100 results on '"Rengo M"'
Search Results
2. Analysis of CT features and quantitative texture analysis in patients with lung adenocarcinoma: a correlation with EGFR mutations and survival rates
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Sacconi, B., Anzidei, M., Leonardi, A., Boni, F., Saba, L., Scipione, R., Anile, M., Rengo, M., Longo, F., Bezzi, M., Venuta, F., Napoli, A., Laghi, A., and Catalano, C.
- Published
- 2017
- Full Text
- View/download PDF
3. Possible role of the microbiota in urinary stones: A prospective study to correlate radiological density (Hounsfield Units) and cultural examination of urinary calculi
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Pastore, A.L., primary, Al Salhi, Y., additional, Fuschi, A., additional, Martoccia, A., additional, Scalzo, S., additional, Suraci, P.P., additional, Rera, O.A., additional, Valenzi, F.M., additional, Maceroni, M.M., additional, Rengo, M., additional, Antonioni, A., additional, and Carbone, A., additional
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- 2022
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4. Possible role of the microbiota in urinary stones: a prospective study to correlate radiological density (hounsfield units) and cultural examination of the urinary calculi
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Pastore, A.L., primary, Fuschi, A., additional, Al Salhi, Y., additional, Martoccia, A., additional, Capone, L., additional, Suraci, P.P., additional, Scalzo, S., additional, Valenzi, F.M., additional, Rera, O.A., additional, Antonioni, A., additional, Rengo, M., additional, Maceroni, M.M., additional, and Carbone, A., additional
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- 2021
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5. Radiogenomics in clear cell renal cell carcinoma: Correlations between advanced CT imaging (texture analysis) and microRNAs expression
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Pastore, A.L., primary, Al Salhi, Y., additional, Fuschi, A., additional, Suraci, P.P., additional, Velotti, G., additional, Capone, L., additional, Rengo, M., additional, Caruso, D., additional, Laghi, A., additional, Fazi, F., additional, Petrozza, V., additional, and Carbone, A., additional
- Published
- 2020
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6. 25th International Congress of the European Association for Endoscopic Surgery (EAES) Frankfurt, Germany, 14–17 June 2017
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Boru, Eugeniu Cristian, Iossa, A., Rengo, M., Guida, A., Termine, P., and Silecchia, G.
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MDCT scan ,HSA ,Surgery ,GERD ,intraoperative measurement - Published
- 2017
7. MR-based artificial intelligence model to assess response to therapy in locally advanced rectal cancer
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Ferrari, R., primary, Mancini-Terracciano, C., additional, Voena, C., additional, Rengo, M., additional, Zerunian, M., additional, Ciardiello, A., additional, Grasso, S., additional, Mare’, V., additional, Paramatti, R., additional, Russomando, A., additional, Santacesaria, R., additional, Satta, A., additional, Solfaroli Camillocci, E., additional, Faccini, R., additional, and Laghi, A., additional
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- 2019
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8. SC243 - Possible role of the microbiota in urinary stones: a prospective study to correlate radiological density (hounsfield units) and cultural examination of the urinary calculi
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Pastore, A.L., Fuschi, A., Al Salhi, Y., Martoccia, A., Capone, L., Suraci, P.P., Scalzo, S., Valenzi, F.M., Rera, O.A., Antonioni, A., Rengo, M., Maceroni, M.M., and Carbone, A.
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- 2021
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9. Prevalence and distribution of colonic diverticula assessed with CT colonography (CTC)
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De Cecco, C, Ciolina, M, Annibale, B, Rengo, M, Bellini, D, Muscogiuri, G, Maruotti, A, Saba, L, Iafrate, F, Laghi, A, De Cecco C. N., Ciolina M., Annibale B., Rengo M., Bellini D., Muscogiuri G., Maruotti A., Saba L., Iafrate F., Laghi A., De Cecco, C, Ciolina, M, Annibale, B, Rengo, M, Bellini, D, Muscogiuri, G, Maruotti, A, Saba, L, Iafrate, F, Laghi, A, De Cecco C. N., Ciolina M., Annibale B., Rengo M., Bellini D., Muscogiuri G., Maruotti A., Saba L., Iafrate F., and Laghi A.
- Abstract
Objectives: This study aimed to evaluate the prevalence of colonic diverticula according to age, gender, distribution, disease extension and symptoms with CT colonography (CTC). Methods: The study population included 1091 consecutive patients who underwent CTC. Patients with diverticula were retrospectively stratified according to age, gender, clinical symptoms and colonic segment involvement. Extension of colonic diverticula was evaluated using a three-point quantitative scale. Using this data, a multivariate regression analysis was applied to investigate the existence of any correlation among variables. Results: Colonic diverticula were observed in 561 patients (240 men, mean age 68 ± 12 years). Symptomatic uncomplicated diverticular disease (SUDD) was present in 47.4 % of cases. In 25.6 % of patients ≤40 years, at least one diverticulum in the colon was observed. Prevalence of right-sided diverticula in patients >60 years was 14.2 % in caecum and 18.5 % in ascending colon. No significant difference was found between symptomatic and asymptomatic patients regarding diverticula prevalence and extension. No correlation was present between diverticula extension and symptoms. Conclusion: The incidence of colonic diverticula appears to be greater than expected. Right colon diverticula do not appear to be an uncommon finding, with their prevalence increasing with patient age. SUDD does not seem to be related to diverticula distribution and extension. Key Points: • Incidence of colonic diverticula appears to be greater than expected. • Right colon diverticula do not appear to be an uncommon finding. • SUDD does not seem to be related to diverticula distribution and extension.
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- 2015
10. Diseases of the upper gastrointestinal tract and small bowel
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Bellini, D., De Cecco, C. N., De Santis, D., Rengo, M., Morris, J., and Laghi, A.
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magnetic resonance ,small bowel ,computed tomography ,upper gastrointestinal tract - Published
- 2017
11. Diffusion-weighted magnetic resonance imaging in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy
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De Felice, F., primary, Magnante, A.L., additional, Musio, D., additional, Ciolina, M., additional, De Cecco, C.N., additional, Rengo, M., additional, Laghi, A., additional, and Tombolini, V., additional
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- 2017
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12. Computed tomography segmental calcium score (SCS) to predict stenosis severity of calcified coronary lesions
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Pugliese, F. (Francesca), Hunink, M.G.M. (Myriam), Meijboom, W.B. (Willem Bob), Gruszczynsnka, K. (Katarzyna), Rengo, M., Zou, L. (Lu), Baron, I. (Ian), Dijkshoorn, M.L. (Marcel), Krestin, G.P. (Gabriel), Feyter, P.J. (Pim) de, Pugliese, F. (Francesca), Hunink, M.G.M. (Myriam), Meijboom, W.B. (Willem Bob), Gruszczynsnka, K. (Katarzyna), Rengo, M., Zou, L. (Lu), Baron, I. (Ian), Dijkshoorn, M.L. (Marcel), Krestin, G.P. (Gabriel), and Feyter, P.J. (Pim) de
- Abstract
To estimate the probability of ≥50 % coronary stenoses based on computed tomography (CT) segmental calcium score (SCS) and clinical factors. The Institutional Review Board approved the study. A training sample of 201 patients underwent CT calcium scoring and conventional coronary angiography (CCA). All patients consented to undergo CT before CCA after being informed of the additional radiation dose. SCS and calcification morphology were assessed in individual coronary segments. We explored the predictive value of patient’s symptoms, clinical history, SCS and calcification morphology. We developed a prediction model in the training sample based on these variables then tested it in an independent test sample. The odds ratio (OR) for ≥50 % coronary stenosis was 1.8-fold greater (p = 0.006) in patients with typical chest pain, twofold (p = 0.014) greater in patients with acute coronary syndromes, twofold greater (p < 0.001) in patients with prior myocardial infarction. Spotty calcifications had an OR for ≥50 % stenosis 2.3-fold (p < 0.001) greater than the absence of calcifications, wide calcifications 2.7-fold (p < 0.001) greater, diffuse calcifications 4.6-fold (p < 0.001) greater. In middle segments, each unit of SCS had an OR 1.2-fold (p < 0.001) greater than in distal segments; in proximal segments the OR was 1.1-fold greater (p = 0.021). The ROC curve area of the prediction model was 0.795 (0.95 confidence interval 0.602–0.843). Validation in a test sample of 201 independent patients showed consistent diagnostic performance. In conjunction with calcification morphology, anatomical location, patient’s symptoms and clinical history, SCS can be helpful to estimate the probability of ≥50 % coronary stenosis.
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- 2015
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13. Computed tomography segmental calcium score (SCS) to predict stenosis severity of calcified coronary lesions
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Pugliese, F, Hunink, Myriam, Meijboom, Bob, Gruszczynsnka, K, Rengo, M, Zou, L, Baron, I, Dijkshoorn, Marcel, Krestin, Gabriel, Feijter, Pim, Pugliese, F, Hunink, Myriam, Meijboom, Bob, Gruszczynsnka, K, Rengo, M, Zou, L, Baron, I, Dijkshoorn, Marcel, Krestin, Gabriel, and Feijter, Pim
- Abstract
To estimate the probability of a parts per thousand yen50 % coronary stenoses based on computed tomography (CT) segmental calcium score (SCS) and clinical factors. The Institutional Review Board approved the study. A training sample of 201 patients underwent CT calcium scoring and conventional coronary angiography (CCA). All patients consented to undergo CT before CCA after being informed of the additional radiation dose. SCS and calcification morphology were assessed in individual coronary segments. We explored the predictive value of patient's symptoms, clinical history, SCS and calcification morphology. We developed a prediction model in the training sample based on these variables then tested it in an independent test sample. The odds ratio (OR) for a parts per thousand yen50 % coronary stenosis was 1.8-fold greater (p = 0.006) in patients with typical chest pain, twofold (p = 0.014) greater in patients with acute coronary syndromes, twofold greater (p < 0.001) in patients with prior myocardial infarction. Spotty calcifications had an OR for a parts per thousand yen50 % stenosis 2.3-fold (p < 0.001) greater than the absence of calcifications, wide calcifications 2.7-fold (p < 0.001) greater, diffuse calcifications 4.6-fold (p < 0.001) greater. In middle segments, each unit of SCS had an OR 1.2-fold (p < 0.001) greater than in distal segments; in proximal segments the OR was 1.1-fold greater (p = 0.021). The ROC curve area of the prediction model was 0.795 (0.95 confidence interval 0.602-0.843). Validation in a test sample of 201 independent patients showed consistent diagnostic performance. In conjunction with calcification morphology, anatomical location, patient's symptoms and clinical history, SCS can be helpful to estimate the probability of a parts per thousand yen50 % coronary stenosis.
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- 2015
14. Aneurysm of Vieussens' arterial ring in a patient studied with coronary computed tomography
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De Cecco, C, Rengo, M, Muscogiuri, G, Caruso, D, Bellini, D, Laghi, A, De Cecco, Carlo N, Rengo, Marco, Muscogiuri, Giuseppe, Caruso, Damiano, Bellini, Davide, Laghi, Andrea, De Cecco, C, Rengo, M, Muscogiuri, G, Caruso, D, Bellini, D, Laghi, A, De Cecco, Carlo N, Rengo, Marco, Muscogiuri, Giuseppe, Caruso, Damiano, Bellini, Davide, and Laghi, Andrea
- Abstract
We present the case of Vieussens' arterial ring aneurysm in a patient who underwent coronary computed tomography. Vieussens' arterial ring is a remnant of the embryonic conotruncal circle. Only four cases of aneurysmare described in literature. This is the first reported case in which a dilated Vieussens' arterial ring is observedwithout coronary stenosis.
- Published
- 2015
15. A0103 - Investigating the role of the prostate multiparametric magnetic resonance imaging sequences quality on biopsies' outcomes.
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Pastore, A.L., Rengo, M., Suraci, P.P., Fuschi, A., Al Salhi, Y., Martoccia, A., Scalzo, S., Rera, O.A., Valenzi, F.M., Antonioni, A., Sequi, M.B., Graziani, D., Sciarra, A., Del Giudice, F., Leonardo, C., Franco, G., De Nunzio, C., Tubaro, A., Capodiferro, P., and Carbone, A.
- Subjects
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MAGNETIC resonance imaging , *PROSTATE , *PROSTATE cancer , *BIOPSY - Published
- 2023
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16. Structured reporting of rectal cancer staging and restaging: A consensus proposal
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Andrea Laghi, Roberto Rizzati, Alfonso Reginelli, Roberta Fusco, Rita Golfieri, Emanuele Neri, Marco Rengo, Lorenzo Faggioni, Roberto Grassi, Vincenza Granata, Vittorio Miele, Gabriele Masselli, Damiano Caruso, Silvia Pradella, Salvatore Cappabianca, Daniele Regge, Giuseppe Lo Re, Francesca Coppola, Granata, V., Caruso, D., Grassi, R., Cappabianca, S., Reginelli, A., Rizzati, R., Masselli, G., Golfieri, R., Rengo, M., Regge, D., Re, G. L., Pradella, S., Fusco, R., Faggioni, L., Laghi, A., Miele, V., Neri, E., Coppola, F., Granata V., Caruso D., Grassi R., Cappabianca S., Reginelli A., Rizzati R., Masselli G., Golfieri R., Rengo M., Regge D., Re G.L., Pradella S., Fusco R., Faggioni L., Laghi A., Miele V., Neri E., and Coppola F.
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re-staging ,Cancer Research ,medicine.medical_specialty ,Staging ,Colorectal cancer ,Intraclass correlation ,Modified delphi ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Re‐staging ,0302 clinical medicine ,Magnetic resonance imaging ,magnetic resonance imaging ,rectal cancer ,re‐staging ,staging ,structured reporting ,Cronbach's alpha ,Structured reporting ,Internal consistency ,medicine ,Medical physics ,Rectal cancer ,RC254-282 ,Final version ,medicine.diagnostic_test ,business.industry ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Interventional radiology ,medicine.disease ,Oncology ,030220 oncology & carcinogenesis ,business - Abstract
Background: Structured reporting (SR) in oncologic imaging is becoming necessary and has recently been recognized by major scientific societies. The aim of this study was to build MRI-based structured reports for rectal cancer (RC) staging and restaging in order to provide clinicians all critical tumor information. Materials and Methods: A panel of radiologist experts in abdominal imaging, called the members of the Italian Society of Medical and Interventional Radiology, was established. The modified Delphi process was used to build the SR and to assess the level of agreement in all sections. The Cronbach’s alpha (Cα) correlation coefficient was used to assess the internal consistency of each section and to measure the quality analysis according to the average inter-item correlation. The intraclass correlation coefficient (ICC) was also evaluated. Results: After the second Delphi round of the SR RC staging, the panelists’ single scores and sum of scores were 3.8 (range 2–4) and 169, and the SR RC restaging panelists’ single scores and sum of scores were 3.7 (range 2–4) and 148, respectively. The Cα correlation coefficient was 0.79 for SR staging and 0.81 for SR restaging. The ICCs for the SR RC staging and restaging were 0.78 (p <, 0.01) and 0.82 (p <, 0.01), respectively. The final SR version was built and included 53 items for RC staging and 50 items for RC restaging. Conclusions: The final version of the structured reports of MRI-based RC staging and restaging should be a helpful and promising tool for clinicians in managing cancer patients properly. Structured reports collect all Patient Clinical Data, Clinical Evaluations and relevant key findings of Rectal Cancer, both in staging and restaging, and can facilitate clinical decision-making.
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- 2021
17. Structured reporting of computed tomography in the staging of colon cancer: a Delphi consensus proposal
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Salvatore Cappabianca, Francesco Bellifemine, Emanuele Neri, Vincenza Granata, Lorenzo Faggioni, Barbara Frittoli, Giulia Grazzini, Vittorio Miele, Giorgia Viola Lacasella, Daniela Rega, Alfonso Reginelli, Roberta Fusco, Roberto Prost, Nicola Maggialetti, Chandra Bortolotto, Francesca Coppola, Eleonora Ciaghi, Marco Rengo, Massimo De Filippo, Duccio Buccicardi, Luca Brunese, Federica De Muzio, Roberto Grassi, Roberta Grassi, Marco Montella, Andrea Laghi, Granata, V., Faggioni, L., Grassi, R., Fusco, R., Reginelli, A., Rega, D., Maggialetti, N., Buccicardi, D., Frittoli, B., Rengo, M., Bortolotto, C., Prost, R., Lacasella, G. V., Montella, M., Ciaghi, E., Bellifemine, F., De Muzio, F., Grazzini, G., De Filippo, M., Cappabianca, S., Laghi, A., Brunese, L., Neri, E., Miele, V., and Coppola, F.
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Structured report ,Research Report ,medicine.medical_specialty ,Consensus ,Correlation coefficient ,Delphi Technique ,Colon ,Context (language use) ,Standard deviation ,Cronbach's alpha ,Structured reporting ,Radiologists ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Computed tomography ,Tomography ,computer.programming_language ,Abdominal Radiology ,Neoplasm Staging ,Protocol (science) ,business.industry ,General Medicine ,colon cancer ,computed tomography ,radiology report ,structured report ,Colon cancer ,Radiology report ,Colonic Neoplasms ,Tomography, X-Ray Computed ,X-Ray Computed ,Data quality ,business ,computer ,Delphi - Abstract
Background Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports in colon cancer during the staging phase in order to improve communication between the radiologist, members of multidisciplinary teams and patients. Materials and methods A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. Cronbach’s alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. Results The final SR version was built by including n = 18 items in the “Patient Clinical Data” section, n = 7 items in the “Clinical Evaluation” section, n = 9 items in the “Imaging Protocol” section and n = 29 items in the “Report” section. Overall, 63 items were included in the final version of the SR. Both in the first and second round, all sections received a higher than good rating: a mean value of 4.6 and range 3.6–4.9 in the first round; a mean value of 5.0 and range 4.9–5 in the second round. In the first round, Cronbach’s alpha (Cα) correlation coefficient was a questionable 0.61. In the first round, the overall mean score of the experts and the sum of scores for the structured report were 4.6 (range 1–5) and 1111 (mean value 74.07, STD 4.85), respectively. In the second round, Cronbach’s alpha (Cα) correlation coefficient was an acceptable 0.70. In the second round, the overall mean score of the experts and the sum of score for structured report were 4.9 (range 4–5) and 1108 (mean value 79.14, STD 1.83), respectively. The overall mean score obtained by the experts in the second round was higher than the overall mean score of the first round, with a lower standard deviation value to underline greater agreement among the experts for the structured report reached in this round. Conclusions A wide implementation of SR is of critical importance in order to offer referring physicians and patients optimum quality of service and to provide researchers with the best quality data in the context of big data exploitation of available clinical data. Implementation is a complex procedure, requiring mature technology to successfully address the multiple challenges of user-friendliness, organization and interoperability.
- Published
- 2022
18. Structured reporting of computed tomography and magnetic resonance in the staging of pancreatic adenocarcinoma: A delphi consensus proposal
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Mirko D'Onofrio, Nicola Maggialetti, Salvatore Cappabianca, Lorenzo Faggioni, Giulia Grazzini, Federica De Muzio, Alfonso Reginelli, Roberto Grassi, Francesca Coppola, Ginevra Danti, Eleonora Ciaghi, Francesca Grassi, Marco Montella, Carmelo Barresi, Roberta Fusco, Duccio Buccicardi, Vincenza Granata, Fabrizio Urraro, Giovanni Morana, Marco Rengo, Emanuele Neri, Chandra Bortolotto, Vittorio Miele, Francesco Bellifemine, Giorgia Viola La Casella, Antonio Barile, Luca Brunese, Granata, V., Morana, G., D'Onofrio, M., Fusco, R., Coppola, F., Grassi, F., Cappabianca, S., Reginelli, A., Maggialetti, N., Buccicardi, D., Barile, A., Rengo, M., Bortolotto, C., Urraro, F., La Casella, G. V., Montella, M., Ciaghi, E., Bellifemine, F., De Muzio, F., Danti, G., Grazzini, G., Barresi, C., Brunese, L., Neri, E., Grassi, R., Miele, V., and Faggioni, L.
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Structured report ,Medicine (General) ,medicine.medical_specialty ,radiology report ,structured report ,pancreatic adenocarcinoma ,computed tomography ,magnetic resonance imaging ,Correlation coefficient ,Clinical Biochemistry ,Section (typography) ,Article ,R5-920 ,Magnetic resonance imaging ,Cronbach's alpha ,Structured reporting ,medicine ,Medical physics ,Computed tomography ,computer.programming_language ,Protocol (science) ,medicine.diagnostic_test ,Interventional radiology ,Radiology report ,Pancreatic adenocarcinoma ,Psychology ,computer ,Delphi - Abstract
Background: Structured reporting (SR) in radiology has been recognized recently by major scientific societies. This study aims to build structured computed tomography (CT) and magnetic resonance (MR)-based reports in pancreatic adenocarcinoma during the staging phase in order to improve communication between the radiologist and members of multidisciplinary teams. Materials and Methods: A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A modified Delphi process was used to develop the CT-SR and MRI-SR, assessing a level of agreement for all report sections. Cronbach’s alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. Results: The final CT-SR version was built by including n = 16 items in the “Patient Clinical Data” section, n = 11 items in the “Clinical Evaluation” section, n = 7 items in the “Imaging Protocol” section, and n = 18 items in the “Report” section. Overall, 52 items were included in the final version of the CT-SR. The final MRI-SR version was built by including n = 16 items in the “Patient Clinical Data” section, n = 11 items in the “Clinical Evaluation” section, n = 8 items in the “Imaging Protocol” section, and n = 14 items in the “Report” section. Overall, 49 items were included in the final version of the MRI-SR. In the first round for CT-SR, all sections received more than a good rating. The overall mean score of the experts was 4.85. The Cα correlation coefficient was 0.85. In the second round, the overall mean score of the experts was 4.87, and the Cα correlation coefficient was 0.94. In the first round, for MRI-SR, all sections received more than a good rating. The overall mean score of the experts was 4.73. The Cα correlation coefficient was 0.82. In the second round, the overall mean score of the experts was 4.91, and the Cα correlation coefficient was 0.93. Conclusions: The CT-SR and MRI-SR are based on a multi-round consensus-building Delphi exercise derived from the multidisciplinary agreement of expert radiologists in order to obtain more appropriate communication tools for referring physicians.
- Published
- 2021
19. Small and Large Bile Ducts Intrahepatic Cholangiocarcinoma Classification: A Preliminary Feature-Based Study
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Riccardo Muglia, Silvia Conforto, Ezio Lanza, Guido Carpino, Gaetano Giunta, Ana Lleo, Marco Rengo, Andrea Laghi, Maurizio Schmid, Vincenzo Cardinale, Chiara Losquadro, Guido Torzilli, Losquadro, C., Conforto, S., Schmid, M., Giunta, G., Rengo, M., Cardinale, V., Carpino, G., Laghi, A., Lleo, A., Muglia, R., Lanza, E., and Torzilli, G.
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medicine.medical_specialty ,medicine.diagnostic_test ,Bile duct ,business.industry ,Computed Tomography (CT) image ,Computed tomography ,Classification ,Malignancy ,medicine.disease ,medicine.anatomical_structure ,Radiomics ,Volumetric CT ,Cholangiocarcinoma (CCA) ,medicine ,Feature based ,Feature extraction ,Radiology ,business ,Intrahepatic Cholangiocarcinoma - Abstract
Cholangiocarcinoma (CCA) is the second most common liver malignancy and the incidence and mortality rates of this disease are worldwide increasing. This paper deals with the problem of Intrahepatic Cholangiocarcinoma (IH-CCA) classification using Computed Tomography (CT) images. Precisely, a radiomics-based approach is proposed by exploiting abdominal volumetric CT data in order to differentiate large bile duct from small bile duct IH-CCA. The developed method relies on the investigation of intrinsic discriminative properties of CT scans according to feature selection methods. The effectiveness of the proposed method is proved by enrolling in the study a total of 26 patients, including 16 patients with large bile duct and 10 with small bile duct pathological disease, respectively. The conducted tests have shown that our approach is a baseline to provide an efficient classification process with a low computational cost in order to facilitate clinical decision-making procedures.
- Published
- 2021
20. CT texture-based radiomics analysis of carotid arteries identifies vulnerable patients: a preliminary outcome study
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Alessandro Napoli, Iacopo Carbone, Andrea Laghi, Fulvio Zaccagna, Leonardo Rundo, Marcello Arca, Ashley M. Groves, Marco Rengo, Balaji Ganeshan, Leon Menezes, Zaccagna F., Ganeshan B., Arca M., Rengo M., Napoli A., Rundo L., Groves A.M., Laghi A., Carbone I., Menezes L.J., Zaccagna, Fulvio [0000-0001-6838-9532], and Apollo - University of Cambridge Repository
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Carotid Arterie ,Pilot Projects ,Asymptomatic ,atherosclerosis ,carotid artery ,computed tomography angiography ,CTA ,risk stratification ,texture analysis ,Standard deviation ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Outcome Assessment, Health Care ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Pilot Project ,Stroke ,Texture analysi ,Risk stratification ,Computed tomography angiography ,Neuroradiology ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Atherosclerosis ,Stenosis ,Carotid Arteries ,Texture analysis ,Skewness ,Case-Control Studies ,Atherosclerosi ,Kurtosis ,Neurology (clinical) ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business ,Case-Control Studie ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery ,Carotid artery ,Human - Abstract
PURPOSE: To assess the potential role of computed tomography (CT) texture analysis (CTTA) in identifying vulnerable patients with carotid artery atherosclerosis. METHODS: In this case-control pilot study, 12 patients with carotid atherosclerosis and a subsequent history of transient ischemic attack or stroke were age and sex matched with 12 control cases with asymptomatic carotid atherosclerosis (follow-up time 103.58 ± 9.2 months). CTTA was performed using a commercially available research software package (TexRAD) by an operator blinded to clinical data. CTTA comprised a filtration-histogram technique to extract features at different scales corresponding to spatial scale filter (fine = 2 mm, medium = 3 mm, coarse = 4 mm), followed by quantification using histogram-based statistical parameters: mean, kurtosis, skewness, entropy, standard deviation, and mean value of positive pixels. A single axial slice was selected to best represent the largest cross-section of the carotid bifurcation or the greatest degree of stenosis, in presence of an atherosclerotic plaque, on each side. RESULTS: CTTA revealed a statistically significant difference in skewness between symptomatic and asymptomatic patients at the medium (0.22 ± 0.35 vs - 0.18 ± 0.39, p < 0.001) and coarse (0.23 ± 0.22 vs 0.03 ± 0.29, p = 0.003) texture scales. At the fine-texture scale, skewness (0.20 ± 0.59 vs - 0.18 ± 0.58, p = 0.009) and standard deviation (366.11 ± 117.19 vs 300.37 ± 82.51, p = 0.03) were significant before correction. CONCLUSION: Our pilot study highlights the potential of CTTA to identify vulnerable patients in stroke and TIA. CT texture may have the potential to act as a novel risk stratification tool in patients with carotid atherosclerosis.
- Published
- 2021
21. Structured Reporting of Computed Tomography in the Staging of Neuroendocrine Neoplasms: A Delphi Consensus Proposal
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Vincenza Granata, Francesca Coppola, Roberta Grassi, Roberta Fusco, Salvatore Tafuto, Francesco Izzo, Alfonso Reginelli, Nicola Maggialetti, Duccio Buccicardi, Barbara Frittoli, Marco Rengo, Chandra Bortolotto, Roberto Prost, Giorgia Viola Lacasella, Marco Montella, Eleonora Ciaghi, Francesco Bellifemine, Federica De Muzio, Ginevra Danti, Giulia Grazzini, Massimo De Filippo, Salvatore Cappabianca, Carmelo Barresi, Franco Iafrate, Luca Pio Stoppino, Andrea Laghi, Roberto Grassi, Luca Brunese, Emanuele Neri, Vittorio Miele, Lorenzo Faggioni, Granata, V., Coppola, F., Grassi, R., Fusco, R., Tafuto, S., Izzo, F., Reginelli, A., Maggialetti, N., Buccicardi, D., Frittoli, B., Rengo, M., Bortolotto, C., Prost, R., Lacasella, G. V., Montella, M., Ciaghi, E., Bellifemine, F., De Muzio, F., Danti, G., Grazzini, G., De Filippo, M., Cappabianca, S., Barresi, C., Iafrate, F., Stoppino, L. P., Laghi, A., Brunese, L., Neri, E., Miele, V., and Faggioni, L.
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Adult ,medicine.medical_specialty ,Consensus ,Delphi Technique ,Correlation coefficient ,Endocrinology, Diabetes and Metabolism ,Computed tomography ,computed tomography ,neuroendocrine neoplasm ,radiology report ,staging ,structured report ,Humans ,Neoplasm Staging ,Neuroendocrine Tumors ,Tomography, X-Ray Computed ,Diseases of the endocrine glands. Clinical endocrinology ,Standard deviation ,Endocrinology ,Cronbach's alpha ,Structured reporting ,Medicine ,Medical physics ,Tomography ,Original Research ,computer.programming_language ,Protocol (science) ,medicine.diagnostic_test ,business.industry ,Interventional radiology ,RC648-665 ,X-Ray Computed ,business ,computer ,Delphi - Abstract
BackgroundStructured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports in Neuroendocrine Neoplasms during the staging phase in order to improve communication between the radiologist and members of multidisciplinary teams.Materials and MethodsA panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A Modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. Cronbach’s alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation.ResultsThe final SR version was built by including n=16 items in the “Patient Clinical Data” section, n=13 items in the “Clinical Evaluation” section, n=8 items in the “Imaging Protocol” section, and n=17 items in the “Report” section. Overall, 54 items were included in the final version of the SR. Both in the first and second round, all sections received more than a good rating: a mean value of 4.7 and range of 4.2-5.0 in the first round and a mean value 4.9 and range of 4.9-5 in the second round. In the first round, the Cα correlation coefficient was a poor 0.57: the overall mean score of the experts and the sum of scores for the structured report were 4.7 (range 1-5) and 728 (mean value 52.00 and standard deviation 2.83), respectively. In the second round, the Cα correlation coefficient was a good 0.82: the overall mean score of the experts and the sum of scores for the structured report were 4.9 (range 4-5) and 760 (mean value 54.29 and standard deviation 1.64), respectively.ConclusionsThe present SR, based on a multi-round consensus-building Delphi exercise following in-depth discussion between expert radiologists in gastro-enteric and oncological imaging, derived from a multidisciplinary agreement between a radiologist, medical oncologist and surgeon in order to obtain the most appropriate communication tool for referring physicians.
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- 2021
22. Computed tomography structured reporting in the staging of lymphoma: A delphi consensus proposal
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Diletta Cozzi, Marco Montella, Marco Rengo, Eleonora Ciaghi, Roberta Fusco, Chandra Bortolotto, Nicola Maggialetti, Salvatore Cappabianca, Carmelo Barresi, Vittorio Miele, Roberto Grassi, Duccio Buccicardi, Massimo De Filippo, Roberta Grassi, Giorgia Viola Lacasella, Lorenzo Faggioni, Francesco Bellifemine, Francesca Coppola, Silvia Pradella, Emanuele Neri, Vincenza Granata, Luca Brunese, Roberto Prost, Granata, V., Pradella, S., Cozzi, D., Fusco, R., Faggioni, L., Coppola, F., Grassi, R., Maggialetti, N., Buccicardi, D., Lacasella, G. V., Montella, M., Ciaghi, E., Bellifemine, F., De Filippo, M., Rengo, M., Bortolotto, C., Prost, R., Barresi, C., Cappabianca, S., Brunese, L., Neri, E., and Miele, V.
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Structured report ,medicine.medical_specialty ,Correlation coefficient ,Lymphoma ,Computed tomography ,Free text report ,Radiology report ,Article ,Standard deviation ,Cronbach's alpha ,medicine ,Medical physics ,computer.programming_language ,Protocol (science) ,medicine.diagnostic_test ,business.industry ,Medical findings ,Interventional radiology ,General Medicine ,Clinical trial ,Medicine ,business ,computer ,Delphi - Abstract
Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports for lymphoma patients during the staging phase to improve communication between radiologists, members of multidisciplinary teams, and patients. A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology (SIRM), was established. A modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. The Cronbach’s alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. The final SR version was divided into four sections: (a) Patient Clinical Data, (b) Clinical Evaluation, (c) Imaging Protocol, and (d) Report, including n = 13 items in the “Patient Clinical Data” section, n = 8 items in the “Clinical Evaluation” section, n = 9 items in the “Imaging Protocol” section, and n = 32 items in the “Report” section. Overall, 62 items were included in the final version of the SR. A dedicated section of significant images was added as part of the report. In the first Delphi round, all sections received more than a good rating (≥3). The overall mean score of the experts and the sum of score for structured report were 4.4 (range 1–5) and 1524 (mean value of 101.6 and standard deviation of 11.8). The Cα correlation coefficient was 0.89 in the first round. In the second Delphi round, all sections received more than an excellent rating (≥4). The overall mean score of the experts and the sum of scores for structured report were 4.9 (range 3–5) and 1694 (mean value of 112.9 and standard deviation of 4.0). The Cα correlation coefficient was 0.87 in this round. The highest overall means value, highest sum of scores of the panelists, and smallest standard deviation values of the evaluations in this round reflect the increase of the internal consistency and agreement among experts in the second round compared to first round. The accurate statement of imaging data given to referring physicians is critical for patient care, the information contained affects both the decision-making process and the subsequent treatment. The radiology report is the most important source of clinical imaging information. It conveys critical information about the patient’s health and the radiologist’s interpretation of medical findings. It also communicates information to the referring physicians and records this information for future clinical and research use. The present SR was generated based on a multi-round consensus-building Delphi exercise and uses standardized terminology and structures, in order to adhere to diagnostic/therapeutic recommendations and facilitate enrolment in clinical trials, to reduce any ambiguity that may arise from non-conventional language, and to enable better communication between radiologists and clinicians.
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- 2021
23. A0041 - Possible role of the microbiota in urinary stones: A prospective study to correlate radiological density (Hounsfield Units) and cultural examination of urinary calculi.
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Pastore, A.L., Al Salhi, Y., Fuschi, A., Martoccia, A., Scalzo, S., Suraci, P.P., Rera, O.A., Valenzi, F.M., Maceroni, M.M., Rengo, M., Antonioni, A., and Carbone, A.
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- *
URINARY calculi , *LONGITUDINAL method , *DENSITY - Published
- 2022
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24. Prevalence and distribution of colonic diverticula assessed with CT colonography (CTC)
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Davide Bellini, Maria Ciolina, Andrea Laghi, Bruno Annibale, Luca Saba, Carlo N. De Cecco, Franco Iafrate, Giuseppe Muscogiuri, Antonello Maruotti, Marco Rengo, De Cecco, C, Ciolina, M, Annibale, B, Rengo, M, Bellini, D, Muscogiuri, G, Maruotti, A, Saba, L, Iafrate, F, and Laghi, A
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Male ,Abdominal pain ,Contrast Media ,Gastroenterology ,0302 clinical medicine ,CT colonography ,Prevalence ,Cecal Diseases ,Neuroradiology ,Aged, 80 and over ,Diverticulosi ,Incidence ,Age Factors ,Sigmoid colon ,General Medicine ,Middle Aged ,Diverticulosis ,Colon, Descending ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Diverticular disease ,Female ,030211 gastroenterology & hepatology ,Radiology ,medicine.symptom ,Colonography, Computed Tomographic ,Colon, Transverse ,medicine.medical_specialty ,Colon ,Diverticulum, Colon ,digestive system ,Descending colon ,Colon, Ascending ,03 medical and health sciences ,Sex Factors ,Colon, Sigmoid ,Internal medicine ,Multidetector Computed Tomography ,medicine ,Humans ,Ascending colon ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,business.industry ,Retrospective cohort study ,medicine.disease ,digestive system diseases ,Asymptomatic Diseases ,abdominal pain ,colon ,diverticular disease ,diverticulosis ,radiology, nuclear medicine and imaging ,business - Abstract
Objectives: This study aimed to evaluate the prevalence of colonic diverticula according to age, gender, distribution, disease extension and symptoms with CT colonography (CTC). Methods: The study population included 1091 consecutive patients who underwent CTC. Patients with diverticula were retrospectively stratified according to age, gender, clinical symptoms and colonic segment involvement. Extension of colonic diverticula was evaluated using a three-point quantitative scale. Using this data, a multivariate regression analysis was applied to investigate the existence of any correlation among variables. Results: Colonic diverticula were observed in 561 patients (240 men, mean age 68 ± 12 years). Symptomatic uncomplicated diverticular disease (SUDD) was present in 47.4 % of cases. In 25.6 % of patients ≤40 years, at least one diverticulum in the colon was observed. Prevalence of right-sided diverticula in patients >60 years was 14.2 % in caecum and 18.5 % in ascending colon. No significant difference was found between symptomatic and asymptomatic patients regarding diverticula prevalence and extension. No correlation was present between diverticula extension and symptoms. Conclusion: The incidence of colonic diverticula appears to be greater than expected. Right colon diverticula do not appear to be an uncommon finding, with their prevalence increasing with patient age. SUDD does not seem to be related to diverticula distribution and extension. Key Points: • Incidence of colonic diverticula appears to be greater than expected. • Right colon diverticula do not appear to be an uncommon finding. • SUDD does not seem to be related to diverticula distribution and extension.
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- 2015
25. Aneurysm of Vieussens’ arterial ring in a patient studied with coronary computed tomography
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Davide Bellini, Giuseppe Muscogiuri, Andrea Laghi, Marco Rengo, Carlo N. De Cecco, Damiano Caruso, De Cecco, C, Rengo, M, Muscogiuri, G, Caruso, D, Bellini, D, and Laghi, A
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Male ,medicine.medical_specialty ,Computed Tomography Angiography ,coronary arterie ,Coronary Vessel Anomalies ,Coronary Vessel Anomaly ,Coronary stenosis ,030204 cardiovascular system & hematology ,Ring (chemistry) ,coronary computed tomography ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine ,Humans ,business.industry ,Vieussens' arterial ring ,aneurysm ,coronary arteries ,Vieussens’ arterial ring ,coronary vessel anomalies ,humans ,male ,middle aged ,tomography, x-ray computed ,Coronary Aneurysm ,General Medicine ,Middle Aged ,Coronary computed tomography ,medicine.disease ,Tomography x ray computed ,Radiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business - Abstract
We present the case of Vieussens' arterial ring aneurysm in a patient who underwent coronary computed tomography. Vieussens' arterial ring is a remnant of the embryonic conotruncal circle. Only four cases of aneurysm are described in literature. This is the first reported case in which a dilated Vieussens' arterial ring is observed without coronary stenosis.
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- 2017
26. Italian registry of cardiac computed tomography
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Cademartiri, Filippo, Di Cesare, Ernesto, Francone, Marco, Ballerini, Giovanni, Ligabue, Guido, Maffei, Erica, Romagnoli, Andrea, Argiolas, Giovanni Maria, Russo, Vincenzo, Buffa, Vitaliano, Marano, Riccardo, Guzzetta, Maria, Belgrano, Manuel, Carbone, Iacopo, Macarini, Luca, Borghi, Claudia, Di Renzi, Paolo, Barile, Vicenzo, Patriarca, Lucia, Donato, Rocco, Zerboni, Filippo, Tresoldi, Silvia, Tessa, Carlo, Rengo, Marco, Manglaviti, Giuseppina, Danti, Massimiliano, Crusco, Federico, Carotti, Lucia, Zobel, Bruno Beomonte, Bernardini, Antonio, Scardapane, Arnaldo, Banderali, Simone, Acquafresca, Manlio, Carusi, Luca Maria, Negro, Umberto, Priotto, Roberto, De Cobelli, Francesco, Quarenghi, Matteo, Paganoni, Silvia, Secchi, Francesco, Sforza, Nicola, Lumia, Domenico, De Rosa, Roberto, Bissoli, Ernesto, Olivotti, Luca, Barbiero, Giulio, Centonze, Maurizio, Leurini, Rodolfo, Malagò, Roberto, Pinto, Dario, Cademartiri, F., Di Cesare, E., Francone, M., Ballerini, G., Ligabue, G., Maffei, E., Romagnoli, A., Argiolas, G. M., Russo, V., Buffa, V., Marano, R., Guzzetta, M., Belgrano, M., Carbone, I., Macarini, L., Borghi, C., Di Renzi, P., Barile, V., Patriarca, L., Donato, R., Zerboni, F., Tresoldi, S., Tessa, C., Rengo, M., Manglaviti, G., Danti, M., Crusco, F., Carotti, L., Zobel, B. B., Bernardini, A., Scardapane, A., Banderali, S., Acquafresca, M., Carusi, L. M., Negro, U., Priotto, R., De Cobelli, F., Quarenghi, M., Paganoni, S., Secchi, F., Sforza, N., Lumia, D., De Rosa, R., Bissoli, E., Olivotti, L., Barbiero, G., Centonze, M., Leurini, R., Malago, R., Pinto, D., Cademartiri, Filippo, Di Cesare, Ernesto, Francone, Marco, Ballerini, Giovanni, Ligabue, Guido, Maffei, Erica, Romagnoli, Andrea, Argiolas, Giovanni Maria, Russo, Vincenzo, Buffa, Vitaliano, Marano, Riccardo, Guzzetta, Maria, Belgrano, MANUEL GIANVALERIO, Carbone, Iacopo, Macarini, Luca, Borghi, Claudia, Di Renzi, Paolo, Barile, Vicenzo, Patriarca, Lucia, Donato, Rocco, Zerboni, Filippo, Tresoldi, Silvia, Tessa, Carlo, Rengo, Marco, Manglaviti, Giuseppina, Danti, Massimiliano, Crusco, Federico, Carotti, Lucia, Zobel, Bruno Beomonte, Bernardini, Antonio, Scardapane, Arnaldo, Banderali, Simone, Acquafresca, Manlio, Carusi, Luca Maria, Negro, Umberto, Priotto, Roberto, De Cobelli, Francesco, Quarenghi, Matteo, Paganoni, Silvia, Secchi, Francesco, Sforza, Nicola, Lumia, Domenico, DE ROSA, Roberto, Bissoli, Ernesto, Olivotti, Luca, Barbiero, Giulio, Centonze, Maurizio, Leurini, Rodolfo, Malagò, Roberto, Pinto, Dario, and Radiology & Nuclear Medicine
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Registrie ,Male ,Radiology, Nuclear Medicine and Imaging ,genetic structures ,Cardiac computed tomography ,Cardiac CT ,Coronary artery ,Heart diseases ,Indications ,Registry ,Adolescent ,Adult ,Aged ,Aged, 80 and over ,Child ,Child, Preschool ,Female ,Heart Diseases ,Humans ,Infant ,Italy ,Middle Aged ,Young Adult ,Cardiac Imaging Techniques ,Registries ,Tomography, X-Ray Computed ,Nuclear Medicine and Imaging ,80 and over ,Medicine ,Young adult ,Tomography ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA ,Neuroradiology ,medicine.diagnostic_test ,Medicine (all) ,Interventional radiology ,General Medicine ,X-Ray Computed ,Radiology ,Human ,medicine.medical_specialty ,Cardiac anatomy ,Heart disease ,Acute chest pain ,Radiology, Nuclear Medicine and imaging ,In patient ,Preschool ,Cardiac Imaging Technique ,business.industry ,Indication ,cardiac CT ,coronary artery ,heart diseases ,indications ,registry ,adolescent ,adult ,aged ,child ,child preschool ,female ,humans ,infant ,male ,middle aged ,young adult ,cardiac imaging techniques ,registries ,tomography X-Ray computed ,radiology ,nuclear medicine and imaging ,business - Abstract
Cardiac CT (CCT) is an imaging modality that is becoming a standard in clinical cardiology. We evaluated indications, safety, and impact on patient management of routine CCT in a multicenter national registry. MATERIALS AND METHODS: During a period of 6 months, 47 centers in Italy enrolled 3,455 patients. RESULTS: CCT was performed mainly with 64-slice CT scanners (73.02 %). Contrast agents were administrated in 3,185 patients (92.5 %). Mean DLP changes with type of scanner and was lower in >64 row detector scanner. The most frequent indication for CCT was suspected CAD (44.8 %), followed by calcium scoring (9.6 %), post-angioplasty/stenting (8.3 %), post-CABGs (7.5 %), study of cardiac anatomy (4.22 %) and assessment in patients with known CAD (4.1 %) and acute chest pain (1.99 %). Most of the CCTs were performed in outpatient settings (2,549; 74 %) and a minority in inpatient settings (719, 20.8 %). Adverse clinical events (mild-moderate) occurred in 26 examinations (0.75 %). None of them was severe. In 45.3 % of the cases CCT findings impacted patient management. CONCLUSION: CCT is performed with different workloads in participating centers. It is a safe procedure and its results have a strong impact on patient management.
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- 2015
27. Occult femoral fracture: Be aware of dual energy computed tomography.
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Ruggiero S, Bellini D, Rengo M, Vicini S, and Carbone I
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- Humans, Male, Aged, Fractures, Closed diagnostic imaging, Diagnosis, Differential, Magnetic Resonance Imaging methods, Tomography, X-Ray Computed methods, Femoral Fractures diagnostic imaging
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A 74-year-old man was admitted to our emergency department following minor trauma. Plain radiographs and standard computed tomography (CT) scans revealed no signs of fractures. Subsequently, virtual noncalcium (VNCa) images were reconstructed, showing a linear area of bone marrow edema (BME) resembling a femoral neck fracture. Magnetic resonance imaging (MRI) was performed to confirm the presence of BME and an associated intraspongious fracture. In an emergency setting, dual-energy CT (DECT) and VNCa images can successfully identify occult femoral fractures, especially in patients with mild symptoms and minor trauma, thereby preventing misdiagnosis., (© 2024 The Author(s). Journal of Clinical Ultrasound published by Wiley Periodicals LLC.)
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- 2024
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28. Multiparametric Prostate MRI Accuracy of Prostate Imaging Reporting and Data System (v2.1) Scores 4 and 5: The Influence of Image Quality According to the Prostate Imaging Quality Score.
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Fuschi A, Suraci PP, Pastore AL, Al Salhi Y, Capodiferro P, Scalzo S, Rera OA, Valenzi FM, Di Dio M, Russo P, Al-Zubi MT, Al Demour S, Fathi Al-Rawashdah S, Mazzon G, Bellini D, Carbone I, Petrozza V, Bozzini G, Zucchi A, Pacini M, Tema G, De Nunzio C, Carbone A, and Rengo M
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Purpose: The accuracy of multiparametric magnetic resonance imaging (mpMRI) heavily relies on image quality, as evidenced by the evolution of the prostate imaging quality (PI-QUAL) scoring system for the evaluation of clinically significant prostate cancer (csPC). This study aims to evaluate the impact of PI-QUAL scores in detecting csPC within PI-RADS 4 and 5 lesions. Methods: We retrospectively selected from our database all mpMRI performed from January 2019 to March 2022. Inclusion criteria were as follows: (1) mpMRI acquired in our institution according to the technical requirements from the PI-RADS (v2.1) guidelines; (2) single lesion scored as PI-RADS (v2.1) 4 or 5; (3) MRI-TBx performed in our institution; (4) complete histology report; and (5) complete clinical record. Results: A total of 257 male patients, mean age 70.42 ± 7.6 years, with a single PI-RADS 4 or 5 lesion undergoing MRI-targeted biopsy, were retrospectively studied. Of these, 61.5% were PI-RADS 4, and 38.5% were PI-RADS 5, with 84% confirming neoplastic cells. In high-quality image lesions (PI-QUAL ≥ 4), all PI-RADS 5 lesions were accurately identified as positive at the final histological examination (100% of CDR). For PI-RADS 4 lesions, 37 (23%) were negative, resulting in a cancer detection rate of 77% (95% CI: 67.51-84.83). Conclusions: The accuracy of mpMRI, independently of the PI-RADS score, progressively decreased according to the decreasing PI-QUAL score. These findings emphasize the crucial role of the PI-QUAL scoring system in evaluating PI-RADS 4 and 5 lesions, influencing mpMRI accuracy.
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- 2024
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29. Is early continence recovery related to the length of spared urethra? A prospective multicenter study comparing preoperative MRI and histologic specimen measurements after robotic radical prostatectomy.
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Valenzi FM, Fuschi A, Al Salhi Y, Sequi MB, Suraci PP, Pacini M, Scalzo S, Rera OA, Antonioni A, Graziani D, Martino G, Candita G, Gianfrancesco F, Zucchi A, Lombardo R, De Nunzio C, Cicione A, Bozzini G, Rengo M, Capodiferro P, Sciarra A, Petrozza V, Carbone A, and Pastore AL
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- Humans, Male, Prospective Studies, Middle Aged, Aged, Recovery of Function, Adenocarcinoma surgery, Organ Sparing Treatments, Postoperative Complications, Urodynamics, Prostatectomy methods, Urinary Incontinence etiology, Urethra diagnostic imaging, Urethra surgery, Prostatic Neoplasms surgery, Prostatic Neoplasms pathology, Robotic Surgical Procedures, Magnetic Resonance Imaging
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Background: Urinary incontinence (UI) is a common complication after radical prostatectomy, significantly affecting patients' quality of life. This study aimed to correlate the length of preserved urethra in robotic radical prostatectomy (RALP) patients with short-term urinary continence rates within 90 days post-surgery., Methods: A prospective multicentric study enrolled 190 prostate adenocarcinoma patients undergoing RALP. Using preoperative magnetic resonance imaging (mpMRI), urethral length was measured from the external urethral sphincter to the bladder neck. After surgery, histological measurements of the removed urethra were compared to the preoperative mpMRI data. Patients were categorized into two groups at the three-month follow-up based on urinary continence assessed through Urodynamic Study (UDS): Group A (94 patients without UI) and Group B (96 patients with UI)., Results: Results revealed a significant difference in mean UI recovery time (Group A: 12.35 days, SD: 3.09 vs. Group B: 93.86 days, SD: 34.8, p < 0.0001). A ROC curve identified a 16.5% cut-off value (p < 0.000, sensitivity 87.5%, specificity 91.8%). Both groups showed a significant negative correlation between preserved urethral percentage and UI recovery time (Group A: r -0.655, p < 0.0001; Group B: r -0.340, p: 0.017). Group A had an average of 21.52% preserved urethra, while Group B had 13.86% (p < 0.0001). At one-year follow-up, 93.2% overall patients reported urinary continence without pads., Conclusions: This study emphasizes the positive correlation between preserved urethra percentage in RALP and early urinary continence recovery, highlighting its surgical significance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)
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- 2024
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30. Peri-gastric appendagitis with lesser omentum hemorrhagic infarction: US, CT, and MRI findings of a rare entity.
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Ruggiero S, Vicini S, Bellini D, Onori A, Rengo M, and Carbone I
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- Humans, Diagnosis, Differential, Magnetic Resonance Imaging, Infarction complications, Infarction diagnostic imaging, Omentum diagnostic imaging, Tomography, X-Ray Computed
- Abstract
Peri-gastric appendagitis followed associated with gastro-hepatic ligament/lesser omentum hemorrhagic infarction has not been well investigated yet. With an accurate radiological diagnosis of peri-gastric appendagitis, even in case of hemorrhagic infarction, the patient can receive supportive measures for the self-limited pain and can forgo surgery, endoscopy, and further invasive testing., (© 2023 Wiley Periodicals LLC.)
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- 2023
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31. CT colonography: can we achieve an adequate bowel preparation without diet restriction?
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Rengo M, Tiberia F, Vicini S, Bellini D, Celestre M, Trionfera G, Laghi A, and Carbone I
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- Humans, Polyethylene Glycols, Feces, Diet, Contrast Media, Cathartics, Colonography, Computed Tomographic
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Objective: To evaluate if an adequate bowel preparation for CT colonography, can be achieved without diet restriction, using a reduced amount of cathartic agent and fecal tagging. To investigate the influence of patients' characteristics on bowel preparation and the impact on patients' compliance., Methods: In total, 1446 outpatients scheduled for elective CT colonography were prospectively enrolled. All patients had the same bowel preparation based on a reduced amount of cathartic agent (120 g of macrogol in 1.5 l of water) the day before the exam and a fecal tagging agent (60 ml of hyperosmolar oral iodinated agent) the day of the exam. No dietary restrictions were imposed before the exam. The bowel preparation was evaluated using a qualitative and quantitative score. Patients were grouped by age, gender, and presence of diverticula in both scores. Patients' compliance has been evaluated with a questionnaire after the end of the exam and with a phone-calling interview the day after the exam., Results: According to the qualitative score, adequate bowel preparation was achieved in 1349 patients (93.29%) and no statistical differences were observed among the subgroups of patients. Quantitative scores demonstrated that colon distension was significantly better in younger patients and without diverticula. A good patients' compliance was observed and most patients (96.5%) were willing to repeat it., Conclusions: The lack of diet restriction does not affect the quality of CTC preparation and good patient's compliance could potentially increase the participation rate in CRC screening programs., Key Points: • An adequate quality bowel preparation for CT colonography can be achieved without diet restriction, using a reduced amount of cathartic agent (120 g of macrogol in 1.5 l of water) and fecal tagging (60 ml of hyperosmolar oral iodinated agent). • A bowel preparation based on the combination of a reduced amount of cathartic agent and fecal tagging, without diet restriction, allows obtaining good quality in more than 90% of patients. • The bowel preparation scheme proposed reduces the distress and discomfort experienced by the patients improving adherence to CTC., (© 2023. The Author(s).)
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- 2023
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32. Long COVID in Young Patients: Impact on Lung Volume Evaluated Using Multidetector CT.
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Bellini D, Capodiferro P, Vicini S, Rengo M, and Carbone I
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- Humans, Adult, Adolescent, Young Adult, Post-Acute COVID-19 Syndrome, SARS-CoV-2, Retrospective Studies, Tomography, X-Ray Computed methods, Lung Volume Measurements, COVID-19 diagnostic imaging
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Purpose: To evaluate using quantitative analysis on chest CT images a possible lung volume reduction in Long COVID patients who complain mild respiratory symptoms, with chest CT negative for inflammatory findings., Materials and Methods: CT images of patients from 18 to 40 years old who underwent chest CT scan at our institution were analyzed retrospectively, using AwServer Thoracic VCAR software for a quantitative study. Exclusion criteria were inflammatory findings at CT, previous lung surgery, lung cancer, and breath artifacts that invalidate the quality of images. Patients were divided into two groups: in the first one ("post-COVID") were patients who had previous SARS-CoV-2 infection, confirmed by an RT-PCR, who underwent chest CT from 3 to 6 months after their negativization for long COVID symptoms; in the control group ("non-COVID"), were enrolled patients who underwent a chest CT scan from January 2018 to December 2019, before the spread of COVID in Italy., Results: Our final population included 154 TC, 77 post-COVID patients (mean age 33 ± 6) and 77 non-COVID patients (mean age 33 ± 4.9). Non statistical significative differences were obtained between groups in terms of age, sex, and other characteristics that affect total lung capacity such as obesity, thoracic malformations, and smoking habit. Mean values of the total lung volume (TV), right-lung volume (RV), and left-lung volume (LV) in the post-COVID group compared with non-COVID group were, respectively: 5.25 ± 0.25 L vs. 5.72 ± 0.26 L ( p = 0.01); 2.76 ± 0.14 L vs. 3 ± 0.14 L ( p = 0.01); 2.48 ± 0.12 L vs. 2.72 ± 0.12 L ( p = 0.01)., Conclusion: In patients with symptoms suggesting Long COVID and negative chest CT macroscopic findings, quantitative volume analysis demonstrated a mean value of reduction in lung volume of 10% compared to patients of the same age who never had COVID. A chest CT negative for inflammatory findings may induce clinicians to attribute Long COVID mild respiratory symptoms to anxiety, especially in young patients. Our study brings us beyond appearances and beyond the classic radiological signs, introducing a quantitative evaluation of lung volumes in these patients. It is hard to establish to what extent this finding may contribute to Long COVID symptoms, but this is another step to gain a wider knowledge of the potential long-term effects caused by this new virus.
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- 2023
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33. Development and Validation of Artificial-Intelligence-Based Radiomics Model Using Computed Tomography Features for Preoperative Risk Stratification of Gastrointestinal Stromal Tumors.
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Rengo M, Onori A, Caruso D, Bellini D, Carbonetti F, De Santis D, Vicini S, Zerunian M, Iannicelli E, Carbone I, and Laghi A
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Background: preoperative risk assessment of gastrointestinal stromal tumors (GISTS) is required for optimal and personalized treatment planning. Radiomics features are promising tools to predict risk assessment. The purpose of this study is to develop and validate an artificial intelligence classification algorithm, based on CT features, to define GIST's prognosis as determined by the Miettinen classification., Methods: patients with histological diagnosis of GIST and CT studies were retrospectively enrolled. Eight morphologic and 30 texture CT features were extracted from each tumor and combined to obtain three models (morphologic, texture and combined). Data were analyzed using a machine learning classification (WEKA). For each classification process, sensitivity, specificity, accuracy and area under the curve were evaluated. Inter- and intra-reader agreement were also calculated., Results: 52 patients were evaluated. In the validation population, highest performances were obtained by the combined model (SE 85.7%, SP 90.9%, ACC 88.8%, and AUC 0.954) followed by the morphologic (SE 66.6%, SP 81.8%, ACC 76.4%, and AUC 0.742) and texture (SE 50%, SP 72.7%, ACC 64.7%, and AUC 0.613) models. Reproducibility was high of all manual evaluations., Conclusions: the AI-based radiomics model using a CT feature demonstrates good predictive performance for preoperative risk stratification of GISTs.
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- 2023
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34. A Focus on the Synergy of Radiomics and RNA Sequencing in Breast Cancer.
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Bellini D, Milan M, Bordin A, Rizzi R, Rengo M, Vicini S, Onori A, Carbone I, and De Falco E
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- Humans, Female, Diagnostic Imaging, Genomics methods, Radiography, Breast Neoplasms diagnostic imaging, Breast Neoplasms genetics, Radiology methods
- Abstract
Radiological imaging is currently employed as the most effective technique for screening, diagnosis, and follow up of patients with breast cancer (BC), the most common type of tumor in women worldwide. However, the introduction of the omics sciences such as metabolomics, proteomics, and molecular genomics, have optimized the therapeutic path for patients and implementing novel information parallel to the mutational asset targetable by specific clinical treatments. Parallel to the "omics" clusters, radiological imaging has been gradually employed to generate a specific omics cluster termed "radiomics". Radiomics is a novel advanced approach to imaging, extracting quantitative, and ideally, reproducible data from radiological images using sophisticated mathematical analysis, including disease-specific patterns, that could not be detected by the human eye. Along with radiomics, radiogenomics, defined as the integration of "radiology" and "genomics", is an emerging field exploring the relationship between specific features extracted from radiological images and genetic or molecular traits of a particular disease to construct adequate predictive models. Accordingly, radiological characteristics of the tissue are supposed to mimic a defined genotype and phenotype and to better explore the heterogeneity and the dynamic evolution of the tumor over the time. Despite such improvements, we are still far from achieving approved and standardized protocols in clinical practice. Nevertheless, what can we learn by this emerging multidisciplinary clinical approach? This minireview provides a focused overview on the significance of radiomics integrated by RNA sequencing in BC. We will also discuss advances and future challenges of such radiomics-based approach.
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- 2023
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35. Intravenous Contrast Material for Cardiac Computed Tomography: Results From the Open-label Multicenter, Multivendor Italian Registry of Contrast Material Use in Cardiac Computed Tomography.
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La Grutta L, Maffei E, Clemente A, Privitera G, Rengo M, Seitun S, Malagò R, Toia P, Acquafresca M, Secchi F, Gravina M, Mantini C, Scardapane A, De Rosa R, Carusi LM, Cossa S, Falzea F, Chiappino D, Annoni A, Francone M, Di Cesare E, Midiri M, and Cademartiri F
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- Male, Humans, Female, Middle Aged, Aged, Tomography, X-Ray Computed methods, Coronary Angiography methods, Registries, Contrast Media, Coronary Artery Disease
- Abstract
Purpose: The Italian Registry of Contrast Material use in Cardiac Computed Tomography (iRCM-CCT) is a multicenter, multivendor, observational study on the use of contrast media (CM) in patients undergoing cardiac computed tomography (CCT). The aim of iRCM-CCT is to assess image quality and safety profile of intravenous CM compounds., Materials and Methods: iRCM-CCT enrolled 1842 consecutive patients undergoing CCT (≥50 per site) at 20 cluster sites with the indication of suspected coronary artery disease. Demographic characteristics, CCT, and CM protocols, clinical indications, safety markers, radiation dose reports, qualitative (ie, poor vascular enhancement) and quantitative (ie, HU attenuation values) image parameters were recorded. A centralized coordinating center collected and assessed all image parameters., Results: The cohort included 891 men and 951 women (age: 63±14 y, body mass index: 26±4 kg/m2) studied with ≥64 detector rows computed tomography scanners and different iodinated intravenous CM protocols and compounds (iodixanol, iopamidol, iohexol, iobitridol, iopromide, and iomeprol). The following vascular attenuation was reported: 504±147 HU in the aorta, 451±146 HU in the right coronary artery, 474±146 HU in the left main, 451±146 HU in the left anterior descending artery, and 441±149 HU in the circumflex artery. In 4% of cases the image quality was not satisfactory due to poor enhancement. The following adverse reactions to CM were recorded: 6 (0.3%) extravasations and 17 (0.9%) reactions (11 mild, 4 moderate, 2 severe)., Conclusions: In a multicenter registry on CM use during CCT the prevalence of CM-related adverse reactions was very low. The appropriate use of CM is a major determinant of image quality., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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36. Structured reporting of computed tomography in the polytrauma patient assessment: a Delphi consensus proposal.
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Granata V, Fusco R, Cozzi D, Danti G, Faggioni L, Buccicardi D, Prost R, Ferrari R, Trinci M, Galluzzo M, Iacobellis F, Scaglione M, Tonerini M, Coppola F, Bortolotto C, Caruso D, Ciaghi E, Gabelloni M, Rengo M, Giacobbe G, Grassi F, Romano L, Pinto A, Caranci F, Bertelli E, D'Andrea P, Neri E, Giovagnoni A, Grassi R, and Miele V
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- Humans, Delphi Technique, Consensus, Tomography, X-Ray Computed, Radiology, Multiple Trauma
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Objectives: To develop a structured reporting (SR) template for whole-body CT examinations of polytrauma patients, based on the consensus of a panel of emergency radiology experts from the Italian Society of Medical and Interventional Radiology., Methods: A multi-round Delphi method was used to quantify inter-panelist agreement for all SR sections. Internal consistency for each section and quality analysis in terms of average inter-item correlation were evaluated by means of the Cronbach's alpha (Cα) correlation coefficient., Results: The final SR form included 118 items (6 in the "Patient Clinical Data" section, 4 in the "Clinical Evaluation" section, 9 in the "Imaging Protocol" section, and 99 in the "Report" section). The experts' overall mean score and sum of scores were 4.77 (range 1-5) and 257.56 (range 206-270) in the first Delphi round, and 4.96 (range 4-5) and 208.44 (range 200-210) in the second round, respectively. In the second Delphi round, the experts' overall mean score was higher than in the first round, and standard deviation was lower (3.11 in the second round vs 19.71 in the first round), reflecting a higher expert agreement in the second round. Moreover, Cα was higher in the second round than in the first round (0.97 vs 0.87)., Conclusions: Our SR template for whole-body CT examinations of polytrauma patients is based on a strong agreement among panel experts in emergency radiology and could improve communication between radiologists and the trauma team., (© 2023. The Author(s).)
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- 2023
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37. Pneumonia Frequency and Severity in Patients With Symptomatic COVID-19: Impact of mRNA and Adenovirus Vector Vaccines.
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Vicini S, Bellini D, Iannarelli A, Rengo M, Pelle G, Ruggiero S, Fusco M, Ambrogi C, and Carbone I
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- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Adenoviridae genetics, BNT162 Vaccine, COVID-19 Testing, Retrospective Studies, RNA-Directed DNA Polymerase, ChAdOx1 nCoV-19, COVID-19 physiopathology, COVID-19 prevention & control, COVID-19 Vaccines therapeutic use
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BACKGROUND. Additional evidence of the role of COVID-19 vaccination in reducing pneumonia frequency and severity in the setting of breakthrough infection could help combat ongoing vaccine hesitancy. OBJECTIVE. The purpose of this article was to compare the frequency and severity of pneumonia on chest CT in patients with confirmed COVID-19 between patients who are unvaccinated and those who are fully vaccinated by messenger RNA (mRNA) or adenovirus vector vaccines. METHODS. This retrospective single-center study included 467 patients (250 men, 217 women; mean age, 65 ± 17 [SD] years) who underwent chest CT between December 15, 2021, and February 18, 2022, during hospitalization for symptomatic COVID-19, confirmed by reverse transcriptase-polymerase chain reaction assay. A total of 216 patients were unvaccinated, and 167 and 84 patients were fully vaccinated (defined as receipt of the second dose at least 14 days before COVID-19 diagnosis) by the BNT162b2 mRNA vaccine or the ChAdOx1-S adenovirus vector vaccine, respectively. Semiquantitative CT severity scores (CT-SS; 0-25 scale) were determined; CT-SS of 0 indicated absence of pneumonia. Presence of bilateral involvement was assessed in patients with pneumonia. Associations were explored between vaccination status and CT findings. RESULTS. The frequency of the absence of pneumonia was 15% (32/216) in unvaccinated patients, 29% (24/84) in patients fully vaccinated with ChAdOx1-S vaccine, and 51% (85/167) in patients fully vaccinated with BNT162b2 vaccine (unvaccinated and ChAdOx1-S vs BNT162b2: p < .001; unvaccinated vs ChAdOx1-S: p = .08). Mean CT-SS was significantly higher in unvaccinated patients (9.7 ± 6.1) than in patients fully vaccinated with BNT162b2 (5.2 ± 6.1) or ChAdOx1-S (6.2 ± 5.9) vaccine (both p < .001). Full vaccination was significantly associated with CT-SS independent of patient age and sex (estimate = -4.46; p < .001). Frequency of bilateral lung involvement was significantly higher in unvaccinated patients (158/184, 86%) and in patients fully vaccinated with ChAdOx1-S vaccine (54/60, 90%) than in patients fully vaccinated with BNT162b2 vaccine (47/82, 57%) (both p < .001). CONCLUSION. Pneumonia frequency and severity were lower in patients with full vaccination by mRNA and adenovirus vector vaccines who experienced breakthrough infections in comparison with unvaccinated patients. CLINICAL IMPACT. The visual observation by radiologic imaging of the protective effect of vaccination on lung injury in patients with breakthrough infections provides additional evidence supporting the clinical benefit of vaccination.
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- 2022
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38. Performance of Machine Learning and Texture Analysis for Predicting Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer with 3T MRI.
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Bellini D, Carbone I, Rengo M, Vicini S, Panvini N, Caruso D, Iannicelli E, Tombolini V, and Laghi A
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- Chemoradiotherapy methods, Humans, Machine Learning, Magnetic Resonance Imaging methods, Neoadjuvant Therapy methods, Treatment Outcome, Neoplasms, Second Primary, Rectal Neoplasms diagnostic imaging, Rectal Neoplasms pathology, Rectal Neoplasms therapy
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Background: To evaluate the diagnostic performance of a Machine Learning (ML) algorithm based on Texture Analysis (TA) parameters in the prediction of Pathological Complete Response (pCR) to Neoadjuvant Chemoradiotherapy (nChRT) in Locally Advanced Rectal Cancer (LARC) patients. Methods: LARC patients were prospectively enrolled to undergo pre- and post-nChRT 3T MRI for initial loco-regional staging. TA was performed on axial T2-Weighted Images (T2-WI) to extract specific parameters, including skewness, kurtosis, entropy, and mean of positive pixels. For the assessment of TA parameter diagnostic performance, all patients underwent complete surgical resection, which served as a reference standard. ROC curve analysis was carried out to determine the discriminatory accuracy of each quantitative TA parameter to predict pCR. A ML-based decisional tree was implemented combining all TA parameters in order to improve diagnostic accuracy. Results: Forty patients were considered for final study population. Entropy, kurtosis and MPP showed statistically significant differences before and after nChRT in patients with pCR; in particular, when patients with Pathological Partial Response (pPR) and/or Pathological Non-Response (pNR) were considered, entropy and skewness showed significant differences before and after nChRT (all p < 0.05). In terms of absolute value changes, pre- and post-nChRT entropy, and kurtosis showed significant differences (0.31 ± 0.35, in pCR, −0.02 ± 1.28 in pPR/pNR, (p = 0.04); 1.87 ± 2.19, in pCR, −0.06 ± 3.78 in pPR/pNR (p = 0.0005); 107.91 ± 274.40, in pCR, −28.33 ± 202.91 in pPR/pNR, (p = 0.004), respectively). According to ROC curve analysis, pre-treatment kurtosis with an optimal cut-off value of ≤3.29 was defined as the best discriminative parameter, resulting in a sensitivity and specificity in predicting pCR of 81.5% and 61.5%, respectively. Conclusions: TA parameters extracted from T2-WI MRI images could play a key role as imaging biomarkers in the prediction of response to nChRT in LARC patients. ML algorithms can be used to efficiently combine all TA parameters in order to improve diagnostic accuracy.
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- 2022
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39. A narrative review on current imaging applications of artificial intelligence and radiomics in oncology: focus on the three most common cancers.
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Vicini S, Bortolotto C, Rengo M, Ballerini D, Bellini D, Carbone I, Preda L, Laghi A, Coppola F, and Faggioni L
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- Artificial Intelligence, Diagnostic Imaging, Female, Humans, Radiography, Breast Neoplasms, Radiology
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The use of artificial intelligence (AI) and radiomics in the healthcare setting to advance disease diagnosis and management and facilitate the creation of new therapeutics is gaining popularity. Given the vast amount of data collected during cancer therapy, there is significant concern in leveraging the algorithms and technologies available with the underlying goal of improving oncologic care. Radiologists will attain better precision and effectiveness with the advent of AI technology, making machine-assisted medical services a valuable and important option for future oncologic medical care. As a result, it is critical to figure out which specific radiology activities are best positioned to gain from AI and radiomics models and methods of oncologic imaging, while also considering the algorithms' capabilities and constraints. Our purpose is to overview the current evidence and future prospects of AI and radiomics algorithms used in oncologic imaging efforts with an emphasis on the three most frequent cancers worldwide, i.e., lung cancer, breast cancer and colorectal cancer. We discuss how AI and radiomics could be used to detect and characterize cancers and assess therapy response., (© 2022. Italian Society of Medical Radiology.)
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- 2022
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40. Clinical relevance of biomarkers in cholangiocarcinoma: critical revision and future directions.
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Macias RIR, Cardinale V, Kendall TJ, Avila MA, Guido M, Coulouarn C, Braconi C, Frampton AE, Bridgewater J, Overi D, Pereira SP, Rengo M, Kather JN, Lamarca A, Pedica F, Forner A, Valle JW, Gaudio E, Alvaro D, Banales JM, and Carpino G
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- Artificial Intelligence, Bile Ducts, Intrahepatic pathology, Biomarkers, Biomarkers, Tumor, Humans, Bile Duct Neoplasms diagnosis, Bile Duct Neoplasms pathology, Cholangiocarcinoma diagnosis, Cholangiocarcinoma pathology
- Abstract
Cholangiocarcinoma (CCA) is a malignant tumour arising from the biliary system. In Europe, this tumour frequently presents as a sporadic cancer in patients without defined risk factors and is usually diagnosed at advanced stages with a consequent poor prognosis. Therefore, the identification of biomarkers represents an utmost need for patients with CCA. Numerous studies proposed a wide spectrum of biomarkers at tissue and molecular levels. With the present paper, a multidisciplinary group of experts within the European Network for the Study of Cholangiocarcinoma discusses the clinical role of tissue biomarkers and provides a selection based on their current relevance and potential applications in the framework of CCA. Recent advances are proposed by dividing biomarkers based on their potential role in diagnosis, prognosis and therapy response. Limitations of current biomarkers are also identified, together with specific promising areas (ie, artificial intelligence, patient-derived organoids, targeted therapy) where research should be focused to develop future biomarkers., Competing Interests: Competing interests: Dr Angela Lamarca reports travel and educational support from Ipsen, Pfizer, Bayer, AAA, Sirtex, Novartis, Mylan and Delcath; Speaker honoraria from Merck, Pfizer, Ipsen, Incyte, AAA, QED, Servier, Astra Zeneca and EISAI; Advisory and consultancy honoraria from EISAI, Nutricia Ipsen, QED, Roche, Servier, Boston Scientific and Albireo Pharma; Member of the Knowledge Network and NETConnect Initiatives funded by Ipsen.Alejandro Forner: Lecture fees from Bayer, Gilead, Roche, Boston Scientific and MSD; consultancy fees from Bayer, AstraZeneca, Roche, Boston Scientific, SIRTEX, Exact Science and Guerbert.Chiara Braconi (or family members) received honoraria from Incyte, Merck-Serono, EliLilly, Pfizer, Roche.Jakob N Kather has provided consulting services for Owkin, France and Panakeia, UK and has received honoraria by MSD, Eisai and Falk Pharma., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2022
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41. Unusual computed tomography findings of gas in the superior mesenteric artery system with no signs of porto-mesenteric venous gas in a case of acute mesenteric ischemia.
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Giulio F, Ruggiero S, Vicini S, Bellini D, Rengo M, and Carbone I
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Acute Mesenteric Ischemia (AMI) is a rare life-threatening entity caused by sudden interruption of the blood supply to a segment of the bowel due to impairment of mesenteric arterial blood flow or venous drainage. Clinical presentation varies according to the time course of vascular occlusion. Contrast-enhanced Computed Tomography (CT) of the abdomen represents the main diagnostic test for AMI diagnosis, enabling fast and excellent evaluation of the intestine, mesenteric vasculature, and other ancillary characteristics of AMI. Typical CT findings of AMI include paralytic ileus, decreased or absent bowel wall contrast-enhancement, pneumatosis intestinalis, and porto-mesenteric venous gas. We hereby report a case of an 89-year-old man presenting with AMI due to Superior Mesenteric Artery (SMA) thrombotic occlusion following endovascular stenting superficial femoral arteries. Typical findings were observed on abdominal CT imaging, yet associated with the presence of gas exclusively in the SMA district, without any involvement of the porto-mesenteric venous system. Different imaging features and pitfalls can help radiologists to accurately diagnose AMI, especially when irreversible bowel damage is about to occur. Therefore, radiologists and emergency physicians should be aware of the unusual association between gas in the SMA arterial district and AMI, even in the absence of porto-mesenteric venous system involvement, in order to urge prompt surgical consultation when observed., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
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- 2022
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42. Blockchain in radiology research and clinical practice: current trends and future directions.
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Tagliafico AS, Campi C, Bianca B, Bortolotto C, Buccicardi D, Francesca C, Prost R, Rengo M, and Faggioni L
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- Artificial Intelligence, Delivery of Health Care, Humans, Radiologists, Blockchain, Radiology
- 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., (© 2022. The Author(s).)
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- 2022
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43. Rectal cancer response to neoadjuvant chemoradiotherapy evaluated with MRI: Development and validation of a classification algorithm.
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Rengo M, Landolfi F, Picchia S, Bellini D, Losquadro C, Badia S, Caruso D, Iannicelli E, Osti MF, Tombolini V, Carbone I, Giunta G, and Laghi A
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- Algorithms, Chemoradiotherapy, Humans, Magnetic Resonance Imaging, Retrospective Studies, Treatment Outcome, Neoadjuvant Therapy, Rectal Neoplasms drug therapy, Rectal Neoplasms therapy
- Abstract
Objective: The aim of this study was to develop and validate a decision support model using data mining algorithms, based on morphologic features derived from MRI images, to discriminate between complete responders (CR) and non-complete responders (NCR) patients after neoadjuvant chemoradiotherapy (CRT), in a population of patients with locally advanced rectal cancer (LARC)., Methods: Two populations were retrospectively enrolled: group A (65 patients) was used to train a data mining decision tree algorithm whereas group B (30 patients) was used to validate it. All patients underwent surgery; according to the histology evaluation, patients were divided in CR and NCR. Staging and restaging MRI examinations were retrospectively analysed and seven parameters were considered for data mining classification. Five different classification methods were tested and evaluated in terms of sensitivity, specificity, accuracy and AUC in order to identify the classification model able to achieve the best performance. The best classification algorithm was subsequently applied to group B for validation: sensitivity, specificity, positive and negative predictive value, accuracy and ROC curve were calculated. Inter and intra-reader agreement were calculated., Results: Four features were selected for the development of the classification algorithm: MRI tumor regression grade (MR-TRG), staging volume (SV), tumor volume reduction rate (TVRR) and signal intensity reduction rate (SIRR). The decision tree J48 showed the highest efficiency: when applied to group B, all the CR and 18/21 NCR were correctly classified (sensitivity 85.71%, specificity 100%, PPV 100%, NPV 94.2%, accuracy 95.7%, AUC 0.833). Both inter- and intra-reader evaluation showed good agreement (κ > 0.6)., Conclusions: The proposed decision support model may help in distinguishing between CR and NCR patients with LARC after CRT., (Copyright © 2022 Elsevier B.V. All rights reserved.)
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- 2022
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44. Structured reporting of computed tomography in the staging of colon cancer: a Delphi consensus proposal.
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Granata V, Faggioni L, Grassi R, Fusco R, Reginelli A, Rega D, Maggialetti N, Buccicardi D, Frittoli B, Rengo M, Bortolotto C, Prost R, Lacasella GV, Montella M, Ciaghi E, Bellifemine F, De Muzio F, Grazzini G, De Filippo M, Cappabianca S, Laghi A, Grassi R, Brunese L, Neri E, Miele V, and Coppola F
- Subjects
- Colon diagnostic imaging, Colon pathology, Consensus, Humans, Neoplasm Staging, Colonic Neoplasms diagnostic imaging, Colonic Neoplasms pathology, Delphi Technique, Radiologists, Research Report standards, Tomography, X-Ray Computed methods
- Abstract
Background: Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports in colon cancer during the staging phase in order to improve communication between the radiologist, members of multidisciplinary teams and patients., Materials and Methods: A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. Cronbach's alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation., Results: The final SR version was built by including n = 18 items in the "Patient Clinical Data" section, n = 7 items in the "Clinical Evaluation" section, n = 9 items in the "Imaging Protocol" section and n = 29 items in the "Report" section. Overall, 63 items were included in the final version of the SR. Both in the first and second round, all sections received a higher than good rating: a mean value of 4.6 and range 3.6-4.9 in the first round; a mean value of 5.0 and range 4.9-5 in the second round. In the first round, Cronbach's alpha (Cα) correlation coefficient was a questionable 0.61. In the first round, the overall mean score of the experts and the sum of scores for the structured report were 4.6 (range 1-5) and 1111 (mean value 74.07, STD 4.85), respectively. In the second round, Cronbach's alpha (Cα) correlation coefficient was an acceptable 0.70. In the second round, the overall mean score of the experts and the sum of score for structured report were 4.9 (range 4-5) and 1108 (mean value 79.14, STD 1.83), respectively. The overall mean score obtained by the experts in the second round was higher than the overall mean score of the first round, with a lower standard deviation value to underline greater agreement among the experts for the structured report reached in this round., Conclusions: A wide implementation of SR is of critical importance in order to offer referring physicians and patients optimum quality of service and to provide researchers with the best quality data in the context of big data exploitation of available clinical data. Implementation is a complex procedure, requiring mature technology to successfully address the multiple challenges of user-friendliness, organization and interoperability., (© 2021. The Author(s).)
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- 2022
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45. Preoperative measurement of the hiatal surface with MDCT: impact on surgical planning.
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Rengo M, Boru CE, Badia S, Iossa A, Bellini D, Picchia S, Panvini N, Carbone I, Silecchia G, and Laghi A
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- Adult, Esophagus diagnostic imaging, Female, Gastroesophageal Reflux complications, Hernia, Hiatal complications, Humans, Male, Middle Aged, Preoperative Care methods, Prospective Studies, Reproducibility of Results, Treatment Outcome, Body Weights and Measures methods, Esophagus anatomy & histology, Gastroesophageal Reflux surgery, Hernia, Hiatal diagnostic imaging, Hernia, Hiatal surgery, Multidetector Computed Tomography methods
- Abstract
Objective: To evaluate the accuracy and reproducibility of hiatal surface area (HSA) measurement on dedicated multidetector computed tomography (MDCT) acquisition, in patients, previously subjected to laparoscopic sleeve gastrectomy (LSG), and affected by gastroesophageal reflux disease (GERD). Intraoperative HSA measurement was considered the reference standard., Methods: Fifty-two candidates for laparoscopic hiatal hernia repair were prospectively included in the study. MDCT images were acquired during swallowing of oral iodinated contrast media and during strain. Measurements were performed by nine readers divided into three groups according to their experience. Results were compared with intraoperative measurements by means of Spearman correlation coefficient. Reproducibility was evaluated with intra- and interreader agreement by means of weighted Cohen's kappa and intraclass correlation coefficient (ICC)., Results: Significant differences between MDCT and intraoperative HSA measurements were observed for swallowing imaging for less experienced readers (p = 0.037, 0.025, 0.028 and 0.019). No other statistically significant differences were observed (p > 0.05). The correlation between HSA measured intraoperatively and on MDCT was higher for strain imaging compared to swallowing (r = 0.94-0.92 vs 0.94-0.89). The overall reproducibility of MDCT HSA measurement was excellent (ICC of 0.95; 95% CI 0,8993 to 0,9840) independently of reader's experience CONCLUSION: HSA can be accurately measured on MDCT images. This method is reproducible and minimally influenced by reader experience. The preoperative measurement of HSA has potential advantages for surgeons in terms of correct approach to hiatal defects in obese patient., (© 2021. The Author(s).)
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- 2021
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46. Structured Reporting of Computed Tomography in the Staging of Neuroendocrine Neoplasms: A Delphi Consensus Proposal.
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Granata V, Coppola F, Grassi R, Fusco R, Tafuto S, Izzo F, Reginelli A, Maggialetti N, Buccicardi D, Frittoli B, Rengo M, Bortolotto C, Prost R, Lacasella GV, Montella M, Ciaghi E, Bellifemine F, De Muzio F, Danti G, Grazzini G, De Filippo M, Cappabianca S, Barresi C, Iafrate F, Stoppino LP, Laghi A, Grassi R, Brunese L, Neri E, Miele V, and Faggioni L
- Subjects
- Adult, Consensus, Delphi Technique, Humans, Neoplasm Staging, Neuroendocrine Tumors pathology, Tomography, X-Ray Computed, Neuroendocrine Tumors diagnostic imaging
- Abstract
Background: Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports in Neuroendocrine Neoplasms during the staging phase in order to improve communication between the radiologist and members of multidisciplinary teams., Materials and Methods: A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A Modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. Cronbach's alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation., Results: The final SR version was built by including n=16 items in the "Patient Clinical Data" section, n=13 items in the "Clinical Evaluation" section, n=8 items in the "Imaging Protocol" section, and n=17 items in the "Report" section. Overall, 54 items were included in the final version of the SR. Both in the first and second round, all sections received more than a good rating: a mean value of 4.7 and range of 4.2-5.0 in the first round and a mean value 4.9 and range of 4.9-5 in the second round. In the first round, the Cα correlation coefficient was a poor 0.57: the overall mean score of the experts and the sum of scores for the structured report were 4.7 (range 1-5) and 728 (mean value 52.00 and standard deviation 2.83), respectively. In the second round, the Cα correlation coefficient was a good 0.82: the overall mean score of the experts and the sum of scores for the structured report were 4.9 (range 4-5) and 760 (mean value 54.29 and standard deviation 1.64), respectively., Conclusions: The present SR, based on a multi-round consensus-building Delphi exercise following in-depth discussion between expert radiologists in gastro-enteric and oncological imaging, derived from a multidisciplinary agreement between a radiologist, medical oncologist and surgeon in order to obtain the most appropriate communication tool for referring physicians., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Granata, Coppola, Grassi, Fusco, Tafuto, Izzo, Reginelli, Maggialetti, Buccicardi, Frittoli, Rengo, Bortolotto, Prost, Lacasella, Montella, Ciaghi, Bellifemine, De Muzio, Danti, Grazzini, De Filippo, Cappabianca, Barresi, Iafrate, Stoppino, Laghi, Grassi, Brunese, Neri, Miele and Faggioni.)
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- 2021
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47. Structured Reporting of Computed Tomography and Magnetic Resonance in the Staging of Pancreatic Adenocarcinoma: A Delphi Consensus Proposal.
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Granata V, Morana G, D'Onofrio M, Fusco R, Coppola F, Grassi F, Cappabianca S, Reginelli A, Maggialetti N, Buccicardi D, Barile A, Rengo M, Bortolotto C, Urraro F, La Casella GV, Montella M, Ciaghi E, Bellifemine F, De Muzio F, Danti G, Grazzini G, Barresi C, Brunese L, Neri E, Grassi R, Miele V, and Faggioni L
- Abstract
Background: Structured reporting (SR) in radiology has been recognized recently by major scientific societies. This study aims to build structured computed tomography (CT) and magnetic resonance (MR)-based reports in pancreatic adenocarcinoma during the staging phase in order to improve communication between the radiologist and members of multidisciplinary teams., Materials and Methods: A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A modified Delphi process was used to develop the CT-SR and MRI-SR, assessing a level of agreement for all report sections. Cronbach's alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation., Results: The final CT-SR version was built by including n = 16 items in the "Patient Clinical Data" section, n = 11 items in the "Clinical Evaluation" section, n = 7 items in the "Imaging Protocol" section, and n = 18 items in the "Report" section. Overall, 52 items were included in the final version of the CT-SR. The final MRI-SR version was built by including n = 16 items in the "Patient Clinical Data" section, n = 11 items in the "Clinical Evaluation" section, n = 8 items in the "Imaging Protocol" section, and n = 14 items in the "Report" section. Overall, 49 items were included in the final version of the MRI-SR. In the first round for CT-SR, all sections received more than a good rating. The overall mean score of the experts was 4.85. The Cα correlation coefficient was 0.85. In the second round, the overall mean score of the experts was 4.87, and the Cα correlation coefficient was 0.94. In the first round, for MRI-SR, all sections received more than a good rating. The overall mean score of the experts was 4.73. The Cα correlation coefficient was 0.82. In the second round, the overall mean score of the experts was 4.91, and the Cα correlation coefficient was 0.93., Conclusions: The CT-SR and MRI-SR are based on a multi-round consensus-building Delphi exercise derived from the multidisciplinary agreement of expert radiologists in order to obtain more appropriate communication tools for referring physicians.
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- 2021
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48. Low-volume reduced bowel preparation regimen for CT colonography: a randomized noninferiority trial.
- Author
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Bellini D, Panvini N, Vicini S, Rengo M, Lucchesi P, Caruso D, Carbone I, and Laghi A
- Subjects
- Aged, Clinical Protocols, Colon, Colonoscopy, Female, Humans, Male, Colonography, Computed Tomographic
- Abstract
Purpose: To determine whether the quality of a low-volume reduced bowel preparation (LV-RBP) for CT Colonography (CTC) is noninferior to full-volume reduced bowel preparation (FV-RBP) regimen., Methods: In this randomized controlled trial, consecutive participants referred for CTC were randomly assigned to receive LV-RBP (52.5 g of PMF104 in 500 mL of water) or FV-RBP (105 g of PMF104 in 1000 mL of water). Images were independently reviewed by five blinded readers who rated the quality of bowel preparation from 0 (best score) to 3 (worst score). The primary outcome was the noninferiority of LV-RBP to FV-RBP in the proportion of colonic segments scored 0 for cleansing quality, with noninferiority margin of 10%. Volume of residual fluids, colonic distension, lesions and polyps detection rates and patient tolerability were secondary outcomes., Results: From March 2019 to January 2020, 110 participants (mean age 65 years ± 14 [standard deviation]; 74 women) were allocated to LV-RBP (n = 55) or FV-RBP (n = 55) arms. There were 92% segment scored 0 in colon cleansing quality in LV-RBP and 94% in FV-RBP for prone scans, and 94% vs 92% for supine scans. Risk difference was - 2.1 (95% CI -5.9 to 1.7) and 1.5 (95% CI -2.4 to 5.4) for prone and supine positions, respectively. Residual fluids and colonic distension were also noninferior in LV-RBP. LV-RBP was associated with a lower number of evacuations during preparation (7 ± 5 vs 10 ± 6, p = 0.002)., Conclusion: The LV-RBP for CTC demonstrated noninferior quality of colon cleansing with improved gastrointestinal tolerability compared to FV-RBP regimen., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2021
- Full Text
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49. Computed Tomography Structured Reporting in the Staging of Lymphoma: A Delphi Consensus Proposal.
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Granata V, Pradella S, Cozzi D, Fusco R, Faggioni L, Coppola F, Grassi R, Maggialetti N, Buccicardi D, Lacasella GV, Montella M, Ciaghi E, Bellifemine F, De Filippo M, Rengo M, Bortolotto C, Prost R, Barresi C, Cappabianca S, Brunese L, Neri E, Grassi R, and Miele V
- Abstract
Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports for lymphoma patients during the staging phase to improve communication between radiologists, members of multidisciplinary teams, and patients. A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology (SIRM), was established. A modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. The Cronbach's alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. The final SR version was divided into four sections: (a) Patient Clinical Data, (b) Clinical Evaluation, (c) Imaging Protocol, and (d) Report, including n = 13 items in the "Patient Clinical Data" section, n = 8 items in the "Clinical Evaluation" section, n = 9 items in the "Imaging Protocol" section, and n = 32 items in the "Report" section. Overall, 62 items were included in the final version of the SR. A dedicated section of significant images was added as part of the report. In the first Delphi round, all sections received more than a good rating (≥3). The overall mean score of the experts and the sum of score for structured report were 4.4 (range 1-5) and 1524 (mean value of 101.6 and standard deviation of 11.8). The Cα correlation coefficient was 0.89 in the first round. In the second Delphi round, all sections received more than an excellent rating (≥4). The overall mean score of the experts and the sum of scores for structured report were 4.9 (range 3-5) and 1694 (mean value of 112.9 and standard deviation of 4.0). The Cα correlation coefficient was 0.87 in this round. The highest overall means value, highest sum of scores of the panelists, and smallest standard deviation values of the evaluations in this round reflect the increase of the internal consistency and agreement among experts in the second round compared to first round. The accurate statement of imaging data given to referring physicians is critical for patient care; the information contained affects both the decision-making process and the subsequent treatment. The radiology report is the most important source of clinical imaging information. It conveys critical information about the patient's health and the radiologist's interpretation of medical findings. It also communicates information to the referring physicians and records this information for future clinical and research use. The present SR was generated based on a multi-round consensus-building Delphi exercise and uses standardized terminology and structures, in order to adhere to diagnostic/therapeutic recommendations and facilitate enrolment in clinical trials, to reduce any ambiguity that may arise from non-conventional language, and to enable better communication between radiologists and clinicians.
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- 2021
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50. Structured Reporting of Lung Cancer Staging: A Consensus Proposal.
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Granata V, Grassi R, Miele V, Larici AR, Sverzellati N, Cappabianca S, Brunese L, Maggialetti N, Borghesi A, Fusco R, Balbi M, Urraro F, Buccicardi D, Bortolotto C, Prost R, Rengo M, Baratella E, De Filippo M, Barresi C, Palmucci S, Busso M, Calandriello L, Sansone M, Neri E, Coppola F, and Faggioni L
- Abstract
Background: Structured reporting (SR) in radiology is becoming necessary and has recently been recognized by major scientific societies. This study aimed to build CT-based structured reports for lung cancer during the staging phase, in order to improve communication between radiologists, members of the multidisciplinary team and patients., Materials and Methods: A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology, was established. A modified Delphi exercise was used to build the structural report and to assess the level of agreement for all the report sections. The Cronbach's alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to perform a quality analysis according to the average inter-item correlation., Results: The final SR version was built by including 16 items in the "Patient Clinical Data" section, 4 items in the "Clinical Evaluation" section, 8 items in the "Exam Technique" section, 22 items in the "Report" section, and 5 items in the "Conclusion" section. Overall, 55 items were included in the final version of the SR. The overall mean of the scores of the experts and the sum of scores for the structured report were 4.5 (range 1-5) and 631 (mean value 67.54, STD 7.53), respectively, in the first round. The items of the structured report with higher accordance in the first round were primary lesion features, lymph nodes, metastasis and conclusions. The overall mean of the scores of the experts and the sum of scores for staging in the structured report were 4.7 (range 4-5) and 807 (mean value 70.11, STD 4.81), respectively, in the second round. The Cronbach's alpha (Cα) correlation coefficient was 0.89 in the first round and 0.92 in the second round for staging in the structured report., Conclusions: The wide implementation of SR is critical for providing referring physicians and patients with the best quality of service, and for providing researchers with the best quality of data in the context of the big data exploitation of the available clinical data. Implementation is complex, requiring mature technology to successfully address pending user-friendliness, organizational and interoperability challenges.
- Published
- 2021
- Full Text
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