Sveva Mortellaro

Objective: To compare patient perceptions of radiologist-written and artificial intelligence (AI)-generated simplifications of breast imaging reports in terms of simplicity, comprehensibility, empathy, and overall preference. Materials and methods: In this prospective multicentre survey-based study, 10 anonymized breast imaging reports (5 ultrasound, 5 mammography; one BI-RADS category 1–5 per modality) were simplified by ChatGPT-4 within a 50-word limit. After assessment by a panel of 20 physicians, paired radiologist-written and AI-generated reports were evaluated by 314 patients (2965 evaluations) who rated simplicity, comprehensibility, and empathy on a 5-point Likert scale and indicated their preferred report. The origin of each report was concealed, and each pair was presented in randomized order. Univariable and multivariable mixed-effects logistic regression analyses were performed to identify factors associated with preferring AI-generated reports. Results: AI-generated reports were preferred in 63.3% (1876/2965) of evaluations. High simplicity and comprehensibility scores (4–5) were more frequently assigned to AI reports than to radiologist-written reports (70.0% vs 43.4% and 68.1% vs 40.4%, respectively). In multivariable analysis, higher comprehensibility was the strongest predictor in both directions: higher comprehensibility of AI-generated reports increased the odds of preferring AI (score 4: adjusted OR 1.87, 95% CI 1.08–3.23, p = 0.025), while higher comprehensibility of radiologist-written reports reduced them (score 4: adjusted OR 0.45, 95% CI 0.29–0.69, p < 0.001). Preference for AI-generated reports showed a non-significant trend toward increase with educational level. Conclusion: AI-generated breast imaging reports were preferred by most patients and perceived as clearer, supporting a complementary and supervised use of AI-generated summaries. Key Points: Question Patients increasingly access their own radiology reports, yet standard radiologist-written reports are often difficult to understand, highlighting the need for patient-friendly alternatives. Findings In this study, AI-generated breast imaging reports were preferred by patients in 63.3% of evaluations, with comprehensibility emerging as the strongest predictor of preference. Critical relevance statement: AI-generated breast imaging reports were preferred by most patients and received higher ratings for simplicity and comprehensibility than radiologist-written reports, supporting a supervised and complementary use of AI-generated summaries in clinical breast imaging.

Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a well-established procedure for managing portal hypertension and its complications that are refractory to medical and endoscopic therapy. However, complex cases may render the conventional approach ineffective. We describe the cross-sight (CS) technique, which combines ultrasound and fluoroscopic guidance to allow simultaneous puncture of the hepatic and portal veins through a single transhepatic needle pass. Following portal access, stent graft deployment is performed via the jugular route, while the percutaneous tract is closed with a vascular plug to minimize bleeding risk. In our experience, this approach enabled safe and effective shunt creation after failed standard TIPS, with no procedure-related complications. The CS technique provides enhanced procedural control and avoids the limitations of alternative strategies such as DIPS or gun-sight methods. By reducing puncture attempts and access points, it represents a feasible salvage option for complex TIPS cases, with potential immediate application in interventional radiology practice.

Aim: To assess the impact of the environment on the attitude and mood of pediatric patients undergoing computed tomography (CT) scans at our pediatric clinic within the colorful setting of a dedicated CT scan room. Background: In pediatric healthcare, interventions must address the specific needs of both children and their parents. While medical imaging is essential for diagnosis and management, it can cause stress and anxiety in children, potentially affecting cooperation and diagnostic quality. Creating a supportive, child-friendly environment can alleviate these challenges and improve the likelihood of successful imaging outcomes. Method: This retrospective quantitative study investigated the phenomenological experience of pediatric patients (aged 0–18) who underwent CT imaging at the “De Marchi” pediatric clinic between November 2021 and June 2024. Patients were manually selected from the clinic’s CT database. A standardized telephone survey assessed perceived environmental impact before, during, and after the procedure. Data were anonymized and recorded in Excel (Microsoft, Redmond, WA, USA). Crosstab analyses and Pearson’s chi-square tests were performed using SPSS version 25.0 (IBM, Armonk, NY, USA). Results: Between November 2021 and June 2024, 838 pediatric patients underwent 1144 CT scans at the “De Marchi” clinic. Patients were grouped as previous-CT elsewhere (12.3%), first-time CT (68.9%), and returning patients (18.8%). Most reported positive experiences: 63.3% of the first group rated the experience better than prior exams, 73.9% of first-time patients found the environment comfortable, and 85.6% of returning patients felt at ease. Overall, 94.2% would recommend the clinic for pediatric CT scans. Conclusions: Our research demonstrates that a child-friendly environment is not just a concept, but a tangible solution that effectively alleviates the stress experienced by young patients and their families during diagnostic exams. This finding should inspire optimism about the potential for creating more reassuring and comfortable hospital settings in pediatric healthcare.

Pulmonary embolism (PE) remains a critical condition that demands rapid and accurate diagnosis, for which computed tomographic pulmonary angiography (CTPA) is widely recognized as the diagnostic gold standard. However, recent advancements in imaging technologies—such as dual-energy computed tomography (DECT), photon-counting CT (PCD-CT), and artificial intelligence (AI)—offer promising enhancements to traditional diagnostic methods. This study reviews past, current and emerging technologies, focusing on their potential to optimize diagnostic accuracy, reduce contrast volumes and radiation doses, and streamline clinical workflows. DECT, with its dual-energy imaging capabilities, enhances image clarity even with lower contrast media volumes, thus reducing patient risk. Meanwhile, PCD-CT has shown potential for dose reduction and superior image resolution, particularly in challenging cases. AI-based tools further augment diagnostic speed and precision by assisting radiologists in image analysis, consequently decreasing workloads and expediting clinical decision-making. Collectively, these innovations hold promise for improved clinical management of PE, enabling not only more accurate diagnoses but also safer, more efficient patient care. Further research is necessary to fully integrate these advancements into routine clinical practice, potentially redefining diagnostic workflows for PE and enhancing patient outcomes.

Background/Objectives: Vacuum-assisted excision (VAE) is a minimally invasive technique for breast tumor treatment, offering precision, comfort, and quick recovery. It is widely used for benign breast lesions and is playing an increasingly important role in the therapeutic management of non-surgical patients or patients who refuse surgery. Optimal outcomes require an understanding of device features to tailor treatment to each lesion. The Mammotome^® Elite 10G operates in a fixed mode, while the Mammotome^® Revolve EX 8G offers multiple aspiration levels and aperture windows for greater versatility. This study analyzed the specimen features (weight and length), comparing the weight obtained from two different VAE systems to aid the appropriate selection of a device based on the clinical setting. It also determined the number of specimens needed to achieve the 4 g diagnostic threshold. Methods: The Mammotome^® Elite 10G and the Mammotome^® Revolve EX were evaluated under controlled conditions. For Mammotome^® Revolve EX, combinations of five aspiration levels and three aperture lengths (12 mm, 18 mm, and 25 mm) were tested. Twelve samples were collected from a chicken breast phantom for each setting. Specimen weights and the minimum excisions required to reach the 4 g threshold were analyzed. Results: The mean weight per sample for the Mammotome^® Elite 10G was 0.16 ± 0.04 g. For the Mammotome^® Revolve EX, the weights increased with aperture size and aspiration level, ranging from a minimum of 0.132 ± 0.028 g (a window length of 12 mm and aspiration level 1) to a maximum of 0.407 ± 0.055 g (a window length of 25 mm and aspiration level 5). The 25 mm window at aspiration level 5 achieved the 4 g threshold in as few as 10 samples. By comparison, the Mammotome^® Elite required up to 26 samples. Conclusions: Compared to the Mammotome Elite, Mammotome^® Revolve EX offers superior versatility and efficiency, reducing patient discomfort by minimizing the required samples. Its technical advantages make it a valuable tool for both diagnostic and therapeutic applications.

Sarcopenia, an extremely common condition in cancer patients, is described as a progressive and generalized musculoskeletal disorder that is associated with an increased likelihood of adverse outcomes, including falls, fractures, physical disability, and mortality. By contrast, cachexia is defined as a syndrome characterized by weight loss with the concomitant loss of muscle and/or fat mass. Cancer cachexia leads to functional impairment, reduced physical performance, and decreased survival, and is often accompanied by cancer progression and reduced response to therapy. The literature states that cancer patients with cachexia or sarcopenia have many more complications than patients without these conditions. The interplay between physiologic sarcopenia and cancer cachexia is, in part, responsible for the complexity of studying wasting disorders in the cancer population, particularly in the geriatric population. For these reasons, a comprehensive assessment of the body composition and physical function of these patients is necessary. There are several modalities adapted to measure skeletal muscle mass, such as dual-energy X-ray absorptiometry (DEXA), bioelectrical impedance analysis (BIA), computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US). The gold standard for the measurement of quantitative and qualitative changes in body composition in patients with cancer is the analysis of tissue density using a CT scan. However, this technique remains poorly implemented in clinical practice because of the use of ionizing radiation. Similarly, DEXA, MRI, and US have been proposed, but their use is limited. In this review, we present and compare the imaging techniques that have been developed so far for the nutritional assessment of cancer patients.