Claudio Pusceddu - Academia.edu (original) (raw)

Papers by Claudio Pusceddu

Journal of Clinical Medicine

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

Poster: "ECR 2011 / C-1234 / Percutaneous Humeral and Femoral Osteoplasty With Or Without R... more Poster: "ECR 2011 / C-1234 / Percutaneous Humeral and Femoral Osteoplasty With Or Without Radiofrequency Thermal Ablation In The Treatment Of Bone Metastases" by: "C. Pusceddu1, B. Sotgia1, D. DeRudas1, L. Melis1, F. Meloni2, S. Profili2, G. B. Meloni2; 1CAGLIARI/IT, 2Sassari/IT"

CardioVascular and Interventional Radiology, 2020

Poster: "ECR 2013 / B-0535 / Percutaneous microwave ablation of lung tumours" by: &quot... more Poster: "ECR 2013 / B-0535 / Percutaneous microwave ablation of lung tumours" by: "C. Pusceddu, L. Melis, G. B. Meloni; Cagliari/IT"

Poster: "ECR 2013 / B-0533 / Feasibility and safety of CT-guided percutaneous radiofrequency... more Poster: "ECR 2013 / B-0533 / Feasibility and safety of CT-guided percutaneous radiofrequency, microwave or cryoablation of the pulmonary and mediastinal unresectable tumours adjacent to the heart and large vessels" by: "C. Pusceddu, L. Melis, G. B. Meloni; Cagliari/IT"

Poster: "ECR 2013 / C-0811 / Percutaneous cryoablation of lung tumors" by: "C. Pus... more Poster: "ECR 2013 / C-0811 / Percutaneous cryoablation of lung tumors" by: "C. Pusceddu1, L. Melis1, G. B. Meloni2; 1Cagliari/IT, 2Sassari/IT"

Diagnostic Imaging for Thoracic Surgery, 2018

Computed tomography (CT) and ultrasound (US) are currently considered as the the main imaging mod... more Computed tomography (CT) and ultrasound (US) are currently considered as the the main imaging modalities in the field of interventional radiology. Because of the different characteristics of these modalities their use is different. In particular CT is widely used to obtain accurate needle-tip localization and excellent delineation of interposed vital structures but the most important draback is the lack of real-time imaging. On the other hand US is readily available, relatively inexpensive, and allows for real time imaging. Moreover, Color flow Doppler imaging can help identify the vascular nature of the mass and the adjacent vascular structures. In this chapter we will show the different Interventional Radiology Procedures by showing advantages and limits of these techniques.

Journal of gastrointestinal cancer, Jan 22, 2017

Microwave ablation (MWA) is an emerging treatment for treatment of patients with hepatocellular c... more Microwave ablation (MWA) is an emerging treatment for treatment of patients with hepatocellular carcinoma (HCC) not amenable of surgical resection. We searched for patients diagnosed as having small-, medium-, and large HCCs treated with MWA under CT guidance between 2010 and 2014. The main outcomes of interest were rates of complete ablation, complications, and overall survival. Rates of complete ablation were compared with Chi-square test, and estimated survival rates were calculated by means of Kaplan-Meier method. Thirty-two patients with 45 HCC nodules received MWA. Seventeen (37.8%) nodules were <3 cm (small), 15 (33.3%) between 3 and 5 cm (medium), and 13 (28.9%) > 5 cm (large). Complete ablation was obtained in 94.1% of small tumors, 80% of medium tumors, and 53.8% of large tumors (p = 0.03). Two patients had HCC located in risk area (paracardiac position). Minor complications occurred after seven procedures (15.5%). Estimated median survival was 37 months (95% confide...

Clinics and Practice, 2015

The optimal management of local recurrences after primary resection of pancreatic cancer still re... more The optimal management of local recurrences after primary resection of pancreatic cancer still remains to be clarified. A 58-yearold woman developed an isolated recurrence of pancreatic cancer six year after distal pancreatectomy. Re-resection was attempted but the lesion was deemed unresectable at surgery. Then chemotherapy was administrated without obtaining a reduction of the tumor size nor an improvement of the patient’s symptoms. Thus the patient underwent percutaneous cryoablation under computed tomography (CT)-guidance obtaining tumor necrosis and a significant improvement in the quality of life. A CT scan one month later showed a stable lesion with no contrast enhancement. While the use of percutaneous cryoblation has widened its applications in patients with unresectable pancreatic cancer, it has never been described for the treatment of local pancreatic cancer recurrence after primary resection. Percutaneous cryoablation deserves further studies in the multimodality treatm...

CardioVascular and Interventional Radiology, 2015

To retrospectively evaluate the effectiveness of computed tomography-guided percutaneous microwav... more To retrospectively evaluate the effectiveness of computed tomography-guided percutaneous microwave ablation (MWA) and cementoplasty in patients with painful bone metastases at high risk of fracture. Thirty-five patients with 37 metastatic bone lesions underwent computed tomography-guided MWA combined with cementoplasty (polymethylmethacrylate injection). Vertebrae, femur, and acetabulum were the intervention sites and the primary end point was pain relief. Pain severity was estimated by visual analog scale (VAS) before treatment; 1 week post-treatment; and 1, 6, and 12 months post-treatment. Functional outcome was assessed by improved patient walking ability. Radiological evaluation was performed at baseline and 3 and 12 months post-procedure. In all patients, pain reduction occurred from the first week after treatment. The mean reduction in the VAS score was 84, 90, 90 % at week 1, month 1, and month 6, respectively. Improved walking ability occurred in 100 and 98 % of cases at the 1- and 6-month functional outcome evaluations, respectively. At the 1-year evaluation, 25 patients were alive, and 10 patients (28 %) had died because of widespread disease. The mean reduction in the VAS score and improvement in surviving patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; walking ability were 90 and 100 %, respectively. No patients showed evidence of local tumor recurrence or progression and pathological fracture in the treated sites. Our results suggest that MWA combined with osteoplasty is safe and effective when treating painful bone metastases at high risk of fracture. The number of surviving patients at the 1-year evaluation confirms the need for an effective and long-lasting treatment.

Journal of Vascular and Interventional Radiology, 2014

To assess retrospectively the safety and feasibility of palliative breast cryoablation to treat p... more To assess retrospectively the safety and feasibility of palliative breast cryoablation to treat primary breast tumors in patients with stage IV breast cancer. In 17 female patients (mean age ± SD, 59 y ± 13; range, 37-81 y) with 22 bone metastatic ductal invasive breast lesions (2.5 cm × 1.6 cm ± 1.4 × 1.1; range, 1.0 cm × 0.5 cm to 6.7 cm × 5.5 cm), 19 computed tomography (CT)-guided percutaneous cryoablation sessions were performed for treatment of primary breast tumors. All patients had radiologic evidence (contrast-enhanced CT or magnetic resonance imaging) of persistence or progression of the primary breast cancer despite systemic therapy. The radiologic outcome was evaluated with a mean follow-up period of 13 months (range, 3-31 mo). Treatment of skeletal metastases was unnecessary during the follow-up period. All of the cryoablation sessions were completed and well tolerated. Complete regression of the disease was achieved in 15 (88%) patients 2 months after the cryoablation. Two (12%) patients underwent a second cryoablation treatment because of a minimal persistence of viable tumor (residual disease). No relapse of primary tumors was observed on breast imaging during the follow-up period. One patient (6%) developed a new lesion localized to the contralateral breast. These data suggest that palliative cryoablation of primary advanced breast cancer is a well-tolerated, feasible, and effective treatment option. Given the palliative effects of breast cryoablation demonstrated in this series, larger studies replicating these results are warranted.

Journal of Vascular and Interventional Radiology, 2013

To retrospectively evaluate the feasibility, safety, and effectiveness of computed tomography (CT... more To retrospectively evaluate the feasibility, safety, and effectiveness of computed tomography (CT)-guided percutaneous microwave ablation (MWA) in patients with bone metastases. Twenty-one patients with metastatic bone lesions were treated in 18 MWA sessions. In patients whose lesions contained fractures, or who had a high risk for fracture (48%; n = 10), MWA was followed by cementoplasty with polymethylmethacrylate injection. The positioning of the MWA antenna into the tumor was guided by CT. Treatments were performed under conscious sedation. All patients underwent clinical (self-reported Brief Pain Inventory [BPI]; scale from 0 to 10) and radiologic evaluation at baseline and 1 month after the procedure. The reported results are data from baseline to a follow-up period of 3 months. There were no complications. A reduction of pain and improvement in quality of life was observed in all patients as measured by BPI score. On average, the mean BPI score during the 3-month follow-up period was reduced by 92% (41%-100%). Thirteen of 18 patients (72%) were symptom-free, four patients (22%) were still symptomatic but with 85% lower average BPI scores (41%-95%), and one patient (6%) experienced a recurrence of symptoms. Preliminary results suggest that MWA of bone metastases is a well tolerated, safe, and effective procedure. However, its efficacy still remains to be determined by medium- and long-term studies.

European Journal of Radiology, 2013

To report the data of our initial experience with CT-guided thin cryoprobes for percutaneous cryo... more To report the data of our initial experience with CT-guided thin cryoprobes for percutaneous cryoablation (PCA) in patients with primary and secondary pulmonary tumors. CT-guided thin needles PCA was performed on 34 lung masses (11 NSCLC=32%; 23 secondary lung malignancies=68%) in 32 consecutive patients (24 men and 8 women; mean age 67 ± 10 years) not suitable for surgical resection. Lung masses were treated using two types of cryoprobes: IceRod and IceSeed able to obtain different size of iceball. The number of probes used ranged from 1 to 5 depending on the size of the tumor. After insertion of the cryoprobes into the lesion, the PCA were performed with two 2 (91%) or 3 (9%) cycles each of 12 min of freezing followed by a 4 min active thawing phase and a 4 min passive thawing phase for each one for all treatments. All cryoablation sessions were successfully completed. All primary and metastatic lung tumors were ablated. No procedure-related deaths occurred. Morbidity consisted of 21% (7 of 34) pneumothorax and 3% (1 of 34) cases asymptomatic small pulmonary hemorrhage, respectively, all of CTCAE grade 1 (Common Terminology Criteria for Adverse Events). Low density of entire lesion, central necrosis and solid mass appearance were identify in 21 (62%), 7 (21%) and 6 (17%) of cryoablated tumors, respectively. No lymphadenopathy developed in the region of treated lesions. Technical success (complete lack of enhancement) was achieved in 82%, 97% and 91% of treated lesions at 1-, 3- and 6-months CT follow-up scan, respectively (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.000). Comparing the tumor longest diameter between the baseline and at 6 month CT images, technical success was revealed in 92% cases (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.000). Our preliminary experience suggests that PCA is a feasible treatment option. Well-designed clinical trials with a larger patient population are necessary to further investigate the long-term results and prognostic factors.

Abdominal Imaging, 2013

To retrospectively evaluate the feasibility and efficacy of computed tomography (CT)-guided radio... more To retrospectively evaluate the feasibility and efficacy of computed tomography (CT)-guided radiofrequency thermal ablation (RFA) in reducing the pain in patients with painful pelvic recurrence of rectal cancer ineligible for surgical resection. Twelve consecutive patients (10 men and 2 women; mean age 67 ± 10 years) with painful pelvic recurrence of rectal cancer underwent CT-guided RFA treatments under conscious sedation. At baseline, in all patients pelvic-sacral pain was classified as severe by Visual Analog Scale (VAS; VAS score ≥75 mm). The tumor density and carcinoembryionic antigen (CEA) serum level averages were 46 ± 7 HU and 15.7 ± 9.3 ng/mL, respectively. Clinical outcome was evaluated by VAS with a mean follow-up period of 23 months. All RFA sessions were completed and well tolerated. Morbidity consisted of recto-vesical fistula (8 %) and rectal abscess (8 %). 1 month after RFA procedure, complete lack of enhancement was obtained in 7 cases (58 %). A significant difference in HU and CEA serum level averages between baseline and 1 month post-RFA was revealed (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.000 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.002, respectively). A significant reduction in pain was obtained: VAS score was significantly different between baseline and the clinical evaluations at week 1 and month 3, 6, 12, and 22) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.000). At the end of follow-up, 11 patients (92 %) were symptom free. CT-guided RFA of painful pelvic recurrence of rectal cancer can be considered as a feasible and effective treatment for reducing the pain in selected cases.

Poster: "ECR 2011 / C-1228 / Percutaneous Radiofrequency Ablation Treatment Of Relapse Color... more Poster: "ECR 2011 / C-1228 / Percutaneous Radiofrequency Ablation Treatment Of Relapse Colorectal Cancer" by: "C. Pusceddu1, B. Sotgia1, L. Melis1, F. Meloni2, G. Podda1, S. Profili2, G. B. Meloni2; 1CAGLIARI/IT, 2Sassari/IT"

$Research paper thumbnail of CT-guided percutaneous screw fixation plus cementoplasty in the treatment of painful bone metastases with fractures or a high risk of pathological fracture$

Skeletal Radiology, Feb 13, 2017

To evaluate the feasibility and effectiveness of computed tomography (CT)-guided percutaneous scr... more To evaluate the feasibility and effectiveness of computed tomography (CT)-guided percutaneous screw fixation plus cementoplasty (PSFPC), for either treatment of painful metastatic fractures or prevention of pathological fractures, in patients who are not candidates for surgical stabilization. Twenty-seven patients with 34 metastatic bone lesions underwent CT-guided PSFPC. Bone metastases were located in the vertebral column, femur, and pelvis. The primary end point was the evaluation of feasibility and complications of the procedure, in addition to the length of hospital stay. Pain severity was estimated before treatment and 1 and 6 months after the procedure using the visual analog scale (VAS). Functional outcome was assessed by improved patient walking ability. All sessions were completed and well tolerated. There were no complications related to either incorrect positioning of the screws during bone fixation or leakage of cement. All patients were able to walk within 6 h after the procedure and the average length of hospital stay was 2 days. The mean VAS score decreased from 7.1 (range, 4-9) before treatment to 1.6 (range, 0-6), 1 month after treatment, and to 1.4 (range 0-6) 6 months after treatment. Neither loosening of the screws nor additional bone fractures occurred during a median follow-up of 6 months. Our results suggest that PSFPC might be a safe and effective procedure that allows the stabilization of the fracture and the prevention of pathological fractures with significant pain relief and good recovery of walking ability, although further studies are required to confirm this preliminary experience.