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The Evolving Role of Diagnostic Imaging Service in Public Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 29048

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Special Issue Editors

Dr. Vittorio Miele

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Department of Radiology, Azienda Ospedaliero Universitaria Careggi, L.go G. A. Brambilla 3, 50134 Florence, Italy
Interests: emergency radiology; abdominal radiology; thoracic imaging; diagnostic imaging in oncology; breast imaging
Special Issues, Collections and Topics in MDPI journals

Prof. Roberto Grassi

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Guest Editor

Department of Radiology, "Università degli Studi della Campania Luigi Vanvitelli" P.za Luigi Miraglia 2 – 80138 Naples (I)
Interests: gastrointestinal radiology; emergency radiology; thoracic imaging; computed tomography; diagnostic imaging in oncology

Special Issue Information

Dear Colleagues,

In public health and disease prevention as well as in both therapeutic and palliative treatment, successful decisions depend on correct diagnoses. Today, the use of radiological imaging cannot be separated from medical diagnosis. The radiologist often plays a key role in patient screening, diagnosis, and follow-up. Technological innovations are opening up new diagnostic perspectives. Appropriate use of medical imaging requires a multidisciplinary approach.

Role of chest imaging in viral lung diseases;
New frontiers: Role of the radiologist in pulmonary disease quantification;
Lung cancer imaging: Screening result and nodule management;
Current standards for emergency radiology in major trauma and clinical impact;
The radiologist as gatekeeper in chest pain;
Imaging of acute stroke: The teachable moment;
Breast imaging timely diagnosis of disease;
Magnetic resonance of the liver made simple;
Pancreatic cancer detection and characterization: State-of-the-art imaging and new perspectives;
The role of CT for Crohn’s disease in the era of magnetic resonance imaging;
MR enterography: Clinical impact of imaging technology;
The role of musculoskeletal imaging in the older athlete;
Interventional radiology in the era of mini-invasive approaches;
Patient safety in medical imaging: CT and MR exams;
Universal access to advanced imaging and healthcare protection: UHC and diagnostic imaging.

Dr. Vittorio Miele
Prof. Roberto Grassi
Guest Editors

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Keywords

abdominal radiology
gastrointestinal radiology
emergency radiology
chest radiology
cardiovascular imaging

Published Papers (10 papers)

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Research

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12 pages, 4058 KiB

Open AccessArticle

Traumatic Impact Assessment of CPR Load on a Human Ribcage

by Luis Antonio Aguilar-Pérez, Christopher René Torres-SanMiguel, Marco Ceccarelli and Guillermo Manuel Urriolagoitia-Calderón

Int. J. Environ. Res. Public Health 2022, 19(6), 3414; https://doi.org/10.3390/ijerph19063414 - 14 Mar 2022

Viewed by 1687

Abstract

Chest compression is a parameter of injury criteria assessment for human beings. Additionally, it is used to find the external compression response as a result of vehicle crashes, falls, or sporting impacts. This behavioral feature is described by many deterministic models related to specific experimental tests, hindering distinct scenarios. The present study evaluates the energy absorbed as a function of rib compression. The proposed model was obtained from three different computed tomography (CT) studies. The anthropometric values are interpolated to obtain a parametric curve for a human rib’s average size. The computed results are compared against an STL-DICOM^® file used to obtain a virtual reconstruction of one rib. A numerical model of the behavior of the thorax displacement expressed injury in the human rib model’s stiffness. The proposed model is used to determine the correlation of the input payload versus the numerical stiffness value. The outcome is confirmed by numerical analyses applied to a virtual human rib reconstruction. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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16 pages, 1577 KiB

Open AccessArticle

A Review of Breast Imaging for Timely Diagnosis of Disease

by Giulia Bicchierai, Federica Di Naro, Diego De Benedetto, Diletta Cozzi, Silvia Pradella, Vittorio Miele and Jacopo Nori

Int. J. Environ. Res. Public Health 2021, 18(11), 5509; https://doi.org/10.3390/ijerph18115509 - 21 May 2021

Cited by 12 | Viewed by 2909

Abstract

Breast cancer (BC) is the cancer with the highest incidence in women in the world. In this last period, the COVID-19 pandemic has caused in many cases a drastic reduction of routine breast imaging activity due to the combination of various factors. The survival of BC is directly proportional to the earliness of diagnosis, and especially during this period, it is at least fundamental to remember that a diagnostic delay of even just three months could affect BC outcomes. In this article we will review the state of the art of breast imaging, starting from morphological imaging, i.e., mammography, tomosynthesis, ultrasound and magnetic resonance imaging and contrast-enhanced mammography, and their most recent evolutions; and ending with functional images, i.e., magnetic resonance imaging and contrast enhanced mammography. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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14 pages, 5823 KiB

Open AccessArticle

Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

by Vincenza Granata, Roberta Grassi, Roberta Fusco, Sergio Venanzio Setola, Andrea Belli, Mauro Piccirillo, Silvia Pradella, Marzia Giordano, Salvatore Cappabianca, Luca Brunese, Roberto Grassi, Antonella Petrillo and Francesco Izzo

Int. J. Environ. Res. Public Health 2021, 18(7), 3598; https://doi.org/10.3390/ijerph18073598 - 30 Mar 2021

Cited by 19 | Viewed by 2680

Abstract

Background: Liver Imaging Reporting and Data Systems (LI-RADS) Treatment Response Algorithm (TRA) was created to provide a standardized assessment of hepatocellular carcinoma (HCC) following loco regional therapy. The aim of this study was to compare sensitivity of standard MRI protocol versus abbreviated protocol (only T1-Weigthed fat suppressed (FS) sequences pre- and post-contrast phase) in the detection of ablated area according to LI-RADS Treatment Response (LR-TR) categories. Methods: From January 2015 to June 2020, we selected 64 patients with HCC, who underwent Radiofrequency ablation (RFA) or Microwave ablation (MWA) treatment. According to inclusion criteria, 136 pathologically proven treated HCC (median 2, range 1–3 per patient; mean size 20.0 mm; range 15–30 mm) in 58 patients (26 women, 32 men; median age, 74 years; range, 62–83 years) comprised our study population. For each ablated area, abbreviated protocol, and standard Magnetic Resonance Imaging (MRI) studies were independently and blindly assessed in random order within and between three expert radiologists. Each radiologist assessed the ablated area by using the following categories: “LR-TR Non-viable” = 1; “LR-TR Equivocal” = 2 and “LR-TR Viable” = 0. Results: According to the concordance between MRI and Contrast enhancement ultrasound (CEUS) among 136 treated HCCs, 115 lesions were assessed as non-viable or totally ablate and 21 as viable or partially ablate. The accuracy for standard MRI protocol and abbreviated MRI protocol for predicting pathologic tumor viability of a consensus reading was 98.6% (sensitivity = 100%; specificity = 98.3%; positive predictive value = 91.3% and negative predictive value = 100%). No differences were found in sensitivity or specificity between standard MRI LR-TR viable and abbreviated MRI LR-TR viable categories (p value > 0.05 at McNemar test). Conclusion: The abbreviated dynamic protocol showed similar diagnostic accuracy to conventional MRI study in the assessment of treated HCCs, with a reduction of the acquisition study time of 30% respect to conventional MRI. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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Review

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10 pages, 2301 KiB

Open AccessReview

Current Standards for and Clinical Impact of Emergency Radiology in Major Trauma

by Francesca Iacobellis, Ahmad Abu-Omar, Paola Crivelli, Michele Galluzzo, Roberta Danzi, Margherita Trinci, Giuseppina Dell’Aversano Orabona, Maurizio Conti, Luigia Romano and Mariano Scaglione

Int. J. Environ. Res. Public Health 2022, 19(1), 539; https://doi.org/10.3390/ijerph19010539 - 04 Jan 2022

Cited by 13 | Viewed by 2558

Abstract

In industrialized countries, high energy trauma represents the leading cause of death and disability among people under 35 years of age. The two leading causes of mortality are neurological injuries and bleeding. Clinical evaluation is often unreliable in determining if, when and where injuries should be treated. Traditionally, surgery was the mainstay for assessment of injuries but advances in imaging techniques, particularly in computed tomography (CT), have contributed in progressively changing the classic clinical paradigm for major traumas, better defining the indications for surgery. Actually, the vast majority of traumas are now treated nonoperatively with a significant reduction in morbidity and mortality compared to the past. In this sense, another crucial point is the advent of interventional radiology (IR) in the treatment of vascular injuries after blunt trauma. IR enables the most effective nonoperative treatment of all vascular injuries. Indications for IR depend on the CT evidence of vascular injuries and, therefore, a robust CT protocol and the radiologist’s expertise are crucial. Emergency and IR radiologists form an integral part of the trauma team and are crucial for tailored management of traumatic injuries. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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16 pages, 2125 KiB

Open AccessReview

Imaging of Pancreatic Neuroendocrine Neoplasms

by Giuditta Chiti, Giulia Grazzini, Diletta Cozzi, Ginevra Danti, Benedetta Matteuzzi, Vincenza Granata, Silvia Pradella, Laura Recchia, Luca Brunese and Vittorio Miele

Int. J. Environ. Res. Public Health 2021, 18(17), 8895; https://doi.org/10.3390/ijerph18178895 - 24 Aug 2021

Cited by 20 | Viewed by 2777

Abstract

Pancreatic neuroendocrine neoplasms (panNENs) represent the second most common pancreatic tumors. They are a heterogeneous group of neoplasms with varying clinical expression and biological behavior, from indolent to aggressive ones. PanNENs can be functioning or non-functioning in accordance with their ability or not to produce metabolically active hormones. They are histopathologically classified according to the 2017 World Health Organization (WHO) classification system. Although the final diagnosis of neuroendocrine tumor relies on histologic examination of biopsy or surgical specimens, both morphologic and functional imaging are crucial for patient care. Morphologic imaging with ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) is used for initial evaluation and staging of disease, as well as surveillance and therapy monitoring. Functional imaging techniques with somatostatin receptor scintigraphy (SRS) and positron emission tomography (PET) are used for functional and metabolic assessment that is helpful for therapy management and post-therapeutic re-staging. This article reviews the morphological and functional imaging modalities now available and the imaging features of panNENs. Finally, future imaging challenges, such as radiomics analysis, are illustrated. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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11 pages, 1812 KiB

Open AccessReview

The Radiologist as a Gatekeeper in Chest Pain

by Silvia Pradella, Giulia Zantonelli, Giulia Grazzini, Diletta Cozzi, Ginevra Danti, Manlio Acquafresca and Vittorio Miele

Int. J. Environ. Res. Public Health 2021, 18(12), 6677; https://doi.org/10.3390/ijerph18126677 - 21 Jun 2021

Cited by 6 | Viewed by 2553

Abstract

Chest pain is a symptom that can be found in life-threatening conditions such as acute coronary syndrome (ACS). Those patients requiring invasive coronary angiography treatment or surgery should be identified. Often the clinical setting and laboratory tests are not sufficient to rule out a coronary or aortic syndrome. Cardiac radiological imaging has evolved in recent years both in magnetic resonance (MR) and in computed tomography (CT). CT, in particular, due to its temporal and spatial resolution, the quickness of the examination, and the availability of scanners, is suitable for the evaluation of these patients. In particular, the latest-generation CT scanners allow the exclusion of diagnoses such as coronary artery disease and aortic pathology, thereby reducing the patient’s stay in hospital and safely selecting patients by distinguishing those who do not need further treatment from those who will need more- or less-invasive therapies. CT additionally reduces costs by improving long-term patient outcome. The limitations related to patient characteristics and those related to radiation exposure are weakening with the improvement of CT technology. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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15 pages, 8738 KiB

Open AccessReview

Role of Chest Imaging in Viral Lung Diseases

by Diletta Cozzi, Eleonora Bicci, Alessandra Bindi, Edoardo Cavigli, Ginevra Danti, Michele Galluzzo, Vincenza Granata, Silvia Pradella, Margherita Trinci and Vittorio Miele

Int. J. Environ. Res. Public Health 2021, 18(12), 6434; https://doi.org/10.3390/ijerph18126434 - 14 Jun 2021

Cited by 5 | Viewed by 4710

Abstract

The infection caused by novel beta-coronavirus (SARS-CoV-2) was officially declared a pandemic by the World Health Organization in March 2020. However, in the last 20 years, this has not been the only viral infection to cause respiratory tract infections leading to hundreds of thousands of deaths worldwide, referring in particular to severe acute respiratory syndrome (SARS), influenza H1N1 and Middle East respiratory syndrome (MERS). Although in this pandemic period SARS-CoV-2 infection should be the first diagnosis to exclude, many other viruses can cause pulmonary manifestations and have to be recognized. Through the description of the main radiological patterns, radiologists can suggest the diagnosis of viral pneumonia, also combining information from clinical and laboratory data. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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10 pages, 1945 KiB

Open AccessSystematic Review

Lung Cancer Imaging: Screening Result and Nodule Management

by Susanna Guerrini, Davide Del Roscio, Matteo Zanoni, Paolo Cameli, Elena Bargagli, Luca Volterrani, Maria Antonietta Mazzei and Luca Luzzi

Int. J. Environ. Res. Public Health 2022, 19(4), 2460; https://doi.org/10.3390/ijerph19042460 - 21 Feb 2022

Cited by 6 | Viewed by 3026

Abstract

Background: Lung cancer (LC) represents the main cause of cancer-related deaths worldwide, especially because the majority of patients present with an advanced stage of the disease at the time of diagnosis. This systematic review describes the evidence behind screening results and the current guidelines available to manage lung nodules. Methods: This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The following electronic databases were searched: PubMed, EMBASE, and the Web of Science. Results: Five studies were included in the systematic review. The study cohort included 46,364 patients, and, in this case series, LC was detected in 9028 patients. Among the patients with detected LC, 1261 died of lung cancer, 3153 died of other types of cancers and 4614 died of other causes. Conclusions: This systematic review validates the use of CT in LC screening follow-ups, and bids for future integration and implementation of nodule management protocols to improve LC screening, avoid missed cancers and to reduce the number of unnecessary investigations. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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5 pages, 2810 KiB

Open AccessCase Report

Occupational Brachial Artery Injury by a Foreign Body with Subsequent Soft Tissue Hematoma Superinfection

by Paweł Gać, Piotr Macek, Barbara Dziadkowiec and Rafał Poręba

Int. J. Environ. Res. Public Health 2021, 18(12), 6400; https://doi.org/10.3390/ijerph18126400 - 13 Jun 2021

Viewed by 1936

Abstract

Vascular injuries constitute a significant problem worldwide. Nearly 90% of arterial injuries concern the vessels in the limbs, of which the arteries of the lower limbs are most often damaged in military operations, while in other cases (mainly road accidents), the vessels of the upper limbs are damaged more often. In this report, the authors present a case of occupational brachial artery injury by a foreign body with subsequent soft tissue hematoma superinfection. The presented case emphasizes the importance of computed tomography angiography as a precise diagnostic tool facilitating the planning of a surgical procedure in patients with an occupational upper limb injury. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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26 pages, 17488 KiB

Open AccessSystematic Review

A Systematic Review about Imaging and Histopathological Findings for Detecting and Evaluating Electroporation Based Treatments Response

by Vincenza Granata, Roberta Fusco, Simona Salati, Antonella Petrillo, Elio Di Bernardo, Roberta Grassi, Raffaele Palaia, Ginevra Danti, Michelearcangelo La Porta, Matteo Cadossi, Gorana Gašljević, Gregor Sersa and Francesco Izzo

Int. J. Environ. Res. Public Health 2021, 18(11), 5592; https://doi.org/10.3390/ijerph18115592 - 24 May 2021

Cited by 21 | Viewed by 2667

Abstract

Background: Imaging methods and the most appropriate criteria to be used for detecting and evaluating response to oncological treatments depend on the pathology and anatomical site to be treated and on the treatment to be performed. This document provides a general overview of the main imaging and histopathological findings of electroporation-based treatments (Electrochemotherapy—ECT and Irreversible electroporation—IRE) compared to thermal approach, such as radiofrequency ablation (RFA), in deep-seated cancers with a particular attention to pancreatic and liver cancer. Methods: Numerous electronic datasets were examined: PubMed, Scopus, Web of Science and Google Scholar. The research covered the years from January 1990 to April 2021. All titles and abstracts were analyzed. The inclusion criteria were the following: studies that report imaging or histopathological findings after ablative thermal and not thermal loco-regional treatments (ECT, IRE, RFA) in deep-seated cancers including pancreatic and liver cancer and articles published in the English language. Exclusion criteria were unavailability of full text and congress abstracts or posters and different topic respect to inclusion criteria. Results: 558 potentially relevant references through electronic searches were identified. A total of 38 articles met the inclusion criteria: 20 studies report imaging findings after RFA or ECT or IRE in pancreatic and liver cancer; 17 studies report histopathological findings after RFA or ECT or IRE; 1 study reports both imaging and histopathological findings after RFA or ECT or IRE. Conclusions: Imaging features are related to the type of therapy administrated, to the timing of re-assessment post therapy and to the imaging technique being used to observe the effects. Histological findings after both ECT and IRE show that the treated area becomes necrotic and encapsulated in fibrous tissue, suggesting that the size of the treated lesion cannot be measured as an endpoint to detect response. Moreover, histology frequently reported signs of apoptosis and reduced vital tissue, implying that imaging criteria, which take into account the viability and not the size of the lesion, are more appropriate to evaluate response to treatment. Full article

(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)

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