Papers by Stefano Brocchi
Poster: "ECR 2016 / B-0139 / Renal allograft shearwave elastography: a new diagnostic tool t... more Poster: "ECR 2016 / B-0139 / Renal allograft shearwave elastography: a new diagnostic tool to assess chronic allograft alterations compared with biopsy" by: "C. Sportoletti, S. Brocchi, A. L. Croci Chiocchini, A. Scrivo, G. Comai, C. Serra, A. Marchetti, M. Zompatori; Bologna/IT"
Poster: "ECR 2014 / C-1199 / Shearwave elastography in kidney transplantation: a new diagnos... more Poster: "ECR 2014 / C-1199 / Shearwave elastography in kidney transplantation: a new diagnostic tool to assess chronic allograft fibrosis" by: "S. Brocchi, C. Sportoletti, C. Serra, M. Zompatori; Bologna/IT"
Therapeutic Advances in Medical Oncology, 2020
Atherosclerosis is considered an irreversible process, with crucial contribution of inflammation ... more Atherosclerosis is considered an irreversible process, with crucial contribution of inflammation and immune cells. Impact of cancer immunotherapy on a partly immune-driven disease, such as atherosclerosis, is poorly understood, but preclinical models suggest its worsening on programmed death/ligand-1 (PD-1/PD-L1) inhibitors. In a previously reported cohort of 11 patients with non-small cell lung cancer (NSCLC) treated with nivolumab and preexisting complicated atheromatous plaques, 3 patients had a dramatic radiologic reduction of aortic plaques while on nivolumab; of these 3, 2 died receiving no further treatment. The remaining patient was an 83-year-old woman with history of arterial hypertension and hypothyroidism who was diagnosed with locally advanced squamous NSCLC. At relapse, complicated aortic atheromatous plaques were demonstrated on scans. The patient was then treated with nivolumab obtaining stable disease at radiological assessment, which also demonstrated almost complete vanishing of aortic plaques. After relapse and interval treatment with chemotherapy, she experienced new development of aortic atheromatous plaques. At further relapse she received atezolizumab, which yielded disease response and new reduction in aortic plaques, until nearly complete resolution. The observation of a repeated improvement of atheromatous plaques on treatment with PD-1/PD-L1 inhibitors favors the protective role of T cells on atheromatous plaques that is impaired by PD-L1 expression by plaque-associated macrophages. Validation by independent and prospective observation is needed.
Clinical Lung Cancer, Mar 1, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Clinical and Translational Imaging, Feb 18, 2023
Background and aim The American College of Radiology (ACR) defines "actionable findings" the ones... more Background and aim The American College of Radiology (ACR) defines "actionable findings" the ones requiring a special communication between radiologists and referring clinicians, suggesting to organize their categorization in a three-degree scale on the basis of the risk for the patient to develop complications. These cases may fall in a grey-zone communication between different care figures with the risk of being underestimated or even not being considered at all. In this paper, our aim is to adapt the ACR categorization to the most frequent actionable findings encountered when reporting PET/CT images in a Nuclear Medicine Department, describing the most frequent and relevant imaging features and presenting the modalities of communication and the related clinical interventions that can be modulated by the prognostic severity of the clinical cases. Materials and methods We performed a descriptive, observational and critical analysis of the most relevant literature on the topic of "actionable findings", in particular, starting from the reports of the ACR Actionable Reporting Work Group, we categorised and described, in a narrative review, the most relevant "actionable findings" encountered in the Nuclear Medicine PET/CT daily practice. Results To the best of our knowledge, to date there are no clear indications on this selective PET/CT topic, considering that the current recommendations target mainly radiologists and assume a certain level of radiological expertise. We resumed and classified the main imaging conditions under the term of "actionable findings" according to the corresponding anatomical districts, and we described their most relevant imaging features (independently of PET avidity or not). Furthermore, a different communication timing and strategy was suggested on the basis of the findings' urgency. Conclusion A systematic categorization of the actionable imaging findings according to their prognostic severity may help the reporting physician to choose how and when to communicate with the referring clinician or to identify cases requiring a prompt clinical evaluation. Effective communication is a critical component of diagnostic imaging: timely receipt of the information is more important than the method of delivery.
XXXV Congresso Nazionale SINU, 2012
HPB, 2018
13 (16.67%) cases, and 3 patients were reoperated (3.85%). No mortality was observed. Although ra... more 13 (16.67%) cases, and 3 patients were reoperated (3.85%). No mortality was observed. Although rarely represented, primary extrahepatic echinococcosis is extremely important because if inadequately diagnosed and treated leads to a significant reduction in the working capacity of patients suffering from this benign disease.
Chirurgia e patologia sperimentale, 1979
Progress in transplantation (Aliso Viejo, Calif.), 2017
Renal allograft biopsy is the gold standard for the detection of histological lesions of chronic ... more Renal allograft biopsy is the gold standard for the detection of histological lesions of chronic allograft dysfunction. The identification of a noninvasive routine test would be desirable. Elastosonography is used to assess tissue stiffness according to viscosity, and no data are available on the use of point quantification shear-wave elastography (ElastPQ) for the evaluation of renal chronic lesions. To evaluate the feasibility of ElastPQ to assess cortical allograft stiffness and to determine the correlation of clinical, biological, and pathological factors with the diagnostic accuracy of kidney stiffness values in patients with histological lesions. Forty-two patients underwent kidney transplant biopsy and 10 valid measurements of ElastPQ, blindly performed by 2 operators. The interobserver reproducibility was assessed according to intraclass correlation coefficient. The ElastPQ measurements and the clinical data were compared using the Spearman correlation analysis. 97.6% reliab...
La radiologia medica, 2022
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide and ... more Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide and one of the most common causes of death among patients with cirrhosis, developing in 1–8% of them every year, regardless of their cirrhotic stage. The radiological features of HCC are almost always sufficient for reaching the diagnosis; thus, histological confirmation is rarely needed. However, the study of cirrhotic livers remains a challenge for radiologists due to the developing of fibrous and regenerative tissue that cause the distortion of normal liver parenchyma, changing the typical appearances of benign lesions and pseudolesions, which therefore may be misinterpreted as malignancies. In addition, a correct distinction between pseudolesions and malignancy is crucial to allow appropriate targeted therapy and avoid treatment delays. The present review encompasses technical pitfalls and describes focal benign lesions and pseudolesions that may be misinterpreted as HCC in cirrhotic livers, providing the imaging features of regenerative nodules, large regenerative nodules, siderotic nodules, hepatic hemangiomas (including rapidly filling and sclerosed hemangiomas), segmental hyperplasia, arterioportal shunts, focal confluent fibrosis and focal fatty changes. Lastly, the present review explores the most promising new imaging techniques that are emerging and that could help radiologists differentiate benign lesions and pseudolesions from overt HCC.
Journal of Clinical Medicine
Background: The aim of the present study is to determine the feasibility of biopsy for atypical l... more Background: The aim of the present study is to determine the feasibility of biopsy for atypical liver nodules in patients under surveillance for hepatocellular carcinoma (HCC), assessing which factors influence the decision to perform it. Methods: A total of 128 atypical liver nodules in 108 patients under surveillance for HCC, who underwent CT between September 2018 and September 2019, were included. All the images were saved digitally (on CD-ROM) and the two most representative images in the arterial and delayed phases were selected for each lesion and inserted into a digital atlas (on PDF). Two experienced radiologists (Readers 1 and 2) reviewed both the CD-ROM and the PDF to define the feasibility of biopsy in both scenarios, specifying the reasons for the unfeasibility of biopsy. The intra-observer variability and inter-observer variability were assessed. Results: When reviewing the PDF, 76 (59.4%) and 68 (53.1%) nodules were deemed unfeasible for biopsy by the less experienced...
Radiology for PET/CT Reporting
Acta Gastro Enterologica Belgica, 2021
Pneumatosis Intestinalis (PI) is a rare radiological finding defined as the presence of extra-lum... more Pneumatosis Intestinalis (PI) is a rare radiological finding defined as the presence of extra-luminal gas within the intestinal wall. Several anti-tumor drugs can induce a damage of the gastrointestinal walls as an adverse effect, causing loss of mucosal integrity and endoluminal gas diffusion, responsible for PI development. We retrospectively analyzed 8 cases of PI detected through radiological imaging in oncologic patients undergoing various therapeutic regimens: five patients were receiving chemotherapy, two molecular targeted therapy (MTT) and one immunotherapy. Three patients were asymptomatic and pneumatosis was incidentally detected at routinary follow-up CT and then treated conservatively. Five patients presented acute abdomen symptoms and in these cases bowel perforation was the cause of death. Our experience confirms PI and perforation as rare complications of drug toxicity, especially in oncologic patients treated with combinations of different anticancer drugs and docum...
Poster: "ECR 2016 / B-0139 / Renal allograft shearwave elastography: a new diagnostic tool t... more Poster: "ECR 2016 / B-0139 / Renal allograft shearwave elastography: a new diagnostic tool to assess chronic allograft alterations compared with biopsy" by: "C. Sportoletti, S. Brocchi, A. L. Croci Chiocchini, A. Scrivo, G. Comai, C. Serra, A. Marchetti, M. Zompatori; Bologna/IT"
Cancers, 2021
Treatment response is usually assessed by the response evaluation criteria in solid tumors (RECIS... more Treatment response is usually assessed by the response evaluation criteria in solid tumors (RECIST). These criteria may not be adequate to evaluate the response to immunotherapy, considering the peculiar patterns of response reported with this therapy. With the advent of immunotherapy these criteria have been modified to include the evaluation of the peculiar responses seen with this type of therapy (iRECIST criteria), including pseudoprogressions and hyperprogressions. Tumor growth rate (TGR) is a dynamic evaluation that takes into account the kinetics of response to treatment and may help catch the real efficacy of an immunotherapy approach. We performed a retrospective monocentric study to explore the impact of TGR change after nivolumab administration as the second or later line of treatment in patients with metastatic renal cell carcinoma (RCC). We evaluated 27 patients, divided into three categories: Disease control (DC) if there was no PD; lower velocity PD (LvPD) if disease ...
Supplemental material, sj-pdf-1-tmj-10.1177_03008916211047888 for Transient asymptomatic pulmonar... more Supplemental material, sj-pdf-1-tmj-10.1177_03008916211047888 for Transient asymptomatic pulmonary opacities and interstitial lung disease in EGFR-mutated non-small cell lung cancer treated with osimertinib by Gianluca Taronna, Alessandro Leonetti, Filippo Gustavo Dall'Olio, Alessandro Rizzo, Claudia Parisi, Sebastiano Buti, Paola Bordi, Stefano Brocchi, Rita Golfieri, Andrea Ardizzoni, Nicola Sverzellati and Marcello Tiseo in Tumori Journal
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Papers by Stefano Brocchi