NAVIGATOR: an Italian regional imaging biobank to promote precision medicine for oncologic patients.

NAVIGATOR is an Italian regional project boosting precision medicine in oncology with the aim of making it more predictive, preventive, and personalised by advancing translational research based on quantitative imaging and integrative omics analyses. The project's goal is to develop an open imaging biobank for the collection and preservation of a large amount of standardised imaging multimodal datasets, including computed tomography, magnetic resonance imaging, and positron emission tomography data, together with the corresponding patient-related and omics-related relevant information extracted from regional healthcare services using an adapted privacy-preserving model. The project is based on an open-source imaging biobank and an open-science oriented virtual research environment (VRE). Available integrative omics and multi-imaging data of three use cases (prostate cancer, rectal cancer, and gastric cancer) will be collected. All data confined in NAVIGATOR (i.e., standard and novel imaging biomarkers, non-imaging data, health agency data) will be used to create a digital patient model, to support the reliable prediction of the disease phenotype and risk stratification. The VRE that relies on a well-established infrastructure, called D4Science.org, will further provide a multiset infrastructure for processing the integrative omics data, extracting specific radiomic signatures, and for identification and testing of novel imaging biomarkers through big data analytics and artificial intelligence.

Muscle strength recovery versus semitendinosus and gracilis tendon regeneration after harvesting for anterior cruciate ligament reconstruction.

Twenty consecutive, chronic and isolated anterior cruciate ligament (ACL) lesions that underwent reconstruction with quadrupled semitendinosus (ST) and gracilis (G) were prospectively examined to compare tendon regeneration and muscle strength recovery. Twenty consecutive axial nuclear magnetic resonance (NMR) scans were done after 1 month, 6 months and 2 years from surgery. A CybexII was used to evaluate concentric strength deficits both in flexion and in internal tibia rotation at 6 months and 2 years. At 2 years, an NMR signal comparable to the contralateral was present in 14 (70%) cases and absent in 6 (30%). Semitendinosus tendon exceeded the meniscal plateau since the first month, while the G tendon crossed the joint line only after 6 months. However, the distal-end insertions of both tendons were always significantly more proximal than the contralateral normal side (ST: P = .002; G: P = .003). In case of tendon regeneration, flexion deficit was not significant after 6 months, while internal tibia rotation deficit became not significant only after 2 years. In case of non-regeneration, a flexion deficit was present after 6 months [15.5% (P = .05)] but not after 2 years, while internal tibial rotation deficit was significant both after 6 months [30.3% (P < .001)] and 2 years [24.3% (P = .03)]. In case of tendon regeneration, isokinetic evaluation showed a non-significant deficit in both flexion and internal rotation strength after ACL reconstruction with ST and G. At the 2-year follow-up, none of the 6 patients without tendon regeneration found any impairment in their sport activities despite the loss of internal rotation strength.