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Biomedical subjects

A Spinazzi

Publications and source records attributed to A Spinazzi.

At least 37 records · Page 2Linked to original sources
PubMed1999

Clinical utility and safety of MultiHance in magnetic resonance imaging of liver cancer: results of multicenter studies in Europe and the USA.

MultiHance (gadobenate dimeglumine; Gd-BOPTA, Bracco SpA, Milano, Italy) is a novel gadolinium-based contrast agent which has recently been made commercially available in Europe for magnetic resonance imaging of the liver. It combines the properties of a conventional extracellular fluid contrast agent with those of a liver-specific agent and has been shown in numerous clinical trials to improve the impact of magnetic resonance imaging for both the detection and characterization of focal liver masses. The present article briefly summarizes the safety and efficacy results of Phase I, II and III clinical studies carried out in almost 800 patient and non-patient volunteers in both Europe and the USA.

Carcinoma, Hepatocellular↗
PubMed1999

MultiHance in the dynamic phase of contrast enhancement: a pictorial assessment.

The present article demonstrates pictorially the use of MultiHance (gadobenate dimeglumine, Gd-BOPTA) in dynamic magnetic resonance imaging and is aimed at ensuring that the product is not misconceived as solely a hepatobiliary agent for use in delayed, static magnetic resonance imaging for the improved detection of focal liver lesions. The enhancement patterns of three malignant (hepatocellular carcinoma, cholangiocarcinoma and metastasis) and three benign (hemangioma, focal nodular hyperplasia and adenoma) lesion types are demonstrated. Each was imaged during the dynamic phase of contrast enhancement immediately following the intravenous bolus administration of 0.05 mmol/kg MultiHance. The article demonstrates that the enhancement patterns observed for these relatively common lesions are similar to those reported in the literature after the intravenous bolus administration of conventional, non-specific 'extracellular fluid' contrast agents, and concludes by inferring that MultiHance behaves in the liver as a conventional gadolinium-based agent in the first minutes after administration.

Adenoma↗
PubMed1999

MultiHance: help or hype?

MultiHance (Gd-BOPTA) couples specific, long lasting enhancement of magnetic resonance signal intensity in the liver parenchyma with the plasma kinetics of agents targeted to the extracellular fluid space. Therefore, this new contrast agent may be used both as an extracellular fluid agent, such as Magnevist (Gd-DTPA) or ProHance (gadoteridol) or as a liver-specific agent, such as Teslascan (mangafodipir) or iron oxides (e.g., Endorem). The clinical studies conducted so far have shown that MultiHance improves liver cancer detection by magnetic resonance imaging, the characterization of liver lesions, when used in combination with bolus dynamic magnetic resonance imaging, and the diagnostic performance of magnetic resonance imaging in extra-hepatic organ areas, such as brain and spine and the cardiovascular system. This brief article attempts to define the potential utility of this novel agent in the daily clinical setting, taking into account what is already available in radiology departments. It summarizes briefly the clinical need for a magnetic resonance contrast agent which improves the impact of magnetic resonance imaging for both the detection and characterization of focal liver lesions and concludes with the affirmation that MultiHance would be a definite help to radiologists working on all aspects of magnetic resonance imaging.

Carcinoma, Hepatocellular↗
PubMed1996

Competitive development of new ultrasound, X-ray and MR contrast media.

Though much has been achieved by pharmaceutical companies in terms of safe and effective contrast media, there is still a reservoir of medical needs in several imaging areas which have not been met as yet and which therefore represents a challenge for further advance. At present Bracco is not only evaluating and developing new contrast agents for MR, ultrasound and X-ray, but is also paying great attention to the cost effectiveness issue. A first step is to minimize the occurrence and severity of contrast media adverse reactions by clearly identifying which adverse reactions depend really on the type of contrast medium and therefore trying to reduce them by modifying the molecule characteristics. An example of this, can be the new nonionic compound for X-ray, iomeprol, which is characterised by the lowest osmolality and viscosity values among all available agents of the same class and that represents a further step toward the ideal contrast medium.

Contrast Media↗
PubMed1996

Focal malignant hepatic lesions: MR imaging enhanced with gadolinium benzyloxypropionictetra-acetate (BOPTA)--preliminary results of phase II clinical application.

PURPOSE: To investigate enhancement with gadolinium benzyloxypropionictetraacetate (BOPTA) at magnetic resonance (MR) imaging to detect focal malignant hepatic lesions. MATERIALS AND METHODS: A phase II trial was performed in 34 patients. Gd-BOPTA-enhanced spin-echo (SE) and gradient-recalled-echo (GRE) T1-weighted MR imaging were performed at 40 and 90 minutes after intravenous injection of 0.05 and 0.10 mmol/kg Gd-BOPTA. RESULTS: The percentage of enhancement in liver parenchyma was significantly (P<.05) increased on GRE T1-weighted compared with SE T1-weighted images at 40 and 90 minutes after injection of the higher dose and compared with SE and GRE T1-weighted images obtained with the lower dose. The contrast-to-noise ratio of metastases was significantly increased on GRE T1-weighted images (0.10 mmol/kg) at 90 minutes compared with precontrast images. Significantly more small primary metastases were detected on GRE T1-weighted images (0.10 mmol/kg) at 90 minutes compared with precontrast SE T1-weighted images. CONCLUSION: Gd-BOPTA is a safe hepatobiliary contrast agent that helps detection of small metastases.

Contrast Media↗
PubMed1995

A randomized, double-blind, parallel group trial of iomeprol, iohexol and iopamidol in intravenous urography.

The aim of this study was to compare the safety, tolerance, and diagnostic efficacy of iomeprol 350 mg I ml-1, iohexol 350 mg I ml-1, and iopamidol 370 mg I ml-1 in 90 adult patients undergoing intravenous urography. Radiographs obtained 5, 10 and 15 min after contrast injection were blindly graded for quality on a four point scale as: 0, non-diagnostic; 1, diagnostic but of limited quality; 2, diagnostic and of good quality; 3, fully diagnostic and of very good quality. The sum of these scores indicated the overall diagnostic quality (0-4, non-diagnostic; 4-8, diagnostic; 9-12, good or excellent). Contrast tolerability was evaluated by discomfort (heat or pain) associated with injection of the test compounds, and patients were monitored and questioned for adverse experiences. The quality of the individual radiographs was assessed as diagnostic and good or fully diagnostic and very good in most cases, with no significant differences between the three study groups, and overall scores were predominantly good or excellent (p = 0.55). All adverse reactions were transient and non-serious, and most of them were reported as mild in intensity. There were no significant differences between the three groups for heat sensation (p = 0.29). Pain at the injection site was reported only in the iohexol group (p = 0.104). It is concluded that iomeprol 350 mg I ml-1 is at least as safe and effective as iohexol 350 mg I ml-1 or iopamidol 370 mg I ml-1 when used for intravenous urography.

Adolescent↗
PubMed1994

Spiral CT of the mediastinum: optimization of contrast medium use.

Spiral computed tomography (CT) allows very satisfactory temporal resolution for the detection and analysis of changes in contrast medium density, so that volumes of contrast material smaller than those recommended for conventional CT can be used. The present double-blind, parallel group study was designed to compare image quality and diagnostic efficacy obtained with two different iodine strengths (200 and 300 mgI/ml) and two different flow rates (2 and 3 ml/s) of a fixed volume (70 ml) of iomeprol in adult consenting patients requiring spiral CT of the mediastinum. Imaging was performed during suspended respiration and, a 15-s delay to scan. Spiral CT was initiated 1 cm above the aortic arch and continued inferiorly for 24 cm in all patients. Two independent readers blindly graded image quality, opacification of the superior vena cava, thoracic aorta and pulmonary arteries, and overall diagnostic quality of the CT examination. CT density measurements were performed over the level of the aortic arch, left and right pulmonary arteries, left atrium, and descending aorta. Opacification of the mediastinal vessels was better in the patients injected at 3 ml/s flow rate and was independent of the iodine strength used, except in the case of the thoracic aorta, which was better opacified by injecting iomeprol 300 mgI/ml at 3 ml/s. The highest diagnostic efficacy of the spiral CT examination was obtained with iomeprol 300 mgI/ml at 3 ml/s infusion rate, which seems to represent the administration scheme of choice.

Adult↗
PubMed1994

A randomised, double-blind trial of iomeprol and iopromide in intravenous excretory urography.

The aim of this double-blind, parallel group study was to compare the safety, tolerance and diagnostic efficacy of iomeprol 350 mgI/ml and iopromide 370 mgI/ml in 100 adult patients undergoing intravenous excretory urography. Fifty patients were randomised to receive 50 ml iomeprol 350 mgI/ml and 50 to receive 50 ml iopromide 370 mgI/ml. Intravenous administration of the contrast agents was always completed in 30 seconds. Images were obtained immediately after and 5, 10 and 15 min after completion of contrast medium injection. Nephrogram and pyelogram opacification quality was blindly graded according to a four point scale as follows: 0, nondiagnostic; 1, diagnostic but of limited quality; 2, diagnostic and of good quality; 3, fully diagnostic and of very good quality'. At the end of each individual patient study, the overall diagnostic quality of the procedure was reported as the sum of the scores attributed to each quality of nephrogram and pyelogram opacification quality on different images (0-4, nondiagnostic procedure; 4-8, diagnostic procedure; 9-12, excellent or good procedure). The tolerability of the test compounds was evaluated in terms of discomfort (heat and pain) associated with the injection of the test compounds. All patients were continuously monitored for adverse experiences for 1 h after completion of the urographic procedure. Reporting of untoward reactions was both spontaneous and elicited. The quality of the radiographs was judged as excellent or good in most cases, without significant differences between the two study groups. The distribution of scores of overall diagnostic quality of procedures was similar for the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Cardiac morphology and function in arterial hypertension. The effects of a new multifactorial hypotensive agent: urapidil.

It has been recognized as increasingly important to determine whether antihypertensive agents, while satisfactorily lowering the blood pressure, at the same time adversely or positively affect the cardiac hemodynamic profile. On theoretical grounds, one would expect that an ideal hypotensive drug should decrease blood pressure by decreasing total peripheral resistances, without affecting cardiac output, and should normalize left ventricular hypertrophy without deteriorating systolic or diastolic left ventricular function. We here briefly review the effects of urapidil on these variables in patients under chronic treatment investigated in a series of studies employing echocardiography. The results of the studies are in fair agreement and indicate a blood pressure decrease already after one month of treatment, due to a decrease of peripheral resistances, without changes in heart rate. A clear trend towards a reduction of cardiac hypertrophy during the treatment is suggested by the significant decrements of the indices measured. One study also suggests that right ventricular wall thickness may be reduced. Left ventricular dimensions remained unchanged in all except one study. Systolic and diastolic function indices were also unchanged during the first 6 months of treatment and, in one study, improvement was found after 12 months of treatment. Taken together these results suggest that urapidil lowers blood pressure favorably, affecting cardiac morphology and function.

Antihypertensive Agents↗