Publications by authors named "Riccardo De Robertis"

Background: The International Society for the Study of Vascular Anomalies (ISSVA) provides a detailed classification system to facilitate accurate diagnosis and management of these conditions based on clinical criteria, imaging, and histopathological findings. This review aims to systematically present the state of the art in Artificial Intelligence (AI) applications for the diagnosis, classification, and treatment planning of vascular anomalies affecting the soft tissues of the head and neck region.

Methods: The PubMed research identified 86 articles.

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Article Synopsis
  • The review discusses primary benign mesenchymal tumors of the pancreas, which are very rare and often diagnosed only after surgery.
  • These tumors are usually identified through postoperative histology, leading to significant pancreatic surgery even for benign cases.
  • The summary includes limited findings from abdominal imaging and endoscopic ultrasound (EUS), with some case reports demonstrating modern ultrasound techniques used for diagnosis.
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Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is a recently recognized pancreatic tumor. Here, we aimed to determine its most essential features with the systematic review tool. PubMed, Scopus, and Embase were searched for studies reporting data on pancreatic IOPN.

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Background: High-grade neuroendocrine neoplasms (NENs) comprise both well-differentiated grade 3 neuroendocrine tumors (G3 NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) nearly always include poorly differentiated NEC as the neuroendocrine component. The efficacy and safety of frontline mFOLFIRINOX chemotherapy has never been investigated in patients with high-grade NENs.

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Background/objectives: To analyze the diagnostic performance of three short magnetic resonance imaging (MRI) protocols for the follow-up of pancratic intraductal papillary mucinous neoplasms (IPMN).

Methods: Follow-up MRI examinations of 287 patients with IPMN performed in two centers were retrospectively retrieved. Four MRI protocols were identified as follows: T1-weighted (T1w), T2-weighted (T2w), and MRCP sequences (protocol 1); T1w, T2w, MRCP, and diffusion-weighted (DWI) sequences (protocol 2); T1w, T2w, MRCP, and post-contrast T1w-sequences (protocol 3); and a comprehensive protocol including all previous sequences (protocol 4).

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Background: Upfront surgery followed by postoperative treatment is a commonly adopted treatment for resectable pancreatic ductal adenocarcinoma (rPDAC). However, the risk of positive surgical margins, the poor recovery that often impairs postoperative treatments, and the risk of recurrence might limit the outcome of this strategy. This study evaluated the safety and the activity of liposomal irinotecan 50 mg/m + 5-fluorouracil 2400 mg/m + leucovorin 400 mg/m + oxaliplatin 60 mg/m (NALIRIFOX) in the perioperative treatment of patients with rPDAC.

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Background: Accurately predicting the risk of clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy before surgery may assist surgeons in making more informed treatment decisions and improved patient counselling. The aim was to evaluate the predictive accuracy of a radiomics-based preoperative-Fistula Risk Score (RAD-FRS) for clinically relevant postoperative pancreatic fistula.

Methods: Radiomic features were derived from preoperative CT scans from adult patients after pancreatoduodenectomy at a single centre in the Netherlands (Amsterdam, 2013-2018) to develop the radiomics-based preoperative-Fistula Risk Score.

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Purpose: To compare ultrasound (US) and US-derived fat fraction (UDFF) with magnetic resonance proton density fat fraction (MRI-PDFF) for the detection of hepatic steatosis and quantification of liver fat content.

Materials And Methods: Between October and December 2022, 149 patients scheduled for an abdominal MRI agreed to participate in this study and underwent MRI-PDFF, US and UDFF. Inclusion criteria were: (a) no chronic liver disease or jaundice; (b) no MRI motion artifacts; (c) adequate liver examination at US.

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Acinar cystic transformation (ACT) of the pancreas, previously called acinar cell cystadenoma, is a poorly understood and rare entity among pancreatic cystic lesions. This study aims to clarify its real nature. This research cohort included 25 patients with pancreatic ACT, representing the largest series in the literature.

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Background: A non-invasive method to improve the prognostic stratification would be clinically beneficial in patients with resectable pancreatic adenocarcinoma (PDAC). The aim of this study was to correlate conventional magnetic resonance (MR) features and the metrics derived from the histogram analysis of apparent diffusion coefficient (ADC) maps, with the risk and the time to metastases (TTM) after surgery in patients with PDAC. Methods: pre-operative MR examinations of 120 patients were retrospectively analyzed.

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Purpose: To develop a predictive model for liver metastases in patients with pancreatic ductal adenocarcinoma (PDAC) based on textural features of the primary tumor extracted by computed tomography (CT) images.

Materials And Methods: Patients with a pathologically proved PDAC who underwent CT between December 2020 and January 2022 were retrospectively identified. Treatment-naïve patients were included.

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Purpose: To investigate the role of CT-texture analysis of liver ablation area to predict local recurrence after HCC ablation.

Methods: Patients treated with liver ablation were retrospectively enrolled. CT-texture analysis was performed on the core and borders of ablation area 1-2 months after procedure.

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The purpose of the work described here was to evaluate the use of ultrasound fusion imaging (US-FI) in percutaneous ablation of hepatic malignancies with respect to its global usefulness, improvement of conspicuity, confidence increment, needle route changes, and time savings. Thirty-four hepatic tumors (28 hepatocellular carcinomas, 6 metastases) were prospectively ablated in 16 consecutive patients (64 ± 11 y, 75% males), first simulating B-mode-only planning and then synchronizing computed tomography/magnetic resonance images with US and proceeding to needle insertion and tumor ablation under US-FI guidance. Surveys were administered to the operators to evaluate their perception of US-FI advantages.

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Acute sialadenitis is a rare adverse reaction to iodine-based contrast agents. Ultrasound (US) is usually the preferred imaging method to evaluate the salivary glands; along with clinical and anamnestic data, US allows the diagnosis of contrast-induced sialadenitis. We present a case of acute bilateral submandibular sialadenitis induced by intravenous administration of iodine-based contrast media for a contrast-enhanced computed tomography scan diagnosed by US.

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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.

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Artificial intelligence (AI) is one of the most promising fields of research in medical imaging so far. By means of specific algorithms, it can be used to help radiologists in their routine workflow. There are several papers that describe AI approaches to solve different problems in liver and pancreatic imaging.

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The aim of this study was to perform a simplified radiomic analysis of pancreatic ductal adenocarcinoma based on qualitative and quantitative tumor features and to compare the results between metastatic and non-metastatic patients. A search of our radiological, surgical, and pathological databases identified 1218 patients with a newly diagnosed pancreatic ductal adenocarcinoma who were referred to our Institution between January 2014 and December 2018. Computed Tomography (CT) examinations were reviewed analyzing qualitative and quantitative features.

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Background And Objective: To assess the dosimetric feasibility of a stereotactic body radiotherapy (SBRT) dose escalated protocol, with a simultaneous integrated boost (SIB) and a simultaneous integrated protection (SIP) approach, in patients with locally advanced pancreatic cancer (LAPC).

Material And Methods: Twenty LAPC lesions, previously treated with SBRT at our Institution, were re-planned. The original prescribed and administered dose was 50/30/25 Gy in five fractions to PTV (tumor-vessel interface [TVI])/PTV (tumor volume)/PTV (overlap area between PTV and planning organs at risk volume [PRV]), respectively.

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Article Synopsis
  • The study aimed to assess how effectively dynamic Magnetic Resonance Imaging (MRI) with Diffusion Weighted Imaging (DWI) can identify mural nodules in Intraductal Papillary Mucinous Neoplasms (IPMN), using pathological results as a reference standard.
  • Review of 91 preoperative MRIs showed strong correlations between the size and number of nodules identified via MRI and their pathological characteristics, notably in nodules larger than 5 mm and their relation to tumor dysplasia.
  • Results indicated that dynamic MR and DWI are reliable for detecting solid nodules in IPMNs and their malignancy, with the ADC map's Entropy indicating the level of dysplasia.
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Purpose:  The aim of this study was to investigate the safety and effectiveness of percutaneous radiofrequency ablation (RFA) in locally advanced pancreatic cancer (LAPC) of the pancreatic body by assessing the overall survival of patients and evaluating the effects of the procedure in the clinical and radiological follow-up.

Materials And Methods:  Patients with unresectable LAPC after failed chemoradiotherapy for at least six months were retrospectively included. Percutaneous RFA was performed after a preliminary ultrasound (US) feasibility evaluation.

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  • An online survey was conducted to assess the impact of COVID-19 on Italian radiology departments, focusing on changes in safety and daily operations.
  • About 20.2% of radiologists participated, revealing significant challenges such as a reduction in elective imaging volumes and issues with obtaining personal protective equipment (PPE).
  • Results indicated that while most radiologists felt adequately protected, a large percentage believed regular testing for COVID-19 should be mandatory for healthcare workers to enhance workplace safety.
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To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the "functional" information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations.

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Pancreatic neuroendocrine tumors (p-NETs) are a rare group of neoplasms that often present with liver metastases. Histological characteristics, metabolic behavior, and liver tumor burden (LTB) are important prognostic factors. In this study, the usefulness of texture analysis of liver metastases in evaluating the biological aggressiveness of p-NETs was assessed.

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