1
|
Pellegrino G, Triggiani S, Desiderio E, Carrafiello G. Obesity in medical imaging: pitfalls and challenges. Minerva Med 2024; 115:1-3. [PMID: 38126795 DOI: 10.23736/s0026-4806.23.09074-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- Giuseppe Pellegrino
- Postgraduate School of Radiodiagnostics, University of Milan, Milan, Italy -
| | - Sonia Triggiani
- Postgraduate School of Radiodiagnostics, University of Milan, Milan, Italy
| | - Elio Desiderio
- Faculty of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gianpaolo Carrafiello
- Unit of Diagnostic and Interventional Radiology, Department of Radiology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda, Milan, Italy
- Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
| |
Collapse
|
2
|
Trovato P, Simonetti I, Morrone A, Fusco R, Setola SV, Giacobbe G, Brunese MC, Pecchi A, Triggiani S, Pellegrino G, Petralia G, Sica G, Petrillo A, Granata V. Scientific Status Quo of Small Renal Lesions: Diagnostic Assessment and Radiomics. J Clin Med 2024; 13:547. [PMID: 38256682 PMCID: PMC10816509 DOI: 10.3390/jcm13020547] [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: 11/01/2023] [Revised: 01/05/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Background: Small renal masses (SRMs) are defined as contrast-enhanced renal lesions less than or equal to 4 cm in maximal diameter, which can be compatible with stage T1a renal cell carcinomas (RCCs). Currently, 50-61% of all renal tumors are found incidentally. Methods: The characteristics of the lesion influence the choice of the type of management, which include several methods SRM of management, including nephrectomy, partial nephrectomy, ablation, observation, and also stereotactic body radiotherapy. Typical imaging methods available for differentiating benign from malignant renal lesions include ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), and magnetic resonance imaging (MRI). Results: Although ultrasound is the first imaging technique used to detect small renal lesions, it has several limitations. CT is the main and most widely used imaging technique for SRM characterization. The main advantages of MRI compared to CT are the better contrast resolution and tissue characterization, the use of functional imaging sequences, the possibility of performing the examination in patients allergic to iodine-containing contrast medium, and the absence of exposure to ionizing radiation. For a correct evaluation during imaging follow-up, it is necessary to use a reliable method for the assessment of renal lesions, represented by the Bosniak classification system. This classification was initially developed based on contrast-enhanced CT imaging findings, and the 2019 revision proposed the inclusion of MRI features; however, the latest classification has not yet received widespread validation. Conclusions: The use of radiomics in the evaluation of renal masses is an emerging and increasingly central field with several applications such as characterizing renal masses, distinguishing RCC subtypes, monitoring response to targeted therapeutic agents, and prognosis in a metastatic context.
Collapse
Affiliation(s)
- Piero Trovato
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (P.T.); (I.S.); (S.V.S.); (A.P.); (V.G.)
| | - Igino Simonetti
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (P.T.); (I.S.); (S.V.S.); (A.P.); (V.G.)
| | - Alessio Morrone
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122 Milan, Italy
| | - Sergio Venanzio Setola
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (P.T.); (I.S.); (S.V.S.); (A.P.); (V.G.)
| | - Giuliana Giacobbe
- General and Emergency Radiology Department, “Antonio Cardarelli” Hospital, 80131 Naples, Italy;
| | - Maria Chiara Brunese
- Diagnostic Imaging Section, Department of Medical and Surgical Sciences & Neurosciences, University of Molise, 86100 Campobasso, Italy;
| | - Annarita Pecchi
- Department of Radiology, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Sonia Triggiani
- Postgraduate School of Radiodiagnostics, University of Milan, 20122 Milan, Italy; (S.T.); (G.P.)
| | - Giuseppe Pellegrino
- Postgraduate School of Radiodiagnostics, University of Milan, 20122 Milan, Italy; (S.T.); (G.P.)
| | - Giuseppe Petralia
- Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy;
| | - Giacomo Sica
- Radiology Unit, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy;
| | - Antonella Petrillo
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (P.T.); (I.S.); (S.V.S.); (A.P.); (V.G.)
| | - Vincenza Granata
- Radiology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (P.T.); (I.S.); (S.V.S.); (A.P.); (V.G.)
| |
Collapse
|
3
|
Triggiani S, Contaldo MT, Mastellone G, Cè M, Ierardi AM, Carrafiello G, Cellina M. The Role of Artificial Intelligence and Texture Analysis in Interventional Radiological Treatments of Liver Masses: A Narrative Review. Crit Rev Oncog 2024; 29:37-52. [PMID: 38505880 DOI: 10.1615/critrevoncog.2023049855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Liver lesions, including both benign and malignant tumors, pose significant challenges in interventional radiological treatment planning and prognostication. The emerging field of artificial intelligence (AI) and its integration with texture analysis techniques have shown promising potential in predicting treatment outcomes, enhancing precision, and aiding clinical decision-making. This comprehensive review aims to summarize the current state-of-the-art research on the application of AI and texture analysis in determining treatment response, recurrence rates, and overall survival outcomes for patients undergoing interventional radiological treatment for liver lesions. Furthermore, the review addresses the challenges associated with the implementation of AI and texture analysis in clinical practice, including data acquisition, standardization of imaging protocols, and model validation. Future directions and potential advancements in this field are discussed. Integration of multi-modal imaging data, incorporation of genomics and clinical data, and the development of predictive models with enhanced interpretability are proposed as potential avenues for further research. In conclusion, the application of AI and texture analysis in predicting outcomes of interventional radiological treatment for liver lesions shows great promise in augmenting clinical decision-making and improving patient care. By leveraging these technologies, clinicians can potentially enhance treatment planning, optimize intervention strategies, and ultimately improve patient outcomes in the management of liver lesions.
Collapse
Affiliation(s)
- Sonia Triggiani
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Maria T Contaldo
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy
| | - Giulia Mastellone
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy
| | - Maurizio Cè
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Anna M Ierardi
- Radiology Department, Fondazione IRCCS Cà Granda, Policlinico di Milano Ospedale Maggiore, 20122 Milan, Italy
| | - Gianpaolo Carrafiello
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy; Radiology Department, Fondazione IRCCS Cà Granda, Policlinico di Milano Ospedale Maggiore, Università di Milano, 20122 Milan, Italy
| | - Michaela Cellina
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, Milano, Piazza Principessa Clotilde 3, 20121, Milan, Italy
| |
Collapse
|
4
|
Biondetti P, Lanza C, Carriero S, Arrigoni F, Bevilacqua M, Ruffino A, Triggiani S, Sorce A, Coppola A, Ierardi AM, Venturini M, Guzzardi G, Carrafiello G. Efficacy and Safety of Transarterial Chemoembolization with DC Beads LUMI in the Treatment of HCC: Experience from a Tertiary Centre. Technol Cancer Res Treat 2023; 22:15330338231184840. [PMID: 37592839 PMCID: PMC10467377 DOI: 10.1177/15330338231184840] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 02/09/2023] [Accepted: 06/07/2023] [Indexed: 08/19/2023] Open
Abstract
PURPOSE The aim of this study was to describe the safety and efficacy profiles of TACE using DC Beads LUMI. MATERIALS AND METHODS We retrospectively analyzed 90 patients with HCC who underwent TACE with DC Bead LUMI™ between November 2018 and November 2020 at Fondazione IRCCS Cà Granda Policlinico Hospital in Milan, Italy. Patient- and tumour-related factors were registered, including the number of treated lesions, dose of DC Beads LUMI™, dose of Epirubicin, DC Beads LUMI™ target tumour coverage (LC) according to the percentage of target nodule involvement (LC1-0%-25%, LC2-25%-50%, LC3-50%-75%, LC4 75%-100%). Treatment efficacy was obtained through reviewing the follow-up imaging for evidence of response in target lesion(s), according to modified response criteria in solid tumours (mRECIST) criteria with the following outcomes: complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Safety assessment was based on the quantitative and qualitative recording of the adverse events, classified according to CIRSE classification. RESULTS Seventy-two patients were enrolled, and 95 procedures were carried out. We observed a target tumour response rate at 1 month with CR in 68%, PR in 10.3% 11.8%, SD in 13%, PD in 7.2%, and an overall tumour(s) (whole liver) response at 1 month with CR in 58.9%, PR in 12.6%, SD in 10.5% and PD in 18%. We found a significant association (p < 0.01) between tumour response CR or CR + PR and the number of the target lesion(s). CIRSE classification grade I and grade II complications were recorded, respectively, in 11 (11.6%) and 6 (6.3%) procedures. No grade III-IV-V complications occurred. CONCLUSION TACE using DC Beads LUMI is a safe and effective treatment option for patients with HCC.
Collapse
Affiliation(s)
- Pierpaolo Biondetti
- Diagnostic and Interventional Radiology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
- Department of Health Science, Università degli Studi di Milano, Milano, Italy
| | - Carolina Lanza
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Serena Carriero
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Francesca Arrigoni
- Department of Health Science, Università degli Studi di Milano, Milano, Italy
| | - Margherita Bevilacqua
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Aurora Ruffino
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Sonia Triggiani
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Adriana Sorce
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Andrea Coppola
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, Varese, Italy
| | - Anna Maria Ierardi
- Diagnostic and Interventional Radiology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Massimo Venturini
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, Varese, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giuseppe Guzzardi
- Department of Diagnosis and Treatment Services, Radiodiagnostics, “Maggiore della carità” Hospital, University of Piemonte Orientale (UPO), Novara, Italy
| | - Gianpaolo Carrafiello
- Diagnostic and Interventional Radiology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
- Department of Health Science, Università degli Studi di Milano, Milano, Italy
| |
Collapse
|
5
|
D'Ambrosio R, De Rosa G, Peppas C, Vincenti B, Martino A, De Cicco A, Leone L, Triggiani S. [Strangulated laparoceles. Our experience]. MINERVA CHIR 1994; 49:1281-8. [PMID: 7746449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The authors present their own experience of emergency in strangulated laparoceles. Between January 1984 and June 1992 they treated at the Division of Emergency Surgery of the Hospital "A. Cardarelli" in Naples 133 cases of laparocele, 63 of which were strangulated. 48 of the 63 cases were treated by simply vertical or transversal laparoplasty ("waistcoat"); in 4 cases a direct plastic surgery; was executed in 11 cases a synthetic patch was used: in 2 cases a Teflon prosthesis was used; in one case a double prosthesis: a reabsorbable Vicryl patch internally and an external Marlex reticulated; in 8 cases a Marlex prosthesis. Moreover in most cases, before the laparoplasty of the abdominal wall operations of viscerolysis, were carried out intestinal and/or epiploon resection because of ischemia, colostomy, a Hartmann (one case). Of the 11 patients treated with synthetic patches, only 4 presented local complications: a seroma, two suppurations of the wound and a skin necrosis. These complications were treated with a medical therapy. In no case it was necessary to remove the prosthesis, as there were no general complications or deaths. We have to underline that notwithstanding the great advances both in surgery and in prosthesis' materials, the problem of the strangulated laparocele still represent a great engagement for the surgeon. The main reasons are: concomitant pathologies ("eventration disease"') and complications. The complications may be local (infection of the wound) or general (cardiocirculatory and respiratory problems due the viscus reduction in the original abdominal cavity).(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- R D'Ambrosio
- Dipartimento di Emergenze, USL 40 Napoli, Ospedale A. Cardarelli
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Triggiani E, Liguori G, Sammarco G, Aloi V, Cavalcanti BS, Cristofaro MG, Triggiani S, Vescio G. [Carcinoma of the gastroesophageal junction. General principles of surgical therapy]. MINERVA CHIR 1990; 45:561-4. [PMID: 2388725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
On the basis of histo-pathological examinations of postoperative samples following gastrectomy for adenocarcinomas of the esophageal gastric junction, the usefulness of the abdominal approach for this kind of surgical treatment is questioned. Assessment is expressed with other authors about the need for an anatomo-surgical classification of the cardial region, and the need to standardise the different surgical approaches in relation to exeresis location and extent as well as for reconstructive procedures is stressed.
Collapse
Affiliation(s)
- E Triggiani
- Università degli Studi di Reggio Calabria, Facoltà di Medicina e Chirurgia, Sede Catanzaro
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Liguori G, Sammarco G, Aloi V, Cavalcanti BS, Peluso E, Triggiani S, Tomasello C, Vescio G, Triggiani E. [The use of Mersilene mesh in the treatment of giant laparoceles]. MINERVA CHIR 1990; 45:571-6. [PMID: 2388726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The paper reports on experience with the use of Mersilene mesh in 6 patients with giant laparoceles. Besides being physiologically compatible, Mersilene mesh is recommended when traditional techniques fail. The Rives technique was used, placing the prostheses between the posterior sheath and the rectus muscle; in one case it was inserted under the peritoneum. A good local and general preparation for the operation is recommended. Even though the introduction of prosthetic materials into the body is not always non-injurious, the use of Mersilene mesh is advised because of its easy positioning and the low incidence of complications.
Collapse
Affiliation(s)
- G Liguori
- Università degli Studi di Reggio Calabria, Facoltà di Medicina e Chirurgia, Sede Catanzaro
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Sammarco G, Iaccarino V, Liguori G, Aloi V, Cavalcanti BS, Cristofaro MG, Triggiani S, Paletta V, Tomasello C, Vescio G. [Fistula following emergency total colectomy: an efficient method of treatment]. MINERVA CHIR 1990; 45:599-602. [PMID: 2388727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A personal case of enterocutaneous fistula secondary to total emergency colectomy is reported with particular emphasis on an effective form of radiological management, based on the percutaneous sclerosing of the fistulous tract using absolute ethanol and a hyperosmotic contrast medium (Angioconray 80%). By this approach a rapid closure of the fistulous tract was obtained. Moreover the procedure was easy to perform, well tolerated by the patient and devoid of untoward side effects.
Collapse
Affiliation(s)
- G Sammarco
- Università degli Studi di Reggio Calabria, Facoltà di Medicina e Chirurgia, Sede di Catanzaro
| | | | | | | | | | | | | | | | | | | |
Collapse
|