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Pancreatic Neoplasms: HELP
Articles by R. Pozzi Mucelli
Based on 7 articles published since 2010
(Why 7 articles?)
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Between 2010 and 2020, R. Pozzi Mucelli wrote the following 7 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Staging cancer of the pancreas. 2010

Morana, G / Cancian, L / Pozzi Mucelli, R / Cugini, C. ·Radiological Department, General Hospital Cá Foncello, Treviso, Italy. gmorana@ulss.tv.it ·Cancer Imaging · Pubmed #20880783.

ABSTRACT: Pancreatic carcinoma is the fourth cause of death from cancer in the United States, with a survival rate at 5 years of less than 5%. About 60% of tumors originate at the head of the pancreas, 15% in the body, 5% in the tail; 20% are diffuse within the pancreas. This article discusses the imaging and staging of pancreatic cancer.

2 Review Imaging of neuroendocrine gastroenteropancreatic tumours. 2010

Graziani, R / Brandalise, A / Bellotti, M / Manfredi, R / Contro, A / Falconi, M / Boninsegna, L / Pozzi Mucelli, R. ·Dipartimento di Scienze Morfologico-Biomediche, Policlinico G.B. Rossi, Istituto di Radiologia, Verona, Italy. graziani.rossella@azosp.univr.it ·Radiol Med · Pubmed #20221711.

ABSTRACT: The role of imaging in functioning endocrine tumours (FETs) is primarily to detect the tumour, that is, to verify lesion number and location. Radiological detection of carcinoid tumours is limited by typical tumour location throughout the gastrointestinal tract or appendix and is therefore dependent on the tumour being large enough to make it recognisable in that site. The most common FET is insulinoma, which is commonly characterised by the typical appearance of a hypervascular lesion at multidetector-row computed tomography and magnetic resonance imaging. A particularly important role is played by intraoperative ultrasound in defining the exact number of lesions, their relationship with adjacent vascular structures and the pancreatic duct for the purposes of correct surgical planning (enucleation or resection). In the setting of nonfunctioning endocrine tumours (NFETs), which manifest late as large masses causing compression symptoms or as incidental findings, imaging is not primarily aimed at tumour detection, as this is relatively easy given the large size of the lesions. Rather, its role is to characterise the tumour and, in particular, to differentiate pancreatic NFET from ductal adenocarcinoma, as in comparison, malignant NFETs have a more favourable prognosis (5-year survival rate 40% compared with 3%-5% for adenocarcinoma) and therefore require different treatment approaches. As NFET are often malignant, they also require accurate staging and appropriate follow-up. In 80% of cases, NFETs have a "typical" imaging appearance: location in the pancreatic head, large dimensions (diameter between 5 and 15 cm, >10 cm in 30% of cases), capsule, sharp and regular margins owing to the expansile and noninfiltrative growth pattern, solid density and arterial hypervascularity. Some 20% of NFETs display different imaging characteristics ("atypical" appearance) as a result of arterial hypovascularity due to the presence of abundant fibrous stroma. Lastly, a small percentage of NFETs has yet a different appearance ("unusual") due to the cystic nature and/or diffuse location throughout the pancreatic parenchyma.

3 Article Correlation between appearance of the retroportal fat plane at preoperative CT and pathology findings in resected adenocarcinoma of the pancreatic head. 2019

Lombardo, F / Zamboni, G A / Bonatti, M / Chincarini, M / Ambrosetti, M C / Marchegiani, G / Malleo, G / Mansueto, G / Pozzi Mucelli, R. ·Department of Radiology, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. Electronic address: fabio.lombardo@me.com. · Department of Radiology, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. · Department of Radiology, Ospedale Centrale di Bolzano, Via L. Boehler 5, 39100 Bolzano, Italy. · Department of Surgery, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. ·Clin Radiol · Pubmed #30691733.

ABSTRACT: AIM: To correlate the appearance of the retroportal fat plane at preoperative computed tomography (CT) and the pathology findings in resected adenocarcinoma of the pancreatic head (PDAC). MATERIAL AND METHODS: Forty-eight patients with resected PDAC of the pancreatic head were included (24 men, 24 women, mean age 63 years, median BMI 24.1). All patients underwent CT <30 days before surgery. The state of the retroperitoneal resection margin and the presence of lymphatic or perineural invasion were obtained from pathology reports. CT images were reviewed independently by two radiologists for assessment of the retroportal fat plane and graded in two categories (clear/effaced). Inter-reader discrepancies were solved in consensus. Interobserver agreement was calculated and Fisher's test was used to assess the correlation between CT and pathology findings. Visceral fat areas were measured and correlated with CT findings. RESULTS: A clear retroportal fat plane was significantly associated with a negative retroperitoneal margin at pathology with 100% specificity and PPV (p=0.0001). No association was observed between the appearance of the fat plane at CT and the presence of lymphatic or perineural invasion (p=ns). Interobserver agreement for retroportal fat plane evaluation was good (0.741). False-positive cases had a significantly lower visceral fat area than the correctly classified patients (p=0.0480). CONCLUSIONS: A clear retroportal fat plane is significantly associated with negative retroperitoneal resection margins at pathology. The lack of visceral adipose tissue can lead to overestimation of retroportal fat plane involvement at preoperative CT.

4 Article An innovative strategy for the identification and 3D reconstruction of pancreatic cancer from CT images. 2016

Marconi, S / Pugliese, L / Del Chiaro, M / Pozzi Mucelli, R / Auricchio, F / Pietrabissa, A. ·Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy. stefania.marconi@unipv.it. · I.R.C.C.S Policlinico San Matteo, Pavia, Italy. · Karolinska Institutet, Stochkolm, Sweden. · Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy. ·Updates Surg · Pubmed #27605209.

ABSTRACT: We propose an innovative tool for Pancreatic Ductal AdenoCarcinoma 3D reconstruction from Multi-Detector-Computed Tomography. The tumor mass is discriminated from health tissue, and the resulting segmentation labels are rendered preserving information on different hypodensity levels. The final 3D virtual model includes also pancreas and main peri-pancreatic vessels, and it is suitable for 3D printing. We performed a preliminary evaluation of the tool effectiveness presenting ten cases of Pancreatic Ductal AdenoCarcinoma processed with the tool to an expert radiologist who can correct the result of the discrimination. In seven of ten cases, the 3D reconstruction is accepted without any modification, while in three cases, only 1.88, 5.13, and 5.70 %, respectively, of the segmentation labels are modified, preliminary proving the high effectiveness of the tool.

5 Article Perfusion CT can predict tumoral grading of pancreatic adenocarcinoma. 2013

D'Onofrio, M / Gallotti, A / Mantovani, W / Crosara, S / Manfrin, E / Falconi, M / Ventriglia, A / Zamboni, G A / Manfredi, R / Pozzi Mucelli, R. ·Department of Radiology, University Hospital G.B. Rossi Piazzale L.A. Scuro 10, 37134 University of Verona, Verona, Italy. mirko.donofrio@univr.it ·Eur J Radiol · Pubmed #23127804.

ABSTRACT: OBJECTIVES: To describe perfusion CT features of locally advanced pancreatic ductal adenocarcinoma and to evaluate correlation with tumor grading. METHODS: Thirty-two patients with locally advanced pancreatic adenocarcinoma were included in this study. Lesions were evaluated by P-CT and biopsy after patient's informed consent. P-CT parameters have been assessed on a large single and on 6 small intratumoral ROIs. Values obtained have been compared and related to the tumor grading using Mann-Whitney U test. Sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy in predicting tumor grading have been calculated for cut-off values chosen by using ROC curves. RESULTS: Out of 32 lesions, 12 were classified as low grade and 20 as high grade. A statistically significant difference between high and low grade neoplasms were demonstrated for PEI and BV parameters. PEI and BV cut-off values were respectively 17.8 HU and 14.8 ml/100g. PEI identified high grade neoplasms with a 65% sensitivity, 92% specificity, 93% PPV, 61% NPV and 75% accuracy. BV identified high grade neoplasms with a 80% sensitivity, 75% specificity, 84% PPV, 69% NPV, 78% accuracy. Considering both PEI and BV, P-CT identified high grade lesions with a 60% sensitivity, 100% specificity, 100% PPV, 60% NPV and 75% accuracy. CONCLUSIONS: PEI and BV perfusion CT parameters proved their efficiency in identifying high grade pancreatic adenocarcinoma.

6 Article Comparison between CT and CEUS in the diagnosis of pancreatic adenocarcinoma. 2013

D'Onofrio, M / Crosara, S / Signorini, M / De Robertis, R / Canestrini, S / Principe, F / Pozzi Mucelli, R. ·Department of Radiology, University of Verona, Italy. mirko.donofrio@univr.it ·Ultraschall Med · Pubmed #23023447.

ABSTRACT: PURPOSE: The aim of this study is to compare CEUS and MDCT features of pancreatic ductal adenocarcinoma in relation to tumor size. MATERIALS AND METHODS: All patients with pathological diagnosis of pancreatic adenocarcinoma and studied by means of CEUS and MDCT were enrolled in this study. Two radiologists evaluated tumor size, site and imaging appearance. Patients in which at least one method yielded a positive result were divided into 4 groups on the basis of lesion size. For each dimensional category, sensitivity of the two imaging methods was calculated and compared using McNemar test. RESULTS: One hundred thirty-three patients were included in this study. In 9 of 133 patients neither MDCT nor US/CEUS could identify the lesion, while in 9 of 133 patients only MDCT and in 13 of 133 only US/CEUS could identify the lesion. In the remaining 102 patients, both MDCT and US/CEUS yielded a positive result. US/CEUS sensitivity was 86.47% while MDCT sensitivity was 83.58%, with no statistically significant difference (p = 0.523). For lesions smaller than 2 cm US/CEUS had a 100% sensitivity, while MDCT had a 73.33% sensitivity with no statistically significant difference (p = 0.125). For lesions between 2.1 and 3 cm US/CEUS had a sensitivity of 95.35%, while MDCT had a sensitivity of 83.72% with no statistically significant difference (p = 0.180). For lesions between 3.1 and 4 cm, US/CEUS had a sensitivity of 87.88%, while MDCT had a sensitivity of 93.94% with no statistically significant difference (p = 0.688). For lesions larger than 4 cm US/CEUS, had a sensitivity of 90.91%, while MDCT had a sensitivity of 100% with no statistically significant difference (p = 0.250). CONCLUSION: US/CEUS sensitivity in diagnosing pancreatic ductal adenocarcinoma is adequate and does not statistically differ from that of MDCT. US/CEUS sensitivity seems to be higher for small and medium lesions, while MDCT sensitivity is higher for large lesions. By combining both the imaging methods a higher accuracy in diagnosing pancreatic ductal adenocarcinoma can be expected.

7 Article Incidentally discovered benign pancreatic cystic neoplasms not communicating with the ductal system: MR/MRCP imaging appearance and evolution. 2013

Manfredi, R / Bonatti, M / D'Onofrio, M / Mehrabi, S / Salvia, R / Mantovani, W / Pozzi Mucelli, R. ·Department of Radiology, University of Verona, Policlinico G.B. Rossi, P.le L.A. Scuro 10, 37134, Verona, Italy. ·Radiol Med · Pubmed #22744342.

ABSTRACT: PURPOSE: The authors sought to determine magnetic resonance/magnetic resonance cholangiopancreatography (MR/MRCP) imaging features of incidentally discovered benign, noncommunicating cystic neoplasms (BNCNs) of the pancreas to assess their evolution over time and identify MR/MRCP imaging features predictive of tumour growth. MATERIAL AND METHODS: This was a retrospective study, so informed consent was waived. Sixty-two patients with a diagnosis of BNCN were assessed. Inclusion criteria were incidentally discovered cystic neoplasm of the pancreas with nonmeasurable walls, no mural nodules and no communication with the pancreatic ductal system and who underwent ≥ 1 MR/MRCP examination. Image analysis, performed at diagnosis and during follow-up, included macroscopic pattern (microcystic/macrocystic/mixed), number of cysts (unicystic/oligocystic/multicystic), BNCN maximum diameter and tumour growth rates. RESULTS: A total of 64 BNCNs was detected. Macroscopic pattern was mixed in 31/64 (48%), microcystic in 28/64 (44%) and macrocystic in 5/64 (8%). BNCNs appeared multicystic in 38/64 (59%) cases, oligocystic in 22/64 (35%) and unicystic in 4/64(6%). All qualitative parameters remained unchanged during follow-up. At diagnosis, the median maximum BNCN diameter was 35.0 mm and 38.0 mm at the final examination (p<0.001). BNCNs showed a tumour growth rate of 2 mm/year. CONCLUSIONS: Mixed and microcystic patterns were the most common, accounting for 48% and 44% of cases, respectively, and showed no change over time. MR/MRCP features predictive of lesion enlargement were a mixed/ macrocystic pattern, and lesion size was >3 cm (both p<0.001).