Radiology

Radiology_2

The Radiology Department of the Ospedale San Raffaele provides clinical services in diagnostic radiology, interventional radiology, ultrasound, CT scan, magnetic resonance imaging and breast imaging.

A team of hard working and experienced diagnostic and interventional radiologists, along with the latest technologies available in the radiologic field, is what the Department’s excellence is based on. The Radiology staff is involved 24 hours a day, 7 days per week, both in diagnostic and emergency activities. The strict cooperation with the San Raffaele Vita-Salute University adds teaching and research activities to the clinical background of our Department that enrich the educational experience and create a multidisciplinary collaborative research environment. The Radiology Department of the Ospedale San Raffaele also provides its Clinicians and Residents with a Preclinical Imaging Centre, which gives the opportunity to conduct preclinical research using the 7-Tesla Magnetic Resonance Imaging and High-Frequency Ultrasound Imaging Unit. Staff radiologists also collaborate with Nuclear Medicine Specialists (PET/CT) in order to obtain and interpret PET and CT scans simultaneously. Multidisciplinary professional teams collaborate on patients’ clinical and surgical planning in daily clinical scenarios.

Main conditions treated

Diagnostic Radiology includes:

  • Conventional X-ray examinations (chest, abdomen, skeleton) and contrast studies before and after surgery.
  • Emergency radiology: ultrasound examinations and eco-FAST, CT and interventional post traumatic procedures performed by radiologist.
  • Ultrasound and colour-Doppler examinations include pediatric ultrasonography, neck and thyroid diagnostic assessment with fine needle aspiration cytology, kidney and liver examination and US-guided procedures/ biopsies.
  • Computed Tomography unit performs a daily high workflow including oncologic evaluation body scans, emergency post-traumatic examinations and chest high-resolution imaging; CT guided biopsies are also frequently performed on lung and bones. Cardiac CT scans are also performed.
  • Magnetic Resonance Imaging unit carries out daily multiorgan routine examinations, with an improving oncologic field with application of innovative contrast media and DWI techniques, and a solid experience in cardiovascular MRI, neck examination and prostatic cancer study. Cardiac MR scans are also performed with high experience.
  • PET/CT provides a morpho-functional powerful tool, mainly in the oncologic field
  • Breast unit has a multidisciplinary experience based on ultrasound, x-ray and MR examinations, associated with Us and MR fine needle, biopsy and vacuum-assisted sample taking.

Interventional Radiology includes:

  • Interventional oncology: locoregional treatments of Liver Cancer and Hepatic Metastases (Chemoembolization, Radiofrequency and Microwave Ablation, Alcoholization), kidney masses ablation.
  • Vascular procedures: embolization of visceral bleeding in emergent situations, Embolization or endovascular exclusion (stenting) of visceral aneurisms; embolization or alcoholization of arteriovenous malformations (MAV); diabetic renal and peripheral obstructive arterial disease treated with angioplasty and stenting, treatment of A-V fistulas stenosis in uremic patients for dialysis treatment
  • Liver/biliary interventions: Obstructive Jaundice and post-surgical biliary fistulas treated with biliary drainages; biliary dilatation and/or placement of biliary stents; trans Jugular Intra-hepatic Porto-systemic Shunt (TIPSS) in the treatment of refractory portal vein hypertension leading to complications such as ascites, gastrointestinal bleeding, porto-systemic encephalopathy; treatment of brittle type I Diabetes with percutaneous intraportal pancreatic islet transplantation.
  • Urological interventions: obstructive nephropathy managed by positioning of nephrostomies, ureteral stents or ureter dilatations.

Research

Clinical trials Clinical research application include cardiovascular analysis, oncologic treatment monitoring and perfusion/diffusion MR techniques. In detail:

  • Cardiac MR (infarction, myocarditis, muscular dystrophies, hypertrophic cardiomyopathy)
  • Cardiac MR and CT in ventricular tachycardia
  • Liver MR perfusion changes occurring during pancreatic islet engraftment
  • MR perfusion and diffusion techniques as diagnostic and prognostic biomarkers in oncologic imaging for gastro-esophageal, rectal, prostatic, endometrial and breast cancer
  • Perfusion and diffusion MR techniques in polymyositis
  • Breast cancer screening and breast MR imaging
  • Safety and efficacy assessment of transarterial chemoembolization of liver metastases (colorectal cancer, cholangiocarcinoma, melanoma)
  • Efficacy of muscular stem cell (mesoangioblasts) intra-arterial infusion in children affected by Duchenne’s Muscular Distrophy
  • Efficacy of percutaneous intraportal pancreatic islet transplantation in the treatment of brittle type I Diabetes.
  • Development of new techniques in targeting of imaging guided radiotherapy

Preclinical Trials Several MR and US experiments has been performed in collaboration with different research groups, for scanners validation and technical development, in the subsequent fields of preclinical research:

  • Quantitative Magnetic Resonance monitoring of acute muscle damage/healing process through diffusion tensor imaging and T2-maps assessment
  • Quantitative Magnetic Resonance assessment of muscle alterations in different chronic myopathies
  • Magnetic Resonance follow-up of iron labelled pancreatic islets
  • Non-invasive Magnetic Resonance phenotypization of mouse models of chronic hepatitis/hepatocellular carcinoma (HCC)
  • Non-invasive Magnetic Resonance phenotypization of mouse models of liver metastases
  • Non-invasive Magnetic Resonance volumetric and diffusion assessment of prostate cancer in TRAMP mice
  • Magnetic Resonance Imaging of Embryonic Stem Cells
  • Non-invasive Magnetic Resonance assessment of cartilage repair
  • Magnetic Resonance and Ultrasound functional and volumetric assessment of the heart in mice
  • Magnetic Resonance imaging of a cerebral ischemic stroke model
  • Characterization of mouse models of neuroferrinopathies
  • US-guided mouse cerebellum puncture (cells/molecules delivery to cure type 2 spinocerebellar ataxia).
  • US-guided mouse intra-cardiac (intra-arterial) stem cells administration.
  • CDUS characterization of mouse bladder cancer (improving through intravesical chemotherapy based on exploitation of cannabinoid system).
  • Characterization by Contrast-enhanced US of mouse models with diabetic nephropathy.

Technology

The Radiology Department takes advantage of state-of-the-art technologies, in particular two 1.5 T magnetic resonances, two CT systems, nine ultrasound systems, an X-ray angiographic suite, two x-ray mammographs and ten x-ray systems. Radiologists also work on different PET/CT systems located in Nuclear Medicine.

The Preclinical Experimental imaging Center facility grounds itself on a 7T magnetic resonance unit and a high frequency ultrasound unit.

Staff

Prof. Alessandro Del Maschio is Head of Radiology Department and San Raffaele Vita–Salute University Rector. Francesco De Cobelli, Head of the Magnetic Resonance Imaging Unit; Associate Professor of Radiology at Vita–Salute University; Director of the Radiology Residency Postgraduate Program; Head of Clinical and Experimental Radiology Unit of the Experimental Imaging Center. Maurizia Del Maschio, Head of the Conventional and Digital Radiology Unit. Roberto Nicoletti, Head of the Computed Tomography Unit. Pierluigi Paesano, Head of the Ultrasound Unit. Maria Grazia Rodighiero, Head of the Breast Imaging Unit. Massimo Venturini, Head of the Vascular and Interventional Radiology Unit. Antonio Esposito, Radiologist, Assistant Professor of Radiology at Vita – Salute University, Vice-Director of the Experimental Imaging Center; Head of the Preclinical MR Unit. Radiologists: Laura Brasca, Maria Giulia Crespi, Angela De Gaspari, Elda Garuti, Domenico Ghio, Simone Gusmini, Claudio Losio, Carlo Martinenghi, Renata Mellone, Silvia Ravelli, Marco Salvioni, Elena Schiani, Simona Tacchini and Roberto Varagona. Elena Contrino, Endocrinologist and Ultrasonography Consultant. In the Department of Radiology are also working over 20 Specialty Resident Physicians, 35 Techologists and Radiographers and 50 nurses.