Publications by authors named "Luca Burroni"

17 Publications

  • Page 1 of 1

18F-Fluciclovine Positron Emission Tomography in Prostate Cancer: A Systematic Review and Diagnostic Meta-Analysis.

Diagnostics (Basel) 2021 Feb 13;11(2). Epub 2021 Feb 13.

Department of Nuclear Medicine, "Ospedali Riuniti" Hospital, 60126 Ancona, Italy.

Background: to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical therapy, biochemical recurrence, and advanced setting.

Methods: A systematic web search through Embase and Medline was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies performed from 2011 to 2020 were evaluated. The terms used were "PET" or "positron emission tomography" or "positron emission tomography/computed tomography" or "PET/CT" or "positron emission tomography-computed tomography" or "PET-CT" and "Fluciclovine" or "FACBC" and "prostatic neoplasms" or "prostate cancer" or "prostate carcinoma". Only studies reporting about true positive (TP), true negative (TN), false positive (FP) and false negative (FN) findings of 18F-fluciclovine PET were considered eligible.

Results: Fifteen out of 283 studies, and 697 patients, were included in the final analysis. The pooled sensitivity for 18F-Fluciclovine PET/CT for diagnosis of primary PCa was 0.83 (95% CI: 0.80-0.86), the specificity of 0.77 (95% CI: 0.74-0.80). The pooled sensitivity for preoperative LN staging was 0.57 (95% CI: 0.39-0.73) and specificity of 0.99 (95% CI: 0.94-1.00). The pooled sensitivity for the overall detection of recurrence in relapsed patients was 0.68 (95% CI: 0.63-0.73), and specificity of 0.68 (95% CI: 0.60-0.75).

Conclusion: This meta-analysis showed promising results in term of sensitivity and specificity for 18F-Fluciclovine PET/CT to stage the primary lesion and in the assessment of nodal metastases, and for the detection of PCa locations in the recurrent setting. However, the limited number of studies and the broad heterogeneity in the selected cohorts and in different investigation protocols are limitation affecting the strength of these results.
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http://dx.doi.org/10.3390/diagnostics11020304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918006PMC
February 2021

Prevalence of interstitial pneumonia suggestive of COVID-19 at F-FDG PET/CT in oncological asymptomatic patients in a high prevalence country during pandemic period: a national multi-centric retrospective study.

Eur J Nucl Med Mol Imaging 2021 Feb 9. Epub 2021 Feb 9.

Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy.

Purpose: To assess the presence and pattern of incidental interstitial lung alterations suspicious of COVID-19 on fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) ([F]FDG PET/CT) in asymptomatic oncological patients during the period of active COVID-19 in a country with high prevalence of the virus.

Methods: This is a multi-center retrospective observational study involving 59 Italian centers. We retrospectively reviewed the prevalence of interstitial pneumonia detected during the COVID period (between March 16 and 27, 2020) and compared to a pre-COVID period (January-February 2020) and a control time (in 2019). The diagnosis of interstitial pneumonia was done considering lung alterations of CT of PET.

Results: Overall, [F]FDG PET/CT was performed on 4008 patients in the COVID period, 19,267 in the pre-COVID period, and 5513 in the control period. The rate of interstitial pneumonia suspicious for COVID-19 was significantly higher during the COVID period (7.1%) compared with that found in the pre-COVID (5.35%) and control periods (5.15%) (p < 0.001). Instead, no significant difference among pre-COVID and control periods was present. The prevalence of interstitial pneumonia detected at PET/CT was directly associated with geographic virus diffusion, with the higher rate in Northern Italy. Among 284 interstitial pneumonia detected during COVID period, 169 (59%) were FDG-avid (average SUVmax of 4.1).

Conclusions: A significant increase of interstitial pneumonia incidentally detected with [F]FDG PET/CT has been demonstrated during the COVID-19 pandemic. A majority of interstitial pneumonia were FDG-avid. Our results underlined the importance of paying attention to incidental CT findings of pneumonia detected at PET/CT, and these reports might help to recognize early COVID-19 cases guiding the subsequent management.
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http://dx.doi.org/10.1007/s00259-021-05219-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871520PMC
February 2021

PET/CT in senior patients: "cui prodest?"

Eur J Nucl Med Mol Imaging 2021 Mar;48(3):661-663

Humanitas Clinical and Research Center-IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy.

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http://dx.doi.org/10.1007/s00259-020-05010-7DOI Listing
March 2021

Cerebral circulation time is prolonged and not correlated with EDSS in multiple sclerosis patients: a study using digital subtracted angiography.

PLoS One 2015 13;10(2):e0116681. Epub 2015 Feb 13.

Dept. of Medicine, Surgery & Neuroscience, University of Siena, Siena, Italy.

Literature has suggested that changes in brain flow circulation occur in patients with multiple sclerosis. In this study, digital subtraction angiography (DSA) was used to measure the absolute CCT value in MS patients and to correlate its value to age at disease onset and duration, and to expand disability status scale (EDSS). DSA assessment was performed on eighty MS patients and on a control group of forty-four age-matched patients. CCT in MS and control groups was calculated by analyzing the angiographic images. Lesion and brain volumes were calculated in a representative group of MS patients. Statistical correlations among CCT and disease duration, age at disease onset, lesion load, brain volumes and EDSS were considered. A significant difference between CCT in MS patients (mean = 4.9s; sd = 1.27 s) and control group (mean = 2.8s; sd = 0.51 s) was demonstrated. No significant statistical correlation was found between CCT and the other parameters in all MS patients. Significantly increased CCT value in MS patients suggests the presence of microvascular dysfunctions, which do not depend on clinical and MRI findings. Hemodynamic changes may not be exclusively the result of a late chronic inflammatory process.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0116681PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334558PMC
January 2016

New-onset hypercholesterolemia as an unusual presenting manifestation of eosinophilic gastroenteritis.

J Clin Lipidol 2013 May-Jun;7(3):229-33. Epub 2013 Feb 4.

Department of Internal Medicine, Endocrine-Metabolic Science and Biochemistry, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100 Siena, Italy.

We describe an unusual case of new-onset hypercholesterolemia in a 28-year-old man. The presence of low serum albumin and hypercholesterolemia established the suspicion of gastrointestinal disease. Technetium-99m diethylenetriaminepentaacetic acid scintigraphy was performed to identify possible protein-losing enteropathy. The results were consistent with eosinophilic gastroenteritis, a rare disease characterized by eosinophilic infiltration that may involve several digestive tract layers. To our knowledge, this is the first time that hypercholesterolemia has been recognizing as the presenting manifestation of eosinophilic gastroenteritis. The patient has been successfully treated with prednisone and budesonide. Hypercholesterolemia may be an early manifestation of a serious underlying disease, among which eosinophilic gastroenteritis should also be considered.
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http://dx.doi.org/10.1016/j.jacl.2013.01.003DOI Listing
October 2013

Preoperative diagnosis of orbital cavernous hemangioma: a 99mTc-RBC SPECT study.

Clin Nucl Med 2012 Nov;37(11):1041-6

Department of Nuclear Medicine, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy.

Purpose: This study aimed to describe 99mTc-labeled RBC scintigraphy as a diagnostic method for orbital cavernous hemangiomas and to evaluate this diagnostic tool according to surgical outcomes.

Methods: Fifty-five patients with clinical and radiological (US, CT, and/or MRI) suspicion of unilateral cavernous hemangioma of the orbit underwent 99mTc-RBC SPECT study.Qualitative and semiquantitative evaluations were performed, and results were statistically analyzed.

Results: SPECT images showed focal uptake in the orbital mass in 36 of 55 patients. Nineteen patients had a negative scintigraphic pattern, with concordance of early and late absence of uptake of 99mTc-RBC.Our procedure showed 100% sensitivity and 88.9% specificity for the diagnosis of orbital cavernous hemangioma, with a positive predictive value of 90.9% and a negative predictive value of 100%.

Conclusions: 99mTc-RBC imaging is safe, easy to perform, and highly accurate in providing adequate clinical and surgical management. As a noninvasive and highly specific method for diagnosing orbital hemangioma, 99mTc-RBC scintigraphy can avoid more invasive imaging or biopsy.
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http://dx.doi.org/10.1097/RLU.0b013e318252d2edDOI Listing
November 2012

Efficacy of alendronate in the treatment of the SAPHO syndrome.

J Clin Rheumatol 2008 Jun;14(3):183-4

Department of Clinical Medicine and Immunologic Sciences, Policlinico Le Scotte, University of Siena, Siena, Italy.

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http://dx.doi.org/10.1097/RHU.0b013e318177a64fDOI Listing
June 2008

Regional cerebral blood flow in childhood autism: a SPET study with SPM evaluation.

Nucl Med Commun 2008 Feb;29(2):150-6

Department of Nuclear Medicine, University of Siena, Italy.

Aim: To establish a link between rCBF assessed with Tc-ECD SPET and the clinical manifestation of the disease.

Methods: We performed the study on 11 patients (five girls and six boys; mean age 11.2 years) displaying autistic behaviour and we compared their data with that of an age-matched reference group of eight normal children. A quantitative analysis of rCBF was performed calculating a perfusion index (PI) and an asymmetry index (AI) in each lobe. Images were analysed with statistical parametric mapping software, following the spatial normalization of SPET images for a standard brain.

Results: A statistically significant (P=0.003) global reduction of CBF was found in the group of autistic children (PI=1.07+/-0.07) when compared with the reference group (PI=1.25+/-0.12). Moreover, a significant difference was also observed for the right-to-left asymmetry of hemispheric perfusion between the control group and autistic patients (P=0.0085) with a right prevalence greater in autistic (2.90+/-1.68) with respect to normal children (1.12+/-0.49). Our data show a significant decrease of global cerebral perfusion in autistic children in comparison with their normal counterparts and the existence of left-hemispheric dysfunction, especially in the temporo-parietal areas devoted to language and the comprehension of music and sounds.

Conclusion: We suggest that these abnormal areas are related to the cognitive impairment observed in autistic children, such as language deficits, impairment of cognitive development and object representation, and abnormal perception and responses to sensory stimuli. Tc-ECD SPET seems to be sensitive in revealing brain blood flow alterations and left-to-right asymmetries, when neuroradiological patterns are normal.
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http://dx.doi.org/10.1097/MNM.0b013e3282f1bb8eDOI Listing
February 2008

Diagnosis of vascular prosthesis infection: PET or SPECT?

J Nucl Med 2007 Aug;48(8):1227-9

University of Siena, Italy.

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http://dx.doi.org/10.2967/jnumed.107.042002DOI Listing
August 2007

A comparison of 1850 (50 mCi) and 3700 MBq (100 mCi) 131-iodine administered doses for recombinant thyrotropin-stimulated postoperative thyroid remnant ablation in differentiated thyroid cancer.

J Clin Endocrinol Metab 2007 Sep 3;92(9):3542-6. Epub 2007 Jul 3.

Department of Internal Medicine, Endocrinology and Metabolism and Biochemistry, Section of Nuclear Medicine, University of Siena, 53100 Sienna, Italy.

Objective: Recently, a multicenter study in differentiated thyroid cancer (DTC) patients showed that 3700 MBq 131-iodine ((131)I) after recombinant human TSH (rhTSH) had a successful thyroid ablation rate similar to that obtained after thyroid hormone withdrawal. We investigated whether 1850 MBq (131)I had a similar successful rate to 3700 MBq in patients prepared with rhTSH.

Design: A total of 72 patients with DTC were randomly assigned to receive 1850 (group A, n = 36) or 3700 MBq (group B, n = 36) (131)I after rhTSH. One injection of 0.9 mg rhTSH was administered for 2 consecutive days; (131)I therapy was delivered 24 h after the last injection, followed by a posttherapy whole-body scan. Successful ablation was assessed 6-8 months later.

Results: Successful ablation (no visible uptake in the diagnostic whole-body scan after rhTSH stimulation) was achieved in 88.9% of group A and B patients. Basal and rhTSH-stimulated serum thyroglobulin was undetectable (<1 ng/ml) in 78.9% of group A and 66.6% of group B patients (P = 0.46). Similar rates of ablation were obtained in both groups also in patients with node metastases.

Conclusion: Therapeutic (131)I activities of 1850 MBq are equally effective as 3700 MBq for thyroid ablation in DTC patients prepared with rhTSH, even in the presence of node metastases.
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http://dx.doi.org/10.1210/jc.2007-0225DOI Listing
September 2007

Focal cortical dysplasia type 1b as a cause of severe epilepsy with multiple independent spike foci.

Brain Dev 2008 Jan 20;30(1):53-8. Epub 2007 Jun 20.

Department of Pediatrics, Section of Pediatric Neurology, Policlinico Le Scotte, University of Siena, Siena, Italy.

To investigate the clinical picture, the neurophysiological pattern, and neuropathological features of a young woman with severe drug-resistant epilepsy of unknown cause. We used the patient's clinical records from the age of 2 to 20years including neurophysiological patterns recorded via both scalp and cortex electrodes and results of studies conducted on the brain neuropathological specimen. The patient, with severe mental/psychomotor retardation, suffered from severe epilepsy from an early age, characterized by daily seizures of multiple types (atypical absences, tonic, and complex partial seizures), high frequency, and intractability. The neurophysiological pattern indicated multiple independent spike foci (SE-MISF). When she was 16, a vagal nerve stimulator was implanted without success. Neither neuroimaging (brain MRI and ictal SPECT) nor surface EEGs identified unique loci of seizure onset, establishing her as a candidate for a complete callosotomy. When the patient was 19, before the callosotomy, invasive EEG (i.e., electrocorticography) using just a few electrodes in different lobes showed the presence of a distinctive pattern. The surgical specimen, taken very close to one of the activity sites, showed architectural abnormalities and neurons that were giant or immature but not dysmorphic, indicative of focal cortical dysplasia (FCD) type 1b. Twelve months after the callosotomy, according to the Engel score, the patient exhibited a large improvement in quality of life, without permanent complications from the interhemispheric disconnection. (1) Hidden FCD type 1b could represent a missing diagnosis in patients with SE-MISF in the absence of other causes for their seizures. (2) Complete callosotomy can be efficacious in patients with SE-MISF with hidden FCD type 1b.
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http://dx.doi.org/10.1016/j.braindev.2007.05.010DOI Listing
January 2008

Technetium tc 99m-labeled red blood cells in the preoperative diagnosis of cavernous hemangioma and other vascular orbital tumors.

Arch Ophthalmol 2005 Dec;123(12):1678-83

Department of Ophthalmology, University of Siena, Siena, Italy.

Objectives: To evaluate technetium Tc 99m (99mTc) red blood cell scintigraphy as a diagnostic tool for orbital cavernous hemangioma and to differentiate between orbital masses on the basis of their vascularization.

Methods: We performed 99mTc red blood cell scintigraphy on 23 patients (8 female and 15 male; mean age, 47 years) affected by an orbital mass previously revealed with computed tomography (CT) and magnetic resonance imaging (MRI) and suggesting cavernous hemangioma. In our diagnosis, we considered the orbital increase delayed uptake with the typical scintigraphic pattern known as perfusion blood pool mismatch. The patients underwent biopsy or surgical treatment with transconjunctival cryosurgical extraction when possible.

Results: Single-photon emission tomography (SPET) showed intense focal uptake in the orbit corresponding to radiologic findings in 11 patients who underwent surgical treatment and pathologic evaluation (9 cavernous hemangiomas, 1 hemangiopericytoma, and 1 lymphangioma). Clinical or histologic examination of the remaining 22 patients revealed the presence of 5 lymphoid pseudotumors, 2 lymphomas, 2 pleomorphic adenomas of the lacrimal gland, 1 astrocytoma, 1 ophthalmic vein thrombosis, and 1 orbital varix.

Conclusions: The confirmation of the preoperative diagnosis by 99mTc red blood cell scintigraphy shows that this technique is a reliable tool for differentiating cavernous hemangiomas from other orbital masses (sensitivity, 100%; specificity, 86%) when ultrasound, CT, and MRI are not diagnostic. Unfortunately, 99mTc red blood cell scintigraphy results were positive in 1 patient with hemangiopericytoma and 1 patient with lymphangioma, which showed increased uptake in the lesion on SPET images because of the vascular nature of these tumors. Therefore, in these cases, the SPET images have to be integrated with data regarding clinical preoperative evaluation and CT scans or MRI studies. On the basis of our study, a complete diagnostic picture, CT scans or MRI studies, and scintigraphic patterns can establish the preoperative diagnosis of vascular orbital tumors such as cavernous hemangioma, adult-type lymphangioma, and hemangiopericytoma.
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http://dx.doi.org/10.1001/archopht.123.12.1678DOI Listing
December 2005

Prevalence of Paget's disease of bone in Italy.

J Bone Miner Res 2005 Oct 31;20(10):1845-50. Epub 2005 May 31.

Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Siena, and Department of Radiology, U.O.A. I. S. Giovanni Battista Hospital of Torino, Italy.

Unlabelled: We examined the prevalence of PDB in Italy from radiological, scintigraphic, and biochemical surveys in two Italian towns. Prevalence rates varied from 0.7% to 2.4%, were higher in males than in females, and slightly differed between the two towns. Unlike previous studies in populations of British descent, no secular trend for a decreasing prevalence emerged.

Introduction: Clinical, radiological, and necropsy data from different countries suggested pronounced geographical variations in the prevalence of Paget's disease of bone (PDB). Despite the impact of the disease on the population, there are limited data on the prevalence of PDB in Italy.

Materials And Methods: The objective of this study was to estimate the prevalence of PDB in the district of Siena (Central Italy) and Turin (Northern Italy) from radiological, biochemical, and scintigraphic surveys. We examined a sample of 1778 consecutive pelvic radiographs performed between 1999 and 2000 at the Hospital Radiology Unit in Siena and 6609 pelvic radiographs performed in 1986-1987, 1992-1993, and 1999-2002 from the Radiology Department of Molinette Hospital in Turin. In Siena, 7906 consecutive (99m)TC-MDP bone scans performed over a 4-year period (January 2000 to May 2004) were also screened for the presence of PDB, and the prevalence of elevated alkaline phosphatase (ALP) levels (>300 UI/liter) was estimated from 7449 computerized medical records over a 3-year period (January 2000 to February 2003). The finding of PDB on the pelvic radiograph and bone scan was based on standardized radiological criteria.

Results: At the end of the radiological surveys, 16/1778 pelvic PDB cases (8 males and 8 females) were observed in Siena and 41/6609 (27 males and 14 females) in Turin. The crude prevalence of the disease was 0.89% in Siena and 0.62% in Turin. Given that pelvic involvement is commonly described in 60-90% of PDB patients, the estimated overall prevalence of PDB ranged from 1.0% to 1.5% in Siena and from 0.7% to 1.0% in Turin. No decrease in the prevalence of PDB was evident after comparison of prevalence rates from different periods. Biochemical analyses showed 296/7449 subjects with elevated ALP levels and normal liver enzymes, 87 of whom had confirmed diagnosis of PDB. The estimated prevalence of biochemical PDB was 1.5%. The scintigraphic survey showed a PDB prevalence of 194/7906 (2.4%), which was significantly higher than the radiological and biochemical estimates.

Conclusions: Our surveys suggest that PDB in Italy has an estimated prevalence of at least 1%, comparable with that observed in United States and other European countries, but lower than that described in Britain and New Zealand. No secular trend for a decreasing prevalence of PDB was observed.
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http://dx.doi.org/10.1359/JBMR.050518DOI Listing
October 2005

Nuclear medicine imaging of inflammatory/infective disorders of the abdomen.

Nucl Med Commun 2005 Jul;26(7):657-64

Nuclear Medicine, II Faculty of Medicine, University "La Sapienza", Rome, Italy.

Different nuclear medicine modalities are currently used to study inflammatory and infective disorders of the abdomen. They are usually complementary to radiology and endoscopy, but they play a pivotal role in particular clinical situations. Several radiopharmaceuticals (e.g., 111In or 99mTc labelled white blood cells, monoclonal antibodies, human polyclonal immunoglobulins, 75Ga citrate) are commercially available, but they can not be used indifferently to study abdominal inflammatory disorders. The lack of comparative studies showing the accuracy of each radiopharmaceutical for the study of inflammatory/infective abdominal diseases does not allow the best nuclear medicine technique(s) to be chosen in an evidence-based manner. To this end we performed a meta-analysis of peer reviewed articles published between 1984 and 2004 describing the use of nuclear medicine imaging for the study of inflammatory bowel disorders, appendicitis and vascular graft infections. A guideline for the optimal radiopharmaceutical(s) to be used in each clinical condition and for different aims is provided.
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http://dx.doi.org/10.1097/01.mnm.0000169202.68011.47DOI Listing
July 2005

Management of thyroid nodules: a clinicopathological, evidence-based approach.

Eur J Nucl Med Mol Imaging 2004 Oct 8;31(10):1443-9. Epub 2004 Sep 8.

Section of Endocrinology and Metabolism, University of Siena, Siena, Italy.

Management of thyroid nodules is one of the most controversial issues in thyroidology. Different approaches derive from geographical variation in presentation, inadequate or incomplete clinical diagnosis, lack of prospective controlled studies and, frequently, the different cultural backgrounds of physicians. This review aims to offer a practical approach to the management of nodular thyroid disorders, considering the way in which the pathophysiology of the disease provides clues to the correct clinical diagnosis and therapy.
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http://dx.doi.org/10.1007/s00259-004-1680-0DOI Listing
October 2004