Diagnosis Of Tumors Research Articles

Key updates and interpretation of the ninth version of AJCC staging system for neuroendocrine tumors of the stomach

The cancer staging system of the American Joint Committee on Cancer (AJCC) is the most widely used clinical basis for tumor staging. In October 2023, AJCC released the staging system (ninth version) for the neuroendocrine tumors of stomach (NET), which has been implemented in January 2024. The ninth version of NET staging system mainly updated the histopathologic classification, diagnosis and staging methods, clinical and pathological staging, prognosis grade, tumor and non-tumor prognostic features. The update and implementation of the staging system provide a more detailed reference for the accurate diagnosis, staging and precise treatment of gastric neuroendocrine tumors. Moreover, it is convenient for clinicians to carry out clinical practice. The purpose of our article is to provide a high-level overview of the major changes in AJCC staging system (version 9) for gastric NET based on the latest evidence-based medical research.

Leveraging interdisciplinary management in people with HIV and lymphoid neoplasms.

Drug-drug interactions between antiretroviral treatment (ART) and cytostatics may have a negative impact in the prognosis of people with HIV (PWH) and cancer. The objective of this study is to evaluate the impact of the implementation of interdisciplinary management and the type of ART in PWH diagnosed with lymphoid neoplasms. This is a multicentric, retrospective observational cohort study including PWH diagnosed with lymphoid neoplasm who started first-line chemotherapy between 2008 and 2020. Demographic, clinical and therapeutic variables were obtained from the electronic medical records and associated with 5-year progression-free survival (PFS) and overall survival (OS) using Cox proportional hazard models. A total of 118 individuals were included. Boosted ART was being used in 55 (46.6%) cases at the time of neoplasm diagnosis. The Infectious Diseases or the Pharmacy Department was consulted before starting chemotherapy in 79/118 (66.9%) cases. Interdisciplinary management resulted in fewer subjects taking boosted ART (17.7% versus 71.8%, P < 0.001) and more subjects using unboosted integrase strand transfer inhibitor-based ART (74.7% versus 7.7%, P < 0.001). The use of boosted ART with chemotherapy was associated with worse 5-year PFS (P = 0.003) and 5-year OS (P = 0.016). There was a trend towards better 5-year PFS and OS when interdisciplinary management was implemented, with significant differences for individuals receiving boosted ART at neoplasm diagnosis (P = 0.0246 and P = 0.0329, respectively). Our findings underscore the significant impact of the type of ART on the prognosis of PWH undergoing chemotherapy. Encouraging collaborative management between oncologists, pharmacists and HIV teams for these patients enhances PFS and OS rates.

Endoscopic ultrasound-guided bite-on-bite biopsy and endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of gastric tumors with negative malignant endoscopy biopsies: a retrospective cohort study.

Specific types of gastric tumors, including gastric linitis plastica and lymphoma, may cause extensive deep-layer infiltration, impeding an accurate diagnosis with endoscopic biopsy. This study aims to evaluate the efficacy of endoscopic ultrasound (EUS)-guided bite-on-bite biopsy and EUS-guided fine-needle aspiration (EUS-FNA) in diagnosing gastric malignancies with negative endoscopic biopsies. We retrospectively analyzed suspicious malignant gastric lesion cases in our hospital from October 2017 to August 2023. Clinical manifestations, radiographical examinations, endoscopic examinations, histopathological results, and therapeutic strategies were recorded and analyzed. Forty malignant gastric tumor cases with negative endoscopic biopsies were incorporated into our study. EUS-guided bite-on-bite biopsy was performed in 16 cases exclusively, whereas 17 patients received EUS-FNA exclusively, and seven patients underwent both simultaneously. Among the 23 patients who received the EUS-guided bite-on-bite biopsy, 22 (95.7%) were diagnosed with malignancies. Among the 24 patients who received EUS-FNA, a total of 19 cases with malignancies (79.2%) were confirmed by EUS-FNA (p = 0.11): 13 gastric adenocarcinomas, five metastatic malignancies, and one malignant stromal tumor. No adverse events were observed in any of the cases. EUS-guided bite-on-bite biopsy and EUS-FNA possess their advantages and disadvantages. EUS-guided bite-on-bite biopsy could serve as a reliable diagnostic method for shallow lesions with negative malignant endoscopic biopsies.

Optimizing the Topology of Convolutional Neural Network (CNN) and Artificial Neural Network (ANN) for Brain Tumor diagnosis (BTD) through MRIs

The use of MRI analysis for BTD and tumor type detection has considerable importance within the domain of machine vision. Numerous methodologies have been proposed to address this issue, and significant progress has been achieved in this domain via the use of deep learning (DL) approaches. While the majority of offered approaches using artificial neural networks (ANNs) and deep neural networks (DNNs) demonstrate satisfactory performance in Bayesian Tree Descent (BTD), none of these research studies can ensure the optimality of the employed learning model structure. Put simply, there is room for improvement in the efficiency of these learning models in BTD. This research introduces a novel approach for optimizing the configuration of Convolutional Neural Networks (CNNs) and Artificial Neural Networks (ANNs) to address the BTD issue. The suggested approach employs Convolutional Neural Networks (CNN) for the purpose of segmenting brain MRIs. The model's configurable hyper-parameters are tuned using a genetic algorithm (GA). The Multi-Linear Principal Component Analysis (MPCA) is used to decrease the dimensionality of the segmented features in the pictures after they have been segmented. Ultimately, the segmentation procedure is executed using an Artificial Neural Network (ANN). In this artificial neural network (ANN), the genetic algorithm (GA) sets the ideal number of neurons in the hidden layer and the appropriate weight vector. The effectiveness of the suggested approach was assessed by utilizing the BRATS2014 and BTD20 databases. The results indicate that the proposed method can classify samples from these two databases with an average accuracy of 98.6% and 99.1%, respectively, which represents an accuracy improvement of at least 1.1% over the preceding methods.

Design of encoded graphene-gold metasurface-based circular ring and square sensors for brain tumor detection and optimization using XGBoost algorithm

This study introduces a circular ring and square metasurfaces-based sensor employing graphene and gold layers for enhanced brain tumor detection. The sensor architecture includes dual graphene circular metasurfaces and a gold square resonator layer on a silicon dioxide substrate. A comprehensive parametric investigation explores the influence of geometric parameters and graphene chemical potential on sensor performance. The sensor achieves a remarkable sensitivity of 769 GHzRIU−1, a high-quality factor of 6.514, a low detection limit of 0.182 RIU, and an FOM of 1.148RIU−1. Electric field intensity analysis identifies optimal transmission frequencies. By employing the XGBoost regressor, the analysis significantly reduces simulation time and resource consumption by at least 80 %. Simulation validation confirms that despite 80 % reduction in simulation time, high prediction accuracy remains achievable, with an impressive R2 score ranging from 0.9 to 1. The proposed sensor presents a promising non-invasive approach for early brain tumor diagnosis, with potential applications in biomedical imaging and other related fields.

The impact of V-flow on preoperative diagnosis of thyroid tumors: individually and as part of multimodal sonographic imaging.

V-flow is a dynamic ultrasound technique that visualizes perfusion patterns by displaying dynamic arrows that change in response to the flow of erythrocytes. Furthermore, it provides quantitative values for the maximum and mean velocity of blood flow as well as a percentage value for turbulence. The aim was to enhance the preoperative diagnostic accuracy of thyroid lesions by combining V-flow with established ultrasound modes.B-mode, CCDS, elastography, CEUS, and V-flow were performed on 101 patients. After the ultrasound examination, every nodule was confirmed as benign or malignant via histopathology. The Kruskal-Wallis test, ROC curve, and binary logistic regression were used for the statistical analysis.93 benign regressive thyroid nodules and 8 carcinomas were included in this study. The average mean velocity value for benign lesions was measured at 19.5 cm/s and at 10.7 cm/s for malignant lesions (p = 0.039). The average turbulence percentage was 26.1% for benign nodules and 46.7% for carcinomas (p = 0.016). Carcinomas exhibited a slower and more turbulent perfusion pattern compared to benign tumors. A V-flow-centered system achieves a sensitivity of 100.0% and a specificity of 84.9% in predicting malignancy. This system could have reduced the number of unnecessary thyroid surgeries for benign lesions in our patient group by 70%.The capillary perfusion of thyroid nodules represents a significant indicator of its status. By analyzing the velocity and turbulence level of microvascular blood flow, V-flow offers promising prospects for accurately distinguishing between benign and malignant thyroid lesions. When integrated into a comprehensive multimodal sonographic imaging approach, V-flow further enhances diagnostic accuracy. · V-flow allows for qualitative and quantitative analysis of microvascular perfusion. · Malignant tumors are associated with slower and more turbulent microvascular hemodynamics. · Combining V-flow with other ultrasound modes eases the diagnosis of thyroid carcinomas. · Brandenstein MK, Zhang L, Scharf G et al. The impact of V-flow on preoperative diagnosis of thyroid tumors: individually and as part of multimodal sonographic imaging. Fortschr Röntgenstr 2024; DOI 10.1055/a-2350-0107.

A "Dual-Key-and-Lock" MRI Contrast Agent with T1-T2 Switchable Function for Accurate Diagnosis of Tumors.

Extremely small iron oxide nanoparticle (ESIONP)-based stimuli-responsive switchable MRI contrast agents (CAs) show great promise for accurate detection of tumors due to their outstanding advantages of high specificity and low background signal. However, currently developed ESIONP-based switchable CAs often suffer single-biomarker-induced responses, which lack absolute specificity to pathological tissues, potentially diminishing diagnostic accuracy. In this study, weak acidity and hypoxia, two of the most remarkable characteristics of tumors, are introduced as dual biomarker stimuli to construct an ESIONP-based switchable MRI CA (DKL-CA), with its signal switch controlled by a "dual-key-and-lock" strategy. Only when DKL-CA is exposed to a coexisting weakly acidic and hypoxic environment can monodispersed ESIONPs form nanoclusters, thereby realizing a switch from the T1 to T2 contrast. Moreover, DKL-CA exhibits favorable biosafety and the capacity for precise tumor diagnosis in tumor-bearing mice. Overall, DKL-CA paves the way for designing highly accurate ESIONP-based MRI CAs for tumor diagnosis.

Current status of endoscopic ultrasound in the diagnosis of intraductal papillary mucinous neoplasms.

The new Kyoto guidelines for the management of intraductal papillary mucinous neoplasm (IPMN) provide evidence-based recommendations for the diagnosis and treatment of IPMN. Endoscopic ultrasonography (EUS) is a diagnostic modality with a high spatial resolution that allows detailed observation and obtaining cyst fluid or tissue samples via EUS-guided fine needle aspiration (EUS-FNA). Currently, EUS is an indispensable examination method for the diagnosis of pancreatic diseases. On the other hand, there have been concerns that EUS imaging tends to be highly operator-dependent, and may lack objectivity. Previous guidelines have assigned EUS as an option for patients with worrisome features. However, recent reports indicate that the sensitivity of EUS for the diagnosis of mural nodules (MNs) is more than 90%, comparable or superior to that of contrast-enhanced computed tomography or magnetic resonance cholangiopancreatography. The specific advantages of EUS in the diagnosis of IPMN are: (1) high spatial resolution imaging for the diagnosis of MNs, (2) contrast-enhanced EUS for differentiation of intra-cystic MNs from mucous clots, and (3) pathological diagnosis using EUS-FNA and differential diagnosis of a pancreatic cystic tumor by cystic fluid analysis. In order to utilize EUS in the diagnosis of IPMN, endoscopists are required to have the skills to provide sufficiently objective imaging findings.

Diffuse, bilateral intraventricular spread of an oligodendroglioma in a Boxer dog

AbstractA case of a high‐grade oligodendroglioma in a boxer dog is presented. Using magnetic resonance imaging, a parenchymal lesion was noted entering into the ventrocaudal, right lateral ventricle. Magnetic resonance imaging showed the mass had extensive, contiguous spread rostrally through the lateral ventricles, and caudally into the third and fourth ventricles, and central canal. This was confirmed with histopathology. This degree of invasion in the ventricles by an oligodendroglioma has not been reported and indicates that oligodendrogliomas should be included as a differential diagnosis for intraventricular tumours with bilateral, contiguous invasion of the ventricular system.

Biomarkers in Cutaneous Keratinocyte Carcinomas.

Skin cancer is the most common cancer type in the USA, with over fivemillion annually treated cases and one in five Americans predicted to develop the disease by the age of 70. Skin cancer can be classified as melanoma or non-melanoma (NMSC), the latter including basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC). Development of BCC and SCC is impacted by environmental, behavioral, and genetic risk factors and the incidence is on the rise, with the associated number of deaths surpassing those caused by melanoma, according to recent reports. Substantial morbidity is related to both BCC and SCC, including disfigurement, loss of function, and chronic pain, driving high treatment costs, and representing a heavy financial burden to patients and healthcare systems worldwide. Clinical presentations of BCC and SCC can be diverse, sometimes carrying considerable phenotypic similarities to benign lesions, and underscoring the need for the development of disease-specific biomarkers. Skin biomarker profiling plays an important role in deeper disease understanding, as well as in guiding clinical diagnosis and patient management, prompting the use of both invasive and non-invasive tools to evaluate specific biomarkers. In this work, we review the known and emerging biomarkers of BCC and SCC, with a focus on molecular and histologic biomarkers relevant for aspects of patient management, including prevention/risk assessments, tumor diagnosis, and therapy selection.

First-in-Human Evaluation of [18F]FDOPA Produced by Organo-Photoredox Reactions.

Photoredox is a powerful synthetic tool in organic chemistry and has been widely used in various fields, including nuclear medicine and molecular imaging. In particular, acridinium-based organophotoredox radiolabeling has significantly impacted the production and discovery of positron emission tomography (PET) agents. Despite their extensive use in preclinical research, no PET agents synthesized by acridinium photoredox labeling have been tested in humans. [18F]FDOPA is clinically used for tumor diagnosis and the evaluation of neuropsychiatric disorders, but its application is limited by complex synthesis methods, the need for expensive modules, and/or the high cost of consumable materials/cassettes. In this report, we integrated a photoredox labeling unit with an automated module and produced [18F]FDOPA for human study. This research not only represents the first human study of a PET agent generated by acridinium-based organophotoredox reactions but also demonstrates the safety of this novel labeling method, serving as a milestone/reference for the clinical translation of other PET agents generated by this technique in the future.

Metal-Coordinated Polydopamine Structures for Tumor Imaging and Therapy.

Meticulously engineered nanomaterials achieve significant advances in the diagnosis and therapy of solid tumors by improving tumor delivery efficiency; and thereby, enhancing imaging and therapeutic efficacy. Currently, polydopamine (PDA) attracts widespread attention because of its biocompatibility, simplicity of preparation, abundant surface groups, and high photothermal conversion efficiency, which can be applied in drug delivery, photothermal therapy, theranostics, and other nanomedicine fields. Inspired by PDA structures that are rich in catechol and amino functional groups that can coordinate with various metal ions, which have charming qualities and characteristics, metal-coordinated PDA structures are exploited for tumor theranostics, but are not thoroughly summarized. Herein, this review summarizes the recent progress in the fabrication of metal-coordinated PDA structures and their availabilities in tumor imaging and therapy, with further in-depth discussion of the challenges and future perspectives of metal-coordinated PDA structures, with the aim that this systematic review can promote interdisciplinary intersections and provide inspiration for the further growth and clinical translation of PDA materials.

A paradigm shift in diagnosis and treatment innovation for mucinous cystic neoplasms of the liver

This study comprehensively explores the clinical characteristics, diagnostic approaches, and treatment methods for liver mucinous cystic neoplasms (MCN). A retrospective analysis was conducted on seven individuals diagnosed with MCN, admitted to the Fifth Medical Center of the PLA General Hospital between October 2016 and May 2023. Preoperative AFP was negative, while CA19-9 was elevated in two cases. Surgical resection was performed for all patients. The patients showed favorable postoperative recovery. Follow-up revealed an excellent overall survival rate, except for one case of invasive carcinoma resulting in tumor recurrence and metastasis 6 months after surgery. MCN poses a diagnostic challenge due to the absence of distinct clinical and radiological features, leading to potential misdiagnosis and inappropriate treatment. Patients with suspected liver cystic diseases should consider the possibility of MCN. Surgical resection has proven to be a practical approach with satisfactory therapeutic outcomes.

A Novel Fluorescent Probe for Nitroreductase Detection and Imaging of cancer Cells under Hypoxia Conditions.

Nitroreductase (NTR) is to be pivotal in the biodegradation of nitroaromatics. NTR is produced in tumor tissues under hypoxic conditions, which is one of the markers for early tumor diagnosis. In this study, a novel probe FD-NTR was developed for NTR detection. Probe FD-NTR can exhibit a specific reaction with NTR in the presence of NADH. The probe displayed satisfactory selectivity and sensitivity towards NTR with a calculated detection limit of 12 ng/mL. Under the conditions of low cytotoxic hypoxia, the FD-NTR probe has shown successful application in imaging both MCF-7 cells and tumor tissues, which indicated that the FD-NTR probe holds promising application prospects for detecting NTR in tumors.

Pancreatic neuroendocrine tumor with abundant mitochondria.

A 40-year-old woman presented with dull, boring periumbilical region pain radiating to the back and vomiting for 1 year. Magnetic resonance cholangiopancreatography detected a polypoid growth in the ampullary region. The patient underwent Whipple's procedure. The specimen revealed a 4.9 × 4.5 × 3.7 cm tumor arising from the pancreas, abutting the posterior pancreatic surface and infiltrating the terminal common bile duct and the ampulla. Microscopic examination showed a pancreatic tumor composed of neuroendocrine cells. In addition, many large foci showing solid sheets of oncocytic cells with abundant granular eosinophilic cytoplasm were observed. Immunohistochemistry studies revealed positivity for synaptophysin, chromogranin, and Ki67 index above 70%. A diagnosis of oncocytic neuroendocrine tumor of Grade 3 was made. In electron microscopy, oncocytic cells showed abundant mitochondria dispersed throughout the cytoplasm. Oncocytic pancreatic neuroendocrine neoplasms are uncommon and can be diagnosed only on histopathological examination. These tumors tend to show a malignant behavior.

Nuclear medicine approaches in the diagnosis and treatment of neuroendocrine neoplasms

Despite, or perhaps because of the rarity of neuroendocrine neoplasms, the diagnosis and treatment of these malignancies is of particular importance. Nuclear medicine can make an important contribution to this challenge. It offers the most sensitive and specific imaging of these tumor entities and can be helpful in treatment due to the radiotherapeutic drugs that have recently been approved. This theragnostic (fusion of therapeutic and diagnostic) concept is based on the frequent overexpression of somatostatin receptors on neuroendocrine tumor cells.Using diagnostic and therapeutic pharmaceuticals based on analogues from somatostatin, most applications from the nuclear medicine are successful, an additional therapeutic method is SIRT, also known as TARE, in which the hypervascularization of NEN-metastases is used as a therapeutic target.

Older Age as a Worrisome Feature in Patients With Intraductal Papillary Mucinous Neoplasms: a Long-Term Surveillance Study.

Aging has been implicated in the development of various cancer types. No study has specifically investigated age at the diagnosis of intraductal papillary mucinous neoplasms (IPMNs) in relation to the long-term risk of pancreatic carcinogenesis. Within a prospective cohort of 4,104 patients diagnosed with pancreatic cysts, we identified 3,142 IPMN patients and examined an association of age at IPMN diagnosis with the incidence of pancreatic carcinoma. Utilizing the multivariable competing-risks proportional hazards regression model, we estimated subdistribution hazard ratios (SHRs) and 95% confidence intervals (CIs) for pancreatic carcinoma incidence according to age at IPMN diagnosis. During 22,187 person-years of follow-up, we documented 130 patients diagnosed with pancreatic carcinoma (64 with IPMN-derived carcinoma and 66 with concomitant ductal adenocarcinoma). Older age at IPMN diagnosis was associated with a higher risk of pancreatic cancer incidence (Ptrend = 0.002). Compared to patients aged < 55 years, patients aged 55-64, 65-74, and ≥ 75 years had adjusted SHRs of 1.80 (95% CI, 0.75-4.32), 2.56 (95% CI, 1.10-5.98), and 3.31 (95% CI, 1.40-7.83), respectively. Patients aged ≥ 70 years had a numerically similar adjusted SHR compared to patients aged < 70 years with worrisome features defined by the international consensus guidelines (1.73 [95% CI, 1.01-2.97] and 1.66 [95% CI, 0.89-3.10], respectively). Older patients with IPMNs were at a higher risk of developing pancreatic carcinoma during surveillance. Surgically fit elderly patients may be good candidates for periodic surveillance aimed at a reduction of pancreatic cancer-related deaths.

The Role of Long Non-Coding RNF144A-AS1 in Cancer Progression.

RNAs transcribing more than 200 nucleotides without encoding proteins are termed long non-coding RNAs (LncRNAs). LncRNAs can be used as decoy molecules, signal molecules, scaffolds, and guide molecules. Long non-coding RNAs can interact with DNA, chromatin-modifying complexes, and transcriptional regulatory proteins, regulating gene expression in the cell nucleus. It is distributed in cytoplasm; they also participate in mRNA degradation and translational regulation via miRNAs, other transcription products, and proteins. They play a significant role in the development of various diseases, including tumors. Cancer seriously threatens human life and health. Regretfully, a great deal of newly diagnosed cancer patients found to have metastasized. RNF144A-AS1, also referred to as GRASLND, was initially recognized for its regulation of chondrogenic differentiation in MSCs. Focusing on RNF144A-AS1, this review summarizes and discusses the latest progress of RNF144A-AS1 in bladder cancer, glioblastoma, papillary renal cell carcinoma, gastric cancer, osteosarcoma, head and neck squamous cell carcinoma, and ovarian cancer. RNF144A-AS1 has good potential in tumor treatment and diagnosis.

A brain tumor diagnosis approach based on deep separable convolutional networks and attention mechanisms

Brain tumors rank among the most lethal types of tumors. Magnetic Resonance Imaging (MRI) technology can clearly display the position, size, and borders of the tumors. Hence, MRI is frequently used in clinical diagnostics to detect brain tumors. Deep learning and related methods have been widely used in computer vision research recently for diagnosis and classification of MRI images of brain tumors. One trend is to achieve better performance by increasing model complexity. However, at the same time, the trainable parameters of the model increases accordingly. Too many parameters will lead to more difficult model training and optimization, and are prone to overfitting. To address this problem, this study constructs a model that incorporates a depthwise separable convolution technique and an attention mechanism to balance model performance and complexity. The model achieves 97.41% accuracy in the brain tumor classification task, which exceeds the 96.72% accuracy of the pre-trained model MobileNetV2, and shows good image classification ability. Future work could test the model's classification results on noisy images and investigate how to optimize the model's generalization ability.

Inflammatory myofibroblastic tumor: an enigma

BackgroundInflammatory myofibroblastic tumor (IMT) of urinary bladder is a rare entity of genitourinary tract which has baffled urologists worldwide. Sign and symptoms are site specific. Usually diagnosed on the basis of immunohistochemistry findings.Case presentation35-year-old female patient presented with gross hematuria since 10 days. Ultrasound revealed a hyperechoic mass from right lateral wall of urinary bladder. Patient was managed with complete transurethral resection of bladder tumor. Histopathology and immunohistochemistry was diagnostic for inflammatory myofibroblastic tumor. 2 months post-surgery patient developed recurrence, following which she was managed with partial cystectomy.ConclusionInflammatory myofibroblastic tumor diagnosis is very challenging because of rarity of the tumor with non-specific presentation, and confirmation is done only by immunohistochemistry. Patients are usually managed with complete resection of tumor with regular follow-up.