An update in musculoskeletal tumors: from quantitative imaging to radiomics.

In the last two decades, relevant progress has been made in the diagnosis of musculoskeletal tumors due to the development of new imaging tools, such as diffusion-weighted imaging, diffusion kurtosis imaging, magnetic resonance spectroscopy, and diffusion tensor imaging. Another important role has been played by the development of artificial intelligence software based on complex algorithms, which employ computing power in the detection of specific tumor types. The aim of this article is to report the most advanced imaging techniques focusing on their advantages in clinical practice.

From Fish Waste to Value: An Overview of the Sustainable Recovery of Omega-3 for Food Supplements.

The disposal of food waste is a current and pressing issue, urging novel solutions to implement sustainable waste management practices. Fish leftovers and their processing byproducts represent a significant portion of the original fish, and their disposal has a high environmental and economic impact. The utilization of waste as raw materials for the production of different classes of biofuels and high-value chemicals, a concept known as "biorefinery", is gaining interest in a vision of circular economy and zero waste policies. In this context, an interesting route of valorization is the extraction of omega-3 fatty acids (ω-3 FAs) for nutraceutical application. These fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have received attention over the last decades due to their beneficial effects on human health. Their sustainable production is a key process for matching the increased market demand while reducing the pressure on marine ecosystems and lowering the impact of waste production. The high resale value of the products makes this waste a powerful tool that simultaneously protects the environment and benefits the global economy. This review aims to provide a complete overview of the sustainable exploitation of fish waste to recover ω-3 FAs for food supplement applications, covering composition, storage, and processing of the raw material.

Use of the Airo mobile intraoperative CT system versus the O-arm for transpedicular screw fixation in the thoracic and lumbar spine: a retrospective cohort study of 263 patients.

OBJECTIVE: Navigation-enabling technology such as 3D-platform (O-arm) or intraoperative mobile CT (iCT-Airo) systems for use in spinal surgery has considerably improved accuracy over that of traditional fluoroscopy-guided techniques during pedicular screw positioning. In this study, the authors compared 2 intraoperative imaging systems with navigation, available in their neurosurgical unit, in terms of the accuracy they provided for transpedicular screw fixation in the thoracic and lumbar spine. METHODS: The authors performed a retrospective analysis of clinical and surgical data of 263 consecutive patients who underwent thoracic and lumbar spine screw placement in the same center. Data on 97 patients who underwent surgery with iCT-Airo navigation (iCT-Airo group) and 166 with O-arm navigation (O-arm group) were analyzed. Most patients underwent surgery for a degenerative or traumatic condition that involved thoracic and lumbar pedicle screw fixation using an open or percutaneous technique. The primary endpoint was the proportion of patients with at least 1 screw not correctly positioned according to the last intraoperative image. Secondary endpoints were the proportion of screws that were repositioned during surgery, the proportion of patients with a postoperative complication related to screw malposition, surgical time, and radiation exposure. A blinded radiologist graded screw positions in the last intraoperative image according to the Heary classification (grade 1-3 screws were considered correctly placed). RESULTS: A total of 1361 screws placed in 97 patients in the iCT-Airo group (503 screws) and in 166 in the O-arm group (858 screws) were graded. Of those screws, 3 (0.6%) in the iCT-Airo group and 4 (0.5%) in the O-arm group were misplaced. No statistically significant difference in final accuracy between these 2 groups or in the subpopulation of patients who underwent percutaneous surgery was found. Three patients in the iCT-Airo group (3.1%, 95% CI 0%-6.9%) and 3 in the O-arm group (1.8%, 95% CI 0%-4.0%) had a misplaced screw (Heary grade 4 or 5). Seven (1.4%) screws in the iCT-Airo group and 37 (4.3%) in the O-arm group were repositioned intraoperatively (p = 0.003). One patient in the iCT-Airo group and 2 in the O-arm group experienced postoperative neurological deficits related to hardware malposition. The mean surgical times in both groups were similar (276 [iCT-Airo] and 279 [O-arm] minutes). The mean exposure to radiation in the iCT-Airo group was significantly lower than that in the O-arm group (15.82 vs 19.12 mSv, respectively; p = 0.02). CONCLUSIONS: Introduction of a mobile CT scanner reduced the rate of screw repositioning, which enhanced patient safety and diminished radiation exposure for patients, but it did not improve overall accuracy compared to that of a mobile 3D platform.

Test-retest reliability of echo intensity parameters in healthy Achilles tendons using a semi-automatic tracing procedure.

OBJECTIVE: To evaluate the test-retest reliability of the ultrasound echo intensity parameters on healthy Achilles tendon using a semi-automatic tracing procedure. MATERIALS AND METHODS: Eighteen healthy volunteers participated. B-mode images were acquired in the transverse plane (mid-tendon; insertion) and used to analyze tendon echogenicity. Grayscale distribution of the pixels within the selected ROIs was represented as a histogram. Descriptive statistics of the grayscale distribution (mean, variance, skewness, kurtosis, and entropy) and parameters from the co-occurrence matrix (contrast, energy, and homogeneity) were calculated. RESULTS: Reliability of echo intensity parameters of the mid-Achilles tendon ranged from high to very high with an ICC2.k of 0.94 for echogenicity, 0.87 for variance, 0.80 for skewness, 0.72 for kurtosis, 0.89 for entropy, 0.90 for contrast, 0.91 for energy, and 0.93 for homogeneity, while for tendon insertion they ranged from moderate to high with an ICC2.k of 0.74 for echogenicity, 0.88 for variance, 0.75 for skewness, 0.55 for kurtosis, 0.87 for entropy, 0.70 for contrast, 0.77 for energy, and 0.56 for homogeneity. CONCLUSION: Ultrasound echo intensity is a reliable technique to characterize the internal structure of the Achilles tendon.

Real-time sonoelastography using an external reference material: test-retest reliability of healthy Achilles tendons.

OBJECTIVE: To establish the test-retest reliability of sonoelastography (SE) on healthy Achilles tendons in contracted and relaxed states using an external reference system. MATERIALS AND METHODS: Forty-eight Achilles tendons from 24 healthy volunteers were assessed using ultrasound and real-time SE with an external reference material. Tendons were analyzed under relaxed and contracted conditions. Strain ratios between the tendons and the reference material were calculated. The intraclass correlation coefficient (ICC2.k) and Bland-Altman plot were used to assess test-retest reliability. RESULTS: The reliability of SE measurements under relaxed conditions ranged from high to very high, with an ICC2.k of 0.84 (95 % CI: 0.64-0.92) for reference material, 0.91 (95 % CI: 0.83-0.95) for Achilles tendons and 0.95 (95 % CI: 0.91-0.97) for Kager fat pads (KFP). The ICC2.k value for skin was 0.30 (95 % CI: -0.26 to 0.61). Reliability for measurements in the contracted state ranged from high to very high, with an ICC2.k of 0.93 (95 % CI: 0.87-0.96) for reference material, 0.72 (95 % CI: 0.50-0.84) for skin, 0.93 (95 % CI: 0.87-0.96) for Achilles tendons, and 0.81 (95 % CI: 0.66-0.89) for KFP. Reliability of the strain ratio (tendon/reference) under relaxed conditions was high with an ICC2.k of 0.87 (95 % CI: 0.75-0.93), and in the contracted state, it was very high with an ICC2.k of 0.94 (95 % CI: 0.90-0.97). CONCLUSION: Sonoelastography using an external reference material is a reliable and simple technique for the assessment of the elasticity of healthy Achilles tendons. The use of an external material as a reference, along with strain ratios, could provide a quantitative measure of elasticity.