Socio-psychological distress, violence, and food insecurity in women undergoing gynecological examinations: insights from a cross-sectional study of an Italian Tertiary Clinic.

Background: The reality of gynecological patients represents a distinct subgroup of the population in which social and psychological distress can coexist alongside the burden of the disease. "Unmet social needs," including social distress, which encompasses gender and family violence, abuse, unemployment, and food insecurity, are now widely recognized as critical determinants of health. Some studies have examined the social needs experienced by patients with gynecological disorders, but primarily in gynecologic oncology patients.

Image-guided real-time optical biopsy in oncologic surgery: a systematic review of the role of confocal microscopy in the era of digital surgery.

Confocal microscopy (CM) is rapidly emerging as a key imaging technology within the evolving paradigm of digital surgery, offering real-time, high-resolution visualization of tissue microarchitecture. Its diverse modalities-including confocal laser endomicroscopy (CLE), probe-based CLE (pCLE), fluorescence confocal microscopy (FCM), and reflectance confocal microscopy (RCM)-enable near-histological evaluation of tissue either directly in vivo or on freshly excised specimens ex vivo. This systematic review, conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251033452), examined 33 clinical studies and 13 ongoing trials exploring intraoperative applications of CM in oncologic surgery.

External validation of ultrasound-based models for differentiating between benign and malignant adnexal masses: a nationwide prospective multicenter study (IOTA phase 6).

Background: The diagnostic performance of the IOTA methods, the O-RADS lexicon, and the RMI has been validated in prospective and retrospective studies, but most validation studies tested the performance in the hands of experienced ultrasound examiners.

Objective: To prospectively validate the performance of the Risk of Malignancy Index, the International Ovarian Tumor Analysis Simple Rules Risk Model, the International Ovarian Tumor Analysis Assessment of Different NEoplasias in the adneXa model, and the International Ovarian Tumor Analysis 2-step strategy across different types of ultrasound centers in Italy. A retrospective post hoc analysis estimates malignancy prevalence in Ovarian-Adnexal Reporting and Data System risk groups when using the 2-step strategy or the Ovarian-Adnexal Reporting and Data System lexicon.

Performance of radiomics analysis in ultrasound imaging for differentiating benign from malignant adnexal masses: A systematic review and meta-analysis.

Introduction: We present the state of the art of ultrasound-based machine learning (ML) radiomics models in the context of ovarian masses and analyze their accuracy in differentiating between benign and malignant adnexal masses.

Material And Methods: Web of Science, PubMed, and Scopus databases were searched. All studies were imported into RAYYAN QCRI software.

Value of frozen section to tailor surgical staging in apparent early-stage epithelial ovarian cancer.

Objective: Frozen section (FS) has been shown to have high accuracy in determining ovarian malignancy. However, its utility in guiding surgical approaches, particularly, lymph node staging, for early-stage epithelial ovarian cancer remains unclear. This study aimed to evaluate the post-test positive probability of FSs in identifying cases requiring lymph node or peritoneal staging.

Image-Guided Robotic Surgery for Sentinel Lymph Node Status Assessment in Uterine Cancers Using Ultrasound Drop-in Probe: Surgical Technique in 10 Steps.

Introduction: Recent guidelines recommend the sentinel lymph node (SLN) technique in uterine cancers, as it is associated with lower perioperative complications. Image-guided surgery can address some limitations of SLN procedures, such as low frozen-section accuracy and risk of empty packets, by providing real-time lymph node assessment. This video describes the surgical procedure of intraoperative robotic ultrasound examination for SLN assessment.

Cutting Edge Microscopic Intraoperative Tissue Assessment for Guidance in Oncologic Surgery: A Systematic Review of the Role of Optical Coherence Tomography.

Introduction: There is a demand for intraoperative diagnostic support and image guidance in oncological surgery. Novel techniques can provide images similar to histopathological slides within a few minutes. Optical coherence tomography (OCT) and full-field OCT (FF-OCT) provide images with resolution greater than a hundred micrometers without the need for exogenous contrast agents or specimen staining.

Prediction of non-resectability in tubo-ovarian cancer patients using Peritoneal Cancer Index - A prospective multicentric study using imaging (ISAAC study).

Background: The aim was to evaluate the performance of the Peritoneal Cancer Index (PCI) using imaging (ultrasound, contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) in assessing peritoneal carcinomatosis and predicting non-resectability in tubo-ovarian carcinoma patients.

Methods: This was a prospective multicenter observational study. We considered all patients with suspected primary ovarian/tubal/peritoneal cancer who underwent preoperative ultrasound, CT, and WB-DWI/MRI (if available).

Role of artificial intelligence applied to ultrasound in gynecology oncology: A systematic review.

The aim of this paper was to explore the role of artificial intelligence (AI) applied to ultrasound imaging in gynecology oncology. Web of Science, PubMed, and Scopus databases were searched. All studies were imported to RAYYAN QCRI software.

Prediction of nonresectability using the updated Predictive Index value model assessed by imaging and surgery in tubo-ovarian cancer: a prospective multicenter ISAAC study.

Background: A laparoscopy-based scoring system was developed by Fagotti et al (Fagotti or Predictive Index value (PIV)score) based on the intraoperative presence or absence of carcinomatosis on predefined sites. Later, the authors updated the PIV score calculated only in the absence of one or both absolute criteria of nonresectability (mesenteric retraction and miliary carcinomatosis of the small bowel) (updated PIV model).

Objective: The aim was to demonstrate the noninferiority of ultrasound to other imaging methods (contrast enhanced computed tomography (CT) and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI)/MRI) in predicting nonresectable tumor (defined as residual disease >1 cm) using the updated PIV model in patients with tubo-ovarian cancer.

Patient satisfaction with ultrasound, whole-body CT and whole-body diffusion-weighted MRI for pre-operative ovarian cancer staging: a multicenter prospective cross-sectional survey.

Background: In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important.

Objective: To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients' experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up.

Methods: In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/MRI for pre-operative work-up between January 2020 and November 2022.

Comparison of clinical and ultrasound examinations in assessing the parametria in patients with deep infiltrating endometriosis: a multicentre prospective study.

Research Question: How do clinical rectovaginal examination and transvaginal ultrasound examination perform in the diagnosis of parametrial infiltration in patients with endometriosis?

Design: This was a multicentre prospective observational study. Patients with suspected deep endometriosis at clinical examination and/or at ultrasound evaluation and scheduled for surgery were included. Following multicentre multidisciplinary meetings, consensus was obtained on terms and methodology to define the parametrium at pelvic anatomy, ultrasound and surgery.

Innovative Ultrasound Criteria for the Diagnosis of Adenomyosis and Correlation with Symptoms: A Retrospective Re-Evaluation.

The 2022 Delphi revision of the MUSA (Morphological Uterus Sonographic Assessment) criteria for the ultrasound diagnosis of adenomyosis divides the ultrasound signs for diagnosis into direct and indirect ones, considering the presence of at least one direct sign as a mandatory criterion. This study aimed to reclassify the patients referred to the Pelvic Pain specialist outpatient clinic of the Gynecological Clinic of Udine according to the new criteria, evaluating the number of overdiagnoses and the possible correlation between the direct and indirect signs and the patients' symptoms. 62 patients affected by adenomyosis were retrospectively recruited.

The Role of Multimodal Imaging in Pathological Response Prediction of Locally Advanced Cervical Cancer Patients Treated by Chemoradiation Therapy Followed by Radical Surgery.

Purpose: This study aimed to develop predictive models for pathological residual disease after neoadjuvant chemoradiation (CRT) in locally advanced cervical cancer (LACC) by integrating parameters derived from transvaginal ultrasound, MRI and PET/CT imaging at different time points and time intervals.

Methods: Patients with histologically proven LACC, stage IB2-IVA, were prospectively enrolled. For each patient, the three examinations were performed before, 2 and 5 weeks after treatment ("baseline", "early" and "final", respectively).

Prognostic Significance of Ultrasound Characteristics and Body Mass Index in Patients with Apparent Early-Stage Cervical Cancer: A Single-Center, Retrospective, Cohort Study.

The primary aim of the present study was to investigate the prognostic impact (defined as disease-free-DFS and overall survival-OS) of the ultrasound scan tumor parameters, patients' anthropometric parameters, and their combination in early-stage cervical cancer. The secondary aim was to assess the relation between ultrasound characteristics and pathological parametrial infiltration. This is a retrospective, single-center, observational cohort study.

Evaluating the Risk of Inguinal Lymph Node Metastases before Surgery Using the Morphonode Predictive Model: A Prospective Diagnostic Study in Vulvar Cancer Patients.

Ultrasound examination is an accurate method in the preoperative evaluation of the inguinofemoral lymph nodes when performed by experienced operators. The purpose of the study was to build a robust, multi-modular model based on machine learning to discriminate between metastatic and non-metastatic inguinal lymph nodes in patients with vulvar cancer. One hundred and twenty-seven women were selected at our center from March 2017 to April 2020, and 237 inguinal regions were analyzed (75 were metastatic and 162 were non-metastatic at histology).

NEFL-Related Charcot-Marie Tooth Disease due to P440L Mutation in Two Italian Families: Expanding the Phenotype and Defining Modulating Factors.

Introduction: Mutations in the neurofilament polypeptide light chain (NEFL) gene account for <1% of all forms of Charcot-Marie-Tooth (CMT) diseases and present with different phenotypes, including demyelinating, axonal and intermediate neuropathies, and with diverse pattern of transmission, with dominant and recessive inheritance being described.

Methods: Here, we present clinical and molecular data in two new unrelated Italian families, affected with CMT.

Results: We studied fifteen subjects (11 women, 4 men), age range 23-62 year.

Transvaginal ultrasound-guided biopsy in patients with suspicious primary advanced tubo-ovarian carcinoma.

Objective: To assess the accuracy of pathological diagnosis by transvaginal ultrasound-guided biopsy versus surgery in patients with suspicious primary advanced tubo-ovarian carcinoma. The Feasibility, adequacy, and safety of the procedure were also evaluated.

Methods: Consecutive women with pre-operative suspicious primary advanced tubo-ovarian carcinoma presenting between July 2019 and September 2021 were enrolled.

Preoperative Tumor Texture Analysis on MRI for High-Risk Disease Prediction in Endometrial Cancer: A Hypothesis-Generating Study.

Objective: To develop and validate magnetic resonance (MR) imaging-based radiomics models for high-risk endometrial cancer (EC) prediction preoperatively, to be able to estimate deep myometrial invasion (DMI) and lymphovascular space invasion (LVSI), and to discriminate between low-risk and other categories of risk as proposed by ESGO/ESTRO/ESP (European Society of Gynaecological Oncology-European Society for Radiotherapy & Oncology and European Society of Pathology) guidelines.

Methods: This retrospective study included 96 women with EC who underwent 1.5-T MR imaging before surgical staging between April 2009 and May 2019 in two referral centers divided into training (T = 73) and validation cohorts (V = 23).

Transobturator tape versus single incision sling: how are they different? Clinical outcomes and ultrasonographic features of two mid-urethral slings.

Purpose: Stress urinary incontinence (SUI) is usually treated with mid-urethral slings. The best approach is still debated and the relationship between slings and pelvic structures is not completely understood. The aim of this study is to identify any difference between trans-obturator tape (TOT) and single incision sling (minisling).

The Role of Ultrasound in the Evaluation of Inguinal Lymph Nodes in Patients with Vulvar Cancer: A Systematic Review and Meta-Analysis.

Objective: To determine the efficacy of ultrasound in assessing the inguinal lymph nodes in patients with vulvar cancer.

Methods: A systematic review of published research up to October 2020 that compares the results of ultrasound to determine groin node status with histology was conducted. All study types that reported primary data on the role of ultrasound in the evaluation of groin lymph nodes in vulvar cancer were included in the systematic review.

Features of cystadenofibroma on magnetic resonance imaging: an update using the O-RADS lexicon and considering diffusion-weighted and perfusion imaging.

Purpose: Cystadenofibroma (CAF) is a rare tumour of the ovary that can be confused with a borderline or malignant lesion due to its morphological characteristics. The study aims to analyse the MRI (magnetic resonance imaging) features of histologically proven ovarian cystadenofibromas according to lexicon-based and O-RADS (Ovarian-Adnexal Reporting and Data System) descriptors, with particular attention to time-intensity curves (TIC) and Diffusion-Weighted sequences (DWI); we also wanted to test the performance of O-RADS MRI risk stratification system in this particular subgroup of patients.

Methods: We have included all patients who performed MR between October 2019 and December 2021 after an inconclusive trans-vaginal ultrasound.