Giant-cell tumours are benign aggressive bone lesions that can affect any part of the skeleton. In early stages, curettage is preferred, but in case of local recurrence or voluminous lesions in the periacetabular region, wide resection and reconstruction are recommended. The purpose of this article is to increase clinicians’ awareness of the importance of the follow-up of these patients and to describe a case of a voluminous recurrence of a giant-cell tumour in the pelvis. We present a 25-year-old female who underwent internal hemipelvectomy assisted by 3D cutting-guides and reconstruction with a custom-made 3D-printed pelvic prosthesis, hip arthroplasty and ilio-sacral arthrodesis. No postoperative complications occurred and, at long-term follow-up, the patient had a stable and painless hip joint, good bone-implant osteointegration, with an excellent functional outcome. In spite of all available reconstructive techniques, in well-selected patients with voluminous pelvic resections, custom-made 3D-printed implants allow patients to have a good mechanical outcome.

Intraosseous lipomas are rare bone lesions that can affect any part of the skeleton. In the calcaneum, they are, generally, asymptomatic, but in some cases, patients may complain of pain, swelling or tenderness. Well-conducted radiography and MRI examinations can lead to an accurate diagnosis. In most cases, patients could benefit from conservative means of treatment, but in long-lasting symptomatic cases, surgical treatment may be a good option. The purpose of this article is to increase clinicians’ awareness of this lesion as a possible cause of heel pain and to describe a case of a symptomatic intraosseous lipoma of the calcaneum who underwent curettage and bone cement filling after failure of conservative treatment.

We report a case of a 52-year-old woman who was referred to our institution with a superior vena cava syndrome and was investigated through echocardiography, CT and MRI revealing a well-defined, encapsulated pericardial mass. The pathology, correlated with the immunohistochemical analysis, concluded it was an extremely rare primary pericardial synovial sarcoma. The patient underwent surgery and chemotherapy with a 16-month disease-free survival and passed away after a contralateral aggressive relapse. Moreover, we discuss the role of each imaging modality together with their pericardial synovial sarcoma reported features.

Myopericytoma is a rare vessel wall tumor, a subtype of hemangiopericytoma that usually develops subcutaneously. Intravascular myopericytoma is a rarer subtype, with only few cases reported in the literature and even fewer with imaging modalities included. We report the case of a 36-year-old man who was referred to our institution with a painless, palpable mass in the right arm and was evaluated with MRI, grey-scale and Doppler-mode ultrasound. Tumor histopathology and imaging characteristics are presented together with the role that each imaging modality played in the management of the patient.

Aims: To analyse the intra- and interobserver variability of two elastographic methods of quantification available on the same machine, the technical factors that may influence variability as well as the intra- and interobserver variability for the same indices between two different ultrasound machines in an in vitro experimental setting.Material and methods: Three different types of silicone experimental devices (ED) were conceived for the purpose of this study. Two observers performed repeated measurements on two ultrasound machines. Strain elastography, with strain ratio determination between the ED was performed on both machines. Shear wave ratio was also assessed. The data obtained were used to calculate intra- and interobservervariability. Reproducibility was assessed in relation to the size of the elastographic region of interest (ROI) and to the difference in stiffness between the ED, through the value of the ICCs (Intraclass Correlation Coefficient).Results: Strain ratio had high inter- and intraobserver reproducibility, regardless of the machine used, on a large number of determinations.The choice of a small ROI diameter (5 mm) over a large ROI diameter (15mm) increased reproducibility (ICC = 0.87 vs 0.78, p=0.000). It is observed that, by Shear Wave Elastography, only when analysing structures with a large difference in hardness, significance is obtained in terms of interobserver reproducibility (ICC = 0.75, p=0.000).Conclusions: On a large number of determinations, both techniques are inter- and intraobserver reproducible. It is preferable to opt for a smaller ROI diameter in order to increase interobserver reproducibility. SWE Ratio provides significant reproducibility only when analysing structureswith large difference in hardness.

Objectives: Our aim was to determine imaging-derived parameters from echocardiography associated with the presence of atrial fibrosis in a cohort of atrial fibrillation (AF) patients. Methods: Initially, 123 participants were included in this prospective cross-sectional observational study (clinicaltrials.gov: NCT03584126); after exclusion criteria, 112 full datasets were analyzed. All participants underwent clinical evaluation, echocardiography, and cardiac MRI. Overall, 29 patients with AF and left atrial (LA) fibrosis at MRI, 37 with AF and without LA fibrosis at MRI, and 46 healthy controls were included in the final database. Results: The cardiac structural parameters as assessed by MRI were not significantly different between AF patients with and without fibrosis, apart from LA volume. The area under the curve (AUC) reached a value of 0.69 when using body-surface-area-indexed LA volume (LAVi) determined by echocardiography as a factor associated with LA fibrosis in AF patients. Moreover, when detecting LA fibrosis using LAVi, an optimal cut-off value of 42.7 mL/m² was obtained, resulting in 41.67% specificity and 88.46% sensitivity with a total accuracy of 65.06%. Testing BSA-indexed left ventricular mass (LVMi) as a factor associated with LA fibrosis, the optimal cut-off value was 140.2 g/m², with 76.92% sensitivity, 58.33% specificity and 67.62% total accuracy for the discrimination between AF patients with and without LA fibrosis. A strong association between body-surface-area-indexed left atrial volume (LAVi) and the presence of atrial fibrillation was identified (54.5 mL/m² vs. 29.8 mL/m² in controls, p-value < 0.0001). Conclusion: LA volume indexed to BSA could be a promising tool for the identification of cardiac fibrosis in AF patients.