Search Results (2,297)

Background: Differentiated thyroid cancer (DTC) is commonly treated with radioactive iodine (RAI), but resistance to RAI remains a significant clinical challenge. The molecular mechanisms driving dedifferentiation and RAI refractoriness, particularly in BRAF^V600E-mutated tumors, are not fully understood. Methods: RNA sequencing was conducted on BRAF^V600E-mutated DTC and RAIR-DTC tissue samples to identify differentially expressed genes. Gadd45B was identified as significantly downregulated in RAIR-DTC. Functional studies including overexpression and knockdown experiments were performed in thyroid cancer cell lines and xenograft models. Downstream targets, including MAP3K4 and MYCBP, were evaluated through co-immunoprecipitation, luciferase assays, and Western blot. The therapeutic efficacy of recombinant Gadd45B protein in combination with BRAF^V600E and TERT inhibitors was assessed in patient-derived xenograft (PDX) models. Results: Gadd45B overexpression suppressed MAPK pathway activity by interacting with MAP3K4 and downregulated c-MYC stability through competition with MYCBP. These interactions enhanced the expression of iodine-metabolism genes (NIS, TPO, Tg), increased RAI uptake, and reversed tumor dedifferentiation. In vivo, Gadd45B restoration reduced tumor burden and improved RAI uptake. Combined treatment with Gadd45B protein, PLX4720, and BIBR1532 produced synergistic therapeutic effects in PDX models. Conclusions: Gadd45B plays a pivotal role in regulating the differentiation status and RAI sensitivity of BRAF^V600E-mutated thyroid cancer. These findings identify Gadd45B as a promising therapeutic target for restoring RAI responsiveness in RAIR-DTC patients. Full article

The controlled incorporation of halogens into carbon materials remains a challenge, particularly under mild and scalable conditions. In this work, we investigate the fixation of iodine on high-surface-area graphite (HSAG-100) using green solvents and moderate temperatures. Commercial HSAG was treated with iodine in aqueous and in organic media, with and without promoters, and characterized by XPS, LEIS, N₂ physisorption, TGA/TPD, and XRD. The results reveal that iodine contents up to ~0.6 at% can be achieved, with incorporation strongly influenced by solvent and reaction time. XPS and LEIS confirmed the presence of C–I bonds, while BET analysis showed only moderate decreases in surface area and unchanged mesopore size distribution. Thermogravimetric and TPD analyses demonstrated the high thermal stability of C–I species, and XRD patterns ruled out intercalation between graphene layers. Collectively, these findings demonstrate that iodine can be covalently anchored to HSAG under mild conditions, preserving the graphitic structure and generating stable edge functionalities, thus opening a route for the design of halogen-doped carbons for catalytic and electrochemical applications. Full article

Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy and typically has a favorable prognosis. However, a subset of patients experience aggressive disease, recurrence, or treatment resistance, underscoring the need for more precise diagnostic and therapeutic strategies. Advances in molecular profiling have improved the management of thyroid cancer by enabling risk-adapted treatment and targeted interventions. This narrative review offers a clinically focused synthesis of the current role of molecular diagnostics and personalized therapeutics in DTC. We examine key genetic alterations and their diagnostic, prognostic, and therapeutic implications, and discuss how molecular markers enhance traditional risk stratification systems, informing surgical decisions, radioactive iodine (RAI) use, and surveillance. The growing role of targeted therapies, such as tyrosine kinase inhibitors and agents against specific oncogenic drivers, is reviewed, particularly for RAI-refractory DTC. We also address real-world challenges in implementing precision medicine, including access, cost, and standardization. Future directions, such as liquid biopsy, artificial intelligence, and multi-omic integration, are explored as tools to achieve fully personalized care. This review aims to bridge the gap between molecular discovery and clinical application, offering practical insights for endocrinologists, surgeons, oncologists, and multidisciplinary teams managing DTC. Full article

Background/Objectives: The occurrence of non-communicable diseases (NCDs) globally is rising rapidly, largely due to modifiable risk factors such as unhealthy diets. Studies have shown that poor dietary habits are prevalent among university students and may persist in later life, increasing the risk of chronic health conditions. The objective of this study was to evaluate the diet of two different groups of university students, in the United Arab Emirates (UAE) and United Kingdom (UK), with the aim of identifying areas for intervention to improve overall health and wellbeing. Methods: Detailed 7-day diet diaries were collected from undergraduate university participants in the UAE and UK. Diet diaries were quantitatively assessed using Nutritics software generating reports on mean intakes for energy, macro- and micronutrients. Independent sample t-tests were utilized to compare nutrient intake between cohorts in the two different regions. Results: A total of 158 students participated in this study. Results showed significant differences in intake levels in most macronutrients and micronutrients (p ≤ 0.05). Upon comparison, UK participants consumed diets higher in sugar (+9.4 g/day), saturated fat (+4.2 g/day), cholesterol (+90 mg/day), and sodium (+307 mg/day) compared to their UAE counterparts, placing them at risk of cardiovascular diseases (CVDs). Cholesterol intake was oversufficient in both UAE and UK males by 40% and 57%, respectively. In UAE females, there were notable deficiencies in protein intake, omega 3, vitamin D, iron, iodine, and folic acid (p ≤ 0.05), placing them at risk of CVDs, anemia, diabetes, and cancer. Interestingly, both UAE males and females were 100% deficient in dietary vitamin D intake. Conclusions: Nutritional imbalances should be addressed through campus-based nutrition education programs. This study also highlights the importance of dietary guidelines targeted at specific populations accounting for cultural differences. Full article

Objective: This study aimed to evaluate the hepatic volume, iodine concentration, and extracellular volume (ECV) of each hepatic segment in cirrhotic patients using three-dimensional (3D) volumetric iodine mapping of the liver segment derived from contrast-enhanced dual-energy CT (DECT) superimposed on extracted color-coded CT liver segments in comparison with non-cirrhotic patients. Methods: The study population consisted of 66 patients, 34 with cirrhosis and 32 without cirrhosis. Using 3D volumetric iodine mapping of the liver segment derived from contrast-enhanced DECT superimposed on extracted color-coded CT liver segments, the volume and iodine concentration of each hepatic segment in the portal venous phase (PVP) and equilibrium phase (EP), the difference in iodine concentration between PVP and EP (ICPVP-liver—ICEP-liver), and ECV fractions were compared between cirrhotic and non-cirrhotic groups. Results: The iodine concentration was not significantly different in all hepatic segments between the cirrhotic and non-cirrhotic groups. Conversely, the difference in iodine concentration between PVP and EP (ICPVP-liver—ICEP-liver) was significantly smaller in the cirrhosis group than in the non-cirrhosis group for all hepatic segments (p < 0.001). The ECV fraction of the left medial segment was significantly higher in the cirrhosis group than in the non-cirrhotic group ([26.4 ± 7.6] vs. [23.1 ± 5.1]; p < 0.05). Conclusions: The decreased difference in iodine concentration between PVP and EP calculated from 3D volumetric iodine mapping of the liver segment using DECT may be a clinically useful indicator for evaluating patients with compensated cirrhosis, suggesting a combined effect of a reduced portal venous flow and increased interstitial space associated with fibrosis. Full article

Background: It is not clear if the administration of iodine-131 in patients with differentiated thyroid cancers induces relevant cystitis and lower urinary tract infections (UTIs). The aim of this study was to evaluate the impact of oral administration of hyaluronic acid and chondroitin sulphate (HA&CS) on the frequency of UTIs induced by iodine-131. Methods: In this study, 166 female patients with a surgical diagnosis of differentiated thyroid cancer who were hospitalized in Sant ’Andrea Hospital of Rome to undergo the first cycle of therapy with iodine-131 for thyroid remnant ablation were evaluated. Sixty-one patients were treated with HA&CS for 8 days, and thirty-nine patients were treated with HA&CS for 17 days. Sixty-six patients were not treated with HA&CS and were used as control subjects. Patients underwent urinalysis at different time points: immediately before ¹³¹I therapy, two days later, and one week later. Patients were divided in six groups based on whether they received the treatment with HA&CS, its duration, and whether they developed a UTI: group A, n = 51 patients who did not receive HA&CS and did not develop UTI; group B1, n = 37 patients treated with HA&CS for 8 days and did not develop UTI; group B2, n = 29 patients treated with HA&CS for 17 days and did not develop UTI; group C, n = 15 patients who did not receive HA&CS and developed UTI; group D1, n = 24 patients treated with HA&CS for 8 days and developed UTI; group D2, n = 10 patients treated with HA&CS for 17 days and developed UTI. Results: The bacteria count, red blood cells and white blood cells did not change when group A was compared to both group B1 and group B2, while pH and epithelial cells showed a decrease over time when comparing group A and group B2 (p = 0.01 and p < 0.0001, respectively). Comparing group C with group D1 and group D2, patients who did not receive HA&CS (group C) showed a higher bacteria and epithelial cell count compared to those who were pre-treated with HA&CS. Conclusions: HA&CS could be an effective supportive therapy to prevent and mitigate UTIs in patients treated with ¹³¹I. Full article

Dermatophytes are highly infectious pathogenic fungi that colonize keratinized tissues like skin, hair, and nails, causing superficial infections such as tinea capitis, onychomycosis, tinea corporis, and tinea pedis in humans and animals. In immunocompromised patients, they may invade deeper tissues and organs, leading to severe or life-threatening conditions if untreated or inadequately managed. While most infections respond to topical antifungals, some require complex treatment and show resistance to standard therapies. Therefore, novel antifungal agents are needed. We investigated the antidermatophytic activity of imidazole-thiosemicarbazides against Microsporum canis, Trichophyton spp., and Chrysosporium spp. using the broth microdilution method, comparing results to ketoconazole and amphotericin B through minimal inhibitory concentration (MIC), half-maximal inhibitory concentration (IC₅₀), and selectivity index (SI). Iodine- and bromine-substituted compounds showed the strongest activity, with MICs of 15.15 (IC₅₀ < 1 μM; SI > 213) and 73.46 μg/mL (IC₅₀ < 1 μM; SI > 846) against T. tonsurans, and 3.87 (IC₅₀ = 7.21 μM; SI > 29.6) and 7.38 μg/mL (IC₅₀ = 11.06 μM; SI = 76.6) against M. canis. In silico analysis revealed interactions with α-keratin and lanosterol-14-α demethylase (the azole target enzyme), suggesting enhanced drug retention and action. These findings support these compounds as promising leads for further antifungal development. Full article

Background/Objectives: Marine-derived oils rich in long-chain polyunsaturated fats have long been associated with positive effects on plasma lipid levels and anti-inflammatory responses. Abalone viscera are rich in oils that are rarely extracted and made available. Methods: Abalone viscera oil (AVO) was extracted by multistage countercurrent extraction using ethanol as a solvent, and its oil quality, fatty acid composition, and in vitro antioxidant activity were determined. Meanwhile, the anti-hyperlipidemic effect of AVO on HFD-induced hyperlipidemia mice was evaluated. Results: The abalone viscera were extracted at a solid–liquid ratio of 1:3 with an oscillation frequency of 300 rpm for 40 min, and the extraction rate was 81.18% after four-stage countercurrent extraction. The acid value, iodine value, peroxide value, vitamin E, and astaxanthin of AVO were 1.26 mg KOH/g, 140.9 g/100 g, 3.6 meq/kg, 105 mg/kg, and 533.8 mg/kg, respectively. The unsaturated fatty acids of AVO account for 56.60%, with eicosapentaenoic acid (C20:5n3) and arachidonic acid (C20:4n6) the two predominant PUFAs, and oleic acid (C18:1n9) the most dominant MUFA. The DPPH, ABTS, and ·OH radicals scavenging capacities of AVO increased with concentration, and the IC₅₀ values were 6.30 mg/mL, 0.45 mg/mL, and 8.95 mg/mL, respectively. Moreover, the administration of AVO significantly alleviated HFD-induced weight gain, liver fat accumulation, lipid disorder, and oxidative stress in mice. Conclusions: Collectively, our study provides a theoretical basis for the application of AVO and the comprehensive utilization of abalone viscera, which helps increase the additional value of abalone. Full article

Traditional synthetic methods, often limited by inefficiency, are increasingly being replaced by sustainable alternatives. This study presents a green approach combining microwave irradiation with in situ FTIR spectroscopy for real-time monitoring and optimising nitrogen-heterocycle synthesis, focusing on quinoxalines. Although both microwave-assisted synthesis and time-resolved FTIR are established techniques, their combined application remains underexplored, limiting their synergistic potential. The methodology was applied to synthesising 2,3-diphenylquinoxaline, a compound of interest in medicinal chemistry. Optimisation of the condensation between benzil and 1,2-phenylenediamine was achieved by exploiting the accelerated kinetics of microwave irradiation and continuous monitoring via in situ FTIR. Three catalytic systems were evaluated—hydrochloric acid (Brønsted acid), Montmorillonite K10 (heterogeneous catalyst), and molecular iodine (halogen/Lewis acid)—alongside a range of solvents, including ethanol, methanol, water, acetonitrile, ethyl acetate, dimethyl sulfoxide, and dichloromethane. Iodine proved to be the most efficient catalyst, while acetonitrile and ethyl acetate provided the most effective solvent systems. This integrated monitoring strategy reduces reliance on trial-and-error optimisation and establishes a streamlined, scalable, and efficient protocol. The dual-technique approach highlights a versatile pathway for advancing green synthetic methodologies with applications across the chemical and pharmaceutical industries. Full article

Material decomposition in X-ray imaging is essential for enhancing tissue differentiation and reducing the radiation dose, but the clinical adoption of photon-counting detectors (PCDs) is limited by their high cost and technical complexity. To address this, we propose Dual-head Pix2Pix, a PCD-guided deep learning framework that enables simultaneous iodine and bone decomposition from single-energy X-ray projections acquired with conventional energy-integrating detectors. The model was trained and tested on 1440 groups of energy-integrating detector (EID) projections with their corresponding iodine/bone decomposition images. Experimental results demonstrate that the Dual-head Pix2Pix outperforms baseline models. For iodine decomposition, it achieved a mean absolute error (MAE) of 5.30 ± 1.81, representing an ~10% improvement over Pix2Pix (5.92) and a substantial advantage over CycleGAN (10.39). For bone decomposition, the MAE was reduced to 9.55 ± 2.49, an ~6% improvement over Pix2Pix (10.18). Moreover, Dual-head Pix2Pix consistently achieved the highest MS-SSIM, PSNR, and Pearson correlation coefficients across all benchmarks. In addition, we performed a cross-domain validation using projection images acquired from a conventional EID-CT system. The results show that the model successfully achieved the effective separation of iodine and bone in this new domain, demonstrating a strong generalization capability beyond the training distribution. In summary, Dual-head Pix2Pix provides a cost-effective, scalable, and hardware-friendly solution for accurate dual-material decomposition, paving the way for the broader clinical and industrial adoption of material-specific imaging without requiring PCDs. Full article

Background/Objectives: Neonatal screening programmes for thyroid function testing, based on thyroid-stimulating hormone (TSH) assessment, detect both Permanent Congenital Hypothyroidism (PCH) and Transient Congenital Hypothyroidism (TCH). Maternal iodine-deficient dietary intake may result in compensatory neonatal TSH elevation; screening for Congenital Hypothyroidism (CH) is used as an indicator of the degree of iodine deficiency and of its control. In Greece, newborn screening for CH, using TSH measurement in dried blood spots (Guthrie card), began in 1979 through the Institute of Child Health (ICH). Although the general Greek population is considered iodine-replete, most pregnant Greek people are mildly iodine deficient according to the stricter WHO criteria. The aim of this retrospective study was to record the cases of TCH and the main causative factors over a 10-year period (2010–2019) in Greece, when the country was deemed to be iodine-replete. Methods: The number of births in Greece between 2010 and 2019 was retrieved from the Hellenic Statistical Authority (ELSTAT) archives: 952,109 births were recorded. The total number of newborns assessed through the ICH was 951,342 (99%). During this period, 22,391 newborns were identified to have TSH > 7 mIU/L after the second check on the initial card. Among those, 17,992 underwent retesting with a serum sample. Out of the retested newborns, 1979 were screened positive for CH and immediately began treatment with levothyroxine. We followed up with families, paediatricians, and paediatric endocrinologists to determine whether L-thyroxine therapy had been successfully discontinued for at least two months after the child’s third birthday. Successful contact was achieved with 889 individuals. From this group, 329 children had successfully discontinued thyroxine, classified as TCH. Demographic data, including gender, gestational age, and birth weight, were collected from the archives of the ICH. Maternal data, including thyroid medication use and the presence of elevated thyroid autoantibodies during pregnancy and childbirth, were also recorded. Results: Logistic regression analysis revealed that, while controlling for all other predictor variables, the odds ratio of transient hypothyroidism was 2.078 (95% CI: 1.530 to 2.821) for prematurely born children compared to those born at term. The effects of other factors on TCH versus PCH were not significant. Conclusions: It seems that prematurity is the main factor contributing to Transient Congenital Hypothyroidism in Greece, a recently iodine-replete country. Full article

Background/Objectives: Thyroid disorders such as Hashimoto’s thyroiditis and Graves’ disease represent major endocrine challenges worldwide, often requiring long-term management. Recently, nutritional supplementation with selenium and myo-inositol has been proposed as a supportive strategy. This review aims to summarize the current evidence regarding their efficacy in improving thyroid function, reducing thyroid autoantibodies in Hashimoto’s disease, and restoring biochemical euthyroidism in Graves’ disease. Methods: A narrative review of the available literature was undertaken, concentrating on randomized controlled trials and observational studies evaluating selenium and myo-inositol, alone or in combination (MYO+Se), in patients with autoimmune thyroid disorders and benign thyroid nodules. Search Strategy and Study Selection: We searched MEDLINE/PubMed, Embase, Cochrane CENTRAL, and Scopus from inception to 31 July 2025. The search used Boolean operators to combine the following keywords: (“selenium” OR “selenomethionine”) AND (“myo-inositol” OR “inositol”) AND (thyroid OR Hashimoto* OR Graves’ OR hyperthyroid* OR hypothyroid* OR nodule* OR goiter OR orbitopathy). We included human studies in English. Inclusion criteria: Research designs include RCTs, quasi-experimental studies, cohort/case-control studies, and big case series (n ≥ 30). Exclusion criteria: Animal-only or in vitro studies (unless mechanistic), pediatric case reports, and editorials/commentaries. Study selection and data extraction: Two reviewers screened independently; discrepancies were settled through consensus. The data retrieved included the population, baseline iodine/selenium status (if reported), dose/formulation, treatment duration, outcomes (TSH, FT4, FT3, TPOAb, TgAb, TRAb, nodule metrics), and adverse events. Quality assessment: The risk of bias was assessed using the RoB-2 for RCTs and the Newcastle-Ottawa Scale or JBI checklists for observational studies. A qualitative synthesis emphasized study quality, consistency, directness, and accuracy. Results: Clinical research indicate that selenium supplementation may reduce thyroid peroxidase antibody (TPOAb) levels in Hashimoto’s disease, thereby attenuating autoimmune activity. Myo-inositol, particularly when combined with selenium, has been proven to improve thyroid hormone profiles while also lowering nodule size or growth. In Graves’ disease, supplementation has been linked to the restoration of biochemical euthyroidism in certain patients, albeit data are limited. Despite these encouraging results, diversity in trial design, treatment length, and dosages restrict the robustness of existing recommendations. Conclusions: Selenium and myo-inositol supplementation have shown promise as adjuvant treatments for autoimmune thyroid diseases and benign thyroid nodules. However, further large-scale, well-designed clinical trials are needed to determine the appropriate dosages, treatment duration, and patient selection criteria. Personalized supplementation solutions may improve medication efficacy and help with more comprehensive thyroid disease care. Full article

Background/Objectives: Accurately distinguishing malignancy in thyroid micronodules (≤10 mm) is crucial for clinical management, yet it is challenging due to the limitations of conventional ultrasonography-guided biopsy. This study aims to evaluate the predictive value of dual-layer spectral computed tomography (DSCT)-derived arterial enhancement fraction (AEF) in diagnosing thyroid microcarcinomas. Methods: In the study, 321 pathologically confirmed thyroid micronodules (benign = 131, malignant = 190) from Chongqing General Hospital underwent preoperative DSCT. Quantitative parameters of DSCT, including the normalized iodine concentration (NIC), normalized effective atomic number (NZ_eff), and slope of the spectral Hounsfield unit curve (λHU_(40–100)), were assessed. Both single-energy CT (SECT)-derived AEF (AEF_S) and DSCT-derived AEF (AEF_D) were calculated. Conventional image features included microcalcifications and enhancement blurring. Correlation between AEF_D and AEF_S was determined using Spearman’s correlation coefficient. Diagnostic performance was evaluated by calculating the area under the curve (AUC) using receiver operating characteristic (ROC) analysis. Results: Malignant micronodules exhibited significantly lower AEF_D (0.958 vs. 1.259, p < 0.001) and AEF_S (0.964 vs. 1.436, p < 0.001) versus benign nodules. Arterial phase parameters—APλHU_(40–100), APNIC, APNZ_eff—differed significantly between groups (all p < 0.001), whereas venous phase parameters (VPλHU_(40–100), VPNIC, VPNZ_eff) showed no differences (all p > 0.05). Multivariate analysis revealed that λHU_(40–100) as an independent predictor of malignancy, with an odds ratio (OR) of 0.600 (95% confidence interval (CI): 0.437–0.823; p = 0.002) and an AUC of 0.752 (95% CI: 0.698–0.806). A significant positive correlation was identified between AEF_D and AEF_S (r = 0.710; p < 0.001). For diagnosing malignancy, AEF_D demonstrated superior overall performance (AUC: 0.794; sensitivity: 70.5%; specificity: 81.7%; accuracy: 75.1%) to AEF_S (0.753; 71.1%; 74.0%; 72.3%), APλHU_(40–100) (0.752; 68.9%; 75.6%; 71.7%), and calcification (0.573; 21.6%; 92.4%; 50.5%). Clinically, AEF_D reduced the unnecessary biopsy rate to 18.3%, preventing 107 procedures in our cohort. Conclusions: AEF_D and AEF_S demonstrated strong correlation and comparable diagnostic performance in the evaluation of thyroid micronodules. Furthermore, AEF_D showed favorable diagnostic efficacy compared to both spectral parameters and conventional imaging feature. More importantly, the application of AEF_D significantly reduced unnecessary biopsy rates, highlighting its clinical value in optimizing patient management. Full article

Contrast-induced encephalopathy (CIE) is a rare complication after percutaneous coronary intervention (PCI) that mimics intracranial hemorrhage (ICH). Its computed tomography (CT) findings (cortical contrast enhancement, sulci effacement) overlap with cerebrovascular conditions (e.g., cerebral infarction, subarachnoid hemorrhage). Dual-energy CT (DECT) differentiates blood/calcification from iodinated contrast medium (CM) extravasation via material decomposition, contributing to the accurate diagnosis of CIE. We report a CIE case highlighting DECT’s value. A 74-year-old woman underwent PCI. 50 min post-PCI, she had moderate headache (Numeric Rating Scale 4), dizziness, non-projectile vomiting (no seizures); vital signs were stable, no focal deficits, mannitol ineffective. Non-contrast CT demonstrated a left parietal 75 Hounsfield unit (HU) high-attenuation lesion, indistinguishable from acute intracerebral hemorrhage. Conventional non-contrast CT revealed a high-attenuation lesion (75 HU) in the left parietal lobe—indistinguishable from ICH. DECT clarified the diagnosis: virtual non-contrast maps showed CM extravasation, iodine concentration maps confirmed focal CM accumulation, and effective atomic number maps improved lesion visualization. The patient’s headache resolved within 5 h; follow-up non-contrast CT at 24 h showed complete disappearance of the lesion. She resumed clopidogrel, discharged day 3 without sequelae. This case underscores DECT’s role in distinguishing CIE (transient CM, normal neuro exam) from ICH (persistent hemorrhage), guiding safe post-PCI antiplatelet therapy. Full article

Background and Clinical Significance: Bladder neoplasms often present with coexisting thrombi and hematuria, appearing as complex intraluminal masses on imaging, and posing a key diagnostic challenge in distinguishing neoplastic tissue from thrombus, to prevent harmful overstaging. Case Presentation: An 82-year-old man with recurrent gross hematuria and urinary disturbances was evaluated by ultrasound, which identified a large endoluminal lesion in the anterior bladder wall. The patient subsequently underwent contrast-enhanced CT using a second-generation dual-layer spectral CT system, which utilizes a dual-layer detector to simultaneously acquire high- and low-energy X-ray data. Conventional CT images confirmed a multifocal, bulky hyperdense lesion along the bladder wall, protruding into the lumen and raising suspicion for a heterogeneous mass, though further characterization was not possible. Spectral imaging enabled the reconstruction of additional maps—such as iodine density, effective atomic number (Z-effective), and electron density—which were used to further characterize these findings. The combination of these techniques clearly demonstrated differences in iodine uptake and tissue composition within the parietal lesions, allowing for a reliable differentiation between neoplastic tissue and intraluminal thrombus. Conclusions: The integration of conventional CT imaging with spectral-derived maps generated in post-processing allowed for accurate and reliable tissue differentiation between bladder neoplasm and thrombus. Spectral imaging holds the potential to prevent tumor overstaging, thereby supporting more appropriate clinical management. The dual-layer technology enables the generation of these maps from every acquisition without altering the scan protocol, thereby having minimal impact on the daily clinical workflow. Full article