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Open in new tab Download slide OBJECTIVES Intraoperative molecular imaging (IMI) uses cancer-targeted fluorescent probe to locate nodules. Pafolacianine is a Food and Drug Administration-approved fluorescent probe for lung cancer. However, it has a 8–12% false negative rate for localization. Our goal is to define preoperative predictors of tumour localization by IMI. METHODS We performed a retrospective review of patients who underwent IMI using pafolacianine for lung lesions from June 2015 to August 2019. Candidate predictors including sex, age, body mass index, smoking history, tumour size, distance of tumour from surface, use of neoadjuvant therapy and positron emission tomography avidity were included. The outcome was fluorescence in vivo and comprehensively included those who were true or false positives negatives. Multiple imputation was used to handle the missing data. The final model was evaluated using the area under the receiver operating characteristic curve. RESULTS Three hundred nine patients were included in our study. The mean age was 64 (standard deviation 13) and 68% had a smoking history. The mean distance of the tumours from the pleural surface was 0.4 cm (standard deviation 0.6). Smoking in pack-years and distance from pleura had an odds ratio of 0.99 [95% confidence interval: 0.98–0.99; P  = 0.03] and 0.46 [95% confidence interval: 0.27–0.78; P  = 0.004], respectively. The final model had an area under the receiver operating characteristic curve of 0.68 and was used to create a nomogram that gives a probability of fluorescence in vivo. CONCLUSIONS Primary tumours that are deeper from the pleural surface, especially in patients with a higher pack-years, are associated with a decreased likelihood of intraoperative localization. We identified a nomogram to predict the likelihood of tumour localization with IMI with pafolacianine. [ABSTRACT FROM AUTHOR]

Despite significant progress in diagnosis and treatment, breast cancer remains a formidable health challenge, emphasizing the continuous need for research. This simulation study uses polarized Monte Carlo approach to identify and locate breast cancer. The tissue model Mueller matrix derived from polarized Monte Carlo simulations provides enhanced contrast for better comprehension of tissue structures. This study explicitly targets tumour regions found at the tissue surface, a possible scenario in thick tissue sections obtained after surgical removal of breast tissue lumps. We use a convolutional neural network for the identification and localization of tumours. Nine distinct spatial positions, defined relative to the point of illumination, allow the identification of the tumour even if it is outside the directly illuminated area. A system incorporating deep learning techniques automates processes and enables real-time diagnosis. This research paper aims to showcase the concurrent detection of the tumour's existence and position by utilizing a Convolutional Neural Network (CNN) implemented on depolarized index images derived from polarized Monte Carlo simulations. The classification accuracy achieved by the CNN model stands at 96%, showcasing its optimal performance. The model is also tested with images obtained from in-vitro tissue models, which yielded 100% classification accuracy on a selected subset of spatial positions., (© 2025 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.)

Objectives: Localization of ectopic ACTH‐secreting tumours causing Cushing syndrome (ECS) is essential for clinical management, yet often difficult. [68Ga]‐DOTATATE PET/CT ([68Ga]‐DOTA‐(Tyr3)‐octreotate)] is an FDA‐approved high‐resolution diagnostic tool for imaging neuroendocrine tumours. Data on the clinical utility of [68Ga]‐DOTATATE in patients with ECS, however, are scarce. The objectives of this study were to determine the efficacy for ECS localization and the clinical benefit of [68Ga]‐DOTATATE imaging. Method: We conducted a retrospective review of all cases with ECS evaluated with [68Ga]‐DOTATATE from November 2016 through October 2018 at three referral centres. The clinical benefit of [68Ga]‐DOTATATE was based on detection of new tumours and resultant changes in management. Results: Over the study period, 28 patients with ECS underwent [68Ga]‐DOTATATE: 17 for identification of the primary tumour and 11 during follow‐up. [68Ga]‐DOTATATE identified the suspected primary ECS in 11/17 patients (65%). Of these, nine patients underwent surgery: eight with confirmed ECS (5 bronchial, 1 thymic, 1 pancreatic and 1 metastatic neuroendocrine tumour of unknown primary origin) and one patient with a false‐positive scan (adrenal gland). Of the 11 patients with ECS who underwent [68Ga]‐DOTATATE evaluation during follow‐up, the study led to changes in clinical management in 7/11 (64%) patients. Conclusions: [68Ga]‐DOTATATE is sensitive in detecting primary and metastatic ECS, often identifies occult tumours after conventional imaging, and impacts clinical care in the majority of patients. [ABSTRACT FROM AUTHOR]

The review of literature indicates that several clinico-morphological factors such as location of the primary tumour as well as its size, histologic subtype, and grade or even selected molecular changes may significantly affect survival of liposarcoma (LPS) patients. Data concerning prognostic importance of DNA ploidy status in LPS cells are extremely limited and results of flow cytometry (FCM) studies have never been compiled with the current classification of malignant adipocytic tumours. Based on evaluation of material from 54 liposarcomas which was available for both histological and FCM analysis, we distinguished four prognostic groups of patients. The best prognosis was noticed for diploid and grade G1 well-differentiated or myxoid liposarcomas localised on extremities. None of the patients with lipoma-like WDLPS and myxoid liposarcoma grade 1 metastasised, while metastases were observed among patients with dedifferentiated LPS (70% of 5-year MFS) and cellular myxoid or round cell liposarcoma (20% of 5-year MFS, only). The metastasis-free survival curves for the above mentioned groups of patients differed significantly (p = 0.00001) [ABSTRACT FROM AUTHOR]

Inflammatory vascular polyps that are complicated by bleeding are difficult to diagnose and localise during the operation. With the improvement in the diagnosis of the small bowel tumours with double balloon endoscopy, the preoperative localization of the lesion is essential to undertake appropriate surgery, and to reduce the time for surgery and avoid resection of wrong segment of small bowel. Double balloon endoscopic tattooing of small bowel tumours and lesions is a new modality to ease the surgery when resection of small bowel is indicated. The literature about double balloon endoscopic tattoo is scant. We present a rare case of small bowel polyp that caused bleeding and the successful use of double balloon endoscopic tattoo preoperatively for the localization of the lesion during surgical procedure. (Dig Endosc 2013;4(2):49-51)

Aim: The aim of our study was to assess the precise tumour localization in radical prostatectomy specimens. Based on the study outcome, we are proposing a modification to the prostate biopsy strategy with the goal of increasing the tumour detection rate. Material and methods: Between May 2008 and June 2011 we evaluated whole mount section of 33 prostates (specimens were obtained by 23 radical retropubic and 10 robot-assisted radical prostatectomies). Tumour localization was assessed according to McNeal's prostate zonal anatomy scheme. Statistical analysis was performed using a chi- -square test. Results: In all cases, the tumour was localized in the peripheral zone (PZ) of the prostate. In 30% of specimens a tumour was also found in the transitional zone (TZ). Neither of the TZ findings involved index tumours. In 15% of cases, separate tumour foci were found in the TZ, which did not affect the patient's prognosis. In the remaining 15% of cases, a large peripheral tumour infiltrated the TZ. We failed to detect a case with the tumour focus presenting with TZ only. In cases of TZ tumour localization, 60 % of patients presented with a locally progressive disease. In the case of tumours localized to the PZ, locally advanced prostate cancer was diagnosed in only 13% of the specimens (statistically significant difference, p = 0,005). In TZ tumours, PSA progression after radical prostatectomy was seen more frequently (in 50 % of patients), in contrast to non-TZ tumours where progression developed in 30% of cases. This difference was found to be statistically insignificant (p > 0.05). Conclusion: During its early stages, prostate cancer is always localized in the PZ. In all cases where the tumour was found in the TZ locations, it was associated with a simultaneous PZ tumour focus or with a central progression of PZ tumour. It is therefore necessary to direct the biopsies into the PZ and we propose the use of a peripheral zone biopsy not only in the course of the initial biopsy, but also in the rebiopsy. A TZ biopsy is indicated when a saturation biopsy is performed in cases where there is suspicion of prostate cancer due to PSA elevation above 10 ng/ml, in addition to repeated prostate biopsies with negative histology findings. [ABSTRACT FROM AUTHOR]

Background Development of both basal cell carcinoma (BCC) and cutaneous malignant melanoma (MM) is associated with acute and intermittent sun exposure. In contrast to MM, the association between socioeconomic status (SES) and BCC is not well documented. Objectives To investigate the incidence of BCC according to SES, stratifying by age and tumour localization in a large population-based cohort. To assess changes over time in the distribution of the patients with BCC across the SES categories. Methods All patients with a histologically confirmed first primary BCC ( n = 27 027) diagnosed between 1988 and 2005 in the Southeast of the Netherlands were stratified by sex, age (25–44, 45–64 and ≥ 65 years), period of diagnosis, SES category (based on income and value of housing) and localization of the BCC. Age-standardized BCC incidence rates were calculated for the year 2004 by SES category and localization. Ordinal regression was used to assess changes over time in the proportion of patients with BCC by sex, age and SES. Results  For men in all age groups higher BCC incidence in the highest SES category was observed, which remained significant after stratification for tumour localization. For women a consistent relationship was found only in younger women (< 65 years) for truncal BCCs, which occurred more frequently in high SES groups. Between 1990 and 2004, the proportion of BCC patients with high SES increased (+6%) and the proportion with low SES decreased (−7%). Conclusions High SES is associated with increased incidence of BCC among men. Our data suggest that BCC is changing from a disease of the poor to a disease of the rich. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine the value of a 21-sample biopsy protocol in predicting tumour localization in radical prostatectomy (RP) specimens, compared with sextant biopsies. PATIENTS AND METHODS In all, 300 consecutive patients underwent 21-sample prostate biopsies, followed by RP. The protocol consisted of sextant, three midline, six far lateral and six transitional zone biopsies. Tumour locations on biopsies and RP specimens were compared. The sensitivity, specificity, positive (PPV) and negative predictive value (NPV) and accuracy were calculated. RESULTS There was no difference between sextant and 21-sample biopsies for sensitivity (38% vs 36%; P = 0.50) and specificity (84% vs 87%; P = 0.46), but the NPV was higher for 21-sample biopsies (57% vs 68% ; P < 0.001). The PPV was higher in the sextant biopsies (74% vs 59%; P = 0.007). Sextant, transitional zone and far lateral biopsies were re-grouped in six regions. Compared with 21-sample biopsies, sensitivity (54%) and PPV (79%) were higher ( P < 0.001), while specificity (74%) and NPV (46%) were lower ( P = 0.05 and P = 0.001, respectively). CONCLUSION A negative biopsy does not confirm the absence of cancer in the corresponding site in the RP specimen in a sextant or 21-sample biopsy protocol and cannot be used as a prognostic element before RP. A positive biopsy does not always correspond with a tumour in the same zone of the RP specimen. When 21-sample biopsies are re-grouped in to six regions, the value of a positive biopsy increases. A positive biopsy corresponds thus to a tumour in the same region, rather than in precisely the same location. The results of this study could help in the biopsy protocol used for making surgical decisions, e.g. preserving the bladder neck or neurovascular bundles. [ABSTRACT FROM AUTHOR]

Objective Laparoscopic surgery for colorectal cancer is now widespread. Small lesions in the colon can be difficult to palpate and with lack of tactile sensation, it is essential to accurately localize them preoperatively. This is a review article on current methods of tattooing including the use of different agents and associated complications. Aim To review current techniques in preoperative tumour localization and methods used for colonic tattooing including agents used, dosage and potential complications. Method A literature search (Medline and Pubmed) was performed with manual cross referencing of all articles related to colonic tattooing. Results Methods for localizing colonic tumours for laparoscopic resection include preoperative barium enema examination, CT colonography and intraoperative colonoscopy. The most effective method is, however, by tattooing with India ink performed endoscopically before surgery. Conclusion India ink is a reliable method of marking tumour location within the colon as prelude to laparoscopic resection. Surgeons must, however, be aware of potential complications associated with this technique. [ABSTRACT FROM AUTHOR]

We have investigated the ability of various predictive studies to assess which monoclonal antibody (MCA) will be most useful in the immunoscintigraphic localization of metastatic colorectal carcinoma. A set of MCAs was obtained by fusing splenic lymphocytes from rats immunized with membrane preparations from fresh human colorectal cancer. Supernatants from 17 cloned hybridomas were found to bind strongly to colon carcinoma lines by indirect radioimmunoassay. Immunofluorescence using these MCAs on sections of fresh frozen colon carcinoma and normal tissue revealed different staining patterns. Nine MCAs were purified and labelled withI. Groups of mice bearing human colorectal tumour xenografts were given radiolabelled MCA and scanned. Six out of the nine MCAs showed tumour localization as determined by rectilinear scanning. Three MCAs which gave good tumour images in mice were selected for clinical evaluation in patients with advanced colorectal cancer. One gave good tumour images, another targeted to bone marrow and the third bound almost exclusively to normal liver. Clinical evaluation is clearly essential in the selection of MCAs for tumour localization. [ABSTRACT FROM AUTHOR]

Extensive investigation including whole-body examinations with computed tomography and magnetic resonance imaging did not detect the suspected ectopic ACTH-producing tumour in a patient with advanced Cushing's syndrome and hypokalemic alkalosis. Gamma camera examination with technetium-99m methoxyisobutylisonitrile (MIBI) depicted the tumour, which was localized in the anterior neck and mediastinum. This was later verified by surgery. Tc-MIBI is normally used for myocardial scintigraphy. Its accumulation is unspecific and merely reflects metabolic activity. Despite this, the present case shows that examination with this agent can provide important information with regard to tumour localization in a given situation, thereby serving as a complement to other imaging modalities. The current literature on Tc-MIBI for tumour diagnosis is reviewed. [ABSTRACT FROM AUTHOR]

To search for the tumour localization mechanism of Tc(V)-DMS, a polynuclear pentavalent technetium complex of dimercaptosuccinic acid [Tc(V)-DMS], the development of medullary thyroid carcinoma (MTC) bearing mouse model was considered. Subcutaneously transplanted tumour was allowed to grow for 2, 4 and 6 weeks, and the influence of the tumour stage on the biodistribution of Tc(V)-DMS was screened. High radioactivity uptake in the tumour tissue was observed, and this accumulation showed a direct correlation with tumour growth and calcitonin secretion, the MTC marker detectable in the blood serum. The gathered data implicated some calcitonin-related factors as the mediator in the Tc(V)-DMS localization; participation of a phosphate-like oxoanion, TcO, is strongly suggested not only by the high radioactivity accumulation in the calcitonin-producing tumour but also by the accumulation in the bones of this model animal. [ABSTRACT FROM AUTHOR]

The immunoreactive fraction of an anti-CEA monoclonal antibody preparation has been progressively decreased by the addition of increasing proportions of impurity in the form of immunologically inert mouse immunoglobulin. Following radioiodination, the immunoreactive fractions of the preparations were determined and their localization in a human tumour xenograft in nude mice was assessed. There was a progressive decline in tumour localization, from tumour to blood ratios of 2:1 with unadulterated antibody to 0.6:1 with preparations only 15% with respect to the initial antibody. These findings demonstrate that the immunoreactive fraction of monoclonal antibody preparations is a major limiting factor in tumour localization and this has implications for experimental and clinical applications of monoclonal antibodies. [ABSTRACT FROM AUTHOR]

[F]-5-fluorocytosine-arabinoside ( 2) and [F]-5-fluorocyclocytidine ( 4) were prepared by reaction of [F]-acetylhypofluorite with cytosine-arabinoside ( 1) or cyclocytidine ( 3) in acetic acid and were isolated in an overall radiochemical yield of 20% and 9%, respectively. The biodistribution of both radiopharmaceuticals was determined in melanoma bearing Syrian golden hamsters. It was found that 2 is a good tumour-localizing agent for pigmented and non-pigmented Greene melanoma. [ABSTRACT FROM AUTHOR]

Background: During percutaneous puncture procedure, breath holding is subjectively controlled by patients, and it is difficult to ensure consistent tumour position between the preoperative CT scanning phase and the intraoperative puncture phase. In addition, the manual registration process is time-consuming and has low accuracy., Methods: We have proposed an automatic registration method using optical markers and a tumour breath-holding position estimation model based on the support vector regression algorithm. A robot system and a tumour respiratory motion simulation platform are built to perform puncture tests under different breath-holding states., Results: The experimental results show that automatic registration has higher accuracy than manual registration, and with the tumour breath-holding position estimation model, the targeting accuracy of puncture under inconsistent breath-holding conditions is greatly improved., Conclusions: The proposed automatic registration and tumour breath-holding position estimation model can improve the accuracy and efficiency of puncture under inconsistent breath-holding conditions., (© 2021 John Wiley & Sons Ltd.)

Objectives: For small pulmonary nodules that are unidentifiable by palpation or in endoscopic surgeries wherein palpation is not feasible, visualizing their location is necessary when performing pulmonary sublobar resection procedures, such as wedge resection or segmentectomy. We invented a new transbronchial lung-marking technique using the photodynamic diagnosis endoscope system and vitamin B2 and examined its feasibility and safety via porcine studies., Methods: We established the marking procedure in pigs and examined the marking clarity and size, fluorescence intensity and duration and possible complications. In another study, sublobar resection for virtual target lesions was performed in pigs based on the fluorescent markings. The procedure duration, marking visibility, surgical margin from the lesions and technique-related complications were assessed., Results: All 36 markings in 6 pigs were identifiable and were widely distributed over the right lung. The median diameter and fluorescence intensity at 60 min after marking were 6.0 (5.5-6.7) mm and 137.5 (122-168), respectively. All 18 markings for the 6 virtual target lesions (3 markings for each target) were clearly identified, and all target lesions were found in the resected specimens. The median duration per marking was 244 (194-255) seconds. The shortest median surgical margin from a target lesion was 11.5 (9.3-13.5) mm. No procedure-related complications were observed., Conclusions: This novel transbronchial fluorescent lung-marking technique was useful and safe in sublobar resections for small non-palpable pulmonary lesions., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Department of Tumour Pathology, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Kraków, Poland The review of literature indicates that several clinico-morphological factors such as location of the primary tumour as well as its size, histologic subtype, and grade or even selected molecular changes may significantly affect survival of liposarcoma (LPS) patients. Data concerning prognostic importance of DNA ploidy status in LPS cells are extremely limited and results of flow cytometry (FCM) studies have never been compiled with the current classification of malignant adipocytic tumours. Based on evaluation of material from 54 liposarcomas which was available for both histological and FCM analysis, we distinguished four prognostic groups of patients. The best prognosis was noticed for diploid and grade G1 well-differentiated or myxoid liposarcomas localised on extremities. None of the patients with lipoma-like WDLPS and myxoid liposarcoma grade 1 metastasised, while metastases were observed among patients with dedifferentiated LPS (70% of 5-year MFS) and cellular myxoid or round cell liposarcoma (20% of 5-year MFS, only). The metastasis-free survival curves for the above mentioned groups of patients differed significantly (p = 0.00001).

Introduction: In the structure of malignant skin neoplasms, the tumours of epithelial origin take the first place, among them the prevalence of cutaneous squamous cell carcinoma (cSCC) is about 20%. The aim of the work involves the analysis of cSCC epidemiological features among the contingent of the State Scientific Institution "Scientific and Practical Centre of Preventive and Clinical Medicine" of the State Administration (SIS) over 2005-2014 (Ukraine, Kyiv)., Material and Methods: For retrospective epidemiological analysis there was used identifying information of patients with cSCC of the contingent of SIS over 2005-2014 in comparison with the data on patients with cSCC of Kyiv city and Kyiv region over the same period of time., Results: The morbidity rate of cSCC among the contingent of SIS in 2005-2014 increased from 6.7 per 100,000people to 37.1 per 100,000 people. Among men it increased from 8.2 per 100,000 people to 59.2 per 100,000 people, and among women - from 6.6 per 100,000 people to 19.2 per 100,000people. Among the contingent of SIS the highest incidence both in men and women was observed in the age group of 85 and upwards; among men it was 115.2 per 100,000 people, and among women - 112.0 per 100,000 people., Conclusions: The morbidity rate of cSCC among the contingent of SIS in 2005-2014 was significantly higher (p<0.05) than the morbidity rate among the population of Kyiv city and Kyiv region over the same period of time, with the prevalence of patients aged 85 and upwards, both men and women.