Real – time three-dimensional anatomical reconstruction of the human heart from normalized dataset

Four-dimensional (3D + time), real-time, cardiac image visualization is an important tool for anatomical procedure, particularly if the dynamic volumetric image can be registered to, and fused with the actual patient anatomy. 4D cardiac image visualization and manipulation platform, based on the opacity density radiation model, which exploits the power of modern graphics processing units in the rendering pipeline. A dynamic multiresolution display is implemented to enable the interactive selection and emphasis of volume of interest (VOI) within the entire contextual cardiac volume and to enhance performance, and a novel color and opacity adjustment algorithm is designed to increase the uniformity of the rendered multiresolution image of heart. Our system provides a visualization environment superior to noninteractive software-based implementations, but with a rendering speed that is comparable to traditional volume rendering approaches based on texture mapping

Real – time three-dimensional anatomical reconstruction of the human heart from normalized dataset

Four-dimensional (3D + time), real-time, cardiac image visualization is an important tool for anatomical procedure, particularly if the dynamic volumetric image can be registered to, and fused with the actual patient anatomy. 4D cardiac image visualization and manipulation platform, based on the opacity density radiation model, which exploits the power of modern graphics processing units in the rendering pipeline. A dynamic multiresolution display is implemented to enable the interactive selection and emphasis of volume of interest (VOI) within the entire contextual cardiac volume and to enhance performance, and a novel color and opacity adjustment algorithm is designed to increase the uniformity of the rendered multiresolution image of heart. Our system provides a visualization environment superior to noninteractive software-based implementations, but with a rendering speed that is comparable to traditional volume rendering approaches based on texture mapping

Transcatheter Aortic Valve Implantation (TAVI) Planning with Dual-Layer Spectral CT Using Virtual Monoenergetic Image (VMI) Reconstructions and 20 mL of Contrast Media

Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical implantation and its implementation is progressively increasing worldwide. We routinely perform pre-procedural aortic angiography CT to assess aortic dimensions and vascular anatomy. This study aims to evaluate the image quality of CTA for TAVI planning using dual-layer spectral CT, with virtual monoenergetic image reconstructions at 40 keV. Thirty-one patients underwent a CTA protocol with the injection of 20 mL of contrast media. Image quality was assessed by measuring the mean density in Hounsfield Units (HU), the signal-to-noise ratio, and the contrast-to-noise ratio in VMI reconstructions. Additionally, a blinded subjective analysis was conducted by two observers. The results showed significant enhancement at all sampled vascular levels with a gradual decrease in HU from proximal to distal regions. Favourable subjective ratings were given for all parameters, with greater variability in the evaluation of iliac axes. A significant negative correlation (p < 0.05) was observed between BMI and CA at all vascular levels, indicating reduced contrast enhancement with increasing BMI. Spectral CT, along with reducing iodine load, allows for obtaining high-quality images without a significant increase in noise. The reduction in iodine load can have positive implications in clinical practice, improving patient safety and resource efficiency

Coronary angiography using spectral detector dual-energy CT:is it the time to assess myocardial first-pass perfusion?

Coronary computed tomography angiography (CCTA) represents a common approach to the diagnostic workup of patients with suspected coronary artery disease. Technological development has recently allowed the integration of conventional CCTA information with spectral data. Spectral CCTA used in clinical routine may allow for improving CCTA diagnostic performance by measuring myocardial iodine distribution as a marker of first-pass perfusion, thus providing additional functional information about coronary artery disease

Multiple, Synchronous Lesions of Differing Histology Within the Same Testis: Ultrasonographic and Pathologic Correlations

Objective: To describe ultrasound (US) and pathologic findings in 11 patients with multiple, synchronous lesions of different histology within the same testis. Materials and methods: We reviewed US and pathologic findings in 11 patients with multiple, synchronous lesions of different histology within the same testis. Lesions were classified as separate or adjacent one to another and attempt was made to predict tumor type on their US textures. Pathologic review assessed presence of normal tissue between adjacent lesions and of Germ Cell Neoplasia In Situ in surrounding parenchyma. Nine cases were from files specifically dedicated to testicular tumors and estimated prevalence was calculated. Results: Two nodules were seen in nine patients and 3 in remaining two. Nine had tumors of different histology; two had one malignancy and one focal benign lesion. Germ Cell Neoplasia In Situ was seen in 7/11 cases. In dedicated archives, these lesions had 1.83% prevalence. Conclusion: Multiple focal lesions identified at imaging within the testis are not always of the same histology. This can be suspected in some cases basing on US texture. Recognition that lesions are multiple and an indication of their locations within the testis is the most important role of imaging and may help pathologists correctly sample the specimen to establish nature of each of them. Presence of multiple lesions is regarded as a contraindication to testicular sparing surgery. In two of our patients, one lesion was benign. Then, when the procedure is indicated all lesions have to be sampled and assessed by pathologists before deciding between conservative or radical technique

Implicazioni diagnostiche e terapeutiche in due casi di tumori cistici del pancreas: mucinoso e sieroso

I tumori cistici del pancreas comprendono, come è noto, un gruppo patologicamente eterogeneo ed alquanto raro di neoplasie che manifestano, peraltro, molti aspetti clinici in comune; essi costituiscono il 10% circa di tutte le lesioni cistiche pancreatiche e l’1% di tutte le forme neoplastiche, avendo così un ruolo importante nell’ambito della chirurgia d’organo. Allo stato attuale vengono distinte due categorie di tumori cistici: la forma sierosa fondamentalmente benigna e quella mucinosa potenzialmente maligna o con caratteristiche di malignità già al momento della diagnosi. Essendo queste neoplasie ancora di difficle interpretazione preoperatoria, è necessario che l’iter diagnostico sia sempre accurato allo scopo di modulare il trattamento chirurgico che si avvale in ogni caso del responso dell’esame istologico estemporaneo, che deve essere sempre fatto su un numero sufficiente di sezioni del tumore. Gli Autori, alla luce di due casi di tumori cistici del pancreas osservati, dopo ampia revisione della letteratura, discutono sulla validità della diagnostica radiologica per immagini ed in particolar modo dell’esame ecografico con mezzo di contrasto, del dosaggio dei markers tumorali specifici e dell’esame istologico supportato dall’immunoistochimica nella caratterizzazione di queste neoplasie, ai fini di un migliore approfondimento sulla conoscenza biologica di una patologia rara e particolarmente interessante

Lipoma primitivo multiplo del mesocolon: una patologia rara

Gli Autori descrivono un caso di lipomatosi multipla del mesocolon e, dopo disamina della letteratura, ne esaminano le caratteristiche peculiari e discutono sulle difficoltà diagnostiche, sugli aspetti anatomopatologici e sul trattamento. La localizzazione intraaddominale del lipoma rappresenta infatti una patologia rara che può porre notevoli difficoltà diagnostiche. Poiché si tratta di tumori che prendono origine da cellule mesenchimali primitive e totipotenti, l’intervento chirurgico radicale è l’unica opzione terapeutica. La diagnosi di certezza spetta all’istologia per differenziare la lesione da altri tipi di tumore mesenchimale

Xanthogranulomatous Pyelonephritis Can Simulate a Complex Cyst: Case Description and Review of Literature

Xanthogranulomatous pyelonephritis is a rare and peculiar form of chronic pyelonephritis and is generally associated with renal lithiasis. Its incidence is higher in females. The peculiarity of this disease is that it requires a differential diagnosis, because it can often simulate dramatic pathologic conditions. In fact, in the literature are also described cases in association with squamous cell carcinoma of the kidney The radiologic clinical findings simulate renal masses, sometimes in association with caval thrombus. We describe a case of xanthogranulomatous pyelonephritis with radiologic aspects of a complex cyst of Bosniak class III in a man 40-year old