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Life
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Imaging of Gastrointestinal Diseases: Issues and Challenges
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Imaging of Gastrointestinal Diseases: Issues and Challenges

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 15270

Special Issue Editors

Prof. Dr. Savino Cilla

E-Mail Website
Guest Editor
Gemelli Molise Hospital, 86100 Campobasso, Italy
Interests: imaging; medical physics; radiation oncology; artificial intelligence
Dr. Antonio Pierro

E-Mail Website
Guest Editor
Gemelli Molise Hospital, 86100 Campobasso, Italy
Interests: oncological imaging; cardiovascular imaging; abdominal imaging

Special Issue Information

Dear Colleagues,

Recent technological advances in non-invasive modalities including magnetic resonance imaging (MRI), ultrasound (US), computed tomography (CT), and positron emission tomography (PET) have profoundly changed the diagnosis of gastrointestinal diseases. Major improvements in imaging resolution, 3D imaging, co-registration modalities and contrast-enhancement techniques have substantially modified the approach to the evaluation of the gastrointestinal tract. In addition, the emerging field of radiomics allows the quantification of lesion heterogeneity on radiological images, extracting additional data that cannot be assessed by visual analysis.  

This Special Issue aims to address all clinical and diagnostic innovations used in the diagnosis of gastrointestinal diseases. We welcome manuscripts addressing the wide range of high-quality radiological investigations to explore the detailed morphology, biomechanical properties, function and pathology of the gastrointestinal tract. Moreover, papers focused on enhancing the training and implementation of these techniques in clinical routine will be especially appreciated.

Dr. Savino Cilla
Dr. Antonio Pierro
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Published Papers (6 papers)

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Research

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13 pages, 3925 KiB  
Article
High Concordance of CT Colonography and Colonoscopy Allows for the Distinguishing and Diagnosing of Intestinal Diseases
by Lyubomir Chervenkov, Nikolay Sirakov, Aleksander Georgiev, Dimitrina Miteva, Milena Gulinac, Monika Peshevska-Sekulovska, Metodija Sekulovski and Tsvetelina Velikova
Life 2023, 13(9), 1906; https://doi.org/10.3390/life13091906 - 13 Sep 2023
Cited by 2 | Viewed by 1333
Abstract
(1) Although new imaging methods for examining the GIT with high diagnostic capabilities were introduced, the improvement and implementation of safe, efficient, and cost-effective approaches continue, and GIT diseases are still challenging to diagnose; (2) Methods: We aim to show the possibilities of [...] Read more.
(1) Although new imaging methods for examining the GIT with high diagnostic capabilities were introduced, the improvement and implementation of safe, efficient, and cost-effective approaches continue, and GIT diseases are still challenging to diagnose; (2) Methods: We aim to show the possibilities of computed tomography (CT) colonography for early diagnosis of colon diseases using a multidetector 32-channel CT scanner after appropriate preparation; (3) Results: After a colonoscopy was performed earlier, 140 patients were examined with CT colonography. Complete colonoscopy was performed in 80 patients (57.1%) out of 140 who underwent CT colonography. Incomplete colonoscopy was observed in 52 patients (37.2%); in 5 patients (3.6%), it was contraindicated, and in 3 patients (2.1%), it was not performed because of patients’ refusal. We determined that in cases of complete FCS in 95% of patients, CT colonography established the same clinical diagnosis as FCS. In cases of incomplete, refused, or contraindicated FCS in 32.7% (17 patients), FCS failed to diagnose correctly. The main reasons for incomplete colonoscopy were: intraluminal obturation of tumor nature-17 patients (33%), extraluminal obturation (compression) from a tumor formation-4 patients (8%), stenotic changes of non-tumor nature-11 patients (21%), congenital diseases with changes in the length of the lumen of the intestinal loops-7 patients (13%), and subjective factors (pain, poor preparation, contraindications) in 13 patients (25%); (4) Conclusions: Our results confirmed that CT colonography is a method of choice in cases of negative FCS results accompanied by clinical data for the neoplastic process and in cases of incomplete and contraindicated FCS. Also, the insufflation system we developed optimizes the method by improving the quality of the obtained images and ensuring good patient tolerance. Full article
(This article belongs to the Special Issue Imaging of Gastrointestinal Diseases: Issues and Challenges)
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Review

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29 pages, 1490 KiB  
Review
Precision Endoscopy in Peroral Myotomies for Motility Disorders of the Upper Gastrointestinal Tract: Current Insights and Prospective Avenues—A Comprehensive Review
by Francesco Vito Mandarino, Edoardo Vespa, Alberto Barchi, Ernesto Fasulo, Emanuele Sinagra, Francesco Azzolini and Silvio Danese
Life 2023, 13(11), 2143; https://doi.org/10.3390/life13112143 - 31 Oct 2023
Cited by 1 | Viewed by 1599
Abstract
Our review delves into the realm of peroral endoscopic myotomies (POEMs) in the upper gastrointestinal tract (UGT). In recent years, POEMs have brought about a revolution in the treatment of UGT motility disorders. Esophageal POEM, the first to be introduced, has now been [...] Read more.
Our review delves into the realm of peroral endoscopic myotomies (POEMs) in the upper gastrointestinal tract (UGT). In recent years, POEMs have brought about a revolution in the treatment of UGT motility disorders. Esophageal POEM, the first to be introduced, has now been validated as the primary treatment for achalasia. Subsequently developed, G-POEM displays promising results in addressing refractory gastroparesis. Over time, multiple endoscopic myotomy techniques have emerged for the treatment of Zenker’s diverticulum, including Z-POEM, POES, and hybrid approaches. Despite the well-established efficacy outcomes, new challenges arise in the realm of POEMs in the UGT. For esophageal POEM, the future scenario lies in customizing the myotomy extent to the minimum necessary, while for G-POEM, it involves identifying patients who can optimally benefit from the treatment. For ZD, it is crucial to validate an algorithm that considers various myotomy options according to the diverticulum’s size and in relation to individual patients. These challenges align with the concept of precision endoscopy, personalizing the technique for each subject. Within our text, we comprehensively examine each myotomy technique, analyzing indications, outcomes, and adverse events. Additionally, we explore the emerging challenges posed by myotomies within the context of the evolving field of precision endoscopy. Full article
(This article belongs to the Special Issue Imaging of Gastrointestinal Diseases: Issues and Challenges)
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27 pages, 20243 KiB  
Review
Small Bowel Imaging from Stepchild of Roentgenology to MR Enterography, Part II: The Reliable Disclosure of Crohn’s Disease and Non-Inflammatory Small Bowel Disorder Plot through MRI Findings
by Antonio Pierro, Laura Maria Minordi, Luigi Larosa, Carla Cipri, Giulia Guerri, Fabio Quinto, Fabio Rotondi, Annalisa Marcellino, Raffaella Basilico, Roberto Iezzi and Savino Cilla
Life 2023, 13(9), 1836; https://doi.org/10.3390/life13091836 - 30 Aug 2023
Cited by 1 | Viewed by 2776
Abstract
MRE has become a standard imaging test for evaluating patients with small bowel pathology, but a rigorous methodology for describing and interpreting the pathological findings is mandatory. Strictures, abscess, inflammatory activity, sinus tract, wall edema, fistula, mucosal lesions, strictures, and mesentery fat hypertrophy [...] Read more.
MRE has become a standard imaging test for evaluating patients with small bowel pathology, but a rigorous methodology for describing and interpreting the pathological findings is mandatory. Strictures, abscess, inflammatory activity, sinus tract, wall edema, fistula, mucosal lesions, strictures, and mesentery fat hypertrophy are all indicators of small bowel damage in inflammatory and non-inflammatory small bowel disease, and they are all commonly and accurately explained by MRE. MRE is a non-invasive modality that accurately assesses the intra-luminal, parietal, and extra-luminal small bowel. Differential MRE appearance allows us to distinguish between Crohn’s disease and non-inflammatory small bowel disorder. The purpose of this paper is to present the MRE pathological findings of small bowel disorder. Full article
(This article belongs to the Special Issue Imaging of Gastrointestinal Diseases: Issues and Challenges)
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23 pages, 1068 KiB  
Review
Imaging in Gastroparesis: Exploring Innovative Diagnostic Approaches, Symptoms, and Treatment
by Francesco Vito Mandarino, Sabrina Gloria Giulia Testoni, Alberto Barchi, Francesco Azzolini, Emanuele Sinagra, Gino Pepe, Arturo Chiti and Silvio Danese
Life 2023, 13(8), 1743; https://doi.org/10.3390/life13081743 - 14 Aug 2023
Cited by 3 | Viewed by 5603
Abstract
Gastroparesis (GP) is a chronic disease characterized by upper gastrointestinal symptoms, primarily nausea and vomiting, and delayed gastric emptying (GE), in the absence of mechanical GI obstruction. The underlying pathophysiology of GP remains unclear, but factors contributing to the condition include vagal nerve [...] Read more.
Gastroparesis (GP) is a chronic disease characterized by upper gastrointestinal symptoms, primarily nausea and vomiting, and delayed gastric emptying (GE), in the absence of mechanical GI obstruction. The underlying pathophysiology of GP remains unclear, but factors contributing to the condition include vagal nerve dysfunction, impaired gastric fundic accommodation, antral hypomotility, gastric dysrhythmias, and pyloric dysfunction. Currently, gastric emptying scintigraphy (GES) is considered the gold standard for GP diagnosis. However, the overall delay in GE weakly correlates with GP symptoms and their severity. Recent research efforts have focused on developing treatments that address the presumed underlying pathophysiological mechanisms of GP, such as pyloric hypertonicity, with Gastric Peroral Endoscopic Myotomy (G-POEM) one of these procedures. New promising diagnostic tools for gastroparesis include wireless motility capsule (WMC), the 13 carbon-GE breath test, high-resolution electrogastrography, and the Endoluminal Functional Lumen Imaging Probe (EndoFLIP). Some of these tools assess alterations beyond GE, such as muscular electrical activity and pyloric tone. These modalities have the potential to characterize the pathophysiology of gastroparesis, identifying patients who may benefit from targeted therapies. The aim of this review is to provide an overview of the current knowledge on diagnostic pathways in GP, with a focus on the association between diagnosis, symptoms, and treatment. Full article
(This article belongs to the Special Issue Imaging of Gastrointestinal Diseases: Issues and Challenges)
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15 pages, 11579 KiB  
Review
Small Bowel Imaging from Stepchild of Roentgenology to MR Enterography: Part I: Guidance in Performing and Observing Normal and Abnormal Imaging Findings
by Antonio Pierro, Laura Maria Minordi, Luigi Larosa, Giulia Guerri, Alessandro Grimaldi, Fabio Quinto, Fabio Rotondi, Annalisa Marcellino, Teresa Bevere, Raffaella Basilico, Roberto Iezzi and Savino Cilla
Life 2023, 13(8), 1691; https://doi.org/10.3390/life13081691 - 5 Aug 2023
Cited by 2 | Viewed by 2006
Abstract
MRE has become a standard imaging test for evaluating patients with small bowel pathology, but the indications, interpretation of imaging findings, methodology, and appropriate use must be standardized and widely known. Several signs of small bowel damage in inflammatory and non-inflammatory small bowel [...] Read more.
MRE has become a standard imaging test for evaluating patients with small bowel pathology, but the indications, interpretation of imaging findings, methodology, and appropriate use must be standardized and widely known. Several signs of small bowel damage in inflammatory and non-inflammatory small bowel pathology include strictures, abscess, inflammatory activity, sinus tract, wall edema, fistula, mucosal lesions, and mesentery fat hypertrophy, all of which are widely and accurately explained by MRE. MRE is a non-invasive modality that accurately assesses the intra-luminal, parietal, and extra-luminal small bowel. The differential MRE appearance allows us to distinguish between different small bowel pathologies, such as neoplastic and non-neoplastic small bowel diseases. The purpose of this paper is to present the MRE technique, as well as the interpretation of imaging findings, through the approach of a rigorous stepwise methodology. Full article
(This article belongs to the Special Issue Imaging of Gastrointestinal Diseases: Issues and Challenges)
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Other

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8 pages, 265 KiB  
Brief Report
Capsule Enteroscopy Using the Mirocam® versus OMOM® Systems: A Matched Case–Control Study
by Maria Manuela Estevinho, Rolando Pinho, Adélia Rodrigues, Ana Ponte, João Correia, Pedro Mesquita and Teresa Freitas
Life 2023, 13(9), 1809; https://doi.org/10.3390/life13091809 - 25 Aug 2023
Cited by 1 | Viewed by 1074
Abstract
Although several devices are available for small bowel capsule endoscopy, few studies have compared their visualization quality and diagnostic yield, despite users reporting subjective differences between them. This study aims to compare two widely used systems (Mirocam® MC1600 and OMOM® HD). [...] Read more.
Although several devices are available for small bowel capsule endoscopy, few studies have compared their visualization quality and diagnostic yield, despite users reporting subjective differences between them. This study aims to compare two widely used systems (Mirocam® MC1600 and OMOM® HD). Patients who underwent OMOM® HD capsule enteroscopy between August 2022 and February 2023 were prospectively included consecutively (cases). Controls were retrospectively selected from a database of patients who underwent Mirocam® MC1600 enteroscopy between March 2018 and July 2022 in a 1:1 ratio. Controls were matched for potential confounders (age, sex, indication, hospitalization, comorbidities, and opioid prescription). The small bowel cleanliness (global and divided by tertiles), the diagnostic yield (positive findings) and the transit times (TT) were compared. Overall, 214 patients were included (107:107). Global bowel preparation was similar between the OMOM® and Mirocam® groups. However, the average scores for each tertile were significantly higher when the OMOM® HD capsule was used (p < 0.05). Small bowel TT was shorter for OMOM® HD (265 ± 118 versus 307 ± 87 min, p = 0.020), while the diagnostic yield (55.0%) and relative distribution of lesions were similar. This study suggests that capsule characteristics, namely resolution, and illumination, systematically interfere with the perception of preparation quality. However, this did not affect the diagnostic yield. Full article
(This article belongs to the Special Issue Imaging of Gastrointestinal Diseases: Issues and Challenges)
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