Table Of ContentPractical Issues in Geriatrics
Series Editor: Stefania Maggi
Giuseppe Guglielmi
Mario Maas Editors
Imaging in
Geriatrics
Practical Issues in Geriatrics
Series Editor
Stefania Maggi, Aging Branch
CNR-Neuroscience Institute, Padua, Italy
This practically oriented series presents state of the art knowledge on the principal
diseases encountered in older persons and addresses all aspects of management,
including current multidisciplinary diagnostic and therapeutic approaches. It is
intended as an educational tool that will enhance the everyday clinical practice of
both young geriatricians and residents and also assist other specialists who deal
with aged patients. Each volume is designed to provide comprehensive information
on the topic that it covers, and whenever appropriate the text is complemented by
additional material of high educational and practical value, including informative
video-clips, standardized diagnostic flow charts and descriptive clinical cases.
Practical Issues in Geriatrics will be of value to the scientific and professional
community worldwide, improving understanding of the many clinical and social
issues in Geriatrics and assisting in the delivery of optimal clinical care.
Giuseppe Guglielmi • Mario Maas
Editors
Imaging in Geriatrics
Editors
Giuseppe Guglielmi Mario Maas
Clinical and Experimental Medicine Department of Radiology and Nuclear
University of Foggia Medicine
Foggia, Italy University of Amsterdam
Amsterdam, Noord-Holland
The Netherlands
ISSN 2509-6060 ISSN 2509-6079 (electronic)
Practical Issues in Geriatrics
ISBN 978-3-031-14876-7 ISBN 978-3-031-14877-4 (eBook)
https://doi.org/10.1007/978-3-031-14877-4
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2023
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Preface
Demographic changes, due to the longer lifespan and the improvement of the qual-
ity of life, led to an aging society, where developing high-quality healthcare for
older people becomes increasingly important.
Nowadays the elderly population is more informed and more demanding of bet-
ter care through cutting-edge technology and treatment. Specifically, radiologists
play an increasingly important role and occupy a frontline position in the evaluation
of this cohort of patients, who necessitate definitive imaging.
In this perspective, the complex relationship between geriatrics and radiology
must be redefined. Imaging in Geriatrics is the result of a teamwork of radiologists,
experts in the field, with the aim to provide guidance for the appropriate use of
imaging in modern geriatric care, describing how to recognize pathology from para-
physiological findings in the elderly population.
The study of diagnostic imaging in geriatrics, enriched by traditional and modern
imaging methods, is primarily oriented to the clinical and radiological analysis most
frequently encountered in these patients and, above all, to the not easy distinction
between “normal” and “pathological,” especially in situations in which para-physi-
ological changes resulting from aging processes are associated with alterations
related to comorbidity and chronicity.
This volume includes a multidisciplinary approach, and it covers all major medi-
cal issues related to aging, divided by apparatus. In particular, it encloses the main
pathologies in the neurological, cardiovascular, pulmonary, gastrointestinal, uro-
genital, hematologic, and musculoskeletal field.
This book considers all imaging techniques that have been the cornerstones of
radiology, but also modern innovations. Conventional radiography is still the first
approach in the diagnosis of a frequent variety of pathological conditions of elderly
patients, such as fractures, often due to osteoporosis, pneumothorax, or heart fail-
ure. On the other hand, Computer Tomography (CT), with its intrinsic resolution
power, allows radiologists to detect a possible ischemic or hemorrhagic cerebral
focus, as well as neoplastic metastases for the staging of the primary pathology.
Spinal cord injuries are best identified with Magnetic Resonance Imaging (MRI).
But nowadays, and therefore modern “tailored” medicine, is changing, going
towards Artificial Intelligence (AI), a technological evolution that brings with it the
limits related to the training and updating of the healthcare personnel involved. For
v
vi Preface
this reason, a section about the role of AI in the management of geriatric patients
could not be missed at the end of this volume.
Finally, the aim of this book is to simplify the approach and the diagnostic imag-
ing process of geriatric diseases, bringing out the potential and limitations of each
imaging technique.
We recommend the reading of this book not only to radiologists for their daily
clinical practice but also to all physicians who require a basic knowledge of imaging
concerning the main geriatric pathologies, because of their complex clinical
presentations.
Foggia, Italy Giuseppe Guglielmi
Amsterdam, The Netherlands Mario Maas
Contents
1 Imaging Techniques in Geriatric Patients . . . . . . . . . . . . . . . . . . . . . . . 1
Caterina Bernetti, Carlo Augusto Mallio, Rosario Francesco Grasso,
and Bruno Beomonte Zobel
2 Neurodegenerative Diseases in Geriatric Patients . . . . . . . . . . . . . . . . . 11
Camilla Russo, Rossana Senese, and Mario Muto
3 Neurovascular Emergencies in Geriatric Patients . . . . . . . . . . . . . . . . . 37
Giuseppe Maria Di Lella, Luca Ausili Cefaro,
and Cesare Colosimo
4 Head and Neck in Geriatric Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
T. Popolizio, L. Cassano, A. Pennelli, R. Izzo, G. Fascia,
M. Masciavè, and Giuseppe Guglielmi
5 Heart Diseases in Geriatric Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Anna Palmisano, Raffaele Ascione, Francesco De Cobelli,
and Antonio Esposito
6 Vascular Diseases in Geriatric Patients. . . . . . . . . . . . . . . . . . . . . . . . . . 137
Gloria Caredda, Giuseppe Guglielmi, and Luca Saba
7 Airway Diseases in Geriatric Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Maurizio Balbi, Roberta Eufrasia Ledda, Silvia Pamparino,
Gianluca Milanese, Mario Silva, and Nicola Sverzellati
8 Neoplastic Diseases of the Respiratory System in Geriatric Patients . 171
Zeno Falaschi, Francesco Filippone, Sergio Pansini, Stefano Tricca,
Paola Basile, Sara Cesano, and Alessandro Carriero
9 The Gastrointestinal System in Geriatric Patients . . . . . . . . . . . . . . . . 217
Damiano Caruso, Domenico De Santis, Francesco Pucciarelli,
and Andrea Laghi
10 The Male Urogenital System in Geriatric Patients . . . . . . . . . . . . . . . . 235
Emilio Quaia and Filippo Crimí
vii
viii Contents
11 The Female Urogenital System in Geriatric Patients . . . . . . . . . . . . . . 271
Maria Assunta Cova, Lorella Bottaro, Cristina Marrocchio,
and Alessandro Marco Bozzato
12 Osteoarthritis in Axial Skeleton in Geriatric Patients . . . . . . . . . . . . . . 319
Francesca Serpi, Salvatore Gitto, and Luca Maria Sconfienza
13 Osteoarthritis in Appendicular Skeleton in Geriatric Patients . . . . . . 345
Antonio Barile, Riccardo Monti, Federico Bruno, Julia Daffinà,
Francesco Arrigoni, and Carlo Masciocchi
14 Metabolic Bone Disease in Geriatric Patients . . . . . . . . . . . . . . . . . . . . 367
Maria Pilar Aparisi Gómez, Francisco Aparisi, Giuseppe Guglielmi,
and Alberto Bazzocchi
15 Body Composition in Geriatric Patients . . . . . . . . . . . . . . . . . . . . . . . . . 397
Maria Pilar Aparisi Gómez, Francisco Aparisi, Giuseppe Guglielmi,
and Alberto Bazzocchi
16 Myeloid and Lymphoid Disorders in Geriatric Patients . . . . . . . . . . . . 427
Patrizia Toia, Massimo Galia, Giuseppe Filorizzo,
Ludovico La Grutta, Federico Midiri, Pierpaolo Alongi,
Emanuele Grassedonio, and Massimo Midiri
17 The Role of Artificial Intelligence (AI) in the Management
of Geriatric Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445
Salvatore Claudio Fanni, Sherif Mohsen Shalaby,
and Emanuele Neri
Imaging Techniques in Geriatric Patients 1
Caterina Bernetti, Carlo Augusto Mallio,
Rosario Francesco Grasso, and Bruno Beomonte Zobel
1.1 I ntroduction: The Delicate Balance of Imaging
in the Elderly
In the last decades, there has been a rising trend toward global population aging,
especially in developed nations. This longevity revolution is happening faster than
historical precedents and a further increase of median age is expected in subsequent
years [1].
The improvement of living conditions and the advent of modern medicine carry-
ing innovations in treatment and prevention are some of the main reasons of
increased life expectancy.
This demographic change is determining a profound impact on society, in par-
ticular with regard to the healthcare system, that now has to face more age-related
diseases [2, 3].
In particular, people over 65 years, defined by convention as elderly, are more
prone to develop multiple chronic conditions, such as cardiovascular diseases,
dementia, cancer, and also osteoporosis that could lead to fragility fractures after
minor traumas [4].
In this population, there is an intrinsic difficulty in distinguishing the boundary
between para-physiologic modifications determined by aging and real pathologic
conditions. Furthermore, given the possibility of an incomplete medical history, the
complexity of symptoms and signs determined by the coexistence of multiple
comorbidities, and the reduced sensitivity of laboratory tests, the diagnosis is often
difficult to achieve. In this context, radiological imaging plays an important role in
the diagnostic workup of elderly patients [2, 5].
C. Bernetti · C. A. Mallio · R. F. Grasso · B. B. Zobel (*)
Imaging Center, Diagnostic Imaging and Interventional Radiology Department, University
Hospital “Campus Bio-Medico”, Rome, Italy
e-mail: [email protected]; [email protected];
[email protected]; [email protected]
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 1
G. Guglielmi, M. Maas (eds.), Imaging in Geriatrics, Practical Issues in
Geriatrics, https://doi.org/10.1007/978-3-031-14877-4_1
