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Article ; Online: Coronavirus covid-19 detection by means of explainable deep learning.

Mercaldo, Francesco / Belfiore, Maria Paola / Reginelli, Alfonso / Brunese, Luca / Santone, Antonella

2023 Volume 13, Issue 1, Page(s) 462

Abstract: The coronavirus is caused by the infection of the SARS-CoV-2 virus: it represents a complex and new condition, considering that until the end of December 2019 this virus was totally unknown to the international scientific community. The clinical ... ...

Abstract	The coronavirus is caused by the infection of the SARS-CoV-2 virus: it represents a complex and new condition, considering that until the end of December 2019 this virus was totally unknown to the international scientific community. The clinical management of patients with the coronavirus disease has undergone an evolution over the months, thanks to the increasing knowledge of the virus, symptoms and efficacy of the various therapies. Currently, however, there is no specific therapy for SARS-CoV-2 virus, know also as Coronavirus disease 19, and treatment is based on the symptoms of the patient taking into account the overall clinical picture. Furthermore, the test to identify whether a patient is affected by the virus is generally performed on sputum and the result is generally available within a few hours or days. Researches previously found that the biomedical imaging analysis is able to show signs of pneumonia. For this reason in this paper, with the aim of providing a fully automatic and faster diagnosis, we design and implement a method adopting deep learning for the novel coronavirus disease detection, starting from computed tomography medical images. The proposed approach is aimed to detect whether a computed tomography medical images is related to an healthy patient, to a patient with a pulmonary disease or to a patient affected with Coronavirus disease 19. In case the patient is marked by the proposed method as affected by the Coronavirus disease 19, the areas symptomatic of the Coronavirus disease 19 infection are automatically highlighted in the computed tomography medical images. We perform an experimental analysis to empirically demonstrate the effectiveness of the proposed approach, by considering medical images belonging from different institutions, with an average time for Coronavirus disease 19 detection of approximately 8.9 s and an accuracy equal to 0.95.
MeSH term(s)	Humans ; COVID-19/diagnosis ; SARS-CoV-2 ; Deep Learning ; Pneumonia ; Lung Diseases
Language	English
Publishing date	2023-01-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-27697-y
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Article: An overview of the irreversible electroporation for the treatment of liver metastases: When to use it.

Belfiore, Maria Paola / De Chiara, Marco / Reginelli, Alfonso / Clemente, Alfredo / Urraro, Fabrizio / Grassi, Roberto / Belfiore, Giuseppe / Cappabianca, Salvatore

Frontiers in oncology

2022 Volume 12, Page(s) 943176

Abstract: Tumour ablation is an established therapy for local treatment of liver metastases and hepatocellular carcinoma. Most commonly two different kind of thermic ablation, radiofrequency ablation and microwave ablation, are used in clinical practice. The aim ... ...

Abstract	Tumour ablation is an established therapy for local treatment of liver metastases and hepatocellular carcinoma. Most commonly two different kind of thermic ablation, radiofrequency ablation and microwave ablation, are used in clinical practice. The aim of both is to induce thermic damage to the malignant cells in order to obtain coagulative necrosis of the neoplastic lesions. Our main concerns about these procedures are the collateral thermic damage to adjacent structures and heat-sink effect. Irreversible electroporation (IRE) is a recently developed, non-thermal ablation procedure which works applying short pulses of direct current that generate an electric field in the lesion area. The electric field increase the transmembrane potential, changing its permeability to ions.Irreversible electroporation does not generate heat, giving the chance to avoid the heat-sink effect and opening the path to a better treatment of all the lesions located in close proximity to big vessels and bile ducts. Electric fields produced by the IRE may affect endothelial cells and cholangiocytes but they spare the collagen matrix, preserving re-epithelization process as well as the function of the damaged structures. Purpose of the authors is to identify the different scenarios where CT-guided percutaneous IRE of the liver should be preferred to other ablative techniques and why.
Language	English
Publishing date	2022-09-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.943176
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Article ; Online: Elipse Balloon: the Pitfalls of Excessive Simplicity.

Angrisani, Luigi / Santonicola, Antonella / Vitiello, Antonio / Belfiore, Maria Paola / Belfiore, Giuseppe / Iovino, Paola

Obesity surgery

2018 Volume 28, Issue 5, Page(s) 1419–1421

MeSH term(s)	Endoscopy ; Gastric Balloon ; Humans ; Obesity, Morbid
Language	English
Publishing date	2018-02-16
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-018-3148-5
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Article: Safety and Aesthetics of Autologous Dermis-Fat Graft after Parotidectomy: A Multidisciplinary Retrospective Study.

Boschetti, Ciro Emiliano / Vitagliano, Rita / Cornacchini, Nicola / Santagata, Mario / Caliendo, Valentina / Belfiore, Maria Paola / Colella, Giuseppe / Tartaro, Gianpaolo / Cappabianca, Salvatore

Journal of personalized medicine

2023 Volume 13, Issue 8

Abstract: 1) Background: In surgical procedures for maxillofacial tumours, it is challenging to preserve functional and cosmetic properties in the affected patients. The use of fat grafting is considered as a valuable alternative to overcome postoperative ... ...

Abstract	(1) Background: In surgical procedures for maxillofacial tumours, it is challenging to preserve functional and cosmetic properties in the affected patients. The use of fat grafting is considered as a valuable alternative to overcome postoperative aesthetic asymmetry problems. (2) Methods: In this study, we enrolled thirty patients with parotid gland tumours in which a partial or complete parotidectomy was performed with positioning in the parotid bed of autologous dermis-fat grafts. We evaluated the satisfaction rate of the patients and the objective efficacy in solving the deformity by comparing MRI data before and after surgery. (3) Results: Twenty-six patients showed a satisfying cosmetic result with proper facial symmetry between the affected side and the healthy one. Two patients presented mild postsurgical complications such as haematomas, and two patients reported temporary weakness of the facial nerve related to the parotidectomy. (4) Conclusions: Based on the imaging data obtained via MRI before and after surgery, we can assess that the employment of fat grafts in parotidectomy surgical procedures gives good cosmetic results and does not affect the post operative management and follow up of oncologic patients.
Language	English
Publishing date	2023-07-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm13081200
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Article: The Role of Coronary CT Angiography in the Evaluation of Dual Left Anterior Descending Artery Prevalence and Subtypes: A Retrospective Multicenter Study.

Maggialetti, Nicola / Greco, Sara / Lorusso, Giovanni / Mileti, Cristiana / Sfregola, Gabriella / Brunese, Maria Chiara / Zappia, Marcello / Belfiore, Maria Paola / Sullo, Pasquale / Reginelli, Alfonso / Lucarelli, Nicola Maria / Scardapane, Arnaldo

Journal of personalized medicine

2023 Volume 13, Issue 7

Abstract: Background: The aim of this multicenter study was to evaluate the prevalence and features of dual left anterior descending artery (LAD) subtypes using coronary CT angiography (CCTA).: Methods: A retrospective multicenter analysis of 2083 CCTA from ... ...

Abstract	Background: The aim of this multicenter study was to evaluate the prevalence and features of dual left anterior descending artery (LAD) subtypes using coronary CT angiography (CCTA). Methods: A retrospective multicenter analysis of 2083 CCTA from December 2020 to November 2022 was conducted to search for the presence and morphological features of dual LAD. The two classifications used were the updated classification of Spindola-Franco and the Jariwala classification. Statistical tests were conducted to evaluate the prevalence of dual LADs among sexes and its association with angina in patients without significant coronary stenoses and/or associated cardiac anomalies. Results: Dual LAD was observed in 124 (5.96%) patients analyzed. According to the Spindola-Franco revisited classification, type I dual LAD was the most common (71/124, 57.26%). According to the Jariwala classification, all cases were group I. In the general population, there was a higher prevalence of dual LAD among females (7.3% females vs. 5.1% males; Conclusions: The acknowledgment and reporting of LAD duplication is helpful for an optimal management of coronary patients with this condition. Dual LAD was more frequent in the female population, mainly not related with angina. Myocardial bridge was more frequent in the dual LAD population than in the no dual LAD population.
Language	English
Publishing date	2023-07-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm13071127
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Article ; Online: Myoid gonadal stromal tumor, a case report with review of the literature.

D'Abbronzo, Giuseppe / Ronchi, Andrea / Belfiore, Maria Paola / Mantia, Elvira La / Feroce, Florinda / Pignata, Sandro / Perdonà, Sisto / Franco, Renato

Indian journal of pathology & microbiology

2022 Volume 65, Issue 2, Page(s) 444–447

Abstract: The diagnosis of myoid gonadal stromal tumor (MSGT) can represent a difficult challenge, both for the extreme rarity of this neoplasm and for the clinical-radiological characteristics similar to other neoplasms of the testicle. The case management we ... ...

Abstract	The diagnosis of myoid gonadal stromal tumor (MSGT) can represent a difficult challenge, both for the extreme rarity of this neoplasm and for the clinical-radiological characteristics similar to other neoplasms of the testicle. The case management we present suggests how a complete differential diagnosis can be obtained by integrating ultrasonographic and pathological data.
MeSH term(s)	Diagnosis, Differential ; Humans ; Male ; Radiography ; Sex Cord-Gonadal Stromal Tumors/diagnostic imaging ; Sex Cord-Gonadal Stromal Tumors/pathology ; Testis/diagnostic imaging ; Testis/pathology
Language	English
Publishing date	2022-03-18
Publishing country	India
Document type	Case Reports ; Review
ZDB-ID	197621-7
ISSN	0974-5130 ; 0377-4929
ISSN (online)	0974-5130
ISSN	0377-4929
DOI	10.4103/0377-4929.343206
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Article: On the Adoption of Radiomics and Formal Methods for COVID-19 Coronavirus Diagnosis.

Santone, Antonella / Belfiore, Maria Paola / Mercaldo, Francesco / Varriano, Giulia / Brunese, Luca

Diagnostics (Basel, Switzerland)

2021 Volume 11, Issue 2

Abstract: Considering the current pandemic, caused by the spreading of the novel Coronavirus disease, there is the urgent need for methods to quickly and automatically diagnose infection. To assist pathologists and radiologists in the detection of the novel ... ...

Abstract	Considering the current pandemic, caused by the spreading of the novel Coronavirus disease, there is the urgent need for methods to quickly and automatically diagnose infection. To assist pathologists and radiologists in the detection of the novel coronavirus, in this paper we propose a two-tiered method, based on formal methods (to the best of authors knowledge never previously introduced in this context), aimed to (i) detect whether the patient lungs are healthy or present a generic pulmonary infection; (ii) in the case of the previous tier, a generic pulmonary disease is detected to identify whether the patient under analysis is affected by the novel Coronavirus disease. The proposed approach relies on the extraction of radiomic features from medical images and on the generation of a formal model that can be automatically checked using the model checking technique. We perform an experimental analysis using a set of computed tomography medical images obtained by the authors, achieving an accuracy of higher than 81% in disease detection.
Language	English
Publishing date	2021-02-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics11020293
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Article: Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment.

Russo, Gaetano Maria / Russo, Anna / Urraro, Fabrizio / Cioce, Fabrizio / Gallo, Luigi / Belfiore, Maria Paola / Sangiovanni, Angelo / Napolitano, Stefania / Troiani, Teresa / Verolino, Pasquale / Sica, Antonello / Brancaccio, Gabriella / Briatico, Giulia / Nardone, Valerio / Reginelli, Alfonso

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 4

Abstract: Basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma are the three main types of nonmelanoma skin cancers and their rates of occurrence and mortality have been steadily rising over the past few decades. For radiologists, it is still ... ...

Abstract	Basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma are the three main types of nonmelanoma skin cancers and their rates of occurrence and mortality have been steadily rising over the past few decades. For radiologists, it is still difficult to treat patients with advanced nonmelanoma skin cancer. Nonmelanoma skin cancer patients would benefit greatly from an improved diagnostic imaging-based risk stratification and staging method that takes into account patient characteristics. The risk is especially elevated among those who previously received systemic treatment or phototherapy. Systemic treatments, including biologic therapies and methotrexate (MTX), are effective in managing immune-mediated diseases; however, they may increase susceptibility to NMSC due to immunosuppression or other factors. Risk stratification and staging tools are crucial in treatment planning and prognostic evaluation. PET/CT appears more sensitive and superior to CT and MRI for nodal and distant metastasis as well as in surveillance after surgery. The patient treatment response improved with advent and utilization of immunotherapy and different immune-specific criteria are established to standardized evaluation criteria of clinical trials but none of them have been utilized routinely with immunotherapy. The advent of immunotherapy has also arisen new critical issues for radiologists, such as atypical response pattern, pseudo-progression, as well as immune-related adverse events that require early identification to optimize and improve patient prognosis and management. It is important for radiologists to have knowledge of the radiologic features site of the tumor, clinical stage, histological subtype, and any high-risk features to assess immunotherapy treatment response and immune-related adverse events.
Language	English
Publishing date	2023-02-20
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13040793
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Article ; Online: Machine Learning Approaches with Textural Features to Calculate Breast Density on Mammography.

Sansone, Mario / Fusco, Roberta / Grassi, Francesca / Gatta, Gianluca / Belfiore, Maria Paola / Angelone, Francesca / Ricciardi, Carlo / Ponsiglione, Alfonso Maria / Amato, Francesco / Galdiero, Roberta / Grassi, Roberta / Granata, Vincenza / Grassi, Roberto

Current oncology (Toronto, Ont.)

2023 Volume 30, Issue 1, Page(s) 839–853

Abstract: Background: breast cancer (BC) is the world's most prevalent cancer in the female population, with 2.3 million new cases diagnosed worldwide in 2020. The great efforts made to set screening campaigns, early detection programs, and increasingly targeted ... ...

Abstract	Background: breast cancer (BC) is the world's most prevalent cancer in the female population, with 2.3 million new cases diagnosed worldwide in 2020. The great efforts made to set screening campaigns, early detection programs, and increasingly targeted treatments led to significant improvement in patients' survival. The Full-Field Digital Mammograph (FFDM) is considered the gold standard method for the early diagnosis of BC. From several previous studies, it has emerged that breast density (BD) is a risk factor in the development of BC, affecting the periodicity of screening plans present today at an international level. Objective: in this study, the focus is the development of mammographic image processing techniques that allow the extraction of indicators derived from textural patterns of the mammary parenchyma indicative of BD risk factors. Methods: a total of 168 patients were enrolled in the internal training and test set while a total of 51 patients were enrolled to compose the external validation cohort. Different Machine Learning (ML) techniques have been employed to classify breasts based on the values of the tissue density. Textural features were extracted only from breast parenchyma with which to train classifiers, thanks to the aid of ML algorithms. Results: the accuracy of different tested classifiers varied between 74.15% and 93.55%. The best results were reached by a Support Vector Machine (accuracy of 93.55% and a percentage of true positives and negatives equal to TPP = 94.44% and TNP = 92.31%). The best accuracy was not influenced by the choice of the features selection approach. Considering the external validation cohort, the SVM, as the best classifier with the 7 features selected by a wrapper method, showed an accuracy of 0.95, a sensitivity of 0.96, and a specificity of 0.90. Conclusions: our preliminary results showed that the Radiomics analysis and ML approach allow us to objectively identify BD.
MeSH term(s)	Female ; Humans ; Breast Density ; Mammography/methods ; Breast Neoplasms/diagnostic imaging ; Breast/diagnostic imaging ; Machine Learning
Language	English
Publishing date	2023-01-07
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol30010064
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Article: Robustness of Radiomics in Pre-Surgical Computer Tomography of Non-Small-Cell Lung Cancer.

Belfiore, Maria Paola / Sansone, Mario / Monti, Riccardo / Marrone, Stefano / Fusco, Roberta / Nardone, Valerio / Grassi, Roberto / Reginelli, Alfonso

Journal of personalized medicine

2022 Volume 13, Issue 1

Abstract: Background: Radiomic features are increasingly used in CT of NSCLC. However, their robustness with respect to segmentation variability has not yet been demonstrated. The aim of this study was to assess radiomic features agreement across three kinds of ... ...

Abstract	Background: Radiomic features are increasingly used in CT of NSCLC. However, their robustness with respect to segmentation variability has not yet been demonstrated. The aim of this study was to assess radiomic features agreement across three kinds of segmentation. Methods: We retrospectively included 48 patients suffering from NSCLC who underwent pre-surgery CT. Two expert radiologists in consensus manually delineated three 3D-ROIs on each patient. To assess robustness for each feature, the intra-class correlation coefficient (ICC) across segmentations was evaluated. The ‘sensitivity’ of ICC upon some parameters affecting features computation (such as bin-width for first-order features and pixel-distances for second-order features) was also evaluated. Moreover, an assessment with respect to interpolator and isotropic resolution was also performed. Results: Our results indicate that ‘shape’ features tend to have excellent agreement (ICC > 0.9) across segmentations; moreover, they have approximately zero sensitivity to other parameters. ‘First-order’ features are in general sensitive to parameters variation; however, a few of them showed excellent agreement and low sensitivity (below 0.1) with respect to bin-width and pixel-distance. Similarly, a few second-order features showed excellent agreement and low sensitivity. Conclusions: Our results suggest that a limited number of radiomic features can achieve a high level of reproducibility in CT of NSCLC.
Language	English
Publishing date	2022-12-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm13010083
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