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Cristina Nanni - One of the best experts on this subject based on the ideXlab platform.

  • fdg pet ct is useful for the interim evaluation of response to therapy in patients affected by haematogenous spondylodiscitis
    European Journal of Nuclear Medicine and Molecular Imaging, 2012
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Alessandro Gasbarrini, Fabio Tumietto, Francesco Cristini, Luigia Scudeller
    Abstract:

    Purpose Antibiotic therapy in patients affected by discitis is often empirical. Therefore, early evaluation of response to therapy is important. In many patients inflammatory indexes are low during all the phases of the diseases or are altered by concomitant diseases. The aim of the study was to assess the possible role of FDG PET/CT for the early evaluation of response to therapy in patients affected by infective discitis, in comparison to C-reactive protein (CRP) serum levels.

  • fdg pet ct is useful for the interim evaluation of response to therapy in pts affected by Diskitis
    The Journal of Nuclear Medicine, 2012
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Pierluigi Viale, Alessandro Gasbarrini, Barbara Del Pin, Stefano Fanti
    Abstract:

    2137 Objectives The antibiotic therapeutical approach in pts affected by Diskitis is often empiric. Therfore, early evaluation of the response to therapy is important. In many pts inflammatory indexes are low during all the phases of the diseases or altered by concomitant diseases. Aim was to assess the possible role of FDG PET-CT for the early evaluation of the response to therapy in patients affected by infective Diskitis, in comparison to CRP serum level. Methods 34 pts (18F, mean age 64) diagnosed with infective Diskitis were enrolled. 6 had a proved tubercular infection, 1 fungal infection and 27 pyogenic Diskitis. All the pts underwent a baseline FDG PET-CT+CRP and a second exam+CRP 2 to 4 weeks after the therapy beginning. PET results in terms of SUV max1, SUV max2 and deltaSUV max were compared to MR, inflammatory indexes and clinical status during therapy. Results Mean SUV max at diagnosis was 8,6±3,7. Mean CRP at diagnosis was 3,8±3,8. 26 pts showed a clinical progressive response while 8 pts were non responder. SUV1 was not correlated to CRP1 (p=0,7) as well as SUV2 to CRP2 (p=0,4). In responder pts, SUV2 and CRP2 were significantly lower than SUV1 and CRP1 (p 36%. ROC curves for SUV2 showed a sensitivity of 84,6% and specificity of 62,5% with a cut-off≤6,4. ROC curves for delta CRP showed a sensitivity of 82,6% and specificity of 71,4% with a cut-off≤ 96%. ROC curves for CRP2 showed a sensitivity of 73,1% and specificity of 85,7% with a cut-off Conclusions Our results indicate that delta SUV max provides the higher specificity for identifying responder pts. SUV max2 and CRP2 provide high and comparable sensitivities. This may help the clinician to guide the antibiotic therapy, especially in case of an empiric line

  • fdg pet ct is useful for the early evaluation of response to therapy in patients affected by Diskitis
    The Journal of Nuclear Medicine, 2011
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Vincenzo Allegri, Pierluigi Viale, Stefano Boriani, Stefano Fanti
    Abstract:

    1375 Objectives Aim was to assess the possible role of FDG PET-CT for the early evaluation of the response to therapy in patients affected by infective Diskitis. Methods 12 pts(4F,8M; mean age 68yo, range 31-85) with infective Diskitis were enrolled. 2had a proved tubercular infection, 3 had a pyogenic Diskitis and 7 were diagnosed on the basis of MR, symptoms, inflammatory indexes and risk factors (non-diagnostic cultural exam). All the patients underwent a baseline FDG PET-CT and a second exam 2to4 wks after the therapy onset. Non responder patients at PET underwent a change in therapy and repeated the scan 2to4 wks after the new therapy onset. The PET results were compared to MR, inflammatory indexes and clinical status during the follow up (mean 6months). Results Mean SUVmax at diagnosis was 7.3(min 4.1; max 12.3). 9 pts showed a significant reduction in SUVmax while 3 were non responder(SUVmax stable or increased). After change in therapy, all non responder patients showed a significant decrease in SUVmax, comparable with responders(Tab1). All the pts showed a persistent clinical complete response at follow-up. Conclusions Our preliminary results indicate that FDG PET-CT is able to show an early response to therapy in patients affected by Diskitis, anticipating a clinical complete response. This may help the clinician to guide the antibiotic therapy,especially in case of an empiric line and in case of negative inflammatory indexes at diagnosis

Stefano Fanti - One of the best experts on this subject based on the ideXlab platform.

  • fdg pet ct is useful for the interim evaluation of response to therapy in pts affected by Diskitis
    The Journal of Nuclear Medicine, 2012
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Pierluigi Viale, Alessandro Gasbarrini, Barbara Del Pin, Stefano Fanti
    Abstract:

    2137 Objectives The antibiotic therapeutical approach in pts affected by Diskitis is often empiric. Therfore, early evaluation of the response to therapy is important. In many pts inflammatory indexes are low during all the phases of the diseases or altered by concomitant diseases. Aim was to assess the possible role of FDG PET-CT for the early evaluation of the response to therapy in patients affected by infective Diskitis, in comparison to CRP serum level. Methods 34 pts (18F, mean age 64) diagnosed with infective Diskitis were enrolled. 6 had a proved tubercular infection, 1 fungal infection and 27 pyogenic Diskitis. All the pts underwent a baseline FDG PET-CT+CRP and a second exam+CRP 2 to 4 weeks after the therapy beginning. PET results in terms of SUV max1, SUV max2 and deltaSUV max were compared to MR, inflammatory indexes and clinical status during therapy. Results Mean SUV max at diagnosis was 8,6±3,7. Mean CRP at diagnosis was 3,8±3,8. 26 pts showed a clinical progressive response while 8 pts were non responder. SUV1 was not correlated to CRP1 (p=0,7) as well as SUV2 to CRP2 (p=0,4). In responder pts, SUV2 and CRP2 were significantly lower than SUV1 and CRP1 (p 36%. ROC curves for SUV2 showed a sensitivity of 84,6% and specificity of 62,5% with a cut-off≤6,4. ROC curves for delta CRP showed a sensitivity of 82,6% and specificity of 71,4% with a cut-off≤ 96%. ROC curves for CRP2 showed a sensitivity of 73,1% and specificity of 85,7% with a cut-off Conclusions Our results indicate that delta SUV max provides the higher specificity for identifying responder pts. SUV max2 and CRP2 provide high and comparable sensitivities. This may help the clinician to guide the antibiotic therapy, especially in case of an empiric line

  • fdg pet ct is useful for the early evaluation of response to therapy in patients affected by Diskitis
    The Journal of Nuclear Medicine, 2011
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Vincenzo Allegri, Pierluigi Viale, Stefano Boriani, Stefano Fanti
    Abstract:

    1375 Objectives Aim was to assess the possible role of FDG PET-CT for the early evaluation of the response to therapy in patients affected by infective Diskitis. Methods 12 pts(4F,8M; mean age 68yo, range 31-85) with infective Diskitis were enrolled. 2had a proved tubercular infection, 3 had a pyogenic Diskitis and 7 were diagnosed on the basis of MR, symptoms, inflammatory indexes and risk factors (non-diagnostic cultural exam). All the patients underwent a baseline FDG PET-CT and a second exam 2to4 wks after the therapy onset. Non responder patients at PET underwent a change in therapy and repeated the scan 2to4 wks after the new therapy onset. The PET results were compared to MR, inflammatory indexes and clinical status during the follow up (mean 6months). Results Mean SUVmax at diagnosis was 7.3(min 4.1; max 12.3). 9 pts showed a significant reduction in SUVmax while 3 were non responder(SUVmax stable or increased). After change in therapy, all non responder patients showed a significant decrease in SUVmax, comparable with responders(Tab1). All the pts showed a persistent clinical complete response at follow-up. Conclusions Our preliminary results indicate that FDG PET-CT is able to show an early response to therapy in patients affected by Diskitis, anticipating a clinical complete response. This may help the clinician to guide the antibiotic therapy,especially in case of an empiric line and in case of negative inflammatory indexes at diagnosis

Connie Y Chang - One of the best experts on this subject based on the ideXlab platform.

  • best practices ct guided percutaneous sampling of vertebral discitis osteomyelitis and technical factors maximizing biopsy yield
    American Journal of Roentgenology, 2020
    Co-Authors: Jad S. Husseini, Sandra B Nelson, Sina Habibollahi, Daniel I Rosenthal, Connie Y Chang
    Abstract:

    Vertebral discitis-osteomyelitis is an infection of the intervertebral disc and vertebral bodies that may extend to adjacent paraspinal and epidural soft tissues. Its incidence is increasing, likely from improved treatments for predisposing chronic disease and increased rates of IV drug use and intravascular intervention. Because blood cultures are frequently negative in patients with vertebral discitis-osteomyelitis, biopsy is often indicated to identify a causative microorganism for targeted antimicrobial therapy. The reported yield of CT-guided percutaneous sampling is 31% to 91%, lower than the reported yield of open biopsy of 76% to 91%. However, the less invasive approach may be favored given its relative safety and low cost. If paravertebral fluid collections are present, CT-guided aspiration should be performed. If aspiration is unsuccessful or no paravertebral fluid collections are present, CT-guided percutaneous biopsy should be performed, considering technical factors (e.g., anatomic approach, needle selection, and needle angulation) that may improve microbiologic yield. Although antimicrobial therapy should be held for 1-2 weeks before biopsy if clinically feasible, biopsy may still be performed without holding antimicrobial therapy if needed. Because of the importance of targeted antimicrobial therapy, repeat biopsy should be considered after 72 hours if initial biopsy does not identify a pathogen.

  • CT-guided discitis-osteomyelitis biopsies: needle gauge and microbiology results
    Skeletal Radiology, 2020
    Co-Authors: Jad S. Husseini, F. Joseph Simeone, Sandra B Nelson, Connie Y Chang
    Abstract:

    Purpose To compare the microbiology results and needle gauge for CT-guided biopsies of suspected discitis-osteomyelitis. Methods All CT-guided biopsies performed for suspected discitis-osteomyelitis at our institution between 2002 and 2019 were reviewed. Biopsy location, needle type and gauge, microbiology, pathology, and clinical and imaging follow-up were obtained through chart review. Yield, sensitivity, specificity, and accuracy were calculated. A pairwise analysis of different needle gauges was also performed with calculations of odds ratios. Naïve Bayes predictive modeling was performed. Results 241 (age: 59 ± 18 years; 88 [35%] F, 162 [65%] M) biopsies were performed. There were 3 (1%) 11 gauge (G), and 13 (5%) 12-G biopsies; 23 (10%) 13-G biopsies; 75 (31%) 14-G biopsies; and 90 (37%) 16-G, 33 (14%) 18-G, and 4 (2%) 20 G biopsies. True disease status (presence of infection) was determined via either pathology findings (205, 86%) or clinical and imaging follow-up (36, 14%). The most common true positive pathogen was Staphylococcus aureus (31, 33%). Overall biopsy yield, sensitivity, specificity, and accuracy were 39%, 56%, 89%, and 66%, respectively. Pooled biopsy yield, sensitivity, specificity, and accuracy was 56%, 69%, 71%, and 69% for 11–13-G needles and 36%, 53%, 91%, and 65% for 14–20-G needles, respectively, with an odds ratio between the two groups of 2.29 ( P  = 0.021). Pooled biopsy yield, sensitivity, specificity, and accuracy was 48%, 63%, 85%, and 68% for 11–14-G needles and 32%, 49%, 91%, and 64% for 16–20-G needles, respectively, with an odds ratio between the two groups of 2.02 ( P  = 0.0086). Conclusion The use of a larger inner bore diameter/lower gauge biopsy needle may increase the likelihood of culturing the causative microorganism for CT-guided biopsies of discitis-osteomyelitis.

  • is biopsying the paravertebral soft tissue as effective as biopsying the disk or vertebral endplate 10 year retrospective review of ct guided biopsy of Diskitis osteomyelitis
    American Journal of Roentgenology, 2015
    Co-Authors: Connie Y Chang, Sandra B Nelson, Joseph F Simeone, Atul K Taneja, Ambrose J Huang
    Abstract:

    OBJECTIVE. The purpose of this study was to determine whether there is a difference in biopsying bone (endplate), disk, or paravertebral soft tissue to culture the pathogenic organism causing Diskitis-osteomyelitis. MATERIALS AND METHODS. A retrospective review was conducted of 111 spinal biopsies performed between 2002 and 2011. Pathologic examination was used as the reference standard for detecting Diskitis-osteomyelitis. Microbiologic yield, sensitivity, and specificity were calculated. The yields for different groups were compared by use of Fisher exact test. The analysis was repeated with biopsy samples from patients not being treated with antibiotics at the time of biopsy. RESULTS. A total of 122 biopsy specimens were obtained from 111 spinal biopsy procedures on 102 patients. Overall, 27 (22%) biopsies were performed on the endplate-disk, 61 (50%) on the disk only, and 34 (28%) on paravertebral soft tissue only. The microbiologic yield was 36% for all biopsies, 19% for endplate-disk biopsies, 39% f...

Giada Rorato - One of the best experts on this subject based on the ideXlab platform.

  • fdg pet ct is useful for the interim evaluation of response to therapy in patients affected by haematogenous spondylodiscitis
    European Journal of Nuclear Medicine and Molecular Imaging, 2012
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Alessandro Gasbarrini, Fabio Tumietto, Francesco Cristini, Luigia Scudeller
    Abstract:

    Purpose Antibiotic therapy in patients affected by discitis is often empirical. Therefore, early evaluation of response to therapy is important. In many patients inflammatory indexes are low during all the phases of the diseases or are altered by concomitant diseases. The aim of the study was to assess the possible role of FDG PET/CT for the early evaluation of response to therapy in patients affected by infective discitis, in comparison to C-reactive protein (CRP) serum levels.

  • fdg pet ct is useful for the interim evaluation of response to therapy in pts affected by Diskitis
    The Journal of Nuclear Medicine, 2012
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Pierluigi Viale, Alessandro Gasbarrini, Barbara Del Pin, Stefano Fanti
    Abstract:

    2137 Objectives The antibiotic therapeutical approach in pts affected by Diskitis is often empiric. Therfore, early evaluation of the response to therapy is important. In many pts inflammatory indexes are low during all the phases of the diseases or altered by concomitant diseases. Aim was to assess the possible role of FDG PET-CT for the early evaluation of the response to therapy in patients affected by infective Diskitis, in comparison to CRP serum level. Methods 34 pts (18F, mean age 64) diagnosed with infective Diskitis were enrolled. 6 had a proved tubercular infection, 1 fungal infection and 27 pyogenic Diskitis. All the pts underwent a baseline FDG PET-CT+CRP and a second exam+CRP 2 to 4 weeks after the therapy beginning. PET results in terms of SUV max1, SUV max2 and deltaSUV max were compared to MR, inflammatory indexes and clinical status during therapy. Results Mean SUV max at diagnosis was 8,6±3,7. Mean CRP at diagnosis was 3,8±3,8. 26 pts showed a clinical progressive response while 8 pts were non responder. SUV1 was not correlated to CRP1 (p=0,7) as well as SUV2 to CRP2 (p=0,4). In responder pts, SUV2 and CRP2 were significantly lower than SUV1 and CRP1 (p 36%. ROC curves for SUV2 showed a sensitivity of 84,6% and specificity of 62,5% with a cut-off≤6,4. ROC curves for delta CRP showed a sensitivity of 82,6% and specificity of 71,4% with a cut-off≤ 96%. ROC curves for CRP2 showed a sensitivity of 73,1% and specificity of 85,7% with a cut-off Conclusions Our results indicate that delta SUV max provides the higher specificity for identifying responder pts. SUV max2 and CRP2 provide high and comparable sensitivities. This may help the clinician to guide the antibiotic therapy, especially in case of an empiric line

  • fdg pet ct is useful for the early evaluation of response to therapy in patients affected by Diskitis
    The Journal of Nuclear Medicine, 2011
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Vincenzo Allegri, Pierluigi Viale, Stefano Boriani, Stefano Fanti
    Abstract:

    1375 Objectives Aim was to assess the possible role of FDG PET-CT for the early evaluation of the response to therapy in patients affected by infective Diskitis. Methods 12 pts(4F,8M; mean age 68yo, range 31-85) with infective Diskitis were enrolled. 2had a proved tubercular infection, 3 had a pyogenic Diskitis and 7 were diagnosed on the basis of MR, symptoms, inflammatory indexes and risk factors (non-diagnostic cultural exam). All the patients underwent a baseline FDG PET-CT and a second exam 2to4 wks after the therapy onset. Non responder patients at PET underwent a change in therapy and repeated the scan 2to4 wks after the new therapy onset. The PET results were compared to MR, inflammatory indexes and clinical status during the follow up (mean 6months). Results Mean SUVmax at diagnosis was 7.3(min 4.1; max 12.3). 9 pts showed a significant reduction in SUVmax while 3 were non responder(SUVmax stable or increased). After change in therapy, all non responder patients showed a significant decrease in SUVmax, comparable with responders(Tab1). All the pts showed a persistent clinical complete response at follow-up. Conclusions Our preliminary results indicate that FDG PET-CT is able to show an early response to therapy in patients affected by Diskitis, anticipating a clinical complete response. This may help the clinician to guide the antibiotic therapy,especially in case of an empiric line and in case of negative inflammatory indexes at diagnosis

Valentina Ambrosini - One of the best experts on this subject based on the ideXlab platform.

  • fdg pet ct is useful for the interim evaluation of response to therapy in patients affected by haematogenous spondylodiscitis
    European Journal of Nuclear Medicine and Molecular Imaging, 2012
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Alessandro Gasbarrini, Fabio Tumietto, Francesco Cristini, Luigia Scudeller
    Abstract:

    Purpose Antibiotic therapy in patients affected by discitis is often empirical. Therefore, early evaluation of response to therapy is important. In many patients inflammatory indexes are low during all the phases of the diseases or are altered by concomitant diseases. The aim of the study was to assess the possible role of FDG PET/CT for the early evaluation of response to therapy in patients affected by infective discitis, in comparison to C-reactive protein (CRP) serum levels.

  • fdg pet ct is useful for the interim evaluation of response to therapy in pts affected by Diskitis
    The Journal of Nuclear Medicine, 2012
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Pierluigi Viale, Alessandro Gasbarrini, Barbara Del Pin, Stefano Fanti
    Abstract:

    2137 Objectives The antibiotic therapeutical approach in pts affected by Diskitis is often empiric. Therfore, early evaluation of the response to therapy is important. In many pts inflammatory indexes are low during all the phases of the diseases or altered by concomitant diseases. Aim was to assess the possible role of FDG PET-CT for the early evaluation of the response to therapy in patients affected by infective Diskitis, in comparison to CRP serum level. Methods 34 pts (18F, mean age 64) diagnosed with infective Diskitis were enrolled. 6 had a proved tubercular infection, 1 fungal infection and 27 pyogenic Diskitis. All the pts underwent a baseline FDG PET-CT+CRP and a second exam+CRP 2 to 4 weeks after the therapy beginning. PET results in terms of SUV max1, SUV max2 and deltaSUV max were compared to MR, inflammatory indexes and clinical status during therapy. Results Mean SUV max at diagnosis was 8,6±3,7. Mean CRP at diagnosis was 3,8±3,8. 26 pts showed a clinical progressive response while 8 pts were non responder. SUV1 was not correlated to CRP1 (p=0,7) as well as SUV2 to CRP2 (p=0,4). In responder pts, SUV2 and CRP2 were significantly lower than SUV1 and CRP1 (p 36%. ROC curves for SUV2 showed a sensitivity of 84,6% and specificity of 62,5% with a cut-off≤6,4. ROC curves for delta CRP showed a sensitivity of 82,6% and specificity of 71,4% with a cut-off≤ 96%. ROC curves for CRP2 showed a sensitivity of 73,1% and specificity of 85,7% with a cut-off Conclusions Our results indicate that delta SUV max provides the higher specificity for identifying responder pts. SUV max2 and CRP2 provide high and comparable sensitivities. This may help the clinician to guide the antibiotic therapy, especially in case of an empiric line

  • fdg pet ct is useful for the early evaluation of response to therapy in patients affected by Diskitis
    The Journal of Nuclear Medicine, 2011
    Co-Authors: Cristina Nanni, Luca Boriani, Eleonora Zamparini, Giada Rorato, Caterina Salvadori, Valentina Ambrosini, Vincenzo Allegri, Pierluigi Viale, Stefano Boriani, Stefano Fanti
    Abstract:

    1375 Objectives Aim was to assess the possible role of FDG PET-CT for the early evaluation of the response to therapy in patients affected by infective Diskitis. Methods 12 pts(4F,8M; mean age 68yo, range 31-85) with infective Diskitis were enrolled. 2had a proved tubercular infection, 3 had a pyogenic Diskitis and 7 were diagnosed on the basis of MR, symptoms, inflammatory indexes and risk factors (non-diagnostic cultural exam). All the patients underwent a baseline FDG PET-CT and a second exam 2to4 wks after the therapy onset. Non responder patients at PET underwent a change in therapy and repeated the scan 2to4 wks after the new therapy onset. The PET results were compared to MR, inflammatory indexes and clinical status during the follow up (mean 6months). Results Mean SUVmax at diagnosis was 7.3(min 4.1; max 12.3). 9 pts showed a significant reduction in SUVmax while 3 were non responder(SUVmax stable or increased). After change in therapy, all non responder patients showed a significant decrease in SUVmax, comparable with responders(Tab1). All the pts showed a persistent clinical complete response at follow-up. Conclusions Our preliminary results indicate that FDG PET-CT is able to show an early response to therapy in patients affected by Diskitis, anticipating a clinical complete response. This may help the clinician to guide the antibiotic therapy,especially in case of an empiric line and in case of negative inflammatory indexes at diagnosis