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Mazzetti S, Giannini V, Di Dia A, Bracco C, Bresciani S, Cauda S, Varetto T, Mastro ED, Gabriele P, Regge D, Stasi M. 228. Predicting neoadjuvant therapy response in locally advanced rectal cancer using texture features. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.239] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Mazzetti S, Giannini V, Di Dia A, Bracco C, Bresciani S, Cauda S, Varetto T, Del Mastro E, Gabriele P, Regge D, Stasi M. 16. Predicting neoadjuvant therapy response in locally advanced rectal cancer using texture features. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.026] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Frangos S, Hustinx R, Boubaker A, Varetto T, Prior JO, Siroos M, Maffioli L. The Future of the Past Is the Present: The Role of the UEMS/EBNM in the Current Challenge of Educating Nuclear Medicine Specialists. J Nucl Med 2017; 59:396-398. [PMID: 29269570 DOI: 10.2967/jnumed.117.206052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 11/28/2017] [Indexed: 11/16/2022] Open
Affiliation(s)
- Savvas Frangos
- UEMS Section of Nuclear Medicine and European Board of Nuclear Medicine, Vienna, Austria
| | - Roland Hustinx
- UEMS Section of Nuclear Medicine and European Board of Nuclear Medicine, Vienna, Austria
| | - Ariane Boubaker
- UEMS Section of Nuclear Medicine and European Board of Nuclear Medicine, Vienna, Austria
| | - Teresio Varetto
- UEMS Section of Nuclear Medicine and European Board of Nuclear Medicine, Vienna, Austria
| | - John O Prior
- UEMS Section of Nuclear Medicine and European Board of Nuclear Medicine, Vienna, Austria
| | - Mirzaei Siroos
- UEMS Section of Nuclear Medicine and European Board of Nuclear Medicine, Vienna, Austria
| | - Lorenzo Maffioli
- UEMS Section of Nuclear Medicine and European Board of Nuclear Medicine, Vienna, Austria
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Maggio A, Gabriele D, Garibaldi E, Bresciani S, Delmastro E, Di Dia A, Miranti A, Poli M, Varetto T, Stasi M, Gabriele P. Impact of a rectal and bladder preparation protocol on prostate cancer outcome in patients treated with external beam radiotherapy. Strahlenther Onkol 2017. [PMID: 28620751 DOI: 10.1007/s00066-017-1163-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE AND OBJECTIVE To test the hypothesis that a rectal and bladder preparation protocol is associated with an increase in prostate cancer specific survival (PCSS), clinical disease free survival (CDFS) and biochemical disease free survival (BDFS). PATIENTS AND METHODS From 1999 to 2012, 1080 prostate cancer (PCa) patients were treated with three-dimensional conformal radiotherapy (3DCRT). Of these patients, 761 were treated with an empty rectum and comfortably full bladder (RBP) preparation protocol, while for 319 patients no rectal/bladder preparation (NRBP) protocol was adopted. RESULTS Compared with NRBP patients, patients with RBP had significantly higher BDFS (64% vs 48% at 10 years, respectively), CDFS (81% vs 70.5% at 10 years, respectively) and PCSS (95% vs 88% at 10 years, respectively) (log-rank test p < 0.001). Multivariate analysis (MVA) indicated for all treated patients and intermediate high-risk patients that the Gleason score (GS) and the rectal and bladder preparation were the most important prognostic factors for PCSS, CDFS and BDFS. With regard to high- and very high-risk patients, GS, RBP, prostate cancer staging and RT dose were predictors of PCSS, CDFS and BDFS in univariate analysis (UVA). CONCLUSION We found strong evidence that rectal and bladder preparation significantly decreases biochemical and clinical failures and the probability of death from PCa in patients treated without daily image-guided prostate localization, presumably since patients with RBP are able to maintain a reproducibly empty rectum and comfortably full bladder across the whole treatment compared with NRPB patients.
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Affiliation(s)
- A Maggio
- Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy.
| | - D Gabriele
- Radiotherapy Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy.,Division of Radiation Oncology, University of Sassari, Sassari, Italy
| | - E Garibaldi
- Radiotherapy Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy
| | - S Bresciani
- Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy
| | - E Delmastro
- Radiotherapy Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy
| | - A Di Dia
- Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy
| | - A Miranti
- Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy
| | - M Poli
- Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy
| | - T Varetto
- Nuclear Medicine Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy
| | - M Stasi
- Medical Physic Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy
| | - P Gabriele
- Radiotherapy Department, Candiolo Cancer Institute - FPO,IRCCS, Candiolo (To), Italy
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Cattari G, Squintu S, Delmastro E, Garibaldi E, Bresciani S, Scapoli P, Cauda S, Bracco C, Varetto T, Gabriele P. EP-1326: The role of PET CT in the IMRT of cervical cancer: the experience of the Institute of Candiolo. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32576-2] [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: 10/21/2022]
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Bracco C, Verdoja F, Grangetto M, Di Dia A, Racca M, Varetto T, Stasi M. Automatic GTV contouring applying anomaly detection algorithm on dynamic FDG PET images. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Varetto T, Costa DC. The new UEMS-EACCME criteria for accreditation of live educational events (LEEs): another step forward to improve the quality of continuing medical education (CME) in Europe. Eur J Nucl Med Mol Imaging 2013; 41:191-6. [PMID: 24126469 DOI: 10.1007/s00259-013-2590-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Teresio Varetto
- Institute for Cancer Research and Treatment, Nuclear Medicine PET Centre, Strada Provinciale 142 km 3,95, 10060, Candiolo, Turin, Italy,
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Affiliation(s)
- Teresio Varetto
- Nuclear Medicine PET Centre, Institute for Cancer Research and Treatment, Strada Provinciale 142 km 3,95, 10060, Candiolo, Turin, Italy.
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Mansi L, Rambaldi PF, Cuccurullo V, Varetto T. Nuclear medicine in emergency. Q J Nucl Med Mol Imaging 2005; 49:171-91. [PMID: 16010253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The role of a procedure depends not only on its own capabilities but also on a cost/effective comparison with alternative techniques giving similar information. Starting from the definition of emergency as a sudden unexpected occurrence demanding immediate action, the role of nuclear medicine (NM) is difficult to identify if it is not possible to respond 24 h a day, 365 days a year, to clinical demands. To justify a 24 h NM service it is necessary to reaffirm the role in diagnosis of pulmonary embolism in the spiral CT era, to spread knowledge of the capabilities of nuclear cardiology in reliably diagnosing myocardial infarction (better defining admission and discharge to/from the emergency department), to increase the number of indications. Radionuclide techniques could be used as first line, alternative, complementary procedures in a diagnostic tree taking into account not only the diagnosis but also the connections with prognosis and therapy in evaluating cerebral pathologies, acute inflammation/infection, transplants, bleeding, trauma, skeletal, hepatobiliary, renal and endocrine emergencies, acute scrotal pain.
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Affiliation(s)
- L Mansi
- Nuclear Medicine Unit, Center for Excellence in Cardiovascular Diseases Research, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy.
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Pelosi E, Ala A, Bellò M, Douroukas A, Migliaretti G, Berardengo E, Varetto T, Bussone R, Bisi G. Impact of axillary nodal metastases on lymphatic mapping and sentinel lymph node identification rate in patients with early stage breast cancer. Eur J Nucl Med Mol Imaging 2005; 32:937-42. [PMID: 15838690 DOI: 10.1007/s00259-005-1797-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2004] [Accepted: 02/16/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to define the impact of the presence of axillary nodal metastases on lymphatic mapping and sentinel lymph node (SLN) identification rate in patients with early breast cancer. METHODS Two hundred and forty-six lymphatic mapping procedures were performed with both labelled nanocolloid and blue dye, followed by SLN biopsy and/or complete axillary dissection. The following parameters were recorded: patient's age, tumour laterality and location, tumour size, tumour histology, tumour stage, tumour grade, lymphovascular invasion, radiotracer injection site (subdermal-peritumoural/peri-areolar), SLN visualisation at lymphoscintigraphy, SLN metastases (presence/absence, size) and other axillary metastases (presence/absence, number). Discriminant analysis was used to analyse the data. RESULTS SLNs were identified by labelled nanocolloid alone in 94.7% of tumours, by blue dye alone in 93.5% and by the combined technique in 99.2%. Discriminant analysis showed the gamma probe SLN identification rate to be significantly limited by the presence of axillary nodal metastases. In particular, the size of SLN metastases and the number of other axillary metastases were the most important variables in reducing the gamma probe SLN identification rate (p = 0.004 and p = 0.002, respectively). On the other hand, high tumour grade was the only parameter limiting the blue dye SLN identification rate. CONCLUSION The accuracy of lymphatic mapping with labelled nanocolloid is limited by the presence of axillary nodal metastases, and particularly by the degree of SLN tumoural invasion and the presence and number of other axillary nodal metastases. Neither of these elements seems to interfere with the blue dye identification rate. The combination of the two tracers maximises the SLN identification rate.
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Affiliation(s)
- Ettore Pelosi
- S.C.D.U. Medicina Nucleare 2, Ospedale S. Giovanni Battista, Turin, Italy
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Pelosi E, Baiocco C, Pennone M, Migliaretti G, Varetto T, Maiello A, Bellò M, Bisi G. 99mTc-HMPAO-leukocyte scintigraphy in patients with symptomatic total hip or knee arthroplasty: improved diagnostic accuracy by means of semiquantitative evaluation. J Nucl Med 2004; 45:438-44. [PMID: 15001684] [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: 04/29/2023] Open
Abstract
UNLABELLED The aim of this study was to evaluate the diagnostic value, in suspected infectious prostheses, of (99m)Tc-labeled hexamethylpropyleneamine oxime ((99m)Tc-HMPAO) leukocyte scintigraphy interpreted with the addition of a semiquantitative analysis. METHODS By means of a retrospective review, we included a group of 78 consecutive patients with suspected hip or knee prosthesis infection. We performed 91 (99m)Tc-HMPAO-leukocyte scintigraphies and examined 95 localizations that were suspect. Images were acquired at 3 different time points after the injection of the labeled leukocytes: 50 min (early images), 4 h, and 24 h (late images). The scintigraphic examinations were independently evaluated by 3 observers; qualitative and semiquantitative analyses were performed. The final diagnosis of infection was based on surgical, histologic, and bacteriologic data and follow-up. RESULTS On qualitative analysis, sensitivity, specificity, and accuracy were 80.4%-87%, 65.3%-71.4%, and 75.8%-77.9%, respectively. On semiquantitative analysis, sensitivity, specificity, and accuracy were 95.6%, 95.8%, and 95.8%, respectively. The analysis of 95% confidential intervals showed statistically significant differences in specificity and accuracy between semiquantitative and qualitative analyses. CONCLUSION In those patients who underwent (99m)Tc-HMPAO-leukocyte scintigraphy for suspected hip or knee prosthesis infection, the addition of a semiquantitative evaluation to the qualitative analysis of early and late images leads to a significant improvement in both specificity and accuracy.
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Affiliation(s)
- Ettore Pelosi
- Dottorato di Ricerca Radioimmunolocalizzazione dei Tumori Umani, Università di Torino, Torino, Italy
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Pelosi E, Baiocco C, Ala A, Gay E, Bello M, Varetto T, Giani R, Bussone R, Bisi G. Lymphatic mapping in early stage breast cancer: comparison between periareolar and subdermal injection. Nucl Med Commun 2003; 24:519-23. [PMID: 12717068 DOI: 10.1097/00006231-200305000-00006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The combination of preoperative lymphatic mapping with intra-operative probe detection is becoming the standard procedure for identifying tumour lymphatic spread at the time of initial treatment in breast cancer. There are a number of identification techniques for sentinel lymph nodes, but the concordance of the results of a sentinel lymph node biopsy with axillary lymph node dissection did not vary significantly among them. Periareolar (p.a.) injection of tracer is a new procedure specifically studied to overcome some limitations of other techniques; in two groups of patients with early breast cancer we compared the periareolar with the subdermal technique. One hundred and fifty biopsy proven breast cancer patients were consecutively enrolled in this study. This population was divided into two groups: (1) group A, including 100 cancers; lymphatic mapping was performed by s.d. injection of both blue dye and radiotracer; and (2) group B, including 50 cancers; lymphatic mapping was performed with a combination of blue dye injected p.a. and radiotracer injected s.d. For group A, with both techniques we identified one or more SLNs in 100/100 tumours; blue dye detected the SLNs in 99/100 cancers (99%), lymphoscintigraphy in 93/100 cancers (93%). The concordance rate was 92%. For group B, with both techniques we identified one or more SLNs in 49/50 cancers (98%); blue dye detected the SLNs in 48/50, lymphoscintigraphy in 46/50 cancers (92%). The concordance rate was 92%. In the present study p.a. and s.d. injection of blue dye give similar and comparable results. The periareolar technique is simpler and has several advantages over the subdermal technique.
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Affiliation(s)
- E Pelosi
- Servizio di Medicina Nucleare Universitario, Ospedale S. Giovanni Battista, Torino, Italy
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Nebiolo PE, Manes M, Bonfant G, Varetto T, Cantalupi D, Alloatti S. [Use of dual energy X-ray absorptiometry (DEXA) in the determination of total body water in patients undergoing chronic dialysis]. MINERVA UROL NEFROL 1996; 48:67-74. [PMID: 8848773] [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: 02/02/2023]
Abstract
In order to assess Total Body Water (TBW), three methods are compared, in 18 patients on regular dialysis treatment: DEXA, Bioimpedance Analysis (BIA) and urea Kinetic Volume (V urea). The mean difference between gravimetric weight and Total Body Mass (TBM) DEXA is closed (1.04 kg, SD of differences 0.4 kg). The mean difference between delta pre-post HD gravimetric weight loss (2.6 kg) and delta pre-post TBM DEXA is--0.03 kg (SD 0.28). TBW measured with the three methods are (Liters): TBW DEXA = 31.2 (SD 5.2), TBW BIA = 29.7 (SD 5.2), TBW V urea = 29.1 (SD 4.8). TBW comparisons between the three methods are (Liters): TBW DEXA-TBW BIA = mean 1.5 (SD 3.8), r = 0.73. TBW DEXA-TBW V urea = mean 2.1 (SD 2.2), r = 0.88. TBW BIA-TBW V urea = mean 0.6 (SD 3.6), r = 0.80. Hydration index of lean body mass, calculated by assuming V urea as standard, is 0.69 (SD 0.05), range 0.62-0.77, in agreement with others studies. In conclusion DEXA, a useful method for body composition and nutritional status assessing, represents a new tool for measuring hydration status, combined with others TBW evaluation formulas (BIA or V urea).
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Affiliation(s)
- P E Nebiolo
- Servizio di Nefrologia e Dialisi, Ospedale Regionale Valle d'Aosta, Aosta
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Palombo D, Porta C, Peinetti F, Brustia P, Udini M, Antico A, Cantalupi D, Varetto T. Cerebral reserve and indications for shunting in carotid surgery. Cardiovasc Surg 1994; 2:32-6. [PMID: 7914143] [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: 01/27/2023]
Abstract
The aim of this study was to establish whether a preoperative evaluation of cerebral haemodynamic reserve, carried out by means of transcranial Doppler and single photoemission computed tomography with a provocative test (acetazolamide) is able to select those patients who require carotid shunting to avoid cerebral ischaemia during clamping. All patients were monitored during operation by means of somatosensitive evoked potentials. Those patients who required shunting because of abnormal evoked potentials were also those who had a poor cerebral reserve with a perfusion and velocity increase below 15%. Only one neurological deficit developed in patients who were not shunted.
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Affiliation(s)
- D Palombo
- Vascular Surgery Unit, Regional Hospital, Aosta, Italy
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Varetto T, Cantalupi D, Altieri A, Orlandi C. Emergency room technetium-99m sestamibi imaging to rule out acute myocardial ischemic events in patients with nondiagnostic electrocardiograms. J Am Coll Cardiol 1993; 22:1804-8. [PMID: 8245332 DOI: 10.1016/0735-1097(93)90761-o] [Citation(s) in RCA: 168] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The goal of this study was to determine the role of nuclear imaging in patients with chest pain. BACKGROUND The diagnosis of myocardial ischemic events in patients with chest pain and a nondiagnostic electrocardiogram (ECG) is problematic. METHODS Rest tomographic technetium-99m sestamibi imaging (740 MBq intravenously) was performed in 64 patients presenting to the emergency room with chest pain of suspected cardiac origin and a nondiagnostic ECG. Patients were admitted to the coronary care unit on the basis of clinical criteria only and were strictly monitored. RESULTS Thirty patients showed a perfusion defect on admission. Of these, 13 developed myocardial infarction within 12 h. Coronary artery disease was diagnosed in 14 patients and the remaining 3 patients were classified as having false positive findings. Normal perfusion scans were seen in 34 patients, none of whom were ultimately diagnosed as having coronary artery disease. A 100% sensitivity was demonstrated versus the final diagnosis of acute cardiac ischemia (kappa 0.91, 95% confidence interval 0.8 to 1.0). A follow-up period of up to 18 months (mean 11 +/- 3) was also carried out for major cardiac events (death, myocardial infarction, coronary angioplasty and coronary artery bypass grafting). Six events (two coronary bypass procedures, three angioplasty procedures and one death) were observed at follow-up in the group of patients with a technetium-99m sestamibi perfusion defect. Patients with normal perfusion scans on admission had no major cardiac events at follow-up study. CONCLUSIONS Technetium-99m sestamibi perfusion imaging is a promising technique for ruling out acute myocardial ischemia in the emergency room. More efficient utilization of intensive therapy beds may be expected with this approach.
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Affiliation(s)
- T Varetto
- Nuclear Medicine Department, Ospedale Regionale, Aosta, Italy
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Palombo D, Porta C, Peinetti F, Brustia P, Udini M, Antico A, Carmonini A, Cantalupi D, Varetto T. [Hemodynamic reserve in carotid surgery and the use of "superselective" shunt]. MINERVA CHIR 1992; 47:1589-94. [PMID: 1480283] [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: 12/27/2022]
Abstract
The aim of this study is to establish whether a preoperative evaluation of the Cerebral Hemodynamic Reserve, carried out by means of transcranial Doppler and SPECT with provocative test (acetazolamide) can single out those patients who, because they are supplied with a poor cerebral reserve, are truly in need of intraoperative shunting after carotid clamping. All patients were intraoperatively monitored by means of Somato Sensitive Evoked Potentials (SSEPs). Those patients who were shunted due to abnormalities in SSEPs were also those who showed a perfusion and velocity increase below 15%, and therefore supplied, in our opinion, with a scanty cerebral reserve. No, but one, neurological deficit appeared on awakening in patients who were not shunted.
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Affiliation(s)
- D Palombo
- Unità di Chirurgia Vascolare ed Angiologia, Ospedale Regionale della Valle d'Aosta, Aosta
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Paolillo V, Iazzolino E, Varetto T, De Berardinis A, Rendine S, Marra S, Picciotto G, Baccega M, De Filippi PG, Casaccia M. [Myocardial scintigraphy with thallium-201 in the evaluation of aortocoronary bypass patients]. G Ital Cardiol 1987; 17:947-56. [PMID: 3502257] [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: 01/06/2023]
Abstract
We have compared the results of 201-Thallium scintigraphy (201 TI Sc) and those of coronary angiography in 48 patients (Pts) at a mean time of 13 months after a coronary artery by-pass grafting operation (CABG). Forty-six pts were males and 2 females, with a mean age of 52 years (range 37-66). Eighteen pts (37%) had had a myocardial infarction (MI) before the operation, 4 (8%) had a perioperative and 3 (6%) a postoperative MI. Nineteen pts (40%) had angina, 9 (19%) atypical chest pain, 6 (12%) shortness of breath or easy fatigability and 14 (29%) had no symptoms. The overall CABG patency was 74% (left anterior descending: 73%, left circumflex: 71%, right coronary artery: 80%). The 201 TI was injected at peak exercise and its myocardial uptake was recorded immediately and after four hours at rest. The 201 TI Sc has shown a sensibility (SN), specificity (SP), positive predictive (PV-pos) and negative predictive value (PV-neg) of 86, 82, 64 and 94% respectively, compared to coronary angiography. In the single patient evaluation the 201 TI Sc has shown a SN, SP, PV-pos, PV-neg of 95, 85, 82 and 96% respectively versus 90, 82, 78 and 92% of the standard exercise test associated with a positive history for 1) residual angina and 2) peri or postoperative MI. The 201 TI Sc has not shown to be significantly superior to standard exercise testing and history in the evaluation of graft patency. However it allows a topographic localization of the disease which is not feasible with the latter techniques. The 201 TI Sc can better predict the patency rather than the occlusion of the grafts because there is a high number of false positives due to residual ungrafted native disease in the territory of a good functioning graft. The 201 TI scintigraphy can give a functional evaluation of borderline grafts stenoses beside the pure anatomic definition of angiography thanks to its capability to qualitatively assess the regional myocardial blood flow during stress.
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Affiliation(s)
- V Paolillo
- Divisione di Cardiologia, Ospedale Maggiore di S. Giovanni Battista, Torino
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Marra S, Paolillo V, Spadaccini F, Boncompagni F, Varetto T, Altieri A, Angelino PF. [Physical rehabilitation. A further therapeutic instrument in treatment of coronary disease]. Minerva Cardioangiol 1981; 29:19-26. [PMID: 7015167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Paolillo V, Marra S, Chiappa E, Boncompagni F, Oddenino G, Varetto T, Spadaccini F, Angelino PF. [Ventricular arrhythmias during ambulatory monitoring of the electrocardiogram in the course of effort tests in recent myocardial infarct]. Minerva Cardioangiol 1980; 28:199-210. [PMID: 6155646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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