Radiomics and liquid biopsy in oncology: the holons of systems medicine
AbstractRadiomics is a process of extraction and analysis of quantitative features from diagnostic images. Liquid biopsy is a test done on a sample of blood to look for cancer cells or for pieces of tumourigenic DNA circulating in the blood. Radiomics and liquid biopsy have great potential in oncology, since both are minimally invasive, easy to perform, and can be repeated in patient follow-up visits, enabling the extraction of valuable information regarding tumour type, aggressiveness, progression, and response to treatment. Both methods are in their infancy, with major evidence of application in lung and gastrointestinal...
Source: Insights into Imaging - November 14, 2018 Category: Radiology Source Type: research

Radiomics: a critical step towards integrated healthcare
AbstractMedical imaging is a vital part of the clinical decision-making process, especially in an oncological setting. Radiology has experienced a great wave of change, and the advent of quantitative imaging has provided a unique opportunity to analyse patient images objectively. Leveraging radiomics and deep learning, there is increased potential for synergy between physicians and computer networks —via computer-aided diagnosis (CAD), computer-aided prediction of response (CARP), and computer-aided biological profiling (CABP). The ongoing digitalization of other specialties further opens the door for even greater mu...
Source: Insights into Imaging - November 12, 2018 Category: Radiology Source Type: research

Brain tumour post-treatment imaging and treatment-related complications
ConclusionAlthough radiological evaluation of brain tumours after treatment can be quite challenging, knowledge of the various imaging techniques available can help the radiologist distinguish treatment response from tumour progression and has the potential to save patients from inappropriate alterations in treatment. In addition, knowledge of common post-treatment-related complications that can be identified on imaging can help the radiologist play a key role in preventing significant patient morbidity/mortality.Teaching points•Contrast enhancement does not reliably define tumour extent in many low-grade or infiltrat...
Source: Insights into Imaging - November 8, 2018 Category: Radiology Source Type: research

Breast imaging surveillance after curative treatment for primary non-metastasised breast cancer in non-high-risk women: a systematic review
ConclusionsAnnual mammography is currently the ‘gold standard’ for breast imaging surveillance. The role of digital breast tomosynthesis (DBT) remains to be further investigated. Most guidelines do not recommend routine breast ultrasound or MRI surveillance, unless indicated by additional risk factors. (Source: Insights into Imaging)
Source: Insights into Imaging - November 8, 2018 Category: Radiology Source Type: research

Common artefacts encountered on images acquired with combined compressed sensing and SENSE
AbstractVarious techniques have been proposed which aim at scan time reduction and/or at improved image quality by increasing the spatial resolution. Compressed sensing (CS) takes advantage of the fact that MR images are usually sparse in some transform domains and recovers this sparse representation from undersampled data. CS may be combined with parallel imaging such as sensitivity encoding (SENSE), hereafter referred to as Compressed SENSE, to further accelerate image acquisition since both techniques rely on different ancillary information. In practice, Compressed SENSE may reduce scan times of two-dimensional (2D) and...
Source: Insights into Imaging - November 8, 2018 Category: Radiology Source Type: research

A panorama of radial nerve pathologies- an imaging diagnosis: a step ahead
AbstractThe radial nerve has a long and tortuous course in the upper limb. Injury to the nerve can occur due to a multitude of causes at many potential sites along its course. The most common site of involvement is in the proximal forearm affecting the posterior interosseous branch while the main branch of the radial nerve is injured in fractures of the humeral shaft. Signs and symptoms of radial neuropathy depend upon the site of injury. Injury to the nerve distal to innervation of triceps brachii results in loss of extensor function with sparing of function of the triceps resulting in the characteristic ‘wrist drop...
Source: Insights into Imaging - November 5, 2018 Category: Radiology Source Type: research

Neuroimaging in Fabry disease: current knowledge and future directions
AbstractFabry disease (FD) is a rare X-linked disorder characterised by abnormal progressive lysosomal deposition of globotriaosylceramide in a large variety of cell types. The central nervous system (CNS) is often involved in FD, with a wide spectrum of manifestations ranging from mild symptoms to more severe courses related to acute cerebrovascular events. In this review we present the current knowledge on brain imaging for this condition, with a comprehensive and critical description of its most common neuroradiological imaging findings. Moreover, we report results from studies that investigated brain physiopathology un...
Source: Insights into Imaging - November 2, 2018 Category: Radiology Source Type: research

Early cross-sectional imaging following open and laparoscopic cholecystectomy: a primer for radiologists
AbstractPerformed on either an elective or urgent basis, cholecystectomy currently represents the most common abdominal operation due to the widespread use of laparoscopy and the progressively expanded indications. Compared to traditional open surgery, laparoscopic cholecystectomy minimised the duration of hospitalisation and perioperative mortality. Albeit generally considered safe, cholecystectomy may result in adverse outcomes with non-negligible morbidity. Furthermore, the incidence of worrisome haemorrhages and biliary complications has not been influenced by the technique shift. Due to the growing medico-legal concer...
Source: Insights into Imaging - November 2, 2018 Category: Radiology Source Type: research

Pictorial review of the pulmonary vasculature: from arteries to veins
AbstractPathology of the pulmonary vasculature involves an impressive array of both congenital and acquired conditions. While some of these disorders are benign, disruption of the pulmonary vasculature is often incompatible with life, making these conditions critical to identify on imaging. Many reviews of pulmonary vascular pathology approach the pulmonary arteries, pulmonary veins and bronchial arteries as individual topics. The goal of this review is to provide an integrated overview of the high-yield features of all major disorders of the pulmonary vasculature. This approach provides a more cohesive and comprehensive c...
Source: Insights into Imaging - October 31, 2018 Category: Radiology Source Type: research

Phenotypes of hypertrophic cardiomyopathy. An illustrative review of MRI findings
ConclusionAn understanding of cardiac MRI manifestations of HCM phenotypes will aid early diagnosis recognition and its functional consequences.Teaching Points•The phenotypic variability of HCM expands beyond myocardial hypertrophy, to include morphological and functional manifestations, ranging from subtle anomalies to remodelling of the LV with progressive dilatation and thinning of its wall.•The stages of HCM, which are based on the clinical evidence of disease progression, include subclinical HCM, the classic HCM phenothype, adverse remodelling and overt dysfunction, or end-stage HCM.•Cardiac MRI provide...
Source: Insights into Imaging - October 22, 2018 Category: Radiology Source Type: research

Phenotypes of hypertrophic cardiomiopathy. An illustrative review of MRI findings
ConclusionAn understanding of cardiac MRI manifestations of HCM phenotypes will aid early diagnosis recognition and its functional consequences.Teaching Points•The phenotypic variability of HCM expands beyond myocardial hypertrophy, to include morphological and functional manifestations, ranging from subtle anomalies to remodelling of the LV with progressive dilatation and thinning of its wall.•The stages of HCM, which are based on the clinical evidence of disease progression, include subclinical HCM, the classic HCM phenothype, adverse remodelling and overt dysfunction, or end-stage HCM.•Cardiac MRI provide...
Source: Insights into Imaging - October 22, 2018 Category: Radiology Source Type: research

Enteric duplication cysts in children: varied presentations, varied imaging findings
AbstractEnteric duplication cysts (EDCs) are rare congenital malformations formed during the embryonic development of the digestive tract. They are usually detected prenatally or in the first years of life. The size, location, type, mucosal pattern and presence of complications produce a varied clinical presentation and different imaging findings. Ultrasonography (US) is the most used imaging method for diagnosis. Magnetic resonance (MR) and computed tomography (CT) are less frequently used, but can be helpful in cases of difficult surgical approach. Conservative surgery is the treatment of choice. Pathology confirms the i...
Source: Insights into Imaging - October 11, 2018 Category: Radiology Source Type: research

Imaging presentation of pancreatic neuroendocrine neoplasms
AbstractPancreatic neuroendocrine neoplasms (P-NENs) are the second most common solid pancreatic neoplasms. P-NENs have a wide range of imaging features presentations and they can be detected with typical and atypical imaging presentations. Typical and atypical appearances can be explained by pathologic correlations. P-NENs are generally hypervascular lesions, showing a typical enhancement behavior after contrast media injection during imaging methods, but they could also have different imaging features, creating some difficulty in differential diagnosis. For this reason, radiologists should be aware of different imaging p...
Source: Insights into Imaging - October 9, 2018 Category: Radiology Source Type: research

Differential diagnosis of thickened myocardium: an illustrative MRI review
ConclusionsMany causes of myocardial thickening may mimic different HCM phenotypes. The unique ability of cardiac MRI to facilitate tissue characterisation may help to establish the aetiology of myocardial thickening, which is essential to differentiate it from HCM phenotypes and for appropriate management.Teaching points•Many causes of myocardial thickening may mimic different HCM phenotypes.•Differential diagnosis between myocardial thickening aetiology and HCM phenotypes may be challenging.•Cardiac MRI is essential to differentiate the aetiology of myocardial thickening from HCM phenotypes. (Source: Insights into Imaging)
Source: Insights into Imaging - October 9, 2018 Category: Radiology Source Type: research

The European Diploma in Radiology (EDiR): investing in the future of the new generations of radiologists
AbstractThis review aims to describe the organisation and the content of the European Diploma in Radiology (EDiR). The EDiR examination is available to radiologists and radiology residents in their last year of training. It certifies that their levels of knowledge and competency are in line with the ESR European Training Curriculum for Radiology (ETC) of the European Society of Radiology (ESR). The EDiR is an additional qualification of excellence, which serves the standardisation and accreditation of radiologists across European borders. It provides an international benchmark for general radiology and is officially and fu...
Source: Insights into Imaging - October 5, 2018 Category: Radiology Source Type: research

Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain
ConclusionCTCA suggested possible causes of non-acute pain in 65% of patients.Main messages•CTCA can either rule in or rule out possible causes of chest pain alternative to CAD.•Clinically relevant findings were detected in 65% of patients with non-acute chest pain.•Non-cardiovascular diseases potentially explained symptoms in 35% of patients. (Source: Insights into Imaging)
Source: Insights into Imaging - October 1, 2018 Category: Radiology Source Type: research

Radiological review of skull lesions
AbstractCalvarial lesions are often asymptomatic and are usually discovered incidentally during computed tomography or magnetic resonance imaging of the brain. Calvarial lesions can be benign or malignant. Although the majority of skull lesions are benign, it is important to be familiar with their imaging characteristics and to recognise those with malignant features where more aggressive management is needed. Clinical information such as the age of the patient, as well as the patient ’s history is fundamental in making the correct diagnosis. In this article, we will review the imaging features of both common and unc...
Source: Insights into Imaging - September 19, 2018 Category: Radiology Source Type: research

Spectrum of lytic lesions of the skull: a pictorial essay
AbstractLytic lesions of the skull include a wide range of diseases, ranging from benign conditions such as arachnoid granulations or vascular lacunae, to aggressive malignant lesions such as lymphomas or metastases. An early and correct characterisation of the nature of the lesion is, therefore, crucial, in order to achieve a fast and appropriate treatment option. In this review, we present the radiological appearance of the most frequent lytic lesions of the skull, describing findings from different imaging modalities (plain X-rays, CT and MRI), with particular attention to diagnostic clues and differential diagnoses.Tea...
Source: Insights into Imaging - September 19, 2018 Category: Radiology Source Type: research

Radiological review of skull lesions
AbstractCalvarial lesions are often asymptomatic and are usually discovered incidentally during computed tomography or magnetic resonance imaging of the brain. Calvarial lesions can be benign or malignant. Although the majority of skull lesions are benign, it is important to be familiar with their imaging characteristics and to recognise those with malignant features where more aggressive management is needed. Clinical information such as the age of the patient, as well as the patient ’s history is fundamental in making the correct diagnosis. In this article, we will review the imaging features of both common and unc...
Source: Insights into Imaging - September 19, 2018 Category: Radiology Source Type: research

Spectrum of lytic lesions of the skull: a pictorial essay
AbstractLytic lesions of the skull include a wide range of diseases, ranging from benign conditions such as arachnoid granulations or vascular lacunae, to aggressive malignant lesions such as lymphomas or metastases. An early and correct characterisation of the nature of the lesion is, therefore, crucial, in order to achieve a fast and appropriate treatment option. In this review, we present the radiological appearance of the most frequent lytic lesions of the skull, describing findings from different imaging modalities (plain X-rays, CT and MRI), with particular attention to diagnostic clues and differential diagnoses.Tea...
Source: Insights into Imaging - September 19, 2018 Category: Radiology Source Type: research

The ESR Audit Tool (Esperanto): genesis, contents and pilot
AbstractClinical audit is a powerful tool to improve patient care, experience and outcome. It consists of measuring a clinical outcome or procedure against predefined standards, identifying differences between current practice and the standards, and changing practice where necessary to facilitate meeting the standards, followed by re-audit (the audit cycle). The recently implemented European Council Basic Safety& Standards (BSS) Directive (2013/59/Euratom) emphasises that carrying out clinical audit is compulsory in the EU “in accordance with national requirements”. In 2017, the ESR published a Clinical Aud...
Source: Insights into Imaging - September 5, 2018 Category: Radiology Source Type: research

Radiology trainees forum survey report on workplace satisfaction, ESR education, mobility and stress level
ConclusionThe level of training in aspects related to management safety and quality is low among trainees. The level of satisfaction at work is adequate but not sufficient. The degree of responsibility in training tasks is scarce. A small percentage is familiar with the ESR educational initiatives. As for the mobility the main reservation is lack of confidence in the training acquired.Main Messages•For satisfaction levels to improve, it is vital to include more creative aspects of the profession, such as research and teaching, in balance with the routine aspects of radiology.•Furthermore, a greater involvement of...
Source: Insights into Imaging - September 5, 2018 Category: Radiology Source Type: research

The ESR Audit Tool (Esperanto): genesis, contents and pilot
AbstractClinical audit is a powerful tool to improve patient care, experience and outcome. It consists of measuring a clinical outcome or procedure against predefined standards, identifying differences between current practice and the standards, and changing practice where necessary to facilitate meeting the standards, followed by re-audit (the audit cycle). The recently implemented European Council Basic Safety& Standards (BSS) Directive (2013/59/Euratom) emphasises that carrying out clinical audit is compulsory in the EU “in accordance with national requirements”. In 2017, the ESR published a Clinical Aud...
Source: Insights into Imaging - September 5, 2018 Category: Radiology Source Type: research

Radiology trainees forum survey report on workplace satisfaction, ESR education, mobility and stress level
ConclusionThe level of training in aspects related to management safety and quality is low among trainees. The level of satisfaction at work is adequate but not sufficient. The degree of responsibility in training tasks is scarce. A small percentage is familiar with the ESR educational initiatives. As for the mobility the main reservation is lack of confidence in the training acquired.Main Messages•For satisfaction levels to improve, it is vital to include more creative aspects of the profession, such as research and teaching, in balance with the routine aspects of radiology.•Furthermore, a greater involvement of...
Source: Insights into Imaging - September 5, 2018 Category: Radiology Source Type: research

Imaging in Lyme neuroborreliosis
This article can educate those engaged in imaging of the nervous system and serve as a comprehensive tool in clinical cases.Key Points•Diagnostic criteria for LNB emphasise exclusion of an alternative cause to the clinical symptoms.•MRI makes a crucial contribution in the diagnosis and follow-up of LNB.•MRI may have normal findings, or show neuritis, meningitis, myelitis, encephalitis or vasculitis.•White matter lesions are not a prominent feature of LNB. (Source: Insights into Imaging)
Source: Insights into Imaging - September 4, 2018 Category: Radiology Source Type: research

Spectrum of gastrointestinal lesions of neurofibromatosis type 1: a pictorial review
AbstractNeurofibromatosis type 1 (NF1) is one of the most common genetic disorders. Gastrointestinal manifestations of NF-1 are seldom thought of in routine clinical practice and might thus be significantly under-recognised. Their heterogeneous spectrum ranges from localised microscopic proliferative lesions to grossly recognizable mass-forming neurofibromas, neuroendocrine and gastrointestinal stromal tumours (GIST). The aim of this study is discussing the imaging evaluation and characterisation of the abdomen lesions in patients with NF1.Teaching Points•Neurofibromatosis type  (NF-1) is one of the most common...
Source: Insights into Imaging - September 4, 2018 Category: Radiology Source Type: research

Breast implant-associated anaplastic large cell lymphoma: a pictorial review
AbstractBreast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a newly described and rare T-cell lymphoma of the breast. Since 2007, there have been 56 cases of confirmed BIA-ALCL in Australia and New Zealand. The incidence is believed to be on the rise as the prevalence of elective breast implantation increases. In 2016, the World Health Organization (WHO) classified BIA-ALCL as a recognised entity and emphasised the importance of surgical management of the disease. BIA-ALCL typically presents as a delayed, non-infective fluid collection around a textured breast implant or residual fibrous scar capsule. Th...
Source: Insights into Imaging - September 4, 2018 Category: Radiology Source Type: research

Imaging in Lyme neuroborreliosis
This article can educate those engaged in imaging of the nervous system and serve as a comprehensive tool in clinical cases.Key Points•Diagnostic criteria for LNB emphasise exclusion of an alternative cause to the clinical symptoms.•MRI makes a crucial contribution in the diagnosis and follow-up of LNB.•MRI may have normal findings, or show neuritis, meningitis, myelitis, encephalitis or vasculitis.•White matter lesions are not a prominent feature of LNB. (Source: Insights into Imaging)
Source: Insights into Imaging - September 4, 2018 Category: Radiology Source Type: research

Spectrum of gastrointestinal lesions of neurofibromatosis type 1: a pictorial review
AbstractNeurofibromatosis type 1 (NF1) is one of the most common genetic disorders. Gastrointestinal manifestations of NF-1 are seldom thought of in routine clinical practice and might thus be significantly under-recognised. Their heterogeneous spectrum ranges from localised microscopic proliferative lesions to grossly recognizable mass-forming neurofibromas, neuroendocrine and gastrointestinal stromal tumours (GIST). The aim of this study is discussing the imaging evaluation and characterisation of the abdomen lesions in patients with NF1.Teaching Points•Neurofibromatosis type  (NF-1) is one of the most common...
Source: Insights into Imaging - September 4, 2018 Category: Radiology Source Type: research

Breast implant-associated anaplastic large cell lymphoma: a pictorial review
AbstractBreast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a newly described and rare T-cell lymphoma of the breast. Since 2007, there have been 56 cases of confirmed BIA-ALCL in Australia and New Zealand. The incidence is believed to be on the rise as the prevalence of elective breast implantation increases. In 2016, the World Health Organization (WHO) classified BIA-ALCL as a recognised entity and emphasised the importance of surgical management of the disease. BIA-ALCL typically presents as a delayed, non-infective fluid collection around a textured breast implant or residual fibrous scar capsule. Th...
Source: Insights into Imaging - September 4, 2018 Category: Radiology Source Type: research

Fasciae of the musculoskeletal system: normal anatomy and MR patterns of involvement in autoimmune diseases
AbstractThe fascial system is a three-dimensional continuum of connective tissues present everywhere throughout the body, from the head to the toes and from the skin to the bone. The current article aims to review the normal anatomy of the fasciae of the musculoskeletal system with macroscopic and microscopic correlations and to describe their appearance at MRI in normal subjects and in patients with autoimmune diseases of the musculoskeletal system.Key Points•The fascial system is a three-dimensional continuum of connective tissues.•It is present everywhere throughout the body, from the head to the toes and from...
Source: Insights into Imaging - August 29, 2018 Category: Radiology Source Type: research

Ultrasound elastography: compression elastography and shear-wave elastography in the assessment of tendon injury
This article reviews the two major techniques used in musculoskeletal elastography, compression elastography (CE) and shear-wave elastography (SWE), and evaluates the studies published on major electronic databases that use both techniques in the context of tendon pathology. CE accounts for more studies than SWE. The mechanical properties of tendons, particularly their stiffness, may be altered in the presence of tendon injury. CE and SWE have already been used for the assessment of Achilles tendons, patellar tendon, quadriceps tendon, epicondylar tendons and rotator cuff tendons and muscles. Achilles tendinopathy is the m...
Source: Insights into Imaging - August 17, 2018 Category: Radiology Source Type: research

Acute mesenteric ischaemia: a pictorial review
AbstractAcute mesenteric ischaemia (AMI) is an uncommon cause of acute hospital admission with high mortality rates (50 –90%) that requires early diagnosis and treatment. With the increase in average life expectancy, AMI represents one of the most threatening abdominal conditions in elderly patients. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and deat h. Early intervention can reverse this process leading to a full recovery, but the diagnosis of AMI is difficult. The failure to recognise AMI before intestinal necrosis has developed is responsible for th...
Source: Insights into Imaging - August 17, 2018 Category: Radiology Source Type: research

Ultrasound elastography: compression elastography and shear-wave elastography in the assessment of tendon injury
This article reviews the two major techniques used in musculoskeletal elastography, compression elastography (CE) and shear-wave elastography (SWE), and evaluates the studies published on major electronic databases that use both techniques in the context of tendon pathology. CE accounts for more studies than SWE. The mechanical properties of tendons, particularly their stiffness, may be altered in the presence of tendon injury. CE and SWE have already been used for the assessment of Achilles tendons, patellar tendon, quadriceps tendon, epicondylar tendons and rotator cuff tendons and muscles. Achilles tendinopathy is the m...
Source: Insights into Imaging - August 17, 2018 Category: Radiology Source Type: research

Acute mesenteric ischaemia: a pictorial review
AbstractAcute mesenteric ischaemia (AMI) is an uncommon cause of acute hospital admission with high mortality rates (50 –90%) that requires early diagnosis and treatment. With the increase in average life expectancy, AMI represents one of the most threatening abdominal conditions in elderly patients. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and deat h. Early intervention can reverse this process leading to a full recovery, but the diagnosis of AMI is difficult. The failure to recognise AMI before intestinal necrosis has developed is responsible for th...
Source: Insights into Imaging - August 17, 2018 Category: Radiology Source Type: research

Artificial intelligence as a medical device in radiology: ethical and regulatory issues in Europe and the United States
AbstractWorldwide interest in artificial intelligence (AI) applications is growing rapidly. In medicine, devices based on machine/deep learning have proliferated, especially for image analysis, presaging new significant challenges for the utility of AI in healthcare. This inevitably raises numerous legal and ethical questions. In this paper we analyse the state of AI regulation in the context ofmedical device development, and strategies to make AI applications safe and useful in the future. We analyse the legal framework regulating medical devices and data protection in Europe and in the United States, assessing developmen...
Source: Insights into Imaging - August 15, 2018 Category: Radiology Source Type: research

Radiological findings of complications after lung transplantation
AbstractComplications following lung transplantation may impede allograft function and threaten patient survival. The five main complications after lung transplantation are primary graft dysfunction, post-surgical complications, alloimmune responses, infections, and malignancy.Primary graft dysfunction, a transient ischemic/reperfusion injury, appears as a pulmonary edema in almost every patient during the first three days post-surgery.Post-surgical dysfunction could be depicted on computed tomography (CT), such as bronchial anastomosis dehiscence, bronchial stenosis and bronchomalacia, pulmonary artery stenosis, and size ...
Source: Insights into Imaging - August 15, 2018 Category: Radiology Source Type: research

Artificial intelligence as a medical device in radiology: ethical and regulatory issues in Europe and the United States
AbstractWorldwide interest in artificial intelligence (AI) applications is growing rapidly. In medicine, devices based on machine/deep learning have proliferated, especially for image analysis, presaging new significant challenges for the utility of AI in healthcare. This inevitably raises numerous legal and ethical questions. In this paper we analyse the state of AI regulation in the context ofmedical device development, and strategies to make AI applications safe and useful in the future. We analyse the legal framework regulating medical devices and data protection in Europe and in the United States, assessing developmen...
Source: Insights into Imaging - August 15, 2018 Category: Radiology Source Type: research

Radiological findings of complications after lung transplantation
AbstractComplications following lung transplantation may impede allograft function and threaten patient survival. The five main complications after lung transplantation are primary graft dysfunction, post-surgical complications, alloimmune responses, infections, and malignancy.Primary graft dysfunction, a transient ischemic/reperfusion injury, appears as a pulmonary edema in almost every patient during the first three days post-surgery.Post-surgical dysfunction could be depicted on computed tomography (CT), such as bronchial anastomosis dehiscence, bronchial stenosis and bronchomalacia, pulmonary artery stenosis, and size ...
Source: Insights into Imaging - August 15, 2018 Category: Radiology Source Type: research

Breast ultrasound: recommendations for information to women and referring physicians by the European Society of Breast Imaging
This article summarises the information that should be provided to women and referring physicians about breast ultrasound (US). After explaining the physical principles, technical procedure and safety of US, information is given about its ability to make a correct diagnosis, depending on the setting in which it is applied. The followingdefinite indications for breast US in female subjects are proposed: palpable lump; axillary adenopathy; first diagnostic approach for clinical abnormalities under 40 and in pregnant or lactating women; suspicious abnormalities at mammography or magnetic resonance imaging (MRI); suspicious ni...
Source: Insights into Imaging - August 9, 2018 Category: Radiology Source Type: research

Facet joint syndrome: from diagnosis to interventional management
AbstractLow back pain (LBP) is the most common pain syndrome, and is an enormous burden and cost generator for society. Lumbar facet joints (FJ) constitute a common source of pain, accounting for 15 –45% of LBP. Facet joint degenerative osteoarthritis is the most frequent form of facet joint pain. History and physical examination may suggest but not confirm facet joint syndrome. Although imaging (radiographs, MRI, CT, SPECT) for back pain syndrome is very commonly performed, there are no effe ctive correlations between clinical symptoms and degenerative spinal changes. Diagnostic positive facet joint block can indica...
Source: Insights into Imaging - August 8, 2018 Category: Radiology Source Type: research

Multidetector CT of iatrogenic and self-inflicted vascular lesions and infections at the groin
AbstractThe number and complexity of endovascular procedures performed via either arterial or venous access are steadily increasing. Albeit associated with higher morbidity compared to the radial approach, the traditional common femoral artery remains the preferred access site in a variety of cardiac, aortic, oncologic and peripheral vascular procedures. Both transarterial and venous cannulation (for electrophysiology, intravenous laser ablation and central catheterisation) at the groin may result in potentially severe vascular access site complications (VASC). Furthermore, vascular and soft-tissue groin infections may dev...
Source: Insights into Imaging - August 1, 2018 Category: Radiology Source Type: research

Rectal cancer MRI: protocols, signs and future perspectives radiologists should consider in everyday clinical practice
We present a practical overview regarding the state of the art of the MRI protocol, the main signs that radiologists should consider for their reports during their clinical activity and future perspectives.Teaching Points•MRI protocol for rectal cancer staging and re-staging.•MRI findings that radiologists should consider for reports during everyday clinical activity.•Perspectives regarding the development of latest technologies. (Source: Insights into Imaging)
Source: Insights into Imaging - August 1, 2018 Category: Radiology Source Type: research

Abdominal manifestations of IgG4-related disease: a pictorial review
AbstractIn the last decade, autoimmune pancreatitis has become recognised as part of a wider spectrum of IgG4-related disease, typically associated with elevated serum IgG4 levels and demonstrating a response to corticosteroid therapy. Radiologically, there is imaging overlap with other benign and neoplastic conditions. This pictorial review discusses the intra-abdominal manifestations of this disease on cross-sectional imaging before and after steroid treatment and the main radiological features which help to distinguish it from other key differentials.Teaching Points• Autoimmune pancreatitis is part of a spectrum of...
Source: Insights into Imaging - August 1, 2018 Category: Radiology Source Type: research

Grading of carotid artery stenosis with computed tomography angiography: whether to use the narrowest diameter or the cross-sectional area
AbstractObjectivesTo compare the estimation of carotid artery stenosis by computed tomography angiography (CTA) based on cross-sectional area versus the smallest diameter measurement, and test the accuracy of both CTA measurements using color Doppler ultrasonography (CDUS) as a reference method.MethodsFor 113 carotid arteries with stenosis ≥50% we analysed the differences in the estimated stenosis level between both CTA methods and CDUS using the Bland-Altman approach. Further, we calculated sensitivity, specificity and plotted receiver operating characteristic (ROC) curves for both CTA methods.ResultsThe mean differenc...
Source: Insights into Imaging - August 1, 2018 Category: Radiology Source Type: research

Postmortem fetal magnetic resonance imaging: where do we stand?
AbstractPostmortem fetal magnetic resonance imaging (PMFMRI) is increasingly used thanks to its good overall concordance with histology paralleling the rising incidence of parental refusal of autopsy. The technique could become a routine clinical examination but it needs to be standardized and conducted by trained radiologists. Such radiologists should be aware of not only the (congenital and acquired) anomalies that can involve the fetus, but also of the “physiological” postmortem changes. In this article, we intend to focus on the contribution of PMFMRI based on the existing literature and on our own experien...
Source: Insights into Imaging - August 1, 2018 Category: Radiology Source Type: research

Imaging the operated colon using water-enema multidetector CT, with emphasis on surgical anastomoses
AbstractWater-enema multidetector CT (WE-MDCT) provides a detailed multiplanar visualisation of mural, intra- and extraluminal abnormalities of the large bowel, relying on preliminary bowel cleansing, retrograde luminal distension, pharmacological hypotonisation and intravenous contrast enhancement. In patients with a history of colorectal surgery for either carcinoma or Crohn ’s disease (CD), WE-MDCT may also be performed via a colostomy, which allows depicting the anatomy and position of the residual large bowel and evaluates the calibre, length, mural and extraluminal features of luminal strictures. Therefore, WE-...
Source: Insights into Imaging - August 1, 2018 Category: Radiology Source Type: research