Nicola Sverzellati

Ospedale Maggiore di Lodi, Lodi, Lombardy, Italy

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Publications (141)372.45 Total impact

  • Cancer Research 08/2015; 75(15 Supplement):932-932. DOI:10.1158/1538-7445.AM2015-932 · 9.28 Impact Factor
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    ABSTRACT: We aimed to assess the relation between basic clinical parameters and evolution of solitary pure ground-glass nodules (pGGN) in the lungs. Baseline and follow-up computed tomography (CT) of patients with solitary pGGN were selected and two radiologists independently reviewed CTs for nodule characterization. CT features of solitary pGGN were: manually measured maximum diameter (D1) and its orthogonal diameter (D2), mean diameter (mD), D1 to D2 ratio as surrogate of roundness, and location according to lobar anatomy. Longitudinal changes were assessed and solitary pGGNs were classified as resolved or persisting. Persisting nodules were further classified as stable or grown according to an increase in mD of ≥2 mm or appearance of solid component. Baseline CT features of solitary pGGNs and clinical metrics of patients were compared between resolved and persisting nodules and, thereafter, between stable and grown lesions. A total of 95 subjects with solitary pGGN were included. After a median 16-month follow-up, 20 nodules resolved, while 75 persisted. Among persisting nodules, 18 were grown and 57 were stable. Grown nodules showed larger D1 and mD compared with stable pGGNs (P < 0.001). Subjects with grown nodules were older (P = 0.021). Logistic regression analyses showed higher likelihood of growth for nodules ≥10 mm (odds ratio [OR], 8.355; P = 0.001) and subjects older than 67 years (OR, 3.656; P = 0.034). Nodules ≥10 mm in subjects older than 67 years showed higher likelihood of growth. These data could contribute to a more individual approach to the management of solitary pGGN.
    Diagnostic and interventional radiology (Ankara, Turkey) 07/2015; DOI:10.5152/dir.2015.14457 · 1.43 Impact Factor
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    ABSTRACT: To describe changes over time in extent of idiopathic pulmonary fibrosis (IPF) at multidetector computed tomography (MDCT) assessed by semi-quantitative visual scores (VSs) and fully automatic histogram-based quantitative evaluation and to test the relationship between these two methods of quantification. Forty IPF patients (median age: 70 y, interquartile: 62-75 years; M:F, 33:7) that underwent 2 MDCT at different time points with a median interval of 13 months (interquartile: 10-17 months) were retrospectively evaluated. In-house software YACTA quantified automatically lung density histogram (10th-90th percentile in 5th percentile steps). Longitudinal changes in VSs and in the percentiles of attenuation histogram were obtained in 20 untreated patients and 20 patients treated with pirfenidone. Pearson correlation analysis was used to test the relationship between VSs and selected percentiles. In follow-up MDCT, visual overall extent of parenchymal abnormalities (OE) increased in median by 5 %/year (interquartile: 0 %/y; +11 %/y). Substantial difference was found between treated and untreated patients in HU changes of the 40th and of the 80th percentiles of density histogram. Correlation analysis between VSs and selected percentiles showed higher correlation between the changes (Δ) in OE and Δ 40th percentile (r=0.69; p<0.001) as compared to Δ 80th percentile (r=0.58; p<0.001); closer correlation was found between Δ ground-glass extent and Δ 40th percentile (r=0.66, p<0.001) as compared to Δ 80th percentile (r=0.47, p=0.002), while the Δ reticulations correlated better with the Δ 80th percentile (r=0.56, p<0.001) in comparison to Δ 40th percentile (r=0.43, p=0.003). There is a relevant and fully automatically measurable difference at MDCT in VSs and in histogram analysis at one year follow-up of IPF patients, whether treated or untreated: Δ 40th percentile might reflect the change in overall extent of lung abnormalities, notably of ground-glass pattern; furthermore Δ 80th percentile might reveal the course of reticular opacities.
    PLoS ONE 06/2015; 10(6):e0130653. DOI:10.1371/journal.pone.0130653 · 3.23 Impact Factor
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    Annals of the Rheumatic Diseases 06/2015; 74(Suppl 2):587.2-588. DOI:10.1136/annrheumdis-2015-eular.6409 · 10.38 Impact Factor
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    ABSTRACT: The aim of the study was to compare both reproducibility and prognostic value of lesion size measurements obtained manually and semiautomatically on computed tomography in advanced non-small cell lung cancer (NSCLC). Manual axial longest diameter, semiautomatic axial longest diameter, and volume of NSCLC lesions were independently analyzed by 4 readers at baseline and after at least 1 cycle of platinum-based chemotherapy. The prognostic value of the proportional change in lesion size between baseline and follow-up CT was evaluated using either RECIST or experimental thresholds derived from the quartiles of the changes as assessed manually or semiautomatically. Semiautomatic axial longest diameter (concordance correlation coefficient [CCC]: 0.980 to 0.987; variation coefficient [VC%]: 6% to 7.3%) and volume (CCC: 0.974 to 0.991; VC%: 5.6% to 9.5%) were more reproducible than manual axial longest diameter (CCC: 0.950 to 0.984; VC%: 6.4% to 11.7%). RECIST categories did not stratify patients with different survival durations. For 3/4 readers, a decrease of ≤70% in lesion volume was associated with shorter survival (median survival: 11 mo, P<0.05; hazard ratio: 5 to 22.2, P<0.05). In advanced NSCLC, semiautomatic measures were more reproducible than manual diameter, and volumetric measurement may better predict patient survival.
    Journal of thoracic imaging 03/2015; Publish Ahead of Print. DOI:10.1097/RTI.0000000000000145 · 1.49 Impact Factor
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    ABSTRACT: ABSTRACT Purpose. Interstitial lung disease (ILD) related to systemic sclerosis (SSc) is assessed with Pulmonary Functional Tests (PFTs) and semiquantitative scores based on ILD extent detectable on chest Computed Tomography (CT). CT quantitative indexes (QCTI) are promising tools to assess ILD extent. This study's aim is to evaluate the validity of QCTI compared with chest CT standard evaluation and PFTs. Moreover QCTI differences between patients' subgroups according to prognostic stratifications were investigated. Methods. ILD-SSc of patients from six rheumatological clinics was routinely assessed with chest CT and PFTs. Patients were clustered according to prognosis based on functional and/or radiological exams. Finally chest CT were processed with OsiriX in order to obtain QCTI. Results. Two hundred fifty-seven SSc patients were enrolled. QCTI correlation between ILD extent and PFTs range, respectively, from -0.60 to 0,58 and from -0,54 to 0,52. The majority of QCTI have a different distribution in patients' subgroups based on prognosis. Most of QCTI discriminate patients with an ILD severity leading to a poor prognosis. Conclusions. QCTI assessment of ILD-SSc is comparable to the evaluation based on chest CT and/or PFTs. QCTI values corresponding to severe ILD were identified. QCTI are excellent candidates for a new and more reliable SSc-ILD assessment.
    Modern Rheumatology 03/2015; DOI:10.3109/14397595.2015.1016200 · 2.21 Impact Factor
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    Mario Silva · Hilario Nunes · Dominique Valeyre · Nicola Sverzellati
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    ABSTRACT: The diagnostic imaging contributes significantly to the diagnosis and management of sarcoidosis. Imaging techniques are widely employed in the assessment of thoracic and extra-thoracic involvement from sarcoidosis. For the diagnosis of sarcoidosis, chest radiograph has been the cornerstone of sarcoidosis since 1961, when Scadding proposed a standardized staging system. Currently, computed tomography (CT) represents the reference standard for the assessment of both mediastinal lymph nodes and pulmonary findings. In particular, high-resolution computed tomography (HRCT) is more accurate compared to chest radiography for the detection of subtle parenchymal involvement, and provides comprehensive overview of anatomical detail and abnormalities of lung structures. Notably, HRCT allows for accurate differentiation between reversible and irreversible lung disease, which is cornerstone of prognostication. Radionuclide imaging (gallium-67 and (18)F-fluorodeoxyglucose) provides information about activity of the disease and is also useful for diagnostic workup of patients with unexplained persistent disabling symptoms. Magnetic resonance is sensitive for the detection of sarcoidosis granulomata within myocardium, thus providing detailed roadmap for biopsy. For the management of sarcoidosis, CT is of paramount importance in the detection and differential of most common complications, such as vascular disease and suspicious nodular lesions. Conversely, the role of CT in the follow-up of asymptomatic subjects is still under debate. This review focuses on the role of diagnostic imaging in the diagnosis and follow-up of sarcoidosis.
    Clinical Reviews in Allergy & Immunology 03/2015; 49(1). DOI:10.1007/s12016-015-8478-7 · 4.73 Impact Factor
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    A Ariani · F Lumetti · M Silva · D Santilli · F Mozzani · G Lucchini · G Delsante · N Sverzellati
  • Revue des Maladies Respiratoires 01/2015; 32. DOI:10.1016/j.rmr.2014.11.051 · 0.49 Impact Factor
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    ABSTRACT: Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is a complex pulmonary syndrome mediated by the immune system and caused by inhalation of a wide variety of antigens to which the individual has been previously sensitized. The pathobiology of the disease is not fully understood, but in addition to the triggers that initiate the disease, host/genetic factors are likely to be important, as only a minority of exposed individuals develop HP. Due to the lack of a diagnostic gold standard, the diagnosis of HP is not straightforward and relies on the integration of a number of factors, including history of exposure, precipitating antibodies to the offending antigen, clinical features, bronchoalveolar lavage, and radiological and pathologic features. However, in the appropriate setting, a high index of suspicion is critically important and may obviate the need for more invasive tests. Clinical presentation and natural history vary widely. Acute forms generally resolve without sequelae, while chronic forms, which are caused by persistent low-grade exposures, are associated with poor prognosis. Corticosteroids may be useful in acute episodes for symptomatic relief or in chronic and progressive disease, but their long-term efficacy has never been validated in prospective clinical trials. Ideally, patients with HP should be referred to centers with expertise, as the overlap with other forms of interstitial lung disease may be substantial. Making the correct diagnosis has critical therapeutic and prognostic implications.
    Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología 01/2015; 25(4):237-50; quiz follow 250. · 2.64 Impact Factor
  • Cancer Research 10/2014; 74(19 Supplement):871-871. DOI:10.1158/1538-7445.AM2014-871 · 9.28 Impact Factor
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    ABSTRACT: Idiopathic pulmonary fibrosis (IPF), the most common and lethal of the idiopathic interstitial pneumonias, is defined by a radiological and/or pathological pattern of usual interstitial pneumonia (UIP). However, UIP is not synonymous with IPF as other clinical conditions may be associated with UIP, including chronic hypersensitivity pneumonitis, collagen vascular disease, drug toxicity, asbestosis, familial IPF and Hermansky-Pudlak syndrome. Differentiating IPF ("idiopathic UIP") from conditions that mimic IPF ("secondary UIP") has substantial therapeutic and prognostic implications. A number of radiological and histological clues may help distinguish IPF from other conditions with a UIP pattern of fibrosis, but their appreciation requires extensive expertise in interstitial lung disease as well as an integrated multidisciplinary approach involving pulmonologists, radiologists and pathologists. In addition, multidisciplinary discussions may decrease the time to initial IPF diagnosis and, thus, enable more timely management. This concept was strongly emphasised by the 2011 ATS/ERS/JRS/ALAT guidelines. This article highlights, with the aid of a clinical case, the difficulties in making a diagnosis of IPF in clinical practice. Yet, an accurate diagnosis is critical, particularly given the availability of drugs that may reduce the pace of functional decline and disease progression in IPF.
    European Respiratory Review 09/2014; 23(133):308-319. DOI:10.1183/09059180.00004914
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    ABSTRACT: BACKGROUND Lung cancer (LC) is frequently associated with idiopathic pulmonary fibrosis (IPF), despite this well-known association the outcome of LC in IPF patients is unclear. The objective of this study was to evaluate the impact of LC on survival of patients with associated IPF. METHODSA total of 260 patients with IPF were reviewed and 186 IPF cases had complete clinical and follow-up data. Among these 5 cases were excluded because LC was radiologically suspected but not histologically proven. The remaining 181 cases were categorized in two groups: 23 patients with biopsy proven LC and IPF (LC-IPF) and 158 patients with IPF only (IPF). Survival and clinical characteristics of the two groups were compared. RESULTSPrevalence of histologically proven LC was 13%, and among those with LC-IPF cumulative incidence at 1 and 3 years was 41% and 82%. Patients with LC were more frequently smokers (91.3% vs 71.6%, p= 0.001), with combined pulmonary fibrosis and emphysema (CPFE) (52% vs 32%, p = 0.052). Survival in patients with LC-IPF was significantly worse than IPF patients without LC (median survival 38.7 months versus 63.9 months (HR=5.0; 95% CI: 2.91-8.57; p<0.001). Causes of death in the study group were respiratory failure in 43% of patients, LC progression in 13 % and LC treatment related complications in 17%. CONCLUSION In patients with IPF LC has a significant adverse impact on survival. Diagnosis and treatment of LC in IPF are burdened by an increased incidence of severe complicating events, apparently as lethal as the cancer itself.
    Chest 08/2014; 147(1). DOI:10.1378/chest.14-0359 · 7.13 Impact Factor
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    A Ariani · F Lumetti · M Silva · D Santilli · F Mozzani · G Lucchini · G Delsante · N Sverzellati
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    ABSTRACT: The pulmonary fibrosis extent in systemic sclerosis (SSc) has a prognostic value. Chest Computed Tomography (CT) is the gold standard to detect an interstitial lung disease (ILD). Semi-quantitative scores and quantitative methods can estimate the ILD. The first ones have a considerable inter-intraobserver variability, while quantitative scores, based on distribution of lung attenuation parameters (also called CT indexes), can be obtained through expensive and not so user-friendly software. The aim of this work is to investigate whether a DICOM-viewer open-source software (OsiriX) can obtain CT indexes correlating with semi-quantitative scores. Sixty-three chest CTs of ILD-SSc patients were assessed with two semi-quantitative methods (visual extent and limited/extensive ILD grading) and then blindly processed with OsiriX to obtain the distribution parameters of lung attenuation (kurtosis, skewness and mean). Semiquantitative assessment and CT indexes were compared through the Spearman rank test and Mann-Whitney test. All CT indexes showed a statistically significant correlation of moderate degree with the visual extent semi-quantitative assessment (p-value less than 0.05). Skewness was the lung attenuation distribution parameter with the strongest correlation (r =-0.378, p-value = 0.0023). Moreover, CT indexes of patients with an extensive and limited disease were statistically different (p less than 0.01). CT indexes correlating with a radiological semi-quantitative ILD assessment can be obtained through OsiriX. CT indexes can be considered very helpful to discriminate patients with extensive and limited ILD.
    Journal of biological regulators and homeostatic agents 07/2014; 28(3):507-13. · 2.41 Impact Factor
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    ABSTRACT: To evaluate the feasibility of coronary artery calcium score (CACS) on low-dose non-gated chest CT (ngCCT).
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    G Lucchini · N Sverzellati · M Silva · G Delsante · A Ariani
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    ABSTRACT: Background Naifold videocapillaroscopy (NVC) is an useful diagnostic test for the early diagnosis and monitoring of Systemic sclerosis (SSc). The NVC semiquantitative evaluation (scleroderma pattern early, active and late) is widely used for its prognostic value of the organ involvement, particularly of the lung. Some authors have proposed quantitative measurements of the following capillaroscopic parameters (also called QNVC parameters): number of giant capillaries (M), number of capillaries in the distal row (N), maximum diameter of giant capillaries (D) and M:N ratio. Recently two scores were developed to assess the nailfold microvascular damage and the digital ulcers risk [1-2]. Interstitial lung disease related to SSc (ILD-SSc) can be assessed by pulmunary function test (PFTs) and by semiquantitative scores based on the extent of radiological lesions presented on pulmonary CT. Goh et al. [3] have proposed a semiquantitative grading system of ILD-SSc that provides discriminatory prognostic information. Objectives To verify the correlation between QNVC parameters and ILD-SSc extent evaluated by pulmunary function tests and by Goh et al. semiquantitative grading system. Furthermore to compare the distribution of ILD-SSc extent and QNVC parameters in the groups of patients with different capillaroscopic pattern. Methods 24 patients with SSc (all met the ACR/EULAR classification criteria for SSC) were examined in a period of three months with the following test: NVC, chest CT e PFTs. NVC was performed according to Sulli et al. [2]. Two experienced rheumatologist in NVC (7 and 6 years) evaluate the images of each patient providing the following QNVC parameters: M, N, D, M:N. Chest CTs were evaluated by two radiologists with 15 and 6 years experience in ILD-SSc evaluation. Spearman rank test was used to verify the correlations between QNVC parameters, PFTs data and CT radiological assessment. Kruskal-Wallis test was used to assess QNVC parameters and CT radiological assessment differences between patients clustered according to capillaroscopic pattern. A p-value <0.05 was considered significant. Results The following QNVC parameters correlate with CT radiological assessment: number of megacapillaries (r = -0,488; p=0,399), density of giant capillaries (p = -0,501; p=0,0343), maximum diameter of megacapillaries (r = -0,685; p=0,0017), M:N ratio (r = -0,502; p=0,0338). The only QNVC correlating with FVC is maximum diameter of megacapillaries (r =0,488; p=0,0212). All NVC parameters had a statistically different distribution between patients with early, late and active scleroderma pattern (p<0.05). Pulmonary fibrosis extent among the three groups, although different, has not reached statistical significance. Conclusions In our study the ILD-SSc extent correlates with maximum diameter and number of giant capillaries. These findings suggest that the loss and dimensional change of giant capillaries could be indicative of a pulmonary evolution towards ILD. Hopefully with more numerous cohorts it might be developed a NVC score to predict ILD presence and/or extent. References Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5457
    EULAR 2014; 06/2014
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    ABSTRACT: Background Interstitial lung disease (ILD) is a relevant extra-articular manifestation of rheumatoid arthritis (RA). Usual interstitial pneumonia (UIP) is the most frequent histo-pathological pattern of RA-ILD, followed by nonspecific interstitial pneumonia (NSIP); high-resolution computed tomography (HRCT) is crucial for the evaluation of ILD patterns without recourse to lung biopsy. Clinically, significant ILD is described in about 4% of RA patients, and recent data suggest that RA-ILD may relate to smoking and/or the presence of anti-citrullinated peptides (APCA). Objectives To identify radiological patterns of ILD in RA patients, and their correlation with clinical, serological or therapeutic features of RA Methods Ninety-nine patients (mean age 63.6±17.2, male/female ratio 1.6), classified as RA according to 2010 ACR/EULAR criteria, who had performed at least one chest HRCT, were retrospectively recruited. For each patient disease duration, smoking habit, use of conventional and biologic DMARDs, presence and titer of APCA, rheumatoid factor (RF), antinuclear antibodies (ANA) and anti-extractable nuclear antibodies (ENA) were recorded. All HRCT images were <2.5 mm in collimation and were reconstructed using high-resolution algorithms. Radiologic patterns were categorized as definite UIP, possible UIP or inconsistent with UIP according to the most current international guidelines. Results RA-ILD (14 definite or possible UIP and 18 inconsistent with UIP) was detected in 32/99 RA patients. No significant associations were observed between ILD and APCA, RF, ANA, ENA, disease duration, conventional and biologic DMARDs and smoking. Comparing the three groups (definite/possible UIP, inconsistent with UIP and controls) a prevalence of male gender, RF and smoking habit were observed in patients with UIP pattern (p not significant). When UIP pattern was compared with the other 85 patients (inconsistent with UIP and controls) a significant association with male gender was observed (p=.04). Moreover, patients with UIP patterns were older (72±6.9 vs 62.3±17.9 years, p=.013), despite a same disease duration compared to patients in the other two groups. Conclusions Our data confirmed that ILD is a frequent complication of RA, although with the limits of a retrospective study. Smoking has been described as an independent predictor of ILD, and a correlation with the presence of rheumatoid factor and APCA antibodies has also been reported. Our study showed no significant associations between clinical and serological data and the presence of ILD, with the exception of male gender and older age in UIP patients. Differently by other authors no significant association was observed with APCA, neither with commonly used drugs, in particular methotrexate and anti-TNF inhibitors. Prevalence, radiological findings, and possible risk factors of RA-ILD should be further investigated in ad hoc prospective studies on large population Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4299
    Annals of the Rheumatic Diseases 06/2014; 73(Suppl 2):917-917. DOI:10.1136/annrheumdis-2014-eular.4299 · 10.38 Impact Factor
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    ABSTRACT: Mortality in pulmonary sarcoidosis is highly variable and a reliable prognostic algorithm for disease staging and for guiding management decisions is needed. The objective of this study is to derive and test a staging system for determining prognosis in pulmonary sarcoidosis. We identified the prognostic value of high-resolution computed tomography (HRCT) patterns and pulmonary function tests, including the composite physiological index (CPI) in patients with pulmonary sarcoidosis. We integrated prognostic physiological and HRCT variables to form a clinical staging algorithm predictive of mortality in a test cohort. The staging system was externally validated in a separate cohort by the same methods of discrimination used in the primary analysis and tested for clinical applicability by four test observers. The test cohort included 251 patients with pulmonary sarcoidosis in the study referred to the Sarcoidosis clinic at the Royal Brompton Hospital, UK, between Jan 1, 2000, and June 30, 2010. The CPI was the strongest predictor of mortality (HR 1·04, 95% CI 1·02-1·06, p<0·0001) in the test cohort. An optimal CPI threshold of 40 units was identified (HR 4·24, 2·84-6·33, p<0·0001). The CPI40, main pulmonary artery diameter to ascending aorta diameter ratio (MPAD/AAD), and an extent of fibrosis threshold of 20% were combined to form a staging algorithm. When assessed in the validation cohort (n=252), this staging system was strikingly more predictive of mortality than any individual variable alone (HR 5·89, 2·68-10·08, p<0·0001). The staging system was successfully applied to the test and validation cohorts combined, by two radiologists and two physicians. A clear prognostic separation of patients with pulmonary sarcoidosis is provided by a simple staging system integrating the CPI and two HRCT variables. National Institute of Health Research Respiratory Disease Biomedical Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London.
    The Lancet Respiratory Medicine 02/2014; 2(2):123-30. DOI:10.1016/S2213-2600(13)70276-5 · 9.63 Impact Factor
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    ABSTRACT: Recent screening trial results indicate that low-dose computed tomography (LDCT) reduces lung cancer mortality in high-risk patients. However, high false-positive rates, costs, and potential harms highlight the need for complementary biomarkers. The diagnostic performance of a noninvasive plasma microRNA signature classifier (MSC) was retrospectively evaluated in samples prospectively collected from smokers within the randomized Multicenter Italian Lung Detection (MILD) trial. Plasma samples from 939 participants, including 69 patients with lung cancer and 870 disease-free individuals (n = 652, LDCT arm; n = 287, observation arm) were analyzed by using a quantitative reverse transcriptase polymerase chain reaction-based assay for MSC. Diagnostic performance of MSC was evaluated in a blinded validation study that used prespecified risk groups. The diagnostic performance of MSC for lung cancer detection was 87% for sensitivity and 81% for specificity across both arms, and 88% and 80%, respectively, in the LDCT arm. For all patients, MSC had a negative predictive value of 99% and 99.86% for detection and death as a result of disease, respectively. LDCT had sensitivity of 79% and specificity of 81% with a false-positive rate of 19.4%. Diagnostic performance of MSC was confirmed by time dependency analysis. Combination of both MSC and LDCT resulted in a five-fold reduction of LDCT false-positive rate to 3.7%. MSC risk groups were significantly associated with survival (χ1(2) = 49.53; P < .001). This large validation study indicates that MSC has predictive, diagnostic, and prognostic value and could reduce the false-positive rate of LDCT, thus improving the efficacy of lung cancer screening.
    Journal of Clinical Oncology 01/2014; 32(8). DOI:10.1200/JCO.2013.50.4357 · 18.43 Impact Factor
  • Paolo Spagnolo · Nicola Sverzellati · Athol U Wells · David M Hansell
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    ABSTRACT: Sarcoidosis is a systemic granulomatous disorder of unknown aetiology with a wide spectrum of radiological appearances and almost invariably pulmonary involvement. Lung involvement accounts for most of the morbidity and much of the mortality associated with sarcoidosis. Imaging contributes significantly to the diagnosis and management of patients with sarcoidosis. In typical cases, chest radiography may be sufficient to establish the diagnosis with little margin of error and CT is not necessary. However, CT can play a critical role in several clinical settings: atypical clinical and/or radiographic findings; normal or near-normal chest radiograph but clinical suspicion of sarcoidosis; and detection of complications. Moreover, in many patients, CT findings are atypical and unfamiliar to most radiologists (e.g. sarcoidosis mimicking other lung diseases and vice versa), and in these cases histological confirmation of the diagnosis is recommended. CT is also useful in assessing disease extent and may help to discriminate between reversible and irreversible lung disease, thus providing critical prognostic information. This review concentrates on the more difficult imaging aspects of sarcoidosis, in particular differential diagnosis and disease complications. Key points •Sarcoidosis is characterized by a wide spectrum of radiological appearances.•In typical cases, imaging substantially contributes to the diagnosis of sarcoidosis.•CT plays a critical role in atypical and complicated cases.•CT may discriminate between reversible and irreversible lung disease.
    European Radiology 01/2014; DOI:10.1007/s00330-013-3088-3 · 4.34 Impact Factor

Publication Stats

983 Citations
372.45 Total Impact Points

Institutions

  • 2015
    • Ospedale Maggiore di Lodi
      Lodi, Lombardy, Italy
  • 2014
    • University of Duisburg-Essen
      Essen, North Rhine-Westphalia, Germany
    • Istituto Nazionale Tumori "Fondazione Pascale"
      Napoli, Campania, Italy
  • 2004–2014
    • Università degli studi di Parma
      • Department of Clinical and Experimental Medicine
      Parma, Emilia-Romagna, Italy
  • 2009–2013
    • Fondazione IRCCS Istituto Nazionale dei Tumori di Milano
      Milano, Lombardy, Italy
  • 2007–2013
    • University Hospital of Parma
      • Reparto di Scienze radiologiche
      Parma, Emilia-Romagna, Italy