Roberto Maroldi | University of Brescia (original) (raw)

Papers by Roberto Maroldi

Cancers

Olfactory neuroblastoma (ONB) is a rare sinonasal neoplasm with a peculiar behavior, for which li... more Olfactory neuroblastoma (ONB) is a rare sinonasal neoplasm with a peculiar behavior, for which limited prognostic factors are available. Herein, we investigate the transcriptional pathways altered in ONB and correlate them with pathological features and clinical outcomes. We analyze 32 ONB patients treated with curative intent at two independent institutions from 2001 to 2019 for whom there is available pathologic and clinical data. We perform gene expression profiling on primary ONB samples and carry out functional enrichment analysis to investigate the key pathways associated with disease-free survival (DFS). The median age is 53.5 years; all patients undergo surgery and a pure endoscopic approach is adopted in the majority of cases (81.2%). Most patients have advanced disease (stages III–IV, 81.2%) and 84.4% undergo adjuvant (chemo)radiotherapy. The median follow-up is 35 months; 11 (26.8%) patients relapse. Clinical characteristics (gender, stage and Hyams’ grade) are not associ...

Italian journal of anatomy and embryology, 2017

Chronic inflammatory fibro-proliferative changes leading to atherosclerotic plaques are considere... more Chronic inflammatory fibro-proliferative changes leading to atherosclerotic plaques are considered hallmark of cardiovascular diseases [1]. Atherosclerosis pathogenesis is a complex entity, which has not been fully understood; however, many studies have demonstrated the role of oxidative stress and inflammation in its development. Melatonin effects on inflammation and oxidative stress process have been demonstrated in the last ten-year literature [2]. However, its role(s) and mechanism(s) of action as a therapeutic tool against atherosclerosis remain largely unexplored. Our aims were to assess the role of melatonin in the onset and developing of atherosclerotic plaques through radiologic and morphometrical tools in 20 apolipoprotein-E knockout (ApoE) mice fed with Western diet (42% calories from fat). 10/20 mice were treated with melatonin (10 mg/kg per os). 18F-FDG PET-CT is a widely used tool to assess inflammatory changes, even before macroscopic changes have taken place. Glucose...

Emergency Care Journal

To evaluate the performance of a clinical-radiological index (RAPID-Covid score) in achieving Saf... more To evaluate the performance of a clinical-radiological index (RAPID-Covid score) in achieving Safe Discharge (SD) of patients accessing the Emergency Department (ED) with symptoms suggesting Covid-19. Clinical and radiological data were retrospectively collected from 853 consecutive patients admitted to the ED during the pandemics with symptoms suggesting Covid-19. Illness severity was graded with RAPID-Covid score, composed of chest X-ray findings, clinical symptoms and PaO2/FiO2. Patients with RAPIDCovid score ≥5 were admitted. Primary outcome was SD of patients to home care. SD was defined as survival of the patient, without evidence of second access to ED requiring hospitalization. 212/853 patients were discharged. 27/212 had a score ≥5 but refused admission. 185/212 were discharged with score <5: 147/185 (79,5%) survived and did not re-access ED; 1/185 (0,5%) died at home after first ED-dismissal; 37/185 (20,0%) had a second access. Of these 15/37 (8,1%) were newly dismissed...

Cancers, 2021

Simple Summary The gene expression profile of ONB defines a group of patients with a dismal progn... more Simple Summary The gene expression profile of ONB defines a group of patients with a dismal prognosis and identifies potentially targetable pathways. Better prognostic stratification may offer new tailored approaches for the treatment and follow-up of ONB. The integration of new therapeutic agents with standard surgical and RT strategies may improve the outcomes in cases with worse prognoses. Furthermore, the ontogenesis of ONB in basal and neural subtypes is mirrored by different transcriptional pathways, paving the way towards different therapeutic approaches. Abstract Olfactory neuroblastoma (ONB) is a rare sinonasal neoplasm with a peculiar behavior, for which limited prognostic factors are available. Herein, we investigate the transcriptional pathways altered in ONB and correlate them with pathological features and clinical outcomes. We analyze 32 ONB patients treated with curative intent at two independent institutions from 2001 to 2019 for whom there is available pathologic a...

Cancers

Sinonasal squamous cell carcinoma is a rare tumor affecting the nasal cavity and paranasal sinuse... more Sinonasal squamous cell carcinoma is a rare tumor affecting the nasal cavity and paranasal sinuses. Several aspects of this disease, ranging from epidemiology to biology, pathology, diagnosis, staging, treatment, and post-treatment surveillance are controversial, and consensus on how to manage this sinonasal cancer is lacking. A narrative literature review was performed to summarize the current evidence and provide the reader with available data supporting the decision-making process in patients affected by sinonasal squamous cell carcinoma, alongside the authors’ personal opinion on the unsolved issues of this tumor. The review has highlighted several advances in molecular definition of epithelial cancers of the sinonasal tract. Surgery represents the pivot of treatment and is performed through an endoscopic transnasal approach whenever feasible. Open surgery is required for a large proportion of cases. Reconstruction of the defect follows principles of skull base and cranio-maxill...

Cancers, 2021

Simple Summary Sinonasal squamous cell carcinomas are a group of diverse tumors affecting the nas... more Simple Summary Sinonasal squamous cell carcinomas are a group of diverse tumors affecting the nasal cavity and paranasal sinuses. As a direct consequence of their rarity and heterogeneity, diagnosis is challenging, and treatment does not follow universally accepted protocols. Though surgery represents the mainstay of treatment, neoadjuvant and adjuvant therapies have pivotal roles in improving outcomes of patients treated with curative intent. Indications to endoscopic surgery have been expanding over the last three decades, but a considerable number of patients affected by sinonasal squamous cell carcinoma still need open surgical procedures. Management of the neck in patients affected by sinonasal squamous cell carcinoma is controversial. Curative-intended treatment of recurrent and/or metastatic tumors, alongside palliation of uncurable cases, represent poorly explored aspects of this disease. Abstract Sinonasal squamous cell carcinoma is a rare tumor affecting the nasal cavity a...

Neuroimaging Clinics of North America

Prostate Cancer and Prostatic Diseases

Background Luteinizing hormone-releasing hormone (LHRH)-agonists in prostate cancer (PCa) patient... more Background Luteinizing hormone-releasing hormone (LHRH)-agonists in prostate cancer (PCa) patients induce sarcopenic obesity. The effect of LHRH-antagonist on body composition has never been explored. We evaluated changes in fat (FBM) and lean body mass (LBM) in PCa patients undergoing Degarelix. Methods This is a single-center prospective study, enrolling 29 non-metastatic PCa patients eligible to LHRH-antagonist from 2017 to 2019. All patients received monthly subcutaneous injection of Degarelix for 12 months. Changes in FBM and LBM between baseline and 12-month Degarelix, as measured by dual-energy x-ray absorptiometry, were the co-primary endpoints. Secondary endpoints were changes in serum lipids, glucose profile and follicle-stimulating hormone (FSH). Appendicular lean mass index (ALMI) and ALMI/FBM ratio were assessed as post-hoc analyses. Linear mixed models with random intercept tested for estimated least squared means differences (EMD). Results FBM significantly increased after 12 months (EMD +2920.7, +13.8%, p < 0.001), whereas LBM remained stable (EMD −187.1, −0.3%, p = 0.8). No differences occurred in lipid profile. Glycated hemoglobin significantly increased and serum FSH significantly decreased. A significant inverse relationship was found between serum FSH and ALMI/FBM ratio after 12 month (r = −0.44, p = 0.02). Conclusions The BLADE study prospectively evaluated changes in body composition after LHRH-antagonist. LHRHantagonist therapy is associated to an increased risk of obesity and diabetes, but lean body mass and serum lipids are not affected. This may represent an additional evidence supporting the reduced cardiovascular risk associated with LHRHantagonist. The role of FSH in influencing sarcopenic obesity in PCa after androgen deprivation deserves to be further explored.

European Journal of Nuclear Medicine and Molecular Imaging

Purpose To assess the presence and pattern of incidental interstitial lung alterations suspicious... more Purpose To assess the presence and pattern of incidental interstitial lung alterations suspicious of COVID-19 on fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) ([18F]FDG PET/CT) in asymptomatic oncological patients during the period of active COVID-19 in a country with high prevalence of the virus. Methods This is a multi-center retrospective observational study involving 59 Italian centers. We retrospectively reviewed the prevalence of interstitial pneumonia detected during the COVID period (between March 16 and 27, 2020) and compared to a pre-COVID period (January–February 2020) and a control time (in 2019). The diagnosis of interstitial pneumonia was done considering lung alterations of CT of PET. Results Overall, [18F]FDG PET/CT was performed on 4008 patients in the COVID period, 19,267 in the pre-COVID period, and 5513 in the control period. The rate of interstitial pneumonia suspicious for COVID-19 was significantly higher during the...

La radiologia medica

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new virus recently isolated fro... more Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new virus recently isolated from humans. SARS-CoV-2 was discovered to be the pathogen responsible for a cluster of pneumonia cases associated with severe respiratory disease that occurred in December 2019 in China. This novel pulmonary infection, formally called Coronavirus Disease 2019 (COVID-19), has spread rapidly in China and beyond. On 8 March 2020, the number of Italians with SARS-CoV-2 infection was 7375 with a 48% hospitalization rate. At present, chest-computed tomography imaging is considered the most effective method for the detection of lung abnormalities in early-stage disease and quantitative assessment of severity and progression of COVID-19 pneumonia. Although chest X-ray (CXR) is considered not sensitive for the detection of pulmonary involvement in the early stage of the disease, we believe that, in the current emergency setting, CXR can be a useful diagnostic tool for monitoring the rapid progression of lung abnormalities in infected patients, particularly in intensive care units. In this short communication, we present our experimental CXR scoring system that we are applying to hospitalized patients with COVID-19 pneumonia to quantify and monitor the severity and progression of this new infectious disease. We also present the results of our preliminary validation study on a sample of 100 hospitalized patients with SARS-CoV-2 infection for whom the final outcome (recovery or death) was available.

Acta Otorhinolaryngologica Italica

La patologia infiammatoria ed ostruttiva delle ghiandole salivari riconosce molteplici eziologie ... more La patologia infiammatoria ed ostruttiva delle ghiandole salivari riconosce molteplici eziologie con coinvolgimento del parenchima ghiandolare e/o del sistema escretore. Il quadro clinico è essenziale per indirizzare l’integrazione diagnostica con adeguate metodiche di imaging. Sulla base dell’anamnesi e dell’esame obiettivo, possono riconoscersi quattro scenari clinici: (1) tumefazione acuta generalizzata delle ghiandole salivari maggiori; (2) tumefazione acuta di un’unica ghiandola salivare maggiore; (3) tumefazione cronica generalizzata delle ghiandole salivari maggiori associata o meno a xerostomia; (4) tumefazione cronica o persistente di una singola ghiandola salivare maggiore. L’algoritmo diagnostico per la scelta della metodica di imaging più appropriata dipende quindi dallo scenario clinico. L’imaging è essenziale per confermare la diagnosi clinica, per definire l’estensione della patologia ed identificare eventuali complicanze. Le metodiche di imaging disponibili includono...

Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)

Diagnostics

The most dreaded thoracic complications in patients with coronavirus disease 2019 (COVID-19) are ... more The most dreaded thoracic complications in patients with coronavirus disease 2019 (COVID-19) are acute pulmonary embolism and pulmonary fibrosis. Both the complications are associated with an increased risk of morbidity and mortality. While acute pulmonary embolism is not a rare finding in patients with COVID-19 pneumonia, the prevalence of pulmonary fibrosis remains unclear. Spontaneous pneumothorax is another possible complication in COVID-19 pneumonia, although its observation is rather uncommon. Herein, we present interesting computed tomography images of the first case of COVID-19 pneumonia that initially developed acute pulmonary embolism and subsequently showed progression toward pulmonary fibrosis and spontaneous pneumothorax.

Journal of Nuclear Cardiology

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new virus recently isolated fro... more Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new virus recently isolated from humans. SARS-CoV-2 was discovered to be the pathogen responsible for a cluster of pneumonia associated with severe respiratory disease occurred in December 2019 in China. This novel pulmonary infection, formally called coronavirus disease 2019 (COVID-19), has spread rapidly in China and beyond. On 8 March 2020, the number of Italians with SARS-CoV-2 infection was 7375 with a 48% hospitalization rate. At present, chest computed tomography imaging is considered the most effective method for detection of lung abnormalities in early-stage disease and for quantitative assessment of severity and progression of COVID-19 infection. Although chest x-ray (CXR) is considered not sensitive for the detection of pulmonary involvement in the early stage of disease, we believe that, in the current emergency setting, CXR can be a useful diagnostic tool for monitoring the rapid progression of lung abnormalities in infected patients, particularly in intensive care units. In this article we present our experimental CXR scoring system that we are applying in hospitalized patients with COVID-19 pneumonia to quantify and monitor the severity and progression of this new infectious disease. We also present the results of our preliminary validation study on a sample of 100 hospitalized patients with SARS-CoV-2 infection for whom the final outcome (recovery or death) was available.

La radiologia medica

Purpose To improve the risk stratification of patients infected with severe acute respiratory syn... more Purpose To improve the risk stratification of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an experimental chest X-ray (CXR) scoring system for quantifying lung abnormalities was introduced in our Diagnostic Imaging Department. The purpose of this study was to retrospectively evaluate correlations between the CXR score and the age or sex of Italian patients infected with SARS-CoV-2. Materials and methods Between March 4, 2020, and March 18, 2020, all CXR reports containing the new scoring system were retrieved. Only hospitalized patients with SARS-CoV-2 infection were enrolled. For each patient, age, sex, and the CXR report containing the highest score were considered for the analysis. Patients were also divided into seven groups according to age. Nonparametric statistical tests were used to examine the relationship between the severity of lung disease and the age or sex. Results 783 Italian patients (532 males and 251 females) with SARS-CoV-2 infection were enrolled. The CXR score was significantly higher in males than in females only in groups aged 50 to 79 years. A significant correlation was observed between the CXR score and age in both males and females. Males aged 50 years or older and females aged 80 years or older with coronavirus disease 2019 showed the highest CXR score (median ≥ 8). Conclusions Males aged 50 years or older and females aged 80 years or older showed the highest risk of developing severe lung disease. Our results may help to identify the highest-risk patients and those who require specific treatment strategies.

International Journal of Infectious Diseases

Diagnostics

Pulmonary subsolid nodules (SSNs) are observed not infrequently on thin-section chest computed to... more Pulmonary subsolid nodules (SSNs) are observed not infrequently on thin-section chest computed tomography (CT) images. SSNs persisting after a follow-up period of three to six months have a high likelihood of being pre-malignant or malignant lesions. Malignant SSNs usually represent the histologic spectrum of pulmonary adenocarcinomas, and pulmonary adenocarcinomas presenting as SSNs exhibit quite heterogeneous behavior. In fact, while most lesions show an indolent course and may grow very slowly or remain stable for many years, others may exhibit significant growth in a relatively short time. Therefore, it is not yet clear which persistent SSNs should be surgically removed and for how many years stable SSNs should be monitored. In order to solve these two open issues, the use of quantitative analysis has been proposed to define the “tailored” management of persistent SSNs. The main purpose of this review was to summarize recent results about quantitative CT analysis as a diagnostic...

Cancers

Olfactory neuroblastoma (ONB) is a rare sinonasal neoplasm with a peculiar behavior, for which li... more Olfactory neuroblastoma (ONB) is a rare sinonasal neoplasm with a peculiar behavior, for which limited prognostic factors are available. Herein, we investigate the transcriptional pathways altered in ONB and correlate them with pathological features and clinical outcomes. We analyze 32 ONB patients treated with curative intent at two independent institutions from 2001 to 2019 for whom there is available pathologic and clinical data. We perform gene expression profiling on primary ONB samples and carry out functional enrichment analysis to investigate the key pathways associated with disease-free survival (DFS). The median age is 53.5 years; all patients undergo surgery and a pure endoscopic approach is adopted in the majority of cases (81.2%). Most patients have advanced disease (stages III–IV, 81.2%) and 84.4% undergo adjuvant (chemo)radiotherapy. The median follow-up is 35 months; 11 (26.8%) patients relapse. Clinical characteristics (gender, stage and Hyams’ grade) are not associ...

Italian journal of anatomy and embryology, 2017

Chronic inflammatory fibro-proliferative changes leading to atherosclerotic plaques are considere... more Chronic inflammatory fibro-proliferative changes leading to atherosclerotic plaques are considered hallmark of cardiovascular diseases [1]. Atherosclerosis pathogenesis is a complex entity, which has not been fully understood; however, many studies have demonstrated the role of oxidative stress and inflammation in its development. Melatonin effects on inflammation and oxidative stress process have been demonstrated in the last ten-year literature [2]. However, its role(s) and mechanism(s) of action as a therapeutic tool against atherosclerosis remain largely unexplored. Our aims were to assess the role of melatonin in the onset and developing of atherosclerotic plaques through radiologic and morphometrical tools in 20 apolipoprotein-E knockout (ApoE) mice fed with Western diet (42% calories from fat). 10/20 mice were treated with melatonin (10 mg/kg per os). 18F-FDG PET-CT is a widely used tool to assess inflammatory changes, even before macroscopic changes have taken place. Glucose...

Emergency Care Journal

To evaluate the performance of a clinical-radiological index (RAPID-Covid score) in achieving Saf... more To evaluate the performance of a clinical-radiological index (RAPID-Covid score) in achieving Safe Discharge (SD) of patients accessing the Emergency Department (ED) with symptoms suggesting Covid-19. Clinical and radiological data were retrospectively collected from 853 consecutive patients admitted to the ED during the pandemics with symptoms suggesting Covid-19. Illness severity was graded with RAPID-Covid score, composed of chest X-ray findings, clinical symptoms and PaO2/FiO2. Patients with RAPIDCovid score ≥5 were admitted. Primary outcome was SD of patients to home care. SD was defined as survival of the patient, without evidence of second access to ED requiring hospitalization. 212/853 patients were discharged. 27/212 had a score ≥5 but refused admission. 185/212 were discharged with score <5: 147/185 (79,5%) survived and did not re-access ED; 1/185 (0,5%) died at home after first ED-dismissal; 37/185 (20,0%) had a second access. Of these 15/37 (8,1%) were newly dismissed...

Cancers, 2021

Simple Summary The gene expression profile of ONB defines a group of patients with a dismal progn... more Simple Summary The gene expression profile of ONB defines a group of patients with a dismal prognosis and identifies potentially targetable pathways. Better prognostic stratification may offer new tailored approaches for the treatment and follow-up of ONB. The integration of new therapeutic agents with standard surgical and RT strategies may improve the outcomes in cases with worse prognoses. Furthermore, the ontogenesis of ONB in basal and neural subtypes is mirrored by different transcriptional pathways, paving the way towards different therapeutic approaches. Abstract Olfactory neuroblastoma (ONB) is a rare sinonasal neoplasm with a peculiar behavior, for which limited prognostic factors are available. Herein, we investigate the transcriptional pathways altered in ONB and correlate them with pathological features and clinical outcomes. We analyze 32 ONB patients treated with curative intent at two independent institutions from 2001 to 2019 for whom there is available pathologic a...

Cancers

Sinonasal squamous cell carcinoma is a rare tumor affecting the nasal cavity and paranasal sinuse... more Sinonasal squamous cell carcinoma is a rare tumor affecting the nasal cavity and paranasal sinuses. Several aspects of this disease, ranging from epidemiology to biology, pathology, diagnosis, staging, treatment, and post-treatment surveillance are controversial, and consensus on how to manage this sinonasal cancer is lacking. A narrative literature review was performed to summarize the current evidence and provide the reader with available data supporting the decision-making process in patients affected by sinonasal squamous cell carcinoma, alongside the authors’ personal opinion on the unsolved issues of this tumor. The review has highlighted several advances in molecular definition of epithelial cancers of the sinonasal tract. Surgery represents the pivot of treatment and is performed through an endoscopic transnasal approach whenever feasible. Open surgery is required for a large proportion of cases. Reconstruction of the defect follows principles of skull base and cranio-maxill...

Cancers, 2021

Simple Summary Sinonasal squamous cell carcinomas are a group of diverse tumors affecting the nas... more Simple Summary Sinonasal squamous cell carcinomas are a group of diverse tumors affecting the nasal cavity and paranasal sinuses. As a direct consequence of their rarity and heterogeneity, diagnosis is challenging, and treatment does not follow universally accepted protocols. Though surgery represents the mainstay of treatment, neoadjuvant and adjuvant therapies have pivotal roles in improving outcomes of patients treated with curative intent. Indications to endoscopic surgery have been expanding over the last three decades, but a considerable number of patients affected by sinonasal squamous cell carcinoma still need open surgical procedures. Management of the neck in patients affected by sinonasal squamous cell carcinoma is controversial. Curative-intended treatment of recurrent and/or metastatic tumors, alongside palliation of uncurable cases, represent poorly explored aspects of this disease. Abstract Sinonasal squamous cell carcinoma is a rare tumor affecting the nasal cavity a...

Neuroimaging Clinics of North America

Prostate Cancer and Prostatic Diseases

Background Luteinizing hormone-releasing hormone (LHRH)-agonists in prostate cancer (PCa) patient... more Background Luteinizing hormone-releasing hormone (LHRH)-agonists in prostate cancer (PCa) patients induce sarcopenic obesity. The effect of LHRH-antagonist on body composition has never been explored. We evaluated changes in fat (FBM) and lean body mass (LBM) in PCa patients undergoing Degarelix. Methods This is a single-center prospective study, enrolling 29 non-metastatic PCa patients eligible to LHRH-antagonist from 2017 to 2019. All patients received monthly subcutaneous injection of Degarelix for 12 months. Changes in FBM and LBM between baseline and 12-month Degarelix, as measured by dual-energy x-ray absorptiometry, were the co-primary endpoints. Secondary endpoints were changes in serum lipids, glucose profile and follicle-stimulating hormone (FSH). Appendicular lean mass index (ALMI) and ALMI/FBM ratio were assessed as post-hoc analyses. Linear mixed models with random intercept tested for estimated least squared means differences (EMD). Results FBM significantly increased after 12 months (EMD +2920.7, +13.8%, p < 0.001), whereas LBM remained stable (EMD −187.1, −0.3%, p = 0.8). No differences occurred in lipid profile. Glycated hemoglobin significantly increased and serum FSH significantly decreased. A significant inverse relationship was found between serum FSH and ALMI/FBM ratio after 12 month (r = −0.44, p = 0.02). Conclusions The BLADE study prospectively evaluated changes in body composition after LHRH-antagonist. LHRHantagonist therapy is associated to an increased risk of obesity and diabetes, but lean body mass and serum lipids are not affected. This may represent an additional evidence supporting the reduced cardiovascular risk associated with LHRHantagonist. The role of FSH in influencing sarcopenic obesity in PCa after androgen deprivation deserves to be further explored.

European Journal of Nuclear Medicine and Molecular Imaging

Purpose To assess the presence and pattern of incidental interstitial lung alterations suspicious... more Purpose To assess the presence and pattern of incidental interstitial lung alterations suspicious of COVID-19 on fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) ([18F]FDG PET/CT) in asymptomatic oncological patients during the period of active COVID-19 in a country with high prevalence of the virus. Methods This is a multi-center retrospective observational study involving 59 Italian centers. We retrospectively reviewed the prevalence of interstitial pneumonia detected during the COVID period (between March 16 and 27, 2020) and compared to a pre-COVID period (January–February 2020) and a control time (in 2019). The diagnosis of interstitial pneumonia was done considering lung alterations of CT of PET. Results Overall, [18F]FDG PET/CT was performed on 4008 patients in the COVID period, 19,267 in the pre-COVID period, and 5513 in the control period. The rate of interstitial pneumonia suspicious for COVID-19 was significantly higher during the...

La radiologia medica

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new virus recently isolated fro... more Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new virus recently isolated from humans. SARS-CoV-2 was discovered to be the pathogen responsible for a cluster of pneumonia cases associated with severe respiratory disease that occurred in December 2019 in China. This novel pulmonary infection, formally called Coronavirus Disease 2019 (COVID-19), has spread rapidly in China and beyond. On 8 March 2020, the number of Italians with SARS-CoV-2 infection was 7375 with a 48% hospitalization rate. At present, chest-computed tomography imaging is considered the most effective method for the detection of lung abnormalities in early-stage disease and quantitative assessment of severity and progression of COVID-19 pneumonia. Although chest X-ray (CXR) is considered not sensitive for the detection of pulmonary involvement in the early stage of the disease, we believe that, in the current emergency setting, CXR can be a useful diagnostic tool for monitoring the rapid progression of lung abnormalities in infected patients, particularly in intensive care units. In this short communication, we present our experimental CXR scoring system that we are applying to hospitalized patients with COVID-19 pneumonia to quantify and monitor the severity and progression of this new infectious disease. We also present the results of our preliminary validation study on a sample of 100 hospitalized patients with SARS-CoV-2 infection for whom the final outcome (recovery or death) was available.

Acta Otorhinolaryngologica Italica

La patologia infiammatoria ed ostruttiva delle ghiandole salivari riconosce molteplici eziologie ... more La patologia infiammatoria ed ostruttiva delle ghiandole salivari riconosce molteplici eziologie con coinvolgimento del parenchima ghiandolare e/o del sistema escretore. Il quadro clinico è essenziale per indirizzare l’integrazione diagnostica con adeguate metodiche di imaging. Sulla base dell’anamnesi e dell’esame obiettivo, possono riconoscersi quattro scenari clinici: (1) tumefazione acuta generalizzata delle ghiandole salivari maggiori; (2) tumefazione acuta di un’unica ghiandola salivare maggiore; (3) tumefazione cronica generalizzata delle ghiandole salivari maggiori associata o meno a xerostomia; (4) tumefazione cronica o persistente di una singola ghiandola salivare maggiore. L’algoritmo diagnostico per la scelta della metodica di imaging più appropriata dipende quindi dallo scenario clinico. L’imaging è essenziale per confermare la diagnosi clinica, per definire l’estensione della patologia ed identificare eventuali complicanze. Le metodiche di imaging disponibili includono...

Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)

Diagnostics

The most dreaded thoracic complications in patients with coronavirus disease 2019 (COVID-19) are ... more The most dreaded thoracic complications in patients with coronavirus disease 2019 (COVID-19) are acute pulmonary embolism and pulmonary fibrosis. Both the complications are associated with an increased risk of morbidity and mortality. While acute pulmonary embolism is not a rare finding in patients with COVID-19 pneumonia, the prevalence of pulmonary fibrosis remains unclear. Spontaneous pneumothorax is another possible complication in COVID-19 pneumonia, although its observation is rather uncommon. Herein, we present interesting computed tomography images of the first case of COVID-19 pneumonia that initially developed acute pulmonary embolism and subsequently showed progression toward pulmonary fibrosis and spontaneous pneumothorax.

Journal of Nuclear Cardiology

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new virus recently isolated fro... more Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new virus recently isolated from humans. SARS-CoV-2 was discovered to be the pathogen responsible for a cluster of pneumonia associated with severe respiratory disease occurred in December 2019 in China. This novel pulmonary infection, formally called coronavirus disease 2019 (COVID-19), has spread rapidly in China and beyond. On 8 March 2020, the number of Italians with SARS-CoV-2 infection was 7375 with a 48% hospitalization rate. At present, chest computed tomography imaging is considered the most effective method for detection of lung abnormalities in early-stage disease and for quantitative assessment of severity and progression of COVID-19 infection. Although chest x-ray (CXR) is considered not sensitive for the detection of pulmonary involvement in the early stage of disease, we believe that, in the current emergency setting, CXR can be a useful diagnostic tool for monitoring the rapid progression of lung abnormalities in infected patients, particularly in intensive care units. In this article we present our experimental CXR scoring system that we are applying in hospitalized patients with COVID-19 pneumonia to quantify and monitor the severity and progression of this new infectious disease. We also present the results of our preliminary validation study on a sample of 100 hospitalized patients with SARS-CoV-2 infection for whom the final outcome (recovery or death) was available.

La radiologia medica

Purpose To improve the risk stratification of patients infected with severe acute respiratory syn... more Purpose To improve the risk stratification of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an experimental chest X-ray (CXR) scoring system for quantifying lung abnormalities was introduced in our Diagnostic Imaging Department. The purpose of this study was to retrospectively evaluate correlations between the CXR score and the age or sex of Italian patients infected with SARS-CoV-2. Materials and methods Between March 4, 2020, and March 18, 2020, all CXR reports containing the new scoring system were retrieved. Only hospitalized patients with SARS-CoV-2 infection were enrolled. For each patient, age, sex, and the CXR report containing the highest score were considered for the analysis. Patients were also divided into seven groups according to age. Nonparametric statistical tests were used to examine the relationship between the severity of lung disease and the age or sex. Results 783 Italian patients (532 males and 251 females) with SARS-CoV-2 infection were enrolled. The CXR score was significantly higher in males than in females only in groups aged 50 to 79 years. A significant correlation was observed between the CXR score and age in both males and females. Males aged 50 years or older and females aged 80 years or older with coronavirus disease 2019 showed the highest CXR score (median ≥ 8). Conclusions Males aged 50 years or older and females aged 80 years or older showed the highest risk of developing severe lung disease. Our results may help to identify the highest-risk patients and those who require specific treatment strategies.

International Journal of Infectious Diseases

Diagnostics

Pulmonary subsolid nodules (SSNs) are observed not infrequently on thin-section chest computed to... more Pulmonary subsolid nodules (SSNs) are observed not infrequently on thin-section chest computed tomography (CT) images. SSNs persisting after a follow-up period of three to six months have a high likelihood of being pre-malignant or malignant lesions. Malignant SSNs usually represent the histologic spectrum of pulmonary adenocarcinomas, and pulmonary adenocarcinomas presenting as SSNs exhibit quite heterogeneous behavior. In fact, while most lesions show an indolent course and may grow very slowly or remain stable for many years, others may exhibit significant growth in a relatively short time. Therefore, it is not yet clear which persistent SSNs should be surgically removed and for how many years stable SSNs should be monitored. In order to solve these two open issues, the use of quantitative analysis has been proposed to define the “tailored” management of persistent SSNs. The main purpose of this review was to summarize recent results about quantitative CT analysis as a diagnostic...