ABSTRACT Purpose To determine if PSAD, PSADtz, and ADC values improve the accuracy of PI-RADS v2 and identify men whose concurrent systematic biopsy detects clinically significant cancer on areas without mpMRI visible lesions. Materials and methods Single reference-center, cross-sectional, retrospective study of consecutive men with suspected or known low to intermediate-risk prostate cancer who underwent 3T mpMRI and TRUS-MRI fusion biopsy from 07/15/2014 to 02/17/2018. Cluster-corrected logistic regression analyses were utilized to predict clinically significant prostate cancer (Gleason score ≥3+4) at targeted mpMRI lesions and on systematic biopsy. Results 538 men (median age=66 years, median PSA=7.0ng/mL) with 780mpMRI lesions were included. Clinically significant disease was diagnosed in 371 men. PI-RADS v2 scores of 3, 4, and 5 were clinically significant cancer in 8.0% (16/201), 22.8% (90/395), and 59.2% (109/184). ADC values, PSAD, and PI-RADS v2 scores were independent predictors of clinically significant cancer in targeted lesions (OR 2.25-8.78; P values <0.05; AUROC 0.84, 95% CI 0.81-0.87). Increases in PSAD were also associated with upgrade on systematic biopsy (OR 2.39-2.48; P values <0.05; AUROC 0.69, 95% CI 0.64-0.73). Conclusions ADC values and PSAD improve characterization of PI-RADS v2 score 4 or 5 lesions. Upgraded on systematic biopsy is slightly more likely with PSAD ≥0.15 and multiple small PI-RADS v2 score 3 or 4 lesions.

ABSTRACT Lentogenic Newcastle disease virus (lNDV) such as Lasota strain and low pathogenicity avian influenza such as H9N2 virus are two of the most economically important viruses affecting poultry worldwide, and little attention in recent years has been paid to simultaneous infections in chickens with these two viruses for the reason that co-infection do occur but are not easily detected. In the present study, chickens were inoculated with lNDV (Lasota) and LPAIV (A/chicken/Tehran/ZMT-173/99(H9N2)) simultaneously or sequentially three days apart. Oropharyngeal and cloacal swabs were collected from chickens from 1 to 14 days after inoculation. RRT-PCR for AIV and NDV detection was performed. The rate of viral shedding was measured within 14 days. No clinical symptoms were observed during the experiment however the pattern of virus shed was different with co-infection, thus comparing the results obtained from viral shedding showed that AIV is a much stronger agent than NDV in the occurrence of viral interference. This is due to the fact that in simultaneous inoculation, AIV replication delayed and reduced NDV replication, while replication of Lasota in simultaneous or pre-inoculated inoculation could not significantly disrupt H9N2 virus replication. These findings indicate that the infection with one virus can interfere with the replication of another, modifying the pathogenesis of the viruses. So, infection of the host with both viral agents simultaneously causes higher shedding of LPAIV than lNDV in OP and CL areas. In conclusion, co-infection with LPAVI in chickens did not impact clinical signs but affected the replication dynamics of these viruses.