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1.
Crit Rev Oncog ; 29(2): 37-52, 2024.
Article in English | MEDLINE | ID: mdl-38505880

ABSTRACT

Liver lesions, including both benign and malignant tumors, pose significant challenges in interventional radiological treatment planning and prognostication. The emerging field of artificial intelligence (AI) and its integration with texture analysis techniques have shown promising potential in predicting treatment outcomes, enhancing precision, and aiding clinical decision-making. This comprehensive review aims to summarize the current state-of-the-art research on the application of AI and texture analysis in determining treatment response, recurrence rates, and overall survival outcomes for patients undergoing interventional radiological treatment for liver lesions. Furthermore, the review addresses the challenges associated with the implementation of AI and texture analysis in clinical practice, including data acquisition, standardization of imaging protocols, and model validation. Future directions and potential advancements in this field are discussed. Integration of multi-modal imaging data, incorporation of genomics and clinical data, and the development of predictive models with enhanced interpretability are proposed as potential avenues for further research. In conclusion, the application of AI and texture analysis in predicting outcomes of interventional radiological treatment for liver lesions shows great promise in augmenting clinical decision-making and improving patient care. By leveraging these technologies, clinicians can potentially enhance treatment planning, optimize intervention strategies, and ultimately improve patient outcomes in the management of liver lesions.


Subject(s)
Artificial Intelligence , Liver Neoplasms , Humans , Genomics , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/therapy
2.
J Cardiovasc Surg (Torino) ; 65(1): 49-63, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38037721

ABSTRACT

The objective of these Guidelines is to provide recommendations for the classification, indication, treatment and management of patients suffering from aneurysmal pathology of the visceral and renal arteries. The methodology applied was the GRADE-SIGN version, and followed the instructions of the AGREE quality of reporting checklist. Clinical questions, structured according to the PICO (Population, Intervention, Comparator, Outcome) model, were formulated, and systematic literature reviews were carried out according to them. Selected articles were evaluated through specific methodological checklists. Considered Judgments were compiled for each clinical question in which the characteristics of the body of available evidence were evaluated in order to establish recommendations. Overall, 79 clinical practice recommendations were proposed. Indications for treatment and therapeutic options were discussed for each arterial district, as well as follow-up and medical management, in both candidate patients for conservative therapy and patients who underwent treatment. The recommendations provided by these guidelines simplify and improve decision-making processes and diagnostic-therapeutic pathways of patients with visceral and renal arteries aneurysms. Their widespread use is recommended.


Subject(s)
Aneurysm , Embolization, Therapeutic , Humans , Renal Artery/diagnostic imaging , Radiology, Interventional , Aneurysm/diagnostic imaging , Aneurysm/surgery , Embolization, Therapeutic/adverse effects , Italy
3.
Aorta (Stamford) ; 10(2): 92-93, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35654436

ABSTRACT

Leriche syndrome is characterized by abdominal aorta and/or bilateral iliac occlusive disease, with a triad of clinical symptoms and signs such as claudication, erectile dysfunction, and decreased distal pulses. Diagnostic imaging is one of the key factors for diagnosis of the anatomic origin of the Leriche symptoms. We report the case of a 56-year-old man with diagnosis of abdominal aorta and bilateral iliac occlusive disease with a wide collateral vascular network.

4.
Aorta (Stamford) ; 9(2): 86-87, 2021 Apr.
Article in English | MEDLINE | ID: mdl-34619798

ABSTRACT

We report the case of a 73-year-old male who underwent abdominal multidetector computed tomography with vascular reconstruction that highlighted a congenital variant of iliac arteries. Iliac artery anatomical variants are exceedingly rare and only a few cases have been reported in the literature.

5.
Minerva Chir ; 74(4): 359-363, 2019 Aug.
Article in English | MEDLINE | ID: mdl-30019879

ABSTRACT

INTRODUCTION: Wandering spleen (WS) is a rare and generally acquired condition, resulting from abnormal ligamentous laxity failing to fixate the spleen in its normal location in the left upper quadrant, thus leading to its migration to the pelvis due to gravity. Such migration leads to an elongated vascular pedicle, which is prone to torsion causing splenic infarction; thus, a prompt surgical intervention is recommended. Since this adverse event affects childbearing women or children, it is crucial to choose the most appropriate surgical strategy, such as splenectomy or splenopexy, both effective and widely diffused options. The aim of this paper is to perform a literature review on WS reports treated by surgery. We also present a case of symptomatic WS migrated in pelvis in a young female treated by splenectomy. EVIDENCE ACQUISITION: All relevant articles from 1895 up to December 2017 were identified by literature searches in PubMed, Scopus and Google Scholar. EVIDENCE SYNTHESIS: A total of 376 patients treated with surgical approach for WS were identified. The most common presentations were abdominal pain and abdominal mass, and approximately half of the patients had an acute clinical onset. Radiology is essential for the diagnosis. Surgical strategy changed over the time; splenectomy is the most reported treatment although in the last years there is an increasing trend towards a more conservative strategy, preferring splenopexy or a laparoscopic approach. CONCLUSIONS: Surgery is the gold standard strategy, and laparoscopic approach is recommended, for the treatment of wandering spleen. Both splenopexy or splenectomy are effective and safe surgical options.


Subject(s)
Abdominal Pain/etiology , Wandering Spleen/complications , Humans , Recurrence , Splenectomy , Wandering Spleen/surgery
6.
Future Oncol ; 14(28): 2957-2967, 2018 Dec.
Article in English | MEDLINE | ID: mdl-29712486

ABSTRACT

This review focuses upon interactions and potential therapeutic targets in the 'vicious cycle' between hypoxia and neoangiogenesis following treatment of hepatocellular carcinoma with transarterial loco-regional therapies. Biomarkers correlated with angiogenesis have been studied by many authors as prognostic determinants following transarterial intrahepatic therapy. According to these results future therapies directed toward specific factors related to angiogenesis could play a significant role in preventing local tumor recurrence and remote metastasis.


Subject(s)
Carcinoma, Hepatocellular/metabolism , Carcinoma, Hepatocellular/pathology , Hypoxia/metabolism , Liver Neoplasms/metabolism , Liver Neoplasms/pathology , Neovascularization, Pathologic/metabolism , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/methods , Combined Modality Therapy , Humans , Liver Neoplasms/therapy , Precision Medicine/methods , Treatment Outcome
7.
Q J Nucl Med Mol Imaging ; 62(2): 140-151, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29166752

ABSTRACT

Since the beginning of second decade of last century, when it was introduced in many oncologic scenarios, immunotherapy has become an important tool in the management of a growing number of cancers. Immunotherapy for cancer appears to be useful, improving not only progression free survival but also overall survival, thus achieving the goal that many advanced cancers, previously considered without effective treatment options, have now become successfully treatable. However, considering the relatively recent introduction of these drugs in clinical scenarios and the continuous release of new drugs, there is a lack of large validated clinical experiences and many issues are today debated amongst which the evaluation of the response to immune-therapy. Engaging the host immune system in fighting against cancer is an energy-consuming process, requiring T-cell recruiting; this process, named "pseudo-progression," sometimes produces an increase of both dimensional and metabolic ratio of the lesions, as well as the appearance of "new lesions." This behavior, always considered as undisputed progressive disease when traditional chemotherapy is employed, should be carefully considered in the field of immunotherapy, where the phenomenon of "flare" followed by regression of the disease can occur. In this paper, Authors analyzed the best available evidence in this field, reviewed the most important issues concerning the development of immunotherapy, and addressed evidence and concerns about the evaluation of response when using immunotherapy drugs, in terms of both radiological and nuclear medicine criteria.


Subject(s)
Immunotherapy/methods , Neoplasms/therapy , Humans , Immunologic Factors/adverse effects , Immunologic Factors/therapeutic use , Immunotherapy/adverse effects , Neoplasms/immunology , Neoplasms/metabolism , Symptom Flare Up , Treatment Outcome
8.
Br J Radiol ; 89(1061): 20150952, 2016.
Article in English | MEDLINE | ID: mdl-26882960

ABSTRACT

Acute vascular injuries are the second most common cause of fatalities in patients with multiple traumatic injuries; thus, prompt identification and management is essential for patient survival. Over the past few years, multidetector CT (MDCT) using dual-phase scanning protocol has become the imaging modality of choice in high-energy deceleration traumas. The objective of this article was to review the role of dual-phase MDCT in the identification and management of acute vascular injuries, particularly in the chest and abdomen following multiple traumatic injuries. In addition, this article will provide examples of MDCT features of acute vascular injuries with correlative surgical and interventional findings.


Subject(s)
Multidetector Computed Tomography/methods , Vascular System Injuries/diagnostic imaging , Wounds, Nonpenetrating/diagnostic imaging , Abdominal Injuries/diagnostic imaging , Humans , Multiple Trauma/diagnostic imaging , Thoracic Injuries/diagnostic imaging
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