Medical Radiology: Current Progress

Recently, medical radiology has undergone significant improvements in patient management due to advancements in image acquisition by the last generation of machines, data processing, and the integration of artificial intelligence. In this way, cardiovascular imaging is one of the fastest-growing radiological subspecialties. In this study, a compressive review was focused on addressing how and why CT and MR have gained a I class indication in most cardiovascular diseases, and the potential impact of tissue and functional characterization by CT photon counting, quantitative MR mapping, and 4-D flow. Regarding rectal imaging, advances in cancer imaging using diffusion-weighted MRI sequences for identifying residual disease after neoadjuvant chemoradiotherapy and [18F] FDG PET/MRI were provided for high-resolution anatomical and functional data in oncological patients. The results present a large overview of the approach to the imaging of diffuse and focal liver diseases by US elastography, contrast-enhanced US, quantitative MRI, and CT for patient risk stratification. Italy is currently riding the wave of these improvements. The development of large networks will be crucial to create high-quality databases for patient-centered precision medicine using artificial intelligence. Dedicated radiologists with specific training and a close relationship with the referring clinicians will be essential human factors

Illuminating the pathway:For image-guided prostate cancer care

The aim of this thesis is to improve the diagnostic pathway for prostate cancer (PCa) and to develop a minimal invasive focal ablative treatment for PCa. In Chapter 2 risk stratification for detection of clinically significant PCa (csPCa) with systematic biopsy in biopsy naive patients with prostate imaging-reporting and data system (PI-RADS) classification ≤2 on pre-biopsy prostate MRI is evaluated, predictors for csPCa are integrated into a novel risk calculator and compared to contemporary risk calculators. Furthermore, in Chapter 3 an optimal biopsy strategy is determined for prostate biopsy patients with a unilateral PI-RADS classification ≥3 on pre-biopsy prostate MRI based on detection rates of csPCa and iPCa using different combinations of MRI-targeted biopsy, ipsilateral and/or contralateral systematic biopsy. Additionally, in Chapter 4 safety and feasibility of needle-based confocal laser endomicroscopy (CLE) for real-time PCa detection is investigated in prostate biopsy patients. In Chapter 5 safety and feasibility and short-term quality of life outcomes of transperineal focal laser ablation (TPLA) for treatment of PCa under local anesthesia in a daycare setting is evaluated. Moreover, in Chapter 6 three-dimensional ablative effects of TPLA for treatment of PCa are visualized on prostate MRI and contrast-enhanced ultrasound (CEUS) and correlated with whole-mount prostate histology after RARP. Finally, in Chapter 7 safety, feasibility and medium-term oncological and functional outcomes of salvage RARP are studied for recurrent localized PCa following initial focal ablative therapy using irreversible electroporation (IRE)

How to Evaluate Fibrosis in IBD?

In this review, we will describe the importance of fibrosis in inflammatory bowel disease (IBD) by discussing its distinct impact on Crohn's disease (CD) and ulcerative colitis (UC) through their translation to histopathology. We will address the existing knowledge on the correlation between inflammation and fibrosis and the still not fully explained inflammation-independent fibrogenesis. Finally, we will compile and discuss the recent advances in the noninvasive assessment of intestinal fibrosis, including imaging and biomarkers. Based on the available data, none of the available cross-sectional imaging (CSI) techniques has proved to be capable of measuring CD fibrosis accurately, with MRE showing the most promising performance along with elastography. Very recent research with radiomics showed encouraging results, but further validation with reliable radiomic biomarkers is warranted. Despite the interesting results with micro-RNAs, further advances on the topic of fibrosis biomarkers depend on the development of robust clinical trials based on solid and validated endpoints. We conclude that it seems very likely that radiomics and AI will participate in the future non-invasive fibrosis assessment by CSI techniques in IBD. However, as of today, surgical pathology remains the gold standard for the diagnosis and quantification of intestinal fibrosis in IBD.info:eu-repo/semantics/publishedVersio