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13. Sentinel node biopsy in breast cancer

Author

Zavagno, G., Busolin, R., Bozza, F., Ramuseello, S., Griggio, L., Montesco, M.C., Valsecchi, M., Capitanio, G., Casara, D., Dalla Pozza, S., Bonazza, A., Rossi, C.R., Meggiolara, F., and Lise, M.

Published
2000
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18. 99mTc-sestamibi radio-guided surgery of loco-regional 131Iodine-negative recurrent thyroid cancer

Author

Merante Boschin I, Casara D, Andrea Piotto, Maria Rosa Pelizzo, Casal Ide E, C Pagetta, Renzo Mazzarotto, Domenico Rubello, Antonio Toniato, and Paolo Bernante

Subjects
Adult, Male, Technetium Tc 99m Sestamibi, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Metastasis, Iodine Radioisotopes, Biopsy, Humans, Medicine, Thyroid Neoplasms, Radionuclide Imaging, Lymph node, Thyroid cancer, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Thyroidectomy, General Medicine, Middle Aged, medicine.disease, Occult, Surgery, Dissection, Treatment Outcome, medicine.anatomical_structure, Oncology, Female, Neoplasm Recurrence, Local, Radiopharmaceuticals, business, Follow-Up Studies
Abstract

We report here our experience in a larger series of differentiated thyroid cancer (DTC) patients who had been treated by (99m)Tc-sestamibi radio-guided surgery (RGS) for (131)Iodine ((131)I)-negative loco-regional recurrent disease.Fifty-eight patients with loco-regional (131)I-negative recurrent disease from DTC were studied with (99m)Tc-sestamibi directed RGS using a hand-held 11-mm gamma probe as an intra-operative detector. Patients were selected for RGS on the basis of (a) progressive increase of serum thyroglobulin (Tg) levels after first treatment during follow-up, (b) negative high dose (100 mCi, 3.7 GBq) (131)I whole-body scan, and (c) positive pre-operative (99m)Tc-sestamibi scintigraphy for the presence of loco-regional recurrent disease. There were 41 papillary (1 "tall" cell variant), 13 follicular and 4 Hürthle cells tumours. In 14 patients thyroid cancer recurred in the thyroid bed while cervical lymph node metastases were found in 37 patients, and 7 patients had recurrent disease both in the thyroid bed and in cervical lymph nodes.At bilateral neck exploration, 147 metastatic foci ranging from 4 mm to 51 mm in largest diameter (mean tumour diameter=17.3+/-9.5mm) were removed. Eighty-five of them (58%) had been pre-operatively identified at (99m)Tc-sestamibi scintigraphy. After RGS, serum Tg levels normalised in 43 of 58 patients (serum Tg2 ng/ml--they were considered disease-free), serum Tg remained slightly increased in 12 patients without evidence of metastatic disease at scintigraphic and radiologic imaging (serum Tg10 ng/mg--they were considered living with microscopic disease), while serum Tg significantly increased up to values900 ng/ml in 3 patients who developed lung metastases. The mean lesion to background (99m)Tc-sestamibi uptake ratios decreased in all 58 patients (p0.0001). Post-surgical follow-up ranged 6-72 months (mean+/-SD=29.6+/-13.5 months). The operating surgeon assessed RGS as very useful in 14 patients in whom metastatic foci were embedded in fibrotic tissues or located behind blood vessels, useful in 22 patients, moderately useful 17 patients and not useful in 5 patients.Our data suggest that a (99m)Tc-sestamibi intra-operative gamma probe can be used to identify and guide resection of recurrent loco-regional tumour in DTC patients with (131)I-negative loco-regional metastatic foci.

Published
2007
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19. Preoperative localization and radioguided parathyroid surgery

Author

Mariani, Giuliano, Mariani, G., Boni, G., Marco Puccini, Pelizzo, Mr, Manca, G., Casara, D., Sotti, G., PAOLA ANNA ERBA, DUCCIO VOLTERRANI, Giuliano, Ae, Mariani, G, Gulec, S, Rubello, D, Boni, G, Puccini, M, Pelizzo, M, Manca, G, Casara, D, Sotti, G, Erba, P, Volterrani, D, and Giuliano, A

Subjects
Parathyroid Glands, Parathyroidectomy, Technetium Tc 99m Sestamibi, Intraoperative Care, Surgery, Computer-Assisted, Hyperparathyroidism, Preoperative Care, Humans, Minimally Invasive Surgical Procedures, Radiopharmaceuticals, Radionuclide Imaging, iperparathyroidism, radioguides surgery, nucléé medicine, PTH
Abstract

Clinical or subclinical hyperparathyroidism is one of the most common endocrine disorders. Excessive secretion of parathyroid hormone is most frequently caused by an adenoma of >or=1 parathyroid gland. Unsuccessful surgery with persistent hyperparathyroidism, due to inadequate preoperative or intraoperative localization, may be observed in about 10% of patients. The conventional surgical approach is bilateral neck exploration, whereas minimally invasive parathyroidectomy (MIP) has been made possible by the introduction of (99m)Tc-sestamibi scintigraphy for preoperative localization of parathyroid adenomas. In MIP, the incision is small, dissection is minimal, postoperative pain is less, and hospital stay is shorter. Localization imaging techniques include ultrasonography, CT, MRI, and scintigraphy. Parathyroid scintigraphy with (99m)Tc-sestamibi is based on longer retention of the tracer in parathyroid than in thyroid tissue. Because of the frequent association of parathyroid adenomas with nodular goiter, the optimal imaging combination is (99m)Tc-sestamibi scintigraphy and ultrasonography. Different protocols are used for (99m)Tc-sestamibi parathyroid scintigraphy, depending on the institutional logistics and experience (classical dual-phase scintigraphy, various subtraction techniques in combination with radioiodine or (99m)Tc-pertechnetate). MIP is greatly aided by intraoperative guidance with a gamma-probe, based on in vivo radioactivity counting after injection of (99m)Tc-sestamibi. Different protocols used for gamma-probe-guided MIP are based on different timing and doses of tracer injected. Gamma-probe-guided MIP is a very attractive surgical approach to treat patients with primary hyperparathyroidism due to a solitary parathyroid adenoma. The procedure is technically easy, safe, with a low morbidity rate, and has better cosmetic results and lower overall cost than conventional bilateral neck exploration. Specific guidelines should be followed when selecting patients for gamma-probe-guided MIP.

Published
2003

20. Tenth Annual Meeting of the European Association for the Study of Diabetes: Jerusalem, Israel, September 11–13, 1974

Author

Alberti, K. G. M. M., Iversen, J., Christensen, N. J., Andersson, A., Jarrousse, Claire, Andersson, Arne, Hellerström, Claes, Andreani, D., Tamburrano, G., Tamburrano, S., Gambardella, S., Ardill, Joy, Montgomery, D. A. D., Hadden, D. R., Assan, R., Attali, J. R., Selmi, A., Bourdillat, N., Soufflet, E., Girard, J. R., Bajaj, J. S., Chinna, G. S., Garg, S. K., Singh, Baldev, Balasse, E. O., Neef, M. A., Beischer, W., Melani, F., Keller, L., Hinz, M., Kroder, A., Maier, V., Pfeiffer, E. F., Bendayan, M., Sandborn, E., Rasio, E., Bensoussan, D., Levy-Toledano, S., Passa, P., Caen, J., Berger, M., Goodman, M. N., Hagg, S. A., Ruderman, N. B., Beyer, J., Cordes, U., Travniczek, H., Heider, W., Schöffling, K., Happ, J., Grimm, H., Pünchera, W., Althoff, P. H., Fröhlich, A., Bianco, A. R., Schwartz, R. H., Handwerger, B. S., Blackshear, P. J., Holloway, P. A. H., Williamson, D. H., Boquist, L., Hellman, Bo, Lernmark, Åke, Täljedabl, Inge-Bert, Bottermann, P., Schweigart, U., Zilker, Th., Hansen, W., Brachet, E., Rogister, C., Broer, Y., Freychet, P., Rosselin, G., Brunengraber, H., Vertongen, F., Boutry, M., Camu, F., Christacopoulos, P., Karamanos, B., Papadimitriou, P., Kardatos, Ch., Christensen, Niels Juel, Neubauer, Bent, Christophe, Jean, Winand, Jacques, Dehaye, Jean, Cuendet, G. S., Loten, E. G., Jeanrenaud, B., Davis, E., Yodaiken, Ralph E., Yanko, L., Herman, J. B., Garcia, S. Duran, Jarrousse, C., Ditzel, J., Daugaard, Niels Peters, Andersen, Haakon, Egeberg, J., Nerup, J., Andersen, O. O., Kromann, H., Bendixen, G., Poulsen, J. E., Eschwege, E., Falkmer, S., Emdin, S. O., Havu, N., Biuw, L. Winbladh, Sundby, F., Cutfield, J. F., Cutfield, S. M., Dodson, G. G., Peterson, J. D., Steiner, D. F., Fallucca, F., Menzinger, G., Iavicoli, M., Federspil, G., de Palo, C., Zago, E., Casara, D., Zaccaria, M., Scandellari, C., Felber, J. -P., Magnenat, G., Curchod, B., Pittet, Ph., Lytras, N., Müller-Hess, R., Geser, C. A., Jéquier, E., Flanagan, R. W. J., Buchanan, K. D., Murphy, R. F., Fölling, Ivar, Fromantin, M., Freyria, J., Bressac, F., Geisthövel, W., Niedergerke, U., Morgner, K. D., Willms, B., Mitzkat, H. J., Gey, K. F., Bühler, E., Sommer, P., Gey, K. F., Georgi, H., Sommer, P., Lengsfeld, H., Ghiea, D., Costiner, E., Simionescu, L., Oprescu, M., Grill, V., Cerasi, E., Gundersen, H. J. G., Gutman, A., Adler, J., Bar-Or, D., Gutzeit, A., Cerasi, E., Guy-Grand, B., Bigorie, B., Gylfe, Erik, Idahl, Lars-Åke, Hamosh, Margit, Hamosh, Paul, Hart, Adrian, Cohen, H., Thorp, J. M., Hedeskov, C. J., Capito, K., Forruby, B., Henquin, J. C., Lambert, A. B., Lambert, A. E., Henquin, J. C., Hepp, K. D., Renner, R., Häring, H. U., Mehnert, H., Kemmler, W., Löffler, G., Mehnert, H., Herchuelz, A., Mahy, M., Herrera, Emilip, Garcia-Rafanell, J., Morell, J., Heuclin, Ch., Attali, J. R., Girard, J. R., Assan, R., Hicks, B. H., Taylor, C. I., Vij, S. K., Pek, S., Knopf, R. F., Floyd, Jr., J. C., Fajans, S. S., Hockaday, T. D. R., Hockaday, J. M., Mann, J. I., Turner, R. C., Hockaday, T. D. R., Honour, A. J., Ikeda, Y., Saito, S., Matsuura, Y., Obayashi, N., Morimoto, Y., Sano, T., Abe, M., Jacouot, R., Felix, J. M., Legrele, C., Sutter-Dub, M. -Th., Sutter, B. Ch. J., Kammerer, L., Fehér, J., Lévai, J., Dénes, R., Stützel, M., Balázsi, I., Láng, I., Littmann, L., Karakash, C., Assimacopoulos, F., Katsilambros, N., Papadopoulos, G., Varonos, D., Daikos, G., Keen, H., Jarrett, R. J., Fuller, J. H., Kiesselbach, N. H. K., Puls, W., Keup, U., Kikkawa, Ryuichi, Duvillard, D., Ravazzola, M., Stauffacher, W., Köbberling, J., Kattermann, R., Kobberling, J., Creutzfeldt, W., Kohner, Eva M., Hamilton, A. M., Joplin, G. F., Blach, R. K., Fraser, T. R., Kolb, H. J., Weiss, L., Wieland, O. H., Korn, A., Waldhäusl, W., Bonelli, J., Magometsohnigg, D., Hitzenberger, G., Kramp, Robert C., Kremer, G. J., Atzpodien, W., Schnellbacher, B., Krug, B., Mialhe, P., Gross, R., Landgraf, R., Landgraf-Leurs, M., Klingenburg, M., Melamed, I., Hörl, R., Jun, István Láng, Littmann, László, Stützel, Mária, Balázsi, Imre, Langslow, Derek R., Buchanan, Keith D., Freeman, Barry M., Berezin, Meir, Mincu, I., Dumitrescu, C., Ionescu-Tirgoviste, C., Mihalache, N., Boboia, D., Stanescu, J., Ghise-Beer, E., Georgescu, St., Bruckner, I., Popa, I., Muggeo, M., Tiengo, A., Padovan, D., Molinari, M., Müller, Walter A., and Sharp, Geoffrey W. G.

Published
1974
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23. Seventh Annual Meeting of the European Association for the Study Of Diabetes Southampton, England, September 15–17, 1971 Abstacts, Part 1

Author

Aboulker, J. P., Valleron, A. J., Papoz, L., Rathery, M., Adams, P. W., Munday, M. J., Oakley, N. W., Wynn, V., Andreani, D., Fallucca, F., Stirati, G., Tamburrano, G., Cinotti, G. A., Andreev, D., Tarkolev, N., Ditzov, S., Pencev, I., Ancreev, D., Sirskov, L., Arnold, R., Creutzfeldt, C., Deuticke, U., Frerichs, H., Track, N. S., Creutzfeldt, W., Asmal, A. C., Butterfieid, W. J. H., Karamanos, B., Whichelow, M. J., Butterfield, W. J. H., Cox, B. D., Ashcroft, S. J. H., Bassett, J. M., Randle, P. J., Asplund, K., Hellerström, C., Brolin, S. E., Berne, C., Edwards, John C., Petersson, B., Taylor, K. W., Assan, R., Hanoune, J., Attali, J. B., Tchobroutsky, G., Gross, G., Assimacopoulos, F., Orci, L., Rouiller, Ch., Jeanrenaud, B., Cameron, D. P., Amherdt, M., Mira, F., Stauffacher, W., Heindel, J. J., Cushman, S. W., Austoni, M., Federspil, G., Casara, D., Sieolo, N., Scandellari, C., Mastrogiacomo, I., Aynsley-Green, A., Alberti, K. G. M. M., Bacanu, Gh., Stoichescu, L., Nistor, F., Turcanu, V., Anghelescu, L., Bacchus, R. A., Meade, L. G., London, D. R., Baiasse, E. O., Barta, L., Brooser, G., Molnár, Maria, Belfiore, F., Vecchio, L. Lo, Napoli, E., Beyer, J., Cordes, U., Sell, G., Krall, N., Schöffling, K., Biebuyck, J. F., de Haan, B. Bierens, Scherrer, J. R., Pometta, D., Björntorp, P., Sjöström, L., Blach, R. K., Cheng, Hung, Bloom, S. R., Bojanowicz, K., Boquist, L., Brachet, E., Bruni, B., Capra, E., Büber, V., Felber, J. P., Buchanan, K. D., Connon, J. J., Buckle, R. M., Campeami, S., Campeanu, L., Ionesou, M., Cerasi, E., Luft, R., Efendic, S., Chabot, V., Gomez, F., Chiumello, G., del Guercio, M. J., Carnelutti, M., Christensen, Niels Juel, Iversen, J., Christiansen, Aa. Hein, Rasmussen, S. Munkgaard, Vø1und, Aa., Vólund, Aa., Clausen, T., Czyzyk, A., Szadkowski, M., Rogala, H., Lawecki, J., Davies, W. H., Martin, L. B., Mills, J. G., Vardey, C. J., Deckert, T., Lauridsen, U. Birk, Linde, J., Madsen, S. Nistrup, De Leeuw, I., Middelheim, A. Z., de Mowbray, R. R., Turner, J. J., Garner, S. D., Bruck, E., Nye, L., Triggs, S., Devlin, J. G., Varma, M., Kuti, J., Dumitrescu, C., Bolea-Feldman, M., Eschwege, E., Warnet, J. M., Richard, J. L., Menzinger, G., Javicoli, M., Fankhauser, S., Michl, J., Piemonte, G., Sicolo, N., Frezzato, S., Reffo, G. C., Luyckx, A., Lefebvre, P., Zaccaria, M., De Palo, C., Fernandes-Cruz, Jr., A., Lopiz-Quijada, C., Fernandez-Cruz, Jr., A., Otero, M. Luque, Fiedler, H., Hahn, H. J., Ziegler, Brigitte, Ziegler, M., Jutzi, E., Michael, R., Fischer, U., Hommel, H., Bibergeil, H., Förster, O., Rippel, W., Rudas, B., Franckson, J. R. M., Vanroux, R., Leclercq, R., Brunengraber, H., Ooms, H., Freytag, G., Klöppel, G., Fussgänger, R. D., Goberna, R., Schröder, K. E., Laube, H., Pfeiffer, E. F., Gazzola, G. C., Franchi, R., Ronchi, P., Saibene, E., Guidotti, G. G., Geldermans, C., Terpstra, J., Krans, H. M. J., Geser, C. A., Rattenhuber, E., Girard, J., Bal, D., Gligore, V., Mosora, N., Fekete, T., Beraru, T., Pipilian, V. V., Olteanu, L., Serban, A., Calusera, I., Holan, T., Miclutia, M., Gnudi, A., Coscelli, C., Ballerio, G., Palmari, V., Alpi, O., Cavazzini, G., Jéquier, E., Goth, E., Fövenyi, J., Hegedüs, A., Greco, A. V., Ghirlanda, G., Fedeli, G., Fenici, R., Gambassi, G., Grüneklee, D., Hessing, J., Daweke, H., Herberg, L., Gries, F. A., Guder, W., Wieland, O., Guillon, J., Bodic, L., Charbonnel, B., Hadden, D. R., Montgomery, D. A. D., Mayne, Elizabeth, Weaver, J. A., George E, Hahn, J., Richter, O., Steinhilber, S., Kerp, L., Heaney, S. J., Varma, S. K., Whyte, W. G., Walker, R. S., Hepp, K. D., Hellman, B., Lernmark, A., Sehlin, J., Täljedal, I. -B., Hinz, M., Katsilambros, N., Rahman, Y. Abdel, Schatz, H., Maier, V., Schröder, B., Howells, D. P. M., Jackson, R. A., Perry, G., Rogers, J., Advani, U., Jafflol, C., Baldet, L., Vierne, Y., Mirouze, J., Jansen, F. K., Jarrett, R. J., Keen, H., Kaeding, A., Kaffarnik, H., Heink, U., Gassel, W. D., Zöfel, P., Mylarch, K., Keller, U., and Froesch, E. R.

Published
1971
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49. [Role of CT/111In-octreotide SPECT digital fusion imaging in the localization of loco-regional recurrence of medullary thyroid carcinoma]

Author

Fiore, Davide, Rubello, D, Casara, D, Pelizzo, MARIA ROSA, Franchi, A, Muzzio, P. C., and Rijksuniversiteit Groningen

Subjects
Tomography, Emission-Computed, Single-Photon, Carcinoma, Medullary, Humans, Female, Thyroid Neoplasms, Middle Aged, Neoplasm Recurrence, Local, Radiopharmaceuticals, Octreotide, Neoplasm Staging
Abstract

The case of a female patient affected by a sporadic medullary thyroid carcinoma (pT1N1aM0 at the onset) is reported. The patient had been initially treated by total thyroidectomy and lymphadenectomy of the central and lateral portions of the neck. During the following 30 years of follow-up, the patient experienced 3 consecutive loco-regional tumoral relapses. At the moment of each relapse, an increase of serum calcitonin levels has anticipated the subsequent detection of tumor deposits at clinical and radiological examination (ultrasound, CT scan). It is well known that, after multiple operations, the structures of the neck can present anatomical distortion and fibrosis that can interfere with ultrasound and CT scan interpretation. In the present patient, a scintigraphic examination with 111In-octreotide, that is a specific radio-tracer for somatostatin receptors, allowed to correctly visualize a tumoral relapse in the left thyroid bed, located in deep para-tracheal planes: in that site the CT scan only showed an unspecific solid mass. Furthermore, the utilization of a digital image fusion technique for CT scan and 111In-octreotide SPECT, furnished useful information for the purpose of planning an accurate re-intervention, both morphologic information (mass size, precise site of the mass and their relationship with the surrounding anatomical structures) and functional information (biological characterization of the mass that was classified as a neuroendocrine tumoral deposit with high density of somatostatin receptors.

Published
2004

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