Matteo Salgarello - Academia.edu (original) (raw)

Papers by Matteo Salgarello

Digestive and Liver Disease, Aug 1, 2014

Background: The role of 18 fluoro-deoxyglucose positron emission tomography/computed tomography i... more Background: The role of 18 fluoro-deoxyglucose positron emission tomography/computed tomography in pancreatic ductal adenocarcinoma is debated. We retrospectively assessed the value of 18 fluorodeoxyglucose positron emission tomography/computed tomography in addition to conventional imaging as a staging modality in pancreatic cancer. Methods: 18 Fluoro-deoxyglucose positron emission tomography/computed tomography was performed in 72 patients with resectable pancreatic carcinoma after multi-detector computed tomography positron emission tomography was considered positive for a maximum standardized uptake value >3. Results: Overall, 21% of patients had a maximum standardized uptake value ≤3, and 60% of those had undergone neoadjuvant treatment (P = 0.0001). Furthermore, 11% of patients were spared unwarranted surgery since positron emission tomography/computed tomography detected metastatic disease. All liver metastases were subsequently identified with contrast-enhanced ultrasound. Sensitivity and specificity of positron emission tomography/computed tomography for distant metastases were 78% and 100%. The median CA19.9 concentration was 48.8 U/mL for the entire cohort and 292 U/mL for metastatic patients (P = 0.112). Conclusions: The widespread application of 18 fluoro-deoxyglucose positron emission tomography/computed tomography in patients with resectable pancreatic carcinoma seems not justified. It should be considered in selected patients at higher risk of metastatic disease (i.e. CA19.9 > 200 U/mL) after undergoing other imaging tests. Neoadjuvant treatment is significantly associated with low metabolic activity, limiting the value of positron emission tomography in this setting.

Clinical and Translational Imaging, Mar 26, 2022

The aim of this study is to analyze peptide receptors radionuclide therapy (PRRT) effectiveness i... more The aim of this study is to analyze peptide receptors radionuclide therapy (PRRT) effectiveness in functioning malignant insulinomas poorly responsive to conventional therapies, by reviewing literature reports and combining them to our Center experience. Due to the rarity of this tumor, most literature is based on case reports. Overall, eight case reports and case series published between 2008 and 2019 were analyzed. A total of 34 patients affected by functioning metastatic insulinomas were evaluated. Among these, 33 patients were treated with 177Lu-DOTATATE and 1 patient received Indium-111 Octreotide. In terms of tumor growth control, 2 patient showed complete response to therapy (5.8%), 19 patients achieved partial response (55.9%), 8 patients presented stable disease (23.5%), and 5 patients progressed (14.7%). In terms of symptoms control, 24 out of 34 of patients (70.6%) reported a better glycemia level control, which is an important result that leads to a significant improvement of patients’ QoL. However, all these case reports profoundly differ between each other, in terms of treatment scheme, eligibility criteria and previous therapies. Therefore, it is extremely complex to statistically compare these studies and objectively evaluate the efficacy of this therapy in insulinomas, although, overall, it would seem to have a significant impact on the patient's QoL, PFS and tumor management. In conclusion, PRRT resulted to be a very promising treatment for inoperable malignant insulinomas, in terms of patients’ quality of life improvement, clinical symptoms and tumor growth control. Further studies are needed, especially to evaluate its possible application as first-line therapy, in association with conventional therapies, which could lead to even better and longer-lasting results.

Digestive and Liver Disease, Mar 1, 2013

Nuclear Medicine Communications, Sep 1, 2020

Aim To explore the potentiality of radiomics analysis, performed on 68 Ga-DOTATOC and fluorine-18... more Aim To explore the potentiality of radiomics analysis, performed on 68 Ga-DOTATOC and fluorine-18fluorodeoxyglucose (18 F-FDG) PET/computed tomography (CT) images, in predicting tumour aggressiveness and outcome in patients candidate to surgery for pancreatic neuroendocrine neoplasms (PanNENs). Patients and methods Retrospective study including 61 patients who underwent 68 Ga-DOTATOC and 18 F-FDG PET/CT before surgery for PanNEN. Semiquantitative variables [SUVmax and somatostatin receptor density (SRD) for 68 Ga-DOTATOC PET; SUVmax and MTV for 18 F-FDG PET] and texture features [intensity variability, size zone variability (SZV), zone percentage, entropy; homogeneity, dissimilarity and coefficient of variation (Co-V)] have been analysed to evaluate their possible role in predicting tumour characteristics. Principal component analysis (PCA) was firstly performed and then multiple regression analyses were performed by using the extracted principal components. Results Regarding 68 Ga-DOTATOC PET, SZV, entropy, intensity variability and SRD were predictive for tumour dimension. Regarding 18 F-FDG PET, intensity variability, SZV, homogeneity, SUVmax and MTV were predictive for tumour dimension. Four principal components were extracted from PCA: PC1 correlated with all 18 F-FDG variables, while PC2, PC3 and PC4 with 68 Ga-DOTATOC variables. PC1 was the only significantly predicting angioinvasion (P = 0.0222); PC4 was the only one significantly predicting lymph nodal involvement (P = 0.0151). All principal components except PC4 significantly predicted tumour dimension (P <0.

Annals of the Rheumatic Diseases, May 30, 2023

Background: Accurate and fast diagnosis of rheumatic diseases affecting the hands is essential fo... more Background: Accurate and fast diagnosis of rheumatic diseases affecting the hands is essential for further treatment decision. Different rheumatic diseases affecting the hands present characteristic patterns and features in fluorescence optical imaging (FOI) as outlined in previous studies [1, 2]. Objectives: We tested an atlas of image features in FOI for their ability to differentiate various rheumatic joint diseases such as rheumatoid arthritis (RA), osteoarthritis (OA), psoriatic arthritis (PsA) and connective tissue diseases (CTD) like systemic sclerosis (SSc) and systemic lupus erythematodes (SLE) with the aim to identify specific features for differential diagnosis.

Reports of Practical Oncology & Radiotherapy, May 19, 2022

this article is available in open access under creative common attribution-non-commercial-no Deri... more this article is available in open access under creative common attribution-non-commercial-no Derivatives 4.0 international (cc BY-nc-nD 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially

Ovarian cancer

women with newly diagnosed ovarian cancer (OC) regardless BRCA mutational status and in homologou... more women with newly diagnosed ovarian cancer (OC) regardless BRCA mutational status and in homologous-recombination deficiency (HRD) positive patients, respectively. However, despite the remarkable improvements in the therapeutic algorithm of OC disease over the years, the best first line treatment is still controversial. Methodology MITO 25.1 is a multicenter, randomized openlabel, phase II study comparing Carboplatin-Paclitaxel-Bevacizumab vs Carboplatin-Paclitaxel-Bevacizumab-Rucaparib vs Carboplatin-Paclitaxel-Rucaparib.Eligible patients, with histological confirmed high grade serous or endometrioid advanced OC, will be randomized in a 1:1 ratio according to HRD status. Results HRD negative patients: ARM A: Carboplatin AUC 5 + Paclitaxel 175 mg/m2 q 21 + Bevacizumab 15 mg/kg for 5 cycles (starting from cycle 2) followed by Bevacizumab 15 mg/ kg q 21 for 17 cycles, ARM B: Carboplatin AUC 5 + Paclitaxel 175 mg/m2 q 21 for 6 cycles followed by Rucaparib 600 mg BID q 28 for 24 cycles as maintenance HRD positive patients: ARM B: Carboplatin AUC 5 + Paclitaxel 175 mg/ m2 q 21 for 6 cycles followed by Rucaparib 600 mg BID q 28 for 24 cycles as maintenance: ARM C: Carboplatin AUC 5 + Paclitaxel 175 mg/m2 q 21 + Bevacizumab 15 mg/kg for 5 cycles (starting from cycle 2) followed by Bevacizumab 15 mg/ kg q 21 days for 16 cycles + Rucaparib 500 mg part BID q 28 for 24 cycles as maintenance Conclusion The primary endpoint will be PFS. The secondary endpoints will be overall survival (OS), PFS2, adverse events according to CTCAE 5.0 and patient-reported outcome. Patients recruiting started in March 2021. To date, 159 of the 300 patients planned have been enrolled.

Neuroendocrinology, 2021

Introduction: The combined use of 68gallium (68Ga)-DOTA-peptides and 18fluorine-fluoro-2-deoxyglu... more Introduction: The combined use of 68gallium (68Ga)-DOTA-peptides and 18fluorine-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scans in the workup of pancreatic neuroendocrine tumors (PanNETs) is controversial. This study aimed at assessing both tracers’ capability to identify tumors and to assess its association with pathological predictors of recurrence. Methods: Prospectively collected, preoperative, dual-tracer PET/CT scan data of G1-G2, nonmetastatic, PanNETs that underwent surgery between January 2013 and October 2019 were retrospectively analyzed. Results: The final cohort consisted of 124 cases. There was an approximately equal distribution of males and females (50.8%/49.2%) and G1 and G2 tumors (49.2%/50.8%). The disease was detected in 122 (98.4%) and 64 (51.6%) cases by 68Ga-DOTATOC and by 18F-FDG PET/CT scans, respectively, with a combined sensitivity of 99.2%. 18F-FDG-positive examinations found G2 tumors more often than G1 (59...

Digestive and Liver Disease, 2018

Background and aim: There are very few reports about the intake of nutrients for the development ... more Background and aim: There are very few reports about the intake of nutrients for the development or progression of non-alcoholic steatohepatitis (NASH). The individual roles of various nutritional and metabolic factors in the pathogenesis and natural history of NAFLD are still incompletely understood. The aim of this study was to identify the dietary habits and the nutrient intake in patients with NASH, in comparison to chronic hepatitis C (HCV)-related patients. Material and methods: We prospectively evaluated the intake of macronutrients and micronutrients in 124 NAFLD and 162 HCV patients, compared to 2326 subjects as a control group. The food intake of a complete week was recorded by each subject using a weekly dietary diary. These were converted to nutrient and food intake data using the Winfood Software 2.0 package (Medimatica s.r.l., Martinsicuro, Italy). Results: We noticed major differences in macro-and micronutrients intakes in NASH and HCV patients compared to controls. Proteins, carbohydrate (glucose, fructose, sucrose, maltose and amide), saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), folic acid, vitamin A and C (p<0.0001), and thiamine (p<0.0003) ingestion was found to be higher in patients with NASH, while total lipids, polyunsaturated fatty acid (PUFA), riboflavin and vitamin B6 daily intake were lower compared to controls (p<0.0001). Similarly, NASH patients had significantly reduced carbohydrate intake (p<0.0001) and an increased intake of calcium (p<0.0001) compared to HCV positive patients. Finally, we showed in NASH males an increase in the intake of SFA, PUFA, soluble carbohydrates (p<0.0001) and a decrease in the amount of fiber (p<0.0001) compared to control males. In NASH female population, we showed an increase of daily total calories, SFA, MUFA, soluble carbohydrates, starch and vitamin D ingested (p<0.0001) with a reduction of fibers and calcium (p<0.0001) compared to control females. Conclusions: This study showed how NASH patients' diets, in both male and females, is affected by a profound alteration in macroand micronutrients intake, and this could be one of the key factors involved in maintaining the metabolic homeostasis necessary for the development of this pathology.

Circulation: Cardiovascular Imaging, 2019

October 2019 1 Carmelo Cicciò, MD Clementina Dugo, MD Antonella Cecchetto, MD Joniada Doraku, MD ... more October 2019 1 Carmelo Cicciò, MD Clementina Dugo, MD Antonella Cecchetto, MD Joniada Doraku, MD Emiliano Dalla Chiara, MD Letizia Boninsegna, MD Enrico Barbieri, MD Matteo Salgarello, MD Giovanni Carbognin, MD A 62-year-old man was admitted to Cardiology Department because of the occasional detection of a cardiac mass at 18F-choline Positron Emission Tomography Computed Tomography (PET-CT) performed during follow-up for prostate cancer, surgically treated 2 years before; focal tracer uptake was also detected in a lymph node at ileocolic level. Patient’s medical and familiar history was negative for cardiovascular disease. The patient was nonsmoker, with borderline dyslipidemia, no arterial hypertension, and he was asymptomatic for angina or dyspnea. One episode of symptomatic hypotension occurred during the hospitalization, with mild electrocardiographic abnormalities (1-mm ST depression on lateral leads), which had fast resolution with fluid administration. Results of laboratory tests show normal hematocrit level, white blood cell count, liver function tests, and C-reactive protein. Transthoracic echocardiography (Figure 1) detected an intramyocardial, mildly hyperechoic, rounded-expansive mass (4 cm) at the anterior interventricular septum, also with some unechogenic cavities inside (Movies I through III in the Data Supplement). There were no signs of mitral valve or left ventricular outflow tract flow obstruction; left ventricular systolic function was normal, and no pericardial fluid was detected. No abnormalities were detected in the right-sided valves. Contrast transthoracic echocardiography perfusion imaging showed only a mild degree of late hyperenhancement with no significant early enhancement (Figure 2). Cardiac magnetic resonance was performed shortly after and confirmed the presence of a large, well-circumscribed mass in the interventricular septum (cine-magnetic resonance with steady-state free precession sequences; Movies IV and V in the Data Supplement). The mass showed hyperintense signal intensity on both T1and T2-weighted short-time inversion recovery turbo spin echo sequences suggestive for fluid/necrotic content also with few and thin intralesional septa (Figure 3). During contrast administration, the mass revealed increased signal intensity during the first pass of perfusion analysis with predominately peripheral ring enhancement and mild contrast enhancement along intralesional septa (Movie VI in the Data Supplement). Late gadolinium enhancement was noticed at both peripheral part and along intralesional septa (Figure 4). There was no evidence of pericardial enhancement or pericardial fluid effusion. magnetic resonance features of the mass were highly suggestive for malignant neoplasms, and even if uncommon, the hypothesis of isolated cardiac metastasis was strongly considered. Thoracic-abdominal CT with contrast material administration (Figure 5) was performed shortly after, to rule out not-known primary tumor other than prostate cancer; the exam detected for the first time a polypoid nodule in the terminal ileum (Figure 5A, white arrowhead), which was highly suggestive for a carcinoid tumor; enlarged lymph nodes with faint calcification and with increased enhancement were detected at ileocolic level (Figure 5A, white arrows). No metastatic lesions were appreciated in abdominal organs or in lungs. To confirm the diagnosis of carcinoid ileal tumor and for more comprehensive © 2019 American Heart Association, Inc. CARDIOVASCULAR IMAGES

European Heart Journal - Cardiovascular Imaging, 2019

A 62-years-old male was admitted to Cardiology department due to the occasional detection of a ca... more A 62-years-old male was admitted to Cardiology department due to the occasional detection of a cardiac mass in a Choline C-11 PET scan which was performed as standard follow-up for prostate cancer in active surveillance strategy. Previous abdominal CT scan detected a mass in the right iliac fossa(as a small bowel disease),and a focal soft tissue mass in the mesentery (lymph node). Patient's medical and familiar history was negative for cardiovascular disease. The patient was no-smoker, with borderline dyslipidaemia, no arterial hypertension and he was asymptomatic. A transthoracic echocardiography(TTE)was performed, which detected a rounded expansive structure, with an intra-myocardial collocation al the level of the interventricular septum and it was characterized by having inside some anecogenic cavities(1a,1c-d). Echo-contrast showed a mild degree of late hyper-enhancement(1b). Cardiac magnetic resonance(CMR)was performed then, which confirmed the presence of the well-circumscribed mass in the interventricular septum. Both in T1 and T2 weighted sequence, the mass had inhomogeneous high signal intensity with a circumferential ipointense ring delimiting the mass to the surrounding myocardium (2a-b). The mass revealed a first pass perfusion enhancement and, after intravenous gadolinium contrast agent injection, late enhancement was noticed at the level of the circumferential ring and at the edges of the cavities (2c). With the suspicion of a neuroendocrine tumor due to the highly suggestive abdominal CT findings, a Ga-68 dotatate and 18F-FDG PET/CT scan ware performed. Intense pathological uptake of the first radioactive agent was detected in both the abdominal findings already reported and at the level of the cardiac mass as well. Regarding 18F-FDG uptake, there was no uptake from the abdominal masses whereas there was a mild uptake from the cardiac mass(3a-b). These findings were conclusive for the diagnosis of a neuroendocrine tumor with a secondary metastatic cardiac mass. The patient was discussed in a multidisciplinary team meeting. A coronary angiography was performed which detected a significative atherosclerosis of the proximal tract of the LAD. Considering the complexity of a eventual cardiac surgery and the possible sequelae (debulking of a wide area, probable subsequent cardiac dysfunction or iatrogenic lesion to the cardiac conduction system), all the specialists agreed to proceed for the PTCA. The patient started a long-acting analogue of somatostatine (lanreodite) in order to manage possible tumor related symptoms and to possible control tumor growth. We have planned to stop one of two antiplatelets in 3 months and, if no limiting factors, to program then the surgical resection of the primitive bowel mass. Regarding the cardiac metastasis, the team decided to adopt an active surveillance scheme with regular and imaging exams, considering the option for an eventual PRRT therapy with the aim of reduction of the cardiac carcinoid.

European Respiratory Journal, 2016

BACKGROUND Thoracic surgeons involved in decision-making of subcentimetric solitary pulmonary nod... more BACKGROUND Thoracic surgeons involved in decision-making of subcentimetric solitary pulmonary nodules(SPN)/ground glass opacities(GGO) SPN/GGO diagnosis difficult by transbronchial/CT-guided biopsy VATS gold-standard in obtaining specimen for pathology OBJECTIVES Several localization methods burdened by significant failure rate&complications To increase efficacy of localization/resection of SPN/GGO,we used radioguided VATS(RV) METHODS Retrospective study on patients undergoing RV from 2008. Inclusion criteria: maxSPN diameter 99m Tc injected in lesion/proximity Identification of nodule in RV based on intensities of γ-probe numeric/acoustic signals During stapling process,γ-probe confirmed maximum radiosignal in tissue excised & absence in remaining lung Primary lung cancers underwent immediately VATS lobectomy RESULTS 78 patients underwent RV Mortality&major complications absent Margins adequate in all CONCLUSIONS RV useful in localization of unpalpable SPN/GGO RV avoids unnecessary thoracotomy in benign lesions RV cost-effective strategy with hight success rate&low morbidity.

Journal of Human Hypertension, 1997

The sympathetic nervous system (SNS) is thought to divided according to their climacteric status ... more The sympathetic nervous system (SNS) is thought to divided according to their climacteric status (10 premenopausal and 10 postmenopausal women). No differ-play an important role in the pathogenesis of essential hypertension and many studies have established a ence in NE values at rest was found between groups and subgroups. During head-up tilt test, Ln NE plasma relationship between plasma levels of norepinephrine (NE) and epinephrine (E) and sympathetic nervous values increased in normotensive and hypertensive groups; the rise was significantly higher in hypertensive activity (SNA). Furthermore, it has been suggested that climacteric than in normotensive women (P Ͻ 0.01). In climacteric subgroups, Ln NE appeared markedly increased above women are more exposed to psychosocial stress which can produce a transient rise in blood pressure (BP) and, resting levels in pre-and postmenopausal hypertensive women when their position was changed from supine with time, determine a hypertensive state. Plasma NE and E levels were measured at rest and to upright (P Ͻ 0.01). Since high plasma NE levels after stimulation (head-up tilt) are associated with sympath-after physiological stimulation (head-up tilt test) in 20 hypertensive (BP: 146 ± 13/101 ± 4 mm Hg) and in 20 etic overactivity, we conclude that SNA is involved in the pathogenesis of essential hypertension in climac-normotensive women (BP: 132 ± 7/85 ± 4 mm Hg). Women in each of these two groups were further sub-teric women.

Radiotherapy and Oncology, Apr 1, 2018

positive paraaortic lymphatic nodes were treated by stereotactic radiotherapy 5 Gy per fraction t... more positive paraaortic lymphatic nodes were treated by stereotactic radiotherapy 5 Gy per fraction to 20 Gy. Results Eight patients were treated following for the abovementioned method. Median follow up was 18 (3-36) months. Nobody had grade 2 acute gastrointestinal toxicity. Local control rate was 100%. Biochemical response rate after radiation therapy was 87,5% (7/8). Conclusion We would like to suggest a new method of radiotherapy for patients with paraaortic lymph nodes metastases of prostate cancer after definitive and salvage radiation therapy which consists of two principles: the one is to prophylactic irradiate paraaortic lymph nodes and the second one is to escalade dose to PET-positive lymph nodes. The result shows that the above-mentioned method is a well-tolerated approach with good rate of biochemical control.

Journal of Clinical Oncology, Feb 20, 2018

322 Background: The potential advantage of the sequential use of the active drugs (ADs) able to p... more 322 Background: The potential advantage of the sequential use of the active drugs (ADs) able to prolong overall survival (OS) in mCRPC (abiraterone, cabazitaxel, docetaxel, enzalutamide, RA223) could be limited by the development of common mechanisms of resistance. According to its unique targeted alpha-radiation mechanism of action, it could be postulated that RA223 does not induce and is not affected by cross-resistance with other agents and consequently its incorporation in therapeutic sequences may improve clinical outcomes. The present study is aimed to describe the clinical outcomes of pts who received RA223 and at least two other ADs for mCRPC. Methods: We collected data of pts who received sequentially 3 or more ADs of which one was RA223. For each pt we recorded the clinical outcome of all treatments received for mCRPC. We also compared the cumulative survival from the start of the first line to that of a contemporary series of 405 mCRPC pts without visceral mets sequentially treated with 3 or 4 ADs not comprising RA223. Results: A consecutive series of 119 mCRPC pts was collected: the median age was 72 yrs. Six pts received all 5 available ADs, 53 pts 4 ADs, and the remaining pts 3 ADs. Most of the pts received RA223 as the 3rd or 4th line of treatment (62 and 42, respectively), and the remaining were treated in less or more advanced lines (10 and 5 pts respectively). Overall the full 6-cycle treatment was completed in 61 pts (51.3%) and in 61.3% and 38.1% of pts when Ra223 was administered as 3rd and 4th treatment line respectively (p = 0.02). Partial response and stable disease as best objective response to RA223 was achieved in 11.3% and 24.5% of pts respectively, while a PSA reduction of ≥ 50% was observed in 7.2% of pts. Median OS from the start of the first line was 48 mos. In pts treated with 3 or 4 ADs that included Ra223, the median OS was significantly longer compared to that of pts whose treatment sequence did not include RA223 (48.4 vs 39.2 mos, p = 0.03). Conclusions: Despite the limitations of its retrospective nature, this preliminary data suggests that treatment sequencing of ADs that includes RA223 offers a survival advantage in mCRPC.

Translational Andrology and Urology, 2019

Cancer biotherapy & radiopharmaceuticals, 2021

Background: The retrospective studies that have so far described the outcomes of the sequential u... more Background: The retrospective studies that have so far described the outcomes of the sequential use of life-prolonging agents (LPAs) did not include metastatic castration-resistant prostate cancer (mCRPC) patients who received radium 223 (RA223) as part of their treatment. Consequently, it is not known whether including RA223 in the therapeutic sequence has an impact on cumulative survival. The aim of this study was to evaluate this impact by comparing the cumulative overall survival (OS) in two series of mCRPC patients sequentially treated with two or three LPAs after first-line docetaxel (DOC), including RA223 and not. Materials and Methods: The authors retrospectively reviewed the records of mCRPC patients with bone involvement alone who received two or three LPAs (including RA223) after first-line DOC. The control group was a contemporary series of mCRPC patients with bone involvement alone treated with sequences of two or three LPAs other than RA223 after first-line DOC. Result...

Radiotherapy and Oncology, 2018