Accuracy of magnetic resonance imaging to identify pseudocapsule invasion in renal tumors

Purpose: To evaluate accuracy of MRI in detecting renal tumor pseudocapsule (PC) invasion and to propose a classification based on imaging of PC status in patients with renal cell carcinoma. Methods: From January 2017 to June 2018, 58 consecutive patients with localized renal cell carcinoma were prospectively enrolled. MRI was performed preoperatively and PC was classified, according to its features, as follows: MRI-Cap 0 (absence of PC), MRI-Cap 1 (presence of a clearly identifiable PC), MRI-Cap 2 (focally interrupted PC), and MRI-Cap 3 (clearly interrupted and infiltrated PC). A 3D image reconstruction showing MRI-Cap score was provided to both surgeon and pathologist to obtain complete preoperative evaluation and to compare imaging and pathology reports. All patients underwent laparoscopic partial nephrectomy. In surgical specimens, PC was classified according to the renal tumor capsule invasion scoring system (i-Cap). Results: A concordance between MRI-Cap and i-Cap was found in 50/58 (86%) cases. ρ coefficient for each MRI-cap and iCap categories was: MRI-Cap 0: 0.89 (p < 0.0001), MRI-Cap1: 0.75 (p < 0.0001), MRI-Cap 2: 0.76 (p < 0.0001), and MRI-Cap3: 0.87 (p < 0.0001). Sensitivity, specificity, positive predictive value, negative predictive value, and AUC were: MRI-Cap 0: Se 97.87% Spec 83.3%, PPV 95.8%, NPV 90.9%, and AUC 90.9; MRI-Cap 1: Se 77% Spec 95.5%, PPV 83.3%, NPV 93.5%, and AUC 0.86; MRI-Cap 2- iCap 2: Se 88% Spec 90%, PPV 79%, NPV 95%, and AUC 0.89; MRI-Cap 3: Se 94% Spec 95%, PPV 88%, NPV 97%, and AUC 0.94. Conclusions: MRI-Cap classification is accurate in evaluating renal tumor PC features. PC features can provide an imaging-guided landmark to figure out where a minimal margin could be preferable during nephron-sparing surgery

Linking crop yields in Tuscany, Italy, to large-scale atmospheric variability, circulation regimes and weather types

AbstractThe paper presents results from a study examining the relationship between large-scale modes of climate variability with the fluctuations in the yield of barley, durum wheat, olives and sunflower crops in Tuscany, Italy. In particular, the blocking circulation over the growing season, with associated hot and dry conditions, decreased yield for olive crops, barley and durum wheat. The teleconnections analysed in this study are the winter North Atlantic Oscillation (NAO) and the Summer North Atlantic Oscillation (SNAO); the West African Monsoon (WAM) and the Intertropical Front (ITF); and although NAO, SNAO, ITF and WAM are not strictly related to each other, the values of these indices are strongly related to the atmospheric circulation regimes and related weather types. Thus, they have an impact on precipitation and temperature patterns in Italy and on yields of important crops in Tuscany. Results show that the large-scale temperate and tropical variability directly influences the crop yield through three main circulation regimes. These patterns illustrate the importance of the large-scale modes, which, together with the associated weather types, have an impact directly on Tuscan crop yields; both barley and olive yields decline significantly when the ITF is further north with warmer and drier conditions in Italy

Accuracy of elastic fusion biopsy in daily practice: results of a multicenter study of 2115 patients

OBJECTIVES: To assess the accuracy of Koelis fusion biopsy for the detection of prostate cancer and clinically significant prostate cancer in the everyday practice. METHODS: We retrospectively enrolled 2115 patients from 15 institutions in four European countries undergoing transrectal Koelis fusion biopsy from 2010 to 2017. A variable number of target (usually 2-4) and random cores (usually 10-14) were carried out, depending on the clinical case and institution habits. The overall and clinically significant prostate cancer detection rates were assessed, evaluating the diagnostic role of additional random biopsies. The cancer detection rate was correlated to multiparametric magnetic resonance imaging features and clinical variables. RESULTS: The mean number of targeted and random cores taken were 3.9 (standard deviation 2.1) and 10.5 (standard deviation 5.0), respectively. The cancer detection rate of Koelis biopsies was 58% for all cancers and 43% for clinically significant prostate cancer. The performance of additional, random cores improved the cancer detection rate of 13% for all cancers (P < 0.001) and 9% for clinically significant prostate cancer (P < 0.001). Prostate cancer was detected in 31%, 66% and 89% of patients with lesions scored as Prostate Imaging Reporting and Data System 3, 4 and 5, respectively. Clinical stage and Prostate Imaging Reporting and Data System score were predictors of prostate cancer detection in multivariate analyses. Prostate-specific antigen was associated with prostate cancer detection only for clinically significant prostate cancer. CONCLUSIONS: Koelis fusion biopsy offers a good cancer detection rate, which is increased in patients with a high Prostate Imaging Reporting and Data System score and clinical stage. The performance of additional, random cores seems unavoidable for correct sampling. In our experience, the Prostate Imaging Reporting and Data System score and clinical stage are predictors of prostate cancer and clinically significant prostate cancer detection; prostate-specific antigen is associated only with clinically significant prostate cancer detection, and a higher number of biopsy cores are not associated with a higher cancer detection rate

Diffusional Kurtosis Imaging of White Matter Degeneration in Glaucoma

Glaucoma is an optic neuropathy characterized by death of retinal ganglion cells and loss of their axons, progressively leading to blindness. Recently, glaucoma has been conceptualized as a more diffuse neurodegenerative disorder involving the optic nerve and also the entire brain. Consistently, previous studies have used a variety of magnetic resonance imaging (MRI) techniques and described widespread changes in the grey and white matter of patients. Diffusion kurtosis imaging (DKI) provides additional information as compared with diffusion tensor imaging (DTI), and consistently provides higher sensitivity to early microstructural white matter modification. In this study, we employ DKI to evaluate differences among healthy controls and a mixed population of primary open angle glaucoma patients ranging from stage I to V according to Hodapp−Parrish−Anderson visual field impairment classification. To this end, a cohort of patients affected by primary open angle glaucoma (n = 23) and a group of healthy volunteers (n = 15) were prospectively enrolled and underwent an ophthalmological evaluation followed by magnetic resonance imaging (MRI) using a 3T MR scanner. After estimating both DTI indices, whole-brain, voxel-wise statistical comparisons were performed in white matter using Tract-Based Spatial Statistics (TBSS). We found widespread differences in several white matter tracts in patients with glaucoma relative to controls in several metrics (mean kurtosis, kurtosis anisotropy, radial kurtosis, and fractional anisotropy) which involved localization well beyond the visual pathways, and involved cognitive, motor, face recognition, and orientation functions amongst others. Our findings lend further support to a causal brain involvement in glaucoma and offer alternative explanations for a number of multidomain impairments often observed in glaucoma patients

Modellistica di accensione per candele ad arco elettrico in motori a combustione interna alternativi

Nel panorama mondiale di contenimento delle emissioni inquinanti in atmosfera é divenuto sempre più importante limitare la parte derivante dai motori a combustione interna: l'utilizzo di motori GDI a carica stratificata e di ricircolo dei gas di scarico (EGR) sono esempi di tecnologie pensate proprio in tale ottica. Sia la presenza di un ambiente magro che di EGR nel cilindro, come anche l'aumento della pressione nel cilindro per l'incremento della pressione di sovralimentazione o del rapporto di compressione, hanno lo svantaggio di limitare la velocità di combustione e rendere più sfavorevoli le condizioni di accensione della miscela; in questo scenario diviene di fondamentale importanza il miglioramento dei sistemi di accensione, la creazione di modelli volti a simularli e la comprensione dei fenomeni che ne stanno alla base. Il seguente lavoro di tesi si inserisce proprio in questo contesto, indagando le varie fasi di cui si compone il fenomeno dell'accensione e le relazioni che legano le variabili di interesse fisico, verificate sulla base di evidenze sperimentali. Successivamente vengono analizzati i principali modelli d'accensione che sono stati proposti e implementati in codici computazionali fluidodinamici; l'analisi mette in luce le differenze, i punti di forza e le semplificazioni introdotte in ognuno di essi, in modo da poterli valutare criticamente. La suddetta analisi é anche utile per introdurre il modello frutto del lavoro del gruppo di ricerca dell'Università di Bologna; ci si concentra particolarmente su quest'ultimo poiché un obiettivo di questo lavoro di tesi é stato proprio l'implementazione e l'utilizzo del modello in un codice fluidodinamico tridimensionale quale CONVERGE CFD. L'implementazione é stata poi validata attraverso simulazioni su una geometria reale di un motore a combustione interna ad elevate prestazioni, confrontando i risultati ottenuti con il nuovo modello rispetto ai dati sperimentali sulla combustione

Pancoast Tumor: The Role of Magnetic Resonance Imaging

We report imaging techniques in the definition of the therapeutic planning of a 65-year-old man with a diagnosis of Pancoast tumor. Computed Tomography has a pivotal role in the assessment of nodes involvement and distant metastasis. Magnetic Resonance allows a detailed study of locoregional extension for its high soft tissue resolution. We particularly highlight the actual importance of Magnetic Resonance Neurography, Diffusion-Weighted Imaging, and Magnetic Resonance Angiography techniques in the assessment of the superior sulcus vascular and nervous structures involvement. Their integrity has been showed in our patient with a complete surgical excision of the lesion

Early Magnetic Resonance Detection of Natalizumab-Related Progressive Multifocal Leukoencephalopathy in a Patient with Multiple Sclerosis

Diagnosis of progressive multifocal leukoencephalopathy is usually based on the clinical presentation, on the demonstration of the brain lesions at the magnetic resonance imaging examination, and on the detection of the JC virus DNA in the cerebrospinal fluid with high sensitive polymerase chain reaction. The role of magnetic resonance imaging specifically in natalizumab-associated progressive multifocal leukoencephalopathy is strengthening, and it is gaining importance not only as an irreplaceable diagnostic tool but also as a surveillance and risk stratifying tool in treated patients. While other imaging techniques such as computed tomography lack sensitivity and specificity, magnetic resonance performed with morphological and functional sequences offers clinicians the possibility to early identify the stage of the disease and the emergence of an immune reconstitution inflammatory syndrome after natalizumab blood removal plasmapheresis

High-resolution molecular phenotyping of human IPSC organoids using CLARITY and 2-photon microscopy

High-resolution molecular phenotyping of human IPSC organoids using CLARITY and 2-photon microscopy Simone Tomasi, Soraya Scuderi, Anahita Amiri, Giovanna G. Altobelli, Jessica Mariani, Cheryl Dambrot, Gianfilippo Coppola, Flora M. Vaccarino To understand the role of gene regulation in human brain development and neuropsychiatric disorders, it is essential to develop cellular models of the human brain. Induced pluripotent stem cells (iPSC)-derived brain organoids can be used to investigate the role of gene regulatory elements, noncoding RNA, and in general, noncoding disease associated gene variants in brain development and function. Organoids enable gradients of morphogenes and other extracellular cues to build up in the intercellular milieu and to interact with the genetic and epigenetic background of a given progenitor cell during the course of brain development. We have developed an iPSC-derived organoid model of the early human forebrain, where differentiation of cortical excitatory and inhibitory neurons can be studied in a reproducible fashion, enabling a more precise identification of molecular events crucially involved in the specification of distinct neuronal subtypes. However, a precise assessment of protein and RNA expression in intact organoids is hampered by the limited penetration of molecular probes, therefore requiring the preparation of thin sections and greatly limiting the capacity of exploring molecular and cellular features in a 3D environment. Here, we labeled telencephalic excitatory and inhibitory lineages in using pLenti-CAMKII-GFP and pLenti-DlxI12b-BG-DsRed vectors, then used two-photon microscopy to image the genetically-encoded fluorescence at higher resolution in live forebrain organoids. Next, we used CLARITY to clear the organoids and perform immunostainings on the intact cell aggregates. Our current protocol enables a 3D reconstruction of GFP/TdTomato filled cells allowing the analysis of axonal and dendritic arborization, dendrite length, synapse and spine distribution, as well as stereological counts of structures labeled by specific markers. Using these combined approaches, we aim at comparing intra-organoid layer cytoarchitecture and its emerging connectivity with parallel data from RNA-seq and ChIP-seq experiments, and develop new tools for linking the molecular and cellular features of organoids derived from different individuals

Integrating Sentinel-2 Imagery with AquaCrop for Dynamic Assessment of Tomato Water Requirements in Southern Italy

A research study was conducted in an open field tomato crop in order to: (i) Evaluate the capability of Sentinel-2 imagery to assess tomato canopy growth and its crop water requirements; and (ii) explore the possibility to predict crop water requirements by assimilating the canopy cover estimated by Sentinel-2 imagery into AquaCrop model. The pilot area was in Campania, a region in the south west of Italy, characterized by a typical Mediterranean climate, where field campaigns were conducted in seasons 2017 and 2018 on processing tomato. Crop water use and irrigation requirement were estimated by means of three different methods: (i) The AquaCrop model; (ii) an irrigation advisory service based on Sentinel-2 imagery known as IRRISAT and (iii) assimilating the canopy cover estimated by Sentinel-2 imagery into AquaCrop model Sentinel-2 imagery proved to be effective for monitoring canopy growth and for predicting irrigation water requirements during mid-season stage of the crop, when the canopy is fully developed. Conversely, the integration of the Sentinel-2 imagery with a crop growth model can contribute to improve the irrigation water requirement predictions in the early and development stage of the crop, when the soil evaporation is not negligible with respect to the total evapotranspiration