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Besson FL, Treglia G, Bucerius J, Anagnostopoulos C, Buechel RR, Dweck MR, Erba PA, Gaemperli O, Gimelli A, Gheysens O, Glaudemans AWJM, Habib G, Hyafil F, Lubberink M, Rischpler C, Saraste A, Slart RHJA. A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06597-x. [PMID: 38221570 DOI: 10.1007/s00259-024-06597-x] [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: 11/05/2023] [Accepted: 01/01/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVES This study aimed to evaluate the level of evidence of expert recommendations and guidelines for clinical indications and procedurals in hybrid nuclear cardiovascular imaging. METHODS From inception to August 2023, a PubMed literature analysis of the latest version of guidelines for clinical hybrid cardiovascular imaging techniques including SPECT(/CT), PET(/CT), and PET(/MRI) was performed in two categories: (1) for clinical indications for all-in primary diagnosis; subgroup in prognosis and therapy evaluation; and for (2) imaging procedurals. We surveyed to what degree these followed a standard methodology to collect the data and provide levels of evidence, and for which topic systematic review evidence was executed. RESULTS A total of 76 guidelines, published between 2013 and 2023, were included. The evidence of guidelines was based on systematic reviews in 7.9% of cases, non-systematic reviews in 47.4% of cases, a mix of systematic and non-systematic reviews in 19.7%, and 25% of guidelines did not report any evidence. Search strategy was reported in 36.8% of cases. Strengths of recommendation were clearly reported in 25% of guidelines. The notion of external review was explicitly reported in 23.7% of cases. Finally, the support of a methodologist was reported in 11.8% of the included guidelines. CONCLUSION The use of evidence procedures for developing for evidence-based cardiovascular hybrid imaging recommendations and guidelines is currently suboptimal, highlighting the need for more standardized methodological procedures.
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Affiliation(s)
- Florent L Besson
- Department of Nuclear Medicine-Molecular Imaging, DMU SMART IMAGING, Hôpitaux Universitaires Paris-Saclay, AP-HP, CHU Bicêtre, Le Kremlin Bicetre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicetre, France
- Commissariat À L'énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), Inserm, BioMaps, Université Paris-Saclay, Le Kremlin-Bicetre, France
| | - Giorgio Treglia
- Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6501, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland
| | - Jan Bucerius
- Department of Nuclear Medicine, Georg-August University Göttingen, Universitätsmedizin Göttingen, Gottingen, Germany
| | | | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh, UK
| | - Paula A Erba
- Department of Medicine and Surgery, University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Institut Roi Albert II, Université Catholique de Louvain, 1200, Brussels, Belgium
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gilbert Habib
- Department of Cardiology, APHM, La Timone Hospital, Marseille, France
| | - Fabian Hyafil
- Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, F75015, Paris, France
| | - Mark Lubberink
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | | | - Antti Saraste
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
- Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands.
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Berchiolli R, Bertagna G, Erba PA, Caroselli C, Fabiani S, Suardi LR, Falcone M, Ferrari M, Troisi N. A rare case of mycobacterial pseudoaneurysm of the superficial femoral artery. Eur Rev Med Pharmacol Sci 2022; 26:5250-5254. [PMID: 35916824 DOI: 10.26355/eurrev_202207_29315] [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 Extrapulmonary localization of tuberculosis accounts for about 15-20% of cases. Several cases of Mycobacterium tuberculosis with vascular involvement have been described, but only few cases for limb vessels. CASE REPORT We report the case of a 33-year-old man from Gambia with a symptomatic pseudoaneurysm of the right superficial femoral artery. Total body positron emission tomography/computed tomography with [18F]FDG revealed an active infection. The patient underwent vascular reconstruction with a straight reversed vein graft. Molecular testing for Mycobacterium tuberculosis was non-diagnostic. Cultures of the pseudoaneurysm wall and thrombus removed during surgery grew Mycobacterium tuberculosis. CONCLUSIONS The diagnosis of vascular tuberculosis infection due to Mycobacterium tuberculosis is a challenge. Epidemiology remains the primary criterion for maintaining a high index of suspicion.
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Affiliation(s)
- R Berchiolli
- Vascular Surgery Unit, Unit of Nuclear Medicine (P.A.E.), Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Erba PA, Sollini M, Zanca R, Cavinato L, Ragni A, Ten Hove D, Glaudemans AWJM, Pizzi MN, Roque A, Ieva F, Slart RHJA. [18F]FDG-PET/CT radiomics in patients suspected of infective endocarditis. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.443] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
AIM [18F]FDG-PET/CT is part of the diagnostic algorithm for IE diagnosis. Increased [18F]FDG uptake with focal and heterogenous pattern at valve, intravalvular or perivalvular at visual analysis is consistent with IE. Diffuse, homogeneous or low valvular [18F]FDG uptake make diagnosis more challenging. Semiquantitative parameters may be of value in such case of equivocal PET findings; however, they are still not validated in IE. In this study we aim to assess the value of [18F]FDG PET/CT radiomics in IE diagnosis. Further, we build a model for radiomics-based prediction of PET/CT findings, patient classification and stratification as well as prediction of the final diagnosis. Materials and Methods We evaluated a series of [18F]FDG PET/CT scans in 447 patients (M:F =284:163, mean age 67± 16yrs), with suspected IE (519 valves, NVE = 109, PVE = 410), studied in 3 different centers between January 2015- 2020. Clinical, surgical data, antimicrobial treatment, microbiology and biochemistry, imaging and the DUKE/2015 ESC classification were collected. PET/CT images were semiautomatically segmented (Advantage Workstation, GE) and texture features extracted by LIFEx software. For the analysis we used absolute correlation exclusion criteria and PCA based dimensionality reduction, MANOVA test and LR for multivariate testing. Prior to model building by Random Forest (80% training sets, 20% test), we applied covariance matrix for correlated feature removal and SMOTE for preprocessing the imbalanced dataset. Results MANOVA and LR showed a positive contribution of radiomics in predicting PET/CT results and IE diagnosis, with a different signature in IE-positive/IE-negative patients (80% in training, 70% in validation). Of interest, the signature of patients with equivocal PET/CT findings was similar to IE-negative signature. Clustering-based stratification identify in two groups, one with milder disease presenting weak or no [18F]FDG uptake and one with more severe disease. Our LR models with incremental complexity (Table 1 and 2) demonstrated that the richer the information fed into the model the higher the performances, reaching 90% of AUC. However, the performance of model M5 and M6 is almost equal, suggesting a limited contribution of radiomics in classifying IE. Conclusion [18F]FDG PET/CT radiomics provide a limited, yet positive, contribution in the classification of EI. Nevertheless, radiomics was fundamental in defining PET outcome, thus it could support visual imaging assessment in particular when equivocal [18F]FDG findings are present. Further steps focusing on refinement of the IE diagnostic criteria, on explainable analysis on positive/negative patients to be transferred in equivocal cases. Ultimately, the identification of radiomic signature would help to define thresholds to discriminate between mild infection and severe IE, in a risk score fashion. Abstract Table 1 Abstract Table 2
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Affiliation(s)
- PA Erba
- Azienda Ospedaliero Universitaria Pisana, Department of Translational Research and Advanced Technology in Medicine , Pisa, Italy
| | - M Sollini
- Humanitas Clinical and Research Center, Nuclear Medicine, Humanitas Clinical and Research,Department of Biomedical Sciences, Milan, Italy
| | - R Zanca
- Azienda Ospedaliero Universitaria Pisana, Department of Translational Research and Advanced Technology in Medicine , Pisa, Italy
| | - L Cavinato
- Milan Polytechnic, MOX – Modeling and Scientific Computing, Department of Mathematics, Politecnico di Milano, Milan, Italy
| | - A Ragni
- Milan Polytechnic, MOX – Modeling and Scientific Computing, Department of Mathematics, Politecnico di Milano, Milan, Italy
| | - D Ten Hove
- University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen, Netherlands (The)
| | - AWJM Glaudemans
- University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen, Netherlands (The)
| | - MN Pizzi
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - A Roque
- University Hospital Vall d"Hebron, Department of Radiology, Barcelona, Spain
| | - F Ieva
- Milan Polytechnic, MOX – Modeling and Scientific Computing, Department of Mathematics, Politecnico di Milano, Milan, Italy
| | - RHJA Slart
- University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen, Netherlands (The)
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Berchiolli R, Bertagna G, Erba PA, Ferrari M, Troisi N. Listeria abdominal endograft infection miming pseudoaneurysm treated with in-situ aortic reconstruction: a case report. Eur Rev Med Pharmacol Sci 2022; 26:1028-1032. [PMID: 35179769 DOI: 10.26355/eurrev_202202_28012] [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: 06/14/2023]
Abstract
We report the case of a 72-year old man previously treated with an aortic endograft for an abdominal aortic aneurysm. After 3 years the patient developed a sepsis. Imaging and blood exams detected an endograft infection related to Listeria monocytogenes. Patients underwent endograft removal and in-situ aortic reconstruction with a cryopreserved allograft. A continuous antibacterial therapy has been established. One-month follow-up revealed the absence of clinically relevant infection with patency of the graft and absence of biochemical inflammatory markers.
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Affiliation(s)
- R Berchiolli
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Zanca R, Bartoli F, Lazzeri E, Sollini M, Slart RHJA, Erba PA. [18F]FDG hypermetabolisms of the spleen and/or bone marrow: indirect signs of bacteremia. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.073] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Aim
Recently hypermetabolisms of the spleen and/or bone marrow has been proposed as an indirect sign of infective endocarditis (IE), useful to reinforce the suspicion of IE in the absence of any other infectious, inflammatory, or malignant disease. The purpose of this study is to determine whether hypermetabolisms of the spleen and/or bone marrow are indirect signs of bacteremia rather than of IE, specifically.
Materials and Method
In this work we retrospectively evaluated a series 240 patients who performed between January 2015 to December 2020 [18F]FDG PET/CT (Discovery 710 GE) for suspected infection. In particular, 80 pts had infections from different origin and a positive blood culture (PBC), 80 pts presented localized infection, but negative blood culture (IDBCN) and 80 pts were classified as definite IE (IED) according to the 2015 ESCcriteria. [18F]FDG SUVmax SUVmean in bone marrow, spleen and liver were measured drawind a 14 cm3 regions of interest (ROIs) positioned close to the centers of the spleen and of the right liver lobe, but excluding abscess and/or ischemic lesions., as previously described (Caroline Boursier et al. ; Jordy P.Pijl et al.). BM SUVmax and SUVmean was obtained from ROIs placed on the bodies of each of the five lumbar vertebrae, excluding any damaged vertebra. BM to liver SUV ratios (BLR) and spleen to liver SUV ratios (SLR) were calculated. Kruskal-Wallis tests and the Dunn’s test procedure for multiple comparison were performed using JMP Statistical Discoverytm.
Results
No significant difference among the three groups of SUVmax/mean or in SLR were found. Nevertheless, by grouping patients for the presence of positive blood culture (142 pts) or negative blood culture (98 pts), irrespectively from the final diagnosis a significant associations of SLR was found (p = 0.0070). No significant associations were found with BLR.
Conclusions
Based on our data SLR in seems to represent an indirect signs of bacteremia, rather than IE.
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Affiliation(s)
- R Zanca
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - F Bartoli
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - E Lazzeri
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - M Sollini
- Humanitas Clinical and Research Center, Nuclear Medicine, Humanitas Clinical and Research,Department of Biomedical Sciences, Milan, Italy
| | - RHJA Slart
- University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen, Netherlands (The)
| | - PA Erba
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
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Zanca R, Marciano A, Bartoli F, Doria R, Conti U, Lazzeri E, Slart RHJA, Erba PA. P148Advance texture analysis: a new step in imaging of IE? Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez147.032] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Zanca
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - A Marciano
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - F Bartoli
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - R Doria
- Azienda Ospedaliero-Universitaria Pisana, Unit of Infectious Diseases, Pisa, Italy
| | - U Conti
- Azienda Ospedaliero-Universitaria Pisana, Division of Cardiology, Pisa, Italy
| | - E Lazzeri
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - RHJA Slart
- University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen, Netherlands (The)
| | - P A Erba
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
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Zanca R, Marciano A, Bartoli F, Mari M, Mocellin DM, Ferrari M, Berchiolli R, Erba PA. P149Comparative assessment of [18F] FDG, [18F]NaF and 68Ga-DOTATATE imaging in patients with symptomatic carotid stenosis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez147.033] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Zanca
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - A Marciano
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - F Bartoli
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
| | - M Mari
- Azienda Ospedaliero-Universitaria Pisana, Vascular Surgery Unit Department of Translational Research and New Technologies in Medicine,, Pisa, Italy
| | - D M Mocellin
- Azienda Ospedaliero-Universitaria Pisana, Vascular Surgery Unit Department of Translational Research and New Technologies in Medicine,, Pisa, Italy
| | - M Ferrari
- Azienda Ospedaliero-Universitaria Pisana, Vascular Surgery Unit Department of Translational Research and New Technologies in Medicine,, Pisa, Italy
| | - R Berchiolli
- Azienda Ospedaliero-Universitaria Pisana, Vascular Surgery Unit Department of Translational Research and New Technologies in Medicine,, Pisa, Italy
| | - P A Erba
- Azienda Ospedaliero-Universitaria Pisana, Regional Center of Nuclear Medicine, Pisa, Italy
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Sollini M, Cozzi L, Pepe G, Antunovic L, Lania A, Di Tommaso L, Magnoni P, Erba PA, Kirienko M. [ 18F]FDG-PET/CT texture analysis in thyroid incidentalomas: preliminary results. Eur J Hybrid Imaging 2017; 1:3. [PMID: 29782578 PMCID: PMC5954705 DOI: 10.1186/s41824-017-0009-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 04/24/2017] [Accepted: 09/01/2017] [Indexed: 02/08/2023] Open
Abstract
Background significance of incidental thyroid 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) uptake on positron emission tomography/computed tomography (PET/CT) scans remains controversial. We aimed to evaluate the ability of [18F]FDG-PET/CT texture analysis to predict final diagnosis in thyroid incidentaloma. Methods We retrospectively evaluated medical records of all patients who performed a [18F]FDG-PET/CT from January 2012 to October 2016. Those patients who presented a thyroid incidentaloma described in the medical records and performed a fine needle aspiration in our institution were considered for the analysis. Cytological and/or histological results were used as reference standard to define the final diagnosis. In case of negative cytology, the nodule was considered benign. In case of non-diagnostic or inconclusive results ultrasound, follow-up and further cytology/histology were used as final diagnosis. For suspected or positive cytological result, histology was used as reference standard. PET images were segmented using a General Electric AW workstation running PET VCAR software (GE Healthcare, Waukesha, WI, USA) settled with a threshold of 40% SUVmax. LifeX software (http://www.lifexsoft.org) was used to perform texture analysis. Statistical analysis was performed with R package (https://www.r-project.org). Results We identified 55 patients with incidental thyroid [18F]FDG uptake. Five patients were excluded from the analysis because a final diagnosis was not available. Thirty-two out of 50 patients had benign nodules while in 18/50 cases a malignancy (primary thyroid cancer = 15, metastases = 3) was diagnosed. Conventional PET parameters and histogram-based features were calculated for all 50 patients, while other matrices-based features were available for 28/50 patients. SUVmax and skewness resulted significantly different in benign and malignant nodules (p = 0.01 and = 0.02, respectively). Using ROC analysis, seven features were identified as potential predictors. Among all the textural features tested, skewness showed the best area under the curve (= 0.66). SUV-based parameters resulted in the highest specificity while MTV, TLG, skewness and kurtosis, as well as correlationGLCM resulted better in sensitivity. Conclusions [18F]FDG-PET/CT texture analysis seems to be a promising approach to stratify the patients with thyroid incidentaloma identified on PET scans, with respect to the risk of the diagnosis of a malignant thyroid nodule and thus, could refine the selection of the patients to be referred for cytology.
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Affiliation(s)
- M Sollini
- 1Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini, 20090 Pieve Emanuele (Milan), Italy
| | - L Cozzi
- 2Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Milan), Italy.,1Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini, 20090 Pieve Emanuele (Milan), Italy
| | - G Pepe
- 3Nuclear Medicine, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Milan), Italy
| | - L Antunovic
- 3Nuclear Medicine, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Milan), Italy
| | - A Lania
- 1Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini, 20090 Pieve Emanuele (Milan), Italy.,4Endocrinology, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Milan), Italy
| | - L Di Tommaso
- 1Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini, 20090 Pieve Emanuele (Milan), Italy.,5Pathology, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Milan), Italy
| | - P Magnoni
- 6Ultrasound Service, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Milan), Italy
| | - P A Erba
- 7Regional Center of Nuclear Medicine, University of Pisa, via Roma 55, 56025 Pisa, Italy
| | - M Kirienko
- 1Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini, 20090 Pieve Emanuele (Milan), Italy
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Puppi D, Pirosa A, Lupi G, Erba PA, Giachi G, Chiellini F. Design and fabrication of novel polymeric biodegradable stents for small caliber blood vessels by computer-aided wet-spinning. ACTA ACUST UNITED AC 2017; 12:035011. [PMID: 28589916 DOI: 10.1088/1748-605x/aa6a28] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Biodegradable stents have emerged as one of the most promising approaches in obstructive cardiovascular disease treatment due to their potential in providing mechanical support while it is needed and then leaving behind only the healed natural vessel. The aim of this study was to develop polymeric biodegradable stents for application in small caliber blood vessels. Poly[(R)-3-hydroxybutyrate-co-(R)-3-hydroxyhexanoate] (PHBHHx), a renewable microbial aliphatic polyester, and poly(ε-caprolactone), a synthetic polyester approved by the US Food and Drug Administration for different biomedical applications, were investigated as suitable polymers for stent development. A novel manufacturing approach based on computer-aided wet-spinning of a polymeric solution was developed to fabricate polymeric stents. By tuning the fabrication parameters, it was possible to develop stents with different morphological characteristics (e.g. pore size and wall thickness). Thermal analysis results suggested that material processing did not cause changes in the molecular structure of the polymers. PHBHHx stents demonstrated great radial elasticity while PCL stents showed higher axial and radial mechanical strength. The developed stents resulted able to sustain proliferation of human umbilical vein endothelial cells within two weeks of in vitro culture and they showed excellent results in terms of thromboresistivity when in contact with human blood.
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Affiliation(s)
- D Puppi
- BIOLab Research Group, Department of Chemistry and Industrial Chemistry, University of Pisa, UdR INSTM Pisa, via Moruzzi 13, I-56124, Pisa, Italy
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Sollini M, Muratore F, Roncali M, Erba PA, Salvarani C, Versari A. Extra-articular rheumatoid arthritis imaged by [18F]FDG-PET/CT. Acta Reumatol Port 2016; 41:268. [PMID: 27771731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Sollini M, Calabrese L, Zangheri B, Erba PA, Gramaglia A, Gasparini M. (18)F-FDG PET/CT versus bone scintigraphy in the follow-up of gastric cancer. Rev Esp Med Nucl Imagen Mol 2015; 35:121-3. [PMID: 26653282 DOI: 10.1016/j.remn.2015.10.002] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/16/2015] [Accepted: 10/19/2015] [Indexed: 11/29/2022]
Abstract
A 53-year-old patient underwent a positron emission tomography/computed tomography with 2-fluoro-2-deoxy-d-glucose ((18)F-FDG PET/CT) in the suspicious of gastric tumor recurrence (mediastinal and abdominal lymph nodes). PET/CT identified only an area of (18)F-FDGuptake in the twelfth thoracic vertebrae. Unexpectedly, a bone scintigraphy revealed many "hot" spots changing the diagnosis (single metastasis versus plurimetastatic disease) and impacting on patient's management.
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Affiliation(s)
- M Sollini
- Nuclear Medicine Unit, IRCCS MultiMedica, Via Milanese 300, 20099 Sesto San Giovanni (MI), Italy.
| | - L Calabrese
- Nuclear Medicine Unit, IRCCS MultiMedica, Via Milanese 300, 20099 Sesto San Giovanni (MI), Italy
| | - B Zangheri
- Nuclear Medicine Unit, IRCCS MultiMedica, Via Milanese 300, 20099 Sesto San Giovanni (MI), Italy
| | - P A Erba
- Regional Center of Nuclear Medicine, University of Pisa, Via Savi 10, 56125 Pisa, Italy
| | - A Gramaglia
- Radiation Oncology Unit, Policlinico di Monza, Via Amati 111, 20900 Monza, Italy
| | - M Gasparini
- Nuclear Medicine Unit, IRCCS MultiMedica, Via Milanese 300, 20099 Sesto San Giovanni (MI), Italy
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Sollini M, Boni R, Traino AC, Lazzeri E, Pasqualetti F, Modeo L, Mariani G, Petrini M, Erba PA. New approaches for imaging and therapy of solid cancer. Q J Nucl Med Mol Imaging 2015; 59:168-183. [PMID: 25693421] [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: 06/04/2023]
Abstract
Radionuclide therapy is a systemic treatment that aims to deliver cytotoxic radiation to cancer cells. Due to their properties, antibodies have been considered as suitable agent for the delivery of therapeutic radioisotopes, radioimmunotherapy (RIT). This article gives an overview of new approaches for imaging and therapy of solid cancer with particular attention to strategies to enhance treatment success. Examples of increased antibody uptake by targeting stromal constituent of tumor microenvironment such as fibronectin (FN) an important tumor-associated angiogenesis targeting agent, with specifically designed antibody format will be provided. Strategies oriented to identify patients most likely to benefit from RIT including identification of radiosensitivity profiles, in vivo target identification by teragnostic approach and better prediction of dosimetric estimates would be presents. Combination regimens such as with chemo-radiotherapy and immunotherapy would be also discussed as an approach to enhance RIT success.
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Affiliation(s)
- M Sollini
- Nuclear Medicine Unit, Department of Oncology and Advanced Technology, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy -
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Iung B, Erba PA, Petrosillo N, Lazzeri E. Common diagnostic flowcharts in infective endocarditis. Q J Nucl Med Mol Imaging 2014; 58:55-65. [PMID: 24231795] [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: 06/02/2023]
Abstract
The presentation of infective endocarditis (IE) has changed over time and its diagnosis remains difficult since it relies on the conjunction of a number of criteria which have their own limitations. The Duke classification allows for a standardized approach and is now recognized as the reference method for the diagnosis of IE. The diagnostic value of the different criteria of the Duke classification can be improved by the use of transoesophageal echocardiography for the detection of endocardial involvement and the use of non-cardiac imaging for the detection of embolic events. The number of cases of IE without identified causative microorganism can be reduced due to serological analyses and broad-range polymerase chain reaction on explanted valves. Radionuclide imaging techniques are useful when the diagnosis of IE remains uncertain. [18F]FDG PET/CT can be used for the diagnosis of cardiac infection and for the detection of embolic events or metastatic infection, keeping in mind the possibility of false positive diagnosis due to its high sensitivity. Radiolabelled-leukocytes scintigraphy is more specific than [18F]FDG PET/CT and can differentiate between septic and sterile vegetations. Diagnostic flowcharts are proposed to combine the Duke classification and recent imaging techniques for the diagnostic workup of IE.
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Affiliation(s)
- B Iung
- Cardiology Department, AP-HP, Bichat Hospital University of Paris Diderot, Paris, France -
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Benedetti E, Proietti A, Miccoli P, Basolo F, Ciancia E, Erba PA, Galimberti S, Orsitto E, Petrini M. Contrast-enhanced ultrasonography in nodular splenomegaly associated with type B Niemann-Pick disease: an atypical hemangioma enhancement pattern. J Ultrasound 2009; 12:85-92. [PMID: 23396497 DOI: 10.1016/j.jus.2009.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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: 11/28/2022] Open
Abstract
INTRODUCTION Niemann-Pick disease (NPD) types A and B are lipid storage disorders. NPD type A is a fatal disorder of infancy. Type B is a non-neuronopathic form observed in children and adults. It is associated with enlargement of the liver, spleen, or both, and nodular splenomegaly may be detected with ultrasound. METHODS A 21-year-old female was admitted to the Emergency Room with fever, pharyngitis, and left upper quadrant abdominal pain. Labwork revealed anemia, thrombocytopenia, increased levels of AST, ALT, GGT, AF, LDH, triglycerides, and total cholesterol and low levels of HDL-cholesterol. PCR blood assays for CMV and EBV were both negative. Chest X-ray was unremarkable. Transabdominal B-mode ultrasound (US) revealed splenomegaly (long axis: >22 cm), an irregular subcapsular hypoechoic lesion in the superior pole that was consistent with splenic infarction, and multiple round highly echogenic nodes measuring 1-5 cm in diameter. Contrast-enhanced ultrasonography (CEUS) was performed using SonoVue(®) (Bracco). RESULTS The presence of a splenic infarction was confirmed. The nodular lesions showed arterial-phase enhancement with late parenchymal phase wash-out. (18)F-FDG-PET revealed splenic nodular uptake. Primary splenic lymphoma was suspected, and the patient underwent open splenectomy. The diagnosis was type B NPD with splenic hemangiomas. DISCUSSION CEUS confirmed the diagnosis and extent of splenic infarction, but the nodular atypical enhancement pattern together with nodular (18)F-FDG-PET uptake was misleading, suggesting as it did lymphoproliferative involvement of the spleen.
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Affiliation(s)
- E Benedetti
- Department of Oncology, Transplantation, and New Advances in Medicine, Hematology Division, University of Pisa, Italy ; Italian Society of Ultrasound in Medicine and Biology, School of Basic and Emergency Ultrasonography, Italy
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