Improving the detection rates of prostate cancer (PCa) and avoiding unnecessary prostate biopsies in men with prostate‐specific antigen (PSA) levels within the gray zone require urgent attention. In this context, rapid advances in MR technology in recent years may offer a promising possibility. A systematic review to evaluate the applications of magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) in detecting PCa and clinically significant PCa (csPCa) in men with PSA levels within the gray zone. The study type is defined as systematic review. In July 2022, out of 229 studies identified by the database search and from other sources, 23 articles related to the selected topic of interest were included in this review. No field strength or sequence restrictions. The data including the study population, study characteristics, as well as basic MRI characteristics, from the final studies included in this review, were extracted independently by two reviewers. The major results of the original study were summarized and no additional statistical analysis was performed. Among the 23 studies included in this review, 17 focused on the applications of MRS and MRI for the prebiopsy diagnosis of PCa. Nine of these 17 articles used Prostate Imaging Reporting and Data System (PI‐RADS) score to interpret MRI results, thereby confirming the practicality of the PI‐RADS score in predicting PCa and csPCa. The remaining six articles evaluated the applications of MRI and MRS in guiding prostate biopsy. Although there was a variation in the biopsy modalities used in these studies, both MRI‐ and MRS‐guided prostate biopsies were observed to improve the detection rates of PCa and csPCa in patients with PSA levels within the gray zone. MRS and MRI showed good performance in the detection of PCa and csPCa before biopsy. In addition, MRS‐ or MRI‐guided prostate‐targeted biopsies were able to improve the detection rates of PCa and csPCa. Evidence Level 3 Technical Efficacy Stage 2

Background. The aim of the study was to find the potential roles of B-type natriuretic peptide (BNP) and imaging markers on distinguishing cardioembolic (CE) stroke from non-CE stroke, so as to provide useful information for making individualized endovascular treatment (EVT) plan for the patients with acute ischemic stroke (AIS). Methods. The patients with unilateral anterior circulation large vessel occlusion who underwent EVT between March 2016 and December 2021 were analyzed in this study, retrospectively. The risk factors, laboratory test indicators, imaging parameters, and other factors were compared between the CE group and non-CE group. Logistic regression was used to analyze the risk factors of CE stroke. ROC curves were used to assess the values of different parameters on distinguishing CE stroke from non-CE stroke. The relationships between BNP and imaging parameters were assessed using the Spearman correlation analysis. Results. 160 patients were enrolled in the study and divided into the CE group ( n = 66 ) and non-CE group ( n = 94 ). BNP (odds ratio OR = 1.004 ; 95% CI, 1.001-1.009; p = 0.038 ), MMR ( OR = 0.736 ; 95% CI, 0.573-0.945; p = 0.016 ), NIHSS ( OR = 1.150 ; 95% CI, 1.022-1.294; p = 0.020 ), and AF ( OR = 556.968 ; 95% CI, 51.739-5995.765; p < 0.001 ) were the independent predictive factors of CE stroke. The area under the curve (AUC) of BNP and mismatch ratio (MMR) were 0.846 (95% CI (0.780-0.898), p < 0.001 ) and 0.636 (95% CI (0.633-0.779), p < 0.001 ), respectively. The cut-off value of BNP was 249.23 pg/mL with the sensitivity of 74.24% and the specificity of 82.98%. BNP combined with MMR improved the predictive value for CE stroke. The AUC of the combination was 0.858 with the sensitivity of 84.85% and the specificity of 73.40%. BNP was correlated with 4D CTA collateral score, MMR, clot burden score, final infarct volume, infarct core volume, and ischemic penumbra volume (all, p < 0.05 ). Conclusion. BNP on admission combined with MMR is valuable for the risk prediction of CE stroke, which will promote the further screening of the high-risk patients with CE stroke and provide more diagnostic information for clinicians.