Artor Niccoli-asabella | University of Bari Italy (original) (raw)
Papers by Artor Niccoli-asabella
Hellenic journal of nuclear medicine
To evaluate the diagnostic and prognostic role of fluorine-18 fluoro-2-deoxy-D-glucose positron e... more To evaluate the diagnostic and prognostic role of fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in comparison to morphological imaging such as computed tomography in primary adrenal malignancies. In this multicenter retrospective study, 68 patients with adrenal malignancy were included. All patients had histologically proven diagnosis of primary adrenal malignancy (adrenocortical carcinoma, malignant pheochromocytoma, neuroblastoma and lymphoma), one whole body (18)F-FDG PET/CT scan and one whole-body contrast enhancement computed tomography (CECT) scan acquired within one month and were followed clinically and by performing morphological tests for at least 12 months. Overall sensitivity, specificity, accuracy, positive and negative predictive values for CECT and (18)F-FDG PET/CT were respectively, 59%, 100%, 65%, 100%, 27% and 75%, 100%, 82%, 100% and 63%. For adrenocortical carcinomas, (18)F-FDG PET/CT showed a better accu...
Abdominal Imaging, 2014
The aim of this study was to prospectively investigate the predictive value of (18)F-FDG PET/CT s... more The aim of this study was to prospectively investigate the predictive value of (18)F-FDG PET/CT semiquantitative parameters for locally advanced low rectal cancer (LARC) treated by neoadjuvant chemoradiation therapy (nCRT). 68 patients with LARC had (18)F-FDG PET/CT scans twice (baseline and 5-6 weeks post-nCRT). All patients underwent surgery with preservation of the sphincter 8 weeks later. (18)F-FDG PET/CT analysis was performed by visual response assessment (VRA) and semiquantitative parameters: SUVmaxbaseline, SUVmeanbaseline, MTVbaseline, TLGbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, TLGpost-nCRT; ΔSUVmax and mean and Response indexes (RImax% and RImean%). Assessment of nCRT tumor response was performed according to the Mandard's Tumor Regression Grade (TRG) and (y)pTNM staging on the surgical specimens. Concordances of VRA with TRG, and with (y)pTNM criteria were evaluated by Cohen's K. Results were compared by t student test for unpaired groups. ROC curve analysis was performed. VRA analysis of post-nCRT (18)F-FDG PET/CT scan for the (y)pTNM outcome showed sensitivity, specificity, accuracy, PPV, and NPV of 87.5%, 66.7%, 83.8%, 92.5%, and 53.3%, respectively. Concordances of VRA with TRG and with (y)pTNM were moderate. For the outcome variable TRG, the statistical difference between responders and non-responders was significant for SUVmaxpost-nCRT and RImean%; for the outcome variable (y)pTNM, there was a significant difference for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. ROC analysis showed better AUCs: for the outcome variable TRG for SUVmaxpost-nCRT, SUVmeanpost-nCRT, and RImean%; for the outcome variable (y)pTNM for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. No significant differences among parameters were found. Qualitative and semiquantitative evaluations for (18)F-FDG PET/CT are the optimal approach; a valid parameter for response prediction has still to be established.
Movement Disorders, 2010
SPECT imaging is widely used for the differential diagnosis of degenerative parkinsonisms by expl... more SPECT imaging is widely used for the differential diagnosis of degenerative parkinsonisms by exploiting the high affinitiy of the radiotracer 123 I-FP-CIT for the dopamine transporter. Reduced levels of DAT are found in Parkinson Disease (PD), Dementia with Lewy Bodies (DLB), and Progressive Supranuclear Palsy (PSP) compared to in Essential Tremor (ET) and Healthy Controls (HC). However, the extent of the neurodegenerative process may extend beyond nigrostriatal system. We have exploited the affinity of the same radiotracer 123 I-FP-CIT for the serotonin transporter to investigate SERT levels in the midbrain of patients with PD, DLB, PSP, and ET compared to HC. Using MRI images as anatomical templates for midbrain uptake quantification, we found a mild decrease in SERT levels in PD compared to ET and HC, with marked interindividual variability; on the other side, PSP and DLB patients displayed markedly reduced to undetectable levels of SERT, respectively. These findings show that the neurodegenerative process affects serotoninergic neurons in parkinsonisms, with much more severe involvement in DLB than in PD patients, despite the comparable loss of striatal DAT. SERT-dependent 123 I-FP-CIT uptake may allow a more comprehensive assessment of neurochemical disturbances in degenerative parkinsonisms and may have a value for differential diagnosis.
PLoS ONE, 2010
Background: Variation of the gene coding for D2 receptors (DRD2) has been associated with risk fo... more Background: Variation of the gene coding for D2 receptors (DRD2) has been associated with risk for schizophrenia and with working memory deficits. A functional intronic SNP (rs1076560) predicts relative expression of the two D2 receptors isoforms, D2S (mainly pre-synaptic) and D2L (mainly post-synaptic). However, the effect of functional genetic variation of DRD2 on striatal dopamine D2 signaling and on its correlation with prefrontal activity during working memory in humans is not known.
Annals of Nuclear Medicine, 2014
To evaluate the role of [18F]-fluorodeoxyglucose positron emission tomography/computer tomography... more To evaluate the role of [18F]-fluorodeoxyglucose positron emission tomography/computer tomography [18F-FDG PET/CT] comparing target background ratio (TBR) and standardized uptake value (SUV) with the histopathological inflammatory status of the carotid plaques. Vulnerable carotid plaques are the primary cause of acute cerebrovascular events. 18F-FDG PET/CT represents a morpho-functional technique able to identify the highly inflamed and most vulnerable carotid plaques. Several literature studies experimented this new method to identify vascular inflammation, but few have effectively compared PET/CT results with plaque histological data and no studies had directly compared TBR to SUV. Thirty-two consecutive patients (20 men and 12 women, mean age 74 ± 8 years) undergoing carotid endarterectomy were enrolled and studied with carotid 18F-FDG PET/CT. Maximum and mean SUV and TBR were used to quantify 18F-FDG uptake while surgical specimens were analyzed by optical microscopy to identify inflamed carotid plaques, with evaluation of macrophages infiltration by mean of immunohistochemistry. On the basis of the presence of inflammation at the histological analysis, we divided population in two groups: group A (n = 12) patients with inflamed carotid plaques and group B (n = 20) patients with non-inflamed ones, then crossed and evaluated the histological data with 18F-FDG PET/CT findings. SUV max and SUV mean values resulted higher in group A (respectively, 2.14 ± 0.77 and 1.99 ± 0.68) than in group B (respectively, 1.79 ± 0.37 and 1.64 ± 0.34) without reaching a statistical significance (p = ns). TBR max and TBR mean values resulted higher in group A (respectively, 1.42 ± 0.32 and 1.34 ± 0.26) than in group B (respectively, 1.16 ± 0.19 and 1.03 ± 0.20) with a statistically significant differences between the two groups and carotid inflammation (respectively, p < 0.01 and p < 0.001). TBR (max and mean values) is a more reliable parameter than SUV in identifying inflamed plaques. Although limited by the small population analyzed, our results suggest the important role of 18F-FDG PET/CT, using TBR, in identification of high-risk carotid atherosclerotic plaques.
![Research paper thumbnail of Whole-body MR-DWIBS vs. [18F]-FDG-PET/CT in the study of malignant tumors: a retrospective study](https://attachments.academia-assets.com/42695082/thumbnails/1.jpg)
](La radiologia medica, 2011
Purpose. Our aim was to assess the overall diagnostic accuracy of magnetic resonance diffusion-we... more Purpose. Our aim was to assess the overall diagnostic accuracy of magnetic resonance diffusion-weighted whole-body imaging with background signal suppression (MR-DWIBS) compared with ([ 18 F]-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT), considered the reference standard of whole-body tumour imaging modalities, in a series of consecutive patients with malignant tumour. Materials and methods. Thirty-eight patients diagnosed with a malignant tumour over a 4-month period were enrolled in this retrospective, observational study. PET/CT and MR-DWIBS images were reviewed in double-blind manner by a nuclear medicine physician and radiologists with 4 years experience. Lesion size, standard uptake value (SUV) and apparent diffusion coefficient (ADC) were measured and calculated for each lesion. Results. The qualitative analysis of MR-DWIBS and [ 18 F]-FDG-PET/CT showed that two patients were negative at both techniques. MR-DWIBS was positive in 36 patients, 34 of whom were positive and two negative at [ 18 F]-FDG-PET/CT, respectively. Two hundred and fiftyfive lesions were identified by MR-DWIBS and 184 by [ 18 F]-FDG-PET/CT, which was a significative discordance. Correlation between SUV and ADC of lesions positive at both techniques was not statistically significant. The mean difference between lesion size in [ 18 F]-FDG-PET/ Riassunto Obiettivo. L'obiettivo del nostro lavoro è stato stabilire il valore di accuratezza diagnostica della whole-body risonanza magnetica (RM)-diffusion weighted whole body imaging with background signal suppression (DWIBS) rispetto alla 18 F-fluor-deossiglucosio (FDG)-tomografia a emissione di positroni (PET)/tomografia computerizzata (TC), considerata il gold standard nell'ambito della diagnostica whole body nell'imaging dei tumori, in un gruppo di pazienti con diagnosi di neoplasia maligna. Materiali e metodi. Sono stati inclusi 38 pazienti con diagnosi di neoplasia maligna in un periodo di 4 mesi. Le immagini PET/TC e RM-DWIBS sono state rivalutate in doppio cieco da un medico nucleare e da un radiologo con 4 anni di esperienza. Per ciascuna lesione sono state valutate dimensioni, standardized uptake value (SUV) e coefficiente di diffusione apparente (ADC). Risultati. La valutazione qualitativa sia della MR-DWIBS che della 18 F-FDG-PET/TC ha riscontrato due soli pazienti negativi per entrambe le tecniche. La RM-DWIBS è risultata positiva in 36 pazienti, di cui 34 erano positivi e 2 risultavano negativi alla 18 F-FDG-PET/TC. Duecentocinquantacinque lesioni sono state identificate con la MR-DWIBS e 184 con 18 F-FDG-PET/TC. È stata dimostrata una discordanza significativa. La correlazione tra SUV e ADC nelle lesioni positive ad entrambe le tecniche non è risultata statisticamente significativa.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2004
Anomalous coronary arteries (ACAs) may be clinically silent and totally benign or associated with... more Anomalous coronary arteries (ACAs) may be clinically silent and totally benign or associated with catastrophic and fatal presentations. It has been postulated that the proximal course of an ACA is a decisive factor in risk stratification and surgical approach. Particularly, a course between the aorta and pulmonary trunk carries a high risk of major adverse events. We sought to evaluate the anatomic course of documented ACAs by transesophageal echocardiography (TEE) and to study their functional importance using stress-rest (99m)Tc-sestamibi ((99m)Tc-MIBI) myocardial perfusion SPECT. From a cohort of patients undergoing coronary angiography in our department between January 1997 and April 2003, we selected 14 with ACAs but without CAD (9 men and 5 women; mean age, 50.7 +/- 14.6 y). All patients underwent TEE and stress-rest (99m)Tc-MIBI myocardial perfusion SPECT. TEE correctly identified the origin of all ACAs and revealed an anomalous course between the great vessels in 5 patients....
International Journal of Nuclear Medicine Research, 2015
Medicine, 2015
The purpose of the report was to evaluate the role of fluorine-18 fluoro-2-deoxy-D-glucose positr... more The purpose of the report was to evaluate the role of fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in staging gastric cancer comparing it with contrast enhancement computed tomography (CECT
Hellenic journal of nuclear medicine
Lymphomas are a heterogeneous group of lymphoid malignancies, which can be broadly divided into n... more Lymphomas are a heterogeneous group of lymphoid malignancies, which can be broadly divided into non-Hodgkin Lymphomas (NHL) and Hodgkin lymphoma (HL) that display different patterns of biological behavior and response to treatment. Their incidence is still increasing and for this reason they require a lot of effort in scientific research. The management of both NHL and HL follows well-established guidelines based on the initial staging assessment. Therefore an accurate staging is the basis for the selection of an appropriate therapeutic approach in order to prevent over or under treatment as well as to minimize morbidity related to the radio-chemotherapy regimens given. (18)F-FDG-PET is currently regarded as the reference standard imaging modality in the staging of the majority of lymphoma type, for evaluation of distribution of the disease by providing both functional and anatomic information in a single whole body examination. In particular its role is established in HL and high-g...
Hellenic journal of nuclear medicine
In the last decade numerous attempts were considered to co-register and integrate different imagi... more In the last decade numerous attempts were considered to co-register and integrate different imaging data. Like PET/CT the integration of PET to MR showed great interest. PET/MR scanners are recently tested on different distrectual or systemic pathologies. Unfortunately PET/MR scanners are expensive and diagnostic protocols are still under studies and investigations. Nuclear Medicine imaging highlights functional and biometabolic information but has poor anatomic details. The aim of this study is to integrate MR and PET data to produce distrectual or whole body fused images acquired from different scanners even in different days. We propose an offline method to fuse PET with MR data using an open-source software that has to be inexpensive, reproducible and capable to exchange data over the network. We also evaluate global quality, alignment quality, and diagnostic confidence of fused PET-MR images. We selected PET/CT studies performed in our Nuclear Medicine unit, MR studies provided...
Hellenic journal of nuclear medicine, Jan 13, 2015
Objective: Mucormycosis is an infection caused by mycetes mucorales, emerged as a life-threatenin... more Objective: Mucormycosis is an infection caused by mycetes mucorales, emerged as a life-threatening infection associated with severe morbidity and high mortality. Conventional imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) are usually performed to assess mucormycosis extension, but they may present insufficiencies in their performance. Case presentation: We present the case of a 13 years old patient with diagnosis of rhino-orbital-cerebral mucormycosis (RCM) who performed head MRI and [(18)F]2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) both for the infection spread assessment and for the early evaluation of response to systemic amphotericin-B treatment. Conclusion: This case suggests that (18)F-FDG PET/CT could be considered as a valuable tool for the initial staging of RCM when compared with MRI and should be performed as soon as possible after the first clinical suspicion of this disease. In addition (...
BioMed Research International, 2014
(124)Iodine ((124)I) with its 4.2 d half-life is particularly attractive for in vivo detection an... more (124)Iodine ((124)I) with its 4.2 d half-life is particularly attractive for in vivo detection and quantification of longer-term biological and physiological processes; the long half-life of (124)I is especially suited for prolonged time in vivo studies of high molecular weight compounds uptake. Numerous small molecules and larger compounds like proteins and antibodies have been successfully labeled with (124)I. Advances in radionuclide production allow the effective availability of sufficient quantities of (124)I on small biomedical cyclotrons for molecular imaging purposes. Radioiodination chemistry with (124)I relies on well-established radioiodine labeling methods, which consists mainly in nucleophilic and electrophilic substitution reactions. The physical characteristics of (124)I permit taking advantages of the higher PET image quality. The availability of new molecules that may be targeted with (124)I represents one of the more interesting reasons for the attention in nuclear medicine. We aim to discuss all iodine radioisotopes application focusing on (124)I, which seems to be the most promising for its half-life, radiation emissions, and stability, allowing several applications in oncological and nononcological fields.
BioMed Research International, 2014
Copper (Cu) is an important trace element in humans; it plays a role as a cofactor for numerous e... more Copper (Cu) is an important trace element in humans; it plays a role as a cofactor for numerous enzymes and other proteins crucial for respiration, iron transport, metabolism, cell growth, and hemostasis. Natural copper comprises two stable isotopes, 63 Cu and 65 Cu, and 5 principal radioisotopes for molecular imaging applications ( 60 Cu, 61 Cu, 62 Cu, and 64 Cu) and in vivo targeted radiation therapy ( 64 Cu and 67 Cu). The two potential ways to produce Cu radioisotopes concern the use of the cyclotron or the reactor. A noncopper target is used to produce noncarrier-added Cu thanks to a chemical separation from the target material using ion exchange chromatography achieving a high amount of radioactivity with the lowest possible amount of nonradioactive isotopes. In recent years, Cu isotopes have been linked to antibodies, proteins, peptides, and nanoparticles for preclinical and clinical research; pathological conditions that influence Cu metabolism such as Menkes syndrome, Wilson disease, inflammation, tumor growth, metastasis, angiogenesis, and drug resistance have been studied. We aim to discuss all Cu radioisotopes application focusing on 64 Cu and in particular its form 64 CuCl 2 that seems to be the most promising for its half-life, radiation emissions, and stability with chelators, allowing several applications in oncological and nononcological fields.
Abdominal Imaging, 2014
The aim of this study was to prospectively investigate the predictive value of (18)F-FDG PET/CT s... more The aim of this study was to prospectively investigate the predictive value of (18)F-FDG PET/CT semiquantitative parameters for locally advanced low rectal cancer (LARC) treated by neoadjuvant chemoradiation therapy (nCRT). 68 patients with LARC had (18)F-FDG PET/CT scans twice (baseline and 5-6 weeks post-nCRT). All patients underwent surgery with preservation of the sphincter 8 weeks later. (18)F-FDG PET/CT analysis was performed by visual response assessment (VRA) and semiquantitative parameters: SUVmaxbaseline, SUVmeanbaseline, MTVbaseline, TLGbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, TLGpost-nCRT; ΔSUVmax and mean and Response indexes (RImax% and RImean%). Assessment of nCRT tumor response was performed according to the Mandard's Tumor Regression Grade (TRG) and (y)pTNM staging on the surgical specimens. Concordances of VRA with TRG, and with (y)pTNM criteria were evaluated by Cohen's K. Results were compared by t student test for unpaired groups. ROC curve analysis was performed. VRA analysis of post-nCRT (18)F-FDG PET/CT scan for the (y)pTNM outcome showed sensitivity, specificity, accuracy, PPV, and NPV of 87.5%, 66.7%, 83.8%, 92.5%, and 53.3%, respectively. Concordances of VRA with TRG and with (y)pTNM were moderate. For the outcome variable TRG, the statistical difference between responders and non-responders was significant for SUVmaxpost-nCRT and RImean%; for the outcome variable (y)pTNM, there was a significant difference for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. ROC analysis showed better AUCs: for the outcome variable TRG for SUVmaxpost-nCRT, SUVmeanpost-nCRT, and RImean%; for the outcome variable (y)pTNM for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. No significant differences among parameters were found. Qualitative and semiquantitative evaluations for (18)F-FDG PET/CT are the optimal approach; a valid parameter for response prediction has still to be established.
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition), 2014
ABSTRACT La hipercalcemia es una complicación de tumores avanzados y se asocia a un mal pronóstic... more ABSTRACT La hipercalcemia es una complicación de tumores avanzados y se asocia a un mal pronóstico. Llevar a cabo una evaluación para establecer la causa es esencial dado que algunos pacientes oncológicos pueden presentar hipercalcemia por hiperparatiroidismo primario no diagnosticado. Se describe el caso de un paciente con linfoma de Hodgkin y con hipercalcemia persistente en el cual un estudio 18F-FDG PET/TC mostró una lesión en la región anterior del cuello, no atribuible a la neoplasia inicial, confirmada por 99mTc-sestamibi y resecada con cirugía mínimamente invasiva. Era un adenoma oxifílico de paratiroides de localización ectópica.
Clinical Nuclear Medicine, 2011
ABSTRACT We report a case of a 26-year-old man who had sarcoidosis with involvement of central ne... more ABSTRACT We report a case of a 26-year-old man who had sarcoidosis with involvement of central nervous system, manifested by symptoms attributable to diabetes insipidus. Laboratory tests, magnetic resonance and computed tomography images, were all partially useful and inconclusive. These investigations have been integrated with 18-Fluorine-labeled-2-deoxy-2-fluoro-D-glucose positron-emission-tomography/computed tomography (F-18 FDG PET/CT), which showed F-18 FDG uptake in the midbrain area and pituitary gland, corresponding to magnetic resonance findings, and in many bone sites, in particular iliac wings. This finding has been useful for biopsy. F-18 FDG PET/CT can demonstrate active skull-base sarcoidosis.
Clinical Nephrology, 2008
The Cockcroft and Gault formula is a quick and reliable method for calculating creatinine clearan... more The Cockcroft and Gault formula is a quick and reliable method for calculating creatinine clearance without a 24-hour urine collection (CG-cl). In obese subjects an excess of fat mass provokes a reduction in daily creatinine urine excretion per body kilo weight and is responsible for overestimated renal function when calculated by CG-cl. The aim of this study was to devise a simple correction method which could also make use of CG-cl in obese subjects. In 52 subjects with a body mass index (BMI) > 25, renal function was assessed by simultaneously determining creatinine clearance using 24-hour urine collection (Cr-cl) and the CG-cl. The percentage difference between the 2 clearances (delta %) was correlated with BMI for each patient using simple linear regression analysis. The estimated regression model (delta% = 1.217 BMI-- 24.81) provided the following CG-cl correction formula for obese subjects: Corrected CG-cl = CG-cl (1.25 - 0.012 BMI). Its validity was evaluated in another group of 20 subjects with BMI > 25 by comparing the results obtained with Corrected CG-cl to those obtained by CG-cl and MDRD formula (MDRD-cl) using the clearance of 51Cr-EDTA (5 Cr-EDTA-cl) as the GFR measurement gold standard. Linear regression analysis of CG-cl, MDRD-cl and Corrected CG-cl compared to 5tCr-EDTA-cl (considered as the independent variable) resulted in the following determination coefficients (R2): 0.687; 0.818; 0.947, respectively. In conclusion, this formula can be considered a quick and reliable method for CG-cl correction in obese subjects.
Frontiers in Behavioral Neuroscience, 2014
&... more "Schizotypy" is a latent organization of personality related to the genetic risk for schizophrenia. Some evidence suggests that schizophrenia and schizotypy share some biological features, including a link to dopaminergic D2 receptor signaling. A polymorphism in the D2 gene (DRD2 rs1076560, guanine > thymine (G > T)) has been associated with the D2 short/long isoform expression ratio, as well as striatal dopamine signaling and prefrontal cortical activity during different cognitive operations, which are measures that are altered in patients with schizophrenia. Our aim is to determine the association of schizotypy scores with the DRD2 rs1076560 genotype in healthy individuals and their interaction with prefrontal activity during attention and D2 striatal signaling. A total of 83 healthy subjects were genotyped for DRD2 rs1076560 and completed the Schizotypal Personality Questionnaire (SPQ). Twenty-six participants underwent SPECT with [(123)I]IBZM D2 receptor radiotracer, while 68 performed an attentional control task during fMRI. We found that rs1076560 GT subjects had greater SPQ scores than GG individuals. Moreover, the interaction between schizotypy and the GT genotype predicted prefrontal activity and related attentional behavior, as well as striatal binding of IBZM. No interaction was found in GG individuals. These results suggest that rs1076560 GT healthy individuals are prone to higher levels of schizotypy, and that the interaction between rs1076560 and schizotypy scores modulates phenotypes related to the pathophysiology of schizophrenia, such as prefrontal activity and striatal dopamine signaling. These results provide systems-level qualitative evidence for mapping the construct of schizotypy in healthy individuals onto the schizophrenia continuum.
Hellenic journal of nuclear medicine
To evaluate the diagnostic and prognostic role of fluorine-18 fluoro-2-deoxy-D-glucose positron e... more To evaluate the diagnostic and prognostic role of fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in comparison to morphological imaging such as computed tomography in primary adrenal malignancies. In this multicenter retrospective study, 68 patients with adrenal malignancy were included. All patients had histologically proven diagnosis of primary adrenal malignancy (adrenocortical carcinoma, malignant pheochromocytoma, neuroblastoma and lymphoma), one whole body (18)F-FDG PET/CT scan and one whole-body contrast enhancement computed tomography (CECT) scan acquired within one month and were followed clinically and by performing morphological tests for at least 12 months. Overall sensitivity, specificity, accuracy, positive and negative predictive values for CECT and (18)F-FDG PET/CT were respectively, 59%, 100%, 65%, 100%, 27% and 75%, 100%, 82%, 100% and 63%. For adrenocortical carcinomas, (18)F-FDG PET/CT showed a better accu...
Abdominal Imaging, 2014
The aim of this study was to prospectively investigate the predictive value of (18)F-FDG PET/CT s... more The aim of this study was to prospectively investigate the predictive value of (18)F-FDG PET/CT semiquantitative parameters for locally advanced low rectal cancer (LARC) treated by neoadjuvant chemoradiation therapy (nCRT). 68 patients with LARC had (18)F-FDG PET/CT scans twice (baseline and 5-6 weeks post-nCRT). All patients underwent surgery with preservation of the sphincter 8 weeks later. (18)F-FDG PET/CT analysis was performed by visual response assessment (VRA) and semiquantitative parameters: SUVmaxbaseline, SUVmeanbaseline, MTVbaseline, TLGbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, TLGpost-nCRT; ΔSUVmax and mean and Response indexes (RImax% and RImean%). Assessment of nCRT tumor response was performed according to the Mandard's Tumor Regression Grade (TRG) and (y)pTNM staging on the surgical specimens. Concordances of VRA with TRG, and with (y)pTNM criteria were evaluated by Cohen's K. Results were compared by t student test for unpaired groups. ROC curve analysis was performed. VRA analysis of post-nCRT (18)F-FDG PET/CT scan for the (y)pTNM outcome showed sensitivity, specificity, accuracy, PPV, and NPV of 87.5%, 66.7%, 83.8%, 92.5%, and 53.3%, respectively. Concordances of VRA with TRG and with (y)pTNM were moderate. For the outcome variable TRG, the statistical difference between responders and non-responders was significant for SUVmaxpost-nCRT and RImean%; for the outcome variable (y)pTNM, there was a significant difference for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. ROC analysis showed better AUCs: for the outcome variable TRG for SUVmaxpost-nCRT, SUVmeanpost-nCRT, and RImean%; for the outcome variable (y)pTNM for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. No significant differences among parameters were found. Qualitative and semiquantitative evaluations for (18)F-FDG PET/CT are the optimal approach; a valid parameter for response prediction has still to be established.
Movement Disorders, 2010
SPECT imaging is widely used for the differential diagnosis of degenerative parkinsonisms by expl... more SPECT imaging is widely used for the differential diagnosis of degenerative parkinsonisms by exploiting the high affinitiy of the radiotracer 123 I-FP-CIT for the dopamine transporter. Reduced levels of DAT are found in Parkinson Disease (PD), Dementia with Lewy Bodies (DLB), and Progressive Supranuclear Palsy (PSP) compared to in Essential Tremor (ET) and Healthy Controls (HC). However, the extent of the neurodegenerative process may extend beyond nigrostriatal system. We have exploited the affinity of the same radiotracer 123 I-FP-CIT for the serotonin transporter to investigate SERT levels in the midbrain of patients with PD, DLB, PSP, and ET compared to HC. Using MRI images as anatomical templates for midbrain uptake quantification, we found a mild decrease in SERT levels in PD compared to ET and HC, with marked interindividual variability; on the other side, PSP and DLB patients displayed markedly reduced to undetectable levels of SERT, respectively. These findings show that the neurodegenerative process affects serotoninergic neurons in parkinsonisms, with much more severe involvement in DLB than in PD patients, despite the comparable loss of striatal DAT. SERT-dependent 123 I-FP-CIT uptake may allow a more comprehensive assessment of neurochemical disturbances in degenerative parkinsonisms and may have a value for differential diagnosis.
PLoS ONE, 2010
Background: Variation of the gene coding for D2 receptors (DRD2) has been associated with risk fo... more Background: Variation of the gene coding for D2 receptors (DRD2) has been associated with risk for schizophrenia and with working memory deficits. A functional intronic SNP (rs1076560) predicts relative expression of the two D2 receptors isoforms, D2S (mainly pre-synaptic) and D2L (mainly post-synaptic). However, the effect of functional genetic variation of DRD2 on striatal dopamine D2 signaling and on its correlation with prefrontal activity during working memory in humans is not known.
Annals of Nuclear Medicine, 2014
To evaluate the role of [18F]-fluorodeoxyglucose positron emission tomography/computer tomography... more To evaluate the role of [18F]-fluorodeoxyglucose positron emission tomography/computer tomography [18F-FDG PET/CT] comparing target background ratio (TBR) and standardized uptake value (SUV) with the histopathological inflammatory status of the carotid plaques. Vulnerable carotid plaques are the primary cause of acute cerebrovascular events. 18F-FDG PET/CT represents a morpho-functional technique able to identify the highly inflamed and most vulnerable carotid plaques. Several literature studies experimented this new method to identify vascular inflammation, but few have effectively compared PET/CT results with plaque histological data and no studies had directly compared TBR to SUV. Thirty-two consecutive patients (20 men and 12 women, mean age 74 ± 8 years) undergoing carotid endarterectomy were enrolled and studied with carotid 18F-FDG PET/CT. Maximum and mean SUV and TBR were used to quantify 18F-FDG uptake while surgical specimens were analyzed by optical microscopy to identify inflamed carotid plaques, with evaluation of macrophages infiltration by mean of immunohistochemistry. On the basis of the presence of inflammation at the histological analysis, we divided population in two groups: group A (n = 12) patients with inflamed carotid plaques and group B (n = 20) patients with non-inflamed ones, then crossed and evaluated the histological data with 18F-FDG PET/CT findings. SUV max and SUV mean values resulted higher in group A (respectively, 2.14 ± 0.77 and 1.99 ± 0.68) than in group B (respectively, 1.79 ± 0.37 and 1.64 ± 0.34) without reaching a statistical significance (p = ns). TBR max and TBR mean values resulted higher in group A (respectively, 1.42 ± 0.32 and 1.34 ± 0.26) than in group B (respectively, 1.16 ± 0.19 and 1.03 ± 0.20) with a statistically significant differences between the two groups and carotid inflammation (respectively, p < 0.01 and p < 0.001). TBR (max and mean values) is a more reliable parameter than SUV in identifying inflamed plaques. Although limited by the small population analyzed, our results suggest the important role of 18F-FDG PET/CT, using TBR, in identification of high-risk carotid atherosclerotic plaques.
La radiologia medica, 2011
Purpose. Our aim was to assess the overall diagnostic accuracy of magnetic resonance diffusion-we... more Purpose. Our aim was to assess the overall diagnostic accuracy of magnetic resonance diffusion-weighted whole-body imaging with background signal suppression (MR-DWIBS) compared with ([ 18 F]-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT), considered the reference standard of whole-body tumour imaging modalities, in a series of consecutive patients with malignant tumour. Materials and methods. Thirty-eight patients diagnosed with a malignant tumour over a 4-month period were enrolled in this retrospective, observational study. PET/CT and MR-DWIBS images were reviewed in double-blind manner by a nuclear medicine physician and radiologists with 4 years experience. Lesion size, standard uptake value (SUV) and apparent diffusion coefficient (ADC) were measured and calculated for each lesion. Results. The qualitative analysis of MR-DWIBS and [ 18 F]-FDG-PET/CT showed that two patients were negative at both techniques. MR-DWIBS was positive in 36 patients, 34 of whom were positive and two negative at [ 18 F]-FDG-PET/CT, respectively. Two hundred and fiftyfive lesions were identified by MR-DWIBS and 184 by [ 18 F]-FDG-PET/CT, which was a significative discordance. Correlation between SUV and ADC of lesions positive at both techniques was not statistically significant. The mean difference between lesion size in [ 18 F]-FDG-PET/ Riassunto Obiettivo. L'obiettivo del nostro lavoro è stato stabilire il valore di accuratezza diagnostica della whole-body risonanza magnetica (RM)-diffusion weighted whole body imaging with background signal suppression (DWIBS) rispetto alla 18 F-fluor-deossiglucosio (FDG)-tomografia a emissione di positroni (PET)/tomografia computerizzata (TC), considerata il gold standard nell'ambito della diagnostica whole body nell'imaging dei tumori, in un gruppo di pazienti con diagnosi di neoplasia maligna. Materiali e metodi. Sono stati inclusi 38 pazienti con diagnosi di neoplasia maligna in un periodo di 4 mesi. Le immagini PET/TC e RM-DWIBS sono state rivalutate in doppio cieco da un medico nucleare e da un radiologo con 4 anni di esperienza. Per ciascuna lesione sono state valutate dimensioni, standardized uptake value (SUV) e coefficiente di diffusione apparente (ADC). Risultati. La valutazione qualitativa sia della MR-DWIBS che della 18 F-FDG-PET/TC ha riscontrato due soli pazienti negativi per entrambe le tecniche. La RM-DWIBS è risultata positiva in 36 pazienti, di cui 34 erano positivi e 2 risultavano negativi alla 18 F-FDG-PET/TC. Duecentocinquantacinque lesioni sono state identificate con la MR-DWIBS e 184 con 18 F-FDG-PET/TC. È stata dimostrata una discordanza significativa. La correlazione tra SUV e ADC nelle lesioni positive ad entrambe le tecniche non è risultata statisticamente significativa.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2004
Anomalous coronary arteries (ACAs) may be clinically silent and totally benign or associated with... more Anomalous coronary arteries (ACAs) may be clinically silent and totally benign or associated with catastrophic and fatal presentations. It has been postulated that the proximal course of an ACA is a decisive factor in risk stratification and surgical approach. Particularly, a course between the aorta and pulmonary trunk carries a high risk of major adverse events. We sought to evaluate the anatomic course of documented ACAs by transesophageal echocardiography (TEE) and to study their functional importance using stress-rest (99m)Tc-sestamibi ((99m)Tc-MIBI) myocardial perfusion SPECT. From a cohort of patients undergoing coronary angiography in our department between January 1997 and April 2003, we selected 14 with ACAs but without CAD (9 men and 5 women; mean age, 50.7 +/- 14.6 y). All patients underwent TEE and stress-rest (99m)Tc-MIBI myocardial perfusion SPECT. TEE correctly identified the origin of all ACAs and revealed an anomalous course between the great vessels in 5 patients....
International Journal of Nuclear Medicine Research, 2015
Medicine, 2015
The purpose of the report was to evaluate the role of fluorine-18 fluoro-2-deoxy-D-glucose positr... more The purpose of the report was to evaluate the role of fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in staging gastric cancer comparing it with contrast enhancement computed tomography (CECT
Hellenic journal of nuclear medicine
Lymphomas are a heterogeneous group of lymphoid malignancies, which can be broadly divided into n... more Lymphomas are a heterogeneous group of lymphoid malignancies, which can be broadly divided into non-Hodgkin Lymphomas (NHL) and Hodgkin lymphoma (HL) that display different patterns of biological behavior and response to treatment. Their incidence is still increasing and for this reason they require a lot of effort in scientific research. The management of both NHL and HL follows well-established guidelines based on the initial staging assessment. Therefore an accurate staging is the basis for the selection of an appropriate therapeutic approach in order to prevent over or under treatment as well as to minimize morbidity related to the radio-chemotherapy regimens given. (18)F-FDG-PET is currently regarded as the reference standard imaging modality in the staging of the majority of lymphoma type, for evaluation of distribution of the disease by providing both functional and anatomic information in a single whole body examination. In particular its role is established in HL and high-g...
Hellenic journal of nuclear medicine
In the last decade numerous attempts were considered to co-register and integrate different imagi... more In the last decade numerous attempts were considered to co-register and integrate different imaging data. Like PET/CT the integration of PET to MR showed great interest. PET/MR scanners are recently tested on different distrectual or systemic pathologies. Unfortunately PET/MR scanners are expensive and diagnostic protocols are still under studies and investigations. Nuclear Medicine imaging highlights functional and biometabolic information but has poor anatomic details. The aim of this study is to integrate MR and PET data to produce distrectual or whole body fused images acquired from different scanners even in different days. We propose an offline method to fuse PET with MR data using an open-source software that has to be inexpensive, reproducible and capable to exchange data over the network. We also evaluate global quality, alignment quality, and diagnostic confidence of fused PET-MR images. We selected PET/CT studies performed in our Nuclear Medicine unit, MR studies provided...
Hellenic journal of nuclear medicine, Jan 13, 2015
Objective: Mucormycosis is an infection caused by mycetes mucorales, emerged as a life-threatenin... more Objective: Mucormycosis is an infection caused by mycetes mucorales, emerged as a life-threatening infection associated with severe morbidity and high mortality. Conventional imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) are usually performed to assess mucormycosis extension, but they may present insufficiencies in their performance. Case presentation: We present the case of a 13 years old patient with diagnosis of rhino-orbital-cerebral mucormycosis (RCM) who performed head MRI and [(18)F]2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) both for the infection spread assessment and for the early evaluation of response to systemic amphotericin-B treatment. Conclusion: This case suggests that (18)F-FDG PET/CT could be considered as a valuable tool for the initial staging of RCM when compared with MRI and should be performed as soon as possible after the first clinical suspicion of this disease. In addition (...
BioMed Research International, 2014
(124)Iodine ((124)I) with its 4.2 d half-life is particularly attractive for in vivo detection an... more (124)Iodine ((124)I) with its 4.2 d half-life is particularly attractive for in vivo detection and quantification of longer-term biological and physiological processes; the long half-life of (124)I is especially suited for prolonged time in vivo studies of high molecular weight compounds uptake. Numerous small molecules and larger compounds like proteins and antibodies have been successfully labeled with (124)I. Advances in radionuclide production allow the effective availability of sufficient quantities of (124)I on small biomedical cyclotrons for molecular imaging purposes. Radioiodination chemistry with (124)I relies on well-established radioiodine labeling methods, which consists mainly in nucleophilic and electrophilic substitution reactions. The physical characteristics of (124)I permit taking advantages of the higher PET image quality. The availability of new molecules that may be targeted with (124)I represents one of the more interesting reasons for the attention in nuclear medicine. We aim to discuss all iodine radioisotopes application focusing on (124)I, which seems to be the most promising for its half-life, radiation emissions, and stability, allowing several applications in oncological and nononcological fields.
BioMed Research International, 2014
Copper (Cu) is an important trace element in humans; it plays a role as a cofactor for numerous e... more Copper (Cu) is an important trace element in humans; it plays a role as a cofactor for numerous enzymes and other proteins crucial for respiration, iron transport, metabolism, cell growth, and hemostasis. Natural copper comprises two stable isotopes, 63 Cu and 65 Cu, and 5 principal radioisotopes for molecular imaging applications ( 60 Cu, 61 Cu, 62 Cu, and 64 Cu) and in vivo targeted radiation therapy ( 64 Cu and 67 Cu). The two potential ways to produce Cu radioisotopes concern the use of the cyclotron or the reactor. A noncopper target is used to produce noncarrier-added Cu thanks to a chemical separation from the target material using ion exchange chromatography achieving a high amount of radioactivity with the lowest possible amount of nonradioactive isotopes. In recent years, Cu isotopes have been linked to antibodies, proteins, peptides, and nanoparticles for preclinical and clinical research; pathological conditions that influence Cu metabolism such as Menkes syndrome, Wilson disease, inflammation, tumor growth, metastasis, angiogenesis, and drug resistance have been studied. We aim to discuss all Cu radioisotopes application focusing on 64 Cu and in particular its form 64 CuCl 2 that seems to be the most promising for its half-life, radiation emissions, and stability with chelators, allowing several applications in oncological and nononcological fields.
Abdominal Imaging, 2014
The aim of this study was to prospectively investigate the predictive value of (18)F-FDG PET/CT s... more The aim of this study was to prospectively investigate the predictive value of (18)F-FDG PET/CT semiquantitative parameters for locally advanced low rectal cancer (LARC) treated by neoadjuvant chemoradiation therapy (nCRT). 68 patients with LARC had (18)F-FDG PET/CT scans twice (baseline and 5-6 weeks post-nCRT). All patients underwent surgery with preservation of the sphincter 8 weeks later. (18)F-FDG PET/CT analysis was performed by visual response assessment (VRA) and semiquantitative parameters: SUVmaxbaseline, SUVmeanbaseline, MTVbaseline, TLGbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, TLGpost-nCRT; ΔSUVmax and mean and Response indexes (RImax% and RImean%). Assessment of nCRT tumor response was performed according to the Mandard's Tumor Regression Grade (TRG) and (y)pTNM staging on the surgical specimens. Concordances of VRA with TRG, and with (y)pTNM criteria were evaluated by Cohen's K. Results were compared by t student test for unpaired groups. ROC curve analysis was performed. VRA analysis of post-nCRT (18)F-FDG PET/CT scan for the (y)pTNM outcome showed sensitivity, specificity, accuracy, PPV, and NPV of 87.5%, 66.7%, 83.8%, 92.5%, and 53.3%, respectively. Concordances of VRA with TRG and with (y)pTNM were moderate. For the outcome variable TRG, the statistical difference between responders and non-responders was significant for SUVmaxpost-nCRT and RImean%; for the outcome variable (y)pTNM, there was a significant difference for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. ROC analysis showed better AUCs: for the outcome variable TRG for SUVmaxpost-nCRT, SUVmeanpost-nCRT, and RImean%; for the outcome variable (y)pTNM for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. No significant differences among parameters were found. Qualitative and semiquantitative evaluations for (18)F-FDG PET/CT are the optimal approach; a valid parameter for response prediction has still to be established.
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition), 2014
ABSTRACT La hipercalcemia es una complicación de tumores avanzados y se asocia a un mal pronóstic... more ABSTRACT La hipercalcemia es una complicación de tumores avanzados y se asocia a un mal pronóstico. Llevar a cabo una evaluación para establecer la causa es esencial dado que algunos pacientes oncológicos pueden presentar hipercalcemia por hiperparatiroidismo primario no diagnosticado. Se describe el caso de un paciente con linfoma de Hodgkin y con hipercalcemia persistente en el cual un estudio 18F-FDG PET/TC mostró una lesión en la región anterior del cuello, no atribuible a la neoplasia inicial, confirmada por 99mTc-sestamibi y resecada con cirugía mínimamente invasiva. Era un adenoma oxifílico de paratiroides de localización ectópica.
Clinical Nuclear Medicine, 2011
ABSTRACT We report a case of a 26-year-old man who had sarcoidosis with involvement of central ne... more ABSTRACT We report a case of a 26-year-old man who had sarcoidosis with involvement of central nervous system, manifested by symptoms attributable to diabetes insipidus. Laboratory tests, magnetic resonance and computed tomography images, were all partially useful and inconclusive. These investigations have been integrated with 18-Fluorine-labeled-2-deoxy-2-fluoro-D-glucose positron-emission-tomography/computed tomography (F-18 FDG PET/CT), which showed F-18 FDG uptake in the midbrain area and pituitary gland, corresponding to magnetic resonance findings, and in many bone sites, in particular iliac wings. This finding has been useful for biopsy. F-18 FDG PET/CT can demonstrate active skull-base sarcoidosis.
Clinical Nephrology, 2008
The Cockcroft and Gault formula is a quick and reliable method for calculating creatinine clearan... more The Cockcroft and Gault formula is a quick and reliable method for calculating creatinine clearance without a 24-hour urine collection (CG-cl). In obese subjects an excess of fat mass provokes a reduction in daily creatinine urine excretion per body kilo weight and is responsible for overestimated renal function when calculated by CG-cl. The aim of this study was to devise a simple correction method which could also make use of CG-cl in obese subjects. In 52 subjects with a body mass index (BMI) > 25, renal function was assessed by simultaneously determining creatinine clearance using 24-hour urine collection (Cr-cl) and the CG-cl. The percentage difference between the 2 clearances (delta %) was correlated with BMI for each patient using simple linear regression analysis. The estimated regression model (delta% = 1.217 BMI-- 24.81) provided the following CG-cl correction formula for obese subjects: Corrected CG-cl = CG-cl (1.25 - 0.012 BMI). Its validity was evaluated in another group of 20 subjects with BMI > 25 by comparing the results obtained with Corrected CG-cl to those obtained by CG-cl and MDRD formula (MDRD-cl) using the clearance of 51Cr-EDTA (5 Cr-EDTA-cl) as the GFR measurement gold standard. Linear regression analysis of CG-cl, MDRD-cl and Corrected CG-cl compared to 5tCr-EDTA-cl (considered as the independent variable) resulted in the following determination coefficients (R2): 0.687; 0.818; 0.947, respectively. In conclusion, this formula can be considered a quick and reliable method for CG-cl correction in obese subjects.
Frontiers in Behavioral Neuroscience, 2014
&... more "Schizotypy" is a latent organization of personality related to the genetic risk for schizophrenia. Some evidence suggests that schizophrenia and schizotypy share some biological features, including a link to dopaminergic D2 receptor signaling. A polymorphism in the D2 gene (DRD2 rs1076560, guanine > thymine (G > T)) has been associated with the D2 short/long isoform expression ratio, as well as striatal dopamine signaling and prefrontal cortical activity during different cognitive operations, which are measures that are altered in patients with schizophrenia. Our aim is to determine the association of schizotypy scores with the DRD2 rs1076560 genotype in healthy individuals and their interaction with prefrontal activity during attention and D2 striatal signaling. A total of 83 healthy subjects were genotyped for DRD2 rs1076560 and completed the Schizotypal Personality Questionnaire (SPQ). Twenty-six participants underwent SPECT with [(123)I]IBZM D2 receptor radiotracer, while 68 performed an attentional control task during fMRI. We found that rs1076560 GT subjects had greater SPQ scores than GG individuals. Moreover, the interaction between schizotypy and the GT genotype predicted prefrontal activity and related attentional behavior, as well as striatal binding of IBZM. No interaction was found in GG individuals. These results suggest that rs1076560 GT healthy individuals are prone to higher levels of schizotypy, and that the interaction between rs1076560 and schizotypy scores modulates phenotypes related to the pathophysiology of schizophrenia, such as prefrontal activity and striatal dopamine signaling. These results provide systems-level qualitative evidence for mapping the construct of schizotypy in healthy individuals onto the schizophrenia continuum.