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State-of-the-art remote sensing image management systems adopt scalable databases and employ sophisticated indexing techniques to perform window and containment queries. Many rely on space-filling curve (SFC) based index techniques designed for key-value databases and are predominantly employable for images that are iso-oriented. Critically, these indexes do not consider the high degree of overlap among images that exists in many data sets and the affiliated storage requirements. Specifically, employing an SFC-based grid cell index approach in consort with ground footprint coverage of the images requires storage of a unique image object identification (IOI) for each image in every grid cell where overlap occurs. Such an approach adversely affects both storage and query response times. In response, this paper presents an optimization technique for an SFC-based grid cell space indexing. The optimization is specifically designed for window and containment queries where the region of interest overlaps with at least a 2 × 2 grid of cells. The technique is based on four cell removal steps, thus called “four step algorithm” (4SA). Each step employs a unique spatial configuration to check for continuous spatial extent. If present, the IOI of the target cell is omitted from further consideration. Analysis and experiments on real world and synthetic image data demonstrated that 4SA improved storage demands by 41.3% – 47.8%. Furthermore, in the performed querying experiments, only 42% of IOI elements needed to be processed, thus yielding a 58% productivity gain. The reduction of IOI elements in querying also impacted the CPU execution time (3.0% – 5.2%). The 4SA also demonstrated data scalability and concurrent user scalability in querying large regions by completing the index searching and concurrent user scalability 1.86% – 3.35% faster than when 4SA was not applied.

Need for a review Guidelines for management and prevention of contrast media extravasation have not been updated recently. In view of emerging research and changing working practices, this review aims to inform update on the current guidelines. Areas covered In this paper, we review the literature pertaining to the pathophysiology, diagnosis, risk factors and treatments of contrast media extravasation. A suggested protocol and guidelines are recommended based upon the available literature. Key Points • Risk of extravasation is dependent on scanning technique and patient risk factors. • Diagnosis is mostly clinical, and outcomes are mostly favourable. • Referral to surgery should be based on clinical severity rather than extravasated volume.

Contrast-enhanced ultrasonography (CEUS) is increasingly being performed in Italy and Europe, particularly in the field of hepato-gastroenterology. Initially, it was mainly carried out to characterize focal hepatic lesions, but, since then, numerous studies have demonstrated its efficacy in the differential diagnosis of focal pancreatic pathologies (D’Onofrio et al. in Expert Rev Med Devices 7(2):257–273, 2010; Vidili et al. in J Ultrasound 22(1):41–51, 2019). The purpose of this paper is to provide Italian Medical Doctors with recommendations and thereby practical guidelines on the management of these patients. The present paper reports the final conclusions reached by the SIUMB guideline commission. This paper addresses particularly percutaneous ultrasound (US) examination (transabdominal US) and is drawn up specifically for publication.

The present document describes the SIUMB (Italian Society of Ultrasound in Medicine and Biology) guidelines for the use of ultrasound in the management of focal liver disease. The aim of the paper is to provide a clinical practice guideline for Italian physicians who are approaching the ultrasound study of a focal liver lesion. In particular, these guidelines provide simple indications, recommendations and general practice advices for the correct use of contrast-enhanced ultrasound (CEUS) in this scenario. They represent the SIUMB position of the ultrasound role in the diagnostic flow charts of the principal focal liver lesions, and are in agreement with other, previously published national and international guidelines.