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Cannella R, Cammà C, Matteini F, Celsa C, Giuffrida P, Enea M, Comelli A, Stefano A, Cammà C, Midiri M, Lagalla R, Brancatelli G, Vernuccio F. Radiomics Analysis on Gadoxetate Disodium-Enhanced MRI Predicts Response to Transarterial Embolization in Patients with HCC. Diagnostics (Basel) 2022; 12:diagnostics12061308. [PMID: 35741118 PMCID: PMC9221802 DOI: 10.3390/diagnostics12061308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives: To explore the potential of radiomics on gadoxetate disodium-enhanced MRI for predicting hepatocellular carcinoma (HCC) response after transarterial embolization (TAE). Methods: This retrospective study included cirrhotic patients treated with TAE for unifocal HCC naïve to treatments. Each patient underwent gadoxetate disodium-enhanced MRI. Radiomics analysis was performed by segmenting the lesions on portal venous (PVP), 3-min transitional, and 20-min hepatobiliary (HBP) phases. Clinical data, laboratory variables, and qualitative features based on LI-RADSv2018 were assessed. Reference standard was based on mRECIST response criteria. Two different radiomics models were constructed, a statistical model based on logistic regression with elastic net penalty (model 1) and a computational model based on a hybrid descriptive-inferential feature extraction method (model 2). Areas under the ROC curves (AUC) were calculated. Results: The final population included 51 patients with HCC (median size 20 mm). Complete and objective responses were obtained in 14 (27.4%) and 29 (56.9%) patients, respectively. Model 1 showed the highest performance on PVP for predicting objective response with an AUC of 0.733, sensitivity of 100%, and specificity of 40.0% in the test set. Model 2 demonstrated similar performances on PVP and HBP for predicting objective response, with an AUC of 0.791, sensitivity of 71.3%, specificity of 61.7% on PVP, and AUC of 0.790, sensitivity of 58.8%, and specificity of 90.1% on HBP. Conclusions: Radiomics models based on gadoxetate disodium-enhanced MRI can achieve good performance for predicting response of HCCs treated with TAE.
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Affiliation(s)
- Roberto Cannella
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
- Correspondence: (R.C.); (F.V.)
| | - Carla Cammà
- University of Palermo, Piazza Marina, 61, 90133 Palermo, Italy;
| | - Francesco Matteini
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
| | - Ciro Celsa
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
- Department of Surgical, Oncological and Oral Sciences (D.C.O.S.), University of Palermo, 90133 Palermo, Italy
| | - Paolo Giuffrida
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
| | - Marco Enea
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
| | - Albert Comelli
- Ri.MED Foundation, Via Bandiera 11, 90133 Palermo, Italy;
| | - Alessandro Stefano
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Contrada Pietrapollastra-Pisciotto, 90015 Cefalù, Italy;
| | - Calogero Cammà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy; (C.C.); (P.G.); (M.E.); (C.C.)
| | - Massimo Midiri
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
| | - Roberto Lagalla
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
| | - Giuseppe Brancatelli
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
| | - Federica Vernuccio
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; (F.M.); (M.M.); (R.L.); (G.B.)
- Department of Radiology, University Hospital of Padova, Via Nicolò Giustiniani, 2, 35128 Padua, Italy
- Correspondence: (R.C.); (F.V.)
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Marrale M, Borgese R, D’Angelo C, Cannella R, Collura G, Iacopino G, D’Amelio M, Napoli A, Bartolotta T, Catalano C, Lagalla R, Midiri M, Gagliardo C. Transcranial magnetic resonance imaging-guided focused ultrasound treatment at 15 T: a retrospective study on treatment- and patient-related parameters obtained from 52 procedures. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00456-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Albano D, Cuocolo R, Patti C, Ugga L, Chianca V, Tarantino V, Faraone R, Albano S, Micci G, Costa A, Paratore R, Ficola U, Lagalla R, Midiri M, Galia M. Whole-body MRI radiomics model to predict relapsed/refractory Hodgkin Lymphoma: A preliminary study. Magn Reson Imaging 2021; 86:55-60. [PMID: 34808304 DOI: 10.1016/j.mri.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/15/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE A strong prognostic score that enables a stratification of newly diagnosed Hodgkin Lymphoma (HL) to identify patients at high risk of refractory/relapsed disease is still needed. Our aim was to investigate the potential value of a radiomics analysis pipeline from whole-body MRI (WB-MRI) exams for clinical outcome prediction in patients with HL. MATERIALS AND METHODS Index lesions from baseline WB-MRIs of 40 patients (22 females; mean age 31.7 ± 11.4 years) with newly diagnosed HL treated by ABVD chemotherapy regimen were manually segmented on T1-weighted, STIR, and DWI images for texture analysis feature extraction. A machine learning approach based on the Extra Trees classifier and incorporating clinical variables, 18F-FDG-PET/CT-derived metabolic tumor volume, and WB-MRI radiomics features was tested using cross-validation to predict refractory/relapsed disease. RESULTS Relapsed disease was observed in 10/40 patients (25%), two of whom died due to progression of disease and graft versus host disease, while eight reached the complete remission. In total, 1403 clinical and radiomics features were extracted, of which 11 clinical variables and 171 radiomics parameters from both original and filtered images were selected. The 3 best performing Extra Trees classifier models obtained an equivalent highest mean accuracy of 0.78 and standard deviation of 0.09, with a mean AUC of 0.82 and standard deviation of 0.08. CONCLUSIONS Our preliminary results demonstrate that a combined machine learning and texture analysis model to predict refractory/relapsed HL on WB-MRI exams is feasible and may help in the clinical outcome prediction in HL patients.
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Affiliation(s)
- Domenico Albano
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 129, 90127 Palermo, Italy; IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy.
| | - Renato Cuocolo
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Via Pansini 5, 80131 Naples, Italy; Laboratory of Augmented Reality for Health Monitoring (ARHeMLab), Dipartimento di Ingegneria Elettrica e delle Tecnologie dell'Informazione, Università degli Studi di Napoli "Federico II", Via Claudio 21, 80125 Naples, Italy
| | - Caterina Patti
- Unità Operativa di Oncoematologia, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco 180, 90146 Palermo, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | - Vito Chianca
- Ospedale Evangelico Betania, Via Argine 604, 80147 Napoli, Italy; Clinica di Radiologia EOC IIMSI, 6900 Lugano, Switzerland
| | - Vittoria Tarantino
- Unità Operativa di Oncoematologia, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco 180, 90146 Palermo, Italy; PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Roberta Faraone
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Silvia Albano
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Giuseppe Micci
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Alessandro Costa
- Unità Operativa di Oncoematologia, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Via Trabucco 180, 90146 Palermo, Italy
| | - Rosario Paratore
- Nuclear Medicine Department, La Maddalena Hospital, Via San Lorenzo 312/D, 90146 Palermo, Italy
| | - Umberto Ficola
- Nuclear Medicine Department, La Maddalena Hospital, Via San Lorenzo 312/D, 90146 Palermo, Italy
| | - Roberto Lagalla
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Massimo Midiri
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Massimo Galia
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 129, 90127 Palermo, Italy
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Vernuccio F, Arnone F, Cannella R, Verro B, Comelli A, Agnello F, Stefano A, Gargano R, Rodolico V, Salvaggio G, Lagalla R, Midiri M, Lo Casto A. Diagnostic performance of qualitative and radiomics approach to parotid gland tumors: which is the added benefit of texture analysis? Br J Radiol 2021; 94:20210340. [PMID: 34591597 PMCID: PMC8631014 DOI: 10.1259/bjr.20210340] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate whether MRI-based texture analysis improves diagnostic performance for the diagnosis of parotid gland tumors compared to conventional radiological approach. METHODS Patients with parotid gland tumors who underwent salivary glands MRI between 2008 and 2019 were retrospectively selected. MRI analysis included a qualitative assessment by two radiologists (one of which subspecialized on head and neck imaging), and texture analysis on various sequences. Diagnostic performances including sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of qualitative features, radiologists' diagnosis, and radiomic models were evaluated. RESULTS Final study cohort included 57 patients with 74 tumors (27 pleomorphic adenomas, 40 Warthin tumors, 8 malignant tumors). Sensitivity, specificity, and AUROC for the diagnosis of malignancy were 75%, 97% and 0.860 for non-subspecialized radiologist, 100%, 94% and 0.970 for subspecialized radiologist and 57.2%, 93.4%, and 0.927 using a MRI radiomics model obtained combining texture analysis on various MRI sequences. Sensitivity, specificity, and AUROC for the differential diagnosis between pleomorphic adenoma and Warthin tumors were 81.5%, 70%, and 0.757 for non-subspecialized radiologist, 81.5%, 95% and 0.882 for subspecialized radiologist and 70.8%, 82.5%, and 0.808 using a MRI radiomics model based on texture analysis of T2 weighted sequence. A combined radiomics model obtained with all MRI sequences yielded a sensitivity of 91.5% for the diagnosis of pleomorphic adenoma. CONCLUSION MRI qualitative radiologist assessment outperforms radiomic analysis for the diagnosis of malignancy. MRI predictive radiomics models improves the diagnostic performance of non-subspecialized radiologist for the differential diagnosis between pleomorphic adenoma and Warthin tumor, achieving similar performance to the subspecialized radiologist. ADVANCES IN KNOWLEDGE Radiologists outperform radiomic analysis for the diagnosis of malignant parotid gland tumors, with some MRI qualitative features such as ill-defined margins, perineural spread, invasion of adjacent structures and enlarged lymph nodes being highly specific for malignancy. A radiomic model based on texture analysis of T2 weighted images yields higher specificity for the diagnosis of pleomorphic adenoma compared to a radiologist non-subspecialized in head and neck radiology, thus minimizing false-positive pleomorphic adenoma diagnosis rate and reducing unnecessary surgical complications.
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Affiliation(s)
- Federica Vernuccio
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy
| | - Federica Arnone
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy.,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Barbara Verro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy
| | - Albert Comelli
- Ri.MED Foundation, Palermo, Italy.,Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Italy
| | - Francesco Agnello
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy
| | - Alessandro Stefano
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Italy
| | - Rosalia Gargano
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy
| | - Vito Rodolico
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Giuseppe Salvaggio
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy
| | - Antonio Lo Casto
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University Hospital of Palermo, Palermo, Italy
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Salvaggio G, Comelli A, Portoghese M, Cutaia G, Cannella R, Vernuccio F, Stefano A, Dispensa N, La Tona G, Salvaggio L, Calamia M, Gagliardo C, Lagalla R, Midiri M. Deep Learning Network for Segmentation of the Prostate Gland With Median Lobe Enlargement in T2-weighted MR Images: Comparison With Manual Segmentation Method. Curr Probl Diagn Radiol 2021; 51:328-333. [PMID: 34315623 DOI: 10.1067/j.cpradiol.2021.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/20/2021] [Accepted: 06/16/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Aim of this study was to evaluate a fully automated deep learning network named Efficient Neural Network (ENet) for segmentation of prostate gland with median lobe enlargement compared to manual segmentation. MATERIALS AND METHODS One-hundred-three patients with median lobe enlargement on prostate MRI were retrospectively included. Ellipsoid formula, manual segmentation and automatic segmentation were used for prostate volume estimation using T2 weighted MRI images. ENet was used for automatic segmentation; it is a deep learning network developed for fast inference and high accuracy in augmented reality and automotive scenarios. Student t-test was performed to compare prostate volumes obtained with ellipsoid formula, manual segmentation, and automated segmentation. To provide an evaluation of the similarity or difference to manual segmentation, sensitivity, positive predictive value (PPV), dice similarity coefficient (DSC), volume overlap error (VOE), and volumetric difference (VD) were calculated. RESULTS Differences between prostate volume obtained from ellipsoid formula versus manual segmentation and versus automatic segmentation were statistically significant (P < 0.049318 and P < 0.034305, respectively), while no statistical difference was found between volume obtained from manual versus automatic segmentation (P = 0.438045). The performance of ENet versus manual segmentations was good providing a sensitivity of 93.51%, a PPV of 87.93%, a DSC of 90.38%, a VOE of 17.32% and a VD of 6.85%. CONCLUSION The presence of median lobe enlargement may lead to MRI volume overestimation when using the ellipsoid formula so that a segmentation method is recommended. ENet volume estimation showed great accuracy in evaluation of prostate volume similar to that of manual segmentation.
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Affiliation(s)
- Giuseppe Salvaggio
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - Albert Comelli
- Ri.Med Foundation, Palermo, Italy; Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Italy
| | - Marzia Portoghese
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - Giuseppe Cutaia
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.
| | - Roberto Cannella
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - Federica Vernuccio
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - Alessandro Stefano
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Italy
| | - Nino Dispensa
- Discipline Chirurgiche, Oncologiche e Stomatologiche - Unità operativa di Urologia, Università degli Studi di Palermo, Palermo, Italy
| | - Giuseppe La Tona
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - Leonardo Salvaggio
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - Mauro Calamia
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - Cesare Gagliardo
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - Roberto Lagalla
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
| | - Massimo Midiri
- Section of Radiology - BiND, University Hospital "Paolo Giaccone", Via del Vespro 129, 90127, Palermo, Italy
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Alongi P, Stefano A, Comelli A, Laudicella R, Scalisi S, Arnone G, Barone S, Spada M, Purpura P, Bartolotta TV, Midiri M, Lagalla R, Russo G. Radiomics analysis of 18F-Choline PET/CT in the prediction of disease outcome in high-risk prostate cancer: an explorative study on machine learning feature classification in 94 patients. Eur Radiol 2021; 31:4595-4605. [PMID: 33443602 DOI: 10.1007/s00330-020-07617-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/10/2020] [Accepted: 12/07/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was (1) to investigate the application of texture analysis of choline PET/CT images in prostate cancer (PCa) patients and (2) to propose a machine-learning radiomics model able to select PET features predictive of disease progression in PCa patients with a same high-risk class at restaging. MATERIAL AND METHODS Ninety-four high-risk PCa patients who underwent restaging Cho-PET/CT were analyzed. Follow-up data were recorded for a minimum of 13 months after the PET/CT scan. PET images were imported in LIFEx toolbox to extract 51 features from each lesion. A statistical system based on correlation matrix and point-biserial-correlation coefficient has been implemented for features reduction and selection, while Discriminant analysis (DA) was used as a method for features classification in a whole sample and sub-groups for primary tumor or local relapse (T), nodal disease (N), and metastatic disease (M). RESULTS In the whole group, 2 feature (HISTO_Entropy_log10; HISTO_Energy_Uniformity) results were able to discriminate the occurrence of disease progression at follow-up, obtaining the best performance in DA classification (sensitivity 47.1%, specificity 76.5%, positive predictive value (PPV) 46.7%, and accuracy 67.6%). In the sub-group analysis, the best performance in DA classification for T was obtained by selecting 3 features (SUVmin; SHAPE_Sphericity; GLCM_Correlation) with a sensitivity of 91.6%, specificity 84.1%, PPV 79.1%, and accuracy 87%; for N by selecting 2 features (HISTO = _Energy Uniformity; GLZLM_SZLGE) with a sensitivity of 68.1%, specificity 91.4%, PPV 83%, and accuracy 82.6%; and for M by selecting 2 features (HISTO_Entropy_log10 - HISTO_Entropy_log2) with a sensitivity 64.4%, specificity 74.6%, PPV 40.6%, and accuracy 72.5%. CONCLUSION This machine learning model demonstrated to be feasible and useful to select Cho-PET features for T, N, and M with valuable association with high-risk PCa patients' outcomes. KEY POINTS • Artificial intelligence applications are feasible and useful to select Cho-PET features. • Our model demonstrated the presence of specific features for T, N, and M with valuable association with high-risk PCa patients' outcomes. • Further prospective studies are necessary to confirm our results and to develop the application of artificial intelligence in PET imaging of PCa.
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Affiliation(s)
- Pierpaolo Alongi
- Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Contrada Pietrapollastra Pisciotto, 90015, Cefalù, PA, Italy.
| | - Alessandro Stefano
- Institute of Molecular Bioimaging and Physiology, National Research Council (CNR), Cefalù, PA, Italy
| | | | - Riccardo Laudicella
- Department of Biomedical and Dental Sciences and of Morpho-functional Imaging, Nuclear Medicine Unit, University of Messina, Messina, Italy
| | - Salvatore Scalisi
- Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Contrada Pietrapollastra Pisciotto, 90015, Cefalù, PA, Italy
| | - Giuseppe Arnone
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Stefano Barone
- Dipartimento di Scienze Agronomiche, Alimentari e Forestali (SAAF), University of Palermo, Palermo, Italy
| | | | - Pierpaolo Purpura
- Department of Radiology, Fondazione Istituto Giuseppe Giglio Ct.da Pietrapollastra, Via Pisciotto, 90015, Cefalù (Palermo), Italy
| | - Tommaso Vincenzo Bartolotta
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
- Department of Radiology, Fondazione Istituto Giuseppe Giglio Ct.da Pietrapollastra, Via Pisciotto, 90015, Cefalù (Palermo), Italy
| | - Massimo Midiri
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Giorgio Russo
- Institute of Molecular Bioimaging and Physiology, National Research Council (CNR), Cefalù, PA, Italy
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Romeo P, Lo Re G, Cester R, Picone D, Di Mauro DM, Privitera G, Salerno S, Lagalla R, Midiri M. Radiologic team performance index: A new paradigm in KPI evaluating radiology examination volumes department performance: Results of Sicilian regional healthcare system survey. International Journal of Healthcare Management 2020. [DOI: 10.1080/20479700.2018.1472841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Placido Romeo
- ASP Messina, UOC Radiodiagnostica-Ospedale S. Vincenzo Taormina, Taormina, Italy
| | - Giuseppe Lo Re
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Roberto Cester
- Sicilia Sistemi Tecnologie srl – Gruppo Dedalus spa, Catania, Italy
| | - Dario Picone
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
| | | | - Giambattista Privitera
- AOU Policlinico-Vittorio Emanuele, UOC Radiodiagnostica Ospedale Vittorio Emanuele, Catania, Italy
| | - Sergio Salerno
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology – Di.Bi.Med., University of Palermo, Palermo, Italy
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Vernuccio F, Cannella R, Comelli A, Salvaggio G, Lagalla R, Midiri M. [Radiomics and artificial intelligence: new frontiers in medicine.]. Recenti Prog Med 2020; 111:130-135. [PMID: 32157259 DOI: 10.1701/3315.32853] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Radiomics is a new frontier of medicine based on the extraction of quantitative data from radiological images which can not be seen by radiologist's naked eye and on the use of these data for the creation of clinical decision support systems. The long-term goal of radiomics is to improve the non-invasive diagnosis of focal and diffuse diseases of different organs by understanding links between extracted quantitative imaging data and the underlying molecular and pathological characteristics of lesions. In the last decade, several studies have highlighted the enormous potential of radiomics in both tumoral and non-tumoral diseases of many organs and systems including brain, lung, breast, gastrointestinal and genitourinary tracts. The enormous potential of radiomics needs to be pursued with the methodological rigor of scientific research and by integrating radiological data with other medical disciplines, in order to improve personalized patient management.
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Affiliation(s)
- Federica Vernuccio
- Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica e di Eccellenza "G. D'Alessandro" (ProMISE), Università di Palermo
| | - Roberto Cannella
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata, Università di Palermo
| | | | - Giuseppe Salvaggio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata, Università di Palermo
| | - Roberto Lagalla
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata, Università di Palermo
| | - Massimo Midiri
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata, Università di Palermo
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9
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Cascio A, Colomba C, Di Carlo P, Serra N, Lo Re G, Gambino A, Lo Casto A, Guglielmi G, Veronese N, Lagalla R, Sergi C. Low bone mineral density in HIV-positive young Italians and migrants. PLoS One 2020; 15:e0237984. [PMID: 32881882 PMCID: PMC7470426 DOI: 10.1371/journal.pone.0237984] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/06/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infected individuals may have osteoporosis. We aimed to evaluate the bone mineral density (BMD) in naïve antiretroviral (ARV) treated HIV positive patients comparing native Italian group (ItG) to a Migrants group (MiG) upon arrival in Italy. METHODS We conducted a cross-sectional study on 83 HIV patients less than 50 years old. We used the dual-energy X-ray absorptiometry (DXA) within six months from the HIV diagnosis. Participants were categorized as having low BMD if the femoral neck or total lumbar spine Z-score was- 2 or less. RESULTS MiG showed low BMD more often than ItG (37.5% vs.13.6%), especially for the female gender (16.7% vs. 0.0%). A low CD4 rate (<200 cells/μl) was most often detected in MiG than ItG. In particular, we found most often male Italians with abnormal CD4 than male migrants (67.8% vs. 33.3%) and vice versa for females (30.5% vs. 66.7%). We found an abnormal bone mineral density at the lumbar site. Low BMD at the lumbar site was more frequently observed in female migrants than female Italians. Both male and female migrants had a Z-score value significantly lower than male and female Italians, respectively. By logistic regression low vitamin-D level was positively correlated to low BMD in ItG only. All data were verified and validated using a triple code identifier. CONCLUSIONS Both DXA and vitamin-D evaluation should be offered after the diagnosis of HIV infection. Lumbar site low BMD is an initial condition of bone loss in HIV young patients, especially in female migrants. Vitamin D levels and supplementation may be considered after HIV diagnosis independently of age to improve bone health. HIGHLIGHTS This study evaluates the frequency of bone mineral density in HIV positive patients naive to antiretroviral therapy. It compares the density of the native Italian population with that of HIV Migrants upon arrival in Italy. The results show that HIV positive migrants, even if younger than 50 years of age, are at risk for osteoporosis, especially if they are female.
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Affiliation(s)
- Antonio Cascio
- Department of Health Promotion and Child Health, University Hospital, Palermo, Italy
| | - Claudia Colomba
- Department of Health Promotion and Child Health, University Hospital, Palermo, Italy
| | - Paola Di Carlo
- Department of Health Promotion and Child Health, University Hospital, Palermo, Italy
| | - Nicola Serra
- Department of Molecular Medicine and Medical Biotechnology, University Federico II of Naples, Naples, Italy
| | - Giuseppe Lo Re
- Department of Biopathology and Biotechnologies (DiBiMed), University Hospital ‘Paolo Giaccone’, Palermo, Italy
| | - Angelo Gambino
- Department of Biopathology and Biotechnologies (DiBiMed), University Hospital ‘Paolo Giaccone’, Palermo, Italy
| | - Antonio Lo Casto
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy
- Department of Radiology, Scientific Institute “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Roberto Lagalla
- Department of Biopathology and Biotechnologies (DiBiMed), University Hospital ‘Paolo Giaccone’, Palermo, Italy
| | - Consolato Sergi
- Department of Lab. Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
- Stollery Children’s Hospital, Edmonton, AB, Canada
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10
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Alongi P, Laudicella R, Stefano A, Caobelli F, Comelli A, Vento A, Sardina D, Ganduscio G, Toia P, Ceci F, Mapelli P, Picchio M, Midiri M, Baldari S, Lagalla R, Russo G. Choline PET/CT features to predict survival outcome in high risk prostate cancer restaging: a preliminary machine-learning radiomics study. Q J Nucl Med Mol Imaging 2020; 66:352-360. [PMID: 32543166 DOI: 10.23736/s1824-4785.20.03227-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Radiomic features are increasingly utilized to evaluate tumor heterogeneity in PET imaging but to date its role has not been investigated for Cho-PET in prostate cancer. The potential application of radiomics features analysis using a machine-learning radiomics algorithm was evaluated to select 18F-Cho PET/CT imaging features to predict disease progression in PCa. METHODS We retrospectively analyzed high-risk PCa patients who underwent restaging 18F-Cho PET/CT from November 2013 to May 2018. 18F-Cho PET/CT studies and related structures containing volumetric segmentations were imported in the "CGITA" toolbox to extract imaging features from each lesion. A Machine-learning model has been adapted using NCA for feature selection, while DA was used as a method for feature classification and performance analysis. RESULTS 106 imaging features were extracted for 46 lesions for a total of 4876 features analyzed. No significant differences between the training and validating sets in terms of age, sex, PSA values, lesion location and size (p > 0.05) were demonstrated by the machine-learning model. Thirteen features were able to discriminate FU disease status after NCA selection. Best performance in DA classification was obtained using the combination of the 13 selected features (sensitivity 74%, specificity 58% and accuracy 66%) compared to the use of all features (sensitivity 40%, specificity 52%, and accuracy 51%). Per-site performance of the 13 selected features in DA classification were as follow: T= sensitivity 63%, specificity 83%, accuracy 71%; N= sensitivity 87%, specificity 91% of and accuracy 90%; bone-M= sensitivity 33%, specificity 77% and accuracy 66%. CONCLUSIONS An artificial intelligence model demonstrated to be feasible and able to select a panel of 18F-Cho PET/CT features with valuable association with PCa patients' outcome.
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Affiliation(s)
- Pierpaolo Alongi
- Nuclear Medicine Unit, Fondazione Istituto G.Giglio, Cefalù, Palermo, Italy -
| | - Riccardo Laudicella
- Nuclear Medicine Unit, Fondazione Istituto G.Giglio, Cefalù, Palermo, Italy.,Department of Biomedical and Dental Sciences and of Morpho-functional Imaging, Nuclear Medicine Unit, University of Messina, Messina, Italy
| | - Alessandro Stefano
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Palermo, Italy
| | - Federico Caobelli
- Clinic of Radiology & Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Albert Comelli
- Ri.MED Foundation, Palermo, Italy.,Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta GA, USA.,Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Palermo, Italy
| | - Antonio Vento
- Department of Biomedical and Dental Sciences and of Morpho-functional Imaging, Nuclear Medicine Unit, University of Messina, Messina, Italy
| | - Davide Sardina
- Department of Industrial and Digital Innovation (DIID), University of Palermo, Palermo, Italy
| | - Gloria Ganduscio
- Department of Industrial and Digital Innovation (DIID), University of Palermo, Palermo, Italy
| | - Patrizia Toia
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Francesco Ceci
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Paola Mapelli
- Nuclear Medicine, Department of Medical Sciences, University of Turin, Turin, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Maria Picchio
- Nuclear Medicine, Department of Medical Sciences, University of Turin, Turin, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Midiri
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Sergio Baldari
- Department of Biomedical and Dental Sciences and of Morpho-functional Imaging, Nuclear Medicine Unit, University of Messina, Messina, Italy
| | - Roberto Lagalla
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Giorgio Russo
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Cefalù, Palermo, Italy
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11
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Gagliardo C, Cannella R, Quarrella C, D'Amelio M, Napoli A, Bartolotta TV, Catalano C, Midiri M, Lagalla R. Intraoperative imaging findings in transcranial MR imaging-guided focused ultrasound treatment at 1.5T may accurately detect typical lesional findings correlated with sonication parameters. Eur Radiol 2020; 30:5059-5070. [PMID: 32346791 DOI: 10.1007/s00330-020-06712-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/28/2019] [Accepted: 02/04/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To assess the intraoperative neuroimaging findings in patients treated with transcranial MR-guided focused ultrasound (tcMRgFUS) thalamotomy using 1.5T equipment in comparison with the 48-h follow-up. METHODS Fifty prospectively enrolled patients undergoing unilateral tcMRgFUS thalamotomy for either medication-refractory essential tremor (n = 39) or Parkinson tremor (n = 11) were included. Two radiologists evaluated the presence and size of concentric lesional zones (zone I, zone II, and zone III) on 2D T2-weighted sequences acquired intraoperatively after the last high-energy sonication and at 48 h. Sonication parameters including number of sonications, delivered energy, and treatment temperatures were also recorded. Differences in lesion pattern and size were assessed using the McNemar test and paired t test, respectively. RESULTS Zones I, II, and III were visualized in 34 (68%), 50 (100%), and 44 (88%) patients, and 31 (62%), 50 (100%), and 45 (90%) patients after the last high-energy sonication for R1 and R2, respectively. All three concentric zones were visualized intraoperatively in 56-58% of cases. Zone I was significantly more commonly visualized at 48 h (p < 0.001). Diameter of zones I and II and the thickness of zone III significantly increased at 48 h (p < 0.001). Diameters of zones I and II measured intraoperatively demonstrated significant correlation with thermal map temperatures (p ≤ 0.001). Maximum temperature significantly correlated with zone III thickness at 48 h. A threshold of 60.5° had a sensitivity of 56.5-66.7% and a specificity of 70.5-75.5% for thickness > 6 mm at 48 h. CONCLUSIONS Intraoperative imaging may accurately detect typical lesional findings, before completing the treatment. These imaging characteristics significantly correlate with sonication parameters and 48-h follow-up. KEY POINTS • Intraoperative T2-weighted images allow the visualization of the zone I (coagulation necrosis) in most of the treated patients, while zone II (cytotoxic edema) is always detected. • Lesion size depicted with intraoperative transcranial MRgFUS imaging correlates well with procedure parameters. • Intraoperative transcranial MRgFUS imaging may have a significant added value for treating physicians.
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Affiliation(s)
- Cesare Gagliardo
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Cettina Quarrella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Marco D'Amelio
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Alessandro Napoli
- Department of Radiological, Oncological and Anatomopathological Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Tommaso Vincenzo Bartolotta
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Anatomopathological Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Massimo Midiri
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Roberto Lagalla
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
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12
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Agnello F, Albano D, Micci G, Di Buono G, Agrusa A, Salvaggio G, Pardo S, Sparacia G, Bartolotta TV, Midiri M, Lagalla R, Galia M. CT and MR imaging of cystic renal lesions. Insights Imaging 2020; 11:5. [PMID: 31900669 PMCID: PMC6942066 DOI: 10.1186/s13244-019-0826-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/05/2019] [Indexed: 01/28/2023] Open
Abstract
Cystic renal lesions are a common incidental finding on routinely imaging examinations. Although a benign simple cyst is usually easy to recognize, the same is not true for complex and multifocal cystic renal lesions, whose differential diagnosis includes both neoplastic and non-neoplastic conditions. In this review, we will show a series of cases in order to provide tips to identify benign cysts and differentiate them from malignant ones.
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Affiliation(s)
- Francesco Agnello
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.
| | - Domenico Albano
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.,Unità di Radiologia Diagnostica ed Interventistica, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Giuseppe Micci
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Giuseppe Di Buono
- Dipartimento di Discipline Chirurgiche Oncologiche e Stomatologiche, Università degli Studi di Palermo, Via Liborio Giuffrè 5, 90127, Palermo, Italy
| | - Antonino Agrusa
- Dipartimento di Discipline Chirurgiche Oncologiche e Stomatologiche, Università degli Studi di Palermo, Via Liborio Giuffrè 5, 90127, Palermo, Italy
| | - Giuseppe Salvaggio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Salvatore Pardo
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Gianvincenzo Sparacia
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Tommaso Vincenzo Bartolotta
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.,Dipartimento di Radiologia, Fondazione Istituto Giuseppe Giglio, Contrada Pietrapollastra, Via Picciotto, 90015, Cefalù (Palermo), Italy
| | - Massimo Midiri
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Roberto Lagalla
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Massimo Galia
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
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13
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Comelli A, Stefano A, Coronnello C, Russo G, Vernuccio F, Cannella R, Salvaggio G, Lagalla R, Barone S. Radiomics: A New Biomedical Workflow to Create a Predictive Model. Communications in Computer and Information Science 2020. [DOI: 10.1007/978-3-030-52791-4_22] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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14
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Giambelluca D, Cannella R, Vernuccio F, Comelli A, Pavone A, Salvaggio L, Galia M, Midiri M, Lagalla R, Salvaggio G. PI-RADS 3 Lesions: Role of Prostate MRI Texture Analysis in the Identification of Prostate Cancer. Curr Probl Diagn Radiol 2019. [PMID: 31761413 DOI: 10.1067/j.cpradiol.2019.10.009.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine the diagnostic performance of texture analysis of prostate MRI for the diagnosis of prostate cancer among Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. MATERIALS AND METHODS Forty-three patients with at least 1 PI-RADS 3 lesion on prostate MRI performed between June 2016 and January 2019 were retrospectively included. Reference standard was pathological analysis of radical prostatectomy specimens or MRI-targeted biopsies. Texture analysis extraction of target lesions was performed on axial T2-weighted images and apparent diffusion coefficient (ADC) maps using a radiomic software. Lesions were categorized as prostate cancer (Gleason score [GS] ≥ 6), and no prostate cancer. Statistical analysis was performed using the generalized linear model (GLM) regression and the discriminant analysis (DA). AUROC with 95% confidence intervals were calculated to assess the diagnostic performance of standalone features and predictive models for the diagnosis of prostate cancer (GS ≥ 6) and clinically-significant prostate cancer (GS ≥ 7). RESULTS The analysis of 46 PI-RADS 3 lesions (ie, 27 [58.7%] no prostate cancers; 19 [41.3%] prostate cancers) revealed 9 and 6 independent texture parameters significantly correlated with the final histopathological results on T2-weighted and ADC maps images, respectively. The resulting GLM and DA predictive models for the diagnosis of prostate cancer yielded an AUROC of 0.775 and 0.779 on T2-weighted images or 0.815 and 0.821 on ADC maps images. For the diagnosis of clinically-significant prostate cancer, the resulting GLM and DA predictive models for the diagnosis of prostate cancer yielded an AUROC of 0.769 and 0.817 on T2-weighted images or 0.749 and 0.744 on ADC maps images. CONCLUSION Texture analysis of PI-RADS 3 lesions on T2-weighted and ADC maps images helps identifying prostate cancer. The good diagnostic performance of the combination of multiple radiomic features for the diagnosis of prostate cancer may help predicting lesions where aggressive management may be warranted.
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Affiliation(s)
- Dario Giambelluca
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Roberto Cannella
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Federica Vernuccio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy; University Paris 7 Diderot, Sorbonne Paris Cité, Paris, France; I.R.C.C.S. Centro Neurolesi Bonino Pulejo, Messina, Italy.
| | - Albert Comelli
- Ri.MED Foundation, Palermo, Italy; Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta GA, US; Department of Industrial and Digital Innovation (DIID), University of Palermo, Italy
| | - Alice Pavone
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Leonardo Salvaggio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Massimo Galia
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Giuseppe Salvaggio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
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15
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Giambelluca D, Cannella R, Vernuccio F, Comelli A, Pavone A, Salvaggio L, Galia M, Midiri M, Lagalla R, Salvaggio G. PI-RADS 3 Lesions: Role of Prostate MRI Texture Analysis in the Identification of Prostate Cancer. Curr Probl Diagn Radiol 2019; 50:175-185. [PMID: 31761413 DOI: 10.1067/j.cpradiol.2019.10.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To determine the diagnostic performance of texture analysis of prostate MRI for the diagnosis of prostate cancer among Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. MATERIALS AND METHODS Forty-three patients with at least 1 PI-RADS 3 lesion on prostate MRI performed between June 2016 and January 2019 were retrospectively included. Reference standard was pathological analysis of radical prostatectomy specimens or MRI-targeted biopsies. Texture analysis extraction of target lesions was performed on axial T2-weighted images and apparent diffusion coefficient (ADC) maps using a radiomic software. Lesions were categorized as prostate cancer (Gleason score [GS] ≥ 6), and no prostate cancer. Statistical analysis was performed using the generalized linear model (GLM) regression and the discriminant analysis (DA). AUROC with 95% confidence intervals were calculated to assess the diagnostic performance of standalone features and predictive models for the diagnosis of prostate cancer (GS ≥ 6) and clinically-significant prostate cancer (GS ≥ 7). RESULTS The analysis of 46 PI-RADS 3 lesions (ie, 27 [58.7%] no prostate cancers; 19 [41.3%] prostate cancers) revealed 9 and 6 independent texture parameters significantly correlated with the final histopathological results on T2-weighted and ADC maps images, respectively. The resulting GLM and DA predictive models for the diagnosis of prostate cancer yielded an AUROC of 0.775 and 0.779 on T2-weighted images or 0.815 and 0.821 on ADC maps images. For the diagnosis of clinically-significant prostate cancer, the resulting GLM and DA predictive models for the diagnosis of prostate cancer yielded an AUROC of 0.769 and 0.817 on T2-weighted images or 0.749 and 0.744 on ADC maps images. CONCLUSION Texture analysis of PI-RADS 3 lesions on T2-weighted and ADC maps images helps identifying prostate cancer. The good diagnostic performance of the combination of multiple radiomic features for the diagnosis of prostate cancer may help predicting lesions where aggressive management may be warranted.
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Affiliation(s)
- Dario Giambelluca
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Roberto Cannella
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Federica Vernuccio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy; University Paris 7 Diderot, Sorbonne Paris Cité, Paris, France; I.R.C.C.S. Centro Neurolesi Bonino Pulejo, Messina, Italy.
| | - Albert Comelli
- Ri.MED Foundation, Palermo, Italy; Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta GA, US; Department of Industrial and Digital Innovation (DIID), University of Palermo, Italy
| | - Alice Pavone
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Leonardo Salvaggio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Massimo Galia
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Giuseppe Salvaggio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
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16
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Iacopino DG, Gagliardo C, Giugno A, Giammalva GR, Napoli A, Maugeri R, Graziano F, Valentino F, Cosentino G, D'Amelio M, Bartolotta TV, Catalano C, Fierro B, Midiri M, Lagalla R. Preliminary experience with a transcranial magnetic resonance-guided focused ultrasound surgery system integrated with a 1.5-T MRI unit in a series of patients with essential tremor and Parkinson's disease. Neurosurg Focus 2019; 44:E7. [PMID: 29385927 DOI: 10.3171/2017.11.focus17614] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Transcranial magnetic resonance-guided focused ultrasound surgery (tcMRgFUS) is one of the emerging noninvasive technologies for the treatment of neurological disorders such as essential tremor (ET), idiopathic asymmetrical tremor-dominant Parkinson's disease (PD), and neuropathic pain. In this clinical series the authors present the preliminary results achieved with the world's first tcMRgFUS system integrated with a 1.5-T MRI unit. METHODS The authors describe the results of tcMRgFUS in a sample of patients with ET and with PD who underwent the procedure during the period from January 2015 to September 2017. A monolateral ventralis intermedius nucleus (VIM) thalamic ablation was performed in both ET and PD patients. In all the tcMRgFUS treatments, a 1.5-T MRI scanner was used for both planning and monitoring the procedure. RESULTS During the study period, a total of 26 patients underwent tcMRgFUS thalamic ablation for different movement disorders. Among these patients, 18 were diagnosed with ET and 4 were affected by PD. All patients with PD were treated using tcMRgFUS thalamic ablation and all completed the procedure. Among the 18 patients with ET, 13 successfully underwent tcMRgFUS, 4 aborted the procedure during ultrasound delivery, and 1 did not undergo the tcMRgFUS procedure after stereotactic frame placement. Two patients with ET were not included in the results because of the short follow-up duration at the time of this study. A monolateral VIM thalamic ablation in both ET and PD patients was performed. All the enrolled patients were evaluated before the treatment and 2 days after, with a clinical control of the treatment effectiveness using the graphic items of the Fahn-Tolosa-Marin tremor rating scale. A global reevaluation was performed 3 months (17/22 patients) and 6 months (11/22 patients) after the treatment; the reevaluation consisted of clinical questionnaires, neurological tests, and video recordings of the tests. All the ET and PD treated patients who completed the procedure showed an immediate amelioration of tremor severity, with no intra- or posttreatment severe permanent side effects. CONCLUSIONS Although this study reports on a small number of patients with a short follow-up duration, the tcMRgFUS procedure using a 1.5-T MRI unit resulted in a safe and effective treatment option for motor symptoms in patients with ET and PD. To the best of the authors' knowledge, this is the first clinical series in which thalamotomy was performed using tcMRgFUS integrated with a 1.5-T magnet.
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Affiliation(s)
- Domenico Gerardo Iacopino
- Unit of Neurosurgery, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo
| | - Cesare Gagliardo
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo
| | - Antonella Giugno
- Unit of Neurosurgery, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo
| | - Giuseppe Roberto Giammalva
- Unit of Neurosurgery, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo
| | - Alessandro Napoli
- Radiology Section, Department of Radiological, Oncological and Anatomopathological Sciences, "Sapienza" University of Rome; and
| | - Rosario Maugeri
- Unit of Neurosurgery, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo
| | - Francesca Graziano
- Unit of Neurosurgery, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo
| | - Francesca Valentino
- Unit of Neurology, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Italy
| | - Giuseppe Cosentino
- Unit of Neurology, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Italy
| | - Marco D'Amelio
- Unit of Neurology, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Italy
| | - Tommaso Vincenzo Bartolotta
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo
| | - Carlo Catalano
- Radiology Section, Department of Radiological, Oncological and Anatomopathological Sciences, "Sapienza" University of Rome; and
| | - Brigida Fierro
- Unit of Neurology, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Italy
| | - Massimo Midiri
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo
| | - Roberto Lagalla
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo
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Giambelluca D, Albano D, Giambelluca E, Bruno A, Panzuto F, Agrusa A, Di Buono G, Cannizzaro F, Gagliardo C, Midiri M, Lagalla R, Salvaggio G. Renal endometriosis mimicking complicated cysts of kidney: report of two cases. G Chir 2019; 38:250-255. [PMID: 29280706 DOI: 10.11138/gchir/2017.38.5.250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Endometriosis is a common gynecologic disorder characterized by ectopic endometrial tissue growth outside the uterine cavity. Although usually occurring in pelvic organs, endometrial lesions may involve urinary tract. Renal endometriosis is extremely rare and it has only occasionally been reported in the past. We report two cases of patients with renal cystic lesions, incidentally found at imaging techniques during oncologic follow-up for gastric sarcoma and melanoma, initially misinterpreted as complicated haemorrhagic cysts and then histologically characterized as renal localizations of extragenital endometriosis.
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Taibbi A, Brancatelli G, Matranga D, Midiri M, Lagalla R, Bartolotta TV. Focal nodular hyperplasia: a weight-based, intraindividual comparison of gadobenate dimeglumine and gadoxetate disodium-enhanced MRI. ACTA ACUST UNITED AC 2019; 25:95-101. [PMID: 30860073 DOI: 10.5152/dir.2019.18165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE We aimed to qualitatively and quantitatively compare the enhancement pattern of focal nodular hyperplasia after gadobenate dimeglumine and gadoxetate disodium injection in the same patient. METHODS 1.5 T magnetic resonance imaging (MRI) examinations of 16 patients with 21 focal nodular hyperplasias studied after the injection of both contrast media were evaluated. Both MRI studies were performed in all patients. A qualitative analysis was performed evaluating each lesion in all phases. For quantitative analysis we calculated signal intensity ratio, lesion-to-liver contrast ratio and liver parenchyma signal intensity gain on hepatobiliary phase. Statistical analysis was performed with the Wilcoxon sign-rank test for clustered paired data and the McNemar test for paired frequencies. A P value < 0.05 was considered statistically significant. RESULTS At qualitative analysis no statistically significant differences were evident during any of the contrast-enhanced phases. Signal intensity ratio (P = 0.048), lesion-to-liver contrast ratio (P = 0.032) and liver parenchyma signal intensity gain (P = 0.012) were significantly higher on hepatobiliary phase after gadoxetate disodium injection. CONCLUSION There were no significant differences in the MRI findings of focal nodular hyperplasia after the injection of a weight-based dose of either gadobenate dimeglumine or gadoxetate disodium.
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Affiliation(s)
- Adele Taibbi
- Department of Radiology, Palermo University Hospital, Palermo, Italy
| | | | - Domenica Matranga
- Department of Radiology, Palermo University Hospital, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology, Palermo University Hospital, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology, Palermo University Hospital, Palermo, Italy
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Salerno S, Terranova MC, Vernuccio F, Picone D, Tudisca C, Lo Re G, Lagalla R. Imaging Assessment of Paediatric Crohn’s Disease: a Literature Review. Hong Kong J Radiol 2019. [DOI: 10.12809/hkjr1916912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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20
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Bartolotta TV, Taibbi A, Midiri M, Lagalla R. Contrast-enhanced ultrasound of hepatocellular carcinoma: where do we stand? Ultrasonography 2019; 38:200-214. [PMID: 31006227 PMCID: PMC6595127 DOI: 10.14366/usg.18060] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 02/25/2019] [Indexed: 12/12/2022] Open
Abstract
Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in ultrasonography (US), and it is being increasingly used for the evaluation of focal liver lesions (FLLs). CEUS is unique in that it allows non-invasive assessment of liver perfusion in real time throughout the vascular phase, which has led to dramatic improvements in the diagnostic accuracy of US in the detection and characterization of FLLs, the choice of therapeutic procedures, and the evaluation of response. Currently, CEUS is included as a part of the suggested diagnostic work-up of FLLs, including in cirrhotic patients with hepatocellular carcinoma, resulting in better patient management and cost-effective delivery of therapy.
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Affiliation(s)
| | - Adele Taibbi
- Department of Radiology, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology, University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology, University of Palermo, Palermo, Italy
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21
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Lo Re G, Salerno S, Terranova MC, Argo A, Casto AL, Zerbo S, Lagalla R. Virtopsy and Living Individuals Evaluation Using Computed Tomography in Forensic Diagnostic Imaging. Semin Ultrasound CT MR 2019; 40:67-78. [PMID: 30686370 DOI: 10.1053/j.sult.2018.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The applications of forensic radiology involve both Virtopsy both studies on living people - to demonstrate bone age, search for foreign bodies, such as voluntary injection of drug ovules or surgical sponges accidentally forgotten, to assess gunshot wounds, to evaluate injuries by road accidents, and cases of violence or abuse (both in adults and in children). Computed tomography is the most used imaging tool used in forensic pathology and its indications are mainly focused on cases of unnatural deaths or when a crime is suspected. It is preferred over the standard autopsy in selected cases, such as in putrefied, carbonized or badly damaged bodies; or as a preliminary evaluation in mass disasters.
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Affiliation(s)
- Giuseppe Lo Re
- Department of Biopathology and Medical Biotechnologies (Di.Bi.Med), University of Palermo, Palermo, Italy
| | - Sergio Salerno
- Department of Biopathology and Medical Biotechnologies (Di.Bi.Med), University of Palermo, Palermo, Italy
| | - Maria Chiara Terranova
- Department of Biopathology and Medical Biotechnologies (Di.Bi.Med), University of Palermo, Palermo, Italy.
| | - Antonella Argo
- Department of Biopathology and Medical Biotechnologies (Di.Bi.Med), University of Palermo, Palermo, Italy
| | - Antonio Lo Casto
- Department of Biopathology and Medical Biotechnologies (Di.Bi.Med), University of Palermo, Palermo, Italy
| | - Stefania Zerbo
- Department of Biopathology and Medical Biotechnologies (Di.Bi.Med), University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Department of Biopathology and Medical Biotechnologies (Di.Bi.Med), University of Palermo, Palermo, Italy
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Gagliardo C, Midiri M, Cannella R, Napoli A, Wragg P, Collura G, Marrale M, Bartolotta TV, Catalano C, Lagalla R. Transcranial magnetic resonance-guided focused ultrasound surgery at 1.5T: a technical note. Neuroradiol J 2018; 32:132-138. [PMID: 30561246 DOI: 10.1177/1971400918818743] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Magnetic resonance-guided focused ultrasound is one of the emerging non-invasive technologies offering both image guidance and thermal monitoring. In recent years transcranial application of this technology is starting to impact heavily the neuroscience field. We present here the imaging protocol and the technological methods successfully used with a transcranial magnetic resonance-guided focused ultrasound system certified for clinical treatments of functional neurological disorders, integrated for the first time with a 1.5T magnetic resonance scanner. Compared to the body radiofrequency coil (the one commonly used with transcranial magnetic resonance-guided focused ultrasound system integrated with 3T magnetic resonance scanners), the use of a dedicated two channel coil enabled a signal-to-noise ratio gain up to five times higher.
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Affiliation(s)
- Cesare Gagliardo
- 1 Department of Biopathology and Medical Biotechnologies, University of Palermo, Italy
| | - Massimo Midiri
- 1 Department of Biopathology and Medical Biotechnologies, University of Palermo, Italy
| | - Roberto Cannella
- 1 Department of Biopathology and Medical Biotechnologies, University of Palermo, Italy
| | - Alessandro Napoli
- 2 Department of Radiological, Oncological and Anatomopathological Sciences, 'Sapienza' University of Rome, Italy
| | - Paul Wragg
- 3 InSightec Ltd., Israel, European Applications, UK
| | - Giorgio Collura
- 1 Department of Biopathology and Medical Biotechnologies, University of Palermo, Italy.,4 Department of Physics and Chemistry, University of Palermo, Italy
| | - Maurizio Marrale
- 4 Department of Physics and Chemistry, University of Palermo, Italy
| | | | - Carlo Catalano
- 2 Department of Radiological, Oncological and Anatomopathological Sciences, 'Sapienza' University of Rome, Italy
| | - Roberto Lagalla
- 1 Department of Biopathology and Medical Biotechnologies, University of Palermo, Italy
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Albano D, Chianca V, Cuocolo R, Bignone R, Ciccia F, Sconfienza LM, Midiri M, Brunetti A, Lagalla R, Galia M. T2-mapping of the sacroiliac joints at 1.5 Tesla: a feasibility and reproducibility study. Skeletal Radiol 2018; 47:1691-1696. [PMID: 29679101 DOI: 10.1007/s00256-018-2951-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/09/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the reproducibility of T2 relaxation time measurements of the sacroiliac joints at 1.5 T. MATERIALS AND METHODS Healthy volunteers underwent an oblique axial multislice multiecho spin-echo sequence of the sacroiliac joints at 1.5 T. Regions of interest were manually drawn using a dedicated software by two musculoskeletal radiologists to include the cartilaginous part of the sacroiliac joints. A senior radiologist performed the measurement twice, while a resident measured once. Intra- and inter-observer reproducibility was tested using the Bland-Altman method. Association between sex and T2 relaxation times was tested using the Mann-Whitney U test. Correlation between T2 relaxation times and body mass index (BMI) was tested using the Spearman's rho. RESULTS Eighty sacroiliac joints of 40 subjects (mean age: 28 ± 4.8 years, range: 20-43; mean BMI: 23.3 ± 3.1, range: 18.9-30) were imaged. The mean T2 values obtained by the senior radiologist in the first series of measurements were 42 ± 4.4 ms, whereas in the second series were 40.7 ± 4.5 ms. The mean T2 values obtained by the radiology resident were 41.1 ± 4.2 ms. Intra-observer reproducibility was 88% (coefficient of repeatability = 3.8; bias = 1.28; p < .001), while inter-observer reproducibility was 86% (4.7; -.88; p < .001). There was significant association between sex and T2 relaxation times (p = .024) and significant inverse correlation between T2 relaxation times and BMI (r = -.340, p = .002). CONCLUSION The assessment of T2 relaxation time measurements of sacroiliac joints seems to be highly reproducible at 1.5 T. Further studies could investigate the potential clinical application of this tool in the sacroiliac joints.
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Affiliation(s)
- Domenico Albano
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
| | - Vito Chianca
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Renato Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Rodolfo Bignone
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Francesco Ciccia
- Department of Rheumatology, Di.Bi.Mis, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Luca Maria Sconfienza
- Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Massimo Midiri
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Roberto Lagalla
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Massimo Galia
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy
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Marrale M, Collura G, Napoli A, Geraci L, Catalano C, Midiri M, Lagalla R, Gagliardo C. 246. Analysis of signal-to-noise ratio for a 2-channels coil developed to enable transcranial Magnetic Resonance-guided Focused Ultrasound Surgery (tcMRgFUS) with 1.5 T MRI scanners. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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25
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Salvaggio G, Calamia M, Purpura P, Bartolotta TV, Picone D, Dispensa N, Lunetta C, Bruno A, Raso L, Salvaggio L, Lo Re G, Galia M, Simonato A, Midiri M, Lagalla R. Role of apparent diffusion coefficient values in prostate diseases characterization on diffusion-weighted magnetic resonance imaging. MINERVA UROL NEFROL 2018; 71:154-160. [PMID: 30421590 DOI: 10.23736/s0393-2249.18.03065-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND To evaluate if normal and pathological prostate tissue can be distinguished by using apparent diffusion coefficient (ADC) values on magnetic resonance imaging (MRI) and to understand if it is possible to differentiate among pathological prostate tissues using ADC values. METHODS Our population consisted in 81 patients (mean age 65.4 years) in which 84 suspicious areas were identified. Regions of interest were placed over suspicious areas, detected on MRI, and over areas with normal appearance, and ADC values were recorded. Statistical differences between ADC values of suspicious and normal areas were evaluated. Histopathological diagnosis, obtained from targeted biopsy using MRI-US fusion biopsies in 39 patients and from prostatectomy in 42 patients, were correlated to ADC values. RESULTS Histopathological diagnosis revealed 58 cases of prostate cancer (PCa), 19 patients with indolent PCa (Gleason Score ≤6) and 39 patients with clinically significant PCa (Gleason Score ≥7), 16 of high-grade prostatic intraepithelial neoplasia (HG-PIN) and 10 of atypical small acinar proliferation (ASAP). Significant statistical differences between mean ADC values of normal prostate tissue versus PCa (P<0.00001), HG-PIN (P<0.00001) and ASAP (P<0.00001) were found. Significant differences were observed between mean ADC values of PCa versus HG-PIN (P<0.00001) and ASAP (P<0.00001) with many overlapping values. Differences between mean ADC values of HG-PIN versus ASAP (P=0.015) were not significant. Significant differences of ADC values were also observed between patients with indolent and clinically significant PCa (P<0.00001). CONCLUSIONS ADC values allow differentiation between normal and pathological prostate tissue and between indolent and clinically significant PCa but do not allow a definite differentiation between PCa, HG-PIN, and ASAP.
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Affiliation(s)
- Giuseppe Salvaggio
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy -
| | - Mauro Calamia
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | - Pierpaolo Purpura
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | - Tommaso V Bartolotta
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | - Dario Picone
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | - Nino Dispensa
- Unit of Urology, Department of Surgery, Oncology, and Stomatology, University of Palermo, Palermo, Italy
| | - Claudio Lunetta
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | - Alberto Bruno
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | - Ludovica Raso
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | | | - Giuseppe Lo Re
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | - Massimo Galia
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | - Alchiede Simonato
- Unit of Urology, Department of Surgery, Oncology, and Stomatology, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
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Gagliardo C, La Tona G, Barone F, Salvaggio G, Cannizzaro C, Lagalla R. Hippocampal reversible lesions in a case of transient global amnesia. Gazz Med Ital - Arch Sci Med 2018. [DOI: 10.23736/s0393-3660.17.03632-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Re GL, Terranova MC, Vernuccio F, Calafiore C, Picone D, Tudisca C, Salerno S, Lagalla R. Swallowing impairment in neurologic disorders: the role of videofluorographic swallowing study. Pol J Radiol 2018; 83:e394-e400. [PMID: 30655916 PMCID: PMC6334091 DOI: 10.5114/pjr.2018.79203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 08/06/2018] [Indexed: 11/17/2022] Open
Abstract
Patients with neurologic diseases almost inevitably develop various degrees of swallowing disorders during their life. Dysphagia is one of the main negative prognostic factors in this class of patients, leading to severe morbidity (i.e. aspiration pneumonia, dehydration, malnutrition, and life quality deterioration) and to a noticeable increase in public health spending. Videofluorographic swallowing study is considered the gold standard technique for swallowing impairment assessment. It is aimed at early identification of the risk of aspiration, definition of the kind and grade of dysphagia, and an indication to suspend oral nutrition and adopt other feeding strategies, and define when the patient is able to return to physiological nutrition. Every radiologist should be familiar with the main videofluorographic swallowing features in neurological patients, not only because early diagnosis of deglutition disorders widely improves their prognosis, but also because customising feeding strategies has a great impact on patients' quality of life.
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Calvagna GM, Grassedonio E, Toia P, La Grutta L, Galia M, Smeraldi T, Patanè S, Midiri M, Lagalla R, Romeo P. Working in the mirror: the safety and effectiveness of closure access leading venous advanced gain new ability in a patient with dextrocardia. Gazz Med Ital - Arch Sci Med 2018. [DOI: 10.23736/s0393-3660.17.03642-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gagliardo C, La Tona G, Arculeo S, Barone F, Salvaggio G, Pappalardo MP, Cannizzaro C, Lagalla R. Non-alcoholic Wernicke's encephalopathy: from MRI findings of a case to differential diagnosis checklist. Gazz Med Ital - Arch Sci Med 2018. [DOI: 10.23736/s0393-3660.17.03661-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Albano D, Patti C, Matranga D, Lagalla R, Midiri M, Galia M. Whole-body diffusion-weighted MR and FDG-PET/CT in Hodgkin Lymphoma: Predictive role before treatment and early assessment after two courses of ABVD. Eur J Radiol 2018; 103:90-98. [PMID: 29803392 DOI: 10.1016/j.ejrad.2018.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/03/2018] [Accepted: 04/10/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate whether imaging features of pathologic lymph nodes on whole-body diffusion-weighted MR have a predictive role before treatment and may assess the response after two courses of chemotherapy in comparison to FDG-PET/CT in Hodgkin Lymphoma. MATERIALS AND METHODS We reviewed the whole-body MR and FDG-PET/CT performed on 41 patients with Hodgkin Lymphoma before and after two Doxorubicin-Bleomycin-Vinblastine-Dacarbazine (ABVD). Responder and non-responder lesions were identified on interim-FDG-PET/CT performed after two ABVD. We used Multivariate Generalized Estimating Equations model to assess statistical association between being-responder and baseline-Maximum Standard Uptake Value (SUVmax), baseline and interim-Apparent Diffusion Coefficient (ADC) and size, ADC and size changes during chemotherapy, site of disease, bulky, and stage. RESULTS 10/41 (24%) patients were positive on interim-FDG-PET/CT. The interim-FDG-PET/CT positivity was associated with worse cumulative survival rate at 24 months in comparison to interim-FDG-PET/CT negativity (P < .05); 3/10 patients with positive interim-FDG-PET/CT and 1/31 with negative interim-FDG-PET/CT experienced disease progression. Baseline-SUVmax was 11.18 ± 5.58 (3.1-28.0) and baseline-ADC was 0.70 ± 0.14 × 10-3 mm2/s (0.39-0.98). There was a significant difference between responder and non-responder lesions based on interim-ADC (1.83 ± 0.34 × 10-3 mm2/s vs. 1.01 ± 0.27 × 10-3 mm2/s;p <.001), interim-size (3.1 cm2 vs. 9.4 cm2;p = .009), and bulky (8.2% vs. 66.7%;p = .002). There was no significant difference between responder and non-responder lesions based on baseline-SUVmax (p = .713), baseline-ADC (p = .253), ADC changes (p = .058), size changes (p = .085), site (p = .209), stage (p = .290), baseline-size (p = .064). CONCLUSIONS Interim-ADC is helpful for identifying non-responder lesions, while size changes are not useful. Baseline-SUVmax and ADC have no predictive role. Bulky is the most useful imaging parameter to predict suboptimal response to chemotherapy.
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Affiliation(s)
- Domenico Albano
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Trabucco 180, 90146 Palermo, Italy.
| | - Domenica Matranga
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy.
| | - Roberto Lagalla
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
| | - Massimo Midiri
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
| | - Massimo Galia
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
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Bartolotta TV, Orlando A, Cantisani V, Matranga D, Ienzi R, Cirino A, Amato F, Di Vittorio ML, Midiri M, Lagalla R. Focal breast lesion characterization according to the BI-RADS US lexicon: role of a computer-aided decision-making support. Radiol Med 2018; 123:498-506. [PMID: 29569216 DOI: 10.1007/s11547-018-0874-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 03/13/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Tommaso Vincenzo Bartolotta
- Department of Radiology Di.Bi.MED, Policlinico P. Giaccone-University of Palermo, Via Del Vespro 129, 90127, Palermo, Italy.
| | - Alessia Orlando
- Department of Radiology Di.Bi.MED, Policlinico P. Giaccone-University of Palermo, Via Del Vespro 129, 90127, Palermo, Italy
| | - Vito Cantisani
- Department of Radiology, Oncology, and Anatomy Pathology, Policlinico Umberto-University Sapienza, Rome, Italy
| | - Domenica Matranga
- Department of Sciences for Health Promotion and Mother, Child Care, Policlinico P. Giaccone-University of Palermo, Via Del Vespro 129, 90127, Palermo, Italy
| | - Raffele Ienzi
- Department of Radiology Di.Bi.MED, Policlinico P. Giaccone-University of Palermo, Via Del Vespro 129, 90127, Palermo, Italy
| | - Alessandra Cirino
- Department of Radiology Di.Bi.MED, Policlinico P. Giaccone-University of Palermo, Via Del Vespro 129, 90127, Palermo, Italy
| | - Francesco Amato
- Department of Radiology Di.Bi.MED, Policlinico P. Giaccone-University of Palermo, Via Del Vespro 129, 90127, Palermo, Italy
| | - Maria Laura Di Vittorio
- Department of Radiology Di.Bi.MED, Policlinico P. Giaccone-University of Palermo, Via Del Vespro 129, 90127, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology Di.Bi.MED, Policlinico P. Giaccone-University of Palermo, Via Del Vespro 129, 90127, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology Di.Bi.MED, Policlinico P. Giaccone-University of Palermo, Via Del Vespro 129, 90127, Palermo, Italy
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Galia M, Agnello F, Sparacia G, Matranga D, Albano D, Midiri M, Lagalla R. Evolution of indeterminate hepatocellular nodules at Gd-EOB-DPTA-enhanced MRI in cirrhotic patients. Radiol Med 2018; 123:489-497. [PMID: 29546493 DOI: 10.1007/s11547-018-0873-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/06/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To retrospectively analyze the evolution of indeterminate hepatocellular nodules in cirrhotic patients on serial Gd-EOB-DPTA-enhanced MRI, and to identify predictors of HCC development. MATERIALS AND METHODS This IRB approved study included 33 cirrhotic patients with 69 indeterminate hepatocellular nodules (mean diameter 1.1 cm) at baseline Gd-EOB-DPTA-enhanced MRI and a Gd-EOB-DPTA-enhanced-MRI follow-up of at least 2 years. Two radiologists evaluated size and signal intensity of each nodule at baseline and follow-up. Age, cirrhosis etiology, and HCC history were recorded. Data were compared between nodules that became HCCs at follow-up (HCC) and those that did not (no-HCC). RESULTS On follow-up, 5/69 nodules became HCCs and 64/69 showed indeterminate characteristics. HCC history was more frequently found in HCCs than in no-HCCs. Age, sex, and cirrhosis etiology were not significantly different between HCCs and no-HCCs. HCCs had a significantly greater baseline diameter and increase in size than no-HCCs. Hepatobiliary phase hypointensity was significantly more common in HCCs than in no-HCCs. Multivariate regression analysis showed that increase in size (OR 10.48; sensitivity, 100%; specificity, 81.2%; p < 0.001) and hepatobiliary phase hypointensity (OR 1.02; sensitivity, 100%; specificity, 78.1%; p < 0.001) was associated with HCC development. CONCLUSION Indeterminate hepatocellular nodules at Gd-EOB-DPTA-enhanced MRI in cirrhotic patients rarely became HCCs. Hepatobiliary phase hypointensity had a weak association with HCC development.
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Affiliation(s)
- Massimo Galia
- Department of Radiology, University of Palermo, Via XII Gennaio 1/g, 90141, Palermo, Italy
| | - Francesco Agnello
- Department of Radiology, University of Palermo, Via XII Gennaio 1/g, 90141, Palermo, Italy.
| | - Gianvincenzo Sparacia
- Department of Radiology, University of Palermo, Via XII Gennaio 1/g, 90141, Palermo, Italy
| | - Domenica Matranga
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Domenico Albano
- Department of Radiology, University of Palermo, Via XII Gennaio 1/g, 90141, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology, University of Palermo, Via XII Gennaio 1/g, 90141, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology, University of Palermo, Via XII Gennaio 1/g, 90141, Palermo, Italy
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Galia M, Albano D, Tarella C, Patti C, Sconfienza LM, Mulè A, Alongi P, Midiri M, Lagalla R. Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now. Eur Radiol 2017; 28:1187-1193. [PMID: 29018927 DOI: 10.1007/s00330-017-5071-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 07/26/2017] [Accepted: 09/11/2017] [Indexed: 12/26/2022]
Abstract
ᅟ: The indolent non-Hodgkin lymphomas (i-NHLs) are characterised by 'indolent' clinical behaviour with slow growth and prolonged natural history. The watchful waiting (WW) strategy is a frequently employed treatment option in these patients. This implies a strict monitoring by imaging examinations, including 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) and CT. A major concern is radiation exposure due to regularly monitoring by conventional imaging procedures. Several studies have demonstrated the reliability of whole-body magnetic resonance imaging (WB-MRI) for lymphoma staging. WB-MRI could be useful for active surveillance in i-NHLs providing the suspect of disease progression that can be then confirmed by additional diagnostic procedures, including 18F-FDG-PET/CT. The directive 2013/59 by the European Union claims that if a radiation-free imaging technique allows obtaining the same diagnostic results, it should be invariably used. In this setting, WB-MRI may be considered a reasonable option in i-NHLs under WW, replacing imaging modalities that cause exposure to ionising radiations. This will help to reduce the cancer risk in i-NHL patients for whom chemo-/radiotherapy remain the usual treatment options following the usually long WW phase. The scientific community should raise the awareness of the risk of ionising radiations in i-NHLs and the emphasise the need for establishing the proper place of WB-MRI in lymphoma imaging. KEY POINTS • Watchful waiting is a reasonable option in patients with indolent non-Hodgkin lymphomas. • Imaging is crucial to monitor patients with indolent non-Hodgkin lymphomas. • CT and 18 F-FDG-PET/CT are commonly used, implying a substantial radiation exposure. • WB-MRI is highly reliable in lymphoma staging. • WB-MRI may be considered to monitor indolent non-Hodgkin lymphomas under watchful waiting.
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Affiliation(s)
- Massimo Galia
- Department of Radiology, Di.Bi.Med., University of Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Domenico Albano
- Department of Radiology, Di.Bi.Med., University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
| | - Corrado Tarella
- Hemato-Oncology Division, European Institute of Oncology, Via Giuseppe Ripamonti 435, 20141, Milan, Italy
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Viale Trabucco 180, 90146, Palermo, Italy
| | - Luca Maria Sconfienza
- Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milano, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milano, Italy
| | - Antonino Mulè
- Department of Hematology I, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Viale Trabucco 180, 90146, Palermo, Italy
| | - Pierpaolo Alongi
- Department of Radiological Sciences, Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, Italy
| | - Massimo Midiri
- Department of Radiology, Di.Bi.Med., University of Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology, Di.Bi.Med., University of Palermo, Via del Vespro 127, 90127, Palermo, Italy
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Cicero G, Lo Re G, DE Luca R, Vernuccio F, Picone D, Midiri M, Lagalla R. Role of Densitometric Criteria in Evaluation of Effectiveness of Antiangiogenic Therapies in Metastatic Colorectal Cancer: An Italian Clinical Experience. Anticancer Res 2017; 37:5187-5192. [PMID: 28870953 DOI: 10.21873/anticanres.11941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 06/30/2017] [Accepted: 07/26/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To evaluate the role of densitometric criterion using the Choi Criteria in the assessment of the response to antiangiogenic treatments of metastatic colorectal cancer (mCRC) compared to the RECIST criteria. PATIENTS AND METHODS Fifty-four patients (mean age=50.6 years) affected by advanced colorectal cancer and with hepatic and possibly peritoneal and pulmonary metastases, that can be treated with bevacizumab, were prospectively evaluated by computerized tomography (CT) scan. Metastases were also evaluated by CT in one-dimensional form according to RECIST. RESULTS Results show that in 58% of analyzed cases, stable disease according to RECIST coincided with stable disease according to the CHOI criteria, whereas in 42% of analyzed cases disease progression according to RECIST corresponded to stable disease or even partial response according to CHOI criteria. CONCLUSION By using the densitometric criterion with CHOI criteria, the evaluation of the response to antiangiogenic treatment of mCRC is partially different compared to RECIST criteria.
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Affiliation(s)
- Giuseppe Cicero
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Giuseppe Lo Re
- Department of Radiology, University of Palermo, Palermo, Italy
| | - Rossella DE Luca
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | | | - Dario Picone
- Department of Radiology, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology, University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology, University of Palermo, Palermo, Italy
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Vernuccio F, Picone D, Midiri F, Salerno S, Lagalla R, Lo Re G. MR Imaging of Perianal Crohn Disease: The Role of Contrast-enhanced Sequences. Radiology 2017; 284:921-922. [DOI: 10.1148/radiol.2017170721] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Federica Vernuccio
- University Hospital “Paolo Giaccone,” Section of Radiology, DIBIMED, University of Palermo, Italy
| | - Dario Picone
- University Hospital “Paolo Giaccone,” Section of Radiology, DIBIMED, University of Palermo, Italy
| | - Federico Midiri
- University Hospital “Paolo Giaccone,” Section of Radiology, DIBIMED, University of Palermo, Italy
| | - Sergio Salerno
- University Hospital “Paolo Giaccone,” Section of Radiology, DIBIMED, University of Palermo, Italy
| | - Roberto Lagalla
- University Hospital “Paolo Giaccone,” Section of Radiology, DIBIMED, University of Palermo, Italy
| | - Giuseppe Lo Re
- University Hospital “Paolo Giaccone,” Section of Radiology, DIBIMED, University of Palermo, Italy
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Galia M, Albano D, Bruno A, Agrusa A, Romano G, Di Buono G, Agnello F, Salvaggio G, La Grutta L, Midiri M, Lagalla R. Imaging features of solid renal masses. Br J Radiol 2017; 90:20170077. [PMID: 28590813 DOI: 10.1259/bjr.20170077] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The widespread use of abdominal imaging techniques has increased the detection of solid renal masses over the past years. Imaging plays a crucial role in the management and surveillance and in determining which lesions need treatment. The "classical angiomyolipoma" is the only benign solid renal mass that can be characterized with confidence by imaging through the detection of a fat-containing lesion without calcifications. There is a large overlap of imaging features between benign and malignant renal masses that often makes difficult a correct characterization of these lesions. In this review, we discuss the imaging features of the main solid renal masses that may suggest a likely benign diagnosis.
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Affiliation(s)
- Massimo Galia
- 1 Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Domenico Albano
- 1 Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Alberto Bruno
- 1 Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Antonino Agrusa
- 2 Department of General Surgery and Emergency, University of Palermo, Palermo, Italy
| | - Giorgio Romano
- 2 Department of General Surgery and Emergency, University of Palermo, Palermo, Italy
| | - Giuseppe Di Buono
- 2 Department of General Surgery and Emergency, University of Palermo, Palermo, Italy
| | - Francesco Agnello
- 1 Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Giuseppe Salvaggio
- 1 Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Ludovico La Grutta
- 1 Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- 1 Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- 1 Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
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Di Piazza A, Vernuccio F, Costanzo M, Scopelliti L, Picone D, Midiri F, Salvaggi F, Cupido F, Galia M, Salerno S, Lo Casto A, Midiri M, Lo Re G, Lagalla R. The Videofluorographic Swallowing Study in Rheumatologic Diseases: A Comprehensive Review. Gastroenterol Res Pract 2017; 2017:7659273. [PMID: 28706536 PMCID: PMC5494561 DOI: 10.1155/2017/7659273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 04/11/2017] [Indexed: 02/01/2023] Open
Abstract
Autoimmune connective tissue diseases are a heterogeneous group of pathologies that affect about 10% of world population with chronic evolution in 20%-80%. Inflammation in autoimmune diseases may lead to serious damage to other organs including the gastrointestinal tract. Gastrointestinal tract involvement in these patients may also due to both a direct action of antibodies against organs and pharmacological therapies. Dysphagia is one of the most important symptom, and it is caused by failure of the swallowing function and may lead to aspiration pneumonia, malnutrition, dehydration, weight loss, and airway obstruction. The videofluorographic swallowing study is a key diagnostic tool in the detection of swallowing disorders, allowing to make an early diagnosis and to reduce the risk of gastrointestinal and pulmonary complications. This technique helps to identify both functional and structural anomalies of the anatomic chain involved in swallowing function. The aim of this review is to systematically analyze the basis of the pathological involvement of the swallowing function for each rheumatological disease and to show the main features of the videofluorographic study that may be encountered in these patients.
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Affiliation(s)
- Ambra Di Piazza
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | | | - Massimo Costanzo
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Laura Scopelliti
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Dario Picone
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Federico Midiri
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Francesco Salvaggi
- Unit of Colorectal Surgery, Department of Medical, Surgical, Neurological, Metabolic and Ageing Sciences, Second University of Naples, Naples, Italy
| | - Francesco Cupido
- Department of Surgical, Oncologic and Stomatologic Diseases, University of Palermo, Palermo, Italy
| | - Massimo Galia
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Sergio Salerno
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Antonio Lo Casto
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Giuseppe Lo Re
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Section of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
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Albano D, Sinagra E, Patti C, Narese D, Agrusa A, Di Buono G, Raimondo D, Midiri M, Lagalla R, Galia M. Caecal leiomyoma detected by whole-body MRI in a patient with Hodgkin lymphoma: first case report. G Chir 2017; 38:27-32. [PMID: 28460200 DOI: 10.11138/gchir/2017.38.1.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Hodgkin Lymphoma (HL) is one of the most curable malignant diseases. Modern treatments, like the combined radiochemotherapy and stem cell transplantation, have increased the number of malignant disease survivors. However, HL survivors are at risk of long-term effects, including the development of solid tumors. Secondary neoplasms are a major cause of late morbidity and mortality following treatment for HL. CASE REPORT We report the case of a male patient, treated for HL by chemotherapy, who developed a large leiomyoma of the cecum one year after the treatment. A whole-body Magnetic Resonance (WBMRI) scan performed during the follow-up allowed the detection of this incidental caecal mass that was absent in a Computed Tomography (CT) scan performed immediately after the treatment. After a CT-guided biopsy, the lesion was surgically removed and the diagnosis of caecal leiomyoma was obtained. DISCUSSION To our knowledge, this is the first case report, according to the scientific literature, of caecal leiomyoma developing after chemotherapy in a HL survivor. Leiomyoma is a rare benign tumor that usually appears as a solitary small mass with a nodular growth and a benign course. CONCLUSION This case shows that WB-MRI allows detecting relevant incidental findings during the oncologic follow-up, avoiding both radiation exposure and contrast agent administration. Furthermore, leiomyoma should be considered in the differential diagnosis between the caecal masses with high growth rate.
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Bartolotta TV, Taibbi A, Picone D, Anastasi A, Midiri M, Lagalla R. Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography. Ultrasonography 2017; 36:160-169. [PMID: 28145108 PMCID: PMC5381848 DOI: 10.14366/usg.16041] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 10/29/2016] [Accepted: 11/16/2016] [Indexed: 12/27/2022] Open
Abstract
Purpose The aim of this study is to assess the role of contrast-enhanced ultrasonography (CEUS) in the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale ultrasonography (US). Methods Thirty-seven consecutive cancer patients (24 women and 13 men; age, 33 to 80 years; mean, 58.1 years) with geographic liver fatty deposition, but without any detectable focal liver lesion on greyscale US, underwent sulphur hexafluoride-enhanced US. Two readers reported by consensus the presence, size, and location of any detected lesion. All patients underwent magnetic resonance imaging (MRI) as a confirmatory study. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy were calculated. Results Seven focal liver lesions (size, 4 to 10 mm; mean, 6.1 mm) were detected in 4/37 patients (10.8%): four metastases (size, 5 to 10 mm; mean, 6.7 mm) were detected both by CEUS and MRI, with one hemangioma and two cysts (size range, 4 to 6 mm; mean, 5.3 mm) detected by MRI only. In 1/37 patients (2.7%), CEUS misdiagnosed geographic fatty change as three metastases. In 32/37 patients (86.5%), no lesions were detected. Sensitivity, specificity, PPV, NPV, and accuracy of CEUS were 100% (95% confidence Interval [CI], 1.000 to 1.000), 97.1% (95% CI, 0.914 to 1.027), 75%, 100%, and 97.3%, respectively. No statistically significant differences were found between CEUS and MRI in the detection of focal liver lesions (P=0.480), whereas both of them performed better than baseline US (P<0.001). Conclusion CEUS improves the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale US.
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Affiliation(s)
| | - Adele Taibbi
- Department of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Dario Picone
- Department of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Andrea Anastasi
- Department of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology-Di.Bi.Med., University of Palermo, Palermo, Italy
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Abstract
Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination. Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contrast media, but may characterize MI with overlapping imaging findings due to the similar kinetics and tissue distribution of gadolinium and iodinated contrast media. CCT may detect first-pass perfusion defects, dynamic perfusion after pharmacological stress, and delayed enhancement (DE) of non-viable territories.
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Affiliation(s)
| | - Patrizia Toia
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Erica Maffei
- Department of Radiology, Montreal Heart Institute/Universitè de Montreal, Montreal, Canada
| | - Filippo Cademartiri
- Department of Radiology, Montreal Heart Institute/Universitè de Montreal, Montreal, Canada.,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Roberto Lagalla
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
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Abstract
Lo studio sequenziale dell'afflusso del mezzo di contrasta a carico del parenchima ipofisario è stato di recente valutato da diversi autori, utilizzando apparecchiature operanti a 1,5 T. Tutta-via, con l'eccezione di 3 casi di macroadenoma, non sono state mai valutate le possibili alterazioni di flus-so ghiandolare nelle diverse affezioni interessanti l'ipofisi. Sono stati esaminati 27 volontari non affetti da patologia ipofisaria e 47 pazienti, in età pediatrica o adulti, affetti da alterazioni ipofisarie su base congenita o acquisita. I pazienti sono stati valutati mediante apparecchiatura operante a medio campo, compa-rando i risultati, ottenuti in tempi diversi, di una valutazione ipofisaria standard versus un esame di tipo sequenziale. Il nostro studio ha dimostrato un modello di accentuazione delle differenti componenti ghiandolari perfettamente corrispondente all'organizzazione microvascolare della ghiandola stessa, con un incremen-to dell'intensità di segnale apprezzabile prima a livello neuroipofisario, poi a carico del peduncolo e della parte prossimale dell'adenoipofisi, ed infine a carico della pars distalis adenoipofisaria. I microadenomi hanno dimostrato un modello di accentuazione di tipo <arterioso>, in rapporto alla neoangiogenesi esi-stente. I macroadenomi hanno dimostrato un modello differente, nelle aree esaminate, in dipendenza del-l'estensione. Nessuna alterazione è stata riscontrata nei pazienti affetti da sella vuota parziale. I pazienti affetti da deficit di ormone della crescita hanno dimostrato una riduzione del potenziamento del peduncolo ipofisario, in possibile relazione a danno del sistema vascolare portale.
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Affiliation(s)
| | - F. Rosato
- Istituto di Endocrinologia, Istituto Radiologia «P. Cignolini» Università di Palermo
| | | | | | | | - A. Janni
- Istituto di Endocrinologia, Istituto Radiologia «P. Cignolini» Università di Palermo
| | - R. Lagalla
- Istituto di Endocrinologia, Istituto Radiologia «P. Cignolini» Università di Palermo
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Abstract
Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in sonography, and it is being increasingly used for the evaluation of focal liver lesions (FLLs). Currently, CEUS is included as a part of the suggested diagnostic workup of FLLs, resulting in a better patient management and delivering cost-effective therapy. After a brief technical note, contrast-enhancement patterns of different types of benign and malignant FLLs, along with hepatic pseudolesions, are described and discussed based on our experience and literature data. At the same time, the most recent concepts and the use of CEUS in different clinical settings are presented.
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Affiliation(s)
| | - Federica Vernuccio
- Section of Radiology, DIBIMED, University Hospital "Paolo Giaccone", Palermo, Italy
| | - Adele Taibbi
- Section of Radiology, DIBIMED, University Hospital "Paolo Giaccone", Palermo, Italy
| | - Roberto Lagalla
- Section of Radiology, DIBIMED, University Hospital "Paolo Giaccone", Palermo, Italy
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43
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Albano D, Patti C, Lagalla R, Midiri M, Galia M. Whole-body MRI, FDG-PET/CT, and bone marrow biopsy, for the assessment of bone marrow involvement in patients with newly diagnosed lymphoma. J Magn Reson Imaging 2016; 45:1082-1089. [PMID: 27603267 DOI: 10.1002/jmri.25439] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/08/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To compare whole-body MRI (WB-MRI) with diffusion-weighted imaging (DWI), FDG-PET/CT, and bone marrow biopsy (BMB), for the evaluation of bone marrow involvement (BMI) in patients with newly diagnosed lymphoma. MATERIALS AND METHODS This retrospective study was approved by our Institutional Review Board. Two independent radiologists and one nuclear medicine specialist reviewed all WB-MRI and FDG-PET/CT scans prospectively performed on 104 patients with newly diagnosed lymphoma (53 males; 47 Hodgkin; mean age: 44 years; range, 15-86 years) between 2013 and 2015. The delay between imaging scans and BMBs was up to 10 days. The diagnostic accuracy of WB-MRI (1.5 Tesla MR scanner, with T1w, T2w-STIR, and DWI sequences) was evaluated using BMB and FDG-PET/CT as the reference standard. We applied Cohen's kappa coefficient to assess the inter-observer agreement in WB-MRI interpretation and to compare WB-MRI, FDG-PET/CT and BMB. The Student's t test was done to compare pelvic marrow ADC values of patients with positive and negative BMB. A P-value of < 0.01 was considered significant. RESULTS Inter-observer agreement was excellent (k = 0.937). Agreement between WB-MRI and FDG-PET/CT was excellent, with a k = 0.935. Agreement between WB-MRI and BMB was moderate (k = 0.489), and fair between FDG-PET/CT and BMB (k = 0.370). WB-MRI and FDG-PET/CT were falsely negative in four indolent non-Hodgkin lymphomas with BMI < 30% of marrow cellularity. Conversely, WB-MRI and FDG-PET/CT detected all cases with a BMI>30% of marrow cellularity. Mean ADC values in patients with positive and negative BMB were not significantly different (P = 0.049). CONCLUSION WB-MRI and FDG-PET/CT are valuable tools for the assessment of BMI. LEVEL OF EVIDENCE 3 J. Magn. Reson. Imaging 2017;45:1082-1089.
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Affiliation(s)
- Domenico Albano
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Massimo Galia
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
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44
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Cardinale A, Lagalla R, de Maria M, Valentino B, Cabibi D, Laconi A. Biologic Effects of Ultrasound on Liver Cells of Rat Embryos. Acta Radiol 2016. [DOI: 10.1177/028418518702800218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Experiments on the biologic effects of ultrasound (US) were carried out on rat embryos exposed for 120 s to a US beam showing features similar to those already employed for diagnostic purposes. Electron microscopic investigation of the liver parenchyma of rat embryos confirmed results obtained from adult guinea pigs with the same duration of exposure, i.e. diffuse vacuolization of cytoplasma and varying degrees of mitochondrial damage.
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45
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Dioguardi Burgio M, Picone D, Cabibbo G, Midiri M, Lagalla R, Brancatelli G. MR-imaging features of hepatocellular carcinoma capsule appearance in cirrhotic liver: comparison of gadoxetic acid and gadobenate dimeglumine. Abdom Radiol (NY) 2016; 41:1546-54. [PMID: 27052455 DOI: 10.1007/s00261-016-0726-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE The purpose of the study is to compare the MR-imaging features of hepatocellular carcinoma (HCC) capsule appearance on gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging, using imaging-based presumptive diagnosis of HCC as the reference standard. METHODS Gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging of 51 patients with 71 HCCs were retrospectively reviewed. Three readers graded in consensus, using a five-point scale, the presence (score 4-5) of capsule appearance on images obtained during T1-weighted GRE portal venous phase (PVP), 3-min phase, and hepatobiliary phase (HBP). The Fisher's exact test and the t student unpaired test were performed. RESULTS A hyperintense capsule appearance was present either on PVP or 3-min phase in 11/46 and in 24/25 HCCs imaged with gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging, respectively (24% vs. 96% p < 0.001). A hypointense capsule appearance was present on HBP in 8/46 and 0/22 HCCs evaluated with gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging, respectively (17% vs. 0% p = 0.046). A capsule appearance was detected either on PVP, 3-min phase, or HBP in 17/46 (37%) HCCs after gadoxetic acid injection and in 24/25 (96%) HCCs after gadobenate dimeglumine injection (p < 0.001). CONCLUSIONS A capsule appearance was more frequently seen on gadobenate dimeglumine-enhanced MR imaging when compared to gadoxetic acid-enhanced MR imaging.
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Affiliation(s)
- Marco Dioguardi Burgio
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies DiBiMed, University of Palermo, Palermo, Italy.
| | - Dario Picone
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies DiBiMed, University of Palermo, Palermo, Italy
| | - Giuseppe Cabibbo
- Section of Gastroenterology, Biomedical Department of Internal Medicine and Specialties DiBiMIS, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies DiBiMed, University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies DiBiMed, University of Palermo, Palermo, Italy
| | - Giuseppe Brancatelli
- Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies DiBiMed, University of Palermo, Palermo, Italy
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46
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Vernuccio F, Taibbi A, Picone D, LA Grutta L, Midiri M, Lagalla R, Lo Re G, Bartolotta TV. Imaging of Gastrointestinal Stromal Tumors: From Diagnosis to Evaluation of Therapeutic Response. Anticancer Res 2016; 36:2639-2648. [PMID: 27272772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 04/27/2016] [Indexed: 06/06/2023]
Abstract
Once considered an obscure tumor entity with poor prognosis, gastrointestinal stromal tumors (GISTs) are nowadays recognized as the most common mesenchymal tumors of the alimentary tract. GISTs differ from other mesenchymal neoplasms at pathology since 90% of them exhibit strong immunohistochemical staining for KIT, a tyrosinase kinase growth factor receptor. In the early 2000s, the ability of imatinib mesylate, a tyrosine kinase inhibitor, to inhibit KIT established a new paradigm for cancer treatment. A reduction in lesion size may not be observed or may appear many months after therapy; thus, tumor response criteria alternative to the Response Evaluation Criteria in Solid Tumors were developed. This review highlights the role of imaging in the detection, characterization, preoperative staging, postoperative assessment, therapy-response evaluation and treatment-related toxicities. All this information is crucial in optimizing patient management. Contrast-enhanced computed tomography is the most commonly used modality for staging the disease and assessing treatment response, whereas positron-emission tomography adds valuable functional information. Magnetic resonance imaging (MRI) may also be useful, especially in ano-rectal GISTs. Diffusion-weighted MRI may provide promising indicators of tumor response to targeted molecular therapy. Radiologists and oncologists should be aware of all these issues related to GISTs, since multidisciplinary teams gathering different expertise are usually needed to properly treat patients with GISTs.
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Affiliation(s)
| | - Adele Taibbi
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Dario Picone
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | | | - Massimo Midiri
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Roberto Lagalla
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Giuseppe Lo Re
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
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47
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Dioguardi Burgio M, Bruno O, Agnello F, Torrisi C, Vernuccio F, Cabibbo G, Soresi M, Petta S, Calamia M, Papia G, Gambino A, Ricceri V, Midiri M, Lagalla R, Brancatelli G. The cheating liver: imaging of focal steatosis and fatty sparing. Expert Rev Gastroenterol Hepatol 2016; 10:671-8. [PMID: 27027652 DOI: 10.1586/17474124.2016.1169919] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Focal steatosis and fatty sparing are a frequent finding in liver imaging, and can mimic solid lesions. Liver regional variations in the degree of fat accumulation can be related to vascular anomalies, metabolic disorders, use of certain drugs or coexistence of hepatic masses. CT and MRI are the modalities of choice for the noninvasive diagnosis of hepatic steatosis. Knowledge of CT and MRI appearance of focal steatosis and fatty sparing is crucial for an accurate diagnosis, and to rule-out other pathologic processes. This paper will review the CT and MRI techniques for the diagnosis of hepatic steatosis and the CT and MRI features of common and uncommon causes of focal steatosis and fatty sparing.
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Affiliation(s)
| | - Onorina Bruno
- b Department of Radiology , Hospital Beaujon , Clichy , France
| | - Francesco Agnello
- a Section of Radiology, Di.Bi.Med. , University of Palermo , Palermo , Italy
| | - Chiara Torrisi
- a Section of Radiology, Di.Bi.Med. , University of Palermo , Palermo , Italy
| | - Federica Vernuccio
- a Section of Radiology, Di.Bi.Med. , University of Palermo , Palermo , Italy
| | - Giuseppe Cabibbo
- c Section of Gastroenterology, Di.Bi.M.I.S ., University of Palermo , Palermo , Italy
| | - Maurizio Soresi
- d Unit of Internal Medicine, Di.Bi.M.I.S ., University of Palermo , Palermo , Italy
| | - Salvatore Petta
- c Section of Gastroenterology, Di.Bi.M.I.S ., University of Palermo , Palermo , Italy
| | - Mauro Calamia
- a Section of Radiology, Di.Bi.Med. , University of Palermo , Palermo , Italy
| | - Giovanni Papia
- a Section of Radiology, Di.Bi.Med. , University of Palermo , Palermo , Italy
| | - Angelo Gambino
- a Section of Radiology, Di.Bi.Med. , University of Palermo , Palermo , Italy
| | - Viola Ricceri
- a Section of Radiology, Di.Bi.Med. , University of Palermo , Palermo , Italy
| | - Massimo Midiri
- a Section of Radiology, Di.Bi.Med. , University of Palermo , Palermo , Italy
| | - Roberto Lagalla
- a Section of Radiology, Di.Bi.Med. , University of Palermo , Palermo , Italy
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48
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Galia M, Agnello F, La Grutta L, Lo Re G, Cabibbo G, Grassedonio E, Gioia BG, Sparacia G, Lo Casto A, Lagalla R, Midiri M. Computed tomography of bowel obstruction: tricks of the trade. Expert Rev Gastroenterol Hepatol 2016; 9:1115-25. [PMID: 26092117 DOI: 10.1586/17474124.2015.1051030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Bowel obstruction (BO) is a frequent cause of hospitalization and surgical consultation for acute abdominal pain. It is usually suspected at physical examination, but clinical and laboratory data are often nonspecific. Thus, computed tomography plays a crucial role in a correct diagnosis of BO. Indeed, computed tomography can confirm a diagnosis of BO, and identify the location and cause of the obstruction. In this review, the computed tomography appearances of common and uncommon causes of BO and pseudo-obstruction are reviewed.
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Affiliation(s)
- Massimo Galia
- Section of Radiological Sciences, DIBIMED, University of Palermo, 90127 Palermo, Italy
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49
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Agnello F, Dioguardi Burgio M, Picone D, Vernuccio F, Cabibbo G, Giannitrapani L, Taibbi A, Agrusa A, Bartolotta TV, Galia M, Lagalla R, Midiri M, Brancatelli G. Magnetic resonance imaging of the cirrhotic liver in the era of gadoxetic acid. World J Gastroenterol 2016; 22:103-111. [PMID: 26755863 PMCID: PMC4698478 DOI: 10.3748/wjg.v22.i1.103] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 07/22/2015] [Accepted: 09/30/2015] [Indexed: 02/06/2023] Open
Abstract
Gadoxetic acid improves detection and characterization of focal liver lesions in cirrhotic patients and can estimate liver function in patients undergoing liver resection. The purpose of this article is to describe the optimal gadoxetic acid study protocol for the liver, the unique characteristics of gadoxetic acid, the differences between gadoxetic acid and extra-cellular gadolium chelates, and the differences in phases of enhancement between cirrhotic and normal liver using gadoxetic acid. We also discuss how to obtain and recognize an adequate hepatobiliary phase.
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50
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Albano D, Patti C, La Grutta L, Agnello F, Grassedonio E, Mulè A, Cannizzaro G, Ficola U, Lagalla R, Midiri M, Galia M. Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas. Eur J Radiol 2015; 85:313-8. [PMID: 26781135 DOI: 10.1016/j.ejrad.2015.12.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 10/12/2015] [Accepted: 12/10/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To compare whole body-MRI (WB-MRI) with diffusion-weighted imaging and FDG-PET/CT in staging newly diagnosed FDG-avid lymphomas. METHODS 68 patients (37 males, 31 females; median age 42 years; range 15-86 years) with histologically confirmed lymphoma (37 Classical Hodgkin, 16 Diffuse large B-cell, 10 Follicular, 5 Mantle cell) underwent both MRI and FDG-PET/CT before treatment. Ann Arbor stages obtained with WB-MRI and FDG-PET/CT were compared using Cohen's k statistics. Moreover WB-MRI and FDG-PET/CT stages were compared with the pathological stages obtained after the diagnostic iter using also bone marrow and available biopsies if clinically indicated. RESULTS The agreement between WB-MRI and FDG-PET/CT was excellent. WB-MRI stage was equal to those of FDG-PET/CT in 62/68 patients (91.2%). There was an excellent agreement between WB-MRI stage and pathological stage (63/68 patients; 92.6%), and between FDG-PET/CT and pathological stage (64/68 patients; 94.1%). The differences between the stages were more frequent in the patients with Mantle cell lymphoma. CONCLUSIONS WB-MRI can be considered as a promising technique for FDG-avid lymphoma staging.
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Affiliation(s)
- Domenico Albano
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy.
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Strasburgo 233, Palermo 90146, Italy
| | - Ludovico La Grutta
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Francesco Agnello
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Emanuele Grassedonio
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Antonino Mulè
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Strasburgo 233, Palermo 90146, Italy
| | - Giorgio Cannizzaro
- Department of Nuclear Medicine, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Strasburgo 233, Palermo 90146, Italy
| | - Umberto Ficola
- Department of Nuclear Medicine, La Maddalena Hospital, Via San Lorenzo Colli 312/d, Palermo 90146, Italy
| | - Roberto Lagalla
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Massimo Midiri
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Massimo Galia
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
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