101
|
Di Bella G, Minutoli F, Mazzeo A, Cssale M, Stancanelli C, Carerj S, Baldari S, Vita G. Usefulness of combining electrocardiogram and echocardiography findings and brain natriuretic peptide in early detection of cardiac amyloidosis in subjects with transthyretin gene mutation. Orphanet J Rare Dis 2015. [PMCID: PMC4642134 DOI: 10.1186/1750-1172-10-s1-p34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
102
|
Di Bella G, Minutoli F, Mazzeo A, Stancanelli C, Gentile L, Baldari S, Carerj S, Vita G. Quantitative comparison between amyloid deposition detected by 99mTc-diphosphonate imaging and myocardial deformation evaluated by strain echocardiography in transthyretin related cardiac amyloidosis. Orphanet J Rare Dis 2015. [PMCID: PMC4642086 DOI: 10.1186/1750-1172-10-s1-p47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
103
|
Campennì A, Pignata SA, Baldari S. Can peptide receptor radionuclide therapy (PRRT) be useful in radioiodine-refractory differentiated thyroid cancer? Endocrine 2015; 50:516-8. [PMID: 25471282 DOI: 10.1007/s12020-014-0491-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 11/22/2014] [Indexed: 11/26/2022]
Abstract
We report on a 70-year-old man affected by radioiodine-refractory differentiated thyroid cancer (DTC) in whom metastases were treated by peptide receptor radionuclide therapy (PRRT). Seven years before, patient had undergone total thyroidectomy. Pathological examination was conclusive for DTC. The patient underwent some radioiodine treatments (RaIT). The last post-therapy whole body scan (pT-WBS) performed five days after RaIT did not show abnormal radioiodine uptake but serum thyroglobulin (Tg) value was high in absence of thyroglobulin-antibodies (Tg-Ab). In-111 DTPA-pentetreotide scintigraphy showed several lung lesions with high somatostatin receptor density. Patient underwent PRRT using Lu-177 DOTATOC. pT-WBS scan confirmed the metastases already demonstrated by In-111 DTPA pentetreotide but radioiodine negative.
Collapse
Affiliation(s)
- Alfredo Campennì
- Nuclear Medicine Unit, Department of Biomedical Sciences and of Morphological and Functional Images, Padiglione E, piano terra Policlinico Universitario "G. Martino" , University of Messina, v. Consolare Valeria, 98125, Messina, Italy.
| | - Salvatore A Pignata
- Nuclear Medicine Unit, Department of Biomedical Sciences and of Morphological and Functional Images, Padiglione E, piano terra Policlinico Universitario "G. Martino" , University of Messina, v. Consolare Valeria, 98125, Messina, Italy
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical Sciences and of Morphological and Functional Images, Padiglione E, piano terra Policlinico Universitario "G. Martino" , University of Messina, v. Consolare Valeria, 98125, Messina, Italy
| |
Collapse
|
104
|
Di Bella G, Minutoli F, Piaggi P, Casale M, Mazzeo A, Zito C, Oreto G, Baldari S, Vita G, Pingitore A, Khandheria BK, Carerj S. Usefulness of Combining Electrocardiographic and Echocardiographic Findings and Brain Natriuretic Peptide in Early Detection of Cardiac Amyloidosis in Subjects With Transthyretin Gene Mutation. Am J Cardiol 2015; 116:1122-7. [PMID: 26253999 DOI: 10.1016/j.amjcard.2015.07.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/03/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
Abstract
Early noninvasive identification of cardiac amyloidosis (CA) is of growing clinical importance. Low voltage on electrocardiogram (ECG), increased left ventricular (LV) septal thickness (ST), and global longitudinal strain (GLS) on echocardiography, and elevated brain natriuretic peptides (BNP) are used as surrogates of CA. Thirty-five patients (50 ± 14 years, 22 women) underwent electrocardiography to analyze low-voltage QRS (<15 mV) pathologic Q waves, poor R-wave progression, ST-T abnormalities, and left bundle branch block. An ECG was considered abnormal if at least one ECG alteration was present. Echocardiography was used to analyze LVST, E/E', and GLS. All participants also had BNP blood testing. (99m)Tc-3,3-diphosphono-1,2 propanodicarboxylic acid scintigraphy assumed as a reference method showed CA in 18 patients (51%, CA group) and no accumulation in 17 patients (no CA group). In descending order of accuracy, LVST >14 mm, E/E' >6.6, GLS <14.1, BNP >129 pg/ml, and an overall abnormal ECG showed good capability to distinguish patients with and without CA. All these parameters were predictors of CA in univariate analysis, whereas low-voltage QRS showed the worst performance. LVST >14 mm (p = 0.002) was the best independent predictor of CA, achieving sensitivity of 78% and accuracy of 89%. However, an LVST >14 mm (p = 0.005) plus an abnormal ECG (p = 0.03) show together a greater sensitivity, equal to 89%, in identifying CA. An integrated evaluation of ECG and echocardiography is a sensitive and low-cost technical approach to identify CA in patients with transthyretin gene mutation.
Collapse
|
105
|
Campennì A, Giovinazzo S, Tuccari G, Fogliani S, Ruggeri RM, Baldari S. Abnormal radioiodine uptake on post-therapy whole body scan and sodium/iodine symporter expression in a dermoid cyst of the ovary: report of a case and review of the literature. Arch Endocrinol Metab 2015; 59:351-4. [DOI: 10.1590/2359-3997000000087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 08/21/2014] [Indexed: 11/22/2022]
|
106
|
Mazzeo A, Russo M, Di Bella G, Minutoli F, Stancanelli C, Gentile L, Baldari S, Carerj S, Toscano A, Vita G. Transthyretin-Related Familial Amyloid Polyneuropathy (TTR-FAP): A Single-Center Experience in Sicily, an Italian Endemic Area. J Neuromuscul Dis 2015; 2:S39-S48. [PMID: 27858761 PMCID: PMC5271421 DOI: 10.3233/jnd-150091] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Familial amyloid polyneuropathy related to transthyretin gene (TTR-FAP) is a life-threatening disease transmitted as an autosomal dominant trait. Val30Met mutation accounts for the majority of the patients with large endemic foci especially in Portugal, Sweden and Japan. However, more than one hundred other mutations have been described worldwide. A great phenotypic variability among patients with late- and early-onset has been reported. Objective: To present a detailed report of TTR-FAP patients diagnosed in our tertiary neuromuscular center, in a 20-year period. Methods: Clinical informations were gathered through the database of our center. Results: The study involved 76 individuals carrying a TTR-FAP mutation. Three phenotypes were identified, each corresponding to a different TTR variant, homogeneous within and heterogeneous between each other: i) Glu89Gln mutation, characterised by 5th – 6th decade onset, neuropathy as presenting symptoms, early heart dysfunction, cardiomyopathy as major cause of mortality followed by dysautonomia and cachexia; ii) Phe64Leu mutation, marked by familiarity reported in one-half of cases, late onset, severe peripheral neuropathy, moderate dysautonomia and mild cardiomyopathy, death for wasting syndrome; iii) Thr49Ala mutation, distinguished by onset in the 5th decade, autonomic disturbances as inaugural symptoms which may remain isolated for many years, moderate polyneuropathy, cachexia as major cause of mortality followed by cardiomyopathy. Conclusions: This survey highlighted a prevalence of 8.8/1,000,000 in Sicily Island. Good knowledge of the natural history of the disease according to different TTR mutations allow clinicians to optimise multiprofessional care for patients and to offer carriers a personalized follow-up to reveal first signs of the disease.
Collapse
Affiliation(s)
- Anna Mazzeo
- Department of Neurosciences, University of Messina, Messina, Italy
| | - Massimo Russo
- NEMO SUD Center for Neuromuscular Disorders, Messina, Italy
| | - Gianluca Di Bella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Fabio Minutoli
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Claudia Stancanelli
- Department of Neurosciences, University of Messina, Messina, Italy.,Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Palermo, Italy
| | - Luca Gentile
- Department of Neurosciences, University of Messina, Messina, Italy
| | - Sergio Baldari
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Scipione Carerj
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonio Toscano
- Department of Neurosciences, University of Messina, Messina, Italy
| | - Giuseppe Vita
- Department of Neurosciences, University of Messina, Messina, Italy.,NEMO SUD Center for Neuromuscular Disorders, Messina, Italy
| |
Collapse
|
107
|
Campennì A, Giovinazzo S, Curtò L, Giordano E, Trovato M, Ruggeri RM, Baldari S. Thyroid hemiagenesis, Graves' disease and differentiated thyroid cancer: a very rare association: case report and review of literature. Hormones (Athens) 2015; 14:451-8. [PMID: 26188237 DOI: 10.14310/horm.2002.1606] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 05/19/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Thyroid hemiagenesis is a rare congenital disorder characterized by the absence of a lobe and/or of isthmus. Studies on the association between thyroid hemiagenesis, Graves' disease and differentiated thyroid cancer are rare. CASE PRESENTATION We describe the medical and surgical history of a patient in whom a molecular evaluation was performed. A 36-year-old man presented with symptoms and signs of hyperthyroidism of a few months' duration. Hyperthyroidism was confirmed biochemically and anti-TSH-receptor antibodies were positive. Thyroid ultrasonography showed no left lobe and demonstrated a diffused enlargement of the right lobe; an ipoechoic, non-homogenous nodule 15 millimeters in size was identified in the middle part of the lobe. A 99mTc-pertechnetate thyroid scintigraphy (111 MBq) confirmed thyroid hemiagenesis due to the absence of the left lobe. Treatment with methimazole (30 mg/day) was started. As the patient's hyperthyroidism improved, he underwent fine-needle needle aspiration cytology (FNAC) of the right nodule. Cytology was suspicious for malignancy (THY4) and the patient was referred for surgery. Histopathological findings revealed a papillary thyroid carcinoma. The molecular analysis did not show PAX8 or TSHR mutations in the thyroid tissue nor mutations of BRAF, H-RAS, N-RAS or K-RAS genes in the tumor. CONCLUSION Though thus far studies on the association of thyroid hemiagenesis, Graves' disease and differentiated thyroid cancer are extremely rare, the possibility of the development of thyroid cancer must be taken into account in patients affected by thyroid hemiagenesis and the nodular variant of Graves' disease.
Collapse
Affiliation(s)
- Alfredo Campennì
- Department of Biomedical Sciences and of Morphological and Functional Images, Unit of Nuclear Medicine, Italy
| | - Salvatore Giovinazzo
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Messina, Italy
| | - Lorenzo Curtò
- Unit of Endocrinology, Hospital of Scilla, Reggio Calabria, Calabria; 4Department of Pathology, University of Messina; Italy
| | - Ernesto Giordano
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Messina, Italy
| | - Maria Trovato
- Unit of Endocrinology, Hospital of Scilla, Reggio Calabria, Calabria; 4Department of Pathology, University of Messina; Italy
| | - Rosaria M Ruggeri
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Messina, Italy
| | - Sergio Baldari
- Department of Biomedical Sciences and of Morphological and Functional Images, Unit of Nuclear Medicine, Italy
| |
Collapse
|
108
|
Campennì A, Caruso G, Barresi V, Pino M, Cucinotta M, Baldari S, Caffo M. Gliomas with intratumoral abscess formation: Description of new cases, review of the literature, and the role of 99mTC-Leukoscan. Kaohsiung J Med Sci 2015; 31:377-83. [DOI: 10.1016/j.kjms.2015.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/11/2014] [Accepted: 12/23/2014] [Indexed: 10/23/2022] Open
|
109
|
Galletti F, Cammaroto G, Galletti B, Quartuccio N, Di Mauro F, Baldari S. Technetium-99m (⁹⁹mTc)-labelled sulesomab in the management of malignant external otitis: is there any role? Eur Arch Otorhinolaryngol 2015; 272:1377-82. [PMID: 24534898 DOI: 10.1007/s00405-014-2938-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 02/06/2014] [Indexed: 02/07/2023]
Abstract
We report two cases of malignant external otitis (MEO) evaluated with Technetium-99m((99m)Tc)-labelled sulesomab. Two patients affected by MEO are presented, together with a literature review. Both patients were studied with clinical examination, ear discharge culture, radiological imaging, blood exams, (99m)Tc Sulesomab, and treated with antibiotic therapy. (99m)Tc-Sulesomab would appear to be an useful tool for diagnosis and follow-up of MEO, highlighting the site and extension of the inflammatory process, and evaluating course and treatment efficacy. (99m)Tc-Sulesomab shows promise as a rapid, effective and safe imaging agent for treatment response evaluation and follow-up of patients with MEO. Further studies are warranted to validate the inclusion of (99m)Tc-Sulesomab scan in the imaging follow-up of patients with MEO.
Collapse
Affiliation(s)
- Francesco Galletti
- Department of Otorhinolaryngology, University of Messina, Messina, Italy,
| | | | | | | | | | | |
Collapse
|
110
|
Amato E, Leotta S, Italiano A, Baldari S. A Monte Carlo approach to small-scale dosimetry of solid tumour microvasculature for nuclear medicine therapies with (223)Ra-, (131)I-, (177)Lu- and (111)In-labelled radiopharmaceuticals. Phys Med 2015; 31:536-41. [PMID: 25979209 DOI: 10.1016/j.ejmp.2015.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/20/2015] [Accepted: 04/25/2015] [Indexed: 11/18/2022] Open
Abstract
The small-scale dosimetry of radionuclides in solid-tumours is directly related to the intra-tumoral distribution of the administered radiopharmaceutical, which is affected by its egress from the vasculature and dispersion within the tumour. The aim of the present study was to evaluate the combined dosimetric effects of radiopharmaceutical distribution and range of the emitted radiation in a model of tumour microvasculature. We developed a computational model of solid-tumour microenvironment around a blood capillary vessel, and we simulated the transport of radiation emitted by (223)Ra, (111)In, (131)I and (177)Lu using the GEANT4 Monte Carlo. For each nuclide, several models of radiopharmaceutical dispersion throughout the capillary vessel were considered. Radial dose profiles around the capillary vessel, the Initial Radioactivity (IR) necessary to deposit 100 Gy of dose at the edge of the viable tumour-cell region, the Endothelial Cell Mean Dose (ECMD) and the Tumour Edge Mean Dose (TEMD), i.e. the mean dose imparted at the 250-μm layer of tissue, were computed. The results for beta and Auger emitters demonstrate that the photon dose is about three to four orders of magnitude lower than that deposited by electrons. For (223)Ra, the beta emissions of its progeny deliver a dose about three orders of magnitude lower than that delivered by the alpha emissions. Such results may help to characterize the dose inhomogeneities in solid tumour therapies with radiopharmaceuticals, taking into account the interplay between drug distribution from vasculature and range of ionizing radiations.
Collapse
Affiliation(s)
- Ernesto Amato
- Department of Biomedical Sciences and of Morphologic and Functional Imaging, University of Messina, Messina, Italy.
| | - Salvatore Leotta
- Department of Physics and Earth Sciences, University of Messina, Messina, Italy
| | - Antonio Italiano
- Istituto Nazionale di Fisica Nucleare, Gr. Coll. Messina, Sez. Catania, Messina, Italy
| | - Sergio Baldari
- Department of Biomedical Sciences and of Morphologic and Functional Imaging, University of Messina, Messina, Italy
| |
Collapse
|
111
|
Cistaro A, Niccoli Asabella A, Coppolino P, Quartuccio N, Altini C, Cucinotta M, Alongi P, Balma M, Sanfilippo S, Buschiazzo A, Piccardo A, Fanelli M, Sambuceti G, Bomanji J, Baldari S, Bisi G, Fanti S, Rubini G. Diagnostic and prognostic value of 18F-FDG PET/CT in comparison with morphological imaging in primary adrenal gland malignancies - a multicenter experience. Hell J Nucl Med 2015; 18:97-102. [PMID: 26187207 DOI: 10.1967/s002449910202] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 06/25/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the diagnostic and prognostic role of fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in comparison to morphological imaging such as computed tomography in primary adrenal malignancies. MATERIALS AND METHODS In this multicenter retrospective study, 68 patients with adrenal malignancy were included. All patients had histologically proven diagnosis of primary adrenal malignancy (adrenocortical carcinoma, malignant pheochromocytoma, neuroblastoma and lymphoma), one whole body (18)F-FDG PET/CT scan and one whole-body contrast enhancement computed tomography (CECT) scan acquired within one month and were followed clinically and by performing morphological tests for at least 12 months. RESULTS Overall sensitivity, specificity, accuracy, positive and negative predictive values for CECT and (18)F-FDG PET/CT were respectively, 59%, 100%, 65%, 100%, 27% and 75%, 100%, 82%, 100% and 63%. For adrenocortical carcinomas, (18)F-FDG PET/CT showed a better accuracy (93.4%) than CECT (75%). For neuroblastomas (18)F-FDG PET/CT also showed better accuracy (70.4%) than CECT (66.7%). For malignant pheochromocytomas (18)F-FDG PET/CT and CECT showed the same accuracy (90%). For primary adrenal lymphomas, (18)F-FDG PET/CT showed better accuracy (100%) than CECT (74.41%). Kaplan-Mayer curves showed that "histotypes" and "metastases at the last follow-up" were similarly detected for both disease free survival (DFS) and overall survival (OS), while "global 18F-FDG PET/CT" and "presence of metastases at diagnosis" were significant for DFS. Stratifying the sample by the presence or absence of metastases at diagnosis, standardized uptake value (SUVmax) was a significant prognostic factor for DFS when metastases were absent (Wald test=7.035, P=0.008). CONCLUSION Our multicenter study demonstrated that (18)F-FDG PET/CT better than CECT diagnosed adrenal malignancies achieving also a good prognostic performance. Therefore management algorithms should include (18)F-FDG PET/CT.
Collapse
Affiliation(s)
- Angelina Cistaro
- Positron Emission Tomography Centre, IRMET S.p.A, Euromedic Inc., Turin, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
112
|
Minutoli F, Mazzeo A, Di Bella G, Vita G, Baldari S. Is 99mTc-diphosphonate uptake the earliest sign of cardiac amyloidosis development in asymptomatic Glu89Gln transthyretin gene mutation carriers? Orphanet J Rare Dis 2015. [PMCID: PMC4642038 DOI: 10.1186/1750-1172-10-s1-p62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
113
|
Quartuccio N, Fox J, Kuk D, Wexler LH, Baldari S, Cistaro A, Schöder H. Pediatric bone sarcoma: diagnostic performance of ¹⁸F-FDG PET/CT versus conventional imaging for initial staging and follow-up. AJR Am J Roentgenol 2015; 204:153-60. [PMID: 25539251 DOI: 10.2214/ajr.14.12932] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of this study was to compare the diagnostic performance of (18)F-FDG PET/CT and conventional imaging for staging and follow-up of pediatric osteosarcoma and skeletal Ewing sarcoma. MATERIALS AND METHODS We calculated sensitivity, specificity, and accuracy of PET/CT and conventional imaging (CT, MRI, bone scanning) for sites of disease and number of lesions. Diagnostic benefit, defined as better characterization of lesions, was evaluated on a per-scan basis, comparing PET/CT and conventional imaging. RESULTS A total of 412 lesions were characterized by imaging in 64 patients (20, osteosarcoma; 44, Ewing sarcoma). For osteosarcoma patients PET/CT was available only at follow-up, where it proved more accurate than conventional imaging for the detection of bone lesions (accuracy, 95% vs 67% for CT and 86% for MRI) and complementary to CT in evaluating lung nodules (sensitivity, 84% vs 94%; specificity, 79% vs 71%) with diagnostic benefit in 18% of examinations. In patients with Ewing sarcoma, PET/CT tended to perform better during follow-up than at initial staging (accuracy, 85% vs 69%). For lung findings, PET/CT was more specific than CT but was less sensitive. The diagnostic benefit of PET/CT was greater at staging (28%) than during followup (9%). On a per-patient basis, PET/CT provided diagnostic benefit in 21 of 44 patients with Ewing sarcoma and nine of 20 patients with osteosarcoma at least once during clinical management. CONCLUSION FDG PET/CT provides diagnostic benefit in Ewing sarcoma and osteosarcoma, with the exception of small lung nodules. Prospective studies are needed to define the best imaging algorithm and combination of tests in the staging and follow-up of patients with pediatric bone sarcoma.
Collapse
Affiliation(s)
- Natale Quartuccio
- 1 Nuclear Medicine Unit, Department of Biomedical Sciences and of Morphologic and Functional Images, University of Messina, Messina, Italy
| | | | | | | | | | | | | |
Collapse
|
114
|
Campennì A, Giovanella L, Siracusa M, Stipo ME, Alibrandi A, Cucinotta M, Ruggeri RM, Baldari S. Is malignant nodule topography an additional risk factor for metastatic disease in low-risk differentiated thyroid cancer? Thyroid 2014; 24:1607-11. [PMID: 25089829 DOI: 10.1089/thy.2014.0217] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Differentiated thyroid cancer (DTC) is the most common endocrine malignancy. In recent decades, the incidence has been increasing, largely due to increased detection of patients with low-risk or very low-risk DTC. According to European Thyroid Association and American Thyroid Association guidelines, radioiodine (RAI) thyroid remnant ablation is not indicated in very low-risk patients, while its role is still debated in low-risk patients. Accordingly, risk stratification of DTC patients is pivotal when deciding for or against RAI ablation. Presently, risk stratification is based on pTNM staging integrated with clinical parameters. The aim of our study was to evaluate the relationship between location of malignant thyroid nodules within the thyroid gland and the presence of loco-regional and/or distant metastases in patients with pT1a-pT1b DTCs. METHODS We reviewed the records of 246 patients (214 women, 32 men; female-to-male ratio 6.7:1) affected by unifocal DTC ≤ 2 cm, who had undergone RAI thyroid remnant ablation (activity ranged 555-4588 MBq) after levothyroxine withdrawal or after recombinant human TSH (rhTSH) stimulation. The majority of the patients (91.5%) were affected by papillary thyroid carcinoma. RESULTS Metastases were discovered by posttreatment whole-body scintigraphy in 29 out of 246 (11.8%) patients. In patients with metastases, malignant thyroid nodules were located in the right lobe (14/123, 11.4%), left lobe (7/95, 7.4%), and isthmus (8/27, 29.6%). The prevalence of metastases was significantly higher in patients with DTC located in the isthmus, compared to other sites (χ(2) = 9.6, p = 0.002). CONCLUSIONS Our data show for the first time that a location of a thyroid cancer in the isthmus is an additional risk factor for RAI avid metastatic disease in pT1a-pT1b DTC patients, regardless of the presence or absence of other risk factors.
Collapse
Affiliation(s)
- Alfredo Campennì
- 1 Department of Biomedical Science and of Morphological and Functional Images, Nuclear Medicine Unit, University of Messina , Messina, Italy
| | | | | | | | | | | | | | | |
Collapse
|
115
|
Di Bella G, Pizzino F, Minutoli F, Zito C, Donato R, Dattilo G, Oreto G, Baldari S, Vita G, Khandheria BK, Carerj S. The mosaic of the cardiac amyloidosis diagnosis: role of imaging in subtypes and stages of the disease. Eur Heart J Cardiovasc Imaging 2014; 15:1307-15. [PMID: 25190073 DOI: 10.1093/ehjci/jeu158] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cardiac amyloidosis is a rare, infiltrative cardiomyopathy that presents with thickened ventricular walls and progressive heart failure. The morphological findings and clinical features are shared with many other diseases (i.e. hypertrophic cardiomyopathy, 'athlete's heart,' Fabry disease, and hypertensive cardiomyopathy), and misdiagnosis occurs frequently. Cardiologists have many instruments that can help reach a correct diagnosis in a relatively short time. As tiles of a mosaic are placed to create an image, thoughtful and smart use of the different diagnostic tools available allows the opportunity to identify amyloid infiltration of the myocardium. When the myocardium is involved, prognosis is poor, so identification of its involvement is crucial for disease management. The diagnostic process begins with an accurate evaluation of clinical elements and includes cardiovascular imaging (echocardiography, magnetic resonance, and nuclear medicine), electrocardiography, serological assays, and myocardial biopsy; only the appropriate integration of these instruments can reveal the diagnosis to an expert physician. The latest improvements in non-invasive diagnostic techniques with increased diagnostic power have reduced the need for biopsy.
Collapse
Affiliation(s)
- Gianluca Di Bella
- Clinical and Experimental Medicine Department, Cardiology Unit, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| | - Fausto Pizzino
- Clinical and Experimental Medicine Department, Cardiology Unit, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| | - Fabio Minutoli
- Department of Biomedical Sciences and of Morphologic and Functional Images, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| | - Concetta Zito
- Clinical and Experimental Medicine Department, Cardiology Unit, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| | - Rocco Donato
- Department of Biomedical Sciences and of Morphologic and Functional Images, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| | - Giuseppe Dattilo
- Clinical and Experimental Medicine Department, Cardiology Unit, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| | - Giuseppe Oreto
- Clinical and Experimental Medicine Department, Cardiology Unit, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| | - Sergio Baldari
- Department of Biomedical Sciences and of Morphologic and Functional Images, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| | - Giuseppe Vita
- Department of Neurosciences, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| | - Bijoy K Khandheria
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, #840, Milwaukee, WI 53215, USA
| | - Scipione Carerj
- Clinical and Experimental Medicine Department, Cardiology Unit, University of Messina, Azienda Ospedaliera Universitaria 'Policlinico G. Martino', Via Consolare Valeria 1, Messina 98125, Italy
| |
Collapse
|
116
|
Caffo M, Campenni A, Caruso G, Barresi V, Pino M, Baldari S, Tomasello F. P17.13 * ABSCESUALIZED GLIOMAS: PREDICTIVE VALUE OF 99MTC-LEUKOSCAN. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
117
|
Ubertini V, Norelli G, D'Arcangelo D, Gurtner A, Cesareo E, Baldari S, Gentileschi MP, Piaggio G, Nisticò P, Soddu S, Facchiano A, Bossi G. Mutant p53 gains new function in promoting inflammatory signals by repression of the secreted interleukin-1 receptor antagonist. Oncogene 2014; 34:2493-504. [PMID: 24998848 DOI: 10.1038/onc.2014.191] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 04/30/2014] [Accepted: 05/28/2014] [Indexed: 12/11/2022]
Abstract
The TP53 tumor-suppressor gene is frequently mutated in human cancer. Missense mutations can add novel functions (gain-of-function, GOF) that promote tumor malignancy. Here we report that mutant (mut) p53 promotes tumor malignancy by suppressing the expression of a natural occurring anti-inflammatory cytokine, the secreted interleukin-1 receptor antagonist (sIL-1Ra, IL1RN). We show that mutp53 but not wild-type (wt) p53 suppresses the sIL-1Ra production in conditioned media of cancer cells. Moreover, mutp53, but not wtp53, binds physically the sIL-1Ra promoter and the protein-protein interaction with the transcriptional co-repressor MAFF (v-MAF musculoaponeurotic fibrosarcoma oncogene family, protein F) is required for mutp53-induced sIL-1Ra suppression. Remarkably, when exposed to IL-1 beta (IL-1β) inflammatory stimuli, mutp53 sustains a ready-to-be-activated in vitro and in vivo cancer cells' response through the sIL-1Ra repression. Taken together, these results identify sIL-1Ra as a novel mutp53 target gene, whose suppression might be required to generate a chronic pro-inflammatory tumor microenvironment through which mutp53 promotes tumor malignancy.
Collapse
Affiliation(s)
- V Ubertini
- Experimental Oncology Laboratories, Regina Elena National Cancer Institute, Rome, Italy
| | - G Norelli
- Experimental Oncology Laboratories, Regina Elena National Cancer Institute, Rome, Italy
| | - D D'Arcangelo
- Istituto Dermopatico Dell'immacolata IDI-IRCSS, Rome, Italy
| | - A Gurtner
- Experimental Oncology Laboratories, Regina Elena National Cancer Institute, Rome, Italy
| | - E Cesareo
- Istituto Dermopatico Dell'immacolata IDI-IRCSS, Rome, Italy
| | - S Baldari
- Experimental Oncology Laboratories, Regina Elena National Cancer Institute, Rome, Italy
| | - M P Gentileschi
- Experimental Oncology Laboratories, Regina Elena National Cancer Institute, Rome, Italy
| | - G Piaggio
- Experimental Oncology Laboratories, Regina Elena National Cancer Institute, Rome, Italy
| | - P Nisticò
- Experimental Oncology Laboratories, Regina Elena National Cancer Institute, Rome, Italy
| | - S Soddu
- Experimental Oncology Laboratories, Regina Elena National Cancer Institute, Rome, Italy
| | - A Facchiano
- Istituto Dermopatico Dell'immacolata IDI-IRCSS, Rome, Italy
| | - G Bossi
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome, Italy
| |
Collapse
|
118
|
Vicchio TM, Giovinazzo S, Certo R, Cucinotta M, Micali C, Baldari S, Benvenga S, Trimarchi F, Campennì A, Ruggeri RM. Lack of association between autonomously functioning thyroid nodules and germline polymorphisms of the thyrotropin receptor and Gαs genes in a mild to moderate iodine-deficient Caucasian population. J Endocrinol Invest 2014; 37:625-30. [PMID: 24789540 DOI: 10.1007/s40618-014-0081-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 04/02/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Mutations of the thyrotropin receptor (TSHR) and/or Gαs gene have been found in a number of, but not all, autonomously functioning thyroid nodules (AFTNs). Recently, in a 15-year-old girl with a hyperfunctioning papillary thyroid carcinoma, we found two somatic and germline single nucleotide polymorphisms (SNPs): a SNP of the TSHR gene (exon 7, codon 187) and a SNP of Gαs gene (exon 8, codon 185). The same silent SNP of the TSHR gene had been reported in patients with AFTN or familial non-autoimmune hyperthyroidism. No further data about the prevalence of the two SNPs in AFTNs as well as in the general population are available in the literature. AIM To clarify the possible role of these SNPs in predisposing to AFTN. METHODS Germline DNA was extracted from blood leukocytes of 115 patients with AFTNs (43 males and 72 females, aged 31-85 years, mean ± SD = 64 ± 13) and 100 sex-matched healthy individuals from the same geographic area, which is marginally iodine deficient. The genotype distribution of the two SNPs was investigated by restriction fragment length polymorphism-polymerase chain reaction. RESULTS The prevalence of the two SNPs in our study population was low and not different to that found in healthy individuals: 8 % of patients vs. 9 % of controls were heterozygous for the TSHR SNP and 4 % patients vs. 6 % controls were heterozygous for the Gαs SNP. One patient harbored both SNPs. CONCLUSIONS These results suggest that these two SNPs do not confer susceptibility for the development of AFTN.
Collapse
Affiliation(s)
- Teresa Manuela Vicchio
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, Policlinico "G. Martino", Messina, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
119
|
Giuffrida G, Giovinazzo S, Certo R, Vicchio TM, Baldari S, Campennì A, Ruggeri RM. An uncommon case of Marine-Lenhart syndrome. Arq Bras Endocrinol Metabol 2014; 58:398-401. [PMID: 24936736 DOI: 10.1590/0004-2730000003173] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 03/03/2014] [Indexed: 11/22/2022]
Abstract
The term Marine-Lenhart syndrome describes the association between Graves' disease and autonomously functioning thyroid nodules (AFTN), such as toxic adenoma or toxic multinodular goiter. The two diseases may coexist or may be present at different moments in the same patient. In the literature, there are many reports on the development of Graves' disease after radioiodine treatment for AFTN, but very little information may be found on the occurrence of AFTN after radioiodine therapy for Graves' disease. We describe here the case of a female patient with Graves' disease who was successfully treated with radioiodine for Graves' disease, returning to normal thyroid function. Three years later, biochemical analysis and ultrasound examination identified a thyroid nodule that progressively increased in size. The 99mTc-pertechnetate scintigraphy showed avid uptake in the right lobule, which corresponded to a nodular lesion consistent with AFTN.
Collapse
Affiliation(s)
- Giuseppe Giuffrida
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Italy
| | - Salvatore Giovinazzo
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Italy
| | - Rosaria Certo
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Italy
| | - Teresa Manuela Vicchio
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Italy
| | - Sergio Baldari
- Department of Biomedical Sciences and of Morphological and Functional Images, Unit of Nuclear Medicine, University of Messina, Italy
| | - Alfredo Campennì
- Department of Biomedical Sciences and of Morphological and Functional Images, Unit of Nuclear Medicine, University of Messina, Italy
| | - Rosaria Maddalena Ruggeri
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Italy
| |
Collapse
|
120
|
Minutoli F, Amato E, Sindoni A, Cardile D, Conti A, Herberg A, Baldari S. Peptide receptor radionuclide therapy in patients with inoperable meningiomas: our experience and review of the literature. Cancer Biother Radiopharm 2014; 29:193-9. [PMID: 24811687 DOI: 10.1089/cbr.2013.1599] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Few studies describe peptide receptor radionuclide therapy (PRRT) using (90)Y- or (177)Lu-labeled peptides in patients with recurrent meningiomas. No clinical data about (111)In-Pentetreotide in such patients are available. We report on (111)In-Pentetreotide therapy in patients with inoperable meningiomas and review the literature about PRRT of meningiomas. METHODS We reviewed clinical records of 8 patients with meningioma/meningiomatosis showing high (111)In-Pentetreotide uptake on pretherapy scintigraphy who were treated with at least one cycle of (111)In-Pentetreotide. In 2 patients, a cocktail of (111)In-Pentetreotide and beta-emitting radiolabeled peptides had been administered. RESULTS No patient experienced acute toxicity, neurological or renal function impairment. Mild transient bone marrow toxicity was observed in 4 patients. Objective partial response was observed in 2 patients, stable disease in 5 and disease progression in one. There were no statistically significant correlations between objective response and patient age, tumor WHO grade, baseline Karnofsky performance score, (111)In-Pentetreotide tumoral uptake grade, tumor/nontumor ratio, disease state at baseline, and cumulative dose. CONCLUSIONS In consideration of its efficacy and the lack of significant toxicity, PRRT of meningiomas using (111)In-Pentetreotide could be proposed even nowadays when the use of (177)Lu- or (90)Y-labeled peptides seems unsafe, namely in patients with renal impairment/toxicity.
Collapse
Affiliation(s)
- Fabio Minutoli
- 1 Department of Biomedical Sciences and Morphological and Functional Images, University of Messina , Messina, Italy
| | | | | | | | | | | | | |
Collapse
|
121
|
Moleti M, Violi MA, Montanini D, Trombetta C, Di Bella B, Sturniolo G, Presti S, Alibrandi A, Campennì A, Baldari S, Trimarchi F, Vermiglio F. Radioiodine ablation of postsurgical thyroid remnants after treatment with recombinant human TSH (rhTSH) in patients with moderate-to-severe graves' orbitopathy (GO): a prospective, randomized, single-blind clinical trial. J Clin Endocrinol Metab 2014; 99:1783-9. [PMID: 24432992 DOI: 10.1210/jc.2013-3093] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Recent evidence suggests thyroidectomy (Tx) followed by radioiodine remnant ablation to be beneficial to Graves' orbitopathy (GO) patients. OBJECTIVE The aim of the study was to evaluate the effect of (131)I thyroid ablation after recombinant human TSH stimulation in patients with moderate-to-severe GO. DESIGN, PATIENTS, AND INTERVENTIONS The study was prospective, randomized, and single-blind, and it included 40 consecutive patients with moderate-to-severe GO randomized into: 1) a Tx-radioactive iodine (RAI) group (20 subjects who underwent total-Tx and (131)I ablation after recombinant human TSH stimulation); and 2) a Tx group (20 subjects who underwent total-Tx alone). OUTCOME MEASURES The overall GO outcome 12 months after Tx/radioiodine ablation was the main measure. RESULTS GO evaluation at the end of iv glucocorticoids showed eye disease to be improved in 65% of the Tx-RAI group and 60% of the Tx group patients. At 6 and 12 months, no further changes in the GO outcome could be observed in the Tx-RAI group. Conversely, five patients from the Tx group exhibited a deterioration in GO. At 12 months, GO was found to be improved in 70% of the Tx-RAI and 20% of the Tx group patients, the latter being found to be stable (55%) or worse (25%) than at baseline evaluation. At 12 months, GO was found to be inactive in a significantly higher percentage of patients in the Tx-RAI than in the Tx group (75 vs 30%; P < .01). CONCLUSIONS Postoperative radioiodine ablation proved more effective than Tx alone in inducing earlier and steadier GO improvement in patients with moderate-to-severe GO treated with iv glucocorticoids over a 24-month follow-up period.
Collapse
Affiliation(s)
- Mariacarla Moleti
- Dipartimento di Medicina Clinica e Sperimentale, Sezione di Endocrinologia (M.M., M.A.V., B.D.B., G.S., S.P., F.T., F.V.); Dipartimento di Scienze Sperimentali Medico-Chirurgiche, Specialistiche ed Odontostomatologiche, Sezione di Oftalmologia (D.M., C.T.); Dipartimento di Scienze Economiche, Finanziarie, Sociali, Ambientali, Statistiche e del Territorio (A.A.); and Dipartimento di Scienze Radiologiche, Sezione di Medicina Nucleare (A.C., S.B.), University of Messina, 98122 Messina, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
122
|
Heisterkamp M, Titze S, Lorenzen J, Eckardt KU, Koettgen A, Kielstein JT, Bouquegneau A, Vidal-Petiot E, Vrtovsnik F, Cavalier E, Krzesinski JM, Flamant M, Delanaye P, Anguiano L, Riera M, Pascual J, Barrios C, Betriu A, Valdivielso JM, Fernandez E, Soler MJ, Denys MA, Viaene A, Goessaert AS, Delanghe J, Everaert K, Kim YS, Choi MJ, Deok JY, Kim SG, Bevc S, Hojs N, Hojs R, Ekart R, Gorenjak M, Puklavec L, Bevc S, Hojs N, Hojs R, Ekart R, Gorenjak M, Puklavec L, Piskunowicz M, Hofmann L, Zurcher E, Bassi I, Zweiacker C, Stuber M, Narkiewicz K, Vogt B, Burnier M, Pruijm M, Rusu E, Zilisteanu D, Atasie T, Circiumaru A, Carstea F, Ecobici M, Rosca M, Tanase C, Mihai S, Voiculescu M, Kim YS, Jeon YD, Choi MJ, Kim SG, Polenakovic M, Pop-Jordanova N, Hung SC, Tarng DC, Tuta L, Stanigut A, Mesiano P, Rollino C, Ferro M, Beltrame G, Massara C, Quattrocchio G, Borca M, Bazzan M, Roccatello D, Maksudova A, Urasaeva LI, Khalfina TN, Zilisteanu D, Rusu E, Atasie T, Ecobici M, Circiumaru A, Carstea F, Rosca M, Tanase C, Mihai S, Voiculescu M, Tekce H, Kin Tekce B, Aktas G, Alcelik A, Sengul E, Lindic J, Purg D, Skamen J, Krsnik M, Skoberne A, Pajek J, Kveder R, Bren A, Kovac D, Kin Tekce B, Tekce H, Aktas G, Delgado G, Drechsler C, Wanner C, Blouin K, Pilz S, Tomaschitz A, Kleber ME, Willmes C, Krane V, Marz W, Ritz E, Van Gilst WH, Van Der Harst P, De Boer RA, Scholze A, Petersen L, Hocher B, Rasmussen LM, Tepel M, De Paula EA, Vanelli CP, Caminhas MS, Soares BC, Bassoli FA, Da Costa DMN, Lanna CMM, Galil AGS, Colugnati FAB, Costa MB, Bastos MG, De Paula RB, Santoro D, Zappulla Z, Alibrandi A, Tomasello Andulajevic M, Licari M, Baldari S, Buemi M, Cernaro V, Campenni A, Pallet N, Chauvet S, Levi C, Meas-Yedid V, Beaune P, Thevet E, Karras A, Santos S, Malheiro J, Campos A, Pedroso S, Santos J, Cabrita A, Mayor MM, Ayala R, Ramos C, Franco S, Guillen R, Kim JS, Yang JW, Han BG, Choi SO, Tudor MN, Navajas Martinez MF, Vaduva C, Maria DT, Mota E, Clari R, Mongilardi E, Vigotti FN, Consiglio V, Scognamiglio S, Nazha M, Roggero S, Piga A, Piccoli G, Mukhopadhyay P, Patar K, Chaterjee N, Ganguly K. CKD LAB METHODS, PROGRESSION & RISK FACTORS 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
123
|
Santoro D, Zappulla Z, Alibrandi A, Andulajevic MT, Licari M, Baldari S, Buemi M, Cernaro V, Campennὶ A. Cross-Sectional Evaluation of Kidney Function in Hospitalized Patients: Estimated GFR Versus Renal Scintigraphy. Kidney Blood Press Res 2014; 39:668-76. [DOI: 10.1159/000355813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2014] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background/Aims: </i></b>Accurate staging of chronic kidney disease (CKD) is very important. We tried to identify difference in GFR evaluation between CKD-EPI and Gates method with renal scintigraphy and which variables are associated with these differences. <b><i>Methods: </i></b>We retrospectively reviewed the records of 341 patients who underwent dynamic renal scintigraphy in the last 5 years. Patients were categorized according to KDIGO staging I to V, using the eGFR calculated with the CKD-EPI equation. Secondarily, we stratified patients according to treatment with renin-angiotensin system (RAS) inhibitors. <b><i>Results: </i></b>Gates method tends to underestimate GFR especially in CKD stage I (mean -22.2 ml/min) and II (mean -12.5 ml/min). The division in quartiles of ages showed an underestimation of GFR only in the first quartile of age (< 50 years old). Gates method underestimation of GFR was more pronounced in stage I patients treated with RAS inhibitors (mean -34.6 ml/min). The same occurs in stage II, even though to a lesser extent. <b><i>Conclusion: </i></b>The assessment of GFR by the Gates method must be carefully considered in the early stages of CKD, especially in younger patients. Moreover, the difference is more pronounced in patients treated with RAS inhibitors. Longitudinal studies will prove which method better predicts cardiovascular or renal events.
Collapse
|
124
|
Minutoli F, Sindoni A, Baldari S. Letter by Minutoli et al Regarding Article, “Reduced Myocardial 123-Iodine Meta-Iodobenzylguanidine Uptake: A Prognostic Marker in Familial Amyloid Polyneuropathy”. Circ Cardiovasc Imaging 2013; 6:e76. [DOI: 10.1161/circimaging.113.001038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Fabio Minutoli
- Department of Biomedical Sciences and of Morphologic and Functional Images, University of Messina, Messina, Italy
| | - Alessandro Sindoni
- Department of Biomedical Sciences and of Morphologic and Functional Images, University of Messina, Messina, Italy
| | - Sergio Baldari
- Department of Biomedical Sciences and of Morphologic and Functional Images, University of Messina, Messina, Italy
| |
Collapse
|
125
|
Minutoli F, Di Bella G, Sindoni A, Vita G, Baldari S. Effectiveness of skeletal scintigraphy in transthyretin-related amyloidosis. Int J Cardiol 2013; 168:4988-9. [DOI: 10.1016/j.ijcard.2013.07.130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 07/13/2013] [Indexed: 11/27/2022]
|
126
|
Abstract
Internal dosimetry of alpha particles is gaining attention due to the increasing applications in cancer treatment and also for the assessment of environmental contamination from radionuclides. We developed a Monte Carlo simulation in GEANT4 in order to calculate the absorbed fractions for monoenergetic alpha particles in the energy interval between 0.1 and 10 MeV, uniformly distributed in ellipsoids made of soft tissue. For each volume, we simulated a spherical shape, three oblate and three prolate ellipsoids, and one scalene shape. For each energy and for every geometrical configuration, an analytical relationship between the absorbed fraction and a 'generalized radius' was found; and the dependence of the fit parameters on the alpha energy is discussed and fitted by parametric functions. With the proposed formulation, the absorbed fraction for alpha particles in the energy range explored can be calculated for volumes and for ellipsoidal shapes of practical interest. This method can be applied to the evaluation of absorbed fraction from alpha-emitting radionuclides. The contribution to the deposited energy coming from electron and photon emissions can be accounted for exploiting the specific formulations previously introduced. As an example of application, the dosimetry of (213)Bi and its decay chain in ellipsoids is reported.
Collapse
Affiliation(s)
- Ernesto Amato
- Section of Radiological Sciences, Department Biomedical Sciences and of Morphologic and Functional Imaging, University of Messina, Italy.
| | | | | |
Collapse
|
127
|
Lacquaniti A, Buemi F, Lupica R, Giardina C, Murè G, Arena A, Visalli C, Baldari S, Aloisi C, Buemi M. Can Neutrophil Gelatinase–associated Lipocalin Help Depict Early Contrast Material–induced Nephropathy? Radiology 2013; 267:86-93. [DOI: 10.1148/radiol.12120578] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
128
|
Ruggeri RM, Campennì A, Giovinazzo S, Saraceno G, Vicchio TM, Carlotta D, Cucinotta MP, Micali C, Trimarchi F, Tuccari G, Baldari S, Benvenga S. Follicular variant of papillary thyroid carcinoma presenting as toxic nodule in an adolescent: coexistent polymorphism of the TSHR and Gsα genes. Thyroid 2013; 23:239-42. [PMID: 22985488 DOI: 10.1089/thy.2012.0279] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Autonomously functioning, "hot", thyroid nodules are not common in children and adolescents. Such nodules are not considered alarming because they are assumed to be benign adenomas. Herein, we present a 15-year-old girl with a papillary thyroid carcinoma of 3.5 cm in diameter, which was functionally autonomous and scintigraphically hot. PATIENT FINDINGS The patient, initially referred to our Endocrine Unit because of a thyroid nodule, returned 6 months later for symptoms of hyperthyroidism. Hyperthyroidism was confirmed biochemically. Radioactive iodine ((131)I) thyroid scintigraphy was consistent with an autonomous thyroid nodule. As per guidelines, the patient underwent surgery and a pathological examination revealed papillary carcinoma, follicular variant. The excised nodule was examined for activating mutations of the thyrotropin receptor (TSHR), Gsα (GNAS1), H-RAS, N-RAS, K-RAS, and BRAF genes by direct sequencing. No mutations were found. Nevertheless, two combined nonfunctioning mutations were detected: a single-nucleotide polymorphism (SNP) of the TSHR gene, in exon 7, at codon 187 (AAT→AAC, both encoding asparagine), and a SNP within exon 8 of the Gsα gene at codon 185 (ATC→ATT, both encoding isoleucine). Both SNPs were also identified in the germline DNA of the patient. The same SNPs were sought in the parents and brother of our patient. Her father was heterozygous for the TSHR SNP, her mother heterozygous for the Gsα SNP, and her brother was wild type. CONCLUSIONS This case demonstrates that the presence of hyperfunctioning thyroid nodule(s) does not rule out cancer and warrants careful evaluation, especially in childhood and adolescence to overlook malignancy.
Collapse
Affiliation(s)
- Rosaria Maddalena Ruggeri
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
129
|
Cistaro A, Quartuccio N, Mojtahedi A, Fania P, Filosso PL, Campenni A, Ficola U, Baldari S. Prediction of 2 years-survival in patients with stage I and II non-small cell lung cancer utilizing (18)F-FDG PET/CT SUV quantification. Radiol Oncol 2013; 47:219-23. [PMID: 24133385 PMCID: PMC3794876 DOI: 10.2478/raon-2013-0023] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 03/04/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The purpose of the study was to evaluate the correlation between the maximum standardized uptake value (SUVmax), size of primary lung lesion, disease-free survival (DFS) and overall survival (OS) in patients with stage I and II non-small cell lung cancer (NSCLC) in 2 years follow-up. PATIENTS AND METHODS Forty-nine patients with stage I-II NSCLC were included in this study. Pre-surgical 2-deoxy-2-[18F]fluoro-D-glucose positron-emission tomography ((18)F-FDG PET/CT) study was performed for all patients. The relationship between SUVmax, tumour size and clinical outcome was measured. The cut-off value for SUVmax and tumour size with the best prognostic significance, probability of DFS and the correlation between SUVmax and the response to therapy were calculated. RESULTS There was a statistically significant correlation between SUVmax and DFS (p = 0.029). The optimal cut-offs were 9.00 for SUVmax (p = 0.0013) and 30mm for tumour size (p = 0.0028). Patients with SUVmax > 9 and primary lesion size > 30 mm had an expected 2years-DFS of 37.5%, while this rose to 90% if the tumour was <30 mm and/or SUVmax was <9. CONCLUSIONS In stage I-II, SUVmax and tumour size might be helpful to identify the subgroup of patients with high chance for recurrence.
Collapse
Affiliation(s)
- Angelina Cistaro
- Positron Emission Tomography Centre IRMET S.p.A., Euromedic inc., Turin, Italy
- Correspondence to: Angelina Cistaro, MD, Positron Emission Tomography Centre IRMET S.p.A, V.O. Vigliani 89, Turin 10136, Italy. Phone: +390113160158; Fax: +390113160828; E-mail:
| | - Natale Quartuccio
- Nuclear Medicine Unit, Department of Biomedical Sciences and of the Morphological and Functional Images, University of Messina, Messina, Italy
| | - Alireza Mojtahedi
- Nuclear Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Piercarlo Fania
- Positron Emission Tomography Centre IRMET S.p.A., Euromedic inc., Turin, Italy
| | - Pier Luigi Filosso
- Department of Thoracic Surgery, S. Giovanni Battista Hospital, Turin, Italy
| | - Alfredo Campenni
- Nuclear Medicine Unit, Department of Biomedical Sciences and of the Morphological and Functional Images, University of Messina, Messina, Italy
| | - Umberto Ficola
- Department of Nuclear Medicine, La Maddalena Hospital, Palermo, Italy
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical Sciences and of the Morphological and Functional Images, University of Messina, Messina, Italy
| |
Collapse
|
130
|
Cistaro A, Quartuccio N, Mojtahedi A, Fania P, Filosso PL, Cucinotta M, Campennì A, Ficola U, Baldari S. Is %ΔSUVmax a useful indicator of survival in patients with advanced nonsmall-cell lung cancer? ScientificWorldJournal 2013; 2013:910957. [PMID: 24228017 PMCID: PMC3817635 DOI: 10.1155/2013/910957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 09/17/2013] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To investigate the impact of the maximum standardized uptake value (SUVmax), size of primary lung lesion, and %ΔSUVmax on outcome (overall survival (OS) and 2-year disease-free survival (2-year DFS)) of patients with advanced nonsmall-cell lung cancer (NSCLC). MATERIALS AND METHODS 86 stage III-IV NSCLC patients underwent 18 F-FDGPET/CT, before and after chemotherapy, and were classified into subgroups according to the response criteria of the European Organization for Research and Treatment of Cancer. SUVmax values and tumor size with the best prognostic significance were searched. Correlation between the SUVmax value and the initial response to therapy (best response) and the relationship between %ΔSUVmax and OS were assessed. RESULTS In patients in PD (20/86), the average pretreatment SUVmax was 11.8 ± 5.23, and the mean size of the primary lesion was 43.35 mm ± 16.63. In SD, PR, and CR patients (66/86), the average pretreatment SUVmax was 12.7 ± 8.05, and the mean size of the primary lesion was 41.6 mm ± 21.15. Correlation was identified only for %ΔSUVmax; patients with PD (ΔSUVmax > +25%) showed a worse OS than patients with ΔSUVmax < +25% (CR, PR, and SD) (P = 0.0235). CONCLUSIONS In stage III-IV NSCLC, among the assessed factors, only %ΔSUVmax may be considered as a useful prognostic factor.
Collapse
Affiliation(s)
- Angelina Cistaro
- Positron Emission Tomography Centre, IRMET S.p.A., Euromedic, V.O. Vigliani 89, 10136 Turin, Italy ; PET Pediatric AIMN InterGroup, 10136 Turin, Italy ; Institute of Cognitive Sciences and Technologies, National Research Council, 00185 Rome, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
131
|
Russo M, Mazzeo A, Stancanelli C, Di Leo R, Gentile L, Di Bella G, Minutoli F, Baldari S, Vita G. Transthyretin-related familial amyloidotic polyneuropathy: description of a cohort of patients with Leu64 mutation and late onset. J Peripher Nerv Syst 2012; 17:385-90. [DOI: 10.1111/j.1529-8027.2012.00436.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | | | | | | | | | | | - Fabio Minutoli
- Department of Radiological Sciences, Nuclear Medicine Unit; University of Messina; Messina; Italy
| | - Sergio Baldari
- Department of Radiological Sciences, Nuclear Medicine Unit; University of Messina; Messina; Italy
| | | |
Collapse
|
132
|
Baldari S, Ferraù F, Alafaci C, Herberg A, Granata F, Militano V, Salpietro FM, Trimarchi F, Cannavò S. First demonstration of the effectiveness of peptide receptor radionuclide therapy (PRRT) with 111In-DTPA-octreotide in a giant PRL-secreting pituitary adenoma resistant to conventional treatment. Pituitary 2012; 15 Suppl 1:S57-60. [PMID: 22222543 DOI: 10.1007/s11102-011-0373-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In prolactin-secreting giant adenomas, cabergoline treatment is the first line approach. Surgery and/or radiotherapy are indicated when the tumour is resistant to medical treatment and continues growing, causing visual field impairment. Data concerning other therapeutic approach are scanty. Although PRL-secreting tumours may express somatostatin receptors type 2, 3 and 5, somatostatin analogs treatment is generally ineffective and peptide receptor radionuclide therapy (PRRT) has never been reported. A 58 year-old woman complaining of severe neurological symptoms caused by a giant prolactinoma, relapsing after surgery and not-responding to dopamine-agonists and octreotide LAR treatment, underwent four cycles of PRRT with 111-Indium-DTPA-octreotide with remarkable tumour shrinkage and a significant improvement in clinical conditions. No side effects were reported. This is the first report on the effectiveness and safety of PRRT with radio-labelled somatostatin analogs in a patient with aggressive giant prolactinoma resistant to conventional treatment.
Collapse
Affiliation(s)
- S Baldari
- Department of Radiological Sciences, Unit of Nuclear Medicine, University of Messina, Messina, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
133
|
Amato E, Minutoli F, Pacilio M, Campennì A, Baldari S. An analytical method for computing voxel S values for electrons and photons. Med Phys 2012; 39:6808-17. [DOI: 10.1118/1.4757912] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
134
|
Campennì A, Ruggeri RM, Sindoni A, Giovinazzo S, Calbo L, Ieni A, Monaco M, Tuccari G, Benvenga S, Baldari S. Parathyroid carcinoma as a challenging diagnosis: report of three cases. Hormones (Athens) 2012; 11:368-76. [PMID: 22908071 DOI: 10.14310/horm.2002.1367] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Parathyroid carcinoma (PC) is a rare malignancy with an indolent but progressive course. This rare tumour is often difficult to diagnose preoperatively, thus limiting the efficacy of surgery. As long-term survival is largely dependent on the extent of the primary surgical resection, it is of great importance to consider PC in the differential diagnosis of hyperparathyroidism. We herein report three PC patients with different clinical histories who were followed up at our hospital for over a 5-year period, emphasizing the variability in clinical presentation of this rare tumour. Moreover, NORA (Nucleolar Organizer Regions, a standardised silver-stain, marker of proliferation rate) values encountered in these PC patients confirm that AgNOR analysis may be regarded as an additional tool when the pathologist encounters difficulties in defining parathyroid lesions which are not clearly benign.
Collapse
Affiliation(s)
- Alfredo Campennì
- Department of Radiological Sciences, Nuclear Medicine Unit, University of Messina, Messina, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
135
|
Minutoli F, Herberg A, Sindoni A, Cardile D, Cucinotta M, Baldari S. A potentially misleading finding at somatostatin receptor scintigraphy: focal pulmonary areas of intense accumulation without computed tomography-detectable lung lesions. J Endocrinol Invest 2012; 35:708-9. [PMID: 22932274 DOI: 10.1007/bf03345801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
136
|
Campennì A, Ruggeri RM, Sindoni A, Giovinazzo S, Calbo E, Ieni A, Calbo L, Tuccari G, Baldari S, Benvenga S. Parathyroid carcinoma presenting as normocalcemic hyperparathyroidism. J Bone Miner Metab 2012; 30:367-72. [PMID: 22246083 DOI: 10.1007/s00774-011-0344-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 12/11/2011] [Indexed: 02/04/2023]
Abstract
Parathyroid carcinoma (PC) is a rare malignancy, with an indolent but progressive course. Long-term survival is largely dependent on the extent of the primary surgical resection. Hence, pre- or intraoperative suspicion of malignancy is of great importance. We describe the case of a 62-year-old woman with a 2-year history of asthenia and mental depression. Her past medical history was significant for osteoporosis. A diagnosis of primary normocalcemic hyperparathyroidism was established and the patient underwent surgery. PC was suspected intraoperatively because of the size and appearance of the parathyroid mass (a grayish, lobulated 3.5 cm mass). Thus, aggressive surgery (en bloc resection) was performed, along with bilateral neck exploration. Pathological examination of the specimens confirmed the suspicion of PC, demonstrating vascular invasion and extracapsular infiltration into adjacent soft tissue. Immunohistochemical staining revealed an elevated Ki-67 score (8.43%; cut-off value 5%). The mean area of silver-stained nucleolar organizer regions (AgNOR) was high (4.972 μm(2)), indicating an elevated proliferation rate. Serum calcium and parathyroid hormone levels normalized postoperatively, and the patient's 5-year outcome was good. The present case provides evidence that parathyroid malignancy cannot be excluded a priori based on normocalcemic hyperparathyroidism, emphasizing the variability in clinical presentation. Moreover, Ki-67 expression and AgNOR analysis confirmed their additional value in complementing the histological evaluation of a parathyroid malignant mass.
Collapse
Affiliation(s)
- Alfredo Campennì
- Unità di Medicina Nucleare, Dipartimento di Scienze Radiologiche, Padiglione E, piano terra, Policlinico Universitario G. Martino, University of Messina, v. Consolare Valeria, 98125, Messina, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
137
|
Fasano A, Baldari S, Di Giuda D, Paratore R, Piano C, Bentivoglio AR, Girlanda P, Morgante F. Nigro-striatal involvement in primary progressive freezing gait: insights into a heterogeneous pathogenesis. Parkinsonism Relat Disord 2012; 18:578-84. [PMID: 22459564 DOI: 10.1016/j.parkreldis.2012.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 02/10/2012] [Accepted: 03/03/2012] [Indexed: 12/11/2022]
Abstract
Primary progressive freezing gait (PPFG) is a clinical syndrome underlain by diverse neurodegenerative diseases and characterized by early occurrence of gait freezing. Either degeneration or integrity of the nigrostriatal terminals have been found by SPECT and PET studies. In this retrospective study, we evaluated (123)I-FP-CIT SPECT findings in a consecutive series of 13 PPFG patients with detailed clinical evaluation over time (mean follow-up duration: 3.1 ± 1.2 years). In all patients, (123)I-FP-CIT SPECT has been performed at the time of first clinical evaluation (1.7 ± 1.4 years after disease onset) and was compared with data from 23 age- and sex-matched healthy subjects. PPFG patients were categorized as having abnormal (n = 8) or normal (n = 5) SPECT. At disease onset, PPFG with abnormal SPECT had more frequent hypophonia, higher UPDRS-III scores and partial levodopa responsiveness. By contrast, PPFG with normal SPECT had more frequent bilateral plantar responses and no response to levodopa. At latest follow-up, initial diagnosis in the abnormal SPECT group was revised (n = 5) to progressive supranuclear palsy (n = 4) and pure akinesia with gait freezing (n = 1). Among the five patients with normal SPECT, follow-up evaluation disclosed corticobasal syndrome (n = 2) and primary lateral sclerosis (n = 1). Dopamine transporter imaging can capture the clinical heterogeneity of PPFG and might have a value to predict possible disease progression.
Collapse
|
138
|
Arena S, Magno C, Montalto AS, Russo T, Mami C, Baldari S, Romeo C, Arena F. Long-term follow-up of neonatally diagnosed primary megaureter: Rate and predictors of spontaneous resolution. ACTA ACUST UNITED AC 2012; 46:201-7. [DOI: 10.3109/00365599.2012.662695] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Salvatore Arena
- Department of Urology
- Department of Medical and Surgical Pediatric Sciences, Unit of Pediatric Surgery
| | | | | | - Tiziana Russo
- Department of Medical and Surgical Pediatric Sciences, Unit of Pediatric Surgery
| | - Carmelo Mami
- Department of Medical and Surgical Pediatric Sciences, Unit of Neonatology
| | - Sergio Baldari
- Department of Radiological Sciences, Section of Nuclear Medicine, University of Messina,
Messina, Italy
| | - Carmelo Romeo
- Department of Medical and Surgical Pediatric Sciences, Unit of Pediatric Surgery
| | - Francesco Arena
- Department of Medical and Surgical Pediatric Sciences, Unit of Pediatric Surgery
| |
Collapse
|
139
|
Baldari S, Sturniolo G, Violi MA, Moleti M, Campennì A, Calbo E, Presti S, Blandino A, Trimarchi F, Vermiglio F. Meningocele due to closed spina bifida mimicking a metastasis of papillary thyroid carcinoma on whole body radioactive iodine scan. Thyroid 2011; 21:1401-2. [PMID: 22066481 DOI: 10.1089/thy.2011.0212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
140
|
Acampa W, Petretta M, Evangelista L, Daniele S, Xhoxhi E, De Rimini ML, Cittanti C, Marranzano F, Spadafora M, Baldari S, Mansi L, Cuocolo A. Myocardial perfusion imaging and risk classification for coronary heart disease in diabetic patients. The IDIS study: a prospective, multicentre trial. Eur J Nucl Med Mol Imaging 2011; 39:387-95. [PMID: 22109666 DOI: 10.1007/s00259-011-1983-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 10/21/2011] [Indexed: 10/15/2022]
Abstract
PURPOSE To determine whether stress-rest myocardial perfusion single-photon emission (MPS) computed tomography improves coronary heart disease (CHD) risk classification in diabetic patients. METHODS In 822 consecutive diabetic patients, risk estimates for a CHD event were categorized as 0% to <3%, 3% to <5%, and ≥5% per year using Cox proportional hazards models. Model 1 used traditional CHD risk factors and electrocardiography (ECG) stress test data and model 2 used these variables plus MPS imaging data. We calculated the net reclassification improvement (NRI) and compared the distribution of risk using model 2 vs. model 1. CHD death, myocardial infarction and unstable angina requiring coronary revascularization were the outcome measures. RESULTS During follow-up (58 ± 11 months), 148 events occurred. Model 2 improved risk prediction compared to model 1 (NRI 0.25, 95% confidence interval, CI, 0.15-0.34; p < 0.001). Overall, 301 patients were reclassified to a higher risk category, with an event rate of 28%, and 26 to a lower risk category, with an event rate of 15%. Among patients at 3% to <5% risk, 53% were reclassified at higher risk and 25% at lower risk (NRI 0.42, 95% CI 0.07-0.76; p < 0.05). The cost per NRI was $880.80 for MPS imaging as compared to an outpatient visit with an ECG stress test. CONCLUSION The addition of MPS imaging data to a prediction model based on traditional risk factors and ECG stress test data significantly improved CHD risk classification in patients with diabetes.
Collapse
Affiliation(s)
- Wanda Acampa
- Department of Biomorphological and Functional Sciences, University Federico II, Napoli, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
141
|
Ruggeri RM, Campennì A, Sindoni A, Baldari S, Trimarchi F, Benvenga S. Association of autonomously functioning thyroid nodules with Hashimoto's thyroiditis: study on a large series of patients. Exp Clin Endocrinol Diabetes 2011; 119:621-7. [PMID: 22068555 DOI: 10.1055/s-0031-1279705] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Autonomously functioning thyroid nodules (AFTNs) associated with Hashimoto's thyroiditis (HT) are rarely reported. This study evaluates the magnitude of such association, elaborating the clinical and biochemical characteristics of HT and AFTN. MATERIALS AND METHODS We reviewed the records of our patients with thyroid nodules, including serum TSH, free T4 and T3, Tg-Ab, TPO-Ab, ultrasonography, Tc-99m Sodium Pertechnetate scintigraphy (performed in overt or subclinical hyperthyroid patients). HT patients with coexisting AFTN(s) (group A) were compared with patients with AFTNs alone (group B, n=267). RESULTS 80 patients (65 women and 15 men; F:M ratio 4.3:1; age 57±15 years) had AFTN(s) and coexisting HT. Except 9 patients who were under methimazole, all had suppressed (<0.01 mU/L) or low (<0.4 mU/L) TSH; 17/71 (24%) had increased FT4 and/or FT3. Subclinical hyperthyroidism prevailed over frank hyperthyroidism in group A (76 vs. 24%), but not in group B (56 vs. 44%) ( P=0.005). Group A patients had lower serum FT3 (∼0.6 pmol/L or 9%) and FT4 (∼0.9 pmol/L or 4%) as compared to group B. The maximum diameter of the AFTN(s) was 8% smaller in group A as compared with group B, thus matching the said difference in FT3. A positive correlation between nodule size and age was found only in group B ( P=0.015). CONCLUSION Even if difference in the size of nodules between groups A and B does not reach statistical significance, the chronic intrathyroid lymphocytic infiltration of HT may decrease the tendency of the AFTNs to grow and diminish their degree of functioning.
Collapse
Affiliation(s)
- R M Ruggeri
- Dipartimento Clinico-Sperimentale di Medicina e Farmacologia, Sezione di Endocrinologia, Policlinico Universitario G. Martino, 98125 Messina, Italy.
| | | | | | | | | | | |
Collapse
|
142
|
Amato E, Lizio D, Ruggeri RM, Raniolo M, Campennì A, Baldari S. An analytical model for improving absorbed dose calculation accuracy in non spherical autonomous functioning thyroid nodule. Q J Nucl Med Mol Imaging 2011; 55:560-566. [PMID: 21242948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM Patients candidate to radioiodine treatment of autonomous functioning thyroid nodule (AFTN) are characterized by a wide range of nodule volumes with different shapes. To optimize the treatment, pretherapeutic dosimetry should account also for the dependence of deposited energy on the nodule geometry. METHODS We developed a Monte Carlo code in Geant4 to simulate the interaction of beta and gamma radiations emitted by Na-131I into ellipsoidal volumes of soft tissue homogeneously uptaking the radionuclide, surrounded by a simplified antropomorphic phantom. We simulated 9 volumes between 0.1 and 50 cm3, each one with 8 different ellipsoidal shapes. We considered the data of 10 patients affected by AFTN, whose nodule volumes were in the range 1-40 cm3, who underwent radioiodine therapy following the traditional dosimetric approach. The patients underwent ultrasonographic (US) study, in order to determine the nodule volume, and radioiodine thyroid uptake measurements between 3 and 168 hours after radioiodine tracer dose administration. RESULTS We found an analytical relationship between the average deposited energy and the ellipsoid's semiaxes and we included it in the formula for the calculation of activity to be administered, A0. For the 10 patients studied, A0 calculated with our approach ranges from +9% to -2% with respect to the one calculated with the traditional formula. CONCLUSION The proposed model, accounting for the dependence of beta and gamma absorbed fractions from nodule volume and shape, can lead to a more accurate estimation of A0 during AFTN therapy. Since the measurement of nodule axes is routinely obtained from pretherapeutic US, our approach can be introduced in the clinical practice without changing the diagnostic pre-therapeutic protocol.
Collapse
Affiliation(s)
- E Amato
- Department of Radiological Sciences, University of Messina, Messina, Italy.
| | | | | | | | | | | |
Collapse
|
143
|
Di Bella G, Minutoli F, Pingitore A, Zito C, Mazzeo A, Aquaro GD, Di Leo R, Recupero A, Stancanelli C, Baldari S, Vita G, Carerj S. Endocardial and epicardial deformations in cardiac amyloidosis and hypertrophic cardiomyopathy. Circ J 2011; 75:1200-8. [PMID: 21427499 DOI: 10.1253/circj.cj-10-0844] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of the present study was to analyze epicardial (EPI) and endocardial (ENDO) strain (S) in patients with transthyretin-related cardiac amyloidosis (TTR-CA) and hypertrophic cardiomyopathy (HCM) using echocardiography (TTE) with 2-dimensional feature tracking imaging (FTI). METHODS AND RESULTS Thirty-three subjects (11 with HCM, 11 with TTR-CA, and 11 healthy subjects as controls) with a New York Heart Association functional class ≤ II underwent conventional TTE and FTI. TTE was used for the evaluation of left ventricle (LV) wall thickness, mass, systolic and diastolic function. FTI was used for the evaluation of EPI and ENDO longitudinal, and circumferential, and radial S. LV wall thickness and mass were higher in both TTR-CA and HCM in comparison with controls (P < 0.001), but ejection fraction (EF) was similar among patients with TTR-CA, HCM and controls (63 ± 6%, 64 ± 6%, 61 ± 5%, respectively). ENDO and EPI longitudinal and circumferential S and radial S were significantly lower in HCM and TTR-CA when compared with controls (P < 0.01). No differences in EPI and ENDO longitudinal S, ENDO circumferential S and radial S were found between TTR-CA and HCM groups, while EPI circumferential S was significantly lower in the TTRCA group (6 ± 3.3%) than in the HCM group (8.1 ± 4.3%; P < 0.0001). CONCLUSIONS Longitudinal, circumferential and radial LV deformations are impaired in patients with TTR-CA and HCM with a preserved EF. Impairment of EPI circumferential strain is greater in TTR-CA than in HCM.
Collapse
Affiliation(s)
- Gianluca Di Bella
- Clinical and Experimental Department of Medicine and Pharmacology, University of Messina, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
144
|
|
145
|
Ruggeri RM, Calamoneri E, Russo A, Sindoni A, Mondello B, Monaco M, Rosa MA, Baldari S, Benvenga S, Campennì A, Trimarchi F. Supra-acetabular brown tumor due to primary hyperparathyroidism associated with chronic renal failure. ScientificWorldJournal 2010; 10:799-805. [PMID: 20454761 PMCID: PMC5763777 DOI: 10.1100/tsw.2010.86] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 63-year-old woman presented to the Orthopedic Unit of our hospital complaining of right hip pain of 6 months' duration associated with a worsening limp. Her past medical history included chronic renal insufficiency. Physical examination revealed deep pain in the iliac region and severe restriction of the right hip's articular function in the maximum degrees of range of motion. X-rays and CT scan detected an osteolytic and expansive lesion of the right supra-acetabular region with structural reabsorption of the right iliac wing. 99mTc-MDP whole-body bone scan showed an abnormal uptake in the right iliac region. Bone biopsy revealed an osteolytic lesion with multinucleated giant cells, indicating a brown tumor. Serum intact PTH was elevated (1020 pg/ml; normal values, 12-62 pg/ml), but her serum calcium was normal (total=9.4 mg/dl, nv 8.5-10.5; ionized=5.0 mg/dl, nv 4.2-5.4) due to the coexistence of chronic renal failure. 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration. After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml. Three months after parathyroidectomy, the imaging studies showed complete recovery of the osteolytic lesion, thus avoiding any orthopedic surgery. This case is noteworthy because (1) primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2) it was associated with a brown tumor of unusual location (right supra-acetabular region).
Collapse
Affiliation(s)
- Rosaria M Ruggeri
- Department of Clinical Experimental Medicine and Pharmacology, University of Messina, Messina, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
146
|
Calbo L, Gorgone S, Palmieri R, Lazzara S, Sciglitano P, Catalfamo A, Calbo E, Campennì A, Ruggeri M, Vermiglio F, Baldari S. [Radio-guided parathyroidectomy]. G Chir 2009; 30:510-513. [PMID: 20109383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The Authors, after a careful review of literature about the instrumental diagnostic techniques (with particular attention to the nuclear-medical ones) and the surgical therapy of parathyroid diseases, report their experience on the use of the radio-guided mininvasive surgery with MIBI and gamma-probe for intraoperative localization of pathological glands. Once exposed their experience, the Authors conclude asserting that this technique is fast, slightly invasive and expensive, and certainly useful for the detection of pathological or ectopic glands. It can be widely employed because, in comparison to its numerous advantages, such as the reduction of the operating time and of the hospital-stay, the greater radicality and the possibility to use mininvasive techniques, it does not present significant technical limitations and/or radio-protectionistic problems.
Collapse
Affiliation(s)
- L Calbo
- Università degli Studi di Messina, Facoltà di Medicina e Chirurgia, Cattedra di Chirurgia Generale
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
147
|
|
148
|
Migliorato A, Andò G, Micari A, Baldari S, Arrigo F. Coronary–subclavian steal phenomenon late after coronary artery bypass grafting: an underappreciated cause of myocardial ischemia? J Cardiovasc Med (Hagerstown) 2009; 10:578-80. [DOI: 10.2459/jcm.0b013e32832c1f83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
149
|
Amato E, Lizio D, Baldari S. Absorbed fractions in ellipsoidal volumes for β−radionuclides employed in internal radiotherapy. Phys Med Biol 2009; 54:4171-80. [DOI: 10.1088/0031-9155/54/13/013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
150
|
Ruggeri RM, Ferraù F, Campennì A, Simone A, Barresi V, Giuffrè G, Tuccari G, Baldari S, Trimarchi F. Immunohistochemical localization and functional characterization of somatostatin receptor subtypes in a corticotropin releasing hormone-secreting adrenal phaeochromocytoma: review of the literature and report of a case. Eur J Histochem 2009; 53:e1. [PMID: 30256857 PMCID: PMC3167276 DOI: 10.4081/ejh.2009.e1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2008] [Indexed: 11/25/2022] Open
Abstract
Somastostatin receptors are frequently expressed in phaeochromocytoma but data on somatostatin receptor subtyping are scanty and the functional response to the somatostatin analogue octretide is still debated.We report an unusual case of pheochromocytoma, causing ectopic Cushing’s syndrome due to CRH production by the tumour cells, in a 50-yr-old woman. Abdominal computed tomography revealed an inhomogeneous, 9-cm mass in the right adrenal gland, and [111In-DTPA0] octreotide scintigraphy showed an abnormal uptake of the radiotracer in the right perirenal region, corresponding to the adrenal mass. The patient underwent laparoscopic surgery and formalin-fixed and paraffin-embedded samples were studied. The tumour was extensively characterized by immunohistochemistry and somatostatin receptor (SSTRs) subtypes expression was analyzed. Histological and immunohistochemical examination of the surgical specimens displayed a typical pheochromocytoma, which was found to be immunoreative to S-100, chromogranin A and neurofilaments. Immunostaining for SSTR subtypes showed a positive reaction for SSTR1, SSTR2A, SSTR2B, antisera on tumour cells. The intense and diffuse immunostaining for corticotropin releasing hormone (CRH) antiserum indicated that Cushing’s disease was dependent on CRH overproduction by the pheochromocytoma, in which no immunostaining for adrenocorticotropic hormone was found. Our report confirms the heterogeneity of the pattern of SSTR expression in pheochromocytomas, and provide further evidence for functional SSTR subtype SSTR2a in a subgroup of pheochromocytomas, suggesting that these tumours may represent potential target for octreotide treatment.
Collapse
Affiliation(s)
- R M Ruggeri
- Department of Medicine and Pharmacology, Section of Endocrinology
| | - F Ferraù
- Department of Medicine and Pharmacology, Section of Endocrinology
| | - A Campennì
- Department of Radiology, Section of Nuclear Medicine
| | - A Simone
- Department of Pathology, University of Messina, Messina, Italy
| | - V Barresi
- Department of Pathology, University of Messina, Messina, Italy
| | - G Giuffrè
- Department of Pathology, University of Messina, Messina, Italy
| | - G Tuccari
- Department of Pathology, University of Messina, Messina, Italy
| | - S Baldari
- Department of Radiology, Section of Nuclear Medicine
| | - F Trimarchi
- Department of Medicine and Pharmacology, Section of Endocrinology
| |
Collapse
|