Abstract Background The differentiation of benign and malignant breast masses is a critical aspect of breast cancer diagnosis. The aim of this study was to assess the capability of IVIM variables to discriminate between benign and malignant breast lesions by obtaining diffusion and perfusion data from normal tissues of breast and breast lesions through intravoxel incoherent motion (IVIM) imaging utilising biexponentially analysis of multiple b-value diffusion-weighted imaging (DWI) and comparing these variables to the apparent diffusion coefficient (ADC) derived from monoexponentially analysis. Results In this prospective work, each subject provided informed consent. Forty-two patients with fifty-two lesions with 31 malignancies and 21 benign lesions were scanned using 1.5 T MRI and DWI with 12 b-values (range 0–1000 s/mm2). Tissue diffusivity (D), perfusion fraction (f), and pseudo-diffusion coefficient (D p) were determined by segmented biexponentially analysis. The ADC (b = 0 and 1000 s/mm2) was computed using monoexponentially fitting of the DWI information. D, f, D p, and ADC values have been acquired for normal tissues of the breast, benign lesions, and malignancies. The contrast of these four variables among each pair indicated that the D and ADC values of malignancies had been substantially lower compared female patients of benign tumours and normal tissues (P < 0.001). The f of malignancies was substantially greater contrasted to that of benign lesions (P < 0.001); nevertheless, no substantial variation in D p was seen between both groups. D, f, and values of ADC exhibited superior sensitivity and specificity in distinguishing benign lesions from malignancies, with areas under the curve (AUC) of 0.945, 0.883, and 0.796, correspondingly. At the same time, D p showed the lowest AUC of 0.515. Conclusions IVIM may play a crucial role in differentiating malignancies and benign lesions of the breast by providing separate quantitative measurements of D for cellularity and D p and f for vascularity.

• Book : 56(1)
• Pub. Date : 2025
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AbstractPurposeBreath‐hold techniques are widely used in radiation therapy to minimize respiratory‐induced tumor or organ‐at‐risk motion. However, residual motion persists, necessitating a reliable daily evaluation method.MethodsAt our institution, fiducial markers serve as surrogates for target localization in pancreatic cancer treatment. We developed an automated method to detect fiducial markers in every projection image of cone‐beam computed tomography (CBCT) scans acquired for patient setup and positioning verification. This method was retrospectively validated using data from nine pancreatic cancer patients.ResultsResidual motion was observed in all patients during breath‐hold maneuvers. Intrafraction target motion in repeated breath‐hold simulation CT scans averaged 1.9 ± 2.2 mm, with a maximum displacement of 8 mm in the superior‐inferior direction. Within a single CBCT scan, residual motion reached up to 7.3 mm, with an average drifting range of 3.8 ± 1.1 mm across 94 CBCT scans. The average standard deviation of drift was 1.5 ± 0.5 mm. Significant drift (1.3 ± 1.2 mm) and inter‐breath‐hold gaps (2.6 ± 2.0 mm) were detected within the same CBCT scan.ConclusionOur method enables daily residual motion assessment without additional equipment or extra radiation exposure. This information is critical for refining planning margins in online adaptive radiation therapy, improving treatment precision and patient safety.

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• Pub. Date : 2025
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ABSTRACTBackgroundThe comparative effectiveness of radiotherapy and surgery for treating intracranial meningioma is unknown.ObjectivesTo compare survival after treatment of suspected intracranial meningioma by either surgery or radiotherapy.AnimalsTwo hundred eighty‐five companion dogs with suspected intracranial meningiomas presenting to 11 specialty clinics in three countries.MethodsParallel cohort comparison study on retrospective data. Dogs diagnosed with intracranial meningioma by board‐certified veterinary neurologists or radiologists and treated by radiotherapy or surgery were identified through medical record searches and presenting and survival data extracted. Lesion site was classified as rostro‐ or caudotentorial and size was measured on contrast magnetic resonance images. Outcome was all‐cause death. Analysis of survival by Cox proportional hazards, including selection for optimal multivariable model using lasso, counterfactual modeling including variables associated with treatment allocation and survival.ResultsOne hundred sixty‐eight dogs received radiotherapy and 117 received surgery. All analyses indicated reduced survival associated with surgery compared to radiotherapy. There was a median survival after surgery of 297 (IQR: 99–768) days compared with 696 (IQR: 368–999) for dogs treated by radiation, associated with a univariable hazard ratio of 1.802 (95% CI: 1.357–2.394). Counterfactual modeling estimated a mean survival of 480 (95% CI: 395–564) days after surgery and 673 (95% CI: 565–782) days after radiotherapy, representing a decrease in survival of 29%. Location and size of the lesion were not associated with survival duration.Conclusions and Clinical ImportanceDogs with suspected intracranial meningioma have substantially superior survival after radiotherapy compared to surgery.

• Book : 39(2)
• Pub. Date : 2025
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Many antifungal agents, including isoconazole nitrate (ISN), suffer from low aqueous solubility and inconsistent dissolution kinetics, which limit their therapeutic potential. To address these challenges, this study aimed to enhance the solubility and stability of ISN through the development of inclusion complexes with hydroxypropyl-β-cyclodextrin (HP-β-CD). HP-β-CD inclusion complexes were prepared using a spray-drying technique and characterized through phase-solubility studies, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), proton nuclear magnetic resonance (1H-NMR), and differential scanning calorimetry (DSC). The inclusion complex significantly improved ISN solubility, increasing from 0.5088 mg/mL to 3.6550 mg/mL. These complexes were incorporated into a thermosensitive, mucoadhesive in situ gel system using Pluronic® F127 and hydroxypropyl methylcellulose (HPMC) to optimize vaginal drug delivery. The formulations were evaluated for gelation temperature, viscosity, swelling behavior, and pH, confirming their suitability for vaginal application. Antimicrobial studies demonstrated that the ISN/HP-β-CD gels exhibited superior activity against Candida albicans, C. glabrata, and C. krusei compared to ISN alone. In vitro release studies further revealed sustained drug release following Peppas-Sahlin kinetics, supporting enhanced bioavailability and prolonged therapeutic action. This study demonstrates that the ISN/HP-β-CD-loaded in situ gel system offers a promising and effective approach for improving the solubility, stability, and antifungal efficacy of ISN for the treatment of vaginal infections.

• Book : 17(4)
• Pub. Date : 2025
• Page : pp.514-514
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The concept of thyroid status is much broader than assessing the levels of thyroid stimulating hormone, free and bound thyroid hormones in the systemic circulation. It includes features of transport, tissue bioavailability, receptor interaction, metabolism, biomolecular mechanisms of action and inactivation, as well as the physiological or pathophysiological basis of changes in function and the pathomorphological substrate of diseases, including malignancies. Therefore, the question of the mechanisms through which thyroid status influences the processes of tumor initiation and promotion in the gastrointestinal tract is extremely relevant. Regarding colorectal cancer, an ambiguous link between thyroid status has been identified – in some studies, an increase in free T4 concentration and thyrotoxicosis are associated with a decreased risk of developing colon cancer, while in others, the administration of levothyroxine in hypothyroidism had a protective effect. The risk of gastric cancer is elevated in men living in regions with suboptimal or above-normal iodine consumption and suffering from various thyroid pathologies. This paper analyzes modern ideas about pathogenetic relationship between gastric and colon cancer and patients' thyroid status. It presents physiological and biochemical basics of thyroid status formation. Deiodinase expression profile in gastric and colon cancer is stated. The problem of iodine-induced disthyroidoses following radiation procedures using iodine-containing contrasts is described in detail.

• Book : 26(4)
• Pub. Date : 2025
• Page : pp.478-483
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