The utility of the 3D imaging software in the macroscopic rendering of complex gynecologic specimens

A new generation of three dimensional (3D) imaging software for the anatomical rendering of the human body, and related surgical pathologies, is postulated. Its practical application is underlined

Inflammatory markers as prognostic factors of survival in patients affected by hepatocellular carcinoma undergoing transarterial chemoembolization

Transarterial chemoembolization (TACE) is a good choice for hepatocellular carcinoma (HCC) treatment when surgery and liver transplantation are not feasible. Few studies reported the value of prognostic factors influencing survival after chemoembolization. In this study, we evaluated whether preoperative inflammatory factors such as neutrophil to lymphocyte ratio and platelet to lymphocyte ratio affected our patient survival when affected by hepatocellular carcinoma. Methods. We retrospectively evaluated a total of 72 patients with hepatocellular carcinoma that underwent TACE. We enrolled patients with different etiopathogeneses of hepatitis and histologically proven HCC not suitable for surgery. The overall study population was dichotomized in two groups according to the median NLR value and was analyzed also according to other prognostic factors. Results. The global median overall survival (OS) was 28 months. The OS in patients with high NLR was statistically significantly shorter than that in patients with low NLR. The following pretreatment variables were significantly associated with the OS in univariate analyses: age, Child-Pugh score, BCLC stage, INR, and NLR. Pretreated high NLR was an independently unfavorable factor for OS. Conclusion. NLR could be considered a good prognostic factor of survival useful to stratify patients that could benefit from TACE treatment

A prospective study on contrast-enhanced magnetic resonance imaging of testicular lesions: distinctive features of Leydig cell tumours

OBJECTIVES: Up to 20 % of incidentally found testicular lesions are benign Leydig cell tumours (LCTs). This study evaluates the role of contrast-enhanced magnetic resonance imaging (MRI) in the identification of LCTs in a large prospective cohort study. MATERIALS AND METHODS: We enrolled 44 consecutive patients with at least one solid non-palpable testicular lesion who underwent scrotal MRI. Margins of the lesions, signal intensity and pattern of wash-in and wash-out were analysed by two radiologists. The frequency distribution of malignant and benign MRI features in the different groups was compared by using the chi-squared or Fisher's exact test. Sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy were calculated. RESULTS: The sensitivity of scrotal MRI to diagnose LCTs was 89.47 % with 95.65 % specificity; sensitivity for malignant lesions was 95.65 % with 80.95 % specificity. A markedly hypointense signal on T2-WI, rapid and marked wash-in followed by a prolonged washout were distinctive features significantly associated with LCTs. Malignant lesions were significantly associated with blurred margins, weak hypointense signal on T2-WI ,and weak and progressive wash-in. The overall diagnostic accuracy was 93 %. CONCLUSIONS: LCTs have distinctive contrast-enhanced MRI features that allow the differential diagnosis of incidental testicular lesions. KEY POINTS: • MRI is able to characterize testicular lesions suggesting a specific diagnosis. • Rapid and marked wash-in is a common feature of Leydig cell tumours. • Markedly hypointense T2-WI signal is significantly correlated with benign lesions. • Blurred margins and weak hypointense T2-WI signal are correlated with malignant tumours. • Weak and progressive wash-in features are present in 85 % of seminomatous lesions

Metabolic syndrome and idiopathic sudden sensori-neural hearing loss

The purpose of this study was to evaluate the association between the presence of Metabolic Syndrome (MetS) and idiopathic sudden sensorineural hearing loss (ISSHL) and the impact of MetS on recovery of patients with ISSHL. 39 Patients with ISSHL and 44 controls were enrolled in this study. Demographic, clinical characteristics and hearing recovery were evaluated. MetS was defined according to the diagnostic criteria of International Diabetes Federation (IDF) consensus definition. Patients affected by ISSHL presented a body mass index (BMI), waist circumference, waist hip ratio (WHR), fasting glucose and blood pressure significantly higher compared to controls. Considering patients with central obesity, 5 controls and 15 ISSHL patients met the criteria of MetS. According to Siegel criteria, a complete or partial recovery was observed in 60% of patients with MetS and in 91,66% of patients without MetS. MetS was associated with ISSHL and this association negatively influenced the hearing recovery of these patients

Diagnosis and endovascular treatment of an internal mammary artery injury

Internal mammary artery (IMA) disruption after blunt chest trauma is rare. In some instances, it may occur after mild chest trauma with minor external physical findings. However, prompt diagnosis and treatment are necessary, as it can be associated with vascular and parenchymal injuries. We report a case of blunt chest trauma resulting in a sternal fracture associated with an IMA injury, active anterior mediastinal bleeding, bilateral lung contusions, and a left hemothorax. It was successfully treated by selective embolization to the left IMA branch and chest tube placement

Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma.

In the assessment of polytrauma patient, an accurate diagnostic study protocol with high sensitivity and specificity is necessary. Computed Tomography (CT) is the standard reference in the emergency for evaluating the patients with abdominal trauma. Ultrasonography (US) has a high sensitivity in detecting free fluid in the peritoneum, but it does not show as much sensitivity for traumatic parenchymal lesions. The use of Contrast-Enhanced Ultrasound (CEUS) improves the accuracy of the method in the diagnosis and assessment of the extent of parenchymal lesions. Although the CEUS is not feasible as a method of first level in the diagnosis and management of the polytrauma patient, it can be used in the follow-up of traumatic injuries of abdominal parenchymal organs (liver, spleen and kidneys), especially in young people or children

Automatic Brain Tumour Segmentation and Biophysics-Guided Survival Prediction

Gliomas are the most common malignant brain tumourswith intrinsic heterogeneity. Accurate segmentation of gliomas and theirsub-regions on multi-parametric magnetic resonance images (mpMRI)is of great clinical importance, which defines tumour size, shape andappearance and provides abundant information for preoperative diag-nosis, treatment planning and survival prediction. Recent developmentson deep learning have significantly improved the performance of auto-mated medical image segmentation. In this paper, we compare severalstate-of-the-art convolutional neural network models for brain tumourimage segmentation. Based on the ensembled segmentation, we presenta biophysics-guided prognostic model for patient overall survival predic-tion which outperforms a data-driven radiomics approach. Our methodwon the second place of the MICCAI 2019 BraTS Challenge for theoverall survival prediction.Comment: MICCAI BraTS 2019 Challeng

MOKA3D : an innovative approach to 3D gas kinematic modelling: I. Application to AGN ionised outflows

Studying the feedback process of active galactic nuclei (AGN) requires the characterisation of multiple kinematical components, such as rotating gas and stellar discs, outflows, inflows, and jets. The usual approach to compare the observed galaxy properties with feedback theoretical predictions relies on simplified kinematic models. This allows us to assess the mutual interaction between the galaxy components and determine the energy injection rate into the interstellar medium. However, these models have several limitations, as they often do not take into account projection effects, beam smearing, or the surface brightness distribution of the emitting medium. Here, we present MOKA3D, an innovative approach to modelling the 3D gas kinematics from integral field spectroscopy observations. In this first paper, we discuss its application to the case of AGN ionised outflows, whose observed clumpy emission and apparently irregular kinematics are only marginally accounted for by the existing kinematical models. Unlike previous works, our model does not assume the surface brightness distribution of the gas, but exploits a novel procedure to derive it from observations by reconstructing the 3D distribution of emitting clouds and providing accurate estimates of the physical properties of spatially resolved outflow (e.g., mass rate, kinetic energy). We demonstrate the capabilities of our method by applying it to three nearby Seyfert-II galaxies observed with the Multi Unit Spectroscopic Explorer (MUSE) at the VLT and selected from the Measuring Active Galactic Nuclei Under MUSE Microscope (MAGNUM) survey, showing that the complex kinematic features observed can be described by a conical outflow with a constant radial velocity field and a clumpy distribution of clouds

MOKA3D: An innovative approach to 3D gas kinematic modelling. I. Application to AGN ionized outflows

Studying the feedback process of Active Galactic Nuclei (AGN) requires characterising multiple kinematical components, such as rotating gas and stellar disks, outflows, inflows, and jets. To compare the observed properties with theoretical predictions of galaxy evolution and feedback models and to assess the mutual interaction and energy injection rate into the interstellar medium (ISM), one usually relies on simplified kinematic models. These models have several limitations, as they often do not take into account projection effects, beam smearing and the surface brightness distribution of the emitting medium. Here, we present MOKA3D, an innovative approach to model the 3D gas kinematics from integral field spectroscopy observations. In this first paper, we discuss its application to the case of AGN ionised outflows, whose observed clumpy emission and apparently irregular kinematics are only marginally accounted for by existing kinematical models. Unlike previous works, our model does not assume the surface brightness distribution of the gas, but exploits a novel procedure to derive it from the observations by reconstructing the 3D distribution of emitting clouds and providing accurate estimates of the spatially resolved outflow physical properties (e.g. mass rate, kinetic energy). As an example, we demonstrate the capabilities of our method by applying it to three nearby Seyfert-II galaxies observed with MUSE at the VLT and selected from the MAGNUM survey, showing that the complex kinematic features observed can be described by a conical outflow with a constant radial velocity field and a clumpy distribution of clouds.Comment: 17 pages, 14 figure