Lorenzo Bonomo - Profile on Academia.edu (original) (raw)

Papers by Lorenzo Bonomo

Journal of medical imaging and radiation oncology, May 18, 2017

Uterine malignancies account for the majority of gynaecologic cancers. Different treatment option... more Uterine malignancies account for the majority of gynaecologic cancers. Different treatment options are available depending on histology, disease grade and stage. Hysterectomy is the most frequent surgical procedure. Chemotherapy and radiation therapy (CRT) represents the preferred therapeutic choice for locally advanced uterine and cervical malignancies. Imaging of the female pelvis following these treatments is particularly challenging due to alteration of the normal anatomy. Radiologists should be familiar with both the expected post-treatment imaging findings and the imaging features of possible complications to make the correct interpretation and avoid possible pitfalls. The purpose of this review is to show the expected computed tomography (CT) and Magnetic Resonance Imaging (MRI) appearances of the female pelvis following surgery and CRT for uterine and cervical cancer, to illustrate the imaging findings of early and delayed most common complications after surgery and CRT, describing the suitable imaging modalities and protocols for evaluation of patients treated for gynaecologic malignancies.

Diagnostic and interventional radiology, Jul 1, 2016

here are two main treatment options in patients with cervical cancer: radical surgery, including ... more here are two main treatment options in patients with cervical cancer: radical surgery, including trachelectomy or radical hysterectomy, which is usually performed in early stage disease as suggested by the International Federation of Gynecology and Obstetrics (FIGO stages IA, IB1, and IIA), or primary radiotherapy with concurrent administration of platinum-based chemotherapy (CRT) for patients with bulky FIGO stage IB2/ IIA2 tumors (> 4 cm) or locally advanced disease (FIGO stage IIB or greater). Some authors suggested the use of CRT followed by surgery for bulky tumors or locally advanced disease (1). Others proposed resection of the Müllerian compartment (fallopian tubes, uterus, proximal and middle vagina, enveloped by peritoneal and subperitoneal mesotissue known as mesometrium) and pelvic lymph node dissection by total mesometrial resection, without adjuvant radiation in FIGO stages IB, IIA, and selected IIB (2), following their ontogenetic theory of locoregional cancer spread (3-6). In all cases, pretreatment assessment of tumor extension and presence of parametrial invasion are of paramount importance to help define an appropriate management strategy. Staging of cervical cancer is still based on FIGO criteria, which are based on clinical findings. Its accuracy is limited in the advanced stages (7). Magnetic resonance imaging (MRI) has been shown to be the most reliable imaging technique in local staging, treatment planning, and follow-up of cervical cancer (8, 9), with staging accuracy ranging from 75% to 96% (10). In 2010, National Comprehensive Cancer Network (NCCN-2010) included MRI in the basic work-up of patients suffering from cervical cancer for stages greater than IB1. The aim of this paper is to show MRI anatomy of the parametrium, paying special attention to the pelvic landmarks, using a series of T2-weighted and diffusion-weighted imaging (DWI) findings that are useful to identify its complete extension (i.e., anterior and posterior extensions, in addition to the lateral extension). The MRI protocol for cervical cancer usually includes anatomical and morphologic sequences of the pelvis, such as T1-weighted imaging in the axial plane and T2-weighted imaging in the axial and sagittal planes, and high spatial resolution axial oblique (short axis of cervix) and coronal oblique (long axis of cervix) T2-weighted imaging with small fieldof-view, which improve identification of parametrial invasion (12). Large field-of-view axial T1-and/or T2-weighted imaging of the abdomen is applied to identify enlarged lymph nodes and hydronephrosis. Dynamic multiphase contrast-enhanced three-dimensional T1-weighted imaging sequence is not routinely used for staging cervical carcinoma, unless the tumor is small and the patient is considered for fertility-sparing surgery or to distinguish 319 From the Department of Radiological Sciences, Institutes of Radiology (A.L.V.  alvalentini@ rm.unicatt.it, B.

Journal of medical imaging and radiation oncology, May 18, 2017

European Heart Journal, Sep 1, 1996

In order to evaluate the relationship between the presence of atherosclerotic disease, documented... more In order to evaluate the relationship between the presence of atherosclerotic disease, documented by angiography, and the fibrinolytic profile, 262 consecutive patients affected by coronary (n = 90), epiaortic (n=60) and peripheral (n = 104) artery disease have been included in the study. Twenty-two healthy subjects were used as controls for laboratory parameters determination. All patients were classified on the basis of the presence (S + ) or absence (S ~) of clinically significant stenosis, according to specific scoring systems. Lipoprotein(a), plasminogen activator inhibitor (PAI-1), tissue plasminogen activator (t-PA) and the PAI-1/t-PA ratio were significantly lower in controls than in coronary, epiaortic and peripheral artery disease patients. However, the levels of these parameters were not statistically different between S + and S~ subjects. These results confirm the association between lipoprotein(a), PAI-1 and t-PA levels and the presence of atherosclerotic disease independently of the arterial districts considered, while they do not appear to be directly linked to the severity of the morphological disease.

Diagnostic and interventional radiology, Jul 1, 2016

Radiation Oncology, Jul 10, 2012

Background: To evaluate the metabolic changes on 18 F-fluoro-2-deoxyglucose positron emission tom... more Background: To evaluate the metabolic changes on 18 F-fluoro-2-deoxyglucose positron emission tomography integrated with computed tomography ( 18 F-FDG PET-CT) performed before, during and after concurrent chemoradiotherapy in patients with locally advanced non-small cell lung cancer (NSCLC); to correlate the metabolic response with the delivered radiation dose and with the clinical outcome. Methods: Twenty-five NSCLC patients candidates for concurrent chemo-radiotherapy underwent 18 F-FDG PET-CT before treatment (pre-RT PET-CT), during the third week (during-RT PET-CT) of chemo-radiotherapy, and 4 weeks from the end of chemo-radiotherapy (post-RT PET-CT). The parameters evaluated were: the maximum standardized uptake value (SUVmax) of the primary tumor, the SUVmax of the lymph nodes, and the Metabolic Tumor Volume (MTV). Results: SUVmax of the tumor and MTV significantly (p=0.0001, p=0.002, respectively) decreased earlier during the third week of chemo-radiotherapy, with a further reduction 4 weeks from the end of treatment (p<0.0000, p<0.0002, respectively). SUVmax of lymph nodes showed a trend towards a reduction during chemo-radiotherapy (p=0.06) and decreased significantly (p=0.0006) at the end of treatment. There was a significant correlation (r=0.53, p=0.001) between SUVmax of the tumor measured at during-RT PET-CT and the total dose of radiotherapy reached at the moment of the scan. Disease progression free survival was significantly (p=0.01) longer in patients with complete metabolic response measured at post-RT PET-CT. Conclusions: In patients with locally advanced NSCLC, 18 F-FDG PET-CT performed during and after treatment allows early metabolic modifications to be detected, and for this SUVmax is the more sensitive parameter. Further studies are needed to investigate the correlation between the metabolic modifications during therapy and the clinical outcome in order to optimize the therapeutic strategy. Since the metabolic activity during chemoradiotherapy correlates with the cumulative dose of fractionated radiotherapy delivered at the moment of the scan, special attention should be paid to methodological aspects, such as the radiation dose reached at the time of PET.

Diagnostic and interventional radiology, Jul 7, 2017

ndometriosis is a systemic disease that affects about 10% to 20% of women during their reproducti... more ndometriosis is a systemic disease that affects about 10% to 20% of women during their reproductive age, characterized by the presence of endometrial glands and stroma outside the uterine cavity (1). Endometriosis lesions are characterized by intralesional recurrent bleeding during menses, because of the hormonal responsiveness of ectopic endometrial tissue, with resulting fibrosis. Typical symptoms are cyclic or chronic pelvic pain, dysmenorrhea, dyspareunia, and pain during defecation or urinating. Unusual endometriosis localizations may be associated with more specific symptoms depending on the site of the localization. According to Siegelmen et al. (2) there are three forms of pelvic endometriosis: (a) superficial peritoneal lesions; (b) ovarian endometrioma; (c) deep (or solid infiltrating) endometriosis (DIE), which is histologically identified as a lesion that extends more than 5 mm into the subperitoneal space and/or affects the wall of organs in the pelvis and ligaments. In superficial endometriosis, superficial plaques are disseminated across the peritoneum, adnexa and ligaments of the uterus; these noninvasive implants are well recognized at laparoscopy and not often detectable with magnetic resonance imaging (MRI). Laparoscopy is the standard of reference for the diagnosis of endometriosis but nodules covered by adhesions and subperitoneal disease are difficult to study. Pouch of Douglas, uterosacral ligaments, torus uterinus, and bowel are the most frequent sites of deep pelvic endometriosis localization. Atypical pelvic localizations of endometriosis can occur at level of the cervix, vagina, round ligaments, ureter, and nerves. Rare extrapelvic endometriosis implants can also be localized in the upper abdomen, subphrenic fold, or subcutaneous fat tissue of the abdominal wall. The focus of this review is to describe atypical pelvic and abdominal localizations of endometriosis that should be known by radiologists in order to correctly identify and characterize these lesions on MRI. Moreover, we describe the MRI appearance of the implants at specific sites and review the literature with special attention to imaging reports and description.

Radiology and Oncology, Sep 1, 2013

Background. The aim of the article is to systematically review published data about the compariso... more Background. The aim of the article is to systematically review published data about the comparison between positron emission tomography (PET) or PET/computed tomography (PET/CT) using Fluorine-18-Fluorodeoxyglucose (FDG) and whole-body magnetic resonance imaging (WB-MRI) in patients with different tumours. Methods. A comprehensive literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through April 2012 and regarding the comparison between FDG-PET or PET/CT and WB-MRI in patients with various tumours was carried out. Results. Forty-four articles comprising 2287 patients were retrieved in full-text version, included and discussed in this systematic review. Several articles evaluated mixed tumours with both diagnostic methods. Concerning the specific tumour types, more evidence exists for lymphomas, bone tumours, head and neck tumours and lung tumours, whereas there is less evidence for other tumour types. Conclusions. Overall, based on the literature findings, WB-MRI seems to be a valid alternative method compared to PET/CT in oncology. Further larger prospective studies and in particular cost-effectiveness analysis comparing these two whole-body imaging techniques are needed to better assess the role of WB-MRI compared to FDG-PET or PET/ CT in specific tumour types.

World Journal of Surgical Oncology, Apr 28, 2012

Background: 18 F-fluoro-deoxy-glucose ( 18 F-FDG) positron emission tomography integrated/combine... more Background: 18 F-fluoro-deoxy-glucose ( 18 F-FDG) positron emission tomography integrated/combined with computed tomography (PET-CT) provides the best diagnostic results in the metabolic characterization of undetermined solid pulmonary nodules. The diagnostic performance of 18 F-FDG is similar for nodules measuring at least 1 cm and for larger masses, but few data exist for nodules smaller than 1 cm. We report five cases of oncologic patients showing focal lung 18 F-FDG uptake on PET-CT in nodules smaller than 1 cm. We also discuss the most common causes of 18 F-FDG false-positive and false-negative results in the pulmonary parenchyma. In patient 1, contrast-enhanced CT performed 10 days before PET-CT did not show any abnormality in the site of uptake; in patient 2, high-resolution CT performed 1 month after PET showed a bronchiole filled with dense material interpreted as a mucoid impaction; in patient 3, contrast-enhanced CT performed 15 days before PET-CT did not identify any nodules; in patients 4 and 5, contrast-enhanced CT revealed a nodule smaller than 1 cm which could not be characterized. The 18 F-FDG uptake at follow-up confirmed the malignant nature of pulmonary nodules smaller than 1 cm which were undetectable, misinterpreted, not recognized or undetermined at contrast-enhanced CT. Conclusion: In all five oncologic patients, 18 F-FDG was able to metabolically characterize as malignant those nodules smaller than 1 cm, underlining that: 18 F-FDG uptake is not only a function of tumor size but it is strongly related to the tumor biology; functional alterations may precede morphologic abnormalities. In the oncologic population, especially in higher-risk patients, PET can be performed even when the nodules are smaller than 1 cm, because it might give an earlier characterization and, sometimes, could guide in the identification of alterations missed on CT.

The European respiratory journal, Oct 31, 2015

Lung cancer kills, the more advanced the disease the lower the chance of survival and therefore e... more Lung cancer kills, the more advanced the disease the lower the chance of survival and therefore early diagnosis is key to improve survival . Recent data from the largest screening study, including more than 50 000 high-risk patients, shows benefit with lung cancer screening, while data from other studies are awaited . The joint white paper published by the European Society of Radiology (ESR) and the European Respiratory Society (ERS) on lung cancer screening is not a general recommendation to perform lung cancer screening in Europe, but a recommendation on how to do it right and under what circumstances . According to the extensive review of all reported low-dose computed tomography (LDCT) lung cancer screening trials by SHLOMI et al. [4] and the NELSON study data from the first three screening rounds, as discussed in the paper (and accompanying online supplementary material) by HOREWEG et al. [5], the percentage of stage I lung cancer detected in prevalence screening rounds varies between 47.6% and 63.9% (if we omit the 81.8% of the LUSI trial). For the NELSON and NLST (National Lung Screening Trial) trials alone the percentage of stage I in the prevalence rounds were 64.9% and 58.3%, respectively . The average percentage of stage I lung cancer detected in incidence rounds in all LDCT trials varied between 53.1% and 76.5% (if we omit the 25% of the Lung Screening Study trial), while these data for NELSON and NLST were 74.3% and 66.4%, respectively. Therefore, we agree with the comment that downstaging as expressed by the difference in percentage of detected stage I lung cancer cases between incidence and prevalence is just below 10%. According to our white paper most cancers detected by LDCT will be in a treatable stage (60-80% stage I) based on the NLST and NELSON as references [2, 5], and we agree that the interval of absolute results for these two trials better should correctly be between 58.3 and 75.8%. Based on the more variable results from all LDCT screening trials [4], it is probably rather optimistic to provide only the absolute values of NLST and NELSON for the percentage of stage I lung cancers as detected by LDCT screening, although these are the two largest screening trials.

The European respiratory journal, Apr 30, 2015

Lung cancer is the most frequently fatal cancer, with poor survival once the disease is advanced.... more Lung cancer is the most frequently fatal cancer, with poor survival once the disease is advanced. Annual low dose computed tomography has shown a survival benefit in screening individuals at high risk for lung cancer. Based on the available evidence, the European Society of Radiology and the European Respiratory Society recommend lung cancer screening in comprehensive, quality-assured, longitudinal programmes within a clinical trial or in routine clinical practice at certified multidisciplinary medical centres. Minimum requirements include: standardised operating procedures for low dose image acquisition, computer-assisted nodule evaluation, and positive screening results and their management; inclusion/exclusion criteria; expectation management; and smoking cessation programmes. Further refinements are recommended to increase quality, outcome and cost-effectiveness of lung cancer screening: inclusion of risk models, reduction of effective radiation dose, computer-assisted volumetric measurements and assessment of comorbidities (chronic obstructive pulmonary disease and vascular calcification). All these requirements should be adjusted to the regional infrastructure and healthcare system, in order to exactly define eligibility using a risk model, nodule management and quality assurance plan. The establishment of a central registry, including biobank and image bank, and preferably on a European level, is strongly encouraged.

Background: despite overlaying an irreplaceable role as a key diagnostic tool in modern medicine,... more Background: despite overlaying an irreplaceable role as a key diagnostic tool in modern medicine, the role of radiologist still appears to be unclear to patients. Methods: We conducted a survey in outpatient clinic of radiological sciences department of the university hospital "a. gemelli" in rome, aiming to assess how correctly patients identify the figure of the radiologist. the patients were interviewed by the trained physician using structured questionnaire. results: We included the number of 259 patients. Majority were female 63.3%, most were 60-69 years old (24.3%), have finished second grade secondary school (35.1%) and were subjected to magnetic resonance (28.6%) while the least were subjected to mammography (8.1%). only 38.7% answered correctly to question no 1 "Who performed your examination?", and only 30.9% correctly identified the radiologist as a person interpreting the exam (question no 2 "Who is going to interpret your radiological examination?"). overall, 16.8% responded correctly to the both questions. significantly less patients with primary school (or: 0.18, cI 95% 0.06-0.49) and first grade secondary school (or: 0.37, cI 95% 0.18-0.75) correctly addressed the question no 1 in compare to those with second grade secondary school. the first grade secondary education (or: 0.43, cI 95% 0.20-0.92) was inversely associated with correct answer to question no 2. Patients with primary education were significantly less prone to give both correct answers (or: 0.12, cI 95% 0.02-0.60). conclusIon: We report insufficient knowledge among patients on radiologist's role in healthcare system. the level of knowledge is associated with level of education.

Chinese Journal of Academic Radiology, 2021

COVID-19 pneumonia represents a global threatening disease, especially in severe cases. Chest ima... more COVID-19 pneumonia represents a global threatening disease, especially in severe cases. Chest imaging, with X-ray and high-resolution computed tomography (HRCT), plays an important role in the initial evaluation and follow-up of patients with COVID-19 pneumonia. Chest imaging can also help in assessing disease severity and in predicting patient’s outcome, either as an independent factor or in combination with clinical and laboratory features. This review highlights the current knowledge of imaging features of COVID-19 pneumonia and their temporal evolution over time, and provides recent evidences on the role of chest imaging in the prognostic assessment of the disease.

Radiotherapy and Oncology, 2016

Diagnostic and Interventional Radiology, 2017

ung cancer accounts for 1.59 million deaths per year worldwide (1). It has one of the poorest sur... more ung cancer accounts for 1.59 million deaths per year worldwide (1). It has one of the poorest survival outcomes of all cancers, with over two-thirds of patients diagnosed at an advanced stage, when curative treatment is no longer feasible. Early diagnosis of lung cancer is the main goal to improve survival. Patients with non-small cell lung cancer (NSCLC) at an operable stage have higher survival rates than those presenting with metastatic disease, with five-year survival of 71%-77% for stage IA and 58% for stage IB (2). Initial identification of lung cancer in asymptomatic patients usually occurs on chest radiography or chest computed tomography (CT). When missed on imaging, lung cancer is inclined to progress from early-stage to advanced-stage disease, particularly if many years pass between radiologic exams (3), with potential medicolegal consequences. Legal actions involving malignancies of the bronchus or lung represent the sixth most common medicolegal issue, and among radiologists it is the second most common cause for litigation (4). About 90% of presumed mistakes in pulmonary tumor diagnosis occurred on chest radiography, only 5% on CT examinations, and the remaining 5% on other imaging studies (4). Awareness of the possible causes for overlooking a pulmonary lesion can help radiologists to reduce the occurrence of this eventuality. In this review, we analyze factors leading to a misdiagnosis of lung cancer mainly on chest radiography, and we discuss the impact of misdiagnosis on prognosis, its medicolegal implications, and methods to reduce the incidence of missed lung cancer. Finally, we briefly analyze the possible causes of errors on CT scans and potential aids. Formerly, different authors recognized the burden of missed lung cancer on radiography of the thorax. Indeed, early studies on the analysis of factors leading to overlooked lung lesions date back to the middle of last century. Despite extensive technological advancement, this issue is currently present and not much has changed since then. Factors that contribute to missed lung cancer on chest X-ray can be classified as deriving from observer error, tumor characteristics, and technical considerations.

European review for medical and pharmacological sciences, 2016

The aim of our study was to compare the apparent diffusion coefficient (ADC) values of pathologic... more The aim of our study was to compare the apparent diffusion coefficient (ADC) values of pathological bowel loops wall (pADC) with the ADC values of normal appearing ones (naADC) and to determine a discriminating threshold. 60 patients were studied at our Institution through a MR-enterography that included free-breathing axial Diffusion Weighted Imaging (DWI) with two b (0 and 800 s/mm2) after histological diagnosis of active Crohn's disease (CD). The one (when unique) or the best analyzable (when multiple) pathological bowel loop was identified in each patient, on the basis of the MRI features: wall thickness, presence of mural oedema and wall contrast enhancement after contrast medium administration. A normal appearing bowel loop was used for comparison. ADC values were measured in consensus by two radiologists, and they were compared with t-test. The ADC threshold value for the differentiation between pathological and normal appearing bowel loops was determined. The pADC values...

Diagnostic and Interventional Radiology, 2014

Hemoptysis is the expectoration of blood that originates from the lower respiratory tract. It is ... more Hemoptysis is the expectoration of blood that originates from the lower respiratory tract. It is usually a self-limiting event but in fewer than 5% of cases it may be massive, representing a life-threatening condition that warrants urgent investigations and treatment. This article aims to provide a comprehensive literature review on hemoptysis, analyzing its causes and pathophysiologic mechanisms, and providing details about anatomy and imaging of systemic bronchial and nonbronchial arteries responsible for hemoptysis. Strengths and limits of chest radiography, bronchoscopy, multidetector computed tomography (MDCT), MDCT angiography and digital subtraction angiography to assess the cause and lead the treatment of hemoptysis were reported, with particular emphasis on MDCT angiography. Treatment options for recurrent or massive hemoptysis were summarized, highlighting the predominant role of bronchial artery embolization. Finally, a guide was proposed for managing massive and nonmassive hemoptysis, according to the most recent medical literature. Hemoptysis has multiple causes usually categorized under parenchymal diseases, airway diseases, and vascular diseases. Bleeding may originate from small or large lung vessels (10). Bleeding from the small vessels usually causes a focal or diffuse alveolar hemorrhage and is mainly due to immunologic, vasculitic, cardiovascular, and coagulatory causes (Table ). Causes of bleeding from the large vessels include infectious, cardiovascular, congenital, neoplastic, and vasculitic diseases (Table ). However, the most frequent diseases causing hemop-From the Department of Radiological Sciences (A.R.L. 

Diagnostic and interventional radiology, Nov 4, 2016

Cesarean section (CS) may have several acute complications that can occur in the early postoperat... more Cesarean section (CS) may have several acute complications that can occur in the early postoperative period. The most common acute complications are hematomas and hemorrhage, infection, ovarian vein thrombosis, uterine dehiscence and rupture. Pelvic hematomas usually occur at specific sites and include bladder flap hematoma (between the lower uterine segment and the bladder) and subfascial or rectus sheath hematoma (rectus sheath or prevescical space). Puerperal hemorrhage can be associated with uterine dehiscence or rupture. Pelvic infections include endometritis, abscess, wound infection, and retained product of conception. Radiologists play an important role in the diagnosis and management of postoperative complications as a result of increasing use of multidetector CT in emergency room. The knowledge of normal and abnormal postsurgical anatomy and findings should facilitate the correct diagnosis so that the best management can be chosen for the patient, avoiding unnecessary surgical interventions and additional treatments. In this article we review the surgical cesarean technique and imaging CT technique followed by description of normal and abnormal post-CS CT findings. MDCT after cesarean delivery: normal and abnormal acute findings • 535 layers, followed by suture of the fascia and the skin.

European review for medical and pharmacological sciences, 2016

OBJECTIVE To evaluate the diagnostic performance of unenhanced MRI (UE-MRI) for malignant breast ... more OBJECTIVE To evaluate the diagnostic performance of unenhanced MRI (UE-MRI) for malignant breast lesions and its reproducibility. PATIENTS AND METHODS We retrospectively included 118 patients who had breast MRI. DWI and STIR images were read in combination and referred to as UE-MRI; the presence or absence of the malignant lesion was noted by two observers. Their results were compared with those of final histopathology or with a two-year negative follow-up for diagnostic performance assessment; ROC curves were built. Diagnostic performance was stratified according to lesion site and size. Interobserver agreement was evaluated through the Cohen's k statistic. RESULTS Specificity of STIR and DWI was 99.3% and 95.7% for Reader 1; 99.3% and 96.4% for Reader 2. Sensitivity was 76.5% and 76.5% for Reader 1; 77.5% and 77.6% for Reader 2. The ROC AUC (Reader 1) was 0.869 and 0.844 for STIR and DWI, respectively (p<0.001 both); for Reader 2, values were 0.874 and 0.853 respectively (p...

Journal of medical imaging and radiation oncology, May 18, 2017

Diagnostic and interventional radiology, Jul 1, 2016

Journal of medical imaging and radiation oncology, May 18, 2017

European Heart Journal, Sep 1, 1996

Diagnostic and interventional radiology, Jul 1, 2016

Radiation Oncology, Jul 10, 2012

Diagnostic and interventional radiology, Jul 7, 2017

Radiology and Oncology, Sep 1, 2013

World Journal of Surgical Oncology, Apr 28, 2012

The European respiratory journal, Oct 31, 2015

The European respiratory journal, Apr 30, 2015

Chinese Journal of Academic Radiology, 2021

Radiotherapy and Oncology, 2016

Diagnostic and Interventional Radiology, 2017

European review for medical and pharmacological sciences, 2016

Diagnostic and Interventional Radiology, 2014

Diagnostic and interventional radiology, Nov 4, 2016

European review for medical and pharmacological sciences, 2016