To determine the short-term intra-operator precision and inter-operator repeatability of radiofrequency echographic multi-spectrometry (REMS) at the lumbar spine (LS) and proximal femur (FEM). All patients underwent an ultrasound scan of the LS and FEM. Both precision and repeatability, expressed as root-mean-square coefficient of variation (RMS-CV) and least significant change (LSC) were obtained using data from two consecutive REMS acquisitions by the same operator or two different operators, respectively. The precision was also assessed in the cohort stratified according to BMI classification. The mean (±SD) age of our subjects was 48.9 ± 6.8 for LS and 48.3 ± 6.1 for FEM. Precision was assessed on 42 subjects at LS and 37 subjects on FEM. Mean (±SD) BMI was 24.71 ± 4.2 for LS and 25.0 ± 4.84 for FEM. Respectively, the intra-operator precision error (RMS-CV) and LSC resulted in 0.47% and 1.29% at the spine and 0.32% and 0.89% at the proximal femur evaluation. The inter-operator variability investigated at the LS yielded an RMS-CV error of 0.55% and LSC of 1.52%, whereas for the FEM, the RMS-CV was 0.51% and the LSC was 1.40%. Similar values were found when subjects were divided into BMI subgroups. REMS technique provides a precise estimation of the US-BMD independent of subjects’ BMI differences.

Radical hysterectomy continues to be the standard treatment for early-stage cervical cancer. Accurate staging plays an important role in the management of cervical cancer, and preoperative imaging is indispensable to ensure appropriate stage assignment and to identify the surgical patient. Many studies have highlighted the need to consider the low-risk patient in a markedly different way from the intermediate- or high-risk patient. The aim of this study is to highlight the most urgent divergences to be addressed in low-risk early cervical cancer patients, such as reducing the radicality of the surgery, avoiding parametriectomy with tumors smaller than 2 cm, replacing bilateral lymphadenectomy with sentinel lymph node dissection, persistence of MIS instead of laparotomy, and preserving fertility. All this evidence is the result of the progress that has been made in recent decades in the early diagnosis, staging, and treatment of cervical cancer, made possible not only by the ever-increasing experience of gynecological oncologists but above all by the increasingly sophisticated imaging techniques that support the work of the clinician.