0000000000693197
AUTHOR
Giorgio Ivan Russo
showing 53 related works from this author
K-nearest neighbor driving active contours to delineate biological tumor volumes
2019
Abstract An algorithm for tumor delineation in positron emission tomography (PET) is presented. Segmentation is achieved by a local active contour algorithm, integrated and optimized with the k-nearest neighbor (KNN) classification method, which takes advantage of the stratified k-fold cross-validation strategy. The proposed approach is evaluated considering the delineation of cancers located in different body districts (i.e. brain, head and neck, and lung), and considering different PET radioactive tracers. Data are pre-processed in order to be expressed in terms of standardized uptake value, the most widely used PET quantification index. The algorithm uses an initial, operator selected re…
Study of the role of particle-particle dipole interaction in dielectrophoretic devices for biomarkers identification
2015
A three dimensional Coupled Monte Carlo-Poisson method has been used to evaluate the impact of particle-particle dipole interactions in the equilibrium distribution of a system of uncharged polarizable particles suspended in a static liquid medium under the action of an oscillating non-uniform electric field generated by polynomial electrodes. We compare the simulated distributions with experimental ones both for micro- (MDA-MB-231 breast tumor cells) and nano-(multiwall carbon nanotubes) particles. In both cases the equilibrium distributions near the electrodes are dominated by dipole interactions which locally enhance the DEP effect and promote long particles chains.
A fully automatic approach for multimodal PET and MR image segmentation in gamma knife treatment planning
2017
The aim of this study is to combine Biological Target Volume (BTV) segmentation and Gross Target Volume (GTV) segmentation in stereotactic neurosurgery.Our goal is to enhance Clinical Target Volume (CTV) definition, including metabolic and morphologic information, for treatment planning and patient follow-up.We propose a fully automatic approach for multimodal PET and MR image segmentation. This method is based on the Random Walker (RW) and Fuzzy C-Means clustering (FCM) algorithms. A total of 19 brain metastatic tumors, undergone stereotactic neuro-radiosurgery, were retrospectively analyzed. A framework for the evaluation of multimodal PET/MRI segmentation is presented, considering volume…
Theoretical and experimental study of the role of cell-cell dipole interaction in dielectrophoretic devices: application to polynomial electrodes
2013
BACKGROUND: We aimed to investigate the effect of cell-cell dipole interactions in the equilibrium distributions in dielectrophoretic devices. METHODS: We used a three dimensional coupled Monte Carlo-Poisson method to theoretically study the final distribution of a system of uncharged polarizable particles suspended in a static liquid medium under the action of an oscillating non-uniform electric field generated by polynomial electrodes. The simulated distributions have been compared with experimental ones observed in the case of MDA-MB-231 cells in the same operating conditions. RESULTS: The real and simulated distributions are consistent. In both cases the cells distribution near the elec…
Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 count…
2022
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods: First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assess…
79. Amyloid-PET analysis based on tissue probability maps
2018
Purpose The regional quantification of amyloid burden is crucial for the clinical diagnosis of Alzheimer’s disease [1]. The best method to evaluate regional amyloid deposition in PET is through the use MR imaging for brain space normalization. However, since MR imaging is not always available in the clinical practice, a MR-less methodology is needed in order to compute semi-quantitative and analyze regional amyloid burden. Methods Forty-four patients with clinical evidence of dementia, underwent 18F-Florbetaben PET (FBB-PET), FDG-PET, neuropsychological assessment and cerebrospinal fluid analysis. We implemented a methodology that uses SPM12 to import and normalize the FBB-PET images in Mon…
Cytokine profile of breast cell lines after different radiation doses
2017
Purpose: Ionizing radiation (IR) treatment activates inflammatory processes causing the release of a great amount of molecules able to affect the cell survival. The aim of this study was to analyze the cytokine signature of conditioned medium produced by non-tumorigenic mammary epithelial cell line MCF10A, as well as MCF7 and MDA-MB-231 breast cancer cell lines, after single high doses of IR in order to understand their role in high radiation response. Materials and methods: We performed a cytokine profile of irradiated conditioned media of MCF10A, MCF7 and MDA-MB-231 cell lines treated with 9 or 23 Gy, by Luminex and ELISA analyses. Results: Overall, our results show that both 9 Gy and 23 …
Computer-Assisted Approaches for Uterine Fibroid Segmentation in MRgFUS Treatments: Quantitative Evaluation and Clinical Feasibility Analysis
2019
Nowadays, uterine fibroids can be treated using Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS), which is a non-invasive therapy exploiting thermal ablation. In order to measure the Non-Perfused Volume (NPV) for treatment response assessment, the ablated fibroid areas (i.e., Region of Treatment, ROT) are manually contoured by a radiologist. The current operator-dependent methodology could affect the subsequent follow-up phases, due to the lack of result repeatability. In addition, this fully manual procedure is time-consuming, considerably increasing execution times. These critical issues can be addressed only by means of accurate and efficient automated Pattern Recognition ap…
Radiomics: A New Biomedical Workflow to Create a Predictive Model
2020
‘Radiomics’ is utilized to improve the prediction of patient overall survival and/or outcome. Target segmentation, feature extraction, feature selection, and classification model are the fundamental blocks of a radiomics workflow. Nevertheless, these blocks can be affected by several issues, i.e. high inter- and intra-observer variability. To overcome these issues obtaining reproducible results, we propose a novel radiomics workflow to identify a relevant prognostic model concerning a real clinical problem. In the specific, we propose an operator-independent segmentation system with the consequent automatic extraction of radiomics features, and a novel feature selection approach to create a…
High-Grade T1 on Re-Transurethral Resection after Initial High-Grade T1 Confers Worse Oncological Outcomes: Results of a Multi-Institutional Study
2018
The aim of this multicenter study was to investigate the prognostic impact of residual T1 high-grade (HG)/G3 tumors at re-transurethral resection (TUR of bladder tumor) in a large multi-institutional cohort of patients with primary T1 HG/G3 bladder cancer (BC).
Combining split-and-merge and multi-seed region growing algorithms for uterine fibroid segmentation in MRgFUS treatments
2016
Uterine fibroids are benign tumors that can affect female patients during reproductive years. Magnetic resonance-guided focused ultrasound (MRgFUS) represents a noninvasive approach that uses thermal ablation principles to treat symptomatic fibroids. During traditional treatment planning, uterus, fibroids, and surrounding organs at risk must be manually marked on MR images by an operator. After treatment, an operator must segment, again manually, treated areas to evaluate the non-perfused volume (NPV) inside the fibroids. Both pre- and post-treatment procedures are time-consuming and operator-dependent. This paper presents a novel method, based on an advanced direct region detection model, …
Choline PET/CT Features to Predict Survival Outcome in High Risk Prostate Cancer Restaging: A Preliminary Machine-Learning Radiomics Study
2020
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 h…
Serenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between…
2014
BACKGROUND Phytotherapy has been used to treat patients with lower urinary tract symptoms (LUTS). We evaluated the efficacy and tolerability of combination therapy between Serenoa Repens (SeR), Lycopene (Ly), and Selenium (Se) + tamsulosin versus single therapies. METHODS PROCOMB trial (ISRCTN78639965) was a randomized double-blinded, double-dummy multicenter study of 225 patients between 55 and 80 years old, PSA ≤ 4 ng/ml, IPSS ≥12, prostate volume ≤60 cc, Qmax ≤15 ml/sec, postvoid residual urine (PVR) <150 ml. Participants were randomized group A (SeR-Se-Ly), group B (tamsulosin 0.4 mg), group C (SeR-Se-Ly + tamsulosin 0.4 mg). The primary endpoints of the study were the reduction of IPSS…
Assessment of Lung Cancer Development in Idiopathic Pulmonary Fibrosis Patients Using Quantitative High-Resolution Computed Tomography:A Retrospectiv…
2020
Purpose The purpose of this study was to investigate histogram-based quantitative high-resolution computed tomography (HRCT) indexes in the assessment of lung cancer (LC) development in idiopathic pulmonary fibrosis (IPF) patients. Materials and methods From IPF databases of 2 national respiratory centers, we retrospectively studied patients with and without LC development-respectively, divided into Group A (n=16) and Group B (n=33). The extent of fibrotic disease was quantified on baseline and follow-up HRCT examinations using kurtosis, skewness, percentage of high attenuation area (HAA%), and percentage of fibrotic area (FA%). These indexes were compared between the 2 groups using the Man…
Robustness of PET Radiomics Features: Impact of Co-Registration with MRI
2021
Radiomics holds great promise in the field of cancer management. However, the clinical application of radiomics has been hampered by uncertainty about the robustness of the features extracted from the images. Previous studies have reported that radiomics features are sensitive to changes in voxel size resampling and interpolation, image perturbation, or slice thickness. This study aims to observe the variability of positron emission tomography (PET) radiomics features under the impact of co-registration with magnetic resonance imaging (MRI) using the difference percentage coefficient, and the Spearman’s correlation coefficient for three groups of images: (i) original PET, (ii) PET after co-…
Potential clinical value of quantitative fluorine-18-fluorodeoxyglucose-PET/computed tomography using a graph-based method analysis in evaluation of …
2019
Objectives To identify the clinical relevance of incidentally detected lesions (IDLs) in the gastrointestinal tract (GIT) with 18F-FDG PET/CT and to assess the potential benefit of using semiquantitative PET measures to discern malignant from benign lesions. Methods Forty-one patients who underwent F-FDG PET/CT scans during the oncologic follow-up, revealing abnormal incidental 18F-FDG accumulations in the GIT were included in this retrospective analysis. Incidental PET/CT findings were correlated with endoscopic and histological findings. Semiquantitative PET values (SUVmax, SUVmean, SULpeak, and TLG) were evaluated by using a new graph-based method. Two sample t-test analysis has been per…
Urology Residency Training in Italy: Results of the First National Survey
2018
Background: Numerous surveys have been performed to determine the competence and the confidence of residents. However, there is no data available on the condition of Italian residents in urology. Objective: To investigate the status of training among Italian residents in urology regarding scientific activity and surgical exposure. Design, setting, and participants: A web-based survey that included 445 residents from all of the 25 Italian Residency Programmes was conducted between September 2015 and November 2015. Outcome measurements and statistical analysis: The main outcomes were represented by scientific activity, involvement in surgical procedures, and overall satisfaction. Results and …
Gene expression profiles in irradiated cancer cells
2013
Knowledge of the molecular and genetic mechanisms underlying cellular response to radiation may provide new avenues to develop innovative predictive tests of radiosensitivity of tumours and normal tissues and to improve individual therapy. Nowadays very few studies describe molecular changes induced by hadrontherapy treatments, therefore this field has to be explored and clarified. High-throughput methodologies, such as DNA microarray, allow us to analyse mRNA expression of thousands of genes simultaneously in order to discover new genes and pathways as targets of response to hadrontherapy. Our aim is to elucidate the molecular networks involved in the sensitivity/resistance of cancer cell …
Gamma Knife treatment planning: MR brain tumor segmentation and volume measurement based on unsupervised Fuzzy C-Means clustering
2015
Nowadays, radiation treatment is beginning to intensively use MRI thanks to its greater ability to discriminate healthy and diseased soft-tissues. Leksell Gamma Knife® is a radio-surgical device, used to treat different brain lesions, which are often inaccessible for conventional surgery, such as benign or malignant tumors. Currently, the target to be treated with radiation therapy is contoured with slice-by-slice manual segmentation on MR datasets. This approach makes the segmentation procedure time consuming and operator-dependent. The repeatability of the tumor boundary delineation may be ensured only by using automatic or semiautomatic methods, supporting clinicians in the treatment pla…
Radiomics analysis of 18F-Choline PET/CT in the prediction of disease outcome in high-risk prostate cancer: an explorative study on machine learning …
2021
Objective: The aim of this study was (1) to investigate the application of texture analysis of choline PET/CT images in prostate cancer (PCa) patients and (2) to propose a machine-learning radiomics model able to select PET features predictive of disease progression in PCa patients with a same high-risk class at restaging. Material and methods: Ninety-four high-risk PCa patients who underwent restaging Cho-PET/CT were analyzed. Follow-up data were recorded for a minimum of 13 months after the PET/CT scan. PET images were imported in LIFEx toolbox to extract 51 features from each lesion. A statistical system based on correlation matrix and point-biserial-correlation coefficient has been impl…
Normal and Abnormal Tissue Classification in Positron Emission Tomography Oncological Studies
2018
Positron Emission Tomography (PET) imaging is increasingly used in radiotherapy environment as well as for staging and assessing treatment response. The ability to classify PET tissues, as normal versus abnormal tissues, is crucial for medical analysis and interpretation. For this reason, a system for classifying PET area is implemented and validated. The proposed classification is carried out using k-nearest neighbor (KNN) method with the stratified K-Fold Cross-Validation strategy to enhance the classifier reliability. A dataset of eighty oncological patients are collected for system training and validation. For every patient, lesion (abnormal tissue) and background (normal tissue around …
Neuro-radiosurgery treatments: MRI brain tumor seeded image segmentation based on a cellular automata model
2016
Gross Tumor Volume (GTV) segmentation on medical images is an open issue in neuro-radiosurgery. Magnetic Resonance Imaging (MRI) is the most promi-nent modality in radiation therapy for soft-tissue anatomical districts. Gamma Knife stereotactic neuro-radiosurgery is a mini-invasive technique used to deal with inaccessible or insufficiently treated tumors. During the planning phase, the GTV is usually contoured by radiation oncologists using a manual segmentation procedure on MR images. This methodology is certainly time-consuming and op-erator-dependent. Delineation result repeatability, in terms of both intra- and inter-operator reliability, is only obtained by using computer-assisted appr…
An increased body mass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer
2018
PURPOSE: The body mass index (BMI) may be associated with an increased incidence and aggressiveness of urological cancers. In this study, we aimed to evaluate the impact of the BMI on survival in patients with T1G3 non-muscle-invasive bladder cancer (NMIBC). METHODS: A total of 1155 T1G3 NMIBC patients from 13 academic institutions were retrospectively reviewed and patients administered adjuvant intravesical Bacillus Calmette-Guérin (BCG) immunotherapy with maintenance were included. Multivariable Cox regression analysis was performed to identify factors predictive of recurrence and progression. RESULTS: After re-TURBT, 288 patients (27.53%) showed residual high-grade NMIBC, while 867 (82.8…
Performance of Radiomics Features in the Quantification of Idiopathic Pulmonary Fibrosis from HRCT.
2020
Background: Our study assesses the diagnostic value of different features extracted from high resolution computed tomography (HRCT) images of patients with idiopathic pulmonary fibrosis. These features are investigated over a range of HRCT lung volume measurements (in Hounsfield Units) for which no prior study has yet been published. In particular, we provide a comparison of their diagnostic value at different Hounsfield Unit (HU) thresholds, including corresponding pulmonary functional tests. Methods: We consider thirty-two patients retrospectively for whom both HRCT examinations and spirometry tests were available. First, we analyse the HRCT histogram to extract quantitative lung fibrosis…
Biological and Mechanical Characterization of the Random Positioning Machine (RPM) for Microgravity Simulations
2021
The rapid improvement of space technologies is leading to the continuous increase of space missions that will soon bring humans back to the Moon and, in the coming future, toward longer interplanetary missions such as the one to Mars. The idea of living in space is charming and fascinating; however, the space environment is a harsh place to host human life and exposes the crew to many physical challenges. The absence of gravity experienced in space affects many aspects of human biology and can be reproduced in vitro with the help of microgravity simulators. Simulated microgravity (s-μg) is applied in many fields of research, ranging from cell biology to physics, including cancer biology. In…
Validation of Neutrophil-to-lymphocyte Ratio in a Multi-institutional Cohort of Patients With T1G3 Non–muscle-invasive Bladder Cancer
2018
The aim of this multicenter study was to investigate the prognostic role of neutrophil-to-lymphocyte ratio (NLR) and to validate the NLR cutoff of 3 in a large multi-institutional cohort of patients with primary T1 HG/G3 non-muscle-invasive bladder cancer (NMIBC).
Automated prostate gland segmentation based on an unsupervised fuzzy C-means clustering technique using multispectral T1w and T2w MR imaging
2017
Prostate imaging analysis is difficult in diagnosis, therapy, and staging of prostate cancer. In clinical practice, Magnetic Resonance Imaging (MRI) is increasingly used thanks to its morphologic and functional capabilities. However, manual detection and delineation of prostate gland on multispectral MRI data is currently a time-expensive and operator-dependent procedure. Efficient computer-assisted segmentation approaches are not yet able to address these issues, but rather have the potential to do so. In this paper, a novel automatic prostate MR image segmentation method based on the Fuzzy C-Means (FCM) clustering algorithm, which enables multispectral T1-weighted (T1w) and T2-weighted (T…
Reverse electrodialysis with saline waters and concentrated brines: A laboratory investigation towards technology scale-up
2015
Abstract The use of concentrated brines and brackish water as feed solutions in reverse electrodialysis represents a valuable alternative to the use of river/sea water, allowing the enhancement of power output through the increase of driving force and reduction of internal stack resistance. Apart from a number of theoretical works, very few experimental investigations have been performed so far to explore this possibility. In the present work, two RED units of different size were tested using artificial saline solutions. The effects of feed concentration, temperature and flowrate on process performance parameters were analysed, adopting two different sets of membranes. These experiments all…
Predicting positive surgical margins in partial nephrectomy: A prospective multicentre observational study (the RECORd 2 project)
2020
PURPOSE: to evaluate clinical predictors of positive surgical margins (PSMs) in a large multicenter prospective observational study and to develop a clinic nomogram to predict the likelihood of PSMs after partial nephrectomy (PN). MATERIALS AND METHODS: We prospectively evaluated 4308 patients who had surgical treatment for renal tumors between January 2013 and December 2016 at 26 urological Italian Centers (RECORd 2 project). Two multivariable logistic models were evaluated to predict the likelihood of PSMs. Center caseload was dichotomized using a visual assessment adjusted for several predictors of PSMs. A nomogram predicting PSMs was developed. RESULTS: Overall, 2076 patients treated wi…
Active contour algorithm with discriminant analysis for delineating tumors in positron emission tomography.
2019
Abstract In the context of cancer delineation using positron emission tomography datasets, we present an innovative approach which purpose is to tackle the real-time, three-dimensional segmentation task in a full, or at least nearly full automatized way. The approach comprises a preliminary initialization phase where the user highlights a region of interest around the cancer on just one slice of the tomographic dataset. The algorithm takes care of identifying an optimal and user-independent region of interest around the anomalous tissue and located on the slice containing the highest standardized uptake value so to start the successive segmentation task. The three-dimensional volume is then…
A Survey on Nature-Inspired Medical Image Analysis: A Step Further in Biomedical Data Integration
2019
Natural phenomena and mechanisms have always intrigued humans, inspiring the design of effective solutions for real-world problems. Indeed, fascinating processes occur in nature, giving rise to an ever-increasing scientific interest. In everyday life, the amount of heterogeneous biomedical data is increasing more and more thanks to the advances in image acquisition modalities and high-throughput technologies. The automated analysis of these large-scale datasets creates new compelling challenges for data-driven and model-based computational methods. The application of intelligent algorithms, which mimic natural phenomena, is emerging as an effective paradigm for tackling complex problems, by…
How Can the COVID-19 Pandemic Lead to Positive Changes in Urology Residency?
2020
The COVID-19 outbreak, in a few weeks, overloaded Italian hospitals, and the majority of medical procedures were postponed. During the pandemic, with hospital reorganization, clinical and learning activities performed by residents suffered a forced remodulation. The objective of this study is to investigate how urology training in Italy has been affected during the COVID-19 era. In this multi-academic study, we compared residents' training during the highest outbreak level with their previous activity. Overall 387 (67.1%) of the 577 Italian Urology residents participated in a 72-h anonymous online survey with 36 items sent via email. The main outcomes were clinical/surgical activities, soci…
18F-Florbetaben PET/CT to Assess Alzheimer's Disease: A new Analysis Method for Regional Amyloid Quantification.
2019
Background and purpose While AD can be definitively confirmed by postmortem histopathologic examination, in vivo imaging may improve the clinician's ability to identify AD at the earliest stage. The aim of the study was to test the performance of amyloid PET using new processing imaging algorithm for more precise diagnosis of AD. Methods Amyloid PET results using a new processing imaging algorithm (MRI-Less and AAL Atlas) were correlated with clinical, cognitive status, CSF analysis, and other imaging. The regional SUVR using the white matter of cerebellum as reference region and scores from clinical and cognitive tests were used to create ROC curves. Leave-one-out cross-validation was carr…
Metabolic Response Assessment in Non-Small Cell Lung Cancer Patients after Platinum-Based Therapy: A Preliminary Analysis
2015
The purpose of this study was to evaluate the clinical value of PET (Positron Emission Tomography) for early prediction of tumor response to platinum-based therapy in patients with nonsmall cell lung cancer (NSCLC). The evaluation was carried out comparing the standard treatment response using RECIST (Response Evaluation Criteria in Solid Tumors) with metabolic treatment response according to European Organization for Research and Treatment of Cancer (EORTC) recommendations, PET Response Criteria in Solid Tumors (PERCIST), Total Lesion Glycolysis (TLG) and Metabolic Tumor Volume (MTV). Seventeen inoperable patients with stage IV NSCLC were enrolled between October 2011 and June 2013: PET st…
Semi-automated and interactive segmentation of contrast-enhancing masses on breast DCE-MRI using spatial fuzzy clustering
2022
Abstract Multiparametric Magnetic Resonance Imaging (MRI) is the most sensitive imaging modality for breast cancer detection and is increasingly playing a key role in lesion characterization. In this context, accurate and reliable quantification of the shape and extent of breast cancer is crucial in clinical research environments. Since conventional lesion delineation procedures are still mostly manual, automated segmentation approaches can improve this time-consuming and operator-dependent task by annotating the regions of interest in a reproducible manner. In this work, a semi-automated and interactive approach based on the spatial Fuzzy C-Means (sFCM) algorithm is proposed, used to segme…
A fully automatic method for biological target volume segmentation of brain metastases
2016
Leksell Gamma Knife is a mini-invasive technique to obtain a complete destruction of cerebral lesions delivering a single high dose radiation beam. Positron Emission Tomography (PET) imaging is increasingly utilized for radiation treatment planning. Nevertheless, lesion volume delineation in PET datasets is challenging because of the low spatial resolution and high noise level of PET images. Nowadays, the biological target volume (BTV) is manually contoured on PET studies. This procedure is time expensive and operator-dependent. In this article, a fully automatic algorithm for the BTV delineation based on random walks (RW) on graphs is proposed. The results are compared with the outcomes of…
A Computational Study on Temperature Variations in MRgFUS Treatments Using PRF Thermometry Techniques and Optical Probes
2021
Structural and metabolic imaging are fundamental for diagnosis, treatment and follow-up in oncology. Beyond the well-established diagnostic imaging applications, ultrasounds are currently emerging in the clinical practice as a noninvasive technology for therapy. Indeed, the sound waves can be used to increase the temperature inside the target solid tumors, leading to apoptosis or necrosis of neoplastic tissues. The Magnetic resonance-guided focused ultrasound surgery (MRgFUS) technology represents a valid application of this ultrasound property, mainly used in oncology and neurology. In this paper
A Graph-Based Method for PET Image Segmentation in Radiotherapy Planning: A Pilot Study
2013
Target volume delineation of Positron Emission Tomography (PET) images in radiation treatment planning is challenging because of the low spatial resolution and high noise level in PET data. The aim of this work is the devel- opment of an accurate and fast method for semi-automatic segmentation of me- tabolic regions on PET images. For this purpose, an algorithm for the biological tumor volume delineation based on random walks on graphs has been used. Va- lidation was first performed on phantoms containing spheres and irregular in- serts of different and known volumes, then tumors from a patient with head and neck cancer were segmented to discuss the clinical applicability of this algo- rith…
A preliminary PET radiomics study of brain metastases using a fully automatic segmentation method
2020
AbstractBackgroundPositron Emission Tomography (PET) is increasingly utilized in radiomics studies for treatment evaluation purposes. Nevertheless, lesion volume identification in PET images is a critical and still challenging step in the process of radiomics, due to the low spatial resolution and high noise level of PET images. Currently, the biological target volume (BTV) is manually contoured by nuclear physicians, with a time expensive and operator-dependent procedure.This study aims to obtain BTVs from cerebral metastases in patients who underwent L-[11C]methionine (11C-MET) PET, using a fully automatic procedure and to use these BTVs to extract radiomics features to stratify between p…
Predicting survival in node-positive prostate cancer after open, laparoscopic or robotic radical prostatectomy: A competing risk analysis of a multi-…
2016
Objectives: To investigate cancer-specific mortality and other-cause mortality in prostate cancer patients with nodal metastases. Methods: The study included 411 patients treated with radical prostatectomy and pelvic lymph node dissection for prostate cancer with lymph node metastases at 10 tertiary care centers between 1995 and 2014. Kaplan–Meier analyses were used to assess cancer-specific mortality-free survival rates at 8 years' follow up in the overall population, and after stratifying patients according to clinical and pathological parameters. Uni- and multivariable competing risk Cox regression analyses were used to assess cancer-specific mortality and other-cause mortality. Finally,…
3D DCE-MRI Radiomic Analysis for Malignant Lesion Prediction in Breast Cancer Patients
2022
Rationale and Objectives: To develop and validate a radiomic model, with radiomic features extracted from breast Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) from a 1.5T scanner, for predicting the malignancy of masses with enhancement. Images were acquired using an 8-channel breast coil in the axial plane. The rationale behind this study is to show the feasibility of a radio-mics-powered model that could be integrated into the clinical practice by exploiting only standard-of-care DCE-MRI with the goal of reducing the required image pre-processing (ie, normalization and quantitative imaging map generation).Materials and Methods: 107 radiomic features were extracted from a …
An automatic method for metabolic evaluation of gamma knife treatments
2015
Lesion volume delineation of Positron Emission Tomography images is challenging because of the low spatial resolution and high noise level. Aim of this work is the development of an operator independent segmentation method of metabolic images. For this purpose, an algorithm for the biological tumor volume delineation based on random walks on graphs has been used. Twenty-four cerebral tumors are segmented to evaluate the functional follow-up after Gamma Knife radiotherapy treatment. Experimental results show that the segmentation algorithm is accurate and has real-time performance. In addition, it can reflect metabolic changes useful to evaluate radiotherapy response in treated patients.
A fully automatic 2D segmentation method for uterine fibroid in MRgFUS treatment evaluation
2015
PurposeMagnetic Resonance guided Focused UltraSound (MRgFUS) represents a non-invasive surgical approach that uses thermal ablation to treat uterine fibroids. After the MRgFUS treatment, an operator must manually segment the treated fibroid areas to evaluate the NonPerfused Volume (NPV). This manual approach is operator-dependent, introducing issues of result reproducibility, which could lead to errors in the subsequent follow-up phase. Moreover, manual segmentation is time-consuming, and can have a negative impact on the optimization of both machine-time and operator-time. MethodTo address these issues, in this paper a novel fully automatic method based on the unsupervised Fuzzy C-Means cl…
Semi-automatic Brain Lesion Segmentation in Gamma Knife Treatments Using an Unsupervised Fuzzy C-Means Clustering Technique
2016
MR Imaging is being increasingly used in radiation treatment planning as well as for staging and assessing tumor response. Leksell Gamma Knife (R) is a device for stereotactic neuro-radiosurgery to deal with inaccessible or insufficiently treated lesions with traditional surgery or radiotherapy. The target to be treated with radiation beams is currently contoured through slice-by-slice manual segmentation on MR images. This procedure is time consuming and operator-dependent. Segmentation result repeatability may be ensured only by using automatic/semi-automatic methods with the clinicians supporting the planning phase. In this paper a semi-automatic segmentation method, based on an unsuperv…
253. An accurate and operator independent method for biological tumour volume segmentation
2018
Purpose The aim of this paper is to develop an operator independent method for biological tumour volume (BTV) delineation from Positron Emission Tomography (PET) images. BTV delineation is challenging because of the low spatial resolution and high noise level in PET images. In addition, BTV varies substantially depending on the method used to segment. Manual delineation is widely-used, but it is strongly user dependent. Methods The proposed method starts with the automatic identification of the PET slice with maximum Standardized Uptake Value (SUV). Then, a user- independent mask is obtained by a rough pre-segmentation step and it is used to perform the local active contour segmentation on …
Systemic Inflammatory Markers and Oncologic Outcomes in Patients with High-risk Non-muscle-invasive Urothelial Bladder Cancer
2018
Background: Serum levels of neutrophils, platelets, and lymphocytes have been recognized as factors related to poor prognosis for many solid tumors, including bladder cancer (BC). Objective: To evaluate the prognostic role of the combination of the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR) in patients with high-risk non–muscle-invasive urothelial BC (NIMBC). Design, setting, and participants: A total of 1151 NMIBC patients who underwent first transurethral resection of the bladder tumor (TURBT) at 13 academic institutions between January 1, 2002 and December 31, 2012 were included in this analysis. The median follow-up was 48 mo.…
Type 2 diabetes mellitus predicts worse outcomes in patients with high-grade T1 bladder cancer receiving bacillus Calmette-Guérin after transurethral…
2020
Objectives: The aim of this multicenter study was to investigate the prognostic role of type 2 diabetes mellitus (T2DM) comorbidity in a large multi-institutional cohort of patients with primary T1HG/G3 non–muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of the bladder (TURB). Materials and methods: A total of 1,172 patients with primary T1 HG/G3 who had NMIBC on re-TURB and who received adjuvant intravesical bacillus Calmette-Guérin therapy with maintenance were included. Endpoints were recurrence-free survival and progression-free survival. Results: A total of 231 (19.7%) of patients had T2DM prior to TURB. Five-year recurrence-free survival estimates were 12.5…
A Semi-automatic Multi-seed Region-Growing Approach for Uterine Fibroids Segmentation in MRgFUS Treatment
2013
Fibroids are benign tumors growing in the uterus. Most of fibroids do not require treatment unless they are causing symptoms. Traditional surgery treatments, like myomectomy and hysterectomy, are very invasive therapeutic approaches which not always preserves reproductive potential of the woman. MRgFUS, performed with Insightec ExAblate 2100 equipment, is a new and noninvasive technique for uterine fibroids treatment, not requiring hospitalization and recovery time for patients. An initial assessment of MRgFUS treatment is made by computing the ablated volume of uterine fibroid. In this paper a semi-automatic approach, based on region-growing segmentation technique, is proposed. The impleme…
Predictors of residual T1 high grade on re-transurethral resection in a large multi-institutional cohort of patients with primary T1 high-grade/grade…
2018
The aim of this multi-institutional study was to identify predictors of residual high-grade (HG) disease at re-transurethral resection (reTUR) in a large cohort of primary T1 HG/Grade 3 (G3) bladder cancer patients. A total of 1155 patients with primary T1 HG/G3 bladder cancer from 13 academic institutions that underwent a reTUR within 6 weeks after first TUR were evaluated. Logistic regression analysis was performed to assess the association of predictive factors with residual HG at reTUR. Residual HG cancer was found in 288 (24.9%) of patients at reTUR. Patients presenting residual HG cancer were more likely to have carcinoma in situ (CIS) at first resection (p=25 kg/m2. On multivariable …
Fully automatic multispectral MR image segmentation of prostate gland based on the fuzzy C-means clustering algorithm
2017
Prostate imaging is a very critical issue in the clinical practice, especially for diagnosis, therapy, and staging of prostate cancer. Magnetic Resonance Imaging (MRI) can provide both morphologic and complementary functional information of tumor region. Manual detection and segmentation of prostate gland and carcinoma on multispectral MRI data is not easily practicable in the clinical routine because of the long times required by experienced radiologists to analyze several types of imaging data. In this paper, a fully automatic image segmentation method, exploiting an unsupervised Fuzzy C-Means (FCM) clustering technique for multispectral T1-weighted and T2-weighted MRI data processing, is…
Genotyping analysis and 18FDG uptake in breast cancer patients: a preliminary research
2013
Background: Diagnostic imaging plays a relevant role in the care of patients with breast cancer (BC). Positron Emission Tomography (PET) with 18F-fluoro-2-deoxy-D-glucose (FDG) has been widely proven to be a clinical tool suitable for BC detection and staging in which the glucose analog supplies metabolic information about the tumor. A limited number of studies, sometimes controversial, describe possible associations between FDG uptake and single nucleotide polymorphisms (SNPs). For this reason this field has to be explored and clarified. We investigated the association of SNPs in GLUT1, HIF-1a, EPAS1, APEX1, VEGFA and MTHFR genes with the FDG uptake in BC. Methods: In 26 caucasian individu…
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
2023
Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, r…
SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study
2021
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 da…