Electrochemotherapy (ECT) combines the administration of cytotoxic agents with high-voltage electric pulses that transiently permeabilize tumor cell membranes and enhance intracellular drug uptake. This minimally invasive, nonthermal technique is particularly suitable for tumors located near critical structures, where surgery, radiotherapy, or percutaneous thermal ablation may be limited. In the spine, ECT can provide pain relief, neural decompression, and local tumor control while preserving neural structures. However, its implementation remains challenging due to complex vertebral anatomy, limited understanding of electric field distribution, the absence of dedicated planning tools, and the risk of neural injury. This protocol describes a reproducible workflow for patient-specific electric field simulation in spinal ECT. Multimodal imaging combining CT and MRI enables reconstruction of tumoral, vertebral, neural, and soft-tissue anatomy using semi-automatic and manual segmentations performed within the open-source 3D Slicer platform. Tissue conductivities are assigned according to the IT'IS database, and linear finite-element simulations (constant conductivity) are performed with AI4DEEP, a dedicated 3D Slicer module, to compute 3D electric field maps across multiple isodose thresholds. Follow-up contrast-enhanced MRI is used for validation through Dice similarity coefficients comparing simulated isoelectric field volumes with post-ECT necrotic tumoral areas. Qualitative comparison of simulated electric field maps, follow-up MRI, and clinical outcomes was performed by expert interventional radiologists to evaluate the ability of the software to predict undertreated and overtreated regions. Nine ECT procedures were processed to assess the workflow. The highest concordance between simulated electric field and post-ECT necrosis was observed in the 160-200 V/cm range in this specific clinical and numerical setting. The workflow also identified regions of insufficient or excessive treatment, consistent with clinical and imaging follow-up. The described workflow lays the groundwork for reproducible ECT planning, supporting optimized electrode placement and parameter adjustment to improve safety and efficacy in complex spinal ECT procedures.

Primary malignant bone tumours of the skeleton have a great diversity in their biological behaviour, and the most common in adolescence is osteosarcoma for which the diagnosis and therapeutic management are both a challenge. The use of machine and deep learning in image analysis for MRI, diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) to diagnose osteosarcoma has shown major improvements recently. This systematic review is performed according to PRISMA 2020 guidelines, and it comprises a critical analysis of 38 peer-reviewed articles from 2020 to 2025, which address the various aspects of tumour segmentation, classification, and prognosis. The methodological mapping revealed seven main categories that included numerous examples of radiomics (n = 8) and convolutional neural networks (CNNs, n = 6), as well as vision transformers and multimodal architectures for emerging technologies (n = 5 each). A quantitative evaluation of the segmentation performance showed that Multimodal achieved the best spatial overlap with an average Dice Similarity Coefficient (DSC) of 94.7% (range: 94.5-94.9%), while CNN of standard size was comparable, Lightweight networks had a DSC between 91.4 and 99.4% with an average of 91.9% and Vision Transformers a range of 90.5-94.9% with an average of 92.1%. By contrast, the performance gap among the Attention Mechanisms was greatest with a mean of 87.67% (64.6-98.5%), while the lowest was the mean 85.7% (81.6-89.8%) for Unsupervised Clustering. In addition to segmentation, the clinical nomograms based on radiomics also showed excellent prognostic potential:The AUC values for predicting pathological necrosis after chemotherapy varied from 0.807 to 0.848. More importantly it was found that there were significant translational gaps because all 38 models were limited to retrospective, single centre cohorts, with evaluation of risk of bias. Advanced algorithms perform well with localized precision but face a number of challenges with robust multicenter testing and a public repository.

Following its discovery, radium was initially promoted as a therapeutic agent for a wide range of conditions, including skin disorders, allergies, visual problems, joint pain, and as a general health-enhancing remedy. However, subsequent research demonstrated its significant radiological toxicity and harmful effects on human health. Despite these risks, more than a century after its discovery, certain radium isotopes continue to have limited medical applications, particularly in the treatment of specific cancers. Following ingestion, radium is absorbed into the body and behaves similarly to calcium, resulting in its deposition in bone tissue. A proportion of absorbed radium is eliminated through feces and urine, while the remaining fraction may persist in the skeleton and contribute to long-term internal radiation exposure. The severity and onset of adverse health effects are closely related to the absorbed dose and duration of exposure. Chronic exposure to elevated radium levels has been associated with hematological abnormalities, cataracts, dental and jaw damage, bone cancer, and increased mortality. Advances in radiobiology, radiation protection, and personalized medicine continue to improve the safety and effectiveness of radiation-based treatments. Modern radiotherapy, including selected applications involving targeted radionuclide therapy, requires a detailed understanding of radiation dose distribution, biological responses, and patient-specific factors. The optimization of re-irradiation strategies remains an important clinical challenge that requires careful assessment of previous radiation exposure, tissue tolerance, and potential risks. Because radium exposure can occur through ingestion, inhalation, or dermal contact, continued monitoring, appropriate regulatory frameworks, and access to specialized analytical methods remain essential components of public health protection. International cooperation and strengthened surveillance programs are needed to ensure the safe management of radium-containing materials and minimize potential health risks.

Chimeric antigen receptor (CAR) T cell therapies have revolutionized treatment of hematologic malignancies such as lymphoma and multiple myeloma. However, their success is limited by high manufacturing costs, reliance on autologous T cells, variable product quality, and life-threatening toxicities like cytokine release syndrome. In contrast, natural killer (NK) cells offer a safer, more flexible alternative, but their clinical translation remains constrained by complex expansion protocols and high production costs. Here, we present a transformative approach using the human NK cell line YTS, which is amenable to large-scale culture, genetic manipulation, and cryopreservation. By introducing a CD19-specific CAR into YTS cells, we generate potent effector cells capable of selectively eliminating CD19-expressing targets. We demonstrate that CAR signaling in YTS cells requires intracellular activation and, in certain tumor settings, is enhanced by co-stimulation via the 2B4-CD48 pathway. Importantly, irradiation of YTS-CAR cells prevents proliferation without compromising their cytotoxic function even after freezing and thawing. In preclinical models, injections of irradiated YTS-CAR cells significantly reduced CD19+ tumor burden, underscoring their therapeutic promise. This work positions engineered YTS cells as a novel, scalable, and cost-effective "off-the-shelf" immunotherapy platform suitable for treating refractory leukemias and lymphomas. Future studies will be required to assess safety and to explore applicability to autoimmune diseases and solid tumors.

Constitutional trisomy 8 mosaicism (CT8M) is a rare chromosomal disorder associated with congenital anomalies and hematologic malignancies, although its hematologic spectrum remains poorly defined. We report two institutional cases and performed a systematic review restricted to patients with trisomy 8 confirmed in both hematopoietic and non-hematopoietic tissues. Among 61 patients, hematologic abnormalities ranged from macrocytosis and cytopenias to dysplastic bone marrow changes and malignancies. No clear age-dependent peak of transformation emerged. Our findings suggest that CT8M represents a lifelong state of mosaic hematopoiesis with variable hematologic manifestations and uncertain malignant potential.

Androgen deprivation therapy (ADT) represents a cornerstone in the treatment of prostate cancer (PC); however, its use is associated with an accelerated deterioration of bone health as a consequence of treatment-induced hypogonadism. Patients receiving ADT experience a rapid loss of bone mineral density (BMD), especially during the first year of therapy, leading to a clinically significant increase in the risk of osteoporosis and fragility fractures. These bone complications are associated with a significant negative impact on quality of life, morbidity and mortality, and healthcare costs. This article aims to provide a critical and practical review of pathophysiology, risk factors, assessment methods, and strategies for the prevention and treatment of ADT-induced bone loss in patients with prostate cancer. Current recommendations from major clinical guidelines are analyzed, highlighting the importance of systematic bone risk assessment using bone densitometry and risk stratification tools like Fracture Risk Assessment Tool (FRAX®). Evidence-based interventions are also reviewed, ranging from lifestyle modifications and calcium and vitamin D supplementation to the use of antiresorptive therapies in selected patients, to provide a comprehensive and clinically applicable approach for daily practice.

A rapidly growing palatal swelling poses a diagnostic challenge due to its wide differential, including odontogenic, epithelial, salivary gland, mesenchymal and haematolymphoid pathologies. We report the case of an elderly female with a history of treated breast carcinoma who presented with a solitary palatal mass. Clinical and radiographic findings initially raised suspicion of a metastatic lesion because of the patient's previous malignancy, rapid lesion enlargement, firm fixation, bone erosion, sinus extension and cervical lymphadenopathy. However, histopathological examination and immunohistochemistry confirmed a diagnosis of extranodal diffuse large B-cell lymphoma rather than metastatic breast carcinoma, establishing it as a second primary malignancy. The patient was placed on palliative care due to her advanced age and compromised systemic condition but succumbed within 1 month. This case underscores the importance of including lymphoma in the differential diagnosis of rapidly enlarging oral swellings, even in patients with a remote history of solid-organ malignancy, and highlights the critical role of immunophenotyping in distinguishing lymphoid neoplasms from more common oral pathologies.

Proptosis in early childhood can be an alarming and stressful situation for parents and paediatricians. Different types of anatomical structures can be found in the orbit, such as nerves, muscles, veins, arteries, glandular and connective tissue and hence the differential diagnosis of unilateral proptosis can be vast. In some cases, orbital disease has the potential to cause substantial morbidity and mortality. Appropriate medical history, examination and diagnostic evaluation with imaging can assist with a prompt diagnosis and management. In young infants, a heightened level of suspicion should be maintained since orbital haemangiomas are the most prevalent primary lesions of the orbit presenting with proptosis. We report the case of an infant who presented at 3 months of age to our Emergency Department with a 2-week history of noticeable and progressively worsening right-sided proptosis.

Lymphangiomas (LMs) are rare, benign congenital malformations that can occur in any part of the body but most frequently in the head and neck region-although rarely intracranially.We present a case of a male in his 60s with sudden onset of paresis in his right fourth and fifth fingers that progressed to a diffuse right upper extremity paresis. Extensive paraclinical examinations were performed, with brain CT and MRI showing an osteolytic lesion over the left side of the cranium corresponding with the motor strip and accompanying brain herniation. The patient underwent neurosurgery with removal of the affected bone, biopsies of the tissue and bone and coverage with a titanium mesh. The histopathological diagnosis was a benign LM. Six months postoperatively, the paresis had improved significantly.Despite being very rare, LMs of the skull can cause significant neurological deficits depending on their location. MRI and histopathological analysis are key to diagnosis.