Corrado Bibbolino

Publications (13)25.82 Total impact

• Source

  Available from: PubMed Central

  Article: Detection of Pulmonary tuberculosis: comparing MR imaging with HRCT.

  Elisa Busi Rizzi, Vincenzo Schinina, Massimo Cristofaro, Delia Goletti, Fabrizio Palmieri, Nazario Bevilacqua, Francesco N Lauria, Enrico Girardi, Corrado Bibbolino
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  ABSTRACT: Computer Tomography (CT) is considered the gold standard for assessing the morphological changes of lung parenchyma. Although novel CT techniques have substantially decreased the radiation dose, radiation exposure is still high. Magnetic Resonance Imaging (MRI) has been established as a radiation- free alternative to CT for several lung diseases, but its role in infectious diseases still needs to be explored further. Therefore, the purpose of our study was to compare MRI with high resolution CT (HRCT) for assessing pulmonary tuberculosis. 50 patients with culture-proven pulmonary tuberculosis underwent chest HRCT as the standard of reference and were evaluated by MRI within 24 h after HRCT. Altogether we performed 60 CT and MRI examinations, because 10 patients were also examined by CT and MRI at follow- up. Pulmonary abnormalities, their characteristics, location and distribution were analyzed by two readers who were blinded to the HRCT results. Artifacts did not interfere with the diagnostic value of MRI. Both HRCT and MRI correctly diagnosed pulmonary tuberculosis and identified pulmonary abnormalities in all patients. There were no significant differences between the two techniques in terms of identifying the location and distribution of the lung lesions, though the higher resolution of MRI did allow for better identification of parenchymal dishomogeneity, caseosis, and pleural or nodal involvement. Technical developments and the refinement of pulse sequences have improved the quality and speed of MRI. Our data indicate that in terms of identifying lung lesions in non-AIDS patients with non- miliary pulmonary tuberculosis, MRI achieves diagnostic performances comparable to those obtained by HRCT but with better and more rapid identification of pulmonary tissue abnormalities due to the excellent contrast resolution.
  BMC Infectious Diseases 09/2011; 11:243. · 3.12 Impact Factor
• Article: Sonographic assessment of facial HIV-related lypoatrophy.

  Ada Petrone, Elisa Busi Rizzi, Vincenzo Schininà, Massimo Cristofaro, Jelena Ivanovic, Rita Bellagamba, Luca Fracasso, Emanuele Nicastri, Pasquale Narciso, Corrado Bibbolino
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  ABSTRACT: To investigate the utility of ultrasonography (US) for assessing and grading facial lypoatrophy (FLA) in patients with HIV. The social effect of FLA is huge and may reduce antiretroviral therapy adherence. Strategies for the early detection of FLA are crucial, because complete correction of FLA in late stages is unlikely. Fifty-two HIV-positive patients undergoing highly active antiretroviral therapy underwent US with nasogenian transversal scan using a high-frequency broadband transducer (5-17 MHz) to detect FLA. Intra- and interobserver variability were calculated to assess US reproducibility. Concerning FLA grading, patients were categorized in five clinical classes and four US classes. Our results regarding inter- and intraobserver coefficients of variation permit the validation of US as a reproducible technique (p<.001), and a high correlation between US and clinical classification was obtained, with complete concordance for more advanced FLA classes. The lack of a reference objective method to quantify subcutaneous fat is a major difficulty in measuring HIV-related FLA. Our results, in accordance with data from the literature, suggest that US is an ideal tool for assessing and grading FLA. Furthermore, US may be suitable for routine evaluation in HIV-infected patients for early detection of FLA and to select its optimal management.
  Dermatologic Surgery 06/2009; 35(7):1066-72. · 1.80 Impact Factor
• Article: Progressive multifocal leukoencephalopathy in HIV-infected patients in the era of HAART: radiological features at diagnosis and follow-up and correlation with clinical variables.

  Maria Letizia Giancola, Elisa Busi Rizzi, Patrizia Lorenzini, Laura Rovighi, Francesco Baldini, Vincenzo Schininà, Dora Larussa, Corrado Bibbolino, Andrea Antinori
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  ABSTRACT: The magnetic resonance (MR) imaging patterns of HIV-infected patients affected by progressive multifocal leukoencephalopathy (PML) in the HAART era have not been extensively documented. The aim of the present study is to describe the MR features of PML in HIV-infected patients at diagnosis, and the evolution during follow-up, evaluating the impact of HAART on imaging, and to correlate the MR pattern with the virological and immunological levels and with survival. We retrospectively reviewed MR imaging at baseline and at the last available follow-up within 6 months of diagnosis (median 4 months, range 1-6) of 31 HIV-positive patients affected by PML. A closer follow-up [median interval from diagnosis 39 days (range 20-139)] was also reported. At the onset of neurological disorder, 19 patients were naive for antiretroviral therapy, 7 patients were on HAART, and 5 patients were experienced but were not taking antiretroviral therapy. Upon PML diagnosis no significant differences at imaging were observed between naive and experienced patients and HAART-treated or non-HAART-treated patients. MR findings were not related to immunological status, either at baseline or at follow-up. A radiological improvement within 6 months was associated with a higher probability of a more favorable clinical evolution [OR 14.0 (2.2-87.2), p = 0.003]. The overall probability of survival at 6 months was 61.5%. A better survival was observed in patients with stable or improved MR imaging findings within 6 months [HR 4.55 (95%CI 1.36-15.19, p = 0.009]. Although HAART prolonged the survival of HIV-positive patients affected by PML, it did not seem to influence the PML MR pattern of presentation and the imaging evolution. Only the radiological outcome was predictive of clinical outcome.
  AIDS Research and Human Retroviruses 03/2008; 24(2):155-62. · 2.25 Impact Factor
• Article: HIV-related pneumococcal lung disease: does highly active antiretroviral therapy or bacteremia modify radiologic appearance?

  Elisa Busi Rizzi, Vincenzo Schininá, Laura Rovighi, Massimo Cristofaro, Eugenio Bordi, Pasquale Narciso, Corrado Bibbolino
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  ABSTRACT: We reviewed chest radiographs of 57 HIV-infected patients with pulmonary diseases in whom Streptococcus pneumoniae was the sole respiratory pathogen isolated to evaluate whether highly active antiretroviral therapy (HAART) or bacteremia modify radiographic appearance. Pneumococcal lung disease presented as lobar pneumonia in 40% of the cases, 54% of whom were on HAART; as bronchopneumonia in 42%, 58% on HAART; as interstitial infiltrates in 17%, 60% on HAART. Bacteremia was observed 38 times in 23 patients with CD4 less than 200/mm(3), and in 15 with CD4 greater than 200/mm(3) (p > 0.05). HAART does not significantly influences radiographic appearances of lung disease caused by Streptococcus pneumoniae (p > 0.05). Immunosuppression induced by HIV infection was a major risk factor for development of pneumococcal lung disease (p = 0.04) and influences radiographic appearance; bronchopneumonia (p = 0.006), in particular multifocal (p = 0.008), which was more frequent in subjects with CD4 less than 200/mm(3). Bacteremia influences radiographic appearance of pneumococcal lung disease; lobar pneumonia was more frequent (p = 0.003), and considering CD4 cell count, was more frequent if CD4 cell count was above 200/mm(3). An original finding of this study was the frequency of interstitial changes. This pattern of pneumonia, found in 17% of our patients, could represent a difference between HIV-seropositive and -seronegative subject in displaying pneumococcal lung disease.
  AIDS patient care and STDs 02/2008; 22(2):105-11. · 2.68 Impact Factor
• Article: Assessment of risk in radiology using malpractice RVU.

  Massimo Cristofaro, Giuseppe Bellandi, Salvatore Squarcione, Antonella Petecchia, Assunta Mammarella, Corrado Bibbolino
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  ABSTRACT: Analysis on the causes and remedies needed to reduce the incidence of malpractice has been under continual studies, although limited data is available regarding quantitative evaluation of the risk. To determine radiological risk in a preventive and quantitative manner and verify if the malpractice relative value units (MP-RVU) are a good indicator of associated risk factors. Radiological examinations executed by our Radiology Department in 2000-2004 have been codified according to nomenclature HCPCS (Healthcare Common Procedure Coding System) used by United States of America Centers for Medicare and Medicaid Services (CMS). For every examination was calculated the annual weight of malpractice. The data has been groupped in macroaggregates by methodology. The ratio MP-RVU/no. examinations has been considered as an index of insurance risk (MP index) A total of 133,005 examinations were performed, which produced 25,252 MP-RVU points, the total mp index was 0.193. Traditional radiology represents 38% of the examinations, accounting for 8% of MP-RVU with a MP index=0.039. Ultrasound represents 35% of the examinations, accounting for 23% of MP-RVU with a MP index=0.125. CT represents 13% of the examinations, accounting for 28% of MP-RVU with a MP index=0.434. MR represents 11% of the examinations, accounting for 39% of MP-RVU with a MP index=0.667. Malpractice relative value units (MP-RVU) are indicative of the risk considered globally and when subgrouped. MP index correlates this risk with number of exams carried out divided by methodology. This model providing quantitative data for projects concerning risk management and in allowing the correlation between data obtained in different departments.
  European Journal of Radiology 03/2007; 61(2):367-71. · 2.61 Impact Factor
• Source

  Available from: ajnr.org

  Article: Dural tail: another face of facial nerve schwannoma?

  Alessandro Stasolla, Angelo Bellussi, Corrado Bibbolino
  American Journal of Neuroradiology 11/2006; 27(9):1804; author reply 1805. · 2.93 Impact Factor
• Article: Imaging of the temporal bone in Camurati-Engelmann dysplasia with an 11-year follow-up.

  Alessandro Stasolla, Giuseppe Magliulo, Angelo Bellussi, Donato Parrotto, Corrado Bibbolino, Mario Marini
  Ontology & Neurotology 08/2005; 26(4):773-7. · 1.90 Impact Factor
• Article: Cavitary pulmonary tuberculosis HIV-related.

  Elisa Busi Rizzi, Vincenzo Schininà, Fabrizio Palmieri, Enrico Girardi, Corrado Bibbolino
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  ABSTRACT: It was usually assumed that pulmonary tuberculosis (TB) in HIV-seropositive patients represents reactivation TB, despite the radiographic appearance frequently consistent rather with a recent disease. Hence, these radiographic features were considered "atypical". We have hypothesised that the so called "atypical" radiographic features could be due to a greater proportion of primary TB among these patients, representing the typical appearance of primary radiological pattern. We reviewed chest imaging of 219 HIV+ patients with microbiological proven pulmonary tuberculosis, who were assessed for the presence, number, distribution of cavitations and for associated pulmonary parenchymal abnormalities, adenopathies and pleural effusion, and were classified as a primary or post-primary pattern. Results: The patients with post-primary pattern were 50%, and the rate of cavitation was 63%, not wandering off the general population. Cavities still occurred with similar proportion in groups with CD4 <200 or >200cells/mm(3). We suggest that HIV-related pulmonary tuberculosis is typical in its radiological appearances, consistent with those of the general population, and this could be confirmed by the most recent molecular epidemiological techniques that allow to definitely classify the tuberculosis episodes as either primary or post-primary disease.
  European Journal of Radiology 12/2004; 52(2):170-4. · 2.61 Impact Factor
• Article: Comparison between indicators for the measurement of radiology activity volumes (Italy-USA).

  Massimo Cristofaro, Corrado Bibbolino, Francesco Nicola Lauria, Antonella Petrecchia, Salvatore Squarcione, Vincenzo David
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  ABSTRACT: Different evaluation systems and indicators have recently been used to measure the activity volumes of Italian hospital departments, and in particular of Diagnostic Imaging Units. These measurements have mostly been based on more or less complex and repeatable indicators such as total accesses, accesses per imaging modality, type and number of exams. The aim of this study was to compare four models for measuring and evaluating productivity to assess their features and propose a common method for measuring activity volumes in a Diagnostic Imaging Unit. The models considered are: a) the numerical count, b) the model proposed by SNR-SAGO-SIRM, c) the model based on transfer prices in use in the Emilia Romagna Region (RER), d) the model used by the U.S. Health Care Financing Agency (HCFA-USA), based on a complex system of weights named RVUs (Relative Value Units). The period under review considers two years of activity (2000-2001) at our Diagnostic Imaging Unit. The data were collected by grouping the radiological procedures into homogeneous groups (macroaggregates) which were then assessed with the four models. The reference parameters considered in order to produce homogeneous data were: the number of procedures per physician hour, the score per hour according to the SNR-SAGO-SIRM model, the score per hour according to the RER model, the number of work-RVUs per hour worked. With regard to the HCFA-USA system, the following indicators were used: the work component (work-RVU), the insurance component (malpractice RVU) and the technical component (practice expense-RVU), the equivalent units of physician time (FTE: Full Time Equivalent), such as the number of procedures per FTE, the difficulty index, and the number of RVUs per FTE. a) The total number of procedures was 55,884, the number of procedures per hour ranged from 2.43 (August 2000) to 4.20 (March 2000); based on the numerical count conventional radiology accounted for the most of the Unit's activity (40%). b) The total score according to the SNR-SAGO-SIRM model was 147,358; the weight of each physician hour ranged from 6.37 (August 2000) to 9.80 (October 2001). The SNR-SAGO-SIRM model indicates that the most significant macroaggregate in the Unit's activity was ultrasound (42%). c) The total score according to the RER model was 4,313,047, the weight of each physician hour varied between 159 (August 2000) and 316 (April 2000). Based on the RER model, CT (42%) accounted for most of the Unit's activity. d) According to the RVU model, the total number of work-RVUs was 37,619, and the physician weight per hour ranged from 1.45 (August 2000) to 2.86 (March 2000). The predominant method was ultrasound (35%); the number of total practice expense-RVUs was 192,749; the month with the highest score was March 2000 (9,398), while the one with the lowest score was August 2000 (4,710); the total number of malpractice RVUs was 9,940, and the months with the highest scores were April 2000 (487) and March 2000 (487), while the month with the lowest score was August 2000 (243), and the modality carrying the highest insurance risks was MRI (38%). We also calculated the number of procedures per FTE (6,141), the number of work-RVUs per FTE (4,134); the difficulty index resulting from the ratio between work-RVUs and number of procedures (0.67); the number of work-RVUs per hour worked (3.06). Based on the numerical count, conventional radiology and ultrasound play a predominant role (40% and 34%, respectively, total 74%). This approach therefore fails to reflect the weight of more technologically advanced procedures. The SNR-SAGO-SIRM model gives adequate importance to the combination ''number- weight of patients'' among the macroaggregates analysed. The RER model rewards the use of more expensive technologies, as it assesses the overall weight of the service and not only the weight of the radiologist's activity. The RVU model, with its distribution of weights, differentiates the different work, cost, and insurance components of the macroaggregates. It also introduces an important aspect that is new to our professional and scientific culture: evaluation of the ''insurance component'', whose role will become increasingly important in Italy. The difficulty index (work-RVUs/no. of procedures), which expresses the ratio between the number of modalities and their complexity, is particularly interesting. This index, adjusted to reflect the Italian situation, might help to assess the true technological and scientific content of the department's activity.
  La radiologia medica 11/2004; 108(4):426-38. · 1.44 Impact Factor
• Article: Reduced value of thallium-201 single-photon emission computed tomography in the management of HIV-related focal brain lesions in the era of highly active antiretroviral therapy.

  Maria Letizia Giancola, Elisa Busi Rizzi, Riccardo Schiavo, Patrizia Lorenzini, Vincenzo Schininà, Lucia Alba, Bruno Del Grosso, Beniamino Gigli, Silvia Rosati, Lucio Mango, Corrado Bibbolino, Andrea Antinori
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  ABSTRACT: To evaluate the diagnostic value of thallium-201 single-photon emission computed tomography (201Tl SPECT) in the management of focal brain disorders in the era of highly active antiretroviral therapy (HAART), a validation study of diagnostic procedure was performed in a tertiary clinical care center in Italy. Thirty-eight consecutive HIV-infected patients with neurological impairment and focal brain lesions (FBL) were enrolled in a prospective evaluation and underwent diagnostic procedures according to a standardized protocol based on modified previously released guidelines. Six out of seven PCNSL presented high uptake at 201Tl SPECT [sensitivity 86% (95% CI 42-99); specificity 77% (95% CI 58-90); positive predictive value (PPV) 46% (95% CI 20-74); negative predictive value (NPV) 96% (95% CI 78-100)]. Among toxoplasmic encephalitis (TE) cases 14 showed no uptake and 5 showed an increased uptake [sensitivity 74% (95% CI 49-90); specificity 42% (95% CI 21-66); PPV 56% (95% CI 35-75); NPV 61% (95% CI 32-85)]. Patients taking HAART were more likely to display an increased uptake of 201Tl in the cerebral lesions than patients without HAART (OR 5.07; 95% CI 1.19-21.5). Considering only the patients with diagnosis of TE, 60% of patients who showed high radionuclide uptake were taking HAART, while 79% of patients without relevant uptake were not taking HAART. As a result of the impact of HAART, the diagnostic value of 201Tl SPECT in the management of HIV-associated FBL could be substantially reduced. This observation suggests that in HAART-treated patients, this diagnostic tool be used only when combined with other more specific diagnostic markers.
  AIDS Research and Human Retroviruses 07/2004; 20(6):584-8. · 2.25 Impact Factor
• Article: Gynecomastia in male HIV patients MRI and US findings.

  Vincenzo Schininà, Elisa Busi Rizzi, Mauro Zaccarelli, Chiara Carvelli, Corrado Bibbolino
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  ABSTRACT: To evaluate the role of MRI and sonography in differential diagnosis between gynecomastia and lipomastia in adult male HIV patients treated with high-activity antiretroviral therapy (HAART) for guide management. Nineteen adult male HIV patients with enlargement of the breast, which developed during treatment with HAART, were examined with ultrasound (US) and magnetic resonance imaging (MRI). MRI was performed with SPIR T2WI, depicted in 95% of the patients, true gynecomastia and in the remaining 5% lipomastia; US demonstrated in all patients, in the subareolar region, a hypoechoic area, but was enable to make a differential diagnosis between glandular tissue and fat accumulation. US and MRI scan should be advised in HIV-infected patient in antiretroviral therapy with enlargement of the breast, in order to assess the best choice in managing this clinical condition. MRI with fat saturation sequences clarifies the tissue distribution in the mammary gland and helps to assess the amount of fat accumulated in the breast.
  Clinical Imaging 26(5):309-13. · 0.75 Impact Factor
• Article: STIR sequence in infectious sacroiliitis in three patients.

  Angelo Bellussi, Elisa Busi Rizzi, Vincenzo Schininà, Andrea De Santis, Corrado Bibbolino
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  ABSTRACT: Magnetic resonance imaging (MRI) provides the most detailed evaluation of the sacroiliac (SI) joint and surrounding soft tissue. Therefore, this technique represents the most sensitive and specific method in early diagnosis of infectious sacroiliitis. Among three patients diagnosed as having infectious sacroiliitis in our hospital, the short tau inversion recovery sequence (STIR) was found to be more effective than the T1 contrast-enhanced sequence, particularly in delineating all findings of the SI joint inflammation and allowing for the early detection of septic sacroiliitis.
  Clinical Imaging 26(3):212-5. · 0.75 Impact Factor
• Article: Reduced computed tomography radiation dose in HIV-related pneumonia: effect on diagnostic image quality.

  Elisa Busi Rizzi, Vincenzo Schininà, Francesco Paolo Gentile, Corrado Bibbolino
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  ABSTRACT: The objective of this study was to compare the diagnostic quality of low-dose computed tomography (CT) with that of standard-dose chest CT in the diagnosis of infectious lung diseases. Thirty chest CT scans [high-resolution computed tomography (HRCT), 15; spiral CT, 15] were performed in HIV-positive patients with an infectious lung disease. Two additional slices were obtained at two lower exposures (HRCT, 120 kV/70 mAs and 120 kV/50 mAs; spiral CT, 100 kV/56 mAs and 100 kV/40 mAs) after chest routine CT. Observers compared the quality of the images obtained at different parameters and image noise. Objective evaluation of image noise was also made. Diagnostic image quality was excellent in 93% of the low-dose HRCT scans and in 86% of the low-dose spiral CT scans, rates that are always acceptable in any case. Significant differences were found in noise levels between the low-dose and reference scans; however, artifacts did not compromise detection of abnormalities. In HRCT, a mean reduction of 77% from the standard technique to the low-dose scan is possible in total and in lung effective doses. In spiral CT, this reduction is lower at 71%. These values can reach a further reduction with ultra-low-dose imaging (84% in HRCT and 80% in spiral CT). Chest CT image quality appears to be adequate to evaluate pulmonary infectious diseases, even with an effective reduction in radiation dose. Standard-dose CT with a higher patient effective dose may be appropriate for selected cases.
  Clinical Imaging 31(3):178-84. · 0.75 Impact Factor