To investigate the diagnostic value of MRI combined with distal radioulnar joint (DRUJ) stability characteristics and ulnar styloid bone marrow edema (BME) in differentiating peripheral vs. central triangular fibrocartilage complex (TFCC) injuries, and to establish a multiparametric MRI diagnostic model to optimize preoperative classification accuracy. A retrospective analysis of 76 patients with arthroscopically confirmed TFCC injuries (55 peripheral tears, 21 central tears) was conducted. Preoperative MRI evaluated DRUJ stability and BME. Chi-square tests analyzed intergroup differences, binary logistic regression identified predictors, diagnostic efficacy metrics were calculated, and MRI-based classification, DRUJ stability, BME, and combined models were compared using arthroscopy as the gold standard. The peripheral tear group exhibited significantly higher BME positivity (82.9% vs. 11.1%) and DRUJ instability rates (70.9% vs. 9.5%) compared to the central tear group (both p < 0.001). Logistic regression identified BME positivity (OR = 0.140, 95% CI: 0.044-0.444) and DRUJ instability (OR = 0.103, 95% CI: 0.013-0.428) as independent predictors of peripheral tears (p = 0.001). The combined model (MRI+DRUJ+BME) demonstrated superior diagnostic performance (AUC = 0.898, 95% CI: 0.818-0.978; sensitivity = 76.2%, specificity = 94.6%) compared to MRI alone (AUC = 0.810) or DRUJ+BME models (AUC = 0.822). The combined model integrating anatomic stability improves diagnostic specificity, providing critical guidance for preoperative stratification, surgical planning, and personalized treatment. Bone marrow edema (BME) and distal radioulnar joint (DRUJ) stability hold potential as supplementary MRI imaging biomarkers for TFCC injuries classification.

Objectives To report a rare case of high-grade prostatic stromal sarcoma (PSS) and delineate its characteristic magnetic resonance imaging (MRI) features to facilitate early detection and accurate diagnosis. Methods A 55-year-old male presented with progressive dysuria. Preoperative multiparametric pelvic MRI was performed. The imaging findings were correlated with histopathology from a robot-assisted laparoscopic radical prostatectomy. Results MRI revealed a large, well-demarcated, encapsulated cystic-solid mass within the prostate. The solid components showed restricted diffusion. The cystic component contained multiple septations and demonstrated no diffusion restriction. An involvement nodule was identified in the right seminal vesicle. Histopathology confirmed high-grade prostatic stromal sarcoma with positive surgical margins. The patient experienced local recurrence within six months despite adjuvant chemotherapy. Conclusions Prostatic stromal sarcoma is a rare malignancy with distinct MRI features that can help differentiate it from more common prostatic neoplasms.

The National Prostate Cancer Registry (ProNAT) of the German Uro-Oncologists (d-uo) was launched in 2022 to provide a real-world, cross-sector overview of prostate cancer management in Germany. Building on the VERSUS study, ProNAT collects detailed longitudinal data on quality of care, guideline adherence, and therapeutic strategies.ProNAT is a non-interventional, prospective, multicenter registry (DRKS00030737, ethics approval Berlin 2018). Patients with histologically confirmed prostate cancer from 55 urology centers are included. Collected data comprise demographics, clinical parameters, tumor stage, treatment modality, comorbidities, and psycho-oncological support.As of August 2025, 3,417 patients were enrolled (analyzable n = 3,052; median age 69 years). Most patients (91.1%) had ECOG 0-1. Common comorbidities included arterial hypertension (30.6%), diabetes mellitus (8.2%), and cardiovascular disease (9.1%). Metastatic disease at diagnosis was present in 6.7%, while 77.6% had T1-T2 tumors. Multiparametric MRI prior to biopsy was performed in 36.6%. Curative surgery was robot-assisted in 87.7 of cases. Among Gleason 3 + 3 cases, 35.1% underwent active surveillance and 37.8% underwent surgery. Psycho-oncological support was documented in only 18.2%.ProNAT provides the first comprehensive real-world dataset on outpatient prostate cancer care in Germany. Findings demonstrate progress in diagnostic guideline adherence but highlight under-utilization of psycho-oncological services and multidisciplinary planning. With continued patient enrollment, ProNAT will enable more detailed analyses of treatment sequences and care quality.

Background Multi-institutional clinical trials frequently use MRI imaging for critical decisions and guidance for medical treatments. Collecting and analyzing images produced by various MR vendors and models is quite difficult since image quality can be highly variable. No unifying quality control targeting protocol studies exists to ensure MRI images used in that study are comparable. This project will investigate variations between imaging sessions and between various scanners using radiomic parameters from prototype MRI QA phantom. Purpose To develop a 3D radiomic phantom for quantifying radiomic feature consistency between MRI scanners across multi-institutions. Methods The prototype phantom consists of five 3D-printed objects (3 grid and 2 egg-shape) using Polylactic Acid (PLA) with/without 20% wood particles placed in a water container. The grid objects consisted of PLA scaffolding with 245 cubic voids (flood-filled by water) stacked in 7rows x 7columns x 5layers with volumes of 3x3x3 mm 3 or 5x5x5 mm 3 , and scaffolding thickness of 1mm or 2mm. The egg-shaped objects are 5cm long with a 2cm or 4cm maximum diameter, filled with vitamin D3-capsules and olive-oil. It was scanned 10 times using T1- and T2-weighted sequences on Philips (1.5T Elekta Unity), GE (1.5T, Signa Artist), Siemens (1.5T MAGNETOM Sola), and Philips (1.5T Ingenia) across four institutions. TrueFISP and T2w sequences were used on ViewRay (0.35T MRIdian) scanners at two institutions. Per object, 107 radiomic features were extracted using the Pyradiomics extension in 3D Slicer. Coefficients of Variation (CV) of individual radiomic features were compared across 10 scans acquired on each scanner and used to compare radiomic feature consistency between objects and MRI scanners. Results The radiomic feature consistency varied across objects with less reproducibility for the egg-shaped objects and more reproducibility for the grid objects, with slightly better reproducibility for T1w than T2w sequences. The GE scanner demonstrated better reproducibility than the other scanners. Both ViewRay scanners showed consistency for acquisitions with the TrueFISP sequence; the median CV of 107 radiomic features between objects was &amp;lt;10%). The consistency was summarized in a heat map. Conclusion Some radiomic features showed significant intra-scanner variations. This study demonstrated that a standardized radiomic phantom is required to characterize individual scanners and MR sequences for establishing the baseline of radiomic features, which could be important for multi-institutional radiomic studies using MRI.

To determine the value of MRI in men with highly elevated PSA values for the exclusion of clinically significant prostate cancer (csPC). In this retrospective bicenter cohort study, consecutive men with PSA values ≥ 15 ng/mL and multiparametric (mp) MRI were included. We excluded patients with acute prostatitis and patients without histopathology or follow-up. Examinations were evaluated regarding MRI quality, PSAD, and PI-RADS classification. For all patients with subsequent biopsy, PC and csPC detection rates were determined. In a subgroup analysis, patients with and without the presence of csPC were compared regarding clinical and MRI parameters. Finally, 376 patients (median PSA 20 ng/mL) were included. MRI quality was excellent (median PI-QUAL 3). 26% of the patients revealed an MRI with a PI-RADS category 2, 16% were classified as category 3, 12% PI-RADS 4, and 46% showed a PI-RADS 5. A total of 280 patients underwent systematic screening with or without targeted prostate biopsy. Among these, 42% with PSA values ranging from 15 to 116 ng/mL (median 19.5 ng/mL) showed no presence of PC. Overall, csPC detection rates were 94% for PI-RADS 5 and 51% for PI-RADS 4. No csPC were identified in PI-RADS 2, and 8% in PI-RADS 3. Comparative analysis between patients with and without csPC revealed significant differences in age, PSA, PSAD, and PI-RADS (p ≤ 0.05). mpMRI demonstrated excellent performance in the detection of csPC in this high-risk cohort with PSA levels ≥ 15 ng/mL. High-quality MRI helps to exclude csPC in cases with significantly elevated PSA levels to avoid unnecessary prostate biopsies. CRITICAL RELEVANCE STATEMENT: mpMRI demonstrated a high diagnostic accuracy for csPCs in men with PSA ≥ 15 ng/mL, and in cases of non-suspicious MRI findings, it can avoid unnecessary biopsies in these patients at risk. MpMRI demonstrated high diagnostic accuracy in men with PSA values of ≥ 15 ng/mL. MpMRI enables the reliable exclusion of csPC in cases with non-suspicious MRI findings in these patients. In patients with significantly elevated PSA levels, mpMRI provides an effective risk stratification to avoid unnecessary biopsies.

The role of perilesional sampling in the era of targeted prostate biopsy: A scoping review.

Artificial intelligence-driven prostate cancer diagnosis: Enhancing accuracy and personalizing patient care.

Accurate segmentation of glioma subregions from multi-parametric MRI (MP-MRI) is critical for clinical management but remains challenging due to tumor heterogeneity and ambiguous tissue boundaries. This study proposes an uncertainty-guided hybrid segmentation framework that integrates spherical projection-based 2D modeling with localized 3D refinement to improve segmentation fidelity. The framework was validated on the BraTS 2020 dataset (N=369). First, a 2D nnU-Net with spherical projection deformation was employed to generate initial slice-wise predictions. Crucially, prediction variance across multiple spherical projections was utilized to quantify voxel-level uncertainty, highlighting regions of low model confidence. A kernel-based sliding window algorithm then spatially localized 3D subvolumes with high cumulative uncertainty. These targeted regions were subsequently fed into a dedicated 3D nnU-Net for volumetric refinement. Finally, the global 2D predictions and local 3D refinements were adaptively fused using weights optimized via Particle Swarm Optimization. The proposed method was implemented to segment the enhancing tumor (ET), tumor core (TC) and whole tumor (WT). Performance was evaluated against standalone 2D and 3D nnU-Net baselines using the Dice Similarity Coefficient (DSC), HD95, sensitivity, and specificity. The proposed method significantly outperformed 2D and 3D baselines across ET, TC, and WT targets. Notably, it achieved a DSC of 0.8124 for ET (vs. 0.7527 for 2D and 0.7530 for 3D), 0.7499 for TC (vs. 0.7002 for 2D and 0.7027 for 3D), 0.9055 for WT (vs. 0.8989 for 2D and 0.9038 for 3D) and demonstrated consistent gains in HD95 and sensitivity. Quantitative metrics and visualizations confirmed improved spatial coherence and boundary preservation in structurally complex regions. By utilizing interpretable uncertainty maps as a spatial attention mechanism, this approach dynamically allocates computational resources to anatomically ambiguous regions. The resulting hybrid framework successfully combines 2D efficiency with 3D contextual accuracy, offering a robust solution for automated glioma segmentation.

TPS415 Background: Of the estimated 31,000 high risk localized prostate cancer (PC) cases in 2025, up to 46% have a risk of biochemical recurrence after definitive treatment (Falgario U, JAMA Netw Open 2023). A pooled analysis showed 3-year biochemical recurrence-free survival (bRFS) was robustly correlated to pathologic complete response (pCR) plus minimal residual disease (MRD) in patients treated neoadjuvantly (NAJ) with androgen deprivation therapy (ADT) plus an androgen receptor pathway inhibitor (ARPI) (McKay R, J Urol 2021). A separate study of localized high-risk PC revealed increased glucocorticoid receptor (GR) expression in residual tumors of PC patients (pts) treated with NAJ ARPI plus ADT (Efstathiou E, Eur Urol 2019). Resistance to the ARPI enzalutamide (Enz) is mitigated by targeting GR (Isikbay M, Horm Cancer 2014). We previously demonstrated the safety of the combination of the selective GR antagonist (SGRA) relacorilant (Rel) plus Enz (Desai, CCR , 2024). We have thus initiated a trial to evaluate the NAJ efficacy of this combination. Methods: This phase 2 placebo-controlled 2:1 randomized trial of NAJ LHRH agonist/antagonist and Enz (160 mg daily) plus Rel (150 mg daily)/placebo has a primary objective of response, measured by pCR and MRD at radical prostatectomy (RP). Eligible pts include those with high risk or very high-risk localized prostatic adenocarcinoma per NCCN guidelines, allowing lymph nodes below the iliac bifurcation. After randomization pts will be treated with 6 mo of LHRH agonist/antagonist plus Enz plus Rel/placebo and undergo RP 1 month later. The total sample size is 90 patients with an interim analysis for futility conducted after 45 pts undergo RP. As of October 2025, 30 pts have enrolled, with 23 in follow up and 7 on treatment. A chi-square test will be used to compare the proportion of pts achieving pCR/MRD. Assuming a true CR/MRD rate of 15% in the control group, 90 pts total would yield a power of 80% with a hypothesized CR/MRD of 32% in the Rel group, based on a one-sided test at the alpha=0.15 significance level. Secondary endpoints include evaluating radiographic response within the prostate with multiparametric MRI (mpMRI) and the 3-year bRFS and metastasis-free survival (MFS) rates in both arms. For correlatives, we will demonstrate decreased nuclear hormone receptor-driven proliferative gene expression in viable PC due to NAJ ARPI combined with GR antagonism versus ARPI alone, as well as correlation between pathologic response and enhanced mpMRI imaging. The study is open and seeking additional sites (currently 3 open). ClinicalTrials.gov Identifier: NCT05726292. Clinical trial information: NCT05726292 .

A0623 Comparison of diagnostic efficacy between post-treatment VI-RADS based on biparametric MRI and multiparametric MRI in assessing residual tumor and muscle invasion after treatment for bladder cancer

High-Resolution Imaging of Knee Meniscus Anatomy and Tears: 2-Dimensional and 3-Dimensional Magnetic Resonance Imaging Perspectives.

Development of a multi-parametric MRI platform to evaluate steady-state water content and optical properties in multiple ex vivo bovine lens.

Repeated salvage high precision radiotherapy for repeated recurrence of high-grade glioma.

Deep-learning-based 3D multi-view multi-parametric MRI fusion model for preoperative T-staging of rectal cancer

Automated assessment of susceptibility map-weighted imaging in patients with clinically uncertain parkinsonism.

Comparison of central FLAIR hypointensity and central vein sign on FLAIR* in a diagnostic cohort.

LCMF-Net: A lightweight collaborative multimodal fusion network for brain tumor segmentation.

Silent magnetic resonance angiography: Techniques and applications of neurovascular imaging.

Objective:To analyze the magnetic resonance hydrography results of the inner ear in patients with total deafness-type sudden sensorineural hearing loss , and to explore the incidence and correlation with therapeutic efficacy in patients with internal auditory canal vascular loops. Methods:Audiological and imaging data were collected from 517 patients with sudden sensorineural hearing loss who were hospitalized in our hospital. All patients underwent T2WI rapid imaging sequence MRI examination, and the vascular loops of the patients were graded according to the Chavda grading method. The impact of different grades of vascular loops on the clinical characteristics and prognosis of the patients was analyzed. Statistical methods such as chi-square test and non parametric rank sum test to analyze the impact of internal auditory canal vascular loops on the clinical characteristics and hearing prognosis of patients with sudden total deafness. Results:From May 2009 to June 2024, a total of 517 hospitalized patients with sudden deafness were analyzed. It was found that: ①110 patients had abnormal hydrography in the internal auditory canal, including 32 patients with mastoiditis, 30 patients with sinus, ethmoid sinus, and maxillary sinus abnormalities, 15 patients with semicircular canal abnormalities, 7 patients with high jugular bulb, and 18 patients with fine or poorly displayed internal auditory canal nerves; ②276 patients with sudden sensorineural hearing loss accompanied by vascular loops, including 156 ears on the affected side and 158 ears on the healthy side with Chavda classification of grade Ⅰ; 104 ears on the affected side and 83 ears on the healthy side with type Ⅱvascular loops; There were 16 ears on the affected side of type Ⅲ and 14 ears on the healthy side. There was no significant difference in the distribution of vascular loops between the patient and the affected side（P>0.05）; ③The frequency of vascular loops in female patients is higher than that in males（P<0.05）, but no significant differences were found in the degree of hearing loss and hearing outcomes at different frequencies among patients with different grades of vascular loops（P>0.05）. ④The incidence of tinnitus in patients with vascular loop grades Ⅰ-Ⅲ was 92.9%, 83.7%, and 100.0%, respectively. There was a statistically significant difference in the incidence of tinnitus among patients with different grades of vascular loops（P<0.05）. Conclusion:For patients with sudden total deafness, more attention should be paid to their inner ear magnetic resonance imaging results. The vascular loop of the internal auditory canal is a possible cause of tinnitus in some patients with sudden total deafness.

Background/Objectives: Aggressive variants of prostate cancer pose significant diagnostic and prognostic challenges due to atypical imaging appearances, variable prostate-specific antigen behavior, and distinct molecular features. Conventional imaging may underestimate their biological aggressiveness. This review aimed to synthesize current evidence on imaging characteristics, biomarker dynamics, tumor localization, histology, and radiomic features of aggressive prostate cancer variants, and to evaluate the potential role of radiomics in early recognition and risk stratification. Methods: A structured narrative review was performed of studies reporting imaging, clinical, and molecular features of aggressive prostate cancer variants. Imaging modalities included multiparametric magnetic resonance imaging, positron emission tomography with prostate-specific membrane antigen or fluorodeoxyglucose, bone scintigraphy, and transrectal ultrasound. Data on prostate-specific antigen levels and kinetics, intraprostatic tumor location, tumor size, metastatic patterns, and molecular alterations were extracted. Evidence for rare entities such as basaloid and primary squamous carcinomas was derived from published case reports and series, while selected variants were complemented by institutional imaging and histopathologic observations. Results: Neuroendocrine and small cell carcinomas frequently showed low prostate-specific antigen levels, high fluorodeoxyglucose uptake, low prostate-specific membrane antigen expression, and central or transitional zone involvement with large tumor size at diagnosis. Ductal adenocarcinoma demonstrated marked diffusion restriction and elevated prostate-specific antigen, whereas basal cell carcinoma often appeared inconspicuous on conventional imaging. Radiomic analysis consistently captured tumor heterogeneity and spatial complexity beyond standard qualitative metrics. Conclusions: Aggressive prostate cancer variants represent a diagnostic blind spot in routine imaging. Radiomics offers complementary quantitative information that may improve early detection, subtype differentiation, and risk stratification when integrated into multimodal imaging workflows. Further prospective and radiogenomic studies are warranted to validate these findings.