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Geenen RWF, van der Molen AJ, Dekkers IA, Bellin MF, Bertolotto M, Correas JM, Heinz-Peer G, Mahnken AH, Quattrocchi CC, Radbruch A, Reimer P, Roditi G, Sebastià C, Stacul F, Romanini L, Clément O, Brismar TB. Contrast media for hysterosalpingography: systematic search and review providing new guidelines by the Contrast Media Safety Committee of the European Society of Urogenital Radiology. Eur Radiol 2024:10.1007/s00330-024-10707-6. [PMID: 38573340 DOI: 10.1007/s00330-024-10707-6] [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: 11/24/2023] [Revised: 01/29/2024] [Accepted: 03/04/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Hysterosalpingography (HSG) is widely used for evaluating the fallopian tubes; however, controversies regarding the use of water- or oil-based iodine-based contrast media (CM) remain. The aim of this work was (1) to discuss reported pregnancy rates related to the CM type used, (2) to validate the used CM in published literature, (3) to discuss possible complications and side effects of CM in HSG, and (4) to develop guidelines on the use of oil-based CM in HSG. METHODS A systematic literature search was conducted for original RCT studies or review/meta-analyses on using water-based and oil-based CM in HSG with fertility outcomes and complications. Nine randomized controlled trials (RCTs) and 10 reviews/meta-analyses were analyzed. Grading of the literature was performed based on the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 classification. RESULTS An approximately 10% higher pregnancy rate is reported for oil-based CM. Side effects are rare, but oil-based CM have potentially more side effects on the maternal thyroid function and the peritoneum. CONCLUSIONS 1. HSG with oil-based CM gives approximately 10% higher pregnancy rates. 2. External validity is limited, as in five of nine RCTs, the CM used is no longer on the market. 3. Oil-based CM have potentially more side effects on the maternal thyroid function and on the peritoneum. 4. Guideline: Maternal thyroid function should be tested before HSG with oil-based CM and monitored for 6 months after. CLINICAL RELEVANCE STATEMENT Oil-based CM is associated with an approximately 10% higher chance of pregnancy compared to water-based CM after HSG. Although side effects are rare, higher iodine concentration and slower clearance of oil-based CM may induce maternal thyroid function disturbance and peritoneal inflammation and granuloma formation. KEY POINTS • It is unknown which type of contrast medium, oil-based or water-based, is the optimal for HSG. • Oil-based contrast media give a 10% higher chance of pregnancy after HSG, compared to water-based contrast media. • From the safety perspective, oil-based CM can cause thyroid dysfunction and an intra-abdominal inflammatory response in the patient.
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Affiliation(s)
- Remy W F Geenen
- Department of Radiology, Northwest Clinics, Alkmaar, The Netherlands
| | - Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marie-France Bellin
- AP-HP, University Hospital Bicêtre, Department of Radiology, BioMaps, University Paris Saclay, Le Kremlin-Bicêtre, France
| | | | - Jean-Michel Correas
- AP-HP, Groupe Hospitalier Necker, DMU Imagina, Service de Radiologie, Université de Paris, Paris, France
| | | | - Andreas H Mahnken
- Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Marburg, Germany
| | | | - Alexander Radbruch
- Clinic for Diagnostic and Interventional Neuroradiology, University Clinic Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Peter Reimer
- Department of Radiology, Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Karlsruhe, Germany
| | - Giles Roditi
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | - Carmen Sebastià
- Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Fulvio Stacul
- Department of Radiology, Ospedale Maggiore, Trieste, Italy
| | | | - Olivier Clément
- AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, Université de Paris, Paris, France
| | - Torkel B Brismar
- Unit of Radiology, CLINTEC, Karolinska Institutet, Alfred Nobels alle 8, 141 52, Huddinge, Sweden.
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden.
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van der Molen AJ, Dekkers IA, Geenen RWF, Bellin MF, Bertolotto M, Brismar TB, Correas JM, Heinz-Peer G, Mahnken AH, Quattrocchi CC, Radbruch A, Reimer P, Roditi G, Romanini L, Sebastià C, Stacul F, Clement O. Waiting times between examinations with intravascularly administered contrast media: a review of contrast media pharmacokinetics and updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol 2024; 34:2512-2523. [PMID: 37823923 PMCID: PMC10957598 DOI: 10.1007/s00330-023-10085-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 03/19/2023] [Revised: 06/04/2023] [Accepted: 07/07/2023] [Indexed: 10/13/2023]
Abstract
The pharmacokinetics of contrast media (CM) will determine how long safe waiting intervals between successive CT or MRI examinations should be. The Contrast Media Safety Committee has reviewed the data on pharmacokinetics of contrast media to suggest safe waiting intervals between successive contrast-enhanced imaging studies in relation to the renal function of the patient. CLINICAL RELEVANCE STATEMENT: Consider a waiting time between elective contrast-enhanced CT and (coronary) angiography with successive iodine-based contrast media administrations in patients with normal renal function (eGFR > 60 mL/min/1.73 m2) of optimally 12 h (near complete clearance of the previously administered iodine-based contrast media) and minimally 4 h (if clinical indication requires rapid follow-up). KEY POINTS: • Pharmacokinetics of contrast media will guide safe waiting times between successive administrations. • Safe waiting times increase with increasing renal insufficiency. • Iodine-based contrast media influence MRI signal intensities and gadolinium-based contrast agents influence CT attenuation.
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Affiliation(s)
- Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Remy W F Geenen
- Department of Radiology, Northwest Clinics, Alkmaar, The Netherlands
| | - Marie-France Bellin
- Department of Radiology, University Paris Saclay, AP-HP, University Hospital Bicêtre, BioMaps, Le Kremlin-Bicêtre, France
| | | | - Torkel B Brismar
- Department of Clinical Science, Intervention and Technology, Unit of Radiology, Karolinska Institutet and Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Jean-Michel Correas
- AP-HP, Groupe Hospitalier Necker, DMU Imagina, Service de Radiologie, Université de Paris, Paris, France
| | | | - Andreas H Mahnken
- Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Marburg, Germany
| | | | - Alexander Radbruch
- Clinic for Diagnostic and Interventional Neuroradiology, University Clinic Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Peter Reimer
- Department of Radiology, Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Karlsruhe, Germany
| | - Giles Roditi
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | | | - Carmen Sebastià
- Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Fulvio Stacul
- Department of Radiology, Ospedale Maggiore, Trieste, Italy
| | - Olivier Clement
- AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, Université de Paris, 20 Rue LeBlanc, 75015, Paris, France.
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3
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van der Molen AJ, Krabbe JG, Dekkers IA, Geenen RWF, Bellin MF, Bertolotto M, Brismar TB, Cadamuro J, Correas JM, Heinz-Peer G, Langlois MR, Mahnken AH, Ozben T, Quattrocchi CC, Radbruch A, Reimer P, Roditi G, Romanini L, Sebastià C, Simundic AM, Stacul F, Clement O. Analytical interference of intravascular contrast agents with clinical laboratory tests: a joint guideline by the ESUR Contrast Media Safety Committee and the Preanalytical Phase Working Group of the EFLM Science Committee. Clin Chem Lab Med 2024; 62:608-614. [PMID: 38050439 DOI: 10.1515/cclm-2023-1184] [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: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 12/06/2023]
Abstract
The Contrast Media Safety Committee of the European Society of Urogenital Radiology has, together with the Preanalytical Phase Working Group of the EFLM Science Committee, reviewed the literature and updated its recommendations to increase awareness and provide insight into these interferences.
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Affiliation(s)
- Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johannes G Krabbe
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Remy W F Geenen
- Department of Radiology, Northwest Clinics, Alkmaar, The Netherlands
| | - Marie-France Bellin
- University Paris-Saclay, AP-HP, University Hospital Bicêtre, Service de Radiologie, BioMaps, Le Kremlin-Bicêtre, France
| | | | - Torkel B Brismar
- Department of Clinical Science, Intervention and Technology, Unit of Radiology, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Jean-Michel Correas
- Université de Paris, AP-HP, Groupe Hospitalier Necker, DMU Imagina, Service de Radiologie, Paris, France
| | | | - Michel R Langlois
- Department of Laboratory Medicine, AZ St.-Jan Hospital, Bruges, Belgium
| | - Andreas H Mahnken
- Department of Radiology, Marburg University Hospital, Marburg, Germany
| | - Tomris Ozben
- Department of Clinical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Türkiye
| | | | - Alexander Radbruch
- Clinic for Diagnostic and Interventional Neuroradiology, University Clinic Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Peter Reimer
- Department of Radiology, Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Karlsruhe, Germany
| | - Giles Roditi
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | | | - Carmen Sebastià
- Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ana-Maria Simundic
- Department of Medical Laboratory Diagnostics, Clinical Hospital Sveti Duh, Zagreb University, Zagreb, Croatia
| | - Fulvio Stacul
- Department of Radiology, Ospedale Maggiore, Trieste, Italy
| | - Olivier Clement
- Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, Paris, France
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4
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Rovira À, Doniselli FM, Auger C, Haider L, Hodel J, Severino M, Wattjes MP, van der Molen AJ, Jasperse B, Mallio CA, Yousry T, Quattrocchi CC. Use of gadolinium-based contrast agents in multiple sclerosis: a review by the ESMRMB-GREC and ESNR Multiple Sclerosis Working Group. Eur Radiol 2024; 34:1726-1735. [PMID: 37658891 DOI: 10.1007/s00330-023-10151-y] [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: 04/24/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 09/05/2023]
Abstract
Magnetic resonance imaging (MRI) is the most sensitive technique for detecting inflammatory demyelinating lesions in multiple sclerosis (MS) and plays a crucial role in diagnosis and monitoring treatment effectiveness, and for predicting the disease course. In clinical practice, detection of MS lesions is mainly based on T2-weighted and contrast-enhanced T1-weighted sequences. Contrast-enhancing lesions (CEL) on T1-weighted sequences are related to (sub)acute inflammation, while new or enlarging T2 lesions reflect the permanent footprint from a previous acute inflammatory demyelinating event. These two types of MRI features provide redundant information, at least in regular monitoring of the disease. Due to the concern of gadolinium deposition after repetitive injections of gadolinium-based contrast agents (GBCAs), scientific organizations and regulatory agencies in Europe and North America have proposed that these contrast agents should be administered only if clinically necessary. In this article, we provide data on the mode of action of GBCAs in MS, the indications of the use of these agents in clinical practice, their value in MS for diagnostic, prognostic, and monitoring purposes, and their use in specific populations (children, pregnant women, and breast-feeders). We discuss imaging strategies that achieve the highest sensitivity for detecting CELs in compliance with the safety regulations established by different regulatory agencies. Finally, we will briefly discuss some alternatives to the use of GBCA for detecting blood-brain barrier disruption in MS lesions. CLINICAL RELEVANCE STATEMENT: Although use of GBCA at diagnostic workup of suspected MS is highly valuable for diagnostic and prognostic purposes, their use in routine monitoring is not mandatory and must be reduced, as detection of disease activity can be based on the identification of new or enlarging lesions on T2-weighted images. KEY POINTS: • Both the EMA and the FDA state that the use of GBCA in medicine should be restricted to clinical scenarios in which the additional information offered by the contrast agent is required. • The use of GBCA is generally recommended in the diagnostic workup in subjects with suspected MS and is generally not necessary for routine monitoring in clinical practice. • Alternative MRI-based approaches for detecting acute focal inflammatory MS lesions are not yet ready to be used in clinical practice.
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Affiliation(s)
- Àlex Rovira
- Section of Neuroradiology, Department of Radiology, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
| | - Fabio M Doniselli
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Cristina Auger
- Section of Neuroradiology, Department of Radiology, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - Lukas Haider
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jerome Hodel
- Department of Radiology, Groupe Hospitalier Paris-Saint Joseph, Paris, France
| | | | - Mike P Wattjes
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | | | - Bas Jasperse
- Department of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Carlo A Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Rome, Italy
| | - Tarek Yousry
- Lysholm Department of Neuroradiology, UCLH National Hospital for Neurology and Neurosurgery, Neuroradiological Academic Unit, UCL Institute of Neurology, London, UK
| | - Carlo C Quattrocchi
- Centre for Medical Sciences CISMed, University of Trento, Trento, Italy
- Radiology, Multizonal Unit of Rovereto and Arco, APSS Provincia Autonoma Di Trento, Trento, Italy
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5
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Mallio CA, Di Gennaro G, Greco F, Pescosolido A, Bernetti C, Piccolo CL, Buffa V, Quattrocchi CC, Beomonte Zobel B. Visceral adiposity in patients with lipomatous hypertrophy of the interatrial septum. Heart Vessels 2024; 39:160-166. [PMID: 37792006 DOI: 10.1007/s00380-023-02319-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/14/2023] [Indexed: 10/05/2023]
Abstract
Lipomatous hypertrophy of the interatrial septum (LHIS) is a benign cardiac mass determined by abnormal deposition of adipose tissue in the interatrial septum. The quantitative relationship between LHIS and visceral adiposity has not been explored to date.In this retrospective study, three groups of consecutive patients undergoing CT imaging were enrolled: L + with LHIS, L- without LHIS, and LO- without both LHIS and history of malignancies. Areas of total adipose tissue (TAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and LHIS areas were calculated on CT images. The relationship between LHIS and abdominal fat distribution was investigated with linear regression models. Bonferroni correction was applied to account for multiple testing. Statistical significance was set at 5%. In this study we enrolled a total of 175 subjects: 58 (33.14%) with LHIS (L +), 51(29.14%) without LHIS (L-) and 66 (37.71%) without both LHIS and medical history of malignancies (LO-). VAT (coeff: 105.82; 95% CI 59.37-152.27), SAT (coeff: 74.59; 95% CI 31.63-117.54), and TAT (coeff: 190.37; 95% CI 115.02-265.72), were significantly higher in L + patients. Moreover, VAT (coeff: 24.95; 95% CI 6.94-42.96) and TAT (coeff: 36.58; 95% CI 8.75-64.41) were statistically significant linear predictors for LHIS area. Here, we report a novel association between LHIS and visceral adiposity using a quantitative CT-based imaging approach. The results are of great importance also because they might drive early identification of subjects with LHIS at risk for visceral obesity, and trigger lifestyle interventions aimed at weight loss.
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Affiliation(s)
- Carlo A Mallio
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
| | - Gianfranco Di Gennaro
- Department of Health Sciences, Chair of Medical Statistics, University of Catanzaro Magna Græcia, Catanzaro, Italy
| | - Federico Greco
- U.O.C. Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Lecce, Italy
| | - Andrea Pescosolido
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Caterina Bernetti
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Claudia Lucia Piccolo
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Vitaliano Buffa
- Department of Radiology, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | | | - Bruno Beomonte Zobel
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
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van der Molen AJ, Quattrocchi CC, Mallio CA, Dekkers IA. Correction: Ten years of gadolinium retention and deposition: ESMRMB-GREC looks backward and forward. Eur Radiol 2024; 34:728. [PMID: 37966523 DOI: 10.1007/s00330-023-10446-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Affiliation(s)
- Aart J van der Molen
- Department of Radiology, C-2S, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands.
| | - Carlo C Quattrocchi
- Centre for Medical Sciences CISMed, University of Trento, 38,122, Trento, Italy
| | - Carlo A Mallio
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Ilona A Dekkers
- Department of Radiology, C-2S, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands
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van der Molen AJ, Quattrocchi CC, Mallio CA, Dekkers IA. Ten years of gadolinium retention and deposition: ESMRMB-GREC looks backward and forward. Eur Radiol 2024; 34:600-611. [PMID: 37804341 PMCID: PMC10791848 DOI: 10.1007/s00330-023-10281-3] [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: 03/13/2023] [Revised: 07/30/2023] [Accepted: 08/09/2023] [Indexed: 10/09/2023]
Abstract
In 2014, for the first time, visible hyperintensities on unenhanced T1-weighted images in the nucleus dentatus and globus pallidus of the brain were associated with previous Gadolinium-based contrast agent (GBCA) injections and gadolinium deposition in patients with normal renal function. This led to a frenzy of retrospective studies with varying methodologies that the European Society of Magnetic Resonance in Medicine and Biology Gadolinium Research and Educational Committee (ESMRMB-GREC) summarised in 2019. Now, after 10 years, the members of the ESMRMB-GREC look backward and forward and review the current state of knowledge of gadolinium retention and deposition. CLINICAL RELEVANCE STATEMENT: Gadolinium deposition is associated with the use of linear GBCA but no clinical symptoms have been associated with gadolinium deposition. KEY POINTS : • Traces of Gadolinium-based contrast agent-derived gadolinium can be retained in multiple organs for a prolonged time. • Gadolinium deposition is associated with the use of linear Gadolinium-based contrast agents. • No clinical symptoms have been associated with gadolinium deposition.
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Affiliation(s)
- Aart J van der Molen
- Department of Radiology, C-2S, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands.
| | - Carlo C Quattrocchi
- Centre for Medical Sciences CISMed, University of Trento, 38122, Trento, Italy
| | - Carlo A Mallio
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Ilona A Dekkers
- Department of Radiology, C-2S, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands
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van der Molen AJ, Krabbe JG, Dekkers IA, Geenen RWF, Bellin MF, Bertolotto M, Brismar TB, Cadamuro J, Correas JM, Heinz-Peer G, Langlois MR, Mahnken AH, Ozben T, Quattrocchi CC, Radbruch A, Reimer P, Roditi G, Romanini L, Sebastià C, Simundic AM, Stacul F, Clement O. Analytical interference of intravascular contrast agents with clinical laboratory tests: a joint guideline by the ESUR Contrast Media Safety Committee and the Preanalytical Phase Working Group of the EFLM Science Committee. Eur Radiol 2023:10.1007/s00330-023-10411-x. [PMID: 38060004 DOI: 10.1007/s00330-023-10411-x] [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: 05/11/2023] [Revised: 08/08/2023] [Accepted: 09/07/2023] [Indexed: 12/08/2023]
Abstract
The Contrast Media Safety Committee of the European Society of Urogenital Radiology has, together with the Preanalytical Phase Working Group of the EFLM Science Committee, reviewed the literature and updated its recommendations to increase awareness and provide insight into these interferences. CLINICAL RELEVANCE STATEMENT: Contrast Media may interfere with clinical laboratory tests. Awareness of potential interference may prevent unwanted misdiagnosis. KEY POINTS: • Contrast Media may interfere with clinical laboratory tests; therefore awareness of potential interference may prevent unwanted misdiagnosis. • Clinical Laboratory tests should be performed prior to radiological imaging with contrast media or alternatively, blood or urine collection should be delayed, depending on kidney function.
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Affiliation(s)
- Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johannes G Krabbe
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Remy W F Geenen
- Department of Radiology, Northwest Clinics, Alkmaar, The Netherlands
| | - Marie-France Bellin
- University Paris-Saclay, AP-HP, University Hospital Bicêtre, Service de Radiologie, BioMaps, Le Kremlin-Bicêtre, France
| | | | - Torkel B Brismar
- Department of Clinical Science, Intervention and Technology, Unit of Radiology, Karolinska Institutet and Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Jean-Michel Correas
- Université de Paris, AP-HP, Groupe Hospitalier Necker, DMU Imagina, Service de Radiologie, Paris, France
| | | | - Michel R Langlois
- Department of Laboratory Medicine, AZ St.-Jan Hospital, Brugge, Belgium
| | - Andreas H Mahnken
- Department of Radiology, Marburg University Hospital, Marburg, Germany
| | - Tomris Ozben
- Department of Clinical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | | | - Alexander Radbruch
- Clinic for Diagnostic and Interventional Neuroradiology, University Clinic Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Peter Reimer
- Department of Radiology, Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Karlsruhe, Germany
| | - Giles Roditi
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | | | - Carmen Sebastià
- Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ana-Maria Simundic
- Department of Medical Laboratory Diagnostics, Clinical Hospital Sveti Duh, Zagreb University, Zagreb, Croatia
| | - Fulvio Stacul
- Department of Radiology, Ospedale Maggiore, Trieste, Italy
| | - Olivier Clement
- Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, 20 Rue LeBlanc, F-75015, Paris, France.
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Rovira À, Quattrocchi CC. Safe and optimized use of gadolinium-based contrast agents in neuroimaging. Eur Radiol 2023:10.1007/s00330-023-10456-y. [PMID: 38001249 DOI: 10.1007/s00330-023-10456-y] [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] [Received: 09/14/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023]
Affiliation(s)
- Àlex Rovira
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | - Carlo C Quattrocchi
- Centre for Medical Sciences CISMed, University of Trento, Trento, Italy
- Radiology, Multizonal Unit of Rovereto and Arco, APSS Provincia Autonoma Di Trento, Trento, Italy
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Mallio CA, Bernetti C, Castiello G, Gangemi E, Tomarchio V, Annibali O, Rigacci L, Van Goethem J, Parizel PM, Beomonte Zobel B, Quattrocchi CC. Neuroradiology of acute pathologies in adults with hematologic malignancies: a pictorial review. Quant Imaging Med Surg 2023; 13:7530-7551. [PMID: 37969623 PMCID: PMC10644134 DOI: 10.21037/qims-22-1201] [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: 11/01/2022] [Accepted: 02/20/2023] [Indexed: 11/17/2023]
Abstract
Hematopoietic and lymphoid tumors are a heterogeneous group of diseases including lymphomas, multiple myeloma (MM), and leukemias. These diseases are associated with systemic involvement and various clinical presentations including acute neurological deficits. Adult patients with hematologic malignancies (HM) are at risk for developing a wide array of acute conditions involving the nervous system. HM in adults may present as tumoral masses responsible for mass effect, possibly resulting in acute neurological signs and symptoms caused by tumor growth with compression of central nervous system (CNS) structures. Moreover, as result of the hematologic disease itself or due to systemic treatments, hematologic patients are at risk for vascular pathologies, such as ischemic, thrombotic, and hemorrhagic disorders due to the abnormal coagulation status. The onset of these disorders is often with acute neurologic signs or symptoms. Lastly, it is well known that patients with HM can have impaired function of the immune system. Thus, CNS involvement due to immune-related diseases such as mycotic, parasitic, bacterial, and viral infections linked to immunodeficiency, together with immune reconstitution inflammatory syndrome, are frequently seen in hematologic patients. Knowledge of the etiology and expected CNS imaging findings in patients with HM is of great importance to reach a fast and correct diagnosis and guide treatment choices. In this manuscript, we review the computed tomography (CT) and magnetic resonance findings of these conditions which can be related to the disease itself and/or to their treatments.
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Affiliation(s)
- Carlo A. Mallio
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Caterina Bernetti
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Gennaro Castiello
- U.O.S. Diagnostica per Immagini, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Emma Gangemi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Valeria Tomarchio
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Ombretta Annibali
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Luigi Rigacci
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Hematology and Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Johan Van Goethem
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium
| | - Paul M. Parizel
- David Hartley Chair of Radiology, Royal Perth Hospital & University of Western Australia, Perth, WA, Australia
| | - Bruno Beomonte Zobel
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
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Mallio CA, Radbruch A, Deike-Hofmann K, van der Molen AJ, Dekkers IA, Zaharchuk G, Parizel PM, Beomonte Zobel B, Quattrocchi CC. Artificial Intelligence to Reduce or Eliminate the Need for Gadolinium-Based Contrast Agents in Brain and Cardiac MRI: A Literature Review. Invest Radiol 2023; 58:746-753. [PMID: 37126454 DOI: 10.1097/rli.0000000000000983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/02/2023]
Abstract
ABSTRACT Brain and cardiac MRIs are fundamental noninvasive imaging tools, which can provide important clinical information and can be performed without or with gadolinium-based contrast agents (GBCAs), depending on the clinical indication. It is currently a topic of debate whether it would be feasible to extract information such as standard gadolinium-enhanced MRI while injecting either less or no GBCAs. Artificial intelligence (AI) is a great source of innovation in medical imaging and has been explored as a method to synthesize virtual contrast MR images, potentially yielding similar diagnostic performance without the need to administer GBCAs. If possible, there would be significant benefits, including reduction of costs, acquisition time, and environmental impact with respect to conventional contrast-enhanced MRI examinations. Given its promise, we believe additional research is needed to increase the evidence to make these AI solutions feasible, reliable, and robust enough to be integrated into the clinical framework. Here, we review recent AI studies aimed at reducing or replacing gadolinium in brain and cardiac imaging while maintaining diagnostic image quality.
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Affiliation(s)
| | - Alexander Radbruch
- Clinic for Diagnostic and Interventional Neuroradiology, University Clinic Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Katerina Deike-Hofmann
- Clinic for Diagnostic and Interventional Neuroradiology, University Clinic Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, CA
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Russo F, Ambrosio L, Giannarelli E, Vorini F, Mallio CA, Quattrocchi CC, Vadalà G, Papalia R, Denaro V. Innovative quantitative magnetic resonance tools to detect early intervertebral disc degeneration changes: a systematic review. Spine J 2023; 23:1435-1450. [PMID: 37247638 DOI: 10.1016/j.spinee.2023.05.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/25/2023] [Accepted: 05/16/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND CONTEXT Low back pain (LBP) is the leading cause of disability worldwide, with a tremendous socioeconomic burden. It is mainly caused by intervertebral disc degeneration (IDD), a progressive and age-related process. Due to its ability to accurately characterize intervertebral disc morphology, magnetic resonance imaging (MRI) has been established as one of the most valuable tools in diagnosing IDD. Innovative quantitative MRI (qMRI) techniques able to detect the earliest signs of IDD have been increasingly reported. PURPOSE To systematically review available reports on the application of novel qMRI techniques to detect early IDD changes. STUDY DESIGN Systematic literature review. METHODS A systematic search of PubMed/MEDLINE, Scopus, CINAHL, EMBASE, CENTRAL and Cochrane databases was performed through January 21, 2023. Randomized and nonrandomized studies on innovative qMRI tools able to diagnose early biochemical and architectural IDD changes in patients with or without discogenic LBP were searched. Data on study population, follow-up time (when applicable) and MRI sequence used were recorded. The QUADAS-2 tool was utilized to assess the risk of bias of included studies. RESULTS A total of 39 articles published between 2005 and 2022 resulted from the search. All novel qMRI techniques showed an increased capacity to detect early IDD changes thanks to the ability to assess subtle alterations of water content, proteoglycan and glycosaminoglycan concentration, and increased levels of catabolic biomarkers compared to conventional MRI. CONCLUSIONS Innovative qMRI techniques have proven effective in identifying premature IDD changes. Further studies are needed to validate their application in wider populations and confirm their applicability in the clinical setting.
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Affiliation(s)
- Fabrizio Russo
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Luca Ambrosio
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
| | - Eugenio Giannarelli
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Ferruccio Vorini
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carlo A Mallio
- Department of Diagnostic Imaging and Interventional Radiology, Research Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Diagnostic Imaging and Interventional Radiology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carlo C Quattrocchi
- Department of Diagnostic Imaging and Interventional Radiology, Research Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Diagnostic Imaging and Interventional Radiology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Gianluca Vadalà
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Vincenzo Denaro
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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Parillo M, Mallio CA, Van der Molen AJ, Rovira À, Ramalho J, Ramalho M, Gianolio E, Karst U, Radbruch A, Stroomberg G, Clement O, Dekkers IA, Nederveen AJ, Quattrocchi CC. Skin Toxicity After Exposure to Gadolinium-Based Contrast Agents in Normal Renal Function, Using Clinical Approved Doses: Current Status of Preclinical and Clinical Studies. Invest Radiol 2023; 58:530-538. [PMID: 37185158 DOI: 10.1097/rli.0000000000000973] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 05/17/2023]
Abstract
OBJECTIVES The aim of this study was to summarize the current preclinical and clinical evidence on the association between exposure to gadolinium (Gd) compounds and skin toxicity in a setting similar to clinical practice. MATERIALS AND METHODS A search of MEDLINE and PubMed references from January 2000 to December 2022 was performed using keywords related to gadolinium deposition and its effects on the skin, such as "gadolinium," "gadolinium-based contrast agents," "skin," "deposition," and "toxicity." In addition, cross-referencing was added when appropriate. For preclinical in vitro studies, we included all the studies that analyzed the response of human dermal fibroblasts to exposure to various gadolinium compounds. For preclinical animal studies and clinical studies, we included only those that analyzed animals or patients with preserved renal function (estimated glomerular filtration rate >30 mL/min/1.73 m 2 ), using a dosage of gadolinium-based contrast agents (GBCAs) similar to that commonly applied (0.1 mmol/kg). RESULTS Forty studies were selected. Preclinical findings suggest that Gd compounds can produce profibrotic responses in the skin in vitro, through the activation and proliferation of dermal fibroblasts and promoting their myofibroblast differentiation. Gadolinium influences the process of collagen production and the collagen content of skin, by increasing the levels of matrix metalloproteinase-1 and tissue inhibitor of metalloproteinase-1. Preclinical animal studies show that Gd can deposit in the skin with higher concentrations when linear GBCAs are applied. However, these deposits decrease over time and are not associated with obvious macroscopic or histological modifications. The clinical relevance of GBCAs in inducing small fiber neuropathy remains to be determined. Clinical studies show that Gd is detectable in the skin and hair of subjects with normal renal function in higher concentrations after intravenous administration of linear compared with macrocyclic GBCA. However, these deposits decrease over time and are not associated with cutaneous or histological modifications. Also, subclinical dermal involvement related to linear GBCA exposure may be detectable on brain MRI. There is no conclusive evidence to support a causal relationship between GBCA administration at the clinical dose and cutaneous manifestations in patients with normal renal function. CONCLUSIONS Gadolinium can produce profibrotic responses in the skin, especially acting on fibroblasts, as shown by preclinical in vitro studies. Gadolinium deposits are detectable in the skin even in subjects with normal renal function with higher concentrations when linear GBCAs are used, as confirmed by both preclinical animal and human studies. There is no proof to date of a cause-effect relationship between GBCA administration at clinical doses and cutaneous consequences in patients with normal renal function. Multiple factors, yet to be determined, should be considered for sporadic patients with normal renal function who develop clinical skin manifestations temporally related to GBCA administration.
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Affiliation(s)
- Marco Parillo
- From the Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carlo A Mallio
- From the Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Aart J Van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Àlex Rovira
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joana Ramalho
- Department of Neuroradiology, Centro Hospitalar Universitário de Lisboa Central, Lisbon
| | - Miguel Ramalho
- Department of Radiology, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Eliana Gianolio
- Department of Molecular Biotechnologies and Health Science, University of Turin, Turin, Italy
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster
| | - Alexander Radbruch
- Department of Neuroradiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Gerard Stroomberg
- RIWA-Rijn-Association of River Water Works, Nieuwegein, the Netherlands
| | - Olivier Clement
- Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, Paris, France
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Mallio CA, Greco F, Gaudino F, Beomonte Zobel B, Quattrocchi CC. Computed tomography density changes of bone metastases after concomitant denosumab. Skeletal Radiol 2023:10.1007/s00256-023-04326-3. [PMID: 36961572 DOI: 10.1007/s00256-023-04326-3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE To evaluate bone density changes at the level of normal trabecular bone and bone metastases (BMs) after denosumab (DM) treatment in oncologic patients. MATERIALS AND METHODS We retrospectively evaluated 31 consecutive adult patients with histologically confirmed solid tumors with at least one newly diagnosed bone metastatic lesion detected at CT. Patients received treatment with DM, 120 mg subcutaneous every 28 days for at least 6 months. Bone density was determined at the level of BMs and at the level of normal trabecular bone of lumbar vertebrae using a region of interest (ROI)-based approach. RESULTS A progressive increase in CT bone density was demonstrated at the level of normal trabecular bone at 6 months (18% ± 5%) and 12 months (23% ± 7%) after the treatment begins. BMs showed a significant increase in CT bone density (p < 0.05) as compared to baseline after 6 months (57% ± 15%) and 12 months (1.06 ± 0.25 times higher) after treatment. CONCLUSION We have found that long-term treatment with DM increases bone density progressively in oncologic patients. This effect can be observed not only at the level of secondary lesions but also at the level of apparently normal trabecular bone and is more pronounced for osteolytic metastases.
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Affiliation(s)
- Carlo A Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy.
| | - Federico Greco
- U.O.C. Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Lecce, Italy
| | - Francesco Gaudino
- U.O.S.D Diagnostica per Immagini Emergenza Urgenza, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Bruno Beomonte Zobel
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
- Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
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Quattrocchi CC, Parillo M, Spani F, Landi D, Cola G, Dianzani C, Perrella E, Marfia GA, Mallio CA. Skin Thickening of the Scalp and High Signal Intensity of Dentate Nucleus in Multiple Sclerosis: Association With Linear Versus Macrocyclic Gadolinium-Based Contrast Agents Administration. Invest Radiol 2023; 58:223-230. [PMID: 36729383 DOI: 10.1097/rli.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to assess the presence of detectable changes of skin thickness on clinical brain magnetic resonance imaging (MRI) scans in patients with MS, history of multiple gadolinium-based contrast agents (GBCAs) administrations, and evidence of gadolinium deposition in the brain. MATERIALS AND METHODS In this observational cross-sectional study, 71 patients with MS who underwent conventional brain MRI with an imaging protocol including enhanced 3D volumetric interpolated breath-hold examination (VIBE) T1-weighted with fat saturation were assessed. Patients with bilateral isointense dentate nucleus on unenhanced T1-weighted images were assigned to group A (controls without MRI evidence of gadolinium deposition), and patients with visually hyperintense dentate nuclei were assigned to group B. Qualitative and quantitative assessment of the skin thickness were performed. RESULTS Group A included 27 patients (median age, 33 years [IQR, 27-46]; 20 women), and group B included 44 patients (median age, 42 years [IQR, 35-53]; 29 women). Qualitative and quantitative assessment of the skin revealed significant differences between group A and group B. The average skin-to-scalp thickness ratios was significantly higher in group B than in group A (mean ± standard deviation = 0.52 ± 0.02 in group B vs 0.41 ± 0.02 in group A, P < 0.0001) and showed a positive correlation with the total number of enhanced MRI scans ( r = 0.39; 95% confidence interval, 0.17-0.57, P < 0.01). CONCLUSIONS Brain MRI detects increased skin thickness of the scalp in patients with MS and dentate nucleus high signal intensity on unenhanced T1-weighted images and shows positive association with previous exposures to linear GBCAs rather than macrocyclic GBCAs.
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Affiliation(s)
- Carlo C Quattrocchi
- From the Unit of Diagnostic Imaging and Interventional Radiology, Fondazione Policlinico Campus Bio-Medico di Roma
| | - Marco Parillo
- From the Unit of Diagnostic Imaging and Interventional Radiology, Fondazione Policlinico Campus Bio-Medico di Roma
| | - Federica Spani
- From the Unit of Diagnostic Imaging and Interventional Radiology, Fondazione Policlinico Campus Bio-Medico di Roma
| | | | - Gaia Cola
- Unit of Neurology, Policlinico Tor Vergata
| | | | - Eleonora Perrella
- Pathology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy
| | | | - Carlo A Mallio
- From the Unit of Diagnostic Imaging and Interventional Radiology, Fondazione Policlinico Campus Bio-Medico di Roma
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Mallio CA, Spagnolo G, Piervincenzi C, Petsas N, Boccetti D, Spani F, Gallo IF, Sisto A, Quintiliani L, Di Gennaro G, Bruni V, Quattrocchi CC. Brain functional connectivity differences between responders and non-responders to sleeve gastrectomy. Neuroradiology 2023; 65:131-143. [PMID: 35978042 DOI: 10.1007/s00234-022-03043-3] [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: 04/13/2022] [Accepted: 08/13/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE To compare resting-state functional connectivity (RSFC) of obese patients responders or non-responders to sleeve gastrectomy (SG) with a group of obese patients with no past medical history of metabolic or bariatric surgery. METHODS MR images were acquired at 1.5 Tesla. Resting-state fMRI data were analyzed with statistical significance threshold set at p < 0.05, family-wise error (FWE) corrected. RESULTS Sixty-two subjects were enrolled: 20 controls (age range 25-64; 14 females), 24 responders (excess weight loss > 50%; age range 23-68; 17 females), and 18 non-responders to sleeve gastrectomy (SG) (excess weight loss < 50%; age range 23-67; 13 females). About within-network RSFC, responders showed significantly lower RSFC with respect to both controls and non-responders in the default mode and frontoparietal networks, positively correlating with psychological scores. Non-responders showed significantly higher (p < 0.05, family-wise error (few) corrected) RSFC in regions of the lateral visual network as compared to controls. Regarding between-network RSFC, responders showed significantly higher anti-correlation between executive control and salience networks (p < 0.05, FWE corrected) with respect to both controls and non-responders. Significant positive correlation (Spearman rho = 0.48, p = 0.0012) was found between % of excess weight loss and executive control-salience network RSFC. CONCLUSION There are differences in brain functional connectivity in either responders or non-responders patients to SG. The present results offer new insights into the neural correlates of outcome in patients who undergo SG and expand knowledge about neural mechanisms which may be related to surgical response.
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Affiliation(s)
- Carlo A Mallio
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
| | - Giuseppe Spagnolo
- Unit of Bariatric Surgery, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy
| | | | | | - Danilo Boccetti
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila AQ, L'Aquila, Italy
| | - Federica Spani
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Ida Francesca Gallo
- Unit of Bariatric Surgery, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy
| | - Antonella Sisto
- Clinical Psychological Service, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy
| | - Livia Quintiliani
- Clinical Psychological Service, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy
| | - Gianfranco Di Gennaro
- Department of Health Sciences, Chair of Medical Statistics, University of Catanzaro Magna Græcia, Catanzaro, Italy
| | - Vincenzo Bruni
- Unit of Bariatric Surgery, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Rome, Italy
| | - Carlo C Quattrocchi
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
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Parillo M, Quattrocchi CC, Pilato F, Di Lazzaro V, Beomonte Zobel B. Whole-body computed tomography as first-line imaging procedure to exclude cancer in patients with neurological suspicion of paraneoplastic syndromes: shall clinical practice adhere to recommendations? Radiography (Lond) 2023; 29:8-13. [PMID: 36179410 DOI: 10.1016/j.radi.2022.09.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION To assess the efficacy of whole-body computed tomography (WB-CT) as imaging procedure to exclude cancer in patients with neurological symptoms and signs at clinical onset. METHODS A retrospective observational study was designed to identify consecutive WB-CT requested by the Neurology Unit with a suspicion of an underlying tumor potentially linked to a paraneoplastic neurological syndrome (PNS) between January 2019 and February 2022. The following data were collected: diagnosis at admission and at discharge, the presence of onconeural antibodies, the scans dose length product (DLP), the estimated effective dose (ED), the total estimated time requested; the PNS-Care-Score was retrospectively calculated only in subjects with available antibodies. RESULTS The total number of patients included was 158. In 13/158 (positive group) a malignant or locally aggressive neoplasm was found while in 145/158 no malignant lesions were found on the WB-CT. Among the positive group, in 7/13 onconeural antibodies were diagnosed, resulting negative in all cases and the most frequent tumor was lung cancer (30.8%). PNS-Care-Score was of 6-7 in 2/7 (probable PNS) and in no case the PNS-Care-Score was ≥8 (definite PNS). The mean DLP for all the scans was 2798 ± 952 mGy cm (average estimated ED of 42 ± 14 mSv). The total estimated time requested for all scans was 11,060 min. CONCLUSION If a PNS is suspected, we encourage the prescription of unenhanced chest CT and/or abdomen/testis/female pelvis ultrasound and/or mammography based on clinical picture. The WB-CT using a single portal phase would be appropriate as a second-line technique while magnetic resonance imaging might be indicated for the exclusion of nervous system diseases. IMPLICATIONS FOR PRACTICE Our suggestion results in saving in terms of radiation exposure, financial resources and time.
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Affiliation(s)
- M Parillo
- Unit of Diagnostic Imaging and Interventional Radiology, Campus Bio-Medico University Hospital Foundation, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
| | - C C Quattrocchi
- Unit of Diagnostic Imaging and Interventional Radiology, Campus Bio-Medico University Hospital Foundation, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | - F Pilato
- Neurology Unit, Campus Bio-Medico University Hospital Foundation, Via Álvaro del Portillo 200, 00128 Rome, Italy
| | - V Di Lazzaro
- Neurology Unit, Campus Bio-Medico University Hospital Foundation, Via Álvaro del Portillo 200, 00128 Rome, Italy
| | - B Beomonte Zobel
- Unit of Diagnostic Imaging and Interventional Radiology, Campus Bio-Medico University Hospital Foundation, Via Alvaro del Portillo, 200, 00128, Rome, Italy
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18
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Cammalleri V, Carpenito M, Nobile E, De Filippis A, Bono MC, Mega S, Nusca A, Cocco N, Vitez L, De Stefano D, Quattrocchi CC, Ussia GP, Grigioni F. Many hands make light work. Echocardiography and computed tomography results from the Tricuspid Regurgitation IMAging (TRIMA) study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.330] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Anatomic knowledge of the tricuspid valve (TV) is the first step in the diagnostic algorithm of patients with tricuspid regurgitation (TR), who are candidates for transcatheter tricuspid valve intervention (TTVI). Currently, echocardiography and computed tomography (CT) are available instruments to study the TV anatomy, guide the decision-making process and support the development of novel transcatheter therapies.
Purpose
The Tricuspid Regurgitation IMAging (TRIMA) study aimed to correlate CT parameters to commonly used echocardiographic variables.
Methods
This prospective, single-center study enrolled 22 consecutive patients with TR equal to or greater than severe (≥3+). All patients underwent transthoracic echocardiogram (TTE), transesophageal echocardiogram (TEE) and cardiac CT study, in order to obtain anatomical dimensions of the tricuspid annulus and quantification of right-chambers remodeling and function. Novel CT scan measurements were analyzed. Correlation between measurements on echocardiography and CT imaging was assessed.
Results
Severe TR (3+) was present in 27.4% patients, massive (4+) in 4.8% and torrential (5+) in 3.2%. The mean right ventricle (RV) length, RV mid diameter, and right atrium area were 60.81±9.11 mm, 41.27±7.67 mm and 31.72±9.66 cm2, respectively. Tricuspid annular plane excursion, fractional area change, longitudinal myocardial velocity (S') were 16.09±3.25 mm, 33.36±9.47% and 9.18±1.94 cm/sec, respectively. The annular dimensions obtained by CT scan were generally observed to reduce from diastole to systole, except for eccentricity, angles and distance between the postero-septal and antero-posterior commissure and distance between centroid and antero-posterior commissure. A Kruskal-Wallis test showed a stepwise increase in the tricuspid anatomical regurgitant orifice area (AROA) values by CT across the expanded TR grades by TEE, χ2(2)=6,466, p=0.039. Using the Pearson correlation coefficient, we found a relationship between the AROA and TR grade (r=0.593; p<0.004), as well as ARO-perimeter and TR grade (r=0.470; p<0.027). Additionally, a significant correlation was found between septal lateral annulus diameter obtained by TEE and CT (r=0.637; p=0.001). Anyway, no correlations were found between novel CT variables and TR grade or RV function assessed by echocardiogram, as well as between CT systo-diastolic annulus variability and RV function.
Conclusions
Standard echocardiographic study provide invaluable information about the anatomy and function of the right-chambers, as well as an accurate grade of TR. Conventional and novel variables derived by CT scan may step up the anatomical assessment of the complex morphology of the TV apparatus, thanks to the high spatial resolution of the technique. Therefore, an integrated multimodality assessment is the key point of the screening process of TR candidates for TTVI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- V Cammalleri
- Campus Bio-Medico University Hospital, Cardiology Department , Rome , Italy
| | - M Carpenito
- Campus Bio-Medico University Hospital, Cardiology Department , Rome , Italy
| | - E Nobile
- Campus Bio-Medico University Hospital, Cardiology Department , Rome , Italy
| | - A De Filippis
- Campus Bio-Medico University Hospital, Cardiology Department , Rome , Italy
| | - M C Bono
- Campus Bio-Medico University Hospital, Cardiology Department , Rome , Italy
| | - S Mega
- Campus Bio-Medico University Hospital, Cardiology Department , Rome , Italy
| | - A Nusca
- Campus Bio-Medico University Hospital, Cardiology Department , Rome , Italy
| | - N Cocco
- Campus Bio-Medico University Hospital, Cardiology Department , Rome , Italy
| | - L Vitez
- University Medical Centre Ljubljana, Department of Cardiology , Ljubljana , Slovenia
| | - D De Stefano
- Campus Bio-Medico University Hospital, Diagnostic Imaging and Interventional Radiology Department , Rome , Italy
| | - C C Quattrocchi
- Campus Bio-Medico University Hospital, Diagnostic Imaging and Interventional Radiology Department , Rome , Italy
| | - G P Ussia
- Campus Bio-Medico University Hospital, Unit of Interventional Cardiology, Cardiology Department , Rome , Italy
| | - F Grigioni
- Campus Bio-Medico University Hospital, Cardiology Department , Rome , Italy
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19
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Parillo M, Vaccarino F, Beomonte Zobel B, Quattrocchi CC. A Rare Case of Contained Chronic Rupture of Abdominal Aortic Aneurysm Associated With Vertebral Erosion: Pre- and Post-operative Findings on Computed Tomography and a Narrative Review. Vasc Endovascular Surg 2022; 56:15385744221108040. [PMID: 35688795 DOI: 10.1177/15385744221108040] [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] [Indexed: 11/15/2022]
Abstract
Contained chronic rupture of aortic aneurysm (CCR-AA) is a rare condition that can be associated with vertebral body erosion (VBE) and is often a diagnostic challenge; in fact, CCR-AAs are in general hemodynamically stable and the patients tend to present with a non-specific low-back pain syndrome secondary to vertebral involvement. Furthermore, the differential diagnosis of a retroperitoneal mass can be difficult on medical imaging. We discuss the case of a 79-years-old man, heavy smoker without history of cardiovascular diseases, admitted to the emergency department with signs of left lower limb ischemia. The patient was hemodynamically stable and the medical examination revealed a pulsatile abdominal mass. Doppler ultrasound showed the presence of aneurysmal dilatation of infra-renal abdominal aorta and chronic femoropopliteal occlusion on the left side. The subsequent computed tomography angiography (CTA) demonstrated a voluminous retroperitoneal mass continuous with the infra-renal aorta, which infiltrated the psoas muscles and caused vertebral bodies erosion of the anterior wall in L2, L3 and L4 suspected for CCR-AA or mycotic aortic aneurysm. Furthermore, the examination confirmed the occlusion of the peripheral arterial circulation of the left lower limb. The patient underwent a successful open replacement of the infra-renal abdominal aorta through aorto-aortic prosthetic graft insertion; the visualization during the surgical procedure of a posterior vessel wall opening in continuity with the eroded vertebral bodies associated with negative microbiological culture of the thrombotic material sample, led to the definitive diagnosis of CCR-AA. The post-operative CTA showed successful open vascular treatment. A bypass surgery of the left lower limb was then performed with positioning saphenous graft between femoral common artery and posterior tibial artery. The patient was finally discharged in good clinical conditions.
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Affiliation(s)
- Marco Parillo
- Unit of Diagnostic Imaging and Interventional Radiology, Departmental Faculty of Medicine and Surgery, 220431Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Federica Vaccarino
- Unit of Diagnostic Imaging and Interventional Radiology, Departmental Faculty of Medicine and Surgery, 220431Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Bruno Beomonte Zobel
- Unit of Diagnostic Imaging and Interventional Radiology, Departmental Faculty of Medicine and Surgery, 220431Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carlo C Quattrocchi
- Unit of Diagnostic Imaging and Interventional Radiology, Departmental Faculty of Medicine and Surgery, 220431Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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20
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Roditi G, Khan N, van der Molen AJ, Bellin MF, Bertolotto M, Brismar T, Correas JM, Dekkers IA, Geenen RWF, Heinz-Peer G, Mahnken AH, Quattrocchi CC, Radbruch A, Reimer P, Romanini L, Stacul F, Thomsen HS, Clément O. Intravenous contrast medium extravasation: systematic review and updated ESUR Contrast Media Safety Committee Guidelines. Eur Radiol 2022; 32:3056-3066. [PMID: 35175378 PMCID: PMC9038843 DOI: 10.1007/s00330-021-08433-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/28/2021] [Revised: 08/29/2021] [Accepted: 10/14/2021] [Indexed: 01/28/2023]
Abstract
NEED FOR A REVIEW Guidelines for management and prevention of contrast media extravasation have not been updated recently. In view of emerging research and changing working practices, this review aims to inform update on the current guidelines. AREAS COVERED In this paper, we review the literature pertaining to the pathophysiology, diagnosis, risk factors and treatments of contrast media extravasation. A suggested protocol and guidelines are recommended based upon the available literature. KEY POINTS • Risk of extravasation is dependent on scanning technique and patient risk factors. • Diagnosis is mostly clinical, and outcomes are mostly favourable. • Referral to surgery should be based on clinical severity rather than extravasated volume.
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Affiliation(s)
- Giles Roditi
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | - Nadir Khan
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | - Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marie-France Bellin
- University Paris-Saclay, AP-HP, University Hospital Bicêtre, Service de Radiologie, BioMaps, Le Kremlin-Bicêtre, France
| | | | - Torkel Brismar
- Department of Clinical Science, Intervention and Technology, Unit of Radiology, Karolinska Institutet and Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Jean-Michel Correas
- Université de Paris, AP-HP, Groupe Hospitalier Necker, DMU Imagina, Service de Radiologie, Paris, France
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Remy W F Geenen
- Department of Radiology, Northwest Clinics, Alkmaar, The Netherlands
| | | | - Andreas H Mahnken
- Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Marburg, Germany
| | - Carlo C Quattrocchi
- Imaging Center, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico Di Roma, Rome, Italy
| | - Alexander Radbruch
- Department of Radiology, Clinic for Diagnostic and Interventional Neuroradiology, Bonn, Germany
| | - Peter Reimer
- Department of Radiology, Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Karlsruhe, Germany
| | | | - Fulvio Stacul
- Department of Radiology, Ospedale Maggiore, Trieste, Italy
| | - Henrik S Thomsen
- Department of Radiology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - Olivier Clément
- Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, 20 Rue LeBlanc, 75015, Paris, France.
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21
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Nagaraj Y, de Jonge G, Andreychenko A, Presti G, Fink MA, Pavlov N, Quattrocchi CC, Morozov S, Veldhuis R, Oudkerk M, van Ooijen PMA. Facilitating standardized COVID-19 suspicion prediction based on computed tomography radiomics in a multi-demographic setting. Eur Radiol 2022; 32:6384-6396. [PMID: 35362751 PMCID: PMC8973680 DOI: 10.1007/s00330-022-08730-6] [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: 12/02/2021] [Revised: 02/13/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
Objective To develop an automatic COVID-19 Reporting and Data System (CO-RADS)–based classification in a multi-demographic setting. Methods This multi-institutional review boards–approved retrospective study included 2720 chest CT scans (mean age, 58 years [range 18–100 years]) from Italian and Russian patients. Three board-certified radiologists from three countries assessed randomly selected subcohorts from each population and provided CO-RADS–based annotations. CT radiomic features were extracted from the selected subcohorts after preprocessing steps like lung lobe segmentation and automatic noise reduction. We compared three machine learning models, logistic regression (LR), multilayer perceptron (MLP), and random forest (RF) for the automated CO-RADS classification. Model evaluation was carried out in two scenarios, first, training on a mixed multi-demographic subcohort and testing on an independent hold-out dataset. In the second scenario, training was done on a single demography and externally validated on the other demography. Results The overall inter-observer agreement for the CO-RADS scoring between the radiologists was substantial (k = 0.80). Irrespective of the type of validation test scenario, suspected COVID-19 CT scans were identified with an accuracy of 84%. SHapley Additive exPlanations (SHAP) interpretation showed that the “wavelet_(LH)_GLCM_Imc1” feature had a positive impact on COVID prediction both with and without noise reduction. The application of noise reduction improved the overall performance between the classifiers for all types. Conclusion Using an automated model based on the COVID-19 Reporting and Data System (CO-RADS), we achieved clinically acceptable performance in a multi-demographic setting. This approach can serve as a standardized tool for automated COVID-19 assessment. Keypoints • Automatic CO-RADS scoring of large-scale multi-demographic chest CTs with mean AUC of 0.93 ± 0.04. • Validation procedure resembles TRIPOD 2b and 3 categories, enhancing the quality of experimental design to test the cross-dataset domain shift between institutions aiding clinical integration. • Identification of COVID-19 pneumonia in the presence of community-acquired pneumonia and other comorbidities with an AUC of 0.92. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-022-08730-6.
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Affiliation(s)
- Yeshaswini Nagaraj
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. .,Machine Learning Lab, DASH, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Gonda de Jonge
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anna Andreychenko
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Healthcare Department, Moscow, Russia
| | - Gabriele Presti
- Unit of Diagnostic Imaging and Interventional Radiology, Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Matthias A Fink
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg, member of the German Center for Lung Research, Heidelberg, Germany
| | - Nikolay Pavlov
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Healthcare Department, Moscow, Russia
| | - Carlo C Quattrocchi
- Unit of Diagnostic Imaging and Interventional Radiology, Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Sergey Morozov
- Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Healthcare Department, Moscow, Russia
| | - Raymond Veldhuis
- Faculty of Electrical Engineering, Mathematics Computer Science (EWI), Data management Biometrics (DMB), University of Twente, Enschede, The Netherlands
| | - Matthijs Oudkerk
- Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands.,Institute for DiagNostic Accuracy Research, Groningen, The Netherlands
| | - Peter M A van Ooijen
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.,Machine Learning Lab, DASH, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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22
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Mallio CA, Quattrocchi CC, Beomonte Zobel B, Parizel PM. Artificial intelligence, chest radiographs, and radiology trainees: a powerful combination to enhance the future of radiologists? Quant Imaging Med Surg 2021; 11:2204-2207. [PMID: 33937001 PMCID: PMC8047344 DOI: 10.21037/qims-20-1306] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/07/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Carlo A. Mallio
- Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Carlo C. Quattrocchi
- Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Bruno Beomonte Zobel
- Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Paul M. Parizel
- Department of Radiology, Royal Perth Hospital and University of Western Australia Medical School, Perth, WA, Australia
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23
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Castiello G, Mallio CA, Altamura C, Marano M, Crescenzi A, Beomonte Zobel B, Quattrocchi CC, Di Lazzaro V. Bilateral MCP Infarct Due to Vertebral Giant Cell Arteritis. J Stroke Cerebrovasc Dis 2020; 30:105430. [PMID: 33160128 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105430] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/17/2020] [Accepted: 10/25/2020] [Indexed: 11/26/2022] Open
Abstract
We present the case of an 83-year-old woman with an isolated bilateral middle cerebellar peduncles stroke caused by complete occlusion of the right vertebral artery and focal occlusion of the left vertebral artery due to giant cell arteritis. The diagnosis was achieved by integrating MRI, ultrasound study, laboratory data and subsequent pathology analysis after biopsy of the temporal artery.
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Affiliation(s)
- Gennaro Castiello
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Carlo A Mallio
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy.
| | - Claudia Altamura
- Neurology Department, Headache and Neurosonology Unit, Università Campus Bio-Medico di Roma, Italy
| | - Massimo Marano
- Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Anna Crescenzi
- Department of Pathology, Università Campus Bio-Medico di Roma, Italy
| | - Bruno Beomonte Zobel
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Carlo C Quattrocchi
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Vincenzo Di Lazzaro
- Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
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24
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Ben-Soussan TD, Marson F, Piervincenzi C, Glicksohn J, De Fano A, Amenduni F, Quattrocchi CC, Carducci F. Correlates of Silence: Enhanced Microstructural Changes in the Uncinate Fasciculus. Front Psychol 2020; 11:543773. [PMID: 33132952 PMCID: PMC7578698 DOI: 10.3389/fpsyg.2020.543773] [Citation(s) in RCA: 5] [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: 03/18/2020] [Accepted: 09/03/2020] [Indexed: 11/13/2022] Open
Abstract
Silence is an important aspect of various meditation practices, but little work has focused specifically on the underlying neurophysiology of silence-related meditative practice, and on how it relates to the self-reported experiences of practitioners. To expand current knowledge regarding the neurophenomenology of silence in meditation, we directly investigated first-person reports of silence-related experiences during the practice of Quadrato Motor Training (QMT) and their association with changes in fractional anisotropy (FA). Participants recorded their cognitive, emotional, and physical experiences upon beginning QMT and again after 6 weeks of QMT practice. These reports were evaluated qualitatively and quantitatively. Findings showed that change between the two time points in self-reported silence-related experiences was negatively correlated with change in attentional effort, and positively correlated with changes in the left uncinate fasciculus. These results expand current knowledge regarding the neuroanatomical correlates of silence-related experiences during meditation.
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Affiliation(s)
- Tal Dotan Ben-Soussan
- Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation, Assisi, Italy
| | - Fabio Marson
- Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation, Assisi, Italy.,Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy
| | - Claudia Piervincenzi
- Human Neuroscience Department, Neuroimaging Laboratory, Sapienza University, Rome, Italy
| | - Joseph Glicksohn
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel.,The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Antonio De Fano
- Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation, Assisi, Italy.,Department of Neuroscience, Imaging, and Clinical Science, Behavioral Imaging and Neural Dynamics (BIND) Center, University of Chieti-Pescara G. d'Annunzio, Chieti, Italy
| | | | - Carlo C Quattrocchi
- Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma," Rome, Italy
| | - Filippo Carducci
- Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy
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25
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Quattrocchi CC, Mallio CA, Presti G, Beomonte Zobel B, Cardinale J, Iozzino M, Della Sala SW. The challenge of COVID-19 low disease prevalence for artificial intelligence models: report of 1,610 patients. Quant Imaging Med Surg 2020; 10:1891-1893. [PMID: 32879867 DOI: 10.21037/qims-20-782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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)
- Carlo C Quattrocchi
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Carlo A Mallio
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Gabriele Presti
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Bruno Beomonte Zobel
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Jacopo Cardinale
- Division of Diagnostic Radiology, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Mario Iozzino
- Department of Interventional Radiology, "S. Maria Goretti" Hospital, Latina, Italy
| | - Sabino W Della Sala
- Division of Diagnostic Radiology, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
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26
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Mallio CA, Parillo M, Zobel BB, Parizel PM, Quattrocchi CC. Effect of Exposure to Gadodiamide and Brain Irradiation on
T
1
‐Weighted Images and
ADC
Maps of the Dentate Nucleus. J Magn Reson Imaging 2020; 52:1525-1530. [DOI: 10.1002/jmri.27198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/02/2020] [Accepted: 05/05/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Carlo A. Mallio
- Departmental Faculty of Medicine and Surgery Università Campus Bio‐Medico di Roma Rome Italy
| | - Marco Parillo
- Departmental Faculty of Medicine and Surgery Università Campus Bio‐Medico di Roma Rome Italy
| | - Bruno Beomonte Zobel
- Departmental Faculty of Medicine and Surgery Università Campus Bio‐Medico di Roma Rome Italy
| | - Paul M. Parizel
- Department of Radiology Antwerp University Hospital Edegem Belgium
| | - Carlo C. Quattrocchi
- Departmental Faculty of Medicine and Surgery Università Campus Bio‐Medico di Roma Rome Italy
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27
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Mallio CA, Quattrocchi CC, Rovira À, Parizel PM. Gadolinium Deposition Safety: Seeking the Patient's Perspective. AJNR Am J Neuroradiol 2020; 41:944-946. [PMID: 32381539 DOI: 10.3174/ajnr.a6586] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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28
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Mallio CA, Rovira À, Parizel PM, Quattrocchi CC. Exposure to gadolinium and neurotoxicity: current status of preclinical and clinical studies. Neuroradiology 2020; 62:925-934. [DOI: 10.1007/s00234-020-02434-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/08/2020] [Indexed: 02/06/2023]
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29
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Mallio CA, Piervincenzi C, Carducci F, Quintiliani L, Parizel PM, Pantano P, Quattrocchi CC. Within-network brain connectivity in Crohn's disease patients with gadolinium deposition in the cerebellum. Neuroradiology 2020; 62:833-841. [PMID: 32246178 DOI: 10.1007/s00234-020-02415-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 01/11/2020] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Patients with Crohn's disease (CD) undergo multiple gadolinium-based contrast agent injections across their lifespan to enhance signal intensity of the intestinal wall and differentiate active from quiescent inflammatory disease. Thus, CD patients are prone to gadolinium accumulation in the brain and represent a non-neurological population to explore gadolinium-related brain toxicity. Possible effects are expected to be greater on the cerebellar network due to the high propensity of the dentate nucleus to accumulate gadolinium. Herein, we provide a whole-brain network analysis of resting-state fMRI dynamics in long-term quiescent CD patients with normal renal function and MRI evidence of gadolinium deposition in the brain. METHODS Fifteen patients with CD and 16 healthy age- and gender-matched controls were enrolled in this study. Relevant resting-state networks (RSNs) were identified using independent component analysis (ICA) from functional magnetic resonance imaging data. An unpaired two-sample t test (with age and sex as nuisance variables) was used to investigate between different RSNs. Clusters were determined by using threshold-free cluster enhancement and a family-wise error corrected cluster significance threshold of p < 0.05. RESULTS Patients showed significantly decreased resting-state functional connectivity (p < 0.05, FWE corrected) of several regions of the right frontoparietal (FPR) and the dorsal attention (DAN) RSNs. No differences between the two groups were found in the functional connectivity maps of all the other RSNs, including the cerebellar network. CONCLUSION Our findings suggest a non-significant impact of gadolinium deposition on within-network cerebellar functional connectivity of long-term quiescent CD patients.
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Affiliation(s)
- Carlo A Mallio
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy.
| | | | - Filippo Carducci
- Department of Physiology and Pharmacology, Neuroimaging Laboratory, Università La Sapienza, Rome, Italy
| | - Livia Quintiliani
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
| | - Paul M Parizel
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium
| | - Patrizia Pantano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,Department of Radiology, IRCCS NEUROMED, Pozzilli, Italy
| | - Carlo C Quattrocchi
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128, Rome, Italy
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Mallio CA, Piervincenzi C, Gianolio E, Cirimele V, Papparella LG, Marano M, Quintiliani L, Aime S, Carducci F, Parizel PM, Quattrocchi CC. Absence of dentate nucleus resting-state functional connectivity changes in nonneurological patients with gadolinium-related hyperintensity on T1
-weighted images. J Magn Reson Imaging 2019; 50:445-455. [DOI: 10.1002/jmri.26669] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 12/25/2022] Open
Affiliation(s)
- Carlo A. Mallio
- Departmental Faculty of Medicine and Surgery; Università Campus Bio-Medico di Roma; Rome Italy
| | - Claudia Piervincenzi
- Department of Physiology and Pharmacology, Neuroimaging Laboratory; Università La Sapienza; Rome Italy
| | - Eliana Gianolio
- Department of Molecular Biotechnology and Health Sciences; Università di Torino; Torino Italy
| | - Vincenzo Cirimele
- Departmental Faculty of Medicine and Surgery; Università Campus Bio-Medico di Roma; Rome Italy
| | - Luigi G. Papparella
- Departmental Faculty of Medicine and Surgery; Università Campus Bio-Medico di Roma; Rome Italy
| | - Massimo Marano
- Departmental Faculty of Medicine and Surgery; Università Campus Bio-Medico di Roma; Rome Italy
| | - Livia Quintiliani
- Departmental Faculty of Medicine and Surgery; Università Campus Bio-Medico di Roma; Rome Italy
| | - Silvio Aime
- Department of Molecular Biotechnology and Health Sciences; Università di Torino; Torino Italy
| | - Filippo Carducci
- Department of Physiology and Pharmacology, Neuroimaging Laboratory; Università La Sapienza; Rome Italy
| | - Paul M. Parizel
- Department of Radiology; Antwerp University Hospital; Edegem Belgium
| | - Carlo C. Quattrocchi
- Departmental Faculty of Medicine and Surgery; Università Campus Bio-Medico di Roma; Rome Italy
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31
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Quattrocchi CC, Ramalho J, van der Molen AJ, Rovira À, Radbruch A. Standardized assessment of the signal intensity increase on unenhanced T1-weighted images in the brain: the European Gadolinium Retention Evaluation Consortium (GREC) Task Force position statement. Eur Radiol 2018; 29:3959-3967. [PMID: 30413951 DOI: 10.1007/s00330-018-5803-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 06/09/2018] [Revised: 08/29/2018] [Accepted: 09/25/2018] [Indexed: 10/27/2022]
Abstract
After the initial report in 2014 on T1-weighted (T1w) hyperintensity of deep brain nuclei following serial injections of linear gadolinium-based contrast agents (GBCAs), a multitude of studies on the potential of the marketed GBCAs to cause T1w hyperintensity in the brain have been published. The vast majority of these studies found a signal intensity (SI) increase for linear GBCAs in the brain-first and foremost in the dentate nucleus-while no SI increase was found for macrocyclic GBCAs. However, the scientific debate about this finding is kept alive by the fact that SI differences do not unequivocally represent the amount of gadolinium retained. Since the study design of the SI measurement in various brain structures is relatively simple, MRI studies investigating gadolinium-dependent T1w hyperintensity are currently conducted at multiple institutions worldwide. However, methodological mistakes may result in flawed conclusions. In this position statement, we assess the methodological basis of the published retrospective studies and define quality standards for future studies to give guidance to the scientific community and to help identify studies with potentially flawed methodology and misleading results. KEY POINTS: • A multitude of studies has been published on the potential of the marketed GBCAs to cause T1w hyperintensity in the brain. • The gadolinium-dependent T1w hyperintensity in the brain depends on patient's history, types of GBCAs used (i.e., linear vs. macrocyclic GBCAs) and MR imaging setup and protocols. • Quality standards for the design of future studies are needed to standardize methodology and avoid potentially misleading results from retrospective studies.
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Affiliation(s)
- Carlo C Quattrocchi
- Unit of Diagnostic Imaging and Interventional Radiology, Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128, Rome, Italy.
| | - Joana Ramalho
- Department of Neuroradiology, Centro Hospitalar de Lisboa Central, Alameda Santo António dos Capuchos, 1169-050, Lisbon, Portugal
| | - Aart J van der Molen
- Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands
| | - Àlex Rovira
- Section of Neuroradiology Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Alexander Radbruch
- Department of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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32
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Piervincenzi C, Ben-Soussan TD, Mauro F, Mallio CA, Errante Y, Quattrocchi CC, Carducci F. White Matter Microstructural Changes Following Quadrato Motor Training: A Longitudinal Study. Front Hum Neurosci 2017; 11:590. [PMID: 29270117 PMCID: PMC5725444 DOI: 10.3389/fnhum.2017.00590] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 07/03/2017] [Accepted: 11/21/2017] [Indexed: 01/18/2023] Open
Abstract
Diffusion tensor imaging (DTI) is an important way to characterize white matter (WM) microstructural changes. While several cross-sectional DTI studies investigated possible links between mindfulness practices and WM, only few longitudinal investigations focused on the effects of these practices on WM architecture, behavioral change, and the relationship between them. To this aim, in the current study, we chose to conduct an unbiased tract-based spatial statistics (TBSS) analysis (n = 35 healthy participants) to identify longitudinal changes in WM diffusion parameters following 6 and 12 weeks of daily Quadrato Motor Training (QMT), a whole-body mindful movement practice aimed at improving well-being by enhancing attention, coordination, and creativity. We also investigated the possible relationship between training-induced WM changes and concomitant changes in creativity, self-efficacy, and motivation. Our results indicate that following 6 weeks of daily QMT, there was a bilateral increase of fractional anisotropy (FA) in tracts related to sensorimotor and cognitive functions, including the corticospinal tracts, anterior thalamic radiations, and uncinate fasciculi, as well as in the left inferior fronto-occipital, superior and inferior longitudinal fasciculi. Interestingly, significant FA increments were still present after 12 weeks of QMT in most of the above WM tracts, but only in the left hemisphere. FA increase was accompanied by a significant decrease of radial diffusivity (RD), supporting the leading role of myelination processes in training-related FA changes. Finally, significant correlations were found between training-induced diffusion changes and increased self-efficacy as well as creativity. Together, these findings suggest that QMT can improve WM integrity and support the existence of possible relationships between training-related WM microstructural changes and behavioral change.
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Affiliation(s)
- Claudia Piervincenzi
- Neuroimaging Laboratory, Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Tal D Ben-Soussan
- Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation, Assisi, Italy
| | - Federica Mauro
- Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation, Assisi, Italy
| | - Carlo A Mallio
- Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Yuri Errante
- Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Carlo C Quattrocchi
- Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Filippo Carducci
- Neuroimaging Laboratory, Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
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33
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Squitti R, Quattrocchi CC, Forno GD, Antuono P, Wekstein DR, Capo CR, Salustri C, Rossini PM. Ceruloplasmin (2-D PAGE) Pattern and Copper Content in Serum and Brain of Alzheimer Disease Patients. Biomark Insights 2017. [DOI: 10.1177/117727190600100019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A dysfunction in copper homeostasis seems to occur in Alzheimer's disease (AD). We previously evidenced that an excess of non-ceruloplasmin-copper (NCC) correlated with the main functional, anatomical as well as cerebrospinal markers of the disease. Aim of our study was to investigate ceruloplasmin isoforms as potential actors in this AD copper dysfunction. Our data show that AD patients have ceruloplasmin fragments of low molecular weight (<50 kDa) both in their serum and brain, contrary to healthy controls. Ceruloplasmin isoforms of higher molecular weight (115 and 135 kDa in serum and 135 kDa in brain), as well as copper levels in the brain, instead, do not seem to mark a difference between AD and healthy subjects. These data suggest a ceruloplasmin fragmentation in the serum of AD patients. Some clues in this direction have been found also in the AD brain.
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Affiliation(s)
- Rosanna Squitti
- AFaR, Dept. of Neuroscience, Fatebenefratelli Hospital, Rome, Italy
| | | | | | - Piero Antuono
- Dept. of Neurology, Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | - David R. Wekstein
- University of Kentucky Alzheimer's Disease Research Center, Lexington, KY, U.S.A
| | | | - Carlo Salustri
- Institute of Cognition Sciences and Technologies (CNR), Rome, Italy
| | - Paolo M. Rossini
- AFaR, Dept. of Neuroscience, Fatebenefratelli Hospital, Rome, Italy
- Depts. of Neurology, “Campus Biomedico” University, Rome, Italy
- IRCCS ‘Centro S. Giovanni di Dio-FBF’, Brescia, Italy
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34
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Carassiti M, Di Martino A, Centonze A, Quattrocchi CC, Caldaria A, Agrò F, Denaro V. Failed back surgery syndrome: a new strategy by the epidural injection of MESNA. Musculoskelet Surg 2017; 102:179-184. [PMID: 29098646 DOI: 10.1007/s12306-017-0520-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 10/13/2017] [Accepted: 10/25/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Evaluate the efficacy and safety of MESNA (sodium 2-mercaptoethanesulfonate) injection into the epidural space in the FBSS. METHODS We designed a prospective phase II longitudinal study. Six consecutive patients were enrolled. Patients underwent one peridural injection per week for 3 weeks. NRS and ODI were investigated before and 48 h after injections, and at 1 week, 1 month and 2 months after the last procedures. Opioids intake is investigated before procedures and 1 week, 1 month and 3 months after the last procedures. Lumbosacral MRI is performed before the first procedure, at the end and 3 months after the last procedures. RESULTS From baseline, at 3 months, NRS in standing, sitting and lying position improved, respectively, of 34.29, 30.56 and 26.47%; ODI improved of 20.3%; the average decrease in morphine intake was 20.54%. No difference in MR images was found. Conclusions Our preliminary results suggest that MESNA might be an efficacy alternative to common practice.
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Affiliation(s)
- M Carassiti
- Department of Anesthesiology, Resuscitation and Pain Medicine, CIR - Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy
| | - A Di Martino
- Department of Orthopaedics and Trauma Surgery, CIR - Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy.
| | - A Centonze
- Department of Anesthesiology, Resuscitation and Pain Medicine, CIR - Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy
| | - C C Quattrocchi
- Department of Diagnostic Imaging, CIR - Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy
| | - A Caldaria
- Department of Orthopaedics and Trauma Surgery, CIR - Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy
| | - F Agrò
- Department of Anesthesiology, Resuscitation and Pain Medicine, CIR - Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy
| | - V Denaro
- Department of Orthopaedics and Trauma Surgery, CIR - Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy
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Lasaponara S, Mauro F, Carducci F, Paoletti P, Tombini M, Quattrocchi CC, Mallio CA, Errante Y, Scarciolla L, Ben-Soussan TD. Increased Alpha Band Functional Connectivity Following the Quadrato Motor Training: A Longitudinal Study. Front Hum Neurosci 2017; 11:282. [PMID: 28659773 PMCID: PMC5466954 DOI: 10.3389/fnhum.2017.00282] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 03/09/2017] [Accepted: 05/15/2017] [Indexed: 01/23/2023] Open
Abstract
Quadrato Motor Training (QMT) is a new training paradigm, which was found to increase cognitive flexibility, creativity and spatial cognition. In addition, QMT was reported to enhance inter- and intra-hemispheric alpha coherence as well as Fractional Anisotropy (FA) in a number of white matter pathways including corpus callosum. Taken together, these results seem to suggest that electrophysiological and structural changes induced by QMT may be due to an enhanced interplay and communication of the different brain areas within and between the right and the left hemisphere. In order to test this hypothesis using the exact low-resolution brain electromagnetic tomography (eLORETA), we estimated the current neural density and lagged linear connectivity (LLC) of the alpha band in the resting state electroencephalography (rsEEG) recorded with open (OE) and closed eyes (CE) at three different time points, following 6 and 12 weeks of daily QMT. Significant changes were observed for the functional connectivity. In particular, we found that limbic and fronto-temporal alpha connectivity in the OE condition increased after 6 weeks, while it enhanced at the CE condition in occipital network following 12-weeks of daily training. These findings seem to show that the QMT may have dissociable long-term effects on the functional connectivity depending on the different ways of recording rsEEG. OE recording pointed out a faster onset of Linear Lag Connectivity modulations that tend to decay as quickly, while CE recording showed sensible effect only after the complete 3-months training.
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Affiliation(s)
- Stefano Lasaponara
- Cognitive Neurophysiology Laboratory, Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation for Development and CommunicationAssisi, Italy.,Department of Neuropsychology, IRCCS Fondazione Santa LuciaRome, Italy
| | - Federica Mauro
- Cognitive Neurophysiology Laboratory, Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation for Development and CommunicationAssisi, Italy.,Department of Psychology, Sapienza Università di RomaRome, Italy
| | - Filippo Carducci
- Department of Physiology and Pharmacology, Sapienza Università di RomaRome, Italy
| | - Patrizio Paoletti
- Cognitive Neurophysiology Laboratory, Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation for Development and CommunicationAssisi, Italy
| | - Mario Tombini
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Carlo C Quattrocchi
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Carlo A Mallio
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Yuri Errante
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Laura Scarciolla
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Tal D Ben-Soussan
- Cognitive Neurophysiology Laboratory, Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation for Development and CommunicationAssisi, Italy
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Casale M, Sabatino L, Greco F, Moffa A, Vella P, Quattrocchi CC, Salvinelli F. A reddish pulsatile mass beyond tympanic membrane: think before act. Eur Rev Med Pharmacol Sci 2016; 20:4837-4839. [PMID: 27981555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We report a case of a 76-year-old man that referred to our hospital because of progressive mixed right hearing loss, aural fullness and pulsatile tinnitus synchronized with heart beats. Otoscopic examination revealed a reddish pulsatile mass beyond tympanic membrane. CT and MRI scans showed a class C glomus tumor. Anamnesis and a complete physical examination, with careful differential diagnosis, should be obtained to rule out highly vascularized middle ear lesion before any invasive procedure.
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Affiliation(s)
- M Casale
- Unit of Otolaryngology, University Campus Bio-Medico, Rome, Italy.
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37
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Pistoia F, Cornia R, Conson M, Gosseries O, Carolei A, Sacco S, Quattrocchi CC, Mallio CA, Iani C, Mambro DD, Sarà M. Disembodied Mind: Cortical Changes Following Brainstem Injury in Patients with Locked-in Syndrome. Open Neuroimag J 2016; 10:32-40. [PMID: 27347263 PMCID: PMC4894864 DOI: 10.2174/1874440001610010032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 02/12/2016] [Revised: 04/06/2016] [Accepted: 04/11/2016] [Indexed: 11/22/2022] Open
Abstract
Locked-in syndrome (LIS) following ventral brainstem damage is the most severe form of motor disability. Patients are completely entrapped in an unresponsive body despite consciousness is preserved. Although the main feature of LIS is this extreme motor impairment, minor non-motor dysfunctions such as motor imagery defects and impaired emotional recognition have been reported suggesting an alteration of embodied cognition, defined as the effects that the body and its performances may have on cognitive domains. We investigated the presence of structural cortical changes in LIS, which may account for the reported cognitive dysfunctions. For this aim, magnetic resonance imaging scans were acquired in 11 patients with LIS (6 males and 5 females; mean age: 52.3±5.2SD years; mean time interval from injury to evaluation: 9±1.2SD months) and 44 healthy control subjects matching patients for age, sex and education. Freesurfer software was used to process data and to estimate cortical volumes in LIS patients as compared to healthy subjects. Results showed a selective cortical volume loss in patients involving the superior frontal gyrus, the pars opercularis and the insular cortex in the left hemisphere, and the superior and medium frontal gyrus, the pars opercularis, the insular cortex, and the superior parietal lobule in the right hemisphere. As these structures are typically associated with the mirror neuron system, which represents the neural substrate for embodied simulation processes, our results provide neuroanatomical support for potential disembodiment in LIS.
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Affiliation(s)
- Francesca Pistoia
- Neurological Institute, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Riccardo Cornia
- Department of Biomedical, Metabolic and Neurosciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Massimiliano Conson
- Neuropsychology Laboratory, Department of Psychology, Second University of Naples, Naples, Italy
| | | | - Antonio Carolei
- Neurological Institute, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Simona Sacco
- Neurological Institute, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carlo C Quattrocchi
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging, University Campus Bio-Medico of Rome, Rome, Italy
| | - Carlo A Mallio
- Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging, University Campus Bio-Medico of Rome, Rome, Italy
| | - Cristina Iani
- Department of Communication and Economy, University of Modena and Reggio Emilia, Modena, Italy
| | - Debora Di Mambro
- Post-Coma Rehabilitation Care Unit, San Raffaele Hospital, Cassino, Italy
| | - Marco Sarà
- Post-Coma Rehabilitation Care Unit, San Raffaele Hospital, Cassino, Italy
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Quattrocchi CC, Giona A, Di Martino A, Gaudino F, Mallio CA, Errante Y, Occhicone F, Vitali MA, Zobel BB, Denaro V. Lumbar subcutaneous edema and degenerative spinal disease in patients with low back pain: a retrospective MRI study. Musculoskelet Surg 2015; 99:159-63. [PMID: 25904349 DOI: 10.1007/s12306-015-0355-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE This study was designed to determine the association between LSE, spondylolisthesis, facet arthropathy, lumbar canal stenosis, BMI, radiculopathy and bone marrow edema at conventional lumbar spine MR imaging. METHODS This is a retrospective radiological study; 441 consecutive patients with low back pain (224 men and 217 women; mean age 57.3 years; mean BMI 26) underwent conventional lumbar MRI using a 1.5-T magnet (Avanto, Siemens). Lumbar MR images were reviewed by consensus for the presence of LSE, spondylolisthesis, facet arthropathy, lumbar canal stenosis, radiculopathy and bone marrow edema. Descriptive statistics and association studies were conducted using STATA software 11.0. Association studies have been performed using linear univariate regression analysis and multivariate regression analysis, considering LSE as response variable. RESULTS The overall prevalence of LSE was 40%; spondylolisthesis (p = 0.01), facet arthropathy (p < 0.001), BMI (p = 0.008) and lumbar canal stenosis (p < 0.001) were included in the multivariate regression model, whereas bone marrow edema, radiculopathy and age were not. CONCLUSIONS LSE is highly associated with spondylolisthesis, facet arthropathy and BMI, suggesting underestimation of its clinical impact as an integral component in chronic lumbar back pain. Longitudinal simultaneous X-ray/MRI studies should be conducted to test the relationship of LSE with lumbar spinal instability and low back pain.
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Affiliation(s)
- C C Quattrocchi
- UOC of Diagnostic Imaging, University Campus Bio-Medico of Rome, Rome, Italy
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Cavedo E, Redolfi A, Angeloni F, Babiloni C, Lizio R, Chiapparini L, Bruzzone MG, Aquino D, Sabatini U, Alesiani M, Cherubini A, Salvatore E, Soricelli A, Vernieri F, Scrascia F, Sinforiani E, Chiarati P, Bastianello S, Montella P, Corbo D, Tedeschi G, Marino S, Baglieri A, De Salvo S, Carducci F, Quattrocchi CC, Cobelli M, Frisoni GB. The Italian Alzheimer's Disease Neuroimaging Initiative (I-ADNI): validation of structural MR imaging. J Alzheimers Dis 2015; 40:941-52. [PMID: 24577455 DOI: 10.3233/jad-132666] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 11/15/2022]
Abstract
BACKGROUND The North American Alzheimer's Disease Neuroimaging Initiative (NA-ADNI) was the first program to develop standardized procedures for Alzheimer's disease (AD) imaging biomarker collection. OBJECTIVE We describe the validation of acquisition and processing of structural magnetic resonance imaging (MRI) in different Italian academic AD clinics following NA-ADNI procedures. METHODS 373 patients with subjective memory impairment (n = 12), mild cognitive impairment (n = 92), Alzheimer's dementia (n = 253), and frontotemporal dementia (n = 16) were enrolled in 9 Italian centers. 22 cognitively healthy elderly controls were also included. MRI site qualification and MP-RAGE quality assessment was applied following the NA-ADNI procedures. Indices of validity were: (i) NA-ADNI phantom's signal-to-noise and contrast-to-noise ratio, (ii) proportion of images passing quality control, (iii) comparability of automated intracranial volume (ICV) estimates across scanners, and (iv) known-group validity of manual hippocampal volumetry. RESULTS Results on Phantom and Volunteers scans showed that I-ADNI acquisition parameters were comparable with those one of the ranked-A ADNI scans. Eighty-seven percent of I-ADNI MPRAGE images were ranked of high quality in comparison of 69% of NA-ADNI. ICV showed homogeneous variances across scanners except for Siemens scanners at 3.0 Tesla (p = 0.039). A significant difference in hippocampal volume was found between AD and controls on 1.5 Tesla scans (p < 0.001), confirming known group validity test. CONCLUSION This study has provided standardization of MRI acquisition and imaging marker collection across different Italian clinical units and equipment. This is a mandatory step to the implementation of imaging biomarkers in clinical routine for early and differential diagnosis.
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Affiliation(s)
- Enrica Cavedo
- LENITEM Laboratory of Epidemiology, Neuroimaging, & Telemedicine - IRCCS Centro San Giovanni di Dio-FBF, Brescia, Italy Cognition, Neuroimaging and Brain Diseases Laboratory, Centre de Recherche de l'Institut du Cerveau et de la Moelle Épinière (CRICM-UMRS 975), Université Pierre et Marie Curie-Paris, France
| | - Alberto Redolfi
- LENITEM Laboratory of Epidemiology, Neuroimaging, & Telemedicine - IRCCS Centro San Giovanni di Dio-FBF, Brescia, Italy
| | - Francesco Angeloni
- IRCCS Fondazione SDN per la Ricerca e l'Alta Formazione in Diagnostica Nucleare, Naples, Italy
| | - Claudio Babiloni
- Laboratory of High resolution EEG, Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy IRCCS San Raffaele Pisana, Rome, Italy
| | | | - Luisa Chiapparini
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy
| | - Maria G Bruzzone
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy
| | - Domenico Aquino
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy
| | | | | | | | - Elena Salvatore
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Of Naples Federico II, Naples, Italy
| | - Andrea Soricelli
- IRCCS Fondazione SDN per la Ricerca e l'Alta Formazione in Diagnostica Nucleare, Naples, Italy Department of Studies of Institutions and Territorial Systems, University of Naples Parthenope, Naples, Italy
| | | | | | - Elena Sinforiani
- IRCCS C. Mondino National Institute of Neurology Foundation and University of Pavia, Pavia, Italy
| | - Patrizia Chiarati
- IRCCS C. Mondino National Institute of Neurology Foundation and University of Pavia, Pavia, Italy
| | - Stefano Bastianello
- IRCCS C. Mondino National Institute of Neurology Foundation and University of Pavia, Pavia, Italy
| | - Patrizia Montella
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - Daniele Corbo
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - Gioacchino Tedeschi
- Department of Neurological Sciences, Second University of Naples, Naples, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | | | - Filippo Carducci
- Laboratory of Neuroimaging, Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy
| | | | - Milena Cobelli
- Neuroradiology Unit, Fondazione Poliambulanza, Brescia, Italy
| | - Giovanni B Frisoni
- LENITEM Laboratory of Epidemiology, Neuroimaging, & Telemedicine - IRCCS Centro San Giovanni di Dio-FBF, Brescia, Italy Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
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Casale M, Errante Y, Sabatino L, Incammisa A, Salvinelli F, Quattrocchi CC. Perilimphatic fistula test: a video clip demonstration. Eur Rev Med Pharmacol Sci 2014; 18:3549-3550. [PMID: 25535121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Perilymphatic fistula (PLF) is an abnormal condition in which a communication is present between the perilymphatic space of the inner ear and the middle ear or mastoid, secondary to a dehiscence in the otic capsule, oval or round window. LF may induce hearing loss, tinnitus, aural fullness, vertigo, disequilibrium, or a combination of these symptoms; the vagueness of symptoms caused by PLF and the lack of specificity of clinical signs and symptoms make the diagnosis elusive. We report a video of a positive PLF test induced by the application of pressure on the tragus, just anterior to the left external auditory canal in a patient with cholesteatoma and PLF of lateral semicircular canal confirmed by CT scan imaging. https://www.youtube.com/watch?v=x5MhSILF9O4.
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Affiliation(s)
- M Casale
- Otolaryngology and Radiology; University Campus Bio-Medico of Rome, Rome, Italy.
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41
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Mallio CA, Tombini M, Errante Y, Beomonte Zobel B, Quattrocchi CC. Progressive post-traumatic myelopathy presenting with magnetic resonance imaging snake-eye appearance. Spine J 2013; 13:830. [PMID: 23541447 DOI: 10.1016/j.spinee.2013.02.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 12/12/2012] [Accepted: 02/18/2013] [Indexed: 02/03/2023]
Affiliation(s)
- Carlo A Mallio
- Diagnostic Imaging, Center for Integrated Research (CIR), Università Campus Bio-Medico di Roma, via Alvaro del Portillo, 21, Rome 00128, Italy
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42
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Quattrocchi CC, Zanni G, Napolitano A, Longo D, Cordelli DM, Barresi S, Randisi F, Valente EM, Verdolotti T, Genovese E, Specchio N, Vitiello G, Spiegel R, Bertini E, Bernardi B. Conventional magnetic resonance imaging and diffusion tensor imaging studies in children with novel GPR56 mutations: further delineation of a cobblestone-like phenotype. Neurogenetics 2012; 14:77-83. [DOI: 10.1007/s10048-012-0352-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Accepted: 12/17/2012] [Indexed: 12/18/2022]
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43
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Casale M, Salvinelli F, Mallio CA, Frari V, Vincenzi B, Bressi F, Quattrocchi CC. Upper airway study should always come before any sleep study in OSAS evaluation: a giant parapharyngeal lipoma behind OSAS. Eur Rev Med Pharmacol Sci 2012; 16 Suppl 4:106-109. [PMID: 23090823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The parapharyngeal space (PPS) is a rare site for neoplasms in the head and neck and lipoma represents 0.5% of all head and neck tumors. CASE REPORT We describe a case of a giant parapharyngeal lipoma in obese adult patient causing anatomic pharyngeal obstruction with severe obstructive sleep apnea (OSA) syndrome. The patient was successfully operated with transcervical approach. CONCLUSIONS In patients presenting with symptoms suggestive of OSA, it is essential to rule out any physical cause and perform a comprehensive ear, nose and throat examination including fibro-endoscopic upper airway examination before referral for sleep study and management. The ideal management for OSA involves treating the underlying cause. If no definitive cause is identified, management should begin with conservative measures such as lifestyle changes and a weight loss program; if these are unsuccessful, continuous positive airway pressure (CPAP), oral appliances or upper airway surgery could be considered. Better diagnostic methods should be developed to identify the main OSA causes and improve therapeutic outcomes.
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Affiliation(s)
- M Casale
- Campus Bio-Medico University, School of Medicine, Rome, Italy.
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44
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Del Vescovo R, Pisanti F, Russo V, Battisti S, Cazzato RL, D'Agostino F, Giurazza F, Quattrocchi CC, Faiella E, Setola R, Giulianelli R, Grasso RF, Beomonte Zobel B. Dynamic contrast-enhanced MR evaluation of prostate cancer before and after endorectal high-intensity focused ultrasound. Radiol Med 2012; 118:851-62. [PMID: 22986696 DOI: 10.1007/s11547-012-0876-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Accepted: 12/04/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE The authors sought to determine the diagnostic performance of dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging in the evaluation of prostate cancer before and after transrectal high-intensity focused ultrasound (HIFU) treatment. MATERIALS AND METHODS We analysed 25 patients with prostate cancer. The prostate-specific antigen (PSA) value was evaluated 1, 4 and 6 months after treatment. DCE-MR imaging was performed the day prior to and 1, 4 and 6 months after HIFU treatment. Transrectal prostate biopsies were obtained at the time of diagnosis and 6 months after treatment. RESULTS Before treatment, intraglandular lesions were considered to be potential sites of neoplasm and subsequently confirmed as sites of prostate adenocarcinoma in all 25 patients based on prostatespecific antigen (PSA) values and histological examinations (rho=1; p<0.001). Using histology as the gold standard, DCE-MR imaging displayed 100% sensitivity, 100% specificity, 100% positive predictive value and 100% negative predictive value before treatment. After HIFU treatment, DCE-MR imaging showed 100% sensitivity and 96% specificity. CONCLUSIONS DCE-MR imaging can be used to visualise prostate adenocarcinoma. Several morphological and postgadolinium modifications in the follow-up DCE-MR images after HIFU treatment were also observed.
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Affiliation(s)
- R Del Vescovo
- Department of Radiology, Campus Bio-Medico, University of Rome, Rome, Italy.
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45
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Landi D, Benvenga A, Quattrocchi CC, Vollero L, Assenza G, Pellegrino G, Campana C, Tombini M. Complex epileptic palilalia: a case report. Seizure 2012; 21:655-7. [PMID: 22776676 DOI: 10.1016/j.seizure.2012.06.009] [Citation(s) in RCA: 3] [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] [Received: 04/05/2012] [Revised: 06/11/2012] [Accepted: 06/13/2012] [Indexed: 11/30/2022] Open
Abstract
Palilalia is a kind of motor perseveration involving speech, consisting in the continuous repetition of words or phrases, or both. Rarely it occurs in seizure disorders as ictal or post-ictal manifestation. We report a case of epileptic palilalia in a 71-year-old patient with a previous history of intracerebral haemorrhage in the left frontal region, characterized by the continuous repetition of the same speech sequence for few minutes. EEG recordings during NREM sleep and wakefulness showed recurrent and prolonged focal subclinical epileptiform paroxysms in the left mesial frontal region. Our case confirms the role of the left frontal lobe, reliably of the supplementary motor area (SMA), as neuroanatomic origin of ictal palilalia.
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Affiliation(s)
- Doriana Landi
- Unità di Neurologia, Campus Bio-Medico University of Rome, Italy.
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Quattrocchi CC, Dell'Aia P, Errante Y, Occhicone F, Longo D, Virzì V, Tonini G, Napoli N, Santini D, Beomonte Zobel B. Differential effect of zoledronic acid on normal trabecular and cortical bone density in oncologic patients with bone metastases. J Bone Oncol 2012; 1:24-9. [PMID: 26909251 PMCID: PMC4723329 DOI: 10.1016/j.jbo.2012.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 01/12/2012] [Revised: 02/23/2012] [Accepted: 02/23/2012] [Indexed: 11/26/2022] Open
Abstract
Purpose To evaluate bone density changes at the level of normal bone and bone metastases after zoledronic acid (ZA) treatment in oncologic patients. Materials and methods We retrospectively evaluated 72 consecutive adult patients with histologically confirmed solid tumors with at least 1 newly diagnosed bone metastatic lesion. Bone metastases were diagnosed by bone scans and confirmed with computed tomography (CT). Patients received intravenous ZA, 4 mg, by 15-min infusion every 28 day through a peripheral or a central venous access and were monitored for at least 3 months and a maximum of 24 months. Bone density was determined at the level of bone metastases and at the level of normal trabecular and cortical bone using a ROI-based approach. Results A significant increase was demonstrated at the level of normal trabecular bone of the calvarium and the femoral neck. No significant increase of density was observed at the level of the normal cortical bone. Bone metastases showed a significant increase in CT density as compared to baseline up to 24 months after zoledronic acid. Conclusion We have found that long term treatment with ZA increases trabecular bone density in oncologic patients whereas normal cortical bone changes are not detectable.
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Affiliation(s)
- Carlo C Quattrocchi
- Radiology at University Campus Bio-Medico of Rome, via Alvaro del Portillo, 21, Rome 00128, Italy
| | - Paola Dell'Aia
- Radiology at University Campus Bio-Medico of Rome, via Alvaro del Portillo, 21, Rome 00128, Italy
| | - Yuri Errante
- Radiology at University Campus Bio-Medico of Rome, via Alvaro del Portillo, 21, Rome 00128, Italy
| | - Filomena Occhicone
- Radiology at University Campus Bio-Medico of Rome, via Alvaro del Portillo, 21, Rome 00128, Italy
| | - Daniela Longo
- IRCCS Ospedale Pediatrico Bambino Gesù, Radiology, Piazza Sant'Onofrio, 4, Rome 00100, Italy
| | - Vladimir Virzì
- Oncology at University Campus Bio-Medico of Rome, via Alvaro del Portillo, 21, Rome 00128, Italy
| | - Giuseppe Tonini
- Oncology at University Campus Bio-Medico of Rome, via Alvaro del Portillo, 21, Rome 00128, Italy
| | - Nicola Napoli
- Endocrinology at University Campus Bio-Medico of Rome, via Alvaro del Portillo, 21, Rome 00128, Italy
| | - Daniele Santini
- Oncology at University Campus Bio-Medico of Rome, via Alvaro del Portillo, 21, Rome 00128, Italy
| | - Bruno Beomonte Zobel
- Radiology at University Campus Bio-Medico of Rome, via Alvaro del Portillo, 21, Rome 00128, Italy
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Babiloni C, Carducci F, Lizio R, Vecchio F, Baglieri A, Bernardini S, Cavedo E, Bozzao A, Buttinelli C, Esposito F, Giubilei F, Guizzaro A, Marino S, Montella P, Quattrocchi CC, Redolfi A, Soricelli A, Tedeschi G, Ferri R, Rossi-Fedele G, Ursini F, Scrascia F, Vernieri F, Pedersen TJ, Hardemark HG, Rossini PM, Frisoni GB. Resting state cortical electroencephalographic rhythms are related to gray matter volume in subjects with mild cognitive impairment and Alzheimer's disease. Hum Brain Mapp 2012; 34:1427-46. [PMID: 22331654 DOI: 10.1002/hbm.22005] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 10/31/2011] [Accepted: 11/01/2011] [Indexed: 11/06/2022] Open
Abstract
Cortical gray matter volume and resting state cortical electroencephalographic rhythms are typically abnormal in subjects with amnesic mild cognitive impairment (MCI) and Alzheimer's disease (AD). Here we tested the hypothesis that in amnesic MCI and AD subjects, abnormalities of EEG rhythms are a functional reflection of cortical atrophy across the disease. Eyes-closed resting state EEG data were recorded in 57 healthy elderly (Nold), 102 amnesic MCI, and 108 AD patients. Cortical gray matter volume was indexed by magnetic resonance imaging recorded in the MCI and AD subjects according to Alzheimer's disease neuroimaging initiative project (http://www.adni-info.org/). EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), beta2 (20-30 Hz), and gamma (30-40 Hz). These rhythms were indexed by LORETA. Compared with the Nold, the MCI showed a decrease in amplitude of alpha 1 sources. With respect to the Nold and MCI, the AD showed an amplitude increase of delta sources, along with a strong amplitude reduction of alpha 1 sources. In the MCI and AD subjects as a whole group, the lower the cortical gray matter volume, the higher the delta sources, the lower the alpha 1 sources. The better the score to cognitive tests the higher the gray matter volume, the lower the pathological delta sources, and the higher the alpha sources. These results suggest that in amnesic MCI and AD subjects, abnormalities of resting state cortical EEG rhythms are not epiphenomena but are strictly related to neurodegeneration (atrophy of cortical gray matter) and cognition.
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Affiliation(s)
- Claudio Babiloni
- Department of Biomedical Sciences, University of Foggia, Viale Pinto 7, Foggia, Italy.
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Babiloni C, Lizio R, Carducci F, Vecchio F, Redolfi A, Marino S, Tedeschi G, Montella P, Guizzaro A, Esposito F, Bozzao A, Giubilei F, Orzi F, Quattrocchi CC, Soricelli A, Salvatore E, Baglieri A, Bramanti P, Cavedo E, Ferri R, Cosentino F, Ferrara M, Mundi C, Grilli G, Pugliese S, Gerardi G, Parisi L, Vernieri F, Triggiani AI, Pedersen JT, Hårdemark HG, Rossini PM, Frisoni GB. Resting state cortical electroencephalographic rhythms and white matter vascular lesions in subjects with Alzheimer's disease: an Italian multicenter study. J Alzheimers Dis 2012; 26:331-46. [PMID: 21673406 DOI: 10.3233/jad-2011-101710] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Resting state electroencephalographic (EEG) rhythms do not deteriorate with the increase of white matter vascular lesion in amnesic mild cognitive impairment (MCI) subjects [1], although white matter is impaired along Alzheimer's disease (AD). Here we tested whether this is true even in AD subjects. Closed-eye resting state EEG data were recorded in 40 healthy elderly (Nold), 96 amnesic MCI, and 83 AD subjects. White matter vascular lesions were indexed by magnetic resonance imaging recorded in the MCI and AD subjects (about 42% of cases following ADNI standards). The MCI subjects were divided into two sub-groups based on the median of the white matter lesion, namely MCI+ (people with highest vascular load; n = 48) and MCI- (people with lowest vascular load; n = 48). The same was true for the AD subjects (AD+, n = 42; AD-, n = 41). EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), beta2 (20-30 Hz), and gamma (30-40 Hz). LORETA software estimated cortical EEG sources. When compared to Nold group, MCI and AD groups showed well known abnormalities of delta and alpha sources. Furthermore, amplitude of occipital, temporal, and limbic alpha 1 sources were higher in MCI+ than MCI- group. As a novelty, amplitude of occipital delta sources was lower in AD+ than AD- group. Furthermore, central, parietal, occipital, temporal, and limbic alpha sources were higher in amplitude in AD+ than AD- group. Amplitude of these sources was correlated to global cognitive status (i.e., Mini Mental State Evaluation score). These results suggest that in amnesic MCI and AD subjects, resting state posterior delta and alpha EEG rhythms do not deteriorate with the increase of white-matter vascular lesion. These rhythms might be more sensitive to AD neurodegenerative processes and cognitive status rather than to concomitant lesions to white matter.
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Affiliation(s)
- Claudio Babiloni
- Department of Biomedical Sciences, University of Foggia, Foggia, Italy Department of Imaging, SAN RAFFAELE Cassino, Italy.
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Nogueira Delfino L, Fariello G, Lancella L, Marabotto C, Menchini L, Devito R, Errante Y, Quattrocchi CC, Longo D. Central nervous system tuberculosis in non-HIV-positive children: a single-center, 6 year experience. Radiol Med 2011; 117:669-78. [PMID: 22095412 DOI: 10.1007/s11547-011-0743-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 04/07/2011] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of this paper is to describe the imaging features of central nervous system (CNS) tuberculosis on computed tomography (CT) and magnetic resonance imaging (MRI) studies in non-HIV-positive children. MATERIALS AND METHODS A retrospective descriptive evaluation was conducted on imaging studies obtained from ten children admitted to our hospital over a 6-year period who fulfilled criteria for a diagnosis of CNS tuberculosis. Data were collected with regard to patients' clinical, laboratory and demographic characteristics, as well as results of radiological investigation. RESULTS We studied ten children, of whom five were boys and five were girls and whose mean age was 4 (range 7 months to 16) years. Neuroradiological findings on the first imaging study were basal meningeal enhancement (100%), hydrocephalus (70%), infarcts (90%), tuberculomas (40%) and cranial nerve involvement (20%). Follow-up studies revealed basal meningeal enhancement, hydrocephalus, and infarcts in all patients, tuberculomas in 70% and cranial nerve involvement in 50%. Only one patient showed a pattern of miliary tuberculosis. CONCLUSIONS CNS tuberculosis is still an important cause of childhood morbidity and mortality even in nonimmunosuppressed children. Because prompt diagnosis results in earlier treatment, it is crucial to be aware of tuberculous meningitis and its complications at imaging, especially because of the impact on patients' prognosis.
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Affiliation(s)
- L Nogueira Delfino
- Department of Radiology, IRCCS, Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
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Quattrocchi CC, Alexandre AM, Tonini G, Errante Y, Grasso RF, Zobel BB. Brain microischemic phenomena in a woman receiving bevacizumab treatment: a case report. J Med Case Rep 2011; 5:84. [PMID: 21352580 PMCID: PMC3058088 DOI: 10.1186/1752-1947-5-84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/01/2010] [Accepted: 02/27/2011] [Indexed: 11/24/2022] Open
Abstract
Introduction Several adverse events have been associated with the use of bevacizumab during the treatment of neoplasms such as colorectal cancer, breast cancer, non-small cell lung cancer, pancreatic cancer and renal cell carcinoma. The present case demonstrates how focal neurological symptoms lead to the magnetic resonance imaging-based differential diagnosis between focal parenchymal metastases and microischemic phenomena, with crucial implications for patient management. Case presentation We describe the case of a 37-year-old Italian Caucasian woman with metastatic colon cancer who developed focal neurological symptoms during a chemotherapy regimen involving the use of bevacizumab. Brain magnetic resonance imaging examination revealed millimetric lesions with restricted diffusion without perilesional edema or contrast enhancement after gadodiamide intravenous injection, suggestive of acute microischemic phenomena. This complication is very rare but clinically significant. Conclusion The differential diagnosis in patients with cancer undergoing bevacizumab treatment should include microischemic phenomena.
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Affiliation(s)
- Carlo C Quattrocchi
- Interdisciplinary Center for Biomedical Research, Department of Radiology, University Campus Bio-Medico of Rome, via Longoni, 47 I-00155 Rome, Italy.
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