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1.
Cereb Cortex ; 33(11): 6701-6707, 2023 05 24.
Artículo en Inglés | MEDLINE | ID: mdl-36646456

RESUMEN

Linguistic tasks facilitate corticospinal excitability as revealed by increased motor evoked potential (MEP) induced by transcranial magnetic stimulation (TMS) in the dominant hand. This modulation of the primary motor cortex (M1) excitability may reflect the relationship between speech and gestures. It is conceivable that in healthy individuals who use a sign language this cortical excitability modulation could be rearranged. The aim of this study was to evaluate the effect of spoken language tasks on M1 excitability in a group of hearing signers. Ten hearing Italian Sign Language (LIS) signers and 16 non-signer healthy controls participated. Single-pulse TMS was applied to either M1 hand area at the baseline and during different tasks: (i) reading aloud, (ii) silent reading, (iii) oral movements, (iv) syllabic phonation and (v) looking at meaningless non-letter strings. Overall, M1 excitability during the linguistic and non-linguistic tasks was higher in LIS group compared to the control group. In LIS group, MEPs were significantly larger during reading aloud, silent reading and non-verbal oral movements, regardless the hemisphere. These results suggest that in hearing signers there is a different modulation of the functional connectivity between the speech-related brain network and the motor system.


Asunto(s)
Corteza Motora , Lengua de Signos , Humanos , Corteza Motora/fisiología , Lenguaje , Lingüística , Estimulación Magnética Transcraneal , Italia , Potenciales Evocados Motores/fisiología
2.
Neurol Sci ; 43(1): 335-340, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34050422

RESUMEN

INTRODUCTION: In patients with Parkinson's disease (PD), impulsivity is still a matter of investigation. It has been hypothesized that impulsive personality traits may favour impulse control disorder (ICD) onset during dopaminergic therapy. In healthy subjects, a relationship between the awareness of motor intention and impulsive personality traits assessed by the Barratt impulsivity scale (BIS-11) has been reported. The aim of this study was to evaluate the relationship between the awareness of voluntary action and impulsivity traits in PD. METHODS: Twenty-eight PD patients (stages I-III on the Hoehn and Yahr scale) underwent an impulsivity trait assessment by the BIS-11 scale and a task based on the Libet's clock. Participants were requested to perform a self-initiated movement and report the time they first feel their intention to move (W-judgement) or the time of the actual movement (M-judgement). RESULTS: In patients with higher BIS-11 scores, the time lag between the W-judgement and the actual movement was significantly lower than in patients with lower BIS-11. No difference emerged in the M-judgement. CONCLUSION: Data suggest that also in PD patients, the impulsive personality trait is related to a "delayed" awareness of motor intention and therefore to a shorter interval to allow a conscious "veto" of the impending action. Characterization of the temporal profile of awareness of motor intention could prove useful in identifying PD patients at risk of developing ICDs during dopaminergic treatment.


Asunto(s)
Enfermedad de Parkinson , Humanos , Conducta Impulsiva , Intención , Juicio , Movimiento , Enfermedad de Parkinson/tratamiento farmacológico
3.
Radiol Med ; 126(3): 388-398, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33044732

RESUMEN

OBJECTIVES: To investigate the role of third-generation iterative reconstruction (ADMIRE) in dual-source, high-pitch chest CT protocol with spectral shaping at 100 kVp in Coronavirus disease 2019 (COVID-19). METHODS: Confirmed COVID-19 inpatients undergoing to unenhanced chest CT were scanned with a dual-energy acquisition (DECT, 90/150Sn kV) and a dual-source, high-pitch acquisition with tin-filtered 100 kVp (LDCT). On the DECT with ADMIRE 3 (DECT3) were evaluated the pulmonary findings and their extension (25-point score). Two radiologists in consensus evaluated with 5-point scales the overall image quality, the anatomical structures, and the elementary findings on LDCT reconstructed with filtered backprojection (LDCT0), with ADMIRE 3 (LDCT3) and 5 (LDCT5), and on DECT3. The signal-to-noise ratio (SNR), the body mass index, the exposure times, and the radiation doses were recorded. RESULTS: Seventy-five patients (57 M/18F; median age: 63 y.o.) were included, with median pulmonary extension of 13/25 points. The imaging findings were detected in proportion comparable to the available literature. The ADMIRE significantly improved the SNR in LDCT (p < 0.00001) with almost no significant differences in overweight patients. The LDCT had median effective dose of 0.39 mSv and acquisition time of 0.71 s with significantly less motion artifacts than DECT (p < 0.00001). The DECT3 and LDCT3 provided the best image quality and depiction of pulmonary anatomy and imaging findings, with significant differences among all the series (p < 0.00001). CONCLUSION: The LDCT with spectral shaping and ADMIRE3 provided acceptable image quality in the evaluation of patients with COVID-19, with significantly reduced radiation dose and motion artifacts.


Asunto(s)
COVID-19/diagnóstico por imagen , Procesamiento de Imagen Asistido por Computador , Pulmón/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dosis de Radiación , Estudios Retrospectivos
4.
Radiol Med ; 125(4): 365-373, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32239472

RESUMEN

AIM: To subjectively and objectively evaluate the feasibility and diagnostic reliability of a low-dose, long-pitch dual-source chest CT protocol on third-generation dual-source CT (DSCT) with spectral shaping at 100Sn kVp for COVID-19 patients. MATERIALS AND METHODS: Patients with COVID-19 and positive swab-test undergoing to a chest CT on third-generation DSCT were included. The imaging protocol included a dual-energy acquisition (HD-DECT, 90/150Sn kVp) and fast, low-dose, long-pitch CT, dual-source scan at 100Sn kVp (LDCT). Subjective (Likert Scales) and objective (signal-to-noise and contrast-to-noise ratios, SNR and CNR) analyses were performed; radiation dose and acquisition times were recorded. Nonparametric tests were used. RESULTS: The median radiation dose was lower for LDCT than HD-DECT (Effective dose, ED: 0.28 mSv vs. 3.28 mSv, p = 0.016). LDCT had median acquisition time of 0.62 s (vs 2.02 s, p = 0.016). SNR and CNR were significantly different in several thoracic structures between HD-DECT and LDCT, with exception of lung parenchyma. Qualitative analysis demonstrated significant reduction in motion artifacts (p = 0.031) with comparable diagnostic reliability between HD-DECT and LDCT. CONCLUSIONS: Ultra-low-dose, dual-source, fast CT protocol provides highly diagnostic images for COVID-19 with potential for reduction in dose and motion artifacts.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , COVID-19 , Protocolos Clínicos , Estudios de Factibilidad , Humanos , Pandemias , Dosis de Radiación , SARS-CoV-2
5.
Radiol Med ; 125(7): 636-646, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32500509

RESUMEN

COVID-19 is an emerging infection caused by a novel coronavirus that is moving so rapidly that on 30 January 2020 the World Health Organization declared the outbreak a Public Health Emergency of International Concern and on 11 March 2020 as a pandemic. An early diagnosis of COVID-19 is crucial for disease treatment and control of the disease spread. Real-time reverse-transcription polymerase chain reaction (RT-PCR) demonstrated a low sensibility; therefore chest computed tomography (CT) plays a pivotal role not only in the early detection and diagnosis, especially for false negative RT-PCR tests, but also in monitoring the clinical course and in evaluating the disease severity. This paper reports the CT findings with some hints on the temporal changes over the course of the disease: the CT hallmarks of COVID-19 are bilateral distribution of ground glass opacities with or without consolidation in the posterior and peripheral lung, but the predominant findings in later phases include consolidations, linear opacities, "crazy-paving" pattern, "reversed halo" sign and vascular enlargement. The CT findings of COVID-19 overlap with the CT findings of other diseases, in particular the viral pneumonia including influenza viruses, parainfluenza virus, adenovirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, etc. There are differences as well as similarities in the CT features of COVID-19 compared with those of the severe acute respiratory syndrome. The aim of this article is to review the typical and atypical CT findings in COVID-19 patients in order to help radiologists and clinicians to become more familiar with the disease.


Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Radiografía Torácica , Tomografía Computarizada por Rayos X , COVID-19 , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Progresión de la Enfermedad , Humanos , Pandemias , Neumonía Viral/epidemiología , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo
6.
HPB (Oxford) ; 22(4): 588-594, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31474455

RESUMEN

BACKGROUND: This retrospective study reviews long-term outcome of hepatic artery embolization (HAE) using microspheres alone in patients presenting with Hepatocellular Carcinoma (HCC) and portal vein tumor (PVT). METHODS: From 2005 to 2015, 43 patients with HCC and PVT underwent HAE. Response to treatment, time-to-progression (TTP), local-tumor-progression (LTP), distant-hepatic-progression (DHP), PVT-progression (PVTP), and/or the development of extra-hepatic progression (EHP) were assessed on pre-HAE CT/MRI scans, within 4 weeks post-HAE and at quarterly intervals thereafter, along with liver function (Child-Pugh score, CP). RESULTS: Forty (40/43) patients progressed during a median follow-up of 10 months with a median TTP of 2.9 months. Eleven of the 40 patients (27.5%) developed EHP, with only 2 patients (5%) demonstrating solely LTP. Six patients (15%) developed PVTP only. At progression, 27 patients (27/40, 77%) maintained their initial CP status, including all 5 CP-B patients. Median survival was 12.5 (95% CI 8-23) months for the entire group; 17.3 (95% CI 10-33) months for the patients with segmental/lobar PVT, compared with 8.4 (95% CI 6-13) months for the patients with main PVT (p = 0.02). CONCLUSION: HAE can be used to treat patients with HCC and PVT with median survival of approximately a year and preserved liver function.


Asunto(s)
Carcinoma Hepatocelular/terapia , Embolización Terapéutica , Neoplasias Hepáticas/terapia , Microesferas , Vena Porta , Adulto , Anciano , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/patología , Progresión de la Enfermedad , Femenino , Humanos , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del Tratamiento
7.
Eur Radiol ; 29(5): 2457-2464, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30402705

RESUMEN

OBJECTIVES: To assess patients' experience of bowel preparation and procedure for screening CT colonography with reduced (r-CTC) and full cathartic preparation (f-CTC) that showed similar detection rate for advanced neoplasia in a randomised trial. METHODS: Six hundred seventy-four subjects undergoing r-CTC and 612 undergoing f-CTC in the SAVE trial were asked to complete two pre-examination questionnaires-(1) Life Orientation Test - Revised (LOT-R) assessing optimism and (2) bowel preparation questionnaire-and a post-examination questionnaire evaluating overall experience of CTC screening test. Items were analysed with chi-square and t test separately and pooled. RESULTS: LOT-R was completed by 529 (78%) of r-CTC and by 462 (75%) of f-CTC participants and bowel preparation questionnaire by 531 (79%) subjects in the r-CTC group and by 465 (76%) in the f-CTC group. Post-examination questionnaire was completed by 525 (78%) subjects in the r-CTC group and by 453 (74%) in the f-CTC group. LOT-R average score was not different between r-CTC (14.27 ± 3.66) and f-CTC (14.54 ± 3.35) (p = 0.22). In bowel preparation questionnaire, 88% of r-CTC subjects reported no preparation-related symptoms as compared to 70% of f-CTC subjects (p < 0.001). No interference of bowel preparation with daily activities was reported in 80% of subjects in the r-CTC group as compared to 53% of subjects in the f-CTC group (p < 0.001). In post-examination questionnaire, average scores for discomfort of the procedure were not significantly different between r-CTC (3.53 ± 0.04) and f-CTC (3.59 ± 0.04) groups (p = 0.84). CONCLUSIONS: Reduced bowel preparation is better tolerated than full preparation for screening CT colonography. KEY POINTS: • Reduced bowel preparation is better tolerated than full preparation for screening CT colonography. • Procedure-related discomfort of screening CT colonography is not influenced by bowel preparation. • Males tolerate bowel preparation and CT colonography screening procedure better than females.


Asunto(s)
Colonografía Tomográfica Computarizada/métodos , Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/métodos , Tamizaje Masivo/métodos , Satisfacción del Paciente , Catárticos/administración & dosificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
8.
Radiol Med ; 124(8): 745-752, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31004322

RESUMEN

AIM: To provide an overview on dose reduction and image quality after the installation of a third-generation dual-source CT (dsCT) in a Pediatric Radiology Department. MATERIALS AND METHODS: We included pediatric patients (< 20 years old) undergoing CT for oncological staging (neck, chest and abdomen) or low-dose chest CT for lung diseases. Each of these two groups were further divided in two age groups (≤ or > 10 years old) including patients scanned in the same period of two consecutive years, in 2017 with a 16-row LightSpeed CT (GE Healthcare) or in 2018 with a Somatom Force dsCT (Siemens Healthineers). Technical parameters such as kVp, mAs, slice thickness, exposure times and dose indicators were retrieved and compared. Image quality was evaluated in consensus by two radiologists on a five-point semiquantitative scale. Nonparametric tests were used. RESULTS: In oncological patients, significantly lower kVp and tube current with better image quality were achieved with the dsCT. Radiation dose (total DLP) was 5-6 times lower with dsCT, thanks also to virtual non-contrast images. In low-dose chest CT, the frequent use of tin filter required higher tube current; a total DLP 3 times lower was achieved with dsCT in patients ≤ 10 years old. The image quality was better with the dsCT in low-dose chest CT protocols. CONCLUSION: The third-generation dsCT provides high-quality images with reduced motion artifacts at lower dose.


Asunto(s)
Enfermedades Pulmonares/diagnóstico por imagen , Tomografía Computarizada Multidetector/normas , Tomografía Computarizada Multidetector/tendencias , Neoplasias/diagnóstico por imagen , Dosis de Radiación , Imagen Radiográfica por Emisión de Doble Fotón/métodos , Adolescente , Factores de Edad , Artefactos , Niño , Femenino , Humanos , Masculino , Tomografía Computarizada Multidetector/instrumentación , Movimientos de los Órganos , Imagen Radiográfica por Emisión de Doble Fotón/instrumentación , Radiografía Torácica/normas , Radiografía Torácica/tendencias , Adulto Joven
9.
Radiol Med ; 124(12): 1281-1295, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31792703

RESUMEN

The physical principles of dual-energy computed tomography (DECT) are as old as computed tomography (CT) itself. To understand the strengths and the limits of this technology, a brief overview of theoretical basis of DECT will be provided. Specific attention will be focused on the interaction of X-rays with matter, on the principles of attenuation of X-rays in CT toward the intrinsic limits of conventional CT, on the material decomposition algorithms (two- and three-basis-material decomposition algorithms) and on effective Rho-Z methods. The progresses in material decomposition algorithms, in computational power of computers and in CT hardware, lead to the development of different technological solutions for DECT in clinical practice. The clinical applications of DECT are briefly reviewed in relation to the specific algorithms.


Asunto(s)
Algoritmos , Imagen Radiográfica por Emisión de Doble Fotón/métodos , Tecnología Radiológica/métodos , Tomografía Computarizada por Rayos X/métodos , Femenino , Humanos , Masculino , Dispersión de Radiación , Rayos X
10.
J Comput Assist Tomogr ; 42(2): 222-229, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29489589

RESUMEN

OBJECTIVE: To evaluate the accuracy of single-source dual-energy computed tomography (ssDECT) in iodine quantification using various segmentation methods in an ex vivo model. METHODS: Ten sausages, injected with variable quantities of iodinated contrast, were inserted into 2 livers and scanned with ssDECT. Material density iodine images were reconstructed. Three radiologists segmented each sausage. Iodine concentration, volume, and absolute quantity were measured. Agreement between the measured and injected iodine was assessed with the concordance correlation coefficient (CCC). Intrareader agreement was assessed using the intraclass correlation coefficient (ICC). RESULTS: Air bubbles were observed in sausage (IX). Sausage (X) was within the same view as hyper-attenuating markers used for localization. With IX and X excluded, CCC and ICC were greater than 0.98 and greater than 0.88. When included, CCC and ICC were greater than 0.94 and greater than 0.79. CONCLUSIONS: Iodine quantification was reproducible and precise. However, accuracy reduced in sausages consisting of air filled cavities and within the same view as hyperattenuating markers.


Asunto(s)
Yodo/análisis , Hígado/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Animales , Bovinos , Imagen Radiográfica por Emisión de Doble Fotón/métodos , Reproducibilidad de los Resultados
11.
J Vasc Surg ; 64(4): 985-989.e2, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27266596

RESUMEN

OBJECTIVE: To determine predictors of cranial nerve injury (CNI) after carotid endarterectomy (CEA). METHODS: Consecutive CEAs performed over a 5-year period were enrolled in this study. Outcomes analyzed included 30-day major adverse event rate (composite of stroke, death, and myocardial infarction), death, stroke, disabling stroke, myocardial infarction, cervical hematoma and CNI rate, reoperation, and hospital readmission at 30 days. RESULTS: There were 1258 CEAs were included in the study, 1168 (93%) were performed using an eversion technique. Patients with symptoms comprised 27% of the cohort (n = 340). At 30 days, there were no deaths, 23 major adverse events (1.8%), 11 strokes (0.9%: nine minor, two major), 12 myocardial infarctions (0.9%), 41 cervical hematomas (3.3%), 9 reoperations (0.7%) and 10 hospital readmissions (0.8%). Median duration of stay was 1 day (interquartile range, 1-2 days). CNI rate at discharge was 2.3% (n = 29). Two patients (9%) had more than one cranial nerve affected. The marginal mandibular branch of the facial nerve was most frequently involved (n = 16; 52%), followed by the hypoglossal (n = 9; 29%), the vagus (n = 4; 13%), and the spinal accessory nerve (n = 2; 6%). Horner's syndrome, consistent with an injury to the cervical sympathetic chain, occurred in 13 patients (1%) who had a true cranial nerve affected as well. The vast majority (94%) of these CNIs and all Horner's syndrome neurapraxias were transient; only the two accessory lesions persisted at their follow-up visit (median, 32 months; range, 8-72 months). Significant predictors for CNI included diabetes (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.0-6.2; P = .048), cervical hematoma (OR, 41.7; 95% CI, 13.8-125.4; P < .001), and dual antiplatelet therapy (OR, 4.4; 95% CI, 1.7-11.4; P = .002). CONCLUSIONS: CNI is predominantly a transient complication, but is associated significantly with dual antiplatelet therapy use and the occurrence of a postoperative cervical hematoma. Scrupulous attention to hemostasis might reduce the incidence of CNI.


Asunto(s)
Enfermedades de las Arterias Carótidas/cirugía , Traumatismos del Nervio Craneal/etiología , Endarterectomía Carotidea/efectos adversos , Hematoma/etiología , Inhibidores de Agregación Plaquetaria/efectos adversos , Anciano , Anciano de 80 o más Años , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Distribución de Chi-Cuadrado , Traumatismos del Nervio Craneal/diagnóstico , Quimioterapia Combinada , Femenino , Humanos , Tiempo de Internación , Modelos Logísticos , Masculino , Análisis Multivariante , Infarto del Miocardio/etiología , Oportunidad Relativa , Readmisión del Paciente , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/etiología , Factores de Tiempo , Resultado del Tratamiento
12.
Cereb Cortex ; 24(4): 1009-16, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23236203

RESUMEN

Synchronization of body movements to an external beat is a universal human ability, which has also been recently documented in nonhuman species. The neural substrates of this rhythmic motor entrainment are still under investigation. Correlational neuroimaging data suggest an involvement of the dorsal premotor cortex (dPMC) and the supplementary motor area (SMA). In 14 healthy volunteers, we more specifically investigated the neural network underlying this phenomenon using a causal approach by an established 1-Hz repetitive transcranial magnetic stimulation (rTMS) protocol, which produces a focal suppression of cortical excitability outlasting the stimulation period. Synchronization accuracy between rhythmic cues and right index finger tapping, as measured by the mean time lag (asynchrony) between motor and auditory events, was significantly affected when the right dPMC function was transiently perturbed by "off-line" focal rTMS, whereas the reproduction of the rhythmic sequence per se (inter-tap-interval) was spared. This approach affected metrical rhythms of different complexity, but not non-metrical or isochronous sequences. Conversely, no change in auditory-motor synchronization was observed with rTMS of the SMA, of the left dPMC or over a control site (midline occipital area). Our data strongly support the view that the right dPMC is crucial for rhythmic auditory-motor synchronization in humans.


Asunto(s)
Potenciales Evocados Auditivos/fisiología , Potenciales Evocados Motores/fisiología , Corteza Motora/fisiología , Periodicidad , Estimulación Acústica , Adulto , Análisis de Varianza , Señales (Psicología) , Femenino , Lateralidad Funcional , Humanos , Masculino , Estimulación Magnética Transcraneal , Adulto Joven
13.
Transplantation ; 108(3): 643-653, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-37389652

RESUMEN

Radiomics is increasingly applied to the diagnosis, management, and outcome prediction of various urological conditions. The purpose of this scoping review is to evaluate the current evidence of the application of radiomics in kidney transplantation, especially its utility in diagnostics and therapeutics. An electronic literature search on radiomics in the setting of transplantation was conducted on PubMed, EMBASE, and Scopus from inception to September 23, 2022. A total of 16 studies were included. The most widely studied clinical utility of radiomics in kidney transplantation is its use as an adjunct to diagnose rejection, potentially reducing the need for unnecessary biopsies or guiding decisions for earlier biopsies to optimize graft survival. Technology such as optical coherence tomography is a noninvasive procedure to build high-resolution optical cross-section images of the kidney cortex in situ and in real time, which can provide histopathological information of donor kidney candidates for transplantation, and to predict posttransplant function. This review shows that, although radiomics in kidney transplants is still in its infancy, it has the potential for large-scale implementation. Its greatest potential lies in the correlation with conventional established diagnostic evaluation for living donors and potential in predicting and detecting rejection postoperatively.


Asunto(s)
Trasplante de Riñón , Humanos , Trasplante de Riñón/efectos adversos , Radiómica , Rechazo de Injerto/diagnóstico por imagen , Riñón/diagnóstico por imagen , Riñón/cirugía , Riñón/patología , Donadores Vivos
14.
World J Radiol ; 16(5): 115-127, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38845606

RESUMEN

BACKGROUND: Gastrointestinal bleeding (GIB) is a severe and potentially life-threatening condition, especially in cases of delayed treatment. Computed tomography angiography (CTA) plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the haemorrhage. AIM: To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic findings. METHODS: In this retrospective single-centre study, 35 patients (22 men; median age 69 years; range 16-92 years) admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were enrolled. Twenty-three (65.7%) patients underwent endoscopy before CTA. Bleeding volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated software. Bleeding rate was obtained from volume change between the two phases and standardised for unit time. Patients were divided into two groups, according to the angiographic signs and their concordance with CTA. RESULTS: Upper bleeding accounted for 42.9% and lower GIB for 57.1%. Mean haemoglobin value at the admission was 7.7 g/dL. A concordance between positive CTA and direct angiographic bleeding signs was found in 19 (54.3%) cases. Despite no significant differences in terms of bleeding volume in the arterial phase (0.55 mL vs 0.33 mL, P = 0.35), a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography (2.06 mL vs 0.9 mL, P = 0.02). In the latter patient group, a significant increase in bleeding rate was also detected (2.18 mL/min vs 0.19 mL/min, P = 0.02). CONCLUSION: In GIB of any origin, extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

15.
Eur Radiol Exp ; 8(1): 72, 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38740707

RESUMEN

Overall quality of radiomics research has been reported as low in literature, which constitutes a major challenge to improve. Consistent, transparent, and accurate reporting is critical, which can be accomplished with systematic use of reporting guidelines. The CheckList for EvaluAtion of Radiomics research (CLEAR) was previously developed to assist authors in reporting their radiomic research and to assist reviewers in their evaluation. To take full advantage of CLEAR, further explanation and elaboration of each item, as well as literature examples, may be useful. The main goal of this work, Explanation and Elaboration with Examples for CLEAR (CLEAR-E3), is to improve CLEAR's usability and dissemination. In this international collaborative effort, members of the European Society of Medical Imaging Informatics-Radiomics Auditing Group searched radiomics literature to identify representative reporting examples for each CLEAR item. At least two examples, demonstrating optimal reporting, were presented for each item. All examples were selected from open-access articles, allowing users to easily consult the corresponding full-text articles. In addition to these, each CLEAR item's explanation was further expanded and elaborated. For easier access, the resulting document is available at https://radiomic.github.io/CLEAR-E3/ . As a complementary effort to CLEAR, we anticipate that this initiative will assist authors in reporting their radiomics research with greater ease and transparency, as well as editors and reviewers in reviewing manuscripts.Relevance statement Along with the original CLEAR checklist, CLEAR-E3 is expected to provide a more in-depth understanding of the CLEAR items, as well as concrete examples for reporting and evaluating radiomic research.Key points• As a complementary effort to CLEAR, this international collaborative effort aims to assist authors in reporting their radiomics research, as well as editors and reviewers in reviewing radiomics manuscripts.• Based on positive examples from the literature selected by the EuSoMII Radiomics Auditing Group, each CLEAR item explanation was further elaborated in CLEAR-E3.• The resulting explanation and elaboration document with examples can be accessed at  https://radiomic.github.io/CLEAR-E3/ .


Asunto(s)
Lista de Verificación , Humanos , Europa (Continente) , Radiología/normas , Diagnóstico por Imagen/normas , Radiómica
16.
Cancers (Basel) ; 16(2)2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-38254855

RESUMEN

Post-hepatectomy liver failure (PHLF) represents a major cause of morbidity and mortality after liver resection. The factors related to PHLF are represented not only by the volume and function of the future liver remnant but also by the severity of portal hypertension. The aim of this study was to assess whether the preservation of the round ligament (RL) may mitigate portal hypertension, thus decreasing the risk of PHLF and ascites in cirrhotic patients while undergoing minimally invasive liver surgery (MILS). All the cirrhotic patients who underwent MILS for HCC from 2016 to 2021 in two international tertiary referral centers were retrospectively analyzed, comparing cases with the RL preserved vs. those with the RL divided. Only patients with cirrhosis ≥ Child A6, portal hypertension, and ICG-R15 > 10% were included. Main postoperative outcomes were compared, and the risk factors for postoperative ascites (severe PHLF, grade B/C) were investigated through a logistic regression. After the application of the selection criteria, a total of 130 MILS patients were identified, with 86 patients with the RL preserved and 44 with the RL divided. The RL-preserved group showed lower incidences of severe PHLF (7.0% vs. 20.5%, p = 0.023) and ascites (5.8% vs. 18.2%, p = 0.026) in comparison with the RL-divided group. After uni/multivariate analysis, the risk factors related to postoperative ascites were RL division and platelets < 92 × 103/µL, calculated with ROC analysis. The preservation of the round ligament during MILS may mitigate portal hypertension, preventing PHLF and ascites in cirrhotic patients with borderline liver function.

17.
Semin Ultrasound CT MR ; 44(3): 214-227, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37245886

RESUMEN

The latest evolutions in Computed Tomography (CT) technology have several applications in oncological imaging. The innovations in hardware and software allow for the optimization of the oncological protocol. Low-kV acquisitions are possible thanks to the new powerful tubes. Iterative reconstruction algorithms and artificial intelligence are helpful for the management of image noise during image reconstruction. Functional information is provided by spectral CT (dual-energy and photon counting CT) and perfusion CT.


Asunto(s)
Inteligencia Artificial , Tomografía Computarizada por Rayos X , Humanos , Fantasmas de Imagen , Tomografía Computarizada por Rayos X/métodos , Algoritmos , Procesamiento de Imagen Asistido por Computador/métodos , Dosis de Radiación
18.
Jpn J Radiol ; 41(10): 1051-1061, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37171755

RESUMEN

Gastrointestinal stromal tumours are rare mesenchymal neoplasms originating from the Cajal cells and represent the most common sarcomas in the gastroenteric tract. Symptoms may be absent or non-specific, ranging from fatigue and weight loss to acute abdomen. Nowadays endoscopy, echoendoscopy, contrast-enhanced computed tomography, magnetic resonance imaging and positron emission tomography are the main methods for diagnosis. Because of their rarity, these neoplasms may not be included immediately in the differential diagnosis of a solitary abdominal mass. Radiomics is an emerging technique that can extract medical imaging information, not visible to the human eye, transforming it into quantitative data. The purpose of this review is to demonstrate how radiomics can improve the already known imaging techniques by providing useful tools for the diagnosis, treatment, and prognosis of these tumours.


Asunto(s)
Tumores del Estroma Gastrointestinal , Humanos , Tumores del Estroma Gastrointestinal/diagnóstico por imagen , Pronóstico , Tomografía Computarizada por Rayos X , Imagen por Resonancia Magnética , Endoscopía
19.
Diagnostics (Basel) ; 13(5)2023 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-36900124

RESUMEN

Breast ultrasound (US) has undergone dramatic technological improvement through recent decades, moving from a low spatial resolution, grayscale-limited technique to a highly performing, multiparametric modality. In this review, we first focus on the spectrum of technical tools that have become commercially available, including new microvasculature imaging modalities, high-frequency transducers, extended field-of-view scanning, elastography, contrast-enhanced US, MicroPure, 3D US, automated US, S-Detect, nomograms, images fusion, and virtual navigation. In the subsequent section, we discuss the broadened current application of US in breast clinical scenarios, distinguishing among primary US, complementary US, and second-look US. Finally, we mention the still ongoing limitations and the challenging aspects of breast US.

20.
J Clin Med ; 12(4)2023 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-36835977

RESUMEN

The treatment of primary and secondary lung neoplasms now sees the fundamental role of radiotherapy, associated with surgery and systemic therapies. The improvement in survival outcomes has also increased attention to the quality of life, treatment compliance and the management of side effects. The role of imaging is not only limited to recognizing the efficacy of treatment but also to identifying, as soon as possible, the uncommon effects, especially when more treatments, such as chemotherapy, immunotherapy and radiotherapy, are associated. Radiation recall pneumonitis is an uncommon treatment complication that should be correctly characterized, and it is essential to recognize the mechanisms of radiation recall pneumonitis pathogenesis and diagnostic features in order to promptly identify them and adopt the best therapeutic strategy, with the shortest possible withdrawal of the current oncological drug. In this setting, artificial intelligence could have a critical role, although a larger patient data set is required.

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