This study evaluated the association between percutaneous transthoracic needle biopsy (PTNB) and recurrence in early-stage non-small-cell lung cancer (NSCLC). A retrospective study was conducted to analyze patients with cT1b-2aN0M0 NSCLC who underwent lobectomy between 2009 and 2021. The exclusion criteria ruled out multiple primary lung cancers and bronchoscopic biopsy. Patients were classified into a PTNB group and a non-biopsy group according to whether they underwent preoperative PTNB. Propensity score-matching was applied, and cumulative incidence of recurrence (CIR) was compared. Fine and Gray competing-risk regression was used to evaluate the association between PTNB and recurrence. Subgroup analyses were conducted according to pathologic stage and the presence of high-risk pathologic features. Of 2208 eligible patients, 674 (30.5 %) underwent PTNB, and 1534 (69.5 %) did not. After propensity score-matching, each group included 416 patients with balanced baseline characteristics. In the matched cohort, the 5-year CIR was significantly higher in the PTNB group (21.1 %; 95 % confidence interval [CI], 18.0-26.1 %) than in the non-biopsy group (13.7 %; 95 % CI, 10.2-17.3 %; P < 0.001). In multivariate competing-risk regression analysis, PTNB was independently associated with increased recurrence risk in models incorporating clinical variables alone (subdistribution hazard ratio [SHR], 1.892; 95 % CI, 1.407-2.545; P < 0.001) as well as in models incorporating both clinical and pathologic variables (SHR, 1.851; 95 % CI, 1.375-2.493; P < 0.001). Subgroup analyses demonstrated that the association between PTNB and recurrence persisted regardless of pathologic tumor-node-metastasis (pTNM) stage and the presence of high-risk pathologic features. Preoperative PTNB was associated with an increased risk of recurrence for patients with early-stage NSCLC.

Mucin-producing breast lesions encompass a diverse range of entities with varied morphologies, distinct molecular genetics and different outcomes. Mucocele-like lesions (MLLs) are being increasingly recognised and sampled due to advancements in imaging techniques. These lesions can present with or without epithelial proliferation and atypia, which hold prognostic significance. Diagnosing MLLs on limited core needle biopsy (CNB) samples can be challenging. Mucinous breast carcinoma (MuBC) generally has an excellent prognosis in its pure form. Recent studies indicate that mucin-producing invasive cancers with micropapillary growth pattern, high nuclear grade or HER2 overexpression/amplification may not fare as well as their pure counterparts, suggesting that they should be distinguished from pure MuBCs. Invasive lobular carcinoma with extracellular mucin (ILCEM) is an emerging subtype of ILC characterised by neoplastic cells in cords, nests and trabeculae, often with signet ring morphology, floating in extracellular mucin. This can lead to misdiagnosis as a ductal phenotype due to varied architectural patterns or a MuBC due to the presence of extracellular mucin. This review highlights the spectrum of mucin-producing breast lesions, focusing on the above-mentioned entities along with recent molecular updates, potential mimics and diagnostic pitfalls on CNB specimens. Awareness of these entities, a practical approach to their diagnosis, combined with judicious use of immunohistochemistry, are crucial for accurate diagnosis by pathologists, which is in turn essential for guiding clinical decision making for optimal patient outcomes.

The purpose of this article is to raise awareness among veterinary specialists in the treatment and prevention of fibrosarcoma in dogs, and to provide an example of the effectiveness of treating fibrosarcoma by surgery followed by irradiation of the postoperative area. The patient is an 8-year-old unsterilized female East European Shepherd. The reason for visiting the clinic was a swelling growing in the projection of the frontal bone for 7 months. The diagnostic methods used were X-ray examination, computed tomography, cytological analysis using the fine-needle biopsy method (FNAB), general and biochemical blood tests. Treatment began at the age of 8 years and to this day the animal is being monitored by oncologists and surgeons. A detailed treatment protocol is provided. The article provides a general description of canine fibrosarcoma, describes its types and clinical picture, recommended treatment regimens and prognoses, and provides information on the average life expectancy of dogs with fibrosarcoma with timely and prompt treatment.

Human muscle biopsies are often required to study or diagnose diseases. However, traditional approaches are challenging due to limited sample size, quality, or participant discomfort. Fine-gauge needle biopsies (≥ 14-gauge), present an alternative but may yield insufficient tissue for comprehensive analysis. Ultrasound guidance, coupled with vacuum-assisted, single needle-insertion multiple sampling addresses these challenges. In 19 healthy participants (mean age: 30.1 ± 10 years, 42% male), 2-3 samples were collected from a single needle insertion into the vastus lateralis (VL) and tibialis anterior (TA). Summed VL and TA sample masses averaged 148 ± 38mg and 166 ± 64mg, with dimensions of 15.83 ± 8 × 2.9 ± 0.6mm2 (VL) and 15.07 ± 7 × 3.1 ± 0.9mm2 (TA). VL had a mean fiber cross-sectional area of 4,347 ± 1,931µm2, with 221 ± 86 fibers quantified. Samples were of sufficient size and quality for thorough analyses from a single biopsy procedure, including mitochondrial respirometry, RT-PCR, collagen content, and biomechanical function. Fibers produced typical isometric stress values of 187kPa with a passive modulus of 239kPa (peak) and 79kPa (stress-relaxed). The procedure was well tolerated, with an average immediate pain rating of 1.5 ± 1 (range:0-4, scale: 0-10) and 24-hour follow-up rating of 1.7 ± 1 (range:0-4). This report describes an approach that yields high-quality muscle samples suitable for histological and biochemical analyses while minimizing discomfort.

The spinal accessory nerve is the external terminal division of the 11th cranial nerve which passes postero-inferiorly in the neck, innervating the sternocleidomastoid and trapezius muscles. The spinal accessory nerve is often in the field of view of neck ultrasound imaging, however, can be overlooked and underappreciated during sonographic neck imaging and ultrasound-guided lymph node biopsies. A scoping review of the literature was conducted to assess current knowledge regarding sonographic imaging of the spinal accessory nerve. The authors' sonographic experience and practical sonographic workshops informed the development of a sonographic technique to image this nerve. Iatrogenic injury is a common cause of spinal accessory neuropathy, particularly from needle biopsies of neck lymph nodes and surgery. Ultrasound imaging can effectively demonstrate the extracranial component of the spinal accessory nerve. An appreciation of the anatomy and path of the spinal accessory nerve is important to ensure appropriate sonographic identification of the spinal accessory nerve and ensure it is not in the needle path during ultrasound-guided neck lymph node biopsies. In addition, ultrasound imaging can be used to diagnose spinal accessory nerve injury, pathology and subsequent denervation of the sternocleidomastoid and trapezius muscles which can affect neck and shoulder pain and mobility, negatively impacting daily activities. Awareness of the spinal accessory nerve anatomy and imaging appearances is required when sonographically imaging the neck to identify the spinal accessory nerve, ensuring it is not in the needle path during ultrasound-guided neck biopsies and identifying any potential injury or pathological involvement.

Cancer is one of the global health problems that affects millions of people every year. Biopsies are among the standard methods for detecting and confirming a cancer diagnosis. Performing this study manually poses several challenges due to tissue movement and the difficulty of precisely locating the target, as is often the case in lung biopsies. This study presents the design and implementation of an autonomous image processing algorithm included in a closed-loop controller that drives the activity of a multi-degree-of-freedom (six) robotic manipulator that performs emulated tissue biopsies. A realistic lung motion emulator, based on a two-degree-of-freedom robotic device with a photon emitter (to simulate radiopharmaceutical identification of cancerous tissue), was used to test the proposed automatic biopsy collector. Applying image processing to detect cancer tissue enables the identification of the centroid and tumor boundaries. Using the detected centroid coordinates, the reference trajectory of the end effector (biopsy needle) was automatically determined. A finite-time convergent controller was implemented to guide the robotic manipulator's motion towards the tumor position within a specified time window. The controller was evaluated using a digital twin representation of the entire robotic system and using an experimental device working on the simulated mobile tumor emulator. Evaluation of simulated tumor detection and reference trajectory tracking effectiveness was used to validate the operation of the proposed automatic robotic lung biopsy sampler. The application of the controller allows one to track the position of the emulated tumor with a deviation of 0.52 mm and a settling time of less than 1 s.

Background: The heterogeneous nature of cancer with varying degrees of fat, necrosis, fibrosis, and varying degrees of tissue repair severely impacts the success of acquiring adequate tissue samples during percutaneous image-guided biopsy. Although ultrasound or CT fluoroscopy are used to identify tumor location and thus to guide biopsy needle insertion, these technologies do not provide the necessary resolution to determine tissue composition and enable the selection of the most appropriate location for biopsy specimen extraction. As a result, biopsy must be repeated, leading to significant cost to the health care system. Methods: In this study, we introduce a combined optical imaging/artificial intelligence (OI/AI) methodology for the real-time assessment of tissue morphology at the tip of the biopsy needle, prior to the collection of a biopsy specimen. Addressing a significant clinical challenge, this approach aims to reduce the proportion of biopsy cores-currently as high as 40%-that yield low diagnostic value due to elevated adipose or low tumor content. Our methodology employs micron-scale optical coherence tomography (OCT) imaging to obtain detailed structural tissue information using a minimally invasive needle probe. The OCT images are automatically analyzed using a convolutional neural network (CNN)-driven AI software developed by our team. A U-net style architecture was used to segment regions of tumor from the OCT scans. U-Net is a specialized convolutional neural network (CNN) architecture designed for fast, precise image segmentation, which involves classifying each pixel in an image to outline objects. This streamlined approach shows promise to provide clinicians with real-time results, supporting more accurate and informed decisions regarding biopsy site selection. To evaluate this technology, we conducted a clinical study using a custom-made OCT imager and recorded OCT images from patients diagnosed with liver cancers. Expert OCT interpreters supplied annotated reference images that were used to train a custom AI algorithm. Results: OCT imaging with ~10 mm axial and 20 mm lateral resolution enabled the collection of high-quality images of the tissue. The AI analysis was performed offline. UNet achieved an AUC of ~0.877 on the validation dataset, indicating promising performance for the relatively small data set used to train the model. The AI model matched human interpretations approximately 90% of the time, highlighting its promise for making biopsy procedures both more accurate and more efficient. Conclusions: A novel OCT instrument and AI software were evaluated for assessing tissue composition at the tip of biopsy needle. The OCT instrument produced micron-scale resolution images of the tissue, enabling AI analysis and accurate real-time discrimination of tissue type. This preliminary study demonstrated the clinical potential of this technology for improving biopsy success.

Abstract Background Metastatic prostate cancer tumor seeding within a percutaneous biopsy tract is rare. While reports of tumor seeding following perineal and transrectal prostate biopsies exist, no cases of prostate cancer tumor seeding along a metastatic percutaneous bone biopsy tract detected by prostate specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) have been reported. Case Presentation We describe a rare case of intramuscular and subcutaneous prostate cancer recurrence along and adjacent to the site of a previous percutaneous metastatic rib biopsy tract. The role of PSMA PET/CT in the early detection of such cases is highlighted. In this case, PSMA PET played a crucial role in achieving both early diagnosis and early targeted management, optimizing the oncological outcome for the patient. Conclusion We hope to increase awareness of this rare presentation and emphasize the need for consensus on management approaches when encountering similar cases of prostate cancer tumor seeding in the future.

ABSTRACT Primary breast angiosarcoma (PBA) is an exceptionally rare and aggressive vascular malignancy, accounting for less than 0.04% of all breast cancers. It is characterized by rapid growth, high recurrence rates, and poor prognosis, often leading to diagnostic and therapeutic challenges. We report the case of a 41‐year‐old woman presenting with a rapidly enlarging left breast mass following trauma, initially misdiagnosed as granulomatous mastitis. Multimodal imaging, including ultrasound, contrast‐enhanced ultrasound (CEUS), and magnetic resonance imaging (MRI), revealed features consistent with a vascular tumor, which was confirmed as PBA through histopathological and immunohistochemical analysis. The patient underwent a core needle biopsy followed by mastectomy. This case highlights the importance of advanced imaging techniques and histopathological evaluation in diagnosing PBA, as well as the need for early recognition and surgical intervention to improve outcomes. Further studies are required to establish standardized diagnostic and treatment protocols for this rare malignancy.

Breast cancer poses a significant threat to the health of women globally. To date, clinically invasive needle biopsy may cause cancer metastasis, and noninvasive imaging methods exhibit suboptimal sensitivity. Therefore, developing a highly specific and sensitive diagnostic method for breast cancer detection continues to be a challenge. In this work, a spatially ordered three-input logic gate KK(GGR)-Luc is rationally designed to achieve precise and sensitive breast cancer in vivo imaging. The as-designed KK(GGR)-Luc can sequentially respond to urokinase-type plasminogen activator (uPA), cathepsin B (CTB), and luciferase (fLuc), and consequently, it generates highly specific bioluminescence (BL) signals in the 4T1 cells and tumors. Experimental results showed that the signal intensities of breast cancer treated with KK(GGR)-Luc exceeded those of all negative control groups by 3.5-fold in living cells and 5.0-fold in vivo, respectively. In addition, this spatially ordered three-input logic gate provided a long BL half-life (t1/2 = 117.2 min) in cells, which showed great potential in breast cancer in vivo imaging. We hope that the proposed sequentially activated three-input logic gate will aid in achieving highly precise and sensitive diagnosis of breast cancer in clinic.

Accurate non-invasive differentiation of primary liver cancers, such as hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (iCCA), and combined hepatocellular-cholangiocarcinoma (cHCC-CCA), is crucial for optimal management but challenging due to shared risk factors and overlapping imaging phenotypes. While the Liver Imaging Reporting and Data System LR-M category effectively captures the classic targetoid appearance of large duct type iCCA, the small duct type frequently exhibits HCC-mimicking non-rim arterial phase hyperenhancement and non-peripheral washout, potentially compromising diagnostic specificity. Furthermore, cHCC-CCA presents a formidable diagnostic dilemma, existing on a continuous imaging spectrum that reflects its histologic dominance. This continuous imaging spectrum not only blurs radiologic distinctions but also complicates tissue sampling, limiting the diagnostic accuracy of core needle biopsies and highlighting the risk of misclassification. To enhance diagnostic clarity, this review highlights their key imaging hallmarks: while HCC typically shows non-rim arterial phase hyperenhancement (APHE) and non-peripheral washout, large duct iCCA displays a classic targetoid appearance with rim APHE and progressive central enhancement. Conversely, small duct iCCA often mimics HCC, and cHCC-CCA exhibits a variable spectrum depending on its predominant histologic component. Ultimately, overcoming these diagnostic pitfalls requires a rigorous, multidisciplinary approach that synthesizes imaging findings, serologic tumor markers, and clinical contexts.

Introduction: Occult breast cancer (OBC) is defined as axillary lymph node metastasis without an identifiable primary breast tumor. Although advances in imaging have reduced the incidence of “true” OBC, long-term outcomes extending beyond a decade remain rarely reported. Recent literature has also suggested that a subset of OBC may originate from ectopic breast tissue located within axillary lymph nodes, suggesting biological heterogeneity within this rare entity. Case Presentation: A 54-year-old woman presented with right axillary lymphadenopathy. Comprehensive imaging showed no intramammary lesion, and surgical biopsy confirmed metastatic breast cancer, consistent with OBC. Axillary lymph node dissection revealed seven metastatic nodes (ER 50%, PR 0%, HER2 3+). She received adjuvant chemotherapy and a non-steroidal aromatase inhibitor for ten years without recurrence. Twenty years later, screening mammography identified a new spiculated mass in the ipsilateral breast. Core needle biopsy revealed HER2-positive invasive ductal carcinoma (ER &lt;5%, PR 15%, HER2 3+, MIB-1 51%). Neoadjuvant chemotherapy with trastuzumab resulted in a clinical complete response, and total mastectomy yielded a pathological complete response. Conclusion: This case illustrates an exceptionally rare occurrence of an ipsilateral HER2-positive breast tumor appearing 20 years after treatment for OBC. The absence of MRI at the initial diagnosis, the long disease-free interval, and the discordant tumor biology highlight the diagnostic challenge of distinguishing a new primary cancer from a delayed manifestation of occult disease. Furthermore, considering emerging evidence that some OBC may arise from axillary ectopic breast tissue, the present case—lacking any pathological features of ectopic tissue—supports a metastatic origin rather than an ectopic primary. Lifelong surveillance is essential for patients with OBC, even after prolonged remission.

Contemporary reporting guidelines require assessment for intraductal carcinoma of the prostate (IDC-P), given its recognition as an adverse prognostic factor. While several benign and malignant mimickers of intraductal carcinoma have been reported and studied, the potential for intraductal aggregates of histiocytes to simulate or complicate assessment of this process has not been addressed in the literature. The authors performed a retrospective multi-institutional review of challenging prostate lesions in which intraductal histiocytic aggregates simulated involvement by IDC-P. Pathology reports and slides were reviewed by 3 fellowship-trained genitourinary pathologists, and clinicopathologic features, immunohistochemistry use, and relative difficulty of the diagnosis were assessed. A total of 47 cases of intraductal histiocytes simulating IDC-P were identified, including 27 needle biopsy, 9 transurethral resection, and 6 radical prostatectomy cases. Overall, 19 cases showed histiocytic aggregates in cases with carcinoma, while 28 occurred in otherwise benign settings. Immunohistochemistry was performed in 14 cases for resolution of the diagnosis. When categorized by the authors in terms of difficulty of the diagnosis, 20 of 47 cases were considered "moderate" or "difficult." Based on their solid appearance spanning an intact duct, aggregates of histiocytes within prostatic ducts may closely simulate IDC-P. Given the prognostic significance of IDC-P, this potential pitfall merits consideration and targeted use of immunohistochemistry in challenging cases.

Fibroepithelial lesions (FELs) diagnosed on core needle biopsy frequently prompt surgical excision because of the diagnostic uncertainty between fibroadenomas (FAs) and phyllodes tumors (PTs). We sought to identify clinical and ultrasound features associated with FEL subtypes to inform individualized surgical decision-making. We performed a retrospective review of women diagnosed with FELs on core biopsy between 2003 and 2024 who underwent diagnostic ultrasound and surgical excision. Clinical and sonographic features were compared between (1) FAs and PTs and (2) benign versus borderline/malignant PTs. Predictors were assessed using univariate and multivariable logistic regression. Among 694 FELs in 673 women, 405 (58.4%) were FAs and 289 (41.6%) were PTs. PTs occurred in older patients (median 40 vs. 32 years), with larger tumors (2.4 vs. 1.9 cm) and higher body mass index (BMI; 25.8 vs. 23.5 kg/m2; all p < 0.001). On multivariable analysis, increasing age (odds ratio [OR] 1.045; 95% confidence interval [CI] 1.027-1.064), increasing BMI (OR 1.036; 95% CI 1.006-1.067), larger tumor size (OR 1.460; 95% CI 1.290-1.672), and non-circumscribed margins (OR 0.688; 95% CI 0.492-0.961) independently predicted PTs. On multivariable analysis of 289 PTs, tumor size (OR 1.363; 95% CI 1.179-1.616) and postmenopausal status (OR 3.052; 95% CI 1.141-8.258) were independently associated with borderline/malignant subtypes (n = 78). Younger, premenopausal patients with normal-range BMI and small, circumscribed tumors demonstrate features strongly associated with fibroadenomas, whereas increasing size, BMI, and postmenopausal status identify higher-risk PTs. These findings support integrating clinical risk stratification into shared decision-making for the management of indeterminate FELs.

We report outcomes of patients who received intraoperative radiation therapy (IORT) using 50kV after lumpectomy and sentinel lymph node biopsy. Women with age > 45 and post-menopausal status, localized, unifocal, invasive breast carcinoma were included in the study. Patients were diagnosed by needle biopsy, and suitable for wide local excision of invasive ductal carcinoma without nodal involvement on conventional examination (cT1 and small cT2 ≤ 3.5cm, cN0, M0). Overall, 489 patients who received adjuvant IORT after breast-conserving surgery were identified between March 2016 to June 2023. The median age was 68 years (range 49-93). The median tumor size was 8mm (0-40mm). Adjuvant whole breast adiation therapy (WBRT), chemotherapy and endocrine were additionally offered in 36 patients (7.4%), 12 (2.4%) and 384 patients (78.5%) respectively. After a median follow-up of 36 months (range, 0-100), the 3-year LR was 1.4% (95% CI 0.6-3.1%). The 3-year LRFS, LRRFS, and PFS were each 97.1% (95% CI 94.6-98.5%), while the 3-year MRFS and OS were both 98.3% (95% CI 96.1-99.2%). The 3-year outcomes did not differ significantly between the IORT and IORT + WBRT cohorts. Patients who did not receive ET (n = 104) experienced a significantly higher rate of local recurrence compared with those who received ET (n = 384) (3-year LR 4.0% vs. 0.7%; p = 0.01). LRFS and LRRFS showed borderline significance (5-year LRFS 96.9% vs. 100%; p = 0.05). MRFS, PFS, and OS did not differ significantly between the two groups. Preliminary 3-year results show that IORT with 50kV achieves excellent local control in selected early-stage breast cancer patients. Endocrine therapy reduced local recurrence, while WBRT added no significant benefit, underscoring the need for longer follow-up.

Primary liver carcinosarcoma (CS) and sarcomatoid carcinoma (SC) are rare malignant tumors of the liver. Although the two tumors often overlap in clinical and imaging manifestations, there are currently no reports comparing the imaging features of these two tumors. Our study aims to compare the clinical characteristics and imaging features of these two tumors to further describe their distinct features, thereby enhancing understanding and diagnostic accuracy. A retrospective analysis was conducted on the clinical and imaging data of 17 patients with CS and 27 patients with SC diagnosed by surgical or needle biopsy between September 2010 and December 2024 at our hospital. The data were summarized and statistically analyzed. Both groups were predominantly male, with a lower mean age (56.65 ± 11.82) in the CS group compared to the SC group (64.93 ± 8.15) (P = 0.01). Compared to the SC group, the CS group more commonly presented with hepatitis B, cirrhosis, and elevated AFP levels. Both groups were more commonly located in the right hepatic lobe, with larger tumors that were often solitary, irregularly shaped, and lobulated. Most tumors exhibited necrosis and hemorrhage. Calcification was observed in two cases in the CS group on CT scans. The tumor margins were predominantly indistinct, and the majority of tumors did not show a capsule. Approximately half of the patients in the SC group had lymph node involvement, which was significantly higher than in the CS group (P = 0.023). After contrast enhancement, all cases in both groups showed heterogeneous enhancement in the arterial phase. Regarding enhancement distribution, the CS group more commonly exhibited enhancement at the margins and in the solid components, while most cases in the SC group showed enhancement at the margins and in the septa. In terms of dynamic enhancement patterns, the CS group more commonly exhibited partial or complete regression in the delayed phase, while the SC group more commonly exhibited progressive or persistent enhancement in the delayed phase, with statistical significance (P = 0.042). Patients in the SC group had significantly higher age and lymph node involvement than those in the CS group. In terms of tumor enhancement patterns, the CS group primarily exhibited delayed-phase regression or partial regression, while the SC group primarily exhibited delayed-phase persistent or progressive enhancement.

Desmoid tumors are benign mesenchymal neoplasms that originate from muscular fasciae and aponeuroses. Breast involvement is exceptionally rare, accounting for less than 0.2% of all breast tumors. A 41-year-old woman with a history of right-sided invasive ductal carcinoma (IDC) diagnosed in 2022 underwent breast-conserving surgery (BCS) and axillary lymph node dissection (ALND), followed by adjuvant chemotherapy, radiotherapy, and daily tamoxifen (20 mg). The tumor measured 3.5 cm at its greatest dimension, was grade 2, estrogen receptor (ER)-positive, progesterone receptor (PR)-positive, HER2 negative, and had a Ki-67 proliferation index of 25%. Histologic examination revealed a cribriform growth pattern without associated ductal carcinoma insitu (DCIS) or lymphovascular invasion (LVI), and one of nine axillary lymph nodes was positive for metastasis. In 2023, a total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed for ovarian suppression. During routine surveillance in 2024, a new mass was detected at the 2 o'clock position in the right breast. Two core needle biopsies performed over 6 months confirmed fibromatosis. Ongoing tumor enlargement and severe pain, despite radiotherapy, led to a wide local excision. Breast fibromatosis can closely mimic carcinoma both clinically and radiologically, and histologic analysis remains essential for definitive diagnosis. Complete surgical excision with negative margins remains the treatment of choice.

Prostate biopsy remains the gold standard for prostate cancer (PCa) diagnosis and treatment planning. However, current techniques suffer from low cancer detection rates, with most biopsy cores sampling benign tissue, leading to undergrading and repeat procedures. Label-free fluorescence lifetime imaging (FLIm) offers a potential solution by enabling real-time discrimination between malignant and benign tissue during biopsy collection, potentially reducing both the number of cores required and the repeat biopsy rates. This pilot study evaluates the feasibility of label-free FLIm for rapid discrimination of malignant from benign prostate tissue in freshly obtained core needle biopsies. Twenty patients undergoing prostate biopsy were enrolled. FLIm measurements were performed immediately after sample collection ( ) using a custom fiber-optic probe. For each point measurement, FLIm parameters from four spectral bands associated with the emission of distinct endogenous fluorophores including structural proteins and metabolic cofactors (e.g., NADH and FAD) were entered in the analysis. Each FLIm point measurement was labeled based on histological annotation. These data were analyzed to characterize tissue-type differences and to train and evaluate support vector machine (SVM) classifiers for malignancy detection. Separation between benign tissue and Gleason pattern can already be observed using just 2 out of 56 FLIm-derived parameters. The SVM classifier, using all parameters, achieved a receiver operating characteristic of 0.88 for identifying Gleason pattern 4 PCa. A shorter lifetime value observed in the NADH-associated band was observed for Gleason pattern 4 PCa relative to benign tissue, consistent with increased free NADH from upregulated glycolysis, supporting the biochemical basis for optical differentiation. FLIm demonstrates strong potential for identifying high-grade PCa. Because measurements were performed using a single fiber optic, this approach can be readily integrated into standard prostate biopsy devices to enable FLIm-guided and real-time tissue characterization during the biopsy procedure and to inform targeted tissue collection.

Amyloidosis is a rare systemic disorder that is underdiagnosed and whose incidence is increasing as the population ages. The reference standard for diagnosis is endomyocardial biopsy, though its utility as a screening tool is limited. Fine needle aspiration (FNA) and surgical excisional biopsy (SEB) of the abdominal fat pad have emerged as alternatives to endomyocardial biopsy as screening tools for amyloidosis. Given concerns about the variable sensitivity of FNA and the more invasive nature of SEB, our referring providers asked our group to perform core needle biopsies (CNB) of the abdominal fat pad. While limited prior work has reviewed the performance of fat pad CNB, the technical details of this procedure have not been described in the literature. With this technical note, we hope to encourage more radiologists to offer ultrasound-guided CNB of the abdominal fat pad as an additional procedure in the toolkit of interventional radiologists.

Upgrade risk in intraductal papillomas: A retrospective analysis of real-world data and predictive model development.