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Nanni C.,Medicina Nucleare
Medecine Nucleaire | Year: 2017

Multiple myeloma is a plasma cell dyscrasia producing bone lytic lesions. In recent years, a wide spectrum of therapeutic approaches are available to treat the disease: an accurate therapy assessment has become, therefore, of utmost importance. In this field, imaging is becoming a cornerstone, especially in association to clinical parameters. Among imaging procedures, FDG PET/CT is recognized to provide reliable information, achieved in a very safe and fast procedure. Literature is producing very concordant results from different groups assessing the value of FDG PET/CT as a prognostic factor in general and in therapy assessment, but some issues remain regarding a standardization of image interpretation especially in borderline cases. So far, no data regarding nor other imaging compounds and the use of hybrid tomographs PET/MR are available to define therapy assessment in PET. © 2017 Elsevier Masson SAS.


Erini M.,Medicina Nucleare | Donner D.,Medicina Nucleare
Radiologia Medica | Year: 2013

Purpose: The aim of this retrospective study was to assess the performance of fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography ([18F]-FDG PET-CT) for diagnosing large-vessel vasculitis (LVV) for a subset of patients at increased risk of rheumatic/immune diseases, taking into account concurrent immunosuppressive therapy. Materials and methods: The study comprised 64 rheumatological referrals with suspected LVV; half of the patients were on immunosuppressive therapy at the time of examination. The final diagnosis of LVV was established in 31 patients. To evaluate vascular uptake, the nuclear medicine physician employed both a semiquantitative method based on standardised uptake value (SUV) determination and a qualitative method based on a visual score from 0 to 3 on the maximum intensity projection (MIP) reformats. Finally, a joint assessment was carried out between the nuclear medicine physician and the reporting radiologist, in which PET metabolic data were re-evaluated taking into account clinical data and baseline CT scans. McNemar's test was used to compare four types of analysis: semiquantitative (cutoff ≥2.4), qualitative with standard cutoff (grade ≥2), qualitative with reduced cutoff (grade ≥1) and joint. Results: Semiquantitative analysis (sensitivity 74.19%, specificity 78.78%, accuracy 76.56%) and qualitative analysis with standard cutoff (sensitivity 64.51%, specificity 84.84%, accuracy 75.00%) showed no statistical difference for the diagnosis of LVV, whereas qualitative analysis with lower cutoff (sensitivity 93.54%, specificity 75.75%, accuracy 84.37%) proved to be better than the other two. Joint analysis (sensitivity 93.54%, specificity 93.93%, accuracy 93.75%) introduced some corrective elements not present in the qualitative analysis with cutoff ≥1 and therefore increased specificity significantly. Conclusions: Interpretation of PET-CT should be individualised for each patient by taking into account clinical-radiological and metabolic data. To this end, cooperation between the nuclear medicine specialist and the radiologist is essential. © 2012 Springer-Verlag Italia.


Rubini G.,Medicina Nucleare | Antonica F.,Medicina Nucleare | Renna M.,Medicina Nucleare | Ferrari C.,Medicina Nucleare | And 4 more authors.
Recenti Progressi in Medicina | Year: 2012

Nuclear medicine images are difficult to interpret because they do not include anatomical details. The aim of this study was to obtain lymphoscintigrams with anatomical landmarks that could be easily interpreted by General Physicians. Traditional lymphoscintigrams were processed with Adobe© Photoshop® CS6 and converted into vector images created by Illustrator®. The combination with a silhouette vector improved image interpretation, without resulting in longer radiation exposure or acquisition times. © Il Pensiero Scientifico Editore.


Detti B.,Radioterapia | Scoccianti S.,Radioterapia | Franceschini D.,Radioterapia | Cipressi S.,Radioterapia | And 12 more authors.
Journal of Cancer Research and Clinical Oncology | Year: 2013

Aim: The purpose of this study was to evaluate the potential usefulness of [18F]-Choline PET/CT in the restaging of prostate cancer patients, who presented a rising PSA. Materials and methods: We evaluated 170 prostate cancer patients, previously radically treated, that were referred for restaging with [18F]-Choline PET/CT. Results: A total of 129 patients (median PSA 4.29 ng/ml at relapse) showed one or more areas of high uptake on PET/CT scan, while 41 patients with a median PSA of 1.07 ng/ml at relapse showed negative PET/CT scans. No false negative was found, while 31 patients were identified as false positive. Specificity of Choline PET/CT in our series was 56.9 %, while sensibility was 100 %. At the time of restaging, a PSA value superior or equal to 1 ng/ml was found to be a statistically significant predictive factor of PET positivity, either at the univariate (p < 0.0001) and at the multivariate analysis (p < 0.0001). Conclusions: Based on our findings, [18F]-Choline PET/CT is confirmed as a useful diagnostic tool to detect early recurrence, in patients with increasing PSA after primary treatment. However, in case of a mild increase in PSA, positive results must be validated with other techniques, as specificity and positive predictive value of [18F]-Choline PET/CT decrease with the lower values of PSA. © 2012 Springer-Verlag Berlin Heidelberg.


Nanni C.,UO Nuclear Medicine | Errani C.,Rizzoli Orthopaedic Institute | Boriani L.,Rizzoli Orthopaedic Institute | Fantini L.,UO Nuclear Medicine | And 7 more authors.
Journal of Nuclear Medicine | Year: 2010

The aim of this work was to preliminarily evaluate the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of 68Ga-citrate PET/CT in a population of patients with suspected bone infections. Methods: We enrolled 31 patients with suspected osteomyelitis or diskitis who underwent a total of forty 68Ga-citrate PET/CT scans. The results were compared with different combinations of diagnostic procedures (MRI, radiography, CT, or white blood cell scintigraphy), biopsy (when diagnostic), and follow-up data (at least 1 y) to determine the performance of 68Ga-citrate PET/CT. Results: We found a sensitivity of 100%, a specificity of 76%, a positive predictive value of 85%, a negative predictive value of 100%, and an overall accuracy of 90%. Conclusion: Although preliminary, these data confirm a possible role for 68Ga-citrate in the diagnosis of bone infections, especially in consideration of its favorable characteristics. Copyright © 2010 by the Society of Nuclear Medicine, Inc.


Rossi M.,Azienda Ospedaliera SantAndrea | Mallardo V.,Medicina Nucleare | Rosati I.,Medicina Nucleare | Prisco M.R.,Medicina Nucleare | And 5 more authors.
Recenti Progressi in Medicina | Year: 2013

Colo-rectal cancer is the most common malignancy of the gastrointestinal tract and is the third frequency for malignancy in humans. CT and MRI development allows an early diagnosis and a modulation of the therapeutic approach. Many papers seem to confirm the role of PET/CT and virtual colonography in the evaluation of primary lesions. The PET/CT appears mode accurate in assessing lymph node metastases. Today, new approaches such as virtual colonoscopy and PET/CT open new horizons in the diagnosis and staging of cancer of the colon and rectum.


Tiseo M.,Oncologia Medica | Ippolito M.,Medicina Nucleare | Scarlattei M.,Medicina Nucleare | Spadaro P.,Oncologia Medica | And 14 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2014

Background: [18F]fluorodeoxyglucose (FDG)-PET is being evaluated as a tool for the early detection of response to various targeted agents in solid tumors. The aim of this study was to evaluate the predictive value of PET response after 2 days of erlotinib in unselected pretrated patients with stage IV NSCLC. Patients and methods: FDG-PET/CT scans were conducted at baseline and after 2 days of erlotinib, with a CT evaluation performed at baseline and after 45-60 days of therapy. PET responses were evaluated by quantitative changes on SUVmax tumor/non-tumor ratio and classified according to EORTC criteria. PET responses were compared with RECIST responses and related to progression-free (PFS) and overall (OS) survival. Erlotinib effects on glucose uptake were also studied in a panel of NSCLC cell lines. Results: Fifty-three patients were enrolled. At 2 days of erlotinib, 20 (38 %) patients showed partial metabolic response (PMR), 25 (47 %) had stable metabolic disease (SMD) and 8 (15 %) had progressive metabolic disease (PMD). All patients with PMD had confirmed RECIST progression at 45-60 days. Patients with early PMR and SMD had significantly longer PFS (p < 0.001 and p = 0.001, respectively) and OS (p = 0.001 for both) than PMD patients. Conclusions: FDG-PET assessment after 2 days of erlotinib could be useful to identify early resistent patients and to predict survival in unselected NSCLC pretreated population. © 2013 Springer-Verlag.


Bengel F.,Hannover Medical School | Bonfiglioli R.,Medicina Nucleare | Fanti S.,Medicina Nucleare
European Journal of Nuclear Medicine and Molecular Imaging | Year: 2014

The 26th European Association of Nuclear Medicine (EANM) annual congress was held in Lyon, France, under the chairmanship of Professor Dominique LeGuludec. The congress was attended by more than 5,200 participants, with about one-quarter coming from outside Europe. This review summarizes the major scientific contributions which were selected from the more than 1,700 submitted abstracts, and presented in the closing highlights session. They covered the diverse areas of nuclear medicine, with particular focus on oncology, cardiovascular science and neurology. Various innovations were reported regarding imaging methodology, physics, radiopharmaceuticals and chemistry. Novel radionuclide applications in both diagnosis and therapy were investigated and described, triggering strong interest from the many professionals involved. Significant progress has been demonstrated in the clinical use of existing nuclear medicine procedures, and a number of new applications are under development in preclinical and early clinical stages. The congress was a unique opportunity to get a thorough update on this research. © 2014 Springer-Verlag.


PubMed | University of Michigan, Medicina Nucleare, University College London, Harvard University and Parthenope University of Naples
Type: | Journal: Abdominal radiology (New York) | Year: 2016

Hybrid PET/MR scanners are innovative imaging devices that simultaneously or sequentially acquire and fuse anatomical and functional data from magnetic resonance (MR) with metabolic information from positron emission tomography (PET) (Delso et al. in J Nucl Med 52:1914-1922, 2011; Zaidi et al. in Phys Med Biol 56:3091-3106, 2011). Hybrid PET/MR scanners have the potential to greatly impact not only on medical research but also, and more importantly, on patient management. Although their clinical applications are still under investigation, the increased worldwide availability of PET/MR scanners, and the growing published literature are important determinants in their rising utilization for primarily clinical applications. In this manuscript, we provide a summary of the physical features of PET/MR, including its limitations, which are most relevant to clinical PET/MR implementation and to interpretation. Thereafter, we discuss the most important current and emergent clinical applications of such hybrid technology in the abdomen and pelvis, both in the field of oncologic and non-oncologic imaging, and we provide, when possible, a comparison with clinically consolidated imaging techniques, like for example PET/CT.


PubMed | Medicina Nucleare
Type: Journal Article | Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine | Year: 2010

The aim of this work was to preliminarily evaluate the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of (68)Ga-citrate PET/CT in a population of patients with suspected bone infections.We enrolled 31 patients with suspected osteomyelitis or diskitis who underwent a total of forty (68)Ga-citrate PET/CT scans. The results were compared with different combinations of diagnostic procedures (MRI, radiography, CT, or white blood cell scintigraphy), biopsy (when diagnostic), and follow-up data (at least 1 y) to determine the performance of (68)Ga-citrate PET/CT.We found a sensitivity of 100%, a specificity of 76%, a positive predictive value of 85%, a negative predictive value of 100%, and an overall accuracy of 90%.Although preliminary, these data confirm a possible role for (68)Ga-citrate in the diagnosis of bone infections, especially in consideration of its favorable characteristics.

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