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A prognostic model based on computed tomography radiomics to evaluate response of immunotherapy in non-small cell lung cancer using clinical data 2 2 Background: This study aimed to develop and validate a computed tomography (CT) radiomics–based model for predicting immunotherapy response and prognosis in patients with advanced non-small cell lung cancer (NSCLC). Materials and Methods: A total of 117 patients with advanced NSCLC treated with PD-1/PD-L1 immune checkpoint inhibitors were retrospectively enrolled from two centers. Baseline CT scans obtained before immunotherapy and follow-up CT scans acquired 6–8 weeks after treatment initiation were analyzed. Tumor lesions were manually segmented, and radiomics features were extracted. Two support vector machine–based models were constructed: a pre-treatment CT (pre-CT) model and a delta-CT model derived from changes in radiomics features before and after immunotherapy. Model performance for predicting immunotherapy response, defined according to RECIST 1.1 criteria, was evaluated using receiver operating characteristic (ROC) analysis. Kaplan–Meier survival analysis was performed to assess the prognostic value of radiomics scores. Results: In the training cohort, the pre-CT and delta-CT models achieved area under the ROC curve (AUC) values of 0.825 and 0.844, respectively. In the validation cohort, the delta-CT model demonstrated superior predictive performance (AUC: 0.795) compared with the pre-CT model (AUC: 0.686). Subgroup analysis showed that the delta-CT model performed well in adenocarcinoma patients, whereas the pre-CT model showed better discrimination in squamous cell carcinoma patients. Higher delta-CT radiomics scores were significantly associated with poorer OS and PFS. Conclusion: CT radiomics models, particularly those based on longitudinal changes after immunotherapy, can effectively predict immunotherapy response and prognosis in advanced NSCLC, providing a non-invasive tool to support clinical decision-making. 577 584 2026/08/16 1405/5/25 2026/04/12 1405/1/23 D. Wang D. Wang Department of Thoracic Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 200000, China X. Wang X. Wang Department of Thoracic Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 200000, China Z. Wang Z. Wang Medical Imaging Center, Hefei First People's Hospital, The Third Affliated Hospital of Anhui Medical University, Hefei, Anhui, 230000, China Y. Xu Y. Xu Department of Thoracic Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 200000, China xyd927927@163.com Non-small-cell lung cancer immunotherapy CT radiomics therapeutic effect prognosis. 1. Desai A and Peters S (2023) Immunotherapy-based combinations in metastatic NSCLC. Cancer Treatment Reviews, 116: 102545.##West HJ and Kim JY (2024) Rapid advances in resectable non-small cell lung cancer: A narrative review. JAMA Oncology, 10(2): 249-55.##Sorin M, Prosty C, Ghaleb L, Nie K, Katergi K, Shahzad MH, et al. (2024) Neoadjuvant chemoimmunotherapy for NSCLC: A systematic review and meta-analysis. JAMA Oncology, 10(5): 621-33.##Alduais Y, Zhang H, Fan F, Chen J, Chen B (2023) Non-small cell lung cancer (NSCLC): A review of risk factors, diagnosis, and treatment. Medicine, 102(8): e32899.##Deshpand R, Chandra M, Rauthan A (2022) Evolving trends in lung cancer: Epidemiology, diagnosis, and management. Indian Journal of Cancer, 59(Supplement): S90-s105.##Lahiri A, Maji A, Potdar PD, Singh N, Parikh P, Bisht B, et al. (2023) Lung cancer immunotherapy: progress, pitfalls, and promises. Molecular Cancer, 22(1): 40.##Caii W, Wu X, Guo K, Chen Y, Shi Y, Chen J (2024) Integration of deep learning and habitat radiomics for predicting the response to immunotherapy in NSCLC patients. Cancer Immunology, Immunotherapy: CII, 73(8): 153.##Hu Q, Li K, Yang C, Wang Y, Huang R, Gu M, et al. (2023) The role of artificial intelligence based on PET/CT radiomics in NSCLC: Disease management, opportunities, and challenges. Frontiers in Oncology, 13: 1133164.##Zheng J, Xu S, Wang G, Shi Y (2024) Applications of CT-based radiomics for the prediction of immune checkpoint markers and immunotherapeutic outcomes in non-small cell lung cancer. Front Immunol, 15: 1434171.##Felfli M, Liu Y, Zerka F, Voyton C, Thinnes A, Jacques S, et al. (2023) Systematic review, meta-analysis and radiomics quality score assessment of ct radiomics-based models predicting tumor egfr mutation status in patients with non-small-cell lung cancer. International Journal of Molecular Sciences, 24(14).##Owens C, Hindocha S, Lee R, Millard T, Sharma B (2023) The lung cancers: staging and response, CT, (18)F-FDG PET/CT, MRI, DWI: review and new perspectives. The British Journal of Radiology, 96(1148): 20220339.##Wu L, Lou X, Kong N, Xu M, Gao C (2023) Can quantitative peritumoral CT radiomics features predict the prognosis of patients with non-small cell lung cancer? A systematic review. European Radiology, 33(3): 2105-17.##Wu M, Zhang Y, Zhang J, Zhang Y, Wang Y, Chen F, et al. (2021) A combined-radiomics approach of CT images to predict response to anti-PD-1 immunotherapy in NSCLC: A Retrospective multicenter study. Front Oncol, 11: 688679.##Chen M, Lu H, Copley SJ, Han Y, Logan A, Viola P, et al. (2023) A novel radiogenomics biomarker for predicting treatment response and pneumotoxicity from programmed cell death protein or ligand-1 inhibition immunotherapy in NSCLC. Official publication of the International Association for the Study of Lung Cancer: Journal of Thoracic Oncology, 18(6): 718-30.##Gong J, Bao X, Wang T, Liu J, Peng W, Shi J, et al. (2022) A short-term follow-up CT based radiomics approach to predict response to immunotherapy in advanced non-small-cell lung cancer. Oncoimmunology, 11(1): 2028962.##Lazzari C, Spagnolo CC, Ciappina G, Di Pietro M, Squeri A, Passalacqua MI, et al. (2023) Immunotherapy in early-stage non-small cell lung cancer (NSCLC): Current evidence and perspectives. Current Oncology (Toronto, Ont), 30(4): 3684-96.##Jonna S and Subramaniam DS (2019) Molecular diagnostics and targeted therapies in non-small cell lung cancer (NSCLC): an update. Discovery Medicine, 27(148): 167-70.##Pan F, Feng L, Liu B, Hu Y, Wang Q (2023) Application of radiomics in diagnosis and treatment of lung cancer. Frontiers in Pharmacology, 14: 1295511.##Manafi-Farid R, Askari E, Shiri I, Pirich C, Asadi M, Khateri M, et al. (2022) [(18)F]FDG-PET/CT radiomics and artificial intelligence in lung cancer: Technical aspects and potential clinical applications. Seminars in Nuclear Medicine, 52(6): 759-80.##Tong H, Sun J, Fang J, Zhang M, Liu H, Xia R, et al. (2022) A machine learning model based on PET/CT radiomics and clinical characteristics predicts tumor immune profiles in non-small cell lung cancer: A retrospective multicohort study. Frontiers in Immunology, 13: 859323.##Lin X, Liu Z, Zhou K, Li Y, Huang G, Zhang H, et al. (2025) Intratumoral and peritumoral PET/CT-based radiomics for non-invasively and dynamically predicting immunotherapy response in NSCLC. British Journal of Cancer, 132(6): 558-68.##Jin H, Wang Y, Li X, Yang Y, Qi R (2024) Radiomics nomogram for predicting chemo-immunotherapy efficiency in advanced non-small cell lung cancer. Scientific Reports, 14(1): 20788.##Farina B, Guerra ADR, Bermejo-Peláez D, Miras CP, Peral AA, Madueño GG, et al. (2023) Integration of longitudinal deep-radiomics and clinical data improves the prediction of durable benefits to anti-PD-1/PD-L1 immunotherapy in advanced NSCLC patients. Journal of Translational Medicine, 21(1):174.##Lei Y, Fan W, Liu B, Liao Y, Liu C, Xue S, et al. (2025) Integrated radiomics and immune infiltration analysis to decipher immunotherapy efficacy in lung adenocarcinoma. Quantitative Imaging in Medicine and Surgery, 15(4): 3123-47.##Zhang Y, Yang Y, Ma Y, Liu Y, Ye Z (2024) Development and validation of an interpretable radiomic signature for preoperative estimation of tumor mutational burden in lung adenocarcinoma. Frontiers in Genetics, 15: 1367434.##Mu W, Tunali I, Gray JE, Qi J, Schabath MB, Gillies RJ (2020) Radiomics of (18)F-FDG PET/CT images predicts clinical benefit of advanced NSCLC patients to checkpoint blockade immunotherapy. European Journal of Nuclear Medicine and Molecular Imaging, 47(5): 1168-82.## ##

Expression of miRNA-21 in experimental autoimmune myositis mouse after radiation and its correlation with Th17 /Treg immune imbalance 2 2 Background: Experimental autoimmune myositis (EAM) is characterized by immune-mediated skeletal muscle inflammation. Imbalance between Th17 and regulatory T (Treg) cells contributes to disease pathogenesis. MicroRNA-21 (miR-21) has been implicated in immune regulation and radiation responses, yet its role in EAM remains unclear. This study aimed to investigate the expression of miR-21 following local radiation in a murine EAM model and to assess its correlation with Th17/Treg immune imbalance. Materials and Methods: Female C57BL/6 mice were induced with EAM and randomized into control and radiation groups. Local hindlimb irradiation (15 Gy) was administered to the radiation group. Muscle tissues and draining lymph nodes were collected at day 28 post-induction. Flow cytometry quantified Th17 (CD4⁺IL-17A⁺) and Treg (CD4⁺FoxP3⁺) populations. Quantitative real-time PCR measured miR-21 expression in muscle samples. Correlations between miR-21 levels and Th17/Treg ratios were analyzed. Results: Radiation significantly reduced muscle inflammation and improved histopathological scores compared to non-irradiated EAM mice (p<0.05). Th17 frequencies decreased while Treg frequencies increased following irradiation (p<0.01). miR-21 expression was significantly downregulated in irradiated muscle tissues (p<0.01). Notably, miR-21 levels showed a positive correlation with Th17/Treg ratios (r=0.68, p<0.01). Conclusion: Local radiation modulates immune responses in EAM by downregulating miR-21 and restoring Th17/Treg balance, suggesting a potential therapeutic mechanism involving miR-21-mediated immune regulation. 585 590 2026/08/162026/08/16 1405/5/25 2026/04/122026/07/28 1405/5/6 L. Wang L. Wang Department of Neurology, Ningbo No.2 Hospital, Ningbo 315000, China Q. Ye Q. Ye Department of Pulmonology, Ningbo No.2 Hospital, Ningbo 315000, China W. Yan W. Yan Department of Neurology, Ningbo No.2 Hospital, Ningbo 315000, China Yw961804121@163.com Experimental autoimmune myositis miR-21 Th17 cells regulatory T-cells immune imbalance radiation. 1. Dalakas MC (2015) Inflammatory Muscle Diseases. New England Journal of Medicine, 372(18): 1734-47.##Figarella‐Branger D, Civatte M, Bartoli C, Pellissier JF (2003) Cytokines, chemokines, and cell adhesion molecules in inflammatory myopathies. Muscle & Nerve, 28(6): 659-82.##Mandel D, Malemud C, Askari A (2017) Idiopathic inflammatory myopathies: A review of the classification and impact of pathogenesis. Int J Molecular Sciences, 18(5): 1084.##Dalakas MC (2011) Pathophysiology of inflammatory and autoimmune myopathies. La Presse Médicale, 40(4): e237-e47.##Espinosa-Ortega F, Gómez-Martin D, Santana-De Anda K, Romo-Tena J, Villaseñor-Ovies P, Alcocer-Varela J (2015) Quantitative T-cell subsets profile in peripheral blood from patients with idiopathic inflammatory myopathies: tilting the balance towards proinflammatory and pro-apoptotic subsets. Clinical and Experimental Immunology, 179(3): 520-8.##Moran EM and Mastaglia FL (2014) The role of interleukin-17 in immune-mediated inflammatory myopathies and possible therapeutic implications. Neuromuscular Disorders, 24(11): 943-52.##Miossec P and Kolls JK (2012) Targeting IL-17 and TH17 cells in chronic inflammation. Nature Reviews Drug Discovery, 11(10): 763-76.##van Loosdregt J, Vercoulen Y, Guichelaar T, Gent YYJ, Beekman JM, van Beekum O, et al. (2010) Regulation of Treg functionality by acetylation-mediated Foxp3 protein stabilization. Blood, 115(5): 965-74.##Zhu S, Pan W, Qian Y (2013) MicroRNA in immunity and autoimmunity. Journal of Molecular Medicine, 91(9): 1039-50.##Yan W, Chen C, Chen H (2016) Estrogen downregulates miR-21 expression and induces inflammatory infiltration of macrophages in polymyositis: Role of CXCL10. Molecular Neurobiology, 54(3): 1631-41.##Allenbach Y, Solly S, Grégoire S, Dubourg O, Salomon B, Butler-Browne G, et al. (2009) Role of regulatory T Cells in a new mouse model of experimental autoimmune myositis. The American Journal of Pathology, 174(3): 989-98.##Lennon VA, Lindstrom JM, Seybold ME (1975) Experimental autoimmune myasthenia: A model of myasthenia gravis in rats and guinea pigs. The Journal of Experimental Medicine, 141(6):1365-75.##Coughenour LL, McLean JR, Parker RB (1977) A new device for the rapid measurement of impaired motor function in mice. Pharmacology Biochemistry and Behavior, 6(3): 351-3.##Kojima T, Tanuma N, Aikawa Y, Shin T, Sasaki A, Matsumoto Y (1997) Myosin-induced autoimmune polymyositis in the rat. Journal of the Neurological Sciences, 151(2): 141-8.##Fiedler SD, Carletti MZ, Christenson LK (2010) Quantitative RT-PCR methods for mature microRNA expression analysis. Methods Mol Biol, 630: 49-64.##Liu C, Li B, Cheng Y, Lin J, Hao J, Zhang S, et al. (2011) MiR-21 plays an important role in radiation induced carcinogenesis in BALB/c mice by directly targeting the tumor suppressor gene Big-h3. Int J Biol Sci, 7(3): 347-63.##Noack M and Miossec P (2014) Th17 and regulatory T-cell balance in autoimmune and inflammatory diseases. Autoimmunity Reviews, 13(6): 668-77.##Shen H, Xia L, Lu J, Xiao W (2011) Interleukin-17 and interleukin-23 in patients with polymyositis and dermatomyositis. Scandinavian Journal of Rheumatology, 40(3): 217-20.##Huo Yuping YH (2013) Detection and significance of peripheral blood regulatory T cells/helper T cells 17 in patients with dermatomyositis. Chinese Journal of Rheumatology, 17(2): 3.##Bartel DP (2004) MicroRNAs. Cell, 116(2): 281-97.##Zhou X, Jeker LT, Fife BT, Zhu S, Anderson MS, McManus MT, et al. (2008) Selective miRNA disruption in T reg cells leads to uncontrolled autoimmunity. The Journal of Experimental Medicine, 205(9): 1983-91.##Hirai T, Ikeda K, Tsushima H, Fujishiro M, Hayakawa K, Yoshida Y, et al. (2018) Circulating plasma microRNA profiling in patients with polymyositis/dermatomyositis before and after treatment: miRNA may be associated with polymyositis/dermatomyositis. Inflammation and Regeneration, 38(1): 1.##Parkes JE, Day PJ, Chinoy H, Lamb JA (2015) The role of microRNAs in the idiopathic inflammatory myopathies. Current Opinion in Rheumatology, 27(6): 608-15.##Shimada S JM, Ogata A (2012) Serum miR-21 levels in patients with dermatomyositis. Clinical and Experimental Rheumatology, 31(1): 161.##Liston A, Linterman M, Lu L-F (2010) MicroRNA in the Adaptive Immune System, in Sickness and in Health. Journal of Clinical Immunology, 30(3): 339-46.##Dai R and Ahmed SA (2011) MicroRNA, a new paradigm for understanding immunoregulation, inflammation, and autoimmune diseases. Translational Research, 157(4): 163-79.##Rouas R, Fayyad‐Kazan H, El Zein N, Lewalle P, Rothé F, Simion A, et al. (2009) Human natural Treg microRNA signature: Role of microRNA‐31 and microRNA‐21 in FOXP3 expression. European Journal of Immunology, 39(6): 1608-18.##Murugaiyan G, da Cunha AP, Ajay AK, Joller N, Garo LP, Kumaradevan S, et al. (2015) MicroRNA-21 promotes Th17 differentiation and mediates experimental autoimmune encephalomyelitis. Journal of Clinical Investigation, 125(3): 1069-80.##Venugopal P, Koshy T, Lavu V, Ranga Rao S, Ramasamy S, Hariharan S, et al. 2018Differential expression of microRNAs let‐7a, miR‐125b, miR‐100, and miR‐21 and interaction with NF‐kB pathway genes in periodontitis pathogenesis. Journal of Cellular Physiology, 233(8): 5877-84.##Rayavarapu S, Coley W, Kinder TB, Nagaraju K (2013) Idiopathic inflammatory myopathies: pathogenic mechanisms of muscle weakness. Skeletal Muscle, 3(1): 13.##Ruan Q and Chen YH (2011) Nuclear factor-κB in immunity and inflammation: The treg and Th17 connection. Advances in Experimental Medicine and Biology: Springer New York, p. 207-21.##Selva-O'Callaghan A, Pinal-Fernandez I, Trallero-Araguás E, Milisenda JC, Grau-Junyent JM, Mammen AL (2018) Classification and management of adult inflammatory myopathies. The Lancet Neurology, 17(9): 816-28.##Yang Z, Lin F, Qin B, Liang Y, Zhong R (2014) Polymyositis/dermatomyositis and Malignancy Risk: A Metaanalysis Study. The Journal of Rheumatology, 42(2): 282-91.##Pauley KM, Cha S, Chan EKL (2009) MicroRNA in autoimmunity and autoimmune diseases. Journal of Autoimmunity, 32(3-4): 189-94.##Chung KH (2006) Polycistronic RNA polymerase II expression vectors for RNA interference based on BIC/miR-155. 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Effectiveness of combined targeted muscle botulinum toxin type A injection, electroacupuncture, and radiotherapy in improving pain and muscle tone in patients with post-stroke upper limb spasticity 2 2 Background: Post-stroke upper limb spasticity (ULS) significantly impairs motor function and quality of life. While botulinum toxin type A (BTX-A) injections reduce muscle tone peripherally, electroacupuncture modulates central neural activity, and radiotherapy offers anti-inflammatory and neuromodulatory effects. This study evaluates the synergistic efficacy of combining these modalities. Materials and Methods: In this randomized controlled trial, 112 patients with post-stroke ULS were allocated to an experimental group (AG: BTX-A + electroacupuncture + radiotherapy, n=56) or control group (BG: BTX-A + electroacupuncture, n=56). BTX-A (Botox, Allergan) was injected into targeted muscles, electroacupuncture applied at specific acupoints, and radiotherapy delivered using low-dose ionizing radiation (Beijing Huayu Radiotherapy System, China) at 2 Gy/fraction for 10 sessions. Primary outcomes: Modified Ashworth Scale (MAS) for muscle tone and Visual Analogue Scale (VAS) for pain. Secondary outcomes: Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and Modified Barthel Index (MBI). Assessments at baseline, 2, 4, and 12 weeks. Results: MAS scores improved significantly in AG vs. BG (mean difference at 12 weeks: 1.2 points, P=0.008). VAS scores reduced more in AG (mean reduction: 3.5 points at 12 weeks, P=0.005). FMA-UE total scores increased by 12.4 points in AG vs. 7.8 in BG (P=0.012). MBI scores showed greater gains in AG (mean increase: 15.2 points, P=0.010). Radiotherapy contributed to 25% additional improvement in tone and pain metrics. Adverse events were comparable (32% AG vs. 30% BG). Conclusion: The triple combination therapy markedly enhances muscle tone, pain relief, and motor function in post-stroke ULS, with radiotherapy providing key synergistic benefits. 591 597 2026/08/162026/08/162026/08/16 1405/5/25 2026/04/122026/07/282026/07/28 1405/5/6 W. Wang W. Wang Department of Rehabilitation Medicine, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou 225300, Jiangsu Province, China S. Wang S. Wang Department of Rehabilitation Medicine, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou 225300, Jiangsu Province, China T. Tang T. Tang Department of Traditional Chinese Medicine, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou 225300, Jiangsu Province, China Y. Zhao Y. Zhao Department of Neurology, Taizhou Fourth People's Hospital, Taizhou 225300, Jiangsu Province, China jswwj1991@163.com Stroke muscle spasticity botulinum toxins type A electroacupuncture radiotherapy. 1. Feigin VL, Brainin M, Norrving B, Martins SO, Pandian J, Lindsay P, et al. (2025) World stroke organization: Global Stroke Fact Sheet 2025. Int J Stroke, 20(2): 132-44.##Potter TBH, Tannous J, Vahidy FS (2022) A contemporary review of epidemiology, risk factors, etiology, and outcomes of premature stroke. Current Atherosclerosis Reports, 24(12): 939-48.##Simpson HD, Duffy JR, Stierwalt JAG, Ahlskog JE, Hassan A (2022) Speech-induced action myoclonus. Parkinsonism ;, Related Disorders, 98: 41-6.##Mihai EE, Popescu MN, Iliescu AN, Berteanu M (2022) A systematic review on extracorporeal shock wave therapy and botulinum toxin for spasticity treatment: a comparison on efficacy. European J Physical and Rehabilitation Medicine, 58(4).##Zhou J, Jia F, Chen P, Zhou G, Wang M, Wu J, et al. (2023) Localisation of the centre of the highest region of muscle spindle abundance of anterior forearm muscles. Journal of Anatomy, 244(5): 803-14.##Jin Z, Zhang W, Liu H, Ding A, Lin Y, Wu S-X, et al. (2022) Potential therapeutic application of local anesthetics in cancer treatment. Recent Patents on Anti-Cancer Drug Discovery, 17(4): 326-42.##Liu F, Chen Y, Huang K (2024) Electro-acupuncture suppresses ferroptosis to alleviate cerebral ischemia-reperfusion injury through KAT3B-mediated succinylation of ACSL4. Applied Biochemistry and Biotechnology, 197(2): 989-1001.##Zhang W, Jin H-T, Wang F, Zhang J-L, Bao Y, Wang S (2024) A randomized controlled study investigating the efficacy of electro-acupuncture and exercise-based swallowing rehabilitation for post-stroke dysphagia: Impacts on brainstem auditory evoked potentials and cerebral blood flow. Medicine, 103(11): e37464.##Bian M, Chen F, Su H, Li Z, Sun X, Liu Y, et al. (2025) Comparison of the effects of different physical stimulation therapies on reducing upper limb spastic paralysis and motor dysfunction in stroke survivors after stroke: a network meta-analysis of randomized controlled trials. Frontiers in Neurology, 16.##Fox C (2023) Pediatric ischemic stroke. Continuum, 29(2): 566-83.##Wissel J, Ri S, Kivi A (2023) Early versus late injections of Botulinumtoxin type A in post-stroke spastic movement disorder: A literature review. Toxicon, 229: 107150.##Struyf P, Triccas LT, Schillebeeckx F, Struyf F (2023) The Place of Botulinum Toxin in Spastic Hemiplegic Shoulder Pain after Stroke: A Scoping Review. Int J Environ Res and Public Health, 20(4): 2797.##Picelli A, Tamburin S, Di Censo R, Smania N, Filippetti M (2024) Does the diffusion profile differ between botulinum toxin type a formulations? Implications for the Management of Post-Stroke Spasticity. Toxins, 16(11): 480.##Falcone N, Leo F, Chisari C, Dalise S (2024) Long-term management of post-stroke spasticity with botulinum toxin: A retrospective study. Toxins, 16(9): 383.##Hokazono A, Etoh S, Jonoshita Y, Kawahira K, Shimodozono M (2022) Combination therapy with repetitive facilitative exercise program and botulinum toxin type A to improve motor function for the upper-limb spastic paresis in chronic stroke: A randomized controlled trial. Journal of Hand Therapy, 35(4): 507-15.##Hu J-C, Hsu L-N, Lee W-C, Chuang Y-C, Wang H-J (2023) Role of urological botulinum toxin-A injection for overactive bladder and voiding dysfunction in patients with parkinson's disease or post-stroke. Toxins, 15(2): 166.##Xu Q, Xiao H, Zhu Z, Guan Y, Wang Y (2025) Research progress in the use of botulinum toxin type a for post-stroke spasticity rehabilitation: a narrative review. Annals of Medicine, 57(1): 2521427.##Zoli M, Guaraldi F, Rustici A, Cirillo L, Asioli S, Mazzatenta D (2022) Bilateral antererior circulation stroke: A rare but threatening consequence of pituitary apoplexy. Case report and systematic literature review. The Neuroradiology Journal, 36(6): 746-51.##Liu Y, Wang Q, Hou Z, Gao Y, Li P (2025) Electroacupuncture inhibits ferroptosis by modulating iron metabolism and oxidative stress to alleviate cerebral ischemia-reperfusion injury. Journal of Molecular Neuroscience, 75(2).##He L, Azizad D, Bhat K, Ioannidis A, Hoffmann CJ, Arambula E, et al. (2024) Radiation-induced cellular plasticity: A strategy for combatting glioblastoma. Cold Spring Harbor Laboratory; 2024.##Liu H and Tang T (2023) Pan-cancer genetic analysis of disulfidptosis-related gene set. Cancer Genet, 278-279: 91-103.## ##

Impact of modified concave lithotomy position on respiratory mechanics and hemodynamics in patients undergoing three-dimensional laparoscopic radical resection and radiotherapy for rectal cancer 2 2 Background: Preoperative pelvic radiotherapy for rectal cancer can induce tissue fibrosis and impair cardiopulmonary reserve, complicating perioperative management. Modified concave lithotomy positioning may help mitigate these challenges. This study evaluated the influence of preoperative radiotherapy and modified concave lithotomy position on intraoperative respiratory mechanics and hemodynamics in rectal cancer patients. Materials and Methods: Eighty patients with rectal cancer who had received standardized neoadjuvant radiotherapy were randomly divided into two groups: observation group (modified concave lithotomy position) and control group (traditional lithotomy position). Respiratory and circulatory parameters were recorded at key intraoperative time points, along with operation time, blood loss, complications, and recovery indicators. Results: At 30 min after surgery through the end of operation, peak inspiratory pressure, plateau pressure, and mean airway pressure were significantly lower, while dynamic and static lung compliance were higher in the modified position group. Heart rate and central venous pressure were lower, and mean arterial pressure was higher in the modified group (P<0.05). Operation time, blood loss, and complication rates were reduced, with faster postoperative recovery. Subgroup analysis indicated that patients with radiation-induced pelvic fibrosis had decreased lung compliance overall, but the modified position partially alleviated this effect. Conclusion: In rectal cancer patients following preoperative radiotherapy, modified concave lithotomy positioning improves intraoperative respiratory mechanics, stabilizes hemodynamics, and promotes safer perioperative outcomes. These findings emphasize the importance of individualized positioning strategies for radiotherapy-treated surgical patients. 599 608 2026/08/162026/08/162026/08/162026/08/16 1405/5/25 2026/04/122026/07/282026/07/282026/07/28 1405/5/6 H. Cui H. Cui Department of Anesthesiology and Surgery, Jianhu County People's Hospital, Yancheng 224700, Jiangsu Province, China T. Qiao T. Qiao Department of Anesthesiology and Surgery, Jianhu County People's Hospital, Yancheng 224700, Jiangsu Province, China X. Zhu X. Zhu Department of Anesthesiology and Surgery, Jianhu County People's Hospital, Yancheng 224700, Jiangsu Province, China 13961903707@163.com Radiotherapy adjuvant rectal neoplasms patient positioning respiratory mechanics hemodynamics intraoperative care. Zhang T (2025) Global regional, and national trends in colorectal cancer burden from 1990 to 2021 and projections to 2040. Front Oncol, 14: 1466159.##Jiang X, Lv G, Yuan J, Lu K (2025) Colorectal cancer burden, trends, and risk factors in China: rising incidence and disparities in the last 3 decades. Lancet Reg Health West Pac, 55(Suppl 1): 101427.##Zhan S, Zhu Z, Yu H, Xia Y, Zhu Y, Wu F, et al. (2024) Comparison of therapeutic effects between conventional 2D laparoscopy and 3D laparoscopy in the treatment of colorectal cancer: a systematic review and meta-analysis. Am Surg, 90(11): 3102-3112.##Nguyen TX and Pham NH (2023) Three-dimensional laparoscopic surgery for colorectal cancer: a 2-year follow-up study at Hue Central Hospital. Surg Open Sci, 17: 35-39.##Zhang Y, Zhu J, Xi C, Wang G (2025) Effect of driving pressure-guided individualized positive end-expiratory pressure (PEEP) ventilation strategy on postoperative atelectasis in patients undergoing laparoscopic surgery as assessed by ultrasonography: study protocol for a prospective randomized controlled trial. Trials, 26(1): 106.##Hara K, Ichihara K, Yamaguchi M, Takeshita H, Kuroki T (2022) Effect of intraoperative operating table rotation on lower limb perfusion index in patients in the lithotomy position. Medicine (Baltimore), 101(38): e30412.##Yukizawa Y, Kamono E, Takagawa S, Hirotomi K, Higashihira S, Choe H, et al. (2024) Evaluation of the postoperative risk of deep tissue injury to the lower extremities following surgery in the lithotomy position. 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Meta-analysis of the correlation between MRI radiomics and HER2 overexpression in breast cancer 2 2 Background: To evaluate the diagnostic efficacy of Magnetic resonance imaging (MRI) radiomics in predicting the overexpression of Human Epidermal Growth Factor Receptor 2(HER2) in breast cancer via meta-analysis, so as to investigate the correlation between MRI radiomics and HER2 overexpression in breast cancer. Materials and Methods: PubMed, Embase, and Web of Science were searched for studies on radiomics and HER2 overexpression in breast cancer (inception–September 2025). Two reviewers independently screened literature, extracted data, and assessed quality (RevMan 5.3). Pooled sensitivity (SEN), specificity (SPE), and AUC were calculated (Stata 17.0). Heterogeneity and bias were evaluated via subgroup/sensitivity analyses and Deeks’ test. Results: 13 studies (4,756 patients) were included. The training set showed pooled SEN 0.90(95%CI:0.81-0.95), SPE 0.82(95%CI:0.72-0.89), and AUC 0.92(95%CI:0.90-0.94). The validation set had SEN 0.74(95%CI:0.62-0.83), SPE 0.80(95%CI:0.70-0.87), and AUC 0.84(95%CI:0.80-0.87). Heterogeneity (I²> 75%) stemmed from sample size and country differences (both P<0.05). Fagan’s plot indicated radiomics increased HER2 overexpression post-test probability to 48%-56% (from 20% pre-test) and reduced negative results to 3%-8%. Sensitivity analysis confirmed robustness; no publication bias was detected (P>0.05). Conclusion: MRI Radiomics correlates with HER2 overexpression in breast cancer and demonstrates high diagnostic accuracy, offering a novel approach for HER2 evaluation. 609 617 2026/08/162026/08/162026/08/162026/08/162026/08/16 1405/5/25 2026/04/122026/07/282026/07/282026/07/282026/07/28 1405/5/6 Q. Lin Q. Lin Department of Ultrasound in Medicine, Ningbo Medical Center Lihuili Hospital, No.1111, Jiangnan Road, Yinzhou District, Ningbo 315048, Zhejiang Province, China X. Kong X. Kong Department of Ultrasound in Medicine, Ningbo Medical Center Lihuili Hospital, No.1111, Jiangnan Road, Yinzhou District, Ningbo 315048, Zhejiang Province, China Y. Yan Y. Yan Department of Ultrasound in Medicine, Ningbo Medical Center Lihuili Hospital, No.1111, Jiangnan Road, Yinzhou District, Ningbo 315048, Zhejiang Province, China yanyun_1975@163.com MRI Radiomics correlates with HER2 overexpression in breast cancer and demonstrates high diagnostic accuracy offering a novel approach for HER2 evaluation. Arnold M, Morgan E, Rumgay H, et al. (2022) Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast, 66 :15-23.##Yoon J, Oh DY (2024) HER2-targeted therapies beyond breast cancer - an update. Nat Rev Clin Oncol, 21(9):675-700.##Kunte S, Abraham J, Montero AJ (2020) Novel HER2-targeted therapies for HER2-positive metastatic breast cancer. Cancer,126(19): 4278-4288.##Spaziani S, Esposito A, Barisciano G, et al. (2024) Combined SERS-Raman screening of HER2-overexpressing or silenced breast cancer cell lines. J Nanobiotechnology, 22(1): 350.##Nguyen HT, Migliozzi D, Bisig B, et al. (2019) High-content, cell-by-cell assessment of HER2 overexpression and amplification: a tool for intratumoral heterogeneity detection in breast cancer. Lab Invest, 99(5): 722-732.##Conti A, Duggento A, Indovina I, et al. (2021) Radiomics in breast cancer classification and prediction. Semin Cancer Biol, 72: 238-250.##Wang H, Sang L, Xu J, et al. (2024) Multiparametric MRI-based radiomic nomogram for predicting HER-2 2+ status of breast cancer. Heliyon, 10(9): e29875.##Shen L, Li Y, Huang H, et al. (2024) HER2 in Gastric Cancer: A Comprehensive Analysis Combining Meta-Analysis and DCE-MRI Radiomics. Cancer Control, 31: 10732748241293699.##Wolff AC, Hammond MEH, Allison KH, et al. (2018) Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update. J Clin Oncol, 36(20): 2105-2122.##Whiting PF, Rutjes AW, Westwood ME, et al. (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 155(8): 529-36.##Zheng S, Yang Z, Du G, et al. (2024) Discrimination between HER2-overexpressing, -low-expressing, and -zero-expressing statuses in breast cancer using multiparametric MRI-based radiomics. Eur Radiol, 34(9): 6132-6144.##Bitencourt AGV, Gibbs P, Rossi Saccarelli C, et al. (2020) MRI-based machine learning radiomics can predict HER2 expression level and pathologic response after neoadjuvant therapy in HER2 overexpressing breast cancer. EBioMedicine, 61: 103042.##Guo Y, Xie X, Tang W, et al. (2024) Noninvasive identification of HER2-low-positive status by MRI-based deep learning radiomics predicts the disease-free survival of patients with breast cancer. Eur Radiol, 34(2): 899-913.##Song X, Xu H, Wang X, et al. (2024) Use of ultrasound imaging Omics in predicting molecular typing and assessing the risk of postoperative recurrence in breast cancer. BMC Womens Health, 24(1): 380.##Sheng W, Xia S, Wang Y, et al. (2022) Invasive ductal breast cancer molecular subtype prediction by MRI radiomic and clinical features based on machine learning. Front Oncol, 12: 964605.##Jeong J, Ham S, Seo BK, et al. (2025) Superior performance in classification of breast cancer molecular subtype and histological factors by radiomics based on ultrafast MRI over standard MRI: evidence from a prospective study. Radiol Med, 130(3): 368-380.##Xu A, Chu X, Zhang S, et al. (2022) Development and validation of a clinicoradiomic nomogram to assess the HER2 status of patients with invasive ductal carcinoma. BMC Cancer, 22(1):872.##Luo HJ, Ren JL, Mei Guo L, et al. (2024) MRI-based machine learning radiomics for prediction of HER2 expression status in breast invasive ductal carcinoma. Eur J Radiol Open, 13:100592.##Huang Y, Zhu T, Zhang X, et al. (2023) Longitudinal MRI-based fusion novel model predicts pathological complete response in breast cancer treated with neoadjuvant chemotherapy: a multicenter, retrospective study. EClinicalMedicine, 58: 101899.##Yue WY, Zhang HT, Gao S, et al. (2023) Predicting breast cancer subtypes using magnetic resonance imaging based radiomics with automatic segmentation. J Comput Assist Tomogr, 47(5): 729-737.##Shang Y, Wang Y, Guo Y, et al. (2024) The Clinical Study of Intratumoral and Peritumoral Radiomics Based on DCE-MRI for HER-2 Positive and Low Expression Prediction in Breast Cancer. Breast Cancer (Dove Med Press), 16: 957-972.##Chen X, Li M, Liang X, et al. (2025) Machine learning model based on the radiomics features of CE-CBBCT shows promising predictive ability for HER2-positive BC. Medicine (Baltimore), 104(37): e44300.##Huang Y, Wei L, Hu Y, et al. (2021) Multi-Parametric MRI-Based Radiomics Models for Predicting Molecular Subtype and Androgen Receptor Expression in Breast Cancer. Front Oncol, 11: 706733.##Gillies RJ, Anderson AR, Gatenby RA, et al. (2010) The biology underlying molecular imaging in oncology: from genome to anatome and back again. Clin Radiol, 65(7): 517-21.##Lambin P, Leijenaar RTH, Deist TM, et al. (2017) Radiomics: the bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol, 4(12): 749-762.##Guiot J, Vaidyanathan A, Deprez L, et al. (2022) A review in radiomics: Making personalized medicine a reality via routine imaging. Med Res Rev, 42(1): 426-440.##Rogers W, Thulasi Seetha S, Refaee TAG, et al. (2020) Radiomics: from qualitative to quantitative imaging. Br J Radiol, 93(1108): 20190948.##Zhou J, Yu X, Wu Q, et al. (2024) Radiomics analysis of intratumoral and different peritumoral regions from multiparametric MRI for evaluating HER2 status of breast cancer: A comparative study. Heliyon, 10(7): e28722.##Ramtohul T, Djerroudi L, Lissavalid E, et al. (2023) Multiparametric MRI and Radiomics for the Prediction of HER2-Zero, -Low, and -Positive Breast Cancers. Radiology, 308(2): e222646.##Ma T, Cui J, Wang L, et al. (2022) A CT-based radiomics signature for prediction of HER2 overexpression and treatment efficacy of trastuzumab in advanced gastric cancer. Transl Cancer Res, 11(12):4326-4337.##Fu Y, Zhou J, Li J (2024) Diagnostic performance of ultrasound-based artificial intelligence for predicting key molecular markers in breast cancer: A systematic review and meta-analysis. PLoS One, 19(5): e0303669.##Zhang L, Cui QX, Zhou LQ, et al. (2024) MRI-based vector radiomics for predicting breast cancer HER2 status and its changes after neoadjuvant therapy. Comput Med Imaging Graph, 118: 102443.##Zhang Y, Huang H, Yin L, et al. (2024) Preoperative prediction of HER-2 expression status in breast cancer based on MRI radiomics model. Zhonghua Zhong Liu Za Zhi, 46(5): 428-437.##Deng K, Chen T, Leng Z, et al. (2024) Radiomics as a tool for prognostic prediction in transarterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis. Radiol Med, 129(8): 1099-1117.##Abbaspour E, Karimzadhagh S, Monsef A, et al. (2024) Application of radiomics for preoperative prediction of lymph node metastasis in colorectal cancer: a systematic review and meta-analysis. Int J Surg, 110(6): 3795-3813.##Dong F, Li J, Wang J, et al. (2024) Diagnostic performance of DCE-MRI radiomics in predicting axillary lymph node metastasis in breast cancer patients: A meta-analysis. 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Clinical features and prognostic analysis of early-onset gastric cancer treated with radiotherapy 2 2 Background: This study examines the clinicopathological characteristics, recurrence patterns, and survival outcomes of early-onset gastric cancer (EOGC) patients treated with radiotherapy, comparing them with non-early-onset gastric cancer (NEOGC) patients to evaluate prognostic differences and the effectiveness of radiotherapy-based treatments. Materials and Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015), analyzing 814 EOGC and 4,997 NEOGC patients who underwent radiotherapy. Descriptive statistics characterized clinical and pathological features. Kaplan-Meier survival analysis and log-rank tests compared overall survival (OS). Cox proportional hazards regression models identified independent prognostic factors. Results: EOGC patients showed a higher proportion of females (42.3%) and advanced-stage disease (44.3%) compared to NEOGC. Signet-ring cell carcinoma was more prevalent in EOGC (26.8% vs. 14.7%, P < 0.001). Tumors in EOGC were predominantly located in the gastric body, fundus, and greater curvature (P < 0.001). Adjuvant radiotherapy was more common in EOGC (78.9% vs. 68.3%, P < 0.001). Survival analysis indicated that radiotherapy alone provided superior OS compared to combined chemoradiotherapy or surgery-radiotherapy approaches. Cox regression identified tumor stage, histological subtype, and radiotherapy modality as key prognostic factors. Conclusion: EOGC treated with radiotherapy exhibits distinct clinicopathological features, including more aggressive histological subtypes. Radiotherapy as monotherapy offers better long-term survival than multimodal treatments. These findings underscore the need for personalized radiotherapy strategies to optimize prognosis in EOGC. 619 625 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/16 1405/5/25 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 X. Kang X. Kang Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou, 014000, China X. Meng X. Meng Department of Gastroenterology, Second Affiliated Hospital of Baotou Medical College, Baotou, 014000, China G. Guo G. Guo Interventional Department, Second Affiliated Hospital of Baotou Medical College, Baotou, 014000, China Y. Nian Y. Nian Department of Gastroenterology, Second Affiliated Hospital of Baotou Medical College, Baotou, 014000, China nianyuanyuannina@163.com Early-onset gastric cancer stomach neoplasms radiotherapy prognosis survival analysis. 1. Rawla P and Barsouk A (2019) Epidemiology of gastric cancer: global trends, risk factors and prevention. 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(2025) Prognosis and distant metastasis patterns of early-onset gastric cancer compared with late-onset: a large-scale, cross-population retrospective study. Journal of Gastrointestinal Surgery, 29(9): 102148.##Zhang C, Tang R, Zhu H, Ge X, Wang Y, Wang X, et al. (2022) Comparison of treatment strategies and survival of early-onset gastric cancer: a population-based study. Scientific Reports, 12(1): 6288.##Angelicone I, de Giacomo F, Priore A, Rotondi M, Facondo G, Osti MF (2023) Radiotherapy in gastric cancer: does it still play a significant role? Digestive Medicine Research, 6.##Yu JI (2023) Role of adjuvant radiotherapy in gastric cancer. J Gastric Cancer, 23(1): 194-206.##Petrillo A, Federico P, Marte G, Liguori C, Seeber A, Ottaviano M, et al. (2023) Non-hereditary early onset gastric cancer: An unmet medical need. Current Opinion in Pharmacology, 68:102344.##McPhail S, Barclay ME, Swann R, Johnson SA, Alvi R, Barisic A, et al. 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(2001) Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. New England J Medicine, 345(10): 725-30.##Lee J, Lim DH, Kim S, Park SH, Park JO, Park YS, et al. (2012) Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial. J Clinical Oncology, 30(3): 268-73.##Yin S, Zhai X, Li Y, Zeng R, Zhang D, Sun X, et al. (2025) Bone metastasis mediates poor prognosis in early‐onset gastric cancer: Insights into immune suppression, coagulopathy, and inflammation. Cancer Medicine, 14(5): e70737.##Niu P, Huang H, Zhao L, Wang T, Zhang X, Wang W, et al. (2022) Clinicopathological characteristics, survival outcomes, and genetic alterations of younger patients with gastric cancer: Results from the China National Cancer Center and cBioPortal datasets. 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Methionine deprivation enhances the radiosensitivity of glioma cells and promotes ionizing radiation-induced immunogenic cell death via the endoplasmic reticulum stress signaling pathway 2 2 Background: Methionine deprivation (MD) affects protein stability, signaling pathway activation and redox status of cancerous cells. In this study, we investigated the effects of MD on the radiosensitivity and radiation-induced immunogenic death of glioma cells and the underlying mechanism. Materials and Methods: Human glioma cells, U251 and T98G, were cultured in DMEM medium with or without methionine under normoxia or hypoxia (1% O2). Cell proliferation, radiosensitivity, and DNA damage repair were detected by EdU assay, colony formation assay, γ-H2AX immunofluorescence staining and single-cell gel electrophoresis, respectively. Cell apoptosis and surface exposure of calreticulin (CRT) were detected via flow cytometry. The expression of autophagy-related proteins microtubule-associated protein 1 light chain 3 (LC3) and P62 and endoplasmic reticulum stress (ERS) pathway-related proteins PKR-like endoplasmic reticulum kinase (PERK) and inositol requiring enzyme 1 alpha (IRE1α) was detected via Western blotting. Results: MD inhibited the proliferation of normoxic or hypoxic glioma cells. MD combined with radiation promoted apoptosis and increased the number of γ-H2AX foci and the percentage of DNA in the tail of the comet. MD enhanced the radiosensitivity of normoxic or hypoxic glioma cells, which was further enhanced when combined with the autophagy inhibitor 3-methyladenine (3-MA). MD enhanced the transformation of LC3 I to LC3 II and decreased the expression of P62. MD also increased radiation-induced CRT exposure, ATP release and PERK and IRE1α phosphorylation. Conclusion: MD enhanced the radiosensitivity of glioma cells by inhibiting DNA repair and promoted ionizing radiation-induced immunogenic cell death through activating the ERS signaling pathway. 627 639 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/16 1405/5/25 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 S. Yang S. Yang State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, Jiangsu, China H. Qin H. Qin Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China X. Jiang X. Jiang State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, Jiangsu, China X. Xue X. Xue State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, Jiangsu, China H. Tan H. Tan State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, Jiangsu, China B. Wang B. Wang Department of Oncology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China T. Sun T. Sun Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China W. Yang W. Yang State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, Jiangsu, China detachedy@aliyun.com Methionine glioma autophagy radiosensitivity immunogenic cell death. Ruan J, Qin Z, Chen P, Chen Y, Fang J, Tang H (2025) Paeonol combined with radiotherapy inhibits the growth of human glioblastoma by inhibiting the two angiogenesis pathways of VEGF/VEGFR and ANG/Tie-2 in-vitro. Int J Radiat Res, 23(3): 643-650.##Zhu H, Luo J (2023) Postoperative intensity-modulated radiotherapy and chemotherapy in patients with high-grade glioma: analysis of efficacy and prognostic factors. Int J Radiat Res, 21(1): 139-145.##Singh S, Dey D, Barik D, Mohapatra I, Kim S, Sharma M, et al. 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Measurement of equivalent organ doses received by medical personnel during coronary intervention procedures using Geant4 Application for Tomographic Emission (GATE) 2 2 Background: This study aims to measure the equivalent organ doses received by medical personnel during the coronary intervention procedure using Monte Carlo Geant4 Application for Tomographic Emission (GATE) simulation. Materials and Methods: The specific dimension of the angiography room was recorded from the Department of Diagnostic Radiology at Singapore General Hospital to generate the angiography room geometry in GATE. ICRP phantom was utilized to represent the medical personnel whereas MIRD phantom was used to represent the patient on the tabletop. Dose received by medical personnel were recorded at anterior posterior (AP) exposure projection at 73 kVp and 350 mAs for all the rooms. Results: The study revealed variations in the equivalent doses received by medical personnel across different room configurations. The highest dose variation was observed in the right and left lens, with the IR1 exhibiting the greatest exposure. Conclusion: This highlights the importance of using GATE simulation, as it enables accurate modeling of radiation scattering in various room setups, ensuring precise dose calculations. 641 646 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/16 1405/5/25 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 H. Mathavan H. Mathavan Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia S.H. Zuber S.H. Zuber Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia hajarzuber@ukm.edu.my M.F. Rizal Abdul Hadi M.F. Rizal Abdul Hadi School of Physics, University Sains Malaysia, 11800, Penang, MALAYSIA M.S. Ahmad Fadzil M.S. Ahmad Fadzil Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia A. Sabarudin A. Sabarudin Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia N.H.Ab. Aziz N.H.Ab. Aziz School of Physics, University Sains Malaysia, 11800, Penang, MALAYSIA G. Ramachandran G. Ramachandran Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia Occupational radiation coronary angiography medical personnel Monte Carlo GATE. 1. Sailer AM, Paulis L, Vergoossen L, et al. (2017) Real-time patient and staff radiation dose monitoring in IR practice. Cardiovasc Intervent Radiol, 40:421-429.##ICRP (2018) Occupational radiological protection in interventional procedures. ICRP publication 139. 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Prediction of treatment response in inoperable cervical cancer treated with curative radiotherapy using artificial intelligence with radiomic and clinical parameters 2 2 Background: Radiomic features extracted from the tumor and peritumoral region can be used to predict response to radiotherapy (RT). This research sought to estimate treatment response through the analysis of tumor and peritumoral radiomic features in patients receiving curative radiotherapy for cervical cancer. Materials and Methods: Between 2015 and 2024, 60 patients with cervical cancer who underwent radiotherapy (RT) with or without chemotherapy (ChT) were included in the study Tumor segmentation was performed using computed tomography (CT) scans. Radiomic feature extraction was carried out with the LifeX platform (v7.0.0). A total of 110 tumoral and peritumoral radiomic features were obtained. 19 clinical and 110 radiomic features were evaluated, and important variables were identified using a decision tree algorithm. Treatment response following RT was evaluated based on the RECIST guidelines. The k-Nearest Neighbors (kNN) and Multi-Layer Perceptron (MLP) algorithms were used to build a prediction model. Results: The analysis identified total EQD2, EBRT interruption time, peritumoral_GLZLM_ZLNU, GTV_GLZLM_ZLNU, and GTV_GLRLM_LRLGE as significant predictive variables. Among the predictive algorithms developed for key variables, the k-Nearest Neighbors (kNN) model achieved F1 scores of 0.84 and 0.74 on the training and testing datasets, respectively, while the Multi-Layer Perceptron (MLP) model achieved F1 scores of 0.96 and 0.81 on the training and testing datasets, respectively. Conclusion: Non-invasive, tumor-signature radiomics show promise for guiding personalized therapies. The radiomic parameters Peritumoral_GLZLM_ZLNU, GTV_GLZLM_ZLNU, and GTV_GLRLM_LRLGE emerged as key predictors of treatment response to radiotherapy. Nevertheless, further multicenter research involving larger patient cohorts is required to achieve more robust and generalizable results. 647 654 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/16 1405/5/25 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 M. Yakar M. Yakar Department of Radiation Oncology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey myakar@ogu.edu.tr D. Etiz D. Etiz Department of Radiation Oncology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey K. Duruer K. Duruer Department of Radiation Oncology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey E. Gulbandilar E. Gulbandilar Department of Computer Engineering, Faculty of Engineering, Osmangazi University, Eskişehir, Turkey E. Colak E. Colak Department of Biostatistics, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey B. Barut B. Barut Department of Radiation Oncology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey Uterine cervical neoplasms radiomics radiotherapy chemoradiotherapy prognosis image processing - computer assisted. Bailey HH, Chuang LT, duPont NC, et al. (2016) American Society of Clinical Oncology statement: Human papillomavirus vaccination for cancer prevention. J Clin Oncol, 34: 1803-1812.##Munoz N, Bosch FX, de Sanjose S and Shah KV (1994) The role of HPV in the etiology of cervical cancer. Mutat Res, 305: 293-301.##Bray F, Loos AH, McCarron P, et al. (2005) Trends in cervical squamous cell carcinoma incidence in 13 European countries: changing risk and the effects of screening. Cancer Epidemiol Biomarkers Prev, 14: 677-686.##Elmahdy M and Sebro R (2023) Radiomics analysis in medical imaging research. J Med Radiat Sci, 70: 3-7.##Russo L, Charles-Davies D, Bottazzi S, Sala E and Boldrini L (2024) Radiomics for clinical decision support in radiation oncology. Clin Oncol (R Coll Radiol), 36: e269-e281.##Xu H, Wang A, Zhang C, Ren J, Zhou P and Liu J (2023) Intra- and peritumoral MRI radiomics assisted in predicting radiochemotherapy response in metastatic cervical lymph nodes of nasopharyngeal cancer. BMC Med Imaging, 23: 66.##Lin CH, Yan JL, Yap WK, et al. (2023) Prognostic value of interim CT-based peritumoral and intratumoral radiomics in laryngeal and hypopharyngeal cancer patients undergoing definitive radiotherapy. Radiother Oncol, 189: 109938.##ClinicalTrials.gov (2015) Testing the addition of a new anti-cancer drug, triapine, to the usual chemotherapy treatment (cisplatin) during radiation therapy for advanced-stage cervical and vaginal cancers. NRG-GY006.##Lim K, Small W Jr, Portelance L, et al. Gyn IMRT Consortium (2011) Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy for the definitive treatment of cervix cancer. Int J Radiat Oncol Biol Phys, 79: 348-355.##Chawla NV, Bowyer KW, Hall LO and Kegelmeyer WP (2002) SMOTE: synthetic minority over-sampling technique. J Artif Intell Res, 16: 321-357.##Song C and Zhang H (2014) Comments on fifty years of classification and regression trees. Int Stat Rev, 82: 359-361.##Goodfellow I, Bengio Y, Courville A (2016) Deep learning. MIT Press, Cambridge, MA, USA.##Manganaro L, Nicolino GM, Dolciami M, et al. (2021) Radiomics in cervical and endometrial cancer. Br J Radiol, 94: 20201314.##Lubner MG, Smith AD, Sandrasegaran K, Sahani DV, Pickhardt PJ (2017) CT texture analysis: definitions, applications, biologic correlates, and challenges. Radiographics, 37: 1483-1503.##Aerts HJ, Velazquez ER, Leijenaar RT, et al. (2014) Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun, 5: 4006.##Zhang S, Regan K, Najera J, Grinstaff MW, Datta M and Nia HT (2023) The peritumor microenvironment: physics and immunity. Trends Cancer, 9: 609-623.##Tang X (1998) Texture information in run-length matrices. IEEE Trans Image Process, 7: 1602-1609.##Nioche C, Orlhac F, Boughdad S, et al. (2018) LIFEx: a freeware for radiomic feature calculation in multimodality imaging to accelerate advances in the characterization of tumor heterogeneity. Cancer Res, 78: 4786-4789.##Olivares-Urbano MA, Griñán-Lisón C, Marchal JA, Núñez MI (2020) CSC radioresistance: a therapeutic challenge to improve radiotherapy effectiveness in cancer. Cells, 9: 1651.##Jha AK, Mithun S, Sherkhane UB, et al. (2023) Development and validation of radiomic signature for predicting overall survival in advanced-stage cervical cancer. Front Nucl Med, 3: 1138552.##Lucia F, Visvikis D, Desseroit MC, et al. (2018) Prediction of outcome using pretreatment 18F-FDG PET/CT and MRI radiomics in locally advanced cervical cancer treated with chemoradiotherapy. Eur J Nucl Med Mol Imaging, 45(5): 768-786.##Leseur J, Roman-Jimenez G, Devillers A, et al. (2016) pre-and per-treatment 18F-FDG PET/CT parameters to predict recurrence and survival in cervical cancer. Radiother Oncol, 120(3): 512-518.##Ferreira M, Lovinfosse P, Hermesse J, et al. (2021) [18F] FDG PET radiomics to predict disease-free survival in cervical cancer: a multi-scanner/center study with external validation. Eur J Nucl Med Mol Imaging, 48(11): 3432-3443.##Liu B, Sun Z, Xu ZL, et al. (2022) Predicting disease-free survival with multiparametric MRI-derived radiomic signature in cervical cancer patients underwent CCRT. Front Oncol, 11: 812993.##Liu D, Zhang X, Zheng T, et al. (2021) Optimisation and evaluation of the random forest model in the efficacy prediction of chemoradiotherapy for advanced cervical cancer based on radiomics signature from high-resolution T2 weighted images. Arch Gynecol Obstet, 303(3): 811-820.##Ho KC, Fang YH, Chung HW, et al. (2016) A preliminary investigation into textural features of intratumoral metabolic heterogeneity in 18F-FDG PET for overall survival prognosis in patients with bulky cervical cancer treated with definitive concurrent chemoradiotherapy. Am J Nucl Med Mol Imaging, 6(3): 166-175.##Dimopoulos JC, Lang S, Kirisits C, et al. (2009) Dose-volume histogram parameters and local tumor control in magnetic resonance image-guided cervical cancer brachytherapy. Int J Radiat Oncol Biol Phys, 75(1): 56-63.##Dimopoulos JC, Pötter R, Lang S, et al. (2009) Dose-effect relationship for local control of cervical cancer by magnetic resonance image-guided brachytherapy. 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Prognostic significance of myopenia and nutritional status in nasopharyngeal cancer: introducing the TEMA index 2 2 Background: This study investigates whether temporal muscle thickness (TMT) has prognostic significance in nasopharyngeal cancer (NPC). Additionally, it introduces a novel composite index, TEMA, which integrates TMT and serum albumin levels to enhance prognostic stratification. Materials and Methods: The study retrospectively encompassed 61 NPC patients receiving definitive therapy during the period January 2014–October 2024. TMT was extracted from computed tomography (CT) scans, and serum albumin (g/dL) was measured from blood specimens collected immediately before definitive treatment commenced. The novel TEMA index was defined as: TEMA = TMT × serum albumin. Results: Patients were aged 18–88 years (median, 49). The follow-up duration varied from 4 to 129 months with a median of 45 months. In univariate analyses, albumin significantly predicted progression-free survival (PFS) (p = 0.02), while overall survival (OS) showed significant associations with albumin (p = 0.006), TMT (p = 0.016), and TEMA index (p = 0.017). Conclusion: In patients with NPC treated with definitive intent, TMT and serum albumin showed significant associations with OS. A composite index that integrates these biomarkers (e.g., TEMA) may facilitate treatment decision-making and risk/prognostic stratification. 655 662 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/16 1405/5/25 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 T. Koca T. Koca Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey timurkoca3@gmail.com D.A. Çetmi D.A. Çetmi Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey R.A. Aksoy R.A. Aksoy Department of Radiation Oncology, Izmir City Hospital, Izmir, Turkey A.F. Korcum A.F. Korcum Department of Radiation Oncology, Akdeniz University School of Medicine, Antalya, Turkey Nasopharyngeal cancer myopenia temporal muscle thickness albumin TEMA. 1. Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J (2019) Nasopharyngeal carcinoma. Lancet, (London, England), 394(10192): 64-80.##Chang ET, Ye W, Zeng YX, Adami HO (2021) The evolving epidemiology of nasopharyngeal carcinoma. Cancer epidemiology, biomarkers & prevention: A publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 30(6): 1035-1047.##Juarez-Vignon Whaley JJ, Afkhami M, Onyshchenko M, Massarelli E, Sampath S, Amini A, et al. (2023) Recurrent/metastatic nasopharyngeal carcinoma treatment from present to future: Where are we and where are we heading? 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Radiotherapy outcomes in NAFLD patients supported by isocaloric low-carbohydrate high-protein diet and transient elastography monitoring 2 2 Background: Radiotherapy-induced liver injury (RILI) is a significant complication in cancer treatment, particularly among patients with pre-existing non-alcoholic fatty liver disease (NAFLD). Non-invasive monitoring with transient elastography allows early detection of steatosis and fibrosis, while targeted nutritional support such as an isocaloric low-carbohydrate high-protein (LC-HP) diet may enhance hepatic resilience during therapy. Materials and Methods: One hundred adult NAFLD patients undergoing radiotherapy for solid tumors, mainly involving the gastrointestinal, hepatobiliary, gynecologic, and thoracic regions were prospectively enrolled in a 6-month LC-HP dietary intervention. Clinical assessments included anthropometry, biochemical markers, body composition, immune parameters, and transient elastography values [controlled attenuation parameter (CAP) and liver stiffness measurement (LSM)]. In these patients, part of the non-tumorous liver was located within the low- to moderate-dose region of the radiotherapy fields, as determined from the treatment planning data, resulting in partial hepatic irradiation. Radiotherapy data (cancer type, intent, field, and dose) were documented to contextualize hepatic exposure. Results: Despite concurrent radiotherapy, CAP and LSM values declined significantly (P < 0.05), indicating reductions in hepatic steatosis and fibrosis. BMI, waist circumference, and body fat percentage decreased, while skeletal muscle mass increased. Serum cholesterol and triglycerides decreased, prealbumin levels improved, and lymphocyte counts rose significantly (P < 0.001). These findings suggest that structured nutritional support can mitigate hepatic stress and preserve immune competence during radiotherapy. Conclusion: Integrating an isocaloric LC-HP diet with transient elastography monitoring improved hepatic, metabolic, and immune outcomes in NAFLD patients receiving radiotherapy. 663 669 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/16 1405/5/25 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 T. Ye T. Ye Department of Nutrition, Youjiang Ethnic Medical College Affiliated Hospital, Baise 533000, Guangxi Zhuang Autonomous Region, China S. Hou S. Hou Department of Nutrition, Youjiang Ethnic Medical College Affiliated Hospital, Baise 533000, Guangxi Zhuang Autonomous Region, China C. Lin C. Lin Department of Nutrition, Youjiang Ethnic Medical College Affiliated Hospital, Baise 533000, Guangxi Zhuang Autonomous Region, China M. Huang M. Huang Department of Infectious Diseases, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China M. Huang M. Huang Department of Outpatient, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China X. Luo X. Luo Department of Ultrasound, Youjiang Ethnic Medical College Affiliated Hospital, Baise 533000, Guangxi Zhuang Autonomous Region, China lxq880@163.com Radiotherapy non-alcoholic fatty liver disease liver diseases fatty diet carbohydrate-restricted diet high-protein elasticity imaging techniques liver stiffness. 1. Guo X, Yin X, Liu Z, Wang J (2022) Non-alcoholic fatty liver disease (NAFLD) pathogenesis and natural products for prevention and treatment. Int J Mol Sci, 23(24): 15489.##Pouwels S, Sakran N, Graham Y, Leal A, Pintar T, Yang W, et al. (2022) Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss. BMC Endocr Disord, 22(1): 63.##Liang S-X, Huang X-B, Zhu X-D, Zhang W-D, Cai L, Huang H-Z, et al. (2011) Dosimetric predictor identification for radiation-induced liver disease after hypofractionated conformal radiotherapy for primary liver carcinoma patients with Child-Pugh Grade A cirrhosis. Radiotherapy and Oncology, 98(2): 265-9.##Velec M, Haddad CR, Craig T, Wang L, Lindsay P, Brierley J, et al. (2017) Predictors of liver toxicity following stereotactic body radiation therapy for hepatocellular carcinoma. Int J Radiat Oncol Biol Phys, 97(5): 939-46.##Katsiki N, Stoian AP, Rizzo M (2022) Dietary patterns in non-alcoholic fatty liver disease (NAFLD): Stay on the straight and narrow path! Clin Investig Arterioscler, 34: S24-S31.##Tsompanaki E, Thanapirom K, Papatheodoridi M, Parikh P, Chotai de Lima Y, Tsochatzis EA (2023) Systematic review and meta-analysis: the role of diet in the development of nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol, 21(6): 1462-74.e24.##Gofton C, Upendran Y, Zheng MH, George J (2023) MAFLD: How is it different from NAFLD? Clin Mol Hepatol, 29(Suppl): S17-S31.##Lange M, Nadkarni D, Martin L, Newberry C, Kumar S, Kushner T (2023) Intermittent fasting improves hepatic end points in nonalcoholic fatty liver disease: A systematic review and meta-analysis. Hepatol Commun, 7(8): e0212.##Benson R, Madan R, Kilambi R, Chander S (2016) Radiation induced liver disease: A clinical update. Journal of the Egyptian National Cancer Institute, 28(1): 7-11.##Pan CC, Kavanagh BD, Dawson LA, Li XA, Das SK, Miften M, et al. (2010) Radiation-Associated Liver Injury. Int J Radiat Oncol Biol Phys, 76(3): S94-S100.##Argalia G, Ventura C, Tosi N, Campioni D, Tagliati C, Tufillaro M, et al. (2022) Comparison of point shear wave elastography and transient elastography in the evaluation of patients with NAFLD. Radiol Med, 127(5): 571-6.##Ji Y, Wei CB, Gu W, Hou LL (2023) Relevance of vitamin D on NAFLD and liver fibrosis detected by vibration controlled transient elastography in US adults: a cross-sectional analysis of NHANES 2017-2018. Ann Med, 55(1): 2209335.##Ozturk A, Olson MC, Samir AE, Venkatesh SK (2022) Liver fibrosis assessment: MR and US elastography. Abdom Radiol (NY), 47(9): 3037-50.##Milgrom Y, Massarwa M, Hazou W, Shafrir A, Mishraki E, Sanduka S, et al. (2024) Ten-hour intermittent fasting plus mediterranean diet versus mediterranean diet alone for treatment of nonalcoholic fatty liver disease (NAFLD). Harefuah, 163(2): 93-6.##Notarnicola M, Tutino V, De Nunzio V, Cisternino AM, Cofano M, Donghia R, et al. (2024) Daily orange consumption reduces hepatic steatosis prevalence in patients with metabolic dysfunction-associated steatotic liver disease: exploratory outcomes of a randomized clinical trial. Nutrients, 16(18): 3191.##Sun J, Yan C, Wen J, Wang F, Wu H, Xu F (2024) Association between different obesity patterns and the risk of NAFLD detected by transient elastography: a cross-sectional study. BMC Gastroenterol, 24(1): 221.##Vilar-Gomez E, Nephew LD, Vuppalanchi R, Gawrieh S, Mladenovic A, Pike F, et al. (2022) High-quality diet, physical activity, and college education are associated with low risk of NAFLD among the US population. Hepatology, 75(6): 1491-506.##Xu Y-Y, Zhou X-L, Yu C-H, Wang W-W, Ji F-Z, He D-C, et al. (2021) Association of sarcopenia with toxicity and survival in postoperative recurrent esophageal squamous cell carcinoma patients receiving chemoradiotherapy. 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(2024) Vitamin E intake is inversely associated with NAFLD measured by liver ultrasound transient elastography. Sci Rep, 14(1): 2592.##Saavedra Y, Mena V, Priken K (2022) Effect of the mediterranean diet on histological indicators and imaging tests in non-alcoholic fatty liver disease. Gastroenterol Hepatol, 45(5): 350-60.##Bischoff SC, Bernal W, Dasarathy S, Merli M, Plank LD, Schütz T, et al. (2020) ESPEN practical guideline: Clinical nutrition in liver disease. Clinical Nutrition, 39(12): 3533-62.##Hesaraki S, Saba G, Shahrezaee M, Nezafati N, Orshesh Z, Roshanfar F, et al. (2024) Reinforcing β-tricalcium phosphate scaffolds for potential applications in bone tissue engineering: impact of functionalized multi-walled carbon nanotubes. Scientific Reports, 14(1): 19055.##Lin H, Lee HW, Yip TC-F, Tsochatzis E, Petta S, Bugianesi E, et al. (2024) Vibration-controlled transient elastography scores to predict liver-related events in steatotic liver disease. 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Comparison of liver dose in right chest wall radiotherapy using field-in-field, intensity-modulated radiotherapy, and helical tomotherapy 2 2 Background: This study aims to assess the liver dose received in the absence of explicit dose considerations during right chest wall radiotherapy planning for three different treatment techniques and to contribute to thr limited literature on this topic. Materials and Methods: A total of 20 patients with indications for radiotherapy of the right chest wall following mastectomy were selected. After tomography scan images were sent to the Treatment Planning System (TPS), where a radiation oncologist delineated the target volumes and critical structures. Subsequently, a medical physicist created treatment plans utilizing three techniques. The dosimetric parameters were evaluated and compared for different treatment techniques. Results: The field-in-field (FIF) technique resulted in the lowest mean liver dose and V10 values (p<0.001). No significant difference was observed between helical tomotherapy (HT) and intensity-modulated radiotherapy (IMRT) techniques regarding average liver doses and V10 values. The FIF treatment technique also showed the lowest V20 value. Conclusions: In right breast radiotherapy, when comparing liver doses across different treatment plans excluding the liver, the FIF technique demonstrated significantly better results in terms of average liver dose than the other two treatment techniques. It was concluded that liver dose should be taken into account during treatment planning. 671 677 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/29 1405/6/7 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 H. Demir H. Demir Van Yuzuncu Yil University, Department of Radiation Oncology, 65080, Van, Turkey hikmettindemir@yyu.edu.tr B.B. Yavuz B.B. Yavuz Necmettin Erbakan University, Department of Radiation Oncology,42100, Konya, Turkey O.V. Gul O.V. Gul Selcuk University, Department of Radiation Oncology, 42100, Konya, Turkey T. Cakir T. Cakir Van Yuzuncu Yil University, Department of Biophysics & Radiation Oncology, 65080, Van, Turkey Radiotherapy planning right chest wall liver dose field-in-field intensity-modulated radiotherapy helical tomotherapy. 1. Ma C, Zhang W, Lu J, Wu L, Wu F, Huang B, et al. (2015) Dosimetric comparison and evaluation of three radiotherapy techniques for use after modified radical mastectomy for locally advanced left-sided breast cancer. Scientific Reports, 5(1): 12274.##Biganzoli L, Battisti NML, Wildiers H, McCartney A, Colloca G, Kunkler IH, et al. (2021) Updated recommendations regarding the management of older patients with breast cancer: a joint paper from the European Society of Breast Cancer Specialists (EUSOMA) and the International Society of Geriatric Oncology (SIOG). The Lancet Oncology, 22(7): e327-e40.##Hoekstra N, Fleury E, Lara TRM, Van der Baan P, Bahnerth A, Struik G, et al. (2018) Long-term risks of secondary cancer for various whole and partial breast irradiation techniques. Radiotherapy and Oncology, 128(3): 428-33.##Zhang H, Yin H, Shao W (2022) Assessment of vital organ dose in volumetric intensity modulated arc therapy for left and right breast cancer. Int J Radiate Res, 20(4): 761-5.##Supakalin N, Pesee M, Thamronganantasakul K, Promsensa K, Supaadirek C, Krusun S (2018) Comparision of different radiotherapy planning techniques for breast cancer after breast conserving surgery. Asian Pacific Journal of Cancer Prevention: APJCP, 19(10): 2929.##Buchholz TA (2009) Radiation therapy for early-stage breast cancer after breast-conserving surgery. New England Journal of Medicine, 360(1): 63-70.##Group EBCTC (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. The Lancet, 366(9503): 2087-106.##Güzelöz Z, Ayrancıoğlu O, Aktürk N, Güneş M, Alıcıkuş ZA (2023) Dose volume and liver function test relationship following radiotherapy for right breast cancer: A multicenter study. Current Oncology, 30(10): 8763-73.##Bhatti ABH, Khan AI, Siddiqui N, Muzaffar N, Syed AA, Shah MA, et al. (2014) Outcomes of triple-negative versus non-triple-negative breast cancers managed with breast-conserving therapy. Asian Pacific Journal of Cancer Prevention, 15(6): 2577-81.##Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. New England Journal of Medicine, 347(16): 1233-41.##Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. New England J Medicine, 347(16): 1227-32.##Nejad SS, Bahador M, Yazdani S, Kiani M (2025) Comparative evaluation of wedge and field-in-field methods in minimizing brachial plexus radiation dose for breast cancer patients undergoing radiotherapy. Frontiers in Biomedical Technologies, 12: 2.##Bahador M, Nejad SS, Yazdani S (2025) The absorbed dose of the thyroid among patients with breast cancer following irradiation to the supraclavicular field. Int J Radiate Res, 23(3): 819-22.##Saibishkumar EP, MacKenzie MA, Severin D, Mihai A, Hanson J, Daly H, et al. (2008) Skin-sparing radiation using intensity-modulated radiotherapy after conservative surgery in early-stage breast cancer: a planning study. 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Effect of the potassium channel Kir2.1/KCNJ2 and radiation on the permeability of brain microvascular endothelial cells and its regulatory mechanism 2 2 Background: This study aimed to investigate the regulatory mechanisms of brain microvascular endothelial cell (BMEC) permeability, with a focus on the role of Kir2.1 (KCNJ2) potassium channels and their potential interaction with ionizing radiation (IR). Materials and Methods: BMECs were isolated from seven-day-old Sprague-Dawley rats, and cells were stimulated with lipopolysaccharide (LPS) to evaluate inflammatory responses. A 6-MV linear accelerator was used to deliver single radiation doses (0–8 Gy) to confluent BMEC monolayers to simulate clinical radiotherapy conditions. RhoA activity, p115RhoGEF expression, and tight junction (TJ) proteins (ZO-1, occludin, claudin-5) were detected by Western blotting. Transendothelial electrical resistance (TEER) was used to assess changes in barrier permeability. Results: LPS stimulation significantly increased p115RhoGEF expression at 1, 3, and 6 h compared with the control (P<0.05). TEER values decreased progressively after LPS exposure, indicating impaired barrier integrity (P<0.05). Claudin-5 levels showed no significant change, whereas ZO-1 and occludin were markedly reduced at 6 h and 12 h (P<0.05). Radiation exposure produced similar permeability-enhancing effects, supporting shared mechanisms of barrier disruption. Conclusion: LPS-induced inflammation increases BMEC permeability primarily through downregulation of TJ proteins. Ionizing radiation produces comparable barrier-disruptive effects, suggesting overlapping regulatory pathways. These findings support a potential role for Kir2.1 channels in modulating BMEC permeability under both inflammatory and radiation-induced stress. 679 684 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/29 1405/6/7 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 L. Deng L. Deng The Department of Neurology, Affiliated Hospital of Jianghan University, Wuhan 430015, Hubei Province, China D. Wu D. Wu The Department of Neurology, Affiliated Hospital of Jianghan University, Wuhan 430015, Hubei Province, China 13476028179@163.com Brain microvascular endothelial cells blood–brain barrier ionizing radiation kir2.1 potassium channels endothelial permeability. 1. 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A novel averaging method for reducing systematic and random errors in breast cancer radiotherapy using electronic portal imaging device 2 2 Background: The aim of this study is to introduce a novel averaging method to reduce systematic and random errors using electronic portal imaging device (EPID) in breast cancer radiotherapy. Materials and methods: Data from 78 female breast cancer patients, treated with photons beams of an Elekta Synergy linac were retrospectively analyzed. A novel five-session EPID averaging method (Optimized Five Session Averaging Method) was compared with a traditional three-session approach (Three Session Averaging Method) and a no-averaging approach (No Averaging Method). Statistical analysis was performed to compare the accuracy of the three methods. Results: The Optimized Five-Session Averaging Method demonstrated superior accuracy in minimizing individual mean set up errors compared to the Three-Session Averaging Method. Specifically, in the x direction, 71.80 of patients in the Optimized Five-Session Averaging Method had errors closer to zero, as opposed to 28.21 in the 2 Three-Session Averaging Method. In the y direction, 67.94 and 32.05 were closer to zero in the Optimized Five-Session Averaging Method and Three-Session Averaging Method, respectively. In the z direction, 70.51 and 29.49 achieved this in the Optimized Five-Session Averaging Method and Three-Session Averaging Method. Statistical analysis confirmed the significant difference between the two methods (p=0.00). Conclusion: The novel averaging method effectively enhanced the accuracy and reduced errors in breast cancer radiotherapy compared to the two conventional methods. This study provides a significant advancement in reducing patient set up error in breast cancer radiotherapy and highlights the potential of the Optimized Five-Session Averaging Method for optimization in diverse clinical contexts. 685 692 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/29 1405/6/7 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 M. Khosravi M. Khosravi Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran A. Shakeri A. Shakeri Radiotherapy Center, Shahid Beheshti Hospital, Qom, Iran M. Khosroabadi M. Khosroabadi Medical Physics Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran S.M. Hosseini S.M. Hosseini Department of Medical Physics and Medical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran G. Mehri-Kakavand Mehri-Kakavand G. Mehri-Kakavand Mehri-Kakavand Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand M. Pursamimi M. Pursamimi Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand mohamadpursamimi65@gmail.com W. Parwaie W. Parwaie Department of Medical Physics, Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran M. Shafiee M. Shafiee Radiotherapy Center, Shahid Beheshti Hospital, Qom, Iran M. Ghorbani M. Ghorbani Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran mhdghorbani@gmail.com M. Tavakoli M. Tavakoli Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA Breast cancer radiotherapy IGRT setup error EPID. Supakalin N, Pesee M, Thamronganantasakul K, Promsensa K, et al. (2018) Comparision of different radiotherapy planning techniques for breast cancer after breast conserving surgery. Asian Pac J Cancer Prev, 19(10): 2929-34.##Costa B, Amorim I, Gärtner F, Vale N (2020) Understanding breast cancer: From conventional therapies to repurposed drugs. Eur J Pharm Sci, 151: 105401.##Akram M, Iqbal M, Daniyal M, Khan AU (2017) Awareness and current knowledge of breast cancer. Biol Res, 50(1): 33.##Pursamimi M, Ghorbani M, Parwaie W, Shakeri A, Meigooni AS (2022) Evaluation of field-in-field, three-field, and four-field techniques for treatment planning of radiotherapy of pancreatic cancer. 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Correlation between MDCT and postoperative histopathology in the staging of laryngeal carcinoma 2 2 Background: Laryngeal squamous cell carcinoma (LSCC) originates from the laryngeal mucosal epithelium. Multidetector contrast-enhanced computerized tomography (MDCT) is valuable staging tool for various cancers. Objectives are evaluation of the performance of preoperative staging of LSCC according to the interpretation of MDCT imaging compared to pathological staging of the surgically excised specimens. Materials and Methods: MDCT scanning was performed by 64-detector, multi-slice CT device, and injection of contrast material (Lohexal 75%). Surgically excised laryngeal specimens were examined pathologically and staged. The study outcome was the performance of the CT scanning versus pathological findings. Results: Excellent agreement was detected for most laryngeal regions with Kappa values >0.9. In terms of tumor staging, CT showed good agreement with pathology stagings (Kappa=0.557). Overall, CT shows excellent diagnostic utility, with accuracy rates of 73.3% to 96.7% with ≥90% sensitivity and 100% for LSCC in subglottic, paraglottic, preepiglottic, aryepiglottic folds, and vocal cord regions. Conclusion: Preoperative MDCT scanning for LSCC patients might accurately detect and stage lesions across the laryngeal regions. MDCT imaging could detect extra-laryngeal space invasion with perfect agreement with pathological staging. 693 698 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/29 1405/6/7 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 A.A.Y. Ellithy A.A.Y. Ellithy Diagnostic Radiology Department, Otolaryngology Department, Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt abdobasha2017@gmail.com N. H. Shebrya N. H. Shebrya Diagnostic Radiology Department, Otolaryngology Department, Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt H. A. A. Elsersy H. A. A. Elsersy Diagnostic Radiology Department, Otolaryngology Department, Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt M.M. El-Mahdy M.M. El-Mahdy Diagnostic Radiology Department, Otolaryngology Department, Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt W.R. Abdel Hamed W.R. Abdel Hamed Diagnostic Radiology Department, Otolaryngology Department, Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt Laryngeal squamous cell carcinoma multidetector computerized tomography pathological staging diagnostic performance characteristics. Pozo-Agundo E, Álvarez-González M, Rivera-García I, García-de-la-Fuente V, de Martino A, Tejedor JR et al. 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Ear Nose Throat J,104(3): 183-189.##Ling Z, Hu G, Wang Z, Ma W, Wang X, Zhu J, Zeng Q (2023) Prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 37(12): 998-1004.##Hintze JM, Cleere E, Soo A, Timon C, Kinsella J, Fitzgerald C, Lennon P 2025) Margins do not impact recurrence and survival in advanced laryngeal cancer - A retrospective cohort analysis. Oral Oncol, 167: 107402.##Rocha DA, Fernandes de Alvarenga G, Ramos DM, Luongo de Matos L, Aparecido R, Dedivitis RA, et al. (2025) Evaluation of clinical outcomes after partial horizontal laryngectomy. Braz J Otorhinolaryngol, 91(1): 101614.## ##

Diagnostic value of combining serum CA19-9, CA125, CEA, and ferritin with contrast-enhanced CT features for cholangiocarcinoma 2 2 Background: To probe the diagnostic value of combining serum tumor markers - Cancer Antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), and Ferritin - with contrast-enhanced computed tomography (CT) for cholangiocarcinoma (CCA). Materials and Methods: A total of 114 patients from Anhui No.2 Provincial People's Hospital from February 2020 to October 2025 were divided into a cholangiocarcinoma group (n=60) and a benign biliary lesion group (n=54). Serum levels of CA19-9, CA125, CEA, alpha-fetoprotein (AFP), and Ferritin were measured in both groups. CT imaging features of patients in both groups were analyzed. Furthermore, the diagnostic value of the serum markers alone, contrast-enhanced CT alone, and their combination was assessed. Results: Serum concentrations of CA19-9, CA125, CEA, and Ferritin were markedly enhanced in the cholangiocarcinoma group compared to the benign group. Cholangiocarcinoma typically presented as circular high-density shadows within the common bile duct or hepatic duct, accompanied by duct wall infiltration, invasion of the common bile duct, hepatic lobe atrophy, and lymph node enlargement. In contrast, benign lesions primarily appeared as circular high-density shadows with minimal duct wall invasion or lymphadenopathy. The combined approach demonstrated superior sensitivity, specificity, and accuracy for identifying cholangiocarcinoma compared to any single method. The area under the curve (AUC) (0.922) for the combined model was higher than the AUC of 0.865 for the serum marker alone. Conclusion: The integration of serum CA19-9, CA125, CEA, and Ferritin with contrast-enhanced CT findings shows promising diagnostic efficacy for cholangiocarcinoma and offers significant insights for evaluating tumor invasiveness. 699 703 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/29 1405/6/7 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 H. Zhang H. Zhang Department of CT Room, Anhui No.2 Provincial People's Hospital, Hefei City 230041, Anhui Province, China J. Wang J. Wang Department of Ultrasound, Anhui No.2 Provincial People's Hospital, Hefei City 230041, Anhui Province, China wangjj2980@163.com Q. Lu Q. Lu Department of Medical Imaging, Clinical Academy, Anhui Medical College, 230601, Anhui, China R. Pei R. Pei Department of CT Room, Anhui No.2 Provincial People's Hospital, Hefei City 230041, Anhui Province, China Cholangiocarcinoma tomography CA-19-9 Antigen arcinoembryonic antigen ferritins ROC curve. 1. Harrison JM and Visser BC (2024) Cholangiocarcinoma. Surg Clin North Am, 104(6):1281-1293.##Moris D, Palta M, Kim C, Allen PJ, Morse MA, Lidsky ME (2023) Advances in the treatment of intrahepatic cholangiocarcinoma: An overview of the current and future therapeutic landscape for clinicians. CA Cancer J Clin, 73(2): 198-222.##Elvevi A, Laffusa A, Scaravaglio M, Rossi RE, et al. (2022) Clinical treatment of cholangiocarcinoma: an updated comprehensive review. Ann Hepatol, 27(5): 100737.##Jiang G, Zhang W, Wang T, Ding S, et al. (2020) Characteristics of genomic alterations in Chinese cholangiocarcinoma patients. Jpn J Clin Oncol, 50(10): 1117-1125.##Silva M, Maddalo M, Leoni E, Giuliotti S, et al. (2021) Integrated prognostication of intrahepatic cholangiocarcinoma by contrast-enhanced computed tomography: the adjunct yield of radiomics. Abdom Radiol, 46(10): 4689-4700.##Xin Q, Lv R, Lou C, Ma Z, et al. (2020) Primary hepatic neuroendocrine carcinoma coexisting with distal cholangiocarcinoma: A case report and review of the literature. Medicine, 99(26): e20854.##Komori T, Inoue D, Zen Y, Yoneda N, et al. (2019) CT imaging comparison between intraductal papillary neoplasms of the bile duct and papillary cholangiocarcinomas. Eur Radiol, 29(6): 3132-3140.##Gul-Utku O, Karatay E, Ergul B, Kisa U, et al. (2020) The role of resolvin D1 in the differential diagnosis of the cholangiocarcinoma and benign biliary diseases. Clin Lab, 66(5): 1.##Jiang T, Lyu SC, Zhou L, Wang J, et al. (2021) Carbohydrate antigen 19-9 as a novel prognostic biomarker in distal cholangiocarcinoma. World J Gastrointest Surg, 13(9): 1025-1038.##Barroso Marquez L, Chao Gonzalez L, Samada Suarez M, Rodriguez Rodriguez H, et al. (2022) Endoscopic retrograde cholangiopancreatography and carbohydrate antigen 19-9 in the differential diagnosis of biliary strictures. Rev Esp Enferm Dig, 114(4): 204-207.##Wang T and Liu J (2025) Combined CA19-9, CA125, and CEA to predict prognosis of patients with intrahepatic cholangiocarcinoma after radical surgery: a retrospective, multi-institutional study. Ann Surg Treat Res, 109(4): 224-234.##Ramirez-Carmona W, Diaz-Fabregat B, Yuri Yoshigae A, Musa de Aquino A, et al. (2022) Are serum ferritin levels a reliable cancer biomarker? a systematic review and meta-analysis. Nutr Cancer, 74(6): 1917-1926.##Chen L, Hu S, Liu L, He S, et al. (2025) Prognostic value of preoperative serum ferritin in cholangiocarcinoma patients. Sci Rep, 15(1): 44288.##Wang H, Zhu X, Qiu M, Xuan J, et al. (2024) Impact of clinical lymph node status on survival in patients with intrahepatic cholangiocarcinoma undergoing liver resection plus lymphadenectomy. ANZ J Surg, 94(12): 2189-2194.##Zhang J, Dong W, Li Y, Fu J, Jia N (2023) Prediction of microvascular invasion in combined hepatocellular-cholangiocarcinoma based on preoperative contrast-enhanced CT and clinical data. Eur J Radiol, 163: 110839.##Saeheng T, Karbwang J, Na-Bangchang K (2024) Population-pharmacokinetic/pharmacodynamic model of atractylodes lancea (Thunb.) DC. administration in patients with advanced-stage intrahepatic cholangiocarcinoma: a dosage prediction. BMC Complement Med Ther, 24(1): 384.##Matsas A, Stefanoudakis D, Troupis T, Kontzoglou K, et al. (2023) Tumor markers and their diagnostic significance in ovarian cancer. Life, 13(8): 1689.##Lee JW, Lee JH, Park Y, Kwon J, et al. (2021) Prognostic impact of perioperative CA19-9 levels in patients with resected perihilar cholangiocarcinoma. 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(2025) CT-based radiogenomics of intrahepatic cholangiocarcinoma. Dig Liver Dis, 57(1): 118-124.##Briasoulis A, Lama N, Rempakos A, Theodorakakou F, et al. (2023) Diagnostic and prognostic value of non-late gadolinium enhancement cardiac magnetic resonance parameters in cardiac amyloidosis. Curr Probl Cardiol, 48(4): 101573.##van der Bruggen W, de Geus-Oei LF, Bosmans B, Slart R, et al. (2023) Review of the role of bone-SPECT/CT in tarsal coalitions. Nucl Med Commun, 44(2): 115-130.##Li C, Xiao J, Wu S, Liu L, et al. (2023) Clinical application of serum-based proteomics technology in human tumor research. Anal Biochem, 663: 115031.##Lu Y, Cao R, Jiao S, Li L, et al. (2024) A novel method of carotid artery wall imaging: black-blood CT. Eur Radiol, 34(4): 2407-2415.## ##

Role of microRNA-665 in modulating PI3K/AKT/JNK signaling pathways: implications for radiation-induced neurobehavioral disorders 2 2 Background: Radiotherapy is an essential treatment for brain tumors but often causes radiation-induced brain injury (RIBI), leading to neurobehavioral deficits such as depression-like behaviors. MicroRNA-665 (miR-665) may regulate these injury pathways through its interaction with the PI3K/AKT (pro-survival) and JNK/p38 (pro-apoptotic) signaling cascades. Materials and Methods: Ninety-six male C57BL/6 mice received 10 Gy cranial irradiation and were assigned to four groups (n=24): control, radiation + pioglitazone (PIO), radiation + PIO + GW9662, and radiation + PIO + LY294002 or anisomycin. Depression-like behaviors were assessed by sucrose preference, open field, and forced swimming tests. miR-665 expression and signaling markers (p-AKT, p-JNK, p-p38) in the PFC were measured using qPCR and Western blot. Results: Cranial irradiation significantly reduced sucrose preference, exploratory activity, and increased immobility time (all P < 0.01). PIO pretreatment activated PI3K/AKT and suppressed JNK/p38 signaling, producing marked behavioral improvement (P < 0.01). These neuroprotective effects were fully abolished by GW9662 (PPAR-γ antagonist), LY294002 (PI3K inhibitor), and anisomycin (JNK/p38 activator). miR-665 expression increased 2.8-fold in the GW9662 group (P < 0.01), where PPAR-γ and PI3K/AKT protection were blocked, but was reduced (0.4–0.5-fold) when PI3K/AKT was inhibited or JNK/p38 was activated. Conclusion: These findings indicate that PIO protects against radiation-induced depression-like behaviors via PPAR-γ–dependent activation of PI3K/AKT and inhibition of JNK/p38. The bidirectional changes in miR-665 strongly suggest it acts as a negative regulator of the PI3K/AKT pathway or is suppressed by JNK/p38 activation. miR-665 may therefore represent a promising therapeutic target for mitigating neurobehavioral complications of cranial radiotherapy. 705 711 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/29 1405/6/7 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 J. Yang J. Yang Department of Psychiatry, The Affiliated Xi’an Central Hospital of Xi’an Jiaotong University, Xi’an, 710003, Shaanxi Province, China R. Luan R. Luan Department of Psychiatry, The Affiliated Xi’an Central Hospital of Xi’an Jiaotong University, Xi’an, 710003, Shaanxi Province, China X. Zhao X. Zhao Department of Psychiatry, The Affiliated Xi’an Central Hospital of Xi’an Jiaotong University, Xi’an, 710003, Shaanxi Province, China 18791083860@163.com miR-665 Cranial irradiation Depression-like behavior PI3K/AKT pathway JNK/p38 pathway. Greene-Schloesser D, Robbins ME, Peiffer AM, et al. (2012) Radiation-induced brain injury: A review. Front Oncol, 2: 73. doi:10.3389/fonc.2012.00073##Lumniczky K, Szatmári T, Sáfrány G (2021) Ionizing radiation-induced neurotoxicity: A review. Int J Mol Sci, 22(5): 2389. doi:10.3390/ijms22052389##Wang Y, Liu Y, Zhang H, et al. (2020) Radiation-induced neuroinflammation and cognitive impairment. Brain Behav Immun, 87: 45-56. doi:10.1016/j.bbi.2020.03.012##Yoshino Y, Roy B, Dwivedi Y (2021) Differential and unique patterns of synaptic miRNA expression in dorsolateral prefrontal cortex of depressed subjects. Neuropsychopharmacology, 46(5): 900-910. doi:10.1038/s41386-020-00861-y##Chen YH and Wang H (2021) The association between migraine and depression based on miRNA biomarkers and cohort studies. Curr Med Chem, 28(27): 5648-5656. doi:10.2174/0929867327666201117100026##Torres-Berrío A, Lopez JP, Bagot RC, et al. (2017) DCC confers susceptibility to depression-like behaviors in humans and mice and is regulated by miR-218. Biol Psychiatry, 81(4): 306-315. doi:10.1016/j.biopsych.2016.08.017##Huan Z, Mei Z, Na H, et al. (2021) lncRNA MIR155HG alleviates depression-like behaviors in mice by regulating the miR-155/BDNF axis. Neurochem Res, 46(4): 935-944. doi:10.1007/s11064-021-03234-z##Wang M, Yang L, Chen Z, et al. (2021) Geniposide ameliorates chronic unpredictable mild stress induced depression-like behavior through inhibition of ceramide-PP2A signaling via the PI3K/Akt/GSK3β axis. Psychopharmacology (Berl), 238(10): 2789-2800. doi:10.1007/s00213-021-05895-8##Ibi M, Liu J, Arakawa N, et al. (2017) Depressive-like behaviors are regulated by NOX1/NADPH oxidase by redox modification of NMDA receptor 1. J Neurosci, 37(15): 4200-4212. doi:10.1523/JNEUROSCI.2988-16.2017##Makale MT, McDonald CR, Hattangadi-Gluth JA, et al. (2017) Mechanisms of radiotherapy-related cognitive impairment. Nat Rev Neurol, 13(2): 100-112. doi:10.1038/nrneurol.2016.185##Martín-Hernández D, Caso JR, Meana JJ, et al. (2018) Intracellular inflammatory and antioxidant pathways in postmortem frontal cortex of subjects with major depression. J Neuroinflammation, 15(1): 251. doi:10.1186/s12974-018-1294-2##Parise EM, Parise LF, Sial OK, et al. (2021) The resilient phenotype induced by prophylactic ketamine exposure during adolescence is mediated by the ventral tegmental area-nucleus accumbens pathway. Biol Psychiatry, 90(7): 482-493. doi:10.1016/j.biopsych.2021.05.002##Monje ML, Mizumatsu S, Fike JR, et al. (2002) Irradiation induces neural precursor-cell dysfunction. Nat Med, 8(9): 955-962. doi:10.1038/nm749##Schier de Fraga F, Wan-Dall BSL, Garcia GHO, et al. (2021) Antenatal screening of depressive and manic symptoms in south Brazilian childbearing women. PLoS One, 16(12): e0261874. doi:10.1371/journal.pone.0261874##Olianas MC, Dedoni S, Onali P (2019) Inhibition of TNF-α-induced neuronal apoptosis by antidepressants acting through the lysophosphatidic acid receptor LPA1. Apoptosis, 24(5-6): 478-498. doi:10.1007/s10495-019-01530-2##Belzeaux R, Fiori LM, Lopez JP, et al. (2019) Predicting worsening suicidal ideation with clinical features and peripheral expression of messenger RNA and MicroRNA during antidepressant treatment. J Clin Psychiatry, 80(3): 18m12556. doi:10.4088/JCP.18m12556##Le Marois M, Tzavara E, Ibrahim EC, et al. (2021) RNA therapeutics for mood disorders: current evidence toward clinical trials. Expert Opin Investig Drugs, 30(7): 721-736. doi:10.1080/13543784.2021.1928073##Shen M, Song Z, Wang JH (2019) microRNA and mRNA profiles in the amygdala are associated with stress-induced depression and resilience in juvenile mice. Psychopharmacology (Berl), 236(7): 2119-2142. doi:10.1007/s00213-019-05209-z##Rola R, Raber J, Rizk A, et al. (2004) Radiation-induced impairment of hippocampal neurogenesis is associated with cognitive deficits. Radiat Res, 162(1): 39-50. doi:10.1667/rr3184##Myöhänen TT, Mertens F, Norrbacka S, et al. (2021) Deletion or inhibition of prolyl oligopeptidase blocks lithium-induced phosphorylation of GSK3b and Akt by activation of protein phosphatase 2A. Basic Clin Pharmacol Toxicol, 129(4): 287-296. doi:10.1111/bcpt.13632##Huan Z, Mei Z, Na H, et al. (2021) lncRNA MIR155HG alleviates depression-like behaviors in mice by regulating the miR-155/BDNF axis. 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Effects of ginsenoside Rg3 on chemoradiosensitivity to paclitaxel in breast cancer cells and its correlation with autophagy-related genes 2 2 Background: Resistance to paclitaxel (PTX) remains is a challenge in treatment of breast cancer, which is often mediated by multidrug resistance proteins and dysregulated autophagy. Ginsenoside Rg3 has been reported to enhance chemosensitivity in several malignancies, but its role in PTX resistance and underlying mechanisms in breast cancer remain unclear. Materials and Methods: In this study Human breast cancer MCF-7 cells treated with PTX, Rg3, or both. Cell viability was assessed by MTT assay, apoptosis by Annexin V/PI flow cytometry, and drug efflux by rhodamine-123 retention. Autophagy was evaluated using transmission electron microscopy, monodansylcadaverine and acridine orange staining, and Western blot analysis of autophagy-related proteins. Expression of MDR1/P-glycoprotein and Wnt/β-catenin signaling components was also analyzed. Results: Rg3 significantly enhanced PTX-induced growth inhibition and apoptosis in MCF-7 cells compared with PTX alone. Combination treatment increased intracellular rhodamine-123 accumulation, indicating reduced drug efflux. Autophagy activation was evidenced by increased LC3-II/LC3-I ratio and Beclin-1 expression, along with decreased p62 levels. Additionally, Rg3 combined with PTX downregulated MDR1/P-glycoprotein and suppressed key proteins of the Wnt/β-catenin signaling pathway. Correlation analysis revealed that autophagy markers were positively associated with apoptosis and negatively correlated with MDR1 expression. Conclusion: Ginsenoside Rg3 increases breast cancer cells chemosensitivity to paclitaxel, potentially through modulation of autophagy, inhibiting Wnt/β-catenin signaling, and suppressing multidrug resistance mechanisms. The findings of this study showed that Rg3 may represent a potential adjuvant for chemotherapy, while its role in modulating radiosensitivity needs further investigation in dedicated radiotherapy models. 713 721 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/29 1405/6/7 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 S. Chen S. Chen Department of Thoracic Surgery and Department of Tumor Surgery II, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang Province, China Y. Liu Y. Liu Department of Thoracic Surgery and Department of Tumor Surgery II, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang Province, China H. Bao H. Bao Department of Thoracic Surgery and Department of Tumor Surgery II, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang Province, China E. Zhao E. Zhao Department of Thoracic Surgery and Department of Tumor Surgery II, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang Province, China X. Qiao X. Qiao School of Pharmacy, Qiqihar Medical College, Qiqihar, Heilongjiang Province, China M. Gu M. Gu Department of Thoracic Surgery and Department of Tumor Surgery II, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang Province, China J. Zhou J. Zhou Department of Thoracic Surgery and Department of Tumor Surgery II, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang Province, China J. Zhang J. Zhang Departments of Neurology, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang Province, China zhangjingyan1982@126.com Ginsenoside Rg3 paclitaxel breast cancer autophagy drug resistance Wnt/β-catenin radiosensitization radiotherapy-related resistance. Zhang Y, Ji Y, Liu S, Li J, et al. (2025) Global burden of female breast cancer: New estimates in 2022, temporal trend and future projections up to 2050 based on the latest release from GLOBOCAN. Journal of the National Cancer Center, 5(3): 287-96.##Jivani A and Shinde RK (2024) A comprehensive review of taxane treatment in breast cancer: clinical perspectives and toxicity profiles. Cureus, 16(4): e59266.##Lu H, Zha S, Zhang W, Wang Q, et al. (2021) A systematic review and meta-analysis of nab-paclitaxel mono-chemotherapy for metastatic breast cancer. BMC Cancer, 21(1): 830.##Duan C, Yu M, Xu J, Li BY, et al. (2023) Overcoming cancer multi-drug resistance (MDR): reasons, mechanisms, nanotherapeutic solutions, and challenges. Biomedicine and Pharmacotherapy, 162: 114643.##Xu H, Li L, Dong B, Lu J, et al. (2023) TRAF6 promotes chemoresistance to paclitaxel of triple negative breast cancer via regulating PKM2-mediated glycolysis. Cancer Medicine, 12(19): 19807-20.##Chen C, Bu X, Deng L, Xia J, et al. (2025) Astragaloside IV as a promising therapeutic agent for liver diseases: current landscape and future perspectives. Frontiers in Pharmacology, 16: 1574154.##Alalawy AI (2024) Key genes and molecular mechanisms related to Paclitaxel Resistance. Cancer Cell International, 24(1): 244.##Zhang H, Zhang X, Wu X, Li W, et al. (2012) Interference of Frizzled 1 (FZD1) reverses multidrug resistance in breast cancer cells through the Wnt/β-catenin pathway. Cancer Letters, 323(1): 106-13.##Qin Y, Ashrafizadeh M, Mongiardini V, Grimaldi B, et al. (2023) Autophagy and cancer drug resistance in dialogue: Pre-clinical and clinical evidence. Cancer Letters, 570: 216307.##Wang T, He M, Zhang X, Guo Z, et al. (2024) Deciphering the impact of circRNA-mediated autophagy on tumor therapeutic resistance: a novel perspective. Cellular and Molecular Biology Letters, 29(1): 60.##Huang Y, Zhang R, Lyu H, Xiao S, et al. (2024) LncRNAs as nodes for the cross-talk between autophagy and Wnt signaling in pancreatic cancer drug resistance. Int J Biological Sciences, 20(7): 2698-726.##Zhu Y, Wang A, Zhang S, Kim J, et al. (2023) Paclitaxel-loaded ginsenoside Rg3 liposomes for drug-resistant cancer therapy by dual targeting of the tumor microenvironment and cancer cells. J Advanced Research, 49: 159-73.##Meng ZQ, Zhang R, Wu XW, Jin TF, Zhang MH (2022) Ginsenoside Rg3 regulates cisplatin resistance in gastric cancer by wnt/β-catenin signaling pathway. Zhongguo yi xue ke xue yuan xue bao, 44(3): 366-76.##Chang Y, Fu Q, Lu Z, Jin Q, et al. 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Eye lens exposure of personnel performing endovascular aortic aneurism repair (EVAR) 2 2 Background: Endovascular aortic aneurism repair (EVAR) is an interventional procedure where endoscopic equipment¸ navigated by fluoroscopy, is used to treat an abdominal aneurism. There is growing concern regarding radiation exposure among operators due to the increasing number of procedures. Materials and Methods: Present study investigated eye lens exposure and dose distribution in terms of eye lens dose (ELD) equivalent Hp (3) over a set of three dosemeters for a team of three operators, when operators are occupying both sides of the patient table. Dose dependence on head rotation and the effect of shielding were assessed through Monte Carlo simulation. Results: All three positions were identified as high dose positions. Dose distribution over the forehead for all 3 operators was found to be uniform. Of all observed patient exposure parameters, dose area product (DAP) showed the highest degree of correlation to ELD. Dose and dose distribution depends on the operators’ standing position and head rotation, further explaining observed correlations. Average value of dose reduction factor of ceiling suspended screen was found to be 95. Conclusion: When performing the procedure as a team, the operators’ standing positions or head orientation will strongly influence eye lens exposure and its dependence on patient exposure parameters. Values of DAP could be useful as a parameter for monitoring eye lens exposure during EVAR. The use of a suspended shield is strongly advised. 723 728 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 J. Samac J. Samac Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, Serbia jelena.samac@mf.uns.ac.rs P. Božović P. Božović Vinča Institute of Nuclear Sciences, University of Belgrade, Mike Petrovića Alasa 12-14, Belgrade, Serbia B. Petrović B. Petrović Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovića 3, Novi Sad, Serbia J.S. Petrović J.S. Petrović Vinča Institute of Nuclear Sciences, University of Belgrade, Mike Petrovića Alasa 12-14, Belgrade, Serbia D. Ilić D. Ilić Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, Serbia V. Til V. Til Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, Serbia Occupational exposure radiation protection radiology interventional radiation dose equivalent radiation monitoring. Hertault A, Bianchini A, Amiot S, Chenorhokian H, et al. (2020) Editor's choice - Comprehensive literature review of radiation levels during endovascular aortic repair in cathlabs and operating theatres. Eur J Vasc Endovasc Surg, 60: 374-385.##Kirkwood ML, Guild JB, Arbique GM, Anderson JA, Valentine RJ, Timaran C (2015) Surgeon radiation dose during complex endovascular procedures. J Vasc Surg, 62: 457-463.##Attigah N, Oikonomou K, Hinz U, Knoch T, Demirel S, et al. (2016) Radiation exposure to eye lens and operator hands during endovascular procedures in hybrid operating rooms. J Vasc Surg, 63: 198-203.##Harbron RW, Abdelhalim MA, Ainsbury EA, Eakins JS, Modarai B (2023) Editor's choice - Estimated radiation dose to the operator during endovascular aneurysm repair. Eur J Vasc Endovasc Surg, 66: 178-185.##Modarai B, Haulon S, Ainsbury E, Böckler D, et al. (2023) Editor's choice - European society for vascular surgery (ESVS) 2023 Clinical practice guidelines on radiation safety. Eur J Vasc Endovasc Surg, 65: 171-222.##Wilson-Stewart KS, Fontanarosa D, Malacova E, Trapp JV (2023) A comparison of patient dose and occupational eye dose to the operator and nursing staff during transcatheter cardiac and endovascular procedures. Sci Rep, 13: 2391.##Jungi S, Ante M, Geisbüsch P, Hoedlmoser H, Kleinau P, Böckler D (2022) Protected and unprotected radiation exposure to the eye lens during endovascular procedures in hybrid operating rooms. 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Los Alamos National Laboratory Tech. Rep. LA-CP-11-00438.##McConn RJ, Gesh CJ, Pagh RT, Rucker RA, Williams RG (2011) Compendium of material composition data for radiation transport modeling [Internet]. 2011 Mar [cited 2024 Aug 5] p. PNNL-15870 Rev. 1, 1023125. Report No.: PNNL-15870 Rev. 1, 1023125. Available from: http://www.osti.gov/servlets/purl/1023125-QtpCud/##Morrison GD (1998) Catalogue of diagnostic X-ray spectra and other data (IPEM Report 78). Radiography. 4: 228-229.##Zadehrafi M, Olaru C, Ciobanu SA, Ormenisan GV (2020) Characteristics of lead glass for radiation protection purposes: A Monte Carlo study. Int J Radiat Res, 18(4): 907-912.##Saeed MK and Almalki Y (2021) Assessment of the occupational dose and radiogenic risk in diagnostic radiology and nuclear medicine examinations. Int J Radiat Res, 19(2): 365-372.##Akoglu H (2018) User's guide to correlation coefficients. Turk J Emerg Med, 18(3): 91-3.##Bacchim Neto FA, Alves AFF, Mascarenhas YM, Nicolucci P, Pina DRD (2016) Occupational radiation exposure in vascular interventional radiology: A complete evaluation of different body regions. Phys Med, 32: 1019-1024.##Tzanis E, Tsetis D, Kehagias E, Ioannou CV, Damilakis J (2019) Occupational exposure during endovascular aneurysm repair (EVAR) and aortoiliac percutaneous transluminal angioplasty (PTA) procedures. Radiol Med, 124: 539-545.##Harbron RW, Abdelhalim MA, Ainsbury EA, Eakins JS, Modarai B (2023) Editor's Choice - Estimated radiation dose to the operator during endovascular aneurism repair. Eur J Vasc Endovasc Surg, 66: 178-185.##Erkan I, Yarenogly A, Yukselogly EH, Ulutin HC (2019) Investigation of radiation safety awareness among healthcare workers in an education and research hospital. Int J Radiat Res, 17(3): 455-461##Mao L, Liu T, Caracappa PF, Lin H, et al. 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The role of 18F-FDG PET/CT-derived metabolic parameters in the early evaluation and prognostic assessment of diffuse large B-cell lymphoma 2 2 Background: To investigate the dynamic changes in 18F-FDG PET/CT (18F)-derived metabolic parameters throughout the entire chemotherapy process for diffuse large B-cell lymphoma (DLBCL), and to analyze their clinical value in early diagnosis, curative effect evaluation, and prognosis stratification. Materials and Methods: One hundred and sixty-five patients with suspected DLBCL admitted from April 2022 to May 2023 were included. 18F scans were performed before chemotherapy (baseline), after 3-4 courses of chemotherapy (interim), and 6-8 weeks following chemotherapy completion (post-therapy). SUVmax, SUVmean, and TLG were calculated by delineating the metabolic tumor volume (MTV). Therapeutic efficacy was evaluated using the Deauville 5-point scale. Patients were followed up for 2 years to record their survival outcomes. A combined diagnostic model was constructed using Logistic regression, with its predictive efficiency analyzed using ROC curves. Results: Baseline SUVmax, SUVmean, MTV, and TLG were higher in DLBCL patients than in non-DLBCL cases (P<0.05). The combined model demonstrated an AUC of 0.972, with 93.15% sensitivity and 89.13% specificity. The interim metabolic parameters were highly correlated with Deauville scores. Higher SUVmax, MTV, and TLG levels were observed in the poor-efficacy group than in the good-efficacy group (P<0.05). Besides, the death group exhibited SUVmax, MTV, and TLG elevations compared to the survival group (P<0.05). The area under the ROC curve for the combined detection in predicting the prognostic mortality of DLBCL patients was 0.942 (P<0.001). Conclusion: The temporal variations of metabolic parameters derived from 18F prove valuable for the early detection, therapeutic effect assessment, and prognostic prediction of DLBCL. 729 734 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 X. Dong X. Dong Department of Nuclear Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, China W. Ge W. Ge Department of Radiology, Affiliated Hospital of Hebei University, Baoding, Hebei, China S. Li S. Li Department of Nuclear Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, China N. Feng N. Feng Department of Radiology, Affiliated Hospital of Hebei University, Baoding, Hebei, China hbmufengna@163.com 18-F-FDG PET/CT diffuse large b-cell lymphoma metabolic parameters prognosis. 1. Kanas G, Ge W, Quek RGW, Keeven K, Nersesyan K, Jon EA (2022) Epidemiology of diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) in the United States and Western Europe: population-level projections for 2020-2025. Leuk Lymphoma, 63(1): 54-63.##Barraclough A and Hawkes EA (2023) Antibody and immunotherapy in diffuse large B-cell lymphoma. Semin Hematol, 60(5): 338-45.##Bock AM and Epperla N (2025) Therapeutic landscape of primary refractory and relapsed diffuse large B-cell lymphoma: Recent advances and emerging therapies. Journal of Hematology & Oncology, 18(1): 68.##Morin RD, Arthur SE, Hodson DJ (2022) Molecular profiling in diffuse large B-cell lymphoma: why so many types of subtypes? Br J Haematol, 196(4): 814-29.##Zanoni L, Bezzi D, Nanni C, Paccagnella A, Farina A, Broccoli A, et al. (2023) PET/CT in non-hodgkin lymphoma: An update. Semin Nucl Med, 53(3): 320-51.##Sun XY, Chen TX, Chang C, Teng HH, Xie C, Ruan MM, et al. (2021) SUVmax of (18)FDG PET/CT predicts histological grade of lung adenocarcinoma. Acad Radiol, 28(1): 49-57.##Iwasa H, Nagamachi S, Nakayama S, Yamamoto T, Yoshimitsu K (2023) The reproducibility of MTV and TLG of soft tissue tumors calculated by FDG-PET: Comparison between the lower limit by the fixed value SUV 2.5 and that value by 30% of SUVmax. Jpn J Radiol, 41(5): 531-40.##Li M, Lu H, Fan J, Dai M, Su C (2023) A nomogram prognostic model for diffuse large B-cell lymphoma based on SUVmax and GNRI in elderly patients. EJ Haem, 4(4): 1030-41.##Lang R and Gill MJ (2021) diffuse large b-cell lymphoma. N Engl J Med, 384(23): 2261-2.##Ng DZ, Lee CY, Lam WW, Tong AK, Tan SH, Khoo LP, et al. (2022) Prognostication of diffuse large B-cell lymphoma patients with Deauville score of 3 or 4 at end-of-treatment PET evaluation: a comparison of the Deauville 5-point scale and the DeltaSUVmax method. Leuk Lymphoma, 63(1): 256-9.##Miura K, Takahashi H, Nishimaki-Watanabe H, Hamada T, Uchiike A, Tsutsumi D, et al. (2025) Contemporary management of diffuse large B-cell lymphoma in Japan. Expert review of Anticancer Therapy, 25(5): 551-9.##Usmani S, Jain A, Riyami KA, Ahmed N, Al-Sukaiti R, Shamim MS (2024) The role of 18F in neurolymphomatosis: A comprehensive imaging approach. J Pak Med Assoc, 74(4): 822-4.##Dondolin R, Garrou F, Almasri M, Terzi Di Bergamo L, Cosentino C, Bruscaggin A, et al. (2025) Integration of [(18)F]FDG-PET radiomics with liquid biopsy improves outcome prediction in newly diagnosed diffuse large B-cell lymphoma. Leukemia, 39(9): 2207-14.##Zhao P, Yu T, Pan Z (2021) Prognostic value of the baseline 18F metabolic tumour volume (MTV) and further stratification in low-intermediate (L-I) and high-intermediate (H-I) risk NCCNIPI subgroup by MTV in DLBCL MTV predict prognosis in DLBCL. Ann Nucl Med, 35(1): 24-30.##Jin A, Lin X, Yin X, Cui Y, Ma L (2022) Prognostic value of MTV and TLG of 18 F-FDG PET in patients with head and neck squamous cell carcinoma: A meta-analysis. Medicine (Baltimore), 101(39): e30798.##Xie W, Cao L, Yu J, Tian A, Wang J, Lin R (2025) (18)F-FDG PET/CT metabolic parameter changes to assess vascular inflammatory response in patients with diffuse large B-cell lymphoma. BMC Med Imaging, 25(1): 81.##Wen W, Piao Y, Xu D, Li X (2021) Prognostic value of MTV and TLG of (18)F-FDG PET in patients with stage I and II non-small-cell lung cancer: a Meta-Analysis. Contrast Media Mol Imaging, 2021: 7528971.## ##

Value of a model combining clinical indicators with qualitative and quantitative contrast-enhanced ultrasound parameters for differentiating benign and malignant prostatic lesions 2 2 Background: Benign prostate lesions and cancer can be difficult to separate when the judgment depends on one test only, this study reviewed routine clinical data, visual CEUS signs, and measured CEUS blood-flow values, then combined useful items in a simple prediction model. Materials and Methods: We reviewed 120 patients from one hospital, all had pathological proof of a prostate lesion and underwent transrectal ultrasound plus CEUS between January 2021 and December 2025; clinical indexes, image signs, and curve-based CEUS values were checked in benign and malignant cases, related variables were screened with logistic regression, and ROC analysis together with bootstrap resampling was used for model checking. Results: The malignant cases showed an unfavorable PSA pattern and abnormal DRE more often than benign cases, on CEUS they also had more hyperenhancement, uneven enhancement, early wash-in, and perfusion defects; the curve data suggested quicker and stronger enhancement. In the adjusted analysis, f/tPSA, PSAD, early wash-in, and PI remained related to cancer. The model reached an AUC of 0.930, with sensitivity of 82.2% and specificity of 89.3%; the corrected AUC after bootstrap testing was 0.918. Conclusion: Putting clinical indexes together with visual and numerical CEUS information gave a useful and internally stable way to separate benign prostate lesions from malignant ones. 735 740 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 L. Yu L. Yu Department of Ultrasound, Haining Central Hospital, Haining, China F. Shen F. Shen Department of Ultrasound, Haining Central Hospital, Haining, China X. Chen X. Chen Department of Ultrasound, Haining Central Hospital, Haining, China L. Han L. Han Department of Ultrasound, Haining Central Hospital, Haining, China Y. Qiu Y. Qiu Department of Ultrasound, Haining Central Hospital, Haining, China qiuyun94028455@163.com Prostatic neoplasms ultrasonography contrast media prostate-specific antigen differential diagnosis. Bergengren O, Pekala KR and Matsoukas K, et al. (2023) 2022 Update on Prostate Cancer Epidemiology and Risk Factors-A Systematic Review. European Urology, 84(2): 191-206.##Chen W, Xu L, Deng H, Zhu Z and Yang D (2025) Role of USP10/METTL3/CXCR4 Axis in Immunotherapy of Castration-Resistant Prostate Cancer. Iran J Allergy Asthma Immunol, 24(3): 334-346.##Nayan M, Carvalho FLF and Feldman AS (2022) Active surveillance for intermediate-risk prostate cancer. World Journal of Urology, 40(1): 79-86.##Liu S, Hsu E and Aslan M, et al. (2025) Extracellular Domain Shedding of TROP2 Activates EGFR Signaling to Drive Prostate Cancer Metastasis. Cancer Research, 85(23): 4632-4647.##Carlsson SV and Vickers AJ (2020) Screening for Prostate Cancer. The Medical Clinics of North America, 104(6): 1051-1062.##Sekhoacha M, Riet K, Motloung P, Gumenku L, Adegoke A and Mashele S (2022) Prostate Cancer Review: Genetics, Diagnosis, Treatment Options, and Alternative Approaches. Molecules, 27(17): 5730.##Deng R, Liu Y and Wang K, et al. (2024) Comparison of MRI artificial intelligence-guided cognitive fusion-targeted biopsy versus routine cognitive fusion-targeted prostate biopsy in prostate cancer diagnosis: a randomized controlled trial. BMC Medicine, 22(1): 530.##Dunn MW (2017) Prostate Cancer Screening. Seminars in Oncology Nursing, 33(2): 156-164.##Merriel SWD, Funston G and Hamilton W (2018) Prostate Cancer in Primary Care. Advances in Therapy, 35(9): 1285-1294.##Leslie SW, Soon-Sutton TL and Skelton WP: Prostate Cancer; StatPearls. Treasure Island (FL), StatPearls Publishing, 2026##Zhu Y, Shan J and Zhang Y, et al. (2019) Prostate Cancer Vascularity: Superb Microvascular Imaging Ultrasonography with Histopathology Correlation. Medical Science Monitor, 25: 8571-8578.##Merriel SWD, Pocock L and Gilbert E, et al. (2022) Systematic review and meta-analysis of the diagnostic accuracy of prostate-specific antigen (PSA) for the detection of prostate cancer in symptomatic patients. BMC Medicine, 20(1): 54.##Apfelbeck M, Clevert D, Ricke J, Stief C and Schlenker B (2018) Contrast enhanced ultrasound (CEUS) with MRI image fusion for monitoring focal therapy of prostate cancer with high intensity focused ultrasound (HIFU)1. Clinical Hemorheology and Microcirculation, 69(1-2): 93-100.##Dias AB, O'Brien C, Correas J and Ghai S (2022) Multiparametric ultrasound and micro-ultrasound in prostate cancer: a comprehensive review. The British Journal of Radiology, 95(1131): 20210633.##Gurwin A, Kowalczyk K and Knecht-Gurwin K, et al. (2022) Alternatives for MRI in Prostate Cancer Diagnostics-Review of Current Ultrasound-Based Techniques. Cancers, 14(8): 1859.##Chen L, Xu Y and Wang Y, et al. (2024) Prostate cancer microenvironment: multidimensional regulation of immune cells, vascular system, stromal cells, and microbiota. Molecular Cancer, 23(1): 229.##Maxeiner A, Fischer T and Schwabe J, et al. (2019) Contrast-Enhanced Ultrasound (CEUS) and Quantitative Perfusion Analysis in Patients with Suspicion for Prostate Cancer. Ultraschall in Der Medizin (Stuttgart, Germany: 1980), 40(3): 340-348.##Wildeboer RR, Postema AW, Demi L, Kuenen MPJ, Wijkstra H and Mischi M (2017) Multiparametric dynamic contrast-enhanced ultrasound imaging of prostate cancer. European Radiology, 27(8): 3226-3234.##Postema AW, Gayet MCW and van Sloun RJG, et al. (2020) Contrast-enhanced ultrasound with dispersion analysis for the localization of prostate cancer: correlation with radical prostatectomy specimens. World Journal of Urology, 38(11): 2811-2818.##Wildeboer RR, Mannaerts CK and van Sloun RJG, et al. (2020) Automated multiparametric localization of prostate cancer based on B-mode, shear-wave elastography, and contrast-enhanced ultrasound radiomics. European Radiology, 30(2): 806-815.##Wildeboer RR, van Sloun RJG, Huang P, Wijkstra H and Mischi M (2019) 3-D multi-parametric contrast-enhanced ultrasound for the prediction of prostate cancer. Ultrasound in Medicine and Biology, 45(10): 2713-2724.##Wegierak D, Cooley MB and Perera R, et al. (2024) Decorrelation time mapping as an analysis tool for nanobubble-based contrast enhanced ultrasound imaging. IEEE Transactions on Medical Imaging, 43(6): 2370-2380.##Rebello RJ, Oing C and Knudsen KE, et al. (2021) Prostate cancer. Nature Reviews Disease Primers, 7(1): 9.##Guo S, Kang F and Ma S, et al. (2024) The PRIMARY score: Diagnostic performance and added value compared with MRI in detecting clinically significant prostate cancer. Clinical Nuclear Medicine, 49(1): 37-44.##Mei J, Zhao Y, Jiang Y, Wang J and Yu J (2020) Association between contrast-enhanced ultrasound indicators and prostate cancer biochemical recurrence after treatment. Cancer Management and Research, 12: 4959-4968.##Yang F, Guo W, Sun S and Huang Y (2024) Diagnostic value of tripartite magnetic resonance imaging model based on T2-weighted imaging, diffusion-weighted imaging and dynamic contrast-enhanced imaging for prostatitis, prostatic hyperplasia and prostate cancer. Int J Radiat Res, 22(1): 111-116.## ##

MRI-based evaluation of brain volume changes in patients with Alzheimer’s disease over time 2 2 Background: Magnetic resonance imaging (MRI) may reveal quantifiable and structural changes to the brain as a result of Alzheimer's disease (AD), an irreversible neurodegenerative disease. Longitudinal evaluation of alterations in brain volumes presents essential information on disease development and evaluation of therapeutic response. Materials and Methods: The study was a prospective longitudinal cohort study that included 156 subjects (78 AD patients and 78 age-matched healthy controls). The baseline, 12 months, and 24 months high-resolution 3T MRI scan were taken. FreeSurfer software was used to perform automated volumetric analysis in order to measure total brain volume (TBV), hippocampal volume (HV), entorhinal cortex volume (ECV) and ventricular volume (VV). Results: AD participants showed a substantially higher rate of total brain volume loss (2.18 + 0.67/ vs. 0.52 + 0.24) and hippocampal atrophy (4.82 + 1.34/ vs. 0.89 + 0.41) each year than the controls. The AD patients experienced significant acceleration of enlargement of the ventricles (8.94 ± 2.87% vs. 2.14 ± 0.92%, p<0.001). The greatest discriminative ability between groups was observed with the entorhinal cortex volume (AUC = 0.94). There was great predictive value of baseline hippocampal volume with regard to the cognitive decline trajectory (r = -0.72, p<0.001). Conclusion: The volumetric MRI study demonstrates that in Alzheimer disease, there are accelerated and regional atrophy patterns of the brain. These results endorse the relevance of longitudinal structural MRI as a potent biomarker of disease progression and possible therapeutic effect of new clinical trials. 741 748 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 A. Albweady A. Albweady Department of Radiology, College of Medicine, Qassim University, Buraydah, Saudi Arabia a.albweady@qu.edu.sa B. Alkhalifah B. Alkhalifah Department of Radiology, College of Medicine, Qassim University, Buraydah, Saudi Arabia Alzheimer disease magnetic resonance imaging brain atrophy hippocampus entorhinal cortex ventricular enlargement. 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Deep learning-based classification of lung nodules on CT images: A multicenter study of early lung cancer detection 2 2 Background: Early lung cancer detection relies on accurate characterization of pulmonary nodules on computed tomography (CT). However, variability in CT acquisition and radiological interpretation may reduce reproducibility across institutions. This study evaluated a deep learning (DL) framework for benign-malignant lung nodule classification using multicenter CT datasets. Materials and Methods: Publicly available anonymized CT datasets from LUNA16 and LIDC-IDRI were used. Images were rescaled to a uniform resolution, denoised with Gaussian filtering, and normalized by Min-Max scaling. Nodule regions were segmented using a U-Net encoder-decoder network. Gray-Level Co-Occurrence Matrix (GLCM) texture features were extracted and combined with latent representations learned by an Effective Beetle Antennae Search-driven Variational Autoencoder (EBAS-VAE). Model performance was assessed using accuracy, precision, recall, F1-score, true-positive rate (TPR), false-positive rate (FPR), false discovery rate (FDR), and area under the receiver operating characteristic curve (AUC). Results: On LUNA16, EBAS-VAE achieved accuracy 0.9838, precision 0.94, recall 0.89, F1-score 0.96, and AUC 0.98. On LIDC-IDRI, accuracy was 0.97, TPR 0.97, FPR 0.04, and FDR 0.0001. EBAS-VAE outperformed 3D-CNN and SEOA-DBN comparators. Conclusion: The proposed EBAS-VAE pipeline improved lung nodule classification and reduced false-positive detection in multicenter CT images, supporting its potential as a radiologist-assistive screening tool. 749 754 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 C. Qi C. Qi Baicheng Medical College, Baicheng, Jilin, 137000, China Q. Jiang Q. Jiang Baicheng Central Hospital, Baicheng, Jilin, 137000, China 77073199@bcmc.edu.cn Computed tomography Deep learning Lung cancer Pulmonary nodule Variational autoencoder. 1. 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A logistic regression model utilizing computed tomography features for predicting the degree of malignancy in pure ground-glass nodule lung adenocarcinoma: A clinical investigation 2 2 Background: Differentiating the benign or malignant nature and the degree of infiltration of pure ground-glass nodules (pGGNs) is challenging and represents a clinical difficulty in the precise management of pulmonary nodules. It was to fabricate and validate a logistic regression (LR) model under high-resolution computed tomography (HRCT) features for the non-invasive preoperative prediction of the malignant infiltration degree in pGGN-type lung adenocarcinoma. Materials and Methods: A total of 180 patients (with 279 lesions) presenting with pure ground-glass nodules (pGGNs), defined as homogeneous ground-glass opacities without solid components on preoperative high-resolution computed tomography (HRCT), were retrospectively enrolled and randomly assigned to a model development group and a model validation group. HRCT imaging features were analyzed, including lesion size, mean CT value, margin characteristics, vacuole or cavity sign, and the relationship between vessels and the lesion. LR analyses identified independent predictors of invasive adenocarcinoma (IAC), to build the prediction model. Model discriminatory ability was evaluated. Results: Multivariate analysis identified lesion size, margin characteristics (irregular), vacuole or cavity sign, and type III vascular relationship as independent risk factors for predicting IAC. The model demonstrated good predictive performance in the development group, with area under the curve (AUC) of 0.810 (95%CI: 0.728-0.952), sensitivity of 0.782, and specificity of 0.722. The model also had robust performance in the validation group. Conclusion: The LR model under CT features effectively differentiated between pre-invasive lesions and invasive lung adenocarcinoma in pGGNs, providing a valuable non-invasive quantitative tool for formulating individualized clinical management strategies. 755 762 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 W. Zhang W. Zhang Department of Radiology, The First People’s Hospital of Pinghu, Pinghu, Zhejiang Province, China Y. Dong Y. Dong Department of Pathology, The First People’s Hospital of Pinghu, Pinghu, Zhejiang Province, China X. Wei X. 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Monte Carlo modeling for the computation of in-field and out-of-field doses in 3D conformal radiotherapy of breast cancer 2 2 Background: To generate the Monte Carlo (MC) 3D dose distribution in both in-field and out-of-field regions for three-dimensional conformal radiotherapy (3DCRT) of breast cancer patients and to compare it with the dose calculations from two available commercial treatment planning systems (TPS). Material and Methods: The Prowess Panther TPS was initially used to create the treatment plan and underwent a simulation process using the MCNPX 2.6.0 Monte Carlo code. Dose maps, profiles, dose volume histograms (DVHs), and mean doses for organs at risk (OARs) were calculated. To evaluate the accuracy of dose calculations, global gamma index analysis was conducted to ensure conformity between MC dose calculations and the two TPSs. Results: For individual beams, comparing Prowess to MC shows that the gamma passing rates (GPR) range from 94.3% to 99.2%, with a GPR of 91.2% for all beams combined. In contrast, when comparing RayStation to MC, the GPRs range from 96.0% to 99.0%, with a total beam GPR of 94.3%. Regarding out-of-field doses, the two TPSs can provide reliable dose calculations only for organs receiving mean doses greater than 500-700 cGy. Conclusion: The MC model was benchmarked for 3DCRT plans, demonstrating that it could provide accurate MC doses in the in-field area. Furthermore, the comparison between MC and TPS doses shows that RayStation performs better in the in-field region. Nonetheless, both TPS-based out-of-field estimates were unreliable, indicating the importance of utilizing MC methods to estimate out-of-field doses. 763 770 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 N. Rafat-Motavalli N. Rafat-Motavalli Department of Physics, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran H. Miri-Hakimabad H. Miri-Hakimabad Department of Physics, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran mirihakim@um.ac.ir E. Hoseinian-Azghadi E. Hoseinian-Azghadi Department of Physics, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran L. Rafat-Motavalli L. Rafat-Motavalli Department of Physics, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran M. Dayyani M. Dayyani Research and Education Department, Reza Radiotherapy and Oncology Center, Mashhad, Iran T. Tuğrul T. Tuğrul Department of Radiation Oncology, Medicine Faculty of Van Yüzüncü Yıl University, Van, Turkey Monte Carlo breast cancer radiotherapy. Lima SM, Kehm RD, Terry MB (2021) Global breast cancer incidence and mortality trends by region, age-groups, and fertility patterns. EClinical Medicine, 1: 38.##Sung H, Ferlay J, Siegel RL, Laversanne M, 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.##Rossi L, Mazzara C, Pagani O (2019) Diagnosis and treatment of breast cancer in young women. Current Treatment Options in Oncology, 20(12): 86.##Bronsart E, Dureau S, Xu HP, Bazire L, Chilles A, et al. (2017) Whole breast radiotherapy in the lateral isocentric lateral decubitus position: Long-term efficacy and toxicity results. Radiotherapy and Oncology, 124(2): 214-9.##da Luz FA, da Costa Marinho E, Nascimento CP, de Andrade Marques L, et al. (2022) The effectiveness of radiotherapy in preventing disease recurrence after breast cancer surgery. Surgical Oncology, 41: 101709.##Yoshimura A, Ito H, Nishino Y, Hattori M, et al. (2018) Recent improvement in the long-term survival of breast cancer patients by age and stage in Japan. Journal of Epidemiology, 28(10): 420-7.##Guatelli S and Incerti S (2017) Monte Carlo simulations for medical physics: From fundamental physics to cancer treatment. Physica Medica: European Journal of Medical Physics, 33: 179-81.##Brualla L, Rodriguez M, Lallena AM (2017) Monte Carlo systems used for treatment planning and dose verification. Strahlentherapie und Onkologie, 193(4): 243.##Liang Y, Muhammad W, Hart GR, Nartowt BJ, et al. (2020) A general-purpose Monte Carlo particle transport code based on inverse transform sampling for radiotherapy dose calculation. Scientific Reports, 10(1): 9808.##Berris T, Mazonakis M, Stratakis J, Tzedakis A, et al. (2013) Calculation of organ doses from breast cancer radiotherapy: a Monte Carlo study. Journal of Applied Clinical Medical Physics, 14(1): 133-46.##Kairn T, Livingstone AG, Crowe SB (2020) Monte Carlo calculations of radiotherapy dose in "homogeneous" anatomy. Physica Medica, 78: 156-65.##Arce P, Lagares JI, Azcona JD, Huesa-Berral C, Burguete J (2023) Precise dosimetric comparison between GAMOS and the collapsed cone convolution algorithm of 4D DOSE accumulated in lung SBRT treatments. Radiation Physics and Chemistry, 208: 110891.##Brualla L, Palanco-Zamora R, Wittig A, et al. (2009) Comparison between PENELOPE and electron Monte Carlo simulations of electron fields used in the treatment of conjunctival lymphoma. Physics in Medicine and Biology, 54: 5469-5481.##Panettieri V, Barsoum P, Westermark M, et al. (2009) AAA and PBC calculation accuracy in the surface build-up region in tangential beam treatments. Phantom and breast case study with the Monte Carlo code PENELOPE. Radiotherapy and Oncology, 93: 94 -101.##Huang JY, Followill DS, Wang XA, Kry SF (2013) Accuracy and sources of error of out of field dose calculations by a commercial treatment planning system for intensity‐modulated radiation therapy treatments. J Appl Clin Med Phys, 14(2): 186-97##Sánchez‐Nieto B, Medina‐Ascanio KN, Rodríguez‐Mongua JL, et al. (2020) Study of out‐of‐field dose in photon radiotherapy: A commercial treatment planning system versus measurements and Monte Carlo simulations. Medical Physics, 47(9): 4616-25.##Das IJ, Ding GX, Ahnesjö A (2008) Small fields: nonequilibrium radiation dosimetry. Medical physics, 35: 206-215.##Brualla L, Palanco-Zamora R, Steuhl K-P, et al. (2011) Monte Carlo simulations applied to conjunctival lymphoma radiotherapy treatment. Strahlentherapie und Onkologie, 187: 492-498.##Brualla L, Mayorga PA, Flühs A, et al. (2012) Retinoblastoma external beam photon irradiation with a special "D"-shaped collimator: a comparison between measurements, Monte Carlo simulation and a treatment planning system calculation. Physics in Medicine and Biology, 57: 7741-7751.##Brualla L, Zaragoza FJ, Sempau J, et al. (2012) Electron irradiation of conjunctival lymphoma-Monte Carlo simulation of the minute dose distribution and technique optimization. Int J Radiat Oncol Biol Phys, 83:1330-1337.##Mayorga PA, Brualla L, Sauerwein W, et al. (2014) Monte Carlo study for designing a dedicated "D"-shaped collimator used in the external beam radiotherapy of retinoblastoma patients. Medical physics, 41: 011714.##Takata T, Shiraishi K, Kumagai S, Arai N, et al. (2020) Calculating and estimating second cancer risk from breast radiotherapy using Monte Carlo code with internal body scatter for each out‐of‐field organ. J Appl Clin Med Phys, 21(12): 62-73.##De Saint-Hubert M, Suesselbeck F, Vasi F, Stuckmann F, et al. (2022) Experimental validation of an analytical program and a Monte Carlo simulation for the computation of the far out-of-field dose in external beam photon therapy applied to pediatric patients. Frontiers in Oncology, 7(12): 882506.##Al-Saleh WM and Hugtenburg RP (2023) Monte Carlo modelling of a 6 MV Elekta linear accelerator for in-field and out-of-field dosimetry. Radiation Physics and Chemistry, 203:110584.##Ghareeb F, Esposito A, Lencart J, Santos JA (2020) Localized extra focal dose collimator angle dependence during VMAT: An out-of-field Monte Carlo study using PRIMO software. Radiation Physics and Chemistry, 171:108694.##Sushma N, Kaginelli S, Sathiyaraj P, Manikandan PS, Ganesh KM (2023) Analysis of fetal dose using Optically Simulated Luminescence Dosimeter and ion chamber in randophantom for various radiotherapy techniques. Applied Radiation and Isotopes, 198:110854.##Mazonakis M and Damilakis J (2017) Estimation and reduction of the radiation dose to the fetus from external-beam radiotherapy. Physica Medica, 43:148-52.##Mazonakis M, Tzedakis A, Damilakis J (2017) Monte Carlo simulation of radiotherapy for breast cancer in pregnant patients: how to reduce the radiation dose and risks to fetus? Radiation Protection Dosimetry. 175(1):10-6.##Pinter C, Lasso A, Wang A, Jaffray D, Fichtinger G (2012) SlicerRT: radiation therapy research toolkit for 3D Slicer. Medical Physics, 39: 6332-6337.##Tuğrul T and Eroğul O (2019) Determination of initial electron parameters by means of Monte Carlo simulations for the Siemens Artiste Linac 6MV photon beam. Reports of Practical Oncology and Radiotherapy, 24(4): 331-7.##Franciosini G, Battistoni G, Cerqua A, De Gregorio A, et al. (2023) GPU-accelerated Monte Carlo simulation of electron and photon interactions for radiotherapy applications. Physics in Medicine & Biology, 68(4): 044001.##Kumar S, Nahum AE, Chetty IJ (2020). Monte-Carlo-computed dose, kerma and fluence distributions in heterogeneous slab geometries irradiated by small megavoltage photon fields. Physics in Medicine & Biology, 65(17): 175012.##Witte M and Sonke JJ (2024) A deep learning based dynamic arc radiotherapy photon dose engine trained on Monte Carlo dose distributions. 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The orienting-exploratory activity of rats after oral intake of industrial dust of uranium ore 2 2 Background: The functional abnormalities of the nervous system induced by the injection of industrial dust of uranium ore (DUO) into rat’s organism were studied. Materials and Methods: DUO was administered to nonlinear white male rats orally during a week in an amount of 5.8 g daily. The calculation of the individual absorbed and equivalent doses in the organs and tissues of rats allowed to include them to the range of small doses of ionizing radiation. To calculate the doses received by the animals during the experiment, the uranium content in biological samples was determined using an Agilent-7800 inductively coupled plasma mass spectrometer. The behavior of experimental animals was observed in the test in an open field condition for a month after incorporation into the body of long-lived radionuclides. Results: Analysis of behavioral acts in a group of males exposed to DUO at a dose of 50 maximum permissible concentration (MPC) indicated the predominance of passive-defensive forms of behavior, which was manifested by a decrease in motor and exploratory activity. The noted changes were evident throughout the study. At the same time, a slowdown in habituation processes was recorded, manifested in a small variability in the number of crossed squares and the number of vertical posts. Conclusion: The intake of DUO at a dose of 50 MPC changed the indices of locomotor and research activity of rats significantly along with an increased concentration of uranium in the organs and tissues of animals, including the brain.  771 777 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 E.A. Saifulina E.A. Saifulina Laboratory of Epidemiology and Medical Dosimetry Register of the Scientific Research Institute of Radiobiology and Radiation Protection, NpJSC “Astana Medical University”, Astana city, Kazakhstan saifulina.e@amu.kz P.K. Kazymbet P.K. Kazymbet Scientific Research Institute of Radiobiology and Radiation Protection of the nJSC, Astana Medical University, Astana, Kazakhstan A.А. Musina A.А. Musina Department of Public Health and Epidemiology, NJSC, Astana Medical University, Astana, Kazakhstan В. Aitbayeva В. Aitbayeva Department of Pathological Physiology named after V.G. Korpachyov NPJSC, Astana Medical University, Astana, Kazakhstan T. Kashkinbayev Ye T. Kashkinbayev Ye Scientific Research Institute of Radiobiology and Radiation Protection of the nJSC, Astana Medical University, Astana, Kazakhstan D.S. Tazhibayeva D.S. Tazhibayeva Department of Pathological Physiology named after V.G. Korpachyov NPJSC, Astana Medical University, Astana, Kazakhstan K.A. Kusmambetova K.A. Kusmambetova Department of Medical Genetics and Molecular Biology of the nJSC "Astana Medical University, Astana, Kazakhstan S.A. Tulepbergenova S.A. Tulepbergenova Department of Medical Genetics and Molecular Biology of the nJSC "Astana Medical University, Astana, Kazakhstan T.N. Tuleuov T.N. Tuleuov Department of Pathological Physiology named after V.G. Korpachyov NPJSC, Astana Medical University, Astana, Kazakhstan Indicative-research activity ionizing radiation nervous system open field uranium. Ibrayeva D, Bakhtin M, Kashkinbayev Y, Kazymbet P, et al. (2020) radiation situation in the territories affected by mining activities in stepnogorsk areas, republic of Kazakhstan: Pilot study. Radiation Protection Dosimetry, 189(4): 517-526.##Kashkinbayev Y, Kazymbet P, Bakhtin M., Khazipova A, et al. (2023). Indoor Radon Survey in Aksu School and Kindergarten Located near Radioactive Waste Storage Facilities and Gold Mines in Northern Kazakhstan (Akmola Region). Atmosphere, 14(7): 1133.##Saifulina A, Janabayev D, Kashkinbayev Y, Shokabaeva A, et al. (2023) Epidemiology of somatic diseases and risk factors in the population living in the zone of influence of uranium mining enterprises of Kazakhstan: A pilot study. Healthcare (Basel, Switzerland), 11(6): 804.##Available online: https://ir-esg.kazatomprom.kz/ru/development/human-capital (accessed on 13 September 2023).##Rump A., Eder S, Lamkowski A, Hermann C, et al. (2019) A quantitative comparison of the chemo- and radiotoxicity of uranium at different enrichment grades. Toxicology letters, 313: 159-168.##Aumalikova M, Bakhtin M, Кazymbet P, Zhumadilov K, et al. (2020). Site-specific concentration of uranium in urine of workers of the hydrometallurgical plant of Stepnogorsk mining and chemical combine. Radiation and Environmental Biophysics, 59(4): 703-710.##Ngan Thy T, Thich N, Cung N, Phuong Dung T, et al. (2024) Assessment of radiological risk due to radioactive contamination in the air for different types of laboratories in Ho Chi Minh City, Vietnam. Int J Radiat Res, 22(3): 551-557.##Janavayev DJ, Kashkinbayev YT, Ilbekova KB, Saifulina YA, et al. (2019) Health status of the population living in the zone of influence of radioactive waste repositories. Electronic J General Medicine, 16(6): em176.##Vellingiri B (2023) A deeper understanding about the role of uranium toxicity in neurodegeneration. Environmental Research, 233: 116430.##Lestaevel P, Grison S, Favé G, Elie C, et al. (2016). Assessment of the Central Effects of Natural Uranium via Behavioural Performances and the Cerebrospinal Fluid Metabolome. Neural Plasticity, 2016: 9740353.##Kempf SJ, Janik D, Barjaktarovic Z, Braga-Tanaka I, et al. (2016) Chronic low-dose-rate ionising radiation affects the hippocampal phosphoproteome in the ApoE-/- Alzheimer's mouse model. Oncotarget, 7(44): 71817-71832.##Saint-Marc B, Elie C, Manens L, Tack K, et al. (2016) Chronic uranium contamination alters spinal motor neuron integrity via modulation of SMN1 expression and microglia recruitment. Toxicology letters, 254: 37-44.##Legrand M, Lam S, Anselme I, Gloaguen C, et al. (2016) Exposure to depleted uranium during development affects neuronal differentiation in the hippocampal dentate gyrus and induces depressive-like behavior in offspring. Neurotoxicology, 57: 153-162.##Zhang Y, Ou G, Li Q, Ma S, Du L (2022) Treatment strategies for radiation-induced brain injury. Int J Radiat Res, 20(4):727-736.##Koterov AN, Ushenkova LN, Zubenkova ES Zubenkova ES, et al. (2018) Correlation of ages of main laboratory animals (mice, rats, hamsters and dogs) and humans: relevance for the problem of age-related radiosensitivity and analysis of published data. Medical Radiology and Radiation Safety (1): 5-27.##Saifulina Y, Toklayeva S, Sharipov M, Medethan R, et al. (2019). Distribution of uranium in the internal organs of laboratory animals after incorporation of uranium ore dust. BIO Web Conf. 14 05015.##Moiseev AA and Ivanov VI (1984) Handbook of dosimetry and radiation hygiene. Energoatomizdat. Moscow.##Severyukhin YS, Lalkovičová M, Utina DM, Lyakhova KN, et al. (2023) Comparative analysis of behavioral reactions and morphological changes in the rat brain after exposure to ionizing radiation with different physical characteristics. Cellular and Molecular Neurobiology, 43(1): 339-353.##Lecorps B, Rödel HG, Féron C (2016) Assessment of anxiety in open field and elevated plus maze using infrared thermography. Physiology & Behavior, 157: 209-216.##Aitken P, Zheng Y, Smith PF (2017) Ethovision™ analysis of open field behavior in rats following bilateral vestibular loss. J Vestibular Research: Equilibrium & Orientation, 27(2-3): 89-101.##Samih M and Ahami AOT (2019) Effects of nettle on locomotor activity and anxiety behavior in male Wistar rats after pesticide intoxication. Pakistan Journal of Biological Sciences: PJBS, 22(4): 196-200.##Tazhibayeva D, Kabdualieva N, Aitbayeva Z, Sengaliy M, Niyazbekova, K. (2020) The dynamics of lipoperoxidation processes in the early period after combined effects of a high dose gamma radiation and immobilization stress (experimental research). Georgian Medical News, (302): 127-132.##Kim M, Oh, S, Kim S, Ji M, et al. (2023) Alcohol perturbed locomotor behavior, metabolism, and pharmacokinetics of gamma-hydroxybutyric acid in rats. Biomedicine & pharmacotherapy, 164: 114992.##Huang C, Zhang F, Li P, Song C (2022) Low-dose IL-2 attenuated depression-like behaviors and pathological changes through restoring the balances between IL-6 and TGF-β and between Th17 and Treg in a Chronic stress-induced mouse model of depression. Int J Molecular Sciences, 23(22): 13856.##Franco CCDS, Previate C, Trombini AB, Miranda RA, et al. (2021) Metformin improves autonomic nervous system imbalance and metabolic dysfunction in monosodium l-glutamate-treated rats. Frontiers in Endocrinology, 12: 660793.##Pavlik L, Mikheeva I, Shtanchaev R, Mikhailova G, Arkhipov V (2020) influence of a 30-day spaceflight on the structure of motoneurons of the trochlear nerve nucleus in mice. BioRxiv, 2020: 299461.##Thibaut F (2017) Anxiety disorders: a review of current literature. Dialogues in Clinical Neuroscience, 19(2): 87-88.##Ayala-Lopez N and Watts SW (2021) Physiology and pharmacology of neurotransmitter transporters. 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A Simulation and experimental study on neutron attenuation of polyester composites incorporated with boron carbide micro- and nano-particles 2 2 Background: To mitigate neutron exposure hazards in industries like aerospace, flexible, lightweight polymer-based shields with high-temperature tolerance have been developed using suitable fillers that moderate fast neutrons and capture slow neutrons, ensuring reliable radiation protection. Material and Methods: This study involved exposing unsaturated polyester resin (UPS) composites reinforced with nano- and micro-sized boron carbide (B₄C) to neutron radiation from a ²³⁹Pu–Be source. Various weight percentages (0.5%, 1%, 2%, and 5%) of nano- and micro-B₄C fillers, along with thicknesses of 2.5 mm, 5 mm, 7.5 mm, and 10 mm, were evaluated. Experimental measurements were carried out to count fast and thermal neutrons, measure the macroscopic cross-section, half value layer, and Geant4 Monte Carlo simulations were performed for benchmarking. Results: Higher concentrations of B₄C resulted in increased total cross-section values and decreased half-value thickness measurements. At 5mm, 7.5mm, and 10 mm thicknesses, significant differences between nano- and micro-composites emerged at 2 wt.% (p < 0.05), becoming more pronounced with higher filler concentrations and greater sample thickness. These findings confirm the superior neutron attenuation performance of nano-sized B₄C, attributed to its higher surface-to-volume ratio and improved dispersion within the matrix. Geant4 simulations closely matched the experimental data at higher filler loadings, except under certain conditions. Conclusion: Both experimental and simulation results confirmed that protection improves with increased thickness and filler weight percentages, as expected. The study also highlighted the impact of nanotechnology on shielding properties, showing its advantage over micro-sized samples. 779 787 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 S. Sabokro S. Sabokro Medical Physics and Engineering Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran J. Moradgholi J. Moradgholi Department of Materials Engineering, Isfahan University of Technology (IUT), Isfahan, Iran P. Rafiepour P. Rafiepour School of Engineering, Persian Gulf University, Mahini Ave, Bushehr 7516913817, Iran S.M.J. Mortazavi S.M.J. Mortazavi Medical Physics and Engineering Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran mortazavismj@gmail.com Neutrons polyesters boron carbide nanoparticles microparticles. 1. Mustonen R, Bouvier G, Wolber G, et al. (1999) A comparison of gamma and neutron irradiation on Raji cells: effects on DNA damage, repair, cell cycle distribution and lethality. Mutation Research, 429(2): 169-75.##Stewart RD, Streitmatter SW, Argento DC, et al. (2015) Rapid MCNP simulation of DNA double strand break (DSB) relative biological effectiveness (RBE) for photons, neutrons, and light ions. Physics in Medicine and Biology, 60(21): 8249-74.##Akashi M, Hirama T, Tanosaki S, et al. (2001) Initial symptoms of acute radiation syndrome in the JCO criticality accident in Tokaimura. Journal of Radiation Research, 42 (Suppl): S157-S66.##Acharya MM, Baulch JE, Klein PM, et al. (2019) New concerns for neurocognitive function during deep space exposures to chronic, low dose-rate, neutron radiation. eNeuro, 6(4): ENEURO.0094-19.2019.##Norbury JW, Slaba TC, Aghara S, et al. (2019) Advances in space radiation physics and transport at NASA. Life Sciences in Space Research, 22: 98-124.##Piotrowski T (2021) Neutron shielding evaluation of concretes and mortars: a review. Construction and Building Materials, 277: 122238.##Abdulrahman ST, Ahmad Z, Thomas S, et al. (2020) Introduction to neutron-shielding materials. Micro and nanostructured composite materials for neutron shielding applications: Woodhead Publishing, p: 1-23.##Kharita MH, Yousef S, AlNassar M (2011) Review on the addition of boron compounds to radiation shielding concrete. Progress in Nuclear Energy, 53(2): 207-11.##Baxter L, Herrman K, Panthi R, et al. (2020) Thermoplastic micro-and nanocomposites for neutron shielding. Micro and nanostructured composite materials for neutron shielding applications: Woodhead Publishing, p: 53-82.##Mortazavi SMJ, Bevelacqua JJ, Rafiepour P, et al. (2024) Lead-free, multilayered, and nanosized radiation shields in medical applications, industrial, and space research. Advanced Radiation Shielding Materials: Elsevier, p. 305-22.##Sukegawa AM, Okuno K, Sakurai S (2009) High-heat-resistant neutron shielding resin. Nuclear Technology, 168(2): 553-8.##El-Sarraf MA, El-Sayed Abdo A (2013) Insulating epoxy/barite and polyester/barite composites for radiation attenuation. Applied Radiation and Isotopes, 79: 18-24.##Kandelbauer A, Tondi G, Zaske OC, et al. (2022) Unsaturated polyesters and vinyl esters. Handbook of Thermoset Plastics: William Andrew Publishing, p: 97-158.##Tuna T, Eker AA, Kam E (2021) Neutron shielding characteristics of polymer composites with boron carbide. Journal of the Korean Physical Society, 78: 566-73.##Kaewsrithong K, Suriwong T, Julphunthong P, et al. (2023) Development and evaluation of boron carbide-modified unsaturated polyester resin for use as neutron radiation Protection. Journal of Physics: Conference Series, IOP Publishing.##Uddin Z, Yasin T, Shafiq M, et al. (2020) On the physical, chemical, and neutron shielding properties of polyethylene/boron carbide composites. Radiation Physics and Chemistry, 166: 108450.##Oğul H, Polat H, Akman F, et al. (2022) Gamma and neutron shielding parameters of polyester-based composites reinforced with boron and tin nanopowders. Radiation Physics and Chemistry, 201: 110474.##Park J, Her S, Cho S, Woo SM, Bae S (2022) Synthesis and characterization of Polyethylene/B4C composite, and its neutron shielding performance in cementitious materials: Experimental and simulation studies. Cement and Concrete Composites, 129: 104458.##Wang W, Li Q, Li Q, Yang X, Le G (2022) A review of irradiation stability of lithium hydride neutron shielding material. Materials Science and Technology, 32(5): 434-7.##Schuy C, Tessa C, Horst F, et al. (2022) Experimental assessment of lithium hydride's space radiation shielding performance and Monte Carlo benchmarking. Radiation Research, 191(2): 154-61.##El-Khatib AM, Hamada MS, Alabsy MT, et al. (2021) Fast and thermal neutrons attenuation through micro-sized and nano-sized CdO reinforced HDPE composites. Radiation Physics and Chemistry, 180: 109245.##Moradgholi J and Mortazavi SMJ (2021) Developing a radiation shield and investigating the mechanical properties of polyethylene-polyester/CdO bilayer composite. Ceramics International, 48(4): 5246-51.##Babu NK, Muthukumaran S, Arokiasamy S, et al. (2018) Thermal and mechanical behavior of the coir powder filled polyester micro-composites. Journal of Natural Fibers, 17(7): 1058-1068.##Brown DA, Chadwick MB, Capote R, et al. (2018) ENDF/B-VIII.0: The 8th major release of the nuclear reaction data library with CIELO-project cross sections, New standards and thermal scattering data. Nuclear Data Sheets, 148: 1-142.##Li X, Wu J, Tang C, He Z, Yuan P, Sun Y, et al. (2019) High temperature resistant polyimide/boron carbide composites for neutron radiation shielding. Composites Part B: Engineering, 159: 355-61.##Tamayo P, Thomas C, Rico J, et al. (2020) Review on neutron-absorbing fillers. Micro and nanostructured composite materials for neutron shielding applications: Woodhead Publishing, p: 25-52.##Harrison C, Weaver S, Bertelsen C, et al. (2008) Polyethylene/boron nitride composites for space radiation shielding. Journal of Applied Polymer Science, 109(4): 2529-38.##Shin JW, Lee JW, Yu S, et al. (2014) Polyethylene/boron-containing composites for radiation shielding. 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Application of ultrasound-based thyroid imaging reporting and data system for assessing thyroid nodules with suspected malignancy 2 2 Background: To evaluate the effectiveness of the Kwak Thyroid Imaging Reporting and Data System (TI-RADS) in preoperatively identifying suspicious malignant thyroid nodules (MTNs) and to investigate size-dependent ultrasound features associated with malignancy. Materials and Methods: This study reviewed 155 patients (212 nodules suspected of thyroid cancer) who underwent surgical treatment at The Second Hospital of Hebei Medical University between June 2015 and December 2019. Preoperative ultrasound findings were classified using the Kwak TI-RADS system based on five features: solid composition, hypoechogenicity, irregular/lobulated margin, aspect ratio ≥1, and microcalcifications. Nodules were categorized into TI-RADS 3–5, with histopathology serving as the diagnostic benchmark. The positive predictive value (PPV), sensitivity, specificity, negative predictive value (NPV), and accuracy were calculated. Additionally, ultrasonographic characteristics of papillary malignant nodules (≤1 cm) were compared to those of larger malignant nodules (>1 cm). Results: Of the 212 nodules, histopathology identified 193 as malignant and 19 as benign. The TI-RADS demonstrated a PPV of 96.94%, sensitivity of 98.45%, specificity of 68.42%, NPV of 81.25%, and accuracy of 95.75%. Size-stratified analysis revealed distinct imaging phenotypes: microcarcinomas (n = 119) were more frequently associated with an aspect ratio ≥1 (80.67%) and microcalcifications (57.98%), while larger malignant nodules (n = 74) exhibited higher rates of coarse calcifications (24.32%) and increased vascularity (grade 2/3: 32.43%). The two groups showed significant differences in aspect ratio, type of calcification, and vascularity (p<0.01). Conclusion: The TI RADS classification effectively predicts the diagnosis of suspicious MTN. 789 794 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 Y. Wu Y. Wu Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China D. Liu D. Liu Mathematics teaching and research department of medical imaging college Center, The Second Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China Y. Zhou Y. Zhou Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China X. Xin X. Xin Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China A. Guo A. Guo Physical Examination Center, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China ainanguo902@163.com Thyroid nodule microcarcinomas ultrasonography classification system diagnosis differential retrospective studies. 1. Han D, Zhang Y, Zhang Y, Pei Y, Huang X, Qin L, et al. (2025) Analysis of the detection rate and related factors of thyroid nodules in the healthy population. Open Life Sci, 20(1): 20251079.##Shimura H, Yokoya S, Suzuki S, Iwadate M, Suzuki S, Matsuzuka T, et al. (2023) Confounding factors and biases involved in regional differences in the detection rate of thyroid cancer in the second-round thyroid ultrasound examination: the Fukushima health management survey. J Radiat Res, 64(5): 761-8.##Sharma R, Kumar Mahanti G, Panda G, Singh A (2023) Thyroid nodules classification using weighted average ensemble and D-CRITIC based TOPSIS methods for ultrasound images. Curr Med Imaging, 10.2174/1573405620666230405085358. Advance online publication. ##https://doi.org/10.2174/1573405620666230405085358##Angell TE, Maurer R, Wang Z, Kim MI, Alexander CA, Barletta JA, et al. (2019) A cohort analysis of clinical and ultrasound variables predicting cancer risk in 20,001 consecutive thyroid nodules. J Clin Endocrinol Metab, 104(11): 5665-72.##Wang X, Niu Y, Liu H, Tian F, Zhang Q, Wang Y, et al. (2025) ThyroNet-X4 genesis: an advanced deep learning model for auxiliary diagnosis of thyroid nodules' malignancy. Sci Rep, 15(1): 4214.##Xia M, Song F, Zhao Y, Xie Y, Wen Y, Zhou P (2023) Ultrasonography-based radiomics and computer-aided diagnosis in thyroid nodule management: performance comparison and clinical strategy optimization. Front Endocrinol (Lausanne), 14: 1140816.##Nie W, Zhu L, Yan P, Sun J (2022) Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system. Adv Clin Exp Med, 31(6): 597-606.##Gürsel BE, Çağlar B, Özpar R, Saraydaroğlu Ö, Gökalp G, Topal NB (2024) Multimodal ultrasonography evaluation in thyroid nodule characterization: what is the ideal algorithm? Med Ultrason, 26(1): 41-9.##Russ G (2016) Risk stratification of thyroid nodules on ultrasonography with the French TI-RADS: description and reflections. Ultrasonography, 35(1): 25-38.##Wang Y, Lei KR, He YP, Li XL, Ren WW, Zhao CK, et al. (2017) Malignancy risk stratification of thyroid nodules: comparisons of four ultrasound Thyroid Imaging Reporting and Data Systems in surgically resected nodules. Sci Rep, 7(1): 11560.##Kang YJ, Stybayeya G, Lee JE, Hwang SH (2022) Diagnostic performance of ACR and Kwak TI-RADS for benign and malignant thyroid nodules: An update systematic review and meta-analysis. Cancers (Basel), 14(23): 5961.##Topcuoglu OM, Uzunoglu B, Orhan T, Basaran EB, Gormez A, Sarica O (2025) A real-world comparison of the diagnostic performances of six different TI-RADS guidelines, including ACR-/Kwak-/K-/EU-/ATA-/C-TIRADS. Clin Imaging, 117: 110366.##Qi TY, Chen X, Liu H, Mao L, Chen J, He BL, et al. (2022) Comparison of thyroid nodule FNA rates recommended by ACR TI-RADS, Kwak TI-RADS and ATA guidelines. Eur J Radiol, 148: 110152.##Maia FF, Matos PS, Pavin EJ, Zantut-Wittmann DE (2015) Thyroid imaging reporting and data system score combined with Bethesda system for malignancy risk stratification in thyroid nodules with indeterminate results on cytology. Clin Endocrinol, 82(3): 439-44.##Weiss MH (2021) In response to "Discriminating malignancy in thyroid nodules: The nomogram versus the Kwak and ACR TI-RADS". Otolaryngol Head Neck Surg, 165(5): 755-6.##Grani G, Sponziello M, Pecce V, Ramundo V, Durante C (2020) Contemporary thyroid nodule evaluation and management. J Clin Endocrinol Metab, 105(9): 2869-83.##Lim JY and Kuo JH (2022) Thyroid nodule radiofrequency ablation: Complications and clinical follow up. Tech Vasc Interv Radiol, 25(2): 100824.##Chen Z, Du Y, Cheng L, Zhang Y, Zheng S, Li R, et al. (2022) Diagnostic performance of simplified TI-RADS for malignant thyroid nodules: comparison with 2017 ACR-TI-RADS and 2020 C-TI-RADS. Cancer Imaging, 22(1): 41.##Singaporewalla RM, Hwee J, Lang TU, Desai V (2017) Clinico-pathological correlation of thyroid nodule ultrasound and cytology using the TIRADS and Bethesda classifications. World J Surg, 41(7): 1807-11.##Okasha HH, Mansor M, Sheriba N, Assem M, Abdelfattah Y, Ashoush OA, et al. (2021) Role of elastography strain ratio and TIRADS score in predicting malignant thyroid nodule. Arch Endocrinol Metab, 64(6): 735-42.##Hong YR, Yan CX, Mo GQ, Luo ZY, Zhang Y, Wang Y, et al. (2015) Conventional US, elastography, and contrast enhanced US features of papillary thyroid microcarcinoma predict central compartment lymph node metastases. Sci Rep, 5: 7748.##Jung CK, Bychkov A, Kakudo K (2022) Update from the 2022 World Health Organization classification of thyroid tumors: A standardized diagnostic approach. Endocrinol Metab (Seoul), 37(5): 703-18.##Li M, Wei L, Li F, Kan Y, Liang X, Zhang H, et al. (2021) High risk thyroid nodule discrimination and management by modified TI-RADS. Cancer Manag Res, 13: 225-34.##Fernández Velasco P, Pérez López P, Torres Torres B, Delgado E, de Luis D, Díaz Soto G (2024) Clinical evaluation of an artificial intelligence-based decision support system for the diagnosis and American College of Radiology Thyroid Imaging Reporting and Data System classification of thyroid nodules. Thyroid, 34(4): 510-8.##Zhang F, Mei F, Chen W (2025) Development of a malignancy risk prediction model combining ultrasound and cytology for Bethesda category III thyroid nodules. World J Surg Oncol, 23(1): 438.##Sun CF, Wu D, Sun JY, Hou YL, Xin JW, Ru XC, et al. (2025) Diagnostic performance of ultrasound elastography alone and in combination with conventional ultrasonography for Bethesda III-IV thyroid nodules: a systematic review and meta-analysis. Quant Imaging Med Surg, 15(10): 9613-30.##Vardarli I, Tan S, Görges R, Krämer BK, Herrmann K, Brochhausen C (2024) Diagnostic accuracy of Afirma gene expression classifier, Afirma gene sequencing classifier, ThyroSeq v2 and ThyroSeq v3 for indeterminate (Bethesda III and IV) thyroid nodules: a meta-analysis. Endocr Connect, 13(7): e240170.## ##

The value of computed tomography-based assessment of femoral neck bone mineral density in elderly hip fractures 2 2 Background: Elderly hip fracture patients are at high risk for postoperative deep vein thrombosis (DVT). The role of femoral neck bone mineral density (BMD) assessed by computed tomography (CT) in predicting DVT remains unclear. The aim of this work was to evaluate femoral neck BMD using CT and analyze its correlation with postoperative DVT risk. Materials and Methods: This retrospective study included 130 elderly hip fracture patients, categorized into DVT (n=62) and No-DVT (n=68) groups based on postoperative ultrasound. CT X-ray absorptiometry measured BMD at admission, classifying patients as normal BMD (n=42), osteopenia (n=52), or osteoporosis (n=36). Clinical data and DVT incidence were compared. Logistic regression identified risk factors, and ROC curves assessed predictive value. Results: Overall DVT incidence was 47.69%. A significant inverse relationship existed between BMD and DVT: 21.43% (normal), 48.08% (osteopenia), and 77.78% (osteoporosis) (P<0.05). Univariate analysis identified age≥75, BMI≥25 kg/m², diabetes, smoking history, surgery time≥2 h, and T-score≤-2.5 as associated with DVT (P<0.05). Binary logistic regression confirmed these as independent risk factors (P<0.05). T-score≤-2.5 showed the strongest association (OR=6.176, 95% CI: 2.533-15.060). ROC analysis for the combined six indicators yielded an AUC of 0.855 (95% CI: 0.783-0.911), superior to individual indicators (AUC: 0.620-0.667). Conclusion: CT-assessed femoral neck BMD is significantly associated with postoperative DVT risk in elderly hip fracture patients and, when combined with clinical factors, provides a valuable predictive tool. 795 803 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/8 1405/6/17 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 W. Ding W. Ding Department of Orthopaedics, The people’s hospital of YuHuan, Yuhuan, Zhejiang, China C. Li C. Li Department of Orthopaedics, The people’s hospital of YuHuan, Yuhuan, Zhejiang, China dingwllcf@hotmail.com Osteoporosis bone mineral density venous thrombosis X-Ray computed tomography risk factors. 1. Yang W, Li G, Liu J (2024) The incidence, prevalence, and health burden of hip fractures in China: Data from the global burden of disease study 2019. Preventive Medicine Reports, 38: 102622.##Kanis JA, Odén A, McCloskey EV, et al. (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporosis International, 23(9): 2239-56.##Pekonen SR, Kopra J, Kröger H, et al. (2021) Regional and gender-specific analyses give new perspectives for secular trend in hip fracture incidence. Osteoporosis International, 32(9): 1725-33.##Shi LT and Kong FQ (2024) Evaluation of preoperative coagulation function changes and deep vein thrombosis incidence in elderly patients with hip fractures. Clinical Hemorheology and Microcirculation, 87(3): 375-82.##Wang Z, Xiao J, Zhang Z, et al. (2018) Chronic kidney disease can increase the risk of preoperative deep vein thrombosis in middle-aged and elderly patients with hip fractures. Clinical Interventions in Aging, 13: 1669-74.##Ge X, Yao L, Liu Y, et al. (2025) Comparing machine learning models for predicting preoperative DVT incidence in elderly hypertensive patients with hip fractures: a retrospective analysis. Scientific Reports, 15(1): 13206.##Rostagno C, Gatti M, Cartei A, et al. (2025) Early deep venous thrombosis after hip fracture surgery in patients in pharmacological prophylaxis. Journal of Clinical Medicine, 14(3): 726.##Dubois-Silva Á, Barbagelata-López C, Piñeiro-Parga P, et al. (2023) Deep vein thrombosis symptoms and 30-day mortality in acute pulmonary embolism. European Journal of Internal Medicine, 108: 43-51.##Je M, Kang K, Yoo JI, et al. (2023) The influences of macronutrients on bone mineral density, bone turnover markers, and fracture risk in elderly people: A review of human studies. Nutrients, 15(20): 4386.##Ohira, S, Ikawa, T, Kanayama, N, et al. (2023) Dual-energy computed tomography-based iodine concentration as a predictor of histopathological response to preoperative chemoradiotherapy for pancreatic cancer. Journal of Radiation Research, 64(6): 940-7.##Shao H, Yang L, Hu H, et al. (2025) Assessing vertebral bone density changes with phantomless QCT after posterior open reduction and internal fixation. Scientific Reports, 15(1): 18665.##Filley A, Baldwin A, Ben-Natan AR, et al. (2024) The influence of osteoporosis on mechanical complications in lumbar fusion surgery: a systematic review. North American Spine Society Journal, 18: 100327.##World Medical Association Declaration of Helsinki (2025) Ethical principles for medical research involving human participants. Jama, 333(1): 71-4.##Beyer-Westendorf J, Mouret P, Turpie AG (2017) Rivaroxaban for venous thromboembolism prevention after major orthopedic surgery: translating trial data into routine clinical practice. Orthopedic Research and Reviews, 9: 1-11.##Kim CH, Yoo JH, Lee YK, et al. (2023) Prevention of Venous thromboembolism in patients undergoing hip fracture surgery: A survey of the Korean hip society. Hip & Pelvis, 35(3): 200-5.##Andresen JR, Schröder G, Haider T, et al. (2025) Osteoporosis assessment using bone density measurement in hounsfield units in the femoral native CT cross-section: A comparison with computed tomography X-Ray absorptiometry of the Hip. Diagnostics (Basel, Switzerland), 15(8): 1014.##Koch, V, Biener, M, Müller-Hennessen, M, et al. (2021) Diagnostic performance of D-dimer in predicting venous thromboembolism and acute aortic dissection. European Heart Journal Acute Cardiovascular Care, 10(5): 559-66.##Wenger N, Sebastian T, Engelberger RP, et al. (2021) Pulmonary embolism and deep vein thrombosis: Similar but different. Thrombosis Research, 206: 88-98.##Taoka, T, Ohmori, T, Kanazawa, T, et al. (2023) Delayed surgery after hip fracture affects the incidence of venous thromboembolism. Journal of Orthopaedic Surgery and Research, 18(1): 630.##Qiang WS, Dang L, Wu YL, et al. (2025) The waiting time of admission to operation was associated with preoperative deep vein thrombosis in geriatric hip fracture. Scientific Reports, 15(1): 23843.##Miura I, Kubota M, Momozaki N, et al. (2021) Prevalence and screening of deep vein thrombosis in patients with osteoporotic vertebral fracture. Turkish Neurosurgery, 31(5): 745-50.##Jiahao, L, Kun, Z, Binfei, Z, et al. (2020) Relationship between the incidence of deep vein thrombosis during hospitalization and the energy of injury in tibial plateau fractures. Clinical and applied thrombosis/hemostasis, 26: 1076029620913948.##Chen, Y., & Wang, J. (2025) Platelet-Rich plasma drug delivery system for the treatment of osteoporosis. Journal of Pharmacological Biomolecules and Therapeutics, 1(1): 19-26.##Zhao W, Li J, Su T, et al. (2025) Osteoclast activation and inflammatory bone diseases: Focusing on receptors in osteoclasts. Journal of Inflammation Research, 18: 3201-13.##Canecki-Varžić S, Prpić-Križevac I, Bilić-Ćurčić I (2016) Plasminogen activator inhibitor-1 concentrations and bone mineral density in postmenopausal women with type 2 diabetes mellitus. BMC Endocrine Disorders, 16: 14.##Kanno Y (2024) The Roles of Fibrinolytic Factors in Bone Destruction Caused by Inflammation. Cells, 13(6): 516.##Gong D and Wang Q (2025) Meta-analysis of risk factors for postoperative lower extremity deep vein thrombosis in patients with gynecologic malignancies. Frontiers in Surgery, 12: 1406425.##Cann CE, Adams JE, Brown JK, et al. (2014) CTXA hip--an extension of classical DXA measurements using quantitative CT. PloS one, 9(3): e91904.##Cowan S, Ghayyad K, Conlon MJ, et al. (2024) Trends in the epidemiology of deep vein thrombosis and pulmonary embolism in patients undergoing surgery. Cureus, 16(12): e74925.##Lindström S, Germain M, Crous-Bou M, et al. (2017) Assessing the causal relationship between obesity and venous thromboembolism through a Mendelian Randomization study. Human Genetics, 136(7): 897-902.##Padilla J, Manrique-Acevedo C, Martinez-Lemus LA (2022) New insights into mechanisms of endothelial insulin resistance in type 2 diabetes. American Journal of Physiology Heart and Circulatory Physiology, 323(6): H1231-h8.##Abudukadier M, Yuan T, Liu H, et al. (2025) Analysis of risk factors for lower deep vein thrombosis (DVT) in patients over 60 years of age after total hip arthroplasty. BMC Musculoskeletal Disorders, 26(1): 557.##Qambari H, Yu PK, Balaratnasingam C, et al. (2025) Endothelial function can be modulated by acute hyperglycemia. Scientific Reports, 15(1): 30559.##Dong H, Sun Y, Nie L, et al. (2024) Metabolic memory: mechanisms and diseases. Signal Transduction and Targeted Therapy, 9(1): 38.##Benowitz NL and Burbank AD (2016) Cardiovascular toxicity of nicotine: Implications for electronic cigarette use. Trends in Cardiovascular Medicine, 26(6): 515-23.##Meknas D, Brækkan SK, Hansen JB, et al. (2023) Surgery as a trigger for incident venous thromboembolism: results from a population-based case-crossover study. TH open: Companion Journal to Thrombosis and Haemostasis, 7(3): e244-e50.##Wu Z, Du Y, Cai X, et al. (2025) Caprini score combined with thrombotic molecular markers for predicting DVT in patients with traumatic fractures. Scientific Reports, 15(1): 1847.## ##

Immunohistochemical double staining with TTF-1 and aldehyde fuchsin with CT scan enhances the detection of visceral pleural invasion in lung cancer 2 2 Background: Accurate assessment of visceral pleural invasion (VPI) is important for lung cancer staging and prognosis, but distinguishing PL0 from PL1 can be difficult on conventional histology. We evaluated whether combined thyroid transcription factor-1 (TTF-1) immunohistochemistry and aldehyde fuchsin elastic staining, interpreted with preoperative computed tomography (CT), facilitates VPI assessment in lung adenocarcinoma. Materials and Methods: This retrospective study included 76 patients with surgically resected lung adenocarcinoma. Clinicopathological characteristics, immunohistochemical findings, pathological stage, VPI status, CT features, and recurrence outcomes were reviewed. Selected sections underwent combined TTF-1/aldehyde fuchsin double staining. Principal component analysis (PCA) and Mahalanobis distance analysis were performed as exploratory analyses. Results: The mean age was 62.0 ± 8.8 years; 58.4% were female and 31.2% had a smoking history. EGFR mutations were detected in 58.4% of tumors. VPI was identified in 75 of 76 evaluable cases (98.7%). Double staining demonstrated the relationship of TTF-1-positive tumor cells to the visceral pleural elastic lamina, distinguishing the single PL0 case from PL1 lesions. Three patients (3.9%) developed recurrence 14–19 months after surgery. The first three principal components explained 64.5% of total variance; the PL0 case had the greatest Mahalanobis distance, whereas recurrent cases were not multivariate outliers. Conclusion: Combined TTF-1 and aldehyde fuchsin staining permits simultaneous visualization of tumor cells and the pleural elastic layer and may serve as a practical adjunct for distinguishing PL0 from PL1 in lung adenocarcinoma. CT may provide complementary information in integrated VPI assessment. 805 812 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/13 1405/6/22 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 L. Wu L. Wu Department of Pathology, Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350008, Fujian Province, China wlpwcx1@163.com Q. Lin Q. Lin Department of Pathology, Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350008, Fujian Province, China Y. Chen Y. Chen Department of Pathology, Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350008, Fujian Province, China N. Qiu N. Qiu Department of Pathology, Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350008, Fujian Province, China J. Huang J. Huang Department of Pathology, Fuzhou Pulmonary Hospital of Fujian, Fuzhou 350008, Fujian Province, China Adenocarcinoma of lung neoplasm invasiveness immunohistochemistry thyroid nuclear factor 1 tomography X-ray computed. 1. Guo L, Zhu C, Cai L, et al. (2024) Global burden of lung cancer in 2022 and projected burden in 2050. Chin Med J (Engl), 137(21): 2576-2582.##Filho AM, Laversanne M, Ferlay J, et al. (2025) The GLOBOCAN 2022 cancer estimates: Data sources, methods, and a snapshot of the cancer burden worldwide. Int J Cancer, 156(7): 1336-1346.##Ji Y, Zhang Y, Liu S, et al. (2025) The epidemiological landscape of lung cancer: current status, temporal trend and future projections based on the latest estimates from GLOBOCAN 2022. 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Accuracy of endoscopic ultrasonography plus abdominal CT versus plus MRI in differentiating benign from malignant pancreatic space-occupying lesions 2 2 Background: Pancreatic space-occupying lesions (PSOLs) represent common yet complex digestive disorders. Current studies focus on endoscopic ultrasonography (EUS) combined with single imaging modality, but direct comparisons between these combination strategies are limited. This study assesses the comparative diagnostic effectiveness of EUS with abdominal computed tomography (CT) versus EUS paired with magnetic resonance imaging (MRI) in distinguishing benign from malignant pancreatic space-occupying lesions (PSOLs), to inform refined clinical diagnostic approaches. Materials and Methods: This prospective study enrolled 158 patients with suspected PSOLs from May 2024 to March 2025. Participants were assigned to either EUS+CT (n=84) or EUS+MRI (n=74) group. The diagnostic accuracy of these combinatorial strategies for PSOLs was appraised against the gold standard (pathological section results or puncture biopsy findings). Additionally, subgroup analyses were conducted on subgroups featuring small lesions (≤2 cm in diameter) or mucinous cystic neoplasms (MCNs). Results: The gold standard confirmed 127 patients to have PSOLs. For EUS + CT, the diagnostic sensitivity, specificity, and accuracy for PSOLs were 72.31%, 63.16%, and 70.24%, respectively, with a Kappa (κ) value of 0.646 (P<0.05). In comparison, EUS combined with MRI showed superior performance with 82.26% sensitivity, 83.33% specificity, and 82.43% accuracy (κ=0.802, P<0.05). Subgroup analysis further indicated that the EUS-MRI strategy was significantly more effective in detecting small lesions and MCNs than the EUS-CT approach (P<0.05). Conclusion: EUS paired with MRI may provide more accurate diagnoses than EUS plus CT in most cases, particularly for small lesions and MCNs, while EUS-CT retains value in specific scenarios. 813 818 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/13 1405/6/22 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 R. Yang R. Yang Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China J. Guo J. Guo Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China L. Yuan L. Yuan Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China Z. Wang Z. Wang Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China S. Liu S. Liu Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China Y. Sun Y. Sun Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China 16650077927@163.com Endoscopic ultrasonography computed tomography magnetic resonance imaging pancreatic space-occupying lesions. 1. Brunner M, Haberle L, Esposito I, Grutzmann R (2022) Pancreatic cystic space-occupying lesions-Diagnostics, treatment and follow-up care : Current recommendations taking the current German S3 guidelines on pancreatic cancer into account. Chirurg, 93(5): 461-475.##Dhali A, Kipkorir V, Srichawla BS, et al. (2023) Artificial intelligence assisted endoscopic ultrasound for detection of pancreatic space-occupying lesion: a systematic review and meta-analysis. Int J Surg, 109(12): 4298-4308.##Maruyama H, Hanada K, Shimizu A, et al. (2021) Value of endoscopic ultrasonography in the observation of the remnant pancreas after pancreatectomy. PloS one, 16(1): e0245447.##Kim KH, Park CH, Cho E, Lee Y (2024) Endoscopic ultrasound-guided tissue sampling induced pancreatic duct leak resolved by the placement of a pancreatic stent: A case report. World J Clin Cases, 12(9): 1677-1684.##Chen S, Zhang H, Fang F, Ye C, Zhang K (2023) Characteristics of mass-forming autoimmune pancreatitis commonly misdiagnosed as a malignant tumor. Front Surg, 10: 1017621.##Velamazan R, García S, Hernandez M, et al. (2022) Pancreatic space occupying lesion (SOL): Another case of pancreatic adenocarcinoma? Gastroenterol Hepatol, 45(3): 207-208.##Zhang D, Tang L, Long X (2025) Value of multi-slice spiral CT combined with tumor markers in diagnosing benignity and malignancy of hepatic tumors. Int J Radiat Res, 23 (3): 577-583##Xiao Y, Zha Y, Li J, Yang C, Chen L, Xie R (2023) Benign pancreatic lesion on 18F-FDG PET-MRI: A case report. Medicine (Baltimore), 102(19): e33706.##Ishikawa T, Ohno E, Mizutani Y, et al. (2022) Comparison of contrast-enhanced transabdominal ultrasonography following endoscopic ultrasonography with GD-EOB-DTPA-enhanced MRI for the sequential diagnosis of liver metastasis in patients with pancreatic cancer. J Hepatobiliary Pancreat Sci, 29(6): 682-692.##Ishii Y, Serikawa M, Tsuboi T, et al. (2021) Role of Endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic cancer. Diagnostics (Basel), 11(2): 238.##Cai JC, Nakai H, Kuanar S, et al. (2024) Fully Automated deep learning model to detect clinically significant prostate cancer at MRI. Radiology, 312(2): e232635.##Duncan ZN, Summerlin D, West JT, Packard AT, Morgan DE, Galgano SJ (2023) PET/MRI for evaluation of patients with pancreatic cancer. Abdom Radiol (NY), 48(12): 3601-3609.##Blackford AL, Canto MI, Dbouk M, et al. (2024) Pancreatic cancer surveillance and survival of high-risk individuals. JAMA Oncol, 10(8): 1087-1096.##Perik TH, van Genugten EAJ, Aarntzen EHJG, Smit EJ, Huisman HJ, Hermans JJ (2022) Quantitative CT perfusion imaging in patients with pancreatic cancer: a systematic review. Abdom Radiol (NY,) 47(9): 3101-3117.##Que R, Chen Y, Tao Z, et al. (2020) Diffusion-weighted MRI versus FDG-PET/CT for diagnosing pancreatic cancer: an indirect comparison meta-analysis. Acta Radiol, 61(11): 1473-1483.##Vilas-Boas F, Ribeiro T, Costa-Moreira P, et al. (2023) Endoscopic ultrasound through-the-needle biopsy of pancreatic cysts: Toward procedure standardization. Dig Dis, 41(1): 154-163.##Park S, Jang JK, Byun JH, et al. (2021) CT in the prediction of margin-negative resection in pancreatic cancer following neoadjuvant treatment: a systematic review and meta-analysis. Eur Radiol, 31(5): 3383-3393.##Lee J, Lin T, He Y, Wu Y, Qin J (2025) Toward diffusion MRI in the diagnosis and treatment of pancreatic cancer. Med Oncol, 42(7): 222.##Lilly AJ, Johnson M, Kuzmiak CM, et al. (2020) MRI-guided core needle biopsy of the breast: Radiology-pathology correlation and impact on clinical management. Ann Diagn Pathol, 48: 151563.##Jajodia A, Wang A, Alabousi M, Wilks C, Kulkarni A, van der Pol CB (2023) MRI vs. CT for pancreatic adenocarcinoma vascular invasion: comparative diagnostic test accuracy systematic review and meta-analysis. Eur Radiol, 33(10): 6883-6891.## ##

Hint1 mitigates high glucose- and radiation-induced apoptosis and inflammation in human retinal pigment epithelial cells through inhibiting the NF-κB pathway 2 2 Background: Histidine triad nucleotide-binding protein 1 (Hint1) has been associated with inflammation, apoptosis, and the DNA damage response. However, its potential role in RPE injury induced by high glucose and/or radiation is unclear. We evaluated the protective effects of Hint1 against high-glucose and irradiation-induced RPE cell injury and the underlying mechanism involved the NF-κB pathway. Materials and Methods: The expression of Hint1 was determined in retinas from mice with type 1 diabetes and in human RPE cells with high-glucose and/or irradiation injury. Modulation of Hint1 protein levels was achieved through Hint1-overexpression and knockdown. Cellular apoptosis, DNA damage, cytokine production, and NF-κB activity were measured by flow cytometry, γH2AX immunofluorescence/Western blot, real-time PCR, ELISA, Western blot, and p65 translocation assay. BAY 11-7082 was used for mechanism validation. Result: Expression of Hint1 was down-regulated in diabetic retinal tissues and in ARPE-19 cells under combined exposure to hyperglycemia and radiation conditions with the most severe downregulation seen in the case of combined stimuli. The combination increased apoptosis, γ-H2AX levels, TNF-α, IL-6, and IL-8 expression, and nuclear translocation of phosphorylated p65. Overexpression of Hint1 reduced apoptosis, DNA damage, and cytokine release, whereas knockdown of Hint1 increased them. Inhibition of NF-κB partially reversed the detrimental effects of Hint1 deficiency. Conclusion: Hint1 attenuates high-glucose- and radiation-induced RPE cell injury, particularly under combined stress, at least in part by suppressing NF-κB activation. These findings suggest that the Hint1/NF-κB axis may represent a potential therapeutic target for retinal injury associated with diabetes and radiotherapy. 819 829 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 W. Luo W. Luo Department of Ophthalmology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, Gansu Province, China R. Xu R. Xu School of Public Health, Tianjin Medical University, Tianjin, China P. Wu P. Wu Department of Ophthalmology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, Gansu Province, China wupch@lzu.edu.cn M. Yu M. Yu Department of Ophthalmology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, Gansu Province, China W. Dong W. Dong Department of Ophthalmology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, Gansu Province, China Histidine triad nucleotide-binding protein 1 diabetic retinopathy retinal pigment epithelium radiation injuries apoptosis Li C, Chen X, Zhang S, Liang C, Deng Q, Li X, et al. (2024) Pericyte loss via glutaredoxin2 downregulation aggravates diabetes-induced microvascular dysfunction. Exp Eye Res, 247: 110025.##Zhang Z, Song C, Wang T, Sun L, Qin L, Ju J (2021) miR-139-5p promotes neovascularization in diabetic retinopathy by regulating the phosphatase and tensin homolog. 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Post-radiotherapy oral frailty and cognitive trajectories in head and neck cancer: A meta-analysis 2 2 Background: To estimate the proportion of patients experiencing cognitive decline after radiotherapy for head and neck cancer using study-level data from eligible cohorts. Materials and Methods: A systematic review and meta-analysis identified studies assessing cognition both before and after radiotherapy. Two prospective cohorts met all inclusion criteria, each applying its own predefined definition of cognitive decline. Events and total participants were pooled using simple aggregation, and 95% confidence intervals were calculated using the Wilson method. No scale harmonization or continuity corrections were applied. Results: A total of 84 patients were included, of whom 39 (46.4%) met study-defined criteria for cognitive decline following radiotherapy (95% CI: 36.2%–57.0%). Heterogeneity between studies was attributable to differences in cognitive assessment tools and timing of follow-up. Conclusions: Based on available evidence from two prospective cohorts with baseline and post-treatment cognitive testing, approximately one in two patients demonstrated measurable cognitive decline after radiotherapy for head and neck cancer. This estimate reflects the current meta-analytic signal derived from limited but methodologically comparable data and can be refined as additional standardized cohorts become available. 831 838 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 A. Luo A. Luo Nanchang Medical College, Nanchang 330052, Jiangxi Province, China luo9388L@hotmail.com Z. Huang Z. Huang Department of Blood Transfusion, Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China C. Mao C. Mao Biomedical Engineering, South Central MinZu University, Wuhan 430074, Hubei Province, China S. Jiang S. Jiang Department of Blood Transfusion, Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China Head and neck neoplasms radiotherapy cognitive dysfunction frailty oral health deglutition disorders. Hsiao KY, Yeh SA, Chang CC, et al. (2010) Cognitive function before and after intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma: a prospective study. Int J Radiat Oncol Biol Phys, 77(3): 722-726.##Cheung MC, Chan AS, Law SC, et al. (2000) Cognitive function of nasopharyngeal carcinoma patients with and without temporal lobe necrosis after radiotherapy. Arch Neurol, 57(9):1347-1352.##Zer A, Boehmer L, Palzkill T, et al. (2018) Neurocognitive deficits after radiotherapy or chemoradiotherapy in head and neck cancer survivors. JAMA Otolaryngol Head Neck Surg, 144(1):71-79.##Welsh LC, Dunlop A, McGovern T, et al. (2014) Neurocognitive function following (chemo)radiotherapy for head and neck cancer. Clin Oncol, 26(12):765-775.##Iyizoba-Ebozue Z, Prestwich R, Brown S, et al. (2023) Neurocognitive function following (chemo)radiotherapy for nasopharyngeal cancer and other head and neck cancers: A systematic review. Radiother Oncol, 188:109863.##Voon NS, Abdul Manan H, Yahya N (2021) Cognitive Decline following Radiotherapy of Head and Neck Cancer: Systematic Review and Meta-Analysis of MRI Correlates. Cancers (Basel), 13(24): 6191.##Wickborn K, van der Weijden CWJ, de Vries EFJ, et al. (2024) Timeline of cognitive impairments after radiotherapy for head and neck cancer: A review. Clin Transl Radiat Oncol, 52: 100890.##Vaassen F, Hofstede D, Zegers CML, et al. (2025) The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients. Clin Transl Radiat Oncol, 52: 100929.##Liu P, Niu X, Ou D, et al. (2020) Dynamic changes in cognitive function in patients with radiation-induced temporal lobe necrosis after IMRT for nasopharyngeal cancer. Front Oncol, 10: 450.##Williams AM, Lindholm J, Cook D, et al. (2017) Association between cognitive function and quality of life in patients with head and neck cancer. JAMA Otolaryngol Head Neck Surg, 143(12): 1228-1235.##Sta Maria MT, Hasegawa Y, Khaing AMM, et al. (2023) The relationships between mastication and cognitive function: A systematic review and meta-analysis. Jpn Dent Sci Rev, 59: 375-388.##Li L, Zhang X, Zhang Z, et al. (2023) Tooth loss and the risk of cognitive decline and dementia: A meta-analysis of cohort studies. Front Neurol, 14: 1103052.##Qi X, Zhu Z, Plassman BL, et al. (2021) Dose-response meta-analysis on tooth loss with the risk of cognitive impairment and dementia. J Am Med Dir Assoc, 22(10): 2039-2045.##Piancino MG, Tortarolo A, Polimeni A, et al. (2020) Altered mastication adversely impacts morpho-functional features of the hippocampus: A systematic review on animal studies in three different experimental conditions involving the masticatory function. PLoS One, 15(8): e0237872.##Krishnamoorthy G, Narayana AI, Balkrishanan D. (2018) Mastication as a tool to prevent cognitive dysfunctions. Jpn Dent Sci Rev, 54(4): 169-173.##Asher S, Glick M, Ship JA (2022) Periodontal health, cognitive decline, and dementia: A systematic review and meta-analysis of longitudinal studies. J Am Geriatr Soc, 70(9): 2695-2709.##Nagatani M, Tanaka T, Son BK, et al. (2023). Oral frailty as a risk factor for mild cognitive impairment in community-dwelling older adults: Kashiwa study. Exp Gerontol, 172: 112075.##Parisius KGH, Wartewig E, Schoonmade LJ, et al. (2022). Oral frailty dissected and conceptualized: a scoping review. Arch Gerontol Geriatr, 100: 104653.##Schimmel M, Katsoulis J, Genton L, Müller F (2023). Assessment and improvement of masticatory performance in older adults. Int J Environ Res Public Health, 20(4): 3214.##Zhao H, Liu J, Sun W, Wang M, Li Z, et al. (2024). Oral frailty: a concept analysis. BMC Oral Health, 24: 43.##Foo WT, Chia JL, Yap P (2025) Oral frailty and outcomes: A scoping review. Proc Singap Healthc, 35.##Dibello V, Zupo R, Sardone R, et al. (2021) Oral frailty and its determinants in older age: a systematic review. Lancet Healthy Longev. 2(8): e507-e520.##Cristofaro MG, Barca I, Ferragina F, et al. (2021) The health risks of dysphagia for patients with head and neck cancer: a multicentre prospective observational study. J Transl Med, 19(1): 472.##Kristensen MB, Isenring E, Brown B (2020) Nutrition and swallowing therapy strategies for patients with head and neck cancer. 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Occupational radiation exposure among dental practitioners using digital intraoral and panoramic imaging systems: A systematic review and meta-analysis 2 2 Background: Digital intraoral and panoramic radiography have significantly reduced patient radiation exposure; however, occupational exposure among dental practitioners in the digital era requires quantitative synthesis. This systematic review and meta-analysis aimed to estimate mean occupational radiation dose among dental professionals using digital 2D imaging systems and to explore heterogeneity sources. Materials and Methods: Five electronic databases were searched from January 2000 to January 2025 following PRISMA 2020 guidelines. Observational and experimental studies reporting quantitative occupational dose measurements (mSv/µSv) were included. Risk of bias was assessed using ROBINS-E and ROB-2 tools. A random-effects meta-analysis was performed. Heterogeneity was evaluated using I² statistics, and subgroup analyses were conducted based on practitioner type and imaging system. Results: Ten studies met inclusion criteria. The pooled correlation effect size was 0.11 (95% CI: 0.06–0.54; p=0.004), with extremely high heterogeneity (I²=99.94%). Subgroup analysis showed dentists had a higher pooled mean dose estimate (0.91 mSv; 95% CI: −0.01 to 1.82) compared to mixed dental staff (0.08 mSv; p=0.000 for subgroup difference). No significant differences were observed between handheld, panoramic, and mixed digital systems. Meta-regression demonstrated a weak but statistically significant association between mean dose and effect size (slope=0.02; p=0.050). Conclusion: Occupational radiation exposure in digital dentistry remains substantially below international safety limits but demonstrates significant variability. Practitioner behaviour and workflow factors appear more influential than equipment type, reinforcing strict adherence to ALARA principles. 839 849 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 A. Kakti A. 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(2021) The use of dose quantities in radiological protection: ICRP publication 147. J Radiol Prot, 41(2): 410. doi:10.1088/1361-6498/abe548.##Anissi HD and Geibel MA (2014) Intraoral radiology in general dental practices-a comparison of digital and film-based X-ray systems with regard to radiation protection and dose reduction. Rofo, 186(8): 762-7. doi:10.1055/s-0034-1366256.##Lee HK (2018) Factors affecting radiation safety management of dental hygienists and anxiety of radiation exposure. J Korea Acad Ind Coop Soc, 19(6): 432-9. doi:10.5762/KAIS.2018.19.6.432.##Younai FS, Murphy DC, Kotelchuck D (2001) Occupational exposures to blood in a dental teaching environment: results of a ten-year surveillance study. J Dent Educ, 65(5): 436-48. doi:10.1002/j.0022-0337.2001.65.5.tb03413.x.##Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372: n71. doi:10.1186/s13643-021-01626-4.##Scells H, Zuccon G, Koopman B, Deacon A, Azzopardi L, Geva S (2017) Integrating the framing of clinical questions via PICO into the retrieval of medical literature for systematic reviews. Proc ACM Conf Inf Knowl Manag, 2291-4. doi:10.1145/3132847.3133080.##Igelström E, Campbell M, Craig P, Katikireddi SV (2021) Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) is frequently misapplied: a methodological systematic review. J Clin Epidemiol, 140: 22-32. doi:10.1016/j.jclinepi.2021.08.022.##Hootman JM, Driban JB, Sitler MR, Harris KP, Cattano NM (2011) Reliability and validity of three quality rating instruments for systematic reviews of observational studies. Res Synth Methods, 2(2): 110-8. doi:10.1002/jrsm.41.##Hayashino Y, Noguchi Y, Fukui T (2005) Systematic evaluation and comparison of statistical tests for publication bias. J Epidemiol, 15(6): 235-43. doi:10.2188/jea.15.235.##Cochrane Collaboration. 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Optimization of radiotherapy infrastructure in cancer treatment facilities: A comprehensive review of strategies for treatment efficiency and patient safety 2 2 Background: Optimizing radiotherapy infrastructure is essential for delivering safe and effective cancer treatments while minimizing costs and improving sustainability. Materials and Methods: A narrative review was conducted using PubMed, Scopus, and Web of Science (2015–2024) with the terms “radiotherapy,” “infrastructure,” “energy efficiency,” and “patient safety.” Inclusion criteria focused on studies addressing energy systems, treatment planning technologies, and infrastructure optimization in cancer facilities. A case study of the Xinhua Cancer Center (Shandong, China) was also analyzed, including renewable energy integration, shielding layouts, and AI-driven maintenance strategies. Results: The literature review identified key strategies such as advanced electrical layouts, real-time dosimetry, AI-assisted planning, and integration of renewable energy. The Xinhua Cancer Center case demonstrated that solar (78,336 kWh/day), wind (1,071 kWh/day), and battery storage (200 kWh/day) provided 87.2% of energy needs, reducing treatment downtime to 12.6%. Ergonomic layouts decreased procedural errors by 17% and improved treatment readiness by 12%. Predictive maintenance lowered equipment downtime by 30% and improved treatment accuracy by 25%. Challenges included retrofitting costs (USD 80–250/m²) and regulatory constraints. Conclusion: Optimized radiotherapy infrastructure can substantially enhance treatment efficiency and patient safety. Future directions include AI-based treatment algorithms, hybrid energy storage, smart grid integration, and block chain-secured patient records. 851 857 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 S. Lu S. Lu Department of Infrastructure, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, 250014, China Q. Zhan Q. Zhan Department of Medical Engineering, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, 250014, China L. Zhang L. Zhang Heze Power Supply Co., State Grid Shandong Electric Power Company, Heze 274002, China J. Cui J. Cui Department of Infrastructure, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, 250014, China jhri911@163.com Radiotherapy Health Facility Infrastructure Energy Efficiency Patient Safety Neoplasms Artificial Intelligence. Dion H, Evans M, Farrell P (2023) Hospitals management transformative initiatives: towards energy efficiency and environmental sustainability in healthcare facilities. 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A meta-analysis and systematic review on the efficacy and safety of traditional Chinese medicine nursing in radiotherapy patients 2 2 Background: Radiotherapy is a cornerstone in cancer treatment, but its associated physical discomfort and psychological distress often impair patients’ quality of life (QOL). Traditional Chinese Medicine (TCM) nursing, integrating syndrome-based care, emotional regulation, and lifestyle guidance, has been increasingly applied as a complementary approach during radiotherapy, while existing literature has not well explored its overall efficacy and safety. Materials and Methods: This study aims at systematically elucidating the efficacy and safety of TCM nursing in patients undergoing radiotherapy. Methods: PubMed, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched from inception to July 2025. Eligible studies included cancer patients receiving radiotherapy, comparing TCM nursing with conventional nursing or placebo care. Primary outcomes were QOL, anxiety, and depression scores; secondary outcomes included radiotherapy-related adverse events. Relevant meta-analysis relied on RevMan 5.4 and Stata 16.0, along with sensitivity and publication bias analyses. Results: Eight studies were included. Pooled results showed that TCM nursing significantly improved QOL (MD = 8.81, 95% CI: 7.09–10.52, P<0.001, I²= 0%) and reduced anxiety (MD = −5.80, 95% CI: −8.33 to −3.28, P=0.001, I²= 73%) and depression scores (MD = −4.58, 95% CI: −5.65 to −3.50, P<0.001, I²= 82%). Radiotherapy-related adverse events did not increase significantly (RR = 0.82, 95% CI: 0.63–1.06, P=0.131), with consistent sensitivity results. Conclusion: TCM nursing may be a beneficial and safe adjunct to radiotherapy, improving QOL and alleviating psychological distress. 859 865 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 X.S. Gao X.S. Gao Department of Pulmonary Medicine, Wenjiang Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China M. Wen M. Wen Department of Pulmonology, Wenjiang Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China T. Liu T. Liu Department of Pulmonology, Wenjiang Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China Z. Fan Z. Fan Department of Pediatrics, Chengdu Wenjiang Maternal and Child Health Hospital, Chengdu, Sichuan, China 546427519@qq.com Traditional Chinese medicine nursing radiotherapy quality of life anxiety depression adverse effects. 1. Huang D, He L, Xiong M, et al. (2022) Study on the value of multi-dimensional conformal radiotherapy and functional imaging in tumor bioimaging. Translational Cancer Research, 11: 3780-3789.##Nishio T, Nakamura M, Okamoto H, et al. (2020) An overview of the medical-physics-related verification system for radiotherapy multicenter clinical trials by the Medical Physics Working Group in the Japan Clinical Oncology Group-Radiation Therapy Study Group. Journal of Radiation Research, 61: 999-1008.##Ma C, Wang X, Nie K, et al. (2025) Recent technical advancements and clinical applications of MR-guided radiotherapy in lung cancer treatment. Frontiers in Oncology, 15: 1622060.##Musa AE and Shabeeb D (2019) Radiation-induced heart diseases: Protective effects of natural products. Medicina (Kaunas, Lithuania) 55: 1-12.##Geng J, Zhang Y, Gao Q, et al. (2021) Switching on prodrugs using radiotherapy. Nature Chemistry, 13: 805-810.##Lu J, Zeng X, Liao J, et al. (2017) Effectiveness of an intervention to promote self-efficacy on quality of life of patients with nasopharyngeal carcinoma of the Zhuang tribe minority in Guangxi, China: A prospective study. Medical Science Monitor, 23: 4077-4086.##Andreou L, Burrows T, Surjan Y (2021) The effect of nutritional interventions involving dietary counselling on gastrointestinal toxicities in adults receiving pelvic radiotherapy: A systematic review. Journal of Medical Radiation Sciences, 68: 453-464.##Miniotti M, Botto R, Soro G, et al. (2024) A critical overview of the construct of supportive care need in the cancer literature: Definitions, measures, interventions and future directions for research. Int J Environ Res and Public Health, 21: 1-18.##Mayo SJ, Ajaj R, Drury A (2021) Survivors' preferences for the organization and delivery of supportive care after treatment: An integrative review. European Journal of Oncology Nursing, 54: 102040.##Yang M and Yu D (2024) The preventive effect of evidence-based nursing combined with traditional Chinese medicine moxibustion on gastrointestinal reactions after radiotherapy and chemotherapy in gastric cancer. Panminerva Medica [Epub ahead of print].##Xiao Q, Liu T, Li J, et al. (2025) Auriculotherapy may help to reduce gastrointestinal reactions and improve quality of life post chemotherapy. 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A systematic review and meta-analysis on the efficacy and safety of combining traditional Chinese medicine with radiotherapy for breast cancer 2 2 Background: Variability in treatment sensitivity and radiation-induced toxicity can adversely affect clinical outcomes. Objective: To evaluate the effectiveness and safety of integrating traditional Chinese medicine with radiotherapy in the treatment. Materials and Methods: To identify eligible studies, a systematic search strategy was applied to five major biomedical databases. Radiotherapy mainly involved conventional external beam techniques, including three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and EBRT. TCM interventions consisted of injectable preparations and oral herbal formulas administered during or around radiotherapy. Results: 9 studies involving 655 patients were included. Combination therapy significantly improved objective response rate (RR = 1.44, P < 0.001) and reduced adverse outcomes (RR = 0.34, P < 0.001). CD4⁺T cells increased significantly (MD = 9.55, P < 0.001), whereas CD8⁺T-cell changes were nonsignificant (MD = –3.89, P = 0.280). The regimen also lowered gastrointestinal toxicity (RR = 0.52, P = 0.008) and myelosuppression (RR = 0.53, P < 0.001). The findings were validated through sensitivity analyses, demonstrating their robustness. Conclusion: TCM combined with radiotherapy may enhance efficacy and reduce toxicity in breast cancer, warranting further large-scale trials. 867 874 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 Y.J. Yu Y.J. 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Decoding genomic heterogeneity in ground-glass nodule lung adenocarcinoma before radiotherpay: Subtype-driven biomarkers and therapeutic vulnerabilities 2 2 Background: Ground-glass nodules (GGNs) represent early-stage lung adenocarcinoma (LUAD) and exhibit substantial genomic and radiomic heterogeneity. Integrating computed tomography (CT) radiomic features with genomic and epigenomic alterations may improve prediction of nodule progression and radiotherapy response. Materials and Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science (2010–2024) using predefined terms related to GGNs, radiogenomics, LUAD, CT radiomics, and radiosensitivity. Studies were included if they reported (1) human GGN data, (2) genomic or epigenomic characterization, and (3) radiomic features or CT phenotypes. Two reviewers independently screened articles, extracted data, and validated radiogenomic associations. Results: A total of 4,820 patients from eligible studies were analyzed. Distinct CT radiomic features - including attenuation, solidity ratio, textural entropy, vascular convergence, and shape irregularity - corresponded with recurrent genomic drivers. EGFR-mutant GGNs typically presented as pure or mixed GGNs with smooth margins, whereas KRAS-, TP53-, and KEAP1/NRF2-altered lesions showed higher solidity and increased heterogeneity. Radiomic complexity correlated with mutational burden, copy-number alterations, and pathway dysregulation in PI3K/AKT/mTOR, MAPK, Hippo/YAP, and TGF-β signaling. Several radiogenomic signatures also corresponded to predicted radiosensitivity or radioresistance, particularly features associated with oxidative stress pathways and immune microenvironment states. Conclusion: Radiogenomic integration provides critical insight into the biological heterogeneity of GGN-associated LUAD. CT radiomic features reflect underlying genomic alterations and may predict progression and radiotherapy responsiveness. This review establishes a structured framework for the radiogenomic interpretation of GGNs and outlines future applications in precision oncology and radiotherapy planning. 875 883 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 F. Yao F. Yao Yan’an Hospital Affiliated to Kunming Medical University, Yunnan Kunming 650051, China Y. Wang Y. Wang Yan’an Hospital Affiliated to Kunming Medical University, Yunnan Kunming 650051, China Z. Li Z. Li Yan’an Hospital Affiliated to Kunming Medical University, Yunnan Kunming 650051, China D. Li D. Li Yan’an Hospital Affiliated to Kunming Medical University, Yunnan Kunming 650051, China lidb88@163.com Ground-glass nodule lung adenocarcinoma radiogenomics X-ray computed tomography radiotherapy. 1. Chen Z, Fillmore CM, Hammerman PS, Kim CF, Wong KK (2019) Non-small-cell lung cancers: a heterogeneous set of diseases. Nature Reviews Cancer, 19(11): 665-78.##Travis WD, Brambilla E, Noguchi M, Nicholson AG, et al. (2021) International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma. 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MRI-based radiomics models for pre-operative prediction of microsatellite instability in rectal cancer: A systematic review and meta-analysis 2 2 Background: This study aimed to comprehensively assess the diagnostic capability of radiomics models derived from magnetic resonance imaging in determining microsatellite instability (MSI) status among patients with rectal cancer, while exploring variables that may affect predictive accuracy. Materials and Methods: We performed a comprehensive literature search across PubMed, EMBASE, Cochrane Library, and Web of Science databases through August 2025, targeting studies employing MRI-derived radiomics for MSI status prediction in rectal malignancies. Summary estimates for sensitivity, specificity, and the area under the summary receiver operating characteristic curve (SROC AUC) were derived through random-effects meta-analysis. Heterogeneity sources were investigated via subgroup stratification. Results: Thirteen eligible investigations encompassing 3,292 individuals with rectal cancer were incorporated. For validation cohorts, pooled estimates demonstrated a sensitivity of 0.88, specificity of 0.82, and SROC AUC of 0.91. According to Fagan nomogram interpretation, positive radiomics findings elevated MSI post-test probability from an initial 18% to 52%, whereas negative findings lowered it to 3%. Meta-regression revealed classifier selection as the predominant determinant of performance variability. Robustness was substantiated through sensitivity testing, with Deeks' funnel plot asymmetry test showing no substantial publication bias (P=0.93). Conclusion: Radiomics models based on MRI exhibit robust diagnostic performance for preoperative MSI status prediction in rectal cancer, demonstrating promise as non-invasive screening instruments to support treatment decision-making. Nevertheless, considering the methodological constraints and inter-study variability observed, rigorously designed multicenter prospective investigations are imperative to establish their clinical utility and economic feasibility. 885 893 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 B. Wang B. Wang Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China J. Gu J. Gu Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China B. Wu B. Wu Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China bingwu1453@163.com Rectal neoplasms microsatellite instability radiomics magnetic resonance imaging machine learning. 1. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 74(3): 229-63.##Glynne-Jones R, Wyrwicz L, Tiret E, Brown G, Rödel C, Cervantes A, et al. (2017) Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 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Integrated medicine in oncology: Enhancing radiotherapy outcomes in gastric cancer through traditional and conventional approaches 2 2 Background: Radiotherapy is a cornerstone in the treatment of gastric cancer, particularly in locally advanced cases, but its clinical benefit is often limited by gastrointestinal and systemic toxicities. Conventional approaches provide mainly symptomatic relief, while Traditional Chinese Medicine (TCM) has been explored for its potential to reduce adverse effects, improve tolerance, and support recovery. Materials and Methods: This narrative review synthesized evidence from PubMed, Web of Science, and CNKI (2000–2024). Eligible studies included clinical trials, observational studies, and reviews evaluating radiotherapy, chemotherapy, and TCM-based interventions in gastric cancer. The focus was on toxicity reduction, treatment adherence, quality-of-life outcomes, and underlying biological mechanisms. Results: Evidence indicates that integrating radiotherapy and chemotherapy with TCM modalities-such as herbal medicine, acupuncture, and dietary therapy-may alleviate mucosal injury, nausea, fatigue, and systemic inflammation. Reported benefits include higher treatment completion rates, improved quality-of-life scores, and modulation of inflammatory biomarkers. However, heterogeneity in trial design and the absence of large randomized controlled studies limit definitive conclusions. Conclusion: Integrating TCM with conventional oncological care may enhance radiotherapy outcomes in gastric cancer by reducing treatment-related toxicities and supporting patient resilience. Future well-designed clinical trials are required to confirm efficacy and establish standardized integrative protocols.  895 900 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 R. Xue R. Xue Gastrointestinal Specialty Hospital, Shanghai General Hospital Jiuquan Hospital (People's Hospital of Jiuquan), Jiuquan City, Gansu, 735000, China Y. Ma Y. Ma Gastrointestinal Specialty Hospital, Shanghai General Hospital Jiuquan Hospital (People's Hospital of Jiuquan), Jiuquan City, Gansu, 735000, China JQmayan@hotmail.com T. Yang T. Yang Gastrointestinal Specialty Hospital, Shanghai General Hospital Jiuquan Hospital (People's Hospital of Jiuquan), Jiuquan City, Gansu, 735000, China yvqp488@163.com Stomach neoplasms radiotherapy chemotherapy integrative medicine medicine Chinese traditional. 1. Rahman R, Asombang AW, Ibdah JA (2014) Characteristics of gastric cancer in Asia. World J Gastroenterol, 20(16): 4483-90.##Hsu J-T, Lin Y-N, Chen Y-F, Kou H-W, Wang S-Y, Chou W-C, et al. (2024) A comprehensive overview of gastric cancer management from a surgical point of view. Biomedical Journal, 100817.##Wong RK, Jang R, Darling G (2015) Postoperative chemoradiotherapy vs. preoperative chemoradiotherapy for locally advanced (operable) gastric cancer: clarifying the role and technique of radiotherapy. J Gastrointest Oncol, 6(1): 89-107.##Sadrzadeh S and Tajik M (2024) Dosimetry calculations of gastric cancer treatment during pencil beam scanning proton therapy. Int J Radiat Res, 22(4): 823.##Baskar R, Lee KA, Yeo R, Yeoh KW (2012) Cancer and radiation therapy: current advances and future directions. Int J Med Sci, 9(3): 193-9.##Shadad AK, Sullivan FJ, Martin JD, Egan LJ (2013) Gastrointestinal radiation injury: symptoms, risk factors and mechanisms. World J Gastroenterol, 19(2): 185-98.##Zheng Z, Zhao X, Zhao Q, Zhang Y, Liu S, Liu Z, et al. (2020) The effects of early nutritional intervention on oral mucositis and nutritional status of patients with head and neck cancer treated with radiotherapy. Front Oncol, 10: 595632.##Ng JY, Cramer H, Lee MS, Moher D (2024) Traditional, complementary, and integrative medicine and artificial intelligence: Novel opportunities in healthcare. Integr Med Res, 13(1): 101024.##O'Brien K, Ried K, Binjemain T, Sali A (2022) Integrative approaches to the treatment of cancer. Cancers (Basel), 14(23).##Yang Y, Chen YK, Xie MZ (2024) Exploring the transformative impact of traditional Chinese medicine on depression: Insights from animal models. World J Psychiatry, 14(5): 607-23.##Lapen K, Cha E, Huang CC, Rosenberg DM, Rooney MK, McArthur M, et al. (2021) The use of complementary and integrative therapies as adjunct interventions during radiotherapy: a systematic review. Supportive Care in Cancer, 29(11): 6201-9.##Lopez G, Narayanan S, Cohen L (2024) Integrative medicine in oncology: redefining the standard of care. Nature Reviews Cancer, 24(11): 739-40.##Racka I, Majewska K, Winiecki J (2023) Three-dimensional conformal radiotherapy (3D-CRT) vs. volumetric modulated arc therapy (VMAT) in deep inspiration breath-hold (DIBH) technique in left-sided breast cancer patients-comparative analysis of dose distribution and estimation of projected secondary cancer risk. Strahlenther Onkol, 199(1): 90-101.##Ren F, Li S, Zhang Y, Zhao Z, Wang H, Cui Y, et al. (2019) Efficacy and safety of intensity-modulated radiation therapy versus three-dimensional conformal radiation treatment for patients with gastric cancer: a systematic review and meta-analysis. Radiat Oncol, 14(1): 84.##Shen J, Lian X, Guan Q, He L, Zhang F, Shen J (2022) Neoadjuvant chemo-radiation using IGRT in patients with locally advanced gastric cancer. Current Oncology, 29(10): 7450-60.##Xi Z, Dai R, Ze Y, Jiang X, Liu M, Xu H (2025) Traditional Chinese medicine in lung cancer treatment. Mol Cancer, 24(1): 57.##Cao S, Xue J, Chen L, Hao Y, Lu M, Feng M, et al. (2022) Effects of the Chinese herbal medicine Hong Huang decoction, on myocardial injury in breast cancer patients who underwent anthracycline-based chemotherapy. Front Cardiovasc Med, 9: 921753.##Chen J, Kang J, Yuan S, O'Connell P, Zhang Z, Wang L, et al. (2024) Exploring the Mechanisms of Traditional Chinese Herbal Therapy in Gastric Cancer: A Comprehensive Network Pharmacology Study of the Tiao-Yuan-Tong-Wei decoction. Pharmaceuticals, 17(4): 414.##Chen Z, Yu T, Wang Y, Li J, Zhang B, Zhou L (2025) Mechanistic insights into the role of traditional Chinese medicine in treating gastric cancer. Frontiers in Oncology, Volume 14 - 2024.##Kim S-D, Kim J-H, Kim D-H, Park J-H, Gong Y, Sun C, et al. (2024) Comprehensive evaluation of traditional herbal medicine combined with adjuvant chemotherapy on post-surgical gastric cancer: A systematic review and meta-analysis. Integrative Cancer Therapies, 23: 15347354231226256.##Zhu Y-j, Wu X-y, Wang W, Chang X-s, Zhan D-d, Diao D-c, et al. (2022) Acupuncture for quality of life in gastric cancer patients undergoing adjuvant chemotherapy. Journal of Pain and Symptom Management, 63(2): 210-20.##Miao X, Wu H, Liu Y, Zhang S, Li C, Hao J (2022) Clinical efficacy of acupuncture on neoadjuvant chemotherapy with capecitabine plus paclitaxel and radiotherapy in progressive gastric cancer. Journal of Oncology, 2022(1): 6156585.##Zheng JY, Zhu J, Wang Y, Tian ZZ (2024) Effects of acupuncture on hypothalamic-pituitary-adrenal axis: Current status and future perspectives. J Integr Med, 22(4): 445-58.##Wang X, Liu MA, He J, Zhao WZ, Wang YX, Yang LQ, et al. (2024) Dietary therapy of the herbal porridge improves the symptoms of functional dyspepsia: A randomized, double-blind, placebo-controlled, clinical trial. Food Sci Nutr, 12(3): 2104-14.##Cui D, Zhang C, Zhang L, Zheng J, Wang J, He L, et al. (2025) Natural anti-cancer products: insights from herbal medicine. Chinese Medicine, 20(1): 82.##Shi JH, Yang H, Wang ST, Wang WJ, Shi Y, Huang SS, et al. (2025) Retrospective analysis on Lou Bei Er Chen decoction and acupuncture in gastroesophageal reflux disease post-gastric cancer surgery. World J Gastrointest Surg, 17(3): 99626.##Zhang K (2022) Acupuncture for quality of life in gastric cancer patients: Methodological issues. Journal of Pain and Symptom Management, 63(4): e447-e8.##Zhang HB, Zhu Y, Mao JJ, Chang XS, Peng JJ, Wu XY, et al. (2023) 2034MO EAGER: A randomized, controlled, multicenter trial of electro-acupuncture in gastric cancer patients undergoing adjuvant chemotherapy. Annals of Oncology, 34: S1080.##Miao X, Wu H, Liu Y, Zhang S, Li C, Hao J (2022) Treatment alternative and high safety profile of acupuncture plus chemotherapy for advanced gastric cancer. Evidence-Based Complementary and Alternative Medicine, 2022(1): 8701779.##Pei L, Wang G, Yang S, Zhou S, Xu T, Zhou J, et al. (2025) Electroacupuncture reduces duration of postoperative ileus after laparoscopic gastrectomy for gastric cancer: A Multicenter Randomized Trial. Gastroenterology, 169(1): 73-84.##Li Z, Zhang G, Cao N, Xu J, Dong J, Li J, et al. (2022) Effects of traditional Chinese medicine collaborative model (TCMCM) combined with adjuvant chemotherapy on IIIb and IIIc gastric cancer: a protocol for a randomized controlled trial. Trials, 23(1): 68.##Wang Y, Zeng Y, Chen X, Lu A, Jia W, Cheung KCP (2024) Gut microbiota modulation through Traditional Chinese Medicine (TCM) - improving outcomes in Gastrointestinal (GI) cancer prevention and management. 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Integration of Neoadjuvant Chemo-Immunotherapy and Adjuvant Radiotherapy in Sinonasal Malignancies: A Narrative Review 2 2 Background: Sinonasal malignancies are rare, aggressive tumours with limited resectability and high recurrence due to complex anatomy and late presentation. Integrating neoadjuvant chemotherapy with programmed cell death protein 1 (PD-1)/ programmed cell death ligand 1 (PD-L1) blockade may enhance tumour regression and improve surgical outcomes. Adjuvant radiotherapy remains a critical component in disease control. Materials and Methods: A narrative review was performed using PubMed, Scopus, and Web of Science (2010–2025). Search terms included Sinonasal Neoplasms, Neoadjuvant Therapy, Immunotherapy, and Radiotherapy. Studies on biological mechanisms, clinical outcomes of chemo-immunotherapy, and radiotherapy integration were included. Results: Evidence from emerging institutional series and extrapolation from head-neck oncology demonstrates that neoadjuvant chemo-immunotherapy promotes immunogenic cell death, enhances T-cell infiltration, and facilitates tumour downstaging. Early sinonasal cohorts report higher major pathological response, improved resectability, and acceptable safety. Adjuvant radiotherapy further augments locoregional control through antigen release and immune activation. Conclusion: Combining neoadjuvant chemo-immunotherapy with adjuvant radiotherapy is biologically rational and clinically promising for locally advanced sinonasal cancers. Prospective, biomarker-driven trials are needed to optimize sequencing and validate efficacy. 901 908 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 Z. Zhu Z. 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Low-dose radiotherapy as an anti-inflammatory strategy in neonatal hypoxic-ischemic encephalopathy 2 2 Background: Neonatal hypoxic-ischemic encephalopathy (HIE) affects 1–26 per 1,000 live births, driving sustained neuroinflammation via NF-κB activation, microglial M1 polarization, and cytokine storms (TNF-α, IL-1β, IL-6), causing secondary brain injury and disability in 40–50% of hypothermia-treated survivors. However, it remains unknown whether low-dose radiotherapy (LDRT, ≤0.1 Gy) resolves this previously elusive cascade through ATM–IKK–NF-κB suppression and microglial repolarization in preclinical models. Materials and Methods: We systematically reviewed preclinical evidence on anti-inflammatory interventions in HIE, with focused synthesis of radiobiological studies using LDRT (≤0.1 Gy) across ischemic, neurodegenerative, and neuroinflammatory models (n > 15 independent reports). Results: LDRT demonstrated 3–6-fold suppression of TNF-α and IL-1β (P < 0.001, 95% CI 2.8–7.1, n = 12 models) through ATM-dependent IKK inhibition. It uncovered microglial M2 repolarization with 4-fold IL-10 and 3.5-fold TGF-β upregulation (P < 0.001). Combined with hypothermia, LDRT resolved previously inaccessible persistent inflammation, achieving 75–85% reduction in secondary injury biomarkers (oxidative stress, apoptosis; P < 0.001). Conclusion: LDRT establishes a radiobiological framework that transforms multimodal neonatal neuroprotection, opening the door to precision anti-inflammatory strategies that mitigate inflammation-driven brain injury in HIE. 909 915 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 X. Du X. Du School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China L. Luo L. Luo School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China josephluoli@hotmail.com Hypoxia-ischemia brain infant newborn inflammation radiotherapy neuroprotective agents nf-kappa b microglia. 1. Douglas-Escobar M and Weiss MD (2015) Hypoxic-ischemic encephalopathy: a review for the clinician. JAMA Pediatr, 169(4): 397-403.##Yang L (2020) Treatment and new progress of neonatal hypoxic-ischemic brain damage. Histol Histopathol, 35(9): 929-36.##Al-Macki N (2009) The spectrum of abnormal neurologic outcomes subsequent to term intrapartum asphyxia. Pediatr Neurol, 41(6): 399-405.##Barnett A (2002) Neurological and perceptual-motor outcome at 5-6 years of age in children with neonatal encephalopathy: relationship with neonatal brain MRI. Neuropediatrics, 33(5): 242-8.##Greco P (2020) Pathophysiology of hypoxic-ischemic encephalopathy: a review of the past and a view on the future. Acta Neurol Belg, 120(2): 277-88.##Yıldız EP (2017) Neonatal hypoxic ischemic encephalopathy: an update on disease pathogenesis and treatment. Expert Rev Neurother, 17(5): 449-59.##Liu F and McCullough LD (2013) Inflammatory responses in hypoxic ischemic encephalopathy. Acta Pharmacol Sin, 34(9): 1121-30.##Silveira RC and Procianoy RS (2015) Hypothermia therapy for newborns with hypoxic ischemic encephalopathy. J Pediatr (Rio J), 91(6 Suppl 1): S78-83.##Ceyzériat K, Zilli T, Millet P, Koutsouvelis N, Dipasquale G, Fossey C, et al. (2022) Low-dose brain irradiation normalizes TSPO and CLUSTERIN levels and promotes the non-amyloidogenic pathway in pre-symptomatic TgF344-AD rats. J Neuroinflammation, 19(1): 311.##Narasimhamurthy RK, Mumbrekar KD, Satish Rao BS (2022) Effects of low dose ionizing radiation on the brain- a functional, cellular, and molecular perspective. Toxicology, 465: 153030.##Schmal Z, Hammer B, Müller A, Rübe CE (2021) Fractionated Low-Dose Radiation Induces Long-Lasting Inflammatory Responses in the Hippocampal Stem Cell Niche. Int J Radiat Oncol Biol Phys, 111(5): 1262-75.##Disdier C (2018) Anti-cytokine therapy to attenuate ischemic-reperfusion associated brain injury in the perinatal period. Brain Sci, 8(6): 98.##Nijboer CH (2008) A dual role of the NF-kappaB pathway in neonatal hypoxic-ischemic brain damage. Stroke, 39(9): 2578-86.##Rocha-Ferreira E (2017) Systemic pro-inflammatory cytokine status following therapeutic hypothermia in a piglet hypoxia-ischemia model. J Neuroinflammation, 14(1): 44.##Boyd A, Byrne S, Middleton RJ, Banati RB, Liu G-J (2021) Control of Neuroinflammation through Radiation-Induced Microglial Changes. Cells, 10(9): 2181.##Ceyzériat K, Jaques E, Gloria Y, Badina A, Millet P, Koutsouvelis N, et al. (2024) Low-dose radiation therapy impacts microglial inflammatory response without modulating amyloid load in female TgF344-AD rats. J Alzheimer's Disease, 98(3): 1001-16.##Wassink G (2014) The mechanisms and treatment of asphyxial encephalopathy. Front Neurosci, 8: 40.##Orrock JE (2016) Association of brain injury and neonatal cytokine response during therapeutic hypothermia in newborns with hypoxic-ischemic encephalopathy. Pediatr Res, 79(5): 742-7.##Balduini W (2012) The use of melatonin in hypoxic-ischemic brain damage: an experimental study. J Matern Fetal Neonatal Med, 25(1): 119-24.##Cardinali DP (2019) An assessment of melatonin's therapeutic value in the hypoxic-ischemic encephalopathy of the newborn. Front Synaptic Neurosci, 11: 34.##Deng WG (2006) Melatonin suppresses macrophage cyclooxygenase-2 and inducible nitric oxide synthase expression by inhibiting p52 acetylation and binding. Blood, 108(2): 518-24.##Koh PO (2008) Melatonin regulates nitric oxide synthase expression in ischemic brain injury. J Vet Med Sci, 70(7): 747-50.##Martínez-Orgado J (2020) Cannabidiol for the treatment of neonatal hypoxic-ischemic brain injury. Front Pharmacol, 11: 584533.##Li B (2017) Brain-immune interactions in perinatal hypoxic-ischemic brain injury. Prog Neurobiol, 159: 50-68.##Rocha-Ferreira E and Hristova M (2016) Plasticity in the neonatal brain following hypoxic-ischaemic injury. Neural Plast, 2016: 4901014.##Tuor UI (1993) Glucocorticoid prevention of neonatal hypoxic-ischemic damage: role of hyperglycemia and antioxidant enzymes. Brain Res, 604(1-2): 165-72.##Tuor UI (1997) Dexamethasone prevents hypoxia/ischemia-induced reductions in cerebral glucose utilization and high-energy phosphate metabolites in immature brain. J Neurochem, 69(5): 1954-63.##Carty ML (2011) Ibuprofen inhibits neuroinflammation and attenuates white matter damage following hypoxia-ischemia in the immature rodent brain. Brain Res, 1402: 9-19.##Wixey JA (2012) Post-insult ibuprofen treatment attenuates damage to the serotonergic system after hypoxia-ischemia in the immature rat brain. J Neuropathol Exp Neurol, 71(12): 1137-46.##Chiappetta O (2007) Evidence to implicate early modulation of interleukin-1β expression in the neuroprotection afforded by 17β-estradiol in male rats undergone transient middle cerebral artery occlusion. Int Rev Neurobiol, 82: 357-72.##Deutsch ER (2013) Progesterone's role in neuroprotection: a review of the evidence. Brain Res, 1530: 82-105.##Durán-Carabali LE (2023) Protective effect of sex steroid hormones on morphological and cellular outcomes after neonatal hypoxia-ischemia: A meta-analysis of preclinical studies. Neurosci Biobehav Rev, 145: 105018.##Li X (2014) Effects of progesterone on hippocampal ultrastructure and expression of inflammatory mediators in neonatal rats with hypoxic-ischemic brain injury. Exp Ther Med, 7(5): 1311-6.##Mirza MA (2015) Sexually dimorphic outcomes and inflammatory responses in hypoxic-ischemic encephalopathy. J Neuroinflammation, 12: 32.##Perez-Alvarez MJ and Wandosell F (2016) Stroke and neuroinflammation: role of sexual hormones. Curr Pharm Des, 22(10): 1334-49.##Ji G (2015) NF-κB signaling is involved in the effects of intranasally engrafted human neural stem cells on neurofunctional improvements in neonatal rat hypoxic-ischemic encephalopathy. CNS Neurosci Ther, 21(12): 926-35.##Au NPB, Wu T, Kumar G, Jin Y, Li YYT, Chan SL, et al. (2024) Low-dose ionizing radiation promotes motor recovery and brain rewiring by resolving inflammatory response after brain injury and stroke. Brain, Behavior, and Immunity, 115: 43-63.##Le Reun E and Foray N (2023) Low-dose radiation therapy (LDRT) against cancer and inflammatory or degenerative diseases: Three parallel stories with a common molecular mechanism involving the nucleoshuttling of the ATM protein? Cancers, 15(5): 1482.##Voshart DC, Oshima T, Jiang Y, van der Linden GP, Ainslie AP, Reali Nazario L, et al. (2024) Radiotherapy induces persistent innate immune reprogramming of microglia into a primed state. Cell Reports, 43(2): 113764.##Donaubauer A-J, Becker I, Weissmann T, Fröhlich BM, Muñoz LE, Gryc T, et al. (2021) Low dose radiation therapy induces long-lasting reduction of pain and immune modulations in the peripheral blood - interim analysis of the IMMO-LDRT01 trial. 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Thyroid ultrasound and thyroid function findings in 3029 hospital employees: a short report 2 2 Background: Evidence on thyroid ultrasound findings among hospital employees remains limited. This study investigated the detection rate and related characteristics of thyroid ultrasound abnormalities and thyroid function indices among employees of a tertiary hospital. Materials and Methods: This retrospective short report reviewed thyroid color Doppler ultrasound and thyroid function test results from 3029 employees of a tertiary hospital in Chengdu, China, in 2017. Employees with a previous history of thyroid disease or thyroid surgery were excluded. Detection rates of thyroid ultrasound abnormalities were compared by sex and age group. Thyroid function indices were compared between ultrasound-normal and ultrasound-abnormal groups. Results: Thyroid ultrasound abnormalities were detected in 1889 employees, with an overall detection rate of 62.4%. The detection rate was higher in women than in men, 66.0% versus 50.8%, and increased with age: 48.8% in employees aged ≤30 years, 67.6% in those aged 30–60 years, and 83.4% in those aged ≥60 years. Compared with the ultrasound-normal group, the ultrasound-abnormal group had lower serum FT3 and FT4 levels and higher TSH, TPOAb, and TgAb levels. FT3 and FT4 decreased with age, whereas TSH increased with age. Conclusion: Thyroid ultrasound abnormalities were common among hospital employees and were associated with sex, age, and thyroid function indices. Combined ultrasound and thyroid function testing may help identify thyroid disorders in this occupational population. 917 920 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 X. Lu X. Lu West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China W. Yang W. Yang West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China 472161263@qq.com F. Zhang F. Zhang West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China Hospital personnel thyroid gland ultrasonography thyroid function tests occupational health. Endocrinology Branch of Chinese Medical Association (2008). Chinese guidelines for diagnosis and treatment of thyroid diseases. Chin J Intern Med, 47(10): 867-868. Chinese.##Sipos JA and Mazzaferri EL (2010) Thyroid cancer epidemiology and prognostic variables. Clin Oncol (R Coll Radiol), 22(6): 395-404.##Chen HX, Zhan DW, Feng BX, et al. (2017) Epidemiology of adult thyroid diseases in Jilin Province. Chin J Endemiol Prev, (3):241-244. Chinese.##Zhang JL, Tuo SJ, Song HP, et al. (2013) Epidemiological investigation of thyroid diseases in Yan'an. Chin Clin Med, 20(4): 548-550. Chinese.##Zhang N (2010) Analysis of the detection status of major chronic diseases among people with different occupational health checkups [dissertation]. Dalian: Dalian Medical University; 2010. Chinese.##Chen HZ and Lin GW (2009) Practical Internal Medicine. 13th ed. Beijing: People's Medical Publishing House, Chinese.##Wu HL, Zhu CY, Zhu LL (2015) Analysis of the detection results of thyroid diseases among staff of a tertiary hospital in Hainan. Hainan Med J, (11): 1699-1700. Chinese.##Liu L, Lu HW, Feng J, et al. (2014) Detection and clinical features of thyroid nodules in 7097 healthy people. Chin J Clinicians, 8: 1490-1494. Chinese.##Vander JB, Gaston EA, Dawber TR (1954) Significance of solitary nontoxic thyroid nodules: preliminary report. N Engl J Med, 251(24): 970-973.##Fan SB, Zhu BL, Fan SQ, et al. (2014) Retrospective analysis of thyroid nodules in a physical examination population in Kunming. Yunnan Med J, (5): 572-573. Chinese.##Azizi G and Malchoff CD (2011) Autoimmune thyroid disease: a risk factor for thyroid cancer. Endocr Pract, 17(2): 201-209.##Zhu XZ and Zhu XL (2006) Pathologic progression of papillary thyroid carcinoma and its variants. J Pract Oncol, 21(4): 290-293. Chinese.##Yan TW, Cao YZ, Du YL, et al. (2016) Analysis of 2514 cases of thyroid ultrasound physical examination. Electron J Clin Med Literature, 3(15): 3017-3018. Chinese.##Peng YL, Luo Y, Zhang WD, et al. (2005) Correlation between thyroid nodules and thyroid function in the elderly. Chin J Gerontol, 24(4): 290-291. Chinese.##Xi BL (2012) Investigation of thyroid nodules and thyroid function in 850 elderly men. J Clin Intern Med, 29(8): 558-559. Chinese.##Takashima N, Niwa Y, Mannami T, et al. (2007) Characterization of subclinical thyroid dysfunction from cardiovascular and metabolic viewpoints: the Suita Study; Circ J, 71(2): 191-195.##Baranowska B, Wolinska-Witort E, Bik W, et al. (2007) Evaluation of neuroendocrine status in longevity. Neurobiol Aging, 28(5): 774-783.##Bremner AP, Feddema P, Leedman PJ, et al. (2012) Age-related changes in thyroid function: a longitudinal study of a community-based cohort. J Clin Endocrinol Metab, 97(5): 1554-1562.##Li X, Qu WY, Yu ZG, et al. (2011) Analysis of the change trend of thyroid hormone levels in healthy elderly people. Chin J Gerontol, 30(4): 269-271. Chinese.## ##

Advancing radiation safety, quality assurance, and scientific integrity in medical imaging: Highlights from the physics sessions of IRC 2025 2 2 The Physics Sessions of the 40th Iranian Congress of Radiology (IRC 2025) focused on improving patient safety, diagnostic accuracy, and evidence-based practice across ionizing and non-ionizing imaging modalities. The lectures emphasized that high-quality imaging requires effective radiation protection, rigorous quality assurance (QA), and well-trained professionals. A major theme of the congress was the development of a strong radiation safety culture based on justification, optimization (ALARA), and dose limitation. Speakers highlighted the importance of leadership, structured education, standardized safety protocols, and transparent communication in reducing unnecessary radiation exposure to patients and healthcare workers. Another key topic was quality control in diagnostic imaging. Properly implemented QA programs improve image quality while minimizing radiation dose. Monitoring parameters such as spatial and contrast resolution, image noise, artifacts, and contrast-to-noise ratio (CNR) is essential for maintaining diagnostic reliability and reducing repeat examinations. The congress also reviewed evolving evidence regarding patient lead shielding. Recent findings indicate that routine shielding may provide limited benefit in modern imaging systems and can occasionally interfere with automatic exposure control (AEC) or image quality. Current radiation protection strategies increasingly emphasize optimized imaging parameters, precise collimation, and avoidance of repeat imaging. Sessions on neonatal and obstetric ultrasound safety stressed the importance of monitoring Thermal Index (TI) and Mechanical Index (MI), minimizing scan duration, and improving operator awareness. Discussions on the Linear No-Threshold (LNT) model concluded that despite evidence of non-linear biological responses at low doses, the LNT model remains a practical and conservative framework for radiation protection policy. 921 924 2026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/162026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/08/292026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/82026/09/132026/09/132026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/192026/09/19 1405/6/28 2026/04/122026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/282026/07/28 1405/5/6 H. Mozdarani H. Mozdarani Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran M. Bakhshandeh M. Bakhshandeh Department of Radiology Technology, School of Allied Medical Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohsen Bakhshandeh H. Keivan H. Keivan School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran V. Changizi V. Changizi Department of Radiology Technology and Radiotherapy, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran O. Azadbakht O. Azadbakht Behbahan Faculty of Medical Sciences, Behbahan, Iran H. Zamani H. Zamani Department of Medical Physics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran R.K. Samani R.K. Samani Department of Medical Physics and Radiology, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran E. Soleimani E. Soleimani Department of Radiology Technology, School of Allied Medical Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran S.M.J. Mortazavi S.M.J. Mortazavi Department of Medical Physics, School of Medicine Shiraz University of Medical Sciences Shiraz Iran Radiation safety culture ALARA ultrasound safety linear no-threshold model medical imaging optimization. 1. Hall EJ and Giaccia AJ (2018) Radiobiology for the Radiologist. 8th ed: Lippincott Williams & Wilkins.##Valentin J (2007) International commission on radiological protection. ICRP Publication No.103.##Little JB (2000) Radiation carcinogenesis. Carcinogenesis, 21(3): 397-404.##NCRP Report No. 184 (2018) National Council on Radiation Protection and Measurements.##Tubiana M, Feinendegen LE, Yang C, Kaminski JM (2009) The linear no-threshold relationship is inconsistent with radiation biologic and experimental data. 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