Radiologia Medica

Interictal EEG spikes increase perfusion in low-grade epilepsy-associated tumors: a pediatric arterial spin labeling study
Gennari AG, Bicciato G, Lo Biundo SP, Kottke R, Cserpan D, Tuura O'Gorman R and Ramantani G
Arterial spin labeling (ASL), a noninvasive magnetic resonance (MRI) perfusion sequence, holds promise in the presurgical evaluation of pediatric lesional epilepsy patients, including those with low-grade epilepsy-associated tumors (LEATs). The interpretation of ASL-derived perfusion patterns, however, presents challenges. Our study aims to elucidate these perfusion changes in children with LEATs, exploring their correlations with clinical, electroencephalography (EEG), and anatomical MRI findings.
Imaging in sensorineural and conductive hearing loss-an educational review
Vassallo E, Gatt AS, Grech R, Capasso S, Caranci F and Ugga L
Hearing loss is the most common sensory impairment globally and can affect all ages. It can be classified into two categories, conductive and sensorineural, though both conditions may coexist. Various causes may be responsible for hearing loss including congenital, infectious, inflammatory and neoplastic. Imaging will help detect or exclude such causes and in combination with the medical history and clinical findings, enable the necessary treatment to be initiated. Imaging also provides an accurate pre-operative anatomical road map for the surgeons to ensure the best possible surgical outcomes. The aim of this educational review is to present a range of common and rare diseases causing hearing loss and provide a brief explanation of the best imaging modalities for each. It also discusses briefly some important anatomical variants which the radiologists should highlight in their report to help prevent inadvertent post-operative complications.
Correlation between nova volume flow rate and TOF signal intensity ratio: value in unilateral internal carotid artery occlusion
Wolf F, Colombo E, Schubert T, Höbner LM, Wegener S, Fierstra J, Sebök M, van Niftrik B, Luft A, Regli L and Esposito G
Non-invasive optimal vessel analysis quantitative magnetic resonance angiography (NOVA-QMRA) has emerged as a valuable tool to characterize cerebral hemodynamics in intracranial atherosclerotic disease (ICAD). Our aim was to explore the eventual correlation between volume flow rate (VFR) measured via NOVA-QMRA and signal intensity ratio (SIR) of time-of-flight (TOF) MRA in M1- and P2-segments bilaterally in patients with unilateral internal carotid artery (ICA) occlusion.
Metastasis-directed ablation of hepatocellular carcinoma with pulmonary oligometastases: a long-term multicenter study
Zhou Q, Li R, Wu S, Zhang Y, Wang W, Zhu K, Wang M, Huang Z and Duan F
Ablation is a promising approach for eliminating intrathoracic metastases. We compared the effectiveness of a combination of metastasis-directed ablation and systemic therapy with that of systemic therapy alone for patients with hepatocellular carcinoma (HCC) having pulmonary oligometastases.
Cardiovascular magnetic resonance in β-thalassemia major: beyond T2
Meloni A, Saba L, Cademartiri F, Positano V, Pistoia L and Cau R
Β-thalassemia major (TM) patients underwent regular transfusions to prevent complications of chronic anemia. However, these regular transfusions result in progressive iron accumulation in vital organs, including the heart. Myocardial iron overload can lead to cardiac dysfunction and ultimately to heart failure. Diagnosis of cardiac dysfunction in β-TM patients is usually made through clinical examination, electrocardiogram, and echocardiography. Cardiac magnetic resonance (CMR), through the measurement of T2* relaxation time, represents the diagnostic modality of choice for assessing myocardial iron overload and guiding the iron chelation therapy. Despite a tailored chelation therapy reducing myocardial iron overload, heart failure remains the leading cause of morbidity and mortality even in well-treated β-TM patients. Advances in CMR, including myocardial strain, parametric mapping (T1, T2, and extracellular volume), and late gadolinium enhancement (LGE) measurements, have expanded its role in the diagnosis, prognosis, and follow-up of these patients. This review seeks to offer a thorough overview of the potential uses of CMR in β-TM, extending beyond the established role of T2* measurement in guiding chelation therapy. It delves into the emerging applications of new CMR imaging biomarkers that could improve the overall management of β-TM patients.
Qualitative and quantitative evaluation of the role of CBCT in rectal cancer radiotherapy
Catona GM and Marcu LG
Verifying patients' position and internal anatomical changes are important steps in the radiotherapy of rectal cancer. Cone Beam Computed Tomography (CBCT) is an advanced imaging method that allows for the quantification of these modifications, ensuring the delivery of radiation dose to the tumor volume, while protecting surrounding organs at risk. The aim of this review is to discuss and analyze the benefits offered by this method of imaging on board the linear accelerator. In view of this, a systematic search of the scientific literature in the Medline/PubMed database was performed for publications over the last decade, with 20 articles found to be relevant for this study. To highlight the benefits of this imaging technique in rectal cancer, the frequency of CBCT use, identification of tumor volume and organs at risk on CBCT images, quantification of the movement of these organs and tumor volume, analysis of positioning errors as well as evaluation of dosimetric parameters were analyzed.
Correction: Diagnostic accuracy of MRI for evaluating myometrial invasion in endometrial cancer: a comparison of MUSE-DWI, rFOV-DWI, and DCE-MRI
Ota T, Tsuboyama T, Onishi H, Nakamoto A, Fukui H, Yano K, Honda T, Kiso K, Tatsumi M and Tomiyama N
Percutaneous microwave ablation of HCC: comparison between 100 and 150 W technology systems
Lanza C, Angileri SA, Biondetti P, Coppola A, Ricapito F, Ascenti V, Amato G, Pellegrino G, Sciacqua LV, Vanzulli A, Carriero S, Venturini M, Ierardi AM and Carrafiello G
To evaluate the differences in efficacy and safety between the 100 and 150 W percutaneous microwave ablation (MWA) systems in the treatment of hepatocellular carcinoma (HCC).
Quantification of normal bone and osseous metastases in castration-resistant prostate cancer using SPECT/CT with xSPECT Quant: prospective imaging sub-study of a phase 2 clinical trial investigating the combination of pembrolizumab plus radium-223 compared to radium-223 alone
Robertson MS, Wang Y, Cheng S, Park H, Glomski S, Harshman LC, Pace A, Kilar J, Flynn M, Gilbert L, Choudhury AD and Jacene H
The purpose of this study is to demonstrate the consistency and reproducibility of quantitative SPECT/CT by evaluating the maximum SUV (SUV) in normal bone, to provide the reference value of metastatic lesions, and to evaluate the clinical implication of SUV changes of osseous metastasis during treatment.
Long-term clinical outcomes of thermal ablation for benign thyroid nodules and unresolved issues: a comprehensive systematic review
Jeong SY and Baek JH
Thermal ablation is widely accepted as an effective and safe method for treating benign thyroid nodules. Many studies reporting short-term results have consistently demonstrated the efficacy and safety of thermal ablation. However, as the clinical application of thermal ablation grows and follow-up periods extend, long-term clinical outcomes of thermal ablation have revealed several issues, including regrowth and diagnosis of malignancy in ablated lesions. In this systematic review, we analyze the long-term clinical outcomes of thyroid thermal ablation, focusing on regrowth, delayed surgery, and the potential for malignancy after thermal ablation and propose solutions to address these unresolved issues and enhance the management of benign thyroid nodules through thermal ablation.
Enhancing detection of high-level axillary lymph node metastasis after neoadjuvant therapy in breast cancer patients with nodal involvement: a combined approach of axilla ultrasound and breast elastography
Huang JX, Liu FT, Tan YT, Wang XY, Huang JH, Lin SY, Huang GL, Zhang YT and Pei XQ
To develop a combined approach using shear wave elastography (SWE) and conventional ultrasound (US) to determine the extent of positive axillary lymph nodes (LNs) following neoadjuvant therapy (NAT) in breast cancer patients with nodal involvement.
A multi-center, multi-organ, multi-omic prediction model for treatment-induced severe oral mucositis in nasopharyngeal carcinoma
Nicol AJ, Lam SK, Ching JCF, Tam VCW, Teng X, Zhang J, Lee FKH, Wong KCW, Cai J and Lee SWY
Oral mucositis (OM) is one of the most prevalent and crippling treatment-related toxicities experienced by nasopharyngeal carcinoma (NPC) patients receiving radiotherapy (RT), posing a tremendous adverse impact on quality of life. This multi-center study aimed to develop and externally validate a multi-omic prediction model for severe OM.
Advancing precision in CT-guided bone biopsies: exploring the potential of dual-energy CT imaging
Boninsegna E, Piovan E, Sozzi C, Simonini E, Aringhieri G, Cioni D and Neri E
This study aimed to investigate the integration of dual-energy CT (DECT) into CT-guided bone biopsy procedures, comparing it with conventional CT techniques. The focus was on technical aspects, accuracy and radiation dose exposure.
Prediction of tumor response to neoadjuvant chemotherapy in high-grade osteosarcoma using clustering-based analysis of magnetic resonance imaging: an exploratory study
Benvenuti G, Marzi S, Vidiri A, Baldi J, Ceddia S, Riva F, Covello R, Terrenato I and Anelli V
To evaluate the ability of magnetic resonance imaging (MRI)-based clustering analysis to predict the pathological response to neoadjuvant chemotherapy (NACT) in patients with primary high-grade osteosarcoma.
Improved prognostication of overall survival after radiotherapy in lung cancer patients by an interpretable machine learning model integrating lung and tumor radiomics and clinical parameters
Luo T, Yan M, Zhou M, Dekker A, Appelt AL, Ji Y, Zhu J, de Ruysscher D, Wee L, Zhao L and Zhang Z
Accurate prognostication of overall survival (OS) for non-small cell lung cancer (NSCLC) patients receiving definitive radiotherapy (RT) is crucial for developing personalized treatment strategies. This study aims to construct an interpretable prognostic model that combines radiomic features extracted from normal lung and from primary tumor with clinical parameters. Our model aimed to clarify the complex, nonlinear interactions between these variables and enhance prognostic accuracy.
Factors of interobserver variability in prostate tumor MRI delineation: impact of PI-QUAL score
Salgues E, Jeganathan T, Schick U, Nguyen TA, Tissot V, Fournier G, Valéri A and Bourbonne V
Prostate cancer ranks as the second most common cancer in men worldwide. Dose escalation to the tumor and/or the prostate improves biochemical recurrence-free survival. However, interobserver variability in lesion contouring poses a significant limitation to such therapeutic approaches. Therefore, a study of factors influencing this variability is necessary.
Intravoxel incoherent motion MRI to assess feto-placental diffusion and perfusion properties in small fetuses
Ercolani G, Capuani S, Celli V, Ciulla S, Ninkova R, Gennarini M, Miceli V, Grimm R, Di Mascio D, Porpora MG, Giancotti A, Catalano C and Manganaro L
To investigate the use of intravoxel incoherent motion (IVIM) to study microperfusion and microstructural characteristics of lungs, brain, and placenta in normal and small fetuses.
Retrospective study on the strength of magnetic resonance signs for predicting breast implant rupture: assessing the impact of radiologist expertise at a breast cancer referral center
Pesapane F, Rotili A, Signorelli G, Dominelli V, Mazzocconi L, Sorce A, Battaglia O, Cugliari G, Gandini S, Nicosia L, Penco S, Pizzamiglio M, De Lorenzi F and Cassano E
This study evaluates the diagnostic criteria of MRI for breast implant rupture and examines the influence of radiologist experience on the accuracy of rupture detection.
BPE on contrast-enhanced mammography: relationship with breast density, age and menopausal status
Moffa G, Galati F, Spagnoli A, Fabrizi E, Maroncelli R, Coppola S, Rizzo V and Pediconi F
This retrospective study aimed to evaluate the relationship between BPE on CEM and breast density, age and menopausal status.
Radiofrequency ablation guided by real-time cardiovascular magnetic resonance
Fusco A, De Santis D, De Ruvo E, Calò L, Borrelli A, Caruso D, Tremamunno G, Laghi A, Simonetti G and Stefanini M
Cardiovascular magnetic resonance (CMR) is gaining ground in guiding electrophysiology (EP)-based ablation procedures of typical atrial flutter and atrial fibrillation, allowing for the avoidance of radiation exposure for patients and operators and reducing the risk of occupational illnesses. CMR allows comprehensive assessment of cardiac anatomy and provides tissue characterization by identifying pathological substrates, such as myocardial scars and edema, identified with the implementation of late gadolinium enhancement and T2-weighted short-tau inversion recovery sequences. Intraprocedural imaging is useful for real-time catheter tracking during the ablation procedure while simultaneously providing visualization of cardiac anatomy. Additionally, CMR facilitates the evaluation of the ablation procedure accuracy by acquiring edema-sensitive sequences, thereby aiding in preventing early complications. This report serves as a primer for radiologists and illustrates the value of CMR in planning and performing the ablation procedure, as well as its role in post-procedural imaging.
Radiomics based on brain-to-tumor interface enables prediction of metastatic tumor type of brain metastasis: a proof-of-concept study
Jiang M, Sun Y, Yang C, Wang Z, Xie M, Wang Y, Zhao D, Ding Y, Zhang Y, Liu J, Chen H and Jiang X
Early and accurate identification of the metastatic tumor types of brain metastasis (BM) is essential for appropriate treatment and management.