Nicola Sverzellati

Università degli studi di Parma, Parma, Emilia-Romagna, Italy

Are you Nicola Sverzellati?

Claim your profile

Publications (113)233.3 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the feasibility of coronary artery calcium score (CACS) on low-dose non-gated chest CT (ngCCT).
    World journal of radiology. 06/2014; 6(6):381-7.
  • [Show abstract] [Hide abstract]
    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.
  • [Show abstract] [Hide abstract]
    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; · 18.04 Impact Factor
  • [Show abstract] [Hide abstract]
    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; · 3.55 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The diagnosis of pulmonary embolism (PE) is frequently considered in patients presenting to the emergency department or when hospitalized. Although early treatment is highly effective, PE is underdiagnosed and, therefore, the disease remains a major health problem. Since symptoms and signs are non specific and the consequences of anticoagulant treatment are considerable, objective tests to either establish or refute the diagnosis have become a standard of care. Diagnostic strategy should be based on clinical evaluation of the probability of PE. The accuracy of diagnostic tests for PE are high when the results are concordant with the clinical assessment. Additional testing is necessary when the test results are inconsistent with clinical probability. The present review article represents the consensus-based recommendations of the Interdisciplinary Association for Research in Lung Disease (AIMAR) multidisciplinary Task Force for diagnosis and treatment of PE. The aim of this review is to provide clinicians a practical diagnostic and therapeutic management approach using evidence from the literature.
    Multidisciplinary respiratory medicine 12/2013; 8(1):75. · 0.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The multidisciplinary approach is ideal in the management of patients with lung cancer. Multidisciplinary evaluation strengthens the differential diagnosis of aspecific radiological findings, indeed. Notably, the differential diagnosis of early stage lung cancer is a current challenge of CT imaging because the earlier the detection, the lower the accuracy of radiological features. This is particularly true for the most common subtype of lung cancer, adenocarcinoma, because it shows various radiological features. Such variety is also reflected by the 2011 classification of lung cancer, that likely affected the diagnostic agreement between radiologist and clinician. This review discusses the common issues of lung cancer diagnosis by paired radiological-histologic interpretation of CT findings.
    Pathologica 12/2013; 105(6):329-36.
  • Source
    Paolo Scanagatta, Stefano Sestini, Nicola Sverzellati
    [Show abstract] [Hide abstract]
    ABSTRACT: We read with interest the well-written study of Tane et al. about the usefulness of 320-multidetector row for preoperative three-dimensional (3D) pulmonary vasculature assessment for candidates for pulmonary segmentectomies [1]. Puzzlingly, quite similar studies have been simultaneously published by other Japanese groups [2, 3]. We would like to add some considerations. Importantly, this paper highlights the preoperative utility of identifying the intersegmental vein to decide whether the segmentectomy is feasible or not. However, it would be interesting to understand if the 3D software is now able to clearly depict and differentiate pulmonary veins from arteries (e.g. by colour-coding these vessels differently), thus facilitating the assessment of tumoural vein invasion. Furthermore, it is unclear if the software can truly facilitate the identification of the intersegmental pulmonary vein as compared to axial computed tomography images. A second comment concerns the surgical technique: if a primary tumour is less than 2 cm in diameter, is it really important to assess pulmonary vasculature precisely? In fact, we think that it could be safe and sufficient (and probably easier) to identify the lines of inflation and deflation to divide lung parenchyma while performing a pulmonary segmentectomy. According to Schuchert and colleagues this approach could decrease the risk of bleeding and prolonged postoperative air leaks [4]. Maybe a well designed randomized controlled trial would be able to clarify these open issues. Conflict of interest: none declared. References [1] Tane S, Ohno Y, Hokka D, Ogawa H, Tauchi S, Nishio W et al. The efficacy of 320-detector row computed tomography for the assessment of preoperative 980 S. Tane et al. / Interactive CardioVascular and Thoracic Surgery pulmonary vasculature of candidates for pulmonary segmentectomy. Interact CardioVasc Thorac Surg 2013;17:974–81. [2] Iwano S, Yokoi K, Taniguchi T, Kawaguchi K, Fukui T, Naganawa S. Planning of segmentectomy using three-dimensional computed tomography angiography with a virtual safety margin: Technique and initial experience. Lung Cancer 2013;81:410–5. [3] Saji H, Inoue T, Kato Y, Shimada Y, Hagiwara M, Kudo Y et al. Virtual segmentectomy based on high-quality three-dimensional lung modelling from computed tomography images. Interact CardioVasc Thorac Surg 2013;17:227–32. [4] Schuchert MJ, Pettiford BL, Keeley S, D’Amato TA, Kilic A, Close J et al. Anatomic segmentectomy in the treatment of stage I non-small cell lung cancer. Ann Thorac Surg 2007;84:92–32.
    Interactive Cardiovascular and Thoracic Surgery 12/2013; 17(6):980-1. · 1.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE : We aimed to compare the intra- and interoperator variability of lobar volumetry and emphysema scores obtained by semi-automated and manual segmentation techniques in lung emphysema patients. MATERIALS AND METHODS : In two sessions held three months apart, two operators performed lobar volumetry of unenhanced chest computed tomography examinations of 47 consecutive patients with chronic obstructive pulmonary disease and lung emphysema. Both operators used the manual and semi-automated segmentation techniques. The intra- and interoperator variability of the volumes and emphysema scores obtained by semi-automated segmentation was compared with the variability obtained by manual segmentation of the five pulmonary lobes. RESULTS : The intra- and interoperator variability of the lobar volumes decreased when using semi-automated lobe segmentation (coefficients of repeatability for the first operator: right upper lobe, 147 vs. 96.3; right middle lobe, 137.7 vs. 73.4; right lower lobe, 89.2 vs. 42.4; left upper lobe, 262.2 vs. 54.8; and left lower lobe, 260.5 vs. 56.5; coefficients of repeatability for the second operator: right upper lobe, 61.4 vs. 48.1; right middle lobe, 56 vs. 46.4; right lower lobe, 26.9 vs. 16.7; left upper lobe, 61.4 vs. 27; and left lower lobe, 63.6 vs. 27.5; coefficients of reproducibility in the interoperator analysis: right upper lobe, 191.3 vs. 102.9; right middle lobe, 219.8 vs. 126.5; right lower lobe, 122.6 vs. 90.1; left upper lobe, 166.9 vs. 68.7; and left lower lobe, 168.7 vs. 71.6). The coefficients of repeatability and reproducibility of emphysema scores also decreased when using semi-automated segmentation and had ranges that varied depending on the target lobe and selected threshold of emphysema. CONCLUSION : Semi-automated segmentation reduces the intra- and interoperator variability of lobar volumetry and provides a more objective tool than manual technique for quantifying lung volumes and severity of emphysema.
    Diagnostic and interventional radiology (Ankara, Turkey) 11/2013; · 1.03 Impact Factor
  • Ugo Pastorino, Nicola Sverzellati
    Nature Reviews Clinical Oncology 11/2013; · 15.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine high resolution computed tomography (HRCT) patterns and pulmonary function indices which are associated with increased mortality in patients with connective tissue disease related fibrotic lung disease (CTD-FLD). HRCTs from 168 patients with CTD-FLD were scored by 2 observers for a variety of HRCT patterns and traction bronchiectasis. A radiological diagnosis of usual interstitial pneumonia (UIP), fibrotic non-specific interstitial pneumonia (NSIP) or indeterminate was also assigned. Using Cox regression analysis, associations with mortality were identified. Honeycombing and traction bronchiectasis scores were converted to binary absence/presence scores and also tested. A subgroup analysis of patients with biopsy material (n=51) was performed by classifying patients according to radiological and histopathological diagnoses, as concordant UIP, discordant UIP and fibrotic NSIP. The prognostic separation of this classification was also evaluated. Severity of traction bronchiectasis (HR 1.10, p=0.001, 95% CIs 1.04 to 1.17), increasing extent of honeycombing (HR 1.08, p=0.021, 95% CI 1.03 to 1.13) and reduction in DLco (HR 0.97, p=0.013, 95% CI 0.95 to 0.99) were independently associated with increased mortality. Interobserver agreement and prognostic strength were higher for binary traction bronchiectasis scores (weighted κ (κw)=0.69, HR 4.00, p=0.001, 95%CI 1.19 to 13.38), than binary honeycombing scores (κw=0.50, HR 2.87, p=0.022, 95% CI 1.53 to 5.43). The radiological-histopathological classification was strongly associated with increased mortality (HR 2.74, p<0.001, 95% CI 1.57 to 4.77) and patients with discordant UIP had a better prognosis than concordant UIP but worse prognosis than fibrotic NSIP. Severity of traction bronchiectasis, extent of honeycombing and DLco are strongly associated with mortality in CTD-FLD. Interobserver agreement for traction bronchiectasis is higher than for honeycombing. In CTD-FLD, radiological diagnosis has survival implications in biopsy proven UIP.
    Thorax 10/2013; · 8.38 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: In 2002 the American Thoracic Society/European Respiratory Society (ATS/ERS) classification of idiopathic interstitial pneumonias (IIPs) defined seven specific entities, and provided standardized terminology and diagnostic criteria. In addition, the historical "gold standard" of histologic diagnosis was replaced by a multidisciplinary approach. Since 2002 many publications have provided new information about IIPs. Purpose: The objective of this statement is to update the 2002 ATS/ERS classification of IIPs. Methods: An international multidisciplinary panel was formed and developed key questions that were addressed through a review of the literature published between 2000 and 2011. Results: Substantial progress has been made in IIPs since the previous classification. Nonspecific interstitial pneumonia is now better defined. Respiratory bronchiolitis-interstitial lung disease is now commonly diagnosed without surgical biopsy. The clinical course of idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia is recognized to be heterogeneous. Acute exacerbation of IIPs is now well defined. A substantial percentage of patients with IIP are difficult to classify, often due to mixed patterns of lung injury. A classification based on observed disease behavior is proposed for patients who are difficult to classify or for entities with heterogeneity in clinical course. A group of rare entities, including pleuroparenchymal fibroelastosis and rare histologic patterns, is introduced. The rapidly evolving field of molecular markers is reviewed with the intent of promoting additional investigations that may help in determining diagnosis, and potentially prognosis and treatment. Conclusions: This update is a supplement to the previous 2002 IIP classification document. It outlines advances in the past decade and potential areas for future investigation.
    American Journal of Respiratory and Critical Care Medicine 09/2013; 188(6):733-48. · 11.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The imaging techniques in patients treated for lung cancer may be challenging to interpret. Radiologists are often asked to evaluate computed tomography (CT) scans after surgery, and this interpretation requires an understanding of both the timing and type of the surgical procedure. However, follow-up strategies are still not well defined. The assessment of tumor response to chemoradiotherapy relies on a tight integration of CT and clinical findings. Positron emission tomography-computed tomography (PET-CT) with fluorodeoxyglucose may help to exclude tumor recurrence when the sole CT scan is equivocal. More efforts are needed to validate the tools for volumetric tumor measurement in routine practice and to demonstrate their superiority compared to the Response Evaluation Criteria in Solid Tumors (RECIST). Familiarity with the assessment of lung cancer perfusion is also important because of the increasing use of cytostatic therapy. In this review, we outlined the imaging assessment of tumor recurrence after surgery and the role of CT, magnetic resonance imaging, and PET-CT in the follow-up after chemotherapy, radiotherapy, and radiofrequency ablation.
    Diagnostic and interventional radiology (Ankara, Turkey) 08/2013; · 1.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to analyse factors predicting the diagnostic accuracy of computed tomography (CT)-guided transthoracic fine-needle aspiration (TTFNA) for solid noncalcified, subsolid and mixed pulmonary nodules, with particular attention to those responsible for false negative results with a view to suggesting a method for their correction. From January 2007 to March 2010, we retrospectively reviewed the CT images of 198 patients of both sexes (124 males and 74 females; mean age, 70 years; range age, 44-90) used for the guidance of TTFNA of pulmonary nodules. Aspects considered were: lesion size and density, distance from the pleura, and lesion site. Multiplanar reformatted images (MPR) were retrospectively obtained in the sagittal and axial oblique planes relative to needle orientation. The overall diagnostic accuracy of TTFNA CTguided biopsy was 86% for nodules between 0.7 and 3 cm, 83.3% for those between 0.7 and 1.5 cm, and 92% for those between 2 and 3 cm. Accuracy was 95.1% for solid pulmonary nodules, 84.6% for mixed nodules, and 66.6% for subsolid nodules. The diagnostic accuracy of CT-guided TTFNA in relation to the distance between the nodule and the pleural plane was 95.6% for lesions adhering to the pleura and 83.5% for central ones. The diagnostic accuracy was 84.2% for the pulmonary upper lobe nodules, 85.3% for the lower lobe and 90.9% for those in the lingula and middle lobe. In 75% of false negative and inadequate/insufficient cases the needle was found to lie outside the lesion, after reconstruction of the needle path by MPR. The positive predictive factors of CT-guided TTFNA are related to the nodule size, density and distance from the pleural plane. The most common negative predictive factor of CT-guided TTFNA is the wrong position of the needle tip, as observed in the sagittal and axial oblique sections of the MPR reconstructions. The diagnostic accuracy of CT-guided TTFNA can therefore be improved by using the MPR technique to plan the needle path during the FNA procedure.
    La radiologia medica 07/2013; · 1.46 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: We aimed to evaluate the validity of lung lobe weight assessment via computed tomography (CT) by comparing CT-derived and ex vivo measurements. MATERIALS AND METHODS: Unenhanced CT scanning was performed in 30 consecutive patients before lobectomy for lung cancer. The CT images were analyzed using research software after allowing for lobar weight quantitation. The lobar weight estimated by CT was then compared with that measured after surgery using a precision scale (ex vivo measurement). Comparisons as well as assessment of intra- and interoperator variability were conducted using the Bland-Altman method and the coefficient of repeatability (CR). Correlations were examined using Pearson's correlation analysis. RESULTS: Comparison analyses were feasible for 28 cases. The ex vivo lobe weight was 186.2±57.3 g, whereas the weights measured by the two operators by CT were 190.0±55 and 182.4±58.2 g, respectively. As compared with ex vivo weights, the CR was 36.4 for operator 1 and 50.4 for operator 2; the mean differences were 3.8 and -3.8 for operators 1 and 2, respectively. The intraoperator and interoperator CR were 20.9 and 36.6, respectively. The mean differences for the intra- and interoperator analysis were -1.5 and -7.5, respectively. The correlation was very high between CT-based and ex vivo measurements (r=0.95 and r=0.90 for operators 1 and 2, respectively; P < 0.001). CONCLUSION: Estimation of lung lobe weight by semi-automated CT analysis is sufficiently reproducible and in agreement with ex vivo measurements.
    Diagnostic and interventional radiology (Ankara, Turkey) 06/2013; · 1.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: The aims of this study were to evaluate the high-resolution computed tomography (HRCT) features of subsolid pulmonary nodules (SSN) detected in cancer patients to differentiate between benign and malignant lesions, to assess their evolution during the follow-up, and to determine which neoplastic diseases are most frequently associated with the growth in size and/or density of SSN. MATERIALS AND METHODS: Ninety-seven patients with a total of 146 subsolid nodules [140 pure ground-glass opacities (pGGOs) and six mixed ground-glass opacities (mGGOs)] were retrospectively recruited. Two chest radiologists independently reviewed the HRCT features of the nodules (location, shape, size, density) and the patients' clinical characteristics (sex, age, smoking and cancer history). Mean duration of follow-up was more than 2 years. RESULTS: During follow-up, 58% of SSN remained stable, 10% disappeared. An increase in size and/or density was seen in 32% of SSN, and in particular in partly solid (mGGOs), large (≥10 mm) and irregular nodules. The majority of small-size (<5 mm) rounded SSN remained stable. SSN growth was more frequent in patients with advanced age and a history of smoking, and occurred even after a long period of stability (39% of pGGOs "changed" over 3 years). The neoplastic diseases most frequently associated with SSN growth were cancers of lung (34%), breast (15%), colon (15%) and bladder (10%). CONCLUSIONS: The observation of a sample of cancer patients has shown that SSN may frequently grow in size and/or density in these patients, especially if associated with cancers of lung, breast, colon and bladder. As the majority of SSN showed a very slow development time, a follow-up period longer than 3 years is warranted even in cancer patients.
    La radiologia medica 05/2013; · 1.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES: To investigate the relationship between emphysema phenotype, mean lung density (MLD), lung function and lung cancer by using an automated multiple feature analysis tool on thin-section computed tomography (CT) data. METHODS: Both emphysema phenotype and MLD evaluated by automated quantitative CT analysis were compared between outpatients and screening participants with lung cancer (n=119) and controls (n=989). Emphysema phenotype was defined by assessing features such as extent, distribution on core/peel of the lung and hole size. Adjusted multiple logistic regression models were used to evaluate independent associations of CT densitometric measurements and pulmonary function test (PFT) with lung cancer risk. RESULTS: No emphysema feature was associated with lung cancer. Lung cancer risk increased with decreasing values of forced expiratory volume in 1s (FEV(1)) independently of MLD (OR 5.37, 95% CI: 2.63-10.97 for FEV(1)<60% vs. FEV(1)≥90%), and with increasing MLD independently of FEV(1) (OR 3.00, 95% CI: 1.60-5.63 for MLD>-823 vs. MLD<-857 Hounsfield units). CONCLUSION: Emphysema per se was not associated with lung cancer whereas decreased FEV(1) was confirmed as being a strong and independent risk factor. The cross-sectional association between increased MLD and lung cancer requires future validations.
    European journal of radiology 02/2013; · 2.65 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: To determine if the measurement of the glenoid surface by computed tomography (CT) with curved multiplanar reconstructions (cMPR) in a cadaveric model is an accurate and reproducible technique. METHODS: Ten dried cadaveric glenoid specimens were used. Two glenoids were subsequently modified mechanically to induce a bony Bankart lesion. Three skilled musculoskeletal radiologists performed cMPR on computed tomographic images of the glenoids; one of the radiologists repeated the same measurements after 3 months. Two of the 3 operators used the traditional "flat" MPR method as a control. An optical scanning system using a high-precision laser (CAM2 Laser Line Probe, Faro Technologies, Lake Mary, FL) was used as a reference. From the data obtained, an evaluation was performed for variability, degree of interoperator and intraoperator agreement, and degree of agreement between the laser and CT methods. Statistical analysis was performed with PASW-SPSS, version 18 (IBM, Armonk, NY) and R, version 2.12 statistical package. RESULTS: The average difference between the 2 sets of cMPR measurements was approximately 1%, and maximum and minimum values were between 6.02% and -0.29%. The flat MPR method showed mean differences of 16% when compared with laser scanning, and maximum and minimum values were 31% and 8%, respectively. The interoperator variability for the "curved" method was limited and showed a coefficient of variation ranging from 0.78% to 2.82%. The Cronbach alpha coefficient for this set of measurements was alpha = 0.995. There was little intraoperator variability with the coefficient of variation between 0% and 2% and an intraclass correlation coefficient of 0.989. CONCLUSIONS: The use of cMPR computed tomographic imaging of the glenoid in a cadaveric model was found to be significantly more accurate than conventional MPR (flat MPR). Moreover, cMPR CT is a reproducible technique providing reliable information despite the relevant variable anatomy of the glenoid surface. This technique could reasonably also be used in a clinical setting as a more accurate noninvasive method. CLINICAL OF RELEVANCE: This technique could also reasonably be used in a clinical setting as a more accurate noninvasive method.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 01/2013; · 3.10 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Factors determining the shape of the human rib cage are not completely understood. We aimed to quantify the contribution of anthropometric and COPD-related changes to rib cage variability in adult cigarette smokers. Rib cage diameters and areas (calculated from the inner surface of the rib cage) in 816 smokers with or without COPD, were evaluated at three anatomical levels using computed tomography (CT). CTs were analyzed with software, which allows quantification of total emphysema (emphysema%). The relationship between rib cage measurements and anthropometric factors, lung function indices, and %emphysema were tested using linear regression models. A model that included gender, age, BMI, emphysema%, forced expiratory volume in one second (FEV1)%, and forced vital capacity (FVC)% fit best with the rib cage measurements (R(2) = 64% for the rib cage area variation at the lower anatomical level). Gender had the biggest impact on rib cage diameter and area (105.3 cm(2); 95% CI: 111.7 to 98.8 for male lower area). Emphysema% was responsible for an increase in size of upper and middle CT areas (up to 5.4 cm(2); 95% CI: 3.0 to 7.8 for an emphysema increase of 5%). Lower rib cage areas decreased as FVC% decreased (5.1 cm(2); 95% CI: 2.5 to 7.6 for 10 percentage points of FVC variation). This study demonstrates that simple CT measurements can predict rib cage morphometric variability and also highlight relationships between rib cage morphometry and emphysema.
    PLoS ONE 01/2013; 8(7):e68546. · 3.73 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Kidney transplantation is currently the treatment of choice in most patients with end-stage chronic renal failure owing to the excellent results in terms of both graft and patient survival. However, surgical complications are still very frequent. Although urological (stricture, urinary fistulas, vesico-ureteral reflux) and lymphatic complications (lymphocoele) have a high incidence, they only rarely lead to graft loss. By contrast, vascular complications (stenosis, arterial and venous thrombosis, arterio-venous fistulas, pseudoaneurysms) are relatively rare, but potentially serious and may affect graft survival. Finally, medical complications such as acute tubular necrosis (ATN), rejection and de novo neoplasms may also arise in kidney transplantation. The purpose of this pictorial review is to illustrate the increasingly significant contribution of magnetic resonance angiography (MRA) in the management of complications of kidney transplantation, and emphasise how this method should now be considered a mandatory step in the diagnostic workup of selected cases. Moreover, the application and role in this setting of new magnetic resonance imaging (MRI) techniques, such as diffusion-weighted and blood oxygen level-dependent (BOLD) MRI, are also discussed.
    La radiologia medica 10/2012; · 1.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Despite the wealth of experience in the management of asthma, the disease remains inadequately controlled in some patients, who face long-term respiratory impairment and disability. The disease has been characterised as an inflammatory condition affecting first the larger airways and eventually the smaller airways, but there is evidence that peripheral airway involvement defines a particular and more severe phenotype of asthma. For this reason, assessing functional and biological parameters reflective of small airways involvement is important prognostically. No assessment method is universally and directly representative of peripheral airway function, but the traditional spirometric tests, including vital capacity, residual volume and forced vital capacity, are somewhat correlated with this function; useful methods for further assessment include the single-breath nitrogen wash-out test, impulse oscillometry, nitrous oxide and exhaled breath concentrate measurements, as well as computed tomography to reflect air trapping and response to treatment. Formulation advancements have made for easier treatment access to the smaller airways, with the new extrafine formulations resulting in better asthma control compared with non-extrafine formulations.
    Pulmonary Pharmacology &amp Therapeutics 10/2012; · 2.54 Impact Factor

Publication Stats

481 Citations
233.30 Total Impact Points

Institutions

  • 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
      Parma, Emilia-Romagna, Italy
  • 2012
    • Università degli studi di Palermo
      • Dipartimento di Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.)
      Palermo, Sicily, Italy
  • 2006–2012
    • University of Bologna
      • Department of Experimental, Diagnostic and Specialty Medicine DIMES
      Bologna, Emilia-Romagna, Italy