Occhiato R

Bio: Occhiato R is an academic researcher from Sapienza University of Rome. The author has contributed to research in topics: Mammography & Hypermedia. The author has an hindex of 5, co-authored 11 publications receiving 216 citations. Previous affiliations of Occhiato R include Policlinico Umberto I.

Breast Lesion Detection and Characterization at Contrast-enhanced MR Mammography: Gadobenate Dimeglumine versus Gadopentetate Dimeglumine

Abstract: PURPOSE: To prospectively and intraindividually compare equivalent (0.1 mmol per kilogram of body weight) doses of gadobenate dimeglumine and gadopentetate dimeglumine for accuracy of detection and characterization of breast lesions at contrast material–enhanced magnetic resonance (MR) mammography. MATERIALS AND METHODS: Ethics committee approval and informed consent were obtained. Twenty-six consecutive women (mean age, 47.8 years) suspected of having a breast tumor at mammography and sonography underwent two identical MR examinations at 1.5 T; examinations were separated by more than 48 hours but less than 72 hours. A T1-weighted three-dimensional gradient-echo sequence was used, and images were acquired before and at 0, 2, 4, 6, and 8 minutes after randomized injection of gadopentetate dimeglumine or gadobenate dimeglumine at an identical flow rate of 2 mL/sec. Separate and combined assessment of unenhanced, contrast-enhanced, and subtracted images was performed blindly by two readers in consensus. Acc...

Tubercular epididymitis and orchitis: US patterns

Abstract: For several decades tuberculosis has been adequately under control in this country, but there has been recent concern that this disease might be coming back to the forefront, due to the influx of immigrants from developing countries where tuberculosis is still rampant. In the years to come we are expecting an increase in cases of genitourinary lesions of tubercular origin, a disease which had practically disappeared in the Western world. The aim of this pictorial essay is to provide an outline of the typical US images of tubercular epididymitis and orchitis.

Radial scars of the breast: contrast-enhanced magnetic resonance mammography appearance.

Abstract: The purpose of this study was to evaluate the appearance of contrast-enhanced magnetic resonance mammography (CE-MRM) in patients with suspected radial scar on mammography. Thirty women with radial opacities or black star findings at mammography, preoperatively underwent CE-MRM. Examinations were performed with a 1.5 T magnet with a bilateral surface coil using a FS T2-weighted turbo spin echo (TSE) and three-dimensional (3D) dynamic T1-weighted fast low-angle shot (FLASH) sequences. Criteria for lesion evaluation included morphologic patterns and signal intensity curves. Mammography and CE-MRM findings were compared with pathologic findings. CE-MRM suggested the presence of radial scar in 18 of 30 cases and the presence of malignancy in 11 of 30 cases; 1 lesion was classified as borderline. At surgery 22 radial scars (including 4 with associated ductal carcinoma in situ) and 8 carcinomas were detected. CE-MRM provided a specificity of 89%, sensitivity of 83%, and accuracy of 87%. Differently from breast cancer, radial scars are nonenhancing at CE-MRM. Nevertheless, the possibility of nonenhancing carcinomatous foci existing within radial scars implies that surgical excision should be performed in all cases.

US-Elastography for Breast Lesion Characterization: Prospective Comparison of US BIRADS, Strain Elastography and Shear wave Elastography

Abstract: Purpose To evaluate the diagnostic performance of strain elastography (SE) and 2 D shear wave elastography (SWE) and SE/SWE combination in comparison with conventional multiparametric ultrasound (US) with respect to improving BI-RADS classification results and differentiating benign and malignant breast lesions using a qualitative and quantitative assessment. Materials and Methods In this prospective study, 130 histologically proven breast masses were evaluated with baseline US, color Doppler ultrasound (CDUS), SE and SWE (Toshiba Aplio 500 with a 7–15 MHz wide-band linear transducer). Each lesion was classified according to the BIRADS lexicon by evaluating the size, the B-mode and color Doppler features, the SE qualitative (point color scale) and SE semi-quantitative (strain ratio) methods, and quantitative SWE. Histological results were compared with BIRADS, strain ratio (SR) and shear wave elastography (SWE) all performed by one investigator blinded to the clinical examination and mammographic results at the time of the US examination. The area under the ROC curve (AUC) was calculated to evaluate the diagnostic performance of B-mode US, SE, SWE, and their combination. Results Histological examination revealed 47 benign and 83 malignant breast lesions. The accuracy of SR was statistically significantly higher than SWE (sensitivity, specificity and AUC were 89.2 %, 76.6 % and 0.83 for SR and 72.3 %, 66.0 % and 0.69 for SWE, respectively, p = 0.003) but not higher than B-mode US (B-mode US sensitivity, specificity and AUC were 85.5 %, 78.8 %, 0.821, respectively, p = 1.000). Conclusion Our experience suggests that conventional US in combination with both SE and SWE is a valid tool that can be useful in the clinical setting, can improve BIRADS category assessment and may help in the differentiation of benign from malignant breast lesions, with SE having higher accuracy than SWE.

Intraarterial portography with gadopentetate dimeglumine: improved liver-to-lesion contrast in MR imaging.

Abstract: Magnetic resonance imaging during arterial portography (MRAP) was performed by the authors in a selected group of 12 patients with hepatic lesions. A low dose of gadopentetate dimeglumine (4 mL of a 0.5-mol/L solution, corresponding to a dose of 0.05-0.07 mmol/kg) was injected into the superior mesenteric artery during acquisition of breath-holding gradient-echo or rapid acquisition spin-echo images. Images were always acquired during the first passage of gadopentetate dimeglumine through the liver parenchyma. An increase in liver-to-lesion contrast was obtained with MRAP imaging (contrast-to-noise ratio = 8 +/- 1.8 vs 19 +/- 2.7). Signal intensity enhancement of the liver was high (signal-to-noise ratio = 9.48 +/- 2.42), while the lesion presented no significant enhancement (signal-to-noise ratio = 0.55 +/- 0.22). Lobar portal vein thrombosis was detected in one patient owing to lack of enhancement of the left lobe of the liver. No side effects related to administration of iodinated and paramagnetic cont...

Gadolinium-enhanced MR aortography.

Abstract: Experience in three patients (one each with meningioma, pineal tumor, and prominent jugular bulb) illustrates that magnetic resonance (MR) angiography can benefit from the administration of gadolinium diethylenetriaminepentaacetic acid. Data were acquired with a three-dimensional velocity-compensated (fast imaging with steady-state precession) sequence. MR angiograms were obtained with a ray projection algorithm by using maximum intensity values. Portions of the vascular anatomy--particularly venous structures and smaller arteries--were better portrayed on the postcontrast than on the precontrast angiograms. Enhancing lesions were also seen on the projection images. Enhancement of dura and extracranial tissues (sinus and nasal mucosa) can obscure vascular detail.

Dynamic gadolinium‐enhanced three‐dimensional abdominal MR arteriography

Abstract: The abdominal aorta and renal, visceral, and iliac arteries were evaluated in 16 patients with three-dimensional Fourier transform imaging enhanced with gadopentetate dimeglumine. By imaging dynamically during the arterial phase of a 5-minute injection (0.2 mmol/kg), highly significant (P < .0001) preferential arterial enhancement (signal-to-noise ratio +/- standard deviation, 10 +/- 0.9), with minimal enhancement of the inferior vena cava (5.1 +/- 1.4) or background tissues (fat, 4.3 +/- 0.7; muscle, 2.4 +/- 0.5), was achieved in every patient. In six patients with angiographic and/or surgical correlation, 10 of 10 stenoses and two of two occlusions were correctly identified. No in-plane saturation or pulsatility artifact was identified in any of the 16 patients. In conclusion, dynamic imaging during the injection of gadopentetate dimeglumine is a promising technique for evaluation of the abdominal aorta and branch vessels.

Relaxivity of Gadopentetate Dimeglumine (Magnevist), Gadobutrol (Gadovist), and Gadobenate Dimeglumine (MultiHance) in human blood plasma at 0.2, 1.5, and 3 Tesla.

Abstract: Objectives:We sought to determine the relaxivity and accurate relaxation rates of Gd-DTPA, Gd-BT-DO3A, and Gd-BOPTA at 0.2, 1.5, and 3 T in human blood plasma.Materials and Methods:Contrast media concentrations between 0.01 and 16 mM in human plasma were used for relaxation measurements. The R1 and

Quantitative diffusion-weighted MR imaging in the differential diagnosis of breast lesion

Abstract: The role of diffusion-weighted magnetic resonance imaging (DWI) to differentiate breast lesions in vivo was evaluated. Sixty women (mean age, 53 years) with 81 breast lesions were enrolled. A coronal echo planar imaging (EPI) sequence sensitised to diffusion (b value=1,000 s/mm(2)) was added to standard MR. The mean diffusivity (MD) was calculated. Differences in MD among cysts, benign lesions and malignant lesions were evaluated, and the sensitivity and specificity of DWI to diagnose malignant and benign lesions were calculated. The diagnosis was 18 cysts, 21 benign and 42 malignant nodules. MD values (mean +/- SD x 10(-3) mm(2)/s) were (1.48 +/- 0.37) for benign lesions, (0.95 +/- 0.18) for malignant lesions and (2.25 +/- 0.26) for cysts. Different MD values characterized different malignant breast lesion types. A MD threshold value of 1.1 x 10(-3) mm(2)/s discriminated malignant breast lesions from benign lesions with a specificity of 81% and sensitivity of 80%. Choosing a cut-off of 1.31 x 10(-3) mm(2)/s (MD of malignant lesions -2 SD), the specificity would be 67% with a sensitivity of 100%. Thus, MD values, related to tumor cellularity, provide reliable information to differentiate malignant breast lesions from benign ones. Quantitative DWI is not time-consuming and can be easily inserted into standard clinical breast MR imaging protocols.