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Gatta E, Maltese V, Cimino E, Cavadini M, Anelli V, Di Lodovico E, Piovani E, Zammarchi I, Gozzoli G, Agosti B, Pirola I, Delbarba A, Girelli A, Buoso C, Bambini F, Alfieri D, Bremi W, Facondo P, Lupo R, Bezzi F, Fredi M, Mazzola AM, Gandossi E, Saullo M, Marini F, Licini M, Pezzaioli LC, Pini L, Franceschini F, Ricci C, Cappelli C. Evaluation of a large set of patients with Autoimmune Polyglandular Syndrome from a single reference centre in context of different classifications. J Endocrinol Invest 2024; 47:857-864. [PMID: 37752372 DOI: 10.1007/s40618-023-02200-6] [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: 07/25/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE To characterize patients with APS and to propose a new approach for their follow-up. Query ID="Q1" Text="Please check the given names and familynames." METHODS Monocentric observational retrospective study enrolling patients referred to the Outpatients clinic of the Units of Endocrinology, Diabetology, Gastroenterology, Rheumatology and Clinical Immunology of our Hospital for Autoimmune diseases. RESULTS Among 9852 patients, 1174 (11.9%) [869 (73.9%) female] were diagnosed with APS. In 254 subjects, the diagnosis was made at first clinical evaluation (Group 1), all the other patients were diagnosed with a mean latency of 11.3 ± 10.6 years (Group 2). Group 1 and 2 were comparable for age at diagnosis (35.7 ± 16.3 vs. 40.4 ± 16.6 yrs, p = .698), but different in male/female ratio (81/173 vs 226/696, p = .019). In Group 2, 50% of patients developed the syndrome within 8 years of follow-up. A significant difference was found after subdividing the first clinical manifestation into the different outpatient clinic to which they referred (8.7 ± 8.0 vs. 13.4 ± 11.6 vs. 19.8 ± 8.7 vs. 7.4 ± 8.1 for endocrine, diabetic, rheumatologic, and gastroenterological diseases, respectively, p < .001). CONCLUSIONS We described a large series of patients affected by APS according to splitters and lumpers. We propose a flowchart tailored for each specialist outpatient clinic taking care of the patients. Finally, we recommend regular reproductive system assessment due to the non-negligible risk of developing premature ovarian failure.
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Affiliation(s)
- E Gatta
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - V Maltese
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - E Cimino
- UOC Medicina Generale ad Indirizzo Metabolico e Diabetologico, ASST Spedali Civili of Brescia, Brescia, Italy
| | - M Cavadini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - V Anelli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - E Di Lodovico
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - E Piovani
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - I Zammarchi
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - G Gozzoli
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - B Agosti
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - I Pirola
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - A Delbarba
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - A Girelli
- UOC Medicina Generale ad Indirizzo Metabolico e Diabetologico, ASST Spedali Civili of Brescia, Brescia, Italy
| | - C Buoso
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - F Bambini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - D Alfieri
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - W Bremi
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - P Facondo
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - R Lupo
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - F Bezzi
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - M Fredi
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - A M Mazzola
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - E Gandossi
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - M Saullo
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - F Marini
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - M Licini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - L C Pezzaioli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - L Pini
- Department of Clinical and Experimental Sciences, Respiratory Medicine Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - F Franceschini
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - C Ricci
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - C Cappelli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy.
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Gitto S, Annovazzi A, Nulle K, Interlenghi M, Salvatore C, Anelli V, Baldi J, Messina C, Albano D, Di Luca F, Armiraglio E, Parafioriti A, Luzzati A, Biagini R, Castiglioni I, Sconfienza LM. X-rays radiomics-based machine learning classification of atypical cartilaginous tumour and high-grade chondrosarcoma of long bones. EBioMedicine 2024; 101:105018. [PMID: 38377797 PMCID: PMC10884340 DOI: 10.1016/j.ebiom.2024.105018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Atypical cartilaginous tumour (ACT) and high-grade chondrosarcoma (CS) of long bones are respectively managed with active surveillance or curettage and wide resection. Our aim was to determine diagnostic performance of X-rays radiomics-based machine learning for classification of ACT and high-grade CS of long bones. METHODS This retrospective, IRB-approved study included 150 patients with surgically treated and histology-proven lesions at two tertiary bone sarcoma centres. At centre 1, the dataset was split into training (n = 71 ACT, n = 24 high-grade CS) and internal test (n = 19 ACT, n = 6 high-grade CS) cohorts, respectively, based on the date of surgery. At centre 2, the dataset constituted the external test cohort (n = 12 ACT, n = 18 high-grade CS). Manual segmentation was performed on frontal view X-rays, using MRI or CT for preliminary identification of lesion margins. After image pre-processing, radiomic features were extracted. Dimensionality reduction included stability, coefficient of variation, and mutual information analyses. In the training cohort, after class balancing, a machine learning classifier (Support Vector Machine) was automatically tuned using nested 10-fold cross-validation. Then, it was tested on both the test cohorts and compared to two musculoskeletal radiologists' performance using McNemar's test. FINDINGS Five radiomic features (3 morphology, 2 texture) passed dimensionality reduction. After tuning on the training cohort (AUC = 0.75), the classifier had 80%, 83%, 79% and 80%, 89%, 67% accuracy, sensitivity, and specificity in the internal (temporally independent) and external (geographically independent) test cohorts, respectively, with no difference compared to the radiologists (p ≥ 0.617). INTERPRETATION X-rays radiomics-based machine learning accurately differentiates between ACT and high-grade CS of long bones. FUNDING AIRC Investigator Grant.
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Affiliation(s)
- Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Alessio Annovazzi
- Nuclear Medicine Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Kitija Nulle
- Radiology Department, Riga East Clinical University Hospital, Riga, Latvia
| | | | - Christian Salvatore
- DeepTrace Technologies s.r.l., Milan, Italy; Department of Science, Technology and Society, University School for Advanced Studies IUSS Pavia, Pavia, Italy
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Jacopo Baldi
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milan, Italy
| | - Filippo Di Luca
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milan, Italy
| | | | | | | | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Isabella Castiglioni
- Department of Physics "G. Occhialini", Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
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Gitto S, Interlenghi M, Cuocolo R, Salvatore C, Giannetta V, Badalyan J, Gallazzi E, Spinelli MS, Gallazzi M, Serpi F, Messina C, Albano D, Annovazzi A, Anelli V, Baldi J, Aliprandi A, Armiraglio E, Parafioriti A, Daolio PA, Luzzati A, Biagini R, Castiglioni I, Sconfienza LM. MRI radiomics-based machine learning for classification of deep-seated lipoma and atypical lipomatous tumor of the extremities. Radiol Med 2023:10.1007/s11547-023-01657-y. [PMID: 37335422 DOI: 10.1007/s11547-023-01657-y] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/26/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE To determine diagnostic performance of MRI radiomics-based machine learning for classification of deep-seated lipoma and atypical lipomatous tumor (ALT) of the extremities. MATERIAL AND METHODS This retrospective study was performed at three tertiary sarcoma centers and included 150 patients with surgically treated and histology-proven lesions. The training-validation cohort consisted of 114 patients from centers 1 and 2 (n = 64 lipoma, n = 50 ALT). The external test cohort consisted of 36 patients from center 3 (n = 24 lipoma, n = 12 ALT). 3D segmentation was manually performed on T1- and T2-weighted MRI. After extraction and selection of radiomic features, three machine learning classifiers were trained and validated using nested fivefold cross-validation. The best-performing classifier according to previous analysis was evaluated and compared to an experienced musculoskeletal radiologist in the external test cohort. RESULTS Eight features passed feature selection and were incorporated into the machine learning models. After training and validation (74% ROC-AUC), the best-performing classifier (Random Forest) showed 92% sensitivity and 33% specificity in the external test cohort with no statistical difference compared to the radiologist (p = 0.474). CONCLUSION MRI radiomics-based machine learning may classify deep-seated lipoma and ALT of the extremities with high sensitivity and negative predictive value, thus potentially serving as a non-invasive screening tool to reduce unnecessary referral to tertiary tumor centers.
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Affiliation(s)
- Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | | | - Renato Cuocolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
- Augmented Reality for Health Monitoring Laboratory (ARHeMLab), Department of Electrical Engineering and Information Technology, University of Naples "Federico II", Naples, Italy
| | - Christian Salvatore
- DeepTrace Technologies, Milan, Italy
- Department of Science, Technology and Society, University School for Advanced Studies IUSS Pavia, Pavia, Italy
| | - Vincenzo Giannetta
- Diagnostic and Interventional Radiology Department, IRCCS Ospedale San Raffaele-Turro, Università Vita-Salute San Raffaele, Milan, Italy
| | - Julietta Badalyan
- Scuola di Specializzazione in Statistica Sanitaria e Biometria, Università Degli Studi Di Milano, Milan, Italy
| | - Enrico Gallazzi
- UOC Patologia Vertebrale e Scoliosi, ASST Gaetano Pini - CTO, Milan, Italy
| | | | - Mauro Gallazzi
- UOC Radiodiagnostica, ASST Gaetano Pini - CTO, Milan, Italy
| | - Francesca Serpi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | | | - Alessio Annovazzi
- Nuclear Medicine Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Jacopo Baldi
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | | | | | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Isabella Castiglioni
- Department of Physics, Università degli Studi di Milano-Bicocca, Milan, Italy
- Institute of Biomedical Imaging and Physiology, Consiglio Nazionale Delle Ricerche, Segrate, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
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Ceddia S, Vari S, Torchia A, Onesti C, Cosimati A, Veroli M, Chiavassa A, Riva F, Salvatori F, Benvenuti G, Anelli V, Sperduti I, Ferraresi V. 83P Radiological evaluation of response in patients with soft tissue sarcoma treated with trabectedin. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101120] [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: 04/05/2023] Open
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Maltese V, Gatta E, Facondo P, Anelli V, Cavadini M, Buoso C, Bambini F, Delbarba A, Pirola I, Cappelli C. SIMULTANEOUS INTAKE OF LIQUID L-T4 FORMULATION AND IRON SALT: FACT OR FICTION? Acta Endocrinol (Buchar) 2023; 19:54-58. [PMID: 37601720 PMCID: PMC10439335 DOI: 10.4183/aeb.2023.54] [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] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Context Hypothyroidism and iron deficiency are among the most common pathologies in population. Therefore, there are a lot of patients assuming both iron salt supplements and levothyroxine therapy. Objective To evaluate the effect of iron salt intake on L-T4 absorption among different L-T4 formulations. Materials and methods A PubMed/MEDLINE, Web of Science, and Scopus research was performed. Original studies and reviews written in English and published online up to 21 December 2022 were selected and reviewed. The final reference list was defined based on the relevance of each paper to the scope of this review. Results The data show an impaired absorption of L-T4 in tablets formulation when taken concomitantly with iron salt supplements. These phenomena seem to be circumvented by new L-T4 formulations. Conclusion Liquid L-T4 formulations can be ingested with iron salts, with no impairment of absorption. More studies are necessary to confirm these data for soft-gel capsules L-T4.
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Affiliation(s)
- V. Maltese
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - E. Gatta
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - P. Facondo
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - V. Anelli
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - M. Cavadini
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - C. Buoso
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - F. Bambini
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - A. Delbarba
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - I. Pirola
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - C. Cappelli
- University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, SSD Endocrinologia, Department of Clinical and Experimental Sciences, Brescia, Italy
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Gitto S, Corino VDA, Annovazzi A, Milazzo Machado E, Bologna M, Marzorati L, Albano D, Messina C, Serpi F, Anelli V, Ferraresi V, Zoccali C, Aliprandi A, Parafioriti A, Luzzati A, Biagini R, Mainardi L, Sconfienza LM. 3D vs. 2D MRI radiomics in skeletal Ewing sarcoma: Feature reproducibility and preliminary machine learning analysis on neoadjuvant chemotherapy response prediction. Front Oncol 2022; 12:1016123. [PMID: 36531029 PMCID: PMC9755864 DOI: 10.3389/fonc.2022.1016123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/17/2022] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE The extent of response to neoadjuvant chemotherapy predicts survival in Ewing sarcoma. This study focuses on MRI radiomics of skeletal Ewing sarcoma and aims to investigate feature reproducibility and machine learning prediction of response to neoadjuvant chemotherapy. MATERIALS AND METHODS This retrospective study included thirty patients with biopsy-proven skeletal Ewing sarcoma, who were treated with neoadjuvant chemotherapy before surgery at two tertiary sarcoma centres. 7 patients were poor responders and 23 were good responders based on pathological assessment of the surgical specimen. On pre-treatment T1-weighted and T2-weighted MRI, 2D and 3D tumour segmentations were manually performed. Features were extracted from original and wavelet-transformed images. Feature reproducibility was assessed through small geometrical transformations of the regions of interest mimicking multiple manual delineations, and intraclass correlation coefficient >0.75 defined feature reproducibility. Feature selection also consisted of collinearity and significance analysis. After class balancing in the training cohort, three machine learning classifiers were trained and tested on unseen data using hold-out cross-validation. RESULTS 1303 (77%) 3D and 620 (65%) 2D radiomic features were reproducible. 4 3D and 4 2D features passed feature selection. Logistic regression built upon 3D features achieved the best performance with 85% accuracy (AUC=0.9) in predicting response to neoadjuvant chemotherapy. CONCLUSION Compared to 2D approach, 3D MRI radiomics of Ewing sarcoma had superior reproducibility and higher accuracy in predicting response to neoadjuvant chemotherapy, particularly when using logistic regression classifier.
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Affiliation(s)
- Salvatore Gitto
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Valentina D. A. Corino
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico Di Milano, Milan, Italy
- Cardiotech Lab, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Alessio Annovazzi
- Nuclear Medicine Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Marco Bologna
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico Di Milano, Milan, Italy
| | - Lorenzo Marzorati
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico Di Milano, Milan, Italy
| | | | - Carmelo Messina
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Francesca Serpi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Virginia Ferraresi
- Sarcomas and Rare Tumours Departmental Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Carmine Zoccali
- Department of Anatomical, Histological, Forensic and Musculoskeletal System Sciences, Sapienza University of Rome, Rome, Italy
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Luca Mainardi
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico Di Milano, Milan, Italy
| | - Luca Maria Sconfienza
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Anastasio G, Marzi S, Petrongari MG, D’Andrea M, Anelli V, Annovazzi A, Avanzolini I, Soriani A. THERMO-RADIOTHERAPY TREATMENT: A SYNERGISTIC APPROACH TO TREAT SUPERFICIAL SOFT TISSUE SARCOMAS EVALUATED BY DYNAMIC CONTRAST ENHANCED MAGNETIC RESONANCE IMAGING (DCE-MRI). Phys Med 2022. [DOI: 10.1016/s1120-1797(22)02521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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8
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Vari S, Riva F, Onesti CE, Cosimati A, Renna D, Biagini R, Baldi J, Zoccali C, Anelli V, Annovazzi A, Covello R, Ascione A, Casini B, Ferraresi V. Malignant Transformation of Giant Cell Tumour of Bone: A Review of Literature and the Experience of a Referral Centre. Int J Mol Sci 2022; 23:ijms231810721. [PMID: 36142631 PMCID: PMC9506170 DOI: 10.3390/ijms231810721] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 11/24/2022] Open
Abstract
Giant cell tumour of bone (GCTB) is a benign, locally aggressive primary bone neoplasm that represents 5% of all bone tumours. The principal treatment approach is surgery. Although generally GCTB is considered only a locally aggressive disease, it can metastasise, and lung metastases occur in 1–9% of patients. To date, only the use of denosumab has been approved as medical treatment for GCTB. Even more rarely, GCTB undergoes sarcomatous transformation into a malignant tumour (4% of all GCTB), but history of this malignant transformation is unclear and unpredictable. Considering the rarity of the event, the data in the literature are few. In this review, we summarise published data of GCTB malignant transformation and we analyse three cases of malignant transformation of GCTB, evaluating histopathology, genetics, and radiological aspects. Despite the rarity of this event, we conclude that a strict follow up is recommended to detect early malignant transformation.
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Affiliation(s)
- Sabrina Vari
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Federica Riva
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, Sapienza University of Rome, 00144 Rome, Italy
| | - Concetta Elisa Onesti
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
- Correspondence:
| | - Antonella Cosimati
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, Sapienza University of Rome, 00144 Rome, Italy
| | - Davide Renna
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Jacopo Baldi
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Carmine Zoccali
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Vincenzo Anelli
- Radiology Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Alessio Annovazzi
- Nuclear Medicine Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Renato Covello
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Andrea Ascione
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
| | - Beatrice Casini
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Virginia Ferraresi
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
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Koudriavtseva T, Lorenzano S, Anelli V, Sergi D, Stefanile A, Piantadosi C. Cerebral amyloid angiopathy-related inflammation during bevacizumab treatment for metastatic cervical cancer. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119954] [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]
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Koudriavtseva T, Lorenzano S, Anelli V, Sergi D, Stefanile A, Di Domenico EG, Maschio M, Galiè E, Piantadosi C. Case Report: Probable Cerebral Amyloid Angiopathy-Related Inflammation During Bevacizumab Treatment for Metastatic Cervical Cancer. Front Oncol 2021; 11:669753. [PMID: 34386418 PMCID: PMC8353446 DOI: 10.3389/fonc.2021.669753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/09/2021] [Indexed: 01/28/2023] Open
Abstract
Bevacizumab is an anti-angiogenic monoclonal antibody targeting Vascular Endothelial Growth Factor (VEGF) that induces the proliferation and migration of vascular endothelial cells thus, promoting vasculogenesis. Bevacizumab inhibits cancer angiogenesis, which is fundamental for either tumor development, exponential growth, or metastatic spread by supplying nutrients and oxygen. We report a new possible adverse event of bevacizumab, a Cerebral Amyloid Angiopathy-Related Inflammation (CAARI), in a 72-year-old woman with metastatic cervical cancer. After six cycles every three weeks of chemotherapy (cisplatin, paclitaxel, bevacizumab) and following two maintenance bevacizumab administrations, the patient presented a worsening confusional state. The MRI scan showed bilateral asymmetric temporo-parieto-occipital hyperintensity with numerous cortical microbleeds indicative of a CAARI. After stopping bevacizumab treatment, steroid therapy was administered resulting in rapid clinical improvement. The subsequent neurological and oncological follow-up was negative for recurrence. The patient was a heterozygote carrier for apolipoprotein-E ε4 that increases the risk of sporadic Cerebral Amyloid Angiopathy (CAA), which is characterized by beta-amyloid accumulation and fibrinoid necrosis in cerebral vasculature leading to micro/macrohemorrhages and dementia. Moreover, CAA is present in 30% of people aged over 60 years without dementia. In the brains of CAA patients, there is a proinflammatory state with cerebrovascular endothelial cell alteration and elevated levels of either adhesion molecules or inflammatory interleukins that increase the blood-brain barrier permeability. Moreover, CAARI is an inflammatory form of CAA. Inhibition of VEGF, which has anti-apoptotic, anti-inflammatory, and pro-survival effects on endothelial cells, impairs their regenerative capacity and increases expression of proinflammatory genes leading to weakened supporting layers of blood vessels and, hence, to damaged vascular integrity. In our patient, bevacizumab administration may have further increased permeability of cerebral microvasculature likely impaired by an underlying, asymptomatic CAA. To our knowledge, this is the first case reporting on the development of probable CAARI during bevacizumab treatment, which should alert the clinicians in case of neurological symptom onset in older patients under anti-angiogenic therapy.
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Affiliation(s)
- Tatiana Koudriavtseva
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Svetlana Lorenzano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Anelli
- Department of Research, Advanced Diagnostics and Technological Innovation, IRCCS Regina Elena National Cancer Institute, IFO, Rome, Italy
| | - Domenico Sergi
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Annunziata Stefanile
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Enea Gino Di Domenico
- Clinical Pathology and Microbiology, IRCCS San Gallicano Dermatologic Institute, IFO, Rome, Italy
| | - Marta Maschio
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Edvina Galiè
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Carlo Piantadosi
- Unità Operativa Complessa (UOC) Neurology, San Giovanni-Addolorata Hospital, Rome, Italy
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Stagno A, Vari S, Annovazzi A, Anelli V, Russillo M, Cognetti F, Ferraresi V. Case Report: Rechallenge With BRAF and MEK Inhibitors in Metastatic Melanoma: A Further Therapeutic Option in Salvage Setting? Front Oncol 2021; 11:645008. [PMID: 34136385 PMCID: PMC8202400 DOI: 10.3389/fonc.2021.645008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/11/2021] [Indexed: 11/19/2022] Open
Abstract
Background The combination of BRAF and MEK inhibitors represents the standard of care treatment for patients with metastatic BRAF-mutated melanoma, notwithstanding the high frequency of emergent resistance. Moreover, therapeutic options outside clinical trials are scarce when patients have progressed after both targeted therapy and therapy with immune checkpoint inhibitors. In this article, we report our experience with targeted therapy rechallenging with BRAF and MEK inhibitors in patients with metastatic BRAF-mutated melanoma after progression with kinase inhibitors and immunotherapy. Methods Four patients with metastatic BRAF-mutated melanoma were rechallenged with BRAF and MEK inhibitors after progression with targeted therapy and subsequent immunotherapy (checkpoint inhibitors). Results Two patients (one of them was heavily pretreated) had partial response over 36 months (with local treatment on oligoprogression disease) and 10 months, respectively. A third patient with multisite visceral disease and high serum levels of lactate dehydrogenase had a short-lived clinical benefit rapidly followed by massive progression of disease (early progressor). The fourth patient, currently on treatment with BRAF/MEK inhibitors, is showing a clinical benefit and radiological stable disease over 3 months of therapy. Adverse events were manageable, similar to those reported during the first targeted therapy; the treatment was better tolerated at rechallenge compared with the first treatment by two out of four patients.
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Affiliation(s)
- Anna Stagno
- Department of Medical Oncology 1, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Sabrina Vari
- Department of Medical Oncology 1, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Alessio Annovazzi
- Nuclear Medicine Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Michelangelo Russillo
- Department of Medical Oncology 1, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Cognetti
- Department of Medical Oncology 1, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Virginia Ferraresi
- Department of Medical Oncology 1, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
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Annovazzi A, Ferraresi V, Anelli V, Covello R, Vari S, Zoccali C, Biagini R, Sciuto R. [ 18F]FDG PET/CT quantitative parameters for the prediction of histological response to induction chemotherapy and clinical outcome in patients with localised bone and soft-tissue Ewing sarcoma. Eur Radiol 2021; 31:7012-7021. [PMID: 33715090 DOI: 10.1007/s00330-021-07841-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/07/2021] [Revised: 02/10/2021] [Accepted: 02/25/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The application of [18F]FDG PET/CT in predicting histologic response to induction chemotherapy in patients with Ewing sarcoma (EWS) has been proposed using the values of pre-post treatment SUVmax as a referral parameter, although with heterogeneous results. The aim of this retrospective study was to evaluate the diagnostic accuracy of [18F]FDG PET/CT volumetric parameters (metabolic tumour volume (MTV) and total lesion glycolysis (TLG)) as compared to SUVmax to predict response to chemotherapy and clinical outcome in patients with localised EWS of bone and soft-tissue. METHODS Twenty-eight patients with non-metastatic EWS of bone (n = 20) and soft tissues (n = 8) who underwent a [18F]FDG PET/CT scan before (PET1) and after induction chemotherapy (PET2) were enclosed in the analysis. Values of PET metrics (SUVmax, MTV, TLG) at diagnosis and after neoadjuvant chemotherapy as well as the percentage change between PET1 and PET2 (ΔSUV, ΔMTV and ΔTLG) were correlated to histological response and to progression-free survival (PFS). RESULTS ΔTLG (cut-off: -60%) is the best predictor for histologic response with 100% sensitivity and 77.8% specificity. MTV1 > 33.4 cm3 and TLG1 > 112 were also associated with a favourable histologic response (sensitivity 80% and specificity 77.8% for both). On multivariate analysis, SUV2 (> 3.3) and ΔTLG (< -18%) were independent predictors of worse PFS. CONCLUSIONS [18F]FDG PET/CT could accurately predict histologic response to neoadjuvant chemotherapy in patients with EWS, also showing a possible prognostic value for future disease relapse. KEY POINTS • The variation of the PET parameter tumour lesion glycolysis (TLG) can predict the histologic response to induction chemotherapy (sensitivity 100%, specificity 77.8%), in patients with Ewing sarcoma. • The percentage variation of TLG and the value of the SUVmax at PET scan after chemotherapy show a prognostic role for future disease relapse. The combination of both the parameters identifies three prognostic classes of patients with low, intermediate and high risk of disease relapse.
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Affiliation(s)
- Alessio Annovazzi
- Nuclear Medicine Unit, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144, Rome, Italy.
| | - Virginia Ferraresi
- First Division of Medical Oncology, IRCCS - Regina Elena National Cancer Institute, Rome, Italy.,Sarcomas and Rare Tumors Unit, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Unit, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Renato Covello
- Department of Pathology, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Sabrina Vari
- First Division of Medical Oncology, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Carmine Zoccali
- Oncological Orthopaedics Unit, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Rosa Sciuto
- Nuclear Medicine Unit, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144, Rome, Italy
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Soriani A, Strigari L, Petrongari MG, Anelli V, Baldi J, Salducca N, Biagini R, Zoccali C. The advantages of carbon fiber based orthopedic devices in patients who have to undergo radiotherapy. Acta Biomed 2020; 91:e2020057. [PMID: 32921754 PMCID: PMC7716998 DOI: 10.23750/abm.v91i3.7769] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/23/2020] [Indexed: 11/24/2022]
Abstract
Background and Objectives: The modern approach to primary and secondary muscular skeletal tumors is multidisciplinary. The right combination of chemotherapy, surgery and radiotherapy (RT) makes obtaining local and distant disease more likely. When surgery is indicated, radiotherapy often has a fundamental role as an adjuvant treatment; however, the titanium alloy instrumentations interfere with Radiotherapy setting, decreasing its effectiveness. It is common opinion that carbon fiber-reinforced devices are convenient in case of adjuvant RT in muscular skeletal oncology. The aim of the study is to support this intuition with experimental data, verifying the more accurate estimation of the delivered dose during RT, comparing Carbon Fiber-Reinforced PEEK (CFRP) plates with titanium-alloy orthopedic devices in order to evaluate their effects on target volume identification and dose distribution for radiation treatment. Methods: Phantoms were then irradiated with a linear accelerator Varian 2100 C/D with photon beams of 6 and 15 MV energies. Absorbed dose in the point of interest was verified by EBT3 gafchromic films above and below the two materials. Images from CT simulations were also analyzed in terms of Hounsfield numbers in patients with titanium and carbon fiber orthopedic implants in the spine or in the femur. Results: For a 6 MV photon beam, the doses measured just under the titanium-alloy plate were less than approximately 20% of the value calculated by the TPS. For a 15 MV beam energy, these differences were slightly lower. Using CFRP plate, the difference between measured and calculated doses was within ±3% for both energies, which was comparable with the statistical uncertainties. In the cases of simulated treatment of humerus titanium implants, the difference varies in range ± 10% with hot spot of + 10% and cold spot of -15%. Conclusions: The use of CFRP for orthopedic devices and implants provides a valuable advantage in identifying the target due to the reduction of artifacts. Clear imaging of the soft tissues surrounding the bone is useful and reduces the discrepancies between calculated/delivered and measured doses, generating a more homogeneous dose distribution. Furthermore, there is a significant benefit in detecting the state of disease in CT imaging during the follow-up of treated patients. In-vivo studies are encouraged to verify whether a more effective radiotherapy leads to a decrease in local recurrence and local progression. (www.actabiomedica.com)
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Annovazzi A, Rea S, Zoccali C, Sciuto R, Baldi J, Anelli V, Petrongari MG, Pescarmona E, Biagini R, Ferraresi V. Diagnostic and Clinical Impact of 18F-FDG PET/CT in Staging and Restaging Soft-Tissue Sarcomas of the Extremities and Trunk: Mono-Institutional Retrospective Study of a Sarcoma Referral Center. J Clin Med 2020; 9:jcm9082549. [PMID: 32781683 PMCID: PMC7463806 DOI: 10.3390/jcm9082549] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Soft-tissue sarcomas (STS) represent a wide heterogeneous class of rare tumors. The exact role 18F-fluorodeoxyglucose positron emission/computed tomography (18F-FDG PET/CT) in the evaluation of STS is not well established. The aim of the present study was to evaluate how the use of 18F-FDG PET/CT in STS could influence patient therapy planning, looking for a possible added value over computed tomography and magnetic resonance imaging—the most used modalities in the study of STS. Differences in SUVmax according to histologic subtype and tumor grade were also considered. Methods: a total of 345 consecutive 18F-FDG PET/CT scans performed for initial staging (n = 171) or for suspected disease relapse (n = 174) in 282 patients with STS extracted from the local Information System database were retrospectively reviewed. Results: 18F-FDG PET/CT altered therapy planning in 80 cases (16.4% for staging and 29.9% in restaging), both for disease upstaging (58.8%) and downstaging (41.2%) Conclusions: 18F-FDG PET/CT could significantly influence management of patients with STS, particularly for restaging.
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Affiliation(s)
- Alessio Annovazzi
- Nuclear Medicine Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.R.); (R.S.)
- Correspondence:
| | - Sandra Rea
- Nuclear Medicine Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.R.); (R.S.)
| | - Carmine Zoccali
- Oncological Orthopaedics Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.Z.); (J.B.); (R.B.)
| | - Rosa Sciuto
- Nuclear Medicine Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.R.); (R.S.)
| | - Jacopo Baldi
- Oncological Orthopaedics Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.Z.); (J.B.); (R.B.)
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Maria G. Petrongari
- Department of Radiation Oncology, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Edoardo Pescarmona
- Clinical Pathology, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.Z.); (J.B.); (R.B.)
| | - Virginia Ferraresi
- Medical Oncology 1, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
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Ferraresi V, Vari S, Rossi B, Maggi G, Giannarelli D, Persichetti A, Petrongari MG, Cercato MC, Annovazzi A, Anelli V, Pescarmona E, Baldi J, Zoccali C, Pellegrini D, Cognetti F, Biagini R. The Real-Life Journey of Elderly Patients in Soft Tissue and Bone Sarcomas: A Retrospective Analysis from a Sarcoma Referral Center. J Clin Med 2020; 9:jcm9082503. [PMID: 32759634 PMCID: PMC7465593 DOI: 10.3390/jcm9082503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/19/2020] [Accepted: 07/28/2020] [Indexed: 11/16/2022] Open
Abstract
The high complexity of multimodality treatment frequently results in undertreatment of elderly sarcoma patients, and this may be one of the factors that influence their prognosis. We describe the real-life approach to a population of patients aged over 70 with both soft tissue (STS) and bone sarcomas (BS) followed by our Sarcoma Disease Management Team from 2012 to 2017. One-hundred and twenty-three patients with a median age of 77 years (range: 70–92) were identified. STS were the most common histological subtypes (94%) and the grade was high in 79/123 patients (64%). At diagnosis, 88% of patients had localized disease (LD) and 12% were metastatic (MD). Overall, 96% of patients with LD underwent surgery, 46/54 (85%) with high grade STS patients underwent complementary radiotherapy, and 10/54 (19%) received adjuvant treatments. Twelve out of 33 patients who relapsed (36%) underwent local therapies. Seventeen (52%) and eight (24%) patients were treated with first-line and second-line medical treatments, respectively. Tolerability to systemic treatments was fairly good. Overall, 21% of the patients with advanced disease were candidates for best supportive care alone. Our case series of elderly patients with both STS and BS shows that personalized multidisciplinary treatment can nevertheless be offered to this frail population in order to control the evolution of disease.
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Affiliation(s)
- Virginia Ferraresi
- First Division of Medical Oncology, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy; (S.V.); (D.P.); (F.C.)
- Correspondence: ; Tel.: +39-06-52666919
| | - Sabrina Vari
- First Division of Medical Oncology, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy; (S.V.); (D.P.); (F.C.)
| | - Barbara Rossi
- Oncological Orthopaedics Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy; (B.R.); (A.P.); (J.B.); (C.Z.); (R.B.)
| | - Gabriella Maggi
- Psychology Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy;
| | - Diana Giannarelli
- Biostatistic Unit—Scientific Direction, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy;
| | - Agnese Persichetti
- Oncological Orthopaedics Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy; (B.R.); (A.P.); (J.B.); (C.Z.); (R.B.)
| | - Maria Grazia Petrongari
- Department of Radiation Oncology, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy;
| | - Maria Cecilia Cercato
- Epidemiology and Cancer Registry Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy;
| | - Alessio Annovazzi
- Nuclear Medicine Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy;
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy;
| | - Edoardo Pescarmona
- Pathology, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy;
| | - Jacopo Baldi
- Oncological Orthopaedics Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy; (B.R.); (A.P.); (J.B.); (C.Z.); (R.B.)
| | - Carmine Zoccali
- Oncological Orthopaedics Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy; (B.R.); (A.P.); (J.B.); (C.Z.); (R.B.)
| | - Domenicangela Pellegrini
- First Division of Medical Oncology, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy; (S.V.); (D.P.); (F.C.)
| | - Francesco Cognetti
- First Division of Medical Oncology, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy; (S.V.); (D.P.); (F.C.)
| | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy; (B.R.); (A.P.); (J.B.); (C.Z.); (R.B.)
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Plantone D, Piantadosi C, Ruggieri S, Anelli V, Koudriavtseva T. Tumefactive Demyelinating Lesions and Pregnancy. Neurol India 2020; 67:1519-1521. [PMID: 31857550 DOI: 10.4103/0028-3886.273654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Until now, only one gestational tumefactive demyelinating lesion (TDL) has been described. Here we report two TDL cases occurring during and after the pregnancy. A 26-year-old 6-week pregnant woman developed a 3-cm left frontotemporoparietal subcortical TDL with inhomogeneous partial enhancement. Brain biopsy revealed a subacute demyelinating lesion with abundant macrophages and mild chronic perivascular inflammatory infiltrates. She also had femoralpopliteal deep vein thrombosis. During the 4-year follow-up, magnetic resonance imaging showed only residual biopsied TDL. The second case was a 41-year-woman affected by both multiple sclerosis (MS) and rheumatoid arthritis who developed a 2-cm right anterior corona radiata TDL with sporadic gadolinium-enhancing "annular spots" eight months after delivery. After steroid therapy at the 6-month radiological follow-up, this TDL was half-reduced. Five years earlier, at the beginning of her MS, she already had a 2-cm TDL with incomplete ring enhancement. These two described TDLs formed in prothrombotic conditions and were likely representative of thromboinflammation around and inside the small-medium veins.
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Affiliation(s)
- Domenico Plantone
- S.O.C. Neurologia, Ospedale San Biagio, Piazza Vittime dei Lager Nazifascisti 1, 28845, Domodossola (VB), Italy
| | - Carlo Piantadosi
- UOC Neurology, San Giovanni-Addolorata Hospital, Via dell'Amba Aradam 9, 00184, Rome, Italy
| | - Serena Ruggieri
- Department of Neurology and Psychiatry, Sapienza University, Viale dell'Università 30, 00185, Rome, Italy
| | - Vincenzo Anelli
- Department of Research, Advanced Diagnostics and Technological Innovation, IRCCS Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Tatiana Koudriavtseva
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy
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Zoccali C, Baldi J, Anelli V, Annovazzi A, Scotto di Uccio A, Arrigoni F, Barile A, Masciocchi C. The giant aggressive chondroma: A rare entity, a difficult approach. J Orthop 2020; 18:181-184. [PMID: 32042223 DOI: 10.1016/j.jor.2019.09.001] [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: 06/23/2019] [Accepted: 09/10/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction enchondromas rarely exceed 3-6 cm in long bones. Although the risk of developing secondary chondrosarcoma has been reported up to 4% in solitary lesions, it is not known if size represents a risk factor for transformation. Objective to describe three exceptional cases of enchondromas of the entire femur whereof one dedifferentiated in chondrosarcoma. Results two patients present stable disease at 5 and 6 years of follow-up; the third, already diagnosed with a dedifferentiated chondrosarcoma, died 14 months after the index surgery for systemic disease. Conclusion based on these observations, our hypothesis is that lesion size is an important risk factor for malignant transformation.
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Affiliation(s)
- Carmine Zoccali
- Oncological Orthopaedics Department, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Jacopo Baldi
- Oncological Orthopaedics Department, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Vincenzo Anelli
- Radiology Department, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Alessio Annovazzi
- Nuclear Medicine, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Alessandra Scotto di Uccio
- Oncological Orthopaedics Department, IRCCS - Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Francesco Arrigoni
- Diagnostic Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, via Vetoio, Coppito, 67010, L'Aquila, AQ, Italy
| | - Antonio Barile
- Diagnostic Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, via Vetoio, Coppito, 67010, L'Aquila, AQ, Italy
| | - Carlo Masciocchi
- Diagnostic Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, via Vetoio, Coppito, 67010, L'Aquila, AQ, Italy
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Annovazzi A, Anelli V, Zoccali C, Rumi N, Persichetti A, Novello M, Sciuto R, Bertoni F, Ferraresi V, Biagini R. 18F-FDG PET/CT in the evaluation of cartilaginous bone neoplasms: the added value of tumor grading. Ann Nucl Med 2019; 33:813-821. [PMID: 31396797 DOI: 10.1007/s12149-019-01392-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 06/28/2019] [Accepted: 07/31/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Cartilaginous bone tumors represent a wide variety of neoplasms ranging from benign to extremely aggressive malignant lesions. Unlike other tumors, the biopsy cannot easily predict the histological grade, sometimes not allowing choosing the best therapeutic approach. The aim of the study was to evaluate the ability of 18F-FDG PET/CT to differentiate enchondroma from chondrosarcoma and to predict the histological grade as compared to biopsy. METHODS 18F-FDG PET/CT of 95 patients with chondroid lesions were retrospectively evaluated. The best SUVmax cutoff to predict the post-surgical histological grade were correlated to those of biopsy and to several radiologic aggressiveness features, which were summarized in the parameter "Radiologic Aggressiveness Score" (AgSCORE). RESULTS A concordance between the preoperative biopsy and the definitive histological grade was observed overall in 78.3% of patients, the lowest accuracy (58.6%) being in the identification of intermediate/high-grade chondrosarcoma (G2/G3). The best SUVmax cutoff was 2.6 to discriminate enchondroma vs. low-grade chondrosarcoma (sensitivity 0.68, specificity 0.86), 3.7 to differentiate low-grade vs. intermediate/high-grade chondrosarcoma (sensitivity 0.83, specificity 0.84) and 7.7 to differentiate intermediate/high-grade vs. dedifferentiated chondrosarcoma (sensitivity 0.92, specificity 0.9). The AgSCORE also showed a high accuracy to differentiate between G1 and G2/G3 chondrosarcoma (cutoff = 4; sensitivity 0.76; specificity 0.89). An even higher accuracy was observed in those cases in which both SUVmax and AgSCORE cutoff were concordant. CONCLUSIONS Results in this large series of patients suggest a potential role of 18F-FDG PET/CT for histological grading of cartilaginous tumors, thus helping the orthopedic surgeon towards the most appropriate surgical procedure.
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Affiliation(s)
- Alessio Annovazzi
- Nuclear Medicine Unit, IRCCS-Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144, Rome, Italy.
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Carmine Zoccali
- Oncological Orthopaedics Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Nicolò Rumi
- Department of Radiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Agnese Persichetti
- Oncological Orthopaedics Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Mariangela Novello
- Pathology Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy.,Pathology, S. Bortolo Hospital, Vicenza, Italy
| | - Rosa Sciuto
- Nuclear Medicine Unit, IRCCS-Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144, Rome, Italy
| | - Franco Bertoni
- Department of Pathology, Villa Erbosa Hospital, Bologna, Italy
| | - Virginia Ferraresi
- First Division of Medical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
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Vari S, Zoccali C, Anelli V, Annovazzi A, Petrongari M, Maggi G, Giannarelli D, Salducca N, Favale L, Zeuli M, Biagini R, Latini A, Faltyn W, Anza M, Covello R, Baldi J, Pellegrini D, Checcucci E, Cognetti F, Ferraresi V. Should we consider altering our patterns of care for elderly sarcoma patients? Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.052] [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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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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21
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Allegretti M, Casini B, Mandoj C, Benini S, Alberti L, Novello M, Melucci E, Conti L, Covello R, Pescarmona E, Milano GM, Annovazzi A, Anelli V, Ferraresi V, Biagini R, Giacomini P. Precision diagnostics of Ewing's sarcoma by liquid biopsy: circulating EWS-FLI1 fusion transcripts. Ther Adv Med Oncol 2018; 10:1758835918774337. [PMID: 29899761 PMCID: PMC5985603 DOI: 10.1177/1758835918774337] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/26/2018] [Indexed: 12/25/2022] Open
Abstract
Background: Limited information is available on the applicative value of liquid biopsy (LB) in rare tumors, including Ewing’s sarcoma (ES). The accepted precision diagnostics standards would greatly benefit from a non-invasive LB test monitoring pathognomonic gene rearrangements in the bloodstream. Methods: Tissue and blood samples were collected from six and four ES patients, respectively. Plasma was cleared by two successive rounds of centrifugation and stored frozen until RNA extraction by the QIAmp CNA kit. RNA was retro-transcribed and subjected to real-time quantitative polymerase chain reaction (RT-qPCR) and digital polymerase chain reaction (dPCR). Reactions were set up using two custom primer sets identifying types 1 and 2 EWS-FLI1 fusion transcripts. Results: The two prevalent types of EWS-FLI1 rearrangements could be identified using only two sets of polymerase chain reaction primers, regardless of patient-specific EWS-FLI1 DNA breakpoints. RT-qPCR and dPCR discriminated the two variants in five tumor tissue RNAs and in four circulating tumor RNAs (ctRNAs). Of note, EWS-FLI1 molecular diagnosis was possible using blood samples even when tumor tissue was not available. ctRNA levels correlated (p < 0.05) with volume-based positron emission tomography (PET) parameters (metabolic tumor volume and total lesion glycolysis), and allowed the fine tracking of disease course after surgery, during adjuvant as well as neoadjuvant chemotherapy, and at follow up in one patient. Conclusions: To our knowledge, this is one of the few single-marker LB assays in solid tumors specifically designed to detect rearranged RNAs in blood, and the first study describing EWS circulating tumor RNAs in ES patients. Altogether, our results support the idea that LB may have a considerable impact on ES patient monitoring and management.
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Affiliation(s)
- Matteo Allegretti
- Oncogenomics and Epigenetics, IRCCS Regina Elena National Cancer Institute, Via E Chianesi 53, Rome, 00144, Italy
| | - Beatrice Casini
- Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Chiara Mandoj
- Body Fluids Biobank, Clinical Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Stefania Benini
- Department of Pathology, The Rizzoli Institute, Bologna, Italy
| | | | - Mariangela Novello
- Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy (Present address): Department of Pathology, San Bortolo Hospital, Vicenza, Italy
| | - Elisa Melucci
- Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Conti
- Body Fluids Biobank, Clinical Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Renato Covello
- Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Giuseppe Maria Milano
- Department of Hematology/Oncology, Bambino Gesù Children's Hospital IRCSS, Rome, Italy
| | - Alessio Annovazzi
- Nuclear Medicine, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Virginia Ferraresi
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Roberto Biagini
- Orthopedics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizio Giacomini
- Oncogenomics and Epigenetics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Pizzi G, Paladini A, Vallati G, Anelli V, Cappelli F. 3:09 PM Abstract No. 251 Osteoid osteoma treated with radiofrequency ablation in non–operating room anesthesia: our experience in 61 cases. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.281] [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: 11/17/2022] Open
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23
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Mori F, Sacconi A, Canu V, Ganci F, Novello M, Anelli V, Covello R, Ferraresi V, Muti P, Biagini R, Blandino G, Strano S. miR-181c associates with tumor relapse of high grade osteosarcoma. Oncotarget 2016; 6:13946-61. [PMID: 26062442 PMCID: PMC4546443 DOI: 10.18632/oncotarget.3539] [Citation(s) in RCA: 19] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 02/17/2015] [Indexed: 11/25/2022] Open
Abstract
High-grade osteosarcoma (OS) is characterized by low incidence, high aggressiveness and moderate 5-years survival rate after aggressive poly-chemotherapy and surgery. Here we used miRNA profiling as a tool to possibly predict and monitor OS's development and therapeutic outcome. First, we evaluated the altered expression of selected miRNAs from a case of Giant Cell Tumor (GCT) apparently evolved into an OS. We found that most of modulated miRs were associated with pathways of bone resorption and osteogenesis. miRNA expression also revealed that GCT and OS were distinct tumors. Second, we validated the observed miRNA profile in two independent casuistries of ten GCT (not evolved into malignant tumors) and sixteen OS patients. Interestingly, we found that miR-181c and other three miRNAs identified in the first step of the study were also consistently de-regulated in all OS patients. Ectopic expression of miR-181c reduced cell viability and enhanced chemotherapeutic-induced cell death of U2OS and SAOS2 cells. These findings indicate that: i) miRNAs aberrantly modulated in GCT could be predictive of its development into OS and ii) miRNAs expression could be useful to monitor the OS therapeutic outcome.
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Affiliation(s)
- Federica Mori
- Molecular Chemoprevention Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Sacconi
- Translational Oncogenomics, Regina Elena National Cancer Institute, Rome, Italy
| | - Valeria Canu
- Translational Oncogenomics, Regina Elena National Cancer Institute, Rome, Italy
| | - Federica Ganci
- Translational Oncogenomics, Regina Elena National Cancer Institute, Rome, Italy
| | | | - Vincenzo Anelli
- UOC Radiology, Regina Elena National Cancer Institute, Rome, Italy
| | - Renato Covello
- UOC Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy
| | | | - Paola Muti
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Roberto Biagini
- UOC Orthopedic Surgery, Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanni Blandino
- Translational Oncogenomics, Regina Elena National Cancer Institute, Rome, Italy.,Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Sabrina Strano
- Molecular Chemoprevention Unit, Regina Elena National Cancer Institute, Rome, Italy.,Department of Oncology, McMaster University, Hamilton, ON, Canada
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Marzi S, Stefanetti L, Sperati F, Anelli V. Relationship between diffusion parameters derived from intravoxel incoherent motion MRI and perfusion measured by dynamic contrast-enhanced MRI of soft tissue tumors. NMR Biomed 2016; 29:6-14. [PMID: 26602061 DOI: 10.1002/nbm.3446] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 10/21/2015] [Accepted: 10/21/2015] [Indexed: 06/05/2023]
Abstract
Our aim was to evaluate the link between diffusion parameters measured by intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and the perfusion metrics obtained with dynamic contrast-enhanced (DCE) MRI in soft tissue tumors (STTs). Twenty-eight patients affected by histopathologically confirmed STT were included in a prospective study. All patients underwent both DCE MRI and IVIM DWI. The perfusion fraction f, diffusion coefficient D and perfusion-related diffusion coefficient D* were estimated using a bi-exponential function to fit the DWI data. DCE MRI was acquired with a temporal resolution of 3-5 s. Maps of the initial area under the gadolinium concentration curve (IAUGC), time to peak (TTP) and maximum slope of increase (MSI) were derived using commercial software. The relationships between the DCE MRI and IVIM DWI measurements were assessed by Spearman's test. To exclude false positive results under multiple testing, the false discovery rate (FDR) procedure was applied. The Mann-Whitney test was used to evaluate the differences between all variables in patients with non-myxoid and myxoid STT. No significant relationship was found between IVIM parameters and any DCE MRI parameters. Higher f and D*f values were found in non-myxoid tumors compared with myxoid tumors (p = 0.004 and p = 0.003, respectively). MSI was significantly higher in non-myxoid tumors than in myxoid tumors (p = 0.029). From the visual assessments of single clinical cases, both f and D*f maps were in satisfactory agreement with DCE maps in the extreme cases of an avascular mass and a highly vascularized mass, whereas, for tumors with slight vascularity or with a highly heterogeneous perfusion pattern, this association was not straightforward. Although IVIM DWI was demonstrated to be feasible in STT, our data did not support evident relationships between perfusion-related IVIM parameters and perfusion measured by DCE MRI.
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Affiliation(s)
- Simona Marzi
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Rome, Italy
| | - Linda Stefanetti
- Department of Radiology, S. Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy
| | - Francesca Sperati
- Biostatistics-Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Department, Regina Elena National Cancer Institute, Rome, Italy
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Mazzara C, Vari S, Vaccaro V, Pozzi M, Corrado G, Fabi A, Anelli V, Ceribelli A, De Marco S, Dell'Antonio G, Aloi F, Savarese A. Fighting cancer in developing countries: a cooperative model of oncology service in uganda. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.15] [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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26
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Pellini R, Manciocco V, Turri-Zanoni M, Vidiri A, Sanguineti G, Marucci L, Sciuto R, Covello R, Sperduti I, Kayal R, Anelli V, Pichi B, Mercante G, Spriano G. Planned neck dissection after chemoradiotherapy in advanced oropharyngeal squamous cell cancer: The role of US, MRI and FDG-PET/TC scans to assess residual neck disease. J Craniomaxillofac Surg 2014; 42:1834-9. [DOI: 10.1016/j.jcms.2014.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Revised: 06/29/2014] [Accepted: 06/30/2014] [Indexed: 10/25/2022] Open
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Zoccali C, Anelli V, Chichierchia G, Erba F, Biagini R. The use of engineered biomaterial Bone Plexur M® in benign epiphyseal tumors: our experience at 20 months of follow-up. J BIOL REG HOMEOS AG 2014; 28:65-71. [PMID: 24750792] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The objective is to reconstruct the subchondral bone after curettage of benign tumors located in the epiphysis, a relevant topic in oncological orthopedics. Several bones substituted are commercially available, yet none of these are suitably moldable to repair or be placed in the bone defect; although autologous bone for little defects and homologous for bigger defects are still considered the standard in reconstruction, we verify the ability to adapt and support articular cartilage through the application of Plexur M (Registered Trademark), a newly engineered biomaterial bone. In the present study, we enrolled the first ten consecutive cases referred to our department, where patients were affected by a benign epiphyseal tumor destroying the subchondral bone through to the articular cartilage. Every patient underwent curettage of the disease, apposition of a newly engineered biomaterial bone and filling with homologous morselized bone. The quality of reconstruction was evaluated by two surgeons and by a radiologist based on the achievement of surgical objectives and comparing pre and postoperative imaging. In seven out of eight cases of lesions located in the lower limbs the quality of reconstruction was considered good, restoring an adequate support to the articular cartilage. The quality of the remaining case was considered poor probably due to the extent of the spread of the disease, which destroyed the entire proximal tibial epiphysis. In the two cases where the disease was located in the upper limbs, the Plexur M application restored support to the articular cartilage sufficiently well. However, in the case of a giant cell tumor of the distal radial epiphysis there was a slight reabsorption of the morselized homologous bone. Our series suggest that Plexur M should be considered a valid option for orthopedic surgeons in restoring adequate mechanical support to the articular cartilage; nevertheless, considering its high cost, its use might be reserved to selected cases until further studies can verify the integration process, the effects on the survival of the articular cartilage and on the prevention of premature osteoarthritis.
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Affiliation(s)
- C Zoccali
- Regina Elena National Cancer Institute, Rome, Italy
| | - V Anelli
- Regina Elena National Cancer Institute, Rome, Italy
| | | | - F Erba
- Regina Elena National Cancer Institute, Rome, Italy
| | - R Biagini
- Regina Elena National Cancer Institute, Rome, Italy
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Ambady P, Holdhoff M, Ferrigno C, Grossman S, Anderson MD, Liu D, Conrad C, Penas-Prado M, Gilbert MR, Yung AWK, de Groot J, Aoki T, Nishikawa R, Sugiyama K, Nonoguchi N, Kawabata N, Mishima K, Adachi JI, Kurisu K, Yamasaki F, Tominaga T, Kumabe T, Ueki K, Higuchi F, Yamamoto T, Ishikawa E, Takeshima H, Yamashita S, Arita K, Hirano H, Yamada S, Matsutani M, Apok V, Mills S, Soh C, Karabatsou K, Arimappamagan A, Arya S, Majaid M, Somanna S, Santosh V, Schaff L, Armentano F, Harrison C, Lassman A, McKhann G, Iwamoto F, Armstrong T, Yuan Y, Liu D, Acquaye A, Vera-Bolanos E, Diefes K, Heathcock L, Cahill D, Gilbert M, Aldape K, Arrillaga-Romany I, Ruddy K, Greenberg S, Nayak L, Avgeropoulos N, Avgeropoulos G, Riggs G, Reilly C, Banerji N, Bruns P, Hoag M, Gilliland K, Trusheim J, Bekaert L, Borha A, Emery E, Busson A, Guillamo JS, Bell M, Harrison C, Armentano F, Lassman A, Connolly ES, Khandji A, Iwamoto F, Blakeley J, Ye X, Bergner A, Dombi E, Zalewski C, Follmer K, Halpin C, Fayad L, Jacobs M, Baldwin A, Langmead S, Whitcomb T, Jennings D, Widemann B, Plotkin S, Brandes AA, Mason W, Pichler J, Nowak AK, Gil M, Saran F, Revil C, Lutiger B, Carpentier AF, Milojkovic-Kerklaan B, Aftimos P, Altintas S, Jager A, Gladdines W, Lonnqvist F, Soetekouw P, van Linde M, Awada A, Schellens J, Brandsma D, Brenner A, Sun J, Floyd J, Hart C, Eng C, Fichtel L, Gruslova A, Lodi A, Tiziani S, Bridge CA, Baldock A, Kumthekar P, Dilfer P, Johnston SK, Jacobs J, Corwin D, Guyman L, Rockne R, Sonabend A, Cloney M, Canoll P, Swanson KR, Bromberg J, Schouten H, Schaafsma R, Baars J, Brandsma D, Lugtenburg P, van Montfort C, van den Bent M, Doorduijn J, Spalding A, LaRocca R, Haninger D, Saaraswat T, Coombs L, Rai S, Burton E, Burzynski G, Burzynski S, Janicki T, Marszalek A, Burzynski S, Janicki T, Burzynski G, Marszalek A, Cachia D, Smith T, Cardona AF, Mayor LC, Jimenez E, Hakim F, Yepes C, Bermudez S, Useche N, Asencio JL, Mejia JA, Vargas C, Otero JM, Carranza H, Ortiz LD, Cardona AF, Ortiz LD, Jimenez E, Hakim F, Yepes C, Useche N, Bermudez S, Asencio JL, Carranza H, Vargas C, Otero JM, Bartels C, Quintero A, Restrepo CE, Gomez S, Bernal-Vaca L, Lema M, Cardona AF, Ortiz LD, Useche N, Bermudez S, Jimenez E, Hakim F, Yepes C, Mejia JA, Bernal-Vaca L, Restrepo CE, Gomez S, Quintero A, Bartels C, Carranza H, Vargas C, Otero JM, Carlo M, Omuro A, Grommes C, Kris M, Nolan C, Pentsova E, Pietanza M, Kaley T, Carrabba G, Giammattei L, Draghi R, Conte V, Martinelli I, Caroli M, Bertani G, Locatelli M, Rampini P, Artoni A, Carrabba G, Bertani G, Cogiamanian F, Ardolino G, Zarino B, Locatelli M, Caroli M, Rampini P, Chamberlain M, Raizer J, Soffetti R, Ruda R, Brandsma D, Boogerd W, Taillibert S, Le Rhun E, Jaeckle K, van den Bent M, Wen P, Chamberlain M, Chinot OL, Wick W, Mason W, Henriksson R, Saran F, Nishikawa R, Carpentier AF, Hoang-Xuan K, Kavan P, Cernea D, Brandes AA, Hilton M, Kerloeguen Y, Guijarro A, Cloughsey T, Choi JH, Hong YK, Conrad C, Yung WKA, deGroot J, Gilbert M, Loghin M, Penas-Prado M, Tremont I, Silberman S, Picker D, Costa R, Lycette J, Gancher S, Cullen J, Winer E, Hochberg F, Sachs G, Jeyapalan S, Dahiya S, Stevens G, Peereboom D, Ahluwalia M, Daras M, Hsu M, Kaley T, Panageas K, Curry R, Avila E, Fuente MDL, Omuro A, DeAngelis L, Desjardins A, Sampson J, Peters K, Ranjan T, Vlahovic G, Threatt S, Herndon J, Boulton S, Lally-Goss D, McSherry F, Friedman A, Friedman H, Bigner D, Gromeier M, Prust M, Kalpathy-Cramer J, Poloskova P, Jafari-Khouzani K, Gerstner E, Dietrich J, Fabi A, Villani V, Vaccaro V, Vidiri A, Giannarelli D, Piludu F, Anelli V, Carapella C, Cognetti F, Pace A, Flowers A, Flowers A, Killory B, Furuse M, Miyatake SI, Kawabata S, Kuroiwa T, Garciarena P, Anderson MD, Hamilton J, Schellingerhout D, Fuller GN, Sawaya R, Gilbert MR, Gilbert M, Pugh S, Won M, Blumenthal D, Vogelbaum M, Aldape K, Colman H, Chakravarti A, Jeraj R, Dignam J, Armstrong T, Wefel J, Brown P, Jaeckle K, Schiff D, Brachman D, Werner-Wasik M, Tremont-Lukats I, Sulman E, Mehta M, Gill B, Yun J, Goldstein H, Malone H, Pisapia D, Sonabend AM, Mckhann GK, Sisti MB, Sims P, Canoll P, Bruce JN, Girvan A, Carter G, Li L, Kaltenboeck A, Chawla A, Ivanova J, Koh M, Stevens J, Lahn M, Gore M, Hariharan S, Porta C, Bjarnason G, Bracarda S, Hawkins R, Oudard S, Zhang K, Fly K, Matczak E, Szczylik C, Grossman R, Ram Z, Hamza M, O'Brien B, Mandel J, DeGroot J, Han S, Molinaro A, Berger M, Prados M, Chang S, Clarke J, Butowski N, Hashimoto N, Chiba Y, Tsuboi A, Kinoshita M, Hirayama R, Kagawa N, Oka Y, Oji Y, Sugiyama H, Yoshimine T, Hawkins-Daarud A, Jackson PR, Swanson KR, Sarmiento JM, Ly D, Jutla J, Ortega A, Carico C, Dickinson H, Phuphanich S, Rudnick J, Patil C, Hu J, Iglseder S, Nowosielski M, Nevinny-Stickel M, Stockhammer G, Jain R, Poisson L, Scarpace L, Mikkelsen T, Kirby J, Freymann J, Hwang S, Gutman D, Jaffe C, Brat D, Flanders A, Janicki T, Burzynski S, Burzynski G, Marszalek A, Jiang C, Wang H, Jo J, Williams B, Smolkin M, Wintermark M, Shaffrey M, Schiff D, Juratli T, Soucek S, Kirsch M, Schackert G, Kakkar A, Kumar S, Bhagat U, Kumar A, Suri A, Singh M, Sharma M, Sarkar C, Suri V, Kaley T, Barani I, Chamberlain M, McDermott M, Raizer J, Rogers L, Schiff D, Vogelbaum M, Weber D, Wen P, Kalita O, Vaverka M, Hrabalek L, Zlevorova M, Trojanec R, Hajduch M, Kneblova M, Ehrmann J, Kanner AA, Wong ET, Villano JL, Ram Z, Khatua S, Fuller G, Dasgupta S, Rytting M, Vats T, Zaky W, Khatua S, Sandberg D, Foresman L, Zaky W, Kieran M, Geoerger B, Casanova M, Chisholm J, Aerts I, Bouffet E, Brandes AA, Leary SES, Sullivan M, Bailey S, Cohen K, Mason W, Kalambakas S, Deshpande P, Tai F, Hurh E, McDonald TJ, Kieran M, Hargrave D, Wen PY, Goldman S, Amakye D, Patton M, Tai F, Moreno L, Kim CY, Kim T, Han JH, Kim YJ, Kim IA, Yun CH, Jung HW, Koekkoek JAF, Reijneveld JC, Dirven L, Postma TJ, Vos MJ, Heimans JJ, Taphoorn MJB, Koeppen S, Hense J, Kong XT, Davidson T, Lai A, Cloughesy T, Nghiemphu PL, Kong DS, Choi YL, Seol HJ, Lee JI, Nam DH, Kool M, Jones DTW, Jager N, Northcott PA, Pugh T, Hovestadt V, Markant S, Esparza LA, Bourdeaut F, Remke M, Taylor MD, Cho YJ, Pomeroy SL, Schuller U, Korshunov A, Eils R, Wechsler-Reya RJ, Lichter P, Pfister SM, Krel R, Krutoshinskaya Y, Rosiello A, Seidman R, Kowalska A, Kudo T, Hata Y, Maehara T, Kumthekar P, Bridge C, Patel V, Rademaker A, Helenowski I, Mrugala M, Rockhill J, Swanson K, Grimm S, Raizer J, Meletath S, Bennett M, Nestor VA, Fink KL, Lee E, Reardon D, Schiff D, Drappatz J, Muzikansky A, Hammond S, Grimm S, Norden A, Beroukhim R, McCluskey C, Chi A, Batchelor T, Smith K, Gaffey S, Gerard M, Snodgras S, Raizer J, Wen P, Leeper H, Johnson D, Lima J, Porensky E, Cavaliere R, Lin A, Liu J, Evans J, Leuthardt E, Dacey R, Dowling J, Kim A, Zipfel G, Grubb R, Huang J, Robinson C, Simpson J, Linette G, Chicoine M, Tran D, Liubinas SV, D'Abaco GM, Moffat B, Gonzales M, Feleppa F, Nowell CJ, Gorelick A, Drummond KJ, Morokoff AP, O'Brien TJ, Kaye AH, Loghin M, Melhem-Bertrandt A, Penas-Prado M, Zaidi T, Katz R, Lupica K, Stevens G, Ly I, Hamilton S, Rostomily R, Rockhill J, Mrugala M, Mandel J, Yust-Katz S, de Groot J, Yung A, Gilbert M, Burzynski S, Janicki T, Burzynski G, Marszalek A, Pachow D, Kliese N, Kirches E, Mawrin C, McNamara MG, Lwin Z, Jiang H, Chung C, Millar BA, Sahgal A, Laperriere N, Mason WP, Megyesi J, Salehi F, Merker V, Slusarz K, Muzikansky A, Francis S, Plotkin S, Mishima K, Adachi JI, Suzuki T, Uchida E, Yanagawa T, Watanabe Y, Fukuoka K, Yanagisawa T, Wakiya K, Fujimaki T, Nishikawa R, Moiyadi A, Kannan S, Sridhar E, Gupta T, Shetty P, Jalali R, Alshami J, Lecavalier-Barsoum M, Guiot MC, Tampieri D, Kavan P, Muanza T, Nagane M, Kobayashi K, Takayama N, Shiokawa Y, Nakamura H, Makino K, Hideo T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Nambudiri N, Arrilaga I, Dunn I, Folkerth R, Chi S, Reardon D, Nayak L, Omuro A, DeAngelis L, Robins HI, Govindan R, Gadgeel S, Kelly K, Rigas J, Reimers HJ, Peereboom D, Rosenfeld S, Garst J, Ramnath N, Wing P, Zheng M, Urban P, Abrey L, Wen P, Nayak L, DeAngelis LM, Wen PY, Brandes AA, Soffietti R, Peereboom DM, Lin NU, Chamberlain M, Macdonald D, Galanis E, Perry J, Jaeckle K, Mehta M, Stupp R, van den Bent M, Reardon DA, Norden A, Hammond S, Drappatz J, Phuphanich S, Reardon D, Wong E, Plotkin S, Lesser G, Raizer J, Batchelor T, Lee E, Kaley T, Muzikansky A, Doherty L, LaFrankie D, Ruland S, Smith K, Gerard M, McCluskey C, Wen P, Norden A, Schiff D, Ahluwalia M, Lesser G, Nayak L, Lee E, Muzikansky A, Dietrich J, Smith K, Gaffey S, McCluskey C, Ligon K, Reardon D, Wen P, Bush NAO, Kesari S, Scott B, Ohno M, Narita Y, Miyakita Y, Arita H, Matsushita Y, Yoshida A, Fukushima S, Ichimura K, Shibui S, Okamura T, Kaneko S, Omuro A, Chinot O, Taillandier L, Ghesquieres H, Soussain C, Delwail V, Lamy T, Gressin R, Choquet S, Soubeyran P, Maire JP, Benouaich-Amiel A, Lebouvier-Sadot S, Gyan E, Barrie M, del Rio MS, Gonzalez-Aguilar A, Houllier C, Tanguy ML, Hoang-Xuan K, Omuro A, Abrey L, Raizer J, Paleologos N, Forsyth P, DeAngelis L, Kaley T, Louis D, Cairncross JG, Matasar M, Mehta J, Grimm S, Moskowitz C, Sauter C, Opinaldo P, Torcuator R, Ortiz LD, Cardona AF, Hakim F, Jimenez E, Yepes C, Useche N, Bermudez S, Mejia JA, Asencio JL, Carranza H, Vargas C, Otero JM, Lema M, Pace A, Villani V, Fabi A, Carapella CM, Patel A, Allen J, Dicker D, Sheehan J, El-Deiry W, Glantz M, Tsyvkin E, Rauschkolb P, Pentsova E, Lee M, Perez A, Norton J, Uschmann H, Chamczuck A, Khan M, Fratkin J, Rahman R, Hempfling K, Norden A, Reardon DA, Nayak L, Rinne M, Doherty L, Ruland S, Rai A, Rifenburg J, LaFrankie D, Wen P, Lee E, Ranjan T, Peters K, Vlahovic G, Friedman H, Desjardins A, Reveles I, Brenner A, Ruda R, Bello L, Castellano A, Bertero L, Bosa C, Trevisan E, Riva M, Donativi M, Falini A, Soffietti R, Saran F, Chinot OL, Henriksson R, Mason W, Wick W, Nishikawa R, Dahr S, Hilton M, Garcia J, Cloughesy T, Sasaki H, Nishiyama Y, Yoshida K, Hirose Y, Schwartz M, Grimm S, Kumthekar P, Fralin S, Rice L, Drawz A, Helenowski I, Rademaker A, Raizer J, Schwartz K, Chang H, Nikolai M, Kurniali P, Olson K, Pernicone J, Sweeley C, Noel M, Sharma M, Gupta R, Suri V, Singh M, Sarkar C, Shibahara I, Sonoda Y, Saito R, Kanamori M, Yamashita Y, Kumabe T, Watanabe M, Suzuki H, Watanabe T, Ishioka C, Tominaga T, Shih K, Chowdhary S, Rosenblatt P, Weir AB, Shepard G, Williams JT, Shastry M, Hainsworth JD, Singer S, Riely GJ, Kris MG, Grommes C, Sanders MWCB, Arik Y, Seute T, Robe PAJT, Leijten FSS, Snijders TJ, Sturla L, Culhane JJ, Donahue J, Jeyapalan S, Suchorska B, Jansen N, Wenter V, Eigenbrod S, Schmid-Tannwald C, Zwergal A, Niyazi M, Bartenstein P, Schnell O, Kreth FW, LaFougere C, Tonn JC, Taillandier L, Wittwer B, Blonski M, Faure G, De Carvalho M, Le Rhun E, Tanaka K, Sasayama T, Nishihara M, Mizukawa K, Kohmura E, Taylor S, Newell K, Graves L, Timmer M, Cramer C, Rohn G, Goldbrunner R, Turner S, Gergel T, Lacroix M, Toms S, Ueki K, Higuchi F, Sakamoto S, Kim P, Salgado MAV, Rueda AG, Urzaiz LL, Villanueva MG, Millan JMS, Cervantes ER, Pampliega RA, de Pedro MDA, Berrocal VR, Mena AC, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Hoekstra O, van Dongen G, Kaspers GJ, Schlamann A, von Bueren AO, Hagel C, Kramm C, Kortmann RD, Muller K, Friedrich C, Muller K, von Hoff K, Kwiecien R, Pietsch T, Warmuth-Metz M, Gerber NU, Hau P, Kuehl J, Kortmann RD, von Bueren AO, Rutkowski S, von Bueren AO, Friedrich C, von Hoff K, Kwiecien R, Muller K, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Walker J, Tremont I, Armstrong T, Wang H, Jiang C, Wang H, Jiang C, Warren P, Robert S, Lahti A, White D, Reid M, Nabors L, Sontheimer H, Wen P, Yung A, Mellinghoff I, Lamborn K, Ramkissoon S, Cloughesy T, Rinne M, Omuro A, DeAngelis L, Gilbert M, Chi A, Batchelor T, Colman H, Chang S, Nayak L, Massacesi C, DiTomaso E, Prados M, Reardon D, Ligon K, Wong ET, Elzinga G, Chung A, Barron L, Bloom J, Swanson KD, Elzinga G, Chung A, Wong ET, Wu W, Galanis E, Wen P, Das A, Fine H, Cloughesy T, Sargent D, Yoon WS, Yang SH, Chung DS, Jeun SS, Hong YK, Yust-Katz S, Milbourne A, Diane L, Gilbert M, Armstrong T, Zaky W, Weinberg J, Fuller G, Ketonen L, McAleer MF, Ahmed N, Khatua S, Zaky W, Olar A, Stewart J, Sandberg D, Foresman L, Ketonen L, Khatua S. NEURO/MEDICAL ONCOLOGY. Neuro Oncol 2013; 15:iii98-iii135. [PMCID: PMC3823897 DOI: 10.1093/neuonc/not182] [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] [Indexed: 08/14/2023] Open
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Arakawa Y, Fujimoto KI, Murata D, Nakamoto Y, Okada T, Miyamoto S, Bahr O, Harter PN, Weise L, You SJ, Ronellenfitsch MW, Rieger J, Steinbach JP, Hattingen E, Bahr O, Jurcoane A, Daneshvar K, Pilatus U, Mittelbronn M, Steinbach JP, Hattingen E, Carrillo J, Bota D, Handwerker J, Su LMY, Chen T, Stathopoulos A, Yu H, Chang JH, Kim EH, Kim SH, Mi, Yun J, Pytel P, Collins J, Choi Y, Lukas R, Nicholas M, Colen R, Jafrani R, Zinn P, Colen R, Ashour O, Zinn P, Colen R, Vangel M, Gutman D, Hwang S, Wintermark M, Jain R, Jilwan-Nicolas M, Chen J, Raghavan P, Holder C, Rubin D, Huang E, Kirby J, Freymann J, Jaffe C, Flanders A, Zinn P, Colen R, Ashour O, Zinn P, Colen R, Zinn P, Dahiya S, Statsevych V, Elson P, Xie H, Chao S, Peereboom D, Stevens G, Barnett G, Ahluwalia M, Daras M, Karimi S, Abrey L, Sanchez J, Beal K, Gutin P, Kaley T, Grommes C, Correa D, Reiner A, Briggs S, Omuro A, Verburg N, Hoefnagels F, Pouwels P, Boellaard R, Barkhof F, Hoekstra O, Wesseling P, Reijneveld J, Heimans J, Vandertop P, Zwinderman K, Hamer HDW, Elinzano H, Kadivar F, Yadav PO, Breese VL, Jackson CL, Donahue JE, Boxerman JL, Ellingson B, Pope W, Lai A, Nghiemphu P, Cloughesy T, Ellingson B, Pope W, Chen W, Czernin J, Phelps M, Lai A, Nghiemphu P, Liau L, Cloughesy T, Ellingson B, Leu K, Tran A, Pope W, Lai A, Nghiemphu P, Harris R, Woodworth D, Cloughesy T, Ellingson B, Pope W, Leu K, Chen W, Czernin J, Phelps M, Lai A, Nghiemphu P, Liau L, Cloughesy T, Ellingson B, Enzmann D, Pope W, Lai A, Nghiemphu P, Liau L, Cloughesy T, Eoli M, Di Stefano AL, Aquino D, Scotti A, Anghileri E, Cuppini L, Prodi E, Finocchiaro G, Bruzzone MG, Fujimoto K, Arakawa Y, Murata D, Nakamoto Y, Okada T, Miyamoto S, Galldiks N, Stoffels G, Filss C, Dunkl V, Rapp M, Sabel M, Ruge MI, Goldbrunner R, Shah NJ, Fink GR, Coenen HH, Langen KJ, Guha-Thakurta N, Langford L, Collet S, Valable S, Constans JM, Lechapt-Zalcman E, Roussel S, Delcroix N, Bernaudin M, Abbas A, Ibazizene E, Barre L, Derlon JM, Guillamo JS, Harris R, Bookheimer S, Cloughesy T, Kim H, Pope W, Yang K, Lai A, Nghiemphu P, Ellingson B, Huang R, Rahman R, Hamdan A, Kane C, Chen C, Norden A, Reardon D, Mukundan S, Wen P, Jafrani R, Zinn P, Colen R, Jafrani R, Zinn P, Colen R, Jancalek R, Bulik M, Kazda T, Jensen R, Salzman K, Kamson D, Lee T, Varadarajan K, Robinette N, Muzik O, Chakraborty P, Barger G, Mittal S, Juhasz C, Kamson D, Barger G, Robinette N, Muzik O, Chakraborty P, Kupsky W, Mittal S, Juhasz C, Kinoshita M, Sasayama T, Narita Y, Kawaguchi A, Yamashita F, Chiba Y, Kagawa N, Tanaka K, Kohmura E, Arita H, Okita Y, Ohno M, Miyakita Y, Shibui S, Hashimoto N, Yoshimine T, Ronan LK, Eskey C, Hampton T, Fadul C, LaMontagne P, Milchenko M, Sylvester P, Benzinger T, Marcus D, Fouke SJ, Lupo J, Bian W, Anwar M, Banerjee S, Hess C, Chang S, Nelson S, Mabray M, Sanchez L, Valles F, Barajas R, Rubenstein J, Cha S, Miyake K, Ogawa D, Hatakeyama T, Kawai N, Tamiya T, Mori K, Ishikura R, Tomogane Y, Ando K, Izumoto S, Nelson S, Lieberman F, Lupo J, Viziri S, Nabors LB, Crane J, Wen P, Cote A, Peereboom D, Wen Q, Cloughesy T, Robins HI, Fisher J, Desideri S, Grossman S, Ye X, Blakeley J, Nonaka M, Nakajima S, Shofuda T, Kanemura Y, Nowosielski M, Wiestler B, Gobel G, Hutterer M, Schlemmer H, Stockhammer G, Wick W, Bendszus M, Radbruch A, Perreault S, Yeom K, Ramaswamy V, Shih D, Remke M, Luu B, Schubert S, Fisher P, Partap S, Vogel H, Poussaint TY, Taylor M, Cho YJ, Piludu F, Pace A, Fabi A, Anelli V, Villani V, Carapella C, Marzi S, Vidiri A, Pungavkar S, Tanawde P, Epari S, Patkar D, Lawande M, Moiyadi A, Gupta T, Jalali R, Rahman R, Akgoz A, You H, Hamdan A, Seethamraju R, Wen P, Young G, Rao A, Rao G, Flanders A, Ghosh P, Rao G, Martinez J, Rao A, Roh TH, Kim EH, Chang JH, Kushnirsky M, Katz J, Knisely J, Schulder M, Steinklein J, Rosen L, Warshall C, Nguyen V, Tiwari P, Rogers L, Wolansky L, Sloan A, Barnholtz-Sloan J, Tatsauka C, Cohen M, Madabhushi A, Rachinger W, Thon N, Haug A, Schuller U, Schichor C, Tonn JC, Tran A, Lai A, Li S, Pope W, Teixeira S, Harris R, Woodworth D, Nghiemphu P, Cloughesy T, Ellingson B, Villanueva-Meyer J, Barajas R, Mabray M, Barani I, Chen W, Shankaranarayanan A, Koon P, Cha S, Wen Q, Elkhaled A, Essock-Burns E, Molinaro A, Phillips J, Chang S, Cha S, Nelson S, Wolf D, Ye X, Lim M, Zhu H, Wang M, Quinones-Hinojosa A, Weingart J, Olivi A, van Zijl P, Laterra J, Zhou J, Blakeley J, Zakaria R, Das K, Sluming V, Bhojak M, Walker C, Jenkinson MD, (Tiger) Yuan S, Tao R, Yang G, Chen Z, Mu D, Zhao S, Fu Z, Li W, Yu J. RADIOLOGY. Neuro Oncol 2013; 15:iii191-iii205. [PMCID: PMC3823904 DOI: 10.1093/neuonc/not189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Nuzzo C, Anelli V, Carpano S, Torsello A, Sergi D, Covello R, Zoccali C, Vaccaro V, Di Filippo F, Giannarelli D, Ferraresi V, Cognetti F. Tumor response assessment in locally unresectable or metastatic soft tissue sarcoma (aSTS) patients (pts): A three-year Regina Elena Cancer Institute (IRE) experience with trabectedin therapy. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e21517] [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
e21517 Background: Trabectedin has emerged as an effective agent for aSTS pts pretreated with anthracyclines and ifosfamide. Recent data suggest that RECIST criteria could underestimate tumor response. Methods: ASTS pts who received trabectedin as 2nd or further line of treatment were retrospectively reviewed. Tumor response was assessed using RECIST, mChoi and MASS criteria. A good response according to mChoi Criteria was defined as ≥ 10% mean decrease in tumor size or a ≥ 15% decrease in tumor attenuation on contrast-enhanced CT images. Predominantly solid enhancing target lesions were evaluated for marked central necrosis or marked decreased attenuation on axial contrast-enhanced CT images by MASS Criteria. Results: From May 2009 to December 2012, 30 pts with aSTS received trabectedin; pts characteristics are summarized in the table. Median number of previous treatment lines was 2 (range 1-5); median number of cycles administered was 4 (range 1–22 cycles). Treatment was well tolerated; main causes of dose-reduction were hematological and liver toxicities. Median progression free survival (PFS) was 8 wks (95% CI: 2-14); median overall survival (OS) was 44 wks (95% CI: 18-94). According to RECIST, 4 pts (15.4%)obtained a partial response (PR)), 9 pts (34.6%) achieved a stable disease (SD); tumor control rate was 50%. 13 pts (43%) obtained a progression of disease (PD). CT Scans of 13 pts were available for comparison of different response assessment methods (2 RP, 5 SD, and 6 PD). In our small series of pts concordance between the three radiologic methods tested was 90%. Conclusions: In aSTS patients treated with trabectedin, there is substantial concordance between mChoi, MASS and RECIST criteria. Prospective validation of the potential role of mChoi and MASS criteria in this setting is warranted. [Table: see text]
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Affiliation(s)
- Carmen Nuzzo
- Regina Elena National Cancer Institute, Rome, Italy
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Telera S, Fabi A, Pace A, Vidiri A, Anelli V, Carapella CM, Marucci L, Crispo F, Sperduti I, Pompili A. Radionecrosis induced by stereotactic radiosurgery of brain metastases: results of surgery and outcome of disease. J Neurooncol 2013; 113:313-25. [PMID: 23525948 DOI: 10.1007/s11060-013-1120-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 03/16/2013] [Indexed: 11/24/2022]
Abstract
Sterotactic radiosurgery (SRS) is an effective and commonly employed therapy for metastatic brain tumors. Among complication of this treatment, symptomatic focal cerebral radionecrosis (RN) occurs in 2-10 % of cases. The large diffusion of combined therapies as SRS followed by WBRT and/or CHT, has significantly amplified the number of patients who potentially might be affected by this pathology and neurosurgeons are increasingly called to treat suspected area of RN. Results of surgery of RN in patients with brain metastases are rarely reported in literature, a standardization of diagnostic work-up to correctly identify RN is still lacking and the timing and indications in favour of surgical therapy over medical treatments are not clear as well. In this retrospective study, we review current concept related to RN and analyze the outcome of surgical treatment in a series of 15 patients previously submitted to SRS for brain metastases and affected by suspected radionecrotic lesions. After surgery, all patients except one neurologically improved. No intra-operative complications occurred. Brain edema improved in all patients allowing a reduction or even suspension of corticosteroid therapy. Pure RN was histologically determined in 7 cases; RN and tumor recurrence in the other 8. Overall median survival was 19 months. An aggressive surgical attitude may be advisable in symptomatic patients with suspected cerebral RN, to have histologic confirmation of the lesion, to obtain a long-lasting relief from the mass effect and brain edema and to improve the overall quality of life, sparing a prolonged corticosteroid therapy.
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Affiliation(s)
- Stefano Telera
- Division of Neurosurgery, Istituto Nazionale Tumori Regina Elena, via Elio Chianesi 53, 00144, Rome, Italy.
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Onesti E, Koudriavtseva T, Galiè E, Anelli V, Jandolo B. A possible case of Hashimoto’s encephalopathy after surgery and radiometabolic therapy for thyroid carcinoma. Neurol Sci 2012; 34:1489-91. [DOI: 10.1007/s10072-012-1234-3] [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: 04/03/2012] [Accepted: 10/25/2012] [Indexed: 11/29/2022]
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Roth P, Silginer M, Goodman SL, Hasenbach K, Thies S, Schraml P, Tabatabai G, Moch H, Tritschler I, Weller M, Perin A, Verginelli F, Dali R, Hei Man Fung K, Lo R, Longatti P, Guiot M, Del Maestro RF, Rossi S, Di Porzio U, Stechishin O, Weiss S, Stifani S, Sanzey M, Golebiewska A, Stieber D, Nazarov P, Muller A, Vallar L, Niclou SP, Lawler SE, Chiocca E, Williams SP, Wanka C, Steinbach JP, Rieger J, Lavon I, Zrihan D, Refael M, Siegal T, Sminia P, Van Nifterik KA, Van den Berg J, Lafleur VM, Stalpers LJA, Slotman BJ, Di stefano A, Enciso-Mora V, Marie Y, Desestret V, Labussiere M, Idbaih A, Hoang-Xuan K, Delattre J, Houlston R, Sanson M, Woehrer A, Slavc I, Stefanits H, Waldhoer T, Heinzl H, Zielonke N, Czech T, Hainfellner JA, Haberler C, Zouaoui S, Darlix A, Virion J, Rigau V, Mathieu-Daude H, Bauchet F, Figarella-Branger D, Duffau H, Taillandier L, Bauchet L, Naydenov E, Popov R, Tanova R, Minkin K, De Vleeschouwer S, Van Gool S, Cavaletti G, Wilbers J, Hoebers F, Boogerd W, van 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Soffietti R, Mackinnon M, Williamson A, Lamb C, Chalmers A, Fukuoka K, Clark B, James A, Fernandez M, Blanchette M, Tremblay L, Lepage M, Fortin D, Matos Nunes B, Bujor L, Vasconcelos A, Kohga T, Amado A, Monteiro Grillo I, Muggeri AD, Calabrese B, Cerrato S, Cervio A, Diez B, Moser W, Tinchon A, Calabek B, Adachi J, Hitzenberger P, Grisold W, Oberndorfer S, Kusak ME, De Campos JM, Martinez Moreno NE, Gutierrez Sarraga J, Rey Portoles G, Martinez Alvarez R, Kubben PL, MIshima K, De Campos JM, Vinas D, Kusak ME, Lo Presti A, Montoya J, Matsutani M, Fujimaki T, Nisikawa R, Kuhnhenn J, Pels H, Reiser M, Deckert M, Egerer G, Vogt-Schaden M, Schackert G, Kroschinsky F, Schmidt-Wolf IGH, Schlegel U, Schiff D, Taylor JW, Flanagan E, O'Neill BP, Siegal T, Omuro A, Baehring J, Gonzalez-Aguilar A, Chamberlain M, Nishikawa R, Zach L, Guez D, Grober Y, Last D, Daniels D, Hoffman C, Nissim O, Spiegelmann R, Cohen ZR, Mardor Y, Radbruch A, Kramp L, Wiestler B, Heiland S, Wick W, Bendszus M, Colavolpe C, Chinot O, Metellus P, Mancini J, Barrie M, Bequet-Boucard C, Tabouret E, Mundler O, Figarella-Branger D, Guedj E, Berghoff AS, Lassmann H, Hoftberger R, Preusser M, Mercurio-Smit S, Padovani L, Colin C, Andre N, Fernandez C, Figarella-Branger D, Ruda R, Bertero L, Trevisan E, Pace A, Carapella C, Dealis C, Caroli M, Faedi M, Bomprezzi C, Soffietti R, Kunz M, Armbruster L, Thon N, Jansen N, Egensperger R, Eigenbrod S, Lutz J, Fougere la C, Tonn J, Kreth F, Berntsson S, Savitcheva I, Larsson E, Smits A, van den Bent MJ, Brandes AA, Taphoorn MJB, Kros JM, Kouwenhoven M, Delattre JY, Bernsen HJJA, Frenay M, Tijssen CC, Grisold W, Sipos L, Enting RH, French PJ, Dinjens WNM, Vecht CJ, Allgeier A, Lacombe D, Gorlia T, Hoang Xuan K, Weller M, Meisner C, Platten M, Simon M, Nikkhah G, Papsdorf K, Sabel M, Braun C, Reifenberger G, Wick W, Kerrigan SJ, Graham C, Stenning S, Thompson LC, Rooney A, Brada M, Grant R, Beauchesne PD, Faure G, Noel G, Schmitt T, Martin L, Jadaud E, Balvers R, Kloezeman JK, Kleijn A, Kremer A, French PJ, Dirven CMF, Leenstra S, Lamfers MLM, Bougnaud S, Golebiewska A, Oudin A, Brons NHC, Bjerkvig R, Niclou SP, Smith SJ, Ward JH, Wilson M, Rahman C, Rose F, Peet A, Macarthur DC, Grundy RG, Rahman R, Cuppini L, Calleri A, Bruzzone M, Prodi E, Anghileri E, Pellegatta S, Mancuso P, Bertolini F, Finocchiaro G, Eoli M, Lang FF, Shinojima N, Gumin J, Takezaki T, Hossain A, Sevim H, Chung L, Wheeler HT, Baxter RC, McDonald KL, Alentorn A, Marie Y, Boisselier B, Carpentier C, Mokhtari K, Capelle L, Hoang-Xuan K, Sanson M, Delattre J, Idbaih A, Lathia J, Li M, Sathyan P, Hale J, Zinn P, Gallagher J, Wu Q, Carson C, Naik U, Hjelmeland A, Majumder S, Rich J, Sturm D, Witt H, Hovestadt V, Khuong-Quang D, Jones DTW, Korshunov A, Tonjes M, Plass C, Jabado N, Pfister SM, Johansson M, Oudin A, Tiemann K, Bernard A, Keunen O, Fack F, Golebiewska A, Stieber D, Wang B, Hedman H, Niclou SP, Alexiou GA, Vartholomatos G, Karamoutsios A, Voulgaris S, Cho W, Patil S, Burzynski S, Mrowczynski E, Grela K, Moeckel S, Meyer K, Bosserhoff A, Spang R, Leukel P, Proescholdt M, Bogdahn U, Vollmann A, Hau P, Nakabayashi H, Shimizu K, Schroeteler J, Reeker R, Suero E, Stummer W, Ewelt C, Campos B, Gal Z, Baader A, Schneider T, Bageritz J, Schmoch T, Mogler C, Goidts V, Unterberg A, Herold-Mende CC, Hagemann C, Kessler AF, Fett S, Hofmann L, Monoranu CM, Al-Jomah N, Polat B, Patel R, Ernestus RI, Vince GH, Busek P, Balaziova E, Hilser M, Vomelova I, Fejfarova E, Sromova L, Sedo A, Kessler AF, Hagemann C, Hofmann L, Patel R, Linsenmann T, Ernestus RI, Vince GH, Sooman L, Ekman S, Bergqvist M, Gullbo J, Bergstrom S, Johansson M, Wu X, Blomquist E, Lennartsson J, Shimazu Y, Levallet G, Planchard G, Duguet AE, Emery E, Guillamo J, Geffrelot J, Zalcman G, Lechapt-Zalcman E, Sjostrom S, Ghasimi S, Broholm H, Brannstrom T, Johansen C, Collatz-Laier H, Henriksson R, Andersson U, Melin B, Kuratsu J, Nakamura H, Makino K, ducray F, meyronet D, Cartalat-Carel S, Guyotat J, Jouanneau E, Frappaz D, d'Hombres A, Sunyach M, Bauchet L, Honnorat J, Jaramillo E, Vargas C, Tze-Chun T, Huang S, Liu J, Hamdan A, Mitchell P, Flechl B, Ackerl M, Sax C, Oberndorfer S, Calabek B, Sizoo E, Reijenfeld J, Crevenna R, Preusser M, Marosi C, Rozumenko V, Khoroshun A, Rozumenko A, Fischbach P, Haquet A, Dutilleux A, Bracke J, Al Bassir M, Denoel C, Pace A, Villani V, Grattarola C, Di Napoli L, Maschio M, Benincasa D, Zucchella C, Burdukova YA, Vlasova EY, Gniteeva LN, Alekseeva OS, Voronin NA, Andreeva EV, Gorbatykh SV, Pavlova EV, Popov VE, Stroganova TA, Satoer DD, Kloet A, Vincent AJPE, Dirven CMF, Visch-Brink EG, Ungureanu G, Alexandra C, Ioana I, Paul M, Rares M, Oana M, Ioan Stefan F, Abdel Karim K, Abdel Wahab MM, Ezz LR, Abdel Raouf S, Shevtsov MA, Pozdnyakov AV, Kim AV, Samochernych KA, Guzhova IV, Romanova IV, Khachatryan WA, Margulis BA, Kleijn A, Kloezeman JJ, Treffers-Westerlaken EJ, Leenstra S, Dirven CMF, Debets R, Lamfers MML, Chirasani SR, Leukel P, Gronwald W, Gottfried E, Stadler K, Bogdahn U, Hau P, Kreutz M, Grauer OM, Persson BR, Engstrom P, Grafstrom G, Baureus Koch C, Widegren B, Salford LG, Gramatzki D, Peipp M, Staudinger M, Weller M, Hill LJ, Hossain-Ibrahim K, Logan A, Cruickshank GS, Pellegatta S, Eoli M, Antozzi C, Frigerio S, Cantini G, Bruzzone M, Anghileri E, Pollo B, Parati E, Finocchiaro G, Stragliotto G, Holm S, Adamson L, Giraud G, Hansson M, Henter J, Martinez-Garcia M, Villalonga R, Martinez-Soler F, Gimenez-Bonafe P, Acebes JJ, Casanovas O, Gil M, Tortosa A, Vinals F, Sander P, Leukel P, Vollmann-Zwerenz A, Jachnik B, Dobner C, Bogdahn U, Kalbitzer H, Hau P, Weissenberger J, Mutlu A, Hensel S, Senft C, Seifert V, Kogel D, Hossain-Ibrahim K, Hill LJ, Logan A, Cruickshank GS, Jung S, Wen M, Pei J, Jang W, Jung T, Kim I, Ishida J, Ichikawa T, Kurozumi K, Inoue S, Maruo T, Onishi M, Fujii K, Shimazu Y, Chiocca A, Date I, Fujii K, Kurozumi K, Ichikawa T, Onishi M, Shimazu Y, Ishida J, Chiocca E, Kaur B, Date I, Kang S, Sin G, Shim J, Lee S, Huh Y, Kim E, Chang J, Kim S, Hong Y, Kim D, Lefranc F, Verschuere T, De Witte O, Van Gool S, Kiss R, DeVleeschouwer S, Ewelt C, Ardon H, Suero E, Gunes D, Wolfer J, Fischer B, Stummer W, Thorsteinsdottir J, Fu P, Gehrmann M, Multhoff G, Tonn JC, Schichor C, Jachtenberg J, Bakker Schut T, Puppels G, French P, Kros M, Lamfers M, Leenstra S, Costello PC, McDonald W, MacDonald D, Zlatescu M, Megyesi J, Rossetto M, Gallego Perez-Larraya J, Boisselier B, Ciccarino P, Labussiere M, Marie Y, Delattre J, SANSON M, Ilhan-Mutlu A, Wohrer A, Berghoff AS, Widhalm G, Marosi C, Wagner L, Preusser M, Di Stefano A, Gallego Perez-Larraya J, Ducray F, Boisselier B, Labussiere M, Paris S, Cheneau C, Delattre J, Sanson M, Lonnqvist F, Gaillard PJ, Gladdines W, Boogerd W, van Tellingen O, Milojkovic Kerklaan B, Schellens JHM, Brandsma D, Denicolai E, Baeza-Kallee N, Tchoghandjian A, Beclin C, Figarella-Branger D, Rahman CV, Smith SJ, Morgan PS, Langmack KA, Macarthur DC, Rose FR, Shakesheff KM, Grundy RG, Rahman R, Nowosielski M, DiFranco MD, Putzer D, Seiz M, Jacobs AH, Stockhammer G, Hutterer M, Okada M, Shishido H, Hatakeyama T, Shinomiya A, Miyake K, Kawai N, Tamiya T, Miyake K, Shinomiya A, Okada M, Hatakeyama T, Kawai N, Tamiya T, Alexiou GA, Tsiouris S, Papadopoulos A, Al-Bokharhli J, Kyritsis AP, Voulgaris S, Fotopoulos AD, Roelcke U, Boxheimer L, Fathi AR, Schwyzer L, Ortega M, Berberat J, Grobholz R, Remonda L, Oikawa M, Sato K, Ito T, Sugio H, Ozaki Y, Nakamura H, Schwyzer L, Berberat J, Boxheimer L, Remonda L, Roelcke U, Kozic D, Njagulj V, Gacesa JP, Prvulovic N, Semnic R, Basmaci M, Hasturk AE, Hasturk AE, Basmaci M, Bahr O, Weise L, Harter PN, Weiss C, Starzetz T, Steinbach JP, Mittelbronn M, Hattingen E, Price SJ, Young AMH, Thomas OM, Mohsen LA, Frary AJ, Lupson VC, McLean MA, Weiss C, Neuschmelting V, Eisenbeis A, Nettekoven C, Grefkes C, Goldbrunner R, Weiss C, Neuschmelting V, Eisenbeis A, Nettekoven C, Grefkes C, Goldbrunner R, Weiss C, Neuschmelting V, Eisenbeis A, Nettekoven C, Rehme A, Grefkes C, Goldbrunner R, Grech-Sollars M, Saunders DE, Phipps KP, Clayden JD, Clark CA, Schwyzer L, Berberat J, Boxheimer L, Remonda L, Roelcke U, Booth TC, Larkin T, Yuan Y, Kettunen M, Markowetz F, Scoffings D, Jefferies S, Brindle KM, Pica A, Hauf M, Slotboom J, Beck J, Schucht P, Aebersold DM, Wiest R, Pace A, Marzi S, Fabi A, Carapella CM, Giovinazzo G, Marucci L, Anelli V, Vidiri A, Riva M, Castellano A, Raneri F, Pessina F, Fava E, Falini A, Bello L, Gahramanov S, Muldoon LL, Varallyay CG, Li X, Kraemer DF, Fu R, Hamilton BE, Rooney WD, Neuwelt EA, Hawkins-Daarud A, Rockne R, Muzi M, Patridge S, Kinahan P, Swanson KR, Radbruch A, Fladt J, Wiestler B, Baumer P, Heiland S, Wick W, Bendszus M, Lwin M, Al-Salihi O, Sharpe G, Izmailov TR, Panshin GA, Datsenko PV, Kavsan VM, Balynska EV, Chernolovskaya EL, Zenkova MA, Buhl RM, Janz C, Gomez Gallego J, Albanna W, Rashidi A, Schmiegelow P, Buhl RM, Alexiou GA, Vartholomatos G, Karamoutsios A, Voulgaris S, Shen D, Wang J, Qiu Z, Chen F, Chen Z, Miwa K, Shinoda J, Ito T, Yokoyama K, Yamada M, Yamada J, Yano H, Iwama T, Brokinkel B, Schober O, Heindel W, Hargus G, Paulus W, Stummer W, Woelfer J, Aoki T, Arakawa Y, Ueba T, Miyatake S, Nozaki K, Taki W, Tsukahara T, Miyamoto S, Matsutani M, Satou K, Ito T, Takanashi M, Oikawa M, Ozaki Y, Sugio H, Nakamura H. Abstracts of the 10th Congress of the European Association of NeuroOncology. Marseille, France. September 6-9, 2012. Neuro Oncol 2012; 14 Suppl 3:iii1-109. [PMID: 22977921 DOI: 10.1093/neuonc/nos183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vidiri A, Pace A, Fabi A, Maschio M, Latagliata GM, Anelli V, Piludu F, Carapella CM, Giovinazzo G, Marzi S. Early perfusion changes in patients with recurrent high-grade brain tumor treated with Bevacizumab: preliminary results by a quantitative evaluation. J Exp Clin Cancer Res 2012; 31:33. [PMID: 22494770 PMCID: PMC3583244 DOI: 10.1186/1756-9966-31-33] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 04/11/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND To determine whether early monitoring of the effects of bevacizumab in patients with recurrent high-grade gliomas, by a Perfusion Computed Tomography (PCT), may be a predictor of the response to treatment assessed through conventional MRI follow-up. METHODS Sixteen patients were enrolled in the present study. For each patient, two PCT examinations, before and after the first dose of bevacizumab, were acquired. Areas of abnormal Cerebral Blood Volume (CBV) were manually defined on the CBV maps, using co-registered T1- weighted images, acquired before treatment, as a guide to the tumor location. Different perfusion metrics were derived from the histogram analysis of the normalized CBV (nCBV) maps; both hyper and hypo-perfused sub-volumes were quantified in the lesion, including tumor necrosis. A two-tailed Wilcoxon test was used to establish the significance of changes in the different perfusion metrics, observed at baseline and during treatment. The relationships between changes in perfusion and morphological MRI modifications at first follow-up were investigated. RESULTS Significant reductions in mean and median nCBV were detected throughout the entire patient population, after only a single dose of bevacizumab. The nCBV histogram modifications indicated the normalization effect of bevacizumab on the tumor abnormal vasculature. An improvement in hypoxia after a single dose of bevacizumab was predictive of a greater reduction in T1-weighted contrast-enhanced volumes at first follow-up. CONCLUSIONS These preliminary results show that a quantification of changes in necrotic intra-tumoral regions could be proposed as a potential imaging biomarker of tumor response to anti-VEGF therapies.
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Affiliation(s)
- Antonello Vidiri
- Radiology and Diagnostic Imaging Department, Regina Elena Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
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Giussani P, Bassi R, Anelli V, Brioschi L, De Zen F, Riccitelli E, Caroli M, Campanella R, Gaini SM, Viani P, Riboni L. Glucosylceramide synthase protects glioblastoma cells against autophagic and apoptotic death induced by temozolomide and Paclitaxel. Cancer Invest 2012; 30:27-37. [PMID: 22236187 DOI: 10.3109/07357907.2011.629379] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Glioblastoma is a deadly cancer with intrinsic chemoresistance. Understanding this property will aid in therapy. Glucosylceramide synthase (GCS) is associated with resistance and poor outcome; little is known about glioblastomas. In glioblastoma cells, temozolomide and paclitaxel induce ceramide increase, which in turn promotes cytotoxicity. In drug-resistant cells, both drugs are unable to accumulate ceramide, increased expression and activity of GCS is present, and its inhibitors hinder resistance. Resistant cells exhibit cross-resistance, despite differing in marker expression, and cytotoxic mechanism. These findings suggest that GCS protects glioblastoma cells against autophagic and apoptotic death, and contributes to cell survival under chemotherapy.
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Affiliation(s)
- P Giussani
- Department of Medical Chemistry, Biochemistry and Biotechnology, LITA-Segrate, University of Milan, Milan, Italy
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Zoccali C, Chichierchia G, Prencipe U, Nuzzo C, Anelli V, Ferraresi V. A greenstick osteoporotic tibial fracture while on chemotherapy in a 12-year-old girl with osteosarcoma of the knee: does a preventive role exist for agents that reduce iatrogenic bone loss and skeletal-related events? J BIOL REG HOMEOS AG 2011; 25:131-135. [PMID: 21382282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In patients with osteosarcoma several causative factors are implicated in the occurrence of osteoporosis, such as no weight-bearing, pre- and post-surgical immobilization, and neoadjuvant and adjuvant chemotherapy. Nevertheless, osteoporotic fractures are a rare complication in young patients. We report the case of a spontaneous greenstick fracture of the distal tibia occurring during adjuvant chemotherapy in a 12-year-old Caucasian girl. Among the various drugs, the main role of methotrexate was investigated. A review of the literature is also presented along with a discussion about the role of preventive agents able to reduce the occurrence of osteopenia and/or osteoporosis following cancer treatment.
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Pacella CM, Bizzarri G, Francica G, Forlini G, Petrolati A, Valle D, Anelli V, Bianchini A, Nuntis SD, Pacella S, Rossi Z, Osborn J, Stasi R. Analysis of factors predicting survival in patients with hepatocellular carcinoma treated with percutaneous laser ablation. J Hepatol 2006; 44:902-9. [PMID: 16545480 DOI: 10.1016/j.jhep.2006.01.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2005] [Revised: 01/15/2006] [Accepted: 01/22/2006] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIMS The factors which predict the long-term outcome in patients with hepatocellular carcinoma who are treated with percutaneous laser ablation (PLA) are not well established. METHODS We prospectively analyzed treatment and survival parameters of 148 cirrhotic patients with nonsurgical hepatocellular carcinoma who had undergone PLA at a single institution during an 11-year period. RESULTS Single tumors were seen in 129 of 148 (87%) patients, and 2-3 nodules were seen in 19 (13%) patients, for a total of 169 tumors. The median overall time survival was 39 months (95% confidence interval [CI], 30-47 months). The 1-, 2-, 3-, 4-, and 5-year cumulative survival rates were 89, 75, 52, 43, and 27%, respectively. From multiple regression analysis, the independent predictors of survival were found to be tumor grading (P=0.002; risk ratio [RR] 0.37, 95% CI 0.20-0.70), bilirubin levels < or =2.5mg/dl (P=0.014; RR 1.58, 95% CI 1.09-2.28), and the achievement of complete tumor ablation (P=0.020; RR 0.53, 95% CI 0.31-0.90). An initial complete tumor ablation was the only factor associated with longer survival in patients with Child-Turcotte-Pugh class A cirrhosis (P=0.012; hazard ratio [HR] 0.48, 95% CI 0.23-1.03). CONCLUSIONS A complete tumor ablation results in improved survival in all patients with nonsurgical hepatocellular carcinoma. Ideal candidates for PLA are those with a well-differentiated histology, and normal bilirubin levels.
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Affiliation(s)
- Claudio Maurizio Pacella
- Department of Diagnostic Imaging and Interventional Radiology, Ospedale Regina Apostolorum, Via San Francesco, 50-00041, Albano Laziale, Rome, Italy.
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Piccioli Cappelli F, Maianti M, Anelli V. Effect of some disease stress on cow milk yield and features. Italian Journal of Animal Science 2005. [DOI: 10.4081/ijas.2005.2s.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Riboni L, Anelli V, Bassi R, Giussani P, Viani P, Tettamanti G. Sphingoid mediators in brain function and dysfunction. J Neurochem 2003. [DOI: 10.1046/j.1471-4159.85.s2.11_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Pacella CM, Bizzarri G, Magnolfi F, Cecconi P, Caspani B, Anelli V, Bianchini A, Valle D, Pacella S, Manenti G, Rossi Z. Laser thermal ablation in the treatment of small hepatocellular carcinoma: results in 74 patients. Radiology 2001; 221:712-20. [PMID: 11719667 DOI: 10.1148/radiol.2213001501] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the safety, local effectiveness, and long-term results of laser thermal ablation (LTA) in the treatment of small hepatocellular carcinoma (HCC). MATERIALS AND METHODS Ninety-two biopsies proved small HCCs (range, 0.8-4.0 cm) in 74 patients who were treated percutaneously with LTA in an outpatient clinic. A laser at a power of 5.0 W was coupled with one to four fibers that were advanced through 21-gauge needle(s) for 6-12 minutes. All lesions were evaluated with computed tomography (CT) for changes in size and vascular pattern, recurrence rates, and cumulative survival rates. Patients were examined for complications. RESULTS No major complications occurred in 117 LTA sessions, with an average of 1.3 sessions per tumor. At 3 months, CT scans showed a nonenhancing area (complete necrosis) in 89 (97%) of 92 lesions. During follow-up (range, 6-66 months; mean, 25.3 months), 84 tumors (91%) decreased in size. The local recurrence rates (range, 1-5 years) ranged from 1.6% to 6.0%. Recurrence rates (range, 12-60 months) in other liver segments ranged from 24% to 73%. Cancer-free survival rates (range, 1-4 years) ranged from 73% to 24%. Overall survival rates were 99%, 68%, and 15% at 1, 3, and 5 years, respectively. Twenty-one patients (28%) died. CONCLUSION LTA is a safe and effective treatment for small HCC.
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Affiliation(s)
- C M Pacella
- Department of Radiology and Diagnostic Imaging, Regina Apostolorum Hospital, Via St Francesco 50, 00041 Albano Laziale, Rome, Italy.
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Pacella CM, Bizzarri G, Cecconi P, Caspani B, Magnolfi F, Bianchini A, Anelli V, Pacella S, Rossi Z. Hepatocellular Carcinoma: Long-term Results of Combined Treatment with Laser Thermal Ablation and Transcatheter Arterial Chemoembolization. Radiology 2001; 219:669-78. [PMID: 11376253 DOI: 10.1148/radiology.219.3.r01ma02669] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.1] [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: 11/11/2022]
Abstract
PURPOSE To determine the potential long-term effectiveness of laser thermal ablation (LTA) followed by transcatheter arterial chemoembolization (TACE) in the percutaneous ablation of large hepatocellular carcinoma (HCC). MATERIALS AND METHODS Thirty large HCCs 3.5-9.6 cm in diameter (mean diameter, 5.2 cm) and 15 small HCCs 0.8-3.0 cm (mean diameter, 1.9 cm) were treated with ultrasonographically guided LTA with TACE and with LTA alone, respectively, in 30 patients: 19 with a solitary large HCC, and 11 with one to three additional synchronous small HCCS: A 1.064-microm neodymium yttrium-aluminium-garnet (Nd-YAG) laser at a power of 5.0 W was coupled with one to four quartz optic fibers that were advanced through 21-gauge needles. Segmental TACE was performed 30-90 days after LTA. All lesions were evaluated for change in size at computed tomography (CT), alpha-fetoprotein (AFP) levels, recurrence rates, and cumulative survival rates. RESULTS No major complications occurred in 127 LTA sessions. CT showed complete tumor necrosis in 27 (90%) of 30 large HCCS: Twenty-eight patients were followed up for 6-41 months (mean, 17.1 months). In 25 patients, all lesions appeared stable or smaller at CT. AFP levels decreased to the normal range in all patients with high pretreatment values. The 1-, 2-, and 3-year local recurrence rate was 7% in large HCCS: Complete tumor necrosis was achieved in all 15 (100%) small HCCs; none of them recurred locally. The 1-, 2-, and 3-year cumulative survival rates were 92%, 68%, and 40%, respectively. CONCLUSION LTA followed by TACE is an effective palliative therapy in treating large HCCS:
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Affiliation(s)
- C M Pacella
- Department of Radiology and Diagnostic Imaging, Regina Apostolorum Hospital, Via St Francesco 50, 00041 Albano Laziale, Rome, Italy.
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Pacella CM, Bizzarri G, Guglielmi R, Anelli V, Bianchini A, Crescenzi A, Pacella S, Papini E. Thyroid tissue: US-guided percutaneous interstitial laser ablation-a feasibility study. Radiology 2000; 217:673-7. [PMID: 11110927 DOI: 10.1148/radiology.217.3.r00dc09673] [Citation(s) in RCA: 125] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To evaluate percutaneous interstitial laser photocoagulation (ILP) as a palliative treatment of recurrent thyroid carcinoma untreatable with surgery or radioiodine administration. MATERIALS AND METHODS By using 18 resected thyroid glands, the volume and histologic pattern of ILP-induced thyroid damage were assessed. In vivo treatment feasibility was evaluated by using a low-energy laser in two volunteers before thyroidectomy for huge autonomously functioning nodules. With ultrasonographic (US) monitoring, a 21-gauge spinal needle was inserted into the thyroid nodules. A 300-microm quartz fiberoptic guide was inserted through the needle lumen, and the fiber tip was placed in direct contact with the tissue. Laser irradiation was performed with a 1.064-nm Nd:YAG laser in surgically resected glands, which were treated with 2, 3, 5, or 7 W. RESULTS Tissue ablation was well-defined histologically, and its area was related to laser irradiation parameters (range, 0-26 mm). No correlation was found between US images and the actual extent of laser-induced lesions. Large colloid or fluid collections did not permit regular heat diffusion within the tissue. In vivo low-energy ILP was performed without technical difficulties or complications. CONCLUSION ILP induces well-defined tissue ablation correlated with energy parameters in thyroid glands devoid of cystic areas. ILP could be a therapeutic tool for highly selected problems in thyroid tumor treatment.
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Affiliation(s)
- C M Pacella
- Departments of Diagnostic Imaging, and Endocrine, Metabolic, and Digestive Diseases, Regina Apostolorum Hospital, Via San Francesco, 50, 00041 Albano Laziale, Rome, Italy.
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Pacella CM, Bizzarri G, Anelli V, Valle D, Fabbrini R, Bianchini A, Fenderico P, Rossi Z. Evaluation of the vascular pattern of hepatocellular carcinoma with dynamic computed tomography and its use in identifying optimal temporal windows for helical computed tomography. Eur Radiol 1998; 8:30-5. [PMID: 9442124 DOI: 10.1007/s003300050332] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The aim of this work was to study the vascularization of hepatocellular carcinoma (HCC) by means of dynamic CT and to demonstrate the existence of optimal temporal windows for visualization of HCC in order to develop new protocols for helical CT of the liver. We studied, by means of dynamic CT, 42 histologically proved HCCs in 30 patients after injecting contrast medium (100 ml, 3 ml/s). We performed a time-density analysis of the aorta, liver, portal vein, spleen and lesion. We identified three temporal curves of attenuation of the neoplastic tissue. Curve 1 was three-phasic: hyperattenuation, isoattenuation and hypoattenuation; curve 2 was two-phasic: hyperattenuation and isoattenuation; curve 3 was two-phasic: isoattenuation and hypoattenuation. Thirty-two lesions were homogeneous (curve 1 in 22 cases, 68.7 %; curve 2 in 7 cases, 21.8 %; curve 3 in 3 cases, 9.4 %), whereas 10 lesions were non-homogeneous. Two optimal temporal windows were identified: the first, with predominantly hyperattenuating lesions (range 29-65 s, 90.4 % sensitivity); the second, with predominantly hypoattenuating lesions (range 132.1-360 s, 76.1 %). There is an interposed time range of reduced visualization (range 62-127 s, 54.7 %) in which lesions are isoattenuating. Combined CT study during the first and second temporal windows improves the detection of HCCs especially for homogeneous and small lesions. The intermediate isoattenuation time range does not increase lesion detection rate.
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Affiliation(s)
- C M Pacella
- Department of Radiology and Diagnostic Imaging, Regina Apostolorum Hospital, Via San Francesco, 50, I-00041 Albano L., Rome, Italy
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Pacella CM, Bizzarri G, Ferrari FS, Anelli V, Valle D, Bianchini A, Rossi Z, Stefani M, Crescenzi A, Guazzi G, Minuto S, Stefani P. [Interstitial photocoagulation with laser in the treatment of liver metastasis]. Radiol Med 1996; 92:438-47. [PMID: 9045247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Interstitial laser photocoagulation (ILP) causes tumor necrosis with local hyperthermia produced by laser light energy. We treated with US-guided ILP 14 patients (7 men and 7 women; mean age: 67 years) and 20 metastases: 9 of them were < 3 cm in max. diameter and 11 were > 3 cm (mean diameter: 2.9 cm); 14 metastases were from colon carcinoma, 5 from breast cancer and 1 from lung cancer. ILP was performed with 300 and 600 microns quartz fiberoptic guides advanced in 21-18G Chiba needles and a continuous-wave Nd: YAG laser with 1064 nm wavelength. We used single expositions of 5-6 minutes with an irradiation power of 5 watts and scheduled 3 treatment sessions, performing CT scans and biopsies at the end of each session. The extent of induced necrosis was classified as follows on the basis of CT findings: grade 1 = 100% necrosis; grade 2 = necrosis > 50%; grade 3 = necrosis < 50%. The average follow-up was 6 months. After the 3 scheduled treatment sessions, CT showed grade 1 necrosis in all the lesions < 3 cm in diameter and in 4/9 (44%) lesions > 3 cm and grade 2 and 3 necrosis in the remaining cases (necrosis > 50% in 95% of the lesions and 92% of the patients). The cytologic findings were in agreement with CT results in all grade 2 and 3 cases, but in one grade 1 necrosis cytology showed residual viable tumor. To conclude, ILP is a safe and well-tolerated procedure. Maximum efficacy was observed in the lesions < 3 cm, while lesion volume was markedly reduced in the lesions > 3 cm. US is a useful tool in the real-time monitoring of this procedure and CT is the most accurate imaging technique to assess treatment efficacy.
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Affiliation(s)
- C M Pacella
- Dipartimento di Radiologia e Diagnostica per Immagini, Albano Laziale, Roma
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Crescenzi A, Papini E, Pacella CM, Rinaldi R, Panunzi C, Petrucci L, Fabbrini R, Bizzarri GC, Anelli V, Nardi F, Marinozzi V. Morphological changes in a hyperfunctioning thyroid adenoma after percutaneous ethanol injection: histological, enzymatic and sub-microscopical alterations. J Endocrinol Invest 1996; 19:371-6. [PMID: 8844457 DOI: 10.1007/bf03344972] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Ultrasound-guided ethanol injection (PEI) is an effective treatment of autonomously functioning thyroid nodules (AFTN) but little is known about the tissue lesions induced by alcohol. We report morphological changes of an AFTN which was removed after successful PEI treatment. At histological evaluation, the adenoma showed multiple areas of coagulative necrosis with eosinophilic ghost follicles, hemorrhages, small vessel thrombosis and a wedge-shaped hemorrhagic infarction. The peripheral adenomatous tissue and the surrounding thyroid parenchyma were free of regressive changes and/or lympho-monocytic inflammatory reactions. Enzyme histochemistry confirmed the hyperfunctioning character of the lesion and showed reduction of succinic dehydrogenase and cytochrome-c-oxydase activity in the viable tissue surrounding the central necrotic areas. By electron microscopy, the hyperfunctioning follicular epithelium showed submicroscopical alterations of the adenomatous cells surrounding the areas of coagulative necrosis. These results suggest that control of hyperthyroidism, after PEI, is due to: a) directly induced, irreversible damage (coagulative necrosis and vascular thrombosis with hemorrhagic infarction) in the central areas of the lesion; b) potentially reversible damage (reduction of intracellular enzyme activity and ultrastructural changes) in the peripheral areas.
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Affiliation(s)
- A Crescenzi
- Histopatology Service, Ospedale Regina Apostolorum, Albano (RM), Rome, Italy
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Pacella CM, Bizzarri G, Fabbrini R, Anelli V. [ Ethanol injection: technique and method of performance]. MINERVA ENDOCRINOL 1993; 18:169-71. [PMID: 8190057] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The authors describe the technique used in the treatment of autonomously functioning thyroid nodules by percutaneous ethanol injection (PEI). They illustrate the free-hand technique followed in their hospital from January 1990 to October 1992 in a group of 25 patients. Results, advantages and disadvantages of this technique are reported and compared with the ultrasound-guided technique. In the latter, widely used, the needle is positioned in the target nodule by means of an ultrasound probe with a specially designed guiding device which forces the needle in the correct direction. This makes the manoeuver rapid and safe as the needle tip can be easily visualized. In this case, the most important drawback lies in the impossibility of changing the ultrasound scanning plane during the ethanol injection as the probe and the needle are fast together. So the correct spreading modality of ethanol inside the tissue is not completely checked. Another disadvantage is the cost of disposable guiding device necessary in order to avoid contamination. On the other side, in the free-hand technique the needle is aimed at the nodule and inserted during an ultrasound examination without restrain on the probe movements. In this way, it is possible to focus the attention on the critical structures to prevent their damage stopping ethanol injection as soon as a seepage outside the thyroid occurs. Furthermore, this technique is particularly inexpensive as a standard probe is used and the risk of contamination can be avoided by just wrapping the probe with a sterline plastic film.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C M Pacella
- Ospedale Regina Apostolorum, Albano Laziale, Roma
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