This study aimed to investigate the recorded cancer frequency in children and adolescents in Isfahan Province, Iran.

As one of the main reasons for death among children and adolescents is reported as cancer with different prevalence worldwide, therefore, reporting the occurrence of cancers in this population is crucial.

Methods: Information from the years between 2013 to 2015 related to the Surveillance, Epidemiology, and End Results; (SEER) was collected from the Isfahan Cancer Registry. The cancer sites studied were defined according to the International Classification of Diseases and recorded by related topography codes.

Results: Among all 30,465 registered cancers, there were 582 cases (2%) of cancer, including 57% of children and 43% of adolescents. The mean ± SD age of patients was 11.5 ± 5.9 years (Min; 1, Max 19). The top four ranked cancers were (n=264; 45%) comprised of; 1) hematopoietic and reticuloendothelial system (n= 122), 2) secondary and unspecified malignant neoplasm of lymph nodes (n=56), 3) malignant neoplasm of the brain (n=43) 4), thyroid gland (n=43). Death-reported data was associated with 32% of the total population studied. The neoplasm was reported in 174 cases, which was associated with 95% death.

Conclusion: This frequency source of children and adolescents cancers could be used for health strategy. The observed variations in the frequency of different cancers require continuous monitoring and investigation. Therefore, plan of health-system should focus based on greater efforts toward advanced evidence-based drug therapy in Isfahan, Iran.

Case Report: A 35-year-old male patient with a known metastatic lung neuroendocrine tumor (NET) who was treated with Sunitinib for many years with partial response and tolerating the treatment well-developed recurrent DIC on Sunitinib after COVID-19 infection.

Discussion: COVID-19 infection is reported to be associated with endothelial injury and inflammation. Vascular endothelial growth factor (VEGF) receptors have a role in the protection and modulation of endothelium. Sunitinib is a multikinase inhibitor with anti- VEGF effect. It is possible that endothelial injury after COVID-19 may have triggered recurrent DIC in this patient who had previously tolerated the same drug without problems.

Conclusion:

DIC may be underreported especially with antineoplastics having anti-VEGF effects. Potential risk, interaction, and association with COVID-19 infection in the Era of the pandemic are unclear but warrants further research, and drug-induced DIC should be considered in the differential diagnosis of such cases.

Methods: Blood and livers were collected from mice. In the in vitro experiments, human normal hepatocyte (LO2 cell line) and human hepatoma cells (HepG2 cell line) with overexpressed DDR1 (DDR1-OE) or DDR1 knockdown (DDR1-KD) were constructed by transfecting the corresponding lentivirus. Human hepatic stellate cells (LX2 cell line) were incubated with a conditioned medium (CM) of the above stable transfected cells treated with collagen. The cells and supernatants were collected for molecular and biochemical analyses.

Results: DDR1 expression was increased in hepatocytes from carbon tetrachloride (CCL4)-induced fibrotic livers compared to normal livers in wild-type (WT) mice. Liver fibrosis was relieved, and hepatic stellate cells (HSC) activation was decreased in CCL4-treated DDR1 knockout (DDR1-KO) mice compared with CCL4-treated WT mice. LX2 cells cultured in CM of LO2 DDR1-OE cells revealed increased α-smooth muscle actin (αSMA) and type I collagen (COL1) expressions and cell proliferation. Meanwhile, cell proliferation and the expression levels of αSMA and COL1 in LX2 cells cultured in CM of HepG2 DDR1-KD cells were decreased. Moreover, IL6, TNFα, and TGFβ1 in CM of DDR1-OE cells appeared to promote LX2 cell activation and proliferation, regulated by NF-κB and Akt pathways.

Conclusion: These results indicated that DDR1 in hepatocytes promoted HSC activation and proliferation and that paracrine factors IL6, TNFα, and TGFβ1 induced by DDR1 through activating NF-κB and Akt pathways may be the underlying mechanisms. Our study suggests that collagen-receptor DDR1 may be a potential therapeutic target for hepatic fibrosis.

Objective: In this comprehensive review, we have elaborated on the pathophysiology, and various signaling pathways linked with Sarcopenia. Also, discussed the preclinical models and current interventional therapeutics to treat muscle wasting in older patients.

Conclusion: In a nutshell, a comprehensive description of the pathophysiology, mechanisms, animal models, and interventions of Sarcopenia. We also shed light on pharmacotherapeutics present in clinical trials which are being developed as potential therapeutic options for wasting diseases. Thus, this review could fill in the knowledge gaps regarding Sarcopenia-related muscle loss and muscle quality for both researchers and clinicians.

Methods: p300 S89A edited P19 cells, and S89AKI mice demonstrated metabolic and neuronal differentiation defects based on proteomic, cell biological and PET imaging studies.

Results: The metabolic and differentiation defects associated with the p300 S89A knockin mutation could be corrected both in vitro and in vivo utilizing the small molecule CBP/beta-catenin antagonist ICG-001.

Conclusion: Rebalancing the equilibrium between CBP/β-catenin versus p300/β-catenin associated transcription, utilizing the small molecule CBP/beta-catenin antagonist ICG-001, enhances mitochondrial oxidative phosphorylation, metabolic function, and neuronal differentiation and may be able to ameliorate the cognitive decline seen in neurodegenerative disorders, including Alzheimer’s Disease.

Objective: This study aimed to investigate the effect of CD73 targeting inhibition on liver fibrosis.

Methods: Intraperitoneal injection of CCl4 was used to induce liver fibrosis in mice models. Adenosine 5′-(α, β-methylene) diphosphate sodium salt (APCP) was used for CD73 blockade. The siRNA was used to induce CD73 knockdown in HSCs. LX2 and HSC-T6 were used to investigate the role of CD73 in HSCs activation in vitro.

Results: The results showed that APCP treatment could alleviate hepatic fibrosis. In fibrotic liver tissues, CD73 exhibited a positive correlation with markers of HSCs activation. Furthermore, APCP treatment and CD73 knockdown could inhibit HSCs (LX2 and HSC-T6) activation and proliferation. By using RNA sequencing of liver tissues from control, CCl4-mice, and APCP-treated mice, 851 genes that were significantly changed in CCl4 mice (vs. control) were reversed by APCP treatment. These genes were mainly enriched in cell division-associated biological processes. Moreover, we found that CD73 might be associated with autophagy in HSCs. In fibrotic liver tissues and HSCs, ATG5 and Beclin1 expression could be downregulated by CD73 knockdown and APCP treatment.

Conclusion: This study demonstrated the effects and mechanism of CD73 in HSCs activation and proliferation, which presents the therapeutical potential of CD73 blockage for liver fibrosis.

Objective: The aim of this review was to discuss several important deregulated miRNAs that are involved in the p53 signaling pathway in BC, especially the TNBC subtype. Finally, miRNAs’ involvement in tumor properties and their applications as diagnostic, prognostic, and therapeutic agents have been elaborated in detail.

Results: The miRNA expression profile of BC is involved in tumor-grade estrogen receptor (ER) and progesterone receptor (PR) expression, and other pathological properties from luminal A to TNBC/basal-like subtypes via p53 signaling pathways.

Conclusion: Developing our knowledge about miRNA expression profile in BC, as well as molecular mechanisms of initiation and progression of BC can help to find new prognostic, diagnostic, and therapeutic biomarkers, which can lead to a suitable treatment for BC patients.

Methods: To investigate IMPDH2 expression in HB tissues and prognostic significance in HB patients, gene expression profiling interactive analysis (GEPIA) has been adopted. Immunohistochemistry has also helped to validate the protein expression of IMPDH2 in HB tissues. The effect of IMPDH2 overexpression or depletion on the proliferation of Hepatoblastoma cells in vitro has been evaluated by CCK8 assays and colony formation assays. Xenograft tumor growth of mice has been detected. Luciferase reporter assays have been conducted to determine the interaction of IMPDH2 and JunB, which was further asserted by pharmacological inhibition of JunB.

Results: IMPDH2 was highly expressed in HB tissues. Experimentally, the proliferation and colony formation of HuH6 cells were increased by IMPDH2 overexpression. Conversely, genetic inactivation of IMPDH2 impaired the proliferative efficiency and colony-forming rate of HepG2 cells. Besides, the luciferase reporter assay validated IMPDH2 overexpression to be associated with enhanced JunB transcriptional activity, while its activity was diminished in the case of IMPDH2 depletion. JunB inhibitor neutralized the IMPDH2-mediated increased phosphorylation of JunB.

Conclusion: Our findings, thus, suggest that IMPDH2 exhibits its oncogenic role in HB partially via JunB-dependent proliferation.

Methods: MTT assay, colony formation assay and Hoechst staining were performed to investigate the growth inhibition effect of quercetin alone or combined with 5-FU. The expression levels of apoptosis and autophagy-related proteins were assessed by western blotting. Intracellular ROS was detected using DCFH-DA. The change in the mitochondrial membrane potential was measured by a JC-1 probe. The effect of quercetin on mitochondrial morphology was examined using a mitochondrial-specific fluorescence probe, Mito-Tracker red.

Results: The results demonstrated quercetin induced apoptosis and autophagy, as well as imbalanced ROS, decreased mitochondrial membrane potential, and Drp-1-mediated mitochondrial fission in CRC cells. Autophagy blockage with autophagy inhibitor chloroquine (CQ) enhanced quercetininduced cytotoxicity, indicating that quercetin induced cytoprotective autophagy. Meanwhile, quercetin enhanced the sensitivity of CRC cells to 5- FU via the induction of mitochondrial fragmentation, which could be further enhanced when the quercetin-induced protective autophagy was blocked by CQ.

Conclusions: The findings of the study suggested that quercetin could enhance the sensitivity of CRC cells to conventional agent 5-FU by regulating autophagy and Drp-1-mediated mitochondrial fragmentation. Therefore, quercetin may act as a chemotherapeutic adjuvant. Moreover, the regulation of autophagic flux may be a potential therapeutic strategy for colorectal cancer.

Conclusion: The progress of developing a cancer treatment that may successfully and efficiently target mutant p53 is on the verge of development. Mutant p53 proteins not only initiate oncogenesis but also cause resistance in cancer cells to certain chemo or radiotherapies, further endorse cancer cell survival and promote migration as well as metastasis of cancerous cells. With this regard, many mutant p53 inhibitors have been developed, some of which are currently being evaluated at the pre-clinical level and have been identified and discussed. To date, APR-246 is the most prominent one that has progressed to the Phase III clinical trial.

Objective: This study aimed to prepare human albumin (HSA) nanoparticles containing Fenoferin (FN) modified with folic acid (FA) attached to Chitosan (CS) to improve its anti-cancer properties.

Methods: Nanoparticles were first synthesized and surface modified. Their physicochemical properties were assessed by different methods, such as FESEM, FTIR, and DLS. In addition, the percentage of drug encapsulated was measured by indirect method. Besides evaluating the cytotoxic effects of nanoparticles using the MTT assay, the antioxidant capacity of FN-HSA-CS-FA was assessed using the ABTS and DPPH methods. Nanoparticles were also investigated for their anti-cancer effects by evaluating the expression of apoptosis and metastasis genes.

Results: Based on this study, FN-HSA-CS-FA was 165.46 nm in size, and a uniform dispersion distribution was identified. Particles were reported to have a zeta potential of +29 mV, which is within the range of stable nanoparticles. Approximately 75% of FN is encapsulated in nanoparticles. Cytotoxic assay determined that liver cancer cells were most sensitive to treatment with an IC₅₀ of 144 μg/ml. Inhibition of free radicals by nanoparticles is estimated to have an IC₅₀ value of 195.23 and 964 μg/ml, for ABTS and DPPH, respectively. In the treatment with nanoparticles, flow cytometry results of arresting the cells in the SubG1 phase and real-time qPCR results indicated increased expression of caspases-3, caspase-8, and caspase-9 genes.

Conclusion: According to this study, synthesized nanoparticles inhibited free radicals and activated apoptosis in liver cancer cells, and the capability of these nanoparticles to inhibit cancer cells was also confirmed. This formulation can, therefore, be used in preclinical studies to test the efficacy of the drug.

Methods: The classification QSAR-based methods namely Bayesian classification and recursive partitioning method were applied to a dataset consisting of HADC9 inhibitors. The structural features strongly suggested that sulphur-containing compounds can be a good choice for HDAC9 inhibition. For this reason, these models were applied further to screen some natural compounds from Allium sativum. The screened compounds were further accessed for the ADME properties and docked in the homology-modelled structure of HDAC9 in order to find important amino acids for the interaction. The best-docked compound was considered for molecular dynamics (MD) simulation study.

Results: The classification models have identified good and bad fingerprints for HDAC9 inhibition. The screened compounds like ajoene, 1,2 vinyl dithiine, diallyl disulphide and diallyl trisulphide had been identified as compounds having potent HDAC9 inhibitory activity. The results from ADME and molecular docking study of these compounds show the binding interaction inside the active site of the HDAC9. The best-docked compound ajoene shows satisfactory results in terms of different validation parameters of MD simulation study.

Conclusion: This in-silico modelling study has identified the natural potential lead (s) from Allium sativum. Specifically, the ajoene with the best in-silico features can be considered for further in-vitro and in-vivo investigation to establish as potential HDAC9 inhibitors.

Background: GBM is the most malignant primary brain cancer with a poor prognosis. Previous studies have suggested that GBM vessels undergo dynamic remodeling modulated by tumor vasodilation and vasoconstriction instead of tumor angiogenesis.

Objective: Here, we have first investigated the expression and function of UTS2, a potent vasoconstrictor, in GBM.

Methods: The mRNA expression profiles and clinical information of GBM patients were obtained from the TCGA database. The clinical relevance of UTS2 was explored by the Mann-Whitney U test and Cox hazard regression survival test. We further explored the role of UTS2 in GBM cell proliferation, migration, and tumor immune microenvironment. Moreover, we established the in vivo mice model to validate its oncogenic effects on GBM progression.

Results: Although we did not find significant correlations between UTS2 expression and patients’ clinical characteristics, UTS2 was identified as a valid independent prognostic indicator according to multivariate survival analysis. Knockdown of UTS2 resulted in decreased GBM cell proliferation and migration. In addition, functional enrichment analysis implied UTS2 to be involved in the regulation of the immune microenvironment. In vivo studies showed that UTS2 knockdown suppressed GBM xenograft growth, highlighting the tumor-promoting effects of UTS2 on GBM.

Conclusion: Our study identified that UTS2 could predict the prognosis of GBM patients and provided evidence regarding its oncogenic effects both in vitro and in vivo.

Methods: Chitosan, a cationic polymer with biocompatible and biodegradable properties, was combined with soy lecithin to develop the NPs loaded with GFN using a self-organizing ionic interaction methodology.

Results: The entrapment efficiency and drug loading were found to be 59.04±4.63 to 87.37±3.82% and 33.46±3.76 to 49.50±4.35%, respectively, and results indicated the encapsulation of GEN in NPs. The pH of the formulations was observed between 4.48-4.62. Additionally, all the prepared NPs showed the size and PDI range of 89.2±15.9 nm to 799.2±35.8 nm and 0.179±0.065 to 0.455±0.097, respectively. The FTIR bands in optimized formulation (GFN-NP1) indicated that the drug might be contained within the NP's core. The SEM photograph revealed the spherical shape of NPs. The kinetic release model demonstrated the combination of diffusion and erosion mechanisms. The IC₅₀ value of GFN and GFN-NP1 formulation against the HepG2 cell lines were determined and found to be 63.22±3.36 μg/ml and 45.80±2.53 μg/ml, respectively. DAPI and PI staining agents were used to detect nuclear morphology.

Conclusion: It was observed that the optimized GFN-NP1 formulation successfully internalized and inhibited the growth of HepG2 cells. Hence, it can be concluded that the prepared NPs can be a new therapeutic option for treating liver cancer.

Methods: After regulating the expression of LKB1, cell proliferation was determined by Cell Counting Kit-8 (CCK-8) assay. The flow cytometry assay was used to analyse cell cycle distribution. Survival fraction and sensitization enhancement ratio (SER) were generated by clonogenic survival assay. Western blot analysis was used to assess expression levels of LKB1, p53, p21, γ-H2AX and p-Chk2.

Results: Our study found that when the NSCLC cells were exposed to ionizing radiation, LKB1 could inhibit NSCLC cell proliferation by promoting DNA double strand break and inducing DNA repair. In addition, LKB1 could induce NSCLC cells G1 and G2/M phase arrest through up-regulating expression of p53 and p21 proteins.

Conclusion: This current study demonstrates that LKB1 enhances the radiosensitivity of NSCLC cells via inhibiting NSCLC cell proliferation and inducing G2/M phase arrest, and the mechanism of cell cycle arrest associated with signaling pathways of p53 and p21 probably.

Objectives: This study aimed to explore the molecular mechanism by which metformin inhibits the expression of NLRP3 inflammasome, regulates the inflammatory microenvironment, and delays the progression of colorectal cancer through in vitro cell experiments.

Methods: In this research, NLRP3 was knocked down in human colorectal cancer cells, and metformin was added to them. Cell proliferation ability was detected by CCK8, and cell migration and invasion abilities were assessed by Transwell assay. The apoptosis rate was determined by flow cytometry. In addition, the expression of NLRP3 inflammatory vesicles and inflammatory factors in each group of cells was studied by qRT-PCR and Western blotting. Finally, clinical colorectal cancer samples were analyzed by immunohistochemistry.

Results: The results of the study showed that NLRP3 expression was significantly increased in colorectal cancer cell lines and human colorectal cancer tissues. Knockdown of NLRP3 significantly inhibited tumor cell proliferation, migration, and invasion. In addition, the proliferation, migration and invasion of tumor cells were also significantly reduced by the addition of metformin intervention. Furthermore, qRT-PCR and WB results demonstrated that the expression of IL-1β, IL-6, TNF- α, TGF-β, and IL-10 was down-regulated in LS1034 tumor cells after NLRP3 knockdown. In addition, metformin intervention also resulted in different degrees of downregulation of NLRP3 and inflammatory factor expression (p π0.05). Notably, the reduction in inflammatory factors was more pronounced after the combination of NLRP3 knockdown and metformin intervention.

Conclusion: Metformin can inhibit the expression of NLRP3 inflammasome, thereby suppressing the expression of inflammation-related factors, reducing the damage of the inflammatory microenvironment to normal cells, and delaying the progression of colorectal cancer.]]> https://www.benthamscience.comarticle/136851Background: Ultrasonic irradiation has the remarkable potential to amplify reactivity by a factor of approximately one million. The effects of ultrasound on chemical processes can be categorized as either homogeneous sonochemistry, which takes place in liquids, or heterogeneous sonochemistry, which occurs in liquid-liquid or liquid-solid systems.

Objectives: Pyrimidines are a vital group of compounds known for their anticancer activities. This study delves into investigating the application of ultrasonic irradiation for the synthesis of pyridopyrimidine derivatives.

Methods: In our study, we utilized pyrimidine derivatives 1, 2a, and 2b as reducing agents during the creation of selenium nanoparticles (Het-SeNPs). The characterization of these nanoparticles was executed through a range of analytical approaches, including ultraviolet-visible spectrometry, dynamic light scattering (DLS, Zeta), and transmission electron microscopy (TEM). Additionally, FTIR and NMR spectroscopic examinations provided proof of the formation of these nanoparticles within the synthesized molecules 1, 2a, and 2b.

Results: The impact of the produced heterocyclic derivatives and Het-SeNPs was assessed on various cancer cell lines, including breast cancer (MCF-7), liver cancer (HepG2), and prostate cancer (PC-3) cell lines. All tested substances demonstrated a reasonable level of safety in the HFB4 cell line, which represents normal human skin melanocytes. Noteworthy is the substantial cytotoxicity exhibited by compound 2b against MCF-7 cell lines.

Conclusion: Moreover, compound 2b-SeNPs demonstrated even higher cytotoxicity against the MCF-7 cell line compared to compound 2b, where 5-fluorouracil was used as a reference standard. Detailed cell division analysis disclosed significant antiproliferative properties in compounds 2b and 2b-SeNPs, leading to the arrest of the cell cycle at the pre-G1 and G2/M phases.

On the other hand, the portal vein carries microbial-produced endogenous compounds from the colon to the liver, where they might disrupt liver function. Acetyl-aldehyde and butyrate are two of the many byproducts produced by the microbiota in the human gut in response to indigestible food. In addition, these two waste products alter liver function and play an important role in maintaining intestinal health in humans. This paper reviews the literature on the link between butyrate and acetyl-aldehyde production in the human gut and the organ's role in the development of liver disease. Butyrate, acetyl-aldehyde, and liver disease all play roles in the gut-liver axis.

Background: Primary hepatic neuroendocrine neoplasms (PHNENs) are rare diseases, and most of the relevant studies are case reports. Characterized by no specific clinical symptoms, PHNENs not only have a low preoperative diagnosis rate with great difficulty in early diagnosis but are frequently misdiagnosed as primary hepatic cancer.

Objective: 15 PHNEN patients were enrolled, with 10 cases in the G2 stage and 5 cases in the G3 stage.

Methods: The imaging and clinicopathological information of 15 patients pathologically diagnosed with PHNENs was retrospectively reviewed.

Results: The average age of the patients enrolled was 46.14±18.24 years, and the average tumor size was 91.00±61.17 mm. 13 cases showed nodules or masses, 8 cases were located in the periphery of the liver, showing capsule depression and subcapsular effusion signs. CT enhanced scan showed heterogeneous and obvious enhancement in 9 arterial-phase cases, 2 cases in arterial and portal venous phases both saw mild enhancement; the enhancement degree of lesions in the G2 stage in the arterial phase was significantly higher than in the G3 stage. Gd-EOB-DTPA dynamic enhanced MRI was conducted on 3 cases, and scattered lesions with heterogeneous and slight hyperintensity were observed in the hepatobiliaryspecific lesions. Image manifestations showed diffuse lesions in 2 cases, with heterogeneous enhancement in the arterial phase and decreased enhancement in the portal venous phase by the dynamic enhanced scan.

Conclusion: PHNENs were the imaging characteristics of PHNENs. The CT-enhanced scanning during the arterial phase may provide a certain reference for pathological grading (G2 and G3 grades). Gd-EOB-DTPA-enhanced MRI is helpful for PHNEN diagnosis.

Background: Over recent years, diagnostic imaging has progressed from a state of commencement to an advanced level. Numerous modern imaging procedures have evolved. Although contemporary medical imaging comprises image exhibition together with image refining, computer-aided diagnosis (CAD), image inscribing and conserving, and image transference, the majority of which are embraced in picture documentation and communication processes.

Aim: This review targets to encapsulate toxicology information on skin cancer unpredictability essential to interpretation measures, report important factor that helps in defining skin cancer condition, and possible medical care alternatives or medical attention endorsed referring to diverse aspects involving the size and site of malignancy, the complications, patient’s priority and well being. We concisely review various therapy alternatives, methods of radiation autoimmunity, prime observational study designs of medical and distinct radiation resources and cancer risks, and current analysis methodologies and research precision.

Conclusion: The detail of this paper covers a brief review of research and evolution in medical imaging discipline and mechanism. This review considers the physiology of melanocytes and the pathogenesis of skin cancer using medical imaging. Also, a description of risk factors, prevention methods, screening, various diagnosis methods and different stages of skin cancer, sub-types and different types of treatment methods is provided in this paper for research and development.

Methods: Dose length product total (tDLPs), volumetric CT dose index (CTDI_vol), size-specific dose estimate (SSDE), effective dose (E), and scan acquisition parameters for a total of 216 adult patients, who underwent an enhanced CT abdomen and pelvis exams over a one-year period, were obtained and retrospectively analyzed. Spearman coefficient and one-way ANOVA tests were used to check significant differences between dose metrics and the different CT protocols.

Results: The data exhibited 9 different CT protocols to acquire an enhanced CT abdomen and pelvis exam at our institute. Out of these, 4 were found more common, i.e., CT protocols were acquired for a minimum of 10 cases. Triphasic liver demonstrated the highest mean and median tDLPs across all 4 CT protocols. Triphasic liver protocol registered the highest E followed by gastric sleeve protocol with a mean of 28.7 and 24.7 mSv, respectively. Significant differences (p < 0.0001) were found between the tDLPs of anatomical location and the CT protocol.

Conclusion: Evidently, wide variability exists across CT dose indices and patient dose metrics relying on anatomical-based dose baseline, i.e., DRLs. Patient dose optimizations require establishing dose baselines based on CT protocols rather than the anatomical location.

Introduction: There are different modalities used for the diagnosis of pancreatic cancer, such as Positron Emission Tomography/Computed Tomography (PET/CT), Magnetic Resonance Imaging (MRI), Multiparametric-MRI (Mp-MRI), Radiomics and Radio-genomics. Although these modalities gave remarkable results in diagnosis on the basis of different criteria. CT is the most commonly used modality that produces detailed and fine contrast images of internal organs of the body. However, it may also contain a certain amount of gaussian and rician noise that is necessary to be preprocessed before segmentation of the required region of interest (ROI) from the images and classification of cancer.

Methods: This paper analyzes different methodologies used for the complete diagnosis of pancreatic cancer, including the denoising, segmentation and classification, along with the challenges and future scope for the diagnosis of pancreatic cancer.

Results: Various filters are used for denoising and image smoothening and filters as gaussian scale mixture process, non-local means, median filter, adaptive filter and average filter have been used more for better results.

Conclusion: In terms of segmentation, atlas based region-growing method proved to give better results as compared to the state of the art whereas, for the classification, deep learning approaches outperformed other methodologies to classify the images as cancerous and non- cancerous. These methodologies have proved that CAD systems have become a better solution to the ongoing research proposals for the detection of pancreatic cancer worldwide.

Case Presentation: This article reports a case of a patient with hormone receptor-positive, HER2-negative breast invasive lobular carcinoma with gastrointestinal tract and skin metastases. The patient was assessed by a second-look ultrasound and diagnosed by subsequent ultrasound-guided needle biopsy. Following endocrine therapy, a favorable effect was observed, with significant regression of the primary breast lesion, cutaneous metastases, and gastrointestinal metastases.

Conclusion: Patients with breast invasive lobular carcinoma should be alert to the possibility of breast cancer metastasis, even if there are no obvious symptoms or signs, when they encounter rapidly progressive cutaneous nodules or plaques, or if they possess gastrointestinal abnormalities. For patients with negative breast ultrasonography for the first time, after combining mammography, Contrast-enhanced Spectral Mammography (CESM) or Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) examinations, if breast cancer is highly suspected, second-look ultrasound is particularly crucial at this juncture, which is the key prerequisite for breast needle biopsy and obtaining the gold standard of pathology.]]> https://www.benthamscience.comarticle/135753Background: Ovarian cancer is a common gynecological malignant tumor in women. Most patients have reached the advanced stage when they visit the hospital. In order to diagnose ovarian cancer at an early stage, treat it at an early stage, and improve the survival rate of patients, this study has used the imaging computed tomography (CT) method to diagnose stage IA ovarian cancer.

Purpose: The purpose of this work was to study CT features of stage IA ovarian cancer, and compare the borderline tumor and stage IC ovarian cancer at the same time so as to improve the CT diagnosis of early ovarian cancer.

Methods: We retrospectively collected clinical and CT data of patients with stage I ovarian cancer and borderline ovarian tumor admitted to Nantong Tumor Hospital from 2013 to 2021. Altogether, 23 cases of patients (borderline ovarian tumor, 9 cases; stage IA ovarian cancer, 5 cases; stage IC ovarian cancer, 9 cases) were involved. CT characteristics of these patients were analyzed in terms of the tumor diameter, cystic solid structure, solid component, septation, enhancement, peritoneal thickening, ascites, and abdominal lymph nodes.

Results: CT features of stage IA ovarian cancer included large tumor size (average diameter: 15 cm), cystic solid structure (4/5; 80%), septation (4/5; 80%), and enhanced cystic wall, septum, or solid components of the tumor on contrast-enhanced CT (5/5; 100%), no peritoneal thickening (0/5; 0%), no ascites (0/5; 0%), and no abdominal lymph node enlargement (0/5; 0%). The tumor structure did not differ significantly between stage IA and IC ovarian cancers (p > 0.05), while intraperitoneal ascites did (χ² = 0.031; p < 0.05). Stage IA and borderline ovarian tumors did not differ significantly in ovarian tumor structure (p > 0.05).

Conclusion: CT features of stage IA ovarian cancer included large tumor size, cystic solid structure, septation, and enhanced cystic wall and solid parts in the tumors. No pelvic or abdominal metastasis was observed.

Case presentation: We presented a case of a 72-year-old female who was admitted to our hospital for chest pain and hematemesis within several minutes after chewing betel nut. Gastroscopy showed two longitudinal ridge-like mucosal eminences in the esophagus located 20 cm from the incisors down to the gastric cardia, which was similar to varices. At last, a CT scan showed concentric-circle thickening of the esophagus wall, suggesting hematomas. Our treatment included fasting, inhibiting gastric acid and maintaining blood volume. After one week of medical treatment, rechecked gastroscopy showed that esophageal hematomas were gradually absorbed, with the formation of multiple shallow ulcers.

Conclusion: The acute toxicity of chewing betel nut can be easily overlooked. Patients who experience chest pain or hematemesis after chewing betel nut products,especially those who take aspirin at the same time, need to be alert to esophageal hematoma.

Objective: This study aims to present a detailed review and investigation of schemes considered in medical clinics to identify the AFLD/NFLD coupled problems and present the merit of the Transient Elastography (TE) combined with Fibroscan® practice to identify liver abnormality.

Methods: This research aims to study the clinical significance and the accuracy of TE-supported liver illness screening.

Results: This work aims to collect the recent research works and clinical reports published from 2011 to 2021 from the chosen databases and provide a detailed review using the clinical information discussed in the selected articles.

Conclusion: The essential statistical investigation of the collected data is executed with Review Manager (RevMan®) software, and the significance of the TE is confirmed using the articles supporting a 2x2 contingency table, and each case is evaluated using a p-score and the Region of Convergence (RoC) curve for 95% confidence intervals.

Case Presentation: The patient was hospitalized with suspected to be a lumbar spine fracture. According to the multimodal imaging, pathologically confirmed to suffer a cardiac metastasis from small cell lung cancer. EP-regimen (Etoposide 0.1gd 1-5+Nedaplatin 30mgd 1-4) was selected for the systemic chemotherapy of the patient. During three years of follow-up, the left intra-atrial occupancy was significantly reduced.

Conclusion: Multimodality imaging can cover up the deficiencies of single imaging examinations and further clarify and enrich the understanding of the relationship between the location and the surrounding structure of the mass, thus providing a good reference for clinical treatment and decisionmaking.

Materials and Methods: A total of 12 patients with MSI-H CRLM and 96 patients with MSS CRLM were randomly divided into the training group and internal validation group according to the ratio of 7: 3 (training: 75 cases, validation: 33 cases). From the enhanced CT (portal phase) image data of patients, 788 radiomics features were extracted, and a random forest model was established with the optimal features selected. The receiver operating characteristics (ROC) curve analysis was performed to assess the model’s diagnostic efficacy.

Results: The training group comprised 8 patients with MSI-H CRLM and 67 patients with MSS CRLM, and the internal validation group included 4 patients with MSI-H CRLM and 29 patients with MSS CRLM. After feature selection, 7 radiomics features good for distinguishing MSI-H CRLM and MSS CRLM were screened out. The ROC curve analysis demonstrated that the random forest model had the AUC (area under the ROC curve) value 0.88, accuracy 0.85, sensitivity 0.85, specificity 0.92, and F1 score 0.88 in the training group. The model had an AUC value of 0.75, accuracy of 0.74, sensitivity of 0.81, specificity of 0.85, and F1_score of 0.78 in the internal validation group in identifying the MSI-H from the MSS CRLM. In order to evaluate the robustness of the overall model, the 788 features obtained were all applied to the 5-fold cross-validation, with the model being built on the random forest and analyzed with the ROC curve analysis. The AUC value of the model was 0.86 (P<0.05), accuracy value 0.91, sensitivity 0.60, and specificity 0.95.

Conclusion: The random forest prediction model built on the radiometric features extracted from enhanced CT images can be used to identify the MSI-H from the MSS CRLM and may provide effective guidance for clinical immunotherapy of CRLM patients with unknown MSI status.

Materials and Methods: Sixty para-vascular VX2 liver tumor models in rabbits were randomly divided into CT-guided microwave ablation group (CT group, n=35) and MR-guided microwave ablation group (MR group, n=35). The complete ablation rate, mean operation time, postoperative complication rate and mean survival time were compared between the two groups.

Results: In the CT group, the rate of complete ablation was 68.6% (24/35), and the mean operation time was 42.1 ± 9.7 minutes. Three cases had ascites and one case had abdominal wall injury. In the MR group, the rate of complete ablation was 94.2% (33/35), and the mean operation time was 53.4 ± 10.9 minutes. One case was complicated with ascites. No serious complications such as pneumothorax, liver abscess, pleural effusion and diaphragm perforation were found in both groups. Between the two groups, the difference in complete ablation rate was statistically significant (P=0.006 < 0.05). A statistically significant difference can also be found in mean operation time (P < 0.01). The follow-up time was 21 days after the operation. As for the postoperative complication rate (11.4% in the CT group and 2.9% in the MR group, P=0.353) and mean survival time (16.9 ± 1.8 days in CT group, 18.3 ± 2.3 days in the MR group, P=0.925), the differences were not statistically significant.

Conclusion: Compared with CT guidance, although the microwave ablation time under MR guidance was longer, the complete ablation rate under MR guidance was high, which proved that MR guidance was a more effective way of microwave ablation guidance and was worth promoting in the clinic. In this experiment, the postoperative complication rate was lower in the MR group, although the difference was not statistically significant, which may be related to the small sample size, and the subsequent study on the postoperative complication rate can increase the sample content.

Objective: The study aimed to introduce the application of Raman spectroscopy to tumor detection. We have introduced the current mainstream Raman spectroscopy technology and related application research.

Methods: This article has first introduced the grim situation of malignant tumors in the world. The advantages of tumor diagnosis based on Raman spectroscopy have also been analyzed. Secondly, various Raman spectroscopy techniques applied in the medical field are introduced. Several studies on the application of Raman spectroscopy to tumors in different parts of the human body are discussed. Then the advantages of combining deep learning with Raman spectroscopy in the diagnosis of tumors are discussed. Finally, the related problems of tumor diagnosis methods based on Raman spectroscopy are pointed out. This may provide useful clues for future work.

Conclusion: Raman spectroscopy can be an effective method for diagnosing tumors. Moreover, Raman spectroscopy diagnosis combined with deep learning can provide more convenient and accurate detection results.

Methods: A total of 19 patients who underwent preoperative spectral CT dual-phase enhancement and who were diagnosed with HCC by postoperative pathology were prospectively selected. Patients with ≥10% Ki67-positive tumor cells formed a high-Ki67 group, and those with <10% Ki67- positive cells formed a low-Ki67 group. The iodine concentrations (ICs) of the lesion and the descending aorta were measured during the arterial and venous phases. Relative iodine concentration (RIC) was calculated thus: RIC=IC_lesion/IC_{descending aorta}. CT values of the lesions at 40 and 70 keV were measured during the enhanced arterial and venous phases. The slope of the spectral curve (λ) was calculated thus: λ = (40 keV-70 keV) /(70-30). To compare the differences in quantitative parameters between the high- and low-Ki67 groups, either an independent samples t-test (normal distribution) or a Mann–Whitney U test (non-normal distribution) was used. Receiver operating characteristic curves were used to evaluate the effectiveness of spectral CT parameters in distinguishing between high-Ki67 and low-Ki67 groups. Pearson correlation analysis was used to evaluate the correlation between spectral CT quantitative parameters and Ki67 expression.

Results: IC, RIC and λ values for the high-Ki67 group in arterial and venous phases were higher than those for the low-Ki67 group, P < 0.05. IC, RIC, and λ values in the arterial phase were 0.83, 0.89, and 0.75, respectively; in the venous phase, the values of these three parameters were 0.76, 0.77, and 0.69, respectively. IC, RIC, and λ were positively correlated with Ki67 expression in both arterial and venous phases, with a highest correlation of 0.82 for arterial-phase RIC.

Conclusion: The quantitative parameters of spectral CT in HCC were correlated with Ki67 expression. This finding may make it easier for clinicians to determine whether a tumor is high or low in Ki67 before surgery.

Background: The heat sink effect is an important factor affecting the therapeutic effect of tumor thermal ablation. At present, there is no algorithm model to predict the intraoperative heat sink effect automatically, which needs to be measured manually, which lacks accuracy and consumes time.

Objective: To construct a segmentation model based on a convolutional neural network that can automatically identify and segment pulmonary nodules and vascular structure and measure the distance between the nodule and vascular.

Methods: First, the classical Faster RCNN model was used as the nodule detection network. After obtaining the bounding box of pulmonary nodules, the VSPP-NET model was used to segment nodules in the bounding box. The distance from the nodule to the vasculature was measured after the surrounding vasculature was segmented by the VSPP-NET model. The lung CT images of 392 patients with pulmonary nodules were used as the training data for the algorithm. 68 cases were used as algorithm validation data, 29 as nodule algorithm test data, and 80 as vascular algorithm test data. We compared the heat sink effect of 29 cases of data with the results of the algorithm model and expert segmentation and compared the difference between the two results.

Results: In pulmonary CT image vasculature segmentation, the recall and precision of the algorithm model reached >0.88 and >0.78, respectively. The average time for automatic segmentation of each image model is 29 seconds, and the average time for manual segmentation is 158 seconds. The output image of the model shows that the results of nodule segmentation and nodule distance measurement are satisfactory. In terms of heat sink effect prediction, the positive rate of the algorithm group was 28.3%, and that of the expert group was 32.1%, with no significant difference between the two groups (p=0.687).

Conclusion: The algorithm model developed in this study shows good performance in predicting the heat sink effect during pulmonary thermal ablation. It can improve the speed and accuracy of nodule and vessel segmentation, save ablation planning time, reduce the interference of human factors, and provide more reference information for surgeons to make ablation plans to improve the ablation effect.

Objective: The impact of the deep learning image reconstruction (DLIR) on the quality of dynamic contrast-enhanced CT imaging of primary liver cancer lesions was evaluated through comparison with the filtered back projection (FBP) and the new generation of adaptive statistical iterative reconstruction-V (ASIR-V).

Methods: We evaluated the image noise of the lesion, fine structures inside the lesion, and diagnostic confidence in 48 liver cancer subjects. The CT values of the solid part of the lesion and the adjacent normal liver tissue and the systolic and diastolic blood pressure (SD) values of the right paravertebral muscle were measured. The muscle SD value was considered as the background noise of the image, and the signal noise ratio (SNR) and contrast signal-to-noise ratio (CNR) of the lesion and normal liver parenchyma were calculated.

Results: High consistency in the evaluation of image noise (Kappa = 0.717). The Kappa values for margin/pseudocapsule, fine structure within the lesion, and diagnostic confidence were 0.463, 0.527, and 0.625, respectively. Besides, the differences in SD, SNR and CNR data of reconstructed lesion images among the six groups were statistically significant.

Conclusion: The contrast-enhanced CT image noise of DLIR-H in the portal venous phase is much lower than that of ASIR-V and FBP in primary liver cancer patients. In terms of the lesion structure display, the new reconstruction algorithm DLIR is superior.

Objectives: To determine whether DLIR can provide better image quality and reduce radiation dose in contrast-enhanced abdominal CT compared with the second generation of adaptive statistical iterative reconstruction (ASiR-V).

Aims: This study aims to determine whether deep-learning image reconstruction (DLIR) can improve image quality.

Methods: In this retrospective study, a total of 102 patients were included, who underwent abdominal CT using a DLIR-equipped 256-row scanner and routine CT of the same protocol on the same vendor's 64-row scanner within four months. The CT data from the 256-row scanner were reconstructed into ASiR-V with three blending levels (AV30, AV60, and AV100), and DLIR images with three strength levels (DLIR-L, DLIR-M, and DLIR-H). The routine CT data were reconstructed into AV30, AV60, and AV100. The contrast-to-noise ratio (CNR) of the liver, overall image quality, subjective noise, lesion conspicuity, and plasticity in the portal venous phase (PVP) of ASiR-V from both scanners and DLIR were compared.

Results: The mean effective radiation dose of PVP of the 256-row scanner was significantly lower than that of the routine CT (6.3±2.0 mSv vs. 2.4±0.6 mSv; p< 0.001). The mean CNR, image quality, subjective noise, and lesion conspicuity of ASiR-V images of the 256-row scanner were significantly lower than those of ASiR-V images at the same blending factor of routine CT, but significantly improved with DLIR algorithms. DLIR-H showed higher CNR, better image quality, and subjective noise than AV30 from routine CT, whereas plasticity was significantly better for AV30.

Conclusion: DLIR can be used for improving image quality and reducing radiation dose in abdominal CT, compared with ASIR-V.

Methods: The preprocessing techniques (smoothing, edge detection, filtering) and segmentation techniques (watershed) are applied to the online data set. The transfer learning technique is used as a classifier whose performance is measured in terms of classification accuracy. Resnet 50, Inception V3VGG16, and VGG19 models are used as classification algorithms. The proposed model is validated using different machine learning techniques considering hybrid features.

Results: 96% accuracy was obtained employing the Inception V3 model & 95% accuracy was attained using hybrid GLDS and GLCM features employing Support Vector Machine algorithm while 93% was attained using Probabilistic Neural Network and k Nearest Neighbor techniques.

Conclusion: Computer-aided systems gave much faster and more accurate results than image processing techniques.1.0% accuracy improvement was observed while using Inception V3 over GLDS + GLCM + SVM and 2.1% accuracy improvement using GLDS + GLCM + SVM over GLDS + GLCM + kNN.

Methods: In this paper, we propose an improved method for the automatic classification of common liver lesions based on deep learning techniques and the variation of Hounsfield Unit densities on CT images with and without contrast. Hounsfield Unit is used to locate liver lesions accurately and support data labeling for classification. We construct a multi-phase classification model developed on the deep neural networks of Faster R-CNN, R-FCN, SSD, and Mask R-CNN with the transfer learning approach.

Results: The experiments are conducted on six scenarios with multi-phase CT images of common liver lesions. Experimental results show that the proposed method improves the detection and classification of liver lesions compared with recent methods because its accuracy achieves up to 97.4%.

Conclusion: The proposed models are very useful to assist doctors in the automatic segmentation and classification of liver lesions to solve the problem of depending on the clinician’s experience in the diagnosis and treatment of liver lesions.

Objective: To investigate the prediction performance of MRI radiomics for MVI in HCC.

Methods: Original studies focusing on preoperative prediction performance of MRI radiomics for MVI in HCC, were systematically searched from databases of PubMed, Embase, Web of Science and Cochrane Library. Radiomics quality score (RQS) and risk of bias of involved studies were evaluated. Meta-analysis was carried out to demonstrate the value of MRI radiomics for MVI prediction in HCC. Influencing factors of the prediction performance of MRI radiomics were identified by subgroup analyses.

Results: 13 studies classified as type 2a or above according to the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis statement were eligible for this systematic review and meta-analysis. The studies achieved an average RQS of 14 (ranging from 11 to 17), accounting for 38.9% of the total points. MRI radiomics achieved a pooled sensitivity of 0.82 (95%CI: 0.78 – 0.86), specificity of 0.79 (95%CI: 0.76 – 0.83) and area under the summary receiver operator characteristic curve (AUC) of 0.88 (95%CI: 0.84 – 0.91) to predict MVI in HCC. Radiomics models combined with clinical features achieved superior performances compared to models without the combination (AUC: 0.90 vs 0.85, P < 0.05).

Conclusion: MRI radiomics has the potential for preoperative prediction of MVI in HCC. Further studies with high methodological quality should be designed to improve the reliability and reproducibility of the radiomics models for clinical application.

The systematic review and meta-analysis was registered prospectively in the International Prospective Register of Systematic Reviews (No. CRD42022333822).

Objective: This study aims to assess the impact of breath training on the quality of chest magnetic resonance imaging obtained during free-breathing sequences.

Methods: A total of 68 patients with lung lesions, such as nodules or masses detected via Computed Tomography (CT) examination, were prospectively gathered. They were then randomly divided into two groups: an observation group and a control group. Standard preparation was performed for all patients in both groups before the examination. The observation group underwent 30 minutes of breath training prior to the MRI examination additionally, followed by the acquisition of MRI free-breathing sequence images. The signal intensity (SI) and standard deviation (SD) of the lesion and adjacent normal lung tissue were measured, and the image signal-to-noise ratio (SNR) and contrast signal-to-noise ratio (CNR) of the lesion were calculated for objective image quality evaluation. The subjective image quality of the two groups of images was also evaluated using a 5-point method.

Results: MRI examinations were completed in both groups. Significantly better subjective image quality (edge and internal structure clarity, vascular clarity, breathing and cardiac artifacts, and overall image quality) was achieved in the observation group compared to the control group (P<0.05). In addition, higher SNR and CNR values for disease lesions were observed in the observation group compared to the control group (t=4.35, P<0.05; t=5.35, P<0.05).

Conclusion: It is concluded that the image quality of free-breathing sequences MRI can be improved through breath training before examination.

Objective: This study aimed to explore the abnormality of brain functional networks in lung cancer patients with post-chemotherapy by modular edge analysis.

Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) scans were performed on 40 patients after chemotherapy, 40 patients before chemotherapy and 40 normal controls. Patients in all three groups were age and sex well-matched. Then, modular edge analysis was applied to assess brain functional network alterations.

Results: Post-chemotherapy patients had the worst MoCA scores among the three groups (p < 0.001). In intra-modular connections, compared with normal controls, the patients after chemotherapy had decreased connection strengths in the occipital lobe module (p < 0.05). Compared with the nonchemotherapy group, the patients after chemotherapy had decreased connection strengths in the subcortical module (p < 0.05). In inter-modular connections, compared with normal controls, the patients after chemotherapy had decreased connection strength in the frontal-temporal lobe modules (p < 0.05). Compared with the non-chemotherapy group, the patients after chemotherapy had decreased connection strength in the subcortical-temporal lobe modules (p < 0.05).

Conclusion: The results reveal that chemotherapy can disrupt connections in brain functional networks. As far as we know, the use of modular edge analysis to report changes in brain functional brain networks associated with chemotherapy was rarely reported. Modular edge analysis may play a crucial part in predicting the clinical outcome for the patients after chemotherapy.

Objective: The aim of the current investigation was to find novel 2-chloroquinoline-3-carboxamide derivatives that target the Ephrin B4 (EPHB4) receptor to treat cancer.

Materials and Methods: Chem Axon Marvin Sketch 5.11.5 was used to create derivatives of 2-chloroquinoline-3-carboxamide. The physicochemical characteristics of compounds as well as their toxicity were predicted using SwissADME& the admet SAR online software’s. Molecular docking technology was used to examine the ligand-receptor interactions of 2-chloroquinoline-3-carboxamide derivatives with the target receptor (PDB- 6FNM) using a variety of software’s, including Autodock1.1.2,Procheck, ProtParam tool, Biovia Discovery Studio Visualizer v20.1.0.19295, MGL Tools 1.5.6, PyMOL, and were all included.

Results: All developed compounds were determined to be orally bioavailable, less toxic, and have acceptable pharmacokinetic properties according to in silico studies. In comparison to the traditional medication Erdafitnib, all new compounds displayed higher docking scores.

Conclusion: The increase in binding energy and the number of H-bonds created by novel derivatives with interactions at distances below 3.40A provide a helpful starting point for formulating and synthesizing compounds that are most suitable for additional research. The application of the 2- chloroquinoline-3-carboxamide moiety as a potential new cancer treatment candidate is supported by its pharmacokinetics &toxicological profile, which may aid medicinal chemists in conducting more in-depth in vitro, in vivo chemical and pharmacological studies.

Methods: Sixty-four patients with single pulmonary lesions (SPLs) received DCE-MRI at 3.0 T. Of them, 49 cases were diagnosed with lung cancer, and 15 with benign pulmonary nodules (8 inflammatory nodules, 5 tuberculosis, and 2 abscesses). SPLs were quantitatively analyzed to determine the pulmonary lesions-related perfusion parameters, including reflux constant (Kep), volume transfer constant (K_trans), the maximum slope of increase (MaxSlope), extravascular extracellular space volume fraction (Ve), apparent diffusion coefficient (ADC), the initial area in the signal intensitytime curve (IAUGC), and contrast-enhancement ratio (CER). In addition, a Student’s t-test was conducted to calculate statistical significance regarding the quantitatively analyzed perfusion parameters in benign SPLs compared to malignant SPLs. The area under (AUC) the receiver operating characteristic (ROC) curve was studied to investigate the performance of perfusion parameters in diagnosing lung cancer.

Results: Values of K_trans, Kep, Ve, MaxSlope, and IAUGC increased within malignant nodules relative to benign nodules (K_trans: 0.21 ±0.08 vs. 0.73 ±0.40, P = 0.0001; Kep: 1.21 ±0.66 vs. 1.83 ±0.90, P = 0.0163; Ve: 0.24 ±0.08 vs. 0.47 ±0.18, P < 0.0001; MaxSlope: 0.09 ±0.14 vs. 0.28 ±0.29, P = 0.0166; IAUGC: 0.18 ±0.09 vs. 0.55 ±0.34, P = 0.0001). Meanwhile, malignant nodules presented higher ADC than benign nodules (0.0016 ±0.0006 vs. 0.0012 ±0.0003, P = 0.0019). K_trans and IAUGC showed the best diagnostic performance with AUCs [1.0, 95%CI (0.99–1.0); 0.93, 95%CI(0.85–1.0), respectively].

Conclusion: Malignant pulmonary lesions had higher values of K_trans, Ve, Kep, MaxSlope, and IAUGC compared to benign pulmonary lesions. Overall, perfusion parameters of DCE-MRI facilitate discrimination between benign from malignant pulmonary nodules.

Methods: A thorough study of different molecular structures and properties was done using extensive computational analyses and simulations in order to identify compounds with the potential to inhibit ER activity. Diverse chemical libraries were subjected to docking against the target ER-α, and molecules with docking scores less than -8.00 kcal/mol were retained.

Results: Further, these virtual hits were evaluated using 3D-QSAR models for predicting activity. ADME/Tox screening was performed to retain compounds with optimal pharmacokinetic profiles. Six compounds with excellent binding potential predicted biological activity and favorable ADME/Tox profiles were chosen. Prolonged molecular dynamics simulations were conducted to assess structural stability over time.

Conclusion: The computational study on breast cancer on the target ER has yielded significant progress with the identification of six promising compounds that can be further evaluated through experimental validations.

Objective: The objective of the research is to implement an advanced modified threshold segmentation and classification model for early and accurate detection of lung cancer from CT images.

Methods: Using the Support Vector Machines (SVM) classifier as well as the Artificial Neural Network (ANN) classifier, the authors propose using Modified adaptive threshold segmentation as a segmentation approach for cancer detection. Here, Lung Image Database Consortium (LIDC) datasets, a collection of CT scans, are used as the video frames in an investigation to authorize the recitation of the suggested technique.

Results: Both quantitative as well as qualitative analyses are used to analyze the segmentation function of the anticipated algorithm. Both the ANN and SVM classifiers used in the suggested technique for lung cancer diagnosis achieve world-record levels of accuracy, with the former achieving a 96.3% detection rate and the latter a 97% rate of accuracy.

Conclusion: This innovation may have a major impact on the worldwide rate of lung cancer rate due to its ability to detect lung tumors in their earliest stages when they are most amenable to being avoided and treated. This method is useful because it provides more information and facilitates quick, precise decision-making for doctors diagnosing lung cancer in their patients.

Objective: This study aimed to compare the duration of the hepatic artery catheterization, fluoroscopy time (FT), radiation exposure, safety, and quality of life associated with the procedure in patients undergoing HAIC via TRA and TFA.

Methods: This prospective, single-center, randomized, controlled study included 120 patients with unresectable HCC undergoing HAIC procedures. Patients were randomly assigned to group A (n = 60, TRA-HAIC) or group B (n = 60, TFA-HAIC). The hepatic artery catheterization time, FT, entrance surface dose (ESD), dose area product (DAP), procedure-related complications, and quality of life associated with the procedure were assessed between the two groups. Independent-sample t-test and analysis of variance (ANOVA) were used to assess differences. Statistical significance was set at P < 0.05.

Results: HAIC procedures were successfully performed in both groups. The hepatic artery catheterization time (19.35 ± 5.84 vs. 18.93 ± 5.62 minutes, P = 0.837), FT (2.35 ± 2.23 vs. 2.25 ± 2.16 minutes, P = 0.901), ESD (259.32 ± 167.46 vs. 250.56 ± 170.58 mGy, P = 0.449), and DAP (125.37 ± 60.65 vs. 120.56 ± 64.33 Gy.cm3, P = 0.566) were comparable between the two groups. The incidence of artery occlusion (10.0% vs. 0%, P < 0.001) in the TRA group was significantly higher than that in the TFA group. TRA was associated with a statistically significant (P < 0.05) improvement in the quality of life.

Conclusion: TRA to HAIC was associated with greater improvement in the quality of life associated with the procedure compared with TFA. Both approaches to HAIC had similar efficiency, safety, radiation exposure, and procedure duration.

Case Presentation: We report a case of a 73-year-old patient with small intestinal smooth muscle sarcoma with hepatic metastasis. No significant abnormalities were seen on examination of the abdomen. We performed abdominal enhancement CT, contrast-enhanced ultrasonography (CEUS), and ultrasoundguided pelvic mass puncture biopsy, and we found a heterogeneous density and echogenicity of the pelvic mass, and the enhancement was progressive with sustained hyperenhancement. The postoperative pathology was smooth muscle sarcoma of the small intestine. The typical fast-in, fast-out bull's-eye sign of metastases, characterized the liver presented with multiple hypodense and echogenic nodules and the enhancement. The clinical presentation, imaging, histologic features, and treatment are also discussed in this article.

Conclusion: This article briefly reviews the literature on small intestinal leiomyosarcoma. The purpose of this case report is to emphasize the specificity of the case and evaluate the imaging presentation of ultrasound (US) and CEUS and the main differential diagnosis of this rare gastrointestinal tumor.

Objective: To investigate the ultrasonographic features and diagnostic value of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion in children and adolescents.

Materials and Methods: The clinical and ultrasonographic data of 10 patients with renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion confirmed by pathology in our hospital were analyzed retrospectively. The age ranged from 3 to 18 years old, including 7 males and 3 females. The tumor location, size, boundary, echo, hemorrhage, cystic change, calcification, blood flow, lymph node status and metastasis were mainly observed, and the results were compared with the pathological results.

Results: There were 10 masses in 10 cases of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion, including 4 in the right kidney and 6 in the left kidney; the maximum diameter line is 5-23cm; 9 cases had clear mass boundary (90%); 9 masses (90%) showed mixed cystic and solid masses with high echo of solid components, and 1 mass (10%) showed huge multilocular cystic mass with multiple septations; necrosis and cystic changes were seen in all 10 masses (100%); calcification in 5 masses (50%); blood flow signals were seen in the solid components of the mass (100%).

Conclusion: Renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion in children and adolescents are mostly large cystic and solid mixed echo masses, with high echo of solid components, and often accompanied by cystic changes and calcification. Its ultrasonic manifestations have certain characteristics. Color Doppler ultrasound has a certain diagnostic value for this disease.

Objective: This study aimed to explore the value of T1 mapping and amide proton transfer weighted (APTw) imaging in predicting LN metastasis in patients with rectal cancer.

Methods: In a retrospective study, twenty-three patients with pathologically confirmed rectal adenocarcinoma who underwent MRI and surgery from August 2019 to August 2021 were selected. Then, 3.0T/MR sequences included conventional sequences (T1WI, T2WI, and DWI), APTw imaging, and T1 mapping. Patients were divided into LN metastasis (group A) and non-LN metastasis groups (group B). The intra-group correlation coefficient (ICC) was used to test the inter-observer consistency. Mann-Whitney U test was used to compare the differences between the two groups. Spearman correlation analysis was performed to evaluate the correlation between T1 and APT values. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the differential performance of each parameter and their combination. The difference between AUCs was compared using the DeLong test.

Results: The APT value in patients with LN metastasis was significantly higher than in those without LN metastasis group (P=0.020). Also, similar results were observed for the T1 values (P=0.001). The area under the ROC curve of the APT value in the prediction of LN metastasis was 0.794; when the cutoff value was 1.73%, the sensitivity and specificity were 71.4% and 88.9%, respectively. The area under the ROC curve of the T1 value was 0.913; when the cutoff value was 1367.36 ms, the sensitivity and specificity were 78.6% and 100.0%, respectively. The area under the ROC curve of T1+APT was 0.929, with a sensitivity of 78.6% and specificity of 100.0%.

Conclusion: APT and T1 values show great diagnostic efficiency in predicting LN metastasis in rectal cancer.

Objective: To address this problem, this paper proposes a joint model called mSegResRF-SPECT, which accomplishes for the first time the task of classifying whole-body bone scan images on a public SPECT dataset [BS-80K] for the diagnosis of bone metastases.

Methods: The mSegResRF-SPECT adopts a multi-bone region segmentation algorithm to segment the whole body image into 13 regions, ResNet34 as an extractor to extract the regional features, and a random forest algorithm as a classifier.

Results: The experimental results of the proposed model show that the average accuracy, sensitivity, and F1 score of the model on the BS-80K dataset reached SOTA.

Conclusion: The proposed method presents a promising solution for better bone scan classification methods.

Case Description: A 57-year-old male presented to our hospital with right upper quadrant abdominal pain. Ultrasonography, computed tomography, and magnetic resonance imaging revealed a large mass with a well-defined margin in the right hemiliver. The patient underwent a right hemihepatectomy, and the final histopathology revealed clear cell-type HCC.

Conclusion: Distinguishing clear cell types from other types of HCC solely based on radiological findings is challenging. If hepatic tumors exhibit encapsulated margins, enhancing rims, intratumoral fat, and arterial phase hyperenhancement/washout pattern despite their large size, consideration of clear cell subtypes in the differential diagnosis list will aid patient management, implying better prognosis than not-otherwise-specified HCC.

Case Presentation: A 47-year-old woman was admitted to the hospital after a lung mass was found during a physical examination one month earlier. The imaging findings for this patient showed a large mass in the lower lobe of the left lung with bronchial invasion. A contrast-enhanced MRI of the brain was normal. Bronchoscopy shows a mass at the opening of the left lower basal branch, with mucosal infiltration, protrusion, and stenosis of the opening. The patient underwent radical left lung cancer surgery, and the pathology specimens stained with hematoxylin–eosin demonstrated tumor cells with the focal invasion of the bronchial cartilage. Immunohistochemical staining was positive for epithelial membrane antigen(EMA), somatostatin receptor 2 (SSTR2), progesterone receptor (PR), Ki-67 (5%–10%), CD34, and D2-40 and weakly positive for p53.The pathologic diagnosis was primary pulmonary meningioma (PPM). The tumor marker CA-125 had significantly increased in the 2 months after surgery.

Conclusion: Malignant PPM is rarer, and a clear pathological definition to distinguish between benign and malignant PPM is lacking. Potential cases should be comprehensively evaluated based on imaging, laboratory, and pathology results. A long-term regular follow-up will be required to rule out metastasis or recurrence of PPM.

Case Presentation: A 17-year-old girl initially presented with enlarged lymph nodes near the main portal vein of the liver and a large liver tumour. Lesions were identified on the imaging findings obtained via positron emission tomography–computed tomography (CT) scanning, including an abnormal increase of heterogeneous glucose metabolism in the intrahepatic mass, with a maximum standardised uptake value of around 3.2. The CT imaging showed multiple dense shadows in the lesion, while the magnetic resonance imaging indicated a long T1 and a slightly longer T2.

Conclusions: This study summarises the imaging features of CNSETs to provide a reference for diagnosing liver tumours. In addition, the literature on the topics covered was systematically reviewed.

Methods: The study involved 205 patients who had breast cancer at stages 1-3. Estrogen receptor (EsR), progesterone receptor (PrR), human epidermal growth factor receptor 2 (Her2), and proliferation index (Ki-67) were histologically analyzed in the tumor. The correlations between the immunohistochemistry and intrinsic subtypes were analyzed using ADC and ADCcV.

Results: The maximum whole tumor (WTu) ADC (p=0.004), minimum WTu ADC (p<0.001), and mean WTu ADC (p<0.001) values were significantly smaller in the EsR-positive tumors than those in the EsR-negative tumors. Compared to the PrR-negative tumors, the PrR-positive tumors showed significantly smaller maximum, minimum, and mean WTu ADC values (p=0.005, p=0.001, and p<0.001, respectively). In the comparisons of the molecular subtypes in terms of ADCcV, the p-values indicated statistically significant differences between the luminal A (lumA) group and the triple negative (TN) group, between the luminal B (lumB) group and the TN group, and between the Her2-enriched and TN groups (p<0.001, p=0.011, and p=0.004, respectively). Considering the luminal and non-luminal groups, while a significant difference was observed between the groups considering their minimum, maximum, and mean WTu ADC values, their ADCcV values were similar (p<0.001, p=0.004, and p<0.001, respectively).

Conclusion: Using ADCcV in addition to ADC parameters increased the diagnostic power of diffusion weighted-MRI (DW-MRI) in the distinction of molecular subtypes of breast cancer.

Case Report: A 52-year-old male patient was admitted to our clinic with the diagnosis of an incidental right renal mass. On contrast-enhanced abdominal CT revealed a mass reaching approximately 8 cm in diameter in the right kidney located in the middle pole. On contrast-enhanced thorax, CT showed a metastatic lesion in the left main bronchus bifurcation. The patient underwent an open radical nephrectomy with the diagnosis of an oligometastatic right renal mass. His pathology was reported as clear cell renal cell carcinoma (ccRCC). The patient was referred to the medical oncology clinic for immunotherapy. The metastatic lesion in the lung completely regressed in the follow-up of the patient who was started on Chek point inhibitors. However, he was referred to our clinic after an incidental metachronous mass was detected in the contralateral left adrenal in FDG PET/CT (SUVmax: 6.7) in 1st year. Dynamic contrast-enhanced MRI was performed to reevaluate and for mass characterization, and a 4 cm mass was observed in the left contralateral adrenal. Laparoscopic metastasectomy was performed for the left adrenal mass. No recurrence or adrenal insufficiency developed in the 6-month follow-up after discharge.

Conclusion: Transperitoneal adrenalectomy is a minimally invasive method that can be safely performed in metastatic adrenal masses. Although contralateral adrenal metastasis is rare in ccRCC, it should be kept in mind that adrenal metastasis may develop in the late period in patients with a history of renal cancer.

Methods: Between May 2021 and January 2022, 397 patients with COVID-19 were included in this retrospective cohort study. All demographic, clinical and laboratory data and chest CT images of patients were retrospectively reviewed. RM-S, V-CAC-S, HS-S, PS-S and C-CT-SS scores were calculated, and their performance in predicting mortality and ICU requirement were evaluated by univariate and multivariable analyses.

Results: A total of 32 (8.1%) patients died, and 77 (19.4%) patients required ICU admission. Mortality and ICU admission were both associated with older age (p < 0.001). Sex distribution was similar in the deceased vs. survivor and ICU vs. non-ICU comparisons (p = 0.974 and p = 0.626, respectively). Multiple logistic regression revealed that mortality was independently associated with having a C-CT-SS score of ≥ 14 (p < 0.001) and severe RM-S category (p = 0.010), while ICU requirement was independently associated with having a C-CT-SS score of ≥ 14 (p < 0.001) and severe V-CAC-S category (p = 0.010).

Conclusion: RM-S, C-CT-SS, and V-CAC-S are useful tools that can be used to predict patients with poor prognoses for COVID-19. Long-term prospective follow-up of patients with high RM-S scores can be useful for predicting long COVID.

Objective: The objective of this study is to present hepatic metastasis of GIST and GEP-NET with Diffusion weighted MR imaging(DWI) and the Apparent diffusion coefficients (ADC) values of masses.

Methods: 18 GIST patients and 8 GEP-NET patients were examined retrospectively. 11 males and 6 females were present in GIST group, 7 males to 5 females were involved in GEP-NET group. 18 primary GIST and 10 hepatic metastasis of GIST, 8 original GEP-NET and 19 hepatic metastasis of GEP-NET; total 55 GIST and GEP-NET masses were analysed by ADC mapping. MR images were acquired by 1,5 T MR units (32 mT/min gradient strength- Achieva; Philips Healthcare, Best, Netherlands and 32 channel GE Signa GE-Wisconsin-USA); by using a 4-8 channel standard phased-array torso XL coil, all images were evaluated by an Abdominal MRI experienced radiologist. DWI was performed in the transverse plane by using spin-echo-planar imaging sequence.

Results: No statistical differences were observed between GIST and GEP-NET patients according to age and gender variations. No significant statistical differences were observed according to the diameters and ADC values of GIST and GEP-NET patients. A significant statistical difference was observed between GIST and GEP-NET groups in terms of size of liver metastasis which was significantly higher in GIST patients. All three groups (GIST_Hep. MET, GEP-NET_Liver_Met and normal) were statistically differed according to ADC values. With the ROC curve analysis: Hepatic metastasis of GIST(n=10) and normal liver (n:47) had cut-off value for ADC: 0.925 under AUC: 0.939 with regard to ADC values and regarded 89.4% Sensitivity, 100% Specificity, 100% PPV and 66.7% PPV. ROC curve of GEP NET_ Hepatic metastasis (n=19) group and normal liver (n:47) group presented cut-off value for ADC: 0.860 under AUC: 0.967 correlated to ADC values with 93.6% sensitivity, 89.5% specificity, 95.7% PPV and 85% PPV.

Conclusion: High cellular tumors resulted from liver metastasis of GIST and GEP-NET’s, and a positive correlation was observed between ADC values and cellularity/differentiation ratios of metastatic masses.

Purpose: This research aimed to create and assess non-invasive diagnostic techniques using pre-operative computed tomography (CT) radiomics models to predict the recurrence of MWA in pulmonary malignancies.

Materials and Methods: We retrospectively enrolled 116 eligible patients with pulmonary malignancies treated with MWA. we separated the patients into two groups: a recurrence group (n = 28) and a non-recurrence group (n = 88), following the modified Response Evaluation Criteria in Solid Tumors (m-RECIST) criteria. We segmented the preoperative tumor area manually. We expanded outward the tumor boundary 4 times, with a width of 3 mm, using the tumor boundary as the baseline. Five groups of radiomics features were extracted and screened using max-relevance and min-redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) regression. Weight coefficients of the aforementioned features were used to calculate the Radscore and construct radiomics models for both tumoral and peritumoral areas. The Radscore from the radiomics model was combined with clinical risk factors to construct a combined model. The performance and clinical usefulness of the combined models were assessed through the evaluation of receiver operating characteristic (ROC) curves, the Delong test, calibration curves, and decision curve analysis (DCA) curves.

Results: The clinical risk factor for recurrence after MWA was tumor diameter (P < 0.05). Both tumoral and four peritumoral radiomics models exhibited high diagnostic efficacy. Furthermore, the combined 1 (C1)-RO model and the combined 2 (C2)-RO model showed higher efficacy with area under the curve (AUCs) of 0.89 and 0.89 in the training cohort, and 0.93 and 0.94 in the validation cohort, respectively. Both combined models demonstrated excellent predictive accuracy and clinical benefit.

Conclusion: Preoperative CT radiomics models for both tumoral and peritumoral regions are capable of accurately predicting the recurrence of pulmonary malignancies after MWA. The combination of both models may lead to better performance and may aid in devising more effective preoperative treatment strategies.

Objective: This study aimed to evaluate ultrasound-based radiomics for predicting outcomes in HBV-ACLF.

Methods: We enrolled 264 HBV-ACLF patients, dividing them into a training cohort (n=184) and a validation cohort (n=80). From hepatic ultrasound images, 455 radiomic features were extracted. Radiomics-based phenotypes were identified through unsupervised hierarchical clustering. A radiomic signature was developed using a Cox-LASSO algorithm to predict 30-day mortality. Furthermore, we integrated the signature with independent clinical predictors via multivariate Cox regression to construct a combined clinical-radiomic nomogram (CCR-nomogram). Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) assessed performance improvements achieved by adding radiomic features to clinical data.

Results: Both clustering and radiomic signature identified two distinct subgroups with significant differences in clinical characteristics and 30-day prognosis. In the training cohort, the signature achieved a C-index of 0.746, replicated in validation with a C-index of 0.747. The CCR-nomogram achieved C-indices of 0.834 and 0.819 for the training and validation cohorts. Incorporating radiomic features significantly improved the CCRnomogram over the signature and clinical-only models, evidenced by IDI of 0.108-0.264 and NRI of 0.292-0.540 in both cohorts (all p0.05).

Conclusion: Ultrasound-based radiomics offered prognostic information complementary to clinical data and demonstrated potential to enhance outcome prediction in HBV-ACLF.

Objective: The aim of this study is to assess the usefulness of Gd-EOB-DTPA-enhanced MRI T1 mapping in distinguishing between DN and HCC.

Methods: This study analyzed 66 patients with confirmed HCC or DN who underwent Gd-EOB-DTPA-enhanced MRI T1 mapping before surgery or puncture at the Army Medical Center in China. The T1 values of each lesion were measured before and after Gd-EOB-DTPA administration, and various calculations were made, including absolute and percentage reduction in T1 value and coefficient of variation. The t-test was used to compare these values between the two groups, and the efficacy of T1 mapping values for differential diagnosis of HCC and DN was evaluated using the receiver operating characteristic curve (ROC).

Results: The study found that T1_pre, T1_hp, ΔT1, ΔT1%, and CV in the HCC group were significantly higher than in the DN group (p < 0.01). The accuracy of T1_hp, ΔT1, and CVT_1-hp in identifying HCC from DN was high, with AUCs of 0.955, 0.910, and 0.932, respectively. ΔT1% also had some accuracy, with an AUC of 0.818.

Conclusion: Our results provide preliminary evidence that Gd-EOB-DTPA-enhanced MRI T1 mapping, can be a valuable tool in diagnosing and differentiating between HCC and DN.

Methods: A total of 600 patients who were admitted to Beijing You an Hospital were chosen for this prospective study and underwent high-concentration contrast three-dimensional CT imaging of liver blood vessels between April 2021 and December 2021. The patients were divided into two groups using the digital table method, with 300 cases. The control group received conventional nursing intervention, while the research group was provided with a mind map-based predictive nursing protocol. We recorded the image quality of three-dimensional CT imaging of liver blood vessels, satisfaction scores regarding nurse examination guidance, and the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) in both groups.

Results: The research group achieved a perfect rate of 100.00% for the high-quality three-dimensional CT imaging of liver blood vessels, which was noticeably higher compared to the rate of the control group of 98.67%. Patients in the research group expressed higher satisfaction levels regarding the guidance provided by nurses, including their attitude, timeliness, accuracy, and overall satisfaction, compared to the control group. Initially, the two groups had no notable differences in the SAS and SDS scores. However, after the intervention, both groups experienced a significant decrease in SAS and SDS scores, with the research group showing an even more substantial decline.

Conclusion: Through the creation of a mind map-based predictive nursing protocol and its implementation on patients undergoing high-concentration contrast three-dimensional CT imaging of liver blood vessels, it is possible to significantly enhance the quality of CT scans, alleviate feelings of anxiety and depression, increase patient satisfaction with examination guidance by nurses, and effectively decrease the occurrences of contrast agent leakage and allergic reactions to iodine.

Case Presentation: Herein, we report a case of recurrent uterine cervical cancer with initial manifestation as a hemorrhagic cyst, assessed using strain sonoelastography, CT, and MRI.

Conclusion: Although cystic recurrence is uncommon, newly detected simple or complex cystic lesions should be closely monitored.

Objective: To explore the influencing factors of repeatability and reliability in IVIM-DWI parameters of ROI-based liver segments in participants with HF and healthy volunteers (HV) and to assess the diagnostic efficiency of these parameters in HF.

Methods: Participants with early HF (EHF, n=59) or advanced HF (AHF, n=38) and HV (n=48) were recruited. Two examiners measured IVIM data using mono-, bi-exponential and stretched exponential models. The results and influencing factors of repeatability and reliability of IVIM-DWI, and the diagnostic efficiency were analyzed.

Results: The repeatability of D* (CV: 26.62–41.47%) and DDC (CV: 18.01–34.40%) was poor, the repeatability of ADC (CV: 4.95–9.76%), D (CV: 7.09–15.52%), f (CV: 9.35–17.15%), and α (CV: 7.48–13.81%) was better; ordered logistic regression showed statistically significant results of IVIM-derived parameters; the reliability showed no obvious trend, and ordered logistic regression showed statistically significant results of IVIMderived parameters, groups, and partial hepatic segments (all p<0.001). IVIM-derived parameters with relatively good repeatability (CV<20%) and reliability (ICC>0.4) were used to establish regression models for differential diagnosis. The AUC of regression models was 0.744–0.783 (EHF vs. AHF), but no statistically significant parameters were found in the HV vs EHF comparison.

Conclusion: IVIM-derived parameters were the most important factors affecting the repeatability and reliability, while staging of HF and hepatic segments may be the influencing factors of reliability. IVIM-derived parameters showed medium diagnostic efficiency in distinguishing between EHF and AHF.

Objective: The aim of this study was to construct and validate a radiomics model based on contrast-enhanced CT to predict the GPC3 expression in HCC.

Methods: This retrospective study included 141 (training cohort: n = 100; validation cohort: n = 41) pathologically confirmed HCC patients. Radiomics features were extracted from the Artery Phase (AP) images of contrast-enhanced CT. Logistic regression with the Least Absolute Shrinkage and Selection Operator (LASSO) regularization was used to select features to construct radiomics score (Rad-score). A final combined model, including the Rad-score of the selected features and clinical risk factors, was established. Receiver Operating Characteristic (ROC) curve analysis, Delong test, and Decision Curve Analysis (DCA) were used to assess the predictive performance of the clinical and radiomics models.

Results: 5 features were selected to construct the AP radiomics model of contrast-enhanced CT. The radiomics model of AP from contrast-enhanced CT was superior to the clinical model of AFP in training cohorts (P < 0.001), but not superior to the clinical model in validation cohorts (P = 0.151). The combined model (AUC = 0.867 vs. 0.895), including AP Rad-score and serum Alpha-Fetoprotein (AFP) levels, improved the predictive performance more than the AFP model (AUC = 0.651 vs. 0.718) in the training and validation cohorts. The combined model, with a higher decision curve indicating more net benefit, exhibited a better predictive performance than the AP radiomics model. DCA revealed that at a range threshold probability approximately above 60%, the combined model added more net benefit compared to the AP radiomics model of contrastenhanced CT.

Conclusion: A combined model including AP Rad-score and serum AFP levels based on contrast-enhanced CT could preoperatively predict GPC3-positive expression in HCC.

Methods: A total of 78 patients were included in this study. T2 weighted imaging (T2WI), conventional diffusion-weighted imaging (DWI) (1000 s/mm²), and DWI with ultrahigh b-values of 2000 s/mm² and 3000 s/mm² were performed in each patient. With reference biopsy as the gold standard, the apparent diffusion coefficient (ADC)s of each b-value DWI image were analyzed. According to different b-value receiver operating characteristic (ROC) curves, the ADC diagnostic cutoff point for prostate cancer was determined.

Results: A total of 154 lesions were identified as prostate cancer. The ADC values for conventional DWI and ultrahigh b-value DWI with 2000 s/mm² and 3000 s/mm² were 1.097×10^-3 mm²/s (1.040-1.153), 0.809×10^-3 mm²/s (0.766-0.851) and 0.622×10^-3 mm²/s (0.591-0.652), respectively, in the peripheral zone and 1.085×10^-3 mm²/s (1.022-1.147), 0.815×10^-3 mm²/s (0.770-0.861) and 0.651×10^-3 mm²/s (0.617-0.685) in the transition zone. The area under the curve (AUC)s of the ADC values from ultrahigh b-value DWI (2000 s/mm² and 3000 s/mm²) were 0.824 and 0.852 in the peripheral zone and 0.905 for the ADC values from ultrahigh b-value DWI (3000 s/mm²) in the transition zone. In the peripheral zone, the ADC diagnostic cutoff values for prostate cancer were 0.75×10^-3 mm²/s and 0.685×10^-3 mm²/s in DWI at 2000 s/mm² and 3000 s/mm², respectively, and the diagnosis of transition zone cancer was 0.8×10^-3 mm²/s and 0.634×10^-3 mm²/s, respectively.

Conclusion: The ADC values from ultrahigh b-value DWI demonstrated better consistency and diagnostic efficacy in the diagnosis of prostate cancer.

Methods: The data on age distribution, clinical symptoms at onset, CA125 detection, MRI findings, including tumor volume, structure, diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and enhancement, etc., of the patients with stage IA ovarian cancer, who were admitted to Nantong tumor Hospital between 2013 and 2020 were analyzed retrospectively.

Results: Only 11 cases of stage IA ovarian cancer were recorded. The age of patients was 30–67 (average 52) years. The initial symptoms were mostly lower abdominal distension and abdominal pain. CA125 was 90% positive. MRI features 1. Large pelvic mass with a volume range of 23–2,009 cm³ (average 669 cm³). 2. Five cases of cyst type (with plaque-like, papillary, or mural nodule vegetations), two cases of cystic-solid mixed type (with thickened septum or wall), and four cases of solid type. 3. DWI diffusion was limited, and ADC was reduced on all solid components (vegetation, septa, and cyst wall). 4. The solid parts were significantly enhanced on T1-enhanced MRI. 5. There was no metastasis in the pelvic cavity, and a few ascites (negative tumor cells) in three patients.

Conclusion: MRI characteristics of stage IA ovarian carcinomas were large tumors; cystic, cystic-solid, or solid; solid parts limited diffusion on DWI and low ADC; enhancement of the cyst wall, vegetation, and septa; no pelvic metastasis.

Objective: This study investigated the discriminatory power of the stretched-exponential model and fractional-order calculus model parameters for hepatocellular carcinoma versus intrahepatic cholangiocarcinoma in orthotopic xenograft nude mice.

Methods: Prototype orthotopic xenograft models of hepatocellular carcinoma and intrahepatic cholangiocarcinoma were developed using 20 nude mice divided into two groups and separately transplanted with MHCC97H and HUCCT1 cells. Readout-segmented diffusion-weighted imaging with multiple b-values (0-2000 s/mm²) was obtained using a 3.0-T magnetic resonance imaging scanner. The apparent diffusion coefficient was calculated using the mono-exponential model. The distributed diffusion coefficient and intravoxel water molecular diffusion heterogeneity (α) were calculated using the stretched-exponential model. The diffusion coefficient (D), fractional-order derivative in space (β), and spatial parameter (μ) were calculated using the fractional-order calculus model. The liver and tumor specimens of nude mice were immunostained after euthanasia to clarify the liver cancer type. Differences in diffusion-related parameters between the groups were evaluated using Mann-Whitney U-test and univariate logistic analysis. Receiver operating characteristic curves were used to assess the diagnostic efficacy of each parameter. P<0.05 was deemed significant.

Results: α, D, and β were significant discriminators between the groups. The area under the curve for these three variables was 0.890, 0.830, and 0.870, respectively, with cutoff values of 0.491, 0.435, and 0.782, respectively.

Conclusion: The stretched-exponential model parameters α and the fractional-order calculus model parameters D and β showed high diagnostic efficacy in discriminating intrahepatic cholangiocarcinoma from hepatocellular carcinoma in orthotopic xenograft nude mouse models.

Objective: This study sought to investigate the predictive capacity of DW-MRI in discerning T stages, lymph node metastasis, and pathological differentiation grades in patients with EHCC.

Methods: Eighty-five patients were pathologically diagnosed with EHCC and underwent abdominal MRI within two weeks before surgery at our hospital from Aug 2011 to Aug 2021. Tumor axial maximum area (AMA) and apparent diffusion coefficient (ADC) values for diverse T stages, N stages, and differentiation grades were retrospectively analyzed.

Results: The Mann-Whitney U test displayed significantly higher lesion AMA values (P =0.006) and lower tumor ADC values (P = 0.001) in the nodepositive group (median ADC and AMA value: 1.220×10^-3 mm²/s, 82.231 mm²) than in the node-negative group (median ADC and AMA value: 1.316×10^-3 mm²/s, 51.174 mm²). A tumor ADC value<1.249×10^-3 mm²/s from the receiver operating characteristic curve (AUC=0.725, P=0.001) exhibited the capability to predict node-positive EHCC with a sensitivity of 64.29%, and specificity of 73.68%. Furthermore, a progressive decrease in the degree of EHCC differentiation was associated with a reduction in the tumor ADC value (P=0.000).

Conclusion: The N stage and differentiation of EHCC can be evaluated non-invasively using diffusion-weighted MRI.

Methods: Eighty-two patients with single HCC who underwent surgery were retrospectively analyzed. All patients underwent preoperative gadoxetic acidenhanced MRI examination. Preoperative clinical factors and MRI characteristics were collected for feature selection. Least Absolute Shrinkage and Selection Operator (LASSO) was applied to select the optimal features for predicting postoperative 1-year recurrence of HCC. Four machine learning algorithms, Multilayer Perception (MLP), random forest, support vector machine, and k-nearest neighbor, were used to construct the predictive models based on the selected features. A Receiver Operating Characteristic (ROC) curve was used to assess the performance of each model.

Results: Among the enrolled patients, 32 patients experienced recurrences within one year, while 50 did not. Tumor size, peritumoral hypointensity, decreasing ratio of liver parenchyma T1 value (ΔT1), and α-fetoprotein (AFP) levels were selected by using LASSO to develop the machine learning models. The area under the curve (AUC) of each model exceeded 0.72. Among the models, the MLP model showed the best performance with an AUC, accuracy, sensitivity, and specificity of 0.813, 0.742, 0.570, and 0.853, respectively.

Conclusion: Machine learning models can accurately predict postoperative 1-year recurrence in patients with HCC, which may help to provide individualized treatment.

Methods: From December 2020 to December 2021, patients who underwent imaging-guided RFA of CRLM at our hospital with available CT/MRI images were enrolled consecutively. 22 patients with 46 lesions had undergone conventional group RFA whereas 29 patients with 63 lesions had undergone fusion group RFA. The lesion detection rate, technical success, local tumor progression (LTP) and complications were calculated.

Results: In this retrospective study, 51 patients with 130 lesions were diagnosed with CRLM. However, there were 12 lesions and 9 lesions invisible in the conventional group and fusion group, respectively. The lesion detection rate on the fusion imaging was significantly higher than on the US or CEUS in the fusion group (P<0.05). There were no significant differences of the detection rate between the conventional group and the fusion group (P=0.207). In both groups, the technical success rate was 100%. For local tumor progression (LTP), there were no significant differences between the two groups (P>0.05). The complications after ablation had no significant differences between the two groups (P=0.97).

Conclusion: CEUS/ Gd-EOB-DTPA-enhanced MRI fusion imaging is a safe and effective method for RFA in the management of CRLM patients, and it may improve the therapeutic effect by detecting small lesions early.

Case Presentation: The patient underwent gastric endoscopy revealing an extensive lower esophageal varix protruding into the proximal stomach, subsequently treated with banding. The stomach and duodenum were found to contain fresh blood and blood clots indicating acute bleeding.

An urgent CT scan identified active bleeding (extravasation) at segment V and blood accumulation at the confluence of the right and left biliary drains. This was followed by celiac and selective hepatic digital subtraction angiography (DSA).

Conclusion: This case study outlines the occurrence of a hepatic artery pseudoaneurysm six months after percutaneous insertion of bilateral biliary drains. The pseudoaneurysm manifested precisely at the confluence of the right and left drains. The reported delayed complication may have resulted from friction between the drains at the confluence or erosion of the adjacent artery by the drains. The insights gained from this case shed light on the causes and preventive measures for potential delayed complications associated with percutaneous biliary drain placement.

Objective: To automatically diagnose bone metastasis with bone scintigraphy, in this work, we proposed to cast the bone metastasis diagnosis problem into automated image classification by developing a deep learning-based automated classification model.

Methods: A self-defined convolutional neural network consisting of a feature extraction sub-network and feature classification sub-network was proposed to automatically detect lung cancer bone metastasis, with a feature extraction sub-network extracting hierarchal features from SPECT bone scintigrams and feature classification sub-network classifying high-level features into two categories (i.e., images with metastasis and without metastasis).

Results: Using clinical data of SPECT bone scintigrams, the proposed model was evaluated to examine its detection accuracy. The best performance was achieved if the two images (i.e., anterior and posterior scans) acquired from each patient were fused using pixel-wise addition operation on the bladder-excluded images, obtaining the best scores of 0.8038, 0.8051, 0.8039, 0.8039, 0.8036, and 0.8489 for accuracy, precision, recall, specificity, F-1 score, and AUC value, respectively.

Conclusion: The proposed two-class classification network can predict whether an image contains lung cancer bone metastasis with the best performance as compared to existing classical deep learning models. The high accumulation of ^99mTc MDP in the urinary bladder has a negative impact on automated diagnosis of bone metastasis. It is recommended to remove the urinary bladder before automated analysis.

Objective: The objective of this study was to see how well 18F-fluorodeoxyglucose (18F-FDG) PET/MRI could be used for differential diagnosis and histologic grading of primary hepatic malignancies.

Methods: We retrospectively evaluated 64 patients (53 patients with HCC, 11 patients with IHCC) with histologically proven primary hepatic malignancies using 18F-FDG/MRI. The Apparent Diffusion Coefficient (ADC), Coefficient of Variance (CV) of the ADC, and standardized uptake value (SUV) were calculated.

Results: The mean SUVmax value was higher for IHCC (7.7 ± 3.4) than for HCC (5.2 ± 3.1) (p = 0.019). The area under the curve (AUC) was 0.737, an optimal 6.98 cut-off value providing 72% sensitivity and 79% specificity. The ADCcv value in IHCC was statistically significantly higher than in HCC (p=0.014). ADC mean values in HCCs were significantly higher in low-grade tumors than in high-grade tumors. The AUC value was 0.73, and the optimal cut-off point was 1.20x10-6 mm2/s, giving 62% sensitivity and 72% specificity. The SUVmax value was also found to be statistically significantly higher in the high-grade group. The ADCcv value in the HCC low-grade group was found to be lower than in the highgrade group (p=0.036).

Conclusion: 18F FDG PET/MRI is a novel imaging technique that can aid in the differentiation of primary hepatic neoplasms as well as tumor-grade estimation.

Case Presentation: In this study, we reported an 83-year-old female patient with ARMM. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) showed uneven thickening of the intestinal wall about 7.0 cm from the anal margin, and no typical T1 high signal was seen on MRI. Dual-energy spectral CT showed that the effective atomic number (Zeff) of the tumor and the iodine concentration in the arterial phase (AP) and venous phase (VP) were different from other rectal malignancies reported in the previous literature. Sigmoidoscopy showed a large polypoid mass approximately 7.0 cm from the anal verge. Immunohistochemical staining showed that about 60% of Melan A and HMB-45 were positive, S-100 protein and Ki-67 were positive, and the pathological diagnosis was ARMM.

Conclusion: This was the first dual-energy spectral CT imaging report of ARMM. The Zeff and iodine concentration in the arterial phase and venous phase could help distinguish between ARMM and other rectal malignancies.

Objective: This study aims to evaluate the efficacy of colour Doppler ultrasound and two-dimensional ultrasound of monitoring patients with cervical cancer.

Methods: Colour Doppler ultrasound (Experimental group) and two-dimensional ultrasound (Control group) are used to monitor cervical cancer and assess the treatment effects. PFS, CI, HR, DCR, ORR, PR, SD, PD, ROD, sensitivity, and specificity, accuracy between the two groups were collected and analyzed.

Results: A total of 50 patients are included in this study, and the results show that PFS (Experimental group (EG) 5.8±2.2 versus Control group (CG) 6.1±2.6), CI (EG 20% versus CG 16%), HR (EG0.31±0.18 versus CG 0.36±0.21), DCR (EG 80% versus CG 84%), ORR(EG 28% versus CG 36%), PR (EG 16% versus CG 20%), SD (EG 48% versus CG 56%), PD (EG 12% versus CG 16%) (EG 12% versus CG 16%), ROD(EG 44% versus CG 52%) between the two groups are >0.05, and the values of sensitivity (EG 75.6% versus CG 40.2%), specificity (EG 78.4% versus CG 43.3%), and accuracy(EG 80.5% versus CG 41.4%) between the two groups are<0.05.

Conclusion: Both Colour Doppler ultrasound and two-dimensional ultrasound are effective methods to evaluate the efficacy of concurrent chemo-radiotherapy in patients with cervical cancer.

Materials and Methods: Using standard T2* relaxation time measurement protocols, in-vivo and ex-vivo MRI data with water and fat nominally in phase or out of phase relative to each other were acquired on a 7 T small animal scanner. Based on a total of 24 different echo times, PDFF maps were calculated in a magnitude-based approach. After identification of the decisive error-prone variables, pixel-wise error estimation was performed by simple propagation of uncertainty. The method was then used to evaluate PDFF data acquired for an explanted mouse liver and an in vivo mouse liver measurement.

Results: The determined error maps helped excluding measurement errors as cause of unexpected local PDFF variations in the explanted liver. For in vivo measurements, severe error maps gave rise to doubts in the acquired PDFF maps and triggered an in-depth analysis of possible causes, yielding abdominal movement or bladder filling as in vivo occurring reasons for the increased errors.

Conclusion: The combination of pixel-wise acquisition of PDFF data and the corresponding error maps allows for a more specific, spatially resolved evaluation of the PDFF value reliability.

Methods: Forty patients who received TCM chest CT scanning were retrospectively collected and divided into four groups according to the tube voltage and sexes. We chose to set up the region of interest (ROI) at the tracheal bifurcation and its upper and lower parts in slice images of the heart, aorta, lungs, paracranial muscles, and female breast, and the SNR of each organ was calculated. We also calculated the corresponding axial volume CT dose index (CTDIvolz) and axial size-specific dose estimate (SSDEz).

Results: The correlation analysis showed that the correlation between the SNR of the slice images of most organs and SSDEz was more significant than 0.8, and that between the SNR and CTDIvol was more significant than 0.7. The simple linear regression analysis results showed that when the sex is the same, the SNR of the same organ at 100kVp was higher than 120kVp, except for the lung. In multiple regression analysis, the result indicated that the determination coefficients of the SNR and SSDEz of the four groups were 0.934, 0.971, 0.905, and 0.709, respectively.

Conclusion: In chest CT examinations with TCM, the correlation between the SNR of each organ in slice images and SSDEz was better than that of CTDIvolz. And when the SSDEz was the same, the SNR at 100 kVp was better than that at 120 kVp.

Case Presentation: We report a 53-year-old female patient with sigmoid colon cancer and perforation who underwent a surgical operation. Three years after the operation, reexamination of the liver through computed tomography and magnetic resonance imagery scanning revealed multiple progressive liver lesions. However, the liver biopsy did not show malignant changes. Repeated analysis of the patient's liver magnetic resonance imaging revealed that multiple liver nodules were significantly enhanced in the arterial phase and that the portal vein density/signal ratio was higher than that of the liver parenchyma. The coincidence of doughnut-shaped nodules and high signal in the hepatobiliary phase, combined with the results of pathological liver puncture examination, led to nodular regenerative hyperplasia being considered as a possible diagnosis.

Conclusion: A review of the relevant literature showed that following oxaliplatin chemotherapy for colorectal cancer, it is not uncommon for doughnut-shaped nodules with obvious enhancement in the middle hepatic artery phase and high signal intensity in the hepatobiliary phase to develop. Such changes should be paid sufficient attention by radiologists.

Objective: This study aims to investigate the role of GS in the neovascularization of gliomas through the utilization of MR vessel-size imaging and histopathological techniques.

Methods: In this exploratory animal study, we randomly divided the C6 glioma rat models into a control group and an L-methionine sulfoximine (MSO) treatment group. Daily intraperitoneal injections were administered for three consecutive days, starting from day 10 following the implantation of C6 glioma cells in rats. Subsequently, MR vessel size imaging was conducted using a BRUKER 7 T/200 mm MRI scanner, and the MRI results were validated through histopathological examination.

Results: A significant decrease in microvessel density was observed in both the tumor periphery and center areas in the MSO treatment group compared to that in the control group. The mean vessel diameter (mVD) and vessel size index (VSI) did not exhibit significant changes compared to the control group. Moreover, the staining intensity of platelet endothelial cell adhesion molecule-1 (CD31) and GS in the tumor periphery was significantly decreased in the MSO treatment group. Additionally, the MSO treatment demonstrated a substantial inhibition of tumor growth.

Conclusion: GS inhibitors significantly reduced angiogenesis in the periphery area of C6 glioma, exerting an inhibitory effect on tumor progression. Thus, GS inhibitors could be potential therapeutic agents for treating glioma. Additionally, in vivo MR vessel size imaging detects changes in vascularrelated parameters after tumor treatment, making it a promising method for detecting neovascularization in glioma.

Methods: Forty rabbits with implanted VX2 liver tumors underwent baseline MRI and were then given 10 mg/kg CA4P (n=20) or saline (n=20). After 4 h, 10 rabbits from each group underwent an MRI examination and were then sacrificed. The remaining rabbits underwent MRI after 1, 3, and 7 days and were then sacrificed. Liver samples were processed for H&E and immunohistochemical staining. IVIM parameters (D, f, D*) were compared in the treatment and control groups, and the correlations of IVIM parameters with microvascular density (MVD) were determined.

Results: At 4 h, the two treatment groups had significantly different f and D* values (p<0.001), and these values were at their minimum in the treatment group. The treatment group had moderate correlations between MVD and f at 4 h (r=0.676, p=0.032) and 7 days (r=0.656, p=0.039) and with D* at 4 h (r=0.732, p=0.016) and 7 days (r=0.748, p=0.013), but no correlation was reported between MVD and f or D* in the control group (all P>0.05).

Conclusion: IVIM DW-MRI is a sensitive imaging technique. It successfully evaluated the effect of CA4P on VX2 liver tumors in rabbits. The f and D* values correlated with MVD at 4 h and 7 days after using CA4P, indicating that these parameters have the potential to be used as indicators of tumor angiogenesis after treatment.

Materials and Methods 123 patients with cirrhosis were retrospectively analyzed; all our patients underwent pre-contrast MRI, triphasic (arterial phase, venous phase, equilibrium phase) Gd-EOB-DTPA dynamic enhancement and hepatobiliary phase (20 minutes delayed). The relative enhancement (RE) of the patient's liver, the liver-spleen signal ratio in the hepatobiliary phase (SI liver/ spleen), the liver-vertical muscle signal ratio in the hepatobiliary phase (SI liver/ muscle), the bile duct signal intensity contrast ratio (SIR), and the radiomics features were evaluated. The support vector machine (SVM) was used as the core of machine learning to construct the liver function classification model using image and radiomics characteristics, respectively.

Results: The area under the curve was the largest in SIR to identify Child-Pugh group A versus Child-Pugh group B+C in the image characteristics, AUC = 0.740, and Perc. 10% to identify Child-Pugh group A versus Child-Pugh group B+C in the radiomics characteristics, AUC = 0.9337. The efficacy of the SVM model constructed using radiomics characteristics was better, with an area under the curve of 0.918, a sensitivity of 95.45%, a specificity of 80.00%, and an accuracy of 89.19%.

Conclusion: The image and radiomics characteristics based on Gd-EOB-DTPA-enhanced MRI can reflect liver function, and the model constructed based on radiomics characteristics combined with machine learning methods can better assess functional liver reserve.

Objectives: In this paper, the SWE was used to quantitatively determine the tissue hardness of the internal and external orifice of the cervix (IOC & EOC) and to relatively objectively analyze the impact of different production methods on the hardness of the cervical tissue.

Methods: A total of 48 patients were selected, and they were divided into three groups according to different production methods: control group (16 cases), cesarean section group (16 cases), and spontaneous delivery group (16 cases). Artificial intelligence has also been incorporated into this work. A deep flexible neural tree model and a new set of FNT models were proposed to assist in classifying cervical physical data in different states. The physical data was extracted as the features, and the different states were considered as category labels.

Results: There was no statistically significant difference in the elasticity of the IOC and the EOC between the groups. However, the difference in the elasticity of the IOC and the EOC within each group was statistically significant. The classification results corresponded with the results of the statistical analysis. The hardness of the EOC is generally lower than that of the IOC, and there was no significant difference in hardness between the IOC and the EOC in the three groups.

Conclusion: There is no significant difference in the cervical elasticity hardness between different delivery modes.

Objective: This study aimed to investigate the impact of ⁶⁸Ga-PSMA PET/CT on overall survival (OS) and management in PCa.

Methods: Consecutive 100 patients who had ⁶⁸Ga-PSMA PET/CT and conventional imaging (CI) were included in this retrospective study. Disease stages and treatment plans according to both CI and ⁶⁸Ga-PSMA PET/CT were compared. The effect of ⁶⁸Ga-PSMA PET/CT on OS was assessed.

Results: After ⁶⁸Ga-PSMA PET/CT, the stage changed in 64 patients (64%). By the reason of ⁶⁸Ga-PSMA PET/CT findings, treatment plans based on CI were changed in 73 patients (73%). According to the ROC analysis, patients with a PSA value below 8 had higher rates of change in staging (p<0.0001) and treatment (p=0.034). Both a PSA below 8 (OR 8.79 95% CI (2.72-28.43), p<0.001), and having a hormone-sensitive disease at the time of imaging (OR 5.6 95% CI (1.35-23.08), p=0.017) were significant independent factors predicting change in staging with ⁶⁸Ga-PSMA PET/CT. The results of a phi correlation coefficient analysis showed a significant relationship between therapy and changes in staging (Φ=0.638, p<0.0001). Two-year OS was statistically different in hormone-sensitive patients with and without treatment change (95% vs 81%, p=0.006).

Conclusion: ⁶⁸Ga-PSMA PET/CT has the effect of changing the treatment in 73% of PCa patients. There is a positive correlation between the changes in staging and treatment. Survival of hormone sensitive patients has improved due to treatment changes based on PET/CT findings.

Objective: To explore the clinical significance of renal lesions with low-level enhancement on CT after exposure to anti-cancer drugs.

Methods: Medical records of patients with cancer who developed renal lesions on CT after exposure to anti-cancer drugs were retrospectively reviewed. Renal lesions were scored according to the extent of involvement, CT attenuation values of lesions and normal parenchyma were measured on precontrast CT and three phases of contrast-enhanced CT, and changes in serum creatinine (SCr) from one week before exposure to drugs to one week before and after the appearance of renal lesions were recorded.

Results: This study included 54 patients (86 lesions). Lesions were slightly lower density on pre-contrast CT, and less enhancing than normal renal parenchyma, especially in the delayed phase. Lesions were wedge-shaped, and involved the renal pyramid and associated renal cortex, as well as, were single or multiple, and occurred in the unilateral or bilateral kidneys. There were patchy and cord-like shadows of increased density in adjacent perirenal adipose tissue. During follow-up, lesions disappeared in 15 patients and persisted in 39 patients without significant progression. There were significant differences in renal lesions and normal renal parenchyma CT attenuation values in each phase of contrast-enhanced CT. Change in SCr level was significantly positively correlated with lesion score.

Conclusion: Renal lesions with low-level enhancement on CT suggest early drug-induced kidney injury. These findings will inform clinical decision-making.

Aim: This review aims to shed light on the therapeutic potential of dandelion by summarizing its nutritional benefits, phytochemical constituents, and effectiveness in addressing health conditions like diabetes, inflammation, and cancer. It also provides insights into the applications of this plant beyond the food industry to gain researchers' attention to unravel the unexplored aspects of this therapeutic plant. It will further help in laying specific considerations, which are required to be taken into account before the development of functional foods incorporated with dandelion.

Scope and approach: Being rich in essential vitamins, minerals, and other phytoconstituents, dandelion is a natural remedy for various ailments. Whether consumed raw or cooked, the plant’s inclusion in the diet poses potential therapeutic effects on conditions such as diabetes, inflammation, liver disease, and tumors. It also aids in immune system modulation and fights infections by targeting microbes at their root. Researchers have developed various value-added food products by incorporating different parts of dandelion.

Conclusion: This review highlights the therapeutic potential of dandelion, emphasizing its effectiveness against various health conditions. Insights into dosage, toxicity, and diverse applications further underscore its role as a versatile and promising natural remedy.