1
|
Arnaldi D, Mattioli P, Raffa S, Pardini M, Massa F, Iranzo A, Perissinotti A, Niñerola-Baizán A, Gaig C, Serradell M, Muñoz-Lopetegi A, Mayà G, Liguori C, Fernandes M, Placidi F, Chiaravalloti A, Šonka K, Dušek P, Zogala D, Trnka J, Boeve BF, Miyagawa T, Lowe VJ, Miyamoto T, Miyamoto M, Puligheddu M, Figorilli M, Serra A, Hu MT, Klein JC, Bes F, Kunz D, Cochen De Cock V, de Verbizier D, Plazzi G, Antelmi E, Terzaghi M, Bossert I, Kulcsárová K, Martino A, Giuliani A, Pagani M, Nobili F, Morbelli S. Presynaptic Dopaminergic Imaging Characterizes Patients with REM Sleep Behavior Disorder Due to Synucleinopathy. Ann Neurol 2024. [PMID: 38466158 DOI: 10.1002/ana.26902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To apply a machine learning analysis to clinical and presynaptic dopaminergic imaging data of patients with rapid eye movement (REM) sleep behavior disorder (RBD) to predict the development of Parkinson disease (PD) and dementia with Lewy bodies (DLB). METHODS In this multicenter study of the International RBD study group, 173 patients (mean age 70.5 ± 6.3 years, 70.5% males) with polysomnography-confirmed RBD who eventually phenoconverted to overt alpha-synucleinopathy (RBD due to synucleinopathy) were enrolled, and underwent baseline presynaptic dopaminergic imaging and clinical assessment, including motor, cognitive, olfaction, and constipation evaluation. For comparison, 232 RBD non-phenoconvertor patients (67.6 ± 7.1 years, 78.4% males) and 160 controls (68.2 ± 7.2 years, 53.1% males) were enrolled. Imaging and clinical features were analyzed by machine learning to determine predictors of phenoconversion. RESULTS Machine learning analysis showed that clinical data alone poorly predicted phenoconversion. Presynaptic dopaminergic imaging significantly improved the prediction, especially in combination with clinical data, with 77% sensitivity and 85% specificity in differentiating RBD due to synucleinopathy from non phenoconverted RBD patients, and 85% sensitivity and 86% specificity in discriminating PD-converters from DLB-converters. Quantification of presynaptic dopaminergic imaging showed that an empirical z-score cutoff of -1.0 at the most affected hemisphere putamen characterized RBD due to synucleinopathy patients, while a cutoff of -1.0 at the most affected hemisphere putamen/caudate ratio characterized PD-converters. INTERPRETATION Clinical data alone poorly predicted phenoconversion in RBD due to synucleinopathy patients. Conversely, presynaptic dopaminergic imaging allows a good prediction of forthcoming phenoconversion diagnosis. This finding may be used in designing future disease-modifying trials. ANN NEUROL 2024.
Collapse
Affiliation(s)
- Dario Arnaldi
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pietro Mattioli
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Stefano Raffa
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alex Iranzo
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Andres Perissinotti
- Nuclear Medicine Service, Hospital Clínic Barcelona, Biomedical Research Networking Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), ISCIII, Barcelona, Spain
| | - Aida Niñerola-Baizán
- Nuclear Medicine Service, Hospital Clínic Barcelona, Biomedical Research Networking Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), ISCIII, Barcelona, Spain
| | - Carles Gaig
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Monica Serradell
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Amaia Muñoz-Lopetegi
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Gerard Mayà
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Karel Šonka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Petr Dušek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - David Zogala
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jiri Trnka
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Tomoyuki Miyamoto
- Department of Neurology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Masayuki Miyamoto
- Center of Sleep Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Monica Puligheddu
- Sleep Disorder Center, Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Michela Figorilli
- Sleep Disorder Center, Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Alessandra Serra
- Nuclear Medicine Unit, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Michele T Hu
- Division of Neurology, Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | - Johannes C Klein
- Division of Neurology, Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | - Frederik Bes
- Clinic of Sleep & Chronomedicine, St. Hedwig-Hospital, Berlin, Germany
- Institute of Physiology, Sleep Research & Clinical Chronobiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Dieter Kunz
- Clinic of Sleep & Chronomedicine, St. Hedwig-Hospital, Berlin, Germany
- Institute of Physiology, Sleep Research & Clinical Chronobiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Valérie Cochen De Cock
- Sleep and Neurology Department, Beau Soleil Clinic, Montpellier, France
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | | | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy
| | - Elena Antelmi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Terzaghi
- Sleep Medicine and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Irene Bossert
- Nuclear Medicine Unit, ICS Maugeri SpA SB IRCCS, Pavia, Italy
| | - Kristína Kulcsárová
- Department of Neurology, P. J. Safarik University, Kosice, Slovak Republic
- Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Alessio Martino
- Department of Business and Management, LUISS University, Rome, Italy
| | - Alessandro Giuliani
- Department of Environment and Health, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Nuclear Medicine Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| |
Collapse
|
2
|
Orso B, Mattioli P, Yoon EJ, Kim YK, Kim H, Shin JH, Kim R, Liguori C, Famà F, Donniaquio A, Massa F, García DV, Meles SK, Leenders KL, Chiaravalloti A, Pardini M, Bauckneht M, Morbelli S, Nobili F, Lee JY, Arnaldi D. Validation of the REM behaviour disorder phenoconversion-related pattern in an independent cohort. Neurol Sci 2023; 44:3161-3168. [PMID: 37140829 PMCID: PMC10415520 DOI: 10.1007/s10072-023-06829-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/23/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND A brain glucose metabolism pattern related to phenoconversion in patients with idiopathic/isolated REM sleep behaviour disorder (iRBDconvRP) was recently identified. However, the validation of the iRBDconvRP in an external, independent group of iRBD patients is needed to verify the reproducibility of such pattern, so to increase its importance in clinical and research settings. The aim of this work was to validate the iRBDconvRP in an independent group of iRBD patients. METHODS Forty iRBD patients (70 ± 5.59 years, 19 females) underwent brain [18F]FDG-PET in Seoul National University. Thirteen patients phenoconverted at follow-up (7 Parkinson disease, 5 Dementia with Lewy bodies, 1 Multiple system atrophy; follow-up time 35 ± 20.56 months) and 27 patients were still free from parkinsonism/dementia after 62 ± 29.49 months from baseline. We applied the previously identified iRBDconvRP to validate its phenoconversion prediction power. RESULTS The iRBDconvRP significantly discriminated converters from non-converters iRBD patients (p = 0.016; Area under the Curve 0.74, Sensitivity 0.69, Specificity 0.78), and it significantly predicted phenoconversion (Hazard ratio 4.26, C.I.95%: 1.18-15.39). CONCLUSIONS The iRBDconvRP confirmed its robustness in predicting phenoconversion in an independent group of iRBD patients, suggesting its potential role as a stratification biomarker for disease-modifying trials.
Collapse
Affiliation(s)
- Beatrice Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Largo Daneo 3, 16132, Genoa, Italy.
| | - Pietro Mattioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Largo Daneo 3, 16132, Genoa, Italy
| | - Eun-Jin Yoon
- Memory Network Medical Research Center, Seoul National University, Seoul, South Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Heejung Kim
- Department of Nuclear Medicine, Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Jung Hwan Shin
- Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea
| | - Ryul Kim
- Department of Neurology, Inha University Hospital, Incheon, South Korea
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy
- Sleep Medicine Center, Neurology Unit, University Hospital "Tor Vergata", Rome, Italy
| | - Francesco Famà
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Largo Daneo 3, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Andrea Donniaquio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Largo Daneo 3, 16132, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Largo Daneo 3, 16132, Genoa, Italy
| | - David Vállez García
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VuMC, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Sanne K Meles
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Klaus L Leenders
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Agostino Chiaravalloti
- IRCCS Neuromed, Pozzilli, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Largo Daneo 3, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Matteo Bauckneht
- IRCCS Ospedale Policlinico S. Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
- Department of Health Science (DISSAL), University of Genoa, Via Antonio Pastore 1, 16132, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico S. Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
- Department of Health Science (DISSAL), University of Genoa, Via Antonio Pastore 1, 16132, Genoa, Italy
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Largo Daneo 3, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Jee-Young Lee
- Department of Neurology, Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Largo Daneo 3, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| |
Collapse
|
3
|
Motta C, Di Donna MG, Bonomi CG, Assogna M, Chiaravalloti A, Mercuri NB, Koch G, Martorana A. Different associations between amyloid-βeta 42, amyloid-βeta 40, and amyloid-βeta 42/40 with soluble phosphorylated-tau and disease burden in Alzheimer's disease: a cerebrospinal fluid and fluorodeoxyglucose-positron emission tomography study. Alzheimers Res Ther 2023; 15:144. [PMID: 37649105 PMCID: PMC10466826 DOI: 10.1186/s13195-023-01291-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Despite the high sensitivity of cerebrospinal fluid (CSF) amyloid beta (Aβ)42 to detect amyloid pathology, the Aβ42/Aβ40 ratio (amyR) better estimates amyloid load, with higher specificity for Alzheimer's disease (AD). However, whether Aβ42 and amyR have different meanings and whether Aβ40 represents more than an Aβ42-corrective factor remain to be clarified. Our study aimed to compare the ability of Aβ42 and amyR to detect AD pathology in terms of p-tau/Aβ42 ratio and brain glucose metabolic patterns using fluorodeoxyglucose-positron emission tomography (FDG-PET). METHODS CSF biomarkers were analyzed with EUROIMMUN ELISA. We included 163 patients showing pathological CSF Aβ42 and normal p-tau (A + T - = 98) or pathological p-tau levels (A + T + = 65) and 36 control subjects (A - T -). A + T - patients were further stratified into those with normal (CSFAβ42 + /amyR - = 46) and pathological amyR (CSFAβ42 + /amyR + = 52). We used two distinct cut-offs to determine pathological values of p-tau/Aβ42: (1) ≥ 0.086 and (2) ≥ 0.122. FDG-PET patterns were evaluated in a subsample of patients (n = 46) and compared to 24 controls. RESULTS CSF Aβ40 levels were the lowest in A - T - and in CSFAβ42 + /amyR - , higher in CSFAβ42 + /amyR + and highest in A + T + (F = 50.75; p < 0.001), resembling CSF levels of p-tau (F = 192; p < 0.001). We found a positive association between Aβ40 and p-tau in A - T - (β = 0.58; p < 0.001), CSFAβ42 + /amyR - (β = 0.47; p < 0.001), and CSFAβ42 + /amyR + patients (β = 0.48; p < 0.001) but not in A + T + . Investigating biomarker changes as a function of amyR, we observed a weak variation in CSF p-tau (+ 2 z-scores) and Aβ40 (+ 0.8 z-scores) in the normal amyR range, becoming steeper over the pathological threshold of amyR (p-tau: + 5 z-scores, Aβ40: + 4.5 z-score). CSFAβ42 + /amyR + patients showed a significantly higher probability of having pathological p-tau/Aβ42 than CSFAβ42 + /amyR - (cut-off ≥ 0.086: OR 23.3; cut-off ≥ 0.122: OR 8.8), which however still showed pathological values of p-tau/Aβ42 in some cases (cut-off ≥ 0.086: 35.7%; cut-off ≥ 0.122: 17.3%) unlike A - T - . Accordingly, we found reduced FDG metabolism in the temporoparietal regions of CSFAβ42 + /amyR - compared to controls, and further reduction in frontal areas in CSFAβ42 + /amyR + , like in A + T + . CONCLUSIONS Pathological p-tau/Aβ42 and FDG hypometabolism typical of AD can be found in patients with decreased CSF Aβ42 levels alone. AmyR positivity, associated with higher Aβ40 levels, is accompanied by higher CSF p-tau and widespread FDG hypometabolism.
Collapse
Affiliation(s)
- Caterina Motta
- UOSD Centro Demenze, University of Rome "Tor Vergata", Rome, Italy.
| | | | | | - Martina Assogna
- UOSD Centro Demenze, University of Rome "Tor Vergata", Rome, Italy
- Experimental Neuropsychophysiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Istituto Neurologico Mediterraneo, Pozzilli, Italy
| | | | - Giacomo Koch
- Experimental Neuropsychophysiology Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
- Human Physiology Unit, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | | |
Collapse
|
4
|
Fernandes M, Chiaravalloti A, Nuccetelli M, Placidi F, Izzi F, Camedda R, Bernardini S, Sancesario G, Schillaci O, Mercuri NB, Liguori C. Sleep Dysregulation Is Associated with 18F-FDG PET and Cerebrospinal Fluid Biomarkers in Alzheimer's Disease. J Alzheimers Dis Rep 2023; 7:845-854. [PMID: 37662614 PMCID: PMC10473116 DOI: 10.3233/adr-220111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/11/2023] [Indexed: 09/05/2023] Open
Abstract
Background Sleep impairment has been commonly reported in Alzheimer's disease (AD) patients. The association between sleep dysregulation and AD biomarkers has been separately explored in mild cognitive impairment (MCI) and AD patients. Objective The present study investigated cerebrospinal-fluid (CSF) and 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG-PET) biomarkers in MCI and AD patients in order to explore their association with sleep parameters measured with polysomnography (PSG). Methods MCI and AD patients underwent PSG, 18F-FDG-PET, and CSF analysis for detecting and correlating these biomarkers with sleep architecture. Results Thirty-five patients were included in the study (9 MCI and 26 AD patients). 18F-FDG uptake in left Brodmann area 31 (owing to the posterior cingulate cortex) correlated negatively with REM sleep latency (p = 0.013) and positively with REM sleep (p = 0.033). 18F-FDG uptake in the hippocampus was negatively associated with sleep onset latency (p = 0.041). Higher CSF orexin levels were associated with higher sleep onset latency (p = 0.042), Non-REM stage 1 of sleep (p = 0.031), wake after sleep onset (p = 0.028), and lower sleep efficiency (p = 0.045). CSF levels of Aβ42 correlated negatively with the wake bouts index (p = 0.002). CSF total-tau and phosphorylated tau levels correlated positively with total sleep time (p = 0.045) and time in bed (p = 0.031), respectively. Conclusion Sleep impairment, namely sleep fragmentation, REM sleep dysregulation, and difficulty in initiating sleep correlates with AD biomarkers, suggesting an effect of sleep on the pathological processes in different AD stages. Targeting sleep for counteracting the AD pathological processes represents a timely need for clinicians and researchers.
Collapse
Affiliation(s)
- Mariana Fernandes
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Marzia Nuccetelli
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Riccardo Camedda
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Sergio Bernardini
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Giuseppe Sancesario
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| |
Collapse
|
5
|
Biggi A, Chauvie S, Fallanca F, Guerra L, Bergesio F, Menga M, Bianchi A, Gregianin M, Chiaravalloti A, Schillaci O, Pavoni C, Patti C, Picardi M, Romano A, Schiavotto C, Sorasio R, Viviani S, La Nasa G, Trentin L, Rambaldi A, Gallamini A. Predictive value on advance hodgkin lymphoma treatment outcome of end-of treatment FDG PET/CT in the HD0607 clinical trial. Hematol Oncol 2023; 41:415-423. [PMID: 36534947 DOI: 10.1002/hon.3117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/27/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
The Lugano classification for response assessment in lymphoma recommends the use of the 5-point-scale Deauville Score (DS) to assess response evaluation of end-of-treatment FDG-PET/CT (eotPET) in Hodgkin Lymphoma (HL); nevertheless, there is a paucity of data on its accuracy and reproducibility. We focus here on the cohort of advanced stage IIb-IV HL patients enrolled in the HD0607 clinical trial (NCT identifier 00795613) that having had a negative interim PET performed 6 cycles of ABVD (Doxorubicin, Vinblastine, Vincristine and Dacarbazine) and then performed an eotPET. Negative patients were randomized to radiotherapy and no further treatment while positive patients were treated based on local policies. eotPET was re-evaluated independently by two readers evaluated and progression free survival was analysed (PFS). eotPET of 254 patients were analysed. The median follow-up was 43 months. The best receiver operator characteristics cut-off values to distinguish positive and negative patients was 4. The area-under-the-curve was 0.81 (95%CI, 0.70-0.91). Three-years PFS was 0.95 (95% CI 0.90-0.97) in eotPET negative and 0.22 (95% CI 0.11-0.43) in eotPET positive. DS demonstrated a good reproducibility of positivity/negativity between the readers consensus and local site evaluation where the agreement occurred on 95.0% of patients. The present study demonstrates that eotPET is an accurate tool to predict treatment outcome in HL and confirms the appropriateness of the Lugano classification for eotPET evaluation.
Collapse
Affiliation(s)
- Alberto Biggi
- Nuclear Medicine Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Stephane Chauvie
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Federico Fallanca
- Nuclear Medicine Division, IRCSS Ospedale San Raffaele, Milano, Italy
| | - Luca Guerra
- Nuclear Medicine Division, Ospedale San Gerardo, Monza, Italy
| | - Fabrizio Bergesio
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Massimo Menga
- Nuclear Medicine Division, Ospedale Trieste, Trieste, Italy
| | - Andrea Bianchi
- Nuclear Medicine Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | | | | | - Chiara Pavoni
- Haematology Division, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Caterina Patti
- Haematologiy. Division, V. Cervello Hospital, Palermo, Italy
| | - Marco Picardi
- Clinical Medicine and Surgery Department, Federico II University, Naples, Italy
| | - Alessandra Romano
- Hematology Division, Policlinico Vittorio Emanuele Hospital, Catania, Italy
| | | | - Roberto Sorasio
- Haematology Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | | | | | - Livio Trentin
- Hematology Division, Università di Padova, Padova, Italy
| | | | - Andrea Gallamini
- Department Recherche Innovation et Statistique, Centre A. Lacassagne, Nice, France
| |
Collapse
|
6
|
Filippi L, Chiaravalloti A. Prostate Cancer: From Molecular Imaging to Immunological and Target Therapies. Biomedicines 2023; 11:biomedicines11041176. [PMID: 37189794 DOI: 10.3390/biomedicines11041176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023] Open
Abstract
Prostate cancer (PCa) is one of the most common malignancies and a leading cause of cancer-related deaths, affecting a million people worldwide with a particularly high burden in countries with a low human development index [...].
Collapse
Affiliation(s)
- Luca Filippi
- Nuclear Medicine Unit, "Santa Maria Goretti" Hospital, Via Antonio Canova, 04100 Latina, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
- IRCCS Neuromed, 86077 Pozzilli, Italy
| |
Collapse
|
7
|
Tripathi S, Mattioli P, Liguori C, Chiaravalloti A, Arnaldi D, Giancardo L. Brain Hemisphere Dissimilarity, a Self-Supervised Learning Approach for alpha-synucleinopathies prediction with FDG PET. Proc IEEE Int Symp Biomed Imaging 2023; 2023:10.1109/isbi53787.2023.10230560. [PMID: 37706192 PMCID: PMC10496490 DOI: 10.1109/isbi53787.2023.10230560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Idiopathic Rem sleep Behavior Disorder (iRBD) is a significant biomarker for the development of alpha-synucleinopathies, such as Parkinson's disease (PD) or Dementia with Lewy bodies (DLB). Methods to identify patterns in iRBD patients can help in the prediction of the future conversion to these diseases during the long prodromal phase when symptoms are non-specific. These methods are essential for disease management and clinical trial recruitment. Brain PET scans with 18F-FDG PET radiotracers have recently shown promise, however, the scarcity of longitudinal data and PD/DLB conversion information makes the use of representation learning approaches such as deep convolutional networks not feasible if trained in a supervised manner. In this work, we propose a self-supervised learning strategy to learn features by comparing the brain hemispheres of iRBD non-convertor subjects, which allows for pre-training a convolutional network on a small data regimen. We introduce a loss function called hemisphere dissimilarity loss (HDL), which extends the Barlow Twins loss, that promotes the creation of invariant and non-redundant features for brain hemispheres of the same subject, and the opposite for hemispheres of different subjects. This loss enables the pre-training of a network without any information about the disease, which is then used to generate full brain feature vectors that are fine-tuned to two downstream tasks: follow-up conversion, and the type of conversion (PD or DLB) using baseline 18F-FDG PET. In our results, we find that the HDL outperforms the variational autoencoder with different forms of inputs.
Collapse
Affiliation(s)
- S Tripathi
- School of Biomedical Informatics, University of Texas Health Center at Houston, TX, USA
| | - P Mattioli
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - C Liguori
- Department of Systems Medicine, University of Rome, Rome, Italy
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome, Rome, Italy
| | - A Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - D Arnaldi
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - L Giancardo
- School of Biomedical Informatics, University of Texas Health Center at Houston, TX, USA
| |
Collapse
|
8
|
Bonomi CG, Chiaravalloti A, Camedda R, Ricci F, Mercuri NB, Schillaci O, Koch G, Martorana A, Motta C. Functional Correlates of Microglial and Astrocytic Activity in Symptomatic Sporadic Alzheimer’s Disease: A CSF/18F-FDG-PET Study. Biomedicines 2023; 11:biomedicines11030725. [PMID: 36979704 PMCID: PMC10045805 DOI: 10.3390/biomedicines11030725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Glial and microglial cells contribute to brain glucose consumption and could actively participate in shaping patterns of brain hypometabolism. Here, we aimed to investigate the association between 18F-fluorodeoxyglucose (18F-FDG) uptake and markers of microglial and astrocytic activity in a cohort of patients with Alzheimer’s Disease (AD). We dosed cerebrospinal fluid (CSF) levels of soluble Triggering Receptor Expressed on Myeloid cells (sTREM2), Glial Fibrillary Acidic Protein (GFAP), a marker of reactive astrogliosis, and β-S100, a calcium-binding protein associated with a neurotoxic astrocytic profile. No associations were found between sTREM-2 and 18F-FDG uptake. Instead, 18F-FDG uptake was associated negatively with CSF β-S100 in the left supramarginal gyrus, inferior parietal lobe and middle temporal gyrus (Brodmann Areas (BA) 21 and 40). Increased β-S100 levels could negatively regulate neuronal activity in the temporo-parietal cortex to prevent damage associated with AD hyperactivity, or rather they could reflect neurotoxic astrocytic activation contributing to AD progression in key strategic areas. We also identified a trend of positive association of 18F-FDG uptake with CSF GFAP in the right fronto-medial and precentral gyri (BA 6, 9 and 11), which has been reported in early AD and could either be persisting as an epiphenomenon tied to disease progression or be specifically aimed at preserving functions in the frontal cortex. Overall, CSF markers of astrogliosis seem to correlate with cortical glucose uptake in symptomatic sporadic AD, highlighting the role of astrocytes in shaping regional hypometabolism and possibly clinical presentation.
Collapse
Affiliation(s)
- Chiara Giuseppina Bonomi
- UOSD Memory Clinic, Policlinico Tor Vergata, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy
- IRCCS Neuromed, 86077 Pozzilli, Italy
- Correspondence:
| | - Riccardo Camedda
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Francesco Ricci
- UOSD Memory Clinic, Policlinico Tor Vergata, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Nicola Biagio Mercuri
- UOSD Memory Clinic, Policlinico Tor Vergata, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Giacomo Koch
- Non-Invasive Brain Stimulation Unit, IRCCS Santa Lucia, 00179 Rome, Italy
- Human Physiology Unit, Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
| | - Alessandro Martorana
- UOSD Memory Clinic, Policlinico Tor Vergata, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Caterina Motta
- UOSD Memory Clinic, Policlinico Tor Vergata, University of Rome “Tor Vergata”, 00133 Rome, Italy
| |
Collapse
|
9
|
Chiaravalloti A, Filippi L, Pagani M, Schillaci O. Functional imaging of chemo-brain: usefulness of Nuclear Medicine in the fog coming after cancer. J Nucl Med 2023; 64:508-514. [PMID: 36732056 DOI: 10.2967/jnumed.121.263294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 01/26/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
The impact of chemotherapy on brain functionality has been widely investigated from a clinical perspective and there is a consensus on a significant impairment of multiple cognitive domains affecting cancer patients after treatment. Nuclear medicine offers a variety of biomarkers for the evaluation of possible effects of chemotherapy on the brain and for depicting brain changes after chemotherapy treatment. This review aims to summarize the most relevant findings on brain imaging in patients treated with chemotherapy for the most common oncological diseases. The literature published to date offers exciting results with several radiolabeled compounds, from the more common imaging of glucose metabolism to neuroinflammation. In this review, a general overview of the literature concerning clinical features and the physiopathological basis of chemotherapy-related cognitive impairment is reported as well.
Collapse
Affiliation(s)
| | - Luca Filippi
- Nuclear Medicine Section, "Santa Maria Goretti" Hospital
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale Delle Ricerche (CNR), Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| |
Collapse
|
10
|
Mattioli P, Orso B, Liguori C, Famà F, Giorgetti L, Donniaquio A, Massa F, Giberti A, Vállez García D, Meles SK, Leenders KL, Placidi F, Spanetta M, Chiaravalloti A, Camedda R, Schillaci O, Izzi F, Mercuri NB, Pardini M, Bauckneht M, Morbelli S, Nobili F, Arnaldi D. Derivation and Validation of a Phenoconversion-Related Pattern in Idiopathic Rapid Eye Movement Behavior Disorder. Mov Disord 2023; 38:57-67. [PMID: 36190111 PMCID: PMC10092506 DOI: 10.1002/mds.29236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/27/2022] [Accepted: 09/06/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Idiopathic rapid eye movement sleep behavior disorder (iRBD) represents the prodromal stage of α-synucleinopathies. Reliable biomarkers are needed to predict phenoconversion. OBJECTIVE The aim was to derive and validate a brain glucose metabolism pattern related to phenoconversion in iRBD (iRBDconvRP) using spatial covariance analysis (Scaled Subprofile Model and Principal Component Analysis [SSM-PCA]). METHODS Seventy-six consecutive iRBD patients (70 ± 6 years, 15 women) were enrolled in two centers and prospectively evaluated to assess phenoconversion (30 converters, 73 ± 6 years, 14 Parkinson's disease and 16 dementia with Lewy bodies, follow-up time: 21 ± 14 months; 46 nonconverters, 69 ± 6 years, follow-up time: 33 ± 19 months). All patients underwent [18 F]FDG-PET (18 F-fluorodeoxyglucose positron emitting tomography) to investigate brain glucose metabolism at baseline. SSM-PCA was applied to obtain the iRBDconvRP; nonconverter patients were considered as the reference group. Survival analysis and Cox regression were applied to explore prediction power. RESULTS First, we derived and validated two distinct center-specific iRBDconvRP that were comparable and significantly able to predict phenoconversion. Then, SSM-PCA was applied to the whole set, identifying the iRBDconvRP. The iRBDconvRP included positive voxel weights in cerebellum; brainstem; anterior cingulate cortex; lentiform nucleus; and middle, mesial temporal, and postcentral areas. Negative voxel weights were found in posterior cingulate, precuneus, middle frontal gyrus, and parietal areas. Receiver operating characteristic analysis showed an area under the curve of 0.85 (sensitivity: 87%, specificity: 72%), discriminating converters from nonconverters. The iRBDconvRP significantly predicted phenoconversion (hazard ratio: 7.42, 95% confidence interval: 2.6-21.4). CONCLUSIONS We derived and validated an iRBDconvRP to efficiently discriminate converter from nonconverter iRBD patients. [18 F]FDG-PET pattern analysis has potential as a phenoconversion biomarker in iRBD patients. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Pietro Mattioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy
| | - Beatrice Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VuMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Sleep Medicine Center, Neurology Unit, University Hospital "Tor Vergata", Rome, Italy
| | - Francesco Famà
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | | | - Andrea Donniaquio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy
| | - Andrea Giberti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy
| | - David Vállez García
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VuMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Sanne K Meles
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Klaus L Leenders
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Fabio Placidi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Sleep Medicine Center, Neurology Unit, University Hospital "Tor Vergata", Rome, Italy
| | - Matteo Spanetta
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Riccardo Camedda
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Center, Neurology Unit, University Hospital "Tor Vergata", Rome, Italy
| | - Nicola B Mercuri
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - Matteo Bauckneht
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy.,Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy.,Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| |
Collapse
|
11
|
Garasto E, Stefani A, Pierantozzi M, Cerroni R, Conti M, Maranesi S, Mercuri NB, Chiaravalloti A, Schillaci O, Viziano A, Moleti A, Sisto R. Association between hearing sensitivity and dopamine transporter availability in Parkinson's disease. Brain Commun 2023; 5:fcad075. [PMID: 37006327 PMCID: PMC10065189 DOI: 10.1093/braincomms/fcad075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/08/2023] [Accepted: 03/18/2023] [Indexed: 04/03/2023] Open
Abstract
In a previous study, we observed: (i) significant hearing function impairment, assessed with pure tone audiometry and distortion product otoacoustic emissions, in patients with Parkinson's disease, compared with a matched control group, and (ii) lateralization of the hearing dysfunction, worse on the side affected by more pronounced Parkinson's disease motor symptoms. This study investigates the association between the basal ganglia dopamine transporter availability and the hearing function in Parkinson's disease patients, focusing also on the lateralization of both dysfunctions, with respect to that of the motor symptoms, and introducing a further distinction between patients with left-sided and right-sided predominant motor symptoms. Patients with right-handed Parkinson's disease with a recent estimation of 123I-FP-CIT striatal uptake were audiologically tested with pure tone audiometry and distortion product otoacoustic emissions. Thirty-nine patients were included in the study. A statistically significant association was found, in the left-side predominant group only, between the distortion product otoacoustic emission levels and the contralateral dopamine transporter availability, and between the hearing threshold and the dopamine transporter availability difference between the ipsi- and the contralateral sides. The hearing impairment lateralization correlated to the motor symptom asymmetry was found significant only in the left-side predominant patients. The association between hearing function and basal ganglia dopamine transporter availability supports the hypothesis that the peripheral hearing function decline associated with dopamine depletion is involved in Parkinson's disease development, with a significant difference between patients with left- and right-sided predominant motor symptoms. These findings also suggest that peripheral hearing function evaluation and its lateralization could be key elements for subtyping the disease.
Collapse
Affiliation(s)
- Elena Garasto
- Parkinson’s Center, Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Alessandro Stefani
- Correspondence to: Alessandro Stefani, PhD Department of Systems Medicine, Parkinson’s Disease Center University of Rome ‘Tor Vergata’ Viale Oxford 81, Rome 00133, Italy E-mail:
| | - Mariangela Pierantozzi
- Parkinson’s Center, Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Rocco Cerroni
- Parkinson’s Center, Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Matteo Conti
- Parkinson’s Center, Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Simone Maranesi
- Parkinson’s Center, Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Nicola B Mercuri
- Parkinson’s Center, Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Arturo Moleti
- Department of Physics and NAST Centre, University of Rome ‘Tor Vergata’, Rome 00133, Italy
| | - Renata Sisto
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL Research, Monte Porzio Catone (Rome)00078, Italy
| |
Collapse
|
12
|
Vacca M, Assogna F, Pellicano C, Chiaravalloti A, Placidi F, Izzi F, Camedda R, Schillaci O, Spalletta G, Lombardo C, Mercuri N, Liguori C. Neuropsychiatric, neuropsychological, and neuroimaging features in isolated REM sleep behavior disorder: does MCI matter? Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
13
|
Vacca M, Assogna F, Pellicano C, Chiaravalloti A, Placidi F, Izzi F, Camedda R, Schillaci O, Spalletta G, Lombardo C, Mercuri NB, Liguori C. Neuropsychiatric, neuropsychological, and neuroimaging features in isolated REM sleep behavior disorder: The importance of MCI. Sleep Med 2022; 100:230-237. [PMID: 36116292 DOI: 10.1016/j.sleep.2022.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/23/2022] [Accepted: 08/25/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is frequently diagnosed in patients with isolated rapid eye movement (REM) sleep behavior disorder (iRBD), although the extent of MCI-associated neuropathology has not yet been quantified. The present study compared the differences in neuropsychiatric, neuropsychological, and neuroimaging markers of neurodegeneration in MCI-iRBD and iRBD patients with normal cognition. METHODS Sixty-one patients with iRBD were included in the study: 30 patients were included in the MCI subgroup (RBD-MCI) and 31 in the normal cognition subgroup (RBD-NC). Both groups underwent neuropsychiatric and neuropsychological assessments to evaluate psychopathological symptoms and neuropsychological functions. Brain [18F]FDG PET and 123I-FP-CIT-SPECT were performed to evaluate brain glucose metabolism and nigrostriatal dopaminergic function in convenient subgroups of patients, respectively. RESULTS Neuropsychological measures generally confirmed overall cognitive decline in patients with iRBD-MCI. Immediate long-term verbal memory and visuospatial functions, as well as attentional-executive impairment were evident in the MCI group compared to the NC group. Neuroimaging results indicated reduced brain glucose uptake in the bilateral posterior cingulate cortex and more evident nigrostriatal deafferentation in the RBD-MCI group. There were no differences in psychopathological symptoms between the two groups. CONCLUSIONS This study confirmed that iRBD patients with MCI had a more impaired cognitive status that those with NC. Moreover, the MCI subgroup presented reduced cerebral glucose consumption in brain areas critical for cognition, and a more severe deafferentation of the nigro-striatal regions, highlighting the importance of identifying iRBD patients with MCI for urgent neuroprotective trials.
Collapse
Affiliation(s)
| | | | | | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy; IRCCS Neuromed, Pozzilli, Italy
| | - Fabio Placidi
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome "Tor Vergata", Italy; Department of Systems Medicine, University of Rome "Tor Vergata", Italy
| | - Francesca Izzi
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome "Tor Vergata", Italy
| | - Riccardo Camedda
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | | | | | - Nicola Biagio Mercuri
- IRCCS Santa Lucia Foundation, Rome, Italy; Sleep Medicine Center, Neurology Unit, University Hospital of Rome "Tor Vergata", Italy; Department of Systems Medicine, University of Rome "Tor Vergata", Italy
| | - Claudio Liguori
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome "Tor Vergata", Italy; Department of Systems Medicine, University of Rome "Tor Vergata", Italy.
| |
Collapse
|
14
|
Fernandes M, Chiaravalloti A, Manfredi N, Placidi F, Nuccetelli M, Izzi F, Camedda R, Bernardini S, Schillaci O, Mercuri N, Liguori C. Ipossia intermittente notturna e frammentazione del sonno: duplice meccanismo di neurodegenerazione? Sindrome delle apnee ostruttive del sonno e disturbo da movimenti periodici degli arti a confronto. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
15
|
Di Giuliano F, Picchi E, Pucci N, Minosse S, Ferrazzoli V, Pizzicannella G, Angeloni C, Nasso D, Chiaravalloti A, Garaci F, Floris R. Comparison between diffusion-weighted magnetic resonance and positron-emission tomography in the evaluation of treated lymphomas with mediastinal involvement. Egypt J Radiol Nucl Med 2022. [DOI: 10.1186/s43055-022-00825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The persistence of residual tissue after treatment is frequent in patients with mediastinal lymphomas and it is often characterized by 18F-Flurodeoxyglucose Positron Emission Tomography (18F-FDG PET) uptake. This study aims to investigate the usefulness of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) sequence in residual tissues of treated mediastinal lymphomas and to compare it with 18F-FDG PET-CT.
Results
We included 21 patients with mediastinal Hodgkin and non-Hodgkin lymphomas who showed residual masses on PET-CT imaging at end of treatment and underwent DWIBS-Magnetic Resonance Imaging (MRI). SUVmax and Apparent Diffusion Coefficient (ADC) values of residual masses were assessed quantitatively, including measurement of mean ADC. 15 patients showed radiotracer uptake at 18F-FDG PET-CT, among them only 3 had positive DWIBS-MRI with low ADC values (median value: 0.90 mm2/s). The mediastinal biopsy in these 3 “double positive” patients confirmed pathological residual tissue. All the patients with positive 18F-FDG PET-CT but negative DWIBS-MRI (n = 18) with high ADC values (median value: 2.05 mm2/s) were confirmed negative by biopsy.
Conclusions
DWIBS-MRI examination combined with ADC measurement allowed to discriminate pathological and non-pathological residual tissue in patients with treated mediastinal lymphoma. These preliminary results seem to pave the way for a leading role of the MRI which could be a useful alternative to the 18F-FDG PET/CT.
Collapse
|
16
|
Fernandes M, Manfredi N, Aluisantonio L, Franchini F, Chiaravalloti A, Izzi F, Di Santo S, Schillaci O, Mercuri NB, Placidi F, Liguori C. Cognitive functioning, cerebrospinal fluid Alzheimer's disease biomarkers and cerebral glucose metabolism in late-onset epilepsy of unknown aetiology: A prospective study. Eur J Neurosci 2022; 56:5384-5396. [PMID: 35678770 DOI: 10.1111/ejn.15734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 05/16/2022] [Accepted: 06/04/2022] [Indexed: 12/14/2022]
Abstract
Epilepsy is increasing, being more common in older adults, with more than 20% of late-onset cases with unknown aetiology (LOEU). Although epilepsy was associated with cognitive impairment, few studies evaluated the trajectories of cognitive decline in patients with LOEU. The present study aimed at assessing biomarkers of Alzheimer's disease (AD) in patients with LOEU and evaluating their cognitive performance for 12 months. For this study, 55 patients diagnosed with LOEU and 21 controls were included. Participants underwent cognitive evaluation and cerebrospinal fluid (CSF) biomarker analysis (ß-amyloid42 , tau proteins) before starting anti-seizure medication and then repeated the cognitive evaluation at the 12-month follow-up. A subgroup of LOEU patients and controls also performed 18 F-fluoro-2-deoxy-D-glucose positron emission tomography (18 F-FDG PET) before starting anti-seizure medication. At baseline, LOEU patients showed lower Mini-Mental State Examination (MMSE) score, worse cognitive performance in several domains, lower β-amyloid42 and higher tau proteins CSF levels than controls. Significantly reduced glucose consumption was observed in the right posterior cingulate cortex and left praecuneus areas in LOEU patients than controls, and this finding correlated with memory impairment. In the longitudinal analysis, a significant decrease in MMSE and an increase in verbal fluency scores were found in LOEU patients. These findings evidence that LOEU patients have a significant cognitive impairment, and alteration of cerebral glucose consumption and CSF AD biomarkers than controls. Moreover, they showed a progressive global cognitive decline at follow-up, although verbal fluency was preserved. Further studies are needed to better understand the pathophysiological aspects of LOEU and its association with AD.
Collapse
Affiliation(s)
- Mariana Fernandes
- Epilepsy Centre, Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Natalia Manfredi
- Epilepsy Centre, Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Lavinia Aluisantonio
- Epilepsy Centre, Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Francesca Izzi
- Epilepsy Centre, Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Nicola Biagio Mercuri
- Epilepsy Centre, Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Fabio Placidi
- Epilepsy Centre, Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Claudio Liguori
- Epilepsy Centre, Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| |
Collapse
|
17
|
Fernandes M, Mari L, Chiaravalloti A, Paoli B, Nuccetelli M, Izzi F, Giambrone MP, Camedda R, Bernardini S, Schillaci O, Mercuri NB, Placidi F, Liguori C. 18F-FDG PET, cognitive functioning, and CSF biomarkers in patients with obstructive sleep apnoea before and after continuous positive airway pressure treatment. J Neurol 2022; 269:5356-5367. [PMID: 35608659 PMCID: PMC9468130 DOI: 10.1007/s00415-022-11182-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/07/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022]
Abstract
Introduction Dysregulation of cerebral glucose consumption, alterations in cerebrospinal fluid (CSF) biomarkers, and cognitive impairment have been reported in patients with obstructive sleep apnoea (OSA). On these bases, OSA has been considered a risk factor for Alzheimer’s disease (AD). This study aimed to measure cognitive performance, CSF biomarkers, and cerebral glucose consumption in OSA patients and to evaluate the effects of continuous positive airway pressure (CPAP) treatment on these biomarkers over a 12-month period. Methods Thirty-four OSA patients and 34 controls underwent 18F-fluoro-2-deoxy-d-glucose positron emission tomography (18F-FDG PET), cognitive evaluation, and CSF analysis. A subgroup of 12 OSA patients treated with beneficial CPAP and performing the 12-month follow-up was included in the longitudinal analysis, and cognitive evaluation and 18F-FDG PET were repeated. Results Significantly reduced glucose consumption was observed in the bilateral praecuneus, posterior cingulate cortex, and frontal areas in OSA patients than controls. At baseline, OSA patients also showed lower β-amyloid42 and higher phosphorylated-tau CSF levels than controls. Increased total tau and phosphorylated tau levels correlated with a reduction in brain glucose consumption in a cluster of different brain areas. In the longitudinal analysis, OSA patients showed an improvement in cognition and a global increase in cerebral 18F-FDG uptake. Conclusions Cognitive impairment, reduced cerebral glucose consumption, and alterations in CSF biomarkers were observed in OSA patients, which may reinforce the hypothesis of AD neurodegenerative processes triggered by OSA. Notably, cognition and brain glucose consumption improved after beneficial CPAP treatment. Further studies are needed to evaluate the long-term effects of CPAP treatment on these AD biomarkers.
Collapse
Affiliation(s)
- Mariana Fernandes
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome "Tor Vergata", Rome, Italy
| | - Luisa Mari
- Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Barbara Paoli
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome "Tor Vergata", Rome, Italy
| | - Marzia Nuccetelli
- Department of Clinical Biochemistry and Molecular Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Izzi
- Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy
| | | | - Riccardo Camedda
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Sergio Bernardini
- Department of Clinical Biochemistry and Molecular Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy.,IRCSS Santa Lucia Foundation, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome "Tor Vergata", Rome, Italy.,Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy
| | - Claudio Liguori
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome "Tor Vergata", Rome, Italy. .,Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy.
| |
Collapse
|
18
|
Falanga M, Masci A, Chiaravalloti A, Dal Monte A, Corsi C, Tomasi C. Left atrium hemodynamic in atrial fibrillation and normal subjects. Europace 2022. [DOI: 10.1093/europace/euac053.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
A computational fluid-dynamics (CFD) model previously developed with the aim of evaluating cardioembolic risk in patient affected by atrial fibrillation (AF) was used for the characterization of the left atrium (LA) hemodynamic in normal subjects (NL), patients affected by paroxysmal atrial fibrillation (PAR-AF) and patients affected by persistent atrial fibrillation (PER-AF). Based on the fluid-dynamics simulations results, we aimed at enhancing differences in blood flow in AF patients and NL and at better understanding the relationship between AF progression and stroke risk on a patient-specific basis.
Methods
3D patient-specific anatomical and motion models were derived from ECG-gated coronary artery CT acquired with retrospective protocol. These models represented the computational domain for CFD simulations in which inflow initial conditions were derived from PW Doppler at the mitral valve and at the pulmonary veins. Velocity field and vortex structures both within the LA and left atrial appendage (LAA) were assessed in 10 NL, 5 PAR-AF and 4 PER-AF. Blood stasis was evaluated by populating the LAA with 500 particles and counting the number of particles still present after five cardiac cycles.
Results
Velocities inside the LA and in the LAA presented different amplitude and distribution in the 3 groups (peak velocity – NL: 50÷60 cm/s, PAR-AF: 40÷50 cm/s, PER-AF: 15÷25 cm/s). The mean velocity resulted lower in the PER-AF compared with PAR-AF (mean velocity – PAR-AF: 25÷35 cm/s, PER-AF: 8÷20 cm/s) at the LAA ostium and inside the LAA, in which the wash-out effect was strongly reduced (Figure 1). On the other hand, the mean velocity in the NL was higher with respect of AF patients (mean velocity – NL: 40÷45 cm/s). A higher number of vortex structures was observed in NL compared with AF patients, thus favouring the hypothesis of a more efficient wash-out of the LA and of the LAA. Blood stasis in terms of number of particles in the LAA after five cardiac cycles confirmed these results (NL: 5±2, PAR-AF: 18±3, PER-AF: 41±10).
Conclusions
The developed approach quantifies differences in LA hemodynamic between AF and NL patients, also allowing a stratification of the atrial disease progression in terms of variations in the blood velocity, organization of blood flow and quantification of blood stasis.
Collapse
Affiliation(s)
- M Falanga
- DEI, University of Bologna, Bologna, Italy
| | - A Masci
- DEI, University of Bologna, Bologna, Italy
| | - A Chiaravalloti
- Santa Maria delle Croci Hospital, AUSL della Romagna, Ravenna, Italy
| | - A Dal Monte
- Santa Maria delle Croci Hospital, AUSL della Romagna, Ravenna, Italy
| | - C Corsi
- DEI, University of Bologna, Bologna, Italy
| | - C Tomasi
- Santa Maria delle Croci Hospital, AUSL della Romagna, Ravenna, Italy
| |
Collapse
|
19
|
Fernandes M, Chiaravalloti A, Manfredi N, Placidi F, Nuccetelli M, Izzi F, Camedda R, Bernardini S, Schillaci O, Mercuri NB, Liguori C. Nocturnal Hypoxia and Sleep Fragmentation May Drive Neurodegenerative Processes: The Compared Effects of Obstructive Sleep Apnea Syndrome and Periodic Limb Movement Disorder on Alzheimer’s Disease Biomarkers. J Alzheimers Dis 2022; 88:127-139. [DOI: 10.3233/jad-215734] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Sleep disorders may cause dysregulation of cerebral glucose metabolism and synaptic functions, as well as alterations in cerebrospinal fluid (CSF) biomarker levels. Objective: This study aimed at measuring sleep, CSF Alzheimer’s disease (AD) biomarkers, and cerebral glucose consumption in patients with obstructive sleep apnea syndrome (OSAS) and patients with periodic limb movement disorder (PLMD), compared to controls. Methods: OSAS and PLMD patients underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET), polysomnographic monitoring, and lumbar puncture to quantify CSF levels of amyloid-β42 (Aβ42), total tau, and phosphorylated tau. All patients were compared to controls, who were not affected by sleep or neurodegenerative disorders. Results: Twenty OSAS patients, 12 PLMD patients, and 15 controls were included. Sleep quality and sleep structure were altered in both OSAS and PLMD patients when compared to controls. OSAS and PLMD patients showed lower CSF Aβ42 levels than controls. OSAS patients showed a significant increase in glucose uptake in a wide cluster of temporal-frontal areas and cerebellum, as well as a reduced glucose consumption in temporal-parietal regions compared to controls. PLMD patients showed increased brain glucose consumption in the left parahippocampal gyrus and left caudate than controls. Conclusion: Sleep dysregulation and nocturnal hypoxia present in OSAS patients, more than sleep fragmentation in PLMD patients, were associated with the alteration in CSF and 18F-FDG PET AD biomarkers, namely reduction of CSF Aβ42 levels and cerebral glucose metabolism dysregulation mainly in temporal areas, thus highlighting the possible role of sleep disorders in driving neurodegenerative processes typical of AD pathology.
Collapse
Affiliation(s)
- Mariana Fernandes
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Natalia Manfredi
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
- Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Marzia Nuccetelli
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Francesca Izzi
- Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| | - Riccardo Camedda
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Sergio Bernardini
- Department of Clinical Biochemistry and Molecular Biology, University of Rome “Tor Vergata”, Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
- IRCSS Santa Lucia Foundation, Rome, Italy
| | - Claudio Liguori
- Department of Systems Medicine, Sleep Medicine Centre, University of Rome “Tor Vergata”, Rome, Italy
- Neurology Unit, University Hospital of Rome “Tor Vergata”, Rome, Italy
| |
Collapse
|
20
|
Filippi L, Bagni O, Crisafulli C, Cerio I, Brunotti G, Chiaravalloti A, Schillaci O, Dore F. Detection Rate and Clinical Impact of PET/CT with 18F-FACBC in Patients with Biochemical Recurrence of Prostate Cancer: A Retrospective Bicentric Study. Biomedicines 2022; 10:biomedicines10010177. [PMID: 35052856 PMCID: PMC8773479 DOI: 10.3390/biomedicines10010177] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/19/2022] Open
Abstract
Our aim was to assess the detection rate (DR) of positron emission computed tomography (PET/CT) with anti-1-amino-3-[18F]-flurocyclobutane-1-carboxylic acid (18F-FACBC) in patients with biochemical recurrence (BCR) from prostate cancer (PC). As a secondary endpoint, we evaluated 18F-FACBC PET/CT’s impact on patients management. Clinical records of 81 patients submitted to 18F-FACBC PET/CT due to PC BCR in two Italian Nuclear Medicine Units were retrospectively assessed. DR was gauged in the whole cohort and stratifying patients by discrete intervals of PSA levels. PET/CT’s impact on clinical management was scored as (1) major if it entailed an intermodality change (e.g., from systemic to loco-regional therapy); (2) minor if it led to an intramodality change (e.g., modified radiotherapy field). PET/CT’s DR resulted in 76.9% in the whole cohort, with a positive predictive value of 96.7%. Stratified by PSA quartile intervals, PET/CT’s DR was 66.7%, 71.4%, 78.9% and 90% for PSA 0.2–0.57 ng/mL, 0.58–0.99 ng/mL, 1–1.5 ng/mL and >1.5 ng/mL without significant difference among groups (p = 0.81). The most common sites of relapse were prostate bed and pelvic lymph nodes (59.3%). PET/CT impacted on clinical management in 33/81 cases (40.7%), leading to a major change in 30 subjects (90.9%). 18F-FACBC PET/CT localized recurrence in patients with BCR, with meaningful DR also at low PSA levels and significantly impacted on clinical management.
Collapse
Affiliation(s)
- Luca Filippi
- Nuclear Medicine Unit, “Santa Maria Goretti” Hospital, Via Antonio Canova, 04100 Latina, Italy;
- Correspondence: ; Tel.: +39-077-3655-3591
| | - Oreste Bagni
- Nuclear Medicine Unit, “Santa Maria Goretti” Hospital, Via Antonio Canova, 04100 Latina, Italy;
| | - Carmelo Crisafulli
- Nuclear Medicine Unit, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara Hospital, Strada di Fiume 447, 34129 Trieste, Italy; (C.C.); (I.C.); (F.D.)
| | - Ivan Cerio
- Nuclear Medicine Unit, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara Hospital, Strada di Fiume 447, 34129 Trieste, Italy; (C.C.); (I.C.); (F.D.)
| | - Gabriele Brunotti
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00100 Rome, Italy;
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (A.C.); (O.S.)
- IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (A.C.); (O.S.)
- IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Franca Dore
- Nuclear Medicine Unit, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara Hospital, Strada di Fiume 447, 34129 Trieste, Italy; (C.C.); (I.C.); (F.D.)
| |
Collapse
|
21
|
Chiaravalloti A, Cimini A, Ricci M, Quartuccio N, Arnone G, Filippi L, Calabria F, Leporace M, Bagnato A, Schillaci O. Positron emission tomography imaging in primary brain tumors. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00042-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
22
|
Ricci M, Cimini A, Camedda R, Chiaravalloti A, Schillaci O. Tau Biomarkers in Dementia: Positron Emission Tomography Radiopharmaceuticals in Tauopathy Assessment and Future Perspective. Int J Mol Sci 2021; 22:ijms222313002. [PMID: 34884804 PMCID: PMC8657996 DOI: 10.3390/ijms222313002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/14/2021] [Accepted: 11/25/2021] [Indexed: 01/20/2023] Open
Abstract
Abnormal accumulation of Tau protein is closely associated with neurodegeneration and cognitive impairment and it is a biomarker of neurodegeneration in the dementia field, especially in Alzheimer’s disease (AD); therefore, it is crucial to be able to assess the Tau deposits in vivo. Beyond the fluid biomarkers of tauopathy described in this review in relationship with the brain glucose metabolic patterns, this review aims to focus on tauopathy assessment by using Tau PET imaging. In recent years, several first-generation Tau PET tracers have been developed and applied in the dementia field. Common limitations of first-generation tracers include off-target binding and subcortical white-matter uptake; therefore, several institutions are working on developing second-generation Tau tracers. The increasing knowledge about the distribution of first- and second-generation Tau PET tracers in the brain may support physicians with Tau PET data interpretation, both in the research and in the clinical field, but an updated description of differences in distribution patterns among different Tau tracers, and in different clinical conditions, has not been reported yet. We provide an overview of first- and second-generation tracers used in ongoing clinical trials, also describing the differences and the properties of novel tracers, with a special focus on the distribution patterns of different Tau tracers. We also describe the distribution patterns of Tau tracers in AD, in atypical AD, and further neurodegenerative diseases in the dementia field.
Collapse
Affiliation(s)
- Maria Ricci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (R.C.); (A.C.); (O.S.)
- Correspondence:
| | - Andrea Cimini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (R.C.); (A.C.); (O.S.)
| | - Riccardo Camedda
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (R.C.); (A.C.); (O.S.)
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (R.C.); (A.C.); (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (R.C.); (A.C.); (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| |
Collapse
|
23
|
Sala A, Caminiti SP, Presotto L, Pilotto A, Liguori C, Chiaravalloti A, Garibotto V, Frisoni GB, D'Amelio M, Paghera B, Schillaci O, Mercuri N, Padovani A, Perani D. In vivo human molecular neuroimaging of dopaminergic vulnerability along the Alzheimer's disease phases. Alzheimers Res Ther 2021; 13:187. [PMID: 34772450 PMCID: PMC8588696 DOI: 10.1186/s13195-021-00925-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 10/18/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Preclinical and pathology evidence suggests an involvement of brain dopamine (DA) circuitry in Alzheimer's disease (AD). We in vivo investigated if, when, and in which target regions [123I]FP-CIT-SPECT regional binding and molecular connectivity are damaged along the AD course. METHODS We retrospectively selected 16 amyloid-positive subjects with mild cognitive impairment due to AD (AD-MCI), 22 amyloid-positive patients with probable AD dementia (AD-D), and 74 healthy controls, all with available [123I]FP-CIT-SPECT imaging. We tested whether nigrostriatal vs. mesocorticolimbic dopaminergic targets present binding potential loss, via MANCOVA, and alterations in molecular connectivity, via partial correlation analysis. Results were deemed significant at p < 0.05, after Bonferroni correction for multiple comparisons. RESULTS We found significant reductions of [123I]FP-CIT binding in both AD-MCI and AD-D compared to controls. Binding reductions were prominent in the major targets of the ventrotegmental-mesocorticolimbic pathway, namely the ventral striatum and the hippocampus, in both clinical groups, and in the cingulate gyrus, in patients with dementia only. Within the nigrostriatal projections, only the dorsal caudate nucleus showed reduced [123I]FP-CIT binding, in both groups. Molecular connectivity assessment revealed a widespread loss of inter-connections among subcortical and cortical targets of the mesocorticolimbic network only (poor overlap with the control group as expressed by a Dice coefficient ≤ 0.25) and no alterations of the nigrostriatal network (high overlap with controls, Dice coefficient = 1). CONCLUSION Local- and system-level alterations of the mesocorticolimbic dopaminergic circuitry characterize AD, already in prodromal disease phases. These results might foster new therapeutic strategies for AD. The clinical correlates of these findings deserve to be carefully considered within the emergence of both neuropsychiatric symptoms and cognitive deficits.
Collapse
Affiliation(s)
- Arianna Sala
- Vita-Salute San Raffaele University, Via Olgettina 60, Milan, 20132, Italy
- In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Silvia Paola Caminiti
- Vita-Salute San Raffaele University, Via Olgettina 60, Milan, 20132, Italy
- In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Luca Presotto
- Nuclear Medicine Unit, San Raffaele Hospital, 20132, Milan, Italy
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, 25121, Brescia, Italy
- Parkinson's Disease Rehabilitation Centre, FERB ONLUS - S. Isidoro Hospital, 24069, Trescore Balneario, Italy
| | - Claudio Liguori
- Division of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133, Rome, Italy
- IRCCS Neuromed, 86077, Pozzilli, Italy
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, University Hospitals of Geneva, and NIMTLab, Faculty of Medicine, Geneva University, 1205, Geneva, Switzerland
| | - Giovanni Battista Frisoni
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, University Hospitals of Geneva, and NIMTLab, Faculty of Medicine, Geneva University, 1205, Geneva, Switzerland
- Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, 1205, Geneva, Switzerland
| | - Marcello D'Amelio
- Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00179, Rome, Italy
- Unit of Molecular Neurosciences, Department of Medicine, University Campus-Biomedico, 00128, Rome, Italy
| | - Barbara Paghera
- Nuclear Medicine Unit, Spedali Civili Brescia, 25123, Brescia, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133, Rome, Italy
- IRCCS Neuromed, 86077, Pozzilli, Italy
| | - Nicola Mercuri
- Division of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
- Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, 00179, Rome, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, 25121, Brescia, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Via Olgettina 60, Milan, 20132, Italy.
- In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, San Raffaele Scientific Institute, 20132, Milan, Italy.
- Nuclear Medicine Unit, San Raffaele Hospital, 20132, Milan, Italy.
| |
Collapse
|
24
|
Vanni G, Pellicciaro M, Combi F, Papi S, Materazzo M, Segattini S, Rizza S, Chiocchi M, Perretta T, Meucci R, Portarena I, Pistolese CA, Ielpo B, Campanelli M, Lisi G, Chiaravalloti A, Tazzioli G, Buonomo OC. Impact of COVID-19 Pandemic on Surgical Breast Cancer Patients Undergoing Neoadjuvant Therapy: A Multicentric Study. Anticancer Res 2021; 41:4535-4542. [PMID: 34475080 DOI: 10.21873/anticanres.15265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Due to the SARS-CoV-2 pandemic, many scientific committees proposed neoadjuvant therapy (NACT) bridging treatment as a novel strategy and indication. The aim of the study was to evaluate the impact of COVID-19 pandemic on breast cancer patients undergoing NACT. PATIENTS AND METHODS All breast cancer patients referred to two Breast Units during COVID-19-pandemic were enrolled. RESULTS Out of 814 patients, 43(5.3%) were enrolled in the COVID-19-group and compared with 94 (7.9%) similar Pre-COVID-19 patients. We observed a reduction in the number of patients undergoing NACT, p=0.0019. No difference was reported in terms of clinical presentation, indications, and tumor response. In contrast, a higher number of vascular adverse events was reported (6.9% vs. 0% p=0.029). Immediate breast cancer reconstructions following invasive surgery suffered a significant slowdown (5.9% vs. 47.7%, p=0.019). CONCLUSION COVID-19 caused a reduction in the number of patients undergoing NACT, with no changes in terms of indications, clinical presentation, and tumor response. Furthermore, there was an increased incidence of vascular events.
Collapse
Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy;
| | - Francesca Combi
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilila, Modena, Italy
| | - Simona Papi
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilila, Modena, Italy
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Silvia Segattini
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilila, Modena, Italy
| | - Stefano Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marcello Chiocchi
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome, Rome, Italy
| | - Tommaso Perretta
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome, Rome, Italy
| | - Rosaria Meucci
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome, Rome, Italy
| | - Ilaria Portarena
- Department of Oncology, Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome, Rome, Italy
| | - Benedetto Ielpo
- Unidad de Chirugia Hepatobiliopancreática, Hospital Universitario del Mar, Barcelona, Spain
| | | | - Giorgio Lisi
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy
| | - Giovanni Tazzioli
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilila, Modena, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| |
Collapse
|
25
|
Zattoni F, Artioli P, Burei M, Chiaravalloti A, Chierichetti F, Donner D, Panareo S, Rambaldi I, Schillaci O, Del Moro F, Evangelista L. Detection rate of 18F-Choline positron emission tomography/computed tomography in patients with non-metastatic hormone sensitive and castrate resistant prostate cancer. ACTA ACUST UNITED AC 2021; 67:167-173. [PMID: 34477346 DOI: 10.23736/s1824-4785.21.03366-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM To assess the detection rate of 18F-choline PET/CT in non-metastatic hormone-sensitive prostate cancer (hsPCa) and non-metastatic castrate resistant prostate cancer (CRPCa), based on the criteria proposed in the phase III SPARTAN trial and with high Gleason Score (GS). METHODS Between October 2008 and September 2019, data from a retrospective multicenter study (n=4 centers), involving patients undergoing 18F-choline PET/CT scans for a biochemical recurrence of PCa, were collected. The following inclusion criteria were used: 1) histologically proven PCa, 2) a non-metastatic disease in accordance with conventional imaging findings; 3) a PSA doubling time (PSAdt) <10 months, 4) a GS > 8 and 5) no pelvic node > 2 cm. The group of hsPCa and CRPCa patients, were compared by using a non-parametric statistical analysis. Moreover, a logistic regression analysis and ROC curves were used. RESULTS 140 patients were included. Of these, 82 patients were affected by hsPCa, and 58 had a CRPCa. Overall, 18F-Choline PET/CT was positive in 99/140 (70.7%). It was positive in 55/82 (67.1%) hsPCa patients and in 44/58 (75.9%) CRPCa subjects, respectively. The site of recurrence at 18F-Choline PET/CT were: 16 (27.6%) and 20 (24.4%) in prostatic bed, 25 (43.1%) and 24 (29.3%) in loco-regional lymph nodes and in 27 (46.6%) and 28 (34.1%) in distant organs, respectively for CRPCa and hsPCa patients. The optimal cut-off values for PSA at the time of PET/CT for the prediction or recurrence were 0.5 vs. 2.5 ng/mL for all site of recurrence (AUC: 0.70 vs. 0.72), 0.48 vs. 3.4 ng/mL for prostatic bed (AUC: 0.60 vs. 0.59), 0.5 vs. 1.5 for loco-regional lymph nodes (AUC: 0.62 vs. 0.57) and 2.2 vs. 2.8 ng/mL for distant metastasis (AUC: 0.74 vs. 0.71), respectively in CRPCa and hsPCa (all p=NS). Sensitivities and specificities of 18F-Choline PET/CT for the identification of recurrence disease in all patient population, in hsPCa and CRPCa were 83.7% and 87.5%, 78.9% and 88.9%, 91.4% and 85.7%, respectively. CONCLUSIONS the rate of positive 18F-Choline PET/CT is similar in patients with a hsPCa and CRPCa, in case of low PSAdt and high GS. Therefore, non-metastatic PCa patients should be assessed by molecular imaging, in order to adapt the most appropriate therapeutic approach.
Collapse
Affiliation(s)
- Fabio Zattoni
- Clinical Urology, Azienda Ospedaliera Universitaria Integrata di Udine, Udine, Italy
| | - Paolo Artioli
- Nuclear Medicine, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Marta Burei
- Nuclear Medicine, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.,IRCCS Neuromed, Pozzilli, Isernia, Italy
| | | | | | - Stefano Panareo
- Nuclear Medicine, Diagnostic Imaging and Laboratory Medicine Department, University of Ferrara, Ferrara, Italy
| | - Ilaria Rambaldi
- Nuclear Medicine, Diagnostic Imaging and Laboratory Medicine Department, University of Ferrara, Ferrara, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.,Nuclear Medicine, S. Chiara Hospital, Trento, Italy
| | - Fabrizio Del Moro
- Department of Surgery, Oncology, and Gastroenterology, Urology Unit, University of Padua, Padua, Italy
| | - Laura Evangelista
- Nuclear Medicine, Department of Medicine - DIMED, University of Padua, Padua, Italy -
| |
Collapse
|
26
|
Chiaravalloti A, Ricci M, Cimini A, Russo F, Ursini F, Filippi L, Schillaci O. 18F-FDOPA PET/CT SUV-Derived Indices and Volumetric Parameters Correlation in Patients with Primary Brain Tumors. Cancers (Basel) 2021; 13:cancers13174315. [PMID: 34503123 PMCID: PMC8431205 DOI: 10.3390/cancers13174315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary This paper aims to improve the knowledge regarding 18F-FDOPA PET/CT parameters that may influence both the interpretation of PET data and the management of primary brain tumors. The evaluation of volumetric parameters in 18F-FDOPA imaging is uncommon, and we aim to increase the scientific interest on the potential role of volumetric parameters in the clinical practice. The standardized uptake value (SUV)-derived indices as SUV max, SUV mean, SUV max ratio, and SUV mean ratio are widely used but the exact methodology to elaborate SUV ratio is not well established. Therefore, this study aims to assess the correlation between SUV-derived indices and volumetric uptake parameters. Abstract Novel parameters in PET imaging, such as volumetric parameters, are gaining interest in the scientific literature, but the role of dopaminergic tumor volume (DTV) and total lesion F-DOPA activity (TLDA) and the correlation between volumetric and SUV-derived parameters are not well defined yet. One hundred and thirty-three patients that underwent 18F-FDOPA imaging for primary brain tumors were included in this retrospective study. SUV-derived indices were calculated (the occipital region was chosen to generate ratios of tumor SUV) and compared with volumetric parameters. Regression models were applied in univariate analysis and lnSUVmax was positively associated with lnDTV (beta 0.42, p = 0.007), the lnSUVmax ratio was positively associated with lnDTV (beta 0.80, p = 0.011), lnSUVmax was positively associated with lnTLDA (beta 1.27, p < 0.0001), and the lnSUVmax ratio was positively associated with lnTLDA (beta 1.87, p < 0.0001). Our study demonstrates that volumetric uptake parameters in 18F-FDOPA PET/CT are easier to assess in primary brain tumors with higher SUV max and SUV max ratios, and supports the emerging role of volumetric parameters in the data interpretation.
Collapse
Affiliation(s)
- Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (A.C.); (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Maria Ricci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (A.C.); (O.S.)
- Correspondence:
| | - Andrea Cimini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (A.C.); (O.S.)
| | - Francesca Russo
- UOC Nuclear Medicine, Policlinico Tor Vergata, 00133 Rome, Italy;
| | - Francesco Ursini
- IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40127 Bologna, Italy
| | - Luca Filippi
- UOC Nuclear Medicine, Santa Maria Goretti Hospital, 04100 Latina, Italy;
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (A.C.); (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| |
Collapse
|
27
|
Cimini A, Ricci M, Gigliotti PE, Pugliese L, Chiaravalloti A, Danieli R, Schillaci O. Medical Imaging in the Diagnosis of Schistosomiasis: A Review. Pathogens 2021; 10:pathogens10081058. [PMID: 34451522 PMCID: PMC8401107 DOI: 10.3390/pathogens10081058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 12/15/2022] Open
Abstract
Schistosomiasis is one of the most important parasitic diseases and it is endemic in tropical and subtropical areas. Clinical and laboratory data are fundamental for the diagnosis of schistosomiasis, but diagnostic imaging techniques such as x-rays, ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) may be helpful in the evaluation of disease severity and complications. In this context, the aim of this review is to explore the actual role of diagnostic imaging in the diagnosis of schistosomiasis, underlining advantages and drawbacks providing information about the utilization of diagnostic imaging techniques in this context. Furthermore, we aim to provide a useful guide regarding imaging features of schistosomiasis for radiology and nuclear medicine physicians of non-endemic countries: in fact, in the last years non-endemic countries have experienced important flows of migrants from endemic areas, therefore it is not uncommon to face cases of this disease in daily practice.
Collapse
Affiliation(s)
- Andrea Cimini
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
- Correspondence: ; Tel.: +39-(06)-20902467
| | - Maria Ricci
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
| | - Paola Elda Gigliotti
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
| | - Luca Pugliese
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
- Department of Radiology, San Giovanni Calibita Fatebenefratelli Hospital, Via di Ponte di Quattro Capi 39, 00186 Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
- Nuclear Medicine Section, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Roberta Danieli
- Department of Human Sciences and Promotion of the Quality of Life, University San Raffaele, Via di Val Cannuta 247, 00166 Rome, Italy;
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Via Cracovia 50, 00133 Rome, Italy; (M.R.); (P.E.G.); (L.P.); (A.C.); (O.S.)
- Nuclear Medicine Section, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| |
Collapse
|
28
|
Quartuccio N, Salem A, Laudicella R, Spataro A, Chiaravalloti A, Caobelli F, Cistaro A, Alongi P, Evangelista L. The role of 18F-Fluorodeoxyglucose PET/CT in restaging patients with small cell lung cancer: a systematic review. Nucl Med Commun 2021; 42:839-845. [PMID: 33741854 DOI: 10.1097/mnm.0000000000001407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM 18F-Fluorodeoxyglucose (FDG) PET imaging may play an important role in the restaging of patients with small-cell lung cancer (SCLC),, nevertheless, a systematic review of literature was still missing in this setting. The aim of this review was to summarize the evidence on literature regarding the utility of 18F-FDG PET imaging in restaging patients with SCLC. METHODS A literature search was performed to retrieve original studies using 18F-FDG PET or 18F-FDG PET/computed tomography (CT) in a minimum of 10 patients with SCLC at restaging. RESULTS The selected literature (17 studies) was discussed in four sections: detection rate, impact on management, prediction of prognosis and evaluation of the response to therapy. According to the literature, PET imaging may result in discordance with conventional imaging, mainly contrast-enhanced CT (ceCT), and detect additional lesions in a certain proportion of cases, leading to upstaging or downstaging. A variable level of disagreement between PET and conventional imaging has been reported also in the evaluation of response to therapy. A positive PET study is associated with shorter survival, especially in the presence of distant metastases. According to some studies, semiquantitative parameters are also inversely associated with overall survival and progression-free survival. Although the retrieved articles proved the utility of 18F-FDG PET imaging in each clinical setting, literature is still limited. CONCLUSIONS This review encourages the use of 18F-FDG PET imaging, especially in conjunction with ceCT in recurrent SCLC patients. Further level I evidence is needed to further assess the diagnostic and prognostic capability of 18F-FDG PET/ceCT findings in SCLC.
Collapse
Affiliation(s)
- Natale Quartuccio
- Nuclear Medicine Unit, ARNAS Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Ahmed Salem
- Division of Cancer Sciences, University of Manchester
- Clinical Oncology Department, Christie NHS Foundation Trust, Manchester, UK
| | - Riccardo Laudicella
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Alessandro Spataro
- Clinical Oncology Department, Christie NHS Foundation Trust, Manchester, UK
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Rome
- Nuclear Medicine Section, IRCCS Neuromed, Pozzilli, Italy
| | - Federico Caobelli
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Petersgraben, Basel, Switzerland
| | | | | | - Laura Evangelista
- Nuclear Medicine Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| |
Collapse
|
29
|
Alongi P, Chiaravalloti A, Berti V, Vellani C, Trifirò G, Puccini G, Carli G, Chincarini A, Morbelli S, Perani D, Sestini S. Amyloid PET in the diagnostic workup of neurodegenerative disease. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00428-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
30
|
Assanto GM, Ciotti G, Brescini M, Agrippino R, Lapietra G, De Luca ML, Annechini G, D'Elia GM, Chiaravalloti A, Del Giudice I, Pulsoni A. FAVOURABLE PROGNOSTIC ROLE OF HIGH BASAL MAXIMAL STANDARDIZED UPTAKE VALUE IN FOLLICULAR LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.95_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- G. M. Assanto
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Ciotti
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - M. Brescini
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - R. Agrippino
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Lapietra
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - M. L. De Luca
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Annechini
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. M. D'Elia
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - A. Chiaravalloti
- Nuclear medicine Department of Biomedicine and Prevention Nuclear Medicine University Tor Vergata Rome Italy
| | - I. Del Giudice
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - A. Pulsoni
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| |
Collapse
|
31
|
Assanto GM, Ciotti G, Brescini M, De Luca ML, Annechini G, D’Elia GM, Agrippino R, Del Giudice I, Martelli M, Chiaravalloti A, Pulsoni A. High Basal Maximal Standardized Uptake Value (SUV max) in Follicular Lymphoma Identifies Patients with a Low Risk of Long-Term Relapse. Cancers (Basel) 2021; 13:cancers13122876. [PMID: 34207518 PMCID: PMC8227030 DOI: 10.3390/cancers13122876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite that the unfavorable prognostic role of a high Total Metabolic Tumor Volume (TMTV) in Follicular Lymphoma has been demonstrated, the role of SUVmax alone at baseline PET/CT could have a different prognostic role. PATIENTS AND METHODS We performed a retrospective observational monocentric cohort study. All patients affected by FL who underwent a basal PET/CT were included. Two subgroups were identified and compared in terms of PFS and OS: (A) Basal SUVmax ≤ 6; and (B) Basal SUVmax > 6. RESULTS Ninety-four patients were included, 34 in group A (36.2%) and 60 in group B (63.8%). The PFS at two years was comparable in the two groups (97%). The five-year PFS was 73.5% for group A and 95% for group B (p 0.005). The five-year PFS in the whole cohort was 87.5%. A clear advantage was confirmed in group A in the absence of other risk factors. Patients with SUVmax ≤ 6 and no risk factors showed a 5-year PFS of 73% against 83% for patients with SUVmax > 6 and at least two risk factors. CONCLUSION A high FDG uptake favorably correlated with PFS. A low basal SUVmax reflected a higher rate of late relapse requiring a prolonged follow-up. The basal SUVmax is an approachable parameter with prognostic implications.
Collapse
Affiliation(s)
- Giovanni Manfredi Assanto
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Giulia Ciotti
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Mattia Brescini
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Maria Lucia De Luca
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Giorgia Annechini
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Gianna Maria D’Elia
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Roberta Agrippino
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
| | - Agostino Chiaravalloti
- Nuclear Medicine, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy;
- Nuclear Medicine, Istituto Neurologico Mediterraneo IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Alessandro Pulsoni
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy; (G.M.A.); (G.C.); (M.B.); (M.L.D.L.); (G.A.); (G.M.D.); (R.A.); (I.D.G.); (M.M.)
- Correspondence:
| |
Collapse
|
32
|
Assanto GM, Agrippino R, Lapietra G, De Luca ML, Chiaravalloti A, Annechini G, D'Elia GM, Ciotti G, Martelli M, Pulsoni A. THE ROLE OF END OF TREATMENT PET CT EVALUATED BY DEAUVILLE FIVE‐POINT SCALE AS PROGNOSTIC ROLE IN HODGKIN LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.69_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- G. M. Assanto
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - R. Agrippino
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Lapietra
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - M. L. De Luca
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - A. Chiaravalloti
- Nuclear medicine Department of Biomedicine and Prevention Nuclear Medicine University Tor Vergata Rome, Italy Rome Italy
| | - G. Annechini
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. M. D'Elia
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - G. Ciotti
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - M. Martelli
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| | - A. Pulsoni
- Haematology Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
| |
Collapse
|
33
|
Li J, Antonecchia E, Camerlenghi M, Chiaravalloti A, Chu Q, Costanzo AD, Li Z, Wan L, Zhang X, D'Ascenzo N, Schillaci O, Xie Q. Correlation of [ 18F]florbetaben textural features and age of onset of Alzheimer's disease: a principal components analysis approach. EJNMMI Res 2021; 11:40. [PMID: 33881633 PMCID: PMC8060386 DOI: 10.1186/s13550-021-00774-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/15/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND When Alzheimer's disease (AD) is occurring at an early onset before 65 years old, its clinical course is generally more aggressive than in the case of a late onset. We aim at identifying [[Formula: see text]F]florbetaben PET biomarkers sensitive to differences between early-onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD). We conducted [[Formula: see text]F]florbetaben PET/CT scans of 43 newly diagnosed AD subjects. We calculated 93 textural parameters for each of the 83 Hammers areas. We identified 41 independent principal components for each brain region, and we studied their Spearman correlation with the age of AD onset, by taking into account multiple comparison corrections. Finally, we calculated the probability that EOAD and LOAD patients have different amyloid-[Formula: see text] ([Formula: see text]) deposition by comparing the mean and the variance of the significant principal components obtained in the two groups with a 2-tailed Student's t-test. RESULTS We found that four principal components exhibit a significant correlation at a 95% confidence level with the age of onset in the left lateral part of the anterior temporal lobe, the right anterior orbital gyrus of the frontal lobe, the right lateral orbital gyrus of the frontal lobe and the left anterior part of the superior temporal gyrus. The data are consistent with the hypothesis that EOAD patients have a significantly different [[Formula: see text]F]florbetaben uptake than LOAD patients in those four brain regions. CONCLUSIONS Early-onset AD implies a very irregular pattern of [Formula: see text] deposition. The authors suggest that the identified textural features can be used as quantitative biomarkers for the diagnosis and characterization of EOAD patients.
Collapse
Affiliation(s)
- Jing Li
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China
| | - Emanuele Antonecchia
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China.,Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy
| | - Marco Camerlenghi
- NIM Competence Center for Digital Healthcare GmbH, Potsdamerplatz, 10, 10785, Berlin, Germany
| | - Agostino Chiaravalloti
- Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy. .,Department of Biomedicine and Prevention, University of Tor Vergata, 86100, Rome, Italy.
| | - Qian Chu
- Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road, Wuhan, 430030, China.,Department of Oncology, Tongji Hospital, Jiefang Avenue, Wuhan, 430030, China
| | - Alfonso Di Costanzo
- Universita degli Studi del Molise, Via Francesco de Sanctis, 1, 10115, Campobasso, Italy
| | - Zhen Li
- Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road, Wuhan, 430030, China.,Department of Radiology, Tongji Hospital, Jiefang Avenue, Wuhan, 430030, China
| | - Lin Wan
- Department of Software Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China
| | - Xiangsong Zhang
- The First Affiliated Hospital, Sun Yat-sen University, Zhongshan 2nd Road, Guangzhou, 510080, China
| | - Nicola D'Ascenzo
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China. .,Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy.
| | - Orazio Schillaci
- Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy.,Department of Biomedicine and Prevention, University of Tor Vergata, 86100, Rome, Italy
| | - Qingguo Xie
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Luoyu Road, Wuhan, 430074, China. .,Department of Medical Physics and Engineering, Istituto Neurologico Mediterraneo NEUROMED I.R.C.C.S, Via Dell'Elettronica, 83008, Pozzilli, Italy.
| |
Collapse
|
34
|
Filippi L, Chiaravalloti A, Basile P, Schillaci O, Bagni O. Molecular and metabolic imaging of castration-resistant prostate cancer: state of art and future prospects. Curr Mol Med 2021; 22:25-36. [PMID: 33573553 DOI: 10.2174/1566524021666210211112423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/23/2020] [Accepted: 02/02/2021] [Indexed: 11/22/2022]
Abstract
Prostate cancer (PCa) represents the most common tumor in male and one of the most relevant causes of death in Western countries. Androgen deprivation therapy (ADT) constitutes a widely used approach in advanced PCa. When PCa progresses in spite of ADT and castrate levels of testosterone, the severe clinical condition termed as metastatic castration-resistant prostate cancer (mCRPC) takes place. The only approach to mCRPC has been represented by chemotherapy with taxanes for many years. Nevertheless, recently introduced treatments such as 2nd generation antiandrogens (i.e. enzalutamide and abiraterone), cell immunotherapy with sipuleucel-T or targeted alpha therapy with 223Ra-dichloride, have dramatically changed mCRPC prognosis. These novel therapies call for an unmet need for imaging biomarkers suitable for patients' pre-treatment stratification and response assessment. In this scenario, nuclear medicine can provide several metabolic and molecular probes for investigating pathological processes at a cellular and sub-cellular level. The aim of this paper is to review the most relevant findings of the literature published to date on this topic, giving particular emphasis to the pros and cons of each tracer and also covering future prospects for defining personalized therapeutic approaches.
Collapse
Affiliation(s)
- Luca Filippi
- Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina. Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome. Italy
| | - Pietro Basile
- Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina. Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome. Italy
| | - Oreste Bagni
- Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina. Italy
| |
Collapse
|
35
|
Ciaffi J, Gigliotti PE, Festuccia G, Borlandelli E, Facchini G, Chiaravalloti A, Miceli M, Meliconi R, Ursini F. Can chest imaging be used to draw information about body mass index and obesity status? Obes Res Clin Pract 2021; 15:187-190. [PMID: 33551289 DOI: 10.1016/j.orcp.2021.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/17/2021] [Accepted: 01/22/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Jacopo Ciaffi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
| | - Paola Elda Gigliotti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gianluca Festuccia
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Elena Borlandelli
- Radiology Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola Malpighi University Hospital, 40138 Bologna, Italy
| | - Giancarlo Facchini
- Diagnostic and Interventional Radiology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Marco Miceli
- Diagnostic and Interventional Radiology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Riccardo Meliconi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; Department of Biomedical and Neuromotor sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy
| | - Francesco Ursini
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; Department of Biomedical and Neuromotor sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy
| |
Collapse
|
36
|
Vanni G, Materazzo M, Pellicciaro M, Morando L, Portarena I, Anemona L, D'Angelillo MR, Barbarino R, Chiaravalloti A, Meucci R, Perretta T, Deiana C, Orsaria P, Caspi J, Pistolese CA, Buonomo OC. Does Age Matter? Estimating Risks of Locoregional Recurrence After Breast-conservative Surgery. In Vivo 2021; 34:1125-1132. [PMID: 32354901 DOI: 10.21873/invivo.11884] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND/AIM In 2016, in the United States, more than 50% of breast cancer (BC) cases were diagnosed in patients older than 60 years of age. Our study aimed to estimate the risk of locoregional recurrence (LR) in patients who underwent breast-conservative treatment (BCT), according to age. PATIENTS AND METHODS This retrospective monocentric study analyzed 613 cases of patients who underwent BCT between 2003 and 2014. Patients were divided into groups according to age: Under70 (under 70 years old) and Over70 (above 70 years old). Margins width, histology results, prognostic and predictive factors were compared. Subgroup analysis was performed for patients who experienced LR. RESULTS LR Incidence among Under70 and Over70 was 5.4% and 1.7%, respectively (p<0.01). Group Over70 is characterized by larger tumors and a lower Ki67 index (p<0.01). CONCLUSION Operation time reduction, better aesthetic results and reduced LR risk support BCT. The Over70 group exhibited better outcomes in terms of LR despite larger tumor dimensions.
Collapse
Affiliation(s)
- Gianluca Vanni
- Breast Unit - Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Materazzo
- Breast Unit - Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit - Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Ljuba Morando
- Breast Unit - Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Ilaria Portarena
- Department of Oncology, Policlinico Tor Vergata University, Rome, Italy
| | - Lucia Anemona
- Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Rome, Italy
| | - Maria Rolando D'Angelillo
- Radiotherapy Unit, Department of Oncology and Hematology, Policlinico Tor Vergata University, Rome, Italy
| | - Rosaria Barbarino
- Radiotherapy Unit, Department of Oncology and Hematology, Policlinico Tor Vergata University, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy
| | - Rosaria Meucci
- Breast Unit - Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy.,Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Tommaso Perretta
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Camilla Deiana
- Breast Unit - Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Paolo Orsaria
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Jonathan Caspi
- Breast Unit - Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit - Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| |
Collapse
|
37
|
Vanni G, Tazzioli G, Pellicciaro M, Materazzo M, Paolo O, Cattadori F, Combi F, Papi S, Pistolese CA, Cotesta M, Santori F, Caspi J, Chiaravalloti A, Muscoli S, Lombardo V, Grasso A, Caggiati L, Raselli R, Palli D, Altomare V, D'Angelillo RM, Palombi L, Buonomo OC. Delay in Breast Cancer Treatments During the First COVID-19 Lockdown. A Multicentric Analysis of 432 Patients. Anticancer Res 2020; 40:7119-7125. [PMID: 33288611 DOI: 10.21873/anticanres.14741] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Extraordinary restrictions aimed to limit Sars-CoV-2 spreading; they imposed a total reorganization of the health-system. Oncological treatments experienced a significant slowdown. The aim of our multicentric retrospective study was to evaluate screening suspension and surgical treatment delay during COVID-19 and the impact on breast cancer presentation. PATIENTS AND METHODS All patients who underwent breast surgery from March 11, 2020 to May 30, 2020 were evaluated and considered as the Lockdown group. These patients were compared with similar patients of the previous year, the Pre-Lockdown group. RESULTS A total of 432 patients were evaluated; n=223 and n=209 in the Lockdown and Pre-lockdown-groups, respectively. At univariate analysis, waiting times, lymph-nodes involvement and cancer grading, showed a statistically significant difference (p<0.05). Multivariate analysis identified waiting-time on list (OR=1.07) as a statistically significant predictive factor of lymph node involvement. CONCLUSION Although we did not observe a clinically evident difference in breast cancer presentation, we reported an increase in lymph node involvement.
Collapse
Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
| | - Giovanni Tazzioli
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy;
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
| | - Orsaria Paolo
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Francesca Cattadori
- Breast Surgery, Breast Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Francesca Combi
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilia, Modena, Italy.,Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy.,Breast Surgery, Breast Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.,PhD Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona Papi
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Maria Cotesta
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
| | - Francesca Santori
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
| | - Jonathan Caspi
- Tor Vergata School of Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy
| | - Saverio Muscoli
- Department of Cardiovascular Disease, Tor Vergata University, Rome, Italy
| | - Vittorio Lombardo
- Department of General Surgery, I.R.C.C.S. Centro Neurolesi Bonino Pulejo P.O. Piemnote, Messina, Italy
| | - Antonella Grasso
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Lorenza Caggiati
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Roberta Raselli
- Breast Surgery, Breast Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Dante Palli
- Breast Surgery, Breast Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Vittorio Altomare
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Rolando Maria D'Angelillo
- Radiotherapy Unit, Department of Oncology and Hematology, Policlinico Tor Vergata University, Rome, Italy
| | - Leonardo Palombi
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, PTV: Policlinico Tor Vergata University, Rome, Italy
| |
Collapse
|
38
|
Ricci M, Cimini A, Chiaravalloti A, Filippi L, Schillaci O. Positron Emission Tomography (PET) and Neuroimaging in the Personalized Approach to Neurodegenerative Causes of Dementia. Int J Mol Sci 2020; 21:ijms21207481. [PMID: 33050556 PMCID: PMC7589353 DOI: 10.3390/ijms21207481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/01/2020] [Accepted: 10/08/2020] [Indexed: 12/14/2022] Open
Abstract
Generally, dementia should be considered an acquired syndrome, with multiple possible causes, rather than a specific disease in itself. The leading causes of dementia are neurodegenerative and non-neurodegenerative alterations. Nevertheless, the neurodegenerative group of diseases that lead to cognitive impairment and dementia includes multiple possibilities or mixed pathologies with personalized treatment management for each cause, even if Alzheimer's disease is the most common pathology. Therefore, an accurate differential diagnosis is mandatory in order to select the most appropriate therapy approach. The role of personalized assessment in the treatment of dementia is rapidly growing. Neuroimaging is an essential tool for differential diagnosis of multiple causes of dementia and allows a personalized diagnostic and therapeutic protocol based on risk factors that may improve treatment management, especially in early diagnosis during the prodromal stage. The utility of structural and functional imaging could be increased by standardization of acquisition and analysis methods and by the development of algorithms for automated assessment. The aim of this review is to focus on the most commonly used tracers for differential diagnosis in the dementia field. Particularly, we aim to explore 18F Fluorodeoxyglucose (FDG) and amyloid positron emission tomography (PET) imaging in Alzheimer's disease and in other neurodegenerative causes of dementia.
Collapse
Affiliation(s)
- Maria Ricci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (A.C.); (O.S.)
- Correspondence:
| | - Andrea Cimini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (A.C.); (O.S.)
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (A.C.); (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Luca Filippi
- Nuclear Medicine Section, “Santa Maria Goretti” Hospital, 04100 Latina, Italy;
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.C.); (A.C.); (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| |
Collapse
|
39
|
Cimini A, Ricci M, Chiaravalloti A, Crocco A, Russo F, Schillaci O. A Rare Case of Pulmonary Schistosomiasis: 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings. Indian J Nucl Med 2020; 35:336-338. [PMID: 33642761 PMCID: PMC7905290 DOI: 10.4103/ijnm.ijnm_79_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 04/28/2020] [Accepted: 05/01/2020] [Indexed: 11/04/2022] Open
Abstract
Schistosomiasis is a helminthic infection acquired through direct contact with contaminated fresh water. To the best of our knowledge, this is the first case pulmonary of schistosomias is evaluated with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) reported in the literature. Functional imaging with 18F-FDG PET/CT may help in the diagnosis of schistosomiasis, leading to a correct definition of the disease extension.
Collapse
Affiliation(s)
- Andrea Cimini
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Maria Ricci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Department of Nuclear Medicine IRCSS, Neuromed, Pozzilli, Italy
| | - Antonio Crocco
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Francesca Russo
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
- Department of Nuclear Medicine IRCSS, Neuromed, Pozzilli, Italy
| |
Collapse
|
40
|
Vanni G, Pellicciaro M, Materazzo M, Bruno V, Oldani C, Pistolese CA, Buonomo C, Caspi J, Gualtieri P, Chiaravalloti A, Palombi L, Piccione E, Buonomo OC. Lockdown of Breast Cancer Screening for COVID-19: Possible Scenario. In Vivo 2020; 34:3047-3053. [PMID: 32871851 DOI: 10.21873/invivo.12139] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND/AIM Coronavirus disease is spreading worldwide. Due to fast transmission and high fatality rate drastic emergency restrictions were issued. During the lockdown, only urgent medical services are guaranteed. All non-urgent services, as breast cancer (BC) screening, are temporarily suspended. The potential of breast cancer screening programs in increasing the survival rate and decreasing the mortality rate has been widely confirmed. Suspension could lead to worse outcomes for breast cancer patients. Our study aimed to analyse the data and provide estimates regarding the temporary BC screening suspension. PATIENTS AND METHODS Data regarding breast cancer and respective screening programs were achieved through literature research and analysis. RESULTS Considering three different scenarios with respect to the lockdown's impact on breast cancer screening, we estimate that approximately 10,000 patients could have a missed diagnosis during these 3 months. Considering a 6-month period, as suggested by the Imperial college model, the number of patients who will not receive a diagnosis will rise to 16,000. CONCLUSION Breast cancer screening should be resumed as soon as possible in order to avoid further breast cancer missed diagnosis and reduce the impact of delayed diagnosis.
Collapse
Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Valentina Bruno
- Section of Gynecology, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Oldani
- Department of Economics and Engineering, University of Viterbo 'La Tuscia', Viterbo, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Buonomo
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Rome, Italy
| | - Jonathan Caspi
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Paola Gualtieri
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy
| | - Leonardo Palombi
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy
| | - Emilio Piccione
- Section of Gynecology, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| |
Collapse
|
41
|
Abstract
INTRODUCTION Alpha emitters present several advantages for cancer therapy. The radiopharmaceutical 223Ra-dichloride has been recently introduced for the targeted alpha therapy (TAT) of metastastic castration-resistant prostate cancer (mCRPC). However, since 223Ra-dichloride targets only skeletal lesions, its use in clinical practice is recommended only in subjects without visceral metastases. To overcome this, several efforts have been made to develop radiopharmaceuticals suitable for TAT and specifically directed toward the biomarker prostate specific membrane antigen (PSMA), overexpressed by both skeletal and visceral metastases from mCRPC. AREAS COVERED The radiobiological principles concerning TAT applications are covered, with particular emphasis on its pros and cons, especially in comparison with beta-emitter radionuclide therapy. Furthermore, the role of PSMA as a theranostic target for imaging and therapy is reviewed. Lastly, the pre-clinical and clinical applications of TAT through 225Actinium (225AC) and 213Bismuth (213Bi) are discussed. EXPERT OPINION PSMA-based TAT holds the promise of becoming a powerful tool for the management of mCRPC. Nevertheless, several issues have still to be addressed, especially concerning TAT toxicity. Furthermore, several efforts have to be made for identifying the more adequate alpha-emitter (225Ac vs 213Bi) with a view to the patient's tailored therapeutic approach.
Collapse
Affiliation(s)
- Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital , Latina, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata , Rome, Italy.,IRCCS Neuromed , Pozzilli, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata , Rome, Italy.,IRCCS Neuromed , Pozzilli, Italy
| | - Oreste Bagni
- Department of Nuclear Medicine, Santa Maria Goretti Hospital , Latina, Italy
| |
Collapse
|
42
|
Vanni G, Pellicciaro M, Materazzo M, Dauri M, D'angelillo RM, Buonomo C, De Majo A, Pistolese C, Portarena I, Mauriello A, Servadei F, Giacobbi E, Chiaravalloti A, Buonomo OC. Awake breast cancer surgery: strategy in the beginning of COVID-19 emergency. Breast Cancer 2020; 28:137-144. [PMID: 32734327 PMCID: PMC7391474 DOI: 10.1007/s12282-020-01137-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/16/2020] [Indexed: 01/09/2023]
Abstract
Introduction COVID-19 is a declared worldwide pandemic. In our country, due to shortage of hospitals and beds in intensive care unit, oncological and breast cancer (BC) resources are temporarily shifted to COVID-19 patients. In addition, risk of cross-infections should be considered in these frail patients. To accomplish more surgical procedures and to reduce the length of hospital stay (LOS), fast track awake BC surgery should be implemented. The aim of the study is to estimate the effects of surgical shift in our facility during the early COVID-19 outbreak. Materials and methods From 30th January 2020 to 30th of March 2020, 86 consecutive patients were retrospectively enrolled and divided into pre-COVID-19-BC and COVID-19-BC. Clinical parameters and anamnestic data were collected and analyzed. Surgical procedures, relative complications and type of anaesthesia were reported. The effect on surgical time (ST), operative room time (ORT) and length of stay (LOS) were described and examined. Results No statistical difference was found in complications rate, clinical data and surgical procedures (p > 0.05). Awake breast conservative surgery (BCS) was the most frequent procedure in COVID-19-BC (p = 0.006). A statistically significant decrease in ORT and LOS was reported in COVID-19-BC (p = 0.040 and p = 0.0015 respectively), while comparable time resulted for ST (p = 0.976). Mean ORT and LOS reduction were 20.79 min and 0.57 hospital bed days. Conclusion In the “COVID-19 era”, fast track awake breast surgery provides a reduction of ORT, LOS and potentially surgical treatment for a wider number of oncological patients.
Collapse
Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, PTV Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, PTV Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy.
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, PTV Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| | - Mario Dauri
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, Italy
| | - Rolando Maria D'angelillo
- Radiotherapy Unit, Department of Oncology and Hematology, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| | - Chiara Buonomo
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, Italy
| | - Adriano De Majo
- Breast Unit, Department of Surgical Science, PTV Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| | - Chiara Pistolese
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| | - Ilaria Portarena
- Department of Oncology, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| | - Alessandro Mauriello
- Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| | - Francesca Servadei
- Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| | - Erica Giacobbi
- Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Via Atinense 18, 86077, Pozzilli, IS, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, PTV Policlinico Tor Vergata University, Viale Oxford 81, 00133, Rome, RM, Italy
| |
Collapse
|
43
|
Chiaravalloti A, Filippi L, Bagni O, Schillaci O, Czosnyka Z, Czosnyka M, de Pandis MF, Federici G, Galli M, Pompucci A, Petrella G. Cortical metabolic changes and clinical outcome in normal pressure hydrocephalus after ventriculoperitoneal shunt: Our preliminary results. Rev Esp Med Nucl Imagen Mol 2020; 39:367-374. [PMID: 32660834 DOI: 10.1016/j.remn.2020.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/31/2019] [Accepted: 01/08/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Our objective was to evaluate the cortical metabolic changes and clinical outcome in patients affected by idiopathic normal pressure hydrocephalus (iNPH) after a placement of ventriculoperitoneal (VP) shunt. MATERIALS AND METHODS 10 patients affected by suspected iNPH underwent a CSF hydrodynamics evaluation based on a lumbar infusion test (LIT). The main selection criterion for surgery was based on intracranial elasticity (IE)>0.30. All subjects with an IE>0.30 underwent a PET scan with 18 fluorodeoxiglucose (18F-FDG) at baseline (PET1) and 1 month after surgery (PET2). Furthermore, the same patients were submitted to clinical evaluation before and 1 month after surgery through neuropsychological tests and gait analysis. RESULTS An overall number of 20 18F-FDG PET scans were performed in all the enrolled patients. As compared to PET1, PET2 showed an increase in glucose consumption in the left frontal and left parietal lobe in PET2 as compared to PET1 (P<.001). All the enrolled patients presented a significant increase in neuropsychological scores (i.e Frontal Assessment Battery and Montreal Cognitive Assessment) and have clinically improved at gait analysis. A significant correlation was found between the increase of cortical glucose consumption in the left parietal area and the cognitive improvement as detectable by neuropsychological assessment. CONCLUSIONS Improvement in 18F FDG PET glucose metabolism could be considered a useful imaging marker for the assessment of iNPH response to VP shunting.
Collapse
Affiliation(s)
- A Chiaravalloti
- Departamento de Biomedicina y Prevención, Universidad Tor Vergata, Roma, Italia; IRCCS Neuromed, Pozzilli, Italia.
| | - L Filippi
- UOC Medicina Nuclear, Hospital Santa Maria Goretti, Latina, Italia
| | - O Bagni
- UOC Medicina Nuclear, Hospital Santa Maria Goretti, Latina, Italia
| | - O Schillaci
- Departamento de Biomedicina y Prevención, Universidad Tor Vergata, Roma, Italia; IRCCS Neuromed, Pozzilli, Italia
| | - Z Czosnyka
- Departamento de Neurociencias Clínicas, División de Neurocirugía, Cambridge University Hospital, Cambridge, Reino Unido
| | - M Czosnyka
- Departamento de Neurociencias Clínicas, División de Neurocirugía, Cambridge University Hospital, Cambridge, Reino Unido
| | - M F de Pandis
- Hospital San Raffaele Cassino, Tosinvest Sanità, Cassino, Italia
| | - G Federici
- Hospital San Raffaele Cassino, Tosinvest Sanità, Cassino, Italia
| | - M Galli
- Departamento de Electrónica, Información y Bioingeniería, Politecnico di Milano, Milán, Italia
| | - A Pompucci
- Departamento de Neurocirugía, Hospital S. Maria Goretti, Latina, Italia
| | - G Petrella
- Departamento de Neurocirugía, Hospital S. Maria Goretti, Latina, Italia
| |
Collapse
|
44
|
Vanni G, Materazzo M, Santori F, Pellicciaro M, Costesta M, Orsaria P, Cattadori F, Pistolese CA, Perretta T, Chiocchi M, Meucci R, Lamacchia F, Assogna M, Caspi J, Granai AV, DE Majo A, Chiaravalloti A, D'Angelillo MR, Barbarino R, Ingallinella S, Morando L, Dalli S, Portarena I, Altomare V, Tazzioli G, Buonomo OC. The Effect of Coronavirus (COVID-19) on Breast Cancer Teamwork: A Multicentric Survey. In Vivo 2020; 34:1685-1694. [PMID: 32503830 DOI: 10.21873/invivo.11962] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND/AIM Despite the large amount of clinical data available of Coronavirus-19 (COVID-19), not many studies have been conducted about the psychological toll on Health Care Workers (HCWs). PATIENTS AND METHODS In this multicentric descriptive study, surveys were distributed among 4 different Breast Cancer Centers (BCC). BCCs were distinguished according to COVID-19 tertiary care hospital (COVID/No-COVID) and district prevalence (DP) (High vs. Low). DASS-21 score, PSS score and demographic data (age, sex, work) were evaluated. RESULTS A total of 51 HCWs were analyzed in the study. Age, work and sex did not demonstrate statistically significant values. Statistically significant distribution was found between DASS-21-stress score and COVID/No-COVID (p=0.043). No difference was found in the remaining DASS-21 and PSS scores, dividing the HCWs according to COVID-19-hospital and DP. CONCLUSION Working in a COVID-19-hospital represents a factor that negatively affects psychosocial well-being. However, DP seems not to affect the psychosocial well-being of BCC HCWs. During the outbreak, psychological support for low risk HCWs should be provided regardless DP.
Collapse
Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Francesca Santori
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Maria Costesta
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Paolo Orsaria
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Francesca Cattadori
- UO Breast Surgery, Breast Unit, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Tommaso Perretta
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Marcello Chiocchi
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Rosaria Meucci
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy.,Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Feliciana Lamacchia
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Massimo Assogna
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Jonathan Caspi
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | | | - Adriano DE Majo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy
| | - Maria Rolando D'Angelillo
- Radiotherapy Unit, Department of Oncology and Hematology, Policlinico Tor Vergata University, Rome, Italy
| | - Rosaria Barbarino
- Radiotherapy Unit, Department of Oncology and Hematology, Policlinico Tor Vergata University, Rome, Italy
| | - Sara Ingallinella
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Ljuba Morando
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Stefania Dalli
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Ilaria Portarena
- Department of Oncology, Policlinico Tor Vergata University, Rome, Italy
| | - Vittorio Altomare
- Department of Breast Surgery, University Campus Bio-Medico, Rome, Italy
| | - Giovanni Tazzioli
- Oncologic Breast Surgery Unit, Azienda Ospedaliero-Universitaria Policlinico Hospital of Modena, Modena, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| |
Collapse
|
45
|
Cimini A, Ricci M, Chiaravalloti A, Filippi L, Schillaci O. Theragnostic Aspects and Radioimmunotherapy in Pediatric Tumors. Int J Mol Sci 2020; 21:ijms21113849. [PMID: 32481723 PMCID: PMC7312954 DOI: 10.3390/ijms21113849] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/22/2020] [Accepted: 05/27/2020] [Indexed: 12/19/2022] Open
Abstract
The use of theragnostic radiopharmaceuticals in nuclear medicine has grown rapidly over the years to combine the diagnosis and therapy of tumors. In this review, we performed web-based and desktop literature research to investigate and explain the potential role of theragnostic imaging in pediatric oncology. We focused primarily on patients with aggressive malignancies such as neuroblastoma and brain tumors, to select patients with the highest chance of benefit from personalized therapy. Moreover, the most critical and groundbreaking applications of radioimmunotherapy in children’s oncology were examined in this peculiar context. Preliminary results showed the potential feasibility of theragnostic imaging and radioimmunotherapy in pediatric oncology. They revealed advantages in the management of the disease, thereby allowing an intra-personal approach and adding new weapons to conventional therapies.
Collapse
Affiliation(s)
- Andrea Cimini
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy; (M.R.); (A.C.); (O.S.)
- Correspondence: ; Tel.: +39-062-090-2467
| | - Maria Ricci
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy; (M.R.); (A.C.); (O.S.)
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy; (M.R.); (A.C.); (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Luca Filippi
- Nuclear Medicine Section, “Santa Maria Goretti” Hospital, 04100 Latina, Italy;
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy; (M.R.); (A.C.); (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| |
Collapse
|
46
|
Di Giuliano F, Picchi E, Muto M, Calcagni A, Ferrazzoli V, Da Ros V, Minosse S, Chiaravalloti A, Garaci F, Floris R, Muto M. Radiological imaging in multiple myeloma: review of the state-of-the-art. Neuroradiology 2020; 62:905-923. [DOI: 10.1007/s00234-020-02417-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 03/26/2020] [Indexed: 12/16/2022]
|
47
|
Filippi L, Chiaravalloti A, Schillaci O, Cianni R, Bagni O. Theranostic approaches in nuclear medicine: current status and future prospects. Expert Rev Med Devices 2020; 17:331-343. [PMID: 32157920 DOI: 10.1080/17434440.2020.1741348] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Theranostics is an emerging field in which diagnosis and specific targeted therapy are combined to achieve a personalized treatment approach to the patient. In nuclear medicine clinical practice, theranostics is often performed utilizing the same molecule labeled with two different radionuclides, one radionuclide for imaging and another for therapy.Areas covered: The authors review the clinical applications of different radiopharmaceuticals in the field of interest, including the well-established use of radioactive iodine in differentiated thyroid cancer, radiolabeled metaiodobenzylguanidine (MIBG) in neuroblastoma and the clinical impact of peptide radionuclide receptorial therapy (PRRT) in the management of neuroendocrine tumors. Furthermore, the more cutting-edge and recently introduced theranostic approaches will be reviewed, such as the radioligand therapy with 177Lu-prostate specific membrane antigen (PSMA) and targeted alpha therapy in castration-resistant prostate cancer. Finally, the main applications of PET for the imaging of biomarkers suitable for the non-radionuclide targeted therapy will be covered.Expert opinion: Theranostics is envisaging a revolutionary clinical approach which is deeply connected with the concept of personalized medicine and ruled by a 'patient-centered' vision. In this perspective, the theranostic applications will need well-trained specialists, capable to manage not only the technological aspects of the discipline, but also to deal with the more innovative oncological therapies in a multidisciplinary setting.
Collapse
Affiliation(s)
- Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Roberto Cianni
- Department of Interventional Radiology, S. Camillo Hospital, Rome, Italy
| | - Oreste Bagni
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| |
Collapse
|
48
|
Vanni G, Materazzo M, Perretta T, Meucci R, Anemona L, Buonomo C, Dauri M, Granai AV, Rho M, Ingallinella S, Tacconi F, Ambrogi V, Chiaravalloti A, Schillaci O, Petrella G, Buonomo OC. Impact of Awake Breast Cancer Surgery on Postoperative Lymphocyte Responses. In Vivo 2020; 33:1879-1884. [PMID: 31662515 DOI: 10.21873/invivo.11681] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Surgical stress and anesthesia affect the patient's immune system. Analysis of the lymphocyte response after breast-conserving surgery was conducted to investigate the differences between effects after general and local anesthesia. MATERIALS AND METHODS Fifty-six patients with breast cancer were enrolled for BCS through local or general anesthesia. Total leukocytes, total lymphocytes, lymphocyte-subsets including CD3+, CD19+, CD4+, CD8+, CD16+CD56+ and CD4+/CD8+ ratio was examined at baseline and on postoperative days 1, 2 and 3. RESULTS Baseline data showed no statistical difference between the two groups. Within-group ANOVA test showed significant differences for total leukocyte count (p<0.001), total lymphocyte count (p=0.009) and proportion of natural-killer cells (p=0.01) in the control group. Between-group analysis showed lower median values of total lymphocytes in the awake surgery group on postoperative days 1, 2 and 3 (p=0.001, p=0.02 and p=0.01, respectively) when compared to the control group. Patients who underwent surgery under general anesthesia had higher total lymphocyte counts on postoperative day 2 (p=0.04). CONCLUSION In this randomized study, breast-conserving surgery plus local anesthesia had a lower impact on postoperative lymphocyte response when compared to the same procedure performed under general anesthesia.
Collapse
Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Tommaso Perretta
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Rosaria Meucci
- Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy
| | - Lucia Anemona
- Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Buonomo
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Rome, Italy
| | - Mario Dauri
- Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Rome, Italy
| | | | - Maurizio Rho
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Sara Ingallinella
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Federico Tacconi
- Division of Thoracic Surgery, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Vincenzo Ambrogi
- Division of Thoracic Surgery, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy
| | - Giuseppe Petrella
- Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| |
Collapse
|
49
|
Ricci M, Chiaravalloti A, Martorana A, Koch G, De Lucia V, Barbagallo G, Schillaci O. The role of epsilon phenotype in brain glucose consumption in Alzheimer's disease. Ann Nucl Med 2020; 34:254-262. [PMID: 32016694 DOI: 10.1007/s12149-020-01441-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/21/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of our study was to investigate the impact of the epsilon phenotype in brain glucose consumption in a population with Alzheimer's disease. METHODS Statistical Parametric Mapping (SPM8) was used to investigate differences in brain glucose consumption (as detectable by means of 18F FDG-PET/CT) in the population examined. A total of 129 patients (72 females and 57 males) with a diagnosis of probable AD according to the NINCDS-ADRDA criteria underwent the PET/CT examination. The mean (SD) age of the patients was 70 (± 7) years; the mean Mini-Mental State Examination was 19(± 5.6). 59 expressed epsilon 4 phenotype (E4) and 70 expressed the epsilon 3 phenotype (E3). Cerebral spinal fluid amyloid, tau, and t-tau have been measured resulting equal to 367.4 (± 149.1), 584.7 (± 312.1), and 79.2(± 45.9) pg/ml, respectively. Patients with confirmed amyloid and Tau changes were classified as AD. Patients with amyloid changes but negative Tau, considered as high risk of AD, were classified as IAD. Age, sex, MMSE, scholarship, and CSF parameters were used as a covariate in the SPM analyses. RESULTS We did not find significant differences in age, gender, and MMSE and CSF parameters among groups. In the analysis of the AD group as compared to AD-E3, AD-E4 subjects show a significant reduction of brain glucose consumption in inferior frontal gyrus bilaterally (BA 45, BA 47). In the analysis of the IAD group as compared to IAD-E3, IAD-E4 subjects show a significant reduction of brain glucose consumption in right in medial, middle, and superior frontal gyrus (BA10, BA11), and in left medial and middle frontal gyrus (BA10, BA11). The differences between IAD-E3 and AD-E3 and between IAD-E4 and AD-E4 (and vice versa analysis) resulted not significant. CONCLUSIONS APO-e4 is related to a major involvement of the frontal cortex confirming its role of risk factor in AD, while APO-3 seems not related to a specific pattern, supporting the hypothesis of neutral/protective role in AD.
Collapse
Affiliation(s)
- Maria Ricci
- Department of Radiological, Oncological and Pathological Sciences, Faculty of Medicine and Surgery, La Sapienza University, Rome, Italy.
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
- IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, IS, Italy
| | - Alessandro Martorana
- UOSD Centro Demenze PTV, System Medicine, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Giacomo Koch
- UOSD Centro Demenze PTV, System Medicine, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
- Non Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Vincenzo De Lucia
- UOSD Centro Demenze PTV, System Medicine, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Gaetano Barbagallo
- Institute of Neurology, Magna Græcia University, 88100, Catanzaro, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
- IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, IS, Italy
| |
Collapse
|
50
|
Chiaravalloti A, Filippi L, Ricci M, Cimini A, Schillaci O. Molecular Imaging in Pediatric Brain Tumors. Cancers (Basel) 2019; 11:cancers11121853. [PMID: 31771237 PMCID: PMC6966547 DOI: 10.3390/cancers11121853] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/16/2019] [Accepted: 11/19/2019] [Indexed: 02/07/2023] Open
Abstract
In the last decade, several radiopharmaceuticals have been developed and investigated for imaging in vivo of pediatric brain tumors with the aim of exploring peculiar metabolic processes as glucose consumption, amino-acid metabolism, and protein synthesis with nuclear medicine techniques. Although the clinical shreds of evidence are limited, preliminary results are encouraging. In this review, we performed web-based and desktop research summarizing the most relevant findings of the literature published to date on this topic. Particular attention was given to the wide spectrum of nuclear medicine advances and trends in pediatric neurooncology and neurosurgery. Furthermore, the role of somatostatin receptor imaging through single-photon emission computed tomography (SPECT) and positron emission tomography (PET) probes, with reference to their potential therapeutic implications, was examined in the peculiar context. Preliminary results show that functional imaging in pediatric brain tumors might lead to significant improvements in terms of diagnostic accuracy and it could be of help in the management of the disease.
Collapse
Affiliation(s)
- Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
- Correspondence: or ; Tel.: +39-062-090-2457
| | - Luca Filippi
- Nuclear Medicine Section, “Santa Maria Goretti” Hospital, 04100 Latina, Italy;
| | - Maria Ricci
- Department of Radiological, Oncological and Pathological Sciences, Faculty of Medicine and Surgery, La Sapienza University, 00161 Rome, Italy;
| | - Andrea Cimini
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy (O.S.)
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
| |
Collapse
|