In applying diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) technique, DW-MR images are acquired during free breathing, which results in images with high signal-to-noise ratio using relatively thin image sections (4–5 mm). Image acquisition during free breathing is possible because bulk tissue motion, including respiratory motion, may be considered as types of coherent motion, which do not result in significant signal loss unlike intravoxel incoherent motion, which reflects random water motion at a cellular level. The concept of DWIBS allows handling of the acquired images as a volumetric dataset and it exploits both prolonged T2 relaxation time and impeded diffusion that the majority of solid lesions (both benign and malignant) exhibit as mechanisms for image contrast, which is used for clinical evaluation of diseases.

Diffusion-Weighted Whole-Body Imaging with Background Body Signal Suppression (DWIBS)

Procedure Appropriateness Category Relative Radiation Level Radiography area of interest Usually Appropriate Varies CT area of interest with IV contrast Usually Not Appropriate Varies CT area of interest without and with IV contrast Usually Not Appropriate Varies CT area of interest without IV contrast Usually Not Appropriate Varies FDG-PET/CT whole body Usually Not Appropriate ☢☢☢☢ MRI area of interest without and with IV contrast Usually Not Appropriate O MRI area of interest without IV contrast Usually Not Appropriate O Bone scan whole body Usually Not Appropriate ☢☢☢ US area of interest Usually Not Appropriate O

The American College of Radiology. ACR Appropriateness Criteria project.

This article summarizes anatomical, neurophysiological, pharmacological, and brain imaging studies in humans and animals that have provided insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract. The functions of the lower urinary tract to store and periodically eliminate urine are regulated by a complex neural control system in the brain, spinal cord, and peripheral autonomic ganglia that coordinates the activity of smooth and striated muscles of the bladder and urethral outlet. The neural control of micturition is organized as a hierarchical system in which spinal storage mechanisms are in turn regulated by circuitry in the rostral brain stem that initiates reflex voiding. Input from the forebrain triggers voluntary voiding by modulating the brain stem circuitry. Many neural circuits controlling the lower urinary tract exhibit switch-like patterns of activity that turn on and off in an all-or-none manner. The major component of the micturition switching circuit is a spinobulbospinal parasympathetic reflex pathway that has essential connections in the periaqueductal gray and pontine micturition center. A computer model of this circuit that mimics the switching functions of the bladder and urethra at the onset of micturition is described. Micturition occurs involuntarily in infants and young children until the age of 3 to 5 years, after which it is regulated voluntarily. Diseases or injuries of the nervous system in adults can cause the re-emergence of involuntary micturition, leading to urinary incontinence. Neuroplasticity underlying these developmental and pathological changes in voiding function is discussed.

/pdf/neural-control-of-the-lower-urinary-tract-2ombjmcwkx.pdf

Neural Control of the Lower Urinary Tract

Multiparametric Magnetic Resonance Imaging for Bladder Cancer: Development of VI-RADS (Vesical Imaging-Reporting And Data System).

Smooth muscles are complex tissues containing a variety of cells in addition to muscle cells. Interstitial cells of mesenchymal origin interact with and form electrical connectivity with smooth muscle cells in many organs, and these cells provide important regulatory functions. For example, in the gastrointestinal tract, interstitial cells of Cajal (ICC) and PDGFRα+ cells have been described, in detail, and represent distinct classes of cells with unique ultrastructure, molecular phenotypes, and functions. Smooth muscle cells are electrically coupled to ICC and PDGFRα+ cells, forming an integrated unit called the SIP syncytium. SIP cells express a variety of receptors and ion channels, and conductance changes in any type of SIP cell affect the excitability and responses of the syncytium. SIP cells are known to provide pacemaker activity, propagation pathways for slow waves, transduction of inputs from motor neurons, and mechanosensitivity. Loss of interstitial cells has been associated with motor disorders of the gut. Interstitial cells are also found in a variety of other smooth muscles; however, in most cases, the physiological and pathophysiological roles for these cells have not been clearly defined. This review describes structural, functional, and molecular features of interstitial cells and discusses their contributions in determining the behaviors of smooth muscle tissues.

https://www.physiology.org/doi/pdf/10.1152/physrev.00037.2013

Interstitial Cells: Regulators of Smooth Muscle Function

Purpose: To prospectively evaluate the ability of diffusion-weighted (DW) magnetic resonance (MR) imaging to be used to determine the T stage of bladder cancer and to measure the correlation between the apparent diffusion coefficient (ADC) and histologic grade. Materials and Methods: This study was approved by the local institutional review board. All patients gave written informed consent. Forty patients with a total of 52 bladder tumors underwent MR imaging that included DW imaging. Histologic grade was determined for all tumors. Two radiologists interpreted four image sets (ie, T2-weighted images alone, T2-weighted plus DW images, T2-weighted plus dynamic contrast agent–enhanced images, all three image types together). Conventional criteria were used for interpreting T2-weighted and contrast-enhanced images. For DW images, new staging criterion developed on the basis of the hypothesis that tumors, submucosal tissue, and muscles show high, low, and intermediate signal intensity, respectively, was used. ...

Urinary Bladder Cancer: Diffusion-weighted MR Imaging—Accuracy for Diagnosing T Stage and Estimating Histologic Grade

Ureteral Wall Thickness as a Preoperative Indicator of Impacted Stones in Patients with Ureteral Stones Undergoing Ureteroscopic Lithotripsy.

Altered distribution of interstitial cells in the guinea pig bladder following bladder outlet obstruction

With the recent technological advancements in endourology, retrograde intrarenal surgery has become a more popular procedure for treatment of urolithiasis. Furthermore, since the introduction of new laser systems and advanced flexible ureteroscopy with miniaturized ureteroscopes, the treatment indications for retrograde intrarenal surgery have expanded to include not only larger renal stones of >2 cm but also upper urinary tract urothelial carcinoma, ureteral stricture, and idiopathic renal hematuria. Clinicians must keep up with these trends and make good use of these technologies in the rapidly changing field of endourology. Simultaneously, we must consider the risk of various complications including thermal injury due to laser use, ureteral injury caused by the ureteral access sheath, and radiation exposure during retrograde intrarenal surgery with fluoroscopic guidance. This review focuses on the past, present, and future of retrograde intrarenal surgery and provides many topics and clinical options for urologists to consider.

/pdf/retrograde-intrarenal-surgery-past-present-and-future-4ri1uzpkka.pdf

Retrograde intrarenal surgery: Past, present, and future.

Peroxisome proliferator-activated receptor-γ and growth inhibition by its ligands in prostate cancer

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