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Berretta M, Morra A, Taibi R, Monari F, Maurea N, Ippolito M, Tirelli U, Fiorica F, Montella L, Facchini G, Quagliariello V, Montopoli M. Improved Survival and Quality of Life Through an Integrative, Multidisciplinary Oncological Approach: Pathophysiological Analysis of Four Clinical Cancer Cases and Review of the Literature. Front Pharmacol 2022; 13:867907. [PMID: 35784762 PMCID: PMC9243589 DOI: 10.3389/fphar.2022.867907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/03/2022] [Indexed: 12/18/2022] Open
Abstract
Objectives: According to the National Cancer Institute, the integrative medicine (IM) approach to medical care combines standard medicine with complementary and alternative medicine practices that have proved safe and effective.Methods: We describe the clinical cases of four patients with malignant pleural mesothelioma (MPM), diffuse malignant peritoneal mesothelioma (DMPM), intrahepatic cholangiocarcinoma, and breast cancer (BC) who received supportive treatment (ST) according to an IM approach after the failure of standard cancer treatments or the appearance of serious adverse events caused by antiblastic chemotherapy. The critical role of complementary drugs in reducing the side effects of cancer treatments and normalizing the white cell count is especially apparent in the case of the patient with metastatic BC, who experienced prolonged neutropenia.Results: The IM approach was well-tolerated and had no adverse side effects. It improved the quality of life (QoL) of all patients and in two cases extended overall survival.Conclusion: The extended clinical and instrumental response to IM of the patients with malignant mesothelioma and the improved health-related QoL and good tolerance of the ST demonstrated in all cases support the value of this approach in patients whose cancer therapies have failed but who show a good performance status. Our data require confirmation in a well-designed prospective clinical trial.
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Affiliation(s)
- M. Berretta
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Integrative Medicine Research Group, IMRG, Noceto, Italy
- *Correspondence: M. Berretta,
| | - A. Morra
- IRCCS SDN, SYNLAB Napoli, Naples, Italy
| | - R. Taibi
- Gruppo Oncologico Ricercatori Italiani, GORI-Onlus, Pordenone, Italy
| | - F. Monari
- Radiotherapy Unit, Policlinico Di Sant'Orsola, University of Bologna, Bologna, Italy
| | - N. Maurea
- Division of Cardiology, Istituto Nazionale Tumori, Naples, Italy
| | - M. Ippolito
- Department of Advanced Technologies, Nuclear Medicine and PET, “Cannizzaro” Hospital, Catania, Italy
| | - U. Tirelli
- Tirelli Medical Center, Pordenone, Italy
| | - F. Fiorica
- Department of Radiation Oncology and Nuclear Medicine, Verona, Italy
| | - L. Montella
- ASL NA2 NORD, Oncology Operative Unit, “Santa Maria Delle Grazie” Hospital, Naples, Italy
| | - G. Facchini
- ASL NA2 NORD, Oncology Operative Unit, “Santa Maria Delle Grazie” Hospital, Naples, Italy
| | - V. Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori, Naples, Italy
| | - M. Montopoli
- Integrative Medicine Research Group, IMRG, Noceto, Italy
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
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Dicuonzo S, Colombo F, Bergamaschi L, Piperno G, Ferrari A, Leonardi M, Zaffaroni M, Zerella M, Rojas D, Gerardi M, Morra A, Rondi E, Vigorito S, Cattani F, Orecchia R, Jereczek-Fossa B, Frassoni S, Bagnardi V. PO-1228 Radiosurgery in her2-breast cancer brain metastasis:local control and overall survival in 32 women. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03192-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dicuonzo S, Leonardi MC, Raimondi S, Corrao G, Bagnardi V, Gerardi MA, Morra A, Zerella MA, Zaffaroni M, Pansini F, Cattani F, Luraschi R, Fodor C, Veronesi P, Orecchia R, Rojas DP, Jereczek-Fossa BA. Acute and intermediate toxicity of 3-week radiotherapy with simultaneous integrated boost using TomoDirect: prospective series of 287 early breast cancer patients. Clin Transl Oncol 2021; 23:1415-1428. [PMID: 33537865 DOI: 10.1007/s12094-020-02538-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/27/2020] [Indexed: 11/26/2022]
Abstract
AIMS To report toxicity of a hypofractionated scheme of whole-breast (WB) intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) to the tumor bed (TB) using Tomotherapy® with Direct modality. METHODS Patients with early breast cancer, undergoing radiotherapy (RT) in 15 daily fractions to WB (prescription dose 40.05 Gy) and SIB to the TB (48 Gy), between 2013 and 2017, was analyzed. Primary endpoint was acute and intermediate toxicity assessed at the end and within 6 months from RT, according to Radiation Therapy Oncology Group (RTOG) scale. Secondary endpoints included early chronic toxicity at 12-months follow-up, using the Late Effects Normal Tissue Task Subjective, Objective, Management, and Analytic (LENT-SOMA) scale, and cosmesis using Harvard criteria. RESULTS The study population was of 287 patients. Acute and intermediate toxicity was collected among 183 patients with data available at the end of RT and within 6 months, 85 (46%) experienced G2 toxicity and 84 (46%) G1 toxicity, while 14 (8%) did not report toxicity at any time. A significant reduction of any grade toxicity was observed between the two time points, with the majority of patients reporting no clinically relevant toxicity at 6 months. At univariate analysis, age < 40 years, breast volume > 1000 cm3 and Dmax ≤ 115% of prescription dose were predictive factors of clinically relevant acute toxicity (G ≥ 2) at any time. At multivariable analysis, only age and breast volume were confirmed as predictive factors, with Relative Risks (95% Confidence Intervals): 2.02 (1.13-3.63) and 1.84 (1.26-2.67), respectively. At 12-month follow-up, 113 patients had complete information on any toxicity with 53% of toxicity G < 2, while cosmetic evaluation, available for 102 patients, reported a good-excellent result for 86% of patients. CONCLUSIONS Hypofractionated WB IMRT with a SIB to the TB, delivered with TomoDirect modality, is safe and well-tolerated. Most patients reported no toxicity after 6 months and good-excellent cosmesis. Predictive factors of clinically relevant toxicity might be considered during treatment planning in order to further reduce side effects.
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Affiliation(s)
- S Dicuonzo
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy
| | - M C Leonardi
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy
| | - S Raimondi
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - G Corrao
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy.
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
| | - V Bagnardi
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - M A Gerardi
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy
| | - A Morra
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy
| | - M A Zerella
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy
| | - M Zaffaroni
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy
| | - F Pansini
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - F Cattani
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - R Luraschi
- Unit of Medical Physics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - C Fodor
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy
| | - P Veronesi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - R Orecchia
- Scientific Directorate, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - D P Rojas
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy
| | - B A Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, via Ripamonti, 435, 20141, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Berretta M, Facchini G, Fiorica F, Nunnari G, Morra A, Tirelli U. Asymptomatic COVID-19 infection in patients with cancer at a cancer-specialized hospital in Wuhan, China - Preliminary results. Eur Rev Med Pharmacol Sci 2020; 24:10924-10925. [PMID: 33215469 DOI: 10.26355/eurrev_202011_23573] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- M Berretta
- Department of Clinical and Experimental Medicine, Policlinico "G Martino" University of Messina, Messina Italy.
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Arculeo S, Frassoni S, Cavallo I, Dicuonzo S, Gerardi M, Morra A, Dell'Acqua V, Cattani F, Comi S, Veronesi P, Pansini F, Galimberti V, Fodor C, Bagnardi V, Orecchia R, Leonardi M, Jereczek-Fossa B. PO-0937: Partial breast re-irradiation with IMRT for local recurrence after whole breast radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00954-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Morra A, Escala-Garcia M, Canisius S, Keeman R, Garcia-Closas M, Pharoah P, Schmidt M. Association of germline genetic variants with breast cancer survival in patient subgroups defined by standard clinic-pathological variables. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30740-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Calabro' L, Rossi G, Morra A, Di Giacomo A, Amato G, Rosati C, Cutaia O, Daffinà M, Giannarelli D, Maio M. MA05.07 Efficacy and Safety of Re-Treatment with Tremelimumab and Durvalumab Within the NIBIT-MESO-1 Study. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.534] [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: 10/25/2022]
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Gerardi M, Leonardi M, Miglietta E, Riva G, Morra A, Dicuonzo S, Camarda A, Casbarra A, Fodor C, Orecchia R, Jereczek-Fossa B. EP-1311 POLO concept: salvage whole breast radiotherapy with Tomotherapy after intraoperative radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31731-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zerella M, Arculeo S, Miglietta E, Casbarra A, Dicuonzo S, Dell'Acqua V, Gerardi M, Morra A, Fodor C, Cattani F, Galimberti V, Veronesi P, Orecchia R, Leonardi M, Jereczek-Fossa B. EP-1315 The FAST approach as adjuvant whole breast irradiation for frail breast cancer patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31735-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gregucci F, Fozza A, Falivene S, Smaniotto D, Morra A, Daidone A, Barbara R, Ciabattoni A. PO-0766 The Italian Society of Radiation and Clinical Oncology (AIRO): snapshot on breast cancer management. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31186-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Dicuonzo S, Leonardi M, Raimondi S, Miglietta E, Gerardi M, Morra A, Dell'Acqua V, Surgo A, Rojas D, Pansini F, Luraschi R, Cattani F, Fodor C, Veronesi P, Orecchia R, Jereczek-Fossa B. EP-1310 Toxicity evaluation of a hypofractionated WBRT with SIB for breast cancer using TomoDirect. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31730-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dicuonzo S, Raimondi S, Surgo A, Spoto R, Gerardi M, Morra A, Ricotti R, Dell'acqua V, Casbarra A, Arculeo S, Rojas D, Luraschi R, Cattani F, Fodor C, Veronesi P, Orecchia R, Leonardi M, Jereczek B. EP-1326: Hypofractionated IMRT using Tomotherapy for early stage breast cancer: early chronic toxicity. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31636-0] [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: 10/14/2022]
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Dicuonzo S, Leonardi M, Radice D, Morra A, Dell'Acqua V, Gerardi M, Rojas D, Surgo A, Cattani F, Cambria R, Fodor C, De Lorenzi F, Galimberti V, Orecchia R, Jereczek-Fossa B. EP-1344: Long-term reconstruction failure after postmastectomy RT to temporary expander or permanent implant. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31653-0] [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: 10/14/2022]
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Gerardi M, Morra A, Dicuonzo S, Arculeo S, Patti F, Ricotti R, Dell'Acqua V, Augugliaro M, Arrobbio C, Viola A, Rojas D, Fodor C, Emiro F, Cattani F, Raimondi S, Galimberti V, Orecchia R, Leonardi M, Jereczek-Fossa B. EP-1323: Dosimetry results and toxicity of a 3-week schedule RT with SIB in breast cancer, with TomoDirect. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31633-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Calabro L, Morra A, Giannarelli D, Amato G, Bertocci E, D'Incecco A, Danielli R, Brilli L, Giannini F, Altomonte M, Di Giacomo A, Maio M. MA 19.02 Tremelimumab plus Durvalumab in First- or Second-Line Mesothelioma Patients: Final Analysis of the NIBIT-MESO-1 Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Dicuonzo S, Spoto R, Leonardi M, Surgo A, Viola A, Augugliaro M, Pansini F, Cattani F, Galimberti V, Morra A, Dell’Acqua V, Orecchia R, Jereczek-Fossa B. PO-0660: Partial breast re-irradiation with IMRT in patients with local failure after conservative treatment. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31097-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gerardi M, Rojas D, Ricotti R, Leonardi M, Riva G, Ciardo D, Francia C, Cambria R, Luraschi R, Cattani F, Fodor C, De Lorenzi F, Rietjens M, Veronesi P, Morra A, Dell’Acqua V, Orecchia R, Jereczek-Fossa B. EP-1191: Postmastectomy locoregional irradiation to temporary tissue-expander or permanent breast implant. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31627-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Macchi V, Porzionato A, Morra A, Picardi EEE, Stecco C, Loukas M, Tubbs RS, De Caro R. The triangles of Grynfeltt and Petit and the lumbar tunnel: an anatomo-radiologic study. Hernia 2016; 21:369-376. [PMID: 27215430 DOI: 10.1007/s10029-016-1509-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 12/04/2015] [Accepted: 05/09/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Lumbar hernias are protrusions of intra-abdominal contents classically through the superior (Grynfeltt) and inferior (Petit) lumbar triangles. The anatomy of the triangles is variable and quantitative data are few. No radiological data on the anatomy of the triangles are available. METHODS Fifty computed tomography angiography of the upper abdomen (M25, F25, mean age 72.5-year-old) were analyzed. The dimensions and the contents of the lumbar triangles were analyzed. The characteristics of the space between the two triangles were also documented. RESULTS The superior lumbar triangle showed a mean surface area of 5.10 ± 2.6 cm2. In the area of the triangle, the 12th intercostal pedicle and the 1st lumbar branches of the iliolumbar vessels were found in 42 and 46 %, respectively. The inferior lumbar triangle had a mean surface of area 18.7 ± 8.4 cm2. In this area, the 2nd, 3rd, and 4th lumbar branches were found in 9, 67, and 8 %, respectively. On oblique coronal images, a direct tunnel between the superior and the inferior lumbar triangles was found, showing an oblique course, with a postero-anterior direction (mean length 36.5 ± 5.8 mm, mean caliber 7.4 ± 3.1 mm). CONCLUSIONS Among the anatomical factors of weakening of the abdominal wall, the course of branches of the lumbar vessels was documented not only in the superior but also in the inferior lumbar triangle. A real musculoaponeurotic tunnel between the superior and the inferior lumbar triangles located in the oblique coronal plane was found, that could play a role in the development of incarceration or strangulation of lumbar hernias.
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Affiliation(s)
- V Macchi
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
| | - A Porzionato
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
| | - A Morra
- Section of Radiology, Euganea Medica Center, Via Colombo 3, Sant'Agostino Di Albignasego, Padua, Italy
| | - E E E Picardi
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
| | - C Stecco
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
| | - M Loukas
- Department of Anatomical Sciences, School of Medicine, St. George's University, True Blue, Grenada
| | - R S Tubbs
- Seattle Science Foundation, Seattle, WA, USA
| | - R De Caro
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy.
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Calabrò L, Morra A, Fonsatti E, Giannarelli D, Annesi D, Bertocci E, Danielli R, Altomonte M, Di Giacomo A, Maio M. A phase II study combining tremelimumab and durvalumab (MEDI4736) immunomodulating antibodies in mesothelioma patients: The NIBIT-MESO-1 study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv514.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ricotti R, Fattori G, Ciardo D, Leonardi M, Morra A, Pansini F, Cattani F, Riboldi M, Jereczek B, Baroni G, Orecchia R. EP-1494: Evaluation of intra-fraction breathing pattern variability in Helical Tomotherapy by means of optical tracking. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41486-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- R. Diez
- Domtar Specialty Chemicals; 1136 Matheson Blvd. L4W 2V4 Mississauga Ontario Canada
| | - A. Morra
- Domtar Specialty Chemicals; 1136 Matheson Blvd. L4W 2V4 Mississauga Ontario Canada
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Dell'Acqua V, Leonardi M, Morra A, Fodor C, Dicuonzo S, Cambria R, Luraschi R, Pansini F, Jereczek B, Orecchia R. EP-1190: Anticipated boost with IORT followed by hypofractionated wholebreast radiotherapy (AFTEREIGHT phase II study). Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31308-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cambria R, Cattani F, Luraschi R, Russo S, Morra A, Leonardi M, Pedroli G, Orecchia R. PO-0811: From 3D conformal to TomoDirect™ modality treatment for the postoperative breast radiotherapy. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33117-0] [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: 10/23/2022]
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Leonardi M, Dell'Acqua V, Cattani F, Morra A, Fodor C, Cambria R, Luraschi R, Gerardi M, Jereczek-Fossa B, Orecchia R. PO-0687: Technical feasibility of whole breast radiotherapy for local relapse after a previous partial breast irradiation. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32993-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Macchi V, Porzionato A, Stecco C, Morra A, De Caro R. Comment on: The anatomical collection of Giovan Battista Rini (1795-1856). Clin Anat 2012; 25:788-90. [DOI: 10.1002/ca.22097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 04/16/2012] [Indexed: 11/08/2022]
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Vavassori A, Gherardi F, Morra A, Colangione S, Fodor C, Comi S, Cattani F, Leonardi M, Lazzari R, Orecchia R. PO-319 HDR BRACHYTHERAPY FOR LOCAL RECURRENCES AFTER PRIOR BREAST RADIOTHERAPY: FEASIBILITY AND PRELIMINARY RESULTS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72285-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Salerno S, Di Giovanna E, Morra A, Bonsignore G, Piro E. High Resolution CT Angiography in Detection of an Aneurysm of the Vein of Galen as a Source of Intracranial Haemorrhage in a Newborn. Neuroradiol J 2011; 24:872-5. [DOI: 10.1177/197140091102400607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 05/15/2011] [Indexed: 11/17/2022] Open
Abstract
Cerebral haemorrhage is a rare condition in infants and carries a known poor prognosis. Common causes of spontaneous haemorrhage include various vascular venous lesions due to incomplete hydrovenous maturation, among them Galen vein aneurysm may be a very rare cause of cerebral haemorrhage. This report emphasizes the role of multidector CT with high resolution CT angiography in a newborn with cerebral hemorrhage caused by Galen vein aneurysm rupture. MDCT with high resolution CT angiography helps to differentiate the cause of haemorrhage, and to address the appropriate treatment.
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Affiliation(s)
- S. Salerno
- Department of Radiological Sciences, University of Palermo; Palermo, Italy
| | - E. Di Giovanna
- Department of Radiological Sciences, University of Palermo; Palermo, Italy
| | - A. Morra
- Department of Radiological Sciences, University of Palermo; Palermo, Italy
| | - G. Bonsignore
- Department of Radiological Sciences, University of Palermo; Palermo, Italy
| | - E. Piro
- Department of Radiological Sciences, University of Palermo; Palermo, Italy
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Murino P, Mammucari M, Borrelli D, Pepe A, Giugliano MF, Morra A, Panelli G, Manzo R, Ravo V, Muto P. Role of Immediate-Release Morphine (MIR) in the Treatment of Predictable Pain in Radiotherapy. J Pain Palliat Care Pharmacother 2011; 25:121-4. [DOI: 10.3109/15360288.2011.554488] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ivaldi G, Leonardi M, Morra A, Lazzari R, Ferrari A, Fodor C, Jereczek-Fossa B, Orecchia R, Veronesi U. 8 poster FOUR YEAR RESULTS OF ELECTRON INTRAOPERATIVE BOOST AND HYPOFRACTIONATED EXTERNAL BEAM RADIOTHERAPY AFTER BREAST-CONSERVING SURGERY IN PREMENOPAUSAL WOMEN. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70131-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Garibaldi C, Cattani F, Comi S, Luraschi R, Leonardi M, Morra A, Pedroli G, Orecchia R. 1243 poster FEASIBILITY STUDY FOR IMAGE-GUIDED PARTIAL BREAST IRRADIATION USING EXACTRAC X-RAY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71365-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tiengo C, Macchi V, Vigato E, Porzionato A, Stecco C, Azzena B, Morra A, De Caro R. Reversed gracilis pedicle flap for coverage of a total knee prosthesis. J Bone Joint Surg Am 2010; 92:1640-6. [PMID: 20595571 DOI: 10.2106/jbjs.i.00195] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [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: 02/01/2023]
Abstract
BACKGROUND Poor wound-healing and skin necrosis are potentially devastating complications after total knee arthroplasty. Primary soft-tissue coverage with a medial or lateral gastrocnemius transposition flap is typically the first choice for reconstruction. The aim of this study was to evaluate the use of a distally based secondary-pedicle flap of the gracilis muscle for reconstruction of a soft-tissue defect. METHODS The characteristics of the distally based (secondary) pedicles of the gracilis muscle were studied with use of dissection (ten cadavers) and computed tomographic angiograms (fifty patients). On the basis of the anatomical features, an extended reversed gracilis flap based on the secondary pedicles was used in three patients with severe soft-tissue complications of total knee arthroplasty. RESULTS The mean number of secondary pedicles was 1.8 (range, one to four). The pedicles originated from the superficial femoral or popliteal artery. The most proximal pedicle was often the largest (mean caliber, 2.0 mm), and its point of entry into the gracilis muscle was an average (and standard deviation) of 21 +/- 3.6 cm (range, 16 to 28 cm) from the ischiopubic branch. A significant positive association (p = 0.001; r(2) = 0.49) was found between the caliber of the proximal secondary pedicle and the number of other secondary pedicles. In all three patients, the adequate caliber of the secondary pedicles (as shown on preoperative computed tomographic angiograms) and good muscle vascularization confirmed the utility of the gracilis as a distally based pedicle flap. CONCLUSIONS For the treatment of large soft-tissue defects of the patella or the proximal part of the knee, or for soft-tissue reconstruction over an exposed total knee prosthesis, the reversed gracilis pedicle flap may be an alternative to, or may be integrated with, a lateral or medial gastrocnemius flap.
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Affiliation(s)
- C Tiengo
- Section of Anatomy, Department of Human Anatomy and Physiology, School of Medicine, University of Padova, Via A Gabelli 65, 35127 Padova, Italy.
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Macchi V, Vigato E, Porzionato A, Tiengo C, Stecco C, Morra A, Mazzoleni F, De Caro R. Response letter: “The gracilis muscle and its use in clinical reconstruction: An anatomical, embryological, and radiological study”. Clin Anat 2009. [DOI: 10.1002/ca.20753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Macchi V, Vigato E, Porzionato A, Tiengo C, Stecco C, Parenti A, Morra A, Bassetto F, Mazzoleni F, De Caro R. The gracilis muscle and its use in clinical reconstruction: An anatomical, embryological, and radiological study. Clin Anat 2008; 21:696-704. [PMID: 18773484 DOI: 10.1002/ca.20685] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- V Macchi
- Section of Anatomy, Department of Human Anatomy and Physiology, University of Padova, Padova, Italy
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Ivaldi G, Leonardi M, Ferrari A, Morra A, Jereczek Fossa B, Vavassori A, Santoro L, Orecchia R. Concomitant Radiotherapy and Anthracycline-based Chemotherapy in Adjuvant Breast Cancer Treatment. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gianino MM, Bosello MG, Ratto AM, Morra A, Galzerano M, Cacello E, Fornero G, Renga G. [Managing waiting lists outpatients clinic. An experience in ASL 4--Turin]. Ann Ig 2008; 20:179-193. [PMID: 18590049] [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: 05/26/2023]
Abstract
Waiting lists issue is one of the main matters of every public health system. The aim of this study is to design a pathway in the Local public health authority 4 in Turin (Piedmont Region, Italy) as far as waiting lists management of outpatient service is concerned between 2004 and 2006. This study emphasizes a new approaching methodology based on: a) clearly defined criteria of clinic priorities to accessing public health facilities; b) working groups composed by a representing member of the District, one or more medical and general practitioners representing different equipe; c) monitoring priority criteria as objectives to both medical practitioners and equipe in order to assess them at the end of the year Results are encouraging because equipe correctly applied defined priority criteria so that they reached objectives improving their performance during considered period (66.3% of conformity with "U", "B" and "D" codes in 2006 and 84.2% with all codes, improving the value of 81.3% in the past year).
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Affiliation(s)
- M M Gianino
- Dipartimento di Sanità Pubblica e Microbiologia, Università degli Studi di Torino.
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Berretta M, Rupolo M, Buonadonna A, Canzonieri V, Brollo A, Morra A, Berretta S, Bearz A, Tirelli U, Frustaci S. Metastatic angiosarcoma of the kidney: a case report with treatment approach and review of the literature. J Chemother 2006; 18:221-4. [PMID: 16736893 DOI: 10.1179/joc.2006.18.2.221] [Citation(s) in RCA: 13] [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] [Indexed: 12/31/2022]
Abstract
Angiosarcomas are rare soft tissue malignancies. Typically they originate from the skin of the scalp or face, whereas visceral sarcomas are very rare. We report the case of a 67-year-old man affected by a large angiosarcoma of the kidney. After surgical removal, a rapid peritoneal, visceral and cutaneous diffusion developed. Palliative chemotherapy, based on anthracycline and ifosfamide, which are normally used to treat all other high-grade spindle cell sarcomas, was totally inactive. On the basis of these results and of the biological characteristics of these rare neoplasms it is mandatory to develop other therapeutic approaches. Antiangiogenetic agents are of interest for this disease due to the peculiar origin of the cells of these sarcomas.
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Affiliation(s)
- M Berretta
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico, Aviano, Italy
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Abstract
BACKGROUND Recreational drug consumption represents a complex issue, because of the lack of a shared definition, settings and patterns of consumptions, and poorness of evidence-based treatments. In spite of the great number of users, just few seek specific treatment, probably representing those at major risk of continuing and problematic use. The general objective of this study was to report the characteristics and main consumption patterns of recreational drug consumers treated in Regione Piemonte (Italy), in order to formulate hypotheses suitable for further research aimed at establishing more effective preventive intervention and treatment. METHODS All addiction treatment services in the region were required to fill in, for each user, a questionnaire reporting: contact of the user with the service, socio-demographic data, drugs consumption and interventions/treatments. RESULTS Among 441 users, 70.3% were new users, 85.5% were males and the average age of consumption onset was 22 years. Psychiatric and traumatics events were present in 13.3% and in 17.9% of cases, respectively. The most frequent primary substances were cocaine (76.9%) and ecstasy (13.8%). Substances taken in association with primary drug are quoted in 75% of cases. CONCLUSIONS The users that get in touch with services are those showing greater problems, representing, therefore, the main target for preventive public health interventions. Some interesting points can be noted: among patients treated, cocaine represents the main issue; females seem to be more sensitive to recreational drug effects; social class (education), settings and use habits are similar for recreational drugs users and heroin users.
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Affiliation(s)
- R Siliquini
- Department of Public Health, University of Torino, Torino, Italy.
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Abstract
The evolution in diagnostic imaging modalities, mainly in computed tomography (CT) and magnetic resonance imaging (MRI), have made it possible to extend the applications of these techniques from diagnosis to staging and surgical planning. Nowadays, the possibility to present images on different planes with an intrinsic resolution close to that of the original axial sections allows presentation of the kidney on sagittal, coronal, and oblique planes. Three-dimensional reconstructions can be obtained with different methods and have attained excellent image quality. Multidetector spiral CT presently is the best technique for planning surgery, but MRI also enables high-quality images to be obtained if state-of-the-art equipment is available. This update reviews the current status and possibilities of diagnostic imaging modalities in planning surgery of renal tumors.
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Affiliation(s)
- R Pozzi-Mucelli
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, Trieste, Italy.
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Morra A, Rimondini A, Adovasio R. Jejunal artery aneurysm: diagnostic efficacy of spiral CT angiography. A case report. Radiol Med 2002; 104:95-8. [PMID: 12386561] [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] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- A Morra
- U.C.O. di Radiologia, Università degli Studi di Trieste, Ospedale di Cattinara, Trieste, Italy
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Morra A, Tirelli G, Rimondini A, Cioffi V, Russolo M, Giacomarra V, Pozzi-Mucelli R. Usefulness of virtual endoscopic three-dimensional reconstructions of the middle ear. Acta Otolaryngol 2002; 122:382-5. [PMID: 12125993 DOI: 10.1080/00016480260000058] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
This work uses a new programme for producing 3D radiological images acquired by means of CT which enables the internal surfaces of the examined structures to be visualized. This new method, which is able to navigate inside organs in a similar way to fibreoptic endoscopy, is known as virtual endoscopy. CT examinations of the temporal bone were carried out using spiral equipment and endoscopic 3D processing was carried out on a separate workstation equipped with a volume-rendering programme. Once the technical parameters necessary for obtaining a representation of the internal surfaces had been defined, a simulation of a virtual otoscopy was conducted by moving the virtual endoscope from the external auditory canal through the annulus to the tympanic cavity. The simulation can be obtained either by moving the endoscope by hand, using the mouse, or by defining a path along which the software automatically creates an endoscopic 3D reconstruction. The images thus obtained are projected sequentially to give a "movie" effect, i.e. a continuous progression of the endoscope. The average time required to conduct the procedure ranges from 20 to 30 min. A virtual endoscopic visualization of the middle ear was obtained which, in particular, generated images of the tympanic cavity with the ossicular chain. In our experience, virtual otoscopy shows the anatomy of the structures of the tympanic cavity in excellent detail and may be considered complementary to CT, providing useful images enabling better visual representation and understanding of this complex structure. Although clinical applications of the technique remain to be defined it may have a role to play in presurgical diagnostic evaluation of the ossicular chain, epitympanum and retrotympanum.
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Affiliation(s)
- A Morra
- Operative Clinical Unit of Radiology, Cattinara Hospital, Trieste, Italy.
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Morra A, Rimondini A, Pozzi-Mucelli R. New automatic software for virtual colonoscopy: technical aspects. Radiol Med 2002; 103:519-25. [PMID: 12207187] [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: 02/26/2023]
Abstract
PURPOSE To evaluate a new virtual endoscopy software package capable of automatically plotting the path along which to perform endoscopic exploration. MATERIALS AND METHODS We reviewed the examinations of 50 patients with colonic neoplasms studied by CT colonoscopy by using a single-detector CT scanner (Philips Tomoscan AVE1). The technical parameters used were: slice thickness 3 mm, pitch 1.4, reconstruction interval 2-2.5, 120 kV, 150-200 mA. The images were processed on a separate workstation (Philips Easy Vision 5.1) running an experimental virtual endoscopy software package capable of automatically drawing a line along which to move the virtual endoscope to explore the colon. Reconstruction of the endoscopic images along the path obtained was set at an interval of 15-20 mm between one endoscopic view and the next, to a total of 70 to 120 images. The endoscopic animated image sequence was then saved and evaluated by comparing the starting axial images and the three-dimensional images obtained. RESULTS The programme plotted the endoscopic path correctly in a single pass in 40 of the 50 cases studied. The overall time spent by the radiologist on image-processing did not exceed 5 minutes. DISCUSSION The need to reduce the time spent by audiologists on post-processing has led to a gradual improvement in image-processing hardware and software. In the context of virtual endoscopy, one of the main goals is to obtain the path for endoscopic exploration in as short a time as possible. The programme we evaluated successfully fulfils this requirement as, once the image-processing technical parameters have been defined, it plots a path along the entire colon and performs the reconstruction procedures automatically. The time spent by the operator on post-processing does not exceed 5 minutes. CONCLUSIONS The new programme evaluated in this study facilitates the processing of endoscopic images, reduces radiologist time and may contribute to the widespread use of virtual colonoscopy.
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Affiliation(s)
- A Morra
- Dipartimento di Scienze Cliniche e Morfologiche, Unità Clinica Operativa di Radiologia, Università degli Studi, Trieste, Italy
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Siliquini R, Morgagni S, Morra A, Saglione GL, Nante N, Renga G. [Quality of hospital discharge data in Piedmont]. Ann Ig 2001; 13:365-74. [PMID: 11590872] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- R Siliquini
- Dip. di Sanità Pubblica, Università degli Studi di Torino
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Rimondini A, Morra A, Bertolotto M, Locatelli M, Pozzi Mucelli R. [Spiral-CT with multiplanar reconstructions (MPRS) in the evaluation of ureteral neoplasms: preliminary results]. Radiol Med 2001; 101:459-65. [PMID: 11479443] [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: 02/20/2023]
Abstract
PURPOSE Urothelial tumors of the upper urinary tract (renal pelvis and ureters) are rare: the most common of these are Transitional Cell Carcinomas (TCC), usually localized in the bladder (75% of cases), whereas only 7-10% arise in the renal pelvis and 2,5-5% in the ureter. Multicentricity is not infrequent and synchronous or metachronous tumors have been reported to develop in 11-13% of patients with upper urinary tract cancer and 2-4% of those with bladder cancer. The presence of additional lesions can change patient management. Clinically these tumors may present with hematuria or flank pain, but sometimes there are no specific clinical findings. Radiological studies play an important role in tumor detection and staging and in follow up. The diagnosis is usually performed by IVU and US, while CT is generally employed in the staging. Our purpose was to verify the role of Spiral CT with Multiplanar Reconstructions (MPRs) in the evaluation of ureteral tumors. MATERIAL AND METHODS Nine patients with ureteral neoplasms were examined with a single detector spiral-CT, using the following parameters: 120 kV, 200 mA; 5 mm collimation, pitch 1.4, slice reconstruction every 5 mm; image acquisition 2-5 minutes after injection of 120 cc of contrast medium (300 mgI/ml). All the exams were transferred to a separate workstation to obtain curvilinear MPRs. RESULTS Spiral CT on the axial plane visualized 4 urothelial tumors as concentric ureteral wall thickening; 3 as intraluminal soft tissue masses, with involvement of almost the entire urinary tract, as far as the bladder in 1 case. In other 2 patients there were synchronous lesions which presented both patterns (wall thickening and intraluminal mass). In all cases the lesions exhibited moderate enhancement after c.m. injection. Medium- to high-grade hydronephrosis above the tumors was always present. On MPRs both ureteral involvement and dilated, urine-filled upper urinary tract were clearly represented on coronal and sagittal oblique planes; these images allowed to visualize the craniocaudal extension of short or long lesions, and to detect multicentricity. DISCUSSION The radiological diagnosis of ureteral tumors is usually performed by IVU, US and CT. IVU allows to visualize the tumors as filling defects or irregular narrowing of the ureteral lumen. IVU however is unable to show the real extent of the tumor in obstructive disease or in nonfunctioning kidney. US visualizes the lesion as an echoic mass in the lumen, although it is sometimes difficult to differentiate neoplastic lesions from other filling defects and to visualize the entire ureteral tract. CT is generally employed in the staging of ureteral tumors. CT findings are usually very useful for distinguishing ureteral neoplasms from other filling defects based on their attenuation and enhancement characteristics. Spiral CT with MPRs allows to obtain panoramic views of the urinary tract; these images are more effective than those of IVU, because of their capability to show the longitudinal extension of the lesion and the presence of multicentric tumors. Furthermore with MPRs it is possible to visualize the ureteral tract distal to the lesion, overcoming the limitations of IVU in nonfunctioning kidney or obstructive disease. CONCLUSIONS Spiral CT with MPRs is useful in the evaluation of ureteral tumors as it is capable of visualizing the whole extension of the lesion and the presence or absence of multicentric lesions, which can change patient management.
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Affiliation(s)
- A Rimondini
- Unità Clinica Operativa di Radiologia, Università degli Studi, Ospedale di Cattinara, Trieste, Italy
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Quaia E, Bertolotto M, Bussani R, Morra A, Pozzi Mucelli R. [Integrated ultrasonography, spiral CT, and magnetic resonance in a case of transitional cell carcinoma of the excretory urinary tract]. Radiol Med 2001; 101:95-9. [PMID: 11360763] [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] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- E Quaia
- Unità Clinico Operativa di Radiologia, Università di Trieste, Ospedale Maggiore, Trieste
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Morra A, Meduri S, Ammar L, Ukmar M, Pozzi Mucelli R. [Colonoscopy with computed tomography with volume reconstruction. The results and a comparison with endoscopy and surgery]. Radiol Med 1999; 98:162-7. [PMID: 10575446] [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: 02/14/2023]
Abstract
PURPOSE Virtual CT colonoscopy is a novel technique whose diagnostic accuracy and clinical yield are currently investigated. Several studies have shown its capabilities in detecting colon and rectal cancers. We report the results of a preliminary experience with the volume rendering technique and compare CT colonoscopy with endoscopy and surgery. MATERIAL AND METHODS Our series consisted of 25 patients with colon cancer confirmed at endoscopy and/or surgery. All examinations were carried out with a spiral CT scanner Philips Tomoscan AVE1. Intestinal preparation was adequate in all patients, consisting in gas insufflated immediately before acquisition, after the injection of 100 mL iodinated contrast agent. All examination were performed in prone position using axial 5 mm slices with 5 mm table feed (pitch 1) and 2 mm reconstruction index; 120 kV and 200-250 mA were used. Images were transferred to a workstation (Easy Vision, Philips, release 4.2.1.1) for processing. We acquired multiplanar (MPR) and virtual endoscopic images with volume rendering; the selected threshold was -250 to -600 Hounsfield Units. Virtual endoscopic images could be obtained in 23 of 25 cases. The results of the radiological study were compared with endoscopic and surgical findings in 25 and 17 cases, respectively. RESULTS Endoscopy and surgery detected 46 lesions: 29 were malignant and 17 benign. Axial CT and MPR alone detected 35 lesions (76%), 29 of them malignant and 6 benign. The 11 benign lesions missed by axial CT ranged 6-8 mm in diameter. There were no false positives. CT colonoscopy alone detected 66 lesions, but 22 of them were false positive due to residual stool in the colon (21 cases) and to residual barium in the colon (1 case). Combining CT colonoscopy and axial and MPR images enabled to correct the false positive diagnoses made by CT colonoscopy alone and to decrease the false negative ratio of axial and MPR images. Forty-one of 44 lesions (93%) were detected. Thirty-seven lesions were found in the 17 surgical patients; 34 of them were correctly identified combining CT colonoscopy and axial and MPR findings, while endoscopy detected only 31 lesions. Thus, CT had 92% sensitivity, versus 83% of fiberoptic endoscopy. CONCLUSION In this preliminary experience volume rendering CT colonoscopy exhibited high sensitivity in detecting colon cancers, but their correct evaluation and characterization can be obtained if axial and MPR studies are combined. Further investigation and technological developments are necessary to define the yield of this new technique.
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Affiliation(s)
- A Morra
- Istituto di Radiologia dell'Università, Trieste
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Sponza M, Morra A, Cuttin Zernich R, Ricci C. [Gas-containing calculi of the gallbladder. Report of a case studied with spiral computerized tomography]. Radiol Med 1999; 97:323-4. [PMID: 10414274] [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] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- M Sponza
- Istituto di Radiologia di Cattinara, Trieste
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Bongiorni MG, Moracchini PV, Nava A, Caprioli V, Gascón D, Morra A, Di Gregorio F. Radiographic assessment of atrial dipole position in single pass lead VDD and DDD pacing. The Multicenter Study Group. Pacing Clin Electrophysiol 1998; 21:2240-5. [PMID: 9825326 DOI: 10.1111/j.1540-8159.1998.tb01160.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Atrial electrode position was determined by radiographic analysis in 160 patients paced in single-lead VDD for second- or third-degree A-V block, implanted > 1 year with Phymos single pass leads and Phymos 3D pacemakers. The packing lead features an atrial dipole with a 30-mm electrode interspace. In 44% of patients, the upper atrial electrode was positioned within a band of 20 mm centered at the level of the superior vena caval insertion (junctional area) and was in the inferior vena cava or in the atrium in 35% and 21% of cases, respectively. In spite of these different dipole locations, all patients had stable atrium-driven pacing at routine follow-up visits. With the electrode in the junctional area, unipolar stimulation of up to 5 V for 1 ms resulted in stable atrial capture in 63% and 59% of the patients in supine and upright positions, respectively. With the electrode in the atrium, corresponding success rates were 45% and 54%. In the atrium, however, the prevalence of diaphragmatic stimulation was significantly lower than at the junction (10% vs 42% in supine position; 21% vs 47% upright). Though atrial sensing function proved adequate in a wide range of positions, these results suggest that the Phymos lead atrial dipole should be positioned within the atrium, as close as possible to the atrial wall, to maximize the number of VDD patients who might benefit from single-lead DDD pacing.
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Affiliation(s)
- M G Bongiorni
- Cardiovascular and Pulmonary Department, University of Pisa, Italy
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Morra A, Sponza M, Stanta G, Urban F, Frezza M. [Complete remission of hepatocarcinoma metastasis during palliative treatment with tamoxifen]. Radiol Med 1998; 96:263-5. [PMID: 9850724] [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] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- A Morra
- Istituto di Radiologia, Università di Trieste
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Morra A, Calgaro A, Cioffi V, Pravato M, Cova M, Pozzi Mucelli R. [Virtual endoscopy of the nasal cavity and the paranasal sinuses with computerized tomography. Anatomical study]. Radiol Med 1998; 96:29-34. [PMID: 9819615] [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: 02/09/2023]
Abstract
INTRODUCTION Virtual endoscopy is a new 3D technique which permits to depict the inner surface of anatomic cavities. We report our experience in the study of the nasal cavity and paranasal sinuses. MATERIAL AND METHODS CT examinations of the maxillofacial region were obtained using 1.5 or 3.0 mm slices, 1.5 or 3.0 mm table feed, 120 kV, 140 mA, 2 s scan time, standard and high resolution algorithms for bony structures and a field of view of 14-16 cm. The images were transferred on a workstation and processed with the Navigator virtual endoscopy software (General Electric). A threshold value ranging -300 to -550 UH was applied. RESULTS We report a series of virtual images of the nasal cavity which includes rhinopharynx vault, torius tubarius, choanae, turbinates, tubal orifice and osteomeatal complex. Moreover, images of frontal sinus and tear duct, of polyps and fracture of maxillary sinus are also presented. 3D virtual endoscopy provides a clear visualization of the anatomic structures of the nasal cavity and sinuses. The images are similar to those of conventional endoscopy. Moreover virtual endoscopy visualizes the paranasal sinuses, which are not accessible at conventional endoscopy. The main limitations of this new technique are the arbitrary choice of the threshold value and the homogenization of different tissue densities, which reduces the contrast resolution. CONCLUSIONS Virtual endoscopy can presently be considered a complementary technique of the standard axial and coronal CT examination. It provides an effective demonstration of the anatomy of these structures and shows areas which are difficult to visualize with conventional endoscopy. This technique could be of help in didactical activity; its clinical application has to be verified.
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Affiliation(s)
- A Morra
- Istituto di Radiologia dell'Università, Trieste
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Pozzi Mucelli R, Morra A, Calgaro A, Cova M, Cioffi V. [Virtual endoscopy with computed tomography of the anatomical structures of the middle ear]. Radiol Med 1997; 94:440-6. [PMID: 9465207] [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: 02/06/2023]
Abstract
INTRODUCTION We applied the new technique of virtual endoscopy to the middle ear because this anatomical area is characterized by favorable contrast. MATERIALS AND METHODS CT examinations of the petrous bone were obtained using 1.5 mm thick 1 coronal axis slices, with 1 mm or 1.5 mm table feed, 120 kV, 140-170 mA and 2 s scan time. The images were reconstructed with the high resolution algorithm for bony structures and a small field of view (9.6 cm), separately for the right and left petrous bone. The images were then transferred on a workstation and processed with the Navigator virtual endoscopic software (General Electric). A threshold value ranging -350 to -600 HU was applied. RESULTS A series of images is acquired as the virtual endoscope moves from the external auditory canal to the middle ear cavity. Images of the anterior, medial, and posterior surfaces of the middle ear are presented. Different views of the ossicles are also presented. High quality images were always obtained for the middle ear structures, including the ossicles. CT endoscopy of the middle ear provides a new view of the anatomy of this complex area. It has some advantages and disadvantages; the former can be summarized as follows: -demonstration of areas which are difficult to show with endoscopy because of the presence of membrana tympani; -the virtual endoscope can be placed in several positions and therefore it can be inserted in all sites and tortuous places of anatomical cavity; -nice and effective demonstration of the ossicular chain including the stapes. The disadvantages are related to the fact that the endoscopic reconstruction (such as any other three-dimensional reconstruction) is a representation of surfaces where different densities are necessarily homogenized. CONCLUSIONS CT virtual endoscopy of the middle ear can currently be considered a complementary technique to conventional CT because it permits better anatomical detailing of this complex region.
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