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7. Simulation PET-CT-based direct planning in head and neck radiotherapy: treatment planning implications and preliminary outcome

Author

Di Biase, S., primary, Bellan, E., additional, Ferretti, A., additional, Pavanato, G., additional, Montesi, G., additional, Virdis, G., additional, Gava, M., additional, Marzola, M.C., additional, Chondrogiannis, S., additional, Grassetto, G., additional, Maffione, A.M., additional, Rampin, L., additional, and Mandoliti, G., additional

Published
2021
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8. Comparison between simulation PET-CT and fusion with diagnostic PET-CT in head and neck radiotherapy planning: effects on target volume determination

Author

Di Biase, S., primary, Ferretti, A., additional, Bellan, E., additional, Virdis, G., additional, Pavanato, G., additional, Montesi, G., additional, Gava, M., additional, Rampin, L., additional, Maffione, A.M., additional, Marzola, M.C., additional, Chondrogiannis, S., additional, Grassetto, G., additional, and Mandoliti, G., additional

Published
2021
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25. Dual PET/CT with 18F-DOPA and 18F-FDG in metastatic medullary thyroid carcinoma and rapidly increasing calcitonin levels: Comparison with conventional imaging.

Author

Marzola, M.C., Pelizzo, M.R., Ferdeghini, M., Toniato, A., Massaro, A., Ambrosini, V., Fanti, S., Gross, M.D., Al-Nahhas, A., and Rubello, D.

Subjects
THYROID cancer patients, CALCITONIN, CANCER relapse, FOLLOW-up studies (Medicine), THYROIDECTOMY, CANCER tomography
Abstract

Abstract: Background: To evaluate the role of a multi-imaging PET with 18F-DOPA and 18F-FDG in comparison with conventional imaging (CI) in recurrent medullary thyroid carcinoma (MTC). Methods: 18 MTC patients who had thyroidectomy were included; they presented with elevated and rapidly increasing calcitonin levels during follow up. CI had revealed metastatic deposits in 9 patients. Patients were referred to us for a PET/CT with 18F-DOPA and 18F-FDG. Histologic/cytologic confirmation of recurrent MTC was obtained in at least one PET-positive lesion in all patients. Results: Foci of abnormal uptake were observed in 15 patients at 18F-DOPA and in 11 at 18F-FDG; 8 patients showed the same number of positive lesions with both tracers, 2 showed more lesions on 18F-FDG, 1 was positive at 18F-FDG alone and 5 at 18F-DOPA alone. In 3 patients with a DOPA-positive loco-regional relapse a re-operation with curative intent was offered. SUVmax values were higher for 18F-FDG compared to 18F-DOPA (mean 12.7±4.1 vs. 5.5±2.1, p <0.05). Calcitonin was higher in PET-positive patients compared to PET negative ones, while no significant differences were observed between 18F-DOPA and 18F-FDG positive patients. Conclusions: In MTC patients with rapidly increasing calcitonin levels during follow up, 18F-DOPA has a good sensitivity and a complementary role with 18F-FDG PET/CT in detecting metastatic deposits. In our experience, the sensitivity of a multi-imaging 18F-DOPA &18F-FDG PET/CT approach is greater than that obtained with CI. The higher SUVmax values found with 18F-FDG in some patients may reflect more aggressive tumors. [Copyright &y& Elsevier]

Published
2010
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26. Accuracy of ultrasonography and 99mTc-sestamibi scintimammography for assessing axillary lymph node status in breast cancer patients. A prospective study.

Author

Lumachi, F., Tregnaghi, A., Ferretti, G., Povolato, M., Marzola, M.C., Zucchetta, P., Cecchin, D., and Bui, F.

Subjects
CANCER patients, BREAST cancer surgery, ULTRASONIC imaging, BREAST cancer
Abstract

Abstract: Aims: The aim of this study was to evaluate the sensitivity, specificity and accuracy of axillary ultrasonography (US) and 99mTc-sestamibi scintimammography (SSM) in patients with breast cancer (BC) undergoing curative surgery. Methods: A series of 77 consecutive women (median age 54 years, range 36–70) with primary BC underwent both US and SSM from 2 to 15 (median 4) days prior to curative surgery. The results of imaging studies were compared against the final pathology. Breast-conserving surgery with axillary node (AN) dissection was performed in 49 (63.6%) patients, and modified radical mastectomy in 28 (36.4%) patients, according to the tumour staging. Results: Final pathology showed 5 pT1bN0, 1 pT1bN1, 28 pT1cN0, 19 pT1cN1, 7 pT2N0, and 17 pT2N1 BC. Overall, 719 AN were removed of which 106 (14.7%) were metastatized nodes (median 3, range 1–5 per patient). The sensitivity, specificity and accuracy were 67.6%, 80.0%, and 74.0% for US, 78.4%, 85.0%, and 81.8% for SSM, and 91.9%, 92.5%, and 92.2% for US and SSM together, respectively. There was a significant difference (p <0.05) in the number of metastatized AN between patients with metastases correctly detected and undetected by both US (3.1±1.3 vs. 2.0±0.7) and SSM (3.2±1.3 vs. 1.7±0.7). Conclusions: Although the results of each diagnostic tests are strictly dependent on the number of the metastatized AN, the combination of axillary US and SSM is a sensitive low-cost procedure that should be suggested in all patients with BC, when a preoperative evaluation of the AN status is required. [Copyright &y& Elsevier]

Published
2006
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27. Relationship between prognostic factors of breast cancer and 99mTc-sestamibi uptake in patients who underwent scintimammography: Multivariate analysis of causes of false-negative results.

Author

Lumachi, F., Ermani, M., Marzola, M.C., Zucchetta, P., Cecchin, D., Basso, S.M.M., Brandes, A.A., and Bui, F.

Subjects
MAMMOGRAMS, BREAST exams, BREAST cancer, TUMORS, CANCER patients, BREAST surgery
Abstract

Summary: The complementary role of sestamibi scintimammography (SSM) in patients with breast cancer (BC) is well established. The aim of this study was to establish whether a relationship exists between sestamibi uptake, evaluated as a tumour-to-background ratio (TBR), and the main prognostic factors of BC. SSM with the measurement of TBR was performed preoperatively in 102 women (median age 57 years, range 32–81 years) who underwent curative surgery for primary BC. Final pathology showed 4 (3.9%) with pT1a, 17 (16.7%) with pT1b, 44 (43.1%) with pT1c and 37 (36.3%) with pT2 breast carcinomas. The overall sensitivity of SSM was 80.4%. An ANOVA showed significant () differences between the TBR of patients with G1 vs. G3 tumours, and between the TBR of those with G2 vs. G3 breast carcinomas. Moreover, there was a difference () between the TBR of patients (, 11.8%) with CEA serum levels >10ng/ml (2.031±0.420), and those with normal (, 88.2%) CEA values (1.713±0.446), whilst no difference (P=NS) was found between patients (, 26.5%) with CA 15-3 >30U/ml (1.893±0.401) and those with normal (, 73.5%) CA 15-3 values (1.699±0.462). There was a mild inverse correlation between TBR and both the oestrogen (, ) and the progesterone receptor (, ) rate. The logistic regression analysis showed that only size and CA 15-3 serum levels represent true independent parameters, but the function was able to predict only 11 out of 21 (52.4%) patients with false-negative SSM. TBR is independent of age and mainly correlates with the size of the tumour. There are no reliable preoperative prognostic factors that are really useful for improving SSM sensitivity in patients with small breast carcinomas. [Copyright &y& Elsevier]

Published
2006
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28. An unexpectedly high rate of pulmonary embolism in patients with superficial thrombophlebitis of the thigh

Author

Verlato, F., Zucchetta, P., Prandoni, P., Camporese, G., Marzola, M.C., Salmistraro, G., Bui, F., Martini, R., Rosso, F., and Andreozzi, G.M.

Abstract

Purpose: The rate of objectively proven pulmonary embolism in patients with thrombophlebitis of the greater saphenous vein was studied. Methods: Consecutive ambulant patients with thrombophlebitis of the greater saphenous vein, involving the above-knee segment, underwent a complete venous echo color Doppler examination of the lower limbs, perfusion lung scanning, and chest radiography. A high probability of pulmonary embolism was defined as the presence of two or more large segmental defects, one large and two or more moderate perfusion defects, or four or more moderate perfusion defects, with no corresponding abnormality found by means of chest radiography. Results: Of the 21 patients included in the study, findings compatible with a high probability of pulmonary embolism were detected in seven patients (33.3%; 95% CI, 14.6 to 57.0), although clinical symptoms of pulmonary embolism were present only in one patient. No association was found between the presence of thrombosis at the saphenofemoral junction and the risk for pulmonary embolism. Conclusion: The rate of pulmonary embolism in patients with thrombophlebitis of the greater saphenous vein is unexpectedly high. This risk is similarly high in patients with thrombosis at the saphenofemoral junction and in patients without thrombosis at the saphenofemoral junction. Our results are consistent with those of other recent investigations and suggest that superficial thrombophlebitis of the thigh is not as benign a disease entity as previously described. (J Vasc Surg 1999;30:1113-5.)

Published
1999
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29. Choline PET/CT for prostate cancer: Main clinical applications

Author

Chiara Fuccio, Maria Cristina Marzola, Paolo Castellucci, Stefano Fanti, Domenico Rubello, Fuccio C., Rubello D., Castellucci P., Marzola M.C., and Fanti S.

Subjects
Male, medicine.medical_specialty, PROSTATE CANCER, Multimodal Imaging, Sensitivity and Specificity, Choline, chemistry.chemical_compound, Prostate cancer, medicine, Humans, Radiology, Nuclear Medicine and imaging, Stage (cooking), Lymph node, Neoplasm Staging, medicine.diagnostic_test, business.industry, Prostatic Neoplasms, General Medicine, Choline pet ct, medicine.disease, Kinetics, Prostate-specific antigen, medicine.anatomical_structure, chemistry, Positron emission tomography, Positron-Emission Tomography, Biochemical relapse, Radiology, Tomography, X-Ray Computed, business, Nuclear medicine
Abstract

Several studies investigated the potential roles of imaging modalities in prostate cancer patients for the evaluation of intra-prostatic disease, stage and restage. However no precise guidelines exist about the use of imaging modalities, in particular about the role of PET/CT hybrid imaging. Considering the results of the literature and our experience, we tried to summarize the main applications of choline positron emission tomography (PET) in prostate cancer patients. The use of choline PET/CT for initial diagnosis and staging is not recommended as a first-line method. Instead the main and important application of choline PET/CT is represented by the restaging of the disease in case of biochemical relapse for the detection of lymph node and distant recurrence. In particular choline PET/CT could play a crucial role as first diagnostic procedure in prostate cancer patients who show a fast growing Prostate Specific Antigen (PSA) kinetics.

Published
2011
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30. 68Ga-somatostatin analogues PET and 18F-DOPA PET in medullary thyroid carcinoma

Author

Domenico Rubello, Valentina Ambrosini, Stefano Fanti, Maria Cristina Marzola, Ambrosini V., Marzola M.C., Rubello D., and Fanti S.

Subjects
Pathology, medicine.medical_specialty, medicine.diagnostic_test, Medullary cavity, business.industry, medullary thyroid carcinoma, (68)Ga-somatostatin analogues, PET, 18F-DOPA, Thyroid, General Medicine, Thyroid carcinoma, Somatostatin, medicine.anatomical_structure, Isotopes of gallium, Medicine, Radiology, Nuclear Medicine and imaging, business, Emission computed tomography, Endocrine gland
Published
2009
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31. Noninvasive and invasive staging of ovarian cancer: review of the literature

Author

Chiara Fuccio, Adil Al-Nahhas, Stefano Fanti, Domenico Rubello, Paolo Castellucci, Maria Cristina Marzola, Fuccio C., Castellucci P., Marzola M.C., Al-Nahhas A., Fanti S., and Rubello D.

Subjects
Oncology, medicine.medical_specialty, Computed tomography, Multimodal Imaging, Imaging modalities, Adnexa Uteri, X ray computed, Fluorodeoxyglucose F18, noninvasive, Internal medicine, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Neoplasm Invasiveness, Neoplasm Staging, Multimodal imaging, Ovarian Neoplasms, medicine.diagnostic_test, business.industry, General Medicine, medicine.disease, OVARIAN CANCER, Transvaginal ultrasound, Positron emission tomography, Positron-Emission Tomography, Neoplasm staging, Female, Radiology, business, Ovarian cancer, Tomography, X-Ray Computed
Abstract

The use of F-18 FDG PET/CT in the characterization of doubtful adnexal findings and in the staging of ovarian cancer is being extensively evaluated. The purpose of our article is to review the literature and to add our experience to the published works. We concluded that F-18 FDG PET/CT could represent an important method in addition to other imaging modalities (transvaginal ultrasound-, and contrast-enhanced computed tomography) in the characterization of adnexal masses and in the staging of ovarian cancer patients, particularly in assessing the presence of extra-abdominal metastatic spread.

Published
2011

32. Prostate-specific antigen kinetics and choline PET/CT in patients with biochemical relapse after primary treatment for prostate cancer

Author

Domenico Rubello, Adil Al-Nahhas, Chiara Fuccio, Paolo Castellucci, Maria Cristina Marzola, Stefano Fanti, Castellucci P., Fuccio C., Marzola M.C., Al-Nahhas A., Rubello D., and Fanti S.

Subjects
Oncology, Biochemical recurrence, Male, medicine.medical_specialty, Disease, Choline, Prostate cancer, chemistry.chemical_compound, Antigen, Recurrence, Internal medicine, medicine, PROSTATE, Humans, Radiology, Nuclear Medicine and imaging, Stage (cooking), medicine.diagnostic_test, choline PET/CT, business.industry, Prostatic Neoplasms, General Medicine, Prostate-Specific Antigen, medicine.disease, Prostate-specific antigen, Kinetics, chemistry, Positron emission tomography, Positron-Emission Tomography, Radiology, business, Tomography, X-Ray Computed
Abstract

Over the past few years, several studies have proved the potential role of diagnostic procedures in patients with treated prostate cancer who develop biochemical relapse. Notably, no precise indications exist regarding the use of emerging modalities such as positron emission tomography/computerized tomography (PET/CT) scanning with radiolabeled choline. However, the literature suggests that the main and most important application of choline PET/CT at present is in disease restaging in cases of biochemical relapse for the detection of local, lymph node-related or distant recurrence. In this setting, it is well known that prostate-specific antigen (PSA) values play a significant role in the follow-up of these patients. This short review aims at summarizing the results of the most relevant published studies with particular interest directed towards a better understanding of the relationship between PSA kinetics and choline PET/CT detection rate and the potential use of PSA kinetics for an optimal selection of patients who may benefit most from this diagnostic procedure particularly at an early stage of biochemical recurrence.

Published
2011

33. Is there a role for 11C-choline PET/CT in the early detection of metastatic disease in surgically treated prostate cancer patients with a mild PSA increase <1.5 ng/ml?

Author

Paolo Castellucci, Cristina Nanni, Stefano Fanti, Stefano Boschi, Vincenzo Allegri, Ivan Santi, Chiara Fuccio, Gian Carlo Montini, Giuseppe Martorana, Maria Cristina Marzola, Domenico Rubello, Riccardo Schiavina, Valentina Ambrosini, Castellucci P., Fuccio C., Rubello D., Schiavina R., Santi I., Nanni C., Allegri V., Montini G.C., Ambrosini V., Boschi S., Martorana G., Marzola M.C., and Fanti S.

Subjects
medicine.medical_specialty, Univariate analysis, PET-CT, PSA Velocity, medicine.diagnostic_test, business.industry, Prostatectomy, PET/CT, medicine.medical_treatment, General Medicine, medicine.disease, prostate cancer, Surgery, Prostate-specific antigen, Prostate cancer, PSA, Positron emission tomography, medicine, Radiology, Nuclear Medicine and imaging, Lymphadenectomy, 11C-Choline, Nuclear medicine, business
Abstract

PURPOSE: The aim of this study was to evaluate the potential usefulness of whole-body (11)C-choline PET/CT in the re-staging of prostate cancer (PC) patients previously treated with radical prostatectomy (RP), who presented a mild increase of prostate-specific antigen (PSA)

Published
2011

34. Present and future of PET and PET/CT in gynaecologic malignancies

Author

Stefano Fanti, Alessandra Musto, Lucia Rampin, Domenico Rubello, Cristina Nanni, Maria Cristina Marzola, Musto A., Rampin L., Nanni C., Marzola M.C., Fanti S., and Rubello D.

Subjects
medicine.medical_specialty, PET/TC, MEDLINE, Sensitivity and Specificity, Diagnosis, Differential, Fluorodeoxyglucose F18, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Neoplasm Staging, PET-CT, medicine.diagnostic_test, business.industry, Cancer, General Medicine, medicine.disease, Occult, Positron emission tomography, Positron-Emission Tomography, Biomarker (medicine), Female, Radiology, Neoplasm Recurrence, Local, Radiopharmaceuticals, Differential diagnosis, Tomography, X-Ray Computed, business, Ovarian cancer, Nuclear medicine, Genital Diseases, Female, Forecasting, gynaecologic malignancies
Abstract

Objectives To review the published data in literature on patients affected by gynaecological malignancies to establish the role of 18 F-FDG positron emission tomography (PET) and PET/CT in comparison to conventional imaging (CI). Materials and methods All papers specifically addressed to the role of 18 F-FDG PET and PET/CT in gynaecological malignancies published on PubMed/Medline, in abstracts from the principal international congresses, in the guidelines from national Societies that had appeared in literature until November 2009 were considered for the purpose of the present study. Results and conclusions The use of 18 F-FDG PET, and even more of 18 F-FDG PET/CT, is increasing in the follow up of patients with gynaecologic malignancies and suspected recurrent disease: there is evidence in the literature that 18 F-FDG PET/CT has a higher sensitivity than CI in depicting occult metastatic spread. An interesting issue is represented by patients with ovarian cancer with an increase of the specific biomarker, CA-125, and negative/inconclusive findings at CI. The use of 18 F-FDG PET in differential diagnosis and staging is more controversial, but there is some evidence that a baseline PET examination performed before commencing therapy, for staging purpose, is also useful to evaluate the response to chemoradiation treatment. In several papers it has been suggested a relevant role of 18 F-FDG PET/CT in evaluating the entity of response to treatment and therefore to plan the subsequent therapeutic strategy.

Published
2011

35. Positron-emission tomography in gynaecologic malignancies

Author

Alessandra Musto, Elena Cracco, Charoula Stavroula Tsamita, Maria Cristina Marzola, Cristina Nanni, Michela Piva, Stefano Fanti, Adil Al-Nahhas, Anna Margherita Maffione, Valentina Ambrosini, Gaia Grassetto, Arianna Massaro, Paolo Castellucci, Egesta Lopci, Domenico Rubello, Lucia Rampin, Maffione A.M., Piva M., Tsamita C.S., Nanni C., Castellucci P., Ambrosini V., Lopci E., Musto A., Rampin L., Grassetto G., Marzola M.C., Massaro A., Cracco E., Al-Nahhas A., Fanti S., and Rubello D.

Subjects
Oncology, Cervical cancer, PET-CT, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Genital Neoplasms, Female, Endometrial cancer, Carcinoma, Obstetrics and Gynecology, Sarcoma, General Medicine, medicine.disease, Sensitivity and Specificity, Imaging Tool, Positron emission tomography, Fluorodeoxyglucose F18, Internal medicine, Positron-Emission Tomography, medicine, Humans, Female, Radiology, Ovarian cancer, business
Abstract

The role of (18)F-FDG PET in the management of gynaecologic malignancies remains unclear mainly due to the failure of clinicians to appreciate the significance of this imaging tool. However, this under utilisation is being actively re-addressed with a large number of reviews and studies, particularly in the last few years.PET has been shown to have high sensitivity and specificity in the evaluation of relapse and nodal disease in cervical cancer, while other uses such as staging and monitoring response to therapies being under further investigation. Similarly, promising results have been published in the use of PET in patients affected by endometrial cancer and uterine sarcomas for detecting lymph nodes metastasis and recurrent disease. In ovarian cancer, PET appears to have a great potential in staging and assessment of disease relapse. An important utility of PET in gynaecologic tumours, which is shared with a large number of other malignancies, is its value in positively changing the patients' management.The surge in studies using PET in gynaecological malignancies is in its early stages, and further studies are required to optimise the role of PET in these conditions.

Published
2008

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