Background Endometrial carcinoma (EC) risk stratification is generally based on histological assessment. It would be beneficial to perform risk stratification noninvasively by MRI. Purpose To investigate the application of amide proton transfer‐weighted imaging (APTWI), monoexponential, biexponential, and stretched exponential intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI) for the evaluation of risk stratification in early‐stage EC. Study Type Prospective. Population Eighty patients with early‐stage EC (47 classified as low risk, 20 as medium risk, and 13 as high risk by histological grade and International Federation of Gynecology and Obstetrics stage). Field Strength/Sequence T1‐weighted imaging, T2‐weighted imaging, IVIM, APTWI, and DKI MRI at 3 T. Assessment The magnetization transfer ratio asymmetry (MTRasym [3.5 ppm]), apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), distributed diffusion coefficient (DDC), water molecular diffusion heterogeneity index (α), mean kurtosis (MK), and mean diffusivity (MD) were calculated and compared between low‐risk and non‐low‐risk groups. Statistical Tests Individual sample t test, analysis of variance, and logistic regression. A P‐value <0.05 was considered statistically significant. Results The α, ADC, D, DDC, and MD were significantly higher and the f, MK, and MTRasym (3.5 ppm) were significantly lower in the low‐risk group than in the non‐low‐risk group. The difference in D* between the two groups was not significant (P = 0.289). MTRasym (3.5 ppm), D, and MK were independent predictors of risk stratification. The combination of these three parameters was better able to identify low‐ and non‐low‐risk groups than each individual parameter. Data Conclusion The IVIM, DKI, and APTWI parameters have potential as imaging markers for risk stratification in early‐stage EC. Level of Evidence 2 Technical Efficacy Stage 3

Parametric imaging of Ki (the net influx rate) in FDG PET has been shown to provide better quantification and improved specificity for cancer detection compared with SUV imaging. Current methods for generating parametric images usually requires a long dynamic scan time. With the recently developed uEXPLORER scanner, a dramatic increase of sensitivity has reduced the noise in dynamic imaging, making it more robust to employ a non-linear estimation method and flexible protocols. In this work, we explored 2 new possible protocols besides the standard 60-minute one for the possibility of reducing scan time for Ki imaging.

Purpose: To assess the impact of enhanced recovery after surgery (ERAS) protocols in pancreaticoduodenectomy. Methods: Four databases were searched for studies describing ERAS program in patients undergoing pancreatic surgery published up to May 01, 2018. Primary outcomes were mortality, readmission, reoperation and postoperative complications. Secondary outcomes were the length of stay and cost. Results: A total of 19 studies met inclusion and exclusion criteria and included 3,387 patients. Meta-analysis showed a decrease in pancreatic fistula (OR = 0.79, 95% CI: 0.67 to 0.95; I 2 = 0%), infection (OR = 0.63, 95% CI: 0.50 to 0.78; I 2 = 0%), especially incision infection (OR = 0.62, 95% CI: 0.42 to 0.91; I 2 = 0%), and pulmonary infection (OR = 0.28, 95% CI: 0.12 to 0.66; I 2 = 0%). Length-of-stay (MD: −3.89 days, 95% CI: −4.98 to −2.81; I 2 = 78%) and cost were also significantly reduced. There was no significant increase in mortality, readmission, reoperation, or delayed gastric emptying. Conclusion: This analysis revealed that using ERAS protocols in pancreatic resections may help decrease the incidence of pancreatic fistula and infections. Furthermore, ERAS also reduces length of stay and cost of care. This study provides evidence for the benefit of ERAS protocols.