“Textural analysis of multiparametric MRI detects transition zone prostate cancer”

Objectives

To evaluate multiparametric-MRI (mpMRI) derived histogram textural-analysis parameters for detection of transition zone (TZ) prostatic tumour.

Methods

Sixty-seven consecutive men with suspected prostate cancer underwent 1.5T mpMRI prior to template-mapping-biopsy (TPM). Twenty-six men had ‘significant’ TZ tumour. Two radiologists in consensus matched TPM to the single axial slice best depicting tumour, or largest TZ diameter for those with benign histology, to define single-slice whole TZ-regions-of-interest (ROIs). Textural-parameter differences between single-slice whole TZ-ROI containing significant tumour versus benign/insignificant tumour were analysed using Mann Whitney U test. Diagnostic accuracy was assessed by receiver operating characteristic area under curve (ROC-AUC) analysis cross-validated with leave-one-out (LOO) analysis.

Results

ADC kurtosis was significantly lower (p?<?0.001) in TZ containing significant tumour with ROC-AUC 0.80 (LOO-AUC 0.78); the difference became non-significant following exclusion of significant tumour from single-slice whole TZ-ROI (p?=?0.23). T1-entropy was significantly lower (p?=?0.004) in TZ containing significant tumour with ROC-AUC 0.70 (LOO-AUC 0.66) and was unaffected by excluding significant tumour from TZ-ROI (p?=?0.004). Combining these parameters yielded ROC-AUC 0.86 (LOO-AUC 0.83).

Conclusion

Textural features of the whole prostate TZ can discriminate significant prostatic cancer through reduced kurtosis of the ADC-histogram where significant tumour is included in TZ-ROI and reduced T1 entropy independent of tumour inclusion.

Key Points

? MR textural features of prostate transition zone may discriminate significant prostatic cancer. ? Transition zone (TZ) containing significant tumour demonstrates a less peaked ADC histogram. ? TZ containing significant tumour reveals higher post-contrast T1-weighted homogeneity. ? The utility of MR texture analysis in prostate cancer merits further investigation.

     

Hereditary fructose intolerance: functional study of two novel ALDOB natural variants and characterization of a partial gene deletion

Hereditary fructose intolerance (HFI) is an autosomal recessive metabolic disease caused by impaired functioning of human liver aldolase (ALDOB). At least 54 subtle/point mutations and only two large intragenic deletions have been found in the ALDOB gene. Here we report two novel ALDOB variants (p.R46W and p.Y343H) and an intragenic deletion that we found in patients with suspected HFI. The residual catalytic activity of the recombinant p.R46W and p.Y343H variants toward F1P was particularly altered. We also characterized a large intragenic deletion that we found in six unrelated patients. This is the first report of six unrelated patients sharing the same ALDOB deletion, thus indicating a founder effect for this allele in our geographic area. Because this deletion involves ALDOB exon 5, it can mimic worldwide common pathogenic genotypes, that is, homozygous p.A150P and p.A175D. Finally, the identification of only one ALDOB mutation in symptomatic patients suggests that HFI symptoms can, albeit rarely, appear also in heterozygotes. Therefore, an excessive and continuous fructose dietary intake may have deleterious effects even in apparently asymptomatic HFI carriers. Hum Mutat 31:–10, 2010. © 2010 Wiley‐Liss, Inc.     

Pigmented apocrine hidradenoma

Apocrine hidradenoma is a benign adnexal neoplasm. It has no specific site predilection, and usually affects middle-aged people. The same as other tumors of the sweat glands, there is a pigmented variety. We present the case of a 92-year-old male who consulted his physician for a slow-growing asymptomatic lesion in the right groin which had been developing for 2 years. After the histopathological study, the diagnosis was established as pigmented apocrine hidradenoma.     

Perceived injustice in fibromyalgia: psychometric characteristics of the Injustice Experience Questionnaire and relationship with pain catastrophising and pain acceptance

ObjectiveTo validate a Spanish version of the Injustice Experience Questionnaire (IEQ), a measure of perceived injustice, in a fibromyalgia sample and to examine its relationship with pain catastrophising and pain acceptance.MethodsThe IEQ was administered along with the Pain Visual Analogue Scale, the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale (PCS) and the Chronic Pain Acceptance Questionnaire (CPAQ) to 250 primary care patients with fibromyalgia.ResultsThe IEQ had good test–retest reliability (intraclass correlation coefficient = 0.98) and internal consistency (Cronbach's α = 0.92). The factor structure obtained was similar to the original validation study. The multiple regression analyses showed that perceived injustice (PI) accounted for significant pain-related outcomes after controlling pain intensity, PCS and CPAQ. Principal component analysis of both the IEQ and the CPAQ taken together showed that the two constructs do not represent opposite extremes of the same dimension.ConclusionThe IEQ is a reliable assessment tool for measuring PI among patients with fibromyalgia. PI seems to be distinct from catastrophising, although the two constructs are very similar. The factor analysis showed that PI and acceptance represent related constructs, and this entails relevant implications for therapy, as acceptance-based interventions would be appropriate.