Radiology and Oncology Feed

Erratum: Visual versus automated CT perfusion for outcome prediction in anterior circulation stroke treated with mechanical thrombectomy

Fri, 02 Oct 2026 00:00:00 GMT

Erratum: CT-guided 125I brachytherapy for hepatocellular carcinoma in high-risk locations after transarterial chemoembolization combined with microwave ablation: a propensity score-matched study

Thu, 01 Oct 2026 00:00:00 GMT

Clinical impact of trace elements as potential biomarkers for diagnosis and prediction of response to systemic treatment in gastrointestinal cancers

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundGastrointestinal cancers are among the most common malignancies worldwide and, at advanced stages, remain incurable. Currently used biomarkers, such as tumour markers, have limited diagnostic value for early detection and relapse, highlighting the urgent need for more sensitive and specific markers. Trace elements are involved in numerous physiological and metabolic processes, and deregulation of their homeostasis is implicated in the carcinogenesis of various cancers, including gastrointestinal malignancies. Several basic and preclinical studies have identified the importance of trace elements in key biological processes. Recent clinical studies and retrospective analyses suggest that fluctuations in trace element levels may be associated with the development and progression of many cancers. Thus, quantitative and dynamic determination of serum trace element concentrations during treatment and follow-up represents a promising option for monitoring treatment efficacy and disease prognosis.ConclusionsTrace elements may serve as potential prognostic and predictive biomarkers for diagnosis and response to systemic treatment.

Comparative assessment of hydration status in intestinal failure patients receiving home parenteral nutrition using different bioimpedance analysis devices

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundIntestinal failure patients receiving home parenteral nutrition (HPN) are at high risk of dehydration and malnutrition. To optimize clinical care, accurate monitoring tools are required. This study aimed to compare the accuracy of two bioelectrical impedance analysis (BIA) devices, one that offers only BIA results and the other that offers BIA results of bioelectrical impedance vector analysis (BIVA) and bioelectrical impedance spectroscopy (BIS), in assessing hydration and nutritional status in HPN patients.Patients and methodsIn a cross-sectional study, 55 adult HPN patients (33 males, 22 females; mean age 61.5 ±13.1 years) underwent BIA measurements using both devices during routine visits. Parameters measured included total body water (TBW), intracellular and extracellular water, fat-free mass, fat mass, and phase angle. Serum urea and creatinine served as hydration markers. Paired t-tests, Mann-Whitney U tests, and Spearman correlations were used for analysis.ResultsThe BIA/BIVA/BIS analysis indicated dehydration in 69.1% of patients compared to 29.1% by BIA (p < 0.001) and showed stronger correlations with serum urea. It also classified more patients as malnourished (24.4% vs. 16.4%, p = 0.436). Correlation between hydration status and phase angle was more pronounced when using phase angle determined with BIA/BIVA/BIS.ConclusionsBIA/BIVA/BIS measurements in the study demonstrated superior sensitivity in detecting dehydration and assessing nutritional status in HPN patients in comparison to BIA, supporting its use for improved clinical monitoring and management in this group of patients.

18F-FDG PET/CT-based recurrence patterns and survival outcomes in esophageal carcinoma: a single center experience

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundThis study aimed to evaluate differences among three patient groups with suspected recurrent esophageal carcinoma, defined by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) findings, in quantitative and semiquantitative PET/CT parameters and serum tumor markers, and to assess their impact on progression-free survival (PFS) and overall survival (OS).Patients and methodsThis retrospective cohort study included 77 patients with positive 18F-FDG PET/CT findings between January 2014 and December 2025. Based on 18F-FDG PET/CT findings, patients were classified into three groups: G1 (isolated locoregional recurrence), G2 (isolated metastases), and G3 (both locoregional disease and metastases). Semiquantitative and quantitative 18F-FDG PET/CT parameters, histopathological characteristics, and blood tumor marker levels were compared among the groups. For survival analysis, patients were stratified into low and high groups according to the median value of each parameter.ResultsElevated carcinoembryonic antigen (CEA) levels were significantly more frequent in G2 and G3 compared with G1 (p = 0.005), while no significant difference was observed for carbohydrate antigen 19-9 (CA19-9) levels (p = 0.280). Significant differences in all analyzed 18F-FDG PET/CT parameters were found among the three groups, with the highest values in G3. Patients with lower maximal standardized uptake values (SUVmax) and SUVmean values demonstrated significantly longer PFS and OS. Lower metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values were associated with significantly longer progression-free survival (PFS), while overall survival (OS) was also longer, although without statistical significance.ConclusionsStudies stratifying patients by isolated locoregional recurrence, isolated metastases, and combined locoregional/metastases on 18F-FDG PET/CT remain limited. Our findings suggest that disease spread patterns and semiquantitative/quantitative 18F-FDG PET/CT parameters may provide important prognostic value in patients with esophageal carcinoma.

Analysis of the effects of individualized nutrition and physical activities on body composition during the treatment of breast cancer patients

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundMalnutrition and loss of skeletal muscle mass are common in breast cancer patients and represent negative prognostic factors. Combined nutrition and exercise interventions may help preserve body composition during treatment. The aim of this study was to evaluate the effects of a targeted nutritional and exercise intervention on body composition, assessed by Bioelectrical Impedance Analysis (BIA), in breast cancer patients undergoing treatment, stratified by baseline nutritional status according to the Global Leadership Initiative on Malnutrition (GLIM) criteria.Patients and methodsIn this retrospective analysis of the OREH pilot study, 287 patients were included in the intervention group and 194 in the control group. All patients underwent BIA measurements at baseline, 6 months, and 12 months. Malnourished patients (GLIM-positive) in both groups received individualized nutritional counseling as standard care. GLIM-negative patients in the intervention group received preventive nutritional counseling via online lectures. All intervention group patients participated in supervised group exercise. Differences in BIA parameters (fat-free mass index, phase angle, fat mass, total body water, and body mass index) between the 3rd and 1st measurements were compared using Welch’s t-test, with p-values adjusted by the Bonferroni-Holm method.ResultsNo statistically significant differences in body composition parameters were observed between the intervention and control groups over the 12-month follow-up period. The adjusted p-value for fat-free mass index (FFMI) was 0.2 in GLIM-positive patients and 1.0 in GLIM-negative patients. A trend toward greater FFMI increase was observed in GLIM-positive patients in the intervention group compared to controls (mean difference 0.30; 95% CI 0.05–0.54; unadjusted p = 0.017), but this did not remain significant after correction for multiple comparisons.ConclusionsThe combined nutritional and exercise intervention did not significantly improve BIA-derived body composition parameters. However, the trend toward FFMI improvement in GLIM-positive patients receiving individualized nutritional counseling suggests that personalized approaches may be more effective than group-based interventions. Future studies should incorporate individualized nutrition and resistance training programs to optimize body composition outcomes in breast cancer patients.

The role of particle therapy in the treatment of locally recurrent rectal cancer: a systematic review

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundColorectal cancer is a common malignancy. Advancements in multimodality treatment have improved outcomes. About 2–10% of patients will have a local recurrence even after optimal treatment. Salvage surgical treatment is the treatment of choice, however, in posterior and lateral recurrences, surgery is linked to a high rate of treatment-related morbidity. Some recurrences remain unresectable even after neoadjuvant treatment.Materials and methodsA systematic literature review was performed to search for studies on curative-intent radiation therapy (RT) with photons, stereotactic body radiation therapy (SBRT) and particle beam therapy. The aim of the literature search was to define the role of particle therapy in the treatment of patients with unresectable or inoperable local recurrences of rectal cancer where neoadjuvant treatment is unlikely to result in downstaging, leaving patients with RT as the only curative treatment option.Results32 studies which fulfil the criteria were identified. In general, SBRT and particle beam therapy permitted the application of significantly higher doses to the target without a concomitant increase in treatment-related toxicities.ConclusionsFor unresectable and inoperable locally recurrent rectal cancer ablative radiotherapy techniques such as SBRT and particle beam therapy offer a curative treatment approach as an alternative to surgery. SBRT can be offered for small local and nodal recurrences, while particle beam therapy can be offered for larger recurrences and complex shapes spanning several anatomical compartments as well. Further research is needed to stratify patients according to their need and eligibility for the different possible modalities of curative-intent RT.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases: a single-institution experience

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundPeritoneal metastases (PM) from colorectal cancer are associated with poor prognosis. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has been proposed for selected patients, although its role remains debated. This study evaluates the efficacy and safety of CRS plus HIPEC in a single institution.Patients and methodsThis retrospective study included patients with colorectal PM treated with CRS and HIPEC between 2009 and 2024. Preoperative staging involved CT and/or MRI, and all cases were discussed in a multidisciplinary team. Disease burden was assessed using the Peritoneal Cancer Index (PCI), and completeness of cytoreduction (CC score) was recorded. HIPEC was performed with oxaliplatin (360 mg/m2 at 42°C for 90 minutes). Overall survival (OS) was the primary endpoint; disease-free survival (DFS) and morbidity were secondary endpoints.ResultsFifty patients (mean age 54 years) were included. Complete cytoreduction (CC-0/1) was achieved in 88% of cases, with a median PCI of 8.33. Severe complications occurred in 18% of patients, with no 30-day mortality. After a median follow-up of 34 months, median OS was 49 months; 1- and 5-year OS rates were 96% and 54%, respectively. Median DFS was 14 months. PCI, CC score, and prior surgical score (PSS) were associated with OS on univariate analysis, while PCI and CC score remained independent prognostic factors.ConclusionsCRS plus HIPEC is a feasible and effective treatment for selected patients with colorectal PM, with acceptable morbidity. Low PCI and complete cytoreduction are key predictors of improved survival.

Does age have an impact on surgical and oncologic outcomes after curative resection for gastric cancer: a ten-year single-centre retrospective study

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundGastric cancer remains a major health burden in Slovenia, particularly among elderly patients. With increasing life expectancy, a growing number of patients aged ≥ 70 years are expected to undergo curative surgery. This study compared clinical, surgical, and oncologic outcomes between elderly (≥ 70 years) and younger (< 70 years) patients with gastric cancer.Patients and methodsA single-center retrospective cohort study included patients who underwent curative-intent surgery for gastric adenocarcinoma between 2015 and 2024. Patients were stratified by age. Demographic data, comorbidities, tumor characteristics, surgical variables, postoperative complications (Clavien-Dindo classification), and overall survival (OS) were analyzed. Survival was assessed using the Kaplan-Meier method, and prognostic factors were evaluated using Cox proportional hazards regression.ResultsA total of 433 patients were included (229 < 70 years; 204 ≥ 70 years). Elderly patients had higher American Society of Anesthesiologists (ASA) scores and a higher incidence of major postoperative complications. R0 resection rates and surgical radicality were comparable between groups; however, elderly patients more frequently underwent subtotal gastrectomy and less extensive lymphadenectomy. Perioperative chemotherapy was more commonly administered in younger patients. Tumour characteristics and TNM stage distribution were similar between groups. Five-year OS was significantly lower in elderly patients (37.3% vs. 59.6%, p < 0.001).ConclusionsCurative gastric cancer surgery should not be denied based solely on chronological age. Carefully selected elderly patients can achieve acceptable surgical and oncologic outcomes, highlighting the importance of biological age and functional status in treatment decision-making.

EPHA3, upregulated in high-risk histological subtypes of gastrointestinal stromal tumor, promotes GIST progression

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundTo explore the expression pattern and functional role of EPH receptor A3 (EPHA3) in high-risk gastrointestinal stromal tumors (GISTs) and its potential relevance to tumor progression.Materials and methodsImmunohistochemical (IHC) analysis was performed to evaluate EPHA3 expression across a pilot cohort of clinical GIST specimens with different risk stratifications. The biological functions of EPHA3 in vitro were assessed using (5-ethynyl-2’-deoxyuridine, EdU) assay, colony formation, apoptosis, wound-healing, and transwell assays in EPHA3-knockout GIST-430 cells. Furthermore, RNA sequencing (RNA-seq) analysis was utilized to identify differentially expressed genes and associated signaling pathways following EPHA3 knockout.ResultsEPHA3 expression was found to be elevated in high-risk GIST specimens compared with intermediate-risk cases. Loss-of-function assays demonstrated that EPHA3 knockout attenuated cell proliferation and migration while promoting apoptosis in vitro. Pathway enrichment analysis suggested that EPHA3 expression is associated with cell adhesion, extracellular matrix interaction, and mesenchymal-related phenotypic remodeling.ConclusionsOur findings suggest that EPHA3 is upregulated in high-risk GIST and contributes to aggressive cellular behavior in vitro. These preliminary data indicate that EPHA3 may play a role in the malignant progression of GIST, although its clinical utility as a biomarker requires further validation in larger cohorts.

Luciferase-induced immune activation prevents orthotopic K7M2luc osteosarcoma establishment in BALB/c mice

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundUse of murine orthotopic tumor models dictates utilization of luciferase-expressing cells for in vivo bioluminescence imaging. However, luciferase may trigger immune responses that impair tumor establishment.Materials and methodsWe transduced K7M2 cells wild-type (wt) with luciferase gene and evaluated their growth in vitro. We then implanted cells orthotopically in BALB/c mice and upon unsuccessful tumor establishment assessed systemical and local mechanism for tumor growth suppression.ResultsAll investigated cell lines had a comparative doubling time in vitro at 24 and 48h. Despite that, K7M2luc E5 differed from K7M2luc A7 and K7M2 wt by having a much higher proliferation rate at 72h (35x, 15x and 17x). In vivo, both luciferase-expressing cell lines failed to establish tumors, whereas K7M2 wt had a 100% success rate. To investigate the underlying mechanism, we assessed systemic and local cell-mediated immunity. Mice in groups K7M2luc A7 and K7M2luc E5 had a higher fold change (5 ± 0.8 and 6 ± 1.05) of GrB secreting splenocytes than naïve mice (1 ± 0.2). In the bone microenvironment, luciferase groups exhibited elevated numbers of GrB-secreting cells and CD8+ T cells relative to K7M2 wt and naïve mice.ConclusionsThese findings indicate that luciferase activates cytotoxic T-cell responses capable of eliminating implanted cells. Tumor establishment was restored in immunodeficient mice lacking CD8+ cells, confirming the immunemediated rejection.

Breast DCE-MRI morphological features and semi-quantitative parameters associated with upgrade to invasive carcinoma in biopsyproven DCIS

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundThe aim of this study was to identify imaging predictors of upgrade to invasive carcinoma (IC) in patients with biopsy-proven ductal carcinoma in situ (DCIS) based on morphological features and semi-quantitative parameters derived from dynamic contrast-enhanced breast magnetic resonance imaging (DCE-MRI).Patients and methodsNinety consecutive patients with biopsy-proven DCIS who had positive findings on standard full-protocol breast DCE-MRI and subsequently underwent surgical excision with final postoperative histopathological diagnosis were included. Patients with final postoperative IC were compared with those without IC. Morphological features (lesion type, size, multifocality/multicentricity, T2-weighted (T2W) and turbo inversion recovery magnitude [TIRM] characteristics) and semi-quantitative parameters (wash-in, peak enhancement, delayed phase of the timeintensity curve [TIC], time to peak [TTP], and positive enhancement integral [PEI]) were analyzed.ResultsFifty-five patients (61.1%) had no IC, while 35 patients (38.9%) had IC on final histopathology. Patients with IC more frequently demonstrated non-mass enhancement (NME) combined with a mass, larger lesion size, multifocal or multicentric disease, T2W/TIRM hyperintensity, fast wash-in, higher peak enhancement, plateau and washout TIC patterns, higher PEI, and shorter TTP. Multivariate analysis identified NME combined with a mass, delayed-phase TIC characteristics, and TIRM hyperintensity as independent predictors of IC.ConclusionsOur study confirmed that prediction models incorporating breast DCE-MRI morphological features and semi-quantitative parameters can stratify patients with biopsy-proven DCIS by their probability of upgrade to IC. TIRM hyperintensity emerged as one of three independent predictors of IC and, to the best of our knowledge, has not been previously reported in this context.

Timed saliva sampling as a new reliable marker for assessing iodine intake

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundIodine is an essential component of thyroid hormones. Therefore, sufficient iodine intake is important for adequate thyroid function. Measuring the urinary iodine concentration (UIC) is the recommended method for assessing population iodine intake, but it has certain drawbacks. In addition to urine, iodine is also excreted into saliva. Therefore, the aim of our work was to determine whether salivary iodine concentration (SLIC) measurement could replace UIC measurements, even a gold standard, urinary iodine excretion (UIE) in the 24-hour urine. We also evaluated the influence of saliva collection time on SLIC measurements.Subjects and methodsWe invited adult volunteers who first provided 24-hour urine and saliva samples collected on the same day at home, strictly according to the protocol. UIC and SLIC before and after meals were measured using the Sandell-Kolthoff method, comparable to inductively coupled plasma mass spectrometry.ResultsThe study included 104 healthy participants from whom all biological samples were completely collected. Importantly, none of them was taking thyroid medication or iodine supplements and all were without thyroid disease. A very good correlation of SLIC values at 60 and 120 min after the first and second meal and 30 min after the second, third, and fourth meals with UIE was observed (P>0.05).ConclusionsWe found an excellent correlation between SLIC values and UIE, where the SLIC value depends on the sampling timing and/or number of meals. SLIC measurement could replace UIE measurement and represents an important and possible new biomarker for assessing iodine intake.

Real-world data survival outcomes of first line immunotherapy with pembrolizumab in high expressers with stage IV non-small cell lung cancer

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundPembrolizumab monotherapy is standard of care in first line treatment of patients with stage IV lung cancer and programmed death ligand 1 (PD-L1) expression ≥ 50%. Whether the higher levels of PD-L1 expression predict higher benefit from the treatment with pembrolizumab is still debatable.Patients and methodsThis trial analyzed clinical and pathological characteristics, overall response rate (ORR), and survival outcomes in patients with non-small cell lung cancer (NSCLC) and PD-L1 expression of ≥ 50% who received front line treatment with pembrolizumab in real-world setting. The aim was to evaluate does the level of expression influence survival endpoints.ResultsFifty-one consecutive patients were evaluated in this study. The median PFS for patients in this study was 12.0 months (95% CI, 7.7–16.2 months), and the median OS was 21.0 months (95% CI, 9.6–32.3 months). Based on PD-L1 status patients were divided into two groups. First one with PD-L1 expression of 50%–79%, and the second with expression over 80%. Gender distribution between the two groups (p = 0.029) and difference in stage of the disease (p = 0.039) were statistically significant. There was no significant difference in progression free survival (p = 0.548) and overall survival (p = 0.153) between two groups.ConclusionsThis trial did not confirm relation between higher expression of PD-L1 and better survival outcomes. However, the pitfall of the trial was relatively small number of patients, so with the expansion of this real-world data (RWD) dataset future results might differ.

Electrochemotherapy for cutaneous tumors combined with tumor irradiation before or after treatment: feasibility, safety, and effectiveness

Mon, 07 Sep 2026 00:00:00 GMT

BackgroundElectrochemotherapy (ECT) can be performed on tumors in patients that precedes tumor irradiation or on recurrent tumors after tumor irradiation. In this study we evaluated the feasibility, safety and effectiveness of the combined ECT and tumor irradiation (radiotherapy, RT) on different tumors in the head and neck region.Patients and methodsFor the present cohort analysis, patients were selected from the Insp-ECT database, based on the following criteria: presence of head and neck lesions of any histological origin, treatment with both ECT and RT in any sequence, and a maximum interval of 12 months between the two treatments. The patients were treated with ECT followed by RT (ECT → RT) or RT followed by ECT (RT → ECT), in both cases because the first treatment resulted in incomplete response or subsequent relapse. In the case of ECT → RT the meantime interval was 5.7 months and in the case of RT → ECT 7.6 months. The minimal time interval between the treatments was 1 month.ResultsTreatment with ECT with bleomycin was feasible in all patients, treated either before or after RT. Included were 37 patients with the head and neck lesions. The combined treatment was performed predominantly on older population of patients with the age range from 50 to 96 years, median over 80 years. Importantly, in the group ECT → RT the major reason for RT was partial response (67%) after ECT. While, in the RT → ECT group the major reason for subsequent ECT was 58% of stable or progressive disease (failure to treatment). In both groups local symptoms decreased, like ulceration, odour and suppuration of tumors. In the ECT → RT group, the short-term response after 2 months was high, with 89% objective responses. In contrast, the RT → ECT group had a significantly lower rate, with 58% objective responses. At 24-month progression free survival (PFS) was 68% in the ECT → RT group and 20% in the RT → ECT group (p = 0.0101). The overall progression free survival Kaplan-Meier curves also differed significantly (log-rank p = 0.0232).ConclusionsThe combined treatment of ECT and RT is feasible, safe, and effective in elderly patients. The findings suggest that ECT may have particular value as a neoadjuvant treatment before RT, especially for bulky, ulcerated, or symptomatic lesions in this population.

Non-thermal ablation and drug delivery by electroporation: expanding current indications beyond cancer and cardiac treatment

Wed, 12 Aug 2026 00:00:00 GMT

BackgroundElectroporation-Based Treatments and Therapies (EBTTs) – electrochemotherapy, irreversible electroporation, pulsed field ablation, and gene electro-transfer – use short, high-voltage electric pulses to permeabilize cell membranes, enabling non-thermal tissue ablation and enhanced local drug delivery. Although EBTTs have been used clinically for over three decades, primarily in oncology, their adoption remains limited compared to thermal ablation modalities. In contrast, cardiac pulsed field ablation (PFA) has seen rapid adoption since the first FDA device approval in December 2023.ConclusionsThis expert opinion paper reviews the current clinical landscape of EBTTs in oncology and cardiac arrhythmia treatments, and focuses on emerging non-oncological and non-cardiac applications, including endoscopic pulsed electric field therapy for type 2 diabetes, bronchial rheoplasty for chronic bronchitis, bleomycin electrosclerotherapy for vascular malformations, nanosecond PFA for benign thyroid nodules, and electroporation-mediated gene delivery – and identifies key barriers to wider adoption: insufficient randomized evidence, lack of validated treatment planning tools, fragmented reimbursement, and limited standardization. We outline measures to facilitate clinical translation.

Diagnostic performance of whole-body diffusion-weighted imaging for staging esophageal cancer: a comparative study with PET-CT

Wed, 29 Jul 2026 00:00:00 GMT

BackgroundAccurate preoperative staging is crucial for selecting treatment strategies and assessing prognosis in esophageal cancer. Positron emission tomography-computed tomography (PET-CT) is currently recognized as an essential staging modality, whereas the value of whole-body diffusion-weighted imaging (WB-DWI), a radiation-free functional magnetic resonance imaging (MRI) technique in esophageal cancer staging remains unclear. The objective of the study was to conduct a head-to-head comparison of the diagnostic accuracy of WB-DWI versus PET-CT in the initial diagnosis of esophageal cancer patients for local T staging, regional lymph node (N) assessment, and distant metastasis (M) detection.Patients and methodsThis study collected data from 96 patients with esophageal cancer who underwent pathological diagnosis and imaging evaluation at Haian People’s Hospital between January 2023 and January 2025. Propensity Score Matching (PSM) was employed to balance confounding factors between groups, ultimately forming matched cohorts for analysis: the WB-DWI group (n = 32) and the PET-CT group (n = 32). Using postoperative pathology (PTNM) and/or 6-month follow-up clinical diagnosis as the gold standard, the following metrics were evaluated: T staging accuracy, N staging sensitivity/specificity, distant metastasis (M staging) detection rate, overall staging accuracy, image signal-to-noise ratio (SNR), examination duration, and inter-observer agreement (Kappa value). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for both methods. Diagnostic performance was analyzed using ROC curves, and the area under the curve (AUC) was compared via DeLong’s test.ResultsWB-DWI and PET-CT demonstrated comparable overall staging accuracy for esophageal cancer (84.4% vs. 87.5%, p > 0.05). For N staging, PET-CT demonstrated higher sensitivity (90.6% vs. 78.1%, p < 0.05), while both methods showed identical specificity (87.5%). In detecting distant metastases, PET-CT exhibited marginally higher detection rates and accuracy than WB-DWI, though differences were not statistically significant. WB-DWI demonstrated lower accuracy for T staging (71.9% vs. 84.4%, p < 0.05). WB-DWI images exhibited significantly lower SNR than PET-CT (p < 0.01), but the examination was shorter in duration and showed good inter-observer agreement (Kappa > 0.60, p < 0.001).ConclusionsWB-DWI demonstrates comparable overall efficacy to PET-CT in esophageal cancer staging. Although its sensitivity and efficiency are slightly lower, its radiation-free nature and high specificity make it a viable supplement or alternative to PET-CT for specific patient populations. These findings provide evidence for precise clinical selection.

Mechanical thrombectomy in acute lower limb ischaemia: beyond clot removal in an interventional radiology-oriented narrative review

Wed, 29 Jul 2026 00:00:00 GMT

BackgroundAcute lower limb ischaemia (ALI) remains a time-critical vascular emergency associated with substantial risks of major amputation and early mortality. As contemporary interventional radiology increasingly incorporates aspiration, rotational, and pharmacomechanical thrombectomy, the key question is no longer whether mechanical thrombectomy (MT) can restore conduit flow, but how it should be positioned relative to catheter-directed thrombolysis (CDT), surgery, and hybrid therapy.ConclusionsThis interventional radiology-oriented narrative review synthesizes current evidence on clinical staging, treatment selection, device classes, culprit-lesion management, post-revascularization antithrombotic treatment, and distal perfusion reassessment in ALI. Current data support MT as an important option, but not as a proven replacement for CDT or surgery. The main practical message is that successful ALI treatment requires more than clot removal: it requires correct staging, treatment of the lesion behind the thrombus, an individualized medical plan after revascularization, and recognition that limb salvage ultimately depends on restored tissue perfusion rather than conduit patency alone. Distal perfusion reassessment after thrombectomy and computed tomography angiography (CTA)-based planning are discussed as structured descriptive frameworks for reporting and future study rather than as validated algorithms.

Visual versus automated CT perfusion for outcome prediction in anterior circulation stroke treated with mechanical thrombectomy

Wed, 29 Jul 2026 00:00:00 GMT

BackgroundThe prognostic value of simple visual assessment of CT perfusion (CTP) for predicting clinical outcomes has already been demonstrated in stroke patients undergoing mechanical thrombectomy (MT). Automated software, however, has become the dominant method of CTP evaluation. The aim of the study was to compare the prognostic accuracy of visually graded CTP maps with automated CTP analysis on clinical outcomes in anterior circulation stroke patients treated with MT.Patients and methodsIn the single centre we retrospectively analysed consecutive patients with anterior circulation large-vessel occlusion treated with MT. Baseline imaging included non-contrast brain CT, CT angiography (CTA) with collateral status (CS) and CTP. Time to peak (TTP) maps were visually graded on a four-level ordinal scale based on estimated penumbra. Automated CTP was processed with syngo.via (SYV) using default thresholds and classified on a comparable ordinal scale. The primary endpoint was favourable 90-day functional outcome (Rankin Scale (mRS) ≤ 3).ResultsWe included 579 patients. Agreement between visual and automated CTP was fair (κ = 0.36). Both methods were significantly associated with favourable outcome (p < 0.01), with visual grading showing a slightly stronger association (Pearson χ2 = 30 vs. 22). In multivariable models, visual CTP remained an independent predictor, whereas automated CTP lost significance when CS was included.ConclusionsVisual CTP grading provided a slightly better prognostic performance than automated CTP. Visual CTP assessment is a simple, accessible and clinically meaningful tool for both treatment decision making and outcome prediction in anterior circulation stroke treated with MT.

Genetic testing for cancer predisposition syndromes in pediatric cancer patients: current practices and recommendations - a systematic review

Mon, 27 Jul 2026 00:00:00 GMT

BackgroundChildhood cancer is rare but remains a leading cause of disease-related mortality in children. Unlike adult malignancies, pediatric cancers often arise from inherited or de novo germline variants, with cancer predisposition syndromes (CPS) identified in approximately 7–15% of cases. Recognition of CPS is clinically important, as it affects treatment decisions, surveillance strategies, and family counseling.Materials and methodsBecause genetic testing practices for hereditary CPS in pediatric cancer patients vary internationally, we conducted a systematic literature review to summarize current clinical practices and the most recent guidelines for genetic testing in children with cancer. PubMed searches (1994–2025) identified 106 articles; after screening and exclusions, 15 studies were included (13 original studies, one meta-analysis, and one review).ResultsIncluded studies reported cohort sizes ranging from 31 to 3,975 participants, mainly pediatric cancer patients. The number of analyzed genes varied widely (1–1,048). Testing approaches ranged from single-gene testing to multigene panel testing, with multi gene panel testing most commonly used. The prevalence of pathogenic or likely pathogenic germline variants ranged from 2.99%to 47.5%, reflecting differences in cohort composition, gene panel size, and genetic testing methodology. Most guidelines recommend genetic testing based on clinical and biological selection criteria, while universal germline testing is generally not supported, except in Sweden, where whole genome sequencing is offered to all pediatric cancer patients.ConclusionsPhenotype-driven genetic testing currently provides the best resource–benefit balance, although ongoing technological advances may enable broader universal testing in the future.