Search PubMed⌕ Search

Biomedical subjects

G Luppi

Publications and source records attributed to G Luppi.

26 records · Page 2Linked to original sources
PubMedDate not supplied

Gadolinium-enhanced MRI with dynamic evaluation in diagnosing the local recurrence of rectal cancer.

BACKGROUND: At early stages, the diagnosis of local recurrence of rectal cancer is often difficult and magnetic resonance imaging (MRI) is currently considered the most accurate method for diagnosing recurrence. We evaluated the role of unhenhanced and gadolinium-enhanced MRI for the diagnosis of local recurrence of rectal cancer. METHODS: Thirty-six patients, suspected of having a pelvic recurrence of rectal cancer, were evaluated by a high field strength MRI unit. Unenhanced spin-echo T1- and T2-weighted sequences and gadolinium-enhanced dynamic fast multiplanar spoiled gradient recalled sequences were performed in all patients. The dynamic images were re-elaborated with semiquantitative postprocessing by plotting intensity-time curves and calculating the percentage of signal increase at the end of the first postcontrast dynamic sequence. The pelvic lesions were classified as recurrent or not recurrent by applying the following diagnostic criteria: (a) morphology and signal intensity of the lesion in unenhanced sequences and (b) percentage of enhancement in dynamic enhanced sequences. Diagnosis was confirmed by computed tomography-guided needle biopsy (12 patients), surgery (four patients), clinical and imaging follow-up (20 patients). RESULTS: The diagnosis was local recurrence in 15 patients and noncancerous lesions in 21 patients. Unenhanced MRI had 80% sensitivity and 86% specificity. Analysis of the percentage of enhancement showed 87% sensitivity and 100% specificity. CONCLUSION: In agreement with the literature, our results showed a high sensitivity and specificity for dynamic MRI. This technique thus can be considered an important adjunct to unenhanced MRI, especially in selected cases in which unenhanced MRI cannot rule out local recurrences. However, these results must be validated by further investigations.

Adult↗
PubMedDate not supplied

Occasional diagnosis of synchronous renal cell carcinoma during staging of other primary tumors.

Synchronous renal cell cancer (RCC) associated with primary neoplasms of other organs or tissues represents a rare diagnostic report during life. Recently, the widespread use of new diagnostic techniques (echography, computed tomography and magnetic resonance imaging) has permitted diagnosis of clinically silent RCC. We report 6 RCC cases occasionally diagnosed during initial staging of a primary cancer of other organs: 1 rhinopharyngeal carcinoma, 1 gastric cancer, 1 Waldenström's disease, 1 non-Hodgkin's lymphoma, 2 breast cancer, RCC was clinically silent in all patients. The diagnostic problems related to a report of a renal mass in patients with neoplastic disease at other sites and the consequent therapeutic implications are discussed.

Aged↗
PubMedDate not supplied

Urinary neopterin in malignant lymphoma.

Urinary neopterin levels were studied in 96 patients with malignant lymphomas. Twenty-eight had Hodgkin's disease and 68 non-Hodgkin's lymphoma. Neopterin excretion was significantly related to the clinical stage of the disease. Mean neopterin excretion in patients with active disease (634 +/- 527 mumol neopterin/mol creatinine) was significantly higher (p = 0.000) than in patients in complete remission (198 +/- 105 mumol neopterin/mol creatinine). Mean neopterin levels of patients in stage III-IV were higher than for patients in stage I-II. These findings were the same in patients with Hodgkin's disease and those with non-Hodgkin's lymphoma (659 +/- 593-425 +/- 316 mumol neopterin/mol creatinine), regardless of the histological subtype. A significant correlation was found between neopterin excretion, ESR (r = 0.31; p = 0.003) and hemoglobin (r = -0.40; p = 0.000). Longitudinal analysis showed a trend towards a correlation between response to therapy and neopterin excretion. These findings suggest that neopterin may be a useful prognostic marker in non-Hodgkin's lymphoma.

Adult↗
PubMedDate not supplied

[Antineoplastic perfusion with percutaneous stop-flow control in the treatment of advanced pelvic malignant neoplasms].

PURPOSE: The object of our study was to apply percutaneous stop-flow technique to advanced pelvic cancer in order to evaluate its feasibility, standardize the procedure and obtain preliminary results. MATERIAL AND METHODS: April to December 1997 we submitted ten patients with advanced pelvic cancer to percutaneous stop-flow technique. Seven patients had a pelvic recurrence from carcinoma of the rectum, two patients had inoperable recto-sigmoid cancer, and another one had a local recurrence of ovarian cancer. All treatments were performed under general anesthesia. A stop-flow balloon catheter was placed via a transfemoral arterial and venous access above the aortocaval bifurcation and below the emergence of renal arteries and veins. The pelvic district was isolated by filling the balloon catheters and pneumatic cuffs at the thigh, and the antineoplastic agents (cisplatinum, 80 mg/m2 followed by mitomycin C, 30 mg/m2) were sequentially infused by means of an extracorporeal circuit. Blood flow was interrupted for a maximum of 20 min to limit tissue damage, especially of the anal sphincter. Hemofiltration was run during the last 3 min of stop-flow and in the following minutes, achieving at least 5 liters of ultrafiltration. Morphological response was evaluated by CT or MR scan performed prior to and 40 days after the treatment. RESULTS: Over a 2-year follow-up 2 of our 10 patients are alive and 8/10 have died (median survival 9.6 months). Death followed tumor progression in 6 cases; one patient died during the procedure and another one after 7 days, both secondary to pulmonary embolism. Complications included intra-arterial rupture of the balloon in one case and a large inguinal hematoma 10 days after the treatment, requiring hospitalization. No patient showed positive morphological response; two patients only showed stable disease. CONCLUSIONS: This trial supports the feasibility of using the percutaneous stop-flow procedure in an angiography room setting; the stop-flow technique failed to permit the effective control of the tumors.

Aged↗
PubMedDate not supplied

[Appendiceal lithiasis: case report and review of literature].

Appendiceal calculi are found in a limited percentage of patients. They are in association to an elevated prevalence of necrotic appendicitis and perforation of the appendix. The Authors report a case of acute appendicitis associated to appendiceal lithiasis with perforation of the organ. They emphasize the possibility to perform a preventive appendectomy in case of incidental appendiceal lithiasis. Besides they consider the differential diagnosis of the calcified images located in the lower abdominal quadrants with the aid of the various imaging methods available today, particularity sonography and computerized tomography.

Adult↗
PubMedDate not supplied

[Benign tumors and pseudotumors of temporo-mandibular joint: radiologic aspects].

Benign tumors and tumor-like lesions that involve temporo mandibular joint are very rare. Those more frequent are osteochondroma, chondroma, osteoma, pigmented villonodular synovitis and synovial chondromatosis. The Authors report six cases of patients affected by these pathologies in which imaging, such as TC, MRI and/or ortopantomography have been useful to have a diagnosis.

Adult↗