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1. The HERMES (High Energy Rapid Modular Ensemble of Satellites) Pathfinder mission

Author

Evangelista, Y., Fiore, F., Campana, R., Baroni, G., Ceraudo, F., Della Casa, G., Demenev, E., Dilillo, G., Fiorini, M., Ghirlanda, G., Grassi, M., Guzmán, A., Hedderman, P., Marchesini, E. J., Morgante, G., Mele, F., Nava, L., Nogara, P., Nuti, A., Caballero, S. Pliego, Rashevskaya, I., Russo, F., Sottile, G., Lavagna, M., Colagrossi, A., Silvestrini, S., Quirino, M., Bechini, M., Brandonisio, A., De Cecio, F., Dottori, A., Troisi, i., Bertacin, R., Bellutti, P., Bertuccio, G., Burderi, L., Chen, T., Citossi, M., Di Salvo, T., Feroci, M., Ficorella, F., Gao, N., Grappasonni, C., Labanti, C., La Rosa, G., Leone, W., Malcovati, P., Negri, B., Pepponi, G., Perri, M., Piazzolla, R., Picciotto, A., Pirrotta, S., Puccetti, S., Rashevsky, A., Riggio, A., Rinaldi, M., Sanna, A., Santangelo, A., Tenzer, C., Tiberia, A., Trenti, M., Trevisan, S., Vacchi, A., Xiong, S., Zampa, G., Zampa, N., Zhang, S., Zorzi, N., Ripa, J., and Werner, N.

Subjects
Astrophysics - Instrumentation and Methods for Astrophysics
Abstract

HERMES (High Energy Rapid Modular Ensemble of Satellites) Pathfinder is a space-borne mission based on a constellation of six nano-satellites flying in a low-Earth orbit (LEO). The 3U CubeSats, to be launched in early 2025, host miniaturized instruments with a hybrid Silicon Drift Detector/GAGG:Ce scintillator photodetector system, sensitive to X-rays and gamma-rays in a large energy band. HERMES will operate in conjunction with Australian Space Industry Responsive Intelligent Thermal (SpIRIT) 6U CubeSat, launched in December 2023. HERMES will probe the temporal emission of bright high-energy transients such as Gamma-Ray Bursts (GRBs), ensuring a fast transient localization in a field of view of several steradians exploiting the triangulation technique. HERMES intrinsically modular transient monitoring experiment represents a keystone capability to complement the next generation of gravitational wave experiments. In this paper we outline the scientific case, development and programmatic status of the mission, Comment: 13 pages, 16 figures. Proceedings of SPIE "Astronomical Telescopes and Instrumentation" 2024. arXiv admin note: text overlap with arXiv:2210.13866

Published
2024
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2. HERMES: Gamma Ray Burst and Gravitational Wave counterpart hunter

Author

Ghirlanda, G., Nava, L., Salafia, O., Fiore, F., Campana, R., Salvaterra, R., Sanna, A., Leone, W., Evangelista, Y., Dilillo, G., Puccetti, S., Santangelo, A., Trenti, M., Guzmán, A., Hedderman, P., Amelino-Camelia, G., Barbera, M., Baroni, G., Bechini, M., Bellutti, P., Bertuccio, G., Borghi, G., Brandonisio, A., Burderi, L., Cabras, C., Chen, T., Citossi, M., Colagrossi, A., Crupi, R., De Cecio, F., Dedolli, I., Del Santo, M., Demenev, E., Di Salvo, T., Ficorella, F., Gačnik, D., Gandola, M., Gao, N., Gomboc, A., Grassi, M., Iaria, R., La Rosa, G., Cicero, U. Lo, Malcovati, P., Manca, A., Marchesini, E. J., Maselli, A., Mele, F., Nogara, P., Pepponi, G., Perri, M., Picciotto, A., Pirrotta, S., Prinetto, J., Quirino, M., Riggio, A., Řípa, J., Russo, F., Selčan, D., Silvestrini, S., Sottile, G., Thomas, M. L., Tiberia, A., Trevisan, S., Troisi, I., Tsvetkova, A., Vacchi, A., Werner, N., Zanotti, G., and Zorzi, N.

Subjects
Astrophysics - High Energy Astrophysical Phenomena
Abstract

Gamma Ray Bursts (GRBs) bridge relativistic astrophysics and multi-messenger astronomy. Space-based gamma/X-ray wide field detectors have proven essential to detect and localize the highly variable GRB prompt emission, which is also a counterpart of gravitational wave events. We study the capabilities to detect long and short GRBs by the High Energy Rapid Modular Ensemble of Satellites (HERMES) Pathfinder (HP) and SpIRIT, namely a swarm of six 3U CubeSats to be launched in early 2025, and a 6U CubeSat launched on December 1st 2023. We also study the capabilities of two advanced configurations of swarms of >8 satellites with improved detector performances (HERMES Constellations). The HERMES detectors, sensitive down to ~2-3 keV, will be able to detect faint/soft GRBs which comprise X-ray flashes and high redshift bursts. By combining state-of-the-art long and short GRB population models with a description of the single module performance, we estimate that HP will detect ~195^{+22}_{-21} long GRBs (3.4^{+0.3}_{-0.8} at redshift z>6) and ~19^{+5}_{-3} short GRBs per year. The larger HERMES Constellations under study can detect between ~1300 and ~3000 long GRBs per year and between ~160 and ~400 short GRBs per year, depending on the chosen configuration, with a rate of long GRBs above z>6 between 30 and 75 per year. Finally, we explore the capabilities of HERMES to detect short GRBs as electromagnetic counterparts of binary neutron star (BNS) mergers detected as gravitational signals by current and future ground-based interferometers. Under the assumption that the GRB jets are structured, we estimate that HP can provide up to 1 (14) yr^{-1} joint detections during the fifth LIGO-Virgo-KAGRA observing run (Einstein Telescope single triangle 10 km arm configuration). These numbers become 4 (100) yr^{-1}, respectively, for the HERMES Constellation configuration., Comment: 13 pages, 6 figures, 4 tabels. Accepted for publication by Astronomy & Astrophysics

Published
2024

3. The HERMES Calibration Pipeline: mescal

Author

Dilillo, G., Marchesini, E. J., Della Casa, G., Baroni, G., Campana, R., Borciani, E., Srivastava, S., Trevisan, S., Ceraudo, F., Citossi, M., Evangelista, Y., Guzmán, A., Hedderman, P., Labanti, C., Virgilli, E., and Fiore, F.

Subjects
Astrophysics - Instrumentation and Methods for Astrophysics, Astrophysics - High Energy Astrophysical Phenomena
Abstract

The HERMES Technologic and Scientific Pathfinder project is a constellation of six CubeSats aiming to observe transient high-energy events such as the Gamma Ray Bursts (GRBs). HERMES will be the first space telescope to include a siswich detector, able to perform spectroscopy in the 2 keV to 2 MeV energy band. The particular siswich architecture, which combines a solid-state Silicon Drift Detector and a scintillator crystal, requires specific calibration procedures that have not been yet standardized in a pipeline. We present in this paper the HERMES calibration pipeline, mescal, intended for raw HERMES data energy calibration and formatting. The software is designed to deal with the particularities of the siswich architecture and to minimize user interaction, including also an automated calibration line identification procedure, and an independent calibration of each detector pixel, in its two different operating modes. The mescal pipeline can set the basis for similar applications in future siswich telescopes.

Published
2024
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4. Design, integration, and test of the scientific payloads on-board the HERMES constellation and the SpIRIT mission

Author

Evangelista, Y., Fiore, F., Campana, R., Ceraudo, F., Della Casa, G., Demenev, E., Dilillo, G., Fiorini, M., Grassi, M., Guzman, A., Hedderman, P., Marchesini, E. J., Morgante, G., Mele, F., Nogara, P., Nuti, A., Piazzolla, R., Caballero, S. Pliego, Rashevskaya, I., Russo, F., Sottile, G., Labanti, C., Baroni, G., Bellutti, P., Bertuccio, G., Cao, J., Chen, T., Dedolli, I., Feroci, M., Fuschino, F., Gandola, M., Gao, N., Ficorella, F., Malcovati, P., Picciotto, A., Rachevski, A., Santangelo, A., Tenzer, C., Vacchi, A., Wang, L., Xu, Y., Zampa, G., Zampa, N., and Zorzi, N.

Subjects
Astrophysics - Instrumentation and Methods for Astrophysics
Abstract

HERMES (High Energy Rapid Modular Ensemble of Satellites) is a space-borne mission based on a constellation of nano-satellites flying in a low-Earth orbit (LEO). The six 3U CubeSat buses host new miniaturized instruments hosting a hybrid Silicon Drift Detector/GAGG:Ce scintillator photodetector system sensitive to X-rays and gamma-rays. HERMES will probe the temporal emission of bright high-energy transients such as Gamma-Ray Bursts (GRBs), ensuring a fast transient localization (with arcmin-level accuracy) in a field of view of several steradians exploiting the triangulation technique. With a foreseen launch date in late 2023, HERMES transient monitoring represents a keystone capability to complement the next generation of gravitational wave experiments. Moreover, the HERMES constellation will operate in conjunction with the Space Industry Responsive Intelligent Thermal (SpIRIT) 6U CubeSat, to be launched in early 2023. SpIRIT is an Australian-Italian mission for high-energy astrophysics that will carry in a Sun-synchronous orbit (SSO) an actively cooled HERMES detector system payload. On behalf of the HERMES collaboration, in this paper we will illustrate the HERMES and SpIRIT payload design, integration and tests, highlighting the technical solutions adopted to allow a wide-energy-band and sensitive X-ray and gamma-ray detector to be accommodated in a 1U Cubesat volume., Comment: arXiv admin note: substantial text overlap with arXiv:2101.03032

Published
2022

5. Calibration of the first detector flight models for the HERMES constellation and the SpIRIT mission

Author

Campana, R., Baroni, G., Della Casa, G., Dilillo, G., Marchesini, E. J., Ceraudo, F., Guzman, A., Hedderman, P., and Evangelista, Y.

Subjects
Astrophysics - Instrumentation and Methods for Astrophysics
Abstract

HERMES (High Energy Rapid Modular Ensemble of Satellites) is a space-borne mission based on a constellation of six 3U CubeSats flying in a low-Earth orbit, hosting new miniaturized instruments based on a hybrid Silicon Drift Detector/GAGG:Ce scintillator photodetector system sensitive to X-rays and gamma-rays. Moreover, the HERMES constellation will operate in conjunction with the Australian-Italian Space Industry Responsive Intelligent Thermal (SpIRIT) 6U CubeSat, that will carry in a Sun-synchronous orbit (SSO) an actively cooled HERMES detector system payload. In this paper we provide an overview of the ground calibrations of the first HERMES and SpIRIT flight detectors, outlining the calibration plan, detector performance and characterization., Comment: 9 pages, 7 figures. Proceedings of SPIE Astronomical Telescopes and Instrumentation 2022

Published
2022
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6. OC.05.2: FIRST AND FURTHER LIVER DECOMPENSATION IN PATIENTS WITH METABOLIC-DYSFUNCTION ASSOCIATED STEATOTIC LIVER DISEASE: WHAT CLINICAL IMPACT?

Author

Pennisi, G., primary, Viganò, M., additional, Fracanzani, A.L., additional, Miele, L., additional, Bugianesi, E., additional, D'Ambrosio, R., additional, Ravaioli, F., additional, Schepis, F., additional, Marra, F., additional, Aghemo, A.M.G., additional, Svegliati Baroni, G., additional, Masarone, M., additional, Valenti, L., additional, Armandi, A., additional, Ciccioli, C., additional, Cerini, F., additional, Colecchia, A., additional, Gasbarrini, A., additional, Infantino, G., additional, Liguori, A., additional, Pelusi, S., additional, Saltini, D., additional, Lampertico, P., additional, Persico, M., additional, Pugliese, N., additional, Tulone, A., additional, Di Marco, V., additional, Cammà, C., additional, and Petta, S., additional

Published
2024
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7. The HERMES calibration pipeline: mescal

Author

Dilillo, G., primary, Marchesini, E.J., additional, Della Casa, G., additional, Baroni, G., additional, Campana, R., additional, Borciani, E., additional, Srivastava, S., additional, Trevisan, S., additional, Ceraudo, F., additional, Citossi, M., additional, Evangelista, Y., additional, Guzmán, A., additional, Hedderman, P., additional, Labanti, C., additional, Virgilli, E., additional, and Fiore, F., additional

Published
2024
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9. Anticoagulation and Vessel Recanalization in Cirrhotic Patients with Splanchnic Vein Thrombosis: A Multidisciplinary “Real Life” Experience

Author

Rupoli S, Fiorentini A, Morsia E, Svegliati-Baroni G, Micucci G, Maroni L, Garvey KB, Fiorentini Snr A, Riva Snr A, Da Lio L, Benedetti A, Offidani M, Olivieri A, and Giuseppe T

Subjects
splanchnic vein thrombosis, cirrhosis, anticoagulant therapy, vessel recanalization, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Serena Rupoli,1 Alessandro Fiorentini,1 Erika Morsia,1 Gianluca Svegliati-Baroni,2 Giorgia Micucci,1 Luca Maroni,2 Kimberly Blaine Garvey,1 Alessandro Fiorentini Snr,3 Alessandra Riva Snr,4 Lidia Da Lio,5 Antonio Benedetti,2 Massimo Offidani,1 Attilio Olivieri,1 Tarantino Giuseppe2 1Clinica Ematologica, Dipartimento di Medicina Interna, Ancona, Italy; 2SOD Clinica di Gastroenterologia, Epatologia ed Endoscopia Digestiva d’Urgenza, Ancona, Italy; 3SOD Malattie Infettive emergenti e degli immunodepressi, Ospedali Riuniti Ancona, Ancona, Italy; 4SOD Clinica Malattie Infettive tropicali, parassitologia, epatiti croniche, Ancona, Italy; 5SOD Medicina di Laboratorio, Ospedali Riuniti Ancona, Ancona, ItalyCorrespondence: Erika MorsiaClinica Ematologica, Ospedali Riuniti Ancona, via Conca 71, 60126, ItalyEmail erika.morsia@ospedaliriuniti.marche.itBackground and Aim: Splanchnic vein thrombosis (SVT) is a potentially life-threatening complication of liver cirrhosis. This study aimed to evaluate the impact of a multi-disciplinary approach and early anticoagulation therapy (AT) on bleeding/thrombotic events, recanalization rates and outcome of cirrhotic patients with SVT.Methods: This is a single-center, registry-based cohort study. Over 17 years, 149 SVT patients were enrolled and prospectively evaluated. Regarding cirrhotic-SVT, a pre-specified algorithm, guiding initial posology of AT and follow-up visits schedule, was performed. Major bleeding (MB), thrombotic events, functional liver scores and all cause-mortality were investigated. Efficacy of AT was evaluated by radiological imaging.Results: In cirrhotic-SVT, the incidence rate of MB was 8.4 per 100 patient-year (95% CI, 3.83– 15.97), while the incidence rate of thrombosis was 5.6 per 100 patient-year (95% CI, 2.05– 12.2). In incidental SVT treated with AT, MB incidence was 6.5 per 100 patient-year (95% CI: 2.8– 12.82), while in symptomatic SVT was 2.2 per 100 patient-year (95% CI: 0.25– 8.02). All thrombotic recurrences occurred in incidental SVT (7.7 per 100 patient-years; 95% CI, 3.71– 14.26). Overall survival was significantly higher in patients who had at least a partial recanalization (p < 0.01) and partial/total recanalization was independently associated with improved MELD score at multivariate analysis (HR 2.62, 95% CI 1.1– 6.47, p = 0.03).Conclusion: In cirrhotic SVT patients, partial or total resolution of thrombosis ameliorates liver function and is associated with higher overall survival. A multidisciplinary approach together with radiological follow-up at pre-fixed time improves patient selection and monitoring.Keywords: splanchnic vein thrombosis, cirrhosis, anticoagulant therapy, vessel recanalization, multidisciplinary approach

Published
2021

14. A novel radioguided surgery technique exploiting $\beta^{-}$ decays

Author

Camillocci, E. Solfaroli, Baroni, G., Bellini, F., Bocci, V., Collamati, F., Cremonesi, M., De Lucia, E., Ferroli, P., Fiore, S., Grana, C. M., Marafini, M., Mattei, I., Morganti, S., Paganelli, G., Patera, V., Piersanti, L., Recchia, L., Russomando, A., Schiariti, M., Sarti, A., Sciubba, A., Voena, C., and Faccini, R.

Subjects
Physics - Medical Physics, Physics - Instrumentation and Detectors
Abstract

The background induced by the high penetration power of the gamma radiation is the main limiting factor of the current Radio-guided surgery (RGS). To partially mitigate it, a RGS with beta+ emitting radio-tracers has been suggested in literature. Here we propose the use of beta- emitting radio-tracers and beta- probes and discuss the advantage of this method with respect to the previously explored ones: the electron low penetration power allows for simple and versatile probes and could extend RGS to tumours for which background originating from nearby healthy tissue makes gamma probes less effective. We developed a beta- probe prototype and studied its performances on phantoms. By means of a detailed simulation we have also extrapolated the results to estimate the performances in a realistic case of meningioma, pathology which is going to be our first in-vivo test case. A good sensitivity to residuals down to 0.1ml can be reached within 1s with an administered activity smaller than those for PET-scans thus making the radiation exposure to medical personnel negligible., Comment: 14 pages, 7 figures

Published
2014
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15. Outcomes of Sorafenib and Metronomic Capecitabine in Child-Pugh B patients with advanced hepatocellular carcinoma in the era of immunotherapy: A real-life comparison with best supportive care

Author

Stefanini, B., primary, Bucci, L., additional, Santi, V., additional, Reggidori, N., additional, Lani, L., additional, Granito, A., additional, Pellizzaro, F., additional, Cabibbo, G., additional, Di Marco, M., additional, Ghittoni, G., additional, Campani, C., additional, Svegliati-Baroni, G., additional, Foschi, F.G., additional, Giannini, E.G., additional, Biasini, E., additional, Saitta, C., additional, Magalotti, D., additional, Sangiovanni, A., additional, Morisco, F., additional, Gasbarrini, A., additional, Rapaccini, G.L., additional, Masotto, A., additional, Sacco, R., additional, Vidili, G., additional, Mega, A., additional, Azzaroli, F., additional, Nardone, G., additional, Brandi, G., additional, Sabbioni, S., additional, Brunetto, M.R., additional, Vitale, A., additional, and Trevisani, F., additional

Published
2023
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16. Prophylaxis of HBV-recurrence after liver transplantation in patients with HCC: Risk of HCC recurrence from a large, multicentre retrospective study from Italy

Author

Battistella, S., primary, Zanetto, A., additional, Turco, L., additional, Manuli, C., additional, Pasulo, L., additional, Giannelli, V., additional, Mameli, L., additional, Ferrarese, A., additional, Marenco, S., additional, Ferri, F., additional, Lenci, I., additional, Scandali, G., additional, Biolato, M., additional, Fornasiere, E., additional, Ponziani, F.R., additional, Baroni, G. Svegliati, additional, Giannini, E., additional, Toniutto, P., additional, Lanza, A. Galeota, additional, Rendina, M., additional, Donato, F., additional, Fagiuoli, S., additional, De Maria, N., additional, Morelli, M. Cristina, additional, Martini, Silvia, additional, Trapani, S., additional, Grossi, P., additional, Aghemo, A., additional, Russo, F.P., additional, and Burra, P., additional

Published
2023
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17. Predictors of extrahepatic progression in patients with hepatocellular carcinoma receiving transarterial chemoembolization

Author

Pinto, E., primary, Pelizzaro, F., additional, Vitale, A., additional, Sangiovanni, A., additional, Cabibbo, G., additional, Caturelli, E., additional, Svegliati-Baroni, G., additional, Masotto, A., additional, Trevisani, F., additional, Foschi, F.G., additional, Piscaglia, F., additional, Raimondo, G., additional, Giannini, E.G., additional, Azzaroli, F., additional, Marra, F., additional, Mega, A., additional, Vidili, G., additional, Brunetto, M.R., additional, Missale, G., additional, Gasbarrini, A., additional, Rapaccini, G.L., additional, Guarino, M., additional, Magalotti, D., additional, Sacco, R., additional, Nardone, G., additional, Marco, M. Di, additional, and Farinati, F., additional

Published
2023
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19. Inter-fractional monitoring of 12C ions treatments: results from a clinical trial at the CNAO facility

Author

Fischetti, M., Baroni, G., Battistoni, G., Bisogni, G., Cerello, P., Ciocca, M., De Maria, P., De Simoni, M., Di Lullo, B., Donetti, M., Dong, Y., Embriaco, A., Ferrero, V., Fiorina, E., Franciosini, G., Galante, F., Kraan, A., Luongo, C., Magi, M., Mancini-Terracciano, C., Marafini, M., Malekzadeh, E., Mattei, I., Mazzoni, E., Mirabelli, R., Mirandola, A., Morrocchi, M., Muraro, S., Patera, V., Pennazio, F., Schiavi, A., Sciubba, A., Solfaroli Camillocci, E., Sportelli, G., Tampellini, S., Toppi, M., Traini, G., Valle, S. M., Vischioni, B., Vitolo, V., and Sarti, A.

Published
2020
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20. PO-2112 Radiomics of diffusion-MRI for predicting Gleason Score in Prostate Cancer treated with radiotherapy

Author

Morelli, L., primary, Paganelli, C., additional, Marvaso, G., additional, Annunziata, S., additional, Parrella, G., additional, Pepa, M., additional, Zaffaroni, M., additional, Vicini, M.G., additional, Isaksson, L.J., additional, Corrao, G., additional, Pricolo, P., additional, Alessi, S., additional, Summers, P.E., additional, Cattani, F., additional, De Cobelli, O., additional, Orecchia, R., additional, Petralia, G., additional, Jereczek-Fossa, B.A., additional, and Baroni, G., additional

Published
2023
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29. Nationwide survey of liver transplantation for Primary Sclerosing Cholangitis in Italy

Author

Morelli, M.C., primary, Gambato, M., additional, Martini, S., additional, Carrai, P., additional, Toniutto, P., additional, Giannelli, V., additional, Donato, F., additional, Lenci, I., additional, Pasulo, L., additional, Mazzarelli, C., additional, Ferrarese, A., additional, Rendina, M., additional, Grieco, A., additional, Lanza, A. Galeota, additional, Svegliati-Baroni, G., additional, De Maria, N., additional, Marenco, S., additional, Mameli, L., additional, and Burra, P., additional

Published
2023
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30. Preoperative predictors of recurrence beyond Milan criteria in hepatocellular carcinoma patients treated with frontline liver resection

Author

Pelizzaro, F., primary, Trevisani, F., additional, Vitale, A., additional, Cillo, U., additional, Piscaglia, F., additional, Missale, G., additional, Sangiovanni, A., additional, Foschi, F.G., additional, Cabibbo, G., additional, Caturelli, E., additional, Di Marco, M., additional, Azzaroli, F., additional, Brunetto, M.R., additional, Raimondo, G., additional, Vidili, G., additional, Guarino, M., additional, Gasbarrini, A., additional, Campani, C., additional, Svegliati-Baroni, G., additional, Giannini, E.G., additional, Mega, A., additional, Masotto, A., additional, Rapaccini, G.L., additional, Magalotti, D., additional, Sacco, R., additional, Nardone, G., additional, and Farinati, F., additional

Published
2023
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31. Presence and severity of esophageal varices drives portal hypertension-related complications in compensated advanced nonalcoholic fatty liver disease

Author

Pennisi, G., primary, Enea, M., additional, Viganò, M., additional, Schepis, F., additional, de Ledinghen, V., additional, Berzigotti, A., additional, Wong, V., additional, Fracanzani, A.L., additional, Sebastiani, G., additional, Romero-Gomez, M., additional, Bugianesi, E., additional, Svegliati-Baroni, G., additional, Marra, F., additional, Aghemo, A., additional, Valenti, L., additional, Calvaruso, V., additional, Colecchia, A., additional, Di Maria, G., additional, La Mantia, C., additional, Lin, H., additional, Mendoza, Y., additional, Pugliese, N., additional, Ravaioli, F., additional, Lara-Romero, C., additional, Saltini, D., additional, Craxì, A., additional, Di Marco, V., additional, Cammà, C., additional, and Petta, S., additional

Published
2023
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33. Lack of substantial improvements in the landscape of alcohol-related hepatocellular carcinoma in the last 15 years: The need to improve cancer prevention and surveillance

Author

Reggidori, N., primary, Bucci, L., additional, Santi, V., additional, Stefanini, B., additional, Lani, L., additional, Rampoldi, D., additional, Caturelli, E., additional, Farinati, F., additional, Masotto, A., additional, Mega, A., additional, Biasini, E., additional, Foschi, F.G., additional, Svegliati-Baroni, G., additional, Sangiovanni, A., additional, Campani, C., additional, Raimondo, G., additional, Vidili, G., additional, Gasbarrini, A., additional, Celsa, C., additional, Di Marco, M., additional, Giannini, E.G., additional, Sacco, R., additional, Brunetto, M.R., additional, Azzaroli, F., additional, Magalotti, D., additional, Morisco, F., additional, Rapaccini, G.L., additional, Nardone, G., additional, Vitale, A., additional, and Trevisani, F., additional

Published
2023
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34. Virtual 4DCT generated from 4DMRI in gated particle therapy: phantom validation and application to lung cancer patients.

Author

Annunziata, S, Rabe, M, Vai, A, Molinelli, S, Nakas, A, Meschini, G, Pella, A, Vitolo, V, Barcellini, A, Imparato, S, Ciocca, M, Orlandi, E, Landry, G, Kamp, F, Kurz, C, Baroni, G, Riboldi, M, and Paganelli, C

Subjects
LUNG cancer, CANCER patients, VALIDATION therapy, LUNGS, MAGNETIC resonance imaging, IMAGE registration
Abstract

Objective. Respiration negatively affects the outcome of a radiation therapy treatment, with potentially severe effects especially in particle therapy (PT). If compensation strategies are not applied, accuracy cannot be achieved. To support the clinical practice based on 4D computed tomography (CT), 4D magnetic resonance imaging (MRI) acquisitions can be exploited. The purpose of this study was to validate a method for virtual 4DCT generation from 4DMRI data for lung cancers on a porcine lung phantom, and to apply it to lung cancer patients in PT. Approach. Deformable image registration was used to register each respiratory phase of the 4DMRI to a reference phase. Then, a static 3DCT was registered to this reference MR image set, and the virtual 4DCT was generated by warping the registered CT according to previously obtained deformation fields. The method was validated on a physical phantom for which a ground truth 4DCT was available and tested on lung tumor patients, treated with gated PT at end-exhale, by comparing the virtual 4DCT with a re-evaluation 4DCT. The geometric and dosimetric evaluation was performed for both proton and carbon ion treatment plans. Main results. The phantom validation exhibited a geometrical accuracy within the maximum resolution of the MRI and mean dose deviations, with respect to the prescription dose, up to 3.2% for target D 95%, with a mean gamma pass rate of 98%. For patients, the virtual and re-evaluation 4DCTs showed good correspondence, with errors on target D 95% up to 2% within the gating window. For one patient, dose variations up to 10% at end-exhale were observed due to relevant inter-fraction anatomo-pathological changes that occurred between the planning and re-evaluation CTs. Significance. Results obtained on phantom data showed that the virtual 4DCT method was accurate, allowing its application on patient data for testing within a clinical scenario. [ABSTRACT FROM AUTHOR]

Published
2023
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40. The impact of first and further decompensation in patients with metabolic-dysfunction associated compensated advanced chronic liver disease.

Author

Pennisi, G., Maria, G. Di, Wong, V. Wai-Sun, de Ledinghen, V., Sebastiani, G., Viganò, M., Fracanzani, A.L., Miele, L., Bugianesi, E., Ekstedt, M., D'Ambrosio, R., Schepis, F., Marra, F., Aghemo, A.M., Svegliati-Baroni, G., Persico, M., Valenti, L., Berzigotti, A., George, J., and Ravaioli, F.

Abstract

The first and further decompensation mark the natural history and the risk of mortality in patients with cirrhosis. We assessed the cumulative incidence of first and further (acute and non-acute) decompensation and evaluated their impact on both liver-related death (LR-D) in patients with compensated advanced chronic liver disease (cACLD) due to metabolic dysfunction-associated steatotic liver disease (MASLD). Consecutive patients with clinical (LSM>10 kPa) or biopsy-proven (F3-F4 fibrosis) diagnosis of cACLD due to MASLD were included. First and further decompensation were defined according to Baveno VII criteria. The acute (AD) and non-acute (NAD)[MOU1] [VW(2] presentation of the decompensation was also evaluated. Competing risk analysis and cumulative incidence functions (CIF) [MOU3] were assessed by Fine and Gray. Cause-specific Cox models with baseline and time-dependent variables were applied. Multistate model was built to better assess the clinical course of cACLD due to MASLD. The cumulative incidence of the first decompensation was 3.5% at 5 years, increasing 20-times the risk of LR-D at cause-specific Cox analysis; the cumulative incidence of further decompensation was 44% at 5 years among patients with first decompensation, additionally increasing 1.6-times the risk of LR-D. Ascites, followed by variceal bleeding, were the most common events in both first and further decompensation. The impact of AD and NAD as both first or further event on LR-D was similar[MOU4]. Hepatocellular carcinoma (HCC) further independently increased the risk of LR-D of 3.2-times and 1.6-times, respectively, in the whole cohort of cACLD due to MASLD and in those who experienced first decompensation. The first and further decompensations (AD and NAD) represent tipping points in the clinical course of patients with cACLD due to MASLD, increasing 20-times and additionally 1.6-times the risk of LR-D. HCC is an independent predictor of LR-D in patients with cACLD due to MASLD, resulting in an additional risk of LR-D when associated with both first and further decompensation. [ABSTRACT FROM AUTHOR]

Published
2024
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41. Overview of Prognostic Systems for Hepatocellular Carcinoma and ITA.LI.CA External Validation of MESH and CNLC Classifications

Author

Vitale, A, Farinati, F, Finotti, M, Di Renzo, C, Brancaccio, G, Piscaglia, F, Cabibbo, G, Caturelli, E, Missale, G, Marra, F, Sacco, R, Giannini, Eg, Trevisani, F, Cillo, U, Bhoori, S, Borzio, M, Burra, P, Casadei Gardini, A, Carrai, P, Conti, F, Cozzolongo, R, Cucchetti, A, D'Ambrosio, R, Dell'Unto, C, De Matthaeis, N, Di Costanzo, Gg, Di Sandro, S, Famularo, S, Foschi, Fg, Fucilli, F, Galati, G, Gambato, M, Gasbarrini, A, Giuliante, F, Ghinolfi, D, Grieco, A, Gruttadauria, S, Guarino, M, Iavarone, M, Kostandini, A, Lai, Q, Lenci, I, Levi Sandri, Gv, Losito, F, Lupo, Lg, Marasco, G, Manzia, Tm, Mazzocato, S, Masarone, M, Melandro, F, Mescoli, C, Miele, L, Morisco, F, Muley, M, Nicolini, D, Pagano, D, Persico, M, Pompili, M, Ponziani, Fr, Pravisani, R, Rapaccini, Gl, Rendina, M, Renzulli, M, Romano, F, Rossi, M, Rreka, E, Russo, Fp, Sangiovanni, A, Sessa, A, Simonetti, N, Sposito, C, Tortora, R, Vigano, L, Vigano, M, Villa, E, Vincenzi, V, Violi, P, Azzaroli, F, Brunetto, Mr, Di Marco, A, Masotto, A, Mega, A, Nardone, G, Oliveri, F, Raimondo, G, Svegliati Baroni, G, Vidili, G, Zoli, M, Vitale A., Farinati F., Finotti M., Di Renzo C., Brancaccio G., Piscaglia F., Cabibbo G., Caturelli E., Missale G., Marra F., Sacco R., Giannini E.G., Trevisani F., Cillo U., Bhoori S., Borzio M., Burra P., Casadei Gardini A., Carrai P., Conti F., Cozzolongo R., Cucchetti A., D'ambrosio R., Dell'unto C., De Matthaeis N., Di Costanzo G.G., Di Sandro S., Famularo S., Foschi F.G., Fucilli F., Galati G., Gambato M., Gasbarrini A., Giuliante F., Ghinolfi D., Grieco A., Gruttadauria S., Guarino M., Iavarone M., Kostandini A., Lai Q., Lenci I., Levi Sandri G.V., Losito F., Lupo L.G., Marasco G., Manzia T.M., Mazzocato S., Masarone M., Melandro F., Mescoli C., Miele L., Morisco F., Muley M., Nicolini D., Pagano D., Persico M., Pompili M., Ponziani F.R., Pravisani R., Rapaccini G.L., Rendina M., Renzulli M., Romano F., Rossi M., Rreka E., Russo F.P., Sangiovanni A., Sessa A., Simonetti N., Sposito C., Tortora R., Vigano L., Vigano M., Villa E., Vincenzi V., Violi P., Azzaroli F., Brunetto M.R., Di Marco A., Masotto A., Mega A., Nardone G., Oliveri F., Raimondo G., Svegliati Baroni G., Vidili G., Zoli M., Vitale, A., Farinati, F., Finotti, M., Di Renzo, C., Brancaccio, G., Piscaglia, F., Cabibbo, G., Caturelli, E., Missale, G., Marra, F., Sacco, R., Giannini, E. G., Trevisani, F., Cillo, U., Bhoori, S., Borzio, M., Burra, P., Casadei Gardini, A., Carrai, P., Conti, F., Cozzolongo, R., Cucchetti, A., D'Ambrosio, R., Dell'Unto, C., De Matthaeis, N., Di Costanzo, G. G., Di Sandro, S., Famularo, S., Foschi, F. G., Fucilli, F., Galati, G., Gambato, M., Gasbarrini, A., Giuliante, F., Ghinolfi, D., Grieco, A., Gruttadauria, S., Guarino, M., Iavarone, M., Kostandini, A., Lai, Q., Lenci, I., Levi Sandri, G. V., Losito, F., Lupo, L. G., Marasco, G., Manzia, T. M., Mazzocato, S., Masarone, M., Melandro, F., Mescoli, C., Miele, L., Morisco, F., Muley, M., Nicolini, D., Pagano, D., Persico, M., Pompili, M., Ponziani, F. R., Pravisani, R., Rapaccini, G. L., Rendina, M., Renzulli, M., Romano, F., Rossi, M., Rreka, E., Russo, F. P., Sangiovanni, A., Sessa, A., Simonetti, N., Sposito, C., Tortora, R., Vigano, L., Vigano, M., Villa, E., Vincenzi, V., Violi, P., Azzaroli, F., Brunetto, M. R., Di Marco, A., Masotto, A., Mega, A., Nardone, G., Oliveri, F., Raimondo, G., Svegliati Baroni, G., Vidili, G., and Zoli, M.

Subjects
Cancer Research, medicine.medical_specialty, Review, lcsh:RC254-282, Prognostic score, 03 medical and health sciences, 0302 clinical medicine, medicine, In patient, Medical physics, Staging system, monotonicity of gradients, Settore MED/12 - Gastroenterologia, discrimination ability, hepatocellular carcinoma, homogeneity, prognostic performance, prognostic system, business.industry, External validation, Mono-tonicity of gradient, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Settore MED/18, Oncology, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Population data, 030211 gastroenterology & hepatology, General health, Liver dysfunction, business
Abstract

Simple Summary This review proposes a comprehensive overview of the main prognostic systems for HCC classified as prognostic scores, staging systems, or combined systems. Prognostic systems for HCC are usually compared in terms of homogeneity, monotonicity of gradients, and discrimination ability. However, despite the great number of published studies comparing HCC prognostic systems, it is rather difficult to identify a system that could be universally accepted as the best prognostic scheme for all HCC patients encountered in clinical practice. In order to give a contribute in this topic, we conducted a study aimed at externally validate the MESH score and the CNLC classification using the ITA.LI.CA database. Abstract Prognostic assessment in patients with HCC remains an extremely difficult clinical task due to the complexity of this cancer where tumour characteristics interact with degree of liver dysfunction, patient general health status, and a large span of available treatment options. Several prognostic systems have been proposed in the last three decades, both from the Asian and European/North American countries. Prognostic scores, such as the CLIP score and the recent MESH score, have been generated on a solid statistical basis from real life population data, while staging systems, such as the BCLC scheme and the recent CNLC classification, have been created by experts according to recent HCC prognostic evidences from the literature. A third category includes combined prognostic systems that can be used both as prognostic scores and staging systems. A recent example is the ITA.LI.CA prognostic system including either a prognostic score and a simplified staging system. This review focuses first on an overview of the main prognostic systems for HCC classified according to the above three categories, and, second, on a comprehensive description of the methodology required for a correct comparison between different systems in terms of prognostic performance. In this second section the main studies in the literature comparing different prognostic systems are described in detail. Lastly, a formal comparison between the last prognostic systems proposed for each of the above three categories is performed using a large Italian database including 6882 HCC patients in order to concretely apply the comparison rules previously described.

Published
2021

43. Pegylated interferon α plus ribavirin for the treatment of chronic hepatitis C: A multicentre independent study supported by the Italian Drug Agency

Author

Mascolo, M.C., Cursaro, C., Scuteri, A., Ranieri, J., Monti, M., Bellentani, S., Gasbarrini, A., Pompili, M., Puoti, C., Bellis, L., Regazzetti, A., Maffezzini, E., Pietrangelo, A., Abbati, G., Raimondo, G., Scribano, L., Martines, D., Baroni, G. Svegliati, Faraci, G., Schianchi, S., Fornaciari, G., Fabris, P., Madonia, S., Civitavecchia, G., Pirisi, M., Smirne, C., Borghi, A., Sardini, C., Andreoletti, M., Morisco, F., Caporaso, N., Fargion, S., Fatta, E., Masutti, F., Bonaventura, M.E., Autolitano, A., Russello, M., Bellia, A., Toniutto, P., Bitetto, D., Mecenate, F., Pasulo, L., Lucà, M.G., Picardi, A., Vespasiani, U., Grattagliano, I., Palasciano, G., Romagno, D., Crespi, C., Gianstefani, A., Gobbo, G., Monti, V., Giannelli, G., Napoli, N., Nosotti, Raspanti, A., Cuccorese, Colombo, A.E., Floridia, Plattella, M.S., Cassano, P., Gentile, I., Blanc, P.L., Messina, V., Bonfante, S., Bellissima, P., Toti, M., Vecchiet, J., Falasca, K., Portelli, V., De Stefano, G., Pietromatera, G., Viganò, P., Re, T., Andreoni, M., Raineri, G., Massari, M., Grossi, P.A., Caputo, S., Cassola, G., Feasi, M., Foti, G., Kunkar, A., Corti, G., Baragli, F., Caterini, L., Migliorini, D., Chiodera, A., Calleri, G., Spezia, C., Baiguera, C., Puoti, M., Brancaccio, G., Gaeta, G.B., Vento, S., Di Biagio, A., Nicolini, L., Liberti, A., Iannece, M.D., Contini, C., Tacconi, D., Caremani, M., Almi, P., Chimenti, M., Cosco, Messeri, D., Esperti, F.C., Paffetti, A., Mastropietro, C., Moretti, A., Spagnolo, A.L., Lomonaco, L., Calì, A., Mandelli, G., Spinzi, G.C., Framarin, L., Berrutti, M., Boccia, S., Simone, L., Pazzi, P., Fornari, F., Comparato, G., Casetti, T., Foschi, F.G., Bertin, T., Salvagnini, M., Samori, A., Ferretti, E., Casiraghi, M.A., Marin, R., Ciancio, A., Campo, N., Testa, R., Rocco, A., Federico, A., Loguercio, C., Rizzo, S., Giannini, E.G., Corbo, M., Riegler, G., Esposito, P., Ricci, G.L., Rosina, Floriano, Tosti, Maria Elena, Borghesio, Elisabetta, Masocco, Maria, Mele, Alfonso, Coppola, Carmine, Milella, Michele, Borgia, Guglielmo, Andreone, Pietro, Koch, Maurizio, Zignego, Anna Linda, Romano, Mario, Carrara, Maurizio, Almasio, Piero Luigi, Azzola, Emilio, Nardone, Gerardo, Benedetti, Antonio, Carosi, Giampiero, Mazzotta, Francesco, Sagnelli, Evangelista, and Rizzetto, Mario

Published
2014
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45. Feasibility Study of the Use of Artificial Neural Networks in Predicting Acute Rectal and Urinary Bladder Toxicity Following Prostate Cancer Radiotherapy

Author

Pella, A., Cambria, R., Jereczek-Fossa, B. A., Zerini, D., Fodor, C., Serafini, F., Baroni, G., Riboldi, M., Ciceri, M., Spadea, M. F., Patete, P., Peroni, M., Cattani, F., Garibaldi, C., Pedroli, G., Pedotti, A., Orecchia, R., Magjarevic, Ratko, editor, Dössel, Olaf, editor, and Schlegel, Wolfgang C., editor

Published
2009
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48. Pattern of macrovascular invasion in hepatocellular carcinoma

Author

Guarino, M., Cucchetti, A., Pontillo, G., Farinati, F., Benevento, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Rodolfo, S., Cabibbo, G., Marra, F., Mega, A., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Trevisani, F., Giannini, E. G., Morisco, F., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Neri, A., Rampoldi, D., Santi, V., Forgione, A., Granito, A., Muratori, L., Piscaglia, F., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Pelizzaro, F., Imondi, A., Sartori, A., Penzo, B., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., Pieri, G., de Matthaeis, N., Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Olivari, A., Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Berardinelli, D., Ercolani, G., Napoli, L., Campani, C., Di Bonaventura, C., Gitto, S., Coccoli, P., Malerba, A., Capasso, M., Fiorentino, A., Pignata, L., Cossiga, V., Romagnoli, V., Guarino M., Cucchetti A., Pontillo G., Farinati F., Benevento F., Rapaccini G.L., Di Marco M., Caturelli E., Zoli M., Rodolfo S., Cabibbo G., Marra F., Mega A., Gasbarrini A., Svegliati-Baroni G., Foschi F.G., Missale G., Masotto A., Nardone G., Raimondo G., Azzaroli F., Vidili G., Oliveri F., Trevisani F., Giannini E.G., Morisco F., Biselli M., Caraceni P., Garuti F., Gramenzi A., Neri A., Rampoldi D., Santi V., Forgione A., Granito A., Muratori L., Piscaglia F., Sansone V., Tovoli F., Dajti E., Marasco G., Ravaioli F., Cappelli A., Golfieri R., Mosconi C., Renzulli M., Cela E.M., Facciorusso A., Pelizzaro F., Imondi A., Sartori A., Penzo B., Cacciato V., Casagrande E., Moscatelli A., Pellegatta G., Pieri G., de Matthaeis N., Allegrini G., Lauria V., Ghittoni G., Pelecca G., Chegai F., Coratella F., Ortenzi M., Olivari A., Inno A., Marchetti F., Busacca A., Camma C., Di Martino V., Rizzo G.E.M., Franze M.S., Saitta C., Sauchella A., Bevilacqua V., Borghi A., Gardini A.C., Conti F., Berardinelli D., Ercolani G., Napoli L., Campani C., Di Bonaventura C., Gitto S., Coccoli P., Malerba A., Capasso M., Fiorentino A., Pignata L., Cossiga V., Romagnoli V., Guarino, M., Cucchetti, A., Pontillo, G., Farinati, F., Benevento, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Rodolfo, S., Cabibbo, G., Marra, F., Mega, A., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Trevisani, F., Giannini, E. G., Morisco, F., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Neri, A., Rampoldi, D., Santi, V., Forgione, A., Granito, A., Muratori, L., Piscaglia, F., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Pelizzaro, F., Imondi, A., Sartori, A., Penzo, B., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., Pieri, G., de Matthaeis, N., Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Olivari, A., Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Berardinelli, D., Ercolani, G., Napoli, L., Campani, C., Di Bonaventura, C., Gitto, S., Coccoli, P., Malerba, A., Capasso, M., Fiorentino, A., Pignata, L., Cossiga, V., and Romagnoli, V.

Subjects
Ablation Techniques, Male, Registrie, Cirrhosis, Clinical Biochemistry, Mesenteric Vein, loco-regional treatment, 030204 cardiovascular system & hematology, Biochemistry, Gastroenterology, surgery, Antineoplastic Agent, Liver disease, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, cirrhosis, hepatocellular carcinoma, portal vein thrombosis, transplantation, Ascites, Ablation Technique, Registries, 030212 general & internal medicine, Chronic, Settore MED/12 - Gastroenterologia, Portal Vein, Liver Diseases, Liver Neoplasms, General Medicine, Middle Aged, Sorafenib, Prognosis, Hepatitis B, Alcoholic, Hepatitis C, Tumor Burden, Survival Rate, Italy, Liver Neoplasm, Hepatocellular carcinoma, Ascite, Female, medicine.symptom, Liver cancer, Human, medicine.medical_specialty, Carcinoma, Hepatocellular, Prognosi, Antineoplastic Agents, End Stage Liver Disease, 03 medical and health sciences, Mesenteric Veins, Hepatitis B, Chronic, Internal medicine, medicine, Humans, Hepatectomy, Neoplasm Invasiveness, portal vein thrombosi, Liver Diseases, Alcoholic, Aged, Neoplasm Invasivene, Performance status, business.industry, Carcinoma, Settore MED/09 - MEDICINA INTERNA, Patient Acuity, Hepatocellular, Hepatitis C, Chronic, medicine.disease, Liver Transplantation, Transplantation, Liver function, business, cirrhosi
Abstract

Background and aims: In patients with hepatocellular carcinoma (HCC), macrovascular invasion (MaVI) limits treatment options and decreases survival. Detailed data on the relationship between MaVI extension and patients' characteristics, and its impact on patients' outcome are limited. We evaluated the prevalence and extension of MaVI in a large cohort of consecutive HCC patients, analysing its association with liver disease and tumour characteristics, as well as with treatments performed and patients' survival. Methods: We analysed data of 4774 patients diagnosed with HCC recorded in the Italian Liver Cancer (ITA.LI.CA) database (2008-2018). Recursive partition analysis (RPA) was performed to evaluate interactions between MaVI, clinical variables and treatment, exploring the inter-relationship determining overall survival. Results: MaVI prevalence was 11.1%, and median survival of these patients was 6.0months (95% CI, 5.1-7.1). MaVI was associated with younger age at diagnosis, presence of symptoms, worse Performance Status (PS) and liver function, high alphafetoprotein levels and large HCCs. MaVI extension was associated with worse PS, ascites and greater impairment in liver function. RPA identified patients' categories with different treatment indications and survival, ranging from 2.4months in those with PS>1 and ascites, regardless of MaVI extension (receiving best supportive care in 90.3% of cases), to 14.1months in patients with PS 0-1, no ascites and Vp1-Vp2 MaVI (treated with surgery in 19.1% of cases). Conclusions: MaVI presence and extension, together with PS and ascites, significantly affect patients' survival and treatment selection. The decision tree based on these parameters may help assess patients' prognosis and inform therapeutic decisions.

Published
2021

49. The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot Study

Author

Scarpellini, E., Abenavoli, L., Cassano, V., Rinninella, Emanuele, Sorge, M., Capretti, F., Rasetti, C., Svegliati Baroni, G., Luzza, F., Santori, P., and Sciacqua, A.

Subjects
liver steatosis, gut microbiota, fibrosis, Settore MED/09 - MEDICINA INTERNA, dysbiosis, small intestinal bacterial overgrowth, General Medicine
Abstract

IntroductionGut microbiota are a complex ecosystem harboring our intestine. They maintain human body equilibrium, while their derangement, namely, “dysbiosis“, has been associated with several gastrointestinal diseases, such as liver steatosis (NAFLD) and liver cirrhosis. Small intestinal bacterial overgrowth (SIBO) is an example of dysbiosis of the upper gastrointestinal (GI) tract.AimThe aim of this study is to evaluate the relationship between SIBO and levels of endotoxemia and grade of liver steatosis (LS) and liver fibrosis (LF) in hepatologic patients.Materials and MethodsConsecutive outpatients referred to our hepatology clinic were tested for SIBO by the lactulose breath test (LBT) and peripheral blood levels of endotoxemia; LS grading and LF were assessed by abdominal ultrasound and transient elastography, respectively.ResultsFifty-two consecutive patients (17 with alcohol abuse (4.5 ± 0.8 alcohol units per day), 4 with HCV and 2 with HBV infection, 24 of metabolic origin, 2 of autoimmune origin, and 3 with cholangiopathies; mean age 54.7 ± 8.3 years, 31 F, BMI 24.1 ± 1.1 Kg/m2) and 14 healthy volunteers (HV) (mean age 50.1 ± 4.3 years, 9 F, BMI 23.3 ± 1.1 Kg/m2) were enrolled. SIBO prevalence was significantly higher in cirrhotic (LC) vs. non-cirrhotic (LNC) patients and vs. HV (all, p < 0.05), with a significant positive trend according to Child-Pugh status (all, p < 0.05). SIBO prevalence was not correlated with LS stages (all, p = NS). Consensually, endotoxin levels were significantly higher in LC vs. LNC and vs. HV (all, p < 0.05) and significantly correlated with LF in patients with LC, according to Child-Pugh status (all, p < 0.05).ConclusionThis study shows that SIBO prevalence and relative endotoxin blood levels seem to be significantly associated with the grade of LF vs. LS in LC. SIBO is also present under pre-cirrhotic conditions, but its prevalence seems to correlate with liver disease irreversible derangement.

Published
2022

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