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Wáng YXJ, Diacinti D, Aparisi Gómez MP, Santiago FR, Becce F, Tagliafico AS, Prakash M, Isaac A, Dalili D, Griffith JF, Guglielmi G, Bazzocchi A. Radiological diagnosis of prevalent osteoporotic vertebral fracture on radiographs: an interim consensus from a group of experts of the ESSR osteoporosis and metabolism subcommittee. Skeletal Radiol 2024:10.1007/s00256-024-04678-4. [PMID: 38662094 DOI: 10.1007/s00256-024-04678-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/09/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
When a low-energy trauma induces an acute vertebral fracture (VF) with clinical symptoms, a definitive diagnosis of osteoporotic vertebral fracture (OVF) can be made. Beyond that, a "gold" radiographic standard to distinguish osteoporotic from non-osteoporotic VFs does not exist. Fracture-shaped vertebral deformity (FSVD) is defined as a deformity radiographically indistinguishable from vertebral fracture according to the best of the reading radiologist's knowledge. FSVD is not uncommon among young populations with normal bone strength. FSVD among an older population is called osteoporotic-like vertebral fracture (OLVF) when the FSVD is likely to be associated with compromised bone strength. In more severe grade deformities or when a vertebra is collapsed, OVF diagnosis can be made with a relatively high degree of certainty by experienced readers. In "milder" cases, OVF is often diagnosed based on a high probability rather than an absolute diagnosis. After excluding known mimickers, singular vertebral wedging in older women is statistically most likely an OLVF. For older women, three non-adjacent minimal grade OLVF (< 20% height loss), one minimal grade OLVF and one mild OLVF (20-25% height loss), or one OLVF with ≥ 25% height loss, meet the diagnosis of osteoporosis. For older men, a single OLVF with < 40% height loss may be insufficient to suggest the subject is osteoporotic. Common OLVF differential diagnoses include X-ray projection artifacts and scoliosis, acquired and developmental short vertebrae, osteoarthritic wedging, oncological deformities, deformity due to high-energy trauma VF, lateral hyperosteogeny of a vertebral body, Cupid's bow, and expansive endplate, among others.
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Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
| | - Daniele Diacinti
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Department of Radiology, IMSKE, Valencia, Spain
| | - Fernando Ruiz Santiago
- Department of Radiology and Physical Medicine, Faculty of Medicine, University of Granada, Granada, Spain
- Musculoskeletal Radiology Unit, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Alberto Stefano Tagliafico
- Department of Radiology, DISSAL, University of Genova, Genoa, Italy
- Department of Radiology, Ospedale Policlinico San Martino, Genoa, Italy
| | - Mahesh Prakash
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amanda Isaac
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Danoob Dalili
- Academic Surgical Unit, Southwest London Elective Orthopaedic Centre (SWLEOC), Dorking Road, Epsom, London, UK
- Department of Radiology, Epsom and St Hellier University Hospitals NHS Trust, Dorking Road, Epsom, London, UK
| | - James F Griffith
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Giuseppe Guglielmi
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy
- Radiology Unit, Dimiccoli Teaching Hospital Barletta, Barletta, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Ramoni D, Coco S, Rossi G, Dellepiane C, Bennicelli E, Santamaria S, Zinoli L, Tagliafico AS, Tagliamento M, Barletta G, Liberale L, Tirandi A, Minetti S, Bertolotto M, Montecucco F, Genova C, Carbone F. Circulating Osteopontin Predicts Clinical and Radiological Response in First-Line Treatment of Advanced Non-Small Cell Lung Cancer. Lung 2024; 202:197-210. [PMID: 38480620 PMCID: PMC11009777 DOI: 10.1007/s00408-024-00675-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/26/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE Pembrolizumab-based regimens are conditioned by the expression of PD-L1, but durable response rate is limited by innate and acquired resistance mechanisms. Here, we focus on osteopontin (OPN), an upfront biomarker of senescence, which closely associated with natural history of non-small cell lung cancer (NSCLC). METHODS Seventy-nine patients eligible to pembrolizumab regimens-alone or in combination with chemotherapy-as first-line treatment of advanced NSCLC were enrolled. Predictive value of OPN toward iRECIST progression disease (PD) was set as first outcome. Secondary ones included performance status (ECOG) at baseline, early (first and best) responses, and overall survival (OS). RESULTS High Serum OPN characterized patients with worse ECOG-PS (p = 0.015) at baseline and subjects experienced PD/death at first (OR 1.17 [1.02 to 1.35]; p = 0.030) and best responses (0.04 [0.00 to 0.81]; p = 0.035). OPN was associated with time-to-progression (B -2.74 [-4.46 to -1.01]) and time-to death (-0.13 [-0.20 to -0.05]). Cox regression models unveil a predictive value for iRECIST-PD (HR 1.01 [1.00 to 1.02]; p = -0.005), RECIST-PD (HR 1.01 [1.00 to 1.02]; p = 0.017), and OS (HR 1.02 [1.01 to 1.03]; p = 0.001). These models were internally validated through bootstrap resampling and characterized by relevant discrimination ability at ROC curve analyses. CONCLUSION Baseline levels of serum OPN is closely associated with performance status and short/long term outcomes in patients with advanced NSCLC, which are candidate to pembrolizumab-based regimens. As upfront biomarker of senescence, OPN may pave the way for future studies focusing on senescence patterns in NSCLC.
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Affiliation(s)
- Davide Ramoni
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Simona Coco
- U.O.S. Tumori Polmonari, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Giovanni Rossi
- IRCCS Ospedale Policlinico San Martino, U.O.C. Oncologia Medica 2, 16132, Genoa, Italy
- Dipartimento di Medicina, Chirurgia e Scienze Sperimentali, Università di Sassari, 07100, Sassari, Italy
| | - Chiara Dellepiane
- IRCCS Ospedale Policlinico San Martino, U.O.C. Oncologia Medica 2, 16132, Genoa, Italy
| | - Elisa Bennicelli
- IRCCS Ospedale Policlinico San Martino, U.O.C. Oncologia Medica 2, 16132, Genoa, Italy
| | - Sara Santamaria
- UOC Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Linda Zinoli
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Alberto Stefano Tagliafico
- Dipartimento di Radiodiagnostica, IRCCS-Ospedale Policlinico San Martino, 16132, Genoa, Italy
- Department of Health Sciences, University of Genoa, 16132, Genoa, Italy
| | - Marco Tagliamento
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Giulia Barletta
- IRCCS Ospedale Policlinico San Martino, U.O.C. Oncologia Medica 2, 16132, Genoa, Italy
| | - Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, Genoa, Italy
| | - Amedeo Tirandi
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Silvia Minetti
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Maria Bertolotto
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, Genoa, Italy
| | - Carlo Genova
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- UOC Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy.
- IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, Genoa, Italy.
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Rescinito G, Brunetti N, Garlaschi A, Tosto S, Gristina L, Conti B, Pieroni D, Calabrese M, Tagliafico AS. Long-term outcome of 9G MRI-guided vacuum-assisted breast biopsy: results of 293 single-center procedures and underestimation rate of high-risk lesions over 12 years. Radiol Med 2024:10.1007/s11547-024-01808-9. [PMID: 38512628 DOI: 10.1007/s11547-024-01808-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Breast magnetic resonance imaging (MRI) can detect some malignant lesions that are not visible on mammography (MX) or ultrasound (US). If a targeted, second-look fails, MRI-guided breast biopsy is the only available tool to obtain a tissue sample and pathological proof of these "MRI-only lesions". The aim of this study is to report the performance and underestimation rate of 9G MRI-guided vacuum-assisted breast biopsy (VABB) over 12 years at a single center. MATERIAL AND METHODS All 9G MRI-VABB procedures performed from January 2010 to December 2021 were retrospectively reviewed. Two MRI scanners (1.5 T and 3 T) were used with the same image resolution and contrast media. All suspicious lesions detected only by breast MRI underwent biopsy. Reference standard was histological diagnosis or at least 1-year negative follow-up. All malignant and atypical lesions underwent surgery, which was used as the reference standard. RESULTS A total of 293 biopsies were retrospectively reviewed. Histopathological VABB results revealed 142/293 (48.4%) benign lesions, 77/293 (26.2%) high-risk lesions, and 74/293 (25.2%) malignant lesions. No significant complications were observed. Surgical pathology results allowed for the reclassification of n = 7/48 B3b lesions: n = 4 were ductal carcinoma in situ, while n = 3 presented invasive features at surgical histology (2 IDC; 1 ILC). B3b underestimation occurred overall in 14.6% of B3 cases. Breast follow-up was achieved for all benign VABB results, and only one false-negative case was observed. CONCLUSION Our results confirm that 1.5 T and 3 T MRI-guided VABB is an accurate and safe procedure for histopathologic final diagnosis of MRI-only lesions. Critical issues remain the potential high-risk underestimation rate of B3b VABB results and management of follow-up of benign lesions.
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Affiliation(s)
- Giuseppe Rescinito
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Nicole Brunetti
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
- Department of Experimental Medicine (DIMES), University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy.
| | - Alessandro Garlaschi
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Simona Tosto
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Licia Gristina
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Benedetta Conti
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy
| | - Diletta Pieroni
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy
| | - Massimo Calabrese
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Alberto Stefano Tagliafico
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy
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Milioto A, Corica G, Nista F, Wildemberg LEA, Rossi F, Bignotti B, Gadelha MR, Ferone D, Tagliafico AS, Gatto F. Skeletal Muscle Evaluation in Patients With Acromegaly. J Endocr Soc 2024; 8:bvae032. [PMID: 38434516 PMCID: PMC10907006 DOI: 10.1210/jendso/bvae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Indexed: 03/05/2024] Open
Abstract
Context Patients with acromegaly are characterized by chronic exposure to high growth hormone (GH) and insulin-like growth factor-1 levels, known for their anabolic effect on skeletal muscle. Therefore, an increased skeletal muscle mass could be hypothesized in these individuals. Herein, we have performed a systematic revision of published evidence regarding skeletal muscle mass, quality, and performance in patients with acromegaly. Evidence Acquisition A systematic review of the literature in the PubMed database up to September 1, 2023, was conducted with the following query: acromegaly AND ("muscle mass" OR "skeletal muscle"). We excluded studies that did not compare different disease states or used nonradiological methods for the skeletal muscle analyses, except for bioelectrical impedance analysis. Evidence Synthesis Fifteen studies met the inclusion criteria. A total of 360 patients were evaluated for skeletal muscle mass, 122 for muscle fatty atrophy, and 192 for muscle performance. No clear evidence of increased skeletal muscle mass in patients with active disease compared to control or healthy individuals emerged. As for skeletal muscle quality, we observed a trend toward higher fatty infiltration among patients with acromegaly compared to healthy participants. Likewise, patients with active disease showed consistently worse physical performance compared to control or healthy individuals. Conclusion Skeletal muscle in acromegaly has lower quality and performance compared to that of healthy individuals. The small number of published studies and multiple confounding factors (eg, use of different radiological techniques) contributed to mixed results, especially regarding skeletal muscle mass. Well-designed prospective studies are needed to investigate skeletal muscle mass in patients with acromegaly.
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Affiliation(s)
- Angelo Milioto
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa 16138, Italy
| | - Giuliana Corica
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa 16138, Italy
| | - Federica Nista
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa 16138, Italy
| | - Luiz Eduardo Armondi Wildemberg
- Neuroendocrinology Research Center/Endocrinology Division, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Federica Rossi
- Department of Radiology, Ospedale Santa Corona, Pietra Ligure 17027, Italy
| | - Bianca Bignotti
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa 16139, Italy
| | - Mônica R Gadelha
- Neuroendocrinology Research Center/Endocrinology Division, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil
| | - Diego Ferone
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa 16138, Italy
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa 16139, Italy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genoa 16138, Italy
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa 16139, Italy
| | - Federico Gatto
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa 16139, Italy
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Giacobbe DR, Di Maria E, Tagliafico AS, Bavastro M, Trombetta CS, Marelli C, Di Meco G, Cattardico G, Mora S, Signori A, Vena A, Mikulska M, Dentone C, Bruzzone B, Bignotti B, Orsi A, Robba C, Ball L, Brunetti I, Battaglini D, Di Biagio A, Sormani MP, Pelosi P, Giacomini M, Icardi G, Bassetti M. External validation of unsupervised COVID-19 clinical phenotypes and their prognostic impact. Ann Med 2023; 55:2195204. [PMID: 37052252 PMCID: PMC10116925 DOI: 10.1080/07853890.2023.2195204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Hospitalized patients with coronavirus disease 2019 (COVID-19) can be classified into different clinical phenotypes based on their demographic, clinical, radiology, and laboratory features. We aimed to validate in an external cohort of hospitalized COVID-19 patients the prognostic value of a previously described phenotyping system (FEN-COVID-19) and to assess the reproducibility of phenotypes development as a secondary analysis. METHODS Patients were classified in phenotypes A, B or C according to the severity of oxygenation impairment, inflammatory response, hemodynamic and laboratory tests according to the FEN-COVID-19 method. RESULTS Overall, 992 patients were included in the study, and 181 (18%), 757 (76%) and 54 (6%) of them were assigned to the FEN-COVID-19 phenotypes A, B, and C, respectively. An association with mortality was observed for phenotype C vs. A (hazard ratio [HR] 3.10, 95% confidence interval [CI] 1.81-5.30, p < 0.001) and for phenotype C vs. B (HR 2.20, 95% CI 1.50-3.23, p < 0.001). A non-statistically significant trend towards higher mortality was also observed for phenotype B vs. A (HR 1.41; 95% CI 0.92-2.15, p = 0.115). By means of cluster analysis, three different phenotypes were also identified in our cohort, with an overall similar gradient in terms of prognostic impact to that observed when patients were assigned to FEN-COVID-19 phenotypes. CONCLUSIONS The prognostic impact of FEN-COVID-19 phenotypes was confirmed in our external cohort, although with less difference in mortality between phenotypes A and B than in the original study.
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Affiliation(s)
- Daniele Roberto Giacobbe
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Emilio Di Maria
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- University Unit of Medical Genetics, Galliera Hospital, Genoa, Italy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Martina Bavastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Carlo Simone Trombetta
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cristina Marelli
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gabriele Di Meco
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Greta Cattardico
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Sara Mora
- Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Alessio Signori
- Section of Biostatistics, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Antonio Vena
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Malgorzata Mikulska
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Dentone
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Bianca Bruzzone
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Bianca Bignotti
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
| | - Andrea Orsi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Robba
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lorenzo Ball
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Iole Brunetti
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Denise Battaglini
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Di Biagio
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Pia Sormani
- Section of Biostatistics, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mauro Giacomini
- Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Bassetti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Raffa S, Lanfranchi F, Satragno C, Giannelli F, Marcenaro M, Coco A, Cena SE, Sofia L, Marini C, Mammoliti S, Levaggi A, Tagliafico AS, Sambuceti G, Barra S, Morbelli S, Belgioia L, Bauckneht M. The prognostic value of FIGO staging defined by combining MRI and [ 18F]FDG PET/CT in patients with locally advanced cervical cancer. Curr Probl Cancer 2023; 47:101007. [PMID: 37684197 DOI: 10.1016/j.currproblcancer.2023.101007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 09/10/2023]
Abstract
The last version of the FIGO classification recommended imaging tools to complete the clinical assessment of patients with cervical cancer. However, the preferable imaging approach is still unclear. We aimed to explore the prognostic power of Magnetic Resonance Imaging (MRI), contrast-enhanced Computed Tomography (ceCT), and [18F]-Fluorodeoxyglucose Positron Emission Tomography ([18F]FDG-PET)/CT in patients staged for locally advanced cervical cancer (LACC, FIGO stages IB3-IVA). Thirty-six LACC patients (mean age 55.47 ± 14.01, range 31-82) were retrospectively enrolled. All of them underwent MRI, ceCT and [18F]FDG-PET/CT before receiving concurrent chemoradiotherapy. A median dose of 45 Gy (range 42-50.4; 25-28 fractions, 5 fractions per week, 1 per day) was delivered through the external-beam radiation therapy (EBRT) on the pelvic area, while a median dose of 57.5 Gy (range 16-61.1; 25-28 fractions, 5 fractions per week, 1 per day) was administered on metastatic nodes. The median doses for brachytherapy treatment were 28 Gy (range 28-30; 4-5 fractions, 1 every other day). Six cycles of cisplatin or carboplatin were administered weekly. The study endpoints were recurrence-free survival (RFS) and overall survival (OS). Metastatic pelvic lymph nodes at MRI independently predicted RFS (HR 13.271, 95% CI 1.730-101.805; P = 0.027), while metastatic paraaortic lymph nodes at [18F]FDG-PET/CT independently predicted both RFS (HR 11.734, 95% CI 3.200-43.026; P = .005) and OS (HR 13.799, 95% CI 3.378-56.361; P < 0.001). MRI and [18F]FDG-PET/CT findings were incorporated with clinical evidences into the FIGO classification. With respect to the combination of clinical, MRI and ceCT data, the use of next-generation imaging (NGI) determined a stage migration in 10/36 (27.7%) of patients. Different NGI-based FIGO classes showed remarkably different median RFS (stage IIB: not reached; stage IIIC1: 44 months; stage IIIC2: 3 months; P < 0.001) and OS (stage IIB: not reached; stage IIIC1: not reached; stage IIIC2: 14 months; P < 0.001). A FIGO classification based on the combination of MRI and [18F]FDG-PET/CT might predict RFS and OS of LACC patients treated with concurrent chemoradiotherapy.
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Affiliation(s)
- Stefano Raffa
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Camilla Satragno
- Department of Experimental Medicine (DIMES), University of Genoa, Genova, Italy
| | - Flavio Giannelli
- Radiation Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Michela Marcenaro
- Radiation Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Angela Coco
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | | | - Luca Sofia
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy; CNR, Institute of Molecular Bioimaging and Physiology (IBFM), Milano, Italy
| | - Serafina Mammoliti
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alessia Levaggi
- Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy.; Radiologic Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Salvina Barra
- Radiation Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Liliana Belgioia
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy.; Radiation Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy..
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Picasso R, Pistoia F, Zaottini F, Marcenaro G, Miguel-Pérez M, Tagliafico AS, Martinoli C. Adhesive Capsulitis of the Shoulder: Current Concepts on the Diagnostic Work-Up and Evidence-Based Protocol for Radiological Evaluation. Diagnostics (Basel) 2023; 13:3410. [PMID: 37998547 PMCID: PMC10670865 DOI: 10.3390/diagnostics13223410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/28/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Adhesive capsulitis is an idiopathic and disabling disorder characterized by intense shoulder pain and progressive limitation of active and passive glenohumeral joint range of motion. Although adhesive capsulitis has been traditionally considered a diagnosis of exclusion that can be established based on a suggestive medical history and the detection of supporting findings at the physical exam, imaging studies are commonly requested to confirm the diagnostic suspicion and to exclude other causes of shoulder pain. Indeed, clinical findings may be rather unspecific, and may overlap with diseases like calcific tendinitis, rotator cuff pathology, acromioclavicular or glenohumeral arthropathy, autoimmune disorders, and subacromial/subdeltoid bursitis. Magnetic resonance imaging, magnetic resonance arthrography, and high-resolution ultrasound have shown high sensitivity and accuracy in diagnosing adhesive capsulitis through the demonstration of specific pathological findings, including thickening of the joint capsule and of the coracohumeral ligament, fibrosis of the subcoracoid fat triangle, and extravasation of gadolinium outside the joint recesses. This narrative review provides an updated analysis of the current concepts on the role of imaging modalities in patients with adhesive capsulitis, with the final aim of proposing an evidence-based imaging protocol for the radiological evaluation of this condition.
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Affiliation(s)
- Riccardo Picasso
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16145 Genova, Liguria, Italy; (R.P.); (F.Z.); (A.S.T.); (C.M.)
| | - Federico Pistoia
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16145 Genova, Liguria, Italy; (R.P.); (F.Z.); (A.S.T.); (C.M.)
| | - Federico Zaottini
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16145 Genova, Liguria, Italy; (R.P.); (F.Z.); (A.S.T.); (C.M.)
| | - Giovanni Marcenaro
- Department of Health Sciences (DISSAL), Università di Genova, Via Antonio Pastore 1, 16132 Genova, Liguria, Italy;
| | - Maribel Miguel-Pérez
- Unidad de Anatomía y Embriología Humana, Departamento de Patología y Terapéutica Experimental, Facultad de Medicina y Ciencias de la Salud (Campus de Bellvitge), Universitat de Barcelona, 08904 Barcelona, Spain;
| | - Alberto Stefano Tagliafico
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16145 Genova, Liguria, Italy; (R.P.); (F.Z.); (A.S.T.); (C.M.)
- Department of Health Sciences (DISSAL), Università di Genova, Via Antonio Pastore 1, 16132 Genova, Liguria, Italy;
| | - Carlo Martinoli
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16145 Genova, Liguria, Italy; (R.P.); (F.Z.); (A.S.T.); (C.M.)
- Department of Health Sciences (DISSAL), Università di Genova, Via Antonio Pastore 1, 16132 Genova, Liguria, Italy;
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Sánchez-Bayuela DÁ, Ghavami N, Tiberi G, Sani L, Vispa A, Bigotti A, Raspa G, Badia M, Papini L, Ghavami M, Castellano CR, Bernardi D, Calabrese M, Tagliafico AS. A multicentric, single arm, prospective, stratified clinical investigation to evaluate MammoWave's ability in breast lesions detection. PLoS One 2023; 18:e0288312. [PMID: 37450545 PMCID: PMC10348515 DOI: 10.1371/journal.pone.0288312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023] Open
Abstract
Microwave imaging is a safe and promising new technology in breast radiology, avoiding discomfort of breast compression and usage of ionizing radiation. This paper presents the first prospective microwave breast imaging study during which both symptomatic and asymptomatic subjects were recruited. Specifically, a prospective multicentre international clinical trial was performed in 2020-2021, to investigate the capability of a microwave imaging device (MammoWave) in allowing distinction between breasts with no radiological finding (NF) and breasts with radiological findings (WF), i.e., with benign or malignant lesions. Each breast scan was performed with the volunteers lying on a dedicated examination table in a comfortable prone position. MammoWave output was compared to reference standard (i.e., radiologic study obtained within the last month and integrated with histological one if available and deemed necessary by responsible investigator) to classify breasts into NF/WF categories. MammoWave output consists of a selection of microwave images' features (determined prior to trials' start), which allow distinction between NF and WF breasts (using statistical significance p<0.05). 353 women were enrolled in the study (mean age 51 years ± 12 [SD], minimum age 19, maximum age 78); MammoWave data from the first 15 women of each site, all with NF breasts, were used for calibration. Following central assessor evaluation, 111 NF (48 dense) and 272 WF (136 dense) breasts were used for comparison with MammoWave output. 272 WF comprised 182 benign findings and 90 malignant histology-confirmed cancer. A sensitivity of 82.3% was achieved (95%CI: 0.78-0.87); sensitivity is maintained when limiting the investigation to histology-confirmed breasts cancer only (90 histology-confirmed breasts cancer have been included in this analysis, having sizes ranging from 3 mm to 60 mm). Specificity value of approximately 50% was achieved as expected, since thresholds were calculated (for each feature) using median value obtained after recruiting the first 15 women (of each site), all NF. This prospective trial may represent another step for introducing microwave imaging into clinical practice, for helping in breast lesion identification in asymptomatic women.
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Affiliation(s)
- Daniel Álvarez Sánchez-Bayuela
- UBT—Umbria Bioengineering Technologies, Perugia, Italy
- Breast Imaging Department, Radiology Service, Complejo Hospitalario Universitario de Toledo, Spain
- Faculty of Chemical Science and Technology, Instituto Regional de Investigación Científica Aplicada, University of Castilla, La Mancha, Spain
| | - Navid Ghavami
- UBT—Umbria Bioengineering Technologies, Perugia, Italy
| | - Gianluigi Tiberi
- UBT—Umbria Bioengineering Technologies, Perugia, Italy
- School of Engineering, London South Bank University, London, United Kingdom
| | - Lorenzo Sani
- UBT—Umbria Bioengineering Technologies, Perugia, Italy
| | | | | | | | - Mario Badia
- UBT—Umbria Bioengineering Technologies, Perugia, Italy
| | | | - Mohammad Ghavami
- School of Engineering, London South Bank University, London, United Kingdom
| | | | - Daniela Bernardi
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Humanitas University, Milan, Italy
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Colò G, Bignotti B, Costa G, Signori A, Tagliafico AS. Ultrasound or MRI in the Evaluation of Anterior Talofibular Ligament (ATFL) Injuries: Systematic Review and Meta-Analysis. Diagnostics (Basel) 2023; 13:2324. [PMID: 37510068 PMCID: PMC10378286 DOI: 10.3390/diagnostics13142324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVES Ankle sprains represent the second most common cause of emergency department access for musculoskeletal injury and lateral ankle ligament complex tears account for 850,000 cases annually in the United States with a relapse rate of 70%. Clinical examination is limited due to its subjectivity and the difficulty of identifying a specific involvement of the ligament; therefore, US and MRI are frequently requested. Therefore, the goal of this study is to analyze the available literature on the use of ultrasound (US) and magnetic resonance imaging (MRI) to diagnose injuries to the anterior talofibular ligament (ATFL) with a meta-analytic approach. METHODS According to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, all studies regarding the diagnostic accuracy of ultrasound and magnetic resonance imaging ATFL injuries were searched and assessed. The data were obtained from two independent reviewers with 12 and 3 years of experience in meta-analysis. A QUADAS-2 (Quality Assessment of Studies of Diagnostic Accuracy Studies) checklist was carried out to assess the risk of biases. From the selected studies, the sensitivity, specificity, and accuracy data were extracted. RESULTS Nine studies were included. The results of the meta-analysis demonstrate a greater sensitivity for ultrasound [96.88 (95% CI: 94-99) (fixed effects); 97 (95% CI: 94-99) (random effects)] compared to MRI [88.50 (95% CI: 85-91) (fixed effects); 86.98 (95% CI: 77-94) (random effects)], p < 0.05. The result of this meta-analysis shows that the less expensive diagnostic technique is also the most sensitive for the diagnosis of ATFL tears. Ultrasound articles resulted to have non-heterogeneity [(p = 0.2816; I° = 21.4607%)]. CONCLUSION This meta-analysis demonstrates that US appears to be a highly sensitive diagnostic technique for diagnosing tears of the ATFL. Compared to MRI, the sensitivity of US result was higher.
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Affiliation(s)
- Gabriele Colò
- Orthopedic Section, National Hospital of SS. Antonio and Biagio and C. Arrigo, 15121 Alessandria, Italy
| | - Bianca Bignotti
- Department of Radiology, IRCCS-Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Giacomo Costa
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, 16126 Genova, Italy
| | - Alessio Signori
- Biostatistics Section, Department of Health Sciences (DISSAL), University of Genova, 16126 Genova, Italy
| | - Alberto Stefano Tagliafico
- Department of Radiology, IRCCS-Ospedale Policlinico San Martino, 16132 Genova, Italy
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, 16126 Genova, Italy
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10
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Tagliafico AS, Houssami N. Towards consensus on managing high mammographic density in population breast screening? Breast 2023; 69:422-423. [PMID: 37167927 DOI: 10.1016/j.breast.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023] Open
Affiliation(s)
- Alberto Stefano Tagliafico
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via Pastore 1, 16132, Genoa, Italy; Department of Radiology, IRCCS-Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
| | - Nehmat Houssami
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
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11
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Caprioli S, Casaleggio A, Tagliafico AS, Conforti C, Borda F, Fiannacca M, Filauro M, Iandelli A, Marchi F, Parrinello G, Peretti G, Cittadini G. High-Frequency Intraoral Ultrasound for Preoperative Assessment of Depth of Invasion for Early Tongue Squamous Cell Carcinoma: Radiological-Pathological Correlations. Int J Environ Res Public Health 2022; 19:ijerph192214900. [PMID: 36429617 PMCID: PMC9690087 DOI: 10.3390/ijerph192214900] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 06/12/2023]
Abstract
The eighth edition of the TNM classification officially introduced "depth of invasion" (DOI) as a criterion for determining the T stage in tongue squamous cell carcinoma. The DOI is a well-known independent risk factor for nodal metastases. In fact, several experts strongly suggest elective neck dissection for tongue cancer with a DOI > 4 mm due to the high risk of early and occult nodal metastases. Imaging plays a pivotal role in preoperative assessments of the DOI and, hence, in planning the surgical approach. Intraoral ultrasound (IOUS) has been proposed for early-stage SCC of the oral tongue as an alternative to magnetic resonance imaging (MRI) for local staging. The aim of this work is to investigate the accuracy of IOUS in the assessment of the DOI in early oral SCC (CIS, pT1, and pT2). A total of 41 patients with tongue SCCs (CIS-T2) underwent a preoperative high-frequency IOUS. An IOUS was performed using a small-size, high-frequency hockey-stick linear probe. The ultrasonographic DOI (usDOI) was retrospectively compared to the pathological DOI (pDOI) as the standard reference. In patients who underwent a preoperative MRI, their usDOI, magnetic resonance DOI (mriDOI), and pDOI were compared. Specificity and sensitivity for the IOUS to predict a pDOI > 4 mm and to differentiate invasive and noninvasive tumors were also evaluated. A high correlation was found between the pDOI and usDOI, pDOI and mriDOI, and usDOI and mriDOI (Spearman's ρ = 0.84, p < 0.0001, Spearman's ρ = 0.79, p < 0.0001, and Spearman's ρ = 0.91, p < 0.0001, respectively). A Bland-Altman plot showed a high agreement between the usDOI and pDOI, even though a mean systematic error was found between the usDOI and pDOI (0.7 mm), mriDOI and pDOI (1.6 mm), and usDOI and mriDOI (-0.7 mm). The IOUS was accurate at determining the T stage (p < 0.0001). The sensitivity and specificity for the IOUS to predict a pDOI ≥4 mm were 92.31% and 82.14%, respectively, with an AUC of 0.87 (p < 0.0001). The specificity, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) for the IOUS to predict an invasive cancer were 100%, 94.7%, 60%, and 100%, respectively. The AUC was 0.8 (95% CI 0.646-0.908, p < 0.0001). The IOUS was accurate in a preoperative assessment of a pDOI and T stage, and can be proposed as an alternative to MRI in the preoperative staging of tongue SCC.
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Affiliation(s)
- Simone Caprioli
- Department of Internal Medicine (DIMI), University of Genova, Viale Benedetto XV 6, 16132 Genoa, Italy
| | - Alessandro Casaleggio
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Alberto Stefano Tagliafico
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genova, Via Pastore 1, 16132 Genoa, Italy
| | - Cristina Conforti
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Fabio Borda
- Department of Health Sciences (DISSAL), University of Genova, Via Pastore 1, 16132 Genoa, Italy
| | - Martina Fiannacca
- Department of Health Sciences (DISSAL), University of Genova, Via Pastore 1, 16132 Genoa, Italy
| | - Marta Filauro
- Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
- Department of Experimental Medicine (DIMES), University of Genoa, 16132 Genoa, Italy
| | - Andrea Iandelli
- Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy
| | - Filippo Marchi
- Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Giampiero Parrinello
- Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy
| | - Giorgio Peretti
- Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Giuseppe Cittadini
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
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Garlaschi A, Valente I, Brunetti N, De Giorgis S, Massa B, Calabrese M, Tagliafico AS. Is 9-G DBT-Guided Vacuum-Assisted Breast Biopsy Sufficient to Completely Remove T1 Breast Cancers (below 20 mm)? Analysis of 146 Patients with Histology as Reference Standard. Breast Care (Basel) 2022; 17:443-449. [PMID: 36684401 PMCID: PMC9851065 DOI: 10.1159/000523909] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 02/14/2022] [Indexed: 01/25/2023] Open
Abstract
Objectives Vacuum-assisted breast biopsy (VABB) is a safe procedure comparable to surgical biopsy for the characterization of distortions, microcalcifications, and mass lesions. Vacuum-assisted excision of T1 breast tumors could be on potential management in alternative to surgery. The primary objective of this work was to assess the therapeutic success of the stereotaxic vacuum breast biopsy in small breast cancer (T1N0M0) lesions excision. Methods From our electronic database, all the vacuum breast biopsies performed from January 1, 2015, to December 1, 2019, have been retrospectively reevaluated. N = 2,200 cases were identified and n = 145 ensured "mammographic complete removal" at the end of vacuum-assisted excision treatment and were considered for analysis. Surgical gold standard was used. Results N = 143 procedures were successfully completed with complete removal of mammographic calcifications. The mean size of the lesions completely excised with VABB was 8.9 ± 3.6 mm (range, 3-23 mm). Lesions below 10 mm were n = 118 and lesion with diameter >10 mm were n = 28. N = 3/146 cases (4.4%), relapses were observed in follow-up (at 12-24 up to a maximum of 60 months): the mean size of relapsed lesions completely excised was 3.6 ± 2.1 mm (range, 2-6 mm). No relapse before 12 months were observed. The mean size of the lesions in these patients with relapse at the time of the first VABB procedures was 13 ± 6.5 mm (range, 7-12 mm). N = 117/118 (99%) lesions excised using VABB without relapse after 1 year of follow-up had a diameter below 10 mm. Conclusions Vacuum breast biopsy could safely remove small breast cancers (T1N0M0) with few relapses.
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Affiliation(s)
| | | | - Nicole Brunetti
- cDepartment of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Sara De Giorgis
- cDepartment of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Barbara Massa
- aIRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Alberto Stefano Tagliafico
- aIRCCS Ospedale Policlinico San Martino, Genoa, Italy,cDepartment of Health Sciences (DISSAL), University of Genoa, Genoa, Italy,*Alberto Stefano Tagliafico,
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13
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Brunetti N, De Giorgis S, Tosto S, Garlaschi A, Rescinito G, Massa B, Calabrese M, Tagliafico AS. A Prospective Comparative Evaluation of Handheld Ultrasound Examination (HHUS) or Automated Ultrasound Examination (ABVS) in Women with Dense Breast. Diagnostics (Basel) 2022; 12:diagnostics12092170. [PMID: 36140571 PMCID: PMC9497758 DOI: 10.3390/diagnostics12092170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Mammography is the gold standard examination for breast cancer screening. In women with high breast density, mammography has reduced sensitivity. In these women, an additional screening option is often recommended. This study prospectively compared ABVS and HHUS in women with mammography-negative examinations and dense breasts. Materials and methods: N = 222 women were evaluated prospectively and consecutively between January 2019 and June 2019 (average age 53 years; range 39−89). McNemar’s test and ROC analysis were used with standard statistical software. We included in the study both symptomatic and asymptomatic women with dense breasts. Women included underwent both HHUS and ABVS after mammography with independent reading. Results: N = 33/222 (15%) women resulted in having breast cancer. Both ABVS and HHUS identified more cancers than standard mammography, and both HHUS and ABVS had false-positive examinations: n = 13 for HHUS and n = 12 for ABVS. We found that HHUS had better accuracy than ABVS. The AUC of the ROC was 0.788 (95% CI 0.687−0.890) for ABVS and 0.930 (95% CI 0.868−0.993) for HHUS. This difference was statistically significant (p < 0.05). Conclusions: HHUS was more accurate in breast cancer detection than ABVS. Multicentric studies must confirm these data for supplemental imaging in women with dense breasts.
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Affiliation(s)
- Nicole Brunetti
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via L.B. Alberti 2, 16132 Genoa, Italy
- Correspondence:
| | - Sara De Giorgis
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via L.B. Alberti 2, 16132 Genoa, Italy
| | - Simona Tosto
- Department of Radiology, IRCCS—Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Alessandro Garlaschi
- Department of Radiology, IRCCS—Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Giuseppe Rescinito
- Department of Radiology, IRCCS—Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Barbara Massa
- Cyto-Histopathological Unit, IRCCS—Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Massimo Calabrese
- Department of Radiology, IRCCS—Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Alberto Stefano Tagliafico
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via L.B. Alberti 2, 16132 Genoa, Italy
- Department of Radiology, IRCCS—Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
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Tagliafico AS, Rossi F, Bignotti B, Torri L, Bonsignore A, Belgioia L, Domineitto A. CT-derived relationship between low relative muscle mass and bone damage in patients with multiple myeloma undergoing stem cells transplantation. Br J Radiol 2022; 95:20210923. [PMID: 34918544 PMCID: PMC9153728 DOI: 10.1259/bjr.20210923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Sarcopenia or low muscle mass is related to worse prognosis in cancer patients. We investigated whether muscle mass is related to bone damage on CT in patients with multiple myeloma (MM). METHODS Approval from the institutional review board was obtained. N = 74 consecutive patients (mean age, 60.8 years ± 9.24 [standard deviation]; range, 36-89 years) for MM who underwent transplant were included. Sarcopenia cut-off points defined as skeletal muscle index (SMI) used were<41 cm2/m2. To assess bone damage in MM the MSBDS (myeloma spine and bone damage score) was used. One-way analysis of variance and the X2 test were used. Kaplan-Meier analysis was performed to generate progression and survival curves according to SMI and MSBDS. The testing level was set at 0.05. RESULTS The median SMI was 47.1 ± 14.2 and according to SMI 18/74 (24%) had sarcopenia which was more prevalent in females (p.001). A strong and significant association between patients with low muscle mass and elevated bone damage (24/74, 32.4%) and patients with normal/non-low muscle mass low bone damage (30/74, 40.5%) was present. Multiple Logistic regression did not show any significant relationship or confounding influence among SMI and MSBDS regarding sex (p.127), cytogenetic status (p.457), staging (p.756) and relapse (.126). Neither SMI nor MSBDS resulted significantly related to overall survival as shown in Kaplan-Meier analysis. CONCLUSION Sarcopenia and bone damage affected MM patients undergoing stem cell transplantation and are significantly associated. ADVANCES IN KNOWLEDGE Quantitative measurement of sarcopenia and bone damage on CT resulted present in MM patients undergoing stem cell transplantation and are significantly associated.
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Affiliation(s)
| | | | | | - Lorenzo Torri
- Vascular
Surgery Unit, Azienda Ospedaliero Universitaria Pisana,
Pisa, Italy
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Sconfienza LM, Adriaensen M, Albano D, Alcala-Galiano A, Allen G, Aparisi Gómez MP, Aringhieri G, Bazzocchi A, Beggs I, Chianca V, Corazza A, Dalili D, De Dea M, Del Cura JL, Di Pietto F, Drakonaki E, Facal de Castro F, Filippiadis D, Gitto S, Grainger AJ, Greenwood S, Gupta H, Ivanoski S, Khanna M, Klauser A, Mansour R, Martin S, Mascarenhas V, Mauri G, McCarthy C, McKean D, McNally E, Melaki K, Messina C, Miron Mombiela R, Moutinho R, Olchowy C, Orlandi D, Prada González R, Prakash M, Posadzy M, Rutkauskas S, Snoj Ž, Tagliafico AS, Talaska A, Tomas X, Vasilevska Nikodinovska V, Vucetic J, Wilson D, Zaottini F, Zappia M, Isaac A. Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)-part VII, nerves of the lower limb. Eur Radiol 2022; 32:1456-1464. [PMID: 34581843 PMCID: PMC8831230 DOI: 10.1007/s00330-021-08283-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 08/01/2021] [Accepted: 08/17/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To perform a Delphi-based consensus on published evidence on image-guided interventional procedures for peripheral nerves of the lower limb (excluding Morton's neuroma) and provide clinical indications. METHODS We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around peripheral nerves in the lower limb (excluding Morton's neuroma) to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper. RESULTS Nine statements on image-guided interventional procedures for peripheral nerves of the lower limb have been drafted. All of them received strong consensus. Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia. CONCLUSION Despite the promising results reported by published papers on image-guided interventional procedures for peripheral nerves of the lower limb, there is still a lack of evidence on the efficacy of most procedures. KEY POINTS • Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. • US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. • US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia. The volume of local anesthetic affects the size of the blocked sensory area.
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Affiliation(s)
- Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
- Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Riccardo Galeazzi 4, 20161, Milan, Italy.
| | - Miraude Adriaensen
- Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, the Netherlands
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Sezione Di Scienze Radiologiche, Dipartimento Di Biomedicina, Neuroscienze E Diagnostica Avanzata, Università Degli Studi Di Palermo, Palermo, Italy
| | | | - Georgina Allen
- St Luke's Radiology Oxford Ltd, Oxford, UK
- University of Oxford, Oxford, UK
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand
- Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Vito Chianca
- Ospedale Evangelico Betania, Napoli, Italy
- Clinica Di Radiologia EOC IIMSI, Lugano, Switzerland
| | | | - Danoob Dalili
- South West London Elective Orthopaedic Centre (SWLEOC), Epsom & St Helier University Hospitals NHS Trust, London, UK
| | | | | | - Francesco Di Pietto
- Dipartimento Di Diagnostica Per Immagini, Pineta Grande Hospital, Castel Volturno, Italy
| | | | | | - Dimitrios Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Haidari/Athens, Greece
| | - Salvatore Gitto
- Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Milan, Italy
| | | | | | | | - Slavcho Ivanoski
- Department of Radiology, Special Hospital for Orthopedic Surgery and Traumatology St. Erazmo, Ohrid, North Macedonia
- Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | | | - Andrea Klauser
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Ramy Mansour
- Oxford Musculoskeletal Radiology, Oxford University Hospitals, Oxford, UK
| | | | - Vasco Mascarenhas
- Hospital da Luz, Musculoskeletal Imaging Unit, Lisbon, Portugal
- AIRC, Advanced imaging research consortium, Lisbon, Portugal
| | - Giovanni Mauri
- Division of Interventional Radiology, Istituto Europeo Di Oncologia, Milan, Italy
| | | | - David McKean
- Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
| | | | - Kalliopi Melaki
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Ricardo Moutinho
- Hospital da Luz, Musculoskeletal Imaging Unit, Lisbon, Portugal
- Hospital de Loulé, Loulé, Portugal
| | - Cyprian Olchowy
- Department of Oral Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Davide Orlandi
- Department of Radiology, Ospedale Evangelico Internazionale, Genoa, Italy
| | | | - Mahesh Prakash
- Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | | | - Saulius Rutkauskas
- Department of Radiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Žiga Snoj
- Institute of Radiology, University Medical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alberto Stefano Tagliafico
- Department of Health Sciences, University of Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Xavier Tomas
- Radiology Dpt. MSK Unit. Hospital Clinic (CDIC), University of Barcelona (UB), Barcelona, Spain
| | - Violeta Vasilevska Nikodinovska
- Clinical Center "Mother Theresa", University Institute of Radiology, Skopje, North Macedonia
- Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Jelena Vucetic
- Radiology Department, Hospital ICOT Ciudad de Telde, Las Palmas, Spain
| | | | | | - Marcello Zappia
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
- Varelli Institute, Naples, Italy
- Guy's and St Thomas' Hospitals, London, UK
| | - Amanda Isaac
- South West London Elective Orthopaedic Centre (SWLEOC), Epsom & St Helier University Hospitals NHS Trust, London, UK
- Guy's and St Thomas' Hospitals, London, UK
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16
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Tagliafico AS, Campi C, Bianca B, Bortolotto C, Buccicardi D, Francesca C, Prost R, Rengo M, Faggioni L. Blockchain in radiology research and clinical practice: current trends and future directions. Radiol Med 2022; 127:391-397. [PMID: 35194720 PMCID: PMC8863512 DOI: 10.1007/s11547-022-01460-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/21/2022] [Indexed: 12/31/2022]
Abstract
Blockchain usage in healthcare, in radiology, in particular, is at its very early infancy. Only a few research applications have been tested, however, blockchain technology is widely known outside healthcare and widely adopted, especially in Finance, since 2009 at least. Learning by history, radiology is a potential ideal scenario to apply this technology. Blockchain could have the potential to increase radiological data value in both clinical and research settings for the patient digital record, radiological reports, privacy control, quantitative image analysis, cybersecurity, radiomics and artificial intelligence. Up-to-date experiences using blockchain in radiology are still limited, but radiologists should be aware of the emergence of this technology and follow its next developments. We present here the potentials of some applications of blockchain in radiology.
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Affiliation(s)
- Alberto Stefano Tagliafico
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy. .,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
| | - Cristina Campi
- Dipartimento Di Matematica, Università Di Genova, via Dodecaneso 35, 16146, Genova, Italy
| | - Bignotti Bianca
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy
| | - Chandra Bortolotto
- Dipartimento Di Radiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Coppola Francesca
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Roberto Prost
- Azienda Ospedaliera Brotzu, Cagliari, Sardegna, Italy
| | - Marco Rengo
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome - I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy
| | - Lorenzo Faggioni
- Diagnostic and Interventional Radiology, University Hospital of Pisa, Via Paradisa 2, 56100, Pisa, Italy
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17
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Bignotti B, Rossi F, Signori A, Solari N, Spina B, Martinoli C, Tagliafico AS. Magnetic Resonance Imaging or Ultrasound in Localized Intermediate- or High-Risk Soft Tissue Tumors of the Extremities (MUSTT): Final Results of a Prospective Comparative Trial. Diagnostics (Basel) 2022; 12:diagnostics12020411. [PMID: 35204502 PMCID: PMC8871362 DOI: 10.3390/diagnostics12020411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023] Open
Abstract
Objectives: To report final results of the MUSTT trial, which has been designed to independently compare magnetic resonance imaging (MRI) and ultrasound (US) for local recurrences of non-metastatic patients operated for malignant soft tissue tumors (STT). Methods: Magnetic resonance imaging or ultrasound in soft tissue tumors (MUSTT) is a prospective monocentric study recruiting asymptomatic, non-metastatic patients operated on for localized soft tissue sarcomas between 2015 and April. Eligible patients had MRI and physician-performed ultrasound (US) with an independent interpretation of imaging. Outcome measures were compared using ROC analysis and the X2 test. An analysis of all patients was performed on a per-follow-up event basis. Results: A total of n = 51 patients who met the inclusion criteria agreed to participate. Among them, n = 8 were lost to follow-up, n = 6 had US and MRI acquired after a time frame > 7 days and were therefore excluded. Complete data available for 37 patients with 232 MRI and 232 US scan were finally considered (men/women: 18/20; age range, 18–84 years). Recurrences within 5 years occurred in 10/37 patients (27%). ROC analysis comparing US and MRI showed an AUC with 95% confidence intervals of 0.909 (0.832 to 0.981) for US and 0.966 (0.939 to 0.989) for MRI with Prob > X2 = 0. Conclusions: Each of these tests detected local recurrences with suitable accuracy. MRI did not result clearly superior to US in terms of diagnostic accuracy, but US showed some false positive or negative results.
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Affiliation(s)
- Bianca Bignotti
- Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (N.S.); (B.S.)
- Department of Experimental Medicine (DIMES), University of Genoa, 16132 Genoa, Italy;
| | - Federica Rossi
- Department of Experimental Medicine (DIMES), University of Genoa, 16132 Genoa, Italy;
- Ospedale Santa Corona, Pietra Ligure, 17027 Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Nicola Solari
- Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (N.S.); (B.S.)
| | - Bruno Spina
- Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (N.S.); (B.S.)
| | - Carlo Martinoli
- Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (N.S.); (B.S.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
- Correspondence: (C.M.); or (A.S.T.)
| | - Alberto Stefano Tagliafico
- Ospedale Policlinico San Martino, 16132 Genoa, Italy; (B.B.); (N.S.); (B.S.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
- Correspondence: (C.M.); or (A.S.T.)
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18
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Giorgis SD, Garlaschi A, Brunetti N, Tosto S, Rescinito G, Monetti F, Oddone C, Massa B, Pitto F, Calabrese M, Tagliafico AS. Axillary adenopathy after COVID-19 vaccine in patients undergoing breast ultrasound. J Ultrason 2021; 21:e361-e364. [PMID: 34970450 PMCID: PMC8678641 DOI: 10.15557/jou.2021.0060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/05/2021] [Indexed: 12/26/2022] Open
Abstract
After COVID-19 vaccination, a spectrum of axillary lymphadenopathy were observed in patients undergoing routine breast ultrasound. Malignancy remains the most serious differential in cases of unilateral axillary adenopathy. Knowledge of axillary ultrasound findings after COVID-19 vaccination is essential to prevent unnecessary biopsy or change in therapy in oncological patients. From March to May 2021, 10 female patients underwent breast ultrasound in our Department for the evaluation of axillary lumps. All the patients received their first or second dose of COVID-19 vaccine 20–30 days before the exam in the same extremity of the ultrasound evaluation where lymphadenopathy was found. Five patients had a personal history of previous breast cancer, and the radiologist decided to perform a core biopsy (the histology was negative for malignancy). The other five patients with no personal history of cancer underwent ultrasound and returned after a short-term follow-up. Regression of the enlarged lymph nodes was found.
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Affiliation(s)
- Sara De Giorgis
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via L.B. Alberti 2, 16132 Genoa, Italy
| | - Alessandro Garlaschi
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Nicole Brunetti
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via L.B. Alberti 2, 16132 Genoa, Italy
| | - Simona Tosto
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Giuseppe Rescinito
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Francesco Monetti
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Claudio Oddone
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Barbara Massa
- Cyto-Histopathological Unit, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Francesca Pitto
- Cyto-Histopathological Unit, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Massimo Calabrese
- Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Alberto Stefano Tagliafico
- Radiology Section, Department of Health Sciences (DISSAL), University of Genova, Via L.B. Alberti 2, 16132 Genoa, Italy.,Department of Radiology, IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
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19
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Schenone D, Dominietto A, Campi C, Frassoni F, Cea M, Aquino S, Angelucci E, Rossi F, Torri L, Bignotti B, Tagliafico AS, Piana M. Radiomics and Artificial Intelligence for Outcome Prediction in Multiple Myeloma Patients Undergoing Autologous Transplantation: A Feasibility Study with CT Data. Diagnostics (Basel) 2021; 11:diagnostics11101759. [PMID: 34679456 PMCID: PMC8535117 DOI: 10.3390/diagnostics11101759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/08/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022] Open
Abstract
Multiple myeloma is a plasma cell dyscrasia characterized by focal and non-focal bone lesions. Radiomic techniques extract morphological information from computerized tomography images and exploit them for stratification and risk prediction purposes. However, few papers so far have applied radiomics to multiple myeloma. A retrospective study approved by the institutional review board: n = 51 transplanted patients and n = 33 (64%) with focal lesion analyzed via an open-source toolbox that extracted 109 radiomics features. We also applied a dedicated tool for computing 24 features describing the whole skeleton asset. The redundancy reduction was realized via correlation and principal component analysis. Fuzzy clustering (FC) and Hough transform filtering (HTF) allowed for patient stratification, with effectiveness assessed by four skill scores. The highest sensitivity and critical success index (CSI) were obtained representing each patient, with 17 focal features selected via correlation with the 24 features describing the overall skeletal asset. These scores were higher than the ones associated with a standard cytogenetic classification. The Mann–Whitney U-test showed that three among the 17 imaging descriptors passed the null hypothesis. This AI-based interpretation of radiomics features stratified relapsed and non-relapsed MM patients, showing some potentiality for the determination of the prognostic image-based biomarkers in disease follow-up.
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Affiliation(s)
- Daniela Schenone
- LISCOMP, Dipartimento di Matematica, Università di Genova, Via Dodecaneso 35, 16146 Genova, Italy; (D.S.); (C.C.); (F.F.)
| | - Alida Dominietto
- Ospedale Policlinico San Martino-IRCCS, Largo Rossana Benzi 10, 16132 Genova, Italy; (A.D.); (M.C.); (S.A.); (E.A.); (L.T.); (B.B.)
| | - Cristina Campi
- LISCOMP, Dipartimento di Matematica, Università di Genova, Via Dodecaneso 35, 16146 Genova, Italy; (D.S.); (C.C.); (F.F.)
| | - Francesco Frassoni
- LISCOMP, Dipartimento di Matematica, Università di Genova, Via Dodecaneso 35, 16146 Genova, Italy; (D.S.); (C.C.); (F.F.)
| | - Michele Cea
- Ospedale Policlinico San Martino-IRCCS, Largo Rossana Benzi 10, 16132 Genova, Italy; (A.D.); (M.C.); (S.A.); (E.A.); (L.T.); (B.B.)
- Dipartimento di Medicina Interna, Università di Genova, Viale Benedetto XV, 16132 Genova, Italy
| | - Sara Aquino
- Ospedale Policlinico San Martino-IRCCS, Largo Rossana Benzi 10, 16132 Genova, Italy; (A.D.); (M.C.); (S.A.); (E.A.); (L.T.); (B.B.)
| | - Emanuele Angelucci
- Ospedale Policlinico San Martino-IRCCS, Largo Rossana Benzi 10, 16132 Genova, Italy; (A.D.); (M.C.); (S.A.); (E.A.); (L.T.); (B.B.)
| | - Federica Rossi
- Dipartimento di Medicina Sperimentale, Università di Genova, Via L. B. Alberti 1, 16132 Genova, Italy;
| | - Lorenzo Torri
- Ospedale Policlinico San Martino-IRCCS, Largo Rossana Benzi 10, 16132 Genova, Italy; (A.D.); (M.C.); (S.A.); (E.A.); (L.T.); (B.B.)
| | - Bianca Bignotti
- Ospedale Policlinico San Martino-IRCCS, Largo Rossana Benzi 10, 16132 Genova, Italy; (A.D.); (M.C.); (S.A.); (E.A.); (L.T.); (B.B.)
- Dipartimento di Medicina Sperimentale, Università di Genova, Via L. B. Alberti 1, 16132 Genova, Italy;
| | - Alberto Stefano Tagliafico
- Ospedale Policlinico San Martino-IRCCS, Largo Rossana Benzi 10, 16132 Genova, Italy; (A.D.); (M.C.); (S.A.); (E.A.); (L.T.); (B.B.)
- Dipartimento di Scienze della Salute, Università di Genova, Via Pastore 1, 16132 Genova, Italy
- Correspondence: (A.S.T.); (M.P.)
| | - Michele Piana
- Ospedale Policlinico San Martino-IRCCS, Largo Rossana Benzi 10, 16132 Genova, Italy; (A.D.); (M.C.); (S.A.); (E.A.); (L.T.); (B.B.)
- CNR-SPIN Genova, Via Dodecaneso 33, 16146 Genova, Italy
- Correspondence: (A.S.T.); (M.P.)
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20
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Sconfienza LM, Adriaensen M, Albano D, Alcala-Galiano A, Allen G, Aparisi Gómez MP, Aringhieri G, Bazzocchi A, Beggs I, Chianca V, Corazza A, Dalili D, De Dea M, Del Cura JL, Di Pietto F, Drakonaki E, Facal de Castro F, Filippiadis D, Gitto S, Grainger AJ, Greenwood S, Gupta H, Isaac A, Ivanoski S, Khanna M, Klauser A, Mansour R, Martin S, Mascarenhas V, Mauri G, McCarthy C, McKean D, McNally E, Melaki K, Messina C, Mirón Mombiela R, Moutinho R, Olchowy C, Orlandi D, Prada González R, Prakash M, Posadzy M, Rutkauskas S, Snoj Ž, Tagliafico AS, Talaska A, Tomas X, Vasilevska Nikodinovska V, Vucetic J, Wilson D, Zaottini F, Zappia M, Obradov M. Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)-part VI, foot and ankle. Eur Radiol 2021; 32:1384-1394. [PMID: 34432122 PMCID: PMC8794903 DOI: 10.1007/s00330-021-08125-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/07/2021] [Indexed: 01/10/2023]
Abstract
Objectives Clarity regarding accuracy and effectiveness for interventional procedures around the foot and ankle is lacking. Consequently, a board of 53 members of the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the published literature to evaluate the evidence on image-guided musculoskeletal interventional procedures around this anatomical region. Methods We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around foot and ankle in order to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper that was shared with all panel members for final approval. Results A list of 16 evidence-based statements on clinical indications for image-guided musculoskeletal interventional procedures in the foot and ankle were drafted after a literature review. The highest level of evidence was reported for four statements, all receiving 100% agreement. Conclusion According to this consensus, image-guided interventions should not be considered a first-level approach for treating Achilles tendinopathy, while ultrasonography guidance is strongly recommended to improve the efficacy of interventional procedures for plantar fasciitis and Morton’s neuroma, particularly using platelet-rich plasma and corticosteroids, respectively. Key Points • The expert panel of the ESSR listed 16 evidence-based statements on clinical indications of image-guided musculoskeletal interventional procedures in the foot and ankle. • Strong consensus was obtained for all statements. • The highest level of evidence was reached by four statements concerning the effectiveness of US-guided injections of corticosteroid for Morton’s neuroma and PRP for plantar fasciitis. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08125-z.
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Affiliation(s)
- Luca Maria Sconfienza
- Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy. .,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
| | - Miraude Adriaensen
- Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, the Netherlands
| | - Domenico Albano
- Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.,Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Palermo, Italy
| | | | - Georgina Allen
- St Luke's Radiology Oxford Ltd, Oxford, UK.,University of Oxford, Oxford, UK
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Vito Chianca
- Ospedale Evangelico Betania, Napoli, Italy.,Clinica di Radiologia EOC IIMSI, Lugano, Switzerland
| | - Angelo Corazza
- Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Danoob Dalili
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | | | | | - Francesco Di Pietto
- Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, Italy
| | | | | | - Dimitrios Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Haidari, Athens, Greece
| | - Salvatore Gitto
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | | | | | | | - Amanda Isaac
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.,Guy's and St Thomas' Hospitals, London, UK
| | - Slavcho Ivanoski
- Department of Radiology, Special Hospital for Orthopedic Surgery and Traumatology, St. Erazmo -, Ohrid, North Macedonia.,Ss. Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | | | - Andrea Klauser
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Ramy Mansour
- Oxford Musculoskeletal Radiology, Oxford University Hospitals, Oxford, UK
| | | | - Vasco Mascarenhas
- Hospital da Luz, Musculoskeletal Imaging Unit, Lisbon, Portugal.,AIRC, Advanced Imaging Research Consortium, Lisbon, Portugal
| | - Giovanni Mauri
- Division of Interventional Radiology, Istituto Europeo di Oncologia, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy
| | | | - David McKean
- Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
| | | | - Kalliopi Melaki
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Carmelo Messina
- Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | | | - Ricardo Moutinho
- Hospital da Luz, Musculoskeletal Imaging Unit, Lisbon, Portugal.,Hospital de Loulé, Loulé, Portugal
| | - Cyprian Olchowy
- Department of Oral Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Davide Orlandi
- Department of Radiology, Ospedale Evangelico Internazionale, Genoa, Italy
| | | | - Mahesh Prakash
- Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | | | - Saulius Rutkauskas
- Department of Radiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Žiga Snoj
- Institute of Radiology, University Medical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alberto Stefano Tagliafico
- Department of Health Sciences, University of Genova, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Xavier Tomas
- Radiology Dpt. MSK Unit. Hospital Clinic (CDIC), University of Barcelona (UB), Barcelona, Spain
| | | | - Jelena Vucetic
- Radiology Department, Hospital ICOT Ciudad de Telde, Las Palmas, Spain
| | | | | | - Marcello Zappia
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.,Varelli Institute, Naples, Italy
| | - Marina Obradov
- Department of Radiology, Sint Maartenskliniek, Nijmegen, The Netherlands
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21
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Tagliafico AS. Imaging in multiple myeloma: Computed tomography or magnetic resonance imaging? World J Radiol 2021; 13:223-226. [PMID: 34367508 PMCID: PMC8326150 DOI: 10.4329/wjr.v13.i7.223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/10/2021] [Accepted: 06/18/2021] [Indexed: 02/06/2023] Open
Abstract
Multiple myeloma (MM) is the second most common type of hematological disease with its incidence rising in the elderly. In MM, the extent of the bone disease increases both morbidity and mortality. The detection of lytic bone lesions on imaging, especially computerized tomography (CT) and magnetic resonance imaging (MRI) is crucial to separate asymptomatic from symptomatic MM patients even when no clinical symptoms are present. Although radiology is essential in the staging and management of patients with MM there is still high variability in the choice between MRI and CT. In addition, there is still suboptimal agreement among readers. The potential of medical imaging in MM is largely under-evaluated: artificial intelligence, radiomics and new quantitative methods to report CT and MRI will improve imaging usage.
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22
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Tagliafico AS, Torri L, Signori A. Treatment of meralgia paresthetica (Lateral Femoral Cutaneous Neuropathy): A meta-analysis of ultrasound-guided injection versus surgery. Eur J Radiol 2021; 139:109736. [PMID: 33933838 DOI: 10.1016/j.ejrad.2021.109736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/20/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare ultrasound (US)-guided injections and surgery for the treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy). METHODS Two reviewers, independently, up to 10 October 2020 retrieved Studies that assessed the outcome of US-guided injections and surgery for the treatment of meralgia paresthetica from major medical libraries. Predefined inclusion and exclusion criteria were adopted. RESULTS 399 studies were initially found, and the meta-analysis was conducted on 10 studies for a total of 149 patients. US-guided injections were done in three studies, surgery in seven studies. N = 38 % (57/149) of patients were treated with US-guided injection and 62 % (92/149) were treated with surgery. After US-guided injections, 85 % (49/57) of patients were treated successfully, whereas 80 % (74/92) were treated with surgery successfully from the clinical point of view. Differences were not statistically significant even with a slight heterogeneity of studies and outcome pooled on random-effect model. No comparative cohort study or RCT was conducted. CONCLUSION This meta-analysis showed that there was no statistically significant difference in treatment of meralgia paresthetica with ultrasound-guided injection or surgery. A RCT to compare a standardized US-guided approach versus surgery is essential to compare these techniques properly.
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Affiliation(s)
- Alberto Stefano Tagliafico
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy; Department of Health Sciences (DISSAL). University of Genoa, Genoa, Italy.
| | - Lorenzo Torri
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy.
| | - Alessio Signori
- Department of Health Sciences (DISSAL). University of Genoa, Genoa, Italy.
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23
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Arezzo F, La Forgia D, Venerito V, Moschetta M, Tagliafico AS, Lombardi C, Loizzi V, Cicinelli E, Cormio G. A Machine Learning Tool to Predict the Response to Neoadjuvant Chemotherapy in Patients with Locally Advanced Cervical Cancer. Applied Sciences 2021; 11:823. [DOI: 10.3390/app11020823] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Despite several studies having identified factors associated with successful treatment outcomes in locally advanced cervical cancer, there is the lack of accurate predictive modeling for progression-free survival (PFS) in patients who undergo radical hysterectomy after neoadjuvant chemotherapy (NACT). Here we investigated whether machine learning (ML) may have the potential to provide a tool to predict neoadjuvant treatment response as PFS. In this retrospective observational study, we analyzed patients with locally advanced cervical cancer (FIGO stages IB2, IB3, IIA1, IIA2, IIB, and IIIC1) who were followed in a tertiary center from 2010 to 2018. Demographic and clinical characteristics were collected at either treatment baseline or at 24-month follow-up. Furthermore, we recorded data about magnetic resonance imaging (MRI) examinations and post-surgery histopathology. Proper feature selection was used to determine an attribute core set. Three different machine learning algorithms, namely Logistic Regression (LR), Random Forest (RFF), and K-nearest neighbors (KNN), were then trained and validated with 10-fold cross-validation to predict 24-month PFS. Our analysis included n. 92 patients. The attribute core set used to train machine learning algorithms included the presence/absence of fornix infiltration at pre-treatment MRI as well as of either parametrium invasion and lymph nodes involvement at post-surgery histopathology. RFF showed the best performance (accuracy 82.4%, precision 83.4%, recall 96.2%, area under receiver operating characteristic curve (AUROC) 0.82). We developed an accurate ML model to predict 24-month PFS.
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24
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De Giorgis S, Brunetti N, Zawaideh J, Rossi F, Calabrese M, Tagliafico AS. Influence of Breast Density on Patient's Compliance during Ultrasound Examination: Conventional Handheld Breast Ultrasound Compared to Automated Breast Ultrasound. J Med Ultrasound 2020; 28:230-234. [PMID: 33659162 PMCID: PMC7869737 DOI: 10.4103/jmu.jmu_13_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/10/2020] [Accepted: 02/15/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Our aim was to study the influence of breast density on patient's compliance during conventional handheld breast ultrasound (US) or automated breast US (ABUS), which could be used as adjunct screening modalities. Methods: Between January 2019 and June 2019, 221 patients (mean age: 53; age range: 24–89 years) underwent both US and ABUS. All participants had independently interpreted US and ABUS regarding patient compliance. The diagnostic experience with US or ABUS was described with a modified testing morbidity index (TMI). The scale ranged from 0 (worst possible experience) to 5 (acceptable experience). Standard statistics was used to compare the data of US and data of ABUS. Breast density was recorded with the Breast Imaging Reporting and Data System (BI-RADS) score. Results: The mean TMI score was 4.6 ± 0.5 for US and 4.3 ± 0.8 for ABUS. The overall difference between patients' experience on US and ABUS was statistically significant with P < 0.0001. The difference between patients' experience on US and ABUS in women with BI-RADS C and D for breast density was statistically significant with P < 0.02 in favor of US (4.7 ± 0.4) versus 4.5 ± 0.6 for ABUS. Patients' experience with breast density B was better for US (4.7 ± 0.4) versus 4.3 ± 0.6 for ABUS with P < 0.01. Pain or discomfort occurred during testing, especially in patients >40 years. Conclusion: Patient age (>40 years) is a significant predictor of decreased compliance to ABUS. Compliance of ABUS resulted lower that of US independently for breast density.
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Affiliation(s)
- Sara De Giorgis
- Department of Health Sciences, (DISSAL) - Radiology Section, University of Genova, Genova, Italy
| | - Nicole Brunetti
- Department of Health Sciences, (DISSAL) - Radiology Section, University of Genova, Genova, Italy
| | - Jeries Zawaideh
- Department of Health Sciences, (DISSAL) - Radiology Section, University of Genova, Genova, Italy
| | - Federica Rossi
- Department of Health Sciences, (DISSAL) - Radiology Section, University of Genova, Genova, Italy
| | | | - Alberto Stefano Tagliafico
- Department of Health Sciences, (DISSAL) - Radiology Section, University of Genova, Genova, Italy.,IRCCS-Ospedale Policlinico San Martino, Genova, Italy
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25
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Rossi F, Torri L, Dominietto A, Tagliafico AS. Spectrum of magnetic resonance imaging findings in transplanted multiple myeloma patients with hip/pelvic pain (according to MY-RADS): A single center experience. Eur J Radiol 2020; 130:109154. [PMID: 32629214 DOI: 10.1016/j.ejrad.2020.109154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/05/2020] [Accepted: 06/22/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE The aim of our study is to evaluate the spectrum of MRI findings in transplanted Multiple Myeloma (MM) patients with hip/pelvic pain and to correlate these findings with standard prognostic clinical outcomes. METHODS A retrospective interpretation of the MRI findings of 54 MM patients with hip/pelvic pain were done according to MY-RADS guidelines. MRI findings included: type of bone marrow involvement and incidental findings (osteonecrosis and fractures). Inter- and intra-reader agreement were calculated using Cohen's kappa test. Survival and relapse rates, type of transplantation and days of hospitalization were correlated with MRI findings. RESULTS 1/52 patient presented normal bone marrow pattern, 10/52 focal pattern, 26/52 diffuse pattern and 15/52 mixed. No cases of micronodular was reported. Among the incidental findings, n = 6 osteonecrosis and n = 5 pathological fractures were found, with average length of stay higher. The intra- and inter-reader agreement assessing MY-RADS, were good (k value between 0.61-0.8). Focal pattern was most represented in patients with osteonecrosis and the worst survival rate. Diffuse pattern was most represented in relapses. No statistically significant correlations were found between bone marrow infiltration patterns and the type of transplantation. CONCLUSION MRI can recognize different infiltration patterns and complications in transplanted MM patients with hip/pelvic pain, correlating with clinical parameters.
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Affiliation(s)
- Federica Rossi
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy; Department of Experimental Medicine (DIMES), University of Genoa, Genova, Italy.
| | - Lorenzo Torri
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Alida Dominietto
- Second Division of Hematology and Bone Marrow Transplantation, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy; Department of Radiology, IRCCS San Martino Hospital, Genova, Italy
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26
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Aparisi Gómez MP, Errani C, Lalam R, Vasilevska Nikodinovska V, Fanti S, Tagliafico AS, Sconfienza LM, Bazzocchi A. The Role of Ultrasound in the Diagnosis of Soft Tissue Tumors. Semin Musculoskelet Radiol 2020; 24:135-155. [PMID: 32438440 DOI: 10.1055/s-0039-3402060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The vast majority of soft tissue masses are benign. Benign lesions such as superficial lipomas and ganglia are by far the most common soft tissue masses and can be readily identified and excluded on ultrasound (US). US is an ideal triaging tool for superficial soft tissue masses. Compared with magnetic resonance imaging (MRI), High-resolution US is inexpensive, readily available, well tolerated, and safe. It also allows the radiologist to interact with the patient as a clinician. In this review, we describe and illustrate the lesions with typical (diagnostic) US features. When the appearances of the lesion are not typical as expected for a benign lesion, lesions are deep or large, or malignancy is suspected clinically, MRI and biopsy are needed. The management of suspicious soft tissue tumors has to be carefully planned by a multidisciplinary team involving specialized surgeons and pathologists at a tumor center.
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Affiliation(s)
- Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand.,Department of Radiology, Hospital Nueve de Octubre, Valencia, Spain
| | - Costantino Errani
- Department of Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Radhesh Lalam
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, United Kingdom
| | - Violeta Vasilevska Nikodinovska
- Medical Faculty, University "Ss. Cyril and Methodius," University Surgical Clinic "St. Naum Ohridski," Skopje, North Macedonia
| | - Stefano Fanti
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Alberto Stefano Tagliafico
- Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, Milan, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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27
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Picasso R, Zaottini F, Pistoia F, Perez MM, Klauser A, Rossi F, Schenone A, Tagliafico AS, Martinoli C. High-Resolution Ultrasound of Small Clinically Relevant Nerves Running Across the Posterior Triangle of the Neck. Semin Musculoskelet Radiol 2020; 24:101-112. [DOI: 10.1055/s-0040-1710067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractWith the advent of high-frequency ultrasound (US) transducers, new perspectives have been opened in evaluating millimetric and submillimetric nerves that, despite their dimensions, can be considered relevant in clinical practice. In the posterior triangle of the neck, the suprascapular, long thoracic, phrenic, supraclavicular, great auricular, lesser occipital, and transverse cervical nerves are amenable to US examination and the object of special interest because they may be involved in many pathologic processes or have a value as targets of advanced therapeutic procedures. The correct identification of these nerves requires a deep knowledge of local neck anatomy and the use of a complex landmarks-based approach with US. This article describes the anatomy and US technique to examine small but clinically relevant nerves of the posterior triangle of the neck (excluding the brachial plexus), reviewing the main pathologic conditions in which they may be involved.
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Affiliation(s)
- Riccardo Picasso
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Federico Zaottini
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Federico Pistoia
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Maribel Miguel Perez
- Departamento de Patología y Terapéutica Experimental, Facultad de Medicina y Ciencias de la Salud (Campus de Bellvitge), Unidad de Anatomía y Embriología Humana, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Andrea Klauser
- Universitätsklinik für Radiologie, Medizinische Universität, Abteilung Rheuma- und Sportbildgebung, Innsbruck, Austria
| | - Federica Rossi
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Angelo Schenone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genova, Italy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Carlo Martinoli
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
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28
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Tagliafico AS, González RP, Rossi F, Bignotti B, Martinoli C. Peripheral Nerves: Not Only Cross-sectional Area in the Era of Radiomics. Semin Musculoskelet Radiol 2020; 24:175-180. [PMID: 32438443 DOI: 10.1055/s-0040-1701629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The peripheral nervous system is increasingly being investigated using medical imaging as a complement or in association with electrodiagnostics tests. The application of imaging techniques, such as ultrasound (US) and magnetic resonance imaging (MRI), allows detailed visualization of the peripheral nervous system. According to the European Society of Musculoskeletal Radiology, the use of US for nerve evaluation is strongly encouraged. In addition, the role of US is further enhanced by the wide application of US-guided techniques to diagnose or to treat peripheral nerve disorders.Standard evaluation of peripheral nerves on US usually relies on cross-sectional area evaluation with different cutoff values in the osteofibrous tunnels and outside them. In several anatomical areas, side-to-side comparison is highly recommended because it helps distinguish subtle variations by using the unaffected limb as an internal control.US is widely used to perform US-guided interventional procedures on peripheral nerves. The recent development of radiomics and machine and deep learning applied to peripheral nerves may reveal new insights beyond the capabilities of the human eye. Radiomics may have a role in expanding the diagnostic capabilities of US and MRI in the study of peripheral nerve pathology, especially when the cross-sectional area is not markedly increased.
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Affiliation(s)
- Alberto Stefano Tagliafico
- Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Federica Rossi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Bianca Bignotti
- Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Carlo Martinoli
- Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
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29
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Abstract
Sarcopenia is a disease characterized by decreased skeletal muscle mass, strength, and loss of function that can impair quality of life and increase physical disability, adverse metabolic effects, and mortality. This review familiarizes the reader with ultrasound (US)-based biomarkers for sarcopenia with a discussion of these topics: why assessing sarcopenia is relevant for radiologists, how to evaluate muscle structure with US, the current challenges or pitfalls of these biomarkers, and the implications of all the available evidence. It summarizes the most up-to-date literature on the pathophysiology behind the use of these US-based biomarkers, the biomarkers themselves, and a protocol used for their assessments. The article also describes representative examples that reflect modern practice in the field. Imaging is routinely used in clinical practice, and radiologists can play an important role in the evaluation of geriatric patients, providing an unprecedented opportunity to improve decision support in sarcopenia prevention and treatment.
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Affiliation(s)
| | - Jelena Vucetic
- Department of Physiology, Universitat de València/INCLIVA, Valencia, Spain.,Radiology Department, Hospital ICOT Ciudad de Telde, Telde, Las Palmas, Spain
| | - Federica Rossi
- Department of Health Sciences (DISSAL), Radiology Section, University of Genoa, Genoa, Italy
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30
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Brunetti N, De Giorgis S, Zawaideh J, Rossi F, Calabrese M, Tagliafico AS. Comparison between execution and reading time of 3D ABUS versus HHUS. Radiol Med 2020; 125:1243-1248. [PMID: 32367322 DOI: 10.1007/s11547-020-01209-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/20/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Breast density is an independent risk factor for breast cancer. Mammography is supplemented with handheld ultrasound (HHUS) to increase sensitivity. Automatic breast ultrasound (ABUS) is an alternative to HHUS. Our study wanted to assess the difference in execution and reading time between ABUS and HHUS. METHODS AND MATERIALS N = 221 women were evaluated consecutively between January 2019 and June 2019 (average age 53 years; range 24-89). The execution and reading time of ABUS and HHUS was calculated with an available stopwatch. Time started for both procedures when the patient was ready on the examination table to be examined to the end of image acquisition and interpretation. RESULTS No patients interrupted the exam due to pain or discomfort. N = 221 women underwent ABUS and HHUS; N = 11 patients refused to undergo both procedures due to time constraints and refused ABUS; therefore, 210 patients were enrolled with both ABUS and HHUS available. The average time to perform and read the exam was 5 min for HHUS (DS ± 1.5) with a maximum time of 11 min and a minimum of 2 min. The average time with ABUS was 17 min (DS ± 3.8, with a maximum time of 31 min and a minimum time of 9 min). The ABUS technique took longer to be performed in all patients, with an average difference of 11 min (range 3-23 min) per patient, P < 0,001. Separating ABUS execution from reading time we highlighted as ABUS execution is more time-consuming respect HHUS. In addition, we can underline that time required by radiologists is longer for ABUS even only considering the interpretation time of the exam. CONCLUSION A significant difference was observed in the execution and reading time of the two exams, where the HHUS method was more rapid and tolerated.
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Affiliation(s)
- Nicole Brunetti
- Department of Health Sciences (DISSAL)- Radiology Section, University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy.
| | - Sara De Giorgis
- Department of Health Sciences (DISSAL)- Radiology Section, University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy
| | - Jeries Zawaideh
- Department of Health Sciences (DISSAL)- Radiology Section, University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy
| | - Federica Rossi
- Department of Health Sciences (DISSAL)- Radiology Section, University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy
| | - Massimo Calabrese
- IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi. 10, 16132, Genoa, Italy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL)- Radiology Section, University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy.,IRCCS - Ospedale Policlinico San Martino, Largo Rosanna Benzi. 10, 16132, Genoa, Italy
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31
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Tagliafico AS, Belgioia L, Bonsignore A, Signori A, Formica M, Rossi F, Piana M, Schenone D, Dominietto A. Development and definition of a simplified scoring system in patients with multiple myeloma undergoing stem cells transplantation on standard computed tomography: myeloma spine and bone damage score (MSBDS). Cancer Imaging 2020; 20:31. [PMID: 32345379 PMCID: PMC7189746 DOI: 10.1186/s40644-020-00306-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/13/2020] [Indexed: 12/21/2022] Open
Abstract
Background In clinical practice, there is the need to optimize imaging usage in MM patients. Accordingly, the aim of this paper was to develop a simple computed tomography (CT) scoring method for MM, able to shorten and simplify the interpretation time with good intra- and inter-reader reliability. This method, named MSBDS (Myeloma Spine and Bone Damage Score) was developed with the final aim to use standard total-body CT in the routine practice of MM centres as a complement of standard evaluations in patients undergoing stem cells transplantation. Methods We used a widely accepted consensus formation method and literature research during three structured face-to-face meetings specifically designed to combine opinions from a group of experts with proven experience in multiple myeloma care and/or musculoskeletal CT to facilitate the consensus on the field of study topics and the contents of the MSBDS score. Seven practical requisites for the MSBDS score were agreed. A total of 70 MM patients (mean age, 60 years ±9.2 [standard deviation]; range, 35–70 years) undergoing total-body CT was included to develop MSBDS scores. Patients data were already stored in the Radiological database for other Research studies IRB approved (054/2019). Readers to test the MSDMS were radiologists and clinicians involved in MM care or expert in bone damage scores with different level of experience in musculoskeletal and total body CT. Readers were blinded to the clinical data of the patients. Results The MSBDS scores based on the consensus work described above and literature analysis was finalized. MSBDS is based on an additive scale with assessment of a total body CT with the bone window one time and includes indicators of structural bone damage and instability or fracture risk. The total score is given by the sum of item scores for abnormalities detected. Its values range from 0 (minimum) to values > 10 where 10 is represented by high-risk patients. In high-risk patients immediate surgical or radiation oncologist consultation is suggested. Conclusions The MSBDS descriptive criteria are easy, highly reproducible and can be considered as a strong base for harmonizing total body CT interpretation in multiple myeloma patients undergoing stem cell transplantation.
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Affiliation(s)
- Alberto Stefano Tagliafico
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy. .,Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.
| | - Liliana Belgioia
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy.,Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Alessandro Bonsignore
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy.,Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy
| | - Matteo Formica
- Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.,Dipartimento Di Scienze Chirurgiche e Diagnostiche Integrate - Disc, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy
| | - Federica Rossi
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy
| | - Michele Piana
- Dipartimento Di Matematica - Dima, University of Genoa, via Dodecaneso 35, 16146, GENOVA Genoa, Italy.,CNR - SPIN, Genoa, Italy
| | - Daniela Schenone
- Dipartimento Di Matematica - Dima, University of Genoa, via Dodecaneso 35, 16146, GENOVA Genoa, Italy
| | - Alida Dominietto
- Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
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Tagliafico AS. Musculoskeletal Ultrasound. Semin Musculoskelet Radiol 2020; 24:81-82. [DOI: 10.1055/s-0040-1708819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Alberto Stefano Tagliafico
- Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
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Zaottini F, Picasso R, Pistoia F, Perez MM, Möller I, Rossi F, Bruns A, Tagliafico AS, Martinoli C. Ultrasound Imaging Guide for Assessment of the Intrinsic Ligaments Stabilizing the Subtalar and Midtarsal Joints. Semin Musculoskelet Radiol 2020; 24:113-124. [PMID: 32438438 DOI: 10.1055/s-0040-1710066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Ligament injuries around the subtalar, talocalcaneonavicular, and calcaneocuboid joints are often underestimated on clinical and imaging findings during investigation of patients with ankle and foot injuries. Because a delayed diagnosis of midtarsal ligament tears may lead to chronic pain and functional disability, an in-depth knowledge of the complex regional anatomy and of the appropriate ultrasound scanning technique is a prerequisite for evaluating these structures and avoiding misdiagnoses. The objective of this article is twofold: to describe the relevant anatomy and biomechanics related to the ligaments that stabilize the subtalar, talocalcaneonavicular, and calcaneocuboid joints, and to illustrate reasoned landmark-based scanning techniques to provide a systematic examination of these ligaments and thus make ultrasound an effective tool for assessment of patients with suspected subtalar or midtarsal sprain.
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Affiliation(s)
- Federico Zaottini
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Riccardo Picasso
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Federico Pistoia
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Maribel Miguel Perez
- Unidad de Anatomía y Embriología Humana, Departamento de Patología y Terapéutica Experimental, Facultad de Medicina y Ciencias de la Salud (Campus de Bellvitge), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Federica Rossi
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alessandra Bruns
- Division of Rheumatology, Sherbrooke University, Sherbrooke, Canada
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Carlo Martinoli
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
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34
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Sconfienza LM, Adriaensen M, Albano D, Aparisi Gómez MP, Bazzocchi A, Beggs I, Bignotti B, Chianca V, Corazza A, Dalili D, De Dea M, Del Cura JL, Di Pietto F, Drakonaki E, Facal de Castro F, Filippiadis D, Gielen J, Gitto S, Gupta H, Klauser AS, Lalam R, Martin S, Martinoli C, Mauri G, McCarthy C, McNally E, Melaki K, Messina C, Mirón Mombiela R, Neubauer B, Obradov M, Olchowy C, Orlandi D, Plagou A, Prada Gonzalez R, Rutkauskas S, Snoj Z, Tagliafico AS, Talaska A, Vasilevska-Nikodinovska V, Vucetic J, Wilson D, Zaottini F, Zappia M, Allen G. Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)-Part II, elbow and wrist. Eur Radiol 2019; 30:2220-2230. [PMID: 31844963 DOI: 10.1007/s00330-019-06545-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/20/2019] [Accepted: 10/23/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although image-guided interventional procedures of the elbow and wrist are routinely performed, there is poor evidence in the literature concerning such treatments. Our aim was to perform a Delphi-based consensus on published evidence on image-guided interventional procedures around the elbow and wrist and provide clinical indications on this topic. METHODS A board of 45 experts in image-guided interventional musculoskeletal procedures from the European Society of Musculoskeletal Radiology were involved in this Delphi-based consensus study. All panelists reviewed and scored published papers on image-guided interventional procedures around the elbow and wrist updated to September 2018 according to the Oxford Centre for Evidence-based Medicine levels of evidence. Consensus on statements drafted by the panelists about clinical indications was considered as "strong" when more than 95% of panelists agreed and as "broad" if more than 80% agreed. RESULTS Eighteen statements were drafted, 12 about tendon procedures and 6 about intra-articular procedures. Only statement #15 reached the highest level of evidence (ultrasound-guided steroid wrist injections result in greater pain reduction and greater likelihood of attaining clinically important improvement). Seventeen statements received strong consensus (94%), while one received broad consensus (6%). CONCLUSIONS There is still poor evidence in published papers on image-guided interventional procedures around the elbow and wrist. A strong consensus has been achieved in 17/18 (94%) statements provided by the panel on clinical indications. Large prospective randomized trials are needed to better define the role of these procedures in clinical practice. KEY POINTS • The panel provided 18 evidence-based statements on clinical indications of image-guided interventional procedures around the elbow and wrist. • Only statement #15 reached the highest level of evidence: ultrasound-guided steroid wrist injections result in greater pain reduction and greater likelihood of attaining clinically important improvement. • Seventeen statements received strong consensus (94%), while broad consensus was obtained by 1 statement (6%).
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Affiliation(s)
- Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy. .,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20100, Milan, Italy.
| | - Miraude Adriaensen
- Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, The Netherlands
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.,Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, 1023, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre, 46015, Valencia, Spain
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy
| | - Ian Beggs
- Department of Radiology, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Bianca Bignotti
- Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genova, Italy
| | - Vito Chianca
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Angelo Corazza
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Danoob Dalili
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,The Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK
| | - Miriam De Dea
- UOC Radiologia, Ospedale di Feltre, AULSS1 Dolomiti, Veneto, Italy
| | - Jose Luis Del Cura
- Department of Radiology, Donostia University Hospital, Begiristain Doktorea Pasealekua, 109, 20014, Donostia/San Sebastian, Spain.,University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Francesco Di Pietto
- Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, CE, Italy
| | - Eleni Drakonaki
- Private Institution of Ultrasonography and MSK Radiology, Heraklion, Greece.,Department of Anatomy, Medical School of the European University of Cyprus, Nicosia, Cyprus
| | - Fernando Facal de Castro
- IBERORAD 1895 S.L., 08021, Barcelona, Spain.,Department of Radiology, General University Hospital of Valencia, Valencia, Spain
| | - Dimitrios Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jan Gielen
- University of Antwerp, Antwerp, Belgium.,University of Antwerp Hospital (UZA), Antwerp, Belgium
| | | | | | - Andrea S Klauser
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Radhesh Lalam
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, UK
| | - Silvia Martin
- Hospital Son Llatzer, Palma de Mallorca, Spain.,Medicine, Universidad de las Islas Baleares, Palma de Mallorca, Spain
| | - Carlo Martinoli
- DISSAL Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genova, Italy.,Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genova, Italy
| | - Giovanni Mauri
- Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Catherine McCarthy
- The Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK.,Oxford Musculoskeletal Radiology, Oxford, UK
| | | | - Kalliopi Melaki
- Medical School of the National and Kapodistrian University of Athens, Athens, Greece
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20100, Milan, Italy
| | - Rebeca Mirón Mombiela
- Department of Physiology, Universidad de Valencia/INCLIVA, Avenida Blasco Ibañez 15, 46010, Valencia, Spain.,Radiologisk Afdeling, Herlev og Gentofte Hospital, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark
| | - Benedikt Neubauer
- Radiology, Medical University of Vienna, Vienna, Austria.,Ordensklinkum Linz, Linz, Austria
| | | | - Cyprian Olchowy
- Department of Oral Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Davide Orlandi
- Department of Radiology, Ospedale Evangelico Internazionale Genova, Genova, Italy
| | - Athena Plagou
- Department of Radiology, Private Institution of Ultrasonography, Athens, Greece
| | | | - Saulius Rutkauskas
- Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Ziga Snoj
- University Medical Centre Ljubljana, Zaloška ul. 7, 1000, Ljubljana, Slovenia
| | - Alberto Stefano Tagliafico
- DISSAL Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genova, Italy.,Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genova, Italy
| | | | - Violeta Vasilevska-Nikodinovska
- Medical Faculty, University "Ss.Cyril and Methodius", University Surgical Clinic "St.Naum Ohridski", Skopje, North Macedonia
| | - Jelena Vucetic
- Department of Radiology, General University Hospital of Valencia, Valencia, Spain.,Radiologisk Afdeling, Herlev og Gentofte Hospital, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark
| | - David Wilson
- St Luke's Radiology Oxford Ltd, Oxford, UK.,Oxford University, Oxford, UK
| | - Federico Zaottini
- DISSAL Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genova, Italy
| | - Marcello Zappia
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.,Varelli Institute, Naples, Italy
| | - Georgina Allen
- St Luke's Radiology Oxford Ltd, Oxford, UK.,Oxford University, Oxford, UK
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Rossi F, Martinoli C, Murialdo G, Schenone A, Grandis M, Ferone D, Tagliafico AS. The primary role of radiological imaging in the diagnosis of rare musculoskeletal diseases. Emphasis on ultrasound. J Ultrason 2019; 19:187-192. [PMID: 31807323 PMCID: PMC6856777 DOI: 10.15557/jou.2019.0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 07/18/2019] [Indexed: 12/20/2022] Open
Abstract
Objective: In July 2017 a multidisciplinary clinical Center specialized in rare diseases was activated. A rare disease can involve the musculoskeletal system. A multimodality musculoskeletal imaging approach allows for a rapid diagnosis. The purpose of this study was to assess when musculoskeletal radiology, ultrasound in particular, plays a primary role in the diagnostic path of a rare disease. Methods and materials: The Center included a list of 621 main rare diseases. Pathologies in which radiology has a primary diagnostic role were extracted from the list. From September 2017 to January 2018 all conditions involving the musculoskeletal system, including the peripheral nervous system, were systematically evaluated by one radiologist. The second radiologist, an official consultant of the Center, verified the list for consistency. Descriptive analysis was performed. Results: A total of 101/621 (16%) rare diseases can be diagnosed for the first time in the diagnostic path of the patient with medical imaging. A total of 36/101 (36%) rare diseases involve the musculoskeletal system. A total of 14/36 (39%) are pediatric diseases, 10/36 (28%) are adult age diseases, while 12/36 (33%) diseases affect all ages. A total of 23/36 (64%) of the selected rare diseases could be diagnosed with MRI, 19/36 (53%) with CT, 23/36 (64%) with X-ray, 9/36 (25%) with an US, and 1/36 (3%) with PET. Conclusions: Musculoskeletal imaging could be important for a non-invasive diagnosis in up to 36/101 (36%) rare diseases, as well as for outcome prediction, especially in pediatrics. Musculoskeletal imaging plays a crucial role in the diagnosis of rare diseases and could strongly influence the clinical pathway. Ultrasound is crucial in up to 25% of patients with rare diseases affecting the musculoskeletal system.
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Affiliation(s)
- Federica Rossi
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | - Carlo Martinoli
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy.,Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni Murialdo
- Department of Internal Medicine, Policlinico San Martino University Hospital, University of Genoa, Genoa, Italy
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genova, Genoa, Italy
| | - Marina Grandis
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, University of Genova, Genoa, Italy
| | - Diego Ferone
- Endocrinology, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genua, Włochy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy.,Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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36
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Sconfienza LM, Adriaensen M, Albano D, Allen G, Aparisi Gómez MP, Bazzocchi A, Beggs I, Bignotti B, Chianca V, Corazza A, Dalili D, De Dea M, Del Cura JL, Di Pietto F, Drakonaki E, Facal de Castro F, Filippiadis D, Gielen J, Gitto S, Gupta H, Klauser AS, Lalam R, Martin S, Martinoli C, Mauri G, McCarthy C, McNally E, Melaki K, Messina C, Mirón Mombiela R, Neubauer B, Obradov M, Olchowy C, Orlandi D, Gonzalez RP, Rutkauskas S, Snoj Z, Tagliafico AS, Talaska A, Vasilevska-Nikodinovska V, Vucetic J, Wilson D, Zaottini F, Zappia M, Plagou A. Clinical indications for image guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)-part III, nerves of the upper limb. Eur Radiol 2019; 30:1498-1506. [PMID: 31712960 DOI: 10.1007/s00330-019-06479-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/30/2019] [Accepted: 09/27/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Image-guided interventional procedures of the nerves are commonly performed by physicians from different medical specialties, although there is a lack of clinical indications for these types of procedures. This Delphi-based consensus provided a list of indications on image-guided interventional procedures for nerves of the upper limb based on updated published evidence. METHODS An expert panel of 45 members of the Ultrasound and Interventional Subcommittees of the ESSR participated in this Delphi-based consensus study. After revision of the published papers on image-guided interventional procedures for nerves of the upper limb updated to September 2018, the experts drafted a list of statements according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus on statements regarding clinical indications was considered as strong when more than 95% of experts agreed, and broad if more than 80% agreed. RESULTS Ten statements were drafted on procedures for nerves of the upper limb. Only two statements reached the highest level of evidence (ultrasound guidance is a safe and effective method for brachial plexus block; ultrasound-guided non-surgical approaches are safe and effective methods to treat carpal tunnel syndrome in the short term, but there is sparse evidence on the mid- and long-term effectiveness of these interventions). Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%). CONCLUSIONS This Delphi-based consensus study reported poor evidence on image-guided interventional procedures for nerves of the upper limb. Sixty percent of statements on clinical indications provided by the expert board reached a strong consensus. KEY POINTS • An expert panel of the ESSR provided 10 evidence-based statements on clinical indications for image-guided interventional procedures for nerves of the upper limb • Two statements reached the highest level of evidence • Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%).
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Affiliation(s)
- Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy.
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy.
| | - Miraude Adriaensen
- Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, The Netherlands
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy
- Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy
| | - Georgina Allen
- St Luke's Radiology Oxford Ltd, Oxford, UK
- University of Oxford, Oxford, UK
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, 1023, New Zealand
- Department of Radiology, Hospital Vithas Nueve de Octubre, 46015, Valencia, Spain
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy
| | - Ian Beggs
- Department of Radiology, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | | | - Vito Chianca
- IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy
| | - Angelo Corazza
- IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
| | - Danoob Dalili
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK
| | - Miriam De Dea
- UOC Radiologia, Ospedale di Feltre, AULSS1 Dolomiti, Veneto, Italy
| | - Jose Luis Del Cura
- Department of Radiology, Donostia University Hospital, 20014, Donostia/San Sebastian, Spain
- University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Francesco Di Pietto
- Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, (CE), Italy
| | - Eleni Drakonaki
- Private Institution of Ultrasonography and MSK Radiology, Heraklion, Greece
- Department of Anatomy, Medical School of the European University of Cyprus, Engomi, Cyprus
| | - Fernando Facal de Castro
- IBERORAD 1895 S.L., 08021, Barcelona, Spain
- Department of Radiology, General University Hospital of Valencia, Valencia, Spain
| | - Dimitrios Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jan Gielen
- University of Antwerp, Antwerp, Belgium
- University of Antwerp Hospital (UZA), Edegem, Belgium
| | | | | | - Andrea S Klauser
- Medical University Innsbruck, Innsbruck, Austria
- Department of Radiology, Innsbruck, Austria
| | - Radhesh Lalam
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, UK
| | - Silvia Martin
- Hospital Son Llatzer, Palma de Mallorca, Spain
- Universidad de las Islas Baleares Medicine, Palma, Balearic Islands, Spain
| | - Carlo Martinoli
- Ospedale Policlinico San Martino, 16132, Genoa, Italy
- University of Genoa - DISSAL Department of Health Sciences, Genoa, Italy
| | - Giovanni Mauri
- Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Catherine McCarthy
- The Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK
- Oxford Musculoskeletal Radiology, Oxford, UK
| | | | - Kalliopi Melaki
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | - Rebeca Mirón Mombiela
- Department of Physiology, Universidad de Valencia/INCLIVA, 46010, Valencia, Spain
- Herlev og Gentofte Hospital Radiologisk Afdeling, Herlev Ringvej 75, opgang 51, Herlev, Denmark
| | - Benedikt Neubauer
- Radiology, Medical University of Vienna, Vienna, Austria
- Ordensklinikum Linz, Linz, Austria
| | - Marina Obradov
- Sint Maartenskliniek, 9011, Nijmegen, 6500GM, The Netherlands
| | - Cyprian Olchowy
- Department of Oral Surgery, Wroclaw Medical University, Wrocław, Poland
| | | | | | - Saulius Rutkauskas
- Radiology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ziga Snoj
- Department of Radiology, University Medical Centre Ljubljana, Zaloška 7, Ljubljana, 1000, Slovenia
| | - Alberto Stefano Tagliafico
- Ospedale Policlinico San Martino, 16132, Genoa, Italy
- Department of Health Sciences, University of Genoa, 16132, Genoa, Italy
| | | | - Violeta Vasilevska-Nikodinovska
- Medical Faculty, University "Ss.Cyril and Methodius", Skopje, North Macedonia
- University Surgical Clinic "St.Naum Ohridski", Skopje, North Macedonia
| | - Jelena Vucetic
- Department of Radiology, General University Hospital of Valencia, Valencia, Spain
- Department of Physiology, Universidad de Valencia/INCLIVA, 46010, Valencia, Spain
| | - David Wilson
- St Luke's Radiology Oxford Ltd, Oxford, UK
- University of Oxford, Oxford, UK
| | - Federico Zaottini
- University of Genoa - DISSAL Department of Health Sciences, Genoa, Italy
| | - Marcello Zappia
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
- Varelli Institute, Naples, Italy
| | - Athena Plagou
- Department of Radiology, Private Institution of Ultrasonography, Athens, Greece
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37
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Tagliafico AS, Cea M, Rossi F, Valdora F, Bignotti B, Succio G, Gualco S, Conte A, Dominietto A. Differentiating diffuse from focal pattern on Computed Tomography in multiple myeloma: Added value of a Radiomics approach. Eur J Radiol 2019; 121:108739. [PMID: 31733431 DOI: 10.1016/j.ejrad.2019.108739] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/08/2019] [Accepted: 11/04/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE Focal pattern in multiple myeloma (MM) seems to be related to poorer survival and differentiation from diffuse to focal pattern on computed tomography (CT) has inter-reader variability. We postulated that a Radiomic approach could help radiologists in differentiating diffuse from focal patterns on CT. METHODS We retrospectively reviewed imaging data of 70 patients with MM with CT, PET-CT or MRI available before bone marrow transplant. Two general radiologist evaluated, in consensus, CT images to define a focal (at least one lytic lesion >5 mm in diameter) or a diffuse (lesions <5 mm, not osteoporosis) pattern. N = 104 Radiomics features were extracted and evaluated with an open source software. RESULTS The pathological group included: 22 diffuse and 39 focal patterns. After feature reduction, 9 features were different (p < 0.05) in the diffuse and focal patterns (n = 2/9 features were Shape-based: MajorAxisLength and Sphericity; n = 7/9 were Gray Level Run Length Matrix (Glrlm)). AUC of the Radiologists versus Reference Standard was 0.64 (95 % CI: (0.49-0.78) p = 0.20. AUC of the best 4 features (MajorAxisLength, Median, SizeZoneNonUniformity, ZoneEntropy) were: 0.73 (95 % CI: 0.58-0.88); 0.71 (95 % CI: 0.54-0.88); 0.79 (95 % CI: 0.66-0.92); 0.68 (95 % CI: 0.53-0.83) respectively. CONCLUSION A Radiomics approach improves radiological evaluation of focal and diffuse pattern of MM on CT.
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Affiliation(s)
- Alberto Stefano Tagliafico
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy; Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, Italy.
| | - Michele Cea
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy; Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, Italy.
| | - Federica Rossi
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Francesca Valdora
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Bianca Bignotti
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy; Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, Italy.
| | - Giulia Succio
- Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, Italy.
| | - Stefano Gualco
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Alessio Conte
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy.
| | - Alida Dominietto
- Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, Italy.
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Tagliafico AS, Piana M, Schenone D, Lai R, Massone AM, Houssami N. Overview of radiomics in breast cancer diagnosis and prognostication. Breast 2019; 49:74-80. [PMID: 31739125 PMCID: PMC7375670 DOI: 10.1016/j.breast.2019.10.018] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022] Open
Abstract
Diagnosis of early invasive breast cancer relies on radiology and clinical evaluation, supplemented by biopsy confirmation. At least three issues burden this approach: a) suboptimal sensitivity and suboptimal positive predictive power of radiology screening and diagnostic approaches, respectively; b) invasiveness of biopsy with discomfort for women undergoing diagnostic tests; c) long turnaround time for recall tests. In the screening setting, radiology sensitivity is suboptimal, and when a suspicious lesion is detected and a biopsy is recommended, the positive predictive value of radiology is modest. Recent technological advances in medical imaging, especially in the field of artificial intelligence applied to image analysis, hold promise in addressing clinical challenges in cancer detection, assessment of treatment response, and monitoring disease progression. Radiomics include feature extraction from clinical images; these features are related to tumor size, shape, intensity, and texture, collectively providing comprehensive tumor characterization, the so-called radiomics signature of the tumor. Radiomics is based on the hypothesis that extracted quantitative data derives from mechanisms occurring at genetic and molecular levels. In this article we focus on the role and potential of radiomics in breast cancer diagnosis and prognostication.
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Affiliation(s)
- Alberto Stefano Tagliafico
- Department of Health Sciences, University of Genoa, Genoa, Italy; Ospedale Policlinico San Martino, Genoa, Italy.
| | - Michele Piana
- Dipartimento di Matematica, Università di Genova, Genova, Italy; CNR - SPIN, Genova, Italy
| | | | | | - Anna Maria Massone
- Dipartimento di Matematica, Università di Genova, Genova, Italy; CNR - SPIN, Genova, Italy
| | - Nehmat Houssami
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
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Garlaschi A, Calabrese M, Zaottini F, Tosto S, Gipponi M, Baccini P, Gallo M, Tagliafico AS. Influence of Tumor Subtype, Radiological Sign and Prognostic Factors on Tumor Size Discrepancies Between Digital Breast Tomosynthesis and Final Histology. Cureus 2019; 11:e6046. [PMID: 31803564 PMCID: PMC6890152 DOI: 10.7759/cureus.6046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Influence of tumor subtype, radiological sign and prognostic factors on tumor size discrepancies between DBT and final histology has not been completely investigated so far. Purpose To study the influence of tumor subtype, radiological sign and prognostic factors on tumor size discrepancies between digital breast tomosynthesis and final histology. Material and methods This is a retrospective study conducted between January 2015 and December 2016. After IRB approval, 130 consecutive patients with breast cancer diagnosed with digital breast tomosynthesis (DBT) were evaluated. A discrepancy between DBT and final histology was considered present if the difference was above the cut-off of 5 mm. Tumor subtype, radiological sign and prognostic factors were evaluated in patients with discrepancies. Descriptive statistic and non-parametric tests were used. Results A total of 105 cases of cancer, in 96 patients, all female, were included. Mean age was 61 years (range: 35-82 yrs). In 19 (18.1%) cases, discrepancies were found: 13 (68.4%) were underestimated by DBT. For tumor subtype, 10 (52.6%) were infiltrating lobular carcinomas (ILC) (p < 0.01). Fourteen (73.7%) discordant cases were architectural distortions (p < 0.01). Prognostic factors did not affect tumor size discrepancies. Conclusion ILC or an architectural distortion represents the majority of cases of tumor size discrepancies between DBT and final histology.
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Affiliation(s)
| | | | | | - Simona Tosto
- Radiology, Ospedale Policlinico San Martino, Genova, ITA
| | - Marco Gipponi
- Surgery, Ospedale Policlinico San Martino, Genova, ITA
| | - Paola Baccini
- Pathology, University of Genova/ AOU IRCCS Policlinico San Martino, Genova, ITA
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Sconfienza LM, Adriaensen M, Albano D, Allen G, Aparisi Gómez MP, Bazzocchi A, Beggs I, Bignotti B, Chianca V, Corazza A, Dalili D, De Dea M, Del Cura JL, Di Pietto F, Drakonaki E, Facal de Castro F, Filippiadis D, Gielen J, Gitto S, Gupta H, Klauser AS, Lalam R, Martin S, Martinoli C, Mauri G, McCarthy C, McNally E, Melaki K, Messina C, Mirón Mombiela R, Neubauer B, Olchowy C, Orlandi D, Plagou A, Prada Gonzalez R, Rutkauskas S, Snoj Z, Tagliafico AS, Talaska A, Vasilevska-Nikodinovska V, Vucetic J, Wilson D, Zaottini F, Zappia M, Obradov M. Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)-part I, shoulder. Eur Radiol 2019; 30:903-913. [PMID: 31529252 DOI: 10.1007/s00330-019-06419-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 07/07/2019] [Accepted: 08/08/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Image-guided interventional procedures around the shoulder are commonly performed in clinical practice, although evidence regarding their effectiveness is scarce. We report the results of a Delphi method review of evidence on literature published on image-guided interventional procedures around the shoulder with a list of clinical indications. METHODS Forty-five experts in image-guided musculoskeletal procedures from the ESSR participated in a consensus study using the Delphic method. Peer-reviewed papers regarding interventional procedures around the shoulder up to September 2018 were scored according to the Oxford Centre for Evidence-based Medicine levels of evidence. Statements on clinical indications were constructed. Consensus was considered as strong if more than 95% of experts agreed and as broad if more than 80% agreed. RESULTS A total of 20 statements were drafted, and 5 reached the highest level of evidence. There were 10 statements about tendon procedures, 6 about intra-articular procedures, and 4 about intrabursal injections. Strong consensus was obtained in 16 of them (80%), while 4 received broad consensus (20%). CONCLUSIONS Literature evidence on image-guided interventional procedures around the shoulder is limited. A strong consensus has been reached for 80% of statements. The ESSR recommends further research to potentially influence treatment options, patient outcomes, and social impact. KEY POINTS • Expert consensus produced a list of 20 evidence-based statements on clinical indications of image-guided interventional procedures around the shoulder. • The highest level of evidence was reached for five statements. • Strong consensus was obtained for 16 statements (80%), while 4 received broad consensus (20%).
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Affiliation(s)
- Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy. .,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
| | - Miraude Adriaensen
- Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, the Netherlands
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy.,Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy
| | - Georgina Allen
- St Luke's Radiology Oxford Ltd, Oxford, UK.,University of Oxford, Oxford, UK
| | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, 1023, New Zealand.,Department of Radiology, Hospital Vithas Nueve de Octubre, 46015, Valencia, Spain
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy
| | - Ian Beggs
- Department of Radiology, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Bianca Bignotti
- Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Vito Chianca
- IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy
| | - Angelo Corazza
- IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy.,Department of Neurosciences, University of Genova, Genoa, Italy
| | - Danoob Dalili
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Nuffield Orthopaedic Hospital, Oxford, UK
| | - Miriam De Dea
- UOC Radiologia, Ospedale di Feltre, AULSS 1 Dolomiti, Veneto, Italy
| | - Jose Luis Del Cura
- Department of Radiology, Donostia University Hospital, Begiristain Doktorea Pasealekua, 109, 20014, Donostia/San Sebastian, Spain.,University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Francesco Di Pietto
- Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, CE, Italy
| | - Eleni Drakonaki
- Department of Musculoskeletal Radiology, Private Ultrasound Institution, Heraklion, Greece
| | - Fernando Facal de Castro
- IBERORAD 1895 S.L., 08021, Barcelona, Spain.,Department of Radiology, General University Hospital of Valencia, Valencia, Spain
| | - Dimitrios Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jan Gielen
- University of Antwerp, University of Antwerp Hospital (UZA), Antwerp, Belgium
| | | | | | - Andrea S Klauser
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Radhesh Lalam
- The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, UK
| | - Silvia Martin
- Hospital Son Llatzer, Palma de Mallorca, Spain.,Universidad de las Islas Baleares, Palma, Spain
| | - Carlo Martinoli
- DISSAL Department of Health Sciences, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Giovanni Mauri
- Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Catherine McCarthy
- Nuffield Orthopaedic Hospital, Oxford, UK.,Oxford Musculoskeletal Radiology, Oxford, UK
| | | | - Kalliopi Melaki
- Medical School of the National and Kapodistrian University of Athens, Athens, Greece
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Rebeca Mirón Mombiela
- Department of Physiology, Universidad de Valencia/INCLIVA, Avenida Blasco Ibañez 15, 46010, Valencia, Spain.,Herlev og Gentofte Hospital Radiologisk Afdeling, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark
| | | | - Cyprian Olchowy
- Department of Oral Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Athena Plagou
- Department of Radiology, Private Institution of Ultrasonography, Athens, Greece
| | | | - Saulius Rutkauskas
- Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Ziga Snoj
- Institute of Radiology, University Medical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia
| | - Alberto Stefano Tagliafico
- Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.,Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy
| | | | - Violeta Vasilevska-Nikodinovska
- Medical Faculty, University "Ss.Cyril and Methodius", Skopje, North Macedonia; University Surgical Clinic "St.Naum Ohridski", Skopje, North Macedonia
| | - Jelena Vucetic
- Department of Radiology, General University Hospital of Valencia, Valencia, Spain.,Herlev og Gentofte Hospital Radiologisk Afdeling, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark
| | - David Wilson
- St Luke's Radiology Oxford Ltd, Oxford, UK.,University of Oxford, Oxford, UK
| | - Federico Zaottini
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Marcello Zappia
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.,Varelli Institute, Naples, Italy
| | - Marina Obradov
- Sint Maartenskliniek, 6500GM, 9011, Nijmegen, the Netherlands
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Garlaschi A, Fregatti P, Oddone C, Friedman D, Houssami N, Calabrese M, Tagliafico AS. Intraoperative digital breast tomosynthesis using a dedicated device is more accurate than standard intraoperative mammography for identifying positive margins. Clin Radiol 2019; 74:974.e1-974.e6. [PMID: 31521327 DOI: 10.1016/j.crad.2019.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 08/19/2019] [Indexed: 11/16/2022]
Abstract
AIM To compare a standard intra-operative mammography (IM) device with digital breast tomosynthesis using a dedicated device (Mozart system) in the evaluation of surgical margins at first excision. MATERIALS AND METHODS The study received institutional review board approval and written informed consent was obtained from participants. From January 2018 to December 2018, a prospective analysis of the images of IM device and intra-operative digital breast tomosynthesis with a dedicated device (Mozart system) in n=89 breast cancer patients (average patients age: 58 years, age range: 35-76 years) was undertaken. Images were evaluated by two expert breast radiologists independently of each other and blinded to each other's interpretation, who indicated the positive cases requiring surgical re-excision intra-operatively. RESULTS Mean cancer size was 12.5±4.5 mm. Radiological signs of the lesions were microcalcifications (n=71), nodules (n=10), and architectural distortions (n=8). A total of 20/89 (17%) patients underwent intra-operative re-excision for positive margins. Intra-operative digital breast tomosynthesis with a dedicated device and IM showed discrepancies in 15/89 cases (17%). Mozart system results informed the necessity to perform a re-excision (n=15). Overall, receiver operating characteristic (ROC) curve analysis showed and area under the ROC curve (AUC) of 0.82 for the Mozart system versus 0.65 for IM. ROC analysis of radiological findings with microcalcifications showed an AUC of 0.92 for the Mozart system versus 0.74 for IM, whereas AUC in cases with no microcalcifications were 0.87 and 0.75, respectively. CONCLUSION Intra-operative digital breast tomosynthesis with a dedicated device provides more information (better accuracy) than IM and facilitated a reduction in re-excision rates.
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Affiliation(s)
- A Garlaschi
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy
| | - P Fregatti
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
| | - C Oddone
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy
| | - D Friedman
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
| | - N Houssami
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - M Calabrese
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy
| | - A S Tagliafico
- IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy; Department of Health Sciences (DISSAL) - Radiology Unit, University of Genoa, Genoa, Italy.
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Tagliafico AS, Bignotti B, Rossi F, Matos J, Calabrese M, Valdora F, Houssami N. Breast cancer Ki-67 expression prediction by digital breast tomosynthesis radiomics features. Eur Radiol Exp 2019; 3:36. [PMID: 31414273 PMCID: PMC6694353 DOI: 10.1186/s41747-019-0117-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/24/2019] [Indexed: 01/24/2023] Open
Abstract
Background To investigate whether quantitative radiomic features extracted from digital breast tomosynthesis (DBT) are associated with Ki-67 expression of breast cancer. Materials and methods This is a prospective ethically approved study of 70 women diagnosed with invasive breast cancer in 2018, including 40 low Ki-67 expression (Ki-67 proliferation index <14%) cases and 30 high Ki-67 expression (Ki-67 proliferation index ≥ 14%) cases. A set of 106 quantitative radiomic features, including morphological, grey/scale statistics, and texture features, were extracted from DBT images. After applying least absolute shrinkage and selection operator (LASSO) method to select the most predictive features set for the classifiers, low versus high Ki-67 expression was evaluated by the area under the curve (AUC) at receiver operating characteristic analysis. Correlation coefficient was calculated for the most significant features. Results A combination of five features yielded AUC of up to 0.698. The five most predictive features (sphericity, autocorrelation, interquartile range, robust mean absolute deviation, and short-run high grey-level emphasis) showed a statistical significance (p ≤ 0.001) in the classification. Thirty-four features were significantly (p ≤ 0.001) correlated with Ki-67, and five of these had a correlation coefficient of > 0.5. Conclusion The present study showed that quantitative radiomic imaging features of breast tumour extracted from DBT images are associated with breast cancer Ki-67 expression. Larger studies are needed in order to further evaluate these findings.
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Affiliation(s)
- Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), Radiology Section, University of Genoa, Genoa, Italy. .,Emergency Radiology, IRCCS Policlinico San Martino, Genoa, Italy.
| | - Bianca Bignotti
- Department of Health Sciences (DISSAL), Radiology Section, University of Genoa, Genoa, Italy.,Emergency Radiology, IRCCS Policlinico San Martino, Genoa, Italy
| | - Federica Rossi
- Department of Health Sciences (DISSAL), Radiology Section, University of Genoa, Genoa, Italy.,Emergency Radiology, IRCCS Policlinico San Martino, Genoa, Italy
| | - Joao Matos
- Department of Health Sciences (DISSAL), Radiology Section, University of Genoa, Genoa, Italy.,Emergency Radiology, IRCCS Policlinico San Martino, Genoa, Italy
| | - Massimo Calabrese
- Department of Health Sciences (DISSAL), Radiology Section, University of Genoa, Genoa, Italy.,Emergency Radiology, IRCCS Policlinico San Martino, Genoa, Italy
| | - Francesca Valdora
- Department of Health Sciences (DISSAL), Radiology Section, University of Genoa, Genoa, Italy
| | - Nehmat Houssami
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
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Rossi F, Zaottini F, Picasso R, Martinoli C, Tagliafico AS. Ankle and Foot Ultrasound: Reliability of Side-to-Side Comparison of Small Anatomic Structures. J Ultrasound Med 2019; 38:2143-2153. [PMID: 30592321 DOI: 10.1002/jum.14911] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/12/2018] [Accepted: 11/19/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES In sonography of clinically relevant small structures of the ankle and foot, the healthy contralateral side can be used as a reference to identify subtle abnormalities. Intrasubject side-to-side variability must be minimal. The aim of this study was to assess the reliability of side-to-side sonographic evaluation of small structures of the ankle and foot. METHODS Thirty healthy volunteers were prospectively studied. Small structures of the ankle and foot were evaluated bilaterally by 2 musculoskeletal radiologists in separate sessions. The deep peroneal nerve, superior extensor retinacula, calcaneofibular ligament, superior peroneal retinacula, tibialis posterior tendon, tibial nerve, Achilles tendon, plantaris tendon, plantar fascia, and sural nerve were considered. To assess intra- and interreader agreements, 30 (100%) examinations were repeated. A nonparametric statistic was used. RESULTS Data were not normally distributed (P > .001). Intrareader agreement was k = 0.67 (95% confidence interval, 0.57-0.78) and interreader agreement was k = 0.73 (95% confidence interval, 0.68-0.77). The mean values and standard deviation for all the structures were 0.36 ± 1.85 mm. The overall coefficient of variation was 18.5%. The intraclass correlation coefficient was 0.93 (95% confidence interval, 0.92-0.94). CONCLUSIONS In ankle and foot sonography, the healthy contralateral side can be used as a reference during a real-time musculoskeletal ultrasound evaluation of small structures.
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Affiliation(s)
- Federica Rossi
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | - Federico Zaottini
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | - Riccardo Picasso
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | - Carlo Martinoli
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
- Department of Radiology, Ospedale Policlinico San Martino, Genoa, Italy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
- Department of Radiology, Ospedale Policlinico San Martino, Genoa, Italy
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Rossi F, Valdora F, Bignotti B, Torri L, Succio G, Tagliafico AS. Evaluation of body Computed Tomography-determined sarcopenia in breast cancer patients and clinical outcomes: A systematic review. Cancer Treat Res Commun 2019; 21:100154. [PMID: 31220793 DOI: 10.1016/j.ctarc.2019.100154] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE Sarcopenia has been considered a poor prognostic factor in various malignant diseases. However, the studies that evaluated the association between CT-determined sarcopenia and outcome in breast cancer patients reported different results. Therefore, the aim of the present study is to perform a systematic review of the current literature on the evaluation of body CT-determined sarcopenia in breast cancer patients, focusing on the correlation with outcome values. METHODS Two reviewers evaluated independently all studies dealing with CT-determined sarcopenia in breast cancer women from major medical libraries up to 24 April 2019. The keywords used for database searching were: "sarcopenia" or "muscles" or "muscle weight" or "body composition" and "breast neoplasms" or "breast cancer" and "computed tomography". Studies reporting clinical outcome values were finally compared. RESULTS Of the n = 191 studies identified, a total of n = 15 articles were included in the systematic review. In all studies, sarcopenia was assessed at the level of the third lumbar vertebra (L3) on CT; n = 14/15 studies were retrospective. N = 13/15 studies evaluated the impact of sarcopenia on clinical outcomes. Among these studies, n = 8/13 studies concluded that sarcopenia is an important risk factor for poor prognosis in breast cancer and n = 5/13 studies concluded that body composition changes are not associated with poor prognosis. CONCLUSIONS Most studies concluded that sarcopenia assessed on CT is an important prognostic risk factor in breast cancer patients. High-quality prospective studies to strongly confirm and assess the impact of sarcopenia evaluated on CT and breast cancer outcome are needed.
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Affiliation(s)
- Federica Rossi
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy.
| | - Francesca Valdora
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Bianca Bignotti
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Lorenzo Torri
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Giulia Succio
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
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Tagliafico AS, Wilson D, Sconfienza LM. Encouraging MSK imaging research towards clinical impact is a necessity: opinion paper of the European Society of Musculoskeletal Radiology (ESSR). Eur Radiol 2019; 29:3410-3413. [PMID: 31062137 DOI: 10.1007/s00330-019-06218-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 01/13/2023]
Abstract
Radiology has not been spared in recent economic crises with a substantial reduction in the turnover of imaging equipment. These problems are exacerbated by increasing demand for healthcare across Europe. Therefore, using existing radiological services while rigorously following evidence-based guidelines might improve patient care. Thus, diagnostic pathways should be assessed not only for technical and diagnostic performance but also for their impact on medical and social outcome. In this paper, we report the advice of the Research Committee of ESSR on how we may guide musculoskeletal radiological research towards studies that have useful clinical impact. The ESSR Research Committee intends to encourage research with potential to influence treatment, patient outcome, and social impact. Key Points • Research in medical imaging has the potential to improve human health. • High-level studies have the potential to place radiology at the pinnacle of quality in evidence-based practice. • The ESSR Research Committee intends to encourage research with potential to influence treatment, patient outcome, and social impact.
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Affiliation(s)
- Alberto Stefano Tagliafico
- University of Genova, Via Balbi 5, 16126, Genova, GE, Italy. .,AOU IRCCS Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genova, GE, Italy.
| | - David Wilson
- St Luke's Radiology Ltd, Latimer Road, Headington, Oxford, OX3 7PF, UK
| | - Luca Maria Sconfienza
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133, Milan, Italy.,Unità Operativa di Radiologia Diagnostica ed Interventistica, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
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Gemelli C, Prada V, Fiorillo C, Fabbri S, Maggi L, Geroldi A, Gibertini S, Mandich P, Trevisan L, Fossa P, Tagliafico AS, Schenone A, Grandis M. A novel mutation in the N-terminal acting-binding domain of Filamin C protein causing a distal myofibrillar myopathy. J Neurol Sci 2019; 398:75-78. [PMID: 30685713 DOI: 10.1016/j.jns.2019.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 02/02/2023]
Abstract
Variants in Filamin C (FLNC) gene may cause either cardiomyopathies or different myopathies. We describe a family affected by a distal myopathy with autosomal dominant inheritance. The onset of the disease was in the third decade with gait impairment due to distal leg weakness. Subsequently, the disease progressed with an involvement of proximal lower limbs and hand muscles. Muscle biopsy, performed in one subject,identified relevant myofibrillar abnormalities. We performed a target gene panel testing for myofibrillar myopathies by NGS approach which identified a novel mutation in exon 3 of FLNC gene (c.A664G:p.M222V), within the N-terminal actin-binding (ABD) domain. This variant has been identified in all affected members of the family, thus supporting its pathogenic role. Differently from previously identified variants, our family showed a predominant leg involvement and myofibrillar aggregates, thus further expanding the spectrum of Filamin C related myopathies.
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Affiliation(s)
- Chiara Gemelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genova, Largo Daneo 3, 16132 Genova, Italy.
| | - Valeria Prada
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genova, Largo Daneo 3, 16132 Genova, Italy
| | - Chiara Fiorillo
- Department of Neuroscience, Paediatric Neurology and Neuromuscular Disorders, Istituto Giannina Gaslini, University of Genova, Via Gerolamo Gaslini, 5, 16147 Genova, Italy
| | - Sabrina Fabbri
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genova, Largo Daneo 3, 16132 Genova, Italy
| | - Lorenzo Maggi
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Via Celoria 11, 20133 Milano, Italy
| | - Alessandro Geroldi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genova, Largo Daneo 3, 16132 Genova, Italy
| | - Sara Gibertini
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Via Celoria 11, 20133 Milano, Italy
| | - Paola Mandich
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genova, Largo Daneo 3, 16132 Genova, Italy; Ospedale Policlinico San Martino IRCCS-Medical Genetic Unit, Largo R. Benzi 10, 16132 Genoa, Italy
| | - Lucia Trevisan
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genova, Largo Daneo 3, 16132 Genova, Italy; Ospedale Policlinico San Martino IRCCS-Medical Genetic Unit, Largo R. Benzi 10, 16132 Genoa, Italy
| | - Paola Fossa
- Department of Pharmacy, Section of Medicinal Chemistry, School of Medical and Pharmaceutical Sciences, University of Genova, Viale Benedetto XV 3, 16132 Genova, Italy
| | - Alberto Stefano Tagliafico
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore, 1-16132 Genova, Italy; Emergency Radiology, Policlinico San Martino, Largo Rosanna Benzi, 10-16132 Genova, Italy
| | - Angelo Schenone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genova, Largo Daneo 3, 16132 Genova, Italy; Ospedale Policlinico San Martino IRCCS-Neurological Unit, Largo R. Benzi 10, 16132 Genoa, Italy
| | - Marina Grandis
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal and Infantile Sciences (DINOGMI), University of Genova, Largo Daneo 3, 16132 Genova, Italy; Ospedale Policlinico San Martino IRCCS-Neurological Unit, Largo R. Benzi 10, 16132 Genoa, Italy.
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Rossi F, Valdora F, Barabino E, Calabrese M, Tagliafico AS. Muscle mass estimation on breast magnetic resonance imaging in breast cancer patients: comparison between psoas muscle area on computer tomography and pectoralis muscle area on MRI. Eur Radiol 2018; 29:494-500. [DOI: 10.1007/s00330-018-5663-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/02/2018] [Accepted: 07/13/2018] [Indexed: 01/04/2023]
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Tagliafico AS, Valdora F, Mariscotti G, Durando M, Nori J, La Forgia D, Rosenberg I, Caumo F, Gandolfo N, Houssami N, Calabrese M. An exploratory radiomics analysis on digital breast tomosynthesis in women with mammographically negative dense breasts. Breast 2018; 40:92-96. [DOI: 10.1016/j.breast.2018.04.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/12/2018] [Accepted: 04/18/2018] [Indexed: 11/16/2022] Open
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Sconfienza LM, Albano D, Allen G, Bazzocchi A, Bignotti B, Chianca V, Facal de Castro F, Drakonaki EE, Gallardo E, Gielen J, Klauser AS, Martinoli C, Mauri G, McNally E, Messina C, Mirón Mombiela R, Orlandi D, Plagou A, Posadzy M, de la Puente R, Reijnierse M, Rossi F, Rutkauskas S, Snoj Z, Vucetic J, Wilson D, Tagliafico AS. Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus. Eur Radiol 2018; 28:5338-5351. [DOI: 10.1007/s00330-018-5474-3] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/02/2018] [Accepted: 04/11/2018] [Indexed: 12/11/2022]
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Valdora F, Houssami N, Rossi F, Calabrese M, Tagliafico AS. Rapid review: radiomics and breast cancer. Breast Cancer Res Treat 2018; 169:217-229. [PMID: 29396665 DOI: 10.1007/s10549-018-4675-4] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/16/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE To perform a rapid review of the recent literature on radiomics and breast cancer (BC). METHODS A rapid review, a streamlined approach to systematically identify and summarize emerging studies was done (updated 27 September 2017). Clinical studies eligible for inclusion were those that evaluated BC using a radiomics approach and provided data on BC diagnosis (detection or characterization) or BC prognosis (response to therapy, morbidity, mortality), or provided data on technical challenges (software application: open source, repeatability of results). Descriptive statistics, results, and radiomics quality score (RQS) are presented. RESULTS N = 17 retrospective studies, all published after 2015, provided BC-related radiomics data on 3928 patients evaluated with a radiomics approach. Most studies were done for diagnosis and/or characterization (65%, 11/17) or to aid in prognosis (41%, 7/17). The mean number of radiomics features considered was 100. Mean RQS score was 11.88 ± 5.8 (maximum value 36). The RQS criteria related to validation, gold standard, potential clinical utility, cost analysis, and open science data had the lowest scores. The majority of studies n = 16/17 (94%) provided correlation with histological outcomes and staging variables or biomarkers. Only 4/17 (23%) studies provided evidence of correlation with genomic data. Magnetic resonance imaging (MRI) was used in most studies n = 14/17 (82%); however, ultrasound (US), mammography, or positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose integrated with computed tomography (18F FDG PET/CT) was also used. Much heterogeneity was found for software usage. CONCLUSIONS The study of radiomics in BC patients is a new and emerging translational research topic. Radiomics in BC is frequently done to potentially improve diagnosis and characterization, mostly using MRI. Substantial quality limitations were found; high-quality prospective and reproducible studies are needed to further potential application.
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Affiliation(s)
- Francesca Valdora
- Department of Health Sciences, University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy
| | - Nehmat Houssami
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Federica Rossi
- Department of Health Sciences, University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy
| | | | - Alberto Stefano Tagliafico
- Department of Health Sciences, University of Genova, Via L.B. Alberti 2, 16132, Genoa, Italy. .,Ospedale Policlinico San Martino IST, Genoa, Italy.
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