Cancer Lesions Research Articles

Helicobacter pylori SlyD stabilizes TPT1 via hnRNPK and enhances OCT1-mediated CDX2 transcriptional activation to drive gastric intestinal metaplasia

Abstract Background Gastric intestinal metaplasia (GIM) represents an important precancerous lesion in intestinal-type gastric cancer, triggered by persistent Helicobacter pylori (H. pylori) infection. In a previous study, we unveiled SlyD as a novel virulence factor of H. pylori, establishing its role in GIM induction through TPT1. However, the underlying mechanism remains undetermined. Methods Gastric epithelial cells were stimulated with H. pylori 26695, a SlyD inactivated mutant (ΔSlyD), and purified HpSlyD protein, respectively. Real-time qPCR and western blot were subsequently used to assess the expression levels of hnRNPK, TPT1, OCT1, and GIM markers. RNA sequencing was employed to identify differentially expressed genes associated with H. pylori SlyD infection. Protein stability was evaluated using cycloheximide. Molecular interactions were investigated through co-immunoprecipitation, chromatin immunoprecipitation, and dual-luciferase reporter assays. Additionally, molecular docking was utilized to predict TPT1 inhibitors. Immunohistochemistry staining was conducted to validate hnRNPK, TPT1, OCT1, and CDX2 expression in gastric tissue samples from both human and Mongolian gerbils. Results H. pylori SlyD upregulates TPT1 and induces the expression of GIM markers through hnRNPK. The interaction between hnRNPK and TPT1 enhances TPT1 protein stability, with H. pylori SlyD intensifying this association. TPT1 promotes the expression of GIM markers mediated via OCT1, which binds to CDX2 promoter region, thereby modulating its transcriptional activity. Dihydroartemisinin has the potential to target TPT1, inhibiting the H. pylori SlyD-induced expression of GIM markers. Conclusions In vitro and in vivo experiments verified that H. pylori SlyD enhances TPT1 stability through hnRNPK, leading to OCT1-mediated transcriptional activation of CDX2 and the initiation of the GIM process. Our study offers novel perspectives on the pathogenesis of H. pylori-related gastric precancerous conditions.

Cross-ViT based benign and malignant classification of pulmonary nodules.

The benign and malignant discrimination of pulmonary nodules plays a very important role in diagnosing the extent of lung cancer lesions. There are many methods using Convolutional neural network (CNN) for benign and malignant classification of pulmonary nodules, but traditional CNN models focus more on the local features of pulmonary nodules and lack the extraction of global features of pulmonary nodules. To solve this problem, a Cross fusion attention ViT (Cross-ViT) network that fuses local features extracted by CNN and global features extracted by Transformer is proposed. The network first extracts different features independently through two branches and then performs feature fusion through the Cross fusion attention module. Cross-ViT can effectively capture and process both local and global information of lung nodules, which improves the accuracy of classifying the benign and malignant nature of pulmonary nodules. Experimental validation was performed on the LUNA16 dataset, and the accuracy, precision, recall and F1 score reached 91.04%, 91.42%, 92.45% and 91.92%, respectively, and the accuracy, precision, recall and F1 score with SENet as CNN branch reached 92.43%, 94.27%, 91.68% and 92.96%, respectively. The results show that the accuracy, precision, recall and F1 score of the proposed method are 0.3%, 0.11%, 4.52% and 3.03% higher than those of the average optimal method, respectively, and the performance of Cross-ViT network for benign and malignant classification is better than most classification methods.

Acetic acid enabled nuclear contrast enhancement in epi-mode quantitative phase imaging.

The acetowhitening effect of acetic acid (AA) enhances light scattering of cell nuclei, an effect that has been widely leveraged to facilitate tissue inspection for (pre)cancerous lesions. Here, we show that a concomitant effect of acetowhitening-changes in refractive index composition-yields nuclear contrast enhancement in quantitative phase imaging (QPI) of thick tissue samples. We aim to explore how changes in refractive index composition during acetowhitening can be captured through a novel epi-mode 3D QPI technique called quantitative oblique back-illumination microscopy (qOBM). We also aim to demonstrate the potential of using a machine learning-based approach to convert qOBM images of fresh tissues into virtually AA-stained images. We implemented qOBM, an imaging technique that allows for epi-mode 3D QPI to observe phase changes induced by AA in thick tissue samples. We focus on detecting nuclear contrast changes caused by AA in mouse brain samples. As a proof of concept, we also applied a Cycle-GAN algorithm to convert the acquired qOBM images into virtually AA-stained images, simulating the effect of AA staining. Our findings demonstrate that AA-induced acetowhitening leads to significant nuclear contrast enhancement in qOBM images of thick tissue samples. In addition, the Cycle-GAN algorithm successfully converted qOBM images into virtually AA-stained images, further facilitating the nuclear enhancement process without any physical stains. We show that the acetowhitening effect of acetic acid induces changes in refractive index composition that significantly enhance nuclear contrast in QPI. The application of qOBM with AA, along with the use of a Cycle-GAN algorithm to virtually stain tissues, highlights the potential of this approach for advancing label-free and slide-free, ex vivo, and in vivo histology.

The interpretation of magnifying endoscopy for the diagnosis of colorectal lesions.

Accurate endoscopic diagnosis is crucial for determining the appropriate treatment strategy for colorectal lesions, which may include cold snare polypectomy (CSP), endoscopic mucosal resection (EMR), or endoscopic submucosal dissection (ESD). While white light imaging (WLI) serves as the basic and initial method for endoscopic diagnosis, additional techniques such as narrow-band imaging (NBI), blue laser/light imaging (BLI), and magnified observation using pit patterns are necessary when WLI results are inconclusive. These advanced diagnostic methods enable precise identification of lesions such as adenoma, T1 cancer, and sessile serrated lesion (SSL). Furthermore, recent advancements in endoscopic systems have enhanced image clarity and detail, thereby improving diagnostic accuracy. This review provides an in-depth discussion on how magnified endoscopy, utilizing the Japan NBI Expert Team (JNET) classification with NBI/BLI and pit pattern classification with chromoendoscopy, aids in the accurate diagnosis of colorectal lesions.

Leveraging the Immunological Impacts of Irreversible Electroporation as a New Frontier for Cancer Therapy.

Irreversible electroporation (IRE) is a nonthermally mediated tissue ablation modality that makes use of short pulsed electric fields to destroy cancerous lesions in situ. In the past two decades, IRE has established itself not only as an effective means to ablate small, unresectable tumor masses but also as a tool particularly qualified to modulate the tumor microenvironment in a way that dismantles pathways of cancer immunosuppression and permits the development of a systemic antitumor immune response. However, despite its immune-stimulating tendencies, for most cancers conventional IRE alone is insufficient to establish an immune response robust enough to fully eliminate disseminated disease and prevent recurrence. Here, we describe the current understanding of the histological and immunological effects of IRE, as well as recent efforts to optimize IRE parameters and develop rational combination therapies to increase the efficacy of the resulting immune response.

Mechanism of Yinxu Weitong Capsule in the treatment of precancerous lesions of gastric cancer based on network pharmacology and experimental validation.

Yinxu Weitong Capsule (YXWTC) is a Chinese patent medicine used to treat chronic gastritis. However, its efficacy and mechanisms of action in treating precancerous lesions of gastric cancer (PLGC) remain unclear. To evaluate the effects of YXWTC on PLGC and explore the underlying mechanisms. YXWTC components were identified using ultra-high-performance liquid chromatography coupled with electrospray ionization quadrupole-exactive orbitrap mass spectrometry. A PLGC animal model was established and the protective effects of YXWTC on the gastric mucosa in PLGC rats were evaluated using hematoxylin and eosin (H&E), Alcian blue-periodic acid-Schiff and Alcian blue-high iron diamine staining, and transmission electron microscopy (TEM). The vital organs of the rats were examined using H&E staining to evaluate biosafety. Network pharmacology identified potential targets and pathways of YXWTC in PLGC treatment, followed by molecular docking validation. Various techniques, including enzyme-linked immunosorbent assay, real-time quantitative reverse transcription PCR, Western blotting, immunohistochemistry, apoptosis detection, and reactive oxygen species fluorescence staining were employed to elucidate the underlying mechanisms. In total, 340 YXWTC components were identified. YXWTC effectively improves gastric mucosal pathology in rats with PLGC. Network pharmacology identified 403 targets common to PLGC and YXWTC. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses identified 2,323 biological processes and 206 signaling pathways, respectively. Molecular docking revealed that the primary target proteins and major drug molecules exhibited strong binding affinities. Animal studies demonstrated that YXWTC inhibited the IL-6/STAT3 pathway, promoted mitochondrial apoptosis, and induced ROS release. We verified the pharmacodynamic effects of YXWTC in PLGC. In summary, the effects are mediated by inhibition of the IL-6/STAT3 pathway, promotion of mitochondrial apoptosis, and induction of ROS release.

Analysis of gut and mucosal microbiomes in patients with extrahepatic cholangiocarcinoma.

620 Background: Cholangiocarcinoma is an aggressive malignancy with a poor prognosis. While gut microbial dysbiosis is linked to various diseases, including biliary disorders and cancer, its association with cholangiocarcinoma remains unclear. Methods: This study compared the mucosal and gut microbiomes of patients with extrahepatic cholangiocarcinoma (n = 21) to those with cholecystitis (n = 21) and healthy individuals (n = 28). Mucosal microbiomes were collected from cancer lesions and gallbladders, with fecal samples obtained from 31 participants. The 16S rRNA gene (V3 and V4 region) was sequenced using the Illumina MiSeq platform and analyzed with QIIME 2. Results: 16S rRNA sequencing revealed Proteobacteria as the dominant taxon in the cancer cohort, with Klebsiella, Aeromonas, Staphylococcus, Fusobacterium, and Haemophilus also enriched. In contrast, Firmicutes dominated in the cholecystitis and control cohorts. β-diversity analysis highlighted significant differences between cohorts. Elevated levels of bile acids, particularly chenodeoxycholic acid and ursodeoxycholic acid, were observed in the cancer cohort and positively correlated with Proteobacteria, Aeromonas, Enterobacter, and Enterococcus. Conclusions: These findings suggest that microbiome dysbiosis contributes to cholangiocarcinoma development.

Intravoxel incoherent motion (IVIM) MRI-derived masseter muscle characteristics: a new diagnostic marker in head and neck cancer?

BackgroundTo use intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) to evaluate the masseter muscle and tumors in patients with head and neck cancer (HNC) and to compare them with those of normal controls.MethodsThe study involved 16 normal controls and 54 patients with HNC (29 newly diagnosed and 25 posttreatment cases) examined using a 3.0T MRI with a 20-channel head and neck coil. IVIM scans, incorporating six b-values in three orthogonal directions, were conducted using a readout-segmented echo-planar sequence. The diffusion coefficient (D), perfusion fraction (f), and pseudodiffusion coefficient (D*) were derived to assess the diffusion and perfusion alterations in the masseter muscles and HNC lesions.ResultsThe masseter muscle f values significantly differed between the patients with newly diagnosed HNC and the normal controls (p < 0.05); no significant differences in remaining D, D*, and f values were observed between the three groups (p > 0.05). The masseter muscle volumes in the newly diagnosed HNC and posttreatment patients were significantly smaller than those in the normal controls (all p < 0.05). The D and f values of the bilateral masseter muscles in the patients with newly diagnosed HNC were significantly higher than those in the primary cancer lesions (p < 0.05).ConclusionsOur study highlights the potential of IVIM parameters for the evaluation of masseter muscles in patients with HNC, with elevated f values on the ipsilateral side of primary tumors and bilaterally increased D and f values. The clinical implications and underlying mechanisms of these findings of distinct perfusion changes warrant further exploration.

Clinical and Diagnostic Study of Breast Cancer in Women and its Relation with Periodontal Disease

Background: Breast cancer (BC) is a common type of malignancy in females in Iraq. This study investigated BC's clinical and diagnostic features in 30 women and displayed its relationship with periodontal disease. Methods: This cross-sectional study comprised 30 BC patients diagnosed in 2023. The clinical signs, ultrasound, biopsy, histopathology and Immunohistochemistry, treatment modules, and clinical signs of periodontal disease were reported and analyzed. Results: The mean and standard deviation of patients’ age was 51.73± 11.41. The location of Breast Cancer lesions was on the left and right sides in 11 (36.66%) and 19 (63.33%) patients, respectively. All patients showed various sizes of non-painful lumps with well-defined masses in different areas of the breast tissue with regular or irregular borders in ultrasound and MRI. The gross and histopathological changes of cancerous tumors differed according to conditions, stage, and interaction with the cancer receptors in Immunohistochemistry. The percentage of metastases was 100% (in 30 cases) for the lymph nodes and 66.66% (in 20 cases) for the rest of the other organs. Different treatment modules were used, including chemotherapy, surgery, radiation, and hormonal therapy. The cases suffering from mild, moderate, and severe periodontal disease were 7 (23.33 %), 2 (6.66%), and 21 (70%), respectively. Conclusion: The clinical signs, histopathological, IHC, and occurrence of periodontal disease in 30 women with breast cancer were documented in this study. The authors recommend further studies on breast cancer to support its early diagnosis and prevention strategies.

A Single Center Study of Genes Involved in Synchronous and Metachronous Multiple Early-Stage Gastric Cancers in Japanese Patients with Current or Former Helicobacter pylori Infection

Background: This study aimed to perform a comprehensive gene expression analysis in patients with early-stage gastric cancer (EGC) to identify gene expression profiles specific to gastric cancer (GC) lesions. Methods: Biopsy specimens were collected from one EGC lesion and three background mucosal areas of patients scheduled for endoscopic submucosal dissection (ESD). Lesion-specific gene profiles in these four biopsies were analyzed using DNA microarrays. Patients with concurrent EGCs at the time of an ESD or a history of GC were classified into the multiple GC group (n = 26), while those without such histories were assigned to the single GC group (n = 74). Results: After excluding patients with heterogeneous factors, 55 patients were analyzed. Twenty-one differential genes exhibiting distinct mean expression profiles stratified by background gastric mucosa were extracted between the single and multiple GC groups. A scoring system constructed using these genes to calculate the weighted expression values for each patient, with an optimal cutoff value of −2.574, yielded a sensitivity and specificity of 85.7%. Conclusions: This study identified the different gene expression profiles between synchronous and metachronous multiple GCs and single GCs in patients with EGC. The developed scoring system has potential to distinguish between single and multiple GCs.

Transformer-Based Explainable Model for Breast Cancer Lesion Segmentation

Breast cancer is one of the most prevalent cancers among women, with early detection playing a critical role in improving survival rates. This study introduces a novel transformer-based explainable model for breast cancer lesion segmentation (TEBLS), aimed at enhancing the accuracy and interpretability of breast cancer lesion segmentation in medical imaging. TEBLS integrates a multi-scale information fusion approach with a hierarchical vision transformer, capturing both local and global features by leveraging the self-attention mechanism. This model addresses the limitations of existing segmentation methods, such as the inability to effectively capture long-range dependencies and fine-grained semantic information. Additionally, TEBLS incorporates visualization techniques to provide insights into the segmentation process, enhancing the model’s interpretability for clinical use. Experiments demonstrate that TEBLS outperforms traditional and existing deep learning-based methods in segmenting complex breast cancer lesions with variations in size, shape, and texture, achieving a mean DSC of 81.86% and a mean AUC of 97.72% on the CBIS-DDSM test set. Our model not only improves segmentation accuracy but also offers a more explainable framework, which has the potential to be used in clinical settings.

Analysis of Risk Factors for Gastric Cancer and Precancerous Lesions: A Case-Control Study.

To investigate the correlation between gastric xanthoma (GX) and precancerous lesions (PCL) and gastric cancer (GC), and to explore other potential risk factors for PCL and GC in northwest China. A case-control study was conducted from September 2022 to September 2023 at Xijing Hospital, Air Force Medical University (Xi'an, Shaanxi Province, China). The patients who underwent gastroscopy were enrolled and divided into the chronic gastritis (CG) group (n = 423), PCL group (n = 422), and GC group (n = 415). The variables were selected through univariate analysis, including demographic information, dietary habits, lifestyle, gastroscopic findings, and Helicobacter pylori (H. pylori) infection. Multivariate logistic regression analysis was performed to analyze the factors associated with PCL and GC, and odds ratio (OR) and 95% confidence interval (CI) were calculated. GX was more prevalent in the PCL group (14.93%) and the GC group (19.76%) than in the CG group (6.15%). Multivariate analysis revealed that age ≥ 50 years, male gender, rural residence, H. pylori infection, family history of GC, GX, and hypertension were independent risk factors for GC and PCL. Furthermore, a diet high in salt and spice, coupled with daily intake of less than 100 g of fresh fruits, might be associated with the occurrence of GC. Age ≥ 50 years, male gender, rural residence, family history of GC and H. pylori infection, presence of GX, and a history of hypertension may be risk factors for PCL and GC.

Evaluation of Artificial Intelligence: Computer-aided Detection of Colorectal Polyps

Colonoscopy is the gold standard for screening cancer and precancerous lesions in the large intestine. Recently, remarkable advances in artificial intelligence (AI) have led to the development of various computer-aided detection (CADe) systems for colonoscopy. This study aimed to evaluate the usefulness of AI for colonoscopy using CAD-EYEⓇ (Fujifilm, Tokyo, Japan) to calculate the adenoma miss rate (AMR). This randomized, open-label, single-center, tandem study was conducted at Fukuoka University Chikushi Hospital from February 2022 to November 2022. Patients were randomly assigned to the CADe or non-CADe group. Immediately after the completion of the first endoscopy by an endoscopist, a new endoscopist was assigned to perform the second endoscopy. As a result, different endoscopists performed the examinations in a tandem fashion. A missed lesion was defined as a newly detected colorectal polyp by the second endoscopy. Finally, the AMR was compared between the two groups. The study population comprised 48 patients in the CADe group and 46 patients in the non-CADe group. The AMR was 17.4% in the CADe group and 30.3% in the non-CADe group. Therefore, the AMR in the CADe group was statistically significantly lower than that in the non-CADe group (P=0.009). The application of CAD-EYEⓇ to colonoscopy reduced the AMR. Overall, CAD-EYEⓇ might be useful for reducing missed colorectal adenomas.

Hereditary colorectal cancer syndromes and inflammatory bowel disease: results from a registry-based study

PurposeIn this study, we investigated the progression of high-grade dysplasia (HGD)/CRC in patients with hereditary colorectal cancer syndromes (HCSS) and concomitant inflammatory bowel diseases (IBDs).MethodsWe described the natural history of a series of patients with confirmed diagnosis of hereditary colorectal cancer syndromes (HCCSs) and concomitant IBDs who were referred to the Hereditary Digestive Tumors Registry at the Fondazione IRCCS Istituto Nazionale dei Tumori of Milan.ResultsBetween January 1989 and April 2024, among 450 patients with APC-associated polyposis and 1050 patients with Lynch syndrome (LS), we identified six patients with IBDs (five with UC, one with ileal penetrating CD) and concomitant HCCSs (five with LS, one with APC-associated polyposis). Three patients developed CRC (two patients with stage IIA, and one with stage IIIA); in one patient, CRC occurred over a median follow-up of 12 months after IBD diagnosis, while in two, both conditions were diagnosed simultaneously. The median age at initial diagnosis of CRC was 33 years (range 27–41). Five patients (83.3%) underwent surgical procedures (three colonic resections for carcinoma and two for other reasons). Most of them progressed to precancerous or cancerous colonic lesions at a young age. Notably, all patients with CRC had a diagnosis of UC.ConclusionIBD patients with coexistent HCCSs can develop early CRC onset at an advanced stage. These patients should be always referred to tertiary referral centers for strict surveillance programs and early surgical management of advanced colorectal neoplastic lesions. Noninvasive biomarkers of neoplastic changes are advocated to further improve the management of IBD patients with HCCSs.

Measures to prevent esophageal stenosis are necessary after endoscopic submucosal dissection for early esophageal cancer lesions with a circumferential ratio of 75%-99%: a retrospective case analysis.

Endoscopic submucosal dissection (ESD) is currently one of the most curative treatments for early esophageal cancer. We conducted a retrospective case analysis to identify the characteristics of early esophageal cancer that indicate esophageal stenosis prevention measures. Our aim was to provide a reference for clinical decision-making. Six hundred and fifty-four patients with early esophageal cancer treated with ESD were admitted to our hospital between January 2011 and December 2018.Clinical information such as patients' demographic characteristics, lesion features, preventive measures if any, and complications of esophageal stenosis after ESD were collected from the hospital information system. The data were statistically analysed by SPSS software (version 23.0). 1. Seventy-nine patients with early esophageal cancer suffered from esophageal stenosis after ESD. The median time from undergoing ESD to the first occurrence of stenosis was 27 (17-43) days. Specifically, among the 79 cases, 47 of them experienced stenosis within one month after ESD, and 23 cases experienced stenosis between 1 and 2 months after ESD, and 9 cases experienced stenosis more than 2 months after the operation.2. Taking preventive measures significantly reduced overall esophageal stenosis incidence in patients with early esophageal cancer with lesion circumferential ratio of 75%-99% (P< 0.05).3. Among patients with early esophageal cancer with 75%-99% circumferential proportion of lesions, the risk of esophageal stenosis within 2 months without prevention measures was 2.617(95% CI, 1.057-6.479) times higher than that with prevention measures. It is necessary to take measures to prevent esophageal stenosis after ESD for early esophageal cancer lesions with a circumferential ratio of 75%-99%.

Effects of data-driven respiratory gating on visualization and quantification of breast and upper abdominal cancers in FDG PET/CT examinations.

Data-driven respiratory gating (DDG) has recently been introduced to improve image quality in the PET portion of PET/CT examinations. The latest DDG system does not require any external equipment or extended examination time. In this study, we investigated the effects of the new DDG system on the visualization and quantification of breast and upper abdominal cancers, comparing the results with those obtained using the standard free-breathing (STD) PET protocol. A total of 223 cancer lesions (138 breast and 85 upper abdominal) evaluated with FDG PET/CT were included in this study. PET images were reconstructed using the STD and DDG algorithms. Lesion blurring and conspicuity were each visually graded on a three-point scale. The longest diameter (LD), SUVmax, and metabolic tumor volume (MTV) of the lesions were used for quantitative analysis. % change in SUVmax or MTV was calculated from the metrics in STD and DDG images. Fifty-six texture features (TFs) were also evaluated. Visual scores and quantitative metrics were compared between STD and DDG images. % change in SUVmax or MTV was compared in the lesion location groups or in the high and low groups based on LD, SUVmax, or MTV in STD images. Visual scores for lesion blurring and conspicuity were both significantly higher in DDG than in STD PET images. SUVmax and MTV were significantly higher and lower, respectively, in DDG than in STD images. An increase in SUVmax and a decrease in MTV were observed in 96% and 86% of all lesions, respectively. Group analysis revealed that % change in SUVmax was greater in the upper abdominal than the breast lesions and % change in MTV was greater in the high LD and high MTV groups than in the lowLD and lowMTV groups, respectively. Quantitative changes in TFs were observed between STD and DDG images for most of the features. This study demonstrated that DDG improved visualization and quantification of breast and upper abdominal cancers in FDG PET/CT examinations. DDG PET images exhibited an increase in SUVmax, a decrease in MTV, and changes in TFs.

Radiomics-Guided Precision Radiation Therapy in Head and Neck Squamous Cell Carcinoma

Radiomics and deep learning computer vision algorithms can extract clinically relevant information from medical images, providing valuable insights for accurate diagnosis of cancerous lesions, tumor differentiation and molecular subtyping, prediction of treatment response, and prognostication of long-term outcomes. In head and neck squamous cell carcinoma (HNSCC), growing evidence supports the potential role of radiomics and deep learning models in predicting treatment response, long-term outcomes, and treatment complications following radiation therapy. This is especially important given the pivotal role of radiotherapy in early-stage and locally advanced HNSCC, as well as in post-operative and concomitant chemoradiotherapy. In this article, we summarize recent studies highlighting the role of radiomics in predicting early post-radiotherapy response, locoregional recurrence, survival outcomes, and treatment-related complications. Radiomics-guided tools have the potential to personalize HNSCC radiation treatment by identifying low-risk patients who may benefit from de-intensified therapy and high-risk individuals who require more aggressive treatment strategies.

Patient satisfaction with radio-frequency identification (RFID) tag localization compared with wire localization for nonpalpable breast lesions: the RFID trial

BackgroundMost breast cancers are detected at an early stage in which case conservative surgery is indicated. An accurate preoperative localization technique is essential for conservative surgery of non-palpable breast lesions. Currently, the gold standard technique is wire localization (WL). However, this technique has well-known drawbacks. Several wire-free techniques have been developed to overcome these drawbacks; one technique is localisation by Radiofrequency Identification (RFID). The purpose of this clinical trial was to assess the superiority of RFID tags (HOLOGIC) in terms of patient satisfaction, over wire localization of non-palpable breast lesions.MethodsThis was a single-centre, prospective, controlled and non-interventional trial. Patients were followed from their inclusion at the time of the preoperative consultation to the postoperative consultation, one month after surgery. Data on anxiety and satisfaction was collected from patients and clinicians using questionnaires, and clinical data was collected from the medical files. The primary outcome was the patients’ satisfaction scores, assessed using a visual analogue scale.ResultsEighty patients were sequentially enrolled in two groups: the wire group (n = 40) and the RFID group (n = 40). One patient from the RFID group was excluded from the analysis because of a substantial migration during deployment. On a 10-point Visual Analogue Scale, the patients’ median satisfaction score was 9.8 (IQR = 1.32) for the wire group and 10 (IQR = 0.07) for the RFID group (p < 0.001). A reduction in pain between device insertion and surgery was observed in the RFID group (p = 0.009). The median placement time was shorter in the RFID group (15 min, IQR = 6) than in the wire group (20 min, IQR = 30) (p = 0.01).ConclusionOur results show a statistically significant difference in median patient satisfaction score with the localization of non-palpable breast cancer lesions using RFID tags compared to the use of the WL. Although our results did not show clinically significant outcomes in terms of satisfaction, RFID tags are a reliable alternative to WL and simplify the organization of patients’ healthcare trajectories.Trial registrationClinicalTrials.gov ID; NCT04750889 registered on February 11, 2021. https://clinicaltrials.gov/ct2/show/NCT04750889?term=rfid&draw=2&rank=1

Diagnostic Certainty in Characterizing Liver Lesions in Rectal Cancer: Abbreviated Liver MRI versus CT.

Early diagnosis of metastases is crucial but routine staging with contrast-enhanced multidetector computed tomography (ceMDCT) is suboptimal. A total of 20% will have indeterminate or too small to characterize (TSTC) liver lesions on CT, requiring formal characterization by magnetic resonance imaging (MRI). This UK cross-sectional study reports our experience undertaking routine abbreviated liver MRI (MRI). A total of 99 patients with rectal cancer had ceMDCT, abbreviated liver MRI, and rectal MRI at diagnosis. Liver imaging was scored for liver metastases, benign or indeterminate/TSTC lesions on a per patient basis. Primary rectal cancer was risk scored on MRI. A total of 42/99 (42%) had liver lesion(s) on ceMDCT versus 55/99 (56%) by MRI, and 46/99 (46%) had high-risk rectal cancer. ceMDCT showed 5 patients with liver metastases, 14 with benign lesions, and 23 with indeterminate/TSTC lesions. MRI showed 6 with liver metastases, 45 with benign lesions, and 4 with indeterminate/TSTC lesions. All liver metastases were in high-risk rectal cancer, OR 17.18 (p = 0.06), with 12.5% conversion rate of TSTC lesions to metastases in high-risk rectal cancer and 0% in low-risk rectal cancer. Diagnostic certainty of the liver findings was achieved in 93% of patients by MRI compared with 45% by ceMDCT (p < 0.0001). Abbreviated liver MRI diagnosed fewer indeterminate/TSTC lesions and provided greater diagnostic certainty than ceMDCT, p < 0.0001. High-risk rectal cancer is associated with a higher conversation rate of TSTC lesions to metastases than low-risk rectal cancers. Risk stratified; routine abbreviated liver MRI sequences should be investigated as part of the patient pathway for high-risk rectal cancer.

Laryngeal cancer diagnosis based on improved YOLOv8 algorithm

Abstract Laryngeal cancer is the most common malignant tumor in the head and neck region. The larynx, also known as the voice box, plays a crucial role in voice production and ventilation. Enhancing the diagnosis and treatment of laryngeal cancer can significantly improve patients’ prognosis and quality of life. Artificial intelligence (AI) technology shows promise as a valuable tool for diagnosing laryngeal cancer. It not only reduces the burden on endoscopists in interpreting images but also performs screening and diagnosis efficiently and accurately. However, due to the hidden and diverse nature of laryngeal cancer lesions, achieving accuracy and efficiency in AI-based diagnosis presents poses challenges. This study introduces an improved YOLOv8 algorithm named MSEC-YOLO, specifically designed for the detection and classification tasks of laryngeal cancer in endoscopic images. A novel multiscale enhanced convolution module has been introduced to improve the model’s feature extraction capabilities for small-sized targets. Additionally, a tiny fully convolutional network architecture has been employed, reducing the number of model parameters and computational costs while maintaining or enhancing performance, which is crucial for real-time medical imaging analysis. The experiments utilized a real-world endoscopic image dataset from the hospital, and the results indicated that MSEC-YOLO outperformed the original YOLOv8 model and its multi-kernel versions across multiple evaluation metrics, especially in critical categories such as malignant tumors, polyps, and papillomas, demonstrating extremely high precision and recall rates.