mothers did not practice physical activity before or during pregnancy (all p  <  0.05). In addition, boys whose mothers remained active had higher scores in all academic indicators (ranging from +0.358 to +0.543) than boys whose mothers remained inactive. Boys whose mothers remained active had higher scores in Language (score +0.546; 95% CI, 0.150–0.940), average of Math and Language (score +0.468; 95% CI, 0.100–0.836) and grade point average (GPA) (score +0.368; 95% CI, 0.092–0.644) than boys whose mothers became active. Conclusions: Maternal physical activity before and during pregnancy may positively influence youth's academic performance. Continuing maternal physical activity practice during pregnancy may have greater benefits for youth's academic performance

Maternal physical activity before and during the prenatal period and the offspring's academic performance in youth. The UP&DOWN study

Objective: To examine the association of maternal physical activity before and during pregnancy with academic performance in youth. Methods: This study included 1868 youth (6–18 years) and their mothers. Mothers recalled their physical activity before and during pregnancy. Mothers were categorized into four groups: “remained active”, “became inactive”, “became active” and “remained inactive”. Academic performance was assessed through school records. Results: Boys whose mothers practiced physical activity before or during pregnancy had significantly higher scores in academic performance indicators independently of physical activity, fitness, current body mass index (BMI) and birthweight than those whose mothers did not practice physical activity before or during pregnancy (all p  <  0.05). In addition, boys whose mothers remained active had higher scores in all academic indicators (ranging from +0.358 to +0.543) than boys whose mothers remained inactive. Boys whose mothers remained active had higher scores in Language (score +0.546; 95% CI, 0.150–0.940), average of Math and Language (score +0.468; 95% CI, 0.100–0.836) and grade point average (GPA) (score +0.368; 95% CI, 0.092–0.644) than boys whose mothers became active. Conclusions: Maternal physical activity before and during pregnancy may positively influence youth's academic performance. Continuing maternal physical activity practice during pregnancy may have greater benefits for youth's academic performance