Cancers最新文献

{"title":"Endobronchial Ultrasound Staging During Navigation Bronchoscopy for Peripheral Pulmonary Nodules in the Real World: Which Patients Will Benefit?","authors":"Desi K M Ter Woerds, Roel L J Verhoeven, Ad F T M Verhagen, Erik H J G Aarntzen, Erik H F M van der Heijden","doi":"10.3390/cancers17101700","DOIUrl":"10.3390/cancers17101700","url":null,"abstract":"<p><strong>Background/objectives: </strong>The prevalence of lung cancer in patients with a peripheral pulmonary nodule referred for navigation bronchoscopy (NB) is high. Combining NB with a systematic EBUS for staging is common practice. We investigated the added value of performing EBUS in the population referred for NB in relation to the available pre-procedural [¹⁸F]FDG-PET and CT imaging information.</p><p><strong>Methods: </strong>This single-center study evaluated all consecutive patients who underwent an NB in an academic referral center. [¹⁸F]FDG-PET and CT scoring of lymphadenopathy was based on routine [¹⁸F]FDG-PET and/or contrast-enhanced chest (ce) CT imaging reports and were correlated to outcome of systematic EBUS and subsequent surgery (when available).</p><p><strong>Results: </strong>In total, 403 patients were included for analysis of which 327 underwent EBUS (81.1%). In 138/403 patients (35%) who had positive lymph nodes on [¹⁸F]FDG-PET (86.5%) or ceCT (13.5%), 12 lung cancer patients were diagnosed with N+ disease by EBUS (8.4%). An additional nine EBUS-negative patients were diagnosed with N+ disease after surgery (5.4%). In the group of patients with imaging-negative lymph nodes (65.8%), no metastatic lymph nodes were found by EBUS, and surgery revealed occult nodal metastasis in eight patients (3.1%).</p><p><strong>Conclusions: </strong>In patients with peripheral pulmonary nodules referred for NB, EBUS may be safely omitted when [¹⁸F]FDG-PET or ceCT imaging does not indicate presence of nodal involvement.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Normal Tissue Toxicity in Pulsed Low Dose Rate Radiotherapy.","authors":"Shahabeddin M Aslmarand, Troy Dos Santos, Dae-Myoung Yang, Dusica Cvetkovic, Lili Chen, C-M Charlie Ma","doi":"10.3390/cancers17101701","DOIUrl":"10.3390/cancers17101701","url":null,"abstract":"<p><p><b>Purpose:</b> Pulsed low dose rate radiotherapy (PLDR) is a radiotherapy approach expected to reduce normal tissue toxicity while maintaining equivalent tumor control as conventional radiotherapy (CRT). This preliminary study evaluates the effectiveness of PLDR in reducing normal tissue toxicity in vivo. <b>Materials and Methods:</b> In the initial phase, C57BL/6 mice underwent histological examination following single-fraction, total-body irradiation. Observations were conducted at 3 and 5 days post-treatment. Mice were divided into control, PLDR, and CRT groups, receiving varying doses ranging from 4 to 12 Gy. Building upon the histological findings, the second phase centered on whole-abdominal irradiation (WAI) and determining the lethal dose for WAI using CRT. Subsequently, this dose was applied in PLDR settings to compare survival rates and changes in body weight. The experiment was replicated to collect histology samples at 1-, 3-, 5-, 7-, and 9-day endpoints, enabling the assessment and comparison of tissue toxicity. Finally, exploration into PLDR's lethal WAI dose was conducted. <b>Results:</b> Histology results showed the abdominal region as the main site of difference between PLDR and CRT, with both methods causing a dose-dependent increase in atrophy and hyperplasia. However, CRT led to higher tissue toxicity compared to PLDR. In the survival study, the fatal dose for WAI treatment was 18 Gy, with mice in the CRT group experiencing substantial weight loss and dying within 9-12 days post-treatment. In contrast, mice in the PLDR group, despite an initial weight loss, recovered their weight and survived. Histology results also showed that the PLDR group had less tissue toxicity. Furthermore, the fatal dose of WAI for PLDR was revealed to be 29 Gy, which is over 60% higher than the dose required for CRT, indicating a substantial difference in tolerance and potential safety margin provided by PLDR treatment. <b>Conclusions:</b> PLDR demonstrated a reduced normal toxicity compared to CRT, potentially beneficial in re-treatment scenarios or for tumors where CRT-induced toxicity limits tumor control, such as in liver cases.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimally Delivered R-da-EPOCH Versus R-CHOP-21 in Primary Mediastinal Large B-Cell Lymphoma: A Real-Life Comparison in a Single Academic Center.","authors":"Alexia Piperidou, Maria K Angelopoulou, Chrysovalantou Chatzidimitriou, John V Asimakopoulos, Maria Arapaki, Fotios Panitsas, Gerassimos Tsourouflis, Marina Belia, Iliana Konstantinou, Anastasia Kopsaftopoulou, Athanasios Liaskas, Alexandros Machairas, Maria-Aikaterini Lefaki, Maria Dimitrakoudi, Sotirios Sachanas, Gerassimos A Pangalis, Konstantinos Konstantopoulos, Eleni Plata, Marina Siakantaris, Theodoros P Vassilakopoulos","doi":"10.3390/cancers17101699","DOIUrl":"10.3390/cancers17101699","url":null,"abstract":"<p><strong>Background/objectives: </strong>The National Cancer Institute introduced the intensified R-da-EPOCH regimen in primary mediastinal large B-cell lymphoma (PMLBCL) to improve outcomes while minimizing radiotherapy use. However, there is no randomized comparison of R-da-EPOCH vs. R-CHOP-21. The objective of this study was to compare R-da-EPOCH with R-CHOP-21 in consecutive patients with PMLBCL of a single, large referral center, where the R-da-EPOCH escalation schedule was strictly followed.</p><p><strong>Methods: </strong>We retrospectively analyzed all 35 consecutive patients who received R-da-EPOCH (2017-2022) compared to 35 consecutive patients treated with R-CHOP-21 arm at the same Department, starting from the most recent patient and going backwards (2005-2017).</p><p><strong>Results: </strong>R-da-EPOCH was given strictly in 33/35 (94%) patients. The 5-year freedom from progression (FFP) was 91% vs. 69% (<i>p</i> = 0.027). The 5-year event-free survival (EFS) was 84% vs. 69% (<i>p</i> = 0.124). The 5-year overall survival (OS) was 97% vs. 80% (<i>p</i> = 0.063). Among R-CHOP-21-responders, 20/29 (69%) received RT compared to 2/34 (6%) R-da-EPOCH-responders. In multivariate analysis, R-da-EPOCH remained better than R-CHOP-21 in terms of FFP [hazard ratios (HRs) 0.21-0.26, all <i>p</i> < 0.05] and was associated with very favorable HR for EFS and OS.</p><p><strong>Conclusions: </strong>Optimally delivered R-da-EPOCH minimized the use of RT in a real-life setting and provided superior outcomes than R-CHOP-21.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom Burden Poorly Responsive to Palliative Care Intervention and Karnofsky Predict Survival in an Acute Palliative Care Unit.","authors":"Sebastiano Mercadante, Yasmine Grassi, Alessio Lo Cascio, Alessandra Casuccio","doi":"10.3390/cancers17101704","DOIUrl":"10.3390/cancers17101704","url":null,"abstract":"<p><p><b>Background/Objective:</b> Survival prediction in the advanced cancer care setting plays a vital role <b>in</b> treatment planning and patients' arrangements. The aim of this study was to examine the association of the global Edmonton Symptom Assessment System (GESAS) and Karnofsky scale (KPS) with overall survival (OS) in patients with advanced cancers admitted to an acute palliative care unit (APCU). The second aim was to assess if GESAS changes after comprehensive palliative treatment could influence OS. <b>Methods:</b> This is a prospective planned sub-analysis of advanced cancer patients. A consecutive sample of 521 patients admitted to an APCU. Patients with available survival in follow-up phone calls, having complete ESAS, and discharged alive were selected. KPS and GESAS were measured at admission and after seven days of individual comprehensive palliative care. <b>Results:</b> Two hundred forty-three of 521 screened patients were assessed according to inclusion criteria. The mean age was 67.1 years (SD 11.5), and 121 patients were male. The mean KPS was 43.5 (SD 9.3). The mean OS was 74.6 (SD 136.2) days. Significant changes in GESAS were observed after one week. Univariate linear regression analysis showed that KPS and GESAS at T0 and at T7 were correlated with OS (<i>p</i> < 0.0005; <i>p</i> = 0.020; <i>p</i> < 0.0005, respectively). At multivariate analysis, OS was correlated with KPS and GESAS at discharge (B = 3.349, 95% CI = 1.560-5.137; B = -2.430, 95% CI = -3.831--1.029). <b>Discussion:</b> KPS and poor response to intensive treatment, maintaining high GESAS scores, can be considered predictive factors of shorter OS. Further studies should confirm whether a specialized intervention in other settings can improve OS.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of DHA Oral Supplementation on Plasma Resolvin D1 and D2 Levels in Naïve Breast Cancer Patients.","authors":"Alessio Molfino, Giovanni Imbimbo, Gerardo Salerno, Luana Lionetto, Alessandro De Luca, Maurizio Simmaco, Carmen Gallicchio, Orietta Picconi, Maria Ida Amabile, Maurizio Muscaritoli","doi":"10.3390/cancers17101694","DOIUrl":"10.3390/cancers17101694","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Specialized pro-resolving lipid mediators, such as resolvins derived from omega-3 fatty acids, play a key role in resolving inflammation and restoring homeostasis. Resolvin D1 and D2, derived from docosahexaenoic acid (DHA), have demonstrated inflammation pro-resolving properties and potential anticancer effects. This study aimed to evaluate the effects of oral DHA supplementation on plasma resolvin D1 and D2 levels in breast cancer patients and in controls, and by stratifying the patients by disease presentation (sporadic, familial, BRCA1/2 mutated) and immunohistochemical characteristics. <b>Methods</b>: This is a single-center, interventional, controlled study conducted in women with breast cancer and women with benign breast disease, serving as controls. Participants consumed DHA (2 g/day) as algal oil syrup for 10 consecutive days. Plasma resolvin D1 and D2 levels were measured at baseline (T0) and after supplementation (T1) using ELISA kits. <b>Results</b>: At baseline, breast cancer patients exhibited higher plasma resolvin D1 levels compared to controls (median 21.3 vs. 7.3 pg/mL, <i>p</i> = 0.039), with no significant difference in resolvin D2. Following DHA supplementation, resolvin D1 and D2 significantly increased in BRCA1/2-mutated patients (+185.8% and +101.2%, <i>p</i> = 0.037, <i>p</i> = 0.028, respectively). Conversely, the familial breast cancer group showed a significant decrease in resolvin D1 (<i>p</i> = 0.015). Patients with low Ki67 expression showed greater increase over time of resolvin D2 levels compared to those with high Ki67 expression (<i>p</i> = 0.046). <b>Conclusions</b>: DHA supplementation modulated resolvin levels in breast cancer patients, with significant increase in BRCA1/2-mutated patients, suggesting enhanced inflammation pro-resolving responses. The reduction in resolvin D1 in the familial group highlights a potential dysregulated response. These findings indicate the potential of resolvins as biomarkers of resolution of inflammation and novel therapeutic targets in breast cancer.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT and MRI Key Features of Benign Tumors and Tumor-like Lesions of the Tongue: A Pictorial Review.","authors":"Michele Pietragalla, Emanuele Gattuso, Cosimo Nardi, Antonio Lo Casto","doi":"10.3390/cancers17101695","DOIUrl":"10.3390/cancers17101695","url":null,"abstract":"<p><p>Benign neoplasms and tumor-like lesions of the tongue are relatively rare entities, encompassing a heterogeneous spectrum of morphological alterations. The recent literature focusing on benign tumors and tumor-like lesions of the tongue is relatively limited, which may lead to a gap in understanding their specific imaging characteristics. Most benign tongue tumors usually appear as submucosal bulges located in the deep portion of the tongue. Both computed tomography (CT) and magnetic resonance imaging (MRI) are essential for the comprehensive diagnostic evaluation of these entities. Cross-sectional imaging plays a pivotal role in narrowing the differential diagnosis and, in selected cases, may suggest a specific histopathological entity. The benign tumors and tumor-like lesions included in this review comprise schwannoma, lipoma, angiomyolipoma, hemangioma, vascular malformations, dermoid cysts, and thyroglossal duct remnants (including cystic formations and ectopic thyroid tissue). Additionally, certain non-neoplastic conditions-such as lingual abscesses, infectious mononucleosis complicated by lingual tonsillitis, and fatty atrophy of the tongue-can mimic neoplastic processes and present as mass-like lesions; these have also been addressed in this pictorial essay. The purpose of this work is to illustrate the key CT and MRI features of the aforementioned benign lingual lesions, with the aim of improving diagnostic confidence and accuracy.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spread Through Air Spaces (STAS) as a Predictive and Prognostic Factor in Patients with Non-Small Cell Lung Cancer-Systematic Review.","authors":"Mikołaj Herba, Sylwia Boczek, Wiktoria Smyła-Gruca, Katarzyna Kost, Damian Czyżewski, Mateusz Rydel","doi":"10.3390/cancers17101696","DOIUrl":"10.3390/cancers17101696","url":null,"abstract":"<p><strong>Background/objectives: </strong>Lung cancer is the second most prevalent cancer in the general population and the third most prevalent among women. STAS (Spread Through Air Spaces) is a term used in pathology, particularly in lung cancer. It refers to the spread of tumor cells through air spaces in the lung tissue. The aim of this study was to evaluate the utility of STAS as a predictive and prognostic factor, as well as to assess the impact of STAS detection on subsequent surgical and pharmacological treatment decisions.</p><p><strong>Methods: </strong>A comprehensive literature search was performed on PubMed, PMC, and Google Scholar between June and September 2024. Search terms included 'STAS', 'lung cancer', 'NSCLC', 'SCLC', 'PET and STAS', 'histopathological STAS', 'treatment methods for STAS', and 'STAS prognosis'. A diverse range of study designs was included in our analysis-encompassing meta-analyses, case-control studies, literature reviews, cross-sectional studies, and prospective longitudinal studies.</p><p><strong>Results: </strong>Lobectomy remains standard, whereas sublobar resection significantly increases recurrence risk in STAS-positive patients. CT, PET/CT, and frozen section analysis offer emerging, reliable predictive markers, supporting optimized treatment selection; however, histopathological examination continues to serve as the standard method for confirming STAS.</p><p><strong>Conclusions: </strong>One of the most significant limitations of our work is the limited number of available studies addressing the topic of STAS, which is the reason why statistical analysis was not provided. To conclude, the presence of STAS is identified as a negative prognostic factor amongst patients with NSCLC; however further research is needed to establish specific treatment guidelines when STAS is identified.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Observer Study on Diagnostic Accuracy of Pediatric Renal Tumors Imaged with Higher-Harmonic-Generation Microscopy.","authors":"Sylvia Spies, Elina Nazarian, Srinivas Annavarapu, Paola Collini, Aurore Coulomb L'Hermine, Ellen D'Hooghe, Jozef Kobos, Guillaume Morcrette, Mariana A Morini, Sergey D Popov, Rajeev Shukla, Isabela Werneck da Cunha, Cornelis P van de Ven, Marry M van den Heuvel-Eibrink, Ronald R de Krijger, Marie Louise Groot","doi":"10.3390/cancers17101693","DOIUrl":"10.3390/cancers17101693","url":null,"abstract":"<p><strong>Background/objectives: </strong>Wilms tumors, the most common pediatric renal tumors, are heterogeneous and consist of varying amounts of three components: blastema, epithelium, and stroma. Postoperative chemotherapy is tailored based on risk group classification and stage. Due to this heterogeneity, pathologists perform extensive tumor sampling to ensure accurate classification. Higher-harmonic-generation microscopy (HHGM) is an innovative imaging technique that enables rapid visualization of fresh tissue without preparation or staining. This makes it particularly valuable for sample selection, as the tissue can be reused for further analysis. This study aims to evaluate the accuracy of pathologists in distinguishing normal renal tissue, abnormal renal tissue, and three types of pediatric renal tumors, Wilms tumor, renal cell carcinoma, and congenital mesoblastic nephroma, in HHGM images.</p><p><strong>Methods: </strong>Twenty-nine samples from eighteen patients with a pediatric renal tumor were imaged using an HHG microscope and subsequently processed for histological analysis. Overview images of the samples were acquired at a rate of 10 s per mm², while high-quality images took 1 min per mm². A multi-observer study involving ten international expert pathologists of the SIOP-RTSG was conducted.</p><p><strong>Results: </strong>Pathologists were able to differentiate between normal and abnormal tissue with 100% (29/29) accuracy and correctly identified tumor versus non-tumor tissue with 97% (28/29) accuracy.</p><p><strong>Conclusions: </strong>These results show that HHGM is a highly promising technique for the rapid assessment of pediatric renal tumor samples, particularly for evaluating sample representativeness.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Quantitative CEUS in the Diagnosis of Peripheral Pulmonary Lesions: A Systematic Review.","authors":"Andrea Boccatonda, Alice Brighenti, Sofia Maria Bakken, Damiano D'Ardes, Cosima Schiavone, Fabio Piscaglia, Carla Serra","doi":"10.3390/cancers17101697","DOIUrl":"10.3390/cancers17101697","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This systematic review describes a largely descriptive synthesis of studies investigating the diagnostic performance of quantitative contrast-enhanced ultrasound (CEUS) in differentiating benign from malignant peripheral pulmonary lesions. <b>Methods</b>: Formal quantitative pooling of effect sizes was not feasible due to variability in outcome measurements and reporting. <b>Results:</b> Combining CEUS parameters with real-time on-site evaluation (ROSE) substantially improved percutaneous biopsy success rates. In one comparative study, biopsy yield reached 97.62% with CEUS, versus 84% using conventional ultrasound, while complications remained minimal. Other investigations focused on the discriminatory value of specific time-based indices (e.g., AT ≥ 10 s, lesion-lung AT difference ≥ 2.5 s) or complex multi-parameter models. A notable large study demonstrated that a six-parameter logistic regression model achieved near-excellent discrimination, with C-statistics exceeding 0.97 for both development and validation cohorts, outperforming single-threshold approaches. Nevertheless, certain findings emphasize that no single indicator-particularly arrival time alone-reliably distinguishes benign from malignant lesions, given the diverse vascular patterns and histological subtypes involved. TDOA-based analyses proved more promising, as malignant lesions generally exhibit a delayed but robust bronchial arterial supply and rapid washout. Heterogeneity in ultrasound systems, operator experience, and patient populations further underscores the need for standardized protocols. <b>Conclusions</b>: Overall, these data suggest that CEUS, particularly when combined with additional sonographic or cytological tools, significantly enhances diagnostic precision for peripheral pulmonary lesions.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Preoperative Diagnostic Nomogram to Predict Tumor Subclassifications of Intrahepatic Cholangiocarcinoma.","authors":"Mizuki Yoshida, Masahiko Kinoshita, Yuta Nonomiya, Ryota Kawai, Ayumi Shintani, Yasunori Sato, Takahito Kawaguchi, Ryota Tanaka, Shigeaki Kurihara, Kohei Nishio, Hiroji Shinkawa, Kenjiro Kimura, Akira Yamamoto, Shoji Kubo, Takeaki Ishizawa","doi":"10.3390/cancers17101690","DOIUrl":"10.3390/cancers17101690","url":null,"abstract":"<p><strong>Background/objectives: </strong>Intrahepatic cholangiocarcinoma (ICC) is subclassified into small and large duct types. Although these subclassifications may help determine the appropriate treatment strategy, subclassification diagnosis currently depends on postoperative pathological examinations. This study aimed to establish a nomogram to predict ICC subclassifications.</p><p><strong>Methods: </strong>This study included 126 patients with ICC who underwent liver resection. The participants were divided into small and large duct-type ICC groups. A nomogram to predict large duct-type ICC was developed using four diagnostic imaging findings: rim-type enhancement in the early phase, an absence of tumor enhancement in the early phase, the presence of peripheral biliary dilatation due to tumor invasion, the presence of penetrating Glisson's vessels in the tumor, and two laboratory test results: serum gamma-glutamyl transpeptidase and carbohydrate antigen 19-9 levels. Nomogram performance was also assessed. Moreover, the bootstrap method and calibration plots were used to assess nomogram validity.</p><p><strong>Results: </strong>Seventy and fifty-six patients were pathologically diagnosed with small and large duct-type ICCs, respectively. The area under the curve of the established nomogram was 0.93 and remained 0.91 after Harrell's bias correction. The sensitivity and specificity of the nomogram developed using the Youden index were higher than those of any of the characteristic imaging findings. Calibration plots demonstrated a strong association between the nomogram and the actual data.</p><p><strong>Conclusions: </strong>We developed a novel preoperative nomogram to predict large duct-type ICC. This nomogram can be clinically useful for predicting the subclassifications of ICCs and may contribute to the establishment of a more appropriate treatment strategy for ICC.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 10","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}