0000000000011847

AUTHOR

Leonardo Salvaggio

Caustic ingestion: CT findings of esophageal injuries and thoracic complications

Ingestion of caustic substances, whether accidental or for the purpose of suicide, can cause severe lesions of the lips, oral cavity, pharynx, upper gastrointestinal system, and upper airways. In particular, caustic agents could be responsible for severe esophageal injuries resulting in short- and long-term complications. Because of these important clinical implications, timely diagnosis and appropriate management are crucial. In the evaluation of esophageal injuries, thoraco-abdominal computed tomography (CT) is preferable to endoscopy as it avoids the risk of esophageal perforation and allows the evaluation of esophageal injuries as well as of the surrounding tissue. In this review, we re…

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PI-RADS 3 Lesions: Role of Prostate MRI Texture Analysis in the Identification of Prostate Cancer

Abstract Purpose To determine the diagnostic performance of texture analysis of prostate MRI for the diagnosis of prostate cancer among Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. Materials and Methods Forty-three patients with at least 1 PI-RADS 3 lesion on prostate MRI performed between June 2016 and January 2019 were retrospectively included. Reference standard was pathological analysis of radical prostatectomy specimens or MRI-targeted biopsies. Texture analysis extraction of target lesions was performed on axial T2-weighted images and apparent diffusion coefficient (ADC) maps using a radiomic software. Lesions were categorized as prostate cancer (Gleason score [GS] …

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PERFORMANCE OF DIFFUSION KURTOSIS IMAGING FOR CHARACTERIZATION OF PROSTATE LESIONS USING 1.5T MAGNETIC RESONANCE IMAGING SCANNER

The aim of the study is to evaluate the diagnostic performance of apparent diffusion coefficient (ADC) and apparent kurtosis coefficient (Kapp) for the characterization of prostate lesions on 1.5T MRI. This retrospective study included 34 patients with at least one lesion with PI-RADS score≥ 3. Performances of ADC and Kapp were evaluated using the Mann-Whitney U test and receiver operating characteristics curve (AUROC). Lesions with Gleason score≥6 had significantly lower Kapp compared to benign lesions (p=0.025). The ADC-ratio was the only significantly different parameter between GS≥7 and GS=6 lesions (p=0.039). Kapp showed the largest AUROC for the diagnosis of GS≥6 prostate cancers (AUR…

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Deep Learning Networks for Automatic Retroperitoneal Sarcoma Segmentation in Computerized Tomography

The volume estimation of retroperitoneal sarcoma (RPS) is often difficult due to its huge dimensions and irregular shape; thus, it often requires manual segmentation, which is time-consuming and operator-dependent. This study aimed to evaluate two fully automated deep learning networks (ENet and ERFNet) for RPS segmentation. This retrospective study included 20 patients with RPS who received an abdominal computed tomography (CT) examination. Forty-nine CT examinations, with a total of 72 lesions, were included. Manual segmentation was performed by two radiologists in consensus, and automatic segmentation was performed using ENet and ERFNet. Significant differences between manual and automat…

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Congenital pulmonary airway malformation in adult: report of two rare cases and literature review

Congenital pulmonary airway malformations (CPAMs) are a heterogeneous group of congenital, non-hereditary lesions of the lung, cystic and non-cystic type with clear developmental anomalies and evident malformative changes, which derive from the excessive proliferation of the tubular bronchial structures. We described two rare cases of type IV CPAM detected in adult patients with different clinical presentation: one of these cases was symptomatic, complaining of cough and hemoptysis. Conversely, the other case was reported as incidental findings in patient with abdominal pain without respiratory symptoms. Chest computed tomography (CT) scan was performed showing voluminous cystic formations …

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ANATOMICAL DISSECTION AND ANALYSIS OF THE STRUCTURES OF THE UPPER LIMB

In 2015, a whole body dissection course was proposed by the University of Palermo, Palermo, Italy, thanks to the cooperation with the University of Malta, Msida, Malta. The purpose of this study was to show the the difference between the studyof anatomy on books and on corpses. The article focuses its attention on the dissection method of the upper limb. The astudy was performed on two corpses, a male and a female, by using a basic surgeon kit. Blunt dissection method was used for fasciae, innards and to isolate vascular-nervous structures from the fat; we used scalped for cutis, sub cutis, muscles, fasciae, veins, arteries and nerves of the upper limb from the shoulder to the hand. The upp…

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Radiomics and Prostate MRI: Current Role and Future Applications

Multiparametric prostate magnetic resonance imaging (mpMRI) is widely used as a triage test for men at a risk of prostate cancer. However, the traditional role of mpMRI was confined to prostate cancer staging. Radiomics is the quantitative extraction and analysis of minable data from medical images; it is emerging as a promising tool to detect and categorize prostate lesions. In this paper we review the role of radiomics applied to prostate mpMRI in detection and localization of prostate cancer, prediction of Gleason score and PI-RADS classification, prediction of extracapsular extension and of biochemical recurrence. We also provide a future perspective of artificial intelligence (machine …

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Prevalence and clinical significance of incidental findings on multiparametric prostate MRI.

Purpose: To assess the prevalence and clinical significance of incidental findings (IFs) detected at multiparametric prostate MRI examination. Materials and methods: Multiparametric prostate MRIs of 647 consecutive patients (mean age 67.1 ± 8.0 years) were retrospectively evaluated by two radiologists recording the presence of all extra-prostatic IFs. Findings were classified as related to or not related to genitourinary system and divided into three classes, according to their clinical significance, as follows: group 1, not significant or scarcely significant; group 2, moderately or potentially significant; and group 3, significant. Differences in distribution of IFs between patients ≤ 65 …

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Computer tomography features of pulmonary vascular involvement in Behçet's disease

Behçet’s disease is a chronic and multisystemic inflammatory vascular disease of unknown etiology, affecting vessels of all kinds and sizes. The involvement of the vascular system is observed in approximately 5-30% of patients. The most frequent vascular manifestations are venous thrombosis followed by arterial aneurysms and arterial thrombosis. The identification of vascular involvement is very important for prognosis, indeed the rupture of an arterial aneurysm represents the leading cause of sudden death in patients with Behçet’s disease. Computed tomography (CT) plays a crucial role in the identification and in the follow-up of vascular involvement. In this paper, we report the case of a…

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Role of apparent diffusion coefficient values in prostate diseases characterization on diffusion-weighted magnetic resonance imaging.

BACKGROUND: To evaluate if normal and pathological prostate tissue can be distinguished by using apparent diffusion coefficient (ADC) values on magnetic resonance imaging (MRI) and to understand if it is possible to differentiate among pathological prostate tissues using ADC values.METHODS:Our population consisted in 81 patients (mean age 65.4 years) in which 84 suspicious areas were identified. Regions of interest were placed over suspicious areas, detected on MRI, and over areas with normal appearance, and ADC values were recorded. Statistical differences between ADC values of suspicious and normal areas were evaluated. Histopathological diagnosis, obtained from targeted biopsy using MRI-…

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CT imaging findings of epiploic appendagitis: an unusual cause of abdominal pain

AbstractEpiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation…

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Deep Learning Network for Segmentation of the Prostate Gland With Median Lobe Enlargement in T2-weighted MR Images: Comparison With Manual Segmentation Method

Purpose: Aim of this study was to evaluate a fully automated deep learning network named Efficient Neural Network (ENet) for segmentation of prostate gland with median lobe enlargement compared to manual segmentation. Materials and Methods: One-hundred-three patients with median lobe enlargement on prostate MRI were retrospectively included. Ellipsoid formula, manual segmentation and automatic segmentation were used for prostate volume estimation using T2 weighted MRI images. ENet was used for automatic segmentation; it is a deep learning network developed for fast inference and high accuracy in augmented reality and automotive scenarios. Student t-test was performed to compare prostate vol…

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