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Reimer P, Vilgrain V, Arnold D, Balli T, Golfieri R, Loffroy R, Mosconi C, Ronot M, Sengel C, Schaefer N, Maleux G, Munneke G, Peynircioglu B, Sangro B, Kaufmann N, Urdaniz M, Pereira H, de Jong N, Helmberger T. Factors Impacting Survival After Transarterial Radioembolization in Patients with Unresectable Intrahepatic Cholangiocarcinoma: A Combined Analysis of the Prospective CIRT Studies. Cardiovasc Intervent Radiol 2024; 47:310-324. [PMID: 38321223 PMCID: PMC10920466 DOI: 10.1007/s00270-023-03657-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/27/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE Transarterial radioembolization (TARE) with Yttrium-90 resin microspheres is a treatment option for patients with intrahepatic cholangiocarcinoma (ICC). However, optimising the timing of TARE in relation to systemic therapies and patient selection remains challenging. We report here on the effectiveness, safety, and prognostic factors associated with TARE for ICC in a combined analysis of the prospective observational CIRT studies (NCT02305459 and NCT03256994). METHODS A combined analysis of 174 unresectable ICC patients enrolled between 2015 and 2020 was performed. Patient characteristics and treatment-related data were collected at baseline; adverse events and time-to-event data (overall survival [OS], progression-free survival [PFS] and hepatic PFS) were collected at every follow-up visit. Log-rank tests and a multivariable Cox proportional hazard model were used to identify prognostic factors. RESULTS Patients receiving a first-line strategy of TARE in addition to any systemic treatment had a median OS and PFS of 32.5 months and 11.3 months. Patients selected for first-line TARE alone showed a median OS and PFS of 16.2 months and 7.4 months, whereas TARE as 2nd or further treatment-line resulted in a median OS and PFS of 12 and 9.3 months (p = 0.0028), and 5.1 and 3.5 months (p = 0.0012), respectively. Partition model dosimetry was an independent predictor for better OS (HR 0.59 [95% CI 0.37-0.94], p = 0.0259). No extrahepatic disease, no ascites, and < 6.1 months from diagnosis to treatment were independent predictors for longer PFS. CONCLUSION This combined analysis indicates that in unresectable ICC, TARE in combination with any systemic treatment is a promising treatment option. LEVEL OF EVIDENCE level 3, Prospective observational.
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Affiliation(s)
- Peter Reimer
- Städtisches Klinikum Karlsruhe, Institute for Diagnostic and Interventional Radiology, Academic Teaching Hospital the University of Freiburg, Moltkestraße 90, 76133, Karlsruhe, Germany
| | - Valérie Vilgrain
- Université Paris Cité, CRI, INSERM, 1149, Paris, France
- Department of Radiology, Hôpital Beaujon APHP Nord, Clichy, France
| | - Dirk Arnold
- Oncology and Hematology, Asklepios Tumorzentrum Hamburg, AK Altona, Paul-Ehrlich-Str. 1, 22763, Hamburg, Germany
| | - Tugsan Balli
- Radiology Department, Çukurova University, Balcalı Hospital, 01330, Adana, Turkey
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, CHU Dijon Bourgogne, François-Mitterrand University Hospital, 14 Rue Gaffarel, 21000, Dijon, France
| | - Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Maxime Ronot
- Université Paris Cité, CRI, INSERM, 1149, Paris, France
- Department of Radiology, Hôpital Beaujon APHP Nord, Clichy, France
| | - Christian Sengel
- Interventional Radiology, Centre Hospitalier Universitaire de Grenoble, Boulevard de La Chantourne, 38100, Grenoble, France
| | - Niklaus Schaefer
- Service de Médecine Nucléaire Et Imagerie Moléculaire, CHUV, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Geert Maleux
- Radiology, Universitair Ziekenhuis Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Graham Munneke
- Interventional Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, UK
| | - Bora Peynircioglu
- Department of Radiology, School of Medicine, Hacettepe University, Sihhiye Campus, 06100, Ankara, Turkey
| | - Bruno Sangro
- Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and CIBEREHD, Avda. Pio XII 36, 31008, Pamplona, Spain
| | - Nathalie Kaufmann
- Clinical Research Department, Cardiovascular and Interventional Radiological Society of Europe, Neutorgasse 9, 1010, Vienna, Austria
| | - Maria Urdaniz
- Clinical Research Department, Cardiovascular and Interventional Radiological Society of Europe, Neutorgasse 9, 1010, Vienna, Austria
| | - Helena Pereira
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Unité de Recherche Clinique, Paris, France
- INSERM, Centre d'Investigation Clinique 1418 (CIC1418), Paris, France
| | - Niels de Jong
- Clinical Research Department, Cardiovascular and Interventional Radiological Society of Europe, Neutorgasse 9, 1010, Vienna, Austria.
| | - Thomas Helmberger
- Department of Radiology, Neuroradiology and Minimal-Invasive Therapy, Klinikum Bogenhausen, Englschalkinger Str. 77, 81925, Munich, Germany
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Cabibbo G, Daniele B, Borzio M, Casadei-Gardini A, Cillo U, Colli A, Conforti M, Dadduzio V, Dionisi F, Farinati F, Gardini I, Giannini EG, Golfieri R, Guido M, Mega A, Cinquini M, Piscaglia F, Rimassa L, Romanini L, Pecorelli A, Sacco R, Scorsetti M, Viganò L, Vitale A, Trevisani F. Multidisciplinary treatment of hepatocellular carcinoma in 2023: Italian practice Treatment Guidelines of the Italian Association for the Study of the Liver (AISF), Italian Association of Medical Oncology (AIOM), Italian Association of Hepato-Bilio-Pancreatic Surgery (AICEP), Italian Association of Hospital Gastroenterologists (AIGO), Italian Association of Radiology and Clinical Oncology (AIRO), Italian Society of Pathological Anatomy and Diagnostic Cytology (SIAPeC-IAP), Italian Society of Surgery (SIC), Italian Society of Gastroenterology (SIGE), Italian Society of Medical and Interventional Radiology (SIRM), Italian Organ Transplant Society (SITO), and Association of Patients with Hepatitis and Liver Disease (EpaC) - Part II - Non-surgical treatments. Dig Liver Dis 2024; 56:394-405. [PMID: 38052656 DOI: 10.1016/j.dld.2023.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/12/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 12/07/2023]
Abstract
Worldwide, hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death. The remarkable improvements in treating HCC achieved in the last years have increased the complexity of its management. Following the need to have updated guidelines on the multidisciplinary treatment management of HCC, the Italian Scientific Societies involved in the management of this cancer have promoted the drafting of a new dedicated document. This document was drawn up according to the GRADE methodology needed to produce guidelines based on evidence. Here is presented the second part of guidelines, focused on the multidisciplinary tumor board of experts and non-surgical treatments of HCC.
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Affiliation(s)
- Giuseppe Cabibbo
- Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties PROMISE, University of Palermo, Gastroenterology Unit, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo, Italy.
| | - Bruno Daniele
- Oncology Unit, Ospedale del Mare, ASL Napoli 1 Centro, Napoli, Italy
| | - Mauro Borzio
- Centro Diagnostico Italiano (CDI), Milano, Italy
| | - Andrea Casadei-Gardini
- Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - Umberto Cillo
- General Surgery 2-Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, Padua University Hospital, 35128 Padua, Italy
| | - Agostino Colli
- Dipartimento di Medicina Trasfusionale ed Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Vincenzo Dadduzio
- Medical Oncology Unit, "Mons. A.R.Dimiccoli" Hospital, Barletta, ASL BT, Italy
| | - Francesco Dionisi
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute - Rome, Italy
| | - Fabio Farinati
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, 35128 Padova, Italy
| | - Ivan Gardini
- EpaC Onlus, Italian Liver Patient Association, Turin, Italy
| | - Edoardo Giovanni Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Rita Golfieri
- Alma Mater Studiorum" Bologna University, Bologna, Italy; Radiology Unit Madre Fortunata Toniolo Private Hospital, coordinator of Radiology centers Medipass Bologna, Bologna, Italy
| | - Maria Guido
- Department of Medicine, University of Padova, Padova - Italy
| | - Andrea Mega
- Department of Gastronterology, Regional Hospital Bolzano, Italy
| | - Michela Cinquini
- Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milano, Italy
| | - Fabio Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Lorenza Rimassa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy; Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Laura Romanini
- Radiology Unit, Ospedale di Cremona, ASST Cremona, Cremona, Italy
| | - Anna Pecorelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Rodolfo Sacco
- Gastroenterology and Endoscopy Unit, Department of Surgical and Medical Sciences, University of Foggia, 71100 Foggia, Italy
| | - Marta Scorsetti
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; Department of Radiotherapy and Radiosurgery, Humanitas Research Hospital IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Luca Viganò
- Hepatobiliary Unit, Department of Minimally Invasive General & Oncologic Surgery, Humanitas Gavazzeni University Hospital, Viale M. Gavazzeni 21, 24125 Bergamo, Italy; Department of Biomedical Sciences, Humanitas University, Viale Rita Levi Montalcini 4, 20090 Milan, Italy
| | - Alessandro Vitale
- General Surgery 2-Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, Padua University Hospital, 35128 Padua, Italy
| | - Franco Trevisani
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
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Mottola M, Golfieri R, Bevilacqua A. The Effectiveness of an Adaptive Method to Analyse the Transition between Tumour and Peritumour for Answering Two Clinical Questions in Cancer Imaging. Sensors (Basel) 2024; 24:1156. [PMID: 38400314 PMCID: PMC10893370 DOI: 10.3390/s24041156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
Based on the well-known role of peritumour characterization in cancer imaging to improve the early diagnosis and timeliness of clinical decisions, this study innovated a state-of-the-art approach for peritumour analysis, mainly relying on extending tumour segmentation by a predefined fixed size. We present a novel, adaptive method to investigate the zone of transition, bestriding tumour and peritumour, thought of as an annular-like shaped area, and detected by analysing gradient variations along tumour edges. For method validation, we applied it on two datasets (hepatocellular carcinoma and locally advanced rectal cancer) imaged by different modalities and exploited the zone of transition regions as well as the peritumour ones derived by adopting the literature approach for building predictive models. To measure the zone of transition's benefits, we compared the predictivity of models relying on both "standard" and novel peritumour regions. The main comparison metrics were informedness, specificity and sensitivity. As regards hepatocellular carcinoma, having circular and regular shape, all models showed similar performance (informedness = 0.69, sensitivity = 84%, specificity = 85%). As regards locally advanced rectal cancer, with jagged contours, the zone of transition led to the best informedness of 0.68 (sensitivity = 89%, specificity = 79%). The zone of transition advantages include detecting the peritumour adaptively, even when not visually noticeable, and minimizing the risk (higher in the literature approach) of including adjacent diverse structures, which was clearly highlighted during image gradient analysis.
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Affiliation(s)
- Margherita Mottola
- Alma Mater Research Institute on Global Challenges and Climate Change (Alma Climate), University of Bologna, 40126 Bologna, Italy;
| | - Rita Golfieri
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy;
| | - Alessandro Bevilacqua
- Department of Computer Science and Engineering (DISI), University of Bologna, 40126 Bologna, Italy
- Advanced Research Center on Electronic Systems (ARCES), University of Bologna, 40125 Bologna, Italy
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4
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Cabibbo G, Daniele B, Borzio M, Casadei-Gardini A, Cillo U, Colli A, Conforti M, Dadduzio V, Dionisi F, Farinati F, Gardini I, Giannini EG, Golfieri R, Guido M, Mega A, Minozzi S, Piscaglia F, Rimassa L, Romanini L, Pecorelli A, Sacco R, Scorsetti M, Viganò L, Vitale A, Trevisani F. Multidisciplinary Treatment of Hepatocellular Carcinoma in 2023: Italian practice Treatment Guidelines of the Italian Association for the Study of the Liver (AISF), Italian Association of Medical Oncology (AIOM), Italian Association of Hepato-Bilio-Pancreatic Surgery (AICEP), Italian Association of Hospital Gastroenterologists (AIGO), Italian Association of Radiology and Clinical Oncology (AIRO), Italian Society of Pathological Anatomy and Diagnostic Cytology (SIAPeC-IAP), Italian Society of Surgery (SIC), Italian Society of Gastroenterology (SIGE), Italian Society of Medical and Interventional Radiology (SIRM), Italian Organ Transplant Society (SITO), and Association of Patients with Hepatitis and Liver Disease (EpaC) - Part I - Surgical treatments. Dig Liver Dis 2024; 56:223-234. [PMID: 38030455 DOI: 10.1016/j.dld.2023.10.029] [Citation(s) in RCA: 1] [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: 06/20/2023] [Revised: 10/07/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
Worldwide, hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death. The remarkable improvements in treating HCC achieved in the last years have increased the complexity of HCC management. Following the need to have updated guidelines on the multidisciplinary treatment management of HCC, the Italian Scientific Societies involved in the management of this cancer have promoted the drafting of a new dedicated document. This document was drawn up according to the GRADE methodology needed to produce guidelines based on evidence. Here is presented the first part of guidelines, focused on the multidisciplinary tumor board of experts and surgical treatments of HCC.
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Affiliation(s)
- Giuseppe Cabibbo
- Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties PROMISE, University of Palermo, Italy; Gastroenterology Unit, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone", Palermo, Italy.
| | - Bruno Daniele
- Oncology Unit, Ospedale del Mare, ASL Napoli 1 Centro, Napoli, Italy
| | - Mauro Borzio
- Centro Diagnostico Italiano (CDI), Milano, Italy
| | - Andrea Casadei-Gardini
- Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - Umberto Cillo
- General Surgery 2-Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, Padua University Hospital, 35128 Padua, Italy
| | - Agostino Colli
- Dipartimento di Medicina Trasfusionale ed Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Vincenzo Dadduzio
- Medical Oncology Unit, "Mons. A.R.Dimiccoli" Hospital, Barletta, ASL BT, Italy
| | - Francesco Dionisi
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute - Rome, Italy
| | - Fabio Farinati
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, 35128 Padova, Italy
| | - Ivan Gardini
- EpaC Onlus, Italian Liver Patient Association, Turin, Italy
| | - Edoardo Giovanni Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Rita Golfieri
- Alma Mater Studiorum" Bologna University, Bologna, Italy; Radiology Unit Madre Fortunata Toniolo Private Hospital, coordinator of Radiology centers Medipass Bologna, Bologna, Italy
| | - Maria Guido
- Department of Medicine, University of Padova, Padova- Italy
| | - Andrea Mega
- Department of Gastronterology, Regional Hospital Bolzano, Italy
| | - Silvia Minozzi
- Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milano, Italy
| | - Fabio Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Lorenza Rimassa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy; Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Laura Romanini
- Radiology Unit, Ospedale di Cremona, ASST Cremona, Cremona, Italy
| | - Anna Pecorelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Rodolfo Sacco
- Gastroenterology and Endoscopy Unit, Department of Surgical and Medical Sciences, University of Foggia, 71100 Foggia, Italy
| | - Marta Scorsetti
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; Department of Radiotherapy and Radiosurgery, Humanitas Research Hospital IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Luca Viganò
- Hepatobiliary Unit, Department of Minimally Invasive General & Oncologic Surgery, Humanitas Gavazzeni University Hospital, Viale M. Gavazzeni 21, 24125 Bergamo, Italy; Department of Biomedical Sciences, Humanitas University, Viale Rita Levi Montalcini 4, 20090 Milan, Italy
| | - Alessandro Vitale
- General Surgery 2-Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, Padua University Hospital, 35128 Padua, Italy
| | - Franco Trevisani
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
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Cacioppa LM, De Cinque A, Cocozza MA, Galaverni MC, Scrivo A, La Manna G, Ierardi AM, Renzulli M, Golfieri R. An unusual spontaneous recanalization by multiple palmar arteriovenous connections of a chronically occluded radiocephalic hemodialysis fistula. J Vasc Access 2024; 25:344-347. [PMID: 35996311 PMCID: PMC10845811 DOI: 10.1177/11297298221119590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/25/2022] [Indexed: 11/15/2022] Open
Abstract
Preservation of a vascular access is crucial in the management of hemodialysis patients. In this regard, percutaneous transluminal angioplasty (PTA) is an effective tool if performed after an adequate understanding of preliminary fistulograms. The present case showed a chronic dysfunction of a radial-cephalic arteriovenous fistula (AVF) due to arterial occlusion and partially relieved by the spontaneous development of multiple small arteriovenous connections in the palmar region of the hand. This dense network had been so far able to ensure a sufficient retrograde blood flow for an effective hemodialytic performance. The angioplasty of the post-anastomotic stenotic segment of the radial artery was effective in restoring this neoformed AVF patency.
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Affiliation(s)
- Laura Maria Cacioppa
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio De Cinque
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maria Adriana Cocozza
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maria Cristina Galaverni
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Anna Scrivo
- Department of Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gaetano La Manna
- Department of Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Anna Maria Ierardi
- Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Renzulli
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Rita Golfieri
- Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Dajti E, Renzulli M, Ravaioli F, Marasco G, Vara G, Brandi N, Rossini B, Colecchia L, Alemanni LV, Ferrarese A, Vestito A, Tamè M, Azzaroli F, Festi D, Golfieri R, Colecchia A. The interplay between sarcopenia and portal hypertension predicts ascites and mortality in cirrhosis. Dig Liver Dis 2023; 55:637-643. [PMID: 36470723 DOI: 10.1016/j.dld.2022.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/24/2022] [Accepted: 11/12/2022] [Indexed: 04/29/2023]
Abstract
BACKGROUND The role of sarcopenia in predicting decompensation other than hepatic encephalopathy is unclear. We aimed to evaluate the prognostic role of sarcopenia, assessed by computed tomography (CT), in the development of ascites and mortality in patients with advanced chronic liver disease (ACLD) outside the liver transplantation (LT) setting. MATERIAL AND METHODS We retrospectively evaluated ACLD patients with liver stiffness measurement (LSM) >10 kPa and an available CT scan within 6 months. Sarcopenia was defined as skeletal muscle index (SMI) <50 and <39 cm2/m2, respectively, in men and women. Competing risk regression models were used to assess the variables associated with the main outcomes. RESULTS 209 patients were included in the final analysis and sarcopenia was present in 134 (64.1%). During a median follow-up of 37 (20-63) months, 52 patients developed ascites, 24 underwent LT, and 30 died. Sarcopenia was found a predictive factor of decompensation with ascites (SHR 2.083, 95%-CI: 1.091-3.978), independently from the features of clinically significant portal hypertension (LSM≥21 kPa or portosystemic shunts). Sarcopenia (SHR: 2.744, 95%-CI: 1.105-6.816) and LSM≥21 kPa (SHR: 3.973, 95%-CI: 1.548-10.197) were independent risk factors for increased mortality. CONCLUSIONS Sarcopenia and portal hypertension are two major and independent risk factors for decompensation with ascites and mortality in cirrhotic patients outside the LT context.
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Affiliation(s)
- Elton Dajti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
| | - Matteo Renzulli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federico Ravaioli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
| | - Giovanni Marasco
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
| | - Giulio Vara
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Nicolò Brandi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Benedetta Rossini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
| | - Luigi Colecchia
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
| | - Luigina Vanessa Alemanni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
| | - Alberto Ferrarese
- Unit of Gastroenterology, Borgo Trento University Hospital of Verona, Italy
| | - Amanda Vestito
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Mariarosa Tamè
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Azzaroli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
| | - Davide Festi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
| | - Rita Golfieri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Unit of Gastroenterology, Borgo Trento University Hospital of Verona, Italy; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy
| | - Antonio Colecchia
- Unit of Gastroenterology, Borgo Trento University Hospital of Verona, Italy; Division of Gastroenterology, Azienda Ospedaliero-Universitaria di Modena and University of Modena and Reggio Emilia, Modena, Italy.
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7
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Mattana F, Zanoni L, Nanni C, Mosconi C, Brocchi S, Golfieri R, Fanti S. Correction: Actionable imaging findings in the daily PET/CT scenario. Clin Transl Imaging 2023. [DOI: 10.1007/s40336-023-00556-6] [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: 04/05/2023]
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8
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Renzulli M, Brandi N, Brocchi S, Balacchi C, Lanza C, Pettinari I, Stefanini B, Carrafiello G, Piscaglia F, Golfieri R, Marasco G. Association between anatomic variations of extrahepatic and intrahepatic bile ducts: Do look up! J Anat 2023; 242:683-694. [PMID: 36670522 PMCID: PMC10008292 DOI: 10.1111/joa.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 11/14/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 01/22/2023] Open
Abstract
Biliary anatomic variations are usually asymptomatic, but they may cause problems in diagnostic investigations and interventional and surgical procedures, increasing both their technical difficulty and their postoperative complication rates. The aim of the present study was to evaluate the prevalence of anatomic variations in the intrahepatic biliary ducts (IHBD) in relation to demographical and clinical characteristics in a large study population requiring magnetic resonance cholangiopancreatography (MRCP) for various clinical conditions. The possible association between IHBD and extrahepatic biliary ducts (EHBD) variants was then explored. From January 2017 to May 2019, 1004 patients underwent MRCP. Demographical and clinical data were collected. IHBD and EHBD anatomy were recorded and the EHBD anatomy was classified using both qualitative and quantitative classifications. The presence of a type 3 EHBD variant (an abnormal proximal cystic duct [CD] insertion) in both qualitative and quantitative classifications and an intrapancreatic CD were associated with the presence of IHBD variants at univariate analysis (p = 0.008, p = 0.019, and p = 0.001, respectively). The presence of a posterior or medial insertion of the CD into the EHBD was a strong predictive factor of the presence of IHBD variants both at uni- and multivariate analysis (p = 0.002 and p = 0.003 for posterior insertion and p = 0.002 and p = 0.002 for medial insertion, respectively). The presence of gallstones on MRCP resulted in a strong predictor of the presence of an anatomical variant of the IHBD both at uni- and multivariate analysis (p = 0.027 and p = 0.046, respectively). In conclusion, the presence of a type 3 variant of the EHBD, an intrapancreatic CD and, especially, a posterior/medial CD insertion into the EHBD represent predictive factors of the concomitant presence of IHBD variants, thus radiologists must be vigilant when encountering these EHBD configurations and always remember to "look up" at the IHBD. Finally, the presence of an IHBD variant is a strong predictive factor of gallstones.
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Affiliation(s)
- Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Nicolò Brandi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Brocchi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Caterina Balacchi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Carolina Lanza
- Diagnostic and Interventional Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Irene Pettinari
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Bernardo Stefanini
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giampaolo Carrafiello
- Diagnostic and Interventional Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giovanni Marasco
- Internal Medicine and Digestive Physiopathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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9
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Zavatta G, Vicennati V, Altieri P, Tucci L, Colombin G, Coscia K, Mosconi C, Balacchi C, Fanelli F, Malagrinò M, Magagnoli M, Golfieri R, Pagotto U, Di Dalmazi G. Mild autonomous cortisol secretion in adrenal incidentalomas and risk of fragility fractures: a large cross-sectional study. Eur J Endocrinol 2023; 188:343-352. [PMID: 36952249 DOI: 10.1093/ejendo/lvad038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE Mild autonomous cortisol secretion (MACS) has been associated with a higher prevalence of osteoporosis, although most data rely on single-center studies with limited sample size. We aimed to assess the prevalence of fragility fractures and contributing factors in a large cohort of patients with adrenal incidentalomas. DESIGN AND METHODS Medical records of 1023 patients with adrenal incidentalomas from 1990 to 2019 were reviewed, and 735 patients were selected. Clinically-obtained electronic radiological images closest to first endocrine evaluation, such as lateral views of spine X-rays or CT thoraco-abdominal scans, were reviewed to screen for asymptomatic morphometric vertebral fractures. Clinical fragility fractures, hormonal and DXA indices were also recorded. RESULTS 474 patients had non-functioning (NF) adrenal incidentalomas, 238 had MACS and 23 Adrenal Cushing's Syndrome (AC). Prevalence of fragility fractures was different (P = 0.018) between groups, respectively 24.1% (NF), 34.0% (MACS) and 30.4% (AC), with significant difference between NF and MACS (P = 0.012). When analyzed separately by sex and menopausal status, this difference remained significant in post-menopausal women (P = 0.011), with a fracture prevalence of 22.2% (NF), 34.6% (MACS). Fracture prevalence was similar in males. Women with MACS aged ≥65 years reported a 48.8% prevalence of fractures, as compared with 29.5% in NF (P < 0.01). In post-menopausal women, fragility fractures were associated with age (OR 1.1, P < 0.001), smoking (OR 1.8, P = 0.048) and 1mg-DST cortisol (OR 3.1, P = 0.029), while in men, only age was associated with fragility fractures. CONCLUSIONS A considerable fracture burden was shown in post-menopausal women with adrenal incidentalomas and MACS, with clinical implications for the evaluation and management of bone metabolism.
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Affiliation(s)
- Guido Zavatta
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Valentina Vicennati
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Paola Altieri
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Lorenzo Tucci
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giacomo Colombin
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Kimberly Coscia
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Caterina Balacchi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Flaminia Fanelli
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Matteo Malagrinò
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Matteo Magagnoli
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Uberto Pagotto
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Guido Di Dalmazi
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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10
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Carlini G, Gaudiano C, Golfieri R, Curti N, Biondi R, Bianchi L, Schiavina R, Giunchi F, Faggioni L, Giampieri E, Merlotti A, Dall’Olio D, Sala C, Pandolfi S, Remondini D, Rustici A, Pastore LV, Scarpetti L, Bortolani B, Cercenelli L, Brunocilla E, Marcelli E, Coppola F, Castellani G. Effectiveness of Radiomic ZOT Features in the Automated Discrimination of Oncocytoma from Clear Cell Renal Cancer. J Pers Med 2023; 13:jpm13030478. [PMID: 36983660 PMCID: PMC10052019 DOI: 10.3390/jpm13030478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/20/2023] [Accepted: 03/06/2023] [Indexed: 03/09/2023] Open
Abstract
Background: Benign renal tumors, such as renal oncocytoma (RO), can be erroneously diagnosed as malignant renal cell carcinomas (RCC), because of their similar imaging features. Computer-aided systems leveraging radiomic features can be used to better discriminate benign renal tumors from the malignant ones. The purpose of this work was to build a machine learning model to distinguish RO from clear cell RCC (ccRCC). Method: We collected CT images of 77 patients, with 30 cases of RO (39%) and 47 cases of ccRCC (61%). Radiomic features were extracted both from the tumor volumes identified by the clinicians and from the tumor’s zone of transition (ZOT). We used a genetic algorithm to perform feature selection, identifying the most descriptive set of features for the tumor classification. We built a decision tree classifier to distinguish between ROs and ccRCCs. We proposed two versions of the pipeline: in the first one, the feature selection was performed before the splitting of the data, while in the second one, the feature selection was performed after, i.e., on the training data only. We evaluated the efficiency of the two pipelines in cancer classification. Results: The ZOT features were found to be the most predictive by the genetic algorithm. The pipeline with the feature selection performed on the whole dataset obtained an average ROC AUC score of 0.87 ± 0.09. The second pipeline, in which the feature selection was performed on the training data only, obtained an average ROC AUC score of 0.62 ± 0.17. Conclusions: The obtained results confirm the efficiency of ZOT radiomic features in capturing the renal tumor characteristics. We showed that there is a significant difference in the performances of the two proposed pipelines, highlighting how some already published radiomic analyses could be too optimistic about the real generalization capabilities of the models.
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Affiliation(s)
- Gianluca Carlini
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy
| | - Caterina Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
| | - Nico Curti
- eDIMESLab, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Correspondence: (N.C.); (R.B.)
| | - Riccardo Biondi
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Correspondence: (N.C.); (R.B.)
| | - Lorenzo Bianchi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Francesca Giunchi
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Lorenzo Faggioni
- Department of Translational Research, Academic Radiology, University of Pisa, 56126 Roma, Italy
| | - Enrico Giampieri
- eDIMESLab, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Alessandra Merlotti
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy
| | - Daniele Dall’Olio
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy
| | - Claudia Sala
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Sara Pandolfi
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy
| | - Daniel Remondini
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy
- National Institute of Nuclear Physics, INFN, 40127 Bologna, Italy
| | - Arianna Rustici
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
| | - Luigi Vincenzo Pastore
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
| | - Leonardo Scarpetti
- Dipartimento Diagnostica per Immagini AUSL Romagna, UOC Radiologia Faenza, 48018 Faenza, Italy
| | - Barbara Bortolani
- eDIMESLab, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Laura Cercenelli
- eDIMESLab, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Emanuela Marcelli
- eDIMESLab, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
- Dipartimento Diagnostica per Immagini AUSL Romagna, UOC Radiologia Faenza, 48018 Faenza, Italy
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, 40138 Bologna, Italy
| | - Gastone Castellani
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
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11
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Mosconi C, O'Rourke J, Kloeckner R, Sturm L, Golfieri R, Celsa C, Fateen W, Odisio BC, Garanzini EM, Peck-Radosavljevic M, Borghi A, Ma YT, Stoehr F, Bettinger D, Giuffrida P, Aithal GP, Lin YM, Spreafico C, Giampalma E, Johnson P, Cucchetti A. Textbook Outcome After Trans-arterial Chemoembolization for Hepatocellular Carcinoma. Cardiovasc Intervent Radiol 2023; 46:449-459. [PMID: 36849836 DOI: 10.1007/s00270-023-03375-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/27/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Textbook Outcome (TO) is inclusive of quality indicators and it not been provided for trans-arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS Data on treatment-naïve HCC patients receiving TACE from 10 centers were reviewed. TO was defined as "no post-TACE grade 3-4 complications, no prolonged hospital stay (defined as a post-procedure stay ≤ 75th percentile of the median values from the total cohort), no 30-day mortality/readmission and the achievement of an objective response (OR) at post-TACE imaging." Grade of adverse event was classified according to the Common Terminology Criteria for Adverse Events and short-term efficacy was assessed by response. Pooled estimates were calculated to account for hospital's effect and risk-adjustment was applied to allow for diversity of patients in each center. RESULTS A total of 1124 patients (2014-2018) fulfilling specific inclusion criteria were included. Baseline clinical features showed considerable heterogeneity (I2 > 0.75) across centers. TACE-related mortality was absent in 97.6%, readmission was not required after 94.9% of procedures, 91.5% of patients had no complication graded 3-4, 71.8% of patients did not require prolonged hospitalization, OR of the target lesion was achieved in 68.5%. Risk-adjustment showed that all indicators were achieved in 43.1% of patients, and this figure was similar across centers. The median overall survival for patients who achieved all indicators was 33.1 months, 11.9 months longer than for patients who did not. CONCLUSIONS A useful benchmark for TACE in HCC patients has been developed, which provides an indication of survival and allows for a comparison of treatment quality across different hospitals.
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Affiliation(s)
- Cristina Mosconi
- Department of Diagnostic Medicine and Prevention, Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Via Albertoni 15, 40138, Bologna, Italy.
| | - Joanne O'Rourke
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, Medical School, University of Birmingham, Birmingham, UK
| | - Roman Kloeckner
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lukas Sturm
- Department of Medicine II, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Hugstetter Street 55, 79106, Freiburg, Germany.,Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Rita Golfieri
- Department of Diagnostic Medicine and Prevention, Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Via Albertoni 15, 40138, Bologna, Italy
| | - Ciro Celsa
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Marina, Italy
| | - Waleed Fateen
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK
| | - Bruno C Odisio
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Markus Peck-Radosavljevic
- Department of Internal Medicine and Gastroenterology, Klinikum Klagenfurt Am Wörthersee, Klagenfurt, Austria
| | - Alberto Borghi
- Department of Internal Medicine, Infermi Hospital, Area Vasta Romagna, Faenza, Italy
| | - Yuk Ting Ma
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, Medical School, University of Birmingham, Birmingham, UK
| | - Fabian Stoehr
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Dominik Bettinger
- Department of Medicine II, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Hugstetter Street 55, 79106, Freiburg, Germany.,Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Paolo Giuffrida
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Marina, Italy
| | - Guruprasad P Aithal
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, The University of Nottingham, Nottingham, UK
| | - Yuan-Mao Lin
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlo Spreafico
- Department of Radiology, Fondazione IRCCS Istituto Nazionale Tumori di Milano, Milan, Italy
| | | | - Philip Johnson
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Alessandro Cucchetti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Morgagni-Pierantoni Hospital, Area Vasta Romagna, Forlì, Italy
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12
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Piazza P, Bianchi L, Luzzago S, Bandini M, Mottaran A, Amirhassankhani S, Bernardino D, Celia A, Serra C, Cappelli A, Golfieri R, Musi G, Gallina A, Liguori G, Trombetta C, De Cobelli F, Mauri G, Orsi F, Capitanio U, Schiavina R, De Cobelli O, Montorsi F, Brunocilla E. New size cut-off proposed by EAU Renal Cancer Working group better identifies patients who can benefit from local tumor ablation. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01306-4] [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: 02/12/2023]
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13
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Chessa F, Schiavina R, Bianchi L, Piazza P, Presutti M, Droghetti M, Massari F, Mollica V, Ardizzoni A, Gaudiano C, Corcioni B, Fiorentino M, Pugliese M, Tamburini S, Mottaran A, Giunchi F, D’Errico A, Golfieri R, Vasuri F, Beretta C, Di Fresco S, Pultrone C, Dababneh H, Brunocilla E. The impact of a multidisciplinary team on treatment of patients with bladder cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00598-5] [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: 02/12/2023]
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14
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Droghetti M, Bianchi L, Gaudiano C, Corcioni B, Rustici A, Piazza P, Beretta C, Balestrazzi E, Costa F, Feruzzi A, Salvador M, Giunchi F, Fiorentino M, Golfieri R, Schiavina R, Brunocilla E. Comparison of prostate cancer detection rate at targeted biopsy of hub and spoke centers mpMRI: experience matters. Minerva Urol Nephrol 2023; 75:42-49. [PMID: 35766364 DOI: 10.23736/s2724-6051.22.04932-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Latest changes in European guidelines on prostate cancer determined a widespread of multiparametric magnetic resonance imaging (mpMRI) even in less experienced centers due to an increased demand. This could decrease diagnostic accuracy of targeted biopsy (TB) since image interpretation can be challenging and requires adequate and supervised training. Therefore we aimed to evaluate the prostate cancer (PCa) detection rate on TB according to mpMRI center's volume and experience. METHODS We retrospectively analyzed data of 737 patients who underwent mpMRI-TB at our institution. Patients were stratified according to mpMRI center: Hub (high volume >100 exams/year with dedicated radiologists and supervised training) and Spoke center (low volume <100 exams/year without dedicated radiologists and/or supervised training). Detection rate of PCa at TB and possible predictors of clinically significant PCa (csPCa) at TB. Differences in detection rate were explored using Chi-square test. Predictors of csPCa were evaluated through uni and multivariable logistic regression. The adjustment for casemix included: age, PSA, mpMRI center, lesion's location, PSA density, PI-RADS score and index lesion's size. RESULTS Four hundred forty-nine (60.9%) and 288 (39.1%) patients underwent mpMRI at a Hub or Spoke center, respectively. Hub group had higher detection rate for both any (60.3% vs. 48.1%) and csPCa (46.9% vs 38.7%; all P≤0.001). After stratifying for PI-RADS score, Hub group had higher detection rate for PI-RADS score 3 (csPCA 25.2% vs. 15.7%; p 0.04) and 4 (csPCa 65.7% vs. 45.7%; P=0.001). At multivariable analyses, receiving an mpMRI scan at a Spoke center was an independent predictor for csPCa on TB (OR 0.65; P=0.04). CONCLUSIONS mpMRI performed in Hub centers provided a significantly higher PCa yield on TB. A dedicated team of experienced radiologist, a supervised training for mpMRI and a central revision of mpMRI performed in non-experienced centres are essential to avoid unnecessary and potentially harmful procedures.
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Affiliation(s)
- Matteo Droghetti
- Division of Urology, IRCCS University Hospital of Bologna, Bologna, Italy -
| | - Lorenzo Bianchi
- Division of Urology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Caterina Gaudiano
- Department of Radiology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Beniamino Corcioni
- Department of Radiology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Arianna Rustici
- Department of Radiology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Pietro Piazza
- Division of Urology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Carlo Beretta
- Division of Urology, IRCCS University Hospital of Bologna, Bologna, Italy
| | | | - Francesco Costa
- Division of Urology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Alberto Feruzzi
- Division of Urology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Marco Salvador
- Division of Urology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Francesca Giunchi
- Department of Pathology, IRCCS University Hospital of Bologna, Bologna, Italy
| | | | - Rita Golfieri
- Department of Radiology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, IRCCS University Hospital of Bologna, Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS University Hospital of Bologna, Bologna, Italy
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15
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Bianchi L, Bortolani B, Cercenelli L, Presutti M, Mottaran A, Boschi S, Spinozzi L, Melloni R, Scarlatti R, Pissavini A, Amirhassankhani S, Droghetti M, Gaudiano C, Rustici A, Tartarini L, Golfieri R, Marcelli E, Schiavina R, Brunocilla E. 3D-derived volumetric and morphologic parameters to predict complications after robotic partial nephrectomy in patients with renal cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00894-1] [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: 02/12/2023]
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16
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Bianchi L, Gaudiano C, Mottola M, Corcioni B, Tonin E, Droghetti M, Cattabriga A, Cocozza M, Palmeri A, Coppola F, Giunchi F, Schiavina R, Fiorentino M, Brunocilla E, Golfieri R, Bevilacqua A. Beyond multiparametric MRI and towards radiomics to detect prostate cancer: A machine learning model to predict clinically significant lesions. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01021-7] [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: 02/12/2023]
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17
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Gaudiano C, Braccischi L, Taninokuchi Tomassoni M, Paccapelo A, Bianchi L, Corcioni B, Ciccarese F, Schiavina R, Droghetti M, Giunchi F, Fiorentino M, Brunocilla E, Golfieri R. Transverse prostate maximum sectional area can predict clinically significant prostate cancer in PI-RADS 3 lesions at multiparametric magnetic resonance imaging. Front Oncol 2023; 13:1082564. [PMID: 36890814 PMCID: PMC9986422 DOI: 10.3389/fonc.2023.1082564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/07/2023] [Indexed: 02/22/2023] Open
Abstract
Background To evaluate multiparametric magnetic resonance imaging (mpMRI) parameters, such as TransPA (transverse prostate maximum sectional area), TransCGA (transverse central gland sectional area), TransPZA (transverse peripheral zone sectional area), and TransPAI (TransPZA/TransCGA ratio) in predicting prostate cancer (PCa) in prostate imaging reporting and data system (PI-RADS) 3 lesions. Methods Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), the area under the receiver operating characteristic curve (AUC), and the best cut-off, were calculated. Univariate and multivariate analyses were carried out to evaluate the capability to predict PCa. Results Out of 120 PI-RADS 3 lesions, 54 (45.0%) were PCa with 34 (28.3%) csPCas. Median TransPA, TransCGA, TransPZA and TransPAI were 15.4cm2, 9.1cm2, 5.5cm2 and 0.57, respectively. At multivariate analysis, location in the transition zone (OR=7.92, 95% CI: 2.70-23.29, P<0.001) and TransPA (OR=0.83, 95% CI: 0.76-0.92, P<0.001) were independent predictors of PCa. The TransPA (OR=0.90, 95% CI: 0.082-0.99, P=0.022) was an independent predictor of csPCa. The best cut-off of TransPA for csPCa was 18 (Sensitivity 88.2%, Specificity 37.2%, PPV 35.7%, NPV 88.9%). The discrimination (AUC) of the multivariate model was 0.627 (95% CI: 0.519-0.734, P<0.031). Conclusions In PI-RADS 3 lesions, the TransPA could be useful in selecting patients requiring biopsy.
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Affiliation(s)
- Caterina Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Braccischi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Alexandro Paccapelo
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Bianchi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,University of Bologna, Bologna, Italy
| | - Beniamino Corcioni
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federica Ciccarese
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,University of Bologna, Bologna, Italy
| | - Matteo Droghetti
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,University of Bologna, Bologna, Italy
| | - Francesca Giunchi
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Michelangelo Fiorentino
- Department of Specialty, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,University of Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Guido A, Cuicchi D, Castellucci P, Cellini F, Di Fabio F, Llimpe FLR, Strigari L, Buwenge M, Cilla S, Deodato F, Macchia G, Galietta E, Golfieri R, Ardizzoni A, Zagari RM, Fanti S, Poggioli G, Fuccio L, Morganti AG. Adaptive Individualized high-dose preoperAtive (AIDA) chemoradiation in high-risk rectal cancer: a phase II trial. Eur J Nucl Med Mol Imaging 2023; 50:572-580. [PMID: 36127416 PMCID: PMC9816267 DOI: 10.1007/s00259-022-05944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 08/12/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To evaluate the pathological complete response (pCR) rate of locally advanced rectal cancer (LARC) after adaptive high-dose neoadjuvant chemoradiation (CRT) based on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG-PET/CT). METHODS The primary endpoint was the pCR rate. Secondary endpoints were the predictive value of 18 F-FDG-PET/CT on pathological response and acute and late toxicity. All patients performed 18 F-FDG-PET/CT at baseline (PET0) and after 2 weeks during CRT (PET1). The metabolic PET parameters were calculated both at the PET0 and PET1. The total CRT dose was 45 Gy to the pelvic lymph nodes and 50 Gy to the primary tumor, corresponding mesorectum, and to metastatic lymph nodes. Furthermore, a sequential boost was delivered to a biological target volume defined by PET1 with an additional dose of 5 Gy in 2 fractions. Capecitabine (825 mg/m2 twice daily orally) was prescribed for the entire treatment duration. RESULTS Eighteen patients (13 males, 5 females; median age 55 years [range, 41-77 years]) were enrolled in the trial. Patients underwent surgical resection at 8-9 weeks after the end of neoadjuvant CRT. No patient showed grade > 1 acute radiation-induced toxicity. Seven patients (38.8%) had TRG = 0 (complete regression), 5 (27.0%) showed TRG = 2, and 6 (33.0%) had TRG = 3. Based on the TRG results, patients were classified in two groups: TRG = 0 (pCR) and TRG = 1, 2, 3 (non pCR). Accepting p < 0.05 as the level of significance, at the Kruskal-Wallis test, the medians of baseline-MTV, interim-SUVmax, interim-SUVmean, interim-MTV, interim-TLG, and the MTV reduction were significantly different between the two groups. 18 F-FDG-PET/CT was able to predict the pCR in 77.8% of cases through compared evaluation of both baseline PET/CT and interim PET/CT. CONCLUSIONS Our results showed that a dose escalation on a reduced target in the final phase of CRT is well tolerated and able to provide a high pCR rate.
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Affiliation(s)
- Alessandra Guido
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Dajana Cuicchi
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Paolo Castellucci
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Cellini
- Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Roma, Italy.
- Università Cattolica del Sacro Cuore, Dipartimento Universitario Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Largo Agostino Gemelli 8, 00168, Roma, Italy.
| | - Francesca Di Fabio
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Milly Buwenge
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Savino Cilla
- Medical Physics, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - Francesco Deodato
- Università Cattolica del Sacro Cuore, Dipartimento Universitario Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Largo Agostino Gemelli 8, 00168, Roma, Italy
- Radiation Oncology, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - Gabriella Macchia
- Radiation Oncology, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - Erika Galietta
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Ardizzoni
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Rocco Maurizio Zagari
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Gastroenterology Unit, Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Bologna, Bologna, Italy
| | - Stefano Fanti
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Gilberto Poggioli
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Digestive Medicine and Surgery, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Lorenzo Fuccio
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Gastroenterology Unit, Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Bologna, Bologna, Italy
| | - Alessio G Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Droghetti M, Bianchi L, Beretta C, Balestrazzi E, Costa F, Feruzzi A, Piazza P, Roveroni C, Gaudiano C, Corcioni B, Giunchi F, Fiorentino M, Golfieri R, Schiavina R, Brunocilla E. Site-specific concordance of targeted and systematic biopsy cores at the index lesion on multiparametric magnetic resonance: can we spare the double-tap? World J Urol 2023; 41:27-33. [PMID: 36471133 DOI: 10.1007/s00345-022-04229-3] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To define the impact of systematic biopsy (SB) cores directed in the same area of index lesion in patients undergoing targeted biopsy (TB) and SB for prostate cancer (PCa) suspicion. METHODS We retrospectively analyzed data of biopsy-naïve patients with one single suspicious lesion at mpMRI who underwent TB plus SB at our institution between January 2015 and September 2021. A convenient sample of 336 patients was available for our analyses. The primary outcome was to evaluate the impact of overlapping SB cores directed to the index lesion at mpMRI. The secondary outcome was to evaluate the SB cores concordance in terms of highest Gleason Score Detection with TB cores. RESULTS 56% of patients were found to have site-specific concordance. SB cores determined disease upgrade in 22.1% patients. Thirty-one (16.4%) site-concordant patients experienced upgrade through overlapping SB cores, while 149 (79.3%) had no benefit by SB cores, and 8 (4.3%) patients had the worst ISUP at TB cores. 50% of the patients with negative-TB were upgraded to insignificant PCa, and 17.5% was upgraded from negative to unfavorable-intermediate- or high-risk PCa. Overall, 14 (19.4%) patients were also upgraded from ISUP 1 on TB to csPCa, with 28.5% of these harboring high-risk PCa. In csPCas at TB, 9 (12.5%) patients were upgraded from intermediate- to high-risk disease by SB. CONCLUSIONS TB alone consents to identify worst ISUP PCa in vast majority of patients scheduled for biopsy. A non-negligible number of patients are upgraded via-SB cores, including also index lesion overlapping cores. Omitting these cores might lead to a suboptimal patient management.
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Affiliation(s)
- Matteo Droghetti
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy.
| | - Lorenzo Bianchi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy
| | - Carlo Beretta
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy
| | - Eleonora Balestrazzi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy
| | - Francesco Costa
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy
| | - Alberto Feruzzi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy
| | - Carlo Roveroni
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy
| | - Caterina Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Beniamino Corcioni
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesca Giunchi
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy
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20
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Mosconi C, Cacioppa LM, Cappelli A, Gramenzi AG, Vara G, Modestino F, Renzulli M, Golfieri R. Update of the Bologna Experience in Radioembolization of Intrahepatic cholangiocarcinoma. Technol Cancer Res Treat 2023; 22:15330338231155690. [PMID: 36927302 PMCID: PMC10026142 DOI: 10.1177/15330338231155690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/18/2023] Open
Abstract
BACKGROUND Intrahepatic cholangiocarcinoma (ICC) is the second most common primitive liver cancer and is rising in incidence worldwide. Given its low survival and resectability rates, locoregional therapies such as Yttrium-90 transarterial radioembolization (Y-TARE) are increasingly being employed. This retrospective study aim was to confirm and update our previous results about overall survival (OR), safety, and efficacy of Y-TARE in patients with unresectable/recurrent ICC. MATERIALS AND METHODS OS was evaluated as primary endpoint while radiological tumor response at 3 months, based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, was considered as secondary endpoint. RESULTS Over a total of 49 patients, the overall median survival was 16 months (27-41 months, 95% confidence interval [CI]) from Y-TARE procedure. A significantly longer survival was recorded in naive patients compared to patients previously submitted to any type of liver-directed treatment and radical surgery (18 vs 14 months, P=.015 and 28 vs 14 months, P=.001, respectively). Target lesion and overall objective response for RECIST 1.1 criteria were 64.6% and 52.1%, respectively. Low rates of postprocedural and late complications were recorded. CONCLUSIONS In unresectable and recurrent ICC, Y-TARE confirms its safety and its potential in increasing OS, especially in naive patients.
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Affiliation(s)
- Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Laura Maria Cacioppa
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alberta Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Anna Giulia Gramenzi
- Division of Semeiotic, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giulio Vara
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Modestino
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Simonetti M, Cavaliere F, Pecorelli A, Fabbrizio B, Vasuri F, Golfieri R. Synchronous hepatocellular carcinoma and renal cell carcinoma in young woman with sarcoidosis: A case report. Radiol Case Rep 2023; 18:358-363. [DOI: 10.1016/j.radcr.2022.10.054] [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] [Received: 09/14/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/18/2022] Open
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Mosconi C, Cappelli A, Pettinato C, Cocozza MA, Vara G, Terzi E, Morelli MC, Lodi Rizzini E, Renzulli M, Modestino F, Serenari M, Bonfiglioli R, Calderoni L, Tabacchi E, Cescon M, Morganti AG, Trevisani F, Piscaglia F, Fanti S, Strigari L, Cucchetti A, Golfieri R. Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value. J Clin Med 2022; 11:jcm11247469. [PMID: 36556085 PMCID: PMC9781303 DOI: 10.3390/jcm11247469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Transarterial Radioembolisation (TARE) requires multidisciplinary experience and skill to be effective. The aim of this study was to identify determinants of survival in patients with hepatocellular carcinoma (HCC), focusing on learning curves, technical advancements, patient selection and subsequent therapies. METHODS From 2005 to 2020, 253 patients were treated. TARE results achieved in an initial period (2005-2011) were compared to those obtained in a more recent period (2012-2020). To isolate the effect of the treatment period, differences between the two periods were balanced using "entropy balance". RESULTS Of the 253 patients, 68 were treated before 2012 and 185 after 2012. In the second period, patients had an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 1 (p = 0.025) less frequently, less liver involvement (p = 0.006) and a lesser degree of vascular invasion (p = 0.019). The median overall survival (OS) of patients treated before 2012 was 11.2 months and that of patients treated beginning in 2012 was 25.7 months. After reweighting to isolate the effect of the treatment period, the median OS of patients before 2012 increased to 16 months. CONCLUSIONS Better patient selection, refinement of technique and adoption of personalised dosimetry improved survival after TARE. Conversely, sorafenib after TARE did not impact life expectancy.
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Affiliation(s)
- Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Alberta Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Cinzia Pettinato
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Maria Adriana Cocozza
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-051-6362-311
| | - Giulio Vara
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Eleonora Terzi
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Maria Cristina Morelli
- Division of Internal Medicine for the Treatment of Severe Organ Failure, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Elisa Lodi Rizzini
- Radiation Oncology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Francesco Modestino
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Matteo Serenari
- General Surgery and Transplantation Unit, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Rachele Bonfiglioli
- Nuclear Medicine Unit, IRCCS, Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Letizia Calderoni
- Nuclear Medicine Unit, IRCCS, Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Elena Tabacchi
- Nuclear Medicine Unit, IRCCS, Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Matteo Cescon
- General Surgery and Transplantation Unit, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | | | - Franco Trevisani
- Department of Medical and Surgical Sciences, Semeiotica Medica, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Fabio Piscaglia
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Stefano Fanti
- Nuclear Medicine Unit, IRCCS, Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Alessandro Cucchetti
- Department of Medical and Surgical Sciences—DIMEC, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy
- Department of General Surgery, Morgagni—Pierantoni Hospital, 47121 Forlì, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Alma Mater Studiorum, Università Degli Studi Di Bologna, 40138 Bologna, Italy
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Pompili M, Ardito F, Brunetti E, Cabibbo G, Calliada F, Cillo U, de Sio I, Golfieri R, Grova M, Gruttadauria S, Guido M, Iavarone M, Manciulli T, Pagano D, Pettinari I, Santopaolo F, Soresi M, Colli A. Benign liver lesions 2022: Guideline for clinical practice of Associazione Italiana Studio del Fegato (AISF), Società Italiana di Radiologia Medica e Interventistica (SIRM), Società Italiana di Chirurgia (SIC), Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB), Associazione Italiana di Chirurgia Epatobilio-Pancreatica (AICEP), Società Italiana Trapianti d'Organo (SITO), Società Italiana di Anatomia Patologica e Citologia Diagnostica (SIAPEC-IAP) - Part II - Solid lesions. Dig Liver Dis 2022; 54:1614-1622. [PMID: 36089523 DOI: 10.1016/j.dld.2022.08.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 12/30/2022]
Abstract
Benign liver lesions are increasingly diagnosed in daily clinical practice due to the growing use of imaging techniques for the study of the abdomen in patients who have non-specific symptoms and do not have an increased risk of hepatic malignancy. They include simple or parasitic hepatic cysts and solid benign tumors which differ widely in terms of prevalence, clinical relevance, symptoms and natural history and often lead to significant clinical problems relating to diagnosis and clinical management. Following the need to have updated guidelines on the management of benign focal liver lesions, the Scientific Societies mainly involved in their management have promoted the drafting of a new dedicated document. This document was drawn up according to the present Italian rules and methodologies necessary to produce clinical, diagnostic, and therapeutic guidelines based on evidence. Here we present the second part of the guideline, concerning the diagnosis and clinical management of hemangioma, focal nodular hyperplasia, and hepatocellular adenoma.
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Affiliation(s)
- Maurizio Pompili
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Gemelli, Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Facoltà di Medicina e Chirurgia, "Agostino Gemelli", Largo A. Gemelli, 8, Roma 00168, Italy.
| | - Francesco Ardito
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Gemelli, Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Facoltà di Medicina e Chirurgia, "Agostino Gemelli", Largo A. Gemelli, 8, Roma 00168, Italy
| | - Enrico Brunetti
- Dipartimento di Scienze Cliniche, Chirurgiche, Diagnostiche e Pediatriche, Università di Pavia. Unità di Malattie Infettive e Immunologia, IRCCS Fondazione Ospedale San Matteo, Pavia, Italy
| | - Giuseppe Cabibbo
- Sezione di Gastroenterologia e Epatologia, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE) Università di Palermo, Italy
| | - Fabrizio Calliada
- Dipartimento di Radiologia, Fondazione Policlinico San Matteo IRCCS, Università di Pavia, Italy
| | - Umberto Cillo
- Chirurgia Epatobiliare e Trapianto di Fegato, Ospedale Universitario di Padova, Italy
| | - Ilario de Sio
- Epatogastroenterologia, Università della Campania Luigi Vanvitelli, Facoltà di Medicina e Chirurgia, Napoli, Italy
| | - Rita Golfieri
- Dipartimento di Radiologia, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Mauro Grova
- Sezione di Gastroenterologia e Epatologia, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE) Università di Palermo, Italy
| | - Salvatore Gruttadauria
- Dipartimento per la cura e lo studio delle Patologie Addominali e dei Trapianti Addominali, Dipartimento di Chirurgia e Specialità Medico-Chirurgiche, IRCCS-ISMETT-UPMCI, Palermo, Università di Catania, Italy
| | - Maria Guido
- Dipartimento di Anatomia Patologica, Azienda ULSS2 Marca Trevigiana, Treviso, Italy; Dipartimento di Medicina - DIMED, Università di Padova, Italy
| | - Massimo Iavarone
- Divisione di Gastroenterologia ed Epatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Tommaso Manciulli
- Dipartimento di Medicina Sperimentale e Clinica - Università degli Studi, Firenze, Italy
| | - Duilio Pagano
- Dipartimento per la cura e lo studio delle Patologie Addominali e dei Trapianti Addominali, IRCCS-ISMETT-UPMC, Palermo, Italy
| | - Irene Pettinari
- Dipartimento di Radiologia, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Francesco Santopaolo
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Gemelli, Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Facoltà di Medicina e Chirurgia, "Agostino Gemelli", Largo A. Gemelli, 8, Roma 00168, Italy
| | - Maurizio Soresi
- Medicina Interna, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE) Università di Palermo, Italy
| | - Agostino Colli
- Dipartimento di Medicina Trasfusionale ed Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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Renzulli M, Braccischi L, D'Errico A, Pecorelli A, Brandi N, Golfieri R, Albertini E, Vasuri F. State-of-the-art review on the correlations between pathological and magnetic resonance features of cirrhotic nodules. Histol Histopathol 2022; 37:1151-1165. [PMID: 35770721 DOI: 10.14670/hh-18-487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hepatocellular carcinoma (HCC) has become the second greatest cause of cancer-related mortality worldwide and the newest advancements in liver imaging have improved the diagnosis of both overt malignancies and premalignant lesions, such as cirrhotic or dysplastic nodules, which is crucial to improve overall patient survival rate and to choose the best treatment options. The role of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) has grown in the last 20 years. In particular, the introduction of hepatospecific contrast agents has strongly increased the definition of precursor nodules and detection of high-grade dysplastic nodules and early HCCs. Nevertheless, the diagnosis of liver tumours in cirrhotic patients sometimes remains challenging for radiologists, thus, in doubtful cases, biopsy and histological analysis become critical in clinical practice. This current review briefly summarizes the history of imaging and histology for HCC, covering the newest techniques and their limits. Then, the article discusses the links between radiological and pathological characteristics of liver lesions in cirrhotic patients, by describing the multistep process of hepatocarcinogenesis. Explaining the evolution of pathologic change from cirrhotic nodules to malignancy, the list of analyzed lesions provides regenerative nodules, low-grade and high-grade dysplastic nodules, small HCC and progressed HCC, including common subtypes (steatohepatitic HCC, scirrhous HCC, macrotrabecular massive HCC) and more rare forms (clear cell HCC, chromophobe HCC, neutrophil-rich HCC, lymphocyte-rich HCC, fibrolamellar HCC). The last chapter covers the importance of the new integrated morphological-molecular classification and its association with radiological features.
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Affiliation(s)
- Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Lorenzo Braccischi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Antonietta D'Errico
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Anna Pecorelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Nicolò Brandi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Elisa Albertini
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Vasuri
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Kolligs F, Arnold D, Golfieri R, Pech M, Peynircioglu B, Pfammatter T, Ronot M, Sangro B, Schaefer N, Maleux G, Munneke G, Pereira H, Zeka B, de Jong N, Helmberger T, Neukölln VK, D’Archambeau O, Balli T, Bilgic S, Bloom A, Cioni R, Fischbach R, Altona AK, Flamen P, Gerard L, Grözinger G, Katoh M, Koehler M, Kröger JR, Kuhl C, Orsi F, Özgün M, Reimer P, Ronot M, Schmid A, Vit A. Factors impacting survival after transarterial radioembolization in patients with hepatocellular carcinoma: Results from the prospective CIRT study. JHEP Rep 2022; 5:100633. [PMID: 36593888 PMCID: PMC9804139 DOI: 10.1016/j.jhepr.2022.100633] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022] Open
Abstract
Background & Aims Transarterial radioembolization (TARE) with Yttrium-90 resin microspheres is an established treatment option for patients with hepatocellular carcinoma (HCC). However, optimising treatment application and patient selection remains challenging. We report here on the effectiveness, safety and prognostic factors, including dosing methods, associated with TARE for HCC in the prospective observational CIRT study. Methods We analysed 422 patients with HCC enrolled between Jan 2015 and Dec 2017, with follow-up visits every 3 months for up to 24 months after first TARE. Patient characteristics and treatment-related data were collected at baseline; adverse events and time-to-event data (overall survival [OS], progression-free survival [PFS] and hepatic PFS) were collected at every 3-month follow-up visit. We used the multivariable Cox proportional hazard model and propensity score matching to identify independent prognostic factors for effectiveness outcomes. Results The median OS was 16.5 months, the median PFS was 6.1 months, and the median hepatic PFS was 6.7 months. Partition model dosimetry resulted in improved OS compared to body surface area calculations on multivariable analysis (hazard ratio 0.65; 95% CI 0.46-0.92; p = 0.0144), which was confirmed in the exact matching propensity score analysis (hazard ratio 0.56; 95% CI 0.35-0.89; p = 0.0136). Other independent prognostic factors for OS were ECOG-performance status >0 (p = 0.0018), presence of ascites (p = 0.0152), right-sided tumours (p = 0.0002), the presence of portal vein thrombosis (p = 0.0378) and main portal vein thrombosis (p = 0.0028), ALBI grade 2 (p = 0.0043) and 3 (p = 0.0014). Adverse events were recorded in 36.7% of patients, with 9.7% of patients experiencing grade 3 or higher adverse events. Conclusions This large prospective observational dataset shows that TARE is an effective and safe treatment in patients with HCC. Using partition model dosimetry was associated with a significant improvement in survival outcomes. Impact and implications Transarterial radioembolization (TARE) is a form of localised radiation therapy and is a potential treatment option for primary liver cancer. We observed how TARE was used in real-life clinical practice in various European countries and if any factors predict how well the treatment performs. We found that when a more complex but personalised method to calculate the applied radiation activity was used, the patient responded better than when a more generic method was used. Furthermore, we identified that general patient health, ascites and liver function can predict outcomes after TARE. Clinical trial number NCT02305459.
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Key Words
- ALBI, albumin-bilirubin
- BCLC, Barcelona Clinic Liver Cancer
- BSA, body surface area
- CIRSE, Cardiovascular and Interventional Radiological Society of Europe
- CIRT, CIRSE Registry for SIR-Spheres Therapy
- ECOG, Eastern Cooperative Oncology Group
- HCC, hepatocellular carcinoma
- HR, hazard ratio
- INR, international normalized ratio
- IPTW, inverse probability of treatment weighting
- OS, overall survival
- PFS, progression-free survival
- PVT, portal vein thrombosis
- REILD, radioembolization-induced liver disease
- SIRT
- TACE, transcatheter arterial chemoembolization
- TARE, transarterial radioembolization
- Y90, Yttrium-90
- dosimetry
- hPFS, hepatic progression-free survival
- liver
- mBSA, modified body surface area
- observational
- radioembolization
- registry
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Affiliation(s)
- Frank Kolligs
- Department of Internal Medicine and Gastroenterology, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Dirk Arnold
- Oncology and Hematology, Asklepios Tumorzentrum Hamburg, AK Altona, Hamburg, Germany
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maciej Pech
- Department of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
| | - Bora Peynircioglu
- Department of Radiology, School of Medicine, Hacettepe University, Sihhiye Campus, Ankara, Turkey
| | - Thomas Pfammatter
- Institute of Diagnostic and Interventional Radiology, Universitätsspital Zürich, Zürich, Switzerland
| | - Maxime Ronot
- Université Paris Cité, Paris & Service de Radiologie, APHP Nord, Hôpital Beaujon, Clichy, France
| | - Bruno Sangro
- Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and CIBEREHD, Pamplona, Spain
| | - Niklaus Schaefer
- Service de médecine nucléaire et imagerie moléculaire, CHUV, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Geert Maleux
- Radiology, Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - Graham Munneke
- Interventional Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Helena Pereira
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Unité de Recherche Clinique, Paris, France,INSERM, Centre d'Investigation Clinique 1418 (CIC1418), Paris, France
| | - Bleranda Zeka
- Clinical Research Department, Cardiovascular and Interventional Radiological Society of Europe, Vienna, Austria
| | - Niels de Jong
- Clinical Research Department, Cardiovascular and Interventional Radiological Society of Europe, Vienna, Austria,Corresponding author. Address: Clinical Research Department, Cardiovascular and Interventional Radiological Society of Europe, Neutorgasse 9, 1010, Vienna Austria; Tel.: +43 1904200347
| | - Thomas Helmberger
- Department of Radiology, Neuroradiology and Minimal-Invasive Therapy, Klinikum Bogenhausen, Munich, Germany
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26
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Pompili M, Ardito F, Brunetti E, Cabibbo G, Calliada F, Cillo U, de Sio I, Golfieri R, Grova M, Gruttadauria S, Guido M, Iavarone M, Manciulli T, Pagano D, Pettinari I, Santopaolo F, Soresi M, Colli A. Benign liver lesions 2022: Guideline for clinical practice of Associazione Italiana Studio del Fegato (AISF), Società Italiana di Radiologia Medica e Interventistica (SIRM), Società Italiana di Chirurgia (SIC), Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB), Associazione Italiana di Chirurgia Epatobilio-Pancreatica (AICEP), Società Italiana Trapianti d'Organo (SITO), Società Italiana di Anatomia Patologica e Citologia Diagnostica (SIAPEC-IAP) - Part I - Cystic lesions. Dig Liver Dis 2022; 54:1469-1478. [PMID: 36089525 DOI: 10.1016/j.dld.2022.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 12/29/2022]
Abstract
Benign liver lesions are increasingly diagnosed in daily clinical practice due to the growing use of imaging techniques for the study of the abdomen in patients who have non-specific symptoms and do not have an increased risk of hepatic malignancy. They include simple or parasitic cysts and solid benign tumors which differ widely in terms of prevalence, clinical relevance, symptoms and natural history and often lead to significant clinical problems relating to diagnosis and clinical management. Following the need to have updated guidelines on the management of benign focal liver lesions, the Scientific Societies mainly involved in their management have promoted the drafting of a new dedicated document. This document was drawn up according to the present Italian rules and methodologies necessary to produce clinical, diagnostic, and therapeutic guidelines based on evidence. Here we present the first part of the guideline, concerning the characterization of focal hepatic lesions detected by ultrasound, and the diagnosis and clinical management of simple and parasitic hepatic cysts, and of polycystic liver disease.
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Affiliation(s)
- Maurizio Pompili
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Gemelli Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Roma 00168, Italy.
| | - Francesco Ardito
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Gemelli Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Roma 00168, Italy
| | - Enrico Brunetti
- Dipartimento di Scienze Cliniche, Chirurgiche, Diagnostiche e Pediatriche, IRCCS Fondazione Ospedale San Matteo, Università di Pavia, Unità di Malattie Infettive e Immunologia, Pavia, Italy
| | - Giuseppe Cabibbo
- Sezione di Gastroenterologia e Epatologia, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE) Università di Palermo, Italy
| | - Fabrizio Calliada
- Dipartimento di Radiologia, Fondazione Policlinico San Matteo IRCCS, Università di Pavia, Italy
| | - Umberto Cillo
- Chirurgia Epatobiliare e Trapianto di Fegato, Ospedale Universitario di Padova, Italy
| | - Ilario de Sio
- Epatogastroenterologia, Facoltà di Medicina e Chirurgia, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | - Rita Golfieri
- Dipartimento di Radiologia, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Mauro Grova
- Sezione di Gastroenterologia e Epatologia, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE) Università di Palermo, Italy
| | - Salvatore Gruttadauria
- Dipartimento per la cura e lo studio delle Patologie Addominali e dei Trapianti Addominali, IRCCS-ISMETT-UPMCI, Dipartimento di Chirurgia e Specialità Medico-Chirurgiche, Università di Catania, Palermo, Italy
| | - Maria Guido
- Dipartimento di Anatomia Patologica, Azienda ULSS2 Marca Trevigiana, Treviso, Italy; Dipartimento di Medicina - DIMED, Università di Padova, Italy
| | - Massimo Iavarone
- Divisione di Gastroenterologia ed Epatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Tommaso Manciulli
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi, Firenze, Italy
| | - Duilio Pagano
- Dipartimento per la cura e lo studio delle Patologie Addominali e dei Trapianti Addominali, IRCCS-ISMETT-UPMC, Palermo, Italy
| | - Irene Pettinari
- Dipartimento di Radiologia, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Francesco Santopaolo
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Gemelli Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Roma 00168, Italy
| | - Maurizio Soresi
- Medicina Interna, Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE) Università di Palermo, Italy
| | - Agostino Colli
- Dipartimento di Medicina Trasfusionale ed Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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27
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Piazza P, Bianchi L, Luzzago S, Bandini M, Mottaran A, Amirhassankhani S, Puliatti S, De Concilio B, Celia A, Serra C, Cappelli A, Modestino F, De Cinque A, Golfieri R, Musi G, Lugano A, De Cobelli F, Mauri G, Orsi F, Capitanio U, Schiavina R, De Cobelli O, Montorsi F, Brunocilla E. The impact of histology and type of energy used on oncological outcomes after local tumor ablation of small renal masses. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02559-9] [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: 11/11/2022] Open
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Droghetti M, Bortolani B, Cercenelli L, Piazza P, Boschi S, Mottaran A, Chessa F, Ercolino A, Angiolini A, Lodi S, Pissavini A, Fontanella L, Spinozzi L, Melloni R, Bevilacqua F, Cangemi D, Gaudiano C, Corcioni B, Golfieri R, Marcelli E, Bianchi L, Schiavina R, Brunocilla E. The impact of 3D modeling in surgical planning and outcomes of partial nephrectomy. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02545-9] [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: 11/11/2022] Open
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Piazza P, Bianchi L, Luzzago S, Bandini M, Amirhassankhani S, Droghetti M, Celia A, Serra C, Cappelli A, De Cinque A, Modestino F, Golfieri R, Musi G, Gallina A, De Cobelli F, Mauri G, Orsi F, Capitanio U, Schiavina R, De Cobelli O, Montorsi F, Brunocilla E. PERC-score as a nephrometry scoring system in percutaneous tumour ablation: Comparison with RENAL, mRENAL, PADUA and SPARE in a multi-centre series. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02547-2] [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: 11/11/2022] Open
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30
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Bianchi L, Cercenelli L, Bortolani B, Piazza P, Droghetti M, Boschi S, Gaudiano C, Carpani G, Chessa F, Lodi S, Tartarini L, Bertaccini A, Golfieri R, Marcelli E, Schiavina R, Brunocilla E. 3D renal model for surgical planning of partial nephrectomy: A way to improve surgical outcomes. Front Oncol 2022; 12:1046505. [PMID: 36338693 PMCID: PMC9634646 DOI: 10.3389/fonc.2022.1046505] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/07/2022] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE to evaluate the impact of 3D model for a comprehensive assessment of surgical planning and quality of partial nephrectomy (PN). MATERIALS AND METHODS 195 patients with cT1-T2 renal mass scheduled for PN were enrolled in two groups: Study Group (n= 100), including patients referred to PN with revision of both 2D computed tomography (CT) imaging and 3D model; Control group (n= 95), including patients referred to PN with revision of 2D CT imaging. Overall, 20 individuals were switched to radical nephrectomy (RN). The primary outcome was the impact of 3D models-based surgical planning on Trifecta achievement (defined as the contemporary absence of positive surgical margin, major complications and ≤30% postoperative eGFR reduction). The secondary outcome was the impact of 3D models on surgical planning of PN. Multivariate logistic regressions were used to identify predictors of selective clamping and Trifecta's achievement in patients treated with PN (n=175). RESULTS Overall, 73 (80.2%) patients in Study group and 53 (63.1%) patients in Control group achieved the Trifecta (p=0.01). The preoperative plan of arterial clamping was recorded as clampless, main artery and selective in 22 (24.2%), 22 (24.2%) and 47 (51.6%) cases in Study group vs. 31 (36.9%), 46 (54.8%) and 7 (8.3%) cases in Control group, respectively (p<0.001). At multivariate logistic regressions, the use of 3D model was found to be independent predictor of both selective or super-selective clamping and Trifecta's achievement. CONCLUSION 3D-guided approach to PN increase the adoption of selective clamping and better predict the achievement of Trifecta.
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Affiliation(s)
- Lorenzo Bianchi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Università degli studi di Bologna, Bologna, Italy
| | - Laura Cercenelli
- eDIMES Lab - Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Barbara Bortolani
- eDIMES Lab - Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Matteo Droghetti
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Sara Boschi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Caterina Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giulia Carpani
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Chessa
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Università degli studi di Bologna, Bologna, Italy
| | - Simone Lodi
- eDIMES Lab - Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Lorenzo Tartarini
- eDIMES Lab - Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Alessandro Bertaccini
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Università degli studi di Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Emanuela Marcelli
- eDIMES Lab - Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Università degli studi di Bologna, Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Università degli studi di Bologna, Bologna, Italy
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Taninokuchi Tomassoni M, Cattabriga A, Gaudiano C, Ciccarese F, Corcioni B, Bianchi L, Schiavina R, Brunocilla E, Golfieri R. Dynamic FDG PET/CT on bladder paraganglioma: A case report. Front Med (Lausanne) 2022; 9:1002663. [PMID: 36300177 PMCID: PMC9588919 DOI: 10.3389/fmed.2022.1002663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/25/2022] [Accepted: 09/21/2022] [Indexed: 12/02/2022] Open
Abstract
Paraganglioma (PGL) is characterized by equivocal clinical manifestations and arriving to a suspicion might be challenging. Nevertheless, diagnostic imaging and nuclear medicine are a fundamental part of the diagnosis and management of this particular neuroendocrine tumor (NET). We herein report a rare case of bladder paraganglioma with unusual onset and typical PET/CT characteristics that led to its recognition.
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Affiliation(s)
- Makoto Taninokuchi Tomassoni
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy,*Correspondence: Makoto Taninokuchi Tomassoni
| | - Arrigo Cattabriga
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Caterina Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Federica Ciccarese
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Beniamino Corcioni
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Bianchi
- Division of Urology, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy,University of Bologna, Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy,University of Bologna, Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy,University of Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
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De Leo A, Vara G, Paccapelo A, Balacchi C, Vicennati V, Tucci L, Pagotto U, Selva S, Ricci C, Alberici L, Minni F, Nanni C, Ambrosi F, Santini D, Golfieri R, Di Dalmazi G, Mosconi C. Computerized tomography texture analysis of pheochromocytoma: relationship with hormonal and histopathological data. J Endocrinol Invest 2022; 45:1935-1944. [PMID: 35680695 PMCID: PMC9463266 DOI: 10.1007/s40618-022-01826-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Pheochromocytomas are rare tumors which can present with heterogeneous secretion profiles, clinical manifestations, and radiologic appearance. Under a histopathological point of view, they can be characterized as more or less aggressive with the Pheochromocytoma of the Adrenal gland Scaled Score (PASS) and the Grading system for Adrenal Pheochromocytoma and Paraganglioma (GAPP) score. The aim of this study is to analyze the texture analysis characteristics of pheochromocytoma and identify whether the texture analysis can yield information aiding in the diagnosis and the characterization of those tumors. METHODS Radiological, biochemical, and histopathological data regarding 30 consecutive patients with histologically confirmed pheochromocytoma were analyzed. Images obtained in the unenhanced, late arterial, venous, and delayed phases were used for the texture analysis. RESULTS Urinary epinephrine and metanephrine levels showed a significant correlation (R2 = 0.946; R2 = 699) in the multivariate linear model with texture features, as well as Ki-67 (R2 = 0.397), PASS score (R2 = 0.182), GAPP score (R2 = 0.705), and cellularity showed a significant correlation (R2 = 0.389). The cluster analysis based on radiomic features resulted in 2 clusters, with significative differences in terms of systolic and diastolic blood pressure values at the time of diagnosis (p = 0.025), GAPP score (4 vs 6, p = 0.05), histological pattern (1-2, p = 0.039), and comedonecrosis (0% vs 50%, p = 0.013). CONCLUSION In conclusion, our study provides the proof of concept for the use of texture analysis on contrast-enhanced CT images as a noninvasive, quantitative tool for helping in the characterization of the clinical, biochemical, and histopathological features of pheochromocytoma.
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Affiliation(s)
- A De Leo
- Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - G Vara
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy.
| | - A Paccapelo
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - C Balacchi
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - V Vicennati
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - L Tucci
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - U Pagotto
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - S Selva
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Division of Pancreatic Surgery, Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - C Ricci
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Division of Pancreatic Surgery, Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - L Alberici
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Division of Pancreatic Surgery, Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - F Minni
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Division of Pancreatic Surgery, Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - C Nanni
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Nuclear Medicine Unit, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - F Ambrosi
- Pathology Unit, Maggiore Hospital, Bologna, Italy
| | - D Santini
- Pathology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - R Golfieri
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
| | - G Di Dalmazi
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
- Unit of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - C Mosconi
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, Via Albertoni 15, 40136, Bologna, Italy
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Ercolino A, Manes F, Vasuri F, Bianchi L, Garofalo M, Piazza P, Corcioni B, Schiavina R, Golfieri R, Fiorentino M, Colecchia M, Brunocilla E. A case report of myoid gonadal stromal tumor treated with testis sparing surgery. Transl Androl Urol 2022; 11:1458-1465. [PMID: 36386257 PMCID: PMC9641068 DOI: 10.21037/tau-22-179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/09/2022] [Accepted: 06/26/2022] [Indexed: 11/22/2022] Open
Abstract
Background Myoid gonadal stromal tumors (MGST) of the testis represent a very rare finding. They are an emerging clinicopathological entity with specific features and identity. Nowadays, pathological recognition and diagnosis of MGSTs still represents a difficult challenge in most cases and there are no data of specific radiological features of these tumors expect for what seen by ultrasound; besides a conservative surgical approach was never performed to treat these lesions. Case Description We present the case of a 20-year-old young man patient with symptoms suspicious for left varicocele, who was incidentally diagnosed with right testicular nodule via scrotal doppler ultrasound powered with contrast enhancement infusion and subsequent multiparametric magnetic resonance imaging. Then, lesion was treated through a testis sparing surgical approach. Histopathology, which included an external revision by an experienced Center, revealed a MGST with benign features, so that no further treatment was considered. 3 and 12 months after surgery a contrast enhancement ultrasound was performed with no evidence of recurrence. Conclusions Previous reported cases of MGST were all difficult to characterize as a specific pathological entity; treatment usually applied was radical orchiectomy and a subsequent total Body CT was performed for staging purpose. No metastatic spreading nor recurrence were ever reported. Considering the favorable behavior of this pathologic entity, testis-sparing surgery with no radiation exposure during follow-up is a safe and effective strategy.
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Affiliation(s)
- Amelio Ercolino
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Manes
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Vasuri
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Bianchi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Garofalo
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Beniamino Corcioni
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Maurizio Colecchia
- Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital and ScientificInstitute, Milan, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Piazza P, Bianchi L, Luzzago S, Bandini M, Amirhassankhani S, Droghetti M, Celia A, Serra C, Cappelli A, De Cinque A, Modestino F, Golfieri R, Musi G, Gallina A, De Cobelli F, Mauri G, Orsi F, Capitanio U, Schiavina R, De Cobelli O, Montorsi F, Brunocilla E. Perc-score as a nephrometry scoring system in percutaneous tumour ablation: comparison with renal, mrenal, padua and spare in a multi-centre series. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01058-8] [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: 11/05/2022] Open
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Ciccarese F, Corcioni B, Bianchi L, De Cinque A, Paccapelo A, Galletta GL, Schiavina R, Brunocilla E, Golfieri R, Gaudiano C. Clinical Application of the New Prostate Imaging for Recurrence Reporting (PI-RR) Score Proposed to Evaluate the Local Recurrence of Prostate Cancer after Radical Prostatectomy. Cancers (Basel) 2022; 14:cancers14194725. [PMID: 36230647 PMCID: PMC9562904 DOI: 10.3390/cancers14194725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/03/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background: We investigated the diagnostic accuracy of the new Prostate Imaging for Recurrence Reporting (PI-RR) score and its inter-observer variability. Secondly, we compared the detection rate of PI-RR and PET and analyzed the correlation between Prostate Specific Antigen (PSA) levels and the PI-RR score. Methods: We included in the analysis 134 patients submitted to multiparametric magnetic resonance imaging for suspected local recurrence. The images were independently reviewed by two radiologists, assigning a value from 1 to 5 to the PI-RR score. Inter-observer agreement and diagnostic accuracy of the PI-RR score (compared to histopathological data, available for 19 patients) were calculated. The detection rate was compared to those of choline PET/CT (46 patients) and PSMA PET/CT (22 patients). The distribution of the PSA values in relation to the PI-RR scores was also analyzed. Results: The accuracy of the PI-RR score was 68.4%. The reporting agreement was excellent (K = 0.884, p < 0.001). The PI-RR showed a higher detection rate than choline PET/CT (69.6% versus 19.6%) and PSMA PET-CT (59.1% versus 22.7%). The analysis of the PSA distribution documented an increase in the PI-RR score as the PSA value increased. Conclusion: The excellent reproducibility of the PI-RR score supports its wide use in the clinical practice to standardize recurrence reporting. The detection rate of PI-RR was superior to that of PET, but was linked to the PSA level.
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Affiliation(s)
- Federica Ciccarese
- Department of Radiology, IRCSS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
- Correspondence:
| | - Beniamino Corcioni
- Department of Radiology, IRCSS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Lorenzo Bianchi
- Division of Urology, Department of Urology, IRCCS University Hospital of Bologna, 40138 Bologna, Italy
| | - Antonio De Cinque
- Department of Radiology, IRCSS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Alexandro Paccapelo
- Department of Radiology, IRCSS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Giovanni Luca Galletta
- Department of Radiology, IRCSS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Riccardo Schiavina
- Division of Urology, Department of Urology, IRCCS University Hospital of Bologna, 40138 Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, Department of Urology, IRCCS University Hospital of Bologna, 40138 Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCSS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Caterina Gaudiano
- Department of Radiology, IRCSS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
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Bianchi L, Schiavina R, Bortolani B, Cercenelli L, Gaudiano C, Mottaran A, Droghetti M, Chessa F, Boschi S, Molinaroli E, Balestrazzi E, Costa F, Rustici A, Carpani G, Piazza P, Cappelli A, Bertaccini A, Golfieri R, Marcelli E, Brunocilla E. Novel Volumetric and Morphological Parameters Derived from Three-dimensional Virtual Modeling to Improve Comprehension of Tumor's Anatomy in Patients with Renal Cancer. Eur Urol Focus 2022; 8:1300-1308. [PMID: 34429273 DOI: 10.1016/j.euf.2021.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/22/2021] [Accepted: 08/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Three-dimensional (3D) models improve the comprehension of renal anatomy. OBJECTIVE To evaluate the impact of novel 3D-derived parameters, to predict surgical outcomes after robot-assisted partial nephrectomy (RAPN). DESIGN, SETTING, AND PARTICIPANTS Sixty-nine patients with cT1-T2 renal mass scheduled for RAPN were included. Three-dimensional virtual modeling was achieved from computed tomography. The following volumetric and morphological 3D parameters were calculated: VT (volume of the tumor); VT/VK (ratio between tumor volume and kidney volume); CSA3D (ie, contact surface area); UCS3D (contact to the urinary collecting system); Tumor-Artery3D: tumor's blood supply by tertiary segmental arteries (score = 1), secondary segmental artery (score = 2), or primary segmental/main renal artery (scoren = 3); ST (tumor's sphericity); ConvT (tumor's convexity); and Endophyticity3D (ratio between the CSA3D and the global tumor surface). INTERVENTION RAPN with a 3D model. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Three-dimensional parameters were compared between patients with and without complications. Univariate logistic regression was used to predict overall complications and type of clamping; linear regression was used to predict operative time, warm ischemia time, and estimated blood loss. RESULTS AND LIMITATIONS Overall, 11 (15%) individuals experienced overall complications (7.2% had Clavien ≥3 complications). Patients with urinary collecting system (UCS) involvement at 3D model (UCS3D = 2), tumor with blood supply by primary or secondary segmentary arteries (Tumor-Artery3D = 1 and 2), and high Endophyticity3D values had significantly higher rates of overall complications (all p ≤ 0.03). At univariate analysis, UCS3D, Tumor-Artery3D, and Endophyticity3D are significantly associated with overall complications; CSA3D and Endophyticity3D were associated with warm ischemia time; and CSA3D was associated with selective clamping (all p ≤ 0.03). Sample size and the lack of interobserver variability are the main limits. CONCLUSIONS Three-dimensional modeling provides novel volumetric and morphological parameters to predict surgical outcomes after RAPN. PATIENT SUMMARY Novel morphological and volumetric parameters can be derived from a three-dimensional model to describe surgical complexity of renal mass and to predict surgical outcomes after robot-assisted partial nephrectomy.
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Affiliation(s)
- Lorenzo Bianchi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy.
| | - Riccardo Schiavina
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Barbara Bortolani
- eDIMES Lab-Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Laura Cercenelli
- eDIMES Lab-Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Caterian Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Angelo Mottaran
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Matteo Droghetti
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Francesco Chessa
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Sara Boschi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Enrico Molinaroli
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Eleonora Balestrazzi
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Francesco Costa
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Arianna Rustici
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giulia Carpani
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Alberta Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alessandro Bertaccini
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Emanuela Marcelli
- eDIMES Lab-Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Eugenio Brunocilla
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli studi di Bologna, Bologna, Italy
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Martinese G, Lucidi V, Masi PD, Adduci F, Cappelli A, Renzulli M, De Paolis M, Fiore M, Golfieri R. Bone echinococcosis with hip localization: A case report with evaluation of imaging features. Radiol Case Rep 2022; 17:3389-3394. [PMID: 35874867 PMCID: PMC9305309 DOI: 10.1016/j.radcr.2022.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/06/2022] [Revised: 06/13/2022] [Accepted: 06/21/2022] [Indexed: 11/12/2022] Open
Abstract
Hydatid disease (HD) is a zoonotic parasitic disease caused by the larvae of Echinococcus. Bone echinococcosis is rare, accounting for 0.5% to 4% of all echinococcosis. We describe a particular case of pelvic echinoccosis. A 29-year-old man initially presents with pain in his left hip for several years. After an accidental fall from a tree, he suffered a fracture of the left acetabulum. X-rays and CT scans showed an osteolytic area of the acetabulum with bony cortical interruption. MR imaging demonstrated extensive area of osteostructural alteration of the iliac wing and the left acetabulum due to multiple cysts with enhancement of the walls after administration of Gadolinium-based contrast agents. A CT-guided biopsy of an osteolytic area was performed with diagnosis of echinococcus cyst. He underwent albendazole therapy and subsequently echinococcus cyst exeresis, bone curettage, and left hip arthroplasty. Twenty-two months after surgery, CT scan showed recurrence of disease. After 4 years and 6 months of chronic therapy CT scan showed an increase in size of the cyst at the site of the disease recurrence. Five years and 4 months after the first operation, a new cyst exeresis and pelvic bone curettage with implant retention was performed. This case report demonstrates that hydatid cysts should be considered as a possible cause for non-specific pelvic pain, especially in endemic locations.
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Affiliation(s)
- Giuseppe Martinese
- Department of Radiology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Vincenzo Lucidi
- Department of Radiology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Paola Di Masi
- Department of Radiology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Francesco Adduci
- Department of Radiology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Alberta Cappelli
- Department of Radiology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Matteo Renzulli
- Department of Radiology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Massimiliano De Paolis
- Department of Orthopedics and Traumatology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Michele Fiore
- Department of Orthopedics and Traumatology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCSS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
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de Baere T, Ronot M, Chung JW, Golfieri R, Kloeckner R, Park JW, Gebauer B, Kibriya N, Ananthakrishnan G, Miyayama S. Initiative on Superselective Conventional Transarterial Chemoembolization Results (INSPIRE). Cardiovasc Intervent Radiol 2022; 45:1430-1440. [PMID: 35978174 PMCID: PMC9499883 DOI: 10.1007/s00270-022-03233-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/18/2022] [Indexed: 12/05/2022]
Abstract
Several publications show that superselective conventional TransArterial ChemoEmbolization (cTACE), meaning cTACE performed selectively with a microcatheter positioned as close as possible to the tumor, improves outcomes, maximizing the anti-tumoral effect and minimizing the collateral damages of the surrounding liver parenchyma. Recent recommendations coming from the European Association for the Study of the Liver (EASL) and European Society of Medical Oncology (ESMO) highlighted that TACE must be used in Hepatocellular Carcinoma (HCC) “selectively targetable” and “accessible to supraselective catheterization.” The goal of the manuscript is to better define such population and to standardize superselective cTACE (ss-cTACE) technique. An expert panel with extensive clinical-procedural experience in TACE, have come together in a virtual meeting to generate recommendations and express their consensus. Experts recommend that anytime cTACE is proposed, it should be ss-cTACE, preferably with a 1.5–2.0 Fr microcatheter. Ideally, ss-cTACE should be proposed to patients with less than five lesions and a maximum number of two segments involved, with largest tumor smaller than 5 cm. Angio Cone-Beam Computed Tomography (CBCT) should be used to detect enhancing tumors, tumor feeders and guide tumor targeting. Whole tumor volume should be covered to obtain the best response. Adding peritumoral margins is encouraged but not mandatory. The treatment should involve a water-in-oil emulsion, whose quality is assessable with the “drop test.” Additional particulate embolization should be systematically performed, as per definition of cTACE procedure. Non-contrast CBCT or Multi-Detector Computed Tomography (MDCT) combined with angiography has been considered the gold standard for imaging during TACE, and should be used to assess tumor coverage during the procedure. Experts convene that superselectivity decreases incidence of adverse effects and improves tolerance. Experts recommend contrast-enhanced Computed Tomography (CT) as initial imaging on first follow-up after ss-cTACE, and Magnetic Resonance Imaging (MRI) if remaining tumor viability cannot be confidently assessed on CT. If no response is obtained after two ss-cTACE sessions within six months, patient must be considered unsuitable for TACE and proposed for alternative therapy. Patients are best served by multidisciplinary decision-making, and Interventional Radiologists should take an active role in patient selection, treatment allocation, and post-procedural care.
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Affiliation(s)
- Thierry de Baere
- Institut Gustave Roussy, Service Radiodiagnostic et Imagerie Médicale, 39, rue Camille Desmoulins, 94800, Villejuif, France.
| | - Maxime Ronot
- Department of Medical Imaging, Beaujon University Hospital, Clichy, France
| | - Jin Wook Chung
- Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea
| | - Rita Golfieri
- Unità Operativa Radiologia Universitaria (Pad 1, 2), Dipartimento delle Radiologie, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Roman Kloeckner
- Radiology Department, Mainz University: Johannes Gutenberg Universitat Mainz, Mainz, Germany
| | - Joong-Won Park
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center (NCC), Goyang-si, South Korea
| | - Bernhard Gebauer
- Department of Diagnostic Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum: Charite, Berlin, Germany
| | - Nabil Kibriya
- Department of Radiology, Kings College Hospital, NHS Foundation Trust, London, UK
| | | | - Shiro Miyayama
- Department of Diagnostic Radiology, Fukui-Ken Saiseikai Hospital, Fukui, Japan
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Corcioni B, Brandi N, Marasco G, Gaudiano C, De Cinque A, Ciccarese F, Ercolino A, Schiavina R, Brunocilla E, Renzulli M, Golfieri R. Multiparametric Ultrasound for the diagnosis of Leydig cell tumours in non‐palpable testicular lesions. Andrology 2022; 10:1387-1397. [DOI: 10.1111/andr.13233] [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] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Beniamino Corcioni
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Via Albertoni 15 Bologna Italia
| | - Nicolò Brandi
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Via Albertoni 15 Bologna Italia
| | - Giovanni Marasco
- Internal Medicine and Digestive Physiopathology Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italia
| | - Caterina Gaudiano
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Via Albertoni 15 Bologna Italia
| | - Antonio De Cinque
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Via Albertoni 15 Bologna Italia
| | - Federica Ciccarese
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Via Albertoni 15 Bologna Italia
| | - Amelio Ercolino
- Division of Urology IRCCS, Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
| | - Riccardo Schiavina
- Division of Urology IRCCS, Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
| | - Eugenio Brunocilla
- Division of Urology IRCCS, Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy
| | - Matteo Renzulli
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Via Albertoni 15 Bologna Italia
| | - Rita Golfieri
- Department of Radiology IRCCS Azienda Ospedaliero‐Universitaria di Bologna Via Albertoni 15 Bologna Italia
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Santoro M, Della Gala G, Paolani G, Zagni F, Strolin S, Civollani S, Calderoni L, Cappelli A, Mosconi C, Lodi Rizzini E, Tabacchi E, Morganti AG, Fanti S, Golfieri R, Strigari L. A novel tool for motion-related dose inaccuracies reduction in 99mTc-MAA SPECT/CT images for SIRT planning. Phys Med 2022; 98:98-112. [PMID: 35526374 DOI: 10.1016/j.ejmp.2022.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/05/2022] [Accepted: 04/27/2022] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION In Selective Internal Radiation Therapy (SIRT), 90Y is administered to primary/secondary hepatic lesions. An accurate pre-treatment planning using 99mTc-MAA SPECT/CT allows the assessment of its feasibility and of the activity to be injected. Unfortunately, SPECT/CT suffers from patient-specific respiratory motion which causes artifacts and absorbed dose inaccuracies. In this study, a data-driven solution was developed to correct the respiratory motion. METHODS The tool realigns the barycenter of SPECT projection images and shifts them to obtain a fine registration with the attenuation map. The tool was validated using a modified dynamic phantom with several breathing patterns. We compared the absorbed dose distributions derived from uncorrected(Dm)/corrected(Dc) images with static ones(Ds) in terms of γ-passing rates, 210 Gy isodose volumes, dose-volume histograms and percentage differences of mean doses (i.e., ΔD¯m and ΔD¯c, respectively). The tool was applied to twelve SIRT patients and the Bland-Altman analysis was performed on mean doses. RESULTS In the phantom study, the agreement between Dc and Ds was higher (γ-passing rates generally > 90%) than Dm and Ds. The isodose volumes in Dc were closer than Dm to Ds, with differences up to 10% and 30% respectively. A reduction from a median ΔD¯m = -19.3% to ΔD¯c = -0.9%, from ΔD¯m = -42.8% to ΔD¯c = -7.0% and from ΔD¯m = 1586% to ΔD¯c = 47.2% was observed in liver-, tumor- and lungs-like structures. The Bland-Altman analysis on patients showed variations (±50 Gy) and (±4 Gy) between D¯c and D¯m of tumor and lungs, respectively. CONCLUSION The proposed tool allowed the correction of 99mTc-MAA SPECT/CT images, improving the accuracy of the absorbed dose distribution.
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Affiliation(s)
- Miriam Santoro
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giuseppe Della Gala
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giulia Paolani
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Federico Zagni
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Silvia Strolin
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Simona Civollani
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Letizia Calderoni
- Nuclear Medicine Unit, IRCCS Azienda Ospedaliero, University of Bologna, 40138 Bologna, Italy
| | - Alberta Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Elisa Lodi Rizzini
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Elena Tabacchi
- Nuclear Medicine Unit, IRCCS Azienda Ospedaliero, University of Bologna, 40138 Bologna, Italy
| | | | - Stefano Fanti
- Nuclear Medicine Unit, IRCCS Azienda Ospedaliero, University of Bologna, 40138 Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Lidia Strigari
- Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
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Cingolani A, Scrivo A, Mattiotti M, Zappulo F, Laura Croci Chiocchini A, Gasperoni L, Hu L, Abenavoli C, DI Nunzio M, Marchegiani B, Tringali E, Cristina Galaverni M, Cappelli A, Mosconi C, Renzulli M, Golfieri R, Donati G, LA Manna G. MO775: Vacuum-Assisted Thromboaspiration with Indigo System After Acute Arteriovenous Fistula Thrombosis: Monocentric Experience of an Innovative Interventional Approach. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac080.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Arteriovenous fistula (AVF) must be the first choice where eligible and a prompt approach within 48–72 h should be performed in case of acute AVF failure in order to maintain the patency of the vascular access. Evaluation of the most appropriate de-clotting technique must be made considering the patient's comorbidity, AVF characteristics and absolute, relative and temporary contraindications to each kind of corrective intervention. The outcome is different between the multiple methods and nowadays mechanical thromboaspiration (MT) seems to be an innovative and promising approach.
METHOD
A total of 9 AVF of 9 chronic haemodialysis patients with acute AVF failure were treated with MT between January 2019 and January 2022 and were retrospectively evaluated. MT was carried out via Indigo catheter (Penumbra Inc.), an aspiration system intended for the removal of emboli and thrombi from vessels through venipuncture of AVF/AVG: the continuous aspiration helps distinguish clots from normal blood flow; in case of resistant clots, separators of many sizes can be used at the tip of the catheter to facilitate their fragmentation and aspiration. Adjunctive procedures such as balloon angioplasty (used at all sites), local fibrinolysis, heparin infusion, or stents placement were considered. Technical success was defined by clot removal from AVF or AVG. Clinical success was defined by the restoration of thrill and bruit together with AVF usability after the procedure. Vascular access survival defined as AVF/AVG usability at 3 and 6 months was assessed.
RESULTS
Average age was 71.2 years; dialysis vintage was 93.4 months. Medium follow-up was 13.1 months. All patients needed placement of a temporary central venous catheter (CVC) and dialysis before the MT. Technical success was achieved in 100% of the procedures, clinical success was achieved in 88.9% of the MT (despite the technical success, in 1/9 patients AVF could not be used due to a severe residual venous stenosis). None reported peri-/intraprocedural complications. In 2/9 MT there was no use of anticoagulation; in 5/9 patients, a single unfractionated heparin bolus was used (2500 UI) during the manoeuvre; in 2/9 patients, a single 2500 UI bolus plus continuous intravenous infusion of unfractionated heparin was administered combined with local thrombolysis with urokinase: both patients needed blood transfusions after the manoeuvre, one of them reporting severe haemorrhage from AVF. As adjunctive procedures, 9/9 patients underwent balloon angioplasty; one of them needed stent placement over the venous stenosis. CVC was removed less than 48 h from the procedure in 5/9 patients (55.6%), in 3/9 patients it was removed after 48 h, while 1/9 patients maintained the temporary vascular access due to the lack of clinical success after MT. Double-needle puncture occurred after a medium time of 3.5 days. AVF survival at 3 months and 6 months was 66.6% (6/9 patients), while 3/9 patients faced AVF failure (1/3 patients deceased 2 months after the procedure with a functioning AVF, in 1/3 patients a relapse of AVG thrombosis occurred 2 months after the procedure, 1/3 never reached clinical success due to severe residual venous stenosis). At the time of study design, 3/9 patients resulted to be deceased due to causes unrelated to the procedure. (1/3 due to complications of abdominal surgery, 1/3 due to sepsis, 1/3 due to subarachnoid haemorrhage).
CONCLUSION
MT is an innovative yet functional and safe procedure that allows declotting of the thrombosed AVF while reducing or avoiding anticoagulation and/or surgery.
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Affiliation(s)
- Alessandra Cingolani
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | - Anna Scrivo
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | - Maria Mattiotti
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | - Fulvia Zappulo
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | | | - Lorenzo Gasperoni
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | - Lilio Hu
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | - Chiara Abenavoli
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | - Miriam DI Nunzio
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | - Beatrice Marchegiani
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | - Edoardo Tringali
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
| | - Maria Cristina Galaverni
- IRCCS Policlinico di Sant'Orsola, Radiology Unit, Department of Diagnostic & Preventive Medicine, Bologna, Italy
| | - Alberta Cappelli
- IRCCS Policlinico di Sant'Orsola, Radiology Unit, Department of Diagnostic & Preventive Medicine, Bologna, Italy
| | - Cristina Mosconi
- IRCCS Policlinico di Sant'Orsola, Radiology Unit, Department of Diagnostic & Preventive Medicine, Bologna, Italy
| | - Matteo Renzulli
- IRCCS Policlinico di Sant'Orsola, Radiology Unit, Department of Diagnostic & Preventive Medicine, Bologna, Italy
| | - Rita Golfieri
- IRCCS Policlinico di Sant'Orsola, Radiology Unit, Department of Diagnostic & Preventive Medicine, Bologna, Italy
| | - Gabriele Donati
- Nephrology, Dialysis and Renal Transplantation Unit, Azienda Ospedaliero-Universitaria di Modena, Surgical, Medical, Dental and Morphological Sciences Department (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
| | - Gaetano LA Manna
- IRCCS Policlinico di Sant'Orsola, Nephrology, Dialysis and Transplant Unit, Bologna, Italy
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Filitto G, Coppola F, Curti N, Giampieri E, Dall’Olio D, Merlotti A, Cattabriga A, Cocozza MA, Taninokuchi Tomassoni M, Remondini D, Pierotti L, Strigari L, Cuicchi D, Guido A, Rihawi K, D’Errico A, Di Fabio F, Poggioli G, Morganti AG, Ricciardiello L, Golfieri R, Castellani G. Automated Prediction of the Response to Neoadjuvant Chemoradiotherapy in Patients Affected by Rectal Cancer. Cancers (Basel) 2022; 14:cancers14092231. [PMID: 35565360 PMCID: PMC9100060 DOI: 10.3390/cancers14092231] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Colorectal cancer is the second most malignant tumor per number of deaths after lung cancer and the third per number of new cases after breast and lung cancer. The correct and rapid identification (i.e., segmentation of the cancer regions) is a fundamental task for correct patient diagnosis. In this study, we propose a novel automated pipeline for the segmentation of MRI scans of patients with LARC in order to predict the response to nCRT using radiomic features. This study involved the retrospective analysis of T2-weighted MRI scans of 43 patients affected by LARC. The segmentation of tumor areas was on par or better than the state-of-the-art results, but required smaller sample sizes. The analysis of radiomic features allowed us to predict the TRG score, which agreed with the state-of-the-art results. Abstract Background: Rectal cancer is a malignant neoplasm of the large intestine resulting from the uncontrolled proliferation of the rectal tract. Predicting the pathologic response of neoadjuvant chemoradiotherapy at an MRI primary staging scan in patients affected by locally advanced rectal cancer (LARC) could lead to significant improvement in the survival and quality of life of the patients. In this study, the possibility of automatizing this estimation from a primary staging MRI scan, using a fully automated artificial intelligence-based model for the segmentation and consequent characterization of the tumor areas using radiomic features was evaluated. The TRG score was used to evaluate the clinical outcome. Methods: Forty-three patients under treatment in the IRCCS Sant’Orsola-Malpighi Polyclinic were retrospectively selected for the study; a U-Net model was trained for the automated segmentation of the tumor areas; the radiomic features were collected and used to predict the tumor regression grade (TRG) score. Results: The segmentation of tumor areas outperformed the state-of-the-art results in terms of the Dice score coefficient or was comparable to them but with the advantage of considering mucinous cases. Analysis of the radiomic features extracted from the lesion areas allowed us to predict the TRG score, with the results agreeing with the state-of-the-art results. Conclusions: The results obtained regarding TRG prediction using the proposed fully automated pipeline prove its possible usage as a viable decision support system for radiologists in clinical practice.
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Affiliation(s)
- Giuseppe Filitto
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy; (G.F.); (G.C.)
| | - Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
- SIRM Foundation, Italian Society of Medical and Interventional Radiology, 40138 Bologna, Italy
| | - Nico Curti
- eDIMES Lab, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
- INFN Bologna, 40127 Bologna, Italy;
- Correspondence: (N.C.); (E.G.)
| | - Enrico Giampieri
- eDIMES Lab, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
- Correspondence: (N.C.); (E.G.)
| | - Daniele Dall’Olio
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy; (D.D.); (A.M.)
| | - Alessandra Merlotti
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy; (D.D.); (A.M.)
| | - Arrigo Cattabriga
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
| | - Maria Adriana Cocozza
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
| | - Makoto Taninokuchi Tomassoni
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
| | - Daniel Remondini
- INFN Bologna, 40127 Bologna, Italy;
- Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy; (D.D.); (A.M.)
| | - Luisa Pierotti
- Sant’Orsola-Malpighi Polyclinic, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Lidia Strigari
- Department of Medical Physics, Sant’Orsola-Malpighi Polyclinic, IRCCS Azienda Ospedaliero-Universitaria di Bologn, 40138 Bologna, Italy;
| | - Dajana Cuicchi
- Medical and Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (D.C.); (G.P.)
| | - Alessandra Guido
- Department of Radiation Oncology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.G.M.)
| | - Karim Rihawi
- Division of Medical Oncology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (K.R.); (F.D.F.)
| | - Antonietta D’Errico
- Pathology Unit, Department of Specialized, Experimental and Diagnostic Medicine, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Francesca Di Fabio
- Division of Medical Oncology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (K.R.); (F.D.F.)
| | - Gilberto Poggioli
- Medical and Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (D.C.); (G.P.)
| | - Alessio Giuseppe Morganti
- Department of Radiation Oncology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.G.M.)
| | - Luigi Ricciardiello
- Department of Medical and Surgical Science, University of Bologna, 40138 Bologna, Italy;
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (A.C.); (M.A.C.); (M.T.T.); (R.G.)
| | - Gastone Castellani
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy; (G.F.); (G.C.)
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Renzulli M, Mottola M, Coppola F, Cocozza MA, Malavasi S, Cattabriga A, Vara G, Ravaioli M, Cescon M, Vasuri F, Golfieri R, Bevilacqua A. Automatically Extracted Machine Learning Features from Preoperative CT to Early Predict Microvascular Invasion in HCC: The Role of the Zone of Transition (ZOT). Cancers (Basel) 2022; 14:cancers14071816. [PMID: 35406589 PMCID: PMC8997857 DOI: 10.3390/cancers14071816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/18/2022] [Accepted: 03/31/2022] [Indexed: 02/08/2023] Open
Abstract
Background: Microvascular invasion (MVI) is a consolidated predictor of hepatocellular carcinoma (HCC) recurrence after treatments. No reliable radiological imaging findings are available for preoperatively diagnosing MVI, despite some progresses of radiomic analysis. Furthermore, current MVI radiomic studies have not been designed for small HCC nodules, for which a plethora of treatments exists. This study aimed to identify radiomic MVI predictors in nodules ≤3.0 cm by analysing the zone of transition (ZOT), crossing tumour and peritumour, automatically detected to face the uncertainties of radiologist’s tumour segmentation. Methods: The study considered 117 patients imaged by contrast-enhanced computed tomography; 78 patients were finally enrolled in the radiomic analysis. Radiomic features were extracted from the tumour and the ZOT, detected using an adaptive procedure based on local image contrast variations. After data oversampling, a support vector machine classifier was developed and validated. Classifier performance was assessed using receiver operating characteristic (ROC) curve analysis and related metrics. Results: The original 89 HCC nodules (32 MVI+ and 57 MVI−) became 169 (62 MVI+ and 107 MVI−) after oversampling. Of the four features within the signature, three are ZOT heterogeneity measures regarding both arterial and venous phases. On the test set (19MVI+ and 33MVI−), the classifier predicts MVI+ with area under the curve of 0.86 (95%CI (0.70–0.93), p∼10−5), sensitivity = 79% and specificity = 82%. The classifier showed negative and positive predictive values of 87% and 71%, respectively. Conclusions: The classifier showed the highest diagnostic performance in the literature, disclosing the role of ZOT heterogeneity in predicting the MVI+ status.
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Affiliation(s)
- Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (M.R.); (M.M.); (F.C.); (M.A.C.); (A.C.); (G.V.); (R.G.)
| | - Margherita Mottola
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (M.R.); (M.M.); (F.C.); (M.A.C.); (A.C.); (G.V.); (R.G.)
- Advanced Research Center on Electronic Systems (ARCES), University of Bologna, 40126 Bologna, Italy;
| | - Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (M.R.); (M.M.); (F.C.); (M.A.C.); (A.C.); (G.V.); (R.G.)
| | - Maria Adriana Cocozza
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (M.R.); (M.M.); (F.C.); (M.A.C.); (A.C.); (G.V.); (R.G.)
| | - Silvia Malavasi
- Advanced Research Center on Electronic Systems (ARCES), University of Bologna, 40126 Bologna, Italy;
| | - Arrigo Cattabriga
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (M.R.); (M.M.); (F.C.); (M.A.C.); (A.C.); (G.V.); (R.G.)
| | - Giulio Vara
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (M.R.); (M.M.); (F.C.); (M.A.C.); (A.C.); (G.V.); (R.G.)
| | - Matteo Ravaioli
- General Surgery and Transplant Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy; (M.R.); (M.C.)
| | - Matteo Cescon
- General Surgery and Transplant Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy; (M.R.); (M.C.)
| | - Francesco Vasuri
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (M.R.); (M.M.); (F.C.); (M.A.C.); (A.C.); (G.V.); (R.G.)
| | - Alessandro Bevilacqua
- Advanced Research Center on Electronic Systems (ARCES), University of Bologna, 40126 Bologna, Italy;
- Department of Computer Science and Engineering (DISI), University of Bologna, 40126 Bologna, Italy
- Correspondence: ; Tel.: +39-05-1209-5409
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Pecorelli A, Franceschi P, Braccischi L, Izzo F, Renzulli M, Golfieri R. MRI Appearance of Focal Lesions in Liver Iron Overload. Diagnostics (Basel) 2022; 12:diagnostics12040891. [PMID: 35453939 PMCID: PMC9029711 DOI: 10.3390/diagnostics12040891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022] Open
Abstract
Liver iron overload is defined as an accumulation of the chemical element Fe in the hepatic parenchyma that exceeds the normal storage. When iron accumulates, it can be toxic for the liver by producing inflammation and cell damage. This can potentially lead to cirrhosis and hepatocellular carcinoma, as well as to other liver lesions depending on the underlying condition associated to liver iron overload. The correct assessment of liver iron storage is pivotal to drive the best treatment and prevent complication. Nowadays, magnetic resonance imaging (MRI) is the best non-invasive modality to detect and quantify liver iron overload. However, due to its superparamagnetic properties, iron provides a natural source of contrast enhancement that can make challenging the differential diagnosis between different focal liver lesions (FLLs). To date, a fully comprehensive description of MRI features of liver lesions commonly found in iron-overloaded liver is lacking in the literature. Through an extensive review of the published literature, we aim to summarize the MRI signal intensity and enhancement pattern of the most common FLLs that can occur in liver iron overload.
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Renzulli M, Brandi N, Pecorelli A, Pastore LV, Granito A, Martinese G, Tovoli F, Simonetti M, Dajti E, Colecchia A, Golfieri R. Segmental Distribution of Hepatocellular Carcinoma in Cirrhotic Livers. Diagnostics (Basel) 2022; 12:diagnostics12040834. [PMID: 35453882 PMCID: PMC9032124 DOI: 10.3390/diagnostics12040834] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 02/21/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 02/07/2023] Open
Abstract
Background: To evaluate the segmental distribution of hepatocellular carcinoma (HCC) according to Couinaud’s anatomical division in cirrhotic patients. Methods: Between 2020 and 2021, a total of 322 HCC nodules were diagnosed in 217 cirrhotic patients who underwent computed tomography (CT) or magnetic resonance imaging (MRI) for the evaluation of suspicious nodules (>1 cm) detected during ultrasound surveillance. For each patient, the segmental position of the HCC nodule was recorded according to Couinaud’s description. The clinical data and nodule characteristics were collected. Results: A total of 234 (72.7%) HCC nodules were situated in the right lobe whereas 79 (24.5%) were detected in the left lobe (p < 0.0001) and only 9 nodules were in the caudate lobe (2.8%). HCC was most common in segment 8 (n = 88, 27.4%) and least common in segment 1 (n = 9, 2.8%). No significant differences were found in the frequencies of segmental or lobar involvement considering patient demographic and clinical characteristics, nodule dimension, or disease appearance. Conclusions: The intrahepatic distribution of HCC differs among Couinaud’s segments, with segment 8 being the most common location and segment 1 being the least common. The segmental distribution of tumour location was similar to the normal liver volume distribution, supporting a possible correlation between HCC location and the volume of hepatic segments and/or the volumetric distribution of the portal blood flow.
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Affiliation(s)
- Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (A.P.); (L.V.P.); (G.M.); (M.S.); (R.G.)
- Correspondence: (M.R.); (N.B.)
| | - Nicolò Brandi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (A.P.); (L.V.P.); (G.M.); (M.S.); (R.G.)
- Correspondence: (M.R.); (N.B.)
| | - Anna Pecorelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (A.P.); (L.V.P.); (G.M.); (M.S.); (R.G.)
| | - Luigi Vincenzo Pastore
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (A.P.); (L.V.P.); (G.M.); (M.S.); (R.G.)
| | - Alessandro Granito
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (F.T.)
| | - Giuseppe Martinese
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (A.P.); (L.V.P.); (G.M.); (M.S.); (R.G.)
| | - Francesco Tovoli
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (F.T.)
| | - Mario Simonetti
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (A.P.); (L.V.P.); (G.M.); (M.S.); (R.G.)
| | - Elton Dajti
- Department of Medical and Surgical Sciences (DIMEC), IRCCS, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy;
| | - Antonio Colecchia
- Unit of Gastroenterology, Borgo Trento University Hospital of Verona, 25122 Verona, Italy;
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (A.P.); (L.V.P.); (G.M.); (M.S.); (R.G.)
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Brandi N, Ciccarese F, Rimondi MR, Balacchi C, Modolon C, Sportoletti C, Renzulli M, Coppola F, Golfieri R. An Imaging Overview of COVID-19 ARDS in ICU Patients and Its Complications: A Pictorial Review. Diagnostics (Basel) 2022; 12:846. [PMID: 35453894 PMCID: PMC9032937 DOI: 10.3390/diagnostics12040846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/10/2022] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 01/08/2023] Open
Abstract
A significant proportion of patients with COVID-19 pneumonia could develop acute respiratory distress syndrome (ARDS), thus requiring mechanical ventilation, and resulting in a high rate of intensive care unit (ICU) admission. Several complications can arise during an ICU stay, from both COVID-19 infection and the respiratory supporting system, including barotraumas (pneumothorax and pneumomediastinum), superimposed pneumonia, coagulation disorders (pulmonary embolism, venous thromboembolism, hemorrhages and acute ischemic stroke), abdominal involvement (acute mesenteric ischemia, pancreatitis and acute kidney injury) and sarcopenia. Imaging plays a pivotal role in the detection and monitoring of ICU complications and is expanding even to prognosis prediction. The present pictorial review describes the clinicopathological and radiological findings of COVID-19 ARDS in ICU patients and discusses the imaging features of complications related to invasive ventilation support, as well as those of COVID-19 itself in this particularly fragile population. Radiologists need to be familiar with COVID-19's possible extra-pulmonary complications and, through reliable and constant monitoring, guide therapeutic decisions. Moreover, as more research is pursued and the pathophysiology of COVID-19 is increasingly understood, the role of imaging must evolve accordingly, expanding from the diagnosis and subsequent management of patients to prognosis prediction.
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Affiliation(s)
- Nicolò Brandi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
| | - Federica Ciccarese
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
| | - Maria Rita Rimondi
- Cardio-Thoracic Radiology Unit, University Hospital S.Orsola-Malpighi, 40138 Bologna, Italy; (M.R.R.); (C.M.); (C.S.)
| | - Caterina Balacchi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
| | - Cecilia Modolon
- Cardio-Thoracic Radiology Unit, University Hospital S.Orsola-Malpighi, 40138 Bologna, Italy; (M.R.R.); (C.M.); (C.S.)
| | - Camilla Sportoletti
- Cardio-Thoracic Radiology Unit, University Hospital S.Orsola-Malpighi, 40138 Bologna, Italy; (M.R.R.); (C.M.); (C.S.)
| | - Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
| | - Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122 Milano, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
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Gaudiano C, Ciccarese F, Bianchi L, Corcioni B, De Cinque A, Giunchi F, Schiavina R, Fiorentino M, Brunocilla E, Golfieri R. The role of MRI in the detection of local recurrence: Added value of multiparametric approach and Signal Intensity/Time Curve analysis. Arch Ital Urol Androl 2022; 94:25-31. [PMID: 35352521 DOI: 10.4081/aiua.2022.1.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/25/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of the study was to evaluate the accuracy of multiparametric Magnetic Resonance Imaging (mpMRI) in the detection of local recurrence of prostate cancer (PCa) with the evaluation of the added value of signal Intensity/Time (I/T) curves. MATERIALS AND METHODS A retrospective analysis of 22 patients undergoing mpMRI from 2015 to 2020 was carried out, with the following inclusion criteria: performing transrectal ultrasound guided biopsy within 3 months in the case of positive or doubtful findings and undergoing biopsy and/or clinical follow-up for 24 months in the case of negative results. The images were reviewed, and the lesions were catalogued according to morphological, diffusion-weighted imaging (DWI) and dynamic contrast- enhanced (DCE) features. RESULTS The presence of local recurrence was detected in 11/22 patients (50%). Greater diameter, hyperintensity on DWI, positive contrast enhancement and type 2/3 signal I/T curves were more frequently observed in patients with local recurrence (all p < 0.05). Of all the sequences, DCE was the most accurate; however, the combination of DCE and DWI showed the best results, with a sensitivity of 100%, a specificity of 82%, a negative predictive value of 100% and a positive predictive value of 85%. CONCLUSIONS The utility of MRI in the detection of local recurrence is tied to the multiparametric approach, with all sequences providing useful information. A combination of DCE and DWI is particularly effective. Moreover, specificity could be additionally improved using analysis of the signal I/T curves.
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Affiliation(s)
- Caterina Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
| | - Federica Ciccarese
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
| | - Lorenzo Bianchi
- Department of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
| | - Beniamino Corcioni
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
| | - Antonio De Cinque
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
| | - Francesca Giunchi
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
| | - Riccardo Schiavina
- Department of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
| | | | - Eugenio Brunocilla
- Department of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
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Gabelloni M, Faggioni L, Cioni D, Mendola V, Falaschi Z, Coppola S, Corradi F, Isirdi A, Brandi N, Coppola F, Granata V, Golfieri R, Grassi R, Neri E. Extracorporeal membrane oxygenation (ECMO) in COVID-19 patients: a pocket guide for radiologists. Radiol Med 2022; 127:369-382. [PMID: 35279765 PMCID: PMC8918086 DOI: 10.1007/s11547-022-01473-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/23/2022] [Indexed: 01/08/2023]
Abstract
During the coronavirus disease 19 (COVID-19) pandemic, extracorporeal membrane oxygenation (ECMO) has been proposed as a possible therapy for COVID-19 patients with acute respiratory distress syndrome. This pictorial review is intended to provide radiologists with up-to-date information regarding different types of ECMO devices, correct placement of ECMO cannulae, and imaging features of potential complications and disease evolution in COVID-19 patients treated with ECMO, which is essential for a correct interpretation of diagnostic imaging, so as to guide proper patient management.
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Affiliation(s)
- Michela Gabelloni
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
| | - Dania Cioni
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122, Milano, Italy
| | - Vincenzo Mendola
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Zeno Falaschi
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Sara Coppola
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Francesco Corradi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Isirdi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Nicolò Brandi
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria Di Bologna, 40138, Bologna, Italy
| | - Francesca Coppola
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122, Milano, Italy
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria Di Bologna, 40138, Bologna, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS Di Napoli, 80131, Naples, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria Di Bologna, 40138, Bologna, Italy
| | - Roberto Grassi
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122, Milano, Italy
- Division of Radiology, Università Degli Studi Della Campania Luigi Vanvitelli, 80127, Naples, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122, Milano, Italy
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Gaudiano C, Rustici A, Corcioni B, Ciccarese F, Bianchi L, Schiavina R, Giunchi F, Fiorentino M, Brunocilla E, Golfieri R. PI-RADS version 2.1 for the evaluation of transition zone lesions: a practical guide for radiologists. Br J Radiol 2022; 95:20210916. [PMID: 34919421 PMCID: PMC8978244 DOI: 10.1259/bjr.20210916] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Multiparametric MRI has been established as the most accurate non-invasive diagnostic imaging tool for detecting prostate cancer (PCa) in both the peripheral zone and the transition zone (TZ) using the PI-RADS (Prostate Imaging Reporting and Data System) v. 2.1 released in 2019 as a guideline to reporting. TZ PCa remains the most difficult to diagnose due to a markedly heterogeneous background and a wide variety of atypical imaging presentations as well as other anatomical and pathological processes mimicking PCa. The aim of this paper was to present a spectrum of PCa in the TZ, as a guide for radiologists.
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Affiliation(s)
- Caterina Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Arianna Rustici
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Beniamino Corcioni
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federica Ciccarese
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | | | - Francesca Giunchi
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Michelangelo Fiorentino
- Department of Specialty, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | | | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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50
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Parmeggiani A, Baldazzi M, Carfagnini F, Vivacqua D, Golfieri R, Lovato L, Greco L. Extensive solitary lymphatic malformation of the liver in a child: a case report and literature review. Radiol Case Rep 2022; 17:427-433. [PMID: 34917222 PMCID: PMC8666449 DOI: 10.1016/j.radcr.2021.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/18/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 11/24/2022] Open
Abstract
Intrabdominal lymphatic malformations are rare benign congenital vascular anomalies that account for less than 5% of benign masses in childhood, with an extremely variable clinical presentation. For this reason, although their radiological appearance is usually typical, diagnosis can be challenging and not always immediate. This report describes a unique case of extensive solitary hepatic lymphatic malformation in a 10-year-old boy with both extra- and intraparenchymal development with no associated symptoms. A literature review of reported cases of solitary hepatic lymphatic malformation is also included.
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Affiliation(s)
- Anna Parmeggiani
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Michelangelo Baldazzi
- Pediatric Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Filomena Carfagnini
- Pediatric Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Donatella Vivacqua
- Pediatric Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Luigi Lovato
- Cardio-Thoracic Radiology Unit, Cardio-Thoracic-Vascular Department, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Laura Greco
- Pediatric Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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