The use of radiomics and artificial intelligence applied for the diagnosis and monitoring of Alzheimer’s disease has developed in recent years. However, this approach is not yet completely applicable in clinical practice. The aim of this paper is to provide a systematic analysis of the studies that have included the use of radiomics from different imaging techniques and artificial intelligence for the diagnosis and monitoring of Alzheimer’s disease in order to improve the clinical outcomes and quality of life of older patients. A systematic review of the literature was conducted in February 2023, analyzing manuscripts and articles of the last 5 years from the PubMed, Scopus and Embase databases. All studies concerning discrimination among Alzheimer’s disease, Mild Cognitive Impairment and healthy older people performing radiomics analysis through machine and deep learning were included. A total of 15 papers were included. The results showed a very good performance of this approach in the differentiating Alzheimer’s disease patients—both at the dementia and pre-dementia phases of the disease—from healthy older people. In summary, radiomics and AI can be valuable tools for diagnosing and monitoring the progression of Alzheimer’s disease, potentially leading to earlier and more accurate diagnosis and treatment. However, the results reported by this review should be read with great caution, keeping in mind that imaging alone is not enough to identify dementia due to Alzheimer’s.

Wedge-shaped areas of increased signal intensity surrounding focal hepatic lesions on T2-weighted images have been described as an occasional finding in patients with hepatic metastases. We reviewed MR images of patients with benign and malignant focal hepatic lesions to determine the prevalence and diagnostic significance of this finding, and in particular to determine if these wedge-shaped areas are characteristic of cancer. One hundred twenty-one patients with focal hepatic lesions (65 patients with metastases, 14 patients with hepatocellular carcinoma, and 42 patients with benign conditions) underwent MR imaging of the liver at 1.0 T. Axial spin-echo T1-weighted and spin-echo and turbo spin-echo T2-weighted MR images were obtained. The MR images were retrospectively evaluated: the number and size of the lesions and the presence of wedge-shaped areas surrounding the lesions were recorded; in patients with cancer, follow-up MR images and a clinical course were used to study the evolution of the lesions and the adjacent wedge-shaped areas. The final diagnosis in patients with cancer was proved by clinical course (54 patients) or fine-needle aspiration biopsy (25 patients); in patients with benign lesions, the findings on various other imaging techniques were accepted as conclusive. The wedge-shaped areas were noted on T2-weighted images in 16 (25%) of 65 patients with metastases, in 3 (21%) of 14 patients with hepatocellular carcinoma, and in 5 (12%) of 42 patients with benign lesions. In 11 of the 16 patients with metastases and wedge-shaped areas of increased signal intensity, a metastatic lesion within the wedge-shaped area was detectable; in the remaining five patients, a metastatic lesion appeared during the subsequent clinical course. In some instances, the wedge-shaped area obscured the lesion. In patients with benign conditions, the wedge-shaped area was frequently seen in association with hemangiomas (4 of 13, 31%). Our results show that wedge-shaped areas of increased signal intensity surrounding lesions on T2-weighted MR images are a common finding in patients with focal hepatic lesions. The wedge-shaped areas cannot be considered pathognomonic of malignant lesions because they are also seen in patients with benign conditions (hemangioma, abscess). However, the appearance of these wedge-shaped areas in a patient with cancer should suggest a metastasis. The possibility that hepatic lesions could be obscured by these wedge-shaped areas also should be considered when response to treatment is being evaluated.

Cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy effects on respiratory function, pulmonary exacerbations and quality of life have been well documented. However, CFTR modulator therapy effects on sinus disease have not been so well reported. A previous study reported that ivacaftor improves appearance of sinus disease on Computed Tomography (CT) in cystic fibrosis (CF) patients with G551D mutation. The aim of this study was to evaluate the effect of CFTR modulator therapy in sinus disease using CT scores in a wider CF patient population. Forty-eight adult patients with CF underwent at least one CT sinus examination before CFTR modulator therapy (ivacaftor, lumacaftor, ivacaftor/lumacaftor or elexcaftor/tezacaftor/ivacaftor) and one CT sinus examination one year after CFTR modulator therapy initiation. Two radiologists assessed the images in consensus. The Lund-Mackay score (LM score) and the Sheikh-Lind CT sinus disease severity scoring system (SL score) were used. The 22-item SinoNasal Outcome Test (SNOT-22) questionnaire was evaluated before CFTR modulator therapy and one year after CFTR modulator therapy initiation. CT sinus examination after CFTR modulator therapy showed statistically significant lower mean LM, SL and SNOT-22 scores than CT sinus examination before CFTR modulator therapy (p < 0.001). Evolution of imaging findings on CT during follow-up closely correlate with improved SNOT-22 score one year after CFTR modulator therapy initiation, indicating that CT may be a useful adjunct during follow-up of CF patients under this treatment as an objective measure of sinonasal disease improvement.

Background. The purpose of this study was to evaluate the prognostic impact of chest X-ray (CXR) score, frailty, and clinical and laboratory data on in-hospital mortality of hospitalized older patients with COVID-19. Methods. This retrospective study included 122 patients 65 years or older with positive reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and with availability to CXRs on admission. The primary outcome of the study was in-hospital mortality. Statistical analysis was conducted using Cox regression. The predictive ability of the CXR score was compared with the Clinical Frailty Scale (CFS) and fever data using Area Under the Curve (AUC) and net reclassification improvement (NRI) statistics. Results. Of 122 patients, 67 died during hospital stay (54.9%). The CXR score (HR: 1.16, 95% CI, 1.04–1.28), CFS (HR: 1.27; 95% CI, 1.09–1.47), and presence of fever (HR: 1.75; 95% CI, 1.03–2.97) were significant predictors of in-hospital mortality. The addition of both the CFS and presence of fever to the CXR score significantly improved the prediction of in-hospital mortality (NRI, 0.460; 95% CI, 0.102 to 0.888; AUC difference: 0.117; 95% CI, 0.041 to 0.192, p = 0.003). Conclusions. CXR score, CFS, and presence of fever were the main predictors of in-hospital mortality in our cohort of hospitalized older patients with COVID-19. Adding frailty and presence of fever to the CXR score statistically improved predictive accuracy compared to single risk factors.

Persistent sciatic artery (PSA) is a rare vascular anomaly classified into five types according to the Pillet and Gauffre classification system. Although PSA may be detected as an incidental finding, symptomatic cases account for approximately 80% of all cases and have variable clinical presentations. Due to the frequent ischemic and aneurysmal complications, PSAs can lead to limb-threatening conditions requiring prompt identification and adequate treatment management. In this paper, we present a series of four cases of PSA with extremely different anatomical characteristics, patients’ ages, medical histories and clinical presentations. All cases were diagnosed in our institution and managed after multidisciplinary discussions involving vascular surgeons and interventional radiologists. The series included three women and one man. In two cases, one of which included gluteal and back pain, pulsatile masses were found. Two patients had lower-limb chronic ischemia, one with rest pain and one with IIb claudication. Whereas selective angiography was performed only in endovascular approaches, computed tomography angiography (CTA) was performed on all patients as the decisive diagnostic modality. In our series, treatment strategies were selected on the basis of clinical and anatomical factors, and after the evaluation of the potential risks and benefits of each technique. Treatment was medical in two cases, endovascular in one case and hybrid in one case.