1
|
De Muzio F, Fusco R, Simonetti I, Grassi F, Grassi R, Brunese MC, Ravo L, Maggialetti N, D'Aniello R, Greco F, Gabelloni M, Granata V. Functional assessment in endometrial and cervical cancer: diffusion and perfusion, two captivating tools for radiologists. Eur Rev Med Pharmacol Sci 2023; 27:7793-7810. [PMID: 37667957 DOI: 10.26355/eurrev_202308_33435] [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] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Uterine cervical and endometrial cancers are two major gynecological malignancies, affecting women's health worldwide. Magnetic resonance imaging (MRI) is appropriate for evaluating malignant disease, thanks to the excellent soft tissue contrast and multiplanar imaging ability. Recently, functional MR techniques, namely diffusion-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE), have proved to be a precious support not only in cancer diagnosis but also in disease staging, in the therapy planning, in monitoring response to treatment and during long-term recurrence surveillance. In the field of gynecologic oncology, the European Society of Urogenital Radiology (ESUR) recommends DWI and dynamic contrast-enhanced imaging (DCE-MRI) for local staging of endometrial and cervical cancer, but the potential application of functional imaging in all different aspects of patient management seems very promising. The aim of this article is to summarize the existing literature, providing a comprehensive update on the role of functional MRI in endometrial and cervical cancer.
Collapse
Affiliation(s)
- F De Muzio
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Reginelli A, Russo A, Berritto D, Patane V, Cantisani C, Grassi R. Ultra-High-Frequency Ultrasound: A Modern Diagnostic Technique for Studying Melanoma. Ultraschall Med 2023; 44:360-378. [PMID: 37068509 DOI: 10.1055/a-2028-6182] [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] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The development of new ultra-high-frequency devices with a resolution of 30 μm makes it possible to use ultrasound in the study of new small anatomical units and to apply this tool to new fields of pathology. Cutaneous melanoma is a severe skin disease with an incidence of approximately 160 000 new cases each year and 48 000 deaths. In this paper, we evaluate the role of HFUS in the diagnosis of cutaneous melanoma, describe the sonographic appearance of skin layers in the pre-excision phase as well as of lesion features, and correlate the characteristics with pathological examination.
Collapse
Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| | - Anna Russo
- Department of Radiology, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| | - Daniela Berritto
- Department of Clinical and Experimental Medicine, Foggia University Hospital, Foggia, Italy
| | - Vittorio Patane
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| | | | - Roberto Grassi
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| |
Collapse
|
3
|
Franco D, Granata V, Fusco R, Grassi R, Nardone V, Lombardi L, Cappabianca S, Conforti R, Briganti F, Grassi R, Caranci F. Artificial intelligence and radiation effects on brain tissue in glioblastoma patient: preliminary data using a quantitative tool. Radiol Med 2023:10.1007/s11547-023-01655-0. [PMID: 37289266 DOI: 10.1007/s11547-023-01655-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE The quantification of radiotherapy (RT)-induced functional and morphological brain alterations is fundamental to guide therapeutic decisions in patients with brain tumors. The magnetic resonance imaging (MRI) allows to define structural RT-brain changes, but it is unable to evaluate early injuries and to objectively quantify the volume tissue loss. Artificial intelligence (AI) tools extract accurate measurements that permit an objective brain different region quantification. In this study, we assessed the consistency between an AI software (Quibim Precision® 2.9) and qualitative neruroradiologist evaluation, and its ability to quantify the brain tissue changes during RT treatment in patients with glioblastoma multiforme (GBM). METHODS GBM patients treated with RT and subjected to MRI assessment were enrolled. Each patient, pre- and post-RT, undergoes to a qualitative evaluation with global cerebral atrophy (GCA) and medial temporal lobe atrophy (MTA) and a quantitative assessment with Quibim Brain screening and hippocampal atrophy and asymmetry modules on 19 extracted brain structures features. RESULTS A statistically significant strong negative association between the percentage value of the left temporal lobe and the GCA score and the left temporal lobe and the MTA score was found, while a moderate negative association between the percentage value of the right hippocampus and the GCA score and the right hippocampus and the MTA score was assessed. A statistically significant strong positive association between the CSF percentage value and the GCA score and a moderate positive association between the CSF percentage value and the MTA score was found. Finally, quantitative feature values showed that the percentage value of the cerebro-spinal fluid (CSF) statistically differences between pre- and post-RT. CONCLUSIONS AI tools can support a correct evaluation of RT-induced brain injuries, allowing an objective and earlier assessment of the brain tissue modifications.
Collapse
Affiliation(s)
- Donatella Franco
- Division of Radiology, Department of Precision Medicine, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Vincenza Granata
- Division of Radiology, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
| | - Roberta Fusco
- Research & Development and Medical Oncology Division, Igea SpA, Naples, Italy
| | - Roberta Grassi
- Division of Radiology, Department of Precision Medicine, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy
| | - Valerio Nardone
- Division of Radiology, Department of Precision Medicine, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Laura Lombardi
- Division of Radiology, Department of Precision Medicine, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Salvatore Cappabianca
- Division of Radiology, Department of Precision Medicine, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Renata Conforti
- Division of Radiology, Department of Precision Medicine, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Francesco Briganti
- Advanced Biomedical Sciences Department, Federico II University, Naples, Italy
| | - Roberto Grassi
- Division of Radiology, Department of Precision Medicine, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Ferdinando Caranci
- Division of Radiology, Department of Precision Medicine, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
4
|
Ciardiello D, Del Tufo S, Parente P, Gravina AG, Selvaggi F, Panarese I, Franco R, Caterino M, Martini G, Ciardiello F, Grassi R, Cappabianca S, Reginelli A, Martinelli E. Case report of unusual synchronous anal and rectal squamous cell carcinoma: clinical and therapeutic lesson. Front Oncol 2023; 13:1187623. [PMID: 37361596 PMCID: PMC10285495 DOI: 10.3389/fonc.2023.1187623] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Synchronous tumors of the rectum and anus are sporadic. Most cases in the literature are rectal adenocarcinomas with concomitant anal squamous cell carcinoma. To date, only two cases of concomitant squamous cell carcinomas of the rectum and anus are reported, and both were treated with up-front surgery and received abdominoperineal resection with colostomy. Here, we report the first case in the literature of a patient with synchronous HPV-positive squamous cell carcinoma of the rectum and anus treated with definitive chemoradiotherapy with curative intent. The clinical-radiological evaluation demonstrated complete tumor regression. After 2 years of follow-up, no evidence of recurrence was observed.
Collapse
Affiliation(s)
- Davide Ciardiello
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Milan, Italy
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Sara Del Tufo
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Antonietta Gerarda Gravina
- Gastroenterology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Francesco Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Iacopo Panarese
- Pathology UniV, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Renato Franco
- Pathology UniV, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | | | - Giulia Martini
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Fortunato Ciardiello
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Roberto Grassi
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Salvatore Cappabianca
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Alfonso Reginelli
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Erika Martinelli
- Oncology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| |
Collapse
|
5
|
Reginelli A, Giacobbe G, Del Canto MT, Alessandrella M, Balestrucci G, Urraro F, Russo GM, Gallo L, Danti G, Frittoli B, Stoppino L, Schettini D, Iafrate F, Cappabianca S, Laghi A, Grassi R, Brunese L, Barile A, Miele V. Peritoneal Carcinosis: What the Radiologist Needs to Know. Diagnostics (Basel) 2023; 13:diagnostics13111974. [PMID: 37296826 DOI: 10.3390/diagnostics13111974] [Citation(s) in RCA: 1] [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: 04/11/2023] [Revised: 05/17/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Peritoneal carcinosis is a condition characterized by the spread of cancer cells to the peritoneum, which is the thin membrane that lines the abdominal cavity. It is a serious condition that can result from many different types of cancer, including ovarian, colon, stomach, pancreatic, and appendix cancer. The diagnosis and quantification of lesions in peritoneal carcinosis are critical in the management of patients with the condition, and imaging plays a central role in this process. Radiologists play a vital role in the multidisciplinary management of patients with peritoneal carcinosis. They need to have a thorough understanding of the pathophysiology of the condition, the underlying neoplasms, and the typical imaging findings. In addition, they need to be aware of the differential diagnoses and the advantages and disadvantages of the various imaging methods available. Imaging plays a central role in the diagnosis and quantification of lesions, and radiologists play a critical role in this process. Ultrasound, computed tomography, magnetic resonance, and PET/CT scans are used to diagnose peritoneal carcinosis. Each imaging procedure has advantages and disadvantages, and particular imaging techniques are recommended based on patient conditions. Our aim is to provide knowledge to radiologists regarding appropriate techniques, imaging findings, differential diagnoses, and treatment options. With the advent of AI in oncology, the future of precision medicine appears promising, and the interconnection between structured reporting and AI is likely to improve diagnostic accuracy and treatment outcomes for patients with peritoneal carcinosis.
Collapse
Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Giuliana Giacobbe
- General and Emergency Radiology Department, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Maria Teresa Del Canto
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Marina Alessandrella
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Giovanni Balestrucci
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Fabrizio Urraro
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Gaetano Maria Russo
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Luigi Gallo
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Ginevra Danti
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Barbara Frittoli
- Department of Radiology, Spedali Civili Hospital, 25123 Brescia, Italy
| | - Luca Stoppino
- Department of Radiology, University Hospital of Foggia, 71122 Foggia, Italy
| | - Daria Schettini
- Department of Radiology, Villa Scassi Hospital, Corso Scassi 1, 16121 Genova, Italy
| | - Franco Iafrate
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Andrea Laghi
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza-University of Rome, Radiology Unit-Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Roberto Grassi
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Luca Brunese
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, 86100 Campobasso, Italy
| | - Antonio Barile
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, 67100 L'Aquila, Italy
| | - Vittorio Miele
- Department of Translational Research, Diagnostic and Interventional Radiology, University of Pisa, 56126 Pisa, Italy
| |
Collapse
|
6
|
Neri E, Aghakhanyan G, Zerunian M, Gandolfo N, Grassi R, Miele V, Giovagnoni A, Laghi A. Explainable AI in radiology: a white paper of the Italian Society of Medical and Interventional Radiology. Radiol Med 2023:10.1007/s11547-023-01634-5. [PMID: 37155000 DOI: 10.1007/s11547-023-01634-5] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/19/2023] [Indexed: 05/10/2023]
Abstract
The term Explainable Artificial Intelligence (xAI) groups together the scientific body of knowledge developed while searching for methods to explain the inner logic behind the AI algorithm and the model inference based on knowledge-based interpretability. The xAI is now generally recognized as a core area of AI. A variety of xAI methods currently are available to researchers; nonetheless, the comprehensive classification of the xAI methods is still lacking. In addition, there is no consensus among the researchers with regards to what an explanation exactly is and which are salient properties that must be considered to make it understandable for every end-user. The SIRM introduces an xAI-white paper, which is intended to aid Radiologists, medical practitioners, and scientists in the understanding an emerging field of xAI, the black-box problem behind the success of the AI, the xAI methods to unveil the black-box into a glass-box, the role, and responsibilities of the Radiologists for appropriate use of the AI-technology. Due to the rapidly changing and evolution of AI, a definitive conclusion or solution is far away from being defined. However, one of our greatest responsibilities is to keep up with the change in a critical manner. In fact, ignoring and discrediting the advent of AI a priori will not curb its use but could result in its application without awareness. Therefore, learning and increasing our knowledge about this very important technological change will allow us to put AI at our service and at the service of the patients in a conscious way, pushing this paradigm shift as far as it will benefit us.
Collapse
Affiliation(s)
- Emanuele Neri
- Academic Radiology, Department of Translational Research and of New Surgical and Medical Technology, University of Pisa, Pisa, Italy
| | - Gayane Aghakhanyan
- Academic Radiology, Department of Translational Research and of New Surgical and Medical Technology, University of Pisa, Pisa, Italy.
| | - Marta Zerunian
- Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, VillaScassi Hospital-ASL 3, Corso Scassi 1, Genoa, Italy
| | - Roberto Grassi
- Radiology Unit, Università Degli Studi Della Campania Luigi Vanvitelli, Naples, Italy
| | - Vittorio Miele
- Department of Radiology, Careggi University Hospital, Florence, Italy
| | - Andrea Giovagnoni
- Department of Radiological Sciences, Radiology Clinic, Azienda Ospedaliera Universitaria, Ospedali Riuniti Di Ancona, Ancona, Italy
| | - Andrea Laghi
- Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| |
Collapse
|
7
|
Sansone M, Fusco R, Grassi F, Gatta G, Belfiore MP, Angelone F, Ricciardi C, Ponsiglione AM, Amato F, Galdiero R, Grassi R, Granata V, Grassi R. Machine Learning Approaches with Textural Features to Calculate Breast Density on Mammography. Curr Oncol 2023; 30:839-853. [PMID: 36661713 PMCID: PMC9858566 DOI: 10.3390/curroncol30010064] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/31/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND breast cancer (BC) is the world's most prevalent cancer in the female population, with 2.3 million new cases diagnosed worldwide in 2020. The great efforts made to set screening campaigns, early detection programs, and increasingly targeted treatments led to significant improvement in patients' survival. The Full-Field Digital Mammograph (FFDM) is considered the gold standard method for the early diagnosis of BC. From several previous studies, it has emerged that breast density (BD) is a risk factor in the development of BC, affecting the periodicity of screening plans present today at an international level. OBJECTIVE in this study, the focus is the development of mammographic image processing techniques that allow the extraction of indicators derived from textural patterns of the mammary parenchyma indicative of BD risk factors. METHODS a total of 168 patients were enrolled in the internal training and test set while a total of 51 patients were enrolled to compose the external validation cohort. Different Machine Learning (ML) techniques have been employed to classify breasts based on the values of the tissue density. Textural features were extracted only from breast parenchyma with which to train classifiers, thanks to the aid of ML algorithms. RESULTS the accuracy of different tested classifiers varied between 74.15% and 93.55%. The best results were reached by a Support Vector Machine (accuracy of 93.55% and a percentage of true positives and negatives equal to TPP = 94.44% and TNP = 92.31%). The best accuracy was not influenced by the choice of the features selection approach. Considering the external validation cohort, the SVM, as the best classifier with the 7 features selected by a wrapper method, showed an accuracy of 0.95, a sensitivity of 0.96, and a specificity of 0.90. CONCLUSIONS our preliminary results showed that the Radiomics analysis and ML approach allow us to objectively identify BD.
Collapse
Affiliation(s)
- Mario Sansone
- Department of Electrical Engineering Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Napoli, Italy
| | - Francesca Grassi
- Department of Precision Medicine, Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Gianluca Gatta
- Department of Precision Medicine, Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
| | - Maria Paola Belfiore
- Department of Precision Medicine, Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
| | - Francesca Angelone
- Department of Electrical Engineering Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Carlo Ricciardi
- Department of Electrical Engineering Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Alfonso Maria Ponsiglione
- Department of Electrical Engineering Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Francesco Amato
- Department of Electrical Engineering Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Roberta Galdiero
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Roberta Grassi
- Department of Precision Medicine, Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy
| | - Roberto Grassi
- Department of Precision Medicine, Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
| |
Collapse
|
8
|
Grassi R, Guerra E, Berritto D. Bone fractures difficult to recognize in emergency: May be cone beam computed tomography (CBCT) the solution? Radiol Med 2023; 128:1-5. [PMID: 36683134 DOI: 10.1007/s11547-022-01584-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/20/2022] [Indexed: 01/23/2023]
Abstract
CBCT is an imaging tool represented by an X-ray computed tomography delivering a conic-shape X-rays source. This system produces volumetric data during a single rotation of both X-ray beam and detector around the stationary patient. CBCT is able to produce three-dimensional images as for MDCT, however, accounting some advantages over it: lower radiation dose, faster volumetric dataset acquisition, higher spatial resolution and bone contrast. For these reasons, CBCT has recently been described and adopted for extremities imaging in orthopedics. Misinterpretation of fractures may determine a delayed treatment and poor outcome for patients treated in the ED. CBCT, by easily identifying occult cortical fractures and using a lower dose of radiation, is proposed as an alternative or supplement to direct radiograms, optimizing the cost-effectiveness ratio and limiting the number of unnecessary immobilizations. The first experiences document excellent performance of CBCT in emergency radiology departments, especially thanks to transverse imaging in trauma of the extremities.
Collapse
Affiliation(s)
- Roberto Grassi
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Egidio Guerra
- Division of Radiology, "Ospedale Policlinico di Foggia", Foggia, Italy
| | - Daniela Berritto
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
| |
Collapse
|
9
|
Monti R, Martinese A, Bonadonna G, Rocco MP, Simonetti I, Arrigoni F, Palumbo P, Bruno F, Granata V, Fusco R, Splendiani A, Di Cesare E, Giovagnoni A, Grassi R, Miele V, Masciocchi C, Barile A. Degenerative and inflammatory musculoskeletal disorders: updates and hot topics in diagnostic and interventional imaging. Eur Rev Med Pharmacol Sci 2022; 26:6958-6971. [PMID: 36263576 DOI: 10.26355/eurrev_202210_29877] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The purpose of this review is to present the latest innovations and current topics in musculoskeletal diagnosis and interventional imaging, with a focus on degenerative and inflammatory diseases. MATERIALS AND METHODS In this study, the search was conducted through the online databases PubMed and Google Scholar, including articles published in English in the past 15 years, in order to find existing studies, clinical cases, and reviews on the latest innovations and current topics in degenerative and inflammatory musculoskeletal pathologies. RESULTS Imaging plays a pivotal role in the diagnosis and treatment of MSK degenerative and inflammatory disease. In the last few years continuous innovations and technological advances have allowed new clinical applications in the management of MSK disorder. Advanced magnetic resonance techniques, the introduction of fusion imaging techniques and new approaches to infiltrative medicine are revolutionizing the clinical and therapeutic approach to degenerative and inflammatory pathologies. Artificial intelligence also increasingly seeks to be applied in all fields of medicine and radiology with increasingly promising results. CONCLUSIONS Imaging modalities undergo continuous innovations and revolutions due to technological advances, with direct repercussions on clinical applications and new therapeutic potential through interventional radiology techniques. In recent years, there have been particular innovations in the context of musculoskeletal imaging of degenerative and inflammatory diseases, both for diagnosis and intervention.
Collapse
Affiliation(s)
- R Monti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Belfiore MP, De Chiara M, Reginelli A, Clemente A, Urraro F, Grassi R, Belfiore G, Cappabianca S. An overview of the irreversible electroporation for the treatment of liver metastases: When to use it. Front Oncol 2022; 12:943176. [PMID: 36119531 PMCID: PMC9477084 DOI: 10.3389/fonc.2022.943176] [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: 05/13/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Tumour ablation is an established therapy for local treatment of liver metastases and hepatocellular carcinoma. Most commonly two different kind of thermic ablation, radiofrequency ablation and microwave ablation, are used in clinical practice. The aim of both is to induce thermic damage to the malignant cells in order to obtain coagulative necrosis of the neoplastic lesions. Our main concerns about these procedures are the collateral thermic damage to adjacent structures and heat-sink effect. Irreversible electroporation (IRE) is a recently developed, non-thermal ablation procedure which works applying short pulses of direct current that generate an electric field in the lesion area. The electric field increase the transmembrane potential, changing its permeability to ions.Irreversible electroporation does not generate heat, giving the chance to avoid the heat-sink effect and opening the path to a better treatment of all the lesions located in close proximity to big vessels and bile ducts. Electric fields produced by the IRE may affect endothelial cells and cholangiocytes but they spare the collagen matrix, preserving re-epithelization process as well as the function of the damaged structures. Purpose of the authors is to identify the different scenarios where CT-guided percutaneous IRE of the liver should be preferred to other ablative techniques and why.
Collapse
Affiliation(s)
- Maria Paola Belfiore
- Division of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
- *Correspondence: Maria Paola Belfiore,
| | - Marco De Chiara
- Division of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Alfonso Reginelli
- Division of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Alfredo Clemente
- Division of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Fabrizio Urraro
- Division of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Roberto Grassi
- Division of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Giuseppe Belfiore
- Department of Diagnostic Imaging, Nursing home L.Cobellis, Vallo della Lucania Salerno, Italy
| | - Salvatore Cappabianca
- Division of Radiology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| |
Collapse
|
11
|
Cariello V, Lombardo P, Castelli L, Brillantino C, De Fusco C, Rossi A, Minelli R, Paviglianiti G, Grassi R, Rossi E. Integrated imaging of systemic Langerhans cell histiocytosis in an infant. Radiol Case Rep 2022; 17:2747-2753. [PMID: 35990570 PMCID: PMC9388885 DOI: 10.1016/j.radcr.2022.05.016] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 11/26/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) is a myeloid neoplasm characterized by a clonal proliferation of CD1a+/CD207+ dendritic cells. Although individuals of any age can be affected, the disease is most common in infants younger than 5 years of age, especially males. A wide range of manifestations, from asymptomatic to aggressive, have been described, along with multiorgan involvement. Even though the majority of bone lesions are observed, skin, lymph nodes, brain and lungs can also be involved. The involvement of hematopoietic system, including bone marrow, liver and spleen, is less frequent yet associated with worse prognosis, due to a worse treatment response. Diagnosis of LCH is based on the integration of clinical, laboratory, and radiological data; however, only histopathological examination might confirm it. As far as the spleen involvement is concerned, according to literature, it has been reported in about 15% patients with multisystem involvement, nonetheless only a few cases show parenchymal lesions. The present study reports the case of an infant with LCH with multisystem involvement, including bone, skin, liver, and spleen, with evidence of parenchymal lesions.
Collapse
|
12
|
Iacobellis F, Brillantino A, Di Serafino M, Dell'Aversano Orabona G, Grassi R, Cappabianca S, Scaglione M, Romano L. Economic and clinical benefits of immediate total-body CT in the diagnostic approach to polytraumatized patients: a descriptive analysis through a literature review. Radiol Med 2022; 127:637-644. [PMID: 35553349 DOI: 10.1007/s11547-022-01495-4] [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: 02/04/2022] [Accepted: 04/14/2022] [Indexed: 11/30/2022]
Abstract
Major trauma is an event causing injuries that may determine an immediate or potential risk to the patient survival. A correct management of major trauma is decisive in reducing disability, which has relevance both from the point of view of the quality of life of the single individual and from the point of view of health expenditure. The primary clinical approach to the polytraumatized patients is managed, in most cases, as outlined in the guidelines of Advanced Trauma Life Support, proposing conventional radiological investigations, such as chest and pelvis x-ray, and of FAST (focused abdominal sonography in trauma)/E-FAST (extended FAST) examinations, followed by selective targeted computed tomography (CT). This approach is questionable and is increasingly common in clinical practice the adoption of the immediate total-body CT in the diagnostic approach to the hemodynamically stable polytraumatized patient. However, the potential advantages of such conduct both in terms of clinical benefits and in terms of cost-effectiveness still need to be discussed. The objective of this review article consists of a descriptive analysis of the economic and clinical benefits of the adoption of immediate total-body CT in polytrauma patients through a literature review.
Collapse
Affiliation(s)
- Francesca Iacobellis
- Department of General and Emergency Radiology, "A. Cardarelli" Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
| | - Antonio Brillantino
- Department of Emergency Surgery, "A. Cardarelli" Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Marco Di Serafino
- Department of General and Emergency Radiology, "A. Cardarelli" Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | | | - Roberto Grassi
- Department of Radiology, University of Campania "L. Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy
| | - Salvatore Cappabianca
- Department of Radiology, University of Campania "L. Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy
| | - Mariano Scaglione
- Department of Clinical and Experimental Medicine, University of Sassari, Via Roma 151, 07100, Sassari, Italy.,Department of Radiology, The James Cook University Hospital, Middlesbrough, TS4 3BW, UK.,School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BX, UK
| | - Luigia Romano
- Department of General and Emergency Radiology, "A. Cardarelli" Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| |
Collapse
|
13
|
Angrisani A, Mastrandrea L, Sangiovanni A, Nardone V, Grassi R, Reginelli A, Guida C, Cappabianca S. PO-1778 MRI Radiomics in prostate cancer: a reliability study. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03742-2] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
14
|
Angrisani A, De Marco G, Nardone V, D'Ippolito E, Grassi R, Reginelli A, Guida C, Cappabianca S. PD-0666 The role of Agatston score in stage III non small cell lung cancer patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02913-9] [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: 11/16/2022]
|
15
|
Palumbo P, Cannizzaro E, Bracci A, Bruno F, Arrigoni F, Splendiani A, Danti G, Cozzi D, Pradella S, Grassi F, Grassi R, Dell'Aversana F, Brunese MC, Cutolo C, Ravo L, Fusco R, Galdiero R, Granata V, Masciocchi C, Di Cesare E. Thoracic non-traumatic cardiovascular diseases: current perspective and multi-detectors Computed Tomography protocols optimization in the emergency setting. Eur Rev Med Pharmacol Sci 2022; 26:3621-3641. [PMID: 35647844 DOI: 10.26355/eurrev_202205_28858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Cardiovascular diseases (CVDs) are among the most common causes of access to the Emergency Department and among the leading causes of death worldwide. Accurate diagnostic algorithms are mandatory to ensure a rapid life-saving treatment. However, non-specific clinical presentation and unnecessary referrals to other subspecialties may lead to misinterpretation of the diagnosis and delays. In recent years, the development of imaging technologies has allowed Computed Tomography (CT) to play a prominent role in the concepts of CVD rule-in and rule-out. An optimization strategy for CT protocols is needed to reduce variability and improve image quality. A correct diagnostic suspicion is crucial, as different districts (i.e., heart, aorta and pulmonary circulation) may require different investigation techniques. Additionally, the CVD pre-test probability assessment is highly correlated with CT accuracy. The purpose of this narrative review is to analyze the current role of CT in the approach to the CVDs in the ED, and to analyze the main strategies of CT optimization.
Collapse
Affiliation(s)
- P Palumbo
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, L'Aquila, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Flammia F, Chiti G, Trinci M, Danti G, Cozzi D, Grassi R, Palumbo P, Bruno F, Agostini A, Fusco R, Granata V, Giovagnoni A, Miele V. Optimization of CT protocol in polytrauma patients: an update. Eur Rev Med Pharmacol Sci 2022; 26:2543-2555. [PMID: 35442469 DOI: 10.26355/eurrev_202204_28491] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Radiologists play a key role in the management of trauma patients. With the improvement of computed tomography (CT), radiologist makes an important contribution to the timely diagnosis of trauma-related findings and the choice of the most suitable treatment, improving patient outcomes. It is important to select the most appropriate imaging technique, which in the trauma patient is CT, and especially the most appropriate CT protocol, to correctly characterize trauma injuries. Currently, there is no agreement on what the optimal protocol is, acquisition times and number of contrast enhanced phases are not standardized. This is a review of the most recent literature on optimizing the CT protocol in polytrauma, with the intent of giving a useful tool for radiologists in the management of trauma patients.
Collapse
Affiliation(s)
- F Flammia
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Fusco R, Granata V, Grazzini G, Pradella S, Borgheresi A, Bruno A, Palumbo P, Bruno F, Grassi R, Giovagnoni A, Grassi R, Miele V, Barile A. Radiomics in medical imaging: pitfalls and challenges in clinical management. Jpn J Radiol 2022; 40:919-929. [PMID: 35344132 DOI: 10.1007/s11604-022-01271-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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: 02/16/2022] [Accepted: 03/14/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND Radiomics and radiogenomics are two words that recur often in language of radiologists, nuclear doctors and medical physicists especially in oncology field. Radiomics is the technique of medical images analysis to extract quantitative data that are not detected by human eye. METHODS This article is a narrative review on Radiomics in Medical Imaging. In particular, the review exposes the process, the limitations related to radiomics, and future prospects are discussed. RESULTS Several studies showed that radiomics is very promising. However, there were some critical issues: poor standardization and generalization of radiomics results, data-quality control, repeatability, reproducibility, database balancing and issues related to model overfitting. CONCLUSIONS Radiomics procedure should made considered all pitfalls and challenges to obtain robust and reproducible results that could be generalized in other patients cohort.
Collapse
Affiliation(s)
| | - Vincenza Granata
- Division of Radiology, "Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli", Naples, Italy.
| | - Giulia Grazzini
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.,Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy
| | - Silvia Pradella
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.,Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy
| | - Alessandra Borgheresi
- Department of Clinical Special and Dental Sciences, School of Radiology, University Politecnica delle Marche, Ancona, Italy
| | - Alessandra Bruno
- Department of Clinical Special and Dental Sciences, School of Radiology, University Politecnica delle Marche, Ancona, Italy
| | - Pierpaolo Palumbo
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy.,Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, 67100, L'Aquila, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy.,Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, 67100, L'Aquila, Italy
| | - Roberta Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy.,Division of Radiology, "Università Degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Andrea Giovagnoni
- Department of Clinical Special and Dental Sciences, School of Radiology, University Politecnica delle Marche, Ancona, Italy
| | - Roberto Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy.,Division of Radiology, "Università Degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Vittorio Miele
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.,Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy
| | - Antonio Barile
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy.,Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, 67100, L'Aquila, Italy
| |
Collapse
|
18
|
Gabelloni M, Faggioni L, Cioni D, Mendola V, Falaschi Z, Coppola S, Corradi F, Isirdi A, Brandi N, Coppola F, Granata V, Golfieri R, Grassi R, Neri E. Extracorporeal membrane oxygenation (ECMO) in COVID-19 patients: a pocket guide for radiologists. Radiol Med 2022; 127:369-382. [PMID: 35279765 PMCID: PMC8918086 DOI: 10.1007/s11547-022-01473-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 11/23/2021] [Accepted: 02/23/2022] [Indexed: 01/08/2023]
Abstract
During the coronavirus disease 19 (COVID-19) pandemic, extracorporeal membrane oxygenation (ECMO) has been proposed as a possible therapy for COVID-19 patients with acute respiratory distress syndrome. This pictorial review is intended to provide radiologists with up-to-date information regarding different types of ECMO devices, correct placement of ECMO cannulae, and imaging features of potential complications and disease evolution in COVID-19 patients treated with ECMO, which is essential for a correct interpretation of diagnostic imaging, so as to guide proper patient management.
Collapse
Affiliation(s)
- Michela Gabelloni
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
| | - Dania Cioni
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122, Milano, Italy
| | - Vincenzo Mendola
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Zeno Falaschi
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Sara Coppola
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Francesco Corradi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Isirdi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Nicolò Brandi
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria Di Bologna, 40138, Bologna, Italy
| | - Francesca Coppola
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122, Milano, Italy
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria Di Bologna, 40138, Bologna, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS Di Napoli, 80131, Naples, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria Di Bologna, 40138, Bologna, Italy
| | - Roberto Grassi
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122, Milano, Italy
- Division of Radiology, Università Degli Studi Della Campania Luigi Vanvitelli, 80127, Naples, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122, Milano, Italy
| |
Collapse
|
19
|
De Muzio F, Cutolo C, Granata V, Fusco R, Ravo L, Maggialetti N, Brunese MC, Grassi R, Grassi F, Bruno F, Palumbo P, Palatresi D, Cozzi D, Danti G. CT study protocol optimization in acute non-traumatic abdominal settings. Eur Rev Med Pharmacol Sci 2022; 26:860-878. [PMID: 35179752 DOI: 10.26355/eurrev_202202_27995] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Abdominal acute pain is a manifestation of heterogeneous medical conditions, with difficult clinical-laboratory assessment. Multi-detector CT (MDCT) is the gold standard imaging technique for evaluating adult patients with acute abdominal pain. Due to its fast execution and the high spatial resolution, CT is fundamental in the diagnostic and therapeutic work-up of patients with time-dependent pathology that could require surgical treatment, reducing mortality and morbidity. However, the radiological risk connected to the ionizing radiation use should not be underestimated, especially in young patients. The aim of this study is to identify optimized CT protocols to apply in the management of non-traumatic acute abdomen. In particular, this review is focused on the main emergency settings: acute pancreatitis, small bowel obstruction, acute appendicitis and acute diverticulitis. This survey would not be complete without mentioning Dual-Energy CT (DECT) technique, one of the last frontiers in CT, achieving encouraging results also in acute abdominal conditions.
Collapse
Affiliation(s)
- F De Muzio
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Granata V, Fusco R, Venanzio Setola S, Barretta ML, Iasevoli DMA, Palaia R, Belli A, Patrone R, Tatangelo F, Grazzini G, Grassi R, Grassi F, Grassi R, Anselmo A, Izzo F, Petrillo A. Diagnostic performance of LI-RADS in adult patients with rare hepatic tumors. Eur Rev Med Pharmacol Sci 2022; 26:399-414. [PMID: 35113415 DOI: 10.26355/eurrev_202201_27864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The rare hepatic tumor can have a wide spectrum of radiologic features, representing a diagnostic challenge. Our purpose is to report the experience of a National Cancer Center, emphasizing the radiological features encountered and assessing the LR-M categories in the diagnostic performances for these lesions. PATIENTS AND METHODS We assessed 113 patients who underwent surgical resection or biopsy for rare liver lesions from May 2010 to December 2020. For these patients a computerized search of radiological records was performed to identify which had been studied with MRI and CT. For each lesion, the radiologists recorded the attenuation on CT studies and signal intensity (SI) in T1 weighted (W), in T2-W, DWI and in the related map of the apparent diffusion coefficient (ADC). We assessed the presence and the type of contrast enhancement (CE) during contrast study on CT and MRI and the enhancement was categorized according to LI-RADS 2018. We also assessed the presence of other features in LR-M categories (ancillary LR-M features) in order to classify different subgroups. The lesions were classified according to LR categories, and the gold standard was histological analysis. RESULTS The final study population included 95 patients (46 females and 49 males), with a mean age of 51 years (range 38-83 years). 83 patients had solid lesions, 12 patients had cystic lesions (simple or complex). According to histological analysis, we categorized 79 patients with malignant lesions and 16 patients with benign lesions. According to radiological features we assessed as malignant 82 patients (79 true malignant and 3 false malignant), as benign 13 patients (all true benign). Therefore, sensitivity, specificity, positive predictive value, negative predictive value and accuracy of radiological features to identify benign and malignant lesions were 100.0%, 81.3%, 96.3%, 100.0% and 96.8%, respectively. We found no significant difference in signal and contrast enhancement appearance among all LR-M categories (p-value =0.34 at Chi square test). However, among LR-M categories the presence of satellite nodules was a feature typical of cHCC-CC (p-value < 0.05 at Chi square test). The presence of intra lesion necrosis and haemorrhage was suggestive of sarcoma (p-value < 0.05 at Chi square test). CONCLUSIONS High diagnostic accuracy was obtained by LI-RADS classification between malignant and benign lesion. The presence of ancillary features could help the radiologist towards a correct diagnosis.
Collapse
Affiliation(s)
- V Granata
- Division of Radiology, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Granata V, Faggioni L, Grassi R, Fusco R, Reginelli A, Rega D, Maggialetti N, Buccicardi D, Frittoli B, Rengo M, Bortolotto C, Prost R, Lacasella GV, Montella M, Ciaghi E, Bellifemine F, De Muzio F, Grazzini G, De Filippo M, Cappabianca S, Laghi A, Grassi R, Brunese L, Neri E, Miele V, Coppola F. Structured reporting of computed tomography in the staging of colon cancer: a Delphi consensus proposal. Radiol Med 2022; 127:21-29. [PMID: 34741722 PMCID: PMC8795004 DOI: 10.1007/s11547-021-01418-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/28/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports in colon cancer during the staging phase in order to improve communication between the radiologist, members of multidisciplinary teams and patients. MATERIALS AND METHODS A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. Cronbach's alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. RESULTS The final SR version was built by including n = 18 items in the "Patient Clinical Data" section, n = 7 items in the "Clinical Evaluation" section, n = 9 items in the "Imaging Protocol" section and n = 29 items in the "Report" section. Overall, 63 items were included in the final version of the SR. Both in the first and second round, all sections received a higher than good rating: a mean value of 4.6 and range 3.6-4.9 in the first round; a mean value of 5.0 and range 4.9-5 in the second round. In the first round, Cronbach's alpha (Cα) correlation coefficient was a questionable 0.61. In the first round, the overall mean score of the experts and the sum of scores for the structured report were 4.6 (range 1-5) and 1111 (mean value 74.07, STD 4.85), respectively. In the second round, Cronbach's alpha (Cα) correlation coefficient was an acceptable 0.70. In the second round, the overall mean score of the experts and the sum of score for structured report were 4.9 (range 4-5) and 1108 (mean value 79.14, STD 1.83), respectively. The overall mean score obtained by the experts in the second round was higher than the overall mean score of the first round, with a lower standard deviation value to underline greater agreement among the experts for the structured report reached in this round. CONCLUSIONS A wide implementation of SR is of critical importance in order to offer referring physicians and patients optimum quality of service and to provide researchers with the best quality data in the context of big data exploitation of available clinical data. Implementation is a complex procedure, requiring mature technology to successfully address the multiple challenges of user-friendliness, organization and interoperability.
Collapse
Affiliation(s)
- Vincenza Granata
- Division of Radiology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale – IRCCS di Napoli”, Naples, Italy
| | - Lorenzo Faggioni
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - Roberta Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122 Milan, Italy
- Division of Radiology, “Università Degli Studi Della Campania Luigi Vanvitelli”, Naples, Italy
| | | | - Alfonso Reginelli
- Division of Radiology, “Università Degli Studi Della Campania Luigi Vanvitelli”, Naples, Italy
| | - Daniela Rega
- Division of Colorectal Surgery, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS Di Napoli, 80131 Naples, Italy
| | - Nicola Maggialetti
- Section of Radiodiagnostic, DSMBNOS, “Aldo Moro” University, Bari, Italy
| | | | - Barbara Frittoli
- Department of Radiology, Spedali Civili Hospital of Brescia, University of Brescia, Brescia, Italy
| | - Marco Rengo
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome - I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100 Latina, Italy
| | - Chandra Bortolotto
- Department of Radiology, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Roberto Prost
- Radiology Unit, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Giorgia Viola Lacasella
- Division of Radiology, “Università Degli Studi Della Campania Luigi Vanvitelli”, Naples, Italy
| | - Marco Montella
- Division of Radiology, “Università Degli Studi Della Campania Luigi Vanvitelli”, Naples, Italy
| | | | | | - Federica De Muzio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Via Francesco De Sanctis 1, 86100 Campobasso, Italy
| | - Giulia Grazzini
- Division of Radiology, “Azienda Ospedaliera Universitaria Careggi”, Florence, Italy
| | - Massimo De Filippo
- Department of Medicine and Surgery, Unit of Radiologic Science, University of Parma, Maggiore Hospital, Parma, Italy
| | - Salvatore Cappabianca
- Division of Radiology, “Università Degli Studi Della Campania Luigi Vanvitelli”, Naples, Italy
| | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
| | - Roberto Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122 Milan, Italy
- Division of Radiology, “Università Degli Studi Della Campania Luigi Vanvitelli”, Naples, Italy
| | - Luca Brunese
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Via Francesco De Sanctis 1, 86100 Campobasso, Italy
| | - Emanuele Neri
- Department of Translational Research, University of Pisa, Pisa, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122 Milan, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122 Milan, Italy
- Division of Radiology, “Azienda Ospedaliera Universitaria Careggi”, Florence, Italy
| | - Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| |
Collapse
|
22
|
Mazzei MA, Bagnacci G, Gentili F, Capitoni I, Mura G, Marrelli D, Petrioli R, Brunese L, Cappabianca S, Catarci M, Degiuli M, De Manzoni G, De Prizio M, Donini A, Romario UF, Funicelli L, Laghi A, Minetti G, Morgagni P, Petrella E, Pittiani F, Rausei S, Romanini L, Rosati R, Ianora AAS, Tiberio GAM, Volterrani L, Roviello F, Grassi R. Structured and shared CT radiological report of gastric cancer: a consensus proposal by the Italian Research Group for Gastric Cancer (GIRCG) and the Italian Society of Medical and Interventional Radiology (SIRM). Eur Radiol 2022; 32:938-949. [PMID: 34383148 PMCID: PMC8359760 DOI: 10.1007/s00330-021-08205-0] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/15/2021] [Accepted: 07/07/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Written radiological report remains the most important means of communication between radiologist and referring medical/surgical doctor, even though CT reports are frequently just descriptive, unclear, and unstructured. The Italian Society of Medical and Interventional Radiology (SIRM) and the Italian Research Group for Gastric Cancer (GIRCG) promoted a critical shared discussion between 10 skilled radiologists and 10 surgical oncologists, by means of multi-round consensus-building Delphi survey, to develop a structured reporting template for CT of GC patients. METHODS Twenty-four items were organized according to the broad categories of a structured report as suggested by the European Society of Radiology (clinical referral, technique, findings, conclusion, and advice) and grouped into three "CT report sections" depending on the diagnostic phase of the radiological assessment for the oncologic patient (staging, restaging, and follow-up). RESULTS In the final round, 23 out of 24 items obtained agreement ( ≥ 8) and consensus ( ≤ 2) and 19 out 24 items obtained a good stability (p > 0.05). CONCLUSIONS The structured report obtained, shared by surgical and medical oncologists and radiologists, allows an appropriate, clearer, and focused CT report essential to high-quality patient care in GC, avoiding the exclusion of key radiological information useful for multidisciplinary decision-making. KEY POINTS • Imaging represents the cornerstone for tailored treatment in GC patients. • CT-structured radiology report in GC patients is useful for multidisciplinary decision making.
Collapse
Affiliation(s)
- Maria Antonietta Mazzei
- Department of Medical, Surgical and Neuro Sciences, University of Siena and Department of Radiological Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy ,SIRM, Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, Milan, Italy
| | - Giulio Bagnacci
- Department of Medical, Surgical and Neuro Sciences, University of Siena and Department of Radiological Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy ,SIRM, Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, Milan, Italy
| | - Francesco Gentili
- SIRM, Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, Milan, Italy ,Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Iacopo Capitoni
- Department of Medical, Surgical and Neuro Sciences, University of Siena and Department of Radiological Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Gianni Mura
- Department of Surgery, Division of General Surgery, Arezzo Hospital, Arezzo, Italy
| | - Daniele Marrelli
- Department of Medicine, Surgery and Neuroscience, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Roberto Petrioli
- Department of Oncology, Unit of Medical Oncology, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Luca Brunese
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy ,SIRM, Italian College of Oncology, Italian Society of Medical and Interventional Radiology, Milan, Italy
| | - Salvatore Cappabianca
- SIRM, Italian College of Oncology, Italian Society of Medical and Interventional Radiology, Milan, Italy ,Division of Radiology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marco Catarci
- FACS; UOC Chirurgia Generale; Ospedale Sandro Pertini – ASL Roma 2, Roma, Italy
| | - Maurizio Degiuli
- Surgical Oncology and Digestive Surgery Unit, Department of Oncology, University of Turin; San Luigi University Hospital, Orbassano, Italy
| | | | - Marco De Prizio
- Department of Surgery, Division of General Surgery, Arezzo Hospital, Arezzo, Italy
| | - Annibale Donini
- Department of Surgery and Biomedical Sciences, University of Perugia, Perugia, Italy
| | | | - Luigi Funicelli
- SIRM, Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, Milan, Italy ,SIRM, Italian College of Oncology, Italian Society of Medical and Interventional Radiology, Milan, Italy ,Digestive Surgery, IEO European Institute of Oncology – IRCCS, Milan, Italy
| | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome – Sant’Andrea University Hospital, Rome, Italy ,SIRM, Italian College of Gastroenterology, Italian Society of Medical and Interventional Radiology, Milan, Italy
| | - Giuseppe Minetti
- SIRM, Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, Milan, Italy ,Radiology Department, Ospedale Policlinico San Martino, IRCCS per L’Oncologia e le Neuroscienze, Genoa, Italy
| | - Paolo Morgagni
- General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Enrico Petrella
- Radiology Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Forlì, Italy
| | - Frida Pittiani
- SIRM, Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, Milan, Italy ,Department of Radiology, ASST Spedali Civili Brescia, Brescia, Italy
| | - Stefano Rausei
- Department of Surgery, ASST Valle Olona, Gallarate, Varese, Italy
| | | | - Riccardo Rosati
- Endocrine Unit, Department of Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Amato Antonio Stabile Ianora
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari, Bari, Italy
| | - Guido A. M. Tiberio
- Surgical Unit, Department of Experimental and Clinical Sciences, University of Brescia, Brescia, Italy
| | - Luca Volterrani
- Department of Medical, Surgical and Neuro Sciences, University of Siena and Department of Radiological Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy ,SIRM, Italian College of Oncology, Italian Society of Medical and Interventional Radiology, Milan, Italy
| | - Franco Roviello
- Department of Medicine, Surgery and Neuroscience, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy
| | - Roberto Grassi
- Division of Radiology, University of Campania Luigi Vanvitelli, Naples, Italy ,SIRM Foundation, Italian Society of Medical and Interventional Radiology, Milan, Italy
| |
Collapse
|
23
|
Albano D, Bruno F, Agostini A, Angileri SA, Benenati M, Bicchierai G, Cellina M, Chianca V, Cozzi D, Danti G, De Muzio F, Di Meglio L, Gentili F, Giacobbe G, Grazzini G, Grazzini I, Guerriero P, Messina C, Micci G, Palumbo P, Rocco MP, Grassi R, Miele V, Barile A. Dynamic contrast-enhanced (DCE) imaging: state of the art and applications in whole-body imaging. Jpn J Radiol 2021; 40:341-366. [PMID: 34951000 DOI: 10.1007/s11604-021-01223-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/06/2021] [Accepted: 11/17/2021] [Indexed: 12/18/2022]
Abstract
Dynamic contrast-enhanced (DCE) imaging is a non-invasive technique used for the evaluation of tissue vascularity features through imaging series acquisition after contrast medium administration. Over the years, the study technique and protocols have evolved, seeing a growing application of this method across different imaging modalities for the study of almost all body districts. The main and most consolidated current applications concern MRI imaging for the study of tumors, but an increasing number of studies are evaluating the use of this technique also for inflammatory pathologies and functional studies. Furthermore, the recent advent of artificial intelligence techniques is opening up a vast scenario for the analysis of quantitative information deriving from DCE. The purpose of this article is to provide a comprehensive update on the techniques, protocols, and clinical applications - both established and emerging - of DCE in whole-body imaging.
Collapse
Affiliation(s)
- Domenico Albano
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento Di Biomedicina, Neuroscienze E Diagnostica Avanzata, Sezione Di Scienze Radiologiche, Università Degli Studi Di Palermo, via Vetoio 1L'Aquila, 67100, Palermo, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Andrea Agostini
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Clinical, Special and Dental Sciences, Department of Radiology, University Politecnica delle Marche, University Hospital "Ospedali Riuniti Umberto I - G.M. Lancisi - G. Salesi", Ancona, Italy
| | - Salvatore Alessio Angileri
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Radiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Benenati
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Oncologia ed Ematologia, RadioterapiaRome, Italy
| | - Giulia Bicchierai
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Michaela Cellina
- Department of Radiology, ASST Fatebenefratelli Sacco, Ospedale Fatebenefratelli, Milan, Italy
| | - Vito Chianca
- Ospedale Evangelico Betania, Naples, Italy
- Clinica Di Radiologia, Istituto Imaging Della Svizzera Italiana - Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Diletta Cozzi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Ginevra Danti
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Federica De Muzio
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Letizia Di Meglio
- Postgraduation School in Radiodiagnostics, University of Milan, Milan, Italy
| | - Francesco Gentili
- Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Giuliana Giacobbe
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giulia Grazzini
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Irene Grazzini
- Department of Radiology, Section of Neuroradiology, San Donato Hospital, Arezzo, Italy
| | - Pasquale Guerriero
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | | | - Giuseppe Micci
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Dipartimento Di Biomedicina, Neuroscienze E Diagnostica Avanzata, Sezione Di Scienze Radiologiche, Università Degli Studi Di Palermo, via Vetoio 1L'Aquila, 67100, Palermo, Italy
| | - Pierpaolo Palumbo
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Abruzzo Health Unit 1, Department of diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, L'Aquila, Italy
| | - Maria Paola Rocco
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Roberto Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Antonio Barile
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| |
Collapse
|
24
|
Granata V, Fusco R, Bicchierai G, Cozzi D, Grazzini G, Danti G, De Muzio F, Maggialetti N, Smorchkova O, D'Elia M, Brunese MC, Grassi R, Giacobbe G, Bruno F, Palumbo P, Lacasella GV, Brunese L, Grassi R, Miele V, Barile A. Diagnostic protocols in oncology: workup and treatment planning. Part 1: the optimitation of CT protocol. Eur Rev Med Pharmacol Sci 2021; 25:6972-6994. [PMID: 34859859 DOI: 10.26355/eurrev_202111_27246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The increase in oncology knowledge and the possibility of creating personalized medicine by selecting a more suitable therapy related to tumor subtypes, as well as the patient's management with cancer within a multidisciplinary team has improved the clinical outcomes. Early detection of cancer through screening-based imaging is probably the major contributor to a reduction in mortality for certain cancers. Nowadays, imaging can also characterize several lesions and predict their histopathological features and can predict tumor behaviour and prognosis. CT is the main diagnostic tool in oncologic imaging and is widely used for the tumors detection, staging, and follow-up. Moreover, since CT accounts for 49-66% of overall patient radiation exposure, the constant reduction, optimization, dose inter- and intraindividual consistency are major goals in radiological field. In the recent years, numerous dose reduction techniques have been established and created voltage modulation keeping a satisfactory image quality. The introduction of CT dual-layer detector technology enabled the acquisition of spectral data without additional CT x-ray tube or additional acquisitions. In addition, since MRI does not expose the body to radiation, it has become a mainstay of non-invasive diagnostic radiology modality since the 1980s.
Collapse
Affiliation(s)
- V Granata
- Division of Radiology, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Granata V, Bicchierai G, Fusco R, Cozzi D, Grazzini G, Danti G, De Muzio F, Maggialetti N, Smorchkova O, D'Elia M, Brunese MC, Grassi R, Giacobbe G, Bruno F, Palumbo P, Grassi F, Brunese L, Grassi R, Miele V, Barile A. Diagnostic protocols in oncology: workup and treatment planning. Part 2: Abbreviated MR protocol. Eur Rev Med Pharmacol Sci 2021; 25:6499-6528. [PMID: 34787854 DOI: 10.26355/eurrev_202111_27094] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Magnetic resonance imaging (MRI) is a non-invasive imaging technique (non-ionizing radiation) with superior soft tissue contrasts and potential morphological and functional applications. However, long examination and interpretation times, as well as higher costs, still represent barriers to MRI use in clinical routine. Abbreviated MRI protocols have emerged as an alternative to standard MRI protocols. Abbreviated MRI protocols eliminate redundant sequences that negatively affect cost, acquisition time, patient comfort. However, the diagnostic information is generally not compromised. Abbreviated MRI protocols have already been utilized for hepatocellular carcinoma, for prostate cancer detection, and for nonalcoholic fatty liver disease screening.
Collapse
Affiliation(s)
- V Granata
- Division of Radiology, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Gatta G, Cappabianca S, La Forgia D, Massafra R, Fanizzi A, Cuccurullo V, Brunese L, Tagliafico A, Grassi R. Second-Generation 3D Automated Breast Ultrasonography (Prone ABUS) for Dense Breast Cancer Screening Integrated to Mammography: Effectiveness, Performance and Detection Rates. J Pers Med 2021; 11:jpm11090875. [PMID: 34575652 PMCID: PMC8468126 DOI: 10.3390/jpm11090875] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 07/01/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 12/22/2022] Open
Abstract
In our study, we added a three-dimensional automated breast ultrasound (3D ABUS) to mammography to evaluate the performance and cancer detection rate of mammography alone or with the addition of 3D prone ABUS in women with dense breasts. Our prospective observational study was based on the screening of 1165 asymptomatic women with dense breasts who selected independent of risk factors. The results evaluated include the cancers detected between June 2017 and February 2019, and all surveys were subjected to a double reading. Mammography detected four cancers, while mammography combined with a prone Sofia system (3D ABUS) doubled the detection rate, with eight instances of cancer being found. The diagnostic yield difference was 3.4 per 1000. Mammography alone was subjected to a recall rate of 14.5 for 1000 women, while mammography combined with 3D prone ABUS resulted in a recall rate of 26.6 per 1000 women. We also observed an additional 12.1 recalls per 1000 women screened. Integrating full-field digital mammography (FFDM) with 3D prone ABUS in women with high breast density increases and improves breast cancer detection rates in a significant manner, including small and invasive cancers, and it has a tolerable impact on recall rate. Moreover, 3D prone ABUS performance results are comparable with the performance results of the supine 3D ABUS system.
Collapse
Affiliation(s)
- Gianluca Gatta
- Dipartimento di Medicina di Precisione Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (S.C.); (V.C.); (R.G.)
| | - Salvatore Cappabianca
- Dipartimento di Medicina di Precisione Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (S.C.); (V.C.); (R.G.)
| | - Daniele La Forgia
- IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy; (R.M.); (A.F.)
- Correspondence: ; Tel.: +39-80-5555111
| | - Raffaella Massafra
- IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy; (R.M.); (A.F.)
| | - Annarita Fanizzi
- IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy; (R.M.); (A.F.)
| | - Vincenzo Cuccurullo
- Dipartimento di Medicina di Precisione Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (S.C.); (V.C.); (R.G.)
| | - Luca Brunese
- Dipartimento di Medicina e Scienze della Salute “Vincenzo Tiberio”—Università degli Studi del Molise, 86100 Campobasso, Italy;
| | | | - Roberto Grassi
- Dipartimento di Medicina di Precisione Università della Campania “Luigi Vanvitelli”, 80131 Napoli, Italy; (G.G.); (S.C.); (V.C.); (R.G.)
| |
Collapse
|
27
|
Russo A, Reginelli A, Pignatiello M, Montella M, Toni G, Cappabianca S, Grassi R. Sirenomelia: The role of post - Mortem diagnostic imaging. Journal of Pediatric Surgery Case Reports 2021. [DOI: 10.1016/j.epsc.2021.101921] [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: 10/21/2022] Open
|
28
|
Borghesi A, Sverzellati N, Polverosi R, Balbi M, Baratella E, Busso M, Calandriello L, Cortese G, Farchione A, Iezzi R, Palmucci S, Pulzato I, Rampinelli C, Romei C, Valentini A, Grassi R, Larici AR. Impact of the COVID-19 pandemic on the selection of chest imaging modalities and reporting systems: a survey of Italian radiologists. Radiol Med 2021; 126:1258-1272. [PMID: 34196908 PMCID: PMC8245660 DOI: 10.1007/s11547-021-01385-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/16/2021] [Accepted: 06/15/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE Chest imaging modalities play a key role for the management of patient with coronavirus disease (COVID-19). Unfortunately, there is no consensus on the optimal chest imaging approach in the evaluation of patients with COVID-19 pneumonia, and radiology departments tend to use different approaches. Thus, the main objective of this survey was to assess how chest imaging modalities have been used during the different phases of the first COVID-19 wave in Italy, and which diagnostic technique and reporting system would have been preferred based on the experience gained during the pandemic. MATERIAL AND METHODS The questionnaire of the survey consisted of 26 questions. The link to participate in the survey was sent to all members of the Italian Society of Medical and Interventional Radiology (SIRM). RESULTS The survey gathered responses from 716 SIRM members. The most notable result was that the most used and preferred chest imaging modality to assess/exclude/monitor COVID-19 pneumonia during the different phases of the first COVID-19 wave was computed tomography (51.8% to 77.1% of participants). Additionally, while the narrative report was the most used reporting system (55.6% of respondents), one-third of participants would have preferred to utilize structured reporting systems. CONCLUSION This survey shows that the participants' responses did not properly align with the imaging guidelines for managing COVID-19 that have been made by several scientific, including SIRM. Therefore, there is a need for continuing education to keep radiologists up to date and aware of the advantages and limitations of the chest imaging modalities and reporting systems.
Collapse
Affiliation(s)
- Andrea Borghesi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, Italy.
| | - Nicola Sverzellati
- Radiological Sciences, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | | | - Maurizio Balbi
- Radiological Sciences, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Elisa Baratella
- Department of Radiology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Marco Busso
- Department of Radiology, Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
| | - Lucio Calandriello
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy
| | - Giancarlo Cortese
- Department of Radiology, Maria Vittoria Hospital, ASL Città Di Torino, Turin, Italy
| | - Alessandra Farchione
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy
| | - Roberto Iezzi
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy.,Department of Radiological and Hematological Sciences, Section of Radiology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Stefano Palmucci
- Department of Medical Surgical Sciences and Advanced Technologies G.F. Ingrassia- Radiology I Unit, University Hospital Policlinico G. Rodolico-San Marco, University of Catania, Catania, Italy
| | - Ilaria Pulzato
- Department of Radiology, San Martino Hospital, University of Genoa, Genoa, Italy
| | - Cristiano Rampinelli
- Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Chiara Romei
- Department of Diagnostic and Imaging, University Hospital of Pisa, Pisa, Italy
| | - Adele Valentini
- Department of Radiology, San Matteo Polyclinic Foundation IRCCS, Pavia, Italy
| | - Roberto Grassi
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.,Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
| | - Anna Rita Larici
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy.,Department of Radiological and Hematological Sciences, Section of Radiology, Università Cattolica del Sacro Cuore, Roma, Italy
| |
Collapse
|
29
|
Granata V, Grassi R, Fusco R, Izzo F, Brunese L, Delrio P, Avallone A, Pecori B, Petrillo A. Current status on response to treatment in locally advanced rectal cancer: what the radiologist should know. Eur Rev Med Pharmacol Sci 2021; 24:12050-12062. [PMID: 33336723 DOI: 10.26355/eurrev_202012_23994] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The assessment of tumor response, after neoadjuvant radiochemotherapy (nCRT), allows stratifying the patient in order to consider the proper therapeutical management. Histopathology analysis of the surgical specimen is considered the gold standard to assess tumour response and the definition of a complete cancer response is related to the clinical and endoscopic features, by direct evaluation of the rectal wall. However, imaging studies, especially Magnetic Resonance Imaging (MRI) have provided additional parameters, as the evaluation of nodal or mesorectal status. MRI provides a radiological tumour regression grade (mrTRG) that is correlated with the pathologic tumor regression grade (pTRG). Functional MRI parameters have additional impending in early prediction of the efficacy of therapy and can be valuable in drug development processes. Some of functional methodologies are already part of clinical practice: diffusion-weighted MRI (DW-MRI) and perfusion imaging (dynamic contrast enhanced MRI [DCE-MRI]). Other technologies, such as radiomics with MRI are still in the experimental phase. An adequate radiological report describing the restaging of rectal cancer after nCRT should be a "structured report" to improve communication in a multidisciplinary team.
Collapse
Affiliation(s)
- V Granata
- Division of Radiology, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Granata V, Grassi R, Fusco R, Belli A, Palaia R, Carrafiello G, Miele V, Grassi R, Petrillo A, Izzo F. Local ablation of pancreatic tumors: State of the art and future perspectives. World J Gastroenterol 2021; 27:3413-3428. [PMID: 34163121 PMCID: PMC8218359 DOI: 10.3748/wjg.v27.i23.3413] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/28/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Currently, the technologies most commonly used to treat locally advanced pancreatic cancer are radiofrequency ablation (RFA), microwave ablation, and irreversible (IRE) or reversible electroporation combined with low doses of chemotherapeutic drugs.
AIM To report an overview and updates on ablative techniques in pancreatic cancer.
METHODS Several electronic databases were searched. The search covered the years from January 2000 to January 2021. Moreover, the reference lists of the found papers were analysed for papers not indexed in the electronic databases. All titles and abstracts were analysed.
RESULTS We found 30 studies (14 studies for RFA, 3 for microwave therapy, 10 for IRE, and 3 for electrochemotherapy), comprising 1047 patients, which were analysed further. Two randomized trials were found for IRE. Percutaneous and laparotomy approaches were performed. In the assessed patients, the median maximal diameter of the lesions was in the range of 2.8 to 4.5 cm. All series included patients unfit for surgical treatment, but Martin et al assessed a subgroup of patients with borderline resectable tumours who underwent resection with margin attenuation with IRE. Most studies administered chemotherapy prior to ablative therapies. However, several studies suggest that the key determinant of improved survival is attributable to ablative treatment alone. Nevertheless, the authors suggested chemotherapy before local therapies for several reasons. This strategy may not only downstage a subgroup of patients to curative-intent surgery but also support to recognize patients with biologically unfavourable tumours who would likely not benefit from ablation treatments. Ablation therapies seem safe based on the 1047 patients assessed in this review. The mortality rate ranged from 1.8% to 2%. However, despite the low mortality, the reported rates of severe post procedural complications ranged from 0%-42%. Most reported complications have been self-limiting and manageable. Median overall survival varied between 6.0 and 33 mo. Regarding the technical success rate, assessed papers reported an estimated rate in the range of 85% to 100%. However, the authors reported early recurrence after treatment. A distinct consideration should be made on whether local treatments induce an immune response in the ablated area. Preclinical and clinical studies have shown that RFA is a promising mechanism for inducing antigen-presenting cell infiltration and enhancing the systemic antitumour T-cell immune response and tumour regression.
CONCLUSION In the management of patients with pancreatic cancer, the possibility of a multimodal approach should be considered, and conceptually, the combination of RFA with immunotherapy represents a novel angle of attack against this tumour.
Collapse
Affiliation(s)
- Vincenza Granata
- Department of Radiology, Istituto Nazionale Tumori –IRCCS- Fondazione G. Pascale, Naples 80131, Italy
| | - Roberta Grassi
- Department of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples 80127, Italy
| | - Roberta Fusco
- Department of Radiology, Istituto Nazionale Tumori –IRCCS- Fondazione G. Pascale, Naples 80131, Italy
| | - Andrea Belli
- Department of Surgery, Istituto Nazionale Tumori –IRCCS- Fondazione G. Pascale, Naples 80131, Italy
| | - Raffaele Palaia
- Department of Surgery, Istituto Nazionale Tumori –IRCCS- Fondazione G. Pascale, Naples 80131, Italy
| | | | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology SIRM, SIRM Foundation Milan 20122, Italy
- Department of Emergency Radiology, San Camillo Hospital, Firenze 50139, Italy
| | - Roberto Grassi
- Department of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples 80127, Italy
- Italian Society of Medical and Interventional Radiology SIRM, SIRM Foundation Milan 20122, Italy
| | - Antonella Petrillo
- Department of Radiology, Istituto Nazionale Tumori –IRCCS- Fondazione G. Pascale, Naples 80131, Italy
| | - Francesco Izzo
- Department of Surgery, Istituto Nazionale Tumori –IRCCS- Fondazione G. Pascale, Naples 80131, Italy
| |
Collapse
|
31
|
Belfiore MP, Reginelli A, Russo A, Russo GM, Rocco MP, Moscarella E, Ferrante M, Sica A, Grassi R, Cappabianca S. Usefulness of High-Frequency Ultrasonography in the Diagnosis of Melanoma: Mini Review. Front Oncol 2021; 11:673026. [PMID: 34178660 PMCID: PMC8226081 DOI: 10.3389/fonc.2021.673026] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 01/30/2023] Open
Abstract
High-frequency equipment is characterized by ultrasound probes with frequencies of over 10 MHz. At higher frequencies, the wavelength decreases, which determines a lower penetration of the ultrasound beam so as to offer a better evaluation of the surface structures. This explains the growing interest in ultrasound in dermatology. This review examines the state of the art of high-frequency ultrasound (HFUS) in the assessment of skin cancer to ensure the high clinical approach and provide the best standard of evidence on which to base clinical and policy decisions.
Collapse
Affiliation(s)
- Maria Paola Belfiore
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Anna Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gaetano Maria Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Maria Paola Rocco
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marilina Ferrante
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Roberto Grassi
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
- Italian Society of Medical Radiology (SIRM) Foundation, Milan, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| |
Collapse
|
32
|
Albano D, Benenati M, Bruno A, Bruno F, Calandri M, Caruso D, Cozzi D, De Robertis R, Gentili F, Grazzini I, Micci G, Palmisano A, Pessina C, Scalise P, Vernuccio F, Barile A, Miele V, Grassi R, Messina C. Imaging side effects and complications of chemotherapy and radiation therapy: a pictorial review from head to toe. Insights Imaging 2021; 12:76. [PMID: 34114094 PMCID: PMC8192650 DOI: 10.1186/s13244-021-01017-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 04/04/2021] [Accepted: 05/18/2021] [Indexed: 02/08/2023] Open
Abstract
Newer biologic drugs and immunomodulatory agents, as well as more tolerated and effective radiation therapy schemes, have reduced treatment toxicity in oncology patients. However, although imaging assessment of tumor response is adapting to atypical responses like tumor flare, expected changes and complications of chemo/radiotherapy are still routinely encountered in post-treatment imaging examinations. Radiologists must be aware of old and newer therapeutic options and related side effects or complications to avoid a misinterpretation of imaging findings. Further, advancements in oncology research have increased life expectancy of patients as well as the frequency of long-term therapy-related side effects that once could not be observed. This pictorial will help radiologists tasked to detect therapy-related complications and to differentiate expected changes of normal tissues from tumor relapse.
Collapse
Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy. .,Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università Degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy. .,Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.
| | - Massimo Benenati
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.,Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Bruno
- Diagnostic and Interventional Radiology Unit, Maggiore Hospital "C. A. Pizzardi", 40133, Bologna, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.,Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Marco Calandri
- Radiology Unit, A.O.U. San Luigi Gonzaga di Orbassano, Department of Oncology, University of Torino, 10043, Turin, Italy
| | - Damiano Caruso
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome - Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Diletta Cozzi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.,Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Riccardo De Robertis
- U.O.C. Radiologia BT, Ospedale Civile Maggiore - Azienda Ospedaliera Universitaria Integrata Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Francesco Gentili
- Unit of Diagnostic Imaging, Department of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Irene Grazzini
- Department of Radiology, Section of Neuroradiology, San Donato Hospital, Arezzo, Italy
| | - Giuseppe Micci
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università Degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.,Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy
| | - Anna Palmisano
- Experimental Imaging Centre, Radiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, via Olgettina 58, 20132, Milan, Italy
| | - Carlotta Pessina
- Department of Radiology, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Paola Scalise
- Department of Diagnostic Imaging, Pisa University Hospital, Via Paradisa 2, 56124, Pisa, Italy
| | - Federica Vernuccio
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università Degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Antonio Barile
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Vittorio Miele
- Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50123, Florence, Italy
| | - Roberto Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122, Milan, Italy.,Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138, Naples, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | | |
Collapse
|
33
|
Granata V, Fusco R, Barretta ML, Picone C, Avallone A, Belli A, Patrone R, Ferrante M, Cozzi D, Grassi R, Grassi R, Izzo F, Petrillo A. Radiomics in hepatic metastasis by colorectal cancer. Infect Agent Cancer 2021; 16:39. [PMID: 34078424 PMCID: PMC8173908 DOI: 10.1186/s13027-021-00379-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [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: 03/29/2021] [Accepted: 05/12/2021] [Indexed: 02/06/2023] Open
Abstract
Background Radiomics is an emerging field and has a keen interest, especially in the oncology field. The process of a radiomics study consists of lesion segmentation, feature extraction, consistency analysis of features, feature selection, and model building. Manual segmentation is one of the most critical parts of radiomics. It can be time-consuming and suffers from variability in tumor delineation, which leads to the reproducibility problem of calculating parameters and assessing spatial tumor heterogeneity, particularly in large or multiple tumors. Radiomic features provides data on tumor phenotype as well as cancer microenvironment. Radiomics derived parameters, when associated with other pertinent data and correlated with outcomes data, can produce accurate robust evidence based clinical decision support systems. The principal challenge is the optimal collection and integration of diverse multimodal data sources in a quantitative manner that delivers unambiguous clinical predictions that accurately and robustly enable outcome prediction as a function of the impending decisions. Methods The search covered the years from January 2010 to January 2021. The inclusion criterion was: clinical study evaluating radiomics of liver colorectal metastases. Exclusion criteria were studies with no sufficient reported data, case report, review or editorial letter. Results We recognized 38 studies that assessed radiomics in mCRC from January 2010 to January 2021. Twenty were on different tpics, 5 corresponded to most criteria; 3 are review, or letter to editors; so 10 articles were included. Conclusions In colorectal liver metastases radiomics should be a valid tool for the characterization of lesions, in the stratification of patients based on the risk of relapse after surgical treatment and in the prediction of response to chemotherapy treatment.
Collapse
Affiliation(s)
- Vincenza Granata
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, Napoli, Italy", Via Mariano Semmola, Naples, Italy
| | - Roberta Fusco
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, Napoli, Italy", Via Mariano Semmola, Naples, Italy.
| | - Maria Luisa Barretta
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, Napoli, Italy", Via Mariano Semmola, Naples, Italy
| | - Carmine Picone
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, Napoli, Italy", Via Mariano Semmola, Naples, Italy
| | - Antonio Avallone
- Abdominal Oncology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Andrea Belli
- Hepatobiliary Surgical Oncology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Renato Patrone
- Hepatobiliary Surgical Oncology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Marilina Ferrante
- Division of Radiology, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Diletta Cozzi
- Division of Radiology, "Azienda Ospedaliera Universitaria Careggi", Florence, Italy
| | - Roberta Grassi
- Division of Radiology, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy
| | - Roberto Grassi
- Division of Radiology, "Università degli Studi della Campania Luigi Vanvitelli", Naples, Italy.,Italian Society of Medical and Interventional Radiology SIRM, SIRM Foundation, Via della Signora 2, 20122, Milan, Italy
| | - Francesco Izzo
- Hepatobiliary Surgical Oncology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, NAPOLI, ITALIA", Via Mariano Semmola, Naples, Italy
| | - Antonella Petrillo
- Radiology Division, "ISTITUTO NAZIONALE TUMORI - IRCCS - FONDAZIONE G. PASCALE, Napoli, Italy", Via Mariano Semmola, Naples, Italy
| |
Collapse
|
34
|
Sosna J, Pyatigorskaya N, Krestin G, Denton E, Stanislav K, Morozov S, Kumamaru KK, Jankharia B, Mildenberger P, Forster B, Schouman-Clayes E, Bradey A, Akata D, Brkljacic B, Grassi R, Plako A, Papanagiotou H, Maksimović R, Lexa F. International survey on residency programs in radiology: similarities and differences among 17 countries. Clin Imaging 2021; 79:230-234. [PMID: 34119915 DOI: 10.1016/j.clinimag.2021.05.011] [Citation(s) in RCA: 1] [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: 10/27/2020] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE With the initiative of the ACR International Economics Committee, a multinational survey was conducted to evaluate radiology residency programs around the world. METHODS A 31-question survey was developed. It included: economic issues, program size and length, resident's activities during daytime and call, academic aspects including syllabus and examinations. Data was tabulated using the forementioned thematic framework and was qualitatively analyzed. RESULTS Responses were received from all 17 countries that were invited to participate (France, Netherlands, Israel, UK, Russia, USA, Japan, India, Germany, Canada, Turkey, Croatia, Serbia, Italy, Ireland, Hungary, and Greece). Residency length varied between 2 and 5 years. The certificate of residency completion is provided by a local hospital [4/17 (23%)], University [6/17 (36%)], National Board [6/17 (36%)], and Ministry of Health [1/17 (6%)]. There was variability among the number of residency programs and residents per program ranging from 15 to 300 programs per nation with a 1-700 residents in each one respectively. Salaries varied significantly and ranged from 8000 to 75,000 USD equivalent. Exams are an integral part of training in all surveyed countries. Length of call varied between 5 and 26 h and the number of monthly calls ranged from 3 to 6. The future of radiology was judged as growing in [12/17 (70%)] countries and stagnant in [5/17 (30%)] countries. DISCUSSION Radiology residency programs worldwide have many similarities. The differences are in the structure of the residency programs. Stagnation and uncertainties need to be addressed to ensure the continued development of the next generation of radiologists. SUMMARY STATEMENT There are many similarities in the academic aims and approach to education and training of radiology residency programs worldwide. The differences are in the structure of the residency programs and payments to individual residents.
Collapse
Affiliation(s)
- Jacob Sosna
- Department of Radiology, Hadassah Medical Center, Hebrew University Faculty of Medicine, Jerusalem, Israel.
| | - Nadya Pyatigorskaya
- Department of Radiology Pitié-Salpêtrière, Sorbonne Universités, UPMC Univ Paris 6, Paris, France; Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Gabriel Krestin
- Department of Radiology Pitié-Salpêtrière, Sorbonne Universités, UPMC Univ Paris 6, Paris, France
| | - Erika Denton
- Department of Radiology, Norfolk & Norwich University Hospital, UK
| | - Kim Stanislav
- Radiology Research and Practical Centre, Moscow, Russia
| | | | | | | | - Peter Mildenberger
- Department of Radiology, Universitätsmedizin Mainz Klinik und Poliklinik Radiologie, Mainz, Germany
| | - Bruce Forster
- Department of Radiology, University of British Columbia, Faculty of Medicine, Vancouver, Canada
| | | | - Adrian Bradey
- Department of Radiology, Mercy University Hospital, Cork, Ireland
| | - Deniz Akata
- Department of Radiology, Hacettepe University, Ankara, Turkey
| | - Boris Brkljacic
- Department of Radiology, Dubrava Hospital, University of Zagreb, Croatia
| | - Roberto Grassi
- Department of Radiology, Università della Campania Luigi Vanvitelli, Naples, Italy
| | - Andras Plako
- Department of Radiology, University of Szeged, Hungary
| | | | | | - Frank Lexa
- The Radiology Leadership Institute and Chair of the Commission on Leadership and Practice Development of the American College of Radiology, Reston, VA, United States of America
| |
Collapse
|
35
|
Granata V, Fusco R, Setola SV, Avallone A, Palaia R, Grassi R, Izzo F, Petrillo A. Radiological assessment of secondary biliary tree lesions: an update. J Int Med Res 2021; 48:300060519850398. [PMID: 32597280 PMCID: PMC7432986 DOI: 10.1177/0300060519850398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Indexed: 12/11/2022] Open
Abstract
Objective To conduct a systematic literature review of imaging techniques and findings
in patients with peribiliary liver metastasis. Methods Several electronic datasets were searched from January 1990 to June 2017 to
identify studies assessing the use of different imaging techniques for the
detection and staging of peribiliary metastases. Results The search identified 44 studies, of which six met the inclusion criteria and
were included in the systematic review. Multidetector computed tomography
(MDCT) is the technique of choice in the preoperative setting and during the
follow-up of patients with liver tumors. However, the diagnostic performance
of MDCT for the assessment of biliary tree neoplasms was low compared with
magnetic resonance imaging (MRI). Ultrasound (US), without and with contrast
enhancement (CEUS), is commonly employed as a first-line tool for evaluating
focal liver lesions; however, the sensitivity and specificity of US and CEUS
for both the detection and characterization are related to operator
expertise and patient suitability. MRI has thus become the gold standard
technique because of its ability to provide morphologic and functional data.
MRI showed the best diagnostic performance for the detection of peribiliary
metastases. Conclusions MRI should be considered the gold standard technique for the radiological
assessment of secondary biliary tree lesions.
Collapse
Affiliation(s)
- Vincenza Granata
- Radiology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli, Naples, Italy
| | - Roberta Fusco
- Radiology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli, Naples, Italy
| | - Sergio Venanzio Setola
- Radiology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli, Naples, Italy
| | - Antonio Avallone
- Abdominal Oncology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli, Naples, Italy
| | - Raffaele Palaia
- Abdominal Surgical Oncology Division, Hepatobiliary Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli, Naples, Italy
| | - Roberto Grassi
- Radiology Unit, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Izzo
- Abdominal Surgical Oncology Division, Hepatobiliary Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli, Naples, Italy
| | - Antonella Petrillo
- Radiology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli, Naples, Italy
| |
Collapse
|
36
|
Granata V, Caruso D, Grassi R, Cappabianca S, Reginelli A, Rizzati R, Masselli G, Golfieri R, Rengo M, Regge D, Lo Re G, Pradella S, Fusco R, Faggioni L, Laghi A, Miele V, Neri E, Coppola F. Structured Reporting of Rectal Cancer Staging and Restaging: A Consensus Proposal. Cancers (Basel) 2021; 13:cancers13092135. [PMID: 33925250 PMCID: PMC8125446 DOI: 10.3390/cancers13092135] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 02/25/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Structured reporting in oncologic imaging is becoming necessary and has recently been recognized by major scientific societies. Structured reports collect all Patient Clinical Data, Clinical Evaluations and relevant key findings of Rectal Cancer, both in staging and restaging, and can facilitate clinical decision-making. Abstract Background: Structured reporting (SR) in oncologic imaging is becoming necessary and has recently been recognized by major scientific societies. The aim of this study was to build MRI-based structured reports for rectal cancer (RC) staging and restaging in order to provide clinicians all critical tumor information. Materials and Methods: A panel of radiologist experts in abdominal imaging, called the members of the Italian Society of Medical and Interventional Radiology, was established. The modified Delphi process was used to build the SR and to assess the level of agreement in all sections. The Cronbach’s alpha (Cα) correlation coefficient was used to assess the internal consistency of each section and to measure the quality analysis according to the average inter-item correlation. The intraclass correlation coefficient (ICC) was also evaluated. Results: After the second Delphi round of the SR RC staging, the panelists’ single scores and sum of scores were 3.8 (range 2–4) and 169, and the SR RC restaging panelists’ single scores and sum of scores were 3.7 (range 2–4) and 148, respectively. The Cα correlation coefficient was 0.79 for SR staging and 0.81 for SR restaging. The ICCs for the SR RC staging and restaging were 0.78 (p < 0.01) and 0.82 (p < 0.01), respectively. The final SR version was built and included 53 items for RC staging and 50 items for RC restaging. Conclusions: The final version of the structured reports of MRI-based RC staging and restaging should be a helpful and promising tool for clinicians in managing cancer patients properly. Structured reports collect all Patient Clinical Data, Clinical Evaluations and relevant key findings of Rectal Cancer, both in staging and restaging, and can facilitate clinical decision-making.
Collapse
Affiliation(s)
- Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy; (V.G.); (R.F.)
| | - Damiano Caruso
- Department of Medical-Surgical and Translational Medicine-Radiology Unit, Sapienza University of Rome, 00185 Rome, Italy; (D.C.); (M.R.); (A.L.)
| | - Roberto Grassi
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80127 Naples, Italy; (R.G.); (S.C.); (A.R.)
- SIRM Foundation, Italian Society of Medical and Interventional Radiology, 20122 Milan, Italy
| | - Salvatore Cappabianca
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80127 Naples, Italy; (R.G.); (S.C.); (A.R.)
| | - Alfonso Reginelli
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80127 Naples, Italy; (R.G.); (S.C.); (A.R.)
| | - Roberto Rizzati
- Division of Radiology, SS.ma Annunziata Hospital, Azienda USL di Ferrara, 44121 Ferrara, Italy;
| | - Gabriele Masselli
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00161 Rome, Italy;
| | - Rita Golfieri
- Division of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (R.G.); (F.C.)
| | - Marco Rengo
- Department of Medical-Surgical and Translational Medicine-Radiology Unit, Sapienza University of Rome, 00185 Rome, Italy; (D.C.); (M.R.); (A.L.)
| | - Daniele Regge
- Department of Surgical Sciences, University of Turin, 10124 Turin, Italy;
- Radiology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy
| | - Giuseppe Lo Re
- Section of Radiological Sciences, DIBIMED, University of Palermo, 90127 Palermo, Italy;
| | - Silvia Pradella
- Division of Radiology, Azienda Ospedaliera Universitaria Careggi, 50139 Florence, Italy; (S.P.); (V.M.)
| | - Roberta Fusco
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy; (V.G.); (R.F.)
| | - Lorenzo Faggioni
- Department of Translational Research, University of Pisa, 56126 Pisa, Italy;
| | - Andrea Laghi
- Department of Medical-Surgical and Translational Medicine-Radiology Unit, Sapienza University of Rome, 00185 Rome, Italy; (D.C.); (M.R.); (A.L.)
| | - Vittorio Miele
- Division of Radiology, Azienda Ospedaliera Universitaria Careggi, 50139 Florence, Italy; (S.P.); (V.M.)
| | - Emanuele Neri
- SIRM Foundation, Italian Society of Medical and Interventional Radiology, 20122 Milan, Italy
- Department of Translational Research, University of Pisa, 56126 Pisa, Italy;
- Correspondence: ; Tel.: +39-050-997313 or +39-050-992913
| | - Francesca Coppola
- Division of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (R.G.); (F.C.)
| |
Collapse
|
37
|
La Marca A, Spaggiari G, Domenici D, Grassi R, Casonati A, Baraldi E, Trenti T, Simoni M, Santi D. Elevated levels of nitrous dioxide are associated with lower AMH levels: a real-world analysis. Hum Reprod 2021; 35:2589-2597. [PMID: 32951044 DOI: 10.1093/humrep/deaa214] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 04/29/2020] [Revised: 07/17/2020] [Indexed: 12/20/2022] Open
Abstract
STUDY QUESTION Are there any associations between environmental pollutants and ovarian reserve, expressed by anti-Mullerian hormone (AMH) serum levels? SUMMARY ANSWER In this first real-world approach to demonstrate the relationship between air pollutants and serum AMH levels, adverse associations were observed for nitrogen dioxide (NO2) but not with particulate matter. WHAT IS KNOWN ALREADY In recent years, air pollution has emerged as a potential disrupter to the homeostasis of physiological hormones, possibly affecting human reproduction. Although the influence of age and smoking on AMH levels is largely accepted, the relationship between AMH and the environment has not currently been established. STUDY DESIGN, SIZE, DURATION A longitudinal, observational, retrospective, real-world study was carried out, including all AMH measurements performed in a single laboratory from January 2007 to October 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Serum AMH data were connected to patients' age and residential address, to include air pollution data after geo-localisation. The air pollution considered daily particulate matter (PM) and NO2 values. MAIN RESULTS AND THE ROLE OF CHANCE A total of 1463 AMH measurements were collected (mean 1.94 ng/ml, median 0.90 ng/ml). AMH was inversely related to patients' age in women older than 25 years (adjusted R-squared 0.120, P < 0.001), but not in those younger than 25 years (adjusted R-squared 0.068, P = 0.055). AMH levels were inversely related to environmental pollutants, such as PM10 (Rho = -0.088, P = 0.001), PM2.5 (Rho = -0.062, P = 0.021) and NO2 (Rho = -0.111, P < 0.001). After subdividing the dataset into quartiles for PM10 and PM2.5, the influence of age on AMH serum levels was found to be a stronger influence than that exerted by PM (P = 0.833 and P = 0.370, respectively). On the contrary, considering NO2 quartiles, higher AMH levels were observed in third quartile compared to fourth quartile, even after adjustment for age (P = 0.028), indicating a stronger influence of NO2 exposure on AMH serum levels. Considering an AMH cut-off of 0.3 ng/ml, a significant higher frequency of women with severe ovarian reserve reduction in the fourth quartile was shown only for NO2 (P = 0.010). LIMITATIONS, REASONS FOR CAUTION Several limitations should be underlined, such as the lack of information about work and life habits of each patient and the retrospective nature of the analysis performed on real-world data. WIDER IMPLICATIONS OF THE FINDINGS Although the genetic component is highly predictive for defining the ovarian reserve at birth, potentially modifiable environmental factors could influence the rate of decline in AMH and ovarian reserve during adulthood. STUDY FUNDINGCOMPETING INTEREST(S) Authors have neither funding nor competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Antonio La Marca
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Giorgia Spaggiari
- Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Daniela Domenici
- Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Enrica Baraldi
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Modena, Italy
| | - Tommaso Trenti
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Modena, Italy
| | - Manuela Simoni
- Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Santi
- Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
38
|
Granata V, Fusco R, Setola SV, Galdiero R, Picone C, Izzo F, D’Aniello R, Miele V, Grassi R, Grassi R, Petrillo A. Lymphadenopathy after BNT162b2 Covid-19 Vaccine: Preliminary Ultrasound Findings. Biology (Basel) 2021; 10:biology10030214. [PMID: 33799618 PMCID: PMC8001230 DOI: 10.3390/biology10030214] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 12/26/2022]
Abstract
Simple Summary Eccentric cortical thickening with wide echogenic hilum and oval shape, asymmetric eccentric cortical thickening with wide echogenic hilum and oval shape, concentric cortical thickening with reduction in the width of the echogenic hilum and oval shape, and huge reduction and displacement of the echogenic hilum and round shape are the features that we found in post BNT162b2 Covid-19 Vaccine lymphadenopathies. Abstract During a spontaneous and autonomous study, we assessed the ultrasound finding of lymphadenopathy after BNT162b2 Pfizer vaccine. We enrolled 18 patients with 58 lymphadenopathies: in 10 patients, they were in the laterocervical side, while in 8 patients in the axillar site. The largest diameter was 16 mm with a range from 7 to 16 mm (median value = 10 mm). In the same patient, we found different ultrasound nodal findings. A total of 25 nodes showed eccentric cortical thickening with wide echogenic hilum and oval shape. In total, 19 nodes showed asymmetric eccentric cortical thickening with wide echogenic hilum and oval shape. Overall, 10 nodes showed concentric cortical thickening with reduction in the width of the echogenic hilum and oval shape. A total of four nodes showed huge reduction and displacement of the echogenic hilum and round or oval shape. No anomaly was found at the Doppler echocolor study. In conclusion, eccentric cortical thickening with wide echogenic hilum and oval shape, asymmetric eccentric cortical thickening with wide echogenic hilum and oval shape, concentric cortical thickening with reduction in the width of the echogenic hilum and oval shape, and a huge reduction and displacement of the echogenic hilum and round shape are the features that we found in post BNT162b2 Covid-19 Vaccine lymphadenopathies.
Collapse
Affiliation(s)
- Vincenza Granata
- Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy; (V.G.); (S.V.S.); (R.G.); (C.P.); (A.P.)
| | - Roberta Fusco
- Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy; (V.G.); (S.V.S.); (R.G.); (C.P.); (A.P.)
- Correspondence: ; Tel.: +39-081590714; Fax: +39-0815903825
| | - Sergio Venanzio Setola
- Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy; (V.G.); (S.V.S.); (R.G.); (C.P.); (A.P.)
| | - Roberta Galdiero
- Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy; (V.G.); (S.V.S.); (R.G.); (C.P.); (A.P.)
| | - Carmine Picone
- Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy; (V.G.); (S.V.S.); (R.G.); (C.P.); (A.P.)
| | - Francesco Izzo
- Hepatobiliary Surgical Oncology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy;
| | - Roberta D’Aniello
- Hospital Pharmacy Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy;
| | - Vittorio Miele
- Division of Radiodiagnostic, “Azienda Ospedaliero-Universitaria Careggi”, 50139 Firenze, Italy;
| | - Roberta Grassi
- Division of Radiology, University of Campania Luigi Vanvitelli, 80125 Naples, Italy; (R.G.); (R.G.)
| | - Roberto Grassi
- Division of Radiology, University of Campania Luigi Vanvitelli, 80125 Naples, Italy; (R.G.); (R.G.)
- Foundation SIRM, 20122 Milan, Italy
| | - Antonella Petrillo
- Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy; (V.G.); (S.V.S.); (R.G.); (C.P.); (A.P.)
| |
Collapse
|
39
|
Coppola F, Faggioni L, Neri E, Grassi R, Miele V. Impact of the COVID-19 outbreak on the profession and psychological wellbeing of radiologists: a nationwide online survey. Insights Imaging 2021; 12:23. [PMID: 33595747 PMCID: PMC7887566 DOI: 10.1186/s13244-021-00962-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 11/09/2020] [Accepted: 01/04/2021] [Indexed: 01/08/2023] Open
Abstract
Background The COVID-19 outbreak has played havoc within healthcare systems, with radiology sharing a substantial burden. Our purpose is to report findings from a survey on the crisis impact among members of the Italian Society of Medical and Interventional Radiology (SIRM). Methods All members were invited to a 42-question online survey about the impact of the COVID-19 outbreak on personal and family life, professional activity, socioeconomic and psychological condition. Participants were classified based on working in the most severely affected Italian regions (“hot regions”) or elsewhere. Results A total of 2150 radiologists joined the survey. More than 60% of respondents estimated a workload reduction greater than 50%, with a higher prevalence among private workers in hot regions (72.7% vs 66.5% elsewhere, p = 0.1010). Most respondents were concerned that the COVID-19 outbreak could impact the management of non-COVID-19 patients and expected a work overload after the crisis. More than 40% were moderately or severely worried that their professional activity could be damaged, and most residents believed that their training had been affected. More than 50% of respondents had increased emotional stress at work, including moderate or severe symptoms due to sleep disturbances, feeling like living in slow motion and having negative thoughts, those latter being more likely in single-living respondents from hot regions [log OR 0.7108 (CI95% 0.3445 ÷ 1.0770), p = 0.0001]. Conclusions The COVID-19 outbreak has had a sensible impact on the working and personal life of SIRM members, with more specific criticalities in hot regions. Our findings could aid preserving the radiologists’ wellbeing after the crisis.
Collapse
Affiliation(s)
- Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Faggioni
- Department of Translational Research, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
| | - Emanuele Neri
- Department of Translational Research, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.,SIRM Foundation, Italian Society of Medical and Interventional Radiology, Milan, Italy
| | - Roberto Grassi
- Department of Precision Medicine, University of Campania, Naples, Italy
| | - Vittorio Miele
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| |
Collapse
|
40
|
Grassi R, Fusco R, Belfiore MP, Montanelli A, Patelli G, Urraro F, Petrillo A, Granata V, Sacco P, Mazzei MA, Feragalli B, Reginelli A, Cappabianca S. Author Correction: Coronavirus disease 2019 (COVID-19) in Italy: features on chest computed tomography using a structured report system. Sci Rep 2021; 11:4231. [PMID: 33589650 PMCID: PMC7883335 DOI: 10.1038/s41598-021-81863-8] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Roberto Grassi
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy.
| | - Roberta Fusco
- Radiology Division, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy
| | - Maria Paola Belfiore
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy
| | | | | | - Fabrizio Urraro
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy
| | - Antonella Petrillo
- Radiology Division, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy
| | - Vincenza Granata
- Radiology Division, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy
| | - Palmino Sacco
- Department of Radiological Sciences, Diagnostic Imaging Unit, "Azienda Ospedaliera Universitaria Senese", Siena, Italy
| | - Maria Antonietta Mazzei
- Department of Radiological Sciences, Diagnostic Imaging Unit, "Azienda Ospedaliera Universitaria Senese", Siena, Italy
| | - Beatrice Feragalli
- Department of Medical, Oral and Biotechnological Sciences ‑ Radiology Unit "G. D'Annunzio", University of Chieti-Pescara, Chieti, Italy
| | - Alfonso Reginelli
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy
| | - Salvatore Cappabianca
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
41
|
Reginelli A, Clemente A, Sangiovanni A, Nardone V, Selvaggi F, Sciaudone G, Ciardiello F, Martinelli E, Grassi R, Cappabianca S. Endorectal Ultrasound and Magnetic Resonance Imaging for Rectal Cancer Staging: A Modern Multimodality Approach. J Clin Med 2021; 10:jcm10040641. [PMID: 33567516 PMCID: PMC7915333 DOI: 10.3390/jcm10040641] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 01/02/2021] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/11/2022] Open
Abstract
Preoperative staging represents a crucial point for the management, type of surgery, and candidacy for neoadjuvant therapy in patient with rectal cancer. The most recent clinical guidelines in oncology recommend an accurate preoperative evaluation in order to address early and advanced tumors to different therapeutic options. In particular, potential pitfalls may occur in the assessment of T3 tumors, which represents the most common stage at diagnosis. The depth of tumor invasion is known to be an important prognostic factor in rectal carcinoma; as a consequence, the T3 imaging classification has a substantial importance for treatment strategy and patient survival. However, the differentiation between tumor invasion of perirectal fat and mesorectal desmoplastic reactions remains a main goal for radiologists. Magnetic resonance imaging (MRI) is actually considered as the best imaging modality for rectal cancer staging. Although the endorectal ultrasound (ERUS) is the preferred staging method for early tumors, it could also be useful in identifying perirectal fat invasion. Moreover, the addiction of diffusion weighted imaging (DWI) improves the diagnostic performance of MRI in rectal cancer staging by adding functional information about rectal tumor and adjacent mesorectal tissues. This study investigated the diagnostic performance of conventional MRI alone, in combination with the DWI technique and ERUS in order to assess the best diagnostic imaging combination for rectal cancer staging.
Collapse
Affiliation(s)
- Alfonso Reginelli
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (A.S.); (R.G.); (S.C.)
| | - Alfredo Clemente
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (A.S.); (R.G.); (S.C.)
- Correspondence: ; Tel.: +39-0815665200
| | - Angelo Sangiovanni
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (A.S.); (R.G.); (S.C.)
| | - Valerio Nardone
- Unit of Radiation Oncology, Ospedale del Mare, 80147 Naples, Italy;
| | - Francesco Selvaggi
- Colorectal Surgery, Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (F.S.); (G.S.)
| | - Guido Sciaudone
- Colorectal Surgery, Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (F.S.); (G.S.)
| | - Fortunato Ciardiello
- Medical Oncology, Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (F.C.); (E.M.)
| | - Erika Martinelli
- Medical Oncology, Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (F.C.); (E.M.)
| | - Roberto Grassi
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (A.S.); (R.G.); (S.C.)
| | - Salvatore Cappabianca
- Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (A.R.); (A.S.); (R.G.); (S.C.)
| |
Collapse
|
42
|
Reginelli A, Grassi R, Feragalli B, Belfiore MP, Montanelli A, Patelli G, La Porta M, Urraro F, Fusco R, Granata V, Petrillo A, Giacobbe G, Russo GM, Sacco P, Grassi R, Cappabianca S. Coronavirus Disease 2019 (COVID-19) in Italy: Double Reading of Chest CT Examination. Biology (Basel) 2021; 10:biology10020089. [PMID: 33504028 PMCID: PMC7911408 DOI: 10.3390/biology10020089] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 01/22/2021] [Indexed: 12/28/2022]
Abstract
To assess the performance of the second reading of chest compute tomography (CT) examinations by expert radiologists in patients with discordance between the reverse transcription real-time fluorescence polymerase chain reaction (RT-PCR) test for COVID-19 viral pneumonia and the CT report. Three hundred and seventy-eight patients were included in this retrospective study (121 women and 257 men; 71 years median age, with a range of 29-93 years) and subjected to RT-PCR tests for suspicious COVID-19 infection. All patients were subjected to CT examination in order to evaluate the pulmonary disease involvement by COVID-19. CT images were reviewed first by two radiologists who identified COVID-19 typical CT patterns and then reanalyzed by another two radiologists using a CT structured report for COVID-19 diagnosis. Weighted к values were used to evaluate the inter-reader agreement. The median temporal window between RT-PCRs execution and CT scan was zero days with a range of (-9,11) days. The RT-PCR test was positive in 328/378 (86.8%). Discordance between RT-PCR and CT findings for viral pneumonia was revealed in 60 cases. The second reading changed the CT diagnosis in 16/60 (26.7%) cases contributing to an increase the concordance with the RT-PCR. Among these 60 cases, eight were false negative with positive RT-PCR, and 36 were false positive with negative RT-PCR. Sensitivity, specificity, positive predictive value and negative predictive value of CT were respectively of 97.3%, 53.8%, 89.0%, and 88.4%. Double reading of CT scans and expert second readers could increase the diagnostic confidence of radiological interpretation in COVID-19 patients.
Collapse
Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80121 Naples, Italy; (A.R.); (R.G.); (M.P.B.); (F.U.); (G.G.); (G.M.R.); (R.G.); (S.C.)
| | - Roberta Grassi
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80121 Naples, Italy; (A.R.); (R.G.); (M.P.B.); (F.U.); (G.G.); (G.M.R.); (R.G.); (S.C.)
| | - Beatrice Feragalli
- Oral and Biotechnological Sciences—Radiology Unit “G. D’Annunzio”, Department of Medical, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Maria Paola Belfiore
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80121 Naples, Italy; (A.R.); (R.G.); (M.P.B.); (F.U.); (G.G.); (G.M.R.); (R.G.); (S.C.)
| | | | | | | | - Fabrizio Urraro
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80121 Naples, Italy; (A.R.); (R.G.); (M.P.B.); (F.U.); (G.G.); (G.M.R.); (R.G.); (S.C.)
| | - Roberta Fusco
- Radiology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy; (V.G.); (A.P.)
- Correspondence: ; Tel.: +39-081-590-3714
| | - Vincenza Granata
- Radiology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy; (V.G.); (A.P.)
| | - Antonella Petrillo
- Radiology Division, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy; (V.G.); (A.P.)
| | - Giuliana Giacobbe
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80121 Naples, Italy; (A.R.); (R.G.); (M.P.B.); (F.U.); (G.G.); (G.M.R.); (R.G.); (S.C.)
| | - Gaetano Maria Russo
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80121 Naples, Italy; (A.R.); (R.G.); (M.P.B.); (F.U.); (G.G.); (G.M.R.); (R.G.); (S.C.)
| | - Palmino Sacco
- Diagnostic Imaging Unit, Department of Radiological Sciences, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy;
| | - Roberto Grassi
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80121 Naples, Italy; (A.R.); (R.G.); (M.P.B.); (F.U.); (G.G.); (G.M.R.); (R.G.); (S.C.)
- Foundation SIRM, 20122 Milan, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80121 Naples, Italy; (A.R.); (R.G.); (M.P.B.); (F.U.); (G.G.); (G.M.R.); (R.G.); (S.C.)
| |
Collapse
|
43
|
Reginelli A, Vacca G, Belfiore M, Sangiovanni A, Nardone V, Vanzulli A, Grassi R, Cappabianca S. Pitfalls and differential diagnosis on adrenal lesions: current concepts in CT/MR imaging: a narrative review. Gland Surg 2021; 9:2331-2342. [PMID: 33447584 DOI: 10.21037/gs-20-559] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The purpose of this pictorial essay is to review the imaging findings of adrenal lesions. Adrenal lesions could be divided into functioning or non-functioning masses, primary or metastatic, and benign or malignant. Imaging techniques have undergone significant advances in recent years. The most significant objective of adrenal imaging is represented by the detection and, when possible, characterization of adrenal lesions in order to direct patient management correctly. The detection and management of adrenal lesions is based on cross-sectional imaging obtained with non-contrast CT (tumour density), contrast-enhanced CT including delayed washout (either absolute percentage washout or relative percentage one) and finally with MR chemical shift analysis (loss of signal intensity between in-phase and out-of-phase images including both qualitative and quantitative estimates of signal loss). The small incidental adrenal nodules are benign, in most of cases; some tumors such as lipid-rich adenoma and myelolipoma have characteristic features that can be diagnosed accurately in CT. On contrary, if the presenting contrast-enhanced CT shows an adrenal mass with uncertain or malignant morphologic features, particularly in patients with a known history of malignancy, further evaluations should be considered. The most significative implications for radiologists are represented by how to assess risk of malignancy on imaging and what follow-up to indicate if an adrenal incidentaloma is not surgically removed.
Collapse
Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giovanna Vacca
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mariapaola Belfiore
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Angelo Sangiovanni
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Valerio Nardone
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Angelo Vanzulli
- Department of Radiology, University "La Statale" of Milan, Milan, Italy
| | - Roberto Grassi
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| |
Collapse
|
44
|
Granata V, Coppola F, Grassi R, Fusco R, Tafuto S, Izzo F, Reginelli A, Maggialetti N, Buccicardi D, Frittoli B, Rengo M, Bortolotto C, Prost R, Lacasella GV, Montella M, Ciaghi E, Bellifemine F, De Muzio F, Danti G, Grazzini G, De Filippo M, Cappabianca S, Barresi C, Iafrate F, Stoppino LP, Laghi A, Grassi R, Brunese L, Neri E, Miele V, Faggioni L. Structured Reporting of Computed Tomography in the Staging of Neuroendocrine Neoplasms: A Delphi Consensus Proposal. Front Endocrinol (Lausanne) 2021; 12:748944. [PMID: 34917023 PMCID: PMC8670531 DOI: 10.3389/fendo.2021.748944] [Citation(s) in RCA: 9] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/12/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports in Neuroendocrine Neoplasms during the staging phase in order to improve communication between the radiologist and members of multidisciplinary teams. MATERIALS AND METHODS A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A Modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. Cronbach's alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. RESULTS The final SR version was built by including n=16 items in the "Patient Clinical Data" section, n=13 items in the "Clinical Evaluation" section, n=8 items in the "Imaging Protocol" section, and n=17 items in the "Report" section. Overall, 54 items were included in the final version of the SR. Both in the first and second round, all sections received more than a good rating: a mean value of 4.7 and range of 4.2-5.0 in the first round and a mean value 4.9 and range of 4.9-5 in the second round. In the first round, the Cα correlation coefficient was a poor 0.57: the overall mean score of the experts and the sum of scores for the structured report were 4.7 (range 1-5) and 728 (mean value 52.00 and standard deviation 2.83), respectively. In the second round, the Cα correlation coefficient was a good 0.82: the overall mean score of the experts and the sum of scores for the structured report were 4.9 (range 4-5) and 760 (mean value 54.29 and standard deviation 1.64), respectively. CONCLUSIONS The present SR, based on a multi-round consensus-building Delphi exercise following in-depth discussion between expert radiologists in gastro-enteric and oncological imaging, derived from a multidisciplinary agreement between a radiologist, medical oncologist and surgeon in order to obtain the most appropriate communication tool for referring physicians.
Collapse
Affiliation(s)
- Vincenza Granata
- Division of Radiology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale – IRCCS di Napoli”, Naples, Italy
| | - Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Roberta Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Division of Radiology, “Università degli Studi della Campania Luigi Vanvitelli”, Naples, Italy
| | | | - Salvatore Tafuto
- Medical Oncology Unit, Istituto Nazionale Tumori IRCCS ‘Fondazione G. Pascale’, Naples, Italy
| | - Francesco Izzo
- Department of Surgery, Istituto Nazionale Tumori -IRCCS- Fondazione G. Pascale, Naples, Italy
| | - Alfonso Reginelli
- Division of Radiology, “Università degli Studi della Campania Luigi Vanvitelli”, Naples, Italy
| | | | | | - Barbara Frittoli
- Department of Radiology, Ospedali Civili, Hospital of Brescia, University of Brescia, Brescia, Italy
| | - Marco Rengo
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome - I.C.O.T. Hospital, Latina, Italy
| | - Chandra Bortolotto
- Department of Radiology, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy
| | - Roberto Prost
- Radiology Unit, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Giorgia Viola Lacasella
- Division of Radiology, “Università degli Studi della Campania Luigi Vanvitelli”, Naples, Italy
| | - Marco Montella
- Division of Radiology, “Università degli Studi della Campania Luigi Vanvitelli”, Naples, Italy
| | | | | | - Federica De Muzio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Ginevra Danti
- Division of Radiology, “Azienda Ospedaliera Universitaria Careggi”, Florence, Italy
- *Correspondence: Ginevra Danti,
| | - Giulia Grazzini
- Division of Radiology, “Azienda Ospedaliera Universitaria Careggi”, Florence, Italy
| | - Massimo De Filippo
- Department of Medicine and Surgery, Unit of Radiology, University of Parma, Maggiore Hospital, Parma, Italy
| | - Salvatore Cappabianca
- Division of Radiology, “Università degli Studi della Campania Luigi Vanvitelli”, Naples, Italy
| | - Carmelo Barresi
- Diagnostic Imaging Section, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Franco Iafrate
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | | | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant’Andrea University Hospital, Rome, Italy
| | - Roberto Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Division of Radiology, “Università degli Studi della Campania Luigi Vanvitelli”, Naples, Italy
| | - Luca Brunese
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Emanuele Neri
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Division of Radiology, “Azienda Ospedaliera Universitaria Careggi”, Florence, Italy
| | - Lorenzo Faggioni
- Department of Translational Research, University of Pisa, Pisa, Italy
| |
Collapse
|
45
|
Scaglione M, Basilico R, Delli Pizzi A, Iacobellis F, Dick E, Wirth S, Linsenmaier U, Calli C, Berger FH, Nieboer KH, Blanco Barrio A, Dumba M, Grassi R, Katulska K, Schueller G, Patlas MN, Laghi A, Muto M, Nicola R, Zins M, Miele V, Hartley R, Katz DS, Derchi L. Correction to: The practice of emergency radiology throughout Europe: a survey from the European Society of Emergency Radiology on volume, staffing, equipment, and scheduling. Eur Radiol 2020; 31:4407-4408. [PMID: 33289875 DOI: 10.1007/s00330-020-07520-2] [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: 11/29/2022]
Affiliation(s)
- Mariano Scaglione
- Department of Radiology, James Cook University Hospital, Middlesbrough, UK.,School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, UK.,Department of Radiology, Pineta Grande Hospital, Castel Volturno, CE, Italy
| | - Raffaella Basilico
- Department of Neuroscience Imaging and Clinical Science, Gabriele D'Annunzio University, Chieti, Italy
| | - Andrea Delli Pizzi
- Department of Neuroscience Imaging and Clinical Science, Gabriele D'Annunzio University, Chieti, Italy
| | - Francesca Iacobellis
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli St 9, 80131, Naples, Italy.
| | - Elizabeth Dick
- Department of Radiology, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Stefan Wirth
- Department of Radiology and Nuclear Medicine, Schwarzwald-Baar Hospital, Klinikstr. 11, 78052, Villingen-Schwenningen, Germany
| | - Ulrich Linsenmaier
- Institute for Diagnostic and Interventional Radiology, HELIOS Klinikum Munich West and Munich Perlach, Munich, Germany
| | - Cem Calli
- Radiology Department, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ferco H Berger
- Department of Medical Imaging, Sunnybrook Health Science Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Koenraad H Nieboer
- Departement of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Ana Blanco Barrio
- Servicio de Radiodiagnóstico, Sección de Radiología de Urgencias, Hospital G.U. Morales Meseguer, Av. Marqués de los Vélez s/n, 30008, Murcia, Spain
| | - Maureen Dumba
- Department of Radiology, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Roberto Grassi
- Department of Radiology, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy
| | - Katarzyna Katulska
- Department of Radiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Gerd Schueller
- ERS Emergency Radiology Schueller, 6302, Zug, Switzerland
| | - Michael N Patlas
- Department of Radiology, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario, L8L 2X2, Canada
| | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, "Sapienza" - University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Mario Muto
- Department of Neuroradiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli St 9, 80131, Naples, Italy
| | - Refky Nicola
- Department of Radiology, SUNY-Upstate University and Medical Center, Syracuse, NY, USA
| | - Marc Zins
- Radiology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Vittorio Miele
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Richard Hartley
- Department of Radiology, James Cook University Hospital, Middlesbrough, UK.,School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, UK
| | - Douglas S Katz
- Department of Radiology, NYU Wintrop Hospital, Mineola, NY, USA
| | - Lorenzo Derchi
- Department of Health Sciences, Radiology Section, University of Genoa, Genoa, Italy.,Department of Emergency Radiology, San Martino Policlinico Hospital, Genoa, Italy
| |
Collapse
|
46
|
Granata V, Grassi R, Fusco R, Setola SV, Palaia R, Belli A, Miele V, Brunese L, Grassi R, Petrillo A, Izzo F. Assessment of Ablation Therapy in Pancreatic Cancer: The Radiologist's Challenge. Front Oncol 2020; 10:560952. [PMID: 33330028 PMCID: PMC7731725 DOI: 10.3389/fonc.2020.560952] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 05/11/2020] [Accepted: 10/30/2020] [Indexed: 12/12/2022] Open
Abstract
This article provides an overview of imaging assessment of ablated pancreatic cancer. Only studies reporting radiological assessment on pancreatic ablated cancer were retained. We found 16 clinical studies that satisfied the inclusion criteria. Radiofrequency ablation and irreversible electroporation have become established treatment modalities because of their efficacy, low complication rates, and availability. Microwave Ablation (MWA) has several advantages over radiofrequency ablation (RFA), which may make it more attractive to treat pancreatic cancer. Electrochemotherapy (ECT) is a very interesting emerging technique, characterized by low complication rate and safety profile. According to the literature, the assessment of the effectiveness of ablative therapies is difficult by means of the Response Evaluation Criteria in Solid Tumors (RECIST) criteria that are not suitable to evaluate the treatment response considering that are related to technique used, the timing of reassessment, and the imaging procedure being used to evaluate the efficacy. RFA causes various appearances on imaging in the ablated zone, correlating to the different effects, such as interstitial edema, hemorrhage, carbonization, necrosis, and fibrosis. Irreversible electroporation (IRE) causes the creation of pores within the cell membrane causing cell death. Experimental studies showed that Diffusion Weigthed Imaging (DWI) extracted parameters could be used to detect therapy effects. No data about functional assessment post MWA is available in literature. Morphologic data extracted by Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) do not allow to differentiate partial, complete, or incomplete response after ECT conversely to functional parameters, obtained with Position Emission Tomography (PET), MRI, and CT.
Collapse
Affiliation(s)
- Vincenza Granata
- Radiology Division, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Roberta Grassi
- Radiology Division, Universita’ Degli Studi Della Campania Luigi Vanvitelli, Naples, Italy
| | - Roberta Fusco
- Radiology Division, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Sergio Venanzio Setola
- Radiology Division, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Raffaele Palaia
- Hepatobiliary Surgical Oncology Division, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Andrea Belli
- Hepatobiliary Surgical Oncology Division, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Vittorio Miele
- Department of Radiology, Careggi University Hospital, Florence, Italy
| | - Luca Brunese
- Department of Medicine and Health Sciences “V. Tiberio,” University of Molise, Campobasso, Italy
| | - Roberto Grassi
- Radiology Division, Universita’ Degli Studi Della Campania Luigi Vanvitelli, Naples, Italy
| | - Antonella Petrillo
- Radiology Division, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| | - Francesco Izzo
- Hepatobiliary Surgical Oncology Division, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy
| |
Collapse
|
47
|
Grassi R, Fusco R, Belfiore MP, Montanelli A, Patelli G, Urraro F, Petrillo A, Granata V, Sacco P, Mazzei MA, Feragalli B, Reginelli A, Cappabianca S. Coronavirus disease 2019 (COVID-19) in Italy: features on chest computed tomography using a structured report system. Sci Rep 2020; 10:17236. [PMID: 33057039 PMCID: PMC7566610 DOI: 10.1038/s41598-020-73788-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023] Open
Abstract
To assess the use of a structured report in the Chest Computed Tomography (CT) reporting of patients with suspicious viral pneumonia by COVID-19 and the evaluation of the main CT patterns. This study included 134 patients (43 women and 91 men; 68.8 years of mean age, range 29-93 years) with suspicious COVID-19 viral infection evaluated by reverse transcription real-time fluorescence polymerase chain reaction (RT-PCR) test. All patients underwent CT examinations at the time of admission. CT images were reviewed by two radiologists who identified COVID-19 CT patterns using a structured reports. Temporal difference mean value between RT-PCRs and CT scan was 0.18 days ± 2.0 days. CT findings were positive for viral pneumonia in 94.0% patients while COVID-19 was diagnosed at RT-PCR in 77.6% patients. Time mean value to complete the structured report by radiologist was 8.5 min ± 2.4 min. The disease on chest CT predominantly affected multiple lobes and the main CT feature was ground glass opacity (GGO) with or without consolidation (96.8%). GGO was predominantly bilateral (89.3%), peripheral (80.3%), multifocal/patching (70.5%). Consolidation disease was predominantly bilateral (83.9%) with prevalent peripheral (87.1%) and segmental (47.3%) distribution. Additional CT signs were the crazy-paving pattern in 75.4% of patients, the septal thickening in 37.3% of patients, the air bronchogram sign in 39.7% and the "reversed halo" sign in 23.8%. Less frequent characteristics at CT regard discrete pulmonary nodules, increased trunk diameter of the pulmonary artery, pleural effusion and pericardium effusion (7.9%, 6.3%, 14.3% and 16.7%, respectively). Barotrauma sign was absent in all the patients. High percentage (54.8%) of the patients had mediastinal lymphadenopathy. Using a Chest CT structured report, with a standardized language, we identified that the cardinal hallmarks of COVID-19 infection were bilateral, peripheral and multifocal/patching GGO and bilateral consolidation with peripheral and segmental distribution.
Collapse
Affiliation(s)
- Roberto Grassi
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy.
| | - Roberta Fusco
- Radiology Division, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy
| | - Maria Paola Belfiore
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy
| | | | | | - Fabrizio Urraro
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy
| | - Antonella Petrillo
- Radiology Division, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy
| | - Vincenza Granata
- Radiology Division, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy
| | - Palmino Sacco
- Department of Radiological Sciences, Diagnostic Imaging Unit, "Azienda Ospedaliera Universitaria Senese", Siena, Italy
| | - Maria Antonietta Mazzei
- Department of Radiological Sciences, Diagnostic Imaging Unit, "Azienda Ospedaliera Universitaria Senese", Siena, Italy
| | - Beatrice Feragalli
- Department of Medical, Oral and Biotechnological Sciences - Radiology Unit "G. D'Annunzio", University of Chieti-Pescara, Chieti, Italy
| | - Alfonso Reginelli
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy
| | - Salvatore Cappabianca
- Division of Radiodiagnostic, "Università Degli Studi Della Campania Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
48
|
Schiavone C, Grassi R, Bertolotto M, Privitera C, Iannetti G, Calliada F, Cantisani V. The sonographic medical act. J Ultrasound 2020; 23:445-447. [PMID: 32968963 DOI: 10.1007/s40477-020-00518-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Cosima Schiavone
- Unit of Internistic Ultrasound, SSD Gastroenterology, Department of Medicine and Science of Aging, G.D'Annunzio University, Chieti-Pescara, Chieti, Italy.
| | - Roberto Grassi
- Medical‑Surgical Department of Clinical and Experimental Internistics "F. Magrassi and A.Lanzara", Faculty Medicine and Surgery, II University of Naples, Naples, Italy
| | - Michele Bertolotto
- U.O.C. Radiology Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Carmelo Privitera
- Complex Operative Unit of Radiology, Vittorio Emanuele Hospital, Catania, Italy
| | | | - Fabrizio Calliada
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Vito Cantisani
- UOS of Diagnostic and Ultrasonographic Innovations, Policlinico Umberto I, University of Rome Sapienza, Rome, Italy
| |
Collapse
|
49
|
Grassi R, Cappabianca S, Urraro F, Feragalli B, Montanelli A, Patelli G, Granata V, Giacobbe G, Russo GM, Grillo A, De Lisio A, Paura C, Clemente A, Gagliardi G, Magliocchetti S, Cozzi D, Fusco R, Belfiore MP, Grassi R, Miele V. Chest CT Computerized Aided Quantification of PNEUMONIA Lesions in COVID-19 Infection: A Comparison among Three Commercial Software. Int J Environ Res Public Health 2020; 17:E6914. [PMID: 32971756 PMCID: PMC7558768 DOI: 10.3390/ijerph17186914] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 01/15/2023]
Abstract
PURPOSE To compare different commercial software in the quantification of Pneumonia Lesions in COVID-19 infection and to stratify the patients based on the disease severity using on chest computed tomography (CT) images. MATERIALS AND METHODS We retrospectively examined 162 patients with confirmed COVID-19 infection by reverse transcriptase-polymerase chain reaction (RT-PCR) test. All cases were evaluated separately by radiologists (visually) and by using three computer software programs: (1) Thoracic VCAR software, GE Healthcare, United States; (2) Myrian, Intrasense, France; (3) InferRead, InferVision Europe, Wiesbaden, Germany. The degree of lesions was visually scored by the radiologist using a score on 5 levels (none, mild, moderate, severe, and critic). The parameters obtained using the computer tools included healthy residual lung parenchyma, ground-glass opacity area, and consolidation volume. Intraclass coefficient (ICC), Spearman correlation analysis, and non-parametric tests were performed. RESULTS Thoracic VCAR software was not able to perform volumes segmentation in 26/162 (16.0%) cases, Myrian software in 12/162 (7.4%) patients while InferRead software in 61/162 (37.7%) patients. A great variability (ICC ranged for 0.17 to 0.51) was detected among the quantitative measurements of the residual healthy lung parenchyma volume, GGO, and consolidations volumes calculated by different computer tools. The overall radiological severity score was moderately correlated with the residual healthy lung parenchyma volume obtained by ThoracicVCAR or Myrian software, with the GGO area obtained by the ThoracicVCAR tool and with consolidation volume obtained by Myrian software. Quantified volumes by InferRead software had a low correlation with the overall radiological severity score. CONCLUSIONS Computer-aided pneumonia quantification could be an easy and feasible way to stratify COVID-19 cases according to severity; however, a great variability among quantitative measurements provided by computer tools should be considered.
Collapse
Affiliation(s)
- Roberto Grassi
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Salvatore Cappabianca
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Fabrizio Urraro
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Beatrice Feragalli
- Department of Medical, Oral and Biotechnological Sciences—Radiology Unit “G. D’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy;
| | | | | | - Vincenza Granata
- Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy;
| | - Giuliana Giacobbe
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Gaetano Maria Russo
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Assunta Grillo
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Angela De Lisio
- Diagnostic Imaging Unit, “Azienda Ospedaliera di Rilievo Nazionale Giuseppe Moscati”, 83100 Avellino, Italy; (A.D.L.); (C.P.); (G.G.)
| | - Cesare Paura
- Diagnostic Imaging Unit, “Azienda Ospedaliera di Rilievo Nazionale Giuseppe Moscati”, 83100 Avellino, Italy; (A.D.L.); (C.P.); (G.G.)
| | - Alfredo Clemente
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Giuliano Gagliardi
- Diagnostic Imaging Unit, “Azienda Ospedaliera di Rilievo Nazionale Giuseppe Moscati”, 83100 Avellino, Italy; (A.D.L.); (C.P.); (G.G.)
| | - Simona Magliocchetti
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Diletta Cozzi
- Division of Radiodiagnostic, Azienda Ospedaliero-Universitaria Careggi, 50139 Firenze, Italy; (D.C.); (V.M.)
| | - Roberta Fusco
- Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy;
| | - Maria Paola Belfiore
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Roberta Grassi
- Division of Radiodiagnostic, “Università degli Studi della Campania Luigi Vanvitelli”, 80138 Naples, Italy; (R.G.); (S.C.); (F.U.); (G.G.); (G.M.R.); (A.G.); (A.C.); (S.M.); (M.P.B.); (R.G.)
| | - Vittorio Miele
- Division of Radiodiagnostic, Azienda Ospedaliero-Universitaria Careggi, 50139 Firenze, Italy; (D.C.); (V.M.)
| |
Collapse
|
50
|
Neri E, Coppola F, Larici AR, Sverzellati N, Mazzei MA, Sacco P, Dalpiaz G, Feragalli B, Miele V, Grassi R. Structured reporting of chest CT in COVID-19 pneumonia: a consensus proposal. Insights Imaging 2020; 11:92. [PMID: 32785803 PMCID: PMC7422456 DOI: 10.1186/s13244-020-00901-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 06/12/2020] [Accepted: 07/21/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The need of a standardized reporting scheme and language, in imaging of COVID-19 pneumonia, has been welcomed by major scientific societies. The aim of the study was to build the reporting scheme of chest CT in COVID-19 pneumonia. METHODS A team of experts, of the Italian Society of Medical and Interventional Radiology (SIRM), has been recruited to compose a consensus panel. They used a modified Delphi process to build a reporting scheme and expressed a level of agreement for each section of the report. To measure the internal consistency of the panelist ratings for each section of the report, a quality analysis based on the average inter-item correlation was performed with Cronbach's alpha (Cα) correlation coefficient. RESULTS The overall mean score of the experts and the sum of score were 3.1 (std.dev. ± 0.11) and 122 in the second round, and improved to 3.75 (std.dev. ± 0.40) and 154 in the third round. The Cronbach's alpha (Cα) correlation coefficient was 0.741 (acceptable) in the second round and improved to 0.789 in the third round. The final report was built in the management of radiology report template (MRRT) and includes n = 4 items in the procedure information, n = 5 items in the clinical information, n = 16 in the findings, and n = 3 in the impression, with overall 28 items. CONCLUSIONS The proposed structured report could be of help both for expert radiologists and for the less experienced who are faced with the management of these patients. The structured report is conceived as a guideline, to recommend the key items/findings of chest CT in COVID-19 pneumonia.
Collapse
Affiliation(s)
- E Neri
- Diagnostic and Interventional Radiology, Department of Translational Research, Università degli Studi di Pisa, Radiodiagnostica 3, Via Roma 67 -, 56126, Pisa, SD, Italy.
| | - F Coppola
- Malpighi Radiology Unit, Department of Diagnostic and Preventive Medicine, University Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - A R Larici
- Section of Radiology, Department of Radiological and Hematological Sciences, Catholic University of the Sacred Heart Rome Campus, "Agostino Gemelli" University Polyclinic Foundation IRCCS, Roma, Italy
| | - N Sverzellati
- Division of Radiology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M A Mazzei
- Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - P Sacco
- Diagnostic Imaging Unit, Department of Medical, Surgical and Neuro Sciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - G Dalpiaz
- Department of Radiology, Bellaria Carlo Alberto Pizzardi Hospital, Bologna, Italy
| | - B Feragalli
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - V Miele
- Department of Radiology, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - R Grassi
- Department of Clinical and Experimental Medicine, "F. Magrassi-A. Lanzara", University of Campania Luigi Vanvitelli, Naples, Italy
| |
Collapse
|