Elena De Ponti - Academia.edu (original) (raw)

Papers by Elena De Ponti

Abdominal Imaging, Jan 20, 2012

The aim of this study was to evaluate the correlation between the changes of SUV(max) and of appa... more The aim of this study was to evaluate the correlation between the changes of SUV(max) and of apparent diffusion coefficient (ADC) before and after neoadjuvant therapy, to enable us predict the therapy response, in patients with locally advanced rectal cancer (LARC). A total of 30 patients with LARC who underwent CRT were recruited for our study. All the patients underwent a whole body 18F-FDG-PET/CT scan and a pelvic MR examination including DW imaging for staging (PET/CT1 and RM1), and after the chemoradiation therapy (PET/CT2, and RM2). Histopathologic analysis of rectal specimen, according to tumor regression grade (Mandard's criteria) was used as the standard reference. MR and PET-CT images were analyzed, and measurements of ADC values and SUV(max) were taken. Diagnostic performance for selection of complete responders (TRG1-2) and overall diagnostic accuracy for each item were calculated. After neoadjuvant therapy, all patients were submitted to surgery. According to Mandard's criteria, 21 tumors showed complete (TRG1) or subtotal regression (TRG2) and were classified as responders; nine tumors were classified as non responders (TRG3, 4, and 5). In all the patients, mean value of SUV(max) in PET/CT1 was higher than those in PET/CT2 (P < 0.001), whereas mean ADC value was lower in RM1 than RM2 (P < 0.001), with a significant percentage decrease of values after the treatment (P < 0.005).The best predictors cut-off values for TRG response were SUV(max) of 4.4 and ADC of 1.28 × 10(3) mm(2)/s with sensitivity, specificity accuracy, negative predictive value, and positive predictive values of 77.3%, 88.9%, 80.7%, 61.5%, and 94.4%, respectively. We conclude from the overall data of this study that the absolute values of SUV(max) and ADC of rectal lesion after CRT were the best parameters to define the response to treatment, by differentiating fibrosis from viable tumor tissue.

CRC Press eBooks, Dec 22, 2021

Annals of Surgical Oncology, Apr 26, 2016

The purpose of this study was to assess the quality of care in patients who underwent sentinel ly... more The purpose of this study was to assess the quality of care in patients who underwent sentinel lymph node (SLN) mapping for endometrial and cervical cancer staging, and evaluate the impact of different techniques on patient satisfaction, i.e. radiotracer Tc99m versus indocyanine green (ICG) or methylene blue injection. Women with preoperative stage I endometrial cancer or stage I (1A2-1B1) cervical cancer who underwent surgical staging, including SLN mapping, were considered for this study. Patient satisfaction was assessed using the European Organisation for Research and Treatment of Cancer IN-PATSAT32 questionnaire. Women were classified into two groups according to the different nodal mapping techniques: intracervical preoperative injection of Tc99m nanocolloid + intraoperative blue dye (Group 1) versus intraoperative cervical injection of ICG or blue dye (Group 2). Differences in patient satisfaction scores between the groups were analyzed. Of the 178 eligible women, 143 were included in the study (endometrial cancer n = 106, cervical cancer n = 37): 57 underwent SLN mapping with Tc99m and blue dye (Group 1), and 86 women were mapped intraoperatively with blue dye alone or ICG (Group 2). Analysis of IN-PATSAT32 questionnaire scores showed a higher patient satisfaction score for patients in Group 2 (p = 0.001), which was independent of the physician and surgical outcomes evaluated. The scores were statistically better for Group 2, and also in rating doctors (p = 0.0001), nurses (p = 0.006), and care and services organizations (p = 0.001). Cervical and endometrial cancer patients who underwent SLN mapping by ICG or blue dye perceived a better quality of care when compared with those patients who underwent the combined radiocolloid and blue dye technique.

Gynecologic Oncology, Dec 1, 2017

Impact on survival of two nodal staging strategies in stage I endometrial cancer • Sentinel node ... more Impact on survival of two nodal staging strategies in stage I endometrial cancer • Sentinel node mapping and selective lymphadenectomy have same survival outcomes. • Sentinel node mapping did not impaired prognosis of women with endometrial cancer.

Clinical and Translational Imaging, Mar 6, 2018

Aim A review was conducted to update the recent published literature on sentinel lymph-node (SLN)... more Aim A review was conducted to update the recent published literature on sentinel lymph-node (SLN) procedures in endometrial cancer. Materials and methods A comprehensive literature search was performed in PubMed and Cochrane library, searching from English language publication of the last 10 years about sentinel lymph node (SLN) in endometrial cancer. Eligible studies had a sample size > 30 patients and reported at least the detection rate. Detection rate, bilateral mapping rate, sensitivity (SN), and negative predictive value (NPV) were evaluated. Different techniques were assessed both for detection rate and for bilateral mapping. A subgroup analysis on studies focused on SPET was performed. Results Forty studies were considered for the analysis (6162 patients). The overall detection rate of SLN mapping was 87.7% (95% CI 77.6-97.9%, range 62-100%). The pooled bilateral mapping rate was 59.9% (95% CI 43.2-76.6%, range 21-92%). The pooled SN resulted 98.3% (range: 50-100%) and the pooled NPV was 99.5% (range 86-100%). Cervical injection was the most used technique. Indocyanine green (ICG) and the combination of radiotracer/blue dye resulted in the highest SLN detection rates: 95% (95% CI 86-100%) and 90% (95% CI 79-100%) with cervical injection, respectively. ICG demonstrated the highest values of bilateral nodal mapping 75% (95% CI 60-91%) with cervical injection. Studies focused on SPET/CT showed a low/moderate correlation between SPET imaging and intraoperative findings. Conclusion SLN mapping accurately predicts nodal status in women with endometrial cancer. Future prospective evaluation of prognosis/outcome is needed to define the impact of this technique for personalized therapy.

Medical Physics, Jan 28, 2011

The aim of this study was to assess the performance measurements of the new PET/CT system Discove... more The aim of this study was to assess the performance measurements of the new PET/CT system Discovery-600 ͑D-600, GEMS, Milwaukee, WI͒. Methods: Performance measures were obtained with the National Electrical Manufacturers Association ͑NEMA͒ NU 2-2007 procedures. Results: The transverse ͑axial͒ spatial resolution FWHMs were 4.9 ͑5.6͒ mm and 5.6 ͑6.4͒ mm at 1 and 10 cm off axis, respectively. The sensitivity ͑average at 0 and 10 cm͒ was 9.6 cps/kBq. The scatter fraction was 36.6% ͑low energy threshold: 425 keV͒. The NEC peak rate ͑k =1͒ was 75.2 kcps at 12.9 kBq/cc. The hot contrasts for 10, 13, 17, and 22 mm spheres were 41%, 51%, 62%, and 73% and the cold contrasts for 28 and 37 mm spheres were 68% and 72%. Conclusions: The Discovery-600 has good performance for the NEMA NU 2-2007 parameters, particularly in improved sensitivity compared to the scanners of the same Discovery family, D-ST and D-STE.

American Journal of Obstetrics and Gynecology, Jul 1, 2006

Radiotherapy and Oncology, 2021

Ovarian cancer, Oct 1, 2022

Journal of Nuclear Cardiology, Nov 23, 2013

Background. The purpose of this study was to evaluate the image quality in cardiac 18 F-FDG PET u... more Background. The purpose of this study was to evaluate the image quality in cardiac 18 F-FDG PET using the time of flight (TOF) and/or point spread function (PSF) modeling in the iterative reconstruction (IR). Methods. Three scanners and an anthropomorphic cardiac phantom with an insert simulating a transmural defect (TD) were used. Two sets of scans (with/without TD) were acquired, and four reconstruction schemes were considered: (1) IR; (2) IR 1 PSF, (3) IR 1 TOF, and (4) IR 1 TOF 1 PSF. LV wall thickness (FWHM), contrast between LV wall and inner chamber (C IC), and TD contrast in LV wall (C TD) were evaluated. Results. Tests of the reconstruction protocols showed a decrease in FWHM from IR (13 mm) to IR 1 PSF (11 mm); an increase in the C IC from IR (65%) to IR 1 PSF (71%) and from IR 1 TOF (72%) to IR 1 TOF 1 PSF (77%); and an increase in the C TD from IR 1 PSF (72%) to IR 1 TOF (75%) and to IR 1 TOF 1 PSF (77%). Tests of the scanner/software combinations showed a decrease in FWHM from Gemini_TF (13 mm) to Biograph_mCT (12 mm) and to Discovery_690 (11 mm); an increase in the C IC from Gem-ini_TF (65%) to Biograph_mCT (73%) and to Discovery_690 (75%); and an increase in the C TD from Gemini_TF/Biograph_mCT (72%) to Discovery_690 (77%). Conclusion. The introduction of TOF and PSF increases image quality in cardiac 18 F-FDG PET. The scanner/software combinations exhibit different performances, which should be taken into consideration when making cross comparisons. (J Nucl Cardiol 2016

American Journal of Orthodontics and Dentofacial Orthopedics, Aug 1, 2021

INTRODUCTION The objective of this study was to evaluate short and long-term results of the appli... more INTRODUCTION The objective of this study was to evaluate short and long-term results of the application of the alternate rapid maxillary expansion/constriction (Alt-RAMEC) technique in patients with skeletal Class III malocclusion. METHODS Forty-two white patients were consecutively treated with the Alt-RAMEC technique. The average age of the patients was 12.7 ± 1.6 years (range, 9.4-15.9 years) before protraction. The average age at long-term follow-up was 19.4 ± 2.8 years (range, 17.2-26.9 years). A sample of nontreated patients with Class III malocclusion from the archives of orthognatic surgery in our hospital was used as a control group. The initial records were matched for sex, the severity of Class III malocclusion, and age (mean, 12.1 ± 1.4 years; range, 9.7-14.1 years) with the old records available in the archive. The control sample had records presurgery (mean, 19.8 ± 2.2 years; range, 16.6-21.6 years). RESULTS The sagittal advancement of A-point, after the application of the technique, was 5.43 ± 2.71 mm. Some mandibular dentoalveolar adaptation was noted. The position of the maxilla was stable in the long term. In contrast, the control group showed limited growth at the maxillary level during the long-term follow-up period. CONCLUSIONS Our results showed that the Alt-RAMEC technique, performed at the correct time, with a double-hinged expander, followed by Class III spring or elastic traction, 24 h/d, allows for satisfactory maxillary protraction, with stable long-term results. The comparison with a sample of matched nontreated patients with Class III malocclusion allowed to suggest the positive effect of the treatment on the maxillary position vs the natural evolution of the Class III skeletal discrepancy.

The Journal of Nuclear Medicine, May 1, 2016

1621 Objectives To evaluate the role of FDG PET/CT with respect to conventional CT scan, in acute... more 1621 Objectives To evaluate the role of FDG PET/CT with respect to conventional CT scan, in acute myeloid leukemia (AML) patients with lung invasive fungal infection (IFI). Methods 14 patients with AML and suspected lung IFI performed chest CT scan (CT1) followed by PET/CT (PET1) scan, before antimicotic treatment. CT and PET/CT were repeated 2 months after the beginning of treatment (n= 12 pts) and compared to basal evaluations to assess treatment efficacy (CT2, PET2): lesions with the highest FDG uptake on PET was selected as “reference lesion” and SUVmax was calculated for PET1 and PET2. Metabolic response (MR) was measured as follow: complete MR (CMR, uptake ≤ than mediastinal blood-pool), partial MR (PMR, partial reduction of the lesion uptake > than mediastinal blood-pool), progressive disease (PD, increase uptake and/or new lesions). Results : In 14/14 cases (100%) PET1 and CT1 were positive for IFI. The mean SUV max was 6.5 ± 2.4 (range 3.3-11.8). PET2 (n = 12) showed 4 CMR, 4 PMR, (with a mean reduction of SUVmax 53%), 2 PD and 2 with both PMR of reference lesion and concomitant new PD lung lesions with FDG uptake (PR/PD). In the same group of 10 patients, CT2 was concordant with PET2 in 10/12 cases (83%), while in 2 cases CT2 showed partial reduction of lung lesions and a CMR on PET2. Of the 10 concordant patients, 5 died because of infections (2PMR, 2PD, 1 both PMR/PD), and 5 are alive, median follow-up 356 days from PET/CT1, (2 CR, 2 PR and 1 PR/PD). Of the 2 discordant patients 1 died because of sepsis, and 1 patient is on follow-up (150 days). Conclusions PET/CT scan can help in monitoring treatment efficacy of IFI in AML patient. However, as PET/CT and CT were concordant in 83% of cases (10/12), while in 2 cases PET/CT showed a complete metabolic response in a persistent lung lesion at CT, these preliminary data cannot support a relevant additional role of PET with respect to CT scan; further follow-up and larger studies are needed.

Journal of Minimally Invasive Gynecology, Sep 1, 2017

To compare sentinel lymph node (SLN) mapping in women with cervical cancer stage &amp... more To compare sentinel lymph node (SLN) mapping in women with cervical cancer stage > IB1 (tumor > 2 cm) by using indocyanine green (ICG) versus the standard radioisotope technetium 99m radiocolloid (Tc99(m)) radiotracer ± blue-dye technique. European multicenter, retrospective observational study (Canadian Task Force Classification II-2) SETTING: Four academic medical centers PATIENTS: 95 women with stage IB1 (> 2 cm) who underwent SLN mapping with Tc99(m) ± blue dye or ICG and radical hysterectomy INTERVENTION: Detection rate and bilateral mapping rate of ICG were compared with those obtained using the standard Tc99(m) radiotracer ± blue dye. Lymphadenectomy was performed, and false negative rate was assessed. Forty-seven patients underwent SLN mapping with Tc99(m) ± blue dye and 48 with ICG. All patients underwent radical hysterectomy with or without bilateral salpingo-oophorectomy between 2008 and 2016. The overall detection rate of SLN mapping was 91.5 and 100% for Tc99(m) ± blue dye and ICG, respectively. Bilateral migration was achieved for ICG (91.7%), significantly higher than the 66% obtained with Tc99(m) ± blue dye (p = .025). Nine of the 23 SLN-positive patients (39.1%), were exclusively diagnosed as a result of ultrastaging used to identify micrometastasis or isolated tumor cells only. In advanced cervical cancer (stage IB1 > 2 cm) the real-time fluorescent SLN mapping with ICG achieved higher detection rate and bilateral migration rate compared with Tc99(m) radiotracer ± blue dye. Sentinel lymph node and ultrastaging could provide additional information for nodal staging in advanced cervical cancer. In this setting, ICG is a promising tool for mapping, as it seems less impacted by the higher stage of disease than traditional methods.

Current Radiopharmaceuticals, Aug 24, 2017

BACKGROUND AND OBJECTIVE Breathing movement can introduce heavy bias in both image quality and qu... more BACKGROUND AND OBJECTIVE Breathing movement can introduce heavy bias in both image quality and quantitation in PET/CT. The aim of this paper is a review of the literature to evaluate the benefit of respiratory gating in terms of image quality, quantification and lesion detectability. METHODS A review of the literature published in the last 10 years and dealing with gated PET/CT technique has been performed, focusing on improvement in quantification, lesion detectability and diagnostic accuracy in neoplastic lesion. In addition, the improvement in the definition of radiotherapy planning has been evaluated. RESULTS There is a consistent increase of the Standardized Uptake Value (SUV) in gated PET images when compared to ungated ones, particularly for lesions located in liver and in lung. Respiratory gating can also increase sensitivity, specificity and accuracy of PET/CT. Gated PET/CT can be used for radiation therapy planning, reducing the uncertainty in target definition, optimizing the volume to be treated and reducing the possibility of "missing" during the dose delivery. Moreover, new technologies, able to define the movement of lesions and organs directly from the PET sinogram, can solve some problems that currently are limiting the clinical use of gated PET/CT (i.e.: extended acquisition time, radiation exposure). CONCLUSION The published literature demonstrated that respiratory gating PET/CT is a valid technique to improve quantification, lesion detectability of lung and liver tumors and can better define the radiotherapy planning of moving lesions and organs. If new technical improvements for motion compensation will be clinically validated, gated technique could be applied routinely in any PET/CT scan.

Diagnostics, May 15, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

European Journal of Echocardiography, Jun 1, 2021

Physica Medica, Dec 1, 2022

Physica Medica, Dec 1, 2021

Abdominal Imaging, Jan 20, 2012

The aim of this study was to evaluate the correlation between the changes of SUV(max) and of appa... more The aim of this study was to evaluate the correlation between the changes of SUV(max) and of apparent diffusion coefficient (ADC) before and after neoadjuvant therapy, to enable us predict the therapy response, in patients with locally advanced rectal cancer (LARC). A total of 30 patients with LARC who underwent CRT were recruited for our study. All the patients underwent a whole body 18F-FDG-PET/CT scan and a pelvic MR examination including DW imaging for staging (PET/CT1 and RM1), and after the chemoradiation therapy (PET/CT2, and RM2). Histopathologic analysis of rectal specimen, according to tumor regression grade (Mandard's criteria) was used as the standard reference. MR and PET-CT images were analyzed, and measurements of ADC values and SUV(max) were taken. Diagnostic performance for selection of complete responders (TRG1-2) and overall diagnostic accuracy for each item were calculated. After neoadjuvant therapy, all patients were submitted to surgery. According to Mandard's criteria, 21 tumors showed complete (TRG1) or subtotal regression (TRG2) and were classified as responders; nine tumors were classified as non responders (TRG3, 4, and 5). In all the patients, mean value of SUV(max) in PET/CT1 was higher than those in PET/CT2 (P < 0.001), whereas mean ADC value was lower in RM1 than RM2 (P < 0.001), with a significant percentage decrease of values after the treatment (P < 0.005).The best predictors cut-off values for TRG response were SUV(max) of 4.4 and ADC of 1.28 × 10(3) mm(2)/s with sensitivity, specificity accuracy, negative predictive value, and positive predictive values of 77.3%, 88.9%, 80.7%, 61.5%, and 94.4%, respectively. We conclude from the overall data of this study that the absolute values of SUV(max) and ADC of rectal lesion after CRT were the best parameters to define the response to treatment, by differentiating fibrosis from viable tumor tissue.

CRC Press eBooks, Dec 22, 2021

Annals of Surgical Oncology, Apr 26, 2016

The purpose of this study was to assess the quality of care in patients who underwent sentinel ly... more The purpose of this study was to assess the quality of care in patients who underwent sentinel lymph node (SLN) mapping for endometrial and cervical cancer staging, and evaluate the impact of different techniques on patient satisfaction, i.e. radiotracer Tc99m versus indocyanine green (ICG) or methylene blue injection. Women with preoperative stage I endometrial cancer or stage I (1A2-1B1) cervical cancer who underwent surgical staging, including SLN mapping, were considered for this study. Patient satisfaction was assessed using the European Organisation for Research and Treatment of Cancer IN-PATSAT32 questionnaire. Women were classified into two groups according to the different nodal mapping techniques: intracervical preoperative injection of Tc99m nanocolloid + intraoperative blue dye (Group 1) versus intraoperative cervical injection of ICG or blue dye (Group 2). Differences in patient satisfaction scores between the groups were analyzed. Of the 178 eligible women, 143 were included in the study (endometrial cancer n = 106, cervical cancer n = 37): 57 underwent SLN mapping with Tc99m and blue dye (Group 1), and 86 women were mapped intraoperatively with blue dye alone or ICG (Group 2). Analysis of IN-PATSAT32 questionnaire scores showed a higher patient satisfaction score for patients in Group 2 (p = 0.001), which was independent of the physician and surgical outcomes evaluated. The scores were statistically better for Group 2, and also in rating doctors (p = 0.0001), nurses (p = 0.006), and care and services organizations (p = 0.001). Cervical and endometrial cancer patients who underwent SLN mapping by ICG or blue dye perceived a better quality of care when compared with those patients who underwent the combined radiocolloid and blue dye technique.

Gynecologic Oncology, Dec 1, 2017

Impact on survival of two nodal staging strategies in stage I endometrial cancer • Sentinel node ... more Impact on survival of two nodal staging strategies in stage I endometrial cancer • Sentinel node mapping and selective lymphadenectomy have same survival outcomes. • Sentinel node mapping did not impaired prognosis of women with endometrial cancer.

Clinical and Translational Imaging, Mar 6, 2018

Aim A review was conducted to update the recent published literature on sentinel lymph-node (SLN)... more Aim A review was conducted to update the recent published literature on sentinel lymph-node (SLN) procedures in endometrial cancer. Materials and methods A comprehensive literature search was performed in PubMed and Cochrane library, searching from English language publication of the last 10 years about sentinel lymph node (SLN) in endometrial cancer. Eligible studies had a sample size > 30 patients and reported at least the detection rate. Detection rate, bilateral mapping rate, sensitivity (SN), and negative predictive value (NPV) were evaluated. Different techniques were assessed both for detection rate and for bilateral mapping. A subgroup analysis on studies focused on SPET was performed. Results Forty studies were considered for the analysis (6162 patients). The overall detection rate of SLN mapping was 87.7% (95% CI 77.6-97.9%, range 62-100%). The pooled bilateral mapping rate was 59.9% (95% CI 43.2-76.6%, range 21-92%). The pooled SN resulted 98.3% (range: 50-100%) and the pooled NPV was 99.5% (range 86-100%). Cervical injection was the most used technique. Indocyanine green (ICG) and the combination of radiotracer/blue dye resulted in the highest SLN detection rates: 95% (95% CI 86-100%) and 90% (95% CI 79-100%) with cervical injection, respectively. ICG demonstrated the highest values of bilateral nodal mapping 75% (95% CI 60-91%) with cervical injection. Studies focused on SPET/CT showed a low/moderate correlation between SPET imaging and intraoperative findings. Conclusion SLN mapping accurately predicts nodal status in women with endometrial cancer. Future prospective evaluation of prognosis/outcome is needed to define the impact of this technique for personalized therapy.

Medical Physics, Jan 28, 2011

The aim of this study was to assess the performance measurements of the new PET/CT system Discove... more The aim of this study was to assess the performance measurements of the new PET/CT system Discovery-600 ͑D-600, GEMS, Milwaukee, WI͒. Methods: Performance measures were obtained with the National Electrical Manufacturers Association ͑NEMA͒ NU 2-2007 procedures. Results: The transverse ͑axial͒ spatial resolution FWHMs were 4.9 ͑5.6͒ mm and 5.6 ͑6.4͒ mm at 1 and 10 cm off axis, respectively. The sensitivity ͑average at 0 and 10 cm͒ was 9.6 cps/kBq. The scatter fraction was 36.6% ͑low energy threshold: 425 keV͒. The NEC peak rate ͑k =1͒ was 75.2 kcps at 12.9 kBq/cc. The hot contrasts for 10, 13, 17, and 22 mm spheres were 41%, 51%, 62%, and 73% and the cold contrasts for 28 and 37 mm spheres were 68% and 72%. Conclusions: The Discovery-600 has good performance for the NEMA NU 2-2007 parameters, particularly in improved sensitivity compared to the scanners of the same Discovery family, D-ST and D-STE.

American Journal of Obstetrics and Gynecology, Jul 1, 2006

Radiotherapy and Oncology, 2021

Ovarian cancer, Oct 1, 2022

Journal of Nuclear Cardiology, Nov 23, 2013

Background. The purpose of this study was to evaluate the image quality in cardiac 18 F-FDG PET u... more Background. The purpose of this study was to evaluate the image quality in cardiac 18 F-FDG PET using the time of flight (TOF) and/or point spread function (PSF) modeling in the iterative reconstruction (IR). Methods. Three scanners and an anthropomorphic cardiac phantom with an insert simulating a transmural defect (TD) were used. Two sets of scans (with/without TD) were acquired, and four reconstruction schemes were considered: (1) IR; (2) IR 1 PSF, (3) IR 1 TOF, and (4) IR 1 TOF 1 PSF. LV wall thickness (FWHM), contrast between LV wall and inner chamber (C IC), and TD contrast in LV wall (C TD) were evaluated. Results. Tests of the reconstruction protocols showed a decrease in FWHM from IR (13 mm) to IR 1 PSF (11 mm); an increase in the C IC from IR (65%) to IR 1 PSF (71%) and from IR 1 TOF (72%) to IR 1 TOF 1 PSF (77%); and an increase in the C TD from IR 1 PSF (72%) to IR 1 TOF (75%) and to IR 1 TOF 1 PSF (77%). Tests of the scanner/software combinations showed a decrease in FWHM from Gemini_TF (13 mm) to Biograph_mCT (12 mm) and to Discovery_690 (11 mm); an increase in the C IC from Gem-ini_TF (65%) to Biograph_mCT (73%) and to Discovery_690 (75%); and an increase in the C TD from Gemini_TF/Biograph_mCT (72%) to Discovery_690 (77%). Conclusion. The introduction of TOF and PSF increases image quality in cardiac 18 F-FDG PET. The scanner/software combinations exhibit different performances, which should be taken into consideration when making cross comparisons. (J Nucl Cardiol 2016

American Journal of Orthodontics and Dentofacial Orthopedics, Aug 1, 2021

INTRODUCTION The objective of this study was to evaluate short and long-term results of the appli... more INTRODUCTION The objective of this study was to evaluate short and long-term results of the application of the alternate rapid maxillary expansion/constriction (Alt-RAMEC) technique in patients with skeletal Class III malocclusion. METHODS Forty-two white patients were consecutively treated with the Alt-RAMEC technique. The average age of the patients was 12.7 ± 1.6 years (range, 9.4-15.9 years) before protraction. The average age at long-term follow-up was 19.4 ± 2.8 years (range, 17.2-26.9 years). A sample of nontreated patients with Class III malocclusion from the archives of orthognatic surgery in our hospital was used as a control group. The initial records were matched for sex, the severity of Class III malocclusion, and age (mean, 12.1 ± 1.4 years; range, 9.7-14.1 years) with the old records available in the archive. The control sample had records presurgery (mean, 19.8 ± 2.2 years; range, 16.6-21.6 years). RESULTS The sagittal advancement of A-point, after the application of the technique, was 5.43 ± 2.71 mm. Some mandibular dentoalveolar adaptation was noted. The position of the maxilla was stable in the long term. In contrast, the control group showed limited growth at the maxillary level during the long-term follow-up period. CONCLUSIONS Our results showed that the Alt-RAMEC technique, performed at the correct time, with a double-hinged expander, followed by Class III spring or elastic traction, 24 h/d, allows for satisfactory maxillary protraction, with stable long-term results. The comparison with a sample of matched nontreated patients with Class III malocclusion allowed to suggest the positive effect of the treatment on the maxillary position vs the natural evolution of the Class III skeletal discrepancy.

The Journal of Nuclear Medicine, May 1, 2016

1621 Objectives To evaluate the role of FDG PET/CT with respect to conventional CT scan, in acute... more 1621 Objectives To evaluate the role of FDG PET/CT with respect to conventional CT scan, in acute myeloid leukemia (AML) patients with lung invasive fungal infection (IFI). Methods 14 patients with AML and suspected lung IFI performed chest CT scan (CT1) followed by PET/CT (PET1) scan, before antimicotic treatment. CT and PET/CT were repeated 2 months after the beginning of treatment (n= 12 pts) and compared to basal evaluations to assess treatment efficacy (CT2, PET2): lesions with the highest FDG uptake on PET was selected as “reference lesion” and SUVmax was calculated for PET1 and PET2. Metabolic response (MR) was measured as follow: complete MR (CMR, uptake ≤ than mediastinal blood-pool), partial MR (PMR, partial reduction of the lesion uptake > than mediastinal blood-pool), progressive disease (PD, increase uptake and/or new lesions). Results : In 14/14 cases (100%) PET1 and CT1 were positive for IFI. The mean SUV max was 6.5 ± 2.4 (range 3.3-11.8). PET2 (n = 12) showed 4 CMR, 4 PMR, (with a mean reduction of SUVmax 53%), 2 PD and 2 with both PMR of reference lesion and concomitant new PD lung lesions with FDG uptake (PR/PD). In the same group of 10 patients, CT2 was concordant with PET2 in 10/12 cases (83%), while in 2 cases CT2 showed partial reduction of lung lesions and a CMR on PET2. Of the 10 concordant patients, 5 died because of infections (2PMR, 2PD, 1 both PMR/PD), and 5 are alive, median follow-up 356 days from PET/CT1, (2 CR, 2 PR and 1 PR/PD). Of the 2 discordant patients 1 died because of sepsis, and 1 patient is on follow-up (150 days). Conclusions PET/CT scan can help in monitoring treatment efficacy of IFI in AML patient. However, as PET/CT and CT were concordant in 83% of cases (10/12), while in 2 cases PET/CT showed a complete metabolic response in a persistent lung lesion at CT, these preliminary data cannot support a relevant additional role of PET with respect to CT scan; further follow-up and larger studies are needed.

Journal of Minimally Invasive Gynecology, Sep 1, 2017

To compare sentinel lymph node (SLN) mapping in women with cervical cancer stage &amp... more To compare sentinel lymph node (SLN) mapping in women with cervical cancer stage > IB1 (tumor > 2 cm) by using indocyanine green (ICG) versus the standard radioisotope technetium 99m radiocolloid (Tc99(m)) radiotracer ± blue-dye technique. European multicenter, retrospective observational study (Canadian Task Force Classification II-2) SETTING: Four academic medical centers PATIENTS: 95 women with stage IB1 (> 2 cm) who underwent SLN mapping with Tc99(m) ± blue dye or ICG and radical hysterectomy INTERVENTION: Detection rate and bilateral mapping rate of ICG were compared with those obtained using the standard Tc99(m) radiotracer ± blue dye. Lymphadenectomy was performed, and false negative rate was assessed. Forty-seven patients underwent SLN mapping with Tc99(m) ± blue dye and 48 with ICG. All patients underwent radical hysterectomy with or without bilateral salpingo-oophorectomy between 2008 and 2016. The overall detection rate of SLN mapping was 91.5 and 100% for Tc99(m) ± blue dye and ICG, respectively. Bilateral migration was achieved for ICG (91.7%), significantly higher than the 66% obtained with Tc99(m) ± blue dye (p = .025). Nine of the 23 SLN-positive patients (39.1%), were exclusively diagnosed as a result of ultrastaging used to identify micrometastasis or isolated tumor cells only. In advanced cervical cancer (stage IB1 > 2 cm) the real-time fluorescent SLN mapping with ICG achieved higher detection rate and bilateral migration rate compared with Tc99(m) radiotracer ± blue dye. Sentinel lymph node and ultrastaging could provide additional information for nodal staging in advanced cervical cancer. In this setting, ICG is a promising tool for mapping, as it seems less impacted by the higher stage of disease than traditional methods.

Current Radiopharmaceuticals, Aug 24, 2017

BACKGROUND AND OBJECTIVE Breathing movement can introduce heavy bias in both image quality and qu... more BACKGROUND AND OBJECTIVE Breathing movement can introduce heavy bias in both image quality and quantitation in PET/CT. The aim of this paper is a review of the literature to evaluate the benefit of respiratory gating in terms of image quality, quantification and lesion detectability. METHODS A review of the literature published in the last 10 years and dealing with gated PET/CT technique has been performed, focusing on improvement in quantification, lesion detectability and diagnostic accuracy in neoplastic lesion. In addition, the improvement in the definition of radiotherapy planning has been evaluated. RESULTS There is a consistent increase of the Standardized Uptake Value (SUV) in gated PET images when compared to ungated ones, particularly for lesions located in liver and in lung. Respiratory gating can also increase sensitivity, specificity and accuracy of PET/CT. Gated PET/CT can be used for radiation therapy planning, reducing the uncertainty in target definition, optimizing the volume to be treated and reducing the possibility of "missing" during the dose delivery. Moreover, new technologies, able to define the movement of lesions and organs directly from the PET sinogram, can solve some problems that currently are limiting the clinical use of gated PET/CT (i.e.: extended acquisition time, radiation exposure). CONCLUSION The published literature demonstrated that respiratory gating PET/CT is a valid technique to improve quantification, lesion detectability of lung and liver tumors and can better define the radiotherapy planning of moving lesions and organs. If new technical improvements for motion compensation will be clinically validated, gated technique could be applied routinely in any PET/CT scan.

Diagnostics, May 15, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

European Journal of Echocardiography, Jun 1, 2021

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