Papers by Federico Caobelli
JACC: Cardiovascular Imaging, 2018
Inflammation after myocardial ischemia influences ventricular remodeling and repair and has emerg... more Inflammation after myocardial ischemia influences ventricular remodeling and repair and has emerged as a therapeutic target. Conventional diagnostic measurements address systemic inflammation but cannot quantify local tissue changes. Molecular imaging facilitates noninvasive assessment of leukocyte infiltration into damaged myocardium. Preliminary experience with 18 F-labeled fluorodeoxyglucose ([ 18 F]FDG) demonstrates localized inflammatory cell signal within the infarct territory as an independent predictor of subsequent ventricular dysfunction. Novel targeted radiotracers may provide additional insight into the enrichment of specific leukocyte populations. Challenges to wider implementation of inflammation imaging after myocardial infarction include accurate and reproducible quantification, prognostic value, and capacity to monitor inflammation response to novel treatment. This review describes myocardial inflammation following ischemia as a molecular imaging target and evaluates established and emerging radiotracers for this application. Furthermore, the potential role of inflammation imaging to provide prognostic information, support novel drug and therapeutic research, and assess biological response to cardiac disease is discussed.
European heart journal cardiovascular Imaging, 2014
Clinical and Translational Imaging
The Quarterly Journal of Nuclear Medicine and Molecular Imaging, 2020
BACKGROUND Radiomic features are increasingly utilized to evaluate tumor heterogeneity in PET ima... more BACKGROUND Radiomic features are increasingly utilized to evaluate tumor heterogeneity in PET imaging but to date its role has not been investigated for Cho-PET in prostate cancer. The potential application of radiomics features analysis using a machine-learning radiomics algorithm was evaluated to select 18F-Cho PET/CT imaging features to predict disease progression in PCa. METHODS We retrospectively analyzed high-risk PCa patients who underwent restaging 18F-Cho PET/CT from November 2013 to May 2018. 18F-Cho PET/CT studies and related structures containing volumetric segmentations were imported in the "CGITA" toolbox to extract imaging features from each lesion. A Machine-learning model has been adapted using NCA for feature selection, while DA was used as a method for feature classification and performance analysis. RESULTS 106 imaging features were extracted for 46 lesions for a total of 4876 features analyzed. No significant differences between the training and validating sets in terms of age, sex, PSA values, lesion location and size (p > 0.05) were demonstrated by the machine-learning model. Thirteen features were able to discriminate FU disease status after NCA selection. Best performance in DA classification was obtained using the combination of the 13 selected features (sensitivity 74%, specificity 58% and accuracy 66%) compared to the use of all features (sensitivity 40%, specificity 52%, and accuracy 51%). Per-site performance of the 13 selected features in DA classification were as follow: T= sensitivity 63%, specificity 83%, accuracy 71%; N= sensitivity 87%, specificity 91% of and accuracy 90%; bone-M= sensitivity 33%, specificity 77% and accuracy 66%. CONCLUSIONS An artificial intelligence model demonstrated to be feasible and able to select a panel of 18F-Cho PET/CT features with valuable association with PCa patients' outcome.
Diagnostics, 2020
In this review, the performance of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/co... more In this review, the performance of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the diagnostic workup of pancreatic ductal adenocarcinoma (PDAC) is evaluated. A comprehensive literature search up to September 2020 was performed, selecting studies with the presence of: sample size ≥10 patients and index test (i.e., “FDG” or “18F-FDG” AND “pancreatic adenocarcinoma” or “pancreas cancer” AND “PET” or “positron emission tomography”). The methodological quality was evaluated using the revised quality assessment of diagnostic accuracy studies (QUADAS-2) tool and presented according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Basic data (authors, year of publication, country and study design), patients’ characteristics (number of enrolled subjects and age), disease phase, type of treatment and grading were retrieved. Forty-six articles met the adopted research criteria. The articles were divided a...
Imaging of Inflammation and Infection in Cardiovascular Diseases, 2021
When 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) is performed to detect car... more When 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) is performed to detect cardiac infection or inflammation, an adequate suppression of the physiological cardiac glucose metabolism plays a pivotal role to increase the interpretability and diagnostic reliability of 18F-FDG PET studies. Many studies report on different strategies to suppress the physiological cardiac glucose metabolism, including dietary preparations, pharmacological approaches, or a combination of both. We here present a comprehensive literature review of the proposed algorithms as well as a practical proposal to help nuclear medicine physicians in clinical practice.
Journal of Neuroimaging, 2019
BACKGROUND AND PURPOSE: Periventricular nodular heterotopias (PNHs) are frequently associated wit... more BACKGROUND AND PURPOSE: Periventricular nodular heterotopias (PNHs) are frequently associated with drug-resistant epilepsy (DRE). Although magnetic resonance imaging (MRI) can define the morphological features of PNHs, still there is a need to assess their metabolic activity in order to provide useful information on epileptogenicity and long-term outcome. To that end, we investigated the ability of 18 F-FDG PET to identify seizure onset zone in order to assess the metabolic activity of the ectopic neurons and to provide prognostic information on the postsurgical outcome. METHODS: Sixteen patients (6 men and 10 women; ranging between 24 and 53 years of age) with PNHs-related DRE were evaluated. All patients underwent clinical evaluation, Stereo-electroencephalogram (SEEG), brain MRI, and 18 F-FDG brain PET/CT. PET images were superimposed on the patient-specific 3-dimensional-brain MRI. The metabolic activity of each nodule and of their cortex was visually and semiquantitatively assessed. The outcome after intervention was assessed in all patients using Engel classification. RESULTS: Thirty-one heterotopic sites were identified. Twenty-one of 23 nodules with detectable electric activity on SEEG were identified by PET (91.3%), while 5 of 8 of nodules without electric activity showed no metabolism on PET (62.5%). Overall, the concordance between SEEG and FDG-PET was 26/31 (83.9%). Furthermore, cortical metabolic alterations were depicted, correlating with epileptogenic areas. A favorable postsurgical outcome was reported in 13 patients (81.3%). The presence of a hypometabolic nodule significantly correlated with a worse outcome after surgical therapy (P = .036). CONCLUSIONS: In PNHs-related epilepsy, FDG-PET more accurately identifies epileptogenic foci, which aids surgical planning and in postoperative seizure control.
The British Journal of Radiology, 2019
The myocardium and the cardiovascular system are often involved in patients with sarcoidosis. As ... more The myocardium and the cardiovascular system are often involved in patients with sarcoidosis. As therapy should be started as early as possible to avoid complications such as left ventricular dysfunction, a prompt and reliable diagnosis by means of non-invasive tests would be highly warranted. Among other techniques,18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has emerged as a high sensitive tool to detect sites of inflammation before morphological changes are visible to conventional imaging techniques. We therefore aim at summarizing the most relevant findings in the literature on the use of18F-fluorodeoxyglucose PET in the diagnostic workup of cardiac sarcoidosis and to underline future perspectives.
Annals of Nuclear Medicine, 2018
European journal of nuclear medicine and molecular imaging, Dec 1, 2018
Effective treatment for pancreatic cancer remains challenging, particularly the treatment of panc... more Effective treatment for pancreatic cancer remains challenging, particularly the treatment of pancreatic ductal adenocarcinoma (PDAC), which makes up more than 95% of all pancreatic cancers. Late diagnosis and failure of chemotherapy and radiotherapy are all too common, and many patients die soon after diagnosis. Here, we make the case for the increased use of molecular imaging in PDAC preclinical research and in patient management.
Nuclear medicine communications, 2018
Patients under hemodialysis (HD) have an increased risk of major adverse cardiac events (MACEs). ... more Patients under hemodialysis (HD) have an increased risk of major adverse cardiac events (MACEs). In these patients, myocardial perfusion scintigraphy (MPS) provides useful prognostic information. Left ventricular mechanical dyssynchrony (LVD) has been proven to predict all-cause death in patients under HD. It remains unclear, whether the same prognostic value pertains also to the prediction of MACEs. Ninety patients under HD (duration range: 2-216 months) with neither history nor symptoms of coronary artery disease at the time of MPS were retrospectively evaluated. All underwent clinical evaluation and MPS with dipyridamole stress test. MPS was reprocessed to derive left ventricular ejection fraction (EF), perfusion scores [summed stress score (SSS) and summed difference score (SDS)] and LVD (phase histogram bandwidth and phase SD).ResultsMACEs were reported in 10 (11.1%) patients as assessed at more than 2 years of follow-up (median 29 months). At univariate analysis, a correlation...
Annals of nuclear medicine, Jan 6, 2017
Medullary thyroid carcinoma (MTC) is a malignancy accounting for about 5-8% of thyroid cancers. S... more Medullary thyroid carcinoma (MTC) is a malignancy accounting for about 5-8% of thyroid cancers. Serum calcitonin and carcinoembryonic antigen (CEA) levels are widely used to monitor disease progression. However, prognostic factors able to predict outcomes are highly desirable. We, therefore, aimed to assess the prognostic role of (18)F-DOPA PET/CT in patients with recurrent MTC. 60 patients (mean age 64 ± 13 years, range 44-82) with recurrent MTC were eligible from a multicenter database. All patients underwent a restaging (18)F-DOPA PET/CT, performed at least 6 months after surgery. CEA/calcitonin levels, local recurrences, nodal involvement and metastases at PET/CT were recorded. SUVmax, SUVmean (also normalized to mediastinal uptake) and metabolic tumor volume were automatically calculated for each lesion, by placing a volume of interest around the lesion with 40% of peak activity as threshold for the automatic contouring. The patients were clinically and radiologically followed ...
World Journal of Radiology, 2016
The authors hereby declare that no one of the coworkers has received fees for serving as a speake... more The authors hereby declare that no one of the coworkers has received fees for serving as a speaker, no one holds a position as advisory board member, none has received research funding, no one owns stocks and/or shares in any Companies, no one owns patents. Data sharing statement: No additional data are available. A formal consent was not obtained due to the nature of the present paper (Review of already published papers).
European journal of nuclear medicine and molecular imaging, Jan 26, 2016
A small number of studies evaluated the detection rate of lesions from bladder carcinoma (BC) of ... more A small number of studies evaluated the detection rate of lesions from bladder carcinoma (BC) of 18 F-FDG PET/CT in the restaging process. However, the prognostic role of FDG PET/CT still remains unclear. The aim of the present study was to evaluate the accuracy, the effect upon treatment decision, and the prognostic value of FDG PET/CT in patients with suspected recurrent BC. Forty-one patients affected by BC underwent FDG PET/CT for restaging purpose. The diagnostic accuracy of visually interpreted FDG PET/CT was assessed compared to histology (n = 8), other diagnostic imaging modalities (contrast-enhanced CT in 38/41 patients and MRI in 15/41) and clinical follow-up (n = 41). Semiquantitative PET values (SUVmax, SUVmean, SUL, MTV, TLG) were calculated using a graph-based method. Progression-free survival (PFS) and overall survival (OS) were assessed by using Kaplan-Meier curves. The risk of progression (hazard ratio, HR) was computed by Cox regression analysis by considering all ...
European heart journal, Feb 28, 2016
High-energy resolution and sensitivity of novel cadmium-zinc-telluride (CZT) detector equipped SP... more High-energy resolution and sensitivity of novel cadmium-zinc-telluride (CZT) detector equipped SPECT systems facilitate simultaneous imaging of multiple isotopes and may enhance the detection of molecular/cellular signals. This may refine the detection of endocarditis. This study was designed to determine the feasibility and diagnostic accuracy of simultaneous imaging of inflammation with (111)In-labeled white blood cells (WBCs) and myocardial perfusion with (99m)Tc-sestamibi, for localization of WBCs relative to the valve plane in suspected endocarditis. A dedicated cardiac CZT camera (Discovery 530c, GE Healthcare) was employed. Anthropomorphic thorax phantom studies were followed by clinical studies in 34 patients with suspected infection of native valves (n = 12) or implants (n = 22). Simultaneous (111)In-WBC/(99m)Tc perfusion imaging was performed, and compared with standard (111)In-WBC planar scintigraphy and SPECT-CT. Phantom studies ruled out significant radioisotope crossta...
Nuclear medicine communications, Jan 2, 2016
PET/computed tomography with F-fluorodeoxyglucose is considered a powerful molecular imaging tech... more PET/computed tomography with F-fluorodeoxyglucose is considered a powerful molecular imaging technique that can provide useful information in the management of patients affected by head and neck cancer. However, misleading findings have been reported because of nonspecific uptake caused by peritumoural inflammation and physiologic changes in nonmalignant tissues in the head and neck region. More specific β-emitting tracers have been introduced that can track other pathological processes. We aimed to review the existing literature performing the search until June 2015 on non-F-fluorodeoxyglucose PET tracers in head and neck cancer to highlight their role in clinical practice.
Clinical and Translational Imaging, 2016
The present review focuses on the current literature about the role of positron emission tomograp... more The present review focuses on the current literature about the role of positron emission tomography (PET) imaging in the evaluation of response to treatment in patients with bone sarcomas. Osteosarcoma and Ewing sarcoma are the most frequent primary bone tumours occurring in the paediatric age. Imaging methods are attractive since they offer a non-invasive approach to evaluate response to treatment and are of particular interest in those patients with non-resectable tumours, for whom full histological assessment cannot be obtained. While conventional radiologic imaging can only assess the occurrence of structural changes in malignant tumours, molecular imaging by means of 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography ([ 18 F]FDG-PET/CT) provides useful information about tumour metabolism, which is more likely to reflect response to treatment. As metabolic changes occur early during the treatment, an earlier assessment of tumour response may be feasible by means of [ 18 F]FDG-PET/CT than using conventional imaging. As such, [ 18 F]FDG-PET/ CT may provide useful information for prognosis and clinical management of sarcoma patients. In contrast to OS, there is still some uncertainty in ES patients as to whether a massive SUVmax reduction in FDG-PET correlates with good histopathological response, despite a strong reduction of FDG uptake after the completion of neoadjuvant treatment.
European Heart Journal – Cardiovascular Imaging, 2015
Nuclear Medicine Review, 2015
Neuroblastoma is the most common extra-cranial solid tumor in pediatric patients. Despite the est... more Neuroblastoma is the most common extra-cranial solid tumor in pediatric patients. Despite the established role of 123 I-MIBG and 131 I-MIBG scintigraphy in this tumor, only limited data are available regarding the use of 124 I-metaiodobenzylguanidine (MIBG) positron emission tomography (PET)/computed tomography (CT). We present our preliminary experience with 124 I-MIBG PET/CT: two pediatric patients affected by neuroblastoma, who underwent 124 I-MIBG PET/CT for pre-therapy distribution evaluation and restaging purposes. We aimed to evaluate whether 124 I-MIBG PET/CT can detect as many or more neuroblastoma lesions than 123 I/ 131 I-MIBG imaging. Our cases show promising results, although further validation and standardization of 124 I-MIBG PET/CT are required.
European Journal of Nuclear Medicine and Molecular Imaging, 2015
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Papers by Federico Caobelli