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E Ceglia

Publications and source records attributed to E Ceglia.

At least 19 recordsLinked to original sources
PubMed1998

[Locally advanced breast tumors. Role of magnetic resonance in the assessment of response to preoperative therapy and of neoplastic residue before the operation].

INTRODUCTION AND PURPOSE: Induction chemotherapy is the preoperative treatment for locally advanced breast carcinoma. The patients affected with this kind of tumor were previously considered inoperable. The sequential use of different cytotoxic drugs reduces the tumor mass effectively, thus allowing resection and improving patients prognosis. Tumor debulking is at times so significant that conservative treatment can even be considered. A reliable assessment of the response to drug therapy by conventional diagnostic procedures is usually hindered by chemotherapy-induced fibrosis. Magnetic resonance imaging (MRI) is a better tool for distinguishing fibrosis from still vascularized pathologic tissue and thus permits more accurate evaluation of tumor response to chemotherapy, namely tumor debulking and residual viability. MATERIAL AND METHODS: We selected 27 patients with breast cancer and submitted them to MRI both before and after chemotherapy. All examinations were performed with a high field system using 3D Flash sequences with optimized spatial and temporal resolution. RESULTS AND DISCUSSION: The morphologic and dynamic parameters of MRI were in agreement with pathologic findings. In case of persistent disease after chemotherapy, MRI demonstrated increased contrast agent uptake at restaging, with dynamic curves indicating early and intense uptake. In case of marked post-chemotherapy changes, the dynamic curves had a shorter and less steep trend. Finally, when no or very little (few microns) tumor tissue was left, MRI showed no uptake. CONCLUSIONS: Our initial experience indicates MRI as a valid too for monitoring chemotherapy response in breast cancer patients.

Adult↗
PubMed1996

[Magnetic resonance in primary bone tumors: a review of 10 years of activities].

All the MR exams of primary bone tumors performed during ten years were reviewed by three different radiologists. In all, 484 exams in 220 patients were considered--namely, 160 exams (33.1%) for staging purposes, 219 (45.2%) during therapy and 105 (21.7%) performed more than 8 months after the last treatment. Its well-known accuracy in the assessment of intra/extraosseous spread confirms the major role of MRI in the staging of primary bone tumors. During treatment, the overall accuracy of this method decreased to 88.8% because of the presence of therapy-induced tissue changes. MRI was 95.2% reliable in the detection of persistent disease or relapse in the exams performed long after therapy. Conventional radiology is still the method of choice in the study of primary bone tumors at presentation as it detects the lesion, differentiates malignant tumors and usually suggests the possible histotype. Nevertheless, MRI seems to be needed to depict actual tumor extent and to find the correct therapeutic approach. In the follow-up, MRI is the best single method to assess the response to therapy and to detect tumor persistence.

Adolescent↗
PubMed1994

[Value of magnetic resonance in the staging of non-small-cell lung carcinoma].

In the last six years, 544 consecutive patients with nonsmall-cell bronchogenic carcinoma were studied with MRI. MR results were compared with surgical specimens and pathologic findings. Both TNM classification and ATS nodal mapping were considered. Local tumor extent (T parameter) was correctly identified in 67.2% of cases, understaged in 19.4% and overstaged in 13.4%. Lymph node metastases (N parameter) were adequately assessed in 55.5% of cases, understaged in 20.3% and overstaged in 24.2%. Considering two groups of patients, the first one with early stage disease (T1-T2, N0-N1) and the second one with advanced stages (T3-T4, N2-N3), MRI exhibited 84.6% overall accuracy, 57.3% sensitivity and 93.7% specificity for the T parameter and 72.3% accuracy, 65.2% sensitivity and 75.1% specificity for the N parameter. In conclusion, MRI did not provide the expected results in the staging of nonsmall-cell bronchogenic carcinoma, but improvement will probably be achieved with technological evolution.

Carcinoma, Non-Small-Cell Lung↗
PubMed1993

Heart involvement in lymphomas. The value of magnetic resonance imaging and two-dimensional echocardiography at disease presentation.

BACKGROUND AND METHODS: Thirty-six patients with mediastinal lymphoma were studied with chest magnetic resonance imaging (MRI) and two-dimensional echocardiography at presentation to define the extent of the disease in the paracardiac area. RESULTS: Involvement of cardiac structures was present in 23 of 36 patients (64%). Pericardial contiguity was detected in 23 of 23 patients (100%) by MRI and in 18 of 23 patients (78%) by echocardiography. Pericardial effusion, present in 17 patients (74%), and pericardial infiltration, present in 7 patients (30%), were detected by both techniques in 71% and 86%, respectively. Myocardial infiltration was identified in two of two patients (100%) by MRI and in one of two patients (50%) by two-dimensional echocardiography. Extrapericardial disease was identified in 100% of patients by MRI but only in 30% of patients by echocardiography. CONCLUSIONS: Extracardiac and intracardiac involvement is a frequent event in mediastinal lymphomas and should be carefully evaluated with different imaging modalities, mainly MRI, for correct diagnosis and proper management.

Echocardiography↗
PubMed1993

Current role of gallium scan and magnetic resonance imaging in the management of mediastinal Hodgkin lymphoma.

BACKGROUND: A residual mediastinal mass after treatment represents a common diagnostic problem in the management of patients with Hodgkin lymphoma (HD). Conventional diagnostic radiology, computed tomography (CT), or ultrasonography (US) do not adequately reflect changes as fibrosis or necrosis. Gallium-67 (67Ga) imaging has been proven to be useful for the evaluation of HD in the mediastinum. The authors compared the ability of gallium scan and magnetic resonance imaging (MRI) to evaluate the mediastinal disease in the follow-up of patients with HD. METHODS: Thirty-four patients previously treated for HD were investigated with gallium scan, MRI, and all the other investigations to evaluate the mediastinal region. Sixteen patients were in restaging after treatment, and 18 were investigated for suspected radiologic recurrence in the mediastinum (follow-up, 9-75 months). The results of gallium scan and MRI were matched with clinical findings during the follow-up. RESULTS: A sensitivity of 85.7% for 67Ga and 92.8% for MRI was found, while the specificity was 100% for the scan and 80.6% for MRI. The predictive positive value that resulted was 100% for 67Ga and 68.4% for MRI. CONCLUSIONS: Both examinations were accurate in assessing the activity of residual masses in the mediastinum after treatment. 67Ga showed a lower sensitivity in comparison with MRI, but 67Ga frequently overestimates the presence of pathologic tissue. The authors acknowledge the complementary role of these two tests, but if only one of these examinations can be performed for logistic or economic reasons, then gallium scan represents the single most adequate diagnostic procedure.

Adolescent↗
PubMed1992

Magnetic resonance imaging of the gastrointestinal tract: investigation of baby milk as a low cost contrast medium.

After the incidental observation of the high signal intensity of the upper GI tract in a nourished baby, we tested eight baby milks; five different fresh commercial milks, one sweetened and condensed and two lyophilized milks in order to compare their ability to contrast MR images. The images were obtained with a 1.5 T magnet whereas the "in vitro" water proton relaxation time (T1 and T2) measurements were carried out at 0.5 T. After having selected the most effective lyophilized product, that was prepared according to the manufacturer's instructions, a group of 23 adult patients, 17 males and 6 females, with a mean age of 55.8 years (range 37 to 71 years) were examined. Thirteen patients had gastric cancer and ten patients had rectal or rectosigmoid junction tumors. The most effective imaging sequence was a spin-echo T1.w. After oral intake of milk a good contrast of the stomach, with sufficient distribution in the duodenum and the very proximal bowel, was achieved in all 13 patients with gastric cancer, as was a good depiction of the rectum and the recto-sigmoid junction after enema achieved in the 10 patients with rectal cancers. Disadvantages of lyophilized milk as a contrast agent are due to partial intestinal absorption, inhomogeneous distribution and irregular intestinal passage, whereas a clear advantage of lyophilized milk as a contrast agent is its good acceptance and palatable, inexpensive and non invasive properties. Because of these limitations lyophilized milk cannot be considered a real oral contrast medium but it can enhance MR imaging of the upper abdomen, and mainly of the lower GI tract in infants and adults.

Adult↗
PubMed1992

[Radiological staging of metastases of urologic tumors].

The present contribution considers the diagnostic possibilities of radiological imaging procedures in the evaluation of the lymphatic and bloodborne metastases in urological tumors. As regards the evaluation of the lymph node chains the presently available imaging modalities are discussed. For each of them, diagnostic accuracy and the percentage of false positive and false negative readings are presented. For the evaluation of the bloodborne metastases, the available imaging procedures for each organ and site are reported and a diagnostic flow chart is suggested.

Humans↗
PubMed1991

[Feasibility of magnetic resonance-guided fine-needle percutaneous biopsy].

Fluoroscopic, US, and CT guidance to aspiration cytology are valuable tools for oncologic diagnosis. MR imaging is now replacing CT as the imaging method of choice to guide biopsy mainly in the abdomen and pelvis. The standard needles used for CT-guided biopsy are unsuitable for MR guidance because ferromagnetic artifacts shade the underlying anatomy. A new needle specifically designed for MR guidance allowed MR-guided aspiration biopsies to be carried out in a group of 17 patients with different neoplastic diseases. To locate the lesion and to assess its depth, a glass pipette containing a diluted solution of paramagnetic contrast medium (Gd-DTPA) was placed on the skin surface. In 13/17 patients (76.5%), biopsy was successful and histology and/or cytology allowed a diagnosis to be made. In spite of their longer measurement times, T1-weighted SE images clearly demonstrated both needle and lesion. On the contrary, fast images (FLASH, 15 degrees-90 degrees), with/without breath holding, although much shorter (7 s), were often useless, due to artifacts, mainly in small lesions.

Biopsy, Needle↗
PubMed1990

Esophageal squamous cell carcinoma: MRI evaluation of mediastinum.

Thirty-two patients with esophageal spinocellular (squamous cell) carcinoma were studied with superconductive magnet in order to evaluate local and extraluminal extent, as well as mediastinal lymph node spread of the disease. In the absence of adenopathy, the localized tumors were considered susceptible to surgical treatment. All patients were operated on within 21 days. The resectability criteria were correctly evaluated in 75% of cases; sensitivity and specificity were 86 and 67%, respectively. Unsatisfactory results were obtained in the evaluation of mediastinal adenopathies. We conclude that magnetic resonance imaging (MRI) is useful in the preoperative evaluation of resectability criteria in patients with esophageal squamous cell carcinoma.

Adult↗
PubMed1990

Local recurrence of rectosigmoid cancer: what about the choice of MRI for diagnosis?

Local recurrence is a frequent event in the natural history of rectosigmoid cancer. The diagnostic possibilities, as well as the limits of computed tomography (CT) and transrectal ultrasonography (TRU), are well known in these conditions. The aim of our study was to define the possible role of magnetic resonance imaging (MRI). We considered 15 examinations carried out in 14 patients, seven of which were obtained before and after Gd-DTPA administration. MRI demonstrated a 93.3% accuracy, 100% sensitivity, and 83.3% specificity in relation to the presence of local recurrence. The presence of pelvic recurrence was suggested on the basis of morphological and signal criteria. The use of paramagnetic contrast gave additional information in four of seven patients. The use of Gd-DTPA may be most beneficial in patients suspected of recurrence, within 6 months of their last treatment, where the diagnosis is more difficult.

Colorectal Neoplasms↗
PubMed1989

The role of magnetic resonance imaging in the evaluation of neoplastic lesions of the breast.

Thirty-seven patients were evaluated for suspected breast cancer by magnetic resonance imaging (MRI) using 0.5- and 1.5-Tesla. We examined the patterns in breast images and the use of MRI in evaluating neoplasms. At the moment the cost/benefit ratio is unfavorable, mainly because of the availability of alternative methods of high accuracy and low cost, like mammography and ultrasonography. Furthermore fine needle aspiration biopsy is not possible with MRI. The widespread use of MRI for breast pathology seems not to be justified by the results obtained.

Breast Neoplasms↗
PubMed1988

MRI as an adjunct to echocardiography for the diagnostic imaging of cardiac masses.

Nine patients underwent magnetic resonance imaging (MRI) as part of the diagnostic evaluation for cardiac masses; eight of them had been preliminarily studied by 2D-echocardiography (US). MRI did not add to the US diagnostic information in patients affected by intracavitary masses. It represented the definitive diagnostic modality in two patients with intramural pathology: one with ventricular rhabdomyoma, the second with an echinococcyal cyst located within the left atrial wall. The complementary role of MRI to US in cardiac masses is discussed.

Adolescent↗
PubMed1988

[Radiodiagnosis of thymomas].

On the ground of the clinical experience gained on thymomas observed during the last decade and controlled by histopathology at the National Cancer Institute of Milan, the authors report and describe the typical morphology of the above neoplasms, which were studied with both the conventional and the most advanced imaging procedures. First of all, the authors point out the common problems of differential diagnosis with other lesions in the anterior mediastinum, with a special emphasis on lymphomas. Attention is also drawn to both the diagnostic and therapeutic value of conventional radiotomographic procedures combined with CT and MRI: in particular, the former can provide an extremely valuable diagnostic support to fine needle biopsy. In the authors' opinion, explorative surgery--e.g. mediastinal endoscopy-is immediately advisable when an unquestionable diagnosis is not reached even after a most rational combination of the different imaging procedures.

Adolescent↗
PubMed1987

Reliability of diagnostic imaging after orchiectomy alone in follow-up of clinical stage I testicular carcinoma: excessive cost with potential risk.

From 1981 to 1984, 86 consecutive patients with previously untreated nonseminomatous testicular carcinoma were classified as clinical radiological stage I and treated with orchiectomy alone. The follow-up program included chest x-ray and lymphangiography (LAG) every month and abdominal computed tomography (CT) bimonthly. All patients were followed for 15 to 63 months after orchiectomy (median 32 mo.). Metastases developed in 23 patients (26.7%) and in 13/23 there was retroperitoneal lymphadenopathy. Time of relapse after orchiectomy ranged from 2 to 36 months (median 7 mo.) with a shorter interval for chest (4 mo.) compared with retroperitoneal metastases (7 mo.). Lung metastases were readily identified at an early stage (less than 2 cm) whereas more than one-third of retroperitoneal nodal metastases were greater than 5 cm at time of diagnosis. LAG detected metastases in 8/11 patients (72.7%), abdominal CT in 8/10 (80%), and both together (LAG and CT) 7/8 (87.5%). In clinical stage I nonseminomatous testicular carcinoma, the high incidence of concomitant but often asymptomatic regional and distant metastases and the relatively high cost and inconvenience of follow-up using abdominal CT imaging, LAG and chest x-ray suggest that orchiectomy is best combined with retroperitoneal node dissection at time of initial presentation to insure more accurate and safe staging of tumor dissemination.

Follow-Up Studies↗
PubMed1987

[Intracavitary and parietal cardiac measurement with nuclear magnetic resonance: comparison with echocardiography in healthy volunteers].

For quantitative evaluation of cardiac dimensions by Nuclear Magnetic Resonance (NMR), we compared the values obtained by ECG gated NMR with those obtained by two-dimensional echocardiography (2D-echo) in 18 adult healthy volunteers aged 20-40 years (mean 31.6 +/- 5.8). NMR was performed using a 2 T super-conducting magnet operating at 0.5 T with a radiofrequency impulse of 21 MHz. Spin-echo pulse sequences with echo-delay times (TEs) of 30-45 msec were used for data acquisition. The interpulse interval was obtained from the R-R interval on the ECG. Slice thickness was set at 1 cm. To obtain planes oriented along the long axis of the left ventricle similar to 2D-echo, paraxial planes were obtained by double angulation. No significant differences of mean values obtained by NMR and 2D-echo were observed. Regression coefficients were not statistically different from 1 for any of the structures measured: left atrium (y = 1.106x), aorta (y = 1.077x), left ventricle (y = 0.66x), interventricular septum (y = x 1.009x), postero-lateral wall of the left ventricle (y = 1.133x), right ventricle (y = 1.093x). However high coefficients of variation were found for measurement of postero lateral wall (79.5) and interventricular septum (41.4) thicknesses; potential causative factors are discussed.

Adult↗
PubMed1986

[Study of adenopathies: what is the current role of magnetic resonance?].

The actual role that MR imaging can play in detection of adenopathies in different body sites has been evaluated in 54 oncologic patients with pathologic nodes already seen with other methods. Enlarged lymph-nodes seen by CT or ultrasound were all visible by MR as well. Relaxation times of pathologic tissue (T1-T2) were calculated at a 0,5 magnetic field: it's our opinion that at present it's not already possible to state the capability of MR to distinguish different pathologic tissues.

Evaluation Studies as Topic↗