Mirko D'Onofrio – författare

The second edition of this atlas focuses on imaging methods and techniques, new diagnostic concepts and therapeutic approaches in management of pancreatic neoplasms. Although interest in pancreatic pathology is very high in the radiological and gastroenterological communities, less is known about it than about, for example, liver pathology. Diagnosis depends on the structure of the pancreatic lesion, which can be directly visualized in US, CT or MR images.

The book’s focus is very much on the imaging and pathological appearances, with most of the text concentrated at the beginning of the book followed by images gallery. A comprehensive overview is provided of typical and atypical presentations and diverse aspects of common and rare pancreatic tumors, including ductal adenocarcinomas with dedicated chapter to ductal adenocarcinoma downstaging, neuroendocrine neoplasms, cystic pancreatic neoplasms and intraductal papillary mucinous neoplasms.

The Verona “Pancreas Centre,”the first institute of its kind in Italy and one of very few in the world, pursues an interdisciplinary approach to treating the problems of this organ, focusing on the patient, on research, and on teaching. A dedicated center that can look back on 40 years of tradition, many of its respected specialists have made essential contributions in surgery, gastroenterology, oncology, pathology, and radiology.

Given its scope, this atlas will be an invaluable asset, helping radiologists understand the underlying pathology and helping pancreatic pathologists understand the imaging translation.

With the aid of an extensive series of high-quality images, this atlas describes all the potential applications of elastosonography in routine clinical practice. After a brief introduction on technical and physical aspects, the diagnostic benefits of elastosonography in a range of settings are illustrated with the aid of numerous representative cases. The coverage encompasses pathologies of the liver, spleen, pancreas, kidney, breast, thyroid, testis, musculoskeletal system, and vascular system. In addition, helpful correlations with imaging appearances on ultrasound and computed tomography are included. Elastosonography is a powerful, relatively new diagnostic technique that assesses the elasticity of tissues as an indicator of malignancy. Readers will find this book to be an excellent aid to use and interpretation of the technique.

L’ecografia è una metodica particolarmente indicata per guidare le procedure interventistiche. L’ecografia interventistica viene spesso impiegata per la diagnosi di malattia. Notevoli e rapidi avanzamenti tecnologici hanno portato alla  sempre maggiore diffusione delle procedure interventistiche ecoguidate, modificando in modo significativo le strategie diagnostiche e terapeutiche di molte patologie. Il volume presenta una concisa panoramica delle più comuni procedure interventistiche percutanee e si propone come guida rapida per il radiologo e l’ecografista ai quali, sempre più frequentemente, viene richiesta l’esecuzione di procedure interventistiche su fegato, vie biliari e pancreas sia per fini diagnostici che terapeutici. La trattazione è estesa anche ad altre metodiche di imaging ad integrazione, completamento o quale alternativa alla guida ecografica. Se da un lato è infatti sempre più sentita la necessità di svolgere il ruolo di interventista, dall’altro risulta indispensabile la competenza nella scelta e nell’impiego della metodica più adeguata per la corretta realizzazione della procedura richiesta in relazione allo specifico quesito (diagnosi, terapia e follow-up).

Ultrasonography (US) has long been considered an important diagnostic imaging modality for investigation of the pancreas despite certain significant and well-known limitations. Indeed, in many countries US represents the first step in the diagnostic algorithm for pancreatic pathologies. Recent years have witnessed major advances in conventional, harmonic, and Doppler imaging.

New technologies, softwares, and techniques, such as volumetric imaging, enhancement quantification, and fusion imaging, are increasing the diagnostic capabilities of US. The injection of microbubble contrast agents allows better tissue characterization with definitive differentiation between solid and cystic lesions. Contrast-enhanced US improves the characterization of pancreatic tumors, assists in local and liver staging, and can offer savings in both time and money. Acoustic radiation force impulse (ARFI) imaging is a promising new US method to test, without manual compression, the mechanical strain properties of deep tissues. Furthermore, the applications and indications for interventional, endoscopic, and intraoperative US have undergone significant improvement and refinement.

This book provides a complete overview of all these technological developments and their impact on the assessment of pancreatic pathologies. Percutaneous, endoscopic, and intraoperative US of the pancreas are discussed in detail, with precise description of findings and with informative imaging (CT and MRI) and pathologic correlations.

Although interest in pancreatic pathology is very high in the radiological and gastroenterological communities, it is still the case that less is known about pathology of the pancreas than about liver pathology, for example. Diagnosis depends on the structure of the pancreatic lesion, which can be directly visualized on US, CT or MR images. This atlas, which encompasses both the imaging and the pathology of pancreatic neoplasms, will therefore be invaluable in enabling radiologists and sonographers to understand the underlying pathology and in allowing pancreatic pathologists to understand the imaging translation.

The emphasis in the atlas is very much on the pathological and imaging appearances, with most of the text concentrated at the beginning of the chapters. A comprehensive overview is provided of typical and atypical presentations and diverse aspects of common and uncommon pancreatic neoplasms, including ductal adenocarcinoma, neuroendocrine neoplasms, intraductal papillary mucinous neoplasms, cystic neoplasms, metastases and lymphoma.