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Piscopo L, Scaglione M, Klain M. Artificial intelligence-based application in multiple myeloma. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06711-z. [PMID: 38587646 DOI: 10.1007/s00259-024-06711-z] [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] [Indexed: 04/09/2024]
Affiliation(s)
- Leandra Piscopo
- Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Sassari, Italy.
| | - Mariano Scaglione
- Radiology Department of Surgery, Medicine and Pharmacy, University of Sassari, Sassari, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
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Volpe F, Piscopo L, Zampella E, Klain M. Alpha emitter isotopes and PSMA ligands: the near future therapeutic prospective for castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging 2024; 51:1207-1209. [PMID: 38141070 DOI: 10.1007/s00259-023-06574-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Affiliation(s)
- Fabio Volpe
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
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Guglielmo P, Alongi P, Baratto L, Conte M, Abenavoli EM, Buschiazzo A, Celesti G, Dondi F, Filice R, Gorica J, Jonghi-Lavarini L, Laudicella R, Librando M, Linguanti F, Mattana F, Miceli A, Olivari L, Piscopo L, Santo G, Volpe F, Evangelista L. FAPi-Based Agents in Thyroid Cancer: A New Step towards Diagnosis and Therapy? A Systematic Review of the Literature. Cancers (Basel) 2024; 16:839. [PMID: 38398230 PMCID: PMC10887091 DOI: 10.3390/cancers16040839] [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: 01/22/2024] [Revised: 02/11/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: Thyroid cancer (TC) is often treated with surgery followed by iodine-131. Up to 50% of the instances of TC lose their avidity to 131I, becoming more aggressive. In this scenario, [18F]FDG PET/CT imaging is used for evaluating the widespread nature of the disease, despite its low sensitivity and a false negative rate of 8-21.1%. A novel class of PET agents targeting the fibroblast activation protein inhibitor (FAPi) has emerged, studied particularly for their potential application to theranostics. (2) Methods: A search of the literature was performed by two independent authors (P.G. and L.E.) using the PubMed, Scopus, Web of Science, Cochrane Library, and EMBASE databases. The following terms were used: "FAP" or "FAPi" or "Fibroblast activating protein" and "thyroid" or "thyroid cancer", in different combinations. The included papers were original articles, clinical studies, and case reports in the English language. No time limits were used. Editorials, conference papers, reviews, and preclinical studies were excluded. (3) Results: There were 31 papers that were selected. Some studies reported a low or absent FAPi uptake in TC lesions; others reported promising findings for the detection of metastases. (4) Conclusions: The preliminary results are encouraging. FAPI agents are an alternative to [18F]FDG and a promising theranostic tool. However, further studies with a larger population are needed.
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Affiliation(s)
| | - Pierpaolo Alongi
- Nuclear Medicine Unit, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, 90127 Palermo, Italy;
| | - Lucia Baratto
- Division of Pediatric Radiology, Department of Radiology, Lucile Packard Children’s Hospital, Stanford University, Stanford, CA 94304, USA;
| | - Miriam Conte
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza University of Rome, 00185 Rome, Italy;
| | | | - Ambra Buschiazzo
- Nuclear Medicine Division, Santa Croce and Carle Hospital, 12100 Cuneo, Italy;
| | - Greta Celesti
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98122 Messina, Italy; (G.C.); (M.L.)
| | - Francesco Dondi
- Division of Nuclear Medicine, Università degli Studi di Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy;
| | - Rossella Filice
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, 90133 Palermo, Italy; (R.F.); (R.L.)
| | - Joana Gorica
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Lorenzo Jonghi-Lavarini
- Department of Nuclear Medicine, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Riccardo Laudicella
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, 90133 Palermo, Italy; (R.F.); (R.L.)
| | - Maria Librando
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98122 Messina, Italy; (G.C.); (M.L.)
| | - Flavia Linguanti
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy;
| | - Francesco Mattana
- Division of Nuclear Medicine, IEO European Institute of Oncology IRCSS, 20141 Milan, Italy;
| | - Alberto Miceli
- Nuclear Medicine Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Laura Olivari
- Nuclear Medicine Unit, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar, Italy;
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, 80138 Naples, Italy; (L.P.); (F.V.)
| | - Giulia Santo
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy;
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, 80138 Naples, Italy; (L.P.); (F.V.)
| | - Laura Evangelista
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy;
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
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Piscopo L, Volpe F. PET/CT imaging with radiolabeled FAPI: new opportunities for diagnosis and treatment of thyroid cancer. Eur J Nucl Med Mol Imaging 2024; 51:800-802. [PMID: 37752269 DOI: 10.1007/s00259-023-06452-5] [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] [Indexed: 09/28/2023]
Affiliation(s)
- Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Piscopo L, Zampella E, Klain M. [ 18F]FET PET/MR and machine learning in the evaluation of glioma. Eur J Nucl Med Mol Imaging 2024; 51:797-799. [PMID: 37953393 DOI: 10.1007/s00259-023-06505-9] [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] [Indexed: 11/14/2023]
Affiliation(s)
- Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Nappi C, Zampella E, Gaudieri V, Volpe F, Piscopo L, Vallone C, Pace L, Ponsiglione A, Maurea S, Nicolai E, Cuocolo A, Klain M. Tumor Burden of Iodine-Avid Bone Metastatic Thyroid Cancer Identified via 18F-Sodium Fluoride PET/CT Imaging. J Clin Med 2024; 13:569. [PMID: 38276075 PMCID: PMC10816004 DOI: 10.3390/jcm13020569] [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: 11/15/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Patients with differentiated thyroid cancer (DTC) are referred to radioactive 131I (RAI) therapy and post-therapy 131I whole-body scintigraphy (WBS) to identify local and/or remote metastases. Positron emission tomography (PET)/computed tomography (CT) imaging with 18F-fluoro-D-glucose (FDG) or 18F-sodium fluoride (NaF) may also be used with these patients for the evaluation of bone metastases. We compared the role of 18F-NaF PET/CT and 18F-FDG-PET/CT in patients with DTC and documented bone metastases at post-therapy WBS. METHODS Ten consecutive DTC patients with iodine avid bone metastasis at post-therapy WBS referred to 18F-NaF PET/CT and 18F-FDG PET/CT were studied. The findings of the three imaging procedures were compared for abnormal detection rates and concordance. RESULTS At post-therapy 131I WBS, all patients had skeletal involvement with a total of 21 bone iodine avid lesions. At 18F-FDG PET/TC, 19 bone lesions demonstrated increased tracer uptake and CT pathological alterations, while 2 lesions did not show any pathological finding. At 18F-NaF PET/CT, the 19 bone lesions detected at 18F-FDG PET/TC also demonstrated abnormal tracer uptake, and the other 2 bone iodine avid foci did not show any pathological finding. CONCLUSIONS In patients with DTC, 18F-NaF PET/CT did not obtain more information on the metastatic skeletal involvement than post-therapy 131I WBS and 18F-FDG PET/CT.
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Affiliation(s)
- Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
| | - Carlo Vallone
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
| | - Leonardo Pace
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Salerno, Italy;
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
| | | | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy (V.G.); (L.P.); (C.V.); (A.C.); (M.K.)
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Piscopo L, Zampella E, Klain M. New opportunities for dosimetric approach in patients with differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2024; 51:330-331. [PMID: 37870586 DOI: 10.1007/s00259-023-06473-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Affiliation(s)
- Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Affiliation(s)
- Fabio Volpe
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
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Volpe F, Piscopo L. The combined evaluation of clinical and biochemical data in management of patients with differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2023; 51:230-232. [PMID: 37552368 DOI: 10.1007/s00259-023-06387-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Affiliation(s)
- Fabio Volpe
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
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Volpe F, Nappi C, Piscopo L, Zampella E, Mainolfi CG, Ponsiglione A, Imbriaco M, Cuocolo A, Klain M. Emerging Role of Nuclear Medicine in Prostate Cancer: Current State and Future Perspectives. Cancers (Basel) 2023; 15:4746. [PMID: 37835440 PMCID: PMC10571937 DOI: 10.3390/cancers15194746] [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] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Prostate cancer is the most frequent epithelial neoplasia after skin cancer in men starting from 50 years and prostate-specific antigen (PSA) dosage can be used as an early screening tool. Prostate cancer imaging includes several radiological modalities, ranging from ultrasonography, computed tomography (CT), and magnetic resonance to nuclear medicine hybrid techniques such as single-photon emission computed tomography (SPECT)/CT and positron emission tomography (PET)/CT. Innovation in radiopharmaceutical compounds has introduced specific tracers with diagnostic and therapeutic indications, opening the horizons to targeted and very effective clinical care for patients with prostate cancer. The aim of the present review is to illustrate the current knowledge and future perspectives of nuclear medicine, including stand-alone diagnostic techniques and theragnostic approaches, in the clinical management of patients with prostate cancer from initial staging to advanced disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy; (F.V.); (C.N.); (L.P.); (E.Z.); (C.G.M.); (A.P.); (M.I.); (A.C.)
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Guglielmo P, Alongi P, Baratto L, Abenavoli E, Buschiazzo A, Celesti G, Conte M, Filice R, Gorica J, Jonghi-Lavarini L, Lanzafame H, Laudicella R, Librando M, Linguanti F, Mattana F, Miceli A, Olivari L, Piscopo L, Romagnolo C, Santo G, Vento A, Volpe F, Evangelista L. Head-to-Head Comparison of FDG and Radiolabeled FAPI PET: A Systematic Review of the Literature. Life (Basel) 2023; 13:1821. [PMID: 37763225 PMCID: PMC10533171 DOI: 10.3390/life13091821] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
FAPI-based radiopharmaceuticals are a novel class of tracers, mainly used for PET imaging, which have demonstrated several advantages over [18F]FDG, especially in the case of low-grade or well-differentiated tumors. We conducted this systematic review to evaluate all the studies where a head-to-head comparison had been performed to explore the potential utility of FAPI tracers in clinical practice. FAPI-based radiopharmaceuticals have shown promising results globally, in particular in detecting peritoneal carcinomatosis, but studies with wider populations are needed to better understand all the advantages of these new radiopharmaceuticals.
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Affiliation(s)
| | - Pierpaolo Alongi
- Nuclear Medicine Unit, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, 90127 Palermo, Italy;
| | - Lucia Baratto
- Department of Radiology, Division of Pediatric Radiology, Lucile Packard Children’s Hospital, Stanford University, Stanford, CA 94304, USA;
| | - Elisabetta Abenavoli
- Nuclear Medicine Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy;
| | - Ambra Buschiazzo
- Nuclear Medicine Division, Santa Croce and Carle Hospital, 12100 Cuneo, Italy;
| | - Greta Celesti
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98122 Messina, Italy; (G.C.); (M.L.)
| | - Miriam Conte
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (J.G.)
| | - Rossella Filice
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, 90133 Palermo, Italy; (R.F.); (R.L.)
| | - Joana Gorica
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (J.G.)
| | - Lorenzo Jonghi-Lavarini
- Department of Nuclear Medicine, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Helena Lanzafame
- Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, 45147 Essen, Germany
| | - Riccardo Laudicella
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, 90133 Palermo, Italy; (R.F.); (R.L.)
| | - Maria Librando
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98122 Messina, Italy; (G.C.); (M.L.)
| | - Flavia Linguanti
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy;
| | - Francesco Mattana
- Division of Nuclear Medicine, IEO European Institute of Oncology IRCSS, 20141 Milan, Italy;
| | - Alberto Miceli
- Nuclear Medicine Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Laura Olivari
- Nuclear Medicine Unit, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar, Italy;
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, 80138 Naples, Italy; (L.P.); (F.V.)
| | - Cinzia Romagnolo
- Department of Nuclear Medicine, “Ospedali Riuniti” Hospital, 60126 Ancona, Italy;
| | - Giulia Santo
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy;
| | - Antonio Vento
- Nuclear Medicine Department, ASP 1-P.O. San Giovanni di Dio, 92100 Agrigento, Italy;
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, 80138 Naples, Italy; (L.P.); (F.V.)
| | - Laura Evangelista
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy;
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
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Piscopo L, Zampella E, Volpe F, Gaudieri V, Nappi C, Cutillo P, Volpicelli F, Falzarano M, Pace L, Cuocolo A, Klain M. Efficacy of Empirical Radioiodine Therapy in Patients with Differentiated Thyroid Cancer and Elevated Serum Thyroglobulin without Evidence of Structural Disease: A Propensity Score Analysis. Cancers (Basel) 2023; 15:4196. [PMID: 37627224 PMCID: PMC10453751 DOI: 10.3390/cancers15164196] [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: 07/07/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
We assessed the outcome of administration of empiric radioactive iodine (RAI) therapy to patients with differentiated thyroid cancer (DTC), in a propensity-score-matched cohort of patients with biochemical incomplete response (BIR) and without evidence of structural disease. We retrospectively evaluated 820 DTC patients without distant metastases, who underwent total thyroidectomy followed by RAI therapy, with available BIR at 12 months and follow-up evaluations. The patients were categorized according to the administration of empiric therapy (ET). To account for differences between patients with (n = 119) and without (n = 701) ET, a propensity-score-matched cohort of 119 ET and 119 no-ET patients was created. The need for additional therapy and the occurrence of structural disease were considered as end-points. During a median follow-up of 53 months (range 3-285), 57 events occurred (24% cumulative event rate). The rate of events was significantly higher in the no-ET compared to the ET patients (30% vs. 18% p < 0.001). The multivariate Cox analysis identified age (p < 0.01), pre-therapy Tg (p < 0.05) and empiric RAI therapy (p < 0.01) as predictors of outcome. The Kaplan-Meier analysis found that progression-free survival was lower in no-ET patients compared to the ET group (p < 0.01). In patients with DTC treated with surgery and RAI, and with biochemical incomplete response at the 12-month evaluation, their prognosis seemed to be affected by Tg values and the empiric treatment. The identification of candidates for this approach may improve prognosis.
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Affiliation(s)
- Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
| | - Paolo Cutillo
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
| | - Federica Volpicelli
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
| | - Maria Falzarano
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
| | - Leonardo Pace
- Department of Medicine Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy;
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy; (L.P.); (E.Z.); (F.V.); (V.G.); (C.N.); (P.C.); (F.V.); (M.F.); (A.C.)
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Piscopo L, Zampella E, Pellegrino S, Volpe F, Nappi C, Gaudieri V, Fonti R, Vecchio SD, Cuocolo A, Klain M. Diagnosis, Management and Theragnostic Approach of Gastro-Entero-Pancreatic Neuroendocrine Neoplasms. Cancers (Basel) 2023; 15:3483. [PMID: 37444593 DOI: 10.3390/cancers15133483] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 05/31/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) constitute an ideal target for radiolabeled somatostatin analogs. The theragnostic approach is able to combine diagnosis and therapy by the identification of a molecular target that can be diagnosed and treated with the same radiolabeled compound. During the last years, advances in functional imaging with the introduction of somatostatin analogs and peptide receptor radionuclide therapy, have improved the diagnosis and treatment of GEP-NENs. Moreover, PET/CT imaging with 18F-FDG represents a complementary tool for prognostic evaluation of patients with GEP-NENs. In the field of personalized medicine, the theragnostic approach has emerged as a promising tool in diagnosis and management of patients with GEP-NENs. The aim of this review is to summarize the current evidence on diagnosis and management of patients with GEP-NENs, focusing on the theragnostic approach.
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Affiliation(s)
- Leandra Piscopo
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
| | - Sara Pellegrino
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
| | - Rosa Fonti
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
| | - Silvana Del Vecchio
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, 80131 Naples, Italy
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Zampella E, Piscopo L, Manganelli M, Volpe F, Nappi C, Gaudieri V, Pace L, Schlumberger M, Cuocolo A, Klain M. Prognostic value of 12-month response to therapy in pediatric patients with differentiated thyroid cancer. Endocrine 2023; 80:612-618. [PMID: 36692657 PMCID: PMC10199830 DOI: 10.1007/s12020-023-03309-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 09/27/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE In pediatric patients with differentiated thyroid cancer (DTC) we assessed the prognostic value of the 12-month response to therapy after initial treatment with surgery and radioactive iodine (RAI). METHODS We retrospectively evaluated 94 pediatric patients with DTC, treated with surgery and RAI who were initially classified as low, intermediate or high risk of relapse of disease according to the American Thyroid Association (ATA) guidelines. Twelve months after RAI administration the response to therapy was assessed by serum thyroglobulin (Tg) measurement and neck ultrasound and patients were classified as having excellent response (ER) or no-ER. RESULTS At the 12 months evaluation, 62 (66%) patients had ER and 32 (34%) no-ER. During a mean follow-up time of 86 months (range 9-517), 19 events occurred (20% cumulative event rate). Events occurred more frequently in younger patients (p < 0.05), in those at ATA intermediate/high risk (p < 0.01) and with a pre-RAI therapy Tg level > 10 ng/mL (p < 0.001), and in those with no-ER (p < 0.001). At multivariate analysis, the evidence of no-ER was the only independent predictor of events. CONCLUSION In pediatric patients with DTC, the response to therapy evaluated 12 months after initial treatment has an independent prognostic impact and is able to predict mid-term outcome. Patients with no-ER at 12 months after RAI therapy should be closely followed-up.
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Affiliation(s)
- Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leonardo Pace
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Martin Schlumberger
- Consultant, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
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Piscopo L, Volpe F, Nappi C, Zampella E, Manganelli M, Matrisciano F, Totaro P, Pace L, Maurea S, Cuocolo A, Klain M. Second Primary Malignancies in Patients with Differentiated Thyroid Cancer after Radionuclide Therapy: A Retrospective Single-Centre Study. Curr Oncol 2022; 30:37-44. [PMID: 36661652 PMCID: PMC9857292 DOI: 10.3390/curroncol30010003] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/14/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
Second primary malignancies (SPM) are described as any primary, not synchronous, malignancy arising in a different anatomical district, with confirmed histological diagnosis. Age at diagnosis, previous non-thyroidal primary malignancy, and radioactive iodine (RAI) therapy have been proposed as independent risk factors for SPM. RAI therapy is a standard treatment for moderate-high risk differentiated thyroid cancer (DTC), and its effect on the development of SPM has become a critical topic in DTC treatment. The purpose of this retrospective single-center study was to investigate the occurrence and the possible association of non-thyroidal SPM diagnosed after DTC and RAI therapy in a cohort of 1326 consecutive DTC patients referred at our Institution for RAI treatment from 1993 to 2009. Eighty-nine patients with ages ≤ 18 years at the time of DTC diagnosis or with a follow-up of ≤12 months were excluded from the final analysis. All patients underwent a complete clinical and hematological follow-up every 6 months for a minimum of 12 months. During follow-up (mean 89 ± 73 months), 25 patients (2%) had an SPM diagnosis (mean 133 ± 73 months). The most common site of the second malignancy was the breast, accounting for 32% of all SPM, followed by colon-rectal cancer (16%), leukemia, and gynecological and kidney cancer (4%). At Cox univariable regression analysis, age at DTC diagnosis (p < 0.001), age ≥55 years (p < 0.001) and follow-up duration (p < 0.004) were associated with SPM onset, while no significant association was observed with the administered activity of radioiodine. In conclusion, our data suggest that the older a person gets, the more sharply the likelihood of developing additional diseases, such as PMS, increases. Similarly, for follow-up, the more a patient is followed up clinically over time, the higher the risk of new diagnoses increases.
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Affiliation(s)
- Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | | | - Francesca Matrisciano
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Pasquale Totaro
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Leonardo Pace
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Fisciano, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy
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Nappi C, Piscopo L, Klain M, Mainolfi CG, Vergara E, Adamo D, Mignogna MD, Cuocolo A. Hyperfunctioning parathyroid gland and skeletal involvement on [ 18F]fluorocholine PET/CT: one look with two views. Eur J Hybrid Imaging 2022; 6:28. [PMID: 36504377 PMCID: PMC9742067 DOI: 10.1186/s41824-022-00149-y] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/15/2022] [Indexed: 12/14/2022] Open
Abstract
Hyperparathyroidism is an endocrine disorder that may be associated with other metabolic diseases. Non-invasive imaging techniques including [99mTc]Tc-sestamibi single-photon emission computed tomography (SPECT) and [18F]fluorocholine positron emission tomography (PET)/computed tomography (CT) play a key role on management of patients with hyperparathyroidism. We report for the first time a case of a patient with evidence of both hyperfunctioning parathyroid tissue and multiple lytic bone lesions on [18F]fluorocholine PET/CT imaging. The present case report highlights the potential role of whole-body [18F]fluorocholine PET/CT for the identification of both parathyroid adenoma and multiple bone lesions in a single diagnostic setting.
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Affiliation(s)
- Carmela Nappi
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy
| | - Leandra Piscopo
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy
| | - Michele Klain
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy
| | - Ciro Gabriele Mainolfi
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy
| | - Emilia Vergara
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy
| | - Daniela Adamo
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Michele Davide Mignogna
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Alberto Cuocolo
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy
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Nappi C, Petretta M, Assante R, Zampella E, Gaudieri V, Cantoni V, Green R, Volpe F, Piscopo L, Mainolfi CG, Nicolai E, Acampa W, Cuocolo A. Prognostic value of heart rate reserve in patients with suspected coronary artery disease undergoing stress myocardial perfusion imaging. J Nucl Cardiol 2022; 29:2521-2530. [PMID: 34346030 PMCID: PMC9553802 DOI: 10.1007/s12350-021-02743-2] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/01/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Chronotropic incompetence is common in patients with cardiovascular disease and is associated with increased risk of adverse events. We assessed the incremental prognostic value of heart rate reserve (HRR) over stress myocardial perfusion single-photon emission computed tomography (MPS) findings in patients with suspected coronary artery disease (CAD). METHODS We studied 866 patients with suspected CAD undergoing exercise stress-MPS as part of their diagnostic program. The primary study endpoint was all-cause mortality. All patients were followed for at least 5 years. HRR was calculated as the difference between peak exercise and resting HR, divided by the difference of age-predicted maximal and resting HR and expressed as percentage. RESULTS During 7 years follow-up, 61 deaths occurred, with a 7% cumulative event rate. Patients experiencing death were older (P < .001), and had a higher prevalence of male gender (P < .001) and diabetes (P < .05). Patients with event also had lower values of HRR (65% ± 27% vs 73% ± 18%, P < .0001) and higher prevalence of stress-induced myocardial ischemia (25% vs 8%, P < .0001). Male gender, HRR and stress-induced ischemia were independent predictors of all-cause mortality (all P < .01). HRR improved the prognostic power of a model including clinical data and MPS findings, increasing the global χ2 from 66 to 82 (P < .005). CONCLUSIONS Chronotropic incompetence has independent and incremental prognostic value in predicting all-cause mortality in patients with suspected CAD undergoing exercise stress-MPS. Hence, the evaluation of HRR may further improve patients' risk stratification.
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Affiliation(s)
- Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | | | - Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Cantoni
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Ciro Gabriele Mainolfi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | | | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
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Volpe F, Piscopo L, Manganelli M, Falzarano M, Volpicelli F, Nappi C, Imbriaco M, Cuocolo A, Klain M. Intramedullary Spinal Cord Metastases from Differentiated Thyroid Cancer, a Case Report. Life (Basel) 2022; 12:863. [PMID: 35743894 PMCID: PMC9225536 DOI: 10.3390/life12060863] [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: 04/01/2022] [Revised: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023] Open
Abstract
Intramedullary spinal cord metastases (ISCM) are uncommon metastases of the spinal cord. Magnetic resonance (MR) plays an important role in surgical planning when ISCM is suspected in the differential diagnosis. The incidence of ISCM is expected to increase due to the longer survival of cancer patients as well as the widespread use of MR in the diagnosis of neurological syndromes. The management of these patients is controversial because of the multiple clinical presentations and lack of controlled studies on the efficacy of different therapeutic approaches. Increased awareness of this rare entity may lead to an earlier diagnosis with novel imaging approaches at a stage when neurological deficits are reversible. A case of ISCM in a 49-year-old patient with differentiated thyroid cancer is reported.
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Nappi C, Klain M, Cantoni V, Green R, Piscopo L, Volpe F, Maurea S, Petretta M, Cuocolo A. Risk of primary breast cancer in patients with differentiated thyroid cancer undergoing radioactive iodine therapy: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 2021; 49:1630-1639. [PMID: 34820683 DOI: 10.1007/s00259-021-05625-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 10/13/2021] [Accepted: 11/15/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE Although it has been proven that radioactive iodine (RAI) treatment is an effective and well-tolerated procedure in patients with differentiated thyroid cancer (DTC), there is still some concern regarding the risk of developing a second primary malignancy after RAI administration. We performed a systematic review and meta-analysis to investigate the risk of primary breast cancer in patients with DTC undergoing RAI therapy. METHODS A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. RESULTS The final analysis included 14 studies accounting for a total of 200,247 patients with DTC (98,368 treated with RAI and 101,879 not treated with RAI). The relative risk of primary breast cancer in patients with DTC treated with RAI to those not treated with RAI among studies ranged from 0.45 to 2.55, the pooled relative risk was 0.83 (95% confidence interval, 0.70-0.99), and the heterogeneity was 71.5%. CONCLUSION The present meta-analysis indicates that patients with DTC treated with RAI do not have a higher risk of primary breast cancer compared to those not treated with RAI. These findings suggest that RAI therapy does not increase the risk of breast cancer.
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Affiliation(s)
- Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Cantoni
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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Klain M, Nappi C, De Risi M, Piscopo L, Volpe F, Manganelli M, Caiazzo E, Bianco D, Schlumberger M, Cuocolo A. Whole-Body Radioiodine Effective Half-Life in Patients with Differentiated Thyroid Cancer. Diagnostics (Basel) 2021; 11:diagnostics11101740. [PMID: 34679438 PMCID: PMC8535104 DOI: 10.3390/diagnostics11101740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022] Open
Abstract
Background: Radioactive 131I (RAI) therapy is used in patients with differentiated thyroid cancer (DTC) after total thyroidectomy for remnant ablation, adjuvant treatment or treatment of persistent disease. 131I retention data, which are used to indicate the time at which a 131I treated DTC patient can be released from the hospital, may bring some insights regarding clinical factors that prolong the length of hospitalization. The aim of this study was to investigate the 131I whole-body retention in DTC patients during 131I therapy. Methods: We monitored 166 DTC patients to follow the 131I whole-body retention during 131I therapy with a radioactivity detector fixed on the ceiling of each protected room. A linear regression fit permitted us to estimate the whole-body 131I effective half-life in each patient, and a relationship was sought between patients’ clinical characteristics and whole-body effective 131I half-life. Results: The effective 131I half-life ranged from 4.08 to 56.4 h. At multivariable analysis, longer effective 131I half-life was related to older age and extensive extra-thyroid disease. Conclusions: 131I effective half-life during 131I treatment in DTC patients is highly variable among patients and is significantly longer in older and in patients with RAI uptake in large thyroid remnants or in extrathyroidal disease that significantly prolongs the whole-body retention of 131I.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Marina De Risi
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Mariarosaria Manganelli
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Elisa Caiazzo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Davide Bianco
- Italian Aerospace Research Centre (CIRA), 81043 Capua, Italy;
| | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, 80131 Naples, Italy; (M.K.); (C.N.); (M.D.R.); (L.P.); (F.V.); (M.M.); (E.C.); (M.S.)
- Correspondence:
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Klain M, Maurea S, Gaudieri V, Zampella E, Volpe F, Manganelli M, Piscopo L, De Risi M, Cuocolo A. The diagnostic role of total-body 18F-FDG PET/CT in patients with multiple tumors: a report of the association of thyroid cancer with lung or renal tumors. Quant Imaging Med Surg 2021; 11:4211-4215. [PMID: 34476200 DOI: 10.21037/qims-21-36] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/14/2021] [Indexed: 01/17/2023]
Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Marina De Risi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
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Nappi C, Petretta M, Cantoni V, Green R, Assante R, Zampella E, Gaudieri V, Mannarino T, D"antonio A, Manganelli M, Piscopo L, Ponsiglione A, Acampa W, Cuocolo A. Prognostic value of heart rate reserve in patients with suspected coronary artery disease undergoing stress myocardial perfusion imaging. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.037] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background. The prognostic value of stress myocardial perfusion single-photon emission computed tomography (MPS) has been widely demonstrated. Also, chronotropic incompetence, evaluated by heart rate reserve (HRR) is associated with increased risk of adverse events. Yet, the incremental prognostic value of HRR over stress MPS data has not been fully investigated.
Purpose. To assess the incremental prognostic value of HRR over stress MPS finding in patients with suspected coronary artery disease (CAD) undergoing exercise stress MPS.
Methods. The study population consisted of 866 consecutive patients with suspected CAD undergoing exercise stress-MPS at University of Naples Federico II, between May 2002 and January 2014 as part of their diagnostic program. The primary study endpoint was all-cause mortality. All patients were followed for at least 60 months. HRR was calculated as the difference between peak exercise and resting HR, divided by the difference of age-predicted maximal and resting HR and expressed as percent. The summed difference score (SDS) was considered an index of ischemic burden. Patients were considered to have mild ischemia with a SDS of 2 to 6, and moderate-severe ischemia with a SDS ≥6. During follow-up, the occurrence of all-cause of deaths was noted and considered as event. Follow-up was censored at 84 months.
Results. During follow-up, 61 deaths occurred, with a 7% cumulative event rate. Patients experiencing death were older (56.2 ± 10.7 years vs. 66.4 ± 8.6 years), with a higher prevalence of male gender (56% vs. 87 %, P < 0.05) and diabetes mellitus (23% vs. 36%, P < 0.05). At stress-MPS, patients with event had lower mean values of HRR (53.2 ± 21.3% vs. 61.5 ± 16.4%, P < 0.0001) and higher prevalence of moderate-severe ischemia (24% vs. 8%, P < 0.0001). The best trade-off between sensitivity and specificity for identifying chronotropic incompetence was a HRR <67% with an area under the receiver operating characteristic curve of 0.62. The event free survival was lower in patients with HRR <67% compared to those with HRR ≥67% (log-rank 9.75, P < 0.005). Accordingly, the annualized event rate was 0.006 in patients with HRR <67% and 0.014 in those with HRR ≥67% (P < 0.001). At Cox regression analysis, univariable predictors of all-cause mortality were age, male gender, diabetes mellitus, HRR and moderate-severe ischemia (all P < 0.05). At multivariable analysis age, male gender, HRR and moderate-severe ischemia were independent predictors of all-cause mortality (all P < 0.05). HRR improved the prognostic power of a model including clinical data and MPS findings for the prediction of all-cause mortality, increasing the global chi-square from 76.16 to 82.68 (P < 0.005).
Conclusion. Chronotropic incompetence assessed by HRR evaluation, has independent and incremental prognostic value in predicting all cause of death in patients with suspected CAD undergoing exercise stress-MPS.
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Affiliation(s)
- C Nappi
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | | | - V Cantoni
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - R Green
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - R Assante
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - E Zampella
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - V Gaudieri
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - T Mannarino
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - A D"antonio
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - M Manganelli
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - L Piscopo
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - A Ponsiglione
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - W Acampa
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - A Cuocolo
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
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Klain M, Nappi C, Zampella E, Cantoni V, Green R, Piscopo L, Volpe F, Manganelli M, Caiazzo E, Petretta M, Schlumberger M, Cuocolo A. Ablation rate after radioactive iodine therapy in patients with differentiated thyroid cancer at intermediate or high risk of recurrence: a systematic review and a meta-analysis. Eur J Nucl Med Mol Imaging 2021; 48:4437-4444. [PMID: 34142215 PMCID: PMC8566414 DOI: 10.1007/s00259-021-05440-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/12/2021] [Accepted: 05/31/2021] [Indexed: 12/01/2022]
Abstract
Purpose We performed a systematic review and a meta-analysis to investigate the successful ablation rate after radioiodine (RAI) administration in patients with differentiated thyroid cancer (DTC) at intermediate-high risk of recurrence. Methods A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. Results The final analysis included 9 studies accounting for 3103 patients at intermediate-high risk of recurrence. In these patients, the successful ablation rates ranged from 51 to 94% with a 71% pooled successful ablation and were higher in intermediate (72%) than in high (52%)-risk patients. Despite the rigorous inclusion standards, a significant heterogeneity among the evaluated studies was observed. Higher administered RAI activities are associated with a lower successful ablation rate in the whole population and in the subgroup of high-risk patients. Furthermore, pooled recurrence rate in intermediate-risk patients achieving successful ablation was only 2% during the subsequent 6.4-year follow-up while the pooled recurrence rate was 14% in patients who did not achieve a successful ablation. Conclusion In a large sample of 3103 patients at intermediate-high risk of persistent/recurrent disease, 71% of patients achieved a successful ablation. In these intermediate-risk patients, the probability of subsequent recurrence is low and most recurrence occurred in those with already abnormal findings at the first control. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05440-x.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Cantoni
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Elisa Caiazzo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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24
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Klain M, Zampella E, Manganelli M, Gaudieri V, Nappi C, D'Antonio A, Piscopo L, Volpe F, Pace L, Schlumberger M, Cuocolo A. Risk of structural persistent disease in pediatric patients with low or intermediate risk differentiated thyroid cancer. Endocrine 2021; 71:378-384. [PMID: 32529282 DOI: 10.1007/s12020-020-02379-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 04/03/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE In pediatric patients with differentiated thyroid cancer (DTC), the risk of recurrence is high and the indication for postoperative 131I administration is still debated. The aim of this study was to assess the outcome in low and intermediate risk pediatric DTC patients. METHODS We retrospectively evaluated 45 pediatric patients with low or intermediate risk DTC, treated with surgery and 131I between 1992 and 2002 and with no detectable antithyroglobulin (Tg) antibodies. Follow-up was performed every 6-12 months with Tg blood level determination and imaging procedures. RESULTS During follow-up (64 ± 53 months), 15 events occurred (33% cumulative event rate, with an annual event rate of 5% person years). Five of these patients were submitted to additional surgery and all these 15 patients underwent a second 131I treatment course. All patients were alive at the end of the follow-up. Structural persistent disease occurred more frequently in patients at intermediate risk (p < 0.01) and in those with Tg values after thyroid hormone withdrawal >10 ng/ml before 131I therapy (p < 0.01). At multivariate analysis, only a postoperative thyroid stimulating hormone-stimulated Tg level >10 ng/ml was an independent predictor of persistent disease. CONCLUSIONS In pediatric patients with DTC, postoperative high stimulated Tg values (>10 ng/ml) should be taken into account for deciding the extent of both initial treatment and follow-up.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leonardo Pace
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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25
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Klain M, Nappi C, Maurea S, De Risi M, Volpe F, Caiazzo E, Piscopo L, Manganelli M, Schlumberger M, Cuocolo A. Management of differentiated thyroid cancer through nuclear medicine facilities during Covid-19 emergency: the telemedicine challenge. Eur J Nucl Med Mol Imaging 2020; 48:831-836. [PMID: 32965559 PMCID: PMC7509822 DOI: 10.1007/s00259-020-05041-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/13/2020] [Indexed: 02/07/2023]
Abstract
Purpose To investigate whether a telemedicine service (TMS) carried out during the Covid-19 pandemic impacted on management of patients with differentiated thyroid cancer (DTC). Methods We retrospectively reviewed the number and the findings of outpatient visits in DTC subjects referred between March 11, 2020, and May 31, 2020, during the Covid-19 pandemic at the Radiometabolic Unit of the University of Naples Federico II. Office visits scheduled in March and May 2020 were converted in teleconsultation reaching all patients planned for an in-ward access to advise them to use the TMS for all clinical necessity. The number and the findings of DTC patients evaluated by in-ward access in the corresponding period of 2019 were also assessed for direct comparison. Results The number of outpatient visits performed by TMS during the pandemic (n = 445) and by in-ward access in the corresponding period of 2019 (n = 525) was comparable with only 15% of outpatient evaluations missed. Conclusions Our findings demonstrate the utility of telemedicine tools to avoid the potential negative impact of interruption or postponement of diagnostic and/or therapeutic procedures. Therefore, investments in medical network system development, including the implementation of telehealth approaches, should be encouraged at national and international levels.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Marina De Risi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Elisa Caiazzo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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Klain M, Nappi C, Nicolai E, Romeo V, Piscopo L, Giordano A, Gaudieri V, Zampella E, Pace L, Carlo C, Salvatore M, Schlumberger M, Cuocolo A. Comparison of simultaneous 18F-2-[18F] FDG PET/MR and PET/CT in the follow-up of patients with differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2020; 47:3066-3073. [DOI: 10.1007/s00259-020-04938-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/21/2020] [Indexed: 12/30/2022]
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27
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Nappi C, Zampella E, Volpe F, De Risi M, Piscopo L, Ponsiglione A, Imbriaco M, Acampa W, Petretta M, Cuocolo A. Identification and typing of cardiac amyloidosis by noninvasive imaging: Two cases for two patterns. J Nucl Cardiol 2020; 27:915-920. [PMID: 31845305 DOI: 10.1007/s12350-019-01982-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/05/2019] [Accepted: 11/26/2019] [Indexed: 11/28/2022]
Abstract
Cardiac amyloidosis is a restrictive infiltrative cardiomyopathy burdened by high mortality. The two more common forms are immunoglobulin light-chain amyloidosis and transthyretin-related amyloidosis with different prognoses and treatments. However, distinguishing between them is challenging. Appropriate utilization of the different available imaging techniques in the evaluation of patients with known or suspected cardiac amyloidosis is mandatory. We report two cases with cardiac amyloidosis of different etiology and with distinct imaging patterns. In the first case, the negative 99mTc-diphosphonate imaging was useful to support the diagnosis of cardiac amyloid light-chain; the second case emphasized the utility of whole-body scintigraphy in recognizing transthyretin-related cardiac amyloidosis and the potential role of cadmium-zinc-telluride SPECT imaging for the evaluation of segmental distribution of cardiac disease. Both cases support the growing interest in looking for noninvasive methods to type cardiac amyloidosis in the place of invasive myocardial biopsy highlighting both possibilities and limitations of available imaging techniques in diagnosis and treatment monitoring.
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Affiliation(s)
- Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Marina De Risi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
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Ambrosio D, Piscopo L, Lauro C, Rotondi M, Gallo E, Balbi F. [Treatment of ovarian carcinoma with intraperitoneal administration of interferon alpha 2b]. Minerva Ginecol 2001; 53:67-71. [PMID: 11526725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Pharmacokinetic studies have confirmed that for many chemotherapeutic agents a substantial pharmacological advantage can be achieved using the intraperitoneal route. Aim of this study is to evaluate the efficacy of intraperitoneal interferon alpha 2b chemotherapy to treat ovarian cancer. METHODS Forty-four patients affected by ovarian cancer have been submitted to intraperitoneal interferon alpha 2b chemotherapy from October 1989 to May 1996 at the Gynecology and Obstetric Institute of the Second University of Naples. Intraperitoneal route has been obtained through a catheter in left iliac fossa. Drugs have been solved in 2000 ml of physiologic solution to obtain a better distribution into the peritoneal fluid. RESULTS Three patients of 15 not-pre-medicated and 16 of 24 pre-medicated have obtained complete anatomo-pathological resolution. No compliances have been checked about catheter. Only two patients have stopped the therapy for asthenia; all the others have well tolerated interferon. CONCLUSIONS Our study shows the very low toxicity of interferon associated to a good tolerance of the intraperitoneal catheter and therefore we retain that intraperitoneal chemotherapy with interferon alpha 2b improves the prognosis of patients with minimal ovarian cancer after systemical chemotherapy.
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Affiliation(s)
- D Ambrosio
- I Divisione Clinica Ostetrica e Ginecologica, Seconda Università degli Studi, Napoli
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29
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Cardone A, Ambrosio D, Tirabasso S, Menditto A, Piscopo L, Musone R, Salzano P. [Prevention of vaginal prolapse in patients undergoing abdominal hysterectomy]. MINERVA CHIR 2000; 55:325-8. [PMID: 10953567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND In our study we evaluate a personally developed surgical technique that, when used for abdominal hysterectomy, helps prevent posthysterectomy vaginal wall prolapse. METHODS We have used this modified surgical procedure in 244 consecutive abdominal hysterectomies performed from January 1973 through December 1986, compared with 133 abdominal hysterectomies performed without this new procedure. Patients returned monthly and annually thereafter for follow-up. The longest follow-up period to date is 12 years. RESULTS Of the 244 patients in our study followed up for 12 years, 234 (95.9%) retained excellent vaginal support. Vaginal wall prolapse occurred in 10 patients (4.1%), and it was asymptomatic prolapse, with the vaginal wall descending less than halfway from the ischial spines to the hymen. CONCLUSIONS This procedure is an acceptable method to help prevent posthysterectomy vaginal wall prolapse.
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Affiliation(s)
- A Cardone
- Istituto di Clinica Ostetrica e Ginecologica, II Università degli Studi, Napoli
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