Gender Medicine in Clinical Radiology Practice.

Gender Medicine is rapidly emerging as a branch of medicine that studies how many diseases common to men and women differ in terms of prevention, clinical manifestations, diagnostic-therapeutic approach, prognosis, and psychological and social impact. Nowadays, the presentation and identification of many pathological conditions pose unique diagnostic challenges. However, women have always been paradoxically underestimated in epidemiological studies, drug trials, as well as clinical trials, so many clinical conditions affecting the female population are often underestimated and/or delayed and may result in inadequate clinical management. Knowing and valuing these differences in healthcare, thus taking into account individual variability, will make it possible to ensure that each individual receives the best care through the personalization of therapies, the guarantee of diagnostic-therapeutic pathways declined according to gender, as well as through the promotion of gender-specific prevention initiatives. This article aims to assess potential gender differences in clinical-radiological practice extracted from the literature and their impact on health and healthcare. Indeed, in this context, radiomics and radiogenomics are rapidly emerging as new frontiers of imaging in precision medicine. The development of clinical practice support tools supported by artificial intelligence allows through quantitative analysis to characterize tissues noninvasively with the ultimate goal of extracting directly from images indications of disease aggressiveness, prognosis, and therapeutic response. The integration of quantitative data with gene expression and patient clinical data, with the help of structured reporting as well, will in the near future give rise to decision support models for clinical practice that will hopefully improve diagnostic accuracy and prognostic power as well as ensure a more advanced level of precision medicine.

Pulmonary Lymphangitis Poses a Major Challenge for Radiologists in an Oncological Setting during the COVID-19 Pandemic.

Due to the increasing number of COVID-19-infected and vaccinated individuals, radiologists continue to see patients with COVID-19 pneumonitis and recall pneumonitis, which could result in additional workups and false-positive results. Moreover, cancer patients undergoing immunotherapy may show therapy-related pneumonitis during imaging management. This is otherwise known as immune checkpoint inhibitor-related pneumonitis. Following on from this background, radiologists should seek to know their patients' COVID-19 infection and vaccination history. Knowing the imaging features related to COVID-19 infection and vaccination is critical to avoiding misleading results and alarmism in patients and clinicians.

COVID-19 integrated imaging: our experience and literature review.

PURPOSE: To investigate the imaging features of emerging COVID-19 pneumonia on chest ultrasound, radiographs and computed tomography examinations performed at admission. In addition, we provide a review of the literature and compare our results with recent evidence regarding the imaging characteristics of this novel disease. MATERIAL AND METHODS: From March 17, 2020 to April 25, 2020, 23 patients with real-time polymerase chain reaction (RT-PCR) assay confirmed COVID-19 were identified. All 23 patients were evaluated and admitted at San Giuseppe Moscati Hospital in Aversa, Italy. Multi-modality imaging findings were evaluated and compared. Literature research was conducted through a methodical search on PubMed. RESULTS: Twenty-three patients were included in the study. Chest transthoracic ultrasound (US), chest X-ray (CXR), and computed tomography (CT) were performed respectively in 11, 16 and 21 patients. Chest US findings were consistent with diffuse B lines (91%), subpleural consolidations (45%), and thickened pleural line (18%). CXR showed prevalent manifestations of consolidations (50%) and hazy increased opacities (37%). Typical CT features are bilateral and multilobar ground-glass opacities (GGO). Indeed GGO were present in 100% of our patients. Consolidations were visible in 76% of our study population. Notably both GGO and consolidations had a peripheral distribution in all our patients. Other CT imaging features included crazy-paving pattern, fibrous stripes, subpleural lines, architectural distortion, air bronchogram sign, vascular thickening and nodules. Our literature review identified thirty original studies supporting our imaging chest findings. CONCLUSIONS: At admission, COVID-19 pneumonia can manifest in chest imaging as B-lines and consolidations on US, hazy opacities and consolidations on CXR, multiple GGO and consolidations on CT scan.

COVID-19 pneumonia manifestations at the admission on chest ultrasound, radiographs, and CT: single-center study and comprehensive radiologic literature review.

PURPOSE: To investigate the imaging features of emerging COVID-19 pneumonia on chest ultrasound (US), radiographs (CXR) and computed tomography (CT) examinations performed at admission and to provide a comprehensive radiological literature review on ongoing radiological data from recent publications. MATERIALS AND METHODS: In this retrospective single-center study, we enrolled consecutive patients from February 15, 2020, to March 15, 2020, with laboratory-confirmed SARS-CoV-2 hospitalized in Valduce Hospital (Como, Italy). Multi-modality imaging findings were evaluated and compared. Literature research was conducted through a methodical search on Pubmed and Embase databases. RESULTS: Fifty-eight patients (36 men, 22 women; age range, 18-98 years) were included in the study. Among these, chest US, CXR, and CT were performed respectively in twenty-two, thirty-two and forty-two patients. Lung US findings were consistent with diffuse B lines (100%) and subpleural consolidations (27.3%). CXR showed prevalent manifestations of consolidations (46.9%) and hazy increased opacities (37.5%). Typical CT features included bilateral and multilobar ground-glass opacities (GGO) with (59.5%) and without (35.7%) consolidations having a predominantly peripheral distribution (64.3%). Other imaging features included crazy paving pattern (57.1%), fibrous stripes (50%), subpleural lines (35.7%), architectural distortion (28.6%), air bronchogram sign (26.2%), vascular thickening (23.8%) and nodules (2.4%). Also, enlarged lymph nodes (14.3 %) and pleural effusion (7.1%) were observed. The literature review identified twenty-six original studies supporting our imaging chest findings. CONCLUSION: The spectrum of chest imaging manifestations of COVID-19 pneumonia upon admission includes B-lines and consolidations on US, consolidations and hazy increased opacities on CXR, and multifocal GGO with consolidations on CT.