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1. Risk of appendiceal neoplasm after interval appendectomy for complicated appendicitis: A systematic review and meta-analysis

Author

Ruggero Lionetti, Michele D'Ambra, Francesco Corcione, Umberto Bracale, Roberta Green, Marcello De Luca, Alberto Cuocolo, Roberto Peltrini, Valeria Cantoni, Carolina Bartolini, Peltrini, Roberto, Cantoni, Valeria, Green, Roberta, Lionetti, Ruggero, D'Ambra, Michele, Bartolini, Carolina, De Luca, Marcello, Bracale, Umberto, Cuocolo, Alberto, and Corcione, Francesco

Subjects
medicine.medical_specialty, Adenoma, Complicated appendiciti, Adenocarcinoma, law.invention, Randomized controlled trial, Appendiceal neoplasm, law, Internal medicine, medicine, Appendectomy, Humans, Neoplasm, Appendicular inflammatory ma, Interval appendectomy, Randomized Controlled Trials as Topic, Retrospective Studies, business.industry, Complicated appendicitis, Appendicitis, medicine.disease, Mucinous Neoplasm, Appendiceal Neoplasms, Meta-analysis, Surgery, business
Abstract

Background Non-operative management is often the treatment of choice in cases of complicated appendicitis and routine interval appendectomy is not usually recommended. Actually, recent studies show an alarming number of appendiceal neoplasms following interval appendectomy. The aim of this study is to evaluate the prevalence of appendiceal neoplasms and their histological types after interval appendectomy for complicated appendicitis in adults. Methods A comprehensive literature search of the PubMed, Scopus and Web of Science databases was conducted according to the PRISMA statement. Studies reporting appendiceal neoplasm rates after interval appendectomy and histopathological characteristics were included. The most recent World Health Organization (WHO) classification of malignant tumours was considered. A pooled prevalence analysis for both prevalence and pathology was performed. Results A total of eight studies was included: seven retrospective series and one randomized controlled trial. The pooled prevalence of neoplasms after interval appendectomy was 11% (95% CI 7-15; I2 = 37.5%, p = 0.13). Appendiceal mucinous neoplasms occurred in 43% (95% CI 19-68), adenocarcinoma in 29% (95% CI 6-51), appendiceal neuroendocrine neoplasm in 21% (95% CI 6-36), globet cell carcinoma in 13% (95% CI -2-28), adenoma or serrated lesions in 20% (95% CI -0-41) of cases. Conclusion The risk of appendiceal neoplasm in patients treated with interval appendectomy for complicated appendicitis is 11%; mucinous neoplasm is the most common histopathological type. Further studies should investigate this association in order to clarify the biological pathway and clinical implications.

Published
2021
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3. Incremental value of 18F-FDG cardiac PET imaging over dobutamine stress echocardiography in predicting myocardial ischemia in patients with suspected coronary artery disease

Author

Letizia Spinelli, Roberta Assante, Mario Petretta, Ciro Mainolfi, Carmela Nappi, Adriana D'Antonio, Pietro Buongiorno, Teresa Mannarino, Emilia Zampella, Wanda Acampa, Alberto Cuocolo, Mariarosaria Panico, Valeria Gaudieri, Zampella, Emilia, Assante, Roberta, Acampa, Wanda, Gaudieri, Valeria, Nappi, Carmela, Mannarino, Teresa, D’Antonio, Adriana, Buongiorno, Pietro, Panico, Mariarosaria, Mainolfi, Ciro Gabriele, Spinelli, Letizia, Petretta, Mario, and Cuocolo, Alberto

Subjects
medicine.medical_specialty, Myocardial ischemia, business.industry, Dobutamine stress echocardiography, Ischemia, medicine.disease, Coronary artery disease, Cardiac PET, Internal medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, In patient, Cardiology and Cardiovascular Medicine, business, Perfusion, Cardiac imaging
Abstract

Background. To assess the incremental value of 18F-fluorodeoxyglucose (FDG) cardiac positron emission tomography (PET) over dobutamine stress echocardiography (DSE) in predicting myocardial ischemia in patients with suspected coronary artery disease (CAD). Methods. Forty-one patients with suspected CAD underwent within 7 days apart rest-stress cardiac PET with 82Rb and DSE followed by cardiac 18F-FDG PET imaging. 18F-FDG images were scored on a 0 (no discernible uptake) to 2 (intense uptake) scale. Logistic regression analysis was performed to identify predictors of stress-induced ischemia. The incremental value of 18F-FDG PET over DSE in detecting ischemia at 82Rb PET cardiac imaging was assessed by the likelihood ratio chi-square and net reclassification index. Results. On 82Rb-PET imaging, myocardial ischemia (ischemic total perfusion defect > 5%) was detected in 20 (49%) patients. Inducible ischemia was found in 22 (54%) patients on DSE (biphasic or worsening response pattern in > 1 segment) and in 21 (51%) patients on 18FFDG PET (uptake score of 2 in ‡ 1 segment). 18F-FDG PET resulted as statistically significant predictor of ischemia on 82Rb-PET. The addition of 18F-FDG PET to DSE increased the likelihood of ischemia on 82Rb-PET (P < .05). 18F-FDG PET was able to reclassify the probability of stress-induced myocardial ischemia on both patient and vessel analyses. Conclusion. 18F-FDG PET performed after dobutamine stress test may provide incremental value to DSE in the evaluation of myocardial ischemia. These results suggest that stress induced myocardial ischemia can be imaged directly using 18F-FDG PET after dobutamine stress test.

Published
2021
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4. Comparing the Prognostic Value of Stress Myocardial Perfusion Imaging by Conventional and Cadmium-Zinc Telluride Single-Photon Emission Computed Tomography through a Machine Learning Approach

Author

Carmela Nappi, Mario Petretta, Leandro Donisi, Teresa Mannarino, Roberta Green, Emilia Zampella, Vincenzo Sannino, Andrea Genova, Alessia Giordano, Alberto Cuocolo, Valeria Cantoni, Giuseppe Cesarelli, Valeria Gaudieri, Wanda Acampa, Giovanni De Simini, Roberta Assante, Adriana D'Antonio, Carlo Ricciardi, Cantoni, Valeria, Green, Roberta, Ricciardi, Carlo, Assante, Roberta, Donisi, Leandro, Zampella, Emilia, Cesarelli, Giuseppe, Nappi, Carmela, Sannino, Vincenzo, Gaudieri, Valeria, Mannarino, Teresa, Genova, Andrea, De Simini, Giovanni, Giordano, Alessia, D'Antonio, Adriana, Acampa, Wanda, Petretta, Mario, Cuocolo, Alberto, and D’Antonio, Adriana

Subjects
Male, Article Subject, Computer applications to medicine. Medical informatics, R858-859.7, Coronary Artery Disease, Single-photon emission computed tomography, Machine learning, computer.software_genre, General Biochemistry, Genetics and Molecular Biology, Machine Learning, Myocardial perfusion imaging, Naive Bayes classifier, medicine, Humans, Myocardial infarction, Aged, Tomography, Emission-Computed, Single-Photon, Univariate analysis, General Immunology and Microbiology, medicine.diagnostic_test, business.industry, Applied Mathematics, Myocardial Perfusion Imaging, Computational Biology, General Medicine, Middle Aged, Prognosis, medicine.disease, Random forest, Support vector machine, Zinc, Modeling and Simulation, Exercise Test, Female, Neural Networks, Computer, Artificial intelligence, Tellurium, business, computer, Algorithms, Emission computed tomography, Research Article, Cadmium
Abstract

We compared the prognostic value of myocardial perfusion imaging (MPI) by conventional- (C-) single-photon emission computed tomography (SPECT) and cadmium-zinc-telluride- (CZT-) SPECT in a cohort of patients with suspected or known coronary artery disease (CAD) using machine learning (ML) algorithms. A total of 453 consecutive patients underwent stress MPI by both C-SPECT and CZT-SPECT. The outcome was a composite end point of all-cause death, cardiac death, nonfatal myocardial infarction, or coronary revascularization procedures whichever occurred first. ML analysis performed through the implementation of random forest (RF) and k -nearest neighbors (KNN) algorithms proved that CZT-SPECT has greater accuracy than C-SPECT in detecting CAD. For both algorithms, the sensitivity of CZT-SPECT (96% for RF and 60% for KNN) was greater than that of C-SPECT (88% for RF and 53% for KNN). A preliminary univariate analysis was performed through Mann-Whitney tests separately on the features of each camera in order to understand which ones could distinguish patients who will experience an adverse event from those who will not. Then, a machine learning analysis was performed by using Matlab (v. 2019b). Tree, KNN, support vector machine (SVM), Naïve Bayes, and RF were implemented twice: first, the analysis was performed on the as-is dataset; then, since the dataset was imbalanced (patients experiencing an adverse event were lower than the others), the analysis was performed again after balancing the classes through the Synthetic Minority Oversampling Technique. According to KNN and SVM with and without balancing the classes, the accuracy ( p value = 0.02 and p value = 0.01) and recall ( p value = 0.001 and p value = 0.03) of the CZT-SPECT were greater than those obtained by C-SPECT in a statistically significant way. ML approach showed that although the prognostic value of stress MPI by C-SPECT and CZT-SPECT is comparable, CZT-SPECT seems to have higher accuracy and recall.

Published
2021
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5. The diagnostic role of total-body 18F-FDG PET/CT in patients with multiple tumors: a report of the association of thyroid cancer with lung or renal tumors

Author

Leandra Piscopo, Emilia Zampella, Michele Klain, Mariarosaria Manganelli, Simone Maurea, Marina De Risi, Fabio Volpe, Alberto Cuocolo, Valeria Gaudieri, Klain, Michele, Maurea, Simone, Gaudieri, Valeria, Zampella, Emilia, Volpe, Fabio, Manganelli, Mariarosaria, Piscopo, Leandra, De Risi, Marina, and Cuocolo, Alberto

Subjects
medicine.medical_specialty, Lung, business.industry, Total body, medicine.disease, medicine.anatomical_structure, medicine, Radiology, Nuclear Medicine and imaging, Fdg pet ct, In patient, Radiology, Multiple tumors, business, Thyroid cancer
Abstract

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Published
2021
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6. Advanced imaging tools for evaluating cardiac morphological and functional impairment in hypertensive disease

Author

Maria Virginia Manzi, Bruno Trimarco, Maria Assunta Elena Rao, Carmine Morisco, Raffaele Izzo, Maria Lembo, Alberto Cuocolo, Costantino Mancusi, Lembo, Maria, Manzi, Maria Virginia, Mancusi, Costantino, Morisco, Carmine, Rao, Maria Assunta Elena, Cuocolo, Alberto, Izzo, Raffaele, and Trimarco, Bruno

Subjects
Pressure overload, medicine.medical_specialty, Functional impairment, Physiology, business.industry, Disease progression, Echocardiography, Three-Dimensional, Heart, Cardiovascular System, Organ damage, Hypertensive disease, Echocardiography, Internal medicine, Hypertension, Internal Medicine, Cardiology, medicine, Humans, Cardiovascular Injury, Cardiology and Cardiovascular Medicine, Cardiac magnetic resonance, business, Subclinical infection
Abstract

Arterial hypertension represents a systemic burden, and it is responsible of various morphological, functional and tissue modifications affecting the heart and the cardiovascular system. Advanced imaging techniques, such as speckle tracking and three-dimensional echocardiography, cardiac magnetic resonance, computed tomography and PET-computed tomography, are able to identify cardiovascular injury at different stages of arterial hypertension, from subclinical alterations and overt organ damage to possible complications related to pressure overload, thus giving a precious contribution for guiding timely and appropriate management and therapy, in order to improve diagnostic accuracy and prevent disease progression. The present review focuses on the peculiarity of different advanced imaging tools to provide information about different and multiple morphological and functional aspects involved in hypertensive cardiovascular injury. This evaluation emphasizes the usefulness of the emerging multiimaging approach for a comprehensive overview of arterial hypertension induced cardiovascular damage.

Published
2021
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7. Ileal inflammatory pseudotumor in adolescent male patient with prior Burkitt lymphoma: A challenging diagnosis

Author

Alberto Cuocolo, Maria Elena Errico, Nicoletta Marra, Dalila De Lucia, Adriana D'Antonio, Salvatore Buffardi, Ciro Mainolfi, Gaia Mango, Mainolfi, Ciro Gabriele, D'Antonio, Adriana, Mango, Gaia, De Lucia, Dalila, Buffardi, Salvatore, Marra, Nicoletta, Errico, Maria Elena, and Cuocolo, Alberto

Subjects
medicine.medical_specialty, Positron emission tomography/computed tomography, R895-920, Molecular imaging, Case Report, Asymptomatic, 030218 nuclear medicine & medical imaging, Inflammatory pseudotumor, Medical physics. Medical radiology. Nuclear medicine, 03 medical and health sciences, 0302 clinical medicine, medicine, Radiology, Nuclear Medicine and imaging, Fever of unknown origin, medicine.diagnostic_test, business.industry, Histopathological analysis, Burkitt lymphoma, medicine.disease, Lymphoma, stomatognathic diseases, Positron emission tomography, Male patient, Radiology, 18F-fluorodeoxyglucose, medicine.symptom, business, 030217 neurology & neurosurgery, Rare disease
Abstract

Inflammatory pseudotumor is a rare benign mesenchymal pediatric neoplasm, that can mimic tumoral residue or relapse at metabolic imaging with nonspecific clinical presentation and difficult diagnosis. We present the case of a 14year old male patient with fever of unknown origin and large ileal mass, diagnosed with and treated for Burkitt lymphoma, who performed several 18-fluoro-deoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) scans, during and after first line chemotherapy, showing persistent and focal uptake, while ileal mass volume decreased dramatically and the patient was clinically asymptomatic. Histopathological analysis of residual ileal mass was suggestive for xanthomatous pseudotumor, a type of inflammatory pseudotumor. No more treatment was performed and a short-term follow up with 18F-FDG PET/CT showed tracer uptake intensity decreasing progressively over the next few months. This case reports an uncommon presentation of a rare disease, inflammatory pseudotumor of the small bowel developed at the site of treated Burkitt lymphoma, underscoring the potential role of 18F-FDG PET/CT imaging in the diagnosis and management of these rare neoplasms, particularly in asymptomatic patients.

Published
2021
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8. Ablation rate after radioactive iodine therapy in patients with differentiated thyroid cancer at intermediate or high risk of recurrence: a systematic review and a meta-analysis

Author

Martin Schlumberger, Michele Klain, Emilia Zampella, Mario Petretta, Mariarosaria Manganelli, Fabio Volpe, Alberto Cuocolo, Carmela Nappi, Elisa Caiazzo, Valeria Cantoni, Roberta Green, Leandra Piscopo, Klain, Michele, Nappi, Carmela, Zampella, Emilia, Cantoni, Valeria, Green, Roberta, Piscopo, Leandra, Volpe, Fabio, Manganelli, Mariarosaria, Caiazzo, Elisa, Petretta, Mario, Schlumberger, Martin, and Cuocolo, Alberto

Subjects
medicine.medical_specialty, medicine.medical_treatment, Population, 030209 endocrinology & metabolism, 131I, Adenocarcinoma, Iodine Radioisotopes, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Recurrent disease, Humans, Radiology, Nuclear Medicine and imaging, In patient, Thyroid Neoplasms, 030212 general & internal medicine, education, Thyroid cancer, Retrospective Studies, education.field_of_study, High risk, business.industry, Intermediate risk, General Medicine, Differentiated thyroid cancer, Ablation, medicine.disease, Meta-analysis, Orthopedic surgery, Thyroidectomy, Original Article, Radioactive iodine therapy, Neoplasm Recurrence, Local, business
Abstract

Purpose We performed a systematic review and a meta-analysis to investigate the successful ablation rate after radioiodine (RAI) administration in patients with differentiated thyroid cancer (DTC) at intermediate-high risk of recurrence. Methods A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. Results The final analysis included 9 studies accounting for 3103 patients at intermediate-high risk of recurrence. In these patients, the successful ablation rates ranged from 51 to 94% with a 71% pooled successful ablation and were higher in intermediate (72%) than in high (52%)-risk patients. Despite the rigorous inclusion standards, a significant heterogeneity among the evaluated studies was observed. Higher administered RAI activities are associated with a lower successful ablation rate in the whole population and in the subgroup of high-risk patients. Furthermore, pooled recurrence rate in intermediate-risk patients achieving successful ablation was only 2% during the subsequent 6.4-year follow-up while the pooled recurrence rate was 14% in patients who did not achieve a successful ablation. Conclusion In a large sample of 3103 patients at intermediate-high risk of persistent/recurrent disease, 71% of patients achieved a successful ablation. In these intermediate-risk patients, the probability of subsequent recurrence is low and most recurrence occurred in those with already abnormal findings at the first control.

Published
2021
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9. Assessment of therapy response to Regorafenib by 18F-DOPA-PET/CT in patients with recurrent high-grade gliomas: a case series

Author

Alessandro Villa, Maria Pia Mazzaferro, Pasqualina Giordano, Marilena Sicignano, Luigi Mansi, Alberto Negro, Alberto Cuocolo, Valeria Gaudieri, Marco Spadafora, Fiorenzo Squame, Francesca Maria Giugliano, Eugenio Di Giorgio, Di Giorgio, Eugenio, Cuocolo, Alberto, Mansi, Luigi, Sicignano, Marilena, Squame, Fiorenzo, Gaudieri, Valeria, Giordano, Pasqualina, Giugliano, Francesca Maria, Mazzaferro, Maria Pia, Negro, Alberto, Villa, Alessandro, and Spadafora, Marco

Subjects
PET-CT, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Magnetic resonance imaging, Interventional radiology, Gold standard (test), 030218 nuclear medicine & medical imaging, Radiation therapy, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, chemistry, 030220 oncology & carcinogenesis, Regorafenib, Medicine, Radiology, Nuclear Medicine and imaging, In patient, business, Nuclear medicine, Perfusion
Abstract

Purpose: Regorafenib (REG) has been recently approved for the treatment of relapsed glioblastoma. Contrast-enhanced (CE) magnetic resonance (MR) imaging represents the gold standard for diagnosis and surveillance of brain tumors. We evaluated the potential role of 18F-DOPA PET/CT in determining the response to REG in a case series of patients with recurrence of high-grade gliomas. Methods: Three patients with recurrence of high-grade gliomas underwent CE-MR and 18F-DOPA PET/CT within 1 week before and at 8-week intervals after REG therapy. 18F-DOPA PET was analyzed using qualitative and quantitative approaches. For the quantitative analysis, maximum (SUVmax), mean standardized uptake values (SUVmean) and metabolic tumor volume (MTV) were obtained. Results: In two patients, an early metabolic response to REG treatment, both visually and in terms of reduction of SUVmax, SUVmean and MTV, was observed. In one subject, no metabolic response was detected. Metabolic PET data were in agreement with morphological and perfusion MRI data in two patients. In one patient, while 18F-DOPA was able to correctly diagnose a metabolic response to REG, MRI had misdiagnosed a pseudo-progression of the disease. Discussion: These preliminary findings suggest that 18F-DOPA PET/CT allows an early and reliable assessment of metabolic response to the REG treatment. A major advantage of PET seems to be obtained in patients in whom MR is unable to differentiate non-response vs tumor pseudo-progression.

Published
2021
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10. International Impact of COVID-19 on the Diagnosis of Heart Disease

Author

Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. B., Pynda, Y., Dondi, M., Gerd Hinterleitner, Paez D., Yao, Lu, Olga, Morozova, Zhuoran, Xu, Juan, Lopez-Mattei, Purvi, Parwani, Mohammad Nawaz Nasery, Artan, Goda, Ervina, Shirka, Rabie, Benlabgaa, Salah, Bouyoucef, Abdelkader, Medjahedi, Qais, Nailli, Mariela, Agolti, Roberto Nicolas Aguero, Maria Del Carmen Alak, Lucia Graciela Alberguina, Guillermo, Arroñada, Andrea, Astesiano, Alfredo, Astesiano, Carolina Bas Norton, Pablo, Benteo, Juan, Blanco, Juan Manuel Bonelli, Jose Javier Bustos, Raul, Cabrejas, Jorge, Cachero, Alejandro, Canderoli, Silvia, Carames, Patrícia, Carrascosa, Ricardo, Castro, Oscar, Cendoya, Luciano Martin Cognigni, Carlos, Collaud, Claudia, Cortes, Javier, Courtis, Daniel, Cragnolino, Mariana, Daicz, Alejandro De La Vega, Silvia Teresa De Maria, Horacio Del Riego, Fernando, Dettori, Alejandro, Deviggiano, Laura, Dragonetti, Mario, Embon, Ruben Emilio Enriquez, Jorge, Ensinas, Fernando, Faccio, Adolfo, Facello, Diego, Garofalo, Ricardo, Geronazzo, Natalia, Gonza, Lucas, Gutierrez, Miguel Angel Guzzo, Victor, Hasbani, Melina, Huerin, Victor, Jäger, Julio Manuel Lewkowicz, Maria Nieves, A López De Munaín, Jose Maria Lotti, Alejandra, Marquez, Osvaldo, Masoli, Edgardo, Mastrovito, Matias, Mayoraz, Graciela Eva Melado, Anibal, Mele, Maria Fernanda Merani, Alejandro Horacio Meretta, Susana, Molteni, Marcos, Montecinos, Eduardo, Noguera, Carlos, Novoa, Claudio Pereyra Sueldo, Sebastian Perez Ascani, Pablo, Pollono, Maria Paula Pujol, Alejandro, Radzinschi, Gustavo, Raimondi, Marcela, Redruello, Marina, Rodríguez, Matías, Rodríguez, Romina Lorena Romero, Arturo Romero Acuña, Federico, Rovaletti, Lucas San Miguel, Lucrecia, Solari, Bruno, Strada, Sonia, Traverso, Sonia Simona Traverzo, Maria Del Huerto Velazquez Espeche, Juan Sebastian Weihmuller, Juan, Wolcan, Susana, Zeffiro, Mari, Sakanyan, Scott, Beuzeville, Raef, Boktor, Patrick, Butler, Jennifer, Calcott, Loretta, Carr, Virgil, Chan, Charles, Chao, Woon, Chong, Mark, Dobson, D'Arne, Downie, Girish, Dwivedi, Barry, Elison, Jean, Engela, Roslyn, Francis, Anand, Gaikwad, Ashok Gangasandra Basavaraj, Bruce, Goodwin, Robert, Greenough, Christian, Hamilton-Craig, Victar, Hsieh, Subodh, Joshi, Karin, Lederer, Kenneth, Lee, Joseph, Lee, John, Magnussen, Nghi, Mai, Gordon, Mander, Fiona, Murton, Dee, Nandurkar, Johanne, Neill, Edward, O'Rourke, Patricia, O'Sullivan, George, Pandos, Kunthi, Pathmaraj, Alexander, Pitman, Rohan, Poulter, Manuja, Premaratne, David, Prior, Lloyd, Ridley, Natalie, Rutherford, Hamid, Salehi, Connor, Saunders, Luke, Scarlett, Sujith, Seneviratne, Deepa, Shetty, Ganesh, Shrestha, Jonathan, Shulman, Vijay, Solanki, Tony, Stanton, Murch, Stuart, Michael, Stubbs, Ian, Swainson, Kim, Taubman, Andrew, Taylor, Paul, Thomas, Steven, Unger, Anthony, Upton, Shankar, Vamadevan, William Van Gaal, Johan, Verjans, Demetrius, Voutnis, Victor, Wayne, Peter, Wilson, David, Wong, Kirby, Wong, John, Younger, Gudrun, Feuchtner, Siroos, Mirzaei, Konrad, Weiss, Natallia, Maroz-Vadalazhskaya, Olivier, Gheysens, Filip, Homans, Rodrigo, Moreno-Reyes, Agnès, Pasquet, Veronique, Roelants, Caroline, M Van De Heyning, Raúl Araujo Ríos, Valentina, Soldat-Stankovic, Sinisa, Stankovic, Maria Helena Albernaz Siqueira, Augusto, Almeida, Paulo Henrique Alves Togni, Jose Henrique Andrade, Luciana, Andrade, Carlos, Anselmi, Roberta, Araújo, Guilherme, Azevedo, Sabbrina, Bezerra, Rodrigo, Biancardi, Gabriel Blacher Grossman, Simone, Brandão, Diego Bromfman Pianta, Lara, Carreira, Bruno, Castro, Tien, Chang, Fernando Cunali Jr, Roberto, Cury, Roberto, Dantas, Fernando de Amorim Fernandes, Andrea De Lorenzo, Robson De Macedo Filho, Fernanda, Erthal, Fabio, Fernandes, Juliano, Fernandes, Thiago Ferreira De Souza, Wilson Furlan Alves, Bruno, Ghini, Luiz, Goncalves, Ilan, Gottlieb, Marcelo, Hadlich, Vinícius, Kameoka, Ronaldo, Lima, Adna, Lima, Rafael Willain Lopes, Ricardo Machado, E Silva, Tiago, Magalhães, Fábio Martins Silva, Luiz Eduardo Mastrocola, Fábio, Medeiros, José Claudio Meneghetti, Vania, Naue, Danilo, Naves, Roberto, Nolasco, Cesar, Nomura, Joao Bruno Oliveira, Eduardo, Paixao, Filipe Penna De Carvalho, Ibraim, Pinto, Priscila, Possetti, Mayra, Quinta, Rodrigo Rizzo Nogueira Ramos, Ricardo, Rocha, Alfredo, Rodrigues, Carlos, Rodrigues, Leila, Romantini, Adelina, Sanches, Sara, Santana, Leonardo Sara da Silva, Paulo, Schvartzman, Cristina Sebastião Matushita, Tiago, Senra, Afonso, Shiozaki, Maria Eduarda Menezes de Siqueira, Cristiano, Siqueira, Paola, Smanio, Carlos Eduardo Soares, José Soares Junior, Marcio Sommer Bittencourt, Bernardo, Spiro, Cláudio Tinoco Mesquita, Jorge, Torreao, Rafael, Torres, Marly, Uellendahl, Guilherme Urpia Monte, Otávia, Veríssimo, Estevan Vieira Cabeda, Felipe Villela Pedras, Roberto, Waltrick, Marcello, Zapparoli, Hamid, Naseer, Marina, Garcheva-Tsacheva, Irena, Kostadinova, Youdaline, Theng, Gad, Abikhzer, Rene, Barette, Benjamin, Chow, Dominique, Dabreo, Matthias, Friedrich, Ria, Garg, Mohammed Nassoh Hafez, Chris, Johnson, Marla, Kiess, Jonathon, Leipsic, Eugene, Leung, Robert, Miller, Anastasia, Oikonomou, Stephan, Probst, Idan, Roifman, Gary, Small, Vikas, Tandon, Adwait, Trivedi, James, White, Katherine, Zukotynski, Jose, Canessa, Gabriel Castro Muñoz, Carmen, Concha, Pablo, Hidalgo, Cesar, Lovera, Teresa, Massardo, Luis Salazar Vargas, Pedro, Abad, Harold, Arturo, Sandra, Ayala, Luis, Benitez, Alberto, Cadena, Carlos, Caicedo, Antonio Calderón Moncayo, Sharon, Gomez, Claudia, T Gutierrez Villamil, Claudia, Jaimes, Juan Luis Londoño Blair, Luz, Pabon, Mauricio, Pineda, Juan Carlos Rojas, Diego, Ruiz, Manuel Valencia Escobar, Andres, Vasquez, Damiana, Vergel, Alejandro, Zuluaga, Isabel Berrocal Gamboa, Gabriel, Castro, Ulises, González, Ana, Baric, Tonci, Batinic, Maja, Franceschi, Maja Hrabak Paar, Mladen, Jukic, Petar, Medakovic, Viktor, Persic, Marina, Prpic, Ante, Punda, Juan Felipe Batista, Juan Manuel Gómez Lauchy, Yamile Marcos Gutierrez, Rayner, Menéndez, Amalia, Peix, Luis, Rochela, Christoforos, Panagidis, Ioannis, Petrou, Vaclav, Engelmann, Milan, Kaminek, Vladimír, Kincl, Otto, Lang, Milan, Simanek, Jawdat, Abdulla, Morten, Bøttcher, Mette, Christensen, Lars Christian Gormsen, Philip, Hasbak, Søren, Hess, Paw, Holdgaard, Allan, Johansen, Kasper, Kyhl, Kristian Altern Øvrehus, Niels Peter Rønnow Sand, Rolf, Steffensen, Anders, Thomassen, Zerahn, Bo, Alfredo, Perez, Giovanni Alejandro Escorza Velez, Mayra Sanchez Velez, Islam Shawky Abdel Aziz, Mahasen, Abougabal, Taghreed, Ahmed, Ahmed, Asfour, Mona, Hassan, Alia, Hassan, Ahmed, Ibrahim, Sameh, Kaffas, Ahmed, Kandeel, Mohamed Mandour Ali, Ahmad, Mansy, Hany, Maurice, Sherif, Nabil, Mahmoud, Shaaban, Ana Camila Flores, Anne, Poksi, Juhani, Knuuti, Velipekka, Kokkonen, Martti, Larikka, Valtteri, Uusitalo, Matthieu, Bailly, Samuel, Burg, Jean-François, Deux, Vincent, Habouzit, Fabien, Hyafil, Olivier, Lairez, Franck, Proffit, Hamza, Regaieg, Laure, Sarda-Mantel, Vania, Tacher, Roman, P Schneider, Harold, Ayetey, George, Angelidis, Aikaterini, Archontaki, Sofia, Chatziioannou, Ioannis, Datseris, Christina, Fragkaki, Panagiotis, Georgoulias, Sophia, Koukouraki, Maria, Koutelou, Eleni, Kyrozi, Evangelos, Repasos, Petros, Stavrou, Pipitsa, Valsamaki, Carla, Gonzalez, Goleat, Gutierrez, Alejandro, Maldonado, Klara, Buga, Ildiko, Garai, Erzsébet, Schmidt, Balint, Szilveszter, Edit, Várady, Nilesh, Banthia, Jinendra Kumar Bhagat, Rishi, Bhargava, Vivek, Bhat, Partha, Choudhury, Vijay Sai Chowdekar, Aparna, Irodi, Shashank, Jain, Elizabeth, Joseph, Sukriti, Kumar, Girijanandan, Mahapatra, Deepanjan, Mitra, Bhagwant Rai Mittal, Ahmad, Ozair, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Patel, Sudhir, Saxena, Shantanu, Sengupta, Santosh, Singh, Bhanupriya, Singh, Ashwani, Sood, Atul, Verma, Erwin, Affandi, Padma Savenadia Alam, Edison, Edison, Gani, Gunawan, Habusari, Hapkido, Basuki, Hidayat, Aulia, Huda, Anggoro Praja Mukti, Djoko, Prawiro, Erwin Affandi Soeriadi, Hilman, 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Ahmed Tawakol, Dustin, Thomas, Randall, Thompson, Tara, Torbet, Desiree, Trinidad, Shawn, Ullery, Samuel, Unzek, Seth, Uretsky, Srikanth, Vallurupalli, Vikas, Verma, Alfonso, Waller, Ellen, Wang, Parker, Ward, Gaby, Weissman, George, Wesbey, Kelly, White, David, Winchester, David, Wolinsky, Sandra, Yost, Michael, Zgaljardic, Omar, Alonso, Mario, Beretta, Rodolfo, Ferrando, Miguel, Kapitan, Fernando, Mut, Omoa, Djuraev, Gulnora, Rozikhodjaeva, Ha Le Ngoc, Son Hong Mai, Xuan Canh Nguyen, Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. B., Pynda, Y., Dondi, M., Paez, D., Cuocolo, A., Einstein, A, Shaw, L, Hirschfeld, C, Williams, M, Villines, T, Better, N, Vitola, J, Cerci, R, Dorbala, S, Raggi, P, Choi, A, Lu, B, Sinitsyn, V, Sergienko, V, Kudo, T, Norgaard, B, Maurovich-Horvat, P, Campisi, R, Milan, E, Louw, L, Allam, A, Bhatia, M, Malkovskiy, E, Goebel, B, Cohen, Y, Randazzo, M, Narula, J, Pascual, T, Pynda, Y, Dondi, M, Paez, D, Pacella, S, and Erba, P

Subjects
INCAPS COVID Investigators Group, Heart disease, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Diagnostic Techniques, Cardiovascular, coronavirus, global health, IAEA, Disease, Telehealth, Cardiorespiratory Medicine and Haematology, 030204 cardiovascular system & hematology, Cardiovascular, 0302 clinical medicine, cardiovascular disease, cardiac testing, COVID-19, diagnostic techniques, cardiovascular, health care surveys, heart diseases, humans, international agencies, Pandemic, Global health, 030212 general & internal medicine, COVID-19 Heart Disease, Cause of death, STATEMENT, Heart Disease, International Agencie, Public Health and Health Services, Biomedical Imaging, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Heart Diseases, 03 medical and health sciences, Clinical Research, medicine, Humans, Personal protective equipment, Heart Disease - Coronary Heart Disease, business.industry, International Agencies, medicine.disease, the, coronaviru, Diagnostic Techniques, Good Health and Well Being, Clinical research, Cardiovascular System & Hematology, Health Care Survey, Health Care Surveys, Emergency medicine, Global Health, business
Abstract

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. OBJECTIVES The study sought to assess COVID-19`s impact on global cardiovascular diagnostic procedural volumes and safety practices. METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. RESULTS Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoradc echocardiography decreased by 59%, transesophageat echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). hi multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower-middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and teteheatth. CONCLUSIONS COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19-related changes in care delivery is warranted. (C) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

Published
2021
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11. Does left ventricular function predict cardiac outcome in Anderson–Fabry disease?

Author

Alberto Cuocolo, Bruno Trimarco, Letizia Spinelli, Eleonora Riccio, Giovanni Esposito, Antonio Pisani, Massimo Imbriaco, Giuseppe Giugliano, Camilla Russo, Spinelli, Letizia, Giugliano, Giuseppe, Pisani, Antonio, Imbriaco, Massimo, Riccio, Eleonora, Russo, Camilla, Cuocolo, Alberto, Trimarco, Bruno, and Esposito, Giovanni

Subjects
Adult, Male, medicine.medical_specialty, Diastole, Anderson-Fabry disease, Ventricular tachycardia, Risk Assessment, Ventricular Function, Left, Ventricular Dysfunction, Left, Predictive Value of Tests, Risk Factors, Interquartile range, Internal medicine, Ventricular Pressure, medicine, Humans, Radiology, Nuclear Medicine and imaging, Sinus rhythm, Myocardial work, Retrospective Studies, Original Paper, Univariate analysis, Anderson–Fabry disease, LV longitudinal strain, Ejection fraction, business.industry, Atrial fibrillation, Middle Aged, Prognosis, medicine.disease, Echocardiography, Doppler, Adverse cardiac event, Heart failure, Cardiology, Fabry Disease, Female, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
Abstract

In Anderson–Fabry disease (AFD) the impact of left ventricular (LV) function on cardiac outcome is unknown. Noninvasive LV pressure–strain loop analysis is a new echocardiographic method to estimate myocardial work (MW). We aimed to evaluate whether LV function was associated with outcome and whether MW had a prognostic value in AFD. Ninety-six AFD patients (41.8 ± 14.7 years, 43.7% males) with normal LV ejection fraction were retrospectively evaluated. Inclusion criteria were sinus rhythm and ≥ 2-year follow-up. Standard echocardiography measurements, myocardial mechano-energetic efficiency (MEE) index, global longitudinal strain (GLS) and MW were evaluated. Adverse cardiac events were defined as composite of cardiac death, malignant ventricular tachycardia, atrial fibrillation and severe heart failure development. During a median follow-up of 63 months (interquartile range 37–85), 14 events occurred. Patient age, cardiac biomarkers, LV mass index, left atrium volume, E/Ea ratio, LV ejection fraction, MEE index, GLS and all MW indices were significantly related to adverse outcome at univariate analysis. After adjustment for clinical and echocardiographic parameters, which were significant at univariate analysis, GLS and MW resulted independent predictors of adverse events (p

Published
2020
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12. Management of differentiated thyroid cancer through nuclear medicine facilities during Covid-19 emergency: the telemedicine challenge

Author

Michele Klain, Martin Schlumberger, Mariarosaria Manganelli, Carmela Nappi, Alberto Cuocolo, Leandra Piscopo, Simone Maurea, Marina De Risi, Elisa Caiazzo, Fabio Volpe, Klain, Michele, Nappi, Carmela, Maurea, Simone, De Risi, Marina, Volpe, Fabio, Caiazzo, Elisa, Piscopo, Leandra, Manganelli, Mariarosaria, Schlumberger, Martin, and Cuocolo, Alberto

Subjects
Male, Medical surveillance, Telemedicine, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Office visits, 131I, Telehealth, Thyroid cancer, 030218 nuclear medicine & medical imaging, Iodine Radioisotopes, 03 medical and health sciences, 0302 clinical medicine, Outpatients, Pandemic, Ambulatory Care, medicine, Humans, Radiology, Nuclear Medicine and imaging, Thyroid Neoplasms, Pandemics, Retrospective Studies, SARS-CoV-2, business.industry, Thyroidectomy, General Medicine, medicine.disease, Italy, Radiology Nuclear Medicine and imaging, 030220 oncology & carcinogenesis, Original Article, Medical emergency, Nuclear Medicine, Southern Italy, Covid-19, business, Delivery of Health Care
Abstract

Purpose To investigate whether a telemedicine service (TMS) carried out during the Covid-19 pandemic impacted on management of patients with differentiated thyroid cancer (DTC). Methods We retrospectively reviewed the number and the findings of outpatient visits in DTC subjects referred between March 11, 2020, and May 31, 2020, during the Covid-19 pandemic at the Radiometabolic Unit of the University of Naples Federico II. Office visits scheduled in March and May 2020 were converted in teleconsultation reaching all patients planned for an in-ward access to advise them to use the TMS for all clinical necessity. The number and the findings of DTC patients evaluated by in-ward access in the corresponding period of 2019 were also assessed for direct comparison. Results The number of outpatient visits performed by TMS during the pandemic (n = 445) and by in-ward access in the corresponding period of 2019 (n = 525) was comparable with only 15% of outpatient evaluations missed. Conclusions Our findings demonstrate the utility of telemedicine tools to avoid the potential negative impact of interruption or postponement of diagnostic and/or therapeutic procedures. Therefore, investments in medical network system development, including the implementation of telehealth approaches, should be encouraged at national and international levels.

Published
2020
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13. Comparison of simultaneous 18F-2-[18F] FDG PET/MR and PET/CT in the follow-up of patients with differentiated thyroid cancer

Author

Marco Salvatore, Emilia Zampella, Martin Schlumberger, Emanuele Nicolai, Carmela Nappi, Alessia Giordano, Leandra Piscopo, Valeria Romeo, Cavaliere Carlo, Michele Klain, Leonardo Pace, Alberto Cuocolo, Valeria Gaudieri, Klain, Michele, Nappi, Carmela, Nicolai, Emanuele, Romeo, Valeria, Piscopo, Leandra, Giordano, Alessia, Gaudieri, Valeria, Zampella, Emilia, Pace, Leonardo, Carlo, Cavaliere, Salvatore, Marco, Schlumberger, Martin, and Cuocolo, Alberto

Subjects
FDG, PET/CT, medicine.medical_treatment, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Differentiated thyroid cancer, PET/MR, Medicine, Radiology, Nuclear Medicine and imaging, Thyroid cancer, Fluorodeoxyglucose, PET-CT, medicine.diagnostic_test, business.industry, Thyroid, Thyroidectomy, General Medicine, medicine.disease, Radiation therapy, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Thyroglobulin, business, Nuclear medicine, Emission computed tomography, medicine.drug
Abstract

Aims 18F-FDG PET/CT is the most accurate imaging modality in differentiated thyroid cancer (DTC) patients with either an aggressive histology, an absence of radioiodine uptake in neoplastic foci, or in the absence of imaging abnormalities in patients with an elevated serum thyroglobulin (Tg) level that progresses with time. We evaluated the diagnostic performance of FDG PET/MR in comparison with that of PET/CT. Methods and results Following the injection of a single 18F-FDG activity, PET/MR and PET/CT were sequentially performed in 40 consecutive patients with DTC previously treated with total thyroidectomy and radioiodine ablation. All patients were then followed up for at least 6 months. PET/MR was positive in 11 patients and PET/CT in 10. PET/MR detected 33 tumor foci and PET/CT 30. During the follow-up of the 12 patients with negative initial PET studies and with a detectable serum Tg, only one patient had a neck recurrence and the administration of an empiric high activity of 131I in the other 11 patients did not reveal any tumor focus. In the 17 patients with an initial serum Tg level < 2 ng/mL, no recurrence occurred. Conclusion This study confirms the high diagnostic accuracy of FDG PET studies in DTC patients with elevated serum Tg levels and shows that PET/MR brings similar information as compared to PET/CT imaging.

Published
2020
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14. FDG-PET/CT imaging during the Covid-19 emergency: a southern Italian perspective

Author

Alberto Cuocolo, Silvana Del Vecchio, Ciro Mainolfi, Alessandra Annunziata, Mario Petretta, Ludovica Attanasio, Claudia Bombace, Simone Maurea, Maurea, Simone, Mainolfi, Ciro Gabriele, Bombace, Claudia, Annunziata, Alessandra, Attanasio, Ludovica, Petretta, Mario, Del Vecchio, Silvana, and Cuocolo, Alberto

Subjects
medicine.medical_specialty, Fluorine Radioisotopes, Coronavirus disease 2019 (COVID-19), Thymoma, Pneumonia, Viral, Standardized uptake value, 030218 nuclear medicine & medical imaging, Imaging, 03 medical and health sciences, Betacoronavirus, 0302 clinical medicine, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Pandemic, medicine, Humans, Radiology, Nuclear Medicine and imaging, Laryngeal Neoplasms, Pandemics, Retrospective Studies, Fluorodeoxyglucose, business.industry, SARS-CoV-2, Carcinoma, COVID-19, Retrospective cohort study, General Medicine, medicine.disease, FDG-PET/CT, Pneumonia, Italy, Radiology Nuclear Medicine and imaging, 030220 oncology & carcinogenesis, Ct technique, Fdg pet ct, Original Article, Radiology, Southern Italy, Radiopharmaceuticals, business, Coronavirus Infections, Procedures and Techniques Utilization, medicine.drug
Abstract

Purpose To assess the impact of the Covid-19 pandemic on FDG-PET/CT work volume and to evaluate the occurrence of abnormal imaging findings suspicious or potentially diagnostic for interstitial pneumonia by Covid-19 infection in south Italy. Methods We retrospectively reviewed the number and the findings of FDG-PET/CT studies acquired between February and April 2020 during the Covid-19 pandemic at the University of Napoli Federico II. The number and the findings of FDG-PET/CT studies acquired in the corresponding period of 2019 were also assessed for direct comparison. Results The number of FDG-PET/CT studies performed during the pandemic (n = 299) and in the corresponding period of 2019 (n = 335) were comparable. The percentage of abnormal FDG-PET/CT findings, suspicious for interstitial pneumonia by Covid-19 infection, was significantly higher during the pandemic (9%) compared with that found in the corresponding period of 2019 (4%) (χ2 5.45, P = 0.02). No significant differences were observed in the distribution of Covid-19 reporting and data system (CO-RADS) classification and in the maximum standardized uptake value between the pandemic (2.6 ± 2.2) and the corresponding period of 2019 (3.2 ± 1.4). Of note, patients with abnormal imaging findings during the pandemic time had clinical data and/or laboratory tests negative for Covid-19 infection. Conclusion Despite the restrictive medical measures for the emergency, the number of FDG-PET/CT studies was unchanged during the pandemic compared with the previous year. Our findings also indicate that Covid-19 infection was contained in our series of patients from southern Italy.

Published
2020

15. Quantification of myocardial perfusion reserve by CZT-SPECT: A head to head comparison with 82Rubidium PET imaging

Author

Adriana D'Antonio, Giovanni De Simini, Ciro Mainolfi, Emilia Zampella, Teresa Mannarino, Roberta Assante, Carmela Nappi, Alberto Cuocolo, Andrea Genova, Wanda Acampa, Valeria Gaudieri, Pietro Buongiorno, Mario Petretta, Acampa, Wanda, Zampella, Emilia, Assante, Roberta, Genova, Andrea, De Simini, Giovanni, Mannarino, Teresa, D'Antonio, Adriana, Gaudieri, Valeria, Nappi, Carmela, Buongiorno, Pietro, Mainolfi, Ciro Gabriele, Petretta, Mario, and Cuocolo, Alberto

Subjects
Coronary angiography, business.industry, Head to head, Area under the curve, Diagnostic and prognostic application, Pet imaging, Blood flow, 030204 cardiovascular system & hematology, Perfusion reserve, Myocardial blood flow, 030218 nuclear medicine & medical imaging, Patient management, 03 medical and health sciences, PET, 0302 clinical medicine, SPECT, Medicine, CAD, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business, Nuclear medicine, Cardiac imaging
Abstract

BACKGROUND: We measured myocardial blood flow (MBF) and perfusion reserve (MPR) by dynamic CZT-SPECT and 82Rb-PET in patients with suspected or known coronary artery disease (CAD) and compared the accuracy of the two methods in predicting obstructive CAD. METHODS: Twenty-five patients with available coronary angiography data underwent 99mTc-sestamibi CZT-SPECT and 82Rb-PET cardiac imaging. Stress and rest MBF and MPR were calculated by both methods and compared. Diagnostic accuracies of CZT-SPECT and PET were also assessed using a receiver-operator-characteristic curve. RESULTS: CZT-SPECT yielded similar baseline MBF, but higher hyperemic MBF and MPR values compared to PET. There was a modest correlation between the two methods for MPR (r = 0.56, P < .01). MPR by CZT-SPECT showed a good ability in identify a reduced MPR by PET, with an area under the curve of 0.85. A MPR cut-off of 2.5 was identified by CZT-SPECT for detection of abnormal MPR by PET, with a sensitivity, specificity and accuracy of 86%, 73% and 80%. The area under the curve for the identification of obstructive CAD by regional MPR were 0.83 for CZT-SPECT and 0.84 for PET (P = .90). At CZT-SPECT, a regional MPR of 2.1 provided the best trade-off between sensitivity and specificity for identifying obstructive CAD. Diagnostic accuracy of CZT-SPECT and PET using respective cut-off values was comparable (P = .62). CONCLUSION: Hyperemic MBF and MPR values obtained by CZT-SPECT are higher than those measured by 82Rb-PET imaging, with a moderate correlation between the two methods. CZT-SPECT shows good diagnostic accuracy for the identification of obstructive CAD. These findings may encourage the use of this new technique to a better risk stratification and patient management.

Published
2020
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16. Left ventricular radial strain impairment precedes hypertrophy in Anderson–Fabry disease

Author

Letizia Spinelli, Antonio Pisani, Andrea Ponsiglione, Bruno Trimarco, Giuseppe Giugliano, Eleonora Riccio, Massimo Imbriaco, Giovanni Esposito, Carmela Nappi, Alberto Cuocolo, Spinelli, Letizia, Giugliano, Giuseppe, Imbriaco, Massimo, Esposito, Giovanni, Nappi, Carmela, Riccio, Eleonora, Ponsiglione, Andrea, Pisani, Antonio, Cuocolo, Alberto, and Trimarco, Bruno

Subjects
Adult, Male, medicine.medical_specialty, Population, Concentric hypertrophy, Speckle tracking echocardiography, Anderson-Fabry disease, 030204 cardiovascular system & hematology, Ventricular Function, Left, Strain, 030218 nuclear medicine & medical imaging, Muscle hypertrophy, Ventricular Dysfunction, Left, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Fibrosis, Internal medicine, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Prospective Studies, education, Cardiac imaging, Aged, Echocardiography, Doppler, Pulsed, education.field_of_study, Anderson–Fabry disease, Ejection fraction, Ventricular Remodeling, business.industry, Speckle-tracking echocardiography, Middle Aged, medicine.disease, Echocardiography, Doppler, Color, Case-Control Studies, Disease Progression, Cardiology, Fabry Disease, Female, Hypertrophy, Left Ventricular, Cardiology and Cardiovascular Medicine, business, Radial stress
Abstract

In Anderson-Fabry disease (AFD), left ventricular (LV) radial function has been scarcely investigated. We hypothesized that LV function may be affected by disease specific mechanisms and sought to comprehensively evaluate LV radial, circumferential and longitudinal function in a large population of AFD patients looking at the influence of LV geometry and fibrosis. We prospectively studied 94 consecutive AFD patients (41.5 ± 14.5 years; 41 men) with preserved LV ejection fraction (EF) utilizing speckle-tracking echocardiography. A subset of patients underwent gadolinium-enhanced cardiac magnetic resonance. Cases were compared to 48 healthy subjects matched for age and sex. LV concentric hypertrophy was found in 33 AFD patients while LV concentric remodeling (relative wall thickness ≥ 0.43) in 16 out 61 patients with normal LV mass. AFD patients had lower radial, longitudinal and circumferential strains than controls, independently by LV geometry pattern. Patients with LV hypertrophy showed reduced global longitudinal strain (p

Published
2020
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17. External validation of the CRAX2MACE model in an Italian cohort of patients with suspected coronary artery disease undergoing stress myocardial perfusion imaging

Author

Adriana D'Antonio, Teresa Mannarino, Wanda Acampa, Pietro Buongiorno, Roberta Assante, Rosario Megna, Roberta Green, Mario Petretta, Carmela Nappi, Alberto Cuocolo, Valeria Cantoni, Valeria Gaudieri, Emilia Zampella, Megna, Rosario, Petretta, Mario, Assante, Roberta, Zampella, Emilia, Nappi, Carmela, Gaudieri, Valeria, Mannarino, Teresa, Green, Roberta, Cantoni, Valeria, Buongiorno, Pietro, D’Antonio, Adriana, Acampa, Wanda, and Cuocolo, Alberto

Subjects
medicine.medical_specialty, medicine.diagnostic_test, Receiver operating characteristic, business.industry, Context (language use), medicine.disease, Coronary artery disease, Myocardial perfusion imaging, Brier score, Internal medicine, Cohort, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, CAD, SPECT, MPI, Diagnostic and prognostic application, Mace
Abstract

Background. Prevention and development of diagnostic and therapeutic techniques reduced morbidity and mortality for coronary artery disease (CAD). In this context, the cardiovascular risk assessment for major adverse cardiac events (MACE) at 2-year (CRAX2MACE) model for prediction of 2-year major adverse cardiac events was developed. We performed an external validation of this model. Methods. We included 1003 patients with suspected CAD undergoing stress-rest single photon emission computed tomography myocardial perfusion imaging at our academic center between March 2015 and April 2019. Results. Considering the occurrence of MACE (death from any cause, acute myocardial infarction, or late coronary revascularization), for the CRAX2MACE model the area under the receiver operating characteristic curve was 0.612 and the Brier score was 0.061. The Hosmer–Lemeshow test estimated a non-optimal fit (X2 28, P < .001). Considering only hard events (cardiac death, acute myocardial infarction), the external validation of the CRAX2MACE model revealed a Brier score of 0.053 and an area under the receiver operating characteristic curve of 0.621. Hosmer–Lemeshow test was calculated by deciles and showed a poor fit (X2 31, P < .001). Conclusion. CRAX2MACE model had a limited value for predicting 2-year major adverse cardiovascular events in an external validation cohort of patients with suspected CAD.

Published
2022

18. A machine learning-based approach to directly compare the diagnostic accuracy of myocardial perfusion imaging by conventional and cadmium-zinc telluride SPECT

Author

Giovanni De Simini, Mario Petretta, Wanda Acampa, Valeria Cantoni, Roberta Green, Roberta Assante, Teresa Mannarino, Carmela Nappi, Emilia Zampella, Andrea Genova, Alessia Giordano, Adriana D'Antonio, Carlo Ricciardi, Alberto Cuocolo, Valeria Gaudieri, Cantoni, Valeria, Green, Roberta, Ricciardi, Carlo, Assante, Roberta, Zampella, Emilia, Nappi, Carmela, Gaudieri, Valeria, Mannarino, Teresa, Genova, Andrea, De Simini, Giovanni, Giordano, Alessia, D’Antonio, Adriana, Acampa, Wanda, Petretta, Mario, and Cuocolo, Alberto

Subjects
Population, Diagnostic accuracy, CAD, Coronary Artery Disease, 030204 cardiovascular system & hematology, Machine learning, computer.software_genre, 030218 nuclear medicine & medical imaging, Machine Learning, 03 medical and health sciences, Myocardial perfusion imaging, chemistry.chemical_compound, 0302 clinical medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Sensitivity (control systems), education, Tomography, Emission-Computed, Single-Photon, education.field_of_study, medicine.diagnostic_test, business.industry, Myocardial Perfusion Imaging, Cadmium zinc telluride, Zinc, chemistry, Known Coronary Artery Disease, Artificial intelligence, Tellurium, Cardiology and Cardiovascular Medicine, business, computer, Emission computed tomography, Cadmium
Abstract

Background. We evaluated the performance of conventional (C) single-photon emission computed tomography (SPECT) and cadmium-zinc-telluride (CZT)-SPECT in a large cohort of patients with suspected or known coronary artery disease (CAD) and compared the diagnostic accuracy of the two systems using machine learning (ML) algorithms. Methods and Results. A total of 517 consecutive patients underwent stress myocardial perfusion imaging (MPI) by both C-SPECT and CZT-SPECT. In the overall population, an excellent correlation between stress MPI data and left ventricular (LV) functional parameters measured by C-SPECT and by CZT-SPECT was observed (all P < .001). ML analysis performed through the implementation of random forest (RF) and k-nearest neighbors (NN) algorithms proved that CZT-SPECT has greater accuracy than C-SPECT in detecting CAD. For both algorithms, the sensitivity of CZT-SPECT (96% for RF and 60% for k-NN) was greater than that of C-SPECT (88% for RF and 53% for k-NN). Conclusions. MPI data and LV functional parameters obtained by CZT-SPECT are highly reproducible and provide good correlation with those obtained by C-SPECT. ML approach showed that the accuracy and sensitivity of CZT-SPECT is greater than C-SPECT in detecting CAD.

Published
2022

19. 18F-FDG PET/CMR in cardiac sarcoidosis: A wild card in the deck?

Author

Andrea Ponsiglione, Alberto Cuocolo, Massimo Imbriaco, Carmela Nappi, Nappi, Carmela, Ponsiglione, Andrea, Imbriaco, Massimo, and Cuocolo, Alberto

Subjects
Wild card, medicine.medical_specialty, business.industry, medicine, MEDLINE, Radiology, Nuclear Medicine and imaging, Cardiac sarcoidosis, Radiology, Cardiology and Cardiovascular Medicine, business, 18f fdg pet
Published
2022

20. Cardiac CT and MRI radiomics: systematic review of the literature and radiomics quality score assessment

Author

Andrea Ponsiglione, Marco De Giorgi, Arnaldo Stanzione, Alberto Cuocolo, Raffaele Ascione, Carmela Nappi, Michele Gambardella, Massimo Imbriaco, Renato Cuocolo, Ponsiglione, Andrea, Stanzione, Arnaldo, Cuocolo, Renato, Ascione, Raffaele, Gambardella, Michele, De Giorgi, Marco, Nappi, Carmela, Cuocolo, Alberto, and Imbriaco, Massimo

Subjects
medicine.medical_specialty, Web of science, Systematic review, Cardiovascular system, Magnetic resonance imaging, Multidetector computed tomography, Multidetector computed tomography, Magnetic resonance imaging, Radiomics, Cardiovascular system, Systematic review, Humans, Radiography, Magnetic Resonance Imaging, Tomography, X-Ray Computed, medicine, Radiology, Nuclear Medicine and imaging, Methodological quality, Tomography, Neuroradiology, medicine.diagnostic_test, business.industry, General Medicine, X-Ray Computed, Quartile, Quality Score, Radiology, business, Medical doctor
Abstract

To systematically review and evaluate the methodological quality of studies using magnetic resonance imaging (MRI) and computed tomography (CT) radiomics for cardiac applications. Multiple medical literature archives (PubMed, Web of Science, and EMBASE) were systematically searched to retrieve original studies focused on cardiac MRI and CT radiomics applications. Two researchers in consensus assessed each investigation using the radiomics quality score (RQS). Subgroup analyses were performed to assess whether the total RQS varied according to study aim, journal quartile, imaging modality, and first author category. From a total of 1961 items, 53 articles were finally included in the analysis. Overall, the studies reached a median total RQS of 7 (IQR, 4–12), corresponding to a percentage score of 19.4% (IQR, 11.1–33.3%). Item scores were particularly low due to lack of prospective design, cost-effectiveness analysis, and open science. Median RQS percentage score was significantly higher in papers where the first author was a medical doctor and in those published on first quartile journals. The overall methodological quality of radiomics studies in cardiac MRI and CT is still lacking. A higher degree of standardization of the radiomics workflow and higher publication standards for studies are required to allow its translation into clinical practice. • RQS has been recently proposed for the overall assessment of the methodological quality of radiomics-based studies. • The 53 included studies on cardiac MRI and CT radiomics applications reached a median total RQS of 7 (IQR, 4–12), corresponding to a percentage of 19.4% (IQR, 11.1–33.3%). • A more standardized methodology in the radiomics workflow is needed, especially in terms of study design, validation, and open science, in order to translate the results to clinical applications.

Published
2022

21. Correction to: Relation between myocardial blood flow and cardiac events in diabetic patients with suspected coronary artery disease and normal myocardial perfusion imaging

Author

Mario Petretta, Parthiban Arumugam, Alberto Cuocolo, Wanda Acampa, Roberta Assante, Valeria Gaudieri, Carmela Nappi, Ciro Mainolfi, Teresa Mannarino, Emilia Zampella, Adriana D'Antonio, Assante, Roberta, Mainolfi, Ciro Gabriele, Zampella, Emilia, Gaudieri, Valeria, Nappi, Carmela, Mannarino, Teresa, D'Antonio, Adriana, Arumugam, Parthiban, Petretta, Mario, Cuocolo, Alberto, and Acampa, Wanda

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Blood flow, medicine.disease, Stress imaging, Coronary artery disease, Myocardial perfusion imaging, Diabetes mellitus, Internal medicine, Cardiology, Medicine, Radiology, Nuclear Medicine and imaging, In patient, Coronary vasodilator, Cardiology and Cardiovascular Medicine, business, Perfusion
Abstract

We assessed the prognostic value of structural abnormalities and coronary vasodilator function in diabetic patients referred to a PET/CT for suspected coronary artery disease (CAD). We studied 451 diabetics and 451 nondiabetics without overt CAD and normal myocardial perfusion. Myocardial blood flow (MBF) was computed from the dynamic rest and stress imaging. Myocardial flow reserve (MFR) was defined as ratio of hyperemic to baseline MBF and was considered reduced when

Published
2022

22. Dynamic CZT-SPECT in coronary artery disease: Where are we now?

Author

Alberto Cuocolo, Roberta Green, Valeria Cantoni, Adriana D'Antonio, Cantoni, Valeria, Green, Roberta, D'Antonio, Adriana, and Cuocolo, Alberto

Subjects
Tomography, Emission-Computed, Single-Photon, medicine.medical_specialty, business.industry, Myocardial Perfusion Imaging, Coronary Artery Disease, medicine.disease, Coronary artery disease, Internal medicine, Cardiology, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Tellurium, Cardiology and Cardiovascular Medicine, business, Cadmium
Abstract

NA

Published
2022

23. A Comparison among Different Machine Learning Pretest Approaches to Predict Stress-Induced Ischemia at PET/CT Myocardial Perfusion Imaging

Author

Alberto Cuocolo, Valeria Gaudieri, Adriana D'Antonio, Carmela Nappi, Parthiban Arumugam, Roberta Green, Rosario Megna, Roberta Assante, Teresa Mannarino, Emilia Zampella, Wanda Acampa, Mario Petretta, Valeria Cantoni, Megna, Rosario, Petretta, Mario, Assante, Roberta, Zampella, Emilia, Nappi, Carmela, Gaudieri, Valeria, Mannarino, Teresa, D’Antonio, Adriana, Green, Roberta, Cantoni, Valeria, Arumugam, Parthiban, Acampa, Wanda, and Cuocolo, Alberto

Subjects
Male, Support Vector Machine, Article Subject, Computer applications to medicine. Medical informatics, R858-859.7, Myocardial Ischemia, Coronary Artery Disease, Machine learning, computer.software_genre, General Biochemistry, Genetics and Molecular Biology, Cohort Studies, Machine Learning, Myocardial perfusion imaging, Naive Bayes classifier, Predictive Value of Tests, Positron Emission Tomography Computed Tomography, medicine, Humans, AdaBoost, Aged, PET-CT, General Immunology and Microbiology, medicine.diagnostic_test, business.industry, Applied Mathematics, Decision Trees, Myocardial Perfusion Imaging, Computational Biology, Bayes Theorem, General Medicine, Gold standard (test), Middle Aged, Random forest, Pre- and post-test probability, Logistic Models, Positron emission tomography, Modeling and Simulation, Exercise Test, Female, Artificial intelligence, business, computer, Algorithms, Research Article
Abstract

Traditional approach for predicting coronary artery disease (CAD) is based on demographic data, symptoms such as chest pain and dyspnea, and comorbidity related to cardiovascular diseases. Usually, these variables are analyzed by logistic regression to quantifying their relationship with the outcome; nevertheless, their predictive value is limited. In the present study, we aimed to investigate the value of different machine learning (ML) techniques for the evaluation of suspected CAD; having as gold standard, the presence of stress-induced ischemia by 82Rb positron emission tomography/computed tomography (PET/CT) myocardial perfusion imaging (MPI) ML was chosen on their clinical use and on the fact that they are representative of different classes of algorithms, such as deterministic (Support vector machine and Naïve Bayes), adaptive (ADA and AdaBoost), and decision tree (Random Forest, rpart, and XGBoost). The study population included 2503 consecutive patients, who underwent MPI for suspected CAD. To testing ML performances, data were split randomly into two parts: training/test (80%) and validation (20%). For training/test, we applied a 5-fold cross-validation, repeated 2 times. With this subset, we performed the tuning of free parameters for each algorithm. For all metrics, the best performance in training/test was observed for AdaBoost. The Naïve Bayes ML resulted to be more efficient in validation approach. The logistic and rpart algorithms showed similar metric values for the training/test and validation approaches. These results are encouraging and indicate that the ML algorithms can improve the evaluation of pretest probability of stress-induced myocardial ischemia.

Published
2021

24. Nuclear cardiac imaging between implementation and globalization: The key role of integration

Author

Alberto Cuocolo, Carmela Nappi, Mario Petretta, Wanda Acampa, Cuocolo, Alberto, Nappi, Carmela, Acampa, Wanda, and Petretta, Mario

Subjects
Tomography, Emission-Computed, Single-Photon, 2019-20 coronavirus outbreak, Internationality, Coronavirus disease 2019 (COVID-19), business.industry, Computed Tomography Angiography, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Physical Distancing, Cardiology, COVID-19, Coronary Artery Disease, Data science, Globalization, Positron-Emission Tomography, Key (cryptography), Medicine, Humans, Radiology, Nuclear Medicine and imaging, Nuclear Medicine, Cardiology and Cardiovascular Medicine, business, Delivery of Health Care, Cardiac imaging, Editor's Page, Societies, Medical
Abstract

NA

Published
2021

25. Risk of primary breast cancer in patients with differentiated thyroid cancer undergoing radioactive iodine therapy: a systematic review and meta-analysis

Author

Mario Petretta, Fabio Volpe, Simone Maurea, Michele Klain, Roberta Green, Leandra Piscopo, Alberto Cuocolo, Carmela Nappi, Valeria Cantoni, Nappi, Carmela, Klain, Michele, Cantoni, Valeria, Green, Roberta, Piscopo, Leandra, Volpe, Fabio, Maurea, Simone, Petretta, Mario, and Cuocolo, Alberto

Subjects
Oncology, medicine.medical_specialty, business.industry, Breast Neoplasms, Neoplasms, Second Primary, General Medicine, Adenocarcinoma, medicine.disease, Malignancy, Confidence interval, Iodine Radioisotopes, Breast cancer, hemic and lymphatic diseases, Relative risk, Internal medicine, Meta-analysis, Medicine, Humans, Radiology, Nuclear Medicine and imaging, In patient, Female, Thyroid Neoplasms, business, Primary breast cancer, Thyroid cancer
Abstract

Purpose: Although it has been proven that radioactive iodine (RAI) treatment is an effective and well-tolerated procedure in patients with differentiated thyroid cancer (DTC), there is still some concern regarding the risk of developing a second primary malignancy after RAI administration. We performed a systematic review and meta-analysis to investigate the risk of primary breast cancer in patients with DTC undergoing RAI therapy. Methods: A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. Results: The final analysis included 14 studies accounting for a total of 200,247 patients with DTC (98,368 treated with RAI and 101,879 not treated with RAI). The relative risk of primary breast cancer in patients with DTC treated with RAI to those not treated with RAI among studies ranged from 0.45 to 2.55, the pooled relative risk was 0.83 (95% confidence interval, 0.70–0.99), and the heterogeneity was 71.5%. Conclusion: The present meta-analysis indicates that patients with DTC treated with RAI do not have a higher risk of primary breast cancer compared to those not treated with RAI. These findings suggest that RAI therapy does not increase the risk of breast cancer.

Published
2021

26. Whole-Body Radioiodine Effective Half-Life in Patients with Differentiated Thyroid Cancer

Author

D. Bianco, Mariarosaria Manganelli, Michele Klain, Martin Schlumberger, Elisa Caiazzo, Alberto Cuocolo, Marina De Risi, Carmela Nappi, Leandra Piscopo, Fabio Volpe, Klain, Michele, Nappi, Carmela, De Risi, Marina, Piscopo, Leandra, Volpe, Fabio, Manganelli, Mariarosaria, Caiazzo, Elisa, Bianco, Davide, Schlumberger, Martin, and Cuocolo, Alberto

Subjects
Total thyroidectomy, medicine.medical_specialty, Medicine (General), business.industry, iodine, medicine.medical_treatment, Clinical Biochemistry, radionuclide therapy, Disease, medicine.disease, Article, R5-920, Internal medicine, Radionuclide therapy, medicine, thyroid cancer, In patient, Whole body, business, Effective half-life, Adjuvant, Thyroid cancer
Abstract

Background: Radioactive 131I (RAI) therapy is used in patients with differentiated thyroid cancer (DTC) after total thyroidectomy for remnant ablation, adjuvant treatment or treatment of persistent disease. 131I retention data, which are used to indicate the time at which a 131I treated DTC patient can be released from the hospital, may bring some insights regarding clinical factors that prolong the length of hospitalization. The aim of this study was to investigate the 131I whole-body retention in DTC patients during 131I therapy. Methods: We monitored 166 DTC patients to follow the 131I whole-body retention during 131I therapy with a radioactivity detector fixed on the ceiling of each protected room. A linear regression fit permitted us to estimate the whole-body 131I effective half-life in each patient, and a relationship was sought between patients’ clinical characteristics and whole-body effective 131I half-life. Results: The effective 131I half-life ranged from 4.08 to 56.4 h. At multivariable analysis, longer effective 131I half-life was related to older age and extensive extra-thyroid disease. Conclusions: 131I effective half-life during 131I treatment in DTC patients is highly variable among patients and is significantly longer in older and in patients with RAI uptake in large thyroid remnants or in extrathyroidal disease that significantly prolongs the whole-body retention of 131I.

Published
2021
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27. Advances in Functional Imaging of Differentiated Thyroid Cancer

Author

Livia Lamartina, Martin Schlumberger, Domenico Salvatore, Emanuele Nicolai, Elena Califaretti, Raffaele Ambrosio, Alberto Cuocolo, Carmela Nappi, Désirée Deandreis, Emilia Zampella, Michele Klain, Klain, Michele, Zampella, Emilia, Nappi, Carmela, Nicolai, Emanuele, Ambrosio, Raffaele, Califaretti, Elena, Lamartina, Livia, Schlumberger, Martin, Deandreis, Désirée, Salvatore, Domenico, and Cuocolo, Alberto

Subjects
Cancer Research, medicine.medical_specialty, Radioiodine uptake, diagnosis, differentiated thyroid cancer, Review, Imaging modalities, medicine, Diagnosis, Differentiated thyroid cancer, Imaging, Radioactive iodine therapy, Theragnostic, Therapeutic intent, Thyroid cancer, RC254-282, business.industry, theragnostic, Fdg uptake, Thyroid, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, imaging, medicine.disease, radioactive iodine therapy, Functional imaging, medicine.anatomical_structure, Oncology, Radiology, Radioactive iodine, business
Abstract

Simple Summary Since the 1940s, radioactive iodine has been used for functional imaging and for treating patients with differentiated thyroid cancer (DTC). During this long-lasting experience, the use of iodine isotopes evolved, especially during the last years due to improved knowledge of thyroid cancer biology and improved performances of imaging tools. The present review summarizes recent advances in the field of functional imaging and theragnostic approach of DTC. Abstract The present review provides a description of recent advances in the field of functional imaging that takes advantage of the functional characteristics of thyroid neoplastic cells (such as radioiodine uptake and FDG uptake) and theragnostic approach of differentiated thyroid cancer (DTC). Physical and biological characteristics of available radiopharmaceuticals and their use with state-of-the-art technologies for diagnosis, treatment, and follow-up of DTC patients are depicted. Radioactive iodine is used mostly with a therapeutic intent, while PET/CT with 18F-FDG emerges as a useful tool in the diagnostic management and complements the use of radioactive iodine. Beyond 18F-FDG PET/CT, other tracers including 124I, 18F-TFB and 68Ga-PSMA, and new methods such as PET/MR, might offer new opportunities in selecting patients with DTC for specific imaging modalities or treatments.

Published
2021

28. Imaging medullary thyroid cancer patients with detectable serum markers: state of the art and future perspectives

Author

Julien Hadoux, Désirée Deandreis, Domenico Salvatore, Martin Schlumberger, Carmela Nappi, Monica Finessi, Alberto Cuocolo, Michele Klain, Raffaele Ambrosio, Klain, Michele, Hadoux, Julien, Nappi, Carmela, Finessi, Monica, Ambrosio, Raffaele, Schlumberger, Martin, Cuocolo, Alberto, Deandreis, Désirée, and Salvatore, Domenico

Subjects
medicine.medical_specialty, Medullary cavity, PET/CT, Endocrinology, Diabetes and Metabolism, Disease, Medullary Thyroid Carcinoma, Imaging, Thyroid carcinoma, Endocrinology, Positron Emission Tomography Computed Tomography, medicine, Humans, Prospective Studies, Thyroid Neoplasms, Tumor marker, Ultrasonography, PET-CT, business.industry, Thyroid, Medullary thyroid cancer, medicine.disease, Carcinoma, Neuroendocrine, medicine.anatomical_structure, MTC, Radiology, business, Biomarkers, Serum markers
Abstract

Purpose: Medullary thyroid carcinoma (MTC) originates from thyroid parafollicular C-cells and represents

Published
2021

29. Impact of COVID-19 infection on short-term outcome in patients referred to stress myocardial perfusion imaging

Author

Elisa Caiazzo, Ciro Mainolfi, Valeria Cantoni, Emanuele Criscuolo, Wanda Acampa, Teresa Mannarino, Carmela Nappi, Roberta Assante, Roberta Green, Mario Petretta, Roberto Bologna, Emilia Zampella, Giulia Zumbo, Alberto Cuocolo, Adriana D'Antonio, Valeria Gaudieri, Assante, Roberta, D’Antonio, Adriana, Mannarino, Teresa, Gaudieri, Valeria, Zampella, Emilia, Mainolfi, Ciro Gabriele, Cantoni, Valeria, Green, Roberta, Caiazzo, Elisa, Nappi, Carmela, Criscuolo, Emanuele, Bologna, Roberto, Zumbo, Giulia, Petretta, Mario, Cuocolo, Alberto, and Acampa, Wanda

Subjects
Tomography, Emission-Computed, Single-Photon, medicine.medical_specialty, Myocardial ischemia, medicine.diagnostic_test, Coronavirus disease 2019 (COVID-19), Myocardial perfusion imaging, business.industry, Coronary Artery Disease, General Medicine, Prognosis, Median time, Internal medicine, Orthopedic surgery, Exercise Test, Cardiology, Humans, Medicine, Original Article, Radiology, Nuclear Medicine and imaging, In patient, Covid-19, business, Perfusion, Emission computed tomography
Abstract

Purpose We assessed the impact of COVID-19 infection on cardiovascular events in patients with suspected or known coronary artery disease (CAD) referred to stress myocardial perfusion single-photon emission computed tomography (MPS). Methods A total of 950 consecutive patients with suspected or known CAD were submitted by referring physicians to stress MPS for assessment of myocardial ischemia between January 2018 and June 2019. All patients underwent stress-optional rest MPS. Perfusion defects were quantitated as % of LV myocardium and expressed as total perfusion defect (TPD), representing the defect extent and severity. A TPD ≥ 5% was considered abnormal. Results During a mean follow-up of 27 months (range 4–38) 31 events occurred. Moreover, 55 (6%) patients had a COVID-19 infection. The median time from index MPS to COVID-19 infection was 16 months (range 6–24). At Cox multivariable analysis, abnormal MPS and COVID-19 infection resulted as independent predictors of events. There were no significant differences in annualized event rate in COVID-19 patients with or without abnormal MPS (p = 0.56). Differently, in patients without COVID-19 the presence of abnormal MPS was associated with higher event rate (p

Published
2021
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30. Renal function and cardiac adrenergic impairment in patients affected by heart failure

Author

Stefania Paolillo, Immacolata Esposito, Francesco Renga, Santo Dellegrottaglie, Paola Gargiulo, Caterina Marciano, Carmela Nappi, Fabio Marsico, Roberta Assante, Simona Dell'Aversana, Luca Esposito, Valentina Parisi, Luca Bardi, Pasquale Perrone Filardi, Giuseppe Rengo, Alberto Cuocolo, Dario Leosco, Marsico, Fabio, Paolillo, Stefania, Gargiulo, Paola, Parisi, Valentina, Nappi, Carmela, Assante, Roberta, Dell’Aversana, Simona, Esposito, Immacolata, Renga, Francesco, Esposito, Luca, Bardi, Luca, Rengo, Giuseppe, Dellegrottaglie, Santo, Marciano, Caterina, Leosco, Dario, Cuocolo, Alberto, and Filardi, Pasquale Perrone

Subjects
Male, medicine.medical_specialty, Population, Adrenergic, Renal function, 030204 cardiovascular system & hematology, Kidney, Statistics, Nonparametric, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Adrenergic Agents, 0302 clinical medicine, renal dysfunction, Internal medicine, Epidemiology, Humans, Medicine, Radiology, Nuclear Medicine and imaging, education, Aged, Heart Failure, glomerular filtration rate, education.field_of_study, Ejection fraction, business.industry, Heart, Middle Aged, medicine.disease, medicine.anatomical_structure, Italy, sympathetic nervous system overactivity, Heart failure, Cardiology, Female, Kidney Diseases, Cardiology and Cardiovascular Medicine, business, Kidney disease
Abstract

Although in heart failure (HF) there is a strict correlation between heart and kidney, no data are available on the potential relationship in HF between renal dysfunction (RD) and the impaired sympathetic innervation. Aim of the present study was to assess the relationship between RD and cardiac sympathetic innervation in HF patients with reduced ejection fraction. Two hundred and sixty-three patients with mild-to-severe HF underwent iodine-123 meta-iodobenzylguanidine myocardial scintigraphy to assess sympathetic innervation, evaluating early and late heart-to-mediastinum (H/M) ratios and washout rate. In all patients, glomerular filtration rate (eGFR) by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula was assessed. A direct association was found between EPI-eGFR and late H/M (r = .215; P

Published
2019
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31. Relationship between epicardial adipose tissue and coronary vascular function in patients with suspected coronary artery disease and normal myocardial perfusion imaging

Author

Wanda Acampa, Carmela Nappi, Mario Petretta, Renato Cuocolo, Andrea Ponsiglione, Alberto Cuocolo, Serena Dell'Aversana, Roberta Assante, Massimo Imbriaco, Valeria Gaudieri, Teresa Mannarino, Emilia Zampella, Nappi, Carmela, Ponsiglione, Andrea, Acampa, Wanda, Gaudieri, Valeria, Zampella, Emilia, Assante, Roberta, Cuocolo, Renato, Mannarino, Teresa, Dell'Aversana, Serena, Petretta, Mario, Imbriaco, Massimo, and Cuocolo, Alberto

Subjects
medicine.medical_specialty, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, 030218 nuclear medicine & medical imaging, Coronary artery disease, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, Positron Emission Tomography Computed Tomography, Internal medicine, Heart rate, medicine, Humans, Radiology, Nuclear Medicine and imaging, PET-CT, medicine.diagnostic_test, business.industry, Myocardial Perfusion Imaging, General Medicine, Blood flow, medicine.disease, Coronary Vessels, Coronary Calcium Score, Adipose Tissue, Positron emission tomography, Cardiology, Cardiology and Cardiovascular Medicine, business, Pericardium, Perfusion
Abstract

Aims We evaluated the relationship between epicardial adipose tissue (EAT) and coronary vascular function assessed by rubidium-82 (82Rb) positron emission tomography/computed tomography (PET/CT) in patients with suspected coronary artery disease (CAD). Methods and results The study population included 270 patients with suspected CAD and normal myocardial perfusion at stress–rest 82Rb PET/CT. Coronary artery calcium (CAC) score and EAT volume were measured. Absolute myocardial blood flow (MBF) was computed in mL/min/ from the dynamic rest and stress imaging. Myocardial perfusion reserve (MPR) was defined as the ratio of hyperaemic to baseline MBF and it was considered reduced when 0 (n = 156). Conclusion In patients with suspected CAD and normal myocardial perfusion, EAT volume predicts hyperaemic MBF and reduced MPR, confirming that visceral pericardium fat may influence coronary vascular function. Thus, EAT evaluation has a potential role in the early identification of coronary vascular dysfunction.

Published
2019
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32. Diagnostic performance of myocardial perfusion imaging with conventional and CZT single-photon emission computed tomography in detecting coronary artery disease: A meta-analysis

Author

Emilia Zampella, Wanda Acampa, Alberto Cuocolo, Mario Petretta, Eugenio Di Vaia, Valeria Gaudieri, Renato Cuocolo, Valeria Cantoni, Carmela Nappi, Roberta Green, Roberta Assante, Teresa Mannarino, Cantoni, Valeria, Green, Roberta, Acampa, Wanda, Zampella, Emilia, Assante, Roberta, Nappi, Carmela, Gaudieri, Valeria, Mannarino, Teresa, Cuocolo, Renato, Di Vaia, Eugenio, Petretta, Mario, and Cuocolo, Alberto

Subjects
medicine.medical_specialty, Quality Assurance, Health Care, CAD, Coronary Artery Disease, 030204 cardiovascular system & hematology, Single-photon emission computed tomography, 030218 nuclear medicine & medical imaging, Coronary artery disease, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, medicine, Humans, Gamma Cameras, Radiology, Nuclear Medicine and imaging, Tomography, Emission-Computed, Single-Photon, medicine.diagnostic_test, business.industry, Myocardial Perfusion Imaging, Area under the curve, medicine.disease, Invasive coronary angiography, Zinc, Meta-analysis, Diameter stenosis, Radiology, Tellurium, Cardiology and Cardiovascular Medicine, business, Cadmium
Abstract

Background. We performed a meta-analysis to compare the diagnostic performance of conventional SPECT (C-SPECT) and cadmium-zinc-telluride (CZT)-SPECT systems in detecting angiographically proven coronary artery disease (CAD). Methods. Studies published between January 2000 and February 2018 were identified by database search. We included studies assessing C-SPECT or CZT-SPECT as a diagnostic test to evaluate patients for the presence of CAD, defined as at least 50% diameter stenosis on invasive coronary angiography. A study was eligible regardless of whether patients were referred for suspected or known CAD. Results. We identified 40 eligible articles (25 C-SPECT and 15 CZT-SPECT studies) including 7334 patients (4997 in C-SPECT and 2337 in CZT-SPECT studies). The pooled sensitivity and specificity were 85% and 66% for C-SPECT and 89% and 69% for CZT-SPECT imaging studies. The area under the curve was slightly higher for CZT-SPECT (0.89) compared to C-SPECT (0.83); accordingly, the summary diagnostic OR was 17 for CZT-SPECT and 11 for C-SPECT. The accuracy of the two tests slightly differs between C-SPECT and CZT-SPECT (chi-square 11.28, P < .05). At meta-regression analysis, no significant association between both sensitivity and specificity and demographical and clinical variables considered was found for C-SPECT and CZT-SPECT studies. Conclusions. C-SPECT and CZT-SPECT have good diagnostic performance in detecting angiographic proven CAD, with a slightly higher accuracy for CZT-SPECT. This result supports the use of the novel gamma cameras in clinical routine practices also considering the improvements in acquisition time and radiation exposure reduction.

Published
2019
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33. Behind Traditional Semi-quantitative Scores of Myocardial Perfusion Imaging: An Eye on Niche Parameters

Author

Carmela Nappi, Alberto Cuocolo, Valeria Gaudieri, Nappi, Carmela, Gaudieri, Valeria, and Cuocolo, Alberto

Subjects
medicine.medical_specialty, Shape index, Cardiomyopathy, Ischaemic Heart Disease, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, Coronary artery disease, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, vascular age, Internal medicine, Diseases of the circulatory (Cardiovascular) system, Medicine, Myocardial infarction, medicine.diagnostic_test, business.industry, phase analysi, epicardial adipose tissue, medicine.disease, Stenosis, phase analysis, RC666-701, Heart failure, Angiography, Cardiology, Cardiology and Cardiovascular Medicine, business, Perfusion, relative flow reserve
Abstract

The evaluation of stress-induced myocardial perfusion defects by non-invasive myocardial perfusion imaging (MPI) modalities has a leading role in the identification of coronary artery disease, and has excellent diagnostic and prognostic value. Non-invasive MPI can be performed using conventional and novel gamma cameras or by PET/CT. New software has allowed novel parameters that may have a role in the identification of early marks of cardiac impairment to be evaluated. We aim to give an overview of niche parameters obtainable by single photon emission CT (SPECT) and PET/CT MPI that may help practitioners to detect initial signs of cardiac damage and identify new therapy targets. In particular, we summarise the role of left ventricular geometry indices for remodelling, phase analysis parameters to evaluate mechanical dyssynchrony, the concept of relative flow reserve in the evaluation of flow-limiting epicardial stenosis, vascular age and epicardial adipose tissue as early markers of atherosclerotic burden, and emerging parameters for the evaluation of myocardial innervation, such as the total defect score.

Published
2019
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34. Temporal trends of abnormal myocardial perfusion imaging in a cohort of Italian subjects: Relation with cardiovascular risk factors

Author

Alberto Cuocolo, Ciro Mainolfi, Valeria Gaudieri, Mario Petretta, Rosario Megna, Roberta Green, Wanda Acampa, Roberta Assante, Valeria Cantoni, Teresa Mannarino, Emilia Zampella, Carmela Nappi, Stefania Daniele, Megna, Rosario, Zampella, Emilia, Assante, Roberta, Nappi, Carmela, Gaudieri, Valeria, Mannarino, Teresa, Cantoni, Valeria, Green, Roberta, Daniele, Stefania, Mainolfi, Ciro Gabriele, Acampa, Wanda, Petretta, Mario, and Cuocolo, Alberto

Subjects
Male, Technetium Tc 99m Sestamibi, Change over time, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Time Factors, Cardiovascular risk factors, Myocardial Ischemia, Blood Pressure, Coronary Artery Disease, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, Coronary artery disease, Angina, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, Risk Factors, Internal medicine, Diabetes mellitus, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Prospective Studies, skin and connective tissue diseases, Cardiac imaging, Aged, Tomography, Emission-Computed, Single-Photon, medicine.diagnostic_test, business.industry, Myocardial Perfusion Imaging, nutritional and metabolic diseases, Heart, Middle Aged, medicine.disease, Italy, Cardiovascular Diseases, Cohort, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Software
Abstract

Background. The frequency of abnormal stress single-photon emission computed tomography myocardial perfusion imaging (MPS) has decreased over the past decades despite an increase in the prevalence of cardiovascular risk factors. This study evaluated the temporal trend of abnormal stress MPS and its relationship with risk factors in a cohort of Italian subjects. Methods. We included all patients who underwent clinically indicated stress MPS at our academic center between January 2006 and December 2017. Patients were assessed for change in demographics, clinical symptoms, risk factors, and frequency of abnormal and ischemic MPS. Results. A total of 8,886 stress MPS studies were performed (3,350 abnormal). Age, male gender, diabetes, smoking, and angina were independent predictors of abnormal MPS. There was a slight decline in the frequency of abnormal (from 39% to 36%, P < .05) and ischemic (from 25% to 22%, P < .01) MPS during the study period, while the percentage of patients with hypertension, hypercholesterolemia, smoking, and angina increased. The Cochran-Mantel-Haenszel test indicates that the likelihood of having an abnormal MPS did not change over time for age, diabetes, smoking, and a history of coronary artery disease (CAD), increased for hypertension and hypercholesterolemia and decreased for male compared to female gender. Conclusions. In our cohort of Italian subjects, there was a slight temporal decline in the frequency of abnormal and ischemic MPS despite an increase over time in the prevalence of many cardiac risk factors. These results strengths the need to develop more effective strategies for appropriately referring patients to cardiac imaging procedures.

Published
2019
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35. Prognostic value of heart rate reserve in patients with suspected coronary artery disease undergoing stress myocardial perfusion imaging

Author

Teresa Mannarino, A D\\'antonio, Emilia Zampella, Wanda Acampa, M Manganelli, Maria Piera Petretta, L Piscopo, Valeria Cantoni, Alberto Cuocolo, Roberta Assante, Valeria Gaudieri, Carmela Nappi, Andrea Ponsiglione, and R Green

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Ischemia, General Medicine, Single-photon emission computed tomography, medicine.disease, Coronary artery disease, Myocardial perfusion imaging, Diabetes mellitus, Internal medicine, Heart rate, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, Adverse effect, business, Cause of death
Abstract

Funding Acknowledgements Type of funding sources: None. Background. The prognostic value of stress myocardial perfusion single-photon emission computed tomography (MPS) has been widely demonstrated. Also, chronotropic incompetence, evaluated by heart rate reserve (HRR) is associated with increased risk of adverse events. Yet, the incremental prognostic value of HRR over stress MPS data has not been fully investigated. Purpose. To assess the incremental prognostic value of HRR over stress MPS finding in patients with suspected coronary artery disease (CAD) undergoing exercise stress MPS. Methods. The study population consisted of 866 consecutive patients with suspected CAD undergoing exercise stress-MPS at University of Naples Federico II, between May 2002 and January 2014 as part of their diagnostic program. The primary study endpoint was all-cause mortality. All patients were followed for at least 60 months. HRR was calculated as the difference between peak exercise and resting HR, divided by the difference of age-predicted maximal and resting HR and expressed as percent. The summed difference score (SDS) was considered an index of ischemic burden. Patients were considered to have mild ischemia with a SDS of 2 to 6, and moderate-severe ischemia with a SDS ≥6. During follow-up, the occurrence of all-cause of deaths was noted and considered as event. Follow-up was censored at 84 months. Results. During follow-up, 61 deaths occurred, with a 7% cumulative event rate. Patients experiencing death were older (56.2 ± 10.7 years vs. 66.4 ± 8.6 years), with a higher prevalence of male gender (56% vs. 87 %, P Conclusion. Chronotropic incompetence assessed by HRR evaluation, has independent and incremental prognostic value in predicting all cause of death in patients with suspected CAD undergoing exercise stress-MPS.

Published
2021
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36. Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Author

Dondi, M., Milan, E., Pontone, G., Hirschfeld, C. B., Williams, M., Shaw, L. J., Pynda, Y., Raggi, P., Cerci, R., Vitola, J., Better, N., Villines, T. C., Dorbala, S., Pascual, T. N. B., Giubbini, R., Einstein, A. J., Paez, D., Italy: Domenico Albano, Pierpaolo, Alongi, Gaspare, Arnone, Elisa, Bagatin, Sergio, Baldari, Matteo, Bauckneht, Paolo, Bertelli, Francesco, Bianco, Rachele, Bonfiglioli, Roberto, Boni, Andrea, Bruno, Isabella, Bruno, Elena, Busnardo, Elena, Califaretti, Luca, Camoni, Aldo, Carnevale, Roberta, Casoni, Armando Ugo Cavallo, Giorgio, Cavenaghi, Franca, Chierichetti, Marcello, Chiocchi, Corrado, Cittanti, Mauro, Colletta, Umberto, Conti, Alberto, Cossu, Alberto, Cuocolo, Marco, Cuzzocrea, Maria Luisa De Rimini, Giuseppe De Vincentis, Eleonora Del Giudice, Alberico Del Torto, Veronica Della Tommasina, Rexhep, Durmo, Paola Anna Erba, Laura, Evangelista, Riccardo, Faletti, Evelina, Faragasso, Mohsen, Farsad, Paola, Ferro, Luigia, Florimonte, Viviana, Frantellizzi, Fabio Massimo Fringuelli, Marco, Gatti, Angela, Gaudiano, Alessia, Gimelli, Raffaele, Giubbini, Francesca, Giuffrida, Salvatore, Ialuna, Riccardo, Laudicella, Lucia, Leccisotti, Lucia, Leva, Liga, Riccardo, Carlo, Liguori, Giampiero, Longo, Margherita, Maffione, Maria Elisabetta Mancini, Claudio, Marcassa, Elisa, Milan, Barbara, Nardi, Sara, Pacella, Giovanna, Pepe, Gianluca, Pontone, Sabina, Pulizzi, Natale, Quartuccio, Lucia, Rampin, Fabrizio, Ricci, Pierluigi, Rossini, Giuseppe, Rubini, Vincenzo, Russo, Gian Mauro Sacchetti, Gianmario, Sambuceti, Massimo, Scarano, Roberto, Sciagrà, Massimiliano, Sperandio, Antonella, Stefanelli, Guido, Ventroni, Stefania Zoboli Members from Rest of the World (alphabetically by country and last name) Afghanistan: Mohammad Nawaz Nasery Albania: Artan Goda, Ervina Shirka Algeria: Rabie Benlabgaa, Salah, Bouyoucef, Abdelkader, Medjahedi, Qais Nailli Argentina: Mariela Agolti, Roberto Nicolas Aguero, Maria del Carmen Alak, Lucia Graciela Alberguina, Guillermo, Arroñada, Andrea, Astesiano, Alfredo, Astesiano, Carolina Bas Norton, Pablo, Benteo, Juan, Blanco, Juan Manuel Bonelli, Jose Javier Bustos, Raul, Cabrejas, Jorge, Cachero, Roxana, Campisi, Alejandro, Canderoli, Silvia, Carames, Patrícia, Carrascosa, Ricardo, Castro, Oscar, Cendoya, Luciano Martin Cognigni, Carlos, Collaud, Claudia, Cortes, Javier, Courtis, Daniel, Cragnolino, Mariana, Daicz, Alejandro De La Vega, Silvia Teresa De Maria, Horacio Del Riego, Fernando, Dettori, Alejandro, Deviggiano, Laura, Dragonetti, Mario, Embon, Ruben Emilio Enriquez, Jorge, Ensinas, Fernando, Faccio, Adolfo, Facello, Diego, Garofalo, Ricardo, Geronazzo, Natalia, Gonza, Lucas, Gutierrez, Miguel Angel Guzzo, Victor, Hasbani, Melina, Huerin, Victor, Jäger, Julio Manuel Lewkowicz, Maria Nieves, A López De Munaín, Jose Maria Lotti, Alejandra, Marquez, Osvaldo, Masoli, Osvaldo Horacio Masoli, Edgardo, Mastrovito, Matias, Mayoraz, Graciela Eva Melado, Anibal, Mele, Maria Fernanda Merani, Alejandro Horacio Meretta, Susana, Molteni, Marcos, Montecinos, Eduardo, Noguera, Carlos, Novoa, Claudio Pereyra Sueldo, Sebastian Perez Ascani, Pablo, Pollono, Maria Paula Pujol, Alejandro, Radzinschi, Gustavo, Raimondi, Marcela, Redruello, Marina, Rodríguez, Matías, Rodríguez, Romina Lorena Romero, Arturo Romero Acuña, Federico, Rovaletti, Lucas San Miguel, Lucrecia, Solari, Bruno, Strada, Sonia, Traverso, Sonia Simona Traverzo, Maria del Huerto Velazquez Espeche, Juan Sebastian Weihmuller, Juan, Wolcan, Susana Zeffiro Armenia: Mari Sakanyan Australia: Scott Beuzeville, Raef, Boktor, Patrick, Butler, Jennifer, Calcott, Loretta, Carr, Virgil, Chan, Charles, Chao, Woon, Chong, Mark, Dobson, D'Arne, Downie, Girish, Dwivedi, Barry, Elison, Jean, Engela, Roslyn, Francis, Anand, Gaikwad, Ashok Gangasandra Basavaraj, Bruce, Goodwin, Robert, Greenough, Christian, Hamilton-Craig, Victar, Hsieh, Subodh, Joshi, Karin, Lederer, Kenneth, Lee, Joseph, Lee, John, Magnussen, Nghi, Mai, Gordon, Mander, Fiona, Murton, Dee, Nandurkar, Johanne, Neill, Edward, O'Rourke, Patricia, O'Sullivan, George, Pandos, Kunthi, Pathmaraj, Alexander, Pitman, Rohan, Poulter, Manuja, Premaratne, David, Prior, Lloyd, Ridley, Natalie, Rutherford, Hamid, Salehi, Connor, Saunders, Luke, Scarlett, Sujith, Seneviratne, Deepa, Shetty, Ganesh, Shrestha, Jonathan, Shulman, Vijay, Solanki, Tony, Stanton, Murch, Stuart, Michael, Stubbs, Ian, Swainson, Kim, Taubman, Andrew, Taylor, Paul, Thomas, Steven, Unger, Anthony, Upton, Shankar, Vamadevan, William Van Gaal, Johan, Verjans, Demetrius, Voutnis, Victor, Wayne, Peter, Wilson, David, Wong, Kirby, Wong, John Younger Austria: Gudrun Feuchtner, Siroos, Mirzaei, Konrad Weiss Belarus: Natallia Maroz-Vadalazhskaya Belgium: Olivier Gheysens, Filip, Homans, Rodrigo, Moreno-Reyes, Agnès, Pasquet, Veronique, Roelants, Van De Heyning Bolivia: Raúl Araujo Ríos Bosnia - Herzegovina: Valentina Soldat-Stankovic, Caroline M., Sinisa Stankovic Brazil: Maria Helena Albernaz Siqueira, Augusto, Almeida, Paulo Henrique Alves Togni, Jose Henrique Andrade, Luciana, Andrade, Carlos, Anselmi, Roberta, Araújo, Guilherme, Azevedo, Sabbrina, Bezerra, Rodrigo, Biancardi, Gabriel Blacher Grossman, Simone, Brandão, Diego Bromfman Pianta, Lara, Carreira, Bruno, Castro, Tien, Chang, Fernando Cunali, Jr., Roberto, Cury, Roberto, Dantas, Fernando de Amorim Fernandes, Andrea De Lorenzo, Robson De Macedo Filho, Fernanda, Erthal, Fabio, Fernandes, Juliano, Fernandes, Thiago Ferreira De Souza, Wilson Furlan Alves, Bruno, Ghini, Luiz, Goncalves, Ilan, Gottlieb, Marcelo, Hadlich, Vinícius, Kameoka, Ronaldo, Lima, Adna, Lima, Rafael Willain Lopes, Ricardo Machado, e Silva, Tiago, Magalhães, Fábio Martins Silva, Luiz Eduardo Mastrocola, Fábio, Medeiros, José Claudio Meneghetti, Vania, Naue, Danilo, Naves, Roberto, Nolasco, Cesar, Nomura, Joao Bruno Oliveira, Eduardo, Paixao, Filipe Penna De Carvalho, Ibraim, Pinto, Priscila, Possetti, Mayra, Quinta, Rodrigo Rizzo Nogueira Ramos, Ricardo, Rocha, Alfredo, Rodrigues, Carlos, Rodrigues, Leila, Romantini, Adelina, Sanches, Sara, Santana, Leonardo Sara da Silva, Paulo, Schvartzman, Cristina Sebastião Matushita, Tiago, Senra, Afonso, Shiozaki, Maria Eduarda Menezes de Siqueira, Cristiano, Siqueira, Paola, Smanio, Carlos Eduardo Soares, José Soares Junior, Marcio Sommer Bittencourt, Bernardo, Spiro, Cláudio Tinoco Mesquita, Jorge, Torreao, Rafael, Torres, Marly, Uellendahl, Guilherme Urpia Monte, Otávia, Veríssimo, Estevan Vieira Cabeda, Felipe Villela Pedras, Roberto, Waltrick, Marcello Zapparoli Brunei Darussalam: Hamid Naseer Bulgaria: Marina Garcheva-Tsacheva, Irena Kostadinova Cambodia: Youdaline Theng Canada: Gad Abikhzer, Rene, Barette, Benjamin, Chow, Dominique, Dabreo, Matthias, Friedrich, Ria, Garg, Mohammed Nassoh Hafez, Chris, Johnson, Marla, Kiess, Jonathon, Leipsic, Eugene, Leung, Robert, Miller, Anastasia, Oikonomou, Stephan, Probst, Idan, Roifman, Gary, Small, Vikas, Tandon, Adwait, Trivedi, James, White, Katherine Zukotynski Chile: Jose Canessa, Gabriel Castro Muñoz, Carmen, Concha, Pablo, Hidalgo, Cesar, Lovera, Teresa, Massardo, Luis Salazar Vargas Colombia: Pedro Abad, Harold, Arturo, Sandra, Ayala, Luis, Benitez, Alberto, Cadena, Carlos, Caicedo, Antonio Calderón Moncayo, Sharon, Gomez, Gutierrez Villamil, Claudia T., Claudia, Jaimes, Juan, Londoño, Juan Luis Londoño Blair, Luz, Pabon, Mauricio, Pineda, Juan Carlos Rojas, Diego, Ruiz, Manuel Valencia Escobar, Andres, Vasquez, Damiana, Vergel, Alejandro Zuluaga Costa Rica: Isabel Berrocal Gamboa, Gabriel, Castro, Ulises, González, Croatia: Ana Baric, Tonci, Batinic, Maja, Franceschi, Maja Hrabak Paar, Mladen, Jukic, Petar, Medakovic, Viktor, Persic, Marina, Prpic, Ante Punda Cuba: Juan Felipe Batista, Juan Manuel Gómez Lauchy, Yamile Marcos Gutierrez, Rayner, Menéndez, Amalia, Peix, Luis Rochela Cyprus: Christoforos Panagidis, Ioannis Petrou Czech Republic: Vaclav Engelmann, Milan, Kaminek, Vladimír, Kincl, Otto, Lang, Milan Simanek Denmark: Jawdat Abdulla, Morten, Bøttcher, Mette, Christensen, Lars Christian Gormsen, Philip, Hasbak, Søren, Hess, Paw, Holdgaard, Allan, Johansen, Kasper, Kyhl, Bjarne Linde Norgaard, Kristian Altern Øvrehus, Niels Peter Rønnow Sand, Rolf, Steffensen, Anders, Thomassen, Bo Zerahn Dominican Republic: Alfredo Perez Ecuador: Giovanni Alejandro Escorza Velez, Mayra Sanchez Velez Egypt: Islam Shawky Abdel Aziz, Mahasen, Abougabal, Taghreed, Ahmed, Adel, Allam, Ahmed, Asfour, Mona, Hassan, Alia, Hassan, Ahmed, Ibrahim, Sameh, Kaffas, Ahmed, Kandeel, Mohamed Mandour Ali, Ahmad, Mansy, Hany, Maurice, Sherif, Nabil, Mahmoud Shaaban El Salvador: Ana Camila Flores Estonia: Anne Poksi Finland: Juhani Knuuti, Velipekka, Kokkonen, Martti, Larikka, Valtteri Uusitalo France: Matthieu Bailly, Samuel, Burg, Jean-François, Deux, Vincent, Habouzit, Fabien, Hyafil, Olivier, Lairez, Franck, Proffit, Hamza, Regaieg, Laure, Sarda-Mantel, Schneider Ghana: Harold Ayetey Greece: George Angelidis, Vania Tacher Germany: Roman P., Aikaterini, Archontaki, Sofia, Chatziioannou, Ioannis, Datseris, Christina, Fragkaki, Panagiotis, Georgoulias, Sophia, Koukouraki, Maria, Koutelou, Eleni, Kyrozi, Evangelos, Repasos, Petros, Stavrou, Pipitsa Valsamaki Guatemala: Carla Gonzalez, Goleat Gutierrez Honduras: Alejandro Maldonado Hungary: Klara Buga, Ildiko, Garai, Pál, Maurovich-Horvat, Erzsébet, Schmidt, Balint, Szilveszter, Edit Várady India: Nilesh Banthia, Jinendra Kumar Bhagat, Rishi, Bhargava, Vivek, Bhat, Mona, Bhatia, Partha, Choudhury, Vijay Sai Chowdekar, Aparna, Irodi, Shashank, Jain, Elizabeth, Joseph, Sukriti, Kumar, Prof Dr Girijanandan Mahapatra, Deepanjan, Mitra, Bhagwant Rai Mittal, Ahmad, Ozair, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Patel, Sudhir, Saxena, Shantanu, Sengupta, Santosh, Singh, Bhanupriya, Singh, Ashwani, Sood, Atul Verma Indonesia: Erwin Affandi, Padma Savenadia Alam, Edison, Edison, Gani, Gunawan, Habusari, Hapkido, Basuki, Hidayat, Aulia, Huda, Anggoro Praja Mukti, Djoko, Prawiro, Erwin Affandi Soeriadi, Hilman Syawaluddin Iraq: Amjed Albadr Islamic Republic of Iran: Majid Assadi, Farshad, Emami, Golnaz, Houshmand, Majid, Maleki, Maryam Tajik Rostami, Seyed Rasoul Zakavi Israel: Eed Abu Zaid, Svetlana, Agranovich, Yoav, Arnson, Rachel, Bar-Shalom, Alex, Frenkel, Galit, Knafo, Rachel, Lugassi, Israel Shlomo Maor Moalem, Maya, Mor, Noam, Muskal, Sara, Ranser, Aryeh Shalev Jamaica: Dainia Baugh, Duane, Chambers, Ernest, Madu, Felix Nunura Japan: Hiroshi Asano, Chimura Misato Chimura, Shinichiro, Fujimoto, Koichiro, Fujisue, Tomohisa, Fukunaga, Yoshimitsu, Fukushima, Kae, Fukuyama, Jun, Hashimoto, Yasutaka, Ichikawa, Nobuo, Iguchi, Masamichi, Imai, Anri, Inaki, Hayato, Ishimura, Satoshi, Isobe, Toshiaki, Kadokami, Takao, Kato, Takashi, Kudo, Shinichiro, Kumita, Hirotaka, Maruno, Hiroyuki, Mataki, Masao, Miyagawa, Ryota, Morimoto, Masao, Moroi, Shigeki, Nagamachi, Kenichi, Nakajima, Tomoaki, Nakata, Ryo, Nakazato, Mamoru, Nanasato, Masanao, Naya, Takashi, Norikane, Yasutoshi, Ohta, Satoshi, Okayama, Atsutaka, Okizaki, Yoichi, Otomi, Hideki, Otsuka, Masaki, Saito, Sakata Yasushi Sakata, Masayoshi, Sarai, Daisuke, Sato, Shinya, Shiraishi, Yoshinobu, Suwa, Kentaro, Takanami, Kazuya, Takehana, Junichi, Taki, Nagara, Tamaki, Yasuyo, Taniguchi, Hiroki, Teragawa, Nobuo, Tomizawa, Kenichi, Tsujita, Kyoko, Umeji, Yasushi, Wakabayashi, Shinichiro, Yamada, Shinya, Yamazaki, Tatsuya Yoneyama Jordan: Mohammad Rawashdeh Kazakhstan: Daultai Batyrkhanov, Tairkhan Dautov Kenya: Khalid Makhdomi, Kevin Ombati Kuwait: Faridah Alkandari, Masoud Garashi Lao People's Democratic Republic: Tchoyoson Lim Coie, Sonexay Rajvong Latvia: Artem Kalinin, Marika Kalnina Lebanon: Mohamad Haidar Lithuania: Renata Komiagiene, Giedre, Kviecinskiene, Mindaugas, Mataciunas, Karim Malta: Luise Reichmuth, Donatas Vajauskas Luxembourg: Christian Picard Malaysia: Noor Khairiah A., Anthony Samuel Mauritius: Mohammad Aaftaab Allarakha, Ambedhkar Shantaram Naojee Mexico: Erick Alexanderson-Rosas, Erika, Barragan, Alejandro Becerril González-Montecinos, Manuel, Cabada, Daniel Calderon Rodriguez, Isabel, Carvajal-Juarez, Violeta, Cortés, Filiberto, Cortés, Erasmo De La Peña, Manlio, Gama-Moreno, Luis, González, Nelsy Gonzalez Ramírez, Moisés, Jiménez-Santos, Luis, Matos, Edgar, Monroy, Martha, Morelos, Mario, Ornelas, Jose Alberto Ortga Ramirez, Andrés, Preciado-Anaya, Óscar Ulises Preciado-Gutiérrez, Adriana Puente Barragan, Sandra Graciela Rosales Uvera, Sigelinda, Sandoval, Miguel Santaularia Tomas, Sierra-Galan, Lilia M., Silvia, Siu, Enrique, Vallejo, Mario Valles Monaco: Marc Faraggi Mongolia: Erdenechimeg Sereegotov Montenegro: Srdja Ilic Morocco: Nozha Ben-Rais, Nadia Ismaili Alaoui, Sara Taleb Myanmar: Khin Pa Pa Myo, Phyo Si Thu Nepal: Ram Kumar Ghimire, Bijoy Rajbanshi Netherlands: Peter Barneveld, Andor, Glaudemans, Jesse, Habets, Klaas Pieter Koopmans, Jeroen, Manders, Stefan, Pool, Arthur, Scholte, Asbjørn, Scholtens, Riemer, Slart, Paul, Thimister, Erik-Jan Van Asperen, Niels, Veltman, Derk, Verschure, Nils Wagenaar New Zealand: John Edmond, Chris, Ellis, Kerryanne, Johnson, Ross, Keenan, Shaw Hua (Anthony) Kueh, Christopher, Occleshaw, Alexander, Sasse, Andrew, To, Niels Van Pelt, Calum Young Nicaragua: Teresa Cuadra, Hector Bladimir Roque Vanegas Niger: Idrissa Adamou Soli, Djibrillou Moussa Issoufou Nigeria: Tolulope Ayodele, Chibuzo, Madu, Yetunde Onimode Norway: Elen Efros-Monsen, Signe Helene Forsdahl, Jenni-Mari Hildre Dimmen, Arve, Jørgensen, Isabel, Krohn, Pål, Løvhaugen, Anders Tjellaug Bråten Oman: Humoud Al Dhuhli, Faiza Al Kindi, Naeema, Al-Bulushi, Zabah, Jawa, Naima Tag Pakistan: Muhammad Shehzad Afzal, Shazia, Fatima, Muhammad Numair Younis, Musab, Riaz, Mohammad Saadullah Panama: Yariela Herrera Papua New Guinea: Dora Lenturut-Katal Paraguay: Manuel Castillo Vázquez, José Ortellado People's Republic of Bangladesh: Afroza Akhter People's Republic of China: Dianbo Cao, Stephen, Cheung, Dai, Xu, Lianggeng, Gong, Dan, Han, Yang, Hou, Caiying, Li, Tao, Li, Dong, Li, Sijin, Li, Jinkang, Liu, Hui, Liu, Bin, Lu, Ming Yen Ng, Kai, Sun, Gongshun, Tang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wang, Jiang, Wu, Zhifang, Wu, Liming, Xia, Jiangxi, Xiao, Lei, Xu, Youyou, Yang, Yin, Wu, Jianqun, Yu, Yuan, Li, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhang, Li Zhu Peru: Ana Alfaro Philippines: Paz Abrihan, Asela, Barroso, Eric, Cruz, Marie Rhiamar Gomez, Vincent Peter Magboo, John Michael Medina, Jerry, Obaldo, Davidson, Pastrana, Christian Michael Pawhay, Alvin, Quinon, Jeanelle Margareth Tang, Bettina, Tecson, Kristine Joy Uson, Mila Uy Poland: Magdalena Kostkiewicz, Jolanta Kunikowska Portugal: Nuno Bettencourt, Guilhermina, Cantinho, Antonio Ferreira Qatar: Ghulam Syed Republic of Ireland: Samer Arnous, Said, Atyani, Angela, Byrne, Tadhg, Gleeson, David, Kerins, Conor, Meehan, David, Murphy, Mark, Murphy, John, Murray, Julie O'Brien Republic of Korea: Ji-In Bang, Henry, Bom, Sang-Geon, Cho, Chae Moon Hong, Su Jin Jang, Yong Hyu Jeong, Won Jun Kang, Ji-Young, Kim, Jaetae, Lee, Chang Kyeong Namgung, Young, So, Kyoung Sook Won Republic of North Macedonia: Venjamin Majstorov, Marija Vavlukis Republic of Slovenia: Barbara Gužic Salobir, Monika Štalc Romania: Theodora Benedek, Imre, Benedek, Raluca, Mititelu, Claudiu Adrian Stan Russian Federation: Alexey Ansheles, Olga, Dariy, Olga, Drozdova, Nina, Gagarina, Vsevolod Milyevich Gulyaev, Irina, Itskovich, Anatoly, Karalkin, Alexander, Kokov, Ekaterina, Migunova, Viktor, Pospelov, Daria, Ryzhkova, Guzaliya, Saifullina, Svetlana, Sazonova, Vladimir, Sergienko, Irina, Shurupova, Tatjana, Trifonova, Wladimir Yurievich Ussov, Margarita, Vakhromeeva, Nailya, Valiullina, Konstantin, Zavadovsky, Kirill Zhuravlev Saudi Arabia: Mirvat Alasnag, Subhani Okarvi Serbia: Dragana Sobic Saranovic Singapore: Felix Keng, Jia Hao Jason See, Ramkumar, Sekar, Min Sen Yew Slovak Republic: Andrej Vondrak South Africa: Shereen Bejai, George, Bennie, Ria, Bester, Gerrit, Engelbrecht, Osayande, Evbuomwan, Harlem, Gongxeka, Magritha Jv Vuuren, Mitchell, Kaplan, Purbhoo, Khushica, Hoosen, Lakhi, Lizette, Louw, Nico, Malan, Katarina, Milos, Moshe, Modiselle, Stuart, More, Mathava, Naidoo, Leonie, Scholtz, Mboyo Vangu Spain: Santiago Aguadé-Bruix, Isabel, Blanco, Antonio, Cabrera, Alicia, Camarero, Irene, Casáns-Tormo, Hug, Cuellar-Calabria, Albert, Flotats, Maria Eugenia Fuentes Cañamero, María Elia García, Amelia, Jimenez-Heffernan, Rubén, Leta, Javier Lopez Diaz, Luis, Lumbreras, Juan Javier Marquez-Cabeza, Francisco, Martin, Anxo Martinez de Alegria, Francisco, Medina, Maria Pedrera Canal, Virginia, Peiro, Virginia, Pubul-Nuñez, Juan Ignacio Rayo Madrid, Cristina Rodríguez Rey, Ricardo Ruano Perez, Joaquín, Ruiz, Gertrudis Sabatel Hernández, Ana, Sevilla, Nahla Zeidán Sri Lanka: Damayanthi Nanayakkara, Chandraguptha Udugama Sweden: Magnus Simonsson Switzerland: Hatem Alkadhi, Ronny Ralf Buechel, Peter, Burger, Luca, Ceriani, Bart De Boeck, Christoph, Gräni, Alix Juillet de Saint Lager Lucas, Kamani, Christel H., Nadine, Kawel-Boehm, Robert, Manka, Prior, John O., Axel, Rominger, Jean-Paul Vallée Thailand: Benjapa Khiewvan, Teerapon, Premprabha, Tanyaluck Thientunyakit Tunisia: Ali Sellem Turkey: Kemal Metin Kir, Haluk Sayman Uganda: Mugisha Julius Sebikali, Zerida Muyinda Ukraine: Yaroslav Kmetyuk, Pavlo, Korol, Olena, Mykhalchenko, Volodymyr, Pliatsek, Maryna Satyr United Arab Emirates: Batool Albalooshi, Mohamed Ismail Ahmed Hassan United Kingdom: Jill Anderson, Punit, Bedi, Thomas, Biggans, Anda, Bularga, Russell, Bull, Rajesh, Burgul, John-Paul, Carpenter, Duncan, Coles, David, Cusack, Aparna, Deshpande, John, Dougan, Timothy, Fairbairn, Alexia, Farrugia, Deepa, Gopalan, Alistair, Gummow, Prasad Guntur Ramkumar, Mark, Hamilton, Mark, Harbinson, Thomas, Hartley, Benjamin, Hudson, Nikhil, Joshi, Michael, Kay, Andrew, Kelion, Azhar, Khokhar, Jamie, Kitt, Ken, Lee, Chen, Low, Sze Mun Mak, Ntouskou, Marousa, Jon, Martin, Elisa, Mcalindon, Leon, Menezes, Gareth, Morgan-Hughes, Alastair, Moss, Anthony, Murray, Edward, Nicol, Dilip, Patel, Charles, Peebles, Francesca, Pugliese, Jonathan Carl Luis Rodrigues, Christopher, Rofe, Nikant, Sabharwal, Rebecca, Schofield, Thomas, Semple, Naveen, Sharma, Peter, Strouhal, Deepak, Subedi, William, Topping, Katharine, Tweed, Jonathan Weir-Mccall United States of America: Suhny Abbara, Taimur, Abbasi, Brian, Abbott, Shady, Abohashem, Sandra, Abramson, Tarek, Al-Abboud, Mouaz, Al-Mallah, Omar, Almousalli, Karthikeyan, Ananthasubramaniam, Mohan Ashok Kumar, Jeffrey, Askew, Lea, Attanasio, Mallory, Balmer-Swain, Bayer, Richard R., Adam, Bernheim, Sabha, Bhatti, Erik, Bieging, Ron, Blankstein, Stephen, Bloom, Sean, Blue, David, Bluemke, Andressa, Borges, Kelley, Branch, Paco, Bravo, Jessica, Brothers, Matthew, Budoff, Renée, Bullock-Palmer, Angela, Burandt, Burke, Floyd W., Kelvin, Bush, Candace, Candela, Elizabeth, Capasso, Joao, Cavalcante, Donald, Chang, Saurav, Chatterjee, Yiannis, Chatzizisis, Michael, Cheezum, Tiffany, Chen, Jennifer, Chen, Marcus, Chen, Andrew, Choi, James, Clarcq, Ayreen, Cordero, Matthew, Crim, Sorin, Danciu, Bruce, Decter, Nimish, Dhruva, Neil, Doherty, Rami, Doukky, Anjori, Dunbar, William, Duvall, Rachael, Edwards, Kerry, Esquitin, Husam, Farah, Emilio, Fentanes, Maros, Ferencik, Daniel, Fisher, Daniel, Fitzpatrick, Cameron, Foster, Tony, Fuisz, Michael, Gannon, Lori, Gastner, Myron, Gerson, Brian, Ghoshhajra, Alan, Goldberg, Brian, Goldner, Jorge, Gonzalez, Rosco, Gore, Sandra, Gracia-López, Fadi, Hage, Agha, Haider, Sofia, Haider, Yasmin, Hamirani, Karen, Hassen, Mallory, Hatfield, Carolyn, Hawkins, Katie, Hawthorne, Nicholas, Heath, Robert, Hendel, Phillip, Hernandez, Gregory, Hill, Stephen, Horgan, Jeff, Huffman, Lynne, Hurwitz, Ami, Iskandrian, Rajesh, Janardhanan, Christine, Jellis, Scott, Jerome, Dinesh, Kalra, Summanther, Kaviratne, Fernando, Kay, Faith, Kelly, Omar, Khalique, Mona, Kinkhabwala, George Kinzfogl Iii, Jacqueline, Kircher, Rachael, Kirkbride, Michael, Kontos, Anupama, Kottam, Joseph, Krepp, Jay, Layer, Steven, H Lee, Jeffrey, Leppo, John, Lesser, Steve, Leung, Howard, Lewin, Diana, Litmanovich, Yiyan, Liu, Juan, Lopez-Mattei, Kathleen, Magurany, Jeremy, Markowitz, Amanda, Marn, Stephen, E Matis, Michael, Mckenna, Tony, Mcrae, Fernando, Mendoza, Michael, Merhige, David, Min, Chanan, Moffitt, Karen, Moncher, Warren, Moore, Shamil, Morayati, Michael, Morris, Mahmud, Mossa-Basha, Zorana, Mrsic, Venkatesh, Murthy, Prashant, Nagpal, Kyle, Napier, Jagat, Narula, Katarina, Nelson, Prabhjot, Nijjar, Medhat, Osman, Purvi, Parwani, Edward, Passen, Amit, Patel, Pravin, Patil, Ryan, Paul, Lawrence, Phillips, Venkateshwar, Polsani, Rajaram, Poludasu, Brian, Pomerantz, Thomas, Porter, Ryan, Prentice, Amit, Pursnani, Mark, Rabbat, Suresh, Ramamurti, Florence, Rich, Hiram Rivera Luna, Austin, Robinson, Kim, Robles, Cesar, Rodríguez, Mark, Rorie, John, Rumberger, Raymond, Russell, Philip, Sabra, Diego, Sadler, Mary, Schemmer, Joseph Schoepf, U., Samir, Shah, Nishant, Shah, Sujata, Shanbhag, Gaurav, Sharma, Steven, Shayani, Jamshid, Shirani, Pushpa, Shivaram, Steven, Sigman, Mitch, Simon, Ahmad, Slim, David, Smith, Alexandra, Smith, Prem, Soman, Aditya, Sood, Monvadi Barbara Srichai-Parsia, James, Streeter, Albert, T, Ahmed, Tawakol, Dustin, Thomas, Randall, Thompson, Tara, Torbet, Desiree, Trinidad, Shawn, Ullery, Samuel, Unzek, Seth, Uretsky, Srikanth, Vallurupalli, Vikas, Verma, Alfonso, Waller, Ellen, Wang, Parker, Ward, Gaby, Weissman, George, Wesbey, Kelly, White, David, Winchester, David, Wolinsky, Sandra, Yost, Michael Zgaljardic Uruguay: Omar Alonso, Mario, Beretta, Rodolfo, Ferrando, Miguel, Kapitan, Fernando Mut Uzbekistan: Omoa Djuraev, Gulnora Rozikhodjaeva Vietnam: Ha Le Ngoc, Son Hong Mai, and Xuan Canh Nguyen

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Cardiology, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, COVID-19, Cardiac imaging, Cardiovascular disease, Article, cardiac imaging, Healthcare delivery, cardiovascular disease, Intensive care, Surveys and Questionnaires, Health care, Pandemic, medicine, Humans, Pandemics, Protocol (science), business.industry, SARS-CoV-2, Non invasive, Italy, humans, pandemics, surveys and questionnaires, cardiology, Emergency medicine, Cardiology and Cardiovascular Medicine, business
Abstract

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p < 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures.

Published
2021
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37. Effect of changes in perfusion defect size during serial stress myocardial perfusion imaging on cardiovascular outcomes in patients treated with primary percutaneous coronary intervention after myocardial infarction

Author

Ciro Mainolfi, Francesco Giallauria, Adriana D'Antonio, Alberto Cuocolo, Teresa Mannarino, Valeria Gaudieri, Valeria Cantoni, Carmela Nappi, Andrea Genova, Roberta Green, Wanda Acampa, Mario Petretta, Emilia Zampella, Roberta Assante, Zampella, Emilia, Mannarino, Teresa, Gaudieri, Valeria, D’Antonio, Adriana, Giallauria, Francesco, Assante, Roberta, Cantoni, Valeria, Green, Roberta, Mainolfi, Ciro Gabriele, Nappi, Carmela, Genova, Andrea, Petretta, Mario, Cuocolo, Alberto, and Acampa, Wanda

Subjects
medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Revascularization, Myocardial perfusion imaging, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Myocardial infarction, medicine.diagnostic_test, business.industry, Unstable angina, Myocardial Perfusion Imaging, food and beverages, Percutaneous coronary intervention, Heart, medicine.disease, Perfusion, Heart failure, Conventional PCI, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Background. We evaluated the prognostic value of changes in perfusion defect size (PDS) on serial MPS in patients treated with primary percutaneous coronary intervention (PCI) after acute myocardial infarction (AMI). Methods. We enrolled 112 patients treated with primary PCI after AMI who underwent two stress MPS within 1 month and after 6 months. Improvement in PDS was defined as a reduction ‡5%. Remodeling was defined as an increase in left ventricular (LV) end-diastolic volume index ‡20%. Cardiac events included cardiac death, nonfatal MI, unstable angina, repeated revascularization, and heart failure. Results. During a median follow-up of 86 months, 22 events occurred. Event rate was higher (P < .01) in patients with worsening of PDS compared to those with unchanged or improved PDS. Moreover, patients with remodeling had a higher (P < .001) event rate compared to those without. At Cox analysis, worsening of PDS and remodeling resulted independent predictors of events (both P < .01). Patients with both worsening of PDS and remodeling had the worst event-free survival (P

Published
2021

39. Bipolar Disorder and Parkinsons Disease: A 123I-Ioflupane Dopamine Transporter SPECT Study

Author

Roberto Erro, Annamaria Landolfi, Giulia D'Agostino, Leonardo Pace, Marina Picillo, Massimo Scarano, Alberto Cuocolo, Sabina Pappatá, Carmine Vitale, Maria Teresa Pellecchia, Palmiero Monteleone, Paolo Barone, Erro, Roberto, Landolfi, Annamaria, D'Agostino, Giulia, Pace, Leonardo, Picillo, Marina, Scarano, Massimo, Cuocolo, Alberto, Pappatá, Sabina, Vitale, Carmine, Pellecchia, Maria Teresa, Monteleone, Palmiero, and Barone, Paolo

Subjects
medicine.medical_specialty, Parkinson's disease, DaTSCAN, antipsychotics (also called neuroleptics), degeneration, dopamine transporter, lithium, medicine.medical_treatment, Population, Nigrostriatal pathway, Gastroenterology, lcsh:RC346-429, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Bipolar disorder, education, Antipsychotic, lcsh:Neurology. Diseases of the nervous system, Dopamine transporter, Original Research, education.field_of_study, biology, business.industry, Parkinsonism, Dopaminergic, medicine.disease, medicine.anatomical_structure, Neurology, biology.protein, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Objectives: Bipolar disorder (BD) has been suggested to be a risk factor for the development of Parkinson's disease (PD). Standard treatment of BD includes drugs that are known to induce drug-induced parkinsonism (DIP). Clinical differentiation between PD and DIP is crucial and might be aided by functional neuroimaging of the dopaminergic nigrostriatal pathway.Methods: Twenty consecutive BD patients with parkinsonism were clinically assessed and underwent 123I-ioflupane dopamine transporter single-photon emission computer tomography (SPECT). Imaging data of BD patients with pathological scans were further compared to a population of 40 de novo PD patients.Results: Four BD patients had abnormal scans, but their clinical features and cumulative exposure to both antipsychotic drugs and lithium were similar to those of BD patients with normal dopamine transporter imaging. BD patients with pathological scans had putaminal binding ratio and putamen-to-caudate ratios higher than those of PD patients despite a similar motor symptom burden.Conclusions: Up to 20% of BD patients with parkinsonism might have an underlying dopaminergic deficit, which would not be due to cumulative exposure to offending drugs and is ostensibly higher than expected in the general population. This supports the evidence that BD represents a risk factor for subsequent development of neurodegenerative parkinsonism, the nature of which needs to be elucidated.

Published
2021
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40. Prognostic value of heart rate reserve in patients with suspected coronary artery disease undergoing stress myocardial perfusion imaging

Author

Mario Petretta, Emanuele Nicolai, Fabio Volpe, Alberto Cuocolo, Wanda Acampa, Emilia Zampella, Valeria Cantoni, Roberta Green, Valeria Gaudieri, Roberta Assante, Leandra Piscopo, Carmela Nappi, Ciro Mainolfi, Nappi, Carmela, Petretta, Mario, Assante, Roberta, Zampella, Emilia, Gaudieri, Valeria, Cantoni, Valeria, Green, Roberta, Volpe, Fabio, Piscopo, Leandra, Mainolfi, Ciro Gabriele, Nicolai, Emanuele, Acampa, Wanda, and Cuocolo, Alberto

Subjects
Male, medicine.medical_specialty, Ischemia, Disease, Coronary Artery Disease, Coronary artery disease, Myocardial perfusion imaging, Heart Rate, Internal medicine, Diabetes mellitus, medicine, Humans, Radiology, Nuclear Medicine and imaging, Adverse effect, Tomography, Emission-Computed, Single-Photon, medicine.diagnostic_test, business.industry, Myocardial Perfusion Imaging, medicine.disease, Prognosis, Cardiology, Exercise Test, Cardiology and Cardiovascular Medicine, business, Perfusion, Emission computed tomography
Abstract

Background Chronotropic incompetence is common in patients with cardiovascular disease and is associated with increased risk of adverse events. We assessed the incremental prognostic value of heart rate reserve (HRR) over stress myocardial perfusion single-photon emission computed tomography (MPS) findings in patients with suspected coronary artery disease (CAD). Methods We studied 866 patients with suspected CAD undergoing exercise stress-MPS as part of their diagnostic program. The primary study endpoint was all-cause mortality. All patients were followed for at least 5 years. HRR was calculated as the difference between peak exercise and resting HR, divided by the difference of age-predicted maximal and resting HR and expressed as percentage. Results During 7 years follow-up, 61 deaths occurred, with a 7% cumulative event rate. Patients experiencing death were older (P < .001), and had a higher prevalence of male gender (P < .001) and diabetes (P < .05). Patients with event also had lower values of HRR (65% ± 27% vs 73% ± 18%, P < .0001) and higher prevalence of stress-induced myocardial ischemia (25% vs 8%, P < .0001). Male gender, HRR and stress-induced ischemia were independent predictors of all-cause mortality (all P < .01). HRR improved the prognostic power of a model including clinical data and MPS findings, increasing the global χ2 from 66 to 82 (P < .005). Conclusions Chronotropic incompetence has independent and incremental prognostic value in predicting all-cause mortality in patients with suspected CAD undergoing exercise stress-MPS. Hence, the evaluation of HRR may further improve patients’ risk stratification.

Published
2021

41. PET/CT in the management of differentiated thyroid cancer

Author

Michele Klain, Alberto Cuocolo, Emilia Zampella, Leonardo Pace, Zampella, Emilia, Klain, Michele, Pace, Leonardo, and Cuocolo, Alberto

Subjects
Male, medicine.medical_specialty, Thyroid neoplasm, medicine.medical_treatment, medicine.disease_cause, Positron emission tomography/computedtomography (PET/CT), Thyroglobulin, 030218 nuclear medicine & medical imaging, Iodine Radioisotopes, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Avidity, Thyroid Neoplasms, Thyroid cancer, PET-CT, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Standard treatment, Thyroid, Iodine-124, General Medicine, medicine.disease, medicine.anatomical_structure, PET/MRI, Positron emission tomography, 030220 oncology & carcinogenesis, Positron-Emission Tomography, Radiology, Radiopharmaceuticals, business
Abstract

The standard treatment of differentiated thyroid cancer (DTC) consists of surgery followed by iodine-131 (131I) administration. Although the majority of DTC has a very good prognosis, more aggressive histologic subtypes convey a worse prognosis. Follow-up consists of periodically measurements of serum thyroglobulin, thyroglobulin antibodies and neck ultrasound and 123I/131I whole-body scan. However, undifferentiated thyroid tumors have a lower avidity for radioiodine and the ability of DTC to concentrate 131I may be lost in metastatic disease. Positron emission tomography (PET)/computed tomography (CT) has been introduced in the evaluation of patients with thyroid tumors and the 2-[18F]-fluoro-2-deoxyd-glucose (18F-FDG) has been largely validated as marker of cell's metabolism. According to the 2015 American Thyroid Association guidelines, 18F-FDG PET/CT is recommended in the follow-up of high-risk patients with elevated serum thyroglobulin and negative 131I imaging, in the assessment of metastatic patients, for lesion detection and risk stratification and in predicting the response to therapy. It should be considered that well-differentiated iodine avid lesions could not concentrate 18F-FDG, and a reciprocal pattern of iodine and 18F-FDG uptake has been observed. Beyond 18F-FDG, other tracers are available for PET imaging of thyroid tumors, such as Iodine-124 (124I), 18F-tetrafluoroborate and Gallium-68 prostate-specific membrane antigen. Moreover, the recent introduction of PET/MRI, offers now several opportunities in the field of patients with DTC. This review summarizes the evidences on the role of PET/CT in management of patients with DTC, focusing on potential applications and on elucidating some still debating points.

Published
2021

42. MRI based radiomics in nasopharyngeal cancer: Systematic review and perspectives using radiomic quality score (RQS) assessment

Author

Gaia Spadarella, Alberto Cuocolo, Lorenzo Ugga, Giuseppina Calareso, Renato Cuocolo, Enrico Garanzini, Spadarella, Gaia, Calareso, Giuseppina, Garanzini, Enrico, Ugga, Lorenzo, Cuocolo, Alberto, and Cuocolo, Renato

Subjects
medicine.medical_specialty, Nasopharyngeal neoplasm, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Radiomics, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, Nasopharyngeal Carcinoma, medicine.diagnostic_test, business.industry, Head and neck cancer, Magnetic resonance imaging, Nasopharyngeal Neoplasms, General Medicine, medicine.disease, Prognosis, Magnetic Resonance Imaging, Nasopharyngeal carcinoma, 030220 oncology & carcinogenesis, Quality Score, Mann–Whitney U test, Biomarker (medicine), Radiology, business
Abstract

Background MRI based radiomics has the potential to better define tumor biology compared to qualitative MRI assessment and support decisions in patients affected by nasopharyngeal carcinoma. Aim of this review was to systematically evaluate the methodological quality of studies using MRI- radiomics for nasopharyngeal cancer patient evaluation. Methods A systematic search was performed in PUBMED, WEB OF SCIENCE and SCOPUS using “MRI, magnetic resonance imaging, radiomic, texture analysis, nasopharyngeal carcinoma, nasopharyngeal cancer” in all possible combinations. The methodological quality of study included ( = 24) was evaluated according to the RQS (Radiomic quality score). Subgroup, for journal type (imaging/clinical) and biomarker (prognostic/predictive), and correlation, between RQS and journal Impact Factor, analyses were performed. Mann-Whitney U test and Spearman’s correlation were performed. P value < .05 were defined as statistically significant. Results Overall, no studies reported a phantom study or a test re-test for assessing stability in image, biological correlation or open science data. Only 8% of them included external validation. Almost half of articles (45%) performed multivariable analysis with non-radiomics features. Only 1 study was prospective (4%). The mean RQS was 7.5 ± 5.4. No significant differences were detected between articles published in clinical/imaging journal and between studies with a predictive or prognostic biomarker. No significant correlation was found between total RQS and Impact Factor of the year of publication (p always > 0.05). Conclusions Radiomic articles in nasopharyngeal cancer are mostly of low methodological quality. The greatest limitations are the lack of external validation, biological correlates, prospective design and open science.

Published
2021

43. Prognostic Value of Coronary Vascular Dysfunction Assessed by Rubidium-82 PET/CT Imaging in Patients With Resistant Hypertension Without Overt Coronary Artery Disease

Author

Adriana D'Antonio, Roberta Green, Mario Petretta, Wanda Acampa, Carmela Nappi, Parthiban Arumugam, Valeria Cantoni, Emilia Zampella, Teresa Mannarino, Roberta Assante, Alberto Cuocolo, Valeria Gaudieri, Gaudieri, Valeria, Mannarino, Teresa, Zampella, Emilia, Assante, Roberta, D'Antonio, Adriana, Nappi, Carmela, Cantoni, Valeria, Green, Roberta, Petretta, Mario, Arumugam, Parthiban, Cuocolo, Alberto, and Acampa, Wanda

Subjects
medicine.medical_specialty, PET/CT, Prognosi, Coronary Artery Disease, 030204 cardiovascular system & hematology, Left ventricular hypertrophy, Ventricular Function, Left, 030218 nuclear medicine & medical imaging, Coronary artery disease, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, Interquartile range, Positron Emission Tomography Computed Tomography, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Myocardial infarction, Ejection fraction, medicine.diagnostic_test, business.industry, Stroke Volume, General Medicine, Prognosis, medicine.disease, Rubidium-82, Resistant hypertension, Myocardial perfusion reserve, Heart failure, Hypertension, Cardiology, Original Article, business, Rubidium Radioisotopes
Abstract

Purpose The identification of coronary vascular dysfunction may enhance risk stratification in patients with resistant hypertension (RH). We evaluated if impaired coronary vascular function, assessed by rubidium-82 (82Rb) positron emission tomography/computed tomography (PET/CT) imaging, is associated with increased cardiovascular risk in patients with hypertension without overt coronary artery disease (CAD). Methods We studied 517 hypertensive subjects, 26% with RH, without overt CAD, and with normal stress-rest myocardial perfusion imaging at 82Rb PET/CT. The outcome end points were cardiac death, nonfatal myocardial infarction, coronary revascularization, and admission for heart failure. Results Over a median of 38 months (interquartile range 26 to 50), 21 cardiac events (4.1% cumulative event rate) occurred. Patients with RH were older (p p p p Conclusion The findings suggest that the assessment of coronary vascular function may enhance risk stratification in patients with hypertension.

Published
2021
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44. Risk of structural persistent disease in pediatric patients with low or intermediate risk differentiated thyroid cancer

Author

Emilia Zampella, Fabio Volpe, Carmela Nappi, Mariarosaria Manganelli, Martin Schlumberger, Leandra Piscopo, Adriana D'Antonio, Michele Klain, Alberto Cuocolo, Valeria Gaudieri, Leonardo Pace, Klain, Michele, Zampella, Emilia, Manganelli, Mariarosaria, Gaudieri, Valeria, Nappi, Carmela, D’Antonio, Adriana, Piscopo, Leandra, Volpe, Fabio, Pace, Leonardo, Schlumberger, Martin, and Cuocolo, Alberto

Subjects
Blood level, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 131I therapy, Pediatric patients, 030209 endocrinology & metabolism, Thyroglobulin, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Internal medicine, Diabetes mellitus, medicine, Initial treatment, Humans, In patient, Thyroid Neoplasms, Child, Thyroid cancer, Retrospective Studies, Differentiated thyroid carcinoma, Prognosis, business.industry, Radioiodine therapy, medicine.disease, Persistent Disease, 030220 oncology & carcinogenesis, Thyroidectomy, Neoplasm Recurrence, Local, Intermediate risk, business, Follow-Up Studies
Abstract

Purpose. In pediatric patients with differentiated thyroid cancer (DTC), the risk of recurrence is high and the indication for postoperative 131I administration is still debated. The aim of this study was to assess the outcome in low and intermediate risk pediatric DTC patients. Methods. We retrospectively evaluated 45 pediatric patients with low or intermediate risk DTC, treated with surgery and 131I between 1992 and 2002 and with no detectable antithyroglobulin (Tg) antibodies. Follow-up was performed every 6–12 months with Tg blood level determination and imaging procedures. Results. During follow-up (64 ± 53 months), 15 events occurred (33% cumulative event rate, with an annual event rate of 5% person years). Five of these patients were submitted to additional surgery and all these 15 patients underwent a second 131I treatment course. All patients were alive at the end of the follow-up. Structural persistent disease occurred more frequently in patients at intermediate risk (p 10 ng/ml before 131I therapy (p 10 ng/ml was an independent predictor of persistent disease. Conclusions. In pediatric patients with DTC, postoperative high stimulated Tg values (>10 ng/ml) should be taken into account for deciding the extent of both initial treatment and follow-up.

Published
2021

45. Prognostic value of pericoronary adipose tissue and coronary vascular function by cardiac 82Rb PET/CT imaging in patients with suspected coronary artery disease and normal myocardial perfusion imaging

Author

Alessia Giordano, Carmela Nappi, Emilia Zampella, Wanda Acampa, Alberto Cuocolo, Teresa Mannarino, Valeria Gaudieri, A D\\'antonio, Parthiban Arumugam, Roberta Assante, Maria Piera Petretta, and Pietro Buongiorno

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Adipose tissue, Pet ct imaging, General Medicine, medicine.disease, Coronary artery disease, Myocardial perfusion imaging, Internal medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, In patient, Cardiology and Cardiovascular Medicine, Vascular function, business, Value (mathematics)
Abstract

Funding Acknowledgements Type of funding sources: None. Introduction Pericoronary adipose tissue, due to its proximity to coronary arteries, has been proposed contribute to the progression of coronary atherosclerosis. Purpose The aim of this study was to evaluate the prognostic value of pericoronary fat thickness (PCFT), coronary artery calcium (CAC) score and myocardial perfusion reserve (MPR) by hybrid 82Rubidium (82Rb) PET/CT imaging in patients with suspected coronary artery disease (CAD) and normal myocardial perfusion imaging (MPI). Methods A total of 640 patients without overt CAD and with normal rest-stress 82Rb PET/CT MPI were studied. PCFT was calculated on CT images as the maximum fat thickness (mm) between heart surface and visceral epicardium surrounding the main coronary arteries. CAC score was categorized as 0, Results During a follow-up of 42 ± 13 months, 29 events occurred (cumulative event rate 5%). Patients with events were older (66 ± 13 vs. 60 ± 13 years, p 11.2 mm (p 11.2 mm and MPR 11.2 to a model including clinical data and MPR 11.2. Conclusions In patients with suspected CAD and normal stress MPI, coronary vascular dysfunction and high PCFT are associated with increased cardiac risk. PCFT could help in identifying patients at higher risk of events. Combined evaluation of anatomical and functional vascular abnormalities by 82Rb PET/CT might allow a better risk stratification.

Published
2021
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46. An international expert opinion statement on the utility of PET/MR for imaging of skeletal metastases

Author

Vinay Prabhu, William E. Palmer, Angel Torrado-Carvajal, Pedram Heidari, David Groshar, Laura Evangelista, Andrea Laghi, Jad S Husseini, Marco Salvatore, Heike E. Daldrup-Link, Bruce R. Rosen, Umar Mahmood, Marcello Henrique Nogueira-Barbosa, Ciprian Catana, Marius E. Mayerhoefer, Ken Herrmann, Ronald Borra, Marcelo Queiroz, Jacob Sosna, Onofrio A. Catalano, Christian J. Herold, Valdair Francisco Muglia, José Ramón García Garzón, Lale Umutlu, Bárbara Juarez Amorim, Alberto Cuocolo, Andrea Soricelli, Thomas C. Kwee, Tiffany Ting-Fang Shih, Cristina Sebastião Matushita, Lina Garcia Cañamaque, Andor W. J. M. Glaudemans, Juliano Julio Cerci, Husseini, Jad S., Amorim, Bárbara Juarez, Torrado-Carvajal, Angel, Prabhu, Vinay, Groshar, David, Umutlu, Lale, Herrmann, Ken, Cañamaque, Lina García, Garzón, José Ramón García, Palmer, William E., Heidari, Pedram, Shih, Tiffany Ting-Fang, Sosna, Jacob, Matushita, Cristina, Cerci, Juliano, Queiroz, Marcelo, Muglia, Valdair Francisco, Nogueira-Barbosa, Marcello H., Borra, Ronald J. H., Kwee, Thomas C., Glaudemans, Andor W. J. M., Evangelista, Laura, Salvatore, Marco, Cuocolo, Alberto, Soricelli, Andrea, Herold, Christian, Laghi, Andrea, Mayerhoefer, Mariu, Mahmood, Umar, Catana, Ciprian, Daldrup-Link, Heike E., Rosen, Bruce, Catalano, Onofrio A., ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Guided Treatment in Optimal Selected Cancer Patients (GUTS), and Translational Immunology Groningen (TRIGR)

Subjects
medicine.medical_specialty, Medizin, Metastases, Article, 030218 nuclear medicine & medical imaging, MR, Osseous, PET, PET/MR, PET/MRI, Skeletal, 03 medical and health sciences, 0302 clinical medicine, metastases, osseous, skeletal, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, medicine, Humans, Radiology, Nuclear Medicine and imaging, Expert Testimony, Magnetic Resonance Imaging, Positron-Emission Tomography, Radiopharmaceuticals, Modalities, business.industry, Primary malignancy, General Medicine, Patient management, Soft tissue contrast, 030220 oncology & carcinogenesis, Expert opinion, Radiology, business, MRI
Abstract

Background: MR is an important imaging modality for evaluating musculoskeletal malignancies owing to its high soft tissue contrast and its ability to acquire multiparametric information. PET provides quantitative molecular and physiologic information and is a critical tool in the diagnosis and staging of several malignancies. PET/MR, which can take advantage of its constituent modalities, is uniquely suited for evaluating skeletal metastases. We reviewed the current evidence of PET/MR in assessing for skeletal metastases and provided recommendations for its use. Methods: We searched for the peer reviewed literature related to the usage of PET/MR in the settings of osseous metastases. In addition, expert opinions, practices, and protocols of major research institutions performing research on PET/MR of skeletal metastases were considered. Results: Peer-reviewed published literature was included. Nuclear medicine and radiology experts, including those from 13 major PET/MR centers, shared the gained expertise on PET/MR use for evaluating skeletal metastases and contributed to a consensus expert opinion statement. [18F]-FDG and non [18F]-FDG PET/MR may provide key advantages over PET/CT in the evaluation for osseous metastases in several primary malignancies. Conclusion: PET/MR should be considered for staging of malignancies where there is a high likelihood of osseous metastatic disease based on the characteristics of the primary malignancy, hight clinical suspicious and in case, where the presence of osseous metastases will have an impact on patient management. Appropriate choice of tumor-specific radiopharmaceuticals, as well as stringent adherence to PET and MR protocols, should be employed. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

Published
2021

47. Role of serial cardiac 18F-FDG PET-MRI in Anderson-Fabry disease: a pilot study

Author

Teodolinda Di Risi, Letizia Spinelli, Roberta Assante, Emanuele Nicolai, Andrea Ponsiglione, Eleonora Riccio, Michele Klain, Alberto Cuocolo, Maurizio Pieroni, Antonio Pisani, Massimo Imbriaco, Carmela Nappi, Wanda Acampa, Nappi, Carmela, Ponsiglione, Andrea, Pisani, Antonio, Riccio, Eleonora, Di Risi, Teodolinda, Pieroni, Maurizio, Klain, Michele, Assante, Roberta, Acampa, Wanda, Nicolai, Emanuele, Spinelli, Letizia, Cuocolo, Alberto, and Imbriaco, Massimo

Subjects
medicine.medical_specialty, Anderson–Fabry disease, medicine.diagnostic_test, business.industry, FASTEX score, Ultrasound, R895-920, Interventional radiology, Enzyme replacement therapy, 18f fdg pet, Anderson-Fabry Disease, Medical physics. Medical radiology. Nuclear medicine, AFD, PET/MRI, Anderson-Fabry disease, Internal medicine, medicine, Cardiology, Late gadolinium enhancement, Original Article, Radiology, Nuclear Medicine and imaging, Abnormality, business, Neuroradiology
Abstract

AimWe investigated the value of serial cardiac18F-FDG PET-MRI in Anderson–Fabry disease (AFD) and the potential relationship of imaging results with FASTEX score.Methods and resultsThirteen AFD patients underwent cardiac18F-FDG PET-MRI at baseline and follow-up. Coefficient of variation (COV) of FDG uptake and FASTEX score were assessed. At baseline, 9 patients were enzyme replacement therapy (ERT) naïve and 4 patients were under treatment. Two patients presented a FASTEX score of 0 indicating stable disease and did not show any imaging abnormality at baseline and follow-up PET-MRI. Eleven patients had a FASTEX score > 20% indicating disease worsening. Four of these patients without late gadolinium enhancement (LGE) and with normal COV at baseline and follow-up had a FASTEX score of 35%. Three patients without LGE and with abnormal COV at baseline and follow-up had a FASTEX score ranging from 30 to 70%. Three patients with LGE and abnormal COV at baseline and follow-up had a FASTEX score between 35 and 75%. Finally, one patient with LGE and normal COV had a FASTEX score of 100%. Of the 12 patients on ERT at follow-up, FASTEX score was significantly higher in those 4 showing irreversible cardiac injury at baseline compared to 8 with negative LGE (66 ± 24 vs. 32 ± 21,p = 0.03).Conclusion18F-FDG PET-MRI may be effective to monitor cardiac involvement in AFD.

Published
2021
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48. 18F-sodium fluoride: An old tracer with a new promising clinical application

Author

Roberta Assante, Alberto Cuocolo, Valeria Cantoni, Cantoni, Valeria, Assante, Roberta, and Cuocolo, Alberto

Subjects
chemistry.chemical_compound, chemistry, business.industry, TRACER, Sodium fluoride, Radiochemistry, MEDLINE, Medicine, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business
Abstract

NA

Published
2021

49. New insights for early assessment of cardiac involvement in Anderson-Fabry disease

Author

Massimo Imbriaco, Carmela Nappi, Antonio Pisani, Alberto Cuocolo, Valeria Gaudieri, Cuocolo, Alberto, Nappi, Carmela, Gaudieri, Valeria, Pisani, Antonio, and Imbriaco, Massimo

Subjects
medicine.medical_specialty, Heart Diseases, business.industry, MEDLINE, Cardiac Imaging Techniques, Anderson-Fabry Disease, Early Diagnosis, medicine, Fabry Disease, Humans, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, Intensive care medicine, business
Abstract

NA

Published
2021

50. 18F-sodium fluoride and vascular calcification: Some like it hot

Author

Adriana D'Antonio, Alberto Cuocolo, Emilia Zampella, Valeria Gaudieri, Gaudieri, Valeria, Zampella, Emilia, D’Antonio, Adriana, and Cuocolo, Alberto

Subjects
chemistry.chemical_compound, Pathology, medicine.medical_specialty, chemistry, business.industry, Sodium fluoride, Medicine, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business, Vascular calcification
Published
2021

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