71 results on '"Rengo M"'
Search Results
2. Radiogenomics in clear cell renal cell carcinoma: Correlations between advanced CT imaging (texture analysis) and microRNAs expression
- Author
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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
- Full Text
- View/download PDF
3. 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
4. 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
- Author
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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.
- Published
- 2021
- Full Text
- View/download PDF
5. 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.
- Published
- 2015
6. Second-generation dual-energy computed tomography of the abdomen: Radiation dose comparison with 64- and 128-row single-energy acquisition
- Author
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De Cecco, C, Darnell, A, Macías, N, Ayuso, J, Rodríguez, S, Rimola, J, Pagés, M, García-Criado, Á, Rengo, M, Muscogiuri, G, Laghi, A, Ayuso, C, De Cecco CN, Darnell A, Macías N, Ayuso JR, Rodríguez S, Rimola J, Pagés M, García-Criado Á, Rengo M, Muscogiuri G, Laghi A, Ayuso C., De Cecco, C, Darnell, A, Macías, N, Ayuso, J, Rodríguez, S, Rimola, J, Pagés, M, García-Criado, Á, Rengo, M, Muscogiuri, G, Laghi, A, Ayuso, C, De Cecco CN, Darnell A, Macías N, Ayuso JR, Rodríguez S, Rimola J, Pagés M, García-Criado Á, Rengo M, Muscogiuri G, Laghi A, and Ayuso C.
- Abstract
Purpose: This study was designed to compare the radiation dose in abdominal dual-energy (DE) and single-energy (SE) acquisitions obtained in clinical practice with a second-generation DE computed tomography (DECT) and to analyze the dose variation in comparison with an SE ac- quisition performed with a 64-row SECT (SECT). Methods: A total of 130 patients divided into 2 groups underwent precontrast and portal abdominal 128-row CT examination. In group A, DE portal acquisition was performed using a detector configuration of 2 40 0.6 mm, tube A at 80 kVp and a reference value of 559 mAs, tube B at 140 kVp and a reference value of 216 mAs, pitch 0.6, and online dose modulation; group B underwent SE portal acqui- sition using a detector configuration of 64 0.6 mm, 120 kVp and a reference value of 180 mAs, pitch 0.75, and online dose modulation. Group C consisted of 32 subjects from group A previously studied with 64-row SECT using the following parameters: detector configuration 64 0.6 mm, 120 kVp and a reference value of 180 mAs, pitch 0.75, and online dose modulation. In each group, the portal phase dose-length product and radiation dose (mSv) were calculated and normalized for a typical abdominal acquisition of 40 cm. Results: After normalization to standard 40-cm acquisition, a dose-length product of 599.0 T 133.5 mGy I cm (range, 367.5 T 1231.2 mGy I cm) in group A, 525.9 T 139.2 mGy I cm (range, 215.7Y882.8 mGy I cm) in group B, and 515.9 T 111.3 mGy I cm (range, 305.5Y687.2 mGy I cm) in group C was calculated for portal phase acquisition. A significant radiation dose increase (P G 0.05) was observed in group A (10.2 T 2.3 mSv) compared with group B (8.9 T 2.4) and group C (8.8 T 1.9 mSv). No significant difference (P 9 0.05) was reported between SE 64- and 128-row acquisitions. A significant positive cor- relation between radiation dose and body mass index was observed in each group (group A, r2 = 0.59, P G 0.0001; group B, r2 = 0.35, P G 0.0001; group C, r2 = 0.2
- Published
- 2013
7. Dual-energy CT: oncologic applications
- Author
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De Cecco, C, Darnell, A, Rengo, M, Muscogiuri, G, Bellini, D, Ayuso, C, Laghi, A, De Cecco C. N., Darnell A., Rengo M., Muscogiuri G., Bellini D., Ayuso C., Laghi A., De Cecco, C, Darnell, A, Rengo, M, Muscogiuri, G, Bellini, D, Ayuso, C, Laghi, A, De Cecco C. N., Darnell A., Rengo M., Muscogiuri G., Bellini D., Ayuso C., and Laghi A.
- Abstract
OBJECTIVE: Dual-energy CT (DECT) is an innovative imaging technique that operates on the basic principle of application of two distinct energy settings that make the transition from CT attenuation-based imaging to material-specific or spectral imaging. The purpose of this review is to describe the use of DECT in oncology. CONCLUSION: Applications of DECT in clinical practice are based on two capabilities: material differentiation and material identification and quantification. The capability of obtaining different material-specific datasets (iodine map, virtual unenhanced, and monochromatic images) in the same acquisition can improve lesion detection and characterization. This approach can also affect evaluation of the response to therapy and detection of oncology-related disorders. DECT is an innovative imaging technique that can dramatically affect the care of oncologic patients.
- Published
- 2012
8. Computed tomography segmental calcium score (SCS) to predict stenosis severity of calcified coronary lesions
- Author
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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.
- Published
- 2015
- Full Text
- View/download PDF
9. Computed tomography segmental calcium score (SCS) to predict stenosis severity of calcified coronary lesions
- Author
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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.
- Published
- 2015
10. Aneurysm of Vieussens' arterial ring in a patient studied with coronary computed tomography
- Author
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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
11. Protocolli di studio in TC spirale multistrato 3: Cuore - Torace
- Author
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Laghi, Andrea and Rengo, M.
- Published
- 2009
12. Global cardiac evaluation without heart rate control: preliminary experience with dual source CT (DSCT)
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Cecco, C. N., Bastarrika, G., Pueyo, J., Amedeo Anselmi, Rengo, M., Enrici, M. M., and David, V.
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x-ray computed ,Male ,coronary vessels ,Coronary Artery Disease ,tomography ,Middle Aged ,Coronary Angiography ,Heart Rate ,ventricular function ,Humans ,Female ,Prospective Studies ,Tomography, X-Ray Computed - Abstract
The aim of this work was to assess the role of dual source computed tomography (DSCT) in global cardiac evaluation without heart rate control, assessing the effect of average heart rate on coronary image quality, optimal reconstruction interval, ventricular function, and evaluation of left chamber valves.Fifteen consecutive patients under-went coronary CT angiography. For coronary evaluation, data sets were reconstructed in 5% steps from 30% to 80% of the RR interval. For the assessment of cardiac function, image were reconstructed with a slice thickness of 2.0 mm and 2.0 mm increment, at 10% steps from 0% to 90% of the RR interval. Two blinded independent readers assessed the image quality of the coronary arteries and left chamber valves.The mean heart rate during the scan was 73+/-11.8 bpm (range 56-97). At the best reconstruction interval excellent diagnostic image quality (score 4) was achieved in 95.5% (43/45) of coronary arteries. Excellent inter-observer agreement was observed for image quality rating (k=0.82). No significant correlation was found between the average heart rate and the mean quality scores (rho=0.29). Comparison of image quality of the coronary arteries in systolic and diastolic reconstructions in each patient showed no statistically significant differences.DSCT is an excellent technique for global cardiac imaging, as it allows to obtain coronary arteries of excellent quality and evaluate ventricular function and valvular area independent of the heart rate.
- Published
- 2008
13. Multislice computed tomography coronary angiography: clinical applications
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Cademartiri F, Aldrovandi A, Palumbo A, Erica Maffei, Fusaro M, Tresoldi S, Messalli G, Rossi A, Rengo M, Pugliese F, Bv, Salamousas, Reverberi C, Wb, Meijboom, Nr, Mollet, Ardissino D, Pj, Feyter, Radiology & Nuclear Medicine, and Cardiology
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Tomography Scanners, X-Ray Computed ,Coronary angiography ,Coronary artery disease ,Tomography, spiral computed ,Tomography, X-Ray computed ,Predictive Value of Tests ,X-Ray computed ,Humans ,Coronary Artery Disease ,Coronary Angiography ,Tomography ,Tomography, Spiral Computed ,spiral computed - Abstract
Cardiac and coronary computed tomography (CT) is becoming increasingly common in clinical practice. Even if there is no well-established evidence, this diagnostic modality is so strong and effective and, in skilled hand, it can be readily used in clinical practice. After learning its potential and the technical limits, this tool could be used for risk stratification as well as for revascularization evaluation. In this review, we will describe the results of present literature, clinical applications at present considered suitable to CT technology (i.e. 64-slice and dual-source scanners) and future applications and innovations.
- Published
- 2007
14. DIAGNOSI E TRATTAMENTO DEL FIBROADENOMA DELLA MAMMELLA 20 ANNI DI ESPERIENZA
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Ranieri, Ersilia, Barberi, S., Caprio, G., Naticchioni, E., Ceccarelli, F., and Rengo, M.
- Published
- 2006
15. Trattamento angioradiologico di un caso di trauma renale di V grado
- Author
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Pascazio, C, Assenza, Marco, Tomei, B, Clementi, I, Romagnoli, F, Caramanico, L, Rengo, M, and Modini, C.
- Published
- 2002
16. Approccio multidisciplinare del trauma chiuso dell'addome. Caso clinico
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Assenza, Marco, Moschella, Cm, Pascazio, C, Romagnoli, F, Caramanico, L, Rengo, M, and Modini, C.
- Published
- 2002
17. Successful treatment of a post-traumatic forearm compartment syndrome misdiagnosed as gaseousesgangrene: a case report
- Author
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Assenza, Marco, Rocco, Monica, Baldassare, E, Lombardo, F, and Rengo, M.
- Published
- 2000
18. Gasless laparoscopic cholecystectomy. Selective intervention in a high surgical risk patient
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Catani M, De Milito R, Massimo Chiaretti, Abati G, and Rengo M
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Liver Cirrhosis ,Male ,Myocardial Ischemia ,Surgery procedure laparoscopic ,laparoscopic ,methods ,Cholecystectomy, Laparoscopic ,Risk factors ,Cholelithiasis ,Acute Disease ,Cholecystitis ,Humans ,Cholecystectomy ,Respiratory Insufficiency ,Aged - Abstract
Disadvantages related to CO2 pneumoperitoneum in high risk patients (anesthesiologic classification in III and IV ASA), have led to the development of the abdominal wall retractor, a device designed to facilitate laparoscopic surgery without conventional pneumoperitoneum. A case of a patient with acute cholecystitis, well-compensated liver cirrhosis, and high respiratory and cardiologic risk (ASA III class), submitted to laparoscopic cholecystectomy with gasless technique is reported.
- Published
- 2000
19. High positive predictive value of CT colonography in a referral centre
- Author
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Iafrate, F, Hassan, Cesare, Ciolina, M, Lamazza, A, Baldassari, P, Pichi, A, Zullo, A, Stagnitti, A, Iannitti, M, Rengo, M, Laghi, A., Iafrate, F, Hassan, Cesare, Ciolina, M, Lamazza, A, Baldassari, P, Pichi, A, Zullo, A, Stagnitti, A, Iannitti, M, Rengo, M, and Laghi, A.
- Abstract
To assess the positive predictive value (PPV) of CTC in the clinical routine of a dedicated referral centre.
- Published
- 2011
20. Colorectal cancer screening: the role of CT colonography
- Author
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Laghi, A, Iafrate, F, Rengo, M, Hassan, Cesare, Laghi, A, Iafrate, F, Rengo, M, and Hassan, Cesare
- Abstract
Computed tomography colonography (CTC) in colorectal cancer (CRC) screening has two roles: one present and the other potential. The present role is, without any further discussion, the integration into established screening programs as a replacement for barium enema in the case of incomplete colonoscopy. The potential role is the use of CTC as a first-line screening method together with Fecal Occult Blood Test, sigmoidoscopy and colonoscopy. However, despite the fact that CTC has been officially endorsed for CRC screening of average-risk individuals by different scientific societies including the American Cancer Society, the American College of Radiology, and the US Multisociety Task Force on Colorectal Cancer, other entities, such as the US Preventive Services Task Force, have considered the evidence insufficient to justify its use as a mass screening method. Medicare has also recently denied reimbursement for CTC as a screening test. Nevertheless, multiple advantages exist for using CTC as a CRC screening test: high accuracy, full evaluation of the colon in virtually all patients, non-invasiveness, safety, patient comfort, detection of extracolonic findings and cost-effectiveness. The main potential drawback of a CTC screening is the exposure to ionizing radiation. However, this is not a major issue, since low-dose protocols are now routinely implemented, delivering a dose comparable or slightly superior to the annual radiation exposure of any individual. Indirect evidence exists that such a radiation exposure does not induce additional cancers.
- Published
- 2010
21. Treatment of an aneurysm of the coeliac axis by transluminal steel wire occlusion
- Author
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Rengo, M., primary, Terrinoni, V., additional, Lamazza, A., additional, Cosimati, A., additional, and Bianchi, G., additional
- Published
- 1997
- Full Text
- View/download PDF
22. Laparoscopic incisional hernia repair by lightweight polypropylene mesh with resorbable coating. Technical notes, preliminary results.
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Cavallaro, G., Campanile, F. C., Rizzello, M., Greco, F., Iorio, O., Angelis, F. De, Rengo, M., and Silecchia, G.
- Published
- 2013
23. [Intravenous cholangiography. Considerations on the diameter and emptying time of the choledochus in 187 cases subjected to surgical intervention of the bile ducts]
- Author
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Alessi, G., Giuliani, A., Caporale, A., Guglielmelli, E., Rengo, M., Schillaci, Alberto, DI GIULIO, Emilio, and Marcellino, M.
- Subjects
Adult ,Common Bile Duct ,Male ,Cholestasis ,Cholecystitis ,Humans ,Female ,Constriction, Pathologic ,Middle Aged ,Cholangiography ,Aged - Published
- 1984
24. [Laparoscopy in emergency: treatment of choice in acute abdomen]
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Catani M, De Milito R, Massimo Chiaretti, Manili G, Spaziani E, Antoniozzi A, and Rengo M
- Subjects
Abdomen, Acute ,Adult ,Male ,appendicitis ,Adolescent ,Middle Aged ,acute abdomen ,Ovarian Cysts ,cholecystitis ,Child, Preschool ,Appendectomy ,Humans ,Female ,Laparoscopy ,Child ,Emergency Treatment ,Intestinal Obstruction - Abstract
From 1992 to November 1999, 225 consecutive cases of acute abdomen were observed: 163 suspicious acute appendicitis, 7 ovarian cysts with suspect torsion, 4 intestinal occlusions, 1 digestive hemorrhage due GIST (Gastro-Intestinal Stromal Tumor), 1 case of hemoperitoneum after laparoscopic appendectomy and 49 cases of acute cholecystitis. In the 225 cases of emergency laparoscopic operations for acute abdomen the diagnostic accuracy has been of 99.5%, with only one case of conversion in to laparotomy for diagnosis. The conversion from laparoscopic to laparatomic surgical technique was registers in 2 cases (1%). The realimentation started in all the cases with a liquid diet as soon as 6 hours after the operation and with solid foods the following morning. The Authors haven't registered wound contaminations. The patients of working age rehabilitated in 8 days (between 7 and 21 days). In the athletic patients the average rehabilitation time was 15 days. On the base of the results obtained with their video-laparoscopy experience in acute abdomen emergency surgery, the Authors confirm that this technique can be advised as Emergency Surgery's first choice treatment.
25. Laparoscopic incisional hernia repair by lightweight polypropylene mesh with resorbable coating. Technical notes, preliminary results
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Cavallaro G, Fabio Cesare Campanile, Rizzello M, Greco F, Iorio O, Fd, Angelis, Rengo M, and Silecchia G
- Subjects
Adult ,Aged, 80 and over ,Male ,incisional hernia ,Middle Aged ,Surgical Mesh ,Polypropylenes ,polypropylene mesh ,Hernia, Ventral ,Treatment Outcome ,Recurrence ,laparoscopy ,Humans ,Female ,Laparoscopy ,Prospective Studies ,Herniorrhaphy ,Aged - Abstract
Laparoscopic repair of ventral hernias has gained popularity, since many studies have reported encouraging results. The choice of the mesh and fixation methods are crucial issues in preventing complications and recurrence. 30 laparoscopic ventral hernia repair performed consecutively in 28 patients (11 males, 17 females) for different kinds of incisional hernias from February 2011 to June 2012 were prospectively evaluated. All patients received total laparoscopic incisional hernia repair by the use of the new lightweight polypropylene mesh with resorbable coating (PhysiomeshTM, Ethicon Endo-Surgery, Johnson Johnson, Inc.). No major postoperative complications were reported. Two recurrences were diagnosed after 5 months from the first repair. Both patients received laparoscopic repair by the same kind of mesh. Lightweight polypropylene mesh with resorbable coating, with its properties of easy positioning and bio-compatibility, represents an innovation in laparoscopic incisional hernia repair, and should be considered for clinical intra-operative as well as long term evaluations.
26. [Current therapeutic orientation toward testicular germ cell tumors]
- Author
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Catani M, De Milito R, Massimo Chiaretti, Cortesi E, Anselmi W, Manili G, Tomei B, Terrinoni V, Bianchi G, and Rengo M
- Subjects
Adult ,Male ,Spermatic Cord ,L-Lactate Dehydrogenase ,Combined Modality Therapy ,Bleomycin ,Testicular Neoplasms ,Lymphatic Metastasis ,Antineoplastic Combined Chemotherapy Protocols ,Cryptorchidism ,testicular germ cell tumors ,Biomarkers, Tumor ,Humans ,Lymph Node Excision ,Chorionic Gonadotropin, beta Subunit, Human ,Germinoma ,alpha-Fetoproteins ,Cisplatin ,Ligation ,Orchiectomy ,Etoposide - Abstract
Personal experience in a case of primary germinal tumor of the testis in advanced state is described. The initial treatment was chemioterapy: the patient received four complete cycles of cisplatin-based chemoterapy (PEB scheme). A surgical treatment consisted of a radical inguinal orchiectomy with high ligation of the spermatic cord at the deep inguinal ring associated with interaortocaval lymphonodes dissection. Actually, after two years from the beginning of treatment, the patient is well, without signs of neoplasm disease.
27. [Laparoscopy in an abdominal emergency: the diagnosis and therapy in 3 clinical cases of acute abdomen]
- Author
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Catani M, De Milito R, Rattà G, Abati G, Massimo Chiaretti, and Rengo M
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Abdomen, Acute ,Adult ,Male ,Torsion Abnormality ,Adolescent ,Uterus ,Appendicitis ,Pregnancy, Ectopic ,acute abdomen ,Pregnancy ,Intestine, Small ,ectopic pregnancy ,Humans ,Laparoscopy ,abdominal emergency ,Female ,Emergencies ,Intestinal Obstruction ,Spleen ,Splenic Diseases - Abstract
Authors report three cases of acute abdomen due a probable appendicitis and submit to laparoscopic procedure. In the first case acute abdomen was due to a bowel obstruction secondary to an ectopic pregnancy; in the second case acute appendicitis was associated with a rare congenital malformation (atresia of uterus); in third case acute abdomen was due to a rare case of torsion of accessory spleen in an adult. In all the cases laparoscopy demonstrated the elective procedure in urgency, permitting the diagnosis and the surgical treatment of acute abdomen with the post-operatory advantage of the technique.
28. Evaluation of postoperative blood coagulation changes in elderly patients undergoing major surgery
- Author
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Caporale A, Mc, Tirindelli, Paolo AURELLO, Mancini F, Giuliani A, Rengo M, Mariani G, and Aureggi A
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Aged, 80 and over ,Male ,Antithrombin III ,Fibrinogen ,Plasminogen ,Thrombophlebitis ,Blood Coagulation Factors ,Risk Factors ,Surgical Procedures, Operative ,von Willebrand Factor ,Humans ,Female ,Aged ,Follow-Up Studies ,Protein C - Abstract
18 elderly patients submitted to major surgery for malignancies or other disease were studied to assess the relationship between changes of blood coagulation factors and inhibitors in the early post-operative period and the appearance of lower limb deep vein thrombosis. A decrease in serum antithrombin III (AT III) Protein C antigen (PC: Ag) and Plasminogen activity (PLG) levels from the second to the fourth postoperative day, together with a simultaneous increase in serum fibrinogen (FG) and von Willebrand Factor (vWF:Ag) antigen levels was observed. In 8 patients, PC:Ag levels dropped below the limit considered at risk to develop DVT (less than 60 U/dl). A patient with the lowest PC:Ag levels had deep vein thrombosis From the analysis of data it was concluded that in the postoperative period, blood coagulation changes occur in elderly patients, predisposing to the risk of deep vein thrombosis.
29. Structured reporting of rectal cancer staging and restaging: A consensus proposal
- Author
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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
30. 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.
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- 2022
31. 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.
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- 2021
32. 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.
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- 2021
33. 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.
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- 2021
34. 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
35. 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
36. 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
37. 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
38. Second-generation dual-energy computed tomography of the abdomen: Radiation dose comparison with 64- and 128-row single-energy acquisition
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Anna Darnell, Carmen Ayuso, Giuseppe Muscogiuri, Juan Ramón Ayuso, Carlo N. De Cecco, Jordi Rimola, Marco Rengo, Napoleón Macías, Sonia Rodríguez, Ángeles García-Criado, Mario Pagés, Andrea Laghi, De Cecco, C, Darnell, A, Macías, N, Ayuso, J, Rodríguez, S, Rimola, J, Pagés, M, García-Criado, Á, Rengo, M, Muscogiuri, G, Laghi, A, and Ayuso, C
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Adult ,Male ,Radiography, Abdominal ,medicine.medical_specialty ,Abdominal imaging ,Radiography ,Single-energy ,Radiation Dosage ,Sensitivity and Specificity ,Radiography, Dual-Energy Scanned Projection ,Young Adult ,Precontrast ,Ct examination ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Computed tomography ,Aged ,Aged, 80 and over ,business.industry ,Radiation dose ,Reproducibility of Results ,Dual-Energy Computed Tomography ,Middle Aged ,Patient management ,medicine.anatomical_structure ,Italy ,Dual-energy ,Abdomen ,Body Burden ,Female ,Radiology ,Tomography ,business ,Tomography, X-Ray Computed - Abstract
Purpose: This study was designed to compare the radiation dose in abdominal dual-energy (DE) and single-energy (SE) acquisitions obtained in clinical practice with a second-generation DE computed tomography (DECT) and to analyze the dose variation in comparison with an SE ac- quisition performed with a 64-row SECT (SECT). Methods: A total of 130 patients divided into 2 groups underwent precontrast and portal abdominal 128-row CT examination. In group A, DE portal acquisition was performed using a detector configuration of 2 40 0.6 mm, tube A at 80 kVp and a reference value of 559 mAs, tube B at 140 kVp and a reference value of 216 mAs, pitch 0.6, and online dose modulation; group B underwent SE portal acqui- sition using a detector configuration of 64 0.6 mm, 120 kVp and a reference value of 180 mAs, pitch 0.75, and online dose modulation. Group C consisted of 32 subjects from group A previously studied with 64-row SECT using the following parameters: detector configuration 64 0.6 mm, 120 kVp and a reference value of 180 mAs, pitch 0.75, and online dose modulation. In each group, the portal phase dose-length product and radiation dose (mSv) were calculated and normalized for a typical abdominal acquisition of 40 cm. Results: After normalization to standard 40-cm acquisition, a dose-length product of 599.0 T 133.5 mGy I cm (range, 367.5 T 1231.2 mGy I cm) in group A, 525.9 T 139.2 mGy I cm (range, 215.7Y882.8 mGy I cm) in group B, and 515.9 T 111.3 mGy I cm (range, 305.5Y687.2 mGy I cm) in group C was calculated for portal phase acquisition. A significant radiation dose increase (P G 0.05) was observed in group A (10.2 T 2.3 mSv) compared with group B (8.9 T 2.4) and group C (8.8 T 1.9 mSv). No significant difference (P 9 0.05) was reported between SE 64- and 128-row acquisitions. A significant positive cor- relation between radiation dose and body mass index was observed in each group (group A, r2 = 0.59, P G 0.0001; group B, r2 = 0.35, P G 0.0001; group C, r2 = 0.20, P = 0.0098). Conclusions: In clinical practice, abdominal DECT acquisition shows a significant but minimal radiation dose increase, on the order of 1 mSv, compared with 64- and 128-row SE acquisition. The slightly increased ra- diation dose can be justified if the additional information obtained using a spectral imaging approach directly impacts on patient management or re- duce the overall radiation dose with the generation of virtual unenhanced images, which can replace the precontrast acquisition.
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- 2013
39. Dual-energy CT: oncologic applications
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Andrea Laghi, Davide Bellini, Carlo N. De Cecco, Carmen Ayuso, Anna Darnell, Marco Rengo, Giuseppe Muscogiuri, De Cecco, C, Darnell, A, Rengo, M, Muscogiuri, G, Bellini, D, Ayuso, C, and Laghi, A
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medicine.medical_specialty ,Response to therapy ,Radiography ,Ct attenuation ,dual-energy ct ,perfusion ,Radiography, Dual-Energy Scanned Projection ,Neoplasms ,monochromatic ,Humans ,Medicine ,cancer ,iodine map ,Radiology, Nuclear Medicine and imaging ,Medical physics ,business.industry ,Digital Enhanced Cordless Telecommunications ,General Medicine ,Spectral imaging ,Clinical Practice ,Neoplasm ,Radiographic Image Interpretation, Computer-Assisted ,Tomography ,Dual energy ct ,business ,Tomography, X-Ray Computed ,Human - Abstract
OBJECTIVE. Dual-energy CT (DECT) is an innovative imaging technique that operates on the basic principle of application of two distinct energy settings that make the transition from CT attenuation–based imaging to material-specific or spectral imaging. The purpose of this review is to describe the use of DECT in oncology. CONCLUSION. Applications of DECT in clinical practice are based on two capabilities: material differentiation and material identification and quantification. The capability of obtaining different material-specific datasets (iodine map, virtual unenhanced, and monochromatic images) in the same acquisition can improve lesion detection and characterization. This approach can also affect evaluation of the response to therapy and detection of oncology-related disorders. DECT is an innovative imaging technique that can dramatically affect the care of oncologic patients.
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- 2012
40. Rationale, design and methods of CTCA-PRORECAD (Computed Tomography Coronary Angiography Prognostic Registry for Coronary Artery Disease): a multicentre and multivendor registry
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Teresa Arcadi, Nazario Carrabba, Filippo Cademartiri, Onofrio A. Catalano, Marco Francone, Massimo Midiri, Carlo Tedeschi, Alberto Cuocolo, Andrea Igoren Guaricci, Roberto Malago, Erica Maffei, Paolo Spagnolo, Marco Rengo, Vincenzo Russo, Sara Seitun, Maffei, E, Midiri, M, Russo, V, Rengo, M, Tedeschi, C, Spagnolo, P, Seitun, S, Francone, M, Guaricci, Ai, Carrabba, N, Malagò, R, Cuocolo, Alberto, Arcadi, T, Catalano, Oa, Cademartiri, F., Guaricci, A, Cuocolo, A, Catalano, O, and Cademartiri, F
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Coronary angiography ,Male ,Contrast Media ,Computed tomography ,Coronary Disease ,Coronary Angiography ,Coronary artery disease ,Computed tomography coronary angiography ,Computer-Assisted ,Risk Factors ,Registries ,Tomography ,Neuroradiology ,education.field_of_study ,medicine.diagnostic_test ,computed tomography coronary angiography ,coronary artery disease ,prevalence of disease ,prognosis ,registry ,risk stratification ,Radiographic Image Interpretation ,Interventional radiology ,General Medicine ,Middle Aged ,Prognosis ,X-Ray Computed ,Research Design ,Risk stratification ,Cardiology ,Prevalence of disease ,Radiographic Image Interpretation, Computer-Assisted ,Female ,Radiology ,medicine.medical_specialty ,Registry ,Prognosi ,Endpoint Determination ,Population ,Risk Assessment ,Analysis of Variance ,Humans ,Proportional Hazards Models ,Retrospective Studies ,Tomography, X-Ray Computed ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,education ,business.industry ,medicine.disease ,business - Abstract
PURPOSE: This study was done to assess the prognostic value of computed tomography coronary angiography (CTCA) in a large multicentre population of patients with suspected coronary artery disease (CAD) and, in particular, its incremental value compared with traditional methods for risk stratification. MATERIALS AND METHODS: This is a retrospective observational study that began in January 2003 conducted on patients with suspected CAD assessed with CTCA on the basis of symptoms (chest pain, dyspnoea) and/or abnormal or equivocal stress test and/or a high cardiovascular risk profile. The participating centres will provide data obtained with CTCA performed with 16-slice or higher equipment. Exclusion criteria are renal insufficiency, allergy to iodinated contrast material, pregnancy and previous myocardial infarction or revascularisation (percutaneous coronary intervention and/or coronary artery bypass graft). All patients are stratified by means of clinical assessment and/or data retrieved from a clinical database. Risk factors considered are hypertension, dyslipidaemia, diabetes mellitus, smoking, family history and obesity. Symptoms are classified as absent, typical chest pain, atypical chest pain and dyspnoea. Primary endpoints are death, major adverse cardiovascular events (cardiac death, unstable angina requiring hospitalisation, acute myocardial infarction) and shifting of cardiovascular risk category on the basis of coronary plaque burden. The secondary endpoint is coronary revascularisation. Telephone interviews and/or clinical databases are used for the follow-up. The study will be conducted on a population >1,000 patients. CONCLUSIONS: The information collected from the Prognostic Registry for Coronary Artery Disease (PRORECAD) will provide insight into the prognostic value of CTCA in addition to demographic and clinical features. The results will allow for better use and interpretation of CTCA for prognostic purposes.
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- 2011
41. 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
- Abstract
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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42. 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
- Abstract
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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43. 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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44. 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
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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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45. 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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46. 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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47. 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
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- Adult, Consensus, Delphi Technique, Humans, Neoplasm Staging, Neuroendocrine Tumors pathology, Tomography, X-Ray Computed, Neuroendocrine Tumors diagnostic imaging
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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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48. 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.
- Published
- 2021
- Full Text
- View/download PDF
49. Computed Tomography Structured Reporting in the Staging of Lymphoma: A Delphi Consensus Proposal.
- Author
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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
- Full Text
- View/download PDF
50. Structured Reporting of Lung Cancer Staging: A Consensus Proposal.
- Author
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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.
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- 2021
- Full Text
- View/download PDF
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