Elbit Imaging

Purpose:Melanoma, a highly aggressive superficial malignancy with rising incidence and mortality, faces limited sonodynamic therapy (SDT) efficacy due to poor sonosensitizer accumulation and penetration. To overcome this, we employed chlorin e6 (Ce6), a high-ROS-yield sonosensitizer, and enhanced its tumor delivery using a synergistic microneedle (MN) and ultrasound (US) strategy. Methods:Using melanoma as an application scenario, a "stepwise drug delivery" system was developed. It consisted of dissolving MN encapsulating US-responsive nanoparticles (Ce6-PFP@PLGA, CPP) and termed CPP@MN. CPP@MN breaks through the stratum corneum to deliver CPP to tumors, followed by US-triggered cavitation that mediates perfluoropentane (PFP) phase transition to enhance the tumor-penetrating capability of chlorin e6 (Ce6). Delivery efficacy was validated using three experimental models: an in vitro agarose skin phantom, ex vivo pig skin, and in vivo tumors. Furthermore, the anti-tumor efficacy of US-combined CPP@MN was evaluated at the cellular level and in tumor-bearing mice. Results:According to the results, CPP@MN showed excellent transdermal performance, including rapid dissolution of sonosensitizer and sufficient mechanical strength. MN combined with US increased the tumor penetration depth of loading drug by 2.5-4 times across all experimental models. Ultrasonic cavitation promotes nanoparticle-derived Ce6 release and deeper tumor diffusion, resulting in specific anti-tumor efficacy. Conclusion:This innovative "stepwise drug delivery" system addresses persistent challenges in superficial tumor SDT, including inadequate sonosensitizer aggregation and poor tissue penetration, while establishing a multifunctional platform for spatiotemporally controlled drug release that sequentially overcomes the skin biological barriers.

The integration of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with radiomics has emerged as a transformative approach for non-invasive prediction of breast cancer molecular subtypes. This review systematically evaluates methodological innovations, clinical validation milestones, and translational applications: (1) Methodological Advancements: Standardized DCE-MRI protocols combined with multidimensional radiomic features (morphological, textural, and wavelet-transformed parameters) significantly improved discriminative performance for ER, HER2, and triple-negative subtypes. (2) Deep Learning Integration: Multitask predictive models achieved early treatment response assessment and recurrence risk stratification through spatiotemporal heterogeneity analysis. (3) Clinical Validation: Prospective multicenter trials demonstrated that radiomic models showed strong concordance with 21-gene assays and could potentially replace 38% of repeat biopsies. Despite these advancements, challenges persist in data heterogeneity and mechanistic interpretation of radiomic biomarkers. Emerging strategies integrating radiogenomic analyses and organoid validation platforms are establishing new paradigms for precision imaging-guided therapy.

Nowadays, a novel contact-force guided ablation technique is used for enclosing pulmonary veins in patients with atrial fibrillation (AF). We sought to determine whether left atrial (LA) wall thickness (LAWT) and pulmonary vein (PV) dimensions, as assessed by cardiac CT, could influence the success rate of first-pass pulmonary vein isolation (PVI). In a single-center, prospective study, we enrolled consecutive patients with symptomatic, drug-refractory AF who underwent initial radiofrequency catheter ablation using a modified CLOSE protocol. Pre-procedural CT was performed in all cases. Additionally, the diameter and area of the PV orifices were obtained. A total of 1034 LAWT measurements and 376 PV area measurements were performed in 94 patients (mean CHA2DS2-VASc score 2.1 ± 1.5, mean age 62.4 ± 12.6 years, 39.5% female, 38.3% persistent AF). Mean procedure time was 81.2 ± 19.3 min. Complete isolation of all PVs was achieved in 100% of patients. First-pass isolation rate was 76% and 71% for the right-sided PVs and the left-sided PVs, respectively. No difference was found regarding comorbidities and imaging parameters between those with and without first-pass isolation. LAWT (mean of 11 regions or separately) had no effect on the acute procedural outcome on logistic regression analysis (all p ≥ 0.05). Out of all assessed parameters, only RSPV diameter was associated with a higher rate of successful right-sided first pass isolation (OR 1.01, p = 0.04). Left atrial wall thickness does not have an influence on the acute procedural success of PVI using ablation index and a standardized ablation protocol. RSPV diameter could influence the probability of right sided first-pass isolation.

Primary angiosarcoma of the breast is a rare malignancy that is important for radiologists to recognize in young patients because its imaging appearance may mimic benign lesions resulting in advanced stages of disease and overall decreased patient survival. We present a unique case of a bilateral primary angiosarcoma in a pregnant patient in her twenties. She presented with a self-detected, rapidly enlarging, non-tender right breast mass while in her third trimester.

Lymph node status is regarded as an important factor in the prognosis of oesophageal cancer. T1 oesophageal adenocarcinoma management has to include endoscopic management as part of the algorithm. We reviewed the literature to assess the true risk of lymph node metastasis in patients with T1 oesophageal adenocarcinoma. Medline, Embase, PubMed and Cochrane where searched for manuscripts in English reviewing lymph node metastasis in superficial (T1) oesophageal adenocarcinoma. The main outcome was probability of lymph node metastasis in T1a and T1b oesophageal adenocarcinoma. Secondary outcome was the rate of lymph node metastasis of submucosal involvement of T1b (SM1, SM2 and SM3). There were 38 studies identified. 22 studies were excluded due to low lymph node yield (<15) or insufficient statistical analysis. For the 16 remaining studies, a total of 1382 cases were included: T1a adenocarcinoma (533 patients) with 11 (2%) node positive and T1b adenocarcinoma (849 patients) with 189 (22%) node positive. Subgroup analysis of T1b lesions was available in 8 reports (365 patients). Node positivity for SM1, SM2 and SM3 was 19.9%, 20.2% and 32.9%, respectively. T1a disease on endoscopic mucosal resection (EMR) demonstrates a 2% nodal metastasis rate, T1b disease a rate of 22%. T1a disease may be safely treated by EMR. T1a disease appears suitable for endoscopic therapy; however, T1b disease presents a high rate of nodal metastasis.