Gianni Bisi | University of torino (original) (raw)
Papers by Gianni Bisi
The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutical Chemistry and Biology, 2011
Endocrine, 2001
Growth hormone releasing peptides (GHRPs) are synthetic molecules endowed with potent neuroendocr... more Growth hormone releasing peptides (GHRPs) are synthetic molecules endowed with potent neuroendocrine activities mediated by specific receptors in the pituitary and in the central nervous system. GHRPs receptors have been reported even in perpheral tissues, particularly in the myocardium, where they probably mediate growth hormone (GH)-independent activities. We studied in humans the cardiac effects of hexarelin administration in 7 normal adults, in 7 severe GH-deficient patients, and in 12 patients with severe dilated cardiomyopathy. Left ventricular ejection fraction (LVEF), mean blood pressure (MBP), heart rate (HR), and GH levels were evaluated at baseline and every 15 min up to 60 min after acute 2.0 µg/kg iv hexarelin administration. Basal LVEF in dilated cardiomyopathy was impaired and lower (p < 0.001) than in GH deficiency, in turn lower (p < 0.001) than in normal subjects. Hexarelin signficantly (p < 0.05) increased LVEF in normal and in GH-deficient subjects, but not in dilated cardiomyopathy, without significant variations in MBP and HR. Hexeralin significantly (p < 0.05) increased GH levels in normal subjects and in dilated cardiomyopathy but not in GH deficiency. These findings suggest that, in humans, the acute administration of hexarelin exerts a GH-independent positive inotropic effect likely mediated by specific GHRPs myocardial receptors.
Acta Diabetologica, 2019
Positron emission tomography/computed tomography (PET/CT) is a standard procedure for imaging can... more Positron emission tomography/computed tomography (PET/CT) is a standard procedure for imaging cancer commonly used in the clinical practice for several diseases, in particular for cancer staging, restaging, treatment monitoring and radiation therapy planning. Despite the availability of many radiotracers, 18F-fluoro-2-deoxy-2-d-glucose ([18F]FDG) is the most used. International PET/CT guidelines propose protocols for patients' correct preparation before [18F]FDG injection, in particular with the regard of diabetic patients and therapy management. Hyperglycemic conditions and oral or insulin medication showed advantages and disadvantages on PET/CT scan accuracy: A correct knowledge of effects of these conditions on glucose metabolism assumes a fundamental role on patients management before [18F]FDG PET/CT scan.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1998
Rest-redistribution 201Tl imaging is currently being used for myocardial viability detection, but... more Rest-redistribution 201Tl imaging is currently being used for myocardial viability detection, but the ideal parameters for territory classification have not yet been defined. The aim of this study was to define the optimal criteria for detecting viable myocardium and predicting postrevascularization recovery with rest-redistribution 201Tl SPECT. In 29 patients with left ventricular dysfunction, tracer activity within asynergic segments was quantified on rest and redistribution 201Tl SPECT. Viability was defined by the presence of functional recovery, which was detected by comparing wall motion in baseline and follow-up echocardiography. Discriminant function analysis and receiver operating characteristic (ROC) curve analysis were used to evaluate the relationship between 201Tl data and viability. Of 214 dysfunctioning segments (135 a-/dyskinetic), viability was demonstrated in 115 (75 a-/dyskinetic). Both rest and redistribution 201Tl activity in these segments were significantly hi...
Nuclear Medicine Communications, 2003
Lymphatic mapping and sentinel lymph node (SLN) biopsy are becoming increasingly useful for the i... more Lymphatic mapping and sentinel lymph node (SLN) biopsy are becoming increasingly useful for the identification of tumour lymphatic spread in a wide variety of neoplasms, such as breast cancer and melanoma, reducing unnecessary radical lymph node resection. The aim of our study was to determine the feasibility of lymphatic mapping with both labelled colloid and patent blue violet in patients with early stage endometrial cancer. Sixteen consecutive patients with endometrial cancer, stage International Federation of Gynecology and Obstetrics (FIGO Ib), were included in the study. Lymphoscintigraphy and laparoscopically assisted intra-operative SLN detection were performed in all patients. In addition, to verify the prognostic role of this method, 12 of 16 patients were followed up for a period of at least 1 year. In 15 of 16 patients, 24 SLNs (all internal iliac lymph nodes) were detected at lymphoscintigraphy (six monolateral and nine bilateral). At histological analysis, three of the 24 were positive for micrometastases, whereas the remaining 21 were negative. No other surgically dissected lymph nodes presented metastases. At 1 year of follow-up, none of the 12 patients presented relapse of their disease. In conclusion, in endometrial cancer, both pre-operative lymphoscintigraphy and intra-operative gamma-probe detection of SLNs represent promising tools for the visualization of SLNs. The status of the latter may yield a correct representation of pelvic lymph node involvement, providing important information for further treatment.
Journal of Nuclear Cardiology, 2001
Journal of Nuclear Cardiology, 1998
Background. To overcome the relatively low accuracy of exercise stress testing (EST) in detecting... more Background. To overcome the relatively low accuracy of exercise stress testing (EST) in detecting coronary artery disease (CAD), both echocardiography and perfusion scintigraphy have been evaluated in conjunction with pharmacologic stress, but there is still uncertainty of the relative value of these tests as possible first-line examinations for suspected CAD. This study evaluated the accuracy of EST, dipyridamole and dobutamine stress echocardiography (DIP-ECHO, DOB-ECHO), and dipyridamole and dobutamine technetium 99m sestamibi tomography (DIP-MIBI, DOB-MIBI) for the detection of CAD in patients evaluated for the first time because of chest pain. Methods and results. Sixty patients underwent EST, DIP-ECHO, DOB-ECHO, DIP-MIBI, and DOB-MIBI. Echocardiographic images were acquired simultaneously with sestamibi injections, and the scintigraphic images were collected 1 hour later. Coronary angiography was performed within 15 days. Out of 33 patients with significant (>70%) coronary stenoses, 19 (58%) were correctly identified by EST, 18 (55%) by DIP-ECHO, 20 (61%) by DOB-ECHO, 32 (97%) by DIP-MIBI, and 30 (91%) by DOB-MIBI (p < 0.005 for MIBI vs EST and ECHO). The specificity of EST was 67% (p < 0.05 vs ECHO and MIBI), 96%, 96%, 89%, and 81%, respectively. Of the 62 stenotic coronary arteries, 20 (32%) were correctly identified by DIP-ECHO, 24 (39%) by DOB-ECHO, 48 (77%) by DIP-MIBI, and 45 (73%) by DOB-MIBI. The sensitivity of the imaging techniques in predicting the presence of multivessel disease was 14% and 29% for DIP and DOB-ECHO compared with 48% and 57% for DIP and DOB-MIBI. Conclusions. Our results confirm the limited reliability of EST in detecting CAD and the good diagnostic value of DIP and DOB-MIBI. Conversely, the lower sensitivity and the poorer capability to recognize multivessel CAD do not support the role of either DIP or DOB-ECHO as first-line examination for suspected CAD.
European Journal of Nuclear Medicine and Molecular Imaging, 1998
The significance of reverse redistribution on rest-redistribution thallium-201 myocardial scintig... more The significance of reverse redistribution on rest-redistribution thallium-201 myocardial scintigraphy is unclear. Previous studies suggested that reverse redistribution segments with normal resting activity include viable myocardium, whilst resting defects with further worsening correspond to scar. We evaluated whether reverse redistribution has an independent significance for the prediction of post-revascularization recovery, particularly as compared with the quantification of redistribution activity. We studied 26 coronary artery disease patients with left ventricular dysfunction, who underwent 201 Tl rest-redistribution single-photon emission tomography (SPET) and echocardiography before revascularization. Viability was defined by the detection of wall motion improvement on follow-up echocardiography. 201 Tl activity was considered normal if ≥80%, moderately reduced if <80% but ≥50%, and severely decreased if <50%. Reverse redistribution was defined as a defect in redistribution images with ≥10% decrease in relative 201 Tl activity compared with the resting value. Reverse redistribution was detected in 33 segments (10%). Baseline dysfunction was equally observed in the reverse redistribution and in the non-reverse redistribution segments (64% vs 56%, P=0.40) and the rate of asynergic segments with post-revascularization recovery was not different between the two groups (33% vs 54%, P=0.11). The rate of functional recovery in redistribution defects without reverse redistribution was 53% in moderate and 30% in severe defects; the corresponding values for the reverse redistribution segments were 50% and 27% (all non-significant versus non-reverse redistribution segments). For the prediction of post-revascularization recovery in asynergic segments, the detection of reverse redistribution on rest-redistribution 201 Tl SPET does not add any information to the quantitative analysis of redistribution activity.
The American Journal of Cardiology, 2002
A main goal of revascularization in patients with chronic ischemic cardiomyopathy is to improve g... more A main goal of revascularization in patients with chronic ischemic cardiomyopathy is to improve global left ventricular (LV) function. This study aimed to verify whether it is possible to predict an increase in LV ejection fraction (EF) after revascularization on the basis of the extent of LV asynergy, myocardial viability, and revascularization completeness. We studied 77 patients with chronic LV ischemic dysfunction using baseline resting and nitrateenhanced technetium-99m sestamibi single-photon emission computed tomography. Regional wall motion and global LVEF were assessed with echocardiography before and after revascularization, which was complete in 51 patients and incomplete in 26. The number of viable asynergic segments included in revascularized coronary artery territories was the strongest predictor of significant (>5 EF U) functional improvement in univariate discriminant analysis. According to multivariate stepwise discriminant analysis, this parameter, together with the number of baseline asynergic segments, allowed the detection of patients with significant LVEF improvement with 75% accuracy. With use of a multivariate regression model, including the 2 mentioned variables, the measure of postrevascularization LVEF increase could be accurately quantified (R 2 0.43, p <0.000001). In conclusion, this study suggests that the severity of baseline asynergy, the extent of myocardial viability, and the completeness of revascularization are the main determinants of postrevascularization functional recovery in patients with LV ischemic dysfunction, and that on the basis of these variables it is possible to predict the measure of LVEF increase. ᮊ2002 by Excerpta Medica, Inc.
International Journal of Radiation Oncology*Biology*Physics, 2013
To investigate the role of radiation therapy (RT) in patients affected with primary mediastinal B... more To investigate the role of radiation therapy (RT) in patients affected with primary mediastinal B-cell lymphoma (PMBCL) with residual 18 fluorodeoxyglucose positron emission tomography (18 FDG-PET)-positive disease after rituximab chemotherapy (R-CT).
Blood, 2012
Role of interim-PET (I-PET) in diffuse large B-cell Lymphoma (DLBCL) is controversial. To determi... more Role of interim-PET (I-PET) in diffuse large B-cell Lymphoma (DLBCL) is controversial. To determine predictive value of I-PET on progression-free survival (PFS), we enrolled 88 first-line DLBCL patients treated with 6-8 R-CHOP courses regardless of I-PET. PET/CT were performed at diagnosis, after 2 to 4 courses and at the end of therapy with central reviewing according to visual dichotomous criteria. Results are as follows: I-PET, 72% negative, 28% positive; final-PET (F-PET), 88% negative, 12% positive; clinical complete response 90%. Concordance between clinical response and F-PET negativity was 97% because of 2 false positive. With a median follow-up of 26.2 months, 2-year overall survival and PFS were 91% and 77%, respectively. Two-year PFS for I-PET and F-PET negative versus positive were as follows: I-PET 85% versus 72% (P = .0475); F-PET 83% versus 64% (P < .001). Because of a small number of events, 2 independent bivariate Cox models were tested for PFS. In model 1, F-PET...
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1997
The aim of this study was to assess the value of the cavity-to-myocardium count ratio (C/M ratio)... more The aim of this study was to assess the value of the cavity-to-myocardium count ratio (C/M ratio) calculated in resting 99mTc-sestamibi SPECT images to identify patients with depressed left ventricular ejection fraction (LVEF). In the 95 patients studied, the C/M ratio was calculated from the midventricular short-axis slice using regions of interest drawn in the center of the cavity and in the most active area of the ventricular wall; its value was compared with LVEF measured using two-dimensional echocardiography. The C/M ratio correlated with LVEF (r = 0.6, p < 0.000001) and was significantly lower in patients with abnormal LVEF than those with normal LVEF: 0.026 +/- 0.028 versus 0.125 +/- 0.093, p < 0.000001. In the entire patient population, a C/M ratio < 0.07 identified the patients with depressed LVEF with a 94% sensitivity, 71% specificity and 82% accuracy. The resting 99mTc-sestamibi C/M ratio is a useful parameter in identifying patients with depressed LVEF directl...
The Quarterly Journal of Nuclear Medicine and Molecular Imaging, 2018
En este artículo se presenta un protocolo de difusión de mensajes de seguridad para emergencia qu... more En este artículo se presenta un protocolo de difusión de mensajes de seguridad para emergencia que utiliza una adaptación dinámica del tiempo de retraso en el entorno de una red vehicular cognitiva. El escenario que se estudia considera la compartición del espectro entre la banda para comunicaciones vehiculares y la banda de la televisión digital con el objetivo de mitigar los efectos de la tormenta de difusión en una red vehicular. Dos de las técnicas de mitigación de la tormenta de difusión más utilizadas en la literatura son comparadas contra el protocolo propuesto en términos de las probabilidades de accesibilidad de los mensajes de emergencia y de la ocupación del canal. Los resultados numéricos muestran que el protocolo con la adaptación dinámica del tiempo presenta un mejor desempeño en condiciones de alta densidad de vehículos, lo cual es característico de un escenario de tormenta de difusión. Palabras clave: Sistemas de transporte y vehículos, tecnología inalámbrica y dispositivo móviles, seguridad y mensajes de emergencia, tormenta de difusión, compartición de espectro Dynamic Adaptation of Delayed Time of Diffusion of Emergency Messages in Cognitive Vehicular Networks
Journal of Nuclear Cardiology, 1996
Background. This study aimed to verify whether the assessment of defect severity and the infusion... more Background. This study aimed to verify whether the assessment of defect severity and the infusion of nitrates during tracer injection improve the capability of data-based ~gmTc-labeled sestamibi single-photon emission computed tomography (SPECT) to recognize hibernating myocardium. Methods and Results. Of 66 asynergic coronary territories in 40 patients with left ventricular dysfunction, 28 had postrevascularization functional recovery (hibernating) and 38 had unchanged dysfunction (fibrotic). Defect severity was lower in the hibernating than in the fibrotic territories on both baseline (p < 0.01) and nitrate SPECT (p < 0.002). Nitrate was superior to baseline SPECT to differentiate the hibernating from the fibrotic territories (sensitivity 96% vs 75%, p < 0.05; receiver-operating characteristic curve area 0.75 vs 0.63, p < 0.001) and to identify the patients with improved left ventricular ejection fraction (receiveroperating characteristic curve area 0.68 vs 0.58; p < 0.05). Conclusions. The analysis of defect severity in combination with nitrate infusion clearly improves the value of 9~mTc-labeled sestamibi SPECT for the recognition of hibernating myocardium and the prediction of postrevascularization recovery.
Growth hormone (GH) secretagogues (GHS) are synthetic peptidyl and non-peptidyl molecules which p... more Growth hormone (GH) secretagogues (GHS) are synthetic peptidyl and non-peptidyl molecules which possess strong, dose-dependent and reproducible GH releasing effects as well as significant prolactin (PRL) and adrenocorticotropic hormone (ACTH) releasing effects. The neuroendocrine activities of GHS are mediated by specific receptors mainly present at the pituitary and hypothalamic level but also elsewhere in the central nervous system. GHS release GH via actions at the pituitary and (mainly) the hypothalamic level, probably acting on GH releasing hormone (GHRH) secreting neurons and/or as functional somatostatin antagonists. GHS release more GH than GHRH and the coadministration of these peptides has a synergistic effect but these effects need the integrity of the hypothalamo-pituitary unit. The GH releasing effect of GHS is generally gender-independent and undergoes marked age-related variations reflecting age-related changes in the neural control of anterior pituitary function. The PRL releasing activity of GHS probably comes from direct pituitary action, which indeed is slight and independent of both age and gender. The acute stimulatory effect of GHS on ACTH/cortisol secretion is similar to that of corticotropin releasing hormone (CRH) and arginine vasopressin (AVP). In physiological conditions, the ACTH releasing activity of GHS is mediated by central mechanisms, at least partially, independent of both CRH and AVP but probably involving GABAergic mechanisms. The ACTH releasing activity of GHS is gender-independent and undergoes peculiar age-related variations showing a trend towards increase in ageing. GHS possess specific receptors also at the peripheral levels in endocrine and non-endocrine human tissues. Cardiac receptors are specific for peptidyl GHS and probably mediate GH-independent cardiotropic activities both in animals and in humans.
UNLABELLED The aim of this study was to evaluate the diagnostic value, in suspected infectious pr... more UNLABELLED The aim of this study was to evaluate the diagnostic value, in suspected infectious prostheses, of (99m)Tc-labeled hexamethylpropyleneamine oxime ((99m)Tc-HMPAO) leukocyte scintigraphy interpreted with the addition of a semiquantitative analysis. METHODS By means of a retrospective review, we included a group of 78 consecutive patients with suspected hip or knee prosthesis infection. We performed 91 (99m)Tc-HMPAO-leukocyte scintigraphies and examined 95 localizations that were suspect. Images were acquired at 3 different time points after the injection of the labeled leukocytes: 50 min (early images), 4 h, and 24 h (late images). The scintigraphic examinations were independently evaluated by 3 observers; qualitative and semiquantitative analyses were performed. The final diagnosis of infection was based on surgical, histologic, and bacteriologic data and follow-up. RESULTS On qualitative analysis, sensitivity, specificity, and accuracy were 80.4%-87%, 65.3%-71.4%, and 75....
![Research paper thumbnail of Role of whole-body [18 F] fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and conventional techniques in the staging of …](https://attachments.academia-assets.com/80493672/thumbnails/1.jpg)
](La Radiologia …, 2008
The aim of this study was to evaluate the role of [ 18 F]fluorodeoxyglucose positron emission tom... more The aim of this study was to evaluate the role of [ 18 F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the staging of Hodgkin's and aggressive non-Hodgkin's lymphoma (HL and NHL), comparing it with conventional diagnostic methods, i.e. contrast-enhanced CT and bone marrow biopsy. Materials and methods. Sixty-five consecutive patients (30 HL and 35 NHL) who underwent conventional disease staging and FDG-PET/CT were included. Concordance between conventional methods and PET was established when both procedures identified the same disease stage. Discordant findings were investigated further by using other diagnostic techniques (ultrasonography or magnetic resonance imaging) and/or clinical follow-up. Results. PET correctly staged 93.8% of enrolled patients (61/65), whereas conventional techniques correctly staged 89.2% (58/65; p=NS, χ 2 test). There was complete concordance in 54/65 patients (83.1%); among the remaining 11 cases, PET upstaged eight patients (seven true positive and one false positive), and downstaged three (all false negative). In 5/65 patients, chemotherapy treatment was modified on the basis of PET findings. Riassunto Obiettivo. Scopo di questo studio è stato quello di valutare il ruolo dell'esame PET/TC total body con 18 F-fluorodesossiglucosio (FDG-PET/TC) nella stadiazione dei linfomi di Hodgkin (LH) e non-Hodgkin aggressivi (NHL), confrontandolo con le tecniche convenzionali di stadiazione (TC con mezzo di contrasto e biopsia osteo-midollare). Materiali e metodi. Sono stati inclusi 65 pazienti consecutivi (30 LH e 35 NHL) che hanno eseguito stadiazione convenzionale e FDG-PET/TC. Le due procedure sono state definite concordanti quando entrambe hanno identificato il medesimo stadio di malattia; in caso di discordanza sono state eseguiti altri esami (ecografia o risonanza magnetica) e/o follow-up clinico. Risultati. L'esame PET ha consentito di stadiare correttamente 61/65 pazienti (93,8%), le metodiche convenzionali 58/65 (89,2%; p=ns, test χ 2). Nella stadiazione, entrambe le tecniche risultavano concordare in 54/65 casi (83,1%); nei restanti 11 casi, l'esame PET ha determinato una sovrastadiazione in 8 pazienti (7 veri positivi ed 1 falso positivo) e una sotto-stadiazione in 3 casi (tutti falsi negativi). Sulla base dei risultati PET il trattamento chemioterapico è stato modificato in 5 pazienti. Conclusioni. I nostri dati confermano l'elevata accuratezza NEURORADIOLOGY NEURORADIOLOGIA
Endocrine
Purpose Aim of our study was to search for variables associated with worse outcomes in patients t... more Purpose Aim of our study was to search for variables associated with worse outcomes in patients treated with radioactive iodine (RAI) for hyperthyroidism by a dosimetric-based approach. Methods Four hundred twenty-four patients with hyperthyroidism related to Toxic Multinodular Goiter (TMG; n = 213), Grave’s disease (GD; n = 150) and toxic adenoma (TA; n = 61) treated with RAI between 2000 and 2018 and with at least 12 months follow-up were retrospectively evaluated. Association between outcomes (response vs. no response) at 6 and 12 months and baseline TSH values, anti-thyroid drugs (ATD) duration and posology, RAI absorbed dose and dimensional reduction of target mass at ultrasound was evaluated by Mann–Whitney test. Risk factors for response vs. no-response were analysed by binary logistic regression model. Results Overall response rate was 78.7 and 83% at 6 and 12 months, respectively. Both at 6 and 12 months higher TSH baseline values ( p < 0.001), lower ATD duration ( p = 0.004 and p = 0.043), lower ATD posology ( p = 0.014 and p = 0.005), and lower dose to target ( D T ) (327 vs. 373 Gy, p = 0.003) were associated to response. Longer ATD duration and higher ATD posology were independent risk factors for no response at 6 and 12 months in GD and TMG, with no response at 6 months in TA subgroups. Conclusions Low TSH levels, longer duration and higher posology of ATD were associated with worse response to RAI. These data confirm that RAI therapy should be considered earlier in patients’ management to allow better outcome and avoid ATD toxicity.
Clinical Imaging, 2009
a single injection was needed. Cortivazol provided superior results compared to dexamethasone. Co... more a single injection was needed. Cortivazol provided superior results compared to dexamethasone. Conclusion: CT-guided injections should be included in the therapeutic armamentarium after standard medical management, with cure as the goal.
European Journal of Heart Failure Supplements
The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutical Chemistry and Biology, 2011
Endocrine, 2001
Growth hormone releasing peptides (GHRPs) are synthetic molecules endowed with potent neuroendocr... more Growth hormone releasing peptides (GHRPs) are synthetic molecules endowed with potent neuroendocrine activities mediated by specific receptors in the pituitary and in the central nervous system. GHRPs receptors have been reported even in perpheral tissues, particularly in the myocardium, where they probably mediate growth hormone (GH)-independent activities. We studied in humans the cardiac effects of hexarelin administration in 7 normal adults, in 7 severe GH-deficient patients, and in 12 patients with severe dilated cardiomyopathy. Left ventricular ejection fraction (LVEF), mean blood pressure (MBP), heart rate (HR), and GH levels were evaluated at baseline and every 15 min up to 60 min after acute 2.0 µg/kg iv hexarelin administration. Basal LVEF in dilated cardiomyopathy was impaired and lower (p < 0.001) than in GH deficiency, in turn lower (p < 0.001) than in normal subjects. Hexarelin signficantly (p < 0.05) increased LVEF in normal and in GH-deficient subjects, but not in dilated cardiomyopathy, without significant variations in MBP and HR. Hexeralin significantly (p < 0.05) increased GH levels in normal subjects and in dilated cardiomyopathy but not in GH deficiency. These findings suggest that, in humans, the acute administration of hexarelin exerts a GH-independent positive inotropic effect likely mediated by specific GHRPs myocardial receptors.
Acta Diabetologica, 2019
Positron emission tomography/computed tomography (PET/CT) is a standard procedure for imaging can... more Positron emission tomography/computed tomography (PET/CT) is a standard procedure for imaging cancer commonly used in the clinical practice for several diseases, in particular for cancer staging, restaging, treatment monitoring and radiation therapy planning. Despite the availability of many radiotracers, 18F-fluoro-2-deoxy-2-d-glucose ([18F]FDG) is the most used. International PET/CT guidelines propose protocols for patients' correct preparation before [18F]FDG injection, in particular with the regard of diabetic patients and therapy management. Hyperglycemic conditions and oral or insulin medication showed advantages and disadvantages on PET/CT scan accuracy: A correct knowledge of effects of these conditions on glucose metabolism assumes a fundamental role on patients management before [18F]FDG PET/CT scan.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1998
Rest-redistribution 201Tl imaging is currently being used for myocardial viability detection, but... more Rest-redistribution 201Tl imaging is currently being used for myocardial viability detection, but the ideal parameters for territory classification have not yet been defined. The aim of this study was to define the optimal criteria for detecting viable myocardium and predicting postrevascularization recovery with rest-redistribution 201Tl SPECT. In 29 patients with left ventricular dysfunction, tracer activity within asynergic segments was quantified on rest and redistribution 201Tl SPECT. Viability was defined by the presence of functional recovery, which was detected by comparing wall motion in baseline and follow-up echocardiography. Discriminant function analysis and receiver operating characteristic (ROC) curve analysis were used to evaluate the relationship between 201Tl data and viability. Of 214 dysfunctioning segments (135 a-/dyskinetic), viability was demonstrated in 115 (75 a-/dyskinetic). Both rest and redistribution 201Tl activity in these segments were significantly hi...
Nuclear Medicine Communications, 2003
Lymphatic mapping and sentinel lymph node (SLN) biopsy are becoming increasingly useful for the i... more Lymphatic mapping and sentinel lymph node (SLN) biopsy are becoming increasingly useful for the identification of tumour lymphatic spread in a wide variety of neoplasms, such as breast cancer and melanoma, reducing unnecessary radical lymph node resection. The aim of our study was to determine the feasibility of lymphatic mapping with both labelled colloid and patent blue violet in patients with early stage endometrial cancer. Sixteen consecutive patients with endometrial cancer, stage International Federation of Gynecology and Obstetrics (FIGO Ib), were included in the study. Lymphoscintigraphy and laparoscopically assisted intra-operative SLN detection were performed in all patients. In addition, to verify the prognostic role of this method, 12 of 16 patients were followed up for a period of at least 1 year. In 15 of 16 patients, 24 SLNs (all internal iliac lymph nodes) were detected at lymphoscintigraphy (six monolateral and nine bilateral). At histological analysis, three of the 24 were positive for micrometastases, whereas the remaining 21 were negative. No other surgically dissected lymph nodes presented metastases. At 1 year of follow-up, none of the 12 patients presented relapse of their disease. In conclusion, in endometrial cancer, both pre-operative lymphoscintigraphy and intra-operative gamma-probe detection of SLNs represent promising tools for the visualization of SLNs. The status of the latter may yield a correct representation of pelvic lymph node involvement, providing important information for further treatment.
Journal of Nuclear Cardiology, 2001
Journal of Nuclear Cardiology, 1998
Background. To overcome the relatively low accuracy of exercise stress testing (EST) in detecting... more Background. To overcome the relatively low accuracy of exercise stress testing (EST) in detecting coronary artery disease (CAD), both echocardiography and perfusion scintigraphy have been evaluated in conjunction with pharmacologic stress, but there is still uncertainty of the relative value of these tests as possible first-line examinations for suspected CAD. This study evaluated the accuracy of EST, dipyridamole and dobutamine stress echocardiography (DIP-ECHO, DOB-ECHO), and dipyridamole and dobutamine technetium 99m sestamibi tomography (DIP-MIBI, DOB-MIBI) for the detection of CAD in patients evaluated for the first time because of chest pain. Methods and results. Sixty patients underwent EST, DIP-ECHO, DOB-ECHO, DIP-MIBI, and DOB-MIBI. Echocardiographic images were acquired simultaneously with sestamibi injections, and the scintigraphic images were collected 1 hour later. Coronary angiography was performed within 15 days. Out of 33 patients with significant (>70%) coronary stenoses, 19 (58%) were correctly identified by EST, 18 (55%) by DIP-ECHO, 20 (61%) by DOB-ECHO, 32 (97%) by DIP-MIBI, and 30 (91%) by DOB-MIBI (p < 0.005 for MIBI vs EST and ECHO). The specificity of EST was 67% (p < 0.05 vs ECHO and MIBI), 96%, 96%, 89%, and 81%, respectively. Of the 62 stenotic coronary arteries, 20 (32%) were correctly identified by DIP-ECHO, 24 (39%) by DOB-ECHO, 48 (77%) by DIP-MIBI, and 45 (73%) by DOB-MIBI. The sensitivity of the imaging techniques in predicting the presence of multivessel disease was 14% and 29% for DIP and DOB-ECHO compared with 48% and 57% for DIP and DOB-MIBI. Conclusions. Our results confirm the limited reliability of EST in detecting CAD and the good diagnostic value of DIP and DOB-MIBI. Conversely, the lower sensitivity and the poorer capability to recognize multivessel CAD do not support the role of either DIP or DOB-ECHO as first-line examination for suspected CAD.
European Journal of Nuclear Medicine and Molecular Imaging, 1998
The significance of reverse redistribution on rest-redistribution thallium-201 myocardial scintig... more The significance of reverse redistribution on rest-redistribution thallium-201 myocardial scintigraphy is unclear. Previous studies suggested that reverse redistribution segments with normal resting activity include viable myocardium, whilst resting defects with further worsening correspond to scar. We evaluated whether reverse redistribution has an independent significance for the prediction of post-revascularization recovery, particularly as compared with the quantification of redistribution activity. We studied 26 coronary artery disease patients with left ventricular dysfunction, who underwent 201 Tl rest-redistribution single-photon emission tomography (SPET) and echocardiography before revascularization. Viability was defined by the detection of wall motion improvement on follow-up echocardiography. 201 Tl activity was considered normal if ≥80%, moderately reduced if <80% but ≥50%, and severely decreased if <50%. Reverse redistribution was defined as a defect in redistribution images with ≥10% decrease in relative 201 Tl activity compared with the resting value. Reverse redistribution was detected in 33 segments (10%). Baseline dysfunction was equally observed in the reverse redistribution and in the non-reverse redistribution segments (64% vs 56%, P=0.40) and the rate of asynergic segments with post-revascularization recovery was not different between the two groups (33% vs 54%, P=0.11). The rate of functional recovery in redistribution defects without reverse redistribution was 53% in moderate and 30% in severe defects; the corresponding values for the reverse redistribution segments were 50% and 27% (all non-significant versus non-reverse redistribution segments). For the prediction of post-revascularization recovery in asynergic segments, the detection of reverse redistribution on rest-redistribution 201 Tl SPET does not add any information to the quantitative analysis of redistribution activity.
The American Journal of Cardiology, 2002
A main goal of revascularization in patients with chronic ischemic cardiomyopathy is to improve g... more A main goal of revascularization in patients with chronic ischemic cardiomyopathy is to improve global left ventricular (LV) function. This study aimed to verify whether it is possible to predict an increase in LV ejection fraction (EF) after revascularization on the basis of the extent of LV asynergy, myocardial viability, and revascularization completeness. We studied 77 patients with chronic LV ischemic dysfunction using baseline resting and nitrateenhanced technetium-99m sestamibi single-photon emission computed tomography. Regional wall motion and global LVEF were assessed with echocardiography before and after revascularization, which was complete in 51 patients and incomplete in 26. The number of viable asynergic segments included in revascularized coronary artery territories was the strongest predictor of significant (>5 EF U) functional improvement in univariate discriminant analysis. According to multivariate stepwise discriminant analysis, this parameter, together with the number of baseline asynergic segments, allowed the detection of patients with significant LVEF improvement with 75% accuracy. With use of a multivariate regression model, including the 2 mentioned variables, the measure of postrevascularization LVEF increase could be accurately quantified (R 2 0.43, p <0.000001). In conclusion, this study suggests that the severity of baseline asynergy, the extent of myocardial viability, and the completeness of revascularization are the main determinants of postrevascularization functional recovery in patients with LV ischemic dysfunction, and that on the basis of these variables it is possible to predict the measure of LVEF increase. ᮊ2002 by Excerpta Medica, Inc.
International Journal of Radiation Oncology*Biology*Physics, 2013
To investigate the role of radiation therapy (RT) in patients affected with primary mediastinal B... more To investigate the role of radiation therapy (RT) in patients affected with primary mediastinal B-cell lymphoma (PMBCL) with residual 18 fluorodeoxyglucose positron emission tomography (18 FDG-PET)-positive disease after rituximab chemotherapy (R-CT).
Blood, 2012
Role of interim-PET (I-PET) in diffuse large B-cell Lymphoma (DLBCL) is controversial. To determi... more Role of interim-PET (I-PET) in diffuse large B-cell Lymphoma (DLBCL) is controversial. To determine predictive value of I-PET on progression-free survival (PFS), we enrolled 88 first-line DLBCL patients treated with 6-8 R-CHOP courses regardless of I-PET. PET/CT were performed at diagnosis, after 2 to 4 courses and at the end of therapy with central reviewing according to visual dichotomous criteria. Results are as follows: I-PET, 72% negative, 28% positive; final-PET (F-PET), 88% negative, 12% positive; clinical complete response 90%. Concordance between clinical response and F-PET negativity was 97% because of 2 false positive. With a median follow-up of 26.2 months, 2-year overall survival and PFS were 91% and 77%, respectively. Two-year PFS for I-PET and F-PET negative versus positive were as follows: I-PET 85% versus 72% (P = .0475); F-PET 83% versus 64% (P < .001). Because of a small number of events, 2 independent bivariate Cox models were tested for PFS. In model 1, F-PET...
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1997
The aim of this study was to assess the value of the cavity-to-myocardium count ratio (C/M ratio)... more The aim of this study was to assess the value of the cavity-to-myocardium count ratio (C/M ratio) calculated in resting 99mTc-sestamibi SPECT images to identify patients with depressed left ventricular ejection fraction (LVEF). In the 95 patients studied, the C/M ratio was calculated from the midventricular short-axis slice using regions of interest drawn in the center of the cavity and in the most active area of the ventricular wall; its value was compared with LVEF measured using two-dimensional echocardiography. The C/M ratio correlated with LVEF (r = 0.6, p < 0.000001) and was significantly lower in patients with abnormal LVEF than those with normal LVEF: 0.026 +/- 0.028 versus 0.125 +/- 0.093, p < 0.000001. In the entire patient population, a C/M ratio < 0.07 identified the patients with depressed LVEF with a 94% sensitivity, 71% specificity and 82% accuracy. The resting 99mTc-sestamibi C/M ratio is a useful parameter in identifying patients with depressed LVEF directl...
The Quarterly Journal of Nuclear Medicine and Molecular Imaging, 2018
En este artículo se presenta un protocolo de difusión de mensajes de seguridad para emergencia qu... more En este artículo se presenta un protocolo de difusión de mensajes de seguridad para emergencia que utiliza una adaptación dinámica del tiempo de retraso en el entorno de una red vehicular cognitiva. El escenario que se estudia considera la compartición del espectro entre la banda para comunicaciones vehiculares y la banda de la televisión digital con el objetivo de mitigar los efectos de la tormenta de difusión en una red vehicular. Dos de las técnicas de mitigación de la tormenta de difusión más utilizadas en la literatura son comparadas contra el protocolo propuesto en términos de las probabilidades de accesibilidad de los mensajes de emergencia y de la ocupación del canal. Los resultados numéricos muestran que el protocolo con la adaptación dinámica del tiempo presenta un mejor desempeño en condiciones de alta densidad de vehículos, lo cual es característico de un escenario de tormenta de difusión. Palabras clave: Sistemas de transporte y vehículos, tecnología inalámbrica y dispositivo móviles, seguridad y mensajes de emergencia, tormenta de difusión, compartición de espectro Dynamic Adaptation of Delayed Time of Diffusion of Emergency Messages in Cognitive Vehicular Networks
Journal of Nuclear Cardiology, 1996
Background. This study aimed to verify whether the assessment of defect severity and the infusion... more Background. This study aimed to verify whether the assessment of defect severity and the infusion of nitrates during tracer injection improve the capability of data-based ~gmTc-labeled sestamibi single-photon emission computed tomography (SPECT) to recognize hibernating myocardium. Methods and Results. Of 66 asynergic coronary territories in 40 patients with left ventricular dysfunction, 28 had postrevascularization functional recovery (hibernating) and 38 had unchanged dysfunction (fibrotic). Defect severity was lower in the hibernating than in the fibrotic territories on both baseline (p < 0.01) and nitrate SPECT (p < 0.002). Nitrate was superior to baseline SPECT to differentiate the hibernating from the fibrotic territories (sensitivity 96% vs 75%, p < 0.05; receiver-operating characteristic curve area 0.75 vs 0.63, p < 0.001) and to identify the patients with improved left ventricular ejection fraction (receiveroperating characteristic curve area 0.68 vs 0.58; p < 0.05). Conclusions. The analysis of defect severity in combination with nitrate infusion clearly improves the value of 9~mTc-labeled sestamibi SPECT for the recognition of hibernating myocardium and the prediction of postrevascularization recovery.
Growth hormone (GH) secretagogues (GHS) are synthetic peptidyl and non-peptidyl molecules which p... more Growth hormone (GH) secretagogues (GHS) are synthetic peptidyl and non-peptidyl molecules which possess strong, dose-dependent and reproducible GH releasing effects as well as significant prolactin (PRL) and adrenocorticotropic hormone (ACTH) releasing effects. The neuroendocrine activities of GHS are mediated by specific receptors mainly present at the pituitary and hypothalamic level but also elsewhere in the central nervous system. GHS release GH via actions at the pituitary and (mainly) the hypothalamic level, probably acting on GH releasing hormone (GHRH) secreting neurons and/or as functional somatostatin antagonists. GHS release more GH than GHRH and the coadministration of these peptides has a synergistic effect but these effects need the integrity of the hypothalamo-pituitary unit. The GH releasing effect of GHS is generally gender-independent and undergoes marked age-related variations reflecting age-related changes in the neural control of anterior pituitary function. The PRL releasing activity of GHS probably comes from direct pituitary action, which indeed is slight and independent of both age and gender. The acute stimulatory effect of GHS on ACTH/cortisol secretion is similar to that of corticotropin releasing hormone (CRH) and arginine vasopressin (AVP). In physiological conditions, the ACTH releasing activity of GHS is mediated by central mechanisms, at least partially, independent of both CRH and AVP but probably involving GABAergic mechanisms. The ACTH releasing activity of GHS is gender-independent and undergoes peculiar age-related variations showing a trend towards increase in ageing. GHS possess specific receptors also at the peripheral levels in endocrine and non-endocrine human tissues. Cardiac receptors are specific for peptidyl GHS and probably mediate GH-independent cardiotropic activities both in animals and in humans.
UNLABELLED The aim of this study was to evaluate the diagnostic value, in suspected infectious pr... more UNLABELLED The aim of this study was to evaluate the diagnostic value, in suspected infectious prostheses, of (99m)Tc-labeled hexamethylpropyleneamine oxime ((99m)Tc-HMPAO) leukocyte scintigraphy interpreted with the addition of a semiquantitative analysis. METHODS By means of a retrospective review, we included a group of 78 consecutive patients with suspected hip or knee prosthesis infection. We performed 91 (99m)Tc-HMPAO-leukocyte scintigraphies and examined 95 localizations that were suspect. Images were acquired at 3 different time points after the injection of the labeled leukocytes: 50 min (early images), 4 h, and 24 h (late images). The scintigraphic examinations were independently evaluated by 3 observers; qualitative and semiquantitative analyses were performed. The final diagnosis of infection was based on surgical, histologic, and bacteriologic data and follow-up. RESULTS On qualitative analysis, sensitivity, specificity, and accuracy were 80.4%-87%, 65.3%-71.4%, and 75....
La Radiologia …, 2008
The aim of this study was to evaluate the role of [ 18 F]fluorodeoxyglucose positron emission tom... more The aim of this study was to evaluate the role of [ 18 F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the staging of Hodgkin's and aggressive non-Hodgkin's lymphoma (HL and NHL), comparing it with conventional diagnostic methods, i.e. contrast-enhanced CT and bone marrow biopsy. Materials and methods. Sixty-five consecutive patients (30 HL and 35 NHL) who underwent conventional disease staging and FDG-PET/CT were included. Concordance between conventional methods and PET was established when both procedures identified the same disease stage. Discordant findings were investigated further by using other diagnostic techniques (ultrasonography or magnetic resonance imaging) and/or clinical follow-up. Results. PET correctly staged 93.8% of enrolled patients (61/65), whereas conventional techniques correctly staged 89.2% (58/65; p=NS, χ 2 test). There was complete concordance in 54/65 patients (83.1%); among the remaining 11 cases, PET upstaged eight patients (seven true positive and one false positive), and downstaged three (all false negative). In 5/65 patients, chemotherapy treatment was modified on the basis of PET findings. Riassunto Obiettivo. Scopo di questo studio è stato quello di valutare il ruolo dell'esame PET/TC total body con 18 F-fluorodesossiglucosio (FDG-PET/TC) nella stadiazione dei linfomi di Hodgkin (LH) e non-Hodgkin aggressivi (NHL), confrontandolo con le tecniche convenzionali di stadiazione (TC con mezzo di contrasto e biopsia osteo-midollare). Materiali e metodi. Sono stati inclusi 65 pazienti consecutivi (30 LH e 35 NHL) che hanno eseguito stadiazione convenzionale e FDG-PET/TC. Le due procedure sono state definite concordanti quando entrambe hanno identificato il medesimo stadio di malattia; in caso di discordanza sono state eseguiti altri esami (ecografia o risonanza magnetica) e/o follow-up clinico. Risultati. L'esame PET ha consentito di stadiare correttamente 61/65 pazienti (93,8%), le metodiche convenzionali 58/65 (89,2%; p=ns, test χ 2). Nella stadiazione, entrambe le tecniche risultavano concordare in 54/65 casi (83,1%); nei restanti 11 casi, l'esame PET ha determinato una sovrastadiazione in 8 pazienti (7 veri positivi ed 1 falso positivo) e una sotto-stadiazione in 3 casi (tutti falsi negativi). Sulla base dei risultati PET il trattamento chemioterapico è stato modificato in 5 pazienti. Conclusioni. I nostri dati confermano l'elevata accuratezza NEURORADIOLOGY NEURORADIOLOGIA
Endocrine
Purpose Aim of our study was to search for variables associated with worse outcomes in patients t... more Purpose Aim of our study was to search for variables associated with worse outcomes in patients treated with radioactive iodine (RAI) for hyperthyroidism by a dosimetric-based approach. Methods Four hundred twenty-four patients with hyperthyroidism related to Toxic Multinodular Goiter (TMG; n = 213), Grave’s disease (GD; n = 150) and toxic adenoma (TA; n = 61) treated with RAI between 2000 and 2018 and with at least 12 months follow-up were retrospectively evaluated. Association between outcomes (response vs. no response) at 6 and 12 months and baseline TSH values, anti-thyroid drugs (ATD) duration and posology, RAI absorbed dose and dimensional reduction of target mass at ultrasound was evaluated by Mann–Whitney test. Risk factors for response vs. no-response were analysed by binary logistic regression model. Results Overall response rate was 78.7 and 83% at 6 and 12 months, respectively. Both at 6 and 12 months higher TSH baseline values ( p < 0.001), lower ATD duration ( p = 0.004 and p = 0.043), lower ATD posology ( p = 0.014 and p = 0.005), and lower dose to target ( D T ) (327 vs. 373 Gy, p = 0.003) were associated to response. Longer ATD duration and higher ATD posology were independent risk factors for no response at 6 and 12 months in GD and TMG, with no response at 6 months in TA subgroups. Conclusions Low TSH levels, longer duration and higher posology of ATD were associated with worse response to RAI. These data confirm that RAI therapy should be considered earlier in patients’ management to allow better outcome and avoid ATD toxicity.
Clinical Imaging, 2009
a single injection was needed. Cortivazol provided superior results compared to dexamethasone. Co... more a single injection was needed. Cortivazol provided superior results compared to dexamethasone. Conclusion: CT-guided injections should be included in the therapeutic armamentarium after standard medical management, with cure as the goal.
European Journal of Heart Failure Supplements