Cancer Research and Treatment

Original Articles

Dual-Functional PTX@Fe₃O₄ Nanobubbles: A Novel Theranostic Platform for Enhanced Ultrasound Imaging and Controlled Drug Delivery in Breast Cancer: Weiyang Lv, Xiaomei Ning, Chunxin Huang, Xing Li, Lianjie Bai, Xiaotong Wang, Zihan Wang, Yunna Song, Huilin Liu; Received September 26, 2025 Accepted November 16, 2025 Published online November 17, 2025; DOI: https://doi.org/10.4143/crt.2025.1055 [Accepted]

Abstract PDF: Purpose
This study aimed to develop a novel theranostic nanoplatform that integrates ultrasound imaging and controlled drug delivery for the treatment of breast cancer.
Methods
PTX@Fe₃O₄ nanobubbles (NBs) were synthesised via microfluidics. Characterisation included transmission electron microscopy, dynamic light scattering, drug release kinetics, phantom imaging and biocompatibility assays in vitro and in mice.
Results
The NBs exhibited uniform size (178 ± 12 nm), high drug loading (8.3%) and pH/ultrasound-responsive release (68.2% at pH 5.5+US). Ultrasound signal enhancement correlated linearly with concentration (R² = 0.988), with imaging duration three times longer than SonoVue. The system exhibited minimal haemolysis (<2%) and low cytotoxicity and induced S-phase arrest (68.2%) in MCF-7 cells. No significant toxicity was observed in mice at 10 mg Fe/kg.
Conclusion
PTX@Fe₃O₄ NBs represent a promising, biocompatible theranostic platform for image-guided breast cancer therapy.

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Noninvasive Assessment of Ki-67 Expression in Breast Cancer Using Ultrasound Radiomics: A Multi-Institutional Study: Sijie Mo, Zhibin Huang, Jing Zheng, Huaiyu Wu, Shuzhen Tang, Mengyun Wang, Jinfeng Xu, Hongtian Tian, Xiaoli Huang, Fajin Dong; Received May 30, 2025 Accepted September 2, 2025 Published online September 5, 2025; DOI: https://doi.org/10.4143/crt.2025.581 [Accepted]

Abstract PDF: Purpose
This study aimed to develop and rigorously evaluate machine learning models using ultrasound (US) breast cancer (BC) images to predict Ki-67 expression. Additionally, the study sought to identify independent factors influencing Ki-67 expression, with further test conducted through external datasets.
Materials and Methods
This study analyzed US images of BC from 347 patients (training set: n = 230; external test set: n=117) from Shenzhen People’s Hospital and Guangxi Academy of Medical Sciences. Radiomic features were extracted using manual region-of-interest (ROI) delineation and the Pyradiomics package. Feature selection was performed using LASSO and decision tree analysis, resulting in 16 features. Machine learning models-logistic regression (LR), support vector machine (SVM), and multilayer perceptron (MLP)-were developed, and their performance was assessed using the area under the receiver operating characteristic curve (ROC), accuracy, sensitivity, specificity, and decision curve analysis. Statistical analysis included univariate and multivariate logistic regression.
Results
Three machine learning models (LR, SVM, MLP) were developed to predict Ki-67 expression from US images. The LR model demonstrated the best diagnostic performance, with an AUC of 0.800 in external test set. Key predictors of Ki-67 expression included ill-defined mass maximum Maximum diameter and HER2 expression, along with other significant clinical variables.
Conclusion
This dual-center study demonstrates the potential of radiomics models based on US BC images to predict Ki-67 expression accurately. As a non-invasive diagnostic tool, this approach offers valuable support for clinical decision-making and personalized treatment planning in BC patients.

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Lung and Thoracic cancer

The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules: Soo Han Kim, Jeongha Mok, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Jung Seop Eom; Cancer Res Treat. 2023;55(2):506-512. Published online November 1, 2022; DOI: https://doi.org/10.4143/crt.2022.1008

Abstract PDF Supplementary Material PubReader ePub

Purpose
The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs).
Materials and Methods
From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022.
Results
The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm²) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm², p < 0.001) and 1.9-mm forceps (3.7 mm², p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications.
Conclusion
Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications.

Citations

Citations to this article as recorded by

A refined diagnostic approach for interstitial lung disease: efficient and safe transbronchial cryobiopsy using a 1.1-mm cryoprobe
Qinghua Zhang, Jinyan Yu, Xiaohao Zhang, Tiangang Ma, Yan Wang
Frontiers in Medicine.2026;[Epub] CrossRef
Comparative study of transbronchial cryobiopsy and transbronchial biopsy for diagnostic yield in peripheral pulmonary lesions
Hao-Chun Chang, Ching-Kai Lin, Lun‑Che Chen, Ling‑Kai Chang, Shun‑Mao Yang, Li-Ta Keng, Chong‑Jen Yu
Annals of Medicine.2026;[Epub] CrossRef
Clinical applications of cryobiopsy in the diagnosis of thoracic malignancies: a comprehensive review
Miwa Kamatani, Nobuyasu Awano, Takehiro Izumo
Japanese Journal of Clinical Oncology.2026;[Epub] CrossRef
Complete resolution of non-tuberculous mycobacterial pulmonary nodule following cryobiopsy: The first case report
Sung Joon Han, Chaeuk Chung, Dongil Park
Diagnostic Pathology.2025;[Epub] CrossRef
Feasibility of a Modified Bronchoscopic Transparenchymal Nodule Access Technique (‘Essen Tunnel’) for Improving the Diagnosis of Intraparenchymal Pulmonary Lesions
Erik Büscher, Faustina Funke, Jane Winantea, Hanna Zellerhoff, Johannes Wienker, Marcel Opitz, Christian Taube, Kaid Darwiche
Respirology.2025; 30(9): 851. CrossRef
Enhanced Detection of Druggable Mutations in Non–Small Cell Lung Cancer Using Targeted Collection of Bronchial Washing Fluid Compared With Plasma and Tumor Tissue
Mi-Hyun Kim, Soo Han Kim, Hayoung Seong, Jung Seop Eom
JCO Precision Oncology.2025;[Epub] CrossRef
Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational study
Ching-Kai Lin, Sheng-Yuan Ruan, Hung-Jen Fan, Hao-Chun Chang, Yen-Ting Lin, Chao-Chi Ho
Annals of Medicine.2025;[Epub] CrossRef
Numerical simulation of bioheat transfer during bronchial cryobiopsy using cryoprobes of different diameters
Junhong Tang, Yudong Bao, Wenqing Du, Wen Wei
Cryobiology.2025; 121: 105320. CrossRef
American Association for Bronchology and Interventional Pulmonology (AABIP) Evidence-Based Guidelines on Bronchoscopic Diagnosis and Staging of Lung Cancer
Russell J. Miller, Ara A. Chrissian, Fayez Kheir, Majid Shafiq, Abigail T. Chua, Neal Navani, Francisco A. Almeida, Abdul H. Alraiyes, Paul A. Bain, Christina R. Bellinger, Cherng H. Chao, George Z. Cheng, Rebecca Cloyes, Javier Diaz-Mendoza, David M. DiB
Journal of Bronchology & Interventional Pulmonology.2025;[Epub] CrossRef
Transbronchial cryobiopsy for diagnosing pulmonary hyalinizing granuloma: a case report
Akihiko Amano, Takashi Niwa, Masamitsu Hamakawa, Yasushi Fukuda, Toshihide Yokoyama, Tadashi Ishida
BMC Pulmonary Medicine.2025;[Epub] CrossRef
Advances in Invasive Diagnostics in Lung Cancer
Pascalin Roy, Sara Shadchehr, Anne V. Gonzalez
Seminars in Respiratory and Critical Care Medicine.2025; 46(05): 530. CrossRef
Transbronchial lung cryobiopsy for peripheral pulmonary lesions. A narrative review
Y. Tang, S. Tian, H. Chen, X. Li, X. Pu, X. Zhang, Y. Zheng, Y. Li, H. Huang, C. Bai
Pulmonology.2024; 30(5): 475. CrossRef
Transbronchial Tumor Ablation
Russell Miller, George Cheng
Current Pulmonology Reports.2024; 13(1): 103. CrossRef
Using cryoprobes of different sizes combined with cone-beam computed tomography-derived augmented fluoroscopy and endobronchial ultrasound to diagnose peripheral pulmonary lesions: a propensity-matched study
Ching-Kai Lin, Sheng-Yuan Ruan, Hung-Jen Fan, Hao-Chun Chang, Yen-Ting Lin, Chao-Chi Ho
Respiratory Research.2024;[Epub] CrossRef
Next‐generation sequencing using tissue specimen collected with a 1.1 mm‐diameter cryoprobe in patients with lung cancer
Mi‐Hyun Kim, Soo Han Kim, Geewon Lee, Jeongha Mok, Min Ki Lee, Ju Sun Song, Jung Seop Eom
Respirology.2024; 29(4): 333. CrossRef
Development of the Korean Association for Lung Cancer Clinical Practice Guidelines: Recommendations on Radial Probe Endobronchial Ultrasound for Diagnosing Lung Cancer - An Updated Meta-Analysis
Soo Han Kim, Hyun Sung Chung, Jinmi Kim, Mi-Hyun Kim, Min Ki Lee, Insu Kim, Jung Seop Eom
Cancer Research and Treatment.2024; 56(2): 464. CrossRef
Navigational bronchoscopy with tranbronchial cryobiopsy in differential diagnosis of peripheral pulmonary lesions
Ya.O. Chesalina, I.Yu. Shabalina, L.A. Semenova, I.V. Sivokozov
Pirogov Russian Journal of Surgery.2024; (6): 36. CrossRef
Advanced Bronchoscopic Diagnostic Techniques in Lung Cancer
Dongil Park
Tuberculosis and Respiratory Diseases.2024; 87(3): 282. CrossRef
Clinical utility of rapid on-site evaluation of brush cytology during bronchoscopy using endobronchial ultrasound with a guide sheath
Kazuhiro Nishiyama, Kei Morikawa, Shotaro Kaneko, Makoto Nishida, Aya Matsushima, Yoshihiro Nishi, Yu Numata, Yusuke Shinozaki, Hajime Tsuruoka, Hirotaka Kida, Hiroshi Handa, Naoki Shimada, Chie Okawa, Nobuyuki Ohike, Junki Koike, Masamichi Mineshita
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Bronchial branch tracing navigation in ultrathin bronchoscopy-guided radial endobronchial ultrasound for peripheral pulmonary nodule
Sze Shyang Kho, Shirin Hui Tan, Swee Kim Chan, Chan Sin Chai, Siew Teck Tie
BMC Pulmonary Medicine.2024;[Epub] CrossRef
The diagnosis of peripheral lung lesions: transbronchial biopsy using a radial probe endobronchial ultrasound
Jung Seop Eom
Journal of the Korean Medical Association.2023; 66(3): 166. CrossRef
Clinical outcomes of transbronchial cryobiopsy using a 1.1-mm diameter cryoprobe for peripheral lung lesions - A prospective pilot study
Soo Han Kim, Jeongha Mok, Saerom Kim, Wan Ho Yoo, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Jung Seop Eom
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Evaluation of Diagnostic Performance of Screening Thyroid Ultrasonography and Imaging Findings of Screening-Detected Thyroid Cancer: Jeongin Yoo, Hye Shin Ahn, Soo Jin Kim, Sung Hee Park, Mirinae Seo, Semin Chong; Cancer Res Treat. 2018;50(1):11-18. Published online February 24, 2017; DOI: https://doi.org/10.4143/crt.2016.600

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to evaluate the diagnostic performance and cost of screening thyroid ultrasonography (US) in an asymptomatic population and determine the US features of screening-detected thyroid cancer.
Materials and Methods
This study included 1,845 asymptomatic participants who underwent screening thyroid US between March and August 2012 at the screening center in our hospital. We evaluated the diagnostic performance of screening thyroid US for thyroid cancer and the average cost of diagnosis for each patient. We also determined the characteristic US features of screening-detected thyroid cancer.
Results
Of the 1,845 subjects, 661 showed no abnormalities, 1,155 exhibited benign thyroid nodules, and 29 exhibited thyroid cancer. Imaging features such as solid composition, hypoechogenicity, taller-than-wide axis, and ill-defined or spiculated margins of nodules were suggestive of malignancy. The rate of detection of cancer was 1.6% (29/1,845), and the sensitivity, specificity, and positive and negative predictive values were 100% (18/18), 98.7% (1,051/1,065), 56.3% (18/32), and 100% (1,051/1,051), respectively. Of 18 patients who underwent thyroidectomy, three (16.7%) had a pathological tumor staging of T3, and four (22.2%) had a pathological nodal staging of N1a. The average cost of diagnosis for each patient with cancer was $7,319.
Conclusion
Screening thyroid US exhibited a good diagnostic performance, with a feasible social cost of use. This modality demonstrated significant differences in sonographic features between screening-detected cancer and benign nodules.

Citations

Citations to this article as recorded by

Temporal Trends in Thyroid Nodule Size on Ultrasonography
Hayley Mann, Natalia Arroyo, Vivian Hsiao, Franklin Tessler, Lori Mankowski Gettle, Yanchen Zhang, Abdullah Adil, Mary Hitchcock, Elian Massoud, Catherine Jensen, Oguzhan Alagoz, Louise Davies, Sara Fernandes-Taylor, David O. Francis
JAMA Otolaryngology–Head & Neck Surgery.2025; 151(1): 47. CrossRef
Thyroid Ultrasonography Screening of a Cohort of Male University Students
Mahmoud S. Babiker, Fathelrehman A. Alamin, Mohammed Almteri, Abdullah Alradaddi, Waleed Alharbi
Journal of Diagnostic Medical Sonography.2025; 41(3): 225. CrossRef
Ultrasonographic study on the prevalence of thyroid abnormalities in asymptomatic females
Meaad Elbashir, Sara Ali, Sawsan Saidahmed, Awatif M. Omer, Rania Mohammed Ahmed, Aishah Hakami, Asala Jammah, Nuha Hazmi, Areej Faqihi, Ali Abdelrazig
Journal of Radiation Research and Applied Sciences.2025; 18(3): 101645. CrossRef
Ultrasonography of Incidental Thyroid Nodules: A Systematic Review and Meta-analysis of Prevalence
Li-Jen Liao, Shun-Fa Hung, Ping-Chia Cheng, Wan-Lun Hsu
Journal of Medical Ultrasound.2025; 33(4): 365. CrossRef
A nomogram based on clinicopathological and ultrasound characteristics to predict central neck lymph node metastases in papillary thyroid cancer
Fei Chen, Shuiping Jiang, Fan Yao, Yixi Huang, Jiaxi Cai, Jia Wei, Chengxu Li, Yanxuan Wu, Xiaolin Yi, Zhen Zhang
Frontiers in Endocrinology.2024;[Epub] CrossRef
Comparison of the value of ultrasound-guided fine needle aspiration biopsy and contrast-enhanced ultrasound in different sizes of thyroid nodules
Qi Liu, Liquan Ouyang, Shengchu Zhang, Yuxia Yang
Medicine.2024; 103(39): e39843. CrossRef
Diagnostic performance of six ultrasound-based risk stratification systems in thyroid follicular neoplasm: A retrospective multi-center study
Jingjing Yang, Yu Sun, Xingjia Li, Yueting Zhao, Xue Han, Guofang Chen, Wenbo Ding, Ruiping Li, Jianhua Wang, Fangsen Xiao, Chao Liu, Shuhang Xu
Frontiers in Oncology.2022;[Epub] CrossRef
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Rosy Setiawati, Tri Wulanhandarini, Fierly Hayati, Dyah Erawati, Merlin Guntur Jaya, Andi Ahmad Thoriq, Triana Mediyawati Wijaya, Galih Nur Ismiyati, Dyan Wahyu Kusumaningrum, Belinda Koesmarsono, Agnes Triana Basja, M. Ikhsan Nugroho, Silvi Yuliana, Syad
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The use of computed tomography as a first-line imaging modality in patients with primary hyperparathyroidism
Mechteld C. de Jong, K. Jamal, S. Morley, T. Beale, T. Chung, S. Jawad, S. Hurel, H. Simpson, U. Srirangalingam, S. E. Baldeweg, V. Rozalén García, S. Otero, M. Shawky, T. E. Abdel-Aziz, T. R. Kurzawinski
Hormones.2021; 20(3): 499. CrossRef
Sex Bias in Differentiated Thyroid Cancer
Valentine Suteau, Mathilde Munier, Claire Briet, Patrice Rodien
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Hashimoto Thyroiditis in Primary Thyroid Non-Hodgkin Lymphoma
Antonio Travaglino, Mirella Pace, Silvia Varricchio, Luigi Insabato, Claudia Giordano, Marco Picardi, Fabrizio Pane, Stefania Staibano, Massimo Mascolo
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Changes in the Diagnostic Efficiency of Thyroid Fine-Needle Aspiration Biopsy during the Era of Increased Thyroid Cancer Screening in Korea
Young Ki Lee, Kyeong Hye Park, Young Duk Song, Taemi Youk, Joo Young Nam, Sun Ok Song, Dong Yeob Shin, Eun Jig Lee
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Sonographic Criteria Predictive of Malignant Thyroid Nodules
Carlos Miguel Oliveira, Rui Alves Costa, Miguel Patrício, Amélia Estêvão, Bruno Graça, Filipe Caseiro-Alves
Academic Radiology.2017;[Epub] CrossRef

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Clinical Significance of Endometrial Cavity Fluid Detected by Ultrasonography in Patients with Gynecologic Neoplasm: Keun Jai Yoo, Soo Nyung Kim, In Jae Cho, Doo Ho Kim, Hae g Jeon, Jeong Hee Park; J Korean Cancer Assoc. 1994;26(3):460-466.

Abstract PDF: There are a number of different causes of endometrial fluid collections. Hematometra, hematocolpos, pregnancy and its complications, pelvic inflammatory disease, menstruation or exogenous estrogen administration have been reported to cause uterine fluid collections. The sonographically detected endometrial cavity fluid in the postmenopausal women has been described as indicative of uterine malignancy. The purpose of this study was to determine whether sonographic detection of the endometrial cavity fluid might be useful in the evaluation of gynecologic neoplasm. The results were as follows; 1) The sonographic detection rate of endometrial fluid in endometrial hyperplasia, endome- trial cancerm uterine myoma, cervical cancer, benign ovarian tumor were 33%(8/24), 50% (3/6), 11%(7/66), 9%(1/l1), 10%(l/10) respectively. 2) The sonographic detection rate of endometrial cavity fluid in vaginal bleeding was 56%(66/ 117) which was not significantly higher than that of other sy mptoms. 3) The sonographic detection rate(37%) of endometrial fluid in endometrial hyperplasia and cancer was significantly higher than that of other gynecologic neoplasms(10%)(P<0.05). 4) The frequency(10/1l) of vaginal bleeding in endometrial hyperplasia and cancer with endometrial cavity fluid detected by ultrasonography was significantly higher than that of other gynecologic neoplasms(P < 0.05). 5) The amounts of endometrial cavity fluid(mean+1SD) were 1.76+-1.35ml in endometrial hyperplasia, 2.33+-1.16m1 in endometrial cancer, 1.76+-1.35ml in uterine myoma, 8.00+-0.00ml in cervical cancer and 1.000.00ml in benign ovarian tumor. 6) In premenopausal and postmenopausal women, endometrial fluid collections were found in 15(18%) and 5(15%) cases respectively and there was no significant difference between the two groups.

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