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Maggialetti N, Torrente A, Lorusso G, Villanova I, Ficco M, Gravina M, Ferrari C, Giordano L, Granata V, Rubini D, Lucarelli NM, Stabile Ianora AA, Scardapane A. Role of Cardiovascular Magnetic Resonance in Cardiac Amyloidosis: A Narrative Review. J Pers Med 2024; 14:407. [PMID: 38673034 PMCID: PMC11051560 DOI: 10.3390/jpm14040407] [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: 03/17/2024] [Revised: 03/31/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Amyloidosis is a rare infiltrative condition resulting from the extracellular accumulation of amyloid fibrils at the cardiac level. It can be an acquired condition or due to genetic mutations. With the progression of imaging technologies, a non-invasive diagnosis was proposed. In this study, we discuss the role of CMR in cardiac amyloidosis, focusing on the two most common subtypes (AL and ATTR), waiting for evidence-based guidelines to be published.
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Affiliation(s)
- Nicola Maggialetti
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Andrea Torrente
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giovanni Lorusso
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Ilaria Villanova
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Michele Ficco
- U.O.C. Radiologia, P.O. San Paolo, ASL Bari, 70123 Bari, Italy
| | - Matteo Gravina
- Radiology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Cristina Ferrari
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Luca Giordano
- U.O.C. Radiodiagnostica, Ospedaliera Vito Fazzi, 73100 Lecce, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131 Naples, Italy
| | - Dino Rubini
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
| | - Nicola Maria Lucarelli
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Amato Antonio Stabile Ianora
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Arnaldo Scardapane
- Sperimental Medicine Department, University of Salento, 73100 Lecce, Italy
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Castelluccia A, Sardaro A, Niccoli Asabella A, Pisani AR, Rubini D, Portaluri M, Tramacere F. Durable complete response to PET-CT driven stereotactic radiation therapy plus pembrolizumab for pleomorphic Pancoast cancer: Case report and literature review. Clin Case Rep 2024; 12:e8633. [PMID: 38585585 PMCID: PMC10996042 DOI: 10.1002/ccr3.8633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/09/2024] Open
Abstract
PET-driven SBRT plus pembrolizumab as first-line therapy against pleomorphic Pancoast cancer appears beneficial, probably due to high equivalent doses of SBRT on photopenic necrotic core and synergic immune system stimulation of immunoradiotherapy.
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Affiliation(s)
| | - Angela Sardaro
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of MedicineUniversity of Bari “Aldo Moro”BariItaly
| | - Artor Niccoli Asabella
- Section of Nuclear Medicine, Interdisciplinary Department of MedicineUniversity of Bari Aldo MoroBariItaly
| | - Antonio Rosario Pisani
- Section of Nuclear Medicine, Interdisciplinary Department of MedicineUniversity of Bari Aldo MoroBariItaly
| | - Dino Rubini
- Department of Precision MedicineUniversità degli Studi della Campania Luigi VanvitelliNapoliCampaniaItaly
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Maggialetti N, Greco CN, Lucarelli NM, Morelli C, Cianci V, Sasso S, Rubini D, Scardapane A, Stabile Ianora AA. Correction: Applications of new radiological scores: the Node‑rads in colon cancer staging. Radiol Med 2024; 129:524. [PMID: 38461215 DOI: 10.1007/s11547-023-01755-x] [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] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Affiliation(s)
- Nicola Maggialetti
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Chiara Noemi Greco
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Nicola Maria Lucarelli
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Chiara Morelli
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.
| | - Valentina Cianci
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Sara Sasso
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Dino Rubini
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138, Naples, Italy
| | - Arnaldo Scardapane
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Amato Antonio Stabile Ianora
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
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Altini C, Asabella AN, Tramacere F, Sardaro A, Pisani AR, Castelluccia A, Rubini D, Ferrari C. Role of 18F-FCH PET/CT in Detecting Recurrences of Prostate Cancer After Curative Treatments. Mol Imaging Radionucl Ther 2024; 33:1-10. [PMID: 38390705 PMCID: PMC10899743 DOI: 10.4274/mirt.galenos.2023.26122] [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] [Indexed: 02/24/2024] Open
Abstract
Objectives To evaluate the role of 18F-fluorocholine (18F-FCH) positron emission tomography/computed tomography (PET/CT) in prostate cancer (PC) patients with biochemical recurrence who were submitted to different curative treatments. Methods Seventy-five patients with PC who underwent 18F-FCH PET/CT for biochemical recurrence were retrospectively analyzed to distinguish patients who were submitted only to prostatectomy (PR group), only to radiotherapy (RT) on prostate with curative intent (RT group), and to both (PR + RT group). Correlations between 18F-FCH PET/CT and outcome and between prostate-specific antigen (PSA) values and sites and the number of metastases were analyzed. The performance of 18F-FCH PET/CT in relation to the PSA value and of maximum standardized uptake value (SUVmax) value in relation to patient outcome were assessed by receiver operating characteristic (ROC) curves. Results 18F-FCH PET/CT relapses mostly involved lymph nodes, bones, and prostate bed. K-cohen test showed moderate agreement with the outcome in the whole population and in the PR group, whereas in the RT group it was perfect and in PR + RT fair. A statistically significant difference in PSA values was observed in the presence of lymph node metastases and with multiple metastases. ROC curves showed PSA cut-off values of 1.96 ng/dL, 1.95, 1.81, and 2.96, respectively, in the whole population, PR, RT and PR + RT group. SUVmax cut-off values of 3.75, 3.45, and 4.7 were described in the whole population, PR group, and PR + RT group. Conclusion The study confirms that 18F-FCH PET/CT is still valid in PC patients with suspected biochemical recurrence. Therefore, we can affirm that it still makes sense to perform it both with high PSA values and with lower values when prostate-specific membrane antigen tracers are not available.
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Affiliation(s)
- Corinna Altini
- University of Bari Aldo Moro, School of Interdisciplinary of Medicine, Department of Nuclear Medicine, Bari, Italy
| | | | | | - Angela Sardaro
- University of Bari Aldo Moro, School of Interdisciplinary of Medicine, Department of Radiology and Radiation Oncology, Bari, Italy
| | - Antonio Rosario Pisani
- University of Bari Aldo Moro, School of Interdisciplinary of Medicine, Department of Nuclear Medicine, Bari, Italy
| | | | - Dino Rubini
- University of Bari Aldo Moro, School of Interdisciplinary of Medicine, Department of Nuclear Medicine, Bari, Italy
| | - Cristina Ferrari
- University of Bari Aldo Moro, School of Interdisciplinary of Medicine, Department of Nuclear Medicine, Bari, Italy
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Pisani AR, Rubini D, Altini C, Ruta R, Gazzilli M, Sardaro A, Iuele F, Maggialetti N, Rubini G. The Role of the 18F-FDG PET/CT in the Management of Patients Suspected of Cardiac Implantable Electronic Devices' Infection. J Pers Med 2024; 14:65. [PMID: 38248766 PMCID: PMC10820973 DOI: 10.3390/jpm14010065] [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: 11/23/2023] [Revised: 12/11/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
Background: Infection of Cardiac Implantable Electronic Devices (CIEDI) is a real public health problem. The main aim of this study was to determine the diagnostic performance of 18F-FDG PET/CT in the diagnosis of CIEDI. Methods: A total of 48 patients, who performed 18F-FDG PET/CT for the clinical suspicion of CIEDI were retrospectively analyzed; all patients were provided with a model with procedural recommendations before the exam. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) of 18F-FDG PET/CT were calculated; the reproducibility of qualitative analysis was assessed with Cohen's κ test. The semi-quantitative parameters (SUVmax, SQR and TBR) were evaluated in CIEDI+ and CIEDI- patients using the Student' t-test; ROC curves were elaborated to detect cut-off values. The trend of image quality with regards to procedural recommendation adherence was evaluated. Results: Se, Sp, PPV, NPV and DA were respectively 96.2%, 81.8%, 86.2%, 94.7% and 89.6%. The reproducibility of qualitative analysis was excellent (K = 0.89). Semiquantitative parameters resulted statistically different in CIEDI+ and CIEDI- patients. Cut-off values were SUVmax = 2.625, SQR = 3.766 and TBR = 1.29. Trend curves showed increasing image quality due to adherence to procedural recommendations. Conclusions:18F-FDG-PET/CT is a valid tool in the management of patients suspected of CIEDI and adherence to procedural recommendations improves its image quality.
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Affiliation(s)
- Antonio Rosario Pisani
- Interdisciplinary Department of Medicine, Section of Nuclear Medicine, University of Bari "Aldo Moro", Policlinic of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Dino Rubini
- Radiotherapy, Precision Medicine Department, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Corinna Altini
- Interdisciplinary Department of Medicine, Section of Nuclear Medicine, University of Bari "Aldo Moro", Policlinic of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Rossella Ruta
- Interdisciplinary Department of Medicine, Section of Nuclear Medicine, University of Bari "Aldo Moro", Policlinic of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | | | - Angela Sardaro
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", Policlinic of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Francesca Iuele
- Interdisciplinary Department of Medicine, Section of Nuclear Medicine, University of Bari "Aldo Moro", Policlinic of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Nicola Maggialetti
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", Policlinic of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Giuseppe Rubini
- Interdisciplinary Department of Medicine, Section of Nuclear Medicine, University of Bari "Aldo Moro", Policlinic of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy
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Pisani AR, Rubini D, Altini C, Lucarelli N, Gaudiano A, Ferrari C, Rubini G. Multimodal radionuclide shuntography for device patency: New procedural tips for anuncommon historical technique. Hell J Nucl Med 2024; 27:58-63. [PMID: 38629818 DOI: 10.1967/s002449912705] [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] [Received: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024]
Abstract
Cerebrospinal fluid (CSF) shunting is an established long-term treatment option for hydrocephalus, and is one of the most commonly performed neurosurgical procedures in western countries.Despite advances in CSF shunt design and management, its failure rates remain high and is most commonly due to obstruction and infection.Cerebrospinal fluidshunt failure diagnosis should be prompt and accurate in establishing timely if its revision is appropriate. Radionuclide shuntography with technetium-99m-diethylenetriaminepetaacetic acid (99mTc-DTPA) is a useful technique for evaluation CSF shunts and management of patients presenting with shunt-related problems, in particular it can avoid unnecessary replacement interventions. Although its execution and interpretation require specific skills, we suggest its execution for the evaluation of device's patency. We here describe the radionuclide shuntography performed with recent hybrid multimodal technologies, with a procedure customized to a complicated patient with hydrocefalus and neoplastic disease. We suggest considering radionuclide shuntography in association with conventional imaging and strongly recommend the additional performance of single photon emission computed tomography/computed tomography (SPECT/CT) because it also provides valuable information to complete the interpretation of planar images.
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Affiliation(s)
- Antonio Rosario Pisani
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine (DIM), University of Bari "Aldo Moro", 70124 Bari, Italy.
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Dondi F, Pisani AR, Lucarelli NM, Gazzilli M, Talin A, Albano D, Rubini D, Maggialetti N, Rubini G, Bertagna F. Correlation between Kidney Uptake at [18F]FDG PET/CT and Renal Function. J Pers Med 2023; 14:40. [PMID: 38248741 PMCID: PMC10817585 DOI: 10.3390/jpm14010040] [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: 12/01/2023] [Revised: 12/24/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Different insights into the connection between kidney [18F]fluorodesoxyglucose ([18F]FDG) uptake at positron emission tomography/computed tomography (PET/CT) and renal function have been proposed in the past. The aim of this study was therefore to assess the presence of a correlation between these two parameters. Kidney uptakes were assessed and compared to the creatinine (Cr) values and estimated glomerular filtration rate (EGFR) among different classes of renal functional impairment or kidney status. A total of 339 patients and 385 different PET/CT scans were included in this study. Significant correlations between kidney uptakes and renal function parameters were reported in most of the groups studied, with the exception of patients with Cr < 1.2 mg/dL and subjects with a kidney transplantation. Strong concordance in the assessment of renal parenchymal uptakes between the different readers was reported. To conclude, strong correlations for renal [18F]FDG uptake with Cr levels and the EGFR were reported, with the exception of the group of patients with a Cr value < 1.2 mg/dL and for the group with a kidney transplantation.
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Affiliation(s)
- Francesco Dondi
- Nuclear Medicine, Università Degli Studi di Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (F.D.); (A.T.); (D.A.); (F.B.)
| | - Antonio Rosario Pisani
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.R.P.); (N.M.); (G.R.)
| | - Nicola Maria Lucarelli
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.R.P.); (N.M.); (G.R.)
| | - Maria Gazzilli
- Nuclear Medicine, ASL Bari—P.O. Di Venere, 70012 Bari, Italy
| | - Anna Talin
- Nuclear Medicine, Università Degli Studi di Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (F.D.); (A.T.); (D.A.); (F.B.)
| | - Domenico Albano
- Nuclear Medicine, Università Degli Studi di Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (F.D.); (A.T.); (D.A.); (F.B.)
| | - Dino Rubini
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy;
| | - Nicola Maggialetti
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.R.P.); (N.M.); (G.R.)
| | - Giuseppe Rubini
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.R.P.); (N.M.); (G.R.)
| | - Francesco Bertagna
- Nuclear Medicine, Università Degli Studi di Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (F.D.); (A.T.); (D.A.); (F.B.)
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Maggialetti N, Greco CN, Lucarelli NM, Morelli C, Cianci V, Sasso S, Rubini D, Scardapane A, Stabile Ianora AA. Applications of new radiological scores: the Node-rads in colon cancer staging. Radiol Med 2023; 128:1287-1295. [PMID: 37704777 DOI: 10.1007/s11547-023-01703-9] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/10/2023] [Indexed: 09/15/2023]
Abstract
PURPOSE The study focuses on the evaluation of the new Node Reporting and Data System 1.0 (Node-rads) scoring accuracy in the assessment of metastatic lymph nodes (LN) in patients with colon carcinoma. MATERIAL AND METHODS From April 2021 to May 2022, retrospective chart reviews were performed on 67 preoperative CT (Computed Tomography) of patients undergoing excisional surgery for colon cancer at the Polyclinic of Bari, Italy. Primary endpoints were to assess lymph node size and configuration to express the likelihood of a metastatic site adopting the Node-rads score system, whose categories of risk are defined from 1 (very low) to 5 (very high). The nodal postsurgical histological evaluation was the gold standard. The relationship between Node-rads score, LN size, configuration criteria (texture, border and shape) and the presence of histological metastases was statistically evaluated. RESULTS All surgical specimens examined had correlation with Node-rads score. They were significantly more likely to present nodes micrometastasis those patients with (a) spherical LN shape (82.8%), (b) with lymph node necrosis (100%), (c) irregular borders (87%) and (d) the LN short axis more than 10 mm (61.9%). CONCLUSIONS Our experience highlights how the Node-rads system proposes an intuitive and effective definition of criteria to standardize the lymph node radiological reports in colon cancer disease. Further studies are needed to streamline the classification of the nodal and peripheral LN in all the oncological imaging.
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Affiliation(s)
- Nicola Maggialetti
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Chiara Noemi Greco
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Nicola Maria Lucarelli
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Chiara Morelli
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy.
| | - Valentina Cianci
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Sara Sasso
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Dino Rubini
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138, Naples, Italy
| | - Arnaldo Scardapane
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - Amato Antonio Stabile Ianora
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari "Aldo Moro", 70124, Bari, Italy
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Rosario Pisani A, Sardaro A, Maggialetti N, Altini C, Rubini D, Mammucci P, Rubini G. Volumetric Modulated Arc Radiotherapy Efficacy After Double Recurrences of Cardiac Sarcoma. Curr Med Imaging 2023:CMIR-EPUB-130810. [PMID: 37038297 DOI: 10.2174/1573405620666230410091236] [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: 09/20/2022] [Revised: 01/13/2023] [Accepted: 01/26/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Volumetric Modulated Arc Therapy (VMAT) has recently become a pivotal treatment of oncological diseases due to the high-precise delineation of target volume contours with sparing organs at risk. This procedure requires a high level of experience and precision and is achievable only with advanced diagnostic support. Magnetic Resonance (MRI) and multimodality imaging, such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), are fundamental in implementing radiotherapy guidance. CASE REPORT A 54-year-old patient underwent surgery twice to remove primitive and recurrent cardiac sarcomas of the left atrium. The appearance of a further relapse required radiotherapy as the only possible treatment. Cardiac MRI was then performed to define the degree of atrial mass invasiveness, and 18F-FDG PET/CT was performed to assess the activity and staging of the cardiac lesion. It revealed high 18F-FDG uptake not only in the left atrium lesion but also in a pancreatic lesion with elevated 18F-FDG uptake (SUV max 5.5). The pancreatic biopsy performed a few days later confirmed the myxoid sarcoma metastasis, and surgeons defined it as not operable due to the patient's clinical condition. Radiotherapy was then urgently performed with the VMAT technique. After 40 days, a cardiac MRI showed a reduction in the cardiac mass with improvement in the respiratory and cardiac symptoms; then, the patient started chemotherapy. One year after diagnosis, the patient is still alive and is receiving chemotherapy with gemcitabine and docetaxel with good compliance. CONCLUSION The correct and timely management of a patient suffering from a rare oncological disease has allowed a better and longer survival, especially due to VMAT, a sophisticated procedure that requires high expertise. This case also demonstrates that cardiac MRI and whole-body imaging procedures, such as 18FDG PET/CT, can be useful in staging patients with oncological diseases.
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Affiliation(s)
- Antonio Rosario Pisani
- Interdisciplinary Department of Medicine, Nuclear Medicine Unit, University of Bari 'Aldo Moro', Bari, Italy
| | - Angela Sardaro
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari 'Aldo Moro', Bari, Italy
| | - Nicola Maggialetti
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Corinna Altini
- Interdisciplinary Department of Medicine, Nuclear Medicine Unit, University of Bari 'Aldo Moro', Bari, Italy
| | - Dino Rubini
- Interdisciplinary Department of Medicine, Nuclear Medicine Unit, University of Bari 'Aldo Moro', Bari, Italy
| | - Paolo Mammucci
- Interdisciplinary Department of Medicine, Nuclear Medicine Unit, University of Bari 'Aldo Moro', Bari, Italy
| | - Giuseppe Rubini
- Interdisciplinary Department of Medicine, Nuclear Medicine Unit, University of Bari 'Aldo Moro', Bari, Italy
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Ferrari C, Santo G, Mammucci P, Rubini D, Sciacqua A, Sardaro A, Pisani AR, Rubini G. [ 18F]FDG PET/CT in head and neck squamous cell carcinoma: a head-to-head between visual point-scales and the added value of multi-modality imaging. BMC Med Imaging 2023; 23:34. [PMID: 36814217 PMCID: PMC9945665 DOI: 10.1186/s12880-023-00989-5] [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: 05/31/2022] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) represents the 6th leading cancer worldwide. In most cases, patients present a locally advanced disease at diagnosis and non-surgical curative treatment is considered the standard of care. Nowadays, [18F]FDG PET/CT is a validated tool in post-treatment evaluation, with a high level of evidence. However, to standardize imaging response, several visual scales have been proposed with none of them approved yet. The study's aim is a head-to-head comparison between the diagnostic performance of the Hopkins criteria, the Deauville score, and the new proposed Cuneo score, to establish their prognostic role. Secondly, we investigate the possible value of semiquantitative analysis, evaluating SUVmax and ΔSUVmax of the lymph node with the highest uptake on the restaging PET scan. Moreover, we also considered morphological features using the product of diameters measured on the co-registered CT images to assess the added value of hybrid imaging. METHODS We performed a retrospective analysis on histologically proven HNSCC patients who underwent baseline and response assessment [18F]FDG PET/CT. Post-treatment scans were reviewed according to Hopkins, Deauville, and Cuneo criteria, assigning a score to the primary tumor site and lymph nodes. A per-patient final score for each scale was chosen, corresponding to the highest score between the two sites. Diagnostic performance was then calculated for each score considering any evidence of locoregional progression in the first 3 months as the gold standard. Survival analysis was performed using the Kaplan-Meier method. SUVmax and its delta, as well as the product of diameters of the lymph node with the highest uptake at post-treatment scan, if present, were calculated. RESULTS A total of 43 patients were finally included in the study. Sensitivity, specificity, PPV, NPV, and accuracy were 87%, 86%, 76%, 92%, and 86% for the Hopkins score, whereas 93%, 79%, 70%, 96%, and 84% for the Deauville score, respectively. Conversely, the Cuneo score reached the highest specificity and PPV (93% and 78%, respectively) but the lowest sensitivity (47%), NPV (76%), and accuracy (77%). Each scale significantly correlated with PFS and OS. The ROC analysis of the combination of SUVmax and the product of diameters of the highest lymph node on the restaging PET scan reached an AUC of 0.822. The multivariate analysis revealed the Cuneo criteria and the product of diameters as prognostic factors for PFS. CONCLUSIONS Each visual score statistically correlated with prognosis thus demonstrating the reliability of point-scale criteria in HNSCC. The novel Cuneo score showed the highest specificity, but the lowest sensibility compared to Hopkins and Deauville criteria. Furthermore, the combination of PET data with morphological features could support the evaluation of equivocal cases.
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Affiliation(s)
- Cristina Ferrari
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Giulia Santo
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Paolo Mammucci
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Dino Rubini
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Alessio Sciacqua
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Angela Sardaro
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy.
| | - Antonio Rosario Pisani
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Giuseppe Rubini
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
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Altini C, Maggialetti N, Branca A, Pisani AR, Rubini D, Sardaro A, Stabile Ianora AA, Rubini G. 18F-FDG PET/CT in peritoneal tumors: a pictorial review. Clin Transl Imaging 2023. [DOI: 10.1007/s40336-022-00534-4] [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: 01/09/2023]
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Nappi AG, Altini C, D'Alò C, Megna M, Niccoli Asabella A, Fiorella ML, Rubini D, Sardaro A, Pisani AR. [The role of oropharyngoesophageal scintigraphy in the assessment of dysphagia in neurological patients.]. Recenti Prog Med 2022; 113:739-748. [PMID: 36420850 DOI: 10.1701/3914.38976] [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: 06/16/2023]
Abstract
PURPOSE The aim of this study was to assess the role of oropharingoesophageal scintigraphy (OPES) in the management of neurological patients, investigating the clinical value of semiquantitative analysis. MATERIALS AND METHODS We enrolled 39 neurological patients clinically evaluated and scored according to the Dysphagia Outcome Severity Scale (DOSS) scale who underwent fibrolaryngoscopic swallowing examination (FEES) and OPES using a 99mTc-nanocolloid-radioblabelled semiliquid bolus. We calculated the following semiquantitative parameters: Oral Transit Time (OTT), Pharyngeal Transit Time (PTT), Esophageal Transit Time (ETT), Retention Index (RI), and Esophageal Emptying Rate (EER10s). Differences in OPES semiquantitative parameters between patients classified according to the DOSS scale were performed using the nonparametric Mann-Whitney U test. Optimal semiquantitative parameters cut-off values that correlated with DOSS classification were investigated with ROC curves. The agreement between OPES, FEES and DOSS results was measured using Cohen's Kappa test (K). RESULTS A significantly higher OTT (p=0.028), PTT (p=0.011) and ETT (p=0.030) and lower EER10s (p=0.016) values were identified. Moderate agreement resulted between OPES and DOSS results (k=0.429, 95%CI: 0.143-0.715, p=0.002). CONCLUSIONS Our study revealed a significant correlation between clinical dysphagia graded using DOSS scale and semiquantitative parameters obtained by OPES evaluation. Despite reliable and reproducible OPES results, allowing an adequate study also of the esophageal phase, nowadays scintigraphic study remains an underestimated method to be considered in the diagnosis of dysphagia and related complications.
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Affiliation(s)
- Anna Giulia Nappi
- UO Medicina Nucleare, Dipartimento Interdisciplinare di Medicina, Università di Bari "Aldo Moro
| | - Corinna Altini
- UO Medicina Nucleare, Dipartimento Interdisciplinare di Medicina, Università di Bari "Aldo Moro
| | - Claudia D'Alò
- UO Medicina Nucleare, Dipartimento Interdisciplinare di Medicina, Università di Bari "Aldo Moro
| | - Marisa Megna
- UO Medicina Fisica e Riabilitativa, Dipartimento di Scienze mediche di base, neuroscienze e organi di senso, Università di Bari "Aldo Moro
| | | | - Maria Luisa Fiorella
- UO Otorinolaringoiatria e Foniatria, Dipartimento di Scienze mediche di base, neuroscienze e organi di senso, Università di Bari "Aldo Moro
| | - Dino Rubini
- UO Medicina Nucleare, Dipartimento Interdisciplinare di Medicina, Università di Bari "Aldo Moro
| | - Angela Sardaro
- UO Radioterapia, Dipartimento Interdisciplinare di Medicina, Università di Bari "Aldo Moro
| | - Antonio Rosario Pisani
- UO Medicina Nucleare, Dipartimento Interdisciplinare di Medicina, Università di Bari "Aldo Moro
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Maggialetti N, Ciaccia M, Rubini D, Pisani AR, Santo G, Lucarelli NM, Ianora AAS. Multimodal study of pelvic splenosis: a rare cause of abdominal pain. Radiol Case Rep 2022; 17:3601-3606. [PMID: 35923337 PMCID: PMC9340123 DOI: 10.1016/j.radcr.2022.06.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 11/26/2022] Open
Abstract
We present a rare case of pelvic splenosis, in a 46-year-old man, with a previous history of partial splenectomy, complaining of nonspecific pain in the lower abdominal quadrants. Splenosis is a benign acquired condition, defined as a heterotopic autotransplantation of splenic tissue in other compartments of the body, caused by rupture of the splenic capsule following trauma or splenectomy. Splenosis is often asymptomatic and incidentally found and does not require treatment. Surgery is indicated only in patients presenting with symptoms or complications. In our case, the multimodal imaging study (ultrasound, MRI, CT, and scintigraphy) allowed a correct differential diagnosis without resorting to invasive procedures, susceptible to complications
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Sardaro A, Mammucci P, Pisani AR, Rubini D, Nappi AG, Bardoscia L, Rubini G. Intracranial Solitary Fibrous Tumor: A "New" Challenge for PET Radiopharmaceuticals. J Clin Med 2022; 11:jcm11164746. [PMID: 36012988 PMCID: PMC9410498 DOI: 10.3390/jcm11164746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Solitary fibrous tumor (SFT) of the central nervous system, previously named and classified with the term hemangiopericytoma (HPC), is rare and accounts for less than 1% of all intracranial tumors. Despite its benign nature, it has a malignant behavior due to the high rate of recurrence and distant metastasis, occurring in up to 50% of cases. Surgical resection of the tumor is the treatment of choice. Radiotherapy represents the gold standard in the case of post-surgery residual disease, relapse, and distant metastases. In this context, imaging plays a crucial role in identifying the personalized therapeutic decision for each patient. Although the referring imaging approach in SFT is morphologic, an emerging role of positron emission tomography (PET) has been reported in the literature. However, there is still a debate on which radiotracers have the best accuracy for studying these uncommon tumors because of the histological or biological heterogeneity of SFT.
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Affiliation(s)
- Angela Sardaro
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Paolo Mammucci
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Antonio Rosario Pisani
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
- Correspondence: ; Tel.: +39-080-5594388
| | - Dino Rubini
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Anna Giulia Nappi
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Lilia Bardoscia
- Radiation Oncology Unit, S. Luca Hospital, Healthcare Company Tuscany Nord Ovest, 55100 Lucca, Italy
| | - Giuseppe Rubini
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
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Maggialetti N, Ferrari C, Nappi AG, Rubini D, Pisani AR, Minoia C, Granata V, Moschetta M, Stabile Ianora Amato A, Rubini G. Prevalence and clinical impact of incidental findings on the unenhanced CT images of PET/CT scan in patients with multiple myeloma: the value of radiological reporting in the multimodal hybrid imaging. Eur Rev Med Pharmacol Sci 2022; 26:5902-5910. [PMID: 36066165 DOI: 10.26355/eurrev_202208_29529] [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: 06/15/2023]
Abstract
OBJECTIVE In the hybrid Positron Emission Tomography/Computed Tomography (PET/CT) method, the functional evaluation is integrated with the morphological information provided by co-registered CT, still performed for attenuation correction and lesion localization. However, co-registered CT images could provide additional diagnostic information that PET alone could underestimate. To optimize the diagnostic potential of this hybrid examination, we evaluated the prevalence and the clinical significance of incidental findings detected on co-registered CT images in a cohort of multiple myeloma (MM) patients. PATIENTS AND METHODS We evaluated 112 MM patients (mean age 65.8 y), who underwent [18F]FDG-PET/CT during their regular workup. All co-registered CT images were retrospectively reviewed by two expert radiologists and each non-myelomatous incidental finding (nM-IF) was collected and clinically graded according to a nM-IF Reporting and Data System (nM-RADS). In addition, nM-IFs were classified according to anatomic localization (skull, lung, mediastinum, abdomen, breast, gastrointestinal, genitourinary and cardiovascular system and muscle/soft tissue). RESULTS 163 nM-IFs were detected in 94/112 patients (83.9%) (mean value: 1.5 IFs per patient). The most interested anatomic districts were the lung (n=33; 20.2%), genitourinary (n=33; 20.2%) and gastrointestinal (n=30; 18.4%) systems. Focusing on the clinically significant findings (nM3+nM4), 92/163 (56.4%) IFs could have been required further investigations, of which 38/163 (23.3%) were potentially important and detected in 33/112 (29.5%) patients. CONCLUSIONS The high percentage of potentially clinically significant IFs detected in MM patients emphasizes that co-registered CT images hold precious information often missed. Giving more relevance to co-registered CT with tailored acquisition and reconstruction protocols and dedicated reporting could optimize the potentiality of this multimodality imaging method with impact on clinical management.
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Affiliation(s)
- N Maggialetti
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
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Tramacere F, Sardaro A, Arcangeli S, Maggialetti N, Altini C, Rubini D, Rubini G, Portaluri M, Niccoli Asabella A. Safety culture to improve accidental event reporting in radiotherapy. J Radiol Prot 2021; 41:1317-1327. [PMID: 34134092 DOI: 10.1088/1361-6498/ac0c01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND PURPOSE The potential for unintended and adverse radiation exposure in radiotherapy (RT) is real and should be studied because RT is a highly complex, multistep process, which requires input from numerous individuals from different areas and steps of the RT workflow. The 'Incident' (I) is an event the consequence of which is not negligible from the point of view of protection or safety. A 'near miss' (NM) is defined as an event that is highly likely to happen but did not occur. The purpose of this work is to show that through systematic reporting and analysis of these adverse events, their occurrence can be reduced. MATERIALS AND METHODS Staff were trained to report every type of unintended and adverse radiation exposure and to provide a full description of it. RESULTS By 2018, 110 worksheets had been collected, with an average of 6.1 adverse events per year (with 780 patients treated per year, meaning an average incident rate of 0.78%). In 2001-2009, 37 events were registered (13 I and 24 NM), the majority of them were in the decision phase (12/37), while in 2010-2013, there were 42 (1 I and 41 NM) in both the dose-calculation and transfer phase (19/42). In 2014-2018, 31 events (1 I and 30 NM) were equally distributed across the phases of the RT process. In 9/15 cases of I, some checkpoint was introduced. CONCLUSION The complexity of the RT workflow is prone to errors, and this must be taken into account by encouraging a safety culture. The aim of this paper is to present the collected incidents and near misses and to show how organization and practice were modified by the acquired knowledge.
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Affiliation(s)
| | - Angela Sardaro
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari 'Aldo Moro', Bari, Italy
| | - Stefano Arcangeli
- Department of Radiation Oncology, ASST Monza-University of Milan 'Bicocca', Milan, Italy
| | - Nicola Maggialetti
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Corinna Altini
- Interdisciplinary Department of Medicine, Nuclear Medicine Unit, University of Bari 'Aldo Moro', Bari, Italy
| | - Dino Rubini
- Section of Diagnostic Imaging, University of Bari 'Aldo Moro', Bari, Italy
| | - Giuseppe Rubini
- Interdisciplinary Department of Medicine, Nuclear Medicine Unit, University of Bari 'Aldo Moro', Bari, Italy
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Garrone O, Paccagnella M, Ruatta F, Abbona A, Falletta A, Croce N, Vanella P, Denaro N, Rubini D, Gallo C, Rivoltini L, Merlano M. 157P Moderate physical activity (MPA) modulates immune system in breast cancer (BC) patients during preoperative chemotherapy: The NEO-RUNNER study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.438] [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: 11/28/2022] Open
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18
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Altini C, Mammucci P, Pisani AR, D'Alò C, Sardaro A, Rubini D, Ferrari C, Rubini G. 18F-FDG PET/CT in GIST treatment response evaluation beyond Imatinib. Hell J Nucl Med 2021; 24:239-246. [PMID: 34901964 DOI: 10.1967/s002449912407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022]
Abstract
Positron emission tomography/computed tomography (PET/CT) represents a reliable promising tool in treatment response evaluation of new therapies beyond Imatinib in gastrointestinal stromal tumors (GIST). This narrative review aims to discuss the literature about the role of fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT in evaluating response in new tyrosine kinase inhibitors (TKI) and radiotherapy (RT) in GIST patients. A comprehensive literature search was performed to retrieve original studies published on PubMed, Scopus and Google Scholar databases. Eighteen studies including 382 patients with GIST were selected. Main findings of included studies are presented. Fluorine-18-FDG PET/CT may enhance performance in GIST management providing significant information in evaluation of treatment response and representing a strong predictor of clinical outcome.
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Affiliation(s)
- Corinna Altini
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy.
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Ferrari C, Nappi AG, Santo G, Mammucci P, Rubini D, Tucci M, Pisani AR. The Day after Mass COVID-19 Vaccination: Higher Hypermetabolic Lymphadenopathy Detection on PET/CT and Impact on Oncologic Patients Management. Cancers (Basel) 2021; 13:cancers13174340. [PMID: 34503150 PMCID: PMC8431447 DOI: 10.3390/cancers13174340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/24/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 12/25/2022] Open
Abstract
The widespread COVID-19 vaccination led to unexpected PET findings. Notably, axillary and interpectoral lymphadenopathies ipsilateral to the vaccine inoculation were observed. We aimed to assess the hypermetabolic lymphadenopathy (HLN) detection rate on PET/CT. Secondly, we investigated factors that might help in HLN differential diagnosis. A retrospective analysis on 1196 consecutive patients referred for a PET/CT was performed. All patients were asked about the date, type and site of vaccine injections. HLNs were recorded and categorized according to risk classes and SUVmax grades. A statistical analysis was performed to assess the correlation between HLN detection and different clinical/vaccine data. HLN detection rate was 15% and 27% in the No Vac- and vac-groups (p < 0.001), respectively. In the Vac-group, age (p < 0.001) and time interval from vaccine-to-PET (p = 0.010) were inversely correlated with HLN detection. Furthermore, SUVmax significantly changed during time intervals, with lower values beyond 20 days (p < 0.001). In the era of mass COVID-19 vaccination, a higher axillary and interpectoral lymphadenopathies detection ipsilateral to vaccine injection was observed. These PET findings can be wrongly interpreted, complicating cancer patients' management. To minimize these pitfalls, a detailed vaccination anamnesis must be recorded and should take into account the appropriate PET schedule.
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Affiliation(s)
- Cristina Ferrari
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.G.N.); (G.S.); (P.M.); (D.R.); (A.R.P.)
- Correspondence: ; Tel.: +39-080-5595-039
| | - Anna Giulia Nappi
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.G.N.); (G.S.); (P.M.); (D.R.); (A.R.P.)
| | - Giulia Santo
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.G.N.); (G.S.); (P.M.); (D.R.); (A.R.P.)
| | - Paolo Mammucci
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.G.N.); (G.S.); (P.M.); (D.R.); (A.R.P.)
| | - Dino Rubini
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.G.N.); (G.S.); (P.M.); (D.R.); (A.R.P.)
| | - Marco Tucci
- Division of Medical Oncology, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Antonio Rosario Pisani
- Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (A.G.N.); (G.S.); (P.M.); (D.R.); (A.R.P.)
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Lorusso F, Scioscia M, Rubini D, Stabile Ianora AA, Scardigno D, Leuci C, De Ceglie M, Sardaro A, Lucarelli N, Scardapane A. Magnetic resonance imaging for deep infiltrating endometriosis: current concepts, imaging technique and key findings. Insights Imaging 2021; 12:105. [PMID: 34292422 PMCID: PMC8298718 DOI: 10.1186/s13244-021-01054-x] [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: 05/23/2021] [Accepted: 07/05/2021] [Indexed: 12/24/2022] Open
Abstract
Endometriosis is an estrogen-dependent chronic disease affecting about 10% of reproductive-age women with symptoms like pelvic pain and infertility. Pathologically, it is defined by the presence of endometrial tissue outside the uterine cavity responsible for a chronic inflammatory process. For decades the diagnosis of endometriosis was based on surgical exploration and biopsy of pelvic lesions. However, laparoscopy is not a risk-free procedure with possible false negative diagnosis due to an underestimate of retroperitoneal structures such as ureters and nerves. For these reasons nowadays, the diagnosis of endometriosis is based on a noninvasive approach where clinical history, response to therapy and imaging play a fundamental role. Trans-vaginal ultrasound and magnetic resonance imaging are suitable for recognizing most of endometriotic lesions; nevertheless, their accuracy is strictly determined by operators’ experience and imaging technique. This review paper aims to make radiologists aware of the diagnostic possibilities of pelvic MRI and familial with the MR acquisition protocols and image interpretation for women with endometriosis.
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Affiliation(s)
- Filomenamila Lorusso
- University of Bari Medical School - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | | | - Dino Rubini
- University of Bari Medical School - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - Amato Antonio Stabile Ianora
- University of Bari Medical School - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | | | - Carla Leuci
- University of Bari Medical School - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - Michele De Ceglie
- University of Bari Medical School - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - Angela Sardaro
- University of Bari Medical School - Interdisciplinary Department of Medicine, Section of Radiation Therapy, Bari, Italy
| | - Nicola Lucarelli
- University of Bari Medical School - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - Arnaldo Scardapane
- University of Bari Medical School - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Piazza Giulio Cesare, 11, 70124, Bari, Italy.
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21
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Sardaro A, Ferrari C, Mammucci P, Piscitelli D, Rubini D, Maggialetti N. The significant role of multimodality imaging with 18Fluorocholine PET/CT in relapsed intracranial hemangiopericytoma. Rev Esp Med Nucl Imagen Mol 2021; 41:S2253-654X(21)00068-8. [PMID: 33858798 DOI: 10.1016/j.remn.2021.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 10/21/2022]
Affiliation(s)
- A Sardaro
- Section of Radiology and Radiation Oncology, DIM, University «Aldo Moro» of Bari, Bari, Italy
| | - C Ferrari
- Section of Nuclear Medicine, DIM, University «Aldo Moro» of Bari, Bari, Italy.
| | - P Mammucci
- Section of Nuclear Medicine, DIM, University «Aldo Moro» of Bari, Bari, Italy
| | - D Piscitelli
- Section of Pathology, DETO, University «Aldo Moro» of Bari, Bari, Italy
| | - D Rubini
- Section of Nuclear Medicine, DIM, University «Aldo Moro» of Bari, Bari, Italy
| | - N Maggialetti
- Section of Radiodiagnostic, DSMBNOS, University «Aldo Moro» of Bari, Bari, Italy
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Farisa Banu S, Rubini D, Shanmugavelan P, Murugan R, Gowrishankar S, Karutha Pandian S, Nithyanand P. Effects of patchouli and cinnamon essential oils on biofilm and hyphae formation by Candida species. J Mycol Med 2018; 28:332-339. [PMID: 29571979 DOI: 10.1016/j.mycmed.2018.02.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 11/13/2017] [Revised: 02/24/2018] [Accepted: 02/24/2018] [Indexed: 12/01/2022]
Abstract
The prevalence and fatality rates with biofilm-associated candidal infections have remained a challenge to the medical fraternity despite major advances in the field of antifungal therapy. Traditionally, essential oils (EOs) from the aromatic plants have been found to be excellent therapeutic agents to treat fungal ailments. The present study explores the antivirulent and antibiofilm effects of under explored leaf EOs of Indian patchouli EO extracted from Pogostemon heyneanus (PH), Indian cassia from Cinnamomum tamala (CT) and camphor EO from C. camphora (CC) against Candida species. The EOs were investigated for its efficacy to disrupt the young and preformed Candida spp. biofilms and to inhibit the yeast to hyphal transition, a hallmark virulent trait of C. albicans. The ability of these EOs to inhibit metabolically active cells was assessed through XTT assay. Of these three EOs, CT EO showed enhanced biofilm inhibition than others and hence it was further selected to study its biomass inhibition potential and exopolysaccharide layer disruption ability. The CT EO reduced the biomass of the preformed biofilms of all three Candida strains, which was supported by confocal microscopy. It also disrupted the exopolysaccharide layer of the Candida strains as shown by scanning electron microscopy. The present findings validate the effectiveness of EOs against the virulence of Candida spp. and emphasize the pharmaceutical potential of several native but yet unexplored wild aromatic plants in the prospect of therapeutic application.
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Affiliation(s)
- S Farisa Banu
- Biofilm Biology Laboratory, School of Chemical and Biotechnology, Anusandhan Kendra II, SASTRA University, 613401 Thanjavur, Tamil Nadu, India
| | - D Rubini
- Biofilm Biology Laboratory, School of Chemical and Biotechnology, Anusandhan Kendra II, SASTRA University, 613401 Thanjavur, Tamil Nadu, India
| | - P Shanmugavelan
- Biofilm Biology Laboratory, School of Chemical and Biotechnology, Anusandhan Kendra II, SASTRA University, 613401 Thanjavur, Tamil Nadu, India
| | - R Murugan
- School of Chemical and Biotechnology, SASTRA University, 613401 Thanjavur, Tamil Nadu, India
| | - S Gowrishankar
- Department of Biotechnology, Science Campus, Alagappa University, 630003 Karaikudi, Tamil Nadu, India
| | - S Karutha Pandian
- Department of Biotechnology, Science Campus, Alagappa University, 630003 Karaikudi, Tamil Nadu, India
| | - P Nithyanand
- Biofilm Biology Laboratory, School of Chemical and Biotechnology, Anusandhan Kendra II, SASTRA University, 613401 Thanjavur, Tamil Nadu, India; Centre for Research on Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA University, 613401 Thanjavur, Tamil Nadu, India.
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Rubini G, Altini C, Notaristefano A, Merenda N, Rubini D, Ianora AS, Asabella AN. Role of 18F-FDG PET/CT in diagnosing peritoneal carcinomatosis in the restaging of patient with ovarian cancer as compared to contrast enhanced CT and tumor marker Ca-125. Rev Esp Med Nucl Imagen Mol 2014. [DOI: 10.1016/j.remnie.2013.12.010] [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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Rubini G, Niccoli Asabella A, Stabile Ianora AA, Rubini D, Gaudiano A, Angelelli G, Rotondo A. Acute pulmonary embolism: comparison and integration of perfusion lung scintigraphy with multislice spiral CT. Radiol Med 2007; 112:174-84. [PMID: 17361378 DOI: 10.1007/s11547-007-0133-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 05/30/2006] [Indexed: 11/27/2022]
Abstract
PURPOSE This study compared and integrated the data from perfusion lung scintigraphy and multislice computed tomography (CT) for the emergency diagnosis of acute pulmonary embolism in nuclear medicine and radiology departments operating around the clock. MATERIALS AND METHODS One hundred and seven patients with a clinical and laboratory suspicion of acute pulmonary embolism who had already undergone chest radiography were divided into four groups according to the time interval between onset of clinical suspicion and performance of the two diagnostic examinations (0-24 h, 24-48 h, 0-48 h, 2-7 days). Cohen's test for the analysis of statistical concordance was used. RESULTS Perfusion lung scintigraphy and multislice CT were positive in 29/107 (27.1%) and negative in 78/107 (72.89%). Positive concordance (PC) was found in 22 cases and negative concordance (NC) in 71 cases: 0-24 h: PC in 12, NC in 32 cases; 24-48 h: PC in 3, NC in 15 cases; 0-48 h: PC in 15, NC in 47 cases; 2-7 days: PC in 7, NC in 24 cases. CONCLUSIONS Perfusion lung scintigraphy and multislice CT demonstrated elevated concordance if performed within 7 days of the onset of suspicion of acute pulmonary embolism. Concordance was higher if the examinations were completed within 24-48 h. In suspected acute pulmonary embolism, it is mandatory to reach a correct diagnosis within few hours--48 at the most.
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Affiliation(s)
- G Rubini
- Sezione di Diagnostica per Immagini, Policlinico Universitario, Piana Giulio Cesare 11, I-70124, Bari, Italy.
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Altomare DF, Rubini D, Pilot MA, Farese S, Rubini G, Rinaldi M, Memeo V, D'Addabbo A. Oral erythromycin improves gastrointestinal motility and transit after subtotal but not total gastrectomy for cancer. Br J Surg 1997; 84:1017-21. [PMID: 9240156 DOI: 10.1002/bjs.1800840735] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [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: 02/04/2023]
Abstract
BACKGROUND Erythromycin has been shown to be a powerful prokinetic of the gastrointestinal tract. Little is known about its value to improve motility and transit in gastrectomized patients. METHODS Thirteen disease-free patients subjected to subtotal gastrectomy and 11 subjected to total gastrectomy for gastric cancer entered the study. Gastrointestinal transit of a standard 99mTc-labelled meal and fasting motility were studied before and after oral erythromycin. RESULTS In patients who had subtotal gastrectomy mean(s.d.) gastric half-emptying time was 42(14) min before and 26(11) min after erythromycin (P = 0.011). Before erythromycin prolonged rhythmical contractions (3 per min) were recorded in eight patients, sporadic non-organized contractions in two and prolonged bursts of waves in one. After erythromycin, clustered waves resembling a migrating motor complex (MMC) appeared in eight patients, while rhythmic motor activity was unchanged in three. In patients who had total gastrectomy jejunal half-emptying time was 39(18) min before and 45(12) min after erythromycin. In eight patients, frequent MMCs were recorded, peristaltic in four, synchronous in one, antiperistaltic in two, with clusters of non-propagated waves in one. After erythromycin, longer peristaltic MMCs were recorded in three, antiperistaltic MMCs persisted in two, synchronous in one and clusters of non-propagated waves in two. CONCLUSION Oral erythromycin improves gastrointestinal transit and motility after subtotal gastrectomy. The findings after total gastrectomy are controversial.
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Affiliation(s)
- D F Altomare
- Istituto di Clinica Chirurgica, Università degli Studi di Bari, Italy
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Lauriero F, Rubini G, D'Addabbo F, Rubini D, Schettini F, D'Addabbo A. I-131 MIBG scintigraphy of neuroectodermal tumors. Comparison between I-131 MIBG and In-111 DTPA-octreotide. Clin Nucl Med 1995; 20:243-9. [PMID: 7750219 DOI: 10.1097/00003072-199503000-00011] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [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: 01/26/2023]
Abstract
An account is given of the results observed with I-131 MIBG scintigraphy in four patients (1 bladder pheochromocytoma, 3 neuroblastomas) chosen on account of their particular clinical and diagnostic interest from a series of 41 apudoma patients examined by means of this technique. In the first patient, the unusual site of the tumor in the posterior wall of the bladder meant that its detection by I-131 MIBG was only possible after catheterization of the bladder. In the second patient, uptake in the metastasis was only evident after removal of the primary tumor. In the third patient, the scintiscan revealed several metastases (some in bone) not detected by CT. In the fourth patient (congenital neuroblastoma), enhanced uptake accompanied the appearance of high plasma catecholamine and urinary vanillylhandelic acid values, suggesting a functional switch from a nonsecreting to a secreting form. a supplementary In-111 DTPA-Octreotide (OCT) scintiscan of this patient demonstrated the presence of somatostatin receptors on the neuroblasts. Thus, this examination would seem particularly useful for the differentiation of nonsecreting neuroblastomas. Its employment in assessment of the therapeutic capacity of OCT itself is also suggested.
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Affiliation(s)
- F Lauriero
- Centro Interdipartimentale di Biocibernetica e Tecniche Radioisotopiche, Università di Bari, Italy
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Rubini G, Anelli F, Correale M, Lauriero F, Rubini D, D'Addabbo A. Renal osteodystrophy with hyperparathyroidism: the diagnostic value of intact parathormone, alkaline phosphatase, osteocalcin and procollagen. J Nucl Biol Med (1991) 1994; 38:489-94. [PMID: 7865545] [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
In 27 patients on periodic haemodialysis, serum levels of alkaline phosphatase (ALP), osteocalcin (BGP), intact parathyroid hormone (PTHi) and its two fragments, terminal COOH (PTH-Cter) and middle molecule (PTH-MM), and procollagen type 1 carboxy-terminal extension peptide (P1CP) were measured. The same patients underwent radiography of the skull and of the hands, ultrasonography of the parathyroids and scintigraphy of the skeleton with 99mTc-MDP. The study was completed by the measurement of aluminium (Al) in the blood and the deferoxamine test (DFO). Two groups of patients emerged, one (group A, n = 14) with PTHi greatly increased (201.07 +/- 109.72 pg/mL) and the other (group B, n = 13) with values within the normal range (32.69 +/- 17.06 pg/mL) (p < 0.001). In group A, ALP, BGP and particularly P1CP were increased with a statistically significant difference compared to group B. Specific radiographic alterations were found in 12 patients of group A; 7 patients also had hypertrophy of the parathyroids. There was no difference in the scintigraphic alterations of the skeleton between the two groups. The authors conclude that it is the association of the high values of PTHi with those of the markers of bone metabolism, the normal level of Al, the negativity of the DFO test and the radiological alterations which together allow the diagnosis of renal osteodystrophy with hyperparathyroidism.
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Affiliation(s)
- G Rubini
- Nuclear Medicine Department, School of Medicine, University of Bari, Italy
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Abstract
The authors report the casual discovery in 1991 of a metastasis during Tc-99m MDP imaging of a 57-year-old woman who underwent surgery in 1983 for cutaneous melanoma on the right calf. The scan did not show bone alterations but did reveal an area of hyperactive uptake in the soft tissue of the medial surface of the thigh, where slightly altered pigmentation was also apparent. A subsequent immunoscan with Tc-99m-F(ab')2 225.28S confirmed increased uptake at this site. The lesion was removed and was histologically diagnosed as a skin metastasis from melanoma. Inguinal adenopathy appeared 6 months later. The uptake of Tc-99m MDP by both primary and metastases tumors has been described, although this may be the first report concerning melanoma. The uptake mechanism is not known.
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Affiliation(s)
- G Rubini
- Department of Nuclear Medicine, Polyclinic, University of Bari, Italy
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Abstract
99Tcm-methylene diphosphonate (MDP) global skeletal uptake (4 h GSU) was determined by quantitative measurement of activity on bone scan images 4 h after injection in whole skeleton regions of interest (ROI) in 16 normal subjects, in five patients with hypertrophic pulmonary osteoarthropathy (HPO) and in 12 with Paget's disease. Values were correlated with those of whole body retention (24 h WBR), and serum bone gla protein (BGP), i.e. osteocalcin, alkaline phosphatase (AP) and type 1 procollagen (P1CP). They were 40% higher in HPO than in the normal controls, while in Paget's disease they increased more in polyostotic than in monostotic patients. A statistically significant difference was noted between 4 h GSU and 24 h WBR values in the two groups of patients compared with the controls. Of the bone metabolism markers, serum AP and P1CP were higher in the patients and positively correlated with their enhanced 4 h GSU values, whereas BGP was always within the normal range. This method may thus be regarded as a useful way of simultaneously determining bone 99Tcm-MDP uptake and altered bone turnover sites, especially in patients with systemic bone disease.
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Affiliation(s)
- G Rubini
- Centro Interdipartimentale di Biocibernetica e Tecniche Radioisotopiche, Cattedra di Medicina Nucleare, Università di Bari, Italy
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D'Addabbo A, Macarini L, Rubini G, Rubini D, Salzillo F, Lauriero F. Correlation between bone imaging and the clinical picture in two unsuspected cases of progressive diaphyseal dysplasia (Engelmann's disease). Clin Nucl Med 1993; 18:324-8. [PMID: 8482029 DOI: 10.1097/00003072-199304000-00012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [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: 01/31/2023]
Abstract
Progressive diaphyseal dysplasia was incidentally discovered in two patients referred for Tc-99m MDP bone scintigraphy (one for intense sciatica, the other for the detection of breast cancer metastases). Tracer accumulation in the diaphyses of the lower limbs and the base of the skull was accompanied by bone thickening and patency of the medullary cavity, as demonstrated by radiography, MRI, and bone marrow scanning. Comparison of the clinical pictures with the results of instrumental examinations showed that these were cases of sporadic progressive diaphyseal dysplasia of slight and average gravity, respectively. The differentiation of Ribbing's disease is explained and reference also is made to a finding not mentioned in the literature, namely frontal bone resorption lacunules in one patient.
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Affiliation(s)
- A D'Addabbo
- Department of Nuclear Medicine, University of Bari, Italy
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