Interventional radiology in gynecology and obstetric practice: Safety issues.

Interventional radiology is continuing to reshape current practice in many specialties of clinical care and the fields of gynecology and obstetrics are no exception. Imaging skills, clinical knowledge as well as vascular and non-vascular interventional technical ability, are essential to practice interventional radiology effectively. Patient safety is of paramount importance in interventional radiology as in all branches of medicine. Potential failures occur throughout successful procedures and are attributed to a spectrum of errors, including equipment unavailability, planning errors, and communication errors. These are mainly preventable by improved preprocedural planning and teamwork. Of all the targeted and effective actions that can be undertaken to reduce adverse events, the use of safety checklists might have a prominent role. The advantage of a safety checklist for interventional radiology is that it guarantees that human error in terms of forgetting key steps in patient preparation, intraprocedural care, and postoperative care are not forgotten.

Three-dimensional (3D) Printed Model to Plan the Endoscopic Treatment of Upper Airway Stenosis.

BACKGROUND: Endoscopic management of tracheal stenosis may be challenging, especially in the case of complex stenosis placed near the vocal folds, and needing stent placement. Herein, we evaluated the utility of the three-dimensional (3D) airway model for procedural planning in a consecutive series of patients with complex airway stenosis and scheduled for endoscopic treatment. METHODS: This strategy was applied to 7 consecutive patients with tracheal stenosis unfit for surgery. The model was printed in a rubber-like material, and almost 7 hours were needed to create it. All patients presented respiratory failure with a mean value of 3.4±0.4 Medical Research Council (MRC) dyspnea scale, 47±3.9 forced expiratory volume in 1 second (FEV1%), and an impairment in the 6-minute walking test (6MWT) (mean value, 175±53 m). The mean length of the stenosis was 19±3.4 mm; 3 of the 7 (43%) patients presented a subglottic stenosis. In 4/7 (57%) patients the stenosis was >5 mm, but its treatment required the placement of a stent because of the presence of tracheal cartilage injury. RESULTS: The mean operation time was 22.7±6.6 minutes. No complications were observed during and after the procedure. A significant increase of MRC (3.4±0.4 vs. 1.6±0.5; P=0.003), of FEV1% (47±3.9 vs. 77±9.7; P=0.001), and of 6MWT (175±53 vs. 423±101; P=0.0002) was observed after the procedure (mean follow-up, 11.1±8.8 mo). CONCLUSION: Our 3D airway model in the management of airway stenosis is useful for procedural planning, rehearsal, and education. The fidelity level of the 3D model remains the main concern for its wider use in patient care. Thus, our impressions should be confirmed by future prospective studies.

[Imaging and radioguided surgery of tumors NETs]. / Imaging e chirurgia radioguidata di tumori neuroendocrini.

Neuroendocrine tumors tend to grow slowly and are notoriously difficult to localize, at least in the early stages. Metastases are in most cases already present at the time of diagnosis. Somatostatin receptor scintigraphy improves detection of small and occult NET tumors. Intraoperative probe counting with a hand-held gamma probe can identify tumors even when they are small and impalpable, but receptor positive. This advanced operative approach may improve the survival of these patients.

[The value of the MRI in defining the morfology of cerebral aging]. / Il ruolo della RM nella definizione morfologica dell'invecchiamento cerebrale.

White matter changes are one of the several aging brain alterations. Actually, magnetic resonance imaging is the best diagnostic tool in investigation and monitoring these lesions that determine some common clinical manifestations in the elderly population.

[Radionuclide imaging of neurendocrine tumors: biological basis and diagnostic results]. / Imaging con radionuclidi dei tumori neuroendocrini: basi biologiche e risultati diagnostici.

Many radiopharmaceuticals have been successfully used in nuclear medicine to detect neuroendocrine tumors, and many of them are based on a specific mechanism of uptake, while others are non-specific probes. This "review" focuses on the clinical applications of metaiodobenzylguanidine, (111)In-pentreotide and positron emission tomography (PET) tracers. New avances in diagnostic imaging will be discussed. Molecular imaging serves these diagnostic functions and provides powerful means for non-invasively detecting disease.

[Virtual colonoscopy and PET/CT for diagnosis and staging of colorectal cancer]. / Colonscopia virtuale e PET/TC per la diagnosi e stadiazione del cancro del colon-retto.

Colo-rectal cancer is the most common malignancy of the gastrointestinal tract and is the third frequency for malignancy in humans. CT and MRI development allows an early diagnosis and a modulation of the therapeutic approach. Many papers seem to confirm the role of PET/CT and virtual colonography in the evaluation of primary lesions. The PET/CT appears mode accurate in assessing lymph node metastases. Today, new approaches such as virtual colonoscopy and PET/CT open new horizons in the diagnosis and staging of cancer of the colon and rectum.