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Management of patients with suspected or confirmed COVID-19, in the radiology department

Moreno Zanardo, MSc Chiara Martini, Caterina Beatrice Monti, Federica Cattaneo, Carmine Ciaralli, Patrizia Cornacchione, Stefano Durante
2020 Radiography  
From December 2019, a novel coronavirus disease named COVID-19 was reported in China. Within 3 months, the World Health Organization defined COVID-19 as a pandemic, with more than 370,000 cases and 16,000 deaths worldwide. In consideration of the crucial role of diagnostic testing during COVID-19, the aim of this technical note was to provide a complete synthesis of approaches implemented for the management of suspected or confirmed COVID-19 patients. The planning of a robust plan to prevent
more » ... transmission of the virus to patients and department staff members should be fundamental in each radiology service. Moreover, the speed of spread and the incidence of the pandemic make it necessary to optimize the use of personal protective devices and dedicated COVID-19 equipment, given the limited availability of supplies. In the management of radiographic and CT imaging, staff should take special precautions to limit contamination between patients and other patients or professionals. An isolated imaging room should be dedicated to suspected or confirmed COVID-19 cases, including radiography and CT scanners. This paper will provide guidance concerning disposable protective gear to be utilized, as well as on the cleaning and sanitation of radiology room and equipment.
doi:10.1016/j.radi.2020.04.010 pmid:32340912 pmcid:PMC7167552 fatcat:u43qc7sldresnk5tl3fffwtyxa

A radiomic approach for adaptive radiotherapy in non-small cell lung cancer patients

Sara Ramella, Michele Fiore, Carlo Greco, Ermanno Cordelli, Rosa Sicilia, Mario Merone, Elisabetta Molfese, Marianna Miele, Patrizia Cornacchione, Edy Ippolito, Giulio Iannello, Rolando Maria D'Angelillo (+1 others)
2018 PLoS ONE  
The primary goal of precision medicine is to minimize side effects and optimize efficacy of treatments. Recent advances in medical imaging technology allow the use of more advanced image analysis methods beyond simple measurements of tumor size or radiotracer uptake metrics. The extraction of quantitative features from medical images to characterize tumor pathology or heterogeneity is an interesting process to investigate, in order to provide information that may be useful to guide the
more » ... and predict survival. This paper discusses the rationale supporting the concept of radiomics and the feasibility of its application to Non-Small Cell Lung Cancer in the field of radiation oncology research. We studied 91 stage III patients treated with concurrent chemoradiation and adaptive approach in case of tumor reduction during treatment. We considered 12 statistics features and 230 textural features extracted from the CT images. In our study, we used an ensemble learning method to classify patients' data into either the adaptive or non-adaptive group during chemoradiation on the basis of the starting CT simulation. Our data supports the hypothesis that a specific signature can be identified (AUC 0.82). In our experience, a radiomic signature mixing semantic and image-based features has shown promising results for personalized adaptive radiotherapy in non-small cell lung cancer.
doi:10.1371/journal.pone.0207455 pmid:30462705 pmcid:PMC6248970 fatcat:4r4ql7gvivcqjgjg3tihdviaka

Interventional radiotherapy as exclusive treatment for primary nasal vestibule cancer: single-institution experience

Luca Tagliaferri, Nadia Carra, Valentina Lancellotta, Davide Rizzo, Calogero Casà, Giancarlo Mattiucci, Claudio Parrilla, Bruno Fionda, Francesco Deodato, Patrizia Cornacchione, Maria Antonietta Gambacorta, Gaetano Paludetti (+2 others)
2020 Journal of Contemporary Brachytherapy  
The aim of this paper was to evaluate treatment outcomes following interventional radiotherapy (brachytherapy - BT) for nasal vestibule cancer. Considering histological diagnosis and staging, a multidisciplinary tumor board indicated an exclusive interventional radiotherapy for all patients. Plastic tubes were placed mainly with interstitial approach. The total dose was 44 Gy in 14 fractions, 3 Gy/fraction (except for the first and last fractions, 4 Gy), 2 fractions per day (b.i.d.), 5 days a
more » ... ek. Inclusion criteria for this analysis were: patients affected by squamous cell carcinoma with follow-up more than 6 months. 20 patients with primary nasal vestibule cancer were treated with IRT from May 2012 to June 2019. We excluded 4 patients due to follow-up less than 6 months and 2 patients affected by basal cell carcinoma. In total, 14 consecutive previously untreated patients were considered for definitive analysis, median age was 67.5 (range, 51-83) years, median follow-up was 53 (range, 6-84) months. All patients followed the protocol except one, who received a total dose of 42 Gy in 12 fractions, 3 Gy per 6 fractions, and 4 Gy per 6 fractions. Local control at 12, 24, and 36 months was 85.7%. Overall survival at 12 months was 92.3%, at 24 months was 76.9%, and at 36 months was 69.2%. Staging system proposed by Wang was statistically significant on local control (LC), disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Excellent cosmetic results were observed. This study confirms that interventional radiotherapy could be considered as a definitive treatment in nasal vestibule cancer with excellent oncological and cosmetic outcomes.
doi:10.5114/jcb.2020.100373 pmid:33299429 pmcid:PMC7701927 fatcat:tvoz2mmkrrgvbdswvre34xhmji

Implementation of a voluntary deep inspiration breath hold technique (vDIBH) using BrainLab ExacTrac infrared optical tracking system

Edy Ippolito, Michele Fiore, Alessia Di Donato, Sonia Silipigni, Carla Rinaldi, Patrizia Cornacchione, Erminia Infusino, Cristina Di Venanzio, Carlo Greco, Lucio Trodella, Sara Ramella, Rolando Maria D'Angelillo (+1 others)
2018 PLoS ONE  
Voluntary deep inspiration breath hold technique (vDIBH) is considered as the key to achieving the widest cardiac sparing in whole breast irradiation. Several techniques have been implemented to achieve a reproducible, fast and friendly treatment. The aim of the present study is to implement vDIBH using the ExacTrac (BrainLAB AG, Germany) monitoring system. Methods Women with left-sided breast cancer, younger than 50 years or with cardiac disease, underwent whole breast RT with vDIBH using the
more » ... xacTrac (BrainLAB AG, Germany) monitoring system. Simulations were performed with patients positioned supine on a breast board with both arms raised above the head. Five optical markers were placed on the skin around the border of the left breast gland and their position was referenced with ink marking. Each patient received a training session to find the individual deep inspiration level. Finally, a vDIBH CT was taken. All patients were also studied in free breathing (FB) in order to compare the dose distribution for PTV, heart and left anterior descending coronary artery (LAD). Pre-treatment verification was carried out through the ExacTrac (BrainLAB AG, Germany) system and verified with electronic portal imaging (EPI). Moreover, daily real time EPIs in during modality (captured during the beam delivery) were taken in order to check the reproducibility. Results 34 patients have been evaluated and 30 were eligible for vDIBH. Most patients showed small setup errors during the treatment course of below 5 mm in 94.9% of the recorded fields. Mean Displacement was less in cranio-caudal direction. Mean intra-fraction displacement was below 3 mm in all directions. vDIBH plans provided better cardiac dosimetry.
doi:10.1371/journal.pone.0195506 pmid:29746482 pmcid:PMC5945040 fatcat:pyawnyevpveilbvinml7ogqova

Estimation of patient setup uncertainty using BrainLAB Exatrac X-Ray 6D system in image-guided radiotherapy

Erminia Infusino, Lucio Trodella, Sara Ramella, Rolando M. D'Angelillo, Carlo Greco, Aurelia Iurato, Luca E. Trodella, Alessandro Nacca, Patrizia Cornacchione, Alessandra Mameli
2015 Journal of Applied Clinical Medical Physics  
The purpose of this study was to evaluate setup uncertainties for brain sites with ExacTrac X-Ray 6D system and to provide optimal margin guidelines. Fifteen patients with brain tumor were included in this study. Two X-ray images with ExacTrac X-Ray 6D system were used to verify patient position and tumor target localization before each treatment. The 6D fusion software first generates various sets of DRRs with position variations in both three translational and three rotational directions (six
more » ... degrees of freedom) for the CT images. Setup variations (translation and rotation) after correction were recorded and corrected before treatment. The 3D deviations are expressed as mean ± standard deviation. The random error (Σ(σ i )), systematic error (μ i ), and group systematic error (M(μ i )) for the different X-ray were calculated using the definitions of van Herk. (1) Mean setup errors were calculated from X-ray images acquired after all fractions. There is moderate patient-to-patient variation in the vertical direction and small variations in systematic errors and magnitudes of random errors are smaller. The global systematic errors were measured to be less than 2.0 mm in each direction. Random component of all patients are smaller ranging from 0.1-0.3 mm small. The safety margin (SM) to the lateral, is 0.5 mm and 2.6 mm for van Herk (1) and Stroom et al., (2) respectively, craniocaudal axis is 1.5 mm and 3.4 mm, respectively, and with respect to the antero-posterior axis, 2.3 mm and 3.9 mm. Daily X-ray imaging is essential to compare and assess the accuracy of treatment delivery to different anatomical locations. PACS number: 87.55.D
doi:10.1120/jacmp.v16i2.5102 pmid:26103179 pmcid:PMC5690103 fatcat:am4liztxyvefza6pggduj3nhsm

HAPPY – Humanity Assurance Protocol in interventional radiotheraPY (brachytherapy) – an AIRO Interventional Radiotherapy Study Group project

Valentina Lancellotta, Vitaliana De Sanctis, Patrizia Cornacchione, Fernando Barbera, Vincenzo Fusco, Cristiana Vidali, Sara Scalise, Giulia Panza, Angela Tenore, Giuseppe Colloca, Renzo Corvò, Maria Gambacorta (+2 others)
2019 Journal of Contemporary Brachytherapy  
Interventional procedures may produce emotional distress, particularly in interventional radiotherapy (IRT, brachytherapy - BT). This work would like to propose a series of recommendations/interventions to guarantee a human approach in order to favor the psychological well-being of the patient during interventional radiotherapy. Thirty patients affected by gynecological cancer and treated with endovaginal high-dose-rate IRT (HDR-IRT) were selected from January to March 2019. A specific
more » ... essional Task Group (MTG) was defined in order to analyze the needs of patients. Each component of the task group spoke with the patients to examine their needs and to investigate their fears and perception. The results of the MTG were subjected to evaluation by an Expert Team (ET) of 4 physicians from 4 different institutions for a final evaluation. Both teams discussed the patient's needs to generate a list of necessary interventions to fulfill every single need in order to obtain their inner well-being. Another team (Master Team - MT) performed an independent check. All patients suggest that the main issue is the "lack of information and fear of the unknown". The fear of feeling pain was a significant source of concern, sadness, and vulnerability for the majority of the patients (76.6%). All patients do not appreciate the use of the word "bunker" to describe the treatment place. In 33.3% of patients the word "brachytherapy" (often unknown) determines insecurity while the term "interventional radiotherapy" reassures. Ninety percent of patients preferred to perform the external genital depilation at home and 80% of them would like the bladder catheter to be placed immediately before the procedure. MTG and ET defined nine "HAPPY recommendations". The MT approved the protocol without changes. The aim of the present paper was to produce a protocol consisting in intervention that could improve the internal serendipity and emotional state of patients who underwent HDR-IRT.
doi:10.5114/jcb.2019.91222 pmid:31969908 pmcid:PMC6964336 fatcat:vtp2i3vipncmdcripldblto2eu

Radiological and clinical findings in uveal melanoma treated by plaque interventional radiotherapy (brachytherapy): Visual atlas and literature review on response assessment

Bruno Fionda, Monica Maria Pagliara, Valentina Lancellotta, Carmela Grazia Caputo, Calogero Casà, Maria Grazia Sammarco, Elisa Placidi, Patrizia Cornacchione, Francesco Boselli, Roberto Iezzi, Cesare Colosimo, Luca Tagliaferri (+1 others)
2022 Journal of Contemporary Brachytherapy  
Uveal melanoma (UM) is the most common intra-ocular tumor in Caucasian adults and may derive from melanocytes. Historically, the first therapeutic approach to treat UM has been surgical removal of the eye, with obvious consequences in terms of function, cosmesis, and psychological impact on patients. Collaborative Ocular Melanoma Study (COMS) introduced the first uniform approach to perform interventional radiotherapy (IRT - brachytherapy) procedure in a standardized way that allowed to
more » ... ate equivalence of IRT with enucleation in terms of overall survival. Since this milestone, several international guidelines have been issued with regard to several technical aspects of this procedure, which has become the mainstream therapy worldwide. However, nowadays, there is still a lack of consensus about the criteria to definitively assess UM response after IRT. We present a collection of paradigmatic cases treated in our institution, and then discuss in detail the latest available evidence on the topic.
doi:10.5114/jcb.2022.113271 pmid:35233241 pmcid:PMC8867240 fatcat:lbxfyjuovjgutihdjpfz47wfny

The role of radiation therapy technologist in interventional radiotherapy (brachytherapy) in Italy: Italian Association of Radiotherapy and Clinical Oncology (AIRO) and Italian Association of Radiation Therapy and Medical Physics Technologists (AITRO) joint project

Patrizia Cornacchione, Luca Tagliaferri, Andrea D'Aviero, Antonella Ciabattoni, Carmela Galdieri, Vitaliana De Sanctis, Francesco Fellin, Sergio Gribaudo, Daniele Lambertini, Maria Antonietta Gambacorta, Barbara Jereczek-Fossa, Vittorio Donato (+1 others)
2021 Journal of Contemporary Brachytherapy  
Interventional radiotherapy (IRT, brachytherapy and intra-operative radiotherapy) is a complex treatment approach that requires a multi-professional approach. The aim of this work was to assess the role of radiation therapy technologist (RTT) in IRT team, with a special focus on brachytherapy as well as to define more appropriate ways to improve skills and training to promote cooperation of multi-professional team. A nationwide survey consisting of 16 questions was proposed between April and
more » ... 2020, with collaboration between the Italian Association of Radiation Therapy and Medical Physics Technologists (AITRO) and the Interventional Radiotherapy Study Group of Italian Association of Radiotherapy and Clinical Oncology (AIRO). The survey was sent through the AITRO contact list to RTTs' contacts from all Italian radiotherapy (RT) departments. A total of 37 answered questionnaires returned (36% of all contacts reached), each from different center. 23 centers (62%) presented with dedicated team for IRT treatments, while 15 centers (41%) had dedicated RTT staff. The majority of RTT (86%) did not consider undergraduate training adequate to acquire the skills required to work in IRT departments or units. This survey underlines the need of additional education and training for RTTs that should focus on treatment management optimization in development of an IRT multi-professional team. Specific updates could be the key to develop further collaboration and to improve cancer patient care.
doi:10.5114/jcb.2021.112109 pmid:35079244 pmcid:PMC8782076 fatcat:ukd3lbvglnhsnbleojaqzkp6vy

Patient Perceptions and Knowledge of Ionizing Radiation From Medical Imaging

Luca Bastiani, Fabio Paolicchi, Lorenzo Faggioni, Massimo Martinelli, Roberta Gerasia, Chiara Martini, Patrizia Cornacchione, Matteo Ceccarelli, Dante Chiappino, Daniele Della Latta, Jacopo Negri, Donatella Pertoldi (+7 others)
Critical revision of the manuscript for important intellectual content: Paolicchi, Faggioni, Martinelli, Gerasia, Martini, Cornacchione, Ceccarelli, Chiappino, Della Latta, Negri, Pertoldi, Negro, Nuzzi  ...  Acquisition, analysis, or interpretation of data: Bastiani, Paolicchi, Faggioni, Martinelli, Gerasia, Martini, Cornacchione, Ceccarelli, Chiappino, Della Latta, Negri, Pertoldi, Negro, Nuzzi, Rizzo, Tamburrino  ... 
doi:10.1001/jamanetworkopen.2021.28561 pmid:34643721 pmcid:PMC8515210 fatcat:slyvcnbyl5frlhubs2r4utnkly

Can A Dedicated Multidisciplinary Tumor Board Improve Personalized Medicine for Patients in Interventional Oncology? A Large Retrospective Single-Center Experience

roberto iezzi
2022 Turkish Journal of Oncology  
A Large Retrospective Single-Center Experience Roberto IEZZI,1 Bruno FIONDA,2 Patrizia CORNACCHİONE,2 Martina IEZZI,3 Valentina LANCELLOTTA,2 Andrea CONTEGIACOMO,1 Fabia ATTILI,4 Alberto LARGHI  ... 
doi:10.5505/tjo.2022.2819 fatcat:po5cnq2cy5hrrkt26yq7zzj7ye

Che tempo che fa

Alice Kopp
2008 unpublished
Patrizia Guariento: 'Per quali ragioni da lei vengono spesso ospiti che in televisione non vanno mai?'39Guariento, Patrizia."  ...  Nelnumero13/2007di"SorrisieCanzoni TV" (20 marzo 2007) si trova, invece, un'intervista concessa da Fabio Fazio a Patrizia Guariento in occasione della vincita del premio "È giornalismo", che Fabio Fazio  ... 
doi:10.25365/thesis.1681 fatcat:nxhgsaio7bcfbekmhi4jwpozke