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Michielan A, Vieceli F, Pravadelli C, Moser L, Agugiaro F, Luppi G, Gatti FL, Costa L, Rozzanigo UM. Combination of transjugular intrahepatic portosystemic shunt and antegrade through-the-TIPS coil embolization for bleeding mixed-type ectopic ileal varices. Clin J Gastroenterol 2023; 16:668-672. [PMID: 37452994 PMCID: PMC10539418 DOI: 10.1007/s12328-023-01830-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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
A 61-year-old man with alcoholic cirrhosis and a history of severe cholecystitis leading to secondary thrombosis of the recanalized paraumbilical vein was admitted to our hospital for recurrent gastrointestinal bleeding and severe anemia. Capsule endoscopy and CT angiography detected profuse bleeding in the proximal ileum from ectopic ileal varices. Hepatic venous-portal gradient (HVPG) measurement was consistent with severe portal hypertension. Persistent bleeding despite transjugular intrahepatic portosystemic shunt (TIPS) placement required a combined approach with antegrade through-the-TIPS coil embolization of the ileal varices.
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Affiliation(s)
- Andrea Michielan
- Department of Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, APSS Trento, Trento, Italy
| | - Filippo Vieceli
- Department of Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, APSS Trento, Trento, Italy
| | - Cecilia Pravadelli
- Department of Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, APSS Trento, Trento, Italy
| | - Luisa Moser
- Department of Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, APSS Trento, Trento, Italy
| | - Flora Agugiaro
- Department of Gastroenterology and Digestive Endoscopy Unit, Santa Chiara Hospital, APSS Trento, Trento, Italy
| | - Giacomo Luppi
- Department of Radiology, Santa Chiara Hospital, APSS Trento, Largo Medaglie D'Oro 9, 38122, Trento, Italy
| | - Francesco Lorenzo Gatti
- Department of Radiology, Santa Chiara Hospital, APSS Trento, Largo Medaglie D'Oro 9, 38122, Trento, Italy
| | - Lorenzo Costa
- Department of Radiology, Santa Chiara Hospital, APSS Trento, Largo Medaglie D'Oro 9, 38122, Trento, Italy
| | - Umberto Maria Rozzanigo
- Department of Radiology, Santa Chiara Hospital, APSS Trento, Largo Medaglie D'Oro 9, 38122, Trento, Italy.
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
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Salati M, Anna B, Luigi F, Antonella I, Gennaro G, Bardasi C, Luppi G, Bocconi A, Antonino I, Maria S, Troncone G, Brunella F, Reggiani Bonetti L, Dominici M, Carotenuto P. P-149 Integrative analysis of the genomic and transcriptomic landscape identifies novel key genes as a therapeutic target in bile duct cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.204] [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: 10/20/2022] Open
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3
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Santini C, Caputo F, Gardini AC, Cerma K, Bardasi C, Passardi A, Garajovà I, Rapposelli I, Lattanzi E, Spallanzani A, Bonetti LR, Piccoli M, Meduri B, Gelmini R, Pecchi A, Benatti S, Dominici M, Luppi G, Gelsomino F. 425P Statins increase pathological response in locally advanced rectal cancer (LARC) treated with chemo-radiation (CRT): A multicentric experience. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.536] [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] Open
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4
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Salati M, Pecchi A, Prampolini F, Kaleci S, Santini C, Canino F, Benatti S, Casadei Gardini A, Gelsomino F, Torricelli P, Luppi G, Dominici M, Spallanzani A. 1486P The impact of CT-based body composition parameters on survival outcomes in Western patients (pts) with resected gastric and gastroesophageal junction adenocarcinoma (GEA). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1992] [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] Open
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Caputo F, Gelsomino F, Spallanzani A, Pettorelli E, Benatti S, Ghidini M, Grizzi G, Ratti M, Merz V, Messina C, Tonelli R, Luppi G, Melisi D, Dominici M, Salati M. 63P Multicentre match-paired analysis of advanced biliary cancer (ABC) long-term survivors: The BILONG study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.041] [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] Open
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6
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Damato A, Spallanzani A, Berselli A, Rovesti G, Benatti S, Luppi G, Pinto C. 1746P Impact of PD-1/PD-L1 blockade therapy in COVID-19 infected cancer patients (pts) hospitalization: Results of an Italian study in the province of Modena and Reggio Emilia during SARS-CoV-2 outbreak. Ann Oncol 2020. [PMCID: PMC7506484 DOI: 10.1016/j.annonc.2020.08.1810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Rimini M, Salati M, Bocconi A, Riccò B, Rovesti G, Caputo F, Santini C, Bardasi C, Riggi M, Canino F, Casadei Gardini A, Gelsomino F, Benatti S, Dominici M, Luppi G, Spallanzani A. 1474P Immune-inflammatory indexes and BMI as predictors of outcome and treatment response in advanced gastric cancer receiving ramucirumab-containing second-line. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1980] [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] Open
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Salati M, Marcheselli L, Ruvo ND, Esposito G, Fenocchi S, Cucciarrè G, Serra F, Cautero N, Cabry F, Gelmini R, Vittimberga G, Radi G, Solaini L, Morgagni P, Ercolani G, Ghidini M, Grizzi G, Ratti M, Gelsomino F, Luppi G, Dominici M, Spallanzani A. SO-12 Multicentre validation of an immune-inflammation-based nomogram to predict survival in western resectable gastroesophageal adenocarcinoma: The NOMOGAST. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.027] [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] Open
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9
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Lenz HJ, Van Cutsem E, Limon M, Wong K, Hendlisz A, Aglietta M, Garcia-Alfonso P, Neyns B, Luppi G, Cardin D, Dragovich T, Shah U, Atasoy A, Postema R, Boyd Z, Ledeine JM, Overman M, Lonardi S. Durable clinical benefit with nivolumab (NIVO) plus low-dose ipilimumab (IPI) as first-line therapy in microsatellite instability-high/mismatch repair deficient (MSI-H/dMMR) metastatic colorectal cancer (mCRC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.019] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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De Stefano A, Nasti G, Febbraro A, Rosati G, Giuliani F, Santini D, Aprile G, Scartozzi M, Silvestris F, Luppi G, Lolli I, Mastroianni C, Leo S, Montesarchio V, Gridelli C, Pozzo C, Sperti E, Giannarelli D, Budillon A, Avallone A. Intermittent or continuous panitumumab (PAN) plus FOLFIRI for first-line treatment of patients (pts) with RAS/BRAF wild-type (WT) metastatic colorectal cancer (mCRC): A randomized phase II trial (IMPROVE). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.154] [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: 11/13/2022] Open
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Abstract
Synchronous renal cell cancer (RCC) associated with primary neoplasms of other organs or tissues represents a rare diagnostic report during life. Recently, the widespread use of new diagnostic techniques (echography, computed tomography and magnetic resonance imaging) has permitted diagnosis of clinically silent RCC. We report 6 RCC cases occasionally diagnosed during initial staging of a primary cancer of other organs: 1 rhinopharyngeal carcinoma, 1 gastric cancer, 1 Waldenstrom's disease, 1 non-Hodgkin's lymphoma, 2 breast cancer. RCC was clinically silent in all patients. The diagnostic problems related to a report of a renal mass in patients with neoplastic disease at other sites and the consequent therapeutic implications are discussed.
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Affiliation(s)
- L Piccinini
- Cattedra di Terapia Medica Sistematica, Università di Modena, Italy
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Brighi M, De Siena N, Vaccari S, Pagano N, Luppi G, Cervellera M, Tonini V. Early colorectal cancer: Is surgery always mandatory? Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.01.044] [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: 10/17/2022] Open
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13
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Grasso RF, Luppi G, Cazzato RL, Faiella E, D'Agostino F, Zobel DB, De Lena M. Percutaneous Computed Tomography-Guided Lung Biopsies: Preliminary Results using an Augmented Reality Navigation System. Tumori 2018; 98:775-82. [DOI: 10.1177/030089161209800616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background “Augmented reality” is a technique to create a composite view by augmenting the real intervention field, visualized by the doctor, with additional information coming from a virtual volume generated using computed tomography (CT), magnetic resonance or ultrasound images previously acquired from the same patient. In the present study we verified the accuracy and validated the clinical use of an augmented reality navigation system produced to perform percutaneous CT-guided lung biopsies. Methods One hundred and eighty consecutive patients with solitary parenchymal lung lesions, enrolled using a nonrandom enrollment system, underwent percutaneous CT-guided aspiration and core biopsy using a traditional technique (group C, 90 patients) and navigation system assistance (group S, 90 patients). For each patient we recorded the largest lesion diameter, procedure time, overall number of CT scans, radiation dose, and complications. The entire experimental project was evaluated and approved by the local institutional review board (ethics committee). Results Each procedure was concluded successfully and a pathological diagnosis was reached in 96% of cases in group S and 90% of cases in group C. Procedure time, overall number of CT scans and incident x-ray radiation dose (CTDIvol) were significantly reduced in navigation system-assisted procedures (P <0.001; z = 5.64) compared with traditional CT-guided procedures. The percentage of procedural complications was 14% in group S and 17% in group C. Conclusion The augmented reality navigation system used in this study was a highly safe, technically reliable and effective support tool in percutaneous CT-guided lung biopsy, allowing to shorten the procedure time and reduce the incident x-ray radiation dose to patients and the rate of insufficient specimens. Furthermore, it has the potential to increase the number of procedures executed in the allocated time without increasing the number of complications.
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Affiliation(s)
- Rosario Francesco Grasso
- Department of Diagnostic Imaging and Interventional Radiology, “Campus Bio-Medico” University Hospital, Rome
| | - Giacomo Luppi
- Department of Diagnostic Imaging and Interventional Radiology, “Campus Bio-Medico” University Hospital, Rome
| | - Roberto Luigi Cazzato
- Department of Diagnostic Imaging and Interventional Radiology, “Campus Bio-Medico” University Hospital, Rome
| | - Eliodoro Faiella
- Department of Diagnostic Imaging and Interventional Radiology, “Campus Bio-Medico” University Hospital, Rome
| | - Francesco D'Agostino
- Department of Diagnostic Imaging and Interventional Radiology, “Campus Bio-Medico” University Hospital, Rome
| | - Daniela Beomonte Zobel
- Department of Diagnostic Imaging and Interventional Radiology, “Campus Bio-Medico” University Hospital, Rome
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Faiella E, Frauenfelder G, Santucci D, Luppi G, Schena E, Beomonte Zobel B, Grasso RF. Percutaneous low-dose CT-guided lung biopsy with an augmented reality navigation system: validation of the technique on 496 suspected lesions. Clin Imaging 2017; 49:101-105. [PMID: 29207301 DOI: 10.1016/j.clinimag.2017.11.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 11/20/2017] [Accepted: 11/28/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To validate a CT-navigation system during percutaneous lung biopsy (PLB). METHODS Four hundred-ninety-six patients underwent low-dose CT-guided PLB. Lesion diameter (LD), procedural time (PT), histologic validity, lesion distance from pleural surface (DPS), needle distance travelled during procedure (DTP), complications and radiation exposure were recorded. RESULTS Hysto-patological diagnosis was obtained in 96.2% cases. Mean PT, DPS, DTP, LD were respectively 29.5min, 12.4mm, 17.9mm, 20.7mm. In cases of major complications (4.6%), higher values of DTP were measured. CONCLUSIONS CT-navigation system allowed a good success in terms of diagnosis in small lesions and when a long DTP is required.
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Affiliation(s)
- Eliodoro Faiella
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Roma, Italy.
| | - Giulia Frauenfelder
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Roma, Italy.
| | - Domiziana Santucci
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Roma, Italy.
| | - Giacomo Luppi
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Roma, Italy.
| | - Emiliano Schena
- Department of Measurement and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy.
| | - Bruno Beomonte Zobel
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Roma, Italy.
| | - Rosario Francesco Grasso
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Roma, Italy.
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Spallanzani A, Gelsomino F, Caputo F, Salati M, Reggiani Bonetti L, Domati F, Andrikou K, Fontana A, Di Emidio K, Baldessari C, Pugliese G, Bettelli S, Luppi G, Cascinu S. The prognostic impact of sidedness across all stages during the last 20 years: the “Modena Cancer Registry” experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.022] [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: 11/13/2022] Open
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16
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Baldessari C, Spallanzani A, Gelsomino F, Bettelli S, Pugliese G, Salati M, Caputo F, Andrikou K, Fontana A, Di Emidio K, Napolitano M, Kaleci S, Luppi G, Cascinu S. Outcome and prognostic factors after resection of liver metastases in patients with colorectal cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.036] [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: 11/14/2022] Open
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17
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Maggio P, Altamura C, Lupoi D, Paolucci M, Altavilla R, Tibuzzi F, Passarelli F, Arpesani R, Di Giambattista G, Grasso RF, Luppi G, Fiacco F, Silvestrini M, Pasqualetti P, Vernieri F. The Role of White Matter Damage in the Risk of Periprocedural Diffusion-Weighted Lesions after Carotid Artery Stenting. Cerebrovasc Dis Extra 2017; 7:1-8. [PMID: 28125807 PMCID: PMC5340215 DOI: 10.1159/000452717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 08/25/2016] [Accepted: 10/10/2016] [Indexed: 12/27/2022] Open
Abstract
Background White matter hyperintensities (WMH) are a common finding in aged individuals affected by carotid artery disease and are a risk factor for first-ever and recurrent stroke. We investigated if white matter damage increases the risk of brain microembolism during carotid artery stenting (CAS), as evaluated by the appearance of new areas of restricted diffusion on diffusion-weighted images (DWI). Methods We evaluated 47 patients with severe internal carotid artery (ICA) stenosis undergoing CAS, comparing preprocedural clinical, ultrasound and radiological characteristics. WMH volume was computed on FLAIR images before CAS. After CAS, the DWI scan was looked over for areas of restricted diffusion (DWI lesions). A first univariate analysis was adopted to compare groups according to the occurrence of DWI lesions. Then, the variable DWI lesion was modelled by means of a logistic regression model. Results Seventeen patients developed at least 1 DWI lesion after CAS. Compared with non-DWI, DWI patients were more commonly treated in the left ICA (p = 0.007) and had a more severe WMH damage (p = 0.027). Indeed, the risk of a DWI lesion was higher in left versus right stenosis (OR = 9.0, 95% CI 1.9-42.7, p = 0.005) and increased for each log-unit of WMH lesion load (OR = 7.05, 95% CI 1.07-46.49, p = 0.042). A WMH lesion load of at least 5.25 cm3 had a 50% probability of occurrence of a new DWI lesion. Conclusions Treated side and preexisting white matter damage are risk conditions for brain microembolism during CAS. This should be taken into account to optimize severe carotid artery disease management.
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Affiliation(s)
- Paola Maggio
- Neurology Unit, ASST Bergamo Est, Azienda Ospedaliera Bolognini, Seriate, Italy
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Lamberti G, Rossi G, Grillo F, Spada F, Pusceddu S, Rinzivillo M, Massironi S, Tafuto S, Faggiano A, Antonuzzo L, Luppi G, Albertelli M, Fazio N, Vernieri C, Delle Fave G, Brighi N, Ferone D, Campana D. Appendiceal neuroendocrine tumors: a large multicentre Italian series. Preliminary result. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.22] [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: 11/12/2022] Open
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19
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Greco S, Depenni R, Ponti G, Cerioli D, Iattoni E, Gelsomino F, Luppi G, Dominici M, Pellacani G, Cascinu S. BRAF, NRAS and C-KIT mutations segregate distinct clinical and histopathological profiles in patients with melanoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw341.07] [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: 11/13/2022] Open
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20
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Pusceddu S, Marconcini R, Spada F, Cavalcoli F, Ibrahim T, Brizzi M, Brighi N, Faggiano A, Puliafito I, Delle Fave G, Perfetti V, Luppi G, Carnaghi C, Razzore P, Davì M, Cauchi C, Duro M, Di Maio M, Buzzoni R, Femia D, De Braud F. Metformin impact on progression-free survival in diabetic patients with advanced pancreatic neuroendocrine tumors (pNET) receiving everolimus and/or somatostatin analogues. The PRIME-NET (Pancreatic multicentric, Retrospective, Italian MEtformin) study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw333.06] [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: 11/14/2022] Open
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21
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Faiella E, Frauenfelder G, Santucci D, Luppi G, Zobel BB, Grasso RF. Percutaneous radiofrequency ablation of a bleeding pseudoaneurysm during CT-guided renal cancer treatment. A case report. Emerg Radiol 2016; 23:527-30. [PMID: 27530739 DOI: 10.1007/s10140-016-1432-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 08/09/2016] [Indexed: 10/21/2022]
Abstract
We describe a new emergency interventional radiology approach in percutaneous procedure complications. We present the case of an 81-year-old male with small renal cancer, approached with percutaneous radiofrequency ablation (RTA) and complicated by pseudoaneurysm bleeding of a renal artery branch. In the emergency setting, pseudoaneurysm was treated in the CT room by the same RTA needle, without any complications or local tumor recurrence during the next 6-month follow-up.
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Affiliation(s)
- Eliodoro Faiella
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via A. del Portillo, 200, 00128, Rome, Italy
| | - Giulia Frauenfelder
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via A. del Portillo, 200, 00128, Rome, Italy.
| | - Domiziana Santucci
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via A. del Portillo, 200, 00128, Rome, Italy
| | - Giacomo Luppi
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via A. del Portillo, 200, 00128, Rome, Italy
| | - Bruno Beomonte Zobel
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via A. del Portillo, 200, 00128, Rome, Italy
| | - Rosario Francesco Grasso
- Department of Diagnostic and Interventional Radiology, Università Campus Bio-Medico di Roma, Via A. del Portillo, 200, 00128, Rome, Italy
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Lonardi S, Cionini L, Pinto C, Cordio S, Rosati G, Sartore Bianchi A, Tagliagambe A, Frisinghelli M, Zagonel V, Rosetti P, Negru M, Bonetti A, Tronconi M, Luppi G, Marsella A, Corsi C, Bochicchio A, Aprile G, Niespolo R, Granetto C, Boni L, Aschele C. O-019 Distant-relapse analysis of STAR-01, a randomized phase III trial comparing preoperative chemoradiation with or without oxaliplatin in locally advanced rectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw198.19] [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: 11/14/2022] Open
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23
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Bertolini F, Valerini S, D'Ambrosio C, Meduri B, Angelo G, Depenni R, D'Angelo E, Luppi G, Bertoni F, Presutti L. Multidisciplinary approach for squamous head and neck cancers: a single report institution. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv342.09] [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: 11/13/2022] Open
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24
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Gelsomino F, Rossi G, Spallanzani A, Bertolini F, Fontana A, Tamma V, Zironi S, Depenni R, Di Emidio K, Luppi G. The role of the activation of mTOR pathway in patients with advanced neuroendocrine tumors treated with everolimus. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.23] [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: 11/13/2022] Open
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25
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Piacentini F, Filieri M, Grizzi G, Omarini C, Maur M, Guaitoli G, Tazzioli G, Madrigali S, Caggia F, Luppi G. Impact of time to surgery after neoadjuvant chemotherapy in patients with operable breast cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv336.06] [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: 11/12/2022] Open
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26
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Fontana A, Federica B, Reggiani-Bonetti L, Pettorelli E, Noventa S, Meduri B, Gelsomino F, Zironi S, Spallanzani A, Mazzeo E, Maiorana A, Conte P, Luppi G. Everolimus in locally advanced rectal cancer (E-LARC study, Ib): biomarkers evaluation. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.39] [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] Open
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Abstract
So far brain metastases represent a critical stage of a disease course and the frequency is increasing over the years. The treatment of brain metastases should be individualized for each patient: in case of single brain metastasis, surgery or radiosurgery should be considered as first options of treatment; in case of multiple lesions, whole-brain radiotherapy is the standard of care in association with systemic therapy or surgery/radiosurgery. Chemotherapy should be considered when surgery or radiation therapy are not possible. In the last decades, TKIs or monoclonal antibodies have shown increase in overall response rate and overall survival in Phase II-III trials. The aim of this paper is to make an overview of the current approaches in management of patients with brain metastases.
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Affiliation(s)
- F Bertolini
- Department of Oncology, Azienda Ospedaliero-Universitaria Modena, via Del Pozzo, 71, 41124, Modena, Italy
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Ciardiello F, Falcone A, Cascinu S, Sobrero A, Boni C, Barone C, Luppi G, Maiello E, Siena S, Zagonel V, Carteni G, Constanzo FD, Bartolomeo MD, Santoro A, Russo A, Moscovici M, Van Cutsem E, Zaniboni A. 2143 Regorafenib for previously treated metastatic colorectal cancer (mCRC): Results from 683 Italian patients treated in the open-label phase 3B CONSIGN study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31064-4] [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: 11/30/2022]
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Grasso RF, Luppi G, Cazzato RL, Del Vescovo R, Giurazza F, Mercurio S, Faiella E, Zobel BB. Cryoablation of lung malignancies recurring close to surgical clips following surgery: Report of three cases. Indian J Radiol Imaging 2015; 25:11-4. [PMID: 25709158 PMCID: PMC4329679 DOI: 10.4103/0971-3026.150130] [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] [Indexed: 11/21/2022] Open
Abstract
Background: Minimally ablative therapies are now available for the treatment of lung malignancies. However, selection of the appropriate technique is not always easy and requires accurate preoperative planning. Aims: To describe the treatment of lung tumors with cryoablation. Settings and Design: We report three cases of lung malignancies that recurred close to surgical clips after surgical treatment, successfully treated by cryoablation. Materials and Methods: An initial freezing cycle was performed for 10 min, followed by a 5-min thawing cycle, and an additional 10-min freezing cycle. A final 5-min thaw was necessary to remove the needle from the iceball formed during the freezing cycle. Results: The procedures were completed successfully with no signs of surgical-clip misplacement, and excellent ablation of the lesions. Conclusion: Cryoablation is a relatively new procedure that potentially permits the local treatment of lung tumors with minimal loss of lung parenchyma.
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Affiliation(s)
- Rosario F Grasso
- Department of Radiology, Università Campus Bio medico, Rome, Italy
| | - Giacomo Luppi
- Department of Radiology, Università Campus Bio medico, Rome, Italy
| | | | | | | | - Simona Mercurio
- Department of Radiology, Università Campus Bio medico, Rome, Italy
| | - Eliodoro Faiella
- Department of Radiology, Università Campus Bio medico, Rome, Italy
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Bertolini F, Pettorelli E, Meduri B, Zironi S, Fontana A, Gelsomino F, Mazzeo E, Depenni R, Spallanzani A, Conte P, Luppi G. A Phase Ib Study of Everolimus, 5-Fluorouracil (5-Fu) and Pelvic Radiotherapy (Rt) As Neo-Adjuvant Treatment for Locally Advanced Rectal Cancer (Larc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.93] [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: 11/14/2022] Open
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Spada F, Fazio N, Marconcini R, Antonuzzo A, Ricci S, Fontana A, Luppi G, Antonuzzo L, Di Costanzo F, Nobili E, Radice D, Galdy S, Sonzogni M, Pisa E, Barberis M. Real-World Study on Oxaliplatin-Based Chemotherapy in Patients with Advanced Neuroendocrine Neoplasms : Clinical Outcomes and Preliminary Correlation with Biological Factors. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu345.19] [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: 11/14/2022] Open
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Grasso RF, Cazzato RL, Luppi G, Mercurio S, Giurazza F, Vescovo RD, Faiella E, Zobel BB. Bilateral transrenal ureteral occlusion by means of n-butyl cyanoacrylate and AMPLATZER vascular plug. Indian J Radiol Imaging 2014; 24:129-31. [PMID: 25024520 PMCID: PMC4094962 DOI: 10.4103/0971-3026.134390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractAMPLATZER vascular plug is a widely used embolic agent. In the present paper, we present a case of an 86-year-old female patient who underwent bilateral ureteral occlusion by means of AMPLATZER vascular plug II coupled to n-butyl cyanoacrylate (NBCA) because of recurring pyelonephritis following cystectomy with subsequent bilateral ureterosigmoidostomy (sec. Mainz type II).
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Affiliation(s)
- Rosario F Grasso
- Department of Radiology, Università Campus Bio-medico di Roma, Rome, Italy
| | | | - Giacomo Luppi
- Department of Radiology, Università Campus Bio-medico di Roma, Rome, Italy
| | - Simona Mercurio
- Department of Radiology, Università Campus Bio-medico di Roma, Rome, Italy
| | - Francesco Giurazza
- Department of Radiology, Università Campus Bio-medico di Roma, Rome, Italy
| | | | - Eliodoro Faiella
- Department of Radiology, Università Campus Bio-medico di Roma, Rome, Italy
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Grasso RF, Faiella E, Cazzato RL, Luppi G, Del Vescovo R, Giurazza F, Mercurio S, Zobel BB. Retrograde fluoroscopy-guided trans-urethral exchange of ureteral stents: Comparison of direct grasping vs. modified snare. Indian J Radiol Imaging 2014; 23:347-50. [PMID: 24604940 PMCID: PMC3932578 DOI: 10.4103/0971-3026.125615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Several different techniques including guide-wire lasso, simple snare, modified snare (MS) and direct grasping (DG), are available for retrograde ureteral stent retrieval and exchange. Choice among them is not always easy and depends on many different factors, including the local level of expertise. OBJECTIVE To compare the MS and DG during retrograde exchange of double-J ureteral stent under fluoroscopic guidance. SETTINGS AND DESIGN 66 patients (36 men and 30 women; mean age 66.6 years) needing retrograde ureteral stent exchange were included. All stents were previously placed through an anterograde way. MATERIALS AND METHODS Time needed to grasp each single stent was recorded as well as the complications. STATISTICAL ANALYSIS Fisher's test was used to compare procedural time in both groups; P < 0.05 was considered significant. RESULTS 102 stents were exchanged. Mean time was 4.46 min for DG and 7.81 min for MS (P = 0.029). No significant complications were encountered. CONCLUSIONS Compared to the MS, the DG is easier, quicker, and less expensive.
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Affiliation(s)
- Rosario Francesco Grasso
- Department of Radiology, University "Campus Bio-Medico di Roma", Via Alvaro del Portillo, 200 00128, Rome
| | - Eliodoro Faiella
- Department of Radiology, University "Campus Bio-Medico di Roma", Via Alvaro del Portillo, 200 00128, Rome
| | - Roberto Luigi Cazzato
- Department of Radiology, University "Campus Bio-Medico di Roma", Via Alvaro del Portillo, 200 00128, Rome
| | - Giacomo Luppi
- Department of Radiology, University "Campus Bio-Medico di Roma", Via Alvaro del Portillo, 200 00128, Rome
| | - Riccardo Del Vescovo
- Department of Radiology, University "Campus Bio-Medico di Roma", Via Alvaro del Portillo, 200 00128, Rome
| | - Francesco Giurazza
- Department of Radiology, University "Campus Bio-Medico di Roma", Via Alvaro del Portillo, 200 00128, Rome
| | - Simona Mercurio
- Department of Radiology, University "Campus Bio-Medico di Roma", Via Alvaro del Portillo, 200 00128, Rome
| | - Bruno Beomonte Zobel
- Department of Radiology, University "Campus Bio-Medico di Roma", Via Alvaro del Portillo, 200 00128, Rome
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Galati G, De Vincentis A, Ripetti V, La Vaccara V, Vespasiani-Gentilucci U, Mazzarelli C, Gallo P, Luppi G, Grasso RF, Picardi A. Haemorrhoidal disease in severe portal hypertension: a combined approach with transjugular intrahepatic portosystemic shunt (TIPS) and transanal haemorrhoidal dearterialization (THD). Arch Med Sci 2014; 10:195-6. [PMID: 24701234 PMCID: PMC3953988 DOI: 10.5114/aoms.2014.40746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 02/04/2013] [Accepted: 02/05/2013] [Indexed: 12/19/2022] Open
Affiliation(s)
- Giovanni Galati
- Department of Clinical Medicine and Hepatology, Campus Bio-Medico University of Rome, Italy
| | - Antonio De Vincentis
- Department of Clinical Medicine and Hepatology, Campus Bio-Medico University of Rome, Italy
| | - Valter Ripetti
- Department of General Surgery, Campus Bio-Medico University of Rome, Italy
| | | | | | - Chiara Mazzarelli
- Department of Clinical Medicine and Hepatology, Campus Bio-Medico University of Rome, Italy
| | - Paolo Gallo
- Department of Clinical Medicine and Hepatology, Campus Bio-Medico University of Rome, Italy
| | - Giacomo Luppi
- Department of Interventional Radiology, Campus Bio-Medico University of Rome, Italy
| | | | - Antonio Picardi
- Department of Clinical Medicine and Hepatology, Campus Bio-Medico University of Rome, Italy
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Cantore M, Fiorentini G, Luppi G, Rosati G, Caudana R, Piazza E, Comella G, Ceravolo C, Miserocchi L, Mambrini A, Del Freo A, Zamagni D, Rabbi C, Marangolo M. Ceravolo. J Chemother 2013; 16:589-94. [PMID: 15700852 DOI: 10.1179/joc.2004.16.6.589] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [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: 10/31/2022]
Abstract
Gemcitabine is considered the gold standard treatment for unresectable pancreatic adenocarcinoma. Intra-arterial drug administration had shown some interesting results in small phase II studies. In this study, patients were randomly assigned to receive gemcitabine at a dose of 1,000 mg/m2 over 30 minutes intravenously weekly for 7 weeks, followed by 1 week of rest, then weekly for 3 weeks every 4 weeks or FLEC: 5-fluoruracil 1,000 mg/m2, leucovorin 100 mg/m2, epirubicin 60 mg/m2, carboplatin 300 mg/m2 infused bolus intra-arterially into celiac axis at a 3-week interval 3 times or 5-fluorouracil 400 mg/m2 plus folinic acid 20 mg/m2 for 5 days every 4 weeks for 6 cycles. The primary endpoint was overall survival, while time to treatment failure, response rate, clinical benefit response were secondary endpoints. Sixty-seven patients were randomly allocated gemcitabine and 71 were allocated FLEC intra-arterially. Patients treated with FLEC lived for significantly longer than patients on gemcitabine (p=0.036). Survival at 1 year increased from 21% in the gemcitabine group to 35% in the FLEC group. Median survival was 7.9 months in the FLEC group and 5.8 months in the gemcitabine group. Median time to treatment failure was longer with FLEC (5.3 vs 4.2 months for FLEC vs gemcitabine respectively; p=0.013). Clinical benefit was similar in both groups (17.9% for gemcitabine and 26.7% for FLEC; p=NS). CT-scan partial response was similar in both groups (5.9% for gemcitabine and 14% for FLEC; p=NS). Toxicity profiles were different. Compared with gemcitabine, the FLEC regimen given intra-arterially improved survival in patients with unresectable pancreatic adenocarcinoma.
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Affiliation(s)
- M Cantore
- Oncological Department, USL 1, Massa and Carrara, Italy.
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Grasso RF, Cazzato RL, Luppi G, D’Agostino F, Schena E, Del Vescovo R, Giurazza F, Faiella E, Beomonte Zobel B. Percutaneous lung biopsies: performance of an optical CT-based navigation system with a low-dose protocol. Eur Radiol 2013; 23:3071-6. [PMID: 23783784 DOI: 10.1007/s00330-013-2932-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/09/2013] [Accepted: 05/25/2013] [Indexed: 10/26/2022]
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Maggio P, Altamura C, Landi D, Migliore S, Lupoi D, Moffa F, Quintiliani L, Vollaro S, Palazzo P, Altavilla R, Pasqualetti P, Errante Y, Quattrocchi CC, Tibuzzi F, Passarelli F, Arpesani R, di Giambattista G, Grasso FR, Luppi G, Vernieri F. Diffusion-weighted lesions after carotid artery stenting are associated with cognitive impairment. J Neurol Sci 2013; 328:58-63. [DOI: 10.1016/j.jns.2013.02.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 01/24/2013] [Accepted: 02/21/2013] [Indexed: 10/27/2022]
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Grasso RF, Luppi G, Cazzato RL, Faiella E, D'Agostino F, Beomonte Zobel D, De Lena M. Percutaneous computed tomography-guided lung biopsies: preliminary results using an augmented reality navigation system. Tumori 2013. [PMID: 23389366 DOI: 10.1700/1217.13503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND "Augmented reality" is a technique to create a composite view by augmenting the real intervention field, visualized by the doctor, with additional information coming from a virtual volume generated using computed tomography (CT), magnetic resonance or ultrasound images previously acquired from the same patient. In the present study we verified the accuracy and validated the clinical use of an augmented reality navigation system produced to perform percutaneous CT-guided lung biopsies. METHODS One hundred and eighty consecutive patients with solitary parenchymal lung lesions, enrolled using a nonrandom enrollment system, underwent percutaneous CT-guided aspiration and core biopsy using a traditional technique (group C, 90 patients) and navigation system assistance (group S, 90 patients). For each patient we recorded the largest lesion diameter, procedure time, overall number of CT scans, radiation dose, and complications. The entire experimental project was evaluated and approved by the local institutional review board (ethics committee). RESULTS Each procedure was concluded successfully and a pathological diagnosis was reached in 96% of cases in group S and 90% of cases in group C. Procedure time, overall number of CT scans and incident x-ray radiation dose (CTDIvol) were significantly reduced in navigation system-assisted procedures (P <0.001; z = 5.64) compared with traditional CT-guided procedures. The percentage of procedural complications was 14% in group S and 17% in group C. CONCLUSION The augmented reality navigation system used in this study was a highly safe, technically reliable and effective support tool in percutaneous CT-guided lung biopsy, allowing to shorten the procedure time and reduce the incident x-ray radiation dose to patients and the rate of insufficient specimens. Furthermore, it has the potential to increase the number of procedures executed in the allocated time without increasing the number of complications.
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Grasso RF, Faiella E, Luppi G, Schena E, Giurazza F, Del Vescovo R, D’Agostino F, Cazzato RL, Beomonte Zobel B. Percutaneous lung biopsy: comparison between an augmented reality CT navigation system and standard CT-guided technique. Int J Comput Assist Radiol Surg 2013; 8:837-48. [DOI: 10.1007/s11548-013-0816-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 01/16/2013] [Indexed: 10/27/2022]
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Grasso RF, Faiella E, Cimini P, Cazzato RL, Luppi G, Martina F, Del Vescovo R, Beomonte Zobel B. Direct magnetic resonance (MR) shoulder arthrography: posterior approach under ultrasonographic guidance and abduction (PAUGA). Radiol Med 2012; 118:806-15. [DOI: 10.1007/s11547-012-0879-6] [Citation(s) in RCA: 3] [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] [Received: 11/21/2011] [Accepted: 01/09/2012] [Indexed: 11/30/2022]
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Grasso RF, Luppi G, Faiella E, Giurazza F, Del Vescovo R, Cazzato RL, Beomonte Zobel B. Radiofrequency ablation of renal cell carcinoma in patients with a solitary kidney: a retrospective analysis of our experience. Radiol Med 2011; 117:606-15. [DOI: 10.1007/s11547-011-0758-6] [Citation(s) in RCA: 3] [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: 05/03/2011] [Accepted: 06/10/2011] [Indexed: 01/29/2023]
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Fabbri F, Passardi A, Ravaioli A, Cavanna L, Luppi G, Mucciarini C, Faedi M, Turci D, Pasquini E, Vertogen B, Milandri C, Amadori D. Sequential treatment strategy for metastatic colorectal cancer: A phase III study of chemotherapy (CT) with or without bevacizumab (Bev) as first-line therapy followed by two phase III studies of CT alone or CT plus bev with or without cetuximab (Cetux) as second-line therapy (ITACa Study IRST 153 01). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bertolini F, Malavasi N, Scarabelli L, Fiocchi F, Bagni B, Del Giovane C, Colucci G, Gerunda GE, Depenni R, Zironi S, Fontana A, Pettorelli E, Luppi G, Conte PF. FOLFOX6 and bevacizumab in non-optimally resectable liver metastases from colorectal cancer. Br J Cancer 2011; 104:1079-84. [PMID: 21386839 PMCID: PMC3068493 DOI: 10.1038/bjc.2011.43] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In patients with colorectal liver metastases (CLM) R0 resection significantly improves overall survival (OS). METHODS In this report, we present the results of a phase II trial of FOLFOX6+bevacizumab in patients with non-optimally resectable CLM. Patients received six cycles of FOLFOX6+ five of bevacizumab. Patients not achieving resectability received six additional cycles of each. A PET-CT was performed at baseline and again within 1 month after initiating treatment. RESULTS From September 2005 to July 2009, 21 patients were enrolled (Male/Female: 15/6; median age: 65 years). An objective response (OR) was documented in 12 cases (57.1%; complete responses (CRs): 3, partial response (PR): 9); one patient died from toxicity before surgery. Thirteen patients underwent radical surgery (61.9%). Three (23%) had a pathological CR (pCR). Six patients (46.1%) experienced minor postsurgical complications. After a median 38.8-month follow-up, the median OS was 22.5 months. Patients achieving at least 1 unit reduction in Standard uptake value (SUV)max on PET-CT had longer progression-free survival (PFS) (median PFS: 22 vs 14 months, P=0.001). CONCLUSIONS FOLFOX6+bevacizumab does not increase postsurgical complications, yields high rates of resectability and pCR. Early changes in PET-CT seem to be predictive of longer PFS.
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Affiliation(s)
- F Bertolini
- Oncology, Haematology and Respiratory Diseases Department, University Hospital of Modena, Modena, Italy.
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Bertolini F, Malavasi N, Scarabelli L, Fiocchi F, Bagni B, Del Giovane C, Colucci G, Gerunda GE, Depenni R, Zironi S, Fontana A, Pettorelli E, Luppi G, Conte PF. FOLFOX6 and bevacizumab in non-optimally resectable liver metastases from colorectal cancer. Br J Cancer 2011. [PMID: 21386839 DOI: 10.1038/bjc.2011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In patients with colorectal liver metastases (CLM) R0 resection significantly improves overall survival (OS). METHODS In this report, we present the results of a phase II trial of FOLFOX6+bevacizumab in patients with non-optimally resectable CLM. Patients received six cycles of FOLFOX6+ five of bevacizumab. Patients not achieving resectability received six additional cycles of each. A PET-CT was performed at baseline and again within 1 month after initiating treatment. RESULTS From September 2005 to July 2009, 21 patients were enrolled (Male/Female: 15/6; median age: 65 years). An objective response (OR) was documented in 12 cases (57.1%; complete responses (CRs): 3, partial response (PR): 9); one patient died from toxicity before surgery. Thirteen patients underwent radical surgery (61.9%). Three (23%) had a pathological CR (pCR). Six patients (46.1%) experienced minor postsurgical complications. After a median 38.8-month follow-up, the median OS was 22.5 months. Patients achieving at least 1 unit reduction in Standard uptake value (SUV)max on PET-CT had longer progression-free survival (PFS) (median PFS: 22 vs 14 months, P=0.001). CONCLUSIONS FOLFOX6+bevacizumab does not increase postsurgical complications, yields high rates of resectability and pCR. Early changes in PET-CT seem to be predictive of longer PFS.
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Affiliation(s)
- F Bertolini
- Oncology, Haematology and Respiratory Diseases Department, University Hospital of Modena, Modena, Italy.
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Di Matteo F, Grasso R, Pacella CM, Martino M, Pandolfi M, Rea R, Luppi G, Silvestri S, Zardi E, Costamagna G. EUS-guided Nd:YAG laser ablation of a hepatocellular carcinoma in the caudate lobe. Gastrointest Endosc 2011; 73:632-6. [PMID: 21030019 DOI: 10.1016/j.gie.2010.08.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 08/11/2010] [Indexed: 02/07/2023]
Affiliation(s)
- Francesco Di Matteo
- Digestive Endoscopy Unit, Campus Bio-Medico, University of Rome, Via Álvaro del Portillo, 200, 00128 Rome, Italy
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Bertolini F, Scarabelli L, Del Giovane C, Zironi S, De Marco G, Fontana A, Depenni R, Bertoni F, Luppi G, Conte PF. Locally advanced rectal cancer (LARC): A 12-year experience of multimodality approach. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
607 Background: Main objective of the report is to review retrospectively a 12 years experience of pre-operative chemo-radiotherapy (CRT) in patients (pts) with LARC at the University Hospital of Modena and to correlate clinical variables with outcome. Methods: Between 1998 and 2010, 275 consecutive pts with stage II, III and IV (oligometastatic in lung or liver) LARC who underwent neo-adjuvant CTR were identified from a single institution. All pts received fluoropyrimidine-based chemotherapy (alone or in combination) and RT (50-50.4 Gy). Results: On 275 pts, 166 were males (61%) and 109 females (39%); median age: 65.9 years (range: 26-84). Rectal primary site (on 260 pts): 112 low (43%), 91 medium (35%) and 57 high (22%). Stage at diagnosis (on 245): 2 cT2N0 (0.8%), 8 cT2N+ (3.3%), 68 cT3N0 (27.8%), 134 cT3N1 (54.7%), 11 cT4N0 (4.5%), 22 cT4N1 (8.9%). Pre-operative treatment (on 268 pts): 168 pts (62.6%) received 5fluorouracil (5FU) in continuous infusion, 37 (13.9%) capecitabine, 36 (13.5%) FU+oxaliplatin and 27 (10%) 5FU+cetuximab (clinical trial). On evaluable 177 pts, only 25 (14%) developed G3 toxicity and subsequent treatment interruption. No grade 4 toxicity was recorded. 252 pts underwent surgery (18 pts are still ongoing; 5 did not receive surgery for multiple distant metastases at pre-operative staging): 189 anterior resection (75%), 59 abdominal-perineal amputation (23.4%) and 4 endoscopic resection (1.6%). On 235 pts, 148 obtained a T and/or N downstaging (63%). Dworak tumor regression grade (TRG) was (on 209 pts): TRG4 (pathological complete response) 38 (18.3%), TRG3 37 (17.8%), TRG2 67 (32%), TRG1 63 (30%) and TRG0 4 (1.9%). 5 y-disease free survival (DFS) and overall survival (OS) are 75% and 73%, respectively. Down-staging, TRG 3-4 and histological features like the positivity for radial margins and vascular invasion correlate with both DFS and OS. Conclusions: Pre-operative CRT is well tolerated; downstaging, TRG and histological features such as radial margins and vascular invasion are the strongest predictors of survival. No significant financial relationships to disclose.
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Affiliation(s)
- F. Bertolini
- Azienda Ospedaliero-Universitaria, Modena, Italy
| | | | | | - S. Zironi
- Azienda Ospedaliero-Universitaria, Modena, Italy
| | - G. De Marco
- Azienda Ospedaliero-Universitaria, Modena, Italy
| | - A. Fontana
- Azienda Ospedaliero-Universitaria, Modena, Italy
| | - R. Depenni
- Azienda Ospedaliero-Universitaria, Modena, Italy
| | - F. Bertoni
- Azienda Ospedaliero-Universitaria, Modena, Italy
| | - G. Luppi
- Azienda Ospedaliero-Universitaria, Modena, Italy
| | - P. F. Conte
- Azienda Ospedaliero-Universitaria, Modena, Italy
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Bengala C, Bettelli S, Bertolini F, Sartori G, Fontana A, Malavasi N, Depenni R, Zironi S, Del Giovane C, Luppi G, Conte PF. Prognostic role of EGFR gene copy number and KRAS mutation in patients with locally advanced rectal cancer treated with preoperative chemoradiotherapy. Br J Cancer 2010; 103:1019-24. [PMID: 20842128 PMCID: PMC2965865 DOI: 10.1038/sj.bjc.6605853] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Epidermal growth factor receptor (EGFR), evaluated by immunohistochemistry, has been shown to have prognostic significance in patients with colorectal cancer. Gene copy number (GCN) of EGFR and KRAS status predict response and outcome in patients treated with anti-EGFR therapy, but their prognostic significance in colorectal cancer patients is still unclear. Methods: We have retrospectively reviewed the baseline EGFR GCN, KRAS status and clinical outcome of 146 locally advanced rectal cancer (LARC) patients treated with preoperative chemoradiotherapy. Pathological response evaluated by Dworak's tumour regression grade (TRG), disease-free survival (DFS) and overall survival (OS) were analysed. Results: Tumour regression grade 4 and TRG3–4 were achieved in 14.4 and 30.8% of the patients respectively. Twenty-nine (19.9%) and 33 patients (19.2%) had an EGFR/nuclei ratio >2.9 and CEP7 polisomy >50% respectively; 28 patients (19.2%) had a KRAS mutation. Neither EGFR GCN nor KRAS status was statistically correlated to TRG. 5-year DFS and OS were 63.3 and 71.5%, respectively, and no significant relation with EGFR GCN or KRAS status was found. Conclusion: Our data show that EGFR GCN and KRAS status are not prognostic factors in LARC treated with preoperative chemoradiation.
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Affiliation(s)
- C Bengala
- Division of Medical Oncology, Department of Oncology, Hematology and Respiratory Disease, University Hospital, University of Modena and Reggio Emilia, Via del Pozzo, 71, Modena-41100, Italy.
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Fiocchi F, Iotti V, Ligabue G, Pecchi A, Luppi G, Bagni B, Rivasi F, Torricelli P. Contrast-enhanced MRI and PET-CT in the evaluation of patients with suspected local recurrence of rectal carcinoma. Radiol Med 2010; 115:906-19. [PMID: 20574705 DOI: 10.1007/s11547-010-0558-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2009] [Accepted: 09/03/2009] [Indexed: 12/19/2022]
Abstract
PURPOSE This study aimed to evaluate the role of contrast-enhanced magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) in the assessment of local recurrence of rectal cancer. MATERIALS AND METHODS Among 200 patients scheduled for CT follow-up, 60 (48 low risk; 12 high risk) were selected due to CT findings suspicious for or suggestive of local recurrence. Patients underwent contrast-enhanced MRI and PET-CT within 2 weeks. Biopsy was considered the gold standard in 39 cases and follow-up at 6 and 12 months in the remaining 21. RESULTS Local recurrence was confirmed by histology in 15 cases (7 low risk; 8 high risk) and was excluded in 21 cases by long-term follow-up and in 24 by histology. Sensitivity, specificity, positive and negative predictive value and accuracy were 86.7%, 68.9%, 48.1%, 93.9% and 73.3% for contrast-enhanced MRI and 93.3%, 68.9%, 50%, 96.9% and 75% for PET-CT. CONCLUSIONS Contrast-enhanced MRI and PET-CT can help in the detection of local recurrence of rectal cancer, even though their roles in early detection remains debatable, as the value of these techniques in current surveillance protocols is still to be defined.
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Affiliation(s)
- F Fiocchi
- Department of Radiology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41100 Modena, Italy.
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Bertolini F, Malavasi N, Scarabelli L, Gerunda GE, Colucci G, Fontana A, Depenni R, Zironi S, Luppi G, Conte PF. FOLFOX6 and bevacizumab in non-optimally resectable liver metastases from colorectal cancer: Results of a phase II trial and role of PET-CT as early predictor of reponse. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14108] [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: 11/20/2022] Open
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Fontana A, Losi L, Bertolini F, Zironi S, Depenni R, Malavasi N, Scarabelli L, Luppi G, Conte PF. FOLFOX6 as first-line treatment in metastatic gastric cancer: Preliminary results of a phase II trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4091] [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: 11/20/2022] Open
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