0000000000076870
AUTHOR
Alberto Bruno
The Elephant in the Machine: Proposing a New Metric of Data Reliability and its Application to a Medical Case to Assess Classification Reliability
In this paper, we present and discuss a novel reliability metric to quantify the extent a ground truth, generated in multi-rater settings, as a reliable basis for the training and validation of machine learning predictive models. To define this metric, three dimensions are taken into account: agreement (that is, how much a group of raters mutually agree on a single case)
Whole‐body magnetic resonance imaging (WB‐MRI) in lymphoma: State of the art
The improvements in magnetic resonance imaging (MRI) technology and the concern related to the increased cancer risk in patients with lymphoma, also due to radiation exposure associated with imaging examinations, have led to the introduction of whole-body MRI (WB-MRI) as a radiation-free alternative to standard imaging procedures. WB-MRI seems a less histology-dependent functional imaging test than 18 F-fluorodeoxyglucose-positron emission tomography/CT (18 F-FDG-PET/CT). In patients with FDG-avid lymphomas, such as diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma (HL), 18 F-FDG-PET/CT remains the imaging reference standard for staging, with WB-MRI potentially being a complementar…
Imaging features of solid renal masses
The widespread use of abdominal imaging techniques has increased the detection of solid renal masses over the past years. Imaging plays a crucial role in the management and surveillance and in determining which lesions need treatment. The "classical angiomyolipoma" is the only benign solid renal mass that can be characterized with confidence by imaging through the detection of a fat-containing lesion without calcifications. There is a large overlap of imaging features between benign and malignant renal masses that often makes difficult a correct characterization of these lesions. In this review, we discuss the imaging features of the main solid renal masses that may suggest a likely benign …
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…
Whole-body magnetic resonance imaging and FDG-PET/CT for lymphoma staging: Assessment of patient experience
Purpose: To compare patient experience of whole-body MRI and FDG-PET/CT performed for lymphoma staging. Methods: One-hundred-fifteen patients (59 males, 56 females; 53 Hodgkin, 62 non-Hodgkin; mean age: 43.8 years) with lymphoma underwent whole-body MRI and FDG-PET/CT for staging and filled a questionnaire regarding their experience of the examinations using a 4-point Likert scale (1, very good; 4,very bad). Differences were evaluated using Wilcoxon signed-rank test. Patients were asked to express their preference on both techniques. Preferences were compared on the basis of gender, age, and Ann Arbor stage using the chi-square test. A p-value ≤ .05 was considered significant. Results: Most…
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 …
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 …
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…
Diffusion-weighted imaging in oncology: An update
To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the “functional” information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment resp…
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-…
Imaging features of adrenal masses
Abstract The widespread use of imaging examinations has increased the detection of incidental adrenal lesions, which are mostly benign and non-functioning adenomas. The differentiation of a benign from a malignant adrenal mass can be crucial especially in oncology patients since it would greatly affect treatment and prognosis. In this setting, imaging plays a key role in the detection and characterization of adrenal lesions, with several imaging tools which can be employed by radiologists. A thorough knowledge of the imaging features of adrenal masses is essential to better characterize these lesions, avoiding a misinterpretation of imaging findings, which frequently overlap between benign …
Diagnostic Performance and Radiation Dose of the EOS System to Image Enchondromatosis: A Phantom Study
Background: Radiation doses and capability of EOS, conventional radiography (CR), and computed tomography (CT) to detect and measure enchondromas in a dedicated five-year-old anthropomorphic phantom were compared. Methods: To simulate enchondromas, minced pieces of chicken bone and cartilage were packed in conventional kitchen plastic foil to create ovoidal/rounded masses and randomly hung on the phantom. The phantom was imaged five times with CR, CT, and EOS, each time changing the number and position of inserts. All images were reviewed by a senior radiologist and a radiology resident. Results: EOS and CR detected all inserts in 4/5 cases (80%), while in one case 1/17 inserts was not seen…
Confronto tra RM Whole Body, TC/PET e biopsia osteomidollare, nella valutazione dell’interessamento midollare in 104 pazienti con linfoma.
Scopo: Parte della stadiazione dei linfomi prevede la valutazione dell'interessamento del midollo osseo (IMO) mediante biopsia osteo-midollare (BOM) [1]. Tuttavia, secondo le ultime linee guida, la BOM non è più indicata per lo studio dei linfomi di Hodgkin [2]. La TC/PET è la tecnica di imaging standard per la stadiazione dei linfomi FDG-avidi, mentre la TC è indicata nei pazienti con istotipi non FDG-avidi [1]. Molti studi hanno dimostrato affidabilità ed elevata accuratezza diagnostica della Risonanza Magnetica Whole Body (RM-WB) nella stadiazione dei linfomi [3,4]. Lo scopo del nostro studio è stato quello di confrontare RM-WB, TC/PET e BOM, nella valutazione dell’IMO in pazienti con li…
Comparison of the Enhancement Pattern of Hepatic Hemangioma on Magnetic Resonance Imaging Performed With Gd-EOB-DTPA Versus Gd-BOPTA
Abstract Purpose To compare magnetic resonance imaging (MRI) findings with gadoxetic acid and gadobenate dimeglumine for the diagnosis of hepatic hemangiomas. Materials and Methods In this retrospective study, we included 26 hemangiomas (mean size was 14 mm ± 10 mm) in 19 patients (mean age 60 ± 14 years) scanned with both gadobenate dimeglumine MRI and gadoxetic acid MRI. For each patient, we collected multiple lesion variables including location, number, size and enhancement pattern on arterial, portal venous, 3-minute and hepatobiliary phases with both gadoxetic acid and gadobenate dimeglumine. The enhancement pattern with the two contrast agents was then compared. Results The typical en…
A xanthogranulomatous process resembling residual disease on endof- treatment 18f-FDG-PET/CT and Whole Body Magnetic Resonance performed on a primary breast lymphoma treated by ibrutinib plus rituximab-chop
We report the case of a woman, affected by breast diffuse large B-Cell lymphoma, who developed a xanthogranulomatous process wrongly interpreted as residual disease on 18F-FDG-PET/CTand Whole Body Magnetic Resonance after treatment with ibrutinib plus standard immunochemotherapy. Newer drugs, such as immunomodulatory agents and checkpoint inhibitors, have demonstrated high effectiveness on lymphoma, but are associated with unclear imaging features such as tumor flare or pseudo-progression, related to inflammatory reactions. Wide imaging techniques availability improves diagnostic possibilities. However, the awareness of the adopted treatment strategy and its possible implications on imaging…