F Sardanelli

Publications (94)173.83 Total impact

• Article: Differences among array, fast array, and high-definition scan modes in bone mineral density measurement at dual-energy x-ray absorptiometry on a phantom.

  A Delnevo, M Bandirali, G Di Leo, C Messina, L M Sconfienza, A Aliprandi, F M Ulivieri, F Sardanelli
  Clinical radiology 01/2013; · 1.65 Impact Factor
• Article: Contrast-enhanced MR imaging of the breast: association between asymmetric increased breast vascularity and ipsilateral cancer in a consecutive series of 197 patients.

  N Verardi, G Di Leo, L A Carbonaro, M P Fedeli, F Sardanelli
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  ABSTRACT: PURPOSE: This study was done to estimate the diagnostic performance of an asymmetric increase in breast vascularity (AIBV) for ipsilateral cancer. MATERIALS AND METHODS: A total of 197 patients without previous breast interventions underwent bilateral contrastenhanced (gadoterate meglumine, 0.1 mmol/kg) magnetic resonance (MR) imaging. Vessels >-2 mm in diameter and ≥3 cm in length were counted on maximum intensity projections: a difference ≥2 in number between the two breasts was considered AIBV. Pathology or ≥1 year follow-up served as a reference standard. The difference in sensitivity of AIBV between invasive and ductal carcinoma in situ (DCIS) as well as the association between AIBV and the diameter of invasive lesions or the histological grade were evaluated using χ(2) test. RESULTS: Pathology revealed 82 malignancies and 20 benign lesions: 70 invasive carcinomas (57 ductal, nine lobular, three mucinous, one papillary) and 12 DCIS: 10 fibroadenomas, two papillomas, two atypical ductal hyperplasias and six other benign lesions. The remaining 95 patients were negative at follow-up. Sensitivity of AIBV was 74% (61/82), specificity 94% (108/115), accuracy 86% (169/197), positive predictive value 90% (61/68) and negative predictive value 84% (108/129). Sensitivity for invasive cancers (80%; 56/70) was significantly higher than that for DCIS (42%; 5/12) (p<0.001). For invasive cancers, sensitivity was 40% (2/5) for lesions ≤9 mm in diameter, 69% (9/13) for those 10-14 mm, 79% (15/19) for those 15-19 mm and 91% (30/33) for those ≥20 mm (p<0.001). The G3 lesion rate was 49% (27/55) among true positives and only 7% (1/14) among false negatives (p=0.009). CONCLUSIONS: An association between AIBV and ipsilateral cancer exists, particularly for invasive cancers ≥20 mm or with high pathologic grade.
  La radiologia medica 08/2012; · 1.44 Impact Factor
• Article: Myocardial delayed enhancement using a single dose (0.1 mmol/kg) of gadobenate dimeglumine: contrast resolution versus intraventricular blood and viable myocardium

  G.D.E. Papini, S. Tritella, F. Secchi, A. Aliprandi, G. Di Leo, F. Sardanelli
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  ABSTRACT: PurposeThis study was done to estimate delayed enhancement (DE) contrast resolution of infarcted myocardium (IM) relative to intraventricular blood (IB) and viable myocardium (VM) using gadobenate dimeglumine (Gd-BOPTA). Materials and methodsAfter approval from the Ethics Committee, we retrospectively evaluated 21 consecutive patients (61±10 years) with a healed myocardial infarction who underwent 1.5-T magnetic resonance (MR) imaging using an inversion-recovery-prepared turbo gradient-echo sequence 10 minutes after injection of 0.1 mmol/kg of Gd-BOPTA. Signal intensity (SI) was measured in arbitrary units (au) for IM, IB, VM, and outside the patient. Contrast-to-noise ratio (CNR) was calculated for IM to IB and IM to VM. Seven consecutive patients (59±6 years) with a healed myocardial infarction studied with similar technique but with 0.1 mmol/kg of gadoterate meglumine (Gd-DOTA) served as the control group. The Mann-Whitney U test was used to compare groups. ResultsMean SI of IM was 44±16 au for Gd-BOPTA and 20±6 au for Gd-DOTA (p<0.001), that of IB 35±15 au and 14±5 au (p=0.016), and that of VM 7±3 au and 5±2 au (p=0.116), respectively. Mean IM to IB CNR was 10±7 for Gd-BOPTA and 8±5 for Gd-DOTA (p=0.836), that of IM to VM was 45±27 and 18±6, respectively (p=0.012). ConclusionsGd-BOPTA at 0.1 mmol/kg produced a higher myocardial DE and an IM to VM CNR than a single dose of Gd-DOTA. No significant difference was observed for IM to IB CNR. ObiettivoScopo del nostro lavoro è stato stimare la risoluzione di contrasto del delayed enhancement (DE) associato a miocardio infartuato (MI) rispetto al sangue ventricolare (SV) e al miocardio sano (MS) ottenuta con gadobenato dimeglumina (Gd-BOPTA). Materiali e metodiDopo approvazione del Comitato Etico, abbiamo valutato retrospettivamente 21 pazienti consecutivi (età 61±10 anni) con infarto miocardico cronico studiati mediante risonanza magnetica (RM) a 1,5 T con sequenza inversion-recovery turbo gradient-echo 10 minuti dopo somministrazione di 0.1 mmol/kg di Gd-BOPTA. Abbiamo misurato l’intensità di segnale (IS) in unità arbitrarie (ua) del MI, del SV, del MS e all’esterno del paziente e calcolato il rapporto contrasto-rumore (CNR) tra MI e SV e tra MI e MS. Una serie consecutiva di sette pazienti con infarto miocardico cronico (età 59±6 anni), studiati con tecnica analoga e 0.1 mmol/kg di gadoterato meglumina (Gd-DOTA) è stata utilizzata come gruppo di controllo. La comparazione tra i due gruppi è stata effettuata mediante il test U di Mann-Whitney. RisultatiL’IS media del MI è risultata 44±16 ua per Gd-BOPTA e 20±6 ua per Gd-DOTA (p<0.001), quella del SV 35±15 ua e 14±5 ua (p=0.016), quella del MS 7±3 ua e 5±2 ua (p=0.116), rispettivamente. Il CNR tra MI e SV è risultato 10±7 per Gd-BOPTA e 8±5 per Gd-DOTA (p=0.836), quello tra MI e MS 45±27 e 18±6, rispettivamente (p=0.012). ConclusioniGd-BOPTA a 0.1 mmol/kg consente di ottenere DE miocardico e CNR tra MI e MS superiori rispetto a Gd-DOTA alla stessa dose. Il CNR tra MI e SV non è significativamente diverso. KeywordsCardiac magnetic resonance (CMR)-Delayed enhancement (DE)-Gadobenate dimeglumine (Gd-BOPTA)-Gadoterate meglumine (Gd-DOTA)-Myocardium Parole chiaveRisonanza magnetica (RM) cardiaca-Miocardio-Delayed enhancement (DE)-Gadobenato dimeglumina (Gd-BOPT A)-Gadoterato meglumina (Gd-DOTA)
  La radiologia medica 04/2012; 115(5):693-701. · 1.44 Impact Factor
• Article: Magnetic resonance imaging of painful total hip replacement: detection and characterisation of periprosthetic fluid collection and interobserver reproducibility.

  A Aliprandi, L M Sconfienza, F Randelli, M Bandirali, G Di Leo, F Sardanelli
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  ABSTRACT: The purpose of our study was to demonstrate the diagnostic value of magnetic resonance imaging (MRI) when measuring and characterising periprosthetic fluid collections in patients with painful hip prosthesis and to provide an estimation of interobserver reproducibility. Nineteen patients (mean age 59±13 years) with painful total hip replacement and clinical suspicion of infection underwent MRI. Images were reviewed blindly by two musculoskeletal radiologists with different levels of experience who evaluated the presence/absence of soft tissue oedema or fluid collection (when present, three-plane maximal diameters were measured; involvement of skin/subcutaneous/deep tissues or prosthesis were estimated; fluid was classified as serous/purulent/haematic according to signal behaviour). Interobserver agreement was calculated (Cohen's ). A total of 26 MRI studies were carried out (three patients underwent two and two patients underwent three MRI examinations). Both readers detected soft tissue oedema (13/26, 50%) or fluid collection (21/26, 81%) and characterised the fluid as serous (9/21, 43%), purulent (8/21, 38%) or haematic (4/21, 19%). The collection involved skin/subcutaneous tissues (16/21, 76%), deep soft tissues (19/21, 91%) or the implant (12/21, 57%). For all evaluations, interobserver agreement was complete (=1). No significant differences were found between the measurements of the collections (p>0.258). MRI is highly reproducible in detection, localisation, quantification, and characterisation of fluid collections when the presence of implant infection is clinically suspected.
  La radiologia medica 07/2011; 117(1):85-95. · 1.44 Impact Factor
• Article: Renal volume assessment with 3D ultrasound.

  A Brancaforte, S Serantoni, F Silva Barbosa, G Di Leo, F Sardanelli, G P Cornalba
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  ABSTRACT: This study was undertaken to determine the accuracy of 3D ultrasound (US) in assessing renal volume, with multislice computed tomography (MSCT) considered as the gold standard. Forty-nine patients (30 men, 19 women; age range 30-82 years) underwent abdominal contrast-enhanced MSCT and 3D-US performed with a 3.5-MHz 3D/4D convex-array probe. The results of the two modalities were compared with the Wilcoxon test. Variability between the two measurements was determined with the Bland-Altman method and reported in terms of bias and coefficient of repeatability (CoR). Mean values obtained were 210 ml with MSCT and 192 ml with 3D-US (p<0.001). Analysis of variability per patient between MSCT and 3D-US showed a bias of 19 ml, a CoR of 47 ml and an accuracy of 78%, with an average 3D-US underestimation of 19 ml (9%). Analysis of variability per kidney showed a bias of 9 ml, a CoR of 34 ml and an accuracy of 80%. Three-dimensional US is a valuable technique for monitoring renal volume, whereas MSCT may be reserved for assessing renal anatomy and relationships with neighbouring organs.
  La radiologia medica 06/2011; 116(7):1095-104. · 1.44 Impact Factor
• Article: Cardiac magnetic resonance: impact on diagnosis and management of patients with congenital cardiovascular disease.

  F Secchi, G Di Leo, G D E Papini, V G Nardella, D Negura, M Carminati, F Sardanelli
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  ABSTRACT: To estimate the clinical impact of cardiac magnetic resonance (CMR) in patients with congenital cardiovascular disease (CCD). Since 2003, 1.5T CMR was used at our university hospital to evaluate morphology, cardiac kinetics, aortic and pulmonary flow, and vascular anatomy in patients with CCD. The present study considered a consecutive series of these patients from 2003 to 2006. A paediatric cardiologist judged our reports as expected or unexpected and, secondarily, as not reliable (level 0), describing findings already known (level 1), not changing therapy/suggested lifestyle (level 2), changing therapy/suggested lifestyle (level 3) or changing diagnosis (level 4). CMR reports were judged to be expected in 187/214 (87%) and unexpected in 27/214 (13%). Less than 2% of CMRs were judged as levels 0 or 1, 66% as level 2, and 5% as level 4. During 2005-2006 the clinical impact improved toward higher impact levels (p<0.001, chi-square test). In patients with CCD, more than one in 10 CMR reports were unexpected to cardiologists and over seven in 10 prompted a change of diagnosis or therapy.
  Clinical radiology 05/2011; 66(8):720-5. · 1.65 Impact Factor
• Article: Myocardial delayed enhancement using a single dose (0.1 mmol/kg) of gadobenate dimeglumine: contrast resolution versus intraventricular blood and viable myocardium.

  G D E Papini, S Tritella, F Secchi, A Aliprandi, G Di Leo, F Sardanelli
  [show abstract] [hide abstract]
  ABSTRACT: This study was done to estimate delayed enhancement (DE) contrast resolution of infarcted myocardium (IM) relative to intraventricular blood (IB) and viable myocardium (VM) using gadobenate dimeglumine (Gd-BOPTA). After approval from the Ethics Committee, we retrospectively evaluated 21 consecutive patients (61+/-10 years) with a healed myocardial infarction who underwent 1.5-T magnetic resonance (MR) imaging using an inversion-recovery-prepared turbo gradient-echo sequence 10 minutes after injection of 0.1 mmol/kg of Gd-BOPTA. Signal intensity (SI) was measured in arbitrary units (au) for IM, IB, VM, and outside the patient. Contrast-to-noise ratio (CNR) was calculated for IM to IB and IM to VM. Seven consecutive patients (59+/-6 years) with a healed myocardial infarction studied with similar technique but with 0.1 mmol/kg of gadoterate meglumine (Gd-DOTA) served as the control group. The Mann-Whitney U test was used to compare groups. Mean SI of IM was 44+/-16 au for Gd-BOPTA and 20+/-6 au for Gd-DOTA (p<0.001), that of IB 35+/-15 au and 14+/-5 au (p=0.016), and that of VM 7+/-3 au and 5+/-2 au (p=0.116), respectively. Mean IM to IB CNR was 10+/-7 for Gd-BOPTA and 8+/-5 for Gd-DOTA (p=0.836), that of IM to VM was 45+/-27 and 18+/-6, respectively (p=0.012). Gd-BOPTA at 0.1 mmol/kg produced a higher myocardial DE and an IM to VM CNR than a single dose of Gd-DOTA. No significant difference was observed for IM to IB CNR.
  La radiologia medica 03/2010; 115(5):693-701. · 1.44 Impact Factor
• Article: Primary hyperparathyroidism: can ultrasonography be the only preoperative diagnostic procedure?

  S Tresoldi, G Pompili, R Maiolino, N Flor, L De Pasquale, A Bastagli, F Sardanelli, G Cornalba
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  ABSTRACT: The purpose of our study was to assess the role of ultrasonography (US) before surgical treatment of primary hyperparathyroidism. We retrospectively evaluated 77 patients (60 women, 17 men; mean age 59 years) with primary hyperparathyroidism who underwent parathyroid US prior to surgery. Sixty-five of 77 (84%) patients had undergone (99m)Tc- sestamibi (MIBI) scintigraphy. The results were correlated with the surgical and histopathological findings. Surgery revealed 85 abnormal parathyroid glands in 77 patients (70 adenomas, 15 hyperplasias). The locations of the parathyroid glands were typical cervical (n=77), thyrothymic ligament (n=3), carotid sheath (n=2), and mediastinum (n=3). In two patients, intrathyroid microadenoma was diagnosed by histopathology. Seventy-four enlarged glands in 64 patients were correctly identified at US. Per-patient sensitivity and positive predictive values, respectively, were 84% (64/76) and 99% (64/65) for US, 68% (44/65) and 100% (44/44) for scintigraphy and 91% (59/65) and 98% (59/60) for both techniques combined. We weighed 63 out of 85 glands, obtaining a value of 1,004+/-1,564 mg; 460 mg (mean+/-standard deviation; median). Preoperative detection and localisation of enlarged parathyroid glands can be based on US, an inexpensive and widely available method, limiting the use of scintigraphy to those cases with negative and/or doubtful findings on US.
  La radiologia medica 09/2009; 114(7):1159-72. · 1.44 Impact Factor
• Article: [Case 15.]

  C Ottonello, A Giardino, F Sardanelli
  Radiología 07/2009;
• Article: MR imaging of aortic coarctation.

  F Secchi, A Iozzelli, G D E Papini, A Aliprandi, G Di Leo, F Sardanelli
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  ABSTRACT: Aortic coarctation accounts for 5%-10% of all congenital heart diseases and represents 7% of critically ill infants with heart disease. Magnetic resonance (MR) imaging allows the study of this disease with several advantages in comparison with conventional angiography, transesophageal echocardiography, and computed tomography. The MR protocol applied at our institution for both diagnosis and follow-up after surgical or endovascular treatment consists of four steps: morphologic study, cine MR study, flow analysis, and MR angiography (MRA). The first three sequences are acquired during breath-hold and with electrocardiographic gating. Anatomy is well depicted with dark-blood half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequences. Cine true-fast imaging with steady-state precession (true-FISP) sequences show not only morphologic features but also blood-flow changes inside the aorta. Gradient-echo sequences for phase-velocity mapping allow flow analysis. Application of Bernoulli's equation--here briefly presented and discussed--allows for calculation of the pressure gradient caused by the coarctation. MRA, acquired with a breath-hold three-dimensional T1-weighted gradient-echo sequence and intravenous administration of paramagnetic contrast material, allows for optimal depiction of the aortic lumen, with a panoramic view of the whole aorta, its main branches and possible collateral circulation.
  La radiologia medica 06/2009; 114(4):524-37. · 1.44 Impact Factor
• Article: Contrast-enhanced breast MR imaging of claustrophobic or oversized patients using an open low-field magnet.

  M Calabrese, D Brizzi, L Carbonaro, M Chiaramondia, M A Kirchin, F Sardanelli
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  ABSTRACT: A number of women who should undergo magnetic resonance (MR) imaging of the breast cannot use this diagnostic tool due to claustrophobia or excessive body size for the restricted confines of standard closed MR systems. Our aim was to evaluate the performance of open low-field magnet breast MR imaging in such patients using a high-relaxivity contrast agent. Of 397 consecutive patients undergoing breast MR imaging, 379 (95.5%) were studied at 1.5 T. Due to claustrophobia (n=15) or large body size (n=3), 18 patients (4.5%) were studied on a 0.2-T open magnet using a body coil. A 3D dynamic T1-weighted gradient-echo 94-s sequence was acquired with intravenous injection of gadobenate dimeglumine (0.1 mmol/kg). The standard of reference was pathological examination for 16 lesions classified with a maximal Breast Imaging Reporting and Data System (BI-RADS) score from 3 to 5, fine-needle aspiration cytology and >or=2-year follow-up for two lesions classified as BI-RADS 3, and >or=2-years follow-up for five lesions classified as BI-RADS 2. Diagnostic MR image quality was achieved for 20/23 lesions in 15/18 patients. Three lesions (two invasive cancers and a cyst) were not assessed due to patient movement and considered as two false negatives and one false positive. Thus, an 86% sensitivity [13/15; 95% confidence interval (CI): 70%-100%], an 87% specificity (7/8; 95% CI: 65%-100%) and an 87% accuracy (20/23; 95% CI: 73%-100%) were obtained. The intraclass correlation coefficient between MR and pathologic lesion size was 0.845. In claustrophobic or oversized patients, open low-field breast MR with gadobenate dimeglumine yields good diagnostic performance.
  La radiologia medica 03/2009; 114(2):267-85. · 1.44 Impact Factor
• Article: MR imaging of the knee in patients with medial unicompartmental arthroplasty: comparison among sequences at 1.5 T.

  A Aliprandi, F Perona, M Bandirali, P Randelli, P Cabitza, F Sardanelli
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  ABSTRACT: This study was done to test a series of magnetic resonance (MR) imaging sequences of the knee after medial unicompartmental arthroplasty. Four patients who had undergone Oxford III medial unicompartmental arthroplasty underwent 1.5-T MR imaging of the operated knee using coronal sequences: T1-weighted spin-echo (SE), T1-weighted turbo SE (TSE), proton-density (PD)- and T2-weighted TSE, T1-weighted gradient echo (GE), short-tau inversion recovery (STIR), multi echo data image combination (MEDIC), T2*-weighted GE, volumetric interpolated breath-hold examination (VIBE), and dual-echo steady state (DESS). For each sequence, we evaluated the visibility of the anatomical structures of the central pivot, lateral compartment, and anterior compartment using a semiquantitative score (0=total masking; 1=insufficient visibility; 2=sufficient visibility; 3=optimal visibility). The sum of the scores given to each sequence was divided by the maximal sum, obtaining a percentage visibility index. Friedman and sign tests were used for statistical analysis. MR examination time was 30-32 min. No patients reported pain, heat or other local discomfort. The visibility index ranged between 83% and 89% for the first four sequences without significant differences among them, 58% for STIR and 11%-36% for the last five sequences. Significant differences were found between each of the four first sequences and the remaining sequences (p<0.004) and between STIR and the last five sequences (p<0.008). MR imaging of the knee after medial unicompartmental arthroplasty was not associated with adverse events. An imaging protocol including SE, TSE and STIR sequences could be used to study the knee with unicompartmental arthroplasty.
  La radiologia medica 02/2009; 114(2):301-11. · 1.44 Impact Factor
• Article: Indications for breast magnetic resonance imaging. Consensus document "Attualità in senologia", Florence 2007.

  F Sardanelli, G M Giuseppetti, G Canavese, L Cataliotti, S Corcione, E Cossu, M Federico, L Marotti, L Martincich, P Panizza, [......], S Morassutt, D Morrone, J Nori, A Orlacchio, F Pane, P Panzarola, R Ponzone, G Simonetti, P Torricelli, G Valeri
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  ABSTRACT: The clinical use of breast magnetic resonance (MR) imaging is increasing, especially for applications requiring paramagnetic contrast-agent injection. This document presents a synthetic list of acceptable indications with potential advantages for women according to evidence from the literature and the expert opinion of the panel that developed this statement. We generally recommend that breast MR imaging be performed in centres with experience in conventional breast imaging [mammography and ultrasonography (US)] and needle-biopsy procedures (under stereotactic or US guidance) as well as in breast MR imaging and second-look US for findings not revealed by conventional imaging performed before MR imaging. In our opinion, there is no evidence in favour of breast MR imaging as a diagnostic tool to characterise equivocal findings at conventional imaging when needle-biopsy procedures can be performed, nor for the study of asymptomatic, non-high-risk women with negative conventional imaging. After a description of technical and methodological requirements, we define the indications and limitations of breast MR imaging for surveillance of high-risk women, local staging before surgery, evaluation of the effect of neoadjuvant chemotherapy, breast previously treated for carcinoma, carcinoma of unknown primary syndrome, nipple discharge and breast implants.
  La radiologia medica 11/2008; 113(8):1085-95. · 1.44 Impact Factor
• Article: In vitro investigation of poor cerebrospinal fluid suppression on fluid-attenuated inversion recovery images in the presence of a gadolinium-based contrast agent.

  L Bonzano, L Roccatagliata, F Levrero, G L Mancardi, F Sardanelli
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  ABSTRACT: Cerebrospinal fluid (CSF) enhancement on fluid-attenuated inversion recovery (FLAIR) images obtained post-gadolinium (Gd)-based agent injection is described in stroke and multiple sclerosis. Blood brain barrier (BBB) disruption with contrast agent extravasation into CSF shortens T(1) relaxation times, reducing fluid suppression. Reduced fluid suppression on FLAIR images was investigated in vitro in the presence of escalating gadopentetate dimeglumine (Gd-DTPA) concentrations mixed with artificial CSF. Low Gd-DTPA concentrations impair fluid suppression of FLAIR imaging in association with progressively reduced T(1) values. At higher concentrations, the prevalent T(2) shortening effect can explain signal intensity (SI) reduction. Post-Gd FLAIR may be useful in detecting subtle BBB leakage.
  Magnetic Resonance in Medicine 08/2008; 60(1):220-3. · 2.96 Impact Factor
• Article: In vitro investigation of poor cerebrospinal fluid suppression on fluid‐attenuated inversion recovery images in the presence of a gadolinium‐based contrast agent

  L. Bonzano, L. Roccatagliata, F. Levrero, G.L. Mancardi, F. Sardanelli
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  ABSTRACT: Cerebrospinal fluid (CSF) enhancement on fluid-attenuated inversion recovery (FLAIR) images obtained post-gadolinium (Gd)-based agent injection is described in stroke and multiple sclerosis. Blood brain barrier (BBB) disruption with contrast agent extravasation into CSF shortens T1 relaxation times, reducing fluid suppression. Reduced fluid suppression on FLAIR images was investigated in vitro in the presence of escalating gadopentetate dimeglumine (Gd-DTPA) concentrations mixed with artificial CSF. Low Gd-DTPA concentrations impair fluid suppression of FLAIR imaging in association with progressively reduced T1 values. At higher concentrations, the prevalent T2 shortening effect can explain signal intensity (SI) reduction. Post-Gd FLAIR may be useful in detecting subtle BBB leakage. Magn Reson Med 60:220–223, 2008. © 2008 Wiley-Liss, Inc.
  Magnetic Resonance in Medicine 06/2008; 60(1):220 - 223. · 2.96 Impact Factor
• Article: What is the sensitivity of mammography and dynamic MR imaging for DCIS if the whole-breast histopathology is used as a reference standard?

  F Sardanelli, L Bacigalupo, L Carbonaro, A Esseridou, G M Giuseppetti, P Panizza, V Lattanzio, A Del Maschio
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  ABSTRACT: Our purpose was to compare mammography and dynamic contrast-enhanced magnetic resonance imaging (MRI) in the detection of ductal carcinoma in situ (DCIS). Ninety patients (aged 58.6+/-16.1 years) who were candidates for unilateral (n=81) or bilateral (n=9) mastectomy underwent mammography and dynamic contrast-enhanced breast MRI using a coronal three-dimensional gradient-echo sequence with slice thickness < or =3 mm before and after intravenous injection of gadoteridol (0.1 mmol/kg). Mammographic and MR images were evaluated by two offsite readers working in consensus. Pathological examination performed on 5-mm sections covering the whole breast was used as a reference standard. Out of 99 breasts, pathology revealed 26 DCIS in 14 breasts of 14 patients, aged 52.0 +/- 9.6 years. Lesion diameter at pathology was <5 mm (n=4); > or =5 and <10 mm (n=7); > or =10 and <20 mm (n=3); > or =20 mm (n=2); not assessed (n=10). Sensitivity was 35% (9/26) for mammography and 38% (10/26) for MRI (not significant difference, McNemar test). Both mammography and MRI provided a true positive result in seven cases (four of them measured at pathology, with a diameter of 20.0+/-12.9 mm; median 20 mm) and a false negative result in 14 cases (10 of them measured at pathology, with a diameter of 4.2+/-1.9 mm; median 4.6 mm) (p=0.024, Mann-Whitney U test). Only 46% (12/26) of DCIS were detected at mammography and/or MRI; the remaining 54% (14/26) were diagnosed only at pathological examination. When the whole breast is used as the histopathological reference standard, both mammography and MRI show low sensitivity for DCIS.
  La radiologia medica 05/2008; 113(3):439-51. · 1.44 Impact Factor
• Article: Supervised automatic procedure to identify new lesions in brain MR longitudinal studies of patients with multiple sclerosis.

  R C Parodi, F Levrero, M P Sormani, A Pilot, G L Mancardi, A Aliprandi, F Sardanelli
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  ABSTRACT: Identification of new enhancing lesions is a major endpoint of longitudinal brain magnetic resonance (MR) studies of multiple sclerosis (MS). To date, this is a visual, time-consuming procedure. We present here a supervised automated procedure (SAP) aimed at reducing the time needed to identify new MS enhancing lesions. The SAP uses an algorithm including Cartesian coordinates of the lesions to be compared, their area and a constant (k). The procedure was validated for enhancing lesions on T1-weighted spin-echo images after intravenous administration of 0.1 mmol/kg of paramagnetic contrast agent, randomly selected from a dataset of a longitudinal MR study on ten relapsing-remitting MS patients followed for 2-5 years. During the validation session, two readers decided by consensus whether two lesions, present on the same slice of two examinations performed on subsequent dates, were the same or not. In this way, k was calibrated to obtain the same result from both visual inspection and automatic algorithm output. After evaluating of 25+/-5 (mean+/-standard deviation) lesions in each of ten different sessions with correction of k value, the k value became a stable value (0.45+/-0.05). Once the suitable value of k was found, SAP was able to identify new enhancing lesions, avoiding visual inspection, which is usually a lengthy procedure.
  La radiologia medica 04/2008; 113(2):300-6. · 1.44 Impact Factor
• Article: MR spectroscopy of the breast.

  F Sardanelli, A Fausto, F Podo
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  ABSTRACT: This literature review assesses the clinical potential of proton ((1)H) magnetic resonance spectroscopy (MRS) of breast lesions. We here illustrate the basic principles of spectrum acquisition for volumes of interest, determined on the basis of dynamic magnetic resonance imaging (MRI) and of MRS postprocessing. We discuss the criteria for interpreting the spectrum with particular reference to the metabolic significance of the peak of total choline containing compounds at 3.2 ppm, a marker that is correlated with malignancy. We then summarise the findings obtained in lesion characterisation (with a possible gain in specificity with respect to dynamic MRI), the assessment of the effects of neoadjuvant chemotherapy and the correlation reported at high-field between the tumour tissue concentration of choline-containing compounds and the presence of lymph node metastases. Lastly, we outline the clinical use of this technique as the final phase of a complete breast MR examination after intravenous administration of paramagnetic contrast material for the dynamic study, with reference to its use by radiologists dedicated to breast imaging.
  La radiologia medica 03/2008; 113(1):56-64. · 1.44 Impact Factor
• Article: Ultrasound guidance for locoregional anesthesia: a review.

  C Baldi, S Bettinelli, P Grossi, A Fausto, F Sardanelli, F Cavalloro, M Allegri, A Braschi
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  ABSTRACT: Although regional anaesthesia has become safer, there are an increasing number of articles regarding complications of regional blocks. During the last few years, many authors have suggested the use of ultrasound to minimize the appearance of complications. This review was performed, through a Medline research, to evaluate articles concerning ultrasound and locoregional anaesthesia published until April 2005. A total of 39 articles were reviewed. Technical procedures, the use of ultrasound guidance in epidural anesthesia, the application of this technique for peripheral nerve blocks, and its indications in pregnancy and in pediatric patients were considered. In these articles, all of the authors focused on the advantages of ultrasound guidance. With the help of this technique, correct catheter placement as close to the target as possible was obtained; the spread of local anesthetic administered around the nerve and its roots can be visualized, reducing the doses needed; in addition, it is possible to avoid the most common complications, such as intravascular injection, dura mater puncture, hematoma formation, and nerve injury. Ultrasound guidance is useful in facilitating peripheral and neuroaxial blocks and offers direct visualization of the target, adjacent structures, and local anesthetic spread. The advantages also include a decreased rate of complications and faster onset of blocks. Finally, ultrasound measurements can even result in suggestions to modify established block technique.
  Minerva anestesiologica 12/2007; 73(11):587-93. · 2.66 Impact Factor
• Article: The value of chemical fat-saturation pulse added to T1-weighted spin-echo sequence in evaluating gadolinium-enhancing brain lesions in multiple sclerosis.

  F Sardanelli, S Schiavoni, A Iozzelli, A Fausto, A Aliprandi, G L Mancardi, M Filippi
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  ABSTRACT: This study was undertaken to assess the value of a chemical (spectral) fat-saturation (fat-sat) pulse added to a T1-weighted spin-echo sequence after intravenous administration of paramagnetic contrast agent in detecting enhancing lesions in multiple sclerosis. Twenty patients with relapsing-remitting multiple sclerosis underwent a brain 1.0-Tesla magnetic resonance (MR) scan with T1-weighted spin-echo sequences (24 contiguous para-axial slices with a thickness of 5 mm, pixel size 0.96 mm(2), number of excitations 2, flip angle 90 degrees ) 5 min after intravenous injection of 0.1 mmol/kg of gadodiamide with and without fat-sat, acquired with randomised order of priority. Two readers counted by consensus the number of enhancing lesions and assigned a conspicuity score (low conspicuity=1; high conspicuity=2) to each enhancing lesion during a randomised reading without any visual comparison between the two corresponding images (with and without fat-sat) of the same patient. McNemar and Wilcoxon matched-pair signed-rank tests were used. Seventy-two enhancing lesions without fat-sat and 94 with fat-sat were detected; 22 lesions were visible only with fat-sat, whereas no lesion was detected only without fat-sat (p<0.0001). The conspicuity score was 1.17+/-0.38 (mean+/-standard deviation) and 1.57+/-0.44, respectively (p<0.0001). A fat-sat pulse added to a T1-weighted spin-echo sequence increases significantly the number and conspicuity of contrast-enhancing lesions in patients with relapsing-remitting multiple sclerosis.
  La radiologia medica 12/2007; 112(8):1244-51. · 1.44 Impact Factor