59 results on '"Mangili, Paola"'
Search Results
52. Detection of systematic errors in external radiotherapy before treatment delivery
- Author
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Calandrino, Riccardo, primary, Cattaneo, Giovanni Mauro, additional, Fiorino, Claudio, additional, Longobardi, Barbara, additional, Mangili, Paola, additional, and Signorotto, Patrizia, additional
- Published
- 1997
- Full Text
- View/download PDF
53. Variations of tumor control and rectum complication probabilities due to random set-up errors during conformal radiation therapy of prostate cancer
- Author
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Ragazzi, Gabriela, primary, Mangili, Paola, additional, Fiorino, Claudio, additional, Cattaneo, Giovanni Mauro, additional, Bolognesi, Angelo, additional, Reni, Michele, additional, and Calandrino, Riccardo, additional
- Published
- 1997
- Full Text
- View/download PDF
54. Feasibility of safe ultra-high (EQD2>100 Gy) dose escalation on dominant intra-prostatic lesions (DILs) by Helical Tomotheraphy.
- Author
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Maggio, Angelo, Fiorino, Claudio, Mangili, Paola, Cozzarini, Cesare, de Cobelli, Francesco, Cattaneo, Giovanni Mauro, Rancati, Tiziana, Maschio, Alessandro Del, Muzio, Nadia Di, and Calandrino, Riccardo
- Subjects
RADIATION injuries ,COMPUTER software ,DIFFUSION ,DOSE-response relationship (Radiation) ,MAGNETIC resonance imaging ,PROSTATE tumors ,RADIATION doses ,RECTUM ,STATISTICS ,TOMOGRAPHY ,PILOT projects ,DATA analysis ,PREVENTION - Abstract
Purpose. To verify the possibility of using Helical Tomotherapy to safely escalate dose to single or multiple highly radioresistant dominant intra-prostatic lesions (DILs) as assessed by functional magnetic resonance imaging (MRI). Material. In seven intermediate/high risk patients, T2WI, T1WI and DWI MRI imaging showed evidence of one DIL in four patients and two DILs in three patients in the peripheral zone of the prostate. The planning strategy was to deliver median doses of 80, 90, 100 and 120 Gy to PTVDIL while delivering 71.4 Gy/28 fractions (EQD
2 =75 Gy) to the remaining portion of PTV. A higher priority was assigned to rectal constraints relative to DIL coverage. Rectal NTCP calculations were performed using the most recently available model data. Results. The median dose to DIL could safely be escalated to at least 100 Gy (EQD2,α/β=10 =113 Gy) without violating safe constraints for the organs at risk. Typical rectal NTCP values were around or below 1-3% for G3 toxicity and 5-7% for G2-G3 toxicity. For the 100 Gy DIL dose boost strategy, mean D95% of DIL and PTVDIL were 98.8 Gy and 86.7 Gy, respectively. The constraints for bladder, urethra and femoral heads were always respected. Conclusions. IGRT by Helical Tomotherapy may permit the safe escalation of EQD2,α/β=10 to at least 113 Gy to DILs without significantly increasing rectal NTCP compared to plans without dose escalation. A Phase I-II clinical study is warranted. [ABSTRACT FROM AUTHOR]- Published
- 2011
- Full Text
- View/download PDF
55. Development and in vivo assessment of a novel MRI-compatible headframe system for the ovine animal model
- Author
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Marco Trovatelli, Andrea Falini, Marco A. Riva, Antonella Castellano, Stefano Brizzola, Dave Johnson, Riccardo Secoli, Lorenzo Bello, Ferdinando Rodriguez y Baena, D. De Zani, Max Woolley, Paola Mangili, Trovatelli, Marco, Brizzola, Stefano, Zani, Davide Danilo, Castellano, Antonella, Mangili, Paola, Riva, Marco, Woolley, Max, Johnson, Dave, Rodriguez Y Baena, Ferdinando, Bello, Lorenzo, Falini, Andrea, and Secoli, Riccardo
- Subjects
0301 basic medicine ,Linear displacement ,Computer science ,Biophysics ,Neurosurgery ,Neurosurgical Procedures ,03 medical and health sciences ,0302 clinical medicine ,Animal model ,In vivo ,medicine ,Animals ,Humans ,Sheep ,Frame (networking) ,Mri compatible ,Human brain ,Surgical procedures ,Magnetic Resonance Imaging ,Computer Science Applications ,030104 developmental biology ,medicine.anatomical_structure ,Brain size ,Models, Animal ,Surgery ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery ,Biomedical engineering - Abstract
BACKGROUND The brain of sheep has primarily been used in neuroscience as an animal model because of its similarity to the human brain, in particular if compared to other models such as the lissencephalic rodent brain. Their brain size also makes sheep an ideal model for the development of neurosurgical techniques using conventional clinical CT/MRI scanners and stereotactic systems for neurosurgery. METHODS In this study, we present the design and validation of a new CT/MRI compatible head frame for the ovine model and software, with its assessment under two real clinical scenarios. RESULTS Ex-vivo and in vivo trial results report an average linear displacement of the ovine head frame during conventional surgical procedures of 0.81 mm for ex-vivo trials and 0.68 mm for in vivo tests, respectively. CONCLUSIONS These trial results demonstrate the robustness of the head frame system and its suitability to be employed within a real clinical setting.
- Published
- 2021
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- View/download PDF
56. Integration of Diffusion Magnetic Resonance Tractography into tomotherapy radiation treatment planning for high-grade gliomas
- Author
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Riccardo Calandrino, Luisa Altabella, Antonella del Vecchio, Sara Broggi, Paola Mangili, Valentina Pieri, Nadia Di Muzio, Antonella Castellano, Gian Marco Conte, Antonella Iadanza, Andrea Falini, Nicoletta Anzalone, Altabella, Luisa, Broggi, Sara, Mangili, Paola, Conte, Gian Marco, Pieri, Valentina, Iadanza, Antonella, del Vecchio, Antonella, Anzalone, Nicoletta, di Muzio, Nadia, Calandrino, Riccardo, Falini, Andrea, and Castellano, Antonella
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Adult ,Male ,Radiology, Nuclear Medicine and Imaging ,medicine.medical_treatment ,Biophysics ,Planning target volume ,General Physics and Astronomy ,Tomotherapy ,White matter ,Brain Neoplasm ,03 medical and health sciences ,Physics and Astronomy (all) ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiation treatment planning ,Aged ,medicine.diagnostic_test ,Radiotherapy ,business.industry ,Brain Neoplasms ,Radiotherapy Planning, Computer-Assisted ,Magnetic resonance imaging ,Radiotherapy Dosage ,General Medicine ,Glioma ,Middle Aged ,Radiation therapy ,Brain tumor ,medicine.anatomical_structure ,Diffusion Tensor Imaging ,Biophysic ,030220 oncology & carcinogenesis ,Female ,Diffusion MR Tractography ,Radiotherapy, Intensity-Modulated ,Neoplasm Grading ,Nuclear medicine ,business ,030217 neurology & neurosurgery ,Tractography ,Diffusion MRI ,Human - Abstract
Introduction Fractionated radiotherapy in brain tumors is commonly associated with several detrimental effects, largely related to the higher radiosensitivity of the white matter (WM) with respect to gray matter. However, no dose constraints are applied to preserve WM structures at present. Magnetic Resonance (MR) Tractography is the only technique that allows to visualize in vivo the course of WM eloquent tracts in the brain. In this study, the feasibility of integrating MR Tractography in tomotherapy treatment planning has been investigated, with the aim to spare eloquent WM regions from the dose delivered during treatment. Methods Nineteen high grade glioma patients treated with fractionated radiotherapy were enrolled. All the patients underwent pre-treatment MR imaging protocol including Diffusion Tensor Imaging (DTI) acquisitions for MR Tractography analysis. Bilateral tracts involved in several motor, language, cognitive functions were reconstructed and these fiber bundles were integrated into the Tomotherapy Treatment planning system. The original plans without tracts were compared with the optimized plans incorporating the fibers, to evaluate doses to WM structures in the two differently optimized plans. Results No significant differences were found between plans in terms of planning target volume (PTV) coverage between the original plans and the optimized plans incorporating fiber tracts. Comparing the mean as well as the maximal dose (Dmean and Dmax), a significant dose reduction was found for most of the tracts. The dose sparing was more relevant for contralateral tracts (P Conclusion The integration of MR Tractography into radiotherapy planning is feasible and beneficial to preserve important WM structures without reducing the clinical goal of radiation treatment.
- Published
- 2018
57. Toxicity and efficacy of salvage carbon 11-choline positron emission tomography/computed tomography-guided radiation therapy in patients with lymph node recurrence of prostate cancer
- Author
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Italo Dell'Oca, Elena Busnardo, Paola Mangili, Margarita Kirienko, Luigi Gianolli, Andrei Fodor, Claudio Fiorino, Elena Incerti, Cesare Cozzarini, Marcella Pasetti, Riccardo Calandrino, Maria Picchio, Nadia Di Muzio, G. Berardi, Fodor, Andrei, Berardi, Genoveffa, Fiorino, Claudio, Picchio, Maria, Busnardo, Elena, Kirienko, Margarita, Incerti, Elena, Dell'Oca, Italo, Cozzarini, Cesare, Mangili, Paola, Pasetti, Marcella, Calandrino, Riccardo, Gianolli, Luigi, and Di Muzio, Nadia G
- Subjects
Biochemical recurrence ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Urology ,salvage radiation therapy ,Multimodal Imaging ,Tomotherapy ,030218 nuclear medicine & medical imaging ,Choline ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Retrospective Studie ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,Lymph node ,Retrospective Studies ,Aged ,Aged, 80 and over ,Salvage Therapy ,11C- Choline PET/CT ,Genitourinary system ,business.industry ,Hazard ratio ,Prostatic Neoplasms ,lymph node recurrence ,Lymphatic Metastasi ,Middle Aged ,medicine.disease ,prostate cancer ,Radiation therapy ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Toxicity ,Prostatic Neoplasm ,Radiology ,Radiotherapy, Intensity-Modulated ,Neoplasm Recurrence, Local ,business ,Nuclear medicine ,Human ,Radiotherapy, Image-Guided - Abstract
Objective: To report the 3-year toxicity and outcomes of carbon 11 (11C)-choline-positron emission tomography (PET)/computed tomography (CT)-guided radiotherapy (RT), delivered via helical tomotherapy (HTT; Tomotherapy® Hi-Art II® Treatment System, Accuray Inc., Sunnyvale, CA, USA) after lymph node (LN) relapses in patients with prostate cancer. Patients and Methods: From January 2005 to March 2013, 81 patients with biochemical recurrence after surgery, with or without adjuvant/salvage RT or radical RT, and with evidence of LN 11C-choline-PET/CT pathological uptake, underwent HTT (median [range] prostate-specific antigen level 2.59 [0.61â187] ng/mL). Of the 81 patients, 72 were treated at the pelvic and/or lumbar-aortic LN chain with HTT at 51.8 Gy/28 fr and with simultaneous integrated boost to a median dose of 65.5 Gy on the pathological uptake sites detected by 11C-choline-PET/CT. Nine patients were treated without simultaneous integrated boost (50â65.5 Gy, 25â30 fr). Results: With a median (range) follow-up of 36 (9â116) months, 91.4% of the patients had a PSA reduction 3 months after HTT. The 3-year overall, local relapse-free and clinical relapse-free survival rates were 80.0, 89.8 and 61.8%, respectively. The 3-year actuarial incidences of â¥grade 2 rectal and â¥grade 2 genitourinary toxicity were 6.6% (±2.9%) and 26.3% (±5.5%), respectively. A PSA nadir of â¥0.26 ng/mL (hazard ratio [HR] 3.6, 95% confidence interval [CI] 1.7â7.7; P = 0.001), extrapelvic 11C-choline-PET/CT-positive LN location (HR 2.4, 95% CI 0.9â6.4; P = 0.07), RT previous to HTT (HR 2.7; 95% CI 1.07â6.9, P = 0.04) and number of positive LNs (HR 1.13, 95% CI 1.04â1.22; P = 0.003) were the main predictors of clinical relapse after HTT. Conclusions: 11C-choline-PET/CT-guided HTT is safe and effective in the treatment of LN relapses of prostate cancer in previously treated patients.
- Published
- 2017
58. Feasibility of safe ultra-high (EQD(2)>100 Gy) dose escalation on dominant intra-prostatic lesions (DILs) by Helical Tomotheraphy.
- Author
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Maggio A, Fiorino C, Mangili P, Cozzarini C, de Cobelli F, Cattaneo GM, Rancati T, Maschio AD, Muzio ND, and Calandrino R
- Subjects
- Aged, Aged, 80 and over, Dose-Response Relationship, Radiation, Feasibility Studies, Humans, Male, Middle Aged, Organs at Risk, Radiotherapy Planning, Computer-Assisted, Rectum radiation effects, Urinary Bladder radiation effects, Prostatic Neoplasms radiotherapy, Radiotherapy Dosage, Tomography, Spiral Computed adverse effects
- Abstract
Purpose: to verify the possibility of using Helical Tomotherapy to safely escalate dose to single or multiple highly radioresistant dominant intra-prostatic lesions (DILs) as assessed by functional magnetic resonance imaging (MRI)., Material: in seven intermediate/high risk patients, T2WI, T1WI and DWI MRI imaging showed evidence of one DIL in four patients and two DILs in three patients in the peripheral zone of the prostate. The planning strategy was to deliver median doses of 80, 90, 100 and 120 Gy to PTVDIL while delivering 71.4 Gy/28 fractions (EQD(2)=75 Gy) to the remaining portion of PTV. A higher priority was assigned to rectal constraints relative to DIL coverage. Rectal NTCP calculations were performed using the most recently available model data., Results: the median dose to DIL could safely be escalated to at least 100 Gy (EQD(2,α/β=10)=113 Gy) without violating safe constraints for the organs at risk. Typical rectal NTCP values were around or below 1-3% for G3 toxicity and 5-7% for G2-G3 toxicity. For the 100 Gy DIL dose boost strategy, mean D95% of DIL and PTVDIL were 98.8 Gy and 86.7 Gy, respectively. The constraints for bladder, urethra and femoral heads were always respected., Conclusions: IGRT by Helical Tomotherapy may permit the safe escalation of EQD(2,α/β=10) to at least 113 Gy to DILs without significantly increasing rectal NTCP compared to plans without dose escalation. A Phase I-II clinical study is warranted.
- Published
- 2011
- Full Text
- View/download PDF
59. Lethal pulmonary complications significantly correlate with individually assessed mean lung dose in patients with hematologic malignancies treated with total body irradiation.
- Author
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Della Volpe A, Ferreri AJ, Annaloro C, Mangili P, Rosso A, Calandrino R, Villa E, Lambertenghi-Deliliers G, and Fiorino C
- Subjects
- Adolescent, Adult, Analysis of Variance, Child, Female, Hematologic Neoplasms mortality, Hematologic Neoplasms therapy, Humans, Leukemia mortality, Lung Diseases mortality, Lymphoma mortality, Male, Middle Aged, Proportional Hazards Models, Radiation Dosage, Transplantation Conditioning, Whole-Body Irradiation methods, Whole-Body Irradiation mortality, Bone Marrow Transplantation mortality, Leukemia therapy, Lung Diseases etiology, Lymphoma therapy, Radiation Injuries complications, Whole-Body Irradiation adverse effects
- Abstract
Purpose: To assess the impact of lung dose on lethal pulmonary complications (LPCs) in a single-center group of patients with hematologic malignancies treated with total body irradiation (TBI) in the conditioning regimen for bone marrow transplantation (BMT)., Methods: The mean lung dose of 101 TBI-conditioned patients was assessed by a thorough (1 SD around 2%) in vivo transit dosimetry technique. Fractionated TBI (10 Gy, 3.33 Gy/fraction, 1 fraction/d, 0.055 Gy/min) was delivered using a lateral-opposed beam technique with shielding of the lung by the arms. The median lung dose was 9.4 Gy (1 SD 0.8 Gy, range 7.8--11.4). The LPCs included idiopathic interstitial pneumonia (IIP) and non-idiopathic IP (non-IIP)., Results: Nine LPCs were observed. LPCs were observed in 2 (3.8%) of 52 patients in the group with a lung dose < or = 9.4 Gy and in 7 (14.3%) of 49 patients in the >9.4 Gy group. The 6-month LPC risk was 3.8% and 19.2% (p = 0.05), respectively. A multivariate analysis adjusted by the following variables: type of malignancy (acute leukemia, chronic leukemia, lymphoma, myeloma), type of BMT (allogeneic, autologous), cytomegalovirus infection, graft vs. host disease, and previously administered drugs (bleomycin, cytarabine, cyclophosphamide, nitrosoureas), revealed a significant and independent association between lung dose and LPC risk (p = 0.02; relative risk = 6.7). Of the variables analyzed, BMT type (p = 0.04; relative risk = 6.6) had a risk predictive role., Conclusion: The mean lung dose is an independent predictor of LPC risk in patients treated with the 3 x 3.33-Gy low-dose-rate TBI technique. Allogeneic BMT is associated with a higher risk of LPCs.
- Published
- 2002
- Full Text
- View/download PDF
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