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| 1 | MR with Gd-EOB-DTPA in assessment of liver nodules in cirrhotic patients显示文摘To date the imaging diagnosis of liver lesions is based mainly on the identification of vascular features, which are typical of overt hepatocellular carcinoma(HCC), but the hepatocarcinogenesis is a complex and multistep event during which, a spectrum of nodules develop within the liver parenchyma, including benign small and large regenerative nodule(RN), low-grade dysplastic nodule(LGDN), high-grade dysplastic nodule(HGDN), early HCC, and well differentiated HCC. These nodules may be characterised not only on the basis of their respective different blood supplies, but also on their different hepatocyte function. Recently, in liver imaging the introduction of hepatobiliary magnetic resonance imaging contrast agent offered the clinicians the possibility to obtain, at once, information not only related to the vascular changes of liver nodules but also information on hepatocyte function. For this reasons this new approach becomes the most relevant diagnostic clue for differentiating low-risk nodules(LGDN-RN) from highrisk nodules(HGDN/early HCC or overt HCC) and consequently new diagnostic algorithms for HCC have been proposed. The use of hepatobiliary contrast agents is constantly increasing and gradually changing the standard of diagnosis of HCC. The main purpose of this review is to underline the added value of Gd-EOB-DTPA in early-stage diagnoses of HCC. We also analyse the guidelines for the diagnosis and management of HCC, the key concepts of HCC development, growth and spread and the imaging appearance of precursor nodules that eventually may transform into overt HCC. | Riccardo Inchingolo Riccardo Faletti Luigi Grazioli Eleonora Tricarico Marco Gatti Anna Pecorelli Davide Ippolito | 2018 | World Journal of Hepatology2018,10,7: | 37 |
| 2 | Locoregional treatments for hepatocellular carcinoma: Current evidence and future directions显示文摘Liver cancers are the second most frequent cause of global cancer-related mortality of which 90%are attributable to hepatocellular carcinoma(HCC).Despite the advent of screening programmes for patients with known risk factors,a substantial number of patients are ineligible for curative surgery at presentation with limited outcomes achievable with systemic chemotherapy/external radiotherapy.This has led to the advent of numerous minimally invasive options including but not limited to trans-arterial chemoembolization,radiofrequency/microwave ablation and more recently selective internal radiation therapy many of which are often the first-line treatment for select stages of HCC or serve as a conduit to liver transplant.The authors aim to provide a comprehensive overview of these various image guided minimally invasive therapies with a brief focus on the technical aspects accompanied by a critical analysis of the literature to assess the most up-to-date evidence from comparative systematic reviews and meta-analyses finishing with an assessment of novel combination regimens and future directions of travel. | Riccardo Inchingolo Alessandro Posa Martin Mariappan Stavros Spiliopoulos | 2019 | World Journal of Gastroenterology2019,25,32: | 14 |
| 3 | Recent advances in non-invasive magnetic resonance imaging assessment of hepatocellular carcinoma显示文摘Magnetic resonance(MR) imaging of the liver is an important tool for the detection and characterization of focal liver lesions and for assessment of diffuse liver disease,having several intrinsic characteristics,represented by high soft tissue contrast,avoidance of ionizing radiation or iodinated contrast media,and more recently,by application of several functional imaging techniques(i.e.,diffusion-weighted sequences,hepatobiliary contrast agents,perfusion imaging,magnetic resonance(MR)-elastography,and radiomics analysis). MR functional imaging techniques are extensively used both in routine practice and in the field of clinical and pre-clinical research because,through a qualitative rather than quantitative approach,they can offer valuable information about tumor tissue and tissue architecture,cellular biomarkers related to the hepatocellular functions,or tissue vascularization profiles related to tumor and tissue biology. This kind of approach offers in vivo physiological parameters,capable of evaluating physiological and pathological modifications of tissues,by the analysis of quantitative data that could be used in tumor detection,characterization,treatmentselection,and follow-up,in addition to those obtained from standard morphological imaging. In this review we provide an overview of recent advanced techniques in MR for the diagnosis and staging of hepatocellular carcinoma,and their role in the assessment of response treatment evaluation. | Davide Ippolito Riccardo Inchingolo Luigi Grazioli Silvia Girolama Drago Michele Nardella Marco Gatti Riccardo Faletti | 2018 | World Journal of Gastroenterology2018,24,23: | 13 |
| 4 | Polyethylene glycol microspheres loaded with irinotecan for arterially directed embolic therapy of metastatic liver cancer显示文摘AIM To study tumor response, and tolerability of arterially directed embolic therapy(ADET) with polyethylene glycol embolics loaded with irinotecan for the treatment of colorectal cancer liver metastases(CRC-LM). Secondary objectives were to monitor quality of life, time to progression and survival of patients.METHODS Patients were included in the study if they were affected by CRC-LM, refractory to systemic chemotherapy, treated with ADET using polyethylene glycol embolics, and had liver involvement < 50%. Tumor response, performance status(PS), tumor marker antigens, and quality of life(QoL) were monitored at 1, 3 and 6 mo after ADET. QoL was assessed with the Palliative Performance Scale(PPS).RESULTS We treated 50 consecutive CRC-LM patients with ADET using polyethylene glycol embolics. Their tumor response one month after ADET was: 28% of complete response(CR), 48% of partial response(PR), 8% stable disease(SD), and 16% of progression. Tumor response 3 mo after ADET was CR 24%, PR 38%, SD 19% and progression disease(PD) 19%. Tumor response 6 mo after ADET was CR 18%, PR 44%, SD 21% and PD 18%. QoL was 90% PPS at each time point. Median time to progression for patients who progressed was 2.5 mo(range 0.8-6). Median follow-up was 14 mo(0.8-25 range). ADETs were performed with no complications. Observed side effects(mild or moderate intensity) were: Pain in 32% of patients, increase of transaminase levels in 20% and fever in 14%, whereas 30% of patients did not complain any adverse event. CONCLUSION The treatment of unresectable CRC-LM with ADET using polyethylene glycol microspheres loaded with irinotecan was effective in tumor response and resulted in mild toxicity, and good QoL. | Giammaria Fiorentini Riccardo Carandina Donatella Sarti Michele Nardella Odysseas Zoras Stefano Guadagni Riccardo Inchingolo Massimiliano Nestola Alessandro Felicioli Daniel Barnes Navarro Fernando Munoz Gomez Camillo Aliberti | 2017 | World Journal of Gastrointestinal Oncology2017,9,9: | 6 |
| 5 | Transjugular intrahepatic portosystemic shunt for Budd-Chiari syndrome:A comprehensive review显示文摘Budd-Chiari syndrome(BCS)is a relatively rare clinical condition with a wide range of symptomatology,caused by the obstruction of the hepatic venous outflow.If left untreated,it has got an high mortality rate.Its management is based on a step-wise approach,depending on the clinical presentation,and includes different treatment from anticoagulation therapy up to Interventional Radiology techniques,such as transjugular intrahepatic portosystemic shunt(TIPS).TIPS is today considered a safe and highly effective treatment and should be recommended for BCS patients,including those awaiting orthotopic liver transplantation.In this review the pathophysiology,diagnosis and treatment options of BCS are presented,with a special focus on published data regarding the techniques and outcomes of TIPS for the treatment of BCS.Moreover,unresolved issues and future research will be discussed. | Riccardo Inchingolo Alessandro Posa Martin Mariappan Tiago Kojun Tibana Thiago Franchi Nunes Stavros Spiliopoulos Elias Brountzos | 2020 | World Journal of Gastroenterology2020,26,34: | 5 |
| 6 | Non-surgical treatment of hilar cholangiocarcinoma显示文摘Cancer of the biliary confluence also known as hilar cholangiocarcinoma(HC)or Klatskin tumor,is a rare type of neoplastic disease constituting approximately 40%-60%of intrahepatic malignancies,and 2% of all cancers.The prognosis is extremely poor and the majority of Klatskin tumors are deemed unresectable upon diagnosis.Most patients with unresectable bile duct cancer die within the first year after diagnosis,due to hepatic failure,and/or infectious complications secondary to biliary obstruction.Curative treatments include surgical resection and liver transplantation in highly selected patients.Nevertheless,very few patients are eligible for surgery or transplant at the time of diagnosis.For patients with unresectable HC,radiotherapy,chemotherapy,photodynamic therapy,and liver-directed minimally invasive procedures such as percutaneous image-guided ablation and intra-arterial chemoembolization are recommended treatment options.This review focuses on currently available treatment options for unresectable HC and discusses future perspectives that could optimize outcomes. | Riccardo Inchingolo Fabrizio Acquafredda Valentina Ferraro Letizia Laera Gianmarco Surico Alessia Surgo Alba Fiorentino Stefania Marini Nicola de'Angelis Riccardo Memeo Stavros Spiliopoulos | 2021 | World Journal of Gastrointestinal Oncology2021,13,11: | 5 |
| 7 | Giant splenic artery aneurysm presenting with massive upper gastrointestinal bleeding:A case report and review of literature显示文摘BACKGROUND Splenic artery aneurysm(SAA)and pseudoaneurysm are rare vessel’s lesions.Pseudoaneurysm is often symptomatic and secondary to pancreatitis or trauma.True SAA is the most common aneurysm of visceral vessels.In contrast to pseudoaneurysm,SAA is usually asymptomatic until the rupture,with high mortality rate.The clinical onset of SSA’s rupture is a massive life-threatening bleeding with hemodynamic instability,usually into the free peritoneal space and more rarely into the gastrointestinal tract.CASE SUMMARY We describe the case of a 35-year-old male patient,with negative past medical history,who presented to the emergency department for massive upper gastrointestinal bleeding,severe anemia and hypotension.An esophagogastroduodenoscopy performed in emergency showed a gastric bulging in the greater curvature/posterior wall with a small erosion on its surface,with a visible vessel,but no active bleeding.Endoscopic injection therapy with cyanoacrylate glue was performed.Urgent contrast-enhanced computed tomography was carried out due to the clinical scenario and the unclear endoscopic aspect:The radiological examination showed a giant SAA which was adherent to posterior stomach wall,and some smaller aneurysms of the left gastric and ileocolic artery.Because of the high risk of a two-stage rupture of the giant SAA with dramatic outcome,the patient underwent immediate open surgery with aneurysmectomy,splenectomy and distal pancreatectomy with a good postoperative outcome.CONCLUSION The management of a ruptured giant SAA into the stomach can be successful with surgical approach. | Francesco Panzera Riccardo Inchingolo Marina Rizzi Assunta Biscaglia Maria Grazia Schievenin Emilia Tallarico Giancarlo Pacifico Beatrice Di Venere | 2020 | World Journal of Gastroenterology2020,26,22: | 4 |
| 8 | Radiofrequency ablation vs surgical resection in elderly patients with hepatocellular carcinoma in Milan criteria显示文摘BACKGROUND Surgical resection and radiofrequency ablation(RFA)represent two possible strategy in treatment of hepatocellular carcinoma(HCC)in Milan criteria.AIM To evaluate short-and long-term outcome in elderly patients(>70 years)with HCC in Milan criteria,which underwent liver resection(LR)or RFA.METHODS The study included 594 patients with HCC in Milan criteria(429 in LR group and 165 in RFA group)managed in 10 European centers.Statistical analysis was performed using the Kaplan-Meier method before and after propensity score matching(PSM)and Cox regression.RESULTS After PSM,we compared 136 patients in the LR group with 136 patients in the RFA group.Overall survival at 1,3,and 5 years was 91%,80%,and 76%in the LR group and 97%,67%,and 41%in the RFA group respectively(P=0.001).Diseasefree survival at 1,3,and 5 years was 84%,60%and 44%for the LR group,and 63%,36%,and 25%for the RFA group(P=0.001).Postoperative Clavien-Dindo IIIIV complications were lower in the RFA group(1%vs 11%,P=0.001)in association with a shorter length of stay(2 d vs 7 d,P=0.001).In multivariate analysis,Model for End-stage Liver Disease(MELD)score(>10)[odds ratio(OR)=1.89],increased value of international normalized ratio(>1.3)(OR=1.60),treatment with radiofrequency(OR=1.46),and multiple nodules(OR=1.19)were independent predictors of a poor overall survival while a high MELD score(>10)(OR=1.51)and radiofrequency(OR=1.37)were independent factors associated with a higher recurrence rate.CONCLUSION Despite a longer length of stay and a higher rate of severe postoperative complications,surgery provided better results in long-term oncological outcomes as compared to ablation in elderly patients(>70 years)with HCC in Milan criteria. | Maria Conticchio Riccardo Inchingolo Antonella Delvecchio Letizia Laera Francesca Ratti Maximiliano Gelli Ferdinando Anelli Alexis Laurent Giulio Vitali Paolo Magistri Giacomo Assirati Emanuele Felli Taiga Wakabayashi Patrick Pessaux Tullio Piardi Fabrizio di Benedetto Nicola de'Angelis Javier Briceño AntonioRampoldi RenèAdam Daniel Cherqui Luca Antonio Aldrighetti Riccardo Memeo | 2021 | World Journal of Gastroenterology2021,27,18: | 4 |
| 9 | Radiomics in colorectal cancer patients显示文摘The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease.However,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high risk of recurrence is challenging.Radiological images can represent a source of data that can be analyzed by using automated computer-based techniques,working on numerical information coded within Digital Imaging and Communications in Medicine files:This image numerical analysis has been named“radiomics”.Radiomics allows the extraction of quantitative features from radiological images,mainly invisible to the naked eye,that can be further analyzed by artificial intelligence algorithms.Radiomics is expanding in oncology to either understand tumor biology or for the development of imaging biomarkers for diagnosis,staging,and prognosis,prediction of treatment response and diseases monitoring and surveillance.Several efforts have been made to develop radiomics signatures for colorectal cancer patient using computed tomography(CT)images with different aims:The preoperative prediction of lymph node metastasis,detecting BRAF and RAS gene mutations.Moreover,the use of delta-radiomics allows the analysis of variations of the radiomics parameters extracted from CT scans performed at different timepoints.Most published studies concerning radiomics and magnetic resonance imaging(MRI)mainly focused on the response of advanced tumors that under-went neoadjuvant therapy.Nodes status is the main determinant of adjuvant chemotherapy.Therefore,several radiomics model based on MRI,especially on T2-weighted images and ADC maps,for the preoperative prediction of nodes metastasis in rectal cancer has been developed.Current studies mostly focused on the applications of radiomics in positron emission tomogra-phy/CT for the prediction of survival after curative surgical resection and assessment of response following neoadjuvant chemoradiotherapy.Since colorectal liver metastases develop in about 25%of patients with colorectal carcinoma,the main diagnostic tasks of radiomics should be the detection of synchronous and metachronous lesions.Radiomics could be an additional tool in clinical setting,especially in identifying patients with high-risk disease.Nevertheless,radiomics has numerous shortcomings that make daily use extremely difficult.Further studies are needed to assess performance of radiomics in stratifying patients with high-risk disease. | Riccardo Inchingolo Cesare Maino Roberto Cannella Federica Vernuccio Francesco Cortese Michele Dezio Antonio Rosario Pisani Teresa Giandola Marco Gatti Valentina Giannini Davide Ippolito Riccardo Faletti | 2023 | World Journal of Gastroenterology2023,29,19: | 4 |
| 10 | Gadoxetic acid magnetic-enhanced resonance imaging in the diagnosis of cholangiocarcinoma显示文摘The use of liver magnetic resonance imaging is increasing thanks to itsmultiparametric sequences that allow a better tissue characterization, and the useof hepatobiliary contrast agents. This review aims to evaluate gadoxetic acidenhanced magnetic resonance imaging in the diagnosis and staging ofcholangiocarcinoma and its different clinical and radiological classificationsproposed in the literature. We also analyze the epidemiology, risk factors incorrelation with clinical findings and laboratory data. | Riccardo Inchingolo Cesare Maino Marco Gatti Eleonora Tricarico Michele Nardella Luigi Grazioli SandroSironi Davide Ippolito Riccardo Faletti | 2020 | World Journal of Gastroenterology2020,26,29: | 4 |
| 11 | Irreversible electroporation for the management of pancreatic cancer: Current data and future directions显示文摘Pancreatic cancer is currently the seventh leading cause of cancer death(4.5%of all cancer deaths)while 80%-90%of the patients suffer from unresectable disease at the time of diagnosis.Prognosis remains poor,with a mean survival up to 15 mo following systemic chemotherapy.Loco-regional thermal ablative techniques are rarely implemented due to the increased risk of thermal injury to the adjacent structures,which can lead to severe adverse events.Irreversible electroporation,a promising novel non-thermal ablative modality,has been recently introduced in clinical practice for the management of inoperable pancreatic cancer as a safer and more effective loco-regional treatment option.Experimental and initial clinical data are optimistic.This review will focus on the basic principles of IRE technology,currently available data,and future directions. | Stavros Spiliopoulos Lazaros Reppas Dimitrios Filippiadis Antonella Delvecchio Maria Conticchio Riccar do Memeo Riccardo Inchingolo | 2023 | World Journal of Gastroenterology2023,29,2: | 3 |
| 12 | Role of gadoxetic acid-enhanced liver magnetic resonance imaging in the evaluation of hepatocellular carcinoma after locoregional treatment显示文摘Locoregional treatments,as alternatives to surgery,play a key role in the management of hepatocellular carcinoma(HCC).Liver magnetic resonance imaging(MRI)enables a multiparametric assessment,going beyond the traditional dynamic computed tomography approach.Moreover,the use of hepatobiliary agents can improve diagnostic accuracy and are becoming important in the diagnosis and follow-up of HCC.However,the main challenge is to quickly identify classical responses to loco-regional treatments in order to determine the most suitable management strategy for each patient.The aim of this review is to provide a summary of the most common and uncommon liver MRI findings in patients who underwent loco-regional treatments for HCC,with a special focus on ablative therapies(radiofrequency,microwaves and cryoablation),transarterial chemoembolization,trans-arterial radio-embolization and stereotactic ablative radiotherapy techniques,considering the usefulness of gadoxetate disodium(Gd-EOB-DTPA)contrast agent. | Marco Gatti Cesare Maino Fatemeh Darvizeh Alessandro Serafini Eleonora Tricarico Alessia Guarneri Riccardo Inchingolo Davide Ippolito Umberto Ricardi Paolo Fonio Riccardo Faletti | 2022 | World Journal of Gastroenterology2022,28,26: | 2 |
| 13 | Liver metastases:The role of magnetic resonance imaging显示文摘The liver is one of the organs most commonly involved in metastatic disease,especially due to its unique vascularization.It’s well known that liver metastases represent the most common hepatic malignant tumors.From a practical point of view,it’s of utmost importance to evaluate the presence of liver metastases when staging oncologic patients,to select the best treatment possible,and finally to predict the overall prognosis.In the past few years,imaging techniques have gained a central role in identifying liver metastases,thanks to ultrasonography,contrast-enhanced computed tomography(CT),and magnetic resonance imaging(MRI).All these techniques,especially CT and MRI,can be considered the noninvasive reference standard techniques for the assessment of liver involvement by metastases.On the other hand,the liver can be affected by different focal lesions,sometimes benign,and sometimes malignant.On these bases,radiologists should face the differential diagnosis between benign and secondary lesions to correctly allocate patients to the best management.Considering the above-mentioned principles,it’s extremely important to underline and refresh the broad spectrum of liver metastases features that can occur in everyday clinical practice.This review aims to summarize the most common imaging features of liver metastases,with a special focus on typical and atypical appearance,by using MRI. | Cesare Maino Federica Vernuccio Roberto Cannella Francesco Cortese Paolo NiccolòFranco Clara Gaetani Valentina Giannini Riccardo Inchingolo Davide Ippolito Arianna Defeudis Giulia Pilato Davide Tore Riccardo Faletti Marco Gatti | 2023 | World Journal of Gastroenterology2023,29,36: | 2 |
| 14 | Benign focal liver lesions:The role of magnetic resonance imaging显示文摘Liver lesions are common findings in radiologists’daily routine.They are a complex category of pathology that range from solitary benign lesions to primary liver cancer and liver metastases.Benign focal liver lesions can arise from different liver cell types:Epithelial(hepatocytes and biliary cells)and nonepithelial(mesenchymal cells).Liver magnetic resonance imaging(MRI)is a fundamental radiological method in these patients as it allows with its multiparametric approach optimal non-invasive tissue characterization.Furthermore,advanced liver MRI techniques such as diffusion-weighted imaging and hepatobiliary contrast agents have improved the detection of focal liver lesions and can be highly effective in differentiating pseudotumor from tumors,as well as benign from malignant lesions,and can also be used for differential diagnosis.Although histological examination can be useful in making a definitive diagnosis,MRI is an important modality in the diagnosis of liver lesions with a significant impact on patient care.This aim of this review is to provide a comprehensive overview of benign liver lesions on MRI. | Marco Gatti Cesare Maino Davide Tore Andrea Carisio Fatemeh Darvizeh Eleonora Tricarico Riccardo Inchingolo Davide Ippolito Riccardo Faletti | 2022 | World Journal of Hepatology2022,14,5: | 2 |
| 15 | Residual shunt after percutaneous closure of patent foramen ovale w ith AM PLATZER occluder devices-influence of anatomic features:a transcranial Doppler and intracardiac echocardiography study显示文摘 | Marchese N Pacilli M A Inchingolo V | 2013 | Euro Intervention2013,9,3: | 1 |
| 16 | Ex vivo lung sonography : morphologic - ultrasound relationship 显示文摘 | Soldati G Inchingolo R Smargiassi A et ai | 2012 | Ultra- sound Med Biol2012,38,7: | 1 |
| 17 | Clinical trial with bromelain in third molar exodontia显示文摘 | Inchingolo F Tatullo M Marrelli M | | 0,,09: | 1 |
| 18 | Synchronous gastric and colonic MALT-lymphoma in coeliac disease: A long-term follow-up on gluten-free diet显示文摘 | A. Tursi C.D. Inchingolo | 2006 | Digestive and Liver Disease2006,,11: | 1 |
| 19 | Trial with Platelct-Rich Fibrin and Bio-Oss used as grafting materials in the treatment of Ihe severe maxillar bone atrophy:clinical and radiological ewlluations 显示文摘 | Inchingolo F Tatullo M Marrelli M | 2010 | Eur Rev Med Pharmacol Sci2010,14,12: | 1 |
| 20 | The role of chest ultrasonography in the management of respiratory diseases:document II显示文摘 | Smargiassi A Inchingolo R Soldati G | 2013 | Multidiscip Respir Med2013,855,: | 1 |