Lasers in Medical Science最新文献

{"title":"Safety of 810 nm photobiomodulation in the developing brain: no evidence of glial reactivity or pro-inflammatory cytokine expression in rats.","authors":"Alba Gutiérrez-Menéndez, Lucía Rodríguez-Fernández, Candela Zorzo, Juan A Martínez, Alina Diez-Solinska, Jorge L Arias","doi":"10.1007/s10103-025-04684-5","DOIUrl":"10.1007/s10103-025-04684-5","url":null,"abstract":"<p><p>Photobiomodulation (PBM) is an innovative non-invasive light-based technique that uses wavelengths around red to infrared light to stimulate neural activity. Literature has addressed PBM's effectiveness in healthy adult subjects, in several neurological conditions, and also in younger populations. However, there is still a lack of both preclinical and clinical studies that evaluate its safety during early developmental stages, when the brain is still maturing. We explored safety of PBM (810 nm) in young male Wistar rats by examining astrocytes and microglia cells thought GFAP and Iba1 immunohistochemistry, as well as the expression of pro-inflammatory cytokines (Interleukin-6, interleukin-1β and tumour necrosis factor α) through quantitative PCR, both in prefrontal cortex and hippocampus. Under the tested parameters and time point, PBM did not induce detectable glial reactivity or pro-inflammatory cytokine expression. This research highlights the potential use of 810 nm-PBM in the developing brain, providing preliminary evidence that this technique does not induce a neuroinflammatory response, representing an important first step to verifying the beneficial use of this technique without risks in paediatric and adolescence populations. More research is necessary to confirm the safety of PBM for different conditions and employing diverse parameters.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"409"},"PeriodicalIF":2.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot randomized split-face trial comparing fractional Q-Switched ruby laser and 1064-nm Q-Switched nd: YAG laser in Chinese women with melasma running titile: fQSRL vs. QSNY in melasma.","authors":"Yumei Gao, Yalan Bi, Eray Yihui Zhou, Zhenghui Li, Jie Ren, Yi Zhao","doi":"10.1007/s10103-025-04626-1","DOIUrl":"https://doi.org/10.1007/s10103-025-04626-1","url":null,"abstract":"<p><p>Laser therapy plays an essential role in the management of melasma. However, direct comparisons between the fractional Q-switched ruby laser (fQSRL) and the Q-switched 1064-nm Nd: YAG laser (QSNY) are limited, particularly in Asian populations. Therefore, we conducted this study to compare the clinical efficacy, safety, and patient-reported outcomes of fQSRL versus QSNY in the treatment of melasma. In this randomized, assessor-blinded, split-face study, 21 Chinese women (Fitzpatrick skin types III-IV) with bilateral melasma received 3 to 6 treatment sessions with fQSRL and QSNY, administered at three-week intervals. Efficacy, safety, and patient satisfaction were assessed. Both lasers achieved a 62.0% response rate, with no significant difference in hemi-mMASI score reduction (P > 0.05). Patient satisfaction scores were similar between treatments. However, pain scores were significantly higher with fQSRL than with QSNY (P < 0.0001). Post-inflammatory hyperpigmentation occurred bilaterally in one patient (4.8%), with no serious adverse events reported. QSNY and fQSRL demonstrated comparable efficacy in treating melasma in Chinese women. However, the higher pain associated with fQSRL may limit its patient acceptability. Further large-scale, multicenter studies are needed to confirm long-term efficacy and safety.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"405"},"PeriodicalIF":2.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research hotspots and trends of pediatric bone age: A bibliometric and visualization analysis.","authors":"Huaping Tang, Zenan Ma, Lanping Gao","doi":"10.1007/s10103-025-04643-0","DOIUrl":"https://doi.org/10.1007/s10103-025-04643-0","url":null,"abstract":"<p><strong>Purpose: </strong>Research related to pediatric bone age has gained substantial scholarly attention over recent decades, given its critical importance in monitoring growth and guiding clinical decision-making in children. This study aims to identify research hotspots and forecast future trends in the field of bone age assessment through bibliometric and visualization analyses.</p><p><strong>Method: </strong>A comprehensive bibliometric analysis was conducted using the Web of Science Core Collection to retrieve publications related to pediatric bone age from 1965 to 2024. Visualization analyses were performed utilizing VOSviewer (version 1.6.20), CiteSpace (version 6.3.R1), and the R package \"bibliometrix.\"</p><p><strong>Results: </strong>A total of 4,652 publications on pediatric bone age were subjected for analysis, with an annual growth rate of 8.09%. The United States emerged as the leading contributor, accounting for 27.7% of the total publications, followed by China and Italy. Harvard University was identified as the most productive institution, with 328 publications, and the Journal of Clinical Endocrinology & Metabolism was the most influential journal in the field. The top three frequently occurring keywords included \"growth,\" \"age,\" and \"therapy.\" Keyword bursts revealed emerging keywords such as \"deep learning\" and \"artificial intelligence.\"</p><p><strong>Conclusion: </strong>This bibliometric analysis identified that the future research within this area is expected to focus on integrating deep learning and artificial intelligence to improve diagnostic accuracy and clinical applications.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"406"},"PeriodicalIF":2.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the efficacy of radial and focused extracorporeal shock-wave therapy (ESWT) in myofascial pain syndrome: a randomized, sham-controlled study.","authors":"Hüma Bölük Şenlikci, Özlem Yücealp, Pınar Borman, Zeynep Ince Keskin, Sevgi Gümüş Atalay, Evren Yaşar","doi":"10.1007/s10103-025-04676-5","DOIUrl":"https://doi.org/10.1007/s10103-025-04676-5","url":null,"abstract":"<p><p>Myofascial pain syndrome (MPS) is one of the most common pain syndromes characterized by painful trigger points. Active trigger points may cause spontaneous pain, reduce quality of life, and result in workforce loss. Extracorporeal shock-wave therapy (ESWT), using radial or focused acoustic waves created outside the body, is a treatment method used for musculoskeletal problems. In Focused ESWT (F-ESWT), the depth of the body part to be targeted can be adjusted. Penetration into the tissue is better than radial waves. Radial ESWT (R-ESWT) has a more superficial effect, and its spread in liquids with a density similar to tissues is half that of focused ESWT. Previous studies have shown that radial and focused ESWT waves applied to trigger points in the upper trapezius fibres reduce reflected and local pain in myofascial pain syndrome. The aim of this study was to compare the effectiveness of radial and focused ESWT types on trigger points in upper trapezius fibres in patients with myofascial pain syndrome. This prospective, randomized, sham-controlled study included 57 patients, randomly assigned to one of 3 groups. The patients underwent R-ESWT, F-ESWT and sham protocols for 4 sessions. Evaluations were made with a Visual Analog Scale (VAS) to assess pain, the Health Assessment Questionnaire (HAQ), and the Beck Depression Inventory (BDI) before treatment, post-treatment, then at 1, 3 and 6 months after completion of the treatment. Symptom duration was the only parameter that was significantly different between the groups before the treatment (p = 0.025). VAS scores improved after treatment compared to baseline for all groups (p < 0.05), with improvements continuing in the ESWT groups. The BDI and HAQ scores did not differ between the groups, and the F-ESWT group showed a significant improvement in BDI and HAQ (p < 0.01, p = 0.018, respectively). The VAS scores of the ESWT groups were similar and significantly higher than those of the sham group, but mid-long term changes did not differ across the groups (p = 0.065). In patients diagnosed with myofascial pain syndrome who underwent R-ESWT, F-ESWT and sham therapy on active trigger points in the upper trapezius fibres, an improvement in pain was observed in the R and F-ESWT groups even in the long term. While the improvement in pain scores was the same for the radial and focused types at all time points, the improvement in both was significantly higher compared to the sham application.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"404"},"PeriodicalIF":2.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-response and efficacy of 660-nanometer low-level laser therapy in healing diabetic foot ulcers: a randomized, double-blind, clinical trial.","authors":"Mariana Bezerra Miranda, Ana Carolina Silva Barros, Lorena Veloso Coelho, Rebeca Barbosa da Rocha, Baldomero Antonio Kato da Silva, Fuad Ahmad Hazime, Alessandra Tanuri Magalhães, Vinicius Saura Cardoso","doi":"10.1007/s10103-025-04641-2","DOIUrl":"https://doi.org/10.1007/s10103-025-04641-2","url":null,"abstract":"<p><p>Diabetic foot ulcers (DFU) negatively impact the quality of life and increase the risk of morbidity and mortality. Although photobiomodulation (PBM) produces better results in DFU healing than standard treatment or in the absence of irradiation, the ideal parameters are not standardized. This study aimed to evaluate the effect of PBM at a wavelength of 660 nm on reducing the DFU area. We compared the PBM treatment of non-infected DFUs. The sessions were held twice a week on non-consecutive days for 10 weeks (20 interventions) using HeNe 660 nm, 20 mW, in continuous mode, with three energy densities (4 J/cm², 8 J/cm², or 12 J/cm²). All patients underwent photobiomodulation therapy and conventional therapy (stereo gauze and Helianthus annuus vegetable oil), administered sequentially during the same treatment session. The control group was treated with GaAs at 904 nm, 70 mW, and an energy density of 10 J/cm² in continuous mode. The sessions were held twice a week on non-consecutive days for 10 weeks (20 sessions). The primary variable was the ulcer size reduction rate. There was no statistically significant difference in the ulcer reduction rate between the groups after 5 (p = 0.2582) and 10 weeks (p = 0.1164). Within each group, a significant reduction in ulcer size was observed over time (p < 0.0001). Regardless of the wavelength, all patients experienced a 50% reduction in the wound area when applying an energy density of 8-12 J/cm². However, the red group, which was treated at a lower energy density (4 J/cm²), had a lower proportion of responders. The application of PBM at a red wavelength of 660 nm at doses of 4, 8, and 12 J/cm², as well as the application of infrared light at 904 nm (10 J/cm²) significantly improved DFU healing after 10 weeks of treatment. Clinical Trial Registration: This study was registered at ClinicalTrials.gov, approved on July 9, 2022 (NCT05530486 || https://www.clinicaltrials.gov/ ).</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"399"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone regeneration therapy using low level laser treatment in a rabbit model: pilot study.","authors":"Afraa Murriky, Mitchell Bloom, Ioana Chesnoiu Matei, John Ricci, Georgios Romanos, Wayne Kye, Nicolas Elian, Sebastiano Andreana","doi":"10.1007/s10103-025-04667-6","DOIUrl":"https://doi.org/10.1007/s10103-025-04667-6","url":null,"abstract":"<p><p>This study investigated the effect of using diode laser on bone wound healing in rabbit calvarial models. A sample of 14 rabbits was used in this study. Bony osteotomies, 5 mm in diameter with half-thickness in the calvaria of each rabbit, were created. The study cohort was divided equally into two groups based on the postoperative observation period of either 2 or 4 weeks. The control group (Group A) received no laser treatment. Groups B, C, and D were laser treated for periods of 15, 30, and 45 s, respectively. Defect sites were assessed using microcomputed tomography. Histology was used to evaluate tissue response. Descriptive and non-parametric statistical analyses were conducted to compare bone structural outcomes across control and laser-treated groups at 2- and 4-week time points. Group differences were assessed using Kruskal-Wallis and Mann-Whitney U tests. Bone structural outcomes were comparable across groups at both 2 and 4 weeks, with no significant differences except for higher histomorphometry values in the laser-treated group at 4 weeks (p = 0.030). Over time, significant improvements in bone fraction and histomorphometry, and a reduction in connectivity density, were observed, particularly in laser-treated groups. Histological analysis revealed enhanced bone formation and more mature bone architecture in laser-treated groups compared to controls. The micro-CT and histological data suggest the potential for enhanced bone formation across all treatment groups. Additionally, no signs of adverse effects were observed in any of the laser-treated groups, supporting the safety of the applied protocols.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"403"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From bench to bedside: recent advances and effective strategies for improving laser bone ablation efficiency-a review.","authors":"Yanfu Liu, Yiou Lyu, Xinlong Ma, Jiaqi Han, Xubo Yuan, Jinhua Li","doi":"10.1007/s10103-025-04672-9","DOIUrl":"https://doi.org/10.1007/s10103-025-04672-9","url":null,"abstract":"<p><p>Laser bone ablation has emerged as a promising alternative to conventional mechanical osteotomy, offering advantages including high precision, minimal collateral damage, non-contact operation, and compatibility with intelligent and robotic surgical systems. However, compared to conventional mechanical tools, its relatively lower ablation efficiency prolongs surgical duration and increases associated risks, thereby hindering its clinical application. This review systematically examines recent advances and effective strategies for improving the efficiency of laser bone ablation. A comprehensive analysis is carried out on the optical and structural properties of bone, laser-tissue interaction mechanisms, and the distinctive ablation characteristics of various laser systems to explore optimization direction for laser osteotomy procedures. The investigation discusses critical factors influencing ablation efficiency, including laser parameters, target bone quality, cooling methodologies, and monitoring techniques. For each laser type, the review provides evidence-based optimization protocols designed to achieve an optimal balance between maximal tissue removal efficiency and minimal collateral damage. Finally, the review summarizes the current optimization challenges faced by laser bone ablation systems, including systematic experiments in various bone quality scenarios, the development of multimodal real-time monitoring, intelligent feedback systems, and specialized hardware components, such as optical fibers. Integrating these solutions will improve laser bone ablation efficiency and clinical outcomes, potentially transforming conventional orthopedic surgical approaches.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"402"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser-induced breakdown spectroscopy for lithium-mediated cancer cell detection and ablation.","authors":"Oğuz Gürcüoğlu, Tuğçe Mutlu, Onur Ferhanoğlu, Mustafa Kemal Ruhi","doi":"10.1007/s10103-025-04680-9","DOIUrl":"https://doi.org/10.1007/s10103-025-04680-9","url":null,"abstract":"<p><p>Laser-Induced Breakdown Spectroscopy (LIBS) has been explored for biomedical applications, such as distinguishing between cancerous and healthy tissues. Previous studies have demonstrated altered emission intensities of elements such as Ca, Mg, Zn, and Fe in malignant tissues, suggesting that elemental profiling via LIBS could aid in the detection of tumors. However, challenges such as weak signal intensity and interference from biological matrices have hindered the development of a standardized clinical protocol. This study aims to address these limitations by enhancing LIBS signal specificity using lithium chloride (LiCl) as a tumor labeling agent. The cytotoxicity of LiCl was evaluated on PC-3 prostate cancer cells and L929 mouse fibroblast cells. Subsequently, the LIBS-mediated cancer cell detection and ablation method was tested in both phantom and in vitro cancer models. LIBS analysis revealed a significant lithium signal in LiCl-incubated groups in both phantom and in vitro models, and the system successfully identified and ablated the lithium-labeled regions. These findings suggest that LiCl-mediated LIBS may serve as a foundation for developing a compact, dual-purpose platform for cancer detection and ablation during tumor resection surgery. Future studies will focus on miniaturizing and optimizing the system for animal tests and clinical trials, aiming to delineate tumor margins based on LIBS feedback and ablate the tumor cells with precision.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"400"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the safety and effectiveness of laser and light therapies for the treatment of pigmented purpuric dermatoses.","authors":"Abbas Dehghani, Mohammed Amin Seddigh, Alireza Jafarzadeh, Elham Behrangi, Shiva Lotfi, Azadeh Goodarzi","doi":"10.1007/s10103-025-04615-4","DOIUrl":"https://doi.org/10.1007/s10103-025-04615-4","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Pigmented purpuric dermatoses (PPD) represent a group of chronic skin disorders distinguished by small hemorrhagic spots and alterations in pigmentation. These conditions frequently resist standard therapies, such as topical corticosteroids and systemic drugs. This systematic review evaluates the safety and effectiveness of light and laser treatments for patients with various types of pigmented purpuric dermatoses. We searched the PubMed, Scopus, and Web of Science databases on 18 March 2025, in accordance with PRISMA guidelines. We examined studies that utilized light therapy and laser therapy for each type of pigmented purpuric dermatosis and analyzed the data based on treatment modality. We evaluated study quality based on design using appropriate assessment tools. Our initial search yielded 98 studies, of which 30 met our inclusion criteria, encompassing 98 cases. Various treatments were evaluated, including NB-UVB, PUVA, IPL, PDT, and lasers such as PDL, fractional (non-ablative 1540 nm erbium glass laser), and excimer lasers. NB-UVB was the most commonly used, showing consistent efficacy in improving pigmentation and pruritus across different PPD subgroups. PUVA also demonstrated significant clinical benefits. Among laser treatments, PDL was particularly effective in targeting vascular lesions, while fractional (non-ablative 1540 nm erbium glass laser) and excimer lasers achieved good lesion clearance with minimal side effects. Light and laser treatments have demonstrated effective results in addressing various types of pigmented purpuric dermatoses, particularly in more challenging cases. NB-UVB, PUVA, PDL, fractional laser, and excimer laser have achieved satisfactory outcomes with minimal side effects. Despite these promising results, clinical trials with larger populations are essential to confirm this data. The results of this study can serve as a useful guide for future research on the efficacy and safety of light- and laser-based therapies for the treatment of patients with pigmented purpuric dermatoses. What is known about this topic Pigmented purpuric dermatoses (PPD) are long-lasting skin conditions characterized by small bleeding spots and changes in skin color, which often do not respond well to standard treatments such as topical corticosteroids and systemic agents. Light- and laser-based therapies targeting vascular and inflammatory components have shown promising results in the treatment of various skin diseases, including PPD. However, previous studies have provided incomplete information, making it difficult to comprehensively understand the effectiveness, safety, and suitability of these treatments for different types of PPD. What this article adds This systematic review combines data from 30 studies involving 98 patients and provides a comprehensive evaluation of light- and laser-based treatments for PPD. Key findings include the high efficacy of NB-UVB and PDL with minimal side effects. The study also identifies im","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"401"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase-aware Cross-Scale U-MAMba with uncertainty-aware segmentation and Switch Atrous Bifovea EfficientNetB7 classification of kidney lesion subtype.","authors":"Shamija Sherryl Rmr, Sudhan Mb, Deeptha R, Thamizharasi M, Vidyasri P","doi":"10.1007/s10103-025-04644-z","DOIUrl":"https://doi.org/10.1007/s10103-025-04644-z","url":null,"abstract":"<p><p>Kidney lesion subtype identification is essential for precise diagnosis and personalized treatment planning. However, achieving reliable classification remains challenging due to factors such as inter-patient anatomical variability, incomplete multi-phase CT acquisitions, and ill-defined or overlapping lesion boundaries. In addition, genetic and ethnic morphological variations introduce inconsistent imaging patterns, reducing the generalizability of conventional deep learning models. To address these challenges, we introduce a unified framework called Phase-aware Cross-Scale U-MAMba and Switch Atrous Bifovea EfficientNet B7 (PCU-SABENet), which integrates multi-phase reconstruction, fine-grained lesion segmentation, and robust subtype classification. The PhaseGAN-3D synthesizes missing CT phases using binary mask-guided inter-phase priors, enabling complete four-phase reconstruction even under partial acquisition conditions. The PCU segmentation module combines Contextual Attention Blocks, Cross-Scale Skip Connections, and uncertainty-aware pseudo-labeling to delineate lesion boundaries with high anatomical fidelity. These enhancements help mitigate low contrast and intra-class ambiguity. For classification, SABENet employs Switch Atrous Convolution for multi-scale receptive field adaptation, Hierarchical Tree Pooling for structure-aware abstraction, and Bi-Fovea Self-Attention to emphasize fine lesion cues and global morphology. This configuration is particularly effective in addressing morphological diversity across patient populations. Experimental results show that the proposed model achieves state-of-the-art performance, with 99.3% classification accuracy, 94.8% Dice similarity, 89.3% IoU, 98.8% precision, 99.2% recall, a phase-consistency score of 0.94, and a subtype confidence deviation of 0.08. Moreover, the model generalizes well on external datasets (TCIA) with 98.6% accuracy and maintains efficient computational performance, requiring only 0.138 GFLOPs and 8.2 ms inference time. These outcomes confirm the model's robustness in phase-incomplete settings and its adaptability to diverse patient cohorts. The PCU-SABENet framework sets a new standard in kidney lesion subtype analysis, combining segmentation precision with clinically actionable classification, thus offering a powerful tool for enhancing diagnostic accuracy and decision-making in real-world renal cancer management.</p>","PeriodicalId":17978,"journal":{"name":"Lasers in Medical Science","volume":"40 1","pages":"398"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}