Publications by authors named "Cesare Maino"

Cross-sectional imaging plays a crucial role in the diagnosis and management of both congenital and acquired hepatic vascular abnormalities. Congenital vascular anomalies, such as arteriovenous malformations, portal vein and hepatic vein anomalies, often present with nonspecific symptoms and require precise imaging for accurate assessment. Acquired hepatic vascular conditions, including cirrhosis-related vascular changes, portal hypertension, and vascular lesions, can lead to clinical complications and may necessitate timely intervention.

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Lesions at the liver periphery may originate from intrahepatic or extrahepatic tissues due to the unique anatomical, peritoneal, and hemodynamic characteristics of the hepatic capsular and subcapsular regions. In this article, the anatomical and physiological factors predisposing the hepatic periphery to pathology are examined, including Laennec's capsule, perihepatic ligamentous connections, and alternative blood supply pathways. A stepwise imaging approach is outlined, emphasizing the role of computed tomography (CT) and magnetic resonance imaging (MRI) in lesion differentiation based on key imaging features.

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Background And Aims: Sarcopenia has a negative impact on clinical outcome in adult patients with Crohn's Disease (CD), but data on children are scarce. The aim of this study is to evaluate the prevalence of sarcopenia in children with CD using magnetic resonance enterography (MRE) and describe its relationship with baseline values and clinical outcome.

Methods: We included children with a new diagnosis of CD from 2 tertiary referral pediatric Inflammatory Bowel Disease (IBD) centres, who underwent MRE at diagnosis between 2013 and 2023.

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Objectives: To provide a consensus statement and recommendations on MR imaging in primary sclerosing cholangitis (PSC).

Methods: The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) convened a multinational European panel of experts selected based on a literature review and their leadership in the field. A modified Delphi process was adopted to draft a list of statements.

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Pancreatic cancer remains one for the most aggressive cancer worldwide, with pancreatic ductal adenocarcinoma being the most common malignant pancreatic lesion, associated with poor prognosis. While surgical resection is the only curative treatment, only a minority of patients is eligible for surgery due to its diagnosis at advanced stages. Therefore, strategies for early detection of pancreatic cancer are needed.

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Article Synopsis
  • - Both Magnetic Resonance Enterography (MRE) and Computed Tomography Enterography (CTE) are important imaging techniques used for diagnosing and treating inflammatory bowel disease (IBD), with CTE being favored in urgent situations like suspected complications.
  • - CTE provides rapid and precise imaging but involves exposure to ionizing radiation, while MRE avoids radiation and excels in evaluating the small intestine and perianal disease, making it ideal for patients requiring frequent monitoring or those who are pregnant.
  • - The review highlights the strengths and weaknesses of both imaging methods, aiming to inform about their technical aspects, benefits, limitations, and the specific findings they can reveal regarding IBD.
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Introduction: No instruments are available to predict preoperatively the risk of posthepatectomy liver failure (PHLF) in HCC patients. The aim was to predict the occurrence of PHLF preoperatively by radiomics and clinical data through machine-learning algorithms.

Materials And Methods: Clinical data and 3-phases CT scans were retrospectively collected among 13 Italian centres between 2008 and 2022.

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  • The study evaluates the effectiveness of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) metrics in predicting responses to neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer.
  • A retrospective analysis of 94 patients was conducted using MRI data to assess pre- and post-treatment ADC values, which were correlated with the tumor regression grade (TRG) after surgery.
  • Results indicated that while pre-ADC values did not correlate with TRG, post-ADC and changes in ADC values were significantly associated with patient responses and overall survival rates, highlighting their potential as predictive markers in treatment outcomes.
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Chronic liver disease (CLD) is a global and worldwide clinical challenge, considering that different underlying liver entities can lead to hepatic dysfunction. In the past, blood tests and clinical evaluation were the main noninvasive tools used to detect, diagnose and follow-up patients with CLD; in case of clinical suspicion of CLD or unclear diagnosis, liver biopsy has been considered as the reference standard to rule out different chronic liver conditions. Nowadays, noninvasive tests have gained a central role in the clinical pathway.

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  • - The study assessed the CARE-Radiology checklist's reliability and usability for evaluating radiological case reports, aiming to encourage its wider use and improvement.
  • - Ten case reports from 2020 were reviewed by 26 experts from 10 different countries, measuring the checklist's effectiveness using statistical methods like Fleiss' Kappa and Cronbach's alpha.
  • - Results showed moderate reliability, with a mean compliance rate of 61.8% for checklist items, and while most evaluators found it easy to use, certain areas need feedback for future enhancements.
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  • This study evaluated the effectiveness of the FLIS (Functional Liver Imaging Score) in predicting post-hepatectomy liver failure (PHLF) and death in patients who had liver surgery for cancer.
  • It involved 150 patients, with a high reliability in assessment results between radiologists, indicating solid agreement in the evaluation processes used.
  • The findings suggest that FLIS, along with factors like blood transfusions and major resections, may help identify patients at risk for adverse outcomes after surgery.
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  • The study aimed to assess the effectiveness of an AI algorithm in detecting acute appendicular fractures in children using conventional X-ray images.
  • It included 600 anonymized X-ray images of patients under 17, finding that the AI demonstrated high sensitivity (91.3%) and accuracy (84%) in identifying fractures.
  • The results suggest that the AI tool is effective for diagnosing these types of fractures in pediatric patients, indicating potential for clinical use.
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Introduction: Neuroendocrine neoplasms (NENs) represent a complex group of tumors arising from neuroendocrine cells, characterized by heterogeneous behavior and challenging diagnostics. Despite advancements in medical technology, NENs present a major challenge in early detection, often leading to delayed diagnosis and variable outcomes. This review aims to provide an in-depth analysis of current diagnostic methods as well as the evolving and future directions of diagnostic strategies for NENs.

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Introduction: Microvascular invasion (MVI) is the main risk factor for overall mortality and recurrence after surgery for hepatocellular carcinoma (HCC).The aim was to train machine-learning models to predict MVI on preoperative CT scan.

Methods: 3-phases CT scans were retrospectively collected among 4 Italian centers.

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  • The study compared low-dose, low-contrast media CT exams using model-based iterative reconstruction (MBIR) vs. hybrid iterative reconstruction (HIR) with a focus on image quality and radiation dose.
  • Patients (401 total) underwent cardiovascular CT scans, with results showing that the MBIR group had significantly better vessel contrast enhancement, lower noise levels, and improved signal-to-noise and contrast-to-noise ratios.
  • Overall, the MBIR method not only reduced radiation exposure but also enhanced both objective and subjective image quality when compared to HIR.
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  • * Cross-sectional imaging, especially contrast-enhanced CT scans, helps doctors find issues early and accurately.
  • * MRI is also useful but usually for later problems or specific areas, and doctors need to communicate well to create the best treatment plans for patients.
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  • Hepatic diffuse conditions and focal liver lesions are common challenges in radiology, with advances in CT and MRI making them essential for non-invasive liver diagnosis.
  • Radiomics enhances the evaluation and management of liver diseases by extracting detailed data from radiological images, aiding in patient characterization and prognosis.
  • This review highlights key studies in liver radiomics, discussing their benefits, limitations, and implications for clinical practice.
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  • A study was conducted to evaluate an AI system's ability to differentiate between COVID-19 pneumonia and typical bacterial pneumonia using chest X-ray (CXR) images from patients in an emergency department.
  • The AI demonstrated high diagnostic accuracy with sensitivity and specificity rates comparable to those of experienced radiologists, achieving nearly perfect interrater reliability scores.
  • Results indicated that both the AI and the radiologists were effective in diagnosing COVID-19 pneumonia and typical bacterial pneumonia, suggesting that AI could enhance the speed and accuracy of pneumonia detection in clinical settings.
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The liver is one of the organs most commonly involved in metastatic disease, especially due to its unique vascularization. It's well known that liver metastases represent the most common hepatic malignant tumors. From a practical point of view, it's of utmost importance to evaluate the presence of liver metastases when staging oncologic patients, to select the best treatment possible, and finally to predict the overall prognosis.

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In female patients, acute pelvic pain can be caused by gynaecological, gastrointestinal, and urinary tract pathologies. Due to the variety of diagnostic possibilities, the correct assessment of these patients may be challenging. The most frequent gynaecological causes of acute pelvic pain in non-pregnant women are pelvic inflammatory disease, ruptured ovarian cysts, ovarian torsion, and degeneration or torsion of uterine leiomyomas.

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During the waves of the coronavirus disease (COVID-19) pandemic, emergency departments were overflowing with patients suffering with suspected medical or surgical issues. In these settings, healthcare staff should be able to deal with different medical and surgical scenarios while protecting themselves against the risk of contamination. Various strategies were used to overcome the most critical issues and guarantee quick and efficient diagnostic and therapeutic charts.

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The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease. However, the evaluation of the overall adjuvant chemotherapy benefit in patients with a high risk of recurrence is challenging. Radiological images can represent a source of data that can be analyzed by using automated computer-based techniques, working on numerical information coded within Digital Imaging and Communications in Medicine files: This image numerical analysis has been named "radiomics".

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The advance in technology allows for the development of different CT scanners in the field of dual-energy computed tomography (DECT). In particular, a recently developed detector-based technology can collect data from different energy levels, thanks to its layers. The use of this system is suited for material decomposition with perfect spatial and temporal registration.

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Derangements of body composition affect surgical outcomes. Chronic statin use may induce muscle wasting and impair muscle tissue quality. Aim of this study was to evaluate the association of chronic statin use, skeletal muscle area (SMA), myosteatosis and major postoperative morbidity.

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Purpose: To assess the completeness of reporting in abstracts of published randomized controlled trials (RCTs) assessing interventional radiology (IR) for liver disease; to assess whether publication of the 2017 CONSORT update for nonpharmacological treatments (NPT) resulted in changes in abstract reporting; and to identify factors associated with better reporting.

Material And Methods: MEDLINE and Embase were searched to identify RCTs of IR for liver disease (January 2015-September 2020). Two reviewers assessed the completeness of abstract reporting according to the CONSORT-NPT-2017-update.

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