Leclerc G.E.,CNRS Biomechanical Engineering Laboratory |
Charleux F.,Radiology Unit |
Robert L.,Radiology Unit |
Ho Ba Tho M.-C.,CNRS Biomechanical Engineering Laboratory |
And 3 more authors.
Journal of Magnetic Resonance Imaging | Year: 2013
Purpose To analyze the relevance of the viscosity measurement as a liver diagnostic marker. Materials and Methods To determine the level of fibrosis, a Fibroscan test was performed on 40 subjects (10 healthy volunteers and 30 patients). Subsequently, multifrequency magnetic resonance elastography (MMRE) tests were made with a pneumatic driver at 60, 70, and 80 Hz. Phase images were analyzed with two different postprocessing methods, without (Method 1) and with (Method 2) the inversion algorithm (IA), using rheological models (Voigt, springpot) in order to characterize the viscoelastic properties (viscosity: η and elasticity: μ). Results MRE cartography of the viscous tendency (G″MRE-M2) measured within the region of interest (ROI) of the liver increased as a function of the level of fibrosis. Similar results were also obtained for the viscosity (ηmodels-M1) calculated with a postprocessing without IA. However, the viscosity (ηmodels-M2) remained constant with the stage of fibrosis when the postprocessing was composed of an IA. The experimental (μMRE-M1 and G′MRE-M2) and rheological (μmodels-M2 and μmodels-M1) elasticities always increased with the level of fibrosis regardless of the postprocessing method. Conclusion The variation of the liver viscosity parameter as a function of postprocessing revealed that this parameter should be further investigated to demonstrate its relevance in clinical practice. © 2012 Wiley Periodicals, Inc. Copyright © 2012 Wiley Periodicals, Inc.
Castellana G.,District Health Center |
Castellana G.,University of Bari |
Gentile M.,Medical Genetics Unit |
Castellana R.,Radiology Unit |
Resta O.,University of Bari
European Respiratory Review | Year: 2015
Pulmonary alveolar microlithiasis (PAM) is a rare disease characterised by the widespread intra-alveolar accumulation of minute calculi called microliths. It is caused by mutation of the SLC34A2 gene encoding the type IIb sodium phosphate cotransporter in alveolar type II cells. The present study explores the epidemiological, familial, genetic, clinical, diagnostic, radiological and therapeutic aspects with the aim of contributing to a better understanding of this uncommon disease. We searched articles on PAM published up to December 2014 and 544 papers were found, accounting for 1022 cases. PAM is present in all continents and in many nations, in particular in Turkey, China, Japan, India, Italy and the USA. Familiality is frequent. The clinical course is not uniform and the causes of this clinical variability seem to be largely nongenetic. The optimal diagnostic procedure is the association of chest high-resolution computed tomography (HRCT) with bronchoalveolar lavage, but a chest radiograph may suffice in families in which a case has already been diagnosed. Moreover, chest radiography and HRCT allow the classification of the evolutionary phase of the disease and its severity. At present lung transplantation is the only effective therapy. However, better knowledge of the gene responsible offers hope for new therapies. © ERS 2015.
Regge D.,Institute for Cancer Research and Treatment |
Iussich G.,Institute for Cancer Research and Treatment |
Senore C.,CPO Piemonte and AO City of Health and Science |
Correale L.,Im3D SpA |
And 4 more authors.
Trials | Year: 2014
Background: Colorectal cancer (CRC) is the second most prevalent type of cancer in Europe. A single flexible sigmoidoscopy (FS) screening at around the age of 60 years prevents about one-third of CRC cases. However, FS screens only the distal colon, and thus mortality from proximal CRC is unaffected. Computed tomography colonography (CTC) is a highly accurate examination that allows assessment of the entire colon. However, the benefit of CTC testing as a CRC screening test is uncertain. We designed a randomized trial to compare participation rate, detection rates, and costs between CTC (with computer-aided detection) and FS as primary tests for population-based screening.Methods/Design: An invitation letter to participate in a randomized screening trial comparing CTC versus FS will be mailed to a sample of 20,000 people aged 58 or 60 years, living in the Piedmont region and the Verona district of Italy. Individuals with a history of CRC, adenomas, inflammatory bowel disease, or recent colonoscopy, or with two first-degree relatives with CRC will be excluded from the study by their general practitioners. Individuals responding positively to the invitation letter will be then randomized to the intervention group (CTC) or control group (FS), and scheduled for the screening procedure. The primary outcome parameter of this part of the trial is the difference in advanced neoplasia detection between the two screening tests. Secondary outcomes are cost-effectiveness analysis, referral rates for colonoscopy induced by CTC versus FS, and the expected and perceived burden of the procedures. To compare participation rates for CTC versus FS, 2,000 additional eligible subjects will be randomly assigned to receive an invitation for screening with CTC or FS. In the CTC arm, non-responders will be offered fecal occult blood test (FOBT) as alternative screening test, while in the FS arm, non-responders will receive an invitation letter to undergo screening with either FOBT or CTC. Data on reasons for participation and non-participation will also be collected.Discussion: This study will provide reliable information concerning benefits and risks of the adoption of CTC as a mass screening intervention in comparison with FS. The trial will also evaluate the role of computer-aided detection in a screening setting.Trial registration: ClinicalTrials.gov Identifier: NCT01739608. © 2014 Regge et al.; licensee BioMed Central Ltd.
Dalla Costa M.,University of Padua |
Mangano F.A.,Radiology Unit |
Betterle C.,University of Padua
Journal of Endocrinological Investigation | Year: 2014
Background: Graves' disease (GD) is commonly associated with other autoimmune conditions, and there is also a rare but well documented association between GD and thymic hyperplasia (TH). It is hard to say the real frequency of this latter association because most cases remain asymptomatic and are consequently not thoroughly investigated. Materials and Methods: We reviewed the literature on GD-related thymus enlargement and found 107 cases published to date. Thymic cancer was only documented in four patients, while the majority of cases were diagnosed as TH. The causative mechanisms behind TH associated with GD have yet to be fully elucidated. Several studies support the hypothesis of a TSH receptor antibody (TRAb) mediating thymic enlargement. Results: We report on a female GD patient with an incidentally discovered anterior mediastinal mass. Our case is not consistent with the hypothesis of a TRAb-mediated mechanism because the thymus reached its largest volume at the onset of GD and shrank during remission of GD under medical treatment, despite persistently positive TRAb levels. Conclusion: We support the hypothesis that two different pathogenic mechanisms might be responsible for thymus enlargement: thymic cortical tissue expansion seems to be due to a hyperthyroid state, while lymphoid hyperplasia appears to correlate with immune abnormalities underlying GD. © 2014 Italian Society of Endocrinology (SIE).
Dalla Costa M.,University of Padua |
Mangano F.A.,Radiology Unit |
Betterle C.,University of Padua
Molecular Diagnosis and Therapy | Year: 2014
Background: Graves’ disease (GD) is commonly associated with other autoimmune conditions, and there is also a rare but well documented association between GD and thymic hyperplasia (TH). It is hard to say the real frequency of this latter association because most cases remain asymptomatic and are consequently not thoroughly investigated.Materials and Methods: We reviewed the literature on GD-related thymus enlargement and found 107 cases published to date. Thymic cancer was only documented in four patients, while the majority of cases were diagnosed as TH. The causative mechanisms behind TH associated with GD have yet to be fully elucidated. Several studies support the hypothesis of a TSH receptor antibody (TRAb) mediating thymic enlargement.Results: We report on a female GD patient with an incidentally discovered anterior mediastinal mass. Our case is not consistent with the hypothesis of a TRAb-mediated mechanism because the thymus reached its largest volume at the onset of GD and shrank during remission of GD under medical treatment, despite persistently positive TRAb levels.Conclusion: We support the hypothesis that two different pathogenic mechanisms might be responsible for thymus enlargement: thymic cortical tissue expansion seems to be due to a hyperthyroid state, while lymphoid hyperplasia appears to correlate with immune abnormalities underlying GD. © 2014, Italian Society of Endocrinology (SIE).
Bertolini M.,Instituto Of Ricovero E Cura A Carattere Scientifico |
Nitrosi A.,Instituto Of Ricovero E Cura A Carattere Scientifico |
Rivetti S.,Ospedale di Sassuolo S.p.A. |
Lanconelli N.,University of Bologna |
And 3 more authors.
Medical Physics | Year: 2012
Purpose: The purpose of this study is to compare digital radiography systems using the metric effective detective quantum efficiency (eDQE), which better reflects digital radiography imaging system performance under clinical operating conditions, in comparison with conventional metrics such as modulation transfer function (MTF), normalized noise power spectra (NNPS), and detective quantum efficiency (DQE). Methods: The eDQE was computed by the calculation of the MTF, the NNPS, the phantom attenuation and scatter, and estimation of x-ray flux. The physical characterization of the systems was obtained with the standard beam conditions RQA5 and RQA9, using the PA Chest phantom proposed by AAPM Report # 31 simulating the attenuation and scatter characteristics of the adult human thorax. The MTF (eMTF) was measured by using an edge test placed at the frontal surface of the phantom, the NNPS (eNNPS) was calculated from images of the phantom acquired at three different exposure levels covering the operating range of the system (E0, which is the exposure at which a system is normally operated, 1/3 E0, and 3 E0), and scatter measurements were assessed by using a beam-stop technique. The integral of DQE (IDQE) and eDQE (IeDQE) was calculated over the whole spatial frequency range. Results: The eMTF results demonstrate degradation due to magnification and the presence of scattered radiation. The eNNPS was influenced by the grid presence, and in some systems, it contained structured noise. At typical clinical exposure levels, the magnitude of eDQE(0) with respect to DQE(0) at RQA9 beam conditions was 13, 17, 16, 36, and 24, respectively, for Carestream DRX-1, Carestream DRX-1C, Carestream Direct View CR975, Philips Digital Diagnost VM, and GE Revolution XR/d. These results were confirmed by the ratio of IeDQE and IDQE in the same conditions. Conclusions: The authors confirm the robustness and reproducibility of the eDQE method. As expected, the DR systems performed better than the CR systems due to their superior signal-to-noise transfer characteristics. The results of this study suggest the eDQE method may provide an opportunity to more accurately assess the clinical performance of digital radiographic imaging systems by accounting for factors such as the presence of scatter, use of an antiscatter grid, and magnification and focal spot blurring effects, which are not reflected in conventional DQE measures. © 2012 American Association of Physicists in Medicine.
Flor N.,1Unita Operativa di Radiologia Diagnostica e Interventistica |
Di Leo G.,Radiology Unit |
Squarza S.A.C.,University of Milan |
Tresoldi S.,1Unita Operativa di Radiologia Diagnostica e Interventistica |
And 5 more authors.
American Journal of Roentgenology | Year: 2013
OBJECTIVE. The objective of our study was to systematically review the evidence on incidental extracardiac findings on cardiac CT with a focus on previously unknown malignancies. MATERIALS AND METHODS. A systematic search was performed (PubMed, EMBASE, Cochrane databases) for studies reporting incidental extracardiac findings on cardiac CT. Among 1099 articles initially found, 15 studies met the inclusion criteria. The references of those articles were hand-searched and 14 additional studies were identified. After review of the full text, 10 articles were excluded. Nineteen studies including 15,877 patients (64% male) were analyzed. A three-level analysis was performed to determine the prevalence of patients with incidental extracardiac findings, the prevalence of patients with major incidental extracardiac findings, and the prevalence of patients with a proven cancer. Heterogeneity was explored for multiple variables. Pooled prevalence and 95% CI were calculated. RESULTS. The prevalence of both incidental extracardiac findings and major incidental extracardiac findings showed a high heterogeneity (I2 > 95%): The pooled prevalence was 44% (95% CI, 35-54%) and 16% (95% CI, 14-20%), respectively. No significant explanatory variables were found for using or not using contrast material, the size of the FOV, and study design (I2 > 85%). The pooled cancer prevalence for 10 studies including 5082 patients was 0.7% (95% CI, 0.5-1.0%), with an almost perfect homogeneity (I2 < 0.1%). Of 29 reported malignancies, 21 (72%) were lung cancers; three, thyroid cancers; two, breast cancers; two, liver cancers; and one, mediastinal lymphoma. CONCLUSION. Although the prevalence of reported incidental extracardiac finding at cardiac CT was highly variable, a homogeneous prevalence of previously unknown malignancies was reported across the studies, for a pooled estimate of 0.7%; more than 70% of these previously unknown malignancies were lung cancers. Extracardiac findings on cardiac CT require careful evaluation and reporting. © American Roentgen Ray Society.
Ferraresi R.,Instituto Clinico Citta Studi |
Palena L.M.,Interventional Radiology Unit |
Mauri G.,Radiology Unit |
Manzi M.,Interventional Radiology Unit
Journal of Cardiovascular Surgery | Year: 2013
The world is facing an epidemic of diabetes, consequently in the next years critical limb ischemia due to diabetic artery disease will become a major issue for vascular and endovascular operators. Revascularization is a key therapy in these patients because reestablishing an adequate blood supply to the wound is essential for healing avoiding a major amputation. In this paper, we summarize our experience in endovascular treatment of diabetic critical limb ischemia, focusing of the main technical challenges in treating below-the-knee vessels. We describe the following topics: 1) targets of the revascularization therapy: "complete" versus "partial" revascularization and the concept of wound related artery. Every procedure must be tailored on technically realistic strategies and on the general patient status; 2) the antegrade femoral access using both, the X-ray and the ultrasound guided techniques; 3) the chronic total occlusions crossing strategy proposing a step-by-step approach: endoluminal, subintimal, retrograde approaches. Particular attention has been given to the different retrograde approaches: pedal-plantar loop technique, trans-collateral approaches and the different types of retrograde puncture. For each step we provide a complete description of the technical details and of the suitable devices. Eventually we in brief describe: 3) acute result optimization and 4) prevention of restenosis.
Neyton L.,Center Orthopedique Santy |
Godeneche A.,Center Orthopedique Santy |
Nove-Josserand L.,Center Orthopedique Santy |
Carrillon Y.,Radiology Unit |
And 2 more authors.
Arthroscopy - Journal of Arthroscopic and Related Surgery | Year: 2013
Purpose: The purpose of the study was to assess the repair site integrity after transosseous equivalent/suture-bridge (TOE/SB) repair with the use of magnetic resonance imaging (MRI). Methods: One hundred seven consecutive shoulders with a small to medium-size full-thickness supraspinatus tear were repaired arthroscopically with use of the TOE/SB technique. There were 64 men and 41 women, and mean age at the time of surgery was 54.8 years (range, 21 to 74 years). All patients underwent postoperative MRI and clinical examination. Mean follow-up was 16.1 months (range, 12 to 28 months). Results: The mean Constant score improved from 54.5 ± 12.5 points preoperatively to 80 ± 12.1 points postoperatively (P <.0001). The mean pain score improved from 7 ± 2 points preoperatively to 13 ± 2.5 postoperatively (P <.0001). The mean active forward flexion improved from 151° ± 37° preoperatively to 169° ± 14° postoperatively (P <.0001). The mean Constant score was 81 points when repaired tendon had healed and it was 72.6 points when repaired tendon was unhealed (P =.02). Smoking status was found to have detrimental influence on the tendon healing (P =.04). Postoperative MRI showed a healed repair in 96 (89.7%) of 107 shoulders. Among 11 retears, 10 occurred at the greater tuberosity and 1 occurred at the musculotendinous junction. Conclusions: Arthroscopic TOE/SB repair of full-thickness supraspinatus tendon led to a healing rate of 89.7%. Patients with healed tendons according to MRI had significant better functional and subjective outcome. Smoking habit was found to be detrimental on healing. Retears occurred mainly at tendon-bone interface at the greater tuberosity, whereas medial cuff failure was observed in only one case in the mean time of follow-up. Level of Evidence: Level IV, therapeutic case series. © 2013 by the Arthroscopy Association of North America.
Golfieri R.,University of Bologna |
Grazioli L.,Radiology Unit |
Orlando E.,Radiology Unit |
Dormi A.,University of Bologna |
And 5 more authors.
Journal of Magnetic Resonance Imaging | Year: 2012
Purpose: To investigate whether the malignancy of atypical nodules in cirrhosis can be identified at gadoxetic-acid-disodium(Gd-EOB-DTPA)-MRI by their hypointensity in the hepatobiliary(HB)-phase alone or combined with any other MR imaging features. Materials and Methods: One hundred eleven atypical nodules detected in 77 consecutive Gd-EOB-DTPA-MRIs were divided, based on arterial-phase behavior, into: Class I, isovascular (n = 82), and Class II, hypervascular without portal/delayed washout (n = 29). The two classes were further grouped based on HB-phase intensity (A/B/C hypo/iso/hyperintensity). Portal/venous/equilibrium-phase behavior and T2w features were also collected. Histology was the gold standard. Per-nodule sensitivity, specificity, negative and positive predictive values (NPV/PPV), and diagnostic accuracy were calculated for HB-phase hypointensity alone, and combined with vascular patterns and T2w hyperintensity. Results: Histology detected 60 benign and 51 malignant/premalignant nodules [10 overt hepatocellular carcinomas (HCCs) and 41 high-grade dysplastic nodules (HGDN)/early HCC]. Class IA contained 31 (94%) malignancies, IB one (3%), and IC only benign lesions. Class IIA had 100% malignancies, IIB three (37.5%) and IIC only two (28.5%). HB-phase hypointensity alone (Classes I-IIA) had 88% sensitivity, 91% NPV, and 93% diagnostic accuracy, superior (P < 0.05, P < 0.006, and P < 0.05, respectively) to any other MR imaging feature alone or combined. Conclusion: In atypical cirrhotic nodules, HB-phase hypointensity by itself is the strongest marker of malignancy. J. Magn. Reson. Imaging 2012;36:648-657. © 2012 Wiley Periodicals, Inc.