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Impact of Slice Thickness and Grid Size on Dose Calculation in Intensity Modulated and Volumetric-Modulated Arc Radiotherapy in Head and Neck Cancer 2 2 Background: The grid size in radiotherapy can have an impact on dose values. When calculating the dose, slice width is a crucial component to consider. A thinner slice provides for a more precise mean dose estimate than a thicker slice. Materials and Methods: For this study, 35 patients with Head and Neck (H&N) cancer were chosen. Planning Target Volume (PTV) and Organ At Risks (OARs) were optimized using the same criteria. Intensity Modulated Radiation Therapy (IMRT) and volumetric-modulated arc therapy (VMAT) plans, which were designed with slice thicknesses (3,5,7 mm) and grid sizes (2,3,5, 7 and 8 mm). Homogeneity (HI) and Conformity Index (CI), dose points, such as D2%, D50%, and D98% for each OAR, assessed in relation to slice thickness and grid size. Results: There is a substantial difference (p<0.05) between grid sizes 3mm, 5mm, 7mm, and 8mm in IMRT and VMAT, but no significant difference (p>0.05) in target and OAR dose between grid sizes 2mm and 3mm. Conversely, the target dosage and OAR dose are significantly affected by variations in the Computed Tomography (CT) slice thickness, with a significant difference (p<0.05) seen in the target dose between 3mm, 5mm, and 7mm slice thickness and an insignificant difference (p>0.05) between 5mm and 7mm in OAR dose. Conclusions: According to this study, using the grid size of 2 mm is not recommended because it generates memory issues in the treatment planning system (TPS) and takes a lot of time, neither of which have a practical clinical effect. 263 270 2025/05/26 1404/3/5 2025/05/20 1404/2/30 N. Ayman N. Ayman Radiotherapy Department, Nasser Institute, Cairo, Egypt A. Abdelaal A. Abdelaal Radiotherapy Department, Nasser Institute, Cairo, Egypt H.H. Amer H.H. Amer Biophysics Department, Faculty of Science, Cairo University, Giza, Egypt H.S. Mohammed H.S. Mohammed Biophysics Department, Faculty of Science, Cairo University, Giza, Egypt haitham@sci.cu.edu.eg Radiotherapy intensity modulated radiotherapy planning radiotherapy dosage computer-assisted tomography. D'Agostino E, Bogaerts R, Defraene G, de Freitas Nascimento L, Van den Heuvel F, Verellen D, et al. (2013) Peripheral doses in radiotherapy: A comparison between IMRT, VMAT and tomotherapy. Radiation Measurements, 57: 62-67.‌##Huang K, Rhee DJ, Ger R, Layman R, Yang J, Cardenas CE, et al. (2021) Impact of slice thickness, pixel size, and CT dose on the performance of automatic contouring algorithms. J Appl Clin Med Phys, 22(5): 168-174.‌##Alirezaei Z, Amouheidari AR, Abedi I, Davanian F, Shokrani P, Nazemzadeh MR (2021) Optimization of CT slice thickness in 3D-CRT and IMRT planning of low grade glioma. International Journal of Radiation Research, 19(2): 291-298.‌##Marta GN, Silva V, de Andrade Carvalho H, de Arruda FF, Hanna SA, Gadia R, et al. (2014) Intensity-modulated radiation therapy for head and neck cancer: systematic review and meta-analysis. Radiotherapy and Oncology, 110(1): 9-15.‌##Holt A, Van Gestel D, Arends MP, Korevaar EW, Schuring D, Kunze-Busch MC, et al. (2013) Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer: a planning study. Radiation Oncology, 8(1): 1-11.‌##Yip C, Thomas C, Michaelidou A, James D, Lynn R, Lei M, et al. (2014) Co-registration of cone beam CT and planning CT in head and neck IMRT dose estimation: a feasible adaptive radiotherapy strategy. The British Journal of Radiology, 87(1034): 20130532.‌##Partridge M, Trapp JV, Adams EJ, Leach MO, Webb S, Seco J (2006) An investigation of dose calculation accuracy in intensity-modulated radiotherapy of sites in the head & neck. Physica Medica, 22(3): 97-104.‌##Wiezorek T, Brachwitz T, Georg D, Blank E, Fotina I, Habl G, et al. (2011) Rotational IMRT techniques compared to fixed gantry IMRT and tomotherapy: multi-institutional planning study for head-and-neck cases. Radiation Oncology, 6(1): 1-10.‌##Zhao N, Yang R, Jiang Y, Tian S, Guo F, Wang J (2015) A hybrid IMRT/VMAT technique for the treatment of nasopharyngeal cancer. BioMed Research International, 2015: 940102.##Bhide SA and Nutting CM (2010) Advances in radiotherapy for head and neck cancer. Oral Oncology, 46(6): 439-441.##Moreno AC, Frank SJ, Garden AS, Rosenthal DI, Fuller CD, Gunn GB, et al. (2019). Intensity modulated proton therapy (IMPT)-The future of IMRT for head and neck cancer. Oral Oncology, 88: 66-74.##Chen J, Mok E, Wang L, Chen C, Le QT (2013) Volumetric-modulated arc radiotherapy for skull-base and non-skull-base head and neck Cancer: a treatment planning comparison with fixed beam IMRT. Technology in Cancer Research & Treatment, 12(1): 11-18.##Didona A, Lancellotta V, Zucchetti C, Panizza BM, Frattegiani A, Iacco M, et al. (2018) Is volumetric modulated arc therapy with constant dose rate a valid option in radiation therapy for head and neck cancer patients?. Reports of Practical Oncology and Radiotherapy, 23(3): 175-182.##Ali YH, El Shahat K, Abou Zeid H, Ashry HA (2017) A comparison of the gamma index and dose volume histogram of patient for IMRT/VMAT with different QA systems. Journal of Scientific Research in Science, 34(part1): 313-332.‌##Ali A, Hussein A, Galal M, El Shahat K (2022) Effect of calculation grid size on plan calculation for anisotropic analytical algorithm and Acuros XB Algorithm in lung stereotactic body radiotherapy. Journal of Radiation and Nuclear Applications, 7(3): 1-5.##Esmailzadeh A, Abedi I, Khorasani A (2023) Investigating variation of dose gradient index by different grid sizes in intensity-modulated radiation therapy of optic nerve sheath meningioma. Applied Radiation and Isotopes, 193: 110657.##Grégoire V and Mackie TR (2011) State of the art on dose prescription, reporting and recording in intensity-modulated radiation therapy (ICRU report No. 83). Cancer/Radiothérapie, 15(6-7): 555-559.##Srivastava SP, Cheng CW, Das IJ (2017) The dosimetric and radiobiological impact of calculation grid size on head and neck IMRT. Practical Radiation Oncology, 7(3): 209-217.##Park JM, Park S-Y, Kim J-i, Carlson J, Kim JH (2017) The influence of the dose calculation resolution of VMAT plans on the calculated dose for eye lens and optic pathway. Australasian Physical & Engineering Sciences in Medicine, 40(1): 209-17.##Prabhakar R, Ganesh T, Rath GK, Julka PK, Sridhar PS, Joshi RC, Thulkar S (2009) Impact of different CT slice thickness on clinical target volume for 3D conformal radiation therapy. Medical Dosimetry, 34(1): 36-41.##Feygelman V, Zhang G, Stevens C (2010) Initial dosimetric evaluation of SmartArc-a novel VMAT treatment planning module implemented in a multi‐vendor delivery chain. Journal of Applied Clinical Medical Physics, 11(1): 99-116.##Caivano R, Fiorentino A, Pedicini P, Califano G, Fusco V (2014) The impact of computed tomography slice thickness on the assessment of stereotactic, 3D conformal and intensity-modulated radiotherapy of brain tumors. Clinical and Translational Oncology, 16: 503-508.##Niemierko A and Goitein M (1989). The influence of the size of the grid used for dose calculation on the accuracy of dose estimation. Medical Physics, 16(2): 239-247.##Chun M, Kim JI, Oh DH, Wu HG, Park JM (2020) Effect of dose grid resolution on the results of patientspecific quality assurance for intensity-modulated radiation therapy and volumetric modulated arc therapy. International Journal of Radiation Research, 18(3): 521-530.## ##

Dosimetric assessment of left anterior descending, heart and brachial plexus in breast cancer patients irradiated with helical tomotherapy 2 2 Background: In this study, it was aimed to evaluate the radiation doses to the heart and uncommon critical organs such as left anterior descending (LAD) and brachial plexus (BP), in breast cancer patients irradiated with tomotherapy. Methods and Materials: Eighty patients with primary breast cancer received whole breast and supraclavicular region radiotherapy (RT) with helical tomotherapy were evaluated. The patients were divided into 4 groups according to the surgical procedure performed right mastectomy (RM-Group 1), left mastectomy (LM-Group 2), right breast-conserving surgery (R-BCS) (Group 3), and left breast-conserving surgery (L-BCS-Group 4). The homogeneity index (HI) for target volume, total volume (V), maximum doses (Dmax), and mean doses (Dmean) for LAD and ipsilateral BP and V, Dmean, V5 (volume of received 5 Gy) and V25 (volume of received 25 Gy) were determined for the heart to all groups. Results: According to the results, HI’s were almost the same in all groups (~1.08). Although the dosimetric parameters for the heart were higher in the left breast irradiations there was a statistical difference between the groups. Dosimetric parameters of LAD are also similar to cardiac dose. However, the increase in the left breast is more pronounced. The brachial plexus dose parameters of all groups were close to each other. Conclusion: It is recommended that the brachial plexus dose should be included in routine dosimetric evaluation in terms of minimizing the risk of radiation-induced plexopathy. Also, the LAD dose should be evaluated with the heart dose to reduce the cardiotoxic effects that may occur after radiotherapy. 271 276 2025/05/262025/05/26 1404/3/5 2025/05/202025/05/20 1404/2/30 S. Barlaz Us S. Barlaz Us Department of Radiation Oncology, School of Medicine, Mersin University, Mersin, Turkey barlaz@gmail.com E.B. Yilmaz E.B. Yilmaz Department of Radiation Oncology, School of Medicine, Mersin University, Mersin, Turkey Y. Balci Y. Balci Department of Radiology, School of Medicine, Mersin University, Mersin, Turkey M.B. Çelik M.B. Çelik Department of Radiation Oncology, School of Medicine, Mersin University, Mersin, Turkey Breast cancer radiotherapy heart left anterior descending brachial plexus tomotherapy. Kashyap D, Pal D, Sharma R, Garg VK, et al. (2023) Global ıncrease in breast cancer ıncidence: Risk factors and preventive measures. Biomed Res Int, 2022: 9605439. doi: 10.1155/2022/9605439.##Sung H, Ferlay J, Siegel RL, et al. (2020) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 71(3): 209-249. doi: 10.3322/caac.21660.##Taylor CW and Kirby AM (2015) Cardiac side-effects from breast cancer radiotherapy. Clin Oncol (R Coll Radiol), 27(11): 621-9.##doi: 10.1016/j.clon.2015.06.007.##Beaton L, Bergman A, Nichol A, et al. (2019) Cardiac death after breast radiotherapy and the QUANTEC cardiac guidelines. Clin Transl Radiat Oncol, 19: 39-45. doi: 10.1016/j.ctro.2019.08.001.##Nilsson G, Holmberg L, Garmo H, et al. (2012) Distribution of coronary artery stenosis after radiation for breast cancer. J Clin Oncol, 30(4): 380-6. doi: 10.1200/JCO.2011.34.5900.##Antunac K, Mayer L, Banovic M, Beketic-Oreskovic L (2023) Correlation of high-sensitivity cardiac troponin I values and cardiac radiation doses in patients with left-sided breast cancer undergoing hypofractionated adjuvant radiotherapy with concurrent anti-HER2 therapy. Curr Oncol, 30(10): 9049-9062. doi:10.3390/curroncol30100654.##Sardaro A, Petruzzelli MF, D'Errico MP, et al. (2012) Radiation-induced cardiac damage in early left breast cancer patients: risk factors, biological mechanisms, radiobiology, and dosimetric constraints. Radiother Oncol, 103(2): 133-142. doi:10.1016/j.radonc.2012.02.008##Van den Bogaard VA, Ta BD, Van der Schaaf A, et al. (2017) Validation and modification of a prediction model for acute cardiac events in patients with breast cancer treated with radiotherapy based on three-dimensional dose distributions to cardiac substructures. J Clin Oncol, 35(11): 1171-1178. doi:10.1200/JCO.2016.69.8480##Wennstig AK, Garmo H, Isacsson U, et al. (2019) The relationship between radiation doses to coronary arteries and location of coronary stenosis requiring intervention in breast cancer survivors. Radiat Oncol, 14(1): 40. doi:10.1186/s13014-019-1242-z##Yan M, Kong W, Kerr A, Brundage M (2019) The radiation dose tolerance of the brachial plexus: A systematic review and meta-analysis. Clin Transl Radiat Oncol, 18: 23-31. doi: 10.1016/j.ctro.2019.06.006.##Thomas OT, Refaat T, Choi M, et.al. (2015) Brachial plexus dose tolerance in head and neck cancer patients treated with sequential intensity modulated radiation therapy. Radiation Oncology, 10: 94. doi: 10.1186/s13014-015-0409-5.##Goyal S, Menon D, Puzhakkal N, Makuny D (2019) Brachial plexus doses in locoregional radiotherapy for breast cancer. Ther Radiol Oncol, 3: 30. Doi: 10.21037/tro.2019.08.03.##Marks LB, Yorke ED, Jackson A, et al. (2010) Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys, 76(3 Suppl): S10-S19. doi:10.1016/j.ijrobp.2009.07.1754##Kültür T, Okumuş M, İnal M, Yalçın S (2018) Evaluation of the brachial plexus with shear wave elastography after radiotherapy for breast cancer. J Ultrasound Med, 37(8): 2029-2035. doi: 10.1002/jum.14556.##Gosk J, Rutowski R, Reichert P, Rabczyński J (2007) Radiation-induced brachial plexus neuropathy - aetiopathogenesis, risk factors, differential diagnostics, symptoms and treatment. Folia Neuropathol, 45(1): 26-30.##Miran C, Bonnet E, Lafont C, et al. (2023) La plexite radique : épidémiologie, diagnostic, facteurs de risque et prise en charge [Radiation induced brachial plexopathy: Diagnosis, risk factors, principles of care]. Cancer Radiother, 27(2): 163-169. doi:10.1016/j.canrad.2022.06.010##Hodapp N. (2012) Der ICRU-Report 83: Verordnung, dokumentation und kommunikation der fluenzmodulierten photonenstrahlentherapie (IMRT) [The ICRU Report 83: prescribing, recording and reporting photon-beam intensity-modulated radiation therapy (IMRT)]. Strahlenther Onkol, 188(1): 97-99. doi:10.1007/s00066-011-0015-x##Arslan A, Aktaş E, Eren S, Dengiz I, Arslan S, Güney Y (2023) Dosimetric comparison of the heart substructures with IMRT and VMAT techniques in left breast radiotherapy: The effect of deep inspiratory breath-hold. Int J Radiat Res, 21 (1): 23-30.##Oymak E, Bozca R, Guler OC, Onal C (2023) Contralateral breast radiation doses in breast cancer patients treated with helical tomotherapy. Med Dosim, 48(1): 61-66. doi: 10.1016/j.meddos.2022.11.002.##Dicuonzo S, Patti F, Luraschi R, et al. (2021) Comparing TomoHelical and TomoDirect in postmastectomy hypofractionated radiotherapy after immediate breast reconstruction. Phys Med, 90: 66-72.##Gyenes G, Fornander T, Carlens P, et al. (1994) Morbidity of ischemic heart disease in early breast cancer 15-20 years after adjuvant radiotherapy. Int J Radiat Oncol Biol Phys, 28(5): 1235-1241##Harris EER, Correa C, Hwang W-T, et al. (2006) Late cardiac morbidity and mortality in early stage breast cancer patients after breast conservation treatment. J Clin Oncol, 24: 4100-4106.##Paszat LF, Mackillop WJ, Groome PA, et al. (1999) Mortality from myocardial infarction following postlumpectomy radiotherapy for breast cancer: a population-based study in Ontario, Canada. Int J Radiat Oncol Biol Phys, 43(4): 755-762.##Darby SC, Ewertz M, McGale P, et al. (2013) Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med, 368(11): 987-998. doi:10.1056/NEJMoa1209825##Taylor C, Correa C, Duane FK, et al. (2017) Estimating the Risks of Breast Cancer Radiotherapy: Evidence from modern radiation doses to the lungs and heart and from previous randomized trials. J Clin Oncol, 35(15): 1641-1649. doi:10.1200/JCO.2016.72.0722##Yeh HP, Huang YC, Wang LY, et al. (2020) Helical tomotherapy with a complete-directional-complete block technique effectively reduces cardiac and lung dose for left-sided breast cancer. Br J Radiol, 93(1108): 20190792. doi:10.1259/bjr.20190792##Hou PY, Hsieh CH, Wu LJ, et al. (2021) Modern rotational radiation techniques with volumetric modulated arc therapy or helical tomotherapy for optimal sparing of the lung and heart in left-breast cancer radiotherapy plus regional nodal irradiation: A comparative dosimetric analysis. Cancers (Basel), 13(20): 5043. doi:10.3390/cancers13205043##Haciislamoglu E, Colak F, Canyilmaz E, et al. (2015) Dosimetric comparison of left-sided whole-breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and volumetric arc therapy. Phys Med, 31(4): 360-367. doi:10.1016/j.ejmp.2015.02.005##Erdiş E, Yücel B, Özyürek B, Bozca R (2020) The comparison of helical-IMRT, Direct-IMRT and 3D radiotherapy modalities in breast radiotherapy planning. Turk J Oncol 2020, 35(3): 257-65. doi: 10.5505/tjo.2020.2271##Kuzba-Kryszak T, Nowakowski S, Winiecki J, Makarewicz R (2021) Comparative analysis of the absorbed dose in the heart and anterior descending branch of the left coronary artery (LAD) in patients with left-sided breast cancer who received radiotherapy using 3D-CRT, IMRT and VMAT techniques. J BUON, 26(3): 753-758.##Arslan A, Aktas E, Sengul B, Tekin B (2021) Dosimetric evaluation of left ventricle and left anterior descending artery in left breast radiotherapy. Radiol Med, 126(1): 14-21. doi:10.1007/s11547-020-01201-2##Jagsi R, Griffith KA, Koelling T, Roberts R, Pierce LJ (2007) Rates of myocardial infarction and coronary artery disease and risk factors in patients treated with radiation therapy for early-stage breast cancer. Cancer, 109(4): 650-657. doi:10.1002/cncr.22452##Cooper BT, Li X, Shin SM, et al. (2016) Preplanning prediction of the left anterior descending artery maximum dose based on patient, dosimetric, and treatment planning parameters. Adv Radiat Oncol, 1(4): 373-381. doi:10.1016/j.adro.2016.08.001##Göksel EO, Tezcanli E, Arifoğlu A, et al. (2022) Dosimetric evaluation of VMAT and helical tomotherapy techniques comparing conventional volumes with clinical target volumes based on new ESTRO ACROP post-mastectomy with immediate implant reconstruction contouring guidelines. Radiat Oncol, 17(1): 168. doi:10.1186/s13014-022-02134-y##Jin K, Luo J, Wang X, et al. (2022) Symptoms Related to Brachial Plexus Neuropathy After Supraclavicular Irradiation and Boost in Breast Cancer. Pract Radiat Oncol, 12(1): e13-e23. doi:10.1016/j.prro.2021.08.003##Emami B (2013) Tolerance of normal tissue to therapeutic radiation. Reports of Radiother Oncol, 1(1): 123-7.##Gałecki J, Hicer-Grzenkowicz J, Grudzień-Kowalska M, Michalska T, Załucki W (2006) Radiation-induced brachial plexopathy and hypofractionated regimens in adjuvant irradiation of patients with breast cancer--a review. Acta Oncol, 45(3): 280-284. doi:10.1080/02841860500371907##Dumane VA, Bakst R, Green S (2018) Dose to organs in the supraclavicular region when covering the ınternal mammary nodes (IMNs) in breast cancer patients: A comparison of volumetric modulated arc therapy (VMAT) versus 3D and VMAT. PLoS One, 13(10): e0205770. doi: 10.1371/journal.pone.0205770.## ##

Relationship between tumor parameters in Ga-68 PSMA PET/CT and pathological grade grouping in patients with prostate cancer 2 2 Background: The study aims to explore the relationship between tumor parameters acquired from Ga-68 PSMA PET/CT and GG system in patients who had prostate cancer. Materials and Methods: One hundred and fourteen patients diagnosed with prostate cancer and who underwent Ga-68 PSMA PET/CT imaging for staging purposes were enrolled. The imaging was performed using a Siemens Biograph Horizon-3R 16 slice PET/CT device, and the tumor parameters (SUVmax, SUVmean, and Tumor volume) were calculated by an experienced nuclear medicine physician. Results: There was a correlation between GG with SUVmax (p:0.010; r:0.241) and SUVmean (p:0.06; r:0.258). In redicting high-risk patients, ROC analysis was conducted for SUVmax and SUVmean, resulting in significant cut-off values for both parameters. A cut-off value of 9.8 for SUVmax resulted in a sensitivity of 69% and a specificity of 58%. 5.8 cut-off value for SUVmean resulted in 68% sensitivity  and 58% specificity. Tumor volume was found to be a significant predictor for distant metastasis. When a cut-off value of 11.53 cm3 was used for tumor volume, sensitivity was found to be 62% and specificity 56%. Conclusion: According to the results, correlation between GG with SUVmax and SUVmax was significant. Additionally, SUVmax and SUVmean were significant predictors of high-risk prostate cancer, while TV was a significant predictor of distant metastases. In summary, Ga-68-PSMA PET CT are deemed a beneficial imaging modality for both prognosis assessment and staging in clinical. 277 281 2025/05/262025/05/262025/05/26 1404/3/5 2025/05/202025/05/202025/05/20 1404/2/30 F. Demir F. Demir Department of Nuclear Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey drfadimedemir@hotmail.com S. Karaçavuş S. Karaçavuş Department of Nuclear Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey H. Gençer H. Gençer Department of Nuclear Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey A. Özdal A. Özdal Department of Nuclear Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey Z. Erdoğan Z. Erdoğan Department of Nuclear Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey İ. Çiftçi İ. Çiftçi Department of Nuclear Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey F. Çevik Kaya F. Çevik Kaya Department of Pathology, Kayseri Training and Research Hospital, Kayseri, Turkey N. Özhan N. Özhan Department of Oncology, Kayseri Training and Research Hospital, Kayseri, Turkey H. İşçi H. İşçi Department of Nuclear Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey M. Kaya M. Kaya Department of Nuclear Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey Ga-68 PSMA PET/CT prostate cancer pathological grade grouping. Gandaglia G, Leni R, Bray F, Fleshner N, Freedland SJ, Kibel A, et al. (2021) Epidemiology and prevention of prostate cancer. Eur Urol Oncol, 4(6): 877-892.##Sekhoacha M, Riet K, Motloung P, Gumenku L, Adegoke A, Mashele (2022) Prostate Cancer review: genetics, diagnosis, treatment options, and alternative approaches. Molecules, 27(17): 5730.##Sehn JK (2018) Prostate cancer pathology: Recent updates and controversies. Mo Med, 115(2): 151-155.##Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA (2016). The 2014 International Society of Urological Pathology (ISUP) Consensus conference on Gleason grading of prostatic carcinoma: Definition of grading patterns and proposal for a new grading system. Am J Surg Pathol, 40(2): 244-52.##Sehn JK (2018) Prostate Cancer Pathology: Recent Updates and Controversies. Mo Med, 115(2): 151-155.##Humphrey PA, Moch H, Cubilla AL, Ulbright TM, Reuter VE (2016) The 2016 WHO Classification of tumours of the urinary system and male genital organs-Part B: Prostate and bladder tumours. Eur Urol, 70(1): 106-119.##Lorenc T, Klimczyk K, Michalczewska I, Słomka M, Kubiak-Tomaszewska G, Olejarz W (2020) Exosomes in Prostate Cancer Diagnosis, Prognosis and Therapy. Int J Mol Sci, 21(6): 2118.##Schwarzenboeck SM, Rauscher I, Bluemel C, Fendler WP, Rowe SP, Pomper MG, et al. (2017) PSMA Ligands for PET ımaging of prostate cancer. J Nucl Med, 58(10): 1545-1552.##Schlemmer HP, Krause BJ, Schütz V, Bonekamp D, Schwarzenböck SM, Hohenfellner M (2021) Imaging of prostate cancer. Dtsch Arztebl Int, 118(42): 713-719.##Ghafoor S, Burger IA, Vargas AH (2019) Multimodality ımaging of prostate cancer. J Nucl Med, 60(10): 1350-1358.##Demirci E, Kabasakal L, Şahin OE, Akgün E, Gültekin MH, Doğanca T, et al. (2019) Can SUVmax values of Ga-68-PSMA PET/CT scan predict the clinically significant prostate cancer? Nucl Med Commun, 40(1): 86-91.##Emmett L, Papa N, Buteau J, Ho B, Liu V, Roberts M, et al. (2022) The PRIMARY Score: Using intraprostatic 68Ga-PSMA PET/CT patterns to optimize prostate cancer diagnosis. J Nucl Med, 63(11): 1644-1650.##Kesler M, Cohen D, Levine C, Sarid D, Keizman D, Yossepowitch O, Even-Sapir E (2023) Staging prostate cancer with 68Ga-PSMA-11 PET/CT in the elderly: Is preimaging biopsy ımperative? J Nucl Med, 64(7): 1030-1035.##Wong LM, Koschel S, Whish-Wilson T, Farag M, Bolton D, Zargar H, et al. (2023) Investigating PSMA-PET/CT to resolve prostate MRI PIRADS4-5 and negative biopsy discordance. World J Urol, 41(2): 463-469.##Eissa A, Elsherbiny A, Coelho RF, Rassweiler J, Davis JW, Porpiglia F, et al. (2018) The role of 68Ga-PSMA PET/CT scan in biochemical recurrence after primary treatment for prostate cancer: a systematic review of the literature. Minerva Urol Nefrol, 70(5): 462-478.##Perera M, Papa N, Roberts M, Williams M, Udovicich C, Vela I, et al. (2020) Gallium-68 prostate-specific membrane antigen positron emission tomography in advanced prostate cancer-updated diagnostic utility, sensitivity, specificity, and distribution of prostate-specific membrane antigen-avid lesions: A systematic review and meta-analysis. Eur Urol, 77(4): 403-417.##Barakzai MA (2019) Prostatic Adenocarcinoma: A Grading from Gleason to the new grade-group system: A historical and critical review. Asian Pac J Cancer Prev, 20(3): 661-666.##Mohler JL, Antonarakis ES, Armstrong AJ, D'Amico AV, Davis BJ, Dorff T, et al. (2019) Prostate cancer, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 17(5): 479-505.##Liu FY, Sheng TW, Tseng JR, Yu KJ, Tsui KH, Pang ST, Wang LJ, Lin G (2022) Prostate-specific membrane antigen (PSMA) fusion imaging in prostate cancer: PET-CT vs PET-MRI. Br J Radiol, 95(1131): 20210728.##Combes AD, Palma CA, Calopedos R, Wen L, Woo H, Fulham M, Leslie S (2022) PSMA PET-CT in the diagnosis and staging of prostate cancer. Diagnostics (Basel), 12(11): 2594.##Awenat S, Piccardo A, Carvoeiras P, Signore G, Giovanella L, Prior JO, Treglia G (2021) Diagnostic role of 18F-PSMA-1007 PET/CT in prostate cancer staging: A systematic review. Diagnostics (Basel), 11(3): 552.##Kim HJ, Lee JS, Kim WC (2020) Clinical outcome of stereotactic body radiotherapy for localized prostate cancer: long -term results. Int J Radiat Res, 18(3): 383-388.##Chen M, Qiu X, Zhang Q, Zhang C, Zhou YH, Zhao X, Fu Y, Wang F, Guo H (2022) PSMA uptake on [68Ga]-PSMA-11-PET/CT positively correlates with prostate cancer aggressiveness. Q J Nucl Med Mol Imaging, 66(1): 67-73.##Yildirim ÖA, Gündoğan C, Can C, Poyraz K, Erdur E, Kömek H (2021) Correlations between whole body volumetric parameters of 68Ga-PSMA PET/CT and biochemical-histopathological parameters in castration-naive and resistant prostate cancer patients. Ann Nucl Med, 35(5): 540-548.##Uprimny C, Kroiss AS, Decristoforo C, Fritz J, von Guggenberg E, Kendler D, et al. (2017) 68Ga-PSMA-11 PET/CT in primary staging of prostate cancer: PSA and Gleason score predict the intensity of tracer accumulation in the primary tumour. Eur J Nucl Med Mol Imaging, 44(6): 941-949.##Erdoğan M, Özkan EE, Öztürk SA, Yıldız M, Şengül SS (2020) The role of Ga-68 PSMA PET/CT scan on differentiating of oligometastatic and high risk prostate cancer. Mol Imaging Radionucl Ther, 29(3): 98-104.##Pepe P, Pepe L, Tamburo M, Marletta G, Savoca F, Pennisi M, Fraggetta F (2023) 68Ga-PSMA PET/CT and prostate cancer diagnosis: Which SUVmax value? In Vivo, 37(3): 1318-1322.##Dong S, Li Y, Chen J, Li Y, Yang P, Li J (2022) 18F-PSMA-1007 PET/CT-derived semi-quantitative parameters for risk stratification of newly diagnosed prostate cancer. Front Oncol, 12: 1025930.##Xie Y, Li C, Zhang L, Zang S, Yu F, Wang S, Wang F (2022) 68Ga-PSMA-I&T PET/CT for assessment of tumor burden in primary lesions of treatmentnaïve prostate cancer. Nan Fang Yi Ke Da Xue Xue Bao, 42(8): 1143-1148.## ##

Lifetime cancer risks of radon and heavy metals levels in groundwater wells around limestone quarry in Ogun State, Nigeria 2 2 Background: Radon (222Rn) and carcinogenic metals are major contaminants in groundwater wells. This research aimed on evaluating the possible lifetime cancer linked with the presence of radon and carcinogenic metals in groundwater wells situated close to a limestone quarry in Ewekoro, Ogun State, Nigeria. Materials and Methods: Twenty (20) groundwater wells near a limestone quarry were sampled for water sample collection. Radon levels in water were assessed utilizing CR-39 detectors, whereas concentrations of carcinogenic metals were analyzed via atomic absorption spectrometry. The resultant data facilitated the estimation of potential lifetime cancer risks for adults exposed to water from these wells. Results: The measured radon concentrations varied between 2.16±1.7 and 11.88±1.6 Bql-1, with an average of 6.67 ± 2.15 Bql-1 across the 20 samples. A significant portion, 81%, of the samples exhibited radon concentrations below the permissible limit of 11.1 Bql-1 fixed by the United States Environmental Protection Agency (USEPA). The annual effective dose (AED) attributable to inhaled and ingested radon ranged from 5.44±4.3 to 29.94±4.0 μSvy-1 and 15.77±13.9 to 86.72±11.7 μSvy-1, respectively. The collective AED across all water sample sources varied from 21.21±16.7 to 116.67±15.7 μSvy-1, with average values of 65.434±10.4 μSvy-1. The cumulative incremental lifetime cancer risk related to the ingested carcinogenic metals adults ranged from 9.70 ×10-5 to 1.03×10-4 with a mean value of 9.72 ×10-5. Conclusion: Water wells situated closer to the limestone quarry exhibited higher mean radon concentrations, while those farther away from the quarry maintained mean radon concentrations below the acceptable limits provided by the World Health Organization (WHO) and the USEPA. 283 289 2025/05/262025/05/262025/05/262025/05/26 1404/3/5 2025/05/202025/05/202025/05/202025/05/20 1404/2/30 D. Oluwaseun D. Oluwaseun Department of Physics, Federal University of Agriculture, Abeokuta 110001, Nigeria dosunmusg@gmail.com O. Inioluwa O. Inioluwa Science Laboratory Technology Department, The Federal Polytechnic, Ilaro, Nigeria A.K. Ademola A.K. Ademola Physical Sciences Department, Bells University of Technology, Ota 112212, Nigeria Radon Heavy Metals Cancer Risks Groundwater Limestone Quarry. 1. Carrard N, Foster T, Willetts J (2019) Groundwater as a source of drinking water in southeast Asia and the Pacific: A multi-country review of current reliance and resource concerns. Water, 11(8): 1605.##Li P, Karunanidhi D, Subramani T, Srinivasamoorthy K (2021) Sources and consequences of groundwater contamination. Arch Environ Contam Toxicol, 80: 1-10.##Khatri N and Tyagi S (2015) Influences of natural and anthropogenic factors on surface and groundwater quality in rural and urban areas. Frontiers in Life Science, 8: 23-39. DOI: 10.1080/21553769.2014.933716##Vermeulen J and Whitten T (2000) Biodiversity and cultural property in the management of limestone resources. Lessons from East Asia, The World Bank , Washington DC: 1-120.##Wang M, Xu Y, Pan S, Zhang J, Zhong A, Song H, Ling W (2011) Long-term heavy metal pollution and mortality in a Chinese population: an ecologic study. Biological Trace Element Research, 142: 362-379.##Khan MA, Khattak NU, Hanif M, Al-Ansari N, Khan MB, Ehsan M, Elbeltagi A (2022), Health risks associated with radon concentrations in carbonate and evaporite sequences of the uranium-rich district Karak, Pakistan. 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Caspian Journal of Internal Medicine, 8(3), 135.##Aschale M, Sileshi Y, Kelly-Quinn M, Hailu D (2017) Pollution assessment of toxic and potentially toxic elements in agricultural soils of the city Addis Ababa, Ethiopia. Bull Environ Contam Toxicol, 98(2): 234-243. doi: 10.1007/s00128-016-1975-4.##Tchounwou PB, Yedjou CG, Patlolla AK, Sutton DJ (2012) Heavy metal toxicity and the environment. Exp Suppl, 101: 133-64. doi: 10.1007/978-3-7643-8340-4_6.##Najam LA, Karim MS, Hameed TK (2016) Measurement of radon gas concentration in tap water samples in Wassit governorate by using nuclear track detector (CR-39). International Journal of Physics, 4(5): 119-122.##Ahmad N, Jaafar MS, Nasir T, Rafique M, (2018) Determination of radon concentration and heavy metals (Ni, Pb, Cd, As, Cr) in drinking and irrigated water sampled from Kulim, Malaysia. 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Ecotoxicology and Environmental Safety, 208: 111548.##Khraisat IAS, Al-Batiana B, Gharaibeh S (2022) Assessment of radon gas concentration at Ayoon al-Hammam, Alkora-Jordan water purification plant. J Environ Geol, 6(4): 21-27.##Gupta N, Yadav KK, Kumar V, Prasad SSMM, Jeon B, Kumar S, Abdellattif MH, Alsukaibia AK (2022) Investigation of heavy metal accumulation in vegetables and health risk to humans from their consumption. Frontiers in Environmental Science, 10: 791052.##Oni AA, Babalola SO, Adeleye AD, Olagunju TE, Amama IA, Omole EO, Adegboye EA, Ohore OG (2022). Non-carcinogenic and carcinogenic health risks associated with heavy metals and polycyclic aromatic hydrocarbons in well-water samples from an automobile junk market in Ibadan, SW-Nigeria. Heliyon, 8(9): e10688.##USEPA (2004). Risk assessment guidance for superfund. Volume 1: Human health evaluation manual (Part E, Supplemental guidance for dermal risk assessment). EPA/540/R/99/005. 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Dosimetric impact of Acuros XB over Anisotropic analytical algorithm in kilo voltage Cone-beam CT based treatment planning 2 2 Background: The Cone beam computed tomography (CBCT)-based planning is an effective approach and can act as an indicator for adaptive radiotherapy. This study assesses the dosimetric impact of Acuros in comparison to the anisotropic analytical algorithm (AAA) in kilo voltage-CBCT dose calculation using protocol-specific calibration and Hounsfield unit (HU) override techniques. Materials and Methods: In this study, three anatomical sites—pelvis, head and neck and thorax—were considered for evaluation. The anthropomorphic phantoms used were the BrainLab pelvis phantom, Accuray’s head phantom, and an indigenously developed thorax phantom, respectively. Results: In the prostate case, the maximum difference between AAA and Acuros was 0.3% for protocol-specific calibration and 0.6% for HU override. In the head and neck case, the differences were 1.1% and 0.9% for the respective techniques. In the study on lung tumors, there was an 8% underestimation in the ipsilateral lung mean dose for the protocol-specific CBCT calibration with Acuros, compared to a 0.6% overestimation with AAA. Compared with the EBT3 film dose profile, the mismatch was evident, with Acuros showing greater accuracy over AAA. Conclusion: The dosimetric accuracy of CBCT-based dose calculation is affected by the choice of dose calculation algorithm for a given image quality and technique. The effect of the dose calculation algorithm depends on site-specific inhomogeneity: it is least for the pelvic region and significant for the head and neck and thorax regions. Acuros appears to be much more effective than AAA in accounting for the image quality differences of CBCT. 291 296 2025/05/262025/05/262025/05/262025/05/262025/05/26 1404/3/5 2025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 C.O. Clinto C.O. Clinto Department of Physics, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India clintoco@gmail.com B. Bindhu B. Bindhu Department of Physics, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India Cone-beam computed tomography Acuros XB Anisotropic analytical algorithm. Sonke JJ, Aznar M, Rasch C (2019) Adaptive radiotherapy for anatomical changes. Seminars in Radiation Oncology, 29(3): 245-257.##Green OL, Henke LE, Hugo GD (2019) Practical clinical workflows for online and offline adaptive radiation therapy. Seminars in Radiation Oncology, 29(3): 219-227.##Yoo S and Yin FF (2006) Dosimetric feasibility of cone-beam CT-based treatment planning compared to CT-based treatment planning. Int J Radiat Oncol, Biol Phys, 66(5): 1553-1561.##Annkah JK, Rosenberg I, Hindocha N, Moinuddin SA, Ricketts K, Adeyemi A, Royle G (2014) Assessment of the dosimetric accuracies of CATPhan 504 and CIRS 062 using kV-CBCT for performing direct calculations. J Med Phys, 39(3): 133-141.##de Smet M, Schuring D, Nijsten S, Verhaegen F (2016) Accuracy of dose calculations on kV cone beam CT images of lung cancer patients. Medical Physics, 43(11): 5934.##Giacometti V, King RB, Agnew CE, Irvine DM, Jain S, Hounsell AR, McGarry CK (2019) An evaluation of techniques for dose calculation on cone beam computed tomography. BJR, 92(1096): 20180383.##Rong Y, Smilowitz J, Tewatia D, Tomé WA, Paliwal B (2010) Dose calculation on kV cone beam CT images: an investigation of the Hu-density conversion stability and dose accuracy using the site-specific calibration. Medical Dosimetry, 35(3): 195-207.##Jarema T and Aland T (2019) Using the iterative kV CBCT reconstruction on the Varian Halcyon linear accelerator for radiation therapy planning for pelvis patients. Physica Medica, 68: 112-116.##Onozato Y, Kadoya N, Fujita Y, Arai K, Dobashi S, Takeda K, et al. (2014) Evaluation of on-board kV cone beam computed tomography-based dose calculation with deformable image registration using Hounsfield unit modifications. Int J Radiat Oncol, Biol Phys, 89(2): 416-423.##Rafic KM, Amalan S, Timothy Peace BS, Ravindran BP (2018) Extended localization and adaptive dose calculation using HU corrected cone beam CT: Phantom study. Reports of Practical Oncology and Radiotherapy, 23(2): 126-135.##Fotina I, Hopfgartner J, Stock M, Steininger T, Lütgendorf-Caucig C, Georg D (2012) Feasibility of CBCT-based dose calculation: comparative analysis of HU adjustment techniques. Radiotherapy and Oncology, 104(2): 249-256.##Cole AJ, Veiga C, Johnson U, D'Souza D, Lalli NK, McClelland JR (2018) Toward adaptive radiotherapy for lung patients: feasibility study on deforming planning CT to CBCT to assess the impact of anatomical changes on dosimetry. Physics in Medicine and Biology, 63(15): 155014.##Marchant TE, Joshi KD, Moore CJ (2018) Accuracy of radiotherapy dose calculations based on cone-beam CT: comparison of deformable registration and image correction-based methods. Physics in Medicine and Biology, 63(6): 065003.##Wen N, Glide-Hurst C, Nurushev T, Xing L, Kim J, Zhong H, et al. (2012) Evaluation of the deformation and corresponding dosimetric implications in prostate cancer treatment. Physics in Medicine and Biology, 57(17): 5361-5379.##Veiga C, Lourenço AM, Mouinuddin S, van Herk M, Modat M, Ourselin S, et al. (2015). Toward adaptive radiotherapy for head and neck patients: Uncertainties in dose warping due to the choice of deformable registration algorithm. Medical Physics, 42(2): 760-769.##Veiga C, Janssens G, Teng CL, Baudier T, Hotoiu L, McClelland JR., et al. (2016) First clinical investigation of cone beam computed tomography and deformable registration for adaptive proton therapy for lung cancer. Int J Radiat Oncol, Biol Phys, 95(1): 549-559.##Moteabbed M, Sharp GC, Wang Y, Trofimov A, Efstathiou JA, Lu HM (2015) Validation of a deformable image registration technique for cone beam CT-based dose verification. Medical Physics, 42(1): 196-205.##Disher B, Hajdok G, Wang A, Craig J, Gaede S, Battista JJ (2013) Correction for 'artificial' electron disequilibrium due to cone-beam CT density errors: implications for on-line adaptive stereotactic body radiation therapy of lung. Physics in Medicine and Biology, 58(12): 4157-4174.##Schröder L, Stankovic U, Remeijer P, Sonke JJ (2019) Evaluating the impact of cone-beam computed tomography scatter mitigation strategies on radiotherapy dose calculation accuracy. Physics and Imaging in Radiation Oncology, 10: 35-40.##Giacometti V, Hounsell AR, McGarry CK (2020) A review of dose calculation approaches with cone beam CT in photon and proton therapy. Physica Medica, 76: 243-276.##Lechuga L and Weidlich GA (2016) Cone beam CT vs. fan beam CT: A comparison of image quality and dose delivered between two differing CT imaging modalities. Cureus, 8(9): e778.##Meng H, Meng X, Qiu Q, Zhang Y, Ming X, Li Q, et al. (2021) Feasibility evaluation of kilovoltage cone-beam computed tomography dose calculation following scatter correction: investigations of phantom and representative tumor sites. Translational Cancer Research, 10(8): 3726-3738.##Hansen DC, Landry G, Kamp F, Li M, Belka C, Parodi K, Kurz C (2018) ScatterNet: A convolutional neural network for cone-beam CT intensity correction. Medical Physics, 45(11): 4916-4926.##Rossi M and Cerveri P (2021) Comparison of Supervised and Unsupervised Approaches for the Generation of Synthetic CT from Cone-Beam CT. Diagnostics (Basel, Switzerland), 11(8): 1435.##Thing RS, Nilsson R., Andersson S, Berg M, Lund MD (2022) Evaluation of CBCT based dose calculation in the thorax and pelvis using two generic algorithms. Physica Medica, 103: 157-165.##Joseph J, Singh A, Pournami PN., Jayaraj PB, Puzhakkal N (2023) Cone beam computed tomography enhancement using feature‐embedded variational autoencoder with a perceptual loss function. Int J Imaging Syst Technol, 33(5): 1767-1778##Gong H, Liu B, Zhang G, Dai X, Qu B, Cai B, Xie C, Xu S (2023) Evaluation of dose calculation based on cone-beam CT using different measuring correction methods for head and neck cancer patients. Technology in Cancer Research Treatment, 22: 15330338221148317.##Title: Evaluations of the dose discrepancies calculated on CT and cone-beam CT using pencil beam convolution and analytical anisotropic algorithms. aapm.org/60-14895-10292-364; Abstract ID: 14895##Catphan 504 Manual 2013 (Greenwich, NY: The Phantom Laboratory, Inc.)##Tuomas Torsti LK, Petaja V. Using Varian Photon Beam Source Model for Dose Calculation of Small Fields. Varian Medical Systems; 2013. (Training material from Varian).##Kroon PS, Hol S, Essers M (2013) Dosimetric accuracy and clinical quality of Acuros XB and AAA dose calculation algorithm for stereotactic and conventional lung volumetric modulated arc therapy plans. Radiation Oncology, 8: 149.##Yan C, Combine AG, Bednarz G, Lalonde RJ, Hu B, Dickens K, et al. (2017). Clinical implementation and evaluation of the Acuros dose calculation algorithm. J Appl Clin Med Phys, 18(5): 195-209.##Seniwal B, Bhatt CP, Fonseca TCF (2020) Comparison of dosimetric accuracy of acuros XB and analytical anisotropic algorithm against Monte Carlo technique. Biomedical physics engineering express, 6(1): 015035.##Gopalakrishnan Z, Bhasi SPR, Menon SVBS, Thayil AG, Nair RK (2022). Dosimetric comparison of analytical anisotropic algorithm and the two dose reporting modes of Acuros XB dose calculation algorithm in volumetric modulated arc therapy of carcinoma lung and carcinoma prostate. Medical Dosimetry, 47(3): 280-287.##Prasath SS and Ramesh Babu P (2023) Dosimetric comparison between Acuros XB (AXB) and anisotropic analytical algorithm (AAA) in volumetric modulated Arc therapy. Asian Pacific Journal of Cancer Prevention, 24(5): 1677-1685.##Abdullah C, Farag H, El-Sheshtawy W, Aboelenein H, Guirguis OW (2021) Clinical impact of anisotropic analytical algorithm and Acuros XB dose calculation algorithms for intensity modulated radiation therapy in lung cancer patients. Journal of X-ray Science and Technology, 29(6): 1019-1031.##Kang SW, Chung JB, Lee JW, Kim MJ, Kim YL, Kim JS, et al. (2017) Dosimetric accuracy of the Acuros XB and Anisotropic analytical algorithm near interface of the different density media for the small fields of a 6- MV flattening-filter-free beam. Int J Radiat Res, 15(2): 157-165.##Ragab H, Abdelaziz DM, Khalil MM, Elbakry MN (2023) Assessment of image quality of two cone-beam computed tomography of the Varian Linear accelerators: Comparison with spiral CT simulator. Int J Radiat Res, 21(3): 491-497.## ##

Effects of laparoscopic ultrasound-guided microwave ablation in combination with surgical resection on liver function and immune function in primary liver cancer patients 2 2 Background: To investigate the effects of laparoscopic ultrasound (LUS)-guided microwave ablation (MWA) combined with surgical resection on liver function and immune function of primary liver cancer (PLC) patients. Materials and Methods: Clinical data of 100 patients with PLC after surgery in our hospital from January 2021 to December 2023 were retrospectively analyzed, and divided into laparoscopic hepatectomy (LH group) and laparoscopic ultrasound-guided microwave ablation combined with laparoscopic hepatectomy (LMWA+LH group). Clinical indicators, clinical efficacy, liver function, tumor markers, immune function, incidence of complications, postoperative overall survival rate along with tumor free survival rate between groups were compared. Results: Compared with the LH group, the intraoperative blood loss and postoperative hospital stay was decreased in the LMWA+LH group (P<0.05). Total effective rate of the LMWA+LH group was 90.00%, higher than the 70.00% in LH group (P<0.05). After therapy, reduction in aspartate alanine aminotransferase (ALT), aminotransferase (AST), total bilirubin (TBIL), and the elevation in albumin (ALB) in the LMWA+LH group were more obvious (P<0.05). The LMWA+LH group showed more obvious elevation in CD4+ and CD4+/CD8+ levels and reduction in CD8+ level relative to the LH group (P<0.05). The complication incidence showed no statistical difference between groups (P>0.05). Postoperative survival and tumor free survival rates in the LMWA+LH group were higher than LH group (P<0.05). Conclusion: Laparoscopic ultrasound-guided microwave ablation combined with surgical resection promotes the postoperative recovery, improves liver function and immune function and improves patient survival rate, which might provide guidance for clinical practice. 297 305 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/27 1404/3/6 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 L. Zhu L. Zhu Department of Ultrasonic Medicine, Yichun City People's Hospital, Yichun 336000, Jiangxi, China L. Chen L. Chen Department of Ultrasonic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China LICHEN7006@163.com C. Du C. Du Department of Ultrasonic Medicine, Yichun City People's Hospital, Yichun 336000, Jiangxi, China N. Tao N. Tao Department of Ultrasonic Medicine, Yichun City People's Hospital, Yichun 336000, Jiangxi, China J. Pan J. Pan Department of Ultrasonic Medicine, Yichun City People's Hospital, Yichun 336000, Jiangxi, China IMRT Primary liver cancer ultrasonography microwave ablation hepatectomy liver function immune function. 1. Liu CY, Chen KF, Chen PJ (2015) Treatment of Liver Cancer. Cold Spring Harb Perspect Med, 5(9): a021535.##Jeong S, Zheng B, Wang H, et al. (2018) Nervous system and primary liver cancer. Biochim Biophys Acta Rev Cancer, 1869(2): 286-92.##Sung H, Ferlay J, Siegel RL, et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a Cancer Journal for Clinicians, 71(3): 209-49.##Feng M, Pan Y, Kong R, et al. (2020) Therapy of primary liver cancer. Innovation (Cambridge (Mass)), 1(2): 100032.##Orcutt ST, Anaya DA (2018) Liver resection and surgical strategies for management of primary liver cancer. Cancer Control, 25(1): 1073274817744621.##Xu ZJ, Wei MJ, Zhang XM, et al. (2022) Effects of microwave ablation on serum Golgi protein 73 in patients with primary liver cancer. World J Gastroenterol, 28(29): 3971-80.##Liu F, Hou B, Li Z, et al. (2023) Microwave ablation of multifocal primary liver cancer guided by real-time 3.0T MRI. Int J Hyperthermia, 40(1): 2228519.##Zhang W, Zhu W, Yang J, et al. (2021) Augmented reality navigation for stereoscopic laparoscopic anatomical hepatectomy of primary liver cancer: preliminary experience. Front Oncol, 11: 663236.##Liang P, Yu J, Lu MD, et al. (2013) Practice guidelines for ultrasound-guided percutaneous microwave ablation for hepatic malignancy. World J Gastroenterol, 19(33): 5430-8.##Yoshida H, Taniai N, Yoshioka M, et al. (2019) Current status of laparoscopic hepatectomy. J Nippon Med Sch, 86(4): 201-6.##Ren H, An C, Liang P, et al. (2019) Ultrasound-guided percutaneous microwave ablation assisted by athree-dimensional visualization treatment platform combined with transcatheter arterial chemoembolization for a single large hepatocellular carcinoma 5 cm or larger: a preliminary clinical application. Int J Hyperthermia, 36(1): 44-54.##Suwa K, Seki T, Aoi K, et al. (2021) Efficacy of microwave ablation versus radiofrequency ablation for hepatocellular carcinoma: a propensity score analysis. Abdominal radiology (New York), 46(8): 3790-7.##Wang Y, Cheng Z, Yu J, et al. (2020) US-guided percutanous microwave ablation for early-stage hepatocellular carcinoma in elderly patients is as effective as in younger patients: A 10-year experience. Journal of Cancer Research and Therapeutics, 16(2): 292-300.##Peng Y, Cui D, Li W, et al. (2021) Ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma originating in the caudate lobe: A pilot clinical study. 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(2019) Radiofrequency ablation and microwave ablation in liver tumors: an update. Oncologist, 24(10): e990-e1005.##Xu Z, Yang Z, Pan J, et al. (2018) Individualized laparoscopic B-ultrasound-guided microwave ablation for multifocal primary liver cancer. Wideochir Inne Tech Maloinwazyjne, 13(1): 9-16.##Fang L, Meng X, Luo W, et al. (2019) Treatment of primary hepatic carcinoma through ultrasound-guided microwave ablation. Niger J Clin Pract, 22(10): 1408-11.##Ran B, Chang YL, Qi J, et al. (2021) The clinical effects of ultrasound-guided microwave ablation in the treatment of primary hepatic carcinoma: Protocol for a retrospective clinical observation. Medicine (Baltimore), 100(48): e28045.##Zhang D, Chen Z, Zhang L, et al. (2023) Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis. J Vis Exp, 3: (193).##Tinguely P, Fusaglia M, Freedman J, et al. (2017). 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Image Quality and Radiation Dose of Portal Venous Imaging by Dual-Source Computed Tomography Single Energy Technology 2 2 Background: The design of this work was to explore the feasibility of optimizing computed tomography (CT) portal vein image quality and radiation dose by virtual single-energy imaging technology. Materials and Methods: Nighty-two patients who underwent dual-source CT (DSCT) examination in our hospital from September 2021 and August 2022 were selected as the study objects. They received CT scanning (90/Sn150 kV) and the images of 40 keV to 100 keV and M_0.6 linear fusion were obtained. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), subjective image quality, and radiation dose of different models were calculated. Results: Statistical significance in the subjective score of image quality was tested among all groups, and the 40 keV group had the highest score. The SD values in 40 keV to 60 keV were elevated, while were declined in 80 keV to 100 keV compared with the M_0.6 fusion image. CNR values in 40 keV to 70 keV groups were significantly higher, and in 90 keV to 100 keV were lower than those in M_0.6 group. SNR in the 40 keV group was significantly better than that in M_0.6 group. The average radiation doses were 6.12 ± 1.30 CTDIvol (mGy) and the radiation dose length product (DLP) was 304.3 ± 87.67 (mGy.cm). Conclusion: DSCT virtual single energy reconstruction technology could greatly improve image quality, and 40 keV single energy reconstruction had the best image quality. 305 309 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/27 1404/3/6 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 X. Li X. Li Department Radiology Department, Beijing Shijitan Hospital, Beijing 100038, China Z. Liang Z. Liang Department Radiology Department, Beijing Shijitan Hospital, Beijing 100038, China Y. Duan Y. Duan Department Radiology Department, Beijing Shijitan Hospital, Beijing 100038, China W. Liu W. Liu Department Radiology Department, Beijing Shijitan Hospital, Beijing 100038, China Z. Han Z. Han Department Radiology Department, Beijing Shijitan Hospital, Beijing 100038, China R. Wang R. Wang Department Radiology Department, Beijing Shijitan Hospital, Beijing 100038, China wangrenguibj@163.com Computed tomography radiographic image enhancement portal vein radiation dosage signal-to-noise ratio. Zane KE, Makary MS (2021) Locoregional therapies for hepatocellular carcinoma with portal vein tumor thrombosis. Cancers, 13(21): 5430.##Senzolo M, Garcia-Tsao G, Garcia-Pagan JC (2021) Current knowledge and management of portal vein thrombosis in cirrhosis. J Hepatol, 75(2): 442-53.##Cruz-Ramon V, Chinchilla-Lopez P, Ramirez-Perez O, Aguilar-Olivos NE, Alva-Lopez LF, Fajardo-Ordonez E, et al. (2018) Thrombosis of the portal venous system in cirrhotic vs. non-cirrhotic patients. Ann Hepatol, 17(3): 476-81.##Galante A and De Gottardi A (2021) Portal vein thrombosis: an overview of current treatment options. Acta Gastroenterol Belg, 84(2): 327-32.##Zaw ST, Zaw T, El-Far A (2022) Acute mesenteric ischemia secondary to superior mesenteric vein thrombosis. Cureus, 14(10): e30819.##Sun B and Wang Z (2024) The application value of computed tomography perfusion imaging in diagnosing early cerebral infarction. International Journal of Radiation Research, 22(1): 139-43.##Zhao P, Xu Y, Xie C, Zhan M, Qian Y, Gao Z (2024) Assessment of the effectiveness of neoadjuvant chemotherapy for rectal cancer by MRI and PETCT: a meta-analysis. International Journal of Radiation Research, 22(1): 85-90.##Baliyan V, Kordbacheh H, Serrao J, Sahani DV, Kambadakone AR (2018) Dual-source dual-energy ct portal venous phase abdominal ct scans in large body habitus patients: preliminary observations on image quality and material decomposition. J Comput Assist Tomogr, 42(6): 932-6.##Lu Z, Wu S, Yan C, Chen J, Li Y (2021) Clinical value of energy spectrum curves of dual-energy computer tomography may help to predict pathological grading of gastric adenocarcinoma. Translational cancer research, 10(1): 1-9.##Chen Q and Zhang C (2023) Dual-source CT imaging in evaluating cardiovascular function after coronary artery bypass grafting. International Journal of Radiation Research, 21(4): 837-40.##Wang T, Han Y, Lin L, Yu C, Lv R, Han L (2022) Image quality enhancement of CT hepatic portal venography using dual energy blending with computer determined parameters. J Xray Sci Technol, 30(2): 307-17.##Ren H, Zhen Y, Gong Z, Wang C, Chang Z, Zheng J (2021) Assessment of virtual monoenergetic images in run-off computed tomography angiography: A comparison study to conventional images from spectral detector computed tomography. Journal of Computer assisted Tomography, 45(2): 232-7.##Li J, Zhao S, Ling Z, Li D, Jia G, Zhao C, Lin X, Dai Y, Jiang H, Wang S (2022) Dual-energy computed tomography imaging in early-stage hepatocellular carcinoma: A preliminary study. Contrast Media & Molecular Imaging, 2022: 2146343.##Liang H, Zhou Y, Zheng Q, Yan G, Liao H, Du S, Zhang X, Lv F, Zhang Z, Li YM (2022) Dual-energy CT with virtual monoenergetic images and iodine maps improves tumor conspicuity in patients with pancreatic ductal adenocarcinoma. Insights into Imaging, 13(1): 153.##De Cecco CN, Buffa V, Fedeli S, Luzietti M, Vallone A, Ruopoli R, et al. (2010) Dual energy CT (DECT) of the liver: conventional versus virtual unenhanced images. European Radiology, 20(12): 2870-5.##Liu S, Sheng H, Shi H, Li W, Fan J, He J, Sun H (2018) Computed tomography portography of patients with cirrhosis with normal body mass index: Comparison between low-tube-voltage CT with low contrast agent dose and conventional CT. Medicine, 97(48): e13141.##Çoruh AG, Uzun Ç, Bozca E, Bozca B, Demir İ B, Atasever HG, et al. (2020) Is it possible to predict the side of hepatic metastases according to the primary location of colorectal cancer? Polish Journal of Radiology, 85: e595-e9.##Miñano C and Garcia-Tsao G (2010) Clinical pharmacology of portal hypertension. Gastroenterology clinics of North America, 39(3): 681-95.##Kurimoto A, Yamanaka J, Hai S, Kondo Y, Sueoka H, Ohashi K, et al. (2016) Parenchyma-preserving hepatectomy based on portal ramification and perfusion of the right anterior section: preserving the ventral or dorsal area. Journal of Hepato-Biliary-Pancreatic Sciences, 23(3): 158-66.##Wang L, Wu M, Zhu C, Li R, Bao S, Yang S, Dong J (2022) Ensemble learning based on efficient features combination can predict the outcome of recurrence-free survival in patients with hepatocellular carcinoma within three years after surgery. Frontiers in Oncology, 12: 1019009.##Wei W, Pu YS, Wang XK, Jiang A, Zhou R, Li Y, Zhang QJ, Wei YJ, Chen B, Li ZF (2017) Wall shear stress in portal vein of cirrhotic patients with portal hypertension. World Journal of Gastroenterology, 23(18):3279-86.##Han R, Sun K, Lu B, Zhao R, Li K, Yang X (2017) Diagnostic accuracy of coronary CT angiography combined with dual-energy myocardial perfusion imaging for detection of myocardial infarction. Experimental and Therapeutic Medicine, 14(1): 207-13.##Lai LY, Jiang Y, Shu J (2023) The application of dual-layer spectral detector ct in abdominal vascular imaging. Current Medical Imaging, 19(14):1609-1615.##Kim C, Lee KY, Shin C, Kang EY, Oh YW, Ha M, Ko CS, Cha J (2018) Comparison of filtered back projection, hybrid iterative reconstruction, model-based iterative reconstruction, and virtual monoenergetic reconstruction images at both low- and standard-dose settings in measurement of emphysema volume and airway wall thickness: A CT phantom study. Korean journal of radiology, 19(4): 809-17.##Cong W, Xi Y, De Man B, Wang G (2021) Monochromatic image reconstruction via machine learning. Machine Learning: Science and Technology, 2(2): 025032.##Kim JE, Kim HO, Bae K, Cho JM, Choi HC, Choi DS (2017) Differentiation of small intrahepatic mass-forming cholangiocarcinoma from small liver abscess by dual source dual-energy CT quantitative parameters. Eur J Radiol, 92: 145-52.##Zeng Y, Geng D, Zhang J (2021) Noise-optimized virtual monoenergetic imaging technology of the third-generation dual-source computed tomography and its clinical applications. 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The value of imaging techniques based on enhanced magnetic resonance imaging in the diagnosis and prediction response of radiotherapy for nasopharyngeal carcinoma 2 2 Background: The To evaluate the value of imaging techniques based on enhanced magnetic resonance imaging (MRI) in diagnosing and predicting radiotherapy for nasopharyngeal carcinoma (NPC). Materials and Methods: This study analyzed 142 hospitalized patient's clinical data with nasopharyngeal carcinoma from March 2020 to December 2021. The patients were divided into valid and invalid groups. Preoperative T2 weighted image (T2WI) images were used for imaging analysis, feature texture parameters were screened based on R language, and a short-term efficacy prediction model for the training group and the validation group was constructed. Results: A total of 432 different texture parameters were obtained by T2WI image analysis of each patient and 5 characteristic texture parameters were obtained by Least Absolute Shrinkage and Selection Operator (LASSO) dimensionality reduction and 10-fold cross-validation screening. Specific examples were standard deviation, Cluster Prominence Angle 135 Offset 4, Correlation Angle 135 offset 4, Inertia Angle 135 Offset 4. The prediction models were constructed and the area under the receiver operating characteristic (ROC) curve of the training group model was 0.826 (95% Confidence intervals (CI): 0.708-0.944). The sensitivity and specificity were 83.67% and 69.14%, respectively. The area under the ROC curve of the validation group model was 0.810 (95% CI: 0.682-0.938) and the sensitivity and specificity were 89.46% and 63.29%, respectively. Conclusion: The prediction model constructed has high predictive accuracy, sensitivity and specificity for diagnosing nasopharyngeal carcinoma. The use of enhanced magnetic resonance imaging (MRI)-based imaging to predict the short-term outcome after radiotherapy for NPC was feasible and the prediction model was stable and reliable. 311 316 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/27 1404/3/6 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 X. Liu X. Liu Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou City, China H. Pang H. Pang Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou City, China H. Zhou H. Zhou Post-graduation Training Department, West China Hospital, Sichuan University, Luzhou City, China J. Li J. Li Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou City, China X. Lu X. Lu Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou City, China Y.R. Wang Y.R. Wang Nursing School Of Southwest Medical University, Luzhou City, China P. Zhou P. Zhou Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou City, China zhouping11@swmu.edu.cn Y. Zhang Y. Zhang Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou City, China zy258789@aliyun.com Magnetic resonance imaging nasopharyngeal carcinoma diagnosis radiotherapy. Tsang CM, Lui VW, Bruce JP, et al. (2020) Translational genomics of nasopharyngeal cancer. Semin Cancer Biol, 61: 84-100.##Lee A, Chow JC, Lee NY (2021) Treatment deescalation strategies for nasopharyngeal cancer: a review. JAMA Oncol, 7: 445-53.##Salehiniya H, Mohammadian M, Mohammadian-Hafshejani A, et al. (2018) Nasopharyngeal cancer in the world: epidemiology, incidence, mortality and risk factors. WCRJ, 5: e1046.##Chan AT, Hui EP, Ngan RK, et al. (2018) Analysis of plasma Epstein-Barr virus DNA in nasopharyngeal cancer after chemoradiation to identify high-risk patients for adjuvant chemotherapy: a randomized controlled trial. J Clin Oncol, 36: 3091-100.##Dong D, Zhang F, Zhong LZ, et al. (2019) Development and validation of a novel MR imaging predictor of response to induction chemotherapy in locoregionally advanced nasopharyngeal cancer: a randomized controlled trial substudy (NCT01245959). BMC Med, 17(1): 190.##Li S, Xiao J, He L, et al. (2019) The tumor target segmentation of nasopharyngeal cancer in CT images based on deep learning methods. Technol Cancer Res Treat, 18: 1533033819884561.##Lin D, Wu Q, Qiu S, et al. (2019) Label-free liquid biopsy based on blood circulating DNA detection using SERS-based nanotechnology for nasopharyngeal cancer screening. Nanomedicine, 22: 102100.##Spadarella G, Calareso G, Garanzini E, et al. (2021) MRI based radiomics in nasopharyngeal cancer: Systematic review and perspectives using radiomic quality score (RQS) assessment. Eur J Radiol, 140: 109744.##Yarza R, Bover M, Agulló-Ortuño MT, et al. (2021) Current approach and novel perspectives in nasopharyngeal carcinoma: The role of targeting proteasome dysregulation as a molecular landmark in nasopharyngeal cancer. J Exp Clin Cancer Res, 40(1): 1-8.##Huang S, Cao B, Zhang J, et al. (2021) Induction of ferroptosis in human nasopharyngeal cancer cells by cucurbitacin B: molecular mechanism and therapeutic potential. Cell Death Dis, 12(3): 237.##Hui EP, Ma BB, Lam WJ, et al. (2021) Dynamic Changes of Post-Radiotherapy Plasma Epstein-Barr virus DNA in a randomized trial of adjuvant chemotherapy versus observation in nasopharyngeal cancer. Clin Cancer Res, 27(10): 2827-2836.##Jiří K, Vladimír V, Michal A, et al. 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Correlation identification between radiotracer uptake and pathological features in non-small cell lung cancer (NSCLC) 2 2 Background: SUV values from PET/CT can reflect disease progression; however, there are few detailed and comprehensive studies. In this study, we hope to provide data to complement the analysis of diagnostic indicators for NSCLC, LUAD, and LUSC by analyzing the correlation between SUVmax and various pathological parameters. Patients and Methods: Patients (n=298) with lung lesions were retrospectively studied and clinicopathological index of these patients were collected. Radiomics texture features were extracted by PET/CT scanning and histological features of each patient was collected. The values of SUVmax were obtained and the inner correlation was analyzed. Evaluation and scoring were performed by calculating area under the curve (AUC), sensitivity, specificity and accuracy. Results: PET data were counted and analyzed for positive/negative relationship between SUV value and T stage and histology (P<0.05). Mean SUVmax was 13.32±6.41 mm; the SUVmax was 14.01±5.72 for male and 11.19±7.95 for female. The results showed that LUSC tumors were smaller and more homogeneous, but with more uptake and greater PET variability. In contrast, LUAD have lower and weaker uptake, variability and homogeneity. Conclusion: By meticulously grouping nearly 300 NSCLC samples, AUC values were calculated to indicate the diagnostic value in NSCLC, LUAD and LUSC. It provides ideas and basis for pathological staging analysis of NSCLC. 317 327 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/7 1404/3/17 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 Y. Sheng Y. Sheng Pulmonary and Critical Care Medicine, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Zhejiang, China zjjhsyj@163.com R. Zhou R. Zhou Pulmonary and Critical Care Medicine, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Zhejiang, China Non-small cell lung cancer (NSCLC) neoplasm histological type 18F-FDG area under curves (AUC) diagnose. Bray F, Laversanne M, Sung H, et al. (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 74(3): 229-263.##Kratzer TB, Bandi P, Freedman ND, et al. (2024) Lung cancer statistics, 2023. Cancer, 130(8): 1330-1348.##Leiter A, Veluswamy RR, Wisnivesky JP (2023) The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol, 20(9): 624-639.##Lee E and Kazerooni EA (2022) Lung cancer screening. 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Effectiveness of levonorgestrel-based intrauterine insemination system therapy combined with hysteroscopic electrosurgery and radiotherapy in the treatment of highly differentiated endometrial cancer 2 2 Background: Exploring the efficacy of levonorgestrel intrauterine contraceptive system combined with hysteroscopic resection for the treatment of early and highly differentiated endometrial cancer in young patients and its impact on reproductive function. Materials and Methods: According to the grouping method, the patients were divided into a single hysteroscopy group and a combined progesterone group, with 77 patients in each group. Among them, the single hysteroscopy group received hysteroscopic resection surgery, while the combined progesterone group received levonorgestrel intrauterine contraceptive system treatment on hysteroscopic resection surgery beside radiation. Results: After treatment, endometrial thickness, uterine volume and myoma volume were lower in the combined treatment group than in the intrauterine sustained release group (P<0.05); after treatment, estradiol, FSH and progesterone levels were lower in the combined treatment group compared with the intrauterine sustained release group (P<0.05); after treatment, Hb and VEGF levels were lower in the combined treatment group compared with the intrauterine sustained release group (P < 0.05); after treatment, compared with the intrauterine sustained release group, Hb and VEGF levels were lower in the combined treatment group (P<0.05);Compared with the intrauterine sustained release group, the dysmenorrhea score and CA125 expression level in the combined treatment group were lower (P<0.05); compared with the intrauterine sustained release group, the effective rate of the combined treatment group was higher (P<0.05). Conclusion: The application of mifepristone combined with levonorgestrel intrauterine sustained release system in the treatment of patients with uterine fibroids can effectively improve the symptoms of patients, alleviate clinical symptoms, alleviate dysmenorrhea, effectively inhibit the further development of the disease, reduce the expression level of CA125, improve the prognosis of patients, and have a significant therapeutic effect. 329 334 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/7 1404/3/17 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 P. Lian P. Lian Department of Nursing College of Changsha Health Vocational College, Changsha, Hunan410600, China H. Xu H. Xu Department of Oncology, Ezhou Central Hospital, Ezhou, Hubei436000, China S. Liu S. Liu H. Qian H. Qian Department of Gynecology, Hubei Geological Hospital, Wuhan, Hubei 430000, China medicalsciences.paper@gmail.com Endometrial cancer levonorgestrel intrauterine contraceptive system hysteroscopic electrocision fertility function radiotherapy. Lu YY, Yang F, Zheng Y (2021) Research progress and prospect on the application of sentinel lymph nodes in endometrial cancer. Chinese Journal of Cancer, 31(10): 944-948.##Laganà AS, Franchi MP, Garzon S (2022) Conservative management of atypical endometrial hyperplasia and early endometrial cancer in childbearing age women. Medicina (Kaunas), 58(9): 1256.##Mo JS, Su BL, Liang XM, et al. (2019) Study on the efficacy and recurrence of hysteroscopic electrosurgery and radiotherapy combined with progesterone in the treatment of young patients with early progesterone receptor-positive endometrial cancer. Chinese Journal of Practical Medicine, 46(12): 58-60.##Zhang YX, Duan GT, Meng P (2020) Observation on the efficacy of conservative hysteroscopic surgery combined with progestin in the treatment of early endometrial cancer. Journal of Clinical and Experimental Medicine, 19(12): 1339-1341.##Fu LY, Duan SY, Wan SZ (2008) Application of visual analog scoring method in patient satisfaction survey. China Nursing Management, 8(9): 68-69.##Li J, Wu S, Zhang Z (2022) Brusatol sensitizes endometrial hyperplasia and cancer to progestin by suppressing NRF2-TET1-AKR1C1-mediated progestin metabolism. Lab Invest, 102(12): 1335-1345.##Li AL, Hou QX, Lei WL (2020) Effect of hysteroscopic electrodesiccation combined with hormonal therapy for endometrial cancer on patients' serum PLGF level, disease progression and recurrence. Journal of Practical Cancer, 35(9): 1449-1455.##Ye XY (2021) Effect of mifepristone combined with hysteroscopic electrosurgery and radiotherapy on fertility function of endometrial cancer patients. China Maternal and Child Health Care, 36(19): 4618-4620.##Zhao YR, Xu YX, Zhou Y (2022) Effect of goserelin combined with hysteroscopic electrosurgery and radiotherapy on postoperative disease remission and recurrence in patients with early endometrial cancer. China Drugs and Clinics, 22(4): 358-360.##Li S, Yang JM, Sun L, et al. (2021) Clinical efficacy and conservation function of hysteroscopic laparoscopic surgery combined with high-efficiency progestin in the treatment of endometrial cancer patients. Cancer Progress, 19(5)519-529.##Aizetz M (2017) Observation on therapeutic effect of hysteroscopic electrosurgery and radiotherapy with biochemical soup plus flavor in the treatment of early endometrial cancer. 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(2019) Study on the value of CEA, CA19-9, CA125, HE4 and menopausal ROMA value determination for clinical staging of endometrial cancer. International Journal of Laboratory Medicine, 40(3): 304-307.##Leombroni M, Dessole M, Lucidi A (2022) Reproductive and pregnancy outcomes of fertility-sparing treatments for early-stage endometrial cancer or atypical hyperplasia: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol, 273: 90-97.##Dai J and Yang B (2021) Current status and problems of fertility preservation treatment for endometrial cancer. Sichuan Medicine, 42(3): 313-317.## ##

Preserving memory function in whole-brain radiation Therapy: Efficacy of HyperArc and Coplanar VMAT techniques 2 2 Background: This study assessed the efficacy of HyperArc planning for whole-brain radiation therapy (WBRT) with hippocampal sparing, comparing it to conventional coplanar volumetric modulated arc therapy (VMAT) techniques using high-definition multileaf-collimators (HDMLC) and millennium MLC (MMLC). Materials and Methods: In this retrospective study, 25 patients with brain metastases received hippocampus-sparing WBRT by RTOG-0933 trial guidelines. Three treatment plans (HyperArc, VMAT-HDMLC, VMAT-MMLC) were created using Eclipse v16.1 Treatment Planning System (TPS), with a prescribed dose of 30Gy in 10 fractions. The Dosimetric parameters assessed included D98%, D2%, HI, Dmax for PTVeval, and Dmax, Dmean, and D100% for hippocampus and other critical structures. Additionally, Monitor Units (MUs) and delivery checks using portal dosimetry were considered. Results: All plans met RTOG-0933 criteria for PTV and OARs. HyperArc matched VMAT-HDMLC in D98% (28.41 Gy vs. 28.38 Gy), outperforming VMAT-MMLC (28.04 Gy). HyperArc surpassed both VMAT techniques in D2% (32.83 Gy vs. 33.24 Gy vs. 34.06 Gy), HI (0.14 vs. 0.15 vs. 0.18), and Dmax (34.84 Gy vs. 35.5 Gy vs. 36.36 Gy). In hippocampus sparing, HyperArc achieved lower Dmax (12.99 Gy vs. 13.73 Gy vs. 14.76 Gy), Dmean (9.58 Gy vs. 10.23 Gy vs. 10.64 Gy), and D100% (8.25 Gy vs. 8.70 Gy vs. 8.85 Gy) values. Further, the HyperArc method provided better organ-at-risk sparing and higher gamma results. Conclusion: All three methods met RTOG-0933 dosimetric goals, with HyperArc outperforming VMAT. Optimized VMAT collimator angles at 0° and 90° improved organ-at-risk doses, exceeding conventional planning in PTV coverage and hippocampal sparing. 335 339 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/7 1404/3/17 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 S. Muthu S. Muthu Department of Physics, School of Advanced Sciences, Vellore Institute of Technology, Chennai, India G. Mudhana G. Mudhana Department of Physics, School of Advanced Sciences, Vellore Institute of Technology, Chennai, India Whole brain radiotherapy hippocampus avoidance HyperArc VMAT MLC. 1.Gondi V, Tomé WA, Mehta MP (2010) Why avoid the hippocam-pus? A comprehensive review. Radiother Oncol, 97: 370-6.##Raber J (2010) Unintended effects of cranial irradiation on cogni-tive function. Toxicol Pathol, 38: 198-202.##Abayomi OK (1996) Pathogenesis of irradiation-induced cognitivedysfunction. Acta Oncol, 35: 659-63.##Gondi V, Pugh SL, Tome WA, et al. (2014) Preservation of memory with conformal avoidance of the hippocampal neural stem-cellcompartment during whole-brain radiotherapy for brain metasta-##ses (RTOG 0933): a phase II multi-institutional trial. J Clin Oncol, 32: 3810-6.##Prado A, Milanés AI, et al. (2019) Dosimetric comparison of fourvolumetric-modulated Arc therapy beam arrangements utilized forhippocampal-sparing whole-brain radiation therapy. J Med Phys,44: 1-8.##Shen J, Bender E, et al. (2015). An efficient Volumetric Arc Therapytreatment planning approach for hippocampal-avoidance whole-brain radiation therapy (HA-WBRT). Med Dosim, 40: 205-9.##Yuen AHL, Wu PM, et al. (2020) Volumetric modulated arc therapy(VMAT) for hippocampal-avoidance whole brain radiation therapy:planning comparison with Dual-arc and Split-arc partial-field tech-niques. Radiat Oncol, 15: 42.##Vergalasova I, Liu H, et al. (2019) Multi-Institutional Dosimetricevaluation of modern day stereotactic radiosurgery (SRS) treat-ment options for multiple brain metastases. Front Oncol, 9: 483.##Smyth G, Evans PM, Bamber JC, Bedford JL (2019) Recent develop-ments in non-coplanar radiotherapy. Br J Radiol, 92: 20180908.##Ruggieri R, Naccarato S, et al. (2018) Linac-based VMAT radiosur-gery for multiple brain lesions: comparison between a convention-al multi-isocenter approach and a new dedicated mono-isocentertechnique. Radiat Oncol, 13: 38.##Ohira S, Ueda Y, et al. (2018) HyperArc VMAT planning for single and multiple brain metastases stereotactic radiosurgery: a new treatment planning approach. Radiat Oncol, 13: 13.##Lyu Q, O'Connor D, et al. (2018) VMAT optimization with dynamiccollimator rotation. Med Phys, 45: 2399-2410.##Kim JI, Ahn BS, et al. (2018) Optimal collimator rotation based onthe outline of multiple brain targets in VMAT. Radiat Oncol, 13: 88.##Kamst O and Desai P (2023) Evaluation of HyperArc™ using filmand portal dosimetry quality assurance. Phys Eng Sci Med, 46: 57-66.##Miften M, Olch A, et al. (2018) Tolerance limits and methodologiesfor IMRT measurement-based verification QA: Recommendations of AAPM Task Group No. 218. Med Phys, 45: e53-e83.##Muthu S and Mudhana G (2024) Dosimetric systems in pre-treatment QA for stereotactic treatments: correlation agreementsand target volume dependency. Asian Pac J Cancer Prev, 25: 1425-1432.##Siglin J,Champ CE, Vakhnenko Y, et al. (2014) Optimizing patient positioning for intensity modulated radiation therapy in hippocam-pal-sparing whole brain radiation therapy. Pract Radiat Oncol, 4: 378-83.##Sprowls CJ, Shah AP, et al. (2021) Whole brain radiotherapy withhippocampal sparing using Varian HyperArc. Med Dosim, 46: 264-268.##Monk JE, et al. (2003) Comparison of a micro-multileaf collimatorwith a 5-mm-leaf-width collimator for intracranial stereotacticradiotherapy. Int J Radiat Oncol Biol Phys, 57: 1443-9.##Hong CS, et al. (2014) Dosimetric effects of multileaf collimatorleaf width on intensity-modulated radiotherapy for head and neckcancer. Med Phys, 41: 021712.##Venencia CD, et al. (2023) Rotational effect and dosimetric impact:HDMLC vs 5-mm MLC leaf width in single isocenter multiple me-tastases radiosurgery with Brainlab ElementsTM. Journal of Radio-therapy in Practice, 22: e35.##Sood S, Pokhrel D, McClinton C, et al. (2017) Volumetric modulat-ed arc therapy (VMAT) for whole brain radiotherapy: not only forhippocampal sparing, but also for reduction of dose to organs atrisk. Med Dosim, 42: 375-383.##Rong Y, Evans J, et al. (2015) Dosimetric evaluation of intensity-modulated radiotherapy, volumetric modulated arc therapy, andhelical tomotherapy for hippocampal-avoidance whole brain radio-therapy. 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Comparison of the application value of spiral computed tomography and x-ray examination in the differential diagnosis of lung cancer and benign lung tumors 2 2 Background: The differential diagnosis of lung cancer (LC) and benign lung tumors is challenging in clinic. Spiral computed tomography (CT) and X-ray are commonly utilized imaging techniques. Accordingly, the practical significance of CT and X-ray imaging in the differential identification of benign versus malignant pulmonary neoplasms was explored. Materials and Methods: A retrospective analysis was performed on data from 105 patients who had undergone both CT and X-ray examinations to evaluate variations in peripheral blood tumor markers. The imaging features of benign and malignant lung tumors were compared, and the diagnostic efficacy of CT and X-ray was assessed. Results: CT examination of patients with unilateral lung tumors or lung insufficiency demonstrated a greatly higher detection rate of speculated lesions compared to X-ray. Additionally, tumor markers showed a positive correlation with tumor size. The positive rate for differential diagnosis using CT was notably superior to that of X-ray (P<0.05). The sensitivity (Sen), specificity (Spe), accuracy (Acc), positive predictive value, and negative predictive value of CT and X-ray in differential diagnosis were 86.4%, 68.3%, 94.9%, 74.4%, 89.5%, 70.5%, 96.6%, 81.8%, 80.4%, and 58.0%, respectively. CT was considerably more valuable for differential diagnosis (P<0.05). Conclusion: X-ray and CT scans serve as pivotal diagnostic tools for distinguishing between benign and malignant pulmonary neoplasms. CT has a better effect in the differential diagnosis of lung tumors, and its imaging performance is more comprehensive, which is worthy of clinical application. 341 347 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 B. He B. He epartment of Radiology, the Affiliated Hospital of Shaoxing University (Shaoxing Municipal Hospital), Shaoxing 312000, Zhejiang Province, China J. Xu J. Xu Department of Radiology, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China L. Wang L. Wang epartment of Radiology, the Affiliated Hospital of Shaoxing University (Shaoxing Municipal Hospital), Shaoxing 312000, Zhejiang Province, China B. Li B. 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Effect of ozone and melatonin on oxidative stress parameters and enzymatic factors of the liver and kidney in mice with busulfan-induced injury 2 2 Background: The aim of this study was to investigate the effects of ozone and melatonin interventions on anti-oxidant effects and enzymatic parameters in the liver and kidneys of mice experiencing busulfan-induced injury, a common chemotherapy-related condition known to severely affect these organs. Materials and Methods: The research included 24 male mice were randomly assigned in four groups of six mice each: a control group without any intervention, busulfan group, busulfan with melatonin group, and busulfan with ozone group. This experimental setup spanned seven days. After a 35-day period, blood, liver and kidney tissues were extracted for the assessment of various parameters, such as super oxide dismutase (SOD), catalase, total antioxidant capacity (TAC), malondialdehyde, and tissue creatinine. Results: Busulfan administration resulted in a decrease in SOD, catalase, and TAC levels, along with an increase in malondialdehyde levels in both the kidneys and liver. Additionally, Busulfan led to elevated ALT levels and decreased AST in liver tissue, as well as increased BUN and tissue creatinine in the kidneys. However, the introduction of ozone and melatonin ameliorated these effects across all parameters. Notably, ozone exhibited a stronger impact on catalase, TAC, and malondialdehyde in both organs. Moreover, ozone showed pronounced effects on ALT and AST in the liver and on creatinine in the kidneys. Conclusion: Both melatonin and ozone show promise in ameliorating Busulfan-induced injury. Interestingly, ozone appears to exhibit greater efficacy in enhancing kidney and liver function in such cases. 349 355 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 R. Dadfar R. Dadfar Department of Anatomical Sciences, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran T. Safari T. Safari Department of Histology, Faculty of Veterinary Medicine Department of Basic Sciences, Shahid Chamran University of Ahvaz, Iran M. Taheri Moghadam M. Taheri Moghadam Department of Anatomical Sciences, Faculty of Medicine, Ahvaz Jundishapur University of Medical sciences, Ahvaz, Iran taherimoghadam-m@ajums.ac.ir Busulfan melatonin ozone oxidative stress liver kidney. 1. Kasi PD, Tamilselvam R, Skalicka-Woźniak K, Nabavi SF, Daglia M, Bishayee A, et al. 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Application value of multimodal ultrasound in differential diagnosis of thyroid nodules 2 2 Background: Background: While conventional ultrasound (US) remains the first-line diagnostic tool, its limitations in distinguishing benign from malignant nodules necessitate exploring complementary techniques. This study aimed to evaluate the potential of integrating contrast-enhanced ultrasound (CEUS) and ultrasound elastography (UE) alongside conventional US to improve diagnostic accuracy compared to individual modalities. Materials and Methods: This retrospective analysis was conducted at Tangshan people's Hospital. We enrolled 180 consecutive patients diagnosed with thyroid nodules between January 2021 and December 2022. All participants underwent comprehensive ultrasound examinations comprising conventional US, CEUS, and UE. Fine-needle aspiration biopsy (FNAB) or surgical specimens were the gold standard for definitive diagnosis. Patients with inconclusive diagnoses or incomplete examinations were excluded. Results: Conventional US (ACR TI-RADS) achieved an AUC of 0.802, excelling in detecting suspicious features but suffering from inherent subjectivity. CEUS, with an AUC of 0.854 and a remarkable sensitivity of 95.29%, captured specific malignant patterns like centripetal enhancement and uneven distribution, but its reliance on contrast limited its applicability. UE provided an area under the curve (AUC) of 0.845 and valuable information about tissue stiffness, but its efficacy was influenced by nodule size and location. However, the true strength emerged when combining all three modalities. Multimodal ultrasound yielded an impressive AUC of 0.958 and a sensitivity of 91.76%, significantly surpassing individual performances. Conclusion: Our findings demonstrate that multimodal ultrasound, integrating conventional US, CEUS, and UE, significantly outperforms individual modalities in diagnosing thyroid nodules. Further research is warranted to refine and optimize this promising diagnostic strategy to benefit patients with thyroid nodules. 357 364 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 J. Zhai J. Zhai Head and Neck Cancer Surgery, Tangshan people's Hospital, Tangshan City, Hebei Province, China 15832577787@163.com J. Li J. Li Head and Neck Cancer Surgery, Tangshan people's Hospital, Tangshan City, Hebei Province, China Thyroid nodules multimodal ultrasound differential diagnosis application value. 1. Offi C, Romano RM, Cangiano A, et al. (2021) Evaluation of LMR, NLR and PLR as predictors of malignancy in indeterminate thyroid nodules. Acta Otorhinolaryngol Ital, 41(6): 530-6.##Alexander EK and Cibas ES (2022) Diagnosis of thyroid nodules. Lancet Diabetes Endocrinol, 10(7): 533-9.##Antonia TD, Maria LI, Ancuta-Augustina GG (2023) Preoperative evaluation of thyroid nodules - Diagnosis and management strategies. Pathol Res Pract, 246: 154516.##Durante C, Grani G, Lamartina L, et al. (2018) The diagnosis and management of thyroid nodules: A review. JAMA, 319(9): 914-24.##Tessler FN, Middleton WD, Grant EG, et al. (2017) ACR thyroid imaging, reporting and data system (TI-RADS): White paper of the ACR TI-RADS Committee. J Am Coll Radiol, 14(5): 587-95.##Chen H, Ye J, Song J, et al. (2021) Comparison of different ultrasound classification systems of thyroid nodules for identifying malignant potential: A cross-sectional study. Clinics (Sao Paulo), 76: e2126.##Xi X, Gao L, Wu Q, et al. (2020) Differentiation of thyroid nodules difficult to diagnose with contrast-enhanced ultrasonography and real-time elastography. Front Oncol, 10: 112.##Radzina M, Ratniece M, Putrins DS, et al. (2021) Performance of Contrast-enhanced ultrasound in thyroid nodules: Review of current state and future perspectives. Cancers (Basel), 13(21): 5469.##Moraes PHM, Sigrist R, Takahashi MS, et al. (2019) Ultrasound elastography in the evaluation of thyroid nodules: evolution of a promising diagnostic tool for predicting the risk of malignancy. Radiol Bras, 52(4): 247-53.##Han Z, Huang Y, Wang H, et al. (2022) Multimodal ultrasound imaging: A method to improve the accuracy of diagnosing thyroid TI-RADS 4 nodules. J Clin Ultrasound, 50(9): 1345-52.##Hoang JK, Middleton WD, Tessler FN (2021) Update on ACR TI-RADS: Successes, challenges, and future directions, from the AJR special series on radiology reporting and data systems. AJR Am J Roentgenol, 216(3): 570-8.##Tian Y, Lu Y, Zhao YZ, et al. (2018) Characteristics of high - resolution ultrasound in the assessment of microcalcification of papillary thyroid carcinoma. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 40(3): 378-84.##Sun C, Zhang Y, Chang Q, et al. (2020) Evaluation of a deep learning-based computer-aided diagnosis system for distinguishing benign from malignant thyroid nodules in ultrasound images. Med Phys, 47(9): 3952-60.##Valenciaga A, Ivancic RJ, Khawaja R, et al. (2021) Efficacy of an Integrated hands-on thyroid ultrasound session for medical student education. Cureus, 13(1): e12421.##Xia R, Sun W, Yee J, et al. (2022) Do ACR TI-RADS scores demonstrate unique thyroid molecular profiles? Ultrasonography, 41(3): 480-92.##Alyami J, Almutairi FF, Aldoassary S, et al. (2022) Interobserver variability in ultrasound assessment of thyroid nodules. Medicine (Baltimore), 101(41): e31106.##Wan P, Chen F, Liu C, et al. (2021) Hierarchical temporal attention network for thyroid nodule recognition using dynamic CEUS imaging. 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The impact of anthropometric measurements on radiotherapy planning for patients with breast cancer 2 2 Background: In the management of breast cancer, radiotherapy plays a crucial role, especially in managing local tumor control. To achieve the best possible outcomes while fully protecting normal tissues, it is important to consider anatomic variations, which can differ between individuals and significantly impact treatment field designs. Materials and Methods: The study involved 40 patients with breast cancer who underwent breast-conserving surgery (BCS) and received both whole breast and lymph node irradiation. The study evaluated the impact of anthropometric characteristics including weight, mid-sternum thickness, Haller index, central lung distance (CLD), and breast volume on the doses of organs at risk (OARs). Results: Breast size was found to be an important factor in determining lung doses. Patients with larger breasts had higher ipsilateral lung doses compared with those with small or medium-sized breasts. On the other hand, patients with mid-sternum thickness above 1.7 cm had higher contralateral breast doses. As expected, patients who received internal mammary nodal irradiation had higher lung doses and contralateral breast doses compared with those who did not. Conclusions: In the radiotherapy of breast cancer, it is important to consider treatment portal designs based on anthropometric variables to reduce the doses of organs at risk. Contralateral breast doses in patients with high mid-sternum thickness and lung doses in patients with large breasts should be carefully and treatment options should be evaluated accordingly. 365 370 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 T. Koca T. Koca Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey timurkoca3@gmail.com Y. Sengun Y. Sengun Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey E. Atak E. Atak Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey M.G. Aksu M.G. Aksu Department of Radiation Oncology, Antalya Yaşam Hospital, Antalya, Turkey N. Tuncel N. Tuncel Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey A.F. Korcum A.F. Korcum Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey Breast cancer radiotherapy anthropometry heart dose lung dose. 1. Siegel RL, Miller KD, Wagle NS, et al. (2023) Cancer statistics, 2023. CA Cancer J Clin, 73(1): 17-48.##Darby S, McGale P, Correa C, et al. (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet, 378(9804): 1707-16.##Giuliano AE, Edge SB, Hortobagyi GN (2018) Eighth edition of the AJCC cancer staging manual: Breast cancer. Ann Surg Oncol, 25(7): 1783-5.##Taylor CW and Kirby AM (2015) Cardiac side-effects from breast cancer radiotherapy. Clin Oncol, 27(11): 621-9.##Donovan EM, James H, Bonora M, et al. 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Task-based fMRI study of activation in the brain network: A seed-based functional connectivity analysis 2 2 Background: Task-based functional magnetic resonance imaging (fMRI) is an effective method for noninvasively studying brain activity. We aim to find representative brain areas of the swallowing movement and compare the functional connectivity differences in these areas. Materials and Methods: A total of 23 participants were recruited to undergo task-based fMRI scans. Subject-level statistical analysis and group-level activation analysis were conducted using SPM12. Seed-based Functional Connectivity (FC) analyses were conducted to construct FC in brain level. We used two-sample t-test to identify distinctive FC patterns in various seeds. The relationship between FC values and swallowing frequency was also explored. Results: In experiment I, group-level activation patterns were observed in 30-second saliva swallowing trial task, but not in 18s-on task. Two sample t-tests showed that the seed located in right pericentral area (Seed3) had significantly more intensive FC than that located in cingulum (Seed5) with left postcentral gyrus, the seed located in left pericentral area(Seed4) had significantly more intensive FC than those located in cerebellum(Seed1,2) or in Seed5 with right postcentral gyrus, Seed5 had significantly more intensive FC than Seed1,2,4 with right middle frontal gyrus, right superior frontal gyrus and left supplementary motor area separately. No significant positive or negative correlations between swallowing frequency and seed-based FC values were found. Conclusions: Saliva swallowing trail task with self-paced rhythm in sufficient time can activate swallowing-related brain regions effectively. The activation peaks in bilateral pericentral area are representative in swallowing process and could be new therapeutic targets for poststroke dysphagia instead of traditional route. 371 378 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 M. Chen M. Chen Affiliated Hospital of Hangzhou Normal University, Hangzhou, China evonne_myi@163.com Y. Chen Y. Chen Zhejiang University, School of Medicine, Hangzhou, China X. Wang X. Wang Affiliated Hospital of Hangzhou Normal University, Hangzhou, China X. Ye X. Ye Affiliated Hospital of Hangzhou Normal University, Hangzhou, China Z. Huang Z. Huang Affiliated Mental Health Center, Zhejiang University, School of Medicine, Hangzhou, China W. Wu W. 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Optimization of computed tomography protocols based on objective and subjective evaluations. 2 2 Background: Computed tomography (CT) is a crucial technique in clinical practice for diagnosing thoracic pathologies. However, the risk associated with ionizing radiation requires measures to reduce patient exposure. Materials and Methods: This study aims to optimize thoracic CT protocols on a multislice CT scanner, using both objective and subjective analyses of image quality to decrease radiation dose without compromising diagnostic accuracy. A 16-channel CT scanner with automatic tube current modulation (ATCM) was utilized, along with an analytical phantom for objective evaluation. Six protocols with different standard deviation values were selected, including three used in clinical routines and three additional ones for testing. Parameters such as spatial resolution, low contrast resolution, noise, and dosimetry were assessed. Subjective Image Quality evaluation was conducted through visual grading analysis (VGA). Results: Optimized protocols were selected based on acceptable image quality and dose results. Data were statistically analyzed, demonstrating that optimized protocols showed a significant reduction in radiation dose while maintaining adequate diagnostic quality. Conclusion: This study contributes to clinical practice by adhering to the ALARA (As Low As Reasonably Achievable) principles of dose reduction, ensuring accurate and safe diagnoses in thoracic CT examinations. 379 385 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 R.A.C. Guassu R.A.C. Guassu Department of Physics and Biophysics, Sao Paulo State University Julio de Mesquita Filho, Institute of Bioscience, R. Prof. Dr. Antônio Celso Wagner Zanin, 250 - Distrito de Rubião Junior, Botucatu, Brazil .A. Santana Souza .A. Santana Souza Department of Physics and Biophysics, Sao Paulo State University Julio de Mesquita Filho, Institute of Bioscience, R. Prof. Dr. Antônio Celso Wagner Zanin, 250 - Distrito de Rubião Junior, Botucatu, Brazil M. Alvarez M. Alvarez São Paulo State University Julio de Mesquita Filho, Medical School, Av. Prof. Mário Rubens Guimarães Montenegro - UNESP, Botucatu, Brazil S.M. Ribeiro S.M. Ribeiro São Paulo State University Julio de Mesquita Filho, Medical School, Av. Prof. Mário Rubens Guimarães Montenegro - UNESP, Botucatu, Brazil J.C.S. Trindade Filho J.C.S. Trindade Filho São Paulo State University Julio de Mesquita Filho, Medical School, Av. Prof. Mário Rubens Guimarães Montenegro - UNESP, Botucatu, Brazil D.R. Pina D.R. Pina São Paulo State University Julio de Mesquita Filho, Medical School, Av. Prof. Mário Rubens Guimarães Montenegro - UNESP, Botucatu, Brazil diana.pina@unesp.br Computed tomography dose optimization image quality thoracic imaging. 1. Saeed MK, Tammam N, Sulieman A (2021) Assessment of dose reduction and influence of gantry rotation time in CT abdomen examinations. Int J Radiat Res, 19(1): 223-230. doi: 10.29252/ijrr.19.1.223.##Bastos Maués NHP, Alves AFF, Pavan ALM, Ribeiro SM, Yamashita S, Trindade AP, et al. (2019) ABdomen-pelvis computed tomography protocol optimization: an image quality and dose assessment. Radiat Prot Dosimetry, 184(1): 66-72. doi: 10.1093/rpd/ncy181.##Brenner DJ (2014) What we know and what we don't know about cancer risks associated with radiation doses from radiological imaging. 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Available: https://ncrponline.org/shop/reports/report-no-184-medical-radiation-exposure-of-patients-in-the-united-states-2019/##Lee S, Yoon SW, Yoo SM, Ji YG, Kim KA, Kim SH, et al. (2011) Comparison of image quality and radiation dose between combined automatic tube current modulation and fixed tube current technique in CT of abdomen and pelvis. Acta Radiol Stockh Swed 1987, 52(10): 1101-1106. doi: 10.1258/ar.2011.100295.##Kalra MK, Maher MM, Toth TL, Schmidt B, Westerman BL, Morgan HT, et al. (2004) Techniques and applications of automatic tube current modulation for CT. Radiology, 233(3): 649-657. doi: 10.1148/radiol.2333031150.##Prasad KN, Cole WC, Haase GM (2004) Radiation protection in humans: extending the concept of as low as reasonably achievable (ALARA) from dose to biological damage. Br J Radiol, 77(914): 97-99. doi: 10.1259/bjr/88081058.##Sookpeng S, Martin CJ, Gentle DJ (2016) Influence of CT automatic tube current modulation on uncertainty in effective dose. 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Comparative study on the clinical efficacy and quality of life of helical tomotherapy and three-dimensional conformal radiotherapy for locally advanced nasopharyngeal carcinoma 2 2 Background: To explore the therapeutic effect of helical tomotherapy (HT) and three-dimensional conformal radiotherapy (3DCRT) on locally advanced nasopharyngeal carcinoma (NPC) and the impact on patients' quality of life. Materials and Methods: Retrospectively, we analyzed data from 354 patients with locally advanced NPC who were admitted to our hospital from January 2015 to January 2019. Patients were divided into 3DCRT group and HT group with distinct therapy modality. The clinical efficacy, appetite changes and adverse reactions of the 2 groups were observed, and quality of life scale (SF-36) scores and 1-, 2- and 3-year survival ratios of the 2 groups at pre-therapy and post-therapy were compared. Results: the HT group exhibited a markedly superior objective remission rate (ORR) compared to the 3DCRT group (P<0.05), but the difference between the disease control rate (DCR) of the two groups was not statistically significant (P>0.05). Conclusion: HT radiotherapy for patients with locally advanced NPC shows precise advantages, which can effectively improve the clinical therapeutic effect of the patients. 387 395 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 Y. Wen Y. Wen Department of Radiation Oncology, General Hospital of Southern Theatre Command, Pepole`s Liberation Army, Guangzhou City, 510010, China Y. Huang Y. Huang Department of Radiation Oncology, General Hospital of Southern Theatre Command, Pepole`s Liberation Army, Guangzhou City, 510010, China W. Luo W. Luo Department of Radiation Oncology, General Hospital of Southern Theatre Command, Pepole`s Liberation Army, Guangzhou City, 510010, China X. Liang X. Liang Department of Radiation Oncology, General Hospital of Southern Theatre Command, Pepole`s Liberation Army, Guangzhou City, 510010, China Y. Cai Y. Cai Department of Radiation Oncology, General Hospital of Southern Theatre Command, Pepole`s Liberation Army, Guangzhou City, 510010, China L. Sun L. Sun Department of Radiation Oncology, General Hospital of Southern Theatre Command, Pepole`s Liberation Army, Guangzhou City, 510010, China J. Zheng J. Zheng Department of Radiation Oncology, General Hospital of Southern Theatre Command, Pepole`s Liberation Army, Guangzhou City, 510010, China 18127950351@163.com Tomotherapy radiotherapy nasopharyngeal neoplasms patient outcome quality of life. 1. Baloche V, Ferrand FR, Makowska A, Even C, Kontny U, Busson P (2020) Emerging therapeutic targets for nasopharyngeal carcinoma: opportunities and challenges. Expert Opin Ther Targets, 24(6): 545-58.##You R, Liu YP, Huang PY, Zou X, Sun R, He YX, et al. (2020) Efficacy and safety of locoregional radiotherapy with chemotherapy vs chemotherapy alone in de novo metastatic nasopharyngeal carcinoma: a multicenter phase 3 randomized clinical trial. JAMA Oncol, 6(9): 1345-52.##Ng WT, Soong YL, Ahn YC, AlHussain H, Choi HCW, Corry J, et al. (2021) International recommendations on reirradiation by intensity modulated radiation therapy for locally recurrent nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys, 110(3): 682-95.##Tang LL, Chen YP, Chen CB, Chen MY, Chen NY, Chen XZ, et al. (2021) The Chinese Society of Clinical Oncology (CSCO) clinical guidelines for the diagnosis and treatment of nasopharyngeal carcinoma. Cancer Commun, 41(11): 1195-227.##Mai HQ, Chen QY, Chen D, Hu C, Yang K, Wen J, et al. (2021) Toripalimab or placebo plus chemotherapy as first-line treatment in advanced nasopharyngeal carcinoma: a multicenter randomized phase 3 trial. Nat Med, 27(9): 1536-43.##Jiromaru R, Nakagawa T, Yasumatsu R (2022) Advanced nasopharyngeal carcinoma: current and emerging treatment options. Cancer Manag Res, 14: 2681-9.##Zheng L, Tong L, Du F, Ren H, Xiao L (2021) Effect of three-dimensional conformal radiotherapy and intensity-modulated radiotherapy on parotid gland function and quality of life in patients with nasopharyngeal carcinoma. Am J Transl Res, 13(5): 5272-9.##Gupta T, Sinha S, Ghosh-Laskar S, Budrukkar A, Mummudi N, Swain M, et al. (2020) Intensity-modulated radiation therapy versus three-dimensional conformal radiotherapy in head and neck squamous cell carcinoma: long-term and mature outcomes of a prospective randomized trial. Radiat Oncol, 15(1): 218.##Fang Y, Wang L, Chen X, Cao C (2024) Maxillary sinus anterior wall recurrence after intensity-modulated radiotherapy for nasopharyngeal carcinoma. International Journal of Radiation Research, 22(1): 239-42.##Ramadan LM and Abdelrazzak AB (2024) The non-targeted effect increases the risk of the radiation-induced myocardial injury. International Journal of Radiation Research, 22(2): 289-95.##Liu Z, Chen Y, Su Y, Hu X, Peng X (2021) Nasopharyngeal carcinoma: Clinical achievements and considerations among treatment options. Front Oncol, 11: 635737.##Hommadi M, N'da G, Bertrand C, Randriamaroson N, Benlemlih M, Mosse WBA, et al. (2022) Volumetric modulated arctherapy for locally advanced nasopharyngeal carcinoma: Clinical efficacy and late toxicity. Cancer Radiother, 26(3): 433-9.##Wu P, Zhao Y, Xiang L, Yang L (2020) Management of Chemotherapy for Stage II nasopharyngeal carcinoma in the intensity-modulated radiotherapy era: A review. Cancer Manag Res, 12: 957-63.##Killock D (2023) Recurrent nasopharyngeal carcinoma: hyperfractionation of IMRT improves outcomes. Nat Rev Clin Oncol, 20(5): 283.##Tang LL, Guo R, Zhang N, Deng B, Chen L, Cheng ZB, et al. (2022) Effect of radiotherapy alone vs radiotherapy with concurrent chemoradiotherapy on survival without disease relapse in patients with low-risk nasopharyngeal carcinoma: a randomized clinical trial. JAMA, 328(8): 728-36.##Lu S, Fan H, Hu X, Li X, Kuang Y, Yu D, et al. (2021) Dosimetric Comparison of helical tomotherapy, volume-modulated Arc therapy, and fixed-field intensity-modulated radiation therapy in locally advanced nasopharyngeal carcinoma. Front Oncol, 11: 764946.##Cantu G (2023) Nasopharyngeal carcinoma. A "different" head and neck tumour. Part B: treatment, prognostic factors, and outcomes. Acta Otorhinolaryngol Ital, 43(3): 155-69.##Zhan Y, Fan S. Multiple Mechanisms Involving in Radioresistance of Nasopharyngeal Carcinoma. J Cancer. 2020;11(14):4193-204.##Yao Z, Zhang B, Huang J, Shi L, Cheng B (2021) Publisher Correction: Radiation-induced acute injury of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in induction chemotherapy followed by concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a prospective cohort study. Sci Rep, 11(1): 17942.##Liu YM, Peng YL, Li QW, Shen G, Ma YR, Chen MN, et al. (2021) Computed tomography-based evaluation of volume and position changes of the target region and organs at risk during radiotherapy for esophageal cancer: A pilot study. Front Oncol, 11: 702400.##Meng L, Teng F, Liu Q, Du L, Cai B, Xie C, et al. (2022) Long-term outcomes of nasopharyngeal carcinoma treated with helical tomotherapy using simultaneous integrated boost technique: A 10-year result. Front Oncol, 12: 1083440.##Fan WJ, Teng F, Liu G, Zhao DW, Li JF, Luo YR, et al. (2021) Diffusion weighted imaging in submandibular gland sparing helical tomotherapy for nasopharyngeal carcinoma. Radiother Oncol, 157: 247-54.##Lv X, Cao X, Xia WX, Liu KY, Qiang MY, Guo L, et al. (2021) Induction chemotherapy with lobaplatin and fluorouracil versus cisplatin and fluorouracil followed by chemoradiotherapy in patients with stage III-IVB nasopharyngeal carcinoma: an open-label, non-inferiority, randomised, controlled, phase 3 trial. Lancet Oncol, 22(5): 716-26.##Hua Y, You R, Wang Z, Huang P, Lin M, Ouyang Y, et al. (2021) Toripalimab plus intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma: an open-label single-arm, phase II trial. J Immunother Cancer, 9(11): e003290.##Liu YP, Wen YH, Tang J, Wei Y, You R, Zhu XL, et al. (2021) Endoscopic surgery compared with intensity-modulated radiotherapy in resectable locally recurrent nasopharyngeal carcinoma: a multicentre, open-label, randomised, controlled, phase 3 trial. Lancet Oncol, 22(3): 381-90.##Lam JC, Wu VW, Chiu G, Kong PS, Wong CM (2020) A comparison of dose and set-up accuracy between flexed and extended neck positions in Helical Tomotherapy of nasopharyngeal carcinoma. Med Dosim, 45(3): 235-40.##Zhao DW, Fan WJ, Fang XM, Luo YR, Wei J, Chen NX, et al. (2022) Sparing submandibular gland to alleviating acute xerostomia in patients with nasopharyngeal carcinoma treated with helical tomotherapy: Evaluation by diffusion kurtosis imaging. Radiother Oncol, 172: 91-8.##Zhang J, Peng Y, Ding S, Zhu J, Liu Y, Chen M, et al. (2020) Comparison of different combinations of irradiation mode and jaw width in helical tomotherapy for nasopharyngeal carcinoma. Front Oncol, 10: 598.##Arslan SA (2020) Clinical outcomes of nasopharyngeal carcinoma patients treated with adaptive helical tomotherapy, A 5-year experience. Niger J Clin Pract, 23(12): 1683-9.##Luo Y, Cai B, Li B, Liu F, Du L, Zhao D, et al. (2022) The acute toxicities and efficacy of concurrent chemotherapy with docetaxel plus cisplatin, or docetaxel, or cisplatin and helical tomotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: a randomized single-center phase II trial. Technol Cancer Res Treat, 21: 15330338221109974.##You R, Liu YP, Xie YL, Lin C, Duan CY, Chen DP, et al. (2023) Hyperfractionation compared with standard fractionation in intensity-modulated radiotherapy for patients with locally advanced recurrent nasopharyngeal carcinoma: a multicentre, randomised, open-label, phase 3 trial. Lancet, 401(10380): 917-27.## ##

A comparison of image quality between digital and analog pet for spatial resolution: A phantom study 2 2 Background: The positron emission tomography (PET) technology has undergone continuous innovation in recent years. New-technology digital PETs are silicon photomultiplier (SiPM) PET systems with digital readouts, which contribute to improved image resolution. This study aimed to compare the image quality of sub-centimeter lesions of NEMA PET phantom images obtained under identical imaging conditions (identical lesion volumes, identical activity and identical scanning time) using dPET, analog PET-1 and analog PET-2 acquired in the clinic. Materials and Methods: For image analysis, a standard NEMA IEC body phantom was used. In the present study, the lesion detection performance of all PETs was evaluated in two categories, sub- and over-centimeter size. The imaging durations of this study were 1, 2, 3, and 5 minutes, while the injection doses were 2.33 and 5.33 kBq/ml for the 1/4 and 1/8 background-to-lesion ratios, respectively. For a quantitative assessment of image quality, a circular ROI with activity concentrations (ACmean) and the mean recovery coefficient were calculated for each lesion via the ACmean. Results: Our study revealed approximately 15% greater RCmean values for dPET with SiPM technology compared to the analog PET-2 with PMT technology. However, analog PET-1 exhibited a significant lack of performance, especially when compared to analog PET-2 and dPET. Conclusion: Although dPET, the first generation of dPETs analyzed in the present study, yields relatively better RCmean values than analog PETs, it is not able to entirely eliminate the unfavorable impacts of PVE for sub-centimeter lesions. 397 405 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 M.C. Karaca M.C. Karaca Department of Health Physics, Graduate School of Health Sciences, İstanbul Medipol University, İstanbul, Türkiye mervecinoglu@gmail.com M. Doyuran M. Doyuran Department of Health Physics, Graduate School of Health Sciences, İstanbul Medipol University, İstanbul, Türkiye T. Çakır T. Çakır Department of Nuclear Medicine, School of Medicine, İstanbul Medipol University, İstanbul, Türkiye S. Karyağar S. Karyağar Department of Nuclear Medicine, Health Science University, Medical Faculty, Prof Dr Cemil Taşçıoğlu City Hospital, Istanbul, Türkiye M. Çağlar M. Çağlar Department of Health Physics, Graduate School of Health Sciences, İstanbul Medipol University, İstanbul, Türkiye Digital PET analog PET lesion detection capability image quality. 1. Jiang W, Chalich Y, Deen MJ (2019) Sensors for positron emission tomography applications. Sensors, 19(22): 1-53.##Roncali E and Cherry SR (2011) Application of silicon photomultipliers to positron emission tomography. Ann Biomed Eng, 39(4): 1358-77.##Sun F, Duan N, Lo G-Q (2013) Highly efficient silicon photomultiplier for positron emission tomography application. Int. Jou. of Biomed. and Bio. Eng. 7(9): 555-557.##del Sordo S, Abbene L, Caroli E, Mancini AM, Zappettini A, Ubertini P (2009) Progress in the development of CdTe and CdZnTe semiconductor radiation detectors for astrophysical and medical applications. Sensors, 9: 3491-526.##Komarov S, Yin Y, Wu H, Wen J, Krawczynski H, Meng LJ, et al. (2012) Investigation of the limitations of the highly pixilated CdZnTe detector for PET applications. Phys Med Biol, 57(22): 7355-80.##Ariño-Estrada G, Mitchell GS, Kwon S Il, Du J, Kim H, Cirignano LJ, et al. (2018) Towards time-of-flight PET with a semiconductor detector. Phys Med Biol, 63(4): 1-9.##Soret M, Bacharach SL, Buvat I (2007) Partial-volume effect in PET tumor imaging. Journal of Nuclear Medicine, 48: 932-45.##Hudson HM and Larkin RS (1994) Accelerated Image reconstruction using ordered subsets of projection data. IEEE Transactions on Medical Imaging, 13: 601-609.##Daube-Witherspoon ME, Surti S, Perkins AE, Karp JS (2014) Determination of accuracy and precision of lesion uptake measurements in human subjects with time-of-flight pet. Journal of Nuclear Medicine, 55(4): 602-7.##Bellevre D, Blanc Fournier C, Switsers O, Dugué AE, Levy C, Allouache D, et al. (2014) Staging the axilla in breast cancer patients with 18F-FDG PET: How small are the metastases that we can detect with new generation clinical PET systems? Eur J Nucl Med Mol Imaging, 41(6): 1103-12.##Ahn S, Ross SG, Asma E, Miao J, Jin X, Cheng L, et al. (2015) Quantitative comparison of OSEM and penalized likelihood image reconstruction using relative difference penalties for clinical PET. Phys Med Biol, 60(15): 5733-51.##Ross S. Q.Clear: A Bayesian penalized likelihood reconstruction algorithm for PET image quantitation. GE Healthcare; 2014. DOC1474189 Rev 3: 1-9.##Assing MA, Patel BK, Karamsadkar N, Weinfurtner J, Usmani O, Kiluk JV, et al. (2017) A comparison of the diagnostic accuracy of magnetic resonance imaging to axillary ultrasound in the detection of axillary nodal metastases in newly diagnosed breast cancer. Breast Journal, 23(6): 647-55.##Aktaş A, Gürleyik MG, Aksu SA, Aker F, Güngör S (2022) Diagnostic value of axillary ultrasound, MRI, and 18F-FDG-PET/CT in determining axillary lymph node status in breast cancer patients. Eur J Breast Health, 18(1): 37-47.##Morawitz J, Bruckmann NM, Dietzel F, Ullrich T, Bittner AK, Hoffmann O, et al. (2022) Comparison of nodal staging between CT, MRI, and [18F]-FDG PET/MRI in patients with newly diagnosed breast cancer. Eur J Nucl Med Mol Imaging, 49(3): 992-1001.##Xu C, Garutti E, Mandai S, Charbon E (2013) Comparison of digital and analog silicon photomultiplier for positron emission tomography application. EJNMMI Phys, 9(1):3: 1-7.##Recker MC, Cazalas EJ, McClory JW, Bevins JE (2019) Comparison of SiPM and PMT performance using a Cs2LiYCl6:Ce3+ (CLYC) scintillator with two optical windows. IEEE Trans Nucl Sci, 66(8): 1959-65.##Wagatsuma K, Miwa K, Sakata M, Oda K, Ono H, Kameyama M, et al. (2017) Comparison between new-generation SiPM-based and conventional PMT-based TOF-PET/CT. Physica Medica, 42: 203-10.##Tsutsui Y, Awamoto S, Himuro K, Kato T, Baba S, Sasaki M (2020) Evaluating and comparing the image quality and quantification accuracy of SiPM-PET/CT and PMT-PET/CT. Ann Nucl Med, 34(10): 725-35.##Adler S, Seidel J, Choyke P, Knopp M V., Binzel K, Zhang J, et al. (2017) Minimum lesion detectability as a measure of PET system performance. EJNMMI Phys, 4(1): 1-14.##Karlberg AM, Sæther O, Eikenes L, Goa PE (2016) Quantitative comparison of PET performance-siemens biograph mCT and mMR. EJNMMI Phys, 3(1): 1-14.##Hsu DFC, Ilan E, Peterson WT, Uribe J, Lubberink M, Levin CS (2017) Studies of a next-generation silicon-photomultiplier-based time-of-flight PET/CT system. Journal of Nuclear Medicine, 58(9): 1511-8.##NEMA NU 2-2012 (2013) Performance measurements of positron emission tomographs [Internet]. Available from: www.medicalimaging.org/##NEMA Standards Publication NU 2-2018 (2018) Performance Measurements of Positron Emission Tomographs (PETS) [Internet]. Available from: www.nema.org##Miwa K, Wagatsuma K, Nemoto R, Masubuchi M, Kamitaka Y, Yamao T, et al. (2020) Detection of sub-centimeter lesions using digital TOF-PET/CT system combined with Bayesian penalized likelihood reconstruction algorithm. Ann Nucl Med, 34(10): 762-71.##Srinivas SM, Dhurairaj T, Basu S, Bural G, Surti S, Alavi A (2009) A recovery coefficient method for partial volume correction of PET images. Ann Nucl Med, 23(4): 341-8.##López-Mora DA, Carrió I, Flotats A (2022) digital PET vs analog PET: Clinical Implications? Seminars in Nuclear Medicine, 52: 302-311.##Fuentes-Ocampo F, López-Mora DA, Flotats A, Paillahueque G, Camacho V, Duch J, et al. (2019) Digital vs. analog PET/CT: intra-subject comparison of the SUVmax in target lesions and reference regions. Eur J Nucl Med Mol Imaging, 46(8): 1745-1750.##Oddstig J, Leide Svegborn S, Almquist H, Bitzén U, Garpered S, Hedeer F, et al. (2019) Comparison of conventional and Si-photomultiplier-based PET systems for image quality and diagnostic performance. BMC Med Imaging, 19(1): 1-9.##Rausch I, Cal-González J, Dapra D, Gallowitsch HJ, Lind P, Beyer T, et al. (2015) Performance evaluation of the Biograph mCT Flow PET/CT system according to the NEMA NU2-2012 standard. 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Analysis of the accuracy of dynamic contrast-enhanced magnetic resonance imaging in assessing lymph node metastasis and prognosis in cervical cancer patients 2 2 Background: To assess the accuracy, specificity, and sensitivity of dynamic contrast-enhanced magnetic resonance imaging (MRI) in assessing lymph node metastasis (LNM) and prognosis after cervical cancer surgery. Materials and Methods: Fifty cervical cancer patients admitted to our hospital from April 2022 to April 2023 were selected. 27 patients were in stage I-IIA and processed radical hysterectomy combined with pelvic lymph node dissection. Twenty-three patients were in stage IIB and beyond and underwent laparotomy with key site biopsy combined with pelvic lymph node biopsy. Postoperative pathological diagnosis was used as the gold standard for diagnosis. All patients underwent MRI scanning, including conventional MRI scanning such as DWI, T2WI, and T1WI of the pelvic cavity. Gadolinium-diethylene triamine pentaacetate (Gd-DTPA) was injected for dynamic contrast-enhanced scanning. The data of postoperative pathological staging, MRI staging, LNM, deep muscle layer invasion, and postoperative recurrence were analyzed. Results: There was no marked difference between MRI staging and postoperative pathological staging (P>0.05). When comparing preoperative clinical staging and MRI staging with postoperative pathological staging as the control group, there was no significant difference in accuracy. Both postoperative pathological diagnosis and MRI diagnosis had high specificity and sensitivity in assessing LNM and deep muscle layer invasion, but the differences were not significant (P>0.05). Conclusion: Dynamic contrast-enhanced MRI examination has high accuracy in assessing lymph node metastasis for cervical cancer patients. It has high sensitivity and specificity in assessing parametrial invasion, LNM, deep muscle layer invasion, and vaginal involvement, as well as has good prognostic value in assessing postoperative recurrence.  407 411 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 C.Y. Zheng C.Y. Zheng Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China Y.Y. Peng Y.Y. Peng Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China Z.Y. Zhang Z.Y. Zhang Department of Radiology, Shanghai First Maternity and Infant Hospital, Shanghai, China zhong71313852@163.com X.M. Zhang X.M. Zhang Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China zhangxinm@zju.edu.cn Cervical neoplasm neoplasm metastasis magnetic resonance imaging prognosis. Perkins RB, Wentzensen N, Guido RS, et al. (2023) Cervical Cancer Screening: A Review. JAMA, 330(6): 547-558.##Zhang H, Qian J, Lin J. (2023) Application of portable vaginal irrigator in patients with cervical cancer undergoing external irradiation combined with intracavitary brachytherapy. International Journal of Radiation Research, 21(3): 499-503.##Berek JS, Matias-Guiu X, Creutzberg C, et al. (2023) Endometrial Cancer Staging Subcommittee FWsCC: FIGO staging of endometrial cancer: 2023. Int J Gynaecol, 162(2): 383-394.##Yun BS, Lee KB, Lee KH, et al. (2024) Therapeutic effects of surgical debulking of metastatic lymph nodes in cervical cancer IIICr: a trial protocol for a phase III, multicenter, randomized controlled study (KGOG1047/DEBULK trial). J Gynecol Oncol, 35(5):e57.##O'Dowd EL, Merriel SWD, Cheng VWT, et al. (2023) Clinical trials in cancer screening, prevention and early diagnosis (SPED): a systematic mapping review. BMC Cancer, 23(1): 820.##Hamdi M, Senan EM, Awaji B, et al. (2023) Analysis of WSI images by hybrid systems with fusion features for early diagnosis of cervical cancer. Diagnostics (Basel), 13(15): 2538.##Abdul-Latif M, Tharmalingam H, Tsang Y, et al. (2023) Functional magnetic resonance imaging in cervical cancer diagnosis and treatment. Clin Oncol, 35(9): 598-610.##Meng H, Guo X, Zhang D (2023) Multimodal magnetic resonance imaging in the diagnosis of cervical cancer and its correlation with the differentiation process of cervical cancer. BMC Med Imaging, 23(1): 144.##Li X, Huang W, Holmes JH. (2024) Dynamic contrast-enhanced (DCE) MRI. Magn Reson Imaging Clin N Am, 32(1): 47-61.##Benjamin J, O'Leary C, Hur S, et al. (2023) Imaging and interventions for lymphatic and lymphatic-related disorders. Radiology, 307(3): e220231.##Long X, He M, Yang L, et al. (2023) Validation of the 2018 FIGO staging system for predicting the prognosis of patients with stage IIIC cervical cancer. Clin Med Insights Oncol, 17: 11795549221146652.##Chen H, Tian X, Luan Y, et al. (2023) Highly expressed circ_0000285 from serum and cervical exfoliated cells as a novel biomarker for the diagnosis of early stage-cervical cancer. J Obstet Gynaecol, 43(1): 2196344.##Kassa R, Irene Y, Woldetsadik E, et al. (2023) Survival of women with cervical cancer in East Africa: a systematic review and meta-analysis. J Obstet Gynaecol, 43(2): 2253308.##Zhong L, Chen Z, Shu H, et al. (2024) Multi-scale tokens-aware transformer network for multi-region and multi-sequence MR-to-CT synthesis in a single model. 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The effect of wall linings and door lamination on photoneutron dose distribution around linear medical accelerators 2 2 Background: The aim of this study is to investigate the shielding effect of the internal wall linings and laminated shield door on photoneutron and capture gamma doses at the isocenter and at the maze entrance of radiotherapy treatment rooms. Material and Methods: The Monte Carlo N-Particle Transport (MCNP5) code was used to simulate the radiotherapy room within a medical linear accelerator operating at 12, 15, 18, and 25 MV. The energy spectra of neutron and secondary gamma rays, with their corresponding dose equivalents, were calculated inside the bunker and at various points along the maze. To verify the accuracy of our Monte Carlo simulation, we compared our findings with those obtained through analytical methods recommended by (IAEA) safety report No.47. Once validated, the Monte Carlo simulation was used for assessing dose reduction by the room wall linings and the laminated shield door. Results: Our results showed that the use of paraffin wax infused with boron carbide within the lining of radiotherapy room walls reduces doses of both neutron and capture gamma radiation at the isocenter by up to 13% and 35.9%, respectively. However, the laminated shield door reduced significantly both neutron and capture gamma dose equivalents near the bunker door by up to 99.75% and 38.20%, respectively. Conclusion: The obtained results show that the use of neutron shielding material in the lining of the radiotherapy wall rooms reduces neutron and capture gamma radiation doses to the patient. While, the laminated shield door presents enough effectiveness in protecting the workers and general public.  413 420 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 F. Azairi F. Azairi EPRA, Department of physics, Faculty of Sciences Semlalia, Marrakech, Morocco J. Ghassoun J. Ghassoun EPRA, Department of physics, Faculty of Sciences Semlalia, Marrakech, Morocco ghassoun@uca.ac.ma R. Bechchar R. Bechchar EPRA, Department of physics, Faculty of Sciences Semlalia, Marrakech, Morocco S. Harif S. Harif EPRA, Department of physics, Faculty of Sciences Semlalia, Marrakech, Morocco S. Kabrane S. Kabrane EPRA, Department of physics, Faculty of Sciences Semlalia, Marrakech, Morocco Radiotherapy radiation shielding neutrons gamma rays Monte Carlo method. Ghiasi H and Mesbahi A (2012) A new analytical formula for neutron capture gamma dose calculations in double-bend mazes in radiation therapy. Reports of Practical Oncology and Radiotherapy, 17(4): 220-5.##Alem-Bezoubiri A, Bezoubiri F, Badreddine A, Mazrou H, Lounis-Mokrani Z (2014) Monte Carlo estimation of photoneutrons spectra and dose equivalent around an 18MV medical linear accelerator. Radiation Physics and Chemistry, 97: 381-92.##Banaee N, Goodarzi K, Nedaie HA (2021) Neutron contamination in radiotherapy processes: a review study. J Radiat Res, 62(6): 947-54.##Rajesh KR, Ganapathi Raman RG, Musthafa MM, Midhun CV, Joseph N (2020) A passive method for absolute dose evaluation of photoneutrons in radiotherapy. Int J Radiat Res, 18(1): 173-178.##Ghiasi H (2014) Monte Carlo characterizations mapping of the (γ,n) and (n,γ) photonuclear reactions in the high energy X-ray radiation therapy. Reports of Practical Oncology and Radiotherapy, 19(1): 30-6.##NCRP, National Council on Radiation Protection and Measurements (2006) Structural shielding design and evaluation for megavoltage X- and gamma-ray radiotherapy facilities. NCRP Report No. 151 NCRP, Bethesda, MD.##IAEA, The International Atomic Energy Ageny (2006) Radiation protection in the design of radiotherapy facilities. Reports series No. 47. Vienna.##Yücel H, Çobanbaş I, Kolbaşi A, Yüksel AÖ, Kaya V (2016) Measurement of photo-neutron dose from an 18-MV medical linac using a foil activation method in view of radiation protection of patients. Nuclear Engineering and Technology, 48(2): 525-32.##Ghassoun J (2015) The effect of the presence of the patient on the particles dose estimations in high energy linear accelerator mazes. Int J Can Ther Oncol, 3(3): 3321.##Ghassoun J and Senhou N (2012) The evaluation of neutron and gamma ray dose equivalent distributions in patients and the effectiveness of shield materials for high energy photons radiotherapy facilities. Appl Radiat Isot, 70(4): 620-4.##Ghassoun J, Senhou N, Jehouani A (2011) Neutron and photon doses in high energy radiotherapy facilities and evaluation of shielding performance by Monte Carlo method. Ann Nucl Energy, 38(10): 2163-7.##Wang X, Esquivel C, Nes E, Shi C, Papanikolaou N, Charlton M (2011) The neutron dose equivalent evaluation and shielding at the maze entrance of a Varian Clinac 23EX treatment room. Med Phys, 38(3): 1141-9.##Afkham Y, Mesbahi A, Alemi A, Zolfagharpour F, Jabbari N (2020) Design and fabrication of a Nano-based neutron shield for fast neutrons from medical linear accelerators in radiation therapy. Radiat Oncol, 15: 105.##Mesbahi A, Ghiasi H, Mahdavi SR (2010) Photoneutron and capture gamma dose equivalent for different room and maze layouts in radiation therapy. Radiat Prot Dosim, 140(3): 242-49.##X-5 Monte Carlo Team (2005) MCNP-A general Monte Carlo N-particle transport code, Version 5. Los Alamos National Laboratory report LAUR-03-1987.##NCRP, National Council on Radiation Protection and Measurements (1971) Protection against neutron radiation. Report No. 38 Bethesda, Maryland.##ICRP, International Commission on Radiological Protection (1996) Conversion coefficients for use in radiological protection against external radiation. ICRP Publication 74, 26(3-4). ICRP, Ottawa, ON.##Simmons G (1978) Book Review: Structural shielding design and evaluation for medical use of X-Rays & gamma rays of energies up to 10 MeV. NCRP Report No. 49. Journal of Nuclear Medicine, 19(2): 228.##Eller LR (2012) An investigation on photoneutron production from medical linear accelerator. M.S. Oregon State University.##Tosi G and Torresin A (1991) neutron measurements around medical electron accelerators by active and passive detection techniques. Med Phys, 18(1): 54-60.##Wu RK and Patton HM (2003) Neutron and capture gamma along the mazes of linear accelerator vaults. J Appl Clin Med Phys, 4(2): 162-71.##Ivković A, Faj D, Galić S, Karimi A, Kasabašić M, Brkić H (2020) Accuracy of empirical formulas in evaluation of neutron dose equivalent inside the 60Co vaults reconstructed for medical linear accelerators1. Int J Radiat Res, 18(1): 99-107.##Followill DS, Stovall MS, Kry SF, Ibbott GS (2003) Neutron source strength measurements for Varian, Siemens, Elekta, and General Electric linear accelerators. J Appl Clin Med Phys, 4(3): 189-194.##Facure A, Falcão RC, Silva AX, Crispim VR, Vitorelli JC. (2005) A study of neutron spectra from medical linear accelerators. Appl Radiat Isot, 62(1): 69-72.##McGinley PH, Butker EK (1991) Evaluation of neutron dose equivalent levels at the maze entrance of medical accelerator treatment rooms. Med Phys, 18(2): 279-81.##Rivera J C, Falcao R C, deAlmeida C E (2008) The measurement of photoneutron dose in the vicinity of clinical linear accelerators. Radiation Protection Dosimetry, 130(4): 403-409.##Mohammadi N, Miri-Hakimabad SH, Rafat-Motavalli L (2014) A Monte Carlo study for photoneutron dose estimations around the high-energy linacs. J Biomed Phys Eng, 4(4): 127-40.##Zabihzadeh M, Ay MR, Allahverdi M, Mesbahi A, Mahdavi SR, Shahriari M (2009) Monte Carlo estimation of photoneutrons contamination from high-energy X-ray medical accelerators in treatment room and maze: A simplified model. Radiat Prot Dosimetry, 135(1): 2.##Suliman II, Khouqeer GA, Mayhoub FH (2023) Photoneutrons and Gamma Capture Dose Rates at the Maze Entrance of Varian TrueBeam and Elekta Versa HD medical linear accelerators. J Toxics, 11(1): 78.##Naseri A and Mesbahi A (2010) A review on photoneutrons characteristics in radiation therapy with high-energy photon beams. Rep Pract Oncol Radiot, 15(5): 138-44.##Chu WH, Lan JH, Chao TC, Lee CC, Tung CJ (2011) Neutron spectrometry and dosimetry around 15 MV linac. Radiation Measurements, 46(11): 1741-1744.##Kim YN, Choi SH, Jeong K, Kim JY, Lee CG, Seong J, Kim CH (2008) A study on optimization of photoneutron shielding in a medical accelerator room by using Monte Carlo simulation. Journal of Nuclear Science and Technology, 45(sup5): 50-53.## ##

Predicting patient-specific prostate motion using pelvic fat and pelvic cavity volume for prostate radiotherapy 2 2 Background: The prediction of prostate motion is important for matching planned and delivered dose distributions in prostate radiotherapy. This study aimed to assess the relationship between anatomical characteristics and inter- and intra-fraction prostate motion. Materials and Methods: Sixty-six patients who underwent fiducial marker implantation were retrospectively evaluated. The anatomical characteristics (subcutaneous adipose tissue thickness, pelvic cavity volume, and fat volume of the lesser pelvis around the prostate), inter- and intra-fraction prostate motion, and standard deviations (SDs) in the anterior-posterior (AP), superior-inferior (SI), and left-right (LR) directions were determined, and their correlations were analyzed. Additionally, the three-dimensional (3D) distance between the coordinates of the center of gravity of the prostate and inferior margin of the symphysis pubis was calculated. Results: The pelvic cavity volume around the prostate exhibited a moderate correlation with the SD for inter-fraction prostate motion in the LR direction (r=0.47) and that for intra-fraction prostate motion in the AP and LR directions (r = 0.41, 0.52). The 3D distance between the coordinates of the center of gravity of the prostate and inferior margin of the symphysis pubis showed a moderate correlation with the average inter-fraction prostate motion in the AP direction (r=0.46). Conclusion: Prostate motion in the AP and LR directions may be related to the fat and pelvic cavity volumes around the prostate. The evaluation of anatomical characteristics can help predict patient-specific prostate motion during treatment planning. 421 426 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 A. Nakamoto A. Nakamoto Department of Radiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, Japan Y. Tanabe Y. Tanabe Faculty of Medicine, Graduate School of Health Sciences, Okayama University, 2-5-1 Shikata, Kita-ku, Okayama, Japan tanabey@okayama-u.ac.jp K. Nishioka K. Nishioka Department of Radiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, Japan Y. Kunii Y. Kunii Department of Radiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, Japan A. Higashi A. Higashi Department of Radiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, Japan H. Nishikawa H. Nishikawa Graduate School of Health Sciences, Department of Radiological Technology, Okayama University, 2-5-1, Shikata, Kita, Okayama, Japan R. Kawano R. Kawano Innovation Center for Translational Research, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, Japan H. Eto H. Eto Department of Radiology, Yamaguchi University Hospital, 1-1-1 Minami Kogushi, Ube, Yamaguchi, Japan Y. Fuji Y. Fuji Department of Radiology, Chugoku Central Hospital of the Mutual Aid Association of Public School Teachers, 148-13, Miyuki, Fukuyama, Hiroshima, Japan H. Aoyama H. Aoyama Division of Radiological Technology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama, Japan S. Yamada S. Yamada Department of Radiological Technology, Tsukuba International University, 6-20-1, Manabe, Tsuchiura, Ibaraki, Japan S. Takahashi S. Takahashi Department of Radiology, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, Japan Inter-fraction prostate motion intra-fraction prostate motion radiotherapy treatment planning volumetric modulated arc therapy anatomical characteristics. 1. Cellini F, Tagliaferri L, Frascino V, Alitto AR, Fionda B, Boldrini L, et al. (2022) Radiation therapy for prostate cancer: what's the best in 2021. Urologia, 89(1): 5-15.##Greco C, Stroom J, Vieira S, Mateus D, Cardoso MJ, Soares A, et al. (2021) Reproducibility and accuracy of a target motion mitigation technique for dose-escalated prostate stereotactic body radiotherapy. Radiother Oncol, 160: 240-249.##Pang EPP, Knight K, Park SY, Lian W, Master Z, Baird M, et al. (2020) Duration-dependent margins for prostate radiotherapy-a practical motion mitigation strategy. Strahlenther Onkol, 196: 657-663.##Tanabe Y and Eto H (2022) Evaluation of patient-specific motion management for radiotherapy planning computed tomography using a statistical method. Med Dosim, 47(2): e13-e18.##Tanabe Y, Ishida T, Eto H, Sera T, Emoto Y, Shimokawa M (2021) Patient-specific radiotherapy quality assurance for estimating actual treatment dose. Med Dosim, 46(1): e5-e10.##Miguel D, de la Llana V, Martinez D, del Castillo A, Alonso D, de Frutos JM, et al. (2019) Dosimetric variations for high-risk prostate cancer by VMAT plans due to patient's weight changes. J Radiother Pract, 18(4): 336-342.##Tanabe Y and Ishida T (2019) Optimizing multiple acquisition planning CT for prostate cancer IMRT. Biomed Phys Eng Express, 5(3): 035011.##Tanabe Y, Ishida T, Eto H, Sera T, Emoto Y (2019) Evaluation of the correlation between prostatic displacement and rectal deformation using the Dice similarity coefficient of the rectum. Med Dosim, 44(4): e39-e43.##Jang H, Baek JG, Kwon SY, Lee, KS, Oh YT (2019) The impact of benign prostatic hyperplasia on bladder volume in radiotherapy of prostate cancer. Int J Radiat Res, 17(3): 401-406.##Maruoka S, Yoshioka Y, Isohashi F, Suzuki O, Seo Y, Otani Y, et al. (2015) Correlation between patients' anatomical characteristics and interfractional internal prostate motion during intensity modulated radiation therapy for prostate cancer. Springerplus, 4(1): 1-7.##Wong JR, Gao Z, Merrick S, Wilson P, Uematsu M, Woo K, Woo K, Cheng CW (2009) Potential for higher treatment failure in obese patients: correlation of elevated body mass index and increased daily prostate deviations from the radiation beam isocenters in an analysis of 1,465 computed tomographic images. Int J Radiat Oncol Biol Phys, 75(1): 49-55.##Tanabe Y, Kiritani M, Deguchi T, Hira N, Tomimoto S (2023). Patient-specific respiratory motion management using lung tumors vs fiducial markers for real-time tumor-tracking stereotactic body radiotherapy. Phys Imaging Radiat Oncol, 25: 100405.##Pang EPP, Knight K, Fan Q, Tan SXF, Ang KW, Master Z, et al. (2018) Analysis of intra-fraction prostate motion and derivation of duration-dependent margins for radiotherapy using real-time 4D ultrasound. Phys Imaging Radiat Oncol, 28(5): 102-107.##Lopez P, Newton RU, Taaffe DR, Singh F, Buffart LM, Spry N, et al. (2022) Associations of fat and muscle mass with overall survival in men with prostate cancer: a systematic review with meta-analysis. Prostate Cancer Prostatic Dis, 25(4): 615-626.##Suzuki T, Saito M, Onishi H, Mochizuki Z, Mochizuki K, Satani K, et al. (2020) Effect of a hydrogel spacer on the intrafractional prostate motion during CyberKnife treatment for prostate cancer. J Appl Clin Med Phys, 21(10): 63-68.##Takayama K, Mizowaki T, Negoro Y, Norihisa Y, Hiraoka M (2011) Impact of double-balloon rectal catheter use in external-beam radiotherapy for prostate cancer. Int J Clin Oncol, 16: 50-56.##de Muinck Keizer DM, Pathmanathan AU, Andreychenko A, Kerkmeijer LGW, van der Voort van Zyp JRN, Tree AC, et al. (2019) Fiducial marker based intra-fraction motion assessment on cine-MR for MR-Linac treatment of prostate cancer. Phys Med Biol, 64(7): 07NT02.##Afkhami Ardekani M, Ghaffari H, Navaser M, Zoljalali Moghaddam SH, Refahi S (2021) Effectiveness of rectal displacement devices in managing prostate motion: a systematic review. Strahlenther Onkol, 197: 97-115.##Pang EPP, Knight K, Hussain A, Fan Q, Baird M, Tan SXF, Irene KLS, Zubin M, Tuan JKL (2018) Reduction of intra-fraction prostate motion-determining optimal bladder volume and filling for prostate radiotherapy using daily 4D TPUS and CBCT. Tech Innov Patient Support Radiat Oncol, 5: 9-15.##Mahdavi SR, Gharehbagh EJ, Mofid B, Jafari AH, Nikoofar AR (2017) Accuracy of the dose delivery in prostate cancer patients-using an electronic portal imaging device (EPID). Int J Radiat Res, 15(1): 39-47.##Venkatesan K, Raphael CJ, Varghese KM, Gopu P, Sivakumar S, Boban M, et al. (2020) Volume and dosimetric analysis of rectum and bladder for prostate carcinoma patients by using kilo voltage cone beam computed tomography (CBCT). Int J Radiat Res, 18(3): 557-569.##Vanhanen A, Poulsen P, Kapanen M (2020) Dosimetric effect of intrafraction motion and different localization strategies in prostate SBRT. Phys Med, 75: 58-68.##Böckelmann F, Putz F, Kallis K, Lettmaier S, Fietkau R, Bert C (2020) Adaptive radiotherapy and the dosimetric impact of inter- and intrafractional motion on the planning target volume for prostate cancer patients. Strahlenther Onkol, 196: 647-656.##Dai Z, Zhu L, Wang A, Guo X, Liu Y, Zhuang Y, et al. (2023) Dosimetric and biological comparison of treatment plans between LINAC and robot systems in stereotactic body radiation therapy for localized prostate cancer. Int J Radiat Res, 21(1): 15-22.##Kim HJ, Lee JS, Kim WC (2020) Clinical outcome of stereotactic body radiotherapy for localized prostate cancer: long-term results. Int J Radiat Res, 18(3): 383-388.## ##

Clinical efficacy of albumin-bound paclitaxel combined with carboplatin in the treatment of nasopharyngeal carcinoma 2 2 Background: This study aims to evaluate the clinical efficacy of concurrent chemoradiotherapy for nasopharyngeal carcinoma (NPC) following induction chemotherapy (IC) with albumin-bound paclitaxel (ABP) combined with carboplatin, through the analysis of serum biomarkers and dynamic contrast-enhanced magnetic resonance imaging (MRI) data. Material and Methods: Ninety-six NPC patients were rolled into Group I (concurrent chemoradiotherapy) and Group II (IC with ABP and carboplatin+concurrent chemoradiotherapy). DCE-MRI scans were utilized to evaluate changes in lesion characteristics. Serum samples were collected to analyze tumor markers including cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), SCC-associated antigen (SCC-Ag), and carbohydrate antigen 125 (CA-125), as well as superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activity, and malondialdehyde (MDA) levels. Toxicities and 2-year overall survival (OS) and progression-free survival (PFS) were also assessed. Results: Group II exhibited a markedly higher objective response rate and disease control rate versus Group I (35.4% vs. 58.3%, 50.0% vs. 81.3%, respectively). MRI scans revealed a drastic reduction in the proportion of patients with obvious enhancement of primary lesions, invasion of the base of the skull/medial pterygoid muscle, etc. Serum levels of CYFRA21-1, SCC-Ag, CA125, and MDA were greatly decreased, while SOD and GSH-Px activities were notably increased (P<0.05). Group II showed a considerable increase in OS and PFS versus Group I (75.0% vs. 89.6%, 68.8% vs. 83.3%, respectively, P<0.05). Conclusion: the combination of ABP and carboplatin has demonstrated enhanced efficacy and improved survival outcomes in patients with NPC, providing new insights and evidence for clinical application. 427 433 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 M. Huang M. Huang Department of Radiotherapy, Zhuji People's Hospital, Zhuji 311809, Zhejiang Province, China jiqawrp975@163.com G. Wang G. Wang Department of Radiotherapy, Zhuji People's Hospital, Zhuji 311809, Zhejiang Province, China F. Xuan F. Xuan Department of Radiotherapy, Zhuji People's Hospital, Zhuji 311809, Zhejiang Province, China Albumin-bound paclitaxel carboplatin nasopharyngeal carcinoma dynamic contrast-enhanced MRI serum biomarkers clinical efficacy. Lee AWM, Ng WT, Chan JYW, et al. (2019) Management of locally recurrent nasopharyngeal carcinoma. Cancer Treat Rev, 79: 101890. DOI: 10.1016/j.ctrv.2019.101890##Juarez-Vignon Whaley JJ, Afkhami M, Onyshchenko M, et al. (2023) Recurrent/metastatic nasopharyngeal carcinoma treatment from present to future: where are we and where are we heading? Curr Treat Options Oncol, 24(9): 1138-1166. DOI: 10.1007/s11864-023-01101-3##Nazeer F, Poulose JV, Kainickal CT (2022) Induction chemotherapy in nasopharyngeal carcinoma - A systematic review of phase III clinical trials. Cancer Treat Res Commun, 32: 100589. DOI: 10.1016/j.ctarc.2022.100589##Fan Y, Hui M, Li F, et al. (2024) Establishment of nomogram prediction model for distant metastasis of nasopharyngeal carcinoma after radiotherapy. Int J Radiat Res, 22(2): 373-378. DOI: 10.61186/ijrr.22.2.373##You R, Liu Y-P, Huang P-Y, et al. (2020) Efficacy and safety of locoregional radiotherapy with chemotherapy vs chemotherapy alone in de novo metastatic nasopharyngeal carcinoma: A multicenter phase 3 randomized clinical trial. JAMA Oncol, 6(9): 1345-1352. DOI: 10.1001/jamaoncol.2020.1808##Natasya Naili MN, Hasnita CH, Shamim AK, et al. (2010) Chromosomal alterations in Malaysian patients with nasopharyngeal carcinoma analyzed by comparative genomic hybridization. Cancer Genet Cytogenet, 203(2): 309-12. DOI: 10.1016/j.cancergencyto.2010.07.136##Smith ER, Wang J-Q, Yang D-H, Xu X-X (2022) Paclitaxel resistance related to nuclear envelope structural sturdiness. Drug Resist Updat, 65: 100881. DOI: 10.1016/j.drup.2022.100881##West H, McCleod M, Hussein M, Morabito A, Rittmeyer A, Conter HJ, et al. (2019) Atezolizumab in combination with carboplatin plus nab-paclitaxel chemotherapy compared with chemotherapy alone as first-line treatment for metastatic non-squamous non-small-cell lung cancer (IMpower130): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol, 20(7): 924-937. DOI: 10.1016/S1470-2045(19)30167-6##Yuan Y, Lee JS, Yost SE, et al. (2021) Phase II trial of neoadjuvant carboplatin and nab-paclitaxel in patients with triple-negative breast cancer. Oncologist, 26(3): e382-e393. DOI: 10.1002/onco.1357##Parisi A, Palluzzi E, Cortellini A, et al. (2020) First-line carboplatin/nab-paclitaxel in advanced ovarian cancer patients, after hypersensitivity reaction to solvent-based taxanes: a single-institution experience. Clin Transl Oncol, 22(1): 158-162. DOI: 10.1007/s12094-019-02122-x##Huang Y, Yan D, Wang M, et al. (2021) Clinicopathological factors affecting the prognosis of massive hemorrhage after radiotherapy for patients having nasopharyngeal carcinoma. J Cancer Res Ther, 17(5): 1219-1224. DOI: 10.4103/jcrt.jcrt_586_21##Liu L, Hu L, Zeng Q, Peng D, Chen Z, Huang C, et al. (2021) Dynamic contrast-enhanced MRI of nasopharyngeal carcinoma: correlation of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters with hypoxia-inducible factor 1α expression and tumor grade/stage. Ann Palliat Med, 10(2): 2238-2253. DOI: 10.21037/apm-21-303##Hengrui L (2023) An example of toxic medicine used in traditional Chinese medicine for cancer treatment. J Tradit Chin Med, 43(2): 209-210. DOI: 10.19852/j.cnki.jtcm.2023.02.001##Kramer K, Pandit-Taskar N, Kushner BH, Zanzonico P, Humm JL, Tomlinson U, et al. (2022) Phase 1 study of intraventricular 131I-omburtamab targeting B7H3 (CD276)-expressing CNS malignancies. J Hematol Oncol, 15(1): 165. DOI: 10.1186/s13045-022-01383-4##Baloche V, Ferrand FR, Makowska A, et al. (2020) Emerging therapeutic targets for nasopharyngeal carcinoma: opportunities and challenges. Expert Opin Ther Targets, 24(6): 545-558. DOI: 10.1080/14728222.2020.1751820##Mai HQ, Chen QY, Chen D, et al. (2021) Toripalimab or placebo plus chemotherapy as first-line treatment in advanced nasopharyngeal carcinoma: a multicenter randomized phase 3 trial. Nat Med, 27(9): 1536-1543. DOI: 10.1038/s41591-021-01444-0##Twu CW, Lin PJ, Tsou HH, et al. (2022) Maintenance metronomic chemotherapy for metastatic/recurrent nasopharyngeal carcinoma. Head Neck, 44(6): 1453-1461. DOI: 10.1002/hed.27044##Li WZ, Lv X, Hu D, Lv SH, Liu GY, Liang H, et al. (2022) Effect of induction chemotherapy with paclitaxel, cisplatin, and capecitabine vs cisplatin and fluorouracil on failure-free survival for patients with stage IVA to IVB nasopharyngeal carcinoma: a multicenter phase 3 randomized clinical trial. JAMA Oncol, 8(5): 706-714. DOI: 10.1001/jamaoncol.2022.0122##Takeshita N, Enokida T, Okano S, et al. (2022) Induction chemotherapy with paclitaxel, carboplatin and cetuximab for locoregionally advanced nasopharyngeal carcinoma: A single-center, retrospective study. Front Oncol, 12: 951387. DOI: 10.3389/fonc.2022.951387##Luo DH, Li XY, Guo SS, et al. (2023) Paclitaxel liposome, cisplatin and 5-fluorouracil-based induction chemotherapy followed by de-escalated intensity-modulated radiotherapy with concurrent cisplatin in stage IVA-IVB childhood nasopharyngeal carcinoma in endemic area: a phase II, single-arm trial. Lancet Reg Health West Pac, 40: 100895. DOI: 10.1016/j.lanwpc.2023.100895##Sharifi-Rad J, Quispe C, Patra JK, et al. (2021) Paclitaxel: Application in modern oncology and nanomedicine-based cancer therapy. Oxid Med Cell Longev, 2021: 3687700. DOI: 10.1155/2021/3687700##Liu H and Li Y (2022) Potential roles of Cornichon family AMPA receptor auxiliary protein 4 (CNIH4) in head and neck squamous cell carcinoma. Cancer Biomark, 35(4): 439-450. 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Investigation of radioprotective effects of WR-1065 and acetylsalicylic acid by micronucleus assay 2 2 Background: The current study aimed to investigate the ability of acetylsalicylic acid (ASA) to prevent ionizing radiation-induced DNA damage in human lymphocytes via the micronucleus (MN) assay and compare it with the efficacy of the agent WR-1065 (2-[(3-Aminopropyl) amino] ethanethiol dihydrochloride), which exhibits radioprotective activity. Materials and Methods: Peripheral blood samples were obtained from four participants, and nine experimental groups were established. Blood samples were treated with 25 µg/mL ASA and 40 µg/mL WR-1065 for 30 min before irradiation. After treatment, the samples were irradiated with 6 MV X-rays in the linear accelerator (LINAC) unit at doses of 2 Gy and 4 Gy. All blood samples were then cultured for the micronucleus assay. Results: In vitro treatments with ASA and WR-1065 at the indicated doses did not result in statistically significant changes in MN frequencies (p˃0.05). Conclusion: Both drugs were did not exhibit radioprotective effects in the experimental model used. 435 439 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 A. Yalcin A. Yalcin Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey aydoganyalcin@gmail.com K. Tabakcioglu K. Tabakcioglu Department of Medical Biology, Faculty of Medicine, Trakya University, Edirne, Turkey V.Y. Caloglu V.Y. Caloglu Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey C. Uzal C. Uzal Department of Radiation Oncology, Faculty of Medicine, Near East University, Faculty of Medicine, Lefkoşa, Turkish Republic of Northern Cyprus I.K. Omurlu I.K. Omurlu Department of Biostatistics, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey Acetylsalicylic acid WR-1065 micronucleus radioprotection ionizing radiation 1. Desborough MJR and Keeling DM (2017) The aspirin story - from willow to wonder drug. Br J Haematol, 177(5): 674-683.##Patrono C and Baigent C (2019) Role of aspirin in primary prevention of cardiovascular disease. Nat Rev Cardiol, 16(11): 675-686.##Brown MT, Bortfeld KS, Sperling LS, et al. (2023) Redefining the roles of aspirin across the spectrum of cardiovascular disease prevention. 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(2022) Aspirin's effect on kinetic parameters of cells contributes to its role in reducing incidence of advanced colorectal adenomas, shown by a multiscale computational study. elife, 11: e71953.##AlMathkour MM and AlSuhaibani ES (2014) Protective effect of aspirin on γ radiation induced chromosomal aberrations in swiss albino male mice. Res J Radiolo, 1(1): 1-6.##AlMathkour MM and AlSuhaibani ES (2014) Protective effect of aspirin on γ radiation-induced sperm malformations in Swiss Albino male mice. Am J Life Sci, 2(4): 205-215.##Demirel C, Kilciksiz SC, Gurgul S, et al. (2016) Inhibition of radiation-induced oxidative damage in the lung tissue: May acetylsalicylic acid have a positive role? Inflammation, 39(1): 158-165.##Niikawa M, Chuuriki K, Shibuya K, et al. (2008) Effect of aspirin on chromosome aberration and DNA damage induced by X-rays in mice. Radiation Effects & Defects in Solids, 163(7): 655-660.##Baltazar MT, Dinis-Oliveira RJ, Duarte JA, et al. (2011). 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Complications of CT-guided pulmonary nodule biopsy, Post-TNAB (Transthoracic needle aspiration biopsy) under CT Guidance 2 2 Background: To investigate the independent risk factors of pneumothorax after CT-guided pulmonary puncture, and to construct a nomogram model to predict the occurrence of pneumothorax. Materials and Methods The relevant factors of 257 patients with pulmonary nodule puncture in the lung tumor ward of a tertiary hospital from 2021 to 2023 were collected, and the logistic regression analysis method of backward elimination was used to obtain independent predictors. Finally, the multivariate logistic regression results were used. By drawing forest charts, exploreing independent risk factors for pulmonary puncture complicated by pneumothorax, risk prediction models were established and general nomograms and develop more intuitive multivariate dynamic nomograms were constructed to evaluate the model by calculating the AUC value of the area under the curve through the ROC curve performance; and to use Bootstrap's internal resampling method to perform internal validation of the model. Results Multivariate logistic regression analysis showed that lung nodule size (every 1 mm increase) (OR=0.82), education (OR=2.73) and age (OR=1.08) were independent risk factors for pneumothorax after lung puncture. Conclusion The nomogram constructed in this study can effectively predict the occurrence of postoperative pneumothorax in patients undergoing CT-guided pulmonary puncture. The model has a good degree of discrimination and consistency, and clinical medical staff can accurately and quickly predict the nomogram through pulmonary puncture complicated with pneumothorax, quickly identify patients with high risk of pulmonary puncture complicated with pneumothorax, and provide a reference for the development of targeted intervention measures. 441 446 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/7 1404/4/16 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 X. Wu X. Wu Department of Respiratory Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui230032, China medicalpaper203@gmail.com H. Wan H. Wan Department of Respiratory Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui230032, China M. Cheng M. Cheng Department of Respiratory Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui230032, China J. Bai J. Bai Department of Respiratory Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui230032, China Lung puncture pneumothorax risk prediction model forest plot nomogram. Chen D, Yang L, Zhang W, et al. (2024) Prevalence and management of pulmonary nodules: a systematic review and meta-analysis. Journal of Thoracic Disease, 16(7): 4619.##Mazzone PJ and Lam L (2022) Evaluating the patient with a pulmonary nodule: a review. JAMA, 327(3): 264-73.##Zhao Y, Zhang N, Yang L, et al. (2021) Application of CT-guided percutaneous pulmonary biopsy in pulmonary space-occupying lesions. International Respiratory Journal, 41(5): 367-71.##Topal U and Ediz B (2003) Transthoracic needle biopsy: factors effecting risk of pneumothorax. European Journal of Radiology, 48(3): 263-7.##Xiao R, Shao Q, Zhao N, et al. (2021) Quantification analysis of pleural line movement for the diagnosis of pneumothorax. World Journal of Clinical Cases, 9(21): 5889-99.##Chen D, Yang L, Zhang W, et al. (2024) Prevalence and management of pulmonary nodules: a systematic review and meta-analysis. Journal of Thoracic Disease, 16(7): 4619.##Mazzone PJ and Lam L (2022) Evaluating the patient with a pulmonary nodule: a review. JAMA, 327(3): 264-73.##Zhao Y, Zhang N, Yang L, et al. (2021) Application of CT-guided percutaneous pulmonary biopsy in pulmonary space-occupying lesions. International Respiratory Journal, 41(5): 367-71.##Topal U and Ediz B (2003) Transthoracic needle biopsy: factors effecting risk of pneumothorax. European Journal of Radiology, 48(3): 263-7.##Xiao R, Shao Q, Zhao N, et al. (2021) Quantification analysis of pleural line movement for the diagnosis of pneumothorax. World Journal of Clinical Cases, 9(21): 5889-99.##Lamfichekh Y, Lafay V, Hamam J, et al. (2023) Score to predict the occurrence of pneumothorax after computed tomography-guided percutaneous transthoracic lung biopsy. Journal of Thoracic Imaging, 38(5): 315-24.##Rong E, Hirschl DA, Zalta B, et al. (2021) A retrospective multi-site academic center analysis of pneumothorax and associated risk factors after CT-guided percutaneous lung biopsy. Lung, 199: 299-305.##Maalouf N, Lavric D, Vasileva L, et al. (2022) Associations between Covariates and Pneumothorax Observations in CT-Guided Lung Biopsies. Journal of Clinical Medicine, 11(7): 1958.##Li Y, Li H, Guo C, et al. (2021) The coaxial biopsy technique and analysis of complications for small lung nodules (≤20mm) under CT guidance. Clinical Pulmonary Journal, 26(6): 905-8.##Zhang J, An J, Jing X, et al. (2024) Assessing risk factors for complications in computer tomography-guided lung biopsy: quantitative analysis for predicting pneumothorax. Annals of Saudi Medicine, 44(4): 228-33.##Huang YS, Chen JL, Ko WC, et al. (2024) Clinical variables and radiomics features for predicting pneumothorax in patients undergoing CT-guided transthoracic core needle biopsy. Radiology: Cardiothoracic Imaging, 6(3): e230278.##Weon J, Robson S, Chan R, et al. (2021) Development of a risk prediction model of pneumothorax in percutaneous computed tomography guided transthoracic needle lung biopsy. Journal of Medical Imaging and Radiation Oncology, 65(6): 686-93.##Kolu I and Yildirim IO (2020) Evaluation of risk factors in pneumothorax development in computer tomography-guided transthoracic biopsy and management of complications. Nigerian Journal of Practice, 23(2): 246-51.##Yang BR, Kim MS, Park CM, et al. (2020) Patterns of percutaneous transthoracic needle biopsy (PTNB) of the lung and risk of PTNB-related severe pneumothorax: A nationwide population-based study. Plos one, 15(7): e0235599.##Herout V, Heroutova MM, et al. (2019) Transbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax-a retrospective study. BMC Pulmonary Medicine, 19: 1-6.##Sargent T, Kolderman N, Nair GB, et al. (2022) Risk factors for pneumothorax development following CT-guided core lung nodule biopsy. Journal of Bronchology & Interventional Pulmonology, 29(3): 198-205.##Li C, Wang D, Yang F, et al. (2021) The role of clinical characteristics and pulmonary function testing in predicting risk of pneumothorax by CT-guided percutaneous core needle biopsy of the lung. BMC Pulmonary Medicine, 21: 1.## ##

Evaluation of PD-L1 expression status in nasopharyngeal carcinoma by 18F-FDG PET/CT radiomics analysis 2 2 Background: We aimed to accurately and efficiently evaluate Programmed Death Ligand-1 (PD-L1) expression by relevant radiomic studies of fluoro-18-fluorodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) images in nasopharyngeal carcinoma (NPC) patients. Materials and Methods: This retrospective study included 60 untreated NPC patients had PET/CT. Cohorts of training and validation were randomly selected among the patients. The CT and PET radiomic features from the training cohort were obtained and screened, to construct CT, PET and combined models. Finally, verification and comparative analysis were performed. Results: According to the analysis, the maximum Standardized Uptake Value (SUVmax) alone was the standalone predictive indicator of PD-L1 presence level, thus incorporated into the combined model. Among our training cohort, the CT, PET, and combined models’ Area under Curve (AUC) values respectively were 0.837, 0.852, and 0.948, demonstrating excellent discrimination and calibration. However, the combined model had higher AUC values in the cohorts of training and validation, reaching AUCs of 0.948 and 0.802, respectively. Clinical decision curve analysis (DCA) further illustrated Combined model surpassed both the CT and PET models, attaining a benefit threshold probability of more than 5% and a net benefit (NB) of 0.450 at the optimal threshold probability. Conclusion: The combined predictive model based on relevant radiomic studies of PET/CT scans performed better than other models in assessing individualized PD-L1 expression in NPC. 447 454 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/12 1404/4/21 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 S. Yang S. Yang Department of Nuclear Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, China nfyyysx@126.com L. Li L. Li Department of Nuclear Medicine, the Third People's Hospital of Mianyang City, Sichuan Mental Health Center, Mianyang, Sichuan 621000, China H. Li H. Li Department of Nuclear Medicine, the Third People's Hospital of Mianyang City, Sichuan Mental Health Center, Mianyang, Sichuan 621000, China 3PET Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China Y. Li Y. Li Department of Nuclear Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, China Nasopharyngeal Neoplasms Immune Checkpoint Inhibitors Radiomics Positron Emission Tomography Computed Tomography. Chen YP, Chan ATC, Le QT, et al. (2019) Nasopharyngeal carcinoma. Lancet, 394(10192): 64-80.##Sung H, Ferlay J, Siegel RL, et al. (2021) Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 71(3): 209-249.##Cao W, Chen HD, Yu YW, et al. 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Meta-analysis and literature review on MRI diagnosis of cartilage invasion in laryngeal neoplasms 2 2 Background: To analyze the sensitivity and specificity of magnetic resonance imaging (MRI) in diagnosing cartilage invasion in laryngeal neoplasms. Materials and Methods: A comprehensive search for relevant studies was conducted in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and the Cochrane Trials Registry, with the search period extending until September 1, 2024.Sensitivity, specificity, and diagnostic likelihood ratio (DLR) were combined. Symmetrical Receiver Operating Characteristic (SROC) curves and Fagan nomograms were plotted. Meta-regression and subgroup analyses were performed to identify heterogeneity sources. Results: A total of seven studies involving 418 participants were included. MRI demonstrated a sensitivity of 0.93 [95% CI: 0.89–0.96, I²=0.00] and a specificity of 0.88 [95% CI: 0.81–0.92, I²=70.36] for detecting cartilage invasion. The negative diagnostic likelihood ratio (DLR-) was 0.08 with a 95% confidence interval of 0.05 to 0.13. The Area Under Curve(AUC) of the SROC curve was 0.95 with a 95% confidence interval of 0.85 to 0.99. Leave-one-out sensitivity analysis validated the robustness of the results concerning heterogeneity, as subgroup analysis did not mitigate it. Deek's funnel plot showed a symmetrical distribution of studies around the regression line, indicating no significant publication bias (t=0.92, P=0.40). Conclusion: MRI provides a reliable diagnostic performance for cartilage invasion in Laryngeal Neoplasms. 455 460 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/12 1404/4/21 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 Z.D. Wang Z.D. Wang Department of Otolaryngology, The Air Force Hospital of the Northern Theater Command of the Chinese People's Liberation Army, Shenyang, Liaoning, China Y. Zhan Y. Zhan Department of Otolaryngology, The Air Force Hospital of the Northern Theater Command of the Chinese People's Liberation Army, Shenyang, Liaoning, China H. Cao H. Cao Department of Otolaryngology, The Air Force Hospital of the Northern Theater Command of the Chinese People's Liberation Army, Shenyang, Liaoning, China X.D. Shan X.D. Shan Department of Otolaryngology, The Air Force Hospital of the Northern Theater Command of the Chinese People's Liberation Army, Shenyang, Liaoning, China X.H. Tai X.H. Tai Department of Otolaryngology, The Air Force Hospital of the Northern Theater Command of the Chinese People's Liberation Army, Shenyang, Liaoning, China 13324042800@163.com IMRT Laryngeal neoplasms cartilage invasion magnetic resonance imaging meta-analysis. Bibi K and Shah MH (2023) Investigation of imbalances in essential/toxic metal levels in the blood of laryngeal cancer patients in comparison with controls. 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Identification of biomarkers for radiation-induced coronary heart disease in breast cancer patients 2 2 Background: This study aims to identify biomarkers associated with radiation-induced coronary heart disease (RICHD) in breast cancer patients by integrating bioinformatics approaches with single-cell sequencing data, providing potential therapeutic targets for RICHD treatment. Materials and Methods: Gene expression profiles associated with coronary heart disease were sourced from the Gene Expression Omnibus (GEO) database, and GEO2R was utilized to identify differentially expressed genes.  Whole-genome sequencing and clinical data of breast cancer patients were obtained from The Cancer Genome Atlas (TCGA) database. Gene expression levels were analyzed using the 'Limma' package to compare radiation-exposed and non-exposed groups. Biological functional enrichment analysis was conducted using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG). The intersection of TCGA and GEO identified key genes. Further analyses of these key genes in breast cancer patients were conducted using the GEPIA, Kaplan-Meier Plotter websites, and single-cell sequencing results. Results: The intersection of datasets from breast cancer and coronary heart disease revealed Hemoglobin A2(HBA2) as a key gene associated with RICHD. HBA2 exhibited statistically significant differences in mRNA expression levels between breast cancer and normal tissues (P<0.05). Kaplan-Meier Plotter analysis revealed a significant prognostic difference between breast cancer patients with varying HBA2 expression levels (P=0.005). HBA2 exhibited significant expression levels in CD8+ T cells. Conclusion: HBA2 could be a biomarker and therapeutic target for RICHD, offering new perspectives for clinical management of RICHD patients. 461 466 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/12 1404/4/21 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 X.L. Huang X.L. Huang Cardiac Intensive Care Unit (CCU), West China Hospital of Sichuan University, Chengdu, Sichuan, China Z. Cai Z. Cai Cardiac Intensive Care Unit (CCU), West China Hospital of Sichuan University, Chengdu, Sichuan, China Y. Xu Y. 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Diagnostic value of preoperative chest computed tomography examination in clinical tumor-node-metastasis staging of non-small cell lung cancer 2 2 Background: This research aimed to investigate diagnostic value of preoperative chest computed tomography (CT) in the staging of clinical tumor-node-metastasis (TNM) in non-small cell lung cancer (NSCLC). Materials and Methods: Hundred and ninety eight patients with NSCLC accepted by the Affiliated Hospital of Shaoxing University (Shaoxing Municipal Hospital) from June 2021 to October 2022 were retrospectively selected as the study subjects. Preoperative multislice spiral computed tomography (MSCT) examination was performed, and the results of pathological examination were the gold standard to evaluate accuracy of CT diagnosis of TNM staging. Results: The staging accuracy of CT diagnosis was 86% for T1, 85.34% for T2, 76.92% for T3, and 66.7% for T4, with an overall accuracy of 83.83%. The Kappa value was 0.744. For nodal staging, the accuracy of CT diagnosis was 85.34% for stage N0, 67.86% for stage N1, and 72.22% for stage N2, yielding an overall accuracy of 79.29%. The Kappa value for nodal staging was 0.702. In terms of specific stages, the accuracy of CT diagnosis was 80.39% for stage IA, 81.40% for IB, 59.38% for IIA, 76.47% for IIB, and 73.21% for IIIA, with an overall accuracy of 75.25%. The Kappa value for these stages was 0.701. Conclusion: The clinical T stage, N stage, and TNM stage diagnosed by CT before surgery were consistent with the pathological T stage after surgery, especially in the early stage of LC. 467 472 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/122025/07/12 1404/4/21 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 X. Xu X. Xu Department of Radiology, The Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province, China J. Xu J. Xu L. Wang L. Wang Department of Radiology, The Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province, China B. Li B. Li Department of Radiology, The Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province, China B. He B. He Department of Radiology, The Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province, China 277528573@qq.com TNM staging CT examination preoperative diagnosis NSCLC. Jones GS and Baldwin DR (2018) Recent advances in the management of lung cancer. Clin Med (Lond), 18(Suppl 2): s41-s46. DOI: 10.7861/clinmedicine.18-2-s41##Zhang K, Lai Y, Axelrod R, et al. (2015) Modeling the overall survival of patients with advanced-stage non-small cell lung cancer using data of routine laboratory tests. Int J Cancer, 136(2): 382-91. DOI: 10.1002/ijc.28995##Li C, Lu H, Jiang X, et al. (2022) Network pharmacology study of Citrus reticulata and Pinellia ternata in the treatment of non-small cell lung cancer. Cell Mol Biol, 67(4): 10-17. DOI: 10.14715/cmb/2021.67.4.2##Novello S, Kowalski DM, Luft A, et al. (2023) Pembrolizumab plus chemotherapy in squamous non-small-cell lung cancer: 5-year update of the phase III KEYNOTE-407 study. J Clin Oncol, 41(11): 1999-2006. DOI: 10.1200/JCO.22.01990##Ikeuchi N, Igata F, Kinoshita E, et al. (2023) Real-world efficacy and safety of atezolizumab plus bevacizumab, paclitaxel and carboplatin for first-line treatment of japanese patients with metastatic non-squamous non-small cell lung cancer. Anticancer Res, 43(2): 713-724. DOI: 10.21873/anticanres.16210##Ren J, Ren J, Wang K, et al. (2023) The location of visceral pleural invasion in stage IB patients with non-small cell lung cancer: Comparison and prognosis. Eur J Surg Oncol, 49(5): 950-957. DOI: 10.1016/j.ejso.2023.01.022##Chen D, Han W, Wang P, et al. (2023) Correlation between the mRNA levels of BCRP and LUNX genes and pathological types and stages of patients with non-small cell lung cancer. Zhonghua Yi Xue Yi Chuan Xue Za Zhi, 40(2): 202-207. DOI: 10.3760/cma.j.cn511386-20210624-00538##Wan Y, Qian Y, Wang Y, et al. (2022) Prognostic value of Beclin 1, EGFR and ALK in non-squamous non-small cell lung cancer. Discov Oncol, 13(1): 127. DOI: 10.1007/s12672-022-00586-y##Mohammed ASS and Faraj KA (2023) Estimation of oesophageal surface dose in breast cancer patients undergoing supraclavicular irradiation by thermoluminescent dosimeter (TLD) and treatment planning system (TPS). International Journal of Radiation Research, 21(4): 647-652. DOI: 10.61186/ijrr.21.4.647##Luo Y, Hu S, Wang F, et al. (2022) miR-137 represses migration and cell motility by targeting COX-2 in non-small cell lung cancer. Transl Cancer Res, 11(10): 3803-3813. DOI: 10.21037/tcr-22-2177##Wang R, Wang S, Li Z, et al. (2022) PLEKHH2 binds β-arrestin1 through its FERM domain, activates FAK/PI3K/AKT phosphorylation, and promotes the malignant phenotype of non-small cell lung cancer. Cell Death Dis, 13(10): 858. DOI: 10.1038/s41419-022-05307-5##Ammann Y, Beutner U, Vital DG, et al. (2021) Impact of the new TNM Staging System (8th edition) on oral tongue cancers. Swiss Med Wkly, 151: w20493. DOI: 10.4414/smw.2021.20493##Baum P, Taber S, Erdmann S, et al. (2021) Validation of the T Descriptor (TNM-8) in T3N0 non-small-cell lung cancer patients##a bicentric cohort analysis with arguments for redefinition. Cancers, 13(8): 1812. DOI: 10.3390/cancers13081812##Li Y, Wu X, Yang P, et al. (2022) Machine learning for lung cancer diagnosis, treatment, and prognosis. Genomics Proteomics Bioinformatics, 20(5): 850-866. DOI: 10.1016/j.gpb.2022.11.003##Belfiore MP, Sansone M, Monti R, et al. (2022) Robustness of radiomics in pre-surgical computer tomography of non-small-cell lung cancer. J Pers Med, 13(1): 83. DOI: 10.3390/jpm13010083##Alhomoud M, Chokr N, Gomez-Arteaga A, et al. (2023) Screening chest CT prior to allogenic hematopoietic stem cell transplantation. Transplant Cell Ther, 29(5): 326.e1-326.e10. DOI: 10.1016/j.jtct.2023.01.029##Kandathil A, Kay FU, Butt YM, et al. (2018) Role of FDG PET/CT in the Eighth Edition of TNM staging of non-small cell lung cancer. Radiographics, 38(7): 2134-2149. DOI: 10.1148/rg.2018180060##Hou X, Zhou C, Wu G, et al. (2023) Efficacy, safety, and health-related quality of life with camrelizumab plus pemetrexed and carboplatin as first-line treatment for advanced nonsquamous NSCLC with brain metastases (CAP-BRAIN): A multicenter, open-label, single-arm, phase 2 study. J Thorac Oncol, 18(6): 769-779. DOI: 10.1016/j.jtho.2023.01.083##Volpe S, Isaksson LJ, Zaffaroni M, et al. (2022) Impact of image filtering and assessment of volume-confounding effects on CT radiomic features and derived survival models in non-small cell lung cancer. Transl Lung Cancer Res, 11(12): 2452-2463. DOI: 10.21037/tlcr-22-248##Liu H, Dilger JP, Lin J (2020) Effects of local anesthetics on cancer cells. Pharmacol Ther, 212: 107558. DOI: 10.1016/j.pharmthera.2020##Jin Z, Zhang W, Liu H, et al. (2022) Potential therapeutic application of local anesthetics in cancer treatment. Recent Pat Anticancer Drug Discov, 17(4): 326-342. DOI: 10.2174/1574892817666220119121204##Erdoğu V, Çıtak N, Sezen CB, et al. (2022) Comparison of 6th, 7th, and 8th editions of the TNM staging in non-small cell lung cancer patients: Validation of the 8th edition of TNM staging. Turk Gogus Kalp Damar Cerrahisi Derg, 30(3): 395-403. DOI: 10.5606/tgkdc.dergisi.2022.20089##Colombi D, Petrini M, Rapacioli F, et al. (2022) Role of visceral pleural invasion and tumor sizing at CT of resected NSCLC in clinical-radiological and pathological T agreement. Tumori, 109(2): 215-223. DOI: 10.1177/03008916221083702##Chen Y, Zhang J, Chen J, et al. (2022) Prognostic relevance of rib invasion and modification of T description for resected NSCLC patients: A propensity score matching analysis of the SEER database. Front Oncol, 12: 1082850. DOI: 10.3389/fonc.2022.1082850##Lazar V, Girard N, Raymond E, et al. (2022) Transcriptomics in tumor and normal lung tissues identify patients with early-stage non-small-cell lung cancer with high risk of postsurgery recurrence who may benefit from adjuvant therapies. JCO Precis Oncol, 6: e2200072. DOI: 10.1200/PO.22.00072##Kucuker M, Kucuker KA, Guney IB, et al. (2021) The importance of anatomical localization of non-small cell lung carcinoma in predicting mediastinal lymph node metastasis. Clin Anat, 35(2): 136-142. DOI: 10.1002/ca.23786##Can C, Kepenek F, Kömek H, et al. (2022) Comparison of 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT in patients with non-small cell lung cancer. Nucl Med Commun, 43(10): 1084-1091. DOI: 10.1097/MNM.0000000000001607##Daylan AEC, Miao E, Tang K, et al. (2023) Lung cancer in never smokers: delving into epidemiology, genomic and immune landscape, prognosis, treatment, and screening. Lung, 201(6): 521-529. 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A practical method of target volume delineation based on peritumoral edema in radiation therapy of glioblastoma 2 2 Background: To introduce a simple glioblastoma (GBM) target delineation method based on peritumoral edema. Materials and Methods: A postoperative GBM patient was selected, the target volume was delineated using three methods, including the methods recommended by the Radiation Therapy Oncology Group (RTOG method), by the European Organization for Research and Treatment of Cancer (EORTC method) and by this study (New method), and radiotherapy plans were formulated by the same physicist. The dose distributions of each schedule were compared. Then, patients treated with the delineation method recommended in this study were retrospectively analyzed, and progression-free survival and overall survival were determined. Results: The distributions of the high-dose regions of the 3 plans were as follows: RTOG method > EORTC method > New method, as was the low-dose region. Thirty-three patients were included in this retrospective study, and the median progression-free survival (PFS) and overall survival (OS) were 12 and 25 months, respectively. Conclusions: Our study suggested that delineating the target volume for GBM radiotherapy based on peritumoral edema is a good choice. 473 480 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/122025/07/122025/07/16 1404/4/25 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 H. Zhang H. Zhang Department of Radiation Oncology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China S. Hao S. Hao Department of Nuclear Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China T. Wu T. Wu Department of Radiation Oncology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China Y. Xu Y. Xu Department of Radiation Oncology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China D. Yang D. Yang Department of Radiation Oncology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China Y. Sun Y. Sun Department of Radiation Oncology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China P. Zhang P. Zhang Department of Radiation Oncology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China Y. Yan Y. Yan Department of Radiation Oncology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China yanyingdoctor@sina.com Glioblastoma Target volume Delineating Peritumoral edema. 1. van Solinge TS, Nieland L, Chiocca EA, Broekman MLD (2022) Advances in local therapy for glioblastoma - taking the fight to the tumour. Nat Rev Neurol, 18(4): 221-236.##Schaff LR and Mellinghoff IK (2023) Glioblastoma and Other Primary Brain Malignancies in Adults: A Review. JAMA, 329 (7): 574-587.##Gilbert MR, Wang M, Aldape KD, Stupp R, Hegi ME, Jaeckle KA, et al. (2013) Dose-dense temozolomide for newly diagnosed glioblastoma: a randomized phase III clinical trial. J Clin Oncol, 31(32): 4085-91.##Niyazi M, Brada M, Chalmers AJ, Combs SE, Erridge SC, Fiorentino A, et al. (2016) ESTRO-ACROP guideline "target delineation of glioblastomas". Radiother Oncol, 118(1): 35-42.##Ermiş E, Jungo A, Poel R, Blatti-Moreno M, Meier R, Knecht U, et al. (2020) Fully automated brain resection cavity delineation for radiation target volume definition in glioblastoma patients using deep learning. Radiat Oncol, 15(1): 100.##Zheng L, Zhou ZR, Yu Q, Shi M, Yang Y, Zhou X, et al. (2021) The definition and delineation of the target area of radiotherapy based on the recurrence pattern of glioblastoma after temozolomide chemoradiotherapy. Front Oncol, 10: 615368.##Minniti G, Tini P, Giraffa M, Capone L, Raza G, Russo I, et al. (2023) Feasibility of clinical target volume reduction for glioblastoma treated with standard chemoradiation based on patterns of failure analysis. Radiother Oncol, 181: 109435.##Joo L, Park JE, Park SY, Nam SJ, Kim YH, Kim JH, Kim HS (2021) Extensive peritumoral edema and brain-to-tumor interface MRI features enable prediction of brain invasion in meningioma: development and validation. 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N Engl J Med, 352(10): 987-96.##Fleischmann DF, Schön R, Corradini S, Bodensohn R, Hadi I, Hofmaier J, et al. (2021) Multifocal high-grade glioma radiotherapy safety and efficacy. Radiat Oncol, 16(1): 165.##Niyazi M, Andratschke N, Bendszus M, Chalmers AJ, Erridge SC, Galldiks N, et al. (2023) ESTRO-EANO guideline on target delineation and radiotherapy details for glioblastoma. Radiother Oncol, 184: 109663.##Seaberg MH, Kazda T, Youland RS, Laack NN, Pafundi DH, Anderson SK, et al. (2023) Dosimetric patterns of failure in the era of novel chemoradiotherapy in newly-diagnosed glioblastoma patients. Radiother Oncol, 188: 109768.##Bernchou U, Arnold TST, Axelsen B, Klüver-Kristensen M, Mahmood F, Harbo FSG,et al.(2021) Evolution of the gross tumour volume extent during radiotherapy for glioblastomas. Radiother Oncol, 160: 40-46.##Tu Z, Xiong H, Qiu Y, Li G, Wang L, Peng S (2021) Limited recurrence distance of glioblastoma under modern radiotherapy era. BMC Cancer, 21(1): 720.##Elmtalab S and Abedi I (2021) Investigating the out-of-field doses and estimating the risk of secondary thyroid cancer in high-grade gliomas radiation therapy with modulated intensity and 3D-conformal: a phantom study. International Journal of Radiation Research 19 (3):569-574.##Huang J, DeWees TA, Badiyan SN, Speirs CK, Mullen DF, Fergus S, et al. (2015) Clinical and Dosimetric predictors of acute severe lymphopenia during radiation therapy and concurrent temozolomide for high-grade glioma. Int J Radiat Oncol Biol Phys, 92(5): 1000-1007.##Ogura K, Mizowaki T, Arakawa Y, Ogura M, Sakanaka K, Miyamoto S, Hiraoka M. (2013) Initial and cumulative recurrence patterns of glioblastoma after temozolomide-based chemoradiotherapy and salvage treatment: a retrospective cohort study in a single institution. Radiat Oncol, 8: 97.##Guberina N, Padeberg F, Pöttgen C, Guberina M, Lazaridis L, Jabbarli R, et al. 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Meta-analysis of c-Myc gene expression in prognosis of elderly patients with NSCLC underwent surgery and chemoradiotherapy 2 2 Background: This paper is conducted to analysis the effects of c-Myc gene expression on surgical intervention and outlook of elderly sufferers with Non-Small Cell Lung Cancer (NSCLC) through meta-analysis. Materials and Methods: Through searching the key words "small cell lung cancer, c-Myc" on China National Knowledge Internet (CNKI) and other platforms, the literature meeting the inclusion criteria was screened. Finally, a total of 14 relevant studies were included. Statistical methods were used to analyze the data, including calculation of standard deviation and 95% confidence interval, and for analysis, the fixed effects model was utilized. Results: Meta-analysis of untreated and healthy groups showed that serum c-Myc mRNA expression in untreated group is remarkably superior to healthy group (standard deviation -1.64, 95% confidence interval -1.85 to -1.45, P<0.001). In addition, serum c-Myc mRNA expression levels in elderly sufferers with NSCLC are remarkably superior to younger group (standard deviation 1.45, 95% confidence interval 1.15 to 1.74, P<0.001). In addition, serum c-Myc mRNA expression in the non-smoking group is remarkably superior to smoking group (OR=-1.78, 95% CI -1.95 to -1.60, P<0.001). Conclusions: Serum c-Myc mRNA expression levels in elderly NSCLC suffers are superior to healthy groups, which were related to age and smoking behavior. This finding is significant for the early screening, diagnosis and prognosis assessment of NSCLC, providing a basis for further research on the role of c-Myc gene in elderly NSCLC. 481 487 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/122025/07/122025/07/162025/07/16 1404/4/25 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 Z.L. Guo Z.L. Guo Department of Geriatrics, Zhuji People's Hospital, Zhuji, China guo198210062023@163.com C-Myc gene expression non-small cell lung cancer chemoradiotherapy meta-analysis. 1. Wang M, Herbst RS, Boshoff C (2021) Toward personalized treatment approaches for non-small-cell lung cancer. Nature Medicine, 27(8): 1345-1356.##Stamatelopoulos A, Kadjianis F, Zoganas L (2009) Non small cell lung cancer: surgical treatment in the elderly.. Journal of B.U.ON., 14(3): 381-389.##Alexander M, Kim SY, Cheng H (2020) Update 2020: management of non-small cell lung cancer. Lung, 198: 897-907.##Reck M, Remon J, Hellmann MD (2022) First-line immunotherapy for non-small-cell lung cancer. Journal of Clinical Oncology, 40(6): 586-597.##Mimae T, Miyata Y, Tsutani Y, et al. (2020) Wedge resection as an alternative treatment for octogenarian and older patients with early-stage non-small-cell lung cancer. Japanese Journal of Clinical Oncology, 50(9): 1051-1057.##de Ruiter JC, Heineman DJ, Daniels JMA, et al. (2020) The role of surgery for stage I non-small cell lung cancer in octogenarians in the era of stereotactic body radiotherapy in the Netherlands. Lung Cancer, 144: 64-70.##Tantraworasin A, Siwachat S, Tanatip N, et al. (2020) Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old. Asian Journal of Surgery, 43(1): 154-165.##Jänne PA, Riely GJ, Gadgeel SM, et al. (2022) Adagrasib in non-small-cell lung cancer harboring a KRASG12C mutation. New England Journal of Medicine, 387(2): 120-131.##Li BT, Smit EF, Goto Y, et al. (2022) Trastuzumab deruxtecan in HER2-mutant non-small-cell lung cancer. New England Journal of Medicine, 386(3): 241-251.##Drilon A, Oxnard GR, Tan DSW, et al. (2020) Efficacy of selpercatinib in RET fusion-positive non-small-cell lung cancer. New England Journal of Medicine, 383(9): 813-824.##Patrapim S, Patcharaporn T, Rassamee C, Surasak S, Paramee T (2022) Copy number gains of chromosome 17 identified by dual in situ hybridization in non-small cell lung cancer tissue correlate with overexpression of c-Myc.. Translational Cancer Research, 11(5): 1033-1044.##Ren X, Yu J, Guo L, et al. (2021) Circular RNA circRHOT1 contributes to pathogenesis of non-small cell lung cancer by epigenetically enhancing C-MYC expression through recruiting KAT5. Aging (Albany NY), 13(16): 20372-20382.##Li W, Li C, Ma L, et al. (2020) Resveratrol inhibits viability and induces apoptosis in the small-cell lung cancer H446 cell line via the PI3K/Akt/c-Myc pathway. Oncology Reports, 44(5): 1821-1830.##Zhang Q, Zhang Y, Chen H, Sun LN, Zhang B, Yue DS, Wang Chang Li, Zhang Zhen Fa (2022) METTL3-induced DLGAP1-AS2 promotes non-small cell lung cancer tumorigenesis through m;6;A/c-Myc-dependent aerobic glycolysis. Cell Cycle, 21(24): 2602-2614.##Wang Z, Huang Y, Lu W, Liu J, Li X, Zhu Sa, Liu H, Song Y (2022) C-myc-mediated upregulation of NAT10 facilitates tumor development via cell cycle regulation in non-small cell lung cancer. Medical Oncology, 39(10): 140.##Chen H, Jia B, Zhang Q, Zhang Y (2022) Meclofenamic acid restores Gefinitib sensitivity by downregulating breast cancer resistance protein and multidrug resistance protein 7 via FTO/m6A-Demethylation/c-Myc in non-small cell lung cancer . Frontiers in Oncology, 12: 870636.##Zhang Y, Wang Y, Li Ya, Huang C, Xiao X, Zhong Z, et al. (2022) Dihydroartemisinin and Artesunate Inhibit Aerobic Glycolysis via Suppressing c-Myc Signaling in non-small Cell Lung Cancer. Biochemical Pharmacology, 198: 114941.##Tu Y, Yao S, Chen Q, Li W, Song Y, Zhang P (2022) 5-Hydroxytryptamine activates a 5-HT/c-Myc/SLC6A4 signaling loop in non-small cell lung cancer. Biochimica et Biophysica Acta (BBA) - General Subjects, 1866(4):130093.##Patrapim S, Patcharaporn T, Rassamee C, Surasak S, Paramee T (2023) Expression and Prognostic Significance of c-Myc, ALK, ROS1, BRAF, and PD-L1 among patients with non-small cell lung cancer. Clinical Medicine Insights. Oncology, 16: 47.##Altorki N, Wang X, Kozono D, et al. (2023) Lobar or sublobar resection for peripheral stage IA non-small-cell lung cancer. New England Journal of Medicine, 388(6): 489-498.##Ettinger DS, Wood DE, Aisner DL, et al. (2022) Non-small cell lung cancer, version 3.2022, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network, 20(5): 497-530.## ##

Diagnostic value of dental cone beams computed tomography using low-dose radiation technique for diagnosis of wrist fractures 2 2 Background: Utilizing dental cone beam computed tomography (DCBCT) in wrist bone fracture diagnosis is relatively new. This study investigated the diagnostic value of DCBCT using a low-dose radiation technique for wrist fractures. Materials and Methods: This study compared dental CBCT (DCBCT) with multidetector computed tomography (MDCT) and extremity CBCT in terms of radiation dose, using the dose-length product (DLP) as the primary comparison metric. Twenty-nine adult patients presenting with various wrist injuries underwent imaging with different parameters using DCBCT. Image quality was independently assessed by two radiologists using a 5-point Likert scale. Results: DCBCT demonstrated a significantly lower radiation dose than MDCT, though slightly higher than extremity CBCT. The optimized DCBCT protocol (70 kV, 2 mAs, 15 seconds) provided high diagnostic image quality, with an interrater agreement of 85.4%. Conclusion: DCBCT offers an effective, lower-radiation alternative for diagnosing wrist fractures compared to MDCT. Optimized protocols provide good image quality and could be cost-effective, particularly in regions where extremity CBCT is unavailable. 489 492 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/122025/07/122025/07/162025/07/162025/07/16 1404/4/25 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 M. Aljamal M. Aljamal Department of Medical Imaging, Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine mohammad.aljamal@aaup.edu A. Qutit A. Qutit Tower Dental X-ray Center, Nablus, Palestine M. Abuzaid M. Abuzaid Medical Diagnostic Imaging Departments, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates N. Omarah N. Omarah Department of Medical Imaging, Ministry of Health, Nablus, Palestine M. Zahri M. Zahri Oncological and Radiological Sciences Cluster, Advanced Medical & Dental Institute, University Sains Malaysia, Pulau Pinang, Malaysia M. Fairus M. Fairus Diagnostic Radiography Department, Faculty of Allied Health Sciences, Singapore Institute of Technology, Singapore Cone beam computed tomography wrist fracture multidetector computed tomography dental CBCT radiation dose. Bäcker HC, Wu CH, Strauch RJ (2020) Systematic Review of Diagnosis of Clinically Suspected Scaphoid Fractures. J Wrist Surg, 9 (1): 81-9.##Balci A, Basara I, Çekdemir EY, et al. (2015) Wrist fractures: sensitivity of radiography, prevalence, and patterns in MDCT. Emerg Radiol, 22 (3): 251-6.##Gibney B, Smith M, Moughty A, et al. (2019) Incorporating Cone-Beam CT Into the Diagnostic Algorithm for Suspected Radiocarpal Fractures: A New Standard of Care? AJR Am J Roentgenol, 213 (5): 1117-23.##Ludlow JB (2018) Hand-wrist, knee, and foot-ankle dosimetry and image quality measurements of a novel extremity imaging unit providing CBCT and 2D imaging options. Med Phys, 45 (11): 4955-63.##Murphy MC, Gibney B, Walsh J, et al. (2022) Ultra-low-dose cone-beam CT compared to standard dose in the assessment for acute fractures. Skeletal Radiol, 51 (1): 153-9.##Ragab H, Abdelaziz DM, Khalil MM, et al. (2023) Assessment of image quality of two cone-beam computed tomography of the Varian Linear accelerators: Comparison with spiral CT simulator. International Journal of Radiation Research, 21 (3): 491-7.##Grassi R, Guerra E, Berritto D (2023) Bone fractures difficult to recognize in emergency: May be cone beam computed tomography (CBCT) the solution? Radiol Med, 128 (1): 1-5.##Edlund R, Skorpil M, Lapidus G, et al. (2016) Cone-Beam CT in diagnosis of scaphoid fractures. Skeletal Radiol, 45 (2): 197-204.##Neubauer J, Benndorf M, Ehritt-Braun C, et al. (2018) Comparison of the diagnostic accuracy of cone beam computed tomography and radiography for scaphoid fractures. Sci Rep, 8 (1): 3906.##Koivisto J, van Eijnatten M, Kiljunen T, et al. (2018) Effective radiation dose in the wrist resulting from a radiographic device, two cbct devices and one msct device: A comparative study. Radiat Prot Dosimetry, 179 (1): 58-68.##Pallaver A, Honigmann P (2019) The role of cone-beam computed tomography (CBCT) scan for detection and follow-up of traumatic wrist pathologies. J Hand Surg Am, 44 (12): 1081-7.##Ferreira Branco D, Bouvet C, Hamard M, et al. (2022) Reliability of radio-ulnar and carpal alignment measurements in the wrist between radiographs and 3D imaging. Eur J Radiol, 154: 110417.##Borel C, Larbi A, Delclaux S, et al. (2017) Diagnostic value of cone beam computed tomography (CBCT) in occult scaphoid and wrist fractures. Eur J Radiol, 97: 59-64.##Hafezi L, Divband D, Deevband MR (2021) New method to organ dose assessment in cone-beam computed tomography using ImPACT software. International Journal of Radiation Research, 19 (4): 1049-53.##Posadzy M, Desimpel J, Vanhoenacker F (2018) Cone beam CT of the musculoskeletal system: clinical applications. Insights Imaging, 9 (1): 35-45.##Hashimoto K, Arai Y, Iwai K, et al. (2003) A comparison of a new limited cone beam computed tomography machine for dental use with a multidetector row helical CT machine. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 95 (3): 371-7.##Hashimoto K, Kawashima S, Araki M, et al. (2006) Comparison of image performance between cone-beam computed tomography for dental use and four-row multidetector helical CT. J Oral Sci, 48 (1): 27-34.##Pauwels R, Beinsberger J, Stamatakis H, et al. (2012) Comparison of spatial and contrast resolution for cone-beam computed tomography scanners. Oral Surg Oral Med Oral Pathol Oral Radiol, 114 (1): 127-35.##Zamani H, Falahati F, Omidi R, et al. (2020) Estimating and comparing the radiation cancer risk from cone-beam computed tomography and panoramic radiography in pediatric and adult patients. International Journal of Radiation Research, 18 (4): 885-93.##Kaasalainen T, Ekholm M, Siiskonen T, et al. (2021) Dental cone beam CT: An updated review. Phys Med, 88: 193-217.## ##

Value of computed tomography angiography (CTA) measured aneurysm morphology and incidence angle 2 2 Background: The study investigates the relationship between aneurysm morphology and incidence angle measured by Computed Tomography Angiography (CTA) and the risk of intracranial aneurysm (IA) rupture. Materials and Methods: We analyzed data from 150 patients with intracranial aneurysms, comparing those with ruptured and non-ruptured aneurysms. Statistical methods were applied to identify key risk factors for rupture. Results: Significant differences were observed in aneurysm morphology, incidence angle, and risk scores between the ruptured and non-ruptured groups. Factors such as irregular aneurysm shape, larger diameter, aspect ratio (AR), size ratio (SR), and incidence angle were associated with higher rupture risk. Conclusion: CTA-measured aneurysm morphology and incidence angle, along with patient-specific factors, are crucial in assessing the risk of IA rupture. These findings can guide clinical decision-making and improve patient outcomes. 493 496 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/122025/07/122025/07/162025/07/162025/07/162025/07/16 1404/4/25 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 Y. Xu Y. Xu Department of Neurosurgery, Quzhou Hospital, Wenzhou Medical University (Quzhou People's Hospital), Quzhou, China Y. Li Y. Li Department of Neurosurgery, Quzhou Hospital, Wenzhou Medical University (Quzhou People's Hospital), Quzhou, China R. Liu R. Liu Department of Neurosurgery, Quzhou Hospital, Wenzhou Medical University (Quzhou People's Hospital), Quzhou, China A. Wu A. Wu Department of Neurosurgery, Quzhou Hospital, Wenzhou Medical University (Quzhou People's Hospital), Quzhou, China D. Mao D. Mao Department of Neurosurgery, Quzhou Hospital, Wenzhou Medical University (Quzhou People's Hospital), Quzhou, China R. Zhou R. Zhou Department of Neurosurgery, Quzhou Hospital, Wenzhou Medical University (Quzhou People's Hospital), Quzhou, China 15605701715@163.com Intracranial aneurysm CT angiography aneurysm rupture aneurysm morphology incidence angle. Rahmani R, Baranoski JF, Albuquerque FC, Lawton MT, Hashimoto T (2022) Intracranial aneurysm calcification - A narrative review. Experimental Neurology, 353: 114052.##van den Berg R (2020) Intracranial aneurysm wall enhancement: fact or fiction? Neuroradiology, 62(3): 269-270.##Sato H, Kamide T, Kikkawa Y, et al. (2021) Clinical characteristics of ruptured intracranial aneurysm in patients with multiple intracranial aneurysms. World Neurosurgery, 149: e935-e941.##Lee MS, Kim MD, Lee M, Won JY, Park SI, Lee DY, Lee KH (2012) Contrast-enhanced MR angiography of uterine arteries for the prediction of ovarian artery embolization in 349 patients. Journal of Vascular and Interventional Radiology, 23 (9): 1174-9.##de Aguiar GB, Ozanne A, Elawady A, et al. (2022) Intracranial aneurysm in pediatric population: A single-center experience. Pediatric Neurosurgery, 57(4): 270-278.##Wang Z, Liu Q, Wang D, Zhang N, Jiang H, Li H, et al. (2024) Secondary sequencing assisted diagnosis of pulmonary infection caused by Aspergillus oryzae in children with acute lymphoblastic leukemia: a case report. International Journal of Radiation Research, 22(1): 229-233.##Andrade L, Hoskoppal A, Hunt MM, et al. (2021) Intracranial aneurysm and coarctation of the aorta: prevalence in the current era. Cardiology in the Young, 31(2): 229-232.##Caliskan E and Oncel D (2021) CT angiography evaluation of intracranial aneurysms: Distribution, characteristics, and association with subarachnoid hemorrhage. Nigerian Journal of Clinical Practice, 24(6): 833-840.##Ferrari F, Cirillo L, Calbucci F, et al. (2019) Wall motion at 4D-CT angiography and surgical correlation in unruptured intracranial aneurysms: a pilot study. Journal of Neurosurgical Sciences, 63(5): 501-508.##Wang GX, Yang Y, Liu LL, et al. (2021) Risk of rupture of small intracranial aneurysms (</=5 mm) among the Chinese population. World Neurosurgery, 147: e275-e281.##Heros RC and Kistler JP (1983) Intracranial arterial aneurysm--an update. Stroke, 14(4): 628-631.##Burns JD and Brown RJ (2009) Treatment of unruptured intracranial aneurysms: surgery, coiling, or nothing? Current Neurology and Neuroscience Reports, 9(1): 6-12.##Jeong HW, Seo JH, Kim ST, Jung CK, Suh SI (2014) Clinical practice guideline for the management of intracranial aneurysms. Neurointervention, 9(2): 63-71.##Juvela S (2022) PHASES score and treatment scoring with cigarette smoking in the long-term prediction of rupturing of unruptured intracranial aneurysms. Journal of Neurosurgery, 136(1): 156-162.##Meyer FB, Morita A, Puumala MR, Nichols DA (1995) Medical and surgical management of intracranial aneurysms. Mayo Clinic Proceedings, 70(2): 153-172.##Mittenentzwei S, Beuing O, Neyazi B, et al. (2021) Definition and extraction of 2D shape indices of intracranial aneurysm necks for rupture risk assessment. International Journal of Computer Assisted Radiology and Surgery, 16(11): 1977-1984.##Waqas M, Rajabzadeh-Oghaz H, Tutino VM, et al. (2019) Morphologic parameters and location associated with rupture status of intracranial aneurysms in elderly patients. World Neurosurgery, 129: e831-e837.##Skodvin TO, Evju O, Sorteberg A, Isaksen JG (2019) Prerupture intracranial aneurysm morphology in predicting risk of rupture: A matched case-control study. Neurosurgery, 84(1): 132-140.##Zuurbier C, Molenberg R, Mensing LA, et al. (2022) Sex difference and rupture rate of intracranial aneurysms: An individual patient data meta-analysis. Stroke, 53(2): 362-369.##Zhai XD, Yu JX, Li CJ, et al. (2020) Morphological characteristics of pericallosal artery aneurysms and their high propensity for rupture. World Neurosurgery, 133: e320-e326.##Ma X, Yang Y, Liu D, Zhou Y, Jia W (2020) Demographic and morphological characteristics associated with rupture status of anterior communicating artery aneurysms. Neurosurgical Review, 43(2): 589-595.##Lombarski L, Kunert P, Tarka S, Piechna A, Kujawski S, Marchel A (2022) Unruptured intracranial aneurysms: relation between morphology and wall strength. Neurologia I Neurochirurgia Polska, 56(5): 410-416.## ##

Integrated radiologic diagnosis of pulmonary artery intimal sarcoma: Report of three cases and literature review 2 2 Background: Pulmonary artery intimal sarcoma (PAIS), a rare malignancy arising primarily within the pulmonary artery's intimal layer, exhibits an estimated prevalence ranging from 0.001% to 0.003%. Due to overlapping clinical manifestations and imaging characteristics, PAIS is frequently mistaken for acute or chronic pulmonary thromboembolism. Tissue biopsy remains the authoritative method for establishing diagnosis. Regarding therapy, surgery is the principal approach, and undertaking thorough surgical resection alongside endarterectomy yields improved survival outcomes. Case Presentations: This study presents three cases of PAIS, analyzing their radiological characteristics, pathological findings, and therapeutic approaches. A comprehensive review of the literature on this condition is also provided. Conclusion: Timely detection proves paramount and can significantly enhance patient prognosis. Complete surgical resection is pivotal for improving prognosis, and multidisciplinary collaboration (e.g., radiology, pathology, and thoracic surgery) plays a vital role in formulating precise diagnostic and therapeutic strategies. 497 502 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/122025/07/122025/07/162025/07/162025/07/162025/07/162025/07/16 1404/4/25 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 X. Fu X. Fu Zhejiang Chinese Medical University, Hangzhou, Hangzhou, China 13586980761@163.com J. Zhao J. Zhao Department of Pathology, Affiliated Jinhua Hospital, Zhejiang University School of Medcine, Hangzhou, China Q. Liu Q. Liu Department of Pathology, Affiliated Jinhua Hospital, Zhejiang University School of Medcine, Hangzhou, China J. Jia J. Jia Department of Pathology, Affiliated Jinhua Hospital, Zhejiang University School of Medcine, Hangzhou, China M. Wang M. Wang Department of Pathology, Affiliated Jinhua Hospital, Zhejiang University School of Medcine, Hangzhou, China PAIS endarterectomy computed tomography angioplasty. Atahan C, Gural Z, Yucel S, Agaoglu F (2024) Pulmonary artery intimal sarcoma: Case report of a patient managed with multimodality treatment and a comprehensive literature review. Strahlentherapie Und Onkologie, 200(8): 725-729.##Bandyopadhyay D, Panchabhai TS, Bajaj NS, Patil PD, Bunte MC (2016) Primary pulmonary artery sarcoma: a close associate of pulmonary embolism-20-year observational analysis. Journal of Thoracic Disease, 8(9): 2592-2601.##Chen D, Zhu G, Wang D, Zhang Z, Fang W, Qu Z (2016). Clinicopathological and immunohistochemical features of pulmonary artery sarcoma: A report of three cases and review of the literature. Oncology letters, 11(4): 2820-2826.##Xu R, Zhao Y, Xu X, et al. (2020) Pulmonary intimal sarcoma involving the pulmonary valve and right ventricular outflow tract: A case report and literature review. Medicine, 99(3): e18813.##Westhofen S, Kugler C, Reichenspurner H, Deuse T (2016) Acute pulmonary artery obstruction as the primary manifestation of a rapidly growing intimal sarcoma in a 54-year-old patient. Thoracic and Cardiovascular Surgeon Reports, 5(1): 36-38.##Deng L, Zhu J, Xu J, Guo S, Liu S, Song Y (2018). Clinical presentation and surgical treatment of primary pulmonary artery sarcoma. Interactive Cardiovascular and Thoracic Surgery, 26(2): 243-247.##Nakrani R, Yeung HM, Kim JS, Kamat B, Kumaran M (2020) Pulmonary artery intimal sarcoma: a diagnostic challenge using a multimodal approach. Case Reports in Medicine, 2020: 6795272.##Jimbo N, Komatsu M, Itoh T, Hirose T (2019) MDM2 dual-color in situ hybridization (DISH) aids the diagnosis of intimal sarcomas. Cardiovascular Pathology, 43: 107142.##Conte GA, Alidoost M, Devita MS, et al. (2020) Diagnostic enigma: spindle cell sarcoma of the aorta presenting as pulmonary embolism and chronic anaemia. Eur J Case Rep Intern Med, 7(12): 1832.##Roszik J, Khan A, Conley AP, et al. (2019) Unique aberrations in intimal sarcoma identified by next-generation sequencing as potential therapy targets. Cancers, 11(9):1283.##Shao N and Deng C (2022) Pulmonary thromboembolic disease or pulmonary artery intimal sarcoma: Case report and literature review. Oncology Letters, 24(4): 350.##Chappell T, Creech CB, Parra D, Strauss A, Scholl F, Whitney G (2008) Presentation of pulmonary artery intimal sarcoma in an infant with a history of neonatal valvular pulmonic stenosis. Annals of Thoracic Surgery, 85(3): 1092-1094.##Lu P and Yin BB (2020) Misdiagnosis of primary intimal sarcoma of the pulmonary artery as chronic pulmonary embolism: A case report. World Journal of Clinical Cases, 8(5): 986-994.##Cox JE, Chiles C, Aquino SL, Savage P, Oaks T (1997) Pulmonary artery sarcomas: a review of clinical and radiologic features. Journal of Computer Assisted Tomography, 21(5): 750-755.##Hieu NL, Tu VN, Hoan L, et al. (2022) A case report of primary pulmonary artery intimal sarcoma. Radiol Case Rep, 17(6): 1986-1990.##Chang DY, Lin KC, Pan JY, Liu HW, Kuo SH, Lee L (2020) Pulmonary artery intimal sarcoma: a case report and literature review. Respirology Case Reports, 8(2): e00530.##Assi T, Kattan J, Rassy E, et al. (2020) A comprehensive review on the diagnosis and management of intimal sarcoma of the pulmonary artery. Critical Reviews in Oncology Hematology, 147: 102889.##Keel SB, Bacha E, Mark EJ, Nielsen GP, Rosenberg AE (1999) Primary pulmonary sarcoma: a clinicopathologic study of 26 cases. Modern Pathology, 12(12): 1124-1131.##Koo N, Sharma AK, Narayan S (2022) Therapeutics Targeting p53-MDM2 interaction to induce cancer cell death. International Journal of Molecular Sciences, 23(9):5005.##Bode-Lesniewska B, Zhao J, Speel EJ, et al. (2001) Gains of 12q13-14 and overexpression of mdm2 are frequent findings in intimal sarcomas of the pulmonary artery. Virchows Archiv, 438(1): 57-65.##Vasuri F, Resta L, Fittipaldi S, Malvi D, Pasquinelli G (2012) RUNX-1 and CD44 as markers of resident stem cell derivation in undifferentiated intimal sarcoma of pulmonary artery. Histopathology, 61(4): 737-743.##Barmpas A, Giannakidis D, Fyntanidou V, et al. (2019) Intimal sarcoma of the pulmonary artery, a diagnostic enigma. Ame Case Reports, 3: 32.##Attina D, Niro F, Tchouante P, et al. (2013) Pulmonary artery intimal sarcoma. Problems in the differential diagnosis. Radiologia Medica, 118(8): 1259-1268.##Jiang W, Liu M, Guo X, et al. (2023) Echocardiographic Characteristics of pulmonary artery intimal sarcoma: Comparison with CTPA. Heart Lung and Circulation, 32(9): 1080-1088.##Suto H, Suto M, Inui Y, Okamura A (2022) Difficulty in distinguishing pulmonary arterial intimal sarcoma from pulmonary thromboembolism using FDG PET/CT. In Vivo, 36(3): 1519-1522.## ##

Diagnostic value of computerized tomography (CT) and CT-angiography in diagnosis of cerebral artery embolism after induced Abortion: A Case Report and Literature Review 2 2 Background: Acute cerebral infarction following induced abortion is a rare but serious complication, often associated with alterations in the coagulation system of pregnant women, hypertension, pregnancy-related vascular disorders, or infections. Considering the societal impact of maternal health issues in reproductive-age women and their effects on families and society, studying the etiology, prevention, and treatment of postpartum stroke is of significant importance. Case Summary: The patient, a 31-year-old female, was diagnosed with an arachnoid cyst in the posterior fossa of the fetal occipital fontanelle during a prenatal examination, leading to the decision for induced abortion via rivanol amniotic cavity injection. Post-delivery, at four hours and 50 minutes, she presented with acute symptoms of right-sided limb weakness and speech impairment. Emergency cranial CT was performed, revealing extensive infarction within the left cerebral hemisphere. Further diagnostic workup with head CT angiography (CTA) confirmed the presence of a critical occlusion in the left middle cerebral artery, a key finding that directed the subsequent management. Given the contraindications for intravenous thrombolysis during the puerperal period, the patient was promptly transferred for endovascular thrombectomy. The CT imaging was pivotal in establishing the diagnosis and guiding the decision for urgent intervention. Subsequent telephone follow-up indicated a favorable prognosis, highlighting the importance of timely and accurate CT imaging in the management of postpartum stroke. Conclusion: Postpartum stroke often results from thrombus formation and is associated with significantly high mortality and risk of residual neurological deficits. Therefore, healthcare professionals should be vigilant in observing early symptoms and providing appropriate treatment to prevent symptom progression. 503 507 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/122025/07/122025/07/162025/07/162025/07/162025/07/162025/07/162025/07/16 1404/4/25 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 X. Tan X. Tan Department of Intensive Care Medicine, Neijiang Maternal and Child Health Hospital, Neijiang, Sichuan Province, China T. Luo T. Luo Department of Gynecology and Obstetrics, Neijiang Maternal and Child Health Hospital, , Neijiang, Sichuan Province, China Z. Hu Z. Hu Department of Critical Care Medicine, the Second People's Hospital of Neijiang City, Neijiang, Sichuan Province, China L. Li L. Li Department of Gynecology and Obstetrics, Neijiang Maternal and Child Health Hospital, , Neijiang, Sichuan Province, China 15884857856@163.com Case report left middle cerebral artery thrombosis acute stroke literature review computerized tomography. Elgendy IY, Gad MM, Mahmoud AN, Keeley EC, Pepine CJ (2020) Acute stroke during pregnancy and puerperium. Journal of the American College of Cardiology, 75(2): 180-190.##Mehta LS, Velarde GP and Lewey J, et al. (2023) Cardiovascular disease risk factors in women: The impact of race and ethnicity: A scientific statement from the American heart association. Circulation, 147(19): 1471-1487.##Miller EC and Leffert L (2020) Stroke in Pregnancy: A Focused Update. Anesthesia and Analgesia, 130(4): 1085-1096.##Doiron T, Ramseyer A, Phelps EN, et al. (2022) Pregnancy-Related Stroke: A Review. Obstetrical & Gynecological Survey, 77(6): 367-378.##Sells CM and Feske SK (2017) Stroke in pregnancy. Seminars in Neurology, 37(6): 669-678.##Camargo EC, Feske SK, Singhal AB (2019) Stroke in Pregnancy: An Update. Neurologic Clinics, 37(1): 131-148.##Sanders BD, Davis MG, Holley SL,Phillippi JC (2018) Pregnancy-associated stroke. Journal of Midwifery & Womens Health, 63(1): 23-32.##Santos M and de Sousa DA (2022) Cerebrovascular disease in pregnancy and postpartum. Current Opinion in Neurology, 35(1): 31-38.##Chunguang L, Zhao D, Min C, Xuejun X (2023) Cardiogenic cerebral infarction with hemorrhagic transformation in the left and right cerebral hemispheres: A case report. Asian Journal of Surgery, 46(9): 3869-3870.##Wang N, Shen X, Zhang G, Gao B, Lerner A (2021) Cerebrovascular disease in pregnancy and puerperium: perspectives from neuroradiologists. Quantitative Imaging in Medicine and Surgery, 11(2): 838-851.##Bodur H, Caliskan E, Anik Y, Cakiroglu Y, Corakci A (2008) Cranial thromboembolism secondary to patent foramen ovale and deep venous thrombosis after cesarean section. Gynecologic and Obstetric Investigation, 65(4): 258-261.##Cheng SJ, Chen PH, Chen LA, Chen CP (2010) Stroke during pregnancy and puerperium: clinical perspectives. Taiwanese Journal of Obstetrics & Gynecology, 49(4): 395-400.##Haber MA and Nunez D (2018) Imaging neurological emergencies in pregnancy and puerperium. Emergency Radiology, 25(6): 673-684.##Scott G, Gillon TE, Pels A, von Dadelszen P, Magee LA (2022) Guidelines-similarities and dissimilarities: a systematic review of international clinical practice guidelines for pregnancy hypertension. American Journal of Obstetrics and Gynecology, 226(2S): S1222-S1236.##Opaskar A, Massaquoi R, Sila C (2021) Stroke in pregnancy. Handb Clin Neurol, 177(283-293.##Soriano D, Carp H, Seidman DS, et al. (2002) Management and outcome of pregnancy in women with thrombophylic disorders and past cerebrovascular events. Acta Obstetricia Et Gynecologica Scandinavica, 81(3): 204-207.##Wu MY, Hu PJ, Wong CS, et al. (2021) Long-term clinical outcome of major adverse vascular events after hypertensive disorders of pregnancy. Obstetrics and Gynecology, 137(2): 285-293.##Swartz RH, Cayley ML, Foley N, et al. (2017) The incidence of pregnancy-related stroke: A systematic review and meta-analysis. International Journal of Stroke, 12(7): 687-697.##Liew BS, Ghani AA, You X (2019) Stroke in pregnancy. Med J Malaysia, 74(3): 246-249.##Wang N, Shen X, Zhang G, et al. (2021) Cerebrovascular disease in pregnancy and puerperium: perspectives from neuroradiologists. Quant Imaging Med Surg.11(2):838-851.##Bodur H, Caliskan E, Anik Y, et al. (2008). Cranial thromboembolism secondary to patent foramen ovale and deep venous thrombosis after cesarean section.Gynecol Obstet Invest. 65(4):258-261.## ##

Primary parotid gland malignant melanoma complicated with lung and bone metastasis; a case report 2 2 Background: Malignant melanoma of the primary parotid gland (PGMM) is extremely rare, and most of the previous reports are case reports. This study describes the clinical and histological characteristics of a single case of PGMM. Materials and methods: The patient was diagnosed following the detection of a mass in the parotid region. Examination of the resected tissue specimens demonstrated cells with copious eosinophilic cytoplasm, significant pleomorphic in the nuclei, and distinct nucleoli. Immunohistochemical analysis was performed to measure HMB45, S-100, SOX-10, and Melan-A markers expression in tumor tissue. The clinicopathological features of a series of parotid gland malignant melanomas were analyzed. Results: Despite undergoing surgical intervention, immunotherapy, and targeted therapy, this case occurred distant metastases. The patient survived 2 years and 3 months after surgery due to multiple metastases throughout the body. Conclusion: This article reported the clinical characteristics of the case and provided an overview of primary PGMM cases documented over the last three decades. 509 512 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/122025/07/122025/07/162025/07/162025/07/162025/07/162025/07/162025/07/162025/07/16 1404/4/25 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/20 1404/2/30 S. Qin S. Qin Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Jining Medical University, Jining 272000, China R. Li R. Li Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China D. Zhou D. Zhou Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China M. Li M. Li Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China G. Li G. Li Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China M. Sun M. Sun Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China sunmingleidr@163.com Parotid gland malignant melanoma metastasis histopathology immunotherapy targeted therapy. 1.Zhao Q, Li ZK, Gui Y, Ma DY, Du GB, Li XF (2023) Surgery, adjuvant immunotherapy plus chemotherapy and radiotherapy for primarymalignant melanoma of the parotid gland (PGMM): A case report.Open Life Sci, 18(1): 20220555.##Sultana M, Chatterjee RP, Kundu S, Mahmud SA (2022) Primary amelanotic malignant melanoma of parotid and submandibular##salivary gland: A rare case report. J Oral Maxillofac Pathol, 26(2): 263-267.##Prayson RA and Sebek BA (2000) Parotid gland malignant melano-mas. Arch Pathol Lab Med, 124(12): 1780-1784.##Chaouki A, Berrada O, Najib Z, et al. (2020) Primary malignant melanoma of the parotid gland: A case report and review of the literature. Annals of Medicine and Surgery, 60:660-663.##Apparau D, Apparau H, Mohamad I, Bhavaraju VMK (2018) Malig-nant melanoma of parotid gland in a child-our unique experience. AME Case Reports, 2: 4.##Qiang Z, Zhi-Ke L, Yan G, Dai-Yuan M, Guo-Bo D, Xian-Fu L (2023) Surgery, adjuvant immunotherapy plus chemotherapy and radio-therapy for primary malignant melanoma of the parotid gland (PGMM): A case report. Open Life Sciences, 18(1): 20220555.##Gao N, Li LJ, Li Y, Wang L (2008) Primary amelanotic malignant melanoma of the parotid gland: a case report. Journal of Interna-tional Medical Research, 36(6):1435-1439.##Bangerter M (2009) Cytomorphologic pitfall of primary malignant melanoma of the parotid gland: a case report. Acta Cytologica, 53(4): 435-436.##Tsutsumida A, Yamamoto Y, Sekido M, Itoh T (2008) Suspected case of primary malignant melanoma of the parotid gland. Scandi-navian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 42(2): 105-107.##Barbieri M, Gentile R, Cordone MP, Mora R, Mora F (2002) Primi-tive malignant melanoma of the parotid gland. ORL, 64(4):297-299.##Karpowicz MK, Shalmon B, Molberg KH, El-Naggar AK (2011) Mela-noma in a carcinoma ex pleomorphic adenoma of the parotid gland: a case report and putative histogenesis. Human Pathology, 42(9): 1355-1358.##Woodwards RT, Shepherd NA, Hensher R (1993) Malignant mela-noma of the parotid gland: a case report and literature review. British Journal of Oral and Maxillofacial Surgery, 31(5): 313-315.##Yan M, Duan S, Du M, Xiao L, Yao G, Ning C (2024) Primary Malig-nant Melanoma in the Parotid Gland: A Case Report and Literature Review. Ear Nose Throat J, 1455613241230219.##Zebbakh H, Lemrabet A, Benbrahim FZ, et al. (2024) Primary malig-nant melanoma of the parotid gland: A case report. Radiol Case Rep, 19(8): 3449-3452.## ##

Comment on the article by Kareem et al. (2025) on radon and heavy metals in Barji village 2 2 Dear Editor, I am writing in response to the article titled “An investigation of radon and heavy metal detection for cancer patients in Barji village, in the Iraqi Kurdistan region” by Kareem et al., published in International Journal of Radiation Research (Vol. 23, No. 1, 2025). The authors are to be acknowledged for their attention to a sensitive and pressing public health issue in a historically impacted region. While the study offers relevant preliminary environmental data, I would like to respectfully offer several critical observations that may enhance the interpretative value and scientific robustness of the findings: 511 513 2025/05/262025/05/262025/05/262025/05/262025/05/262025/05/272025/05/272025/05/272025/06/72025/06/72025/06/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/72025/07/122025/07/122025/07/122025/07/122025/07/162025/07/162025/07/162025/07/162025/07/162025/07/162025/07/162025/07/20 1404/4/29 2025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/202025/05/30 1404/3/9 Volkan Çevik Volkan Çevik ## ##