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.

Antineoplastic medications that cause oxidative stress by raising ROS and blocking antioxidant mechanisms have recently attracted much interest. The rapid accumulation of ROS impairs redox balance and damages cancer cells severely. Here, we discuss ROS-instigating malignancy therapy and the antineoplastic mechanism used by prooxidative drugs.

Methods: In this study, we have studied the anti-tumor properties and potential mechanisms of PF-04449913. Colorectal cancer cell viability was reduced by PF-04449913 in a dose-dependent manner. The migration and invasion ability of malignant colon cells were attenuated by the drug, as demonstrated by the Transwell test. Moreover, PF-04449913 repressed the phosphorylation levels of ERK and other proteins, and the expression levels of MMP9. The anti-tumor effects of the drug in vivo were demonstrated in BALB/c-nude mice models, and PF-04449913 inhibited the malignant phenotype of colorectal cancer cells, including reduction of tumor size and promotion of apoptosis. At the molecular level, PF-04449913 induced a significant decrease in ERK and p65 protein phosphorylation levels and inhibited MMP9 protein expression.

Results: Both in vivo and in vitro results showed PF-04449913 to demonstrate antitumor effects, which have been proposed to be mediated through blockade of the ERK/p65 signaling pathway, and subsequent repression of MMP9 expression.

Conclusion: Our study provides a new perspective on the potential clinical application of PF-04449913 in the treatment of 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: 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: Here, using scRNA-sequencing and ATAC-seq on primary chronic myelogenous leukemia (CML) patient samples, combined with bioinformatics analyses, we further examine the heterogeneity of a previously characterized in vitro imatinib-selected CD34-CD38- CML LSC population. We utilized a series of functional analyses, including single-cell metabolomic and Seahorse analyses, to validate the existence of the deepest quiescent leukemia initiators (LI) subset.

Results: Current study revealed heterogeneity of therapy resistant LSC in CML patients and their existence of two functionally distinct states. The most deeply quiescent LI suppress the expression of MC-1, yet are highly dependent on fatty acid oxidation (FAO) for their metabolic requirements and ATAC-seq demonstrated increased chromatin accessibility in this population, all consistent with an extremely primitive, quiescent stemness transcriptional signature. Importantly, the specific CREB binding protein (CBP)/β-catenin antagonist ICG-001 initiates the differentiation of LSC, including LI, decreases chromatin accessibility with differentiation and increasing expression of MC-1, CD34, CD38 and BCR-ABL1, thereby resensitizing them to imatinib.

Conclusion: We investigated the biological aspects related to LSC heterogeneity in CML patients and demonstrated the ability of specific small molecule CBP/β-catenin antagonists to safely eliminate deeply quiescent therapy resistant CSC. These observations may represent an attractive generalizable therapeutic strategy that could help develop better protocols to eradicate the quiescent LSC population.

Aims: Using clinically collected non-small cell lung cancer (NSCLC) samples, we sought to hypothesize an innovative intact signaling cascade for the disorder.

Methods: We dissected snap-frozen NSCLC tissues along with sibling-paired nearby non-tumorous tissues from 108 NSCLC patients. We measured the expression levels of miR-451/ETV4/MMP13 using qRT-PCR and did a thorough investigation of the molecular mechanism for the signaling axis in NSCLC cell line A549. We also studied the epithelial-mesenchymal transition (EMT) process.

Results: The activity of miR-451 was significantly decreased in NSCLC tissues, while the expression levels of ETV4 and MMP13 were remarkably increased. At the same time, miR-451 levels maintained a declining trend across TNM stage I–III. Inversely, ETV4 and MMP13 increased as the TNM stage increased. The miR-451/ETV4/MMP13 signaling axis was closely associated with prognosis in NSCLC patients. Based on in vitro experiments, ETV4 was a direct targeting factor for miRNA-451. Meanwhile, ETV4 promoted the tumor properties of NSCLC cells by directly activating MMP13. Silencing MMP13 blocked the EMT progress of NSCLC cells.

Conclusion: Overall, we hypothesized an impeccable signaling pathway for NSCLC from a new aspect, and this can offer alternative insights for a better understanding of the disorder.

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.

Aims: Sanguinarine (sang) mediated the anticancer effect in LCC lines by involving the stimulation of reactive oxygen species (ROS), impeding Bcl2, and enhancing Bax and other apoptosis-associated protein Caspase-3, -9, and -PARP, subsequently inhibiting the LC invasion and migration.

Objective: This study was conducted to investigate the apoptotic rate and mechanism of Sang in human LC cells (LCC) H522 and H1299.

Methods: MTT assay to determine the IC₅₀, cell morphology, and colony formation assay were carried out to show the sanguinarine effect on the LC cell line. Moreover, scratch assay and transwell assay were performed to check the migration. Western blotting and qPCR were done to show its effects on targeted proteins and genes. ELISA was performed to show the VEGF effect after Sanguinarine treatment. Immunofluorescence was done to check the interlocution of the targeted protein.

Results: Sang significantly inhibited the growth of LCC lines in both time- and dose-dependent fashions. Flow cytometry examination and Annexin-V labeling determined that Sang increased the apoptotic cell percentage. H522 and H1299 LCC lines treated with Sang showed distinctive characteristics of apoptosis, including morphological changes and DNA fragmentation.

Conclusion: Sang exhibited anticancer potential in LCC lines and could induce apoptosis and impede the invasion and migration of LCC, emerging as a promising anticancer natural agent in lung cancer management.

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: Hsa_circ_0000021, miR-3940-3p, and KPNA2 expression levels were estimated through qRT-PCR. Nuclear/cytoplasmic separation was conducted to find the subcellular location of hsa_circ_0000021. Western blot was done to estimate the levels of KPNA2 protein. CCK-8, BrdU, wound healing, transwell, and tumor xenograft assays were performed to study how hsa_circ_0000021/miR-3940-3P/KPNA2 function affect CC. Hsa_circ_0000021’s targeting relationships with miR-3940-3p and KPNA2 were ascertained through RIP and luciferase experiments.

Results: Hsa_circ_0000021 and KPNA2 were overexpressed and inversely associated with the levels of miR-3940-3p in CC. Knocking down either hsa_circ_0000021 or KPNA2 repressed the growth of CC tumors as well as the proliferation, invasion, and migration of CC cells. Silencing miR-3940-3p promoted the malignant proliferation of CC cells. Regarding its mechanism, hsa_circ_0000021 affected the malignant CC cell proliferation via the sponging of miR-3940-3p, which targeted KPNA2.

Conclusion: Hsa_circ_0000021 regulates the miR-3940-3p/KPNA2 axis to promote CC occurrence. This potentially is a novel target for CC treatment.

Objective: The goal of the current research was to create a biocompatible GSH-depleting and tumor- targeting nanoparticle (denoted as DOX/CA@PCN-224@HA) for the combined photodynamic and chemo photo-chemo) therapy.

Methods: The nanoparticles were characterized by transmission electron microscopy (TEM). A UV-vis spectrophotometer was used to measure the drug loading efficiency (DE) and encapsulation efficiency (EE). The GSH-depleting ability was measured using Ellman's test. Confocal laser scan microscopy (CLSM) was used to assess the cellular uptake. MTT was adopted to evaluate the cytotoxicity of DOX/CA@PCN-224@HA against 4T1 cells.

Results: The altered PCN-224 showed excellent monodispersing with a dimension of approximately 193 nm ± 2 nm in length and 79 nm ± 3 nm in width. The larger and spindle grid-like structure of PCN-224 obtains better dual-drug loading ability (DOX: 20.58% ± 2.60%, CA: 21.81% ± 1.98%) compared with other spherical PCN-224 nanoparticles. The ultimate cumulative drug release rates with hyaluronidase (HAase) were 74% ± 1% (DOX) and 45% ± 2% (CA) after 72 h. DOX/CA@PCN-224@HA showed GSH-consuming capability, which could improve the PDT effect. The drug-loaded nanoparticles could accurately target 4T1 cells through biological evaluations. Moreover, the released DOX and CA display cooperative effects on 4T1 cells in vitro. DOX/CA@PCN-224@HA nanoparticles showed inhibition against 4T1 cells with an IC₅₀ value of 2.71 μg mL^-1.

Conclusion: This nanosystem displays great potential for tumor-targeted enhanced (photo-chemo) therapy.

Methods: The NSCLC/AR cells, resistant to anlotinib, have been produced. The role of AS-IV in the AR of NSCLC cells about the miR-181a-3p/unfolded protein response (UPR)- endoplasmic reticulum associated degradation (ERAD) pathway was then discussed by treating the cells with anlotinib or AS-IV, or by manipulating them with inhibitors or mimics of miR- 181a-3p, HRD1 or Derlin-1 overexpression plasmids.

Results: We found that AS-IV could suppress the AR of NSCLC cells. In addition, miR-181a- 3p was elevated in NSCLC/AR cells. Functionally, AS-IV limited the AR of NSCLC cells by reducing miR-181a-3p. Further, activation of the UPR-ERAD pathway was correlated with AR in NSCLC cells. Increased sensitivity of NSCLC cells to anlotinib caused by miR-181a-3p inhibitor could be reversed by overexpression of HRD1 or Derlin-1.

Conclusion: This research revealed a promising NSCLC/AR treatment approach by showing that AS-IV exposed NSCLC cells to anlotinib by inhibiting the miR-181a-3p/UPR-ERAD axis.

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: 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.

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.

Objective. In this work, we have focused on the possible protective effect of Trx1 and Grx1 against oxidative stress-induced DNA damage and apoptosis-signaling, by studying the phosphorylation of MAP kinases.

Methods. Trx1 and Grx1 were overexpressed or silenced in cultured H1299 non-small cell lung cancer epithelial cells. We examined cell growth, DNA damage, and the phosphorylation status of MAP kinases following treatment with H₂O₂.

Results. Overexpression of both Trx1 and Grx1 had a significant impact on the growth of H1299 cells and provided protection against H₂O₂-induced toxicity, as well as acute DNA single-strand breaks. Conversely, silencing of these proteins exacerbated DNA damage. Furthermore, overexpression of Trx1 and Grx1 inhibited the rapid phosphorylation of JNK (especially at 360 min of treatment, ****p=0.004 and **p=0.0033 respectively) and p38 MAP kinases (especially at 360 min of treatment, ****p<0.0001 and ***p=0.0008 respectively) during H₂O₂ exposure, while their silencing had the opposite effect (especially at 360 min of treatment, ****p<0.0001).

Conclusion. These results suggest that both Trx1 and Grx1 have protective roles against H₂O₂ induced toxicity, emphasizing their significance in mitigating oxidative stress-related cellular damage.

Methods: Health-beneficial aspects of atractylodin in medicine have been investigated in the present work through collected scientific information on atractylodin from different literature databases. Scientific data on atractylodin has been collected from Google, Science Direct, Scopus, and PubMed. Further, detailed pharmacological activities and analytical aspects of atractylodin were discussed in this paper in order to know its biological potential in medicine. Analytical techniques of atractylodin were also discussed in the present work for separation, isolation, and identification of atractylodin.

Results: Scientific data analysis signified the biological importance of Atractylodes lancea Thunb. and its active phytochemical atractylodin in medicine. Scientific data signified the presence of atractylodin in Atractylodes lancea, Atractylodes chinensis, Atractylodes japonica, Atractylodes macrocephala, Atractylodes ovate and Atractylodis Rhizoma. Atractylodin has a significant biological effect on cholangiocarcinoma, hepatocellular carcinoma, breast cancer, lung cancer, cancer anorexiacachexia syndrome, colitis, rheumatoid arthritis, respiratory complications, GIT complications, hepatic complications, atopic dermatitis, aging process, neurodegenerative disease, calcified aortic valve disease, hypertension, pulmonary fibrosis, body temperature, olfactory neurons, podocyte hypermotility and toxicity. Further, its anti-nociceptive, anti-fibrotic, anti-angiogenic, anti-virulence, antibacterial, insecticidal, lipase inhibitory potential, immunomodulatory, and positive inotropic effects were also discussed in the present paper. Analytical techniques for the separation, isolation and identification of atractylodin in different samples were also discussed in the present work.

Conclusion: The present work's scientific data signified the biological importance of atractylodin in medicine.

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.

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.

Methods: A prediction model was developed based on a dataset of radiomic features obtained from 132 patients with lung cancer receiving IMRT. Dimension reduction was performed for the features using the maximum-relevance and minimum-redundancy (mRMR) algorithm, and the least absolute shrinkage and selection operator (LASSO) regression model was utilized to optimize feature selection for the IMRT-sensitivity prediction model. The model was constructed using binary logistic regression analysis and was evaluated using the concordance index (C-index), calibration plots, receiver operating characteristic curve, and decision curve analysis.

Results: Fifty features were selected from 1348 radiomic features using the mRMR method. Of these, three radiomic features were selected by LASSO logistic regression to construct the radiomics nomogram. The C-index of the model was 0.776 (95% confidence interval: 0.689–0.862) and 0.791 (95% confidence interval: 0.607–0.974) in the training and validation cohorts, respectively. Decision curve analysis showed that the radiomics nomogram was clinically useful.

Conclusion: Radiomic features have the potential to be applied to predict the short-term efficacy of IMRT in patients with inoperable lung cancer.

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.

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: We employ a deep learning method to diagnose the most commonly encountered patterns in ILD differentially.

Materials and Methods: Patients were categorized into usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), and normal lung parenchyma groups. VGG16 and VGG19 deep learning architectures were utilized. 85% of each pattern was used as training data for the artificial intelligence model. The models were then tasked with diagnosing the patterns in the test dataset without human intervention. Accuracy rates were calculated for both models.

Results: 1 The success of the VGG16 model in the test phase was 95.02% accuracy. 2 Using the same data, 98.05% accuracy results were obtained in the test phase of the VGG19 model.

Conclusion: Deep Learning models showed high accuracy in distinguishing the two most common patterns of ILD.

Methods: In this study, we proposed a new model called Blend U-Net, which incorporates nested structures, redesigned long and short skip connections, and deep supervisions. The nested structures and the long and short skip connections combined characteristic information of different levels from feature maps in all scales, while the deep supervision learning hierarchical representations from all-scale concatenated feature maps. Additionally, we employed a mixed loss function to obtain more accurate results.

Results: We evaluated the performance of the Blend U-Net against other architectures on the publicly available Lung Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI) dataset. Moreover, the accuracy of the segmentation was verified by using the dice coefficient. Blend U-Net with a boost of 0.83 points produced the best outcome in a number of baselines.

Conclusion: Based on the results, our method achieves superior performance in terms of dice coefficient compared to other methods and demonstrates greater proficiency in segmenting lung nodules of varying sizes.

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: 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.

Case Presentation: A 64-year-old female presented with a huge thyroid mass resulting in compressive myelopathy and was diagnosed as CCV-PTC, not anaplastic carcinoma. After multidisciplinary discussions, we decided to proceed with otolaryngological, thoracic, and orthopaedic surgery. All tumours were unresectable, and we planned to proceed with R2 resection to resolve the gait disturbance and anterior fusion to resolve spinal instability.

Conclusion: Advanced-stage thyroid cancer is relatively uncommon, but desirable treatment effects can be expected through accurate pathological diagnosis. Immunohistochemical staining and tissue-specific markers can be helpful.

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.

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.

Objective: This study examines the safety and efficacy of thoracoscopic-assisted surgery for the treatment of penetrating chest wall tuberculosis as a means of exploring novel concepts of minimally invasive surgery.

Methods: Our hospital conducted a retrospective study of 25 patients with penetrating chest wall TB who underwent thoracoscopic surgery between January 2020 and June 2021. General demographics, CT scan data linked to surgery, and postoperative patient outcomes were compared between the two groups. The data was also evaluated to determine the range of operation time and the volume of bleeding from different foci in the thoracic cavity.

Results: All procedures went well after patients took conventional antituberculosis medication for at least two weeks prior to surgery. CT scans showed that thoracoscopic surgery needed a smaller incision than traditional chest wall TB surgery, with no discernible increase in surgical time. Postoperative tube use, length of hospital stay, and blood loss were all significantly lower than they would have been with conventional surgery. In addition, thoracoscopy was associated with a significantly reduced rate of subsequent treatment. Fibrous plate development and calcification caused the longest operation times in the thoracoscopic surgery group, whereas multiple pleural tuberculomas generated the most hemorrhage. Thoracoscopic surgery usually reveals tuberculous foci hiding in the thoracic cavity.

Conclusion: Thethoracic surgery can eliminate the TB focus in the chest wall and intrathoracic while treating penetrating chest wall tuberculosis. The CT scan is a crucial part of the diagnostic process for these patients. Minor surgical trauma, low complication and recurrence rates, and good results. There is a greater distinction between the two surgical approaches for patients with penetrating chest wall TB as opposed to those with basic chest wall tuberculosis.

Methods: A retrospective analysis was conducted on a patient with synchronous CRC and ccRCC who underwent ¹⁸F-FDG PET/CT and contrast-enhanced CT before treatment. Databases were analyzed to identify differentially expressed genes between CRC and ccRCC, and co-expression genes were extracted for RCC and CRC.

Results: ¹⁸F-FDG PET/CT revealed intense metabolic activity in the primary colorectal lesion (SUVmax 13.2), while a left renal mass (diameter = 35 mm) was observed with no significant uptake. Contrast-enhanced CT during the arterial phase showed heterogeneous intense enhancement of the renal lesion, and the lesion washed out earlier than in the renal cortex in the nephrographic and excretory phases, indicating ccRCC. The histopathological results confirmed synchronous double primary malignant tumors. Our bioinformatic analysis results showed that synchronous occurrence of CRC and ccRCC may correlate with simultaneous expression of Carbonic Anhydrase 9 (CA9), integrin-binding sialoprotein (IBSP), and Fibrinogen γ chain (FGG).

Conclusion: ¹⁸F-FDG PET/CT combined with contrast-enhanced CT is an effective diagnostic tool in evaluating synchronous CRC and RCC. By analyzing this clinical case and conducting bioinformatic analysis, we improved our current understanding of the mechanisms underlying synchronous tumors.

Objective: The aim of this study was to determine whether there is a radiological difference in lung parenchymal involvement between infected vaccinated and unvaccinated patients. Additionally, we aimed to investigate whether vaccination has an impact on the course of illness and the need for intensive care.

Methods: This study includes all patients undergoing chest computed tomography (CT) or x-ray imaging in case of a proven SARS-CoV-2 infection between September and November 2021. Anonymized CT and x-ray images were reviewed retrospectively and in consensus by two radiologists, applying an internal severity score scheme for CT and x-ray as well as CARE and BRIXIA scores for x-ray. Radiological findings were compared to vaccination status, comorbidities, inpatient course of the patient’s illness and the subjective onset of symptoms.

Results: In total, 38 patients with acute SARS-CoV-2 infection underwent a CT scan, and 168 patients underwent an x-ray examination during the study period. Of these, 32% were vaccinated in the CT group, and 45% in the x-ray group. For the latter, vaccinated patients exhibited significantly more comorbidities (cardiovascular (p=0.002), haemato-oncological diseases (p=0.016), immunosuppression (p=0.004)), and a higher age (p<0.001). Vaccinated groups showed significantly lower extent of lung involvement (severity scores in CT cohort and x-ray cohort both p≤0.020; ARDS 42% in unvaccinated CT cohort vs. 8% in vaccinated CT cohort). Furthermore, vaccinated patients in the CT cohort had significantly less need for intensive care treatment (p=0.040).

Conclusion: Our data suggest that vaccination, in the case of breakthrough infection, favours a milder course of illness concerning lung parenchymal involvement and the need for intensive care, despite negative predictors, such as immunosuppression or other pre-existing conditions.

Methods: This retrospective study collected the clinicopathological and imaging data of 218 patients with EC in Yuncheng Central Hospital from March 2018 to May 2022. The patients were randomly divided into training group (n=152) and validation group (n= 66) according to the ratio of 7: 3. Based on the ADC, CE-sag, CE-tra, DWI, T2WI-sag-fs, T2WI-tra sequence images of each patient, the region of interest was manually segmented and the features were extracted. The four-step dimensionality reduction method based on max-relevance and min-redundancy (MRMR) and least absolute shrinkage and selection operator (LASSO) regression was used for feature selection and radiomics model construction. Independent predictors of clinicopathological features were screened by multivariate logistic regression analysis. The imaging model based on ADC, CE-sag, CE-tra, DWI, T2WI-sag-fs, T2WI-tra single sequence and combined sequence and the fusion model with clinicopathological features were constructed, and the nomogram was made. ROC curve, correction curve and decision analysis curve were used to evaluate the efficacy and clinical benefits of the nomogram.

Results: There was no significant difference in general clinical data between the training and validation groups (P > 0.05). After screening the extracted features, 16 radiomics features were obtained, which were all related to LVSI in EC patients (P < 0.05). The area under the ROC curve (AUC) of the six independent sequence radiomics models in the training group was 0.807, 0.794, 0.826, 0.794, 0.828, 0.824, respectively. The AUC corresponding to the radiomics model constructed by the combined sequence was 0.884, and the diagnostic efficiency was the best, which was verified in the validation group. The AUC of the nomogram constructed by the combined radiomics model and age maximum tumor diameter(MTD), lymph node enlargement (LNE) in the training group and the validation group were 0.914 and 0.912, respectively. The correction curve shows that the nomogram has good correction performance. The decision curve suggests that taking radiomics nomogram to predict LVSI net benefit when the risk threshold is > 10% is better than considering all patients as LVSI+ or LVSI-.

Conclusion: The combined model based on multi-parametric MRI radiomics features and clinical features has good predictive value for LVSI status in EC patients.

Case Report: We reported a case of an NTM infection in a patient with IPF, manifested as a mass-like consolidation with cavitation on chest CT, mimicking lung cancer.

Conclusion: Being aware of the unusual radiologic features of NTM lung disease in IPF patients can be useful in the differential diagnosis of newly detected lesions.

Objective: The purpose of this study was to evaluate the clinical value of contrast-enhanced fast fluid-attenuated inversion recovery (CE FLAIR) imaging in combination with contrast-enhanced T1 weighted imaging (CE T1WI) in detecting BM of lung cancer and explore a quick and effective MRI protocol.

Material and Methods: In 201 patients with lung cancers and suspected BM, T1WI and FLAIR were performed before and after administration of gadopentetate dimeglumine. Two radiologists reviewed pre- and post-contrast images to determine the presence of abnormal contrast enhancement or signal intensity and decided whether it was metastatic or not on CE T1WI (Group 1) and CE FLAIR (Group 2). The number, locations and features of abnormal findings in two groups were recorded. Receiver Operating Characteristic (ROC) analyses were conducted in three groups: Group 1, 2 and 3(combination of CE FLAIR and CE T1WI).

Results: A total of 714 abnormal findings were revealed, of which 672 were considered as BM and 42 nonmetastatic. Superficial and small metastases(≤10mm) in parenchyma and ependyma, leptomeningeal and non-expansive skull metastases were typically better seen on CE FLAIR. The areas under ROC in the three groups were 0.720,0.887 and 0.973, respectively. Group 3 was significantly better in diagnostic efficiency of BMs than Group 1 (p<0.0001) or Group 2 (p=0.0006).

Conclusion: The combination of CE T1WI and CE FLAIR promotes diagnostic performance and results in better observation and characterization of BM in patients with lung cancers. It provides a quick and efficient way of detecting BM.

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.

Materials and Methods: Thoracic CT was collected from 120 advanced NSCLC patients who suffered progression on first- or second-generation TKIs. Radiomics signatures were retrieved from the entire tumor. Pearson correlation and the least absolute shrinkage and selection operator (LASSO) regression method were adopted to choose the most suitable radiomics features. Clinical and radiological factors were assessed using univariate and multivariate analysis. Three Machine Learning (ML) models were constructed according to three classifiers, including Logistic Regression (LR), Support Vector Machine (SVM), and RandomForest (RF), combining clinical and radiomic features. A nomogram combining clinical features and the rad score signature was built. The predictive ability of the nomogram was assessed by the ROC curve, calibration curve, and decision curve analysis (DCA).

Results: Multivariate regression analysis showed that two clinicopathological characteristics and two radiological features were highly correlated with the acquired T790M mutation, including the progression-free survival (PFS) of first-line EGFR TKIs (P = 0.029), the initial EGFR profile (P = 0.01), vascular convergence (P = 0.043), and air bronchogram (P = 0.030). The AUCs of clinical, radiomics, and combined models using RF classifiers for T790M mutation detection were 0.951 (95% confidence interval [CI] 0.911,0.991), 0.917 (95%CI 0.856,0.978), and 0.961 (95%CI 0.927,0.995) in the training cohort, respectively, higher than those of other classifier models.The calibration curve and Hosmer-Lemeshow Test showed good calibration power, and the DCA demonstrated a significant net benefit.

Conclusion: A radiomics-clinical nomogram based on CT radiomics proved valuable in non-invasively and efficiently predicting the acquired T790M mutation in patients who suffered progression on first-line TKIs.

Case Presentation: A 72-year-old woman is presented, hospitalized for a left-sided pleural effusion with bilateral, multiple nodulеs of different sizes in the lungs. Thoracentesis revealed data for atypical cells in the pleural fluid. The CT scan suspected a probable neoplastic process, but the subsequently performed fiberbronchoscopy couldn’t prove the existence of the same. The final diagnosis was established after ultrasound controlled transthoracic tru-cut needle biopsy of a pulmonary lesion with the application of a contrast medium.

Conclusion: The CEUS allows precise detection of the metastatic area because of its unique perfusion characteristics and ability to remain hypocontrasted after the application of the contrast medium sulfur hexafluoride. The persistence of a concomitant left-sided pleural effusion is used as an ultrasound window during the performance of the manipulation, with the successful verification of the pathology as primary pulmonary adenocarcinoma. By the application of this minimally invasive manipulation, an accurate final histological result was obtained.

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/131770Introduction: The concept of occult breast carcinoma (OBC) was first described in 1907 by Halsted, who described this type of breast cancer to arise from small, undetectable tumours in the breast that had already metastasized to the lymph nodes. Although the breast is the most likely site for the primary tumour, non-palpable breast cancer presenting as an axillary metastasis has been reported, but with a low frequency of less than 0.5% of all breast cancers. OBC represents a complex diagnostic and therapeutic dilemma. Considering its rarity, clinicopathological information is still limited.

Case Report: A 44-year-old patient presented to the emergency room with an extensive axillary mass as the first manifestation. Conventional evaluation of the breast with mammography and ultrasound was unremarkable. However, a breast MRI confirmed the presence of conglomerate axillary nodes. A supplementary whole-body PET-CT established the axillary conglomerate with a malignant behaviour with SUVmax of 19.3. The primary tumour was not detected in the breast tissue of the patient, confirming the diagnosis of OBC. Immunohistochemical results showed positive receptors for estrogen and progesterone.

Conclusion: Although OBC is a rare diagnosis, its existence is a possibility in a patient with breast cancer. Mammography and breast ultrasound with unremarkable findings but with high clinical suspicion should be supplemented with additional imaging methods, such as MRI and PET-CT, emphasizing the appropriate pre-treatment evaluation.

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.

Methods: 10,000 participants (5428 males, and 4,572 females, mean age 50+/-13.5 years [SD] years; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. Following that, the reconstructed images were interpreted to identify and categorize various bronchial patterns in the RSL. Cross-tabulation analysis and the Pearson chi-square test (χ2) were used to calculate the component ratios of bronchial branch types and determine their relevance between male and female groups.

Results: Our results revealed mainly six types for the RSL bronchial tree, i.e., (B1, B2, B3, 60.70%); (B1+2, B3, 18.72%); (B2+3, B1, 6.68%); (B1+3, B2, 7.57%); (B1, B2, B3, B*, 3.19%); (B1a+B3, B1b+B2, 3.14%). There were significant sex-related differences in the proportion of bronchial branches in the RSL (P< 0.05).

Conclusion: The current study has validated the presence of segmental bronchial variations in the RSL. These findings may have significant implications for diagnosing symptomatic patients and performing particular procedures, including bronchoscopy, endotracheal intubation, and lung resection.

]]> https://www.benthamscience.comarticle/135451Objective: This study aimed to determine the utility of a radiomic nomogram combined with clinical imaging and radiomic features based on MRI for the diagnosis of triple-negative breast cancer.

Methods: Multi-parametric MRI images of 136 breast cancer patients were retrospectively analyzed, 95 cases were stratified into the training cohort, and 41 cases were selected for the test group. According to the pathological molecular typing, the patients were divided into 23 cases of triple-negative breast cancer and 113 cases of non-triple-negative breast cancer. ITK software was used to manually delineate the lesion volume region of interest (VOI), and the Pyradiomics package was used to extract radiomic features for screening and model building. The platform was then used to analyze the clinical and imaging risk factors of breast cancer to build a characteristic model separately. Finally, a radiomic nomogram was constructed by integrating the radiomic and independent clinical image features. The diagnostic performance of the model was assessed using ROC curves.

Results: Univariate and multivariate analyses showed that the menstrual cycle, glandular density, and skin thickening were risk factors for clinical imaging characteristics of triple-negative breast cancer. The Area Under the Curve (AUC) was 0.839 and 0.826 for univariate and multivariate analysis, respectively. After screening, 11 radiomic features participated in the calculation of the radiomic score, and its AUC in the test set was 0.803. Combining it further with clinical models, the AUC improved to 0.899.

Conclusion: The radiomic nomogram developed in this study has great value in the diagnosis of triple-negative breast cancer.

Objective: In this study, we introduce a novel approach known as Unsupervised Imbalanced Registration, to address the challenge of data imbalance and prevent overconfidence while increasing the accuracy and stability of 4D image registration.

Methods: Our approach involves performing unsupervised image mixtures to smooth the input space, followed by unsupervised image registration to learn the continual target. We evaluated our method on 4D-Lung using two widely used unsupervised methods, namely VoxelMorph and ViT-V-Net.

Results: Our findings demonstrate that our proposed method significantly enhances the mean accuracy of registration by 3%-10% on a small dataset while also reducing the accuracy variance by 10%.

Conclusion: Unsupervised Imbalanced Registration is a promising approach that is compatible with current unsupervised image registration methods applied to 4D images.

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.

Methods: One hundred and four cases of pulmonary nodules confirmed by clinicopathology were analyzed retrospectively, including 79 cases of malignant nodules and 25 cases of benign nodules. They were randomly divided into a training group (n = 74 cases) and test group (n = 30 cases) according to the ratio of 7:3. Using ITK-SNAP software to manually mark the region of interest (ROI), and using AK software (Analysis kit, Version 3.0.0.R, GE Healthcare, America) to extract image radiomics features, a total of 1316 radiomics features were extracted. Then, the minimum–redundancy–maximum–relevance (mRMR) algorithms were used to preliminarily reduce the dimension, and retain the 30 most meaningful features, and then the least absolute shrinkage and selection operator (LASSO) algorithm was used to select the optimal subset of features, so as to establish the final model. The performance of the model was evaluated by using the receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), accuracy, sensitivity and specificity. Calibration refers to the agreement between observed endpoints and predictions, and the clinical benefit of the model to patients was evaluated by decision curve analysis (DCA).

Results: The accuracy, sensitivity, and specificity of the training and testing groups were 81.0%, 77.7%, 82.1% and 76.6%, 85.7%, 73.9%, respectively, and the corresponding AUCs were of 0.83 in both groups.

Conclusion: CT image-based radiomics could differentiate benign from malignant pulmonary nodules, which might provide a new method for clinicians to detect benign and malignant pulmonary nodules.

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.

Case Presentation: A 73-year-old woman was presented with a right breast lesion found on mammography screening, which revealed a metastatic neuroendocrine tumor by histopathological analysis with a tru-cut biopsy. Subsequently, ⁶⁸Ga-DOTATATE PET/CT imaging performed for the initial evaluation showed increased radiotracer uptake in the lesion in the right breast as well as the nodular lesion in the middle lobe of the right lung, which was histologically confirmed to be AC.

Conclusion: Metastasis of uncommon AC of the lung to the breast is extremely rare. However, it is essential to properly differentiate metastatic tumors from primary disease due to differences in clinical management and prognosis, and ⁶⁸Ga-DOTATATE PET/CT is a unique diagnostic tool with the advantage of whole-body imaging.

Objective: To investigate the clinical efficacy of EBUS-TBNA in the diagnosis and differential diagnosis of mediastinal and hilar lesions.

Methods: A retrospective observational study was undertaken to investigate patients diagnosed with mediastinal and hilar lymphadenopathy based on imaging at our hospital from 2020 to 2021. After evaluation, EBUS TBNA was used and data including the puncture site, postoperative pathology, and complications were recorded.

Results: Data from 137 patients were included in the study, of which 135 underwent successful EBUS TBNA. A total of 149 lymph node punctures were performed, of which 90 punctures identified malignant lesions. The most common malignancies were small-cell lung carcinoma, adenocarcinoma, and squamous cell carcinoma. Forty-one benign lesions were identified, resulting from sarcoidosis, tuberculosis, and reactive lymphadenitis, amongst others. Follow-up findings showed that 4 cases were malignant tumors, with 1 case of pulmonary tuberculosis and 1 case of sarcoidosis). Four specimens where lymph node puncture was insufficient were subsequently confirmed by other means. The sensitivity of EBUS TBNA for malignant lesions, tuberculosis and sarcoidosis in mediastinal and hilar lesions was 94.7%, 71.4%, and 93.3%, respectively. Similarly, the negative predictive values (NPV) were 88.9%, 98.5%, and 99.2%, and the accuracy was 96.3%, 98.5%, and 99.3%.

Conclusion: EBUS TBNA is an effective and feasible approach for the diagnosis of mediastinal and hilar lesions that is minimally invasive and safe.

Methods: In this retrospective study, a total of 70 patients diagnosed with pulmonary embolism by computed tomography pulmonary angiography (CTPA) from January 2016 to May 2021 in Anhui Chest Hospital were included. Among them, 35 patients with pulmonary embolism combined with pulmonary tuberculosis were set as the study group, and the other 35 patients with pulmonary embolism only were set as the control group. The imaging findings of chest CT examination, the incidence of pulmonary hypertension, the level of N-terminal proto-B-type brain natriuretic peptide (NT-proBNP), and the prognosis of patients were compared between the two groups. The incidence of deep venous embolism was evaluated by ultrasonography of the lower extremity.

Results: In the study group, the median age of patients was 71 years, and the ratio of males to females was 2.5 to 1. In the control group, the median age was 66 years old, and the male-to-female ratio was 2.2 to 1. There were 16 cases (16/35, 45.71%) in the study group and 10 cases (10/35, 28.57%) in the control group with an increased level of NT-proBNP. Pulmonary hypertension occurred in 10 patients (10/35, 28.57%) in the study group and 7 patients (7/35, 20.00%) in the control group. Patients who lost follow-up included 5 in the study group (5/35, 14.29%) and 3 in the control group (3/35, 8.57%). There were 17 cases (17/35, 48.57%) in the study group and 3 cases (3/35, 8.57%) in the control group with pulmonary artery widening, and the difference was significant (P < 0.001). There were 13 deaths in the study group (13/35, 37.14%) and 1 death in the control group (1/35, 2.86%), and the difference was significant (P <0.001).

Conclusion: Special signs of pulmonary artery widening, pulmonary hypertension of varying degrees, and increased levels of NT-proBNP of varying degrees can be found in patients with pulmonary tuberculosis complicated with pulmonary embolism, and the three signs are positively correlated. The mortality of patients with pulmonary tuberculosis complicated with pulmonary embolism is significantly higher than that of patients with pulmonary embolism alone. Pulmonary tuberculosis and pulmonary embolism both occur in the ipsilateral lung, causing clinical symptoms to cover each other, thereby making diagnosis difficult.

Objective: In response to the challenges posed by the COVID-19 pandemic, we aimed to develop a deep learning model that accurately classifies chest X-ray images, specifically focusing on lung regions, to enhance the efficiency and accuracy of COVID-19 and pneumonia diagnosis.

Methods: We have proposed a novel deep network called “FocusNet” for precise segmentation of lung regions in chest radiographs. This segmentation allows for the accurate extraction of lung contours from chest X-ray images, which are then input into the classification network, ResNet18. By training the model on these segmented lung datasets, we sought to improve the accuracy of classification.

Results: The performance of our proposed system was evaluated on three types of lung regions in normal individuals, COVID-19 patients, and those with pneumonia. The average accuracy of the segmentation model (FocusNet) in segmenting lung regions was found to be above 90%. After reclassification of the segmented lung images, the specificities and sensitivities for normal, COVID-19, and pneumonia were excellent, with values of 98.00%, 99.00%, 99.50%, and 98.50%, 100.00%, and 99.00%, respectively. ResNet18 achieved impressive area under the curve (AUC) values of 0.99, 1.00, and 0.99 for classifying normal, COVID-19, and pneumonia, respectively, on the segmented lung datasets. Moreover, the AUC values of the three groups increased by 0.02, 0.02, and 0.06, respectively, when compared to the direct classification of unsegmented original images. Overall, the accuracy of lung region classification after processing the datasets was 99.3%.

Conclusion: Our deep learning-based automated chest X-ray classification system, incorporating lung region segmentation using FocusNet and subsequent classification with ResNet18, has significantly improved the accuracy of diagnosing respiratory lung diseases, including COVID-19. The proposed approach has great potential to revolutionize the diagnosis of COVID-19 and other respiratory lung diseases, offering a valuable tool to support healthcare professionals during health crises.

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.

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 goal of this study is to evaluate the effectiveness of using seven layers to classify breast cancer as either benign or malignant using mammograms.

Materials and Methods: The open-source MIAS dataset of 322 images was used for our study, of which 207 were normal images and 115 were abnormal images. The proposed CNN model convolves an image into seven layers that extract features from the input images, and these features are used to classify breast cancer as malignant or benign.

Results: The proposed CNN used a limited data set and achieved the best result compared to previous work. The method achieved results with a 0.39% loss, 99.89% accuracy, 99.85% precision, 99.89% recall, 99.87% F1-score, and an area under the curve noted to be 100.0%.

Conclusion: CNN uses a small amount of data to determine abnormalities; the method will assist a medical doctor in determining whether or not a specific patient has cancer.

Methods: This retrospective research included 36 patients with pathologically confirmed NSCLC who underwent dual-energy enhanced CT scans. The quantitative parameters of DECT were analyzed, including iodine concentration, water concentration, the CT values corresponding to 40keV, 70keV, 100keV, and 130keV in arterial and venous phases, and the normalized iodine concentration and the slope of the energy spectrum curve were calculated. Postoperative specimens underwent HIF immunohistochemical staining by two pathologists. Spearman correlation analysis was adopted as the statistical methodology. The data were analyzed by SPSS26.0 statistical software.

Results: Water concentration (r=0.659, P<0.001 and r= 0.632, P<0.001, the CT values corresponding to 100keV (r=0.645, P<0.001 and r= 0.566, P<0.001) and 130keV (r=0.687, P<0.001 and r= 0.682, P<0.001) in arterial and venous phases, and CT value of 70keV in arterial phase (r=0.457, P=0.005) were positively correlated with HIF-1α expression level. There was no correlation among iodine concentration, standardized iodine concentration, CT value of 40keV, λHU, and HIF-1α expression in arterial and venous levels (P >0.05).

Conclusion: The quantitative parameters of DECT have a certain correlation with HIF-1α expression in NSCLC. Moreover, it has been demonstrated that DECT can be used to predict hypoxia in tumor tissues and the prognosis of lung cancer patients.

Objective: The objective of this study was to quantify the extent of interstitial lung abnormalities (ILA) in a non-smoking asymptomatic urban cohort in China using low-dose CT (LDCT) and to analyze the age-related pathological changes.

Methods: We retrospectively analyzed clinical data and chest LDCT images from a cohort of 733 subjects who were categorized into 3 groups: 18–39, 40-59, and ≥60 years old according to age. Furthermore, we selected 40 cases of wax-embedded lung tissue blocks archived after pulmonary bullectomy and the same age groups were categorized. Four representative CT signs of ILA, including interlobular septal thickening (ILST), intralobular interstitial thickening (ILIT), ground-glass opacity (GGO), and reticular shadow (RS), were semi-quantified based on the percentage of the affected area. The scores and distribution of four CT signs of ILA were compared between different sex and age groups. The age-related pathological changes were analyzed.

Results: The ILA findings were found predominantly in the lower lobes and the subpleural region. The semi-quantitative scores of four CT signs in all subjects under 40 were 0. However, in subjects over 40 years old, the scores gradually increased with age, although most of them remained low. The size of the alveoli increased, the number of alveoli decreased, the alveolar septum became thinner, and the number of ATII cells increased with age. A statistically significant difference was observed among the different age groups (χ²=50.624, P=0.033; χ²=80.000, P=0.043; χ²=33.833, P=0.000; χ²=13.525, P=0.031). The macrophage population and the percentage of collagen fibers in the alveolar septum increased, while the percentage of elastic fibers decreased with age. There was no significant difference among the different age groups (χ²=19.817, P=0.506; χ²=52.419, P=0. 682; χ²=54.868, P=0.518).

Conclusion: When the four CT signs mentioned above are in the upper central area, and the score has a medium or high score, it is crucial to determine the underlying pathological causes. ILA may be the result of chronic lung injury.

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.

Case Presentation: A chest CT scan of a 72-year-old man with suspected chronic pneumonia revealed a well-defined consolidation in the upper lobe of the left lung. The lesion was slightly enlarged at the 9-month follow-up, and low FDG accumulation was subsequently observed using 18F-fluorodeoxyglucose (18F-FDG) PET/CT scans. The patient was later diagnosed with PEAC through percutaneous lung biopsy.

Conclusion: Our case has demonstrated specific imaging findings of PEAC.

Objective: This study aims to design a model to classify BC Histopathology images accurately by leveraging segmentation techniques.

Methods: This work proposes a combined segmentation and classification approach for classifying BC using histopathology images to address these issues. Chan-Vese algorithm is used for segmentation to accurately delineate regions of interest within the histopathology images, followed by the proposed SegEIR-Net (Segmentation using EfficientNet, InceptionNet, and ResNet) for classification. Bilateral Filtering is also employed for noise reduction. The proposed model uses three significant networks, ResNet, InceptionNet, and EfficientNet, concatenates the outputs from each block followed by Dense and Dropout layers. The model is trained on the breakHis dataset for four different magnifications and tested on BACH (BreAst Cancer Histology) and UCSB (University of California, Santa Barbara) datasets.

Results: SegEIR-Net performs better than the existing State-of-the-Art (SOTA) methods in terms of accuracy on all three datasets, proving the robustness of the proposed model. The accuracy achieved on breakHis dataset are 98.66%, 98.39%, 97.52%, 95.22% on different magnifications, and 93.33% and 96.55% on BACH and UCSB datasets.

Conclusion: These performance results indicate the robustness of the proposed SegEIR-Net framework in accurately classifying BC from histopathology images.

Materials and Methods: This was a retrospective cohort study. Patients were divided into two groups according to the stage of cervical cancer. The mean term of pregnancy at the time of the diagnosis was the early second trimester (range 10-27 weeks) and the median age was 33 years (range 26-40 years). The abdominal and pelvic MRI images and clinical data of these patients were reviewed. Tumor size, local tumor spread, and nodal involvement were evaluated using an MRI dataset. The treatment and follow-up imaging were analyzed as well, and the ADC was measured before and after the chemotherapy.

Results: 16 patients with histopathologically confirmed cervical cancer during pregnancy were retrospectively enrolled. 7 patients were diagnosed with local cervical cancer (FIGO stage IAI) and designated as early stage group, as the lesion was invisible on MRI. In this group, pregnancies were allowed to continue until cesarean delivery (CD) at 38-41 weeks. The other 9 patients presenting with local or extensive cervical cancer (FIGO stage IB2-IIA2) were designated as the advanced-stage group. The lesion could be measured and analyzed on MRI. They were treated with neoadjuvant chemotherapy in pregnancy. Among them, 6 patients underwent TP regimen (paclitaxel 135~175 mg/m2 plus cisplatin 70~75 mg/m2), while 3 patients received TC regimen (paclitaxel 135~175 mg/m2 plus carboplatin AUC=5). NACT was performed for 1 to 2 courses before surgery. ADC demonstrated significant differences before and after chemotherapy administered during pregnancy (1.06 ± 0.12 sec/mm2 vs. 1.34 ± 0.21 sec/mm2).

Conclusion: MRI has been found to be helpful in staging cervical cancer in pregnancy. Patients with stage IA confirmed by MRI can choose conservative treatment and continue the pregnancy until term birth. MRI can dynamically monitor the efficacy of chemotherapy for patients with stage IB and above during pregnancy. ADC value can have a potential role in the evaluation of chemotherapy efficacy.

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.

Objective: To evaluate and compare the safety and effectiveness of aspiration-type semi-automatic cutting biopsy needles and non-aspiration-type biopsy needles when performing computed tomography (CT)-guided core needle biopsies (CNBs).

Methods: A total of 106 patients underwent CT-guided CNB for chest lesions between June 2013 and March 2020 at our hospital. Non-aspiration-type cutting biopsy needles were used in 47 of these patients, while aspiration-type needles were used in the remaining 59 patients. All needles used were 18- or 20-gauge biopsy needles. Parameters, like forced expiratory volume in 1-second percent (FEV1.0%), the maximum size of the target lesion, puncture pathway distance in the lung, number of needle passes, procedure time, diagnostic accuracy, and incidence of complications, were measured. Comparisons were made between the needle-type groups.

Results: No significant difference was observed in terms of diagnostic accuracy. However, the procedure time was shorter and a lesser number of needle passes were required with the aspiration-type cutting biopsy needle compared to the non-aspiration-type needle. Pneumothorax and pulmonary hemorrhage were the complications encountered, however, their incidence was not significantly different between the two types of needles.

Conclusion: The aspiration-type semi-automatic cutting biopsy needle had similar diagnostic accuracy as the non-aspiration-type biopsy needle, with added advantages of a lesser number of needle passes and shorter procedure time.

Aim: The current study aimed to compare the effects of nutritional status on the clinical outcomes in moderate to severe COPD patients with bronchiectasis.

Objective: This study identifies the nutritional risk in hospitalized patients with moderate to severe COPD complicated by bronchiectasis phenotype during acute exacerbation screened using computer tomography (CT). Also, determines its correlation with disease progression.

Materials and Methods: NRS 2002 (Nutrition Risk Screening Evaluation Tool) was used to determine and evaluate the nutritional risk status in 182 hospitalized patients with moderate to severe COPD complicated by bronchiectasis phenotype during an acute exacerbation. Selected patients were divided into the nutritional risk (NR) group and the non-nutritional risk (NNR) group according to their nutritional status determined by NRS 2002. The body mass index (BMI), serum albumin (ALB), pre albumin (PAB), lymphocyte count (TLC), FEV1/FVC, FEV1% predicted, PEF% predicted, blood gas analysis, number of acute exacerbations in the past year, number of respiratory failure cases, number of anti-infection days, and length of hospitalization of the two groups were observed.

Results: The hospitalized patients in acute exacerbation of moderate to severe COPD complicated by bronchiectasis phenotype had a nutritional risk of 62.64%. BMI, ALB, PAB, TLC, FEV1% predicted, FEV1/FVC, PEF% predicted, blood gas analysis, number of acute exacerbations in the past year, number of respiratory failure cases, number of anti-infection days, and length of hospitalization were statistically significantly different between the NR group and NNR group (P<0.05).

Conclusion: Hospitalized patients with moderate to severe COPD complicated by bronchiectasis phenotype during acute exacerbation are often associated with nutritional risk. An increase in nutritional risk reduces the level of pulmonary function of the patient and elevates the risk for repeated acute exacerbations, which predispose the patient to respiratory failure, thereby increasing the length of hospitalization. Therefore, the nutritional risk status of COPD patients with bronchiectasis was closely related to the occurrence, development, and prognosis of the disease.

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: In this article, we aim to present a new AI model that solves this challenge by allowing the differentiation, diagnosis and classification of three distinct diseases, whose symptoms are very similar. The fundamental contribution is to reduce the number of parameters used while maintaining the same level of precision for use in embedded systems.

Methods: Our proposed model combines the power of the neural network using the SqueezeNet architecture with a set of machine learning algorithms as classifiers, including logistic regression, support vector machine (SVM), k-nearest neighbors (KNN), decision tree, and naive Bayes. The chest Xray dataset used in the proposed model consists of CXR images that are classified into four categories: pneumonia, tuberculosis, COVID-19, and normal cases.

Results: Our proposed model demonstrated remarkable accuracy (97,32%), precision (97,33), F1 score (97,31%), recall (97,30%), and AUC (99,40), which is close to the best model. Whereas, the number of parameters used by our model (4,6 M) is very small compared to the best model in the literature (47M).

Conclusion: The model demonstrated good classification accuracy. In addition, the proposed model has the ability to use fewer parameters, which means it requires less internal memory and computing resources.

Background: The presence of iodine in iodinated contrast agents (ICAs) can impede the effectiveness of radioactive iodine treatment (RAIT) and diagnostic scans in individuals diagnosed with DTC, as it can engage in competitive interactions with 131I. According to established guidelines, it is recommended to postpone RAIT for a period of three to four months in individuals who have had prior exposure to ICAS. The measurement of spot urine iodine concentration is a valuable indicator for assessing the overall iodine content throughout the body.

Objective: The objective is to identify the optimal timing for administering postoperative RAIT in DTC patients.

Methods: At various time points after surgery, a cohort of 467 random urine samples (126 male samples, 341 female samples, age (45±12 years)) was obtained from 269 DTC patients. The samples were analyzed for urinary iodine and urinary creatinine levels, and the urinary iodine/urine creatinine ratio (I/Cr) was computed. All samples were divided into two groups according to whether eCT before operation: the non-enhanced CT (eCT-) group and the enhanced CT (eCT+) group. The urine samples in the eCT- group were categorized into four subgroups according to the duration of strict low iodine diet (LID): (eCT-I+) no LID; (eCT-I-2W) 2 weeks of LID; (eCT-I-4W) 4 weeks of LID; and (eCT-I-6W) 6 weeks of LID. The last three groups were merged into the eCT- and effective LID group (eCT- I-). The urine samples from the eCT+ group were categorized into five subgroups: (0.5M eCT+)0.5 month after eCT+; (1M eCT+)1 month after eCT+; (2M eCT+) 2 months after eCT+; (3M eCT+) 3 months after eCT+; (≥4M eCT+) ≥4 months after eCT+. In addition, the patients within 2 months after eCT+ were divided into 2 groups according to their LID: no effective LID group (eCT+ I+) and effective LID group (eCT+ I-). Utilizing the Kruskal-Wallis and Mann-Whitney U rank sum tests, the differences in I/Cr between groups were compared.

Results: In the eCT-group, the I/Cr ratios of eCT-I-2W, eCT-I-4W, and eCT-I-6W were significantly lower than those of eCT-I+ (χ2 values: 4.607.99, all P 0.05). However, there was no significant difference in I/Cr between eCT-I-2W, eCT- I-4W, and eCT-I-6W (2 values: 0.591.31, all P > 0.05). Significantly higher I/Cr values were observed in 0.5M eCT+ and 1M eCT+ than in eCT-I+ (χ2 values: 3.22 and 2.18, respectively, all P<0.05). There was no significant difference in I/Cr between 2M eCT+ and eCT-I+ (χ2 = 0.76, P = 0.447). The I/Cr rations of 3M eCT+, ≥4M eCT+ were not significantly different with eCT-I- (χ2 values: 1.76; 0.58; all P > 0.05). However, they were considerably lower than eCT-I+ (χ2 values: 7.03; 5.22; all P<0.05). The I/Cr for patients who underwent eCT within two months (eCT+ I-, eCT+ I+) did not differ significantly (χ2 = 1.79, P = 0.073).

Conclusion: For patients who are considering receiving radioactive iodine therapy (RAIT) following a diagnosis of differentiated thyroid cancer (DTC), it is recommended that the interval between RAIT treatment and enhanced computed tomography [eCT] scans be conducted at least three months.

Objective: This review aimed to briefly discuss pharmacological and non-pharmacological approaches for treating ALI.

Methods: Nowadays, drug delivery and illness diagnosis are the most advanced areas of modern nanotechnology research, particularly concerning the lungs. So, we focused on various novel approaches, viz., organic nanoparticles, inorganic nanoparticles, metal nanoparticles, and bio nanoparticles, that combat ALI and improve lung functions. This review discussed many studies and the advancement of different nanomaterials as novel drug carriers in the lungs that can influence the immune system, suppressing proinflammatory cytokines and improving lung functions.

Results: Another aspect of studying nanotechnology is the release kinetics of nanoparticles and safety when administered to a targeted tissue.

Conclusion: The higher uptake of nanomaterials and, thus, the drugs is another advancement in nanotechnology. Herein, we explored different approaches to improving and curing acute lung injury.

Many pharmacologic challenges and opportunities for current metastasis therapies are presented. To overcome the dilemma and shortcomings of antimetastatic treatment, medical, chemical, pharmaceutical, methodological and technical issues are integrated and highlighted. To introduce up-to-date knowledge and insights into drug targeting and pharmaceutical features and clinical paradigms, relevant drug design insights are discussed—including different pathological modes, diagnosis advances, metastatic cascade, tumor plasticity, variety of animal models, therapeutic biomarkers, computational tools and cancer genomics. Integrated knowledge, systems and therapeutics are focused.

In summary, medicinal comparison, pharmaceutical innovation and clinical strategies should be increasingly investigated.

Objective: This study was designed to analyse the changes in the expression levels of epidermal growth factor receptor (EGFR) and B-Raf in the lung tissues of B[a]P-induced mice during the cancer development stage itself and to find the suppressive effect of free ATRA and lipo-ATRA.

Methods: Lung cancer was induced in mice by oral ingestion of 50mg/kg body weight B[a]P weekly twice for four consecutive weeks. Then, the mice were treated with free and lipo-ATRA (0.60 mg/kg) for 30 days via i.v injection. The EGFR and B-Raf gene expressions were analyzed in lung cells by reverse transcriptase polymerase chain reaction (RT-PCR) and quantitative polymerase chain reaction (qPCR).

Results: The RT-PCR gene band density and the relative quantity (RQ) values from qPCR revealed both EGFR and B-Raf genes to be significantly overexpressed in B[a]P control mice while having very low or no expression in normal mice. This indicates that they function as oncogenes in B[a]P-induced lung carcinogenesis. The lipo-ATRA treatment has shown a highly significant increase in RQ values for both EGFR and BRaf when compared to the free ATRA treatment.

Conclusion: The study results have revealed the cationic lipo-ATRA treatment to have enhanced the bioavailability of ATRA in lung tissue due to its significant suppression action on EGFR-mediated oncogenes’ expressions. Furthermore, the EGFR and BRaf could be the molecular targets of ATRA action in lung carcinogenesis.

Material and Methods: In this study, we explored the effects of MFAP5 on the stem cell features of NSCLC cells for the first time. We established MFAP5 overexpression and knockdown NSCLC cells. Clone formation assays and cell sphere culture assays were conducted for the exploration of the growth and stem cell features of these cells. Western blotting was applied for the detection of Sox9 and FBW7 expression in these cells. CHX was applied for the treatment of these cells for the detection of degradation of Sox9. Finally, we overexpressed the Sox9 in MFAP5 knockdown NSCLC cells.

Results: MFAP5 promoted the growth and stem cell features of these cells. Knockdown of MFAP5 induced higher levels of FBW7 while restricting the expression of Sox9. Knockdown of MFAP5 aggravated the degradation of Sox9. Overexpression of Sox9 abrogated the efficacy of MFAP5 inhibition on the growth as well as stem cell features of these cells. The results of this study clarified the role of MFAP5/FBW7/Sox9 axis on the development of non-small cell lung cancer cells, providing the potential therapeutic target for the clinical treatment of NSCLC.

Conclusion: MFAP5 maintained the stem cell features of non-small cell lung cancer cells by modulating FBW7/Sox9 axis.

Methods: We synthesized EF-AuNps using a direct reduction method and characterized the NPs by employing various techniques, including UV-visible spectroscopy, DLS, XRD, EDX, TEM, and FT-IR. The anti-proliferative activity against MDA-MB-231 cells was assessed using MTT and colony formation assays, alongside evaluating cell viability with PI-FACS and live/dead assays. Furthermore, a Western blot was performed to determine the mechanism of action of EFAuNps in TNBC cells.

Result: We successfully synthesized triangular EF-AuNps (<100nm) and observed a substantial inhibition of cell proliferation (IC₅₀ 18μg/ml). Compared to EF alone, EF-AuNps significantly enhanced cell death in TNBC cells, as confirmed by flow cytometry and viability assays. Besides, Western blot analysis verified that the expression of apoptotic-related signal proteins, such as survivin, caspase 3, and caspase 9, were modulated by EF-AuNps.

Conclusion: EF-AuNps showed higher anti-cancer efficacy than EF in the MDA-MB-231 cell line. These findings suggest the therapeutic potential of EF-AuNps for TNBC treatment, advocating for further preclinical and clinical investigations into this promising anti-cancer formulation.

Methods: The viability and IC₅₀ rate of cells treated with different concentrations of Pio and Cet were evaluated using the MTT test. EMT and CSC markers and cell morphology were assessed in Pio and Cet treated and untreated HT29-shE cells using flow cytometry, realtime PCR, immunocytochemistry, and microscopic monitoring.

Results: The findings showed that Pio and Cet at concentrations of 250 μM and 40 μg/ml, respectively, decrease cell viability by 50%. Also, they were able to reduce the expression of CSC markers (CD133 and CD44) in the CSC enriched HT29 cell line. Furthermore, Pio and Cet could efficiently reduce the expression of vimentin as a mesenchymal marker and significantly upregulate the expression of E-cadherin as an epidermal marker of EMT and its reverse mesenchymal- toepithelial transition (MET). In addition, the mesenchymal morphology of HT29-shE changed into epithelial morphology after Cet treatment.

Conclusion: Pio and Cet could inhibit EMT and reduce CSC markers in the EMT induced/CSC enriched cell line. We expect that focus on finding EMT/CSC-targeting agents like these drugs can be helpful for cancer treatment.