CT-based tumour response criteria compared after combined treatment for liver metastases of colorectal cancer

open6noPurpose: The aim of this analysis is to compare different tumour response criteria (TRC) after chemotherapy combined with bevacizumab in liver metastases from colorectal cancer (mCRC) to ascertain the best early prognostic indicator of response. Methods and Materials: 103 target liver metastases from 65 mCRC patients treated with chemoterapy plus bevacizumab were examined at the Istituto Oncologico Veneto IOV-IRCSS (March 2008-January 2013). All patients had baseline CT and at least one follow-up scan. Tumour response was retrospectively analyzed by two radiologists using RECIST1.1, modified Choi, and Chun morphologic criteria. Tumour response, classified as good (complete or partial response) or poor (stable or progressive disease), was compared with progression-free survival (PFS) at first follow-up (t1) and time of best response. Interobserver agreement and concordance between TRC were measured. Results: At t1, 32.31% showed a good response according to RECIST1.1 (median PFS 11.1), 84.62% according to Choi (median PFS 10.8). These percentages rose to 49.23% (median PFS 12.1) and 87.69% (median PFS 10.8), respectively, at the time of best response. According to Chun, 67.69% showed a good response at the time of best response (median PFS 10.8). The Choi criteria detected a higher proportion of good responders at t1, showing a better correlation with PFS; all methods correlated with PFS at the time of best response. Conclusion: The Choi criteria proved more consistent in the early detection of response in mCRC treated with chemotherapy plus bevacizumab, underscoring the importance of using these criteria in the early assessment of response to combined treatment.openopenVarotto, A.; Di Grazia, L.; Aliberti, C.; Bergamo, F.; Nardin, M.; Pomerri, F.Varotto, A.; Di Grazia, L.; Aliberti, C.; Bergamo, F.; Nardin, M.; Pomerri, Fabi

ONE-TROCAR VIDEO-ASSISTED STRIPPING TECHNIQUE FOR USE IN THE TREATMENT OF LARGE OVARIAN CYSTS IN INFANTS

Background Management of ovarian cysts in infants is controversial; it can be conservative or surgical, and the management is determined by the cyst''s size and sonographic features. Methods A surgical approach using a 10-mm umbilically placed operative laparoscope was taken in 3 female infants with antenatally diagnosed large, simple ovarian cysts. The contents of the cysts were partially aspirated and the cyst walls were stripped off the remaining ovarian parenchyma. No intraoperative or postoperative complications were recorded. Conclusions The one-trocar video-assisted stripping technique for large ovarian cysts in infants appears to be an ovarian-tissue-preserving procedure, and it sidesteps the disadvantages of large scars and formation of adhesions

Volcano monitoring and early warning on Mt Etna, Italy, using volcanic tremor – Methods and technical aspects

Recent activity on Mt Etna was characterized by 25 lava fountains occurred on Mt Etna in 2011 and the first semester of 2012. In summer 2012 volcanic activity in a milder form was noticed within the Bocca Nuova crater, before it came to an essential halt in August 2012. Together with previous unrests (e. g., in 2007-08) these events offer rich material for testing automatic data processing and alert issue in the context of volcano monitoring. Our presentation focuses on the seismic background radiation – volcanic tremor – which has a key role in the surveillance of Mt Etna. From 2006 on a multi-station alert system exploiting STA/LTA ratios, has been established in the INGV operative centre of Catania. Besides, also the frequency content has been found to change correspondingly to the type of volcanic activity, and can thus be exploited for warning purposes. We apply Self Organizing Maps and Fuzzy Clustering which offer an efficient way to visualize signal characteristics and its development with time. These techniques allow to identify early stages of eruptive events and automatically flag a critical status before this becomes evident in conventional monitoring techniques. Changes of tremor characteristics are related to the position of the source of the signal. Given the dense seismic network we can base the location of the sources on distribution of the amplitudes across the network. The locations proved to be extremely useful for warning throughout both a flank eruption in 2008 as well as the 2011 lava fountains. During all these episodes a clear migration of tremor sources towards the eruptive centres was revealed in advance. The location of the sources completes the picture of an imminent volcanic unrest and corroborates early warnings flagged by the changes of signal characteristics. Automatic real time data processing poses high demands on computational efficiency, robustness of the methods and stability of data acquisition. The amplitude based multi-station approach is not sensitive to the failure of single stations and therefore offers a good stability. On the other hand, the single station approach, exploiting unsupervised classification techniques, limits logistic efforts, as only one or few key stations are necessary. A common characteristics of both strategies is their robustness to disturbances (undesired transients like earthquakes, noise, short gaps in the continuous data flow). False alarms were not encountered so far. A critical issue it the reliability of data storage and access. Therefore, a specific hardware cluster architecture has been proposed for failover protection, including a Storage Area Network system. We present concepts of the software architectures which allow easy data access following predefined user policies. We also envisage the integration of seismic data and those originating from other scientific fields (e. g., volcano imagery, geochemistry, deformation, gravity, magneto-telluric). This will facilitate cross-checking of evidences encountered from the single data streams, in particular allow their immediate verification with respect to ground truth

Volcanic tremor at Mt. Etna, Italy, preceding and accompanying the eruption of July-August, 2001

The July 17 – August 9, 2001 flank eruption of Mt. Etna was preceded and accompanied by remarkable changes in volcanic tremor. Based on the records of stations belonging to the permanent seismic network deployed on the volcano, we analyze amplitude and frequency content of the seismic signal. We find considerable changes in the volcanic tremor which mark the transition to different styles of eruptive activity, e.g., lava fountains, phreatomagmatic activity, Strombolian explosions. In particular, the frequency content of the signal decreases from 5 Hz to 3 Hz at our reference station ETF during episodes of lava fountains, and further decreases at about 2 Hz throughout phases of intense lava emission. The frequency content and the ratios of the signal amplitude allow us to distinguish three seismic sources, i.e., the peripheral dike which fed the eruption, the reservoir which fed the lava fountains, and the central conduit. Based on the analysis of the amplitude decay of the signal, we highlight the migration of the dike from a depth of ca. 5 km to about 1 km between July 10 and 12. After the onset of the effusive phase, the distribution of the amplitude decay at our stations can be interpreted as the overall result of sources located within the first half kilometer from the surface. Although on a qualitative basis, our findings shed some light on the complex feeding system of Mt. Etna, and integrate other volcanological and geophysical studies which tackle the problem of magma replenishment for the July–August, 2001 flank eruption. We conclude that volcanic tremor is fundamental in monitoring Mt. Etna, not only as a marker of the different sources which act within the volcano edifice, but also of the diverse styles of eruptive activity

The GEANT4 toolkit capability in the hadron therapy field: simulation of a transport beam line

At Laboratori Nazionali del Sud of the Instituto Nazionale di Fisica Nucleare of Catania (Sicily, Italy), the first Italian hadron therapy facility named CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) has been realized. Inside CATANA 62 MeV proton beams, accelerated by a superconducting cyclotron, are used for the radiotherapeutic treatments of some types of ocular tumours. Therapy with hadron beams still represents a pioneer technique, and only a few centers worldwide can provide this advanced specialized cancer treatment. On the basis of the experience so far gained, and considering the future hadron-therapy facilities to be developed (Rinecker, Munich Germany, Heidelberg/GSI, Darmstadt, Germany, PSI Villigen, Switzerland, CNAO, Pavia, Italy, Centro di Adroterapia, Catania, Italy) we decided to develop a Monte Carlo application based on the GEANT4 toolkit, for the design, the realization and the optimization of a proton-therapy beam line. Another feature of our project is to provide a general tool able to study the interactions of hadrons with the human tissue and to test the analytical-based treatment planning systems actually used in the routine practice. All the typical elements of a hadron-therapy line, such as diffusers, range shifters, collimators and detectors were modelled. In particular, we simulated the Markus type ionization chamber and a Gaf Chromic film as dosimeters to reconstruct the depth (Bragg peak and Spread Out Bragg Peak) and lateral dose distributions, respectively. We validated our simulated detectors comparing the results with the experimental data available in our facility

Reply to comment by D. Carbone and D. Patanè on “Multi-disciplinary investigation on a lava fountain preceding a flank eruption: the 10 May 2008 Etna case”

Bonaccorso et al. [2011a] investigated the source and magma dynamics of the 10 May 2008 lava fountain at the South-East Crater (SEC) of Mount Etna through a multidisciplinary approach that integrated a wide data set ranging from bulk rock compositions of the erupted products to seismic tremor and long-period events, tilt and gravity signals. Using a large dataset, the study provided a robust framework in which the mechanism of the 10 May 2008 lava fountain is explained as a violent release of bubble-rich magma layer previously trapped at the top of a shallow reservoir located between −0.5 and 1.5 km above sea level (asl). This result is in agreement with recent relevant literature [Allard et al., 2005; Vergniolle and Ripepe, 2008; Aiuppa et al., 2010; Andronico and Corsaro, 2011; Bonaccorso et al., 2011b; Calvari et al., 2011; Vergniolle and Gaudemer, 2012]. In the introduction of their comment Carbone and Patanè [submitted] affirm that in their opinion the interpretation that “the lava fountain was generated by the fragmentation of a foam layer trapped at the top of shallow reservoir” is not soundly based. This comment’s conclusion is puzzling because one of the comment’s authors (D. Patanè) is also a co-author on the paper by Aiuppa et al. [2010] where the same conclusion, now criticized, was well supported (see figure 5 and conclusions of that paper). In particular, in the conclusions Aiuppa et al. [2010] reported that “The paroxysmal SEC episodes mark the violent release of a bubble-rich magma layer, with bubbles having relatively shallow reservoir ...", that is, the same conclusion now criticized in the comment. After this, the comment raises issues concerning the analysis and interpretation of gravity and tilt data in the multidisciplinary approach presented by Bonaccorso et al. [2011a]. The comment by Carbone and Patanè is divided into 4 paragraphs, labelled “1. Introduction”, “2. Gravity changes”, “3. Tilt changes” and “4. Concluding remarks” with only paragraphs 2 and 3 containing specific comments. In this reply, we address these two paragraphs, and we shall show how the assumptions underlying the comment are merely speculative and why the results presented by Bonaccorso et al.[2011a] remain valid

Serosurvey of schmallenberg virus infection in sheep in Abruzzo, Italy : short report

Infection with Schmallenberg virus (SBV) causes congenital musculoskeletal and vertebral malformations as well as neurological failures in fetuses of several ruminant species. In this study 1038 sheep samples from 10 flocks in the provinces of Chieti, Teramo and Pescara in Italy have been tested for antibodies against SBV by ELISA test. The purpose of the study was to ascertain the extent of SBV infections in sheep in Italy. The results of the ELISA test identified at least one positive animal in 9 of the 10 sheep flocks tested, and a mean within-flock prevalence of 8.57%. Furthermore, large variability of positive animals between flocks was observed (0 and 42.5%). These results demonstrate that SBV was endemic in this region and there could be is a risk of novel SBV infections in the following lambing season, raising serious concerns about its so rapid and pervasive spread

Comparison of Histochemical Stainings in Evaluation of Liver Fibrosis and Correlation with Transient Elastography in Chronic Hepatitis

Background and Aim. The best staining to evaluate liver fibrosis in liver hepatitis is still a debated topic. This study aimed to compare Masson's trichrome (MT), Sirius Red (SR), and orcein stainings in evaluating liver fibrosis in chronic HCV hepatitis (CHC) with semiquantitative and quantitative methods (Collagen Proportionate Area (CPA) by Digital Image Analysis (DIA)) and correlate them with transient elastography (TE). Methods. Liver stiffness evaluation of 111 consecutive patients with CHC was performed by TE. Semiquantitative staging by Metavir score system and CPA by DIA were assessed on liver biopsy stained with MT, SR, and orcein. Results. MT, SR, and orcein staining showed concordant results in 89.6% of cases in staging CHC, without significant difference in both semiquantitative and quantitative evaluations of fibrosis. TE values were concordant with orcein levels in 86.5% of the cases and with MT/RS in 77.5% (P < 0.001). No significant correlation between the grade of necroinflammatory activity and TE values was found. Conclusion. In CHC, SR/MT and orcein stainings are almost concordant and when discordant, orcein staining is better related to TE values than MT/RS. This suggests that elastic fibers play a more important role than reticular or collagenous ones in determining stiffness values in CHC