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Topic Review
FDG-PET/CT in the Monitoring of Lymphoma Immunotherapy Response
Cancer immunotherapy is a type of cancer treatment that uses the immune system to fight cancer cells. Some of these treatments stimulate the immune system, while others prime the immune system to identify better and target cancer cells. In parallel with the implementation of cancer immunotherapy, therapy-specific FDG PET/CT response criteria were explicitly designed specifically for that purpose. FDG PET/CT plays a key role in the newly developed response criteria, and several FDG PET/CT-based criteria have been proposed to address all patterns of response to therapy, including indeterminate response, pseudoprogression, and hyperprogression using several metrics, such as SUV, MTV, and TLG. This research aims to discuss the effects and side effects of cancer immunotherapy and to correlate this with the proposed criteria and relevant patterns of FDG PET/CT in lymphoma immunotherapy as applicable. Additionally, the latest updates and future prospects will be explored.
  • 3.4K
  • 24 Feb 2023
Topic Review
Theranostic Radiopharmaceuticals
Theranostic Radiopharmaceuticals (Radiotheranostics) is a term in the medical field to define the combination of therapeutic and diagnostic techniques by a suitable radiopharmaceutical agent. Radionuclides are isotopes that emit radiation or have excess nuclear energy, making them chemically unstable and tend to change into another atom. Various types of radiation can be emitted by radionuclides e.g. alpha particles, beta particles, and gamma energy. In radiotheranostics, a pharmaceutical agent (drug) is needed to be a carrier molecule that introduces the radionuclide to its target. Radionuclides are then used as a source of radiation in radiotheranostics that are responsible for diagnosing or treating various diseases.
  • 2.5K
  • 24 May 2022
Topic Review
Renal Artery Ultrasound
Renal artery stenosis (RAS) is one of the major causes of secondary hypertension and renal impairment. Ultrasound (US) is a noninvasive, real-time examination method for detecting RAS. The available US scanners enable the depiction of small vessels or organs. Gray-scale US can assess the morphology of the renal artery and kidney. Hemodynamic changes in the renal artery and kidney are evaluated with color and spectral Doppler US. Contrast-enhanced US may directly show the diameter change in the renal artery with intravascular contrast material that is not harmful to patients with poor renal function. Therefore, US is a useful examination method for detecting RAS, regardless of patient renal function. 
  • 2.4K
  • 14 Oct 2022
Topic Review
Hydatid Cyst Radiological Pictorial Review
Hydatid cyst is a common name for the larval stage of a tapeworm species of the genus Echinococcus granulosus, which is transmitted from animals to humans via the fecal–oral route. Hydatid cysts predominantly affect the liver (75%), followed by the lung (15%), and they can affect many organs in the human body. Medical imaging modalities are the keystone for the diagnosis of hydatid cysts with high sensitivity and specificity. Ultrasound imaging with high resolution is the first choice for diagnosis, differential diagnosis, staging, establishing a role in interventional management, and follow-up, and it can differentiate Type I hydatid cysts from simple liver cysts. Unenhanced computed tomography (CT) is indicated where or when an ultrasound is unsatisfactory, such as with chest or brain hydatid cysts, when detecting calcification, and in obese patients. Magnetic resonance imaging (MRI) is superior for demonstrating cyst wall defects, biliary communication, neural involvement, and differentiating hydatid cysts from simple cysts using diffusion-weighted imaging (DWI) sequences.
  • 2.4K
  • 03 Apr 2023
Topic Review
Imaging Techniques in Adult Acquired Flatfoot Deformity
Adult acquired flatfoot deformity (AAFD) is a disorder caused by repetitive overloading, which leads to progressive posterior tibialis tendon (PTT) insufficiency. It mainly affects middle-aged women and occurs with foot pain, malalignment, and loss of function. After clinical examination, imaging plays a key role in the diagnosis and management of this pathology. Imaging allows confirmation of the diagnosis, monitoring of the disorder, outcome assessment and complication identification. 
  • 2.3K
  • 28 Jan 2023
Topic Review
Artificial Intelligence Integration in Medical Imaging
Radiology, since its inception, has experienced a revolutionary journey, punctuating modern medicine with its profound influence. From the discovery of X-rays to the subsequent integration of artificial intelligence (AI) and machine learning (ML), this multifaceted discipline continually evolves, transforming itself and the healthcare ecosystem it underpins.
  • 2.2K
  • 30 Aug 2023
Topic Review
Clinical Applications of MR Spectroscopy in Pediatrics
In vivo MR spectroscopy is a non-invasive methodology that provides information about the biochemistry of tissues. It is available as a “push-button” application on state-of-the-art clinical MR scanners. MR spectroscopy has been used to study various brain diseases including tumors, stroke, trauma, degenerative disorders, epilepsy/seizures, inborn errors, neuropsychiatric disorders, and others.
  • 2.2K
  • 01 Jul 2022
Topic Review
Dual-Layer Spectral Computed Tomography
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. Thanks to post-processing techniques, these scanners can generate conventional, material decomposition (including virtual non-contrast (VNC), iodine maps, Z-effective imaging, and uric acid pair images) and virtual monoenergetic images (VMIs). 
  • 2.2K
  • 06 Jun 2023
Topic Review
Imaging Findings of Lung Nodule or Mass
Systemic endemic mycoses are a group of dimorphic fungi prevalent in specific geographical locations. Histoplasma capsulatum, Coccidioides spp., Blastomyces dermatitidis, Cryptococcosis gattii, and Paracoccidioides brasiliensis are the primary pulmonary fungal pathogens of otherwise healthy people. Acute or chronic fungal infections may manifest as solitary or multiple lung nodules or masses. The most frequent pathogens are histoplasmosis, coccidioidomycosis, cryptococcosis, and blastomycosis. The nodules have a nonspecific appearance, may be ill or well-defined, have regular or spiculated borders, and may also demonstrate cavitation or ground glass halo.
  • 2.1K
  • 04 Nov 2022
Topic Review
Portal Vein Embolization of Indications and Contraindications
Preoperative portal vein embolization (PVE) via the purposeful occlusion of select portal vein branches to promote contralateral hepatic lobar hypertrophy has become the accepted standard for liver regeneration. Advances in embolic materials, selection of treatment approaches, and PVE with hepatic venous deprivation or concurrent transcatheter arterial embolization/radioembolization are all active areas of research. The primary indication for pre-operative PVE is centered on the inability of the pre-embolization future liver remnant (FLR) to support whole liver function post-resection. Contraindications to PVE are severe portal hypertension, uncontrollable intrahepatic portal-to-hepatic vein shunts, tumor thrombus in the portal vein, and occlusion of the portal vein in the FLR.
  • 2.1K
  • 14 Feb 2023
Topic Review
Posteromedial Lesions of the Chest Wall
A heterogeneous group of tumors can affect the posteromedial chest wall. They form diverse groups of benign and malignant (primary or secondary) pathologies that can arise from different chest wall structures, i.e., fat, muscular, vascular, osseous, or neurogenic tissues. Chest radiography is very nonspecific for the characterization of chest wall lesions. The modality of choice for the initial assessment of the chest wall lesions is computed tomography (CT). More advanced cross-sectional modalities such as magnetic resonance imaging (MRI) and positron emission tomography (PET) with fluorodeoxyglucose are usually used for further characterization, staging, treatment response, and assessment of recurrence. A systematic approach based on age, clinical history, and radiologic findings is required for correct diagnosis. It is essential for radiologists to be familiar with the spectrum of lesions that might affect the posteromedial chest wall and their characteristic imaging features. Although the imaging findings of these tumors can be nonspecific, cross-sectional imaging helps to limit the differential diagnosis and determine the further diagnostic investigation (e.g., image-guided biopsy). Specific imaging findings, e.g., location, mineralization, enhancement pattern, and local invasion, occasionally allow a particular diagnosis.
  • 2.1K
  • 16 Feb 2022
Topic Review
MRS in Hepatic Fat
Magnetic resonance spectroscopy (MRS) is a powerful tool that allows direct quantification of metabolites in tissue or areas of interest. MRS has been applied in both research and clinical studies to assess liver fat noninvasively in vivo. MRS has also demonstrated excellent performance in liver fat assessment with high sensitivity and specificity compared to biopsy and other imaging modalities. Because of these qualities, MRS has been generally accepted as the reference standard for the noninvasive measurement of liver steatosis. MRS is an evolving technique with high potential as a diagnostic tool in the clinical setting. 
  • 2.0K
  • 12 Oct 2021
Topic Review
225Ac as a Potential Theranostic Radionuclide
α radioisotopes can offer a treatment choice to individuals who are not responding to β− or gamma-radiation therapy or chemotherapy drugs. Only a few α-particle emitters are suitable for targeted alpha therapy (TAT) and clinical applications. The majority of available clinical research involves 225Ac and its daughter nuclide 213Bi. Additionally, the 225Ac disintegration cascade generates γ decays that can be used in single-photon emission computed tomography (SPECT) imaging, expanding the potential theranostic applications in nuclear medicine. Despite the growing interest in applying 225Ac, the restricted global accessibility of this radioisotope makes it difficult to conduct extensive clinical trials for many radiopharmaceutical candidates.
  • 2.0K
  • 05 Dec 2023
Topic Review
Imaging of Hypersensitivity Pneumonitis
Hypersensitivity pneumonitis (HP) is a complicated and heterogeneous interstitial lung disease (ILD) caused by an excessive immune response to an inhaled antigen in susceptible individuals. HP, also previously known as extrinsic allergic alveolitis, is the culmination of a dysregulated immune response to a provocative inhaled antigen appearing as inflammation and/or fibrosis of the lung parenchyma and small airways.
  • 1.8K
  • 24 Nov 2022
Topic Review
Magnetic Resonance Imaging for Sjögren’s Syndrome
Primary Sjögren’s Syndrome (pSS) is a chronic autoimmune exocrinopathy affecting 0.3–3.0% of the population. Its main clinical hallmarks are the sicca symptoms (mucosal dryness manifesting mainly ocularly and orally) and extra-glandular symptoms, among which joint pain and chronic fatigue are the most important. Besides these symptoms, pSS may also manifest in the central nervous system (CNS), as noted in the original description of the disease by Sjögren himself in 1933. The most common radiological lesions in pSS are white matter hyperintensities (WMH), scattered alterations hyperlucent on T2 and FLAIR sequences, typically located periventricularly and subcortically. Cortical atrophy and ventricular dilatation can also occur in pSS. Whilst these conditions are thought to be more common in pSS than healthy controls, diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (fMRI) alterations demonstrate evident microstructural changes in pSS. As pSS is often accompanied by cognitive symptoms, these magnetic resonance imaging (MRI) alterations are expectedly related to them. 
  • 1.8K
  • 31 Jan 2023
Topic Review
AAZTA-Derived Chelators as Innovative Radiopharmaceuticals
The chelating agent AAZTA features a mesocyclic seven-membered diazepane ring, conferring some of the properties of both acyclic and macrocyclic chelating agents. Described in the early 2000s, AAZTA and its derivatives exhibited interesting properties once complexed with metals and radiometals, combining a fast kinetic of formation with a slow kinetic of dissociation. Importantly, the extremely short coordination reaction times allowed by AAZTA derivatives were particularly suitable for short half-life radioelements (i.e., 68Ga).
  • 1.8K
  • 28 Feb 2022
Topic Review
PET-Based Criteria for Response Assessment in Lymphoma
Criteria for response assessment in lymphoma have deeply evolved in the last decade, assigning an outstanding role to FDG-PET/CT. This path starts from the first lymphoma specific CT-based criteria and leads towards the PET-based Lugano Classification, that, nowadays, represents the gold standard. LYRIC (Lymphoma Response to Immunomodulatory Therapy Criteria) criteria, the recent refinement of the Lugano Classification, were conceived to capture new patterns of response (delayed response and pseudoprogression) observed during treatment with novel immunotherapy agents that have entered the clinic.
  • 1.7K
  • 05 Jun 2023
Topic Review
COVID-19 Pneumonia and Lung Cancer
Oncological patients are more prone to present severe forms of COVID-19 pneumonia and are subject to worse complications. Radiologists have the challenging role of suggesting a differential diagnosis with lung cancer and treatment-induced lung diseases or suggesting an overlap between these pathologies. Despite similarities or overlapping findings, the combination of clinics and some specific radiological findings, which are also identified by comparison with previous and follow-up CT scans, may guide differential diagnosis.
  • 1.7K
  • 01 Apr 2022
Topic Review
Hepatic Vessel Skeletonization
Hepatic vessel skeletonization serves as an important means of hepatic vascular analysis and vessel segmentation. Skeletonization provides an effective and compact representation of an image object by reducing its dimensionality to a centerline while preserving the original topologic and geometric properties. Hepatic vascular analysis plays a critical role in the diagnosis and treatment of many liver diseases, classification of liver function regions and inquiry into the nature of vascular growth. Hepatic vessel skeletonization serves as an important means of hepatic vascular analysis, particularly because a hepatic vessel is a kind of thin tubular object satisfying the growth principle of Murray’s law.
  • 1.6K
  • 15 Apr 2022
Topic Review
Focal Nodular Hyperplasia-like Regenerative Nodules
Budd–Chiari syndrome (BCS) is a rare clinical entity characterized by hepatic venous outflow obstruction, resulting in liver congestion and subsequent chronic parenchymal damage. This condition often leads to the development of focal liver lesions, including benign focal nodular hyperplasia-like regenerative nodules, hepatocellular carcinoma, and perfusion-related pseudo-lesions. Computed tomography, ultrasound, and magnetic resonance are the commonly employed imaging modalities for the follow-up of BCS patients and for the detection and characterization of new-onset lesions. The accurate differentiation between benign and malignant nodules is crucial for optimal patient management and treatment planning. 
  • 1.6K
  • 19 Jul 2023
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