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Recent advances in non-invasive magnetic resonance imaging assessment of hepatocellular carcinoma

World Journal of Gastroenterology 2018年第23期24卷 2413-2426页

作者： Davide Ippolito Riccardo Inchingolo Luigi Grazioli silvia girolama drago Michele Nardella Marco Gatti Riccardo Faletti School of Medicine University of Milano-Bicocca Department of Diagnostic Radiology HS Gerardo Monza Division of Interventional Radiology Department of RadiologyMadonna delle Grazie Hospital Department of Radiology University of Brescia "Spedali Civili" Department of Surgical Sciences Radiology UnitUniversity of Turin

Magnetic resonance(MR) imaging of the liver is an important tool for the detection and characterization of focal liver lesions and for assessment of diffuse liver disease,having several intrinsic characteristics,represented by high soft tissue contrast,avoidance of ionizing radiation or iodinated contrast media,and more recently,by application of several functional imaging techniques(i.e.,diffusion-weighted sequences,hepatobiliary contrast agents,perfusion imaging,magnetic resonance(MR)-elastography,and radiomics analysis). MR functional imaging techniques are extensively used both in routine practice and in the field of clinical and pre-clinical research because,through a qualitative rather than quantitative approach,they can offer valuable information about tumor tissue and tissue architecture,cellular biomarkers related to the hepatocellular functions,or tissue vascularization profiles related to tumor and tissue biology. This kind of approach offers in vivo physiological parameters,capable of evaluating physiological and pathological modifications of tissues,by the analysis of quantitative data that could be used in tumor detection,characterization,treatmentselection,and follow-up,in addition to those obtained from standard morphological imaging. In this review we provide an overview of recent advanced techniques in MR for the diagnosis and staging of hepatocellular carcinoma,and their role in the assessment of response treatment evaluation.

关键词： Liver Cirrhosis Hepatocellular carcinoma Magnetic resonance Transarterial chemoembolization Contrast media

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Role of dynamic perfusion magnetic resonance imaging in patients with local advanced rectal cancer

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World Journal of Gastroenterology 2020年第20期26卷 2657-2668页

作者： Davide Ippolito silvia girolama drago Anna Pecorelli Cesare Maino Giulia Querques Ilaria Mariani Cammillo Talei Franzesi Sandro Sironi Department of Diagnostic Radiology H.S.Gerardo MonzaSan Gerardo HospitalUniversity of Milano-BicoccaMonza 20900Italy Department of Diagnostic Radiology Papa Giovanni XXIII HospitalUniversity of Milano-BicoccaBergamo 20110Italy

BACKGROUND The management of rectal cancer patients is mainly based on the use of the magnetic resonance imaging(MRI)technique as a diagnostic tool for both staging and restaging.After treatment,to date,the evaluation of complete response is based on the histopathology assessment by using different tumor regression grade(TRG)features(e.g.,Dworak or Mandard classifications).While from the radiological point of view,the main attention for the prediction of a complete response after chemotherapy treatment focuses on MRI and the potential role of diffusion-weighted images and perfusion imaging represented by dynamiccontrast enhanced MRI.The main aim is to find a reliable tool to predict tumor response in comparison to histopathologic findings.AIM To investigate the value of dynamic contrast-enhanced perfusion-MRI parameters in the evaluation of the healthy rectal wall and tumor response to chemo-radiation therapy in patients with local advanced rectal cancer with histopathologic correlation.METHODS Twenty-eight patients with biopsy-proven rectal adenocarcinoma who underwent a dynamic contrast-enhanced MR study performed on a 1.5 T MRI system(Achieva,Philips),before(MR1)and after chemoradiation therapy(MR2),were enrolled in this study.The protocol included T1 gadolinium enhanced THRIVE sequences acquired on axial planes.A dedicated workstation was used to generate color permeability maps.Region of interest was manually drawn on tumor tissue and normal rectal wall,hence the following parameters were calculated and statistically analyzed:Relative arterial enhancement(RAE),relative venous enhancement(RVE),relative late enhancement(RLE),maximum enhancement(ME),time to peak and area under the curve(AUC).Perfusion parameters were related to pathologic TRG(Mandard’s criteria;TRG1=complete regression,TRG5=no regression).RESULTS Ten tumors(36%)showed complete or subtotal regression(TRG1-2)at histology and classified as responders;18 tumors(64%)were classified as non-responders(TRG3-5).Perfusion MRI parameters were significantl

关键词： Rectal neoplasm Chemotherapy Radiotherapy Tumor staging Treatment response Magnetic resonance imaging

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Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion

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World Journal of Gastroenterology 2016年第20期22卷 4891-4900页

作者： Davide Ippolito silvia girolama drago Cammillo Talei Franzesi Davide Fior Sandro Sironi School of Medicine University of Milano-Bicocca Department of Diagnostic Radiology H. San Gerardo Hospital

AIM: To assess the diagnostic accuracy of multidetectorrow computed tomography(MDCT) as compared with conventional magnetic resonance imaging(MRI), in identifying mesorectal fascia(MRF) invasion in rectal cancer patients.METHODS: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner(ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 m As. Imaging data were reviewed as axial and as multiplanar reconstructions(MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images(DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed.RESULTS: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91(41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged(45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value(PPV) 80.4%, negative predictive value(NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared to the reference magnetic resonance images. The

关键词： Magnetic resonance Multi detector computed tomography Rectal cancer Mesorectal fascia Multiplanar re

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Cadaveric bone marrow mesenchymal stem cells:first experience treating a patient with large severe burns

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Burns & Trauma 2015年第2期3卷 74-82页

作者： Eduardo Mansilla Gustavo H.Marín Mirta Berges silvia Scafatti Jaime Rivas Andrea Núñez Martin Menvielle Roberto Lamonega Cecilia Gardiner Hugo drago Flavio Sturla Mercedes Portas silvia Bossi Maria Victoria Castuma Sandra Peña Luengas Gustavo Roque Karina Martire Jose Maria Tau Gabriel Orlandi Adrian Tarditti Tissue Engineering Regenerative Medicine and Cell Therapies LaboratoryCUCAIBAProvince of Buenos Aires Ministry of HealthTransplantation ProgramLa PlataProvince of Buenos AiresArgentina Burns and Plastic Surgery Department San Martín HospitalProvince of Buenos Aires Ministry of HealthLa PlataProvince of Buenos AiresArgentina Burns Hospital Buenos Aires CityArgentina Department of Chemistry Mayaguez CampusUniversity of Puerto RicoMayaguezPuerto RicoUSA.

Background:In January 2005,Rasulov et al.originally published"First experience in the use of bone marrow mesenchymal stem cells(MSCs)for the treatment of a patient with deep skin burns".Here,we present the first ever treated patient with cadaveric bone marrow mesenchymal stem cells(CMSCs)in the history of Medicine.Methods:A young man,who severely burned 60%of his total body surface with 30%of full-thickness burns while working with a grass trimmer that exploded,was involved in the study.MSCs were obtained from the bone marrow of a cadaver donor in a routine procurement procedure of CUCAIBA,the Province of Buenos Aires,Argentina,Ministry of Health,Transplantation Agency,cultured,expanded,and applied on the burned surfaces using a fibrin spray after early escharotomy.Results:So far,our preliminary experience and our early results have been very impressive showing an outstanding safety data as well as some impressive good results in the use of CMSCs.Conclusions:Based on al this,we think that improvements in the use of stem cells for burns might be possible in the near future and a lot of time as well as many lives could be saved by many other research teams all over the world.CMSCs will probably be a real scientific opportunity in Regenerative Medicine as well as in Transplantation.

关键词： Burns Cadaveric Transplantation Skin regeneration Mesenchymal stem cells

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Combined value of apparent diffusion coefficient-standardized uptake value max in evaluation of post-treated locally advanced rectal cancer

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World Journal of Radiology 2015年第12期7卷 509-520页

作者： Davide Ippolito Davide Fior Chiara Trattenero Elena De Ponti silvia drago Luca Guerra Cammillo Talei Franzesi Sandro Sironi School of Medicine University of Milano-Bicocca Department of Diagnostic Radiology H S.Gerardo Monza Department of Medical Physics San Gerardo Hospital Department of Nuclear Medicine and PET Unit-Molecular Bioimaging Centre San Gerardo Hospital

AIM:To assess the clinical diagnostic value of functional imaging,combining quantitative parameters of apparent diffusion coefficient(ADC) and standardized uptake value(SUV)max,before and after chemo-radiation therapy,in prediction of tumor response of patients with rectal cancer,related to tumor regression grade at histology.METHODS:A total of 31 patients with biopsy proven diagnosis of rectal carcinoma were enrolled in our study.All patients underwent a whole body ^(18)FDG positron emission tomography(PET)/computed tomography(CT) scan and a pelvic magnetic resonance(MR)examination including diffusion weighted(DW) imaging for staging(PET1,RM1) and after completion(6.6 wk)of neoadjuvant treatment(PET2,RM2).Subsequently all patients underwent total mesorectal excision and the histological results were compared with imaging findings.The MR scanning,performed on 1.5 T magnet(Philips,Achieva),included T2-weighted multiplanar imaging and in addition DW images with b-value of 0 and 1000 mm^2/s.On PET/CT the SUVmax of the rectal lesion were calculated in PET1 and PET2.The percentage decrease of SUVmax(△SUV) and ADC(△ADC) values from baseline to presurgical scan were assessed and correlated with pathologic response classified as tumor regression grade(Mandard's criteria;TRG1 = complete regression,TRG5 = no regression).RESULTS:After completion of therapy,all the patients were submitted to surgery.According to the Mandard's criteria,22 tumors showed complete(TRG1) or subtotal regression(TRG2) and were classified as responders;9tumors were classified as non responders(TRG3,4 and5).Considering all patients the mean values of SUVmax in PET 1 was higher than the mean value of SUVmax in PET 2(P < 0.001),whereas the mean ADC values was lower in RM1 than RM2(P < 0.001),with a △SUV and △ADC respectively of 60.2%and 66.8%.The best predictors for TRG response were SUV2(threshold of4.4) and ADC2(1.29 × 10^(-3) mm^2/s) with high sensitivity and specificity.Combining in a single analysis both the obtained median value,the positive pred

关键词： Advanced rectal cancer Functional imaging FDG-PET/CT Magnetic resonance imaging Apparent diffusion coefficient Neoadjuvant treatment Tumor regression grade

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Detection of β-Glucuronidase Activity within Actinomadura madurae Grains of Human Actinomycetoma

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Advances in Microbiology 2014年第6期4卷 317-323页

作者： Alejandro Palma-Ramos Samantha Reyes-Mayén Laura Estela Castrillón-Rivera silvia Elena Fernández-López Carmen Padilla-Desgarennes María Elisa Vega-Memije Roberto Arenas-Guzmán María Elisa drago-Serrano Teresita Sainz-Espunes Department of Biological Systems Universidad Autónoma Metropolitana-XochimilcoMexico CityMéxico Dermatology Center“Dr.Ladislao de la Pascua” Mycology ServiceMexico City Health SecretaryMexico CityMéxico General Hospital“Manuel Gea González” Dermatology ServiceMexico City Health SecretaryMexico CityMéxico General Hospital“Manuel Gea González” Mycology ServiceMexico City Health SecretaryMexico CityMéxico

Actinomycetoma syndrome by Actinomadura (A.) madurae is characterized by a subcutaneous chronic lesion that affects fascia, muscle and bone. A. madurae produces colonies that form grains of less than 1 mm in diameter. Grains are surrounded and infiltrated by neutrophils involved in the grain disruption by enzymes like β-glucuronidase released after the neutrophil degranulation. The aim of this work was to evaluate the polysaccharide degradation of grains treated with β-glucuronidase and to detect the presence and activity of β-glucuronidase within the A. madurae grains. Actinomadura madura grains from patients infected were processed to quantify the total content of polysaccharide with the phenol-sulfuric acid reaction. Grains were treated with β-glucuronidase at different conditions to evaluate the optimal polysaccharide degradation. Grains were analyzed to detect the enzyme by using anti-human β-glucuronidase antibody while enzymatic activity was assessed by evaluating the release of reduced sugars and by in situ enzymatic activity. Optimal degradation of polysaccharide in the grains treated with β-glucuronidase was found with 300 units/ml of enzyme and 24 hr of incubation at 37°C. Presence and activity of β-glucuronidase enzyme within the grains were detected. Results suggested that β-glucuronidase present within A. madurae grain resulted from degranulated neutrophils surrounding and/or infiltrated within the grain.

关键词： Actinomycetoma A. madurae β-Glucuronidase

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