P Pavone

Sapienza University of Rome, Roma, Latium, Italy

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Publications (189)324.03 Total impact

  • Encyclopedia of Magnetic Resonance, 03/2007; , ISBN: 9780470034590
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    ABSTRACT: PURPOSE Crohn’s Disease (CD) is a chronic relapsing disease, whose activity is evaluated using clinical and laboratory parameters, endoscopy and radiological examinations. CT scan and MR imaging have been widely employed to define disease extent and attempted to correlate the degree of parietal contrast enhancement with disease activity. To prospectively investigate a new high resolution MRI technique for dynamic evaluation of the enhancement kinetics of small bowel parietal layers and to correlate it with CDAI, CRP, endoscopic activity and hystologic features. METHOD AND MATERIALS 16 consecutive patients with established CD by standard criteria underwent ileocolonoscopy with biopsy and serial bowel dynamic contrasted-MRI (CE-D-MRI) evaluated in blind fashion. Quantitative analysis of bowel wall enhancement kinetics was performed basing on signal to noise ratio (SNR) of a region-of-interest. Enhancement curves were obtained at the inner parietal layers (Mucosa-Submucosa, M-SM) and at the outer parietal layers (Muscular-Sierosa, Ms-S). Disease activity was defined by CDAI>150 and serum CRP>5 mg/dl. Endoscopic severity was graded according to an endoscopic score adapted from Rutgeert’s score. Six asymptomatic volunteers underwent the same protocol. RESULTS 9 patients with active ileal CD at endoscopy with mean (95% Confidence Interval) CDAI value of 177 (122-232) and CRP value of 20 (2-38) showed significant difference in parietal layered enhancement curves (M-SM vs Ms-S, p<0.03) not observed in 7 patients with inactive ileal disease (CDAI 82 [65-99] and CRP 1 [0.6-1.7]) and in controls. M-SM and Ms-S enhanced curves in clinically active patients were significantly different respect to those of patients with inactive CD and controls (p<0.001). Parietal CE-D-MRI pattern completely correlated with hystologic features (r = 0,8; p<0.001, Spearman test). CONCLUSION Layered enhancement pattern in the bowel wall could be related to the increased local inflammation in active CD. CE-D-MRI could be a useful tool for the clinical follow-up and in the treatment strategies in patient with active CD. CLINICAL RELEVANCE/APPLICATION CE-D-MRI could be a useful tool for CD activity determination and for clinical follow-up and the treatment strategy.
    Radiological Society of North America 2006 Scientific Assembly and Annual Meeting; 11/2006
  • Digestive and Liver Disease 04/2006; 38. DOI:10.1016/S1590-8658(06)80105-2 · 2.89 Impact Factor
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    ABSTRACT: PURPOSE The aim of the study was to assess the accuracy of 16-row detector Computed Tomography (MDCT)(Somatom Sensation, Siemens) in the preoperative evaluation of pancreatic cancer in comparison with endoscopic ultrasound (EUS)(Pentax Europe GmbH, Hamburg, Germany). We considered the role of both techniques in the detection, localization and staging of pancreatic cancer. METHOD AND MATERIALS Between September 2003 and February 2005 56 Pts suspected for pancreatic tumor were evaluated with MDCT and by EUS; in case of suspected lesion, biopsies were performed under ultrasonographic endoscopic guidance. 42/56 patients (19 male and 23 female, mean age 62,8) were considered in the study considering the results of the biopsies. All patients underwent surgical resection. MDCT examinations were performed with triphasic technique (basal, arterial and portal phase), after the automatic injection of 2ml/Kg of non-ionic uroangiografic contrast agent (Xenetix 350 mg I/ml, Guerbet) at a flow rate of 4-3,5 cc/sec. A linear array echoendoscope (frequency 5, 7,5, 10 MHz) )(FG3830UT Pentax Europe GmbH ) was used .The images were then post-processed with Multi-Planar Reformatting (MPR). We evaluated the primary tumor characteristics, the nodal and vessel involvement, the presence or absence of liver or other metastases. All the patients enrolled in the study underwent surgery; the preoperative EUS and MDCT staging was evaluated against the pathology findings. RESULTS EUS was more sensitive than MDCT in tumor detection and characterization, mostly in case of cystic neoplasm, and in evaluation of tumor size. MDCT had the highest accuracy in assessing extent of primary tumor (83% vs 78%), locoregional extension (78%) and the presence of distant metastases (81%). EUS had the highest accuracy in assessing lymph node involvement (62% vs. 58%) CONCLUSION According to our data, both diagnostic techniques prove to be useful for the definition of the extent of pancreatic cancer. Our results indicate that EUS should routinely performed in association with MDCT to improve the accuracy in staging of the disease.
    Radiological Society of North America 2005 Scientific Assembly and Annual Meeting; 11/2005
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    ABSTRACT: Volumetric analysis was compared with conventional unidimensional measurements for follow-up of rectosigmoid cancer before and after radiation therapy. Fifteen patients with rectosigmoid cancer underwent helical CT before and after neoadjuvant radiation therapy. The helical CT examination was performed after colon distention with air and IV administration of an antiperistaltic drug. Two scans were obtained: one with the patient in the supine position and the other with the patient in the prone position after contrast medium injection. The maximal wall thickness and the volumetric analysis of the tumor were obtained through manual segmentation. The mean of the differences between the volumetric analysis of the scans obtained before and after radiation therapy was 8.3 +/- 10.3 (SD) mL (-22.7%) (p <0.05). The mean of the differences between the maximal wall thickness of the pre- and post-radiation therapy scans was 3.4 +/- 2.6 mm (-19.1%) (p <0.05). A significant difference was observed between the variation of the maximal wall thickness and the variation of volumetric analysis in pre- and post-radiation therapy scans (p <0.05). The patients could be classified in different response categories depending on the measurement method and on the response criteria. Volumetric analysis of rectosigmoid cancer is feasible. A long-term study is needed to correlate volumetric assessment with patient outcome.
    American Journal of Roentgenology 03/2005; 184(2):526-30. DOI:10.2214/ajr.184.2.01840526 · 2.74 Impact Factor
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    ABSTRACT: Computed Tomography (CT) with three-dimensional reconstructions was studied in cranio-facial deformities. The pre-operative and follow-up study of cranio-facial deformities can be performed with spiral CT. With this modality quantitative information can be provided in order to measure the entity of airway obstruction and the result of procedure affecting bone structures.
    Acta bio-medica: Atenei Parmensis 09/2004; 75(2):122-5.
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    Filippo Cademartiri, Paolo Pavone
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    ABSTRACT: The visualization of coronary arteries has become possible only after the introduction of multislice CT scanners (MSCT), which allow a gantry rotation time of 500/ms, a number of 4 detector array, and an in-plane spatial resolution of 1 mm. Such spatial and temporal resolution has been recently improved with a new generation of MSCT scanners with 16 detector rows and a gantry rotation time of 420/ms. We report a preliminary experience with this new generation of scanners in a patient with coronary artery stent. Technical parameters are described with particular focus on the comparison with the past generation of 4-row MSCT scanners.
    Acta bio-medica: Atenei Parmensis 05/2004; 75(1):63-8.
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    ABSTRACT: Since its introduction, spiral computed tomography (CT) technology underwent a continuous and fast technical and clinical development. In particular, spatial and temporal resolutions were constantly increased during the last decade. The main breakthrough for clinical application was the introduction of multislice technology, first with 2-row and 4-row equipment and more recently with 16-row scanners. A high-resolution sub-millimeter CT dataset can be acquired easily, although with an increased x-ray exposure for the patient. The high speed of the scan requires up-to-date and careful protocol optimization. Scanner technology and geometry affect image formation procedure and imaging protocols should be adapted accordingly. The technical foundations of spiral CT imaging and the main scan and reconstruction parameters are described in this article. Updated protocols and clinical examples of the latest applications are also discussed.
    Seminars in Ultrasound CT and MRI 03/2004; 25(1):2-16. DOI:10.1053/j.sult.2003.12.002 · 1.08 Impact Factor
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    Filippo Cademartiri, Paolo Pavone
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    ABSTRACT: To test the added information of a retrospective ECG-gating to the 16-row Multislice Computed Tomography (MSCT) scan of intrathoracic vessels. Ninety-six patients (61 males, aged 59 +/- 20 years) underwent MSCT with a 16-row scanner (Sensation 16, Siemens, Germany) for the study of the thoracic vessels. In group 1 (66 patients) a retrospectively ECG-gated protocol was applied; in the control-group 2 (30 patients) a conventional MSCT protocol for thoracic imaging was applied. Images were scored regarding 1) presence or absence of artifacts determined by breath-hold, beam hardening and mis-triggering; 2) visualization (optimal, mild and poor) of great intrathoracic vessels (aorta, pulmonary arteries and veins); 3) visualization (presence or absence) of proximal, mid and distal coronary arteries (left main--LM, left anterior descending--LAD, circumflex--CX, and right coronary artery--RCA). Ascending aorta showed motion artifacts in 7 (24%) cases in group 2 and 2 (4%) in group 1. In group 1, proximal LAD, CX, and RCA were assessable in 89%, 91%, and 89%, respectively. Left main coronary artery was assessable in 61 (92%) and 18 (60%) cases for group 1 and 2, respectively. The retrospectively ECG-gated 16-row MSCT provides information regarding ascending aorta and coronary arteries not available in the conventional scan.
    Acta bio-medica: Atenei Parmensis 01/2004; 74(3):126-30.
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    ABSTRACT: To compare two different techniques to improve vessels opacification in coronary angiography with multislice CT (MSCT) scanner. Thirty consecutive patients were divided into two groups. In group 1, the synchronisation was obtained administering 20 ml of cm at 4 ml/s during a dynamic monitoring sequence. In group 2, the real time monitoring of the main bolus was used to trigger the scan. The CT angiography was performed in both groups by administering 100 ml of cm at 4 ml/s, with MSCT scanner and the following parameters: collimation 16 x 0.75 mm, rotation time 0.42 s, retrospective ECG gating. Three regions of interest were created in order to measure attenuation at: 1) ascending aorta (ROI 1); 2) descending aorta (ROI 2); 3) pulmonary artery (ROI 3). Attenuation was also measured at the origin of the main coronary arteries and their larger branches. The average time/density curve showed lower enhancement in group 1 compared to group 2 in the first 4 s and 7 s in ROI 1 and ROI 2, respectively (p<0.05). The maximum enhancement value were 342 HU and 347 HU for group 1 in ROI 1 and ROI 2, and 356 HU and 352 HU for group 2 in ROI 1 and ROI 2, respectively. The attenuation at the origin of the main coronary arteries was higher in group 2 than in group 1 (p<0.05). Real time monitoring technique allows to use 20% less cm and provides better and more homogeneous enhancement.
    La radiologia medica 01/2004; 107(1-2):24-34. · 1.37 Impact Factor
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    ABSTRACT: Aim of this paper is to describe the technical main features that characterize Spiral Computed Tomography (CT) angiography. In particular, the technical features of the three main generations of single, four, and sixteen multislice scanners have been analised. Particular attention have been addressed to scan and reconstruction parameters, and to the geometry of contrast material related to angiographic scan. Guidelines for the different generations of CT scanner have been extracted to give the radiologist a platform for diagnostic questions.
    La radiologia medica 11/2003; 106(4):269-83. · 1.37 Impact Factor
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    ABSTRACT: Until now conventional angiography has represented the only technique for assessing the coronary arteries. During the last decade, attempts have been made to validate a non-invasive technique for the study of coronary arteries. In particular, Electron-beam Tomography and Magnetic Resonance Imaging have been used for this purpose, even though they have not become clinical tools. More recently, spiral computed tomography (CT) technology, improved by the use of multiple slices and 500ms gantry rotation times, has shown a good potential without entering routine clinical practice. The introduction of multislice technology with 16 rows and rotation times below 500ms has yielded such good results in detecting significant (>50%) coronary artery stenosis that it has been proposed as a clinical tool. This paper describes the examination technique and the results achieved in CT angiography of the coronary arteries.
    La radiologia medica 10/2003; 106(4):284-96. · 1.37 Impact Factor
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    ABSTRACT: To compare virtual endoscopy of the upper airways with fiberoptic bronchoscopic examination in patients affected by non-neoplastic inflammatory disease of the trachea. Twelve patients with non-neoplastic tracheal stenosis or with tracheo-oesophageal fistula underwent a fiberoptic endoscopy and a spiral CT examination with the following protocol: collimation/table feed/reconstruction increment 3 mm/6 mm/1 mm from the larynx to the carenabronchial septum. Images were sent to a dedicated workstation equipped with a software allowing generation of 3D reconstructions and virtual endoscopic images. Lesion features were compared in the two examinations. In all cases the lesions features visualized with virtual display modality were confirmed by conventional endoscopy. Measurements were easily made on the 3D MPR images while conventional endoscopy allowed only a qualitative assessment of the lesion. In no cases did virtual endoscopy provide information on the mucosa appearance. Swallowing and breathing never caused significant artifacts during the 3D post processing. Virtual bronchoscopy is a useful technique for preoperative evaluation and for the follow-up of patients with non-neoplastic inflammatory disease of the upper airways.
    La radiologia medica 10/2003; 106(3):147-53. · 1.37 Impact Factor
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    ABSTRACT: The purpose of this study was to compare different techniques for the estimation of liver volume, and to evaluate errors associated with volume estimation techniques based on linear measurements. Fifteen patients with focal liver lesion underwent spiral CTA for preoperative evaluation. The scan protocol was: collimation 3 mm; rotation time 0.75 s; pitch 2; and reconstruction index 1 mm. Reconstructed images were sent to a workstation running on a NT platform equipped with post-processing software allowing 3D reconstructions. Linear measurements and volume estimation through manual segmentation were obtained with preset window and magnification. Volume was calculated from linear measures using different equations. With equations based on linear measurements the right lobe was overestimated (mean=+53%; mean error=14.7%), the second and third segments were underestimated (mean=-47%; mean error=43.3%) and the total volume was underestimated (mean=-86%; mean error=36%). The volume calculated by summing the areas of all the sections and multiplying the result by the increment was not significantly different from the volume estimated using the manual volumetric segmentation technique. Volume estimation obtained through linear measurements is not reliable to appraise the volume of irregular-shaped solids, even assuming the prevalence of a particular morphology.
    European Radiology 07/2003; 13(6):1286-90. DOI:10.1007/s00330-002-1706-6 · 4.34 Impact Factor
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    ABSTRACT: This study was performed to evaluate the relationship between dose levels of contrast medium and image quality in magnetic resonance (MR) angiography of the carotid arteries with fluoroscopically monitored, manually triggered, elliptically ordered image acquisitions. Twenty-five patients with clinical indications for angiography of the carotid arteries were examined with MR at 1.5 T by using a fluoroscopically monitored, manually triggered, elliptically ordered pulse sequence with the administration of one of three different volumes of gadolinium-based contrast medium. The signal intensities of the vessel lumen and the surrounding tissues were measured in single partitions at the origin of the common carotid artery, the carotid bifurcation, and the intracranial internal carotid arteries. The contrast-to-noise ratio in these regions of interest also was measured. Maximum intensity projection image quality was appraised for blurring, artifacts, venous enhancement, background suppression, and contrast medium distribution. No artifacts or venous enhancement was observed. The position of the fluoroscopic section affected the distribution of contrast medium along the vessel, as evidenced by the difference between the contrast-to-noise ratio at the origin of the common carotid artery and the ratio at the carotid bifurcation and the intracranial internal carotid arteries (P < .01). The contrast medium dose administered was strongly correlated with image quality (r = 0.90). Contrast medium dose is related to image quality in MR angiography of the carotid arteries performed with elliptical ordering, fluoroscopic monitoring, and manual triggering.
    Academic Radiology 05/2003; 10(5):520-6. · 2.08 Impact Factor
  • Circulation 03/2003; 107(5):E34-5. · 14.95 Impact Factor
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    ABSTRACT: To evaluate centric ordered MR angiography with fluoroscopic triggering of renal artery disease. 21 patients underwent MR-Angiography with a fluoroscopically triggered centric ordered sequence. The fluoroscopic trigger was obtained with the parameters that follow: TR/TE/TI: 1000/1.7/500 ms; NEX 1; MTX 141 x 256; SL 10mm; AT 0.83 s. The angiographic sequence was obtained with a CareBolus sequence (TR/TE: 3.9/1.5 ms; NEX 1; MTX 176 x 512; SL 1.1 mm; AT ~20s) after the intra-venous injection of 18 ml of Gd-BOPTA 0.5M followed by saline solution at a rate of 2.5 ml.s-1. Contrast-to-noise ratio (CNR) was obtained at the origin of the renal arteries. Statistical analysis was performed considering image quality, contrast media dose and the CNR. Ringing artifacts never occurred. The collaboration of the patient and the use of the earphones are critical to avoid motion artifacts. Renal veins have never been visualized. High CNR were noticed. This technique allows a more efficient use of the contrast media. MRA with centric ordering and fluoroscopic triggering allows an optimal and easy assessment of the renal arteries.
    La radiologia medica 01/2003; 105(1-2):42-7. · 1.37 Impact Factor
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    ABSTRACT: Ganglion cysts of the common peroneal nerve are rarely described in the literature and a bilateral lesion has not been previously reported. We present a case of a 41-year-old man with a bilateral cyst of the common peroneal nerve diagnosed with ultrasound and magnetic resonance imaging.
    European Radiology 12/2002; 12(11):2803-6. DOI:10.1007/s00330-002-1322-5 · 4.34 Impact Factor
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    ABSTRACT: To evaluate the accuracy of spiral hydro-CT in the diagnosis and preoperative staging of colo-sigmoideal neoplasms and the impact of this technique on therapeutic decisions. Sixty patients with colo-sigmoideal neoplasms, 16 in caecum-ascending colon, 2 in transverse colon, 14 in descending colon, and 28 in sigmoid colon, diagnosed with fiberoptic colonoscopy and histopathological specimen, under-went spiral hydro-CT with IV contrast medium administration. Local invasion (T factor) and nodal involvement (N factor) were evaluated. In all cases, the CT reports were compared with the result of the histopathological examination of the surgical specimen. TNM and Dukes staging classifications were applied. Local invasion was correctly identified in 80% of cases. There was overstaging in 18.3% and understaging in 1.7% of the patients. Sensitivity, specificity and accuracy for nodal involvement were 57.9%, 67.5% and 63.3%, respectively. There was overstaging in 23.3% and understaging in 15% of patients. With Dukes classification, CT correctly staged 38.8% of patients. Significant differences were detected in different stages. The stage with the highest concordance was A/B1 with 58.8% (10/17), whereas the one with the lowest concordance was B2 with 9.1% (2/22). All of the three patients in stage D were correctly staged and none of the patients with stage C was overstaged. Spiral hydro-CT with intravenous contrast medium administration, despite the limits in the correct evaluation of local depth invasion and nodal involvement, proved useful for selecting patients likely to benefit from surgery.
    La radiologia medica 11/2002; 104(4):295-306. · 1.37 Impact Factor
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    Academic Radiology 09/2002; 9 Suppl 2:S417-20. DOI:10.1016/S1076-6332(03)80249-0 · 2.08 Impact Factor

Publication Stats

1k Citations
324.03 Total Impact Points

Institutions

  • 1988–2007
    • Sapienza University of Rome
      • Department of Radiological, Oncological and Pathological Sciences
      Roma, Latium, Italy
  • 2001–2005
    • Università degli studi di Parma
      • Department of Clinical and Experimental Medicine
      Parma, Emilia-Romagna, Italy
  • 2002–2004
    • Erasmus MC
      • Department of Radiology
      Rotterdam, South Holland, Netherlands
  • 1998
    • The American University of Rome
      Roma, Latium, Italy
    • Umberto I Policlinico di Roma
      Roma, Latium, Italy
  • 1988–1993
    • Università degli Studi dell'Aquila
      • SS in Radiology
      Aquila, Abruzzo, Italy
  • 1990
    • Università Iuav di Venezia
      Venetia, Veneto, Italy