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Antonella FRANCESCHETTO

Ricercatore Universitario
Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto

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Pubblicazioni

2019 - The prognostic role of end of treatment FDG-PET-CT in patients with diffuse large B cell lymphoma can be improved by considering it with absolute monocyte count at diagnosis [Articolo su rivista]
Marcheselli, R.; Franceschetto, A.; Sacchi, S.; Bari, A.; Levy, I.; Pizzichini, P.; Prosperi, D.; D'Apollo, R.; Massi, L.; Casolo, A.; Pozzi, S.; Marcheselli, L.; Tadmor, T.; Prandini, N.; Cox, M. C.
abstract

It is well established that some patients with diffuse large B-cell lymphoma (DLBCL) and the negative end of treatment PET-CT (EOT-PET-CT) will relapse, while a proportion with positive uptake can still obtain long-term EFS. We reviewed data of 200 consecutive, previously untreated patients with DLBCL recorded in Italy and Israel between 2007 and 2015. We found that patients with negative EOT-PET-CT with AMC > 630/mmc have a 3-years EFS of 72%, compared to those with AMC ≤ 630/mmc that have an EFS of 84%. Furthermore, considering patients with positive EOT-PET-CT, those with AMC > 630/mmc have a 3-years EFS of 8%, while those with AMC ≤ 630/mmc have an EFS of 38%. Thus, it appears that combining the gold standard for response evaluation EOT-PET-CT with a simple and inexpensive parameter like AMC at diagnosis, further improves prognostication in DLBCL. Applying this simple method can be useful for all doctors working in lymphoma clinical practice.

2018 - Role of sentinel node in differentiated thyroid cancer: a prospective study comparing patent blue injection technique, lymphoscintigraphy and the combined technique [Articolo su rivista]
Gelmini, Roberta; Campanelli, Michela; Cabry, Fancesca; Franceschetto, Antonella; Ceresini, Graziano; Ruffini, Livia; Zaccaroni, Alberto; Del Rio, Paolo
abstract

Purpose The purpose of the present study was to evaluate the feasibility and reproducibility of the sentinel lymphnode (SLNs) biopsy in differentiated thyroid cancer using patent blue injection, lymphoscintigraphy and the combined techniques. Methods Between January 2011 and January 2013, 82 consecutive patients were enrolled in our prospective multicentre study. Inclusion criteria were 18 years of age, preoperative diagnosis of differentiated thyroid carcinoma, no evidence of lymph node enlargement and multifocal neoplasm. To investigate the benefits of each procedure, all patients underwent total thyroidectomy plus central compartment lymphadenectomy, and in all cases, the SLN was identified via one of three techniques using the same protocol. Results Lymphoscintigraphy was used in five patients, patent blue injection was used in 40 patients, and a combined technique was used in 40 patients to identify sentinel lymphnodes (SLN). SLNs were identified in 61 cases. In the patent blue injection technique, the sensitivity, specificity and false negative rates were 88.9, 94.4 and 3.8%, respectively. In the lymphoscintigraphy technique, the percentages of sensitivity and specificity were 100%, and the percentage false negative was 0%. For the combined techniques, the corresponding values were, respectively, 69.2, 90, and 17.4%. Metastases were detected in nine cases of lateral-cervical nodes, ipsilateral tumour metastases were observed in eight cases, and contralateral tumour metastasis was observed in one case. Conclusion Additional well-designed randomized studies are needed to validate and further optimize the SLN biopsy in patients with differentiated thyroid cancer.

2016 - Adapted treatment guided by interim PET-CT scan in advanced Hodgkin's lymphoma [Articolo su rivista]
Johnson, Peter; Federico, Massimo; Kirkwood, Amy; Fosså, Alexander; Berkahn, Leanne; Carella, Angelo; D'Amore, Francesco; Enblad, Gunilla; Franceschetto, Antonella; Fulham, Michael; Luminari, Stefano; O'Doherty, Michael; Patrick, Pip; Roberts, Thomas; Sidra, Gamal; Stevens, Lindsey; Smith, Paul; Trotman, Judith; Viney, Zaid; Radford, John; Barrington, Sally
abstract

BACKGROUND: We tested interim positron-emission tomography-computed tomography (PET-CT) as a measure of early response to chemotherapy in order to guide treatment for patients with advanced Hodgkin's lymphoma. METHODS: Patients with newly diagnosed advanced classic Hodgkin's lymphoma underwent a baseline PETCT scan, received two cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy, and then underwent an interim PET-CT scan. Images were centrally reviewed with the use of a 5-point scale for PET findings. Patients with negative PET findings after two cycles were randomly assigned to continue ABVD (ABVD group) or omit bleomycin (AVD group) in cycles 3 through 6. Those with positive PET findings after two cycles received BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone). Radiotherapy was not recommended for patients with negative findings on interim scans. The primary outcome was the difference in the 3-year progression-free survival rate between randomized groups, a noninferiority comparison to exclude a difference of 5 or more percentage points. RESULTS: A total of 1214 patients were registered; 937 of the 1119 patients (83.7%) who underwent an interim PET-CT scan according to protocol had negative findings. With a median follow-up of 41 months, the 3-year progression-free survival rate and overall survival rate in the ABVD group were 85.7% (95% confidence interval [CI], 82.1 to 88.6) and 97.2% (95% CI, 95.1 to 98.4), respectively; the corresponding rates in the AVD group were 84.4% (95% CI, 80.7 to 87.5) and 97.6% (95% CI, 95.6 to 98.7). The absolute difference in the 3-year progression-free survival rate (ABVD minus AVD) was 1.6 percentage points (95% CI, -3.2 to 5.3). Respiratory adverse events were more severe in the ABVD group than in the AVD group. BEACOPP was given to the 172 patients with positive findings on the interim scan, and 74.4% had negative findings on a third PET-CT scan; the 3-year progression-free survival rate was 67.5% and the overall survival rate 87.8%. A total of 62 patients died during the trial (24 from Hodgkin's lymphoma), for a 3-year progression-free survival rate of 82.6% and an overall survival rate of 95.8%. CONCLUSIONS: Although the results fall just short of the specified noninferiority margin, the omission of bleomycin from the ABVD regimen after negative findings on interim PET resulted in a lower incidence of pulmonary toxic effects than with continued ABVD but not significantly lower efficacy.

2016 - PET-CT for staging and early response: Results from the Response-Adapted Therapy in Advanced Hodgkin Lymphoma study [Articolo su rivista]
Barrington, Sally F; Kirkwood, Amy A.; Franceschetto, Antonella; Fulham, Michael J.; Roberts, Thomas H.; Almquist, Helén; Brun, Eva; Hjorthaug, Karin; Viney, Zaid N.; Pike, Lucy C.; Federico, Massimo; Luminari, Stefano; Radford, John; Trotman, Judith; Fosså, Alexander; Berkahn, Leanne; Molin, Daniel; D'Amore, Francesco; Sinclair, Donald A.; Smith, Paul; O'Doherty, Michael J.; Stevens, Lindsey; Johnson, Peter W.
abstract

International guidelines recommend that positron emission tomography-computed tomography (PET-CT) should replace CT in Hodgkin lymphoma (HL). The aims of this study were to compare PET-CT with CT for staging and measure agreement between expert and local readers, using a 5-point scale (Deauville criteria), to adapt treatment in a clinical trial: Response-Adapted Therapy in Advanced Hodgkin Lymphoma (RATHL). Patients were staged using clinical assessment, CT, and bone marrow biopsy (RATHL stage). PET-CT was performed at baseline (PET0) and after 2 chemotherapy cycles (PET2) in a response-adapted design.PET-CTwasreported centrally by experts at 5 national core laboratories. Local readers optionally scored PET2scans. TheRATHLand PET-CT stages were compared. Agreement among experts and between expert and local readers was measured. RATHL and PET0 stage were concordant in 938 (80%) patients. PET-CT upstaged 159 (14%) and downstaged 74 (6%) patients. Upstaging by extranodal disease in bone marrow (92), lung (11), or multiple sites (12) on PET-CT accounted for most discrepancies. Follow-up of discrepant findings confirmed the PET characterization of lesions in the vast majority. Five patients were upstaged by marrow biopsy and 7 by contrast-enhanced CT in the bowel and/or liver or spleen. PET2 agreement among experts (140 scans) with a k (95% confidence interval) of 0.84 (0.76-0.91) was very good and between experts and local readers (300 scans) at 0.77 (0.68-0.86) was good. These results confirm PET-CT as the modern standard for staging HL and that response assessment using Deauville criteria is robust, enabling translation of RATHL results into clinical practice.

2016 - Primary sarcomatoid carcinoma of the lung: radiometabolic (18F-FDG PET/CT) findings and correlations with clinico-pathological and survival results [Articolo su rivista]
Rapicetta, Christian; Lococo, Filippo; Stefani, Alessandro; Rossi, Giulio; Richetti, Tommaso; Filice, A; Franceschetto, Antonella; Treglia, G; Paci, Massimiliano
abstract

Introduction: Pulmonary sarcomatoid carcinoma (PSC) is a very rare and uninvestigated subtype of non-small cell lung cancer (NSCLC). Methods: The aims of this study were to define the radiometabolic features (by 18F-FDG PET/CT) in a bi-centric cohort of 49 PSC patients and to explore their relation with clinico-pathological characteristics and long-term survival results after surgical treatment. Results: There were 40 males and 9 females aged 65.2 ± 10.47 years. Overall long-term survival was 26.7 % at 5 years. Mean and median values of SUVmax were 15.21 and 15, respectively (SD ±5.5). Performing an age-, gender- and staging-matched analysis comparing PSC Stage-I only with a cohort of Stage-I NSCLC (n = 93), we observed significantly higher SUVmax values in PSC group (15.11 vs 7.66, p = 0.001). Conclusions: No differences in terms of SUVmax were found with regard to tumour dimensions, histology (pure vs mixed, pleomorphic vs others), pathological stage and pattern of recurrence. P-stage, surgical radicality, vascular/lymphatic invasion but not SUVmax affected long-term survival in PSC

2014 - Prognostic value of PET-CT after first-line therapy in patients with follicular lymphoma: a pooled analysis of central scan review in three multicentre studies [Articolo su rivista]
Trotman, J.; Luminari, Stefano; Boussetta, S.; Versari, A.; Dupuis, J.; Tychyl, C.; Marcheselli, Luigi; Berriolo Riedinger, A.; Franceschetto, Antonella; Julian, A.; Ricard, F.; Guerra, L.; Haioun, C.; Biasoli, I.; Tilly, H.; Federico, Massimo; Salles, G.; Meignan, M.
abstract

Background The value of 18F-fluorodeoxyglucose (FDG) PET-CT (PET) imaging in response assessment after first-line rituximab chemotherapy for follicular lymphoma has been documented. We analysed the application of the five-point Deauville scale (5PS; used to score FDG uptake on PET images) in a large cohort derived from three studies, to assess the correlation between post-induction PET status and survival in patients with follicular lymphoma. Methods In this pooled analysis, we used data from three multicentre prospective studies of first-line rituximab chemotherapy for patients with high-tumour-burden follicular lymphoma (the PRIMA study, the PET-Folliculaire study, and the Fondazione Italiana Linfomi FOLL05 study). Patients included in this analysis received at least six cycles of rituximab and chemotherapy before response assessment with conventional contrast-enhanced CT and PET low-dose CT (PET). We included only patients who had a PET scan within 3 months of the last dose of induction rituximab. Patient data, including conventional CT-based response assessment, were recorded for all patients undergoing PET review. Scans undergoing central PET review were scored independently by three reviewers according to the 5PS. The primary endpoints were progression-free survival and overall survival according to the 5PS score of post-induction PET scan (ie, positive [≥4 points] or negative [<4 points]), analysed in the central review population. Findings Between Dec 24, 2004, and Sept 22, 2010, 439 of the patients enrolled in the three studies underwent local PET assessment, 246 of whom had centrally reviewed post-induction scans. 41 (17%) of 246 patients had a positive post-induction PET scan according to a cutoff of 4 or higher on the 5PS, with substantial reporter concordance. With a median follow-up of 54·8 months (IQR 39·7–68·5; range 7·7–90·1), the hazard ratio (HR) for progression-free survival for patients with a positive PET scan versus those with a negative PET scan was 3·9 (95% CI 2·5–5·9; p<0·0001), and for overall survival was 6·7 (2·4–18·5; p=0·0002). For patients with a positive PET scan, 23·2% (95% CI 11·1–37·9) of patients were progression free at 4 years compared with 63·4% (55·9–70·0) of those who had a negative PET scan (p<0·0001); 4-year overall survival was 87·2% (95% CI 71·9–94·5) versus 97·1% (93·2–98·8), respectively (p<0·0001). Conventional CT-based response (ie, complete response or unconfirmed complete response vs partial response) was weakly predictive of progression-free survival (HR 1·7 [95% CI 1·1–2·5]; p=0·017). Interpretation PET-CT rather than contrast-enhanced CT scanning should be considered as a new standard for response assessment of follicular lymphoma in clinical practice, and could help guide response-adapted therapy. Funding Groupe d'Etude des Lymphomes de l'Adulte (Paris, France), now LYSA (Lymphoma Study Association), Direction de la Recherche Clinique de l'Assistance Publique–Hôpitaux de Paris, Fondazione Italiana Linfomi, and the Italian Ministry of Health.

2014 - The natural history of HIV-associated lipodystrophy in the changing scenario of HIV infection [Articolo su rivista]
Guaraldi, Giovanni; Stentarelli, Chiara; Zona, Stefano; A., Santoro; Beghetto, Barbara; Carli, Federica; Orlando, Gabriella; Franceschetto, Antonella; A., Casolo; Mussini, Cristina
abstract

Objectives: In long-term HIV-infected patients, peripheral lipoatrophy (LA) and central lipohypertrophy (LH) appear to be related to the same insults (virus and antiretroviral drugs), but are likely to be associated with different fat depot physiologies. The objective of this study was to describe the natural history of lipodystrophy assessed using dual energy X-ray absorptiometry (DEXA) and computed tomography (CT) in a large HIV out-patients metabolic clinic. Methods: An observational retrospective study was carried out including HIV-infected patients recruited at the Metabolic Clinic of Modena, Modena, Italy, who were assessed for lipodystrophy and had at least two anthropometric evaluations using DEXA for leg fat per cent mass and abdominal CT for visceral adipose tissue (VAT). Factors associated with leg fat per cent and VAT changes were analysed using multivariable generalized estimating equation (GEE) regression models. Results: A total of 6789 DEXAs and 7566 CT scans were evaluated in the observation period. A total of 1840 patients were included; the mean age was 45.2±7.2 (standard deviation) years, 621 (34%) were women, and the median HIV infection duration was 176 (interquartile range 121-232) years. According to the GEE multivariable regression analysis, leg fat per cent evaluated with DEXA appeared to increase over calendar years (ß=0.92; P<0.001); moreover, a progressive increase in VAT was observed in the cohort (ß=5.69; P<0.001). No association with antiretroviral drugs was found. Conclusions: In our study, neither LA nor LH appeared to be associated with antiretroviral drug exposure. We observed a progressive increase in LH in HIV-infected patients over calendar years. This anthropometric change, together with loss of appendicular lean mass, could describe a physiological aging process in HIV-infected patients.

2014 - The prognostic role of post-induction FDG-PET in patients with follicular lymphoma: a subset analysis from the FOLL05 trial of the Fondazione Italiana Linfomi (FIL) [Articolo su rivista]
Luminari, Stefano; Biasoli, I.; Versari, A.; Rattotti, S.; Battelli, C.; Rusconi, C.; Merli, F.; Spina, M.; Ferreri, A. J.; Zinzani, P. L.; Gallamini, A.; Franceschetto, Antonella; Boccomini, C.; Franceschetti, S.; Salvi, F.; Raimondo, F. D.; Carella, A. M.; Quaresima, Micol; Balzarotti, M.; Musto, P.; Federico, Massimo
abstract

BACKGROUND: [18F]fluorodeoxyglucose-positron emission tomography (PET) is emerging as a strong diagnostic and prognostic tool in follicular lymphoma (FL) patients. PATIENTS AND METHODS: In a subset analysis of the FOLL05 trial (NCT00774826), we investigated the prognostic role of post-induction PET (PI-PET) scan. Patients were eligible to this study if they had a PI-PET scan carried out within 3 months from the end of induction immunochemotherapy. Progression-free survival (PFS) was the primary study end point. RESULTS: A total of 202 patients were eligible and analysed for this study. The median age was 55 years (range 33-75). Overall, PI-PET was defined as positive in 49 (24%) patients. Conventional response assessment with CT scan was substantially modified by PET: 15% (22/145) of patients considered as having a complete response (CR) after CT were considered as having partial response (PR) after PI-PET and 53% (30/57) patients considered as having a PR after CT were considered as a CR after PI-PET. With a median follow-up of 34 months, the 3-year PFS was 66% and 35%, respectively, for patients with negative and positive PI-PET (P<0.001). At multivariate analysis, PI-PET (hazard ratio 2.57, 95% confidence interval 1.52-4.34, P<0.001) was independent of conventional response, FLIPI and treatment arm. Also, the prognostic role of PI-PET was maintained within each FLIPI risk group. CONCLUSIONS: In FL patients, PI-PET substantially modifies response assessment and is strongly predictive for the risk of progression. PET should be considered in further updates of response criteria.

2014 - Utilità della FDG-PET/TC nella diagnosi dei carcinoidi polmonari [Abstract in Atti di Convegno]
Stefani, Alessandro; Franceschetto, Antonella; Nesci, Jessica; Aramini, Beatrice; Proli, Chiara; Kaleci, Shaniko; Casolo, Lucia; Massi, Lucia; Casali, Christian; Morandi, Uliano
abstract

Scopo del lavoro I carcinoidi polmonari entrano nella diagnosi differenziale dei noduli polmonari solitari (NPS). I carcinoidi sono tradizionalmente considerati come tumori PET negativi, anche se studi più recenti hanno evidenziato una certa sensibilità della FDG-PET/TC per la diagnosi di queste neoplasie. Lo scopo di questo studio è di determinare l’utilità della PET/TC nella valutazione dei NPS sospetti per carcinoide. Materiali e metodi Si tratta di uno studio retrospettivo eseguito su tutti i pazienti sottoposti ad exeresi chirurgica di carcinoide e precedente FDG-PET/TC dal 2006 al 2012. L’esame PET/TC è stato eseguito con la stessa macchina e la stessa tecnica in tutti i casi. Sono state analizzate le seguenti variabili: età, sesso, aspetti TC (lato, sede, dimensioni, forma, margini), SUVmax, tipo di intervento, aspetti patologici (dimensioni, numero di mitosi). Riguardo alla valutazione PET, è stato considerato soltanto il SUVmax e non la valutazione qualitativa. I carcinoidi sono stati classificati come tipici o atipici e periferici o centrali. E’ stato registrato anche il follow-up a distanza. Il SUVmax è stato confrontato con tutte le altre variabili cliniche, radiologiche e patologiche, al fine di evidenziare eventuali associazioni o differenze. Risultati Sono stati recuperati 25 pazienti. Si è trattato di 24 forme tipiche e un carcinoide atipico, 21 periferici e 4 centrali. Il diametro medio alla TC è stato di 25.3mm e il dato correlava con le dimensioni patologiche. 60% dei tumori avevano forma ovalare e il 68% margini lisci. Il SUVmax medio è stato 3.6 (range 1.4-12.9). Tutte le lesioni sono state asportate in modo radicale. L’analisi di regressione lineare ha evidenziato una associazione diretta tra il SUVmax e le dimensioni (p=0.004), mentre nessun’altra correlazione è stata ritrovata tra il SUVmax e le altre variabili. Nessun paziente ha presentato recidiva o è morto durante il follow-up. Conclusioni Questo studio dimostra che la FDG-PET/TC è utile nella valutazione del NPS sospetto per carcinoide. E’ necessario utilizzare il SUVmax e non la valutazione qualitativa e il confronto deve essere eseguito con il resto del polmone e non con la captazione mediastinica, come usualmente nell’interpretazione della captazione FDG. Quando un NPS si presenta con forma ovoidale/rotonda e margini lisci alla TC e mostra una captazione alla FDG-PET superiore a quella del polmone circostante, con un SUVmax>1-1.5, in questo caso è elevato il sospetto di carcinoide. Pertanto, se si può ragionevolmente escludere una lesione benigna, si raccomanda la resezione chirurgica o almeno una biopsia della lesione.

2013 - Integrated FDG-PET/CT imaging is useful in the apporach to carcinoid tumors of the lung [Articolo su rivista]
Stefani, Alessandro; Franceschetto, Antonella; Nesci, Jessica; Aramini, Beatrice; Proli, Chiara; Kaleci, Shaniko; Casolo, Alessandra; Massi, Lucia; Casali, Christian; Morandi, Uliano
abstract

Background. Carcinoids enter the differential diagnosis of the solitary pulmonary nodule. Bronchial carcinoids have been traditionally considered as FDG-PET negative but recent studies have found an higher sensitivity of integrated FDG-PET/CT for the detection of these neoplasms. The purpose of this study was to investigate the value of integrated FDG-PET/CT for the evaluation of SPN suspected to be carcinoids. Methods. All patients with pathologically proven bronchial carcinoids who had FDG-PET/CT scans between 2006 and 2012 have been retrospectively reviewed. PET/CT was performed with the same scanner and the same technique for all patients. The following data were retrieved: age, sex CT findings (side, location, size, shape, margins), SUVmax, type of operation, pathological findings (size and number of mitoses). Regarding PET findings, only SUVmax was considered, whereas the visual assessment was not undertaken. Carcinoids were defined as typical and atypical and as central and peripheral. The long-term follow-up was also recorded. The SUVmax was compared with the other clinical, radiological and pathological variables to find any significant difference or correlation. Results. Twenty-five patients were retrieved, 24 typical and one atypical carcinoid, 21 peripheral and 4 central lesions. The mean diameter on CT-scan was 25.3mm and the clinical size correlated well with the pathological size. Fifty-six percent of the tumors were ovoid and 68% had smooth margins. The mean SUVmax was 3.6 (range 1.4-12.9). All the lesions were completely resected. The regression analysis showed a direct correlation between the SUVmax and the tumor size (p=0.004). No further correlations were found between the SUVmax and the other variables. None of the patients had recurrent disease or died during the follow-up. Conclusions. Our study showed that FDG-PET/CT might be a useful tool in the evaluation of SPNs suspected to be bronchial carcinoids. When a solitary pulmonary nodule shows an ovoid/round shape and smooth margins on the CT scan and demonstrates an FDG uptake higher than that of the normal lung and with a SUVmax value >1-1.5, a carcinoid should be suspected. If benign lesions can be presumably excluded, surgical resection or at least a biopsy of the lesion is recommended.

2010 - Concordance between four European centre of PET reporting criteria designed for use in multicentre trials in Hodgkin lymphoma. [Articolo su rivista]
Barrington, S. F.; Qian, W.; Somer, E. J.; Franceschetto, Antonella; Bagni, Bruno; Brun, E.; Almquist, H.; Loft, A.; Hojgaard, L.; Federico, Massimo; Gallamini, A.; Smith, P.; Johnson, P.; O'Doherty, M. J.
abstract

PURPOSE: To determine if PET reporting criteria for the Response Adapted Treatment in Hodgkin Lymphoma (RATHL) trial could enable satisfactory agreement to be reached between 'core' laboratories operating in different countries.METHODS: Four centres reported scans from 50 patients with stage II-IV HL, acquired before and after two cycles of Adriamycin/bleomycin/vinblastine/dacarbazine. A five-point scale was used to score response scans using 'normal' mediastinum and liver as reference levels. Centres read scans independently of each other. The level of agreement between centres was determined assuming (1) that uptake in sites involved at diagnosis that was higher than liver uptake represented disease (conservative reading), and (2) that uptake in sites involved at diagnosis that was higher than mediastinal uptake represented disease (sensitive reading).RESULTS: There was agreement that the response scan was 'positive' or 'negative' for lymphoma in 44 patients with a conservative reading and in 41 patients with a sensitive reading. Kappa was 0.85 (95% CI 0.74-0.96) for conservative reading and 0.79 (95% CI 0.67-0.90) for sensitive reading. Agreement was reached in 46 and 44 patients after discussion for the conservative and sensitive readings, respectively.CONCLUSION: The criteria developed for reporting in the RATHL trial are sufficiently robust to be used in a multicentre setting.

2009 - Concordance between four European Centres of PET reporting criteria designed for use in multicentre trials in Hodgkin Lymphoma [Abstract in Atti di Convegno]
S. F., Barrington; W., Qian; E. J., Somer; Franceschetto, Antonella; Bagni, Bruno; E., Brun; H., Almquist; A., Loft; L., Hojgaard; Federico, Massimo; A., Gallamini; P., Smith; P., Johnson; J., Radford; M. J., O'Doherty
abstract

The criteria developed for interpretation of PET scans in the RATHL study are sufficiently robust to be used in a multicentre setting. Continued audit will be required to ensure consistency in reporting is maintained. The criteria could be adapted to change the threshold for "positivity" according to the clinical research context.

2008 - PET features [Capitolo/Saggio]
Bagni, Bruno; Franceschetto, Antonella; A., Casolo; M., Cucca
abstract

18F-FDG PET-CT is a sensitive method for detecting, staging, and monitoring the effects of therapy of many tumors. In the evaluation of malignancy with 18F-FDG, a potential pitfall in the assessment of the anterior mediastinum is mistaking normal uptake within the thymus from disease such as adenopathy or local invasion by tumor. Thymic uptake was classified as "normal" on the basis of morphologic features, size, and contour at 18F-FDG PET. The standardized uptake value (SUV) to measure 18F-FDG uptake may be useful in evaluating the differentiation of thymic carcinoma from other thymic neoplasm, and hyperplasia.

2007 - Studio radioisotopico nella patologia bollosa [Abstract in Atti di Convegno]
Bagni, Bruno; Franceschetto, Antonella
abstract

Nelle patologie bollose polmonari la medicina nucleare è in grado di offrire informazioni riguardanti sia la distribuzione del flusso ematico polmonare, sia la ventilazione alveolare utilizzando uno studio combinato: la scintigrafia ventilo/perfusoria. La PET-TC con 18F-FDG può dare importanti notizie nel caso in cui, durante il follow-up, la patologia bollosa si complica con la comparsa di un'area di addensamento che potrebbe essere indice di presenza di lesione maligna. La PET-TC, grazie alla possibilità di indagare i processi metabolici, è diventata un mezzo essenziale nel differenziare le lesioni maligne da quelle di altra natura.

2006 - Splenosis: 99mTc-labelled colloids provide the diagnosis in splenectomised patients [Articolo su rivista]
Franceschetto, Antonella; A., Casolo; M., Cucca; Bagni, Bruno
abstract

The diagnosis of abdominal splenosis is usually made by surgical biopsy of an abdominal mass incidentally discovered on abdominal ultrasonography, computed tomography or magnetic resonance imaging. To avoid exploratory surgery, 99mTc-sulphur colloid scintigraphy may be used: this technique is the most specific, easily performable, and cost-effective tool for the diagnosis of splenosis.

2003 - Scintimammography with 99mTc-MIBI and magnetic resonance imaging in the evaluation of breast cancer [Articolo su rivista]
Bagni, Bruno; Franceschetto, Antonella; A., Casolo; M., DE SANTIS; I., Bagni; F., Pansini; C., DI LEO
abstract

This study was performed to evaluate the sensitivity and specificity of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) scintimammography (SMM) and contrast-enhanced magnetic resonance imaging (MRI) in patients with breast masses, using the histological findings as the gold standard. Forty-five consecutive patients with a breast lesion, detected by self-examination, physical examination or screening mammography, underwent SMM and MRI. In 38 cases (84.5%), the histopathology was malignant; the breast cancers ranged from 3 to 100 mm in diameter (mean 22 mm). In the overall patient group, MRI showed a slightly higher sensitivity than SMM (92% vs 84%), but SMM showed a better specificity: 71% vs 42%. The accuracy was 82% and 84% for SMM and MRI respectively. To evaluate the influence of lesion size on the results, patients with lesions ≤20 mm and ≤15 mm were examined. In patients with lesions ≤20 mm, the sensitivity of SMM and MRI decreased to 64% and 82% respectively, while SMM again displayed considerably better specificity: 83% vs 50% for MRI. The accuracy of SMM and MRI was 64% and 82% respectively. In patients with lesions ≤15 mm, SMM again showed better specificity (75% vs 50%), while MRI displayed better sensitivity and accuracy (sensitivity, 81% vs 62%; accuracy, 75% vs 65%). In this study the specificity of SMM in patients with breast lesions was thus superior to that of MRI. The combination of SMM and MRI may be used in those patients with equivocal findings at mammography and ultrasound to reduce the number of unnecessary surgical biopsies.

2002 - 99mTc-HMPAO Labelled autologous granulocytes scintigraphy in Crohn’s disease [Articolo su rivista]
Bagni, Bruno; C., Mannucci; Franceschetto, Antonella; A., Casolo; I, Bagni
abstract

99mTc-HMPAO labelled granulocytes scintigraphy can accurately assess Crohn's disease extent, its severity and relapses, and providing a non-invasive alternative technique to colonoscopy and radiological investigations.

2002 - Peripheral Quantitative Computer Tomography (pQCT), Broad Band Ultrasound Attenuation (BUA) and Speed of Sound (SOS) in a population of normal females aged from 8 to 20 years [Articolo su rivista]
Bagni, Bruno; Corazzari, Tolmino; A., Casolo; Franceschetto, Antonella; I., Bagni
abstract

The sexual growth influences the position of bone density peak. The results obtained show a statistically significative correlation between BUA and BMD versus age, the menarche-age, and the period of exposure of bone-tissue to the oestrogen. After all, pQCT and ultrasound are useful techniques to evaluate bone density and structure also in a growing population. The results of this study show the possibility to use bidimensional quantitative ultrasound devices in clinical practice also in young population taking in account age and sexual development.

2002 - Peripheral Quantitative Computer Tomography (pQCT), Broad Band Ultrasound Attenuation (BUA) and Speed of Sound (SOS) in a population of normal females aged from 8 to 20 years [Articolo su rivista]
Bagni, Bruno; Corazzari, Tolmino; A., Casolo; Franceschetto, Antonella; I., Bagni
abstract

The sexual growth influences the position of bone density peak. The results obtained show a statistically significative correlation between BUA and BMD versus age, the menarche-age, and the period of exposure of bone-tissue to the oestrogen. After all, pQCT and ultrasound are useful techniques to evaluate bone density and structure also in a growing population. The results of this study show the possibility to use bidimensional quantitative ultrasound devices in clinical practice also in young population taking in account age and sexual development.

2002 - Sensitivity and specificity of scintimammography versus magnetic resonance imaging: a comparison in 58 patients with breast lesions using histology as a gold standard [Articolo su rivista]
Bagni, Bruno; Franceschetto, Antonella; A., Casolo; M., De Santis; I., Bagni; A., Bagni
abstract

In our study the MRI and scintimammography sensitivity resulted to be superimposable, whereas specificity is greatly in favour of scintimammography: thus, we believe that in the specific clinical conditions, such as in dense breast and in multifocal breast cancer, scintimammography colud be a great help.

2001 - Peripheral Quantitative Computed Tomography (pQCT), Broad Band Ultrasound Attenuation (BUA) and Speed of Sound (SOS) in a population of normal females aged from 8 to 20 years [Articolo su rivista]
Bagni, B.; Corazzari, T.; Saccani-Jotti, G.; Casolo, A.; Franceschetto, A.; Romagnoli, R.
abstract

Purpose. To evaluate, in a population of young healthy females aged from 8 to 20 years the bone mass peak (or density), the normal ranges versus age and menarche-age using two methods: pQCT (peripheral Quantitative Computed Tomography) and ultrasound absorptiometry. Material and methods. From 1998 to 2000 selective measurement of Bone Mineral Density (BMD) of trabecular bone at the ultradistal radius using pQCT, BUA (Broad Band Attenuation) and SOS (Speed of Sound) was carried out on 426 healthy females (aged from 8 to 20 years) in north Italy. BMD was measured using a single photon miniaturized tomographic scanner in the ultradistal radius, SOS and BUA were measured at the same time, using a water bath device obtaining parametric bidimensional images of BUA and SOS. The population studied refers to normal females free of bone metabolism alteration, in pre and post-pubertal status. Results. A normal range of BMD, BUA and SOS versus age and menarche age were established. A linear correlation was found between BUA and BMD measured with pQCT. SOS does not show any correlation with BMD. The pre-puberty and the post-puberty groups show statistically significative differences between SOS, BUA and BMD. We found the peak bone density (measured with pQCT) in the trabecular bone at the ultradistal radius at 15 years of age (mean menarche age of 10 years).The same position of me peak was found for BUA, for SOS the situation is not well defined. The analytical fitting of the data highlights a polynomial correlation of BMD vs. age, SOS vs. age, BUA vs. age. Conclusions. It appears that sexual growth influences the position of peak bone density. The results obtained show a statistically significant correlation between BUA and BMD and age, the menarche-age and the period of exposure of bone tissue to oestrogen. After all, pQCT and ultrasound are useful techniques to evaluate bone density and structure also in a growing population. The results of this study show that it is possible to use bidimensional quantitative ultrasound devices in clinical practice also in young populations taking in account age and sexual development.

2000 - Effect of the serotonin antagonists ritanserin and ketanserin in Cushing's disease [Articolo su rivista]
N., Sonino; G. A., Fava; F., Fallo; Franceschetto, Antonella; P., Belluardo; M., Boscaro
abstract

Central serotoninergic regulation could have a role in the course of pituitary-dependent Cusghing's disease. We studied the effect of ritanserin and ketanserin, two related selective 5HT2 receptor antagonists, in 11 patients with Cushing's disease. Treatment lasted from 1 month to 1 year (up to 4 years in one patient). Daily doses were 10-15 mg for ritanserin, and 40-80 mg for ketanserin. Since the two drugs share the same mechanism of action and no qualitative or quantitative differences in response to their administration were observed, the results were pooled together. An inhibitory effect of ritanserin and ketanserin on ACTH and cortisol production in Cushing's disesase appeared to be limited both in terms of duration of response and number of patients with a satisfactory outcome. However, the results may provide a better understanding of serotoninergic modulation in Cushing's disease and lead to therapeutic developments.