Search

Aim: We aim to assess the overall survival (OS) in patients with Anaplastic Astrocytoma (AA) undergoing gross total resection (GTR) as compared to partial resection (PR) subtotal resection (STR), or biopsy. Methods: This systematic review followed Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. An electronic search from PubMed/Medline was conducted from their inception to 26th April 2022. We included AA patients undergoing any surgical intervention resulting in GTR, PR, STR or biopsy. We did not include letters, case reports, abstracts, conference papers, reviews, and studies where full text was unavailable. We included only those articles which were published in English. Results: Five cohorts were used in this study. Two studies assessed OS in GTR, PR/STR and biopsy, while one study compared GTR and STR/biopsy. Another study was used to compare OS between GTR and local excision/STR, and another was used to assess the complications/benefits of these surgeries. Three studies showed a significant increase in OS in patients who underwent GTR compared to the other interventions, while one study showed a non-significant effect on OS (p= 0.249). Conclusion: Our study concluded a significant increase in OS when patients with AA had GTR instead of STR, PR or biopsy. Although these surgeries might carry some disadvantages, GTR allows a more positive effect on neurological status. Still, more studies need to be conducted to assess the efficiency of these surgeries. [ABSTRACT FROM AUTHOR]

Introduction: Proper orientation of endoscopic mucosal biopsies is crucial for accurate histomorphologic assessment. Aim: To compare the morphology on two different templates, filter paper and gelfoam for orientation of biopsies. Materials and Methods: In this study a total of 21 duodenal biopsies were studied which were taken from the same site, fixed and oriented on wet filter paper and gelfoam in formalin, from patients who presented with malabsorptive symptoms. Histomorphological parameters studied were villous architecture, crypt architecture, intraepithelial lymphocyte (IEL) count per 100 enterocytes, villous tip IEL count per 20 enterocytes, inflammatory cells in lamina propria. Statistical analysis was done using IBM-SPSS software version 21. p-value <0.05 was considered as statistically significant. Results: Twenty-one biopsies were taken in both the templates. Authors had 18 biopsies for analysis as three sections on gelfoam were lost during processing. All the histomorphological parameters were studied and it was similar on both the templates. The level of agreement by kappa statistics was significant with kappa value of 0.727 for villous architecture, 0.852 for lamina propria inflammatory infiltrate, 1 for IEL and eosinophils in lamina propria with p-value of <0.001. Conclusion: Authors concluded, gelfoam or filter paper serves as a good template for proper orientation of tiny mucosal biopsies. However, further studies are needed on larger sample size to validate this finding. [ABSTRACT FROM AUTHOR]

Bladder cancer (BCa) is the fourth most common cancer in men and one of the most common urinary tract cancers, especially in developed countries. The aim of this paper is to comprehensively analyze the biology of bladder cancer, including its epidemiology, etiology, histological types, risk factors, clinical symptoms, and diagnostic methods. The paper presents the dominant histological types of bladder cancer, such as transitional cell carcinoma (TCC), which accounts for 90–95% of cases, squamous cell carcinoma (SCC), and adenocarcinoma, which is much rarer. Risk factors, such as smoking, occupational exposure to chemicals, schistosomiasis, and genetic factors, which significantly affect the pathogenesis of bladder cancer, are also discussed. The paper focuses on modern diagnostic methods, including blue light cystoscopy (BLC) and computed tomography urography (CTU), which show increased sensitivity and specificity in detecting early neoplastic changes. The importance of TNM classification and the role of neoadjuvant chemotherapy in improving patient prognosis are also discussed. Based on a review of the scientific literature, the paper emphasizes the need for early diagnosis and an individualized therapeutic approach, which may contribute to improving the survival and quality of life of patients with bladder cancer. The potential for prevention, including quitting smoking and limiting exposure to harmful chemicals, has also been demonstrated to significantly reduce the risk of disease. Patient education and monitoring high-risk groups are key to reducing the incidence of bladder cancer. [ABSTRACT FROM AUTHOR]

Simple Summary: Rare diseases represent a significant health problem since patients face difficulty obtaining a rapid diagnosis and a proper treatment. An inflammatory pseudotumor of the liver (IPTL) is a rare and benign entity in which reaching a correct preoperative diagnosis can be challenging since it is similar to the worst form of liver cancer, intrahepatic cholangiocarcinoma (ICC). Our paper aims to report our experience and to review the available literature on this topic, thus summarizing previous experiences and central issues to point out a prompt road map of treatment that still needs to be standardized. IPTL is not associated with substantial risk factors and presents with faint symptoms. Imaging data via MRI and CT scan are not specific, thus often requiring ultrasound (US)-guided biopsy. Proper and widely accepted gold standard treatment does not exist; conservative strategies represent an accepted option, while the decision for surgery still exists where there is a suspicion of malignancy. An inflammatory pseudotumor of the liver is a rare tumor-like lesion composed of polymorphous inflammatory cell infiltrates and variable amounts of fibrosis that can often mimic a malignant liver neoplasm. The etiology of inflammatory pseudotumors of the liver is unknown; symptoms are faint and imaging non-specific. Thus, it is often hard to make a diagnosis preoperatively and it is not so rare to over-treat patients with this disease or vice versa. Thus, more profound knowledge is necessary to plan appropriate disease management. We reported our two cases and systematically searched the literature regarding IPTL. We selected articles published in English from four databases, PubMed, Scopus, Web of Science and Google Scholar, and we included only articles with consistent data. Twenty nine papers fulfilling criteria for the review were selected. The analysis of 69 cases published from 1953 confirmed that the risk factors are unclear, the imaging data is not specific, and biopsy is crucial but not so widely used in clinical practice due to the procedure's related risks, and relatively low effectiveness and improvement in imaging analysis. Regarding treatment, surgeons have moved towards a more conservative attitude over the years due to better imaging quality and patient surveillance. However, surgery remains the modality of choice for most cases with an indeterminate diagnosis. Even if an inflammatory pseudotumor of the liver is a benign tumor with a good prognosis, not requiring any treatment in most cases, sometimes it remains challenging to differentiate it from ICC; therefore, there is a solid recommendation to manage this condition with a multidisciplinary team. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic brought into prominence several emergent medical and surgical entities, but, also, it served as trigger and contributor for numerous apparently unrelated ailments such as arterial and venous thromboembolic complications. Additional risk factors for these thrombotic traits may be concurrent (known or unknown) malignancies, including at hepatic level. Among these, cholangiocarcinoma (CCA), a rare cancer of intra- and extra-hepatic biliary ducts, represents a very aggressive condition that typically associates local and distant advanced stages on first presentation requiring a prompt diagnosis and a stratified management. This neoplasia has been reported to present a large spectrum of paraneoplastic syndromes in terms of dermatologic, renal, systemic, neurologic, endocrine, and cardiovascular settings, that, overall, are exceptional in their epidemiologic impact when compared to other cancers. Our aim was to introduce a most unusual case of CCA-associated distant thrombosis in a male adult who initially was considered to experience COVID-19-related thrombotic features while having a history of obesity and bariatric surgery. This is a hybrid type of paper: this clinical vignette is accompanied by two distinct sample-focused analyses as a basis for discussion; they each had different methods depending on their current level of statistical evidence. We only included English-published articles in PubMed, as follows: Firstly, we conducted a search of reports similar to the present case, regarding distant vein thrombosis in CCA, from inception until the present time. We performed a literature search using the keywords "cholangiocarcinoma", "thrombosis", and "Trousseau's syndrome" and identified 20 cases across 19 original papers; hence, the current level of evidence remains very low Secondly, we searched for the highest level of statistical evidence concerning the diagnosis of venous thrombosis/thromboembolism in patients who underwent COVID-19 infection (key search terms were "COVID-19", alternatively, "coronavirus", and "SARS-CoV-2", and "thrombosis", alternatively, "thromboembolism") and included the most recent systematic reviews and meta-analyses that were published in 2024 (from 1 January 2024 until 8 July 2024). After excluding data on vaccination against coronavirus or long COVID-19 syndrome, we identified six such articles. To conclude, we presented a probably unique case of malignancy with an initial manifestation consisting of recurrent superficial vein thrombosis under anticoagulation therapy, with no gastrointestinal manifestations, in a patient with a notable history for multiple episodes of SARS-CoV-2 infection and a prior endocrine (gastric) surgery. To our knowledge, this is the first identification of a CCA under these specific circumstances. [ABSTRACT FROM AUTHOR]

Simple Summary: Intraneural tumours are difficult to diagnose. A plethora of pathologies can involve the nerve from schwannoma, neurofibroma, intraneural ganglion to more esoteric intraneural tumours like ewings sarcoma, metastasis, synovial sarcoma and perineuroma. The imaging features of these can be variable and management of intraneural lesions requires a mutidisciplinary approach to decrease morbidity and mortality. This paper aims to describe the key MRI characteristics which can help differentiate between the benign and malignant tumours, aid in biopsy and surgical planning as well as help in post-treatment monitoring. Background/Objectives: Intraneural tumors (INTs) pose a diagnostic challenge, owing to their varied origins within nerve fascicles and their wide spectrum, which includes both benign and malignant forms. Accurate diagnosis and management of these tumors depends upon the skills of the radiologist in identifying key imaging features and correlating them with the patient's clinical symptoms and examination findings. Methods: This comprehensive review systematically analyzes the various imaging features in the diagnosis of intraneural tumors, ranging from basic MR to advanced MR imaging techniques such as MR neurography (MRN), diffusion tensor imaging (DTI), and dynamic contrast-enhanced (DCE) MRI. Results: The article emphasizes the differentiation of benign from malignant lesions using characteristic MRI features, such as the "target sign" and "split-fat sign" for tumor characterization. The role of advanced multiparametric MRI in improving biopsy planning, guiding surgical mapping, and enhancing post-treatment monitoring is also highlighted. The review also underlines the importance of common diagnostic pitfalls and highlights the need for a multi-disciplinary approach to achieve an accurate diagnosis, appropriate treatment strategy, and post-therapy surveillance planning. Conclusions: In this review, we illustrate the main imaging findings of intraneural tumors, focusing on specific MR imaging features that are crucial for an accurate diagnosis and the differentiation between benign and malignant lesions. [ABSTRACT FROM AUTHOR]

Primary renal hypouricemia (RHUC) is a rare autosomal recessive disorder with a mean duration of end-stage acute kidney injury (EIAKI) of 14 days. The pathogenesis of EIAKI in patients with RHUC remains unclear. Several hypotheses have been proposed, including those related to the renal vasoconvulsive effect and the elevating effect of xanthine oxidase (XO). The effect of xanthine oxidase (XO) is most often observed following strenuous anaerobic exercise, which is frequently accompanied by low back pain, nausea, and acute kidney injury (AKI). Consequently, we postulate that EIAKI could be prevented by avoiding strenuous exercise, thus preventing the onset and recurrence of EIAKI. In this paper, we present a case of recurrent EIAKI in a patient with RHUC and a mutation in the SLC2A9 gene. [ABSTRACT FROM AUTHOR]

Simple Summary: This review paper explores advanced imaging technologies for prostate cancer because traditional methods often miss or misclassify cancers. The aim of this study is to provide a comprehensive overview of three key technologies, MRI, micro-ultrasound, and prostate-specific membrane antigen (PSMA) PET scans, and how they can improve prostate cancer detection and management. The findings showed that these techniques have improved our ability to detect prostate cancer; however, further studies are needed to determine each imaging technique's specific role in the diagnosis of prostate cancer. Background/Objectives: Prostate cancer is a prevalent malignancy often presenting without early symptoms. Advanced imaging technologies have revolutionized its diagnosis and management. This review discusses the principles, benefits, and clinical applications of multiparametric magnetic resonance imaging (mpMRI), micro-ultrasound (microUS), and prostate-specific membrane antigen positron emission tomography–computed tomography (PSMA PET/CT) in localized prostate cancer. Methods: We conducted a comprehensive literature review of recent studies and guidelines on mpMRI, microUS, and PSMA PET/CT in prostate cancer diagnosis, focusing on their applications in biopsy-naïve patients, those with previous negative biopsies, and patients under active surveillance. Results: MpMRI has demonstrated high sensitivity and negative predictive value in detecting clinically significant prostate cancer (csPCa). MicroUS, a newer technology, has shown promising results in early studies, with sensitivity and specificity comparable to mpMRI. PSMA PET/CT has emerged as a highly sensitive and specific imaging modality, particularly valuable for staging and detecting metastatic disease. All three technologies have been incorporated into urologic practice for prostate cancer diagnosis and management, with each offering unique advantages in different clinical scenarios. Conclusions: Advanced imaging techniques, including mpMRI, microUS, and PSMA PET/CT, have significantly improved the accuracy of prostate cancer diagnosis, staging, and management. These technologies enable more precise targeting of suspicious lesions during biopsy and therapy planning. However, further research, especially randomized controlled trials, is needed to fully establish the optimal use and inclusion of these imaging modalities in various stages of prostate cancer care. [ABSTRACT FROM AUTHOR]

Simple Summary: Sentinel lymph node assessment is becoming a standard of care procedure in patients with surgically treatable endometrial cancer due to its cost-effectiveness and the advantages it offers in guiding post-operative management. Unlike in breast cancer, however, several key aspects regarding this technique's employment in endometrial cancer remain unclear, such as tracer injection volume and final pathology interpretation. The aim of this paper is to investigate the current literature on this technique in order to provide simple and clear insight on the matter and to facilitate the reproducibility of this technique, ultimately resulting in improving patients' oncological outcomes. As the number of patients diagnosed with endometrial cancer rises, so does the number of patients who undergo surgical treatment, consisting of radical hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymphadenectomy or lymph node sampling. The latter entail intra- and post-surgical complications, such as lymphedema and increased intra-operative bleeding, which often outweigh their benefits. Sentinel Lymph Node (SLN) sampling is now common practice in surgical management of breast cancer, as it provides important information about the disease without jeopardizing surgical radicality and patient outcomes. While this technique has also been shown to be feasible in patients with endometrial cancer, there is little consensus on several aspects, such as tracer injection volume and site, pathological ultrastaging, and result interpretation. The aim of this review is to analyze the current literature on SLN assessment in order to help standardize the procedure. [ABSTRACT FROM AUTHOR]

Objective: To comprehensively report Society for Assisted Reproductive Technology (SART) member program usage of preimplantation genetic testing (PGT), preimplantation genetic diagnosis (PGD) for diagnosis of specific conditions, and preimplantation genetic screening for aneuploidy (PGS). Design: Retrospective study. Setting: United States SART cohort data. Patient(s): Women undergoing a PGT cycle in which at least one embryo underwent biopsy. Intervention(s): PGT. Main Outcome Measure(s): PGT use, indications, and delivery rates. Result(s): Of 190,260 fresh, nondonor assisted reproductive technology (ART) cycles reported to SART CORS in 2007–2008, 8,337 included PGT. Of 6,971 cycles with a defined indication, 1,382 cycles were for genetic diagnosis, 3,645 for aneuploidy screening (PGS), 527 for translocation, and 1,417 for elective sex election. Although the total number of fresh, autologous cycles increased by 3.6% from 2007 to 2008, the percentage of cycles with PGT decreased by 5.8% (4,293 in 2007 and 4,044 in 2008). As a percentage of fresh, nondonor ART cycles, use dropped from 4.6% (4,293/93,433) in 2007 to 4.2% (4,044/96,827) in 2008. The primary indication for PGT was PGS: cycles performed for this indication decreased (−8.0%). PGD use for single-gene defects (+3.2%), elective sex selection (+5.3%), and translocation analysis (+0.5%) increased. PGT usage varied significantly by geographical region. Conclusion(s): PGT usage in the United States decreased between 2007 and 2008 owing to a decrease in PGS. Use of elective sex selection increased. High transfer cancellation rates correlated with reduced live-birth rates for some PGT indications. [ABSTRACT FROM AUTHOR]

Simple Summary: Lung cancer is the most commonly diagnosed and most lethal cancer. Since healthcare outcomes have improved with the advent of targeted therapy, it is incumbent upon treating physicians to precisely identify the particular histological subtype. This paper summarizes studies exploring immunohistochemical and "omics" techniques to highlight diagnostic biomarkers for lung cancer subtyping. A comprehensive discussion along with an elucidation of challenges and future direction for further progress are also touched upon. As of 2022, lung cancer is the most commonly diagnosed cancer worldwide, with the highest mortality rate. There are three main histological types of lung cancer, and it is more important than ever to accurately identify the subtypes since the development of personalized, type-specific targeted therapies that have improved mortality rates. Traditionally, the gold standard for the confirmation of histological subtyping is tissue biopsy and histopathology. This, however, comes with its own challenges, which call for newer sampling techniques and adjunctive tools to assist in and improve upon the existing diagnostic workflow. This review aims to list and describe studies from the last decade (n = 47) that investigate three such potential omics techniques—namely (1) transcriptomics, (2) proteomics, and (3) metabolomics, as well as immunohistochemistry, a tool that has already been adopted as a diagnostic adjunct. The novelty of this review compared to similar comprehensive studies lies with its detailed description of each adjunctive technique exclusively in the context of lung cancer subtyping. Similarities between studies evaluating individual techniques and markers are drawn, and any discrepancies are addressed. The findings of this study indicate that there is promising evidence that supports the successful use of omics methods as adjuncts to the subtyping of lung cancer, thereby directing clinician practice in an economical and less invasive manner. [ABSTRACT FROM AUTHOR]

Objective: Improved prostate biopsy procedures have been developed to overcome traditional limitations, aiming to enhance cancer diagnosis accuracy. Materials and Methods: To assess the existing knowledge of the effectiveness and risks linked to transperineal (TP) vs. transrectal (TR) prostate biopsy. Approaches: a comprehensive search was carried out in PubMed, Embase, Web of Science, and Cochrane Library to locate all pertinent papers published till June 8, 2023. Data on cancer detection rate and complications after prostate biopsy were gathered and analyzed via Review Manager software. A subgroup analysis was conducted to evaluate the influence of the study type. Results: A total of 19 publications, involving 80 133 patients with suspicion of prostate cancer who underwent prostate biopsy, were enrolled in the analysis. The pooled estimate demonstrated no significant differences in the cancer detection rate between TR and TP (risk difference (RD) = 0.03; 95% CI: -0.01 to 0.08; P = .12). In terms of complications, the TP approach significantly decreased the risk of rectal bleeding (odds ratio (OR) = 0.24; 95% CI: 0.12-0.51; P < .001), fever and urinary tract infection (OR = 0.28; 95% CI: 0.15-0.52; P < .001), and sepsis (OR = 0.50; 95% CI: 0.28-0.90; P = .02) compared to the TR approach. Conclusion: In conclusion, there was no significant disparity in the cancer detection rate between TP and TR approaches. However, the TP strategy exhibited an advantage over TR due to a reduced risk of infection and rectal bleeding. Further research is needed to validate these results and develop a more efficient diagnostic approach for prostate cancer. [ABSTRACT FROM AUTHOR]

Computed tomography (CT)-guided lung biopsy is one of the oldest and most widely known minimally invasive percutaneous procedures. Despite being conceptually simple, this procedure needs to be performed rapidly and can be subject to meaningful complications that need to be managed properly. Therefore, knowledge of principles and techniques is required by every general or interventional radiologist who performs the procedure. This review aims to contain all the information that the operator needs to know before performing the procedure. The paper starts with the description of indications, devices, and types of percutaneous CT-guided lung biopsies, along with their reported results in the literature. Then, pre-procedural evaluation and the practical aspects to be considered during procedure (i.e., patient positioning and breathing) are discussed. The subsequent section is dedicated to complications, with their incidence, risk factors, and the evidence-based measures necessary to both prevent or manage them; special attention is given to pneumothorax and hemorrhage. After conventional CT, this review describes other available CT modalities, including CT fluoroscopy and cone-beam CT. At the end, more advanced techniques, which are already used in clinical practice, like fusion imaging, are included. [ABSTRACT FROM AUTHOR]

Conducting marine mammal research can raise several important ethical issues. For example, the continuation of whaling for commercial purposes despite the international moratorium provides opportunities for scientists to obtain data and tissue samples. In 2021 we analysed 35 peer-reviewed papers reporting research based on collaborations with Icelandic whalers. Results highlighted little consideration or understanding of the legal and ethical issues associated with the deliberate killing of whales amongst those researchers, funding bodies, universities and journals involved. Ethical statements were rarely provided. Those that were written were incomplete. Whilst research using whaling data may seem acceptable to some, it often becomes hard to justify when subject to scrutiny by the media and the public. Thus, there is a particular danger of reputational harm for early career researchers who may become unwittingly involved in such activities. Here we also consider the broader variety of ethical issues raised by non-lethal research (both historical and recent) on marine mammals including tagging and biopsy. We discuss instances where study animals were harmed or even killed and where the public mistook tags for harpoons. Without clear guidelines, reviewers and journal editors are put in an impossible position when considering whether to reject papers on ethical grounds. We propose that for such studies, universities, funders, journals, and permit issuers must require ethical assessments and that journals more effectively implement their existing policies on publishing ethical statements. The professional marine mammal societies need to work together to produce modern ethical guidance. Such guidance should require transparency in the provenance of data and samples while including advice on law, welfare issues, involvement of local scientists, and offshoring. Furthermore, it should require appraisal of and justification for the absolute necessity of invasive procedures. As is already the case in biomedical disciplines, ethical statements should be required in marine mammal science. [ABSTRACT FROM AUTHOR]

Simple Summary: A large body of multidisciplinary evidence involves the topic of thyroid cancer (the most common endocrine malignancy). Nevertheless, exceptional findings such as thyroid cancer in ectopic thyroid tissue, representing 0.3–0.5% of the malignant neoplasia with any location, suggest even greater challenges. Awareness remains the key operative element since the index of suspicion is low, especially in non-cervical areas. Hence, currently, the ectopic thyroid remains a matter of individualized management. The ectopic mediastinal thyroid (EMT) is part of the less frequent sublingual ectopic sites. Here, we introduce the most complex analysis in published EMT data (N = 117 patients) that identified an unexpectedly high rate of malignancy (18.8%), papillary cancer being the most frequent histological type. A rate of 5.98% amid all EMTs represented individuals confirmed with unrelated (non-thyroid) malignancies. Thyroid anomalies (other than EMT presence) were reported in 38.33% of the benign EMT, while the overall malignancy rate in EMTs was higher than expected according to prior data when compared to other ectopic sites. We aimed to analyze the management of the ectopic mediastinal thyroid (EMT) with respect to EMT-related cancer and non-malignant findings related to the pathological report, clinical presentation, imaging traits, endocrine profile, connective tissue to the cervical (eutopic) thyroid gland, biopsy or fine needle aspiration (FNA) results, surgical techniques and post-operatory outcome. This was a comprehensive review based on revising any type of freely PubMed-accessible English, full-length original papers including the keywords "ectopic thyroid" and "mediastinum" from inception until March 2024. We included 89 original articles that specified EMTs data. We classified them into four main groups: (I) studies/case series (n = 10; N = 36 EMT patients); (II) malignant EMTs (N = 22 subjects; except for one newborn with immature teratoma in the EMT, only adults were reported; mean age of 62.94 years; ranges: 34 to 90 years; female to male ratio of 0.9). Histological analysis in adults showed the following: papillary (N = 11/21); follicular variant of the papillary type (N = 2/21); Hürthle cell thyroid follicular malignancy (N = 1/21); poorly differentiated (N = 1/21); anaplastic (N = 2/21); medullary (N = 1/21); lymphoma (N = 2/21); and MALT (mucosa-associated lymphoid tissue) (N = 1/21); (III) benign EMTs with no thyroid anomalies (N = 37 subjects; mean age of 56.32 years; ranges: 30 to 80 years; female to male ratio of 1.8); (IV) benign EMTs with thyroid anomalies (N = 23; female to male ratio of 5.6; average age of 52.1 years). This panel involved clinical/subclinical hypothyroidism (iatrogenic, congenital, thyroiditis-induced, and transitory type upon EMT removal); thyrotoxicosis (including autonomous activity in EMTs that suppressed eutopic gland); autoimmune thyroiditis/Graves's disease; nodules/multinodular goiter and cancer in eutopic thyroid or prior thyroidectomy (before EMT detection). We propose a 10-item algorithm that might help navigate through the EMT domain. To conclude, across this focused-sample analysis (to our knowledge, the largest of its kind) of EMTs, the EMT clinical index of suspicion remains low; a higher rate of cancer is reported than prior data (18.8%), incident imagery-based detection was found in 10–14% of the EMTs; surgery offered an overall good outcome. A wide range of imagery, biopsy/FNA and surgical procedures is part of an otherwise complex personalized management. [ABSTRACT FROM AUTHOR]

Simple Summary: In this paper, we look at the role of artificial intelligence (AI) advancements in prostate cancer diagnosis and management. Specifically, we focus on magnetic resonance prostate reconstruction, prostate cancer detection/stratification/reconstruction, positron emission tomography/computed tomography, androgen deprivation therapy, and prostate biopsy. A total of 64 studies were included. Our results showed that deep learning AI models in prostate cancer diagnosis show promise but are not yet ready for clinical use due to variability in methods, labels, and evaluation criteria. Conducting additional research while acknowledging the limitations is crucial for reinforcing the utility and effectiveness of AI-based models in clinical settings. Background: The aim was to analyze the current state of deep learning (DL)-based prostate cancer (PCa) diagnosis with a focus on magnetic resonance (MR) prostate reconstruction; PCa detection/stratification/reconstruction; positron emission tomography/computed tomography (PET/CT); androgen deprivation therapy (ADT); prostate biopsy; associated challenges and their clinical implications. Methods: A search of the PubMed database was conducted based on the inclusion and exclusion criteria for the use of DL methods within the abovementioned areas. Results: A total of 784 articles were found, of which, 64 were included. Reconstruction of the prostate, the detection and stratification of prostate cancer, the reconstruction of prostate cancer, and diagnosis on PET/CT, ADT, and biopsy were analyzed in 21, 22, 6, 7, 2, and 6 studies, respectively. Among studies describing DL use for MR-based purposes, datasets with magnetic field power of 3 T, 1.5 T, and 3/1.5 T were used in 18/19/5, 0/1/0, and 3/2/1 studies, respectively, of 6/7 studies analyzing DL for PET/CT diagnosis which used data from a single institution. Among the radiotracers, [68Ga]Ga-PSMA-11, [18F]DCFPyl, and [18F]PSMA-1007 were used in 5, 1, and 1 study, respectively. Only two studies that analyzed DL in the context of DT met the inclusion criteria. Both were performed with a single-institution dataset with only manual labeling of training data. Three studies, each analyzing DL for prostate biopsy, were performed with single- and multi-institutional datasets. TeUS, TRUS, and MRI were used as input modalities in two, three, and one study, respectively. Conclusion: DL models in prostate cancer diagnosis show promise but are not yet ready for clinical use due to variability in methods, labels, and evaluation criteria. Conducting additional research while acknowledging all the limitations outlined is crucial for reinforcing the utility and effectiveness of DL-based models in clinical settings. [ABSTRACT FROM AUTHOR]

Simple Summary: Currently, contrast-enhancing gliomas FLAIRectomies or supramarginal gliresections are gaining momentum. This paper presents a semiquantitative analysis of FET uptake in biopsy targets inside and outside glioma masses based on PET/MR images. An exact threshold to differentiate glioma and astrogliosis within FLAIR using dual-timepoint PET acquisition and referring to various anatomical structures is a major strength of this study. Doing so paves the way for an optimized PET protocol to enable precise and reproducible FET-PET quantification for glioma mapping in clinical trials and practice. Accurately defining glioma infiltration is crucial for optimizing radiotherapy and surgery, but glioma infiltration is heterogeneous and MRI imperfectly defines the tumor extent. Currently, it is impossible to determine the tumor infiltration gradient within a FLAIR signal. O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-PET often reveals high-grade glioma infiltration beyond contrast-enhancing areas on MRI. Here, we studied FET uptake dynamics in tumor and normal brain structures by dual-timepoint (10 min and 40–60 min post-injection) acquisition to optimize analysis protocols for defining glioma infiltration. Over 300 serial stereotactic biopsies from 23 patients (mean age 47, 12 female/11 male) of diffuse contrast-enhancing gliomas were taken from areas inside and outside contrast enhancement or outside the FET hotspot but inside FLAIR. The final diagnosis was G4 in 11, grade 3 in 10, and grade 2 in 2 patients. The target-to-background (TBRs) ratios and standardized uptake values (SUVs) were calculated in areas used for biopsy planning and in background structures. The optimal method and threshold values were determined to find a preferred strategy for defining glioma infiltration. Standard thresholding (1.6× uptake in the contralateral brain) in standard acquisition PET images differentiated a tumor of any grade from astrogliosis, although the uptake in astrogliosis and grade 2 glioma was similar. Analyzing an optimal strategy for infiltration volume definition astrogliosis could be accurately differentiated from tumor samples using a choroid plexus as a background. Early acquisition improved the AUC in many cases, especially within FLAIR, from 56% to 90% sensitivity and 41% to 61% specificity (standard TBR 1.6 vs. early TBR plexus). The current FET-PET evaluation protocols for contrast-enhancing gliomas are limited, especially at the tumor border where grade 2 tumor and astrogliosis have similar uptake, but using choroid plexus uptake in early acquisitions as a background, we can precisely define a tumor within FLAIR that was outside of the scope of current FET-PET protocols. [ABSTRACT FROM AUTHOR]

The promise of precision medicine as a model to customize health care to the individual patient is heavily dependent upon new genetic tools to classify and characterize diseases and their hosts. Liquid biopsies serve as a safe alternative to solid biopsies and are thus a useful and critical component to fully realizing personalized medicine. The International Liquid Biopsy Standardization Alliance (ILSA) comprises organizations and foundations that recognize the importance of working towards the global use of liquid biopsy in oncology practice to support clinical decision making and regulatory considerations and seek to promote it in their communities. This manuscript provides an overview of the independent liquid biopsy- and standardization-based programs engaged with ILSA, their objectives and progress to date, and the tools and resources each is developing to contribute to the field. It also describes the unique areas of effort as well as synergy found within the group. [ABSTRACT FROM AUTHOR]

Background: CEM-guided breast biopsy is an advanced diagnostic procedure that takes advantage of the ability of CEM to enhance suspicious breast lesions. The aim pf this paper is to describe a single-center retrospective experience on CEM-guided breast biopsy in terms of procedural features and histological outcomes. Methods: 69 patients underwent the procedure. Patient age, breast density, presentation, dimensions, and lesion target enhancement were recorded. All the biopsy procedures were performed using a 7- or 10-gauge (G) vacuum-assisted biopsy needle. The procedural approach (horizontal or vertical) and the decubitus of the patient (lateral or in a sitting position) were noted. Results: A total of 69 patients underwent a CEM-guided biopsy. Suspicious lesions presented as mass enhancement in 35% of cases and non-mass enhancement in 65% of cases. The median size of the target lesions was 20 mm. The median procedural time for each biopsy was 10 ± 4 min. The patients were placed in a lateral decubitus position in 52% of cases and seated in 48% of cases. The most common approach was horizontal (57%). The mean AGD was 14.8 mGy. At histology, cancer detection rate was 28% (20/71). Conclusions: CEM-guided biopsy was feasible, with high procedure success rates and high tolerance by the patients. [ABSTRACT FROM AUTHOR]

Background: Detecting breast cancer in its early stages remains a significant challenge in the present context and is a leading cause of death among women, primarily due to delayed identification. This paper presents a practical and accurate approach based on deep learning to identify breast cancer in cytology images. Method: The analytical approach leverages knowledge from a related problem through a technique known as transfer learning. Convolutional neural networks (CNNs) are employed due to their remarkable performance on large datasets. Image classification architectures such as Google network (GoogleNet), Visual geographical group network (VGGNet), residual network (ResNet), and dense convolution network (DenseNet) are utilized in this approach. By applying transfer learning, the images are classified into two categories: those containing cancer cells and those without them. The performance of the proposed ensemble method is evaluated using a breast cytology image dataset. Results: The results of our proposed ensemble framework outperform conventional CNN models in terms of precision, recall, and F1 measures, achieving an impressive 86% prediction accuracy. Visual representations of validation graphs for each classifier demonstrate that the ensemble framework surpasses the performance of pre-trained CNN architectures. Conclusion: Combining the outcomes of conventional CNN architectures into an ensemble framework enhances early breast cancer detection, leading to a reduction in mortality through timely medical interventions. [ABSTRACT FROM AUTHOR]

Simple Summary: Even if tongue abscesses are rare, they have very heterogeneous clinical, laboratory and radiological findings. In some cases, their presentation can be particularly nuanced, and they can easily be mistaken for a submucosal malignancy, leading to a dangerous delay in diagnosis. The present paper presents a review of the literature on the possible manifestations (including symptoms, clinical and laboratory findings, imaging) and the management of tongue abscesses in relation to the differential diagnosis of oral tumors. Tongue abscesses are rare conditions that usually follow mucosal disruption due to mechanical trauma or foreign body impaction. They typically manifest abruptly as a rapidly growing, hard mass or swelling in the context of tongue muscles; the patient frequently complains of pain, difficulties in swallowing or speaking, and fever. Nonetheless, the features of its presentation, together with accurate clinical evaluation, blood tests, and appropriate imaging tests, are usually sufficient to easily discern a tongue abscess from a malignancy. However, in rare cases, they may occur with slowly progressing and subtle symptoms, nuanced objective and laboratory findings, and inconclusive radiological evidence, leading to difficult differential diagnosis with submucosal malignancy. Herein, we review the literature, available on Pubmed, Embase, and Scopus, on publications reporting tongue abscesses, with atypical presentation suggesting an oral tumor. Our review confirms that tongue abscesses may manifest as a slowly growing and moderately painful swelling without purulent discharge and minimal mucosal inflammation; in this case, they may constitute an actual diagnostic challenge with potentially severe impact on correct management. Atypical tongue abscesses must therefore be considered in the differential diagnosis of tongue malignancy with submucosal extension, even when other diagnostic elements suggest a neoplasia; in this case, a deep biopsy under general anesthesia is essential for differential diagnosis, and simultaneous drainage of the necrotic and abscessual material may resolve the condition. [ABSTRACT FROM AUTHOR]

Simple Summary: Vacuum-assisted breast biopsy (VABB) represents one of the best instruments for radiologists to obtain a histological diagnosis of suspicious lesions on imaging. The advent of digital breast tomosynthesis (DBT)-guided VABB has increased the accuracy of diagnosis in the most complex lesions, particularly those without ultrasound correlation or those visible only on DBT. In this paper, we retrospectively analyzed our experience with VABB. Starting from a review of the literature, we evaluated the challenges arising from clinical practice to provide useful indications for the implementation of this technique. We identified 37 breast cancers at an early stage with a low complication rate and high histopathological concordance between VABB and surgery. Compared to the literature, our results confirmed the fundamental role of DBT-VABB in achieving a timely diagnosis for nonpalpable lesions, offering a safe and minimally invasive approach when the technique is executed correctly. Vacuum-assisted breast biopsy (VABB) guided by digital breast tomosynthesis (DBT) represents one of the best instruments to obtain a histological diagnosis of suspicious lesions with no ultrasound correlation or those which are visible only on DBT. After a review of the literature, we retrospectively analyzed the DBT-guided VABBs performed from 2019 to 2022 at our department. Descriptive statistics, Pearson's correlation and χ2 test were used to compare distributions of age, breast density (BD) and early performance measures including histopathology. We used kappa statistics to evaluate the agreement between histological assessment and diagnosis. Finally, we compared our experience to the literature to provide indications for clinical practice. We included 85 women aged 41–84 years old. We identified 37 breast cancers (BC), 26 stage 0 and 11 stage IA. 67.5% of BC was diagnosed in women with high BD. The agreement between VABB and surgery was 0.92 (k value, 95% CI: 0.76–1.08). We found a statistically significant inverse correlation between age and BD. The post-procedural clip was correctly positioned in 88.2%. The post-procedural hematoma rate was 14.1%. No infection or hemorrhage were recorded. When executed correctly, DBT-guided VABB represents a safe and minimally invasive technique with high histopathological concordance, for detecting nonpalpable lesions without ultrasound correlation. [ABSTRACT FROM AUTHOR]

Simple Summary: Glioblastoma (GBM) generally recurs locally with a dismal median survival of <18 months. Combining thermal therapy with radiation therapy enhances radiation response and improves clinical outcomes. This study evaluates a thermobrachytherapy balloon implant intended for the simultaneous heat and radiation treatment of tumor resection cavities. The data demonstrate that our prototype implant produces spherically symmetric heat and radiation dose distributions around the balloon, while the in vivo experiments confirm our ability to heat ≥40 °C at a 5 mm distance from the balloon surface in highly perfused pig brain tissue. The device is now ready for the finalization of regulatory approvals in anticipation of early-stage clinical investigation. Previous work has reported the design of a novel thermobrachytherapy (TBT) balloon implant to deliver magnetic nanoparticle (MNP) hyperthermia and high-dose-rate (HDR) brachytherapy simultaneously after brain tumor resection, thereby maximizing their synergistic effect. This paper presents an evaluation of the robustness of the balloon device, compatibility of its heat and radiation delivery components, as well as thermal and radiation dosimetry of the TBT balloon. TBT balloon devices with 1 and 3 cm diameter were evaluated when placed in an external magnetic field with a maximal strength of 8.1 kA/m at 133 kHz. The MNP solution (nanofluid) in the balloon absorbs energy, thereby generating heat, while an HDR source travels to the center of the balloon via a catheter to deliver the radiation dose. A 3D-printed human skull model was filled with brain-tissue-equivalent gel for in-phantom heating and radiation measurements around four 3 cm balloons. For the in vivo experiments, a 1 cm diameter balloon was surgically implanted in the brains of three living pigs (40–50 kg). The durability and robustness of TBT balloon implants, as well as the compatibility of their heat and radiation delivery components, were demonstrated in laboratory studies. The presence of the nanofluid, magnetic field, and heating up to 77 °C did not affect the radiation dose significantly. Thermal mapping and 2D infrared images demonstrated spherically symmetric heating in phantom as well as in brain tissue. In vivo pig experiments showed the ability to heat well-perfused brain tissue to hyperthermic levels (≥40 °C) at a 5 mm distance from the 60 °C balloon surface. [ABSTRACT FROM AUTHOR]

This paper provides a laboratory workflow for single-nucleus RNA-sequencing (snRNA-seq) including a protocol for gentle nuclei isolation from fresh frozen tumor biopsies, making it possible to analyze biobanked material. To develop this protocol, we used non-frozen and frozen human bladder tumors and cell lines. We tested different lysis buffers (IgePal and Nuclei EZ) and incubation times in combination with different approaches for tissue and cell dissection: sectioning, semi-automated dissociation, manual dissociation with pestles, and semi-automated dissociation combined with manual dissociation with pestles. Our results showed that a combination of IgePal lysis buffer, tissue dissection by sectioning, and short incubation time was the best conditions for gentle nuclei isolation applicable for snRNA-seq, and we found limited confounding transcriptomic changes based on the isolation procedure. This protocol makes it possible to analyze biobanked material from patients with well-described clinical and histopathological information and known clinical outcomes with snRNA-seq. [ABSTRACT FROM AUTHOR]

In this paper, the authors present a clinical picture of the diagnosis and current treatment regimens of optic pathway glioma in the pediatric population, with an emphasis on the role of an ophthalmic diagnosis in the differentiation and monitoring of lesions. Glioma is the most common optic nerve tumor in children. Material: Articles in PubMed, Scholar and Website were reviewed, taking into account current standards of management related to sporadic or NF1-related optic glioma, epidemiology, location, course of the disease, clinical manifestations, histological types of the tumor, genetic predisposition, diagnostic ophthalmic tests currently applicable in therapeutic monitoring of the tumor, neurological diagnosis, therapeutic management and prognosis. The importance of current screening recommendations, in line with standards, was emphasized. Results: Glioma occurs in children most often in the first decade of life. Initially, they may be asymptomatic, and clinically ophthalmic changes are associated with the organ of vision or with systemic changes. Gliomas associated with the NF1 mutation have a better prognosis for sporadic gliomas. Diagnosis includes radiological imaging methods/MRI/ophthalmology/OCT and visual acuity log MAR assessment. The basis of treatment is clinical observation. In the case of disease progression, surgical treatment, chemotherapy and targeted therapy are used. Conclusion: Further research into novel techniques for detecting gliomas would allow for early monitoring of the disease. [ABSTRACT FROM AUTHOR]

Accurate detection of non-alcoholic fatty liver disease (NAFLD) through biopsies is challenging. Manual detection of the disease is not only prone to human error but is also timeconsuming. Using artificial intelligence and deep learning, we have successfully demonstrated the issues of the manual detection of liver diseases with a high degree of precision. This article uses various neural network-based techniques to assess non-alcoholic fatty liver disease. In this investigation, more than five thousand biopsy images were employed alongside the latest versions of the algorithms. To detect prominent characteristics in the liver from a collection of Biopsy pictures, we employed the YOLOv3, Faster R-CNN, YOLOv4, YOLOv5, YOLOv6, YOLOv7, YOLOv8, and SSD models. A highlighting point of this paper is comparing the state-of-the-art Instance Segmentation models, including Mask R-CNN, U-Net, YOLOv5 Instance Segmentation, YOLOv7 Instance Segmentation, and YOLOv8 Instance Segmentation. The extent of severity of NAFLD and non-alcoholic steatohepatitis was examined for liver cell ballooning, steatosis, lobular, and periportal inflammation, and fibrosis. Metrics used to evaluate the algorithms' effectiveness include accuracy, precision, specificity, and recall. Improved metrics are achieved by optimizing the hyperparameters of the associated models. Additionally, the liver is scored in order to analyse the information gleaned from biopsy images. Statistical analyses are performed to establish the statistical relevance in evaluating the score for different zones. [ABSTRACT FROM AUTHOR]

Ultrasound-guided percutaneous core-needle biopsy is an excellent diagnostic tool for solid pancreatic lesions. It allows for identifying neoplastic pancreatic tumors with nearly 100% sensitivity, specificity and accuracy. Unresectable tumor assessment prior to planned palliative treatment is the primary indication for percutaneous pancreatic tumor biopsy. In the case of potential tumors eligible for radical surgery, endosonography-guided biopsy is used, if clinically necessary, to avoid the peritoneal spread of tumor cells during puncture. The possibility of obtaining a specimen for a detailed microscopic assessment during an easily accessible and simple procedure is the main advantage of core-needle biopsy over the low, yet higher when compared to other biopsy techniques, risk of complications. Obtaining tissue samples for molecular analysis is essential for palliative targeted therapy in pancreatic cancer and may become the main indication for the common core-needle biopsy of inoperable pancreatic tumors in the near future. The present paper describes the indications and the technique for core-needle biopsy in pancreatic tumors. Based on the studies published to date, the safety of the procedure, significant complications, including bleeding in particular, and the diagnostic sensitivity and specificity, also compared to other biopsy techniques, have been summarized. The present paper may contribute to the introduction of core-needle biopsy of pancreatic masses into clinical practice. [ABSTRACT FROM AUTHOR]

We aimed to overview the most recent data on sternal metastases from a multidisciplinary approach (diagnosis strategies, outcome, and histological reports). This narrative review based on a PubMed search (between January 2020 and 22 July 2023) using key words such as "sternal", "manubrium", and "metastasis" within the title and/or abstract only included original papers that specifically addressed secondary sternal spreading of cancer in adults, for a total of 48 original articles (14 studies and 34 single case reports). A prior unpublished case in point is also introduced (percutaneous incisional biopsy was used to address a 10 cm sternal tumour upon first admission on an apparently healthy male). The studies (n = 14) may be classified into one of three groups: studies addressing the incidence of bone metastases (including sternum) amid different primary cancers, such as prostate cancer (N = 122 with bone metastases, 83% of them with chest wall metastases), head and neck cancers (N = 3620, 0.8% with bone metastases, and 10.34% of this subgroup with sternum involvement); and glioblastoma (N = 92 with bone metastases, 37% of them with non-vertebral metastases, including the sternum); assessment cohorts, including breast cancer (N = 410; accuracy and sensitivity of PET/CT vs. bone scintigraphy is superior with concern to sternum spreading) and bone metastases of unknown origin (N = 83, including a subgroup with sternum metastases; some features of PET/CT help the differentiation with multiple myeloma); and cohorts with various therapeutic approaches, such as palliative arterial embolization (N = 10), thymic neuroendocrine neoplasia (1/5 detected with sternum metastases), survival rates for sternum metastases vs. non-sternum chest wall involvement (N = 87), oligo-metastatic (sternal) breast cancer (3 studies, N = 16 for all of them), oligo-metastatic head and neck cancer (N = 81), conformal radiotherapy (N = 24,215, including an analysis on sternum spreading), and EBRT followed by MR-HIFU (N = 6). Core data coming from the isolated case reports (N = 34) showed a female to male ratio of 1.6; the females' ages were between 34 and 80 (mean of 57.28) and the males' ages varied between 33 and 79 (average of 58.78) years. The originating tumour profile revealed that the most frequent types were mammary (N = 8, all females) and thyroid (N = 9, both women and men), followed by bladder (N = 3), lung (N = 2), and kidney (N = 2). There was also one case for each of the following: adenoid cystic carcinoma of the jaw, malignant melanoma, caecum MiNEN, a brain and an extracranial meningioma, tongue carcinoma, cholangiocarcinoma, osteosarcoma, and hepatocellular carcinoma. To our knowledge, this is the most complex and the largest analysis of prior published data within the time frame of our methods. These data open up new perspectives of this intricate, dynamic, and challenging domain of sternum metastases. Awareness is a mandatory factor since the patients may have a complex multidisciplinary medical and/or surgical background or they are admitted for the first time with this condition; thus, the convolute puzzle will start from this newly detected sternal lump. Abbreviations: N = number of patients; n = number of studies; PET/CT = positron emission tomography/computed tomography; EVRT = external beam radiotherapy; MR-HIFU = magnetic resonance-guided high-intensity focused ultrasound; MiNEN = mixed neuroendocrine-non-neuroendocrine tumour. [ABSTRACT FROM AUTHOR]

Accurately diagnosing specific variants of alopecia remains challenging for pathologists, potentially delaying appropriate therapeutic decisions by dermatologists. Issues such as limited knowledge on optimal biopsy types and processing methods add complexity. Understanding the normal histology of hair follicles and their changes throughout the follicular cycle further complicates microscopic evaluation. This paper aims to summarize these characteristics and highlight essential diagnostic clues for pathologists to confidently suggest a diagnosis, therefore playing a key role in alopecia diagnosis. Ongoing education, collaboration with dermatologists, and staying up to date on advancements is crucial for the accurate diagnosis and effective management of different types of alopecia. [ABSTRACT FROM AUTHOR]

Simple Summary: US-MRI fusion biopsy is established as a technique of reference for the detection of clinically significative prostate cancer compared to the ultrasound "template" technique. Several software have been developed to aid clinicians to perform a real-time fusion between MRI and US prostate imaging; however, the images can also be mentally superimposed by the operator performing a cognitive fusion. Many papers in the literature describe the feasibility and efficacy of these two techniques, but few have performed a direct comparison between them. Therefore, we selected all comparative studies with the aim to perform a meta-analysis to find if one technique leads to an improvement in the detection rate of clinically significant prostate cancer (csPCa) for biopsies performed with a transperineal approach. Our findings indicate that csPCa detection is comparable between these techniques. Thus, clinicians can choose to perform a cognitive or software-assisted biopsy in accordance with their personal experience or technologic availability without the potential risk of offering an underperforming methodology. Introduction: We aimed to find potential differences in clinically significant prostate cancer (csPCa) detection rates between transperineal software-assisted fusion biopsy (saFB) and cognitive fusion biopsies (cFB). Methods: A systematic review of the literature was performed to identify comparative studies using PubMed, EMBASE, and Scopus according to the PICOS criteria. Cancer detection and complication rates were pooled using the Cochran–Mantel–Haenszel method with the random effect model and reported as odds ratios (ORs), 95% confidence intervals (CI), and p-values. A meta-analysis was performed using Review Manager (RevMan) 5.4 software by Cochrane Collaboration. The quality assessment of the included studies was performed using the Cochrane Risk of Bias tool, using RoB 2 for randomized studies and ROBINS-I for retrospective and nonrandomized ones. Results: Eight studies were included for the meta-analysis, including 1149 cases in software-based and 963 cases in cognitive fusion biopsy. The detection rates of csPCa were similar between the two groups (OR 1.01, 95% CI 0.74–1.37, p = 0.95). Study heterogeneity was low (I2 55%). Conclusion: There is no actual evidence of the superiority of saFB over cFB in terms of the csPCa detection rate. Operator experience and software availability can drive the choice of one fusion technique over the other. [ABSTRACT FROM AUTHOR]

Epithelioid rhabdomyosarcoma is an uncommon tumor. It is found mainly in somatic soft tissues like parotid, urinary bladder, trunk, neck, and limbs. Only two cases of this tumor in gastrointestinal tract (liver and gastro esophageal junction) has been reported to date; thus, we herein reported an unusual site of this tumor in the pylorus part of the stomach. In the present paper, we studied a 67-year-old male subject with complaint of dyspepsia, belching, and reflux for about 4 years. He had also consumed herbal drugs to relieve the pain for several years. In the endoscopy procedure, there was a large tumor at the distal part of the gaster. Furthermore, excisional biopsy was performed and the histological specimens showed tumor necrosis with high mitotic cell counts, large vesicles, eosinophilic cytoplasm of epithelial cells, and round nuclei. Immunohistochemistry staining was positive for Myogenin, Desmin, MyoD1 (30% ratio), and Ki67 (70 % ratio). Computed tomography scan images showed several metastases to peritoneum and lungs. After initiating the treatment, the adverse effects of chemotherapy persuaded us to discontinue the regimen. Finally, the patient died due to pulmonary embolism. To conclude, primary epithelioid rhabdomyosarcoma is a very rare lethal cancer that may be found as gastrointestinal cancers. Hence, it requires further diagnostic investigations in order for the best treatment to be found. [ABSTRACT FROM AUTHOR]

According to the ESMO and ASCO clinical guidelines, the main role of liquid biopsy in EGFR+ advanced NSCLC patients is represented by T790M detection after erlotinib/gefitinib/afatinib progression. However, the general international expert consensus regards osimertinib as the preferred upfront treatment in this setting; therefore, this role has been scaled back in recent years. As of today, liquid biopsy has no ASCO or ESMO recommendation following first-line osimertinib; in the same vein, no targeted therapy has received ASCO or ESMO recommendation following post upfront Osimertinib progression. However, this standard could change in the near future. Therefore, adopting a clinical point of view, this paper aims to provide a comprehensive review on the previous, the current and the possible future role of liquid biopsy in the framework of the diagnostic–therapeutic algorithm of EGFR+ advanced NSCLC. [ABSTRACT FROM AUTHOR]

Transperineal ultrasound-guided (TP) prostate biopsy has been shown to significantly decrease the risk of post-procedural sepsis when compared to transrectal ultrasound-guided (TRUS) prostate biopsy. With guidance from the European Urology Association favouring adoption of a TP biopsy route, it is clear that, despite being a more technically challenging procedure, TP biopsy in an outpatient setting will replace TRUS biopsy. This paper gives the reader a succinct summary of outpatient transperineal prostate biopsy under local anaesthetic utilising a free-hand ultrasound technique. Patient preparation and consent process is outlined. A comprehensive pictorial review of the procedure, pitfalls and common post-procedural outcomes is presented. This paper provides a framework and guide for those wishing to adopt the transperineal approach under local anaesthetic. [ABSTRACT FROM AUTHOR]

Objective: Radical mastectomy was first described by Halsted almost 130 years ago, and has been applied as a treatment strategy in Taiwan since the middle of the 20th century. However, due to the development of nonsurgical treatment modalities, the management of breast cancer has undergone tremendous change. This study examined Taiwanese publications between 1965 and 2020 to identify trends in the surgical management of breast cancer. Data Sources: We searched for papers published by authors from the Taiwan Breast Cancer Society and 18 tertiary referral medical centers in Taiwan. Study Selection: After excluding papers completely unrelated to surgery, there were 50 English language articles and 5 Chinese language articles available for historical review. Results: This nationwide survey of breast cancer over the past 40 years revealed the following trends in surgical management. (1) As detection rates of early-stage breast cancer increased, the amount of removed breast tissue decreased, with a corresponding reduction in percentage of total mastectomy. (2) Axillary sentinel node biopsy should be routinely performed in early breast cancer rather than axillary lymph node dissection without lymph node metastasis. (3) Since the development of gonadotropin antagonist, bilateral oophorectomy is no longer needed in the early stage in premenopausal population. Further pregnancy is allowed if the cancer is well controlled. (4) Breast reconstruction may be recommended, depending on the patients' preference, after total mastectomy for malignancy. Conclusion: Although this review of the literature may not be complete, the trends revealed in our analysis indicate that surgical management of breast cancer has become more patient-friendly, humanistic, and feasible in Taiwan. Currently, breast cancer may not have a poor outcome if the tumor can be detected at an earlier stage. [ABSTRACT FROM AUTHOR]

The article reports that a white paper published by the American Urological Association (AUA) and the Society of Urologic Nurses and Associates states that risk assessment should be performed in all men undergoing prostate biopsy to determine their risk of complications and alternative strategies should be used to prevent these complications. Topics covered include bleeding complications being the most prevalent after prostate biopsy.

Folliculotropic mycosis fungoides (FMF) represents 10% of all mycosis fungoides cases and even though supraciliary lesions and alopecia are characteristic, there are few published papers documenting trichoscopic findings in these patients. We report the case of a 50-year-old man who presented to our department with FMF stage IB. Clinical findings included disseminated erythematous patches and plaques with a fine white-grayish scale, madarosis, and multifocal patchy alopecia of the scalp. Trichoscopy revealed a decreased number of pilosebaceous units, dilated follicular openings, black dots, vellus, and dystrophic hairs. Examination of the scalp presented widespread white scaling and areas with dotted and spermatozoa-like vessels. A revision of the literature showed that dilated follicular openings, black dots, and scale were less frequent findings in FMF, and dystrophic hairs were more common in advanced FMF. In the future, trichoscopic evaluation might guide differential diagnosis and define the threshold to biopsy lesions to identify early disease. [ABSTRACT FROM AUTHOR]

The growth of liquid biopsy, i. e., the possibility of obtaining health information by analysing circulating species (nucleic acids, cells, proteins, and vesicles) in peripheric biofluids, is pushing the field of sensors and biosensors beyond the limit to provide decentralised solutions for nonspecialists. In particular, among all the circulating species that can be adopted in managing cancer evolution, both for diagnostic and prognostic applications, microRNAs have been highly studied and detected. The development of electrochemical devices is particularly relevant for liquid biopsy purposes, and the screen‐printed electrodes (SPEs) represent one of the building blocks for producing novel portable devices. In this work, we have taken miR‐2115‐3p as model target (it is related to lung cancer), and we have developed a biosensor by exploiting the use of a complementary DNA probe modified with methylene blue as redox mediator. In particular, the chosen sensing architecture was applied to serum measurements of the selected miRNA, obtaining a detection limit within the low nanomolar range; in addition, various platforms were interrogated, namely commercial and hand‐made SPEs, with the aim of providing the reader with some insights about the optimal platform to be used by considering both the cost and the analytical performance. [ABSTRACT FROM AUTHOR]

Endoscopic ultrasound (EUS) offers the ability to obtain tissue material via a fine needle under direct visualization for cytological or pathological examination. Prior studies have looked at EUS tissue acquisition; however, most reports have been centered around lesions of the pancreas. This paper aims to review the literature on EUS tissue acquisition in other organs (beyond the pancreas) such as the liver, biliary tree, lymph nodes, and upper and lower gastrointestinal tracts. Furthermore, techniques for obtaining tissue samples under EUS guidance continue to evolve. Specifically, some of the techniques that endoscopists employ are suction techniques (i.e., dry heparin, dry suction technique, wet suction technique), the slow pull technique, and the fanning technique. Apart from acquisition techniques, the type and size of the needle utilized play a major role in the quality of samples. This review describes the indications for tissue acquisition for each organ, and also describes and compares the various tissue acquisition techniques, as well as the different needles used according to their shape and size. [ABSTRACT FROM AUTHOR]

The transformation from non‐small‐cell lung cancer (NSCLC) to small‐cell lung cancer (SCLC) is one of the mechanisms of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) resistance. Previous studies exhibited that the median transformation time was 17.8 months for NSCLC to SCLC. Here we introduced a case of lung adenocarcinoma (LADC) with EGFR19 exon deletion mutation in which the pathological transformation emerged only 1 month after lung cancer surgery and receiving EGFR‐TKI inhibitor. Eventually, the pathological examination confirmed the patient experienced a transformation from LADC to SCLC with EGFR, tumor protein p53 (TP53), RB transcriptional corepressor 1 (RB1), and SRY‐box transcription factor 2 (SOX2) mutation. Although the transformation of LADC with EGFR‐mutant into SCLC after targeted therapy was frequent, the pathological results of most patients were only biopsy specimens, which cannot rule out the existence of mixed pathological components of the primary tumor. In this case, the patient's postoperative pathology was sufficient to exclude the probability of mixed tumor components, confirming that the patient's pathological change was indeed transformation from LADC to SCLC. In addition, primary drug resistance in such a short time after surgery and osimertinib‐targeted therapy has not been reported before. We detected the molecular state of this patient before and after SCLC transformation through targeted gene capture and high‐throughput sequencing, and also found for the first time that the mutations of EGFR, TP53, RB1, and SOX2 continue to exist before and after transformation, but the mutation abundance is different. In our paper, the occurrence of small‐cell transformation is affected largely by these gene mutations. [ABSTRACT FROM AUTHOR]

Simple Summary: Proteomics is a booming field in life sciences and, increasingly, is not only based on mass spectrometry (MS), but also on multiplex bead or aptamer assays and proximity extension assays. The use of untargeted MS generates big data sets in little time, but it also has limitations. Here, we discuss the plausibility of screening proteomic shotgun MS raw data for viral proteins in human gastric biopsies. Though this is technically possible and, thus, appealing to researchers, low-abundant proteins of guest species are barely present at suitable concentrations for measurement. Still, the processing algorithms will return hits due to chance assignments of low-quality spectra, but these should be red-flagged. A sanity check needs to establish whether or not certain proteins can be available at a sufficient concentration for measurement in the sample at all. Not every possible analysis is, thus, sensible. Even though both instrumentation and bioinformatic processing are continuously improving, a quality control of the data output will always be advisable. This paper uses practical examples to explain difficulties in spectral assignment leading to false-positive protein matches and is, thus, a tutorial for laymen and novices in MS-based proteomics. (1) Background: Untargeted mass spectrometry (MS)-based proteomic analysis is highly amenable to automation. Software algorithms translate raw spectral data into protein information obtained by a comparison to sequence databases. However, the technology has limitations, especially for analytes measured at the limit of detection. In a protein expression study of human gastric biopsies, the question arose whether or not it is possible, as well as sensible, to search for viral proteins in addition to those from the human host. (2) Methods: Experimental data-independent MS data were analyzed using protein sequences for oncoviruses, and BLAST analyses were performed to elucidate the level of sequence homology to host proteins. (3) Results: About one hundred viral proteins were assigned, but there was also up to 43% sequence homology to human proteins. (4) Conclusions: There are at least two reasons why the matches to viral proteins should be used with care. First, it is not plausible that large amounts of viral proteins should be present in human gastric biopsies, so the spectral quality of the peptides derived from viral proteins is likely low. As a consequence, the number of false assignments is high. Second, homologous peptides found both in human and virus proteomes contribute to matching errors. Thus, though shotgun proteomics raw data can technically be analyzed using any database, meaningful results cannot be always expected and a sanity check must be performed. Both instrumentation and bioinformatic processing in MS-based proteomics are continuously improving at lowering the limit of detection even further. Nevertheless, data output should always be controlled in order to avoid the over-interpretation of results. [ABSTRACT FROM AUTHOR]

Global health practitioners and policymakers have become increasingly vocal about the complex challenges of identifying and quantifying the causes of death of the world's poorest people. To address this cause-of-death uncertainty and to minimise longstanding sensitivities about full autopsies, the Bill and Melinda Gates Foundation have been one of the foremost advocates of minimally invasive autopsy technology (MIA). MIA involves using biopsy needles to collect samples from key organs and body fluids; as such, it is touted as potentially more acceptable and less invasive than a complete autopsy, which requires opening the cadaver. In addition, MIA is considered a good means of collecting accurate bodily samples and can provide the crucial information needed to address cause-of-death uncertainty. In this paper, we employ qualitative data to demonstrate that while MIA technology has been introduced as a solution to the enduring cause-of-death uncertainty, the development and deployment of technologies such as these always constitute interventions in complex social and moral worlds; in this respect, they are both the solutions to and the causes of new kinds of uncertainties. We deconstruct the ways in which those new dimensions of uncertainty operate at different levels in the global health context. [ABSTRACT FROM AUTHOR]

Simple Summary: Colic, a condition affecting the digestive tract of horses, manifests itself in severe pain and may be life-threatening. Recurrent colic is usually caused by ongoing, chronic inflammatory process (and may be defied as: ≥3 episodes of colic within a 6-month period, with at least 48 h between colic episodes), associated with a chronic process, often of an inflammatory nature. Multiple causes of recurrent colic may exist, including, for an improper diet, management changes, stress, or parasites infestation. During the diagnostic process, a noninvasive test in the form of taking a biopsy of the duodenal or rectal mucosa proves to be useful, but its usefulness is limited only to diffuse processes. The study presented here depicts a retrospective analysis of the histopathological findings of samples taken from 77 horses with recurrent colic, focusing on cellular infiltration, fibrosis, and erosions. All samples from the duodenum showed the presence of leukocytes infiltrates in the mucosal lamina propria, of which almost 70% were diffuse infiltrates. The most frequently observed cellular infiltration was a moderate infiltration consisting of lymphocytes and plasma cells. More than one-fourth of the horses were also found to have shortened intestinal villi. Similarly, in biopsies from the rectum, cellular infiltration was observed in all horses in this section, which consisted of a mixed population of plasma cells, lymphocytes, and eosinophilia. Analysis of the inflammatory lesions present may help in understanding the pathogenesis of chronic colic in horses. Colic, a condition affecting the gastrointestinal tract of horses, manifests as severe pain and may be a life-threatening condition. It is possible to distinguish between an acute, disposable process, as well as recurrent colic symptoms (abdominal pain) caused by an ongoing chronic inflammatory process. This paper presents a retrospective analysis of the histopathological findings of duodenal and rectal samples taken from horses with recurrent colic, with the aim to determine the frequency and extent of inflammation. The samples, i.e., duodenal biopsy (60 samples) and rectal biopsy (17 samples), were taken from 77 horses showing recurrent colic symptoms. Histopathological examination included staining with hematoxylin and eosin. The examination included evaluation of the superficial epithelium, mucosal lamina propria, and submucosa. All samples from the duodenum and rectum showed the presence of leukocyte infiltration in the mucosal lamina propria. The most frequently observed cellular infiltration was a moderate infiltration consisting of lymphocytes and plasma cells in duodenum and mixed populations of plasma cells, lymphocytes, and eosinophilia in the rectum. Mott cells were also noted among the inflammatory infiltrates. More than one-fourth of the horses were found to have shortened intestinal villi. The results presented here showed the involvement of inflammation in the course of recurrent colic, which can be both its cause (by impairing motility and absorption) and its effect (as a result of obstruction or ischemia). [ABSTRACT FROM AUTHOR]

This paper reviews the role of fine needle aspiration biopsy (FNAB) in assessing the axilla prior to definitive surgery or neoadjuvant therapy in breast cancer patients. The radiological criteria for biopsy are discussed and pathological techniques and pitfalls illustrated. The sensitivity and specificity of the technique and the clinical utility are addressed, with particular reference to the current controversies in the management of the axilla in the light of the American College of Surgeons Oncology Group Z0011 trial results. The low morbidity procedure of FNAB is recommended when the radiological and clinical features suggest a high yield from the abnormal axillary nodes, with consideration of core biopsy if an expected positive result is not obtained or the circumstances require tissue for ancillary studies. In conclusion, FNAB of the axilla is a highly sensitive procedure which can offer further valuable information to assist in clinical decision making. The technique is of particular value in the setting of a large primary tumour size and multiple enlarged nodes. A summary flow chart is provided to facilitate pre-operative management of the axilla and to encourage a universal approach. [ABSTRACT FROM AUTHOR]

Of all animals considered subjects for instrumentation for behavioral or physiological studies, cetaceans probably represent the greatest challenge to the engineer and biologist. The marine environment being harsh to electronics, evasive behavior during tagging approaches and the short time window available to attach instruments, all imply a need for innovative tagging solutions to facilitate better understanding of their life cycle, migration, physiology, behavior, health and genetics. Several animal-attached tag packages holding specific data loggers, e.g., time depth recorders, position, orientation, acoustic and video recorders for short to medium term studies, as well as tags developed for large scale migration telemetry studies are available as off-the-shelf devices, or in many cases as custom made sensor packages. Deployment of those instruments is often the limiting factor for data collection. The Aerial Remote Tag System (ARTS) is a flexible system which can easily be adapted to deploy different tag sensor packages and biopsy collection devices. This paper presents the history and design of the ARTS, and accessories developed for instrumentation and biopsy sampling of cetaceans, such as the recent developed ARTS–LKDart for biopsy sampling. Deployment of archival tags usually requires radio tracking of the instrumented animal, or at least tracking of the tag for recovery. Thus, we also here describe the automatic digital signal processing radio direction finder, the Direction Finder Horten (DFHorten unit). [ABSTRACT FROM AUTHOR]

Simple Summary: In this paper we systematically evaluate the evidence regarding the role of [68Ga]PSMA PET/CT for clinical suspicions of prostate cancer in patients with or without previous negative biopsy. A critical review of PubMed and Web of Science according to the PRISMA statement was conducted. Eighteen publications were selected for inclusion in the analysis. In 8 articles, there was a direct comparison with mpMRI. [68Ga]PSMA PET/CT resulted more accurate in identifying primary prostate cancer with PSA values between 4 and 20 ng/mL than mpMRI. Moreover, its use combined with MRI improved sensitivity for csPCa detection, thus potentially avoiding unnecessary biopsies. Overall, [68Ga]PSMA PET/CT resulted a promising technique in patients with clinical suspicion of PCa and precedent negative biopsy or contraindications to MRI. The purpose of the study is to systematically evaluate the evidence regarding the role of [68Ga]PSMA PET/CT for clinical suspicions of prostate cancer in patients with or without previous negative biopsy. We performed a critical review of PubMed and Web of Science according to the PRISMA statement. Eighteen publications were selected for inclusion in this analysis. QUADAS-2 evaluation was adopted for quality analyses. [68Ga]PSMA-11 was the radiotracer of choice in 15 studies, while [68Ga]PSMA-617 was used in another 3. In 8 articles, there was a direct comparison with mpMRI. The total number of patients included was 1379, ranging from 15 to 291, with a median age of 64 years (range: 42–90). The median baseline PSA value was 12.9 ng/mL, ranging from 0.85 to 4156 ng/mL. Some studies evaluated the PSMA uptake comparing the SUVmax of suspicious lesions with the SUVmax of the normal biodistribution to find out optimal cut-off points. In addition, some studies suggested a significant association between PSA levels, PSA density, and [68Ga]PSMA PET/CT finding. [68Ga]PSMA PET/CT seems to be more accurate in identifying primary prostate cancer with PSA values between 4 and 20 ng/mL than mpMRI. Moreover, in some trials, the combination of PSMA PET/CT and MRI improved the NPV in the detection of clinically significant prostate cancer (csPCa) than MRI alone. Our findings are limited by the small numbers of studies and patient heterogeneity. [68Ga]PSMA PET/CT is a promising technique in patients with clinical suspicion of PCa and precedent negative biopsy or contraindications to MRI. Furthermore, its use combined with MRI improves sensitivity for csPCa detection and can avoid unnecessary biopsies. [ABSTRACT FROM AUTHOR]

Wilms tumor is rare in adults, constituting only 0.5% of all renal masses. Tumors in adults are diagnosed later than those in children, and survival after treatment is still low. Some reasons for this are considered as patients not receiving neoadjuvant chemotherapy before surgery and late initiation of treatment due to delays in receiving pathology results. In this paper, we present a 38-year-old male patient diagnosed with Wilms tumor after percutaneous biopsy and review the related literature. [ABSTRACT FROM AUTHOR]

Simple Summary: In patients with relapsed or metastasized squamous cell cancer of the head and neck (R/M SCCHN), the PD-L1 Combined Positive Score (CPS) is currently the only predictive biomarker for treatment with anti-PD-1 agents. However, ambiguous results have been determined regarding the overall response rates of immunotherapeutic agents based on PD-L1 status, which may be partially attributed to spatiotemporal heterogeneity. Furthermore, tumor-infiltrating lymphocytes (TILs) have proven to be of significant prognostic value, yet lack of a standardized method for quantification impedes their integration into the current armamentarium of biomarkers in SCCHN. In this paper, concordance of PD-L1 CPS and stromal TILs was investigated in different paired samples of SCCHN subtypes. The results were then linked to well-known clinicopathological variables and prognosis. Background: The clinical significance of tumor-infiltrating lymphocytes (TILs) and programmed cell death-ligand 1 (PD-L1) expression has been thoroughly researched in squamous cell carcinoma of the head and neck (SCCHN). To address the impact of intra- and intertumoral heterogeneity in these biomarkers, we explored the concordance of PD-L1 combined positive score (CPS) and stromal TILs in different paired tissue sample types, while evaluating their internal relationship and prognostic impact. Methods: A total of 165 tissue blocks from 80 SCCHN patients were reviewed for TILs and PD-L1 CPS. Concordance between paired tissue samples was evaluated, and their association with several clinicopathological variables, overall survival (OS), and disease-free survival (DFS) was determined. Results: Biopsies and paired resection material were severely discordant in 39% and 34% of samples for CPS and TIL count, respectively, of which CPS was underscored in 27% of biopsies. In paired primary tumor–metastatic lesions, the disagreement was lower for CPS (19%) but not for TIL count (44%). PD-L1 CPS was correlated with prolonged OS when calculated from tissue acquirement, while extended OS and DFS were observed for high TIL density. Conclusion: Intertumoral and, especially, intratumoral heterogeneity were confounding factors when determining PD-L1 CPS and TIL count on paired tissue samples, indicating the increasing necessity of assessing both biomarkers on representative tissue material. Although TILs hold valuable prognostic information in SCCHN, the robustness of PD-L1 as a biomarker in SCCHN remains ambiguous. [ABSTRACT FROM AUTHOR]

Background: Early identification of the stage of oral cancer development can lead to better treatment outcomes and avoid malignant transformation. Therefore, this review aims to provide a comprehensive overview that describes the development of standardized procedures for oral sample collection, characterization, and molecular risk assessment. This can help investigators to choose the appropriate sampling method and downstream analyses for different purposes. Methods: This systematic review was conducted according to the PRISMA guidelines. Using both PubMed and Web of Science databases, four independent authors conducted a literature search between 15 and 21 June 2021. We used key search terms to broaden the search for studies. Non-conforming articles were removed using an EndNote-based and manual approach. Reviewers used a designed form to extract data. Results: This review included a total of 3574 records, after eliminating duplicate articles and excluding papers that did not meet the inclusion criteria. Finally, 202 articles were included in this review. We summarized the sampling methods, biopsy samples, and downstream analysis. The biopsy techniques were classified into tissue and liquid biopsy. The common sequential analysis of tissue biopsy includes histopathological examination such as H&E or IHC to identify various pathogenic features. Meanwhile, liquid samples such as saliva, blood, and urine are analyzed for the purpose of screening to detect mutations in cancer. Commonly used technologies are PCR, RT-PCR, high-throughput sequencing, and metabolomic analysis. Conclusions: Currently, tissue biopsies provide increased diagnostic value compared to liquid biopsy. However, the minimal invasiveness and convenience of liquid biopsy make it a suitable method for mass screening and eventual clinical adoption. The analysis of samples includes histological and molecular analysis. Metabolite analysis is rising but remains scarce. [ABSTRACT FROM AUTHOR]

The histopathological diagnosis of prostate adenocarcinoma in needle biopsy specimens is of pivotal importance for determining optimum prostate cancer treatment. Since diagnosing a large number of cases containing 12 core biopsy specimens by pathologists using a microscope is time-consuming manual system and limited in terms of human resources, it is necessary to develop new techniques that can rapidly and accurately screen large numbers of histopathological prostate needle biopsy specimens. Computational pathology applications that can assist pathologists in detecting and classifying prostate adenocarcinoma from whole-slide images (WSIs) would be of great benefit for routine pathological practice. In this paper, we trained deep learning models capable of classifying needle biopsy WSIs into adenocarcinoma and benign (non-neoplastic) lesions. We evaluated the models on needle biopsy, transurethral resection of the prostate (TUR-P), and The Cancer Genome Atlas (TCGA) public dataset test sets, achieving an ROC-AUC up to 0.978 in needle biopsy test sets and up to 0.9873 in TCGA test sets for adenocarcinoma. [ABSTRACT FROM AUTHOR]

The paper critically looks at the state of forensic medicine in India, and makes an appeal to all concerned to make some concerted efforts to raise its levels. [ABSTRACT FROM AUTHOR]