Bilateral thalamic infarction in a young adult: The artery of Percheron conundrum.

Artery of Percheron (AOP) infarction is a rare form of ischemic stroke resulting from the occlusion of a single arterial trunk that supplies both sides of the paramedian thalamus and the midbrain. Its occlusion can lead to bilateral and symmetrical infarctions of the paramedian thalami, and occasionally, the midbrain. Due to its atypical presentation, this condition is often diagnosed late.

Focal areas of signal intensity in neurofibromatosis type 1: Correlation between MRI findings and cognitive function.

Background: Focal areas of signal intensity (FASI) are T2-weighted hyperintensities detected on brain MRI in 43 %-93 % of children with neurofibromatosis type 1 (NF1). Their association with cognitive impairment, a common feature of NF1, remains controversial.

Objective: To investigate potential correlations between the presence, number, and location of FASI and cognitive performance in children with NF1.

Management and Treatment of Carotid Stenosis: Overview of Therapeutic Possibilities and Comparison Between Interventional Radiology, Surgery and Hybrid Procedure.

Carotid stenosis is a common pathology in clinical practice and unfortunately carries a high risk of serious cerebrovascular events. The early recognition of carotid plaque and, consequently, a careful analysis by means of multimodal imaging are the necessary steps to undertake a correct management pathway, aimed at preventing or, if not possible, reducing the risk of atherogenic phenomena responsible for cerebral infarction. In particular, the presence or absence of clinical symptoms, understood as the occurrence of events such as TIAs in the last 6 months, non-disabling strokes or repeated episodes of amaurosis fugax, and the degree of carotid stenosis, are certainly the most studied parameters, and as reported by several international guidelines, can lead to the best therapeutic strategy: whether to rely on conservative medical therapy or to resort to mechanical revascularization of the carotid stenosis.

Radiological Insights into UIP Pattern: A Comparison Between IPF and Non-IPF Patients.

: This study aims to distinguish radiological differences between primary idiopathic Usual Interstitial Pneumonia (UIP) and secondary UIP patterns : This retrospective study included patients with HRCT findings consistent with a UIP pattern. Final diagnoses were established via multidisciplinary discussion and classified as primary UIP/IPF or secondary UIP, following the 2022 ATS/ERS/JRS/ALAT guidelines. An expert thoracic radiologist (>10 years of experience), blinded to clinical data, reviewed the earliest available HRCT assessing key imaging features: honeycombing (micro-, macro- or exuberant), fibrosis distribution (symmetry, anterior-upper lobe sign, etc.

Percutaneous Locoregional Therapies for the Treatment of Liver Metastases from Uveal Melanoma: A Systematic Review.

IntroductionThe prognosis of patients with uveal melanoma is related to several factors, including local or extraocular extension of the disease. Up to 50% of the patients with initial diagnosis of uveal melanoma develop metastases within few years and the liver represents the main site of metastatic spread. Patients with metastatic disease have a generally poor prognosis and few treatment options are available.

Pilomatricomas in a patient with Rubinstein-Taybi syndrome: diagnostic and therapeutic clues.

Pilomatricoma is a rare benign neoplasm originating from hair cortex cells and typically manifests in children as a slow-growing bluish-red, superficial and firm mass. Multiple pilomatricomas can be associated with genetic mutations and syndromic disorders, most commonly with Rubinstein-Taybi syndrome, Gardner syndrome, myotonic dystrophy, Turner syndrome, and Sotos syndrome. Ultrasound examination allows this tumor to be characterized, to assess the involvement of deeper structures and to plan treatment.

Immunosuppressive Therapy for Usual Interstitial Pneumonia in Autoimmune Rheumatic Diseases: A Review.

Usual Interstitial Pneumonia (UIP) is the most severe radiological/histological pattern of Interstitial Lung Disease (ILD). It is typical of Idiopathic Pulmonary Fibrosis (IPF), but is also frequently described in Autoimmune Rheumatic Diseases (ARDs), sharing with IPF common risk factors, genetic backgrounds, and in some cases, disease progression and prognosis. Following the results of the PANTHER study, immunosuppressive drugs are now not recommended for the treatment of IPF; however, their use for the treatment of UIP secondary to ARDs is still under debate.

The Role of Dual-Energy CT in Differentiating Adrenal Adenomas from Metastases: A Comprehensive Narrative Review.

Dual-energy CT (DECT) has emerged as a novel imaging modality that offers a multiparametric approach for noninvasive adrenal lesion characterization. This narrative review examines recent advances in DECT-including virtual non-contrast imaging, iodine density quantification, spectral curve analysis, and material density mapping-for differentiating benign adrenal adenomas from metastases. Conventional CT techniques rely primarily on unenhanced attenuation measurements and contrast washout kinetics; however, these methods may be limited in evaluating lipid-poor adenomas, and in cases where imaging features overlap with metastatic lesions.

Transarterial embolization for acute lower gastrointestinal bleeding: a retrospective bicentric study.

Transcatheter arterial embolization (TAE) represents an effective treatment option for acute lower gastrointestinal bleeding (LGIB). This retrospective, bicentric study evaluated the safety and efficacy of TAE in 77 patients with LGIB. The mean patient age was 68.

Quantification of progressive pulmonary fibrosis by visual scoring of HRCT images: recommendations from Italian chest radiology experts.

Interstitial lung diseases (ILD) constitute a large and heterogeneous group of disorders affecting the lung parenchyma. While idiopathic pulmonary fibrosis (IPF), the most common type of ILD, is the prototype of progressive fibrosis, other forms, collectively termed "progressive pulmonary fibrosis" (PPF), can show a similar clinical course. Detecting chronic fibrosing ILD progression necessitates radiological evidence using high-resolution computed tomography (HRCT), which determines eligibility for treatment.

Orbital Radiotherapy for Graves' Ophthalmopathy: Single Institutional Experience of Efficacy and Safety.

Unlabelled: Graves' ophthalmopathy is the most common extrathyroidal manifestation of Graves-Basedow disease. Radiotherapy is effective especially when used in synergy with the administration of glucocorticoids. The aim of our study was to analyze the effectiveness and safety of radiotherapy, using different protocols, to improve ocular symptoms and quality of life.

Inter-Reader Agreement in LR-TRA Application and NLR Association in HCC Patients Treated with Endovascular vs. Ablative Procedures.

Objectives: This study aimed to assess the performance of the LI-RADS tumor response algorithm in analyzing inter-reader agreement in patients with hepatocellular carcinoma (HCC) treated with Microwave Ablation (MWA) and Transarterial Embolization (TAE) and the relationship between inter-reader agreement and Neutrophils to Lymphocytes ratio dynamic variations at different time points to explore how inflammation influences tumor response and its interpretation on imaging.

Methods: A retrospective analysis was conducted on 78 HCC patients treated with MWA or TAE. Two independent radiologists evaluated pre- and post-treatment imaging and assigned categories according to the LR-TRA.

Latest Advancements in the Management of H3K27M-Mutant Diffuse Intrinsic Pontine Glioma: A Narrative Review.

Despite recent advancements in radiotherapy for Diffuse Intrinsic Pontine Glioma (DIPG), the prognosis of this disease remains poor, highlighting the need for new treatment strategies to improve outcomes. Adding stereotactic biopsy to the diagnostic process for children with DIPG has been crucial in improving the management of this disease. Indeed, the discovery of the H3K27M mutation as a key driver of DIPG has led to the development of new drugs that are more effective than traditional ones.

Recognition of Idiopathic Inflammatory Myopathies Underlying Interstitial Lung Diseases.

Interstitial Lung Disease (ILD) is one of the most common causes of mortality in idiopathic Inflammatory Myopathies (IIM). Despite these conditions being commonly associated with proximal weakness, skin rashes and arthritis, ILD can be the first or the sole clinical feature in up to 60% of patients, potentially leading to incorrect diagnosis. The early recognition of an underlying IIM in ILD patients can allow for prompt treatment, which could potentially stabilize or even improve the lung disease, also avoiding the development of other clinical features associated with the condition.

Imaging of Carotid Stenosis: Where Are We Standing? Comparison of Multiparametric Ultrasound, CT Angiography, and MRI Angiography, with Recent Developments.

Atherosclerotic disease of the carotid arteries is a crucial risk factor in predicting the likelihood of future stroke events. In addition, emerging studies suggest that carotid stenosis may also be an indicator of plaque load on coronary arteries and thus have a correlation with the risk of acute cardiovascular events. Furthermore, although in symptomatic patients the degree of stenosis is the main morphological parameter studied, recent evidence suggests, especially in asymptomatic patients, that plaque vulnerability should also be evaluated as an emerging and significant imaging parameter.

Thyroid Nodule Characterization: Overview and State of the Art of Diagnosis with Recent Developments, from Imaging to Molecular Diagnosis and Artificial Intelligence.

Ultrasound (US) is the primary tool for evaluating patients with thyroid nodules, and the risk of malignancy assessed is based on US features. These features help determine which patients require fine-needle aspiration (FNA) biopsy. Classification systems for US features have been developed to facilitate efficient interpretation, reporting, and communication of thyroid US findings.

The Immunomodulatory Potential of Concurrent High-Dose Radiotherapy and Immune Checkpoint Inhibitor Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma: Initial Results.

In this retrospective case series, we investigate the synergistic effect and the immunomodulatory potential of combination radiotherapy and immunotherapy on 11 patients affected by locally advanced or metastatic cutaneous squamous cell carcinoma (CSCC), treated at our institution between 2020 and 2023. The primary endpoints of this study are objective tumor response, assessed by Immunotherapy Response Evaluation Criteria in Solid Tumors (iRECIST), and time to treatment failure (disease progression). In all patients, surgery was deemed not amenable, due to its potential functional and aesthetic impact.

Congenital Lung Malformations: A Pictorial Review of Imaging Findings and a Practical Guide for Diagnosis.

The term congenital lung malformation (CLM) is used to describe a wide range of pathological conditions with different imaging and clinical manifestations. These anomalies stem from abnormal embryological lung development, potentially occurring across various stages of prenatal life. Their natural history can be variable, presenting in a wide range of severity levels and encompassing asymptomatic individuals who remain so until adulthood, as well as those who experience respiratory distress in the neonatal period.

Magnetic Resonance Imaging of Central Nervous System Manifestations of Type 1 Neurofibromatosis: Pictorial Review and Retrospective Study of Their Frequency in a Cohort of Patients.

: type 1 neurofibromatosis (NF1) is the most common neurocutaneous disorder, and it is an inherited condition that causes a tumour predisposition. Central nervous system (CNS) manifestations are a significant cause of morbidity and mortality in NF1. We provide a pictorial review of neuroradiological features of NF1, with emphasis on magnetic resonance imaging (MRI), and we assess the frequency of those features on a cohort of NF1 patients.

Pharmacological treatment in Idiopathic Pulmonary Fibrosis: current issues and future perspectives.

Idiopathic pulmonary fibrosis (IPF) represents a fibrotic interstitial lung disease characterized by uncertain etiology and poor prognosis. Over the years, the path to effective treatments has been marked by a series of advances and setbacks. The introduction of approved antifibrotic drugs, pirfenidone and nintedanib, marked a pivotal moment in the management of IPF.