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Double tracer PET/CT:what is it and what does it mean?

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Journal of Cancer Metastasis and Treatment 2016年第1期2卷 321-328页

作者： Mattia Pellicciari Silvia Ortolani Elisabetta Grego giampaolo tortora Sara Cingarlini Department of Clinical Oncology Comprehensive Cancer NetworkG.B.Rossi University HospitalUniversity of Verona37134 VeronaItaly

^(68)Ga-DOTA-peptide PET/CT is a recommended imaging modality in the workup of neuroendocrine neoplasms(NENs),which shows high diagnostic sensitivity and is a strong predictor of successful somatostatin receptor directed *** not routinely recommended,reliable evidences show that^(18)F-FDG PET/CT can provide complementary information in this setting with the ability to discriminate slow-proliferating tumors from aggressive,rapidly-proliferating ***,it has been proposed as an independent prognostic factor for the prediction of either overall survival or progression free *** this review,we provide insight into the biologic significance of ^(68)Ga-DOTA-peptides and ^(18)F-FDG uptake,and of the use of double tracer(^(68)Ga-DOTA-peptides plus ^(18)F-FDG)PET/CT in the clinical evaluation of patients affected by NENs.

关键词： 68Ga-DOTATOC PET/CT ^(18)F-FDG PET/CT neuroendocrine neoplasms

Pancreatic neuroendocrine neoplasms: Magnetic resonance imaging features according to grade and stage

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World Journal of Gastroenterology 2017年第2期23卷 275-285页

作者： Riccardo De Robertis Sara Cingarlini Paolo Tinazzi Martini Silvia Ortolani Giovanni Butturini Luca Landoni Paolo Regi Roberto Girelli Paola Capelli Stefano Gobbo giampaolo tortora Aldo Scarpa Paolo Pederzoli Mirko D'Onofrio Department of Radiology Casa di Cura Pederzoli Course in Inflammation Immunity and CancerUniversity of Verona Verona Comprehensive Cancer Network Department of Medical OncologyG.B.Rossi HospitalUniversity of Verona Department of Oncology Casa di Cura Pederzoli Department of Pancreatic Surgery Casa di Cura Pederzoli Department of Pathology Casa di Cura Pederzoli

AIMTo describe magnetic resonance (MR) imaging features of pancreatic neuroendocrine neoplasms (PanNENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and to determine the accuracy of MR imaging features in predicting their biological *** study was approved by our institutional review board; requirement for informed patient consent was waived due to the retrospective nature of the study. Preoperative MR examinations of 55 PanNEN patients (29 men, 26 women; mean age of 57.6 years, range 21-83 years) performed between June 2013 and December 2015 were reviewed. Qualitative and quantitative features were compared between tumor grades and stages determined by histopathological *** defined margins were more common in G2-3 and stage III-IV PanNENs than in G1 and low-stage tumors (P -3 mm2/s vs 1.45 × 10-3 mm2/s and 1.10 × 10-3 mm2/s vs 1.53 × 10-3 mm2/s, P = 0.003 and 0.001). Receiving operator characteristic analysis determined optimal cut-offs of 1.21 and 1.28 × 10-3 mm2/s for the identification of G2-3 and stage III-IV tumors, with sensitivity and specificity values of 70.8/80.7% and 64.5/64% (95%CI: 48.7-86.6/60-92.7 and 45.4-80.2/42.6-81.3).CONCLUSIONMR features of PanNENs vary according to their grade of differentiation and their stage at diagnosis and could predict the biological behavior of these tumors.

关键词： Pancreatic neuroendocrine tumor World Health Organization classification 2010 Diffusion-weighted imaging European Neuroendocrine Tumor Society staging system Magnetic resonance imaging

Neoadjuvant treatment:A window of opportunity for nutritional prehabilitation in patients with pancreatic ductal adenocarcinoma

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World Journal of Gastrointestinal Surgery 2021年第9期13卷 885-903页

作者： Ilaria Trestini Marco Cintoni Emanuele Rinninella Futura Grassi Salvatore Paiella Roberto Salvia Emilio Bria Carmelo Pozzo Sergio Alfieri Antonio Gasbarrini giampaolo tortora Michele Milella Maria Cristina Mele Section of Oncology Department of MedicinePancreas InstituteUniversity of Verona Hospital TrustVerona 37126Italy Scuola di Specializzazione in Scienza dell’Alimentazione Universitàdi Roma Tor VergataRoma 00133Italy UOC Nutrizione Clinica Dipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico A.Gemelli IRCCSRoma 00168Italy Dipartimento di Medicina e Chirurgia Traslazionale UniversitàCattolica del Sacro CuoreRoma 00168Italy General and Pancreatic Surgery Unit Pancreas InstituteUniversity of Verona Hospital TrustVerona 37126Italy Oncologia Medica Unit Comprehensive Cancer CenterFondazione Policlinico Universitario A Gemelli IRCCSRoma 00167Italy Oncologia Medica Unit UniversitàCattolica del Sacro CuoreRoma 00168Italy Digestive Surgery Unit and Pancreatic Surgery Gemelli Center Director Fondazione Policlinico Universitario A Gemelli IRCCSRoma 00167Italy UOC di Medicina Interna e Gastroenterologia Dipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario A Gemelli IRCCSRoma 00167Italy UOSD Nutrizione Avanzata in Oncologia Dipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario A Gemelli IRCCSRoma 00167Italy

Patients affected by pancreatic ductal adenocarcinoma(PDAC)frequently present with advanced disease at the time of diagnosis,limiting an upfront surgical *** treatment(NAT)has become the standard of care to downstage non-metastatic locally advanced ***,this treatment increases the risk of a nutritional status decline,which in turn,may impact therapeutic tolerance,postoperative outcomes,or even prevent the possibility of *** on prehabilitation programs on surgical PDAC patients show a reduction of postoperative complications,length of hospital stay,and readmission rate,while data on prehabilitation in NAT patients are scarce and randomized controlled trials are still ***,appropriate nutritional management represents an important therapeutic strategy to promote tissue healing and to enhance patient recovery after surgical *** this regard,NAT may represent a new interesting window of opportunity to implement a nutritional prehabilitation program,aiming to increase the PDAC patient’s capacity to complete the planned therapy and potentially improve clinical and survival *** these perspectives,this review attempts to provide an in-depth view of the nutritional derangements during NAT and nutritional prehabilitation program as well as their impact on PDAC patient outcomes.

关键词： Pancreatic cancer Neoadjuvant treatment Pancreatic cancer surgery Nutritional status Nutritional prehabilitation Malnutrition

“Targeting” renal cell carcinoma patients with “targeted” agents: Are we there yet?

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World Journal of Clinical Urology 2014年第1期3卷 9-19页

作者： Francesca Maines Sara Pilotto Michele Milella Francesco Massari Vanja Vaccaro Alessandra Felici Emilio Bria giampaolo tortora Medical Oncology Azienda Ospedaliera Universitaria Integrata University of Verona Medical Oncology Regina Elena National Cancer Institute

The rapid approval of several novel agents, targeting the vascular endothelial growth factor or mammalian target of rapamycin pathways(sunitinib, pazopanib, sorafenib, axitinib, bevacizumab, everolimus, temsirolimus) has given to metastatic renal cell carcinoma(m RCC) patients and their treating physicians many new and effective therapeutic options. The treatment paradigm for these patients is rapidly evolving, with future studies needed to defi ne the optimal sequencing of these new agents. Despite progresses, no validated biomarkers able to predict clinical outcome or useful to guide patient selection for treatment are currently available. Recent studies have suggested that some biomarkers, including cytokines, circulating proangio-genic factors, markers of hypoxia or targets of signaling pathways are potentially promising prognostic or predictive factors in m RCC. We present an overview of the most recent developments in identifying biomarkers for targeted therapies in advanced RCC.

关键词： Biomarkers Renal cell carcinoma Prognostic biomarker Predictive biomarker Vascular endothelial growth factor tyrosine kinase inhibitors Mammalian target of rapamycin inhibitors

Metastatic pancreatic cancer: Is there a light at the end of the tunnel?

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World Journal of Gastroenterology 2015年第16期21卷 4788-4801页

作者： Vanja Vaccaro Isabella Sperduti Sabrina Vari Emilio Bria Davide Melisi Carlo Garufi Carmen Nuzzo Aldo Scarpa giampaolo tortora Francesco Cognetti Michele Reni Michele Milella Medical Oncology A Regina Elena National Cancer Institute Medical Oncology A and Biostatistics Regina Elena National Cancer Institute Medical Oncology University of VeronaAzienda Ospedaliera Universitaria Integrata ARC-Net Research Centre and Department of Pathology Diagnostics and SurgeryUniversity of Verona Medical Oncology Unit Department of OncologySan Raffaele Scientific Institute

Due to extremely poor prognosis,pancreatic cancer(PDAC)represents the fourth leading cause of cancerrelated death in Western *** more than a decade,gemcitabine(Gem)has been the mainstay of first-line PDAC *** efforts aimed at improving single-agent Gem efficacy by either combining it with a second cytotoxic/molecularly targeted agent or pharmacokinetic modulation provided disappointing ***,the field of systemic therapy of advanced PDAC is finally moving *** has shown promise over single-agent Gem:regimens like PEFG-PEXG-PDXG and GTX provide significant potential advantages in terms of survival and/or disease control,although sometimes at the cost of poor *** PRODIGE 4/ACCORD 11 was the first phaseⅢtrial to provide unequivocal benefit using the polychemotherapy regimen FOLFIRINOX;however the less favorable safety profile and the characteristics of the enrolled population,restrict the use of FOLFIRINOX to young and fit PDAC *** nanoparticle albumin-bound paclitaxel(nab-Paclitaxel)formulation was developed to overcome resistance due to the desmoplastic stroma surrounding pancreatic cancer *** of whether or not this is its main mechanisms of action,the combination of nabPaclitaxel plus Gem showed a statistically and clinically significant survival advantage over single agent Gem and significantly improved all the secondary ***,recent findings on maintenance therapy are opening up potential new avenues in the treatment of advanced PDAC,particularly in a new era in which highly effective first-line regimens allow patients to experience prolonged disease ***,we provide an overview of recent advances in the systemic treatment of advanced PDAC,mostly focusing on recent findings that have set new standards in metastatic *** avenues for further development in the metastatic setting and current efforts to integratenew effective chemotherapy regimens

关键词： Pancreatic cancer Metastatic disease Chemotherapy Folfirinox nab -Paclitaxel

Prognostication and response assessment in liver and pancreatic tumors:The new imaging

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World Journal of Gastroenterology 2015年第22期21卷 6794-6808页

作者： Riccardo De Robertis Paolo Tinazzi Martini Emanuele Demozzi Gino Puntel Silvia Ortolani Sara Cingarlini Andrea Ruzzenente Alfredo Guglielmi giampaolo tortora Claudio Bassi Paolo Pederzoli Mirko D'Onofrio Department of Radiology Verona Comprehensive Cancer Network G.B. Rossi Hospital University of Verona Department of Radiology Casa di Cura Pederzoli Department of Oncology Verona Comprehensive Cancer Network G.B.Rossi Hospital University of Verona Department of Hepato-Biliary Surgery Verona Comprehensive Cancer NetworkG.B. Rossi Hospital University of Verona Department of Pancreatic Surgery Verona Comprehensive Cancer Network G.B. Rossi Hospital University of Verona Department of Pancreatic Surgery Casa di Cura Pederzoli

Diffusion-weighted imaging(DWI), dynamic contrastenhanced magnetic resonance imaging(DCE-MRI) and perfusion computed tomography(CT) are technical improvements of morphologic imaging that can evaluate functional properties of hepato-bilio-pancreatic tumors during conventional MRI or CT ***, the term "functional imaging" is commonly used to describe molecular imaging techniques, as positron emission tomography(PET)CT/MRI, which still represent the most widely used methods for the evaluation of functional properties of solid neoplasms; unlike PET or single photon emission computed tomography, functional imaging techniques applied to conventional MRI/CT examinations do not require the administration of radiolabeled drugs or specific equipments. Moreover, DWI and DCE-MRI can be performed during the same session, thus providing a comprehensive "one-step" morphological and functional evaluation of hepato-bilio-pancreatic tumors. Literature data reveal that functional imaging techniques could be proposed for the evaluation of these tumors before treatment, given that they may improve staging and predict prognosis or clinical outcome. Microscopic changes within neoplastic tissues induced by treatments can be detected and quantified with functional imaging,therefore these techniques could be used also for posttreatment assessment, even at an early stage. The aim of this editorial is to describe possible applications of new functional imaging techniques apart frommolecular imaging to hepatic and pancreatic tumors through a review of up-to-date literature data, with a particular emphasis on pathological correlations,prognostic stratification and post-treatment monitoring.

关键词： Diffusion magnetic resonance imaging Perfusion imaging Hepatocellular carcinoma Liverneoplasms Pancreatic neoplasms

A Double Assessment of Privacy Risks Aboard Top‑Selling Cars

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Automotive Innovation 2023年第2期6卷 146-163页

作者： giampaolo Bella Pietro Biondi Giuseppe Tudisco Dipartimento di Matematica e Informatica Universitàdegli Studi di CataniaCataniaItaly Osservatorio Astrofisico di Catania Istituto Nazionale di AstrofisicaCataniaItaly

The advanced and personalised experience that modern cars offer makes them more and more *** example,the cabin preferences of the possible drivers must be recorded and associated to some identity,while such data could be exploited to deduce sensitive information about the driver’s ***,drivers’privacy must be taken seriously,requiring a dedicated risk assessment framework,as presented in this paper through a double assessment combining the asset-oriented ISO approach with the threat-oriented STRIDE *** framework is tailored to the level of specific car brand and demonstrated on the ten top-selling brands as well as,due to its innovative character,*** two approaches yield different,but complementary findings,demonstrating the additional insights gained through their parallel adoption.

关键词： Automotive Cyber physical systems Risk management ISO 27005 STRIDE

A gate driver for parallel connected MOSFETs with crosstalk suppression

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iEnergy 2023年第3期2卷 240-250页

作者： Yury Mikhaylov giampaolo Buticchi Michael Galea Department of Electrical and Electronic Engineering University of Nottingham Ningbo ChinaNingbo 315100China Department of Electrical Engineering University of MaltaMalta

New semiconductor materials offer several advantages for modern power systems,including low switching and conduction losses,excellent thermal conduction of a die,and high operation *** is one of the main beneficiaries of the progress in power devices,as it enables more compact and lighter converters for future More Electrical ***,these advancements also come with new challenges that must be addressed to avoid potentially dangerous situations and fully utilize the capabilities of fast SiC *** such challenge is the high drain voltage rate during the switching process,which leads to a significant injection of current into the gate circuit(crosstalk effect).This increased current injection increases the risk of shoot-through conduction and thermal *** preventive measures are well-known,they offer limited protection in the case of parallel MOSFET ***,this paper considers crosstalk features for parallel MOSFET connections,such as parasitic inductance of gate driver trace and gate voltage distribution.A special model is proposed to predict the magnitude of induced gate voltage under different conditions considering the nonlinear behavior of the MOSFET reverse capacitance.A new clamp circuit with an individual low-inductance path for each parallel switch is also proposed to suppress the consequences of *** modified circuit operates independently from the main gate driver circuit;therefore,it does not change the switching time and electromagnetic interference pattern of the *** efficiency of the new gate driver is confirmed through simulation and experimental results.

关键词： Power electronics SiC MOSFET parallel connection gate driver parasitic effects

Morbidity and psychological impact of prostate biopsy： the future calls for a change

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Asian Journal of Andrology 2014年第3期16卷 415-417页

作者： Andrea Minervini Gianni Vittori giampaolo Siena Marco Carini Department of Urology University of FlorenceCareggi Hospital Florence Italy.

Currently transrectal ultrasound-guided prostate biopsy （TRUS-Bx） is one of the most common urological procedures, with more than 1 million performed per year in Europe and the United States. Among patients undergoing TRUS-Bx, approximately one-third will receive a diagnosis of prostate cancer （PCa）, while two-thirds receive a negative result on initial biopsy. Negative biopsy patients maintain an estimated risk of repeated biopsy of 12% at I year and 38% at 5 years. 2 Standard TRUS-Bx is likely to systematically miss significant tumors, particularly in the anterior and apical parts of the gland.3 A crucial aim of urologists in the next decade is to increase the accuracy of the procedure and avoid the use of inappropriate biopsies.

关键词： Morbidity psychological impact prostate biopsy