The finding of a high proportion of R0 resection among all resections performed confirms the activity of neoadjuvant radiochemotherapy and should not be neglected. Based on these data, patients with unresectable pancreatic cancer without disease progression after chemoradiotherapy should be considered for radical surgery.
Purpose:To assess the transferability of the magnetic resonance imaging (MRI) multislice multiecho T2* technique for global and segmental measurement of iron overload in thalassemia patients.
Materials and Methods:Multiecho T2* sequences were installed on six MRI scanners. Five healthy subjects (n ϭ 30) were scanned at each site; five thalassemia major (TM) patients were scanned at the reference site and were rescanned locally (n ϭ 25) within 1 month. T2* images were analyzed using previously validated software.Results: T2* values of healthy subjects showed intersite homogeneity. On TM patients, for global heart T2* values the correlation coefficient was 0.97, coefficients of variation (CoV s ) ranged from 0.04 -0.12, and intraclass coefficients (ICC s ) ranged from 0.94 -0.99. The mean CoV and ICC for segmental T2* distribution were 0.198 and 88, respectively.
Conclusion:The multislice multiecho T2* technique is transferable among scanners with good reproducibility.
BACKGROUND: In advanced ovarian cancer, maximal efforts have to be attemptedto achieve optimal cytoreduction, as this represents the keystone in the therapeutic management. This large, prospective study aims at investigating the role of computed tomography (CT) scan in predicting the feasibility of optimal cytoreduction in ovarian cancer. METHODS: A total of 195 consecutive patients with clinical/radiographic suspicion of advanced ovarian/peritoneal cancer were enrolled at the Gynecologic Oncology Unit, Catholic University of Rome and Campobasso, Italy. Preoperative CT scans were performed with a high-speed scanner (CT Hi Speed Nx/i Pro; 2-slice; GE Medical System). All patients underwent standard laparotomy, and maximal surgical effort was attempted. The following CT parameters were used: peritoneal thickening, peritoneal implants 42 cm, bowel mesentery involvement, omental cake, pelvic sidewall involvement and/or hydroureter, suprarenal aortic lymph nodes 41 cm, infrarenal aortic lymph nodes 42 cm, superficial liver metastases 42 cm and/or intraparenchimal liver metastases any size, large volume ascites (4500 ml). Clinical data included were age, Ca125 serum levels, and ECOG-PS. Radiographic and clinical features exhibiting a specificity 475%, a positive and negative predictive value 450%, an accuracy 460% in predicting surgical outcome were assigned a point value of 2. With this scoring system, a predictive index (PI) was calculated for each patient. RESULTS: The PI scores ranged from 0 to 6, and from 0 to 8, in Model 1 (including only radiographic parameters) and in Model 2 (including radiographic and clinical data). The AUC was 0.78 þ 0.035 in Model 1, and 0.81 þ 0.031 in Model 2. Therefore, the addition of ECOG-PS data led to the improvement of the diagnostic performances (z ¼ 2.41, P-value o0.05). CONCLUSIONS: Computed scan still represents a valid tool to predict ovarian cancer optimal cytoreduction; the predictive ability of a CT scan-based model is improved by integrating ECOG-PS data.
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