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Medicina
Special Issues
Diagnostic Imaging: Recent Advancements and Future Developments
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Diagnostic Imaging: Recent Advancements and Future Developments

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 22 December 2026 | Viewed by 4206

Special Issue Editors

Dr. Alberto Negro

E-Mail Website
Guest Editor
Neuroradiology Unit, Ospedale del Mare, Via Enrico Russo, 80147 Naples, Italy
Interests: brain tumors; segmantatio; radiomics; genomics; olomics
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Fabio Tortora

E-Mail Website
Guest Editor
Department of Advanced Biomedical Sciences, University “Federico II”, Via Pansini, 5, 80131 Naples, Italy
Interests: neuroradiologia; MRI; tumors
Dr. Mario Tortora

E-Mail Website
Guest Editor Assistant
Department of Advanced Biomedical Sciences, Università “Federico II”, 80138 Naples, Italy
Interests: pediatric neuroradiology; fetal radiology; artificial intelligence; machine learning; advanced MRI

Special Issue Information

Dear Colleagues,

Diagnostic imaging has become essential for modern clinical practice. Its role extends far beyond simple visualization—today, imaging is central to diagnosis, disease monitoring, treatment planning, and outcome evaluation. Over the last few decades, this field has evolved rapidly thanks to technological innovations such as high-resolution MRI, CT, ultrasound, and nuclear imaging techniques. More recently, the integration of artificial intelligence and machine learning has revolutionized how imaging data are interpreted, offering the potential for faster, more accurate, and more reproducible diagnostic insights. These advancements are transforming the way we approach personalized medicine and minimally invasive interventions.

This Special Issue, "Diagnostic Imaging: Recent Advancements and Future Developments," aims to highlight the latest scientific and clinical progress in the field of diagnostic imaging. It intends to provide a comprehensive overview of both technological innovation and its practical implications in healthcare. Topics of interest include, but are not limited to, advances in imaging modalities, novel imaging biomarkers, AI-driven diagnostic tools, image-guided therapy, and innovations in radiologic workflow. We also seek to address broader issues such as access to imaging in low-resource settings, the education of imaging professionals, and ethical considerations related to AI and big data in radiology.

We are particularly interested in cutting-edge studies that demonstrate the application of emerging imaging technologies in real-world clinical settings. Examples include the development and validation of AI-based image analysis tools, hybrid imaging techniques (e.g., PET/MRI), functional and molecular imaging, and image-guided precision interventions. Interdisciplinary research that bridges imaging with genomics, pathology, or computational modeling is additionally encouraged; these approaches help pave the way toward the next generation of precision diagnostics.

We welcome the submission of high-quality original research articles that present novel findings in the field of diagnostic imaging and comprehensive review articles that synthesize current knowledge and identify future research directions. Submissions may cover clinical, technical, or theoretical aspects and should be of interest to researchers, clinicians, and healthcare policymakers involved in medical imaging and diagnostics.

Dr. Alberto Negro
Prof. Dr. Fabio Tortora
Guest Editors

Dr. Mario Tortora
Guest Editor Assistant

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 250 words) can be sent to the Editorial Office for assessment.

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. Medicina 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 2200 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.

Keywords

  • diagnostic imaging
  • medical imaging technologies
  • artificial intelligence in radiology
  • imaging biomarkers
  • precision medicine
  • hybrid imaging (e.g., PET/MRI, PET/CT)
  • image-guided interventions
  • radiomics and machine learning
  • functional and molecular imaging
  • clinical applications of imaging

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Published Papers (4 papers)

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11 pages, 357 KB  
Article
Carotid Plaque Characteristics Evaluation on DUS and MDCTA: Interobserver and Intermodality Agreement in a Single-Center Study
by Perica Mutavdzic, Tijana Kokovic, Branko Gakovic, David Matejević, Ivan Tomić, Miloš Sladojević, Aleksandar Tomic and Igor Koncar
Medicina 2026, 62(4), 724; https://doi.org/10.3390/medicina62040724 - 10 Apr 2026
Viewed by 374
Abstract
Background and Objectives: Carotid artery stenosis has traditionally guided therapeutic decision-making; however, plaque morphology and composition are increasingly recognized as more reliable indicators of cerebrovascular risk than luminal narrowing alone. As imaging strategies shift toward vulnerability-based assessment, reproducibility of plaque characterization becomes [...] Read more.
Background and Objectives: Carotid artery stenosis has traditionally guided therapeutic decision-making; however, plaque morphology and composition are increasingly recognized as more reliable indicators of cerebrovascular risk than luminal narrowing alone. As imaging strategies shift toward vulnerability-based assessment, reproducibility of plaque characterization becomes essential for consistent clinical decision-making. This study aimed to evaluate interobserver agreement in carotid plaque assessment using multidetector computed tomography angiography (MDCTA) and to assess intermodality agreement with duplex ultrasonography (DUS). Materials and Methods: In this single-center study (January–September 2022), 50 patients with ≥60% internal carotid artery stenosis diagnosed by DUS (NASCET criteria), the majority of whom were asymptomatic (90%), were included. MDCTA examinations were independently analyzed by two radiologists, while DUS examinations were evaluated by a third observer. Plaque composition (lipid, fibrous, calcified), surface characteristics (regular, irregular, ulcerated), degree of stenosis, and plaque length were assessed. CT plaque characterization was based on Hounsfield unit (HU) thresholds (<50 HU lipid; 50–120 HU fibrous; >120 HU calcified). Interobserver agreement and intermodality agreement were calculated using Cohen’s kappa coefficient. Results: Good interobserver agreement was observed between the two MDCTA readers (κ = 0.751). Intermodality agreement between MDCTA and DUS was moderate (κ = 0.624 and κ = 0.595). Although significant differences were identified in 3 of 16 HU measurement points, no significant differences were found in overall plaque composition classification between MDCTA observers. DUS yielded significantly higher stenosis values (p = 0.007 and p = 0.005) and greater plaque length measurements (p < 0.0005) compared with MDCTA. Significant differences were also observed in plaque surface assessment between modalities (p = 0.044 and p = 0.033). Conclusions: MDCTA demonstrates good interobserver reproducibility for carotid plaque characterization, while intermodality agreement between MDCTA and DUS is moderate. Minor attenuation measurement differences do not significantly affect plaque classification; however, systematic intermodality differences in stenosis grading, plaque surface evaluation, and plaque length measurement should be considered in clinical decision-making. Full article
(This article belongs to the Special Issue Diagnostic Imaging: Recent Advancements and Future Developments)
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12 pages, 1526 KB  
Article
Added Value of Thin-Section Coronal DWI for Lesion Visualization in Acute Brainstem Infarction: A Retrospective Analysis
by Alberto Negro, Mario Tortora, Ivano Palladino, Laura Gemini, Ciro Riccio, Francesco Pacchiano, Laura Lombardi, Raffaele Iaccarino, Stefano Bianco, Gianvito Pace, Simone Cepparulo, Arturo De Falco, Fabio Tortora, Giuseppe Buono and Vincenzo D’Agostino
Medicina 2026, 62(4), 635; https://doi.org/10.3390/medicina62040635 - 26 Mar 2026
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Abstract
Background and Objectives: Brainstem infarctions remain challenging to identify due to their small size, complex anatomy, and known limitations of conventional axial diffusion-weighted imaging (DWI), particularly in the posterior fossa. Thin-section coronal DWI may improve lesion conspicuity by providing higher spatial resolution and [...] Read more.
Background and Objectives: Brainstem infarctions remain challenging to identify due to their small size, complex anatomy, and known limitations of conventional axial diffusion-weighted imaging (DWI), particularly in the posterior fossa. Thin-section coronal DWI may improve lesion conspicuity by providing higher spatial resolution and an orthogonal imaging perspective. To evaluate whether 3 mm thin-section coronal DWI improves lesion visualization and delineation compared with standard 4 mm axial DWI in patients with MRI-confirmed acute brainstem infarction. Materials and Methods: In this retrospective single-center study, 125 consecutive patients with isolated brainstem infarction confirmed by MRI (January 2021–January 2024) were included. All patients underwent both axial and coronal DWI acquisitions. Lesions were classified by anatomical location and by the imaging plane providing better visualization (“coronal better” vs. “equal”). Lesion volumes were calculated using manual segmentation. Image interpretation was performed independently by two neuroradiologists. Interobserver agreement was assessed using Cohen’s kappa and intraclass correlation coefficient (ICC). Statistical analysis included both parametric and nonparametric tests, with confidence intervals reported. Results: Coronal DWI provided improved or equivalent lesion visualization in all cases. Improved visualization was most frequent in midbrain infarctions (100%) and in a subset of medullary lesions (26.7%). Lesions better visualized on coronal DWI were significantly smaller than those equally visualized (mean volume ~0.23 mL vs. ~0.55 mL, p < 0.0001). Twelve midbrain and eight medullary lesions were identified only on coronal DWI within the imaging protocol, all showing confirmation on ADC and/or FLAIR correlation. Interobserver agreement was substantial to excellent. Conclusions: Thin-section coronal DWI improves visualization and delineation of small brainstem infarctions, particularly in anatomically compact regions. These findings support its role as a complementary sequence rather than a replacement for standard axial imaging. Full article
(This article belongs to the Special Issue Diagnostic Imaging: Recent Advancements and Future Developments)
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13 pages, 656 KB  
Article
Quantitative and Qualitative MRI Assessment of Perivascular Spaces in Parkinson’s Disease Patients
by Evelina Stagisa, Arturs Silovs, Gvido Karlis Skuburs, Nauris Zdanovskis, Aleksejs Sevcenko, Janis Mednieks, Edgars Naudins, Santa Bartusevica, Solvita Umbrasko, Liga Zarina, Laura Zelge, Agnese Anna Pastare, Jelena Smilga, Jurgis Skilters, Baingio Pinna and Ardis Platkajis
Medicina 2026, 62(4), 613; https://doi.org/10.3390/medicina62040613 - 24 Mar 2026
Viewed by 553
Abstract
Background and Objectives: Enlarged perivascular spaces (ePVS) demonstrated by MRI have recently been associated with cerebral small vessel disease and glymphatic dysfunction, implicated in Parkinson’s disease (PD) pathophysiology. This study aimed to quantify the burden of ePVS in PD patients versus healthy [...] Read more.
Background and Objectives: Enlarged perivascular spaces (ePVS) demonstrated by MRI have recently been associated with cerebral small vessel disease and glymphatic dysfunction, implicated in Parkinson’s disease (PD) pathophysiology. This study aimed to quantify the burden of ePVS in PD patients versus healthy controls and to examine associations with cognitive performance. Materials and Methods: A total of 51 participants underwent 3T MRI, including a T2-weighted sequence. Twenty-one patients with Parkinson’s disease and 21 age-matched healthy controls were included in the final analysis. The ePVS burden was assessed quantitatively by counting visible PVS in the basal ganglia and centrum semiovale, and qualitatively using Potter and Heier rating scales. Cognitive function was measured with the Montreal Cognitive Assessment (MoCA). Statistical analyses used Mann–Whitney U tests and Spearman correlations. Results: PD patients had significantly higher total PVS counts in the basal ganglia (84.8 vs. 48.0; p < 0.001) and centrum semiovale (290.6 vs. 143.9; p < 0.001). Potter scale ratings were higher in PD across regions (p ≤ 0.025). Largest per-slice PVS counts negatively correlated with MoCA scores in right basal ganglia (ρ = −0.362, p = 0.012) and bilateral centrum semiovale (right: ρ = −0.421, p = 0.003; left: ρ = −0.431, p = 0.002). Heier scale differences were significant only in the right centrum semiovale (p = 0.023). PVS diameters were larger in PD only in the centrum semiovale (right: p = 0.010; left: p = 0.040). Conclusions: In this cohort, increased ePVS burden in the basal ganglia and centrum semiovale was associated with cognitive impairment in PD patients. Qualitative and quantitative PVS assessment, notably the largest-per-slice counts, may serve as a sensitive, non-invasive imaging biomarker for neurodegeneration and cognitive decline in PD. Larger group studies and longitudinal data are needed to assess their prognostic value in the long term, as well as the development of automatic quantification applications for better reproducibility. Full article
(This article belongs to the Special Issue Diagnostic Imaging: Recent Advancements and Future Developments)
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16 pages, 1430 KB  
Systematic Review
Diagnostic Accuracy of Non-Contrast CT for Acute Appendicitis in the Emergency Department: A Systematic Review and Meta-Analysis
by Se Kwang Oh
Medicina 2025, 61(12), 2163; https://doi.org/10.3390/medicina61122163 - 4 Dec 2025
Viewed by 2345
Abstract
Background and Objectives: Contrast-enhanced computed tomography (CT) is widely regarded as the gold standard for diagnosing acute appendicitis. However, the use of contrast agents may be contraindicated in patients with renal impairment or a history of allergic reactions. Non-contrast CT (NCCT) offers a [...] Read more.
Background and Objectives: Contrast-enhanced computed tomography (CT) is widely regarded as the gold standard for diagnosing acute appendicitis. However, the use of contrast agents may be contraindicated in patients with renal impairment or a history of allergic reactions. Non-contrast CT (NCCT) offers a potential alternative, but its diagnostic performance has been variably reported across studies. This systematic review and meta-analysis aimed to evaluate the pooled diagnostic accuracy of NCCT in detecting acute appendicitis. Materials and Methods: A comprehensive literature search was conducted across PubMed, Ovid MEDLINE, EMBASE, Cochrane Library, and Google Scholar from inception to June 2025. Studies assessing the diagnostic accuracy of NCCT for acute appendicitis were included. Pooled sensitivity, specificity, and area under the hierarchical summary receiver operating characteristic (HSROC) curve were estimated using a bivariate random-effects model. Study quality was assessed with the QUADAS-2 tool, and publication bias was evaluated using Deeks’ funnel plot asymmetry test. Results: Eleven studies comprising 1996 patients met the inclusion criteria. The pooled sensitivity and specificity of NCCT were 0.93 (95% confidence interval; CI, 0.91–0.95) and 0.97 (95% CI, 0.95–0.97), respectively. The area under the HSROC curve was 0.89 (95% CI, 0.83–0.96), indicating moderate diagnostic performance. Heterogeneity was moderate for sensitivity (I2 = 48.2%) and substantial for specificity (I2 = 77.6%), likely due to differences in study populations and CT acquisition protocols. No significant publication bias was detected (Deeks’ test, p = 0.079). Conclusions: NCCT demonstrates moderate diagnostic accuracy for detecting acute appendicitis and offers a practical alternative for patients who cannot receive contrast media. Its safety and rapid applicability make NCCT a useful imaging option in emergency settings, especially when contrast use is limited. Full article
(This article belongs to the Special Issue Diagnostic Imaging: Recent Advancements and Future Developments)
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