Lung Involvement in Pulmonary Vasculitis: A Radiological Review.

Pulmonary vasculitis identifies a heterogeneous group of diseases characterized by inflammation, damage and necrosis of the wall of pulmonary vessels. The most common approach to classify vasculitis is according to etiology, therefore dividing them into primary and secondary, with a further sub-classification of primary vasculitis based on the size of the affected vessels (large, medium, and small). Pulmonary involvement is frequently observed in patients with systemic vasculitis and radiological presentation is not pathognomonic, but may vary between diseases.

The Role of T2 Mapping in Cardiac Amyloidosis.

Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy divided into two types: light-chain (LA) and transthyretin (ATTR) CA. Cardiac magnetic resonance (CMR) has emerged as an important diagnostic tool in CA. While late gadolinium enhancement (LGE), T1 mapping and extracellular volume (ECV) have a consolidate role in the assessment of CA, T2 mapping has been less often evaluated.

Focal Lesions of the Liver and Radiomics: What Do We Know?

Despite differences in pathological analysis, focal liver lesions are not always distinguishable in contrast-enhanced magnetic resonance imaging (MRI), contrast-enhanced computed tomography (CT), and positron emission tomography (PET). This issue can cause problems of differential diagnosis, treatment, and follow-up, especially in patients affected by HBV/HCV chronic liver disease or fatty liver disease. Radiomics is an innovative imaging approach that extracts and analyzes non-visible quantitative imaging features, supporting the radiologist in the most challenging differential diagnosis when the best-known methods are not conclusive.

Local Recurrences in Rectal Cancer: MRI vs. CT.

Rectal cancers are often considered a distinct disease from colon cancers as their survival and management are different. Particularly, the risk for local recurrence (LR) is greater than in colon cancer. There are many factors predisposing to LR such as postoperative histopathological features or the mesorectal plane of surgical resection.

Practical Guide to Interpreting Cardiac Magnetic Resonance in Patients with Cardiac Masses.

It is common for a cardiac mass to be discovered accidentally during an echocardiographic examination. Following the relief of a cardiac mass, being able to evaluate and characterize it using non-invasive imaging methods is critical. Echocardiography, computed tomography (CT), cardiac magnetic resonance imaging (CMR), and positron emission tomography (PET) are the main imaging modalities used to evaluate cardiac masses.

Imaging in Hepatocellular Carcinoma: What's New?

Hepatocellular carcinoma (HCC) is the most common liver cancer and is one of the uppermost 2 causes of cancer death. About 70%-90% of HCCs develop within a cirrhotic liver. According to the most recent guidelines, the imaging characteristics of HCC on contrast-enhanced Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) are generally satisfactory to make a diagnosis.

Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications.

Rectal cancer (RC) is one of the deadliest malignancies worldwide. Surgery is the most common treatment for RC, performed in 63.2% of patients.

Branch duct-intraductal papillary mucinous neoplasms (BD-IPMNs): an MRI-based radiomic model to determine the malignant degeneration potential.

Background: Branch duct-intraductal papillary mucinous neoplasms (BD-IPMNs) are the most common pancreatic cystic tumors and have a low risk of malignant transformation. Features able to early identify high-risk BD-IPMNs are lacking, and guidelines currently rely on the occurrence of worrisome features (WF) and high-risk stigmata (HRS).

Aim: In our study, we aimed to use a magnetic resonance imaging (MRI) radiomic model to identify features linked to a higher risk of malignant degeneration, and whether these appear before the occurrence of WF and HRS.

Imaging of metabolic and overload disorders in tissues and organs.

Metabolic and overload disorders are a heterogeneous group of relatively uncommon but important diseases. While imaging plays a key role in the early detection and accurate diagnosis in specific organs with a pivotal role in several metabolic pathways, most of these diseases affect different tissues as part of a systemic syndromes. Moreover, since the symptoms are often vague and phenotypes similar, imaging alterations can present as incidental findings, which must be recognized and interpreted in the light of further biochemical and histological investigations.

Risk Assessment and Pancreatic Cancer: Diagnostic Management and Artificial Intelligence.

Pancreatic cancer (PC) is one of the deadliest cancers, and it is responsible for a number of deaths almost equal to its incidence. The high mortality rate is correlated with several explanations; the main one is the late disease stage at which the majority of patients are diagnosed. Since surgical resection has been recognised as the only curative treatment, a PC diagnosis at the initial stage is believed the main tool to improve survival.

Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs): a radiomic model to predict tumor grade.

Purpose: The aim of this single-center retrospective study is to assess whether contrast-enhanced computed tomography (CECT) radiomics analysis is predictive of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) grade based on the 2019 World Health Organization (WHO) classification and to establish a tumor grade (G) prediction model.

Material And Methods: Preoperative CECT images of 78 patients with GEP-NENs were retrospectively reviewed and divided in two groups (G1-G2 in class 0, G3-NEC in class 1). A total of 107 radiomics features were extracted from each neoplasm ROI in CT arterial and venous phases acquisitions with 3DSlicer.

Combined Hepatocellular-Cholangiocarcinoma: What the Multidisciplinary Team Should Know.

Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare type of primary liver malignancy. Among the risk factors, hepatitis B and hepatitis C virus infections, cirrhosis, and male gender are widely reported. The clinical appearance of cHCC-CCA is similar to that of HCC and iCCA and it is usually silent until advanced states, causing a delay of diagnosis.

FLORA software: semi-automatic LGE-CMR analysis tool for cardiac lesions identification and characterization.

Purpose: Today there is a growing interest in the quantification of late gadolinium enhancement (LGE) in ischemic and non-ischemic cardiac pathologies. We build an automatic self-made free software FLORA (For Late gadOlinium enhanced aReas clAssification) for the recognition, classification and quantification of LGE areas that allows to improve the observer's performances and that homogenizes the evaluations between different operators.

Material And Methods: We have retrospectively selected 120 CMR exams: 40-ischemic with evident scar tissue on LGE sequences; 40-non-ischemic cardiomyopathy; 40-any myocardial alteration on CMR, especially on LGE sequences.

Radiomics in medical imaging: pitfalls and challenges in clinical management.

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.

An update on radiomics techniques in primary liver cancers.

Background: Radiomics is a progressing field of research that deals with the extraction of quantitative metrics from medical images. Radiomic features detention indirectly tissue features such as heterogeneity and shape and can, alone or in combination with demographic, histological, genomic, or proteomic data, be used for decision support system in clinical setting.

Methods: This article is a narrative review on Radiomics in Primary Liver Cancers.

Acute Pulmonary Embolism: Prognostic Role of Computed Tomography Pulmonary Angiography (CTPA).

Computed Tomography Pulmonary Angiography (CTPA) is considered the gold standard diagnostic technique in patients with suspected acute pulmonary embolism in emergency departments. Several studies have been conducted on the predictive value of CTPA on the outcomes of pulmonary embolism (PE). The purpose of this article is to provide an updated review of the literature reporting imaging parameters and quantitative CT scores to predict the severity of PE.

Dynamic contrast-enhanced (DCE) imaging: state of the art and applications in whole-body imaging.

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.

Structured Reporting of Computed Tomography in the Staging of Neuroendocrine Neoplasms: A Delphi Consensus Proposal.

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.

Structured Reporting of Computed Tomography and Magnetic Resonance in the Staging of Pancreatic Adenocarcinoma: A Delphi Consensus Proposal.

Background: Structured reporting (SR) in radiology has been recognized recently by major scientific societies. This study aims to build structured computed tomography (CT) and magnetic resonance (MR)-based reports in pancreatic adenocarcinoma 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.

Structured reporting of computed tomography in the staging of colon cancer: a Delphi consensus proposal.

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.

Imaging of Pancreatic Neuroendocrine Neoplasms.

Pancreatic neuroendocrine neoplasms (panNENs) represent the second most common pancreatic tumors. They are a heterogeneous group of neoplasms with varying clinical expression and biological behavior, from indolent to aggressive ones. PanNENs can be functioning or non-functioning in accordance with their ability or not to produce metabolically active hormones.

Gastrointestinal neuroendocrine neoplasms (GI-NENs): hot topics in morphological, functional, and prognostic imaging.

Neuroendocrine neoplasms (NENs) are heterogeneous tumours with a common phenotype descended from the diffuse endocrine system. NENs are found nearly anywhere in the body but the most frequent location is the gastrointestinal tract. Gastrointestinal neuroendocrine neoplasms (GI-NENs) are rather uncommon, representing around 2% of all gastrointestinal tumours and 20-30% of all primary neoplasms of the small bowel.

Diagnostic evaluation and ablation treatments assessment in hepatocellular carcinoma.

This article provides an overview of diagnostic evaluation and ablation treatment assessment in Hepatocellular Carcinoma (HCC). Only studies, in the English language from January 2010 to January 202, evaluating the diagnostic tools and assessment of ablative therapies in HCC patients were included. We found 173 clinical studies that satisfied the inclusion criteria.

The Radiologist as a Gatekeeper in Chest Pain.

Chest pain is a symptom that can be found in life-threatening conditions such as acute coronary syndrome (ACS). Those patients requiring invasive coronary angiography treatment or surgery should be identified. Often the clinical setting and laboratory tests are not sufficient to rule out a coronary or aortic syndrome.

Gastrointestinal stromal tumors: relationship between preoperative CT features and pathologic risk stratification.

Objective: To investigate a relationship between contrast-enhanced computed tomography (CECT) features of gastrointestinal stromal tumors (GISTs) and risk of relapse according to Miettinen stratified risk classifications.

Methods: After ethical committee approval, a retrospective analysis was conducted on the preoperative CECT of patients with pathologically proven GIST undergoing surgery between June 2009 and December 2019. Chi-square analysis was used to evaluate the correlation between Miettinen stratified risk categories and the following imaging features: tumor size and location, growth pattern, margins, type and degree of contrast enhancement, presence of calcifications, necrosis, signs of ulceration/fistulation, internal hemorrhagic foci, enlarged feeding or draining vessels (EFDV), ascites, peritoneal implants, lymphadenopathy, or metastasis.