The development of integrated platforms capable of both monitoring and purifying pollutants is crucial for next-generation environmental remediation. Herein, we report a series of novel isostructural bimetal 0.5n[H2bpy]·[EuxEr1-x(dpa)(H2O)2]n·4nH2O [H4dpa = 5-(3, 4-dicarboxy- phenoxy) isophenic acid, H2bpy = protonated 4,4'-bipyridin]. By precisely modulating the molar ratio of Eu3+ to Er3+, we not only preserved the robust three-dimensional framework structure (as confirmed by single-crystal X-ray diffraction and IR spectroscopy) but also successfully tailored its photophysical properties. The optimized Eu0.6Er0.4-MOF demonstrates strong and stable fluorescence, allowing for the rapid and highly sensitive detection of fluazinam (Flu) and tetracycline (TC) in water, with detection limits reaching 14.2 nM for Flu and 79.8 nM for TC, respectively. Mechanistic studies utilizing UV-vis absorption, fluorescence lifetime measurements, XRD, and XPS analyses reveal that the fluorescence quenching is dominated by the inner filter effect (IFE), synergistically enhanced by hydrogen bonds and coordination interactions. Significantly, beyond its sensing capability, the introduction of Er3+ endows the framework with suitable semiconductor bandgap characteristics. This allows Eu0.6Er0.4-MOF to act as an efficient photocatalyst, achieving a 94% degradation efficiency for tetracycline under simulated light. This work presents a synergistic dual-functional material that bridges the gap between contaminant identification and removal, offering a promising strategy for designing advanced spectroscopic sensors integrated with catalytic remediation technologies.

Platinum-resistant OCCC misdiagnosis risks ineffective chemotherapy. CT morphology is widely used for diagnosis, and our prior single-center study showed radiomics is feasible. Whether radiomics adds value beyond morphology remains unclear. This multicenter study compares CT, radiomics, and integrated models for OCCC diagnosis. 457 patients with epithelial ovarian cancer (training = 280, internal testing = 69, external testing = 108). Two radiologists assessed 10 CT morphological features. From CT, 1,218 radiomic features were ICC-filtered (≥ 0.8) + JMIM selection. Three logistic regression models were built: traditional (clinical + CT morphology), radiomics (selected features, output as rad-score), and integrated (traditional + rad-score). Performance was evaluated using ROC analysis, and rad-score correlation with morphological features was examined. Of 457 patients, 96 (21

OBJECTIVE:To evaluate the diagnostic performance of contrast-enhanced CT (CE-CT) in restratifying epithelial ovarian tumors (EOTs) among high-risk patients categorized as Ovarian-Adnexal Reporting and Data System (O-RADS) 4 or 5 on ultrasound (US). METHODS:This retrospective study included patients with pathologically confirmed EOTs who underwent preoperative transvaginal US and abdominopelvic CE-CT between September 2017 and December 2022. Lesions were classified into benign, borderline, or malignant categories according to O-RADS lexicon-based CT morphologic and enhancement features. Diagnostic performance parameters, including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, were calculated on both patient and lesion levels, and interreader agreement was assessed using Cohen's κ. The McNemar's test with continuity correction was used to compare the diagnostic performance of CE-CT and US for discriminating between borderline ovarian tumors and invasive carcinomas after excluding patients with benign EOTs. RESULTS:A total of 210 women (mean age, 48.2 ± 14.2 years) with 258 adnexal lesions were analyzed. At the lesion level, the overall predictive accuracy of CE-CT was 88.8% (229 of 258; 95% confidence interval [CI]: 84.3%-92.1%). Among O-RADS 4 and 5 lesions, CE-CT demonstrated an accuracy of 87.5% (95% CI: 80.7%-92.2%) and 90.0% (117 of 130; 95% CI: 83.6%-94.1%), respectively. At the patient level, CE-CT achieved higher diagnostic accuracy than US (89.3%; 95% CI: 84.0%-92.9% versus 72.0%; 95% CI: 65.2%-78.0%) when excluding patients with benign EOTs. CONCLUSION:CE-CT provides added diagnostic value in restratifying patients with EOTs who are categorized as O-RADS 4 or 5, aiding in characterizing adnexal lesions and supporting more individualized surgical planning.

Active Pharmaceutical Ingredients (APIs) face significant challenges in end-to-end continuous flow synthesis, including low throughput, inefficient condition optimization, and discontinuous multi-step processes. This study develops a methodological framework for the continuous flow synthesis of fluconazole, centered on three key innovations: a milliliter-scale 3D microfluidic chip (MFC) with a high-density Barker transform structure, which achieves >99% mixing efficiency within 6 s (Reynolds number 3-350) and overcomes the volume limitation of traditional microfluidics; a synergistic optimization strategy combining Bayesian Optimization (BO) and in-line UV monitoring, which identifies optimal reaction conditions with minimal experiments; and a fully uninterrupted flow process integrating in-line extraction and circulating flow, eliminating off-line workup and streamlining time-consuming steps. Applied to fluconazole synthesis, this framework achieves an 86% yield in 2 h and 40 min, outperforming traditional batch processes and existing continuous flow routes. This work provides a scalable methodological paradigm for the full-process continuous synthesis of other APIs, highlighting the value of integrated device-design, real-time analytics, and process regulation in pharmaceutical manufacturing.

BackgroundMagnetic resonance imaging (MRI) is increasingly used to evaluate axillary lymph node (ALN) status in breast cancer. However, the correlation between MRI features of the primary tumor and the ALN metastasis (ALNM) burden remains poorly understood. This study aimed to develop a non-invasive MRI-based model to preoperatively distinguish between low (≤2 nodes) and high (>2 nodes) ALNM burden in T1 and T2 stage breast cancer.MethodsThis retrospective single-center study included 185 patients, categorized by ALNM burden [≤ 2 nodes (n = 149) or >2 nodes (n = 36)]. The kinetic and radiomic features were extracted from the segmented whole tumor on dynamic contrast-enhanced MRI (DCE-MRI). A forward-stepwise feature selection method was employed based on the ANOVA F-score from the training cohort. Features were added according to F-values and logistical regression model was built iteratively. The final model, trained on the entire training set, was evaluated on the independent test cohort.ResultsThe model incorporated five kinetic and three radiomic features, demonstrating moderate predictive performance. The model achieved an area under the receiver operating characteristic curve (AUC) of 0.705 in the test cohort. It showed a sensitivity of 72.7% and a specificity of 77.8%. The negative predictive value (NPV) was 92.1%.ConclusionThe kinetic and radiomic features from DCE-MRI showed potential for predicting ALNM burden (≤2 or > 2 nodes) in T1 and T2 stage breast cancer. The high NPV particularly supported their utility as a non-invasive tool to identify candidates for less invasive axillary procedures.

Fluoroorganic chemistry is one of the most hectic areas of current chemical research, exerting a profound effect on the most vital industries such as medicine, pesticide, and material science. Synthesis of fluorine-containing organic molecules, particularly those that bear C(sp3)-F bonds, remains a great challenge in modern chemical synthesis. Herein, we disclose a new strategy for the construction of a carbon-fluorine quaternary center, which was accomplished with the silver(I)-catalyzed intramolecular Wagner-Meerwein rearrangement fluorination of allylic gem-disubstituted alkene derivatives by using a hypervalent monofluoroiodine(III) reagent 1 (AFBI). Interestingly, the tunable five/six-membered heterocycle selectivity is achieved by the intramolecular Wagner-Meerwein rearrangement fluorination via a judicious choice of the group R1 attached to the C-C double bond. This versatile strategy features simple starting materials, mild reaction conditions, good functional-group compatibility, high bond-forming efficiency (e.g., one C-F and one C-O bond), and excellent chemoselectivity. The proposed reaction mechanisms and the roles of the catalyst AgBF4 were understood by control experiments and density functional theory calculations. (c) 2026 Published by Elsevier B.V. on behalf of Chinese Chemical Society and Institute of Materia Medica, Chinese Academy of Medical Sciences.

A novel terbium(III) metal-organic framework (Tb-MOF), namely: {[Tb4(Pta)2 (C2O4)3(H2O)8]& sdot;7H2O}nwas designed and hydrothermal synthesized based on 2, 4, 6-tricarboxylic pyridine (H3Pta) and 1, 2-dipiperidyl ethane (1, 2-bib) ligands. The structure was systematically characterized by single crystal X-ray diffraction, powder X-ray diffraction, elemental analysis and infrared spectroscopy. The structural analysis revealed that Tb-MOF contains two independently crystalline Tb3+ions. Adjacent Tb3+ions form a 1D ring-like chain structure through the coordination of oxalate ions (C2O42-), and H3Pta ligands further connect these chains, ultimately forming a 3D network framework. Tb-MOF exhibits excellent luminescent properties and can achieve highly sensitive and selective detection of Er3+, nitrobenzene (NB), and tryptamine (TRY) in aqueous solutions through fluorescence quenching effects. Interestingly, Tb-MOF can perform high-precision quantitative detection of TRY in aqueous solutions based on ratiometric fluorescence sensing. What is more valuable in terms of application is that we have successfully transformed Tb-MOF into a stable portable fluorescent test strip. When exposed to ultraviolet light (UV), this test strip can directly show the fluorescence changes with the naked eye, enabling rapid and visual on-site detection of TRY, significantly enhancing the convenience and practicability of the detection process. In addition, XPS, fluorescence lifetime, ultraviolet absorption and other principles are used to explore the mechanism of fluorescence quenching.

BackgroundCavitation is a special radiological feature of lung cancer, commonly observed in squamous cell lung cancer (SqCLC). This study intended to report two cases of cavitated and non-cavitated SqCLCs treated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and discuss their different therapeutic responses.Case presentationTwo SqCLC patients with EGFR exon 19 deletions were treated with osimertinib as first-line therapy. One patient presented with a thick-walled cavitated lesion, while the other had a non-cavitated mass. After 3 months of osimertinib treatment, the cavitated SqCLC case showed disease progression. This patient subsequently underwent surgical resection of the primary tumor, followed by chemotherapy and immunotherapy, achieving an overall survival of 41 months to date. In contrast, the non-cavitated SqCLC case responded better to osimertinib, achieving partial remission with a progression-free survival of 14 months. Upon subsequent growth in both the primary lesion and lymph nodes, this patient began treatment with chemotherapy combined with immunotherapy, with a current overall survival of 31 months.ConclusionsThese cases suggest that osimertinib may be less effective as a first-line treatment for EGFR driver gene positive cavitated SqCLC than non-cavitated cases. Further research is needed to evaluate whether combining EGFR-TKIs with other therapies provides greater benefits than EGFR-TKIs alone for EGFR-positive cavitated SqCLC.

A coordination polymer {[Cd(H(2)dpa)(bpy)]3H(2)O}(n) (Cd-CP) was designed and hydrothermal synthesized based on 4-(2,4-dicarboxyphenoxy) phthalic acid (H(4)dpa), 2,2'-bipyridine (bpy) and Cd(NO3)(2)4H(2)O. The structure was characterized by singlecrystal X-ray diffraction, powder X-ray diffraction, elemental analysis, and infrared spectroscopy. Cd-CP belongs to the monoclinic crystal system with the P2(1)/c space group and performs in a 1D double-chain structure. The adjacent double chains further form a 3D supramolecular network structure through hydrogen bonding. Thermogravimetric analysis shows that Cd-CP has good thermal stability. Fluorescence analysis showed that Cd-CP had good choosing selectively and was sensitive to metal ions (Fe3+ and Zn2+), 2,4,6-trinitrophenylhydrazine (TRI), and pyrimethanil (Pth). Interestingly, when Cd-CP was used for fluorescence detection of metal ions, it was found to have a fluorescence quenching effect on Fe3+ but had an obvious enhancement effect on Zn2+. Therefore, we designed an"on-off-on"logic gate. In addition, the mechanism of fluorescence sensing has been deeply explored. CCDC: 2258625.

Herein, we reported an integrated device that was utilized to directly separate plasma and analyze glucose (Glu), cholesterol (Chol) from whole blood samples. The separating module primarily consists of a porous asymmetric polysulfone membrane. The vertical placement of membrane and the gravity settlement of blood cells can reduce mechanical damage to blood cells and blockage of the membrane, resulting in improved separation efficiency of the membrane. The detection module consists of a smart phone and a ratio fluorescence sensing system based on NH2-MIL-53(Al) and o-phenylenediamine (OPD). The sensing system presents a dual emission response to H2O2 the main oxidation product of Glu and Chol. Due to the fluorescence resonance energy transfer (FRET), the response of the fluorescence intensity ratio (F574 nm/F434 nm or F554 nm/F434 nm) gradually increases with increasing H2O2 concentration, accompanied by a color change from weak to strong. The visual detection of Glu and Chol can be realized through the recognition of RGB values by smart phones. The integrated device has been successfully used to analysis Glu and Chol in real blood samples, which provided a universal platform for sensing biocatalytic processes with H2O2 production.

Circulating tumor cells (CTCs) hold significant potential as biomarkers for the diagnosis and management of non-small cell lung cancer (NSCLC). However, their clinical utility is limited by the heterogeneity of CTC subtypes and the need for robust, quantitative assays. In this study, a quantitative CTC RNA assay incorporating multi-antibody-based CTC isolation and specific mRNA quantification by RT-ddPCR is developed. Two distinct models are established: NSCLC CTC ScoreD for detecting early NSCLC (stages I-II), and NSCLC CTC ScoreM for monitoring advanced NSCLC (stages III-IV), based on distinct cohort criteria. NSCLC CTC ScoreD demonstrates high diagnostic performance for early-stage NSCLC, achieving an area under the receiver operating characteristic curve (AUC) of 0.93, significantly outperforming serum CEA (AUC = 0.70). Compared to NSCLC CTC ScoreD, NSCLC CTC ScoreM captures a key gene feature of KRT19, whose fragment protein, serum CYFRA 21-1, is used as a prognostic biomarker for advanced NSCLC. Notably, CTC ScoresM exhibits a more accurate early warning of patient responses to different therapies than serum CYFRA21-1 levels, which may provide a potential blood test-based biomarker for improved treatment assessment in advanced NSCLC.

This study aimed to quantify dynamic changes in the Apparent Diffusion Coefficient (ADC) values of the parotid glands during radiotherapy and explore their correlation with early-stage gland dysfunction. Nasopharyngeal carcinoma patients receiving definitive chemoradiotherapy were prospectively enrolled. Magnetic Resonance Diffusion-Weighted Imaging (MR-DWI) was performed at pre-radiotherapy (pre-RT), the 5th, 15th fractions, and end of radiotherapy. ADC values and volumes for ipsilateral (IP) and contralateral parotid glands (CP) were recorded. Salivary function was assessed using scintigraphy (SGS) and the Radiation Therapy Oncology Group (RTOG) xerostomia criteria. A total of 80 eligible patients were analyzed. From pre-radiotherapy(pre-RT) to the end of radiotherapy, Pearson correlation analysis showed that changes in ADC values were positively correlated with the delivered dose (p < 0.01) and reduction in parotid volume (p < 0.01).From pre-RT to the 5th fraction, mean ADC values((ΔADC5) increased significantly by 17.7

Background:Accurate preoperative human epidermal growth factor receptor 2 (HER2) status assessment is crucial for guiding treatment selection, particularly with the emergence of anti-HER2 antibody-drug conjugates (ADCs) for HER2-low breast cancer. However, current immunohistochemistry (IHC)-based classification is limited by spatial heterogeneity and sampling bias. Quantitative analysis of intra- and peri-tumoral heterogeneity (ITH) on imaging may offer a non-invasive, objective, and reproducible approach to distinguish HER2-low breast cancer from other subtypes. This study aimed to investigate quantitative ITH from high-spatial resolution ultrafast dynamic contrast-enhanced magnetic resonance imaging (UF DCE-MRI) based kinetic curves in distinguishing HER2 low from HER2 zero or positive breast cancer. Methods:Consecutive breast cancer patients who underwent preoperative high-spatial-resolution UF DCE-MRI were retrospectively enrolled. They were stratified into HER2 zero, HER2 low, or HER2 positive groups based on IHC and in situ hybridization results. Traditional MRI findings and clinicopathological characteristics were evaluated, and personalized ITH scores were constructed using semi-quantitative parameters derived from kinetic curves. Models incorporating ITH, MRI, and clinicopathological distinctions were developed for dichotomized HER2 statuses prediction using multivariable logistic regression. The added value of ITH in the Final Combined Model was evaluated. Results:This study enrolled 368 patients, with 45.9% (169/368) having HER2-low breast cancer. The ITH score was higher in HER2 low than that in HER2 zero (P<0.001), but lower than that in HER2 positive (P<0.001). The ITH score was higher in HER2 positive compared to HER2 zero (P<0.001). The Final Combined Model integrating ITH, MRI, and clinicopathological variables achieved good predictive performance, achieving area under the curve (AUC) values of 0.80 [95% confidence interval (CI): 0.75-0.86] for HER2 low vs. zero, 0.85 (95% CI: 0.80-0.89) for HER2 low vs. positive, and 0.83 (95% CI: 0.77-0.88) for HER2 zero vs. positive. The corresponding sensitivity/specificity values were 77%/72%, 77%/81%, and 94%/58%, respectively. The ITH score significantly enhanced HER2 status prediction, supported by AUC improvement (DeLong test, P<0.05), along with statistical significance in net reclassification improvement (NRI) (P<0.001) and integrated discrimination improvement (IDI) (P<0.001) across all tasks. Conclusions:Integrating ITH from high-spatial resolution UF DCE-MRI-based kinetic curves improved the non-invasive differentiation of HER2-low breast cancer. This approach may guide targeted biopsy strategies and aid in selecting candidates for anti-HER2 ADC therapy, optimizing HER2-targeted precision medicine.

Two kinds of isomorphism three-dimensional metal-organic frameworks (Zn-MOF, Co-MOF) namely, {[Zn (H2dppaa)(bpy)(H2O)0.5]n} (1), {[Co(H2dppaa)(bpy)(H2O)0.5]n} (2) have been synthesized under hydrothermal conditions and characterized by singlecrystal X-ray diffraction, thermogravimetric analysis, IR spectra and fluorescent analysis. The single crystal structure analysis shows that both Zn-MOF and Co-MOF belong to monoclinic crystal system and P21/c space group. Taking Zn-MOF as an example, the asymmetric unit contains a Zn (II) atom, an incomplete deprotonated (H2dppaa)2- ion and a 2, 2 '-bipyridine (bpy) ligand. The (H2dppaa)2ion connects Zn (II) through a tridentate chelate bridge coordination mode to form a one-dimensional helix chain structure, which were expanded into a three-dimensional supramolecular network structures by hydrogen bonding. Zn-MOF showed good fluorescence sensing performance in water, and could sensitively detect a variety of water pollutants, such as nitrobenzene (NB), tetracycline (TC) and pyrimethamine (Pth), with detection limits of 0.40 mu M, 89.1 nM and 0.39 mu M, respectively, which could be used for the determination of TC in river water. The fluorescence quenching mechanism of Zn-MOF on TC was studied in detail. It was found that Co-MOF had excellent photocatalytic degradation of methylene blue (MB), the degradation rate was 80 %, and the degradation mechanism was further discussed.

In this work, rare earth ions (REs) including Yb3+/Er3+, Yb3+/Ho3+ and Yb3+/Tm3+ co-doped manganese oxyfluoride glasses were fabricated using melt quenching method. By fully utilizing the upconversion luminescence (UCL) of REs and regulating energy transfer between the different energy levels of RE ions and the 4T1 level of Mn2+, the output of UCL was regulated and even pure-red light can be achieved. Moreover, owing to the selective partitioning caused by phase-separation network structure in the oxyfluoride glass, the UCL intensity of glasses annealed for 72 h is significantly enhanced 58 times compared to the rapidly quenched samples.

Background:Early-stage lung adenocarcinoma exhibits high postoperative recurrence rates, yet the role of TP53 co-mutations with other tumor suppressor genes (TSGs) in driving this risk remains elusive. We aim to elucidate the relationship between different TP53/TSG statuses and recurrence-free survival (RFS) and optimize treatment and follow-up strategies of early-stage patients. Methods:Patients with stage I lung adenocarcinoma who underwent resection at West China Hospital of Sichuan University were categorized into three groups: TP53+/TSG+ (co-mutations), TP53+/TSG- (only TP53 mutation), and TP53-. Kaplan-Meier and Cox regression models assessed the association between TP53/TSG status and RFS, with validation from Memorial Sloan Kettering (MSK) cohort. Hazard function estimation described changes in recurrence risk over time. Results:Among 618 patients, 130 had TP53 mutations (TSG+: 21 vs. TSG-: 109). TP53+ patients were more inclined to be smokers and male compared to TP53- patients (all P<0.001). In MSK dataset, TP53+/TSG+ group had the highest smoking rate (all P<0.05). TP53+ tumors showed higher rates of spiculation, pleural indentation, and visceral pleural invasion (all P<0.05). Recurrence occurred in 45 patients (7.3%). TP53+/TSG+ patients exhibited shorter RFS than both TP53+/TSG- and TP533- groups (our cohort: 14.7 vs. 25.6 vs. 30.5 months, P<0.001; MSK cohort: 11.2 vs. 19.9 vs. 14.9 months, P=0.005). Multivariate Cox analysis confirmed TP53+/TSG+ as an independent risk factor for relapse [TP53+/TSG+ vs. TP53+/TSG-, hazard ratio (HR) = 3.0, 95% confidence interval (CI): 1.2-7.6, P=0.02; TP53+/TSG+ vs. TP53-, HR =3.0, 95% CI: 1.2-7.2, P=0.01]. Tumor mutation burden elevated in TP53+/TSG+ patients (all P<0.05), with a spike in recurrence risk at 3-4 years. Conclusions:TP53+/TSG+ patients exhibit higher recurrence risk, highlighting the need for close surveillance and further research into the potential role of neoadjuvant strategies.

BACKGROUND:Early detection of epithelial ovarian cancer (EOC) is crucial for improving clinical outcomes. However, the sensitivity of primary serological marker cancer antigen 125 (CA125) is suboptimal for detecting early-stage EOC. Tumour-derived extracellular vesicles (EVs) are promising biomarkers for early cancer detection. METHODS:We developed an EOC EV Surface Protein-mRNA Integration (SPRI) Assay for early detection of EOC. This assay quantifies reference mRNAs within subpopulations of EOC EVs enriched by EV Click Beads targeting three EOC EV surface protein markers. Three EOC EV surface protein markers (i.e., FRα, MSLN, and TROP2) were selected through a bioinformatic framework using multi-omics data and underwent rigorous validation using EOC cell lines and EOC tissue microarrays. We then explored the translational potential of the EOC EV SPRI Assay through a phase II case-control study. The EOC EV SPRI Score was established using a logistic regression model in a training cohort (n = 118) and then validated in an independent validation cohort (n = 118). FINDINGS:EOC EV SPRI Score demonstrated superior performance for distinguishing EOC from benign ovarian masses and healthy donors with an area under the receiver operating characteristic (AUROC) of 0.99 (95% CI: 0.97-1.00) in the training cohort and 0.93 (95% CI: 0.88-0.97) in the validation cohort. It outperformed matched serum CA125, and the performance remained excellent in earlier stages of EOC (Stage I/II, AUROC = 0.93, 95% CI: 0.88-0.98) and the subgroup of high-grade serous carcinoma (AUROC = 0.97, 95% CI: 0.87-0.97). INTERPRETATION:The EOC EV SPRI assay demonstrated significant potential for early detection of EOC and improving long-term patient outcomes. FUNDING:This work is supported by National Institutes of Health (R01CA277530, R01CA255727, R01CA253651, R01CA253651-04S1, R21CA280444, R01CA246304, U01EB026421, R44CA288163, U01CA271887, and U01CA230705), DOD (HT9425-23-1-0361) and OCRA (CRDG-2023-3-1000) for the U.S. STUDY:Additionally, we acknowledge the support of the Science and Technology Foundation of Suzhou (SZS2023006, SSD2023004) and the Youth Innovation Promotion Association CAS (2023335) for the work conducted at SINANO.

Accurate size and stage estimation is important to monitor tumor response and plan further treatment in breast cancer patients undergoing neoadjuvant chemotherapy. To evaluate the accuracy of imaging findings [ultrasound (US) and magnetic resonance imaging (MRI)] for tumor size and stage estimations in early breast cancer patients and to elucidate the factors influencing tumor stage assessment. We retrospectively enrolled consecutive women having pathologically confirmed breast cancer (stage T1/T2, 199 patients and 201 lesions) and preoperative records available for both US and MRI. The concordance between imaging-determined and pathological tumor size and stage was explored. The McNemar’s test was conducted to compare the concordance between imaging-determined tumor size and imaging-determined tumor stage. Multivariate logistic regression was used to analyze the factors that influenced the accuracy. The concordance between US-determined and pathological tumor size (71.1

To evaluate the value of enhanced T1 mapping MR imaging in assessing the depth of myometrial invasion (MI) and in detecting DNA mismatch repair (MMR) status in endometrial cancer (EC) as a non-invasive imaging biomarker. This prospective study enrolled 46 patients with pathologically confirmed EC who underwent pelvic MRI and surgery within two weeks. Each patient underwent multiparametric MRI including T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), dynamic contrast-enhanced imaging (DCE), native T1 mapping and enhanced T1 mapping. Four radiologists (two junior, two senior) independently assessed MI depth of EC using two combinations: T2WI + DWI + DCE and T2WI + DWI + enhanced T1 mapping. Histopathology served as the reference standard. MMR status was determined by immunohistochemistry. Quantitative analysis of native T1, enhanced T1, and Apparent diffusion coefficient (ADC) values was performed, and inter-reader agreement and diagnostic performance were compared. Receiver operating characteristic curve (ROC) analysis was performed. Statistical significance was set at p < 0.05. The diagnostic accuracy of T2WI + DWI + enhanced T1 mapping for assessing MI was higher than that of T2WI + DWI + DCE across all readers, especially among junior radiologists, though differences were not statistically significant (P > 0.05). Inter-reader agreement improved with enhanced T1 mapping, particularly for junior readers (κ = 0.898 vs. κ = 0.538). Native T1 values were significantly higher in the proficient MMR group compared to the deficient MMR group (1655.5 ± 131.9 ms vs. 1549.1 ± 125.9 ms, P = 0.047). ROC analysis yielded an Area under the curve (AUC) of 0.729 for differentiating deficient MMR from proficient MMR, with a sensitivity of 87.0