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Gallina FT, Cappelli F, Forcella D, Tajè R, Bruschi M, Gennari V, Vallati GE, Facciolo F, Melis E. CT-guided indocyanine green and lipiodol marking of ground glass opacity before robotic-assisted lung resection. J Surg Oncol 2023; 127:1223-1224. [PMID: 36987599 DOI: 10.1002/jso.27249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/12/2023] [Indexed: 03/30/2023]
Affiliation(s)
| | - Federico Cappelli
- Radiology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Daniele Forcella
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Riccardo Tajè
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Mattia Bruschi
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valeria Gennari
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Francesco Facciolo
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Enrico Melis
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Tajè R, Gallina FT, Forcella D, Vallati GE, Cappelli F, Pierconti F, Visca P, Melis E, Facciolo F. Fluorescence-guided lung nodule identification during minimally invasive lung resections. Front Surg 2022; 9:943829. [PMID: 35923440 PMCID: PMC9339676 DOI: 10.3389/fsurg.2022.943829] [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] [Received: 05/14/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Abstract
In the last few years, minimally invasive surgery has become the standard routine practice to manage lung nodules. Particularly in the case of robotic thoracic surgery, the identification of the lung nodules that do not surface on the visceral pleura could be challenging. Therefore, together with the evolution of surgical instruments to provide the best option in terms of invasiveness, lung nodule localization techniques should be improved to achieve the best outcomes in terms of safety and sensibility. In this review, we aim to overview all principal techniques used to detect the lung nodules that do not present the visceral pleura retraction. We investigate the accuracy of fluorescence guided thoracic surgery in nodule detection and the differences among the most common tracers used.
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Affiliation(s)
- Riccardo Tajè
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Filippo Tommaso Gallina
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
- Correspondence: Filippo Tommaso Gallina
| | - Daniele Forcella
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Federico Cappelli
- Radiology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Federico Pierconti
- Anesthesiology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Visca
- Pathology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Enrico Melis
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Facciolo
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Vallati GE, Trobiani C, Teodoli L, Lai Q, Cappelli F, Ungania S, Catalano C, Lucatelli P. Sarcopenia Worsening One Month after Transarterial Radioembolization Predicts Progressive Disease in Patients with Advanced Hepatocellular Carcinoma. Biology (Basel) 2021; 10:biology10080728. [PMID: 34439960 PMCID: PMC8389627 DOI: 10.3390/biology10080728] [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] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/15/2021] [Accepted: 07/27/2021] [Indexed: 11/30/2022]
Abstract
Simple Summary Sarcopenia measured at one-month CT follow up after TARE (transarterial radioembolization) treatment is a predictive factor for the best tumor response in patients with locally advanced HCC. Abstract (1) Background: To demonstrate correlation between skeletal muscle depletion measured before and after one month of TARE treatment and its induced local response rate. (2) Material and methods: For this retrospective, single center study, we evaluated 86 patients with HCC treated with TARE. Sarcopenia status was measured using the psoas muscle index (PMI). The PMI was calculated according to the formula: PMI [mm/m2]: [(minor diameter of left psoas + major diameter of left psoas + minor diameter of right psoas + major diameter of right psoas)/4]/height in m2. Population was divided in two groups according to the delta value of PMI measured at the time of TARE and one month after TARE, a group in which the delta PMI was stable or increased (No-Sarcopenia group; n = 42) vs. a group in which the delta-PMI decreased (Sarcopenia group; n = 44). Patient response was evaluated at 1, 3 and 6 months after TARE treatment with CT/MRI. (3) Results: When the radiological response of the tumor was evaluated according to the mRECIST criteria, the two groups were similar in terms of rates of complete response (p = 0.42), partial response (p = 0.26) and stable disease (p = 0.59). Progressive disease (PD) was more commonly observed in the Sarcopenia group (38.6% vs. 11.9%; p = 0.006). (4) Conclusions: Worsening of sarcopenia status measured one month after TARE is able to predict patients who will undergo disease progression.
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Affiliation(s)
- Giulio Eugenio Vallati
- Interventional Radiology Unit of “IRCCS Istituto Nazionale Tumori Regina Elena”, 00138 Rome, Italy; (G.E.V.); (F.C.)
| | - Claudio Trobiani
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Policlinico Umberto I, University of Rome “Sapienza”, 00161 Rome, Italy; (L.T.); (C.C.); (P.L.)
- Correspondence:
| | - Leonardo Teodoli
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Policlinico Umberto I, University of Rome “Sapienza”, 00161 Rome, Italy; (L.T.); (C.C.); (P.L.)
| | - Quirino Lai
- Department of General Surgery and Organ Transplantation, Sapienza University of Rome, 00161 Rome, Italy;
| | - Federico Cappelli
- Interventional Radiology Unit of “IRCCS Istituto Nazionale Tumori Regina Elena”, 00138 Rome, Italy; (G.E.V.); (F.C.)
| | - Sara Ungania
- Physics Department of “Istituto Regina Elena, Istituto di Ricovero e Cura a Carattere Scientifico”, 00138 Rome, Italy;
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Policlinico Umberto I, University of Rome “Sapienza”, 00161 Rome, Italy; (L.T.); (C.C.); (P.L.)
| | - Pierleone Lucatelli
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Policlinico Umberto I, University of Rome “Sapienza”, 00161 Rome, Italy; (L.T.); (C.C.); (P.L.)
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Paladini A, Lucatelli P, Cappelli F, Pizzi G, Anelli V, Amodeo EM, Beomonte Zobel D, Paladini L, Biagini R, Attala D, Zoccali C, Vallati GE. Osteoid osteoma treated with radiofrequency ablation in non-operating room anesthesia. A different way of approaching ablative therapy on osteoid osteoma. Eur Rev Med Pharmacol Sci 2018; 22:5438-5446. [PMID: 30229814 DOI: 10.26355/eurrev_201809_15803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study is to verify the effectiveness and complications occurrence of radiofrequency ablation (RFA) in the treatment of osteoid osteoma (OO) in non-operating room anesthesia (N.O.R.A.). PATIENTS AND METHODS From 2014 to 2017, 61 patients affected by OO (40 men and 21 women) with an age of 20.7 years on average (range, 4-51 years; 12 patients aged 20 years or younger) underwent computed tomography-guided percutaneous radiofrequency ablation (RFA) in N.O.R.A. (Non-Operating Room Anesthesia). Lesion sites treated were: femur (27), tibia (22), pelvis (2), talar bone (3), distal radius (1), and humerus (6). Mean follow-up time was 36 months. In each case, anesthesiologic support followed a new protocol (N.O.R.A. protocol), approved by our Institute. Primary success rate, complications, symptom-free intervals, and follow-up results were evaluated. RESULTS Pain relief (evaluated with Visual Analogue Scale - VAS) was significant in 97% of patients; it disappeared within 24 hours of the procedure in 44 patients, within 3 days in 10 patients, and within 7 days in 7 patients. After 6 months of observation time, 60 of 61 patients were successfully treated and had no more complaints. In 2 patients, two major complications were found: infection of the site treated, healed with antibiotics, and a nerve lesion, healed with steroid therapy. No other complications were observed. CONCLUSIONS RFA is a highly effective, efficient, minimally invasive and safe method for the treatment of OO following N.O.R.A. PROTOCOL
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Affiliation(s)
- A Paladini
- Diagnostic Imaging Area, Catholic University of the Sacred Heart, Gemelli Foundation, School of Medicine, Rome, Italy.
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D’Alessio D, Giliberti C, Soriani A, Carpanese L, Pizzi G, Vallati GE, Strigari L. Dose evaluation for skin and organ in hepatocellular carcinoma during angiographic procedure. J Exp Clin Cancer Res 2013; 32:81. [PMID: 24423052 PMCID: PMC3832252 DOI: 10.1186/1756-9966-32-81] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 09/18/2013] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate the radiation dose in patients undergoing liver angiographic procedure and verify the usefulness of different dose measurements to prevent deterministic effects. Gafchromic film, MicroMOSFET data and DIAMENTOR device of the X-ray system were used to characterize the examined interventional radiology (IR) procedure. MATERIALS AND METHODS A liver embolization procedure, the SIRT (Selective Internal Radiation Therapy), was investigated. The exposure parameters from the DIAMENTOR as well as patient and geometrical data were registered. Entrance skin dose map obtained using Gafchromic film (ESDGAF) in a standard phantom as well as in 12 patients were used to calculate the maximum skin dose (MSDGAF). MicroMOSFETs were used to assess ESD in relevant points/areas. Moreover, the maximum value of five MicroMOSFETs array, due to the extension of treated area and to the relative distance of 2-3 cm of two adjacent MicroMOSFETs, was useful to predict the MSD without interfering with the clinical practice. PCXMC vers.1.5 was used to calculate effective dose (E) and equivalent dose (H). RESULTS The mean dose-area product (DAPDIAMENTOR) for SIRT procedures was 166 Gycm2, although a wide range was observed. The mean MSDGAF for SIRT procedures was 1090 mGy, although a wide range was experienced. A correlation was found between the MSDGAF measured on a patient and the DAPDIAMENTOR value for liver embolizations. MOSFET and Gafchromic data were in agreement within 5% in homogeneous area and within 20% in high dose gradient regions. The mean equivalent dose in critical organs was 89.8 mSv for kidneys, 22.9 mSv for pancreas, 20.2 mSv for small intestine and 21.0 mSv for spleen. Whereas the mean E was 3.7 mSv (range: 0.5-13.7). CONCLUSIONS Gafchromic films result useful to study patient exposure and determine localization and amplitude of high dose skin areas to better predict the skin injuries. Then, DAPDIAMENTOR or MOSFET data could offer real-time methods, as on-line dose alert, to avoid any side effects during liver embolization with prolonged duration.
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Affiliation(s)
- Daniela D’Alessio
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Via E. Chianesi 53, Rome, 00144, Italy
| | - Claudia Giliberti
- Dipartimento Installazioni di Produzione e Insediamenti Antropici, INAIL, Via Alessandria 220/E, Rome, 00198, Italy
| | - Antonella Soriani
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Via E. Chianesi 53, Rome, 00144, Italy
| | - Livio Carpanese
- Department of Radiology and Diagnostic Imaging, Regina Elena National Cancer Institute, Via E. Chianesi 53, Rome, 00144, Italy
| | - Giuseppe Pizzi
- Department of Radiology and Diagnostic Imaging, Regina Elena National Cancer Institute, Via E. Chianesi 53, Rome, 00144, Italy
| | - Giulio Eugenio Vallati
- Department of Radiology and Diagnostic Imaging, Regina Elena National Cancer Institute, Via E. Chianesi 53, Rome, 00144, Italy
| | - Lidia Strigari
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Via E. Chianesi 53, Rome, 00144, Italy
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