Medical Digital Twin: A Review on Technical Principles and Clinical Applications.

The usage of digital twins (DTs) is growing across a wide range of businesses. The health sector is one area where DT use has recently increased. Ultimately, the concept of digital health twins holds the potential to enhance human existence by transforming disease prevention, health preservation, diagnosis, treatment, and management.

Conventional MRI-Based Structural Disconnection and Morphometric Similarity Networks and Their Clinical Correlates in Multiple Sclerosis.

Background And Objectives: Although multiple sclerosis (MS) can be conceptualized as a network disorder, brain network analyses typically require advanced MRI sequences not commonly acquired in clinical practice. Using conventional MRI, we assessed cross-sectional and longitudinal structural disconnection and morphometric similarity networks in people with MS (pwMS), along with their relationship with clinical disability.

Methods: In this longitudinal monocentric study, 3T structural MRI of pwMS and healthy controls (HC) was retrospectively analyzed.

Conformational Antibodies to Proteolipid Protein-1 and Its Peripheral Isoform DM20 in Patients With CNS Autoimmune Demyelinating Disorders.

Background And Objectives: Antibodies to proteolipid protein-1 (PLP1-IgG), a major central myelin protein also expressed in the peripheral nervous system (PNS) as the isoform DM20, have been previously identified mostly in patients with multiple sclerosis (MS), with unclear clinical implications. However, most studies relied on nonconformational immunoassays and included few patients with non-MS CNS autoimmune demyelinating disorders (ADDs). We aimed to investigate conformational PLP1-IgG in the whole ADD spectrum.

Multimodality Imaging in the Diagnostic Work-Up of Patients With Cardiac Masses: State-of-the-Art Review.

Cardiac masses encompass a diverse range of benign and malignant tumors as well as pseudotumors. Accurate histologic identification is essential for guiding appropriate treatment, yet the diagnostic process remains challenging. Although biopsy is traditionally the diagnostic gold standard, its invasive nature and associated risks limit its application.

Reversible Perfusion Changes during Acute Attacks in Glucose Transporter Type 1 Deficiency Syndrome: A Pediatric Case Series.

Glucose transporter type 1 deficiency syndrome (GLUT1-DS) is an uncommon condition represented by an infantile-onset disorder, frequently arising from heterozygous mutations in the gene. Individuals with GLUT1-DS may present with early-onset seizures (typically manifesting before 4 years of age), developmental delay, and complex movement disorders. In fewer cases, stroke-like events or hemiplegic migraine-like symptoms are also reported, defined by unilateral paresis affecting 1 side of the body and/or one-half of the face, occasionally accompanied by speech impairment.

Absence of Viral Replication Is Associated With Improved Outcome in Anti-HCV-Positive Patients With Hepatocellular Carcinoma.

Background And Aims: Presence of active hepatitis C virus (HCV) infection may influence the outcome of patients treated for hepatocellular carcinoma (HCC), although this issue has never been adequately assessed in a large series of patients. The aim of this study was to evaluate whether the presence of active HCV affects the survival of patients treated for HCC.

Methods: This study assessed the outcome of 3123 anti-HCV-positive patients with HCC, subdivided according to the presence of active HCV infection or previous sustained virological response (SVR).

Comprehensive Non-invasive Versus Invasive Approach to Evaluate Cardiac Allograft Vasculopathy in Heart Transplantation: The CCTA-HTx Study.

Background: Coronary computed tomography angiography (CCTA) is emerging as a valuable tool for noninvasive surveillance of cardiac allograft vasculopathy (CAV) in patients with heart transplant (HTx). We assessed the diagnostic performance of a comprehensive CCTA-based approach compared with the invasive reference, which includes invasive coronary angiography, intravascular ultrasound, and fractional flow reserve, for detecting CAV.

Methods: This was a multicenter prospective study including 37 patients with HTx who underwent CCTA, invasive coronary angiography, intravascular ultrasound, and fractional flow reserve.

The Relationship Between Quantitative Ischemia, Early Revascularization, and Major Adverse Cardiovascular Events: A Multicenter Study.

Background: Observational data have suggested that patients with moderate to severe ischemia benefit from revascularization. However, this was not confirmed in a large, randomized trial.

Objectives: Using a contemporary, multicenter registry, the authors evaluated differences in the association between quantitative ischemia, revascularization, and outcomes across important subgroups.

More Than the Sum of Its Parts: Disrupted Core Periphery of Multiplex Brain Networks in Multiple Sclerosis.

Disruptions to brain networks, measured using structural (sMRI), diffusion (dMRI), or functional (fMRI) MRI, have been shown in people with multiple sclerosis (PwMS), highlighting the relevance of regions in the core of the connectome but yielding mixed results depending on the studied connectivity domain. Using a multilayer network approach, we integrated these three modalities to portray an enriched representation of the brain's core-periphery organization and explore its alterations in PwMS. In this retrospective cross-sectional study, we selected PwMS and healthy controls with complete multimodal brain MRI acquisitions from 13 European centers within the MAGNIMS network.

Prostate cancer MRI methodological radiomics score: a EuSoMII radiomics auditing group initiative.

Objectives: To evaluate the quality of radiomics research in prostate MRI for the evaluation of prostate cancer (PCa) through the assessment of METhodological RadiomICs (METRICS) score, a new scoring tool recently introduced with the goal of fostering further improvement in radiomics and machine learning methodology.

Materials And Methods: A literature search was conducted from July 1st, 2019, to November 30th, 2023, to identify original investigations assessing MRI-based radiomics in the setting of PCa. Seven readers with varying expertise underwent a quality assessment using METRICS.

Conservation of structural brain connectivity in people with multiple sclerosis.

Multiple sclerosis (MS) is a neurodegenerative disease that affects the central nervous system. Structures affected in MS include the corpus callosum, connecting the hemispheres. Studies have shown that in mammalian brains, structural connectivity is organized according to a conservation principle, an inverse relationship between intra- and interhemispheric connectivity.

The density histograms-derived computerized integrated index (CII) predicts mortality in idiopathic pulmonary fibrosis.

Quantitative assessment of the extent of radiological alterations in interstitial lung diseases is a promising field of application that goes beyond the limitations of qualitative scoring. Analysis of density histograms, i.e.

Impact of software-assisted structured reporting on radiology residents approaching prostate MRI.

Purpose: To evaluate the potential advantages of software-assisted structured reporting for radiology residents approaching multiparametric prostate MRI (mpMRI).

Methods: MpMRI scans from 100 patients, performed for prostate cancer (PCa) detection or staging, were anonymized, and reviewed by six second-year radiology residents without previous experience in prostate MRI, following 6 h of intensive training. The dataset was split into two subsets of 50 cases each.

Prevalence of Mitral Annular Disjunction at Cardiac MRI: Results from a Multicenter Registry.

Purpose To determine the prevalence of mitral annular disjunction (MAD) in patients undergoing cardiac MRI for various clinical indications and to assess the association of MAD with arrhythmia, mitral valve prolapse (MVP), and myocardial alteration. Materials and Methods This study analyzed data from a retrospective observational registry of consecutive patients undergoing cardiac MRI for different clinical indications. Cardiac MRI examinations were performed from January 2019 to June 2019 at 13 Italian hospitals.

Clinico-pathological predictors of radiologic complete response to first-line anti-HER2 therapy in metastatic breast cancer.

This study aimed to identify the clinico-pathological variables predictive of radiologic complete response (rCR) to first-line anti-HER2 therapy in patients with HER2-positive metastatic breast cancer. Patients were selected from the database of the GIM14 study and classified according to the best radiologic response obtained to first-line anti-HER2 therapy and upon time-to-treatment-discontinuation (TTD). A total of 545 patients were included in the analysis.

A case report of hepatic inflammatory myofibroblastic tumor in a pediatric patient: diagnostic challenges and management strategies.

Purpose: The aim of this study is to present a case of inflammatory myofibroblastic tumor (IMT) of the liver in a 4-year-old girl. We will discuss the diagnostic challenges, the role of the radiologist in differential diagnosis, treatment modalities, and clinical outcomes.

Methods: A case report of a 4-year-old girl with IMT of the liver is presented.

Large Language Model Ability to Translate CT and MRI Free-Text Radiology Reports Into Multiple Languages.

Background High-quality translations of radiology reports are essential for optimal patient care. Because of limited availability of human translators with medical expertise, large language models (LLMs) are a promising solution, but their ability to translate radiology reports remains largely unexplored. Purpose To evaluate the accuracy and quality of various LLMs in translating radiology reports across high-resource languages (English, Italian, French, German, and Chinese) and low-resource languages (Swedish, Turkish, Russian, Greek, and Thai).

-related disorder in 87 adults: Natural history and self-sustainability.

Purpose: is one of the most frequently mutated genes in intellectual disability cohorts. Thus, far few adult-aged patients with -related disorder have been described, which limits our understanding of the disease's natural history and our ability to counsel patients and their families.

Methods: Data on patients aged 18+ years with -related disorder were collected through an online questionnaire completed by clinicians and parents.

Unveiling preferences in multiple sclerosis care: insights from an Italian discrete-choice experiment with patients and healthcare professionals.

Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating, neurodegenerative disease of the central nervous system, significantly impacting patients' quality of life. Understanding patient and healthcare professional (HCP) preferences for MS treatments is crucial for optimizing therapeutic strategies and improving adherence and outcomes. This Discrete-Choice Experiment (DCE) assesses preferences for various MS treatment attributes among Italian patients and HCPs.

Identifying predictors of treatment response and molecular changes induced by neoadjuvant chemotherapy and endocrine therapy in hormone receptor-positive/HER2-negative breast cancer: the NEOENDO translational study.

Background: Predictors of response to neoadjuvant chemotherapy (NACT) and endocrine therapy (NET) in hormone receptor-positive (HoR+)/human epidermal growth factor receptor 2 (HER2)-negative breast cancer (BC) are required. Also, pathological and molecular changes induced by both strategies and their impact on patients' outcomes have not been reported so far.

Patients And Methods: In a cohort of 186 patients with early-stage HoR+/HER2-negative BC treated with NACT or NET, we assessed the association of baseline main clinicopathological features and PAM50 gene expression (GE), intrinsic subtypes (IS) and risk-of-relapse (ROR-P) score with pathological outcomes according to treatment strategy.

Preoperative prediction of post hepatectomy liver failure after surgery for hepatocellular carcinoma on CT-scan by machine learning and radiomics analyses.

Introduction: No instruments are available to predict preoperatively the risk of posthepatectomy liver failure (PHLF) in HCC patients. The aim was to predict the occurrence of PHLF preoperatively by radiomics and clinical data through machine-learning algorithms.

Materials And Methods: Clinical data and 3-phases CT scans were retrospectively collected among 13 Italian centres between 2008 and 2022.

Aortic Dimension in Elite Athletes: Updated Systematic Review and Meta-Analysis.

Aims: To assess the presence and the extent of an "aortic remodeling" in elite athletes.

Methods: A systematic review and meta-analysis of literature were conducted for studies (1981-2024) reporting echocardiographic aortic diameters of elite athletes compared to non-athlete healthy controls. Among the 5,494 studies retrieved, 21 (9,464 elite athletes vs.