343 results on '"Colletti PM"'
Search Results
2. Incidental medullary thyroid microcarcinoma revealed by mild increase of preoperative serum calcitonin levels: therapeutic implications
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MERANTE BOSCHIN, Isabella, Torresan, F, Toniato, A, Zane, Mariangela, Ide, Ec, Pennelli, Gianmaria, Rampin, L, Colletti, Pm, Rubello, Domenico, Pelizzo, MARIA ROSA, and Torresan, Francesca
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Adult ,Calcitonin ,Male ,medicine.medical_specialty ,Goiter ,endocrine system diseases ,Medullary cavity ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Biopsy, Fine-Needle ,Medullary thyroid microcarcinoma ,Endocrinology ,Adenocarcinoma, Follicular ,Biomarkers, Tumor ,medicine ,Humans ,Thyroid Nodule ,Stimulated calcitonin measurement ,Aged ,Ultrasonography ,Basal calcitonin measurement ,Incidental diagnosis ,business.industry ,Thyroid ,Thyroidectomy ,Histology ,Pentagastrin stimulus ,Middle Aged ,medicine.disease ,Surgery ,Pentagastrin ,Dissection ,medicine.anatomical_structure ,Carcinoma, Medullary ,Preoperative Period ,Female ,Nuclear medicine ,business ,medicine.drug - Abstract
To investigate whether further, diagnostic procedures should be recommended in patients with slight increase of preoperative serum basal calcitonin (bCT) levels in whom surgical treatment can be recommendable. Fourteen consecutive patients with nodular thyroid disease underwent thyroidectomy in our center for suspected medullary thyroid microcarcinoma (MTC) because their serum bCT levels were slightly higher than the upper limit of normal range. Serum bCT was measured by radioimmunoassay, normality range = 0–20 ng/L. Surgical specimens were examined by the same pathologist using histologic and immunohistochemistry techniques. An extensive search for parafollicular C-cell hyperplasia (CCH) and/or microscopic MTC foci was performed. At preoperative ultrasound, a single thyroid nodule was depicted in three patients while a multinodular goiter in 11. The bCT values ranged between 24.4 and 94.6 ng/L, median 42.2 ng/L while the pentagastrin-stimulated CT (sCT) values by pentagastrin test ranged between 61.5 and 1,262 ng/L, median 245.0 ng/L. Total thyroidectomy was performed in 13 patients, and lobectomy in the other one; central node dissection was also performed in eight cases. At histology, MTC was diagnosed in nine patients (64.3 %), showing a median maximum diameter of 6.1 mm (range, 1.5–17 mm); CCH was diagnosed in the other five patients (35.7 %). The pentagastrin stimulation test was obtained in all patients. It is worth noting that a very high increase of sCT >100 ng/mL was observed in 5/9 patients with MTC and in 2/4 patients with HCC, therefore suggesting the absence of a relationship between the entity of response to pentagastrin test with a specific pathology (MTC vs. HCC). In six patients, the MTC was the nodule on which preoperative FNAC had been performed, while in other three patients preoperative FNAC had been performed on a different nodule from the MTC. Based on our experience, in case of the pentagastrin stimulation test with sCT
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- 2014
3. Comparison between anatomical cross-sectional imaging and 18F-FDG PET/CT in the staging, restaging, treatment response, and long-term surveillance of squamous cell head and neck cancer: a systematic literature overview
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Evangelista, L, Cervino, Ar, Chondrogiannis, S, Marzola, Mc, Maffione, Am, Colletti, Pm, Muzzio, Pc, and Rubello, D.
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- 2014
4. Magnetic-resonance imaging used for determining fat distribution in obesity and diabetes
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Gray, DS, primary, Fujioka, K, additional, Colletti, PM, additional, Kim, H, additional, Devine, W, additional, Cuyegkeng, T, additional, and Pappas, T, additional
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- 1991
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5. Multifidus morphology in persons scheduled for single-level lumbar microdiscectomy: qualitative and quantitative assessment with anatomical correlates.
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Kulig K, Scheid AR, Beauregard R, Popovich JM Jr., Beneck GJ, and Colletti PM
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- 2009
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6. B-cell non-Hodgkin lymphoma: PET/CT evaluation after 90Y-ibritumomab tiuxetan radioimmunotherapy--initial experience.
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Ulaner GA, Colletti PM, Conti PS, Ulaner, Gary A, Colletti, Patrick M, and Conti, Peter S
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- 2008
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7. CT of amebic liver abscess
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Radin, DR, primary, Ralls, PW, additional, Colletti, PM, additional, and Halls, JM, additional
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- 1988
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8. Color-flow Doppler sonography in Graves disease: "thyroid inferno"
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Ralls, PW, primary, Mayekawa, DS, additional, Lee, KP, additional, Colletti, PM, additional, Radin, DR, additional, Boswell, WD, additional, and Halls, JM, additional
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- 1988
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9. Pheochromocytoma: detection by unenhanced CT
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Radin, DR, primary, Ralls, PW, additional, Boswell, WD, additional, Colletti, PM, additional, Lapin, SA, additional, and Halls, JM, additional
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- 1986
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10. Sonography in recurrent oriental pyogenic cholangitis
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Ralls, PW, primary, Colletti, PM, additional, Quinn, MF, additional, Lapin, SA, additional, Morris, UL, additional, and Halls, J, additional
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- 1981
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11. Spinal subarachnoid hemorrhage in necrotizing vasculitis.
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Torralba KD, Colletti PM, and Quismorio FP Jr
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- 2008
12. Magnetic resonance imaging in patients with cardiac pacemakers: era of 'MR Conditional' designs.
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Shinbane JS, Colletti PM, and Shellock FG
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Advances in cardiac device technology have led to the first generation of magnetic resonance imaging (MRI) conditional devices, providing more diagnostic imaging options for patients with these devices, but also new controversies. Prior studies of pacemakers in patients undergoing MRI procedures have provided groundwork for design improvements. Factors related to magnetic field interactions and transfer of electromagnetic energy led to specific design changes. Ferromagnetic content was minimized. Reed switches were modified. Leads were redesigned to reduce induced currents/heating. Circuitry filters and shielding were implemented to impede or limit the transfer of certain unwanted electromagnetic effects. Prospective multicenter clinical trials to assess the safety and efficacy of the first generation of MR conditional cardiac pacemakers demonstrated no significant alterations in pacing parameters compared to controls. There were no reported complications through the one month visit including no arrhythmias, electrical reset, inhibition of generator output, or adverse sensations. The safe implementation of these new technologies requires an understanding of the well-defined patient and MR system conditions. Although scanning a patient with an MR conditional device following the strictly defined patient and MR system conditions appears straightforward, issues related to patients with pre-existing devices remain complex. Until MR conditional devices are the routine platform for all of these devices, there will still be challenging decisions regarding imaging patients with pre-existing devices where MRI is required to diagnose and manage a potentially life threatening or serious scenario. A range of other devices including ICDs, biventricular devices, and implantable physiologic monitors as well as guidance of medical procedures using MRI technology will require further biomedical device design changes and testing. The development and implementation of cardiac MR conditional devices will continue to require the expertise and collaboration of multiple disciplines and will need to prove safety, effectiveness, and cost effectiveness in patient care. [ABSTRACT FROM AUTHOR]
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- 2011
13. Multifidus muscle volume in persons with and without chronic unilateral low back pain.
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Beneck GJ, Kulig K, and Colletti PM
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- 2010
14. Restaging Clear Cell Renal Carcinoma With 18F-FDG PET/CT
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Patrick M. Colletti, Sotirios Chondrogiannis, Domenico Rubello, Elena Giulia Spinapolice, Daniela D’Ambrosio, Paolo Castellucci, Chiara Fuccio, Eugenio Brunocilla, Gaia Grassetto, Giuseppe Trifirò, Francesco Ceci, Raffaella Palumbo, Anna Margherita Maffione, Riccardo Schiavina, Stefano Fanti, Antonio Bernardo, Fuccio C, Ceci F, Castellucci P, Spinapolice EG, Palumbo R, D'Ambrosio D, Bernardo A, BRUNOCILLA E., Schiavina R, Maffione AM, Chondrogiannis S, Grassetto G, Colletti PM, Rubello D, Fanti S, and Trifirò G
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Adult ,Male ,medicine.medical_specialty ,clear cell renal carcinoma ,urologic and male genital diseases ,Multimodal Imaging ,Fluorodeoxyglucose F18 ,X ray computed ,restaging ,18F-FDG PET/CT ,Carcinoma ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Carcinoma, Renal Cell ,neoplasms ,Aged ,Neoplasm Staging ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Clear cell renal cell carcinoma ,Positron emission tomography ,Positron-Emission Tomography ,Clear Cell Renal Carcinoma ,Female ,Fdg pet ct ,Radiology ,Tomography, X-Ray Computed ,business ,Clear cell - Abstract
AIM: The aim of our retrospective study was to assess the usefulness of F-FDG PET/CT in the restaging of clear cell renal cell carcinoma (RCC) patients. PATIENTS AND METHODS: Sixty-nine patients (median age = 62 years; range = 36-86 years) affected by clear cell RCC (TNM at staging: T1, 42 patients; T2, 13 patients; T3, 11 patients; T4, 3 patients; Fuhrman grade: G2, 47 patients; G3, 20 patients; G4, 2 patients) underwent whole-body F-FDG PET/CT to restage the disease after nephrectomy for clinical or radiological suspicion of metastases. Areas of abnormal uptake at PET/CT were classified, taking the liver uptake as reference, as follows: 1 = faint uptake, lower than liver; 2 = moderate uptake, equal to liver; and 3 = high uptake, higher than liver. Validation of F-FDG PET/CT results was established by (1) biopsy (23 patients) and (2) other imaging modalities (addressed BS; c.e.CT; MRI; F-fluoride PET/CT; subsequent F-FDG PET/CT), and/or clinical and radiological follow-up of 12 months (46 patients). RESULTS: F-FDG PET/CT was positive in 42 patients and negative in 27 patients. Sixteen patients presented single lesions and 26 patients presented multiple localizations of the disease. On a patient basis, 40 patients resulted true positive, 2 patient false positive, 23 patients true negative, and 4 patients false negative. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 90%, 92%, 91%, 95%, and 85%, respectively. On a lesion basis, PET/CT detected 114 areas of abnormal uptake in 42 positive patients of which 112 resulted to be true positive. FDG uptake of the true positive lesions resulted to be high in 83 cases, moderate in 17 lesions, and finally faint in 12 lesions. CONCLUSIONS: F-FDG PET/CT demonstrated a good sensitivity in the restaging of clear cell RCC. Most of the lesions showed intense activity. According to our results, it seems that the use of F-FDG PET/CT in the restaging of RCC is feasible because the number of false-negative cases is limited.
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- 2014
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15. Diagnostic Accuracy of 11C-Choline PET/CT in Preoperative Lymph Node Staging of Bladder Cancer
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Michelangelo Fiorentino, Lorenzo Bianchi, Giuseppe Martorana, Paolo Castellucci, Sotirios Chondrogiannis, Francesca Giunchi, Stefano Fanti, Anna Margherita Maffione, Matteo Cevenini, Patrick M. Colletti, Marco Borghesi, Francesco Ceci, Domenico Rubello, Riccardo Schiavina, Eugenio Brunocilla, BRUNOCILLA E., Ceci F, Schiavina R, Castellucci P, Maffione AM, Cevenini M, Bianchi L, Borghesi M, Giunchi F, Fiorentino M, Chondrogiannis S, Colletti PM, Rubello D, Fanti S, and Martorana G
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Male ,medicine.medical_specialty ,Enhanced ct ,medicine.medical_treatment ,PET/TC ,Diagnostic accuracy ,Multimodal Imaging ,Cystectomy ,choline ,Preoperative Care ,medicine ,Carcinoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Carbon Radioisotopes ,Lymph node staging ,Lymph node ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Bladder cancer ,business.industry ,General Medicine ,Middle Aged ,BLADDER CANCER ,medicine.disease ,STAGING ,Dissection ,medicine.anatomical_structure ,ROC Curve ,Urinary Bladder Neoplasms ,Positron-Emission Tomography ,Female ,Lymph Nodes ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
AIM: The aim of this study was to evaluate the role of C-choline PET/CT in the preoperative evaluation of the nodal involvement of patients with bladder carcinoma (BC) suitable for radical cystectomy and extended pelvic lymph node dissection in comparison with contrast-enhanced CT (CECT) using the pathologic specimen as reference standard. PATIENTS AND METHODS: Twenty-six consecutive patients (69.5 ± 9.3 years; range, 49-84) with histologically proven transitional cell BC were treated with radical cystectomy and pelvic lymph node dissection and were enrolled from April 2011 to January 2013. In all patients, paravesical, internal, eternal, and common iliac nodes as well as obturatory, presacral, preaortic, and precaval lymph nodes (LNs) were dissected up to the origin of the inferior mesentery artery. The areas of the LN dissection were grouped as follow: region A included preaortic and precaval LNs; region B included paravesical, common, internal and external iliac, obturatory, and presacral LNs in the right pelvis; region C included paravesical, common, internal and external iliac, obturatory, and presacral LNs in the left pelvis. C-choline PET/CT and abdominal CECT were used to assess the presence of lymph node metastases on a per patient, region, and lesion analysis using the results of surgical specimens obtained at operation as criterion standard. RESULTS: Seven of 26 patients (26.9%) showed nodal metastases at pathologic analysis. Overall, 844 LNs were evaluated, and 38 of them (4.5%) showed metastatic involvement. On a patient-based analysis, C-choline PET/CT showed a sensitivity of 42% and specificity of 84%, whereas, CECT showed a sensitivity of 14% and specificity of 89%. On a region-based analysis, C-choline PET/CT showed a sensitivity of 11% and specificity of 82%, whereas CECT showed a sensitivity of 5% and specificity of 80%. On a lesion (LN)-based analysis, C-choline PET/CT showed a sensitivity of 10% and specificity of 64%, whereas CECT showed a sensitivity of 2% and specificity of 63%. CONCLUSIONS: C-choline PET/CT could provide additional diagnostic information in preoperative nodal staging of patients with invasive BC in comparison with CECT. A study with a larger population should determine if C-choline PET/CT could be recommended as a routine technique in high-risk patients with BC
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- 2014
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16. Performance of FDG PET/ceCT in the evaluation of patients with lung cancer
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Stefano Fanti, Donatella Mascherini, Patrick M. Colletti, Domenico Rubello, Cinzia Pettinato, Maria Cristina Marzola, Valeria Montesi, Virginia Rossetti, Cristina Nanni, Maurizio Zompatori, Valentina Ambrosini, Nanni C., Rossetti V., Zompatori M., Ambrosini V., Montesi V., Mascherini D., Pettinato C., Marzola MC., Colletti PM., Rubello D., and Fanti S.
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Adult ,Male ,medicine.medical_specialty ,Lung Neoplasms ,Contrast Media ,Multimodal Imaging ,Sensitivity and Specificity ,Fluorodeoxyglucose F18 ,Histological diagnosis ,medicine ,Humans ,Lung cancer ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Pharmacology ,business.industry ,Reproducibility of Results ,Cancer ,Mean age ,General Medicine ,Combined procedure ,respiratory system ,FG PET ,Middle Aged ,False positivity ,medicine.disease ,respiratory tract diseases ,True negative ,Positron-Emission Tomography ,Combined test ,Female ,Radiology ,Radiopharmaceuticals ,Tomography, X-Ray Computed ,Nuclear medicine ,business ,CT - Abstract
Aim The aim of this study was to assess the performance of FDG PET/ceCT simultaneously acquired, contemporary read and finally discussed by the radiologist and the nuclear medicine physician for staging and restaging lung cancer patients. Methods We analysed 17 consecutive patients (7F; 10M; mean age 68). Six patients were in staging, 8 patients were in restaging (1 during therapy, 2 after therapy and 5 during the follow-up) and 2 patients needed to characterise a suspect pulmonary mass. All the patients underwent combined FDG PET/CT and ceCT acquired simultaneously on the same tomograph. The images were read and reported together by the nuclear medicine physician and the radiologist. Results None of the patients had adverse reactions nor complained about the procedure. Thirteen FDG PET/ceCT turned out positive, while 4 were completely negative. Among positive patients, a significant SUV max was detected in all the cases (range 1.8–17.5). In the end, 9 patients had a true positive result, 4 true negative, 3 false positive and 1 false negative. Sensitivity, specificity and accuracy of the combined procedure were 90%, 57% and 76% respectively. In 7/17 patients FDG PET/CT and ceCT were completely concordant. FDG PET/CT provided a significant impact on the final interpretation in 7/17 patients while ceCT had a major impact in 3/17 patients. Discussion This preliminary study shows that FDG PET/ceCT is a feasible technique for lung cancer patients, providing an optimal sensitivity (90%). From our results it is advisable not to include patients without an histological diagnosis of cancer due to possible false positivity of the two methods, significantly reducing specificity. However, a proper patient selection is not easy and the future of this combined test relies essentially on the capacity to early identify only the subjects who would really benefit from both the procedures.
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- 2014
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17. Prognostic Evaluation of Disease Outcome in Solid Tumors Investigated With 64Cu-ATSM PET/CT
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Sandro Mattioli, Patrick M. Colletti, Filippo Lodi, Claudio Dazzi, Gianfranco Cicoria, Alessandro Gamboni, Silvia Cambioli, Ilaria Grassi, Egesta Lopci, Domenico Rubello, Stefano Fanti, Fabrizio Salvi, Lopci, E, Grassi, I, Rubello, D, Colletti, Pm, Cambioli, S, Gamboni, A, Salvi, F, Cicoria, G, Lodi, F, Dazzi, C, Mattioli, S, and Fanti, S.
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Adult ,Male ,Thiosemicarbazones ,medicine.medical_specialty ,Lung Neoplasms ,Disease outcome ,Multimodal Imaging ,030218 nuclear medicine & medical imaging ,64Cu-ATSM, PET/CT, hypoxia imaging, tumor hypoxia, head and neck cancer, non–small cell lung cancer ,03 medical and health sciences ,0302 clinical medicine ,Coordination Complexes ,Carcinoma, Non-Small-Cell Lung ,Organometallic Compounds ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Tumor imaging ,Multimodal imaging ,PET-CT ,medicine.diagnostic_test ,Tumor hypoxia ,business.industry ,Head and neck cancer ,General Medicine ,Middle Aged ,medicine.disease ,Tomography x ray computed ,Positron emission tomography ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Positron-Emission Tomography ,Female ,Radiology ,Radiopharmaceuticals ,business ,Tomography, X-Ray Computed - Abstract
PURPOSE: Cu-ATSM is a very promising PET radiopharmaceutical for tumor imaging of hypoxia. One of the advantages of this compound compared with other hypoxia-avid tracers is the high tumor-to-background signal offered, which guaranties facilitated tumor delineation. This study analyzes optimal semiquantitative and quantitative parameters obtained by Cu-ATSM PET/CT in the same cohort of patients with special focus on their correlation to disease outcome. PATIENTS AND METHODS: A prospective recruitment of 18 consecutive patients (M:F, 13:5; mean age, 60.7 years) with locally advanced non-small cell lung cancer (n = 7) or head and neck cancer (HNC) was performed. Each participant received 105 to 500 MBq of tracer according to body size and was scanned in a 3-dimensional mode PET/CT 60 minutes after tracer injection. PET images were reconstructed and visualized on a GE Advanced 4.6 workstation for the definition of semiquantitative and quantitative parameters: SUVmax, SUVratio-to-muscle, hypoxic tumor volume (HTV), and hypoxic burden (HB = HTV × SUVmean). These data were subsequently correlated to disease outcome, expressed in terms of progression-free survival calculated on a follow-up period with a median of 14.6 months. RESULTS: All patients showed a moderately to highly increased uptake of Cu-ATSM in tumor lesions, with a mean SUVmax of 5.2 (range, 1.9-8.3) and mean SUVratio of 4.4 (range, 1.6-6.8). In addition, a broad range of HTV and HB was defined as mean values of 99.3 cm (range, 2.5-453.7 cm) and 301 (4.2-1134), respectively. Receiver operating characteristic analysis identified as reference cutoffs with respect to disease outcome with the following values: SUVmax >2.5 (AUC, 0.57; sensitivity, 88.9%; specificity, 50%), SUVratio ≤4.4 (AUC, 0.60; sensitivity, 50; specificity, 83.3%), HTV >160.7 cm (AUC, 0.61; sensitivity, 55.6%; specificity, 75%), and HB >160.7 (AUC, 0.67; sensitivity, 58.3%; specificity, 83.3%). In our cohort, HB showed a statistically significant difference in terms of mean values on the analysis of variance test with respect to disease progression (P = 0.04). On univariate analysis, Cox regression confirmed these findings and showed a significant correlation to progression-free survival for HB (P = 0.05) and HTV (P = 0.02). CONCLUSIONS: In our cohort, the definition of optimal semiquantitative and quantitative parameters on Cu-ATSM PET/CT seems feasible and in line with previously published data. However, when considering the prognostic role with respect to disease outcome, the more robust parameters are represented by HTV and HB.
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- 2016
18. 11C-choline PET/CT identifies osteoblastic and osteolytic lesions in patients with metastatic prostate cancer
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Stefano Costa, Patrick M. Colletti, Riccardo Schiavina, Domenico Rubello, Tiziano Graziani, Sotirios Chondrogiannis, Francesco Ceci, Rachele Bonfiglioli, Irene Virgolini, Stefano Fanti, Paolo Castellucci, Ceci F, Castellucci P, Graziani T, Schiavina R, Chondrogiannis S, Bonfiglioli R, Costa S, Virgolini IJ, Rubello D, Fanti S, and Colletti PM
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Oncology ,Male ,medicine.medical_specialty ,Bone Neoplasms ,urologic and male genital diseases ,Multimodal Imaging ,Choline ,Prostate cancer ,Text mining ,Antigen ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Carbon Radioisotopes ,Aged ,Aged, 80 and over ,Psa kinetics ,business.industry ,11C-Choline PET/CT Identifies Osteoblastic and Osteolytic Lesions in Patients with Metastatic Prostate Cancer ,Prostatic Neoplasms ,General Medicine ,Middle Aged ,medicine.disease ,11c choline pet ct ,Positron-Emission Tomography ,Radiology ,Radiopharmaceuticals ,business ,Tomography, X-Ray Computed - Abstract
AIM: The aim of this study was to compare C-choline PET/CT, prostate-specific antigen (PSA), PSA kinetics, and C-choline uptake in recurrent metastatic prostate cancer patients with osteoblastic and osteolytic bone metastases. PATIENTS AND METHODS: We retrospectively analyzed 140 patients with the following criteria: (a) positive bone lesions identified with C-choline PET/CT and validated as true positive by histology (14.2%), correlative imaging (33.4%), or clinical follow-up (52.4%); (b) after radical prostatectomy (67.9%) or primary radiotherapy (22.1%); (c) proven biochemical relapse with rising PSA levels; (d) no chemotherapy, zoledronic acid, or palliative bone external beam radiation therapy previously administrated during biochemical relapse; and (f) asymptomatic for bone pain. Lesions were categorized as osteoblastic, osteolytic, or bone marrow lesions. Patients were divided into osteoblastic and osteolytic patient groups. RESULTS: C-Choline PET/CT detected oligometastatic bone disease (1-3 lesions) in 98 (70%) of the 140 patients and multiple bone lesions in 42 (30%) of the 140 patients. By per-lesion analysis of 304 lesions, there were 184 osteoblastic, 99 osteolytic, and 21 bone marrow lesions.By per-patient analysis, 97 (69.3%) of the 140 patients were in the osteoblastic group, whereas 43 (30.7%) of the 140 patients were in the osteolytic group. Statistically significant differences in SUVmax (P < 0.001), fast PSA doubling time (P = 0.01), and PSA velocity (P = 0.01) were observed between osteoblastic (lower values) and osteolytic (higher values) groups. By multivariate analysis, fast PSA doubling time was a significant predictor for osteolytic lesions. CONCLUSIONS: We demonstrated differences in PSA kinetics and SUVmax between osteolytic and osteoblastic lesions. C-Choline PET/CT may identify patients that could benefit from early targeted therapies, depending on the type of bone lesions expressed.
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- 2015
19. 11C-Choline PET/CT and Bladder Cancer: Lymph Node Metastasis Assessment With Pathological Specimens as Reference Standard
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Patrick M. Colletti, Brunocilla Eugenio, Tiziano Graziani, Domenico Rubello, Paolo Castellucci, Francesco Ceci, Giuseppe Martorana, Stefano Fanti, Lorenzo Bianchi, Christian Pultrone, Riccardo Schiavina, Ceci F, Bianchi L, Graziani T, Castellucci P, Pultrone C, Eugenio B, Martorana G, Colletti PM, Rubello D, Fanti S, and Schiavina R
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Adult ,Male ,medicine.medical_specialty ,Pathology ,Lymph node metastasis ,Multimodal Imaging ,Choline ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Carbon Radioisotopes ,skin and connective tissue diseases ,Pathological ,Reference standards ,Aged ,Aged, 80 and over ,Bladder cancer ,business.industry ,Carcinoma ,General Medicine ,Middle Aged ,Reference Standards ,medicine.disease ,Bladder Cancer ,11c choline pet ct ,Urinary Bladder Neoplasms ,Lymphatic Metastasis ,Positron-Emission Tomography ,Female ,Radiology ,Radiopharmaceuticals ,Tomography, X-Ray Computed ,business - Abstract
AIM: The aim of this study was to evaluate the potential role of C-choline-PET/CT in nodal assessment in patients with bladder cancer (BCa) using the pathological specimen as reference standard. PATIENTS AND METHODS: Fifty-nine patients with proven BCa were retrospectively enrolled from April 2011 to January 2014 (mean [SD] age, 70.1 [9] years; range 49-85 years). Of 59 patients, 39 (staging group) were referred to C-choline-PET/CT for preoperative lymph node (LN) evaluation before radical cystectomy and extended pelvic LN dissection. Of the 59 patients, 29 (restaging group) had C-choline-PET/CT for suspected BCa relapse after primary radical surgery. In both groups, C-choline-PET/CT findings were correlated with histology. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated to assess C-choline-PET/CT feasibility in LN assessment. Age, TNM, histology, and previous chemotherapy were analyzed as additional predictive factors. RESULTS: C-choline-PET/CT overall detection rate was 62.7% (37/59 patients). On a regional-based analysis, C-choline-PET/CT was considered positive for primary cancer and/or local relapse in bladder bed in 54.2% of the patients (32/59). Pathological LN uptake was reported in 23.7% of the patients (14/59) and systemic choline deposit (bone or lung) in 11.8% of the patients (7/59). Considering LN metastasis detection, compared with histological analysis, C-choline-PET/CT showed in the whole population a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 59%, 90%, 71%, 84%, and 81%, respectively. No other investigated factors reached statistical significance. CONCLUSIONS: C-choline-PET/CT may provide additional diagnostic information in preoperative nodal staging of patients with BCa and be considered a useful tool to restage patients with BCa suspected of relapse. Further studies are needed to assess if C-choline-PET/CT could have an influence on survival of patients with BCa.
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- 2015
20. Pretherapeutic dosimetry in patients affected by metastatic thyroid cancer using 124I PET/CT sequential scans for 131I treatment planning
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Stefano Fanti, C. Pettinato, Vincenzo Allegri, Simona Civollani, Gaia Grassetto, Paolo Zagni, S. Cima, Emiliano Spezi, Domenico Rubello, Fabio Monari, Cristina Nanni, Patrick M. Colletti, Renzo Mazzarotto, Pettinato C, Spezi E, Nanni C, Grassetto G, Monari F, Allegri V, Civollani S, Cima S, Zagni P, Mazzarotto R, Colletti PM, Rubello D, and Fanti S
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Adult ,Male ,medicine.medical_specialty ,chemistry.chemical_element ,Iodine ,Multimodal Imaging ,Lesion ,Iodine Radioisotopes ,Therapeutic index ,medicine ,Dosimetry ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Thyroid Neoplasms ,Neoplasm Metastasis ,Radiation treatment planning ,Thyroid cancer ,Aged ,PET-CT ,business.industry ,Radiotherapy Dosage ,General Medicine ,Middle Aged ,medicine.disease ,chemistry ,Positron-Emission Tomography ,metastatic thyroid, 124I, 131I ,Female ,Radiology ,medicine.symptom ,Radiopharmaceuticals ,Nuclear medicine ,business ,Tomography, X-Ray Computed - Abstract
Purpose: This study evaluates the use of sequential 124I PET/CT for predicting absorbed doses to metastatic lesions in patients with differentiated thyroid cancer undergoing 131I therapy. Methods: From July 2011 until July 2013, 30 patients with metastatic differentiated thyroid cancer were enrolled. Each participant underwent PET/CT at 4, 24, 48, and 72 hours with 74 MBq of 124I. Blood samples and whole-body exposure measurements were obtained to calculate blood and red marrow doses. Activity concentrations and lesion volumes obtained from PET/CT were used to evaluate tumor doses with medical internal radiation dose formalism and spheres modeling. Mean administered 131I therapeutic dose was 5994 MBq (range, 1953–11,455 MBq). Results: 124I PET/CT demonstrated all lesions detected by posttherapy 131I whole-body scans. Mean dose rates for blood, red marrow, and lesions were as follows: 0.07 ± 0.02 mGy/MBq, 0.05 ± 0.02 mGy/MBq, and 46.5 ± 117 mGy/MBq, respectively. Despite the high level of thyroid-stimulating hormone and CT detectable lesions, 15 of 30 patients did not show any abnormal 124I uptake. Conclusions: The quantitative value of 124I PET/CT allows simple and accurate evaluation of lesion dosimetry following medical internal radiation dose formalism. Negative 124I PET/CT predicts absence of iodine avidity, potentially allowing avoidance of therapeutically ineffective 131I administration.
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- 2014
21. Usefulness of 64Cu-ATSM in head and neck cancer: a preliminary prospective study
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Feisal Bunkheila, Claudio Blasi, Egesta Lopci, Gianfranco Cicoria, Cristina Nanni, Domenico Rubello, Ilaria Grassi, Patrick M. Colletti, Stefano Fanti, Grassi I, Nanni C, Cicoria G, Blasi C, Bunkheila F, Lopci E, Colletti PM, Rubello D, and Fanti S
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Male ,Thiosemicarbazones ,Prognostic factor ,medicine.medical_specialty ,Response to therapy ,Multimodal Imaging ,Coordination Complexes ,medicine ,Organometallic Compounds ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,business.industry ,Head and neck cancer ,Positron emitters ,General Medicine ,Radiotherapy treatment planning ,Hypoxia (medical) ,Middle Aged ,medicine.disease ,64Cu-ATSM, neck, head ,Tumor Burden ,Head and Neck Neoplasms ,Positron-Emission Tomography ,Female ,Radiology ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
AIMS: Cu-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) is a hypoxia-avid, positron emitter radiotracer. The primary aim of this study is to assess the efficacy of pretherapy Cu-ATSM PET/CT as a prognostic factor of response to therapy. The secondary aims are to investigate if there is a difference between early and late PET/CT scans and if there is a difference between the biologic tumor volume (BTV) in radiotherapy treatment planning calculated between Cu-ATSM and F-FDG, and to assess if Cu-ATSM is a prognostic marker of disease progression. METHODS: Eleven patients with head and neck cancer treated with chemoradiotherapy were enrolled prospectively; both Cu-ATSM and F-FDG PET/CT scans before and after treatment were obtained. The Cu-ATSM scans were performed after 1 hour (early) and 16 hours (late). RESULTS: All patients had stage III or IV squamous cell head and neck cancer; 7 of 11 patients had nodal metastasis, and 22 cancer foci were detected with Cu-ATSM. SUVmax was 16.2 ± 7.9, and there was no significant SUVmax difference between early and late imaging. F-FDG SUVmax before therapy was 15.6 ± 9.4, whereas F-FDG SUVmax after therapy was 1.5 ± 1.2. Sensitivity and specificity values of Cu-ATSM calculated with receiver operating characteristic curves were 100% and 50% considering the SUVmax and 100% and 33% considering the volume, respectively. No difference has been found between the BTV contoured with Cu-ATSM and F-FDG. CONCLUSIONS: The Cu-ATSM scans showed high sensitivity but low specificity in predicting neoadjuvant chemoradiotherapy response. No difference was noted between early and late scans. F-FDG and Cu-ATSM provided similar results about delineation of BTV.
- Published
- 2013
22. 11C-choline PET/CT scan in patients with prostate cancer treated with intermittent ADT: A sequential PET/CT study
- Author
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Paolo Castellucci, Claudio Malizia, Giuseppe Martorana, Daniele Romagnoli, Chiara Fuccio, Domenico Rubello, Francesco Ceci, Stefano Fanti, Riccardo Schiavina, Alice Ferretti, Eugenio Brunocilla, Sotirios Chondrogiannis, Patrick M. Colletti, Ceci F, Schiavina R, Castellucci P, Brunocilla E, Fuccio C, Colletti PM, Ferretti A, Chondrogiannis S, Rubello D, Romagnoli D, Malizia C, Martorana G, and Fanti S.
- Subjects
Male ,11C-choline ,medicine.medical_specialty ,C-Choline PET/CT ,Androgen deprivation therapy ,Prostate cancer ,Recurrent prostate cancer ,ADT ,Multimodal Imaging ,Choline ,Text mining ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Carbon Radioisotopes ,Antiandrogen Therapy ,Aged ,Aged, 80 and over ,PET-CT ,business.industry ,Prostatic Neoplasms ,Androgen Antagonists ,General Medicine ,medicine.disease ,humanities ,11c choline pet ct ,Positron-Emission Tomography ,Radiology ,Tomography, X-Ray Computed ,business ,Nuclear medicine - Abstract
AIM: The purpose of this preliminary study was to evaluate the usefulness of 11C-choline PET/CT in patients with recurrent prostate cancer and hormone-sensitive disease treated with intermittent antiandrogen therapy scheme. PATIENTS AND METHODS: We retrospectively evaluated 10 patients after radical prostatectomy (n = 8) or external beam radiotherapy (n = 2) as primary therapy, studied with sequential 11C-choline PET/CT. The first PET/CT (PET1) was performed during antiandrogen therapy (ADT) and the second PET/CT (PET2) was performed after therapy interruption. Only patients with negative results at PET1 were included in the study. At the time of PET1, all patients were under ADT from at least 6 months (mean PSA 0.54 ng/mL). At the time of PET2, all patients had completed ADT for a mean period of 7 months. 11C-Choline PET/CT findings were validated by a follow-up of at least 12 months or histological confirmation in case of local relapse. RESULTS: PET2 has been able to detect the site of recurrences in all cases. At the time of PET2, mean PSA was 3.88 ng/mL; mean PSAdt was 2.46 months; and mean PSAvel was 6.94 ng/mL/year. Four out of 10 patients showed a single lesion, 5 out of 10 patients showed 2 lesions and 1 patient showed multiple lymph-node lesions. CONCLUSION: When performed during ADT interruption, 11C-choline PET/CT has been able to detect the site of recurrence in patients with increasing PSA values. In this context, 11C-choline PET/CT may help to assess the burden of disease or to change the therapeutic approach using more aggressive and addressed therapies like guided RT or salvage lymph-node dissection.
- Published
- 2013
23. Role of 18F-choline PET/CT in biochemically relapsed prostate cancer after radical prostatectomy: correlation with trigger PSA, PSA velocity, PSA doubling time, and metastatic distribution
- Author
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Sotirios Chondrogiannis, Domenico Rubello, Gaia Grassetto, Maria Picchio, Adil Al-Nahhas, Patrick M. Colletti, Adriano Marcolongo, Lucia Rampin, Maria Cristina Marzola, Paolo Castellucci, Alice Ferretti, Arianna Massaro, Marzola, Mc, Chondrogiannis, S, Ferretti, A, Grassetto, G, Rampin, L, Massaro, A, Castellucci, P, Picchio, M, Al Nahhas, A, Colletti, Pm, Marcolongo, A, and Rubello, D.
- Subjects
Oncology ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Urology ,18F-choline ,Multimodal Imaging ,Choline ,Prostate cancer ,Recurrence ,Internal medicine ,medicine ,Distribution (pharmacology) ,Doubling time ,Humans ,Radiology, Nuclear Medicine and imaging ,Neoplasm Metastasis ,Aged ,Aged, 80 and over ,Prostatectomy ,PSA Velocity ,PET-CT ,business.industry ,Prostatic Neoplasms ,General Medicine ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Positron-Emission Tomography ,Multivariate Analysis ,Biochemical relapse ,business ,Tomography, X-Ray Computed - Abstract
The aim of this study was to evaluate the efficacy of ¹⁸F-choline PET/CT (18FCH-PET/CT) in restaging patients previously treated by radical prostatectomy for a prostate cancer, presenting with biochemical relapse during follow-up (FU).Three hundred thirty-one patients referred to us from January 2009 to April 2011 to perform 18FCH PET/CT were evaluated: 233 of them (mean age 69.7 years) met the inclusion criteria of the study: (1) biochemical relapse after radical prostatectomy (trigger PSA0.2 ng/mL) (n=224) and (2) high risk for relapse (elevated Gleason score≥8) in spite PSA0.1 ng/mL during FU (n=9). Trigger PSA was available for all patients (mean 8 ng/mL) and in 44 of them also PSA kinetic (PSA velocity-PSAvel; PSA doubling time-PSAdt). Correlation between 18FCH PET/CT detection rate and trigger PSA, PSAvel, PSAdt, and tumoral spread distribution were evaluated by univariate and multivariate analysis. Subsequent minimum FU was 1 year (mean 26 months, range 12-40).Overall detection rate of 18FCH PET/CT was 54%, which significantly increased when the trigger PSA increases (P0.001). PET-positive patients presented a "fast" PSA kinetic (mean PSAdt=6 months and mean PSAvel=9.3 ng/mL/yr), while PET-negative patients presented a "slow" PSA kinetic (mean PSAdt=15.4 months and mean PSAvel=0.9 ng/mL/yr). Disease relapse was local in 17% of cases, distant in 66%, and combined in 17%.Overall 18FCH PET/CT detection rate was 54% (ie, similar to that reported in literature with ¹¹C-choline), which increases with the increase in trigger PSA: this condition was particularly true in patients with accelerated PSA kinetic. In about 20% of patients, 18FCH PET/CT demonstrated local relapses early enough to offer locoregional radiation therapy.
- Published
- 2012
24. PET/CT in the management and prognosis of pancreatic exocrine tumors
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Stefano Fanti, Patrick M. Colletti, Domenico Rubello, Cristina Nanni, Nanni C, Fanti S, Colletti PM, and Rubello D.
- Subjects
Male ,PET-CT ,medicine.medical_specialty ,business.industry ,pacreatic exocrine ,General Medicine ,Multimodal Imaging ,Pancreatic Neoplasms ,Positron-Emission Tomography ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Female ,Radiology ,Misonidazole ,business ,Tomography, X-Ray Computed - Abstract
Detection of hypoxia with 18F-fluoromisonidazole (18F-FMISO) PET/CT in suspected or proven pancreatic cancer.
- Published
- 2012
25. SNMMI Procedure Standard/EANM Practice Guideline for Brain [ 18 F]FDG PET Imaging, Version 2.0.
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Arbizu J, Morbelli S, Minoshima S, Barthel H, Kuo P, Van Weehaeghe D, Horner N, Colletti PM, and Guedj E
- Abstract
PREAMBLEThe Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote the science, technology, and practical application of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional nonprofit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The EANM was founded in 1985. SNMMI and EANM members are physicians, technologists, and scientists specializing in the research and practice of nuclear medicine.The SNMMI and EANM will periodically define new guidelines for nuclear medicine practice to help advance the science of nuclear medicine and to improve the quality of service to patients throughout the world. Existing practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated.Each practice guideline, representing a policy statement by the SNMMI/EANM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI and EANM recognize that the safe and effective use of diagnostic nuclear medicine imaging requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guideline by those entities not providing these services is not authorized.These guidelines are an educational tool designed to assist practitioners in providing appropriate care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, both the SNMMI and the EANM caution against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question.The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the physician or medical physicist in light of all the circumstances presented. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines.The practice of medicine includes both the art and the science of the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment.Therefore, it should be recognized that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)
- Published
- 2024
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26. Dr. Carolyn Meltzer: Pioneer, innovator, mentor, and 2023 ACR Gold Medal winner.
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Collier NS and Colletti PM
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- History, 21st Century, Humans, United States, History, 20th Century, Societies, Medical history, Awards and Prizes, Radiology history, Mentors
- Abstract
Dr. Carolyn Meltzer is an extraordinary radiologist, researcher, mentor, and distinguished leader who deserves recognition for her immense impact on the discipline of radiology. This article serves to acknowledge and celebrate Dr. Meltzer for winning the 2023 American College of Radiology (ACR) Gold Medal. The ACR Gold Medal award is the highest honor awarded to distinguished radiologists with exceptional contributions to the field, and Dr. Meltzer is no exception. She is the 14th woman to win this prestigious award, compared to 191 male winners, although it began as an annual tradition in 1927. Throughout this piece, Dr. Meltzer discusses her journey to where she is today as the dean of Keck School of Medicine at USC, the guidance and development that lead her to this point and provides sound advice for those who seek to follow in her footsteps as a leader and mentor committed to seeking ways to advance and contribute immensely to the field of radiology., Competing Interests: Declaration of competing interest The authors have no competing interests to declare. All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is original work and not under review at any other publication., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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27. Advancements and future directions in positron emission tomography-guided radiotherapy: a narrative review.
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Mehta S, Yang C, Jadvar H, Colletti PM, Conti PS, Ma L, Chang EL, and Ye JC
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- Humans, Neoplasms radiotherapy, Neoplasms diagnostic imaging, Positron-Emission Tomography methods, Radiotherapy, Image-Guided methods
- Abstract
Background and Objective: Positron emission tomography (PET) imaging has been useful in delineating tumor volumes and allowing for improved radiation treatment. The field of PET-guided radiotherapy is rapidly growing and will have significant impact on radiotherapy delivery in the future. This narrative review provides an overview of the current state of PET-guided radiotherapy as well as the future directions of the field., Methods: For this narrative review, PubMed was searched for articles from 2010-2023. A total of 18 keywords or phrases were searched to provide an overview of PET-guided radiotherapy, radiotracers, the role of PET-guided radiotherapy in oligometastatic disease, and biology-guided radiotherapy (BgRT). The first 300 results for each keyword were searched and relevant articles were extracted. The references of these articles were also reviewed for relevant articles., Key Content and Findings: In radiotherapy, 18F-2-fluoro-2-deoxy-D-glucose (F-FDG or FDG) is the major radiotracer for PET and when combined with computed tomography (CT) scan allows for anatomic visualization of metabolically active malignancy. Novel radiotracers are being explored to delineate certain cell types and numerous tumor metrics including metabolism, hypoxia, vascularity, and cellular proliferation. This molecular and functional imaging will provide improved tumor characterization. Through these radiotracers, radiation plans can employ dose painting by creating different dose levels based upon specific risk factors of the target volume. Additionally, biologic imaging during radiotherapy can allow for adaptation of the radiation plan based on response to treatment. Dose painting and adaptive radiotherapy should improve the therapeutic ratio through more selective dose delivery. The novel PET-linear accelerator hopes to combine these techniques and more by using radiotracers to deliver BgRT. The areas of radiotracer uptake will serve as fiducials to guide radiotherapy to themselves. This technique may prove promising in the growing area of oligometastatic radiation treatment., Conclusions: Significant challenges exist for the future of PET-guided radiotherapy. However, with the advancements being made, PET imaging is set to change the delivery of radiotherapy.
- Published
- 2024
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28. PSMA Radioligand Therapy in Prostate Cancer: Where Are We and Where Are We Heading?
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Almeida LS, Etchebehere ECSC, García Megías I, Calapaquí Terán AK, Hadaschik B, Colletti PM, Herrmann K, Giammarile F, and Delgado Bolton RC
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- Male, Humans, Prostate-Specific Antigen, Prostatic Neoplasms radiotherapy, Prostatic Neoplasms, Castration-Resistant
- Abstract
Abstract: Diagnosis and treatment of prostate cancer are complex and very challenging, being a major health care burden. The efficacy of radioligand therapy with prostate-specific membrane antigen agents has been proven beneficial in certain clinical indications. In this review, we describe management of prostate cancer patients according to current guidelines, especially focusing on the available clinical evidence for prostate-specific membrane antigen radioligand therapy., Competing Interests: Conflicts of interest and sources of funding: K.H. reports personal fees and other from Sofie Biosciences; nonfinancial support from ABX; grants and personal fees from BTG; and personal fees from Bayer, SIRTEX, Adacap, Curium, Endocyte, IPSEN, Siemens Healthineers, GE Healthcare, Amgen, Fusion, Immedica, Onkowissen.de, Novartis, Molecular Partners, Y-mAbs, Aktis Oncology, Theragnostics, Pharma15, Debiopharm, AstraZeneca, and Janssen. B.H. reports grants to institution from Novartis, BMS, and the German Research Foundation; consulting fees from ABX, Amgen, AstraZeneca, Bayer, BMS, Janssen, Lightpoint Medical, and Pfizer; payment for lectures from Janssen; support for travel or attending meetings from Bayer and Janssen; and participation on data safety monitoring boards for Janssen. The rest of the authors report that they have no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2024
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29. Skeletal Fluorosis.
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Gerges MM, Ngo VT, Tu J, Colletti PM, and Wassef H
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- Male, Humans, Adult, Fluorides, Tomography, X-Ray Computed, Bone and Bones
- Abstract
Abstract: A 27-year-old man with polysubstance abuse including methamphetamine, fentanyl, and 1.5 years of electronics compressed gas duster inhalation presented following an assault. Radiologic imaging performed for suspected fractures revealed periosteal reaction, cortical thickening with increased bone density, and ligament and tendon ossification, which were not present on imaging obtained 3 years before presentation. A bone scan was subsequently performed revealing a metabolic superscan with cortical irregularity. Further investigation revealed skeletal fluorosis from electronics compressed gas duster inhalation. Skeletal fluorosis may be considered when these osseous findings are encountered., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
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30. Chatbots in Medical Research: Advantages and Limitations of AI-Enabled Writing With a Focus on ChatGPT as an Author: Reply.
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Colletti PM
- Subjects
- Humans, Artificial Intelligence, Biomedical Research
- Published
- 2023
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31. Clinical Trials of Prostate-Specific Membrane Antigen Radiopharmaceutical Therapy.
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Jadvar H and Colletti PM
- Subjects
- Male, Humans, Prostate, Prostate-Specific Antigen, Dipeptides therapeutic use, Radiopharmaceuticals therapeutic use, Prostatic Neoplasms, Castration-Resistant pathology
- Abstract
Prostate-specific membrane antigen (PSMA) theranostics has been a momentous triumph for nuclear medicine. The recent approvals of PSMA-targeted imaging agents (
68 Ga-PSMA-11,18 F-DCFPyL) and radiopharmaceutical therapy (177 Lu-PSMA-617) have paved the way for theranostics as a viable care strategy for men with metastatic castration-resistant prostate cancer. The imaging clinical trials OSPREY, CONDOR, and those conducted at the University of California (Los Angeles and San Francisco), as well as the randomized phase 3 therapy trial VISION, have been the fruitful beginnings for PSMA theranostics. There are currently several ongoing clinical trials to expand the reach of PSMA theranostics to the earlier phases of prostate cancer and to optimize its utility in combination therapeutic regimens. We provide a brief narrative review of the many PSMA-directed radiopharmaceutical therapy clinical trials with the β-emitter177 Lu-PSMA-617 and the α-emitter225 Ac-PSMA-617 in prostate cancer., (© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)- Published
- 2023
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32. Supply Issues in Nuclear Medicine.
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Jadvar DA and Colletti PM
- Subjects
- Humans, Radionuclide Imaging, Nuclear Medicine, COVID-19
- Abstract
Abstract: Issues related to the distribution and availability of supplies and personnel in nuclear medicine are well known and episodic. The combination of COVID-related restrictions and the unprecedented growth of our specialty have acutely exacerbated these supply and demand mismatches., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
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33. Re: Aducanumab-Related ARIA: Paean or Lament?
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Wassef HR and Colletti PM
- Subjects
- Humans, Reproducibility of Results, Antibodies, Monoclonal, Humanized adverse effects, Amyloid, Amyloid beta-Peptides, Alzheimer Disease diagnostic imaging
- Abstract
Abstract: Høilund-Carlsen and colleagues raise concern regarding the reliability of amyloid PET to exclude Alzheimer disease. We present additional studies of amyloid PET and discuss the diagnostic challenges in Alzheimer disease. We discuss the limitations of amyloid in diagnosis and evaluation of therapy response in AD., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
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34. Commentary: Aducanumab-Related ARIA: Paean or Lament?
- Author
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Wassef HR and Colletti PM
- Subjects
- Amyloid, Amyloid beta-Peptides, Antibodies, Monoclonal, Humanized adverse effects, Humans, Plaque, Amyloid, Alzheimer Disease diagnostic imaging
- Abstract
Abstract: Høilund-Carlsen and colleagues raise important issues related to amyloid PET, diagnosis of Alzheimer disease, and recently approved antiamyloid treatment aducanumab. We discuss new developments that may direct us to methods of presymptomatic detection of Alzheimer disease and development of effective prevention and therapy., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2022
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35. Molecular Imaging Assessment of Androgen Deprivation Therapy in Prostate Cancer.
- Author
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Jadvar H and Colletti PM
- Subjects
- Androgen Antagonists therapeutic use, Androgens, Humans, Male, Molecular Imaging, Positron Emission Tomography Computed Tomography methods, Positron-Emission Tomography, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms drug therapy, Prostatic Neoplasms pathology
- Abstract
Hormonal therapy has long been recognized as a mainstay treatment for prostate cancer. New generation imaging agents have provided unprecedented opportunities at all phases along the natural history of prostate cancer. We review the literature on the effect of androgens and androgen deprivation therapy on prostate tumor at its various biological phases using the new generation molecular imaging agents in conjunction with positron emission tomography., (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Published
- 2022
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36. Sentinel Node Biopsy Imaging in Breast Cancer: Scatter Reduction Using 3-Dimensionally Printed Lead Shields.
- Author
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Cañete-Sánchez FM, Boulvard-Chollet XLE, Chamorro X, Marrodán MArch PJ, Garrastachu Zumarán P, Ramírez Lasanta R, Colletti PM, Giammarile F, and Delgado Bolton RC
- Subjects
- Female, Humans, Lymph Nodes pathology, Lymphatic Metastasis pathology, Radionuclide Imaging, Radiopharmaceuticals, Sentinel Lymph Node Biopsy methods, Breast Neoplasms pathology
- Abstract
Background: Point of injection scatter (SPI) confounds breast cancer sentinel lymph node detection. Round flat lead shields (FLSs) incompletely reduce SPI, requiring repositioning. We designed lead shields that reduce SPI and acquisition time., Methods: Two concave lead shields, a semioval lead shield (OLS) and a semispherical lead alloy shield (SLS), were created with a SICNOVA JCR 1000 3D printer to cover the point of injection (patent no. ES1219895U). Twenty breast cancer patients had anterior and anterior oblique imaging, 5 minutes and 2 hours after a single 111 MBq nanocolloid in 0.2 mL intratumoral or periareolar injection. Each acquisition was 2 minutes. Absolute and normalized background corrected scatter counts (CSCs) and scatter reduction percentage (%SR) related to the FLS were calculated. Repositionings were recorded. Differences between means of %SR (t test) and between means of CSC (analysis of variance) with Holm multiple comparison tests were determined., Results: Mean %SR was 91.8% with OLS and 92% using SLS in early images (P = 0.91) and 87.2%SR in OLS and 88.5% in late images (P = 0.66). There were significant differences between CSC using FLS and OLS (P < 0.001) and between FLS and SLS (P < 0.001), but not between OLS and SLS (P = 0.17) in early images, with the same results observed in delayed studies (P < 0.001 in relation to FLS and P = 0.1 between both curved lead shields). Repositioning was required 14/20 times with FLS, 4/20 times with OLS, and 2/20 times with SLS., Conclusions: We designed 2 concave lead shields that significantly reduce the SPI and repositioning with sentinel lymph node lymphoscintigraphy., Competing Interests: Conflicts of interest and sources of funding: F.M.C.-S., X.L.E.B.-C., X.C., and P.J.M. are listed as inventors on the Spanish patent application number ES 1 219 895 U filed by the Centre for Biomedical Research of La Rioja relating to the process of creation use and properties of scatter absorption shields. The other authors have no conflicts of interest to declare., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2022
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37. Targeted α-therapy in non-prostate malignancies.
- Author
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Jadvar H and Colletti PM
- Subjects
- Humans, Male, Radiopharmaceuticals, Prostatic Neoplasms, Radioisotopes
- Abstract
Progress in unraveling the complex biology of cancer, novel developments in radiochemistry, and availability of relevant α-emitters for targeted therapy have provided innovative approaches to precision cancer management. The approval of
223 Ra dichloride for treatment of men with osseous metastatic castrate-resistant prostate cancer unleashed targeted α-therapy as a safe and effective cancer management strategy. While there is currently active research on new α-therapy regimens for prostate cancer based on the prostate-specific membrane antigen, there is emerging development of radiopharmaceutical therapy with a range of biological targets and α-emitting radioisotopes for malignancies other than the prostate cancer. This article provides a brief review of preclinical and first-in-human studies of targeted α-therapy in the cancers of brain, breast, lung, gastrointestinal, pancreas, ovary, and the urinary bladder. The data on leukemia, melanoma, myeloma, and neuroendocrine tumors will also be presented. It is anticipated that with further research the emerging role of targeted α-therapy in cancer management will be defined and validated., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)- Published
- 2021
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38. Hip Adduction during Running: Influence of Sex, Hip Abductor Strength and Activation, and Pelvis and Femur Morphology.
- Author
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Liu J, Lewton KL, Colletti PM, and Powers CM
- Subjects
- Adolescent, Adult, Biomechanical Phenomena, Electromyography, Female, Femur diagnostic imaging, Humans, Male, Muscle, Skeletal physiology, Pelvis diagnostic imaging, Tomography, X-Ray Computed, Young Adult, Femur anatomy & histology, Hip Joint physiology, Muscle Strength, Pelvis anatomy & histology, Running physiology, Sex Characteristics
- Abstract
Purpose: To examine the influence of hip abductor strength, neuromuscular activation, and pelvis and femur morphology in contributing to sex differences in hip adduction during running. In addition, we sought to determine the best predictors of hip adduction during running for both men and women., Methods: Fifteen female runners and 14 male runners underwent strength testing, instrumented overground running (e.g., kinematics and muscle activation), and computed tomography scanning of pelvis and femur. Morphologic measurements included bilateral hip width to femur length ratio, acetabulum abduction, acetabulum anteversion, femoral anteversion, and femoral neck-shaft angles. Sex differences for all variables were examined using independent t tests. Linear regression was used to assess the ability of each independent variable of interest to predict peak hip adduction during the late swing and stance phase of running., Results: Compared with men, women exhibited significantly greater peak hip adduction during both late swing (8.5° ± 2.6° vs 6.2° ± 2.8°, P = 0.04) and stance phases of running (13.4° ± 4.2° vs 10.0° ± 3.2°, P = 0.02). In addition, women exhibited significantly lower hip abductor strength (1.8 ± 0.3 vs 2.0 ± 0.3 N·m·kg-1, P = 0.04), greater femoral neck-shaft angles (134.1° ± 5.0° vs 129.9° ± 4.1°, P = 0.01), and greater hip width to femur length ratios than men (0.44 ± 0.02 vs 0.42 ± 0.03, P = 0.03). Femoral anteversion was the only significant predictor of peak hip adduction during late swing (r = 0.36, P = 0.05) and stance (r = 0.41, P = 0.03)., Conclusions: Our findings highlight the contribution of femur morphology as opposed to hip abductor strength and activation in contributing to hip adduction during running., (Copyright © 2021 by the American College of Sports Medicine.)
- Published
- 2021
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39. EANM guideline on the role of 2-[ 18 F]FDG PET/CT in diagnosis, staging, prognostic value, therapy assessment and restaging of ovarian cancer, endorsed by the American College of Nuclear Medicine (ACNM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the International Atomic Energy Agency (IAEA).
- Author
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Delgado Bolton RC, Aide N, Colletti PM, Ferrero A, Paez D, Skanjeti A, and Giammarile F
- Subjects
- Female, Fluorodeoxyglucose F18, Humans, Molecular Imaging, Neoplasm Recurrence, Local, Neoplasm Staging, Positron Emission Tomography Computed Tomography, Prognosis, Radiopharmaceuticals, United States, Nuclear Energy, Nuclear Medicine, Ovarian Neoplasms diagnostic imaging, Ovarian Neoplasms pathology, Ovarian Neoplasms therapy
- Abstract
In most patients with ovarian carcinoma, the diagnosis is reached when the disease is long past the initial stages, presenting already an advanced stage, and they usually have a very bad prognosis. Cytoreductive or debulking surgical procedures, platinum-based chemotherapy and targeted agents are key therapeutic elements. However, around 7 out of 10 patients present recurrent disease within 36 months from the initial diagnosis. The metastatic spread in ovarian cancer follows three pathways: contiguous dissemination across the peritoneum, dissemination through the lymphatic drainage and, although less importantly in this case, through the bloodstream. Radiological imaging, including ultrasound, CT and MRI, are the main imaging techniques in which management decisions are supported, CT being considered the best available technique for presurgical evaluation and staging purposes. Regarding 2-[
18 F]FDG PET/CT, the evidence available in the literature demonstrates efficacy in primary detection, disease staging and establishing the prognosis and especially for relapse detection. There is limited evidence when considering the evaluation of therapeutic response. This guideline summarizes the level of evidence and grade of recommendation for the clinical indications of 2-[18 F]FDG PET/CT in each disease stage of ovarian carcinoma., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)- Published
- 2021
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40. ACR Appropriateness Criteria® Intensive Care Unit Patients.
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Laroia AT, Donnelly EF, Henry TS, Berry MF, Boiselle PM, Colletti PM, Kuzniewski CT, Maldonado F, Olsen KM, Raptis CA, Shim K, Wu CC, and Kanne JP
- Subjects
- Diagnostic Imaging, Humans, Intensive Care Units, United States, Critical Care, Societies, Medical
- Abstract
Chest radiography is the most frequent and primary imaging modality in the intensive care unit (ICU), given its portability, rapid image acquisition, and availability of immediate information on the bedside preview. Due to the severity of underlying disease and frequent need of placement of monitoring devices, ICU patients are very likely to develop complications related to underlying disease process and interventions. Portable chest radiography in the ICU is an essential tool to monitor the disease process and the complications from interventions; however, it is subject to overuse especially in stable patients. Restricting the use of chest radiographs in the ICU to only when indicated has not been shown to cause harm. The emerging role of bedside point-of-care lung ultrasound performed by the clinicians is noted in the recent literature. The bedside lung ultrasound appears promising but needs cautious evaluation in the future to determine its role in ICU patients. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment., (Copyright © 2021. Published by Elsevier Inc.)
- Published
- 2021
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- View/download PDF
41. Agreement Between 18F-FDG PET/CT and Whole-Body Magnetic Resonance Compared With Skeletal Survey for Initial Staging and Response at End-of-Treatment Evaluation of Patients With Multiple Myeloma.
- Author
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Gómez León N, Aguado Bueno B, Herreros Pérez M, León Ramírez LF, Alegre A, Colletti PM, Rubello D, Carreras JL, and Delgado Bolton RC
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Multiple Myeloma diagnostic imaging, Retrospective Studies, Treatment Outcome, Fluorodeoxyglucose F18, Magnetic Resonance Imaging, Multiple Myeloma pathology, Multiple Myeloma therapy, Positron Emission Tomography Computed Tomography, Skeleton diagnostic imaging, Whole Body Imaging
- Abstract
Purpose: To compare the agreement between whole-body (WB) magnetic resonance (MR) imaging, 18F-FDG PET/CT, and skeletal survey (SS) in patients with multiple myeloma (MM) for diagnosis, initial staging, response evaluation, and early detection of complications., Methods: This is a retrospective cohort study including MM patients who were diagnosed, treated, and followed in 2 institutions. These patients were studied with SS, WB-MR, and/or 18F-FDG PET/CT. We studied bone lesions by anatomical locations and analyzed the concordance between SS and a tomographic technique (WB-MR or 18F-FDG PET/CT) and between both tomographic techniques (WB-MR and PET/CT)., Results: Forty-four MM patients with a mean age of 62.6 years (range, 38-85 years) were included from January 2012 to February 2016. Whole-body MR and 18F-FDG PET/CT found more lesions than SS in every location except in the skull. Concordance between WB-MR and 18F-FDG PET/CT was either good or excellent in most of the locations and in plasmacytoma studies. However, WB-MR was better than 18F-FDG PET/CT in the study of complications (medullar compression and vascular necrosis)., Conclusions: Our results suggest the study of MM patients should include WB-MR and/or 18F-FDG PET/CT, whereas SS is only useful for the skull. Whole-body MR and 18F-FDG PET/CT are complementary techniques, because both of them show good concordance in almost every location. It is still necessary to individualize the indication of each technique according to patient characteristics., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
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42. Machine learning-based differentiation between multiple sclerosis and glioma WHO II°-IV° using O-(2-[18F] fluoroethyl)-L-tyrosine positron emission tomography.
- Author
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Kebir S, Rauschenbach L, Weber M, Lazaridis L, Schmidt T, Keyvani K, Schäfer N, Milia A, Umutlu L, Pierscianek D, Stuschke M, Forsting M, Sure U, Kleinschnitz C, Antoch G, Colletti PM, Rubello D, Herrmann K, Herrlinger U, Scheffler B, Bundschuh RA, and Glas M
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Radiopharmaceuticals, Tyrosine analogs & derivatives, Brain Neoplasms diagnostic imaging, Glioma diagnostic imaging, Image Interpretation, Computer-Assisted methods, Machine Learning, Multiple Sclerosis diagnostic imaging, Positron-Emission Tomography methods
- Abstract
Introduction: This study aimed to test the diagnostic significance of FET-PET imaging combined with machine learning for the differentiation between multiple sclerosis (MS) and glioma II°-IV°., Methods: Our database was screened for patients in whom FET-PET imaging was performed for the diagnostic workup of newly diagnosed lesions evident on MRI and suggestive of glioma. Among those, we identified patients with histologically confirmed glioma II°-IV°, and those who later turned out to have MS. For each group, tumor-to-brain ratio (TBR) derived features of FET were determined. A support vector machine (SVM) based machine learning algorithm was constructed to enhance classification ability, and Receiver Operating Characteristic (ROC) analysis with area under the curve (AUC) metric served to ascertain model performance., Results: A total of 41 patients met selection criteria, including seven patients with MS and 34 patients with glioma. TBR values were significantly higher in the glioma group (TBRmax glioma vs. MS: p = 0.002; TBRmean glioma vs. MS: p = 0.014). In a subgroup analysis, TBR values significantly differentiated between MS and glioblastoma (TBRmax glioblastoma vs. MS: p = 0.0003, TBRmean glioblastoma vs. MS: p = 0.0003) and between MS and oligodendroglioma (ODG) (TBRmax ODG vs. MS: p = 0.003; TBRmean ODG vs. MS: p = 0.01). The ability to differentiate between MS and glioma II°-IV° increased from 0.79 using standard TBR analysis to 0.94 using a SVM based machine learning algorithm., Conclusions: FET-PET imaging may help differentiate MS from glioma II°-IV° and SVM based machine learning approaches can enhance classification performance.
- Published
- 2021
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43. Novel Experience in Hybrid Tracers: Clinical Evaluation of Feasibility and Efficacy in Using ICG-99mTc Nanotop for Sentinel Node Procedure in Breast Cancer Patients.
- Author
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Manca G, Garau LM, Mazzarri S, Mazzuca L, Muccioli S, Ghilli M, Naccarato G, Colletti PM, Rubello D, Roncella M, Volterrani D, and Desideri I
- Subjects
- Adult, Aged, Breast Neoplasms diagnostic imaging, Feasibility Studies, Female, Humans, Lymphadenopathy, Lymphatic Metastasis, Middle Aged, Radioactive Tracers, Single Photon Emission Computed Tomography Computed Tomography, Breast Neoplasms pathology, Indocyanine Green chemistry, Sentinel Lymph Node Biopsy methods, Technetium chemistry
- Abstract
Purpose: The clinical introduction of a radioactive and fluorescent hybrid tracer allowed for preoperative lymphatic mapping and intraoperative real-time fluorescence tracing of the sentinel lymph node (SLN) by a single injection. The aim of this feasibility study is to evaluate the first-in-human use of the hybrid tracer by combining indocyanine green (ICG) and radiocolloid based on Nanotop compound (99mTc Nanotop) for SLN biopsy (SLNB) in breast cancer patients., Methods: The day before surgery, ICG-99mTc Nanotop was injected periareolarly in breast cancer patients scheduled for SLNB. Planar lymphoscintigraphic (PL) and SPECT/CT images were then acquired. An intraoperative optonuclear probe was used to detect SLN gamma and fluorescent signals. The harvested SLNs were examined by hematoxylin-eosin staining, and patients were clinically evaluated 1 month after surgery., Results: Twenty-one consecutive patients were enrolled. The PL and SPECT/CT techniques identified at least 1 SLN in all patients for a preoperative sentinel detection rate of 100%. SPECT/CT revealed 3 additional lymph nodes in the same nodal basin, which had not been visualized on conventional PL (κ = 0.747; P < 0.005). All 30 preoperative SLNs were localized and excised up to 16 hours after injection. The counts measured via gamma tracing showed a very strong correlation with those measured via near-infrared fluorescent tracing (P < 0.005, r = 0.964). No adverse reactions were observed., Conclusions: The SLNB technique used with the ICG-99mTc Nanotop tracer resulted to be feasible, reliable, and safe. This hybrid compound allowed us to obtain excellent performance in terms of both preoperative lymphatic mapping and intraoperative SLN detection in breast cancer patients., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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44. Pulmonary Target Sign: A New Finding or a Neglected Feature?
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Saburi A, Colletti PM, and Jafari R
- Published
- 2021
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45. Venous Air Embolism Identified by 18F-Fluorocholine Dual-Phase PET/CT.
- Author
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Cañete-Sánchez FM, Romero Robles LG, Boulvard Chollet XLE, Mangas Losada M, Colletti PM, Rubello D, Ramírez Lasanta R, and Delgado Bolton RC
- Subjects
- Female, Humans, Middle Aged, Choline analogs & derivatives, Embolism, Air diagnostic imaging, Positron Emission Tomography Computed Tomography, Veins diagnostic imaging
- Abstract
Abstract: A 60-year-old woman with primary hyperparathyroidism with previous nonconclusive imaging studies was referred for 18F-fluorocholine (18F-FCH) PET/CT as part of the preoperative diagnostic imaging workup to localize the adenoma before minimally invasive surgery. 18F-FCH PET/CT with dual time point was performed, acquiring immediately and 60 minutes after 18F-FCH administration. The early images demonstrated possible hyperfunctioning parathyroid tissue in the mediastinum, located in the right upper paratracheal space (region 2R), with an incidental iatrogenic subclavian venous air bubble embolism presenting as high uptake in the early images that disappeared in the late images. No symptomatology was reported during the examination., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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46. PET/CT Integrated With CT Colonography in Preoperative Obstructive Colorectal Cancer by Incomplete Optical Colonoscopy: A Prospective Study.
- Author
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Sánchez-Izquierdo N, Pagès M, Mayoral M, Rubello D, Colletti PM, Campos F, Romero I, Casanueva S, Fritsch A, and Fuster D
- Subjects
- Adult, Aged, Aged, 80 and over, Colorectal Neoplasms pathology, Colorectal Neoplasms surgery, Female, Humans, Male, Middle Aged, Neoplasm Staging, Preoperative Period, Prospective Studies, Sensitivity and Specificity, Colonography, Computed Tomographic, Colonoscopy, Colorectal Neoplasms diagnostic imaging, Positron Emission Tomography Computed Tomography
- Abstract
Aim: The aim of this study was to evaluate if integrating whole-body PET/CT with CT colonography (PET/CTC) improves the preoperative diagnosis of obstructive colorectal cancer (CRC)., Methods: We prospectively included 47 consecutive patients (18 women and 29 men; mean age, 71 ± 14 years) suspected of having CRC by optical colonoscopy, which was not completed due to obstructive masses. To perform PET/CTC, a small caliber Foley catheter was inserted to distend the colon with CO2 insufflations. Polyps measuring 10 mm or larger were considered as high risk of malignancy. All findings were histologically confirmed., Results: Colorectal cancer was localized in the sigmoid (n = 21), rectum (n = 7), rectosigmoid junction (n = 5), ascending (n = 7), descending (n = 5), and transverse (n = 2) colon. All tumors showed FDG uptake (mean ± SD SUVmax, 20.02 ± 9.9) including one synchronic tumor (SUVmax, 10.46). Forty-seven polyps were histologically confirmed as smaller than 10 mm (n = 35) and 10 mm or larger (n = 12). All 12 polyps 10 mm or larger showed FDG uptake (SUVmax range, 3.08-19.5), but only one smaller than 10 mm could be identified by PET. Pathological lymph nodes were diagnosed in 17/47 cases after surgical removal with a sensitivity and specificity for CTC and PET/CTC of 71% and 97% and 59% and 100%, respectively. Liver metastases were confirmed in 9 patients and in 4/9 along with lung metastases (n = 2) or implants (n = 2), showing a sensitivity and specificity for CTC of 89% and 100% and both 100% for PET/CTC., Conclusions: PET/CTC is a reliable technique for staging CRC and diagnosing synchronous tumors. In this series, PET/CTC was not able to identify small polyps but showed potential use for ruling out 10 mm or larger polyps at high risk of malignancy.
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- 2020
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47. Reorganization of a Nuclear Medicine Department in Northern Italy During a 2-Month Lockdown for COVID-19 Pandemic.
- Author
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Maffione AM, Chondrogiannis S, Rampin L, Grassetto G, Marzola MC, Bassan A, Massaro A, Colletti PM, and Rubello D
- Subjects
- COVID-19, Humans, Italy epidemiology, Coronavirus Infections epidemiology, Hospital Departments organization & administration, Nuclear Medicine, Pandemics, Pneumonia, Viral epidemiology
- Abstract
Coronavirus disease (COVID-19) outbreak has profoundly changed the organization of hospital activities. We present our experience of reorganization of a nuclear medicine service settled in Northern Italy during the pandemic period of March and April 2020 characterized a government-mandated lockdown. Our service remained open during the whole period, performing approximately 80% of the routine practice, while maintaining it COVID-free despite the geographical context characterized by a high risk of infection. Reorganization involved all aspects of a nuclear medicine department, following local, national, and international guidelines for prioritizing patients, telephone and physical triages, deployment of appropriate personal protective equipment, social distancing, and logistic changes for scheduling examinations and disinfection procedures. All staff remained COVID-19-negative despite the unintentional admission of 4 patients who later turned out to be positive for the severe acute respiratory syndrome coronavirus 2. These adopted measures would serve as the basis for safe nuclear medicine services in the post-lockdown phase.
- Published
- 2020
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48. ACR Appropriateness Criteria® Blunt Chest Trauma-Suspected Cardiac Injury.
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Stojanovska J, Hurwitz Koweek LM, Chung JH, Ghoshhajra BB, Walker CM, Beache GM, Berry MF, Colletti PM, Davis AM, Hsu JY, Khosa F, Kicska GA, Kligerman SJ, Litmanovich D, Maroules CD, Meyersohn N, Syed MA, Tong BC, Villines TC, Wann S, Wolf SJ, Kanne JP, and Abbara S
- Subjects
- Humans, Societies, Medical, Tomography, X-Ray Computed, United States, Myocardial Contusions, Thoracic Injuries diagnostic imaging, Wounds, Nonpenetrating diagnostic imaging
- Abstract
Blunt cardiac injuries range from myocardial concussion (commotio cordis) leading to fatal ventricular arrhythmias to myocardial contusion, cardiac chamber rupture, septal rupture, pericardial rupture, and valvular injuries. Blunt injuries account for one-fourth of the traumatic deaths in the United States. Chest radiography, transthoracic echocardiography, CT chest with and without contrast, and CT angiography are usually appropriate as the initial examination in patients with suspected blunt cardiac injury who are both hemodynamically stable and unstable. Transesophageal echocardiography and CT heart may be appropriate as examination in patients with suspected blunt cardiac injuries. This publication of blunt chest trauma-suspected cardiac injuries summarizes the literature and makes recommendations for imaging based on the available data and expert opinion. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment., (Copyright © 2020 American College of Radiology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
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49. Sentinel Node Imaging and Radioguided Surgery in the Era of SPECT/CT and PET/CT: Toward New Interventional Nuclear Medicine Strategies.
- Author
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Valdés Olmos RA, Rietbergen DDD, Rubello D, Pereira Arias-Bouda LM, Collarino A, Colletti PM, Vidal-Sicart S, and van Leeuwen FWB
- Subjects
- Humans, Sentinel Lymph Node pathology, Image-Guided Biopsy methods, Nuclear Medicine, Positron Emission Tomography Computed Tomography, Sentinel Lymph Node diagnostic imaging, Sentinel Lymph Node surgery, Single Photon Emission Computed Tomography Computed Tomography
- Abstract
We review recent technological advances and new clinical indications for sentinel node (SN) and radioguided surgery in order to delineate future tendencies of interventional nuclear medicine in this field. A literature research was performed in PubMed to select relevant articles to be used as key references for analysis of the current approaches and tendencies in SN and radioguided surgery, as well as the evolving contribution of nuclear medicine intervention techniques to the various clinical applications. For classic indications such as melanoma and breast cancer, the incorporation of the SN approach based on the combined use of existing and new preoperative and intraoperative technologies in high-risk patient categories is becoming an emerging area of clinical indication. For SN biopsy staging in other malignancies with more complex lymphatic drainage, the incorporation of sophisticated tools is most helpful. The consecutive use of PET/CT and the SN procedure is increasing as a potential combined approach for the management of specific areas such as the axilla and the pelvis in patients at high risk of regional dissemination. Also, for the management of locoregional metastasis and oligometastatic disease, interventional nuclear medicine techniques are becoming valuable alternatives. The extended experience with SN biopsy is leading to technological advances facilitating the incorporation of this procedure to stage other malignancies with complex lymphatic drainage. New nuclear medicine-based approaches, incorporating SPECT/CT and PET/CT to guide resection of SNs and occult metastases, have recently been gaining ground.
- Published
- 2020
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50. 18F-FDG PET/CT in Hodgkin Lymphoma With Unsuspected COVID-19.
- Author
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Boulvard Chollet XLE, Romero Robles LG, Garrastachu P, Cabrera Villegas A, Albornoz Almada MC, Colletti PM, Rubello D, Ramírez Lasanta R, and Delgado Bolton RC
- Subjects
- Aged, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques, Coronavirus Infections complications, Coronavirus Infections diagnosis, Fluorodeoxyglucose F18, Humans, Male, Pandemics, Pneumonia, Viral complications, Positron Emission Tomography Computed Tomography, SARS-CoV-2, Betacoronavirus, Coronavirus Infections diagnostic imaging, Hodgkin Disease complications, Pneumonia, Viral diagnostic imaging
- Abstract
We present an asymptomatic 70-year-old man referred for an F-FDG PET/CT for initial staging of a Hodgkin lymphoma. F-FDG PET/CT showed bilateral cervical lymphadenopathy (stage II). Incidentally, the CT demonstrated bilateral ground-glass opacities with low-grade F-FDG activity. CT findings were suspicious for COVID-19 pneumonitis. The COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) examination result was negative. Given the high clinical suspicion for COVID-19, the patient was isolated and repeat RT-PCR was positive at 72 hours. RT-PCR may be falsely negative in early COVID-19 disease, even with positive CT findings.
- Published
- 2020
- Full Text
- View/download PDF
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