Search Results (4,883)

Background/Objectives: Liver metastasis after surgery for adrenocortical carcinoma (ACC) is a critical factor affecting patient prognosis; however, relevant ultrasound imaging features remain poorly characterized. This retrospective study aims to systematically describe the conventional ultrasound and contrast-enhanced ultrasound (CEUS) features of post-surgical hepatic metastases from ACC and to evaluate the clinical utility of ultrasonography in the diagnosis and follow-up. Methods: A total of 10 patients with post-surgical ACC liver metastases via ultrasound-guided liver biopsy between January 2000 and June 2026 at West China Hospital of Sichuan University were retrospectively enrolled. All patients underwent conventional ultrasound (B-mode and color Doppler flow imaging, CDFI) and CEUS. Given the small sample size, only descriptive statistics were performed, and all findings should be interpreted as exploratory. Results: All 10 patients were female (age range: 38–56 years), 70% had multiple lesions. On B-mode ultrasound, 80% of lesions appeared hypoechoic, 100% exhibited heterogeneous internal echotexture, 80% had irregular shapes, and 60% displayed well-defined margins. CDFI detected internal or perilesional blood flow signals in 90% of lesions, predominantly perilesional (50%). CEUS demonstrated arterial-phase hyperenhancement in all cases (50% heterogeneous hyperenhancement, 30% peripheral-dominant enhancement, and 20% ring-like nodular hyperenhancement), followed by rapid wash-out during the portal venous or delayed phases, with 100% of lesions showing hypoenhancement at 180 s. Conclusions: These exploratory findings suggest that post-surgical ACC liver metastases typically manifest on conventional ultrasound as hypoechoic, heterogeneous solid masses with variable margins and predominant perilesional blood flow. CEUS reveals a characteristic “fast-in, fast-out” malignant enhancement pattern. CEUS may serve as a useful adjunct to conventional imaging within a multimodal surveillance strategy, but larger prospective studies are needed to confirm its diagnostic value. Full article

Objectives: To evaluate ¹⁸F-labelled fluoroazomycinarabinoside ([¹⁸F]F-FAZA) PET in post-transplant patients and examine the association of its kinetic and uptake parameters with kidney allograft function measurements, including laboratory and histopathological assessments. Methods: In this prospective pilot study, renal transplant patients were evaluated with a dedicated positron emission tomography/magnetic resonance imaging (PET/MR) protocol between 2018 and 2023. Twenty patients with impaired kidney allograft function (cases) and ten sex- and time-post-transplant-matched control patients with stable transplant allograft function (controls) were included. All patients underwent [¹⁸F]F-FAZA PET/MR, including initial dynamic and delayed static imaging. Cases underwent an ultrasound-guided biopsy for histopathological assessments. Results: From the [¹⁸F]F-FAZA PET-derived parameters, dynamic total volume distribution (V_T) was significantly higher in control patients than in cases (2.11 ± 0.55 vs. 1.62 ± 0.45; p = 0.026). When correlating [¹⁸F]F-FAZA PET parameters with creatinine levels and estimated glomerular filtration rate, V_T was again the only variable that significantly correlated with both metrics. Regarding histopathological parameters, a significant positive correlation was found between k₁ and vascular fibrous intimal thickening, a significant negative correlation between k₃ and arteriolar hyalinosis, and k₃/k₄ (binding potential) was significantly correlated with the percentage of globally sclerotic glomeruli and arteriolar hyalinosis. Additionally, V_T was significantly correlated with interstitial inflammation. SUV_mean on the static PET was significantly correlated with the percentage of globally sclerotic glomeruli. Conclusions: Non-invasive assessment of renal microcirculation using dynamic [¹⁸F]F-FAZA PET is potentially feasible. The dynamic PET-derived parameters showed strong correlations with renal function. There were also correlations with various histopathological findings. Additionally, static [¹⁸F]F-FAZA PET-derived parameters showed complementary findings with hypoxia-related end-stage histopathological indicators. Full article

Background/Objectives: Interventional endoscopic ultrasound (I-EUS) has evolved from a diagnostic imaging modality into a transformative therapeutic platform encompassing biliary drainage, pancreatic interventions, luminal bypass, pain management, and ablative therapies. Despite the rapid proliferation of I-EUS research, a comprehensive bibliometric analysis characterizing the global intellectual architecture of this field is lacking. Methods: A Web of Science Core Collection search identified 4340 records, of which 2237 were included (2001–2024), analyzed with R bibliometrix (version 5.0) and VOSviewer (version 1.6.20). Results: Publication output demonstrated three distinct phases with pronounced acceleration from 2017. The United States led global output (n = 625, 27.9%), followed by Japan (n = 435, 19.4%) and Italy (n = 166, 7.42%). At the continental level, Asia collectively produced the largest share of output (n = 884, 39.5% of the total corpus), exceeding the Americas (n = 687, 30.7%) and Europe (n = 492, 22.0%). Gastrointestinal Endoscopy was the most productive journal (n = 173). Tokyo Medical University was the most productive institution (n = 93, 4.16%). Four thematic clusters were identified: EUS-guided biliary and pancreatic ductal drainage; diagnostic, ablative, and injection EUS for pancreatic tumors; LAMS-enabled luminal bypass and gallbladder drainage; and pancreatic fluid collections and necrotizing pancreatitis. Temporal overlay confirmed EUS-guided gastroenterostomy, EUS-guided gallbladder drainage, and EUS-guided radiofrequency ablation as the leading research frontiers. Annual output showed no discernible contraction during the COVID-19 pandemic period (2020–2021). Conclusions: The United States led global I-EUS research output with higher rates of international collaboration compared with East Asian nations, although Asia as a continent generated the largest aggregate volume of publications. EUS-guided biliary drainage and pancreatic fluid collection management constitute the established, high-volume core of the field, while EUS-guided gastroenterostomy and novel ablative technologies represent the most dynamic investigative frontiers. Full article

A 12-year-old neutered male domestic shorthair cat presented with recurrent pleural effusion following repeated thoracentesis. Initial analysis of the pleural effusion did not reveal neoplastic cells. Thoracic imaging demonstrated pleural effusion without identifiable nodular lesions. However, abdominal computed tomography and histopathological examination of an ultrasound-guided percutaneous core liver biopsy identified a large hepatic mass, confirmed to be cholangiocarcinoma, with suspected metastases to the spleen. After exclusion of other potential causes, the effusion was suspected to be a paramalignant pleural effusion. Despite palliative management, the disease progressed, and the cat was euthanized 98 days after definitive diagnosis. Postmortem examination revealed widespread metastatic cholangiocarcinoma involving the lungs, spleen, and intercostal muscles. No gross mass lesions were identified in the pulmonary parenchyma. Histological results demonstrated neoplastic cell infiltration within both the pulmonary lymphatic and blood vessels, a finding consistent with lymphovascular spread, which can contribute to the development of pleural effusion. This case show that while the characteristics of neoplasia-associated pleural fluid may vary according to disease stage, cholangiocarcinoma-associated pleural effusion may occur in the absence of cytologic evidence of malignancy, pulmonary nodules on thoracic imaging, or typical hepatobiliary signs. Full article

Corticosteroid injections (CSIs) are widely used in Physical and Rehabilitation Medicine, but their safety profile is strongly influenced by the formulation-specific chemical structure and physicochemical properties of each molecule, as well as by injection technique and dosing strategy. Particulate corticosteroids such as triamcinolone acetonide and methylprednisolone acetate exhibit low aqueous solubility, microcrystal formation, and prolonged intra-articular residence, which translate into sustained anti-inflammatory effects but also higher risks of chondrotoxicity, calcifications, tendinopathy, cutaneous and muscular atrophy, osteonecrosis, nerve injury, infection, and post-injection flare, especially with repeated or high-dose use. In contrast, more soluble preparations like betamethasone and dexamethasone sodium phosphate provide rapid onset and shorter duration of action, with reduced local depot-related complications but a greater propensity for transient systemic effects such as glycemic spikes. Across adverse events, less soluble, longer-acting formulations and inaccurate extra-articular delivery consistently emerge as key drivers of local tissue damage. Ultrasound guidance significantly improves injection accuracy, optimizes drug deposition of both particulate and non-particulate agents, and may enhance clinical outcomes while limiting complications, thereby representing a relevant component of CSI practice. In conclusion, this narrative review proposes a formulation-oriented framework for corticosteroid selection, integrating pharmaceutical formulation, physicochemical properties, imaging guidance, and individualized rehabilitation strategies to optimize molecule selection, minimize adverse effects, and advance a precision rehabilitation paradigm. Full article

Optical coherence tomography (OCT) and photoacoustic imaging (PAI) provide complementary structural and absorption contrasts but require different coupling conditions: 1310 nm swept-source OCT is attenuated by water, whereas PAI requires acoustic coupling. We developed a large-field dual-modal imaging system combining temporal medium separation with hardware-based coordinate locking. The OCT head, linear-array ultrasound transducer, and photoacoustic excitation fiber bundle were mounted on a rigid common platform, and a one-time calibration established a two-dimensional affine transformation between the modality coordinate systems. OCT was acquired in air and PAI in deionized water within a common large-field coordinate range. In five paired air–water measurements with an approximately 23 mm water path, the displayed OCT peak level decreased from 98.4 ± 1.5 dB in air to 79.4 ± 1.8 dB in water, corresponding to a mean reduction of 19.0 ± 1.4 dB. Quantitative registration was evaluated using a 5 × 5 dual-modal landmark phantom, with nine landmarks used for affine calibration and 16 excluded landmarks reserved for independent validation. The mean two-dimensional validation error was 0.235 ± 0.128 mm, with an RMSE of 0.266 mm and a maximum error of 0.446 mm. Five additional medium-switching cycles performed without recalibration yielded an overall registration error of 0.369 ± 0.163 mm across 80 validation measurements. PA spatial resolution was further characterized using six thin hair targets, yielding lateral and axial FWHM values of 0.342 ± 0.069 mm and 0.394 ± 0.073 mm, respectively. These results demonstrate reproducible two-dimensional en face OCT–PA coordinate mapping under modality-specific coupling conditions and support the proposed workflow as a phantom-based technical validation for large-field multimodal imaging. Full article

Microbubbles (MBs) have been used as a radiosensitizer, and their combination with ultrasound (US) has emerged as a promising strategy to improve radiotherapy outcomes in tumor treatment. Nanobubbles (NBs), which are about 1000 times smaller than MB and have enhanced stability, have been considered to have the potential for further radiosensitization enhancement. In this study, tumor-bearing models were treated with and without nanobubble–ultrasound (NBUS) treatment before radiotherapy (XRT) to evaluate the radiosensitization. The time intervals between the NB injection and US exposure, and between US and XRT, were optimized to maximize the therapeutic efficacy. A derivative texture analysis was applied to extract microstructural features from haematoxylin and eosin (H&E)-stained images. A one-way ANOVA test combined with a k-NN classifier and Tukey’s Honestly Significant Difference (HSD) test was used to identify the best features for assessing treatment outcomes. These were applied to H&E-stained tumor sections for evaluating microstructural alterations associated with NB-driven radiosensitization. The results indicated that both the 2 Gy and 8 Gy radiation groups showed enhanced treatment outcomes when NBUS therapy was administered before radiotherapy. Notably, NBUS + 2 Gy could achieve outcomes comparable to 8 Gy only. Additionally, a derivative texture analysis was demonstrated to be a promising and powerful technique for analyzing H&E images. This study provides a quantitative framework for assessing nanobubble-enhanced radiotherapy. Full article

Cardiovascular ultrasound is a cornerstone of noninvasive cardiac and vascular assessment, yet conventional interpretation remains operator-dependent, variable, and limited in sensitivity for subclinical disease. Artificial intelligence (AI), particularly machine learning (ML), deep learning (DL), and, most recently, vision–language and foundation models, offers tools to automate, standardize, and extend ultrasound analysis. This narrative review examines the role of AI-enhanced cardiovascular ultrasound in the transition from descriptive imaging toward predictive and personalized medicine. We conducted a structured literature search of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar (January 2016–May 2026), combining Medical Subject Headings and free-text terms related to AI and cardiovascular ultrasound. Original studies, meta-analyses, reviews, consensus documents, and seminal works were considered. AI now spans the entire echocardiographic workflow, acquisition guidance, view classification, segmentation (Dice ≈ 0.92–0.94 on public datasets), and automated quantification of ejection fraction and global longitudinal strain, achieving expert-level accuracy and improved reproducibility. Across clinical domains, AI supports ischemia detection on stress echocardiography, heart-failure phenogrouping, Doppler-independent aortic stenosis detection, and carotid plaque characterization for stroke-risk stratification. Emerging vision–language and multitask foundation models (e.g., EchoCLIP, EchoPrime, and PanEcho) point toward general-purpose interpretation, and a growing number of tools (Caption Guidance, Us2.ai, and Ultromics EchoGo) have obtained FDA clearance and/or CE marking. Increasingly, AI-derived imaging biomarkers feed multimodal models that enable individualized risk prediction and therapy selection. AI-enhanced cardiovascular ultrasound is poised to become a central tool of precision cardiology. Realizing its potential will require prospective multicenter validation, cross-vendor standardization, attention to generalizability, interpretability, and reproducibility, and evolving regulatory and ethical frameworks. Full article

Background/Objectives: The genital tubercle develops in the fourth week from mesenchymal cells in the lateral edges of the embryo. In females the genital tubercle develops into the clitoris while in males it participates in forming the penis. The aim of this study was to perform a macroscopic as well as an ultrasonographic assessment of the genital tubercle and its gender-dependent derivates, presenting a parallel comparative evaluation between the two. Methods: We performed a morphological assessment of the genital tubercle through micro-dissection of 141 embryos and fetuses with gestational ages between 5 and 14 weeks, in the Department of Anatomy of “Carol Davila” University of Medicine and Pharmacy. An ultrasound imaging study of the genital tubercle using 3-dimensional ultrasonography (3DUS) was also performed in the Department of Obstetrics and Gynecology of University Emergency Hospital of Bucharest. The morphology of the genital tubercle was analyzed by ultrasound scanning of 119 embryos and fetuses with gestational ages between 5 and 14 weeks. The age of all the embryos was determined by measuring the crown–rump length. Results: The dimensions and especially the direction of the genital tubercle were evaluated and compared in order to establish whether sex determination is possible as early as 7–8 weeks of gestation. The genital tubercle orientates cranially in males and caudally in females as early as 6 weeks of gestation, during the bi-potential phase. Conclusions: The orientation of the genital tubercle plays an essential role in establishing the sex of the fetus, regardless of its size. Full article

Aronia melanocarpa contains abundant phenolic compounds, including procyanidins, flavonols, flavan-3-ols, and phenolic acids, but its pronounced astringency limits its broader use in food applications. Catechol and other oxygen-donor motifs in plant phenolics are known to associate with Fe³⁺ and can support metal–phenolic assembly. In this study, ultrasound-assisted cellulase–pectinase extraction was used to recover an A. melanocarpa polyphenol extract, which was subsequently combined with Fe³⁺ to construct a plant-derived hair dye coating on keratin fibers. Under optimized extraction conditions, the total phenolic yield reached 82.315 mg gallic acid equivalents (GAE)/g dry fruit. A limited targeted LC–MS/MS panel was used to evaluate 12 selected non-anthocyanin phenolic analytes, including procyanidin dimers, a flavan-3-ol, flavonols, and phenolic acids; the contribution of the pH-sensitive anthocyanin fraction was not resolved. Among the tested metal ions, Fe³⁺ produced the strongest chromogenic response. The optimized L-cysteine pretreatment–Fe³⁺ mordanting–polyphenol dyeing sequence produced a ΔE* of 55.42. Adsorption experiments empirically described the uptake behavior of the polyphenol extract, whereas complementary surface, spectroscopic, elemental, diffraction, thermal, and wettability analyses were consistent with the presence of a relatively uniform Fe-containing polyphenol coating at the hair fiber interface. Neither the adsorption-model fits nor the individual characterization techniques uniquely resolved the underlying molecular mechanism. Preliminary HET-CAM, single-exposure dermal, and acute eye irritation assessments showed no obvious acute irritation under the tested conditions. An exploratory image-based analysis examined whether standardized hair tress photographs could approximate a predefined colorimetric score. Because only 30 independent original samples were available and no external validation was performed, this analysis was treated solely as a proof of concept. This laboratory proof-of-concept extends established Fe³⁺–polyphenol assembly chemistry to a compositionally complex A. melanocarpa extract for hair fiber coloration. Further work is required to clarify anthocyanin behavior, simplify the sequential protocol, and benchmark its performance against representative commercial hair dyes. Full article

Bronchopulmonary dysplasia (BPD) remains one of the leading chronic respiratory complications of extreme prematurity despite major advances in neonatal intensive care. Current diagnostic definitions are primarily based on respiratory support requirements and provide limited information on the biological heterogeneity and longitudinal evolution of lung injury. Lung ultrasound (LUS) is progressively reshaping the clinical approach to BPD by enabling radiation-free, bedside, and repeatable assessment of peripheral lung abnormalities throughout the neonatal course. This narrative review examines the current role of LUS in BPD, integrating its pathophysiological basis with the available evidence and distinguishing explicitly between its diagnostic, prognostic, monitoring, and treatment-guiding applications, which are supported by markedly different levels of evidence. We discuss how LUS findings reflect the major components of BPD pathophysiology, compare LUS with conventional imaging modalities, and summarize the scanning protocols, semiquantitative scoring systems, examination schedules, and patient populations that have been evaluated to date. We also review the emerging contribution of artificial intelligence to automated image analysis, standardized image acquisition, and personalized risk prediction. Most of the available evidence is prognostic rather than diagnostic: early LUS scores predict BPD subsequently defined at 36 weeks’ postmenstrual age, whereas LUS has not been validated as a diagnostic test for established BPD, and reported cutoffs remain study- and protocol-specific rather than universally applicable. Randomized evidence is confined to LUS-guided surfactant administration, where the demonstrated benefits concern the timing of treatment and the need for invasive ventilation; no trial has yet shown that LUS-guided management reduces the incidence of BPD. Current evidence supports LUS as a complementary imaging modality that extends beyond the assessment of acute neonatal respiratory disease and enables longitudinal bedside monitoring of peripheral lung aeration. Although further multicenter prospective studies are required to harmonize protocols and validate LUS-guided management strategies, the integration of standardized LUS assessment with emerging artificial intelligence technologies has the potential to establish LUS as a key component of precision respiratory care for infants at risk of BPD. Full article

Background/Objectives: Primary benign and malignant musculoskeletal tumours are generally treated with surgical excision. Metastatic musculoskeletal disease may require both systemic and local treatment. This review focuses on the use of radiofrequency ablation (RFA), cryoablation, cementoplasty, and high-intensity focused ultrasound (HIFU) in primary musculoskeletal tumours and bone and soft-tissue metastases. Methods: We reviewed English-language studies addressing the indications, clinical outcomes, patient selection, and complications of these techniques in patients with primary musculoskeletal tumours or bone and soft-tissue metastases. Results: RFA is the preferred minimally invasive treatment for osteoid osteoma and may be considered for selected small intraosseous tumours. In symptomatic bone metastases, RFA may provide pain relief and can be combined with cementoplasty when structural support is needed. Cryoablation is used selectively for benign, locally aggressive, recurrent, and metastatic tumours, with the advantage of visualizing the ablation zone. Cementoplasty is mainly used to relieve mechanical pain and reinforce weakened bone. HIFU has been studied mainly for pain palliation in bone metastases, while evidence in primary malignant tumours remains limited. Conclusions: Image-guided interventions can complement surgery and radiotherapy in selected patients. Treatment choice depends on tumour type, location, treatment intent, skeletal stability, and proximity to critical structures. Full article

Ovarian cancer remains a leading cause of gynaecological cancer mortality, and ultrasound-based deep learning systems for its diagnosis are typically built as separate post hoc processes for classification, segmentation, and interpretability, which introduces workflow inefficiencies and may produce inconsistent predictions. This work addresses that limitation. We propose UM-TOTA (Unified Multi-Task Ovarian Tumour Architecture), a Vision Transformer (ViT)-based architecture that performs eight-class tumour classification, three-class malignancy detection, tumour segmentation, and clinical concept interpretability within a single unified framework. We integrate a concept bottleneck guided by the IOTA and O-RADS clinical guidelines to enable transparent decision-making through medical concepts that clinicians can understand, and we employ combined adaptive t-vMF Dice and boundary-enhanced segmentation losses with progressive task weighting to stabilise multi-task optimisation. We evaluated the model on the Multi-Modality Ovarian Tumor Ultrasound (MMOTU) 2D dataset under two protocols: image-level 5-fold stratified cross-validation, and the patient-disjoint partition released with the dataset. Under cross-validation, UM-TOTA achieved 80.26% ± 1.10% accuracy (97.06% one-vs-rest macro specificity) for eight-class classification, 90.88% ± 1.14% accuracy (90.41% specificity) for malignancy detection, and 77.29% ± 1.29% Dice for segmentation. Under the patient-disjoint partition, which excludes any overlap of patients between training and testing, the corresponding values were 78.46%, 89.13%, and 75.41%, a reduction of under 2.2 percentage points on every metric. The UM-TOTA reduced the computational parameter load by approximately 65.1% relative to sequential single-task pipelines. The learned concepts aligned with established malignancy criteria, identifying vascularisation, solid components, and papillary projections as key predictors. This unified approach offers an efficient and interpretable framework for clinical ovarian ultrasound workflows. Full article

Background: Prenatal diagnosis of congenital heart defects (CHD) is important for perinatal planning, yet the gestational week at which CHD is diagnosed varies considerably. In referred cohorts, diagnostic timing may be influenced by maternal, fetal, temporal, and lesion-specific factors. This study examined factors associated with the gestational week of prenatal diagnosis among pregnancies with prenatally recognized and subsequently confirmed CHD referred to a national tertiary fetal cardiology centre. Methods: This study analyzed 833 pregnancies with confirmed CHD managed between 2005 and 2020. The primary outcome was the gestational week of prenatal diagnosis. Univariable associations with binary predictors were assessed using Student’s t-test, Welch’s t-test, or the Mann–Whitney U test according to distributional assumptions. A primary fully adjusted multivariable linear regression model with heteroscedasticity-robust standard errors was used to evaluate variables associated with the gestational week of diagnosis. The model included maternal age, calendar year as a continuous variable, twin pregnancy, amniotic fluid abnormalities, chromosomal status, and selected lesion-specific diagnoses. Chromosomal status was modelled hierarchically as no chromosomal abnormality, Down syndrome, or other chromosomal abnormality. Results: In univariable analyses, advanced maternal age, Down syndrome, and chromosomal abnormalities were associated with earlier diagnosis, whereas oligohydramnios was associated with later diagnosis. In the primary fully adjusted multivariable model, increasing maternal age was associated with earlier diagnosis (β = −0.169 weeks per year, 95% CI −0.238 to −0.099; p < 0.001), as was later calendar year (β = −0.211 weeks per year, 95% CI −0.311 to −0.111; p < 0.001). Coarctation of the aorta/aortic arch stenosis (β = 2.276 weeks, 95% CI 0.787 to 3.764; p = 0.003), pulmonary stenosis (β = 1.996 weeks, 95% CI 0.376 to 3.617; p = 0.016), and oligohydramnios (β = 2.097 weeks, 95% CI 0.228 to 3.965; p = 0.028) were associated with later prenatal diagnosis. Down syndrome showed a borderline association with earlier diagnosis (β = −1.350 weeks, 95% CI −2.702 to 0.002; p = 0.050). The model explained 12.2% of the variability in the gestational week of diagnosis, with an adjusted R² of 0.107. Conclusions: In this tertiary referral-centre cohort of pregnancies with prenatally recognized and confirmed CHD, the gestational week of prenatal diagnosis was associated with maternal age, calendar year, oligohydramnios, and selected lesion-specific diagnoses. These findings should be interpreted as observational associations within an already recognized referral cohort rather than determinants of prenatal CHD detection in the general pregnant population. Future studies should incorporate referral pathways, screening history, ultrasound quality, operator experience, fetal position, and lesion-specific imaging characteristics to better characterize factors influencing the timing of prenatal CHD diagnosis. Full article

Robot-assisted radical prostatectomy (RARP) requires a balance between complete cancer excision and preservation of urinary continence and erectile function. Because the preservation of neurovascular bundles adjacent to the prostate surface contributes to postoperative functional recovery, intraoperative margin assessment and surgeon-guidance technologies may help refine resection and support individualized nerve-sparing decision-making. Neurovascular structure-adjacent frozen-section examination remains the most studied and clinically established method, with evidence supporting reduced positive surgical margins and broader nerve preservation, but its use is limited by cost, workflow complexity, and pathology infrastructure. Fluorescence confocal microscopy is promising but remains limited by short and apical margins; its improved accuracy for longer margins raises concerns about its reliability for routine intraoperative margin assessment. Other optical, spectroscopic, and prostate-specific membrane antigen-targeted molecular margin assessment techniques have demonstrated inconsistent diagnostic performance, with particularly low sensitivity for assessment approaches remain investigational, whereas intraoperative ultrasound, three-dimensional and augmented-reality models, fluorescence guidance, and image-enhancement systems should be viewed as surgical guidance tools rather than direct margin-assessment methods. Intraoperative technologies may improve surgical decision-making during RARP, but prospective multicenter studies with standardized oncological and functional endpoints are needed before broader adoption. Full article