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Article ; Online: Hydrogel drug delivery systems for minimally invasive local immunotherapy of cancer.

Mikhail, Andrew S / Morhard, Robert / Mauda-Havakuk, Michal / Kassin, Michael / Arrichiello, Antonio / Wood, Bradford J

2023 Volume 202, Page(s) 115083

Abstract: Although systemic immunotherapy has achieved durable responses and improved survival for certain patients and cancer types, low response rates and immune system-related systemic toxicities limit its overall impact. Intratumoral (intralesional) delivery ... ...

Abstract	Although systemic immunotherapy has achieved durable responses and improved survival for certain patients and cancer types, low response rates and immune system-related systemic toxicities limit its overall impact. Intratumoral (intralesional) delivery of immunotherapy is a promising technique to combat mechanisms of tumor immune suppression within the tumor microenvironment and reduce systemic drug exposure and associated side effects. However, intratumoral injections are prone to variable tumor drug distribution and leakage into surrounding tissues, which can compromise efficacy and contribute to toxicity. Controlled release drug delivery systems such as in situ-forming hydrogels are promising vehicles for addressing these challenges by providing improved spatio-temporal control of locally administered immunotherapies with the goal of promoting systemic tumor-specific immune responses and abscopal effects. In this review we will discuss concepts, applications, and challenges in local delivery of immunotherapy using controlled release drug delivery systems with a focus on intratumorally injected hydrogel-based drug carriers.
MeSH term(s)	Humans ; Delayed-Action Preparations ; Hydrogels ; Drug Delivery Systems ; Neoplasms/drug therapy ; Immunotherapy/methods ; Tumor Microenvironment
Chemical Substances	Delayed-Action Preparations ; Hydrogels
Language	English
Publishing date	2023-09-09
Publishing country	Netherlands
Document type	Journal Article ; Review ; Research Support, N.I.H., Intramural
ZDB-ID	639113-8
ISSN	1872-8294 ; 0169-409X
ISSN (online)	1872-8294
ISSN	0169-409X
DOI	10.1016/j.addr.2023.115083
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Article ; Online: Providing optimal interventional oncology procedures at one of the COVID-19 referral center in Italy.

Pesapane, Filippo / Ierardi, Anna Maria / Arrichiello, Antonio / Carrafiello, Gianpaolo

Medical oncology (Northwood, London, England)

2020 Volume 37, Issue 9, Page(s) 83

Abstract: The COVID-19 pandemic has deeply impacted the activity of interventional oncology in cancer centers. Since the first COVID case was diagnosed in Italy on February 21st, our Hospital, located in Milan downtown, has been at the frontline to manage this ... ...

Abstract	The COVID-19 pandemic has deeply impacted the activity of interventional oncology in cancer centers. Since the first COVID case was diagnosed in Italy on February 21st, our Hospital, located in Milan downtown, has been at the frontline to manage this emergency and to try to ensure essential services. In the present article, we discuss the changes that need to be done for the organization, safety, and patient management in interventional oncology.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Health Personnel/standards ; Humans ; Italy/epidemiology ; Medical Oncology/methods ; Medical Oncology/standards ; Neoplasms/epidemiology ; Neoplasms/therapy ; Pandemics ; Personal Protective Equipment/standards ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; SARS-CoV-2 ; Tertiary Care Centers/standards ; Workflow
Keywords	covid19
Language	English
Publishing date	2020-08-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1201189-7
ISSN	1559-131X ; 0736-0118 ; 1357-0560
ISSN (online)	1559-131X
ISSN	0736-0118 ; 1357-0560
DOI	10.1007/s12032-020-01405-6
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Zs.A 1899: Show issues

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Article: Lifesaving embolization in a massive lumbar artery bleeding: Interventional radiology management.

Di Meglio, Letizia / Rodà, Giovanni Maria / Arrichiello, Antonio / Gurgitano, Martina / Carrafiello, Gianpaolo / Angileri, Salvatore Alessio

Radiology case reports

2021 Volume 16, Issue 10, Page(s) 3113–3116

Abstract: Vertebral fractures are the most frequent fractures associated with osteoporosis. Thus far, there are no reported cases in literature analyzing intervertebral bleeding as a result of an osteoporotic vertebral fracture. The authors report a case of an 85- ... ...

Abstract	Vertebral fractures are the most frequent fractures associated with osteoporosis. Thus far, there are no reported cases in literature analyzing intervertebral bleeding as a result of an osteoporotic vertebral fracture. The authors report a case of an 85-year-old woman in hemorrhagic shock for an unusual vertebral fracture causing a massive bleeding, which was contained by the vertebral ligament system inside the body of L4, treated with an endovascular approach. Since there are no guidelines for a treatment for the case mentioned above or similar, our aim is to describe a possible approach to a potentially life-threatening rare event.
Language	English
Publishing date	2021-08-16
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2021.07.022
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Article: X-ray imageable, drug-loaded hydrogel that forms at body temperature for image-guided, needle- based locoregional drug delivery.

Delgado, Jose F / Pritchard, William F / Varble, Nicole / Lopez-Silva, Tania L / Arrichiello, Antonio / Mikhail, Andrew S / Morhard, Robert / Ray, Trisha / Havakuk, Michal M / Nguyen, Alex / Borde, Tabea / Owen, Joshua W / Schneider, Joel P / Karanian, John W / Wood, Bradford J

Research square

2024

Abstract: Liver cancer ranks as the fifth leading cause of cancer-related death globally. Direct intratumoral injections of anti-cancer therapeutics may improve therapeutic efficacy and mitigate adverse effects compared to intravenous injections. Some challenges ... ...

Abstract	Liver cancer ranks as the fifth leading cause of cancer-related death globally. Direct intratumoral injections of anti-cancer therapeutics may improve therapeutic efficacy and mitigate adverse effects compared to intravenous injections. Some challenges of intratumoral injections are that the liquid drug formulation may not remain localized and have unpredictable volumetric distribution. Thus, drug delivery varies widely, highly-dependent upon technique. An x-ray imageable poloxamer 407 (POL)-based drug delivery gel was developed and characterized, enabling real-time feedback. Utilizing three needle devices, POL or a control iodinated contrast solution were injected into an ex vivo bovine liver. The 3D distribution was assessed with cone beam computed tomography (CBCT). The 3D distribution of POL gels demonstrated localized spherical morphologies regardless of the injection rate. In addition, the gel 3D conformal distribution could be intentionally altered, depending on the injection technique. When doxorubicin (DOX) was loaded into the POL and injected, DOX distribution on optical imaging matched iodine distribution on CBCT suggesting spatial alignment of DOX and iodine localization in tissue. The controllability and localized deposition of this formulation may ultimately reduce the dependence on operator technique, reduce systemic side effects, and facilitate reproducibility across treatments, through more predictable standardized delivery.
Language	English
Publishing date	2024-03-06
Publishing country	United States
Document type	Preprint
DOI	10.21203/rs.3.rs-4003679/v1
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Article ; Online: Bedside vascular access procedures for COVID-19 patients.

Arrichiello, Antonio / Angileri, Salvatore Alessio / Ierardi, Anna Maria / Di Meglio, Letizia / Carrafiello, Gianpaolo

The journal of vascular access

2020 Volume 22, Issue 4, Page(s) 654–657

Abstract: This report aims to illustrate how to perform a venous access to a COVID-19 patient at the bedside. The decision on the type of venous access, the selection of the material necessary to perform the procedure, and the preparation of the operators are ... ...

Abstract	This report aims to illustrate how to perform a venous access to a COVID-19 patient at the bedside. The decision on the type of venous access, the selection of the material necessary to perform the procedure, and the preparation of the operators are described. The described approach can reduce costs, speed up execution times, and make the operator's work safer. Furthermore, these precautions may help control the spread of COVID-19 within the healthcare facility.
MeSH term(s)	COVID-19/diagnosis ; COVID-19/epidemiology ; Catheterization, Central Venous/methods ; Central Venous Catheters ; Humans ; Pandemics ; Point-of-Care Testing ; Radiography, Interventional/methods ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-08-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2252820-9
ISSN	1724-6032 ; 1129-7298
ISSN (online)	1724-6032
ISSN	1129-7298
DOI	10.1177/1129729820951000
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Article ; Online: Glue embolization of a pial arteriovenous fistula of the spinal artery.

Doniselli, Fabio Martino / Paolucci, Aldo / Conte, Giorgio / Rampini, Paolo / Arrichiello, Antonio / Triulzi, Fabio Maria

Acta bio-medica : Atenei Parmensis

2020 Volume 91, Issue 10-S, Page(s) e2020004

Abstract: There are no clear guidelines about the treatment Pial Arteriovenous Fistulae (PAVF). For high-risk and severally symptomatic fistulae surgery is the first choice of treatment, including feeding artery ligation, surgical resection, radiosurgery and ... ...

Abstract	There are no clear guidelines about the treatment Pial Arteriovenous Fistulae (PAVF). For high-risk and severally symptomatic fistulae surgery is the first choice of treatment, including feeding artery ligation, surgical resection, radiosurgery and endovascular embolization techniques. We described a case of a patient with a symptomatic PAVF at the craniocervical junction fed by the anterior spinal artery, successfully treated with endovascular approach consisting of glue embolization of the feeding vessel.
MeSH term(s)	Arteries ; Arteriovenous Fistula/diagnostic imaging ; Arteriovenous Fistula/therapy ; Embolization, Therapeutic ; Endovascular Procedures ; Humans ; Treatment Outcome
Language	English
Publishing date	2020-09-23
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v91i10-S.10282
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Article ; Online: Smartphone Augmented Reality Outperforms Conventional CT Guidance for Composite Ablation Margins in Phantom Models.

Lee, Katerina H / Li, Ming / Varble, Nicole / Negussie, Ayele H / Kassin, Michael T / Arrichiello, Antonio / Carrafiello, Gianpaolo / Hazen, Lindsey A / Wakim, Paul G / Li, Xiaobai / Xu, Sheng / Wood, Bradford J

Journal of vascular and interventional radiology : JVIR

2023 Volume 35, Issue 3, Page(s) 452–461.e3

Abstract: Purpose: To develop and evaluate a smartphone augmented reality (AR) system for a large 50-mm liver tumor ablation with treatment planning for composite overlapping ablation zones.: Materials and methods: A smartphone AR application was developed to ... ...

Abstract	Purpose: To develop and evaluate a smartphone augmented reality (AR) system for a large 50-mm liver tumor ablation with treatment planning for composite overlapping ablation zones. Materials and methods: A smartphone AR application was developed to display tumor, probe, projected probe paths, ablated zones, and real-time percentage of the ablated target tumor volume. Fiducial markers were attached to phantoms and an ablation probe hub for tracking. The system was evaluated with tissue-mimicking thermochromic phantoms and gel phantoms. Four interventional radiologists performed 2 trials each of 3 probe insertions per trial using AR guidance versus computed tomography (CT) guidance approaches in 2 gel phantoms. Insertion points and optimal probe paths were predetermined. On Gel Phantom 2, serial ablated zones were saved and continuously displayed after each probe placement/adjustment, enabling feedback and iterative planning. The percentages of tumor ablated for AR guidance versus CT guidance, and with versus without display of recorded ablated zones, were compared among interventional radiologists with pairwise t-tests. Results: The means of percentages of tumor ablated for CT freehand and AR guidance were 36% ± 7 and 47% ± 4 (P = .004), respectively. The mean composite percentages of tumor ablated for AR guidance were 43% ± 1 (without) and 50% ± 2 (with display of ablation zone) (P = .033). There was no strong correlation between AR-guided percentage of ablation and years of experience (r < 0.5), whereas there was a strong correlation between CT-guided percentage of ablation and years of experience (r > 0.9). Conclusions: A smartphone AR guidance system for dynamic iterative large liver tumor ablation was accurate, performed better than conventional CT guidance, especially for less experienced interventional radiologists, and enhanced more standardized performance across experience levels for ablation of a 50-mm tumor.
MeSH term(s)	Humans ; Augmented Reality ; Smartphone ; Tomography, X-Ray Computed/methods ; Surgery, Computer-Assisted ; Phantoms, Imaging ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/surgery
Language	English
Publishing date	2023-10-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1137756-2
ISSN	1535-7732 ; 1051-0443
ISSN (online)	1535-7732
ISSN	1051-0443
DOI	10.1016/j.jvir.2023.10.005
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Article ; Online: Virtual Treatment Zone From Cone Beam CT Commonly Alters Treatment Plan and Identifies Tumor at Risk for Under-Treatment in US or US Fusion-Guided Microwave Ablation of Liver Tumors.

Arrichiello, Antonio / Ierardi, Anna Maria / Caruso, Alessandro / Grillo, Pasquale / Di Meglio, Letizia / Biondetti, Pierpaolo / Iavarone, Massimo / Sangiovanni, Angelo / Angileri, Salvatore Alessio / Floridi, Chiara / Wood, Bradford / Carrafiello, Gianpaolo

Technology in cancer research & treatment

2023 Volume 22, Page(s) 15330338231181284

Abstract: Tumor ablation is included in several major cancer therapy guidelines. One technical challenge of percutaneous ablation is targeting and verification of complete treatment, which is prone to operator variabilities and human imperfections and are directly ...

Abstract	Tumor ablation is included in several major cancer therapy guidelines. One technical challenge of percutaneous ablation is targeting and verification of complete treatment, which is prone to operator variabilities and human imperfections and are directly related to successful outcomes, risk for residual unablated tumor and local progression. The use of "Prediction Ablation Volume Software" may help the operating Interventional Radiologist to better plan, deliver, and verify before the ablation, via virtual treatment zones fused to target tumor. Fused and superimposed images provide 3-dimensional information from different timepoints, just when that information is most useful. The aim of this study is to evaluate the technical success and efficacy of an ablation treatment flowchart provided by a cone beam computed tomography (CBCT) "Prediction Ablation Volume Software." This is a single-center retrospective study. From April 2021 to January 2022, 29 nonconsecutive evaluable patients with 32 lesions underwent liver ablation with Prediction Ablation Volume Software. Each patient was discussed in a multidisciplinary tumor board and underwent an enhanced computed tomography or magnetic resonance imaging approximately 1 month before the procedure, as well as ∼1 month after. Technical success was defined as treatment of the tumor according to the protocol, covered completely by the Prediction Ablation Volume. Technical efficacy was defined as assessment of complete ablation of the target tumor at imaging follow up (∼1 month). Technical success, technical efficacy, and procedural factors were studied. Technical success was achieved in 30 of 32 liver lesions (94%), measuring 20 mm mean maximum diameter. The antenna was repositioned in 16 of 30 (53%) evaluable target lesions. Residual tumor was detected at 1 month imaging follow up in only 4 of 30 (13%) of the treated lesion. Technical efficacy was of 87% in this retrospective description of our process. The implementation of a CBCT Prediction Ablation Volume Software and flowchart for the treatment of liver malignancies altered the procedure, and demonstrated high technical success and efficacy. Such tools are potentially useful for procedural prediction and verification of ablation.
MeSH term(s)	Humans ; Retrospective Studies ; Microwaves/therapeutic use ; Treatment Outcome ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/radiotherapy ; Liver Neoplasms/surgery ; Cone-Beam Computed Tomography/methods ; Catheter Ablation/methods
Language	English
Publishing date	2023-08-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2146365-7
ISSN	1533-0338 ; 1533-0346
ISSN (online)	1533-0338
ISSN	1533-0346
DOI	10.1177/15330338231181284
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Article ; Online: Corrigendum to 'Arterial Embolization and Second-Look in Spindle Cell Oncocytoma of the Pituitary Gland: Case Report and Review of Literature' [World Neurosurgery 142 (2020) 87-92].

Tariciotti, Leonardo / Arrichiello, Antonio / Fiore, Giorgio / Bertani, Giulio / Conte, Giorgio / Paolucci, Aldo / Ferrante, Emanuele / Mantovani, Giovanna / Locatelli, Marco

World neurosurgery

2021 Volume 148, Page(s) 269

Language	English
Publishing date	2021-01-23
Publishing country	United States
Document type	Published Erratum
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.12.156
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Article: Stereotactic body radiotherapy with CyberKnife

Borzillo, Valentina / Scipilliti, Esmeralda / Pezzulla, Donato / Serra, Marcello / Ametrano, Gianluca / Quarto, Giuseppe / Perdonà, Sisto / Rossetti, Sabrina / Pignata, Sandro / Crispo, Anna / Di Gennaro, Piergiacomo / D'Alesio, Valentina / Arrichiello, Cecilia / Buonanno, Francesca / Mercogliano, Simona / Russo, Antonio / Tufano, Antonio / Di Franco, Rossella / Muto, Paolo

Frontiers in oncology

2023 Volume 13, Page(s) 1270498

Abstract: Simple summary: Stereotactic body radiotherapy (SBRT) of 35-36.25 Gy in five fractions with the CyberKnife System yields excellent control with low toxicity in low-intermediate-risk prostate cancer patients. We found no differences in biochemical ... ...

Abstract	Simple summary: Stereotactic body radiotherapy (SBRT) of 35-36.25 Gy in five fractions with the CyberKnife System yields excellent control with low toxicity in low-intermediate-risk prostate cancer patients. We found no differences in biochemical control and overall survival in relation to dose. There were no significant differences in toxicity or quality of life between the two groups. Aims: Stereotactic body radiotherapy (SBRT) is an emerging therapeutic approach for low- and intermediate-risk prostate cancer. We present retrospective data on biochemical control, toxicity, and quality of life of CyPro Trial. Materials and methods: A total of 122 patients with low- and intermediate-risk prostate cancer were treated with the CyberKnife System at a dose of 35 Gy or 36.25 Gy in five fractions. Biochemical failure (BF)/biochemical disease-free survival (bDFS) was defined using the Phoenix method (nadir + 2 ng/ml). Acute/late rectal and urinary toxicities were assessed by the Radiation Therapy Oncology Group (RTOG) toxicity scale. Quality of life (QoL) was assessed by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C30 and PR25. International Erectile Function Index-5 (IIEF5) and International Prostate Symptom Score (IPSS) questionnaires were administered at baseline, every 3 months after treatment during the first years, and then at 24 months and 36 months. Results: The 1-, 2-, and 5-year DFS rates were 92.9%, 92.9%, and 92.3%, respectively, while the 1-, 2-, and 5-year bDFS rates were 100%, 100%, and 95.7%, respectively. With regard to risk groups or doses, no statistically significant differences were found in terms of DFS or bDFS. Grade 2 urinary toxicity was acute in 10% and delayed in 2% of patients. No Grade 3 acute and late urinary toxicity was observed. Grade 2 rectal toxicity was acute in 8% and late in 1% of patients. No Grade 3-4 acute and late rectal toxicity was observed. Grade 2 acute toxicity appeared higher in the high-dose group (20% in the 36.25-Gy group versus 3% in the 35-Gy group) but was not statistically significant. Conclusion: Our study confirms that SBRT of 35-36.25 Gy in five fractions with the CyberKnife System produces excellent control with low toxicity in patients with low-intermediate-risk prostate cancer. We found no dose-related differences in biochemical control and overall survival. Further confirmation of these results is awaited through the prospective phase of this study, which is still ongoing.
Language	English
Publishing date	2023-11-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1270498
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