Most common misconceptions about transradial approach in interventional radiology: results from an international survey

PURPOSEWe aimed to assess the use of transradial approach (TRA) among interventional radiologists (IRs) and its perceived advantages and disadvantages that have driven the decision to select or refuse this endovascular approach.METHODSA multicountry survey of 20 multiple-choice questions was conducted among interventional radiologists in Europe and the United States. Questions assessed demographic information of the participants and whether they performed TRA routinely, pre-procedural screening modalities for TRA, TRA technique, complications, reasons for adopting TRA and reasons for not adopting TRA. A total of 187 IRs completed the survey.RESULTSOne hundred respondents (53.5%) performed TRA routinely. TRA was chosen based on the procedure (90%, mostly embolization) and physical examination (75%). Patient preference (79%) and faster patient ambulation/discharge (73%) were the main drivers for TRA. Long learning curve (45%), lack of training (32%), prolonged procedural time (31%), potential risk for neurological complications (31%), and increase in radiation exposure (28%) were the most frequent detractors. TRA use was significantly higher in the US than in Europe (p < 0.001) and among male IRs than female IRs (p < 0.01). There was a declining trend in use of TRA with advanced age and more years of experience of IRs.CONCLUSIONTRA usage among IRs is limited by issues that can easily be addressed. This survey could help IRs to better understand the real advantages of TRA and how it can offer higher value in patient care

Imaging Modalities for the Diagnosis of Vascular Graft Infections:A Consensus Paper amongst Different Specialists

Vascular graft infection (VGI) is a rare but severe complication of vascular surgery that is associated with a bad prognosis and high mortality rate. An accurate and prompt identification of the infection and its extent is crucial for the correct management of the patient. However, standardized diagnostic algorithms and a univocal consensus on the best strategy to reach a diagnosis still do not exist. This review aims to summarize different radiological and Nuclear Medicine (NM) modalities commonly adopted for the imaging of VGI. Moreover, we attempt to provide evidence-based answers to several practical questions raised by clinicians and surgeons when they approach imaging in order to plan the most appropriate radiological or NM examination for their patients

The non-inflammatory role of C1q during Her2/neu-driven mammary carcinogenesis

There is an ever increasing amount of evidence to support the hypothesis that complement C1q, the first component of the classical complement pathway, is involved in the regulation of cancer growth, in addition to its role in fighting infections. It has been demonstrated that C1q is expressed in the microenvironment of various types of human tumors, including breast adenocarcinomas. This study compares carcinogenesis progression in C1q deficient (neuT-C1KO) and C1q competent neuT mice in order to investigate the role of C1q in mammary carcinogenesis. Significantly accelerated autochthonous neu(+) carcinoma progression was paralleled by accelerated spontaneous lung metastases occurrence in C1q deficient mice. Surprisingly, this effect was not caused by differences in the tumor-infiltrating cells or in the activation of the complement classical pathway, since neuT-C1KO mice did not display a reduction in C3 fragment deposition at the tumor site. By contrast, a significant higher number of intratumor blood vessels and a decrease in the activation of the tumor suppressor WW domain containing oxidoreductase (WWOX) were observed in tumors from neuT-C1KO as compare with neuT mice. In parallel, an increase in Her2/neu expression was observed on the membrane of tumor cells. Taken together, our findings suggest that C1q plays a direct role both on halting tumor angiogenesis and on inducing apoptosis in mammary cancer cells by coordinating the signal transduction pathways linked to WWOX and, furthermore, highlight the role of C1q in mammary tumor immune surveillance regardless of complement system activation

Gestione della fertilizzazione e produttività del guado (<i>Isatis tinctoria</i> L.) nella collina marchigiana

La Isatis tinctoria L., altrimenti conosciuta con il termine di guado, è una pianta della famiglia delle brassicaceae (o cruciferae) a ciclo biennale. Il guado è una pianta di origine asiatica, in Italia è diffusa particolarmente al Nord in Val d'Aosta, Piemonte Liguria e Veneto, in alcune regioni del centro come Toscana, Umbria Lazio e Marche e del sud come Abruzzo. È presente anche in Sicilia e Sardegna (in questa seconda isola particolarmente nella sottospecie canescens).Il guado fa parte delle cosiddette piante da blu. Il colorante si estrae dalle foglie di questa pianta raccolte durante il primo anno di vita. Dopo macerazione e fermentazione in acqua si ottiene una soluzione giallo verde che agitata e ossidata produce un precipitato (indigotina). Il colorante, molto solido, è utilizzabile nella tintura della lana, seta, cotone, lino e juta, ma anche in cosmetica e colori pittorici. Fu coltivato in Italia almeno dal XIII secolo fino alla seconda metà del XVIII quando la concorrenza dell'indaco asiatico e americano ne ridusse drasticamente la produzione. Un rinnovato e crescente interesse verso i prodotti naturali ha incoraggiato, nel contesto agricolo europeo, la reintroduzione delle colture che producono indaco (Sales E. et al, 2006). Il lavoro di seguito descritto rientra in un Progetto di Ricerca che si pone, come obiettivo generale, la riqualificazione e differenziazione dell'attività agricola marchigiana con lo scopo di fornire ai produttori primari nuove fonti di reddito. Nello specifico il lavoro, del quale sono forniti solamente i risultati preliminari, si pone l’obiettivo di identificare un protocollo di tecnica agronomica a basso impatto ambientale per introdurre e diffondere nel territorio marchigiano la coltivazione di guado. Il lavoro descritto è parte di un progetto di ricerca finanziato con Fondi della Regione Marche nell’ambito del Piano di Azione Bieticolo – Saccarifero (PABS) 2009-2010 ed è svolto in collaborazione con i Ricercatori della Sez. di Microbiologia Alimentare, Industriale ed Ambientale del Dipartimento SAIFET dell’Università Politecnica delle Marche

Imaging Modalities for the Diagnosis of Vascular Graft Infections: A Consensus Paper amongst Different Specialists

Vascular graft infection (VGI) is a rare but severe complication of vascular surgery that is associated with a bad prognosis and high mortality rate. An accurate and prompt identification of the infection and its extent is crucial for the correct management of the patient. However, standardized diagnostic algorithms and a univocal consensus on the best strategy to reach a diagnosis still do not exist. This review aims to summarize different radiological and Nuclear Medicine (NM) modalities commonly adopted for the imaging of VGI. Moreover, we attempt to provide evidence-based answers to several practical questions raised by clinicians and surgeons when they approach imaging in order to plan the most appropriate radiological or NM examination for their patients

Sequestro potenziale di carbonio in sistemi colturali cerealicoli della collina marchigiana

Una delle sfide più importanti dell’agricoltura di questi anni è lo sviluppo di pratiche colturali in grado di aumentare il sequestro di carbonio organico nel suolo (Purakayastha et al. 2008). La scelta del sistema colturale e in particolare l’utilizzo di una bilanciata gestione della fertilizzazione può influenzare in misura molto rilevante il potenziale di incremento del carbonio organico nei suoli agrari (Lal, 2002). Il lavoro aveva l’obiettivo di valutare, attraverso sperimentazioni di campo e modelli di simulazione, l’impatto sulla sostanza organica del suolo di diverse modalità di fertilizzazione azotata nell’ambito di un avvicendamento asciutto frumento duro-mais della collina marchigiana

How to Reduce the Risk for Complications?

Interventional oncology represents a relatively new clinical discipline based upon minimally invasive therapies applicable to almost every human organ and disease. Over the last several decades, rapidly evolving research developments have introduced a newer generation of treatment devices, reagents, and image-guidance systems to expand the armamentarium of interventional oncology across a wide spectrum of disease sites, offering potential cure, control, or palliative care for many types of cancer patients. Due to the widespread use of locoregional procedures, a comprehensive review of the methodologic and technical considerations to optimize patient selection with the aim of performing a safe procedure is mandatory. This article summarizes the expert discussion and report from the Mediterranean Interventional Oncology Live Congress (MIOLive 2020) held in Rome, Italy, integrating evidence-reported literature and experience-based perceptions as a means for providing guidance on prudent ways to reduce complications. The aim of the paper is to provide an updated guiding tool not only to residents and fellows but also to colleagues approaching locoregional treatments.publishersversionpublishe

Assessment of Sexual Dysfunction in Cervical Cancer Patients after Different Treatment Modality: A Systematic Review

Background and Objectives: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB-IVA FIGO. Several studies have shown that image-guided adaptive IRT resulted in excellent local and pelvic control, but it is associated with vaginal toxicity and intercourse problems. The purpose of this review is to evaluate the dysfunctions of the sexual sphere in patients with cervical cancer undergoing different cervix cancer treatments. Materials and Methods: We performed a comprehensive literature search using Pub med, Scopus and Cochrane to identify all the full articles evaluating the dysfunctions of the sexual sphere. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. Results: One thousand three hundred fifty-six women included in five studies published from 2016 to 2022 were analyzed. The median age was 50 years (range 46-56 years). The median follow-up was 12 months (range 0-60). Cervical cancer diagnosis and treatment (radiotherapy, chemotherapy and surgery) negatively affected sexual intercourse. Sexual symptoms such as fibrosis, strictures, decreased elasticity and depth and mucosal atrophy promote sexual dysfunction by causing frigidity, lack of lubrication, arousal, orgasm and libido and dyspareunia. Conclusions: Physical, physiological and social factors all contribute to the modification of the sexual sphere. Cervical cancer survivors who were irradiated have lower sexual and vaginal function than the normal population. Although there are cures for reducing discomfort, effective communication about sexual dysfunctions following treatment is essential

Tailoring protocols for chest CT applications: when and how?

In the medical era of early detection of diseases and tailored therapies, an accurate characterization and staging of the disease is pivotal for treatment planning. The widespread use of computed tomography (CT)—often with the use of contrast material (CM)—probably represents the most important advance in diagnostic radiology. The result is a marked increase in radiation exposure of the population for medical purposes, with its intrinsic carcinogenic potential, and CM affecting kidney function. The radiologists should aim to minimize patient’s risk by reducing radiation exposure and CM amount, while maintaining the highest image quality. To achieve this goal, it is necessary to perform “patient-centric imaging”. The purpose of this review is to provide radiologists with “tips and tricks” to control radiation dose at CT, summarizing technical artifices in order to reduce image noise and increase image contrast. Also chest CT tailored protocols are supplied, with particular attention to three most common thoracic CT protocols: aortic/cardiac CT angiography (CTA), pulmonary CTA, and routine chest CT

Gadoxetic acid uptake as a molecular imaging biomarker for sorafenib resistance in patients with hepatocellular carcinoma: a post hoc analysis of the SORAMIC trial

PURPOSE Gadoxetic acid uptake on hepatobiliary phase MRI has been shown to correlate with ß-catenin mutation in patients with HCC, which is associated with resistance to certain therapies. This study aimed to evaluate the prognostic value of gadoxetic acid uptake on hepatobiliary phase MRI in patients with advanced HCC receiving sorafenib. METHODS 312 patients with available baseline hepatobiliary phase MRI images received sorafenib alone or following selective internal radiation therapy (SIRT) within SORAMIC trial. The signal intensity of index tumor and normal liver parenchyma were measured on the native and hepatobiliary phase MRI images, and relative tumor enhancement higher than relative liver enhancement were accepted as high gadoxetic acid uptake, and its prognostic value was assessed using univariate and multivariate Cox proportional hazard models. RESULTS The median OS of the study population was 13.4 (11.8-14.5) months. High gadoxetic acid uptake was seen in 51 (16.3%) patients, and none of the baseline characteristics was associated with high uptake. In univariate analysis, high gadoxetic acid uptake was significantly associated with shorter overall survival (10.7 vs. 14.0~months, p = 0.005). Multivariate analysis confirmed independent prognostic value of high gadoxetic acid uptake (HR, 1.7 1.21-2.3, p = 0.002), as well as Child-Pugh class (p = 0.033), tumor diameter (p = 0.002), and ALBI grade (p = 0.015). CONCLUSION In advanced HCC patients receiving sorafenib (alone or combined with SIRT), high gadoxetic acid uptake of the tumor on pretreatment MRI, a surrogate of ß-catenin mutation, correlates with shorter survival. Gadoxetic acid uptake status might serve in treatment decision-making process