Background/Objectives: Giant Retroperitoneal Liposarcomas (giant RPLs) represent a rare malignant disease of adulthood that does not yet have a univocal definition in the scientific literature. The symptoms may be late, depending on the position and the size reached. The weight may exceed 20 kg, and the diameter 25 cm. The main treatment is the surgical approach. This systematic review aims to collect data from the present literature and to answer some questions on the nature of this pathology. Methods: We performed a search on the PubMed, Cochrane, and Scopus databases using specific search strings. Non-English written articles and abstracts were excluded. Results: Dimensional, histological, and pathological data of giant RPLs were extracted and recorded in an electronic database, and charts were used to synthesize the results. We selected 126 manuscripts, all case reports and case series, and obtained data for 157 giant RPLs. The major axis varied from 15 to 80 cm, and the weight ranged between 2.5 and 98 kg. Sex distribution was homogenous. Age was reported 146 times, and almost 1/3 of the study population was under 50 years old. The most frequent hystotype reported was well-differentiated liposarcomas, while the rarest was pleomorphic liposarcomas. In 139 cases, the symptoms were reported and generally included a mass effect on surrounding organs. The exclusive surgical operation was the most frequent treatment option, and it included both the resection of the tumor and other organs involved. Chemo- and radiotherapy were also performed, in a few cases. In 36 reports, distant metastasis was suspected, but only 6 were effectively positive. Conclusions: Giant RPLs are a clinical entity that shares some common features with normal-size liposarcomas but are different in dimensions, age distribution, histologic prevalence, rate of incidental diagnosis, organ sparing, and R0 resection. More studies are needed to completely characterize these tumors.
Background: Inflammatory Bowel Disease (IBD), comprising Crohn’s disease and ulcerative colitis, requires accurate assessment over time. Imaging techniques play a crucial role in diagnosis, monitoring disease activity, and guiding therapeutic response. This review summarizes the current evidence on radiologic imaging techniques in IBD, focusing on intestinal ultrasound (IUS), computed tomography enterography (CTE), magnetic resonance enterography (MRE), and other emerging technologies. Methods: A literature review was conducted using PubMed, EMBASE, Scopus, and the Cochrane Library, encompassing publications up to 31 October 2024. Results: IUS offers a non-invasive tool for assessing bowel wall thickness, vascularity, and complications. CTE and MRE provide detailed visualization of luminal and extraluminal disease, with MRE preferred for routine monitoring due to the absence of ionizing radiation. Standardized indices and scoring systems aid in objective disease activity assessment. Emerging technologies like Positron Emission Tomography (PET)/MRI and radiomics show promise in combining metabolic and morphological information for complex cases. Conclusions: Imaging has a central role in IBD management, with IUS, CTE, and MRE demonstrating high diagnostic accuracy. Radiomics and Artificial Intelligence (AI) are paving the way for precision imaging. Integrating advanced imaging techniques, scoring systems, and AI-driven analytics represents a transformative step toward more effective and individualized care for patients with IBD.
Accurate assessment of safety margins after percutaneous thermal ablation of liver tumours is critical to minimize local tumour progression (LTP). However, post-ablation margin assessment remains challenging, especially given that ablated tumours cannot be readily appreciated on standard post-ablation imaging. This pictorial essay illustrates the use of contrast-based tumour tagging during CT hepatic arteriography (CTHA)-guided ablation, which preserves tumour conspicuity on post-ablation imaging. By injecting contrast medium and starting energy delivery at the time of maximal tumour enhancement, the contrast agent depicts the tumour, rendering it hyperdense on post-ablation CT scans. This enables direct visualization of the ablated tumour and its margins on post-ablation scans, facilitating both visual and software-assisted margin evaluation. Eleven clinical cases are presented, demonstrating the versatility, reproducibility, and potential pitfalls of this technique. Prospective studies are warranted to validate its impact on local tumour control and to optimize integration into standard image-guided ablation protocols. Graphical Abstract
18 June 2025 in CardioVascular and Interventional Radiology
Interventional radiology is a rapidly advancing medical specialty that uses imaging to diagnose and guide minimally invasive procedures for the treatment of a wide range of conditions, from vascular disease to oncological malignancies. Specialized interventional radiologists perform well-defined treatments with inherent lower risk, reduced recovery times, and minimal discomfort compared to traditional surgery. These treatment options have become an essential alternative in multidisciplinary toolboxes. As this field is in continuous evolution, the role of interventional radiology is expanding, with safer and more efficient treatment options aimed at significantly improving healthcare outcomes. The focus of this chapter will be on the most common interventional techniques in the management of patients with acute and chronic renal failure, in particular percutaneous nephrostomy, arteriovenous fistula management, and renal artery stenosis treatment.