34 research outputs found
Solitary fibrous tumours : unusual aspects of a rare disease
Background: In literature there are only a few descriptions of the typical presentation of solitary fibrous tumours (SFT) and only a few case reports showing its unusual clinical and radiological features. Methods: We retrospectively evaluated the computed tomography scans of 36 patients presenting with a histological diagnosis of SFT between 1998 and 2008. Results: We present five cases of SFT with an atypical clinical presentation and radiological features. Conclusions: SFT can occasionally present with unusual radiological features making a differential diagnosis difficult. Even thought imaging plays a fundamental role in the initial diagnostic approach, final diagnosis in only confirmed by biopsy and histology
Swallowing Disorders after Oral Cavity and Pharyngolaryngeal Surgery and Role of Imaging
Head and neck squamous cell carcinoma is the sixth most common cancer diagnosed worldwide and the eighth most common cause of cancer death. Malignant tumors of the oral cavity, oropharynx, and larynx can be treated by surgical resection or radiotheraphy with or without chemotheraphy and have a profound impact on quality of life functions, including swallowing. When surgery is the chosen treatment modality, the patient may experience swallowing impairment in the oral and pharyngeal phases of deglutition. A videofluoroscopic study of swallow enables the morphodynamics of the pharyngeal-esophageal tract to be accurately examined in patients with prior surgery. These features allow an accurate tracking of the various phases of swallowing in real time, identifying the presence of functional disorders and of complications during the short- and long-term postoperative recovery. The role of imaging is fundamental for the therapist to plan rehabilitation. In this paper, the authors aim to describe the videofluoroscopic study of swallow protocol and related swallowing impairment findings in consideration of different types of surgery
A possible connective tissue primary lymphoepithelioma-like carcinoma (LELC)
Lymphoepithelial carcinoma is an undifferentiated nasopharyngeal carcinoma with lymphoid stroma and non-keratinizing squamous cells with distinctive clinical, epidemiological and etiological features. Conversely, lymphoepithelioma-like carcinomas (LELCs) are carcinomas that arise outside the nasopharynx but resemble a lymphoepithelioma histologically. In this case study, LELC presentation in connective tissue (left sternocleidomastoid muscle) is peculiar and unusual, but its diagnosis is supported by histological findings and clinical history, especially long disease free survival and no primary lesions in nasopharynx and lung district. We also discuss the pathogenesis, hypothesizing an embryological theory. To our knowledge, it could be the first reported case of a primary connective tissue LELC to the neck
A pragmatic approach improves the clinical management of stage IV gastric cancer: Comparison between the Meta-Gastro results and the GIRCG's retrospective series
Introduction: The Italian Research Group for Gastric Cancer developed a prospective database about stage IV gastric cancer, to evaluate how a pragmatic attitude impacts the management of these patients. Materials and methods: We prospectively collected data about metastatic gastric cancer patients thanks to cooperation between radiologists, oncologists and surgeons and we analyzed survival and prognostic factors, comparing the results to those obtained in our retrospective study. Results: Three-hundred and eighty-three patients were enrolled from 2018 to September 2022. We observed a higher percentage of laparoscopic exploration with peritoneal lavage in the prospective cohort. In the registry only 3.6 % of patients was submitted to surgery without associated chemotherapy, while in the retrospective population 44.3 % of patients were operated on without any chemotherapy. At univariate and multivariate analyses, the different metastatic sites did not show any survival differences among each other (OS 20.0 vs 16.10 vs 16.7 months for lymphnodal, peritoneal and hepatic metastases, respectively), while the number of metastatic sites and the type of treatment showed a statistical significance (OS 16,7 vs 13,0 vs 4,5 months for 1, 2 and 3 different metastatic sites respectively, p < 0.001; 24,2 vs 12,0 vs 2,5 months for surgery with/without chemotherapy, chemotherapy alone and best supportive treatment respectively, p < 0.001). Conclusions: Our data highlight that the different metastatic sites did not show different survivals, but survival is worse in case of multiple localization. In patients where a curative resection can be achieved, acceptable survival rates are possible. A better diagnostic workup and a more accurate staging impact favorably upon survival
Persistence and Turnover in Desert Plant Communities during a 37-yr Period of Land Use and Climate Change
Understanding longâterm changes in ecological communities during global change is a priority for 21stâcentury ecology. Deserts, already at climatic extremes, are of unique interest because they are projected to be ecosystems most responsive to global change. Within a 500âkm2 landscape in the Mojave Desert, USA, we measured perennial plant communities at 100 sites three times (1979, 2008, and 2016) during 37 yr to evaluate six hypotheses of community change. These hypotheses encompassed shifts in community measures (e.g., diversity, cover) and species elevational distributions, biotic homogenization, disproportionately large change at the highest elevations, relationships between turnover and speciesâ responses to disturbance and drought, and that environmental refugia (e.g., moist topographic positions) would receive species during climatic warming and drying. Most community measures changed temporally, such as species density (species/600 m2) increasing 23% and plant cover doubling between 1979 and 2016. There was no increase in nonnative species and minimal evidence for biotic homogenization. Highâelevation communities did not display greater change than lowâelevation communities. ... See full text for complete abstrac
An independent validation of the EEG-based complex trial protocol with autobiographical data and corroboration of its resistance to a cognitively charged countermeasure
The Complex Trial Protocol (CTP) is a P300-based Concealed Information Test (CIT). The theoretical underpinnings of the
CIT in the context of law enforcement usage are sound. The CTP is said to effectively discriminate individuals who recognize novel and meaningful stimuli and to be countermeasure resistant. Forty-five undergraduate students were assigned to three groups and instructed to perform a computer task using autobiographical data in connection to a mock burglary script.
P300 peak-to-peak amplitude differences between probe (surname) and irrelevant (patronymic foils) items accurately identified 100% (14/14) of Innocent Controls (IC), 94% (15/16) of Simply Guilty (SG) participants, and 93% (14/15) of Guilty Countermeasure (GCM) subjects who were asked to counter all stimuli by mentally counting backwards continuously during their test presentation. Increased number of mistakes during the test, from combined cognitive erroneous responses to pop quizzes and behavioral errors with button presses, significantly discriminated GCM from IC and SG individuals. GCM participants committed more errors than IC and SG which did not differ from one another. Reaction Time (RT) was only significant between GCM and IC groups. Implications for forensic issues are discussed
Previsione idrologica per la gestione degli impianti idroelettrici
Nel presente lavoro è descritto un modello idrologico a parametri concentrati ideato per migliorare i sistemi di previsione per la produzione idroelettrica. Particolare enfasi è data alla struttura del modello e alla metodologia di calibrazione adottata. In particolare, viene presentato un approccio mirato a scomporre le fasi di calibrazione in funzione dei processi da simulare. Tale approccio ha consentito di definire una struttura di modello robusta in grado di fornire buone stime del deflusso in alveo a supporto del collocamento nella borsa elettrica dellâenergia prodotta. Il modello è stato utilizzato sul bacino del Fiume Aniene per generare previsioni di tipo deterministico. Queste analisi sono servite per valutare lâattendibilitĂ delle previsioni con tempi di preavviso di 1, 2 e 3 giorni. I risultati mostrano un buon livello di affidabilitĂ delle previsioni con un giorno di anticipo, mentre gli errori delle previsioni a 2 e 3 aumentano in modo piĂš marcato
CT-Guided Percutaneous Radiotracer Localization and Resection of Indistinct/Small Pulmonary Lesions
BACKGROUND:
Detection of small pulmonary lesions has increased and often they are difficult to localize and resect. We present our mature experience with preoperative computer-tomography (CT)-guided radiotracer localization followed by resection of these lesions.
METHODS:
Patients with pulmonary nodule smaller than 1 cm and/or deep below the visceral pleura underwent CT-guided injection of radiotracer technetium macroaggregates (99mTc-MAA) in/close to the lesion. A gamma probe was used to localize the marked area that was resected and in case of primary lung cancer, a lobectomy with nodal dissection was performed.
RESULTS:
Between November 2007 and December 2017, 262 patients (196 men; median age 63 years) underwent preoperative radiotracer injection with a successful marking in all patients. Complications included 35 (13.4%) asymptomatic pneumothoraces, 36 (13.7%) parenchymal hemorrhage suffusions, and 2 (0.7%) mild allergic reactions to contrast medium. In all cases, except for 3, the gamma probe revealed the pulmonary lesion. Mean distance from the pleura was 10 mm (range, 0-40 mm). Pulmonary resection was performed by thoracoscopy in 212 (80.9%) cases, intentional thoracotomy in 42 (16.0%), converted thoracoscopy in 8 (3.1%). Mean pathological nodule size was 9.3 mm (range, 2.5-39 mm). 166 (63.4%) nodules were nonsolid, 64 (24.4%) were partially solid, and 32 (12.2%) had a solid morphology. Histology showed 16 (6.1%) benign and 246 (93.9%) malignant lesions (218 primary lung cancers).
CONCLUSIONS:
Preoperative radiotracer localization of small/indistinct pulmonary lesions is simple and feasible with a high rate of success. It may be an effective and attractive alternative in managing lung lesions
Peritoneal carcinomatosis from ovarian cancer: the role of CT and [18F]FDG-PET/CT
PURPOSE: The diagnosis of peritoneal carcinomatosis secondary to ovarian cancer is a real challenge in the cancer imaging field. In this retrospective study, we evaluate the accuracy of Single Detector Computed Tomography (SDCT), Multi Detector Computed Tomography (MDCT), and Positron Emission Tomography-Computed Tomography with F18-fluorodeoxyglucose ([\ub9\u2078F]FDG-PET/CT) in the diagnosis of peritoneal seeding and we evaluate the possible applications of MDCT to predict the complete surgical removal of the peritoneal deposits.
METHODS AND MATERIALS: A total of 228 scans (91 SDCT, 89 MDCT, and 48 [\ub9\u2078F]FDG-PET/CT) of patients with peritoneal carcinomatosis secondary to ovarian cancer proved at laparoscopy and confirmed by histopathology were retrospectively reviewed by two independent groups of Radiologists and Nuclear Medicine Physicians for the evaluation of ascites, peritoneal nodules, and omental cake signs.
RESULTS: MDCT showed 81% of true positives, SDCT 72.5%, and [\ub9\u2078F]FDG-PET/CT 77%. False negatives were 19% for MDCT, 27.5% for SDCT, and 23% for [\ub9\u2078F]FDG-PET/CT.
CONCLUSION: From our results, we concluded that MDCT is the technique of choice in the diagnosis of peritoneal seeding, while [\ub9\u2078F]FDG-PET/CT, though showing similar accuracy, remains the most accurate technique for monitoring therapeutic response and disease recurrence. MDCT could play an important role due to its ability to predict the possibility of complete surgical removal of disease thus influencing the treatment plan aimed to improve quality of life