Alessandro Napoli

Alessandro Napoli
Sapienza University of Rome | la sapienza · Department of Radiological, Oncological and Pathological Sciences

MD, PhD

About

253
Publications
29,272
Reads
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4,056
Citations
Additional affiliations
January 2011 - present
Sapienza University of Rome
Position
  • Professor (Assistant)
December 2002 - January 2004
Stanford University
Position
  • Research Associate

Publications

Publications (253)
Article
Full-text available
Purpose To assess the potential role of computed tomography (CT) texture analysis (CTTA) in identifying vulnerable patients with carotid artery atherosclerosis. Methods In this case-control pilot study, 12 patients with carotid atherosclerosis and a subsequent history of transient ischemic attack or stroke were age and sex matched with 12 control...
Article
Full-text available
The prevalence and impact of imaging findings detected during screening procedures in patients undergoing transcranial MR-guided Focused Ultrasound (tcMRgFUS) thalamotomy for functional neurological disorders has not been assessed yet. This study included 90 patients who fully completed clinical and neuroradiological screenings for tcMRgFUS in a si...
Article
Lumbosacral disc herniation (LDH) represents the most common cause of sciatica. Currently, there is limited evidence about minimally invasive interventional therapies for the treatment of this condition. This paper presents the protocol for a multicenter, prospective, randomized, controlled, phase III trial evaluating if PRF in addition to TFESI le...
Article
Background: A phase 3 multicenter trial demonstrated that magnetic resonance imaging (MRI)-guided focused ultrasound (US) is a safe, noninvasive treatment that alleviated pain from bone metastases. However, outcomes varied among institutions (from 0%-100% treatment success). Purpose: The aim of this study was to identify patient selection, techn...
Article
Dysregulation of the human's energy balance, mediated by non-performing endocrine organs (liver, skeletal muscle and adipose tissue, above all), can be related to human metabolic disorders characterized by an impaired body composition (BC), such as obesity and sarcopenia. While it is possible to monitor the BC and its variations at different levels...
Article
Uterine fibroids (UFs) are the most common neoplasm in women. These lesions may be associated with impaired fertility and adverse obstetric outcomes. Medical treatment, myomectomy, hysterectomy and uterine artery embolization (UAE) have been employed for the management of UFs. Focused ultrasound surgery (FUS) is a relatively recent technique that r...
Article
e17600 Background: With improvements in diagnostic modalities such as functional imaging, oligometastatic prostate cancer is being diagnosed with greater frequency than ever before. Our aim was to determine MRgFUS ability to downstage patients with oligometastatic bone disease with single session of non-invasive metastasis-directed therapy. Methods...
Article
Objectives To assess the intraoperative neuroimaging findings in patients treated with transcranial MR-guided focused ultrasound (tcMRgFUS) thalamotomy using 1.5T equipment in comparison with the 48-h follow-up. Methods Fifty prospectively enrolled patients undergoing unilateral tcMRgFUS thalamotomy for either medication-refractory essential tremor...
Article
INTRODUCTION: High-intensity focused ultrasound (HIFU) is a noninvasive procedure that has shown promising results in a wide range of malignant and non-malignant conditions, including localized prostate cancer (PCa). AREAS COVERED: This review aims to describe the application of HIFU in the management of patients with PCa, explaining its basic ther...
Article
Full-text available
Objective: To present a retrospective analysis of patient- and sonication-related parameters of a group of patients treated with a transcranial magnetic resonance imaging (MRI)-guided focused ultrasound (tcMRgFUS) system integrated with a 1.5-T MRI unit. Methods: The data obtained from 59 patients, who underwent the tcMRgFUS procedure from January...
Article
Full-text available
Background Osteoid osteoma is a benign and painful musculoskeletal tumour that usually affects children. Current standard treatment is CT-guided radiofrequency ablation, a minimally invasive percutaneous procedure, with clinical success rates ranging between 85% and 98%. Though minimally invasive, however, this type of procedure is not free from co...
Article
Full-text available
Objectives The aim of this work was to examine the cross-sectional relationship between body composition (BC) markers for adipose and lean tissue and bone mass, and a wide range of specific inflammatory and adipose-related markers in healthy elderly Europeans. Methods A whole-body dual-energy X-ray absorptiometry (DXA) scan was made in 1121 healthy...
Chapter
Magnetic resonance-guided focused ultrasound (MRgFUS) is an innovative noninvasive technique for pain management in skeletal metastases. This technology enables the performance of three-dimensional treatment planning with MR imaging and continuous real-time temperature monitoring of target zone with MR thermometric map, ensuring an accurate identif...
Article
Full-text available
Magnetic resonance-guided focused ultrasound is one of the emerging non-invasive technologies offering both image guidance and thermal monitoring. In recent years transcranial application of this technology is starting to impact heavily the neuroscience field. We present here the imaging protocol and the technological methods successfully used with...
Article
Purpose In recent years trans-cranial Magnetic Resonance-guided Focused Ultrasound Surgery (tcMRgFUS) treatments have aroused large scientific and medical interest [1]. Usually, tcMRgFUS systems are integrated with 3 T systems which allow the use of the body RF coil for both real time imaging and MR-thermometry. At University Hospital of Palermo th...
Article
In the last decades, an increasing interest has developed towards non‐invasive breast lesion treatments, which offer advantages such as the lack of surgery‐related complications, better cosmetic outcomes, and less psychological distress. In addition, these treatments could be an option for patients with poor health who are not candidates for surger...
Article
Objective: The aim of this study was to review the existence and types of correlations between body composition densitometric parameters and laboratory values associated to cardiometabolic risk. Methods: We retrospectively analyzed data from 316 individuals in the weight range from normality to super-obesity, submitted to total body dual-energy...
Article
High-intensity focused ultrasound (HIFU) is a totally noninvasive procedure that has shown promising results in the management of numerous malignant and nonmalignant conditions. Under magnetic resonance or ultrasound guidance, high-intensity ultrasound waves are focused on a small, well-defined target region, inducing biologic tissue heating and co...
Article
Interventional radiology provides local management of bone metastases (BM) with a palliative intent in most cases, or with a curative intent in selected patients. Its role has rapidly expanded in the last decade, offering new treatment solutions often in combination with surgery, radiation therapy and medical treatments. The aim of the present pape...
Article
Full-text available
Currently, different treatment options are available in the management of uterine fibroids: Medical therapy aims at relieving symptoms, while semi-invasive or non-invasive procedures aim to treat symptoms and eventually to reduce the fibroids' size. A wide spectrum of treatments may be confusing to implement correctly, and the gynecologist should b...
Article
Pancreatic cancer is a poor prognostic tumor and about 20% of patients are eligible for surgical resection at the time of diagnosis. Recently, minimally invasive procedures have provided promising results as a therapeutic option for locally advanced unresectable pancreatic cancer. In particular, high-intensity focused ultrasound is an emerging noni...
Article
Full-text available
OBJECTIVE Transcranial magnetic resonance–guided focused ultrasound surgery (tcMRgFUS) is one of the emerging noninvasive technologies for the treatment of neurological disorders such as essential tremor (ET), idiopathic asymmetrical tremor-dominant Parkinson’s disease (PD), and neuropathic pain. In this clinical series the authors present the prel...
Article
Full-text available
Bone and muscle are two deeply interconnected organs and a strong relationship between them exists in their development and maintenance. The peak of both bone and muscle mass is achieved in early adulthood, followed by a progressive decline after the age of 40. The increase in life expectancy in developed countries resulted in an increase of degene...
Article
Cancer-related pain affects up to 80% of patients with malignancies. Pain is an important distressing symptom that diminishes the quality of life and negatively affects the survival of patients. Opioid analgesics are generally the primary therapy for cancer-related pain, with surgery, radiation therapy, chemotherapy, and other interventions used in...
Article
Objectives: To evaluate potential relationship between qualitative CT features, quantitative texture analysis (QTA), histology, WHO staging, Masaoka classification and myasthenic syndrome in patients with thymic tumors. Materials and methods: Sixteen patients affected by histologically proven thymic tumors were retrospectively included in the st...
Article
Full-text available
Background Pancreatic adenocarcinoma is currently the fourth-leading cause of cancer-related death. Up to 60?90% of patients with advanced disease suffer cancer-related pain, severely impacting their quality of life. Current management involves primarily pharmacotherapy with opioid narcotics and celiac plexus neurolysis; unfortunately, both approac...
Article
Five patients with painful vascular malformations of the extremities that were refractory to standard treatment and were confirmed as low-flow malformations on dynamic contrast-enhanced magnetic resonance (MR) imaging were treated with MR imaging–guided high intensity focused ultrasound. Daily maximum numeric rating scale scores for pain improved f...
Article
Purpose Bone metastases are a common cause of cancer-related pain. The aim of this study is to determine the optimal radiotherapy schedule for the treatment of painful bone metastases and verify if could cause different biological effects on bone. This has been achieved using functional Magnetic Resonance Imaging (MRI) with diffusion-weighted imagi...
Article
Background: High-intensity focused ultrasound ablation is an emerging mode of therapy for benign and malignant neoplastic processes; with respect to musculoskeletal tumors, high-intensity focused ultrasound ablation has been used for palliative treatment of bone metastases and primary treatment of osteoid osteoma, synovial sarcoma, osteosarcoma, Ew...
Article
Purpose To demonstrate that magnetic resonance (MR) imaging-guided high-intensity focused ultrasound (HIFU) is a safe, effective, and durable treatment option for the management of osteoid osteoma in children and young adults. Materials and Methods This prospective study was institutional review board approved and is registered with clinicaltrials....
Article
Full-text available
Uterine fibroids, the most common benign tumor in women of childbearing age, may cause symptoms including pelvic pain, menorrhagia, dysmenorrhea, pressure, urinary symptoms, and infertility. Various approaches are available to treat symptomatic uterine fibroids. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) represents a recently int...
Conference Paper
To assess safety and feasibility of non-invasive high intensity 3T MR guided focused ultrasound (MRgFUS) treatment of localized prostate cancer in an exploratory designed study. Men aged 45–80 years were eligible for this prospective study if they had low-risk localized prostate cancer (prostate specific antigen [PSA] ≤10 ng/mL, Gleason score ≤ 3 +...
Conference Paper
To determine the effect of acoustic energy delivered during MR guided Focused Ultrasound (MRgFUS) treatment of symptomatic osteoid osteomas. This prospective, IRB approved study involved 15 consecutive patients (11 m; 4f; mean age, 21) with clinical and imaging diagnosis of Osteoid Osteoma; all patients underwent MRgFUS ablation (ExAblate, InSighte...
Conference Paper
Purpose: To evaluate the clinical performance of MRgFUS in primary pain palliation of painful bone metastases and in local tumor control. Materials and Methods: We enrolled 26 consecutive patients (female/male 12/14; age: 64.7±7.5yrs) with painful bone metastases. Before and 3 months after MRgFUS treatment pain severity and pain interference scores...
Article
Aim: To investigate the correlation between conventional computed tomography (CT) features, quantitative texture analysis (QTA), epidermal growth factor receptor (EGFR) mutations, and survival rates in patients with lung adenocarcinoma. Materials and methods: Sixty-eight patients were evaluated for conventional CT features and QTA in this retros...
Article
Full-text available
Recent studies have demonstrated the effectiveness of magnetic resonance-guided focused ultrasound (MRgFUS) in the treatment of osteoid osteoma (OO), a painful, benign bone tumor. As MRgFUS is a noninvasive and radiation-free treatment, it stands to replace the current standard of care, percutaneous radiofrequency, or laser thermal ablation. Within...
Conference Paper
Full-text available
http://www.fusfoundation.org/symposium/2016/docs/FUSF_Symposium_2016_Abstracts_web.pdf
Conference Paper
Full-text available
Magnetic Resonance (MR) guided Focused Ultrasound Surgery (MRgFUS) technology, combined with High Intensity Focused Ultrasound (HIFU) beams, has opened to new therapeutic protocols for various pathological conditions. The success of this therapy relies on the accuracy of the guidance for therapy provided by thermal mapping of sonication, which is o...
Article
Purpose: Definition of the role of real-time elastography (RTE) in the evaluation of response to treatment of uterine fibroids using MRgFUS in symptomatic patients. Materials and methods: 28 women with 34 symptomatic fibroids, selected for MRgFUS, were enrolled. The patients were preliminarily studied with MRI and suprapubic and transvaginal ult...
Article
Purpose: Breast conserving surgery is effective for breast cancer treatment but is associated with morbidity in particular high re-excision rates. We performed a systematic review to assess the current evidence for clinical outcomes with minimally invasive ablative techniques in the non-surgical treatment of breast cancer. Methods: A systematic...
Article
Purpose: To assess the correlation between functional MRI, including ADC values obtained from DWI and DCE, and clinical outcome in patients with bone metastases treated with MRgFUS. Methods and materials: Twenty-three patients with symptomatic bone metastases underwent MRgFUS treatment (ExAblate 2100 system InSightec) for pain palliation. All pa...
Article
Full-text available
Objectives To assess the feasibility, safety and preliminary efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for the treatment of extra-abdominal desmoid tumours. Methods Fifteen patients with desmoid fibromatosis (six males, nine females; age range, 7–66 years) were treated with MRgFUS, with seven patients requiring multiple trea...
Article
Full-text available
In past years non-invasive clinical applications of magnetic resonance-guided focused ultrasound for the treatment of neurological disorders have been hampered by technical limitations that today have been finally overcome. In 2015, for the first time in the world, the very first treatments have been performed in Italy by the use of an affordable 1...
Chapter
In the past decade, three new minimally invasive procedures surfaced: Thermal ablations, high-intensity focused ultrasound (HIFU), and magnetic resonance imaging (MRI)-guided interventions. Each has the potential to transform or replace invasive tumor surgeries. Thermal ablations using surgically or percutaneously inserted probes became an alternat...
Article
Full-text available
Uterine fibroids are benign neoplasms that can cause distressing symptoms in women during their reproductive age. They are often associated with menorrhagia that can determine anemia or bulk- related symptoms. Different treatment options are available: medical therapy has the goal to treat related symptoms, while semi-invasive or non-invasive uteru...
Article
Magnetic resonance guided focused ultrasound surgery (MRgFUS) has become an attractive, non-invasive treatment for benign and malignant tumours, and offers specific benefits for poorly accessible locations in the liver. However, the presence of the ribcage and the occurrence of liver motion due to respiration limit the applicability MRgFUS. Several...
Article
In past years non-invasive clinical applications of magnetic resonance-guided focused ultrasound for the treatment of neurological disorders have been hampered by technical limitations that today have been finally overcome. In 2015, for the first time in the world, the very first treatments have been performed in Italy by the use of an affordable 1...
Article
Full-text available
Background: To compare image quality and diagnostic performance of Gadoteridol-enhanced MR angiography (MRA) with Gadobutrol-enhanced MRA in the evaluation of carotid artery stenosis. Methods: MRA was performed in 30 patients with carotid stenosis diagnosed at DUS. Patients were randomly assigned to group A (Gadobutrol-enhanced MRA) or group B (Gad...
Article
Full-text available
Magnetic Resonance imaging guided Focused Ultrasound Surgery (MRgFUS) is a minimally invasive treatment guided by the most sophisticated imaging tool available in today clinical practice. Both imaging and therapeutic sides of the equipment are based on non-ionizing energy. This technique is a very promising option as potential treatment for several...
Article
To evaluate image quality and diagnostic accuracy of different dual-energy computed tomography (DECT) datasets for identification of hepatocellular carcinoma (HCC), assess the reliability of virtual unenhanced (VU) images in replacing standard unenhanced (SU) images, and quantify effective dose (ED) at different tube voltages. Thirty cirrhotic pati...
Article
A systematic review was undertaken to assess the clinical efficacy of non-invasive high-intensity focused ultrasound (HIFU) ablation in the treatment of breast cancer. MEDLINE/PubMed library databases were used to identify all studies published up to December 2013 that evaluated the role of HIFU ablation in the treatment of breast cancer. Studies w...
Article
Full-text available
Magnetic resonance guided focused ultrasound surgery (MRgFUS) of the musculoskeletal system achieved significant results in the treatment of painful bone metastases, and recently showed promise for benign bone lesions (e.g. osteoid osteoma) and osteoarthritis (e.g. facet joint syndrome and knee osteoarthritis). MRgFUS works on the main basis of pai...
Article
Full-text available
To evaluate the efficacy of non-invasive high intensity MR guided focused Ultrasound Surgery (MRgFUS) for pain palliation of bone metastasis in patients who had exhausted EBRT or refused other therapeutic options.
Article
Full-text available
To assess safety and effectiveness of non-invasive high intensity 3T MR guided Focused Ultrasound Surgery (MRgFUS) treatment of localized prostate cancer as salvage therapy and as an alternative to active surveillance.