62 results on '"Paparo, F."'
Search Results
2. Comparison between magnetic resonance imaging and rigid rectoscopy in the preoperative identification of intra- and extraperitoneal rectal cancer
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Paparo, F., Puppo, C., Montale, A., Bacigalupo, L., Pascariello, A., Clavarezza, M., Binda, C., Rollandi, G. A., and Binda, G. A.
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- 2014
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3. Additional value of integrated 18F-choline PET/4D contrast-enhanced CT in the localization of hyperfunctioning parathyroid glands and correlation with molecular profile
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Piccardo, Arnoldo, primary, Trimboli, P., additional, Rutigliani, M., additional, Puntoni, M., additional, Foppiani, L., additional, Bacigalupo, L., additional, Crescenzi, Anna, additional, Bottoni, G., additional, Treglia, G., additional, Paparo, F., additional, Del Monte, P., additional, Lanata, M., additional, Paone, G., additional, Ferrarazzo, G., additional, Catrambone, U., additional, Arlandini, A., additional, Ceriani, L., additional, Cabria, M., additional, and Giovanella, L., additional
- Published
- 2018
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4. Additional value of integrated 18F-choline PET/4D contrast-enhanced CT in the localization of hyperfunctioning parathyroid glands and correlation with molecular profile.
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Piccardo, Arnoldo, Trimboli, P., Rutigliani, M., Puntoni, M., Foppiani, L., Bacigalupo, L., Crescenzi, Anna, Bottoni, G., Treglia, G., Paparo, F., Del Monte, P., Lanata, M., Paone, G., Ferrarazzo, G., Catrambone, U., Arlandini, A., Ceriani, L., Cabria, M., and Giovanella, L.
- Subjects
PARATHYROID glands ,POSITRON emission tomography ,CHOLINE ,DIAGNOSTIC imaging ,BIOGENIC amines - Abstract
Purpose: The localization of hyperfunctioning parathyroid gland(s) (HPTG) in patients with primary hyperparathyroidism (PHPT) with negative or inconclusive first-line imaging is a significant challenge. This study aimed to evaluate the role of integrated
18 F-choline PET/4D contrast-enhanced computed tomography (4DCeCT) in these patients, compare its detection rate and sensitivity with those of18 F-choline PET/CT and (4DCeCT), and analyse the association between choline metabolism and morphological, biochemical and molecular parameters of HPTG.Methods: We prospectively enrolled 44 PHPT patients with negative or inconclusive first-line imaging.18 F-Choline PET/CT and 4DCeCT were performed at the same time, and integrated18 F-choline PET/4DCeCT images were obtained after coregistration. Experienced physicians examined the images. The SUVratio and degree of contrast enhancement were recorded for each positive finding. Histopathology, laboratory and multidisciplinary follow-up were used as the standard of reference. Both the detection rates and sensitivities of the three imaging modalities were calculated retrospectively. Immunohistochemistry was performed to evaluate the molecular profile of HPTGs.Results:18 F-Choline PET/4DCeCT was positive in 32 of 44 patients with PHPT (detection rate 72.7%), and 31 of 31 surgically treated patients (sensitivity 100%). These results were significantly (p < 0.05) better than those of18 F-choline PET/CT (56.8% and 80%, respectively) and those of 4DCeCT (54.5 and 74%, respectively). A significant correlation between SUV and calcium level was found. In a multivariate analysis, only calcium level was significantly associated with18 F-choline PET/4DCeCT findings. SUVratio and Ki67 expression were significantly correlated.Conclusion: Integrated18 F-choline PET/4DCeCT should be considered as an effective tool to detect PHPT in patients with negative or inconclusive first-line imaging. Choline metabolism is correlated with both calcium level and Ki67 expression in HPTG. [ABSTRACT FROM AUTHOR]- Published
- 2019
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5. Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology
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Piccardo, A, primary, Puntoni, M, additional, Treglia, G, additional, Foppiani, L, additional, Bertagna, F, additional, Paparo, F, additional, Massollo, M, additional, Dib, B, additional, Paone, G, additional, Arlandini, A, additional, Catrambone, U, additional, Casazza, S, additional, Pastorino, A, additional, Cabria, M, additional, and Giovanella, L, additional
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- 2016
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6. THU0276 Comparison of Two Different Scoring Methods for the Evaluation of Articular and Vascular FDG-PET/CT Uptake in PMR Patients
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Camellino, D., primary, Paparo, F., additional, Morbelli, S., additional, Cutolo, M., additional, Sambuceti, G., additional, and Cimmino, M.A., additional
- Published
- 2015
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7. 18F-FDG PET/CT is a prognostic biomarker in patients affected by bone metastases from breast cancer in comparison with 18F-NaF PET/CT
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Piccardo, A., primary, Puntoni, M., primary, Morbelli, S., primary, Bongioanni, F., primary, Paparo, F., primary, Altrinetti, V., primary, Gonella, R., primary, Gennari, A., primary, Iacozzi, M., primary, Sambuceti, G., primary, DeCensi, A., primary, and Massollo, M., additional
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- 2015
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8. An Exploratory Study of Adult Baby-Diaper Lovers’ Characteristics in an Italian Online Sample
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Francesco Paparo, Raffaella Perrella, Antonietta Lasala, Vincenzo Paolo Senese, Lasala, A., Paparo, F., Senese, Vincenzo Paolo, and Perrella, Raffaella.
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Adult ,050103 clinical psychology ,Adolescent ,Health, Toxicology and Mutagenesis ,Exploratory research ,lcsh:Medicine ,050109 social psychology ,Sample (statistics) ,Anxiety ,paraphilia ,Article ,Developmental psychology ,Young Adult ,paraphilic infantilism ,Enuresis ,Fetishism, Psychiatric ,Surveys and Questionnaires ,diaper lovers ,Personal history ,medicine ,Humans ,0501 psychology and cognitive sciences ,Aged ,fetishism ,Parenting ,05 social sciences ,Diapers, Infant ,lcsh:R ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,diaper lover ,Clinical Practice ,Italy ,Paraphilia ,medicine.symptom ,Personality Assessment Inventory ,Rejection, Psychology ,Psychology ,adult baby - Abstract
Background: Knowledge of the Adult Baby-Diaper Lovers (ABDL) phenomena is quite recent and there are, of yet, few studies on this phenomenon. Aim: This study was conceived to investigate the functions of ABDL behaviours and the characteristics of ABDL in an online Italian community sample. We hypothesized that ABDL phenomena were associated with general psychological maladjustment and with an experience of parental rejection during childhood. It was also assumed that there would be differences in ABDL profiles based on the age of appearance of their first Adult Baby-Diaper Lover (ABDL) fantasies. Method: An internet-based study was conducted and it involved 38 adults aged between 18 and 74 years (M = 34.95, SD = 12.25). Participants were first given an ad hoc questionnaire, which was devised to obtain information about the anamnestic variables related to ABDL. Then, the participants filled out the Cognitive Behaviour Assessment 2.0 battery to obtain anamnestic information regarding their psychological, medical, and personal history and to evaluate primary psychological dimensions in clinical practice. Finally, they filled out the Adult Parental Acceptance&ndash, Rejection Questionnaire, to evaluate their recollections of parental perceived rejection, and the Personality Assessment Questionnaire, to evaluate the primary psychological aspects related to parental rejection. Results: The data indicated that adults with ABDL showed the presence of anxious traits and recollections of parental rejection during childhood. Moreover, associations were observed between current or previous ABDL phenomena enuresis and negative mood states. Conclusion: Specific kinds of parental modes, anxiety traits, and enuresis seem to be the source of ABDL interests. Moreover, ADBL behaviours seem to assume different functions and meanings.
- Published
- 2020
9. Discriminant score for celiac disease based on immunohistochemical analysis of duodenal biopsies
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Antonella Tosco, Francesco Paparo, Renata Auricchio, Mariantonia Maglio, Riccardo Troncone, Luigi Greco, Tosco, Antonella, Maglio, Mariantonia, Paparo, F, Greco, Luigi, Troncone, Riccardo, and Auricchio, Renata
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Male ,Validation study ,Pathology ,medicine.medical_specialty ,Adolescent ,CD3 Complex ,Duodenum ,Biopsy ,T-Lymphocytes ,MEDLINE ,Disease ,Sensitivity and Specificity ,GTP-Binding Proteins ,Medicine ,Humans ,Protein Glutamine gamma Glutamyltransferase 2 ,Lymphocyte Count ,Intestinal Mucosa ,Child ,Transglutaminases ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Case-control study ,Interleukin-2 Receptor alpha Subunit ,nutritional and metabolic diseases ,Infant ,digestive system diseases ,Immunoglobulin A ,Celiac Disease ,Case-Control Studies ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Immunohistochemistry ,Female ,business - Abstract
OBJECTIVES: Celiac disease (CD) represents a spectrum, which includes cases with minor histological abnormalities (potential CD). The aim of this work is to evaluate the contribution of immunohistochemical analysis of duodenal biopsies to the diagnosis of gluten-related minor enteropathy. METHODS: Duodenal biopsies from 56 patients with untreated CD and 56 controls were analyzed for CD3 and γδ intraepithelial lymphocyte number, γδ/CD3 ratio, and density of CD25+ lamina propria cells. A discriminant equation was obtained by which 61 more biopsies with normal villous architecture were blindly evaluated. RESULTS: All of the immunohistochemical parameters were significantly different between patients with CD and controls. None of the single parameters showed sufficient specificity for CD. The combination of all of the 4 markers resulted in the following discriminant equation: discriminant score (Dscore) = (CD3 × 0.06) - (γδ × 0.119) + (CD25 × 0.012) + (γδ/CD3 × 0.131) - 4.709. Using this Dscore, patients were correctly classified as celiac or controls in 97.3% of the cases. When this equation was applied to a validation set of 61 patients with normal villous architecture and unknown diagnosis, 92.9% of those with a positive score turned out to be patients with potential CD. A normal score, however, did not exclude this condition. CONCLUSIONS: Immunohistochemistry represents a specific tool for the diagnosis of CD, but does lack sensitivity in detecting all of the potential CD cases.
- Published
- 2014
10. Report from the OECI Oncology days 2014
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F Paparo, F Lemare, Darius Razavi, P De Paoli, PA Cadariu, F. De Lorenzo, Johannes Haybaeck, GA Rollandi, Gunnar Folprecht, Giovanni Bussolati, Peter Riegman, JA López Guerrero, Giorgio Stanta, T Ciuleanu, Marco A. Pierotti, Claudio Lombardo, József Lövey, S Zupo, R Buiga, W.H. van Harten, Mauro Truini, A Bagg, M Dono, Karl-Friedrich Becker, Gerald Hoefler, Mahasti Saghatchian, N. Goedbloed, G Weiner, Health Technology & Services Research, Faculty of Behavioural, Management and Social Sciences, van Harten, W, Stanta, Giorgio, Bussolati, G, Riegman, P, Hoefler, G, Becker, K, Folprecht, G, Truini, M, Haybaeck, J, Buiga, R, Dono, M, Bagg, A, López Guerrero, J, Zupo, S, Lemare, F, de Lorenzo, F, Goedbloed, N, Razavi, D, Lövey, J, Cadariu, P, Rollandi, G, Paparo, F, Pierotti, M, Ciuleanu, T, De Paoli, P, Weiner, G, Saghatchian, M, Lombardo, C., and Pathology
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Oncology ,Cancer Research ,medicine.medical_specialty ,Designation ,organisation ,comprehensive cancer centres ,designation ,accreditation ,personalized medicine ,Comprehensive cancer centres ,Accreditation ,Environnement et pollution ,Clinical decision making ,SDG 3 - Good Health and Well-being ,Internal medicine ,IR-97320 ,medicine ,Tumor biopsy ,METIS-311886 ,business.industry ,comprehensive cancer centre ,Cancer survival ,Conference Report ,Personalized medicine ,Health care delivery ,Cancérologie ,Organisation ,Cancer Radiotherapy ,Day hospital ,business - Abstract
The 2014 OECI Oncology Days was held at the 'Prof. Dr. Ion Chiricuta' Oncology Institute in Cluj, Romania, from 12 to 13 June. The focus of this year's gathering was on developments in personalised medicine and other treatment advances which have made the cost of cancer care too high for many regions throughout Europe., SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2014
11. Multimodality imaging features of small bowel cancers complicating Crohn's disease: a pictorial review.
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Paparo F, Panvini N, Montale A, Pigati M, Marinaro E, Melani EF, Piccardo A, and Molini L
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- Humans, Magnetic Resonance Imaging methods, Adenocarcinoma diagnostic imaging, Crohn Disease diagnostic imaging, Crohn Disease complications, Multimodal Imaging methods, Intestine, Small diagnostic imaging, Intestinal Neoplasms diagnostic imaging
- Abstract
Patients with Crohn's disease (CD) are at increased risk of developing small bowel cancer, since chronic inflammation may trigger the histopathological sequence that begins from low-grade dysplasia of the intestinal epithelium and may eventually lead to malignant transformation. Owing to their location in a portion of the gastrointestinal tract which is not easily accessible to conventional endoscopic techniques, the detection of CD-related small bowel cancers is still a clinical challenge. The radiological features of CD-related small bowel adenocarcinoma (SBA) in patients with CD have been described in some previous studies, including its appearance in both CT and MRI examinations. Radiological signs of active or fibrostenotic CD may be intermixed with those suggesting the presence of CD-related SBA. In CT studies, the most relevant findings consistent with malignant transformation are the presence of a stricture with irregular asymmetric thickening of small bowel walls, loss of mural stratification, and moderate enhancement after intravenous administration of iodinated contrast media, in association with enlarged adjacent mesenteric lymph nodes. Many of the CD-related SBA features that can be observed on CT imaging are similar to those detectable by MRI. This latter modality provides the additional value of the functional characterization of small bowel strictures, thereby helping to distinguish between inflammatory, fibrotic, and malignant stenosis in the setting of active CD. Positron Emission Tomography (PET)/CT enables the metabolic assessment of enlarged mesenteric lymph nodes, and PET/MRI fusion imaging can incorporate morphological, functional and metabolic information into a single set of imaging data, thus overcoming the limitations of the separate assessment of each individual modality. Owing to the low incidence and prevalence of this long-term complication of CD, we believe that a detailed multimodality pictorial essay on this topic, also including the PET-CT and fusion imaging documentation of some cases, would be useful to the medical literature., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2024
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12. Clinical and FDG-PET/CT correlates in patients with polymyalgia rheumatica.
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Camellino D, Paparo F, Morbelli SD, Pesce G, Bauckneht M, Bagnasco M, Cutolo M, Sambuceti G, and Cimmino MA
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- Aged, Aged, 80 and over, Female, Fluorodeoxyglucose F18, Humans, Middle Aged, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Radiopharmaceuticals, Giant Cell Arteritis diagnostic imaging, Polymyalgia Rheumatica diagnostic imaging
- Abstract
Objectives: We aimed to evaluate joint and vessel uptake in patients with polymyalgia rheumatica (PMR) by FDG-PET and correlate it with clinical findings., Methods: Consecutive PMR patients, without clinical signs of giant cell arteritis, underwent a standardised clinical examination and FDG-PET/CT. Controls were consecutive subjects undergoing FDG-PET for the suspicion of neoplasm not confirmed by the examination. Uptake was evaluated by a qualitative visual score, using the liver uptake as reference and by the semi-quantitative mean standardised uptake value (SUV) and target-to-background ratio (TBR) methods., Results: Eighty-four patients and 84 controls (55 women, median age 73 years, range 50-92 years in both groups) were studied. Sixteen patients were taking glucocorticoids (GC). PMR patients showed a higher articular uptake than controls. GC-treated patients showed uptake lower than GC-naïve patients, but still higher than controls. PMR patients showed a higher vascular uptake than controls in all districts except in the carotid arteries, when evaluated by the visual score. Conversely, the semi-quantitative approach yielded no significant differences. Forty-two patients (50%) showed PET evidence of large-vessel vasculitis (LVV), defined as uptake ≥ than that of the liver, and 11.9% showed LVV with vascular uptake higher than that of the liver. The correlation between clinical findings and uptake was scarce. Neither clinical nor laboratory findings could predict the presence of LVV., Conclusions: Patients with PMR show a typical joint pattern at FDG-PET. There are no clinical or laboratory predictors of LVV. Imaging appears to be the only tool to assess LVV in these patients.
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- 2022
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13. Dermal Regeneration Templates in Maxillo-Facial District: A Multipurpose Aid.
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Spallaccia F, Benedetti S, Massarelli M, Paparo F, Rivaroli A, and Vellone V
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- Chondroitin Sulfates, Collagen, Humans, Regeneration, Retrospective Studies, Plastic Surgery Procedures, Skin Transplantation
- Abstract
Abstract: Since 1980s, the use of dermal regeneration templates (DRT) for reconstructive purposes has been described in Literature.1 The authors present their experience of 13 patients treated with integra dermal regeneration template and a single-stage surgery for different indications like oncologic reconstruction, trauma injuries, and preprosthetic surgery in the maxillo-facial district.The authors retrospectively reviewed a total of 13 patients treated with DRT at Maxillo-Facial Department of S. Maria Hospital in Terni.Inclusion criteria included the presence of a defect nonapproachable primarily or by secondary intention with an easy locoregional flap reconstruction, a complete clinical record, and a minimum 6 months follow-up.A total of 12 patients underwent surgical reconstruction with DRT at the S. Maria Hospital from June 2018 to February 2020.During follow-up, all patients in which intraoral reconstruction was performed showed first signs of re-mucosization and neovascularization after 10 days.Only in 1 patient (8%) a seroma underneath the silicon sheet was observed. Afterward, the patient healed correctly with no other complications.Dermal regeneration template represents an option that should be considered in the head and neck district reconstruction, especially for intraoral defects where, thanks to its long-term functional results and limited alternatives, should represent a relevant choice., Competing Interests: The authors report no conflicts of interest., (Copyright © 2020 by Mutaz B. Habal, MD.)
- Published
- 2021
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14. To Enhance or Not to Enhance? The Role of Contrast Medium 18 F-FDG PET/CT in Recurrent Ovarian Carcinomas.
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Massollo M, Fiz F, Bottoni G, Ugolini M, Paparo F, Puppo C, Provinciali N, Iacozzi M, Altrinetti V, Cistaro A, Cabria M, DeCensi A, Treglia G, and Piccardo A
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- Humans, Neoplasm Recurrence, Local diagnostic imaging, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Radiopharmaceuticals, Retrospective Studies, Sensitivity and Specificity, Tomography, X-Ray Computed, Carcinoma, Fluorodeoxyglucose F18
- Abstract
Background and Objectives :
18 F-fluorodeoxyglucose (FDG) positron emission tomography/X-ray computed tomography (PET/CT) represents the mainstay diagnostic procedure for suspected ovarian cancer (OC) recurrence. PET/CT can be integrated with contrast medium and in various diagnostic settings; however, the effective benefit of this procedure is still debated. We aimed to compare the diagnostic capabilities of low-dose and contrast-enhanced PET/CT (PET/ldCT and PET/ceCT) in patients with suspected ovarian cancer relapse. Materials and Methods : 122 OC patients underwent both PET/ldCT and PET/ceCT. Two groups of nuclear medicine physicians and radiologists scored the findings as positive or negative. Clinical/radiological follow-up was used as ground truth. Sensitivity, specificity, negative/positive predictive value, and accuracy were calculated at the patient and the lesion level. Results : A total of 455 and 474 lesions were identified at PET/ldCT and PET/ceCT, respectively. At the lesion level, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were not significantly different between PET/ldCT and PET/ceCT (98%, 93.3%, 97.4%, 94.9%, and 96.9% for PET/ldCT; 99%, 95.5%, 98.3%, 97%, and 98% for PET/ceCT, p = ns). At the patient level, no significant differences in these parameters were identified (e.g., p = 0.22 and p = 0.35 for accuracy, in the peritoneum and lymph nodes, respectively). Smaller peritoneal/lymph node lesions close to physiological FDG uptake sources were found in the cases of misidentification by PET/ldCT. PET/ceCT prompted a change in clinical management in four cases (3.2%) compared to PET/ldCT. Conclusions : PET/ceCT does not perform better than PET/ldCT but can occasionally clarify doubtful peritoneal findings on PET/ldCT. To avoid unnecessary dose to the patient, PET/ceCT should be excluded in selected cases.- Published
- 2021
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15. Gastric glomus tumor: Endoscopy, MD-CT and pathologic features.
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Rossi UG, Rutigliani M, Paparo F, and Filauro M
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- Gastroscopy, Humans, Male, Middle Aged, Multidetector Computed Tomography, Pyloric Antrum diagnostic imaging, Glomus Tumor diagnostic imaging, Glomus Tumor pathology, Stomach Neoplasms diagnostic imaging, Stomach Neoplasms pathology
- Published
- 2021
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16. Copper, PET/CT and prostate cancer: a systematic review of the literature.
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Piccardo A, Ugolini M, Righi S, Bottoni G, Cistaro A, Paparo F, Giovanella L, and Evangelista L
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- Animals, Antigens, Surface therapeutic use, Biomarkers, Tumor metabolism, Copper Radioisotopes pharmacology, Fluorine Radioisotopes chemistry, Glutamate Carboxypeptidase II therapeutic use, Humans, Magnetic Resonance Imaging, Male, Radiopharmaceuticals pharmacology, Structure-Activity Relationship, Tomography, X-Ray Computed, Antigens, Surface metabolism, Copper Radioisotopes chemistry, Glutamate Carboxypeptidase II metabolism, Positron Emission Tomography Computed Tomography methods, Prostatic Neoplasms radiotherapy, Radiopharmaceuticals chemistry
- Abstract
Copper is an essential element that plays an important role in both cancer development and growth. Indeed, high levels of copper have been found in prostate cancer (PCa), and this finding have paved the way for the use of this element as a target for positron emission tomography (PET) imaging. Copper64 (64Cu) can be used alone, as
64 CuCl2 , and also as a precursor for the in-vitro radio-labelling of specific carriers for PET imaging in PCa, (e.g. associated to prostate-specific membrane antigen: PSMA). The use of64 Cu-PSMA can yield late acquisitions in which PET images are characterized by a higher target-to-background ratio. At the same time, the shorter positron range of64 Cu provides high spatial resolution, which leads to better detection of small lesions. In this context, the aim of this review was to systematically review studies evaluating the identification of PCa in humans by means of64 CuCl2 and other PET tracers radio-labelled with64 Cu.- Published
- 2020
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17. A rare case of maxillary nodular fasciitis: Case report and short literature review.
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Massarelli M, Paparo F, and Benedetti S
- Abstract
Nodular fasciitis has to be considered as an option in the presence of a solitary, rapidly growing mass even in older adults. When possible, direct surgery should be preferred to FNAC, particularly in the older adults because of high misdiagnostic risk., Competing Interests: None declared., (© 2020 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)
- Published
- 2020
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18. Diagnostic value of retrospectively fused 64 CuCl 2 PET/MRI in biochemical relapse of prostate cancer: comparison with fused 18 F-Choline PET/MRI, 64 CuCl2 PET/CT, 18 F-Choline PET/CT, and mpMRI.
- Author
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Paparo F, Peirano A, Matos J, Bacigalupo L, Rossi U, Mussetto I, Bottoni G, Ugolini M, Introini C, Ruggieri FG, Rollandi GA, and Piccardo A
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- Choline, Copper, Humans, Magnetic Resonance Imaging, Male, Neoplasm Recurrence, Local diagnostic imaging, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Retrospective Studies, Multiparametric Magnetic Resonance Imaging, Prostatic Neoplasms diagnostic imaging
- Abstract
Purpose: To assess the diagnostic value of retrospectively fused PET/MRI by comparing the detection rates (DRs) of fused
64 CuCl2 PET/MRI vs. fused18 F-Choline PET/MRI in patients with suspected prostatic cancer (PCa) recurrence. The secondary objective was to compare the DRs of fused PET/MRI vs. those of the separate imaging modalities., Methods: We retrospectively evaluated 50 PCa patients with biochemical relapse after radical prostatectomy (RP) or radiotherapy (RT). All patients underwent64 CuCl2 PET/CT,18 F-Choline PET/CT, and multiparametric magnetic resonance imaging (mpMRI) within 15 days. Fused64 CuCl2 -PET/MRI and fused18 F-Choline PET/MRI images were obtained by retrospective co-registration of MRI and PET images. Experienced readers interpreted the images, and the DRs of each imaging modality were assessed., Results: In the patient-based analysis, overall DRs of fused64 CuCl2 PET/MRI, fused18 F-Choline PET/MRI,64 CuCl2 PET/CT,18 F-Choline PET/CT, and mpMRI were 88%, 68%, 82%, 56%, and 74%, respectively. In the lesion-based analysis, overall DRs of fused64 CuCl2 PET/MRI, fused18 F-Choline PET/MRI,64 CuCl2 PET/CT,18 F-Choline PET/CT, and mpMRI were 95%, 66%, 87%, 58%, and 71%, respectively., Conclusions: Retrospectively fused PET/MRI is able to overcome the limitations of the separate interpretation of the individual imaging modalities. Fused64 CuCl2 PET/MRI provided the highest diagnostic performance in the detection of PCa local relapse.- Published
- 2020
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19. Contamination inside CT gantry in the SARS-CoV-2 era.
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Matos J, Paparo F, Mori M, Veneziano A, Sartini M, Cristina ML, and Rollandi GA
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- COVID-19, Humans, Pandemics, RNA, Viral isolation & purification, Real-Time Polymerase Chain Reaction, SARS-CoV-2, Betacoronavirus isolation & purification, Coronavirus Infections virology, Equipment Contamination, Pneumonia, Viral virology, Tomography Scanners, X-Ray Computed virology, Tomography, X-Ray Computed instrumentation
- Abstract
We investigated whether the internal gantry components of our computed tomography (CT) scanner contain severe acute respiratory syndrome 2 (SARS-CoV-2) ribonucleic acid (RNA), bacterial or fungal agents. From 1 to 27 March 2020, we performed 180 examinations of patients with confirmed SARS-CoV-2 infection using a dedicated CT scanner. On 27 March 2020, this CT gantry was opened and sampled in each of the following components: (a) gantry case; (b) inward airflow filter; (c) gantry motor; (d) x-ray tube; (e) outflow fan; (f) fan grid; (g) detectors; and (h) x-ray tube filter. To detect SARS-CoV-2 RNA, samples were analysed using reverse transcriptase-polymerase chain reaction (RT-PCR). To detect bacterial or fungal agents, samples have been collected using "replicate organism detection and counting" contact plates of 24 cm
2 , containing tryptic soy agar, and subsequently cultured. RT-PCR detected SARS-CoV-2 RNA in the inward airflow filter sample. RT-PCR of remaining gantry samples did not reveal the presence of SARS-CoV-2 RNA. Neither bacterial nor fungal agents grew in the agar-based growth medium after the incubation period. Our data showed that SARS-Cov-2 RNA can be found inside the CT gantry only in the inward airflow filter. All remaining CT gantry components were devoid of SARS-CoV-2 RNA.- Published
- 2020
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20. Solitary Fibrous Tumor of the Prostate.
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Matos J, Paparo F, Calcagno T, Marinaro E, Introini C, and Rollandi GA
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- Aged, Humans, Male, Prostatic Neoplasms diagnosis, Solitary Fibrous Tumors diagnosis
- Abstract
Even though most tumors located in the prostate derive from prostatic glands, there is a long list of malignant and nonmalignant causes for prostatic growths that clinicians should be aware of. Tumors of the prostate can be grouped in epithelial, neuroendocrine, stromal, mesenchymal, hematolymphoid, and miscellaneous. Solitary fibrous tumor of the prostate (SFT), is an extremely rare mesenchymal tumor (only about 20 cases reported in the literature). Histologic features resemble those of the more common variant pleural SFT. Of all, 10%-20% of SFTs, also known as malignant SFTs, behave aggressively. Herein, we describe a case of prostatic SFT in a 66-year-old patient that presented with obstructive urinary symptoms and normal prostate-specific antigen levels., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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21. Evaluation of novel coronavirus disease (COVID-19) using quantitative lung CT and clinical data: prediction of short-term outcome.
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Matos J, Paparo F, Mussetto I, Bacigalupo L, Veneziano A, Perugin Bernardi S, Biscaldi E, Melani E, Antonucci G, Cremonesi P, Lattuada M, Pilotto A, Pontali E, and Rollandi GA
- Subjects
- Adult, Aged, Aged, 80 and over, COVID-19, Coronavirus Infections diagnostic imaging, Evaluation Studies as Topic, Female, Humans, Male, Middle Aged, Pandemics, Patient Outcome Assessment, Pneumonia, Viral diagnostic imaging, Predictive Value of Tests, Prognosis, Reproducibility of Results, SARS-CoV-2, Betacoronavirus, Coronavirus Infections diagnosis, Lung diagnostic imaging, Pneumonia, Viral diagnosis, Real-Time Polymerase Chain Reaction methods, Tomography, X-Ray Computed methods
- Abstract
Background: Computed tomography (CT) enables quantification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, helping in outcome prediction., Methods: From 1 to 22 March 2020, patients with pneumonia symptoms, positive lung CT scan, and confirmed SARS-CoV-2 on reverse transcription-polymerase chain reaction (RT-PCR) were consecutively enrolled. Clinical data was collected. Outcome was defined as favourable or adverse (i.e., need for mechanical ventilation or death) and registered over a period of 10 days following CT. Volume of disease (VoD) on CT was calculated semi-automatically. Multiple linear regression was used to predict VoD by clinical/laboratory data. To predict outcome, important features were selected using a priori analysis and subsequently used to train 4 different models., Results: A total of 106 consecutive patients were enrolled (median age 63.5 years, range 26-95 years; 41/106 women, 38.7%). Median duration of symptoms and C-reactive protein (CRP) was 5 days (range 1-30) and 4.94 mg/L (range 0.1-28.3), respectively. Median VoD was 249.5 cm
3 (range 9.9-1505) and was predicted by lymphocyte percentage (p = 0.008) and CRP (p < 0.001). Important variables for outcome prediction included CRP (area under the curve [AUC] 0.77), VoD (AUC 0.75), age (AUC 0.72), lymphocyte percentage (AUC 0.70), coronary calcification (AUC 0.68), and presence of comorbidities (AUC 0.66). Support vector machine had the best performance in outcome prediction, yielding an AUC of 0.92., Conclusions: Measuring the VoD using a simple CT post-processing tool estimates SARS-CoV-2 burden. CT and clinical data together enable accurate prediction of short-term clinical outcome.- Published
- 2020
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22. An Exploratory Study of Adult Baby-Diaper Lovers' Characteristics in an Italian Online Sample.
- Author
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Lasala A, Paparo F, Senese VP, and Perrella R
- Subjects
- Adolescent, Adult, Aged, Anxiety, Enuresis, Humans, Italy, Middle Aged, Parenting, Rejection, Psychology, Surveys and Questionnaires, Young Adult, Diapers, Infant, Fetishism, Psychiatric
- Abstract
Background: Knowledge of the Adult Baby-Diaper Lovers (ABDL) phenomena is quite recent and there are, of yet, few studies on this phenomenon., Aim: This study was conceived to investigate the functions of ABDL behaviours and the characteristics of ABDL in an online Italian community sample. We hypothesized that ABDL phenomena were associated with general psychological maladjustment and with an experience of parental rejection during childhood. It was also assumed that there would be differences in ABDL profiles based on the age of appearance of their first Adult Baby-Diaper Lover (ABDL) fantasies., Method: An internet-based study was conducted and it involved 38 adults aged between 18 and 74 years (M = 34.95; SD = 12.25). Participants were first given an ad hoc questionnaire, which was devised to obtain information about the anamnestic variables related to ABDL. Then, the participants filled out the Cognitive Behaviour Assessment 2.0 battery to obtain anamnestic information regarding their psychological, medical, and personal history and to evaluate primary psychological dimensions in clinical practice. Finally, they filled out the Adult Parental Acceptance-Rejection Questionnaire, to evaluate their recollections of parental perceived rejection, and the Personality Assessment Questionnaire, to evaluate the primary psychological aspects related to parental rejection., Results: The data indicated that adults with ABDL showed the presence of anxious traits and recollections of parental rejection during childhood. Moreover, associations were observed between current or previous ABDL phenomena enuresis and negative mood states., Conclusion: Specific kinds of parental modes, anxiety traits, and enuresis seem to be the source of ABDL interests. Moreover, ADBL behaviours seem to assume different functions and meanings., Competing Interests: The authors declare no conflict of interest.
- Published
- 2020
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23. Noninvasive liver fibrosis assessment in chronic viral hepatitis C: agreement among 1D transient elastography, 2D shear wave elastography, and magnetic resonance elastography.
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Matos J, Paparo F, Bacigalupo L, Cenderello G, Mussetto I, De Cesari M, Bernardi SP, Cevasco L, Forni GL, Cassola G, and Rollandi GA
- Subjects
- Biomarkers blood, Female, Humans, Male, Middle Aged, Pilot Projects, Prospective Studies, Elasticity Imaging Techniques methods, Hepatitis C, Chronic diagnostic imaging, Hepatitis C, Chronic virology, Liver Cirrhosis diagnostic imaging, Magnetic Resonance Imaging methods
- Abstract
Purpose: To assess the agreement of one-dimensional transient elastography (1D-TE), two-dimensional shear wave elastography (2D-SWE), and magnetic resonance elastography (MRE) in a consecutive cohort of patients affected by hepatitis C virus (HCV) and to understand which patient-related factors are associated with disagreement., Methods: Ninety-one consecutive patients with current or previous chronic HCV infection were enrolled between March 2017 and September 2018. We assessed the correlation between stiffness measurements expressed in kilopascals (kPa). After converting kPa values in three groups of increasing fibrosis burden using validated cut-off values, we assessed the agreement among the different techniques. Factors influencing inter-modality disagreement were examined by employing multivariate logistic regression analysis., Results: Seventy-seven patients met the inclusion criteria and had reliable measurements by all stiffness imaging techniques. At the quantitative analysis, a strong correlation between stiffness measurements was found (Spearman's rho values ranging from 0.7 to 0.89 in all pairs of techniques). Complete concordance among MRE, 1D-TE, and 2D-SWE was found in 64.9% of patients, and the agreement was highest between MRE and 1D-TE, with κ value of 0.801. In only 2/77 patients (2.6%), there was complete disagreement. High body mass index (BMI) was the only factor significantly associated with inter-modality discordance., Conclusions: MRE, 1D-TE, and 2D-SWE assigned the majority of patients to the same fibrosis group. The agreement was at least good, and there was a strong correlation between kPa values in all three pairs of techniques. Highest agreement was found between MRE and 1D-TE. High BMI was associated with discordance among the techniques.
- Published
- 2019
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24. Five Branches Variant of the Aortic Arch.
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Valdata A, Paparo F, and Rossi UG
- Subjects
- Aorta, Thoracic diagnostic imaging, Aortography methods, Computed Tomography Angiography, Humans, Male, Middle Aged, Aorta, Thoracic abnormalities, Vascular Malformations diagnostic imaging
- Published
- 2019
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25. 64 CuCl 2 PET/CT in Prostate Cancer Relapse.
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Piccardo A, Paparo F, Puntoni M, Righi S, Bottoni G, Bacigalupo L, Zanardi S, DeCensi A, Ferrarazzo G, Gambaro M, Ruggieri FG, Campodonico F, Tomasello L, Timossi L, Sola S, Lopci E, and Cabria M
- Subjects
- Aged, Aged, 80 and over, Humans, Male, Middle Aged, Recurrence, Copper chemistry, Copper Radioisotopes, Positron Emission Tomography Computed Tomography, Prostatic Neoplasms diagnostic imaging
- Abstract
Our objective was to evaluate the biodistribution, kinetics, and radiation dosimetry of
64 CuCl2 in humans and to assess the ability of64 CuCl2 PET/CT to detect prostate cancer (PCa) recurrence in patients with biochemical relapse. Methods: We prospectively evaluated 50 PCa patients with biochemical relapse after surgery or external-beam radiation therapy. All patients underwent64 CuCl2 PET/CT,18 F-choline PET/CT, and multiparametric MRI within 15 d of each other. Experienced readers interpreted the images, and the detection rate (DR) of each imaging modality was calculated. Histopathology, when available; clinical or laboratory response; and multidisciplinary follow-up were used to confirm the site of disease. In parallel, biodistribution, kinetics of the lesions, and radiation dosimetry of64 CuCl2 were evaluated. Results: From a dosimetric point of view, an administered dose of 200 MBq for64 CuCl2 translated into a 5.7-mSv effective dose. Unlike18 F-choline,64 CuCl2 was not excreted or accumulated in the urinary tract, thus allowing thorough pelvic exploration. The maximum64 CuCl2 uptake at the sites of PCa relapse was observed 1 h after tracer injection. In our cohort,64 CuCl2 PET/CT proved positive in 41 of 50 patients, with an overall DR of 82%. The DRs of18 F-choline PET/CT and multiparametric MRI were 56% and 74%, respectively. The difference between the DRs of64 CuCl2 PET/CT and18 F-choline PET/CT was statistically significant ( P < 0.001). Interestingly, on considering prostate-specific antigen (PSA) value,64 CuCl2 PET/CT had a higher DR than18 F-choline PET/CT in patients with a PSA of less than 1 ng/mL. Conclusion: The biodistribution of64 CuCl2 is more suitable than that of18 F-choline for exploring the pelvis and prostatic bed. The64 CuCl2 effective dose is like those of other established PET tracers. In patients with biochemical relapse and a low PSA level,64 CuCl2 PET/CT shows a significantly higher DR than18 F-choline PET/CT., (© 2018 by the Society of Nuclear Medicine and Molecular Imaging.)- Published
- 2018
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26. Biokinetic and dosimetric aspects of 64 CuCl 2 in human prostate cancer: possible theranostic implications.
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Righi S, Ugolini M, Bottoni G, Puntoni M, Iacozzi M, Paparo F, Cabria M, Ceriani L, Gambaro M, Giovanella L, and Piccardo A
- Abstract
Background: The aim of the present study is to evaluate the kinetics and dosimetry of
64 CuCl2 in human prostate cancer (PCa) lesions. We prospectively evaluated 50 PCa patients with biochemical relapse after surgery or external beam radiation therapy. All patients underwent64 CuCl2 -PET/CT to detect PCa recurrence/metastases. Volumes of interest were manually drawn for each64 CuCl2 avid PCa lesion with a diameter > 1 cm on mpMRI in each patient. Time-activity curves for all lesions were obtained. The effective and biological half-life and the standard uptake values (SUVs) were calculated. Tumour/background ratio (TBR) curves as a function of time were considered. Finally, the absorbed dose per lesion was estimated., Results: The mean effective half-life of64 CuCl2 calculated in the lymph nodes (10.2 ± 1.7 h) was significantly higher than in local relapses (8.8 ± 1.1 h) and similar to that seen in bone metastases (9.0 ± 0.4 h). The mean64 CuCl2 SUVmax calculated 1 h after tracer injection was significantly higher in the lymph nodes (6.8 ± 4.3) and bone metastases (6.8 ± 2.9) than in local relapses (4.7 ± 2.4). TBR mean curve of64 CuCl2 revealed that the calculated TBRmax value was 5.0, 7.0, and 6.2 in local relapse and lymph node and bone metastases, respectively, and it was achieved about 1 h after64 CuCl2 injection. The mean absorbed dose of the PCa lesions per administrated activity was 6.00E-2 ± 4.74E-2mGy/MBq. Indeed, for an administered activity of 3.7 GBq, the mean dose absorbed by the lesion would be 0.22 Gy., Conclusions: Dosimetry showed that the dose absorbed by PCa recurrences/metastases per administrated activity was low. The dosimetric study performed does not take into account the possible therapeutic effect of the Auger electrons. Clinical trials are needed to evaluate64 Cu internalization in the cell nucleus that seems related to the therapeutic effectiveness reported in preclinical studies.- Published
- 2018
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27. Magnetic resonance imaging of breast cancer: does the time interval between biopsy and MRI influence MRI-pathology discordance in lesion sizing?
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Mennella S, Paparo F, Revelli M, Baccini P, Secondini L, Barbagallo S, Friedman D, and Garlaschi A
- Subjects
- Adult, Aged, Biopsy, Female, Humans, Middle Aged, Retrospective Studies, Time Factors, Tumor Burden, Breast Neoplasms diagnostic imaging, Breast Neoplasms pathology, Magnetic Resonance Imaging
- Abstract
Background Breast magnetic resonance imaging (MRI) is more accurate than ultrasound and mammography in estimating local extension of both invasive breast cancer and ductal carcinoma in situ (DCIS) and it is part of a breast cancer patient's preoperative management. Purpose To verify if time interval between breast biopsy and preoperative MRI, lesion margins, and biopsy technique can influence tumor sizing on MRI. Material and Methods By a database search, we retrospectively identified all women with a newly diagnosed, biopsy-proven, primary breast cancer who underwent MRI before surgery. The time interval between biopsy and MRI, the type of biopsy procedure, and various pathological features of tumors were collected. We defined the concordance between MRI and pathology measurements as a difference of <5 mm in lesion sizing. Results One hundred and sixty-six women (mean age, 51.4 ± 10.4 years) were included. The time interval between biopsy and MRI showed only a weak correlation with the absolute MRI-pathology difference (r = 0.236). Stratifying the whole cohort of patients using a cutoff value of 30 days, we found that the MRI-pathology discordance was significantly higher in patients with a biopsy-MRI time interval >30 days ( P < 0.05). By means of multivariate analysis, we found that DCIS subtype and the presence of poorly defined margins on MRI are the only two factors independently and strongly associated with MRI-pathology discordance in lesion sizing. Conclusion Size, histology, and margins of tumors may affect the accuracy of MRI measurements. The type of biopsy procedure and the time interval between biopsy and preoperative MRI are not independently associated to MRI-pathology discordance.
- Published
- 2017
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28. Lower limb ischemia due to long-term abuse of cocaine.
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Denegri A, Ameri P, Paparo F, and Murialdo G
- Subjects
- Angiography, Angioplasty, Balloon, Cocaine-Related Disorders diagnosis, Humans, Ischemia diagnosis, Ischemia physiopathology, Ischemia therapy, Male, Middle Aged, Recurrence, Regional Blood Flow, Tibial Arteries diagnostic imaging, Tibial Arteries physiopathology, Time Factors, Treatment Outcome, Central Nervous System Stimulants adverse effects, Cocaine adverse effects, Cocaine-Related Disorders complications, Ischemia chemically induced, Lower Extremity blood supply, Tibial Arteries drug effects, Vasoconstriction drug effects
- Abstract
: Cocaine is the most commonly used recreational drug among young adults with levels reaching epidemics proportions. This accelerated rate of use is due mainly to easy access and administration, reduced cost, and, importantly, underestimation of the drug risks. Cocaine, instead, is responsible of endothelial dysfunction and accelerated atherosclerosis with consequent organ damage. Cocaine abuse is not only associated with central necrotizing vasculitis, but it is also appeared to play a role in the development of peripheral vasoconstriction with symptoms similar to Buerger's disease. The current study reports a middle-aged man addicted to cocaine for 20 years. The patient presents several cardiovascular disease risk factors and manifestations, including diabetes mellitus and hypertension. Additionally, arteriography showed complete left posterior tibial artery obstruction with distal collateral vessels and severe leftfoot ischemia. For clinical worsening 1 month later, the patient underwent another arteriography. Although angioplasty of posterior tibial artery showed recovery of blood flow, immediately after treatment (selective percutaneous transluminal angioplasty of posterior tibial artery, dilation with balloon without stenting), a return to pretreatment blood flow 2 min later was observed. This transient change was mediated by severe vasospasm resulting in a complete re-obstruction of the vessel. The poor vascular manifestations are most probably due to cocaine-necrotizing vasculitis subsequent to endothelial dysfunction and accelerated atherosclerosis usually associated with cardiovascular risk factors. Therefore, treatments of young cocaine addicts presenting many cardiovascular risk factors and manifestations should always be carefully investigated and cautiously approached, especially in those with poor outcomes.
- Published
- 2016
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29. Renal trauma in adolescent skateboarders.
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Campodonico F, Paparo F, Calcagno T, Capponi G, and Conzi G
- Subjects
- Adolescent, Humans, Male, Kidney injuries, Skating injuries
- Abstract
Objective: Kidney is the most commonly injured organ of the genitourinary tract after trauma. Half of blunt renal injuries are caused by traffic accidents, but sport activities are also included as frequent causes. Skatebording is popular among young people but it deserves being considered a potential cause of severe injuries. A number of published medical reports mainly refer to bone, joint and head injuries but no cases have been reported on urologic or kidney trauma., Methods: We present two cases of renal trauma in adolescent males occurred while doing skateboarding., Results: The first patient had a grade 3 renal trauma with urinary extravasation, managed conservatively with ureteral stenting. The second patient had a grade 4 to 5 renal trauma with cardiovascular instability requiring an urgent nephrectomy., Conclusions: We would emphasize these cases as an emergent urological warning. Scientific information and medical education should be addressed from physicians to a targeted population, in order to reduce among teens the incidence of injuries of such at-risk activity.
- Published
- 2016
30. Comparison between different software programs and post-processing techniques for the MRI quantification of liver iron concentration in thalassemia patients.
- Author
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Bacigalupo L, Paparo F, Zefiro D, Viberti CM, Cevasco L, Gianesin B, Pinto VM, Rollandi GA, Wood JC, and Forni GL
- Subjects
- Adolescent, Adult, Biopsy, Child, Female, Humans, Male, Middle Aged, Retrospective Studies, Image Interpretation, Computer-Assisted methods, Iron analysis, Iron Overload diagnostic imaging, Liver diagnostic imaging, Magnetic Resonance Imaging, Software, Thalassemia diagnostic imaging
- Abstract
Purpose: In magnetic resonance imaging (MRI) relaxometry, various software programs are available to perform R2* measurements and to estimate the liver iron concentration (LIC). The main objective of our study was to compare R2* LIC values, obtained with three different software programs based on specific decay models and calibration curves, with LIC estimates provided by R2-relaxometry (FerriScan)., Methods: This retrospective study included 15 patients with 15 baseline MRIs and 34 serial examinations. R2* LIC estimates were calculated using the FuncTool, CMRtools/Thalassemia Tools and Quanta Hematology programs. Longitudinal LIC changes (ΔLIC) were calculated using the subset of 34 serial MRIs., Results: After Bland-Altman analysis on baseline data, Quanta Hematology, which employs the monoexponential-plus-constant fit, produced the lowest mean difference [0.01 ± 0.14 log(mg/gdw)] with the closest limits of agreement. In the longitudinal setting, Quanta Hematology again gave the lowest mean difference between R2 and R2* LIC (0.1 ± 2.6 mg/gdw). Using FerriScan as reference, the value of concordant directional ΔLIC changes was the same for all programs (27/34, 85.7 %)., Conclusions: R2* LICs are higher than R2 LICs at iron levels <7 mg/gdw, while R2 LIC averages higher than R2* LIC with increasing iron load. The monoexponential-plus-constant model provided the best agreement with R2 LIC estimates.
- Published
- 2016
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31. Chondromatosis of the Temporomandibular Joint as a Consequence of Persistent Long-Lasting Joint Dysfunction: Late Diagnosis of a Rare Occurrence.
- Author
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Paparo F, Massarelli M, Cordeschi R, Sciannameo V, and Spallaccia F
- Subjects
- Adult, Arthroscopy, Chondromatosis etiology, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Temporomandibular Joint Dysfunction Syndrome complications, Time Factors, Tomography, X-Ray Computed, Chondromatosis diagnosis, Delayed Diagnosis, Temporomandibular Joint diagnostic imaging, Temporomandibular Joint Disorders diagnosis, Temporomandibular Joint Dysfunction Syndrome diagnosis
- Abstract
The authors present a rare patient of right synovial chondromatosis (SC) of the temporomandibular joint in which diagnosis was late and delay led to SC extension to the cranial base. Synovial chondromatosis is a rare benign disorder characterized by multiple cartilaginous free-floating nodules originated from the synovial membrane of large articular joints of the body. Differential diagnosis is with neoplasm and radical surgical removal is essential. The patient came to the authors' observation complaining about long-lasting temporomandibular joint dysfunction. The patient already underwent either functional or medical therapy in times without any improvement. Clinical examination showed limited mouth opening and swelling of the right preauricolar region with no signs of facial nerve palsy and without paresthesia or hearing loss. No history of recent trauma was recorded. Magnetic resonance imaging showed a mucous-like hyperintense mass with small hypointense spots inside. A preoperative computed tomography scan was performed and showed a mass extending from the superior aspect of the temporomandibular joint to the glenoid fossa, which was partially eroded. The patient underwent either open joint surgery or arthroscopy of the superior joint space and a large number of chondrocytes were removed. No complications were recorded postoperatively and the patient completely recovered after 6 months. Histology confirmed the diagnosis of synovial condromatosys of the right temporomandibular joint.
- Published
- 2016
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32. Lung hyperaeration assessment by computed tomography: correction of reconstruction-induced bias.
- Author
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Ball L, Brusasco C, Corradi F, Paparo F, Garlaschi A, Herrmann P, Quintel M, and Pelosi P
- Subjects
- Aged, Female, Humans, Image Processing, Computer-Assisted statistics & numerical data, Lung pathology, Male, Middle Aged, Respiration, Respiration, Artificial, Retrospective Studies, Lung diagnostic imaging, Lung Volume Measurements methods, Tomography, X-Ray Computed statistics & numerical data
- Abstract
Background: Computed tomography (CT) reconstruction parameters, such as slice thickness and convolution kernel, significantly affect the quantification of hyperaerated parenchyma (VHYPER%). The aim of this study was to investigate the mathematical relation between VHYPER% calculated at different reconstruction settings, in mechanically ventilated and spontaneously breathing patients with different lung pathology., Methods: In this retrospective observational study, CT scans of patients of the intensive care unit and emergency department were collected from two CT scanners and analysed with different kernel-thickness combinations (reconstructions): 1.25 mm soft kernel, 5 mm soft kernel, 5 mm sharp kernel in the first scanner; 2.5 mm slice thickness with a smooth (B41s) and a sharp (B70s) kernel on the second scanner. A quantitative analysis was performed with Maluna® to assess lung aeration compartments as percent of total lung volume. CT variables calculated with different reconstructions were compared in pairs, and their mathematical relationship was analysed by using quadratic and power functions., Results: 43 subjects were included in the present analysis. Image reconstruction parameters influenced all the quantitative CT-derived variables. The most relevant changes occurred in the hyperaerated and normally aerated volume compartments. The application of a power correction formula led to a significant reduction in the bias between VHYPER% estimations (p < 0.001 in all cases). The bias in VHYPER% assessment did not differ between lung pathology nor ventilation mode groups (p > 0.15 in all cases)., Conclusions: Hyperaerated percent volume at different reconstruction settings can be described by a fixed mathematical relationship, independent of lung pathology, ventilation mode, and type of CT scanner.
- Published
- 2016
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33. A rare case of parotid gland lipoma arising from the deep lobe of the parotid gland.
- Author
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Paparo F, Massarelli M, and Giuliani G
- Abstract
Lipomas are the most commonly encountered benign mesenchymal tumors, but their occurrence in the head and neck is rare, even more at the level of the parotid region where they can be found nearby the parotid capsule, inside the capsule, or within the gland. In addition, lipomas involving the deep parotid lobe are extremely unusual. That is why lipomas are not often considered for differential diagnosis of parotid lumps. Concerning diagnostic tools, magnetic resonance imaging (MRI) is nowadays considered as the main imaging examination for parotid lipomas due to a characteristic signal intensity on T1- and T2-weighted images. Furthermore, even if the cost of MRI is nearly three times that of computed tomography, MRI is accurate, safe, and has few biological costs for the patient. In this reported case, MRI provided all information for either diagnosis or preoperative planning being the best diagnostic tool regarding tumor margin characteristics and surrounding tissues' involvement. Concerning treatment, surgical excision of parotid masses is always mandatory for definitive diagnosis, but it is challenging because of the facial nerve. For this reason, a well-established surgical technique is mandatory for success. The authors present a rare case of parotid gland lipoma arising from the deep lobe and discuss diagnostic tools and surgical technique., Competing Interests: There are no conflicts of interest.
- Published
- 2016
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34. Degree of colonic distension: intrapatient comparison between CT colonography and CT with water enema.
- Author
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Revelli M, Bacigalupo L, Cevasco L, Furnari M, Paparo F, Scopelliti L, Rosenberg I, and Rollandi GA
- Subjects
- Adult, Aged, Aged, 80 and over, Colon, Sigmoid, Female, Humans, Male, Middle Aged, Colon, Colonography, Computed Tomographic methods, Enema, Prone Position, Supine Position, Water
- Abstract
Purpose: Compare colonic distension using CT colonography (CTC) and CT with water enema (CTWE) in the same patients., Methods and Materials: Twenty-seven patients who underwent both CTC and CTWE, considering separately supine (CTC-S) and prone (CTC-P) acquisition of CTC were included. The colon was divided into six segments, performing both a qualitative and quantitative analysis., Results: Adequate distension of sigmoid colon was more frequently achieved with CTC-P and CTWE compared to CTC-S (P<.05). CTC-P and CTWE showed better distension of the left colon compared to CTC-S (P<.01 and P=.03 regarding sigmoid colon, respectively; P=.01 and P=.03 regarding descending colon, respectively)., Conclusions: Computed tomography (CT) studies of the colon should be customized to fulfill the clinical query., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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35. Management of Bile Leak from Luschka Ducts After Laparoscopic Cholecystectomy: An Original Procedure for Coil Embolization.
- Author
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Salsano G, Paparo F, Valdata A, Patrone L, Filauro M, Rollandi GA, and De Caro G
- Subjects
- Aged, Anastomotic Leak etiology, Bile, Bile Ducts injuries, Embolization, Therapeutic, Humans, Male, Anastomotic Leak therapy, Cholecystectomy, Laparoscopic adverse effects, Gallbladder Diseases surgery
- Published
- 2016
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36. Corrigendum to "Value of Fused (18)F-Choline-PET/MRI to Evaluate Prostate Cancer Relapse in Patients Showing Biochemical Recurrence after EBRT: Preliminary Results".
- Author
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Piccardo A, Paparo F, Piccazzo R, Naseri M, Ricci P, Marziano A, Bacigalupo L, Biscaldi E, Rollandi GA, Grillo-Ruggieri F, and Farsad M
- Published
- 2016
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37. Comparison of computed tomography and magnetic resonance imaging in the discrimination of intraperitoneal and extraperitoneal rectal cancer: initial experience.
- Author
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Revelli M, Paparo F, Bacigalupo L, Puppo C, Furnari M, Conforti C, Binda GA, Savarino E, Risso D, and Rollandi GA
- Subjects
- Aged, Anal Canal diagnostic imaging, Anal Canal pathology, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Peritoneum diagnostic imaging, Peritoneum pathology, Retrospective Studies, Sensitivity and Specificity, Magnetic Resonance Imaging methods, Rectal Neoplasms diagnostic imaging, Rectal Neoplasms pathology, Tomography, X-Ray Computed methods
- Abstract
Objectives: To compare computed tomography (CT) and magnetic resonance imaging (MRI) in evaluation of intraperitoneal/extraperitoneal location of rectal cancers., Methods and Materials: We assessed the identification of the anterior peritoneal reflection (APR) and the distance from the inferior edge of tumors to the anal verge and from the APR to the anal verge., Results: Distances obtained with CT and MRI showed a strong correlation [Spearman's coefficient of rank correlation (rho): 0.995; P<.0001]. Magnetic resonance showed sensitivity of 100% (95% CI: 89.62-100.00%), specificity of 75% (95% CI: 20.34-95.88%), positive predictive value (PPV) of 97.14% (95% CI: 85.03-99.52%), and negative predictive value (NPV) of 100% (95% CI: 30.48-100.00%). CT showed a sensitivity of 100% (95% CI: 89.32-100.00%), specificity of 60% (95% CI: 15.40-93.51%), PPV of 94.29% (95% CI: 80.81-99.13%), and NPV of 100% (95% CI: 30.48-100.00%)., Conclusions: CT demonstrated a potential supporting role in the evaluation of rectal cancer, showing a strong correlation with MRI., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2016
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38. Ankylosis of the wrist bones in patients with rheumatoid arthritis: a study with extremity-dedicated MRI.
- Author
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Barbieri F, Zampogna G, Camellino D, Paparo F, Cutolo M, Garlaschi G, and Cimmino MA
- Subjects
- Adult, Aged, Aged, 80 and over, Case-Control Studies, Disease Progression, Equipment Design, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Severity of Illness Index, Ankylosis pathology, Arthritis, Rheumatoid pathology, Magnetic Resonance Imaging instrumentation, Wrist Joint pathology
- Abstract
Objectives: Ankylosis, or spontaneous bone fusion, of the small joints of the hand is a rare event in patients with rheumatoid arthritis (RA), being observed in 0.8% of them on conventional radiographs. It is associated with long-lasting and severe disease. In other settings, such as fracture healing, bone fusion is a reparative process. The aim of this paper is the study of the frequency of wrist ankylosis in patients with RA in comparison with other arthritides; to correlate ankylosis with disease activity., Methods: A total of 94 patients affected by RA, 71 patients with different rheumatic conditions and 42 controls with no joint disease or with slight hand osteoarthritis were studied. DAS-28 CRP was calculated in patients with RA and psoriatic arthritis. MRI of the clinically most involved wrist was performed with a 0.2 T, extremity-dedicated MRI system., Results: Of RA patients, 10/94 (10.6%) showed ankylosis in comparison with 2/113 (1.8%) controls (p=0.015). RA patients with ankylosis had longer disease duration (p=0.019) but similar disease activity., Conclusions: MRI-defined bone ankylosis is frequent in RA. It is not limited to seronegative spondyloarthritides and may be part of the bone damage observed in RA.
- Published
- 2016
39. Multimodality fusion imaging in abdominal and pelvic malignancies: current applications and future perspectives.
- Author
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Paparo F, Piccardo A, Bacigalupo L, Piccazzo R, Rollandi L, Galletto Pregliasco A, Filauro M, DeCensi A, and Rollandi GA
- Subjects
- Humans, Abdominal Neoplasms diagnosis, Abdominal Neoplasms therapy, Multimodal Imaging methods, Pelvic Neoplasms diagnosis, Pelvic Neoplasms therapy
- Abstract
Medicine is evolving toward personalized care and this development entails the integration, amalgamation, and synchronized analysis of data from multiple sources. Multimodality fusion imaging refers to the simultaneous visualization of spatially aligned and juxtaposed medical images obtained by two or more image modalities. PET/MRI scanners and MMFI platforms are able to improve the diagnostic workflow in oncologic patients and provide exquisite images that aid physicians in the molecular profiling and characterization of tissues. Advanced navigation platforms involving real-time ultrasound are promising tools for guiding personalized and tailored mini-invasive interventional procedures on technically challenging targets. The main objective of the present essay was to describe the current applications and future perspectives of multimodality fusion imaging for both diagnostic and interventional purposes in the field of abdominal and pelvic malignancies. We also outlined the technical differences between fusion imaging achieved by means of simultaneous bimodal acquisition (i.e., integrated PET/MRI scanners), retrospective co-registration, and multimodality fusion imaging involving ultrafast or real-time imaging modalities.
- Published
- 2015
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40. The clinical role of multimodality imaging in the detection of prostate cancer recurrence after radical prostatectomy and radiation therapy: past, present, and future.
- Author
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Paparo F, Massollo M, Rollandi L, Piccardo A, Ruggieri FG, and Rollandi GA
- Abstract
Detection of the recurrence sites in prostate cancer (PCa) patients affected by biochemical recurrence after radical prostatectomy (RP) and radiation therapy (RT) is still a challenge for clinicians, nuclear medicine physicians, and radiologists. In the era of personalised and precision care, this task requires the integration, amalgamation, and combined analysis of clinical and imaging data from multiple sources. At present, multiparametric Magnetic Resonance Imaging (mpMRI) and choline-positron emission tomography (PET) are giving encouraging results; their combination allows the effective detection of local, lymph nodal, and skeletal recurrences at low PSA levels. Future diagnostic perspectives include the clinical implementation of PET/MRI scanners, multimodal fusion imaging platforms for retrospective co-registration of PET and MR images, real-time transrectal ultrasound/mpMRI fusion imaging, and novel organ-specific PET radiotracers.
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- 2015
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41. Incidental physiological sliding hiatal hernia: a single center comparison study between CT with water enema and CT colonography.
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Revelli M, Furnari M, Bacigalupo L, Paparo F, Astengo D, Savarino E, and Rollandi GA
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- Adolescent, Adult, Aged, Aged, 80 and over, Contrast Media, Enema adverse effects, Female, Hernia, Hiatal diagnostic imaging, Humans, Incidental Findings, Iohexol analogs & derivatives, Male, Middle Aged, Retrospective Studies, Water, Colonography, Computed Tomographic adverse effects, Hernia, Hiatal etiology, Tomography, X-Ray Computed adverse effects
- Abstract
Purpose: Hiatal hernia is a well-known factor impacting on most mechanisms underlying gastroesophageal reflux, related with the risk of developing complications such as erosive esophagitis, Barrett's esophagus and ultimately, esophageal adenocarcinoma. It is our firm opinion that an erroneous reporting of hiatal hernia in CT exams performed with colonic distention may trigger a consecutive diagnostic process that is not only unnecessary, inducing a unmotivated anxiety in the patient, but also expensive and time-consuming for both the patient and the healthcare system. The purposes of our study were to determine whether colonic distention at CT with water enema and CT colonography can induce small sliding hiatal hernias and to detect whether hiatal hernias size modifications could be considered significant for both water and gas distention techniques., Methods: We retrospectively evaluated 400 consecutive patients, 200 undergoing CT-WE and 200 undergoing CTC, including 59 subjects who also underwent a routine abdominal CT evaluation on a different time, used as internal control, while a separate group of 200 consecutive patients who underwent abdominal CT evaluation was used as external control. Two abdominal radiologists assessed the CT exams for the presence of a sliding hiatal hernia, grading the size as small, moderate, or large; the internal control groups were directly compared with the corresponding CT-WE or CTC study looking for a change in hernia size. We used the Student's t test applying a size-specific correction factor, in order to account for the effect of colonic distention: these "corrected" values were then individually compared with the external control group., Results: A sliding hiatal hernia was present in 51 % (102/200) of the CT-WE patients and in 48.5 % (97/200) of the CTC patients. Internal control CT of the 31 patients with a hernia at CT-WE showed resolution of the hernia in 58.1 % (18/31) of patients, including 76.5 % (13/17) and 45.5 % (5/11) of small and moderate hernias. Comparison CT of the 28 patients with a hiatal hernia at CTC showed the absence of the hernia in 57.1 % (16/28) patients, including 68.8 % (11/16) and 50 % (5/10) of small and moderate hernias. The prevalence of sliding hiatal hernias in the external control group was 22 % (44/200), significantly lower than the CT-WE and CTC cohorts' prevalence of 51 % (p < 0.0001) and 48.5 % (p < 0.0001). After applying the correction factors for the CT-WE and the CTC groups, the estimated residual prevalences (16 and 18.5 %, respectively) were much closer to that of the external control patients (p = 0.160 for CT-WE and p = 0.455 for CTC)., Conclusions: We believe that incidental findings at CT-WE and CTC should be considered according to the clinical background, and that small sliding hiatal hernias should not be reported in patients with symptoms not related to reflux disease undergoing CT-WE or CTC: When encountering these findings, accurate anamnesis and review of medical history looking for GERD-related symptoms are essential, in order to address these patients to a correct diagnostic iter, taking advantage from more appropriate techniques such as endoscopy or functional techniques.
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- 2015
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42. Value of bimodal (18)F-choline-PET/MRI and trimodal (18)F-choline-PET/MRI/TRUS for the assessment of prostate cancer recurrence after radiation therapy and radical prostatectomy.
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Paparo F, Piccardo A, Bacigalupo L, Romagnoli A, Piccazzo R, Monticone M, Cevasco L, Campodonico F, Conzi GM, Carmignani G, and Rollandi GA
- Subjects
- Aged, Aged, 80 and over, Choline, Diagnosis, Computer-Assisted, Fluorine Radioisotopes, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Multimodal Imaging, Neoplasm Recurrence, Local diagnostic imaging, Neoplasm Staging, Positron-Emission Tomography, Prostatectomy, Prostatic Neoplasms radiotherapy, Prostatic Neoplasms surgery, Radiopharmaceuticals, Ultrasonography, Neoplasm Recurrence, Local diagnosis, Prostatic Neoplasms diagnosis
- Abstract
Between 27% and 53% of all patients who undergo radical prostatectomy (RP) or radiation therapy (RT) as the first-line treatment of prostate cancer (PCa) develop a biochemical recurrence. Imaging plays a pivotal role in restaging by helping to distinguish between local relapse and metastatic disease (i.e., lymph-node and skeletal metastases). At present, the most promising tools for assessing PCa patients with biochemical recurrence are multiparametric magnetic resonance imaging (mpMRI) and positron emission tomography (PET)/computed tomography (CT) with radio-labeled choline derivatives. The main advantage of mpMRI is its high diagnostic accuracy in detecting local recurrence, while choline-PET/CT is able to identify lymph-node metastases when they are not suspicious on morphological imaging. The most recent advances in the field of fusion imaging have shown that multimodal co-registration, synchronized navigation, and combined interpretation are more valuable than the individual; separate assessment offered by different diagnostic techniques. The objective of the present essay was to describe the value of bimodal choline-PET/mpMRI fusion imaging and trimodal choline-PET/mpMRI/transrectal ultrasound (TRUS) in the assessment of PCa recurrence after RP and RT. Bimodal choline-PET/mpMRI fusion imaging allows morphological, functional, and metabolic information to be combined, thereby overcoming the limitations of each separate imaging modality. In addition, trimodal real-time choline-PET/mpMRI/TRUS fusion imaging may be useful for the planning and real-time guidance of biopsy procedures in order to obtain histological confirmation of the local recurrence.
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- 2015
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43. Characterization of ferromagnetic or conductive properties of metallic foreign objects embedded within the human body with magnetic iron detector (MID): Screening patients for MRI.
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Gianesin B, Zefiro D, Paparo F, Caminata A, Balocco M, Carrara P, Quintino S, Pinto V, Bacigalupo L, Rollandi GA, Marinelli M, and Forni GL
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- Adult, Aged, Contraindications, Female, Humans, Iron Overload diagnosis, Male, Middle Aged, Patient Safety, Sensitivity and Specificity, Foreign Bodies diagnosis, Iron, Magnetic Fields, Magnetic Resonance Imaging methods, Magnetometry instrumentation, Magnetometry methods, Magnets, Mass Screening, Metals, Prostheses and Implants
- Abstract
Purpose: A preliminary assessment of the MRI-compatibility of metallic object possibly embedded within the patient is required before conducting the MRI examination. The Magnetic Iron Detector (MID) is a highly sensitive susceptometer that uses a weak magnetic field to measure iron overload in the liver. MID might be used to perform a screening procedure for MRI by determining the ferromagnetic/conductive properties of embedded metallic objects., Methods: The study was composed by: (i) definition of MID sensitivity threshold; (ii) application of MID in a procedure to characterize the ferromagnetic/conductive properties of metallic foreign objects in 958 patients scheduled for MID examination., Results: The detection threshold for ferromagnetic objects was found to be the equivalent of a piece of wire of length 2 mm and gauge 0.8 mm(2) and, representing purely conductive objects, an aluminum sheet of area 2 × 2 cm(2) . Of 958 patients, 165 had foreign bodies of unknown nature. MID was able to detect those with ferromagnetic and/or conducting properties based on fluctuations in the magnetic and eddy current signals versus control., Conclusion: The high sensitivity of MID makes it suitable for assessing the ferromagnetic/conductive properties of metallic foreign objects embedded within the body of patients scheduled for MRI., (© 2015 Wiley Periodicals, Inc.)
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- 2015
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44. Discriminant score for celiac disease based on immunohistochemical analysis of duodenal biopsies.
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Tosco A, Maglio M, Paparo F, Greco L, Troncone R, and Auricchio R
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- Adolescent, Biopsy, Case-Control Studies, Celiac Disease blood, Celiac Disease pathology, Child, Child, Preschool, Duodenum pathology, Female, GTP-Binding Proteins blood, Humans, Immunoglobulin A blood, Infant, Interleukin-2 Receptor alpha Subunit analysis, Intestinal Mucosa pathology, Lymphocyte Count, Male, Protein Glutamine gamma Glutamyltransferase 2, Sensitivity and Specificity, Transglutaminases blood, CD3 Complex analysis, Celiac Disease diagnosis, Duodenum chemistry, Intestinal Mucosa chemistry, T-Lymphocytes chemistry
- Abstract
Objectives: Celiac disease (CD) represents a spectrum, which includes cases with minor histological abnormalities (potential CD). The aim of this work is to evaluate the contribution of immunohistochemical analysis of duodenal biopsies to the diagnosis of gluten-related minor enteropathy., Methods: Duodenal biopsies from 56 patients with untreated CD and 56 controls were analyzed for CD3 and γδ intraepithelial lymphocyte number, γδ/CD3 ratio, and density of CD25+ lamina propria cells. A discriminant equation was obtained by which 61 more biopsies with normal villous architecture were blindly evaluated., Results: All of the immunohistochemical parameters were significantly different between patients with CD and controls. None of the single parameters showed sufficient specificity for CD. The combination of all of the 4 markers resulted in the following discriminant equation: discriminant score (Dscore) = (CD3 × 0.06) - (γδ × 0.119) + (CD25 × 0.012) + (γδ/CD3 × 0.131) - 4.709. Using this Dscore, patients were correctly classified as celiac or controls in 97.3% of the cases. When this equation was applied to a validation set of 61 patients with normal villous architecture and unknown diagnosis, 92.9% of those with a positive score turned out to be patients with potential CD. A normal score, however, did not exclude this condition., Conclusions: Immunohistochemistry represents a specific tool for the diagnosis of CD, but does lack sensitivity in detecting all of the potential CD cases.
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- 2015
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45. Extrusion of the medial meniscus in knee osteoarthritis assessed with a rotating clino-orthostatic permanent-magnet MRI scanner.
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Paparo F, Revelli M, Piccazzo R, Astengo D, Camellino D, Puntoni M, Muda A, Rollandi GA, Garlaschi G, and Cimmino MA
- Subjects
- Aged, Aged, 80 and over, Body Mass Index, Female, Humans, Male, Middle Aged, Pain Measurement, Patient Positioning, Pilot Projects, Prospective Studies, Weight-Bearing, Magnetic Resonance Imaging instrumentation, Menisci, Tibial pathology, Osteoarthritis, Knee pathology
- Abstract
Purpose: The objectives of this study were to assess the influence of weight-bearing on tibiofemoral osteoarthritis, including medial meniscal extrusion, by using a low-field (0.25 T) rotating clino-orthostatic permanent-magnet magnetic resonance (MR) scanner, and to analyse correlations of medial meniscal extrusion with the patient's Kellgren-Lawrence score, body mass index, and all the osteoarthritis features of the WORMS scoring system., Materials and Methods: Twenty-six patients (69.2% women and 30.8% men; mean age 67 ± 9.7 years) with medial tibiofemoral knee osteoarthritis were prospectively enrolled and MR sequences were acquired in both clino- and orthostatic position. MR images were assessed by two independent radiologists, according to the WORMS scale. Medial meniscal extrusion was measured and its clino-orthostatic difference (∆MME) was calculated., Results: Intra- and inter-observer agreement of the WORMS Global Score readings was high by Cohen's K test (>0.81). No significant clino-orthostatic changes in the scoring parameters of the medial tibiofemoral joint were shown by Wilcoxon's test. Medial meniscal extrusion measured on orthostatic images was significantly higher than that measured in clinostatic position (p < 0.0001). At univariate analysis, the Kellgren-Lawrence score, WORMS Global Score, cartilage loss, meniscal damage, and osteophytes were significantly correlated to ∆MME (p < 0.005). Using a multiple regression model, tibiofemoral cartilage loss was found to correlate independently with ∆MME (p = 0.0499)., Conclusions: Medial meniscal extrusion, evaluated with an open-configuration, rotating MR scanner, increased from the clinostatic to the orthostatic position. ∆MME, a new meniscal parameter, correlated with several important features of medial tibiofemoral osteoarthritis.
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- 2015
- Full Text
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46. Magnetic resonance imaging of breast cancer: factors affecting the accuracy of preoperative lesion sizing.
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Mennella S, Garlaschi A, Paparo F, Perillo M, Celenza M, Massa T, Rollandi GA, and Garlaschi G
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- Carcinoma, Ductal, Breast pathology, Carcinoma, Intraductal, Noninfiltrating pathology, Carcinoma, Lobular pathology, Female, Humans, Middle Aged, Observer Variation, Reproducibility of Results, Retrospective Studies, Breast pathology, Breast Neoplasms pathology, Magnetic Resonance Imaging methods, Preoperative Care methods, Tumor Burden
- Abstract
Background: Accurate preoperative sizing of breast cancer with imaging modalities has a great importance in the surgical planning., Purpose: To assess the influence of tumor size and histology on the accuracy of measurement of cancer local extension by magnetic resonance imaging (MRI)., Material and Methods: One hundred and eighty-six patients with primary breast cancer, for a total of 221 lesions, were included in this retrospective study. Tumors were divided into five histological groups: invasive ductal carcinoma (IDC), IDC with extensive intraductal component (EIC), invasive lobular carcinoma (ILC), ductal carcinoma in situ (DCIS), and "other histology" (mucinous, papillary, medullary, tubular, and apocrine breast cancer). Microscopic measurement of the largest diameter of tumors at pathology was chosen as reference standard and compared with MRI measurement. Concordance was defined as a difference ≤ 5 mm between MRI and pathology., Results: The mean size of tumors at pathology was 24.8 ± 19.4 mm, while at MRI it was 29.7 ± 20 mm (P < 0.05), with a significant overestimation of MRI. MRI-pathology concordance was found in 98/221 cases (44.3%), while MRI overestimated the size of 81/221 tumors (36.7%). The extent of overestimation was significantly different among the five histological groups (P < 0.05). At multivariate analysis, DCIS histology was the factor more significantly associated with MRI-pathology discordance (P = 0.0005), while the influence of tumor dimension at pathology was less significant (P = 0.0073)., Conclusion: DCIS histology is strongly associated with discordance between MRI and pathology sizing of breast cancer. Lesion size can also influence the accuracy of MRI measurements, but to a lesser extent., (© The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)
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- 2015
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47. Diagnostic value of MRI proton density fat fraction for assessing liver steatosis in chronic viral C hepatitis.
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Paparo F, Cenderello G, Revelli M, Bacigalupo L, Rutigliani M, Zefiro D, Cevasco L, Amico M, Bandelloni R, Cassola G, Forni GL, and Rollandi GA
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Fatty Liver pathology, Female, Hepacivirus pathogenicity, Hepatitis C, Chronic pathology, Hepatitis C, Chronic virology, Humans, Liver pathology, Male, Middle Aged, Protons, Radiography, Fatty Liver diagnostic imaging, Hepatitis C, Chronic diagnostic imaging, Liver diagnostic imaging, Magnetic Resonance Imaging
- Abstract
Objective: To assess the diagnostic performance of a T1-independent, T2*-corrected multiecho magnetic resonance imaging (MRI) technique for the quantification of hepatic steatosis in a cohort of patients affected by chronic viral C hepatitis, using liver biopsy as gold standard., Methods: Eighty-one untreated patients with chronic viral C hepatitis were prospectively enrolled. All included patients underwent MRI, transient elastography, and liver biopsy within a time interval <10 days., Results: Our cohort of 77 patients included 43/77 (55.8%) males and 34/77 (44.2%) females with a mean age of 51.31 ± 11.27 (18-81) years. The median MRI PDFF showed a strong correlation with the histological fat fraction (FF) (r = 0.754, 95% CI 0.637 to 0.836, P < 0.0001), and the correlation was influenced by neither the liver stiffness nor the T2* decay. The median MRI PDFF result was significantly lower in the F4 subgroup (P < 0.05). The diagnostic accuracy of MRI PDFF evaluated by AUC-ROC analysis was 0.926 (95% CI 0.843 to 0.973) for S ≥ 1 and 0.929 (95% CI 0.847 to 0.975) for S = 2., Conclusions: Our MRI technique of PDFF estimation allowed discriminating with a good diagnostic accuracy between different grades of hepatic steatosis.
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- 2015
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48. Quantitative analysis of lung ultrasonography for the detection of community-acquired pneumonia: a pilot study.
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Corradi F, Brusasco C, Garlaschi A, Paparo F, Ball L, Santori G, Pelosi P, Altomonte F, Vezzani A, and Brusasco V
- Subjects
- Humans, Pilot Projects, Tomography, X-Ray Computed, Ultrasonography, Community-Acquired Infections diagnostic imaging, Lung diagnostic imaging
- Abstract
Background and Objective: Chest X-ray is recommended for routine use in patients with suspected pneumonia, but its use in emergency settings is limited. In this study, the diagnostic performance of a new method for quantitative analysis of lung ultrasonography was compared with bedside chest X-ray and visual lung ultrasonography for detection of community-acquired pneumonia, using thoracic computed tomography as a gold standard., Methods: Thirty-two spontaneously breathing patients with suspected community-acquired pneumonia, undergoing computed tomography examination, were consecutively enrolled. Each hemithorax was evaluated for the presence or absence of abnormalities by chest X-ray and quantitative or visual ultrasonography., Results: Quantitative ultrasonography showed higher sensitivity (93%), specificity (95%), and diagnostic accuracy (94%) than chest X-ray (64%, 80%, and 69%, resp.), visual ultrasonography (68%, 95%, and 77%, resp.), or their combination (77%, 75%, and 77%, resp.)., Conclusions: Quantitative lung ultrasonography was considerably more accurate than either chest X-ray or visual ultrasonography in the diagnosis of community-acquired pneumonia and it may represent a useful first-line approach for confirmation of clinical diagnosis in emergency settings.
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- 2015
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49. Renal Doppler Resistive Index as a Marker of Oxygen Supply and Demand Mismatch in Postoperative Cardiac Surgery Patients.
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Corradi F, Brusasco C, Paparo F, Manca T, Santori G, Benassi F, Molardi A, Gallingani A, Ramelli A, Gherli T, and Vezzani A
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- Aged, Aged, 80 and over, Biomarkers blood, Female, Humans, Kidney blood supply, Kidney diagnostic imaging, Kidney physiopathology, Male, Cardiac Surgical Procedures, Oxygen blood, Ultrasonography, Doppler, Color
- Abstract
Background and Objective: Renal Doppler resistive index (RDRI) is a noninvasive index considered to reflect renal vascular perfusion. The aim of this study was to identify the independent hemodynamic determinants of RDRI in mechanically ventilated patients after cardiac surgery., Methods: RDRI was determined in 61 patients by color and pulse Doppler ultrasonography of the interlobar renal arteries. Intermittent thermodilution cardiac output measurements were obtained and blood samples taken from the tip of pulmonary artery catheter to measure hemodynamics and mixed venous oxygen saturation (SvO2)., Results: By univariate analysis, RDRI was significantly correlated with SvO2, oxygen extraction ratio, left ventricular stroke work index, and cardiac index, but not heart rate, central venous pressure, mean artery pressure, pulmonary capillary wedge pressure, systemic vascular resistance index, oxygen delivery index, oxygen consumption index, arterial lactate concentration, and age. However, by multivariate analysis RDRI was significantly correlated with SvO2 only., Conclusions: The present data suggests that, in mechanically ventilated patients after cardiac surgery, RDRI increases proportionally to the decrease in SvO2, thus reflecting an early vascular response to tissue hypoxia.
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- 2015
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50. Report from the OECI Oncology Days 2014.
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van Harten W, Stanta G, Bussolati G, Riegman P, Hoefler G, Becker K, Folprecht G, Truini M, Haybaeck J, Buiga R, Dono M, Bagg A, López Guerrero J, Zupo S, Lemare F, de Lorenzo F, Goedbloed N, Razavi D, Lövey J, Cadariu P, Rollandi G, Paparo F, Pierotti M, Ciuleanu T, De Paoli P, Weiner G, Saghatchian M, and Lombardo C
- Abstract
The 2014 OECI Oncology Days was held at the 'Prof. Dr. Ion Chiricuta' Oncology Institute in Cluj, Romania, from 12 to 13 June. The focus of this year's gathering was on developments in personalised medicine and other treatment advances which have made the cost of cancer care too high for many regions throughout Europe.
- Published
- 2014
- Full Text
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