Publications by authors named "Renato Argirò"

20 Publications

  • Page 1 of 1

Clinical Utility of Plasma KRAS, NRAS and BRAF Mutational Analysis with Real Time PCR in Metastatic Colorectal Cancer Patients-The Importance of Tissue/Plasma Discordant Cases.

J Clin Med 2020 Dec 29;10(1). Epub 2020 Dec 29.

Medical Oncology Unit, Department of Systems Medicine, Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy.

Background: Tumor tissue (T) mutational analysis represents the standard for metastatic colorectal cancer (mCRC); however, circulating tumor DNA (ctDNA) detected by liquid biopsy in plasma (PL) can better represent tumor heterogeneity.

Methods: mCRC patients undergoing standard first-line chemotherapy with known T-KRAS/NRAS/BRAF status were enrolled in the present prospective study. PL mutations were assessed within 2 weeks before chemotherapy start with real time PCR and correlated with T status and Progression free survival (PFS). Clinical and biochemical variables including also total number of tumor lesions (TNL) and the sum of maximum diameter (SMD) of all lesions were assessed as potential predictors of T/PL discordance.

Results: Among 45 enrolled patients, all BRAF mutations were concordant between T and PL and there were 20% of patients RAS discordant: 9% wild type in T and mutated in PL and 11% mutated in T and wild type in PL. T mutations were significantly associated to median PFS (mPFS of 4.5, 8.3 and 22.9 months for T-BRAF mutated, T-RAS mutated, and T-wild type patients, respectively, for trend 0.00014). PL mutations further refined prognosis: RAS wild type in T and mutated in PL had significantly shorter PFS than concordant RAS wild type in T and PL: mPFS 9.6 vs. 23.3 months, respectively, = 0.02. Patients RAS mutated in T and wild type in PL had longer PFS than concordant RAS mutated in T and PL: 24.4 vs. 7.8 months, respectively, = 0.008. At a multivariate cox regression analysis for PFS, PL mutations were independent prognostic factor superior to T analysis (HR 0.13, = 0.0008). At multivariate logistic regression analysis TNL and SMD were significant predictors of discordant cases.

Conclusions: PL mutational analysis allows a better prognostication than T analysis alone and could help in mCRC treatment management.
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http://dx.doi.org/10.3390/jcm10010087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794782PMC
December 2020

Super selective arterial embolization to treat radiation-induced hemorrhagic gastritis: a case report and review of the literature.

Scand J Gastroenterol 2021 Jan 2;56(1):118-121. Epub 2020 Dec 2.

Department of Systems Medicine, GI Unit, University "Tor Vergata" of Rome, Rome, Italy.

Radiation-induced hemorrhagic gastritis (RIHG) is a rare but potentially fatal event following radiotherapy for locally advanced gastric cancer; the treatment of this condition is not standardized. Only few cases of RIHG have been reported, treated with different therapeutic approaches. Here we report the case of a 79-year-old patient who underwent subtotal gastrectomy for gastric cancer, followed by adjuvant chemo-radiotherapy. Approximately 3 months after the end of the treatment, she developed recurrent diffuse bleeding originating from the entire mucosa of the gastric pouch and from a marginal ulcer. As the bleeding was refractory to several endoscopic treatments and surgery was not indicated, the patient underwent two sessions of transcatheter selective arterial embolization, with resolution of bleeding. Arterial embolization has already been reported for the treatment of hemorrhagic cystitis, developing after irradiation of the pelvis for prostate, bladder, rectum, and cervix cancer. However, to our knowledge, it has never been reported as a treatment for hemorrhagic gastritis. Based on this case, we suggest arterial embolization as an option in the management of RIHG, when standard endoscopic treatment fails.
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http://dx.doi.org/10.1080/00365521.2020.1853219DOI Listing
January 2021

Mechanical Thrombectomy for Acute Intracranial Carotid Occlusion with Patent Intracranial Arteries : The Italian Registry of Endovascular Treatment in Acute Stroke.

Clin Neuroradiol 2020 Dec 10. Epub 2020 Dec 10.

Stroke Unit, University of Rome La Sapienza, Roma, Italy.

Purpose: Intracranial carotid artery occlusion represents an underinvestigated cause of acute ischemic stroke as well as an indication for mechanical thrombectomy. We investigated baseline and procedural characteristics, outcomes and predictors of outcome in patients with acute ischemic stroke secondary to intracranial carotid artery occlusion.

Methods: A retrospective analysis of the Italian Registry of Endovascular Treatment in Acute Stroke was performed. Patients with intracranial carotid artery occlusion (infraclinoid and supraclinoid) with or without cervical artery occlusion but with patent intracranial arteries were included. The 3‑month functional independence, mortality, successful reperfusion and symptomatic intracranial hemorrhage were evaluated.

Results: Intracranial carotid artery occlusion with patent intracranial arteries was diagnosed in 387 out of 4940 (7.8%) patients. The median age was 74 years and median baseline National Institute of Health Stroke Scale (NIHSS) was 18. Functional independence was achieved in 130 (34%) patients, successful reperfusion in 289 (75%) and symptomatic intracranial hemorrhage in 33 (9%), whereas mortality occurred in 111 (29%) patients. In univariate analysis functional independence was associated with lower age, lower NIHSS at presentation, higher rate of successful reperfusion and lower rate of symptomatic intracranial hemorrhage. Multivariable regression analysis found age (odds ratio, OR:1.03; P = 0.006), NIHSS at presentation (OR: 1.07; P < 0.001), diabetes (OR: 2.60; P = 0.002), successful reperfusion (OR:0.20; P < 0.001) and symptomatic intracranial hemorrhage (OR: 4.17; P < 0.001) as the best independent predictors of outcome.

Conclusion: Our study showed a not negligible rate of intracranial carotid artery occlusion with patent intracranial arteries, presenting mostly as severe stroke, with an acceptable rate of 3‑month functional independence. Age, NIHSS at presentation and successful reperfusion were the best independent predictors of outcome.
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http://dx.doi.org/10.1007/s00062-020-00980-5DOI Listing
December 2020

CT-guided Emergency Drainage of Tension Pneumomediastinum in a Young Patient With Acute Lymphoid Leukemia and Aspergillus fumigatus Pulmonary Infection.

J Bronchology Interv Pulmonol 2020 Nov 17. Epub 2020 Nov 17.

Division Diagnostic Imaging and Interventional Radiology, Interventional Radiology Unit.

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http://dx.doi.org/10.1097/LBR.0000000000000727DOI Listing
November 2020

Heparin-Related Major Bleeding in Covid-19-Positive Patient: Perspective from the Outbreak.

Cardiovasc Intervent Radiol 2020 08 28;43(8):1216-1217. Epub 2020 May 28.

Diagnostic Imaging and Interventional Radiology, University Hospital of Rome Tor Vergata, Rome, Italy.

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http://dx.doi.org/10.1007/s00270-020-02532-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255445PMC
August 2020

Endovascular Treatment of Critical Hand Ischemia: A Single-Center Experience.

Cardiovasc Revasc Med 2020 Nov 14;21(11):1438-1443. Epub 2020 Apr 14.

University Hospital "Tor Vergata", Department of Interventional Radiology, Viale Oxford, 81-00133 Roma, Italy.

Purpose: To clarify the role of endovascular treatment in patients with Critical Hand Ischemia of the distal upper extremity.

Methods: From January 2012 to January 2017, 18 dialyzed patients presented chronic critical hand ischemia; 6 patients had a chronic occlusion of the ulnar artery and radial artery stenosis, 5 patients had a chronic occlusion of the radial artery and ulnar artery stenosis, 4 patients presented multiple stenosis of the ulnar, radial and interosseous arteries, 2 patients had only ulnar artery occlusion while one patient presented only radial artery occlusion. All patients underwent duplex ultrasound and a subsequent brachial angiography, in order to evaluate the distal run-off circulation. Revascularization was achieved via antegrade brachial puncture in all patients, with retrograde approach in 4 patients, with distal retrograde puncture in 3 patients and in one patient with loop technique.

Results: No complications were observed during the periprocedural follow-up. One patient was not successfully revascularized (technical success rate: 94.4%). The patient had no direct flow after ulnar artery angioplasty. The procedure was clinical effective in 15 patients (clinical success rate: 83.3%). Clinical evaluation and Duplex-US were performed in the follow up period. TcpO2 evaluated in the perilesional skin surface increased from 20.2 ± 6.5 mmHg to 53.8 ± 13.1 mmHg in the follow up period (P < .01). We observed an improvement of pain, ulcers and infection healing in all treated remaining patients during the postoperative period.

Conclusion: Percutaneous intervention prevents hand loss and functional impairment in patients with Critical Hand Ischemia and multiple comorbidities.
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http://dx.doi.org/10.1016/j.carrev.2020.04.017DOI Listing
November 2020

Polyethylene Glycol Epirubicin-Loaded Transcatheter Arterial Chemoembolization Procedures Utilizing a Combined Approach with 100 and 200 μm Microspheres: A Promising Alternative to Current Standards.

J Vasc Interv Radiol 2019 03 31;30(3):305-313. Epub 2019 Jan 31.

Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Rome, Italy.

Purpose: To report clinical effectiveness, toxicity profile, and prognostic factors of combined 100 μm ± 25 and 200 μm ± 50 epirubicin-loaded polyethylene glycol (PEG) microsphere drug-eluting embolic transcatheter arterial chemoembolization protocol in patients with hepatocellular carcinoma.

Materials And Methods: In this prospective, single-center, single-arm study with 18 months of follow-up, 36 consecutive patients (mean age 69.9 y ± 10.8; 26 men, 10 women; 54 naïve lesions) were treated. Embolization was initiated with 100 μm ± 25 microspheres, and if stasis (10 heart beats) was not achieved, 200 μm ± 50 microspheres were administered. Each syringe (2 mL) of PEG microsphere was loaded with 50 mg of epirubicin. Results were evaluated using Modified Response Evaluation Criteria In Solid Tumors with multidetector computed tomography/magnetic resonance imaging at 1, 3-6, 9-12, and 15-18 months. Toxicity profile was assessed by laboratory testing before and after the procedure. Complications were recorded. Postembolization syndrome (PES) was defined as onset of fever/nausea/pain after the procedure. Patient/lesion characteristics and treatment results were correlated with predicted outcome using regression analysis. Child-Pugh score was A in 86.1% of patients (31/36) and B in 13.9% (5/36).

Results: In 10 of 21 lesions, < 2 cm in diameter (47.5%) stasis was achieved with 100 μm ± 25 microspheres only, whereas all other lesions required adjunctive treatment with 200 μm ± 50 microspheres. Reported adverse events were grade 1 acute liver bile duct injury (3/39 cases, 7.7%) and PES (grade 2; 3/39 cases, 7.7%). Complete response (CR) at 1, 3-6, 9-12, and 15-18 months was 61.1%, 65.5%, 63.63%, and 62.5%. Objective response (CR + partial response) at 1, 3-6, 9-12, and 15-18 months was 83.3%, 65.85%, 63.63%, and 62.5%. No single factor (laboratory testing, etiology, patient status, hepatic status, tumor characteristics, administration protocol) predicted outcomes except for albumin level at baseline for CR (P < .05, odds ratio = 1.09).

Conclusions: The combined microsphere sizing strategy was technically feasible and yielded promising results in terms of effectiveness and toxicity.
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http://dx.doi.org/10.1016/j.jvir.2018.10.026DOI Listing
March 2019

A review discussing the use of polyethylene glycol microspheres in the treatment of hepatocellular carcinoma.

Future Oncol 2019 Mar 16;15(7):695-703. Epub 2018 Nov 16.

Oncology Radiodiagnostics, Oncology Institute of Veneto, Institute for the Research & Treatment of Cancer (IRCC), 35128 Padova, Italy.

Transarterial chemoembolization (TACE) is indicated in unresectable hepatocellular carcinoma and allows the delivery of embolics inside tumor vascularization to reduce blood supply and release gradually the drug. This lowers the systemic exposure to chemotherapeutics, while increasing their local concentration and tissue necrosis that is higher than conventional TACE. The technology of TACE has seen the introduction of several types of embolics that are made of different materials. Available embolics for TACE include: drug-eluting beads (DC beads), acrylic copolymer, tris-acrylic microspheres and polyethylene glycol (PEG) microspheres. Few studies are available on PEG embolics and their use for TACE. This review focuses on the efficacy and safety of TACE performed with PEG microspheres for the treatment of hepatocellular carcinoma and discusses future therapeutic advantages.
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http://dx.doi.org/10.2217/fon-2018-0425DOI Listing
March 2019

Single Injection Dual-Phase Cone Beam CT (DP-CBCT): Vascular Anatomy Assessment and Occult Nodule Detection; Have We Reached the Focus?

Acad Radiol 2018 09 12;25(9):1236. Epub 2018 Jun 12.

"Sapienza" University of Rome, Departement of Radiological Oncological and Anatomo-pathological sciences, Vascular and Interventional Unit, Viale del Policlinico, 155, 00161 Rome, Italy.

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http://dx.doi.org/10.1016/j.acra.2018.03.033DOI Listing
September 2018

Diagnostic accuracy of 3T magnetic resonance imaging in the preoperative localisation of parathyroid adenomas: comparison with ultrasound and 99mTc-sestamibi scans.

Eur Radiol 2018 Nov 7;28(11):4900-4908. Epub 2018 May 7.

Department of Radiological Sciences, Oncology and Pathology, Sapienza University, viale Regina Elena 324, 00161, Rome, Italy.

Objectives: To evaluate the diagnostic performance of 3TMRI in comparison with ultrasound (US) and 99mTc-sestamibi scan for presurgical localisation of parathyroid adenomas (PTAs) in patients with primary hyperparathyroidism (PHPT).

Methods: Fifty-seven patients affected by PHPT were prospectively enrolled and underwent US, 99mTc-sestamibi and 3TMRI. T2-weighted and post-contrast T1-weighted Iterative decomposition of water and fat with Echo Asymmetry and Least squares estimation (IDEAL) sequences were acquired. Diagnostic performance of US, 99mTc-sestamibi and MRI in localising PTAs to correct quadrant were compared according to surgical and pathological findings.

Results: According to surgical findings, US correctly localised 41/46 PTAs (sensitivity of 89.1%; specificity 97.5%; PPV 93.1% and NPV 95.6%); 99mTc-sestamibi correctly localised 38/46 PTAs (sensitivity 83.6%, specificity 98.3%, PPV 95% and NPV 93.7%). US and 99mTc-sestamibi combined had a sensitivity of 93.4% (43/46 PTAs), specificity of 98.3%, PPV 95% and NPV 98.3%. MRI correctly localised 45/46 PTAs (sensitivity 97.8%; specificity 97.5%; PPV 93.7% and NPV 99.2%). MRI was able to detect six adenomas missed by 99mTc-sestamibi and two adenomas missed by US. MRI and US were able to detect all enlarged parathyroid glands in patients with multiglandular disease. MRI identified six of seven ectopic adenomas.

Conclusions: Our study demonstrated high diagnostic performance of 3T MRI in the preoperative PTAs quadrant localisation, as well as in patients with multiglandular disease and ectopic PTAs. MRI may be preferred to adequately select patient candidates for minimally invasive parathyroidectomy (MIP).

Key Points: • PTA(s) quadrant localisation by 3TMRI was more accurate than US+99mTc-sestamibi. • MRI identified all enlarged glands in multiglandular disease similarly to US. • MRI identified 6/7 ectopic PTAs similarly to 99mTc-sestamibi. • Presurgical PTA(s) localisation by 3TMRI select the optimal candidates for MIP.
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http://dx.doi.org/10.1007/s00330-018-5437-8DOI Listing
November 2018

Single-Injection Dual-Phase Cone-Beam CT Is Better than Split-Bolus Single-Phase Cone-Beam CT for Liver Catheter-Based Procedures.

J Vasc Interv Radiol 2018 05;29(5):748-749

Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-pathological Sciences, Sapienza University of Rome, Rome 00161, Italy.

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http://dx.doi.org/10.1016/j.jvir.2017.12.026DOI Listing
May 2018

Arms Down Cone Beam CT Hepatic Angiography: Are We Focusing on the Wrong Target?

Cardiovasc Intervent Radiol 2018 07 12;41(7):1134-1135. Epub 2018 Apr 12.

Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.

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http://dx.doi.org/10.1007/s00270-018-1951-yDOI Listing
July 2018

Single injection dual phase CBCT technique ameliorates results of trans-arterial chemoembolization for hepatocellular cancer.

Transl Gastroenterol Hepatol 2017 24;2:83. Epub 2017 Oct 24.

Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Italy.

Cone-beam CT (CBCT) application to the field of trans-arterial chemoembolization has been recently the focus of several researches. This imaging modality is performed with a rotation of the C-arm around the patient, without needs of patient repositioning. Datasets are immediately processed, obtaining volumetric CT-like images with the possibility of post-processing and reconstruction of images. Dual phase CBCT recently introduced in clinical practice consists in a first arterial acquisition followed by a delayed acquisition corresponding to a venous phase. The introduction of this feature has overcome the limit of single-phase acquisitions, allowing lesions characterization. Moreover these recent advantages have several intra-procedural implications. Detailed technical and acquisition parameters will be widely exposed in this review with particular attention to: catheter positioning, acquisition delay, injection parameters, patient positioning and contrast dilution. Comparison with standard of practice second line imaging [multidetector computer tomography (MDCT) and MDCT/arteriography] demonstrate the capability of detecting occult nodules providing some clinical implications thus potentially identifying a sub set of patients with aggressive disease behaviour. Other intra-procedural advantages of dual phase CBCT usage consist in a better tumor feeder visualization, reduction of proper DSA and fluoroscopic time, suggestion the presence of an extrahepatic parasitic feeder thus resulting in a more accurate treatment. Finally, the volumetrical intraprocedural evaluation of accumulation of embolic agent has proved to be correlate with treatment response if compared with MRI.
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http://dx.doi.org/10.21037/tgh.2017.10.03DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676208PMC
October 2017

Does Sorafenib Fit for All?

Radiology 2017 09;284(3):919-921

Department of Surgical Sciences, Sapienza University of Rome, Via Casimiro Mondino, 10, Rome, Italy §.

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http://dx.doi.org/10.1148/radiol.2017170716DOI Listing
September 2017

Comparison of Image Quality and Diagnostic Performance of Cone-Beam CT during Drug-Eluting Embolic Transarterial Chemoembolization and Multidetector CT in the Detection of Hepatocellular Carcinoma.

J Vasc Interv Radiol 2017 Jul 9;28(7):978-986. Epub 2017 May 9.

Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-pathological Sciences, Sapienza University of Rome, Rome, Italy.

Purpose: To compare image quality and diagnostic performance of cone-beam computed tomography (CT) and multidetector CT in the detection of hypervascular hepatocellular carcinoma (HCC) in patients with cirrhosis undergoing transarterial chemoembolization with drug-eluting embolic agents.

Materials And Methods: Fifty-five consecutive patients referred for chemoembolization of hypervascular HCC were prospectively enrolled. Imaging included preprocedural multidetector CT within 1 month before planned treatment, intraprocedural cone-beam CT, and 1-month follow-up multidetector CT. Analysis of image quality was performed with calculations of lesion-to-liver contrast-to-noise ratio (LLCNR) and lesion-to-liver signal-to-noise-ratio (LLSNR). One-month follow-up multidetector CT was considered the reference standard for the detection of HCC nodules.

Results: Median LLCNR values were 3.94 (95% confidence interval [CI], 3.06-5.05) for preprocedural multidetector CT and 6.90 (95% CI, 5.17-7.77) for intraprocedural cone-beam CT (P < .0001). Median LLSNR values were 11.53 (95% CI, 9.51-12.44) for preprocedural multidetector CT and 9.36 (95% CI, 8.12-10.39) for intraprocedural cone-beam CT (P < .0104). Preprocedural multidetector CT detected 115 hypervascular nodules with typical HCC behavior, and cone-beam CT detected 15 additional hypervascular nodules that were also visible on 1-month follow-up multidetector CT.

Conclusions: Cone-beam CT has a significantly higher diagnostic performance compared with preprocedural multidetector CT in the detection of HCCs and can influence management of patients with cirrhosis by identifying particularly aggressive tumors.
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http://dx.doi.org/10.1016/j.jvir.2017.03.008DOI Listing
July 2017

Combined Endoscopic-Radiological Rendezvous for Distal Tail Postoperative Pancreatic Fistula (POPF).

Cardiovasc Intervent Radiol 2016 Sep 5;39(9):1327-31. Epub 2016 Apr 5.

Department of Radiological Sciences, Oncological and Anatomo-pathological Sciences, Vascular and Interventional Radiology Unit, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.

Postoperative pancreatic fistula (POPF) with leakage of pancreatic juice is a rare, severe complication following pancreatic resection or, less commonly, splenectomy. Definitive treatment can require multidisciplinary approaches. We report a case of stenosis of the main pancreatic duct with distal tail GRADE C POPF, occurred after splenectomy for Hodgkin lymphoma, successfully treated with combined radiological-endoscopic approach.
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http://dx.doi.org/10.1007/s00270-016-1332-3DOI Listing
September 2016

Multifocal bilateral desmoid tumour of perirenal tissues with peribiliary localization.

BJR Case Rep 2016 16;2(2):20150099. Epub 2015 Dec 16.

Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.

Desmoid tumour (DT) is an unusual, benign tumour, more frequently observed in patients with familial polyposis and pregnant females. It usually presents as a single mass lesion, more frequently showing a compressive rather than an infiltrative growth pattern. We report a case of a 70-year-old male presenting with a multifocal, bilateral infiltrative DT of the perirenal tissue, with involvement of the choledochus wall. The patient was partly treated with tamoxifen and docetaxel, but both therapies were discontinued in accordance with the patient's decision owing to mild toxicity; however, a CT examination performed 3 months later showed an unexpected remarkable reduction of the tumour at all sites. At 1 year follow-up, new pathologic tissue was visible surrounding the right renal pelvis and the calices.
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http://dx.doi.org/10.1259/bjrcr.20150099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180855PMC
December 2015

Role of 3.0 Tesla magnetic resonance hysterosalpingography in the diagnostic work-up of female infertility.

Acta Radiol 2016 Sep 8;57(9):1132-9. Epub 2015 Dec 8.

Department of Radiological, Oncological and Pathological Sciences, University of Rome "Sapienza", Rome, Italy.

Background: Imaging evaluation plays a crucial role in the diagnostic work-up of female infertility. In recent years, the possibility to evaluate tubal patency using 1.5 Tesla magnetic resonance (1.5T MR) has been studied.

Purpose: To assess the feasibility of 3.0 Tesla magnetic resonance (3.0T MR) hysterosalpingography and its role in the diagnostic work-up of female infertility and to evaluate if this fast "one-stop-shop" imaging approach should be proposed as a first-line examination.

Material And Methods: A total of 116 infertile women were enrolled in this prospective study; all underwent 3.0T MR hysterosalpingography. After standard imaging of the pelvis, tubal patency was assessed by acquiring 3D dynamic time-resolved T1-weighted (T1W) sequences during manual injection of 4-5 mL of contrast solution consisting of gadolinium and normal sterile saline. Images were evaluated by two radiologists with different experience in MR imaging (MRI).

Results: The examination was successfully completed in 96.5% of cases, failure rate was 3.5%. Dynamic sequences showed bilateral tubal patency in 64.3%, unilateral tubal patency in 25.9%, and bilateral tubal occlusion in 9.8%. Extratubal abnormalities were found in 69.9% of patients. Comprehensive analysis of morphological and dynamic sequences showed extratubal abnormalities in 43.1% of patients with bilateral tubal patency.

Conclusion: 3.0T MR hysterosalpingography is a feasible, simple, fast, safe, and well-tolerated examination, which allows evaluation of tubal patency and other pelvic causes of female infertility in a single session, and it may thus represent a "one-stop-shop" solution in female infertility diagnostic work-up.
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http://dx.doi.org/10.1177/0284185115617351DOI Listing
September 2016

Impact of 3D Rotational Angiography on Liver Embolization Procedures: Review of Technique and Applications.

Cardiovasc Intervent Radiol 2015 Jun 9;38(3):523-35. Epub 2014 Dec 9.

Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy,

In the last years, the interest into interventional applications of C-arm cone-beam CT (CBCT) progressively raised, widening its clinical application from the original field of interventional neuroradiology to the field of peripheral procedures. Liver embolization procedures, due to their complexity and potential treatment-related life-threatening complications, represent one of the main clinical applications of this novel angiographic technique. CBCT has been demonstrated to render procedures safer and technically easier, and to predict outcome as well as to avoid major complications in different treatment scenarios (trans-arterial embolization, trans-arterial chemoembolization, selective internal radiation therapy, percutaneous portal vein embolization). This review summarizes all technical, dosimetric and procedural aspects of CBCT techniques, underlying all its potential clinical advantages in the field of liver embolization procedures. Moreover, the paper provides all the instructions to obtain the best diagnostic performance out of this novel angiographic technique.
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http://dx.doi.org/10.1007/s00270-014-1023-xDOI Listing
June 2015

Preliminary clinical experience with a dedicated interventional robotic system for CT-guided biopsies of lung lesions: a comparison with the conventional manual technique.

Eur Radiol 2015 May 23;25(5):1310-6. Epub 2014 Nov 23.

Department of Radiological, Oncological and Anatomopathological Sciences - Radiology - Sapienza, University of Rome, Viale Regina Elena 324, 00161, Rome, Italy,

Objective: Evaluate the performance of a robotic system for CT-guided lung biopsy in comparison to the conventional manual technique.

Materials And Methods: One hundred patients referred for CT-guided lung biopsy were randomly assigned to group A (robot-assisted procedure) or group B (conventional procedure). Size, distance from entry point and position in lung of target lesions were evaluated to assess homogeneity differences between the two groups. Procedure duration, dose length product (DLP), precision of needle positioning, diagnostic performance of the biopsy and rate of complications were evaluated to assess the clinical performance of the robotic system as compared to the conventional technique.

Results: All biopsies were successfully performed. The size (p = 0.41), distance from entry point (p = 0.86) and position in lung (p = 0.32) of target lesions were similar in both groups (p = 0.05). Procedure duration and radiation dose were significantly reduced in group A as compared to group B (p = 0.001). Precision of needle positioning, diagnostic performance of the biopsy and rate of complications were similar in both groups (p = 0.05).

Conclusion: Robot-assisted CT-guided lung biopsy can be performed safely and with high diagnostic accuracy, reducing procedure duration and radiation dose in comparison to the conventional manual technique.

Key Points: • CT-guided biopsy is the main procedure to obtain diagnosis in lung tumours. • The robotic device facilitates percutaneous needle placement under CT guidance. • Robot-assisted CT-guided lung biopsy reduces procedure duration and radiation dose.
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http://dx.doi.org/10.1007/s00330-014-3508-zDOI Listing
May 2015