BACKGROUND AND PURPOSE: Pretreatment prediction of patients with nasopharyngeal carcinoma who will fail conventional treatment would potentially allow these patients to undergo more intensive treatment or closer posttreatment monitoring. The aim of the study was to determine the ability of pretreatment DWI to predict local failure in patients with nasopharyngeal carcinoma based on long-term clinical outcome. MATERIALS AND METHODS: One hundred fifty-eight patients with pretreatment DWI underwent analysis of the primary tumor to obtain the ADC mean, ADC skewness, ADC kurtosis, volume, and T-stage. Univariate and multivariate analyses using logistic regression were performed to compare the ADC parameters, volume, T-stage, and patient age in primary tumors with local failure and those with local control, by using a minimum of 5-year follow-up to confirm local control. RESULTS: Local control was achieved in 131/158 (83%) patients (range, 60.3–117.7 months) and local failure occurred in 27/158 (17%) patients (range, 5.2–79.8 months). Compared with tumors with local control, those with local failure showed a significantly lower ADC skewness (ADC values with the greatest frequencies were shifted away from the lower ADC range) (P = .006) and lower ADC kurtosis (curve peak broader) (P = .024). The ADC skewness remained significant on multivariate analysis (P = .044). There was a trend toward higher tumor volumes in local failure, but the volume, together with T-stage and ADC mean, were not significantly different between the 2 groups. CONCLUSIONS: Pretreatment DWI of primary tumors found that the skewness of the ADC distribution curve was a predictor of local failure in patients with nasopharyngeal carcinoma, based on long-term clinical outcome.

INTRODUCTION: Visceral adipose tissue (VAT) has been found to play a critical role in the development of metabolic syndrome and nonalcoholic fatty liver disease (NAFLD) independent of generalized obesity. METHODS: In this secondary study of prospectively acquired data, 625 participants underwent magnetic resonance spectroscopy and chemical shift fat–water separation MRI (2-point Dixon) of the liver and whole abdomen, respectively, in a 3 Tesla magnet. Whole abdominal VAT and subcutaneous adipose tissue (SAT) were extracted from the 2-point Dixon image series using an automated method. Clinical/anthropometric/blood biochemistry parameters were measured. Using region-specific body mass index, participants were classified into 3 paired subgroups (lean, overweight, and obese) and presence of NAFLD (liver fat content ≥ 5.5%). RESULTS: All relevant clinical/anthropometric/blood biochemistry characteristics and liver enzymes were statistically significant between groups (P < 0.001). NAFLD was found in 12.1%, 43.8%, and 68.3% and metabolic syndrome in 51.1%, 61.9%, and 65% of the lean, overweight, and obese, respectively. Odds ratio for metabolic syndrome and NAFLD was increased by 2.73 (95% confidence interval [CI] 2.18–3.40) and 2.53 (95% CI 2.04–3.12), respectively, for 1SD increase in VAT volume while prevalence of metabolic syndrome was increased by 2.26 (95% CI 1.83–2.79) for 1SD increase in liver fat content (%). VAT/SAT ratio in the lean with fatty liver showed the highest ratio (0.54) among all the subgroups, without a significant difference between the lean and obese with NAFLD (P = 0.127). DISCUSSION: Increased VAT volume/disproportional distribution of VAT/SAT may be vital drivers to the development of metabolic syndrome and NAFLD irrespective of body mass index category.

Background: While conventional magnetic resonance imaging (MRI) in multiple sclerosis (MS) primarily evaluates focal lesions, the normal-appearing white matter (NAWM) encompasses brain tissue that appears radiologically normal but harbors subtle pathological changes that contribute to the overall disease burden. The aim of this study was to investigate the role of T1rho MRI in characterising distance-dependent microstructural changes in the perilesional NAWM in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: T1rho and diffusion tensor imaging (DTI) images were acquired from 30 patients with RRMS and 30 age-matched healthy controls. A total of 217 non-contrast-enhancing MS lesions were identified, and five perilesional layers were delineated from the lesion margins. T1rho values in the intralesional and perilesional regions in MS patients and the corresponding normal white matter of controls were quantified and compared. Results: T1rho values progressively decreased from the lesional regions (111.82±27.58 ms) to the perilesional layer 5 (78.06±4.76 ms) (P value <0.05). Significant correlations were found between T1rho values and mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in the perilesional areas, with a pattern of progressively lower correlation coefficients (r, 0.23 to 0.73, P value <0.01) between T1rho values and the DTI metrics as the distance from the lesion increased. Conclusions: Our findings suggest that T1rho is a sensitive method for the detection of microstructural changes in the NAWM, and may provide valuable information about the spatial extent and severity of these changes.

Background: Bone health and brain function may be closely interconnected through a complex bone–brain axis. The relationship between bone mineral density (BMD), vertebral perfusion, marrow composition, cerebral perfusion, brain volume, and cognitive decline, however, remain incompletely understood. Methods: Ninety-nine female subjects (mean age 65.00 ± 5.00 years) with clinically suspected mild cognitive impairment underwent dual-energy X-ray absorptiometry, carotid ultrasound, and multimodal magnetic resonance imaging (MRI) of the brain and lumbar spine to measure BMD, bone perfusion, marrow fat content as well as cerebral perfusion, cerebral volume, cerebral white matter burden and large vessel atherosclerosis. Cognitive function was assessed using the Hong Kong Montreal Cognitive Assessment (HK-MoCA). Bone, cerebral, vascular, and cognitive measures were correlated using Spearman correlation coefficients and compared in group comparisons. Results: Lower BMD was correlated with reduced subcortical cerebral blood flow (CBF) (r = 0.27, p = 0.031) and lower total brain parenchymal volume (r = 0.25, p = 0.021). Reduced bone marrow perfusion and increased marrow fat content were also associated with lower total brain parenchymal volume (r = 0.24, p = 0.023 and r = −0.26, p = 0.025). Subjects with the lowest L3 vertebral body perfusion or highest marrow fat content had significantly reduced total brain and hippocampal volumes (p = 0.029–0.049) compared with those with the highest perfusion or lowest marrow fat content. Conclusions: This study shows an association between lower BMD, reduced vertebral perfusion, and increased marrow fat with reduced brain parenchymal volumes and reduced brain perfusion. Further studies are warranted to clarify these relationships and explore the underlying shared mechanisms affecting bone health and cerebral microvascular and structural brain changes.

To evaluate the distraction effect, intrinsic structure visibility, and wearability of a novel direct wrist traction device for wrist magnetic resonance (MR) imaging. A total of 34 healthy subjects underwent wrist MR imaging initially without traction and then with traction using a direct traction device and were enrolled in this study. Joint space width, articular cartilage visibility, intrinsic ligaments and triangular fibrocartilage complex (TFCC) visibility, and lesion detection were assessed before and after traction. A 10-point visual analogue scale (VAS) questionnaire was used to assess pain during MRI. Paired sample t-test and marginal homogeneity test were used to compare joint space width, articular cartilage and intrinsic ligament visibility before and after traction, respectively. Mean joint space width was 0.7 ± 0.34 mm wider after traction (adjusted P < 0.001). Articular cartilage visibility improved at the radiolunate, scaphocapitate, and lunocapitate joints after traction (all adjusted P < 0.001). Intrinsic ligaments and TFCC lesion detection tended to improve following traction with improved visibility. Twenty-one (62%) of 34 subjects had no wrist pain during traction while 13 (38%) had an average increase of 2.6 VAS points in wrist pain. No subjects had shoulder or neck pain. This direct traction device effectively distracts the wrist joint, which may potentially improve articular cartilage visibility as well as the detection of intrinsic ligament and TFCC lesions.