La radiologia medica最新文献

{"title":"Management of the axilla in breast cancer patients: critical review, regional modified Delphi consensus and implementation in the Tuscan breast network","authors":"Matteo Ghilli, Carlotta Becherini, Icro Meattini, Catia Angiolini, Carmelo Bengala, Aroldo Marconi, Lorenzo Galli, Giovanni Angiolucci, Luigi Coltelli, Simona Borghesi, Luciana Lastrucci, Gianpiero Manca, Simonetta Bianchi, Morena Doria, Donato Casella, Lorenza Marotti, Gianni Amunni, Manuela Roncella","doi":"10.1007/s11547-024-01818-7","DOIUrl":"https://doi.org/10.1007/s11547-024-01818-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Data from recently trials have provided practice-changing recommendations in management of the axilla in early breast cancer (eBC). However, further controversies have been raised, resulting in heterogeneous diffusion of these recommendations. Our purpose was to obtain a better homogeneity.</p><h3 data-test=\"abstract-sub-heading\">Material and methods</h3><p>In 2021, the Tuscan Breast Network (TBN) established a consensus with the aim to update recommendations in this area. We performed a literature review on axillary management in eBC patients which led to an expert Delphi consensus aiming to explore the gray areas, build consensus and propose evidence-based suggestions for an appropriate management. Thereafter, we investigate their implementation in clinical practice.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>(1) DCIS patients should have SLN biopsy only in case of mastectomy or in conservative surgery if tumor is in a location that would preclude future nodal sampling or in case of a mass; (2) ALND may be omitted for 1–2 positive SLN patients undergoing BCS in T1-2 tumors with 1–2 SLN positive, eligible for whole-breast irradiation and adjuvant systemic therapies; (3) consider the option of RNI in patients with 1–3 positive lymph nodes and one or more high-risk characteristics; (4) the population identified in 2) should NOT undergo lymph node irradiation as an alternative to axillary surgery and (5) patients with clinically (pre-operatively) positive axilla, or undergoing primary systemic therapy, or outside the criteria reported in 2) must receive additional ALND and/or RT as per local policy.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This consensus provided a practical tool to stimulate local and national breast surgical and radiotherapy protocols.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140812797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-dimensional perfusion angiography permits direct visualization of redistribution of flow in hepatocellular carcinoma during b-TACE","authors":"Pierleone Lucatelli, Simone Ciaglia, Bianca Rocco, Gianluca De Rubeis, Guido Bolognesi, Elio Damato, Mario Corona, Pier Giorgio Nardis, Alessandro Cannavale, Paolo Ricci, Carlo Catalano","doi":"10.1007/s11547-024-01816-9","DOIUrl":"https://doi.org/10.1007/s11547-024-01816-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To demonstrate in vivo redistribution of the blood flow towards HCC’s lesions by utilizing two-dimensional perfusion angiography in b-TACE procedures.</p><h3 data-test=\"abstract-sub-heading\">Material and methods</h3><p>In total, 30 patients with 35 HCC nodules treated in the period between January 2019 and November 2021. For each patient, a post-processing software leading to a two-dimensional perfusion angiography was applied on each angiography performed via balloon microcatheter, before and after inflation. On the colour map obtained, reflecting the evolution of contrast intensity change over time, five regions of interests (ROIs) were assessed: one on the tumour (ROI-t), two in the immediate peritumoural healthy liver parenchyma (ROI-ihl) and two in the peripheral healthy liver parenchyma (ROI-phl). The results have been interpreted with a novel in silico model that simulates the hemodynamics of the hepatic arterial system.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among the ROIs drawn inside the same segment of target lesion, the time-to-peak of the ROI-t and of the ROI-ihl have a significantly higher mean value when the balloon was inflated compared with the ROIs obtained with deflated balloon (10.33 ± 3.66 s vs 8.87 ± 2.60 s (<i>p</i> = 0.015) for ROI-t; 10.50 ± 3.65 s vs 9.23 ± 2.70 s (<i>p</i> = 0.047) for ROI-ihl). The in silico model prediction time-to-peak delays when balloon was inflated, match with those observed in vivo. The numerical flow analysis shows how time-to-peak delays are caused by the obstruction of the balloon-occluded artery and the opening of intra-hepatic collateral.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The measurements identify predictively the flow redistribution in the hepatic arteries during b-TACE, supporting a proper positioning of the balloon microcatheter.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140623742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-based radiomics for early predicting response to neoadjuvant chemotherapy in patients with breast cancer: a systematic review with meta-analysis","authors":"Zhifan Li, Xinran Liu, Ya Gao, Xingru Lu, Junqiang Lei","doi":"10.1007/s11547-024-01783-1","DOIUrl":"https://doi.org/10.1007/s11547-024-01783-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>This study aims to evaluate the diagnostic accuracy of ultrasound imaging (US)-based radiomics for the early prediction of response to neoadjuvant chemotherapy (NAC) in breast cancer patients.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We comprehensively searched PubMed, Cochrane Library, Embase, and Web of Science databases up to 1 January 2023 for eligible studies. We assessed the methodological quality of the enrolled studies with Radiomics Quality Score (RQS) and the Quality Assessment of Diagnostic Accuracy Studies-2 tools. We performed meta-analyses to summarize the diagnostic efficacy of US-based radiomics in response to NAC in breast cancer patients.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Eight studies proved eligible. Eligible studies exhibited an average RQS score of 12.88 (35.8% of the total score), with the RQS score ranging from 8 to 19. In the meta-analyses, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.87 (95% CI 0.81–0.92), 0.78 (95% CI 0.72–0.83), 4.02 (95% CI 3.18–5.08), 0.16 (95% CI 0.10–0.25), and 25.17 (95% CI 15.10–41.95), respectively. Results from subgroup analyses indicated that prospective studies apparently exhibited more optimal sensitivity than retrospective studies. Sensitivity analyses exhibited similar results to the primary analyses.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>US-based radiomics may be a potentially crucial adjuvant method for evaluating the response of breast cancer to NAC. Due to limited data available and low quality of eligible studies, more multicenter prospective studies with rigorous methods are required to confirm our findings.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140612261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing osteoporosis in postmenopausal women: preliminary results using a novel lumbar spine phantom-based MRI scoring method","authors":"Rahman Ud Din, Tahira Nishtar, Xiaoguang Cheng, Haisheng Yang","doi":"10.1007/s11547-024-01814-x","DOIUrl":"https://doi.org/10.1007/s11547-024-01814-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>To develop a novel magnetic resonance imaging (MRI) phantom for producing <i>F</i>-score (for fat) and <i>W</i>-score (for water) and to evaluate the performance of these scores in assessing osteoporosis and related vertebral fractures.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>First, a real-time phantom consisting of oil and water tubes was manufactured. Then, 30 female volunteers (age: 62.3 ± 6.3 years) underwent lumbar spine examination with MRI (using a novel phantom) and dual-energy X-ray absorptiometry (DXA), following ethical approval. MRI phantom-based <i>F</i>-score and <i>W</i>-score were defined by normalizing the vertebral signal intensities (SIs) by the oil and water SIs of the phantom on <i>T</i>1- and <i>T</i>2-weighted images, respectively. The diagnostic performances of the new scores for assessing osteoporosis and vertebral fractures were examined using receiver operating characteristic analysis and compared with DXA-measured areal bone mineral density (DXA-aBMD).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The <i>F</i>-score and <i>W</i>-score were greater in the osteoporotic patients (3.93 and 2.29) than the non-osteoporotic subjects (3.05 and 1.79) and achieved AUC values of 0.85 and 0.74 (<i>p</i> &lt; 0.05), respectively, when detecting osteoporosis. Similarly, <i>F</i>-score and <i>W</i>-score had greater values for the fracture patients (3.94 and 2.53) than the non-fracture subjects (3.14 and 1.69) and produced better AUC values (0.90 for <i>W</i>-score and 0.79 for <i>F</i>-score) compared to DXA-aBMD (AUC: 0.27, <i>p</i> &lt; 0.05). In addition, the <i>F</i>-score and <i>W</i>-score had a strong correlation (<i>r</i> = 0.77; <i>p</i> &lt; 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>A novel real-time lumber spine MRI phantom was developed, based upon which newly defined <i>F</i>-score and <i>W</i>-score were able to detect osteoporosis and demonstrated an improved ability over DXA-aBMD in differentiating patients with vertebral fractures.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140574023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the malignancy of suspicious breast microcalcifications: the role of contrast enhanced mammography","authors":"Catherine Depretto, Elisa D’Ascoli, Gianmarco Della Pepa, Giovanni Irmici, Claudia De Berardinis, Daniela Ballerini, Alice Bonanomi, Eleonora Ancona, Claudio Ferranti, Gianfranco Paride Scaperrotta","doi":"10.1007/s11547-024-01813-y","DOIUrl":"https://doi.org/10.1007/s11547-024-01813-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To assess the role of contrast-enhanced mammography (CEM) in predicting the malignancy of breast calcifications.</p><h3 data-test=\"abstract-sub-heading\">Material and methods</h3><p>We retrospectively evaluated patients with suspicious calcifications (BIRADS 4) who underwent CEM and stereotactic vacuum-assisted biopsy (VAB) at our institution. We assessed the sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) of CEM in predicting malignancy of microcalcifications with a 95% confidence interval; we performed an overall analysis and a subgroup analysis stratified into group A-low risk (BIRADS 4a) and group B-medium/high risk (BIRADS 4b–4c). We then evaluated the correlation between enhancement and tumour proliferation index (Ki-67) for all malignant lesions.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Data from 182 patients with 184 lesions were collected. Overall the SE of CEM in predicting the malignancy of microcalcifications was 0.70, SP was 0.85, the PPV was 0.82, the NPV was 0.76 and AUC was 0.78. SE in group A was 0.89, SP was 0.89, PPV was 0.57, NPV was 0.98 and AUC was 0.75. SE in group B was 0.68, SP was 0.80, PPV was 0.87, NPV was 0.57 and AUC was 0.75. Among malignant microcalcifications that showed enhancement (N = 52), 61.5% had Ki-67 ≥ 20% and 38.5% had low Ki-67 values. Among the lesions that did not show enhancement (N = 22), 90.9% had Ki-67 &lt; 20% and 9.1% showed high Ki-67 values 20%.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The absence of enhancement can be used as an indicative parameter for the absence of disease in cases of low-suspicious microcalcifications, but not in intermediate-high suspicious ones for which biopsy remains mandatory and can be used to distinguish indolent lesions from more aggressive neoplasms, with consequent reduction of overdiagnosis and overtreatment.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140574105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical assessment of local recurrence site in breast cancer patients after breast reconstruction and post-mastectomy radiotherapy: implications for radiation volumes and techniques","authors":"Viola Salvestrini, Marianna Valzano, Icro Meattini, Carlotta Becherini, Luca Visani, Giulio Francolini, Ilaria Morelli, Niccolò Bertini, Lorenzo Orzalesi, Marco Bernini, Simonetta Bianchi, Gabriele Simontacchi, Lorenzo Livi, Isacco Desideri","doi":"10.1007/s11547-024-01812-z","DOIUrl":"https://doi.org/10.1007/s11547-024-01812-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Post-mastectomy radiotherapy (PMRT) improves local control rates and survival in patients with adverse prognostic features. The dose coverage to target volumes is critical to yield maximum benefit to treated patients, increasing local control and reducing risk of toxicity. This study aims to assess patterns of breast cancer relapse in patients treated with mastectomy, breast reconstruction and PMRT.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Breast cancer patients treated with PMRT between 1992 and 2017 were retrospectively reviewed. Clinical and pathological characteristics of patients were collected. Recurrences were defined as “in field,” “marginal” or “out of field.” Survival analyses were performed in relation to progression-free survival (PFS) and overall survival (OS). Correlation between baseline features was explored.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Data of 140 patients are collected. After a median follow-up time of 72 months, median PFS and OS of 63 and 74 months were detected, respectively. Neoadjuvant chemotherapy, lympho-vascular space invasion (LVI) and size of primary tumor were all significantly associated with worst PFS and OS. Ten patients developed local recurrence: 30% \"in field,\" 30% marginal recurrences, 20% \"out of field\" and 20% both “in field” and “out of field.” No recurrence was detected under the expander, 80% above the device and 20% patients relapsed on IMN chain. The mean distant relapse-free survival was 39 months. Overall, 39 of 140 patients developed distant metastases.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The onset of local–regional relapses occurred mainly above the expander/prosthesis, underlying the importance of inclusion of the subcutaneous tissues within the target volume. In order to refine new contouring recommendations for PMRT and breast reconstruction, future prospective studies are needed.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140574022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-based radiomics analysis in predicting RAS mutational status using magnetic resonance imaging","authors":"Vincenza Granata, Roberta Fusco, Maria Chiara Brunese, Annabella Di Mauro, Antonio Avallone, Alessandro Ottaiano, Francesco Izzo, Nicola Normanno, Antonella Petrillo","doi":"10.1007/s11547-024-01779-x","DOIUrl":"https://doi.org/10.1007/s11547-024-01779-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To assess the efficacy of radiomics features, obtained by magnetic resonance imaging (MRI) with hepatospecific contrast agent, in pre-surgical setting, to predict RAS mutational status in liver metastases.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Patients with MRI in pre-surgical setting were enrolled in a retrospective study. Manual segmentation was made by means 3D Slicer image computing, and 851 radiomics features were extracted as median values using the PyRadiomics Python package. The features were extracted considering the agreement with the Imaging Biomarker Standardization Initiative (IBSI). Balancing was performed through synthesis of samples for the underrepresented classes using the self-adaptive synthetic oversampling (SASYNO) approach. Inter- and intraclass correlation coefficients (ICC) were calculated to assess the between-observer and within-observer reproducibility of all radiomics characteristics. For continuous variables, nonparametric Wilcoxon–Mann–Whitney test was utilized. Benjamini and Hochberg's false discovery rate (FDR) adjustment for multiple testing was used. Receiver operating characteristics (ROC) analysis with the calculation of area under the ROC curve (AUC), sensitivity (SENS), specificity (SPEC), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) were assessed for each parameter. Linear and non-logistic regression model (LRM and NLRM) and different machine learning-based classifiers including decision tree (DT), k-nearest neighbor (KNN) and support vector machine (SVM) were considered. Moreover, features selection were performed before and after a normalized procedure using two different methods (<i>3-sigma</i> and <i>z-score</i>). McNemar test was used to assess differences statistically significant between dichotomic tables. All statistical procedures were done using MATLAB R2021b Statistics and Machine Toolbox (MathWorks, Natick, MA, USA).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Seven normalized radiomics features, extracted from arterial phase, 11 normalized radiomics features, from portal phase, 12 normalized radiomics features from hepatobiliary phase and 12 normalized features from T2-W SPACE sequence were robust predictors of RAS mutational status. The multivariate analysis increased significantly the accuracy in RAS prediction when a LRM was used, combining 12 robust normalized features extracted by VIBE hepatobiliary phase reaching an accuracy of 99%, a sensitivity 97%, a specificity of 100%, a PPV of 100% and a NPV of 98%. No statistically significant increase was obtained, considering the tested classifiers DT, KNN and SVM, both without normalization and with normalization methods.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Normalized approach in MRI radiomics analysis allows to predict RAS mutational status.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139662664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning and atlas-based models to streamline the segmentation workflow of total marrow and lymphoid irradiation","authors":"Damiano Dei, Nicola Lambri, Leonardo Crespi, Ricardo Coimbra Brioso, Daniele Loiacono, Elena Clerici, Luisa Bellu, Chiara De Philippis, Pierina Navarria, Stefania Bramanti, Carmelo Carlo-Stella, Roberto Rusconi, Giacomo Reggiori, Stefano Tomatis, Marta Scorsetti, Pietro Mancosu","doi":"10.1007/s11547-024-01760-8","DOIUrl":"https://doi.org/10.1007/s11547-024-01760-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To improve the workflow of total marrow and lymphoid irradiation (TMLI) by enhancing the delineation of organs at risk (OARs) and clinical target volume (CTV) using deep learning (DL) and atlas-based (AB) segmentation models.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>Ninety-five TMLI plans optimized in our institute were analyzed. Two commercial DL software were tested for segmenting 18 OARs. An AB model for lymph node CTV (CTV_LN) delineation was built using 20 TMLI patients. The AB model was evaluated on 20 independent patients, and a semiautomatic approach was tested by correcting the automatic contours. The generated OARs and CTV_LN contours were compared to manual contours in terms of topological agreement, dose statistics, and time workload. A clinical decision tree was developed to define a specific contouring strategy for each OAR.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The two DL models achieved a median [interquartile range] dice similarity coefficient (DSC) of 0.84 [0.71;0.93] and 0.85 [0.70;0.93] across the OARs. The absolute median Dmean difference between manual and the two DL models was 2.0 [0.7;6.6]% and 2.4 [0.9;7.1]%. The AB model achieved a median DSC of 0.70 [0.66;0.74] for CTV_LN delineation, increasing to 0.94 [0.94;0.95] after manual revision, with minimal Dmean differences. Since September 2022, our institution has implemented DL and AB models for all TMLI patients, reducing from 5 to 2 h the time required to complete the entire segmentation process.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>DL models can streamline the TMLI contouring process of OARs. Manual revision is still necessary for lymph node delineation using AB models.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139666489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance-guided focused ultrasound versus percutaneous thermal ablation in local control of bone oligometastases: a systematic review and meta-analysis","authors":"Mario Leporace, Valentina Lancellotta, Valentina Baccolini, Ferdinando Calabria, Francesca Castrovillari, Dimitrios K. Filippiadis, Luca Tagliaferri, Roberto Iezzi","doi":"10.1007/s11547-024-01780-4","DOIUrl":"https://doi.org/10.1007/s11547-024-01780-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The percutaneous thermal ablation techniques (pTA) are radiofrequency ablation, cryoablation, and microwave ablation, suitable for the treatment of bone oligometastases. Magnetic resonance-guided focused ultrasound (MRgFUS) is a noninvasive ablation technique.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>To compare the effectiveness and safety of MRgFUS and pTA for treating bone oligometastases and their complications.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Studies were selected with a PICO/PRISMA protocol: pTA or MRgFUS in patients with bone oligometastases; non-exclusive curative treatment. Exclusion criteria were: primary bone tumor; concurrent radiation therapy; palliative therapy; and absence of imaging at follow-up. PubMed, BioMed Central, and Scopus were searched. The modified Newcastle–Ottawa Scale assessed articles quality. For each treatment (pTA and MRgFUS), we conducted two separate random-effects meta-analyses to estimate the pooled effectiveness and safety. The effectiveness was assessed by combining the proportions of treated lesions achieving local tumor control (LTC); the safety by combining the complications rates of treated patients. Meta-regression analyses were performed to identify any outcome predictor.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 24 articles were included. Pooled LTC rate for MRgFUS was 84% (<i>N</i> = 7, 95% CI 66–97%, <i>I</i>² = 74.7%) compared to 65% of pTA (<i>N</i> = 17, 95% CI 51–78%, <i>I</i>² = 89.3%). Pooled complications rate was similar, respectively, 13% (95% CI 1–32%, <i>I</i>² = 81.0%) for MRgFUS and 12% (95% CI 8–18%, <i>I</i>² = 39.9%) for pTA, but major complications were recorded with pTA only.</p><p>The meta-regression analyses, including technique type, study design, tumor, and follow-up, found no significant predictors.</p><h3 data-test=\"abstract-sub-heading\">Discussion</h3><p>The effectiveness and safety of the two techniques were found comparable, even though MRgFUS is a noninvasive treatment that did not cause any major complication. Limited data availability on MRgFUS and the lack of direct comparisons with pTA may affect these findings.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>MRgFUS can be a valid, safe, and noninvasive treatment for bone oligometastases. Direct comparison studies are needed to confirm its promising benefits.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139666588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic investigation of cerebellar functional alterations and their association with surgical outcomes in patients with degenerative cervical myelopathy: a resting-state fMRI study","authors":"Yuqi Ge, Rui Zhao, Xing Guo, Meng Liang, Yuan Xue","doi":"10.1007/s11547-024-01776-0","DOIUrl":"https://doi.org/10.1007/s11547-024-01776-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>The aim of this study was to systematically investigate the changes in cerebellar neural activity and cerebellar-cortical functional connectivity (FC) in patients with degenerative cervical myelopathy (DCM) using resting-state functional magnetic resonance imaging (fMRI).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this study, we collected clinical data and resting-state fMRI data from 54 DCM patients and 50 healthy controls (HCs). We analyzed voxel-wise regional fMRI metrics, including amplitude of low frequency fluctuation (ALFF), fractional ALFF, regional homogeneity, functional connectivity density, and voxel-mirrored homotopic connectivity. In analysis 1, we examined the differences in regional fMRI metrics within the cerebellum between the DCM patient group and the healthy control group, as well as their correlation with preoperative neurological status and prognosis. In analysis 2, we investigated cerebellar-cortical functional connectivity differences between the two groups and their correlation with preoperative neurological status and prognosis. Lastly, in analysis 3, we explored the internetwork connectivity between the 'cerebellar-SMN' (sensorimotor network) system, examined the between-group differences, and investigated its correlation with preoperative neurological status and prognosis.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>(1) Relative to HCs, DCM patients exhibited functional alterations in wide-spread cerebellar regions; (2) DCM patients exhibited altered cerebellar-cortical FC which was associated with the preoperative neurological status and prognosis; (3) DCM patients exhibited altered internetwork connectivity between ‘cerebellar-SMN’ system which was associated with duration of symptom.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Wide-spread cerebellar functional alterations occur in DCM pathogenesis and the deficits in cerebellar-SMN functional connectivity may be beneficial in future studies for predicting surgical outcomes in patients with DCM.</p>","PeriodicalId":501689,"journal":{"name":"La radiologia medica","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139662660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}